Friday, March 11, 2016

Fighting an Epidemic One Back at a Time

It seems to me that stories of the heroin epidemic are all over the news. From the allowance of every pharmacy in New York state to carry Narcan over the counter to the proposal of a heroin clinic in Ithaca that is staffed by licensed medical personnel (so that addicts can receive medical attention so they don't die while shooting up), the war on heroin is dominating the news coverage. 20/20 is running a special on it tonight, and a few weeks ago, I watched PBS's Frontline special, Chasing Heroin, about the measures being taken in Seattle to combat heroin.

I've never been addicted to drugs. I cannot speak to that. But here's what I keep gleaning from the coverage. Once someone is addicted to heroin, it is very difficult to come clean and stay clean. I'm not convinced that daily methadone is any better.

The other fact I keep hearing. Four out of five heroin addicts started with prescription narcotics. Let me say that again. FOUR OUT OF FIVE started with prescription pills.

Our medical system is broken, and this heroin crisis is a by-product of it. Fragmented, sequestered medical care that looks only at body systems and not the whole person. Physicians who won't refer to other fields, lest they be cut out of the loop financially. Big pharma pushing, encouraging, bribing. Patients get trapped in a downward spiral of doctor's visits, medications, diagnostic imaging.

This post may be biased. I am a physical therapist. I have eight years of college education and passed a state board exam in the field of treating dysfunction. That's what physical therapists do. We treat dysfunction. What is the largest symptom of dysfunction? Pain.

Why do people take narcotics? Pain

What leads to heroin use in 4 out of 5 heroin addicts? Pain pills.

Do we see a correlation here?

Studies have shown that early referral to physical therapy reduces medical costs in terms of follow up diagnostic imaging, spinal injections, and surgeries. If people are feeling better quicker, they will not need to take narcotics. If people are feeling better and do not have to have surgery, they will not need to take narcotics.

I know there is a time and place for prescription pain pills. There are some cases that narcotics are needed, like in post-surgical cases. However, I firmly believe that both the patients and the physicians are to blame in the growing crisis of narcotic addiction. The patients who want a quick fix, that magic pill. Physicians who are too eager to write that script for the quick fix.

What would happen if we shift our thinking when we hurt our backs (or shoulders or knees)? What if instead of visit upon visit to physicians and specialists, we went right to PT? Only 17 states have unrestricted direct access to physical therapy (meaning there is no physician referral/prescription needed). The other 33 states have limited or provisional access. Here's the catch: even though your state may have direct access to physical therapy, your insurance company most likely will still require you to have a physician referral otherwise they won't cover it. Additionally, in many states, physical therapy services are charged as a Specialist fee, which often means higher co-pays, and can be cost prohibitive for patients.

What if instead of relying on a little pill, we took a look at our lifestyles and made changes to make our bodies function better?

You know, going to the physical therapist a few times a week and making lifestyle modifications may seem like a pain in the neck, but as compared to life as a heroin addict, it seems like a no brainer.

I'm not naive enough to think that physical therapy is the cure for the heroin epidemic. It's not that simple. But we have to start somewhere, doing something. Allowing children to buy Narcan OTC so they can save their friends from overdosing is not the answer. We need to look at the root causes, and start there.

So, the next time you are hurting, instead of asking your physician for a prescription for pills, ask him or her if a referral to PT might be a better plan.

Tuesday, March 8, 2016

Good Timing for #International Women's Day

Sometimes, things work out for a reason. Today, is not only release day for my latest novel, Live For This, but it's International Women's Day. (It's also #NationalPancakeDay, but that has nothing to do with either issue)

If I've said it once, I've said it a million times, and will continue to say that I'd be nowhere without the women in my life. From my mother to my daughter to my best friend Michele (you may notice her name makes it into every book) to the mom's at school to my co-workers to my author friends, I've got a fantastic support system.

It's from these women that I draw inspiration to write my female characters. My resilient women. My characters are flawed, realistic. They're not perfect. Sometimes, they make terrible mistakes. But they get up, put their big girl panties on, and carry on. Much like the women in my real life do. The women that struggle with the balance of career and family and responsibilities, often putting not only their personal lives aside, but their health as well in order to take care of everyone else.

I've got a great support system around me, and out of it has come my sixth novel. Samirah, the main character in Live For This, is not quite as together as some of my other main characters. She's young--only 24, and has had a rough go of it. She puts up walls and defense mechanisms, which turns her into not a very nice person. There's not a lot there that makes her likable. Except, you know she's had a raw deal. Watching her grow, mature, and evolve is emotional, and heartbreaking at times. Like my other characters, she finds her resilience. Not necessarily by choice, but she embraces it none the less.

So, today, on my seventh publishing day, I ask you to celebrate the women in your life. May we all be resilient.



Saturday, March 5, 2016

A Somber Experience

Yesterday, I had the pleasure of chaperoning my son's field trip (which in and of itself is a long story, but I'll save that for another time, as it is not the point of this post). We had a group of about 48 11 and 12 year-olds (sixth graders), and part of the trip was a tour of the 9/11 Memorial in New York City.

One thing that stuck not only me, but the teachers and other chaperones as well is that none of the children were alive when 9/11 happened.

They've always existed in a post-9/11 world.

They don't know know what the NYC skyline looked like with the Twin Towers, and how once they were gone, it created a huge hole.

They don't know what it is like to say good-bye to someone at the airport gate, or greet them there the moment they deplane.

They don't remember the days when bags weren't searched and x-ray scanners weren't the norm. When you didn't have to remove your coat and belt and shoes just to enter a museum.

They've always known the term Al Qaeda. They've always known of Osama Bin Laden and Jihad.

They don't have the memories of that day, knowing exactly where they were and what they were doing. Watching the horrible events unfold, live on CNN.

They don't understand the gravity of the statement, "He worked for Cantor Fitzgerald."

They don't know how eerie it is to see a sky with no air traffic.

They don't know how frightening it is to see a low flying plane.

My personal recollections are in this post, but we all have those stories. The teacher who had a view of the Pentagon from his classroom. The teacher with a classroom full of kids who was summoned to the office because her principal knew her sister lived in the city. The mother who's youngest sister was late for work at her job in the South Tower, arriving just after the first plane crash (she grabbed a friend and high tailed it across the Brooklyn Bridge).



I had four boys with me yesterday. We didn't have time to read every exhibit, so I gave them the quick synopsis. I have to say, I'm proud at the respect and somberness they showed. I still don't know if they got the gravity of the situation. The steel beams, twisted and mangled, crumpled like paper. Seeing the steel arch and how massive it is, and how small it was compared to the rest of the building. The fire truck (Engine 3) with the front end melted off. All 11 members of the Company perished that day. How the phone lines to pretty much all of New York were jammed, so that loved ones could not be contacted. The missing flyers that grew in the days after. The horror of knowing all the emergency personnel mobilizing at the local hospitals would have no survivors to treat. Of knowing that there would be a high casualty count from the plane crashes themselves, but that no one expected the towers to fall.


Of watching people jump out the window.

I don't know if I said the right things yesterday. It's hard to believe it's been almost 15 years. It feels like yesterday.

I feel like I need to take my youngest to the 9/11 Museum and Memorial, when she's a little older. And then I will have no need to go back. I will carry in my mind, and in my heart, the terrible losses of that day until the day I die.

And I will pray that my children will have no such defining event in their lives.