A glassware breaks... you pick up the shards of glass... and glue them together... but it is a broken one and the cracks are so visible... and to hide them, you paint it with beautiful colours and place it somewhere safe and use it for something else that it was not meant to be used for...
There are moments when I wonder, isn't that what I am? Isn't this a short write on my life? Isn't the writer the glassware painted and kept elsewhere and used for something else like... discarding what's not needed...? Or things that we might need one day... Someday...?
This is a weak moment, I confess. And more often than not, Sana Rose is the person I become when I run away from my life. When love is not very fair... When life seems so... blunt... When it's so blank even when it could be filled with so many precious things that matter... When I am not heard...
When my heart is a hearth where my very average and sensitive dreams and hopes are burnt... God hears me and keeps me going even when I am denied the lesser things that I need most, unlike other girls of my age...
But it can make me cry, if you offered me some love that's unstained, some tenderness... I would crumble down to nothingness moistened by tears if you gave me a hug - I am so fragile...
My heart quivers as I write this, for opening myself to the numerous eyes out here is not the coolest thing...
I grew up wanting time and words of love and care, instead of food, clothes and a house from my mother.
The void is so great that, I constantly tried to fill it, but nothing substituted it, not for a long time. And now, I thought, someone has. But I again and again find, that void is still empty... And every time I try to fill it, it just stays that way. Everyone passes me over that void, no one looks into it. And those who try, can't see into it.
Even after all these years...
It's three months until we move, but in the spirit of making hay while the sun shines
, I've begun casually, nostalgically sorting and packing a few things. In a pile of books in the parlor I came across a collection of Anne Sexton's poems. Opening randomly, I read--and burst into tears.
Daisy doesn't care for horses, but she is
13, and I see this moment coming.
Pain for a Daughter // Anne Sexton
Blind with love, my daughter
has cried nightly for horses,
those long necked marchers and churners
that she has mastered, any and all,
reining them in like a circus hand -
the excitable muscles and the ripe neck -
tending, this summer, a pony and a foal.
She who is squeamish to pull
a thorn from the dog’s paw
watched the pony blossom with distemper,
the underside of the jaw swelling
like an enormous grape,
Gritting her teeth with love,
she drained the boil and scoured it
with hydrogen peroxide until pus
ran like milk on the barn floor.
Blind with loss all winter,
in dungarees, a ski jacket, and a hard hat,
she visits the neighbors’ stables,
our acreage not zoned for barns,
they who own the flaming horses
and the swan-necked thoroughbred
that she tugs at and cajoles,
thinking it will burn like a furnace
under her small-hipped English seat.
Blind with pain, she limps home;
The thoroughbred has stood on her foot.
He rested there like a building;
He grew into her foot until they were one.
The marks of the horseshoe printed
into her flesh, the tips of her toes
ripped off like pieces of leather,
three toenails swirled like shells
and left to float in blood in her riding boot.
Blind with fear, she sits on the toilet,
her foot balanced over the washbasin,
her father, hydrogen peroxide in hand,
performing the rites of the cleansing.
She bites on a towel, sucked in breath,
sucked in and arched against the pain,
her eyes glancing off me where
I stand at the door, eyes locked
on the ceiling, eyes of a stranger,
And then she cries…
Oh! My god, Help me!
Where a child would have cried “Mama!”
Where a child would have believed “Mama!”
She bit the towel and called on God,
And I saw her life, stretch out…
I saw her torn in childbirth,
And I saw her, at that moment,
in her own death,
And I knew that she knew.
Poetry Friday is hosted today by Tabatha at The Opposite of Indifference
, where she's sharing some of the poems exchanged through the Summer Poem Swap she has organized. I'm participating and will have at least three to share next Friday--thanks, Tabatha!
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What do anaesthetists do? How does anaesthesia work? What are the risks? Anaesthesia is a mysterious and sometimes threatening process. We spoke to anaesthetist and author Aidan O’Donnell, who addresses some of the common myths and thoughts surrounding anaesthesia.
On the science of anaesthesia:
Click here to view the embedded video.
The pros and cons of pain relief in childbirth:
Click here to view the embedded video.
Are anaesthetists heroes?
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Aidan O’Donnell is a consultant anaesthetist and medical writer with a special interest in anaesthesia for childbirth. He graduated from Edinburgh in 1996 and trained in Scotland and New Zealand. He now lives and works in New Zealand. He was admitted as a Fellow of the Royal College of Anaesthetists in 2002 and a Fellow of the Australian and New Zealand College of Anaesthetists in 2011. Anaesthesia: A Very Short Introduction is his first book. You can also read his blog post Propofol and the Death of Michael Jackson.
The Very Short Introductions (VSI) series combines a small format with authoritative analysis and big ideas for hundreds of topic areas. Written by our expert authors, these books can change the way you think about the things that interest you and are the perfect introduction to subjects you previously knew nothing about. Grow your knowledge with OUPblog and the VSI series every Friday!
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Today would have been my father's 90th birthday.
Ten years ago, my family made a decision we have never regretted. Ten years ago we asked that my father be allowed to die.
No one at the hospital suggested we stop aggressively treating my 80-year-old father. Even as test after test came back negative, even as he continued to deteriorate. He asked my brother Joe where Joe was, asked my mom what time the curtain would go up, and thought it was 1902.
He had long suffered from Alzheimer’s and Parkinson’s, his life a narrow circle from bed to living room, navigated by his walker. There were times his brown eyes were full of love, and times when they were blacker, lost, blank. Then a sudden illness began to ravage his body. In the hospital, he was put on three antibiotics. Still his skin was so clammy from fever that each new nurse recoiled when she first touched him.
I made a list of questions for his doctor – What was my father’s diagnosis? His prognosis? Why did his white blood count keep climbing? Why did he cry out whenever they moved him? And a few days later I added - What could we stop? - to my list of unanswered questions.
A series of problems
To the hospital staff, my father was no longer a person, but a series of problems. His unrelenting diarrhea indicated a bowel infection. But when the sigmoidoscopy turned up negative, the specialist only shrugged when I asked what was wrong. “Who knows why?” I wrote down carefully. The doctor who admitted Dad concentrated on getting his fever down. The nurses wanted to see if my father was ‘oriented.’ “Hank?” one cajoled him, prodding his shoulder while he stared at me with sagging, rheumy eyes. “Hank, do you know who this young lady is?”
I wanted to tell her to stop poking him, to leave him alone, to stop us both looking at each other with embarrassed eyes. Finally, my dad mumbled something like “Mary once or twice.” Or was it Merry? Or Marry?
My name is April.
He slept more and more, sometimes moaning. When he woke, he might say a few words, and I would think, I have to remember this. These might be his last words. And then he would mumble something else.
Planning for events we knew wouldn't happen
The social worker and discharge planner discussed the options with us, which I dutifully wrote down. If my father got better and seemed capable of rehabilitation, he could go to a skilled nursing facility. This was meant, the discharge planner explained, strictly to be transitional. Dad would have to be able to participate in physical therapy. At this point, my father couldn’t participate in rolling over. Parkinson’s had frozen his legs. When he was first admitted, Joe had tried to push Dad’s legs, hovering a few inches above the bed, down onto the mattress – at least until my father screamed.
If Dad didn’t meet the criteria for a skilled nursing facility, he could go to a nursing home. Or home to my mother, who had already injured her hip and back trying to lift him – from the toilet, the bed, the bath, the chair. And that was when he knew who she was, where he was.
Even as it became clear that he would probably never be coherent again, never walk again, never be anything more than a confused, bed-ridden person waiting for pneumonia to settle into his lungs, no one talked about just – stopping. Not the doctors, not the nurses, not the social worker. My dad talked about it without words. Even when coaxed, he ate nearly nothing. He closed his mouth and turned his head. His body began to forget how to swallow even water.
There was one horrible day when dad began crying out in pain - luckily my mom was at the bank getting into their safe deposit box - and I could not get the nurses to speed along the process for getting morphine. I would go out and beg, and the nurse would chirp that she had paged the doctor. Then I would have to go back to the room, go back to his muffled screams.
If you had a cat this sick...
My brother and I started to have conversations that began, “If you had a cat this sick…” and then our words would trail off. What kind of children were we?
We finally steeled ourselves to talk with my mom. She found my dad’s living will. Step by step, it spelled out all possible interventions. And in all cases, my dad had initialed that he did not want them. My father’s final gift was to take the decision out of our hands, or at least make it easier for us to release him.
Now we had to tell the hospital personnel. I found his young nurse and told her we wanted to stop everything, including the IV fluids. With wide eyes, she said, "Then your father’s going to have to drink a lot more!" Feeling like the angel of death, I explained what I meant. We wanted my father to die. The doctor grasped it more quickly. But why hadn’t he brought it up himself? He had a copy of my father’s living will. He knew my father’s wishes.
On the fourth day of no IV fluids and no antibiotics, my brother called me. The doctor had been by and said Dad’s heart and lungs sounded good. I felt awful. No matter how
much I reasoned with myself – But he can’t even swallow! But he’s too weak to even sit up! But he has a catheter and keeps having attacks of diarrhea on his bedclothes! – I would
think, maybe we should have tried harder.
A few hours later, my father died. My mother was holding his hand, with classical music playing softly in the background. I realized he died the way he would have wanted, and the way he lived, quietly and with dignity.
About the last thing my father said to me was, “You learn how to do it just by doing it.” And he was right. My father learned how to die, and we learned how to fight, not for his life, but for his right to die.
Imagine this nut is your head. And this vice . . . is a migraine.
According to Migraine.com, “In the U.S., more than 37 million people suffer from migraines. Some migraine studies estimate that 13 percent of adults in the U.S. population have migraines, and 2-3 million migraine suffers are chronic. Almost 5 million in the U.S. experience at least one migraine attack per month, while more than 11 million people blame migraines for causing moderate to severe disability.”
I have been battling migraines since my early twenties. Unfortunately, as I get older, my migraines have gotten more frequent and more debilitating. In fact, today, I had one while on vacation with my family and had to be left behind in a darkened hotel room with ear plugs in place and a sign on the door, no housekeeping please. It’s not the first time I’ve missed out on something with the kids because, “Mommy has a headache today,” and I’m sure it won’t be the last.
“Take some Excedrin and get back to business.” If only it were that simple. If you get migraines or know someone who does, you understand that over-the-counter pain relievers do not even make a dent in the pain. Sometimes Hydrocodone can knock me out long enough for the migraine to pass, and a couple times a shot of morphine at the ER has done the trick.
Preventive medicine has had mixed results. For a while I was taking Topimax (normally prescribed for folks who suffer from seizures) . It worked at keeping the migraines at bay, but the side effects were miserable: kidney stones and liver cysts, hallucinations, tingling hands and feet, and horrific brain fog. They don’t call it “Dopimax” for nothing. When I first started taking it, I snapped out of one stupor to find I’d been brushing my teeth for twenty minutes. Despite my uber-white smile, I decided to trade out the Topimax for rational thought.
These days I’ve been managing with daily high doses of magnesium and Vitamin D and Imitrex shots and pills. It works. But only if those shots and pills are timed just right. If I don’t catch the migraine when it first starts, I just end up with the dizzy, racing-heart side effects of the medication on top of the migraine pain.
A strategy that has been semi-successful is the headache diary. It’s been helpful to keep a log of the things that I’ve eaten and the things I’ve done on the days preceding and during a migraine. The result? A crazy-long list of headache triggers, which I share with you now in no particular order:
Dehydration, Aspartame, Sucralose, Alcohol (especially wine and beer), Flashing lights, Wearing 3D glasses, Monosodium Glutamate, More than 26 mg of caffeine in 24 hours, Grape juice, Monthly hormone fluctuations, the Summer Solstice, the Winter Solstice, Cigarette smoke, Staying out in the hot sun for 5+ hours at temps greater than 90 degrees Fahrenheit, Sinus infections, Mold, Not eating for 10+ hours, Stress lasting multiple consecutive days, Vigorous workouts, Pinching neck nerves, Lima beans.
OK, lima beans don’t trigger my migraines. I just hate their nastiness and avoid them at all costs.
So, some of these triggers are completely within my control and I successfully avoid them. And others, not so much. As an Earthling, it’s a bit difficult to avoid the solstices.
If you have a migraine sufferer in your life you can help by listening and avoiding insensitive comments such as, “It’s just a headache” or “Get some sunshine and fresh air” or “Reduce the stress in your life” or “have you tried XYZ? It worked for a friend of mine”. Because a migraine is not just a headache, and going outside can often be a trigger or exacerbate the pain, and even a stress-free, meditation-filled, yoga lover will still suffer from migraines, and chances are, the person has been afflicted with migraines for decades and has tried everything. Every. Thing.
Hypnosis. Been there. Acupuncture. Done that. Biofeedback. Yep. Drugs. Tends to be the first recommendation from the medical professionals, so, yes. And too many other “remedies” to mention.
The best thing I’ve done recently for myself is find a doctor who specializes in migraine treatment. It’s nice to have a physician who speaks the language of migraines. It’s nice to have a physician who doesn’t look at me like I’m a nut when I tell him I can’t drive underneath the canopy of a tree-line road while the sun is shining. “Perfectly understandable,” he says. “I bet you can’t watch the new Transformers movie in IMAX 3D either.”
Photo © Robert Faric
In 2001, my first book, Circles of Confusion, was chosen for the Oregonian’s Book Club. The paper sent a photographer to take a picture of me at my local bookstore, Annie Blooms. The photographer liked the store’s black cat and asked me to pose with it on my lap.
While I’m a cat-person, that cat is not a people-cat, not at all. In the photograph, I’m wearing the strangest expression, a pained smile that’s on its way to just plain pain. It’s because the cat has sunk his claws deep into my thigh.
On Sunday, the Oregonian published an essay I wrote about what it’s really like to quit your day job. They also used that photo from so long ago. Today when I was out for a run, a couple walking a dog stopped me and congratulated me. I kept trying to place them, but couldn’t. Did my kid go to school with theirs? Were they neighbors? It was only after I started running again that I realized they must have recognized me from that photo. Maybe I wear the same pained expression as I stagger up the hill.
You can read the essay here. No photo, though.
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Dr. John D. Otis is the Director of Medical Psychology at Boston University School of Medicine and the director of the Pain Management Psychology Services at the VA Boston Healthcare System. He is also Associate Professor of Psychology and Psychiatry at Boston University. In his newest book, Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach, Workbook, which is part of our Treatments That Work Series, Otis provides a guide to increasing productivity in the face of chronic pain. Below are some tips, excerpted from the book, which will help you decrease the stress in your life, which in turn decreases your pain.
Stress and pain reinforce each other. You may have noticed that when you are stressed out, your pain gets worse. On the other hand, chronic pain is often a source of stress. This can result in a cycle of pain and stress…
Ways to Decrease Stress:
Given the relationship between stress and pain, it is important to learn how to manage stress. The good news is that there are things you can do to decrease your stress….
Change Lifestyle Habits:
-Decrease caffeine intake (coffee, tea, colas, chocolate)
-Maintain a balanced diet and decrease consumption of junk food
-Eat Slowly and at regular intervals
-Exercise regularly (at least 30 minutes three times per week)
-Get adequate sleep (figure out how much you need)
-Take time-outs and leisure time (do something for yourself every day)
-Do relaxation exercises (e.g., breathing, imagery, PMR)
Change How you Approach Situations:
-Time and money management
-Problem-solving coping skills
Change your Thinking:
-Have realistic expectations (when expectations are more realistic, life seems more manageable)
-Keep a sense of humor (being able to see the humor in the things helps o lighten the situation)
-Have a support system (speak with someone or write down your thoughts)
-Focus on the positive (think half-full versus half-empty)
-Challenge negative thinking using cognitive restructuring skills
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Paul G. Kreis, MD, is the Medical Director, Division of Pain Medicine, Professor of Anesthesiology and Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis. Scott M. Fishman, MD, is Chief, Division of Pain Medicine, Professor of Anesthesiology, Department of Anesthesiology and Pain Medicine, University of California, Davis. Together they wrote, Spinal Cord Stimulation: Percutaneous Implantation Techniques, which looks at the basic multidisciplinary information necessary for understanding SCS and pursing safe and effective implantation. In the excerpt below we look at the origins of sensory stimulation.
Sensory stimulation has been used to treat pain since antiquity. It is believed that anciet Egyptians may have used electrogenic fish to treat ailments 4,500 years ago. One such fish, the black torpedo fish, was used for centuries by the ancient Greeks and Romans.
The live fish was placed over the painful site, and the patient endured the electrical discharge from the fish until the pain was relieved. The Roman physician Scribonius Largus recorded the medical use of the torpedo fish in 46 CE, and Claudius Galen (131-201 CE) also described shocks from the torpedo fish to treat gout and headache.
An 1871 publication by Beard and Rockwell presented a case of “Faradization” and described the application of faradic current (i.e., discontinuous, asymmetric, alternating current) to stimulate muscles and nerves in a subject using a direct current inductorium device. Units…were also used by early researchers, including Benjamin Franklin, for pain relief, as well as for treatment of other ailments.
The first modern attempt at electrical stimulation of the brain took place in a conscious patient in 1874. The patient had ostemyelitis of the scalp, and the brain was exposed during debridgement. Muscle contractions were apparent when the exposed motor cortex as subjected to electrical stimulation but not when it was mechanically stimulated. Not until 1948, however, were electrodes successfully implanted in the brain, to treat a patient with psychiatric disorder.
The Electreat, the first electrical stimulator designed specifically for therapeutic use, was patented by Charles Willie Kent in 1919. It appears to have been remarkably similar to transcutaneous electrical nerve stimulation units that wold appear later in the century.
Advertised to the public as a cure-all therapy, an estimated 250,000 Electreat stimulators were sold over the next 25 years. Eventualy, Keat would be the first individual prosecuted under the new 1938 Food, Drug, and Cosmetic Act for making unsubstantiated medical claims for the device. The Electreat Company was subsequently forced to limit its claims to pain relief alone.
By: Joan Leslie Woodruff,
Betrayal is the number one deal breaker, it is one of the most devastating experiences a person will ever endure. It is more than a psychologically damaging event, it is a physical insult to the deep limbic system. Betrayal inflicts wounds to our senses which are played out by the body's chemical response network. Neurotransmitters fall out of balance. Brain chemistry churns out feelings so painful, so devastating, it often seems as if we cannot possibly survive into a new moment because the one we are living in is so hurtful, so filled with suffering, we are too stuck to imagine a new door will ever open. I am dealing with this in my life today. I will have to deal with it for many tomorrows that come, because the injury caused by this kind of event requires an entire overhaul of ones personal life, including plans, dreams,hopes, goals, beliefs, trusts, reality. I will ache and I will heal. I will pause to learn, and I will move forward. I've endured similar pain before, yet never this much betrayal. But I will be okay.
By: Joan Leslie Woodruff,
Have you ever received messages, which were always delivered to you in a similar way, and which you were certain came from a person once in your family, who was now deceased? I have. In particular, I have received such messages from my brother approximately half a dozen times since he died. How do they begin? Always exactly the same way. I will be listening to a radio, usually in my car, and I hear a specific song twice in a row. When that happens my mind kicks in to high alert. I pay attention to every one and every thing around me. And I clear my mind of whatever I have been thinking, and I allow myself to be as open and receptive to what ever it is I need to discover or learn about. These occasions have always, one hundred percent of the time, proved pivotal in my life. Something always happens which is life changing. And when I say life changing, I mean just that. Old doors close, new doors open, insights sit on my porch, and I find myself on the path of new transformations. Such an event recently happened to me. I was driving through the nearby town of Belen, that song played, then when it finished, I changed the channel, and it played all over again. As in the past, I let the day play out, and I followed my senses. Today I am transforming pain into happiness. And without pain, there would be no happiness. Life is wonderful, but so is the ability to remain in communication with those who have left us. They do speak to us, I believe this with all my spirit and soul. If experience is proof, I do have proof. And when our departed loved ones find it important enough to speak to us, we are wise to pay attention and learn.
I love this quote. Sometimes courage is a quiet voice that says, "Keep on doing what you are doing, and things will eventually get better." It could be doing a job that you really don't like, but you give it your best, and you're pleasant and positive with all the people that you meet at your job. That takes courage. To fight a serious illness, takes a vast amount of courage. To watch your spouse's hand shake, knowing that the medicine to stop the shaking causes more problems than it's worth, takes courage. We are never "innocent" bystanders to the pain of the ones we love. We see their pain, and we feel their pain, even if we hardly ever verbalize it. That is the nature of true love.
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It's been a while since I've gotten to reflect on the ins and outs of writerdom, mostly because I've been hanging on by the skin of my teeth in my MFA program. There are just not enough hours in the day.
A few emails ago, however, one of my advisors put me onto a short tome written by a fellow traveler in the writing lane, Haruki Murakami's What I Talk About When I Talk About Running
I am a dedicated runner, which this advisor knows as we've crossed paths in the wee hours of the morn running during residencies. Although the reading tower is approaching critical heights in my office, I got the book (downloaded it to my Kindle, actually, thus not adding to the teetering tower).
Murakami hooked me right away with these words--"Pain is inevitable. Suffering is optional."
In this life, if you live it even a little, pain is inevitable. Doesn't matter if you're running, swimming, have kids, are married, or, god forbid, decide to try art for a living. Pain is inevitable.
That's a liberating thought. I'm not alone. Everybody suffers! Don't get me wrong, I'm so not taking joy in somebody else's pain. Far from it. I'm just relieved that, well, the pain thing, it's...dare I say it, normal.
Yippee! I'm normal! (Have I been waiting an eternity to say that).
Well, I can either fall into it, or accept the pain and move through it.
Which gets back to the running thing. In running, at least, the longer I work through the pain, the greater the reward when I finish. All I need to do is juxtapose my running attitude to my writing. There will be pain. There is pain. What I do with it, that's the true test.