The above picture, and every one I use in this post, are from “What the World Eats”. It’s a nifty little photo book from Faith D’Alusio that documents what families around the world eat in a week. Faith knows that food is an ideal window through which to explore cultural differences. It’s a delight. Moving on…
I want to start by saying the case of Baby Joseph is heartbreaking.
This little boy, only fifteen months old, is suffering from a terminal illness. He’s going to die. His Canadian doctors said if the boy was taken off a ventilator at at his most recent hospitalization, he would die. Those doctors refused to perform a tracheotomy on him. So the parents started asking doctors in the US for help. The Children’s Hospital in Detroit was among those that said no. SSM Cardinal Glennon Children’s Medical Center in Saint Louis said yes.
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Up to it, down to it, fuck bitches that don’t do it, we do it cause we use to it, now lift motherfucker, lift. In lifting as in drinking, mantras help. Now chug that wheatgrass shot like a real woman and lift wit yo legs, gurl.
I’m assuming you’re now drunk on anti-oxidants? Which doesn’t mesh with the pain in your thighs and have got you feeling ornery? Good, I’ll get some honest dirt out of you!
Welcome to the Super Squats Club. Your weekly corner to track your (non) workouts, bitch about Becky from Boot Camp, and share the latest (safe) dieting dirt with the snarkiest fools around. Might as well enjoy workout hell. The latest Harvard Business Weekly reports that 70% of winning the interwebz is looking good. We’re on a mission critical assignment here.
One rule to remember, people get sensitive bout their fitness –ish so be nice! It’s like discussing my momma…I may call her Sloppy Cunt but it’s Ms. Jackson to you.
You in? And with that, we’re off. I may bring friends next week if you’re good!
Author’s Note: It has been brought to my attention by an insightful reader that this post could be perceived as presenting psychiatric maxims and advice. I want to be clear for anyone reading this that I have no psychiatric or medical training. This post is written purely from the perspective of a layperson with bipolar disorder and is not intended to diagnose, treat or judge any illness or disorder. I apologize retroactively for any lack of clarity on my part.
In a recent Crasstalk comment thread, I made the mistake of writing the sentence “Catherine Zeta Jones is pretending to be in rehab for bipolar disorder.” Although it was certainly not my intention, my very poor choice of words made it seem that I was flippantly saying that Ms. Jones was faking her illness. Perhaps my comment is even worse considering that I do know much better than to make light (even unintentionally) of serious matters.
In hindsight, I know that I should have clarified my point by writing, “Catherine Zeta Jones’ publicist says that she is in rehab for bipolar disorder.” The point I was trying to make is that for an A-list actor, the stigma of admitting to treatment in a psychiatric facility is far greater than the stigma associated with going to rehab. My theory is that drug addicts – regardless of the severity of their addiction – can always say their behavior was a result of temporary weakness, whereas people with mental illness are often viewed as inherently and irrevocably defective. Chemical imbalances in the brain that must be treated with medication are deemed far worse than chemical imbalances in the body that require medication.
Ms. Jones has been diagnosed with bipolar II disorder, which is markedly different from bipolar I. (Bipolar II is characterized by more lows than highs, and the highs are rarely manic. Bipolar I is characterized by less severe lows and intermittent manic highs.) But I think the media lumps the two together because it’s more “exciting” to potentially have a manic-behaving celebrity, as in the case of Britney Spears’ paparazzi-fueled meltdown and hospitalization. But regardless, I think that arguing over degrees of mental illness is both missing the point and enhancing the stigma. I also think that the media’s tendency to publicly “out” people as being bipolar – even if they are exhibiting clear symptoms of the disorder – is victim-shaming at its worst. (Charlie Sheen comes to mind.)
Not every celebrity can be as open as, say, Carrie Fisher, who publicly talks about taking 8 different meds to manage her bipolar I disorder. I can understand a famous person not wanting to be painted with the mental illness brush. I think Catherine Zeta Jones is to be admired for acknowledging it. Of course, the extenuating circumstances of the personal stress she’s been under have clearly been a factor, but she could have instead chosen to say that she was suffering from exhaustion and face far less public scrutiny.
The brouhaha which my crass comment regarding Ms. Jones created in the comments has made me rethink my own situation. Despite my ebullient friendliness online, in many ways, I am a private person. I didn’t want to offer up as a defense for my remarks the fact that I have bipolar I disorder, because I didn’t want to be perceived as (1) insane, (2) self-hating or (3) unsupportive of other bipolar people, none of which is the case at all. I was merely recognizing the social stigma of the disorder – a stigma so great that it leads to inpatient psychiatric care being euphemistically referred to as rehab, and creates a hierarchy between “good” bipolar (II) and “bad” bipolar (I).
Having dealt with bipolar disorder consistently for eleven years (I was diagnosed a decade earlier) I can tell you that it’s challenging at times, but as long as I’m on top of things, I can consciously forestall circumstances spiraling out of my control. I take only one medication and manage my moods and thoughts quite diligently. Sleep is the best leveler I know of, and I make a concerted effort to keep my body healthy and balanced in all other ways as well. Bipolar disorder does not have to be a dramatic, violent life-interruptor, although mania is often portrayed that way on TV and in movies. It helps to have supportive people in your life; everyone close to me is well aware that I am bipolar, and my family and closest friends don’t judge me for it.
It is my intention to clear up the misunderstanding I created by offering a piece of my personal experience. It is obviously my hope that those reading this will open their minds to the possibility that bipolar disorder – and mental illness in general – is not the death sentence many people have been led to believe. There are varying degrees of the disorder, and I know that I am fortunate to have a milder version of bipolar I. Rather than look at it as a curse, I prefer to look at it the way Jimi Hendrix did: “Manic depression is touching my soul.”
UPDATE: bens made a fantastic — and crucial — comment that deserves to be in the body of this post. He offered some explicit clarification regarding the connection between drug abuse and mental illness that I had completely missed. Here is his comment in its entirety:
Drug addiction is a mental illness. You are mentally ill if you are a drug addict, plain and simple. Not everybody who goes to rehab or goes to a psychiatric facility for “drug addiction” is a drug addict, but for those who are genuine drug addicts there’s no way you can say its not a mental illness.
And then you get to the problem whereby many different mental illnesses mimic symptoms. You could be doing drugs because you’re depressed, have bipolar disorder, have a geniune addiction to drugs, because you’re self medicating anxiety symptoms, etc. There’s a lot of overlap and misdiagnosis.
The first thing anyone will tell a patient seeking help at a rehab is that “you can’t easily put the toothpaste back in the tube.” Its something that doesn’t go away.
For CZJ, she probably went to a dual-diagnosis rehab, to get the appropriate level of care. She’s most likely abusing substances, hence the rehab. Just going to a psych facility not tailored to treat her addiction would only be treating part of the problem.
Last month the California Public Utilities Commission issued a ruling that limited the powers of Pacific Gas and Electric in dictating the kinds of technology customers were required to have in their home. At issue were Smart Meters, a digital monitoring technology that allows the PG&E to more accurately monitor gas and electricity usage and reduce the need for manual meter readings. The utility company has already installed thousands of the meters in Northern California, and plans to roll out thousands more over the next few years. PG&E claims that the meters will be more efficient than traditional meters and will allow for more sensitive pricing which will increase efficiency in energy use. Now because of the ruling, PG&E must offer different metering alternatives for customers who do not want smart meters.
However, critics argue that the meters are a health hazard and violate customer privacy. Opponents of the meters assert that the meters cause headaches, heart problems, insomnia, and nausea because of the communication technology used to transmit data from the home to the power company. Smart meters are wireless devices that emit small amounts of electromagnetic radiation when they transmit. This raises protests from people who consider themselves “electrosensitive.” According to advocacy groups for the electrosensitive, radio and microwaves, even in trace amounts, cause certain people to become ill when exposed to technology like smart meters.
However, the problem with these arguments is that smart meters have been found to be well with in guidelines for safe usage in homes and businesses. While there are legitimate concerns about wireless technology (particularly cell phones), there has been no conclusive evidence that wireless technology is unsafe in any way. The issues found with cell phones are only when the phones are within centimeters of the brain and smart meters are installed on the exterior of buildings, well away from where people keep their brains. Furthermore, there is simply no evidence that electrosensitivity exists at all. While opponents of smart meters provide anecdotal evidence, there is simply no science to back up the claim that radio waves make you sick.
The conflict over smart meters is nothing new. It is the same fear advanced by opponents to radio and cell phone towers, as well as electric power lines. There is no evidence that any of those things make you sick either, but that has not stopped opposition from the public to these forms of technology. The reality is that the concerns of a few misinformed but well-meaning people are stopping the universal adoption of smarter energy policy. These efforts may be crucial in our struggle to make efficient energy policies and reduce the impacts of global climate change, which could kill lots of people through increased skin cancer rates, decreased food production, or geographic displacement. In a desire to stay personally healthy these individuals may not be able to see the technology forests for the trees, and may be missing the long term risks of bad energy practices. While PG&E has no choice to accommodate its customers, this issue underscores the need for a wider public discussion about emerging technologies and about what constitutes good public science and policy.
Have you heard of reflexology? It’s the fake alternative medical practice where a hippie holistic practitioner rubs the bottoms of your feet and magically heals you…. because you obviously are a moron who never realized that all your vital organs are connected to the soles of your feet. Yes, people actually believe in this.
Well apparently the reflexologists have their own cartel trade organization that wants to prevent the scourge of unlicensed foot rubbers from ever harming the good people of New York.
State Sen. Martin Golden and a handful of other lawmakers got what looked suspiciously like foot massages in the cavernous lobby of the Legislative Office Building.
“They are looking for some of our brains,” Golden (R-Brooklyn) quipped as a member of the New York State Reflexology Association rubbed down his bare feet.
“We are finding out all about reflexology,” Golden added as he sat back in a reclining chair with his feet lifted above his head.
Reflexology, for those who don’t know, is defined as the “systematic application of alternating pressure by the use of the practitioner’s hands, thumbs and fingers to reflex points on an individual’s hands, feet, face or ears.” It is promoted primarily as a stress reduction technique.
The group was in Albany pushing for passage of an Assembly bill that would require licensing of reflexologists and set competence standards
First of all, let’s get one thing straight. Reflexology is complete bullshit with absolutely no scientific evidence to back it up. Accupuncture and yoga, this ain’t.
And it would also be nice if legislators would be a little more skeptical when a trade organization wants to require licensing. Sorry, but they don’t want licensing because they’re oh so concerned about public safety. It’s because they want to restrict competition by increasing the barriers to entry. There is simply no logical reason to impose higher foot rubbing costs on society under the guise of public wellness.
Or as Matt Yglesias put it: “Another day, another spurious occupational licensing effort.”
The most awkward and painful discussions health professionals have is the conversation about end of life care. Working in Geriatrics, I often have this conversation with family members or even friends of patients who are not able to make their own decisions. Even in the best of circumstances, when the patient’s wishes are generally known, it is a difficult call to make. In the absence of any idea of what that person may have wanted, it can be heart-wrenching. In America, which is an especially ‘death denying’ culture, most people don’t want to think about, never mind plan for, their own death. But without clear Advanced Directives and and a Health Care Proxy you can trust, you risk having your final days be everything you never wanted – including a protracted, bitter battle amongst family members, a la Terri Schiavo.
The first thing you must do is admit that you will die. And it may not happen the way you would like or when you expect. You may become incapacitated for a period of time before death and be unable to direct your care or make decisions. This may happen from an accident or a heart attack or stroke. You may also develop dementia or another neurological condition that impairs your cognition. Any of these situations may happen at any time, so even if you think you are too young to think about this – you’re not.
Secondly, you must find a Health Care Proxy. A Health Care Proxy (HCP) is a person you appoint to make decisions about your care on your behalf. It is, in most cases, extremely simple to do this. Your doctor or hospital will have forms or you can find the forms on the internet. You simply fill out the forms, have them signed and witnessed and give copies to your HCP and your alternate, your health care provider, attorney and/or any one else who will be available to provide these forms to your medical providers if you become ill. There are also online registries, which for a fee, will archive your HCP paperwork or Living Will. Generally speaking, without an HCP, most hospitals and facilities will default decision making to your next of kin. However, that can easily get sticky and complicated should there be disagreement among family members or if long term relationships are not recognized by the laws of the state in which you become ill and seek care. It is not unheard of for facilities to seek to have a legal guardian appointed, should the family situation become unstable. Then you may end up with a stranger making decisions for you.
I will note here as well, that you do not have to appoint your legal next of kin as HCP. If you are not appointing your spouse, I would recommend that you have that discussion with them and involve an attorney in drawing up the papers.
Choosing an HCP should be done with care. You want to pick someone who will follow your wishes. It is important to note that your HCP does not have to abide by your wishes. The HCP you choose should understand and accept your wishes regarding end of life care and promise to act accordingly – even if your medical providers or other family/friends do not agree and pressure them to act otherwise. Also make sure you are using the appropriate paperwork for the state in which you reside or frequent. State requirements for HCP and Advanced Directives do vary. If you travel frequently, a trip to an estate attorney may be in order to obtain a durable power of attorney for healthcare decisions that will be iron clad wherever you roam.
Which brings us to Advanced Directives. I will go into great detail about all the decisions you will need to make in my next post. As a general overview, Advanced Directives are your written wishes about what kind of care you would want if you were unable to make your own decisions. The more specific, the better. Simply saying ‘no heroic measures’ is way too open to interpretation. In my next post, I will review the options and share with you my own Advanced Directives document.
The problem with Advanced Directives, however, is that they do not carry the force of law. It is simply a statement that you make regarding your philosophy of care for yourself. I have unfortunately seen clearly written and properly notarized Advanced Directives ignored, because the HCP or legal guardian had different ideas. But don’t let that stop you from writing them! The more information that is out there about what you want, the better. And all the more reason to pick your HCP with care and discuss your wishes with them
You don’t need an attorney to fill out paperwork for an HCP, however if your situation is complicated (e.g., not appointing your spouse, same sex couple in most states, long term unmarried couples) you may want to consult an estate attorney. It’s also a good idea to appoint someone to be responsible for your finances as well and draw up a will while you’re there.
My next post will explore the decisions you need to make – DNRs, feeding tubes, etc. Also, please let me know if there is any other information you would like to know.
Cartoon from jakejacob.blogspot.com.
UPDATE: I fixed the linkies.
As we all should know by now, after my minor freak-outs in various open threads, our government is currently doing some pretty shitty things regarding our reproductive health! And if you didn’t know that, well, let me tell you, in listicle form! Everybody loves listicles.
Children of the Corn Syrup by Dana Ellyn
A new study being published in the March edition of Diabetes, Obesity, and Metabolism finds that glucose and fructose are not treated the same by the brain. This flies in the face of the ‘Corn Sugar’ Industry’s claims of “It’s just sugar, Sugar.”