| posts tagged ‘mental health’ |


Ashes to ashes, roots to branches

12 Mar 2010 19:53 EST

Fire burns; fire kills. Fire reduces wood and bone to ashes. From the ashes grow new forests which in turn are consumed in fire and fall to ash. The forests have learned to subsume this cycle; the ashes feed the next generation’s seeds. There’s even a sort of tree termed a fire-climax pine: the Obsipo pine not only survives fire, but depends on the heat to open its cones and release its seeds.

The phoenix is a fantasy, a dreamed-up bird that burns only to rise again. We humans aren’t so lucky, are we? The firebird sees his perennial reinvention simply as part of his nature. It’s simple for the phoenix to rise up from the embers. We humans, though: we really have to work at it. Reinvention and rebuilding are born of necessity but they ain’t necessarily easy.

I’m pushing the metaphor too much here, of course: fire is our enemy, but ever since Prometheus earned his life sentence fire has also been our tool. The trick’s in putting that fire to its best use.  But rest unassured: you’re not going to avoid getting burned.

Car crash, cancer, bankruptcy, prison; bereaved spouses, torched houses — only a few among us will escape disaster, and honestly I’m not sure they’re truly the ‘lucky’ few. Resiliency’s such a useful capability and if you don’t learn it sooner you may regret it later. What gives some people the knack to rebuild themselves from scratch? Or, what makes some people unable to rise after a fall?

Part of it is that luck, or that unluck: crush a man to pieces and maybe he’s reduced to rubble. I won’t venture to guess why that fate befalls some; I’ll just note that in the end none of us escape it. But there’s a whole lotta bad luck that’s not mortally bad. When this submortal luck chooses you, how do you see it? As defeat and despair? As a challenge to rise above? Or even as an opportunity and a second (or third, fourth…) chance?

Reduce the tree’s trunk to ashes and perhaps its rootstock will survive. It may remain a ruined stump, technically but not practically alive.  It may shoot out a few sucker branches stabbing forth green but really not a tree now, we must admit. Or it might, just might, grow to full height again. But look: the tree that grows from the ruined stump will not be the same tree that stood before. Not a leaf, not a branch, will remain in place or grow as it once grew. It’s the same tree, but not the same tree.

I don’t quite understand it and I’m living inside of it; but then I’m not a phoenix, just a man.

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Jacob Jordaens, Prometheus (1640)


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Prometheus: From thoughts of death I freed the minds of men.
Chorus: What medicine finding for this malady ?
Prom: Blind hopes I gave them, in their breasts to dwell.
Chor: A priceless boon they have received from thee.
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Mental Health, or "Hey! If my kidneys are the problem, why do I need my head shrunk?"

25 Sep 2009 19:18 EST

You may have read my recent references to trying to go off steroids after 18 years. I’ve taken oral prednisone during that whole time, and also had occasional high doses of IV steroids as well.  The reason I take steroids is of course so I can compete at a nation level in weightl…actually, no. The reason I take them is because steroids have an anti-inflammatory effect; specifically, they depress the immune system. Normally, depressing the immune system is a Bad Thing, but in my case it prevents my immune system from attacking my donated kidneys.  But because of advances in medicine, immune suppression no longer requires steroids; the doctors would like me to discontinue them because they do have nasty side effects like diabetes and osteoporosis, especially over the long run. They also can cause your adrenal cortex to stop working. But either starting or stopping steroids has its effects too, one of which is “the crazies”.  OK, you’ve all heard that already.

I spoke with the psychologist at my transplant clinic, who confirmed that, yes, discontinuing steroids can certainly make one cranky. She said that my regular shrink would certainly have encountered this issue before and should be able to handle it. Sure enough, at my psychiatrist appointment earlier this month, we brought this up with him, and he was very familiar with it. Evidently this is a common problem, and patients discontinuing steroids often need adjustments to psychiatric medicines at the very least.

So the outcome in my case was to increase my anti-crazy pills, to take it slow on the steroid discontinuation, and to be patient. It will pass, it will take time. This is excellent news, since with this new kidney, I have plennnnnnty of time :)

I’ll editorialize now:  this has direct bearing on the current American health insurance debate. Coverage for mental health conditions by health insurance companies is not comparable to coverage for other conditions. But as my example above should show, you really can’t separate the two. Physical health and mental health are so intimately related as to be indistinguishable.   The body and the brain are both biology. In my opinion, if it is not medically or scientifically defensible to totally separate mind from body, then it is not morally defensible either:

Diseases of the brain are diseases of the body. 

Mental health coverage should be on a 100% par with coverage for other health conditions.

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A short update

11 Aug 2009 00:17 EST

The news after the last update has been rather anticlimactic. My lab tests have revealed that my fasting glucose is indeed impaired, but that it’s not what you’d call diabetes. At least, no one has given me that diagnosis yet. So, I’m proceeding as expected, reducing my sugars and starches and trying to make sure I get enough exercise. It’ll be good for me to do those things anyway.

The condition is exacerbated by the steroids I take. I’ve been taking some level of prednisone every day for about 18 years now. My dose has been small, 7.5 mg, for the past few years. The consensus of all my doctors is that even this dose needs to be gradually reduced and ideally eliminated, and I agree. Long-term steroid use is bad for you, just ask A-Rod.

There’s a drawback to weaning off steroids, though. If you take steroids long enough, your adrenal glands (which produce your body’s own steroids) stop working; they figure, hey, why should I bust my ass makin’ hormones when there are so many around already? Then when you reduce your steroids, your adrenals aren’t there to do the job. This can cause bouts of joint pain, funny pulse and blood pressure, and mood swings.

Pretty damn bad mood swings. From what I understand, chemically it’s similar to premenstrual hormone imbalances. That’s right, I’ve been PMS’ing for the past month.

All kidding aside, my wonderful and beautiful wife and children have had to live with my mood swings and ill temper for the last month. This really bothers me, but I’m optimistic that the mood swings will end as my system equalizes.

That’s all for now, comrades.

Ad astra per aspera!

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