Digital Doorway

Now that it’s Springtime (well, almost), my wife and I are thinking about opening the windows and airing out the stale Winter air. This is a great idea in theory, but in our neighborhood we are challenged by factors that make us think that our windows should probably stay sealed year-round.

We live in a small community of homes that are quaintly clustered together. Separated by small yards, abundant trees and footpaths that wind through the neighborhood, it is idyllic in many ways. Many visitors say that our neighborhood resembles a Methodist summer camp, and I take that as a compliment. Wooded and a ten-second walk from a picturesque pond, we hear birds singing all around us.

Living with Multiple Chemical Sensitivity (MCS), we are consistently challenged to function in a world where vaporized chemicals and fragrances fill the air. In stores, at work, in medical offices and supermarkets, we are constantly bombarded with drifting clouds of toxins that cause us a variety of symptoms, some of which are irritating and others which are potentially debilitating, at least temporarily.

With our neighbors’ homes in such close proximity, the ubiquitous use of scented dryer sheets is a practice that causes us great consternation and physical symptoms. Our driveway is situated some 200 feet from our home, thus in order to walk to our front door we pass by four different homes. As we meander the paths of our community, we are often hit with a cloud of vaporized Bounce that can cause each of us instant irritability, a burning sensation in our sinuses, sore throat, and asthmatic symptoms in the case of my wife. You can imagine that this is at once unpleasant and unhealthy (plus instant irritability does nothing for a marital relationship!).

As the weather warms and we want to open the windows to let in the “fresh” air, the breeze will often bring with it a wafting scent of fabric softener that invades our home and has the potential to seriously impact our health. Adding insult to injury, one of our neighbors still uses a charcoal grill rather than a gas grill, and the vapors of burning lighter fluid can be carried to our home on almost every summer evening when they’re in the mood to grill some burgers.

Last year, we sent a letter to several of our abutting neighbors to request that they consider changing their habits in the interest of our health, as well as theirs. We received some sympathetic comments (and very unhelpful but well-meaning problem-solving), but we have noticed that no one has actually chosen to change their lifestyle. So, this week we drafted another letter with slightly stronger language, but still not demanding any change. With the letter, we included a plethora of educational materials, brochures and articles which are highly informative, easy to read, and backed up by science and research. Yesterday, on an afternoon walk with our dog, we delivered a packet to each of our neighbors, hoping that at least one or two will consider our request, realize that these chemicals are also unhealthy for them and their families, and make a positive lifestyle change that will be better for all concerned.

Navigating a world that’s literally bathed in chemicals and fragrances is a distinctly unpleasant challenge, one that brings up many of our worst fears. While many people are personally offended when the MCS community attempts to educate them about the dangers of chemicals and fragrances, we are stalwart in our opinion that most simply have not considered that alternatives even exist for these products, and it is part of our mission to educate anyone who is willing to listen with an open mind.

Manufacturers obviously care little for the environment, or for the health of the people who use their products. Corporate loopholes and trade secrets have kept the ingredients of these products hidden from the American people, and continue to do so. Meanwhile, commercials and advertisements effectively convince Americans that odors are bad, and that products like scented trash bags and “air fresheners” are absolutely essential in order to cover up offending smells.

Americans like a world that’s sanitized, shrink-wrapped and tidy, and we have bought this way of thinking hook, line and sinker, thoughtlessly purchasing the products that are shoved in our faces, barely wondering whether we need them or not. Static in your laundry? Buy Bounce! Dirty toilet? Use Febreze! Car smells like the dog? Hang a Christmas tree air freshener on your rear-view mirror! Do we even consider what’s in that can of Febreze? Do we really think that a strawberry-scented candle was made with strawberries? The fragrance in that scented candle was manufactured in a factory where the chemist gives absolutely no thought to the effects of his or her work on your health. That company does not have to disclose the ingredients in the scent which they’ve created, and most of the ingredients that they use are unregulated by the federal government and have never been tested for health effects on humans. So, consider that Plug-In that’s in the nursery next to your baby’s crib. Do you know what’s being released into the air as your baby’s brain develops? Do you know what your baby is taking into his or her lungs with every breath? Surely you do not.

As you can see, I’m fired up. I’m fired up that we are so blind to what has been forced upon us. Whether it’s war or chemicals or fragrances or the economy, our role as accepting and loyal sheep can do nothing but bring us harm. Sure, some people may say that people with MCS are anxious, depressed and antisocial. They can tell us it’s all in our head. But those of us who are aware that we are constantly bombarded by foreign substances in our environment that harm us are not necessarily going to stand by while the air we breathe is consistently polluted.

I can’t shut down the factories, and I can’t get those companies to listen to me. But I can talk to my neighbors, educate my colleagues, discuss options with the owners of stores and restaurants, and consistently demand and request that people take a look at what they are doing and decide for themselves whether it’s healthy or not.

As for my neighbors, I hope to be able to report quite soon that several agreed to change their ways. I hope that, this Spring and Summer, we’ll open our windows and be greeted with the scent of warm pine rather than the toxic scent of Bounce. Whatever happens, I can rest assured that I put myself out on a limb, offered information, asked for what I needed, and (perhaps) opened someone’s eyes to a slice of my personal reality.

So, the next time you do your laundry or clean your house, consider what it is that you’re using. Where did it come from? What is it doing to you, your children and your health? What does it do to the environment when it washes down the drain or vaporizes into the air? Fifteen years ago, few people believed that second-hand smoke was dangerous. Well, the dangers of chemically-based fragrances are no different, and perhaps some of us will now choose to wake up and smell the (real) roses.

I am humbled to discover that (the Blogger-platform version) Digital Doorway is now ranked the 38th most referenced health care blog on the web by Wikio. Previously ranked #65 for some time, Digital Doorway took a quantum leap of 27 points to land at #38, and I am extremely grateful for this honor.

According to an article on BloggerBuster, the Europe-based Wikio ranks blogs based solely on the number of times a blog is referenced within posts on other blogs. On the other hand, Technorati (the most popular and well-known blog aggregator) ranks blogs based on references, backlinks, and blogrolls on other blogs.

Digital Doorway has been referenced on many “best of” lists over the years, and I am eternally thankful for every mention, blogroll, backlink, and other honor that readers choose to bestow. Blogging has been quite an education for me, and I look forward to continued surprises and successes as the years (blog)roll by.

Best,

Keith

As a person with Multiple Chemical Sensitivity who is especially reactive to chemically-based fragrances, I am consistently dismayed by the overwhelming ubiquity of “air fresheners” in public and private spaces.

These days, especially here in the U.S., chemical air fresheners can be found in almost every public restroom. Many of these devices emit a puff of spray on a timer, and if you are unfortunate to be the recipient of such a noxious burst, you are then cursed to spend the rest of the day smelling like a sickening, chemical-induced ersatz petroleum-based flower substitute. And that’s saying it nicely.

Contrary to popular opinion, the fragrance and chemical industry is woefully unregulated, and the companies making the products that allegedly “freshen” the air that we breathe are not beholden to disclose the ingredients in their products to consumers. Based on corporate “trade secret” loopholes, these multinational corporations create fragrances and chemicals filled with acetone, formaldehyde, and myriad other toxic materials that are clinically proven to cause rashes, respiratory distress, neurological disturbances, metabolic effects, and a host of other symptoms. Some theorize that the rise in autism, ADD, and other neurological and behavior problems in children and adults may be directly linked to the number of unregulated and toxic chemicals that permeate the very air we breathe. Meanwhile, the government continues to allow these products to gain a greater and greater foothold in our society, with no way for consumers to have a voice in the matter.

The next time you go into a public rest room, look up at the walls, close to the ceiling. You’ll notice a white plastic box that usually houses a battery, a fragrance canister, and some type of timer. Now, I’m not necessarily advocating vandalism, but those canisters and batteries are fairly easy to remove, and the wires that connect the timer to the battery housing are generally pretty flimsy. However, a more constructive approach would be to speak with the manager of said establishment, informing him or her that the chemicals in that “air freshener” are actually fairly toxic, most likely petroleum-based, and generously laced with formaldehyde, acetone, and any number of unregulated chemicals. You can remind this person that a truly clean bathroom needs no “freshening”, and cleanliness need not be masked with a chemical haze.

Those of us “canaries” who are living in this 21st century coal mine of toxic chemicals and fragrances walk the streets in fear of what chemical may next cause us symptoms which can run the gamut from irritating to debilitating. Although the American Medical Association is slow to accept MCS as a real disorder, MCS is now a protected disability under the Americans With Disabilities Act (ADA), and people with MCS are becoming increasingly active in pushing for rights and accommodations that will render our lives less limited.

Unregulated chemicals now saturate the air we breathe, and millions of Americans willingly use “Plug-Ins” and other devices that release heated versions of these substances into their homes, subjecting children’s developing neurological systems to a chemical onslaught with unknown consequences.

The fragrance industry is thrilled that we now equate cleanliness with a smell, rather than the absence of odor. We have played right into their hands, and their products can now be found throughout the land. So, those of us suffering with chemical injury and environmental illness have paid the price, and millions more will follow. Perhaps your children will one day rue the day that a “Plug-In” released its toxins into their nursery as they slept. These chemicals and chemically-based fragrances are addictive and ubiquitous, but they are wholly dispensable and unnecessary. When will we wake up and see that we ourselves are a science experiment, and billions of dollars are made each year as we stew in this unregulated pot of toxins?

So, I recently posted about the $500 million dollars appropriated by Congress for nursing education and other healthcare-related expansion. As I speak with nervous friends and acquaintances who are keen to apply to nursing school, I assure them that there is money coming down the pike. In the meantime, I tell them earnestly, they should take care of as many prerequisite classes as they can, do volunteer work to add to their resume, network with nurses and other professionals for advice, and research every available scholarship, grant, loan program and nursing-related entitlement out there.

For women of color who want to be nurses, I am even more adamant that there will be money available for them if they want to pursue it. African American women, Latina women, Asian women, Native American women, Pacific Islanders—nurses of color are needed and there apparently will be money available for those particular groups to pursue their healthcare-related education. Of course, no government pool of money appears to be unlimited (unless, of course, it’s money for bank and corporate bailouts), and some of these women and men will not be able to avail themselves of appropriated dollars to pursue their goals. Still, nurses are needed, and as nursing schools build capacity to educate more students, the best and brightest with the most robust resumes will have a corner on the market.

At this point in history, if I was a wannabe nurse, I would get on the phone, interview every nurse I could find, look for places to volunteer and learn, insinuate myself in places where a pre-nursing student would be a welcome extra pair of hands, and I would then proceed to make myself indispensable.

I would build relationships with nurses, doctors and other sympathetic professionals. I would read books and magazines, and then troll the internet for the latest information on nursing scholarships, the hottest nursing schools, the schools with the highest level of open spaces for new students, and the schools without specific faculty deficits. I would befriend nurse bloggers like myself and get the inside scoop on as many aspects of nursing and nursing education as
I could.

Once I chose the schools that interested me, I would write to the Dean of Nursing of each school, request informational interviews, meet with faculty if possible, and ask current students what they felt most helped them to get accepted. Making friends with the administrative assistant or secretary at each school of nursing would also not hurt my cause, especially if some gourmet chocolate found its way to their desk when I paid a visit.

Once contact was made, I would send hand-written notes to each Dean or faculty member who met with me, and I would subsequently follow up by email periodically to ascertain any changes or developments.

This may all sound cynical and calculated, but I truly believe that in a world where loans and scholarships for a limited number of slots in a limited number of nursing schools is the norm, building relationships and connections is the best way to find your way into the school of your choice, or at least a school which you would accept attending if need be. Also, one secret at this point in history would be applying to schools in multiple regions of the country. The Northeast , Southeast and West Coast are densely populated, and it would behoove pre-nursing students to examine schools somewhat off the beaten track in regions of the country which are perhaps somewhat less desirable places to pursue an education.

Nurses will be needed in droves for many decades to come as Baby Boomers continue to retire in ever increasing numbers, and as the most trusted people in America for the seventh straight year, nurses are in good moral and ethical standing on a societal level. While nurses may not always earn salaries commensurate with their level of education and expertise, they are desirable professionals providing a valuable and meaningful service to millions of people every day.

Nursing will perhaps soon enter a new heyday, wherein nurses assume an even more central role in health care as preventive care gains an increasing share of the limelight. Most nurses are experts in preventive health care, and we need more nurses to educate and care for the aging population of the U.S. (and other countries).

So, Dear Reader, if you are a wannabe nursing student with a fire in the belly and an itch to get that education under your belt so that you can wield a stethoscope and the ubiquitous nurse’s pen, work those connections and hit the ground running. Now is the time to jump into the fray as nurses continue to be the growing edge of the health care industry.

In a recent post, I extolled the virtues of collaboration and open cooperation. Every day, it seems further opportunities for such cross-pollination continue to make themselves known.

Just the other day, I was meeting with some regional public health colleagues, and I let it be known that I have started publishing a blog for my local health department. One individual claimed to not know what a blog was (as he lifted his head from under a very large rock). Then the light bulb went off: I would offer a class in Blogging 101 to my colleagues so that they could also have blogs for their local health departments. They were (mostly) thrilled, except perhaps for the hapless middle-aged man emerging from under aforementioned rock.

Moving on from blogs, I entered the Twitterverse several months ago, and began to utilize Twitter for the purpose of micro-blogging and networking. Just this week, my public health and emergency preparedness colleagues realized that Twitter has only recently hit the big time, with the events in Mumbai and the plane crash on the Hudson River being disseminated on Twitter before the mainstream media knew what hit them. Seeing this new reality, many colleagues now see the usefulness and immediacy of Twitter, and I will apparently be offering another class in the art of tweeting quite soon. Hooray for new technologies.

So, my use of the latest technnology and communication tools has parlayed itself into my being able to offer an introduction to such tools to my colleagues who so desperately need to fully enter the 21st century. However, change is the only constant in this universe of ours, and by the time I master Twitter and the art of blogging, a new form of communication will emerge, calling for my (slightly divided) attention. Until then, blogging and tweeting are the forms of the day, and I will soon introduce a very interested cohort of professionals to these extremely useful and contemporary technologies.

A blogger friend of mine recently posted an article about the nursing profession’s “unbreakable” standing despite these challenging economic times. Several of her points are very well taken, and I wanted to take this opportunity to weigh in and expand upon some of her most salient ideas.

According to the 2008 Gallup Honesty/Ethics Poll, nurses are once again in the #1 spot, and have been for the past seven years. In fact, 24% of respondents rated nurses’ ethics as “very high“, whereas 60% rated nurses’ ethics as “high“, with only 1% rating nurses as “low” on the ethics scale. Not surprisingly, bankers did not fare so well, along with stockbrokers, people who sell cars, lobbyists, and telemarketers.

My blogger friend points out in her article that the general public adheres to a “nurses are angels” ethos wherein nurses are still regarded as angelic and selfless individuals who serve others due to their higher-than-normal moral standing and ceaseless desire to give. While this “nurse as angel” motif is indeed quite vexing to those of us who would like nursing to eschew it in favor of simple professionalism, the public’s consistent habit of equating nurses with the angelic realm has certainly cemented our status as a trustworthy source of care for the infirm. Now, if we could trade in those angel-nurse statuettes for higher salaries, I’d be delighted.

Setting those ridiculous and maddening nurse angel images aside, nurses are indeed a very trusted group of people in many societies, and here in the U.S., it seems that Americans hold us nurses in very high esteem. Personally, I’m happy to be a member of a profession that is so revered. Taking that into consideration, I feel strongly that the nursing profession should more aggressively utilize this trust as a means to, 1) recruit more people into the profession, 2) gain further recognition as a true profession (not just a “calling”) with its own code of ethics and standards, 3) advance recognition of nursing research, 4) parlay that trust and recognition into higher pay and better benefits, 5) demand government support for those wishing to enter the profession, and 6) pressure the President to create an Office of the National Nurse that would be on equal footing with the Surgeon General in terms of public health and national health policy.

Nurses have earned the trust of millions of Americans, and it is my point of view that the nursing profession should intelligently and wisely parlay this trust into an acceptance of an agenda of greater professional recognition and increased earning potential.

Speaking of earning potential, here is a conundrum that is especially troubling to this nurse who has actually seen his salary decline over the last few years. If lobbyists, lawyers, bankers, stockbrokers, business executives, and members of Congress rank so low on the public’s list of trusted professionals, why do those groups earn so much more than nurses? If nurses are so revered by our society, why are we not paid on a scale that matches the importance of the service which we provide? And why don’t pharmacists (the second most trusted professionals) and high school teachers (the third most trusted) receive remuneration equal to their societal value and level of public esteem? As corporate CEOs walk away with multimillion dollar severance packages and bonuses at a time of economic implosion across the board, why aren’t the professionals who have actually earned the trust of the American people rewarded for that trust?

Nurses have served the public in myriad capacities for many centuries, and like physicians, nurses frequently hold lives (and troubled hearts) in their capable hands. It is an honor to be a nurse, to know that I am a member of a profession held in such esteem, and I honestly and consciously work to earn that esteem as I execute my professional duties.

My blogger friend feels that nursing is a “unbreakable” profession, trusted and needed by all who interface with the health care system. Yes, we are unbreakable, and as a profession we use integrity, competence and character to garner the trust that is so freely given to us by an appreciative public. Integrity, competence and character are truly a great foundation, and that strong foundation is what will continue to carry us through the difficult times ahead.

Even as March begins and February is left in the dust, flu season shows no signs of abating. In the last week, two otherwise healthy teenage boys died from the complications of influenza infection in Maryland. It is unclear whether or not they had been vaccinated against the flu, but even the most optimistic prognosis tells us that this year’s vaccination does not confer complete protection against some of the strains making their way around the country.

According to the Washington Post, 83 Americans under the age of 18 died from complications related to influenza last year. This year, 17 young Americans have died, not including the two Maryland teens.

Checking in on the CDC website devoted specifically to influenza, 24.6% of all specimens submitted to the CDC for testing have been positive for influenza, and the proportion of deaths is well below the “pandemic threshold”.

In terms of the flu vaccine, it appears that several circulating B strains are indeed not covered by this year’s vaccine, and several strains are also showing resistance to common antiviral drugs. Still, public health officials and the CDC recommend vaccination in order for susceptible members of the public to be afforded the most protection possible.

When checking on Google Flu Trends, one notes that high levels of flu activity can be seen in most regions of the country, although overall flu activity for the United States is still deemed as “moderate”. This information mostly concurs with that of the CDC surveillance site, where widespread activity is seen throughout the northeastern, southeastern and southwestern US.

In terms of pandemic flu, resources have been mobilized by the federal government to prepare for such an eventuality, and public health officials like myself are regularly updated on how national preparations are developing. Unbeknownst to most Americans, enormous stockpiles of antiviral medications are currently stored in massive warehouses in every region of the country, and this Strategic National Stockpile (SNS) can be mobilized and delivered to local municipalities within 24-48 hours of its activation. Many of us public health officials have surveyed local schools and buildings as SNS sites for emergency dispensing of such medication, and plans have been submitted to the CDC so that we can quickly receive these deliveries from regional SNS sites.

The 1918 flu pandemic that killed anywhere from 20 to 100 million people worldwide does indeed seem like a long time ago, and protections against such an eventuality were at that time completely nonexistent. These days, the flu vaccine (which we realize can be woefully inadequate at times) and antiviral medications (to which some strains of the flu are resistant) do offer us some modicum of protection. Adding insult to injury, we are now seeing many secondary bacterial infections in patients with the flu, realizing that some of those infections are themselves antibiotic resistant organisms like MRSA (methycillin-resistant staph aureus), adding yet another layer of complication to the prevention and treatment of acute influenza.

Not to paint a picture of doom and gloom, I am simply pointing out that the surveillance, treatment and epidemiology of influenza has become increasingly complicated in the 21st century, and the likelihood of further resistant strains developing is rather high. Since most epidemiologists feel that a worldwide pandemic is indeed likely in the coming century, it seems that the judicious use of government resources to prepare for such an event is indeed quite prudent.

While I have not personally been touched by an influenza-related death, I feel deeply for the parents of children who have died during this flu season, and I hope that our collective efforts to thwart further unnecessary and tragic losses are widely successful. We’ve seen that influenza is no laughing matter, and being prepared for the worst often seems to be our best defense.

In my current position as a Public Health Nurse, I am seeing so clearly how the building of collaborative relationships is the key to success. Whether I am creating wellness programs for municipal employees, writing town-sponsored blogs, developing emergency preparedness protocols, fostering communication with other town health departments, or working with the local university and colleges, my work revolves around positive relationships and a collaborative spirit of cooperation and mutual benefit.

As I delve deeper into the areas for which I am responsible, there is precious little that I can satisfactorily accomplish without some form of collaboration. If I want employees of the town to exercise, then I have to develop positive relationships in order to motivate employees to take part in my programs. If I want to move forward with our emergency preparedness plans, then I have to work closely with town officials and school department personnel in order to conduct surveys of potential emergency shelter sites and Emergency Dispensing Sites. When there’s a case of tuberculosis or salmonella in town, I have to use my contacts at the state Department of Public Health to fully undertake my investigation.

Every step I take here in my work is collaborative on some level. Every initiative I undertake suggests a way in which I might get the "buy in" of a key individual or group of individuals. With each idea I have or new program I wish to launch, some connections must be made, relationships must be fostered, and alliances forged.

This position of mine is not one in which I can thrive as a lone agent. Sure, I could act on my own, burning bridges as I run rough-shod over my colleagues and other innocent bystanders. But in order to truly create public health programs and initiatives of any intrinsic and lasting value, collaboration and relationship building is key.

I am building such alliances every day, feeding relationships, fostering connection, finding common ground, and building confidence within and without. I am gathering my forces and lining up my allies. And with these elements in place, success is assured.

Several major American nursing organizations are applauding the Obama administration’s demonstrated support for the nursing profession, with newly allocated funding that should have a profound impact on every aspect of nursing, including the central focuses of education, practice, retention and recruitment.

As part of the American Recovery and Reinvestment Act (H.R. 1), $300 million were awarded to the National Health Service Corps and $200 million will be divided between the Nursing Workforce Development Programs (Title VIII of the Public Health Service Act) and the Health Professions Training Programs (Title VII). $10 billion will also be allocated for the National Institutes of Health, with $7.4 billion distributed to various Institutes, including the National Institute of Nursing Research, further demonstrating that nursing’s contributions to both the clinical and research worlds is indeed taken seriously.

The provisions in H.R. 1 allow for money to be distributed directly to nursing students and schools of nursing, with allocations for Title VII programs like Scholarships for Disadvantaged Students and the Faculty Loan Repayment Program.

Additionally, the monies allocated for the National Health Service Corps will fund scholarships and loans to nurse practitioners, certified nurse-midwives, primary care physicians, dentists, mental and behavioral health professionals, physician assistants and dental hygienists.

In blog posts leading up to President Obama’s inauguration, I voiced cautious optimism (and some considerable doubt) that an Obama administration would pay close enough attention to the nursing shortage, addressing not only the need for increased scholarships and education funding for nursing students, but also funding to address the lack of qualified nursing professors available to educate new nurses. Seemingly, multiple levels of the nursing profession have been addressed under the auspices of these new programs, and the money allocated will not only provide scholarships for nursing students, but will also offer loan repayment programs for those nurses who might wish to teach but would likely be dissuaded by the relatively low salaries offered to nursing professors.

I am heartened by this news, and foresee a blossoming of the nursing profession at a time when a universal nursing shortage (and an economy in apparent free fall) inform the overarching zeitgeist that currently casts a pall over the entire health care industry. Yes, most nursing schools are filled to capacity, yet that capacity is generally hobbled by a profound shortage of professors, a reality which very well may be addressed as these funds become available.

These are difficult economic times for many Americans, and as President Obama’s economic recovery plan is actualized, we will begin to see the ways in which the plan may succeed and fail. Over all, I feel optimistic that, in terms of the nursing profession and the profound shortage therein,we will sense a discernible sea change if the allocated funds are targeted and distributed as proposed. While I have not seen the fine print (and we all know that the large print can giveth and the small print taketh away), my hope is that the fine print will in no way diminish the potential impact of such an historically and economically significant investment in the future of nursing.

Despite the dire warnings and the hand wringing occuring nationwide as the unemployment roles grow, perhaps some optimism, positive movement and job growth within the nursing profession will have a ripple effect throughout the health care industry. And for this we can only hope.

Listening to a guided meditation today, I was struck by a statement reminding me about what happens each morning when we wake up. Every morning of our lives, we open our eyes and completely take for granted that our heart is still beating, our lungs are breathing without a second thought from us, our kidneys are churning out urine, and the blood and lymph and other vital fluids of our body are busily going about their work as we rub our eyes and set feet to the floor.

I, for one, am so often lost in the daily deluge of email, phone calls, papers, appointments and “things to do” that I completely forget what’s happening right here inside my little envelope of skin. How can this be?

My wife often reminds me to be sure to feel, express and contemplate gratitude every day. Gratitude for what? For breathing, for another day, for our home, our dog, our son, our health, the money we have in the bank, the jobs that we’re so very lucky to have. Gratitude, she says, for everything and anything, is what’s most important to contemplate every day.

So, how do we remember to do this? How do we remember to feel grateful every day? Do we put Post-It notes on every surface, reminding us to be grateful? Perhaps. Do we tattoo “Remember to be grateful” backwards on our foreheads so that we remember every time we look in a mirror? (Perhaps a little extreme, but if you try it, please send me a photo!)

I admit that I am as guilty as the next person, and I am more likely to forget than to remember. Luckily, I have my own “Gratitude Guru” in my life, and I am reminded to be grateful more often than I would sometimes like! Still, I appreciate the effort, and am slowly making strides.

So, dear Reader, how do you remember to be grateful? Do you feel gratitude from time to time? What happens when your feet hit the floor each morning?