Posts Tagged ‘Wellbeing’

Part 3: Walter Michka’s journey through major heart surgery in the U.S.

Jun 24 2013

Getting what you pay for?  

Before my near heart attack and subsequent quadruple bypass, I pretty much had one doctor, not counting my dentist— my Primary Care Physician. His name is Joel. I saw him regularly for check-ups and the occasional sinus infection. I went to him with the chest pains I thought were acid reflux, the chest pains that turned out to be a 90% blockage in three of the major arteries to my heart. Joel essentially saved my life when he set up the stress test that found the blockage just before it would’ve killed me.

Now, after my bypass, I’m under the care of two cardiologists: my main one and another one from the same practice who happened to be on duty in the ER the night I came in with an accelerated but shallow pulse. He diagnosed it as SVT (supraventricular tachycardia) so I check in with him every so often.

While my visits are tapering off, I still drop by my psychologist every six weeks.

I see a urologist because Joel discovered I have low testosterone.

I go to a podiatrist to get orthotics to correct the unusual arches in my feet.

I see an endocrinologist periodically because of the benign, but ever-growing, nodule on my thyroid.

Joel’s sent me to a pulmonologist because the endo found a cyst in my lung (I knew about the cyst; I’ve had it since I was a child).

I see an ophthalmologist now that I need trifocals and for that eye infection I can’t seem to shake.

I’ve been to physical therapists because of a rotator cuff and bulging disks in my back.

I get a colonoscopy every five years because they found a polyp two exams ago.

I’m taking, or rubbing on myself, six prescription drugs every day. That doesn’t count the low dose aspirin, fish oil, and other supplements various doctor have recommended.

Medical professionals use “for your age” a lot more now when we discuss my various ailments. Sometimes it’s sort of positive: “you’re doing well for your age.” But mostly it’s: “that kind of thing is expected for men your age.”

My quadruple bypass was my Big Event. Old people have those. My mother’s Big Event was an aneurism at fifty-seven that killed her instantly. My father’s was in his early 60s, his first stroke. He had his second stroke soon after and it was downhill from there. I was blindsided by my Big Event; it came out of nowhere. Now my life is divided into before my Big Event and after.

I’m lucky; I have really good insurance. When I’m checking in for one of my many appointments at the front desk, the receptionist’s posture straightens and her eyes light up when she sees my insurance card. I pay $5,100 every year for this privilege. (That’s for a family of 6) Even with that steep fee, there’s a “co-pay” on top of it, $20 that they ask for up front, before my visit to the doctor or specialist. There’s a co-pay for my prescriptions, too. That can be as little as $5 or as much as $30.

I never quite understood the co-pay. On top of the thousands I’m already shelling out, they need that little bit more. It’s like the ante in a poker game, I guess, or the cover charge at a nightclub.

The bill for my bypass: from admitting me on a Thursday evening, the angiogram the next day, waiting, watching cable TV Saturday and Sunday, the open heart surgery Monday, then recovery the next four days came to $158,000. They mailed us a copy. Because I’m insured, I only owed about 3% of it. Without insurance, I would’ve been on the hook for the whole thing.

In the States, we’ll never deny medical care for anyone who needs it. That’s true. It’s just a matter of how much debt you have when it’s over. Major medical events like mine bankrupt some families. It wipes out life savings, college funds. People lose their homes. It can devastate lives.

We didn’t have health insurance when I was a kid. My dad “didn’t believe” in health insurance, like it was the Easter Bunny or ghosts. He called it “a racket,” paying into a fund you never use. In his case that was pretty much true, it worked out for him. No one in my family really had any major medical problems. The two times I went to the hospital my dad whipped out his checkbook and paid in cash!

Of course, it was 1967 and hospitals didn’t charge sixty dollars for a Tylenol and I didn’t need surgery. Twelve days in the hospital cost just over $376 (I found the original bill). Okay, gas was a quarter a gallon back then, too, but still… They charged us twenty-one dollars for the room each day; an x-ray was five bucks…

The myth is: the more you pay, the better the care, like it’s a cut of beef. But there’s a point of diminishing returns. Our politicians talk about healthcare reform but the likelihood of anything ever getting reformed is slim when there’s so much money to be made. It’s a weird, broken system that really isn’t keeping anyone any healthier. It’s big business and I’ve become one of their best customers.








The Wisdom Quest: A Rite of Passage into Elderhood

Jun 07 2013

Rites of passage are activities and rituals to recognise, enable and celebrate the move from one life stage to another.  We can see a faint vestige of this currently for teenagers finishing secondary school.  Traditional tribal cultures placed great importance on rites of passage, and I believe modern society would benefit too: including the start of elderhood.

The Vision Quest is a traditional rite of passage for adolescents moving towards adulthood, and I have helped lead several of these at Hazel Hill.  Central to these is spending 24 hours or more alone in a natural setting, with the support of older guides to prepare for and come out of this time.

hazel hill wood quest image

Hazel Hill Wood


Since 2011, I have led several groups for older men and women, and have been working on my book, Out of the Woods: A Guide to Life for Men Beyond 50.  This has led me into a lot of pondering about rites of passage for the move into elderhood.  I’ve concluded that this is a very different process than approaching adulthood.

The initiation of teenagers into adulthood is typically led by older men or women, and includes instructing them in the norms, values and codes of adult society.  Whereas my sense of initiation into elderhood is that it should be more a self-guided, gradual process, which a mentor can support rather than direct.  There are many other differences: for example, a teenager may seek a vision around personal fulfilment, whereas new elders are often moving towards being, presence and enabling.  And in a Wisdom Quest, the level of physical challenge/comfort can be tailored to each person.

My main ally in exploring this is Jeremy Thres, who is the best guide I know for Vision Quests, and similar processes.  We have coined the term Wisdom Quest to describe a rite of passage for elderhood, and we are offering the first of these at Hazel Hill Wood on July 3 – 8. 

The maximum group size will be 8, so that we can tailor the event closely to the needs and life situation of the participants.  We are intending to have a solo time of up to 48 hours as the heart of the event, and the wisdom and healing of Hazel Hill Wood will undoubtedly play a big part.  Our intent is to create a process suitable for men and women approaching elderhood, entering it, or already well into it.  Facing our dying to enrich our living is also likely to be an important part of the event, and is a major theme which Jeremy and I have already worked on.

WisdomQuest pic

For more information and bookings:

contact Alan on 07976 602787 or,

or Jeremy on  07717 853967 or  You can see more details about the event here.


Relaxation – the wise fish!

Nov 28 2012

FROM Good Medicine, Dr James Hawkins 

 Relaxation and Dealing with Mental Chatter

 The balance between attention and letting go:

 When you start practising relaxation calming exercises you will soon notice how often your attention is sidetracked by thoughts and other distractions.  If you simply let go your tensions and allow your mind to wander as much as it may want to, you are likely to end up in a daydream or fast asleep.  However if you try very hard to keep your attention concentrated on the calming exercise, it is easy to end up frustrated by your lack of success and even more tense than when you started.  The challenge is to achieve a balance between keeping your attention on the exercise and at the same time letting go tightness and tension.

The fish analogy:

 There are many ways of tackling this challenge.  One image I often use is of a fish who is doing a calming exercise that involves focussing its attention on a gently waving bunch of weed.  It finds this very relaxing!  Floating past however are many fishing hooks with tempting worms on them.  The worms represent memories, plans, fantasies, physical distractions, outside noises and other competitors for our attention.  It is easy to get hooked and distracted away from the exercise that we are doing.


The challenge is to be a wise fish!

There are three main lessons that I want to take from this image.  The first is that hooks are normal.  Distracting thoughts will float through our minds.  This is usual.  One major lesson is to accept that the distractions are there without being hooked by them.  Let the irrelevant thoughts float by without giving them our attention.


The second lesson is that we will occasionally be hooked.  This too is normal.   When we are hooked, the challenge is to notice that this is what has happened.  We don’t have to struggle or make some great effort.  Fighting the distraction is likely to get us more involved with it.  We will tense up and drive the hook in more deeply.  Noticing – simply and honestly noticing – this is what’s important.  When we notice, when we attend to what is actually happening, then our mind automatically slides off the hook.  We don’t blame ourselves.  What happened is already the past.  We are not interested in history when doing calming exercises.  We are interested in the present, in the state of our mind, our nerves and our muscles right now.


This leads to the third main lesson from this image.  Attending to what is happening in the present is an art.  We lead most of our lives in a sort of daydream, half asleep.  We are remembering, planning, worrying, wanting, fearing.  We are distracted in so many ways.     Our lives are short, yet we waste them by being elsewhere – lost in our self centred concerns.  It is fascinating to notice how much of what we learn when doing calming skills exercises also applies to our everyday lives.  The calming skill is just another slice of life.  It is simplified so it is easier to notice the games our minds get up to.  What we learn however often applies to our lives in general.






Practical Checklist for the Serious Illness Journey

Nov 28 2012

Here are a number of check-lists for the journey to help you think about, plan and prepare for all the different aspects of having a serious illness:

Consultations and Appointments: Ask the Questions you want Answered

Write down a short list of the most important questions you want answered before each and every consultations and appointments. Areas and topics you may want to ask about include:


  • Is there a diagnosis, and what further tests are needed
  • What is the disease, and what are the main symptoms
  • What are the main treatment options, and also where and when
  • What is the time period for treatment, and how long until you get better
  • What are the main side-effects and other major problems about treatment
  • Where do you find out more about your illness.



  • Who are the available specialists
  • What are the local success rates dealing with your illness
  • Do you want to ask for a Second Opinion



  • How far should you try (and are going to be able) to continue with your ‘normal life’.
  • What extra care is available, and how do you go about  getting it.
  • What is the best nutritional care for your condition, and who can provide the best advice.
  • What other approaches can you use to help you, and who are the best people to ask about this (it may not be the doctors).
  • What can complementary and alternative medicine contribute to treatment and your wellbeing.


Serious Illness – Managing Change

Nov 28 2012

Waterfall Visualisation Exercise

This is an exercise to help you find your personal meaning in the experience and to regain control of your life. It is also a way of helping you take stock and make the big choices in your life.

You need to feel it is the right time to do this visualisation, probably after the first shock of the onset of a serious illness is over and you are through the main initial treatment period. You can also do this exercise several times if you want to, at intervals of several weeks or possibly months. It is a powerful exercise, and if it is realistic and feels right for you I suggest you do it in the company of someone supportive, such as your partner or a trusted friend.

You will need about 30 minutes to do the visualization, and pencil and paper. If you write the important things that come into your head during the process this can be useful for you afterwards when you want to think back and reflect on the experience, and as a record to look at again at a later time.

When you feel it is the right time and place, and you are ready to begin:

Imagine your serious illness as being like a waterfall. Draw this on the blank piece of paper. Draw a horizontal line, then the waterfall, and then continue the horizontal line forward along  the page to the paper’s edge..

  • Now imagine that the line is the river of  your life, with the waterfall representing the powerful and irreversible  change that your serious illness has brought. Take a little time to slowly  look back and forward along this river, and take it all in.
  • Next draw a canoe on the horizontal line of  the river below the waterfall, and draw yourself in it as a stick person.
  • Begin to have a look around in your own mind  from this position in your canoe. You can look back at the waterfall, its  power and suddenness, the shock and upset , and the turbulence in your life it has brought to you.
  • Then look further back up the river above the waterfall, and remember how it was before your serious illness occurred.  Tears may come, so be ready. Have some paper tissues nearby, and if you  are with somebody else, let them support and comfort you as much as you feel that you need.
  • After a time and when you are ready. You can  now turn your attention to where you are now, sitting in the canoe on the  river below the waterfall. Begin to examine your position. Look at the health you still have, and assess it carefully and honestly. Yes, there have been losses, but begin to think of the things you can still do. Take stock of yourself. Be honest about the upsetting parts but also look for the positive and uplifting parts, and what makes your life worth living.
  • Now turn to look downstream, and imagine the river of your life ahead flowing on. Begin to think of all the things you want to do and could do if you set your mind to it, including the big choices you need to make in your life, as well as some of the other  smaller, perhaps practical but still important things you need to do. Write these down if you want to.
  • When you have done enough and you feel like  finishing, begin to return to being inside your own body. Let the waterfall dissolve, along with the idea of the river and the canoe, and you in it. Take a few moments to become wholly present in the here and now, and when you are ready make it a moment of conscious decision to end the visualization session.