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The “Bug Bag”

Pick an old backpack and load it up with some essential supplies for emergencies.  This is a general packing list that should be suitable for both medical and psychiatric admissions, as well as other kinds of unexpected overnights (from evacuations and emergency shelters to something as benign as a weekend at a festival).  My term “Bug Bag” is short for “Bug Out Bag”.

Skip folding your clothes individually.  Instead lay all shirts on top of each other, fold in the sides, and roll them up into one smooth bundle.  Insert into bag.  Do the same with pants (I prefer to fold each pair in half and then stack, then roll).

  • Clothes
    • Shirts
      • 3 comfortable shirts that are easy to wash
    • Pants
      • I prefer pajama pants*, sweat pants*, and a pair of shorts
      • Psych hospitals will want you to remove any drawstrings.
    • Socks
      • 3 pairs should be plenty
    • Underwear (including bras and beaters)
      • 3 of each should be enough
      • Many times, one bra is plenty
    • Shoes
      • Flip Flops
        • Can be used as shower shoes and as slippers
        • Some psych hospitals might prefer the slip-on style be used as “thongs” are sometimes banned for safety.
      • Slippers
      • Sneakers*
        • Psych patients, ditch the laces.
    • Robe*
      • Psych hospitals will want any ties or belts removed.
  • Toiletries
    • Dental
      • Toothbrush
      • Toothpaste
      • Floss*
      • Mouthwash*
        • Packing a non-alcoholic mouth rinse is helpful for psych patients.
    • Bathing
      • 3-in-1 shampoo, body wash, conditioner is ideal
        • Original bottle with label is important for psych admits
      • Lotion
      • A loofa* or washcloth
        • The Supracor SpaCells facial sponge and bath mitt are my favorite for both psych hospital and camping because they dry quickly, aren’t banned, and the facial sponge is really small but can do it all.
        • I’ve also successfully used a small mesh laundry bag (zippered) as a travel wash cloth for the hospital.  It dries fast and can store my soap.
    • Menstrual products*
      • Maxi pads* and light days pads*
      • Tampons*
      • Diva Cup
      • Wipes
    • Nail care
      • Paper/foam nail file
      • Nail clippers*
    • Hair
      • Small plastic comb or brush
      • Hair ties or clips*
      • Shaver* or razor*
      • Tweezers*
    • Q-tips
  • Laundry
    • Quarters for the machines
      • Get a roll of quarters from any cashier or bank
      • Anticipate it costing anywhere between $1-$2 (or more) per load
      • Remember, sink washing is a thing.  Use those quarters for the dryer.
    • Detergent
      • A small/sample bag of Tide Pods should do the trick
      • A sample bottle of Tide (typically found at Target or Dollar Tree)
      • Travel packets of Tide
    • Fabric Softener
      • Totally optional for most people
      • Dollar Tree has sample bottles, worth about 5 full loads.
    • Dryer Sheets
      • Again, optional for most people
      • Just stuff a few in a pocket of your backpack
  • Health
    • It is helpful to keep a list of your current doctors with your medication list
      • Include the doctor’s name, phone number, and fax number.
    • Keep an updated medication list in your bag
      • Include prescription and non-prescription medications
      • Include any vitamins or supplements you may use
      • Include dosage, times typically taken, and what you take it for.
    • Ideally, hospitals like patients to bring all medications in labeled bottles.
      • This isn’t always possible for patients in an emergency, don’t sweat it.
      • Try to make a habit of keeping your meds in a single location at home so that a friend or family member can potentially bring them for you.
    • Keep a list of food allergies, intolerances, and medication allergies
  • Incidentals
    • USB battery or phone charger
    • Calling card
      • Typically, psych hospitals require patients to have one to call family.
      • You can find calling cards at Walgreens
      • It’s also possible to purchase a calling “card” online and print it.
    • Contact book
      • Typically, psych hospitals do not allow patients access to their phones.
      • Keep important numbers for friends and family in a small notebook
        • The notebook needs to be plain bound
        • No spiral binding and no elastic
    • Chapstick
    • Ear plugs
    • Books
    • Food
      • small non-perishable snacks are a good idea, especially for the ER or waiting room.
    • Warmth and comfort
      • A soft sweater that mimics your favorite blanket
        • Packs easy
        • Works for hospitals that don’t allow bedding.
        • Avoid hoods and drawstrings if a psych patient
      • A favorite pillowcase
        • Packs easy
        • Most hospitals don’t mind pillow cases
      • Thermal underwear
        • You know who you are.  Pack it.

Anything starred (*) is an item that may be restricted for psych patients but are a good idea to pack for stays potentially longer than 2 weeks.

Disclaimer:
this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.
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Treatment Review: Vision of Hope (Lafayette, IN)

In this post, the use of “NANC” and “ACBC” are interchangeable terms for the same organization.  The use of the terms “resident” and “patient” are also interchangeable.

This post is for Vision of Hope at Faith Ministries East on 5652 Mercy Way in Lafayette, IN.

Ideas of things to answer:

  • When were you there:
    • July 2011 – January 2013
  • How many patients on average?
    • 24 residents
  • Does it treat both males and females? If so, is treatment separate or combined.
    • Female only.
  • How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc?
    • Never.  There wasn’t even a nurse there except for the occasional meeting to discuss potential residents (new admits).
    • Counseling sessions with your biblical counselor is about once or twice per week.
  • What is the staff ratio to patients?
    • There were about 2 or 3 interns on staff per shift that directly dealt with the residents and then one head staff person in charge of the interns per shift.
    • Residents were split up into 2 groups, at times, and one intern would be assigned to each group.
    • Each counselor (senior staff) was responsible for counseling about 4-6 residents per week.
      • Per diem counselors were acquired directly from Faith Ministries’ counseling program across campus when Vision of Hope’s counselors were unable to take on additional clients.
  • What sort of therapies are used? (DBT, CBT, EMDR) etc?
    • Nouthetic Counseling (a form of biblical counseling) is the only “therapy” utilized.
    • All counselors were either NANC certified or in the process of being certified (and were under supervision).

Describe the average day:

  • What were meals like?
    • Meals were “family style” in a dining room.
      • There were several tables and an intern would sit at (almost) each table to supervise Phase 1 residents.
      • I remember being assigned seats at times and not at other times.
      • Whichever group of residents didn’t cook/prepare the meal would be responsible for cleaning the kitchen and dining room after each meal.
      • Breakfast was split into two groups/shifts where half of the residents would get breakfast as Group A and then shower after.  The other half of the residents were Group B and would shower before breakfast.
        • This not only organized the shower schedule, it also prevented Group B members from possibly purging.
        • Group B was responsible for cleaning up breakfast every day, Group A was responsible for setting up breakfast and starting the coffee.
    • You had to “clean your plate” (finish everything you were served).
    • Half of the residents each day would cook the meals for the entire house (about 40 people) with one intern supervising meal prep.
    • Meals were decided by the Household Manager (who was equally responsible for finances, house chores, schedules, and nutrition… but had no dietetics degree).
    • There were optional snacks throughout the day.
      • Sometimes underweight residents were required snacks.
      • I remember there being a snack before workout, an hour before lunch (before leaving to clean the Community Center and Gym), and a snack around night meds.  There may have been one more.
  • What sorts of food were available or served?
    • Just normal family food.  Somewhat southern but mostly traditional American platters.
    • Everyone got the same thing.
    • Seconds were optional.
    • Dessert was optional and offered about twice per week.
  • Did they supplement? How did that system work?
    • No.
  • What is the policy of not complying with meals?
    • Consequences, Consequences Homework, Probation (involving more consequences, being dropped a level, more homework, and having counseling sessions taken away), and being asked to leave the program- in that order.
    • Consequences can include losing the “privilege” of being able to speak.
  • Are you able to be a vegetarian?
    • No.  Vegetarianism is not allowed and Kosher is not accommodated as it goes against their religion.
    • Food allergies were hardly accommodated without specific medical documentation.
  • What privileges are allowed?
    • Residents were allowed cameras but the cameras had to be locked in sharps/contraband when not in use.
    • All residents exercise at the gym each day.
      • Exercise usually consisted in walking in circles at 6 am for an hour on a track.
      • Underweight residents were restricted to sitting during workout but were required to still be awake while watching.
    • Phase 1 residents were allowed iPods (no internet) at night, during morning workout, and on weekends.  Sometimes iPods were allowed during week day house chores, as well.
    • Phase 2 residents were allowed to have their cell phones at all times.
    • Phase 2 residents were allowed to use the classroom computers upstairs or check out their personal laptops from the secretary during the day.
      • Computer use was only allowed if they were specifically approved to do so by their counselor and had it put it on their approved daily schedule.
        • If a resident missed their planned computer time, they were not allowed to use the computer that day.
      • What a resident specifically did on the computer also had to be approved.
        • If a resident wanted to watch videos on YouTube, she had to write exactly which videos she wanted to watch and have her counselor sign off on it.
          • Ex: “Christian music videos” might not have been specific enough get approved but “music videos by Jeremy Camp and MercyMe” would likely have been approved.
    • Phase 2 residents were required to have a job nearby that paid.  It was about a 3/4 mile walk to the nearest bus station.  A couple of jobs were available on campus (through the church’s daycare or gym).  Very few residents were exempt from this requirement.  Residents who were disabled (couldn’t legally earn money) would get volunteer jobs.
    • Phase 2 residents could apply to local colleges to do some classes.
    • Phase 2 residents were allowed to use the gym cards to access the exercise equipment (and maybe also the pool?) at the Community Center next door.
  • Does it work on a level system?
    • Yes.
      • Phase 1: is a minimum of 6 months for all residents and is the most restrictive.
      • Phase 1b: is where you are still in Phase 1 and do everything a Phase 1 resident does but you also go out to job interviews.
        • The sole purpose of this level is to get a job so you can be in Phase 2.
      • Phase 2: is where you’ve completed Phase 1 and now have a job.  Your day consists of working at your job, eating some meals at Vision of Hope, counseling homework, working out, and sleeping at Vision of Hope.
      • Phase 3: is where you no longer live at Vision of Hope.  You either move back home, move somewhere else, move in somewhere locally, or some ladies would apply to stay at the Sunshine House (which was a Christian transitional living program in the area but was not affiliated with Faith Ministries).
        • Counseling would occur either long distance by phone/Skype/email or on campus (for those who chose to stay in the Lafayette area).
      • Graduation: is when you complete Phase 3 and have a special ceremony.  It can take years to graduate the program.
  • How do you earn privileges?
    • The only way to progress from Phase 1 to Phase 2 is by “getting saved” (even if you were a Christian before joining their program, you’ll likely have to re-convert or do salvation homework to prove you’re “actually saved”) and making it through the minimum 6 months of Phase 1.
    • Do your homework.
    • Don’t sin (not limited to, but including eating disorder, self harm, or addictive behaviors).
    • Be submissive.
  • What sort of groups do they have?
    • Curriculum groups include decades of recordings from Faith Church sermons and worksheets you have to fill in while listening.  The curriculum recycled about every 6-8 months.  This group is usually an hour per day.
    • Book groups are an hour or so of group study on particular Christian books that function as the textbooks for this group.
      • Examples of books used are: “Momentary Marriage” by John Piper, “Girls Gone Wise” by Mary Kassian, “Heaven” by Randy Alcorn, “Soul Physicians” by Robert Kelleman, and several books written by members of Faith Ministries (namely, Amy Baker).
    • Devotionals/Study Hall… you just do your homework and study your bible and journal about it.  There were specific devotional worksheets required.  Interns would typically assign a bible passage for everyone.
    • Worship… an intern would select lyric videos on YouTube and project them onto the wall and we’d sing along.  The good interns let us take requests.  The musically talented interns would use their own instruments (one even had a harp).
    • GNO “Girls’ Night Out” on Fridays were the weekly field trip.  Every other week it would be a free activity (like a hike or visiting someone’s house to make fudge).  The odd weeks would be a paid activity (paid for by the ministry or by a sponsor) such as ice cream, Chipotle, photo scavenger hunts, bowling, roller blading, or the annual school play (there was a private Christian school on campus).
    • Girls’ Night In on Saturdays was typically doing nails, a craft, a game, maybe something fun in the kitchen, or a movie.
    • Wednesday night “FCI” (Faith Community Institute) bible study classes at the church which involved going to the church and joining a “class” with the other parishioners.  Each course lasted quite awhile, a couple of months maybe?  Phase 1 girls had to join the same course and attend with a VOH intern.
    • ABF “Adult Bible Fellowship” every Sunday morning.  Phase 1 girls usually had to go to an ABF with a VOH intern there, unless they got special permission or a VOH volunteer to supervise them.
  • What was your favorite group?
    • Probably worship because it was fun.
  • What did you like the most?
    • Not having to worry about insurance cutting out.  The only people who determined my length of stay there were myself and the staff at the program.
    • Really comfortable house.
  • What did you like the least?
    • The inflexibility of the program.  They don’t treat us as individuals with needs.  Just as people with sin.  Everything and anything is considered “sin” and will be punished as such.
    • Being denied medical care even when I offered to pay for it myself.  I couldn’t even access a phone to call an ambulance myself.
  • Would you recommend this program?
    • In general, no.
    • There is no dietitian on staff to prescribe meal plans to residents and Phase 1 residents never get to learn how to eat.  Phase 2 residents were assigned exchanges but by a staff member with a finance degree, not a dietetics degree.
    • If someone is truly interested in this program because it is in line with their own religious beliefs, I highly recommend going to a secular program first to become medically stable (either with psych meds, detox for substance, or refeeding for eating disorders) and then going to this program.  There is no medical support at Vision of Hope and the program has even denied seeking medical care for certain residents who clearly required it (myself as both witness of this and as victim of this) and even asked for it.
  • What level of activity or exercise was allowed?
    • Lots and lots of physical chores in the house, in the church, on campus, in the school, in the community center, and on the grounds.
    • Workout every morning.
      • Exercise usually consisted in walking in circles at 6 am for an hour on a track or around the pond.
        • Despite being specifically advertised that we would use the gym equipment and pool facilities, we never got to use them.
        • One time we got to use the pool, but it was a Church event and essentially a one time deal.
      • Underweight residents were restricted to sitting during workout but were required to still be awake while watching everyone else walk around the track.
      • Sometimes we got to play basketball or do circuit training.
    • GNO activities like hikes or visiting a lake.
  • What did people do on weekends?
    • GNO on Friday night.
    • GNI on Saturday night.
    • A laid back Saturday morning group where we’d listen to a recreational book such as Hinds’ Feet on High Places or A Pilgrim’s Progress.
    • Extra chores on Saturdays, deep cleaning style.
    • Church all morning on Sundays plus Church Family Day once per month on Sunday nights.
  • Do you get to know your weight?
    • No, but sometimes you’d be told if you’ve been stable.
  • How fast is the weight gain process?
    • No idea.  Some people took ages to visibly gain anything.
  • What was the average length of stay?
    • A year and a half or longer.  Sometimes years.
  • What was the average age range?
    • Mid-teens to early thirties.  But I don’t recall what the oldest cut-off age was.
  • How do visits/phone calls work?
    • One 15 minute phone call per week on one of two phone call nights.
      • Special cases would get a second phone call or a 30 minute call.
      • A staff person would listen in on all phone calls and take notes on what you said, which were forwarded to your counselor.
    • There were visiting arrangements available after your first month was over.
    • After about 2 months you could get “checked out” for the weekend by family, if approved.
    • I recall some residents being allowed to sit with family members at church, if their family attended.
    • A resident was allowed to go to a different church on Sundays with her family because it was “good enough” by Vision of Hope’s standards for Christianity.
  • What kind of aftercare do they provide? Do they help you set up an OP treatment team?
    • None.  No.
    • If you stay in their program, you keep whatever counselors that get assigned to you while you’re in the program (including Phase 3).
    • If you finish the program, you don’t need counseling anymore but can stay in touch.
    • If you quit, or are “asked to leave”, they do next to nothing for you.
      • Those who did not complete the program were essentially shunned for a period of 6 months after leaving.  VOH had a “zero contact” policy during this time for both staff and residents. (No phone calls, letters, or messages to those who left the program.)
    • If anything, they’ll “pray for you”.  That’s your aftercare.
  • Are there any resources for people who come from out of state/country?
    • Not really.  Most people came from out of state.  Quite a few were from other countries.  You just show up on the day/time you’re supposed to show up and how you get there is up to you.
  • Other?
    • We cleaned the community center and gym almost every day.
    • After I left, they also added daily house chores.
    • There were room checks every morning for cleanliness and bible verse drills while waiting for checks.
    • Room searches occurred infrequently but were rather thorough.  There were only a couple of things that ever got overlooked while I was there.
    • We were put to work every single day.  It was like we were working to pay off our “free treatment”.
      • I’m all for “giving back” to a program that literally housed me for free (at the time, room and board were free) and I didn’t even mind the work existing (because I was happy to “give back”, which is how I personally viewed it) until after I left the program and realized that it had zero therapeutic value and the time could have been better spent doing actual therapy.  It was just teaching us to be drones.
      • Two persons each week were assigned to do “House Laundry”, which included various linens and used cleaning rags/dish rags.
      • We were frequently utilized for menial tasks such as stuffing envelopes, to ask donors for more donations, as well as making and signing tons of cards for various purposes.
      • We would be utilized for other fundraising opportunities, setting up the Race for Hope, setting up the banquet, giving speeches/testimonies, speaking a public hearings on behalf of the church, gift wrapping for an annual holiday ministry, serving at the Living Nativity and Stewardship Celebration, volunteering for the ACBC conference, and running a table at the Subaru factory’s Halloween festival (which was weird considering VOH doesn’t recognize or support Halloween…. it took a lot to even get them to let us do Valentines).
      • In the mornings we would clean the church’s gym/workout equipment (at the community center which was essentially like a YMCA).
      • In the afternoons we would alternately clean the Christian school or the church sanctuary (depending on the day).
        • This included cleaning bathrooms, locker rooms, and handling cleaning chemicals and equipment.
      • I remember doing a lot of window washing, water fountain sanitizing, vacuuming, and mopping at the community center, as well, throughout the week.
      • We were responsible for shoveling Mercy Way drive ways and sidewalks.  If the snow fell overnight, shoveling would replace our morning workout.
      • We were responsible for outdoor chores once or twice a week.
        • Mowing the grounds at Vision of Hope and around the pond (huge property) with gas powered push mowers (even the underweight residents).
        • Weed whacking.
        • Weed pulling all of the garden beds on the Mercy Way side of campus and around the pond.
        • Watering all of the giant flowering pots.
    • You were required to ask family and friends for donations for the annual Race for Hope fundraiser 5k and the annual banquet.
    • Laundry was assigned at specific times for each resident once per week.  If you missed your laundry day, or if you had a schedule conflict, you’d have to try to swap with another resident.  If you couldn’t swap or pull favors (“hey can you put some of mine in with yours?”), then you were either SOL or had to wash by hand in the basin and hang dry.
    • Speech and expression were highly censored.
      • Speech:
        • No cursing.
        • No talk about past or current sins (including past history of eating disorder behaviors, addictions, promiscuity, and self harm).
        • No “glorifying sin”…. hard to explain but essentially don’t talk about anything that isn’t G rated.
        • Some residents would lose the “privilege” to speak at all.
        • Some residents would be required to say the same phrases over and over, regardless of whether they agreed with those phrases.
          • Example:  “Yes ma’am, I will obey joyfully and whole heartedly.”
        • Phone calls were strictly monitored by a staff person who would listen in on phone calls and take notes on what you said, which were forwarded to your counselor.
      • Writing:
        • All mail and phone calls were monitored.  Residents were not allowed to receive mail until the counselor had opened, read, and signed off on it.  Outgoing mail also had to be unsealed and approved, iirc.
        • Vision of Hope implemented “thought journals” for some residents, where a resident would be required to write all of her thoughts down every 15 minutes.  These then would be reviewed by her counselor.
      • Physical expression:
        • The church campus itself banned dancing, but Vision of Hope would allow it.
        • There was a strict “no touching” policy for all staff and residents.  To the point of having to ask for permission to braid or curl someone’s hair.
        • No sharing of belongings was allowed.  No hand-me-downs, either.
          • Unwanted belongings could be donated to the “Blessings Closet” where other residents could “buy” those items with Blessings Bucks earned by memorizing scripture.
          • Lost and Found items also went to the Blessings Closet and had to be “bought” back by their rightful owner.
      • Reading:
        • All reading materials had to be approved by your counselor.  Anything that wasn’t fundamentalist Christian or required for school would not be approved.
        • Materials from other religions (including Catholicism) were likely not approved.
      • Music:
        • Only approved Christian music was allowed.
      • Clothing:
        • Vision of Hope had a very strict and very detailed dress code.  Residents were expected to dress conservatively and modestly, and as if they were at their job.
          • Sweatpants, yoga pants, jogging pants, etc were not permitted during the day and would even be taken away if caught wearing them.
          • Jeans were allowed but couldn’t be revealing.
            • Vision of Hope didn’t allow their residents or interns to wear jeans to church services.  But the church itself didn’t have a rule against jeans.
          • Blankets were banned outside of bedrooms during the day and so wearing layers was encouraged.  Winters were cold and summers brought some frigid air conditioning.
            • I would secretly wear sweatpants under my long skirts and dresses in order to cope with the climate indoors.
          • Spaghetti straps, camisoles, necklines that showed chest or cleavage, short shorts, plumber butt pants, and more were banned.
            • If you were caught wearing these items without a modest layer underneath or over it, you would be asked to change your clothes and the offending item would be locked away until discharge.
            • I bought the entire collection of Cami Secret modesty guards and it was worth every penny.  I was able to continue wearing all of my shirts and dresses without risking confiscation.
              • The nickel in the buttons gave me a rash, but still worth it.
              • Honestly, it might have been more worth it to have never done this program at all.
            • One time VOH hosted a clothing swap where no Blessings Bucks were required and all clothes were available to whomever needed them and anyone could give away their unwanted clothing to someone else who could use them.
              • This was in response to a lot of residents complaining about their clothes getting confiscated due to being “too revealing” after the resident had gained weight.
    • The only information we could access about the outside world was through a daily local newspaper (The Journal & Courier) and the rare occasion where the TV would be allowed on for local news.
      • Sometimes we’d get to peek at the televisions in the gym while cleaning, which were frequently tuned to CNN.

LGBT:
You will essentially go through conversion treatment for gender and sexuality issues to conform with being a cis-female heterosexual.  Even asexuals are not entirely safe from this as residents are taught that sex is a requirement to honor G-d in one’s marriage and to honor one’s husband.

Handicap Access:  There was one deaf resident when I was there who was oral/auditory.  There weren’t any special accommodations given to her, other than for subtitles on videos and ensuring that she had a hearing roommate for emergencies (fire evacuations).  My blind friend tried to apply to Vision of Hope back in 2011 and they denied her access to their program because they were unwilling to utilize braille resources or accommodate her screen reader laptop (with which they could have emailed her digital texts so her computer could read them to her).  There was one disabled patient that required mobility equipment there who was accommodated for the most part but was mostly on bed rest until she left.
The house was two stories with no elevator (unless they’ve converted the downstairs and upstairs closets into one since I left, you’ll have to ask) and three staircases.  A majority of the groups are upstairs in the classroom.  The upstairs is entirely carpeted.
The downstairs has both tile and carpet.
I recall one bedroom suite had a fully handicap accessible bathroom.  I believe this suite was on the first floor.
The main entrance to the building had steps but the side entrance is mostly wheelchair accessible.  The back porch is not accessible.
The dining room and downstairs living room are both accessible.  The “public” toilets downstairs and upstairs are not accessible.

The community center/gym is generally wheelchair accessible except for the upstairs walking track.  The church and Christian school are generally wheelchair accessible with one elevator available on the school side to access the upstairs bible fellowship groups.

Service Dog Access:  I did not have a service dog when I went to this program.  Churches and ministries such as Vision of Hope are not required to abide by ADA law.  There was a teacher at the Christian school on campus who had a guide dog, which implies that Faith Ministries has worked with service dog handlers at least once before.  Now that Vision of Hope charges for room and board (not treatment), they might be required to adhere to the Fair Housing Act (which requires certain landlords to allow assistance animals in no-pets housing), but I can’t say for sure that they actually fall under this.  You would need to ask.  And you would need to be prepared for the possibility that your service dog/assistance animal may not be able to accompany you to certain areas on campus.

Disclaimer:
this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.

Assistance from Service Dogs for People with Eating Disorders

GuidingGolden  provided a really thorough blog post examining the benefits of a service dog for persons with eating disorders.  I encourage everyone to read it from start to finish- there’s a lot in there on how and what to train a dog to do.

Here’s a really important quote from their post, regarding the status of being disabled in order to qualify for a service dog at all:

“It’s important to emphasize that a diagnosis is not synonymous with a disability. While two people may receive the same diagnosis, that doesn’t mean they are both affected by the criteria an individual must meet to receive such a diagnosis in the same manner. The manifestation of a diagnosis for one person may be significantly life-limiting, while the other is able to manage symptoms and care for himself or herself independently. This is not exclusive to eating disorders; it is applicable to any medical condition, whether it is psychiatric, neurological or physical in nature.”

Dog Day

National Eating Disorders Awareness Week 2013

We are currently in the midst of National Eating Disorder Awareness Week 2013 (Feb 24-March 2nd). The message NEDA (National Eating Disorders Association) is promoting is, “Everyone knows someone.” The unfortunate reality is that this holds true with far more prevalence than most people are aware; According to NEDA, “30 Million Americans will suffer from an eating disorder during their lifetime.” Don’t think you know someone with an eating disorder? If you know me, you do. I’ve lived with an eating disorder for the past ten years.

In honor of ‘NEDA Week 2013,” I’d like to dedicate this post to exploring the potential for assistance that service dogs may offer to those struggling with eating disorders.

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A Brief Review of the Role of Service Dogs
Service dogs are dogs who receive individual training to do work or perform tasks which mitigate their handlers’ unique…

View original post 2,592 more words

The “Diaper Bag”

This is an excerpt from my extensively detailed Bringing a Service Dog to Treatment master post.

Having a service dog is like having a toddler.  And, just like with a toddler, having a service dog typically involves carrying around a bag of supplies just for the dog.  This is where I introduce our “Diaper Bag”.

The diaper bag contained everything for my service dog that I would not be allowed to have with me in my bedroom at treatment due to contraband rules or safety restrictions (sharps, ligatures, etc.).  But, these are things that I need multiple times on a daily basis for my service dog and cannot be locked up because of this frequency.  So, I got myself an actual diaper bag and loaded it up with everything we would need that would be kept at the nurse’s station in a secure location.

Some of the things kept in the diaper bag were:

  • poop bags
    • eating disorder facilities do not allow patients to have plastic bags or containers
    • psychiatric facilities in general could consider plastic bags a safety risk for suicidal patients
  • cans of dog food (sharp metal)
    • be sure to pack wet food that doesn’t need a can opener
  • dog food in general
    • unsealed kibble is a hazard because contraband could be hidden in the kibble
    • a patient (even the handler) could potentially choose to eat the dog food, thus, a safety hazard
    • sometimes dogs need human food and eating disorder patients are not allowed to have access to food that is not on their meal plans
  • dog food bowl (container)
  • metal grooming supplies (sharp)
    • metal tooth combs and brushes, nail clippers, etc.
    • I highly recommend bringing some grooming supplies that aren’t contraband to keep on hand in your room for daily touch-ups (Kong Zoom Groom is terrific).  It’s just easier sometimes, especially if the mood strikes you in the middle of the night to brush your dog.
  • doggy first aid kit
    • pretty much everything in a first aid kit will be considered contraband in a psychiatric facility
    • we used our first aid kit several times
    • I highly recommend having one for your service dog as the facility will not be able to distribute medications or supplies to the dog
    • however, the facility did provide hydrogen peroxide for an injury my dog sustained because I needed a lot to clean a wound (they were not obligated to do this in any way and it was merely an inexpensive favor).  I was closely supervised during this.
  • collars and leashes (ligatures, metal)
  • charger for an e-collar (ligatures)
  • a favorite dog toy that might be considered contraband (ligatures, stuffed animal)
    • some facilities might not permit cloth toys due to sanitization issues
    • some toys *could* be used as a weapon
    • some toys could be used for self harm in various ways
    • stuffed animals can be used for smuggling contraband

If I think of anything else we had kept in the diaper bag, I’ll add it in.

I had no problems at all at Renfrew asking for the items and dog food in our diaper bag.  It was usually easy for staff to access and I could ask any clerc, counselor, or nurse to grab something for me.

End of excerpt.
You can read more thoughts on the “Diaper Bag” & related contraband in this master post.
Disclaimer:
this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.

Bringing a Service Dog to Treatment

This is an incomplete (and highly unorganized) master post that I will update and re-publish as I go.  The reason for posting this incomplete work-in-progress is because this information can’t be found elsewhere online.  I am working on a table of contents for this post to make it easier to navigate.  Feel free to comment questions or suggestions for this post.  You can also message me your questions on Facebook via http://m.me/abittachy for a quicker reply.

So you wanna bring your service dog to rehab?  I have now been to two IOPs, two Day programs (PHP), and two Residential treatment centers with my service dog.  It is an undertaking not for the faint of heart but was absolutely necessary for me to do in order to access treatment at all.

In order to bring your service dog to treatment, you will (more often than not) need to possess good advocacy skills.  This is a tall order for most people seeking treatment because it may be a skill they do not already possess.  If you believe you will need help advocating for your needs as a service dog handler, please reach out to a friend or community member (from the service dog community) who would be willing to help you do this.

This post is written from the perspective of an American and all information is given through the lens of the Americans with Disabilities Act.

Schedules, Stress, and Service Dogs In Training:

If you have a service dog in-training, now is not the time to bring your dog to treatment with you.  While some states do protect service dogs in-training and offer them the same rights as fully trained service dogs, the likelihood of that dog being ready to handle working from dawn until dusk is highly unlikely.  The reality for my service dog working in the inpatient and residential treatment environment was a life of being on-duty from 7am to 10pm at night.  Sometimes earlier.  My first and second admissions had required vitals and weights done at 3:30am every day.  For this, I left my service dog in my room to allow her to sleep.  Other handlers may not be able to do this due to the nature of their disability or due to hospital expectations of their dog being with them at all times.

It is not fair to force a service dog in-training to comply with such a rigorous work schedule.  Dogs that are still training need shorter “shifts”, regardless of age.  Puppies and adolescent dogs especially need shorter shifts as well as ample play time to regulate themselves (and possibly more potty breaks).

The typical rehab schedule is vitals, breakfast, meds, groups, groups, more groups, lunch, meds, groups, therapy, groups, break, dinner, meds, groups, break, meds, bed.  This is a lot on both the handler and the dog.  For the dog, it is a lot of laying down and staying quiet.  The schedule is much more rigorous than most college schedules, even.  On top of this, there may be air travel or trains involved in travelling to treatment and the entire experience as a whole is very disruptive and stressful on both dog and handler (especially an inexperienced dog).

Down Time:

Depending on where you go, there may be a lot of down time or there may be very little to none.  You may have access to your room during the day, or you might not.  During my first admission, I had ample access to my bedroom except for during groups or after meals.  During my second admission, I didn’t access to my bedroom between breakfast and 4pm because I was on supervised “day room” (which means I couldn’t leave the day room without permission) but I had ample access right before dinner and after the last group of the evening.  My third admission I had almost no access to my room between breakfast and 9:30pm.

Having access to my bedroom during the first two admissions allowed me to access items for my service dog throughout the day, rest with, and play with my service dog off-leash in my bedroom.  Not having this kind of flexibility during my third admission was more wearing on my service dog because she was “on duty” from breakfast until bedtime.  However, there was the occasional 15 minute block of down time during that third admission where I would play with my dog in the day room.  This was not professional of me and is it not required that any facility allow this.  However, the staff supervising the day room were excellent and understanding and allowed it.  I would keep a small dog toy with me for moments like these where my dog could be silly for a few minutes.  It is better to have these “off duty” moments in the privacy of a bedroom.  I had a bit of an attitude of “I’ll take what I can get” when it came to providing my dog with exercise in an environment where I was not permitted to exercise myself.  Leaving my bathroom door open made the room a bit “larger” to play fetch and utilizing a treat ball/toy for meals gave my dog a little mental and physical workout twice per day.  (Utilizing both sides of a suite also makes for a great private “playground”- if your suitemates are agreeable to it!)

Service Dog Gear:

So, I hate to break this to you but, your service dog’s working gear could be a safety hazard and therefore be contraband.  One of the ways I cope with necessary contraband items in rehab is with the “diaper bag” method (scroll down for more on that).  But, some things, (like a metal mobility harness or a prong collar) could pose an unfortunate conflict of interest for your safety and your wellbeing during treatment.  You may need to be prepared to handle your service dog without a harness, or collar, or leash.  This might sound unreasonable, but it’s very possible.  Especially when some psych wards don’t even permit canes or crutches, causing patients to resort to wheelchair use during their stay.

Is your dog capable of working off leash?  Do they obey verbal commands or hand signals well enough to do their job without a head collar or treats or a prong or e-collar?  Do you require door tethers in your room/bathroom that might be taken away?  These are things to consider before a planned admission with your service dog.

During my first admission I was able to use our door tether, a leash and collar, and all of my training tools without any issues.  During my second admission I had my leashes and tethers restricted, for my safety, but was permitted to use a 6 inch traffic loop with a plastic Starmark prong collar (because I seemingly couldn’t harm myself with either).  During my third admission, I was only allowed to use our e-collar system and had to turn it in to the nurse’s station at night (they would also kindly charge it for me).  During all three admissions, I was permitted to keep our nylon counter-balance (mobility) harness on my dog at all times.

The “Diaper Bag”:

Having a service dog is like having a toddler.  And, just like with a toddler, having a service dog typically involves carrying around a bag of supplies just for the dog.  This is where I introduce our “Diaper Bag”.

The diaper bag contained everything for my service dog that I would not be allowed to have with me in my bedroom at treatment due to contraband rules or safety restrictions (sharps, ligatures, etc.).  But, these are things that I need multiple times on a daily basis for my service dog and cannot be locked up because of this frequency.  So, I got myself an actual diaper bag and loaded it up with everything we would need that would be kept at the nurse’s station in a secure location.

Some of the things kept in the diaper bag were:

  • poop bags
    • eating disorder facilities do not allow patients to have plastic bags or containers
    • psychiatric facilities in general could consider plastic bags a safety risk for suicidal patients
  • cans of dog food (sharp metal)
    • be sure to pack wet food that doesn’t need a can opener
  • dog food in general
    • unsealed kibble is a hazard because contraband could be hidden in the kibble
    • a patient (even the handler) could potentially choose to eat the dog food, thus, a safety hazard
    • sometimes dogs need human food and eating disorder patients are not allowed to have access to food that is not on their meal plans
  • dog food bowl (container)
  • metal grooming supplies (sharp)
    • metal tooth combs and brushes, nail clippers, etc.
    • I highly recommend bringing some grooming supplies that aren’t contraband to keep on hand in your room for daily touch-ups (Kong Zoom Groom is terrific).  It’s just easier sometimes, especially if the mood strikes you in the middle of the night to brush your dog.
  • doggy first aid kit
    • pretty much everything in a first aid kit will be considered contraband in a psychiatric facility
    • we used our first aid kit several times
    • I highly recommend having one for your service dog as the facility will not be able to distribute medications or supplies to the dog
    • however, the facility did provide hydrogen peroxide for an injury my dog sustained because I needed a lot to clean a wound (they were not obligated to do this in any way and it was merely an inexpensive favor).  I was closely supervised during this.
  • collars and leashes (ligatures, metal)
  • charger for an e-collar (ligatures)
  • a favorite dog toy that might be considered contraband (ligatures, stuffed animal)
    • some facilities might not permit cloth toys due to sanitization issues
    • some toys *could* be used as a weapon
    • some toys could be used for self harm in various ways
    • stuffed animals can be used for smuggling contraband

If I think of anything else we had kept in the diaper bag, I’ll add it in.

I had no problems at all at Renfrew asking for the items and dog food in our diaper bag.  It was usually easy for staff to access and I could ask any clerc, counselor, or nurse to grab something for me.  Some things required me waiting for supervision in order to use them.  When it came to poop bags, I was usually given two (one as backup) and was expected to return the extra one if I didn’t need to use it.  The protocol we set for poop bags was much like the traditional “napkin protocol” used in several eating disorder programs.

My first and second admissions permitted me to keep our e-collar charger in my bedroom.  My third admission necessitated that the charger be kept in the nurse’s station, where they would charge it in plain sight so I always knew where it was, but they also let me keep all of the dog kibble in my room that admission.  Every place and every admission will be different.

Dog Poop and the “Dookie Bin”:

For lack of a better term, I called the “place where we put the bags of dog poop” our “dookie bin” and the poop bags “dookie bags”.  (See my section above, “Diaper Bag”, on how the poop bags were restricted by the facility.)  Maybe the name was dumb, but it worked.  So, because I was in eating disorder treatment, we were not allowed to have bags or containers in which we could store and hide food or vomit.  Also, being in eating disorder treatment, long walks were not an option (including the walk down to the facility’s dumpsters) because those are considered exercise and exercise is verboten.

I didn’t want to have to triple-bag every “deposit” my dog made just to throw it out inside- or even risk making the inside of the facility smell like a farm.  So, I brought my own “dookie bin”.  This was a small trash can from the dollar store that had holes all over it to prevent it being used for illicit eating disorder activities and therefore not being contraband.  This bin was kept in a designated location, as directed by maintenance, and was typically emptied on a nightly basis by maintenance staff.

My second admission to the facility was rather sudden and so I didn’t bring a bin with me.  The facility provided a bin in the same location and it was maintained as before.  My third admission was to a different facility that happened to already have a pet waste bin and free bags- so I had no issues whatsoever there.

Potty Breaks:

Basically, potty breaks will function different everywhere.  My first admission, I could take my dog outside independently during any break period (and then some) but was not allowed to go on “walks” due to exercise restrictions.  My second admission, I had to ask before going outside (for my safety) and stay within view of the nurses’ station (the front doors were glass).  My third admission, I had to be escorted by staff and one time was not permitted to leave my bedroom (for my safety) so a staff person volunteered to take my dog out for me on-leash.  (They were so awesome and my dog got a full walk and was really happy.)  For these admissions, my dog typically peed on mulch or grass.  At the outpatient facility I went to for IOP and PHP she would pee on ivy in the garden.  Some rehab facilities are in places where foliage is very sparse (think: Arizona) and your dog may need to know how to pee on gravel or sand/dirt.

Some facilities may not allow a patient to go outside at all.  Hospitals are not required to provide a dog walker.  Be prepared to have to possibly pay for a dog walker to come multiple times per day (or friends/family) to potty your dog.  Be prepared to advocate for yourself to have a staff person escort you as a reasonable accommodation.  Be prepared to ask that smoke breaks be utilized as potty breaks.  Be prepared to have to utilize puppy pee-pads, a doggy litter box (indoor potty), or an indoor dog lawn for  high levels of psychiatric care that won’t permit you to go outside at all.  Be aware that your health insurance might cut your care if they learn that you are being permitted outside, even for your service dog to potty (because, to American insurance companies, this supposedly indicates that you are “healthy enough” to not need to be in the hospital).

If you are planning an admission to an inpatient or detox facility, be prepared to effectively advocate for your service dog’s potty needs.  If your facility cannot accommodate outdoor potty breaks, then you need to make sure your dog is capable of utilizing indoor potty methods and you’ll need to advocate for those methods to be accommodated.  (Research and ask around about how service dogs “potty” on cruise ships for more ideas on how to manage indoor potty methods.)  (I will try to link to something about this in the future, currently the only information I know of exists in closed Facebook groups.  Ask around, though.  Somebody will know someone who went on a cruise with their dog.) (Here’s an interesting forum related to service dogs on Disney cruises.)

Water Bowls:

Eating Disorder treatment comes with a host of contraband restrictions that aren’t typical of other psychiatric facilities.  This includes the “containers” restriction common at most eating disorder facilities which impedes the ability to use dog bowls or poop bags.  I had been in eating disorder treatment twice prior to my first admission with my service dog, so I anticipated this obstacle readily.  For the bowl issue, I asked, as a reasonable accommodation, if my dog could have a water bowl set up near the nurse’s station.  The request was readily granted and I had a gallon of water, a little mat, and a water bowl set up next to the nurse’s station which we could access at any time and also walked past frequently (my dog would signal that she wanted to stop and take a drink).

During my second admission I got away with just having the bowl in my room.  I just didn’t even ask and it didn’t get confiscated during admission or even room searches.  During my third admission I was hardly ever in my room because I was under strict supervision from dawn ’til dusk.  Luckily, my room was in a highly foot trafficked area for the program (and basically next to the nurse’s station anyway), so I chose to keep the water bowl just inside my bedroom door with the door propped open at all times.  This functioned in the same way as the nurse’s station water bowl from my first admission and we had no issues keeping my service dog hydrated throughout the day with this setup.  Whenever I was in the med line (usually three times a day or more), my dog’s bowl was right there.  Whenever we got escorted for a potty break, we’d pass her bowl on the way and back and it gave us an opportunity to also have a “water break”.

Dog Tags and Microchips:

Get a new dog tag made up with an emergency contact for your service dog’s collar.  This number should be someone who is able to be responsible for your service dog, should something happen to your or your dog, while you are in treatment.  “Owner is in hospital, ICE call: ###-###-####” works fine to get the message across regarding your dog’s temporary emergency contact.  Shit happens.  Your service dog could run away somehow and get lost.  You could end up in a higher level of care where you’re unable to make decisions for yourself or for your dog.  You could end up in the ER.  Lots of things could happen.

Update your dog’s microchip registration to include that secondary emergency contact’s information as well as information on where you are being treated (effectively, your “temporary address”).  If you’re not sure where your dog’s microchip is registered, you can look up their microchip number via the AAHA Universal Pet Microchip Lookup database.  Some companies may charge you a yearly fee to update your dog’s information.  You can update your dog’s microchip for  free at Found.org  and they will allow you to include loads of information on your dog and any special veterinary needs your dog may have.  The updated registration will be available on the AAHA database as the most recent entry (you can go back and check this for yourself).

Transitional Living:  If you’re going to be living in transitional housing for a period longer than 30 days after inpatient or residential treatment, be sure to talk to the city or county in which you are residing during that time.  You may need to register your dog for a dog license in that locale.  Many times, you will not need to do this.  But, if you’re looking at 6 months to a year of transitional/sober living, then it’s a really good idea to register your dog in case anything happens to them.  Check Animal Law to see if the state you’re staying in waives registration fees for service dogs.  (You probably do not need to worry about this for inpatient or residential treatment.  I have called cities prior to admission and their offices assured me that I don’t need to register my dog because I’m not living in their city and won’t have a real address or bills for utilities in that city.  Literally do not fret over these details.  It’s much more important that you get admitted as soon as possible.  If anything, just keep your dog’s registration up to date in the town you do live in and have family handle renewal for you if you will be gone during a renewal period- such as December through January.)  [note to self: create a section on transitional living and DTLA that covers service dog access under the Fair Housing Act and ADA]

I have experienced…

Grooming/Hygiene:

I’ll get back to this topic later.  Basically, I brushed the dog, de-shedded the dog, and used wipes on her.

Preventatives and Dog Medications:

For all three admissions, I was able to use a flea collar (we use Seresto) for my service dog.  Not all facilities will be able to permit flea collars, however, for safety reasons (ligatures).  If you are planning to be in treatment for longer than a month, be prepared to plan for switching up your flea/tick prevention routine for admission.  Talk to the director of the ward ahead of your admission to discuss whether a flea collar is permissible or if your dog needs to switch to either a topical or oral preventative during your stay.  Ask about how the facility will accommodate you so that you can administer the dose to your dog, since it will be considered a chemical (topical) or medication (oral).  This goes for monthly heartworm preventatives as well, which are typically oral.  Discuss with your veterinarian which options are available for your dog’s needs.  There are several options including an injectable heartworm preventative (which protects your dog for several months) as well as some oral preventatives that protect against both fleas and heartworm.

If the facility you are staying at permits outdoor walks or passes, be sure to consider whether a tick preventative will also be necessary for your dog.  Research the prevalence of ticks in that region and ask around online.

I kept a stock of Zyrtec, fish oil, Benadryl, and gas tablets in my dog’s “Diaper Bag” behind the nurse’s counter during my first and second admissions.  It wasn’t really tightly controlled and, honestly, I was surprised at this.  However, lucky for me, it meant that my dog’s allergies and digestive issues could be addressed without much staff involvement or interference.  During my third admission, all “Diaper Bag” type stuff was locked in a contraband closet.  Lucky for us, that third admission was across the country and my dog didn’t have many allergy issues there at all.  I think that third admission would have handled my dog’s medications in the same way in which they handled our canned dog food: kept in the same bag in the same locked closet (where a nurse or counselor would escort us to grab what we needed).

Boundaries and “Petting” Policies:

Every service dog team is different when it comes to “petting policies”.  Some organizations that train service dogs will tell their clients “no petting” is always the rule on-duty.  Some organizations and private trainers may also recommend that a service dog not play with or bond with any other persons except for the handler while off-duty.  Many organizations don’t have these rules.  For the owner trained teams, it is personal choice.

When I was in treatment, I was asked by a therapist that I not allow other patients to pet my dog during groups.  I thought this was both fair and a good idea.  The facility had a “no distractions” rule during all groups- which meant that fidget toys, knitting, journaling, and crossword puzzles were all banned during group times.  I felt that their request fell in line with the general expectations of the facility and was not unfair because I was still allowed to engage with my own service dog however I needed to during group times.  Now, I personally enforce a “no petting during groups” rule whenever I’m in treatment.  It simply makes sense.

I am generally very lax with boundaries when it comes to my service dog.  In general, I tell people simply to ask me before petting or engaging with my service dog.  I have a hard-fast rule that when I’m using her mobility harness, that no one is permitted to talk to her or pet her.  If I’m just chilling during down-time, I let people fawn over her and I even let my assigned roommate treat her as a pet when we are in our bedroom at night.  I usually don’t mind this and feel that it helps me to create social connections with others.  However, just because I don’t mind doesn’t mean that you, or another handler/team, won’t mind.  Be vocal about your “petting policy” and stick with it.  And, sometimes I do mind and will say so if it becomes a problem for me.

During my first admission to treatment, the facility tried to strongarm me into signing a “no petting” contract after I was admitted.  I think they were afraid of liability issues with either my service dog becoming injured by another patient or (more likely) that my dog could injure another patient.  I was taught early on that it is not legal for an ADA covered entity (such as a rehab) to require documentation for a service dog- this includes contracts.  I held my ground and said “If you want to institute a behavior contract regarding interactions with my service dog, then you need to have that contract with the community (of patients)- not with me.”  Meaning, if they are so concerned about this, then the hospital itself needs to make the rule “patients are not allowed to pet another patient’s service dog” and have every single patient sign a contract to that extent.  Why?  Because this puts the responsibility on the hospital and staff to enforce that rule- not me.  And, if a patient breaks that rule, it would be that patient who gets reprimanded- not me.  As a patient, it is not my responsibility to manage another patient’s behavior.

It is, however, my responsibility to manage my own behavior and uphold my service dog’s behavior to the standards put out by ADA law.

“Get Help”:

My dog was trained to use a battery operated doorbell as an emergency alarm to alert for help in the event of a fall when I’m bathing/showering.  At home, this task is usually performed with a cordless phone.  In rehab, I don’t have access to a phone.  So, I bought a doorbell.  (It’s actually the same doorbell inside of the Pebble Smart system for dogs, without the fancy packaging.)  We informed nursing staff of how this system worked and they would keep the battery operated doorbell receiver on their desk.  This was helpful, not only for falls, but also for when I was bedridden due to my physical disabilities and refeeding.

We learned the hard way that my wireless system has a limited range.  I regret now not buying a more expensive system with further reach.  If anything, just make sure you have the nurses test the range while you press the button so that they can leave the receiver in a reasonable spot.

During my third admission, I brought the doorbell with me but didn’t ever need it.  Not only was I never in my room (because of day room supervision), I also was eventually put on supervised showers- so I had staff right there for me anyway.  Even if I wasn’t under such strict supervision, my suitemates (roommates) were so awesome that it wouldn’t have been a problem either way.

Air Travel:

A note on airline rules and documentation: Please review the new airline rules set by Delta and some other airlines as of March 2018.  They require more documentation for travelling service animals, which will complicate things for persons seeking medical and mental health treatment from afar.  Also research the Air Carrier Access Act for information on access for service dogs, psychiatric service dogs, and emotional support animals.  [note to self: include updated information on documentation requirements and how this affects persons travelling long distance for treatment with their service dog, link to a blog post on training a service dog for air travel including TSA pat down and tucking under seats]

Renfrew, when I went, didn’t seem to be very experienced with ADA law and it took a lot of self advocating to clarify that they could not legally ask me for documentation/papers/etc on my dog.  I’m a little overwhelmed right now with the details and will come back at a later date to discuss such.  In the end, they were super accommodating of my service dog and I really didn’t have any issues meeting her needs while I was there.  (Note to self:  include info on the “diaper bag”, “dookie bin”, scissors, tuna/bananas, poop bag protocol, and dog crate) 

Afterthoughts:

Label your stuff.  Address labels for letters work.  Print a sheet of labels off with some Avery label paper.  Hell, just write on the labels yourself- no computer needed.  Use duct tape, if you need to.  Just rip off small pieces of duct tape and use a permanent marker to write your name and stick those home-made labels on everything important that you own (note: in rehab you will not be allowed Sharpies or rolls of duct tape- those are definitely contraband!).  Basically, rehab is like summer camp from hell.  Label everything if you want it back when you leave.

A blue service dog vest with patch.

Photo generously donated by Mack’s handler for this blog. The edit of this photo is owned by abittachy and Mack’s handler (to remain anonymous at this time). Do not reproduce without written permission from myself (abittachy) or Mack’s handler (tba).

Disclaimer:
this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.

The Cordoba Mini M (Guitalele)

I love my Mini M.  I love it to pieces.  But, for the love of G-d, do not buy it from Amazon or even Sam Ash.  The frets are undressed and sharp- resulting in a very sliced and chapped index finger.  There are only 4 ways around this issue:

  • Buy it from The Ukulele Site where they will do a full set-up at no extra charge.
    • It will take longer for your instrument to get to you, but it will be PERFECT.
    • The shipping costs a little more than most online retailers, but that cost is far less than the cost of a fret-dress or pro-setup at a music shop.
  • Pay for a professional fret dressing (where they file down the sharp edges) or professional set-up (which may or may not include a fret re-dress) at your local music shop or luthier.
    • I was quoted around $150 for the fret re-dress at multiple shops.
  • Do the fret re-dress yourself
    • There are several YouTube videos explaining how to do this
    • It takes a lot of time, especially for a beginner
    • You will need to buy tools to do this.  The cost of the tools equate to about the cost of shipping from the site mentioned above that does all of this for you.
    • You could damage the wood or frets in the process
  • Buy a display model instrument from your local music shop
    • Many display instruments will have a partial or full set-up so that they play pristine in order to entice customers to buy the instruments.
    • What you see is what you get- no surprises.
    • It’ll have come from a humidity-controlled environment.
    • No shipping!  You can go home with it right away.
But, seriously, just buy it from The Ukulele Site.  I really regret not going with them, despite being happy with the instrument I do have.  It just would have been a lot less stressful to have THEM handle all or any issues instead of the work falling on me to solve problems.

(I went with a display model because I simply couldn’t wait any longer to enjoy my gift.)

  • You better believe I got the shop to make the instrument as perfect as possible before I told them I was buying it.
  • It had some “buzzing” and the shop adjusted it several times until I was satisfied with its performance.
  • I felt like an annoying POS doing this but honestly it was worth every minute I spent k’vetching over it.  They were happy to see me leave and I was happy with my almost perfect guitalele in hand!

My first Mini M came via Amazon from the official Cordoba seller on there.  Boy, there were issues!  I could immediately tell that the instrument was dry and it was cold (December, joy). It was packaged perfectly and very well but it was warehoused at Amazon and it’s possible that Amazon doesn’t know how to properly store musical instruments.  Typically, this dryness isn’t a huge issue if the instrument isn’t damaged by it at all (and mine wasn’t damaged), but it’s definitely a risk that would have been avoided had I gone with The Ukulele Site.

Another issue I had with my Amazon Mini M was that the sound hole was improperly cut and the finish was imperfect.  No, this doesn’t affect play.  However, this was an expensive guitalele, considering the current market.  While Cordoba may not be high-end, they are selling this instrument for $199 despite the original  Yamaha GL1 Guitalele only costing $99.  I expected to see a lot more quality from this instrument, especially after having played a display model in my local shop 6 months prior that seemed to have been built much better.

The biggest issue, by far, that caused me to return my beloved Mini M to Amazon was that it cut my hand up.  Not gonna lie, my friend’s Yamaha GL1 guitalele did the same thing to me a year ago, which is exactly why I sought out a different maker and stumbled upon the Cordoba.  I didn’t want to deal with sharp fret edges.  I didn’t want my finger to be scratched up, sliced up, and chapped from playing.  I was shocked to find that the Mini M actually has the same issue.  Too bad I already fell in love with the Mini M or else I might’ve saved loads of money by just going with the Yamaha.  After careful consideration of whether this was just a humidity issue (it wasn’t, it was too extreme to only be that), and after calling around to find out how much the fret re-dress would cost (nearly the cost of the instrument itself!), and researching the cost of the tools to re-dress it myself, I came to my decision.  Not only was it cheaper to just send it back to Amazon (free return), it was also an opportunity to hold Cordoba responsible for their shitty instrument.  (I did attempt to contact Cordoba before contacting Amazon for the return.  Cordoba never reached out to me and still hasn’t for 6 weeks.)

The same day that I printed out my return label for Amazon, I called Guitar Center to see if they had the Mini M in stock.  Nope.  So, I headed down to Sam Ash to meet, what would become, my new guitalele.

Sam Ash was slim pickings that day, let me tell ya.  It was the day after Christmas and it was very apparent that, not only had Santa shopped there, everyone who got Christmas money and gift cards had quickly flocked to Sam Ash in order to claim their beloved music gear as soon as they could.  Fortunately, for me, there were still two Mini M guitaleles in stock.  One was in the warehouse and the other (mine) was on display.

I could tell it was the same display model I had touched 6 months prior and fell in love with.  Perfect sound hole, smooth finish, soft rounded fret edges, and a luster that can only be explained by the properly controlled environment (humidity) of Sam Ash’s guitar room.  It also had a problem:  it buzzed.

I tried to ignore the buzzing.  I played it for half an hour.  I put it down and tried every other guitalele brand in stock.  I picked it back up.  Tried to ignore the buzzing some more… I couldn’t.  So, I said something.  It took the shop several adjustments of the truss rod to decrease the buzzing to where I didn’t mind it anymore.  I think we passed it back and forth for maybe 45 minutes before I was satisfied and put my money down.

I got exactly what I wanted that day.  And it wasn’t problem free.  Due to it being a display model, the strings are starting to unwind on me- something I hadn’t anticipated. It’s definitely been played a lot before I came to own it. Some of the frets were a little bit scratchy, I came to find, but it wasn’t problematic like my Amazon instrument was.  I keep a file in my case and, whenever I find a stubborn fret edge during a high neck riff, I just pull out the file and give the edge two swipes.  Definitely not as labor intensive as having to do a full fret dress myself on a factory-fresh instrument.  (Again, this is where I regret having missed out on The Ukulele Site’s free professional set-up.)

However, I am happy and I am both glad and fortunate to possess my Mini M.  Even as I sweat and watch my beloved strings slowly unwind, I am grateful that I have the Mini M that I fell in love with from the beginning.  It’s funny how things work out that way.

Disclaimer: this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.

Why do I have an eating disorder?

Ok so for the longest time for me it didn’t totally make sense why I had an eating disorder.  Yeah, sure, I had trauma.  Yeah, sure, I was bullied for being “fat” (note: I actually wasn’t, but I wasn’t a stick either).  Yeah, sure, I grew up in a female body in a society obsessed with diet culture.  Sure.

But, no, really.  Why did I have an eating disorder?

I just assumed it was my fault- because nobody made me do it.  I supposedly made the “choice” to have one.  But what actually drove me to doing that?

After my friendly neighborhood Renfrew MFG last night, it hit me like a sack of bricks.

Now, my background of “treatment” includes both secular and religious “treatment” models.  While a majority of what was taught in the religious model was useless in the long term, one interesting thing that stuck with me was the “Idols of the Heart” concept.  I knew early on that two of my strongest/most prevalent “idols” (note: idols there = bad) were safety and being normal (with some sub-idols of perfectionism and comfort).  This is important for you to know in order to understand my thought process last night in MFG.

The subject of self esteem was brought up in group and I realized while sitting there that I didn’t actually know what self esteem was.  I haven’t ever known.  To me, self esteem = feeling safe.  In some ways, that could be true.  But what was important is that, in that moment, I instantly recognized I was equating self esteem to my most prevalent “idol”.  And, it struck me that, this is huge.

Then I began a “downward arrow” of “why?” questions in my head:
“Why do I think self esteem and safety are the same thing?”
“Because I don’t have self esteem because I was bullied by peers and abused by family”
“Why did that take away self esteem from me?”
“Because I wasn’t safe”
“Why wasn’t I safe?”
“Because I wasn’t normal”
“Why wasn’t I normal?”
“Because I had autism”
“Why did that make me unsafe?”
“Because it made me a target, for people to bully”
“So, why do I have an eating disorder?”
“Because I wanted to be normal”
“How does an eating disorder make me “normal”?”
“Because then there’s less of me to see, so people can’t notice that I’m different.”
“And why is that good?”
“Because it will make me safe.”

(Safe = not abused/not bullied)

I was only recently diagnosed with Autism as an adult, and it was only very recently that one of my parents came out about me being on the spectrum while growing up and how that prompted the severe bullying I experienced as a child.  Suddenly it all makes so much sense to me how I used my eating disorder to protect myself.  It also makes sense to me why I hated myself so deeply from such a very young age.  I didn’t understand why I was different and I didn’t understand how to be like other people.  No one could accept me for the atypical person I was, so, I had no model of how to accept myself.  Even my parents couldn’t accept my differences because they didn’t really know or understand what was going on either (at the time).  I had nobody to learn from, no role model, no mentor to model to me how I could embrace my differences and recognize my strengths.  I had no one I could feel safe with, so I made my own rules to try to navigate a confusing world where everyone had a map except for me.  If the world was flat and people could fall off of it, I felt like I was about to fall off the edge of the world at any moment because I had no idea where the edge was and it would seemingly appear so suddenly out of thin air without any warning.  Other people could step confidently, knowing exactly where the edge of the world was and that they wouldn’t fall off of it.  I had to tread carefully and retrace my own steps to ensure I stayed inside a box of “safety” which kept me from accidentally encountering that edge- because I hadn’t a clue where it was or when it’d show up.

Other people didn’t understand why I was so rigid and had to stay inside of my box.  But, for me, my box of safety was necessary to survive.

And while I no longer consider my “idol” of safety a “sin” like that religious program taught me, I can see why it hinders me long term.  My box was necessary to help me function at first but now I have the beginnings of a map that I can use to step outside of that box with less fear.

And, so, this is the story of how MFG showed me that my undiagnosed autism was a huge reason for my developing an eating disorder.  It wasn’t the autism itself but, rather, the lack of diagnosis, the lack of assistance, and the lack of acceptance from other humans (leading to years of abuse and bullying) which stole my ability to learn self-esteem and basically stole my childhood.  My eating disorder was a tiny pinprick of light for me in a very dark and confusing world.

Disclaimer: this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.