Warning- Objects in Life May Be Larger Than They Appear

     I am sure that we have all heard those well meaning platitudes at one time or another... small Hallmark card snippets that are meant to uplift us and give us hope when people cannot think of something better to say and there are times when these little gems of wisdom do help us get through a trying moment.

     There are also times when those little gems of "inspirational and motivational wisdom" are as welcome and wanted as a root canal with a plastic spork in the middle of a tax audit.

     I will list off a few of the gems that make me want to chew tinfoil and after thoroughly exhausting my bile on them give a few alternative things that could be said in their place.

     Get Busy Living or Get Busy Dying

     This little gem is pulled out of the blue and tossed at people when empathy has left the building and the speaker thinks that the listener needs a little tough love and less self pity.  Basically what this is saying is "stop complaining or die already because I am tired of hearing about it", or at least that is what the person being told this is hearing no matter how well meaning the speaker is.

     When a person with a chronic health condition is told this it is a major slap in the face because the speaker has no clue how much that person is already fighting just for the smallest aspect of normalcy and the fact that they are there at all means that they battled to get there.  

     Want to encourage someone to never speak to you again... pull out these words because they will honestly believe that you do not care about them, how they are feeling emotionally, physically or spiritually and will be uncomfortable around you from that point on.

     Things could be worse

     You are right... things could be worse and thank you for reminding the person of that because now not only are they feeling rotten but they are feeling guilty that they feel rotten when things could be worse.  Great job of belittling what is going on and helping us have a healthy dose of guilt for selfishly mentioning it.

   My neighbors mothers cousins dog groomers niece had that and they cured it by eating avocados

   That is nice... and here we are wasting our credit scores, life savings, dreams of home ownership and sanity wasting money on seeing Doctors and specialists who wasted all those years in medical school when all I need to do is track down this magical person and their magical avocado.  Just think of all the money that can be saved... no more research into cures or treatments... 

        Basically you are saying that we are so stupid that we do not know that what we have can be cured by a simple thing that you heard about offhand years ago. 

     You need to just stop dwelling on it

     Seriously????

     Would you tell someone paralyzed from the waste down that all they need to do to walk is not think about it?  How about telling a blind person that they could see their family if they just calmed down and took their mind off it for a while?  

     But you do not look sick

     This one is a major one to those suffering from chronic and often invisible illness.

     Those who suffer have to be actors to be out in society and have to try to hide what is going on... fake smiles are plastered on... jokes are said... nothing is taken seriously.  Either we are great at hiding the pain and illness or you are blind and see only what you want to see.

     I have to bite my tongue from replying to this gem "yeah, and you do not look like an idiot... guess we were both wrong".

     You need to slow down and rest more

     If all we ever did was slow down and rest when we had no energy or were feeling bad we would never leave the bed and eventually would have to have our pillows surgically removed from our cheek.  

     It is well meaning, and we know where it is coming from, but when we push ourselves to get something done or want to battle to have some kind of life and hear this it causes anger.  We want to be normal... we want to do things... we want to do "something".  We know we will pay for it... (we do not need the "I told you so's" at that time, either) but we desperately want to have a part in life beyond 'this'.

*****

     Now comes the things that you can say or do differently... 

1. Instead of saying "get busy living or get busy dying" you can say something like "I know that making plans can be hard because you never know how you will feel from one moment to the next, but they next time you feel like venturing out give me a call and we can go do something fun".  You want them to get out there and live life and that is great... just try to do it in a way that both of you can enjoy.
2. Instead of saying "things could be worse" when they complain or vent about something, let them just vent.  It is important to be able to get that emotional garbage out and to release those feelings so that they can move beyond the moment.  They feel invisible as it is and it helps them to know that they are "seen" as well as heard.  They do not want you to fix them or fix the situation, just to acknowledge that there is one to begin with.
3. Unless you can cite medical reviews and reports from reputable sources (like the NIH.GOV website) please refrain from trying to give 'hope' by passing on some urban legend of a cure that you heard about some obscure place.  Believe me when I say that those suffering from chronic illness tend to follow any developing news about their condition and know what is out there.  If there was a way to cure it with avocados, honey, salt or a cucumber diet they would have done so long ago.
4. Instead of saying "you need to just stop dwelling on it" try to understand that they can never escape what is going on in their body.  When you leave them you can go home to your life, you can forget about it as you clean the house or shop or help with homework or put in a full day at work.  They can never leave their body and the symptoms are with them 24/7 affecting every aspect of their lives and every decision they make.  Imagine having someone poke you in the side every time you eat or drink anything... even if it was not painful at first it would grow painful over time and you would come to dread eating or drinking anything.  You would either be in discomfort from the last time you ate or worried that you have to eat again soon... and you have to eat and drink because without it you will die.  You tell yourself you will get 'used to it', but it is always on your mind.  You avoid eating or drinking around others because the pokes make you wince and they ask questions and when you try to explain they just do not understand.  This is what it is like to have a chronic condition... it is always there and just because others cannot see it happening does not mean that it isn't.
5. Instead of saying "but you do not look sick" you can say "I do not know how you are able to deal with what you do and still get so much done".  Is this basically saying the same thing?  Yes... but is is saying it in a way that is supportive and tells the person that you see them and what they are going through and respect their strength.  
6. Instead of saying "you need to slow down and rest more" you could ask what you could do to make what they are doing at the time easier.  They are trying to get something done, and it is taking an obvious effort... they may be exhausted after it is done and need a long time to recover but they are proud of the fact that they battled through to get something done that either needed to be done or that they wanted to get done.  They might take you up on your offer to help or they might not... but no matter what they do you should never tell them afterwards when they are recovering from it "I told you that you were over-doing it" because in those few words you have just taken their victory away from them.  You would never tell a marathon runner that just won the race "you should have walked most of it... you would not have muscle cramps and blisters if you had" because you see what they did as a victory.  Let us have our victories as well.

     Many times it is not what is being said so much as how it is being said that can make all the difference in the world.

Instead of Gun Control Laws...

     The Nation is strongly divided over the issue of more regulation on gun control laws and every time there is another shooting or another child finds their parents gun and accidentally kills themselves or others there is a loud cry that rings across the land...

     "WE NEED MORE GUN CONTROL!!!"

     This is answered by those against any form of regulation crying back...

     "GUNS DO NOT KILL PEOPLE, PEOPLE KILL PEOPLE!"

     "THE SECOND AMENDMENT GIVES US THE RIGHT TO BEAR ARMS!!"

Which reads "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed"

     Actually, valid points all... there does need to be more control over firearms and safety and we do have the right to bear arms.

     One major issue with trying to enact any type of gun control is that there are already so many guns already out of the realm of control out there that even if they made the sale of new guns illegal tomorrow there are more than enough guns out there that cannot be accounted for to make the measure less than a drop in the ocean.  Guns, when properly cared for, can last decades or longer and once a private citizen has one they can sell it without any background checks at all to whomever they please.

     So... if we cannot make a dent in gun safety by simply regulating new gun sales then how can we make the guns that are out there safer?

     We could ask for licensing of all gun owners the same way all drivers are licensed, where they have to pass a safety test and know the laws of their state pertaining to guns.  Of course, there would still be illegal owners out there the same way there are people with no license or revoked license out there on the roads driving.

     I think a better idea would not be to regulate guns... the horse is long gone and the barn empty on that one so closing the barn door will do nothing but make the barn dark... instead, we need to regulate BULLETS!

     When the Second Amendment was created there was a need for the common man to have weapons available to defend hearth and home, if needed, from foreign armies.  The guns of that time were black powder guns that shot lead round bullets and I doubt seriously that our founding Fathers ever envisioned a day when there would be guns that could shoot multiple rounds in seconds without the hassle of reloading.

     The regulation of bullets IS something that could be done and definitely WOULD have an impact on gun violence, because without bullets all those guns floating around out there unchecked are no more than paperweights with attitude.

     People would have to register to purchase bullets, in doing so they would have to pass a background test, psychological exam and safety course.  They would have to give the reason for the number of bullets they needed (target practice, hunting, home safety) and would be limited to the number they could get for each reason.  Those who want to do target practice would have to do so at approved locations where they would obtain the bullets.  People would have to turn in the empty casings or shells of bullets they use hunting or in target practice in order to get more bullets, one for every shell or casing they turn in.  This would be recorded on their registration so that every bullet would be accounted for.  This would have another benefit of keeping the trash left behind by shooters to a minimum... no more taking a stroll in the woods and finding those red spent shotgun casings littering the ground.

     Yes... you have the right to bear arms... but NOWHERE does it say that you have the right to bullets without control! 

Pointing Fingers? Point at the Mirror!

     In the aftermath of the tragic events of Friday, December 14, 2012, at Sandy Hook Elementary School I have seen way too many posts on social media and heard way too many talking heads on the Television who point to the fact that the lack of by rote led prayer in public schools had a hand in what occurred...

     I am offended by the very premise of this idea in more ways than one!

1.      While it is true that children cannot be FORCED (yes, forced) to recite the secular prayers of any one religion in a Public School there is no law that states that they cannot pray silently to themselves.  When Prayer in School was ongoing all children were made to recite prayers no matter their own views or the views of their parents... they had no choice.  Removing the forced recitation by all students of prayer was not an attack against any one religion (no matter what some would like to believe) but was instead done so that the children of those who follow a different religion were not subject to oppression.  If Schools were suddenly forcing students to recite a passage of the Koran daily the very same people who want prayer back in schools would be screaming in protest that their children were being forced to recite something against their own religious views.  If children were made to say a Praise of the Earth Goddess those parents would be screaming even louder... but it is okay for their religious prayers to be forced out of the mouths of the children of others?
2. The shootings did NOT happen because "God was taken out of the Schools"... they happened because someone with a mental illness did not get the care they needed from a society that would rather battle over the rights to marry the person you love irregardless of how many x or y chromosomes are involved in the union.  This is a society that will kill Doctors who preform an abortion in the name of "God" and will protest at clinics to shame desperate women... where politicians say that a woman cannot conceive a baby if it is from rape because her body can stop that process... where the unborn is precious but strangely after birth they lose interest and the person is on their own.  Mentally ill teenagers terrorize their parents and siblings and there is no help for any of them.
3. To say that this happened because prayer is not allowed in school is paramount to saying that the Christian God is consciously allowing and condoning the murder of these innocent children as a lesson or punishment for not having children recite prayers by rote.  To believe this is to virtually tie yourself with the monsters of Westboro Baptist Church who delight in trying to tell the world that God is happy these things happen and that it is to teach a lesson.
4. You have no idea if the shooter was a Christian (only he knew that, no one else can ever say if he was or wasn't) and his reasons behind what he did... 

     Faith is something that is supposed to bring you peace and understanding of the world around you.  It is supposed to give you a purpose in life and an answer to things that cannot be explained.  It should NEVER be used as a tool against others... it should not be forced on others, especially for their "own good" because who are you to decide what is good for another?

     No one is asking you to deny your faith... but there are many who would like it if you stopped trying to press it to the point of oppression on others.

     There is a line... one that with respect should not be crossed... 

     The moment you believe that your own rights are more important than those around you when it comes to religious views you cross that line, especially if you push to have your rights be validated at the expense of all others.

     The moment talking heads on TV and posts in social media start blaming the fact that prayer is not in school and saying things along the lines of Huckabee on Fox News where it is basically said that non-Christians are all capable of horrific acts because they do not believe that they will face judgement by God after they die is the moment that lines are crossed.

     What keeps non-Christians accountable for their actions, if not God?  

     Personal responsibility and the knowledge of right and wrong... the same thing that keeps Christians from doing those acts.  If they ONLY reason a Christian is being a good person is for a reward after death and fear of judgement after death then I feel sorry for that person and fear them, because they are the ones that are likely to do horrible acts in a time of crises in faith. (Luckily, I do not believe I know any of those people... but I think you get my drift)

     So... stop blaming religion (the presence or lack of) in these shootings and start blaming the society that has grown blind to the need for better care of the mentally ill and support for the families of the mentally ill... don't simply let the horror fade until the next tragedy then start pointing fingers again and asking "why"... we already know "why".

Innocence Lost

     Today is not a day for Snark... it is a day for mourning and asking "why?".

     The sad fact of the matter is that the answer will not help the Parents who sent their children off to school this morning not knowing that they would never come home again nor will it help the families of the adults who were also taken away.

     We are all stunned as a Nation... we all cry the same question, but perhaps we should be crying a different question... "how?".

     In the coming weeks some answers will come out as the surviving shooter is questioned by Police and examined by Psychiatrists but the "how" question goes much deeper than just the shooters to the society that created them. (edit- it was later announced that there was a single shooter, so the question of 'why' may never have an answer)

     Some say that this calls for tighter gun control or banning guns completely, but with the guns already out there in the hands of Americans they could make the sale of new guns illegal tomorrow and the issue would not go away because guns can last a very very very long time.  

     In order to get a handgun in many states you must fill out paperwork and have a background check run where they look for past criminal activity or recorded hospitalizations in a Psychiatric Hospital which could take up to a week... but in those same states a rifle can be purchased and carried home the same day with a 'quick check'. 

     With the ease in which identities can be stolen these days it would be all too easy for someone to get a gun in a name other than their own and get around this law.

     We could try licenses like a drivers license where gun owners must take safety courses and renew their license yearly with an eye exam and psychological evaluation... but once again, those that have guns illegally would not be doing this.

     At this point, gun regulation would be as effective as closing the gate after all the cows have escaped... they are already out there with no real way of tracking them.

      Some could argue that Schools need to be safer... but this school already had a lock-down policy in place where the doors were all locked once school was in session and any visitors had to ring a bell at the main door.  The School secretary would then use a camera and intercom system to visually and verbally identify the person at the door, ask for ID and their reason for visiting.  The shooters in this case were the adult children of one of the teachers and though it has not been stated as such, probably gained access because of that, giving a reason to see their Mother.

     But... as I stated before... the how goes back well beyond December 14, 2012... it has been stated (but not confirmed at this time) that one or both of the men had mental illness that was not being addressed.

     This is a serious issue in this country... the mentally ill that are unable to get treatment and are lost in the crowd and as families grow unable to handle them anymore often end up homeless on the streets endangering us all.  There is no system in place to help these people... no way to deal with those that refuse to be medically compliant.  (Many with mental illness do not want to take the medications meant to help them regulate their conditions because they are mind altering drugs that often feel like they are removing all emotion and leaving them a shell of a human being.  Others decide, while on medication, that they are now 'fine' and no longer need the drugs due to denial of the fact that is the drugs that is making them 'fine')

     As a society we turn a blind eye... we live the life of NIMBY (Not In My BackYard) and as long as our lives are comfortable and we are not confronted by these people we can forget that they exist.  Then something like today happens and we are asking "why?".

     My heart is aching badly for the families impacted by today's tragedy... innocent lives stolen... innocent children that will forever be touched by evil and will have to deal with a safe haven in their lives no longer feeling safe.  Childhood was stolen from every student at that school today... innocence forever gone.

     Today and tomorrow we grieve as a Nation... then it will be time to ask "how" and not "why" and what we can do as a Nation to see that this never happens again.  

     Those wishing to send a card or letter of condolence to the families of this tragedy can do so by sending them to-

Sandy Hook Elementary School
12 Dickenson Drive
Sandy Hook, CT     06482

Zollinger-Ellison Syndrome- Monday Zebra

Condition- Zollinger-Ellison Syndrome

Pronunciation- Zoh-Ling-Ger  El-Lis-Son

Rarity- very rare

Difficulty in Diagnosis- Often tricky to diagnose due to the rarity and for that reason is often one of the last things checked for.  Blood testing for certain enzyme levels is the most common way it is diagnosed.

     Zollinger-Ellison Syndrome (ZES), first described in 1955 by Robert Zollinger and Edwin Ellison, surgeons at The Ohio State University, is caused by a gastrin-secreting micro-tumor which causes the stomach to "ramp up" acid secretion to "maximum" and is suspected when treatment for gastric ulcers that are not caused by h pylori (Helicobactor Pylori) is unsuccessful and physicians start to look for other causes.

     People with Zollinger–Ellison Syndrome may experience upper abdominal pain and diarrhea though not all patients have these symptoms. The diagnosis is also suspected in patients without symptoms who have severe ulceration of the stomach and small bowel, especially if they fail to respond to treatment and have a negative biopsy for h pylori (taken during an upper endoscopy exam).

     Gastrinomas may occur as single tumors or as multiple, small tumors which may not be visible during an upper endoscopy exam. About one-half to two-thirds of single gastrinomas are malignant tumors that most commonly spread to the liver and lymph nodes near the pancreas and small bowel. Nearly 25 percent of patients with gastrinomas have multiple tumors as part of a condition called multiple endocrine neoplasia type I (MEN I). 

     Symptoms for Zollinger-Ellison Syndrome include-

• chronic diarrhea 
• pain in the esophagus (especially after meals at night)
• nausea
• wheezing
• heartburn
• vomiting digested blood (looks like coffee grounds)
• malnutrition
• weight loss

     Testing for ZES is almost exclusively done through laboratory blood testing and includes-

• Secretin stimulation test, which measures evoked gastrin levels
• Fasting gastrin levels, on at least three separate occasions
• Gastric acid secretion and pH. Normal basal gastric acid secretion is less than 10 mEq/hour, while in Zollinger–Ellison syndrome it is usually more than 15 mEq/hour.
• Increased level of Chromogranin A is a common marker of endocrin tumors

     Treatment for ZES includes use of Proton pump inhibitors (such as omeprazole and lansoprazole) and histamine H2-receptor antagonists (such as famotidine or andranitidine) are used to slow down acid secretion. A cure is only possible if the tumors are surgically removed, or treated with chemotherapy.

     

     

Why the Princess Kate Pregnancy Hate????

     Great Britain's Princess Kate has been announced to be pregnant and carrying the future heir to England, which brought the 'hate mongers' out of the woodwork...

     When it was announced that she has been hospitalized with "acute morning sickness" those same hate mongers went almost rabid with glee and started tweeting, blogging and posting on just about every social media outlet how she was, well, being treated like a Princess!

     What they fail to realize is that her actual diagnosis is Hyperemesis Gravidarum (HG), a severe form of morning sickness that is thought to be triggered by the increase of the pregnancy hormone beta HCG (human chorionic gonadotrophin) and usually lasts the entire pregnancy but can continue after pregnancy.

     This is not your run of the mill morning sickness... this is a condition that must be carefully monitored to safeguard the health of the mother and child.

     In the Mother if inadequately treated, HG can cause renal failure, central pontine myelinolysis, coagulopathy, atrophy, Mallory–Weiss syndrome, hypoglycemia, jaundice, malnutrition, Wernicke's encephalopathy, pneumomediastinum, rhabdomyolysis, and vasospasms of cerebral arteries.  Depression is a common secondary complication of HG.

     

     Prior to the availability of IV Nutrition in the 1950's, hyperemesis gravidarum was sometimes fatal.

    

     She has to struggle daily to try to get in enough nutrition and fluids to sustain her pregnancy and insure the health of her child while battling dehydration, malnutrition, constipation and gestational gastroparesis (which may or may not be permanent).

     Sometimes people get so caught up in "Celebrity Hate" that they forget that they are people, too, and suffer the same things we do and they have to do it on the front page while people tear them apart for daring to be human!

     Imagine if the next time you have the stomach flu it makes the papers and everyone in the world criticizes your going to the Doctor for it when you become dehydrated, what you wore to the Doctor, the fact that you went to a good Doctor, what you could have done to cause it, their opinion on how you are treating it and how they could have done it at home with some crackers and ginger ale!

     This poor woman is ill... it is not fake, it is not being taken more seriously because of who she fell in love with and she does not deserve the hate being cast upon her and those who are attacking without knowing the hell she is going through should really step back and ask if they would like the same to be cast on them in her situation?

     Grow some humanity, people!

Trigeminal Neuralgia- Monday Zebra

Condition- Trigeminal Neuralgia

Pronunciation- Try-gem-in-el  New-ral-gee-ah

Rarity- rare

Difficulty in Diagnosis- There is no clear way to diagnose either with a physical exam or laboratory testing often making it a diagnosis of exclusion.

     Trigeminal Neuralgia, also known as prosopalgia, Fothergill's Disease or the Suicide Disease is a neuropathic disorder characterized by episodes of intense pain stemming from the trigeminal nerve in the face and is estimated to affect between 15,000 to 20,000 people, though that number may be low due to misdiagnosis of sufferers.

     While often symptoms do not start appearing until a person is in their 50's there have been reports of patients as young as 3 years old being diagnosed.

     Most attacks are unilateral (meaning they only affect one side of the face) but about 10-12% are bi-lateral or affect both sides of the face at the same time.

     Referred to by some as "the most painful condition in the world", attacks can be triggered by touching the affected area, talking, eating, shaving and brushing teeth. Wind, high pitched sounds, loud noises such as concerts or crowds and chewing can aggravate the condition in many patients meaning that this condition can be very limiting and affect the quality of life in many ways, especially since symptoms can occur spontaneously with no outward stimuli.

     An average attack can last from a few seconds to a few minutes and has been described as stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable and can occur hundreds of times in a single day.

     While attacks normally affect the left side of the face, it can effect both sides of the face and has even been reported to affect the middle finger!

     It may slowly spread to involve more extensive portions of the trigeminal nerve. The spread may even affect all divisions of the nerve, sometimes simultaneously. Systemic development is suggested with: rapid spreading, bilateral involvement, or simultaneous participation with other major nerve trunks. Examples of systemic involvement include multiple sclerosis or expanding cranial tumor. 

     There is also a variant of Trigeminal Neuralgia called atypical trigeminal neuralgia (also referred to as "trigeminal neuralgia, type 2"), based on a recent classification of facial pain. In some cases of atypical trigeminal neuralgia the sufferer experiences a severe, relentless underlying pain similar to a migraine in addition to the stabbing shock-like pains. In other cases, the pain is stabbing and intense but may feel like burning or prickling, rather than a shock. Sometimes the pain is a combination of shock-like sensations, migraine-like pain, and burning or prickling pain or can also manifest as an unrelenting, tunneling, piercing pain.

     The trigeminal nerve is a mixed cranial nerve responsible for sensory data such as pressure, temperature, and pain originating from the face above the jawline-- it is also responsible for the motor function of the muscles involved in chewing but not facial expressions (such as smiling and frowning).

     The current theory is that it is caused by an enlarged blood vessel (possibly the superior cerebellar artery) compressing or throbbing against the microvasculature of the trigeminal nerve near its connection with the pons. Such a compression can injure the nerve's protective myelin sheath and cause erratic and hyperactive functioning of the nerve. This can lead to pain attacks at the slightest stimulation of any area served by the nerve as well as hinder the nerve's ability to shut off the pain signals after the stimulation ends. This type of injury may rarely be caused by an aneurysm (an outpouching of a blood vessel); by a tumor; by an arachnoid cyst in the cerebellopontine angle; or by a traumatic event such as a car accident, though the cause is not often able to be found and it is then classified as "Idiopathic".

     While there are ways to manage the pain, they are not often successful and include-

• Medications- carbamazepine is the first line treatment; second line medications include baclofen, lamotrigine, oxcarbazepine, phenytoin, gabapentin, and sodium valproate. 
• Surgery- (often only used as a last resort when all medications fail in offering relief since evidence shows that while there can be relief from pain there will also be loss of all sensation) The focus with surgery is to relieve pressure on the nerves by decompression (either removing a tumor or otherwise taking pressure off the nerve) but the effectiveness might diminish over time.
• Glycerol injections involve injecting an alcohol-like substance into the cavern that bathes the nerve near its junction. This liquid is corrosive to the nerve fibers and can mildly injure the nerve enough to hinder the errant pain signals. In a radiofrequency rhizotomy, the surgeon uses an electrode to heat the selected division or divisions of the nerve. Done well, this procedure can target the exact regions of the errant pain triggers and disable them with minimal numbness.

     (This condition was requested for a "Monday Zebra" by a reader... if you know of a condition that is rare/incurable and has low awareness let us know and we will add it to the list of conditions to get a spotlight in our blog)