Xanax

0

I find a lot of things I like in the New York Times. This article resonated with me as few others. First, there is the purpose of the human profiled.  Changing medicine into data science?  God save us all.

Sometimes I feel the best thing I do for a patient is to be human.  Just to have the pretension (a pretension which I do not take lightly) of being one human being in a room with another human being, trying to make them feel better.  This does more, I think, to make most of my patients “better” than all of the pills I have spent years studying about. All those years studying normative use of medications on large populations of humans.  And they work enough to please the powers that be.

Read more on Human Beings Are Not Computers…

Filed under medicine, News, Psychology, Research by on . Comment#

0

Army veteran Galmiche, who served his country for 20 years, was diagnosed with post-traumatic stress disorder in 2002. He says he worked with a counselor and took medication for years, but did not find relief from his symptoms until he was matched with a PTSD service dog.

The first time I met a patient with a service dog was when I was doing social security examinations, as a psychiatrist.  The woman was about 60 years old, motherly and white-haired, and she told me that she was nervous about the interview and was being treated for an anxiety disorder.  She did not think she could “make it” unless I saw her with her “service dog.”  Many years before, when my allergy to dog-hair was in flower, I would have declined.  I had since treated it effectively with alternative methods, so I told her we could try it. It was a tiny dog, the kind my husband would call a “barfy” dog.  The dog had the cutest little blue coat with very official looking embroidery — including the wheelchair picture that is usually used to mark places that are reserved for such vehicles.  The little dog wouldn’t stop staring at me. I did a customary and very basic psychiatric interview.  I started with questions that involved little or no stress, like name and diagnosis.  Eventually, I ramped up to questions about the topics that generated anxiety, such as past traumas.  The pooch stood on its hind legs while she rubbed it vigorously, staring at me.  I stared back. Read more on Service Dogs for PTSD Veterans…

2

Ever heard of capitation?  In healthcare, it can mean that a clinic makes more money by following more patients.  Payments are per person, rather than per service.  I guess I shouldn’t be surprised, then, that they refused to dismiss this guy from their care.

He was a 32 year old young man who was diagnosed with an anxiety disorder.  He had been working independently as a pool cleaner but he couldn’t stand it anymore.  He was always nervous.  As a matter of fact, this man was nervous about everything he did.  Perhaps it was a generalized anxiety disorder, but surely something a great deal more.  He wasn’t having panic attacks, and he exhibited far more than the usual one or two things found in generalized anxiety disorder.

I tried to start him on some medications — as much as I didn’t like the medications he had been started upon.  He had been given regular Xanax in slowly increasing doses.  As nervous as he was, he wasn’t stupid.  He said, “It’s really funny.  The medication makes me sleep, but it sure doesn’t stop me from being nervous.” Read more on The Nervous Pool Cleaner…

0

Whitney Houston’s death might be “old news” already, but I still think her death may not have been in vain.

Because Whitney was a star, we were treated to hearsay before facts.  She drank in the morning, in a public place, and according to some observers may have been behaving a bit strangely.

There is an old screener for alcoholism called the “CAGE” questionnaire.  It’s named after the four questions that presumably even a primary care physician — who has little room left in an overtaxed memory — could remember. Read more on Whitney Houston’s Death May Not Have Been in Vain…

0

California is known as “The Golden State” and some have called it “The Land of Milk and Honey.”

The Beverly Hillbillies noted that it was the home of “Swimming pools – Movie stars.”

That should be encouraging for people like my 27 year old, freckled, red-headed patient.   After all, he had a pool cleaning business. But he was nervous — really nervous.

He did not have full-blown panic attacks, though he certainly fit the criteria for generalized anxiety attacks. Sometimes he did get a “heart in the throat” kind of feeling; something which some people would have called a “truncated anxiety attack.” But he had a lot of them and they really didn’t cramp his style very much.

He did not sleep very well, confessed that concentration was poor, and had great difficulty trying to find any interest in collegiate academics. As a result, his grades suffered considerably. And while I could potentially chalk this up to him falling into a category of males who may be better equipped for trade school than an actual 4-year college (based on patience; not necessarily intelligence), I didn’t believe this to be his case at all.

This guy was anxious. Read more on Stuck On The Treatment Treadmill…

Filed under Public Health System by on . Comment#

0

The patient was no Paris Hilton, and the clinic where I saw her is not someplace Ms. Hilton would ever frequent.  But one thing the two women had in common was carrying a dog in a handbag.

I often see ladies carry in more than one bag – a standard handbag and perhaps a sack full of medical records.  I’d never had anyone bring a purse-dog in to an interview, though. Read more on Is There Anything A Service Dog Can’t Do?…

Filed under Service animals by on . Comment#

0

The next person to see me made a dramatic entrance. First, she had gotten a head start on her crying in the waiting room. But more than the sound of her crying and sobbing, she could barely make it through the waiting room door. I am no good at guessing someone’s weight.  She later admitted to being 380 pounds.  I took her word, as our clinic’s scale only went to 300. Her general appearance was that she was swollen with water – a human sponge.  The edema bloated every part of her body, and her crying eyes were nearly swollen shut. I started by asking her when her problems began.  She was now 42, and said she had thought everything was okay until age 15, when she had been raped by a “friend of the family.” This man was not really a friend, he was a person who went to the same church.  Moreover, he was a Sunday school teacher.  You would think that by now everyone would know that being a Sunday school teacher does not make someone a saint.  But this family had not yet figured it out. In many such cases, this type of person is shielded by the religious community, and even the victim’s parents are often in denial.  This woman was lucky. Her parents told her that they were going to prosecute this sinner to the extent of the law.

There was a trial, and she had testified.  She thought everything had turned out great, and so did her parents. The rapist was convicted and sent to jail. Again, those who are experienced in these things know that this type of trauma is never over quite so easily. The woman went on with her life and ended up in a really abusive relationship — the kind where someone locks you up and won’t let you leave the house and beats you if you look out the window.  By the time she got the courage to escape this living hell and seek a shelter, had a peck of kids. They lived in this shelter for over a year before she found that she had what it takes to start over.  She went to school, gained some clerical skills, and started over. She was actually doing pretty well until something happened that triggered a demon she didn’t know had possessed her. She was called for jury duty and went, with pride, wanting to do her civic duty.  She couldn’t.  She had a panic attack as soon as she entered the courtroom.  She ran to the ladies’ room, threw up, and tried to enter the courtroom again – and it was even worse. People thought she was having a heart attack, and they sent an ambulance for her.  I do not recommend this means of getting out of jury duty, although it sure worked for her. Read more on Murphy’s Law Of Medicine At Work…

0

My dear, remarkable father of blessed memory was no mere a musician.  He was a Harvard-trained composer and arranger, played that complicated organ at his temple for fifty years, and was very, very serious about music.

In fact, he was so serious that only “serious” music could be played in our household.  After all, he was a classmate of Leonard Bernstein, and studied under Aaron Copland and was one of the few fellowship students allowed to attend lectures by the great Stravinsky.

Now THAT’S serious!

As such, I missed out on popular music while growing up.  I was not allowed “American Bandstand” after school.  I was not give Beatles records.  We didn’t even watch Elvis on Ed Sullivan.

Record of Elvis Presley Read more on Elvis Cures The Panic Attacks…

Filed under Panic Attacks by on . Comment#

0

Ahh – 19 years old!  It is a magical age.  At least it has been my experience in public mental health clinics.

You see, almost without exception any male of 19 years who appears in my office – is a really messed up and sometimes just, plain rotten fellow.

I don’t know what it is about 19.

Caffeine addict sitting at computer with IV drip of coffeeOne of the typical cases – though legally an adult — was functionally a kid, living with his parents and acting out the same kind of adolescent rebellion that most go through at 14 or 15 and out-grow by 17.

Oh, he had it all — One of those cylinders in his earlobe, spreading a hole from a small piercing to the size of a basketball. He told me it was “tribal.” He was a music major at a local, broken down branch of the state college.  He wanted to be a performance artist.

Read more on Yes, Virginia — Coffee Can Cause Illness…

Filed under Substance Abuse by on . Comment#

0

It does not matter what country they were from. The father got into the system when his 19 year old son went stark raving looney bonkers and started destroying the homestead. Luckily it was an apartment in an urban setting, or I don’t think anyone else would have known about it. There was one older child who had already flown the coop, one wife who had died because the strain of leaving the old country had been too much. I had a feeling she had also gotten raped or something, but that was father’s post-traumatic stress disorder if anything. I told him to come back for himself, but I never saw him again. He swore on a stack of bibles that his son did not use drugs.  He said nobody had ever explained to him what was wrong with his son. At least no way he could understand and explain back to me.

For an American the solution would have been a support group, like the Alliance for the Mentally Ill. They lived in a rural area, though, and I did not know if the local chapter had anybody who spoke his language.  There is no way the patient could have handled that – and probably not the father, either. Read more on You Can’t Pick And Choose Which Medicines You Want…

Filed under medicine, prescription drugs by on . Comment#