Thursday, March 31, 2011

You know when you are a mood altering drug when:

6 small green pills stare up at me from my hand. One more pill might make the smile they eerily form appear sardonic. They know that when I lift them to my fat scalloped tongue and wash them down my swollen uvuless throat, there is no turning back. The next seven days of my life belong to them! Of course, they start out with enticements like, "You feel great," Anything is possible," and "Everybody loves you." You know they have taken over when voice suddenly at 1:47 P.M. feels like it has raced down a dusty track on a hoarse with no name.
The decadron ride at 5:00, usually blasting rock music while taking corners in the 'Beemer' at 50 miles/hour today is replaced with a Zuma 125 cc powered fuel injected scooter. This bad boy will get up to 50 going down hill hunched over. The negative ions feel great on my face as I split lanes and zip in front of those fat cars.
Of course then comes the 11:00 P.M. hiccups with insomnia provoking me to sit down and write about hiccups and insomnia. My remaining rational thoughts remind me that Friday Night Lights will be dim and Saturday we won't be singing Italian songs in the park.
Contrast Thursdays with impetuous emails promulgating reason to double my weekly work hours (quickly recanted) to Monday morning dressed to go to work, yet drooling on the couch composing a mental e-mail on why I should retire. Aah, fun with Decadron.

I always assume my mood is stable. If my perceived reality changes, it must be all of the other inhabitants of 'me world'. However, occasionally, flaws in the Matrix appear and I am confronted with the possibility that I may be the problem.
When your mood is changed by 6 green pills it appears to yourself that you are still quite normal, status quo, steady. Why then is every one else suddenly annoying?

You know when you are on a mood altering drug when:
  1. Every treats you like you have male PMS.
  2. Your to-do list screams at you so you shred it mercilessly.
  3. You always search for the nearest chair.
  4. You do all of the work and get none of the credit
  5. The bed feels exceptionally comfortable.
  6. You worry more than usual and on Monday felt a brief flash of guilt.
  7. On Sunday you can't find a shovel big enough to stuff food down your throat.
Finally, Wednesday morning returns, green sirens singing of 2.5 more up days. Just swallow me and me and me. The cycle continues. But it is all for a good cause, I think; wait is this Thursday night or Monday morning?
If you want a large loan, see me Wednesday night, I will be in the OR operating late because I offered to cover call for my partner on National Doctors Day. Wednesday is our all-nighter. Line em up!


Thursday, March 24, 2011

Guided Imagery

Cliffs of insanity
 A few weeks ago I attended the Amyloidosis support group held in Walnut Creek, CA. Early in the meeting I presented an update from Dr Gertz's recent article on treatment for AL Amyloidosis. It was a wonderful review article on the diagnosis, prognosis (via cardiac classifications of 1,2 and 3) and chemotherapy options and their respective results. I highly recommend a review of this article if you have AL amyloidosis and haven't read it.Gertz Abstract
Later in the meeting a woman specializing in guided imagery taught us techniques in self relaxation (This has never been a major issue for me, I was always a generally lazy boy, but driven by lofty goals.) As she described the process, it became apparent that I had been doing this for years. When I needed to psych myself up for a particularly difficult new surgery, I would replay the entire case in my mind while lying in bed. I anticipated problems and pre-resolved them. Another form of guided image, although I didn't call it that, was to go to my 'happy place' while in a painful situation such as dental work or a bone marrow biopsy.
This is a real place in Northern Yosemite. At 13 I was hiking from Stanislaus national Forrest through Northern Yosemite to Touolemme Meadows. On our third day we arrive at the most beautiful spot on earth. I was seated on plush thick grass, dry and slightly warmed from the overhead sun filtering through the pine trees surrounding us, To my immediate left was babbling brook hidden from view between banks made of 12 inch tuft of green grass. The water trickled into the crystal clear blue-silver water expanse before. Golden trout a plenty were jumping to catch the dinner at dusk. A symphony played surrounding us; the light wind through the trees, the ruffling of the grass as we shifted, babbling to the right answered by the snap of the waves in the wind and the trout splashing with there hors Du hourves. Beyond the lake were two mountain peaks that God placed symmetrically to meet at a V on the west end of the lake.The point of the V just resting on the water. And like a ball sliding into a cup, the setting sun silently slid down where the V folded itself, like a fan in a woman's hand.
The most miraculous event took place in the immature mind of a 13 year old boy that actually had the presence of my to be overwhelmed by this singular moment of miraculous beauty. He wrapped it up in a neuron box and store it in a place where important memories reside. Since then, I close my eyes and pull it out when I need it, be it pain, insomnia, test anxiety, or to escape.
The leader then asked if she could take us on an extended guided imagery, We all agreed. We were going to a tropical beach. She then stopped to mention that in a previous class a woman complained of major anxiety as she had once nearly drown at a tropical beach. Three or four people glanced at me, having read my blog on my near drowning in Cabo San Lucas. They waited for me to object; I remained silent.
The imagery began sitting on a warm beach, the waves lapping over your toes. Soon you are in the water up to your waist. The you dive in and become engulfed in a million bubbles swirling around you, you are disoriented....Anxious Memory-I Shift.....Now I could see the Golden trout jumping for dinner as the setting sun silent slithered for the seventy-seventh time in my happy place.  I didn't like the memory of the disorienting bubbles. They are actual quite scary.
Guided imagery is actually quite useful in daily life. I used it today during a vasectomy to distract the patient and they feel less pain and anxiety. You should try it out. (The guide imagery, not the vasectomy)


Saturday, March 5, 2011

New Beginnings

The last two weeks have seen both culminations and beginnings. A week after I stepped down as chief of the department of Urology, I was called to a new position in church. I now serve as a high councilor, one of twelve men that support the Presidency of the newly formed Lincoln, California Stake. I haven't served in a calling requiring a significant time commitment in years and did not suspect I would as people often worry that my illness might prevent me from fulfilling my duties. Barbie and I both see this as confirmation that God still needs me around for a while. To make it even sweeter, President Perez has assigned me to work with the Spanish Branch. I left the branch 2 and 1/2 years ago when I got sick. It feels as if all that I had lost has now been returned. I feel complete again.
Barbie works so hard to succeed in dental hygiene school. She is doing well despite the impossible pace with which they teach and test her. She is committed to finish school and start a new career.
Rebecca and Jason are ridiculously in love and Rebecca is really establishing herself in her advertising career as junior faculty at BYU
Last week, Caitlin was accepted to BYU in Provo, Utah to begin in August. Yesterday she graduated from Lincoln High School at the top of her class, two months ahead of schedule. Despite being officially done, she will continue to attend AP chemistry to prepare herself for the exam.
Samuel called today to inform us that he was accepted to Penn State to complete a masters of engineering in acoustics. He and Michele now are face with the decision to move east or stay at BYU for the graduate program there. He has done some major work on his Senior Capstone project with John Deere and may have a research grant with Caterpillar.
And finally, Jeremy called on Thursday to inform us that his dream of becoming a doctor will be realized. He was accepted to be a medical student at Midwestern School of Osteopathic Medicine in Glendale, AZ.  It will be exciting to see Jeremy and Alexandria embark on this new phase of their lives. They have waited so long for this day. We are so proud of all of them.
I know this may sound like a Christmas letter, sounding off on all of the accomplishments of our children, but it feels like much more for us. In a two week period, we have witnessed the fulfilment of our childrens' dreams. They will each get to pursue their passions. What more could any parent ask for. One more item to check off on the old 'bucket list'.
President Perez once told me that a parent is only as happy as their saddest child. Just because they are no longer at home, we are still concerned about them.
Barbie and I are very happy right now.