Reproduction

We all know, or should know, the danger of global warming to our futures, but most people are unaware of another very real danger. Did you know that sperm counts are dropping and women are having more problems with egg quality? There are more miscarriages today and more genital abnormalities in infant boys. Girls are reaching puberty at an earlier age. These problems are not just in humans, but also in animals, fish and amphibians. 

Shanna H. Swan, an epidemiologist at Mount Sinai Medical Center in New York, has sounded the alarm in her new book, “Count Down.” Swan states that from 1973 to 2011 sperm count fell by 59%. The question is why and Swan says that the problem is endocrine disruptors which are in chemicals that fool the body’s reproductive cells. This plays disaster on the sexual development of fetuses. These chemicals are in almost everything we touch, canned foods, cosmetics, even ATM receipts. Chemical companies lobby against safety testing of these endocrine disruptors and that leaves us unaware of the dangers we face.

There are those who have other theories about the reproductive changes seen over the past few years but the World Health Organization and other professional groups, such as the Endocrine Society warn about endocrine disruptors. Canada and some countries in Europe have regulated these chemicals but the United States has not. We need to let our representatives in the Congress know of our awareness and concern. 

What else can be done to protect against these chemicals? Swan suggests storing food in glass rather than plastic, not microwaving in plastic, buying organic produce and avoiding pesticides. 

Photos by Pixabay

The Beast

Those of you who have followed this blog for a long time know how much I have enjoyed walking, especially in the parks near my home. I loved enjoying the changing seasons, animals such as deer which I often saw and just the exhilarating feel of being out in nature. A year or so ago I was walking 3-4 miles most days and then trouble struck. Like many seniors I now have a bum knee. Some of my friends are getting knee replacement, but I’m determined that isn’t going to be me. I’ve had two steroid injections with varying results and weight bearing can still be very painful at times.

After a few weeks of physical therapy I forgot all that I’d been taught and instructed to do, i.e., exercises. I’m not a good PT patient. Recently though I recalled a horrible machine that the therapist seem to enjoy seeing me suffer on. It was big and intimidating but was supposed to strengthen the leg muscles that would better support the knee. The more I thought about that contraption the more I thought I should have one to use at home. That was a problem because there was no room for it in my condo.

The more I thought about it the more I decided that I could live without the sofa in my office. With the help of my daughter someone was identified who needed a sofa so, much to the chagrin of my cat, Elliott, I gave the sofa away. Elliott would probably say I sacrificed his “napper.”

Next I had to find the machine and it wasn’t hard to do. It is called a Cardio Strider, which I promptly named The Beast! I will never tame it, but over the past week I’ve averaged 1.5 hours and eight miles per day. The Beast is big, it’s ugly and Elliott hates it. He seems to be embarrassed for me when I sit astride it and begin to work-out. I’m not going to give up. I’m going to get this bum knee in better condition so that I may be back walking in the park when spring gets here.

The Beast

COVID GRIEF

It has been a year since the pandemic began here in the United States. At that time, none of us knew what we were in store for. We were innocent and naive thinking we’d be inconvenienced for a short time. Now we know the hardships COVID19 is capable of causing. We wear masks, try to maintain a safe distance from others, don’t hug our loved ones and avoid shopping or eating out. People are working from home. Children have been trying to learn through virtual lessons. People we know and love are sick or perhaps even dying. Nothing is normal and we miss everything that we took for granted.

Most of us are aware that we are changed. We are not ourselves in many ways. Our feelings are not unlike those of grief when experiencing a specific loss, such as in divorce, a loss of a job or home, the death of a loved one or our own approaching death. In 1969, Elizabeth Kubler-Ross first described what she called the five stages of grief. Looking at these stages now may help us to understand some of our current feelings and moods. Those five stages are Denial, Anger, Bargaining, Depression and Acceptance.

It is easy to see that our first reaction to the pandemic was denial that it could possibly be this serious. As time went on and we realized our lives were severely altered it was natural to feel anger. Anger at being told what we could and could not do, anger at those who refused to take those necessary precautions and anger at the inconvenience of it all was a frequent feeling. Bargaining may be harder to recognize, but at times we surely promised mentally that we’d follow the rules and that would bring an end to this curse sooner. Depression, including suicide, today is a significant problem according to mental health professionals. It is hard to fight when one is depressed and the condition becomes a vortex of despondency and a feeling of inertia that makes each day hard to face. Acceptance is having hope and in the case of COVID a feeling that normalcy will return and that life will be joyous again.

These stages of grief do not always come in this order and it isn’t unusual to switch back and forth among these stages. There are no exact parameters. Some degree of each stage will probably linger and overlap other stages. After twelve months of this experience you can probably identify these stages of grief in your life. Hopefully this recognition of the process and an understanding of the stages will help us to go forward with hope.

Photo by Pixabay

Masks Are Simple

Masks, hand washing, social distancing, Three easy things to do that saves lives, but they have to be done correctly.

  • Distancing = six feet separation.
  • Hand washing with soap and water for twenty seconds.
  • Masks cover the nose and mouth.

I am sick of encountering people with their mask placed UNDER the nose! What part of breathing do they not understand?

Suicide Prevention

This is National Suicide Prevention Awareness Week. During this pandemic it is more important than ever that we be there for each other. You don’t have to be a mental health professional to make a difference. Being aware of the signs, knowing where to turn for help are things we can all do for ourselves and each other.

On average there are 132 suicides per day in the United States. Over fifty percent of these are carried out by firearms.

See this post for signs and symptoms of suicide as well as resources that are available: https://crookedcreek.live/2017/03/01/death-suicide/

Appointments

2020 Appointments

As we age we have more medical appointments and so my calendar is full of them. Appointments today are nothing like in the past. Thanks to the Novel Corona Virus everything is complicated. And each provider’s office has a different way of approaching safe environments for patients. Some work and some confuse.

I’ve had two virtual appointments where I can see and converse with my provider on screen. Providers use various platforms with names like “Blue Jeans” and “Ring Central.” Some require the use of nine digit numbers and symbols, some have you to sign in to a virtual waiting room, which means you wait for them to be ready for you and one had me to read and sign a HIPPA document. Life would sure be simpler if they all used one system.

I thought in-person visits would be simpler, but I’ve now had two of those and they were complicated as well. One office had me to wait in the car until they texted me to enter the building. The immunologist came into the exam room wearing a full hazmat suit and we talked. It could have easily and safely been done virtually.

The most important in-person visit was with my oncologist. Entering the professional building my temperature was taken along with my name. Then a detailed interview was performed to determine if I was at risk for COVID. At this point, wearing my favorite personal mask I was allowed to enter the elevator and proceed to my physician’s office suite. Exiting the elevator I followed directional stickers on the floor placed at six foot intervals. Eventually I reached the admission office where they took one look at my pretty mask with the Mercedes logo and told me to remove it and wear one of theirs. Of course I did as I was told. The visit continued with lab work and consultation and I was discharged one hour and forty minutes later.

I’ve sure you have had similar experiences regardless of what country you call home. I don’t care for this new normal, but I do appreciate all the attention to safe procedures.

“I recently went to a new doctor and noticed he was located in something called the Professional Building. I felt better right away.” George Carlin

 

Graphics by Pixabay

A Rebooted Brain

Do you ever wish you could reboot and start over? I think that sometimes we do and yet maybe not really if you hear the story I want to share with you. I came across a tiny article about Dr. Jill Bolte Taylor that piqued my interest so I researched her and was fascinated by what I learned. Dr. Taylor’s profession was the study of the human brain when she had a severe stroke. She refers to it as a “stroke of insight.” She was 37 years old when this disaster struck and she spent the next eight years recovering.

She tells her fascinating story most entertainingly in her Ted Talk at https://www.ted.com/talks/jill_bolte_taylor_my_stroke_of_insight

 

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Graphics by Pixabay

Quarantine

John Pavlovitz is a blogger who I follow. His latest post (the link is below) says a lot that is important during this time of physical distancing. I’ve been thinking about blogging about the issues he discusses. He does it so well, please read. Thank You

https://johnpavlovitz.com/2020/04/01/dont-quarantine-yourself-from-life/

Distancing

Experts on the Coronavirus have warned that we need to remain six feet apart when we interact to prevent viral spread. This has been dubbed “Social Distancing” but I believe a better term would be “physical distancing.” We need to be socially close perhaps more than ever before.

Our social contacts may be by phone, texting or email. Maintaining the six feet of separation we can even be present together if neither has symptoms. I am so grateful to those who have reached out to me. Some just ask how I’m doing. Others are able to offer specific help like grocery shopping. Besides my immediate family, these are friends, neighbors, and relatives. One friend provides food, another dropped off pink azaleas! While I am in one of those high-risk groups health-wise I am also over the age of sixty (>70), but so are some of those checking in with me. It is not that I am in need or dependent. It is that people care.

Let’s all try to do better in remaining socially close during these unprecedented times.

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Kindness, Helpfulness and Support – ALWAYS ACCEPTABLE

 

 

Graphics by Pixabay

Something to Consider

In the past, we discussed end-of-life decisions. Please review some of the resources and information provided during that series on Death.

https://crookedcreek.live/2017/01/25/death-decisions/

One of my readers made an important point in a personal discussion we were having today and I feel it is worth mentioning here.

During the current COVID-19 pandemic many more patients are being put on respirators (ventilators) to assist in breathing. Many, if not most, will recover and are again able to breathe on their own. They are discharged to fully recover.

For some, this may be a reason to re-think one’s Living Will or written instructions for a health care surrogate.  If your legal document(s) currently says, “no ventilator,” is this still your desire?

This is a valid point and I present it for your consideration.

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Graphic by Pixabay

Colors

As we age most of us expect our vision to worsen. We expect to wear glasses and to eventually have cataracts that require surgical removal. Some unfortunate individuals have eye diseases that greatly impair vision, such as macular degeneration. One thing that might blindside (sorry, I couldn’t resist the pun) seniors is color-blindness more accurately called color vision deficiency.

Researchers from The Smith-Kettlewell Eye Research Institute administered color vision tests to several hundred adults ages 58 to 102 and found that 40 percent had abnormal results. The rate was significantly higher in those over 70 and rises with age after seventy. The type of color vision abnormality is different from inherited color-blindness which usually involves red and green.

I first realized I had this problem a couple of years ago. In my experience purple almost always looks brown. Often pink looks yellow. The amount and type of light greatly affect how I perceive these and other colors. Purple inside looks brown, but moving it into the sunlight sometimes reveals the true color.

If you have this problem you probably are already aware, but there are simple tests available Online. A word of caution, some sites charge a fee and others may result in unwanted email followup.

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“Just because a man lacks the use of his eyes doesn’t mean he lacks vision.” Stevie Wonder

 

 

Photos by Pixabay

Are You Prepared

A novel form of coronavirus originating in China late last year has spread globally. There is no vaccine for this particular type of corona, named COVID-19. I won’t list the morbidity and mortality statistics here because they are changing by the hour and news coverage is widespread and nearly constant. It is important that we listen to and read reputable news sources. Social media and even some government representatives can be misleading. We need scientific statistics, not hunches.

I have known for some time that there are a few things that should be on hand at home if we are to be prepared, but I have not followed through. Today I plan to at least be sure I have some extra food and over-the-counter remedies available in addition to the gloves, masks, and disinfectants that I already have in stock.

Prepare For What?

  • Isolation – staying at home to protect yourself from others
  • Infection – staying at home to protect others from yourself

Prepare How?

There is no dearth of good information available regarding what to do to protect ourselves from this virus. It includes masks, gloves, hand sanitizers, and new greetings to take the place of handshakes. I’m not going to outline them here.

We know that should we become ill with flu-like symptoms we should isolate ourselves from others and treat the symptoms. If developing a fever or in the case of more serious symptoms we should go to a healthcare facility where they may or may not have test kits for COVID-19. Regardless, the more serious symptoms and complications can be treated by health care professionals when the virus is too serious for self-treatment.

Older individuals and those weakened by other diseases are most susceptible to more serious complications. Some thought should be given to who would care for such individuals in your family should they contract COVID-19.

At this point, we do not know how much worse this situation will become, but we have all the information necessary to plan and make the most of what could be a horrific pandemic. Test kits are lacking, there will not be a vaccine for 12-18 months, but we have information that is crucial even if it sounds too simple, like “do not touch your face.”

Are You Prepared?

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Picture by Pixabay

“Life belongs to the living, and he who lives must be prepared for changes.” Johann Wolfgang von Goethe

Pangolin

Ever hear of a Pangolin? Me either, until recently. We might never have known about this unusual animal had it not been for the Coronavirus (COVID-19) sweeping China since December of 2019.

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These unusual mammals are scaly anteaters who curl into a ball when threatened. Various species live mostly in Asia and Africa. As potential transmitters of COVID-19 and because of deforestation they are gravely endangered of becoming extinct. Pangolins eat ants and termites and believe it or not people eat them! They are the most trafficked non-human mammals in the world both for their meat and their scales. While the scales have no known medical value they are used in traditional Chinese medicine. The meat is a delicacy in China and that is where the transfer of the virus comes into play.

These shy nocturnal animals are now more endangered of being killed needlessly in the wild because of the fear of COVID-19. Recently there was a Pangolin Day to recognize this danger and to inform the world of these harmless animals’ plight.

 

 

 

 

Benefits of Owning a Dog

Why Own a Dog

The most obvious reason is that they are wonderful pets who bring immense joy to one’s life. 

As pointed out in an earlier post https://crookedcreek.live/2019/03/06/staying-alive/ owning a dog may help you to live longer. This is strongly indicated in a recent study published in the peer-reviewed journal “Circulation: Cardiovascular Quality and Outcomes” of the American Heart Association.

The study was a meta-analysis of research published from 1950 to May of this year. This research evaluated dog ownership and its association to mortality. The data was from more than 3 million participants.

Scientists found dog owners had a 24% risk reduction for death from any cause, according to the study. For people with heart problems, living with a dog had an even greater benefit, the authors said. 

Walking a dog daily for twenty or thirty minutes is one of the obvious benefits and stress reduction and social interaction may also play a role. The scientists emphasized that dog ownership would not make up for cardiovascular risk factors such as high blood pressure, cholesterol, diabetes, and smoking.

While there are reasons why it is not practical for some individuals to own a dog, longevity might be enhanced by noting the importance of daily walking or other exercises. The American Heart Association recommends weekly activity of 150 minutes of moderate exercise to improve overall cardiovascular health.

Title Art of Luke by Pat Brooks

Skin Cancer

Skin cancer is the most common type of cancer. There are several kinds but basal cell is the most frequent. More than four million cases are diagnosed in the US each year. Squamous cell is next, diagnosed in one million people annually. Both are easily treated either surgically or with special medications. Sometimes radiation or cryotherapy are used. The most important thing about these and any skin cancer is early detection.

Melanoma is a type of skin cancer which can be much more serious and difficult to treat depending upon the stage at the time of detection. Melanoma can spread to other parts of the body and require chemotherapy or radiation in addition to surgery. If a first-degree relative has had melanoma your chance of developing it is 50% higher.

Recognizing melanoma relies on the ABCDEs which stands for these characteristics:

  • A – Asymmetry
  • B – irregular Borders
  • C – changes in Color
  • D – Diameter larger than 1/4 inch
  • E – Evolving (changes over time)

 

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An example of melanoma skin cancer

 

Early detection of skin cancer requires close observation of your own body, including hard to see areas that might require enlisting the help of another person. Most important is having an annual skin check by a dermatologist.

Prevention includes the use of sunscreen every day regardless of the weather or your activity. UV rays are always present and even penetrate glass in your car, office or home.

The benefits of sunscreen for African Americans has not been fully established. One should discuss this with their physician.


You can read much more specific details of skin cancer and its treatment at this American Cancer Society website https://www.cancer.org/cancer/skin-cancer/galleries/skin-cancer-image-gallery.html

This site also has several photos of different types of skin cancer and includes a chat line if you have further questions.

The Cancer Helpline number is:  1-800-227-2345  

Heart Attacks in Women

What we need to know about Heart Attacks in Women

  1. Heart attacks are the number one killer of women (as well as men)
  2. Heart attack symptoms can be more subtle in women
  3. Women are not men, there are physical reasons such as pregnancy and menopause that account for some variable symptoms in women
  4. Heart attacks are often not promptly diagnosed/treated in women
  5. Women are more likely to experience “silent” heart attacks

Risks

  • Diabetes (more common in women than men)
  • Mental Stress and Depression
  • Smoking
  • Inactivity
  • Menopause (due to estrogen changes)
  • Some chemotherapy such as those used to treat breast cancer
  • Pregnancy complications

Symptoms – onset often at rest or during stress

  • Odd feeling in the chest or minor chest discomfort rather than severe pain
    • Often described as pressure or tightness
    • Palpitations
  • Neck, jaw, upper back or shoulder discomfort
  • Shortness of breath
  • Pain or odd sensation in arm(s)
  • Abdominal pain, nausea and/or vomiting
  • Indigestion or heartburn
  • Sweating
  • Lightheadedness, dizziness
  • Extreme fatigue

Women should not ignore these symptoms and should work to reduce those risk factors in their control. 

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Sources: mayoclinic.com, prevention.com, womenshealth.gov, healthline.com

Graphic by Pixabay

The “C” Word

Doug Weaver is my longtime friend who is a professor of Baptist studies in the department of religion at Baylor University. He is the current president of the Baptist History and Heritage Society and past-president of the National Association of Baptist Professors of Religion.

In spite of the fact that I am a recovering Southern Baptist, I highly respect Doug’s opinion. Also, please note that “Southern” is nowhere listed in his credentials even though he is a Virginian.

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It is Well

By Doug Weaver 

It is well with my soul. Is that an elusive ideal, a hauntingly compelling confession of hope, or both?

In 1983, my father died of colon cancer. In 1984, my mother was diagnosed with colon cancer but thankfully survived it and was later declared cured. My older brother’s doctor once told him, “It is not if you and your younger brother get colon cancer, but when.” After more purifying colonoscopies than I can count, the cancer never came. But, I never really fasted from the fear of the possibility.

Fast forward. In 2006, I was diagnosed with bladder cancer. I was told that it was a good cancer to get – the cancer was just in the lining and was not invasive. My hearing is pretty bad and I see with trifocals, but trust me, I can feel with the best of them. The cancer and the side effects of my treatments constantly bent me over with knife-like pain. Depends were not dependable; no wonder I started wearing black pants to work. The doctor in Waco where I live thought the medications which turned my flow into Texas burnt orange would lessen the pain, but I told him I was burning horrifically and unless he had magical Baylor green and gold, it was not going to help. And it didn’t. The treatments, however, worked.

In 2009, the bladder cancer came back – same situation – in the lining, not invasive, burning like a Gehenna fire. I was again on the extreme end of the spectrum with bodily reactions to the condition and the medication. However, what scared me was the doctor’s suggestion that cancer cells might be in a kidney too. I visited a specialist in Dallas who said it was so rare for bladder cancer to go into the kidney that it must be a tainted test. So do not fear.

The treatments worked again, but one more time, in 2013, the C word returned. This time cancer cells were in the lining of the bladder and both kidneys. So much for fasting from fear. Even though I had been his patient for seven years, I left the Waco doctor for good since he had said if the cancer ever got to the kidneys he’d have to try voodoo medicine to treat it. To confront the fear, I headed to MD Anderson Hospital in Houston. They put two nephrostomy tubes in my back (an amazing procedure), administered the medicine, and the treatments worked. The tubes dangled, hidden under my shirt for months, but at least voodoo stayed in Waco.

I made the 185-mile trip to MD Anderson in Houston every three months from spring 2013 to fall 2016 with good checkups, but once again I received word that the cancer cells had returned to the lining of both kidneys, now my fourth time. I did the standard treatments and kept the tubes in for a few months as we awaited results. I threatened a few colleagues with a “lift-the-shirt” presentation on a couple of occasions but other than being a Baptist who couldn’t be immersed in water, I did fine. But, I wasn’t fasting from an increasing fear.

I have now reached the one-year anniversary of surgery to remove a cancerous kidney. (The good news was that one kidney and the bladder didn’t reveal cancer cells anymore.) After the surgery, my wife and I heard the line many people living with cancer hear: “You had some microscopic cancer in lymph nodes, so we need to do some chemotherapy.” So, we did.

Today, I am fine – good, actually. My hair returned, curly (and unruly) like it was when I was a teenager. Subsequent scans (yes, cancer survivors often date the calendar by their regular three-month checkups) have been good. I am feeling hopeful.

Yet, during this journey, I haven’t been one of those patients who has “conquered” fear. On rare occasions, I was able to confront the repeated news of cancer returning with a bit of confidence. Most of the time, I was forced to my knees by the demon of cancer and begged God for a miracle my dad never received. Sometimes I have been near despair.

I knew my situation wasn’t as bad as patients I saw walking alongside me in the halls of MD Anderson; yet to compare cancer cases is not fair to anybody. Along the way, I have told friends too many details. My wife has had to hear me ask questions that I either already know the answer to or know that there are no answers. I love the church, but it isn’t always the best place to fast from fear (although, in my case at our church in Waco I am gifted with the wonderful pastoral presence of Mary Alice Birdwhistell). Baptists have a few saints.

One of my favorite Holy Week phrases is from Tony Campolo’s powerful old sermon: “It’s Friday, but Sunday’s coming.” I need to repeat that. “It’s Friday, but Sunday’s coming!” When you are sick, sometimes it is Friday. In fact, it can be months or years of mostly Fridays. It is hard and physically, emotionally and spiritually taxing. The Easter we just celebrated tells us that Sunday is now here, and that means hope amid fear. I think that is what the earliest disciples experienced.

Ah, that word “experience.” The longer I study Baptist history, the more I am confronted by that compelling word. We interpret our faith through our experience. Heretical? Ha, call me Harry Emerson Fosdick who once said that if dispensationalism is orthodoxy, then call me a heretic. The role of experience is at the core of Baptist DNA: voluntary faith, dissenting conscience as an act of faith, believer’s church and so on.

I’ve been researching in recent years the role of the Holy Spirit in Baptist identity (shameless plug: stay tuned for the book this fall). The desire for an ever increasing awareness of the Spirit – an experience of the power of the Spirit – is not absent in Baptist life. As we approach the observance of Pentecost in a few weeks, I understand standing on that promise of presence.

Fear needs the experience of hope.

I am a cancer survivor. This is the first time I have used those words in a public forum. I am still hesitant to call myself that because of others whose lives have been hit so much harder. Friday’s coming, Sunday’s here, and Pentecost promises glory. I am healthy(!), but I still can’t say hope without fear, and I refuse to say fear without hope.

It is well with my soul. I love the hymn that bears that title. It is an elusive ideal and a hauntingly compelling confession of hope.

From BaptistNews.com

Stroke II

Stroke

Stroke, also known as a cerebral vascular accident (CVA), is the fifth leading case of death and a major cause of disability. 

Kinds 

There are two types of stroke, hemorrhagic and ischemic. Hemorrhagic is caused by bleeding (a blood vessel rupture) within the brain. The more common, ischemic, makes up 87% of all strokes and is caused by a blockage to blood flow to or within the brain.

Prevalence

Stroke happens to one in twenty people averaging one every 40 seconds. 

Risks

The major causes of stroke include high blood pressure, high cholesterol, smoking, obesity, and diabetes. Strokes are nearly twice as high in blacks as in whites.

Treatment

Treatment of ischemic strokes is with the use of “clot-busting” drugs which must be administered within 3 hours to be effective. The “T” in FAST should also be a reminder to note the time of symptom onset. This can be vital information for doctors. In some cases, a clot must be removed surgically.

Hemorrhagic strokes are treated by stopping the source of bleeding.

Rehabilitation is often necessary to treat residual disability from stroke.

Symptoms

Is the Face drooping?

Is there Arm weakness?

Is there difficulty with Speech?

If yes, to any of these questions it is Time to call 911

F A S T 

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Sources: Centers for Disease Control and Prevention (CDC) and the American Stroke Association.

 

Graphic by Pixabay

Stroke

Signs of Stroke

F A S T

The word to remember when concerned about a stroke is FAST because time is crucial in reaching and instituting care. FAST will also help you to look for the signs of stroke.

Is the Face drooping?

Is there Arm weakness?

Is there difficulty with Speech?

If yes, to any of these questions it is Time to call 911

In the next post, we will look at stroke in a little more detail, but the most important take away here is to remember this mnemonic when questioning whether you or someone else is having a stroke.

Memorize it. Test yourself. Spread the word to others.

F A S T

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Source: Centers for Disease Control and Prevention (CDC)

Graphic by Pixabay

Staying Alive 6 of 6

Over the past five posts, we have reviewed some ways to achieve longevity. I have had some fun with the topic of “Staying Alive.” It seemed fitting that since I discuss death so frequently I owed you these tips on survival. Some of the content has been tongue-in-cheek, but that doesn’t mean the advice isn’t sound. It should be obvious that there are many other measures we can take to increase our chances of living longer. A few that come to mind immediately are not smoking, regular medical checkups, good nutrition, safe driving habits, and a multitude of others. 

If this series has helped you to be a little more mindful of a few ways to live a longer, healthier life, then I am happy.  All together now! Hit this link with your sound turned up:  https://www.youtube.com/watch?v=fNFzfwLM72c

 

A special thanks to the Bee Gees for helping us to wrap up “Staying Alive!”

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Theme graphic by Pixabay

Staying Alive 4 of 6

Now that you have a puppy on your lap as you read your book and have regular checkups with your female doctor what else can you do to stay alive?

Next: Stay Out of the Hospital!

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There was a time when the term “hospital clean” meant sterile and spotless. Today, unfortunately, the meaning could be the opposite. The Centers for Disease Control and Prevention (CDC) lists nineteen nosocomial (hospital-acquired) infections three of which are antibiotic resistant. These can be life-threatening infections and they are transmitted in various ways including, but not limited to, patient to patient. Viruses and bacteria can also be spread by health care workers, contamination of furniture and other articles and through the air.

Hazards other than infection can result from surgery, treatment, immobility, and falls. The Centers for Medicare and Medicaid Services (CMS) tracks the rate of the following complications resulting from hospitalization: (notes are parentheses are mine)

  • Pressure Ulcer (bed sore)
  • Pneumothorax (lung collapse)
  • Fracture (broken bones from falls)
  • Hemorrhage or Hematoma (bleeding)
  • Acute Kidney Injury Requiring Dialysis (kidney failure)
  • Postoperative Respiratory Failure
  • Perioperative Pulmonary Embolism or Deep Vein Thrombosis (blood clot during surgery)
  • Postoperative Sepsis (serious, often life-threatening, infection of blood or other tissue)
  • Postoperative Wound Dehiscence (incision opening following surgery)
  • Unrecognized Abdominopelvic Accidental Puncture/Laceration (accident in surgery of the abdomen or pelvis)

What Can You Do?

There are times when hospitalization cannot be avoided. During those times one has little choice but given the option of outpatient care that is usually the best recourse. Understanding the risk of infection, in particular, should make one hesitant about visitation in hospitals. Situations vary and there are times when a hospitalized patient needs someone with them. If that is not the case protect yourself and them by waiting until they return home for visits. 

“A hospital is no place to be sick.” Samuel Goldwyn

Writing this reminds me of many years ago when I was in the hospital for a couple of days. My then eleven year-old daughter gave me a book for a gift when I left home to have surgery.   Although I no longer have that book, I clearly remember the title, “Staying Alive!” Thanks for the smiles, Allison!

Theme graphic & photo by Pixabay

Staying Alive 3 of 6

Now we all have a puppy and female doctors . . . . . 

Next: Read 

Obviously, you are reading at the moment, but this blog post is too short to meet the recommendation for “Staying Alive.” Research shows that reading a book for one-half hour each day has a significant survival advantage. Other reading counts such as blogs or magazines but books are best according to a study by professors at Yale University. 

Several books have been reviewed here on Crooked Creek and many readers shared their favorite authors and books in an earlier post. So, I know there are readers out there. If you are not one of those it’s time to grab a book off the shelf and start prolonging your life. It’s never too late to start good habits. 

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“A room without books is like a body without a soul.”  Marcus Tullius Cicero

Theme graphic and photo by Pixabay

Staying Alive 2 of 6

OK! Now everyone has a puppy, right?

Next: Get a Female Doctor

No kidding, a study of 1.5 million hospital records proves this is a good method of “Staying Alive.” Harvard researchers reviewed and analyzed these Medicare records in 2016 and found that patients cared for by female doctors were, (A.) More likely to survive and (B.) Less likely to be readmitted within thirty days of discharge. Furthermore, “If male physicians achieved the same outcomes as female physicians” 32,000 fewer people would die each year.  

I realize these are startling claims and we all know that this is not saying that each female doctor is superior to each male doctor. What the study shows is that overall female doctors as a demographic have better outcomes. This study and others suggest that female doctors are more likely to follow clinical guidelines for care and are overall better at communicating with patients. 

Since over 50% of graduates from medical schools are women, there is no scarcity of female doctors from which to choose. 

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“The good physician treats the disease; the great physician treats the patient who has the disease.” William Osler

Graphics by Pixabay

 

 

Staying Alive 1 of 6

Life Expectancy

Life expectancy is a tricky term. Statistics vary greatly in the way they are gathered and calculated, e.g., whether they include infant mortality and what country is being studied. As the chart below demonstrates women have a longer life expectancy than men, but we will not discuss the possible reasons for that here. Let’s just look at ways of “Staying Alive” for all of us. 

TIME

FEMALE

MALE

COMBINED

2012

78.7

1985

62

1900

30

Current

80.1

73.4

Born in 2018

81

76

Various sources including USA Today, Statistica and Wikipedia

Staying Alive

There is no lack of advice out there for ways to stay healthy and live a long life. Every person who hits 100 years has some type of answer for the secret to their longevity. Some say a glass of wine a day or perhaps a cigar or some other thing they enjoy.

Do you have “secrets” to a long, healthy, and happy life? If so, please share them with us. I can’t say that I do, so I’ll share what some of the experts tell us. We’ll just look at a few over the next several posts.

First: A Four-Legged Friend

Those of you who own a pet will probably attest to the fact that pets reduce anxiety. Research also shows they lower the owner’s blood pressure. For those of you who may doubt this advice let’s see what the American Heart Association says.

In the journal “Circulation” the AHA recommends owning a dog, in particular. As an owner of cats, I’m hurt, but I can see one big advantage to having a dog. Dogs must be walked so the owner is more active. But, the AHA goes even further and states that a person with a dog is more likely to survive a heart attack. 

Some of my doggie friends: Luke, Jackson, Hawkeye, Monty and Aslan

 

“My fashion philosophy is, if you’re not covered in dog hair, your life is empty.” Elayne Boosler

Theme graphic by Pixabay

Stress Test

A Test of Stress

She (we’ll call her “Barb”) dressed in her exercise clothes and walking shoes and set out early for the hospital; so early that the rush hour drivers were still at home flossing and spraying.

As she pulled into the parking lot Barb had her choice of primo spots, but hardly appreciated this because her mind was on the fact that her system was as empty of caffeine as the lot was of cars.

The person at the front desk could have been a bit more friendly, but the sign-in process was simple and Barb was ready for the treadmill which looked less than the expected state-of-the-art equipment.

Reba Raines didn’t seem all that enthusiastic as she pointed and indicated that Barb should move to the machine. “Straddle the belt” she directed in an absent-minded way. Barb complied, at least she thought she did but she heard again with more presence, “Straddle the belt!” so she quickly moved her feet to the treadmill frame and watched as the belt began to go slowly forward. Barb stood awkwardly until given the command to “walk” and assumed that she was not expected to walk where her feet currently were so she carefully stepped onto the belt.

It didn’t take long to reach the target heart rate . . . it will take days before the results are relayed to Barb who left for the nearest cup of coffee.

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Graphic by Pixabay

Depression II

Phillip

When I was in the first grade my little brother, a toddler, died on the way to the hospital. He had been ill his entire little life.    https://crookedcreek.live/2016/09/27/little-blue-bird/

Daddy

That loss brought about many changes in our family. The most profound change was in my father. Fortunately, perhaps, I do not remember details about the absences, but my father was often missing from our family after Phillip died. I learned many years later that he was hospitalized for a mental illness. In those days depression was called “involutional melancholia” and if the condition was severe the patient spent time in a mental hospital. 

In researching my father’s condition and medical records (this was before HIPAA) and eventually meeting with his psychiatrist many years later I learned that he underwent two types of shock treatments. In the late forties and early fifties, he was repeatedly given massive doses of insulin which caused a coma. The coma was then treated with glucose to save the patient from death. When insulin coma/shock therapy fell into disfavor as dangerous electroshock (electroconvulsive) therapy became the treatment of choice for depression and some other mental illnesses. EST (also called ECT) is initiated by applying an electrical current to the anesthetized patient causing a grand mal seizure (convulsion). The intended result of these repeated treatments was the improvement of depression.

Both of these methods of treatment seem cruel and bizarre and although insulin shock was discontinued many decades ago, EST remains an accepted, although infrequent, mode of treatment for depression. The side effects include loss of memory, learning problems, muscle aches, and upset stomach. In my father’s case, I believe a loss of his personality (or at least a significant change) was also an effect of the numerous treatments he underwent. 

He was a good man. He was intelligent and managed to work again, but was never quite the same person. He had to fight hard to participate in life, but he did so for many years. He died of a heart attack at age sixty-nine. 

Today

Major depression, also known as unipolar or major depressive disorder, is characterized by a persistent feeling of sadness or a lack of interest in outside stimuli. It is generally treated today by medications and talk therapy. 

 

Graphic by Pixabay

 

 

 

Depression

Impact

Depression affects about 121 million people worldwide (World Health Organization) and 14.8 million in the U.S. making it the leading cause of disability (National Institutes of Mental Health). According to the WHO, depression ranks number four on the list of diseases and is predicted to be number two by next year. 

There has been much in the news lately about the role that vitamin D plays in depression. There have been numerous studies, large and small, that indicate adequate vitamin D could be a simple way to combat this growing disease. Unfortunately proof of this benefit remains unsettled at present.

The Sunshine Vitamin

A deficiency of vitamin D is implicated in many diseases (diabetes, osteoporosis and cardiac to mention a few). According to the CDC in 2006 at least 25% of the US population was deficient. Why would this be? It isn’t hard to imagine that people today are not outside as much as in past generations. And, when we do go outside most of us use sunscreen as advised by dermatologists. Sunscreen of any strength blocks UVB rays which produce vitamin D. These rays do not penetrate glass so time spent by a window or in the car does not help. Many people experience added depression during dark, cloudy months, a condition known as Seasonal Affect Disorder (SAD).

The Quandary 

We can benefit from knowing more about vitamin D and its benefits. For instance, calcium for strong bones cannot be absorbed without adequate vitamin D. With each source of this important vitamin there are drawbacks. Too much sun can lead to skin cancer. Excessive use of over-the-counter supplements of vitamin D can lead to toxicity.

The answer to this quandary is to do research and become better informed if you suffer from depression or think you might not be getting enough vitamin D. And, the bottom line is always to consult your physician and discuss a lab test for your vitamin D level. 

 

 

Graphic by Pixabay

 

 

 

Health Care

Rant #1 

HIPAA – To improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act of (HIPAA), Public Law 104-191, included Administrative Simplification provisions that required HHS to adopt national standards for electronic health care transactions and code sets, unique health identifiers, and security. At the same time, Congress recognized that advances in electronic technology could erode the privacy of health information. Consequently, Congress incorporated into HIPAA provisions that mandated the adoption of Federal privacy protections for individually identifiable health information.

What does HIPAA mean to you? To me, it has always meant privacy of my confidential information relative to healthcare. I do remember when HIPAA was passed in 1996 and that it was comprehensive reform of many things other than patient privacy. Back then I was still in the provider/payor role in health care. Today I am just a consumer and I am appalled by the lack of privacy and security of information. 

A few days ago I walked into the waiting room of one of my doctors and the person behind the desk asked me piece by piece for the following information: 

  • Your Name?
  • Your address?
  • Your phone number?
  • Your date of birth?

Does anyone see a problem here? The only identifying information left out for the dozen or so people in the waiting area to hear was my Social Security number. How is this privacy? How was my information secure? 

Rant #2

While I’m at it, have you not been told all your life to never sign any document without reading it first? OK, I know we won’t read every word of every page, but shouldn’t we at least SEE the document we are asked to sign? Maybe glance at the title? 

Does your doctor’s office or other medical facility have one of these little gadgets? Most of mine do now and I’m asked to sign this Topaz thingy three to five times with each encounter. If I ask, “What am I signing?”, I’m told, but I do not see the document. This may seem like a small thing, but it is very bad business and I wonder how it stands up in court? “Your Honor I do not recall signing a Consent for Treatment” or “When did I sign an agreement to pay? I only signed the little Topaz machine when told, your Honor.”

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There are also iPad versions of this process which gather a new patient’s medical history, demographics and consents. These at least show the form being signed and one can see one’s own signature on that form via the screen. 

Rant #3

Sorry, I’ve forgotten, but I am sure it is just as important and I’ll get back to you. 

 

“Healthcare is becoming part of information technology.” Bill Maris

 

 

Title photo courtesy Pixabay

Personal Grief

We Will All Grieve

By adulthood, most people have experienced loss that triggers grief. If you have yet to lose a person or something that means the world to you, then you are probably very young and certainly very lucky. 

Facing loss of another or one’s own approaching death will bring on an overabundance of feelings. Some of these feelings we discussed earlier from Dr. Elizabeth Kubler-Ross’s book “On Death and Dying.” 

These feelings are especially likely to fall on the anniversary of a loss. It might be the actual date but it might also occur on the day of the week or a day that is similar in weather or season. Unexpected grief can be triggered by sounds, smells or sights such as a bird, a flag or a similar face. In these cases, grief comes even on a good day.

Holidays

The holiday season which we are facing now can be particularly painful following a loss.  While there is no single solution some ways that one can prepare or minister to self include the following:

  1. It is okay to say, “No” to invitations and to spend some time alone. Likewise, it is okay to join friends and family and to enjoy oneself even while grieving.
  2. Be honest with those who want to help you and let them know your needs. 
  3. Get enough rest, exercise and a well-balanced diet. Physical wellbeing is necessary for emotional strength. 
  4. Recognize that grief is not an obstacle but a necessary process. It is not an illness to be healed. 
  5. Consult your spiritual mentor or a professional counselor. 
  6. Prepare a way for your loved one to be memorialized such as a special candle or ornament in their honor.
  7. Take advantage of support groups such as those listed below. Often funeral homes offer such services, too.  

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Resources: 

GreifShare (church related) https://www.griefshare.org

Soaring Spirits International (for widowers) https://www.soaringspirits.org

Compassionate Friends (after the loss of a child) https://www.compassionatefriends.org

Hospice https://hospicefoundation.org/End-of-Life-Support-and-Resources/Grief-Support/Support-Groups

Pet Loss – Humane Society or http://www.petloss.com

“The flowers bloom, then wither . . . the stars shine and one day become extinct. .  This earth, the sun, the galaxies and even the big universe someday will be destroyed . . . Compared with that, the human life is only a blink, just a little time . . In that short time, the people are born, laugh, cry, fight, are injured, feel joy, sadness, hate someone, love someone. All in just a moment. And then, are embraced by the eternal sleep called death.”  Virgo Shaka (Saint Seya)

 

Theme photo in title by Pixabay

Silent Ailment

Hearing Loss

When a person has problems seeing or walking it is obvious and most people make allowances for the person who has such disabilities. When a person is hearing impaired it is less obvious. Often the person with a hearing deficit seems to not be paying attention or to be ignoring the conversation.

Prevalence

Hearing loss is common for people over the age of sixty-four (64) and often progresses for a decade or more. In America, it affects more than 48 million people and is more common than either diabetes or cancer.

Causes

Hearing loss can be acute from head trauma and illnesses such as infection. More likely, however, the cause is exposure to prolonged loud noises, an illness such as diabetes, heart disease or high blood pressure. Genetics can play a factor and some medications can contribute to hearing loss. 

Treatment 

Treatment may include surgery, medication or cochlear implants (for younger patients) but is more likely to require hearing aids. Hearing aids come in various styles and the cost may range from around two to seven thousand dollars. This is a good reason to shop around and do serious research before investing in aids. It also helps to have realistic expectations for hearing aids. They amplify sounds. They do not restore normal hearing. Hearing aids take time and patience to learn how best to use them.

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It also helps if family and friends understand that they can assist the hearing impaired by 1. Getting their attention prior to speaking, 2. Making sure they are positioned so that their lips can be seen and 3. Speaking clearly, but not shouting. Most people with hearing loss are particularly impaired when there is more than one person speaking at once. 

Decibels

Sounds and therefore hearing are measured in decibels. A hearing loss of thirty decibels or more is considered significant. The sounds in our environment can be measured in decibels. 

You can measure decibels easily by using a smartphone app. Restaurants are notoriously noisy and knowing the decibel level can be helpful in choosing which to patronize. I use VenueDB on my iPhone, but there are several for both Android and IOS phones. https://www.healthyhearing.com/report/47805-The-best-phone-apps-to-measure-noise-levels I recently measured one of my favorite restaurants at eighty-two (82) decibels. That can be appreciated by knowing that a lawn mower registers around 90. 

NOTE: some information contained herein obtained from WebMD. 

“Sometimes we should express our gratitude for the small and simple things like the scent of the rain, the taste of your favorite food or the sound of a loved one’s voice.” Joseph B. Wirthlin

 

Photo & graphic by Pixabay

THE Binder

Several years ago I worked for a Fortune 500 company that had a binder for everything. I must have caught “binderitis” during my eighteen years there. I have binders all over the house. About seventy are filled with family photos and mementos and they are stored everywhere, some visible, many hidden. I feel sorry for my family when I die because they are going to have to figure out what to do with all these scrapbooks. 

There are other binders for various purposes. I find it easy to organize records in binders with dividers and color coding. OKAY! Maybe I am sicker than I thought, so if you are laughing it is fine. I’m hooked on binders and not likely to give up my habit. 

There is one binder however that I know my family will appreciate one day. I have two daughters and when I die they will know where to start to plan my memorial and to settle my estate. They will unlock the secret place and pull out THE BINDER.

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This particular one is over eight years old and has been revised several times as situations change. It had a smaller predecessor. Let me tell you what this binder contains in its seven sections. 

  1. End of Life – Copies of the Power of Attorney, Living Will, Healthcare Surrogate and Will. The originals are in a lockbox for which they have the keys.  
  2. Finance – Banking and Insurance account information including account/policy numbers and contact names and phone numbers. Inventory of lockboxes. Charts (containing photos) listing family heirlooms (and other valuables), their locations and their origin (from grandparents, etc.) 
  3. Funeral and Burial – Information on cemetery plot, gravestone contract regarding adding dates, suggestions and wishes for memorial service and data necessary for an obituary. 
  4. House and Property – Copy of Deed(s), photos showing locations of water shutoff valves and electrical circuitry. 
  5. Medical Information that may be needed by Healthcare Surrogate
  6. Historical Information as needed
  7. Miscellaneous and Resources 

You may not be happy working with a binder. That’s okay. A box will do or a drawer. It is simply important for everything to be in one place. It does not have to be meticulously organized (although that’s nice). The important thing is that it is all together and that the person(s) who will settle your estate knows where it is and has any keys necessary. It is also critical that the contents of the box, drawer, or binder be discussed ahead of the time it is needed. I call that THE TALKhttps://crookedcreek.live/2017/01/25/death-decisions/

 

“Expect the best and prepare for the worst.” Muhammad Ali Jinnah

CPR in the Hospital

CPR

Cardio Pulmonary Resuscitation (CPR) can be life-saving especially when performed in a hospital with all the talent, knowledge and equipment that is available. It has become routine for patients to be asked on admission to the hospital some form of the following question: “Do you want emergency measures to be performed if your heart stops?” 

That question can be daunting in myriad ways. If one is being admitted for a routine procedure it can be a bit of a shock. If the patient is critical and/or of advanced age then it might be even more upsetting. Three things can help at this point, #1. Expecting such a question, #2. Being an informed patient about just what “emergency measures” entails and the risks involved, and #3. Having already considered this question and having discussed it with your loved ones. https://crookedcreek.live/2017/01/25/death-decisions/

Expectations

The first thing we all need to acknowledge is that we will one day die. Sobering as that thought might be, it is essential to know that regardless of how we answer the question above we may not be saved by CPR or any of the extraordinary measures taken if our heart stops beating. Perhaps worse yet might be to survive and be dependent upon breathing machines, feeding tubes and narcotics for pain relief. Cardiac arrest can cause organ failure leaving such organs as the liver and kidneys unable to function. Neurological deficits as the result of brain damage from lack of oxygen can occur. Unrealistic expectations can cause physical and psychological pain for both the patient and their family.

An Informed and Prepared Patient

An informed patient will have realistic expectations, will ask questions and will be prepared to make an informed consent. When a patient decides that they do not want heroic measures they can have a DNR (do not resuscitate) order to alert staff that the patient does not want CPR performed. Some hospitals now use the less promising acronym DNAR (do not attempt resuscitation). Before making this decision it is imperative that a patient know what resuscitation is and is not. It does present a chance at survival but it is nowhere close to a guarantee. The average chance of successfully resuscitating a healthy young person, i.e., to be neurologically intact, is only 30 percent overall. 

Once you have researched these issues and are armed with scientific information the next step is to discuss your wishes with your loved ones. Finally, prepare the legal documents that leave no doubt if the time comes when you need to inform your healthcare provider of your decision.  https://crookedcreek.live/2017/01/19/death-intro-ii/

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In the end, what matters most, quantity or quality of time here on this planet? 

 

Graphics by Pixabay

High BUN

Google

Who has not looked up medical terms, test results and diagnoses Online? I do it often even when I know or think I know what something means. It never hurts to review and become better enlightened, right?

Today I wondered about a BUN value on my Metabolic Panel. I knew it meant Blood Urea Nitrogen and involved kidney function, but I googled “high BUN” anyway.

Among all the excess information I received were literally hundreds of photos similar to this one! 

 

High-Bun-Hairstyles

 

“All things are subject to interpretation; whichever interpretation prevails at a given time is a function of power and not truth.” Friedrich Nietzsche

 

Photos by Pixabay

Book Review – Ghost Girls

Book Review

Recently I read the true story of young women who lost their health and their lives due to exposure to radium on their jobs. Several aspects of this tragedy stand out in my mind, but especially the fact that girls were hired as young as thirteen to work six days a week. Throughout the years that followed they were still referred to as “girls” no matter their ages. The radium dial companies they worked for kept important information about the dangers of radium from them and treated them as expendable. These young women had no way to know that the pretty glow that showed on their clothes, hair, and bodies was slowly poisoning them. 

As they suffered tooth loss, amputations, sarcomas and extreme pain these brave women eventually fought courageously for the truth and for monetary compensation. Their suffering and their efforts resulted in workplace regulations still in place today and even safeguards in the manufacture of the atomic bomb. 

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I highly recommend “The Radium Girls” by Kate Moore. The story begins around 1917 and covers the WWI and WWII eras and well into the 1970s. The results of the courage of these “ghost girls” protect us all even today in the 21st Century.  


 “Courage, sacrifice, determination, commitment, toughness, heart, talent, guts. That’s what little girls are made of.” Bethany Hamilton

 

Theme photo in title by Pixabay

Wasting Planet Earth

Do We Need It?

Plastic Straws

Plastic drinking straws are taken for granted, but they should not be. The United States uses and disposes of over 500 million of these devices per day. Straws are unnecessary, but if one does not agree with that, how about this? “Plastic” straws are unnecessary. Paper straws are less hazardous to our environment and to wildlife. Reusable straws can easily be washed and reused for a lifetime. The next time you are in a restaurant, how about saying “No straw please.”

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Thank you to “The Last Plastic Straw” for this illustration. 

Plastic, Plastic, Plastic

Starting out with straws is easy. It’s a little thing that each of us can give up without any pain. Plastic, in general, is a different challenge. Take a minute and look around where you are at the moment. How much plastic do you see? Are you touching it? I am, both the keyboard and the protective cover over the top of it are plastic. There’s my phone case, my TV remote and on and on. I know we cannot eliminate plastic completely, but that does not mean we cannot reduce it. I’ve been trying but barely making a dent. I can do better. 

First, we must care. Then it helps to be informed. I’ve done some research today and the statistics are sickening. Here are just a few provided by EcoWatch.  

  1. The average American discards 185 pounds of plastic per year.
  2. Americans throw away 35 billion water bottles per year.
  3. Worldwide, one million plastic bags are used per minute!
  4. By age six years 93% of all Americans’ blood tests positive for BPA, a plastic chemical.                                                       

Read more of these alarming statistics at https://www.ecowatch.com/22-facts-about-plastic-pollution-and-10-things-we-can-do-about-it-1881885971.html

We cannot do without many things that are plastic, perhaps, but what about the things we can eliminate? What about the things that we can use over and over again before tossing?

There are many who do better than I. My cloth grocery bags are often forgotten in the back seat of my car, only to be remembered after I have filled my grocery cart. I carry a nylon bag in my purse to carry smaller purchases in other stores and forget to use it as well. Today I put the cloth grocery bags in the front seat where I can see them more easily. I plan to say, “No bag please” for more purchases in other stores. I can do better.

I know someone who has completely eliminated non-recycle materials from her life. It began during March of this year, her birthday month, when she eliminated all plastic of any kind for thirty-one days. I couldn’t believe what she was able to accomplish, buying food in bulk and placing it in paper or nylon bags, for instance. That was an inspiration to me to do better.

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Ideas? 

Are there ways that you eliminate waste and especially plastic that you’d like to share?

“Pollution is a serious one. Water pollution, air pollution, and then solid hazardous waste pollution. And then beyond that, we also have the resources issue. Not just water resources but other natural resources, the mining resources being consumed, and the destruction of our ecosystem.” Ma Jun

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Photos and graphics by Pixabay

Russian People

st-petersburg-2066974_1280

Women 

While in Russia I met many interesting people. There were men who were bus drivers and pastors and volunteers, but it was some of the women who I really felt that I got to know. The interpreter, Natasha (yes, really, Natasha) was a beautiful young woman in her early twenties. She never lost patience with my questions and never seemed to tire of explaining what it was like to be Russian. She was proud of her country and especially that unlike when she was young, now she has the opportunity to meet travelers from all over the world.

Then there was Maria who was about thirty or so, it was very hard to tell because she wore a scarf that appeared to cover a shaved head. Her five-year-old son, Eugenia, was with her. He was wearing undershorts and a soiled button up shirt. After talking with her through Natasha for a couple of days, I learned of her sad history.

She said that she had been born and raised in the Islamic tradition, but was no longer sure of that status. Her mother died when she was a child and her husband and father were both recently deceased and she had no “papers” to prove that she was a citizen. The government had taken her father’s apartment and she was left without a home or income. She and Eugenia had been living in a cemetery for weeks at this point with some food provided by a friend. She was looking for work and offered to clean the church (Central Baptist of St. Petersburg, membership of 1,200) for food for her son.

There were many older women who dutifully cleaned the church, so there was no work there for Maria. They were caring, giving women who had little to give, but soon though, Maria and her son had clothes and food and a few other necessities. There were those who offered to help her in trying to obtain the papers necessary for livelihood. I had no way of knowing the outcome for Maria and Eugenia. I look at their photos and wonder what their lives are like today.

Unfortunately, there was another group of women in Russia who worked in what some call the “oldest profession,” prostitution. Apparently many women were all over the country trying to live by selling intimate services. Below is one of the cards left throughout the hotel where I stayed. This is not a profession. And, it is not a choice many women make other than out of necessity. Based upon recent news from Moscow, the situation has not changed for this population of Russian women. 

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Apartments/Schools

In St. Petersburg it seemed that everyone lived in an apartment. I saw no private homes, although I am sure there were some grand ones for those high up in the government, mafia members and others with access to wealth. 

I walked through an apartment complex that must have housed at least a thousand residences. There were no sidewalks, simply paths through the knee-high grass. There was a school that could only be identified by a couple of crude pieces of playground equipment, otherwise, the school looked like another apartment building. 

I visited a couple from Kentucky who lived in a ninth floor apartment and the elevator was out of service. I was rewarded by seeing a mama cat and her kittens living on the seventh-floor landing, making the climb work the effort. 

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Pushkin stock-vector-vector-portrait-alexander-pushkin-471393209

Alexander Pushkin was a poet and playwright who lived from 1799-1837 in St. Petersburg. There was a little town named after him and I was fortunate enough to be able to visit not only the park-like village but also a small hospital there. The facility looked more like a US nursing home of years ago. The beds were small and uncomfortable looking. Many of the patients who chatted away in Russian with clueless visitors looked old but it may have been due more to life conditions than chronological age.

One thing that I will never forget in that hospital was a very large printed, framed portrait of our then current US President, William J. Clinton.

Part 4 of 6

Theme graphic in title by Pixabay

Russia 2

Preparation

Traveling to Russia in 1994 was no doubt very different than today. At that point, Russia had just become more open to travelers due to “perestroika” but was not yet well prepared for those travelers. Before leaving home certain shots and immunizations were recommended. While at the Health Department meeting these requirements I received a handout warning against eating raw fruits and vegetables or anything, including using ice, that might have come into contact with unpurified water. There was a warning to use bottled water for toothbrushing and to not open the mouth while showering!

The Trip

The trip from Louisville to St. Petersburg, Russia took almost nineteen (19) hours with about fifteen (15) actually in the air. Along the way, we landed in Germany and then in Poland, which did not allow passengers to deplane. Officers came on board and checked our passports and visas and then would not allow the pilot to take off for two unexplained hours.

When looking down at Russia prior to landing in St. Petersburg it was hard to comprehend the country’s size, nearly twice as large as the US and containing eleven (11) time zones. Local time was eight hours ahead of EST, which made phone calls home complicated, so I only called once to say I had arrived safely. It is just as well because phone calls to the US were difficult to make, unreliable and very expensive. 

The population of Russia at this time was 149.5 which was actually about 5.6 million more than the current population. Education was free and the literacy rate was 99% at that time. 

The Culture

Before the trip, I read a document prepared by Brigham Young University which provided insight into properly interacting with the Russian people. It was entitled  “Culturgram ’94 Russia (Russian Federation)” In it, I learned many things that made me better prepared, but also a bit apprehensive. Here are a few customs that I tried hard to remember while visiting.

  • If you ask “How are you” be prepared for a detailed answer. It is not the casual greeting that we use, but a serious question.
  • One should eat with the fork in the left hand and the knife in the right. Hands are kept above the table at all times. Leaving food on one’s plate is rude.
  • Pointing the index finger is impolite, as is talking with one’s hands in the pockets or with arms folded.

Some other information of interest was that flowers are given in uneven numbers except at funerals! Russians prefer social interaction prior to business discussions and when a bottle of vodka is opened it is expected that it will be emptied by those present. Not surprising is that alcoholism is a serious problem. 

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Part 2 of 6

Theme graphic in title and photo by Pixabay

Thanks

Thank You Readers

As of today Crooked Creek has 120 followers! While I am happy about the numbers, I am a little skeptical. It seems likely that some (or many) of these “followers” signed up but do not actually read many posts. I suppose my doubt comes from the dearth of feedback. Regardless, I appreciate each follower/reader, each comment and “like.”

A couple of folks have told me that they cannot “like” a post without signing up for WordPress. This is up to you of course, but I don’t believe that it would be obligatory in any way to do so. Many “likes” now come from other bloggers because they are already a part of WordPress. If you have questions, please communicate them to me and I will try to find the answers.    suebmattingly@gmail.com 

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Thank You Donors

While concentrating on gratitude, I want to also thank all the people in the US and around the globe who donate blood and plasma. We are all very familiar with the Red Cross and the crucial need for blood during times of disaster and war. What many do not realize unless personally impacted is that very vital components of plasma also play a role in saving or sustaining life.

If you will pardon the very personal account of some of my medical history I want to share with you how donated antibodies withdrawn from donor plasma have kept me safe for almost seven years. In 2011 I was hospitalized and very ill. At that time I learned that I had some serious hematological issues. There is no need to go into a lot of detail and I won’t bore you with the long names of two significant diagnoses that resulted. It is enough to say that I have a primary immune deficiency because I am no longer able to manufacture my own antibodies to fight off infections. That’s where the gratitude comes in.

The immunologist immediately began a treatment with IV antibodies (immunoglobulin) available through donated blood plasma. I responded fairly well to continued monthly treatment as evidenced by a rise in antibodies in my blood but soon these treatments had to be terminated because of serious reactions. For the following year and a half, I was at risk of and sick with infections due to the lack of antibodies. In the spring of 2013 before my 70th birthday, I was put on weekly self-administered subcutaneous (as opposed to IV) infusions of the same type of human antibodies. My antibody level immediately began to rise and it has been in the normal range for a long time now, allowing me to live with much less risk.

#250

This is on my mind because tonight as I began to document the required infusion information in my log I noted that this is infusion number 250. These years passed quickly and easily for me. All I have to do to maintain the ability to fight infection is invest a couple of hours weekly and endure 3 needle sticks in my abdomen or upper thighs. A piece of cake!

This would not be possible without the altruism of thousands upon thousands of plasma donors. Many of you are already blood and/or plasma donors, as are many of my friends and family and I appreciate each of you so very much. Some of you, perhaps, may not have been aware of all the other crucial needs for blood components. Lives are not only being saved in emergencies, but lives are being preserved for patients from birth (remember the so-called “bubble boy?”) through older adults. Immune deficiency is only one of those conditions, but I hope that my account of this diagnosis has been informative and might lead to more donors.

Sometimes we hear so much of inhumanity and selfishness that it would be easy to forget that there are altruistic people who give not only their time and money to help others through charities but some give even their blood, tissue and organs. Each Thursday evening when I assemble the supplies for my infusion, I am mindful of those who made it possible.

 


If you are interested in further information on this particular subject you may reference:

https://www.ncbi.nlm.nih.gov/pubmed/26174901

or

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935641/

 

Theme photo in title & graphic by Pixabay

She

Sharing Time

For well over forty years I have been in possession of a poem handwritten by a patient when I was a nursing student. I have never shared it because I do not know whether it is original or if he simply copied someone else’s poem. My guess has always been that it was not the latter. Today I have again made serious efforts to find the poem on the Internet. I’ve Googled keywords and even whole stanzas without finding it. I’ve researched poetry sites as well without results. 

Another concern I’ve had is patient confidentiality, but since I will not be revealing anything about the patient and I don’t even remember his name, I believe that it is safe to post the poem. 

Over the years I have read these pages several times, trying to understand the poem better, trying hard to remember what the person looked like who gave it to me or what he said at that moment. I cannot recapture that scene. I remember that I was assigned to his care for at least several days. I recall a few things of interest that surrounded his hospital stay and certainly his diagnosis. Always, I have felt that I was entrusted with something beautiful and that it needed to be shared. 

That is why I am posting it here for you. I believe that it needs to be heard. I look forward to what you think of the poem, “She.”


Note: Unfortunately this WordPress platform will not allow the four line stanza formatting used by the poet. The poet’s words have been transcribed exactly as written except one word which I was unable to make out and have marked by “????”. Where there is an apparent misspelling or wrong use of a word these have been noted by “sic”. Punctuation is also transcribed exactly as handwritten. 


 

She 

Sometimes I see her for you see

She’s the part of reality

Walking in twilight she’s so fair

With shinning eyes, the stars her hair

Sometimes I see her walking there

In starry tiered imaginings

Where dreams are born & if you care,

Go find the one with stars for hair. 

For those who care, theres (sic) an easy way

One takes the road mid night & day

To places lying everywhere

That just exist for those who care

From there they go inside their soul

To see themselves & others whole

To find themselves & if they do

They may even find her too

For she’s as real as she can be

Yet not for every eye to see

Just how to meet one so acclaimed

Just find her first then ask her name

II

I met her, was it yesterday?

Between the mountains & the see (sic)

Traveling for to find a place

Where I could bad thoughts erase

The Timeless plane of many lands

A place that held no grasping hands

I came upon a city fair

And there she was beyond compare

I told her we could travel far

To lands beyond the farthest star

To places ever springtime fair

Where even I would have no cares

But she said, “No, why can’t you see?”

“That all there is lies here with me

“And seeker, through (sic) you have no fame

“You have to do but ask my name”

I looked at her then softly left

For then I knew she placed me free

In a quiet grove I softly wept

For starry eyed seekers who were like me

That woeful day I left that place

Last saw the sunshine on her face

But under the starry midnight sky

I often stop to wonder why

And then with smiling face I stare

And see the starlight of her hair. 

Yet now I see her everyday

On every walk, in every way

But now she turns her face from me

Why? I know yet cannot say

For if I stopped then she would come

Thus giving all of what she is

Yet I cannot for I can see

I’ve gone too far to stop just yet

What do you say seeker, isn’t it sweet

to see the sun rise in the sky

to the right of where the shadows lie?

To close your mouth and blind your eyes?

Yes, try to climb that mountain where 

You were born & had no cares

You’ll see the walls & hateful stares

of the ones above you left behind

You’ll dream about the sunlit skies

Your own little world you once held dear

Your place is lost, you’ve wondered why

And so you learn that which I fear

Your place in life I’ve never known

To step to mine you’ve never tried

And so I thread my path above 

And, now and then, say this to you

Just find a place & sleep in the sun

And tell yourself you’re (sic) seeking’s done

She doesn’t exist for eye to see

Just a dream that never could be

So part of her is just called life

And part of that is sweet and fair

And that you find with much to spare

Yes, you can see it everywhere

Yet part of her cries all the time

It’s exploited, raped and bind (sic)

To racks where greed can find the time

To twist out life & leave just sins

And lastly she is partly love

A part of her most never known

The part of her that’s most abused

A part of her most vilely used

Look seeker see her raked (sic) with pain 

Which (????) braid her starlit hair

to make a rope to hang us with

They hate us for they know she cares

And then she smiles and so is free

For she is all that can ever be

Now as then in Babylon

The spirit of eternity

And so existing around the bend

Kept out of sight from those obsessed

She’s there for those who seek her out

Who want the curse of happiness

For they must share her loveliness

And they must bear her loneliness

And for the sake of living yet

Must die a little to forget

 

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Author unknown by blogger.

Crooked Creek makes no claims to ownership of this poem.  

 

Medicine 4

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Childbirth

Most mothers since the beginning of time had given birth at home with midwives or other women in attendance. It was a long, painful and exhausting experience. Finally in the 1850s wealthy women were offered some relief from ether after it was used for Queen Victoria during her labor. Following the Queen’s lead ether, chloroform, and even laughing gas in the United States, were administered for decades to women able to afford delivery in a hospital. Because some doctors were better trained than others babies being born at home were likely to have had safer births without the effects of these gases.

Painless Childbirth

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Page 1106 in our 1910 manuscript states that a method of “painless childbirth” had been developed by doctors, Bernard Kronig and Carl Gause, in Germany. Hallelujah! Just what every woman in the world had been hoping for. It sounded wonderful, even the name “Twilight Sleep” (Dämmerschlaf in German) was promising. Doctors from the US went to Germany to learn to use this new miracle combination of drugs that would herald childbirth without pain. Soon gas was out of favor and powerful drugs were in. 

Twilight sleep was said to be “especially suited to the requirement of nervous women.” I find it interesting that men were so sure what women needed in view of the fact that not one of them had passed a bowling-ball-sized human through their loins. To this day many men are inclined to have very strong opinions about a woman’s body and what she should be allowed to do with it, but back to the topic at hand. 

Twilight Sleep

Twilight Sleep was made up of a combination of morphine and scopolamine. Morphine is derived from opium and acts on the central nervous system, causing pain relief. Scopolamine comes from a mixture of nightshade plants. It causes patients to fall into a semi-conscious state resulting in amnesia.

Both drugs are still in use today, but not routinely with labor patients. Morphine is a powerful and useful pain reliever that can lead to opioid dependence in some situations. Scopolamine is used orally or by a transdermal patch to treat nausea, vomiting and motion sickness. You may have used or seen fellow passengers use these patches to prevent or combat seasickness.

Possible side effects from scopolamine listed today include the following:  drowsiness, disorientation, dry mouth, blurred vision, dilated pupils, confusion, hallucinations, difficulty urinating and rash.    https://medlineplus.gov/druginfo/meds/a682509.html

What is wrong with this picture? In retrospect, it does not seem a chemistry degree is necessary to foresee problems with this combination of drugs. The pain relief of morphine was a big plus for the laboring mother, however, it could depress respiration in the newborn leading to a life-threatening emergency. The scopolamine rendered the mother semiconscious during the painful childbirth experience, however, it caused amnesia. The mother usually remembered nothing of the experience including seeing her newborn for the first time nor hearing the first cries. The effects of this drug had significant potential to defer or even diminish bonding between mother and child. 

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Both of these drugs crossed the placenta and depressed the fetus’s central nervous system. For decades babies would be born drugged, and unable to breathe normally. It is no wonder they were held upside-down and spanked to start them breathing. After over sixty years of Twilight Sleep administration, the practice was abandoned in the 1970s due to the harmful side effects. Unfortunately, this was after the birth of my two daughters and I am sure after many of you or your children were born. 

Lakshmipati G. (Care of the Medical Outpatient, (Preface) 1st ed. 2003. pp. vii–vii. Nama publication, Coimbatore, Tamilnadu) has said:  

“Half of what is true today will be proven to be incorrect in the next five years. Unfortunately we don’t know which half that is going to be.” 

Sadly, this is true even today. One only hopes that such truth will be proven in only a few years rather than the centuries or decades it has taken in the past. 

 An Art or a Science?

Whether the practice of medicine is an art or a science has been debated for centuries. Many, if not most, feel that it must include both. For a comprehensive discussion of this subject read Dr. Sadhu Charan Panda’s research. He is Editor, Journal of Community Medicine.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190445/

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Change, does it occur too fast or too slowly? 

https://wordpress.com/post/crookedcreek.live/2578


 The Complete Guide to Prevention and Cure of Disease is still in print. If you are interested in reading all 20 medical books in one volume written over 100 years ago see: https://www.amazon.com/Library-Health-Twenty-Books-One-Scholl/dp/B007GNBQB6/ref=sr_1_10?s=books&ie=UTF8&qid=1516977599&sr=1-10&keywords=library+of+health+by+Scholl

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Part 4 of 4

Medicine 3

Sexology Continued

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Conceiving a “Babe”

There is little doubt why there were very large families at the beginning of the 20th Century. The Complete Guide to Prevention and Cure of Disease, which was no doubt the prevalent thinking of the time, provided a very long and detailed chart outlining fertile and barren periods in a woman’s menstrual cycle. Unfortunately, it was dead wrong. The chart lists the days at the beginning and end of the cycle as “probable fertile” and the middle of the cycle which is we now know when ovulation occurs as “probable barren.”  By accident, a couple of the “probable fertile” days may have been in fact fertile. 

Birth control is not a subject of these chapters on Sexology and I am glad. No way would I care to describe here the method most common at that time. We’ll just move on to determining whether the “babe” will be a boy or a girl. This book seems very confident in opinions regarding choosing the sex of a child. 

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Will the “Babe” be a boy or a girl?

We know today that the male sperm determines the sex of a baby. We’ve had more than a   century to study and learn, so it is unfair, I suppose, to make fun of the 1910 thinking. But hey, that’s up to you. Here’s what the manuscript says in direct quote or paraphrase:

  • “The ovary is undoubtedly the predominant factor.” 
  • “Nutritional disturbances” such as diabetes are more likely to lead to the birth of a girl. 
  • “Emotion” is a factor in sex determination and the soul pervades every element of our bodies with either pleasure or pain.
  • To conceive the desired sex, during intercourse (or coitus as Sheldon of “Big Band Theory” would say) ones’ mental recollections should be pleasant and calm. 
  • Experiments were made using cows and horses resulting in eight (8) different conditions that influenced the sex of a calf or colt, including the age, strength, health and work history of each animal parent. 
  • These animal observations were then applied to human parents.

 

 

 

Want a Boy?

The husband must partake of “substantial food, exercise in open air and indulge in light literature.” He should also not “indulge” himself for a few days prior to intercourse. The wife should eat a vegetarian diet, exercise daily to almost fatigue and spend some time with older women. She should also take certain extracts which are listed. 

Want a Girl? 

Do the opposite! The wife should eat animal food, not “indulge her passions” and keep all her “vigor for the desired time.”  The husband should do “exercise to fatigue,” and take a “sitz bath of cold rock-salt water” morning and night. 

Final Sexology Warning 

Above all take “Care of the Passions.” The book cautions that those who are reckless in this respect will “Produce disorders of the nervous system. Messengers of evil or of good are ever passing” through the reflex centers of the brain, stomach, and genitals and “to touch one is to touch all.”  

 

 

 

https://crookedcreek.live/2018/01/23/medicine/

Part 3 of 4

 

 

Medicine 2

Sexology

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It seems to me that Dr. Scholl and his writers hedge their bets in giving advice on Courtship and Matrimony. The recommendations are pretty emphatic but then a little wiggle room for the exception exists.

Those reading this post on a device smaller than a computer may not be able to read the print on the copied page above so I will paraphrase it for you. In summary:

  • Dispositions should be studied before falling in love. To do otherwise is blind folly. 
  • Run around long enough to be sure about the person you are settling on.
  • Courtship shouldn’t be rushed.
  • Long engagements are a spectacle of the couple getting on each other’s nerves.
  • Affinity (vs. aversion?) is essential.
  • Don’t marry someone dumber than you.
  • Grow up before you get married.

I am sorry to report that a page or two of Sexology seems to be missing, but have no fear there is more information to convey. I was both surprised and concerned to learn the following: 

  • Courage in a woman is illustrated by how well she cares for her children, especially when the children are ill for “weary hours, days or weeks.”
  • The mood determines whether pregnancy occurs, i.e., there will be no conception without “sexual emotion.”  
  • Life itself should be a sober hilarity” whatever that means and homes that approach sex with “holy fidelity” . . . prepare children to “dwell in heaven.”

Now that we have all that cleared up we will in the next post move on the section entitled “Can Parents Control the Sex of the Child?” Most parents of teens today would quickly answer, of course not, they will do whatever they decide regarding having sex, but on closer scrutiny, I believe that the advice refers to choosing the sex when a child is conceived.

https://crookedcreek.live/2018/01/23/medicine/

Part 2 of 4

Medicine

The Bookshelf

Bookshelves barely exist today. Those that remain often contain old books left over from a former era or perhaps ones with some sentimental memory attached. I must admit that I still like the feel of a real book and I like to highlight and make notes in margins. I can do that with my Kindle but it just does not feel the same. I will admit though that clicking on an unfamiliar word and having the definition pop up on the screen is a valuable feature of electronic readers. 

1970s Print

This framed print from my office is a drawing by Robert Conley.  Conley’s art was in tribute to nurses who cared for his terminally ill wife in the 1970s. I love it for many personal reasons, but I’m sharing it today to point out two essential medical books of that era. The Physicians’ Desk Reference (PDR) and The Merck Manual seen here were essentials in any clinical area. The PDR was published each year and contained page after page of details about each prescription drug available.  It was heavily used by doctors and nurses alike. The Merck Manual explained diagnoses and treatments. I am willing to bet that you do not recall seeing either of these in the past thirty years and younger readers will not likely remember ever seeing a doctor referencing a book of any kind. 

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The reason, of course, is that now all this information and so much more is available and up to date electronically. This easily accessible data saves time and, no doubt lives. One only needs a handheld device to answer any inquiry. 

1910 Manuscript

Recently I ran across a few pages I had photocopied from an old book at some point long ago. I have no recollection why I had them or had kept them, but I’m glad that I did. Especially since that out of all “Twenty Books” in the “One Volume” I had chosen to copy Book VIII entitled “Sexology.”

Library of Health – Complete Guide to Prevention and Cure of Disease

Edited by B. Frank School, Ph.G, M.D.

Graduate of Jefferson Medical College and Philadephia College of Pharmacy

Table of Contents:

Anatomy, Physiology and Preventive Medicine, Curative Medicine, First Aid Measures, Diagnosis, Nursing, Sexology, Simple Home Remedies, Care of the Teeth, Occupational Diseases, Garden Plant Remedies, Alcohol and Narcotics, Treatment by Fifteen Schools of Medicine, Beauty Culture, Physical Culture, the Science of Breathing and the Dictionary of Drugs. 

Historical Publishing Co.          Philadelphia, PA


In the next few posts, I will summarize some of the wisdom contained in this 108-year-old manuscript. So if you have questions about courtship, matrimony, procreation and more HANG ON! The answers are on the way. 

Part 1 of 4

 

 

Cats 3

Here We Are in 2018

In these almost ten years of cohabitation, I’m unable to find one photo of Zoe and Elliott together. She has never warmed up to him. He has never learned that she likes her personal space. 

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Monetary Liability

I am not exaggerating when I say that the medical care for the two cats combined is a few thousand dollars. Even though I have all the records and receipts I don’t want to know the actual total. I do recall that Elliott’s heart ultrasound was $350 back in 2008 and that his workup last year for a period of lethargy when I thought he was surely terminal was about the same. He was apparently just faking it since all his tests and exams were normal.

These charges are fair and are part of the deal when we take animals into our lives. The total includes annual exams and vaccinations as well as illnesses. Add to that food, litter, treats, toys, brushes, nail trimmers, bathing (Elliott loves his spa days, Zoe not so much) and laser pointers which are so much fun for cat and human and the investment is not insignificant. This fact is important to know before taking on the responsibility of a pet.

Are They Worth It?    

Absolutely, many times over, but if money is tight this may not be the time to adopt a cat (or other pet). 

Hard Decisions 

To the vets’ chagrin, Elliott has continued to gain weight. None of the counseling, handouts or warnings has worked. Not even four pounds when we adopted him, this week he topped the scales at nearly twenty-two pounds. It wasn’t that I did not understand the instructions or the cardiac condition that made being overweight a risk. I did. I do. But when there are two cats who live together and one is skinny and the other obese it is a dilemma. The only way to limit Elliott’s food is to put the cats into separate living areas and that is next to impossible in this space. So, the decision I have made, right or wrong, is quality over quantity.

Elliott was rescued on a railroad track when he was a kitten. There is no way to know how he got there or how he survived long enough to be saved, but he has been happy for all the years since. 

We are lucky that his murmur has not worsened in spite of the weight. He is a big fat happy boy whose heart is full of love. 

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Number 3 of 4

 

Theme photo in title by Kate Puckett Elliott

 

Seasons

“The coming and going of the seasons give us more than the springtimes, summers, autumns, and winters of our lives. It reflects the coming and going of the circumstances of our lives like the glassy surface of a pond that shows our faces radiant with joy or contorted with pain.” Gary Zukav

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Inertia

When I ended the last post I stated “more to come!” with an exclamation point no less. I was excited to go forward and begin our second year in Crooked Creek, but that was three weeks ago. There are times that no inspiration comes. I want to write but cannot seem to start, much less complete anything meaningful. It is not that I do not have ideas or opinions (you know I have opinions), but that I am overcome by inertia. That is the best way I know to describe my chronic depression. It is a bit like I imagine being stuck in quicksand would be, wanting desperately to move, but not being able. Something very powerful holds me back with arms of steel. I know I need to act, to move but it is extremely difficult to do and so much easier to sleep instead. During these past few weeks, I have not taken my daily walks at the park that I enjoyed all summer. It is not possible to explain the reason, or whether there is a reason. Every single act takes all the power I possess, whether it is to prepare food, interact with friends or show up for appointments. Daily life is fatiguing during these times as is the effort of trying to appear as though nothing is wrong. 

A few close friends and of course, family members are aware of this lifelong struggle. I share it with you (readers) today in the hope that it will benefit you or someone you know. If you live with clinical depression please know that you are not alone. If someone you care about is depressed perhaps this will help you to understand their actions or lack thereof. Their lethargy, their cancellations, their lifelessness when you feel they should be excited has nothing to do with you. If they see their doctors and counselors and take prescribed medication then they are trying and likely to get better. Depression cycles, sometimes triggered by external events, but often without obvious reason. 

Seasons

Speaking of cycles, I find it hard to believe that it is October! Can you believe summer is over and we are well into autumn? The past couple of days I did some walking in my neighborhood but found it not worth the effort. Today I returned to my beloved Pope Lick in the Parklands and what a difference it made. Since I was last there flowers have changed, grasses have dried and leaves have fallen. I glimpsed only a couple of very small butterflies. A tiny squirrel was the only animal to show its face and I don’t think that was on purpose, but because of the necessity of gathering for the coming winter. The golden finches seem to be gone. Walnuts are ripe and thumping to the ground below. 

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The cool breeze and temperatures in the 60s made walking in the sunshine so easy. Before I knew it I had walked almost 3.5 miles and I was not particularly tired. It is important for me to remember today’s walk and the inspiration that being in nature provided. For me, it was more invigorating than a massage or one of those healthy kale smoothies or even church. Winter is coming, but the sky is still blue, the air is refreshing and there are weeks of majesty ahead before the next season which will have its own splendor. 

Finally, I must remember with Tom Brokaw, “In the seasons of life, I have had more than my share of summers.”

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“Expect to have hope rekindled. Expect your prayers to be answered in wondrous ways. The dry seasons in life do not last. The spring rains will come again.”                                        Sarah Ban Breathnach

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If you desire more information about depression you may want to read this blog post by John Pavlovitz: http://johnpavlovitz.com/2017/05/10/one-reason-to-keep-living-fighting-depression/

The Ritz

Recollections of Travel 

One of my favorite places to stay during my travels was the Ritz-Carlton Pentagon City in Arlington, VA just outside Washington, DC. It was right on the Metro (subway) line and even attached to a first rate shopping mall, not that I had much time to shop while working. I was supposed to be at this venue on 9/11/2001, but two days before I canceled my plans for reasons I do not recall. Others who attended that meeting spent several days getting home because all flights were grounded for days. One of my associates got back home to Florida via train. While I would have been in no danger, I am glad I was not so close to the horrendous disasters of that day.

Before you think I’m bragging about staying at the Ritz-Carlton, I will hasten to add I also stayed at Holiday Inns, La Quinta Suites and once at what must have been a truck stop motel in Bluefield, WV. So West Virginians don’t become offended, let me clarify it was many years ago and I know from a current Google search Bluefield has many nice hotels today. I was in Bluefield briefly to observe an eye operation at the Ophthalmic Center of Excellence. Back to the Ritz story. I was attending a conference, I believe it was sponsored by the North American Transplant Coordinators Organization (NATCO), a group to which I belonged. In the middle of the night before the conference was to begin the next day the fire alarm jolted me out of bed. I grabbed my robe and room key and followed the emergency exit lights. Down many flights of stairs, as the alarm continued to scream, I finally arrived at a door that surprisingly led me straight into the kitchen. Several people who appeared to be employees did not seem in a hurry to evacuate, but the sight that will always remain in my mind is chicken and a few other food items scattered about the floor. Pieces of fried chicken and I distinctly remember kicking a piece aside as I made my way to another door opening into the main lobby.

As I looked about the lobby I saw people looking dazed, some women were wearing fur coats, others were tightly clutching purses and a couple of men had brought their luggage down with them. I felt a bit underdressed, but I was proud of the fact I had followed emergency procedures and left valuables in the room, exiting quickly. Never mind I was wearing terry cloth, had a severely broken nail from the stair rail and no shoes. I wish I could tell you what was on fire, but I do not recall. Obviously, it was nothing significant because the firefighters soon allowed us to return to our rooms. I will never know why I did not encounter other guests on all those flights of stairs or why I ended up in the kitchen with the chicken.

Winding Up

It is time to wind up my recollections of business travel. If only I could remember more details, i.e., dates and exact locations, I don’t think I would ever run out of true stories to share. Of course some, because of confidentiality or intellectual property rights cannot be told. During those twenty-plus years, I visited over one-half of the states in the US and went to Canada three or four times.

The Transplant World

In those many cities, I worked with a diverse collection of people. There were transplant professionals, contract specialists, hospital administrators, lawyers, government and military officials and on very rare occasions a patient or family member. It was a humbling experience because each person had personal gifts, amazing intellect, and made contributions that helped to build not only a strong transplant network but a better and safer approach to life-saving procedures.

When I began my own journey in the transplant world, after a few years developing the immediate care centers, I found each day intriguing whether in the office in Louisville or in some distant city. When the first living liver donor transplant was done in the US, I was present at the hospital where the baby girl received part of her Mom’s liver. Years later, they looked me up and I was so privileged to see this young woman, healthy and ready to enter college. Her donor, (mother), was equally as healthy. Contracts were a challenge, but real people were the inspiration.

Kidney transplants from living donors were first performed in the 1950s and it was about eight years before kidneys from deceased (cadaveric) donors were viable. I became involved at the time heart transplants were first reimbursed by Medicare in the 1980s and one by one other solid organs and even double organs, e.g. heart-lung, were successful particularly after the development of anti-rejection drugs. Bone marrow and stem cell transplantation as better matching has been developed between donor and recipient have developed rapidly as well. I will always find transplantation fascinating. I was never in a clinical transplant role, my expertise in this field was administering benefits , contracting for services and third party reimbursement.

If you would like to know more about solid organ transplantation or becoming an organ donor see the United Network of Organ Sharing (UNOS) at https://www.unos.org

Information regarding bone marrow transplants can be obtained through the National Marrow Donor Program (NMDP) at https://bethematch.org which matches patients and donors internationally.

And, here’s a bonus site for those who love technology. The so-called “heart in a box” is a development by TransMedics, Inc. Check it out here to see a video (<3min.) of the device with a cadaveric heart actually beating prior to being transplanted into the recipient. http://www.transmedics.com/wt/page/ocsheart-improve-tx_med

The company has also developed a similar device for lungs and livers which can allow donor organs to be transported further as well as tested and treated prior to transplantation. There is little doubt that these technologies will extend and improve life for many.    http://www.transmedics.com/wt/page/organ_care

The future is truly now. 

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Thank you for following along with me in my Recollections of Travel. 

 

Photos by Pixabay

 

What I Know for Sure 4

The Last Seven

As you may have noticed, this subject has been difficult for me. Quite honestly I am surprised, because I’ve been nothing in life if not sure of my opinions, but therein lies the problem, I believe. Opinions are easy to come by, easy to hold, easy to change. Knowing something for sure is utterly different. Knowing means possessing proof, irrefutable facts, it is a reality, the unwavering truth. This reality is harder to come by. In previous posts, I came up with thirteen (13), if you allow me to include those I threw in facetiously. In order to meet the high bar set by Oprah, in number only, I was determined to come up with seven (7) more things of which I am sure. After much contemplation, here they are:

14. The love of an animal is pure. They give physical comfort, make no demands, don’t pout and are quick to forgive. 

15. Death comes to all living creatures. No matter how we try to avoid this fact it is a reality. 

16. There are no perfect marriages. Some are happier than others, some have more trials, but regardless of the effort put into a marriage, it is not possible to live with another human being without some rough spots and adjustments along the way.

17. White privilege is real. The greatest advantage I’ve been given in life, I have done nothing to earn. It was provided to me at birth simply as a result of having two white parents. 

18. Time spent in nature is rewarding. The sounds of birds, crickets, and water flowing, the feel of breezes that touch one’s face, the glimpse of a small furry animal scurrying along the ground, even the faint fragrance of a wildflower are healing and rejuvenating to the spirit of who we are or were meant to be. 

19. I cannot turn over a new leaf. No matter how many times I try, simply acknowledging that I need to make a change is not incentive enough. For me to make a change, it must involve serious consequences.

20. High heels are detrimental to a woman’s health. Created in Persia (Iran today) to be worn by men riding horses, a raised heel served the practical purpose of keeping the feet within the stirrup. High heels today serve no purpose except to hobble women, making them more vulnerable not only to assault, but to back pain, falls, and injuries to the foot and ankle. Yes, I am aware that they can be beautiful and that women who are strong and agile, can look stunning wearing them, but I maintain that they are not worth the risks involved. 


We have explored and exhausted this subject for now at least. You, the readers, have contributed many things that you know to be true and they are listed below. Please feel free to comment, adding more things you have decided are true over the past month. I believe that something can be true to one of us, yet not all of us. We are individuals and we do not think, feel or believe the same. Thank you so much for sharing with me and with each other. 

What Readers Know for Sure:

I am but a microscopic speck in the great macrocosm of the universe.  
My existence has had a purpose
Life IS worth living
I am a morning person  
I know God is real
A true friend lifts you when you’re down, listens to your problems, is caring and encouraging.
Columbus Day marks the beginning of recorded history in America.
Millions of European migrants came here bringing their music, art, science, medicine and religious principles that shaped the United States.
A leopard can’t change its spots.   
You can’t go back, only forward.
You can’t change the past.
One hand washes the other hand.
You can’t change a person’s thinking when it comes to religion or politics.
What I believe for sure, you may not.
My mother, brothers, and sister have loved me unconditionally.
I have the inner faith and strength to get through very difficult times.
Teachers can change a student for a lifetime.  
Seasons follow each other.
Spring starts from the ground up.
The moon and stars follow the sun. 
Full moons cause strange behavior in people.
Everyone is either predator or prey.
Every action has a reaction.
The human body is the most incredible organism.
Every person has a story.
Every person can choose how to react to their story.
We move through seasons and chapters of our lives individually.
Some decisions are more difficult than others.
When inflated, balloons float up.  
We all die alone, even when others are around us.
We are on this earth as we know it today, only once.

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What I Know for Sure:

I love my family with all my heart.      
Having time alone is a necessity for me.
Native Americans should not be called Indians.
Dish towels should be laundered separately.
April is not delivering in March.   
Love, at first sight, is a real phenomenon. 
Depression should be renamed. 
April had a baby.
Alot is not a word.
I am no Oprah.
CPR does not always work. 
Grandparents are not infallible.   
Adventure Animal Park will continue to make money on April through May. 
The love of an animal is pure.
Death comes to all living creatures.
There are no perfect marriages.
White privilege is real.
Time spent in nature is rewarding.    
I cannot turn over a new leaf.
High heels are detrimental to a woman’s health.   

The flowers bloom, then wither . . . the stars shine and one day become extinct . . . This earth, the sun, the galaxies and even the big universe someday will be destroyed . . . Compared with that, the human life is only a blink, just a little time . . .  In that short time, the people are born, laugh, cry, fight, are injured, feel joy, sadness, hate someone, love someone. All in just a moment. And then, are embraced by the eternal sleep called death.     Virgo Shaka

Part 4 of 4

Theme photo by Akiko Kobayashi (Japan)

Death – Suicide

“Suicide occurs, not because the deceased was selfish or because their loved ones failed them. Suicide occurs when one’s pain outweighs their resources of strength.” 

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Suicide

After our first discussion of Death back in mid-January, one reader stated: “Perhaps it is the way a person dies (long illness, accident, suicide, etc. ) that shakes our world more than the actual act of death itself? ” I agree with that assessment. While permanently saying goodbye to a person we love is always unbearably painful, it seems some losses are harder to accept than others. One of those circumstances is suicide. 

The very word “suicide” brings on so many questions; the first, of course, is “why”. There are many factors that contribute to the act of suicide, but rarely is it one event or situation resulting in an individual ending their own life. There may be a trigger, but the reason is much more complicated than one incident. Seldom is suicide chosen without being preceded by a long struggle, often accompanied by chronic depression. For some the desire to die is such a strong compulsion there reaches a point where it can no longer be denied. 

When I worked as a RN in an Emergency Department many years ago I witnessed firsthand the victims of suicide, some successful and others who were not. I saw the shock, confusion and heartbreak of families and regretfully at least one doctor who could not understand nor empathize with such a patient. I recall the horror of working on self-inflicted gunshot wounds, pumping stomachs to remove poisons and overdoses and witnessing myriad other ways in which people took their own lives. I never doubted that they were serious, although there were one or two who I thought might have been too immature to fully understand their actions. Many patients were saved, some were not. I recall one man who had shot himself and survived who wept and confided, “I can’t do anything right.” I will never forget his sorrow at being unsuccessful. I’m sharing these few details of that hospital environment to demonstrate that suicide is not an act for attention, but an act of desperation. 

Incidence

According to the World Health Organization (WHO) suicide occurs globally every 40 seconds. This translates, tragically, to the loss of 2,160 lives each day. In the US in 2014 (the last year for which there are complete statistics) suicide was the tenth leading cause of death and claimed the lives of over 42,000 people according to the Center for Disease Control and Prevention (CDC). Perhaps more disturbing, the suicide rate over the past fifteen years has increased by 24%. 

Eulogy for a Mom

There is so much that can be said on this subject. Sadly most of us have some experience with the heartbreak associated with a friend or loved one ending their own life. Perhaps you have undergone a close or recent loss due to suicide. Aside from listing some resources at the end of this post I feel the most helpful thing to do is to share with you a eulogy I was honored to hear at a memorial service in December of 2014. 

This eulogy was given by the daughter of my neighbor and friend, Marilyn Lamb. Marilyn’s daughter, Laurie Lamb Ray, has graciously given her permission for this tribute to her Mom to be reproduced here. Laurie’s words lovingly and sensitively state what we need to hear and understand when one dies as the result of suicide. I believe you will find it enlightening and that it will be helpful if you have the opportunity to comfort someone who has lost a loved one under these circumstances. 


Here are Laurie’s words:

I know you expect me to talk about mom tonight, maybe share funny foibles, touching tributes. And, I could. I have hundreds to share. But, I’ll leave that to others. Today, I’m going to talk about the elephant in the room. And, the elephant in the room is suicide. And now that you know I’m going to talk about suicide, I know that you are terribly uncomfortable and would like nothing better than to get up, jump in your car and go home. But you are a captive audience so, in honor of my mom, I’m going to ask you to stay and I’m going use this opportunity to try and help you understand my mom and her suicide.

Yes, my mom committed suicide. And we are all horrified and shocked and so very sad. And, let’s face it, even if we try really hard not to, we all tend to judge her just a little bit. Even the words we use seem a little damning, don’t they? She committed suicide. As if it is a crime akin to murder. We say, How could she do this? To me, to all of us? How selfish. How awful. How could she? And we are puzzled. She looked fine to me. She seemed fine when I saw her at the party just the night before. Well, don’t feel bad, she seemed fine at the party to me too.

But, you see she wasn’t fine; hadn’t been fine for my entire life. My mom had severe chronic depression. I don’t know how many of you know someone with severe chronic depression, but I know all of you have known someone who died of cancer…they fought it, they wanted desperately to live, they took medicine, sought help, people prayed for them and “yes” sometimes they even seemed fine. Yet, at some point they could no longer fight – they had become too weary, too weak and they just could not continue to live. And, that you see is exactly what happened to my mom. 

My mom died from a chemical imbalance in her brain. Not a weakness, not selfishness, not a sin against God. A very real, physical imbalance that left her unable to cope and unable to hope for things to get better.

So many of you have asked what you can do to help during this time. I’ll tell you what you can do. In memory of my mom, I ask that you re-file “suicide” from that place in your brain that judges and is horrified, to a place where there is nothing, but compassion and understanding. 

Your mom died of cancer? Well, my mom died of chronic depression. And, today she is no longer hopeless. She is with my dad and, even in the midst of my sadness, THAT has to make me smile.

Mom, I understand and I love you.


Thank you Laurie for sharing with us. We are grateful for your kindness and generosity. I would also like to thank Laurie’s Aunt Janet, who graciously agreed to share this message concerning her sister’s death. 


 

The following signs, symptoms and risk factors are from: https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

Signs & Symptoms

The behaviors listed below may be signs that someone is thinking about suicide.

1.  Talking about wanting to die or wanting to kill themselves

2.  Talking about feeling empty, hopeless, or having no reason to live

3.  Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun

4.  Talking about great guilt or shame

5.  Talking about feeling trapped or feeling that there are no solutions

6.  Feeling unbearable pain (emotional pain or physical pain)

7.  Talking about being a burden to others

8.  Using alcohol or drugs more often

9.  Acting anxious or agitated

10. Withdrawing from family and friends

11. Changing eating and/or sleeping habits

12. Showing rage or talking about seeking revenge

13. Taking great risks that could lead to death, such as driving extremely fast

14. Talking or thinking about death often

15. Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

16. Giving away important possessions

17. Saying goodbye to friends and family

18. Putting affairs in order, making a will

(Blogger’s note: It is conceivable there are some victims who do not display outward signs prior to suicide.)

Risk Factors 

Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex and there is no single cause. In fact, many different factors contribute to someone making a suicide attempt. But people most at risk tend to share certain characteristics. The main risk factors for suicide are:

1.  Depression, other mental disorders, or substance abuse disorder

2.  Certain medical conditions

3.  Chronic pain

4.  A prior suicide attempt

5.  Family history of a mental disorder or substance abuse

6.  Family history of suicide

7.  Family violence, including physical or sexual abuse

8.  Having guns or other firearms in the home

9.  Having recently been released from prison or jail

10. Being exposed to others’ suicidal behavior, such as that of family members, peers, or celebrities

Many people have some of these risk factors, but do not attempt suicide. It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress, not a harmless bid for attention, and should not be ignored.


If you need help:

Contact the National Suicide Prevention Lifeline

Available 24 Hours a day, 7 days a week.
The service is free, confidential and available to anyone.
All calls are confidential.
You’ll be connected to a skilled, trained counselor in your area.

Call 1-800-273-TALK (1-800-273-8255) or
Use the online Lifeline Crisis Chat: https://suicidepreventionlifeline.org

For more information, Visit the National Suicide Prevention Lifeline

(the source of this contact information)

 

 

Death-Hospice

Follow Up

To follow up on important topics from the last post in this series, please read the comments left by “Lula.” Remember that little black bubble at the end of each post?  fullsizeoutput_9edJust click the bubble on Death Decisions (Jan. 25, 2017) to read the important information she has shared with us. 

Lula shared interesting information about a service which sounds like a good idea for anyone, but especially those who travel often. I am not familiar with Living Will Registry, but you can read about Lula’s own experience as a frequent traveler (in her comments) as well as reviewing the service Online.*

One issue that Lula mentioned is Emergency Medical Services (EMS), when called to a home, will likely begin CardioPulmonary Resuscitation (CPR), even if one has a Do Not Resuscitate (DNR) order on a Living Will. I have always heard the same thing, but an official form** in this state (KY) is meant to address this problem. You should check with your own state, city and/or county for the law where you live. Regardless of one’s current health status it would be helpful to fully understand the guidelines before a need arises. It is understandable this is a potential for problems. The very fact EMS is called indicates an emergency and they come prepared to do what is necessary to save lives. If one has a terminal condition CPR is not likely an appropriate response, but it is unfair to expect emergency personnel to make that distinction or take that responsibility. 

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Hospice

Having Hospice involved in end-of-life care can often prevent such situations from occurring. Hospice is a national organization with local offices across the US, providing palliative care to patients facing advanced illnesses and to their families. Palliative care involves relieving pain and enhancing quality of life (as opposed to addressing a cause and/or cure) and may be provided in the home, special centers, extended care facilities or special units within an acute care hospital.

When Hospice care began gradually in the US, during the second half of the Twentieth Century,  there were specific parameters regarding how long a patient was expected to live in order to be admitted into palliative care. Although this is no longer the case, it is a lingering belief and can make it hard for families to approach the subject. I personally feel Hospice is extremely valuable in providing clinical, pastoral and grief support as well as practical assistance with medical supplies, equipment and even volunteer and respite care. Extensive information is available from National Hospice & Palliative Care Organization*** (NHPCO).

Possibly many of you used Hospice services for your family or maybe a close friend and I invite you to share your experience with us if you are comfortable doing so. I will share that in my experience with loved ones the service was not instituted soon enough. In one case, incredulously, it was not possible to get the physician to admit the patient was dying and by the time a referral was made the patient only lived a few hours. The other personal case was just the opposite. The physician recommended, even urged, Hospice service, but the patient wanted to wait a little longer, not realizing the time would approach as quickly as it, in fact, did. In each case the patient did not receive care that would have perhaps eased their passing. I painfully share this hoping it might prevent others from waiting too long. 


Websites referenced:

*Living Will Registry http://www.alwr.com

**KY DNR Form http://manuals.sp.chfs.ky.gov/Resources/sopFormsLibrary/Do%20Not%20Resuscitate%20Form.pdf

***NHPCO http://www.nhpco.org


Coming Up

We will look at Funeral and Burial Planning in the next post. I realize this may be a bit too pushy, but if you are so inclined how about working on writing your own Obituary before then? Then we will work together. Your participation is great and makes our experience together so much richer. Thank you!


“I find it delightful that the optimal way I can live my life from moment-to-moment is also the optimal way I can prepare for my death, and equally delightful that acknowledging our future death is a prerequisite for living a truly joyful life now.”  Ram Dass, Still Here

Death – Decisions

Decisions

It is understood that family units are all different and may be made up of biological or chosen family, spouses or partners, relatives or close friends. We will use the term “family” for those closest to you. These differences may dictate what, exactly, you need to do to from a practical standpoint to prepare for your death, but regardless, the first step should be honest family discussion. We’ll call it “The Talk.”

The Talk

It doesn’t have to be a formal meeting. If you and your family are open to the discussion of death “The Talk” can be in increments and flow from normal conversations. When discussing the death of an acquaintance it is a natural time to say, “When I die, I prefer . .” Since such discussions may not include everyone who needs to hear, having your wishes in writing, leaves no doubt or confusion. So, what do you need to talk about and how will you document it?

Living Will

Legal agreements can be our guides. Let’s start with those things usually addressed in a Living Will. If you are diagnosed as terminal and are no longer able to make your own decisions, because you are permanently unconscious or otherwise unable to express your wishes:

  1. Do you want treatment withdrawn except for pain control?
  2. Does that include withdrawal of food, water?
  3. What about a DNR (do not resuscitate) order?
  4. Do you wish to participate in anatomical donation?

Decisions for #1-#3 can be very difficult for a family member. You may have no doubt that these life prolonging actions are inappropriate or undesirable for you, but to your loved one it is not that clear. To them it may feel as they are hastening your death, while you are more likely to feel that such measures would prolong suffering. If this has been discussed and documented ahead of time, there is less anxiety when the decisions must be put into practice. Physicians, emergency personnel and hospitals must provide every means available to save a life if they have not been given the legal right to withhold those interventions. Resuscitation (CPR) will be initiated, regardless of the patient’s prognosis, unless there is an order in place for DNR.

Number four (#4) involves whether you would like to donate organs for transplantation or all of your body to science. If donating the entire body is your desire, besides documenting, it is best to make logistical arrangements in advance. Most such donations are made through a university or medical school.

Organ donation decisions are often made long before formal end of life planning. In most states one can designate the wish to be an organ donor while obtaining or renewing a driver’s license. Organ donation more specifically is addressed in the Living Will. If you have explicit wishes, maybe you are willing to donate corneas, but not hands for example, this needs to be legally documented. On this subject people often think first of heart or kidney, organs which dramatically save lives. In fact, donations may be made of tissues such as skin which is used as dressings for severely burned patients or bone for spinal surgery. There may be personal or practical reasons for specifying exactly which organs/tissues you are willing to donate and these can be itemized in your Living Will.

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Consider Donation of Organs or Tissue

Transplantation is a subject that I feel strongly about, having worked in that field for many years. I find it unfortunate that after over sixty years of successful transplantation, only 52% in the US choose to donate. If you have not already made your decision, please give some consideration to it now. There is no lack of information available to answer any questions you may have. I recommend calling your local/state donor affiliate or researching Online.

The United Network of Organ Sharing (UNOS) is the national organization which governs transplant facilities and Organ Procurement Organizations (OPO) in the United States. Their website probably contains more information than you would ever need: https://www.unos.org

Cornea transplantation differs in some ways from other donation and a good site for more information is https://www.donatelife.net/types-of-donation/cornea-donation/

Bone marrow and stem cell transplantation is still in the experimental phase for cadaveric donation, but is showing promise. If you are interested you may find information at the National Marrow Donor Program: https://bethematch.org

Your Surrogate

A Living Will allows one to record legally, exactly what one wants and does not want. Or, with this document you can authorize a HEALTH CARE SURROGATE, sometime referred to as a proxy or Medical Power of Attorney (POA), to make these determinations for you at the time of need.

Choosing a Health Care Surrogate is a very critical decision. First, of course, is that it be a person you trust. Your designated surrogate should be geographically close if at all possible and should know your wishes before accepting this responsibility. A few of the subjects included in a legal Surrogate Designation are:

  1. Access to your medical record
  2. Right to choose your health care providers and long term facilities
  3. Withdrawal of life-prolonging treatment

This legal document names your surrogate and an alternate surrogate in the event the first person designated is unable or unwilling to serve at the time she/he is needed.

Update and Storage of Documents

Sometimes we change our minds about the directions we’ve given and the Living Will and/or Surrogate Designation may require legal revision. These documents need to be reviewed on a regular basis. If our wishes remain the same, it is probably advisable to initial and date each page to show that they remain current. Having your Living Will on file at your hospital can make it difficult to keep current. I would trust a photocopy carried by my surrogate (and in my car’s glove box) more than the hospital’s computer system. It goes without saying that original documents need to be stored in a locked fireproof box and that your surrogate and/or POA has access.


“It seems to me most strange that men should fear; Seeing that death, a necessary end,  Will come when it will come”  Shakespeare in Julius Caesar

Death – Intro II

Introduction II

As we move forward discussing the topic of death and end of life decisions, in particular, I refer you back to this blog’s first page, HOME. At the bottom is a disclaimer and it is important that you review it at now, particularly this:

The content of this blog is not intended as advice . . . . Information contained herein is not presented as medical, legal or clinical recommendation . . . .”

And, I would add:

  1. It is extremely advisable to seek legal counsel from an attorney for estate/end of life planning.
  2. Forms are available Online for your review (or printing), but I caution you to use either the US Government (https://www.usa.gov/federal-agencies/a) or (https://www.irs.gov/forms-pubs), your State Government (state laws differ) or the American Bar Association (http://www.americanbar.org/groups/real_  property_trust_estate/resources/estate_planning/living_wills_health_care_proxiesadvance_health_care_directives.html) Websites. Using these sites one can avoid ads and scams.

The kind of end of life decisions we will focus on are sometimes included during estate planning which deals with financial issues. Money management is not part of our discussion.


Future Posts

In the next few posts we will discuss the following topics, some more in depth than others:

  • Power of Attorney (POA)
  • Living Wills
  • Health Care Surrogate/Proxy
  • Organ Donation
  • DNR (do not resuscitate) orders

Other topics in the future will include: Funerals, Obituaries, Grief and Suicide.

In the last post I asked you to say the words: “When I die” and to acknowledge we are born terminal. Some of you responded with your thoughts and experiences and I appreciate your honesty and willingness to share. It is not surprising there are those who are not ready to talk about such personal feelings. Discussing death is difficult in varying degrees based upon our past experiences and other factors, e.g., religion, age, health status. It was reassuring some of you have already taken formal steps to inform others of your wishes at the time of your death.

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Reader Feedback

Marybeth, while sharing that her parents were very organized in having preparations in place for death, also stated, “Perhaps it is the way a person dies (long illness, accident, suicide, etc. ) that shakes our world more than the actual act of death itself? ” This is a valid observation, because while losing a person one loves will always be painful, there are many variables which affect how we react and how we grieve.

Rita discussed the awe of her own conception which is the beginning of the brief interlude we have on this planet. We often hear “cradle to grave,” which sums it up.

Finally, Lula shared the preparation she has made for her own death having had that responsibility for deceased loved ones. Such experiences in dealing with the estates and last wishes of others certainly point out the value of thinking ahead and making the decisions we are about to discuss.

Thank you to each of you who shared.

With the next post we will begin discussing the person (proxy) who makes medical decisions for you when you are unable to express your wishes. That person may be designated in a Medical POA, a Living Will and/or Designation of Health Care Surrogate.

“Life cannot exist without death; neither can death exist with life.” Osho Rajnish


Past Problems with the COMMENT Section

Some have expressed frustration with trying to comment on posts. I understand and I admit it isn’t easy to figure out and I’ve made some changes AND mistakes along the way. To comment on any post click the little bubble below and right on this page. If yours is the first comment that little black bubble will have a + sign on it. If others have already commented there will be a number in the bubble. Either way, all you have to do is click the bubble and a space will be provided on which to write.

Here is a screen shot from my phone that shows the illusive “bubble.”

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Thanks again!

Minnie I

Minnie at Church

Deciding to rush from work to join Minnie tonight and not wanting to make her late, I had actually arrived early. I knew how much it meant to her to attend the meetings just as she had attended church regularly for her eighty-plus years of life. Too late I learn she is disappointed, because when I am not here the Preacher stops by and brings her to the service. She feels special, I supposed, arriving with the Preacher. As I look around for familiar faces arriving in all manner of garb, I made a mental note to be late next time so she could be escorted the way she preferred.

Attendees 

There is Dr. Lee, as reticent as ever. It is my opinion she is not stuck up, but rather, she has difficulty in social situations. Her athletic shoes look strangely out of place, not for the venue, but for her. Charles enters looking troubled and carrying the dogeared spiral notebook in which he writes throughout each service. I used to think he was a serious Bible scholar critiquing the message, but today I overheard him saying something about bills as he flipped madly through the pages. Strangely, he seemed concerned about NOT receiving bills as he queried others about the status of their bills. Mr. and Mrs. Harvey arrive together and she looks more frail than in the past. Minnie had told me “Mrs. Harvey is on the verge of dialysis, but she is resisting.” I didn’t know dialysis was an optional treatment.

There’s Lena walking straight to a seat which will accommodate her should she care to lie down during the service.  Some people are extremely bothered by her habit of reclining at any time and in any setting, but others hardly seem to notice. There’s a lady coming this way who I do not know. Carefully groomed, she has small delicate hands with perfectly polished nails. She doesn’t look left or right as she gets settled in the seat next to Minnie who pointedly doesn’t look at her either.  Instead, she is looking enviously at the woman being escorted into the service by the Preacher.

The room is almost full now. Some faces are less familiar, but just as interesting. The piano player is getting out song books for the worshipers to share.  Finally, when all are quiet and poised for the singing to begin, my favorite makes her entrance. Esther truly is an aristocratic sight as she makes her way first to greet the musician. She is wearing a navy blue blazer, oxford shirt, neatly creased trousers and low heeled pumps.  Her navy purse is perfectly balanced hanging from one stately squared shoulder. She stops by each person, graciously offering her hand as she bends down ever so slightly, so she can look them directly in the eyes. As she comes closer I can hear each greeting, “So glad you came,” “Thank you for coming,” “It is so good to see you!”  As she completes the circle, addressing the last person, she regally exits the room to be seen no more this evening.

Singing

Hymn books are passed, the song leader takes her place and the piano begins a cadence not unlike a funeral dirge. The hymns are old and familiar Protestant fare, including Rock of Ages, On Jordan’s Stormy Banks and The Old Rugged Cross. Charles scribbles in his book, Lena starts to ease toward a recumbent position, Dr. Lee’s face is immobile as she holds her head and song book erect. Minnie and the two Harveys are each on a different note and none are the same as the one the song leader is singing. The Preacher grins goofily at his congregation while singing loudly in the note the leader was determined to maintain.

Praying

Prayer request and praise time is next in the order of service and the Preacher begins this portion by sharing how thankful he is that he is “healthy and able to do the Lord’s work,” while looking around the room at blank faces and ailing bodies. Next, he invites the congregation to share prayer needs and praises. A small black lady in the front row said she would like prayer that she could “walk good again.”  The Preacher responds, “Yes, Mrs. Long.”  Another woman tearfully asks prayer for her great nephew who was paralyzed in a recent football accident.  The Preacher was visibly moved and replied, “We will certainly pray for him.  How hard it must be on the whole family. You know, it is so tragic for this to happen to a young man. Girls can just take this sort of thing better, but a boy knows he needs to get out into the world and work, provide for a family.” The worshippers nod in agreement. The prayer requests continue ranging from paltry to profound amid sounds of hymnals hitting the floor and people coughing and muttering. Finally, the Preacher closes prayer time with a long prayer imploring God to hear, to have mercy and “If it was in His will” to grant the requests just made.  He didn’t mention the gentleman who had just shared that his “ass hurt.”

Preaching

The Preacher resumed his goofy grin and began the meat of the service. He started by telling some personal anecdotes, his eyes sweeping the room for reaction. The lady with the nephew didn’t disappoint. She kept her smiling eyes glued to his face and her hearing aid tuned to his every word. Charles kept reviewing his notebook. Lena was quietly supine. Dr. Lee stared straight ahead. Just as the Preacher began to read from his text for his main event, Minnie turned to the woman beside her with the nice manicure and suddenly shook her roughly by the shoulder shouting, “Wake up! Don’t you know you are not supposed to sleep in church!” The pretty woman’s head bobbed back and forth with the shaking making me wonder whether she was asleep or deceased. Either way, I was embarrassed. The Preacher didn’t miss a beat. Dr. Lee’s expression didn’t change. Charles didn’t take his eyes off the notebook. Mr. Harvey smiled broadly. As the Preacher’s words piled higher and deeper, I let my mind wonder like many in the room had done from the beginning.

Finally the service was over and I took Minnie by the hand, leading my Mother back to her room as the attendants, one by one, escorted the other nursing home residents to their rooms.

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Written 7/1/98      Revised December 2016

Words Matter – I

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Newspaper & Portrait Photography

It may sound trite, but there are words I do not like.  It is not necessarily that they do not sound pleasant, although that may be part of it. And, have you noticed words do not sound the same to everyone? For instance, “coin” is one of those for me. When I say it one of my daughters chuckles quietly. I think I pronounce it normally, but obviously I do not say the simple four letter word correctly. My Mom had a similar problem with the word “oxygen,” however I find that more forgivable. But, I am getting sidetracked before I actually begin.

Depression

What I intended to discuss are words that either do not sound like what they mean or that have meanings with which I disagree. Let me start with depression, which sounds like a lower surface, a dip or swag. A road uncared for might have a depression. An old floor may be depressed in spots. This versatile word may be applied to the economy or even a weather pattern. You get it, but what if this word is used regarding another human? Many people immediately think of a person in a bad mood, sad probably and maybe even lazy. Too often the person suffering from depression is told to “snap out of it” or “get over” themselves. Even if not said in actual words that is likely the message they receive, whether intentional or not. I believe it may be time for a new word for this complex diagnosis which covers an entire spectrum of symptoms from mild and transient to suicide.

“Domestic” Violence?

Another word, or term rather, is not only inadequate, like depression, but is also inaccurate.  “Domestic violence” describes a range of situations from emotional and physical threats to injury or even murder. There is nothing “domestic” about “violence!” This terminology should never have been used to begin with and it serves an injustice to victims of violence, whether in the home or elsewhere. Recently, the term “Relationship Violence” is sometimes used in media reporting and I strongly support this more accurate terminology. Some prefer “intimate partner violence,” but in my opinion this comes up short. First, it obviously leaves out victims whose abuser is someone other than a partner. The abuser could be any relative or friend with whom one has a relationship. Statistics indicate one in three women will be the victim of intimate partner violence, but including other types of relationships would most certainly increase the statistic greatly and there is no reason to limit attention to a particular type of relationship or gender.

Pink & Purple

For many years October has been Breast Cancer Awareness Month and we have been encouraged to wear pink to bring attention to this illness which effects over 124 women per 100,000 population (1.3 men/100,000). Wear pink if you choose, it isn’t my favorite color and reminds me of

milek9giagirl babies more than women, but I would suggest pink ribbons do little to combat this deadly disease which has touched most of us either directly or indirectly. More helpful is knowing the signs of breast cancer, performing self exams and having regular mammography.

Someone in all sincerity I’m sure, has designated today as Purple Thursday and we are asked to “Wear a little purple with our pink” today. I must admit purple is one of my favorite colors, but rather than looking for something special to wear today I am writing this post. I wish to bring attention to Relationship Violence and encourage each of you, regardless of gender, to take action against this devastating situation which, like cancer, effects so many. Relationship Violence may take various forms other than physical abuse, including emotional, sexual, financial or verbal mistreatment. The signs and symptoms can be reviewed Online, including such sites as this National Hotline: http://www.thehotline.org/is-this-abuse/abuse-defined/

  • Let’s be better informed.
  • Let’s be brave enough to report, whether it is personal or is suspected in another.
  • Let’s refuse to say, “domestic” violence from this day forward.

 

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