Just relax in the sun.
For the Ragtag Daily Prompt: layabout.
relaxation
Category Archives: 7 sins and friends
hold on
With the recent atmospheric river coming through, the water soaks into the bluffs and sections collapse. Most of the trees are holding on in the face of loss.
For the Ragtag Daily Prompt: loss.
Gold in the hills
Flaming pumpkin
A prototype stove to cook on today?
The Introverted Thinker in New York
The Introverted Thinker is eight. Her mother takes her out of school for a week to go to New York City.
They leave her sister and her father behind.
Her mother complains about the school paperwork. “Never let school get in the way of your children’s education,” she says. “That’s what my father says.”
The IT is not sure what all this means. But she is excited.
They go on an airplane. She gets to sit by the window. She can see the ground and it is squares like a quilt with hills. It is so beautiful! She is amazed, magic!
In New York City they go to the house of an old friend of her mother’s. The old friend is old and wears dresses to the ground and a lot of jewelry. The house is dark and there are many things in it. The IT is told that the things are antiques and she must not touch anything. She walks around carefully in the dark places, looking at all of the strange things while her mother talks to the old friend. They talk about the past and people that she does not know.
Her mother takes her to museums on some days. Some are art museums. The IT is already used to art museums because her mother is an artist. The museum is like an art gallery only much bigger and the ceilings are very high. A lot of the art is very big too.
One museum is different. Natural History, says her mother. There are dinosaur bones. The IT can’t touch them either but they are wonderful. Huge animals from the past that are not here any more! She loves it.
They fly home. First she has to thank the old friend with the house like a museum, only darker. Then they go to the plane. This time there are some clouds so the IT can’t see as much, but she still gets to see the quilt of the land.
She decides that she likes museums and she likes natural history. Especially dinosaurs.
safety in motion
Can you feel safe while being in motion?
atmospheric river
The current flooding rivers in the Pacific Northwest (1) now are ascribed to an atmospheric river. Atmospheric rivers are long narrow weather regions that carry enormous amounts of moisture from the tropics in the sky. This sky river carries water vapor and moves with the weather, “carrying an amount of water vapor roughly equivalent to the average flow of water at the mouth of the Mississippi River.”(2) When they make landfall, they can release the water in the form of rain or snow.
They can stall over watersheds and release huge amounts of wind and rain and cause severe flooding. The atmospheric river from Hawaii to the Pacific Northwest is called the “Pineapple Express”. “On average, about 30-50% of annual precipitation on the West Coast occurs in just a few AR events and contributes to the water supply and flooding.”(2) An atmospheric river is approximately 250-375 miles wide.
“Not all atmospheric rivers cause damage; most are weak systems that often provide beneficial rain or snow that is crucial to the water supply.”(2) If it were colder we would have an amazing snow pack right now.
The bomb cyclone that came through a few weeks ago caused much less damage. An atmospheric river does not sound as dramatic, but the drone pictures of houses and cars deep in water (1) tell a different story. There is road and bridge damage and already talk of Thanksgiving travel disrupted.
(2) https://www.noaa.gov/stories/what-are-atmospheric-rivers
(3) Meanwhile the Olympic Peninsula still has a section cut off: https://www.peninsuladailynews.com/news/flooded-roadways-cut-off-west-end/
The photographs are of the Sol Duc River, taken by a friend. The river rising and huge amounts of debris being carried down the river. The huge log in the earlier pictures that was on the other side of the river, is gone.
Next is the heading photograph, from Monday, November 15, 2021.
whiskers
For today’s Ragtag Daily Prompt.
The kittens were both two pounds and a bit when I got them. Last Thursday they got their last set of vaccines for a year and they are now both six pounds. They are growing like weeds. My last cat was a small cat. If the stated age was right when I got them, these two are going to be BIG.
Why care for addicts?
I posted this in November, 2015. I am reposting it.
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Why care for addicts?
Children. If we do addiction medicine and help and treat addicts, we are helping children and their parents and our elderly patientsβ children. We are helping families, and that is why I chose Family Practice as my specialty.
Stop thinking of addiction as the evil person who chooses to buy drugs instead of paying their bills. Instead, think of it as a disease where the drug takes over. Essentially, we have trouble with addicts because they lie about using drugs. But I think of it as the drug takes over: when the addict is out of control, the drug has control. The drug is not just lying to the doctor, the spouse, the parents, the family, the police: the drug is lying to the patient too.
The drug says: just a little. You feel so sick. You will feel so much better. Just a tiny bit and you can stop then. No one will know. You are smart. You can do it. You have control. You can just use a tiny bit, just today and then you can stop. They say they are helping you, but they arenβt. Look how horrible you feel! And you need to get the shopping done and you canβt because you are so sickβ¦. just a little. I wonβt hurt you. I am your best friend.
I think of drug and alcohol addiction as a loss of boundaries and a loss of control. I treat opiate overuse patients and I explain: you are here to be treated because you have lost your boundaries with this drug. Therefore it is my job to help you rebuild those boundaries. We both know that if the drug takes control, it will lie. So I have to do urine drug tests and hold you to your appointments and refuse to alter MY boundaries to help keep you safe. If the drug is taking over, I will have you come for more frequent visits. You have to keep your part of the contract: going to AA, to NA, to your treatment group, giving urine specimens. These things rebuild your internal boundaries. Meanwhile you and I and drug treatment are the external boundaries. If that fails, I will offer to help you go to inpatient treatment. Some people refuse and go back to the drug. I feel sad but I hope that they will have another chance. Some people die from the drug and are lost.
Addiction is a family illness. The loved one is controlled by the drug and lies. The family WANTS to believe their loved one and often the family βenablesβ by helping the loved one cover up the illness. Telling the boss that the loved one is sick, procuring them alcohol or giving them their pills, telling the children and the grandparents that everything is ok. Everything is NOT ok and the children are frightened. One parent behaves horribly when they are high or drunk and the other parent is anxious, distracted, stressed and denies the problem. Or BOTH are using and imagine if you are a child in that. Terror and confusion.
Children from addiction homes are more likely to be addicts themselves or marry addicts. They have grown up in confusing lonely dysfunction and exactly how are they supposed to learn to act βnormallyβ or to heal themselves? The parents may have covered well enough that the community tells them how wonderful their father was or how charming their mother was at the funeral. What does the adult child say to that, if they have memories of terror and horror? The children learn to numb the feelings in order to survive the household and they learn to keep their mouths shut: itβs safer. It is very hard to unlearn as an adult.
I have people with opiate overuse syndrome who come to see me with their children. I have drawings by children that have a doctor and a nurse and the words βheroesβ underneath and βthank youβ. I have had a young pregnant patient thank me for doing a urine drug screen as routine early in pregnancy. βMy friend used meth the whole pregnancy and they never checked,β she said, βNow her baby is messed up.β
Addiction medicine is complicated because we think people should tell the truth. But it is a disease precisely because itβs the loss of control and loss of boundaries that cause the lying. We should be angry at the drug, not the person: love the person and help them change their behavior. We need to stop stigmatizing and demeaning addiction and help people. For them, for their families, for their children and for ourselves.
adaptive theory of PANS/PANDAS
This is my working theory on PANS/PANDAS. Pediatric autoimmune neuropsychiatric syndrome/Pediatric autoimmune neuropsychiatric disorders associated with Strep A.
Four or more antibodies. The antibodies can take different patterns in different people.
- Antibodies to dopamine 1 and dopamine 2 receptors.
The antibodies are like keys fitting in a lock. The key may fit in the lock and BLOCK or fit in the lock and OPEN IT. So, there are a very large number of patterns that could arise from this, especially when we remember the rat neuron with 300 different receptors for serotonin in one neuron. Think of the possibilities here.
If this antibody BLOCKS, an ANTAGONIST, it will cause slowing/brain fog/depression/and I don’t know what all.
If this antibody is an AGONIST and the key turns, it apparently can cause mania, ADHD, OCD, oppositional defiance, clinginess, separation anxiety, anxiety, etc.
We do not know what causes psychiatric disorders. Now we have a category called neuropsychiatric, where it is caused by an antibody. Or antibodies. What percentage of psychiatric disorders are caused by this? I am betting high rather than low.
- Antibodies to tubulin.
If the antibody is an ANTAGONIST, blocking, then slow or fast twitch muscles won’t function correctly. It could block both. I think if it blocks both, that is the severe lie in bed chronic fatigue. I have trouble with my fast twitch muscles but my slow twitch ones work just fine.
If the antibody is an AGONIST, you get some super athletes. I know a number of people that I would suspect fall into this category. I can name five off the top of my head, friends.
- Antibodies to lysoganglioside.
This one worries me. Lysogangliosides lyse ganglions. These antibodies are used in soap making, among other things. They break down fatty cell walls.
When I have a high antibody level, I have trouble eating any carbohydrates. As I improve, I have trouble mostly with sucrose, fructose and gluten but not lactose. Also, when I eat gluten, I get acidic. When you get acidic, your body tries to compensate by slowing your breathing to hold on to CO2, because you need to balance the acid H+ with a base, OH-. So: triple whammy. Acidic I automatically breathe slower, which is not helpful when I am already hypoxic and tachycardic.
I have not figured out whether my antibody is an agonist or antagonist.
An agonist would lyse more ganglions. This could be bad for the brain and for peripheral nerves. Neuropathy and dementia.
An antagonist would stop ganglion lysing. Um, in theory, cancer. Lysogangliosides are supposed to clear out bad cells.My guess is that I have an antagonist because of the family history. At least, on my mother’s and sister’s side. My father smoked two packs of Camels for 55 years and did not get cancer: tough bugger, right? Or did he have an Agonist? This line of thinking makes me very highly motivated to eat in whatever way the antibodies want me to. I do not understand why gluten would trigger this and why the gluten effect in me lasts longer than the fructose and sucrose effect. Gluten intolerance and other gut problems are on the rise and this would certainly explain that. This is the cause of at least some fibromyalgia patterns. Not only does eating gluten screw up my breathing, but it makes any muscle that I have used recently hurt like hell. I ate some meatballs without reading the stupid package back in April. Two hours of chest wall muscle pain and honestly, heart pain. I dug the package out and duh: bread crumbs. Gol dang it, I hate it when I am stupid. However, it hurts like hell but at it’s worst I had normal cardiac enzymes and no heart attack. Weird.
Ok, but WAIT, you said ADAPTIVE. How can this nightmare be adaptive?
Sure, adaptive. Remember the back up system for when we are starving? We switch from metabolizing glucose to metabolizing protein and fats, our own if necessary. We go from glycogen metabolism to protein/fat metabolism which produces ketones.
This is the crisis shit hits the fan emotionally and in plagues system.
So, can be caused by stress or infection or a combination.
Why why why?
Because if the stress gets too high or the infection gets too bad, our body switches gears and runs a back up system. I’ve thought of chronic fatigue as some sort of switch the body throws for years, because it’s the hypercrazy work too hard workaholic Type A people who get it. Type B people do not get it or don’t notice or don’t care. Type B people just say, wow, I’m tired, I think I will rest. The Type A people flip out and say “Put me back like I was!!!!” and then they go to 47 doctors and refuse to do anything the doctors say and do internet research and see any kind of quack you can imagine and they are the most exhausting patients.
Why the psychiatric stuff? Ok, take mania. If there is plague or you are in a really dangerous abusive situation, mania suddenly makes sense. Overnight you are different and what’s more, it scares the hell out of everyone. You are shunned. You are alone. You may get thrown out of a job, family, friend group or all of the above. This would tend to protect you against both plague and the really dangerous abusive situation. Whether you like it or not.
And how clever of the brain/body. Here is a back up system. It changes at least four systems, so you are now a different person. You freak your employer, friends and family out. AND you are sick as shit and they won’t listen. You have to get out and go elsewhere for help or hide in your castle or house or whatever. You can’t move or you have super muscles. And every single person has a different pattern.
I look at the long haul covid. The most common symptoms are psychiatric, shortness of breath and fatigue. Sound familiar?
Now, will someone PLEASE fund my NIH west?
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Guidelines for treating PANS/PANDAS: https://www.pandasppn.org/jcap2017/
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