Category Archives: joy

by

sleep and defiance

Oh, gosh, CNN is making everyone panic about sleep again: https://www.cnn.com/2022/11/08/health/sleep-deprivation-wellness/index.html

Don’t buy it. It used to be 8 hours. Now they are saying 7 in this article. SLEEP AT LEAST 7 HOURS OR YOUR BRAIN WILL MELT.

Nope. The media likes us to panic because it sells papers and gets shares. Don’t buy the hoopla.

After all, I took call at night for 30 years and my brain has not melted. (Ok, if you disagree, post your own blog, heh, heh.) Starting third year of medical school. Sometimes it was every third night, sometimes every fourth. We were often up and awake and working for much of the night and then through the next day. If we had to be ready for rounds at 8 am, we had to be there earlier to see the patients, check the lab work, check any studies, drink a gallon of coffee and then be coherent on rounds, where the faculty physician might quiz us about the nineteen causes of high potassium. Uh. Taking too much potassium is one. Kidney failure, diabetic ketoacidosis, etc, etc.

I made up the number nineteen.

Anyhow, I was a sleep rather than eat person. If we got a break, I would go to sleep and skip food. The bad rotations were obvious because my weight would drop. We’d meet for “nutrition rounds” in the morning. I would skip lunch, hoping to have it at home post call, but the list might have things added even as I ran around checking things off. At last I would stop for lunch at 2 or 3 or 4 because my brain was no longer functioning.

Doesn’t sound very healthy, does it?

Here is a post on sleep from 2015: https://drkottaway.com/2015/01/08/sleep/. I sent a copy to our sleep specialist and he liked it.

When I got my flu vaccination and covid booster a month ago, it hit me pretty hard. I am sleeping as I normally do at night, for 6.5-7 hours. But I also started napping, once or twice a day. I was sleeping 11 or 12 hours total daily. I canceled pulmonary rehabilitation exercise, because it wiped me out. I was starting to feel better after three weeks, so I restarted pulmonary rehab. I promptly slept 12 hours a day again and my muscles gave me HELL.

So what in the heck IS this? Well, healing. My body is knocking me out to do repair work. It’s sending a pretty clear message that running on a treadmill is not ok right now. My immune system is busy making antibodies and is saying HEY WE DO NOT HAVE ENERGY TO SPARE FOR ANYTHING ELSE. This is sort of annoying except that having had four rounds of really bad pneumonia, the last one requiring oxygen for a year, still on oxygen to sing and for heavy exertion, I am willing to listen to my body. It is annoying, but: my mother, father and sister are dead, so even though I am struggling some, I’m not dead. It’s all relative, right?

When I had pneumonia #3 (2014) and pneumonia #4 (2021), both times part of the healing is sleeping twelve hours a day. I went back to work six months after the 2014 one and promptly slept twelve hours a night. I was seeing 4-5 patients a day and could barely do that. I went into denial about chronic fatigue, but I knew I had it. NO WAY, I AM TOUGH. Well, I am tough, but that means chronic fatigue and not dead.

I do not worry about sleeping 7 hours a night or 8 hours. I sleep when I get sleepy. Naps are fine and one gets to relearn napping after age 50 or 60 and it’s ok. If you need to stay awake after lunch, have a small lunch and no alcohol. Alcohol is not good for sleep in the long term and neither is marijuana. Benzodiazepines are worse than either. Ambien and those drugs are approved for “short term” use, meaning two weeks. Great. We don’t know what it does if you are on it for years, but some of us note that those drugs are closely related to the benzodiazepines. I think the most addictive drug is tobacco, followed by benzodiazepines and then methamphetamines. That is from asking patients and observation over 30 years. There are individual quirks though, and I have had people say, “Alcohol is no problem but the first time I was given oxycodone I wanted more.” Sometimes there is a bit of denial in those statements.

The photograph is me doing my second sleep study last week. I scored. Um, or rather, it was a positive test. Sleep apnea, darn. I am now waiting for my bipap machine. The funny bit is that I had to drive an hour to the lab. I was supposed to be there at 8. I got there an hour early because I get really tired at night. The tech let me in and wired me up. “But,” she said, “you can’t go to sleep until 9, because I have another patient and they are not here yet.” “Ok,” I said. I read for a while in the chair, put my head back and (don’t tell) fell asleep.

She came back in, did the final connections and then left. There is a ceiling camera and a disembodied voice. We tested the connections. “Flex and extend your right foot.” “Now breath through your nose.” I did and immediately fell asleep. She woke me, “Breath through your mouth now.” “Was I asleep?” “Yes.” The wires didn’t bother me much, though I had to surface part way during the night to change position.

I’ve slept sitting up in hospital meetings. I fell asleep standing against the wall in medical school. It is really a blessing to be able to fall asleep.

The year my father died, I had a terrible time falling asleep. His will was very out of date, written 40+ years before. It was a mess. His house had 13 years worth of unopened mail. I used Jon Kabat Zinn’s Mindfulness Meditation tape to fall asleep. But I used it in a rather weird way. He has a section where he says “Do NOT fall asleep.” It was a body scan. I would think, hey, you can’t tell ME what to do, and I would always fall asleep during it. So there, Dr. Kabat Zinn. Thank you.

The pandemic is enormously stressful, not to mention all of the other things. You can still relax though. What relaxes YOU? Stupid animal videos? A walk around a yard or park? Dancing in your kitchen? Knitting? Reading your absolutely most boring textbook? Put the phone and the television and the computer away at least one hour before you want to sleep and preferably two hours.

And here, to relax you, are pictures of sleep: https://drkottaway.com/2018/04/30/zzzzzz/

Blessings.

by

Birds

Rainshadow Chorale is going to sing like Shakespeare birds on November 5th and 6th. I think this will be another delightful and really fun concert. I tried out for a solo wearing a cowgirl hat. My hat got a solo. I got a small group part. I’m too jealous of my hat, of my hat.

Why a cowgirl hat for Shakespeare? You’ll have to come to the concert to find out! We have composers ranging from Purcell to modern, all using Shakespeare’s words.

Anyhow, mark your calendars. My father was one of the initial eight choral members in 1997 and I joined in 2000. Sing on!

Here is our website: Rainshadow Chorale.

For the Ragtag Daily Prompt: birds.

by

Water reflections: fire sunrise

I took this three days ago, watching the sunrise on East Beach, Marrowstone Island. The fires in eastern Washington cause amazing colors. We could really use some rain in Washington, though not too much. The rivers are down, fishing is locked up, because the salmon are stuck in smaller pools and are too vulnerable. Some rain, please, but not those flooding atmospheric rivers?

At any rate, it is gorgeous watching the sky and water turn pink and orange.

For Jez’s Water Water Everywhere #147.

by

Superlative Spectacle

I am still enjoying my photographs of The Great Port Townsend Bay Kinetic Sculpture Race. Above we have a Kinetic Kop in action, just as the parade is starting! Stop the cars! The sculptures are on the move!

All of the color and costumes are so fabulous, especially after quarantines and isolation. Red, orange and yellow predominated!

Talents show up! Walking on stilts in costume with wings!

These racers are having a grand time!

A serious discussion on the Kiwanis Train.

Kop Kar, I mean, Kykle.

Mud, mud, glorious mud, nothing quite like it for cooling the blood!

Waiting for their turn at the Mud Bog.

Superlative Feathers!

For the Ragtag Daily Prompt: superlative.

by

Red and yellow ribbons

We are half way through the Great Port Townsend Bay Kinetic Sculpture Race.

https://ptkineticrace.org/2022-annual-art-kontest-and-parade

Yesterday was the Parade and the Brake Test and the Bribing of Judges and the Going Full Speed No Brakes into Port Townsend Bay and then paddling or floating or somehow getting out. And the glorious Kinetic Ball and Krowning of the Kween!

Today, so many more events! The race up the winding hill and then the Mud Bog at the fair grounds! The Teddy Bear trebuchet! More Bribes! And the coveted “most mediocre” award!

Blessings on all the Kinetic Kops for keeping everyone from being run over and for everyone who contributed! The Chimacum High School Marching Band and the Unexpected Brass Band added to the festivities!

For the Ragtag Daily Prompts: ribbon and red and yellow.

by

Getting ready

Rainshadow Chorale is practicing, masked, but practicing, for our concerts the first week of November.

I think it’s going to be fabulous!

Our website: http://rainshadowchorale.org/

Now all we need is the audience! Mark your calendars!

For the Ragtag Daily Prompt: audience.

RainShadow Chorale
RainShadow Chorale
by

Practicing Conflict

An essay from my church talks about the writer avoiding conflict, fearing conflict and disliking conflict. This interests me, because I do not avoid conflict, I don’t fear conflict and actually, I like it. Our emeritus minister once did a sermon in which he said that when you are thinking about two conflicting things at once, that is grace. I have thought about his words many times, especially when I am not in agreement about something.

Does this interest in conflict mean I fight all the time? Well, sort of, but not in the way you think. I don’t fight with other people much. I fight myself.

What? No, really. Most topics have multiple sides. Not one, not two, but many. Like a dodecahedron or a cut gem. Hold it up to the light, twelve sides, each different. I argue the different sides with myself.

I learned this from my parents. My parents would disagree about something, they would discuss or argue about it, and then they would bet. Sometimes they bet a penny, sometimes a quarter, sometimes one million dollars. Then one of them would get up and get the Oxford English Dictionary, or the World Atlas, or some other reference and look it up. This was pre-internet, ok? 1970s and 1980s.

Sometimes my parents would even pay each other. The penny or quarter. My father spoke terrible French and my mother had lived in Paris for a year after high school, so he could get her going by insisting that his French was correct. It wasn’t. Ever.

There were other arguments in the middle of the night that were not friendly and involved yelling, but the daytime disagreements were funny and they would both laugh.

Once my sister is visiting after my mother has died. My father is present. My father, sister and I get in a three way disagreement about physics. I’m a physician, my sister was a Landscape Architect and my father was a mathematician/engineer, so we are all three talking through our hats. However, we happily argue our positions. Afterwards, my gentleman friend says, β€œThat was weird.” β€œWhat?” I ask. β€œThat was competitive and you were all arguing.” β€œIt was a discussion and we disagreed.” β€œI won’t compete.” β€œWe let my dad win, because it makes him happy.” β€œThat was weird.” β€œOk, whatever.”

My gentleman friend is also shocked when my teen son challenges me at dinner. My son says, β€œI am researching marijuana and driving for school and there isn’t much evidence that it impairs driving.”  I reply, β€œWell, there is not as easy a test as an alcohol test and it was illegal, so it has not been studied.” We were off and having a discussion.

Afterwards my gentleman friend says, β€œI am amazed by your son bringing that up. We weren’t allowed to discuss anything like that at dinner.” I say, β€œWe pretty much discuss anything at dinner and both my kids are allowed to try to change my mind. About going to a party or whatever.” He shakes his head. β€œThat is really different.” β€œOk,” I say.

This habit of challenging authority, including adults, did not go over well when my son was an exchange student to Thailand. It did not occur to me to talk to him about it. He figured it out pretty quickly.

Back to my internal arguments. If I take a position, I almost immediately challenge it. I think of it as the old cartoons, with the angel on one shoulder and the devil on the other. The devil will make fun of things and suggest revenges and generally behave really badly. The angel will rouse and say, β€œHey, you aren’t being nice.” Then they fight. The internal battle very quickly becomes comic with the two of them trading insults and bringing up past fights and fighting unfairly. When it makes me laugh inside, I can also be over the driver who cut me off, or someone who spoke nastily, or whatever. My devil is very very creative about suggested revenges. When the angel says, β€œYou are meaner than the person who cut you off!” I am over it.

When I was little and disagreeing with my family, my sister could tell. β€œYou have your stone face on!” That meant I was attempting to hide a feeling, especially fear or anger or grief. Siblings and family are the most difficult because they can read us and see through us like glass. My physician training also teaches control of feelings. I have sometimes wanted to grab a patient and scream β€œWhy are you doing this to yourself?” but that really is not part of the doctor persona. I am doing it inside, but I can put it aside until later. Then the devil goes to town! And the angel tries to calm the devil down.

Maybe we all need more of this skill. Pick a mildly controversial topic. Argue one side of it. Then switch positions and argue the other side. Go back and forth until it gets ridiculous. Let each side get unreasonable and inflammatory and annoying. This can play in your head and not on your face. Once you can do a mild topic, move on to something a bit more difficult. If you only know the arguments on your side, read. You can find the other side, the internet is huge. Start gently.

A friend says, β€œYou always argue about things.” I say, β€œI prefer to think of it as a discussion.” β€œYou always take the other side.” β€œWell, it interests me. And if there is no one to discuss something with, I discuss it with myself!” β€œWeirdo,” says the friend. I think he’s jealous, really I do. Don’t you?