Boy oh boy, it has been too long since I have posted a blog entry! It certainly isn't for a lack of things to stay, it has been more of getting used to a 40 hour work week and a commute that went from 8 miles to 50. Long days for sure.

I started off the year with a brand new job. THE Job. The "dream" job. Since my job offer in December of 2014, I have been trying to figure out how to get my license transferred from Minnesota to Wisconsin. I have to provide a few boring details about the difference here so you have an idea of what happened here. The IC&RC exam is a national test for drug and alcohol counselors. The test was created in order to have a more national standard and to help facilitate the transfer of credentials between the states. I took this test as a part of my licensing in Minnesota. Past that test in March 2014. Now, in MN, once we file for the application and it's accepted, we are good to go. No additional training hours of supervision are required. Be on your merry way. Independent practitioner. 

Wisconsin, on the other hand, requires supervised practice for up to three years depending on the level of education. Typically in Wisconsin, people do not take the IC&RC exam until they have complete their supervised hours. There is a tiered system - Substance Abuse Counselor - In Training, Substance Abuse Counselor and Clinical Substance Abuse Counselor. The fancier the title means the more hours of supervised practice that has been completed. 4,000 hours- 7000 hours - something like that.

Originally when I call Wisconsin to talk about license transfer, they indicated to me that if I had passed the IC&RC test, I should be able to just apply for the highest level of credentialing. I stated clearly that I do not have that number of supervised hours and was told - as long as I had passed the test, I was good to go. A classmate of mine (MR - I know you read this blog :) told me that he knew for a fact that this was not possible - I would need to come in on the in training level because of the supervised hours thing. I called back again - got the same message that I could. Called my future supervisor and she called the state and got the same message - apply for the highest level, you passed the test already. 

I attempted to get all the forms to get the highest level of licensure in WI and started to run into the issue with the IR&RC test results. Yes, I had passed the test. Yes, I was licensed in MN, but in order to have the reciprocity from MN to WI, MN requires an application for reciprocity certification that would then allow the transfer to WI. That certification required 6,000 hours of supervised practice. I kept telling everyone (I had started the job now....) I don't have this, they are not going to be able to process the application for the highest level. Mid-January, panic is starting to set in because my supervisors flat out told me they do not hire people at the in-training level and this was going to be a problem, a major one.

Well, WI, just like MN, takes forever to process the paperwork. It was three weeks before they even cashed the check. They had 20 days to respond, at which time they did and it still appeared to be processing. We are getting into mid-February now and the administrator is starting to get really irritated that this licensing issue is not resolved. I start throwing out the emails trying to figure out why I was told I could come in at a higher level without supervision. Nobody seemed to know why I was told this and my application was ultimately rejected on February 20th. I needed to apply for the lower level of licensure - the level that they don't hire at. 

So, it's my birthday today. I know many people who don't like birthdays, but I love them. I love when other people have them and I love when I have them as well. It's not so much about the age, but about celebrating a special day just for that person. This birthday, I am feeling tremendously loved after having a brilliant weekend with a great friend and my super cool family.

I spoke at the TEDxWooster Event in Wooster, Ohio at my alma mater The College of Wooster. Here is a link to my talk:

https://www.youtube.com/watch?v=_mO3IBZkE18

I have always enjoyed reading my horoscope whatever the source. I never really think that it is going to predict anything but I do find some reasonable advice from time to time. So, of course I have an app on my phone and get one delivered everyday. For the past few days, the horoscopes that have come across are quite perfect for me. They are talking about big changes coming in the year ahead. I am not to expect that these will be easy changes, but they will be changes that promote a better quality of life. 

For those of you who know me fairly well, I am totally obsessed with cosmology, astronomy and anything to do with space. I have watched almost every single documentary that Netflix has to offer on the subject. I have been watching Nova on PBS's site for the past several months. I love learning about anything to do with the subject with my most recent interest being in black holes. 

For any of you with whom I have spoken in the past 6 months or have followed this blog, I make no particular secret that I have been having difficulties with finding my path in this new career of drug and alcohol counseling. I have tried three positions thus far and have been unable to connect with any of these positions. I found areas within each position that I really liked, but failed, ultimately, to stay. I was starting to wonder if I had chosen the wrong path in pursuing alcohol and drug counseling versus education. 

I have been spending some time on recovery groups on Facebook for the past few weeks. The holiday times bring a lot of angst to those in recovery. Whether it be meeting up with family and friends who have not yet forgiven the addict's transgression or active use is going to on, the holidays are stressful. Let's face it, the holidays are pretty stressful even when you are not in recovery!

This year will be my 5th years of attending the holidays sober. I am really lucky in that my family and I are in good standing with one another and using at the holidays is virtually non-existent. My holidays, in fact, are pretty low key. Actually, for the past several years, I appreciate my recovery so much during this time of year because when I was using I was so obsessed, paranoid and unhappy about not being able to use on my normal schedule. I was so stressed out that maybe this year would be the year that everyone would figure out what was going on. Hours and hours of driving on the road to multiple locations, the destination not always being the happiest of places to be. 

Since getting into recovery, the holidays are not very stressful at all. For one, I can be present and enjoy the purpose of the holidays. I have the opportunity to be grateful for all that I had and still have in my life. I can enjoy my niece and nephew ecstatically opening presents. I don't have to worry about when I am going to get a chance to be at home and drink the night away. I don't feel the loneliness and emptiness that I used to feel. I don't feel compelled to drink away my sadness and my lack of connectedness to others. I actually look forward to this time of year now. 

What I find interesting is that some resentments and regrets tend to pop up at this time of the year. I wonder to the extent other addicts and alcoholics agree that this time of the year makes one more susceptible to dwell on these things. Maybe it's because it is the end of the year and we have the time to reflect on another year. While we can see the lengths we have gone, we regret the time we lost or resent the things we want but don't yet have. For me, I continue to regret the number of years that I stayed engaged in addiction. I regret what I put my family through. I regret the relationships that I lost. I become resentful about not being in a relationship or having the white picket fence life. Ironically, I almost had it a while ago and it was, quite frankly, one of the most miserable period of my life. So, why do I long for that now? I don't think that I really do. I think it is the time of the year and I have this idea of where I "should" be - married, kids, house. Instead, I am single, 2 cats and I rent an apartment. Somehow, I feel like this scenario doesn't quite live up  to the norm. I constantly remind myself this time of year that I am damn lucky to be working, living in a great place, great friends and family and I am sober. Many of my fellow brothers and sisters in addiction don't have anything like this yet they have the husband and kids and the house. They aren't enjoying the "norm". 

So, this holiday season, I am working to avoid the self-induced pity party. I was starting down this path. Yet, today, while at work, I realized how lucky I have been this year. Despite all the challenges with school and work for the past year, I am still financially OK, I am working, I still live in a great place and I have wonderful plans for the holidays. When reflecting on the year, I would be remiss if I didn't remember some of the struggles this year held, but I would be negligent if I decided that nothing good happened either. When in "pity party" mode, I tend to only see the worse. One of the strongest skills in recovery is keeping an attitude of gratitude. Is life perfect? Nope. But, I have so much more than I had five years ago. While sometimes, I view myself as broken now, I am not. I was broken then. When I was using, I was depressed and I was hopeless. Life just doesn't work if there is no hope. 

This fifth year of holiday recovery is especially important to me this year. I have maintained my hope. I have expressed my gratitude. I have the faith to believe that my dreams will come true in 2015. Heck, there is still some time in 2014, I might still have some milestones to achieve. Although, I have to admit, there have been some really huge milestones this year like the writing award I received in grad school, the TEDx talk, the graduation ceremony from grad school. While the jobs haven't panned out as I had hoped, I have the opportunity to learn some very valuable lessons. I will continue to have faith that things are the way they are because they are suppose to be. If I were to continue into a pity party, it's hard to see life that way.  So, I will keep my focus moving forward. I haven't been as consistent as I wanted to be this year, so I will working hard to be the person that makes me happy and content. I am not quite there, but I am getting better. I had lost some of consistency in the past few years because if stress and maybe some more persistent depression. I feel like this is making a turn in the right direction now. For that, I am extremely grateful.

November 2014 is going to go down as one of the weirder months in my recovery. Even 6 months ago, if you would have told me that I would be where I am at, I don't think I would have believed you. 

I found out this summer that I would presenting at a TEDx event in Wooster Ohio. When I submitted my proposal, I thought this would be the perfect opportunity to dive into some research about a curiosity of mine. Ever since I started my internship hours, I have always been curious about all the post-gastric bypass patients that were sitting in treatment for alcoholism. I had planned to do an independent study on the topic, but I became too burnt out from school and opted to take a different class. 

Since announcing that I was going, I have had people contacting me frequently wanting to know more. So, I thought, now that I am finally done with the talk, I would share some of the information that I learned. 

I start out with a little "about me" segment. I proudly declared my past history of alcoholism and moved right on! There were some weird faces out in that audience :) I explained what addiction is. Addiction as a disease of the brain reward system. I threw up some stats from the National Institute of Health to bring home another quick message - addiction affects 40 million people and only 1 in 10 will receive treatment.

I moved on to talk about gastric bypass - in particular the Roux-en-Y procedure. The patients after this particular intervention seem to be the ones who are now developing the struggles with alcohol. Obesity in America in rampant and this procedure is very effective in the management of weight loss - rapid weight loss at that. It's dramatic but so is life at a BMI of 40 or larger. It's hard to be hopeful when someone tells you, you need to lose 100 pounds. This surgery provides consistent and rapid weight loss which in theory, I can imagine, keeps motivation up to continue to make lifestyle  changes. 

In the procedure a new smaller stomach is created. The gastric juices and enzymes are still active in the main stomach so that is reconnected at a lower spot in the intestinal tract. The intestine at a higher point is then connect back to the new smaller stomach. This reconfiguration prevents an individual from eating large quantities at one time and also limits the absorption of calories. 

I presented about 2 major studies completed in 2012 and 2013 that clearly showed that there is something going on in the gastric bypass population. The rate appeared to double at year 2 post-op for some patients. The number of reports of alcoholism reported prior to the surgery and the first year after the surgery, appeared to stay stagnant. It wasn't until the 2nd year post op the problems started up.

Thought #1 - the psychosocial profile of an obese individual - high rates of depression, higher rates of PTSD, agoraphobia and bulimia nervosa. Also, there were higher rates of issues with body image and self-confidence. Also high rates of social isolation and societal rejection. These issues are very much seen in the general addiction population and people much more susceptible to developing addiction especially with issues of undertreated mental health.

Additionally in this psychosocial profile - I discussed the issue of having unmet expectations and new life stressors because of the surgery. Regardless of the education and the information out there, when people get set on and idea and think it can do something life-changing for them, we build expectations. While individuals may clearly  be losing weight, the weight loss and surgery are not going to change the other issues list above. Additionally, up to 40% of gastric bypass patients have some form of complications. That can also let someone down as well. With these particular issues, a gastric bypass patient may not have the proper coping mechanisms to deal with all of this and end up turning to alcohol to cope. 


Thought #2 - altered alcohol metabolism. The enzyme alcohol dehydrogenase which starts to immediately breakdown alcohol in the stomach is no longer accessible. So this leads to the system to start the absorption in the intestine instead. This leads people to become intoxicated quicker and for longer period of time. I presented a small study that showed this phenomenon and subsequent studies have been showing the same result. This could lead to a quicker physical dependence on alcohol. Not to mention, it might look pretty enticing to the psychosocial model - get drunker, faster and for longer to deal with my problems that didn't go away after surgery.

Thought #3 - Cross addiction - This thought assumes that there is such a thing as food addiction. I believe there is such a thing and I buy into this thought more than all others. If there is addiction prior to surgery to food and this is not adequately treated, the addiction is likely to pop up somewhere else. The surgery limits this amount of food that a person can take in. They are no longer able to eat the way they used to and are no longer able to get that addiction satisfied. Here comes alcohol - high calorie, fast high......a new addiction emerges. 

All in all, I think it is a combination of these three factors. There is also other research that is talking about the 
gut-brain" communication. Our GI system and brains are linked hormonally and physiologically in such a way that if we take out the communication path between the two of them, we are setting up people for trouble. I can't explain it very well just yet and couldn't find all the needed research to throw into my presentation, but I will keep you posted as I learn more. My advisor in grad school mentioned to me that after gastric bypass people report personality changes because this communication path have been altered. 

This past weekend, I went back to St. Cloud to meet up with a friend for lunch. I grew up in St. Cloud and made my move to the cities in 1999. I have a few friends and relatives still up in the area. When my mom moved out of St. Cloud, I stopped going back on any regular basis. 
 
I arrived on the early side, so I opted to drive around. That city has been on growth mode for about 25 years now. Every time I get back into town there are 100 new buildings, houses or business that have popped up since my visit. Nonetheless, I still know that place like the back of my hand. It is one the places on earth where I know how to get around but I couldn't tell you a street name. I don't need to know the street names, I know it all by sight!

As I was driving out of town, I stopped by my childhood home/neighborhood. It really doesn't change much. I drove past the cemetery where my Dad is buried. I had a pang of guilt. I thought about stopping, but I haven't been to cemetery since before I left for Melk, Austria in 1993. I haven't been back since, mainly because I have been incapable to dealing with the pain that brings up. This time around, I wasn't worried about experiencing emotion, I just couldn't remember where he was buried. I have a memory in my head of the view, but nothing beyond that. Anyway, I pray everyday and talk to my Dad. I don't always feel that visiting there would make me feel any closer. 

Today, I am in Wooster, Ohio. I went to college here. I left in 1999 and haven't been back since. Although I started drinking in high school, I solidified by alcoholism here. I particularly remember my senior year as being the time when I started drinking daily and alone. Both times when I came back from living abroad for a year, my transitions back into my previous life were very very difficult. Although I thought I was prepared for the return in college, I still had the same issues: the world had moved on without me. I felt very alone. Academically, I was writing my senior thesis which was ultimately 90 page paper written entirely in German. Impressive, given the fact that I was a near daily drinker at this point. I actually convinced myself that I spoke better German when I was drunk so in order to write this paper, I needed to be drunk in order to do it. I suppose on some level it worked, I got it done.

Anyway, my stomach has been in knots since I have been here. I am actually 100% triggered by being back here again. My time here was a time in which my alcohol use was "in control". It was when alcohol was fun. It was when alcohol provided happiness to me. I loved my time in college. I felt smart, pretty, confident. I had a lot of friends and really felt there were people I connect with here that made me feel like I was "normal". I struggled a lot with that "normal" thing in the school situation. I wasn't quite a nerd (at least in my mind), I certainly wasn't in the popular crowd. My friends tended to go either way and I often felt abandoned. College was different in that there were groups of people who got along. They may have fallen into a social "group" title. In general, there was always a group of people for a person to find. My sophomore year was probably by favorite year. I returned to campus with a group of friends and it expanded. 

My senior year was much harder. I still had connection to all of these people. I had made the decision to go back to Minnesota after graduation. As I tended to do, I was living in the future and had "moved" home in my mind in December. I failed to enjoy the remaining time with my friends and firebombed some of those relationships on my way out as a way of showing my pain. Distance and time made those relationships harder to maintain.

So, I am back here again for a very exciting event. I am very happy to be here and I certainly hope that some of the butterflies in my stomach are related to the excitement of the event which I am sure it is. I arrived in town last night. This town is on the same growth trajectory of St. Cloud. I recognized some of staples that were still alive and well. My plan is wander around the campus this afternoon and see what has changed here. Probably security for one. I doubt I will be able to wander around like I used to be able to. As I drove down the "main drag" of the college, I was just flooded with memories, both good and bad - mainly good. Just feels a little surreal to be back here again. It's been 15 years. 19 years ago I walked on campus! 20 years ago, I found the place! If anything, it is making feel a little old :)

I am very excited to be here right now. I am just aware of feeling very triggered while being here. There is something about "going home". Hopefully there is something reconciling the past. Both with St. Cloud and with Wooster, I have both very positive and very negative memories. In my old black and white thinking, I was incapable of understanding that both can coexist in the same space. I can feel both happy and sad, excited and disappointed; I can have a sense of pride and moment of terror!! So, I am sitting back in a place that has a lot of emotion for me. I am happy to be at home again, if only for a couple of day. This was my home for 3 years. I ate, slept and lived here. It was a much simpler time. Life was less complicated, although at the time, I was convinced it was VERY complicated. 

After my talk is down, I will be sure to post a blog talking about some of the research on my topic. It is truly fascinating. 

Julie