Hill of Beans

The Huffington Post reports that scientists at Stanford have figured out a way to turn anxiety off and on in mice. About one-fifth of Americans are anxious in any given year, says the Huff Post, allegedly quoting the NIH, but the link didn't lead me to the source.

The scientists found ways of stimulating cell projections in the amygdala section of the brain, causing mice to be less anxious, and seem emboldened, spending more time exploring open spaces than control mice.

They sound like the mice I had in my old place. They would run around the kitchen with impunity, and stand there in the middle of the floor with the lights on, looking around. I don't know what emboldened them. Maybe their drinking water was contaminated with Prozac.

So here are many questions: What does it mean that one-fifth of us are anxious at any given time? Have humans always been anxious and are we only now finding a way to keep track of the numbers? Are we more anxious now because of our fast-paced life? Or eating food additives, or living with the minute hand so close to midnight, or with constant reminders of war and terror and uneven distribution of wealth?

Maybe we should be anxious. Since the invention of the telegraph, we humans have been able to transmit news of death and destruction immediately all over the world. Our species has grown cognizant that the earth is fragile. At the same time, we've been assaulting the earth with toxins, pollution, strip mines, cement and so on and so forth. Nature (tsunami, earthquake) combines with culture (nuclear reactors) to extend disaster.

Does anxiety to lead to working for social change? That's the real question. If we weren't all medicated, would we be up in arms more? Are we sedated and inert? Probably not. When I was at my deepest level of anxiety, I wouldn't answer the phone because I would start weeping. I was not in the mood to go to a rally or knock on doors. On the other hand, does political action lead to feelings of connectedness and mastery and increased self-worth? Yes, it can. So as the song says, Don't mourn, organize (while it's still legal).



... it doesn't take much to see that the problems of three little people don't amount to a hill of beans in this crazy world. Someday you'll understand that. Now, now... Here's looking at you kid.

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Magic mushrooms & no magic bullet for patient communication

Johns Hopkins tells us that researchers are looking at illegal drugs to help people with OCD (obsessive-compulsive disorder), PTSD (post-traumatic stress disorder), anxiety and depression--anxiety being Cancer Bitch's major bugbear. MDMA aka Ecstacy, says Johns Hopkins health reports, also increases brain levels of oxytocin, which arouses feelings of trust and confidence that can be particularly helpful during psychotherapy. The idea is that a dose of the drug, taken before a talk therapy session, may help individuals with PTSD reduce their fear and anxiety long enough to discuss and process the events that traumatized them. Ketamine aka Special K, is an FDA-approved general anesthetic that is being studied as a fast-acting antidepressant. Ketamine binds to receptors in the brain and blocks the neurotransmitter glutamate that normally activates neurons, thus producing a calming effect.

I haven't tried any of the above, though in high school, the guys in Future Farmers of America were allegedly growing the mushrooms on their school farm. It was the '70s, after all.

You can participate in clinical trials of these drugs (or a placebo)if you meet the criteria. For example, New York University is administering one dose of psilocybin to anxious people with life threatening, advanced, or recurrent cancer. If you're in Baltimore, check a study out here.

University of Rochester is studying whether topical amitriptyline and ketamine cream are effective in treating neuropathy caused by chemo.

There are tons of clinical trials and they can save or at least improve lives, even your own. For example, in researchers in Downstate Illinois are studying how best to get breast cancer survivors to exercise. There's another one on whether flaxseed is helpful in combatting hot flashes. My favorite is one at Fancy Hospital on communication with patients. A major goal: •Determine patients' health communication needs during the first 6 months of care by interviewing patients with breast cancer (as well as their families, caregivers, and healthcare teams) and observing interactions between patients and oncologists throughout the trajectory of care from initial diagnosis through the initial treatment course.

This involves video and extensive interviews. What should also be done:

* HIRE ENOUGH ONCOLOGISTS & STAFF SO THAT THE WAIT TIME IS NOT TWO HOURS FOR CHEMO OR ONCOLOGY APPOINTMENTS.

* REQUIRE DOCTORS TO READ PATIENTS' CHARTS BEFORE ENTERING THE EXAMINATION ROOM.

* REQUIRE DOCTORS TO SIT DOWN DURING PATIENT APPOINTMENTS.

* TRAIN DOCTORS (STARTING WITH MEDICAL STUDENTS) WITH EXTENSIVE ROLE-PLAYING EXERCISES.

* INVITE JEROME GROOPMAN TO TALK TO ALL STAFF ABOUT COMMUNICATION WITH PATIENTS AND FOLLOW WITH SMALL MIXED (SEE POINT BELOW ABOUT MIXING STAFF) DISCUSSION GROUPS ON RELATING AND COMMUNICATING WITH PATIENTS.

* CONTINUE ATTEMPTS TO LOCATE/ENCOURAGE HUMANITY IN DOCTORS AND TO BREAK DOWN THE HOSPITAL HIERARCHY (BASED ON RANK, EDUCATION, CLASS AND MOST OF ALL RACE) BY HOLDING WRITING WORKSHOPS, BOOK AND OTHER DISCUSSION GROUPS, IMPROV & EXERCISE CLASSES AND OTHER ACTIVITIES THAT INCLUDE EVERYONE, FROM IMPORTANT & SELF-IMPORTANT DOCTORS TO CLERICAL STAFF.

* HIRE HOSPITAL CLOWNS TO EASE TENSION & BRAINSTORM WITH THEM ABOUT IDEAS TO EASE ANXIETY AND COMMUNICATION. IT'S HARD TO LISTEN WELL WHEN YOU'RE TENSE.



To search for clinical trials, go here.

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The Looming Future

R said she was afraid that after she gave birth to her twins, she would be seized by post-partum depression. She was afraid she'd turn into one of those mothers who hears the voice of the devil and butchers her babies in the bath tub.
I said, You can take drugs to prevent that.
I was surprised to find someone as neurotic as I am, already thinking of the worst-case scenario.
She said she wanted to take something now. I said, You can't take it now, it won't work. I said, You don't have the depression yet, it comes after birth and all the hormone upset. I said, You could take Prozac, maybe Buspar.
S, who was eating lunch with us, said, It takes those drugs a few weeks to kick in.
R said, Yes, that's what I'm afraid of. What do I do before they start working?
I said, You could take Ativan, Ativan works quickly.
She said, Yes, my brother's girlfriend takes it before she flies.
So perfect, I said. You see how fast it works.
She said, Can I still breastfeed?
Ah. I didn't know. But wouldn't anyone give up breastfeeding if they knew that otherwise they'd be crazy and harmful to others?

I pride myself on my medical knowledge, all gained through experience. One day I hope to be awarded an honorary medical degree, and then I will get me a pad of prescription blanks and go to town.

***
An old boyfriend said once, Oh, you'd be a great mother. How would he know? When he knew me I was not a very good adult. I was too needy and lump-in-my-throat frightened, and Prozac wasn't on the market yet. I was not patient or happy or satisfied and after six months he decided I wasn't marriage material either.

During my junior year abroad in Paris my sink detached itself from the wall, and when I saw it, I ran out the door. I didn't want to deal with it. I thought: If a sink makes me run away, what about children? They'd yell or scream or cry and I'd leave and never come back. I would not be responsible. I would be an improper mother. I take three calming drugs now just to get through the day. Some days I'm wearing the same T shirt I just slept in. I can't believe that parents used to trust me, as a teen-ager, to take care of their children when they were gone. Luckily, none of the plumbing broke under my watch.

I made an attempt to find out about Ativan and breastfeeding. I found this about other anti-anxiety medicines:

From Druginfonet:
Question: What are the possible effects on an infant of taking Paxil and Xanax while breastfeeding?

Answer: Both are passed into milk, no clear idea of the long term effect, but, short term effects would be probably most marked with Xanax(sedation etc). If you need to take these drugs, I would consider formula or a wet nurse.

Wet nurse?

There don't seem to be any on Craig's List.

READ MORE - The Looming Future

Art vs. Mammon

The other day I stopped in at B & S's house and brought in the mail. B asked me to open the plastic wrapper that Poetry magazine had come in. Before I handed it to him I looked on the back for the authors this month and read off names I recognized. B took it and read off more names. He's a poet, so of course he'd know more of his ilk. He said, You gave up journalism for Art. Which was a nice way of saying things and isn't entirely true. It wasn't a conscious decision. I can be slow to realize what the common wisdom is--about anything. I didn't realize for years that many people think of fiction as Art, and journalism as Lesser Non-Art. For undergrad I went to J-school, and then to Famous Creative Writing School, where I'd questioned the purpose of Art when Reagan had his finger on the button and the budget. I would travel to Des Moines and Milwaukee and DC and New York City to protest nuclear proliferation and draft registration. I thought journalism was the highest and best you could aspire to because it Did Something, especially investigative journalism, which, by the way, I wasn't doing. I was writing features. But some of them had a socially-useful aspect. OK, some of them.

A friend of mine, N, taught a course on journalism that changed society, using books as texts. When student complained to her and her boss that N had assigned too much reading, she didn't back down. She decided the next year to add more required reading. She's tenured.

In graduate school I discovered radical philosophers on art and society and almost created an independent study for myself on political novels. I don't remember why I didn't follow through. When I worked for the major newspaper after grad school, someone in the newsroom said as if it were an acknowledged fact, that the novel was the real writing, not journalism, and I was mystified. I may still be. While at the same time, when I heard a major historian talk about the numbers of men who become cold mass killers in certain situations, I thought about William Carlos Williams' short story, "The Use of Force," which shows that the most humanitarian intentions can lead to violence and corrode the soul.

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Update

Cancer Bitch is afraid she will get her blogger award stripped from her because she hasn't blogged in ever so long. She is working hard revising the manuscript based on this blog. It's due at University of Iowa Press June 1 and she is ever so anxious about it. She has had a lump in her throat for about 10 days and takes Ativan for it from time to time and then gets anxious she will become addicted. She is also in the midst of buying a house and quakes at the prospect of actually living full-time with her husband. Right now they live together most of the time in her condo, where 95 percent of the furniture and Stuff is hers. He has half a (big) closet and two dressers and half the bathroom. The rest is in his house in Gary, which he'll sell next spring. But he dislikes most of her furniture and pictures and she doesn't like his pictures so much and she thinks he hangs them too close to the floor anyway. Everything is overwhelming though she knows that in the grand scheme of things these problems are but fly specks. She wonders if any of her readers have anything to say about the New York Times magazine story about blogging and becoming Known. She understands the author's tendency to "overshare" and her feeling that her life is public and private at the same time. But didn't Jennifer Weiner mine some of this same territory in Good in Bed? The NYT story is very thin on cultural history, or any history not the narrator's own. There are no references to other tell-alls, except one that unfolded right as hers did: "For a few hours, my personal dramas took a backseat — sort of — to news that a Pulitzer-winning author had described his wife’s affair with a media mogul in a crazy e-mail message to his graduate students." But what do you expect from a piece that begins "Back in 2006..."?

Is C. Bitch being too harsh? Perhaps. It may be too much to expect a confession to provide cultural and political perspective about a phenomenon while the author is in the middle of it. Mostly, she is amazed at how quickly someone can become famous. But in this day and age, she shouldn't be surprised.

READ MORE - Update