Guest speaker Sharon Katz and sidekick Bill Quigley, RN

Bill Quigley, RN, is a psych nurse at Brooke Glen Behavioral Health in Fort Washington. His wife Shelly is a retired social worker and also a comedian, a very funny woman.

Years ago she took me to meet her brother who lives in a group home. We went around Xmas bearing gifts for the men who lived there. What I remember most was their love of coffee. Her brother has schizophrenia.

Sharon Katz - ready for her credentials? -  MSN, FPMH-ARPN, CRNP - is the owner of Collaborative Care of Abington, a full service psychiatric agency that serves teens up to older adults. 

Here are some highlights from the information-packed session:

- Before you are medicated with psych meds see your family doctor. Get your thyroid levels tested - your TSH and your T3 and T4. Possibly your mental distress is caused by a thyroid imbalance, which can make you feel hyper or antsy.

- Get your cholesterol tested. Your new psych meds may raise your cholesterol.

- Get your liver tested. Your meds are mostly metabolized in the liver.

- Get your blood pressure taken by either a nurse or the doctor. Believe it or not, there's a correct way to taking the blood pressure and many health aides don't know how to do it right. Sharon said the patient should sit down, feet on the floor, and sit there for 5 minutes before the cuff is put on.

- It's shocking that many psychiatrists fail to ask their patients to get routine blood tests. Make sure you get your CDC panel  (complete blood count) at least once a year. AND keep a copy of your own records. Share them with all of your doctors.

CO-EXISTING DISORDERS occur with bipolar disorder. Substance abuse, for one.

Another, unexpected disease, is arthritis, which is an inflammatory disease.

Too much alcohol interferes with the efficacy of meds. It accentuates their action. You get drunk faster.

75 percent of all smokers are mental health consumers!

Let's hear from Bill Quigley who is passionate about helping people stop smoking. We had a guy in our group, "Harry," who quit smoking a dozen years ago after he got a colostomy bag. His colon cancer was attributed to smoking.

Harry had told me that not a day goes by that he doesn't long for a cigarette.

Bill Quigley emphasized that it's not the nicotine that kills you, it's the inhaling thru the lungs....the smoke.

Smokers need to take more psych meds, said Sharon. When a person smokes, he inhales CO2 or carbon monoxide into the lungs. The gas from the cigarette is absorbed by the blood plasma and inhibits the action of the medication, thereby needing more meds to do their job.

Bill mentioned the different treatments for smoking cessation. The nicotine patch has only half the amount of nicotine that cigarettes do, so people will go thru withdrawal - which has been described as "climbing the walls."

There's also nicotine chewing gum and lozenges. And meds such as Wellbutrin (Zyban) and Chantix.

Psych hospitals, said Bill, reward the smoker. They get to go out for a cigarette break and socialize with their fellow patients. One man in our group said he took up smoking in the inpatient unit b/c of all the benefits such as going outside and getting a break from the therapy or possibly from the tedium one finds in hospitals.

PSYCHIATRISTS. There are 46,000 psychiatrists in the USA, half of them are over 59 years of age. Why don't more med students become psychiatrists? Stigma. Psychiatry is not exactly a respected profession due to the prejudice against the mentally ill, including the association with the psychiatrist.

Med students now want to become cardiologists or plastic surgeons, areas where more money is to be made.

America, however, has seen an influx of psychiatrists from other countries. Sharon made an excellent point about these doctors. How can they assess you for bipolar disorder when they don't know our culture or our customs or our language?

Sharon has one good psychiatrist at her practice and recommended two more at Abington Memorial Hospital. Shimon Waldfogel, who now only sees patients over 65, and John Worthington, who does not take private patients, but only if he gives them ECT (electroshock therapy).

She said he's really refined the process so that there's minimal or no memory loss. He's also an expert on psych meds. Sharon had the highest praise for him. He spoke to our group many years ago and was among the smartest psychiatrists I've ever met. John O'Reardon was another. So was Karl Rickels.

This morning, Sharon sent me an email about a new gene that was discovered:  THE BIPOLAR GENE. At our meeting, she said this takes the burden off the mother being blamed, the way that "cold" mothers were blamed for autism. Bipolar comes from a gene, inherited. It's nobody's fault. Of course, there are factors that account for the gene's being expressed.

The great thing about the genetic discovery, she said, was it drew from a huge amount of subjects. Let's hear from ScienceDaily.com: 

Replicating Risk Genes in Bipolar Disorder (click this)

ScienceDaily (Oct. 15, 2012) — One of the biggest challenges in psychiatric genetics has been to replicate findings across large studies.

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Scientists at King's College London, Institute of Psychiatry have now performed one of the largest ever genetic replication studies of bipolar affective disorder, with 28,000 subjects recruited from 36 different research centers. Their findings provide compelling evidence that the

chromosome 3p21.1 locus contains a common genetic risk for bipolar disorder, the PBRM1 gene.

Knowing the chromosome location means having the ability in the future to turn off this gene so there will be no more bipolar disorder.

A woman in our support group, who has late-onset bipolar, is manic or hypomanic every 17 days and depressed and bed-bound 17 days a month.

Another woman, also late-onset, is 5 weeks up and 5 weeks down.

While most cases of bipolar disorder are well-managed, women like these live half a life.

We're all the more grateful for folks like Sharon and Bill who try to lift everyone up into good health.

Sharon's gift was this pot of autumn-looking mums. Bill's gift was a pack of Marlboro Lites, not really, just a hearty thank-you since I didn't know he was coming.