Hummingwolf at Home

"Help, My Friend Won't Stop Having Fibromyalgia At Me!"
Here's that bad advice you were hoping for.

(Link via supergee)

Because I've been reminded of this by recent discussions in other journals (especially nellorat's), here's Dorothy L. Sayers, from her 1941 book Mind of the Maker, in the "Problem Picture" chapter (in which she is discussing both theology and detective stories):

2. The detective problem is completely soluble: no loose ends or unsatisfactory enigmas are left anywhere. The solution provides for everything and every question that is asked is answered. We are not left with a balance of probabilities in favor of one conclusion or another; nor does the fixing of the crime on the butler involve the detective in fresh enigmas connected with the cook. Such uncertainties may appear to arise in the course of the story, but they are all cleared up in the end by the discovering of the complete solution. It should not be necessary to point out here that this happy result proceeds from the simple fact that the author has been careful not to ask the questions that the solution will not answer.

Now, our tendency to look for this kind of complete solution without lacunae or compensatory drawbacks badly distorts our view of a number of activities in real life. Medicine is a good example. We are inclined to think of health in terms of disease and cure. Here on the one hand is (we think) one definite disease, and there, on the other hand, should be the one, definite and complete "cure." Apply the cure to the disease, and the result ought to be an exact "solution" of the "problem" presented. If the physician cannot name the disease on sight and immediately produce the prescribed cure, we feel resentfully that the man does not know his business.

In the same way, there used to be a firmly-rooted belief that to every poison there existed "the antidote"--a benevolent drug which would exactly reverse, each by each, the effects of the original poison and restore the body to the status quo ante. There are in fact, I believe, only two drugs which are complementary in this way, atropine and physostigmine (incidentally, neither of them is "benevolent"--both are deadly poisons). With other drugs which are used to counteract one another, the reversal of the effects is only partial, or is rather a counteraction of the symptoms than a healing of the mischief done to the organs. In most cases, the usefulness of the curative drug is only to hold off or mitigate the effects of the poison until the body can summon its physical resources to cure itself. In certain instances, one disease can be got rid of only at the cost of contracting another, as in the malaria treatment of syphilis. Or the treatment demanded by--let us say--a diseased condition of the lungs may be impossible for one particular patient, because his constitution could not stand its violent effects upon the heart.

We have, perhaps, abandoned the superstitious belief in antidotes; but we continue to hug the delusion that all ill-health is caused by some single, definite disease, for which there ought to be a single, definite and complete cure without unfortunate after-effects. We think of our illness as a kind of cross-word of which the answer is known to somebody: the complete solution must be there, somewhere; it is the doctor's business to discover and apply it.

But the physician is not solving a cross-word: he is performing a delicate, adventurous, and experimental creative act, of which the patient's body is the material, and to which the creative co-operation of the patient's will is necessary. He is not rediscovering a state of health, temporarily obscured; he is remaking it, or rather, helping it to remake itself. This may indeed be looked upon as a problem; but it is not the same kind of problem as that presented by those in the algebra-book: "If a cistern is filled by pipes A and B in 25 and 32 minutes respectively"; and the answer is not likely to be so precise or to cover all the conditions so satisfactorily.

The patient's best way to health and peace of mind is to enter with understanding into the nature of the physician's task. If he does so, he will not only be better placed to co-operate creatively with him, but he will be relieved from the mental misery of impatience and frustration.

"An important analysis conducted by Children's Hospital Oakland Research Institute scientists suggests the importance of ensuring optimal dietary intakes of vitamin K to prevent age-related conditions such as bone fragility, arterial and kidney calcification, cardiovascular disease, and possibly cancer (1). Vitamin K is concentrated in dark green plants such as spinach or Swiss chard, and is either not present or present in only small amounts in most multivitamin pills."

Found article because various things lately have been nudging me in the direction of looking into vitamin K. "Various things" including the facts that I bleed far too much from my assorted body parts (including nose, hands, [TMI DELETED]), that antiepileptic drugs block vitamin K, that I feel better when I eat vast quantities of yogurt--that sort of thing.

This page from an interested layperson is certainly... interesting. Must do more looking.

Based on news reports coming out today, incoming U.S. President Barack Obama seems to be right on track in his goal to assemble the Hottest Administration Evar. Behold the potential Surgeon General!

Info via urbpan, who may think the potential Surgeon General doesn't look enough like Dr. Koop, but still includes a lovely photo in this post.

Monday: Considerably better than the weekend. Felt energetic enough to go to the library and various other places, walking a little less than four miles total. Hurrah!

Tuesday: Scrubbed the bathroom tub & tiles a bit, though not enough to keep the bathroom from still being a bit disgusting. Hey, something is better than nothing. Went to the library again. Got lots of typing practice. Did some walking around for pleasure as well, walking a bit more than four miles during the day, which was a lovely change of pace from my recent lethargy.

Wednesday: Felt like all my limbs were made out of lead. Wondered why my arms ached so much, then remembered the previous day's scrubbing. Didn't bother leaving the house all day. Developed a nasty migraine in the evening, so went to bed earlyish in hopes that getting a good, solid eight or nine hours of sleep would help me feel better the next day.

Thursday: Was awakened after about five hours of sleep. Ugh. Migraine still nasty, so I took some prescription medication for it and ended up feeling slightly high, or possibly low (it was a little hard to tell which way was up by that point). Constantly bumped into walls as I walked through the house. Headache waned enough during the day for me to go to the grocery store for a few good foods, so that was a plus. Went to sleep relatively early, woke up an hour later to put a load of laundry in the dryer, then spent the next hour-plus in utter misery because the headache had gotten much, much worse and would not allow me to get back to sleep no matter what position I contorted myself into.

I called my doctor's clinic's answering service to find out the maximum dose of my headache medication that I could safely take in a day, enthusiastically thanked the doctor on call when he told me that yes, in a 24-hour period it was okay to take about three times as much of the drug as I had already taken. Took another pill. Promptly puked my guts out (was grateful that my body had given me enough warning for me to run to the bathroom and pull my hair out of the way first). Greeted incoming housemate with the words, "You know, intense pain and nausea really aren't conducive to sleep." Refreshed my memory of the symptoms of meningitis. Decided that migraine + muscle tension was still a better fit for the symptoms, and besides, the thought of enduring the lights of even the most dimly-lit ER for any length of time sounded like a taste of Hell. Took another pill, which stayed down this time and noticeably decreased the pain within a few minutes. Wondered if any of that relief was related to placebo effect, but decided I didn't care as long as the pain went away enough to let me sleep.

Friday, so far: Woke up after sleeping somewhere around seven hours, which was better than I'd expected. Still feeling a wee bit headachy, I took more of the headache meds as well as my usual drugs. The migraine's still there, but it's more of a normal migraine rather than something seriously making me consider a trip to the emergency room, so I'm grateful for that. I haven't braved breakfast yet, and I do have an appointment with the neurologist today, so wish me luck!

Based on the way I felt Monday & Tuesday, I'd say my good days on Keppra are better than my good days on Depakote were (at least in the last few months I was taking it). Based on the last couple of days--especially last night--I'd say that my bad days are significantly worse. I wonder if this dose of Keppra is actually helping any, or if I'm just relearning what it's like to live without Depakote's side effects.

So within the last few weeks, when other excuses wore out and facts had to be faced, I finally acknowledged that the CNS depressant I've been taking for a little over a year has, in fact, caused a low-grade depression. Well, the medication's known psychiatric side effects were likely boosted by the fact that the drug hasn't been keeping either migraines or seizures under control at the current dose, and any higher dose tends to make my digestive system deeply unhappy. Mostly it's the medication's current ineffectiveness which the neurologist was focused on (though nobody's particularly happy with some of the other recent side effects, even when you're not taking the Great Bleh into account). Since a higher dose is a bad idea, I'm now on a lower dose and will be going on a lower dose still until I've stopped taking the drug altogether. For those interested in such things, I'm tapering off of Depakote and will start taking Keppra--beginning with a low level of that, since we've established that my body is oversensitive to the nastier effects of mindbending meds. Wish me luck!

(Note to local people: Keppra's side effects include mood changes too, most famously RAGE. If any of you happen to notice me being more psychotic than usual, please let me know (from a distance, if you have to)!)

Anyway, the big thing that made me realize that Depakote's been less-than-good for me mindwise is that I've barely even wanted to be creative this last year, except perhaps theoretically. I hardly recognize myself! Did play pointlessly with some POV-Ray pigment patterns, though. At first I wasn't sure if I wanted to experiment with fractals or heart curves, so I did both:



See?

After that, I played with hearts a little more: ( In my heart of hearts )

So if things go well I hope to find some of that old creativity again, or possibly find some new and fresh creativity that I can call my own. "Better living through chemistry" can be such an elusive goal sometimes.

You know those anxiety dreams everybody has? The dreams like the one where you're in school, say, and you've just found out that you have an exam in five minutes in a class you'd forgotten you were supposed to be taking and if you don't pass it you will FAIL at LIFE with no chance of repentance, no opportunity for clemency? I don't have those dreams. Not a single one. Ever since sometime in the nineties, I have had, instead, dreams in which I suddenly realize that tomorrow is the last scheduled day of classes, I haven't been to class since the beginning of the semester, I don't even know who all my professors are--and it doesn't matter. All of the professors are kind and understanding, they all recognize that circumstances have made things difficult, and they all are willing to wait as long as it takes until I am finally able to do the work that was supposed to be done. No matter how stressful my life has been on the outside, in my dreams, at least, there has been acknowledgement that patience is necessary.

Since the latest diagnosis, my dreams have taken a different turn. I have had one dream that I remember clearly and another half-remembered one where it's been made clear to me that some assignments will be due soon and I need to get working. This still isn't the standard hectic anxiety dream, but it is a dream involving a deadline and an implied threat. Is this my subconscious mind's way of saying that it believes my limitations will be reduced soon and I'll be able to tolerate the levels of subconscious nagging everybody else has to deal with? If so, that's kinda nifty, in a perverse sort of way.

One of my other recent dreams was a rarity for me--a nightmare. This one involved people being tortured and small, furry animals feeding off the--
no, you're quite right, you really don't want to know. Anyway, the man directing the torture was Detective Tritter from this last season of House, M.D., though he seemed to be working for the Initiative from Buffy season 4, which means that one single dream managed to combine pain, adorable animals, and really crappy story arcs from two otherwise entertaining TV shows. Buffy the Vampire Slayer did recover from that one substandard season (though I know some of you think some later season was worse); but I have substantially less faith in the writers of House, possibly because the writers of House are the folks trying to convince us that a character who is in genuine, chronic, incurable pain for perfectly valid reasons; has been prescribed pain medication in accordance with best practices (at least as far as anyone on staff can tell); and has proven that he functions much better when he's got some kind of pain relief, is somehow a bad person because he wants to keep taking the drugs rather than go cold turkey and endure more pain for no good reason. (The previous sentence did not spoil the latest season of House, by the way, since the writers have apparently been compelled to pull this stuff every half-dozen or so episodes since the series began.)

I really do miss the Joss Whedon shows. I said as much in comments at house_md recently, mentioning that I'd like Charisma Carpenter, J. August Richards, and Alexis Denisof to appear on the show. "I don't think they should be ducklings, necessarily, but people House can bounce ideas off of who are capable of restraining him when he loses his soul is about to do something stupid..."

Speaking of bright doctors doing stupid things, I was looking through some of my old medical records and saw in a neurologist's notes in early 1995 that "She [me] will have an EEG for possible partial complex seizures." This never happened. After my father died two months later, the doctor decided that all my health problems must be related to my reaction to Dad's death--in spite of the fact that my health problems had begun several years earlier and my father died from meningitis, which isn't exactly what you'd call a chronic disease of long duration. I do wonder how different life would be now if the neurologist had listened to me after that point. Maybe nothing would have shown up on the EEG back then anyway; maybe nothing major would be all that different now. I still have to wonder, though.

In Donald A. Norman's book Emotional Design, there's some discussion of why human designers might want to create intelligent machines with something like human emotion.

The component failure should be detected at the visceral level and used to trigger an alert: in essence, the system would become "anxious." The result of this increased anxiety should be to cause the machine to act more conservatively, perhaps slowing down or postponing non-critical jobs. In other words, why shouldn't machines behave like people who have become anxious? They would be cautious even while attempting to remove the cause of anxiety. With people, behavior becomes more focused until the cause and an appropriate response are determined. Whatever the response for machine systems, some change in normal behavior is required.

Animals and humans have developed sophisticated mechanisms for surviving in an unpredictable, dynamic world, coupling the appraisals and evaluations of affect to methods for modulating the overall system. The result is increased robustness and error tolerance. Our artificial systems would do well to learn from their example.

Yesterday afternoon I went to see a psychiatrist, in part because my rheumatologist suggested a newish drug which he thought Medicaid would be more likely to pay for if it was prescribed by a psychiatrist. The new doctor did write a prescription for the rheumy's recommended drug, as well as a new prescription for Ritalin (which I've taken off & on for somewhere between eight years and a decade). After hearing a bit about my life as it is now, he also tried to convince me to take several more drugs, based on the fact that I'm clearly anxious and not sleeping all that well. The man was rather insistent.

During the appointment there was an uncomfortable argument going on in my mind as I tried to decide whether I should tell him that maybe the best treatment for the anxiety of someone who's worried about ending up homeless within a very short time period would be to figure out how to help that person find a home

or tell him that he really needs to change the medication for his own ADHD because he was acting very much like a ferret on crack.

The more reasonable part of my brain won, and I did tell him that I'd rather not take a bunch of new drugs when I've got an anxiety-provoking situation to deal with. He wasn't convinced. I guess there's just so much you can say to a crack-addled ferret.

A friend thought last night that I was pretty anti-drug. I'm not against drugs. I do take Ritalin and am grateful for the help it gives me in dealing with the cognitive problems that go along with fibromyalgia. What I am against is a culture where a person can say "Hi, I'm very upset right now because I'm afraid I'm going to end up on the streets and I need to find a place to live quickly and I don't know where to turn," a doctor can say "Here, take this pill to wipe your anxiety away," and the doctor's response is considered a helpful one. Of course I don't expect a doctor to help me find a place to live. But I do think they should recognize that not every emotion is a disease in need of a cure.

Essay by Seinfeld writer Marjorie Gross.

( Cancer Becomes Me )

Because a few of us have been discussing (and experiencing) potassium deficiency recently, here's a list of some foods and their potassium content, taken from the book Prevention's Food & Nutrition, 1993.

Food	Portion	Potassium (mg.)
Avocado	1	1,204
Raisins	1 cup	1,089
Acorn squash, baked	1 cup	891
Potato, baked	1	844
Spinach, cooked	1 cup	838
Cauliflower florets, raw	1 cup	795
Navy beans, cooked	1 cup	719
Apricots, fresh	1 cup	628
Plain nonfat yogurt	1 cup	579
Asparagus, cooked	1 cup	558
Mushrooms, fresh	1 cup	555
Orange juice	1 cup	496
Cantaloupe	1 cup cubes	494
Apricots, dried	10 halves	482
Lima beans	1/2 cup	478
Banana	1	451
Skim milk	1 cup	447
Chicken breast, broiler/fryer	1	440
Sockeye salmon, fresh, cooked	3 oz.	319
Flounder, cooked	3 oz.	292
Ground beef, extra-lean	3 oz.	266
Turkey white meat	3 oz.	259
Turkey dark meat	3 oz.	247
Chicken breast, roasted	3 oz.	220

This month, I have craved every food on this list. Well, everything except raisins, which I'm still convinced are demon spawn disguised as dried fruit.

Oh good grief.

Why is it so many people think they're healing when all they're doing is finding something else to be dependent upon? That's not health by any stretch of the imagination--it's just finding a new way to hide your emptiness from yourself.

Don't mind me. This is just the crazy woman ranting off in the corner. At least I'm not talking about you-know-what.

[Edit: I'm not talking specifically about anyone likely to pay any attention to this. Though come to think of it, the people I'm thinking of wouldn't pay attention to this even if they were reading it.]