December 21st. 2009

This month people  braved the snow flurries and bitter cold, to come to the Lexi for our film club. They all enjoyed the film, so imagine my surprise to read  Peter Bradshaw in The Guardian the very next day quoting Mrs. Caldicot’s Cabbage War in a column entitled Talking in films:

“At the end of one dire day of screenings, we critics once sat down to a horrible tear-jerker called Mrs. Caldictot’s Cabbage War. Pauline Collins played a lonely widow who is pathetically grateful to be given a nice lunch in a restaurant. She simpered: ‘I haven’t had many afternoons like this’. ‘We have’ remarked the Observer’s Philip French drily. (The Guardian 17/12/2009)

Not one word referring to the film is accurate, they all misrepresent it. The film is not horrible, it is definitely not a tear jerker, Pauline Collins does not play a lonely widow, she is not pathetic and at no time does she simper.  Six years after its release, Bradshaw sees fit to denigrate this film again. On its release in January 2003  he said in the Guardian  : ” About 10 mins in, I all but lost the will to live”.  When it was scheduled on TV in December of the same year : “We’ll have enough turkey on our plates without having it on the telly as well. Most people reading this will not, for example have seen Mrs. Caldicot’s Cabbage War, a horribly twee British comedy that came out this year starring Pauline Collins and John Alderton, about a feisty lady packed off to an old people’s home.

What is it in this film that so disturbs Bradshaw that he needs to attack it again and again? what is it in this film that puts off critics, reviewers, distributors and programmers alike?.  Is it pure ageism? Amongst the unfavourable reviews the following comments would point to this:   ’It’s hard to imagine anyone under 60 judging this worth a trip to the cinema (ch4 film reviews)’ ‘its target audience is undemanding oldies (Sunday Times) , ”An old biddy campaigns against cabbage in an old folk’s home”. (Time out)”, Pauline Collins plays a geriatric Shirley Valentine in this senile comedy that’s well past its prime”. (BBC film review)

The comedy it is true deals with many issues concerning older people. The exploitation of a recently widowed mother by her son, the unscrupulous property developers, the running of care homes for profit rather than care, the sedation and neglect of older people, the manipulation of the media.

The story is a simple one. Thelma Caldicot  has been oppressed and cheated on by her husband all her life. After his death she is tricked by her son into a care home. The care home managed by a tyrannic manager and matron and poorly trained staff, abuses its residents by denying decent food, stimulation and genuine care. There, she is so sedated that she signs her rights away. Thanks to an understanding nurse she regains her self confidence, leads a revolt of the residents and eventually with the help of a sympathetic journalist obtains the ownership of the home.

The acting of all the well known actors and the less famous is very good and the script intelligent. There are extremely well observed and very funny scenes. The opening sequences recall Shirley Valentine and suggest the coming rebellion against authority. The breaking of the news of the death of her husband to Thelma by two novice police officers is hilarious in its realism. The comic quality of a slightly demented Audrey in a luxury hotel ordering a profusion of room service food challenges our preconceptions. Why should not care homes be more like luxury hotels? Finally the TV presenter, his put downs and Thelma resistance are satirically brilliant.

There are other touches which are fun. The cabbage which is the smelly everyday food is transformed into a football for young men, and boule for the pensioners. The idea of ‘mature students’ hijacking a school bus raised a laugh in our U3A audience.

But there are also touching moments. The relationship between Thelma and the nurse, the solidarity of the residents with Thelma, the change from passivity to creativity in people who have been overmedicated. Joyce who repeats what everyone says suddenly regaining her lovely voice.

It is true that there are a few misjudged scenes, and that a more stringent editing out of some redundant ones would have improved the pace of the action. It is also true that this is a film that conveys a message in an obvious way. That is not to say that all the issues it raises are not important ones that need to be aired and presented to a general audience.

Have all these people who decide what we see on the big screen no mothers or fathers, have they not heard of the the appalling regime in some rest homes and hospitals? Have none of them had to make the difficult decisions about their parents’ care? Many members of the Lexi audience said that the conditions of the Twilight Care Home do exist in real life, and that the film was worth showing in the cinemas. The comments of users on a variety of web sites were also complimentary

Does the genre of the film defeats its purpose? Maybe for some people but why not give the opportunity for the audiences to decide?  Only around 3000 saw it  in the UK and it has had no international distribution at all. Why?

Yet Mid August Lunch where the old women are infantalised and trivialised has been praised and internationally distributed in spite of being described as slight , anecdotal, good for TV by a good number of critics.

What is the difference between these two feelgood films about old people and their carers. In Mid August Lunch the old women are one dimensional and amenable. Their sons and carer gentle and inoffensive. In Mrs Caldicot’s Cabbage War the old people are characters in their own right. They rebel against an uncaring system.

The first film is seen from a younger person’s point of view. The second from an older one’s. The first film gets acclaimed, the second ignored.

opiated toddler

September 11, 2001 is the day Joseph Gabriel Mattia IV was born.  He asked tonight about the “terrorist attack” in attempt to distract us from putting him to bed at 8.30.

My partner is the biological father of an eight year old.  What does that mean?  I haven’t quite figured it out yet.  However, I do know that explaining anything involving “terrorists” is a challenge.

The foundation of the conversation was brainwashing of our planet through television.   Thank you Rupert Murdoch.  Try explaining that one to an eight year old.  Okay Joey,

“so…the whole world  watches this “terrorist attack” on 9/11 right?  We’re all scared, right?  Our country is being attacked, people are dying.”

Impressionable young minds crave positive nourishment.  They are our future.    Their sensory intake will soon manifest as the tangible projection of our world.   Thus the development  of our society, our earth…

One of the main problems that people with mental illness face is taking medication.

I am taking 2 medications which means that I have to not only remember to take them twice a day, but also have to deal with the side effects.

The side effect that causes me the most stress and worry is weight gain.  I put on a lot of weight when I first started taking my medication and then again every time the dose has been increased (which has been quite a few times).

I feel quite embarrassed when I go to see the GP and they say I need to loose weight.  It’s funny, when I tell them what medication I’m on they tend to say “OK that explains it” and stop pushing the issue.  This doesn’t actually help much as no matter how hard I try it is difficult to loose the weight.

I feel so self-conscious about my weight now and wish there was a away around it.  This can lead to me really not wanting to take my medication any more, even though I know I need it to maintain my mental health.

The other side effect of medication that really bothers me is sedation.  It makes me get tired really easily and my boyfriend can sometimes call me a zombie.

Before I started taking medication, I used to have so much energy, which I really miss. I used to be able to work full time and then do extra hours on my day off.  Now I can’t do that and it makes me sad.  Sometimes, its all I can do to go into university and I find it hard to do much else.

People just don’t understand what its like to feel like a zombie and think that I am being lazy or pathetic. They just don’t understand what its like to feel so tired that the whole world is spinning and you just can’t keep your eyes open.

Having said that, I try to remember how important it is for me to take my medication; without it I don’t even want to think about what my mental health would be like.  When I feel bad all I have to do is think back to when I have had a breakdown and ended up in hospital. I know I never want to be like that again.

Well A went into surgery last night for his tracheostomy about 6:30pm and at 8pm we got word from his ENT that all went wonderful. We were able to see him in the PCCU very shortly after. He is on a lot of medications for sedation however he is NOT sleeping.

Right now he is currently on the ventilator (life support) but is taking some breaths on his own above the machine. They want to keep him very sedated and pretty still for another 24 hours before they even think of weaning him off the meds and the vent.

I have a lot of emotions right now but so far I feel okay with what has gone on. It was a VERY tough decision and I hope that I never ever have to make one like this ever again in my life!!!!

Here is my tough little guy….

Keep the prayers coming….we have a LONG road ahead of us. He has been a very good boy though for mommy so far on her birthday which is the best birthday present EVER!!!!

Yesterday I had to go to the hospital for endoscopy\a camera down my throat (don’t worry, gravy fans, it turned out to just be a hiatus hernia).  Anyway, you have two options for the procedure; a ‘throat spray’ or sedation.  With the throat spray you’re allowed to leave straight afterwards; with sedation you’re not allowed to drive or be alone for 24 hours.  I was semi-tempted to go for the spray, but, once I was there, I chickened out and went for the sedation.

My advice: don’t bother.  The sedative was injected through my hand and I was lay there waiting for it to kick in.  After a minute or two the doctor told me that I should be feeling dozy; I wasn’t.  He started anyway.  If you imagine that you have to swallow a garden hose all the way down to your duodenum, then that’s exactly what happens.  It’s both as horrible as it sounds and not that bad, in equal measure.  The worst bit is getting the initial part of the camera past your throat, as you literally have to swallow it down.  Once you’ve done that, you just need to cope with the occasional gagging and the odd sensation that someone has a camera inside you.  It’s not at all painful.  It’s definitely odd though.  The whole procedure only takes about 10 minutes and then you’re fine.

I then had to ‘rest’ for an hour, even though the sedation had no effect, and had to stay with my folks over night.  This meant I had to endure the horror of not having full control of the television remote.  That was more harrowing than the camera.

P.s.

The doctors and nurses were all lovely.  Don’t slag them off.

Probably would have been cool if my dad wasn’t sedated.

Simply sedated.
Not even sedated, I’ve just been around and trying to get out of certain things the best way I can…but it’s all to get the better part of the sandwich. Last week I kept telling people that I was waiting for something to hit me, then I ended up throwing up into a trash can in the middle of China Town. It wasn’t exactly what I was looking for but it did help me realize something:
don’t drink tea from Mcdonalds!
No, there has to be a more substantial reason as to why you haven’t been writing in your blog!
There’s really not, though.
For the past week I’ve been really tired and really thirsty.
Thanksgiving is coming up.
I think this is one of the most dull blogs I’ve written by far…
probably because I am writing to fill up space.
Most defiantly cause I am writing to fill up space.
I am going to pretend like there is no more space and write at a time where I am not even thinking about the space.
Does that even make sense to you?
Pause.
Don’t answer.
Replay.

Guess what arrived today? My travel crate!

The lovely Dogtainers Pet Travel Consultants people brought it to our house in a big car machine…

Ooh! Look who's here!

I helped by supervising the unloading…

You take the left, I've got the right...

Are you tensing your core muscles before you lift?

Usually, travel crates are put in the house – like in the living room, where most of the family spend their time – so us doggies can get used to staying in it there…but in my case, it’s so big and our house is so small that it would have taken up half the house!

So my humans decided to leave it in the garage and I could just go and practise staying in it there for a short time each day.

Hmm...the latest in luxury canine travel, huh?

Anyway, my human, Hsin-Yi, will probably be spending a lot of her time in the garage in these last couple of weeks packing up all our stuff…so it’ll give me a handy place to laze around while supervising her!

Hsin-Yi let me sniff all around the crate and explore it in my own time – she didn’t try to force me to get in or anything like that, which made me think it wasn’t so scary after all.

Good thing they took my measurements to make sure it's tall enough!

You see, I have never been crate-trained and so I have not been used to being confined in anything small in my life. But the key to introducing new things to us doggies is to not rush us but be very patient and let us take “baby steps” at our own pace and have lots of positive experiences with it, so we associate it with nice things and learn to like it.

Hsin-Yi had put an old yoga mat and blanket down in the floor of the crate to make it nice and comfy for me to lie on…and then she put 2 yummy cookies in it and just waited to see what I would do…

Well, silly human – what does she think?

Wow - this travel crate comes with inflight snacks!

It was a bit of a tight squeeze turning around to get back out but I managed!

Breathe in! Breathe in!

(To be honest, I’ve had lots of practice squeezing into tight spaces this year having to ride in our tiny car machine!)

Since Hsin-Yi was busy doing her ‘crazy Camera Machine dance’ around me, I decided to humour her and stay in the crate a bit to pose for her pictures…

Did you get it from this angle?

After that, she let me get out and we went back into the house. She said that since this was the first day, it was good enough just getting me going into it happily & voluntarily - after a few more days of this, she will try getting me to do a Down Stay in there (with the door open) so I learn that I have to stay in there for a while…

…and then after a few more days of that, she will shut the door but stay around me, doing stuff in the garage…

…and then after a few more days of that, she will shut me in it and go back in the house for a few minutes…

…gradually working up to leaving me shut in it alone for longer and longer times. Baby steps, remember?

This is quite similar to the normal method of introducing a puppy to a crate. If you would like more information about that, here are some useful links:

• http://www.humanesociety.org/animals/dogs/tips/crate_training.html
• http://www.siriusweb.com/AAD/crate.html
• http://www.canismajor.com/dog/crate1.html
• http://www.dogbreedinfo.com/cratetraining.htm

I will also be getting super yummies when I go in the crate, like special chews and stuffed Kongs, etc – and maybe also having some of my meals fed in there, so I will really associate it with good things!

* By the way, in my original post about doing our “Moving Overseas” thing, some of you asked in your comments about whether us doggies should be sedated when we are going in the Big Flying Machine. Actually, this is a very old idea which is wrong because the medicines used to sedate us can make us doggies very sick when we are in the air.

Hsin-Yi recently wrote an article on Emigrating with Your Pet for one of her dog magazines and here is an excerpt from that article, which will explain to your humans better why pets shouldn’t be sedated for air travel:

You might think that a good solution for nervous, timid dogs would be sedation. But in fact, sedating an animal is probably the worst thing you can do and airlines now refuse to carry any animal which looks like it has been sedated.

Sedation reduces an animal’s ability to cope with stress, such as moving around, panting, drinking and so on, and some sedatives, such as ACP, may actually directly affect thermoregulation. Furthermore, aircrafts are pressurised at between two-thirds and three-quarters of normal atmospheric pressure, which lowers the blood pressure of both humans and animals. Since sedatives also work by lowering blood pressure, the combined effect would be seriously dangerous to the health of the dog.

However, help is at hand for anxious dogs, through the use of natural anxiety-relievers which do not lower blood pressure and are safe to give when administered according to veterinary advice.

“Dogs with major behavioural/ anxiety problems such as severe separation anxiety are not good candidates for travel,” admits homeopathic veterinarian Richard Allport. “The dog is away from the carer, in a strange, noisy place for a long period. However, natural anxiety relievers such as herbal Skullcap and Valerian, or homoeopathic Passiflora are usually helpful.”

“Most dogs will cope, which is not to say there isn’t some degree of stress involved. Just like people, every dog is different. Most dogs subjected to sitting in a kennel in the cargo hold for several hours would find the experience pretty unpleasant but would soon – perhaps not forget – but put the experience behind them. Because dogs live much more in the here and now than we do, the experience may be, if anything, more stressful at the time, but conversely they may be even more able to move on and put it behind them. A few, more sensitive, dogs might have a deeper and longer-acting reaction. It’s a question of knowing your own dog.”

Choosing a reputable, experienced pet transport company can also make a big difference in reducing the stress to an anxious animal. Not only would the company know how to select the most direct air route and keep the time spent in travel crates to a minimum but many of them also have ‘strategies’t to help anxious animals cope better.

“We spray all our crates with DAP pheromone spray which helps the dogs,” says says Bob Ghandour, Veterinary Consultant and Director of PetAir UK, which flies thousands of pets per year around the world. “Also, a nervous pet can have his crate to get used to it before the flight and they will usually travel very well.”

I hope you found that useful!

3210719    การลดความวิตกกังวลและยาที่ใช้บ่อยทางทันตกรรม    Conscious Sedation and Common Drugs in Dentistry

การซักประวัติและประเมินสภาพร่างกายของผู้ป่วย ซึ่งรวมถึงการตรวจทางห้องปฎิบัติการที่จำเป็น การทำให้ผู้ป่วยคลายความวิตกกังวลด้วยยาทั้งยาชนิดรับประทานและยาที่ฉีดเข้ากล้ามเนื้อ/หลอดเลือดดำ รวมทั้งชนิดสูดดม การป้องกันและแก้ไขภาวะฉุกเฉินทางการแพทย์ การช่วยพื้นคืนชีพขั้นพื้นฐานและขั้นสูง ยาที่ใช้บ่อย ๆ ในทางทันตกรรม ได้แก่ ยาชา ยาแก้ปวด ยาลดการอักเสบ ยาปฎิชีวนะ ตลอดจนยาที่ใช้บ่อย ๆ ในผู้ป่วยที่มีโรคทางระบบ ที่มีผลกระทบต่อการรักษาทางทันตกรรม

(History taking and physical evaluation including essential laboratory examination of patients; oral intramuscular/intravenous and inhalation sedation for anxiety control; prevention and management of medical emergencies; basic and advanced cardiac life support; drugs commonly used in dentistry: localanesthetics, analgesics, anti-inflammatory drugs, antibiotics and drugs commonly used in medically compromised patients which affect dental treatment.)

(3210719 จุฬาลงกรณ์มหาวิทยาลัย)

3212738    การรักษาทางทันตกรรมสำหรับเด็ก โดยการใช้ยาลดความกังวลและการดมยาสลบ 1    Sedation and General Anesthesia in Pediatric Dentistry clinic I

การฝึกปฏิบัติงานเป็นผู้ช่วยในการรักษาผู้ป่วยเด็กที่ต้องใช้ยาลดความกังวลและการดมยาสลบ การจดบันทึกประวัติการรักษา การตรวจและแปลผลอาการทางคลินิกที่สำคัญ การรักษาฉุกเฉินเมื่อเกิดภาวะแทรกซ้อน

(Practice as an assistant in treating child patients under sedation and general anesthesia; record taking; monitoring and interpreting vital signs; emergency treatment in case of complications.)

(3212738 จุฬาลงกรณ์มหาวิทยาลัย)

3212745    ทันตกรรมป้องกันสำหรับเด็ก    Sedation and General Anesthesia in Pediatric Dentistry Clinic I

กระบวนการของโรคฟันผุ การจำแนกเด็กตามความเสี่ยงของการเกิดโรคฟันผุ การป้องกันโรคฟันผุซึ่งครอบคลุมตั้งแต่วัยแรกเกิดจนถึงวัยรุ่น โดยมีรายละเอียดทั้งส่วนของการเพิ่มความแข็งแรงของฟัน การควบคุมอาหารคาร์โบไฮเดรต และการลดปริมาณแบคทีเรียโดยวิธีการต่างๆ

(Practice as an assistant in treating child patients under sedation and general anesthesia; record taking; monitoring and interpreting vital signs; emergency treatment in case of complications.)

(3212745 จุฬาลงกรณ์มหาวิทยาลัย)

3212938    ทันตกรรมคลินิกสำหรับเด็กโดยใช้ยาลดความกังวลและการดมยาสลบ 1    Sedation and General Anesthesia in Pediatric Dentistry Clinic I

การเพิ่มพูนทักษะทางคลินิกในการบำบัดทางทันตกรรมโดยเทคนิคที่ใช้ยา การประเมินผู้ป่วยที่มีลักษณะตามข้อบ่งชี้ การตรวจ พยากรณ์โรค และวางแผนการรักษา โดยใช้ยาลดความกังวลโดยการกินและ/หรือการสูดดมไนตรัสออกไซด์/ออกซิเจน รวมทั้งการดมยาสลบ การดูแลผู้ป่วยทั้งก่อนและหลังการรักษา การให้ความรู้ทางทันตสุขศึกษาและคำแนะนำทางโภชนาการแก่ผู้ปกครอง การกู้ชีวิต และการรักษาฉุกเฉินหากเกิดภาวะแทรกซ้อน

(Improving clinical skills of dental treatment under pharmacological techniques; evaluating the indicated patient, examination, prognosis and treatment planning for dental treatment using oral sedatopm and/or nitrous oxide/oxygen inhalation as well as general anesthesia; pre-and post-operative care; oral hygiene instruction and diet counseling to parents; cardio-pulmonary resuscitation and emergency treatment of the complications.)

(3212938 จุฬาลงกรณ์มหาวิทยาลัย)

3215750    การทำให้สงบและยาทางทันตกรรม    Sedation and Drugs in Dentistry

การตรวจร่างกาย การช่วยฟื้นคืนชีพขั้นพื้นฐานและขั้นสูง การทำให้ชาเฉพาะที่ การทำให้สงบ ยาต่างๆ ทางทันตกรรม ได้แก่ ยาต้านคราบจุลินทรีย์และยาต้านหินน้ำลาย ยาแก้ปวด ยาปฏิชีวนะ ยาลดการอักเสบ ยาห้ามเลือด ยาลดความดันโลหิต และยาขับปัสสาวะ ยาที่ใช้บ่อยๆ ในผู้ป่วยโรคหัวใจ และยาต้านเมแทบอไลต์ที่ใช้สำหรับเคมีบำบัด

(Physsical examination; basic and advanced life support; local anesthesia; conscious sedation; drugs in dentistry : antiplaque and anticalculus agents, analgesics, antibiotics, anti-inflammatory agents, hemostatic agents, antihypertensives and diuretics, drugs commonly used in cardiac care, and antimetabolites used in chemotherapy.)

(3215750 จุฬาลงกรณ์มหาวิทยาลัย)

Hello my raw vegan friends!

This isn’t going to be much of a GOING RAW VEGAN! post, as it is an update on my dental surgery showdown yesterday. Things went pretty badly, and I thought maybe it would be okay if instead of focusing entirely on my raw vegan struggles, I could warn about the painful qualities of anesthesia. If you’re not interested in reading my nightmare, skip down a few paragraphs for an update on my raw vegan adventures.

I went in for surgery to remove all four of my wisdom teeth, and I was told it was important to do it sooner than later because all four were impacted, and well-rooted into my jawbone. So yesterday, Friday 13th, I went in as a nervous wreck. I have an unexplainable fear of dentists, which was only justified yesterday. Don’t get me wrong, I have a wonderful dentist, and a wonderful oral surgeon. They are both very kind and caring, and prior to the surgery, they had relieved a lot of my dental anxiety. My surgeon even told me he was desperately trying to go vegan himself, and asked if honey is vegan or not, but at that point I was little high on an IV sedative they gave me, so I think all I said was “agave”, ha. He probably thought I wanted tequila, and that wouldn’t have been an entirely bad idea considering my nerves.

The problem lies in the fact that I had an adverse reaction to the pain blocker in my IV sedation. The sedative worked, but not the pain medication. I’ve heard those stories on Discovery Health before, where patients have been agonized and tortured because only select anesthesia worked, and that was one of my major fears. Typically, the surgery only lasts about 45 minutes, but after an hour only one tooth had been removed, and I was screaming and crying the whole time. I’m told they tried a series of pokes and pricks, asking me if I felt anything, and all that was deducted was that I must be losing my mind, but I couldn’t feel any pain.

Now, I initially didn’t remember anything, but as time is going by bits and pieces are coming to me. Mostly when I sleep. I feel sorry for my poor mother who arrived to pick me up, and went to pieces of crying hysteria when she heard me screaming. At one point I guess she demanded they stop and tell her completely what was happening, and they assured her that I was having an adverse reaction, but as far as they could tell, I wasn’t in any pain (which I’m sorry to say, is completely false). She didn’t believe it either, and got a little carried away, telling the dentist, “If I find out she felt any of that pain, I will kill you.”

Good move, mom. Let’s hope nothing happens to him, because we know who they’ll be looking for, haha.

She ended up calling my father, which is huge for my parents since they have been very bitterly divorced for twelve years, because she knew he would march up to that front desk and raise hell. He did, but shortly after his arrival the surgery was finished and I was no longer screaming.

And by screaming I mean, they turned away all other morning appointments. Other patients weren’t allowed into the building, because I’m sure they would have thought their small Mom and Pop dentist office had been sold out to a new,  more torturous, collection of S&M dentists.

</Dental nightmare>

After that, my mom tells me I sobbed the entire way back to my apartment. I bitched that the car seat was uncomfortable, and bitched that I couldn’t find the handle to lean the seat back, and when I finally did, it SLAMMED backwards into the backseat, pushing me into a whole new dimension of screaming and crying.

Then I slept for an hour, and have been eating fruit smoothies and refried beans all day, with the occasional pudding. I don’t even like pudding, but I can’t seem to find any raw vegan foods that are soft and smooth without particles to get stuck in the four gaping holes in my mouth.

Now, not once have I just jumped off the raw vegan wagon to enjoy something I shouldn’t. Not once. I may have reluctantly eaten things that could have been better choices, but I’ve never said, “Oh, to hell with it!”, and had a burger for selfish reasons. I did that for the first time Thursday night. The boyfriend wanted barbecue ribs and potato cheese soup, and I thought to myself, “If I die in that dentist chair tomorrow, I want my last meal to be ribs.” I don’t know why I thought that, but it was true I hadn’t had ribs in a while, and If was going to die tomorrow, I really didn’t need to worry about my health the night before.

So, I jumped (dived head first) off the wagon and into some barbecue. I could definitely tell a difference in how I felt. I had zero energy, was slow and sluggish, and felt ridiculously full, despite not eating all that much barbecue or soup. My head hurt, and it took so long to digest that I sat in the bathroom praying for a bowel movement. It’s over and done with, and it’s back to the raw vegan grind as soon as I’m not aching with tooth pain.

My WONDERFUL mother did all my dishes while I was asleep, even after I threw a fit in her car on the way back from surgery, and I’ve never been so appreciative of a favor before. That was so sweetheart of her, I could cry.

So, that’s the update. Hopefully everyone is feeling better than I am!

OH! VERY GOOD NEWS! I FINALLY HAVE A DEHYDRATOR! Expect raw vegan cookies and treats from this newly raw vegan as soon as I can gum down some solid foods again! I’m so excited!!

Happy eating,

A newly raw vegan.

what is it like to think without your thoughts.

are the thoughts that are conspiring against me my own?  are they the culmination of some hostile environment that has bred them to attack the very host who has created them.

when the time comes, and the sedatives arrive to calm the fears, will those thoughts be mine own? will they belong to me or will they be bastards that i will shun, that no matter how much greatness those thoughts are to achieve i will shun them as not being mine own – will i shun them as the bastard children of the love between the anxiety and sedatives – neither or which i recognize as myself  – but more and more i must admit that they recognize me.

no. no i must not see myself as this. they must not become myself. i am not these things. i am so much more. these thoughts will come and go and all these thoughts will be mine own – i must accept.  the thoughts that cannibalize my mind and the thoughts that beg to bring love to the world – both are mine own – as well as all those inbetween.

what will thought be like with the interceptor?  what will thought be like after the interceptor?

all these thoughts, all the thoughts to come – i accept as mine own.

This past Thursday, I had to take Bethany to the Dentist’s office to have a tooth removed. Because of her age and the nature of the surgery the Dentist had to administer a sedative. “Versed” was the name of this orally ingested drug. It is the kind of sedative that doesn’t put you to sleep, but makes you unable to remember what you are doing or experiencing. (I tried to sneak a little home with me, but they wouldn’t let me!)

So, it’s that time of year again. We head into the hospital tonight after dinner to hydrate Austin for another CT scan tomorrow. His last was in the end of June and if this one comes back clear, we’ll be able to wait six months until the next (a welcome break to be sure).

We’re going to try this one unsedated, now that he’s three, which I think will be fine.  The real reason we’ve been sedating him is so they can run a tube down his throat and give him the contrast he needs to “drink” for the abdominal scan (not easy to do on an unsedated child, I can tell you from experience). But this time they’ll mix it with Gatorade and let him sip away for a few hours, which I imagine he’ll enjoy since it’s the only thing he’ll be allowed to eat or drink all morning. Then Mark will stand on one end of the machine and I’ll stand on the other and we can even hold his hands while he moves through it. He’s done that part unsedated once before when he just needed a chest CT (which doesn’t require drinking the contrast). He’s also scheduled for an ECHO in the morning to check for possible heart damage from one of his chemo drugs.

We’ll hang out in the hospital for six hours after the scan to continue IV hydration and should be home tomorrow evening. The boys have both been promised a hospital cafeteria corn dog for dinner tomorrow, so they are plenty excited!

This afternoon, Braedan and I will make another glittery wishing star to hang from Austin’s ceiling and then it’s back to the old routine: wish, worry, wait . . . and exhale with relief when the good news is announced.  Thanks for doing the same.

Dr. Hair is one of the very few dentists in the State of Georgia who provides dental services to children and adults in a hospital environment under general anesthesia. He enjoys working with people from Atlanta & West Georgia who suffer from dental phobias, as well as those who have medical conditions, special needs, disabilities, or time constraints that might require this hospital option.

Working in cooperation with Wellstar Douglas Hospital in Douglasville, Georgia, Dr. Hair performs all general procedures including cosmetic, implant, and restorative dentistry in an operating room equipped especially for dentistry. A trained anesthesiologist and surgical nurses work with Dr. Hair to provide these procedures in the safest of all environments.

Patients who cannot be successfully treated in a dental office can often be treated in a hospital setting on an outpatient basis.  Our hospital patients fall into five major categories:

Young children

Those who are not manageable in an office setting such as the physically and/or mentally disabled

The sick and elderly or others with high risk medical problems

Patients with dental phobias

Busy Adults who desire the convenience of a single visit

Young Children – patient management for young children is necessary for good dental treatment. It is nearly impossible for the dentist to provide quality dentistry on a moving, crying child. Dr Hair believes the risk in sedating a child in the office is unacceptable; therefore, we only treat children with management issues in the hospital where your child is under the care of an Anesthesiologist.

Physical Disabilities – physically disabled patients often have special needs. For many reasons, treatment in the hospital with general anesthesia may be indicated. This group of patients must be evaluated on an individual basis.

Mental Disabilities – Mentally disabled patients often cannot be managed in a traditional dental office setting. The use of general anesthesia is an effective way to manage this group of patients.

Medical High Risk Patients – The range of patients and medical conditions are too many to discuss individually. Many times dental treatment in the hospital under the watchful eye of a trained Anesthesiologist provides the safest avenue of treatment for this group of patients.

Dental Phobia – Sometimes patients have a condition called Dental Phobia. For patients with this debilitating disorder, dental treatment with general anesthesia is the only way to provide treatment and alleviate the patients’ fear of dentistry.

Busy Adults – Adults who prefer to have the most treatment provided in the fewest possible number of appointments.

While it is not necessary for all patients, general anesthesia under the watchful eye of a physician with additional training as an anesthesiologist is the safest way to treat many of these patients.  Mothers tell us that it was the easiest appointment the child has ever had, and the child seems to recover more quickly.

If you or a member of your family needs dental treatment in the hospital please call the office for information. We like to see the patient in the office for an evaluation so we can develop the outline of a treatment plan, and determine the amount of operating room time needed to complete the treatment.  Treatment is usually completed in one visit.

Please call for an appointment.

770-949-1005

It might be time.

For years my hernia rarely bothered me, then it started getting out of line. Still, I put it off. My Cardiologist reminded me of my low blood oxygenation and told me that as long as I could deal with it, he wasn’t really in favor of me heading for surgery. I would have to be monitored pretty closely, and this was not a job for a community hospital – or a casual surgical team who saw me as Hernia Operation #47,632.

That was fine with me. It was livable, and I’m not really thrilled with the idea of another operation either. So I did what I needed to do to work around it, and on the few times that it really caused problems, I learned how to pop a pain pill, grit my teeth, and just grin and bear it.

But right now my hernia is angry at me – VERY angry. I’m spending a good portion of time lying in the bed or on the couch, trying to get it to calm down, and it is interfering with my daily activities.  I even know when this all started – on the day I was scheduled to leave for Durham, my hernia said, “It is a beautiful Friday morning, perfect for lying here on the couch. Let’s not do anything today!” But I told it no, that wasn’t the plan. Rather that lying around wasting the day away, we had a train to catch.

And it has been angry at me ever since. It didn’t give me much peace that Friday, and it misbehaved a lot on Saturday – enough so that I left the Symposium early to go back to the hotel and rest. This hernia caused me to miss out on the Ice Cream Social (time I could have spent meeting the Cardiac Kids and talking individually with their parents… and eating a wheelbarrow full of Ice Cream!) and it also caused me to miss the group’s planned trip to the baseball game.

So I have called my Cardiologist’s office and told them that when I am in town for my regular checkup next week, we should seriously discuss that consult with the surgeons that we have talked about. It could very well be time to get this problem fixed.

This decision isn’t final; I am very hopeful the hernia is looking over my shoulder, reading this as I type, and has realized that if it keeps misbehaving it is going to be “snatched up” and taken to the woodshed. I am not thrilled with the prospect of  more surgery of any kind. I’d like nothing better than to go to Atlanta and tell my Cardiologist that the hernia has calmed down, it must have just been one of those things, and perhaps we don’t need to talk to the Emory Sewing Circle after all.

Asking for a surgical consult and then cancelling it would be embarassing, but I’d  live with it!

UPDATE: I wrote the main part of this entry a couple of days ago. There has been some good news, the hernia seems to have calmed down! I spoke to my Cardiologist’s office and mentioned to them that things were looking up. I think it was just in a mood, but I’ll still discuss it with the doctor.

Last Monday I was subjected to a very unpleasant medical procedure without the benefit of the tempting intravenous Midazolam I thought I would get. I was hoping that within a few minutes of the syringe being plunged I would be floating in a world of calm while the doctor endoscoped me. Not the case. Instead of the procedure being a vague drug filled memory I had to experience it fully compos mentis. I asked for the drugs – I always do! I was emotionally blackmailed into going without: everyone else has managed today without sedation, it still feels uncomfortable, we’ll have to take you back to the ward on a trolley, you won’t be able to drive/work/drink alcohol, you’ll have to be monitored for two hours … and wait for it: sedation will make you fight us! Really? Being sedated makes you fight?? I thought I would lie there feeling pretty placid rather than coughing, gasping and feeling like something from an episode of the X Files. I hate all those Sci-Fi things where aliens escape through people’s chest/stomach/mouth or where things are forced into throats. I was trembling afterwards and felt awful.

Anyway, moving on. I have taken to typing out hundreds of words of unhelpful introspection. I have been pontificating about all manner of things such as depression, happiness, love, fear, children, the desire to travel, and my own wild intolerance of so many different types of people. I type it out, save it and then look at it again either later that day or the next day. I almost always delete it. Why do I do this? Is it a substitute for actually speaking about it? Probably not, I do talk an awful lot. I do wish I could be a different person sometimes. I’d like to have different hair, wear different clothes, be confident, not care, act in a totally different way. I feel imprisoned by my own neuroticism most of the time. I have endless running away fantasies where I become a new me. I’ll never do it. This time next year I’ll be just the same as I am now except I’ll be even older. That’s what neurotic people do, they sort of stay the same but just get more so.

It’s true; I really hate flying. Of course, it’s better than the alternative (2 or 3 days in a car to get to the beach North Carolina, for example, and then the whole thing in reverse to come home, except now with a sunburn), but I really dislike flying. It’s not what it does to my carbon footprint (I’m very good at telling myself that the plane would be in the air whether I’m on it or not and that I don’t fly enough to cost the earth very much). It’s not even that I’m scared. Shoot, I flew two weeks after 9/11 and didn’t give it a second thought. I don’t need sedatation, like a very dear friend who requires much mind alteration before and during flights all the way to Hawaii or wherever. Alright, maybe ATL’s wind shear is not something I look forward to, but that roller coaster dropped stomach feeling should only occur on a roller coaster. And I do picture the plane exploding in midair over the city just after takeoff. but who doesn’t?

The real reason I hate to fly is that, although I am known for my ebullient and kind nature, I cannot stand most other human beings. And when there are so many other human beings in close proximity, I go a tidge nuts. There are the gum chewers/snappers/bubble blowers. There are the designer imposters purfume wearers. There are the chatterers who ignore the not-so-subtle hint that a book is suppose to drop. There is the man (or boy) who simply must sit with his knees and elbows as far apart as possible, regardless of the fact that his elbow is digging into the side of my arm and his knee is pushing into my quad.  Do you think putting your legs together will make you a girl? Guess what, fella– it won’t. It won’t even make you gay; it will simply show that you are not oblivious to those around you.  Next up, the four-year-olds sitting behind me, kicking the back of my seat whose parents  don’t, you know, stop them. Another favorite was a shining example from last night: a grown woman with a cold who refused to go blow her nose, so every six seconds I heard the slurp of her snot going up into her nasal cavity,  but, as Radiohead so eloquently stated over ten years ago, gravity always wins, so just when the snot is about to slip out of her nose, I got to hear the slurp again.

And repeat.

I can’t really sleep on planes. When I went to Europe, I read and watched the movies to and fro. I generally have a hard time sleeping anywhere except a bed or a couch, but when I’m tired enough I can doze off in strange places. I remember one red eye from SFO to ATL; about a half hour in, I had successfully fallen asleep, which was most excellent because I had a four hour drive in a rental car in the morning upon my arrival in Orlando. I had a whole row to myself in which to sprawl. Shortly after I (and most of the plane) had fallen into dreamland, a man pushed my legs over to sit in the aisle seat. Then he proceeded to take frequent deep breaths which he would  exhale through his nose, rubbing his finger against his nostrils whilst he exhaled. This made a sound not unlike a clogged air conditioner vent. I was in shock, and it still ticks me off. He then hopped around to different seats on the plane, like it was musical chairs. I could hear him everywhere he went, and I never got back to sleep on the flight. This was years ago. Maybe I’ll be able to let it go now that I’ve written it down. But seriously,  it’s one thing to invade others’ personal space on a plane because you simply have no choice, but to purposely wreck someone’s sleep and ignore the unwritten rule that on flights that take off at midnight, everyone should just sit there and be fucking quiet is something completely different.

Can you believe that this rant said nothing about airports? I don’t really mind them. People watching, eavesdropping, having an excuse to eat unhealthy food and waste money on magazines, sitting on the floor and not giving a damn if people are judging . . .  all good things.

Happy  Hungry and Horny : Some benefits of Propofol.

Anesthesiologists know that propofol has many benefits including the fact that it is practically an ideal anesthetic agent. If Micheal Jackson had been given propofol he would have realized how wonderful an anesthetic agent propofol is as a sleep aide in spite of the fact that is not an FDA approved usage of the drug. Propofol does not induce proper restful REM sleep. The three H’s are very unique benefits that an anesthesia patient can identify and enjoy. Propofol is a white emulsion (1 calorie per ml) sedative hypnotic agent that has been given the nicknames, milk of amnesia and mother’s milk. Propofol also is known to ease nausea and itching. These are five anesthetic properties which make propofol somewhat “tricky” to administer.

1) Giving propofol appears too easy. Just push the syringe and the patient goes to sleep in less than 40 seconds. That is what makes other caregivers think they can give propofol for the procedures they do on their patients. Vital signs must be monitored closely and maintained within normal limits during use and recovery from intravenous propofol.

2) Severe respiratory depression: Occurs when combined with oral, intramuscular or intravenous medications, particularly with narcotics (e.g., morphine, meperidine, and fentanyl, etc.) and combinations of opioids and sedatives (e.g., benzodiazepines, barbiturates).

3) Prexisting conditions: Sleep apnea syndrome.  Total obstruction of breathing can be the result of even a small dose of propofol.

4) Cardiac depression: Many conditions can lead to low blood pressure after intravenous propofol for instance dehydration after a bowel preparation for colonoscopy.

5) Potential for abuse and analysis: Murder,  death, suicide, self administration, toxicolgy hair analysis.

Awareness and Anesthesia (excerpts from The Sweet Smell of Success: Ideal Anesthesia)
Monitor with Vigilance

The motto of anesthesia practice is vigilance. Anesthesiologists and critical care doctors use the “rule of trends” in acute care medicine settings to assess and measure response to treatment.

To arrive at the ideal anesthetic, we need to understand more about how anesthesia works and how people consent to have anesthesia. Some types of surgical procedures can and should be accomplished using a technique called conscious sedation, with monitored anesthesia care. Some awareness is intended and expected during conscious sedation, so patients need to be educated and consent to undergo that type of surgery and anesthesia if indicated. Awareness while under the influence of general anesthesia is very rare. It is a potential complication of general anesthesia.

The awareness during general anesthesia portrayed in the Hollywood thriller Awake reveals a frightening medical issue. The post traumatic stress syndrome (PTSS) that may develop as a result of a medical sentinel event such as awareness under general anesthesia requires specialized intervention. Anyone experiencing an awareness event can obtain help from special interest groups that can provide support, such as the Anesthesia Awareness Campaign, and obtain appropriate referral to qualified mental health care professionals.

Increasing patients’ overall educational awareness about the events surrounding surgery pertaining to anesthesia improves patient satisfaction and surgical outcomes. Providing the satisfactory service of patient safety and comfort is the goal of every anesthesiologist.

Micheal Jackson, The King of Pop. May you Rest in Peace.

James Geiger MD

The oilMD

www.oilmd.com