Category Archives: Stages of grief

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Don’t try this at home

https://news.ohsu.edu/2022/03/17/little-evidence-on-how-psilocybin-therapy-interacts-with-existing-psychiatric-treatments-review-finds?linkId=156952130

People are busily hopping on the psilocybin bandwagon. DON’T. Why not, you say, it’s NATURAL. Well, the death angel mushroom is also natural but it will kill you. So are red tides, poisonous snakes and sharks.

You wouldn’t take your buddy’s appendix out in your kitchen, would you? Don’t mess with your buddy’s brain either. Especially if there is already a behavioral health diagnosis and/or an addiction already on board. Either or both might get WORSE rather than better. Wait for the research.

And remember: one in four people meets diagnostic criteria for a behavioral health diagnosis at least once in their life. When there is also an addiction, we call it dual diagnosis.

And for pity’s sake, be careful with pot products, ok? It’s a total myth that they are not addictive. Yeah, people have told me for my entire career, over 30 years, “I am not addicted to (pot, heroin, alcohol, gambling, cocaine, meth, crack, whatever)”. ALL ALCOHOLICS say this the first time they are admitted for crashing a car or alcohol poisoning or vomiting blood or liver failure. “Not me. I am stopping today. I am NOT addicted. I do not need to talk to the substance abuse person.” We roll our eyes and send in the substance abuse person anyhow, because HEY, THE PERSON IS TOO ADDICTED AND IN DENIAL.

If you are going to use pot products, use them one or two times a week. Max three. Because a study of teens that paid them (with parental permission, consent, etc) to stop for a month found that almost none of the teens who used pot daily could stop. They relapsed. And they complained of anxiety and insomnia. And I have worked with adults trying to quit: again, anxiety and insomnia. The teens in the study who only used 2-3 days a week COULD stop for the month. The study monitored urine drug screens quite strictly.

And if you say, well, I can’t sleep without it. Um, yeah, that is addiction. I would wean. Reduce amounts and then start with one night a week without it. Good luck. Get help if you need it.

And don’t jump on the psilocybin bandwagon!!! Holy moly, humans are amazing, the ways they think up to hurt themselves and each other. If you want to be in a clinical trial, go find one. Don’t fool with Mother Nature, she can be a killer.

Happy solstice and blessings.

Here is the scientific paper for the science geeks like me:

https://link.springer.com/article/10.1007/s00213-022-06083-y

The picture is just a picture. No worries.

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wearing sunglasses in the rain

Trigger warning: this is about dementia. I wrote this over ten years ago.

wearing sunglasses in the rain

I am weeping for you both

you have cared for her
for better or worse, for richer or poorer, in sickness and health

and she has lost her memory

you told me on the phone
that it’s not that bad

you say it again in the room

I knew before I saw her
that it was bad, very bad, much worse
she is only 60

she becomes agitated when we try to weigh her
old style doctor’s scale
frightens her to try to step up.
gentle caregiver that you have hired
pushes her, until I say stop, stop, stop
her weight does not matter

shuffling gait
she is frightened to be in a new place
I ask her questions gently
she does not want to sit in the chair in the exam room
“No!” she says “No!”
I leave the room until she’s calmer

when I return
I give her choices
“Shall I examine you first with my stethoscope
or shall I talk to your husband?”
I choose for her, the latter
she relaxes, a little
later, I tell her each step before I do it
she is slightly tense when I lay the stethoscope
on her thin shoulders, but she doesn’t fight

she tenses as I ask her husband questions
about the memory loss
ten years now, a steady course
I ask him what he understands about the prognosis
he shifts uncomfortably
and I ask her if she would like to wait in the waiting room
while I talk to him
Firm and clear: “Yes, I would.”

She is not in the room now
he says that she is not too bad
the picture comes slowly in to focus
mild memory loss, is what he thinks

there are three stages of memory loss, I say
mild, the short fibers, where short term memory is affected
we forget what someone just said
moderate, the medium axons
we forget the recipe that we’ve know for 50 years
we forget how to do math
we forget names and how to get to the store
we forget how to operate the car
severe, the long axons
executive function
we do not initiate things
we forget to get dressed
we forget how to speak
we forget our potty training

his eyes grow sadder and sadder

at last, we return to being a baby
we forget everything
at last, we remember the womb
we no longer want to eat

is she forgetting to eat?

he is not ready to answer

as we leave the room
he says that she is not sleeping well
she seems to be awake at night
eyes closed
but her fingers are moving, as in play
he doesn’t speak to her
he needs to sleep and thinks she should too

should he give her a sleeping pill?

maybe she is happy, I say
maybe in bed in the dark
you are there and it is safe
no one is making her get dressed
no one is making her bathe
maybe that is where she wants to be awake
I would not give her a sleeping pill

the dogs are in the room
he says
and the tv is on just a little
maybe she is happy

he is wearing sun glasses
as they cajole and help her in to the van

he is wearing sun glasses
though it is overcast, low clouds and raining

sometimes it is so hard
to say what I see
to try to say the truth

sometimes the truth is not gentle
but sometimes the truth is love

I am weeping for you both

written 2010

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Avoid death by fentanyl

Some of the West Point Cadets overdosed on March 12, 2022 are still on ventilators. They took what they thought was cocaine. It was laced with fentanyl and they all nearly died.

Not only that, but two of the bystanders who did not use the drug, but did cardiopulmonary resuscitation, CPR, also succumbed. They stopped breathing because they got a heavy dose of fentanyl giving CPR.

Fentanyl is being laced into ANY illegal drug, and being 50 times stronger than morphine, it can kill you by making you stop breathing. Also, fake pills are made. Do not buy pills on the street. And I don’t care if it is your friend. Remember that when someone is really addicted, the addiction is running the show. They need the drug more than your friendship. People will lie, steal and sell drugs. Protect yourself:

Please read the website at

https://www.cdc.gov/stopoverdose/

If you or a family member uses illegal drugs, please get naloxone to have at home. If the shot is given in time, very soon after the person stops breathing, it can save their life.

Here: https://www.cdc.gov/stopoverdose/naloxone/index.html

If you give someone a dose of naloxone CALL AN AMBULANCE. Because it is short acting and the opioid may take back over. The person may need to be on naloxone iv! You must get them to an emergency room as fast as possible.

Our local Health Department was giving out naloxone shot kits in the last few years for free. Our local police carry naloxone. If you are on prescription opioids, you should be offered a prescription for naloxone and your family should be instructed on how to use it.

And teach your children well. I interviewed my patients for years on the age they started smoking. Most of my patients started at age nine. One woman said age seven. We have to start talking to children about drugs and risk and not smoking anything by third grade. That is the horrific reality.

And Bless the punk band The Offspring for reaching out to opioid overuse people and saying, “Get help. You can do it. Please do not die.”

The Opioid diaries live by the Offspring.

And they too are inimitable.

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Playlist: Stages of Grief 3

Stages of Grief Playlist 3

All women all the time today. Grieving for their men or our culture. Fighting back.

Denial

Dolly Parton: The Grass is Blue

Bargaining

Ann Peebles: I can’t stand the rain

Anger

Lily Allen: Not Fair

Acting Out/Fighting Back

Sweet Honey in the Rock: Give Your Hands to Struggle

Revenge

Dolly Parton: Silver Dagger

Grief

Tricia Walker: The Heart of Dixie

Acceptance

Bessie Smith: You been a good old wagon

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don’t kill your clients

I wrote this in 2016, when at least nine people died of overdoses in Vancouver, BC at Christmas, from fentanyl. I knew fentanyl was hitting my corner of the Washington State too. Warning, this contains a lot of swearing (edited so this does not become a “mature” site). I was in a very bad mood when I wrote it. It is meant to be black humor, to help me deal with grief.

http://www.cbc.ca/news/canada/british-columbia/fentanyl-crisis-up-to-9-drug-overdose-deaths-in-vancouver-last-night-1.3900437

But the news today is STILL talking about fentanyl and overdose: https://www.cnn.com/2022/03/12/us/west-point-cadets-overdose-fentanyl/index.html. When will we ever learn? And also, drug dealers are not actually trustworthy…. your cocaine might contain fentanyl. Don’t do it.

don’t kill your clients

oh, you think I’m talking to physicians….

….no, I’m talking to my fellow dealers.

See, heroin is rather labor intensive to produce, being from the opium poppy and all that. (When people say “I only take natural supplements.” I want to say, “You mean like opium and heroin? You know, plant based.”) Also, Afganistan, those fungkers shoot you as soon as look at you. It turns out that fentanyl is cheaper to make and you can source the ingredients from China.

And then, you can make fake oxycodone tabs and fake hydrocondone pills and sell them for bitcoin on the silk road. But you know, ya gotta mix the sheet right. If you mix it wrong and a buncha people overdose and die, there are complaints. Ya might get some scared clients, like, junkie friends of junkies. And then there are also those chronic pain people who aren’t junkies but been forced onto the streets to treat they habit, I mean, pain. We got a good thing going, the pill thing, because the junkies think that pills is safer than heroin. You might scare the fungkers and then how the fungk will I be able to buy that island with my bitcoin?

So dealers, ya’ll fungkheads, ya messing it up if you don’t get the goddarn mix right. See, fentanyl is not routinely tested for on the blood and urine drug screens. So the person gets labelled as an oxycodone overdose and no one knows that it’s fake pills. But when there are too many deaths, the goddarn feds and doctors get suspicious and start testing the pills.

Same with heroin. Cheapens things to cut it with fentenyl. But you gotta calculate right, because if you kill a whole bunch of clients at once, 1. you cut into profits 2. you make the cops and docs suspicious. You gonna ruin it for everyone, you goddarn morons.

And now I hear we got a new mix. Carfentanil, an elephant tranquilizer. Read the recipes carefully, morons, it’s 10,000 times as strong as morphine, you gotta dilute the sheet 10,000 times. Don’t you know math? Take a goddarn chemistry course.

Don’t fungk things up for the responsible drug dealers. A live client keeps on paying.

Be careful out there.

https://www.theguardian.com/global/2016/dec/11/pills-that-kill-why-are-thousands-dying-from-fentanyl-abuse-http://www.cnn.com/2016/08/24/health/elephant-tranquilizer-carfentanil-heroin/

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Stages of Grief Playlist 2

Wait, another? We don’t go through the stages of grief once. We go around and around, like a spiral. Some days we want to lie down in the driveway and just not move. Others it seems like the there might be a tiny bit of sun in the world after all. A mourning handout from the American Academy of Family Practice writes about a culture where one is considered “legitimately crazy” for a year after the death of someone loved. The person is allowed to be emotional, complain, wear their bathrobe all day and call people at 3 am.

Maybe we are all in that stage right now.

Stages of Grief Playlist 2

Denial

The Offspring: Pretty Fly for a White Guy

Bargaining

Kate and Anna McGarrigle: Hard Times Come Again No More

Anger

The Offspring: The opioid diaries

Acting Out

Nathanial Ratcliff and the Night Sweats: SOB

Revenge

Bessie Smith: Young Woman’s Blues

Grief

Over the Rhine: Let it Fall

Acceptance

Sweet Honey in the Rock: Run, Mourner, Run

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Stages of grief playlist

Stages of grief playlist

My sister had breast cancer for 7 years. She said that the five stages of grief missed two. She adds β€œActing Out” and β€œRevenge”. I am planning a series of stages of grief playlists, because we are coming up on one million US citizens dead of Covid-19 and we are at six million world wide and counting. We need help grieving. I have other stuff going on to, so my go to is music.

Denial

Eagle Mountain String Band

Bargaining

Lake Street Dive: I want you back

Anger

Over the Rhine: oh yeah by the way

Acting out

Lily Allen: Smile

Revenge

Lily Allen: Fuck you

Grief

Citizen Cope: Sideways

Acceptance

Over the Rhine: All of My Favorite People

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AtoZ Theme Reveal

My theme for the April AtoZ blog challenge this year is art. I think it will mostly be my mother’s art. She died in 2000 of ovarian cancer. My only sibling died in 2012 of breast cancer and my father in 2013 of emphysema. And I have the art: my parents were both packrats and trying to deal with the house and an out of date will took about three years. Moving stuff around, getting rid of stuff. The art initially went in to a storage unit and then into my house. My mother Helen Burling Ottaway was prolific! And she kept every single piece of art and her diaries back to high school! I found a suitcase with my grandfather’s poetry as well: that will be for another day.

This painting is of my sister. My mother started oils later in her career and Michael Platt, a DC artist, said something like, “Quit doing tiny things. Do something big.” My mother started doing life size and larger than life portraits in chalk pastel and in oils. This painting captures my sister when she was twenty: emotions. I like it but I also think that it is frightening.

Christine Robbins Ottaway age 20, by Helen Burling Ottaway, oil, 1984

http://www.a-to-zchallenge.com/