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Monday, February 29, 2016

Coffee - To Drink or Not to Drink - That is the Issue

Ours is a mixed marriage - not racially mixed or even divided over religion. The great divide in our marriage was over coffee. You see, I grew up in a small Seventh-day Adventist college town in Texas. We rolled up the streets at sundown on Friday and rolled 'em back out at Sundown on Saturday. Adventists, especially in college hive towns, are pretty strict about things like Sabbath observance (we don't work, play army, or watch TV on Sabbath), alcohol (we don't drink period), meat-eating (we didn't sell it in any stores in town - you had to drive 7 miles to Cleburne to get a hamburger), AND coffee.  Oh, there were those who smuggled it in and drank it on the sly, but those folk were committing sin and they knew it and didn't care.

I never got the big deal about coffee. My step-dad liked coffee, but to me it always tasted like the liquid my Mom would pour off a pot of burned pinto beans. Don't ask how I know - it's one of those inexplicable things one does in childhood to find out about stuff. I could never get past the taste.

Also, caffeine has virtually no discernible effect on me other than as a sleep aid. I have ADHD. I once chewed up and swallowed two No-Doze (at that time roughly the equivalent of 20 cups of coffee) in an effort not to fall asleep while driving on I-20 in Louisiana. It did not work. My wife had to keep picking fights with me to keep me awake the rest of the way there. We got to her parents house a half hour later at 1am. I immediately went straight to bed, chock full of caffeine. I must have rolled and tossed for 3 or 4 minutes before I fell asleep. I slept like a baby. So without the "hit" you get from the caffeine, coffee for me was all about the taste and for those of you so caffeine-addled that you missed it, coffee doesn't taste very good. If I put a lot of milk in the cup with a half pound or so of sugar, I can just about drink it, but only to be polite to my relatives for whom coffee is a religious rite.

My Sweet Baboo, unlike me, was weaned on coffee - literally. Her mother used to drink 3 or 4 pots of the stuff a day, so my wife was already on massive doses of caffeine in utero. Miz Bea's breast milk was probably the equivalent of a Red Bull for caffeine content. Sheila went straight from breast milk to coffee at around 18 months. I think her mom used to lace her baby bottles with it.

Sheila's constitution is quite different from mine with respect to caffeine. If she drinks a Coke after 6pm, she'll spend half the night sitting up in bed quivering with her eyes peeled open like a hoot owl. You should see her clean a house after a couple of cups of morning coffee. It's like those old Mr. Clean commercials. She's like a white tornado. Me and the dog go hide when she gets cranked up. 

And there's the taste! My wife growing up always envisioned sitting around the breakfast table with her handsome husband, talking about feelings and drinking a morning cup o' coffee. It had to be coffee in order to complete the picture. Chocolate milk would NOT do. Orange juice in a coffee cup would not do.  And MILK absolutely ruined the tableau for her.

Unfortunately, I just really hate coffee. It has been a forty year long source of grief to my poor wife, for whom sitting on the porch talking doesn't really work without a cup of coffee in everybody's hand. That's how it was done back home and pouring a diet Dr. Pepper into a cup fools no one. It keeps making bubbles and a fizzy sound and coffee aficionados are not fooled. They also think you're a sissy if you don't drink coffee and that's not something you want to be among people from Louisiana (or East Texas for that matter).

Trouble was, I didn't really like the SDA official coffee substitute either. The folk at Post used to make a grain-based beverage called Postum. Charlie Post, was the guy who stole the idea for corn flakes from John Harvey Kellogg who ran the Adventist Sanitarium in Battle Creek (yeah, that Kellogg). Post developed enough of an SDA following that he dug back into Civil War alternatives for coffee and created a coffee substitute aimed at the Adventists and Mormons who don't do caffeine and the unfortunate folk who can't tolerate it. I don't know if they make it anymore. I haven't seen it around on store shelves lately.

Fortunately for me Loma Linda foods, and SDA vegetarian food manufacturer does produce a product called Kaffree Roma, which is actually pretty good. It looks like coffee, but with a little milk, sweet n' low and vanilla flavoring, it comes pretty close to hot cocoa for taste without the caffeine.

Sadly, it may be a little late for this mixed marriage to get the same boost from sharing a hot coffee-like beverage on the porch or over the breakfast table. Once you get old, it's hard to reset your habits. Besides, my Sweet Baboo has decided to quit her caffeine habit and she's drinking decaf these days. I'm not sure decaf will work as a substitute for the old morning cup o' joe.  Rituals tied to beverages are hard to recreate with substitutes. It's one of the reasons smokers and alcoholics have such a hard time quitting.

Still, I think I'll make me a cup of coffee substitute when I fix up Miss Sheila's morning cup of decaf. Who knows. We may get her fondly remembered ritual going again.  Just without the kick it once had.  I did save some of the evil caffeine kind of coffee in the freezer, just in case Mama needs a jolt to get her housework done or I need help falling asleep.

© 2016 by Tom King

Friday, February 19, 2016

Aramis - The Agent Orange of Middle School

If you've ever been a teacher of 5th and 6th grade boys, you have likely been on the receiving end of something little short of a chemical warfare attack. You may be suffering its after effects to this day.As puberty strikes boys between the ages of 11 and 13, for some inexplicable reason, their little bodies express this sudden effluence of testosterone by making their feet go bad. Bad is, perhaps, a wholly inadequate word for what happens within the confines of a 6th grade boy's tennis shoes.

The military is always experimenting with doomsday weaponry; I feel they have missed something by not collecting and testing middle school boys' sweaty sneakers from their school lockers. The smell coming from a roomful of sixth grade boys in the throes of pubescent is quite over-whelming. Imagine being a teacher trapped in that classroom, day after day, unable to leave. And unlike factory workers, garbage men and sewer staff, middle-school teachers are not required by OSHA or even allowed by the school board to wear surgical masks soaked in disinfectant, to wrap their faces in a wet bandanna or to break out a war surplus gas mask. School authorities, of course, fear that to do such a thing on the part of the teacher would be to damage the self-esteem of the precious snowflakes we are raising them to be.

It was actually better back in my day because Keene Public School had no air-conditioning. Mrs. Webb, my sixth grade teacher God rest her soul, used to open all the windows in the classroom and turn the big stand fans, that we had back in those prehistoric times, so that they would face outward. She sometimes did this in the wintertime. I remember my pencil once iced up during a math class.
During WWII middle school teachers often held extended gas mask drills ostensibly so that the children could "get used to breathing in the things". Shropshire sixth grade teacher Dudley Ramsbottom actually made a formal proposal to his school board to make the masks standard equipment in grades 5 through 8 classrooms. Sadly, nothing ever came of his excellent idea, much to the disappointment of middle school teachers throughout England who had rather enjoyed the brief respite from the combined fumes of strong cheap cologne and really bad feet afforded by the drills.

The worst part of it is that, what with the surge of youthful hormones suddenly bringing the presence of girls to the attention of these budding young Lotharios, they are suddenly struck with the idea that some sort of masculine scent would be appropriate at this juncture. The human nose is strangely immune to scents emanating from its own body. It is perhaps this biological self-defense method which seems to protect the boys from the pungent fumes rising from below their school desks. This scent-dampening effect may be the reason boys are drawn to cologne scents strong enough to peel paint off the walls of the classroom. These guys are not even trying to mask the smell of their sneakers. They are blissfully unaware of it. 

Now imagine yourself a teacher facing a roomful of adolescent boys, their shoes giving off toxic fumes and their necks emitting an array of powerful scents from the most pungent colognes they can buy with their paper route money. In my day, the favored scent seemed to be Aramis.  There were other less powerful knockoffs that were tried, but for the recently sexually awakened 12 year old male, there is nothing quite like Aramis. It makes little girls swoon and teachers cry.

It's a wonder Aramis didn't use that as a slogan in their commercials!  Just looking at a picture of the bottle still makes my eyes water.

Tom King © 2016

Tuesday, February 02, 2016

Psychiatry does NOT Kill: Stupid Internet Videos Kill

Not everyone who hangs out their shingle
on the Internet knows what they are
talking about.

Okay, can you tell I'm angry? I just saw a video entitled "Psychiatry Kills". The premise is that the medicines psychiatrist give are all bad and you should get off them. The trouble is, rather than trust a highly trained physician with years of study and research behind him, you're going to trust a lot of anecdotal "evidence" from a group of people that the video says, quit all their meds "cold-turkey".


Here's what happens when you quit a psychotropic medication cold turkey.  First, you start going back into the depressed, panicked, schizophrenic or whatever state you were in that caused the medication to be prescribed in the first place. Second, the change in neurochemistry in the brain caused by the sudden stopping of your meds triggers all sorts of brain neuro-transmitters to either shut down or kick into overdrive giving you the equivalent of a very bad LSD trip.  So every story in this video (and no I'm not going to give you the link to some advice that can kill you, so don't ask), is based on someone doing what their doctor told them not to and in many cases probably because the person saw one of these scary videos about evil Big Pharma and decided some anonymous Internet video cares more about them than the physician you are paying to look out for your health.

Do psychotropic meds sometimes cause side effects?  YES.  You see, you can't peek inside the human skull when the patient is alive to see what's causing his mental problems. That would do more damage than good (remember lobotomies).  Diagnosing psychoses is a very much working in the dark process. We can only diagnose by observing behavior and listening to you tell what is wrong.

If you do a lousy job of telling the doctor what's going on in your head or if you spin the story to make it sound worse or sound not so bad, you will almost certainly get the wrong medication the first time out.  That's how psychiatry works. It's a partnership between patient and physician. He is not a magician. There are no magic words he can say nor magic pills he can give you, especially if he doesn't get good information from you. If you don't tell your physician what is going on, you probably are going to have a bad experience.

The truth is that the chances of the first medication you try working for you are pretty slim. That's because the causes of many mental disorders cause symptoms that look pretty much the same. One pill may work great for one kind of depression and be really bad for another kind of depression.

And yes, not every depression is exactly the same and cannot necessarily be cured by the same treatment.  I know people expect doctors to wave their magic prescription pad and cure their problems, but it's not that easy.

Think of the doctor/patient relationship as a collaborative research partnership.  Here's an example.  My grandmother's physician prescribed a powerful anti-biotic for an infection she had.  Just after she started taking it, she had a terrible panic attack. I was in grad school at the time and so the first thing I did was ask if she was taking any new medications. I'd never heard of an anti-biotic causing panic attacks, so I went down to the pharmacist to ask about side effects (this was pre-Internet).  Sure enough one of the side effects listed was panic attacks.

We called her general practitioner and he prescribed valium for her anxiety. It didn't work and the problem escalated. She was so freaked out, she was afraid to drink water. Fortunately, at school I had access to Medline and looked up some info on panic attack. A doctor in Shreveport had done some work on panic attacks and noted that anti-anxiety meds don't work on severe panic when used alone. He recommended pairing it with an anti-depressant and had shown good results with a combination treatment.  I went down to the doctor's office (his secretary wouldn't let me talk to him). I ambushed him as the office was closing, told him about my grandmother's problem and showed him the research I had found (he was not a psychiatrist, remember).  He said he'd take a look. He called me a couple of hours later and told me I was right. He prescribed an anti-depressant to go with the valium and once we convinced my grandmother to take it, she got better immediately and within two weeks, just like the research said, the panic attacks were totally gone and she was able to quit the meds as she should have.

Treating mental illness is a tricky process. There are no instant cures. If you are lucky and diligent to give the doctor good information, you may get the right treatment the first time, but don't count on it. If you have bad effects from the medicine, tell the doctor and he'll try something else. Trying a lot of different meds doesn't mean you've got a bad doctor. On the contrary it may be a sign that you have a very good doctor.

Here is some advice for those of you with mental illness who are taking or considering taking psychotropic meds like anti-depressants, anti-anxiety or anti-psychotic medications:

  1. If you need psychotropic meds see a psychiatrist: If the problem is severe, you may need to see a psychologist too. A psychologist will test you to find out what's wrong. A psychiatrist handles medication.  Either may send you to a counselor for talking therapy if that's appropriate.
  2. Trust your physician:  Take the meds as he or she tells you to. Don't fiddle around with the dosages or times you take them. Doing that can cause some side effects or mess up what the drug is supposed to do.
  3. Choose a treatment partner:   Your spouse is the best or a parent or adult child who lives with you. That person needs to know what you are taking, why you are taking it and go along on doctor visits to provide a 3rd party report to the psychiatrist as to what your behavior is really like. They WILL see things from outside that you don't see from inside your rattled brain.
  4. Trust your partner! Your partner will tell you when you are going off the rails. It's the hardest thing in the world to trust someone to tell you your behavior is erratic. You probably don't want to hear that and you may be so screwed up that you think your partner is out to get you. You need to know that this may happen. It's the illness, not necessarily the meds. It could be both if you have the wrong medication too.  Here's where you have to use cold rational thinking to overcome your feelings. If you are mentally ill, you cannot trust your feeling.
  5. Don't self-medicate:  Pot may make you feel "mellow", but it may also have some nasty interactions with the stuff your doctor gave you. Illegal drugs are notoriously irregular in their strength and dosages and pushers are a real hazard to your health. My son wound up 3 days in a coma because he believed pot had no dosage limits and smoked his whole supply wrapped up in papers his helpful dealer had treated with PCP. It nearly killed him.  That's why you don't self-medicate.
  6. Call the doctor if there is something wrong or give your partner permission to call on your behalf: When you are having an "episode", you cannot trust yourself to act in your own best interests. People who trust their own judgement when they are mentally ill are the ones who kill themselves or do something monumentally stupid that they wind up in jail or worse. You need someone who will get you to the help you need and you have to keep reminding yourself that you trust that person, no matter what you feel emotionally.
  7. Don't switch doctors:   Too many people switch doctors the first time their medicines don't work and then complain because the new doctor gives them the same medication.  Each mental illness diagnosis has a protocol that doctors follow. You give Medicine A first and then Medicine B if that doesn't work and then Medicine C and so on. Change doctors and he's going to start down the same protocol list.  Stick with your doc till the two of you figure it out. If you find a physician that will listen to you when you tell him what's wrong, then stick with that doctor. You've found a jewel.
  8. NEVER QUIT COLD TURKEY:  Every damned story in the "Psychiatry Kills" video was of someone who belonged to a group which quit their meds cold turkey and they all had suicidal ideation, homicidal thoughts and really twisted urges. No wonder. THEY QUIT COLD TURKEY. The warnings that come with the medicine say never to quit cold turkey. It can be fatal.
  9. Don't believe everything you see on the Internet:  There are some wonderful resources there. Mayo Clinic, Johns Hopkins and other reputable information sources have a wealth of material about every disease imaginable. If you see some hysterical warning on Facebook, skip it. Search out the information for yourself. Avoid the independent websites. Hook up with social media groups to share stories and learn how other people handled their disease, but be careful of quack cures and hysteria. Your doctor studied all those years because she wanted to help people. Besides, killing your patients is not a very good way to make a living. Dead people don't pay for doctor visits.
  10. Remember that you are unique:  No two people are alike and there is no "blood test" or X-ray for mental illness. Even MRIs and CAT scans can diagnose your mental illness on their own. It's a long and complex process.
  11. Don't make big decisions when you're not thinking clearly:  If you or a loved one is struggling with mental illness, make it an agreed upon thing that you don't make big decisions when you're having an "episode". Always let your treatment partner be the one to be the final word on whether you are up to it or not. That's hard to do, but it's the best way to regain control of your world. By deciding not to make impulse decisions when you aren't at your best is very wise.
Finally, remember that fear, paranoia, sadness, elevated mood and rage are all components of various mental illnesses.  They come with the territory. Apologize in advance to your loved ones. You may say stupid things that you regret later, but which, at the time, seem like they simply must be said. Build around you a circle of loved ones who know what you are going through and who you trust to be on your side when you are in trouble. You want people who won't let you go to the casino when you're manic, because they know you'll bankrupt yourself if given a chance.  You want doctors who have enough experience with you to piece together a correct diagnosis and who trust you to tell them what's really going on in your head. Not every general practitioner is good with medications for your mental health. If you need medication support, go to a psychiatrist who is expert in treating mental illness and build a partnership with him or her in helping you reach stability.


Tom King
© 2016