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The Only Way Out Of The Fog Is Through It

We all go through it: Something upsets us so much that we go into a fog; unable to function when we’re still required to do so. It rises up like a brick wall.

Mood music:

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We smash into it a few too many times and go through the rest of the day dazed and confused. It’s a natural reaction to life’s more stressful and traumatic moments.

If a loved one is sick or dead, or you get into a huge fight with your spouse, or you just discover you’ve been robbed, the feeling hits you.

But what do you do when that feeling clings to you every day like a wet, filthy rag?

I’ve been there many times. It used to cripple me every day. It’s no longer a daily thing, but it still gets me on occasion.

Monday was one of those days; let’s just say it was driven by guilt.

But here’s the difference between now and the old days:

It didn’t incapacitate me and leave me lying half dead on the couch like it used to. I didn’t check out of the hotel of reality. I may have wanted to, but I didn’t.

I felt every bad feeling and it did stick in my brain all day like a splinter. But somehow, I was able to make it through the day. I got my work done, I got chores done and I was even able to focus on the not-always-easy task of helping Duncan do his homework.

I can point to a lot of things that make the difference today:

—Medication to control my OCD, ADD and the depression that comes with it;

–Regular visits to the therapist to get things off my chest; and

–An eating program devoid of flour and sugar. When I’m not sinking under the weight of a food binge, my thinking is clearer.

I don’t think it’s possible to avoid the fog altogether. Life is too unpredictable and dramatic for that. Sometimes the stresses get the better of you and you lose sight of everything around you. It’s a very shitty place to be.

But there is a positive in this: If you never felt the fog, it would mean you didn’t care about anything or anyone.

You would see clearly and keep walking, but the destination would always be some selfish pursuit.

Some of this may sound a bit hyperbolic. I use some fancy language along the way to explain it.

But that’s how my brain rolls this morning.

“Heartsign,” by EddieTheYeti

Heartsign_by_EddieTheYeti

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ALS Ice Bucket Challenge: Dumb Stunt or Change Agent?

Like pretty much everyone else on Facebook, my news feed has been full of videos of friends and relatives dumping a bucket of ice on their heads to raise awareness of ALS and money for research that may one day lead to better treatment.

Some people have suggested this is a useless exercise, something people are doing so friends on Facebook can say, “Wow, look how awesome that person is.”

Is that so?

Mood music:

For some people, probably.

According to one local ALS Association chapter, the challenge calls for people to get doused with buckets of ice water on video, posting that video to social media, and then nominating others to do the same, all to raise ALS awareness. Those who refuse to take the challenge are asked to make a donation to the ALS charity of their choice.

I’m certainly for raising awareness of ALS, a terrible disease that has killed people I know and left families devastated. If people dousing themselves gets others to take it more seriously, I’m for that. I’m for raising money to fight it even more.

And I’ll admit that I enjoy watching friends and relatives doing this on video. It’s harmless fun.

Like all awareness causes, I’d like to see more.

People in these videos say they’re raising awareness, but many of them aren’t talking about the disease itself. Some are, but most are just announcing what they’re doing and dousing themselves.

To make this a more effective exercise, I suggest people throw in some dialogue. Tell us about people you know who have suffered at the hands of ALS. Give us some statistics of how many people are afflicted each year and how many die from it. Shed some light on what the research money is being used for.

Nothing raises awareness like details.

If people are filming themselves performing the stunt instead of donating, then it’s a hollow deed that fuels the argument that there’s some narcissism at work.

In the big picture, though, I think people have their hearts in the right place, and they seem to be getting results.

The ALS Association says it raised $1.35 million nationally from July 29 to August 11. A spokesperson for the association told Fox News they raised $22,000 during the same period in 2013.

So keep dumping the ice on your head. And add some personal stories to your videos to make the tragedy of ALS more real.

UMass leaders take the Ice Bucket challenge. Photo from CBS NewsUMass Medical School Chancellor Michael Collins and Chair and Professor of Neurology Robert H. Brown Jr., DPhil, MD, accept the Ice Bucket Challenge. Photo from CBS News.

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Find Yourself a Real Doctor

Written in June, 2010.

Here’s the thing: Asking me for medical advice is like asking Charles Manson how to be a pacifist.

Mood music:

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In the months since I started this blog, I’ve noticed something expected but weird nonetheless:

People are coming to me for medical advice.

Several people who saw my post on living with Crohn’s Disease sent me their phone numbers and asked me to call them. I always do, and the person at the other end will start listing a bunch of issues they’re having and asking me what I think.

In one of my posts about the binge eating addiction I mentioned that at the deepest depths of the addiction I would get chest pains and wake up in the middle of the night puking up stomach acid. Someone wanted to talk about how that’s been happening to them.

Then there’s the OCD itself. People will approach me in droves about their issues and how they think they might have OCD or some other mental disorder.

To be clear, I’m not putting down those who have come to me with this stuff. I respect them all and am glad they feel they can talk to me. Sometimes talking about your problems in and of itself is a huge step on the road to dealing with it. I’m more than happy to help. Heck, that’s one of the reasons I started this blog.

But before we go any further, I just want everyone to remember that I’m not a doctor and no two sufferers are the same.

I’m the last person you want to go to for a medical advice. That would be like going to Charles Manson for a better understanding of law and order.

It’s natural to ask someone who has been through something you think you might have for advice before seeking out a doctor. I’ve done it many times myself. The thought of seeing a doctor and going for a bunch of tests is scary.

But it’s necessary.

Had I not found the right doctors along the way, I’d be in bad shape today, maybe even dead (mentally dead, anyway).

All I have to offer is my personal experiences. I can tell you where I’ve been, what I’ve learned from the experience and how I got to the generally good health I enjoy today. But none of what I tell you will be rooted in medical certainty. There are people out there who have been through very similar experiences as mine. But everyone’s outcome is a bit different, especially when it comes to the treatment methods that work for the individual.

My solution to the binge-eating disorder was Overeaters Anonymous, a rigid food plan devoid of flour and sugar and a 12-step program. The combination has been a life saver for me, but probably wouldn’t work for a lot of other people.

One of my many tools for managing OCD is the drug Prozac. But the same drug will do nothing for the next guy and might even make matters worse.

This is tricky stuff.

And for that, you need a real doctor.

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A Night in the Sleep Lab

I’m a chronic snorer. Hardly a week goes by where I’m not banished to the living room couch at least once for making a racket. My oldest son gleefully tells his buddies that I sound like a “busted chainsaw” at night. Erin has also observed that I sometimes stop breathing for short spurts.

It’s an old problem, and two surgeries to the nose and throat failed to fix it. A hefty weight loss didn’t help much, either.

So last week, I went for a sleep study.

Mood music:

I expected to spend the night in one of your average hospital beds in an average hospital room. Instead, I walked in to discover something not unlike the business-class hotels I frequent. A big flat-screen TV was mounted on the wall, the bed was big and comfortable and the color scheme of the room relaxing, unlike the white, sterile hospital environment I expected.

sleep study

The tech kept an eye on me all night through the camera above the TV.

The technician, John, came in and had me sit in a chair, while he spent the next hour hooking me up with a bunch of electrodes. As he worked, the two of us howled with laughter at the over-the-top drama of The Discovery Channel‘s Shark Week, which played on the TV overhead.

Sleep study 2

The wires that protruded from my head, chest and arms as I slept

Then it was time to retire. I crawled into bed gingerly, worried that I’d knock out some of the wires John had painstakingly attached. I brought the book Black Mass — a must-read about James “Whitey” Bulger’s decades-long reign of terror in Boston — and I got through three pages before I passed out. That’s not unusual. At home, I usually fall asleep after just a few pages of whatever book I’m reading.

Sleep study 3

This bed was damn comfortable.

I only remember John coming into the room once overnight, to tighten an electrode on the chest that had come loose.

He woke me up at 6 a.m. I asked him if I did anything interesting overnight. Did the busted chainsaw make an appearance? “You did snore a bit,” he said, smiling. Did I talk in my sleep, stop breathing or make any bizarre movements? Nope. In fact, he said, I failed to make the top 10 of interesting case studies.

Truth be told, that bummed me out a little bit. First, because that raises the possibility that the real sleep problems I’m having decided not to make an appearance that night. Second, because I don’t like to bore people.

Thursday I’ll get the results of the sleep study. If it proves inconclusive, I may be sent back for another sleep test.

Given the first experience, that wouldn’t bother me at all.

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Why Do Americans Die Sooner?

CNN reports that despite spending more per person on healthcare than any other country, Americans are getting sicker and dying younger than our international peers.

Why is this? Because Americans are too high strung and overworked. You could say the stress is killing us.

Mood music, ironically sung by a couple of Brits:

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Here’s the takeaway from CNN:

Data from 2007 show Americans’ life expectancy is 3.7 years shorter for men and 5.2 years shorter for women than in the leading nations — Switzerland for men and Japan for women.

As of 2011, 27 countries had higher life expectancies at birth than the United States.

“The tragedy is not that the United States is losing a contest with other countries,” the report states, “but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.”

I’ve had conversations about this with friends from Europe, and they always go on about how crazy we Americans are. We respond to job stress by putting in even more hours, trying to keep up with the ever-growing demands of our corporate masters. Some of us now work holidays like Thanksgiving and Christmas. We seek solace from the stress in all the things that are bad for us: Overeating, drinking, pills.

When Erin and I got married, we spent our honeymoon traveling around Ireland. The slower pace of life floored us. They took the first Monday of every month off for a “bank holiday.” In restaurants, people weren’t in a rush to put their orders in. Waitresses would talk for several minutes with patrons before taking down their orders. Accustomed to faster service, Erin and I didn’t like that much. We are, after all, Americans. Rushing ourselves and others is in the blood.

At the time, I was working at least 60 hours a week in a job that paid $28,000 a year. I was a ball of tension, and I comforted myself with food binges. I was 280 pounds on that trip.

I still put a lot into my work today, but it’s different because I love what I do. I’ve also spent a lot of time building a relationship with God, taking a mindfulness class heavy on meditation techniques, and playing guitar. I’ve slowly learned to enjoy life and not rush through it to the next pressure. But I still have a long, long way to go.

I’m not a unique case. Americans put ridiculous amounts of pressure on themselves over trivial things.

To be fair, I know a lot of Europeans who have bad habits and bad health. Americans are simply destroying themselves a little bit faster.

But I also have a lot of American friends who have fought back. One friend is a passionate weight lifter. Another friend does jujitsu. Many of them are now doing yoga. They’ve made radical and necessary changes to their diets. This gives me hope.

We may be dying faster, but in never giving up and trying to better ourselves, we have a pretty good shot at learning to live longer.

Man under job stress

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All You Wanted Was a Pepsi. Instead You Got Drugs

A friend of mine likes to refer to antidepressants as “brain candy.” I hate when he does, because it oversimplifies the very complicated science of mental medication. It’s not about seeing flowers and sunshine where neither exist.

Mood music:

There is this notion that taking antidepressants is a sign of weakness. I come across a lot of people who see the medicine as something to take out of desperation and to get off of as soon as possible.

There are very legitimate reasons to want off of the drug prescribed to you. The most obvious is that sometimes the drug doesn’t work. I know plenty of people who have tried a litany of medications without success. I can’t blame them for wanting to be done with them. One friend has tried every antidepressant under the sun and still struggles with crippling depression.

Another good reason is that some of these drugs have side effects that the patient just can’t live with, like excessive weight gain or loss, headaches, acne or loss of one’s libido.

To learn about how antidepressants work, read “The Engine” and “Serotonin, Dopamine and Two Blue Pills.”

But if you and your doctor manage to find something that works and you get obsessed with getting off that drug simply because you don’t like the idea of needing it, that’s foolish.

It’s easy for me to say that because I’ve been fairly lucky. Prozac was the first drug I tired and it started working within a couple weeks. When it first kicked in, I felt like it was the first time I truly felt comfortable in my own skin. I’ve still had bouts of depression, especially during winter, and dosage adjustments have been required. This past January, I went on Wellbutrin as well, the idea being that it would help the Prozac work better. It worked. I either have a powerful army of guardian angels looking out for me or am just insanely lucky.

But I’m not a special case, either. I know plenty of people, including the friend I mentioned at the start of this post, who have gotten good results but wanted off as soon as possible.

If I thought I could manage my own issues without the drugs, I’d want off, too. But I don’t think I’m there yet. Not even close.

My attitude is simple: As long as the drugs work, I’m going to keep taking them. It’s better than feeling fear and anxiety again. It’s better than being a miserable bastard whose a beast to his family, friends and colleagues.

If I have to take the medicine for the rest of my life, so be it.

Those who want off the drugs simply because they fear the stigmas or feel weak if they can’t manage without it are barking up the wrong tree.

Stop worrying about your destination and focus on the journey instead.

Brain Lollipops

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Exeter Hospital: Stop Making Excuses and Test Employees for Hepatitis C

An open letter to New Hampshire’s Exeter Hospital.

To Whom It May Concern:

You may find the outrage I’m about to unleash unfair. But the Hepatitis C scare caused by your lax security has threatened someone I love and thousands of others. I spent my childhood in and out of the hospital, getting stuck with needles weekly and sometimes daily. I had a blood transfusion in the 1970s, before blood was tested for AIDS contamination, so I know the fear many of your patients feel right now.

Mood music:

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I just read about your clash with state health officials over whether some of your employees should be tested for Hepatitis C along with thousands of your patients. The state is worried that more than one employee was involved in your outbreak because another patient contracted Hep C even though that patient had a procedure at the hospital prior to David Kwiatkowski working there.

State officials are practicing the due diligence you failed to practice when your lax procedures made it easier for Kwiatkowski to steal drugs and leave contaminated needles behind — needles that were then used on your patients. You cite your employees’ right to privacy, which is pathetic. Your first responsibility is to your patients and employees, protecting both from being infected and taking care of them if they become so.

You’re probably thinking, “Who is this jerk to criticize us? We’re the hospital that blew the whistle on Kwiatkowski when hospitals across the country had failed to contact the police after he was caught doing the same thing in their facilities.”

I do give you credit for blowing the whistle, and I agree this isn’t just about your hospital. The entire system failed to protect the public from this monster. Hopefully, this will lead to better reporting in and more cooperation between all states.

That doesn’t absolve you of all responsibility. The Centers for Medicare & Medicaid Services found that you “failed to follow standard procedures for preventing the abuse of powerful narcotics administered by staff,” according to an Exeter Patch article. Their investigation found that drugs were not secured to prevent theft by employees who should not have had access to them, among other violations. Your president and CEO, Kevin J. Callahan, failed to apologize for this when he was busy writing a letter to the editor about how proud he was of his institution’s response to the crisis.

Now you balk at the state’s plan to test other employees because of their right to privacy? Give me a break. What about their health?

As I sit here waiting to learn if my relative has Hepatitis C or not, the last thing on my mind is the privacy of your employees. Do I think most of them are excellent at what they do and free of blame here? Absolutely.

But when there’s a danger of Hepatitis C spreading further, you have to stop complaining and roll up your sleeves.

For the sake of your patients and your employees, let state health officials do their job.

Sincerely,

Bill Brenner

Kwiatkowski Exeter Hospital Mashup

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Exeter Hospital’s Hepatitis C Scare Hits Close to Home

David Kwiatkowski made national news for spreading Hepatitis C to patients at Exeter Hospital in N.H. He worked his way across the country, getting fired from several hospitals but escaping arrest until officials at Exeter blew the whistle. The story hits too close to home, as a relative was potentially exposed during an ER visit there last fall.

Mood music:

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To date, 31 patients have tested positive for Hepatitus C. The hospital realized something was horribly wrong after a cluster of patients from the Cardiac Catheterization Unit Kwiatkowski was assigned to were diagnosed with the potentially life-threatening disease.

According to Exeter Patch, The Centers for Medicare & Medicaid Services found that the hospital “failed to follow standard procedures for preventing the abuse of powerful narcotics administered by staff.” The investigation found drugs were not secured to prevent theft by employees who should not have had access to them, among other violations, the publication said.

Exeter Hospital President and CEO Kevin J. Callahan defended the hospital in a letter to the editor in the Union-Leader, saying, among other things, “I am proud of the way our staff has handled this tragic situation. We stopped Mr. Kwiatkowski from working. We immediately notified authorities and we have been assisting investigators ever since.”

Now state health officials have fanned out across the region to test more than 3,000 patients.

A few thoughts:

  • Callahan is right that his staff has acted diligently to deal with the situation, but there’s no apology in his letter. He needs to apologize, because despite the larger problem of Kwiatkowski slipping through the cracks, the hospital still failed to secure its drugs from this sort of thing.
  • The hospital needs to ensure that everyone who caught Hepatitis C is taken care of for life. No hospital bills, no waiting in lines. The hospital’s lax procedures allowed this to happen, and the victims shouldn’t have to pay a cent for their care. If they are charged, they should sue Exeter’s ass off.
  • Hospitals need to rethink how they vet potential employees and, when one is fired for something like this, they should be legally obligated to call the police. I’m sure the inevitable pile of lawsuits will help bring about those requirements.

I want to have have some compassion for Kwiatkowski. Having an addictive personality as I do, I know how your sanity and common sense melt away when you start to itch and twitch at the hands of your addiction. But his actions have put someone I love at risk.

That being the case, I hope he gets the maximum penalty. I suspect I’m not the only one who feels that way.

David Kwiatkowski

David Kwiatkowski
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How to Stop Screwing Your Patients in Four Simple Steps

A colonoscopy I was supposed to have today was abruptly canceled over missing paperwork. Normally I wouldn’t complain about something like this because life happens. But I’m hearing a lot lately about medical offices screwing up and making the patient feel stupid instead of taking responsibility.

Mood music:

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I know people who get scared shitless when they have to go for a procedure. They worry for weeks and just want to get it over with, and when they’re kicked to the curb, it makes their angst 10 times worse.

I used to get that way. I’d obsess for weeks before the colonoscopies I have to have because of the Crohn’s Disease. I’d work myself up into a frenzy about getting the damned thing over with. As a result, a cancellation would send me deep into a depressed fog, and then I’d work myself up into another frenzy for a few more weeks.

Fortunately, I got past the frenzy-depression cycle long ago. I’m deeply annoyed about today’s cancellation, but I’m not in a fog. I was happy to break my fast with an iced coffee from Starbucks and have an extra workday to get things done. But in the process, I’ve had to throw other people’s plans into chaos so that I could get this test rescheduled.

With that, I want medical professionals to understand a few things:

  • If you have to cancel someone’s procedure, it can be traumatic. Don’t be cold and make the patient feel stupid for being upset. Saying “I’m sorry, but …” isn’t good enough. You need to reassure the patient that setbacks like this happen and that everything will work out in the end.
  • Doctors shouldn’t hide behind their staff. If the doctor screws up on paperwork, sending staff to deliver the bad news isn’t enough. The doctor should call the patient and personally apologize. For a patient suffering from anxiety, that small personal gesture can be the thing that helps them reset their expectations.
  • Don’t blame HIPAA. People in the medical profession love blaming everything on HIPPA and other laws. When I noted that the botched paperwork was never necessary before, the medical assistant said new laws had taken affect since the last time I had this procedure. I’ve lost count of the times doctors’ offices held back information under the excuse of HIPPA. I’ve been writing about HIPPA in my day job for eight years, and I know you guys violate HIPAA daily. And there are ways to tell patients what they need to know without violating HIPAA.
  • Don’t save paperwork until the last minute. As I’ve said, life happens. In my case, the specialists couldn’t access needed medical records because my primary care physician was called away on a family emergency. If the specialist had sought the paperwork a week or two ago, this wouldn’t have happened.

If you’re in the medical profession and disagree with anything I’ve just said, tell me why. And spare me the HIPAA excuses.

Doctor's Office

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The Monkey Will ALWAYS Be On Your Back

I’m standing at a bar in Boston with my wife and stepmom. They order wine and I order coffee. My stepmom beams and says something about how awesome it is that I beat my demons.

I appreciate the pride and the sentiment. But it’s also dangerous when someone tells a recovering addict that they’ve pulled the monkey off their back for good.

Mood music:

Here’s the thing about that monkey: You can smack him around, bloody him up and knock him out. But that little fucker is like Michael Myers from the Halloween movies. He won’t die.

Sometimes you can keep him knocked out for a long time, even years. But he always wakes up, ready to kick your ass right back to the compulsive habits that nearly destroyed you before.

That may sound a little dramatic. But it’s the truth, and recovering addicts can never be reminded of this enough.

Dr. Drew had a good segment on the subject last year, when he interviewed Nikki Sixx:

Sixx talked about his addictions and how he always has to be on guard. Dr. Drew followed that up with a line that rings so true: “Your disease is doing push ups right now.”

So painfully true.

I know that as a binge-eating addict following the 12 Steps of Recovery, I can relapse any second. That’s why I have to work my program every day.

But Sixx makes another point I can relate to: Even though he’s been sober for so many years, he still gets absorbed in addictive behavior all the time. The difference is that he gives in to the addiction of being creative. He’s just released his second book and second album with Sixx A.M. Motley Crue still tours and makes new music. He has four kids, a clothing line and so on. He’s always doing something.

I get the same way with my writing. That’s why I write something every day, whether it’s here or for the day job. I’m like a shark, either swimming or drowning. By extension, though I’ve learned to manage the most destructive elements of my OCD,I still let it run a little hot at times — sometimes on purpose. If it fuels creativity and what I create is useful to a few people, it’s worth it.

The danger is that I’ll slip my foot off the middle speed and let the creative urge overshadow things that are more important. I still fall prey to that habit.

And though it’s been well over three years since my last extended binge, my sobriety and abstinence has not been perfect. There have been times where I’ve gotten sloppy, realized it, and pulled back.

But the occasional sloppiness and full-on relapse will always be separated by a paper-thin wall.

I’ll have to keep aware of that until the day I die.

The monkey isn’t going anywhere. My job is to keep him tame most of the time.