Monday, September 30, 2013

He didn't remember me - what a narcissist I am!

Lt Carl Robinson of the Upper Moreland Police Department is on the right. Photo from Patch.com.

The Emergency Preparedness Program was just finishing when I walked into the Upper Moreland Library to pick up some books.

A svelte portly police officer in a gorgeous pressed uniform was packing up with his corpulant companion.

"Can that be Lt. Robinson?" I remarked to librarian Cathy.

"I think so," she said.

I told her he was in the police station when I was picked up as I stood on the corner of Byberry and Masons Mill Road while having my first manic-psychotic episode.

Even tho I was outa my mind, the sane part of my brain knew who he was. His son Greg went to school with my son Dan.

I marched into the community room. On a table was part of the emergency preparedness kit. A shiny silver whistle was on the end.

"Hello, Lt. Robinson," I said. "Dyou remember me?"

"No, I don't," he said. "But I know you're gonna tell me."

Well, I certainly wasn't gonna say that back in 1984, when I was 38 years old, one of his officers drove me to Norristown State Hospital, for a mandatory three-day stay. The beginning of my 20 years of having bipolar disorder.

My sister Donna, who accompanied me to the police station, told me I was cussing like a truck driver.

Who, me?

Robinson and I talked awhile. He's the longest-serving officer in the history of Upper Moreland. Forty-five years. We use the word 'officer' in front of them, but behind their backs we call them cops. 

"What are the worst crimes committed in the township?" I asked.

"We have all the crimes everyone else does - burglary, robbery, rape, murder - but on a smaller scale," he said.

"Have you ever killed anyone?" I asked.

"Who, me personally?"

"Yes," I said.

"No one in our department has ever killed anyone."

I've often envisioned a Theme Park where you experience various means of death. For example, What would it feel like to get hit by a bullet?

You might have to sign a release form. You'd go into a little room and you'd hear the popping sounds of bullets which would scare the living daylights out of you. 

In the room where you'd be hanged, you'd be blindfolded and a noose would be placed around your neck.

Quick! Change the subject. Think of something pleasant.




Sunday, September 29, 2013

Lake Galena with Betsey Kirk and family - Paddle-boat and Picnic


Lake Galena - View from our paddle-boat. Betsey and I rested our legs and enjoyed the spectacular view. 

Forty-one years ago the lake did not exist. There was a small town called Leven. Its economy was largely based on lead ore (galena).

Bucks County decided to flood the town and create a reservoir in Peace Valley Park.

The sad thing is that I got lost on my way to Lake Galena. Don't tell anyone but I was there just two weeks ago! These once secluded roads are so industrialized now you can hardly recognize them.

I pulled into a housing development, rang the bell of a house on a cul de sac with two cars in the driveway, waited 60 seconds, turned around and - yay! - saw a car pull into another driveway.

Nancy Smith, a lovely blond woman with a husband and two or three kids, said "You're only five minutes away."

I wrote all the direx down on my Bogg Printing Pad.

I made our one o'clock appt for paddle-boating and picknicking.

Here's a nest of pine needles in the crags of Betsey's trunk.

We had an easier time today as we pedaled with the current.

Betsey was the idea man on the boat. I was the executioner of her ideas. She learned the important point: Pedal backwards.

"Betsey! We're gonna beach. This is not good."

"Paddle backwards," she said.

When we started out at 1:30, there weren't many people renting boats for the LAST DAY of the rental season.

Lines were much longer when we left.


We had a wonderful lunch which Betsey said was like being in a French movie. Except we didn't have wine. Betsey and husband Will, left, often drink wine at dinner.

They brought a marvelous beverage



Their son Raneigh is an assistant teacher at Central Bucks. He's got a degree in special ed. Our feast was made up of:

H'ors derves and dessert:

Brie cheese
Fresh fig slices
Shiny black olives
Crackers
Honeydew and strawberries from Produce Junction in Hatboro

Main dish:

Italian stew with eggplant, yellow squash, mushrooms and Chicken Sausage, all bathed in Classico Roasted Garlic Pasta Sauce.

Unsalted peanuts in the shell was the dessert.

DELICIOUS... EVERY BITE.

Just printed out the above index card so I remember how to pack for a Betsey Kirk and Family Picnic.

As we left to go home, we met these darling pit bull puppies in the parking lot, who sniffed the stew

Saturday, September 28, 2013

John P O'Reardon on Mood Disorders - Devices to help depression

Great turnout! Ada and I worked hard notifying our Group about this knowledgeable speaker. Her husband Rich was downstairs in the 'bullpen' just in case we needed to pull him out to help fill up the room.

I always set up the room at the Giant in the morning. Suzanne, in the Community Room, helped me. All the staff are great at the Giant.

On two tables I put 3 years' worth of Compass mags, our MH magnet, brochures, plus the new edition of my 'book'


Hmmm. Is writing this self-serving?

After setting up, I went home and took a nap. I was exhausted since I was up until 3 a.m. working on an article for the Upper Moreland Hysterical Society.

John P O'Reardon, MD.

At Penn, he was an assistant professor. At the College of New Jersey and Dentistry he's a full professor. He does research into TMS, transcranial magnetic stimulation.

CONTACT DR O'REARDON at 856-482-9000 ext 228 and speak with Amanda.



When we began the program, I asked him where he was from (for the benefit of the audience).

"The Emerald Isle," he said.



We do need wizards to help people with hard-to-treat depression, which is O'Reardon's specialty.

About 80 percent of people with mood disorders respond to medication.

About 8 family members were in the audience including our lovely Carole Hodges, head of our Family Member Group.

Dr O stressed the importance of compassionate family members, who, he said, experience almost as much suffering as the individual.

They can encourage their loved one to take medication and not give up. When a patient takes new meds "It takes a long time for them to work, to produce the changes in your brain."

"The brain is a dark mysterious field. Our galaxy, The Milky Way, has about 400 billion stars. Our brains have 100 billion neurons but 100 billion connections."



Said the late poet Syvia Plath, "The mind is as wide as the sky."

No, Sylvia was not a member of New Directions.

We briefly discussed her tragic life and the web of suicide spun after her DBO: death by oven.

MED CATEGORIES


Click to enlarge on this handout. The info is covered in this post. Desiree: ask me for the sheet on Tuesday nite.

PSYCHIATRISTS

They should take a complete history of the patient, including Family History.

Genetic factors account for mood disorders, esp. bipolar and anxiety. "Oh, my mom was a nervous wreck," a patient will say.

My own 91-yo mother, bless her strongly beating heart, is quite the Anxiety Queen who loves nothing better than staying home.

The doctor, continued O'Reardon, should give the patient HOPE. It's more important than a prescription.

The initial diagnostic evaluation should take an hour. Follow-up med checks should last half an hour. The short med checks are due, of course, to insurance.

BTW, New Directions is gonna have a guest speaker in November who will talk about the Affordable Care Act. Thanks to Harriet for finding us the speaker. Will it be.....



O'Reardon was curious to know who our speakers are. I told him I'd asked Michael Thase, head of Penn's mood disorders program, and Rajnish Mago, head of Jefferson, and both of them wrote back with their regrets.

"Tell Rajnish Dr O'Reardon said to come and speak and he'll listen," said Dr O'Reardon.



Here's Rajnish now.

AT THE END of the psychiatric session, the doctor should not be looking down and writing his notes, he needs to pay attention to the patient and ask questions like, "Do you have any more questions? - Did I answer all your questions?"

There are at least 70 different treatments for mood disorders.

"I understand the suffering you are going through" is something a patient likes to hear.

Treating mood disorders is very challenging. It's important to get therapy once a week, he said. Changes take place in the neurons. Exercise also builds new neurons. Half an hour three times a week should be fine.


ARE WE MAKING PROGRESS?

Yes! said the white-haired Dr O'Reardon, who wore a beautiful suit and tie.
 We now have DEVICES for the brain, non-invasive devices.

TMS - transcranial magnetic stimulation. It's now covered by Medicare. One of his patients was recently covered by Magellan.

Treatments are five days a week for FOUR TO SIX WEEKS for 30 minutes per session.

The stimulation turns on neurons that have been switched off by depression.

Now, I have no idea what that means, but I find it fascinating.

I'm thinking of my house now. I'm sitting in the living room typing this up. What if I can't switch on the light in the kitchen or the upstairs bedrooms?



Look! It worked.

There are NO side effects with TMS.

Effectiveness is 50 percent.

Most effective treatment is ECT, electroshock therapy, with a 75 percent success rate.

But the patient must be anesthetized. One of our gals had ECT with Dr Worthington, who Dr O said was excellent. We had him speak about 8 years ago. Super-smart.



There's a new type of ECT, which is administered with an INFUSION OF KETAMINE. Steven P Levine, MD, in Princeton gives ketamine infusions. Read his column about it here.

A new type of TMS is now being researched. sTMS. Dr O is researching this with an Australian team.


The Australian team can't wait to get to the office to do more research.

Deep Brain Stimulation is another treatment, pioneered by Helen Mayburg. It's also effective for Parkinson's.

Dr O likened today's treatment of depression to that of CARDIOLOGY 30 years ago. Back then, patients were told to change their diets and to exercise. Today the treatments include stents, defibrillators and pacemakers.

EXERCISE: half hour three times a week - this creates new neurons, swimming is good b/c it exercises the whole body.

ADJUNCTIVE EDIBLES:

Folic acid, 1 mg a day

Deplin, a stronger form of folic acid

Thyroid hormone

Dopamine agonists such as REQUIP and MIRAPEX, both used for Parkinson's.

Hormones such as testosterone.

BIPOLAR MEDS

Leading cause of death among teens is suicide.

Bipolar people must use a mood stabilizer. Taking antidepressants may make the bipolar worse.

UNIPOLAR OR MAJOR DEPRESSION

SSRIs - 6 of them, including Prozac.

SNRIs - 3 of them Effextor, Cymbalta, Prestique

Wellbutrin is in a class by itself. 

Remeron is in a class by itself.

Max Deming is in a class by himself.

Photo: Blueberry Yogurt and white nectarines!
What a serotonin boost he is!

MAO Inhibitors work best for some people. These were the first antidepressants invented. The original eating restrictions have been loosened up.

Two of our people take NARDIL. Dr O said it's okay to eat yogurt and chocolate. And Ed may drink his Manhattans in moderation.

Aged cheese is forbidden. You'll get a splitting headache from a hypertensive event. 

Chinese food is prohibited b/c of the soy sauce, which is aged. That's the wrong word. Fermented! It just came to me while doublechecking this post.

Tyromines are the food component that has a bad reaction with MAOIs. 

Gosh, aren't we learning a lot today?

 Dr O suggested NEURONTIN for anxiety. Now, that's one thing I learned today. He also suggested benzos for anxiety, particularly Klonopin, which he much prefers over Xanax.

When Gerri complained about her three-year-long depression O'Reardon suggested she see Dr Mario Cristancho at Penn.

"He's good," he said. "I trained him myself."

Betsey asked a question about meds for older adults. She and I are going paddle-boating at Lake Galena in Chalfont tomro.


Hey, Betsey, wait for me! I'll just be a moment swimming toward you.

Betsey's question was understandable. We wonder how we're gonna feel in our later years. Will our meds continue to work?

"Every so often," said O'Reardon, "the cocktail needs to be adjusted."

TMS is fine for older adults. THE RECEPTORS GO BACK INTO THE NEURON AND RESET THEMSELVES.

We sent Dr O back to Cherry Hill with a pot of.... fill in the blank.

 Ada and Betsey. Ada, did you get a new back pack?

Then a dozen of us went downstairs to kvell over the program.

 Ann Tucker came all the way out from Q'town. Her mom was a member of ND and died four years ago. Her mom, a very calm woman who was a schoolteacher, and I would go swimming at one of Abington Township's swimming pools.

George and Ann Tucker raised their family on Acorn Lane, which is 7 minutes away from me. George was a classical music lover and jazz aficionado and I borrowed a number of his CDs - Mahler's Titan Symphony and Brubeck's Time Out. He used to drink his beverages out of jars.

Ann inherited his music collection.
 Kevin used to live in Woodwinds where my sister Donna now lives. FEMA is buying out her condo and she'll come live with me until she can get her own place.

George Tucker on the right is a schoolteacher at STEM Academy in Downingtown. He taught English in China during the summer and really enjoyed it. One of his Chinese students attends some of his classes at STEM, reporting in through Skype.

His class warmly welcomes her and want to chat her up, but she's all business and simply wants to learn.
I always like to relax with a cuppa decaf but the line was too long, so I bought a bowl of Egg Drop Soup at the Chinese concession at the Giant. Way too much sodium in there. I got very thirsty.
Ann Tucker, Jr, as she calls herself was very impressed with our Giant and all it offers. She shops at one is Q'town, but it's just a regular grocery store.

Ann is a psychotherapist. 

Her nephew Dan and I discussed Facebook and the difficulty of posting comments that may be taken out of context unless you know the person real well.
Desiree took a break and came all the way from Haverford, I think. Her 5-yo son Jonathan was having fun with his dad.

Front yard gets autumn facelift - I need to manage my money better

Have photos, must blog






Rich is the father, Erik is the son. They live in Warminster. They came over yesterday and gave me an estimate of $250 for the work I wanted.

Today Erik said $350. I should've put my foot down....

instead of being Ms Nice Guy

What I did was say, when I came out to see how they were doing and gave them a small additional assignment was, I can't pay more than $350.

So then the total charge was $340.

Gotta get ready for my program at the Giant. John O'Reardon will perform a solo concert on meds for bipolar and depression and the new treatment of TMS.

My Italian stew with eggplant, yellow squash and a new type of sausage that won't cause me agita is simmering on stove. I've already dressed for the show and watered the mums above. Luckily they reminded me to do it.

With my truthfully incurring forgetfulness it didn't occur to me. Oh, heck, lemme use the word - incurring senility. Quick, change the subject!


I'm looking to order red poppies online and have them shipped here.

Friday, September 27, 2013

Sighting of Mailman Bob - Herculean task of typing up 10 pp of Notes for Upper Moreland Hysterical Association

No, Ruthie, you are not allowed to eat. It's 1:08 a.m. You weighed-in yesterday at 135 at Kidney Clink and still have the belly of a 2-month pregnant woman.

Donna calls me up. "I keep thinking about that Italian Stew with Sausage you made. Can I come over?"

Both she and her grandson Tyler came over and we all feasted.

What fun it was having company!

I showed them FB photos of

Photo: One of the best, sweetest things ever!!
Max, of course.

My g'daughter Grace pays no attention to me. I bought her a terrific book for her third birthday.

She was totally uninterested. Author Peter Spiers is a concentration camp survivor.

I'm a survivor of Grandmother neglect.

After breakfast of a Kale-Raspberry-Peanut Smoothie, made with
Chocolate Soy Milk, Scott came over for our morning walk before he goes to sleep.

We're on Davisville Road, passing Tires-Plus, where I was ripped off royally, and a good-looking tall guy is striding along, coming toward us.

He stops.

Don't you recognize me, he says.

Mailman Bob! I say.

He's having his own car inspected at REMS Automotive. They're honest, he says.

How ya doing? I ask. How's Doreen? (his wife)

Dyou still drink Folger's Instant every day?

Doreen left him after he retired.

Nuff said.

We must've stood there at least half an hour chatting. And would've stood there longer except I had a therapy client coming over at 11.


What the heck?

Oh, we're fast forwarding to 8 in the evening. Donna and Tyler are here. We've finished gorging ourselves on my delicious food. I insisted they finish the stew.

Since I'm gonna stay up late typing up my notes, I ask if they want coffee.

Sure, they say, and I make 8 cups of Giant Breakfast Blend, which Donna likes, but then they leave early b/c her stomach is upset.

Is it something she ate? My stew?

I walk them outside. Tyler wants to drive b/c it's dark and he doesn't trust Donna.

Ty, I say, do not 'baby' older people. We are responsible and need to have your trust. It's fine that Donna is driving home.



Jayne Mansfield and famous boobs.

I love the programs at the Upper Moreland Historical Assn. This one was about famous graves in the Keystone State. I'm a natural teacher so I asked Tyler if he knew we were the Keystone State.

Mansfield was born in Bryn Mawr and buried in Pen Argyl, PA, Chester County.

She was a brilliant woman, but boy oh boy, was she screwed up.

Her death, in Biloxi, Mississippi, was from head trauma. Everyone in the front seat was killed. Her children, in the back seat, sustained minor injuries.

She was not decapitated, as popular mythology has it.

So, Allan Heller and I arrive at the Upper Moreland Township Bldg to listen to the talk by Joe Farrell and Joe Farley who have wrin three books about PA graveyards. Allan Heller has also wrin a couple.

After I sit down, Jack Houriet comes over and asks me to write about the program for the newsletter.

I protest.

And then agree.

I have 10 pages of illegible notes like this.

It takes me, oh, maybe 8 hours to type up the notes.

They're fascinating. Now I've gotta write the story.

Is this where you work? Donna asks me.

Shot of my living room work space.

No, I say, but I can't SEE in my upstairs office.

I hate writing on my laptop. With the wrong touch of a key, I erase entire paragraphs. 

I print out my notes, 11 pages. The next step is to go upstairs into my Upstairs Office and start writing the story.


Harry Kalas, the voice of the Phillies. I'm a total fan of his voice, but not of the Phillies.