What Inhibitor Family Camp Means to Us:

It Just “Clicks”

Published: LifeLines for Health, vol. 4 (Winter 2014)

A Father’s Words

by Wayne Camarro

This is the second year my family has attended Inhibitor Family Camp at Victory Junction Camp. My wife Jackie and I went with our sons Jacob, age 9 who has Hemophilia A with an inhibitor and our son Harrison, age 17. Harry has Lenox Gastau Sydrome, which means he is non-ambulatory, non-verbal, is developmentally impaired and has a seizure disorder.

Attending camp gives Jake and our whole family a chance for fun, education, relaxation and friendship with other families that are or have gone through some of the same experiences with hemophilia and an inhibitor that we have. We see it as a mini family vacation where we get to see old friends, make new ones, share experiences, learn new ways to cope, relax and ease pain.

It gives us a chance to see Jake playing with kids who understand him and all that he has been through. To see him make friends so fast warms my heart. There is no awkward adjustment period for them to bond, they become fast friends in minutes and are off and running to the next fun activity.

”There is no worry that he’s not going to fit in or have other kids fear him or label him as different due to his condition. He just ‘clicks’ with the other kids.”

Inhibitor Family Camp gives Harry a chance to experience cool activities like archery and horseback riding for the first time, that he might not have had a chance to do otherwise because everything is adapted! We have taken Harry to traditional campgrounds previously, but they tend to be over crowded and are typically not equipped to handle kids with special needs. At Inhibitor Family Camp the staff is very well versed in caring for kids of his ability level, which makes us so much more comfortable and makes it so much easier for him to participate. You can see it in the huge smile on his face!

For us as parents, Jackie and I get the benefit of attending informative sessions presented by medical professionals. Open group “jam” sessions with the other visiting parents are a favorite of mine. We get to discuss topics such as how our kids’ siblings are dealing with this illness. Having such a varied group together in one place and still being able to relate to each other’s struggles is truly amazing and not an experience that is easy to duplicate.

We really look forward to getting a break from the day-to-day challenges of dealing with hemophilia and an inhibitor. No matter how overwhelming things can seem at times, knowing we have our Inhibitor Family Camp experiences to fall back on is huge. We truly appreciate the effort that goes into making this event happen. Our sincere thanks for letting us be a part of the Inhibitor Family Camp family.

A Mother’s Words

by Jackie Camarro

There are many things I enjoy about the CHES Inhibitor Family Camp weekends. I enjoy meeting families from all over the country. I enjoy the feeling of community you get when you know that the people around you understand what you are going through when raising a son diagnosed with hemophilia and an inhibitor.

It’s nice to not have to explain what hemophilia is and then add all that additional information needed to explain the inhibitor too. All you have to do is introduce yourself and say the diagnosis and the conversation has begun. It’s fun to participate in the Serious Fun camp experience too.

My favorite part of camp is interacting with other parents, listening to their story and realizing that we are a community of people with many similarities. I never would have had the opportunity to meet such awesome people and hear such inspiring stories. These stories empower me and give me the strength to continue.

As many parents in the inhibitor family know, there are times that I, as a parent have been worried about my child’s future. It is very hard to see your child in pain or to see him sad because he can’t do all the things his friends can do. It hurts when I see him become angry because of his medical condition.

Inhibitor Family Camp is also great for my son. It’s nice to see him make new friends, laugh, play and do all sorts of fun things that can only be done at a Serious Fun Camp.

“He needs to know that he is not alone and that other children can relate to his situation too.”


Exploring the Science of Mindfulness

Published: LifeLines for Health, vol. 4 (Winter 2014)

by Dr. Maureen Strafford

Mindfulness is a word that we are hearing about quite a bit these days. In January, Time Magazine had a cover story called “The Mindful Revolution” with the subtitle “Finding peace in a stressed- out, digitally dependent culture may just be a matter of thinking differently.” Do a search on Amazon and 9,893 books are found with the word “Mindfulness” in the title, including a book by U.S. Congressman Tim Ryan called “A Mindful Nation.” One might think that “Mindfulness” has just been discovered by our 21st century society. In fact, mindfulness and the use of mindfulness meditation techniques can be traced back to ancient meditative and contemplative practices and are seen in many, if not all, religious traditions.

However, the practice of mindfulness techniques --- practiced in a non-religious, secular manner --- with the introduction of such techniques into health care settings, the classroom, the corporate world and even in the locker rooms of national athletic teams --- has increased dramatically over the last several decades. In 1979, Dr. Jon Kabat-Zinn introduced mindfulness meditation into mainstream medicine when the University of Massachusetts Stress Reduction Clinic was begun at the University of Massachusetts Medical Center in Worcester, MA. Patients with a variety of medical problems attended an 8-week, once a week meeting with a group of other patients and a leader. This course was called Mindfulness-Based-Stress- Reduction (MBSR) and has now expanded to thousands of hospitals across the world where many thousands of patients have found improvement in symptoms including anxiety, pain, and depression from a wide array of diagnoses.

But what do we mean when we say Mindfulness? The definition of Dr. Jon Kabat-Zinn has been widely quoted.

“Mindfulness means paying attention in a particular way; on purpose, in the present moment and nonjudgmentally.”

We have all experienced being “mindless.” We park our car in the morning and when we return at the end of the day, we have no memory where the car is. Where was our mind when we were parking our car? We
were certainly “not paying attention on purpose.” We have also experienced how one thought can spiral into an entire narrative usually of doom and gloom or negative self-descriptions or we can create a fantasy pleasurable scene and miss the unfolding of the present moment. We may experience pain and fear and anxiety that leads to panic that leads to increased suffering. Mindfulness slows down the reactive, out of control thinking called rumination. Mindfulness can help us observe the moments when our pain is different, diminishes, even disappears. The word nonjudgmental is so important. When we stop labeling every experience as good or bad, we eliminate the reactivity that causes us additional suffering.

The way we “practice” mindfulness starts with the formal practice of sitting meditation, or movement practices such as yoga, tai chi, or walking meditation. There is no “right” or “wrong” way to sit and meditate. The breath is a good anchor for our attention because it is always
there and has a changing quality to it. We may attend to the breath and have the shopping list for dinner pop into our heads and pull our attention away. As a parent firmly but lovingly moves the wandering child away from the dangerous road, so too with attention to the breath, we bring our attention back to the breath without judgment – no statements that “I’m a lousy meditator” or “This isn’t working.” With this commitment to attention and awareness, we move away from reactivity and rumination and the tendency of
the mind to create entire scenarios and screenplays that may be pleasant or unpleasant and move into the vibrant experience of the present.

While MBSR courses were blossoming all over this country and internationally over the last several decades, research on MBSR was also exploding and describing the positive effects of this practice on both physical and mental health. Research --- including a fascinating look at the brain with tools such as functional MRI (a scan of the brain where areas that are stimulated “light” up on the scan) --- began to suggest that indeed the brain can change and areas where anxiety, anger, and fear “reside” in the brain have been shown to quiet down when a person meditates. Of great interest is that the practice of mindfulness may have long-lasting effects and that the “brain” does indeed change. The “ruts” created by years of rumination, anxiety, and worry begin to “smooth over” as practice time increases. Mindfulness meditation --- even after the basic 8 week MBSR course --- has demonstrated a strengthening of the immune system, significant amelioration of depression comparable to the use of anti-depressant medications and improvement in the symptoms of Attention Deficit Disorder (ADD). The quality and quantity of excellent clinical research on the beneficial effects of mindfulness has exploded and drawn the attention of neuroscientists and other basics research scientists. Teachers, health care providers, veterans suffering from PTSD, prisoners, children and patients with a wide array of symptoms and challenges improve the symptoms of their diseases, diminish the risk of caretaker burnout, and uniformly report an improved quality of life, including improved relationships.

So how does one learn “Mindfulness” and how does one implement the changes mindfulness can stimulate?

We practice! The “formal” practice complements and strengthens the “informal” practice. The formal practice
is the time we take to “practice” observing our experience in a different way. We can practice sitting and using the breath as our anchor. We can practice yoga and observe our movements in a mindful manner.
We use the skills learned and practiced during formal sitting meditation to observe the simple activities of daily life with an energized and creative curiosity. This is the “informal practice” of mindfulness when we observe the sensation of the splash of water on our face, the feel of the weather on the skin, the taste of a small morsel of food and in this “informal” practice, we experience life in a more deeply felt manner with less reactivity and suffering. We also experience benefits in the informal practice of mindfulness when we have pain or anxiety. We may observe moments when our pain is intense and moves to areas of our body and even a moment when the pain disappears. We learn that we are not our thoughts and we can move away from the “over and over” rumination of our worried mind.

How does one train or learn more about mindfulness and how to include it as part of a health self-care regimen?

There are now programs throughout the US, many based in hospitals that may be covered by health insurance. There are also therapists who have been trained

in MBSR and offer traditional 8-week MBSR courses. A review of the UMass Center for Mindfulness website - http:// www.umassmed.edu/cfm/ - is a wonderful place to start in understanding the training required for MBSR teaching. A web search for MBSR courses and teachers in your area will be a productive place to start and after reviewing the UMass site, you will have good questions to ask when looking for MBSR courses. While programs are more limited for children, local mindfulness teachers can guideone in finding well-qualified teachers for children. There are increasing resources in books and apps that will also be helpful and asking your child’s pediatrician and teachers can also be a helpful place to start. The 8-week MBSR course
is very helpful if doing it on your own is more difficult, and the group format adds to the insights gained as one progresses through the course. For those who are interested in more individual work or want to investigate a bit more on your own before committing to an MBSR course, there are many books, online courses and apps to help you.

We have a wealth of resources to learn about Mindfulness and the effect on health, well-being and relationships. But even before one Internet search or book is ordered, remember we always have our breath. Our anchor. Sitting here reading, take a moment to find your place in your seat. Slowly bring attention to bringing your shoulders back, and moving your body into a more upright position, slowly close your eyes if that feels comfortable where you are and bring your attention to that part of your body where the breath is noted – the nostrils, the upper chest, the belly. Notice how the quality of the breath changes with breathing in and breathing out. Notice how thoughts –“I don’t have time right now.” “I think this is not going to work.” “I can’t forget to send the check.” pop into the mind like popcorn being cooked. And with the gentle firmness and kindness of the parent moving the child off the dangerous road, bring your attention back to the breath. Some days, you may find yourself pulling the wandering mind back after every breath. That’s practice .... not “bad” meditation because there is no “good” or “bad” meditation. A great start to understanding mindfulness is with you at all times --- your breath.

As a parent, you might find it helpful to do some practice and observe the positive effects with yourself before introducing some of the practices o your child. The introduction of mindfulness into the classroom has found positive results. Better classroom management and calmer children result when mindfulness has been utilized and teachers feel less stress as well. Programs such as the Mind-Up Program (www. thehawnfoundation.org/mindup) and Mindful Schools (www. mindfulschools.org) have established programs for teachers and schools.

An overview of some of the books, programs and apps available might be helpful as you seek out more information about mindfulness and how to help yourself and your family with dealing with the stress of everyday life and the particular stress of learning healthy coping strategies for chronic medical conditions.

Dr. Maureen Strafford, Associate Professor of Anesthesia and Pediatrics, Tufts University School of Medicine. The study of the effects of pediatric pain and the positive effects of mindfulness has been a career long concentration.

Recognize Your Own Resilience: And Then Build On It

Published: LifeLines for Health, vol. 4 (Winter 2014)

by Dr. Gary McClain, PhD

If you are living with the challenges of a chronic condition – or if your family member is – then this phrase most likely has special meaning to you. The successes, the frustrations, and those unexpected curveballs that can come your way.

But, yet you keep yourself going, one step at a time. How do you do it? Psychologists call that resilience. The ability to recover or adjust to misfortune or change. In other words, picking yourself up, dusting yourself off, and getting back on the path.

How’s your resilience these days?

My clients who are living with a chronic condition – and learning to roll with the ups and downs – often tell me that this experience has taught them to recognize their own resilience. They are able to tap into sources of strength, and to be resourceful, in ways they never thought possible. Yet, at the same time, one of those curveballs, or a series of curveballs, can leave you wondering if you’re all that resilient after all.

So you might ask: Are some people more resilient than others? In other words, is resilience a gift that some of are given while others aren’t so lucky? Actually, no. The good news is that resilience can be learned by following some basic guidelines for practicing resilience-building skills to develop a more resilient mindset. And practicing these skills can also help you to further strengthen your resilience. Kind of like toning up at the gym.

1. Take an inventory
Use the past as a teacher. Think about the rough spots that you have
hit over the years. What’s gone well for you? And not so well? Life’s tough lessons can leave us with a gift: experience. Review how you have dealt with challenges in the past. Use that learning to take an inventory of what’s in your resilience toolbox. This will help you to identify your strengths as well as to better understand what tools you want to add.

And then, decide to believe in yourself. Being a resilient person starts with believing in your own potential. Bolster your own self- esteem by giving yourself a daily pep talk, with messages like “I can do it” and “I’m ready to handle whatever comes my way.” Intention leads to action.

2. Stay Hopeful
Decide to focus on what’s going right in your life. Take the time to recognize the simple pleasures that exist all around you. Remind yourself of everything that is good in your life. Tell that bleak voice of negativity to be quiet, while you pay more attention to what’s possible.

3. Stay connected to your support network
Who’s in your court? Make a list of the people in your life that you count on to stand by your side when you need a listening ear, and who count on you in return. Stay in touch with them on a regular basis, including regular check-ins with each other. Schedule time together. Reach out when you’re feeling alone. Vent when you need to. Be supported and give support in return. We are all in this together!

4. Laugh (or at least smile)
Having a sense of humor is a great antidote for stress. And let’s face it, sometimes you just gotta stand back, shake your head, and laugh. Better yet, find someone who can have a laugh along with you. Humor helps you to maintain your perspective and avoid getting caught up in the downward spiral of helplessness. Humor and resilience go hand in hand.

5. Maintain your self-care
It (almost) goes without saying that, to be resilient, you need to feel your best. That means staying on top of your health by getting regular check-ups, staying in touch with your healthcare team between visits, being compliant with your treatment, and maintaining your self-care routine. By the way, this goes for children and parents! Just had to throw that in.

6. Update your knowledge – continuously
Stay abreast of the newest thinking about what you can do to take the best possible care of
yourself, and how your loved ones can take care of themselves. Medical science is constantly on the
move, so keep up with what’s new in treating your condition. Be your own expert. Knowledge is power!

7. Keep your problem-solving muscles exercised
When you bump up against a new challenge, go off by yourself and do some brainstorming. Define the challenge. Review your strengths, as well as the resources that you have to draw upon to solve it. Come up with a potential solution. By going through this process, you will have a clearer idea of what you can do, including what’s under your control, what you can’t control, and where you need help. This is resilience in action.

8. Accept that life is always changing
Humans are hard-wired to avoid change. But we know that life keeps moving, and that means that nothing stays the same forever. In other words, we aren’t in control of everything that occurs in our lives, even if we think we should be. Fighting change is like fighting against yourself, and your own potential for growth. So give up the battle and go with the flow. You’ll be surprised at how much more energy and optimism you’ll have.

9. Know who to ask for help, and then ask
Keep your resource list up to date. Part of being resilient is keeping track of the resources that you can draw upon when you need them. People who are willing and able to step inand lend you a hand or give you some guidance. Services and organizations that you can enlist. Information sources that you can tap into. Resilience doesn’t mean doing it alone, it means asking for help when you need it.

10. Have a vision for the future
Now, back to the hope thing. Take time to create a vision for the person that you want to be in life – how you want to live, what you want to accomplish, what you can do to be there for the people that you care about. Having a vision for our future motivates you to be more resilient. While you’re at it, create a vision for your family. Think: Optimistic. Realistic. Flexible.

11. And when the going gets tough... Remember that the tough go shopping
Shrink shopping, that is. If you need some additional help in strengthening those resilience muscles, then talking with a mental health professional can give you some additional perspective and help you develop new resilience skills as you face life’s challenges.

Two steps forward, one step back. But two steps forward again. Look how far you’ve come in the face of a lot of challenges. Celebrate your own resilience! And challenge yourself to build even more resilience into your life!

Gary McClain, PhD, LMHC, is a therapist, patient advocate, and author, specializing in helping clients deal with the emotional impact of chronic and life-threatening illnesses, as well as their families and professional caregivers. He works with them to understand and cope with their emotions, to learn about their lifestyle and treatment options, to maintain compliance with medical regimens, to communicate effectively with the medical establishment, and to listen to their own inner voice as they make decisions about the future. His email is: gary@JustGotDiagnosed.com. He welcomes your questions and comments.

New Pilot Program Unveiled A Patient’s Perspective

Published: LifeLines for Health, vol. 5 (Summer 2015)

by Tom Sitzler

The recent Men’s Inhibitor Retreat, hosted by Comprehensive Health Education Services with an educational grant from Kedrion, held at the Excalibur Hotel in Las Vegas on April 24-27, 2015, was very informative and definitely worth attending. Not only did I learn some things, I also created new friendships! It’s always nice to connect with others within our inhibitor family. Sometimes the most important things that I learn come from others with inhibitors. Yes, the professionals will provide important information that is useful, but by talking to others about their own experiences, resources, etc., is also helpful.

The first night in Vegas, most of us were there for supper and a social, and it was a nice way to meet people in a relaxed setting; the entire weekend was a relaxed setting. Several people were especially impressed with their dessert - can’t go wrong with chocolate!

Saturday started early with a nice breakfast and more socializing. Throughout the day we had doctors and nurses talk to us about a variety of topics. The first presenter, Dr. Mark Heiny from the Indiana Hemophilia and Thrombosis Center, spoke about different treatment options. I especially liked that he didn’t pressure us in what we should or shouldn’t be using for treatment. Our next presenter, Dr. Paul Bregman informed us of the use of medical cannabis/marijuana. He was very passionate and informative. The discussions brought up some very good questions and I learned a lot about this controversial treatment. I found it interesting that it can be made into a cream or oil. The CBD (cannabidiol, an active ingredient in cannabis) cream could be helpful during a bleed as an anti-inflammatory, and I wouldn’t be against trying it, especially if it helps with some joint relief. After an enjoyable lunch, we learned some valuable lessonson how to access veins easier. Who knew that a strong LED flashlight can help you locate a vein? That was a nice tip!

Saturday night was full of fun. We all went to the Monte Carlo Hotel for dinner and a show. After dinner we went to Blue Man Group. I can’t think of a better way to end an evening. They put on a great show; I would go see them again! Sunday morning we had breakfast and time for more relationship building. Our last presenter, Don Molter from the Indiana Hemophilia and Thrombosis Center, spoke about career counseling. This was a good opportunity for people to learn about various funding sources for college and how to pick a career that is a good fit for you. He stressed the importance of picking a career that is suitable to our interests and limitations. Overall, this was a great weekend. We had an opportunity to become more educated, meet new people, and create some nice memories.

Tom Sitzler is an adult with hemophilia and an inhibitor. He is a vocational counselor in his home state of South Dakota where he lives with his wife Shirley. Tom has served on manufacturer’s Consumer Councils and is a frequent attendee at Inhibitor Summits.

The Pavri’s First Inhibitor Family Camp: “The Painted Turtle”

Published: LifeLines for Health, vol. 5 (Summer 2015)

Written by: Farah and Porus Pavri Edited by: Yasmin Pavri

Day 1: Our very excited wait came to an end when we boarded the plane to California in April, for the first time, to attend Inhibitor Family Camp at The Painted Turtle. After a long trip from New Jersey to California, we boarded a bus which took around two hours to get to the venue. The route leading to camp was very scenic. As soon as our bus entered the premises, our Camp Director, April was there, all dressed up, to welcome us. She seemed more excited than any of the participants. Her excitement and enthusiasm could make even an antisocial person come alive!

We were dropped off near our cabins. Ours was “Yellow 3”. A beautiful cabin that fit two or perhaps even three families. The cabins were very creative on the inside and had a beautiful welcome basket and kit ready for us.

There we also met our camp counselor. His name was Dave. Such a fantastic person. His level of maturity made us feel very comfortable leaving our son with hemophilia and inhibitors with him. He was caring and went out of his way to see that our trip was all worth it.

The next person we met was a very interesting person. His name was “PUN”. He looked funny and spoke bone-tickling funny. He immediately made us feel comfortable and engaged us in some hilarious conversations. The one very outstanding quality that he had was remembering each and everyone’s names. How amazing is that? Some of us can’t remember the name of a friend or a neighbor we met two days back, but he was tremendous. He was the life and soul of the camp. Our family loved and adored him. A humble person by nature and someone who loves, simply loves kids.

Being our first camp experience, we didn’t know there were fixed times to eat and only a certain amount of minutes were given to complete your meal. It worked perfectly for parents who have fussy children that take over an hour to eat at home.

Day 2: Saturday morning we started our day with archery, ate breakfast, went horseback riding (met/saw some beautiful horses), did wood carving with POPS (made a turtle, the kids made their pine wood derby car and we also made a “PAVRI” sign key holder). Then we had lunch and the adults went for an education session while the kids had a blast with their camp counselors and enjoyed blasting rockets. After that we went fishing, had dinner and enjoyed some restful quiet time.

Day 3: By now we were a bit tired so we missed the early morning activity which we can go to before breakfast. After breakfast, we went boating, did some arts and crafts, had lunch, and the kids had a lovely time playing on the huge chess board. Later we attended a beautiful session on how to keep calm when you are in the middle of a bleed. We also learned that we must be kind and loving to the part of the body that is bleeding instead of cursing and saying bad things about it. Then it was time for the main attraction of the camp. Ta na na na.... Ta na na na... The Pine Wood Derby organized by our very own POPS. Porus really wanted his car to win and was pretty disappointed when it was eliminated in the first round :( After dinner we enjoyed the talent show in which Farah participated and played the keyboard. We went to the camp store and picked up some souvenirs for ourselves and the kids enjoyed an awesome magic show by our very own Pun.~

Day 4: Time to go home. Mrs. POPS had put together a wonderful presentation of family pictures and several other pictures taken at various activities which we saw. We had to pack and say goodbye to our friends, both old and new, and a goodbye to our cabin, and our swing outside our cabin, and the big chess board, and our wonderful counselors and friends and volunteers at the camp. Thank you Janet, Eric and Joan for inviting us and giving us this beautiful camp experience that we had only been hearing of in the past. Our kids had a blast and seeing their enjoyment gave us adults a very satisfying feeling. The environment was safe and the “Well Shell” took care of all our medical needs. Our kids still have and love their turtle pillows. Porus has “Lee” written on his and remembers his new buddy Lee fondly when he cuddles up with the pillow. We really look forward to coming back and having the same fun each year.

Follow the Heart Line (2015 Feature)

Published: LifeLines for Health, vol. 5 (Summer 2015)

Written by: Russel Friedman

Moms: “Do you remember how you felt in the moment you first became aware that you were pregnant with your child?”

Dads: “Do you remember how you felt in the moment your wife first let you know that she was pregnant with your child?”

We know that every parent, from that moment of awareness of a coming child, begins to create hopes, dreams, and expectations about the future. Every one of the images they conjure up is glorious, uplifting, and happy. “My child will be brilliant, a great artist, a gifted athlete, socially gracious, and will of course be of service to humanity and do greatworks of charity.” It may sound a little overblown, but you know what we mean. Many expectant parents vow that they will do “right” the things their own parents did “wrong.”They will love and cherish their children in better ways, so that their lives will be better.T he pledge we each make is that our children will have a better life than we had, no matter how good [or bad] our life and circumstances have been.

Some people, who had ideal childhoods [we’ve actually met a few], make a commitment to recreate and even improve the kind of loving atmosphere and treatment they recall from their youth.

THE THIRD QUESTION

The two questions that opened this article were asked in a speech we made to a group of parents who were at the first annual convention of an organization that had nothing to do with hemophilia. It was a group whose common linkage was that each member had a child, or children, who were bound up in the tentacles of drug or alcohol addiction.

None of them had imagined they would wind up in that hotel conference room15 or 20 years after their child’s birth. Nor that they would be with nearly one thousand other parents that weekend whose hopes, dreams, and expectations had also been dashed on the rocks of a condition that wreaks havoc on all who are caught in its wake.

Like them, we imagine that you never thought in the moment you learned you were going to have your child, that one day you would be reading an article like this. There was also a third question we needed to ask. It was an awkward one: “How many of you are still married to the co-parent of the child whose condition caused you to be here?” The limited showing of hands indicated a divorce rate much higher than the national average. Dealing with situations that are outside the range of normal puts inordinate pressure on marriages.

Hemophilia, and later, the complication of inhibitors, undoubtedly affect everyone concerned to their emotional cores. Along with that, each family member brings their own beliefs and feelings to the painful task of dealing with the massive loss of shattered hopes and dreams.

Many people carry forward the emotional reactions they had to other grief-related events that affected their lives. Like most of us, rather than beingtaught how to effectively grieve and complete their relationship to what had happened, they learned to bypass those feelings, to bury them out of sight and out of mind.

But the reality is that if you don’t deal with those feelings, eventually they will deal with you, and potentially, with some very negative consequences. Until you deal effectively with the emotions that you may have stored, it can be exponentially difficult to deal with the ongoing emotions that are constantly provoked by living with a condition that requires 24/7 hyper- vigilance. In guiding people who must deal with the daily confrontation of an ongoing condition, we have helped a great number of them not become divorce statistics. We will pass some of that help on to you in this article.

MY GET UP AND GO, GOT UP AND WENT

Our experience with grieving people suggests that there are two things that almost universally impact everyone whose lives have been affected by losses of all kinds. First, is they have a very hard time concentrating, and second, is the ongoing grief drains energy. While this is typical in the early days following a death or divorce, it can be constant when dealing with a continuing situation, as is the case with parenting a child with hemophilia and an inhibitor.

The inability to focus or concentrate looks like this: You walk into a room to do something and then have no idea what you wanted to do when you get there. That’s just one example. We’re sure that you can think of other ways in which you have found it difficult to keep your mind, body, heart, and soul all in the same place at the same time. Having to be on high alert at all times is physically draining and emotionally exhausting. Dealing with an ongoing condition that requires both physical and emotional attention tends to deplete our capacity to bemost effective. We can feel as if we’ve been ground down to nothing.

Because of the potential for emotional exhaustion, we believe it essential that you learn how to deal with any emotions you’ve stored up over time, and how to deal with the ones that crop up daily. One benefit of dealing directly and effectively with your emotions is that you will be able to focus better on all aspects of your daily life and participate fully in all of the relationships that are important to you. And you will be able to stay emotionally present for your child and others who are important in your life.

DON’T FEEL BAD— HERE HAVE A COOKIE, YOU’LL FEEL BETTER

Advising someone who obviously feels bad not to feel that way makes no sense at all. To illustrate, we use the classic story of a child who comes home from pre- school with tears in her eyes. Her mom or dad asks, “What happened?”, and the child responds, “The other little girls were mean to me.” To which the parent says, “Don’t Feel Bad, here have a cookie, you’ll feel better.”

In reality, the cookie doesn’t make the child feel better, it makes her feel different. She has merely been distracted from her hurt feelings. And, she has been told by her parents whom she trusts, not to feel bad—even though that makes no sense at all. She has also been taught that when she feels bad she should medicate herself with a substance, in this case, sugar.

Ten years later, we act surprised when after her first romantic break-up, she starts drinking beer
or smoking marijuana to push away her hurt feelings. Yet, she’s doing exactly what her parents taught her—treating her feelings with substances. Those actions are the result of the well-intended, but misguided, idea of trying to tell someone not to feel bad when they already do.

Another parallel is any attempt to help our mates by trying to shift them from their normal feelings of fear about what might be happening with their child to the intellectual or spiritual ideas that would remove those feelings. Sad, painful, or negative feelings are natural and even serve a purpose. Anything that indicates that we shouldn’t have them is counter-productive and removes some of the safety and trust that partners need to have with each other and with their children.

A better response to the little girl, instead of the offer of cookies, would be, “Ouch, how sad for you to have
your feelings hurt. I can remember that happening when I was young, I didn’t feel good either.” Usually, a parent doesn’t need to say much more than that and the child feels heard and is ready to go out and play. Sometimes the child will want to talk more about what happened and that’s okay, too. But first you must really hear the hurt feelings, and not try to fix them, just acknowledge them.

BE STRONG OR BE HUMAN – PICK ONE

It’s not uncommon, in the face of a medical diagnosis, for each parent to react differently. Each of us has our own style of communicating [or not] the feelings we are feeling. It is at this point, that a gender-based socialization may play a role. There’s a lot of talk about gender and feelings, but we have never been able to correlate happy or sad feelings exclusively to either males or females. One of the major myths we all learn in childhood, is the incorrect idea that when faced with losses, we must BE STRONG and/or, BE STRONG FOR OTHERS.

Men, seeing the emotional impact the diagnosis of their child’s condition has on their spouses, will often try to “Be Strong” for their wives. Even though those men are also emotionally affected, they sometimes perceive it as their job to take care of their wives. In so doing, they often push theirown emotions about their child’s condition aside, in an attempt to come to the aid of their wives. When the man hides his emotions in an attempt to be strong for his wife, his non- display of emotions will appear to his wife as if he doesn’t care and doesn’t love their child. Nothing could be further from the truth. He cares and loves, but he’s trapped inside the idea that in order to “Be Strong” for his wife, he must not show his feelings.

Compounding the issue is that it’s not uncommon for both parents to try to Be Strong for their child, who then receives very mixed messages, as his parents’ verbal and non-verbal communications don’t match. This is very confusing for the child who’s having his own struggle adapting to the reality of his condition.

We think to be open, honest, and emotional is what strong really looks like. We’d like to give you a choice: You can Be Strong or you can Be Human, pick one!

FEELINGS AREN’T BROKEN – THEY DON’T NEED TO BE FIXED

Your spouse is no different than your child when feelings are the presenting issue. He or she needs to be heard and not fixed, and definitely doesn’t need to be given substances to cover up feelings. So if your mate has a long face and you ask what happened, and they say, “I’m really scared, I think Joey’s having a hard time,” you must NOT respond with “Don’t Feel Bad.”

Your response would be better if it sounded something like, “Yes, I can hear that you’re scared, and I’m worried also.” Think about the impact of that give and take: No judgment of the other person’s feelings, no attempt to switch the first partner from heart to head, and the creation of a stronger connection by telling your own emotional truth. All of that reinforces trust and safety between the couple at a point when they are really needed.

LISTEN WITH YOUR HEART, NOT YOUR HEAD

No matter when the diagnosis hits your family, it’s not too late to start using this new and better idea for debriefing each other on a regular basis. After all, hemophilia is going to remaina central part of your life. The constant stimuli that create emotions in each member of your family are not going to stop. You must become better equipped to deal with the frustration of living with and managing the situation, which includes the never-ending reminder of the original hopes, dreams, and expectations you had for you and your child.

The little girl in the pre-school/ cookie scenario could just as well have been a little boy.
Both genders are subject to the “cookies for feelings” trade off negotiated by adult guardians. And though we did mention that gender sometimes plays a part in how we behave in a crisis, there are no hard and fast rules as to which partner might be “strong” and which one might be “emotional.”

Within many couples, both partners try to give unsolicited opinions and advice—even though none were asked for. When your mate or child tells you how he or she feels, what they most need and want is to be heard, not fixed.

Our final word on this is, “Listen with your heart not your head.” Be a heart with ears. Do that for each other and your relationship to each other will expand as will your ability to really hear your affected child, as well as any other children you may have.

LISTENING VS. HEARING: A DISTINCTION WITH A DIFFERENCE

There’s a world of difference between listening and hearing. Unfortunately, because we’ve learned to incorrectly separate happy and sad feelings, and to discourage the expression of the latter, we’ve madea significant portion of our feelings out of bounds. One result of that emotional inequity is that we’ve also learned the bad habit of responding to sad feelings from an intellectual perspective.

On the other hand, we never try to convert other people’s happy feelings into their intellects, only the sad or scary ones. That makes no sense when someone is trying to tell us about a feeling. You must apply some diligence to develop this new habit of really hearing what is being said. The comment, “I’m really scared that Joey’s having a hard time,” is a very clear and honest statement of feeling. It is not a call for an opinion or advice.

At the very least, you must acknowledge hearing your mate. If you have a “me too” to add, by all means do so. But never contest or argue with a feeling.

CREATING A “NO- ADVICE” ZONE

In today’s world it’s often true that both parents work in jobs outside the home. As the divorce rate indicates, this can add emotional pressure to marital relationships. In families with one or more children with hemophilia, it is not uncommon for one of the parents to be the full-time, hands-on care provider for the children, while the other is out there in the work-day jungle. The at-home job, while different from the one outside the home, is equally pressure packed and exhausting

As the returning worker needs to debrief his or her day, so does the stay- at-home worker, who may have been dealing with emotional forces that expand the boundaries of reason and patience. Different jobs can never be compared, so it can never be presumed that one set of pressures is worse than another.

Both sides of the communication spectrum must be present for each partner to benefit. Telling the truth about the events and feelings that affected your day is not possible if your partner doesn’t listen or hear effectively.

The obvious solution is that both partners need the opportunity to safely spill out the good, the bad, and the sometimes ugly, that affected their day. Telling the truth and being heard is the only way to avoid loading up a time bomb that will explode on you when you least expect it.

PRACTICE, PRACTICE, PRACTICE.

Make a pact with yourself not to offer unsolicited opinions or advice. They almost always rob the other person of dignity. Here’s a little trick to help you develop the new habit. If your mate [or child] has told you something, especially about their feelings, and hasn’t asked a question, don’t offer an opinion or give advice.

Practice listening to feelings without offering solutions that weren’t requested.

However, as you listen, you might be bursting to tell them what you think about what they said or how they feel. If so, you can ask this, “I have an opinion about that, would you like to hear it?” If they say “yes,” by gosh, you can tell them what you think. If not, you no longer have an opinion. It’s that simple.

People often tell stories that are wrapped around the feelings they are trying to communicate. The most important parts of those stories are the feelings they contain.

Practice listening to the “heart line” not the storyline.

We know it’s one thing to tell you to do something and another to tell you how to do it. Here are some tips that will help you hear your mate and your children better.

  • Listen with your heart, not your head. Allow all emotions to be expressed, without judgment, criticism, or analysis.

  • Recognize that feelings are emotional, not intellectual. Feelings do not need to be understood, just expressed and heard.

  • Avoid the trap of asking, “What’s wrong?” The automatic response is “Nothing.”

  • Go first. Instead of asking someone how they feel, tell the truth about your own feelings. That will create safety for the other person to open up.

  • Be patient. Don’t force others to talk about feelings.

  • Never say “Don’t feel sad” or “Don’t feel scared.” Sadness

    and fear, the two most common feelings attached to loss of any kind, are essential to being human.

Who knows? Maybe they’ll hear your heart too.

Russell Friedman is Executive Director of The Grief Recovery Institute Educational Foundation, and co-author of The Grief Recovery Handbook, When Children Grieve, Moving On, Moving Beyond Loss, and The Grief Recovery Handbook for Pet Loss . Please visit the website at: www.griefrecoverymethod. com, which features many articles on Grief Recovery.

Everybody Gets to Have a Bad Day Once in Awhile

Everybody Gets to Have a Bad Day Once in Awhile

Published: LifeLines for Health, vol. 5 (Summer 2015)

by Dr. Gary McClain, PhD

Our family members can certainly be a joy. Except when they’re not. In the right place at the right moment, even someone you love can seem like a pretty bad person, like when a family member:

  • Accuses you of not holding up your end on the household chores, when you’re doing the best you can

  • Tells you to “just think positive” when you try to talk about the challenges you’re dealing with

  • Criticizes you for neglecting some aspect of taking care of a family member – or yourself – without understanding what really happened

  • Just plain ignores you

When one member of the family is living with a chronic condition, everybody in the house is living with it because everybody is affected. And dealing with the challenges of a chronic condition can put your emotions on edge. Especially those days when you don’t feel so well, or when you’ve had yet another problem to solve, or when you feel like you’re spinning your wheels and not getting anywhere.

When you’re feeling on edge, a supportive family member can makea positive difference in your life by giving you the encouragement you need to have a better day. A smile, a few caring words, an offer to give you a helping hand... Who doesn’t feel better when a little love is tossed in their direction? And after all, isn’t that what you do for everyone else?

On the other hand... some days, family members aren’t able or willing to provide that encouragement and, instead, say something angry, or hurtful, or just not seem to care at all.

Wow! I thought you loved me! What happened!

So if you are having one of those dark cloud days – and so is your family member – your cloudy day and their cloudy day on the same day equals the perfect storm. And when the storm hits, all you can see is what’s in front of you. Something relatively small – like the actions of a family member – may suddenly look very large. So large that, in fact, not only are their actions magnified, but so is the impact of these actions on your day. Those words of impatience may feel like the harshest thing they could ever say to you. Or, not noticing that you need some help may feel like the ultimate rejection. How could you possibly be this way!!!

What’s important to consider is that turning your loved one into a bad guy doesn’t make you feel any better, or at least not for long. It just gives you a target for your frustration. Along with an excuse to let your feelings bubble up and boil over, and shove reason and rational thinking off into the corner. You end up feeling that all of that negativity is justified. That means more suffering, and stress, for everybody in the house!

Making a family member the bad guy can drive a wedge between the two of you. You risk damaging a relationship with someone who plays an important role in your life!

So... when you’re having one of those days when your reactions to other people are a little over the top, here are some ideas to consider:

Take a step back and look at the situation objectively

Yes, our loved ones do things that disappoint us or make us mad. But the frustration or anger or disappointment that you are feeling may be part ofsomething much bigger, something going on with you. The people who are closest to us can also be the closest target for our frustration. Is it your family member, or is something else bothering you?

Try to identify what button is being pushed

When someone isn’t very helpful, or is unkind, we can be remindedof all the other times in our life when people weren’t very helpful, or treated us poorly, or bullied us. And feel that pain again. And when we are feeling this way, old resentments that we feel toward a loved one – resentment that we thought we had left in the past – can suddenly bubble up. Yes, it’s about that person, but it might also be about a lot of other people in your past. Do you see the pattern? Is there something that the two of you need to talk about and resolve? Or is it something that you need to do some more work on letting go of?

Stand back and get a wider view

Your family member’s current behavior may stick out like a sore thumb, but isn’t there more to the relationship than this moment in time? What do you most value about your relationship? What do you most admire about them? Recall a time when your family member was there when you needed them. Or a fun time that you enjoyed together. Or the loving manner in which they treated you yesterday. In other words, look at the big picture.

Consider the possibility that someone else is also having a bad day

It’s only human to have expectations for the people in our lives who are closest to us. But let’s face it; people don’t always meet our expectations. Your loved one may have something going on that they aren’t ready to share, or don’t know how to share. Is there anything you can do to make their day better?

Keep in mind that time doesn’t always heal all wounds

When someone close to you disappoints or angers you, it is easy to react by cutting them off. But when we stop communicating with someone, our minds have a way of rewriting the story, making the wound that much deeper, and turning a misdemeanor into a major crime. How about getting the communication going again, maybe starting out with making a kind gesture of your own, or offering to talk things out. Don’t let a tiff turn into a tragedy.

Do what you can to keep the communication going

Accept what you can’t do. Some family members may be unable or unwilling to be supportive, or at least as supportive as we need them to be. Expand your social network by bringing more supportive and caring people into your life. Let’s give everybody in the house some breathing space, starting with allowing each other to be human. After all, we are all in this together!

Gary McClain, PhD, LMHC, is a therapist, patient advocate, and author, specializing in helping clients deal with the emotional impact of chronic and life-threatening illnesses, as well as their families and professional caregivers. He works with them to understand and cope with their emotions, to learn about their lifestyle and treatment options, to maintain compliance with medical regimens, to communicate effectively with the medical establishment, and to listen to their own inner voice as they make decisions about the future. His email is: gary@JustGotDiagnosed.com. He welcomes your questions and comments.

504 or IEP Making Sense of It - All!

Published: LifeLines for Health, vol. 5 (Summer 2015)

by Janet Brewer, M.Ed

There are two federally mandated plans that all school age students are entitled to. States also are mandated to provide special education services or related services and accommodations to children with a diagnosed disability.

IDEA-Individuals with Disabilities Education Act- 1974 Amended 2004

IDEA requires states to provide a “free appropriate public education” to children with disabilities so they can be educated to the fullest extent possible with other children. If qualified, children are provided with special education AND related services under an Individualized Education Plan.

Disabilities Include:

• Physical, sensory, mental or emotional • Emotional Disturbance
• Orthopedic Impairment
• Hearing-Vision Impairment• Autism• Traumatic Brain Injury
• Other Health Impairment
• Intellectual Disability
• Specific Learning Disability
• Multiple Disabilities

If your child is diagnosed with any of the above disabilities AND they require specialized instruction-they qualify for an INDIVIDUALIZED EDUCATION PLAN.

Specialized instruction is defined as adapted instruction designed to meet the unique need of the child with a disability. The content, methodology or delivery of instruction is changed to ensure the child’s access to the general curriculum.

Section 504 of the Rehabilitation Act of 1973

This Act’s focus is on non-discrimination. It maintains “no otherwise qualified individual with a disability will be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance”.

American with Disabilities Act 1990

ADA is almost like an extension of Section 504. It provides for the elimination of barriers related to accessibility for the disabled to buildings, transportation, and communication.

Both 504 and ADA provide related services and accommodations to qualified individuals with a disability through a 504 plan. Its intent is to provide access or remove barriers
to participation. It provides students with the same rights and services as their “NON Disabled Peers”.

How a Bleeding Disorder Fits In:

IDEA-Other Health Impairment

IDEA defines Other Health Impairments as due to chronic or acute health problems such as asthma, attention deficit disorder, crohn’s or hemophilia and adversely affects a child’s educational performance.

ADA/504-Medically Related Disability

ADA/504 defines a Medically Related Disability as a physical or mental impairment that substantially limits one or more major life activities or those basic activities that the average person in the general population can perform with little or no difficulty. The individual has a record of such impairment and is regarded as having such impairment.

How Does My Child Qualify?

If there are NO academic, behavior or emotional concerns:

Make an appointment with your building principal/ADA coordinator, teacher (s), and school nurse and ask to develop a 504/ADA plan.

If there ARE academic, behavior or emotional concerns:

Write a letter to your child’s teacher asking for a formal evaluation process stating your concerns and submit it to the school. The school has an obligation to complete all assessments in the areas of suspected disability (ies) within 60 calendar days.

When assessments are complete:

1. A meeting will be scheduled

2. Reports will be shared with you regarding your child’s abilities

3. The Student Assist Team will then decide if your child: 

a. Has a disability
b. Requires specialized instruction in order to make process

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What are Related Services?

Related services may include:

• Speech/language therapy
• Audiology (hearing loss)
• Psychological
• Physical/Occupational therapies
• Counseling
• Rehabilitative counseling 
• School health services
• Transportation

For Example:

If you are comfortable with your school district’s physical therapist then PT could be included on your child’s ADA/504 plan and they could receive physical therapy during the school day. Providing the therapist with additional information on physical therapy with an individual with hemophilia will probably be necessary, as well as contact information from the ordering physician to be sure the therapist proceeds slowly.

What Accommodations Can Be Provided?

Reasonable accommodations are provided to remove barriers related to access. For example: If your child is on crutches, ambulating safely in the hallway is a barrier. Allowing extended travel time around the building removes that barrier. An extra set of books to prevent a heavy backpack and subsequent shoulder bleeds. A locker that is accessible from a wheelchair at the end of the row is more accessible.

Maintaining open and honest communication with your school district enables your child to be more successful. Stating your needs in a detailed, positive manner yields better results. Most school districts are very responsive, but they are working with tight budgets and are often understaffed. Letting them know that you appreciate their efforts on behalf of your child goes a long way. Also remember, there may come a time that your child may not want these accommodations such as leaving early from class while on crutches or a wheelchair as it calls unwanted, sometimes intrusive attention. More than anything, our children just want to fit it. Let them make those decisions. Their social interactions with peers are just as important, if not more important than leaving class early. Or, there are times that it is ok to “play the hemophilia card” and invite a special friend or attractive classmate to push their wheelchair or carry their books!

Sources: Federal Regulations Part 300



Is It Time to Be Kind to Yourself? Ten Steps Toward Self-Compassion

Published: LifeLines for Health, vol. 6 (Winter 2015)

by Dr. Gary McClain, PhD

“You knew that would happen!” “Can’t you do anything right?” Or how about: “Idiot!”

Who’s saying all those mean things to you? Most likely, your own harshest critic. YOU!

We human beings sure can be tough on ourselves. Pointing out our own mistakes. Our misjudgments. Anything we do that falls short of a demand we didn’t meet. All too often demands we created for ourselves and that weren’t realistic in the first place.

And just where does that critical voice come from? I suspect it’s a voice we hear
as children, maybe from parents who criticized and scolded when we were judged as not having met the demands that were placed on us. Or teachers. Maybe other kids. Somewhere along the way we learn that when we make a mistake, or can’t quite perform as well as someone else thinks we should, we’re going to hear about it. Often with some pretty harsh words.

Sure, criticism can make us better. That’s probably what was behind all that criticism that came your way as a child. Or at least that’s what you were told.

Turn Off the Self-Criticism and Replace It With Kindness

But what happens is that, as we become adults, that baton magically gets passed to us. And unfortunately we latch onto it. By doing so, we invite those critical voices into our minds, and give them free reign to sound off at will. And do they ever take advantage of every opportunity! While compassion for ourselves gets pushed off into the corner.

If you’re living with a chronic condition, or have a family member with
a chronic condition, you know about demands. The chronic condition places all kinds of demands on you, every day, even throughout the night. And with each demand, another reason to be hard on yourself when your performance doesn’t quite measure up.

Let me ask you something: Have you ever thought about the toll it takes on you when the person in the mirror always has a good scolding at the ready, just waiting to unleash it? That’s a lot of pressure to live with. And another question: Is it possible that you might be demanding a little too much of yourself in some areas of your life? And how about this: Is all the scolding the only way you have to keep yourself motivated?

You’ve heard that expression, with friends like you, who needs enemies? So I have to ask: Are you being a friend to yourself? And I have to add something here. When you’re that hard on yourself that becomes your view of the world. And that can translate into being hard on other people, too.

Compassion starts with being kind to yourself. Here’s how to get started.

SET PRIORITIES

Sit down with yourself and think about what you really need to do to take the best possible care of yourself. Focus on the basics, what you need to do to maintain your optimal health, physically, emotionally, and in your relationships. Make a list. And a schedule. These are your priorities. (And don’t forget: If you are taking good care of yourself, you are all that more able to take care of others.)

REMINd YOURSELF THAT NOT EVERYTHING IS A CRISIS

One of the best ways to give yourself a rough time is to look at anything less than perfection as an absolute catastrophe and then make yourself at fault. Take a step back and consider the situation. Let’s say you slipped up on your compliance, or made a mistake in judgment. Is this something that can be fixed? Do you know how to get things back on track? And if not, is there someone who can help? All that energy spent on self-criticism can be channeled toward finding a solution.

FOCUS ON THE BIG PICTURE

Who knows, you may even decide that what felt like a crisis at the moment was only a bump in a much longer road. What a relief, right?

LOOK FOR THE LESSON

Here’s where you have a choice. You can look at a mistake or a setback as a reason for punishment, and call yourself lazy, stupid, etc. Or you can turn this into an opportunity for learning. Try this: “Oh, so that’s what happens if I.... At least I know how to avoid this problem in the future.” And then move forward, that much more educated.

WATCH YOUR SELF-TALK

We spend our waking hours talking to ourselves. Evaluating, predicting, explaining... judging. And it’s that judgment talk that can make us very unhappy. So be more aware of your self-talk. When you feel the critical voice gearing up to let loose with a good old scolding, tell him/her to be quiet. And then engage that kindly, compassionate voice that’s been cowering in the corner for too long.

GIVE YOURSELF A BREAK

Ask that voice of kindness for a little pep talk. Remind yourself: “I’m human. I’m trying hard. This is not an easy road. And I am doing the best I can, even if not everything I do is perfect.” Having trouble conjuring up that voice? It might help to sit down with a sheet of paper and do some journaling. Give yourself a positive self-talk script you can read when you need a lift. Try some affirmations. Start out with: “I am a work in progress. I get better every day.”

AND LET YOURSELF FEEL

One of the ways we punish ourselves is by telling ourselves that we shouldn’t be feeling the way we feel. But there is no right or wrong way to feel. So as emotions come up, don’t swallow them. Let yourself feel, whether that judging voice approves or not. Sad, mad, afraid. It’s all part of being human. That’s being kind to yourself.

REPLACE PUNISHMENT WITH REWARDS

Chances are, if you are letting loose on yourself with that critical voice, you may also be punishing yourself in some way. Avoiding people. Not doing things you know you would enjoy. Pushing yourself to overwork. What if you gave yourself some rewards when you meet an expectation you have for yourself? This is a way to shift your focus to what’s going well, and to give yourself some encouragement to keep up whatever you’re doing that got you there. Indulge in something you enjoy that promotes your wellness, a little break, a favorite activity, some fun with a loved one. You deserve it!

LET SOMEBODY HELP

Limit your time with people who take away the need to criticize yourself because they are so good at doing it for you. Instead, try to surround yourself with people who bring out the best in you. Be kind back. Kindness leads to more kindness. And it sure feels a whole lot better than criticism!

SMILE AT YOUR IMPERFECTIONS

Nobody’s perfect. Now, how do such imperfect people manage to dress themselves in the morning? It’s a mystery. We’re all so imperfect that we just have to shake our heads and laugh at ourselves sometimes. How’s that for lightening up?

You’re dealing with a lot. So how about giving yourself credit for doing the best you can? Show yourself some compassion. And some love while you’re at it. Be kind to yourself.

Gary McClain, PhD, LMHC, is a therapist, patient advocate, and author, specializing in helping clients deal with the emotional impact of chronic and life-threatening illnesses, as well as their families and professional caregivers. He works with them to understand and cope with their emotions, to learn about their lifestyle and treatment options, to maintain compliance with medical regimens, to communicate effectively with the medical establishment, and to listen to their own inner voice as they make decisions about the future. His email is: gary@JustGotDiagnosed.com. He welcomes your questions and comments.

504 Plans: When Good Plans Go Wrong, Part One

Published: LifeLines for Health, vol. 6 (Winter 2015)

by Janet Brewer, M.Ed

So, you have worked closely with your school’s team to develop a carefully crafted 504 accommodation plan for your child (and if you haven’t, do so!) The accommodations seem reasonable and the school has agreed it is their responsibility to make sure it is followed across all content areas, including specials. Everything seems to be going fine then, ROAD BLOCK - your child is struggling.

Some potential struggles:

  • The substitute doesn’t let your child go to the nurse if s/he is in pain resulting in a bleed that takes longer to recover.

  • Your child is told they “can’t go out for recess because it is too dangerous.”

  • Your child’s class is going on a field trip and your child is told s/he can’t go because “they can’t provide a nurse, or the building isn’t wheelchair accessible, or it might be too risky.”

  • The second semester teacher won’t provide your child with an extra book saying, “there aren’t enough.”

The list of reasons, aka “excuses”, could be endless! By now, you probably get the picture and most likely have dealt with at least one these scenarios or a more severe scenario! (I have heard many of your stories and they make me shudder). Each of these examples is a violation of your child’s civil rights. Yes, civil rights. Remember, a 504 accommodation plan is developed under the Americans for Disabilities Act, a federal law designed to remove barriers, prevent discrimination and to provide your child the same experiences as every other child in their classroom, school or school district.

Section 504 of the Rehabilitation Act of 1973

This Act’s focus is on non-discrimination. It maintains that, “no otherwise qualified individual with a disability will be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance”.

In addition, the Office for Civil Rights also has responsibilities under Title II of the Americans with Disabilities Act (http:// www2.ed.gov/about/offices/list/ocr/disabilityoverview.html) of 1990 (ADA) that prohibits discrimination based on disability in any program or activity operated by recipients of federal funds and prohibits discrimination based on disability by public entities, regardless of whether they receive federal financial assistance. This may have the potential to apply to children who are in private school (http://www.ada.gov/t2hlt95.htm).

Americans with Disabilities Act 1990

ADA is an extension of Section 504. It provides for the elimination of barriers related to accessibility for the disabled to buildings, transportation, and communication.

Both 504 and ADA provide related services and accommodations to qualified individuals with a diagnosed disability through a 504 plan. Its’ intent is to provide access or remove barriers to participation. It provides students with the same rights and services as their “NON Disabled Peers”.

What does this look like?

If your child’s friend Sean can go on a field trip or play on the playground, it is the school’s FEDERAL obligation to provide the related services and accommodations so that your child can participate in the same activities. What is available to one student is available to all! Equality!

The Office for Civil Rights is the governing body whose mission is to ensure equal access to education and to promote educational excellence through vigorous enforcement of civil rights in our nation’s schools. A complaint of discrimination can be filed by anyone who believes that an education institution that receives federal financial assistance has discriminated against someone on the basis of race, color, national origin, sex, disability, or age. The person or organization filing the complaint need not be a victim of the alleged discrimination, but may complain on behalf of another person or group. (http://www.hhs. gov/ocr/civilrights/complaints)

Examples of the types of discrimination prohibited include inequitable access to educational programs and facilities, denial of a free appropriate public education for elementary and secondary students, and refusal to implement or inappropriate implementation of academic adjustments in higher education.

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The HOPE is that you never reach a point where you need to contact the Office for Civil Rights. If you feel as though the accommodations or related services in your child’s 504 plan are not being provided, you must act in a calm, controlled manner to rectify the situation by:

  1. Speak with your child’s teacher. There is
    a “chain of command” that is an unspoken tenant of most school systems. The first point of reference is the classroom teacher (at lower grade levels). If your child has more than one teacher, you may want to contact the 504 coordinator. If you remain unsatisfied, the principal would be next.

  2. Schedule a meeting with the building principal and outline your concerns. Remember, documentation is your friend! Keep a notebook, document all conversations with a date & time stamp and always keep your email communications!

Keep in mind, stay calm, be professional and always refer to the situation as a team approach! “How will we as a TEAM provide the services to my child with a disability to be successful?” If you continue to encounter resistance, inform the principal that you will be speaking with the district’s ADA coordinator and/or superintendent.

Schedule your meeting with the ADA Coordinator and use your notes and an open communication style. Explain why you believe your child’s rights are being violated. Make it clear that you have exhausted all steps with the school district and have no recourse but to contact your local Office for Civil Rights. In the majority of cases, the situation will be rectified at the level of the OCR, ADA Coordinator, or Superintendent. The school district will be subjected to an investigation by OCR that could potentially reduce federal funding for the school district.