Category Archives: outdoors

by

Pick a plan right for you…..

We are in open enrollment for health insurance in the US. Meaning that they all are going up in cost and they are cancelling plans and offering new ones. And advertising: pick a plan right for you!

What the hell does that mean?

It means that all of the plans exclude things. Oh, well, aromatherapy…. that’s what you are thinking if you are not a US citizen. Of course the plan doesn’t cover aromatherapy or crystal healing or fringe treatments….

Well, no. I had to choose between two plans when my daughter was 17, that is, two years ago. I could choose the one that covered cancer OR the one that covered pregnancy. Uh, yes, that is correct. One EXCLUDED pregnancy healthcare and the other EXCLUDED cancer healthcare. For me and my children.

Which would you choose?

My mother died of cancer at 61 and my sister at 49. My daughter was not dating yet. Observing.

So we picked cancer.

I photographed the crows out on a walk the other day… how many does it take to make a murder?

 

 

by

Will you dance?

For the Daily Prompt: filthy.

I am with my EX. He has that wicked trickster expression, which can mean fun or trouble or both.

“Let’s go.” he says, “Dancing. I have something new to show you.”

I go, warily, choosing boots rather than high heels. I love to dance, but I know that expression. There is a twist here. He is messing with me and I need to be careful.

He leads me into a park. We go through various sections and into a part with a rectangular green. The rectangle is broken by a hole in the corner, shaped like a billiard pocket. It is not very big and about 15 feet deep.

“Wait,” he says and goes down the steep muddy slope covered with leaves… and right into the mud covered wall, completely in. The earth struggles and then he pulls back out, covered with dirt and filth, frankly. It stinks. He taps a grayish structure beside him, and it lights up with soft light and starts playing a Charleston. It also moves a little, parts moving against each other, more awkward blobs than humanoid. And around me, three other statues also light up and move.

And my EX is climbing back up the muddy wall towards me and sinking in up to his waist with each step. He will be at the top soon. The Charleston is a cheap tinny version.

I am trying to decide: Will I dance?

I wake up.

Will you dance?

I took the photograph in 2014. My daughter was on the Killer Whale Mountain Bike Team. This is her coach, annoyed because he had to drop out of the race. He was riding with a belt chain, but the mud was so deep that it packed the chain and he couldn’t ride. My daughter finished the race but said that there were many sections that they just picked up their bikes and tried to run through thick sticky mud six or more inches deep.

 

by

Stress and the sympathetic nervous system

People talk about adrenal fatigue: what is it that they mean? And how can we address it?

When we are relaxed, or less stressed, we make more sex hormones and thyroid hormone.

When we are in a crisis, or more stressed, we make more adrenaline and cortisol.

The pain conference I went to at Swedish Hospital took this a step further. They said that chronic pain and PTSD patients are in a high sympathetic nervous system state. The sympathetic nervous system is the fight or flight state. It’s great for emergencies: increases heart rate, dilates air passages in the lungs, dilates pupils, reduces gut mobility, increases blood glucose, and tightens the fascia in the muscles so that you can fight or run. But…. what if you are in a sympathetic nervous system state all the time? Fatigue, decreased sex drive, insomnia and agitated or anxious. And remember the tightened fascia? Muscle pain.

When we are relaxed, the parasympathetic system is in charge. Digesting food, resting, sexual arousal, salivation, lacrimation, urination, and defecation. So saliva, tears, urine, and bowel movements, not to mention digesting food and interest in sex. And muscles relax.

If the sympathetic nervous system is in overdrive, how do we shut it off? I had an interesting conversation with a person with PTSD last week, where he said that he finds that all his muscles are tight when he is watching television. He can consciously relax them.

“Do they stay relaxed?” I asked.

“I don’t know.” he replies, “but my normal is the hyperalert state.”

“Maybe the hyperalert state, the sympathetic state, is what you are used to, rather than being your normal.”

He sat and stared at me. A different idea….

So HOW do we switch over from the sympathetic to the parasympathetic state?

Swedish taught a breathing technique.

Twenty minutes. Six breaths per minute, either 5 seconds in and 5 seconds out, or 6 in and 4 out. Your preference. And they said that after 15 minutes, people switch from the sympathetic to the parasympathetic state.

Does this work for everyone? Is it always at 15 minutes? I don’t know yet. But now I am thinking hard about different ways to switch the sympathetic to parasympathetic.

Meditation.
Slow walking outside.
Rocking: a rocking chair or glider.
Breathing exercises.
Massage: but not for people who fear being touched. One study of a one hour massage showed cortisol dropping by 50% on average in blood levels. That is huge.
Playing: (one site says especially with children and animals. But it also says we are intelligently designed).
Yoga, tai chi, and chi kung.
Whatever relaxes YOU: knitting, singing, working on cars, carving, puttering, soduku, jigsaw puzzles, word searches, making bean pictures or macaroni pictures, coloring…..and I’ll bet the stupid pet photos and videos help too….

My patient took my diagrams and notes written on the exam table paper home. He is thinking about the parasympathetic state: about getting to know it and deliberately exploring it.

More ideas: http://www.wisebrain.org/ParasympatheticNS.pdf

I like this picture of Princess Mittens. She looks as if she has her head all turned around. Isn’t that how we get with too much sympathetic and not enough parasympathetic nervous system action?

by

Veteran

My clinic has gotten three calls in the last week to take more rural Veteran’s Choice patients. One was too far away on Whidby Island. Apparently few providers will work with Veteran’s Choice: but I understand that too, because it took me a full year to get the contractor for the insurance, Triwest, to start paying me. And it took me hours, hours that I could spend doing medicine, instead of fighting with a corrupt for profit corporation.

And I am glad that I won that round.

I took the photograph at our Rhody Parade, in 2006.