The Busy PTs Guide to Finding Balance

Spring Cleaning

JANEY GOUDE — Tue, 13 May 2008 17:58:00 GMT

Last week my oldest daughter looked at our dining table centerpiece and asked, "Mom, if you went in someone's home and they had this much dust, what would you say?" I told her if I knew they'd had a month like we just had, I'd give them a pass. Long story short, our May is devoted to spring cleaning...amazingly my 12-year-old is actually looking forward to it!

I remember the day spring cleaning became a reality for me. I wasn't 12, I was 37! The dust on a baseboard caught my eye and I thought, "Hmmm, you must have to clean those." Up until then, we'd always moved before spring cleaning became a necessity. It never occurred to me to routinely clean the baseboards or behind the refrigerator...I always did that when I moved in and again when I moved out. It's actually easier that way, without all that pesky furniture to mess with! Plus, during a move, I take time off to concentrate on my home. Having to fit spring cleaning in with my regular routine seems a monumental task.

Whether you need to clean out your home or your office, here are a few tips to put the spring back in your step during spring cleaning.

Mountains into Molehills
Break overwhelming tasks into smaller, manageable bits. Don't plan to spring clean your entire home in one day. Tackle one room at a time. When you finish that room, start on the next. You can do a room a day, a weekend, or a week. Or, you could do one room a month and spread your spring cleaning out over an entire year. If your goal is to deep clean every room once a year, does it matter that all rooms don't get cleaned at the same time?

Enlist the Troops
Your children can be great cleaners. Even little ones can get in on the action. It may take a little longer, but you'll be preparing them to spring clean their own home one day.

Save the Best for Last
Do the least desirable tasks first. Once they are out of the way, the other tasks will feel like a cake walk. An added bonus: You'll have less reason to procrastinate.

Supercharge your Motivation
If you find all spring cleaning tasks equally heinous, try completing the quickest task first. Getting that first room under your belt--seeing the shining surfaces, deeply inhaling the scent of clean--will inspire you to tackle the next room!

Reward Yourself
Set goals for yourself. When you reach a goal, reward yourself! Go out to dinner. Slurp your favorite milkshake. Buy yourself new jewelry, perfume, candles...whatever you love that you consider a special treat! If you decide to have your children help, don't forget to reward them, too!

Spring cleaning is an unavoidable part of life, though you have to admit, I almost beat the odds. I mean 37 years without spring cleaning...that is pretty impressive! If you have any tricks to take the pain out of spring cleaning, will you take a minute to share them here?

Are You Ready For a Date?

JANEY GOUDE — Wed, 07 May 2008 14:12:00 GMT

How can you get the most out of your date? What can you do that will supercharge yourself or your relationship with your spouse, child or friend?

This month is all about atmosphere! In April my husband and I enjoyed a weekend-long date with our two oldest children. Hannah and Lauren participated in the State Bowling Tournament in Charleston. In between the nine games they bowled, we took in the sights, sounds, and flavors Charleston has to offer. Here are a few of our favorite moments for you to recreate in your town.

Dine with Abandon
Break out of your normal routine. Choose a restaurant as much for its ambiance as its food. If you usually go someplace bright and loud, try someplace quiet and dimly lit. If you usually sit at a table, try a booth. If you always go to the same spot, go somewhere new.

Go for a Carriage Ride
Granted, a horse and buggy don't grace every city. If your town is buggy-less, let your bicycle be your carriage. Explore your own neighborhood or go to a local park and investigate new trails. If you or your date aren't the coordinated type, walk the trails. Our new bridge construction just opened up a walk/bike path that traverses the bridge. You can park at one side and bike to the other--all the while enjoying the gorgeous lake view--then relax at the park before the invigorating return ride.

Breathe in Nostalgia
Whether you are alone, with a spouse, children, or a friend, a stroll down memory lane can set your endorphins cascading. We took time to relive the glory days in the town my husband and I met and married. We showed our daughters the barracks my husband called home for four years and the chapel where we wed. They tolerated the experience, while we basked in it.

Enjoy the Outdoors
While spring is in the air--and before bugs invade--take every opportunity to enjoy the outdoors. Dine at outside vistas...with a water view whenever possible! If you aren't near the ocean, fountains do nicely. You don't even have to dine...just order a drink and enjoy the view!

Hands-on Shopping
We strolled through a plaza and happened upon a Brookstone store. What a find! Aside from a sumptuous bathrug, I didn't see anything in my price range. But oh the fun we had touching and feeling in that place!! We rode on a simulated horse and surfboard, laughing ourselves silly in the process! Then we relaxed as the programmed fingers of the shiatsu massager kneaded from our occiputs to our gluts, at which point a leg massager took over and milked our calves and feet. The ultimate tactile toy store--a Chuck E. Cheese for adults! So go, play!

Try It, You'll Like It

JANEY GOUDE — Tue, 22 Apr 2008 12:08:00 GMT

"When you catch yourself becoming irritated or disturbed at circumstances, stop and laugh at the little things that steal your peace." - Debi Pearl

Driving down the road last week, I caught myself being entertained by other drivers. Granted, I wasn't in a hurry and I wasn't in traffic. I smiled remembering the times I'd caught people picking their nose or singing. Then I wondered how much more relaxed my rush hour drives would be if I would take this same attitude of being entertained rather than being annoyed.

Let's face it, when you are in gridlock, you aren't going anywhere any faster if you get ticked. You just get to sit there ticked instead of happy. My favorite saying is, "Every minute you spend angry is 60 seconds of happiness you can never get back." So, turn on the radio and start singing. Maybe you'll be the entertainment for the guy sitting in the car next to you! Or turn to your favorite talk show. Or pop in a book on tape. Or you could just study the people in the cars around you and marvel at their idiosyncrasies.

If you can't change it, you might as well embrace it. When you feel yourself getting angry, stop. Then find something that makes you laugh...or at least smile. Just the act of smiling will help you relax and de-stress. Try it. You'll like it!

Microchipping: It's Not Just for Fido Anymore

JANEY GOUDE — Tue, 15 Apr 2008 13:13:00 GMT

I'm not a big news buff, but by now my husband would have clued me in on something this sensational. Amazingly, he hadn't heard of it either. I just read an article on the use of microchips in Alzheimer's patients. Yes, I said IN. The same technology that has been used in pets since the 1980's is now being used in humans.

I did a quick search to gather a bit more information. Not surprisingly, Florida, a state well known for retirees, is pioneering this effort. To date, at least 100* Florida residents (humans with Alzheimer's and their caregivers) have been implanted with an RFID microchip, similar to the one used in man's best friend. I haven't seen a clear reason for implanting the caregivers--maybe as a control group or perhaps to lessen the blowback of using invasive technology on an unwitting patient?

Another murky area is what this chip will and won't do. In reading the articles it is easy to get the impression that the microchip acts as a tracking device, a sort of human GPS. But to date, that is not the case. The people in Florida have microchips that only contain personal data, like a traveling medical history. If a patient wanders off and happens to be taken to one of a handful of Emergency Rooms equipped with a scanner, they can pull up the patient's name, personal information, and medical history from a database where it has been stored and updated since implantation of the RFID microchip device.

But there are states that have entertained human GPS systems--for prisoners. As early as 2004, the Ohio Department of Rehabilitation and Corrections had plans to fit 44,000 inmates and guards with wristwatch-sized transmitters. These transmitters have GPS tracking capabilities and would also sound an alarm if they were being tampered with or if a guard fell to the ground. In 2007, Oklahoma legislators upped the ante when they introduced a bill to implant microchips into prisoners convicted of violent crimes in order to monitor them after their release from prison. Articles are unclear whether these devices would be informational or tracking in nature. The House of Representatives in Oklahoma sent the prisoner microchip bill back to committee, but only after the Senate passed it! Reportedly the House was concerned that the forced implantation of the microchip might potentially violate the prisoners' constitutional civil liberties. Perhaps if we called it a "clinical trial"?

*some reports say 100, some 200, some as high as 400.

Most Embarrassing Moment

JANEY GOUDE — Tue, 08 Apr 2008 11:22:00 GMT

Everybody has those days. With four kids, I probably have more than my share! This particular day, it had nothing to do with my kids. I went through a drive-thru for a milkshake. A seemingly simple feat, but I'll admit I'm not your run of the mill milkshake orderer. I'm high maintenance with my food, like Meg Ryan in "When Harry Met Sally." But I try to be reasonable. There are some things I can roll with, like the wrong ingredients on my hamburger. I can pick off the onion. I can live without the mustard. But there are unforgivable food mishaps, like cold French fries. Not preparing my milkshake to specifications also falls in the realm of unforgivable, meaning I'm going to request a do-over or a refund.

Because there was someone behind me in the drive-thru, I pulled forward before I took my first sip. I had requested extra thick with no syrup, only milk and ice cream. The milkshake was like water. If I'd have paid $2 and hadn't really had a taste for it, I would have passed it off to my kids. But this milkshake was over $4 and I really, really wanted it. So, I wheeled back thru the drive-thru of this family owned business. The teenage daughter had taken my order, made and delivered my milkshake. She contended that I had not made those specific requests and she could do nothing. In essence, "Lump it."

Perhaps if this was the first time I had wanted a milkshake prepared precisely this way, I would have questioned myself. But I have been ordering my milkshakes this way for years. It is the only way I drink them. Plus, I had eight other ears in the car that said I did order the milkshake that way...and at least four of those ears were trustworthy, given to correcting me when I misspeak. So I asked to speak with her supervisor, aka her mother. Her mother told me her daughter didn't lie, that for all she knew I could have been sitting in the parking lot while the milkshake melted. The inference, of course, is that I was lying.

I was livid. Keeping a calm exterior, I requested she make me a new milkshake or refund my money. She refused. As I tried to reason with her, appealing to her apparently absent customer service skills, she began to shut the window in my face. That closing window was like the red cape waving in front of a bull. In a moment that can only be likened to a psychotic break, I tossed my milkshake at her through the closing window and drove off. My kids sat in momentary disbelief before exclaiming, "Mom, you rock!"

I've never done anything like that before. I like to think I'll never do anything like that again. I wish I could say I regretted the act. I didn't. But I did have remorse. I hated the example I had set for my children. And I was sickened thinking this woman might attribute my behavior to prejudice against a foreigner. Her ethnicity had no bearing on my actions-her being an unreasonable jerk was my only motivation. It bothered me that she could deny her own culpability by pawning off my actions on perceived prejudice.

So, a week later, after explaining to my kids how much I didn't rock, I went back to the restaurant to apologize, kids in tow for them watch me eat crow. The restaurant was closed. Not for the day, for good. I'll admit we all basked in the righteous vindication the world had to offer at that very moment. You can't treat people poorly and expect them to keep coming back. She learned that the hard way. Or she learned nothing as she sat oblivious to her own actions in a pool of self pity for a perceived prejudice that was so wrongly thrust against her.

That day, I couldn't understand how a business owner would risk losing a customer over a $4+ milkshake that probably only cost her $1 to make. Even if she had made me another milkshake, at worst she would have broken even. Now her refusal to make me a new milkshake made more sense. Either she was fighting for her survival and every penny counted, or she had already lost her fight and didn't care about losing a customer. Either way, there was something below the surface I couldn't see. I didn't give her the benefit of the doubt.

How often do I assume someone is just being a jerk for the pure joy of annoying me? A co-worker, a boss, a spouse, a child, a relative, another driver? How often are my actions driven by the sentiment that I deserve to be treated better by those around me? How often do I treat others poorly and expect them to react graciously to me because I'm having a bad day?

You never know what personal battle someone is fighting. Even on my worst day, someone who is irritating me may actually be having a worse day than I am. Hopefully I can remember that the next time I get a watery milkshake!

Higher Education: At What Cost--For What Gain?

JANEY GOUDE — Tue, 01 Apr 2008 11:19:00 GMT

This weekend, I passed a couple talking on the street outside Starbucks. A young man sweeping the street engaged them in conversation:

Sweeper: Do you like music?

Man at table: Yes.

S: What kind?

MaT: All kinds, but especially classical.

S: Really?

MaT: Yes. I study classical music.

S: Oh, are you getting your Bachelor's or Master's?

MaT: Doctorate.

S: Oh. (his voice dripping with admiration)

By this time I'm exiting earshot. My first thought, was, "Wow. Impressive." Followed quickly by, "What do you do with a PhD in classical music?" The reality of his options made the pursuit not so impressive.

I know people who make an occupation of education to avoid having an occupation. I think they are affectionately referred to as "career students". Education is a noble pursuit, but it is not an end unto itself. There has to be a reason for the education.

When I was in PT school, the Master's program was just gaining popularity. The college I attended entertained the idea of transitioning to a Master's program. The PT faculty convened a student board to gather feedback and gave them the proposed curriculum to review. There were many intellectuals in our group who were enthralled with the idea of going to a Master's. But as we deliberated, we found that essentially no material was added to the Master's curriculum. They had merely stretched our four year program over five years, collecting another year of tuition.

Our conclusion was that if anyone deserved a Master's degree it was us--completing the same amount of information in one year less. It was our contention that it took less intelligence and character to complete their proposed Master's degree than to complete the current Bachelor's degree. They would be turning out weaker students, but awarding them with a higher degree. What good would that do our profession?

We must have made a good argument because the Master's degree was tabled. Eventually my alma mater did go to a Master's, but I'd like to think it was a revamped, higher octane version.

There are people who are impressed with degrees. There always will be. But what do those additional credentials mean? Do they mean anything? Or are they just more money for the colleges? What does that additional education allow you to do that you can't do with a lesser degree? If the degree opens doors that would otherwise remain closed, then it is a worthy pursuit. If the degree merely allows you to put off entering the real world or put money in the college's pocket, then it is an end unto itself and of no value to society or to our profession.

Oops

JANEY GOUDE — Tue, 25 Mar 2008 14:48:00 GMT

I went for a PAP in October which came back abnormal. I declined a retest. I'd had abnormal PAPs before due to infections and knew a retest would be normal. Besides, Christmas was coming and I had better places to invest $30 than my gynecologist's Christmas fund. The nurse called back to tell me this abnormal result wasn't indicative of infection. This finding required a different test, not another PAP. The doctor urged me to follow-up, sooner rather than later. He's not an alarmist, so I heeded his concern and enjoyed my first colposcopy. Positively lovely.

As I had predicted, albeit with the wrong information, the test came back completely normal. That was November.

The last week of February, I heard my gynecologist's voice on my voice mail. Unsettling. The doctor's voice, rather than his nurse's, is never a good sign. Even more unsettling, he left me his cell phone to contact him.

He told me the lab had an audit system for quality control and my slide was pulled. The two pathologists who reviewed my slide found abnormalities and sent the sample to Harvard to confirm the diagnosis: adenocarcinoma in situ. The next step was a consult with a gynecological oncologist. While my physical exam showed nothing of concern, the oncologist said the diagnosis can't be made conclusively from the colposcopy. Due to the topography of the cervix, a conization has to be performed for a definitive diagnosis to be made. If the diagnosis is confirmed, then the conization will double as a diagnostic measure and the only treatment that will be needed. The doctor expects this outcome. I echo his optimism.

I've always gone for routine PAPs, mainly because I'm a by the book kind of person. When I told my sister, an ex-hospice social worker, about my diagnosis and how I almost didn't get the follow-up test done, she said that cervical cancer typically has no symptoms and often goes from diagnosis to death in a year. That's why they drill yearly PAPs into our heads.

I am grateful for a doctor who urged me to share my Christmas money with him. I am grateful for the lab's audit system and the providence that had my slide pulled. I am grateful for two pathologists who weren't too prideful to seek a second opinion. Turns out a full 1/3 of these diagnoses are missed on first pass. Partly because the diagnosis is so rare. The abnormal PAP result I had accounts for less than 1% of abnormal PAP slides. The colposcopy diagnosis is similarly uncommon. I'm glad the profession recognizes the potential for missed diagnosis, admits there is an issue, and takes measures to safeguard the patient.

If you are one of those women who puts off screening tests, I urge you to make a deposit into your gynecologist's Christmas fund this year.

Who is Doing Your Job?

JANEY GOUDE — Tue, 18 Mar 2008 14:45:00 GMT

I'm transferring my kids' care from the pediatrician to my family doctor. As with anything medical, paperwork precedes productivity. So, I took the completed release forms to the pediatrician.

The next day, I received a call saying I'd have to pick up the records. Apparently after nearly five years, the records were too bulky to mail or fax. I'm pretty sure it would have been cheaper for me to mail them a check for postage than to pay for the gas to go get them. But, we got them and took them to the family doctor.

The family doctor asked me to call the shot nurse and have her review the transferred vaccination records to determine if any of the kids would need a vaccine during their well visits. The shot nurse informed me that the shot records were incomplete, either missing altogether or missing the patient's name. Then she asked me to phone the doctors' offices where the records had originated and get the necessary information. I asked her for her fax number so I could have those few records transmitted quickly. Not only did she not know the number, she didn't offer to get it for me.

At this point, I realized I was agreeing to do her job for her. In fact, I'd been doing a couple of people's jobs in this process. As the patient, my responsibility should have ended when I hand delivered the release form requesting the medical records be transferred.

I'm pretty sure my co-pays for four children over the last four+ years would more than cover any postage that may have been required. My kids' haven't been that sickly; one priority mailing box, costing less than $10, should have sufficed. At a minimum, they should have given me the option of being charged for the postage if the $10 was really going to bankrupt them.

I have the utmost respect for my doctor, but I shouldn't have been giving his shot nurse tasks to complete...either the doctor or his nurse should have followed up on that.

As far as the shot nurse asking me to call to get completed records, there are two obstacles. First, she had the records and knew exactly what she needed. I didn't have any copies. More significantly, when was the last time a doctor's office responded more effectively to a discharged patient than to another doctor's office?

A more rudimentary issue is her not knowing the fax number, or at least offering to find it, especially since she originated the call to me and knew she was going to ask me to acquire information for her. She should have been prepared to give me the tools I needed to do her job for her. Don't you think? Honestly, if she had been able to give me the number, I don't think it would have dawned on me that she was asking me to do her job.

So, who is doing your job?

All Weather Dates

JANEY GOUDE — Tue, 11 Mar 2008 15:25:00 GMT

This has been a crazy month so far, how about you? Spring fever is knocking at our door, but the weather keeps driving us back inside. Yesterday we experienced our high temp early in the morning. As the day progressed, the mercury kept falling and the wind blew out our power. No rain, no lightning, just wind...lots and lots of wind. I talked to my parents last night and they were shoveling a path through the blizzard (18 inches of snow and still coming down) for their dogs to pee!

I love to go out to eat (someone else to cook and clean up!) and I love to get time alone with my husband. But I have to admit, in this weather, even I would just as soon stay in. Fortunately, no one says you have to go out to go on a date!

Try a TV series. I know, I know, TV isn't the greatest; but two of my guilty pleasures are House, MD and 24. And they are so much more enjoyable without the commercials!

Make a mix tape or CD. Take turns selecting songs to record. If you've been married awhile, try making one with hits from your dating days. This is fun for couples, but also for parents and kids. Be sure to make two copies so you can each have your own.

Snuggle on the couch, maybe in front of a fire, and do crossword puzzles or word finds.

Do a jigsaw puzzle. Now they're available the perfect size to do in just one evening.

Make your own pizza (Chef Boyardee has a complete kit), make your own ice cream sundae and put in your favorite old movie: A Few Good Men and Pretty Woman are two of my favorite oldies.

Remember, dating is about spending time together, not spending money. Enjoy your March!

*An email I received got my idea train going. For more ideas, you can check out http://www.redbookmag.com/601230.

Human Error or Negligence?

JANEY GOUDE — Mon, 03 Mar 2008 17:41:00 GMT

Recently I received an email rejoicing that an unborn child had saved the mother's life. My joy was short circuited by my anger. The unborn child should never have been called upon to save her mother's life...that task was the responsibility of the ER physician who couldn't be bothered to do his job.

I've made my share of mistakes. We all have. If you haven't, give it time, you will. We need to have procedures in place to minimize the risk and consequences of human error, but we will never eradicate it. This wasn't human error.

Human error is altogether different from negligence. Human error can happen to the most dedicated caregiver. Negligence is arrogant and self-indulgent. Negligence assumes it knows the answer without conducting the appropriate tests. Negligence dismisses complaints it deems excessive. Negligence is more concerned with the caregiver's convenience than the patient's outcome.

We've all had bad days, annoying patients and patients who are taking advantage of the system. The problem comes when we think we have some sort of at-a-glance superpower that allows us to distinguish sincere patients from phonies with a minimal intake history. When we get to this level of arrogance, we are a disservice to our patients and our profession.

I worked with an orthopedic surgeon who had seen his share of malingerers. He never treated patients like they were lying, even if he thought they were. He believed if he gave them enough rope, they'd eventually hang themselves. But if he assumed they were lying and acted on that assumption, then he might cause harm to an innocent and sincere patient. That was an unacceptable outcome.

But that is exactly what happened in the ER. The doctor minimized the patient's complaints and administered meds without performing any tests. Within a few hours, the patient was in an emergency C-section. While his 2 pound daughter was delivered breathless and his wife lay bleeding out from an unknown source, the patient's husband was escorted by the head nurse to meet with the hospital chaplain to pray. Prayers were answered. Mom was transported to ICU with a breathing tube. Their daughter was taken to NICU, her home for weeks to come. Days would pass before Mom could see or touch her newborn daughter.

How much pain could this family have been spared, not to mention medical costs, if the doctor had assumed the patient was telling the truth? If he had given her the benefit of the doubt and done a complete work-up? What would that decision have cost him? What might that decision have saved this family?

Are you acting on your assumptions instead of your assessment? Your patients and your profession deserve better.

Life Changing List

JANEY GOUDE — Tue, 19 Feb 2008 12:11:00 GMT

Would you like to know how to make time for what is important to you? The answer is as simple as two little letters: N-O. But simple is not always easy. Actually saying "No" can be difficult. Knowing when to say "No" can be equally challenging.

Basic list-making can help you identify what commitments to decline in order to make room for what is most important to you. Are you ready to discover what responsibilities are worthy of your time and what obligations merit a firm, "No"?

Okay, make three lists:

1. "What I do"

2. "What I have chosen not to do"

3. "What I don't have time to do"

What I do
This is NOT a "to do" list. This isn't a list of what you have to do, but a list of what you actually do. In the course of a week--or a month--what activities do you do? What items fill your days and your calendar? Include activities such as personal care, committees (work, kids' school, church), errands, kids' sports practices and games, caretaking for family (prepare meals, laundry). If you have done a thorough job, you'll be tired just looking at this list! We tend to underestimate how much we actually do.

What I have chosen not to do
Include items you have already decided to remove or outsource. If you use a housekeeping service, then housecleaning goes on this list since someone else does that for you now. I choose not to wear makeup regularly; a seemingly small feat that saves me 20 minutes every day.

What I don't have time to do
What have you been saying "No" to because you don't have time? A committee you'd like to serve on; a graduate degree; volunteering at your child's school; going on a picnic with your family; taking a 30 minute bath with candles, a good book, and solitude.

Once your lists are complete, examine your "What I do" list. Do you like how you're spending your time? Are you pleased with the activities that have won your affections? This list reflects your priorities as of today. You are choosing to apportion time to these activities.

Now take a look at your "What I don't have time to do" list. This list doesn't exist. Everything on this list belongs on the "What I have chosen not to do" list. If you aren't making time for an activity, then you are choosing NOT to do that activity. So now, you only have two lists.

Look closely at your two lists. What items do you wish you could swap? What's stopping you? This is where you get to reconfigure your priorities. What do you really want? What are you willing to give up to get it?

With lists in hand, you are armed and ready! Take charge of your days and make time for what is important to you.

Valentine Surprise

JANEY GOUDE — Tue, 12 Feb 2008 16:26:00 GMT

As a kid I intensely disliked Valentine's Day. I've always been an over-analyzer, so deciding which card was right for which friend was painful. Should I give Abbie the puppy or the kitty Valentine? What if she spells her name "Abi"? What if I forget someone? Oh, the embarrassment! But, then, what if I am forgotten? Who thought up this torturous holiday?

My dad is a real romantic...he'd bring home flowers for no reason. On Valentine's Day, he'd buy flowers for all his "girls". Sadly, his efforts were not held in high regard. I'm practical like my mom, "They're just going to die; they probably won't even last the weekend." That sucks all the romance out of the air, doesn't it?! With age, I've learned to take pleasure in a nice bouquet of flowers. On occasion I'll even buy one myself, just because. I still have trouble bringing myself to participate in the Valentine's Day floral price gouging, but I do appreciate the sentiment.

My husband threw me off guard this year. He asked me to find a babysitter for Valentine's Day! From the sounds of my daughter coughing until she gags, my soul mate's gesture may not come to fruition, but this is one time the thought definitely counts.

I can't remember a time when we have celebrated with more than a card. As you may have guessed from my warm memories of Valentine's Days past, our lack of Valentine fanfare has never bothered me. Even though I would have been perfectly delighted with my husband's exquisitely selected card, I was delighted to know that on Valentine's Day #17 he wanted more.

Who will you surprise this Valentine's Day?

Employees

Have an employee Valentine's drawing. Give away a basket, a dinner, or a day off--whatever is in your budget. You can randomly choose an employee, or you can use it as a productivity incentive. Each employee gets to put their name in one time for every four units billed, or for every progress note written, or for every evaluation performed. Whatever benchmark you are working on, you can use a Valentine's Day drawing as an incentive.
Pass out personalized Valentines--write a quality you appreciate about that employee.

Employer

Pitch in and take your boss out for a Valentine's lunch.
Take up a collection and buy your boss a bouquet...send it anonymously!

Clients

Ask your clients to share their most memorable Valentine's Day. It may be the perfect conversation starter to build rapport.
Have clients make Valentines while they work on sitting balance or standing endurance.
Make a Valentine obstacle course for wheelchair mobility or a Valentine treasure hunt that incorporates mobility challenges.

Family

Cook your kids heart-shaped pancakes for breakfast.
Make handmade Valentines to put in your spouse's or children's lunches.
Help your sons pick out flowers for Mommy or sisters.
Have a Mommy/Son or Daddy/Daughter Valentine's Date.
Have a Grandpa/Granddaughter or Grandma/Grandson Valentine's Date while Mommy/Daddy have their date.

Take a minute to share your Valentine's Day ideas. You may help to make someone's day special.

JUST SAY “NO!”

JANEY GOUDE — Tue, 05 Feb 2008 19:42:00 GMT

There is simply not enough time in a day to do all I want and need to do. How about you? If you are like me, always wishing for just a few more minutes--or hours--read on.

In 10 years, what will you regret NOT doing today?

That is what you need to make time for. To make time for your that, whatever your that is, you'll have to say, "No," to other commitments. Every time you say, "Yes," you are saying "No," to at least one other option.

If you are saying "Yes," to working overtime, the reality is that you are saying, "No," to every other option for that time slot: "No," to spending time with your family, "No," to watching your son's soccer game, "No," to writing a letter to a friend, "No," to going with your spouse to a basketball game, "No," to getting a massage.

For every hour you choose to watch television or engage your computer, you are declining outdoor activities. For every 30 minutes you spend on paperwork, there are 30 minutes of hands-on treatment a client isn't receiving.

To make room for activities that you want to do, you'll have to say, "No," to some other activities that currently fill your day. For those required tasks (paperwork-ugh), look for ways to work smarter. Find someone who does the same task more efficiently and ask their counsel.

Life is about priorities. You decide how you will spend every minute. One of my favorite sayings is, "Every minute you spend being mad is 60 seconds of lost happiness." Yes, you really decide to be mad...or scared...or happy. And for how long!

How will you decide to spend your next minute? And the one after that?

Date Time

JANEY GOUDE — Fri, 01 Feb 2008 20:17:00 GMT

One of the most difficult tasks is finding down time with my husband and my kids. In the daily chaos that is life, time always seems to slip through my fingers. There is always "to do" list left over at the end of my day. I'm guessing I'm not alone. So once a month I'm going to dedicate a blog post to some fresh date ideas to get your creative juices flowing! You'll find some may be a bit quirky, but I want to try to cover something for everyone. Whatever your cup of tea, this weekend take time out to enjoy life with the people who mean the most to you.

Instead of a movie, try live entertainment: a live band, a balloon artist, a community theatre performance.

A new twist to dinner: try a local pizzeria instead of a chain pizza place. When you order your pizza, ask them to cut it in a heart shape.

Have a picnic inside. Spread out a blanket in front of the TV and put on your favorite movie while you munch.

Play a board game...this time turn the television off.

Visit a local museum. Call ahead and ask for special rates/discounted times.

Go window shopping for houses. Even if you aren't in the market for a move, touring homes for sale (new or established) can give you great ideas for redecorating your own home.

Read a book aloud. You could make this a nightly date for 15 minutes. I found a book I thought my kids would love., They were considerably less enthused. So I told them we'd read it aloud together. At first they only wanted me to read. On the third day, one daughter wanted to read some. The next daughter followed. They got so involved in the book, they couldn't wait to see what happened. They ended up finishing it silently without me!

In case you weren't counting, four of these six ideas are FREE! Whether you go with your spouse, your kids, your parent, your sibling, your friend, or just by yourself...enjoy some downtime.

*I can't take complete creative credit for this brainstorm. An email I received got my idea train going. If you can't wait for next month's ideas, you can check out http://www.redbookmag.com/601230.

Cure For The Common Meltdown

JANEY GOUDE — Mon, 21 Jan 2008 15:22:00 GMT

Have you ever had one of those days when your deepest desire is for the world to stop spinning so you can get off? A day that starts off bad and snowballs until you want to crawl under a table and disappear? Unfortunately, all too often I ride the spiral downward. Once it's over, I shake my head in disbelief wondering what in the world just happened.

I'm an all or nothing person. If I start something, I finish it...laundry, dishes, my schedule. Stopping midstream and changing direction is not in my makeup. Turns out that may be making life a lot tougher for me.

Recently I read an article about identifying a meltdown-in-the-making and taking steps to avert it. The primary means of prevention is throwing my schedule out the window. If I'm amidst a meltdown, at the clinic or at home, I have to realize my agenda isn't being effective under the immediate circumstances. If my plan was working, I wouldn't be having a meltdown!

Just a few days after I read the meltdown article, as if on cue, my daughter got sick. When she's running a fever, her emotions are raw. Her little world falls apart, and so does mine. Normally I would let her lie around while the rest of us plow through our day. To not do my laundry, or pick up the floor, or have the kids make their beds...unheard of.

Inevitably, this tenacious determination to stick to my schedule when a child is sick ends with all of us crying by the time Daddy hit's the door. My house is in order, but tempers are in disarray. So I decided to implement this new concept. I threw my plan out the window and relaxed.

I have to admit, "relax" is not something I do well. I've heard that men have a "nothing box"; I've even seen my husband enact it. But I've never tried it, until now. I found my "nothing box"! And for this day, for these circumstances, it served us well. We all just hung out together. We cuddled, watched some shows, made our own card game (the sick daughter's idea during a perky moment), and made a pillow mess of the living room. I have pictures to prove it; I knew no one would believe I let my living room look like that!

My house didn't get cleaned. My beds didn't get made. My dinner didn't get cooked. But it was just one day. Well, it was actually one week. But all those chores are there for us to do this week. As I work to balance my life, I'm slowly embracing the truth that life isn't about chores and checklists, it is about relationships.

I identified a potential meltdown heading straight for us. Rather than following my normal game plan, I made a new game plan for the meltdown. It wasn't easy. It wasn't comfortable. But it worked beautifully and was well worth the effort. The next time you feel a meltdown coming on, be proactive. Change your game plan. Do something different from what you would usually do. See where it takes you.