Healthcare and ACA: Part Three

This will be the last of this group of blogs, but I wanted to talk about what you can do to help stem the tide of rising healthcare cost. This is going to be about healthy living and accountability. Your circumstances, lifestyle, and personality all play an important factor in this so this will not be a how to guide. More like guidelines. There are four basic pillars that I think are key for getting a healthy lifestyle.

The first pillar. See your doctors! There is the pervading fear that doctors are out to steal all your money by putting you through a slew of unnecessary tests. If you are 45-years-old and haven’t seen your actual primary care doctor since you were a child, yes, you probably will have to go through a battery of tests. This is not to bilk you of your money, but to create a baseline for where you are at. Here is a list of doctors you should be seeing on a regular basis, how often, and why you should see them.

Primary Care Physician (Family Care or PCP): Once a year you should schedule a general check-up. Without insurance this will likely cost you $100-200 a visit. In your twenties this is to gain report with your doctor and set up a good habit of getting checked out and booster shots as you need them.  This also helps to start tracking your primary chemical profiles. You won’t need lab work every year, but if something goes wrong it can be caught fairly early. When I was in nursing school I felt overly fatigued and had issues with my weight. I thought stress was the culprit. Turns out I have the beginning stages of thyroid problems. I wouldn’t have known if I hadn’t seen my doctor on the regular. In your thirties you will probably have more frequent lab work but nothing crazy. Forty plus adds additional procedures, such as colonoscopies. None of these are to cash in on your paycheck. These are to track your health and catch anything suspicious early. Cancer, hypertension, pre-diabetes, and many more chronic health problems can be curtailed well before they become problems if you see a regular doctor regularly. This is also the office you call with non-emergencies. If I look at the ER list of who is in there, trying to gauge who my next admission is, I get annoyed with seeing “Has been feeling weak for 3 weeks” or “Cough lasting two weeks”. I am not joking, these are real “problems” people come to the ER for at three in the morning. GO SEE YOUR PCP.

Dentist: This is a twice a year event. Without insurance this will likely cost you $100-500 a visit, depending on x-rays and stuff like that. Usually x-rays can be done every other year. Oral hygiene is super important to your health. I don’t really understand the fear behind going to the dentist other than that people don’t like their gums being prodded and the noise. If you get super anxious going to the dentist, talk to your PCP about getting something to help with anxiety. You should still go! Gum disease, tooth disease, over crowding of your teeth, bad breath, all sorts of things can get sorted out here. Besides, clean teeth are amazing. Dentists are also aware of any notable changes in your oral cavity and can refer you to your PCP if they find something suspicious. Keep your teeth as long as you can! Another lovely thing I see on that ER list is tooth pain. Unlike a dentist, ER doctors are not as skillfully equipped to deal with your rotting tooth. They will likely refer you to a dentist or an oral surgeon. Now you just wasted $1500 for something I am telling you for free. Go to your dentist with any dental problems.

Optometrist/Ophthalmologist: Eye doctors. You need to see this guy once a year. Without insurance you will likely pay $100-200 a visit. Did you know these guys diagnose diabetes in patients sometimes before the PCP? Vision is super important so why stick your head in the sand about it? I don’t like the puff in the eyes and I don’t like paying a crap ton for glasses but I need to be able to see! Go get your eyes checked.

Gynecologist: Once a year. No insurance visit will likely run about $150. Ladies, this is important but does not replace your PCP. Your reproductive health is necessary to take care of. Ovarian, cervical, uterine, and breast cancer are not a joke and one of those is a silent killer (ovarian). Polycystic ovarian syndrome, endometriosis, and a slew of others are also very unfun. Don’t skip this. This is also who you call when you have vaginal discharge. Honey, that didn’t start at midnight. You have had that funk for a few days. Call your gynecologist.

Guys, sorry, I don’t know much about dude doctors. Not to say male reproductive health is not equally important. It is. But your genitals are on the outside. It is easier to spot when something is really off really quickly. If it isn’t an emergency, i.e. intense pain, bleeding, or some sort of abnormal swelling, call your PCP and get it checked out. Trauma is an ER visit. Make that a routine thing to talk about with your PCP. I know it is uncomfortable, but testicular cancer is worse, I promise.

This is one of the building blocks to a healthy lifestyle. Doctors are able to make much more personalized plans for you if they know you and have a report with you. If you don’t like your current provider, find another! You can get copies of your health records and take them with you. This will help you save money as there will be less trips to the ER and less time off of work if your doctor can provide you with the appropriate care on the first go around. Set the baselines, open the dialogue, and work together towards healthy lifestyle.

The second pillar is eating healthy. I am not saying eat green, be a vegetarian, go paleo, or whatever the latest craze is. What I am saying is try to eat along the outside of the grocery store more often than not. What does that mean? If you look at the layout of grocery stores you will notice the whole foods are along the outside of the wall. Fresh meats, veggies, and fruits are along the outside. You want those to be your main staples for your diet.

But, but, but, this is expensive! The expense comes when you throw out food you don’t eat. If you eat it, it isn’t wasted. Yes, it can still be more costly than buying the boxed foods in the center aisles, and those are not completely cut off for you. Just think of it as an 80/20 or 70/30 type of lifestyle. Seventy percent should come from the outside of the grocery store and the other thirty comes from the aisles. You can also save additional money by stocking up on frozen fruit and veggies. You have to be savvy. Meal plan, budget effectively, and stick to it. It gets easier with time and practice.

The third pillar is to be active. I don’t advocate running on the treadmill for hours at a time. Find something active that you enjoy doing. I love to pole dance and biking. My husband loves Cross-fit and martial arts. Whatever it is, it should be something you enjoy doing. Why is that so important? If you don’t enjoy it, love it, get ramped up about it, it will turn into another chore. Yes, there will be days when you simply can’t or don’t want to. That is fine. You will get the desire back. If not for what you were doing then for something else. Find something and get pumped.

The last pillar. Get your home in order. Take a minute. This is the hardest pillar to stack correctly, but it is essential. Finances, debt, is your biggest enemy. This is hard when our society embraces debt like a lover. You have to get that in order. I will be posting some budget challenges soon, but if you need additional guidance pick up Dave Ramsey’s Total Money Makeover or his Financial Peace. Get your home clean. This is impossible with children, but if you have a plan to get things done that is better than nothing. Get your schedule organized. You can’t keep appointments if you rely on text messages reminding you that you have one. There are thousands of posts out there about how to organize, clean, and shape up your home. Take the time to put it in order and watch your stress level drop.

I do have one last pillar. This is a bonus pillar. Find a career that you love. This is also a hard pillar. Part of building a healthy life is that it should be a life you don’t need a vacation from. The number one thing that people run away from is their job. I 100% understand that you need to pay off your debt and bills. Get that done. Don’t wait. Do the things you hate if you have to get there (no don’t really). When the focus is no longer on making the ends meet, you can focus on building that very life you want, including your career. Take the time while you dig yourself out of your hole to think about what you want to do. Then plan your steps to get you there.

I don’t have any fast and hard rules to transform your life into a healthy one. As a medical provider these are the general guidelines to get there. There are lots of resources for you to explore on your own. I have done a post on meal planning. Like I said I will be posting budget challenges based off of the Total Money Makeover. I will journey with you as far as you want to go!


Healthcare and ACA: Part 2

The second part of my healthcare is going to focus on the biggest driver of our costs. Us. I know that sounds a little painful but it is the truth. We have brought the system to its knees.

There is a common thought that there are two types of medicine; Western and Eastern. This is not wholly inaccurate but I would like to challenge that there should only be one type of medicine.

Eastern medicine is considered a more holistic approach to caring for the body, incorporating a mind, body, spirit mentality. The goal tends to focus on preventing disease before it occurs. Western medicine is considered targeted medicine, focusing on the current problem and fixing that, as opposed to trying to prevent the problem to begin with. Eastern medicine, stop heart disease before it happens. Western medicine, triple bypass after a heart attack.

These are not two opposite systems. The notion that one type of medicine treats disease before it happens and the other only after it happens is false. Vaccines are an excellent example of Western medicine preventing disease before it happens. Yoga after a mental breakdown is an excellent example of Eastern medicine treating disease after it has occurred.

I am not advocating one over the other, I am advocating for both. There is a knot in my plan, however. YOU.

In our current society we want the quick fix and, trying to be politically correct, we have embraced the idea that unhealthy practices are not wrong, but a persons choice. Cool. My current favorite TV show is My 600lbs Life. Talk about heebee jeebees. My husband things I am morbid for watching the show. I think it is fascinating. These men and women are killing themselves with food. It would be like watching My Heroin Life, but since the substance is illegal all the people would go to jail. While watching this show there are advertisements for My Fat Fabulous Life. WHAT? You are airing a program that is showing the worst of our morbidly obese society and then advertising a show that glamorizes obesity? *Head explodes*.

I am not here to shame fat. I am here to say obesity is unhealthy. I do not care if you don’t have problems now. It is simply a matter of time.

This is a hugely complex problem. We tend to be ostriches when it comes to our health. Nothing is wrong until it goes very wrong. We bury our heads in the sand and pretend that our lifestyle is normal and ignore the health risks associated with it.

Obesity- one of the top contributors to a wide range of health issues including, but not limited to, cardiovascular disease, hypertension, obstructive sleep apnea, diabetes, multiple cancers, and mental health issues like depression and anxiety.

Smoking- one of the leading risk factors of a multitude of cancers, stroke, and hearth disease, as well as being lined to mental health issues.

Excessive drinking- one of the leading causes of liver disease, cancer, hypertension, and cardiovascular disease, as well as mental health issues.

Stress- One of the leading risk factors for obesity, smoking, and excessive drinking.

None of these are new phenomena and nothing I have said so far has shocked anyone. What is shocking is that most of us will continue with our current lifestyle, making minimum effort to change what is wrong in our lives.

This is normal. Like I said in my previous post the US population will work itself into the ground to make money then spend all of the money to fix it’s health issues RIGHT NOW. I know it took me a decade to get to 600+lbs. Make me skinny now! I know I have been smoking three packs a day for the past 20 years, give me a patch to make me stop and replace my lungs now! I know I have been drinking like a fish for most of my life, give me some Ativan to control the withdraw symptoms and replace my liver now! Madness!

This is what drives up our healthcare costs to the extreme. This page taken from the CDC website states that chronic disease (cardiovascular disease, diabetes, renal and liver disease, cancer, etc.) were 7 of the top 10 causes of death in 2012, with cancer and heart disease taking a whopping 48% combined. Read that again if you need to. These numbers are disturbing.

So, what happened and how did we get like this? Like I said, this is a complex socioeconomic problem that interacts with our psychosomatic systems. Our current social structure doesn’t support healthy living mentally or physically.

I am going to discuss this from a middle-class perspective, as that is what I am, and delve a bit into how this is more complicated for the working poor and poor. We are, after all, the other 98% of the population.

And what is this mythical beast that keeps us unhealthy rats running on a wheel that continues to drive healthcare costs through the roof? DEBT. I wish I were joking. If you asked 100 of your friends and family what they would do if they won the lottery 98 of them would tell you they would pay off their debt first. They would then quit their jobs, take an expensive vacation, buy their dream car, build their dream house, and do whatever they want.

Problem! No one will mention changing their unhealthy habits. No one mention saving money for the future expenses of said belongings. Pretty much no one has an extended plan with that new Get Out Of Jail Free card. The lottery is a golden egg that cures all of right-now’s problems but does nothing for the future. Why? Because no one links their unhealthy habits to their debt. No one links the 60-100h work weeks or the three jobs to their unhealthy eating, sleeping, and exercise habits, because they have to pay the bills, but they will buy that PS4 on credit because it’s the only thing they’ve got going for them. It’s a bleak picture, but I promise if you didn’t have to work so much you could do the things you need to keep your health in balance.

I feel like this has sort of spiraled off topic so let me highlight several things:

  1. Rising healthcare costs are driven by the consumer. We want it good and we want it fast, which means it will be expensive.
  2. The consumer does not take care of their health appropriately. We as a society glorify health without enacting healthy behaviors or we glorify unhealthy people in an effort to be politically correct.
    1. I want to eat healthier. Are you going to turn into one of those health nuts?
    2. I want to work out. Oh no, are you going to be a gym junkie?
    3. I want to reduce the stress in my life and work less. You’re lazy.
    4. It’s OK that I am teetering on the edge of obesity as long as I love my body.
    5. Binging on alcohol is totally normal in your early 20’s. Everyone does it. It’s called partying.
  3. The consumer ignores the mental aspect of health as “fake” and “in your head” without understanding the complex dynamic between the mind and body.
  4. Because of unhealthy consumer habits (increasing debt) in a system driven by the false assumption of capitalism and democracy, the consumer put’s their health and family on the back burner to earn more money, then spends all the money on health when it fails.

This is a chronic condition in the US. I see it and live it every day. I am not here to preach to you. I am sitting on $200,000 of debt myself and I was forced to slow down due to poor health choices. I am speaking to you from the bottom of what we consider middle class. These things are only exacerbated as you go down in socioeconomic class. The working poor and poor don’t even pretend to have access to quality living conditions, quality food, or quality healthcare.

From these poor conditions huge healthcare costs are incurred. The leading cause of healthcare spending is on chronic disease most of which could have been prevented or minimized with a healthy lifestyle. Healthy lifestyles are supported by healthy habits with money. Healthy habits with money are a learned behavior. And now we circle back to what I said in my first blog. All of our systems are broken because our education system is broken and does not adequately prepare us for life.

Alright, this was another long post. I hope I adequately laid out why the consumer is just as big a driver of healthcare costs as insurance companies and Big Pharma. My next and final post on this topic will be about leading a healthy lifestyle from a medical professionals perspective. Again, keep your comments positive and productive!

Healthcare and ACA: Part 1

This is a very touchy subject right now. Our sitting Senate has voted to repeal the Affordable Care Act (Obamacare) without having an alternative in place. I have mixed feelings about this.

I want to start out that our healthcare system, like many of our systems, are broken. The biggest reason for this is our failure as a society to provide adequate education. From this system alone all our other systems fail. However, I am going to talk today about the ACA, insurance, and our current healthcare system.

Let’s talk about insurance first, or what insurance is not. Insurance is NOT a guarantee of quality health care. Insurance is NOT there to take care of all your little medical expenses. Insurance is NOT there to keep you healthy. If you have great health insurance but you eat four times a day at McDonalds your health insurance will not be able to prevent your heart disease. Insurance IS there for emergencies (appendicitis or a broken bone). Insurance IS there (or should be there) to cover passing medical disabilities (pregnancy or slipped discs) and should help cover the costs of care during these types medical needs.

Insurance is a gamble. I am betting (though praying not), with my premiums, that I will need some sort of emergency care. The insurance company is betting that I won’t. Much like a casino the insurance company makes its money when you are perfectly healthy. You make money… when you are sick. Does that sound like a win to you?

Why should insurance NOT be a guarantee of quality healthcare? Because we, as healthcare providers, should be attempting to provide quality healthcare no matter what. There are very few healthcare workers out there who wake up in the morning and say to themselves, “You know what? Today I am going to provide shitty care to all my patients. What do I care? I get paid the same.” I am not saying we don’t have bad days. I am not saying some aren’t out for the money. We do and some are. The vast majority of us want to do our jobs and do them well. We also want to get paid appropriately for our skills.

Why should insurance NOT take care of all your medical expenses? Does you car insurance pay for your gas, tires, and oil change? If it does for a reasonable price please tell me which company you use ’cause I will be on that like white on rice. How about your life insurance? Does that cover your rent/mortgage and food? Again, what company!? I am not pointing this out to be rude, but we don’t expect any other insurance to cover our routine costs in life, so why do we expect our health insurance to? Because we don’t go to the doctor every other week? So? You don’t get your oil changed that often either. Preventative maintenance should be our responsibility in all aspects of our life, including out health.

I pick out emergencies for the obvious reason. You buy life insurance for when you die, car insurance for when you wreck, and homeowner’s insurance for when your house burns to the ground. An EMERGENCY. I added the caveat of short term disabilities because they are emergent non-emergencies. I planned on getting pregnant. I did not plan on going on disability for complications of pregnancy. It is also a temporary medical condition. I will not always be pregnant and will be able to go back to work. If not, there are other financial securities I should have in place to cover my costs. No one plans on getting cancer, but it happens and the cost can be astronomical. Again though, this is for a limited time or it is terminal. Care should extend to treatments and continued screening for cancer.

So, now I have covered what insurance should be doing in an optimal system. Does this sound like the system we have? No, it doesn’t. It has been fed to us that health insurance should cover all our costs. This is impossible and a bad business model. It drives up the cost of health insurance and the cost of health care! Insurance is a band-aide on a symptom of our poor healthcare system, not the cause and certainly not the cure.

Now that we have covered insurance, let’s talk a little bit about the system of care. It is a service industry. Just like waiters, taxi cab drivers, and your lawn guy, we provide you with a service. Our main difference is you will need us at some point. This isn’t a question of if, it is a question of when, because you will need our care. And you probably will not like it.

I am not sure where this idea developed. I suspect because it is an easy parameter to measure is the excuse. Your hospital is NOT a hotel. Your doctor’s office is NOT a restaurant. Your satisfaction is not our markers for successful treatment. Why do you have to be at the doctor’s office 15 minutes before your appointment and wait an hour before you see the doctor? Because of these stupid scores. Why is there a spiking opioid addiction in the US? Because of these scores. Why do your nurses sound like robots and you get asked the same question over and over? Because of these scores. What scores am I talking about? HCAHPS and Press-Ganey surveys. This is a painful subject for me.

The parameter I am talking about is your satisfaction with your care. Not “did you get better,” or “were you given the appropriate information,” but “how do you feel you were treated?”. This is a terrible parameter and studies have shown that higher scores correlate positively (they both go up) with morbidity (illness) and mortality (death). You can be very satisfied with your care and still be dead. This paper showed that health outcomes did not affect patient satisfaction (isn’t that the point of the intervention?). This paper showed positive correlation with higher healthcare costs and higher mortality rates. This is not to say we shouldn’t strive to provide a satisfactory experience, but the current parameters we use to verify satisfaction are not well made. If you are constipated I will give you an enema and you probably will not enjoy it. But you pooped. Which is the greater indicator of successful intervention for your current problem?

You would think that the long waits have to do with greedy doctors trying to squeeze in one more patient so they can make more money. This is absolutely true, but not for the reasons you want to believe. With the rising cost of healthcare, doctors are feeling the pinch. It is not the financial windfall you think it is. Primary care doctors (your family doctor) don’t make bank. Most new MDs and DOs won’t go into family medicine because there is no longer financial stability there. Their student loans and the amount of overhead it costs to run a family practice is too high to contemplate. Less doctors equate to longer waits at the office and docs trying to see as many patients as possible to make ends meet. It is not an ideal situation. The same can be said for hospitals.

All of these things drive healthcare costs up without improving the system. Increasing healthcare costs on this front are reflected in our insurance premiums. The cycle continues.

The last part of this problem, within the system itself, is two fold. We have an over-dependence on drugs, pushed by Big Pharma, and a lack of ability to experiment with alternative medicine. Big Pharma first. These guys are not out to help cure you. They are out to make you loyal customers. Look how many ads are for different drugs for the same type of disease. Whenever I watch TV I see at least three ads for different medications for psoriasis and blood sugar. “Ask your doctor if BlahBlah is right for you!” The US pharmacopoeia is huge. Fine, whatever. But there was a reason the EpiPens hiked this past year and multiple Pharma CEO’s have been in the news for basically defrauding the public.

I am not against medicine. They are usually necessary. I don’t think medicine should be the end game and most medical professionals will agree with that.

The second part of this is the inability for healthcare providers to offer a multitude of different treatment options. You have pain? Here is your prescription of pain killers. You have high blood pressure, here are your BP meds. It doesn’t stop. I just read Dave Ramsey’s Total Money Makeover (go buy it. It will change your life) and, as of 2012, Big Pharma had paid over $88 million dollars in lobbying and advertisement, while alternative therapies spent $4 million. I haven’t looked at recent numbers, but I also haven’t seen any commercials for acupuncture. Doctor’s hands tend to be tied to what INSURANCE will cover (and since most of this is routine, existing conditions) not always what is best for the patient. I would love to see chronic pain patients get weekly massages. Cheaper to give them Norco. I would love to see obese patients get assistance with diet and exercise. Cheaper to give them meds to cover their many illnesses. Insurance tries to keep things cheap to keep their money coming in. You will only get eight physical therapy sessions, then meds will have to be your answer because INSURANCE won’t pay for more.

Are we seeing a trend here? This was the original problem with the ACA. Insurance never equates to quality healthcare. It is expensive and escalates healthcare costs. Big Pharma is out to make a buck and create long-lasting customers. This drives healthcare costs up and insurance up. Insurance reimbursement is tied to Patient Satisfaction, not health outcomes, which drives healthcare cost up. The system is tied so tightly to Big Pharma, Insurance, and Patient Satisfaction that healthcare providers are required to find the easiest, cheapest way to manage our health problems. Notice how I said manage and not fix. You don’t get out of the system. You wouldn’t be a loyal customer if you did.

Alright, I have covered a lot in this blog and it hasn’t even covered the biggest problem in our healthcare system. YOU. Let me know what you think. Please be courteous and respectful, even if you disagree with me. I am open to honest discussion but I will delete any comments that I feel are out of line (and yes, that is up to me). Thanks for reading and join me for my next blog!

We the Millennials

I am sincerely tired of hearing how terrible we millennials are. I get it. We are self-indulgent, immediate-gratification seeking, special snowflakes that need to grow up. Most of you reading this will either agree with that assessment of my generation, or say that it doesn’t apply to you. You are both wrong. I think I am going to have to split this into several blog posts.

I am 31. I am on the cusp of that millennial generation. Somewhere between the year 1980 and 1985 is when this generation starts. The exact date is hard to pin down.This website says that Millennials, or Generation Y, were born between ’77 and ’94. I think it is easier to just say those of us born between ’80 and ’90, those of us who are now firmly adults, are considered this generation. Sorry to anyone who thought you managed to squeak out of this particular generation bracket.

I want to start with a bit of history, for those who don’t really know the differences between the generations and how that has directly evolved into us being self-indulgent brats. We were self-indulgent. This is, first and foremost, our parent’s fault. WHAT?!?! You little brat! It is not our fault! I want to box ears when I hear this. Yes, it is, indeed, our parents fault. If you want, you can keep blaming generations back and say it is our grandparent’s fault, or our great-grand parents. Please, pass the buck. We will end up doing it too. However, most of us are not self-indulgent little brats anymore.

How, though? How did it come to this? As a parent you never want to see your child suffer. I dream of this, just kidding! the 1900’s was a gloriously hard century. Two world wars, technological advances bringing science fiction to life, major medical breakthroughs prolonging life, social networking and globalization. There was more change in the past 100 years than there had been in the past 1000 years combined. Really, it was incredible. With that came the bleak. The Depression, Vietnam, a depressing rise in divorce and incurable, debilitating disease, and political and corporate greed that has taken us from the Greatest Nation in the World, to the laughing stock.

I digress. Back to the suffering. WWI and the Depression sucked. If you want to learn about going without just look at the crash after the war boom. My grandpa would unscrew light bulbs, wear his shirts until they literally fell off his body, and wouldn’t turn on the heat until the house fell below freezing (he lived in northwest Ohio). This was a learned behavior from his parents who actually lived through the Depression. Apparently my grandmother’s sisters hated pancakes, because it was the only thing to eat some days. My grandma loves pancakes. Misery! Then things started picking up. We moved into manufacturing and innovation during the WWII boom. We eradicated disease, we made big cars, big guns, and big buildings. We came together as a people to stop a common enemy. We did great things! However, great-grandpa was still in charge. After what he went through, I can’t imagine being raised in a home like that. You did what you were told, when you were told, and you didn’t give any lip about it. You didn’t like dinner, you didn’t eat. You got bad grades, you got beat. Gender lines were strict. Moms stayed home, Dads went to work. You did something bad, you paid the price both at home and socially. Your goal was to get a good job after high school, settle down, and procreate.

Thus the next generations, Baby Boomers, who did get boxed ears, said, “Times are better now and I will not raise my children like this.” Apparently there are two cohorts of boomers. Boomers I and Boomers II. Boomers I lived through the assassinations of Kennedy and King, and contended with the Vietnam War. Women wanted to work, men wanted to be more involved with their children and there was lots of opportunity for it. Great strides were made in social reform. The Civil Rights movement happened. We went to the moon. Boomers I raised their kids with a bit more freedom. With great strides came some unfortunate consequences that weren’t felt for several generations. I have seen this particular excerpt circulate several times. While I do enjoy it, it certainly misses the point of what is happening now. How could they have known that they were damaging the world?

Boomers II started to have a healthy skepticism about government involvement in their lives. They also said, “We are going to raise our kids differently,” but where as Boomer I’s still had relatively stable families and more authoritarian outlooks on raising children, Boomer II, who were post war and post Civil Rights movement, were starting to lean towards a more entitled thought process. The general theme was “I’m out for me.” This was the beginning of the end of the post WWII boom. Jobs were less plentiful and there was a decided frown at trade skills. Going to college and landing that high paying job was the better bet, as the mid-level factory worker was already established by the earlier Boomers. With the high profile jobs and education, coupled with the “I’m out for me” attitude, there was a spike in divorce rates. Parents weren’t less invested in their children but with both parents out of the house there was less involvement. What involvement was there tended to be more authoritarian. Do what you are told, when you are told.

Enter Gen X, the products of this new type of home environment. They too said they would raise their children (us) differently. In their homes Mom and Dad were never around, divorce rates spiked, child care was left in the hands of others, and public education started its downward decline. Gen Xers had a rough go of it and the attitude shifted from “I’m out for me” to “what’s in it for me?”. With the focus still on high-profile jobs and college education there was an even bigger snub at the trade skills, which were starting to thin with the retirement of the older generations. “No, no,” they said. “Our kids would not be put through the same unattached parenting that we went through”. They wanted more involvement in their children’s lives. They would be there for the kids. The world was harsh and the children needed to be protected. “Our parents were abusive and no one is going to hurt my child! My child is unique, not told to step in line and follow the mould, but to march to the beat of their own drum. They can be what they want to be!” At the same time manufacturing plummeted as we moved more and more to a service society. Not only was it “What’s in it for me”, but also “What can you do for me?”. US innovation stalled, companies moved their workforce off-shore to increase profits, and with the focus on mid- and high-level jobs, no one really noticed the gap widening between the poor and the middle class.

Now we come to the millennials. Between 1980 and 2000 there was such a rapid shift in the technological world that most adult’s heads were spinning. However, much like toddlers can pick up a foreign language faster than an adult, so, too, did we millennials take to technology. There was a small problem though. Our parents did not want to raise us like they were raised. In a world so rapidly changing we needed to be protected. Bullying escalated to cyber bullying. Sex and sexual content was now so easily available that most parents didn’t realize we were jaded by it by the time we were 13. Our parents desperately wanted to see us succeed, so they made it easy for us as children. You participated? Here’s a trophy. There are no winners or losers, just the game play. What do you mean he/she didn’t get a good grade? Fix this right now! We were patted, coddled, and given stuff just because we existed. Why would it have occurred to us that the real world was cruel and didn’t give a damn about us? To our parents, we were everything. Both the “What’s in it for me” and the “What can you do for me?” morphed into “You owe me”. Being told no, or you’re wrong, or you failed, never crossed our minds.

This isn’t me! I didn’t have that childhood! My parents told me no all the time! Blah, blah, blah. No, not every single bit of this pertains to every person. However, the term ‘helicopter mom’ is usually applied to Gen X, and millennials are the product of that. We have been beat up and blamed for a lot of stuff that isn’t our fault. Even so, there is still a general air about us that reeks of “You owe me”. Now that we are firmly in our adulthood and reality has smacked us in the face, we are starting to recognize the problems all the previous generations have compiled and placed on us, and then blame us for. The “You owe me” is starting to feel a lot like “It’s not my fault”, though we will continue to bear the brunt of it until the previous generations are gone.

We millennials did not break our government processes. That started several generations ago, in Boomer II, when they started focusing on the Me instead of the We. It has only escalated from there and it confuses Gen X that we are starting to move away from the Me back to the We. We also didn’t break our political system. The system was broken a long time ago, when the focus on education shifted from us thinking and being innovative to us being able to recite information and work within the corrupt corporate system. We millennials did not break our environment. Science has shown over and over again that there has been dramatic change in our climate. Whether this is human involvement or not doesn’t matter. We millennials recognize that there is a problem and we need to work on fixing it instead of ignoring or denouncing it. We millennials did not break our education system. Emphasis on education to the exclusion of all else had failed us miserably. Yeah, I know the Pythagorean Theorem. Fat lot of good it did me when I filed my taxes by myself for the first time at the age of 30. Nor has it helped fix our failing infrastructure, or keep us out of debt, or land us better jobs. Undergraduate degrees are a dime a dozen now. Go get your Masters, then we will talk. We millennials did not break our corporate systems. When we look for jobs/careers we want to do something meaningful, which means we need to perceive the company as meaningful. We are no longer okay being a cog in a machine if that machine is only to make a profit for one person or a family. We are tired of watching companies like Wal-Mart pay their employees pitiful wages, which we have to the subsidize off of our own taxes, while the company makes billions in profits. This is not to say we begrudge companies making profits! Business is business.  We can see the social inequity in schemes that keep its employees poor though. We millennials did not break our social structure. With the increase in diversity that technology has brought we see the blatant racism, sexism, and classicism that has driven our society close to another civil war. We are actively trying to avoid that.

Now we are having babies, or those babies are almost adults, depending on the end of the spectrum you fall in. Gen Z has quite a mess on its hands. Millennials have recognized the harmful patterns from previous generations. Too harsh on kids and they rebel. Too soft on kids and they become entitled brats. Slowly the pendulum is starting to swing towards the center, though it may not happen for another generation or two. I can only hope that we, as a generation, can raise our kids to recognize and strive towards balance, socially, economically, politically, and environmentally. Now the future is truly in our hands.

Bath and Body for the Holidays

This is my final post about holiday gift giving ideas. I know we are passed the holidays, but I think it is important to finish it. This post is going to focus on the idea of giving homemade body care products to friends and family.

Much like the treats and the hand made textile gifts, these products also need to fit the trifecta. Time, money, effort/skill. If you are lacking in one, do everyone a favor and just buy the stuff to give.

Effort/skill. I love making my own body products. Yesterday I made a hair mask out of an egg, some coconut oil, and some lemon juice. My hair feels really nice and I noticed a distinct shine I didn’t have before. I cannot, however, give this as a gift. Eesh, what a disaster. When giving homemade body products you have to know what you are capable of and if it is feasible to do.

Pretty good staples for gift giving would be soap, a salt or sugar scrub, soaks or bath bombs, lip balm, and body butters made of only oils. Note how lotions, masks, and hair products are not listed. Unless you have your own line of products that you have developed and tested, it is unlikely that whatever you make is going to be shelf stable long enough for your gift recipient to use it. The reason being is the ingredients used. Making lotion requires the mixture of water and oil in specific blends to make an emulsion. This is great to practice with and use on yourself, as these homemade blends are usually stable for about two weeks before they spoil. Maybe a bit longer if stored in the inconvenient refrigerator. Who doesn’t want stroll to the kitchen naked to put on frigid lotion after a warm, lovely shower? Bacteria usually contaminate lotions, and they grow well in the oil/water mixture, which make them spoil. Body butters, on the other hand, are made with only oils. These do not promote the growth of bacteria as rapidly as lotion does. This is the same for soap, which after the chemical reaction of saponification, also eliminates water. Lip balms are usually oil. Bath bombs and soaks are made with dry ingredients and left to dry. Sugar and salt scrubs are just mixtures of soap and sugar or salt. All of these are shelf stable for a very long time. So, if in doubt, don’t make it.

Time. A bar of soap needs to cure for up to six weeks. Did you know that? Make sure you have ample time to make the products you want. Much like making your own chocolates, or crocheting everyone scarves, it can take an extraordinary amount of time to craft quality products you would be proud to give as gifts. On top of this, if you want to customize, you will have to take that into account when preparing each batch. You will quickly find yourself spending a large amount of time figuring out how to make x number of bath bombs with this fragrance or that without having to make six large batches. Basically time and planning go hand in hand.

Money. This is going to be your biggest blockade, I promise. Body products claim to be pennies on the dollar, and they can be. However, the initial cost is no joke. I good soap mold for making a block is anywhere between $10-50. Quality essential oils and fragrances  can be expensive as well. The cost savings comes in when you buy in bulk, not just the little you need to make 2lbs of soap. It took me several hundred dollars, over a period of time, to accumulate the supplies and stock I have now to make what I want, while only replenishing ingredients as I need them. Just be aware when you start this project.

I would love to hear about your successes or failures at giving homemade bath products. Let me know in the comments. Until next time!

Holiday Crafts

This is the second part of my holiday gift giving series. A little late, but better than never. Part 2 is about fabric crafts. Sewing, stitching, crochet, knitting, whatever it is as long is it has to do with some type of textile.

Much like my previous post, this  is not for everyone and should be approached with caution. I understand that you want to give a hand made gift. These types of gifts aren’t necessarily cheap or easy to make.

Let’s start with my trifecta. Time, cost, item. If it’s December 19th and you were bored at work and Pintresting I am going to tell you to put the breaks on this plan right now.

Time. How many home made textile gifts do you want to make and how much time do you actually have? I decided one year to crochet my family hats, scarves, and gloves for Christmas. It was September, I had never crocheted a day in my life, and I had 30 people I wanted to make something for. I was also working full-time and trying to maintain my apartment. Lucky for me I  had time! Almost four months of it to dedicate to learning how to crochet and actually making the items. I had also picked some pretty basic items to make. This was to my benefit. I planned what I thought was an adequate amount of time. By the way, I cut it very close.

Cost. Every buy a nice ball of yarn, or a yard of fabric? It’s not cheap. Each of my homemade gifts used about 4 balls or yarn to complete the set. Four balls costing $6 each equals $24 on each person. That seems to be reasonable, right? Some balls cost more than others, some a little less. I would normally spend this much on a person. But, considering the time I put into my gifts, and my job and a nurse pays a decent wage per hour, the cost of each item was roughly $40-$60.

Why does that matter at all? Because of the ITEM I made. While everyone was appreciative at the time, really, another scarf? Hat? Fingerless gloves in Ohio? My items were a dime a dozen. Considering time and cost I put into each gift, I could have spent a similar initial amount on similar items at sale prices, which were also much better produced since I was so green at crocheting, and been done in September without much hassle. Ah, hindsight being 20/20.

So, for some finishing thoughts. If you have an active hobby in textiles and currently have a stock of handmade gifts that you can give out, by all means, use them. If you have a hobby that you enjoy and its early in the year, by all means make gifts for everyone, but pick an item that is not so generic and will be used much more frequently. Not only that, but customize it to the person you are making it for. Otherwise, what’s the point? Finally, plan,  plan, plan appropriately. Gifts are supposed to be fun both to give and to get. If what you are doing is stressing you out, either because you did not plan enough time, money,  or the right item, then stop! Buy a gift that they will enjoy and try again next  year with your handmade craft. It will be better.

Let me know what kind of handmade gifts  you like to give, the stories of successes and failures, and any helpful ideas for those who really want to be unique next holiday season.

Holiday Giving

It’s that time of the year again. We spend too much, eat too much, and drink too much. For some of us, we try to be a little thrifty and give home made gifts. This may seem like quite the money saver, but any crafter can tell you that this can be a money sink. This week I am going to tackle a few of the home made gifts of choice, and why you might be better off buying it. If, however, your money is worth more than your time, then I can also give a few pointers on saving yourself.


First, I am a professional chocolatier, so I am going to tackle the most obvious, and likely most wasted, home made gift of choice. Sweets! I strongly urge you to only do this if you love spending excessive amounts of time in the kitchen. If you do not, save your pennies and buy something that will likely be more appreciated… booze.

My first tip is to plan accordingly. More is not necessarily better. With the excess of sweets available this season, you really have to stand out in a crowd or you tasty treats are going to find their way on the fast track to the garbage can, especially when the purge happens after New Year’s Day.

If cookies and brownies are your thing, pick 3 to 4 treats that you know you make really well and people have commented on before hand. These should be unique to you. Sorry, but sugar cookies, chocolate chip cookies, and others like that, will be so abundant that yours will need to be laced with ambrosia. If cookies or brownies are the direction you are going to go, make them special cookies that you make, not Pillsbury.

For my fudge and caramel makers, make sure it is out of this world and packaged appropriately. A brick of caramel is hard to eat and dried out fudge is gross. Again, make this something you are very familiar with. Not really the time to test new recipes.

Lastly, for my bread people. Little loaves are best for this. Pick 3 or 4 different types and make mini, easy to freeze, breads. I prefer pumpkin, banana, and zucchini bread myself, but I have made some good apple bread too.

I list those three categories first because they are not my specialty, but my sister is quite the accomplished baker, so we tag teamed our traditional family baskets. My forte is chocolates. I am going to state this now. THIS IS NOT EASY OR QUICK. If you are not willing to commit to the right amount of time and money to make good chocolates do yourself, and your loved ones, a favor and go to a local chocolate shop. Please do not waste your time otherwise.

If, however, you are willing to plan, spend money, and spend time making quality home made chocolates, then I have some good tips for you.

  1. Plan appropriately. You need to know how many people you are going to make for so you can scale recipes accordingly. You will also need to know for packaging purposes. Think candy boxes, candy cups, and stickers at least. Ribbon is also nice, but to save time I would buy little pre-made bows.This can get expensive quickly, but you can buy bulk if you buy ahead and plan, plan, plan.
  2. Buy quality ingredients. You can fudge on centers a bit, but your candies will stand out if you buy quality. Most people would rather get a 6 piece box of nice chocolates than 16 pieces of mediocre chocolates. The number one thing you should splurge on is chocolate. You can find plenty of quality chocolate online, and I highly encourage this. Please, for the love of all that is, do not try to use chocolate chips for the majority of your chocolate work. You, and your loved ones, will be highly disappointed, and it isn’t really that much cheaper in the long run.
  3. Learn how to properly temper chocolate. That will be a good Google search for you. If you are going to spend the time and money on good chocolate, then you need to understand the basics of working it, and tempering is the very basics. It is also why chocolate chips don’t work. The cocoa solids to cocoa fat and sugar ratios are off and make chocolate chips a mess to try and dip with.
  4. DO NOT PUT WAX IN YOUR CHOCOLATE. We yell at children for eating candles and there you go grating one into their chocolate. Stop it. You were being cheap, trying to do this with chocolate chips, and your grandma told you to make them smooth and shiny you needed to put paraffin wax in it. PFFT. Go back to tip 3. Properly tempered chocolate has the shine and snap you are looking for, without the wax. Bonus, you can temper and retemper chocolate, over and over again. Practice the technique. Its a fancy trick to know and can be really impressive for all your dessert making adventures.
  5. Buy some good equipment. A digital scale, a digital thermometer, a double boiler or tempering machine, parchment paper, and a cutting mat (I use a fondant cutting mat I bought from Michael’s) are the minimum, as I assume you have cookie sheets and bowls. You save time with the tempering machine, you save money with the double boiler.
  6. Put aside the proper amount of time to make these. Making chocolate candies can be time consuming. You have to make the centers, roll or cut the centers, then dip them. Cupping and packaging can also take a bit of time. If you are doing all of this by hand, then be sure you have the time to enjoy the process. My best advice is to make all your centers first. You can make a good portion of these up during the week and use the weekend for dipping and packaging. Starting with a clean kitchen Saturday morning, choose your chocolate that you want to dip with first. I like working from white to dark, but the choice is yours. Start tempering your first batch of chocolate. While this process is started, choose all the centers that you will be dipping in that chocolate. Measure and roll, or cut your centers while tempering the chocolate. This is where that scale comes in handy, as you can make your centers all the same weight. You can have everything set up and ready to go when your chocolate is ready. If you don’t, that’s okay. You will likely have to temper several batches of chocolate, which will give you plenty of time to finish cutting and rolling.
  7. Finally, if you want, you can use dipping forks for your candies. I, personally, do not as I like the little bit thicker coat I get when I use my fingers. I also haven’t included anything about molded chocolates. That is more advanced than the dipping. This can be a messy process. Keep your nails clean and short or use gloves while dipping if you want to save your manicure.

If you do this correctly, you could have a wonderful gift by the end of the weekend without a huge mess. It costs time and money to do though! If your time is worth more to you, spend the money at a chocolate shop. If your money is worth more to you, spend it a chocolate shop instead of cheap ingredients. If you want a stellar gift for friends and family and are willing to plunk down the time and money to say you made it, please feel free to follow the above steps!

I’ll post some of my chocolates next week, as I only just started making my centers today. Please, feel free to share your home made gifts, and don’t cheat yourself. Your time and money are important. If the gift isn’t going to be appreciated the way a hand made gift should be, don’t waste the effort!

Until Wednesday, Ciao!