The OCD Diaries

August 12, 2013

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.

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.

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.

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.

January 11, 2013

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

November 16, 2012

WebMD’s Symptom Checker: Crack for OCD Heads

WebMD has a fantastic thing called the Symptom Checker. Have a headache and numbness in the toes? Just punch it into the symptom checker and get a diagnosis.

Mood music:

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In the hands of an OCD patient, this thing can provide hours of obsessive-compulsive fun, as you pinpoint every ache and pain in your body and have the Symptom Checker tell you what’s the matter.

The first thing you do is point to parts of a human body displayed in the first column on the page. If the problem area is the abdomen, click there and a list of possible symptoms pop up. Click the different symptoms (bloating, lumps, etc.) to collect them in the second column. The third column gives you a list of possible ailments. Click bloody vomit or vomit that resembles coffee grounds, and a red box pops up telling you to get “emergency medical attention.” Given all the coffee I consume, it’s hard to imagine my vomit not looking like coffee grounds.

Occasionally you’ll get a diagnosis for something you’ve probably never heard of, like Mallory-Weiss Syndrome. This affliction is some pretty serious shit. WebMD describes it this way:

Mallory-Weiss syndrome occurs in the mucous membrane where the esophagus and stomach connect. Vomiting or coughing strongly or for a long period of time can cause the membrane to tear and possibly bleed. Seizures may also cause tearing. People in their 40s or 50s are most likely to have Mallory-Weiss tears, but children can have them, too. Pregnant women are also at risk due to vomiting in the first trimester. Mallory-Weiss tears often heal on their own in a few days. In rare cases, surgery is required. Blood loss is a concern, so get medical care right away.

I get a lot of headaches, so I played around with the Symptom Checker for a while. I already know my trouble stems from sinuses that refuse to drain properly, but WebMD offers a much wider list of possible ailments: brain tumor, brain bleed, and so on. Go back a decade, when I would feel a pain and instantly assume the worst, and this potential diagnosis would have catapulted me straight to the nearest emergency room.

It turns out that pulling whiskers from my beard is a sign of bone infection. I always thought I did it as a distraction when the kids ignore my commands to pick up the room or shut the TV.

Bottom line: This can be a useful tool, but if you’re an OCD case it can be the catalyst for endless worry and panic. Like any medical symptom tool to be found online, it lists everything from the slightest to most serious conditions. I can poke fun now, but back when my fear and anxiety were out of control I’d have played with this thing for hours, breaking into a cold sweat and assuming the worst.

If you’re in that situation now, my advice is to walk away. A tool like this is dangerous in the hands of an unstable mind. If you’re in a calmer state of mind, it’s nothing more than a time-sucking distraction.

It’s a lot like Facebook, actually.

Sympton Checker

September 19, 2012October 27, 2015

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

August 28, 2012

Update on Dad

Thanks to everyone who left prayers for Dad on my Facebook page yesterday, and thanks to my sister-in-law Robin for dropping everything to watch the kids so Erin and I could go to the hospital last night.

Mood music:

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Dad had emergency surgery last night for a malfunctioning heart. In the end, it turned out the heart was pumping fine, but that the blood has nowhere to go. All but one artery is blocked, as it was explained to me. There’s not much they can do about that because of his overall health right now, so once he’s up and about the doctors will manage it as best they can with medication.

Dad’s a stubborn one, and I can see how it’s rubbed off on me over the years. He’ll overdo an activity when his doctors tell him to take it easy. He’ll eat things he knows he shouldn’t eat. He’ll get schemes in his head and won’t listen to anyone once he sets his mind on something. Like father, like son.

When you’ve had two or more strokes like he has, that behavior is all the riskier.

As infuriating as it can be, I have to give the man credit: He’s not willing to let physical disabilities keep him down. He keeps pushing, and that’s admirable.

With everyone’s continued prayers and good vibes, I think he’ll be back on his feet before long.

Heart Pinata

August 17, 2012

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

August 15, 2012

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.

June 15, 2012

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

May 3, 2012

For A Girl Recently Diagnosed With Crohn’s Disease

The daughter of close friends just found out she has Crohn’s Disease. She’s suffering a lot right now, and I know exactly what she’s going through. This post is for her.

Mood music:

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Hello, my young friend. I’m sorry that you’re hurting so much right now. I was diagnosed with Crohn’s Disease when I was around your age, and spent many weeks in the hospital between ages 8-16. It stinks. But if there’s one thing I’d like you to remember after reading this, it’s that it WILL get better.

I experienced all the things you are now — the massive loss of blood, the knifing pain in the gut, sleepless nights in the bathroom, and more blood.

A couple times, I’ve been told, the doctor’s came close to removing the colon. Too much of it was under siege and they didn’t know where to start in terms of targeting it. But it never came to that.

The pain was pretty intense. I really don’t know how my parents were able to get through it. I think it would cause me more anguish to see one of my kids suffer than to go through it myself. That had to hurt. Especially since they lost another child along the way. It also couldn’t have helped that I would be in the hospital for six-week stretches in 1978, 1979, 1980 and 1981.

I mention this because you should know how hard it is for your Mom and Dad to see you hurting. They’re new to this Crohn’s thing, and they will worry endlessly about what they are doing for you and whether it’s the right thing. Be patient with them if you can. But if you need to yell at them once in awhile so you can cope, go ahead. That’s what parents are for.

As you will probably soon discover, the most popular drug to treat what’s making you sick is Prednisone, which comes with a long list of side effects. Your face might get puffy and you’ll want to eat everything in sight. But you’re a strong kid and you can handle that.

A lot of people helped me survive a childhood of brutal Crohn’s Disease: My parents, great doctors, school friends who helped me catch up with my schoolwork and rooted for me whenever I got out of the hospital, and a great therapist who helped me sort through the mental byproducts of illness.

I think you’re going to get through the current attack and that you will be able to move on to a better life. Again, I lean on my personal experience.

I’m probably one of the luckiest Crohn’s patients on Earth. The last bad flare up was in 1986 and I haven’t had once since. I still go through frequent periods of inflammation, but nothing that requires drugs or hospital stays. The colon is checked out every other year to make sure the layers of scar tissue don’t run wild and morph into cancer.

Had the doctors removed the colon when I was a kid, I think things still would have worked out. I would have learned to live with it. Whatever you have in front of you, I think you can make the best of it and push through.

Be strong and keep the faith, my young friend. I hope you feel better soon.

–Bill

March 23, 2012

Hey, Kids! Here’s Something For ‘When Your Brain Gets Stuck’

I just got a book in the mail called “What To Do When Your Brain Gets Stuck: A Kid’s Guide To Overcoming OCD” by psychologist-author Dawn Huebner. I asked for a copy so I could review it, but it might warrant more than one simple review.

Mood music:

http://youtu.be/HiYK8TDbPRQ

Someone I’m connected to on Facebook got a copy to help her OCD-suffering child. Since the upcoming relaunch of THE OCD DIARIES will have an expanded section for children’s mental health issues, reviewing this seemed natural.

The book, published by Magination Press with illustrations by Bonnie Matthews, guides kids and parents through cognitive-behavioral techniques used to treat Obsessive Compulsive Disorder. I’ve learned a lot of techniques in therapy over the years, but my first impression from this book is that a few more simple tools could have helped me nip this disorder in the bud BEFORE I reached adulthood.

From the synopsis:

Did you know that people have brain sorters that keep their brains from getting cluttered with unnecessary thoughts? Sometimes these brain sorters get mixed up, though, holding onto thoughts that frighten kids. If this has happened to you, if it’s hard for you to feel safe or sure of yourself because scary thoughts have gotten stuck, this book is for you.

Two-plus years into this blog, I’ve never been able to explain it that clearly. I came closest in a post comparing the brain to a car engine.

What To Do When Your Brain Gets Stuck guides children and their parents through the cognitive-behavioral techniques used to treat Obsessive Compulsive Disorder. This interactive self-help book turns kids into super-sleuths, able to recognize and more appropriately respond to OCD’s tricks. Engaging examples, activities, and step-by-step instructions help children master the skills needed to break free from the sticky thoughts and urges of OCD, and live happier lives.

First impressions:

–The illustrations are terrific. Cheers to Bonnie Matthews. She managed to give OCD a face in the form of this little furry guy who resembles the tribbles from Star Trek — with legs. When you can put a face on your nemesis, it’s easier to fight him.

–Huebner scores points with me by setting the exploration of OCD up as a game. Right off the bat, if you can make something look like a game, dealing with it becomes less scary.

–She covers several coping techniques that deserve more attention than I could offer in one post.

I’m going to approach my study of this book from the perspective of a kid who lacked the right tools and allowed OCD to follow him into adulthood.

The author takes kids on an important journey, and it seems fitting to show their parents what happens when their little OCD cases miss out on that journey. I’m the guy who went through puberty and into adulthood with that insidious fur ball following me around. It grew up with me and got a lot uglier and menacing than the little guy in the book.

I’ll look at the different symptoms the author lays out and explain how they manifested themselves in the younger me. From there, I think I’ll be able to tell you how this book — though designed for kids — can be a life-saver for grownups, too.