I have many friends who live in disbelief that this guy, who already knows that I was denied WLS by my insurance once, is still pressuring me to get the surgery. As I waited for his assistant in the room, the Jaguar (my trainer/nutritionist) examined the poster with the various surgical options on it – the Roux En Y, the lap band procedure, the the gastric sleeve, and the duodendal switch – and even on the poster it listed the various deficiencies one has to deal with for life if one chooses that surgery. They all thrive on malnutrition. There are no long term studies on the effectiveness, or on how they impact other health factors. Some of the mid-term studies that are coming out now show that over 50% of WLS patients regain some or all of the weight due to restretching the pouch/sleeve. Many patients do not adapt to the lifestyle that comes with having the surgery, because they were so pressured into it that they never considered what life would be like five years down the line. It’s one thing to commit to a lifestyle change in the present, but it’s a whole different animal to learn that there’s no “giving up” if you don’t like it, if you don’t like the new you, if you don’t like how it changes your life.

Now, I know I have many friends for whom this surgery changed their life in a positive way, and I mean them no disrespect. I believe WLS is an incredibly personal decision, like any sort of body modification, and you shouldn’t be bullied, pressured, or otherwise pushed into having it, or even considering it, if that’s not what you want to do to your body. I feel like the treatment I have received from Dr. WLS is as though someone was standing there in front of a trans man telling him, “You won’t truly be a man until you lop your breasts off. You’ll never pass, no one will ever see you as a man, you won’t be able to live a full and meaningful life if you don’t have a masectomy right now.”

I can carve you up like an ice sculpture!

Do I feel that being obese (even morbidly so) is a good thing? I think it’s just a thing. We all have unhealthy things in our lives. Some of these things could be solved by surgery. Many of my friends have hernias that they’ve suffered with for years, but since they aren’t emergent, they haven’t had the operation. At any moment, my appendix could go rogue and explode on me, but I don’t feel the need to have it removed today. I don’t know anyone in perfect health, who couldn’t use some sort of medical intervention. But no one gets hassled about it the way fat people get hassled about WLS.

Anyway, so there I am in the room to talk about my hernia surgery. The nurse asks me a bunch of questions about my diet – and when I give her honest answers about being on a strict plan to help lower blood sugar, rebuild myelin, and the like, she writes nothing down.  She asks if I have been supplementing with protein shakes. I tell her not only no, but if that’s mentioned I might stab someone, because the last time I was on the protein shake diet I got seriously ill. She definitely doesn’t write that down, either.

I took a picture of her intake notes and this is what it said.

Dr. WLS’s assistant, we’ll call her PA Perky, comes in. She claims to remember me from the last time I was there. Before she even asks about the surgery, she asks if “we can get back on the ball with the weight loss.” I tell her I’m not interested, that I am seeing a trainer/nutritionist who is helping me, and that the protein shake diet made me very ill. She gets very fakey-disappointed. As the appointment progresses, she decides to take out my staples. However, she calls Dr. WLS in to look at my scar, and together they decide that maybe they should only take out every other one, since the scar site is under a lot of stress. I tell Dr. WLS that a lot of my post-surgical pain is because the scar is in a very difficult place on my body – right where my belly ends and my mons pubis begins. He claims it’s in the same site as the old scar. This is not true – it is a good three inches lower. The assistant tries to give me the same song and dance about how my scar could “unzip” and I could have organs falling out. My trainer makes a face -  she knows that my organs would have to miraculously make their way through my ab wall and the layer of fat before they’d do that, and that would take something traumatic, not just a little pressure on an external scar. But this is the exact line they used last time to scare me into WLS.

Before you say it, I’ll be clear, here. I am never having surgery with this doctor again. Next time, I *will* go to one of the other hospitals in hopes that they will see how serious I am about not wanting to discuss WLS. I just have to put up with him through the aftercare of this surgery, and then I am never going to see him again. Unfortunately, it’s going to take some time, because my drain is still putting out a fair amount of drainage, which means I will likely have to have it in for a few weeks.

And this time around, Dr. WLS has even more invested; he now sells a line of protein shakes and vitamin supplements in house, where I’m sure he makes a nice percentage. He also has a sleep study doc in house, so maybe this isn’t the first time he’s gone tete-a-tete with my neuro (whom I met when I needed to have a sleep study as part of my pre-WLS examinations). But a friend reminded me of something I’m going to use from here on out when WLS is brought up – since my insurance doesn’t have it as a covered benefit, and we know that for certain now, every time they bring it up I’m going to ask if they’re willing to do it pro-bono. If not, they can stop offering me a procedure that isn’t covered by insurance, please and thank you. (Although I’m almost scared that he’d say yes.)

So last Thursday I started having lower abdominal cramps around 4pm. (Right after I posted, in fact.) I get these from time to time, and lately I’ve had some serious hurty bouts of them, so I figured it was one of those and slowed down and started watching my Netflix and trying to wait it out.

About two hours later, I started getting seriously nauseous. Also not alarming for Dels, so I took one nausea med, and then the other, stronger one when that didn’t seem to help. The cramps were getting pretty serious, and showed no signs of slowing down.

I really fought the idea of going to the ER, because I’ve been to the ER with ab pain before and one of two things happen – either they find nothing and I go home and eventually feel better, or on rarer occasions, it’s something really serious and I end up going through a medical ordeal. Neither of these appealed to me, and usually if I just wait, they go away.

I tell Ninja that if I”m still in pain at 8:30 I’ll entertain the idea of going. It comes and goes. Maybe the cramps are getting better, or maybe I’m convincing myself of this so I don’t have to go to the ER. 9:30 comes and goes, and it’s getting worse. Finally, at 10 o’clock we decide that at the very least, I might be able to get some heavy duty pain meds if I go, so we find someone to take us (yeah, remember that we both don’t drive? So we were calling friends at 10:30 at night looking for someone to take us!) and go directly to the actual hospital and not the more local ER extension. Although I’ll be seen faster at the extension, if it’s serious there’s only so much they can do before they have to transport me via ambulance to the “real” hospital, so we might as well just go there.

Let’s cut to the chase and say that I was in the ER for 36 hours without sleep or food. They kept moving me around, and once tried to move me to Labor and Delivery. They let me know that I needed surgery by telling me they had called The Weight Loss Surgeon (we’ll call him Dr. WLS) with whom I have some bad history. I wasn’t thrilled, but I knew why they did it – he’s also a general surgeon and because of his experience with bariatric patients, he’s the best surgeon to do abdominal surgery on someone like me. I later learned that I had a ventral hernia – my second – and it needed to be fixed.

This is what a ventral hernia looks like from the inside. Basically, part of your intestine breaks through the abdominal wall and can get trapped. It hurts quite a bit.

Dr. WLS shows up and the first thing he says to me is, “Weren’t you supposed to have weight loss surgery by now?” He and I have a bit of a back and forth, with me telling him that my neuro thinks that the rapid weight loss I experienced while under Dr. WLS care last time caused or exacerbated my neurological condition. Dr. WLS disagrees, telling me I likely have early onset Parkinsons (!!), and he demands to know who my neuro is. I tell him, and later on he actually called the neuro to demand why the neuro told me this when it was impossible. The neuro stuck to his guns, but Dr. WLS just dismisses this.

Anyway, I tell Dr. WLS that I’m not interested in weight loss surgery. He tells me that I have 3 options – I can go home and do nothing, but this is dangerous and can lead to serious complications, I can go to another hospital that “specializes in hernia repair” (he actually listed two other hospitals with bariatric units), or I can listen to his lectures on weight loss surgery and he’ll do the repair that night. He is surprised when I tell him I need time to think it over. I call patient advocacy and they aren’t pleased with these options.

Dr. WLS returns, a little cowed. We agree to disagree, and I make him promise that if he does the surgery, that he won’t bring up weight loss at all, or weight loss surgery in specific, until I’m seeing him in his office for surgery follow up. He agrees.

I am brought directly from the ER to pre-op, and I don’t know if I have a room to go to when they’re finished. They actually warn me that I may need to go back to the ER if they don’t have a room. This makes pre-op so much more fun. [insert Mike the Surgical Nurse story here]

The surgery goes well. I am wheeled into post op and I hurt all over. Not only from the surgery, but also from being in one position for so long, and also because I’ve had all kinds of tubes in me, some of which were still in (a nasal trumpet, which sounds more whimsical than it is, and a foley catheter). After a few hours, I’m taken up to a real room.

I was given an epidural to help with the surgical pain. It does okay – I still felt some discomfort when I moved, and I was hitting the dose button often – but I end up going into opiate withdrawal because they deny me my maintenance pain meds for over 48 hours and the epidural isn’t enough to ward that off. The hospitalist decided I am on too much OxyContin and cuts my (prescribed by my pain doc) dose in half. Somewhere along the way, they also tell me that my A1C is three points higher than it was six months ago, and now I need mealtime insulin. I’m baffled by this but do not argue.

Unfortunately, it wasn't tequila. Might have worked better.

Fast forward through some bad  nurses. It gets to be time to remove the epidural. Dr. WLS tells me that they’re going to walk me from the epidural to IV pain meds to oral pain meds. This is not what happens. They take the epidural away and I am given less pain medication than I take on a day-to-day basis to cope with the surgical pain. Obviously, this fails to quell the pain I’m experiencing. I stop eating food, and when doctors/nurses try to encourage me to eat, I tell them that I want to, and I will when my pain is below an 8. It takes almost 12 hours before finally I’m given a bolus of IV dilaudid, and am given the option of IV push pain meds to supplement the orals.

However, I’m totally guilted by everyone – the hospitalist, Dr. WLS, and even the nurses – every time I ask for IV meds. I can’t go home until my pain is controlled by orals, they say. I tell them that it’s insane to think that my day to day maintenance drugs are going to be enough to cope with not one, but three incisions in my abdomen, one of which is on a part of my body that experiences a lot of pressure when I sit up or walk. Even the night before I was discharged, I got a dose of IV meds. But they’re so keen to send me home, and at this point I’ve had less than six hours sleep in six days, I just nod my head and agree to whatever they say.

I get home and call my pain management doc just to inform them that I was in the hospital, and that I was given a med to deal with pain but that it was cleared by the hospital with them. They tell me that no one ever told them about the med, and if I have already filled it I am in breach of my contract. Thank the Gods I hadn’t. I get their okay to fill the med, but only if I stop taking my other breakthrough med. This sucks because the hospital’s plan was to augment my regular drugs with the new drug, not replace one of them. So needless to say I’ve been in some pretty bad pain since I’ve been home. But I have slept like I invented sleep, and that’s been good.

Just keep going until you feel less sugary, I guess.

If that weren’t enough, I was sent home with insulin, but with no instructions on how much to administer. I had to call the hospital’s diabetes educator, who was deeply embarrassed and shocked when I told her that no one told me how much to give myself. What’s funny, is that since being home, I rarely test high enough to warrant insulin, and when I do, it’s just over the limit for the lowest dose. I am having my A1C retested at my primary care doc’s next week; I think something hinky is going on.

Tomorrow I see the pain doc, and I’m praying together we can find a way to get my pain under better control. As of now, I can basically lay down (on one side, because I have a drain in the other), sit up for short periods of time, and waddle to the bathroom. Anything more than that is too taxing, pain wise.

The other surgeries, the D&C and the ablation, are on hold for now. I’m hoping to be well enough by mid-May to get them then.

And I’m bringing my nutritionist/trainer to the follow-up appointment with Dr. WLS, so she can tear him a new one if he tried to put me on protein shakes or threatens surgery. I like having attack jaguars.

So that’s where things are. I hate that this happened, I hate the timing of it, I am very serious about wanting to address why I keep having hernias (I have a weak ab wall; my trainer is all over working on that once I am healed from surgery), but for now all I want to do is sleep a lot.

As a member of the human race, the idea of a group of strangers standing around my unconscious naked body while it is being cut open and organs lay bare, makes me a fair amount of nervous. Even when I know it’s the best option to heal and feel better, once I have signed the necessary consent forms in pre-op I am now given a gentle sedative just so I can remain functional enough to follow instructions and pay attention to what I’m being told. And as this surgery was completely not on my radar when I went into the ER the night before, and there had been some crazy drama in the hours leading up the surgery, I was pretty emotionally wrung out and keyed up at the same time, which is difficult on a body.

I don’t remember from my previous surgeries if pre-op always seemed so rushed, or if it was this experience on its own, but there were two nurses and two doctors asking me questions and examining me all at the same time, while also instructing Ninja as to what he should be doing as well. I was really losing grip on any sense of stability, and that’s even after I started employing meditative techniques that I practice specifically for situations like these. I was also in a great deal of pain, which didn’t make things easier.

The sedative starts to slow down my heart rate and my breathing, and I see the socks. At first, I wonder if maybe the Versed is affecting me in a whole new way and I’m seeing things now. I take a quick assessment of the space around me, to see if anything else seems odd or unusual. Nope, the only unexpected thing in my line of sight is that this person has the bottom of their scrubs tucked into a pair of pink and green argyle knee socks.

Not actually Mike. I chose this photo because these are, colorwise, the right pinks and greens. Also, I'm pretty sure Mike is the hairy-leg kind of guy.

I unfocus my attention from all the bustle and questions and fear and take a moment to look at this argyled person. He was about six foot three or four inches tall, with a state-school-football-player’s build. He had rusty red hair tucked into the surgical hair net, and a short, just slightly wild looking red Van Dyke. The last two thoughts I remember in this slow-motion Matrix moment was that a) boy, it’s been a long time since I found a tradtionally-masculine-looking, cisgender man attractive, and b) boy, I find this traditionally-masculine looking cisgender man attractive. (I admit, I had no way of knowing if Mike was cisgender. I was more musing on the fact that he ‘read’ that way to me and it wasn’t a deterrent.)

“Nice socks.” I break out of the reverie and find myself feeling the Versed more, as usually complimenting someone I find attractive pretty damn nervewracking.

He starts talking to me, and all of a sudden I’ve completely forgotten that in just a few moments, someone is going to be slicing my belly open and unkinking my intenstines. He gets me into the stretcher to wheel me into the OR (which he calls “his”, even though he’s not the surgeon) and usually at this point, Versed or no, I’m beyond comprehensible thought. Instead, I’m able to help transfer me to the operating table while discussing our tattoos and how he flies home to Mississippi to get his done because that’s where the artist he’s been going to since he turned 18 is.

I have to get an epidural to help with post-operative pain, and because of my body shape I have to hold this kinda uncomfortable position while the anesthesiologist does whatever he needs to. Mike helps hold me in position, and we talk about my experience of getting songs trapped in my head when I go under general, and how he wishes they could allow patients to request what music they listen to before they go under. I don’t remember what was playing, but I remember we both liked it.

Should have known this was an odd looking "oxygen" mask

I laid back down on the table and went through some last minute positioning things. Mike rubs my arm as my eyes begin to tear up a little, because I realize that I’m going to be in the same position for an unknown amount of time and oh yeah, that’s because they’re going to cut me open and blah blah Del is made of meat and people die on the table and blah. He tells me I’m going to do fine, and the anesthesiologist puts a mask over my face and tells me to breathe the “oxygen”.

(That’s the one part of my actual surgical experience that pissed me off. Normally, they do the whole, “This is the general. Take deep breaths and count backwards from 100.” It’s purposeful, I know what’s happening, it’s all above board. This time, it was a little underhanded. I mean, I totally think they did it that way because I was having such a hard time emotionally they didn’t want me to have an anxiety attack when he said, “Okay, we’re about to begin.”)

The next thing I am aware of is being wheeled into post-op. I desperately try to figure out if Mike is there, but I’m too out of it and can barely keep my eyes open. I never see him again.

The PS to this story is that at another point later in my stay, I am seen by some surgical assistants. Either Ninja or I mentions Mike, and all of them go on about what a great guy he is and how they like working with him. Ninja then mentions that it would mean a lot to me if he would come by for a visit. I must have turned six shades of red.

He never came. But meeting Mike, and the emotional support he gave me through the scariest part of the whole experience, is something I not only won’t forget, but will strive to give to others. Ordeal workers need Mike the Surgical Nurse too.

"It's going to be okay in the end. If it's not okay, it's not the end."

I am clearly out of shape, even though at first glance I appear to be fit. I discovered the 5k last fall when I signed up for one in order to force myself to start working out again. It worked, and I went from having to walk most of the 3 miles each day I trained, to being able to run the entire thing by the end. It was awesome. Definitely empowering to know that my body is capable of running a race, actually completing it.

Back in the fall, those thirty-five minutes each weeknight evening or Saturday morning were so calming and thought-provoking for me. I knew I needed to find another one this spring, so I recently signed up for one in early May giving myself a month and a half to get ready.

This is week one of training and it’s been the most perfect weather for running. Slightly cool, mostly sunny, with a light breeze to keep you going. The smells of spring are everywhere around me as I’m running and I find myself taking the deepest breaths possible to make sure I take it all in to the fullest.

My sense of smell is hyperactive. I tie scents to experiences, to specific times in my life. I can recall memories just by taking a whiff of an old perfume or cologne my husband used to wear. It’s kindof weird, but neat at the same time.

When the scent of a season starts to emerge, I sometimes think of two of my hospitalizations. One was in the spring and one was in the fall. The spring one was the most recent, and the spring time was also the season in 2006 when I was diagnosed and then fell into a deep depression for the rest of the year. My parents were with me every step of the way and my mom and I used to go on long walks and we’d pray the rosary as we walked.

I think she prayed because she felt helpless. I felt helpless too, so I followed. I think our prayers were answered many months later when I found the medicine that works for me. My daily tears dried up and I started to enjoy life again. It was incredible.

I think the way the seasons constantly turn helps to remind us of the past and how far we’ve come. And no matter how bad things may be now, they can only get better with time. The next season will be here before we know it.

I remember when I lost my mind

There was something so pleasant about that place

Even your emotions have an echo in so much space

~ Gnarls Barkley: “Crazy” lyrics

Whenever this song comes on the radio, or “Unwell” by Rob Thomas for that matter, I think of my the time I spent in the hospital. Having to be committed against your will, to get well because you cannot help yourself, is a very humbling experience.

I remember some significant moments about the last hospitalization. Specifically, how when my husband had to call 911 to have them come and take me, I pleaded with the EMT’s and police officers to let me introduce my son to them. I was so excited for him to get to meet an actual police officer in person. He had such a fascination with police cars, fire trucks and ambulances. Such a typical little boy. My mother-in-law was in the nursery with him, trying to get him to go back to sleep. He had been sleeping, but woke up to all the commotion I was causing in my fight to not go to the hospital. My baby, at only 18 months old, was so sheltered from what was happening to his mommy. My other baby, the one that was just a tiny little miracle in my belly which we had found out about only the week before, would never know that her mommy needed to get well before she would ever be able to take care of two little babies.

I was the textbook definition of “crazy”, and needed the medical attention I could only receive in the hospital to be able to come home and focus on my health so that I could be the best mommy to my little boy. I like to think that I retain some of the clear memories that I have from my hospitalizations so that I remember how important it is to stay on my medication and see my doctor and therapist regularly.

These days, I like to sing those songs when they come on over the radio.  They remind me that bipolar disorder is just a part of who I am, and it doesn’t define me as a person. I think I experienced those four hospitalizations for a reason, and I am a stronger person because of them.

I like how my doctor asks about my writing. She knows it is important to me and she supports my voice. My last psychiatrist didn’t read my book draft since I became emotional during the one appointment when I told her about it, handing her the draft to read. She told me at the next visit that she hadn’t read it since I became so upset. The fact that she didn’t read it (or so she said) made me sad. I was handing her a glimpse into my thoughts, feelings, and emotions having lived with bipolar disorder and she turned around and told me what felt like “you’re not worth my time outside of paid appointments.”

I would have stopped seeing her, but didn’t really have a choice since insurance was covering my visits at almost 90%. So I stuck with her until our insurance changed and I was forced to find a new doctor. I was lucky enough to find a very good one whose office is only 5 minutes from our house.

We talked about my mood during today’s visit and I admitted I’ve had some hypomanic periods over the past two months, but they are manageable. I always have a good sense of awareness about my moods and when I feel an elevated period, I know that I need to get more sleep and nap when the kids nap. I take Ambien if my mind is still buzzing when I know it’s bedtime. I’m also fortunate in that my husband stays on top of things too and encourages me to get rest when he knows I need it. We work as a team to keep me healthy and I like that.

My doctor and I discussed the recent news of the Kony 2012 movement and how Jason Russell, the filmmaker who was the voice of the campaign, was recently hospitalized in California under a 5150 psychiatric hold. He was trying to raise awareness about a horrible war that was going on which most Americans probably knew absolutely nothing about until news of the viral video his organization created hit the evening news. When I first watched the video two weeks ago, I’ll be the first to admit, I was kindof shocked by the message of “Making Joseph Kony famous”. But then it hit me. What better way to slap the world in the face to get them to realize how much shear devastation this one person has caused to so many innocent children? The campaign had a call to action too. They want to get the word out to have Kony arrested and put to justice. By the end of the 30-minute video I was a follower. I even shared it on my Facebook wall, encouraging my friends to watch it.

And then the story broke on Friday about Jason’s detainment by police after he was found naked on the streets shouting obscenities and pounding the pavement with his hands. The first thing I did was remove the share post of the Invisible Children Kony 2012 campaign from my Facebook wall.

How incredibly narrow-minded and judgmental of me to act in such haste. I immediately didn’t want to be associated with the guy just because he had suffered a public mental breakdown? Wow. Talk about needing to have an introspective weekend.

All I could do was think back, all weekend long, about how his story has some similar characteristics to my own. Not nearly on the same scale, of course, but in small part, similar. At the time of my first psychotic episode, I was under a great deal of stress from my career and the goals management had set for me in the coming year, in addition to being in the midst of an emotional affair with a co-worker and mid-way through building a brand new single-family house with my husband. Talk about having a lot on my plate.

I feel so blessed to have had the support I did when I went through that most trying time of my life (and theirs, I’m sure.) My husband did not abandon me, my parents and in-laws wrapped their arms around me in support, and my closest friends were there to listen to what I was going through whenever I needed to talk. I was so lucky that I didn’t have to suffer in the public eye like Jason is right now.

I’m sure there were things said behind my back by people wondering what the heck was going on with me. But I didn’t have to read about it online or hear about it on the news like his friends and family are doing right now. I pray that they don’t read or hear the negative words being thrown about on the Internet and news talk shows, and that if they do, that it only strengthens their defense for him and their efforts to help him get well. I’m praying for him. He’s done so much good work. He does not deserve all the hate. Not one bit of it.

I am not proud of my initial reaction to what happened to him. I wanted to write about it here to help teach myself, someone who suffers from a mental illness which caused four psychiatric hospital stays, not to turn my back on someone because they are going through a trying time. Let this be a learning experience to myself and the other 83 million people who watched the video. Don’t turn away because I believe that some people come into our lives as blessings, and others come into our lives as lessons.

The Holy Prophet (Peace Be Upon Him) said,
“One who gives us adulterated goods is not from us.”
He repeated this sentence thrice then said,
“And Allah will remove barakat from the livelihood of the Muslim brothers. (Allah) will destroy his economy and leave him upon his own condition.”

However one of the most serious problems Pakistan today is the phenomenon of adulteration of food. Food commodities in the country have always been vulnerable to fraudulent admixture or adulteration with cheaper inferior materials. This unprincipled and nefarious practice, increasing in degree as it has been found difficult of detection, is now applied to almost every commodity, and is carried on to a most alarming extent in every part of the country, and food adulteration certainly has now become one of the biggest proliferating industries. Fruits, vegetables, edibles especially beverages, bottled water, cooking oil/ghee, spices, tea, sweeteners like sugar, sweetmeats and bakery products, milk and milk products might be contaminated that producers can save a few rupees; are constant threat to the health of the  citizens. Contaminated foods and drinks are common sources of infection.

Food adulteration in Pakistan starts from the field itself where fertilizers and pesticides are overused. Therefore one kind of contaminant that is present across all range of food is very high level of pesticide residues. In the market very often food is adulterated by merchants and traders who are unscrupulous and want to make a quick profit. But shortages and increasing prices, consumer demands for variety in foods, a lack of awareness, negligence, indifference and lethargy among consumers and inadequate enforcement of food laws and food safety measures also lead to food adulteration. Food insecurity and adulteration have not only worsened but also playing havoc with the lives of people. From mixing of edible oils with inferior varieties to ripening of bananas and mangoes with banned chemicals, Pakistan is home to the worst kind of adulteration of food in the country. While these details are startling, what is alarming is the fact that most of the culprits engaged in this illegal activity in the country go unpunished. Not a single person or a company has been convicted for food adulteration in the country in the last four years.

There are about 60 million children in Pakistan. Malnutrition, diseases like polio, typhoid fever or bacillary dysentery, cryptosporidiosis, cholera, rotavirus infections, and a variety of worm infestations, and even prejudice continue to threaten their healthy existence. Urea, which is used in the preparation of synthetic milk, is particularly harmful for kidneys, and caustic soda is a slow poison for people suffering from hypertension and heart ailments. When we see such young children and adults suffering from various diseases due to the adulteration of food, we realize that it become a big problem now. There have been various debates in this regard in the parliament, but no action has been taken so far. Two years back National Assembly Standing Committee on Human Rights was informed that 70% adulterated food and 52% adulterated mineral water was being sold in the market and also cadmium, hair removing powder, surf, bleaching powder, salt and lead was being used in tetra pack milk, which is dangerous for human health but no stern law has been introduced to apprehend the adulterators in the country till now.

The average Pakistani family is eating dangerous dyes, sawdust, soapstone, harmful chemicals and other harmful substances mixed with consumable goods. According to our Ministry of Science and Technology there is 35% microbiological contamination in bottled water and 1 kilogram of pure milk is being mixed with 39 kg of contaminated milk consisting of Urea, bleaching powder and other poisonous chemicals. High Level of pesticides content is present in grains, pulses, in fruits and vegetables that we eat. Arsenic is being used in mineral water, which is common particularly in Sindh province. Salt is the classic preservative, but is seldom classified as an adulterant. Many products used in everyday cooking, such as cottage cheese and clarified butter, are adulterated. Coloring agents in spices are also posing problems. Apples are the basis for many jellies, which are colored so as to simulate finer ones. In confectionery, dangerous colors, such as chrome yellow, Prussian blue, copper and arsenic compounds are employed. Cream is adulterated with gelatin, and formaldehyde is employed as a preservative for it. Brick dust in chilly powder, colored chalk powder in turmeric, injectable dyes in watermelon, peas, capsicum, brinjal, papaya seeds in black pepper etc are frequently used.

Due to the lack of fresh clean water in rural areas, people are forced to drink water that is high in fluoride content; it consists of high impurities and other harmful pesticides contents. Due to the consumption of such impure water, people are prone to diseases of the bone, cancer etc.   It is estimated out of the total, 40% of the diseases prevalent in the country are water borne and about 20 to 40% hospitalizations are due to these diseases. Consumption of food and beverages obtained from street food vendors has been associated with an increased risk of illness. Pesticides that are now banned in the western world (such as DDT) are still used frequently by our farmers. I can go on describing the harmful impacts adulterated foods can have on your health. What is however disturbing is the complete indifference being shown by the consumers as well as the regulatory bodies in checking the menace of adulterated food products, milk, fruits and vegetables.

Just take the example of Karachi. As reports suggest, the authorities have absolutely failed to tackle the menace of adulteration, which puts the health of consumers at risk. There are only 13 food inspectors in this city of 18 million people and a tedious legal procedure mean that the city government is unable to keep a check on adulteration. Apart from the insufficient number of food inspectors in Karachi, reports from other parts of the country reveal that in some instances the inspectors are not qualified for their job. The state needs to take food safety seriously qualified food scientists need to be recruited. The number of food inspectors in our cities and towns must be increased and eateries` staff better trained. Officials must also be equipped with better technology to test food quality, and empowered through legislation to take swift action against those who flout food safety laws. The available laws against adulteration are just the tip of the iceberg. The roots are much deeper and embedded in the weak legal and regulatory procedures that allow the indicted to go scot-free even after being held for a culpable crime, and pursue his business as usual. Extremely low conviction rate raises a finger at the probity of the Government to book the culprits. There is no denying the fact that the officials do file a case against a company when its food samples are found adulterated in the laboratory and then matters are settled underhand.

The overall picture for the country too is not impressive enough regarding anti-adulteration measures. In Pakistan no Prevention of Food Adulteration Program has been developed to regulate the quality of food and to ensure safe food for the consumers. There exist a large number of food laws in Pakistan. However, most of them deal with control of production, distribution and supply of food; adulteration, however, goes on unabated in our country and no one ever has been handed down this maximum punishment. Punishments on food adulteration, in fact, are very rare in the country. The adulterator after been caught red-handed settles the issue with the regulators that benefit both of them at the expense of the consumers. Adulterators are not scared of any legal or punitive action due to the various loopholes in the existing laws. Majority of adulterators arrested or challaned for the offence easily get bails from courts. Now that the reality behind what we eat has come out, the indirect poison that we intake unknowingly, has to be corrected with immediate steps. Adulteration of food items has become a severe health hazard which needs to be curbed with stern action. Food adulteration, and for that matter any type of adulteration should be stopped at any cost.  The practice of injecting chemical substances to ripen the fruit has caught the attention of many people.  Even though they are practiced day in day out, there is no mechanism or legislation to prevent such kind of acts.

The lives of the people are endangered and simple fines and small imprisonments are not enough for the adulterators. There should be provision for stringent punishments like confiscation of property, life imprisonment, and even death sentence. So long exemplary punishments are not given, this menace cannot be stopped. The same punishments needs also be given to the officials and politicians who collaborate with them. There are stringent punishments to the adulterators are prevalent in some countries. Pakistan is a soft state where crime has taken the cancerous dimension.  The cases pending against violators could set examples instead of letting the violators to go untamed by the law. People should start suing the shop owners who sell tainted food. And law should be impartial. Provincial and local governments need to work in coordination for the provision of hygienic and healthy food and the departments concerned should take necessary steps to cancel licenses of factories of adulterated food and food related other products manufacturers and mineral water producers in order to cope with the situation. Consumers have to be aware of their rights, and nonprofit organizations should play an active role in this regard. The Government should also periodically intimate as how many adulterators were punished for food adulteration.

What’s more, about two-thirds of the hospitalizations that occur in people with dementia are for potentially preventable illnesses, such as a urinary tract infection, the study shows.”

Find out more:

http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2012/01/10/dementia-may-lead-to-avoidable-hospitalizations

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No, I’m not all prepped for surgery.  Neither in Cuba, no less.  I’ve got a little bit of a problem for my second IV anemia infusion tomorrow.  I had a similar problem last time.  It was just a pesky virus that I’d hoped would be gone by the date, but nope.  It was gone the next day.  Nonetheless, since I was still a wee bit sick, I suggested they should mask me.

There’s a reason I need to take precautions on the floor.  I’ll get into all of that, as I found out another cause due to what my infusions involve.  So that’s why I was completely up front about them masking me in the first place.  A hint is that I’ve worked in a Hospice.  Also, my infusions take at least an hour and a half.  I’m hanging around a long time.  A lot of traffic?

What’s my problem now? I fear a lot worse than a “pesky virus.”

I ordered some take away and for dessert, they gave me some sort of food-borne pathogen.  Charming.  Of course I am still quite ill, otherwise I wouldn’t be writing this.

“They” say “most people” recover from such lovely incidents within 12-48hrs.  Well, certainly I wouldn’t fall into “that” section of the population.  I ingested my toxic meal on Friday night.

As awful as it is when you get this sick, I do find the following scenario absolutely hilarious.  I think a lot of us have been here?

You’re sitting on the shitter (quite literally at point in time) with your stomach heaving and churning.  Then, you start to feel something creeping up…and up…and…! OH NO! Are there any other “receptacles” nearby? A bathtub? A sink? If not, SHIT! I didn’t grab a bucket (or maybe didn’t have time.)

Luckily, my bathtub is right beside my toilet.  If not, I would have repainted my entire bathroom in a latex paint that has not yet been invented.  The name of it would be: “Incandescent Vegetarian Pizza.”  All of this was going on sometime in the wee hours of “Who Knows When.”  All I know is that I woke up, thought I was giving birth to Satan’s child, and it was still dark out.

Now why do I have to (and want to!) be so completely, extra cautious when carrying some Infectious UFO in my body? The floor where I have my infusions done is, I believe, also a chemotherapy floor.  A lot of the equipment is labelled as such, and judging from some other patients I’ve seen, it seems likely.  Also, I was surprised to read about what they are shooting me up with (no it’s not someone’s iron rich blood!)

It’s called Venofer.  To try and keep the med geekiness simple, it’s a liquid form of iron and/in sucrose.  They are bound together and when in my body, the iron hits certain precursor cells.  Then they go on to do stuff–like hit cells that will go on to zone in on my hemoglobin.  But what is also interesting about Venofer is that it’s not just used for people who are only anemic.  It’s actual use is for people who are anemic due to chronic kidney disease! I don’t have CKD!

Therefore, another reason to be careful tomorrow.  Who else is on that floor receiving treatment for other conditions? So I’m going full on.  Mask and gloves.  Especially since I don’t even know what I have!

What complicates things more is I’m still dealing with the Clobazam withdrawal, some breakthrough seizures, and all of that nightmare.  So naturally, when I’m getting nailed with anything else that makes me sick, there are only certain variables I can rely upon to figure out the differences.  And most of the time, those variables are extremely minimal.

I’m not sure how many of you have seen this film I am about to mention.  Although it may not be the most thought provoking, intellectually stimulating, or a piece of cinema to be philosophically debated for generations.  Nonetheless, it does deliver an extremely potent message for us all.  I am speaking of “The Italian Job” that was made in 2003 (not to be confused with the original from 1969.)

What does it impart that is such an unbelievable gem? It is only within a small piece of dialogue.  About what determines “fine.”

F – FREAKED OUT

I – INSECURE

N – NEUROTIC

E – EMOTIONAL

Thus, when we do answer we are “fine” we are telling the exact truth.  It really is a perfectly, reasonable response.  In knowing this, I think we can all heave a collective sigh or relief and feel a great weight lifted from our shoulders.

However, I see a problem that still exists.  This new knowledge is imbalanced (and I am not referring to the acronym.)  It almost appears as a “secret.”  A sort of “insider information” thing.  We know the answer, but what about the person who posed the question (unless it was one of us.)  So, it leaves only one choice.  We must spread the word! We must tell everyone!

We have to paint it on billboards! Slap it on every form used for transportation! Posters on every street! Take over the Internet as daunting, and even frightening that may be!

Moreover, this must be a global commitment! We all must take part and do our share, no matter how insignificant it may seem.  Not-for-profit organizations must be contacted, so please make them aware.  Surely there are wealthy individuals who would be willing to offer financial support.  Just pause for a moment and think of the possibilities.

I vow to lead this project, but I will need others to form an Executive Team, other individuals who have special skills and experience to serve in their areas of expertise, as well.  Please contact me if you are willing to join and serve with me.  We WILL make the world understand!

What got me started thinking about it was my drive home this weekend. My high school girlfriends and I had planned a girls’ weekend to catch up and unwind without the stress of having to chase around toddlers, change diapers, and do naps, baths and bedtimes. (Our husbands graciously all agreed to our request for some R&R and amazingly we were able to find a weekend that worked for everyone.) Except the weather decided not to cooperate and instead of the beach for four days of sun, sand and cocktails, we were forced to choose a different location. One of the girls had just sold her house, and she was in the process of moving out so we gathered some air mattresses and crashed there for three days while Hurricane Irene wrecked havoc all up and down the East Coast. Luckily for us it was not much more than a bad thunderstorm with heavy winds by the time it got to our area.

I guess a part of me was hoping that at some point over the weekend I’d get a chance to talk with everyone about my hospitalizations, my recoveries, and my hope that I can somehow change the public’s perception of bipolar disorder and postpartum psychosis by telling my story and the lessons I’ve learned. But our conversations seemed to revolve more around our kids, work, and family life in general. Don’t get me wrong, I had so much fun getting to catch up and spend time with some of my friends who I have known for the longest time. The memories we made this weekend were priceless. I should probably get back to seeing my therapist regularly again instead of trying to turn one of my friends into my own personal Carl Jung. It’s on my to-do list for tomorrow morning.

Lately at night when I am drifting off to sleep, I find that I am reminding myself how lucky I am to have an incredible husband who loves and supports me, two beautiful healthy children, an amazing family surrounding me in my parents, brother and his wife, and in-laws and sister-in-law in addition to an extended support system of loving friends whom I trust so much. It sometimes doesn’t seem real. But I am living proof that just because a person is living with a mental illness doesn’t mean they can’t work hard to manage it well and this blog is my way of giving back. I want to take the past six and a half years and share what I have learned from my journey to somehow help other young women who may have been feeling the way I was feeling back at the beginning of when it all started for me.

If you like what you are reading, and know someone who could benefit from my experiences, please, pass on the link to my blog. Over 5 million Americans live with this illness, so chances are within your family, friends, work, school, or church you probably know someone who may be suffering. They may find comfort in reading a story of someone who is doing better than average at managing it. I know I always do.

While transitional care is a central theme in these provisions, there is little information available to guide those responsible for implementing these important opportunities. To bridge the gap, researchers at the University of Pennsylvania School of Nursing reviewed existing programs in order to determine what works, for whom and for how long.

They discovered “a robust body of evidence” that transitional care can improve health outcomes and reduce hospital readmissions. Their paper published in a recent edition of Health Affairs, highlights a range of solutions to reduce avoidable hospitalizations and health care costs.

The team conducted a systematic review of the research literature and summarized twenty one randomized clinical trials of transitional care interventions targeting chronically ill adults. From these, they identified nine interventions that demonstrated positive effects on measures related to hospital readmissions. “All nine interventions that showed any positive impact on readmissions relied on nurses as the clinical leader or manager of care,” wrote lead author Mary Naylor, Ph.D., R.N.

The strategies they identified have been shown to result in short term benefits and effectively reduce all-cause hospital readmissions through six or 12 months. “If we capitalize on what we know, the real beneficiaries will those living with complex chronic conditions and their family caregivers,” explained Naylor.

This makes sense to us and is certainly a lot easier than trying to understand the Affordable Care Act.