This review explores the relationship between engagement with the creative arts and health outcomes, specifically the health effects of music engagement, visual arts therapy, movement-based creative expression, and expressive writing. Although there is evidence that art-based interventions are effective in reducing adverse physiological and psychological outcomes, the extent to which these interventions enhance health status is largely unknown. Our hope is to establish a foundation for continued investigation into this subject and to generate further interest in researching the complexities of engagement with the arts and health.
Tomorrow is my last day of occupational therapy at HealthSouth. Last week, I completed the 28 weeks of physical therapy Medicare allows. I asked HealthSouth C.E.O. at Pleasant Gap PA yesterday as she prepared for a meeting and I for a 10th cup of coffee, how Medicare came up with the number 28. Susan Hartman said she thought it an arbitrary number. I speculated Medicare consulted with a palm reader.
The issue matters because I experience considerable pain over the course of the day. Last weekend, I figured the level (on a scale of one to ten) was over 7.
Two years ago, I would have dialed 911 and waited until the ER physician injected me with morphine. Not that I would get enough morphine. Not that it would be injected quickly enough. The principal relief was not the medication. Rather, the sense at least I was doing something rather than nothing.
A little over a year ago, I had a spinal stimulator surgically implanted. The device is manufactured by Medtronic of Minneapolis. Medtronic also manufactured the pacemaker which studies have shown my heart relies upon to keep me alive.
There have been times over the past three years pursuing specialized surgery in New York when, I thought I would rather be dead than experience the pain which on several occasions had me rolling on the floor in agony.
April 8th will be cause for celebration when my granddaughter reaches her second birthday. Ever since Juliet appeared in my world and hers, the idea of premature death (however relieving) has been replaced by a commitment to persistence whatever the cost.
I need to be alive for Juliet—at least until she graduates from college and architecture school and begins designing airports and wheel chair accessible jets.
In October 2016, I celebrated my 69th birthday at HealthSouth recovering from the surgery which has since kept me out of the ER. The sophistication of Mount Nittany Medical Center has reached the point where surgery once available only in New York and at sophisticated centers such as Johns Hopkins, MD Anderson, and of course the Silicon Valley’s facility in Stanford (where the Corporate Angel Network flew me a seeming lifetime ago for the expertise that resulted in my being on this planet and not in the world to come).
Now, sophistication has reached river city. Last year I received at State College the surgery that makes regulating pain achievable. However, the value of a vibrator in my spine reducing dependence upon opiates is most effective when coupled with physical and occupational therapy.
It helps reduce pain when I move my body—especially at those moments when I delude myself into believing lying in bed in a fetal position is preferable to transferring to my scooter, navigating to the kitchen sink, and standing safely. Standing is better than sitting. Using the parallel bars (not available at home) helps build strength and reduce pain.
Now that I have achieved the Biblical-described age of three score and ten, Medicare will pay for something.Given Medicare, the insurance feels happiest when it pays too much for relief best achieved at lower cost preventatively.
I paid into the trust fund with extremely well-paid consultancy fees from Silicon Valley companies for my expertise as a senior technical writer. I can resume well-paid employment to compensate HealthSouth for the $300 or so cost of an hour of physical therapy. I would rather do that than complain about Medicare. However, putting myself back on the money-making track requires patience and persistence—convincing potential employers reluctant to pay a 70 year old paraplegic.
The consequence of my not having access to 36 hours of physical and occupational therapy between now and January—when the arbitrary 28 weeks of rehabilitation resume—might very well mean that because of a penny wise and pound foolish Medicare, your tax dollars will pay for expensive hospital care that could easily be avoided.
Liz Beaulieu, my editor at HME (Home Medical Equipment) News, has commissioned me to resume my published work for HME News with a 750 word article on the subject of Medicare’s reimbursement policy on rehabilitation. Although Liz is a fan of long New Yorker articles (appreciation she sneaks into her editorial notes), I will need to be brief.
First, however, I need to be comprehensive. I have requested a formal interview with the able Susan Hartman, C.E.O. at HealthSouth’s Pleasant Gap facility. Naturally, I will be descending upon the press office of the Centers for Medicare and Medicaid Services in Baltimore. I will start at the top seeking an interview with Seema Verma, President Trump’s choice to run the agency (who is pals with Vice President Pence).
I also will be seeking interviews with Mark J. Tarr, who runs the HealthSouth empire from its headquarters in Birmingham, Alabama. On its Securities and Exchange Commission 10-K form, HealthSouth (eventually to be renamed EncompassSouth) notes: ““We are the nation’s largest owner and operator of inpatient rehabilitation hospitals in terms of patients treated and discharged, revenues, and number of hospitals. We provide specialized rehabilitative treatment on both an inpatient and outpatient basis. We operate hospitals in 30 states and Puerto Rico, with concentrations in the eastern half of the United States and Texas.”
I will be arranging interviews with Senators Casey and Toomey. Next step is to follow the advice of Rep. Thompson’s excellent press officer Renee Gamela who wrote yesterday, “Hi, Joel! Yes, you should contact Barbara Ives in GT’s Titusville office.” Then, I will interview Rep. Thompson, who was a physical therapist before his election to Congress.
My current (ever changing) plan is to report all (in my customary dribs and drabs work in progress publication) in a posting on my website where my webmaster is the excellent Kathy Forer. Sarah, my one and only sister who knows me all too well, says writing long is my default. Hence, I will write long then boil it down to 750 words and submit to HME News.
Continually hat in hand, it would help if you were to send me $18 given the paltry state of my checking account which tomorrow (after checks are cleared) will contain $16.34. Yesterday, I had to pay Harvey Israel, my wonderful dentist, for emergency work. Yes, I have set up a crowd funding proposal. Need to set up more. The $18 figure is based on Jewish tradition. In the Hebrew alphabet, each letter has a number value. The alphabetical equivalent of eighteen is the Hebrew word for life—Chai. When my late mother Miriam (a Hebrew school teacher) wanted to donate to a cause, but did not have enough money to do so as she liked, she donated $18.
If I were not a [Jewish] Buddhist, this would be my Mad As Hell and I Can’t Take it Anymore moment.
It is 3:04 AM. I am making coffee. Washing the dishes. A shower is overdue. At 8:10 a Cataride para-transit bus will pick me up here in Downtown State College where parking (believe it or not) is a problem.
This is the parking lot at Addison Court–a residence for low-income elderly and disabled: A ghetto by any other name is a ghetto.
After riding through the astonishingly beautiful countryside of Centre County, PA, I will be arriving at HealthSouth, Pleasant Gap–one of an empire of 123 U.S. physical and rehabilitation hospitals based in Birmingham, Alabama. Coming soon, as a result of a recent merger, HealthSouth will have a new name: Encompass South. [East, West, and North still in the planning stage.]
Whenever possible, always go to the Securities and Exchange Commission 10-K form.
This is what the parking lot at HealthSouth is like when I arrive before 9 this morning.
At 9, I will begin the routine Pittsburgh-trained Occupational Therapist Christine Vuchenich has established. The routine consists of:
Stretching exercises at her wooden table.
Use of the Baltimore Technology shoulder stretching wheel
Push ups and other exercises.
On Friday, progress stops. Then, I have to resort to in-home exercises. No sophisticated equipment. No informed instruction. Just hours a week of exercise exercise exercise.
Last week, I completed the 28 weeks of physical therapy with Shannon Duranko who received her doctorate from Slippery Rock University. For the first time (last week) I walked the length of the parallel bars and back.
I do not have parallel bars at home.
What I have at home is persistence. Think of Medicare as city hall. I have already begun my plan to fight city hall. Medicare’s short-sighted cutback of physical and occupational therapy means that using movement to relieve pain likely will be replaced with using Oxycontin to relieve pain. Instead of continuing progress so I might use Lofstrand crutches and a walker for mobility–with the eye on the prize of being able to walk again–Medicare may once again spend unnecessarily for frequent trips to the emergency room or for hospitalization.
My lungs are clogged. After surgery at Mount Nittany Medical Center, the hospital commissioned a van to take me and my mobility device (a.k.a. scooter–an Amigo [accept no substitutes]) from State College to Pleasant Gap. There on my 69th birthday the HealthSouth Physical Rehabilitation nurse tried again to get me to breathe deeply–handing me the contraption from the night table. But [why is there a “but”?] but I felt too sick. Hence I am paying for it now.
Hint. Hint. Try singing this stanza. See what it does to your breathing.
Harry Truman, Doris Day, Red China, Johnnie RaySouth Pacific, Walter Winchell, Joe DiMaggioJoe McCarthy, Richard Nixon, Studebaker, TelevisionNorth Korea, South Korea, Marilyn MonroeRosenbergs, H-Bomb, Sugar Ray, PanmunjomBrando, The King And I, and The Catcher In The RyeEisenhower, Vaccine, England's got a new queenMarciano, Liberace, Santayana goodbye
It is 2:41 A.M. I am awake after four hours of sleep because my lungs are clogged with phlegm and so I sing (cough, spit, breathe) to Billy Joel’s Vevo video–a stylized recreation of my youth (and Billy’s [I am two years older than he; we share joint memories of the Edsel and Diem Bien Phu). [See Footnote 1.]
See what singing this stanza does to your lungs.
Joel (finally more sleep and more on the subject of sleep; don’t touch that dial)