RT @mtnwriter77: The Oregon Experiment:

RT @mtnwriter77: The Oregon Experiment: Health Insurance, Health Care and Health – why doesn’t 1 + 2 equal 3? http://t.co/ucHwVnzv1E

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The Oregon Experiment: Health Insurance, Health Care and Health – why doesn’t 1 + 2 equal 3?

I’m taking off my author hat today and replacing it with my health care administrator hat. There’s been so much talk about this all week, I had to add my two cents.

For those of you who are unfamiliar with this topic, I refer you to Ashish Jha’s The Health Care Blog – “Misunderstanding Oregon.” or Mike Mieson’s “Evidence That Health Does Not Equal Healthcare? Early Results From the Oregon Experiment Are In” – or head straight to the New England Journal of Medicine if research details are your thing.

The experiment and the published results are described in these blogs. Essentially a group of uninsured folks were given Medicaid and a control group was not, and the results showed higher utilization, fewer catastrophic medical cost-related bankruptcies, lower rates of depression, and generally healthier quality of life for the insured group. But specific measures like hypertension, cholesterol, and diabetes showed no meaningful improvements. The conclusion that could be drawn from this was that access to health insurance (1) and therefore to health care (2) did not improve health (3).

BUT…

One plus two doesn’t equal three in the assessment of the experiment’s results because there is at least one missing piece, possibly two.

Dr. Jha says that missing piece is health care QUALITY. That may be true in some cases. Certainly it is important to have an invested primary care physician – without that, a passive patient or those not knowledgeable of what a PCP should assess and recommend, could flounder. But surely an important missing piece is, as one of the responses to Dr. Jha’s posting stated, habits and environment. The average person doesn’t have a lot of control over environmental influences like air quality and pollutants. But everyone (with the possible exception of the most vulnerable – those with limited mental capacity) has or is capable of having control over habits. Two words: personal responsibility.

Genetics play a role in tendencies toward high blood pressure and high cholesterol and even diabetes. But it is personal choices and behaviors that tip the scale (literally and figuratively).

If you are prone to high cholesterol, the most stringent diet probably will fail to get your numbers into ideal ranges. So health care plays a role there, by prescribing appropriate medications. But if you persist in living on a diet of high fat, high sugar and little to no exercise, you’ll probably end up obese with diabetes. Don’t then blame your doctor when you have a heart attack or stroke, or end up on dialysis, or lose your eyesight. Your doctor can provide you with preventive medications and lifestyle advice, but you are the one who has to follow that advice and plan of care.

And don’t get me started on smoking. In NYS, the average one-pack-a-day smoker drops between $250 and $300/month on cigarettes. And die-hard smokers often don’t stop at one pack per day. How anyone can watch the graphic and grotesque anti-smoking ads and still delude themselves that smoking isn’t hurting them is beyond my comprehension. When someone tells me their budget doesn’t permit fresh vegetables, fruits and fish purchases while they exhale smoker’s breath, I’m torn between presenting reality and minding my own business. I’m not a crusader. I just believe people make their own choices in life and for the most part the rest of us should not be held responsible, financially or otherwise, for their choices.

As for quality of health care: A good primary care provider (PCP) pays attention to preventive care and listens to your needs and tailors your “care plan” realistically to your lifestyle and personality while steering you in healthy directions. He/she diagnoses problems and treats or refers you for specialist treatment and then follows up with you. That’s all you really should ask of your doctor.

After a wonderful PCP of mine retired, I went to one who, three years after seeing him twice a year, still asked me every time “who’s your primary?” Only after I reminded him that he was did he, for the duration of that visit, act like a primary. When I returned six months later it was Ground Hog Day all over again.

I gave up finally and tried a female doctor (that wonderful PCP I had was a woman) – and went from the frying pan into the fire. In four office visits I saw her only once. That wouldn’t have bothered me so much if the NP I saw paid attention to my family medical history. Serious heart disease is rampant in our family – yet not once in over a year, including my initial visit, have I had an EKG done. Even without my history, that’s standard for a sixty-something woman. I had to ask for an annual physical. I’ve not been asked when my last colonoscopy or GYN exams have been. I wasn’t asked if I’d had a flu shot or if I’d be interested in the Shingles vaccine. I’m in health care, so I know about these things – but what about the patients who do not? Last December I had a bout of severe muscle burning that kept me up at night. Lab work (which I had to request) showed borderline liver issues that could point to an adverse effect of the simvistatin I was taking for high cholesterol. The doc told me to stop the simvistatin, follow a low fat diet and start getting regular exercise. (If she’d paid attention to my history, she’d know I have run numerous marathons/half marathons in the past several years, mix it up with other exercise and maintain a healthy weight.) Then, she said, get the lipids retested in three months. I had labs done in March and my worst fears were realized – my total cholesterol had shot up nearly 100 points and my LDL was way over the safe range even for people without a family history of heart disease. I had to call for the results and drag the details out of the nurse (who only said it was “up”), and was told, once again, to follow a low fat diet and get more exercise. “Time’s up,” I thought. Time to find a PCP who has my back.

So, yes, quality of care plays a role. But so does personal responsibility. I’m not a doctor, but I pay enough attention to these things to know that cholesterol management is not an all or nothing situation. I also know that genes trump diet every time. I’m on the hunt for a new PCP, but in the meantime I put myself back on simvistatin at a reduced dose – damage control, I rationalized. When I find the right doctor, we will discuss other options for managing my cholesterol safely. And hopefully she will assess and treat the total person that I am, not just whatever symptom I’m presenting at a given visit. If not, the search will continue.

Let’s come full circle back to the Oregon experiment and whether health insurance improves outcomes. The answer depends on what outcomes you are measuring (cost, utilization, depression, financial security, or patient outcomes). There is no doubt in my mind that the cause and effect of insurance on patient outcomes is influenced by other factors that weren’t measured in Oregon: yes, the quality of the care. But as the old saying goes, “You can lead a horse to water, but you can’t make him drink it.” At least as important is the patient’s personal accountability for his/her own health, as reflected in their lifestyle choices.

Okay, I’ll get off my soapbox now.

 

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HOW WILL YOU HONOR YOUR MOTHER?

With Easter behind us, Mothers’ Day can’t be far away.

Some mothers just plain and simple should never have been mothers. This is not about them.

This is about the less-than-perfect mothers who looked forward to having children and truly love their sons and daughters – but didn’t have a clue how to go about the whole parenting thing. And usually with good reason. Maybe their own mothers were in that first category – they should never have been mothers. Maybe their mothers were absent in their formative years – having died early or abandoned the family, or had mental health/substance use issues that made them “absent” even when they were present. Or maybe their mothers, like themselves, had a flawed role model because their own mothers and grandmothers weren’t so great.

Very few mothers set out intending to be lousy parents. But if they never learned the skill by watching their own caregivers’ example, or they experienced inconsistent or poorly nurturing mothering, all the parenting books in the world aren’t, by themselves, going to overcome the damage of experience going back multiple generations. One can believe that mothering is instinctual, but it is not. A mother’s love may be, perhaps. A mother can love her children on a very deep level, but can’t overcome generations of that love never bubbling to the surface and being demonstrated unconditionally when she is not even aware that her own mother-daughter interactions lay the foundation for her own behavior. She may not have had the opportunity to learn the full scope of mothering.
More mothers than not fall into this category – intending to be good parents, aspiring to be, but falling short of their own expectations, and not having a clue how to do it better – or why they’re not doing it “right” in the first place.

We really are shaped by our experiences in life, and no experience is more influential than the parent-child one, particularly mothers and daughters.

That is what In Her Mother’s Shoes is about. Meredith is emotionally distanced from her own children but doesn’t understand why. She loves them more than life itself, yet she has not a clue how to show it, let alone say it. As she sorts through her mother, Katherine’s, house before selling, she finds clues to Katherine’s shadowy past. Meredith begins to understand why her mother related so poorly to her children and is shaken by parallels in her relationships with her own children. But understanding is the first step in healing.

So often mothers and daughters struggle with their relationships. Consider giving the moms in your life the gift of In Her Mother’s Shoes, a story of difficult relationships and the journey to understanding and healing.

Both In Her Mother’s Shoes and Autumn Colors can be purchased as paperback or ebook at Amazon, Barnes and Noble, through the Apple Store, or can be ordered through your local bookstore. Signed copies are available through my website, www.dawnlajeunesse.com. If you have read either or both and liked them, a review on any of the book sites would be appreciated!

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PRODUCTIVITY HAS MANY MOTIVATIONS

I’m sitting here at 5am knowing it’s my only time to write and knowing with equal certainty that creative writing is not going to happen this morning. Sometimes these early morning attempts work and sometimes nary a word spills out of my brain onto the page. This morning seems somewhere in the middle, as my brain clearly isn’t spilling the next chapter of my novel, and yet it is not completely blank, as it sometimes is when I try to force writing. Sometimes mornings like this evolve to more creative writing, and sometimes the best my brain can do is ruminate on how to get productive creative writing – as in the next chapter of my novel – flowing.

I’ve read lots of articles about how writers motivate themselves. Some have rituals they apply. Like lining up multi-color pens and/or pencils and pulling out a favored notebook and shutting out the rest of the world, either literally, as in locking the door of the room in which you are working, or by putting up mental blocks to the sounds and movements around you (as I do when writing on a train – sans the colored pens and pencils).

Sometimes writers bribe themselves, as in “if I write five pages by lunch time I can….” That one never works for me, as the latent adolescent in me counters with “if I want whatever I’m bribing myself with, I can have it whether I produce or not, nah nah nah-nah nah!

There are days when words just flow. They are rare lately, but I live for those days. On those days, when I even like what I read as I review what I’ve written, I imagine producing something so commercially appealing that I land an agent and a major publisher and a fat advance and I can say bye-bye to my full time job.  They give me hope, however illusive, of a true writing life. The odds are against that, but I do love those days. Today is not one of those days.

Sometimes the only thing that works is the potential for embarrassment and shame.  That’s when I bring out the big guns.  That’s when I sign up for a class where, if I don’t produce, that fact is there for everyone to see.  I may not be motivated by guilt or bribes or pretty colored writing instruments, but I never miss a deadline in a writing class because I can’t bear the embarrassment of others knowing I don’t have my homework done.

It’s sort of a last resort. As I’ve written in recent postings, I’ve been a bit distracted by the realities of life for the past few months. Maybe creativity is stimulated by adversity for some writers. But in my case when things get really bad my coping mechanism is to shut my brain off any moment when I don’t absolutely have to function.  It’s a pretty miraculous coping mechanism, in that I mostly don’t miss a beat at work and I manage to pay bills and balance the checkbook and do all the stuff that has to be done in our house. But it isn’t conducive to creative writing. Then that inertia I mentioned in a previous post digs in deep and only desperate action can get things moving again.

So my class starts one week from today. I’m sort of cheating, because I’m starting with two assignments (10,000 words each) that I already wrote. But they needed a lot of work, and spending time revising has helped me get back into the story. After the first two I will have to produce 10,000 words every three weeks starting with a blank page. But it will work. It always does. When my first novel, Autumn Colors, was hopelessly stalled, it was two consecutive writing courses that carried me to “The End.”  I wrote most of In Her Mother’s Shoes without the prodding of class deadlines, but a class was what got me started and helped shape the direction of the story.

The moral of this story is, do whatever works, whatever it takes to motivate yourself. Strip yourself of any delusions or fantasies and figure out what motivates you. Then just do it.

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With Easter nearly here, Mother’s Day can’t be far away. So often mothers and daughters struggle with their relationships. Consider giving the moms in your life the gift of In Her Mother’s Shoes, a story of difficult relationships and the journey to understanding and healing.

Both In Her Mother’s Shoes and Autumn Colors can be purchased as paperback or ebook at Amazon, Barnes and Noble, through the Apple Store, or can be ordered through your local bookstore. Signed copies are available through my website, www.dawnlajeunesse.com. If you have read either or both and liked them, a review on any of the book sites would be appreciated!

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EASING INTO THE STORY VS BOUNDING OUT OF THE GATE

Writing classes and journal articles and agent/editor webinars these days emphasize the importance of making a huge splash on the first page – even the first paragraph, the first sentence – for any novel to be successful. That approach, perhaps, derives from the unfortunate truth that many readers, particularly younger readers, have the attention span of a gnat. If you don’t grab them immediately, they will toss the book aside, never to pick it up again. At least, that is the theory.

Yet so many very successful books – including most of the classics – get off to a more leisurely start, laying building blocks one at a time, sometimes before you have any idea what the book will be about (that is, if you haven’t read the blurb on the back of the book – or are limiting your reading to e-books, which don’t have a back-of-the-book blurb for you to read).

I will admit, as a teen, many of the classic novels we were required to read seemed boring at the outset . Truth is, for more required reading than I could admit at the time (some 40+ years ago), I simply gave up and bought the Cliff Notes version. If my teachers were on to me, they never said a word, and I never received less than an A in high school or college English or Literature classes. Of course, that was pre-computer age and smart phones and texting and instant gratification and cheap electronic books. If those novels were slow for me, I can imagine how they seem to youth of today. So perhaps if you are directing your writing at that youthful age group, there is something to the advice.

However, some of the best stories and best written books I have read in recent years had slow starts. A prime example is the trilogy of the immensely successful Stieg Larsson books. You had to wade through 50-100 pages before the stories became so riveting you couldn’t put them down.

And currently I am reading a book by an author I’ve never read, Elizabeth Haynes, Into The Darkest Corner. It was so slow and disjointed for the first couple of chapters (much of which were transcripts from a trial), I almost set it aside. But I have a bit of an obsession about reading every book I start (maybe a delayed reaction to my high school habit of almost never finishing those books). And at the time I had nothing else on my Kindle that I hadn’t read. So I plowed on.

I hope I don’t offend anyone if I use a sexual analogy. A well-written book that eases you into the story and connects you with the main characters is a bit like long and gentle foreplay that takes you on a gradual ascent and builds momentum so subtly you barely know it is happening. And then you reach a point of no return and shazam! An ending/climax so powerful it leaves you weak as a kitten, some perverse part of you wishing it could have gone on forever.

Admittedly, there is a risk to this approach, particularly if you are not an established, traditionally published author. It is far too easy for an agent or editor, faced with a mountain of manuscripts, to toss aside one that doesn’t grab her/him with the first paragraph.

But there is something to be said for slow starts in the hands of a master storyteller. This book could have been just another tedious read, had Ms. Haynes not been so masterful about drawing you in. Most of us need to work not just on finding ways to make our stories bound out of the gate, but also honing our craft to a level that holds readers long past the big bang opening – or skipping that entirely if you are brave and skilled enough to go that route.

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While I’m working on my new book, Transition, if you haven’t already read Autumn Colors or In Her Mother’s Shoes, I invite you to check them out on Amazon, Barnes and Noble, or through the Apple Store. If you have read either or both and liked them, a review on any of the book sites would be appreciated!

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INERTIA – WRITER’S FRIEND OR FOE?

Travel back to high school physics. Can you recall the definition of inertia? A body in motion tends to stay in motion and a body at rest tends to stay at rest unless acted upon by an outside force.

You witness the rule every day in many ways. If it weren’t for friction and gravity, your car would keep rolling indefinitely after taking your foot off the gas unless you applied the brakes. That golf ball will sit on the tee forever unless you swing your club (and don’t miss).  Just getting out of bed in the morning requires you to overcome inertia (not to mention abandoning the sheer pleasure of snuggling under warm blankets when the surrounding room is cold).

The same rule applies to writing.

The last time I wrote, I bemoaned the long period I’ve gone without writing. Yes, I had lots of reasonably valid reasons. But there was also the effect of inertia. Getting back to active writing required dredging up energy in a form I haven’t used in several months. Mental energy – specifically, creative energy.

I was overwhelmed by the thought of starting work on Transition again, after not touching it for so long. I knew it would be hard to pick up the story where I left off. I knew I’d have to go back and, essentially, re-read and edit everything I’d written up to the point when I packed the manuscript into a box in preparation for our move. It seemed like so much work, and it scared me – not the work, but rather the possibility that after all this time I’d find the story lacking, that I wouldn’t be as excited as I was when I started it.

So I started off slowly, re-reading and revising the synopsis, on my way back to the full manuscript. And what do you know? I got excited about the story line all over again! I made major revisions to the synopsis (and therefore the planned trajectory of the story). I recognized that trying to cram a whole century into one book would mean short-changing the story, so I broke the synopsis into three parts. And got more excited. I moved on to what would be book 1 of a trilogy and my heart raced as I read the first chapter. Who wrote this? I thought! Well, what do you know, it was me!

My momentum grew. I moved on to chapter two and found myself immersed in young love. I saw what the main character saw in her beloved and felt what she felt. I rolled on to chapter 3, and felt more of the same. All the way along I was making modifications, not because I didn’t like what I read but because, having taken a break from it, I saw ways it could be even better.

I still had time constraints, so I couldn’t do it all in one sitting (127 pages). But I was rolling, and other than time, there were no outside forces acting upon me to make me stop! I remembered why I write – because I love it – and remembered how I managed to fit writing into my life before our move and before all the house issues we’ve come through. I just did it. And once I sat down and started, inertia and the pleasure that writing brings to me kept me going. Each time I had to stop, I couldn’t wait for the next opportunity to pick it up. And each time I started, it was easier to get going and took more to bring me to a halt – like the force needed to stop a fully loaded freight train as opposed to the force needed to halt a leisurely walk.

It told me I have to write to find time to write, to make time to write. I have to remember that if I overcome the inertia of inactivity, I can embrace the more satisfying inertia that comes with moving forward with pouring words onto the page.

Inertia at rest might be challenging to get past, but the inertia of stories flowing from your mind and into fingers that fly over the keys – that inertia definitely is the writer’s friend.

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While I’m working on Transition, if you haven’t already read Autumn Colors or In Her Mother’s Shoes, I invite you to check them out on Amazon, Barnes and Noble, or through the Apple Store. If you have read either or both and liked them, a review on any of the book sites would be appreciated!

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SLOW AND TOUGH RE-ENTRY

The wayward author has resurfaced!

This is by far my longest gap between postings, and mea culpa doesn’t cut it. I have lots of reasons that I consider valid, but when I am totally honest I can also admit that inertia played a role. Once I got away from my usual daily routines – writing, exercise, social media postings – and was forced by time constraints to stay away for a while…well, the more time that went by, the harder it seemed to be to get back to a daily schedule that required discipline, motivation, and energy – all of which flagged progressively as time went on.

So just what was the initial culprit that interfered with my usual routine?

Back in early October, we sold our beloved log home in the Adirondacks. The upkeep and my long commute (which I’ve whined about once or twice – or a dozen times here) and our desire to reduce expenses in preparation for my eventual retirement from my full time job left us no real choice. I had two high-speed accidents last summer, neither of which were my fault, but which left me with a gaping hole in my sense of security on the road. I couldn’t stop wondering how bad the next one would be. The cost and effort of upkeep of a log home proved to be more than we had anticipated when we built it. And the design and size meant high heating bills – not to mention being impractical as we aged. Anyway, we put the house on the market in April and it sold six months later.

At that point our packing and preparing began in earnest. I focused on the packing, while my husband did basic repairs and cosmetic fixes so our buyers wouldn’t have any reason to question their purchase decision. (Ah, if only the sellers of the house we bought had felt the same way…but that story will come later). It amazed me how much stuff we had. And when we selected a replacement house that was smaller, we knew we had to unload a lot. I joked about feeling like as soon as I emptied one square yard of space, more stuff grew there overnight. It felt like we’d never be ready to move – and indeed, we were packing right up to closing day and a bit beyond (fortunately our buyers allowed us to come back for some stuff the movers hadn’t taken).

Fast forward to moving day. In spite of increasingly frantic calls to lawyers and banks, the closing on the house we were purchasing was not coordinated with the closing on our old house. The sellers of the house we were buying were moving into a temporary living arrangement in a furnished apartment, so we began working on them to let us move into their house before the closing. We ignored the red flags, not the least of which was a comment by the seller about being advised by his attorney not to let us in before closing because of what we may discover about the house. How desperate were we that we didn’t take a few backward steps to find out exactly what that meant?

Anyway, we didn’t. All we were focused on was having a place to live after we had to leave the old house, preferably without having to pay to move twice (i.e. to an apartment or hotel first).  We did try to pin him down on what the issues were that he was concerned about, and he made some general statement about older houses having warts that you don’t see until you live with them.

Warts?

We knew there were a lot of cosmetic issues that we’d have to take care of, not the least of which were the drab gray and dark blue walls throughout this otherwise lovely home, and the trashed bedroom that had been inhabited by a teenager. We also knew from the periodic odor that they had sulfur water. Knowing nothing about that other than the unpleasant odor and taste, we simply budgeted for a water treatment system to handle it.

Minor stuff.

Alas, these were not the warts to which he referred.

Finally, he agreed to our moving in the day after the closing on our old house, and the new owners of our house agreed to our staying an extra day. The warts, which revealed themselves to be massive lesions, began to surface on Day One.

We woke, after our first night in our new home, to a very cold house. The furnace had died, and the arrival of a repair service resulted the news that the furnace was dead. We didn’t own the house, so we had no right (or responsibility) to replace the furnace. The seller stepped up to the plate and agreed to pay for it. During the course of the installation of a new furnace, we learned the extent of the damage that can be (and was) caused by sulfur water. Apparently – in addition to the smell and the chronically black/gray water – it oxidizes pipes and fixtures. Who knew???

In the interest of keeping this story to a reasonable length (are you still awake?), I’ll give you the Readers’ Digest Condensed version. So far we have had to replace the furnace, the water heater, all faucets and showerheads, most valves and shutoffs, and miles of pipes. We have had to scrub every salvageable surface touched by the water to remove the build-up of oxidized sulfur, which manifests as a gray to black film and in some cases pocked surfaces.

Needless to say we also had a water treatment system installed. A few days after installation (which was AFTER the closing and two weeks after we moved in), the new water treatment system warning light went on saying the well was running dry. We knew that wasn’t the case because the water table here is high and our back yard was a lake, so the assumption was the well pump was bad. Several hours later the very responsive well company, with heavy equipment and some digging, found a leak in the pipe running from the well to the house – eaten away by the sulfur – which accounted not only for the treatment system’s misinterpretation but also for the “bubbling spring” and mini-lake in the yard. The next day the plumber, who had already been here twice, finished replacing the fixtures and repairing the new leak under the master bath sink and in the washer drain.

I bought a kit to refinish the blackened and pocked white kitchen sink, but will have to replace that if the process doesn’t work.

Meanwhile, in week three of this adventure, our house electrical system kicked the bucket as it terminated the life of our clothes dryer. Remember the movie “The Money Pit?” Well, I think we may surpass that. It seems the former owner put the electric in himself, and nothing about it was up to code. On top of that, a family of mice fried themselves in the box in the basement AND one lone mouse in the box outside. Our wires are underground and we are responsible between the house and the pole, so it took five men twelve hours, working non-stop, to get both boxes replaced and wired properly so we’d have heat and water during that very frigid week. They also had to rewire the plugs for the major appliances, which were not 220. The head guy said we were a fire waiting to happen. All together (so far, and not counting the optional cosmetic stuff) we have spent close to $25,000.

Someone suggested we pursue the inspector, who should have picked up on the more serious issues. Alas, the contract for the inspection had so many disclaimers there was no hope of any help there.

My husband couldn’t understand how I was handling all of this so well. Hmmm. About four weeks into it all I was flattened by back spasms that kept me out of work and immobile for the better part of a week. Guess I wasn’t handling it as well as it appeared.

The night of the electrical crisis, my husband’s doctor called to tell him he has prostate cancer. Since then we’ve been talking with doctors and radiologists about the optimal treatment of his particularly aggressive form. Prostate cancer aggressiveness is rated on a scale of one to ten. He scored 8. So surgery and possibly radiation is in his (our) future.

It has been nearly two weeks now since the last major disaster (not counting the ongoing stress related to Den’s cancer). Little issues have cropped up that we could handle ourselves and there are lots of additional projects on the horizon.

Fortunately I still see the beauty of the house that appealed to me since we first viewed it, and its potential when we are past all this! In the past three weeks we have patched and painted most of the main floor and the stairway and one spare bedroom – and it looks fantastic – exactly as I had envisioned! Slowly we are hanging pictures and filling shelves with items that make this bright, attractive house very much our home.

But I think you might have a clue from this about why my blog and social media postings have been silent. Hopefully that – and my hiatus from writing – is coming to an end!

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RT @mtnwriter77: REALITY OF LIFE, LACK O

RT @mtnwriter77: REALITY OF LIFE, LACK OF DISCIPLINE – OR SOMETHING ELSE? http://t.co/JTvQ0L6D

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RT @mtnwriter77: REALITY OF LIFE, LACK O

RT @mtnwriter77: REALITY OF LIFE, LACK OF DISCIPLINE – OR SOMETHING ELSE? http://t.co/JTvQ0L6D

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RT @mtnwriter77: REALITY OF LIFE, LACK O

RT @mtnwriter77: REALITY OF LIFE, LACK OF DISCIPLINE – OR SOMETHING ELSE? http://t.co/JTvQ0L6D

Posted in Uncategorized | Leave a comment