If someone had told me on November 13, 2007, that I was signing up for 66 consecutive months of blogging, I would have said, "There's no way!" But, 284 posts later, here we are. One post at a time, you've invited me into your work and home. You've shared your life through comments. It's been a wonderful five-and-a-half years. That makes it more difficult to say goodbye.

I love to write. I love to communicate. Both are integral to who I am. Years ago, someone pointed out that in pursuing the vision we had for homeschooling our children, I didn't need to lose sight of who I was -- those gifts in me shouldn't be neglected. There seemed to be much wisdom in that advice. So, I pursued avenues to enrich those gifts and began to welcome more opportunities to write. A number of exciting adventures filtered into my life, filling my days. My passion for writing has grown, and I have a bigger vision for that gift than I ever imagined.

However, somewhere in the midst of this, I forgot what was most important. My passion eclipsed my purpose. As I've written repeatedly through the years, when priorities get out of balance, it's time to course correct.

Ironic. This blog began as an exercise in finding balance and gradually morphed into focusing on perspective. I close this chapter of my life having lost both. I'm glad I had another someone who was brave enough to point out my misstep while I still had time to get back on track.

So now, I'm going to follow the very first words from my very first Finding Balance blog post: "Take a deep breath."

Next, I'm going to incorporate Lencioni's wisdom from a blog that posted on December 14, 2011: "The beauty about passionately pursuing a wrong decision is that you discover quickly the error of your way and can boldly enact a second decision to right your mistake."

Are you passionately pursuing your purpose or has your passion derailed you? If you've drifted from your priorities, know you aren't alone. Perhaps you want to join me in course correcting, even if -- like me -- you didn't discover the error quickly!

Thank you for a most pleasurable five-and-a-half years. I hope you've enjoyed our time together as much as I have, and I hope our paths cross again.

Until then -- here's to finding peaceful, productive lives of balance.

Last November my daughter experienced her first migraine-free month -- at the hands of gabapentin. The GI effects were worse than the headaches, so she stopped taking the medication. The headaches immediately returned.

When my daughter's neurologist put gabapentin on the table, I was already familiar with it from two decades earlier -- when I worked as the clinical director of a rehab facility. The orthopedic surgeon prescribed Neurontin (generic wasn't yet available) for intractable nerve pain and paresthesia. The theory: some nerve pain and paresthesias are caused by nerves that are seizing. (This same theory is used to explain some migraines). Neurontin/gabapentin, used as adjunctive therapy for seizures, calms those nerves and reduces symptoms. In February, my neurologist prescribed gabapentin for nerve pain and paresthesias.

Then I saw this article on Neurontin, written in 2010. I'm behind the times, which is particularly sad since I live in South Carolina, where Pfizer* is a common name. An acquaintance's friend was working there when the lawsuits went down. She conveyed the accuracy of some details in the article, specifically about the pharmaceutical company paying ghostwriters to author and doctors to sign off on publications.

Another article, written by two medical doctors, gets to the heart of why this is such a big issue. Drs. Landefeld and Steinman describe Neurontin's comprehensive marketing plan as involving "the systematic use of deception and misinformation to create a biased evidence base and manipulate physicians' beliefs and prescribing behaviors." Sadly, they point out that Parke-Davis' way of doing business, while over the top, is neither unusual nor illegal.

An article about the use of Neurontin for bipolar disorder quotes the director of the Harvard Bipolar Research Program at Massachusetts General Hospital in Boston, Dr. Gary Sachs, "Yes, patients get better on Neurontin, but they get better at an even more impressive rate if they don't get Neurontin."

Read that quote again -- slowly.

That's right. The study, which compared Neurontin to sugar pills, showed patients taking the sugar pills got better faster! This conclusion, based on a research study Sachs helped design and conduct for Parke-Davis, was not released by the pharmaceutical company until just before Neurontin's patent ran out.

In addition to manipulating studies and publications, the company tapped into the power of peer trust by recruiting local physicians and academic leaders. Landefeld and Steinman underscored the breadth of this problem when they wrote, "Employees of Parke-Davis, the medical-education companies it hired, and many physicians (consultants, advisors, educators, and researchers) all participated knowingly. Universities, hospitals, professional organizations, and foundations also participated, and oversight agencies such as the FDA and the Department of Justice did not intervene quickly. Apparently, there was a shared acceptance that Parke-Davis' marketing was simply business as usual."

This information stunned me and left me with more questions than it answered. How does a medication with no real solid science remain on the market? How does a drug manufacturer that actively pursues fraudulent practices remain in business? How do we know that any medication actually does what the package insert says it does?

* Parke-Davis owned the initial patent on Neurontin, which expired in 2000. That same year, Pfizer purchased Warner-Lambert, the parent company of Parke-Davis.

I heard an interesting statistic on the radio: After the long wait for their children to be seen by a pediatrician, only one-third of parents heed the doctor's advice. That means for every 99 pediatrician visits, 66 parents might as well have taken their children to lunch or bought them ice cream cones. They wasted precious hours and dollars on those children's pediatrician visits.

I wonder how many adults do the same when they see their primary care physicians, or even specialists for that matter? What about patients who go to therapy?

What about you? When you go to the doctor, after you've spent all that time in the waiting room and shelled out for the co-pay, do you follow doctor's orders -- or would you have been just as well off going for a massage?

Last week I promised a statistical discussion about an article that appeared in The Washington Post. Before you get all down on statistics, let me make a confession. It wasn't until I reached the end of writing last week's post that the statistics even hit me. I'd glanced right over them and accepted their validity -- something I've cautioned against in previous posts. I know better. I still did it.

A scholarly article appears in what many consider to be a well-respected newspaper. Put those two together and we have every right to expect a modicum of journalistic integrity. After what I discovered, I'd bet they are banking on -- literally, banking on -- us expecting journalistic integrity, but not demanding it.

According to the article, "the nationwide rate of hospital readmissions of Medicare patients within 30 days of discharge declined to about 17.8 percent by last November after remaining stuck near 19 percent over the five years that the data has been collected, and likely for decades prior to that." So let's jump right in.

First, notice there are no sources given for either of the listed statistics. Granted, the article asserts Jonathan Blum's intention to "release the figures Thursday at a Senate Finance Committee hearing." I wonder how many readers marked their calendars to follow up on Thursday and check statistical references. Hmmm. That's right. Probably none. However, if anyone did, they would have found that while Blum repeated the claims in his report, he never once sited his sources or provided any objective proof for his statements.¹ Not once. Apparently, Blum was banking on our naivety as well.

Second, on an initial search to verify the claim that readmissions were stuck at near 19 percent over five years, I could find only two statistics.

1. In 2005, 17.6 percent of hospital admissions resulted in readmissions within 30 days of discharge (MedPAC, Medicare Payment Advisory Commission).

2. According to claims data from 2004-2005, 19.6 percent of Medicare fee-for-service patients discharged from a hospital were rehospitalized within 30 days (study by Jencks, Williams, and Coleman that appeared in the April 2, 2009, New England Journal of Medicine).

Using a variety of searches, that's all I found. Over and over and over. Those two statistics kept coming up in various articles and reports. They reappeared year after year. Sometimes I had to read the fine print to realize it was the same statistic.

What's the basic problem with these statistics? You have two different agencies measuring the data. Without careful analysis of the data and procedures, you can't know if you're comparing apples to apples or apples to oranges. One could logically posit that we're comparing apples to oranges since the two studies are using data extracted from a similar timeframe, yet show a 2-percent difference. Two interesting notes to consider:

1. This 2-percent difference is double the Premier Healthcare Alliance's 1-percent improvement cited by the Washington Post article, an improvement that occurred over a two-year period at great expense - money that could have been used for direct patient care.

2. If one argues these studies use the same data with a statistically insignificant difference, then you have to dismiss the foundation for the Washington Post article, as its entire hypothesis rests on an improvement of less than 2 percent.

Finally, with more persistent and creative searches, I ran across what appears to be an apples-to-apples comparison of data about readmission rates from a few consecutive years. Fair warning: it isn't pretty.

MedPAC analysis of Medicare files from 2009-2011 shows a fairly steady readmission rate of (drum roll, please): 15.6, 15.5, 15.3 (consecutively from 2009-2011).² This is a huge problem for Blum's assertions that Obama's healthcare law is the reason for a drop in Medicare hospital readmissions. Why?

1. This is a more than 2-percent drop from the 2005 study by the same agency.

2. It's 2.5-percent lower than the "improvement" touted by the Washington Post article.

3. In Blum's written report,¹ he states, "After fluctuating between 18.5 percent and 19.5 percent for the past five years, the 30-day all-cause readmission rate dropped to 17.8 percent in the final quarter of 2012." MedPAC's data makes Blum's lack of credible sources an even more glaring issue.

For me, this appears to be a no-brainer in terms of someone trying to manipulate reality into something it clearly is not. I'm open to lively debate or to being proven wrong. What am I missing?

References

1. Statement of Jonathan Blum, Delivery System Reform: Progress Report from CMS before the US Senate Finance Committee on February 28, 2013. http://www.finance.senate.gov/imo/media/doc/CMS%20Delivery%20System%20Reform%20Testimony%202.28.13%20(J.%20Blum).pdf

2. Refining the Hospital Readmissions Reduction Program, September 7, 2012. http://www.medpac.gov/transcripts/readmissions%20Sept%2012%20presentation.pdf

A recent article in the Washington Post boasts a national reduction in hospital readmissions of Medicare patients within 30 days of discharge. According to the article, Jonathan Blum, a top official at the Centers for Medicare and Medicaid Services, credits the provisions in President Obama's healthcare law for this reduction. The article goes on to explain how the financial penalties and rewards in these provisions impact the way hospitals are doing business.

Rather than using their monetary gains to directly improve patient care, organizations are using the financial incentives they receive for reduced readmissions to form committees whose sole purpose is to make sure they receive more financial incentives. You could argue that the patients are the end winners since they are staying out of the hospital. Unfortunately, you might be wrong.                                                                                             

There's no distinction made regarding the reason for readmission. Case in point, this article describes one hospital that successfully instituted measures significantly reducing preventable readmissions. Despite this targeted reduction, the facility's overall readmissions increased, resulting in a fine.

This reminds me of another presidential program that boasted early successes: No Child Left Behind. What may have started out as a well-intentioned initiative has become a numbers game. Organizations using financial incentives to get more incentives continue to be rewarded with no real incentive to provide better healthcare, while facilities providing measurably better healthcare are penalized if their patient populations have an unavoidably bad year.

As is common in journalism these days, comments sometimes yield the best discussion points. Scroll to egaudin's comment from March 11 at 9:20 p.m. (EDT) for a frightening twist hospitals have undertaken in an attempt to stack the deck in their favor. As it turns out, patients can be kept overnight at the hospital -- for days on end -- as outpatients so long as they are coded "in observation."

For patients unversed in Medicare/Medicaid regulations, this seems harmless enough. Unless they transfer to a skilled nursing facility for rehabilitation, where they'll have to eat the cost of what would have been a covered stay had they met the three-day inpatient stay qualification for skilled care.

What are your thoughts on how this initiative is impacting health care?

Spoiler alert: For those so inclined, please save the statistics discussion for next week's post.

A common refrain in our home is, "Can you tell me what I just said?" I'm often surprised when people answer in the affirmative, given the multimedia lovefest taking place under our roof.

We use verbal and nonverbal communication when we speak and when we listen. Last week's post, "When Listening Isn't Hearing," shared verbal skills that help us move beyond hearing just the spoken words to being able to hear the speaker's heart. We can use verbal components of speech to help our clients, coworkers and loved ones feel "heard."

Nonverbal communication also plays a major role in letting others know we care. In a society fixated on multitasking, our nonverbal actions can give others the impression we aren't interested in what they have to say. If our eyes are on computer screens, for example, the people speaking to us feel like we aren't giving them our attention.

Sometimes if you ask the listeners, "What did I say," they can totally tell you -- verbatim. Their answer shocks you because of what they were doing while you were talking to them. Even if they can repeat what you said, you still don't feel like you've truly been "heard." You leave the conversation feeling empty -- like the communication was lacking.

Communication classes place a great deal of emphasis on the speaker's nonverbal actions but spend less time discussing the listener's nonverbal communication. Implementing a few simple tips can show the people speaking to you that you care.

1. Put away distractions. Close your laptop. Turn off the television. Close your book -- after you've bookmarked it, of course. Let the person speaking with you know he has your full attention. At work, specific to therapists, put down your pen and the patient's chart or the computer. Some clinic supervisors expect therapists to chart during their visits. Conversation may be nothing more than polite chit chat to fill the time. However, you should be prepared for patients to share from their hearts a concern or a triumph. For those conversations, stop what you're doing and listen without distractions.

2. Ask the speaker to wait. It's okay to ask the speaker to give you a minute to remove distractions. If you have one sentence left in your patient note, if you are 15 seconds from the end of a computer game, if you have two minutes left in a TV show -- ask the speaker to wait. As a speaker I'd rather let my listener finish the last five minutes of her show than have her wondering how it ends the entire time I'm speaking. (Side note: A wise speaker will ask her listener, "Is this a good time to talk, or do we need to get together later?")

3. Make eye contact. Looking at people when they're speaking let's them know you're listening. Granted, you could be looking someone in the eyes and be zoning out. Still, most people stand a much better chance of paying attention if they're making eye contact. If you're one of those people who can't sit still and pay attention, let your speaker know and make adjustments that work for both of you.

4. Use open body language and avoid closed body positions. Open body language -- leaving the trunk exposed through open arm and leg positions -- shows the speaker that you're engaged in the conversation. A listener also exhibits an open posture through pleasant facial expressions and leaning slightly forward toward the speaker, as well as appropriate head nodding and body mirroring. A closed body position indicates the listener is not receptive to the speaker. As one might suspect, closed body positioning -- distressing facial expressions, closed arm and leg positions, leaning away from the speaker, and a stiffened posture -- is opposite of open body language.

Nonverbal communication is often a subconscious act. We don't realize we're smiling or frowning, leaning forward or leaning away, sitting relaxed with our arms to our sides, or sitting stiffly with our arms and legs crossed. Alice Springs School of the Air's PDF on nonverbal communication suggests listeners may have a preferred posture simply because it's comfortable for them. The author(s) suggests that shifts in listeners' body language (from open to closed, or vice versa) are far more telling than their static postures.

What is your nonverbal communication telling people who are speaking to you, and how can you become a more attentive listener?

We say everything we know to say, and we can tell the other person is listening -- yet, understanding is elusive. Just because a supervisor listens, doesn't mean her employee feels "heard." We tend to brush past this communication chasm, in part because we feel powerless to change it. A few simple steps will help bridge the gap.

1. As the listener, reflect the speaker's thoughts back to him. Human nature begs us to avoid following through with this final step of active listening, perhaps because it can feel condescending. However, using phrasing you're comfortable with, this is an easy way to communicate you value and respect the other person. In the scenario we're using, the supervisor would paraphrase what the employee said: "Steve, thank you for sharing your thoughts with me. I want to make sure we're on the same page. You'd like to take this Friday off by using eight hours of your sick leave. Is that accurate?"

2. As the speaker, ask the listener to reflect your thoughts back to you. If you're the one speaking and the listener doesn't try to paraphrase your thoughts, ask her to do so: "Mary, I appreciate you listening so attentively. Sometimes my thoughts make a lot more sense inside my head than after they come out of my mouth. I want to make sure we're on the same page. Will you please share your impression of what I said?

3. Ask questions. Ask as many clarification questions as you need to in order to be confident you've achieved mutual understanding. Remember, there are no stupid questions.

4. Accept understanding; don't require agreement. The goal of communication isn't agreement, it's understanding. It's okay to disagree. If you're the supervisor, be generous to those who serve under your authority. If you're an employee, be respectful to those in leadership positions.

Strive to understand all those with whom you communicate. Give each other the space to disagree, and respect when you don't get to make the decision.

What makes you feel "heard?"

I ran across an article in Time magazine about the costs of healthcare, "Bitter Pill: Why Medical Bills are Killing Us." I'll admit I haven't read it all yet. Since it's not healthy for your blood to boil too long, I'm having to read the 11 pages in doses.

Author Steven Brill discusses inflated healthcare costs and the personal toll they take on patients. I've read, and written, similar articles. In this piece, Brill takes it up a notch, exposing the degree of greed that has overtaken healthcare. He provides examples of patients who have been the victims of hospital policies that deny life-saving treatment to those who can't front the cost of their medical care.

Corporate medical leaders are making insane amounts of money from overcharging for goods and services. Brill does the math: the average hospital charges 11 times the actual cost of doing business (yes, that statistic includes overhead costs). Even cutting the costs in half, corporate big wigs could still afford a lifestyle few Americans will ever know.

Corporate medical America has chosen to trade American lives for their personal excessive lifestyle.

Have you ever been denied healthcare?

I know a family whose six children have never had to see a doctor for an illness. They've had a few stitches and broken bones among them, but never a "sick" visit. A growing body of evidence suggests that it's possible to provide our bodies with the nutrients, hydration and exercise we need to maintain health. Some would add chiropractic to this list, in order to keep spinal alignment allowing for maximal neural communication. Regardless of which of these components you wish to include, sadly the majority of Americans don't pursue the path of optimal health.

Perhaps that's why Americans do not have healthcare. We have sick care. The current American healthcare system has nothing to do with maintaining health but everything to do with healing sickness. We seek medical attention to alleviate disease symptoms.

Take a look at these statistics:

● 75 percent of all healthcare dollars are spent on patients with one or more chronic conditions, many of which can be prevented, including diabetes, obesity, heart disease, lung disease, high blood pressure and cancer. (Source: Health Affairs)

● The share of the economy devoted to healthcare has increased from 7.2 percent in 1970 to 17.9 percent in 2009 and 2010. (Source: Kaiser Family Foundation, May 2012)

● The U.S. spends substantially more on healthcare than other developed countries. As of 2009, health spending in the U.S. was about 90 percent higher than in many other industrialized countries. The most likely causes are higher prices, more readily accessible technology and greater obesity. (Source: Kaiser Family Foundation, May 2012)

How different would our healthcare picture look if we changed our mindset, actively seeking out healthcare instead of sick care?

I've never liked Valentine's Day. When I was a kid in school, I feared not receiving any cards from classmates. In retrospect, an irrational fear -- but even today, thinking about it makes my stomach flip.

Perhaps that fear of rejection lingered, casting shadows on the cards and chocolate -- because even during years when I've had a Valentine, this holiday has felt shallow, hollow. I've never attached meaning to it. I know some people who do. Some take the holiday to the extreme, choosing to propose.

For others, this holiday fills them with despair, a nagging reminder of what they have lost -- or never had. I wonder if whoever started the holiday thought about the potential effects on those struggling with relationships.

Last week we looked at steps in decision-making. The final step was evaluating the outcome. I wonder if the Valentine's Day's founder would feel like he met his goals.

I wish I had thought to write this before Valentine's Day, to encourage those who find the holiday challenging. Alas, I did not. So here's my post-mortem advice:

● If you don't like Valentine's Day, take heart -- you aren't alone.

● If Valentine's Day makes you sad (or mad), take two hearts -- you aren't alone.

● On Valentine's Day -- or any day -- be kinder than you have to be to those whose paths you cross. You never know when someone is having a bad day.

Do you know the five steps to making a decision? A month ago, I didn't even know there were five steps to making a decision. Thanks to homeschooling my fifth-grader, I'm now educated. Sadly, I realize there's one step I too often skip. My guess is it's one that many of us skip.

Unfortunately, it's the most important step -- the one that keeps us from repeating mistakes.

Step One: Set Goals

You can't make a good decision if you don't know the results you want to achieve.

Step Two: Identify Options

Identify all of the possible options that could lead to meeting your goals.

Step Three: Gather Information/Consider Choices

Collect information about your options. Be careful to collect facts, not opinions. Use the facts to form your own opinion regarding the pros and cons of each choice. How does each option relate to your goals?

Step Four: Make a Decision

Looking at the pros and cons, decide which option gets you closest to your goals. When considering the immediate and future consequences of each option, you may find you need to reevaluate your goals.

Step Five: Evaluate Your Decision

Is the outcome of your decision what you expected? The day after your decision, look at what happened. Then look again in a week, a month, a year. Evaluate the results of your decision. Did you meet your goal or did something go wrong?

The decision-making process doesn't stop with the decision. In order to make wise decisions in the future, we must continue to evaluate the impact of our decision long after we make it. This is a simple truth, but I confess I fall short.

Once a decision is made, I move on rather than actively evaluating the effectiveness of my decision. That's likely why I see cycles repeating in my life. Insanity, "they" say, is doing the same thing but expecting a different result. If I objectively evaluate the results of my actions, I can probably stop the insanity by making different -- better -- decisions next time.

What do you find to be the most difficult step in decision-making?

* Decision-making steps taken from Skills Handbook Using Social Studies, Level 5 (SRA/McGraw-Hill, 2002)

Our youngest daughter took a turn for the worse. This last week reminded me -- sick kids create a lot of collateral work!

Can you remember the last time one of your kids got sick?

Children blindside us out of nowhere. One minute they're fine. The next minute, we're scrambling to rearrange the day -- get coverage for work, secure transportation for siblings' activities, cancel and reschedule appointments etc.

The needs of the sick child add to the chaos -- schedule a doctor's office "sick" visit, two pharmacy stops (one to drop off the prescription, a second to pick up the medicine), grocery shop for specialty food items, extra laundry.

As their tolerance for siblings plummets, skirmishes escalate. The emotional needs of the sick child can drain the entire household, leaving everyone's nerves raw.

When you have a sick child at home, what is your plan to reestablish balance?

Addressing the practical and emotional needs of all family members will set the tone for peaceful passage through times of illness.

● Get proper nutrition and rest so your bodies can heal most effectively and quickly.

● Drink plenty of water -- at least half of your body weight in ounces (100 pounds = 50 ounces/day).

● Have siblings take a breather from interacting. Instruct them to play individually in separate areas.

● Encourage calm activities: read a book, listen to music, watch a comedy, play a card/board game.

● Take a soothing bubble bath or shower. A child or an adult with a fever should not take a hot shower.

● Give yourself permission to abandon regular activity while you focus on your family's health.

● Enjoy the extra cuddle time with your sick child. They grow quickly. "No one has ever looked back at the end of his life and wished he spent more time at his desk!"

How do you decide if a doctor (or other healthcare practitioner) is right for you?

Back in the fall, we received notice we'd need to find new doctors. My post, "Twinkies and Insurance Companies," tells the why. Here are a few factors I took into consideration in my search.

1. Ask people you trust for recommendations.

2. Knowing who to avoid can be as useful as knowing who to vet.

3.  Inquire about the provider's clinical outcomes, bedside manner, wait times and practice parameters -- does he order many/few tests and medicines?

4. Confirm insurance status with the practice provider. Unfortunately, the insurance customer service representatives are not always accurate.

5. If the physician is a specialist, ask if you'll need a referral to be treated. Some specialists require a referral even if your insurance doesn't.

6. Ask about the office's financial policies. Does the provider require payment when services are rendered or can you pay over time?

7. Consider how far the location is from your work or home. This may seem simplistic; but with the cost of gas steadily climbing, it could be a deal breaker.

What other factors do you consider when choosing a medical practitioner?

As we close out January 2013, I'm proud to say I've kept off those 30 pounds I lost in 2012. I'm devastated to say losing weight wasn't the answer I expected it to be. I'm thinner but not healthier. Despite making what I thought were healthy eating choices, symptoms continued and daily meds became a way of life. The ultimate negative outcome: surgery, scheduled for March 20.

On the recommendation of friends, I checked out It Starts with Food from the library. I can't say I agree 100 percent with everything I read, but I do have enough confidence in the science I saw to order my own copy of the book. My highlighter is ready for action when it arrives.

Dallas and Melissa Hartwig have taken the vast collection of nutritional information and boiled it down into one easy-to-read book that delivers a relatively uncomplicated plan to optimal health. The Hartwigs write in a conversational tone with infusions of humor, making their book a very easy read. That's saying a lot for me, because I hate to read. Their information would be useless if I couldn't make it past the first chapter.

Part of what has made a healthy lifestyle elusive for me is the seemingly disjointed bits of information I've gleaned, all floating aimlessly about in my mind. I'm a relatively intelligent person with a medical background, yet it's been difficult for me to connect the dots. Dallas (a physical therapist, by the way) and Melissa fit those many pieces into one coherent masterpiece. They use common language and brilliant analogies, making this information easily digestible for anyone - even someone without any medical knowledge.

A foundational principle they introduce early on is, "There is no food Switzerland." Everything we put in our mouth makes us either healthier or less healthy. As the Hartwigs untangle the biological responses that occur with our eating choices, a clear picture emerges that can give us the strength to be intentional in our decision-making.

Dallas and Melissa have made the road to change as simple as possible. As I was writing this post, I first described their book as "an easy-to-follow plan." But, it isn't easy to follow. There's nothing easy about change. Change is difficult. The Hartwigs are refreshingly honest about that as they come alongside their readers with humor and tough love, encouraging them to succeed.

The Hartwigs also provide online help to complement the information in their book. In fact, physicians and patients used the Hartwigs' online resources to reclaim health before It Starts with Food existed. Both the website and book have numerous testimonials from once-unhealthy individuals who were taking daily medications and suffering daily pain. After pressing the Hartwigs' reset button, those same individuals now experience a quality of life they didn't even know existed, medication-free and pain-free.

An excerpt from the Hartwigs' website sums up my expectation of what will occur as a result of embracing their program: "...designed to change your life in 30 days. Think of it as a short-term nutritional reset, designed to help you restore a healthy metabolism, heal your digestive tract, calm systemic inflammation and put an end to unhealthy cravings, habits and relationships with food." In a perfect world, I'll get to cancel my surgery.

If "short-term" jumped out at you, don't worry. The Hartwigs show you how to reintroduce a variety of foods into your diet after the initial 30-day nutritional reset is complete. You'll develop a personal eating prescription that is perfect for your body.

Does anyone want to join me on this journey? Does anyone have any information to share?

Lesson of the week: Never assume that people doing a job have been educated or trained for the position they hold. This is a particularly frightening proposition in medicine.

The hospital registration lady asked me to review the admission paperwork for accuracy. Most everything was in order. I updated one piece of personal information. Then I saw the diagnosis: Pure Hyperglycemeredemia.

I was stumped. I readily admit my scope as a physical therapist is limited. However, I've had enough education and seen enough as a practitioner that I usually recognize medical words, even if I can't remember exactly what they mean. I figured "hyperglycem-" should have something to do with high blood sugar, which I've never come close to having.

So, I told the registration lady I thought my diagnosis might be incorrect. She shrugged it off, making no attempt to inquire about or correct it. When I got to the prep area, I asked the nurse.

She laughed and said, "I was going to show that one to the other nurses. I've never seen it before. I'm pretty sure it isn't even a word. The people who input this don't have any medical training. Sometimes they get carried away. We see some crazy things, but I haven't seen anything quite that creative. Don't worry; I can change your diagnosis to something appropriate for the procedure."

Medical establishments won't hire people with advanced medical degrees to input admission data, but they should require a minimal level of competence and integrity of employees who handle medical information. Since that obviously isn't the case, here are my personal takeaways:

1. When I receive information about a client -- information that was documented by someone other than the client -- I won't assume it's correct.

2. I won't be annoyed when professionals ask me the same questions their colleagues have already asked. In the past, this act has felt like an inconsiderate waste of my time. Now I'll appreciate this measure of accountability.

Don't assume others have been conscientious in their preparation of your information. Current news is replete with warnings to be careful with personal information from a security perspective. Be as vigilant about reviewing your medical information.