Use Your Words Debuts with Bizarre Sh*t

Want to know how I feel this morning?  It’s all right here:  Been there, done that, wrote about it in my blog. 


I am, once again, suffering through the awful withdrawal of discontinuing Cymbalta.  It’s just as bad.  Maybe worse, because I know that I can’t go back this time.  A $118 per month medicine just isn’t possible for me right now.  It would interfere with my crafting budget.  It would cramp my Weight Watchers fees.  It would piss me off so badly that I couldn’t enjoy the medicine. 


For some reason, I thought that withdrawal wouldn’t be so bad this time.  After all, I’m coming off half the dose I was on last year, and replacing it with Prozac as I go.  But it is bad.  I’m reminding myself of the quote attributed to Einstein:   “insanity:  doing the same thing over and over again and expecting different results.”  I don’t expect to find myself restarting Cymbalta and then having to go through this again. 


So, here I sit, hands too sore to pick up needles or hook, waiting for pain medicine and optimism to kick in.  For some reason, what comes to mind is something I can only call “Bizarre Sh*t from My Past, Part I”.  Here goes.


Several times in my college history I had to schedule a weekly lab on a Friday afternoon.  Like most other schools, the weekend at Vanderbilt started as early as possible, and academic areas of campus were deserted by 5 p.m.  on Friday.  One such day I came out of my lab, one of the last to finish the experiment, and sat on the steps of the building.  That’s a habit I’ve had for decades – finishing up a difficult day, and escaping the building only to be stalled on the front steps, where I have to sit down and collect myself.  Another story.


This particular day, I was sitting on the steps, readjusting myself to nature, enjoying the nonchemical smells and crisp air, when a squirrel approached me.  I sat very still, knowing that a tame campus squirrel might come as far as the steps and entertain me for a moment.  It approached, sat still for one long moment, looking at me, then lunged.  The bright brass buttons on my coat had caught its eye, and it grabbed one and hung on.  I screamed, struggled out of my coat as quickly as I could, grabbed my books, and ran.  I returned much later for the coat.  I no longer think squirrels are cute.  They are maniacally aggressive little monsters. 


Whew.  I can feel the pain medicine kicking in.  It’s too late for knitting, but I can pick up my sticks and work on the cotton tape shirt and the fun wool mitts that won’t require a rigid grasp.  I can also show you some cool stuff from this week.  dsc03635

Meet my new model.  I don’t have a baby in my house, and the ones down the street all have jobs.  I made myself a strip of canvas with hand-drawn faces.  I can wrap it around a toilet paper roll and fit on a baby hat and take photos for the store (   This particular hat has two cables just over the left ear (or where there would be an ear if my model didn’t have a slight congenital deformity).  I love it.  Here’s another:  dsc03644  Meet Henri, wearer of a green beret knit from recycled cotton.  Speak to him wiz zee French accent. 


On another note, in my grownup store ( I have a new collection of cards.  The Use Your Words greeting cards are individual pieces of original art, mounted on card stock and left blank for you to send a message.  The artist is someone very dear to me, a young woman who has been very shy about sharing her artwork.  I hope this is just the beginning.   




 Lovely words to leave you with on this Valentine’s Day.




Happy Ramblings

Today is for miscellaneous.  That’s what I was thinking while I was eating breakfast oatmeal for my dessert just now.  That’s not an indication of laziness.  Sometimes there are just short, unrelated comments to be made.  Far be it from me to leave a thing unsaid.  Yeah, those of you who know me are laughing.


I’m back at the level of functioning I aim for after every lupus flare.  I wake up in the morning and there’s no major pain.  I can get out of bed and have breakfast, take my meds and get ready to go out in less than two hours.  I remember most of my vocabulary.  I have the energy to do more than one thing in a day.  I can exercise (ride my bike in this case) more than 15 minutes per day.  This is my best “normal”.  The longer I stay in this zone, the more active I can be.  Sometimes I get back to walking a mile a day.  I lose weight.  I start bigger projects.  Eventually, this phase gets closed down by another flare.  Hopefully, the current meds will keep that time far, far away. 


I’ve been working steadily today.  I did some knitting on my cool new sock design at knitting group.  I finished a pink and magenta cotton child’s chemocap.  I piled up some things that need to be photographed and put into my store inventory.  I finally took my red Berocco sweater to knitting group and modeled it.  I had been a little nervous about doing that, but everyone was gracious with compliments.  Whew! 


This weekend was another prom experience.  My son came home from college to attend a local prom, having been asked by a girl that he doesn’t know very well.  It was a group enterprise with five of his good friends, some still in high school.  All the guys dressed at our house.  When they came downstairs, I had to catch my breath.  They had all ordered black tuxedos with black shirts, and had on their best sneakers or slip-ons.  They sported ties to match their dates’ dresses, and some had sunglasses and black hats.  They were adorable!  I was honored to be the prom mom for this bunch.  They are always sweet when they come over, finding me before they go upstairs, giving out hugs and greetings.


I got a text message that I have been waiting for today.  Sometimes it just takes a sentence to set your mind at ease and let you know someone is safe and well.  Even though I am verbose in person and on paper (well, on email), I don’t require equal numbers of words in return.  I love when someone will drop a line to say “hey, I’m still alive, just busy with work”. 


Filled up my car today at the only locally-owned gas station in my little area.  I was the only one there, because there was cheaper gas at several stations down the street.  I felt sorry for the owner.  He changed his station from a Chevron to an independent several years ago so that he could bring cheaper gas to this community.  Now his folks have abandoned him because he isn’t the cheapest this month.  It is so difficult to see the prices on everything going up at the same time.  I’m fortunate that I don’t have to drive many miles, so I can splurge the extra $1.00 per tank and give this poor guy some business.


I was talking to one of my sisters on the phone today, and she said she was trying to think back to when she was really happy.  I felt blessed, because I’m really happy today.  And I was yesterday, and pretty much every day, except when somebody (oh, yeah, that was me!!!) messes with my antidepressants.  And it’s not that antidepressant medicines make you happy.  They just allow you to perceive the good things as well as you perceive the bad.  They keep those distorted signals from coloring your life.  How nice for me!


I visited my little old parents two days ago.  We had a lovely time, just talking.  My dad walked me outside and to my car when I left, being courtly and giving me his arm.  Despite the difficulties of my childhood years, I grew up to realize that they did what they thought was best in raising us.  In some ways, they were extraordinarily good parents.  As they have aged, they have made sure to tell us all how much they love us.  Now it’s rare for a conversation to end without “I love you” being said. 


I’ve learned some valuable aging lessons from my parents.  They were in their early seventies when I was pregnant with my daughter.  They immediately began to plan to be her babysitters when I was at work.  My mom hastened to have a nerve problem in her elbow surgically repaired.  They both attended grandparenting classes to learn what had changed in child-rearing since their time.  They showed me that you could still grow and learn at any age, the way they took their new knowledge to heart and put it into practice.


I’m thinking that I need some Sudoku before bed.  A cup of tea would go well with that.



More Depression, and Not the Last

Okay, this is the day I turn on my air conditioning.  It is in the 80s outside and my bedroom has reached at least 376 degrees.  I will air condition this place or be roasted.  In just a minute.  When I finish typing.  And watching Ugly Betty, which is a new episode for the first time in forever. 


I mentioned depression yesterday and received an unexpected number of comments, both on and off the blog.  Actually, that shouldn’t surprise me, because the prevalence of this disorder is astonishingly high.  According to the World Health Organization, depression is the leading cause of disability in persons over the age of 5 worldwide.  In the United States, it is the 8th leading cause of death for men and the 16th for women (and climbing).  (2004 National Institutes of Mental Health statistics)  The NIMH estimates that 7% of U.S. adults experience an episode of major depression each year-11% if you include less severe depressive disorders and bipolar disorder.  Given those numbers, we should expect that in company where we mention depression, we will be among people who have experienced it either first-hand or in friends or relatives.  How could something that common be something we can’t discuss? 


The sad thing is, when we don’t discuss it, and let the world know that it’s an illness that affects a lot of us and it is treatable and we are dealing with it and living our lives–when we don’t convey that, more people are afraid to admit to symptoms and reluctant to seek treatment.  If the research into brain chemistry and our ever-improving understanding of the brain and how it works doesn’t convince people that depression is an illness and not a weakness of the will, the attitudes and successes of the millions of us in treatment should accomplish that. 


The worst thing about depression (after feeling lousy, losing productivity, ruining your home life, and having sleep and eating disturbances) is that it is a risk factor for suicide.  That means it is a potentially fatal illness.  The incidence of suicide in the U.S. has recently climbed sharply.  It went up 8% from 2003-2004.  It is the 8th leading cause of death in men, the 16th in women, and the 3rd in young people age 10-24.  All of those statistics are from the NIMH, which also has terrific patient information on their website (google “NIMH depression”). 


My daughter recently mentioned that she thought the roommate of a friend was depressed.  I suspect she was right.  It’s a hard diagnosis to miss in adults when you’ve lived in a family with a strong genetic tendency to depression.  As a medical student learning diagnostic techniques, I could diagnose depression by just sitting in the room with a depressed person.  You learn to feel it before you hear it.  Children are another matter-you need to know the symptoms for them, because they can look like inattention, or misbehaviour, or attention-seeking.  And it’s important to know that it occurs in children, with results that are just as ominous as in adults if it isn’t treated. 


Grey’s Anatomy is on.  It’s my favorite doctor-in-training tv series yet.  It is heavily skewed toward surgery, so the contest amongst the residents tonight involves getting points for things like numbers of sutures placed.  In internal medicine, we made our points by (1) presenting every history and physical to our team on morning rounds fully from memory, even after being up all night and admitting eight patients; (2) having an arsenal of journal articles on every relevant topic that we could quote from memory; and (3) single-handedly making complex diagnoses before anyone else on the team.  We thought surgeons were Neanderthals.  Numbers of sutures indeed!  (Not to say that I couldn’t suture.  Two of my best friends, both a year ahead of me, made me practice until I was adept at suturing, and my surgical attendings complimented me on my skills.  I could also place my full 128 pounds on a retractor and keep all the guts out of the way on an abdominal surgery.)


Okay, not the time for medical exploits.  Today I have worked some more on the prototype sock.  Those of you who want to see it will be able to, after you are sworn to secrecy.  Not that there’s much to show right now.  I’m just approaching the part with the innovation, and it’s gonna be hard to knit, so I may still just be talking about it for the next few days. 


Oh no, wisdom from Grey’s!  George just said “Great doctors-they know when to stop.”  How true and real is that?  One of the hardest things to teach to my interns and residents. 



I Want My Neurotransmitters and a Little Taste of Curry

Today I hunkered down with a ball of sock yarn and two pairs of skinny circular needles and tried to figure out how to knit the innovative sock that I want to create.  By the time I finished, I had ripped out and started over twice, grabbed another ball of yarn, unwound yarn all over my bed (the research center) and said a few mumbly words to myself.  Guess what?  I figured it out!  I feel like 30 years ago when I solved a really tough calculus problem.  (Yes, I took four or five semesters of calculus-I was an engineering student.)  Now that I know how I’m going to manage this strategically, I have to do some experimental knitting to determine the exact numbers of stitches that will make this work.  Then I’ll try and knit a prototype.  This makes me so excited my toes are wiggling. 


Speaking of toes, has anyone seen my brown Crocs?  The old mary janes, not the new cross-strap ones with canvas uppers.  Since I walked so much yesterday, my feet are crying out for the comfort of my cushiest Crocs.  I swear, they are such big babies.  After all, they are cradled in perfectly good Landsend slip-ons which I probably paid $9.95 for in the Landsend Overstocks.  Red slip-ons!  What more could a foot want?  I have a tendency to take off my shoes in weird places.  I grew up walking barefoot whenever I could, and there are times when I’m in my house and the shoes just have to come off right that minute. 


I can smell my dinner.  I followed a recipe for curried pink lentils, and I have brown/wild rice in my rice cooker and a skillet full of cabbage, onion, garlic, and well-cooked pink lentils waiting to be eaten together.  Mmmm, it was as good as it smelled.  The curry is quite spicy (I have a liberal hand with seasonings) and my next round I’ll put a dollop of Greek yogurt on top. 


When I talked about my depression the other day, someone commented that it was nice to be able to have it in the open.  I’ve always been upfront with everyone (including patients) about my ailments, with no reservations about doing so.  For years we in medicine have understood that depression and other mood disorders are physical illnesses, brain dysfunctions.  Our moods are controlled by chemical messengers in the brain.  Those messengers can be affected to some extent by our activities and circumstances, but the largest effect is totally chemical.  Treating depression with medicines involves increasing those neurotransmitters to normal levels. 


Yesterday on the Ellen Show, Dr. Wayne Dyer was promoting his new book.  He spouted a lot of rhetoric about kindness curing depression, i.e. being in the vicinity of acts of kindness causing increased serotonin levels.  I spent an hour today searching through the entire Medscape library and 25 pages of Google references, looking for a published scientific study that confirms that.  I couldn’t find a single one.  It seems that an entire world of new age, self-proclaimed experts and amateurs are all quoting Dr. Dyer’s position without any documentation in evidence. 


I don’t have anything against kindness; we could all stand to be more kind to our fellow woman, and we certainly thrive in the receipt of kindness.  The big problem is that this is another instance of blaming the patient for the disease.  If kindness causes increased neurotransmitters in the brain, the corollary is that people who have depression (low neurotransmitter levels) must be unkind.  That’s bunk.  Dyer went so far as to suggest that more children were suffering from depression because of the lack of kindness surrounding them.  We can plainly see the genetic influences on depression, and we won’t be surprised if there aren’t strong environmental factors, like our brain chemistry being affected by the chemicals and hormones in our foods.  Pooey!  I could use a little real science with my curry.



I’m Back, in More Ways Than One

Two days ago I decided to throw in the towel and return to my old antidepressant.  I made the switch in hopes of getting some favorable metabolic support (losing weight, okay?).  If you’ve been hanging in there with me you will remember how bad the withdrawal was-remember Medication Side Effects… ( )?  I began another antidepressant medication simultaneously with tapering the old one.  I knew it would take some time for the new drug to be effective, but after more than a month my depression symptoms were coming back rapidly.  The new drug just wouldn’t hold me.  Twenty years of treatment for a very chemical (serotonin-related) major depression have taught me not to play with this.  The symptoms reached my critical point and I restarted the old drug.  Scraping my mood out of a Black Hole is important to me.  It has kicked in already, and I am back to normal. 


Sometimes medications have side effects that are actually helpful.  One of the side effects of this particular medication is that it helps to decrease our perception of certain kinds of pain.  A few days ago, I complained about moving into a more painful stage with my disease.  I don’t think it was more pain-I just felt more pain once I was off that particular med.  It’s pain relief is an advantage I didn’t value enough until I was off of it.  Now I realize that the drug is doing double duty, and worth every penny for that. 


When I was practicing medicine, this trial-and-error, see how an individual reacts to a medication was an approach I frequently had to take.  It may be daunting to lay people to see how much of that is required to achieve the desired result without undue side effects.  I enjoyed the tinkering.  It was what I was there for, doing internal medicine instead of surgery, treating diseases with lifestyle changes and medications, instead of doing those permanent pruning procedures. 


Enough of that!  I had a great day.  I was back at knitting group, and happy to see all the fabulous people in the group.  This afternoon, after group, my sister (one of the many) called and was telling me about the joyous reception she received when she returned to church after missing two Sundays.  She related how good that made her feel.  I had to laugh, because I think I felt the same way about returning to knitting group.  Not sure how she took that comparison.  She may be praying for my soul right now, especially since she knows I’m between churches. 


While at knitting group I finished the dusty rose Cashsilk hat.  Well, I finished the knitting.  Gotta pull piece of yarn through the last few stitches and close up the top, and weave in my ends.  It turned out just like I envisioned.  I’ll photograph and post it soon.  Meanwhile, I think it’s time for a bit of a break.