Happy Sunday: Mental Illness Edition

Let us face it, we are facing a rise in mental illness for obvious reasons. It would be lovely to find one person who does not suffer from some form of mental illness that ranges from persistent anxiety to full blown and debilitating disorder.

We are calling more people “evil”, which is the only word for a human who does things that we cannot understand or process in our minds.

We are hearing more words and phrases like “coo coo”, “looney tunes”, “ditzy”, “not wrapped too tight”, “batshit” and so on.

We are using more of those words and phrases.

The only action that we can take right now is to get a better understanding of all of the forms of mental illness, whether we are suffering  and can still admit it, or whether we must deal with someone else who is suffering and cannot admit it.

With better understanding and knowledge, family and friends have better odds of getting help and of evaluating the quality of the help.

Even when the relationship or situation is a dangerous, abusive or harmful one, it is best to know more about any illness or behavioral problems that have the potential to put others in harms way.

THE MOST IMPORTANT FACTS TO KNOW ARE: That fear, ignorance, stigmatizing and social disapproval will drive people to lie, deny, withhold, enable and to block efforts to put a person into care. There are a lot of horror stories and myths about putting a person into “the system”.

THE TREATING PHYSICIANS ARE NOT THE MAD SCIENTISTS FROM THE MOVIES AND TELEVISION. These hard working folks need to know as much as possible in order to make a sound diagnosis. This is not an easy job, since flawed and limited anecdotal or statistical evidence may be all that they have to work with.

THE FAMILY, CLOSE FRIENDS AND OTHER CLOSE INDIVIDUALS NEED TO GIVE AS MUCH USEFUL AND TRUTHFUL INFORMATION ABOUT THE PATIENT AS POSSIBLE. In many cases, the most important witnesses will lie, do not know what information to give, lack trust, or will not want to get involved.



We are going to find out about a different kind of “bible” today. This bible is the guide for health professionals and for all of us when we are confronted by mental illness.

The best resource for all is the Diagnostic and Statistical Manual, Volume IV. (DSM-IV-TR). AllPsych Online has made this all important resource available for free to anyone who needs it.

In May of 2013, the DSM V will be published. This greatly improved diagnostic and statistical manual has changed a lot about the way in which mental health problems are diagnosed. Inputs were taken from a much wider group of concerned individuals and organizations, including families and friends, a wider range of professionals, and the general public.

These manuals are published by the American Psychiatric Association and covers all diagnosed psychiatric disorders for children and adults.  This manual will help to understand the self and will help to understand loved ones who are in distress.

There are four Axis of diagnosis that are important to know.

The general understanding is that there are diagnosed disorders, there are the psychosocial stressors  that affect or trigger the disorders, and there are levels of functioning that change from time to time when a person has a disorder. All three planes are used to identify the troubles and conditions.

Axis I disorder are the actual diagnoses, with schizophrenia, social phobia, or depression as examples.

Axis II disorders are the diagnosed developmental and personality disorders. Autism, retardation, social phobias, and  borderline personality disorders are examples of Axis II disorders.

Axis II covers the physical conditions that make disorders worse, or that involve impaired mental function on their own.

Axis IV describes the severity of psychosocial stressors. The thinking is that certain events in a person’s life will affect their mental health.  People do not just “get” certain disorders, so Axis IV describes events that are known to trigger or aggravate Axis I and II disorders. Key stressors, such as marriage, divorce, losing a job, death of a loved one, trauma and more have been identified and rated in terms of severity.

Axis V describes the person’s highest level of functioning. This axis compares the patient’s functioning from one year to the next, and helps to understand what kinds of changes to expect.

All of this is done with evidence gathering through personal observation, interview, theraputic sessions, physical medical examinations, testing, research and statistical analysis.

This can be a long, painstaking and arduous process, especially when the patient cannot speak for him or her self. In those cases, the only information comes from witnesses and others who may or may not be reliable.

So take a few steps on this journey of understanding today. Take a few more tomorrow. Then take a few more into the future of  understanding more about mental illness. This will help to end the reluctance to tell the truth and will help to stand up to  shaming and stigmatizing. We can all become more observant and proactive, rather than having to react blindly in the heat of a crisis.


Hug A Vet; Or Pray For One

I woke up Sunday Morning with a lump the size of a golf ball under my right chin and boy did it hurt. I had a sore throat and all kinds of conniptions going on.

 After realizing that it would take a two hour round trip drive, plus about four to six hours to be seen by a doctor, I decided to see if it was infection (or would get worse) or virus (which should get better on its own) or an acid attack from that damned Hebrew National sauerkraut that I put into the absolutely perfect Reuben sandwich that I made on Saturday.

So, I vacuumed, then shampooed my rugs with my handy dandy new miniature carpet shampooer. That thing worked like a champ and was worth the splurge.

I felt better, the golf ball was gone. So I plopped on the couch for a nap.

And woke up on Monday to a lump the size of  a baseball and even more pain that was rolling around the right side of me head. It went away when I got up and slept on the other side of me head.

So I waited until Monday afternoon, thinking that the weekend heart and stroke victims would have been triaged and would not be so sour.

I go by myself, as I hate to have anyone with me or driving for me. Can’t stand the idea of someone waiting for hours for a routine deal. Especially David, who talks and talks as if he has to get every word that ever comes into his mind out through his mouth. He’s a sweet guy and is very smart, but dang.

I arrived at the VA emergency room at about 2:30 pm to find it full of people. It was a full house. My scheme had backfired.

Hell, this was going to be at least five hours. 

By now, the roof of my mouth was getting puffy with little lumps, a clear sign of way too much acid. Must have been aggravated by the lime juice that I put into the smoothies and that Hebrew National sauerkraut. It comes in a bag from the chilled pickes section. It’s the best. I suffer for my culinary art. The perfect Reuben is not a thing to be trifled with.

The VA emergency room, which was non existent years ago, now has a beautiful new monster of a complex attached to it. It’s state-of-the-art. They rub the thermometer around your head. They slap a computer generated hospital band on your wrist.

You are now in the system, in the database. Coded, collected and collated.

The receptionists are no longer surly idiots who made us want to snatch their wigs and hairpieces off of their heads.

Even the doctors and security guards in the hallway look us in the eye, give a smile and give a “hello” these days.

We have all worked through a huge move from the old digs on Broadway, a huge renovation at their new location and a huge improvement of the whole patient care system. It is much appreciated. 

I like to listen to a couple of people in the VA waiting room just to see how far they’ve travelled and how they are doing. One young woman, her husband in a wheelchair, said that they came from Sonora. They have a choice of going to Palo Alto, Martinez or Sacramento. Damn. That’s hundreds of miles and hours of driving or riding in a VA van.

For medical care.

It’s worse at home. That poor woman’s stories about how they get medical care in Sonora were from the gold rush days of California hill country medicine. There are so many places up in those hills where it’s an hour drive to get to town, let alone to see a doctor.

I met a man who’s son, at age 30, needed to be put into detox for severe alcoholism. He was in Afghanistan and now is in so much distress that he has to be hospitalized. The kid always had a drinking problem, but there is something that has driven him over the cliff. The man is praying that his son gets detox,  or something.

The triage nurse calls me in, asks a few questions, looks alarmed and assures me that I will be put ahead of a few folks.

One young woman comes from Lodi, near Stockton. She came to help a relative. It’s a decently long drive, about as far as I used to have to drive when I lived farther away from Sacramento.

Lots of young people come here now. I used to be one of the youngest, and I was no spring chicken. Now some of them look like college and high school kids.

We all share something, even if we never served in the same war or branch or era. The VA feels like home and the people feel like one giant family, even when we’ve never seen each other before. The military is like that and so goes the VA.

I’m called in, put in a room, get on the bed and start to read “Sherlock Holmes” on my Droid.

I’m finally seen at about 4 pm. I get a woman who is in training to be a patient assistant or something. She apparently was a “health educator” and now is acting as if she is a doctor for God’s sake. She says that the roof of my mouth does look “unusual”.

The real doctor has the affect and self posession of a 12 year old. He orders a “rapid” strep swab. Gag.

Everything else is moving real slow, but everyone is being cared for. It’s a full house and it has probably been a full house since the wee hours of Monday morning. 

It takes the crew about half an hour to finally do the requisite blood test to see if I have antibodies. I read a sign that tells us the times for various tests. I see that it will take “30 to 60” minutes for blood tests.  Dang, little vampires. They filled about five tubes. Do I get cookies and juice?

The phlebotomist is showing the alleged patient assistant how to find a vein. WTF? 

Of course, you clowns.

 I’ve got two bumps on the roof of my mouth that just started up.

At about 6:30 and we got antibodies. I get penicillin and advisement to see the dentist, because it might be from bad dental care. Me, the sibling of a dentist who made my front teeth after a terrible bike accident, who rinses with Listerine and peroxide, brushes and flosses and scrapes daily.

You can’t be the Lisa to a Bart of a dentist and not be hip to a few extra factoids about oral health!

Can you? I’ve never heard of it. Dentists never stop proselytizing about oral health.


Of course, you clowns. Bring on the student geniuses. Bring ’em on, with their off the top of their heads wisdom. Makes me flash on that poster for the film “Brazil”, where the top of that poor man’s head is blowing up.

As I leave, I look at the other patients and wonder which one is the 30 year old with the severe alcoholism. He will haunt me as many others have.

I’m home now. The bumps on the roof of my mouth are tripled in size and I still have a golf ball under my jaw. I’m watching “Law And Order”. It’s a heartbreaking story about some Black people who had a mega corporation coming after their blood because the grandfather had some cancerous tissue stolen decades earlier…without approval compensation. Now the mega corporation has made billions off of life saving cultures from the man’s tissue,  and still comes after the kids and grandkids for blood…offering something like $500…or nothing. The family, of course, lives in poverty.

I wonder if my five tubes of dubious blood are going to kuwait to cure some bulge-ion-aire.

I’m wondering about all of those people who are on the road right now, in the dark, trying desperately to bring their loved ones to emergency care at the beautiful new VA facility. 

The care will overall be quite excellent once they’re in the system. 

It’s always good to be home, safe and sound after a great VA adventure, but my fellow emergency room vets always haunt me for days after a rare visit.

If you can’t hug one, at least pray for a vet today.

Nic Bubba Too Fatu: Paula Deen, Paula Deen!

Oh Lord help us, we are getting Paula Deen when we really need Michael Rennie.

 The woman has no template for self control when it comes to the four food groups: flour, fat, sugar, and whatever else it is that the doctor won’t let us have!

She boldly dares to go where we’ve been told not to go, and she does it with such abandon and glee that I long to follow her to the Food Network studios, where I could lap up gravy with chunks of dough and meat to my heart’s content.

Today, I have found a recipe that is the stuff of gustatory madness. Something wicked this way comes, and be forewarned that you anorexics and bulimics will be heading for the restroom before the full content and impact of this recipe even processes through your malnourished brains.

There is no explanation on Earth for that kind of food and I long for some ubermensch with an afro and a six pack to arrive in a burst of glory, and to warn us, not about our violence and aggression, but our gluttony. Perhaps the coalition of powerful space civilizations will send their robot. Maybe they will threaten to take away all of our gravy-making capacity if we don’t start walking right.

In my fantasy, Michael Rennie would intone,”Nic bubble butt too fatu!” as he hauls in giant lasers to convert our planetary saturated fat supply into a giant pool of Omega-3 fatty acid! With Vitamin C!

Back to Paula. She never explained what she planned to do with the english muffins or the buns. She just dove for those doughnuts in the same way that Al Pacino dove his face into that huge pile of cocaine, in “Scarface”. I’m waiting for Paula to grab her love handles and howl “Say hello to my little friends!”

In summary, Paula Deen is the queen of food porn, with her mostly delicious, yet completely impractical food recipes! The rest of these recipes are madness that comes from a society of gustatorial excess!

But we publicly wince and we secretly cheer!

 While we groan and yell aloud, we silently crave the tasties. We don’t yell to our doctors that they’re effete yuppies, sucking the life out of us with their vile, healthy diet recommendations! We wait until we’re driving past the “Krispy Kreme” franchise to indulge in the delightful confections while in the privacy of our own automobiles.

We throw out eating advice, boast about our self control, bore everyone to tears with competitive righteousness about our successful diet restricting. In public, we are Puritans. In private, we are hedonists.

In private, we salute those who are about to die from atheroscloresis. We know that, in moderation, nothing kills.

But my friend, Paula, has no moderation as she cranks out delicious travesty after delicious travesty!

I salute her! But I also count my days supply of calories and take my cholesterol pills!

The Allergy Chronicles


I feel like I’ve been beat with a stick.  After going to get a flu shot at the VA (and finding that it was not the prized H1N1 vaccine), I decided to drag myself to the store for some substantial delight.

I got there so sick that all I could grab was macaroni salad, dishwasher soap (great discount) and toll house cookie dough.

The past weeks have been an insane overload of work and writing, with decent pay as a reward, but with exhaustion as a consequence.

Just when I resolved to stop that nonsense, settle down, and take time to smell the stinky shoes, the Fall allergy season moved in and started unpacking.


The Sacramento Valley is one of the top allergy resorts in the world. We have far too many exotic plants and gorgeous landscapings.

Sacramento has more trees per capita than most places in the world.

People come here with allergies and find out that those allergies thrive well. Then people come here without allergies, then find out that new allergic type of action in going on. No one escapes.

Neither young nor old are bolstered against this mistaken set of ferocious attack processes that make our autoimmune systems want to pull a Thelma and Louise on our bodies.

My autoimmune system is completely psychotic.

It is as if the Sopranos, the Crips, the Bloods, and Scarface took over my T-cells, and are running around, having chemical romances and  yelling “say hello to our little friends!”


So, this year, it could be the Sri Lankan Bigpussy Shrubs and the Andalusian Fart Knocker Trees are spewing forth some dusty plant carpet bombing style of long distance insemination that winds up in our sinuses and bodies.

The Chlorpheniramine pills, those delightful little yellow drowse merchants; those highly effective line officers that soldier on in their mission of rounding up histamines and receptors, are my drug of choice these days, along with the steroidal spray which burns the sinuses like a bad pool dive.

But, still, the double knockout of flu shot and allergy serve to make me relish a long morning in bed. Actually in la la land, dreaming of talking enchiladas and buttery mens who stalk me through glamorous hotels in exotic destinations and give me looks with their eyes.

When I finally wake up, it’s off the cheap matinee at the movies, with the requisite snuck- in snacks and Roger Moore whacking capitalism as the assignment for the week.

Photobucket As a word to the medically ungainly: You do NOT get the flu from the flu shots. The mild, temporary symptoms mean that the vaccine is working as it should. Your body is just making antibodies and having a party in there, building up protection against the real thing.

So, have a lovely day. I am off to snooze and to not work.