Lend Me Your Ears

Okay, so I made it clear in my last post that I do not like really big, long term change. That’s just me. That being said, I have been in a maelstrom of rapid, relentless, major, workflow altering change, much as many of you have, over the last two weeks now. Sort of like that frog in the pot of water that is unaware that the temperature is rising until he starts to boil, we have been the recipients of a slowly gathering storm, pushing a tidal wave of change on us from way out at sea, knowing that it is coming but not having a clue exactly when it will hit, how much damage it will do, or whether we will survive it.

On top of that, we are now seeing reports of people actually dying from this COVID-19 infection and disease, not just getting sickened or inconvenienced by it. A young lady. A middle aged media executive, a child, an infant, a renowned neurosurgeon, a country music artist. In other words, people like us or people that we love and care about. Ouch. Much too close to home. Anxiety, More stress. Worry. Paranoia. Enforced isolation which leads to functional isolation which leads to real isolation even at home. Not good for the psyche. Not good at all.

I can handle this, I tell my bad self. I will not get sick. This could never happen to me. I’m too young to die. I’m in my prime. My brain, smart as it is in the area of fact assessment and reality testing, is also super duper good at deception. The person it is the best at deceiving is me. I do not feel sick, therefore I cannot get sick. I am able to handle this stress, and even more stress, without feeling it physically. I will not notice a thing, not one little thing that will give me a clue that maybe my physical or emotional systems are overloaded. Right.

A couple of weeks ago, my left ear started to feel a bit stuffy. Annoying, but not terribly debilitating. I chalked it up to the myriad allergens in the air in the southern United States at this time of the year. I had felt this before, sometimes saw it turn into a mild cold, and had developed a way to cruise through it. Daytime and nighttime cold medicine at the very start of this syndrome, plus nasal spray to keep me breathing enough to work and be productive, all for about a week or so, had always worked before. Dutifully, at that first little feeling of stuffiness and discomfort, I embarked on my standard regimen. I thought little more about it.

A week later, things were worse. The ear was more stopped up, I could not hear well on the left side, and there was an uncomfortable feeling of having one side of my head in a barrel. I knew best, I told me, and I continued to doggedly prosecute my tried and true regimen. More liquicaps, more spray, more time. Nothing doing, my ear said, we will not budge. The left side of my head, down onto my neck, around to my cheekbone, got numb. When I would talk to colleagues, albeit from six feet away, I felt that I was shouting. Conversations at the island in the morning with my wife were unsatisfyingly one sided unless I turned my head towards her and practiced a mixture of something like torticollis and lip reading. “This is one bad allergy season!” I pontificated. All the while, this was really starting to drive me nuts, with the changes at work, schedules upended, my wife getting back on planes to fly germs, I mean passengers, around the country.

Then I remembered an episode a few years ago when a similar thing happened, but a time that I felt that I lost ALL the hearing in the same ear. Total hearing loss. Nothing. Scary. I ended up going to an urgent care center that time, and as you may have guessed by now, I had a monster, hard, obstructive impaction of cerumen, that’s ear wax to you and me, in that ear canal, completely and utterly obliterating any path for air or sound to travel one way or the other down my ear canal. A little soaking and a splashing shower of irritation, I mean irrigation into a small metal pan, and I could hear! I had never felt that happy in my entire life.

Fast forward to this week. No hearing, numbness in my face, unsteady on my feet, oh my God do have a tumor somewhere kind of angst running amok among the COVID-19 particles , I finally remembered that episode. I go to Walgreens, buy some ear wax nuking stuff (No, they still don’t have hand sanitizer), and get to work. I won’t bore you with the tedious details, but after three nights of this intervention, one evening in the midst of a showering royal flush, out came an ugly piece of wax that had bugged me for days. I could hear! I was no longer numb! It was a miracle!

Funny thing, though, the right ear, the one that had felt pretty normal through all this, felt a little stuffy itself once the left one was crystal, drive a gondola down the ear canal clear. Oh, no, migratory aural tumor, I thought to myself, and had to smile. Really? Really? More wax nuking drops, two more days, then blessed relief. I am virtually normal now, if I ever was.

So, I quipped to my wife at breakfast the next morning, sitting at the island, and NOT turning my head as I could already hear her replies, I wonder if increased stress and anxiety can cause one to create more ear wax? Ever at the ready to end wanton ignorance in our little world, she snatched up her iPhone and searched for an answer.

I’ll be damned.

Turns out, increased stress and fear can cause the body to produce more cerumen.

WHAT?

PRODUCE MORE CERUMEN!

SEASON WITH CUMIN? WHAT?

NO! EAR WAX. EAR WAX!

Oh……

We are all overloaded right now. We are frogs in a pot. The temperature is rising, and we are in jeopardy of boiling if we are not careful. We think that we have seen it all, done it all, figured it all out because we are smart, successful, resourceful people. We have all the answers. We are large and in charge.

Wrong.

This is bigger than us. Tiny viral particles, too small for us to see, have brought our world to its knees. Our economies are reeling. Our social institutions are paralyzed. Some of us are sickened. Some of us are dying. Our bodies know this, the ancient parts of our bodies and those cells and systems that really HAVE seen it all and survived, they know this, even if our younger, smarter, more resourceful brains cannot accept it.

Listen to your body. It will tell you when you are maxing out your biological credit line. It will tell you when to slow down, when to meditate, when to eat, when to rest. If you do not heed it, it will find a way to get your attention.

Thanks for lending me an ear while I waxed eloquent.

Yes, I really went there. Be well.

F5s

F5
Incredible tornado.
261-318 mph.
Strong frame houses lifted off foundations and carried considerable distances to disintegrate; automobile sized missiles fly through the air in excess of 100 meters; trees debarked; steel reinforced concrete structures badly damaged.

tornadoproject.com

 

We had a strong storm front come through the southeastern United States last week. Of course, this was not the first time this happened, and it will certainly not be the last. It was fascinating to watch it march inexorably across the country, showing up on my weather app as a ragged green diagonal slash from Gulf to heartland to northeast, moving slowly and relentlessly across the landscape. In the center of the ragged slash was a well defined hard bright yellow-orange-red line of destruction. Pretty on the screen, destructive on the ground. Destroyer of worlds.

Texts began to trickle in from my daughter, who lives in Spartanburg, of an apparent tornado that touched down not five miles from her house and destroyed a shopping center. A coworker who sees patients at the mental health center by telehealth connection also reported frightening noises that drove her to her basement to hunker down until all warnings were lifted later in the day. Both reported the loud, surreal wail of tornado warning sirens, something that I have never heard in real life, but that I am sure must be quite distressing in the midst of gray skies, howling winds,  pouring rain and lightning flashes. Not an F-5, but terrifying nonetheless.

When I hear about such stressful situations and see evidence of the destruction they bring,  I think of my friends, family, acquaintances and patients have who struggled with cancer, financial stress, persecution for various reasons, and other stresses that lead to anxiety, fear and emotional upheaval. My aunt who succumbed to ovarian cancer when I was a boy. My mother, who is a breast cancer survivor. My friend, who tragically committed suicide. My patients, who tell me stories of unbelievable trauma, neglect, abuse and hopelessness. Like an F-5 monster tornado, these life circumstances can drop on any of us unexpectedly from the sky. Pretty colored X-rays and scans reveal the destructive power of the cancer underneath. Sirens go off. The mind screams take cover, take cover! The body sometimes is only grazed, shrapnel cutting but not killing. Other times, the impact is devastating. Nothing looks as it did before the storm. The landscape is flattened and only rubble is left. We return to a place, time or set of circumstances that we expect to be familiar, only to realize that all of our old landmarks are gone, destroyed. We do not know whether to drop to our knees and cry, run headlong into the pile of rubble, or turn and walk away.

Is there anything good about F-5s, cancer, abuse, trauma, and destruction?  What an odd question, I hear you asking me.

These scourges, while leaving city blocks, body parts, and psyches in absolute ruin, are often coldly surgical in their devastation. That is, a few hundred yards away, or a few inches outside the margins, or in some other part of the emotional us, the sun is shining, the tissue is healthy, the coping is reasonably good and life goes on. Friends rush to help. Prayers go up. Communities, wonderful , supportive, dynamic communities form. Support is not only offered but insisted upon. Rebuilding begins immediately in the aftermath of the siren’s wail, the surgeon’s knife, and the abuser’s fist.

When the horror and the shock and the denial and the anger and the tears and all of it subsides, victims become empowered survivors.

Strong!

The chorus goes up.

We will rebuild.

Life will go on.

We’re still here.

A Routine Should Be Just That

So, I was on vacation last month.

A seven thousand mile trip in my little red car, zooming from Chicago to Fargo to Billings to Seattle to Salt Lake.

I had a blast. Maybe you’ve read about it.

It was funny to me how many of my friends and readers and acquaintances, how many of you, worried about me. Not about my safety or my driving or my being run down by one of those triple rig FedEx trucks in North Dakota (I must admit, I did have a few moments of fear and trepidation around those monsters). You worried that I was not slowing down enough. That I was not sleeping in. That I was (gasp!) going to the gym and (oh, my GOD!) exercising every day. On vacation! Away from home, where the air is sweet and the food has no calories and dessert comes automatically with every meal.

When I would post that I was walking or biking at the Hampton Inn in Portland, someone would tell me to take it easy, relax, skip a day, take a nap.

Funny, that, because if you know me well, as many of you do, you know that I do NOT do well with down time. I do NOT relax if I am lying on a bed or in a chair trying to make my eyelids close for a late afternoon nap before dinner. I do NOT feel good if I skip the morning workout and sleep an extra hour, then eat two plates of free breakfast that includes pancakes, sausage, and plenty of syrup.

Oh, I’ve tried. I have. I have tried to lie down in the evening and watch television. I have tried to not set an alarm on vacation and just sleep until the sun smacks me on the eyelids and says, “Get up, rise and shine, buddy!” Every once in a while I’m successful.

But you know what, dear readers of mine? As we get older, we get set in our ways, for better or worse. Now, we can argue until the cows come home what is better for you, healthier for you, what makes you happier, calmer, lowers your blood pressure, etc. I’m not writing this to do that.

I’m writing to tell you that I firmly believe that we all have set-points, mid-points that we naturally settle into. Places and states (not literal states, no, though Washington state was killer…) where we feel our best, have the most energy, eat the healthiest for our own metabolism and where we are the most creative, productive and happy. I believe this. I think you should give it some thought.

No matter how hard I try, I keep coming back to what my body is trying to tell me is a good place, a happy place, a contented place where it wants to do what I tell it to do with minimal muss and fuss. Now, for many of you this will sound absolutely crazy, and thats okay.

It’s my set-point, not yours. Get your own!

I do best if I get up at five AM. At that time of the day, which I love, I can make coffee, eat some breakfast, read the paper, process my email, and acknowledge comments here on the blog and elsewhere. I do not need to worry about the day, because I’ve already thought it through. I can take my time, not feel rushed, get ready, and get out the door by seven or so most days depending on where I need to be.

I do not exercise in the morning, with one exception. In the winter months when basketball season is upon us, like now, I like to go watch the Aiken Pacers, who play a mile or two down the road from me in the evenings. This cuts into gym time, so I must work an hour walk into my morning routine. No problem. It just needs to get done, people. Make it happen!

I count on working until the day is done. Some clinic days, that means five PM and finished. Days that I tack a telepsych shift on after clinic, the day is done at midnight or one AM. I feel much more content if I do NOT worry about the crazy hours I work. For now, I choose to work these hours. That will change one day, no doubt. For now, I work until the work is done.

Exercise usually comes in the evening, an hour and a half or so at the gym. If I don’t have time to exercise today because I’m working sixteen hours, that’s okay. If I’m not working the whole day and I have time to exercise, there is no excuse to deprive my fifty-seven year old body of what it needs to stay active and healthy-movement. This is not a chore after you get used to it. You miss it if you miss it.

I try to eat “real” food, when my lifestyle is much more conducive to eating junk or whatever I can grab on the way from one place to another. My body has repeatedly told me, very clearly, that it does NOT like and does NOT feel good if it is topped off with sweets or excess carbs or junk food. The insulin rush and crash after candy bars and Pop Tarts is not for this boy. That said, I LOVE sweets and had rather eat that kind of stuff more than almost anything on earth. I just know that if I want to feel strong and healthy and alert and awake, I’d better not overdo it. It’s just not worth the blahs and the bloats and the mental dulling that comes with that short-lived binge of sweetness.

I use a Jawbone Up24 (Yes, I have pre-ordered the Jawbone Up3, to be shipped December 1st and it looks awesome) to help me track activity and sleep primarily. I have learned about my own non-patterns (again, I work crazy hours, have an insane schedule and most people think I am slightly off for doing so). The software for this device has told me in no uncertain terms a couple of times that it cannot figure me out! There are not enough patterns for it to process and give me meaningful feedback about. Wow.

That being said, sleep is not normal for me, but I’ve learned that this is okay too. I can try to get seven to nine hours of sleep per night as suggested by those who know, but I will just be constantly frustrated because I NEVER sleep more than six and half hours on a normal night. I have found, again, that I feel much better if I get up at the same time every day (which I CAN control most every day) and get to bed just as soon as I am finished work (which I usually CANNOT control at all most days) I do okay. I get enough sleep. I could be getting more, but in my life right now, that is not going to be the routine pattern for me. No worries. I run with it.

Some of you need eight or ten or twelve hours of sleep a night. That’s great and I’m glad you can do that. I can’t.

Any time that I have more than just a day or two off work, I plan to DO something. Go somewhere, see something new, hike, fish, travel, take pictures, visit, see a show, eat in a new restaurant. This is routine for me right now. (See down time above). I love football and basketball games. I like to see my family. I have dreams to make a few more big trips.

The take home?

Routine should be just that, whatever that means for you.

Figure out what keeps your body feeling physically good, energized and ready for action.

Eat healthy as much as you practically can.

Exercise.

Sleep as much or as little as you need to perform at your peak level.

Seek out stimulation that makes you learn and grow.

Be responsible for your own happiness.

In the end, you’re the only one that has that duty in the present.

Don’t let your future self down.

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