Monthly Archives: May 2016

My Advice

Which route to ride? This is a question that comes up regularly for me. And sometimes it doesn’t. I used to consult my collection of maps and cycling routes books and decide that way. A whole variety of rides, some starting locally, some I would take a train to the start of the route. At some point I stopped consulting them. No map required since I knew my favourite rides by heart. I mislaid the books. They sat in a drawer, untouched. Gradually the familiar routes were forgotten. I would ride just one or two different routes – both headed north on the same roads for 5 miles or so before splitting off in different directions. The same lanes, the same hedgerows, the same fields, the same horses, the same sheep.

Recently I came across those maps and books. And, yes, I have been out on one of those rides I had forgotten. But only one. But they’ve sat in the drawer again since then. It was weeks and weeks ago that I went on that ride. A couple of weeks since I’ve been on a ride of any distance, really, except for those trips into town and back. They help, sure. But they’re also part of the problem.

I know what’s good for me and I’m not doing it. And I need to be. Last week my psychiatrist signed me off work for 2 weeks. I’ll see him next week to decide whether I’m fit to return to the world of helping folks in their respective recovery journeys.

The depression is back.

I knew it was coming and I kept on going, regardless. Winston Churchill – himself a sufferer of severe depression – once said ‘when the going gets tough, keep going.’ I am reluctant to criticise a fellow sufferer, but I have never agreed with this maxim. It just seems too, too … macho, somehow. It doesn’t speak of change, it doesn’t speak of how weakened we are by the ‘Black Dog’ – his expression – to personify this most canine of maladies. It doesn’t speak of the need for outside help when our own mental and physical resources are so compromised. I think he forgot that we can’t all lead a country to victory in a world war while laid low, as he was, with depression.

When things are on the slide the best thing to do is to pause. I’m not saying drop everything and slow down. No, what I’m saying is call upon what works. Call upon what and who has worked before. I  realise that I am talking like you have the energy and will power to take these steps. I need to stop pedalling and free – wheel a little here. I know well how crushing solutions and advice, even good advice can be – especially when we have nothing left to act in our own interest. I know from my own experience that motivational quotes and stories of triumph over adversity only serve to remind me of how alienated we are from, well, everything.

flat tyre

And then there’s the debilitating optimism of people who want to help (please don’t) with nuggets such as ‘what doesn’t kill us makes us stronger.’ Really? I think it just makes us weaker. Or that sunny practice of counting one’s blessings. In a recent personal audit of my own blessings I counted, oooh, lots. Double figures. Helpful, yes? Dispiriting is putting a positive spin of what I feel when I think of everything and everyone I have to be grateful for. The gravelly feel of guilt, more like. All these riches, like my bicycle, as useless as its pedals, its chain, its saddle at times like these.

Punch and Judy

He feels so old, something primordial,

something that surfaced through the permafrost

sliding blindly towards warmth …

Icy against her back: she dreams herself

diving through breakers in the winter sea.

 

Rain at three, rain again at seven,

Hanging leaden in the tiny square.

Dawn after dawn – detriutis from the whirlpool,

the spars and splinters of  shipwreck.

Walls of water roar beside the windows.

 

The girl’s blonde head is drawn

into a caul of weed

and her long legs trawl the dark.

His shoulders rap the sea bed. There comes

a noise like singing as their bodies sunder.

 

Picked over by dabbing fish …

her plump lips on his face and on his neck,

dampness of her hair uncoiling.

His mind comes loose: he sees a figure

out on the drowning streets,

 

camouflaged by morning twilight,

watching the room, his eyes

luminous, like an assassin’s.

Her shadow runs on the curtain, then she floats,

a tangle of pink and gold on frosted glass.

 

Love is his energy and his trap, spurring

the thug beneath the skin: homunculus

hooknosed, hunchbacked …Her voice

rings in the shower … it stirs in its cage of ribs,

inarticulate and murderous and mad.

David Harsent (1942 – )

 


Cancer, Aging, & Second-hand Sheila

Been wearing hoodies since they were sweat shirts. Photo by Tina Stevens

The picture of anti-fashion, at Chatsworth. Photo by Tina Stevens

Today’s tune is by David Bowie, and is about fashion. This blog, however, is about its dark-matter twin. Aka, “Wear whatever the hell you want. Because you’re old(er) now.”

Young lasses who are gobsmacked whenever a woman over 30 wears a short(ish) skirt, non-standard hair (1), or funky boots rather than functional court shoes don’t realise that our concept of “old” does a flip-flop (2) as we age.

In my own young and exceptionally foolish late teens and early 20s, I thought that if I made it to 30, I’d be soooo together. Later, I turned into a young and exceptionally foolish 30-year-old. What a disappointment that was.

Now I’m nearer 2 x 30, and realise I know jackdaw-shit. And yet, at times I’m more comfortable in my ageing skin than I ever was in my young one. And my idea of what’s old is creeping up toward the 80+ mark.

Having a laugh at my younger, stupider self

Having a laugh at my younger, stupider self

This blog was partly inspired by this one, posted by a friend on Facebook. But it’s also inspired by my friend Sharon, who runs the lovely  “Enchanted Way” stall on Donny Market. I popped by to see Sharon sometime between receiving the date for my breast cancer surgery, and having the actual op. Talking to Sharon always brightens my day, even more than browsing through, and purchasing, some of the lovely things she sells.

I was wearing a new-to-me light jacket in my favourite yellow, and a white and red scarf. For years I’d avoided decorative scarves, lacking the nerve carry them off. Both jacket and scarf are from Aurora, a marvelous local charity which offers free beauty & therapy treatments to people with cancer, and has a shop on Scott Lane, Doncaster.

I talked to Sharon about trying out different colours, and styles, one sale (4) and charity shop at a time. About dyeing my hair before surgery, so I’d look nice whilst under general anesthetic, wearing one of the NHS’s lovely hospital gowns.

About my fear that I wouldn’t survive surgery, or general anesthetic.

I think you will survive, said Sharon. Because you’re talking about dyeing your hair, and overhauling your wardrobe.

It’s only taken me 57 years, to think that it’s ok  for me to wear a yellow jacket, and a red-and-white scarf, with one of my favourite Doctor Who t-shirts, walking trousers, and boots.

Twilight has its own delights.

Twilight has its own delights.Aurora

I should have done it years ago. But I didn’t. One of the goals of the rest of my life is to stop plaguing myself with shoulds, and musts.

I’ve earned the right to wear yellow. To dye my hair teal if I wish (I don’t). To grow it despite my mother’s belief that older women with long hair “look haggard”.

The right, to borrow a phrase from author Tom Cox, to go “full jackdaw”.

I don't wear a cloak every day, but when I do, it's usually Halloween.

You can’t go much fuller jackdaw than a shiny green cloak.

(1) eg, teal, purple, or even long.
(2) In the sense of a somersault, and not the footwear known as flip-flops in Britain, and thongs (3) in the States
(3) Yes, I am aware what a “thong” is in Britain. You can stop sniggering now.
(4) Thank you, BHS. I do hope you survive.

Tagged: ageing, Aurora, breast cancer, Cancer, David Bowie, fashion, full jackdaw, nostalgia, older women, style, The Enchanged Way, Tom Cox

10 Things You Need to Give Up If You Want to Be Happy

I know, we’ve heard all or most of these before, yet this is so spot on that I decided to post it. One more thing I would add is to give up expectations, giving up expecting other people to act a certain way will definitely contribute to our happiness, because we all act our own way, not the way that someone might expect us to act. That is normal and should be the expectation. Ok time for me to go off to dreamland. So good night my friends 😴💤


Bipolar Disorder and Alcohol Misuse, Who is more at risk?

Based on the article: Sukhmeet Singh, Liz Forty, Arianna di Florio, Katherine Gordon-Smith, Ian Jones, Nick Craddock, Lisa Jones and Daniel J. Smith, Affective temperaments and concomitant alcohol use disorders […]

Medical research: Time to think differently about diabetes

Wow, this is quite amazing. Diabetic people who get bariatric surgery don’t need to be on insulin anymore. This is more than just the effect of the following weight loss. Changes to GI anatomy can directly influence glucose homeostasis! Quite amazing. GI surgery can cure diabetes! 

Wouldn’t it be wonderful if they found knee replacement operations cured bipolar disorder 🙃🙃

http://www.nature.com/news/medical-research-time-to-think-differently-about-diabetes-1.19955?WT.mc_id=FBK_NatureNewsClinical guidelines published this week1 announce what may be the most radical change in the treatment of type 2 diabetes for almost a century. Appearing in Diabetes Care, a journal of the American Diabetes Association, and endorsed by 45 professional societies around the world, the guidelines propose that surgery involving the manipulation of the stomach or intestine be considered as a standard treatment option for appropriate candidates. This development follows multiple clinical trials showing that gastrointestinal surgery can improve blood-sugar levels more effectively than any lifestyle or pharmaceutical intervention, and even lead to long-term remission of the diseases. 

As someone who has been investigating the link between gastrointestinal surgery and glucose homeostasis since the late 1990s (see ‘Surgical breakthrough’), I have witnessed first-hand how getting to this point has required many clinical scientists to put aside long-standing preconceptions. Indeed, the guidelines come nearly 100 years after the first clinical observations that diabetes could be improved or even resolved by a surgical operation (see ‘A long road’)2. The evidence that surgery can prompt the remission of a disease that has long been considered irreversible could bolster searches for what causes diabetes and even reinvigorate hopes to find a cure. But future progress will require more thinking outside the box.

Surgical breakthrough
In 1925, a report in The Lancet2 described a ‘side effect’ of a gastrointestinal operation to treat a peptic ulcer. This was the almost overnight resolution of an excess of sugar in the urine (glycosuria) — the chief symptom of diabetes at the time. Similar observations were reported in subsequent decades and became more common after the advent of bariatric or weight-loss surgery in the mid 1950s, which led to more people with diabetes receiving these types of operations. And during the 1980s and 1990s, resolution of diabetes after bariatric surgery was noted on many occasions, including in a landmark report involving more than 120 patients9.
In 1999, while working as a research fellow at Mount Sinai School of Medicine in New York City, I stumbled across a report showing that nearly all people with type 2 diabetes who had undergone a complex bariatric operation (biliopancreatic diversion) had completely normal blood-sugar levels as early as one month after surgery. They had been able to stop taking medication and come off a low-calorie diet. I wondered whether gastrointestinal surgery could influence diabetes directly. If so, surgery could be used to treat diabetes or to understand how it works.
The next day, I persuaded my mentor to seek approval from the institutional review board to run trials in humans. Failing to obtain approval, we turned to rats to investigate whether a modified form of gastric-bypass surgery could directly influence glucose homeostasis. Our experiments confirmed that it could, although it took us more than two years to publish the findings. 
In 2006 and 2007, surgical teams showed that the operation had the same effect in humans, and other groups began to investigate the molecular mechanisms that might be responsible. On the back of these studies, a multidisciplinary group of leading clinicians and scientists at the first Diabetes Surgery Summit in 2007 reviewed the preliminary mechanistic and clinical data available on the effects of surgery on diabetes and established an agenda for research priorities. The summit inspired the randomized clinical trials that now provide the evidence supporting a role of surgery in diabetes. In September 2015, the introduction of surgery into standard care for type 2 diabetes was formally recommended by the participants of the second Diabetes Surgery Summit. 
Clinical shift
The number of adults around the world with diabetes quadrupled from 108 million in 1980 to 422 million in 2014 (ref. 3). About 90% of these people have type 2 diabetes — a major cause of kidney failure, blindness, nerve damage, amputations, heart attack and stroke. Fewer than 50% of people with type 2 diabetes control their blood-sugar levels adequately by changing their diet or exercise regime, or by taking drugs.

Bariatric or weight-loss surgery refers to various procedures. Surgeons may, for instance, remove a portion of the person’s stomach or divide the stomach into two and reroute the small intestine to the upper part (see ‘Gastric bypass’). Since the mid 1950s, people whose body mass index (BMI) is greater than 40 have received bariatric surgery to induce weight loss. Many of these people also had diabetes. The new guidelines advise that such procedures (metabolic surgery) be considered specifically for the treatment of diabetes in people who have not adequately controlled their blood-sugar levels through other means, and whose BMI is greater than 30 (or 27.5 for people of Asian descent). Perhaps more significantly, they also state that the gastrointestinal tract is an appropriate biological target for interventions designed to treat diabetes. 
These recommendations arguably signify the most radical departure from mainstream approaches to the management of diabetes since the introduction of insulin in the 1920s. They are based on findings from a large body of work, including 11 randomized clinical trials conducted over the past decade1. In these studies, most surgically treated people (up to 80% in a recent 5-year follow-up4 of a randomized trial) fall into one of two categories. Either their diabetes goes into apparent remission or their blood-sugar levels can be stabilized using reduced medication or exercise and a calorie-controlled diet (see ‘Big benefits’).
Non-randomized studies, involving people receiving surgery and matched subjects treated with standard interventions, suggest that surgery may also reduce heart attacks, stroke and diabetes-related mortality1. And several economic analyses suggest that the costs of surgery (roughly US$20,000–25,000 per procedure in the United States) may be recouped within 2 years through reduced spending on medication and care. 

  • The effects of surgery on diabetes are dramatic. Yet it has taken nearly a century to unearth them since observations of major improvement or remission of diabetes after surgical operations were first reported. 

Having a wonderful time with my son, but…

I’m still in Buffalo, spending really wonderful days with my son. I am so happy that I am able to do this. We’ve had a graduation, parties, and dinners, and the Stanley Cup Playoffs, and movies and shooting bows and arrows, and wonderful conversations and meals. And I know I am one lucky mom because I have such a great relationship with my son!

But this Friday, I’ll be going back to Louisville, and that’s where the “but” comes in. That’s when I know I’ll look at all these pictures and miss my son very much and fear that something may go wrong and miss him, miss him, and miss him some more. Ugh… is that what being a mother means, or are my emotions more extreme because of bipolar disorder? I know some moms who miss their children just as much as I do and they don’t have even one symptom of bipolar disorder. I think it is just being a mom, you give birth to these helpless little infants. You heart just breaks seeing how little and adorable they are, you take care of them and love them unconditionally, your primary role is mother, at least for 18 years. Then they leave for college and your heart breaks for the absence of them. Of course you’re happy they’re on their way to an independent life, you wouldn’t have it any other way, but… and here’s that but again. But, as happy as you are that your babies are growing up, your heart breaks that you are not a family anymore, that you are no longer a hands on mom, and you miss your children no matter how old and accomplished they get, you just miss them.

Well, I’m telling myself right now to start preparing for the low next week, but also to remember I will most likely be back in July:-) so it won’t be too much of a low.  And writing this out helps, because it reminds me that nothing is as bad as my mind sometimes makes it out to be. Writing therapy! Also why writing a journal is exceptionally helpful. Here’s to all the moms out there who love their children, may we be loving, happy, and healthy, and so may our wonderful children!

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Cooked OUT

Two cookouts in two days. Pardon my crassness but I am burping charcoal flavor and don’t care if I ever eat another hot dog or burger cooked on anyone’s grill, ever.

Today was not one of my finer days. I was anxious, worn out (people do it to me every time) and my kid had the devil girls here, playing inside. Three of them all bickering, tantrums, tattletelling…On my last nerve. I was gonna be nice and ask their dad if they could come to the cookout with Spook so she’d have playmates. NOPE. They couldn’t even play Uno without drama. Then the three of them started bawling and no longer like me. I’m crushed. The worst came when my kid told me J had said she hopes “Niki lives in hell”. I went to scold her and it turns out…my snowflake was the one who said it, not the devil girls. She LIED on her own friend and acted like it was nothing.

I sent them home. End of my rope, plus she deserved punishment for lying. Also, she told me to apologize to them and um…No. I am the adult. Those brats have cost me $20 in food and bottled water this week and most of that was them just grabbing shit before I could stop them. GRRR. Being nice does not pay because people just take and take. And what kind of whackadoodles are raising these greedy ungrateful bundles of demands? I know, same complaint for four years now, I need to grow up and OWN being the adult.

My kid puts me in an impossible situation over and over again. I offered her lunch before the girls got here today. She wasn’t hungry. Second they get here, she’s starving and so are her friends and I can’t feed her in front of them without offering them something (another one of my mother’s charming edicts she pounded into my skull) and bam…Twenty dollars in a week on kids that are not mine.

Why do people have to ruin everything? I try to be a decent person, pass out popsicles on a hot day, and all I get in return is this “you owe us” mentality. No amount of correction changes any of their heads, least of all my own.

Tonight I stuck to my guns and didn’t let her play when B came knocking. She’s pissed at me that J and A never did come back and were, in fact, playing at the new neighbor’s house. Good riddance.

I am so damned frustrated. Saturday I was on an even keel, the kids weren’t annoying me at all, I felt pretty damned good minus some gastric agony that prevented me from hitting some yard sales. (week two of missing them, that’s gotta be the depression’s lingering grip.) I want my state of mind from Saturday back. I don’t like being grouchy and irate and annoyed.

But these trailer park kids could push a saint to homicide.

In other news…I did not need to cremate my dad with the dragon-a-q.  We just didn’t discuss either car. I had a moment of sheer panic when my nephew, who was heir apparent to that Buick even though he has his mom willing to get a loan and help buy him something better if he ever gets his license…he kept asking me how much I wanted for it. Like, bitch, please. Mom gave it to me and I am not letting that car go until it is pried from my cold dead hands or ceases to run. Just makes me leery cos my mom has a tendency to cave when Little Lord Fauntleroy is involved. She’d throw me under the bus in a heartbeat if he hit the right manipulation buttons.

So…Friday cannot come soon enough. Once that car is in my name, I won’t have to worry about that drama bullshit. I’m a mom with a kid, I need a car a hell of a lot more than a 17 year old who’s not finished high school and has no job. In fact, today, one of my sister’s friends offered nephew C money to babysit her 8 year old son…And C said, “Oh, I can do it, I just don’t get up until after ten or eleven.” REALLY? You want money but the employer has to work around your “stayed up all night playing video games” schedule?

Maddening people, my family. Sadly, I know July 4th they will probably have another shindig, plus stepmonster and my brother’s birthdays are in July so that will be a fucking drama.

I want the meds to kick in and MAKE me look forward to all this shit.

Or at least make it seem like less of a chore.

I just can’t do the heat and sunlight very well. The lithium is an issue with sunlight and it’s not even staying hydrated. It’s like instead of feeling warmth, my skin feels sunburned. Now from what I’ve Googled the party line is that Lithium does not cause any photosensitivity. Yet a few years back I had a doctor who advised me to stay out of the sun for more than short bursts plus drink plenty of water because sweating could alter the lithium level in my blood. Anyway, I made a comment about the lithium and  sunlight making my skin feel burned and my dad sneered, “Oh, you poor baby….” Prick, serious shit can happen from this stuff…

I am so sick of ten different pieces of advice from ten different doctors. I am especially sick of the internet and its forums pushing information that’s simply not true or unestablished. Like lithium not causing photosensitivity. Yet it’s in the manufacturer list even though it was reported in less than 1% of patients.

Makes me want to flush all the pills (let the sewer crocodiles get stoned on lithium) and treat myself with whiskey and coke. No shocker on what happens there. You get buzzed, you puke, you get hungover and pray for death…then do it all over again.

With these meds…I don’t know whether to believe Dr. C or Dr. M or Dr.B…they all tell me different things about the same medication.

Guess I am stuck with current doc’s party line.

And now I am gonna go back to watching Hemlock Grove because werewolves are a lot less scary than trying to count all the mood swings this med increase has induced.


Latuda

Recently my doctor increased my Latuda to 80mg up from 60mg.  I didn’t connect the fact that the Latuda and these horrible hot flashes I’ve been having were connected. Well since it has gotten worse since the increase I am going to say it is definitely from the Latuda.

The thing is it’s working for me. I’m less depressed but more anxious. I also think that’s related so I don’t know what to do about it. I hope that both pass as I get used to the drug being in my system.

If you’ve never had a hot flash then you have no idea how horrible it makes you feel. You are all of a sudden on fire, it’s so hot it make’s you nauseated. It feel like it it never going to end but then it does and you are completely soaked head to toe in sweat. I feel consistantly sticky all the time. My dogs love it though cause I’m salty. I hope they pass or there is something that will help cause I don’t want to give up the Latuda.


I’m a Good Daughter, I Promise


Filed under: Alcoholism, Bipolar Disorder, Dementia, Family, Stroke Tagged: alcohol related dementia, aphasia, caregiving, dysphagia, guilt, memory care, vascular dementia

Catharsis


Filed under: Bipolar Disorder, Dementia, Family, Mental Health, Stroke Tagged: aging, alcohol related dementia, anxiety, aphasia, caregiving, emotional catharsis, memory care