Thursday, July 30, 2009

April 2009 General Conference: Be Your Best Self

President Thomas S. Monson counseled in his General Priesthood address about striving to put forward our best.

He cited several sources indicating that we face grave difficulties in this task, and offered his advise on how to be successful. The Lord is on our side -- we cannot fail. It is not a time to fear, but to go forth with courage.

The three key elements for success he enumerates are:
1. Study diligently.
2. Pray fervently.
3. Live righteously.
President Monson suggests that if we study the scriptures daily we will have power to resist any temptation that is put before us. The Holy Spirit will guide us as we study.

Fervent prayer will be answered, as with God, all things are possible. Prayer is the provider of spiritual strength.

Holders of the priesthood may not necessarily be eloquent in their speech. They may not hold advanced degrees in difficult fields of study. They may very well be men of humble means. But God is no respecter of persons, and He will sustain His servants in righteousness as they avoid the evils of our day and live lives of virtue and purity

Reiterating: Temper Tantrums

Like I said, I have them too...

I remember one of mom's expressions " mad I could spit!"

But mom is not alone with this problem. I recall one sister who stormed off to her room on a regular basis, trailing the refrain, "...I'm Never gonna love you again, Never Ever, Never!!!"

To be concluded by the slamming of the bedroom door with an energy and vigor that would shake the dust and shiver the whole house.

Peculiar to this family is the internal antagonism that characterizes family groups. but an expectation that we should somehow be different. A strange idea. We ought to be better.

We remember things from early childhood rather selectively, I suppose. Any suggestion can direct memory to be positive or negative, depending on the particular chosen bias.

Let others comment about their own experience. Each has their own perspective.

Sunday, July 26, 2009

Neurology 103: Basilar Artery Thrombosis

I have been studying a series of medical journal articles about basilar artery thrombosis, which is what caused my brain stem strokes.

According to one online journal, Basilar artery occlusion is associated with a poor prognosis. Some patients with partial occlusion have limited ischemic injury and, therefore, a better prognosis, although outcomes continue to be poor.

Those factors associated with poor outcome include decreased level of consciousness, dysarthria, pupillary abnormalities, bulbar symptoms, diplopia, bilateral cerebellar lesions, tetraplegia, and a cardiac cause of embolism. Up to 90% of patients with no such factors have a good functional outcome, while all patients with such factors either died or had severe disability.

The mortality rate is consistently reported at greater than 70%. Recanalization may decrease the mortality rate by 50%. However, the outcome in a recent series of patients with basilar artery thrombosis treated with antithrombotics was similar to the reported outcome in the available series of patients treated with thrombolytic therapy.

tPA treatment was not applied in a timely manner in my case, but I started using Plavix, a antithrombotic drug that may serve to moderate future thrombosis. I hope so, anyway.

Friday, July 24, 2009

Amateur Pshrink VII: Klonopin addiction

Klonopin Addiction and Treatment- K-pin - Kiddie Cocaine – Another Form of Prescription Drug Abuse

Some people become addicted to prescription drugs. Their doctors may not recognize the symptoms as well as those who spend more time with these individuals.

Klonopin is classified as a depressant, similar in every respect to alcohol, and similarly addictive to the abuser. The changes in personality and behavior are notable:

• Drowsiness
• Confusion
• Impaired motor function
Impaired coordination and balance.

Some of the less seen side effects of Klonopin use include the following:
dis-inhibition rage
excitement irritability
hangover-like symptoms feeling drowsy
headaches sluggish irritable after waking

This occurs because of Klonopin’s long half-life which means that the medication itself stays in the person’s bloodstream.

The real danger related to Klonopin comes when individuals either mix the drug with another substance. Use of other drugs intensifies the general effects.

The other situation where Klonopin use is dangerous is when use of the drug is abruptly discontinued after long term use. Everyone who utilizes Klonopin long term becomes low dose dependent. Side effects of the drug itself are generally benign, but sudden withdrawal after long-term use can cause severe, even fatal, symptoms. Symptoms of withdrawal include: Anxiety, irritability, insomnia, panic attacks, tremors and DT’s (delirium tremens) which occurs with long term use.

Not only can long term Klonopin use result in dependence, it can also result in protracted withdrawal. This means withdrawal can last for months, years, or even a life time. This only occurs in ten to fifteen percent of cases, however, the risk is real. This results because of brain damage, which is usually irreversible. Some symptoms include: anxiety, insomnia, tinnitus, tingling and numbness in limbs, muscle pain and tension, cramps, weakness, irritable bowel, and cognitive difficulties.

DEA Link on Klonopin
benzodiazepine addiction

Thursday, July 23, 2009

Amateur Pshrink VI: Major Depression

Major Depressive Disorder

Signs & Symptoms

  • Persistent sad, anxious, or "empty" mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed
  • More about Signs & Symptoms »

I am currently taking Cymbalta as an antidepressant, Zyprexa sedative and antipsychotic, and Zonegran antiseizure medicine. I was taking Seroquil but quit using it. I was also taking Klonopin but quit using it too. It has some unpleasant side effects.

I take Verapamil, quite a large dose, twice daily, because the calcium channel blocker mechanism seems to prevent my basilar type attacks, as well as lowering blood pressure. I also take Plavix which does something to prevent blood clotting as normal.

Without the Seroquil I was only able to sleep for an hour or two per day. Apparently some brain mechanism that regulates my sleeping was damaged in one of my brain stem strokes.

Wednesday, July 22, 2009

Reiterating: Silence is Perfect

I reiterate, at the risk of repeating myself.

I am still trying to find the fullest measure of love and life. My choices don't please everyone. I realize that, but it is a catch-22 situation.

The harder I try to please certain others, the less satisfied I am. They define their own arbitrary rules for things that seem axiomatic and standard to me. Truth is not situational or a matter of convenience. That which is true one moment must necessarily be true the next, all else being equal.

I am an advocate of Thumper's Rule -- "IF YOU CAN'T SAY SOMTHIN' NICE, DON'T SAY ANYTHIN' AT ALL".

As a result, I find myself speaking and writing less and less. Perhaps silence is perfection.

Monday, July 13, 2009

April 2009 General Conference: "Man Down!"

President Henry B. Eyring First Counselor in the First Presidency advised in his priesthood address that feeling of responsibility for others is at the heart of faithful priesthood service.
President Eyring asserts,
You will need bravery and you will need boldness because you are enlisted in the Lord’s army in the last dispensation. This is not a time of peace. That has been so since Satan arrayed his forces against our Heavenly Father’s plan in the premortal existence. We don’t know the details of the combat then. But we know one result. Satan and his followers were cast down into the earth. And since the creation of Adam and Eve, the conflict has continued. We have seen it intensify. And the scriptures suggest that the war will become more violent and the spiritual casualties on the Lord’s side will mount.
Almost all of us have seen a battlefield portrayed in a film or read the description in a story. Over the din of explosions and the shouts of soldiers, there comes a cry, “Man down!”

The metaphor is extended -- soldiers rush to the aid of a fallen comrade.
Such a feeling of responsibility for others is at the heart of faithful priesthood service. Our comrades are being wounded in the spiritual conflict around us. So are the people we are called to serve and protect from harm. Spiritual wounds are not easily visible, except with inspired eyes. But bishops, branch presidents, and mission presidents sitting before fellow disciples of the Savior can see the wounded and the wounds.
The wounds of sin are often not perceived as such by the one injured. Satan uses some soporific to deaden the spiritual pain while wounding. Unless there is intervention to begin repentance, the wound can worsen and widen.

You may think, “Maybe the trouble I thought I saw is just my imagination. What right do I have to judge another? It’s not my responsibility. I’ll leave it alone until he asks for help.”

You are responsible to be brave enough and bold enough not to turn away.
you are under covenant, as has been made clear to you, that when you accepted the trust from God to receive the priesthood, you accepted a responsibility for whatever you might do or fail to do for the salvation of others however difficult and dangerous that might appear to be for you.

Jacob in the Book of Mormon described his sacred trust when he moved in difficult circumstances to give aid: “Now, my beloved brethren, I, Jacob, according to the responsibility which I am under to God, to magnify mine office with soberness, and that I might rid my garments of your sins, I come up into the temple this day that I might declare unto you the word of God.”

Now, you might object that Jacob was a prophet and you are not. But your office, whatever it is in the priesthood, brings with it an obligation to “lift up the hands which hang down, and strengthen the feeble knees”3 of those around you. You are the Lord’s servant covenanted to do for others, as best you can, what He would do.
Jacob believed the woe of any fallen man or woman he could have helped and did not would become his own sorrow. Your happiness and that of those you are called to serve as a priesthood holder are bound together.

Now, we come to the question of how best to help those you are called to serve and rescue. That will depend on your capacities and on the nature of your priesthood relationship to the person who is in spiritual peril. Let me give three cases which may be your opportunity at times in your priesthood service.

Let’s start when you are an inexperienced junior companion, a teacher in the Aaronic Priesthood assigned with a seasoned companion to visit a young family. Before preparing for the visit you will pray for strength and inspiration to see their needs and know what help you could give. If you can, you will have that prayer with your companion, naming those you will visit. As you pray your heart will be drawn out to them personally and to God. You and your companion will agree on what you hope to accomplish. You will work out a plan for what you will do.

Whatever the plan, you will watch and listen with great intensity and humility during the visit. You are young and inexperienced. But the Lord knows their spiritual state and their needs perfectly. He loves them. And because you know He sends you to act for Him, you can have faith that you can sense their needs and what you can do to meet your charge to help. It will come as you visit face-to-face in their home. That is why you have this priesthood charge in the Doctrine and Covenants: “Visit the house of each member, and exhort them to pray vocally and in secret and attend to all family duties.”

And then you have an added charge which takes even greater discernment:

“The teacher’s duty is to watch over the church always, and be with and strengthen them;
“And see that there is no iniquity in the church, neither hardness with each other, neither lying, backbiting, nor evil speaking;
“And see that the church meet together often, and also see that all the members do their duty.”

You and your companion will rarely receive inspiration to know the details of the degree to which they are meeting that standard. But I can promise you from experience that you will be given the gift to know what is well with them. And from that you will be able to encourage them. There is another promise I can make: you and your companion will be inspired to know what changes they could make to begin the spiritual healing they need. The words of what you are charged to have happen in their lives will almost certainly contain some of the most important changes the Lord would have them make.

If your companion feels an impression to urge change, watch what he does. You will likely be surprised at the way the Spirit guides him to speak. There will be the sound of love in his voice. He will find a way to tie the needed change with a blessing that will follow. If it is the father or mother who needs to make a change, he may show how it would lead to happiness for the children. He will describe the change as a move away from unhappiness to a better and safer place.

Your contribution during the visit may seem to you small, but it can be more powerful than you may think possible. You will show by your face and manner that you care for the people. They will see that your love for them and the Lord makes you unafraid. And you will be bold enough to bear your testimony to truth. Your humble, simple, and perhaps brief testimony may touch the heart of a person more easily than that of your more experienced companion. I have seen it happen.
Whatever part you play in that priesthood visit, your desire to go to the people for the Lord to help them will bring at least two blessings. First, you will feel the love of God for the people you visit. And, second, you will feel the Savior’s gratitude for your desire to give the help the Savior knew they needed.

He sent you to them because He trusted that you would go feeling responsible to urge them toward Him and toward happiness.

As you grow a little older, there is another opportunity which will come to you in priesthood service. You will come to know your fellow quorum members well. You may have played basketball or football or shared some youth activities and service projects. With some you will have become close friends.

You will recognize when they are happy and when they are sad. Neither of you may be in a position of authority in the quorum. But you will feel responsible for your fellow member in the priesthood. He may confide in you that he is beginning to break a commandment which you know will do him spiritual harm. He may ask for advice because he trusts you.

If you succeed in influencing one away from a dangerous path, you will never forget the joy which came from being his true friend. If you do not succeed, I promise that when his grief and sadness come, as they will, you will feel his pain as if it were your own. Yet if you tried to help, you will still be his friend. And, in fact, for years he may talk with you about what good things there might have been and how grateful he is that you cared enough to try. You will comfort him then and invite him again, as you did in your youth, to come back to the happiness which the Atonement still makes possible for him.

Living Notes

Life is tough.

Nothing can be more difficult than what I have experienced in the past year. I can say this from my own subjective point of view. But that is my basis for judgment.

Good thing it is that I can only describe the experiences in words. You do not want to go there yourself, take my assurance.

In any case, we do not have the prerogative to determine the limits or bounds of our own lifetime, except under the most extraordinary circumstances. God knows and manages these parameters. When it is my time for the end of life, I will be summoned, and I will go.

Until that day, I stay in the race...

Next instalment:  Living Notes 2

Thursday, July 02, 2009

Sensory Inventory XIII

These signals are not all functioning properly in my body. The neural network that is supposed to do the work of transmitting signals through my brain is partly dead or dying. Cells that used to be in the loop no longer carry any signals, so like a little child, I am teaching my body to send the signal through parts of the brain that are still living.

This process is frustrating, because not only is it agonizingly slow, but also ensuing strokes can undo all the work I have done for months, and more. All in a matter of seconds.

Not that I am griping.

Yes I am.

It is patently unfair. Tedious and tiresome. Long and uneventful, with short meaningful episodes that tend to be filled with despair and horror.

I think death would bring welcome peace.

Much of the sensory map of my body seems to be fairly static for the past few weeks. But I am concerned about a growing proprioception faultiness in my hips that throws me off balance betimes. It catches me at odd moments when I let down my guard, and I awkwardly stumble and teeter to keep from falling.

If it continues to get worse, I will consult with the neurologists again. But that is a tough choice, when they want something objective to evaluate, and I have only a feeling to offer.

Toes on my left foot have come to life, after a fashion -- they hurt, most of the time. Right foot, pretty dead. Legs - not much tactile sense. Abdomen same. The consistent thing is not much change to report. If things are changing, it is very slow.

Slow seems to be the order of the day.

Rehab progress 35

I am performing as well as can be expcted at my PT sessions. Up to a half mile in fifteen minutes on the treadmill, with very minimal noticeable exertion. I will start increasing the pace, as my balance and equilibrium hopefully continue to improve. By my estimate I am equivalent to the level of performance I was at after recovering from the first stroke for two months. At that point I had another stroke, so I am not hoping for a repeat of that sequence.

I am having other problems, though. Lack of ability stops me at every turn. I cannot do all the things I want to do. I am suffering from mental depression that makes everything look that much more difficult. And I have seeming insurmountable troubles with running my business venture,.

I suppose these things will work out. They always do...