Wednesday, March 14, 2018

Pour me a drink, my kid is turning 30

The first picture of Ariel

In March 1988, I was a 22 year old pregnant military spouse living in Alamaogordo, New Mexico.  I remember it like it was yesterday. 

Pour me a drink, that kid is turning 30. 

I only lived in Alamogordo for a few weeks, just long enough to finish gestating and give birth to Ariel Marie, 9 lbs 1 oz, 21 1/2 inches long, and perfect. 

Pour me a drink, that kid is turning 30. 

We moved on to Clovis, New Mexico only a few months later, where we learned to cope with the smells of herds of Texas cattle and the sleep deprivation of having a newborn. 

Pour me a drink, that kid is turning 30. 

When she was 9 months old we flew to live in England. When we came back to the states she was 3 and spoke with an English accent.  

Pour me a drink, that kid is turning 30. 

When she started Kindergarten we were living in Lubbock, Texas, and her beloved sister, and playmate, Lacey, was born. 

Pour me a drink, THAT kid is turning 25 in June! 

In middle school Ariel refused to go to her Confirmation and started reading Ayn Rand and Ann Rice. She was my first, and I had no idea what I was doing. 

Pour me a drink, that kid is turning 30. 

In high school she cried before and after debate tournaments and became editor of the school newspaper. She looked like a fashion model in her prom dresses. I had no idea what I was doing. 

Pour me a drink, that kid is turning 30. 

Trinity University awarded Ariel the President's Scholarship and she double majored in English and Communications. I thought maybe I'd done something right. 

Pour me a drink, that kid is turning 30. 

I knew day would come when she would move away but I wasn't expecting the news that it was 1,111 mikes away (I looked it up). She went off to Ft Lauderdale, Florida to be a newspaper reporter. 

Pour me a drink, my kid is turning 30. 

When she moved back home 4 years later she told me that journalism was dying, and she was depressed. I had no idea what I was doing. 

Pour me a drink, my kid is turning 30. 

Ariel proposed to her fiancĂ© this past year and they're planning a wedding for April 2019.  They live and work and play and travel together. Her birthday is today and she is in Nevada at a conference for her work in the marketing department of a gaming company. 

Pour me a drink, my kid is a beautiful, accomplished young woman turning 30. 

Make it a double!  I hear 30 is the new 20. 

Tuesday, March 13, 2018

Prevention is Hard: A prison pipeline story

For over 20 years I have been working in the nonprofit sector youth development space.  Over that same span of time my brother has been working in the federal prison system.  He says his side is winning. 

What he means by that is that he wins in the revenue department.  His system is more well funded than mine. Way more.  He recognizes this despite the fact that he is constantly lobbying to stop cutting federal funding for the prison system.  So here we both are:  Me struggling to find revenue to keep kids out of prison, and him struggling to find revenue to adequately care for them when they ultimately get there. 

Isn't that a happy family story?  

My brother (left) in a picture not involving work. #gospursgo
We came to this realization sitting around a bunch of beer coolers in a parking lot about 7 or 8 years ago.  The story is fuzzy in my memory* except for that vivid illustration of the consequences of a lack of funding for prevention in the youth development space.  My brother's union had a conference and the hotel they stayed in was right across the street from my nonprofit.  They basically packed out the hotel and one night they brought a barbecue grill across the street, and the prison guards and social workers had themselves a party.

We told them about our waiting list of kids needing mentors.  They told us about guard to prisoner ratios and how often that rule is broken. We talked about the challenges the kids in our program face, and how long they stay on the wait list; some til it's too late.  They were familiar with the dysfunctional cycles that plague the families of kids who end up in jail; they knew how common it was for multiple family members to all end up in prison.  We talked budgets and they laughed at ours (around $2 million).  They said the cycle of incarceration was inevitable and it was "nice of us" to try - but we would lose way more often than we win. As the beer flowed, they even laughed at us a little for even trying.

It's not a question of can we prevent kids from going to jail?  At my nonprofit we know that mentoring works.  There is both anecdotal evidence and research that it does. But as I wrote about before, outcomes don't really matter in the current system.  One of the craziest things I have ever experienced in my professional career was when a state government department-head told me that it didn't matter that we were 100% successful in our program, and that had nothing to do with being funded.

A year or so ago we got a list of kids from our local probation department referred to us for mentoring services.  They were all between the ages of 14 and 17.  Most of them were already in our system - un-served back when they were 7,8, or 9 - what we called "file closed, unmatched." They were unmatched because we have around 1,000 kids on the wait list all the time and never enough  funding to meet the demand. You have to wonder if those 7,8 and 9 year olds had had mentors back in the day, would they have gone down the same path?  Probably not. 

Recently I spoke with a juvenile court judge and told him that getting kids in our program graduated was not a challenge.  He said that "can't be true," or he "would have heard about it.**  Why is it so hard to believe?  Because it sounds too easy?  Well, it's not easy. Running a quality mentoring program is very difficult.  Human relationships are complicated, and a quality mentoring program is a massive challenge to implement.  Part of the problem is that many mentoring programs are not quality, don't even track outcomes, and everyone assumes we are as marginally effective as they are, if at all.

Prevention is hard to measure. It's a challenge to prove that something that didn't happen might have happened if not for that intervention. But preventing the problem from happening is arguably less expensive - and easier- than fixing the problem once it's occurred. Those teenage boys referred to us from juvenile probation are now criminals.  Changing who they are now is a far greater challenge than teaching them to avoid that path when they are 7, 8 or 9. 

Just when we thought the situation couldn't get worse, along came the proliferation of for profit prisons. That's one way to solve a problem. There's no doubt in my mind that decreasing funding for juvenile delinquency prevention is related to the increase in for profit prisons.  When the future is all about keeping beds filled, why in the world would we invest in preventing it now?

So what's the point of this post?  I'm not sure, but I wrote it while on vacation from my nonprofit work.  The lack of investment in the prevention of juvenile delinquency weighs on me. One of the ways I cope with things that bother me is to write them down.  It doesn't solve anything but it tames the chaos in my brain, perhaps preventing madness. The situation is enough to drive anyone crazy, so you never know. I'm pretty sure that it would cost more to admit me. 

*there was a LOT of beer
**as if I have the funding to make sure everyone hears about my program! Can you say "nonprofit overhead?"

Monday, March 12, 2018

Prevention is Hard: The story of a glucose monitor

When I was pregnant at the age of 22 I had gestational diabetes.  They told me that it goes away most of the time after delivery, and it did. It came back 5 years later with my second pregnancy but went away again.  However, I started having higher glucose tests at my check ups than I had post pregnancy before, and when I had my third child in 2002, the diabetes stuck.  A lifetime of preventing pre-diabetes from becoming full-fledged diabetes began about a year later, and I have been swimming upstream against a health care system that refuses to prioritize prevention ever since.

During my 3rd pregnancy I was given a glucose monitor.  This is an amazing little device that tells you what your glucose levels are any time you prick your finger and feed it a drop of blood.  It's used to monitor sugar levels for the purpose of learning how to control them.  It was very hard to get one a year after I had my baby.  I wished I had kept the one I had during my pregnancy, but I thought the diabetes would go away.  I probably wouldn't have been able to get the lancets and tests strips anyway though.  As I watched my glucose levels rise and fall at appointments from 2003-2009, I asked several times for a monitor but was told it "wasn't necessary at this time."  In 2009 my A1C* went over 6.

I was determined to beat the evil diabetes and knew from pregnancy that I had the willpower to control it with diet and exercise. I read everything I could find about nutrition and glucose. I lost 40 pounds in 3 months and kept it off for over 5 years.  My glucose stayed steady at 5.  In 2014, I started gaining weight but couldn't figure out why. Over the next 2 years I gained about 30 pounds, kicking and screaming all the way.  I thought it was the infamous "metabolism" slowing down as I aged, but it turned out to be a non-functioning thyroid covered with polyps that may or may not be cancerous,  which I had hastily removed. 

It wasn't until 2016 when my A1C went over 7 that my insurance finally approved nutrition education that I no longer needed because I could have by then taught the classes. I asked for a glucose monitor again but they told me to "just go to the classes" because "the key is eating the right foods." I told them I was eating the right foods. They were skeptical. I asked if the thyroid problems could be causing my high glucose levels. They said no.  This turned out to be false. 

In 2016 I started seeing a glandular disease doctor to monitor my thyroid medication.  He became very interested in my diabetes problem and told me I needed medication.  I told him I could control it without medication and he told me all about how my organs and my eyesight would suffer if I didn't follow his advice. I drove home feeling defeated. I had lost the battle.  I was officially diabetic.

I had two choices:  Give up, take pills and go eat ice cream, or go see a different doctor.  I chose door number 2 and finally! found a doctor who gave me a glucose monitor.**  From February 2017 to June 2017, I lost 30 pounds and my A1C went from 7.1 to 5.3.  My doctor was so excited that she could not stop smiling. Seriously, she was just gleeful.  I don't think they see a lot of diabetes reversal.  I told her it was all the monitor. It is the missing piece in the Glucose Wars because it gives you the intel you need to understand what effect any food you ever eat has on your body.  It also helps me see the relationship between food and exercise.  For example, I can eat ice cream*** and then go for a walk and then test my levels 2 hours later.  If I test high I either ate too much ice cream or didn't walk long enough, or a combination of those factors that I can play with next time.  I can also monitor the effect my weight has on glucose levels.  I know that if I go over 150 lbs, my glucose levels will go higher than if I stay under 150.  It's a very powerful tool.

If I'd been able to get a glucose monitor in 2009, this would be a very different story.  I don't think  my A1C could have ever gone so high.  I honestly don't understand the reluctance to give them out, and it wasn't just the insurance - the doctors weren't supportive either.  Everyone was far more interested in prescribing medication that chemically lowers glucose - medication that can have the some of the same side effects that my doctor told me would happen if I continued to refuse medication! How freaking confusing.

I know the journey isn't over.  Stress can cause my glucose to rise even if I am doing the right things with food and exercise.  I saw that when I had the thyroid problems.  And controlling my weight is hard too, which probably does have something to do with metabolism over the age of 50.  But I feel that much more confident in my ability to win the war, now that I have the right tools.   The moral of this story is that prevention may be hard, but not necessarily for me now.  

*A1C is the number that measures your average glucose over the paste 3 months
**and an insurance company!
***it's usually not ice cream, it's way more likely to be mac-n-cheese or a hamburger