Healing: Receiving Serious Health Diagnoses, Anger & Bargaining Responses

 Today we are briefly discussing the anger and bargaining phases of the grief model outlined by Elisabeth Kübler-Ross. 

Receiving Serious Health Diagnoses

When a person receives a cancer or aortic dissection or aneurysm diagnosis, after the initial shock and denial phase, they may experience the anger and bargaining phases. These stages are characterized by anger directed at various sources, manifesting in numerous ways and also often an attempt to negotiate, usually with a higher power, in a desperate hope to reverse or lessen the reality of their situation.

During the anger phase, it is crucial for the individual with the diagnoses and their loved ones to understand that this reaction is a normal part of the shock and grieving process. As we mentioned in the previous post, mental health professionals can provide essential support during this time, helping the individual express their anger in healthy ways and explore the feelings underlying their anger.

Some of the ways anger may be expressed by persons diagnosed with aortic dissection and/or cancer can include:

Anger at the Unfairness: After the reality of the diagnosis sets in, it is common for individuals to feel a deep sense of injustice. They may question, "Why me? Why now?" This anger can stem from the perceived randomness and unfairness of their situation, especially if they have been living a healthy lifestyle or are young with many unfulfilled plans. I personally have asked the ‘why me’ question time and time again.  This reaction is normal and I now acknowledge these feelings as valid when I begin to dwell on the ‘why me’ questions.

Anger at Physicians and Health Care Providers: Some people may feel anger towards their physicians or healthcare providers. This can result from frustration with perceived delays in diagnosis, dissatisfaction with the course of treatment, or simply as a transference of their fear and helplessness.  I personally am so over directing anger at my doctors.  After years of dealing with both my diagnoses and my doctors I am frankly just tired of blaming anyone, including my attending health care professionals. However for others, blaming doctors is a recognized emotional response.

Anger at God or a Higher Power: For those with spiritual or religious beliefs, anger may be directed towards God or a higher power. Individuals may feel abandoned or punished and may struggle with their faith during this challenging time.  I've been there done that with this type of anger.  Today my world view has more of a Daoist flavor so there aren’t really any ‘Gods’ or ‘Personal Higher Powers’ that could even hear me.  But for those with beliefs in a higher power, this avenue of blame is normal.

Anger at Oneself: There can be feelings of self-blame, especially if the individual believes their lifestyle choices may have contributed to their illness. They may also feel frustration at their body for "betraying" them.  Today, after many years, I’ve learned to love myself for whom I am, dissection and cancer and all.

Anger at Family and Friends: It's also common for individuals with a terminal illness to experience anger towards their family and friends. This can stem from a perception of being treated differently or from frustration over others' inability to fully understand their experience.  Caregivers, family and friends have it as hard as us, IMHO, in dealing with those of us that were diagnosed with these serious illnesses.

It's important for loved ones and caregivers to practice patience and empathy, avoiding taking any anger personally. Encouraging communication and providing a safe space for the individual to express their feelings can be beneficial. Over time, as individuals processes their anger, they may move towards the other stages of grief, such as the other phase we are going to briefly discuss here, the bargaining phase.

As for the bargaining behavior often experienced, here are some ways bargaining behavior may present:

Negotiations with a Higher Power: A person may seek to make a deal with God or a higher power, promising to live a better life, devote themselves to service, or make other significant changes in exchange for a cure or more time. 

Regret and Remorse: The individual may spend a lot of time thinking about what they could have done differently to prevent their illness. They may regret past lifestyle choices or not taking symptoms seriously earlier. This period is often characterized by guilt and self-blame.

Revisiting Past Choices: The person may start obsessively considering different scenarios in which their illness could have been prevented. They might think about what could have happened if they had made different decisions about their health, diet, or medical treatment.

Seeking Alternative Treatments: In their desperation to find a cure, the person might start exploring alternative treatments and remedies, often in cases where conventional medicine has provided no solution or hope.

It's important to note that, like all the stages of grief, both the anger and bargaining stages are not experienced by everyone, and can occur in any order. Additionally, these stages are not rigid categories, but rather part of a framework to help us understand the typical emotional process involved in dealing with terminal illness.

It's also crucial to approach a person in the anger and bargaining stages with empathy and patience. Many of us are grappling with the harsh reality of our imminent mortality and are seeking to exert some control over our situation. Mental health professionals can provide invaluable support during this stage, helping us process our emotions and gradually move towards acceptance of our diagnoses.  Like my mother used to say, “after ten years its not the first thing we think of when we wake in the morning”.

I’ve found that dealing with these serious medical diagnoses is a journey, one that has many twists and turns.  For me, acceptance of my diagnoses took time.  Today my understanding of the grief processes has led me to appreciate each and every breath and moment.  Next post we will discuss the last two remaining phases of diagnosis grief; depression and finally acceptance.  Many blessings as always, Kevin.

Healing: Receiving Serious Health Diagnoses & Survivorship

 When diagnosed with a life-threatening illness, such as cancer or as in many of our cases an aortic rupture or dissection, we may often experience a range of emotions and psychological responses. 

Me wearing a wound vac and chillin after my second open chest aortic procedure

The response to such life impacting news can be likened to grief, as we grapple with the loss of our former "perceived as OK" health status and we begin to confront own own mortality. The processes we encounter often mirror the five stages of grief and loss initially outlined by psychiatrist Elisabeth Kübler-Ross in her book “On Death and Dying”.  If you've never read this book you should.

Here's a brief look at these stages as applied to any diagnosis of a significant medical condition or illness but especially written here for aortic dissection/aneurysm or and/or cancer survivors as these challenges are two I am personally familiar with:

1. Denial: This is often our first reaction. We may not accept the diagnosis or may think there has been some mistake in the test results. Denial serves as a psychological defense mechanism that helps us cope with the initial shock of diagnosis.
2. Anger: As the reality of the situation sets in, we may feel anger and resentment. This can be directed toward ourselves, our doctors, loved ones, or even a higher power. I kept asking myself, "Why me?"
3. Bargaining: This stage involves negotiating or pleading with a higher power, doctors, or even oneself. We may seek to make lifestyle changes, try alternative treatments, or adopt healthy habits in the hope of reversing the disease.
4. Depression: This stage is characterized by feelings of sadness, hopelessness, and despair. We may become overwhelmed by the potential implications of our disease, including pain, disability, and especially the prospect of our untimely death.
5. Acceptance: Over time, we may reach a stage of acceptance. We acknowledge the reality of our situation and may start to make plans for our future care or end-of-life arrangements. This stage is not about being okay with the cancer or aortic dissection but rather about acknowledging our physical and mental challenges and working with our diseases rather than fighting against them.

These above stages are not linear and we may cycle through them multiple times, even experiencing more than one stage simultaneously. Importantly, not everyone will experience all stages, or in this order.

Receiving support from mental health professionals, such as psychologists or counselors, can be vital during this time. Health care professionals can provide strategies to cope with our trauma and emotions associated with our diagnoses. Additionally, joining support groups, either in-person or online, can also be beneficial, providing a platform to share experiences and feelings with those who are going through a similar situation.  Facebook support groups have been a tremendous help for me and I know for many others.  I've also met some awesome people in these support groups who inspire me and give me hope.

It's also important to note that our journey with our challenging illnesses is unique, and there's no 'right' way to react or cope. The primary goal is to find ways of managing the illness and maintaining quality of life that work best for us.

As discussed above, one of the initial stages we may encounter is denial.  Denial serves as a psychological defense mechanism that buffers the immediate shock of our diagnoses. It is a normal and in some ways, a healthy initial response, as it allows us some time to adjust emotionally to the diagnoses and to gather strength for our journey ahead.

I've personally found that denial can manifest in various ways and progress through several stages, including:

1. Shock and Disbelief: This is the immediate reaction to our diagnoses. We may feel numb, and there's often a sense of disbelief, as if what we've just heard can't be possible. We might think, "This can't be happening to me."
2. Dismissal of Diagnosis or Prognosis: We may question the competence of the medical professionals involved or insist on multiple retests, seeking a different opinion in the hope that the initial diagnosis was mistaken. We may also downplay the seriousness of the disease or believe that we will be the exception to the prognosis. This was especially true for me.  I spent so many hours on the internet researching how I would be spontaneously healed of my extensive aortic dissection.
3. Avoidance: In this stage, we might avoid medical appointments, refuse treatments, or avoid talking about the disease with friends and family. We might keep ourselves extremely busy so as to not have the time to confront the reality of our condition.  Again, I see a period of time where I did everything possible to try and get my doctors to allow me to stop taking the meds I was prescribed, including anticoagulants, beta blockers, statins, aspirin and others.  I was convinced that if I was not taking these prescriptions then I’d wouldn’t necessarily be sick.
4. Rationalization: We may also try to find explanations that could discredit our dissection or cancer diagnosis. For instance, we might attribute our symptoms to less serious conditions or to factors like stress or fatigue. We may also overemphasize stories of misdiagnosis we’ve heard or read about.  I too, to an extent was guilty of thinking my doctors may not have really known what they were seeing on the CT scans.  Ditto me on that.

While denial can serve us as a protective function initially, prolonged denial can be harmful.  Unreasonably prolonged denial can delay necessary treatment and prevent us from taking steps to manage our condition effectively.  For a caregiver, friend or medical professional it’s important to approach those of us in denial with frankness and truth but also with empathy and understanding, providing us with emotional support while also encouraging us to face the reality of our dissection or cancer.

Professional help from a psychologist, counselor, or a psychiatrist can be very helpful during our denial phase. Mental health professionals can use various therapeutic techniques to guide us gently towards acceptance of our conditions, providing us with the psychological tools needed to handle our diagnosis and the implications. As we mentioned above support groups can also be beneficial, as they allow us to interact with others who are facing similar challenges.

Both cancer and aortic dissection have been a challenge for me.  Its been well over a decade since my ascending aortic repair and I’m still living with a  complex descending dissection. It’s been seven years since my melanoma surgery, fifteen years since most of my large colon was removed and three years since half of my kidney was ablated for renal cell carcinoma. During these times I’ve experienced denial on a regular basis. Today, with the help of family and health care professionals I find myself able to recognize the stages Mrs. Ross describes in her book On Death and Dying.  Living with serious health challenges is just that, a huge challenge.  Kudos to us survivors.  Next blog post I’ll be discussing the second dimension of dealing with this type of trauma, the Anger phase.

Many blessings, Kevin

IPM: Whitewashed Hemp Leaf Appearance, Classic Glassy Winged Sharpshooter Damage

This is a photograph of one of our more aggressive pest insects here at Arendell Hill Nursery, commonly known as a Glassy Winged Sharpshooter, (Homalodisca vitripennis).

Glassy Winged Sharpshooter on the stem of one of our hemp plants

When we first began growing hemp I would sometimes mistake the whitewashed appearance of hemp leaves as white mold. However what we learned was that the leaves' white coating was actually defecation material from the glassy winged sharpshooters.

Glassy Winged Sharpshooter 'Whitewash' on one of our hemp plant leaflet

Glassy winged sharpshooters require copious amounts of liquid to grow and reproduce. Much of this liquid is excreted out in the form of a white paste, hence the whitewash effect across our hemp leaves.

Across Florida and throughout much of North America, the glassy-winged sharpshooter is a serious agricultural pest known for its potential to spread bacterial diseases to a variety of plants, including agricultural hemp. It feeds on a wide range of host plants and can spread the bacterium Xylella fastidiosa, the causal agent of diseases such as Pierce's disease in grapes and leaf scorch in a variety of other plants.

The glassy-winged sharpshooter, like other members of the leafhopper family, has specialized mouthparts adapted for piercing plant tissues and sucking out fluids. These mouthparts, known as stylets, function much like a straw. However, unlike a typical straw, the process involves more than just applying suction.

When feeding, the sharpshooter pushes its stylets into the plant tissues, navigating past cells until it reaches the plant's xylem - the system of tiny tubes that transport water and dissolved nutrients from the roots to the rest of the plant. Xylem fluid is under negative pressure, or tension, due to the process of transpiration (water evaporation) at the plant's leaves.

Once the sharpshooter's stylets are in the xylem vessels, the tension within these vessels causes the fluid to move into and up the insect's food canal (formed by its stylets), similar to how water will rise in a thin tube or straw. Thus, the sharpshooter doesn't need to actively suck up the fluid. In fact, the sharpshooter has to work to prevent the xylem fluid from flooding its alimentary canal and has a special filter chamber to help manage the volume and pressure of the ingested fluid.

It's worth noting that feeding on xylem fluid presents nutritional challenges, as this fluid is low in nutrients compared to the sugary sap in the plant's phloem (which many other sucking insects, like aphids, prefer). Sharpshooters have adapted to this diet in part through symbiotic relationships with bacteria that help them metabolize and extract nutrients from their food.

When it feeds, it can also introduce the Xylella fastidiosa bacterium into the plant, leading to blockages that can cause leaf scorch, wilting, and even death of the plant. Glassy winged sharpshooters also may be a host for Xylella fastidiosa, another significant plant pathogen.

As for the Integrated Pest Management (IPM) of the glassy-winged sharpshooter, here are some strategies that could be used:

Monitoring: Regular inspections of the hemp fields to catch any sharpshooter infestations early before they become a significant problem.

Biological control: There are several natural predators and parasites of the glassy-winged sharpshooter that could potentially be used for control. For instance, egg parasitoid wasps, such as Gonatocerus spp., lay their eggs inside the eggs of the sharpshooter, preventing them from hatching.

Cultural control: Changing farming practices to make the environment less conducive to the sharpshooter. This could include altering irrigation practices (since sharpshooters are attracted to water), removing potential host plants around the hemp field, or adjusting the timing of planting and harvesting to avoid peak sharpshooter activity.

Chemical control: If necessary, organic-approved insecticides could be used to control sharpshooter populations. These should be used judiciously to avoid killing beneficial insects and to prevent the development of resistance in the sharpshooter population.

As always, the specific IPM strategies used would need to be tailored to the individual farm and its unique conditions. Always consider local laws and regulations when implementing pest management strategies.

IPM: Growing Hemp on the Green Roof Panels Has Proven Successful

It is time to install this year's FAMU Pilot Project Florida x Hepius variety of hemp plants.

Shallow, extensive green roof panels ready for x Hepius hemp plants

Last year the x Hepius thrived in the shallow planting trays. Rainfall and irrigation water are collected and recycled. We use a special, non-organic planting medium designed by the University of Central Florida's engineering department. Organic nutrients are mixed with irrigation water and delivered via drip irrigation.

Growing hemp on the green roof panels last year proved to be a successful experiment. The x Hepius variety growing in the green roof panels were shorter and exhibited a significantly more compact growth habit than the x Hepius plants growing in the ground level garden soil.

One huge advantage of growing hemp on a roof is that there are significantly fewer caterpillars and other pest insects who crawl up the support walls to reach the hemp. Additionally, any aggressive bugs that make it up to the roof are prime targets for hungry birds.

The x Hepius variety produces significant amounts of aromatic terpenes on flower buds without any detectable level of THC. Last year I noticed the living roof x Hepius plants filled the garden air with a complex scent of citrus and spice.

I prefer shallow green roof systems because I prefer creating shallow but wide root architecture patterns so that our Florida hemp plants can better survive tropical storm wind patterns. Shallow root architecture is not necessarily better than deep, intensive planting systems but they are my preference having worked with coastal and hurricane resilient green roofs over the decades.

As mentioned above, not all green roof systems are shallow such as these.

Green roof systems can be classified based on their depth into extensive, semi-intensive, and intensive systems. Shallow or extensive green roofs, often referred to as "eco-roofs," are the simplest and lightest type. They are typically used on residential, commercial, and small-scale buildings for their ease of implementation and maintenance. Here are some key points to understand about shallow green roof systems:

1. Depth and Weight: Extensive green roofs have a shallow growing medium, typically ranging from 1/2 to 6 inches in depth. The shallow depth makes them relatively lightweight, adding approximately 15-50 pounds per square foot, including plants and saturated growing medium. This makes them suitable for a variety of building structures without requiring significant structural reinforcement.

2. Plant Selection: Due to the shallow depth, the types of plants used in extensive green roofs are those that are drought-tolerant, wind-resistant, and can thrive in shallow soil. These often include succulents (like sedums), herbs, grasses, and some types of wildflowers.

3. Water and Nutrient Requirements: The plants used in shallow green roof systems are typically adapted to harsh conditions and require minimal irrigation and nutrients. This is ideal for conserving water resources and reducing maintenance requirements.

4. Installation and Maintenance: Extensive green roofs are typically easier and less expensive to install compared to their intensive counterparts. They also require minimal maintenance, primarily in the form of periodic weeding and checks to ensure the roof's waterproof membrane is intact.

5. Environmental Benefits: Like all green roofs, shallow systems provide many environmental benefits. They can help reduce the heat island effect, improve air quality, manage stormwater runoff, provide habitat for wildlife, and enhance a building's thermal performance, potentially saving on heating and cooling costs.

6. Aesthetic Value: Extensive green roofs can improve the visual appeal of a building, providing a lush, green space in urban environments that are often dominated by concrete and other hard surfaces.

Despite their many benefits, extensive green roofs aren't suitable for all situations. They require a waterproof and root-resistant roof membrane to protect the building, and while their maintenance needs are relatively low, they still require some care to stay healthy and attractive. Lastly, not all plant species will thrive in the shallow growing medium, limiting the plant diversity compared to intensive green roofs.

IPM: Parasitoid Wasps Are Important Members of Our Hemp Integrated Pest Management Program

 Parasitic wasps can be highly effective in the biological control of pests like armyworms, an approach that aligns with the principles of Integrated Pest Management (IPM).

Armyworm crawling across one of our hemp plants

Its that time of year again here on the Arendell Hill Hemp and Veggie Farm and we are seeing hungry armyworms crawling over our crops.

We do not use industrial pesticides to control insects. Instead we employ Integrated Pest Management (IPM) techniques such as planting lure/trap plants & also planting host plants for beneficial insects such as parasitoid wasps.

There are different species of these wasps, and they each have their unique behaviors, but all work towards the common goal of pest control.

Parasitoid wasp laying eggs in a caterpillar

Parasitic wasps do not directly attack or consume the pests. Instead, they lay their eggs inside or on the body of the armyworms. When the wasp larvae hatch, they begin to feed on the host worm, ultimately leading to its death. This is a gradual process, and the host pest continues to live for some time even after the wasp eggs have been laid.

Two well-known types of these wasps are braconid wasps and ichneumonid wasps. Braconid wasps are generally smaller and often lay their eggs inside their hosts. Ichneumonid wasps, on the other hand, are larger and usually deposit their eggs on the host's exterior.

Parasitoid wasp larvae eat pest insects

Importantly, these wasps target a variety of pests beyond armyworms, such as caterpillars, aphids, and other insect larvae. This makes them incredibly beneficial for maintaining balance in garden ecosystems.

By encouraging the presence of parasitic wasps in your garden, you can help keep armyworm populations under control. This can be achieved by planting a variety of native flowering plants (my favorite is a native mint, Monarda punctata) that provide nectar for adult wasps, or by avoiding broad-spectrum insecticides that can harm these beneficial insects along with the pests.

This approach not only helps manage pests in a way that's safe for the environment but also fosters a balanced and biodiverse ecosystem in your garden.

Let's hear it for the parasitoid wasps in our hemp garden here in Tallahassee!

Nature Art: Short Verse Wednesday, Joys of a Wildflower & Cool Creek Water

 I was inspired to pen several short verse poems for Wednesday tonight.

The first is about a nana & a garden bloom:

Solitude fed grandmother's heavy heart
laughter's echo now silent
today a solitary wildflower in her unkempt garden
soft smile curved her lips
and she whispered a joyful word

...

Joys of a Wildflower

And the second, a neo-haiku about a happy wren bathing in the creek:

Joyous Wren Splashing in the Creek

In babbling creek
wren does dance in ecstasy
water's glee cool song

...

Nature Art: Spending Time In The Forest & Swamps, A Source of Art Inspiration

 Spending time in forests can greatly inspire an artist looking to create native plant artwork, offering them an opportunity to explore and understand the intricate beauty of nature in its purest form.

Nature Art, Finding Inspiration In the Forests and Swamps

Below are some of my thoughts about the many ways how a forest could serve as a wonderful resource for any artist but especially a native plant artist:

1. Observation and Realism: The first and foremost benefit of being in a forest is the opportunity to observe native plants in their natural habitats. The artist can study their forms, colors, and textures in detail. This direct observation can lead to more realistic and accurate representations in the artwork.

2. Seasonal Changes: A forest presents an ever-changing tableau as the seasons shift, offering a range of different visuals from fresh spring blossoms to autumn foliage. The artist can depict the lifecycle of the plants or create a series of artwork illustrating these transitions.

3. Connection with Nature: Immersion in a forest allows the artist to develop a deep, personal connection with nature. This emotional bond could be reflected in the artwork, creating pieces that not only depict the physical aspects of the plants but also the artist's feelings towards them.

4. Understanding Ecosystems: A forest provides a unique opportunity to understand the interdependence of various life forms. By noticing how plants interact with other elements of the forest, such as animals and weather, the artist could incorporate these aspects into the artwork, making it richer and more complex.

5. Inspiration and Creativity: The serenity and beauty of a forest can stimulate an artist's creativity. The variations in landscapes, the play of light and shadow, the myriad colors, shapes, and textures, all contribute to an array of visual stimuli that can trigger new ideas and approaches to the artwork.

6. Symbolism: Plants in a forest can carry a wealth of symbolism, often tied to cultural or spiritual beliefs. An artist may choose to incorporate these symbolic meanings into their artwork, adding layers of depth and interpretation to their pieces.

7. Learning Different Perspectives: Spending time in a forest can lead an artist to see things from different perspectives. They might find beauty in the understory that many overlook, or see the towering majesty of old-growth trees. Each new perspective provides fresh inspiration for artwork.

8. Healing & Health: I can speak from first hand experience here as to just how spending time in the wilds has redirected my mind from dwelling on my physical challenges and instead allowing me the opportunity to instead see the beauty of the natural world around me. Fresh air, sunshine, earth colors & hues, wildlife sounds, bird calls, all these help me breathe deeper and feel more whole. When I feel uplifted physically then my mind is ready to create art.

So, spending time in forests allows me to develop a deeper understanding of the natural world, fostering creativity and providing endless inspiration for my native plant artwork. Through direct observation and immersion in nature, we artists can create pieces that are not only visually stunning but also imbued with a sense of authenticity and emotional depth.