Saturday, April 12, 2008

New Poems to keep ya involved

It has been quite a while since I have posted anything new. There is a reason for this, and I expect in a few weeks to be writing more about Hypertension and my medicalized life.

But in the meantime, just to be active (or something!) here is some of the latest poetry I've been working on. Warning: some of it's kinda grim. But, to be positive, writing it sure helped ME feel better! Hope I haven't gone Weldon Kees on ya!!

He wanted a taste

He stood outside

on a very cold day

steamy breath

smoking air

searched for cigarette butts

in the building entrance ashtray

parka several times patched

eyes hopeful for treasure

he picked out the good butts

checked each carefully

put it in a bag if it measured up

cancer sticks we call them

searching through garbage for poison

until he found enough

the taste of the life

mostly smoked cancer sticks

back in his room

hearing the shared toilet flush

he placed a plastic bag over his head

the one he put the butts in

one by one he lit them

enjoyed the taste, a taste

the bag held in

better to enjoy, a last puff

then he put the butt down

grasped the plastic tight around his neck

and waited for life to finally be done

Victor Schwartzman

victors@mts.net


See me no more

As his mom wakes her eyes brighten

she sees him now

standing by her nursing home bed

she is so happy to see him

he does not want to see her

he wishes she was still asleep

she loves him, he loves her

love makes it worse

when he sees her blank eyes

or when he sees she knows

what she has lost

fleeting memories of what she had been

he answers her same questions

works at chatting

pushes her wheelchair

hoping it will soon be over

wishing it was him instead

knowing it will be

Victor Schwartzman

victors@mts.net


Why are we alone

ever struggled

wondered how

your friends

become smoke

vanishing

burning fire

drives smoke away

ever fought the good fight

you v. the world

principle v. reality

the loneliness

cripples your heart

friends avoid you

you deny them

why desert you

in your need

they do not want your pain

they can not help anyway

and when you feel better

you will come around

friends exist to betray you

Victor Schwartzman

victors@mts.net


Bob Solves Living in Fear

Bob lived in fear

fear of home invasions

fear of muggers

no violence in his life

but tv was full of it

Bob bought a gun

Bob watched the news

the Virginia Tech Massacre

shootings everywhere

his outside was sunny

his tv darkness was spreading

Bob looked at the gun

Bob was afraid most at work

fear of clients

meeting the public

he was paid to serve

nothing ever happened but

Bob loaded the gun

Bob held the gun

shiny heavy black metal

everyone wanted him afraid

everyone on tv

Bob pointed the gun

Bob shot the tv

Victor Schwartzman

Victors@mts.net


Love: boon or pain in the ass?

we love rules as much as fences

love has two basic rules:

your partner is always right

forgive your partner’s mistakes

people have died trying to figure it out

love is

waiting for your partner to be ready

though your partner rushed you

phoning mom

when she can‘t remember how to answer the phone

love is thinking of the other person first

when the other person doesn’t remember you

love is putting your needs on the back burner

while you’re in the deep fat fryer

love is understanding
what can’t

or won’t

be done for you

love: boon or pain in the ass

Victor Schwartzman

victors@mts.net


Forgetting what is important

Every day he phones

mom in the nursing home

10 am - 10:30 am

most days she forgets

did he call yesterday?

really?

why, he hasn’t called in a week

she tells cousins to phone him

asking if something is wrong

he phones every day

because he loves her

wants to hear her voice

feels guilty he doesn’t see her enough

and she forgets

Victor Schwartzman

victors@mts.net

Sunday, October 21, 2007

Please sign a petition

Outsider Writers, and the people signing this petition, urge Amazon.com to add an “Alternative” literature listing under its “Books” pull-down menu. Alternative Literature needs a room of its own. I have spent close to a year trying to get Amazon to make a decision on this issue without a response, so now it is time to see if people who buy and sell books on Amazon want to see Amazon.com have an “Alternative Literature” listing.

Amazon is an extremely important online sales tool for independent publishers and authors. Bookstore shelf space is more limited than ever, and it can be impossible to find new poetry or fiction from independent publishers. That is why independent publishers increasingly use online sites such as Amazon.com to market their books.

There are thousands and thousands of products listed on Amazon, but Amazon has made it easy to browse through products until you find what you want. Its site has pull down menus for main product categories. Click on “Books” and you will find extensive listings for everything from Graphic Novels to Performing Arts to SF and Fantasy. There is even a Poetry category. There is not such a Literature category, though.

The Amazon system works well if you want to browse through mainstream publications, or if you already know the author and/or title. But if you are looking for “Alternative” you have a problem. There is no Alternative category. The Alternative literature is there, but it is crowded out by the mainstream books. If you don’t know exactly what Alternative writing you are looking for, you won’t find it--but if you want to browse you will find plenty o’ pages listing books, but the Alternative writing is buried among the mainstream products.

It is time for Amazon to create an Alternative listing in its Books section, dedicated to alternative/underground poetry, fiction and prose. Amazon can start by simply listing books from small, independent publishers, and then can create subsections under Alternative, for poetry, flash fiction, political writing, and other subgroups. This would be great for publishers, authors, readers--and Amazon itself.


http://www.thepetitionsite.com/1/amazoncom-should-create-an-alternative-literature-section

Victor Schwartzman

Outsider Writers

www.outsiderwriters.org

Tuesday, October 02, 2007

Two poems related by email

Subject line not enough for this email

I have to enter a body

before I am allowed

to send an email

a subject line is not enough

I have to enter a body

but entering a body

is not to be taken lightly

whose body do I have to enter

is it the body of an internet employee

does she or he get a bonus

the things you do for work

now I have performance anxiety

Victor Schwartzman

victors@mts.net


Email to Cousin Lew

Hey Lew, thanks for the jokes

funny!

all the same up here, pretty much

mom probably had more t.i.a.s

mini strokes, they call them

she was not answering questions yesterday

staring into I don’t know what

her own world, her new world

dropped by her place today

just to see again, to know

she was not surprised when

I walked into her nursing home room

though I said nothing about coming

it was like, oh you’re here, that’s nice

she's very quiet

never reads, doesn’t even watch much tv

sleeps a lot

could be worse

she's still here

not in any pain

sigh

Victor Schwartzman

victors@mts.net

Thursday, September 20, 2007

Hypertension 49: Where are we at now?

It's been a long while since I have posted anything on this blog about Hypertension? Why the delay? The basic reason is that through multiple postings I was able to write down my history. Once I got that far, there seemed to be nothing particularly new.

Right now, I am waiting for a followup with my third specialist. The first specialist moved to Alberta. The second generally only saw people once as he worked out of a hospital cardiology ward. So I've now hooked up with a third specialist.

Seeing the third specialist meant going through a new battery of various tests & bloodwork. In particular, I wore a blood pressure arm cuff for twenty four hours. It is just like the home cuff I use, but it's attached to a battery pack and a an electronic data gathering device. Every half hour, it would pump up, no matter what I was doing. Kinda cool, actually.

I have no idea what the readings ended up being. I was out late that night as it was the first night, at midnight, that the last Harry Potter book went public. My 18 year old daughter had to pick up her pre-ordered copy asap, so we went down to the bookstore together. It was a marvelous experience, seeing a bookstore mobbed with eager readers! I like the Potter series, although I've only read the first two--I was partway through the third when my daughter lent it to a friend, & I've never seen it again. Tributes to Rowling for writing so well that she has brought millions of readers into bookstores!!

My blood pressure remains unstable, but is generally below 140 systolic and hovers around 80 diastolic. I gather the diastolic readings are still not good, but often my systolic readings are in the normal range. At times, though--as when I started this morning--the readings are still too high (this morning, 151/88), especially given the multiple prescription medications I take.

Life remains draggy, meds-wise. One would think that if those doctors who insist that it just takes a little time to adjust to the meds are correct, that by now I would have adjusted--it has been over two years, after all. Whether the feels of weakness and tiredness are due to low blood pressure, the side effects of the medications, or some combination of both--who knows?

But the end result is that while I can work, I can only work successfully with a reduced work load. I can still produce the right amount of completed work, provided I do not have to juggle too much. The more work, the less gets done. It is as if concentrating and focussing uses up so much energy that, if I work very hard in the morning, it is almost impossible to stay awake in the afternoon. I have yet to find a way around this.

I did stop exercising for a while after my mom was in and out of hospital due to heart attacks. She also had to move into a nursing home. I'll try restarting the gym shortly--but, interestingly, it appears to have had no special impact on either my blood pressure or my weight.

The best advice for weight loss came from my third specialist. He did not bother with calorie counting, he just told me to get used to being hungry. Believe it or not, that worked--I just don't eat when I get hungry. That approach must be combined with sensible eating, of course. I find an ice cream cone today adds a pound or more within two days. Simple as that. Gotta avoid the ice cream, the chocolate, the pizza--all that stuff. I lost the most weight when for a few days I simply ate canteloupe and cottage cheese. That was filling, but very low in calories.

Some decisions are coming up--do I keep working full time, do I retire on a small pension & find other work, do I go to part time work? At 62 I don't feel like retiring, although I would find plenty to do. We are all too much tied into our paid work ethic, I guess.

Friday, September 07, 2007

Poem: Three Views of an Alcoholic

Three Views of an Alcoholic

1.

I don’t drink that much

I’m okay if I don’t start before noon

otherwise the day is gone

I know I slur words

feel normal until I stand

sneak drinks when she’s shopping

at night when she’s asleep

worried about getting caught

but not worried enough to stop

2.

Our son is a drunk

where did we go wrong

he was always a happy child

seemed on track in school

then he dropped out

started drifting through life

eyes always bloodshot

couldn’t get him on the phone

we failed him

3.

Dad’s pissed most of the time

I tried talking, yelling, crying

when he’s drinking he’s not there

says stupid things thinks they’re funny

you can always see it in his eyes

the visine and mouthwash fool no one

we all kept up the lie

I needed him

I’ll never forgive him

Victor Schwartzman

victors@mts.net

Poem: Children, parenting, pets

Children, parenting, pets

They said

they would look after them

forever

the pets of his children

just as a parent

he said

he would look after his children

forever

Jake looked at the cockatiel

his son’s from ten years ago

before his son went to college

then his son moved overseas

Jake still has the bird

the bird lives in a cage

solitary confinement as punishment for flying

Jake has to clean the cage

Joan looked at the little dog

her daughter’s from ten years ago

she swore she would never

walk or groom her daughter’s dog

three years ago her daughter moved out

and got a cat

the dog has accidents in the house

regularly

Joan has to clean the crap

Victor Schwartzman

victors@mts.net

Monday, August 20, 2007

Several Poems

Wondering what I've been up to? Here are some poems. There will be more Hypertension stuff coming up soon!

Life Partners

1.

I wasn’t looking forward to the meeting

the worker was a pain in the ass

we bend over backwards to help him

all he does is file grievances

three more years to retirement

it’s like leaves falling in autumn

I waste a lot of time raking up

what he leaves on me

I wasn’t looking forward to the meeting

the manager is a pain in the ass

I’ve bent over backwards to avoid problems

all he does is ignore me

I dream of freedom

It’s like showers falling in spring

I waste a lot of time mopping up

what he showers on me

2.

Lived with that woman thirty years

every hour of which she had a job for me

she never talks until I start something

always having to get her way

always having to be right

she’s not like me

me, why I’m Mr. Easy

I love her if this is what love is

Lived with that man thirty years

he sat on the couch most of them

always waiting for me to talk

without me he’d have nothing to do

there’s a right way to do things

he’s not like me

me, why I’m Ms. Easy

I love him, if this is what love is

3.

My parents started driving me crazy

and never stopped

nineteen years until I moved

nothing ever good enough

I know they love me and all but

all I heard was the crap

they never left me alone

with their purse or wallet

Our daughter started driving us crazy

when Fran was pregnant with her, actually

she’s moved out twice, both times painful

her boyfriend has his hands full

that’s what she needs to mature

we know she loves us and remembers

all the good times we gave her

(and, we have always been careful with money)

Victor Schwartzman

victors@mts.net


The Meaning of Life

In the beginning

the plot of dirt

was under an ocean

the ocean dried

dinosaurs left their footprints

people walked into those steps

a hut was built

then a city

a house rose on the dirt

the woman born in the house

loved her back yard garden

nurtured the flowers

until she could no longer

lift the watering can

she left the dirt. The new owner

built a large sandbox in the back yard

each morning with a rake

he sculpted a design in the sand

some designs looked like flowers

Victor Schwartzman

victors@mts.net


The Mind of an 16 year old

The mind of an 16 year old

can I remember

that far back

when there were

more dreams than realities

more goals than results

the world was about me

it was better that way

Victor Schwartzman

victors@mts.net


Hey pal, the bar is closing

Hey pal, does this sound familiar

work all day, eat and

sleep the rest away

with hobbies and cleaning

but mostly working

support my children

support my stuff

I use up my time

all to help the hive

we come and leave

I’ll be remembered or forgotten

matters not a snowflake

Hey pal, the bar is closing

I heard the last call

this final drink burns

been good talking with you

it’s dark outside but I’m not afraid

the air I breathe is killing me

why worry about people or accidents

about what I was born into

about what I helped create

can’t do nothing about anything

sometimes I dream

of driving and never looking back

Victor Schwartzman

victors@mts.net


Three Views of an Alcoholic

I don’t drink that much

I’m okay if I don’t start before noon

otherwise the day is gone

sometimes I slur words

I feel normal until I stand

then the world spins

there is so much I could do

I don’t want to do any of it

Our son is a drunk

where did we go wrong

he was always a happy child

seemed on track through school

but then he dropped out

drifting through life

eyes always bloodshot

we failed him

Dad’s pissed most of the time

I tried talking, yelling, crying

but when he looked at me

he only saw a roadblock

between him and the bottle

he doesn’t fool me with the Visine or mouthwash

I need my father, where is he?

Victor Schwartzman

victors@mts.net

Sunday, July 22, 2007

Poem: Lying To Your Grandmother

Lying To Your Grandmother

(1)


honey I’m back

get me a beer

it’s left me a wreck

get the kids in here


children today my mom

your dear grandmother

was moved from her home

by me and my brother


and put in a…facility

sorry for tears, it ain’t easy

what I did wasn’t me

it was this guy who was sleazy


to make her happy I lied

you’ll leave two months, maybe three

mom sat and she cried

when I’m old don’t lie to me


(2)

The bed is hard

my room mate snores

the food is lard

the nurses whores


I knew it was in the works

when they came that morning

their eyes low, like jerks

moving me with no warning


their little brains think

it’s them it’s about

so I end up in the clink

because they ain’t figured life out


they worry alone I’ll fail

they only love my money

it’s cause I’m cheaper in jail

damn calling me honey


(3)

Dad got me freaked

he tried to sell us

such a geek

when he’s zealous


what he and Dave done

getting gram in that place

what is a good son

Dad is a disgrace


oh he’s understood

we should believe the big lie

it’s for your own good

lay down and die


dad cried like never before

then waited unsteady

guess he was thinking up more

lies, but he said plenty already


Victor Schwartzman

victors@mts.net

Poem: Cherish Your Last MomentsTogether

Cherish Your Last Moments Together

I walk towards her

not yet seen

so I can sigh

it did not take long

before she began

to look like one of them

92 years old, my mom

two weeks ago in the hospital she did not look like one of them

now her gray hair brushed back institutionally flat

no make up

blank expression

slumped in her wheel chair

blank expression

breakfast crumbs on her blouse

blank expression

where is her wedding ring?

blank expression

“hi mom”

for the first time she does not recognize me

focusing her eyes

then the smile

pushing up against her cheeks

brightening her eyes

and she starts to cry

she had not seen me yesterday

where had I been?

she was worried something had happened

“mom I couldn’t see you yesterday

every day is becoming hard

and you’re not here

two weeks from the hospital

you have to get used to being here

at least until you’re stronger

maybe when you’re stronger

you can move back”

the phone rang, interrupting the lie

it was on the table next to her

she looked at it

she looked at it




the suite was three months ago

a distant dream for her

sitting in her retirement community

the illusion of independence

aides and nurses there every hour

giving her the medications

helping her use the washroom

but she could sit on her own couch

watch her own tv

in her private apartment

moving her to this nursing home

splintered her confidence

each day a little more frightened

a little more confused

a little more unable

putting her this environment has worn her down

like a glorious wooden sculpture

always out in the sun and rain and ice

daring life, living in the moment

beautiful until its creator forgets it

and no longer protects it

the sculpture ages and dries

the beautifully carved wood cracks

splintering piece by piece in the wind

until nothing is left

but the memory

the memory of her

I look at her now

she already is a memory

has been for a while

I remember my mother, sitting next to her

that is why she is in this nursing home

that is why she lives her last days in a facility

that is why we no longer have a use for her

she has not been here for months

longer

five years ago, after that surgery

she could not add her cheque book

two years ago she suddenly forgot

how to use the message system on the phone

I will never forget

driving in the rain to her retirement suite

to show her how to press the buttons

I will never forget

this will not happen to me

I will never forget

she will otherwise disappear




I try to cherish our time together

it is a challenge to cherish a cruel joke

yes I’m neurotic and worry too much

she gets worried but ten minutes later she has forgotten

and we share a joke together

I leave her smiling

then drive home in the night gripping the wheel

I have it good

most of my friends their parents are gone

at least she is still here

I can look after her

I can be her son

I can slip into childhood memories so easily with her

we enjoy those golden days

she can not remember lunch

but recalls vividly our playing in Brookville Park

for a few moments now we play together again

she is always the mother

but I can never again be the child

the child does not push the wheelchair

and I pretend to let her look after me

with endless questions

what I have eaten

have I had enough sleep, how is work

I let her mother me

give me advice like I should eat better

and there is some comfort in being that child again

until she asks the questions all over again

and I remember it is just pretend

but I was her child for a moment more

finally there is our time together

last times together, knowing the end is near

sitting in the same room

looking at the family photos on the wall

the blue sky through the window

knowing I can reach out and touch her hand

Friday, July 06, 2007

Poem: Elder Care

And here is a poem I wrote yesterday, still in progress. As you can see, there are issues I'm dealing with regarding looking after mom, who is 91. However this particular poem is a total fabrication, based on the temptation. So don't worry about mom's money, it's safe. At least, hers is.... But there is always the temptation, and my understanding is that this can be a common problem in elder care.

as with all my poetry these days I tend to post it quickly, so it's fresh, new and probably not so good. Any feedback? always welcome!


Elder Care

The first time I stole from mom was the hardest
it was the guilt, I think, she is 91
but maybe it was that I hadn’t done it before
a thousand dollars means zero to her
so she did not miss the money at all, no
but I did not want to meet a teller’s eyes
so I used the atm instead


Mom lost the ability to manage her cheque book
after the hip replacement surgery
mini-strokes made her worse
while I stood by she went from strong woman
who wrote letters to the New York Times
to not understanding her voicemail

I resisted stealing her money for a long time
but I had all those bills to pay
and it was so easy, she trusted me completely
hell, I’m doing everything for her
she owes me. By now, she doesn’t have much left
I gamble with what remains, trying to win back what I took
and with her spare change, I drink

Victor Schwartzman

victors@mts.net

Poem: Cross Talk

I wrote this poem after attending back to back high school grads: it's sorta a prose poem or story poem, or whatever:

Cross Talk

I was trying to listen to speeches
at the high school graduation
those people on stage were talking to me
about our children becoming adults
but instead what I heard
were the two women in front of me
blathering about someone I didn’t know
women! hell, I could gossip plenty
our son got some girl pregnant but she lost it
I don’t need to know details
or wallow in someone else’s problems
so I told them to be quiet


I was telling my daughter about Mary
when this jerk told me to be quiet
while talking about my granddaughter
about the miscarriage, her future
the boy who disappeared on her
men, there to cause trouble
the jerk behind me does not know
life is more important than speeches
to finish I had to whisper in my daughter’s ear
Marilyn needed to know my feelings
a daughter relies on her mother for advice
she relies on me just as Mary will rely on her


When he complained I was so glad
I hoped maybe mom would stop—but no,
she had to finish, leaning in
her breath smelling like a toilet
you’d think Mary was her daughter
all I wanted was to enjoy the moment
Mary’s cap and gown, how grown she was
to forget, for a moment, the mess
how she kept the baby for the future
endured the jerks, then lost it all
speeches about the future mean little
when the future stands before me

Victor Schwartzman

victors@mts.net

Sunday, July 01, 2007

Roger Keeling Letter

Hi. Roger Keeling, who lives in Portland, Oregon, has written me several emails regarding his own experiences with Hypertension. I am posting, below, an excerpt from his latest letter, where he discusses his own concerns about Hypertension treatments, and notes a book he found exceptionally helpful.

I encourage others who read this blog to send me similar emails, and I will post those, as well. There does not seem to be enough of a dialogue among patients about Hypertension issues--perchance we can start one here!

The excerpt:

I may surprise you by noting that a bit of skepticism has crept in to my brain… with the idea that by merely reducing BP, one smoothly increases one's odds against strokes and heart attacks. That applies to BP reductions from drugs as well as from other methods.

I have, all along, been under the illusion that the health effects of hypertension are completely connected to one's absolute BP readings. That is, if your chance of dying in a given year from a stroke or heart attack is X at an average BP of 120/80; and if that risk becomes 2X should your BP jump to 150/100; then if you can get your BP back down to an average of 120/80 by one means or another, your risk will decline back to X.

Ain't true. My first clue of that was something you wrote, the observation that without treatment, your chance of a major "incident" (morbidity or mortality) in the next five years was about 17%; and if you took your drugs like a good little boy, and kept your BP down (and suffered every damned minute of it), your risk only dropped to about 12%. I thought, "Well, that must mean that if you'd been one of those blessed people who never develop hypertension, your normal risk would have been around 12% at your age and condition." But now I don't think that's the case.

I say all of this because I recently found a book that is, well, stunning. It is -- absolutely -- the best book on this topic I've seen. A couple of weeks ago I resolved to buy The DASH Diet book, which everyone in the medical community praises. Another book I got was "The High Blood Pressure Solution," by
Richard Moore, M.D., Ph.D. Just from reading his Preface and Preface to the 2nd Edition, I now understand (for the first time!) what the hell has been happening to my body. He does something no one, certainly none of the $&%*$# doctors, ever did. Something none of the other written materials, including brochures and the like on hypertension, ever did. He explains the CAUSE of "essential" hypertension. "Essential" means, in effect, "we haven't got a fucking clue," but in truth science DOES have a clue, and a good one.

Thing is,
Moore is a biophysicist (now retired, I think, but previously of the University of Vermont Medical School, and a graduate of Purdue). So he was primarily interested in what goes on at the cellular level. He and the teams he's worked with -- and the research he draws upon, all of it from peer-reviewed research journals, many of them well known (e.g., JAMA, Lancet, etc.) -- comes from this fundamental level of focus. So he talks, in language fully accessible to any intelligent layperson (very comparable, say, to Issac Asimov's "Intelligent Man's Guide to Science," that kind of thing), all about what's going on at the cellular level, and what the best research has shown. It's no big mystery at all! It's the potassium-sodium balance, what he called the K-Factor with his co-author back in the 80s when he wrote his first book ("The K-Factor", naturally).

Here's the thing: the entire nation of
Finland (that's right: the WHOLE country) adopted one of the primary recommendations that he emphasized in his first book. They mandated the use of a potassium-sodium-magnesium mixture to replace straight salt in all processed foods (including what's used at McDonald's, for example). The result was a better-than 60% decline in stroke and heart attacks in the country, reported after 10 years of the new diet (in 1996). Moore notes that 15% is attributable to better medications. The rest goes to the use of "pansalt." This drop occurred even though smoking by women had increased over those years, and obesity in Finnish men was up also. So this isn't something that's untried or unproven.

Anyhow, I not only have hypertension, but -- starting a year or two ago -- I was diagnosed with Type II diabetes. And my cholesterol, which was always really good, shot up after taking one anti-hypertensive drug. I was tested again this week, and happily it's back down to an admirable 138 (but, the triglycerides did NOT drop, and my HDL “good” cholesterol dropped some 8 points).
Moore explains it all! He explains why the drugs did what they did. He explains how diabetes is connected to all of this. He explains what happened to me back in 2002, when I first had my hypokalemia (low potassium) crisis that sent me to the ER ... something none of the friggin' doctors would do for me at the time. This is true: I never got a single clue from any of them. Not a word! They just didn't know, yet wouldn't tell me that they didn't know.

So I'm strongly -- emphatically -- encouraging everyone I encounter who has any problems along these lines to go get
Moore's book. Interestingly, one thing he does is explain (with terrific references to the original studies, some of them among the largest ever conducted) how the link between forcibly lowering your BP via drugs and reducing your chances of dying aren't all that strong. There are benefits, of course, but THIS explains why forcing your BP back to the "normal" range does not, in fact, reduce your chances of a stroke or heart attack back to the same level it would have been had your BP never gone up in the first place (and, in fact, may improve your chances only by a total of about 10%).

He also explains how you can
REALLY improve your chances, a lot. Really beat the thing.

You may roll your eyes, because at one level is sounds just like what you've surely already been told: cut out all salt, go on a very veggie-rich diet, etc. But the difference is,
Moore is quite specific about what the goal is: getting a total ratio of 1:4 for salt:potassium, preferably from foods (rather than pills). This is where you get back to what happened in Finland. They didn't do anything nearly that extreme, yet still managed to reduce their stroke and heart attack rates by over 60%.

Best regards,

Roger Keeling
Portland, OR.

Friday, June 08, 2007

Poem: Regrets

I had been feeling regrets. My mom has been in the hospital for over a month. She's 91 and had a mild heart attack, and still is not stable. She's in the hospital for another two months at least. I had been visiting every evening, after work, and on the weekends. It was getting exhausting, and I was thinking of seeing her every other day, or a few times a week--and then feeling guilty.

So I decided to write something about regrets. It started out one way, but then the poem and characters took over, what can I tell you? I've been working on this one the last couple of days--any feedback, as always, is appreciated!


Regrets

Johnny Canuck never tried to do much
so past mistakes never haunted him
his life was sitting in a depot
watching trains pull in and out
people getting on, people getting off
Johnny was a life voyeur
watching others ride

Johnny had no regrets
Johnny was an idiot
only fools have no regrets
only fools have too many

Janey Canuck had only regrets
she sought every night temptation
then suffered every morning
over imagined bad deeds
her past was her future
the only present she got
ulcers and guilt

Our lives are a balancing act
mistakes haunting us
the past trapping us
in the dream of 'what if'

Johnny and Janey met at the train station
he made room on the bench
no one else had sat there before
but when they were to make love
he only wanted to watch
Janey loved it, for the first time
she had no regrets

So of course they were married
and lived together but
apart from themselves

love means compromise

Victor Schwartzman
victors@mts.net

Sunday, June 03, 2007

Poem: Masturbation Goals

One day I want to masturbate while reading

about the top CEOs in Forbes Magazine

I want to play with myself while looking at

a shiny new SUV, fully loaded

I want to jerk off watching the President at a media conference

and to pleasure myself looking at photos of Fort Knox

I want to get aroused at boxers dominating each other

I should be turned on by the Hydrogen Bomb.

Everything in our world is about power

our most powerful are rich jerks

jerking off on them makes cents

Victor Schwartzman
victors@mts.net

Monday, May 14, 2007

Poem: I Pays For My Bad Ways

I was sitting at home, having a smoke
when determined to fix what was not broke
the Authorities barged into my house
and declared me an environmental louse

To start with they towed my beloved SUV
okay, conservation was never important to me
but when they went and took all my plastic
I realized that they were going to be drastic.

They took my tv, because of what I watch
took the drugs, wine, beer and scotch
cleared the fridge of my favourite unhealthy food
and I was forced to agree it was all good.

Now I sit here more dead than alive
nothing to drive in, hell, nowhere to drive
nothing to eat, drink, smoke or watch
I don’t like this new world very much.

I was taught to be selfish, to throw things away
to think of tomorrow and not of today
but there’ll be no tomorrow if I’m hit by a truck
so why worry so much about trees and muck?


Victor Schwartzman
victors@mts.net

Friday, May 11, 2007

Still working on this one too:

I’m trying to work

I’m trying to work
though not very much
We need our perk
money’s our crutch

I work because they pay
wouldn’t if they didn’t
nothing you’ll say
will be any different

Force myself to type
but I’m only a reactor
I ignore the hype
about work building character

Victor Schwartzman
victors@mts.net

Poem: Death Watch, Do Not Resuscitate

Still working on this one


Death Watch, Do Not Resuscitate

When the doctor asked me
to kill my mother
it was a routine request
after the next heart attack, do not resuscitate

His office had no windows
floor to ceiling medicines
posters of colons and urinary tracts
no other world to see

She gave me the gift of life
I give her the gift of death
she would thank me if she knew
will my children pull the plug on me?

Victor Schwartzman
victors@mts.net

Friday, April 27, 2007

Poem: This one's for the generation who grew up watching tv

Television has made me what I am today

I always talked sarcastically
especially to my friends and parents
problems were resolved in an hour
sometimes half an hour
people were always cured at the last minute
someone you did not like very much dies
between pauses to sell products


When dad got cancer
and I sat for hours by his bed
I felt betrayed by my culture
no breaks, no jokes, no easy outs
he even got fat and ugly
it sounds terrible to say it,
but it was no North American way to go


A misanthrope is an optimist who has met people
dad taught me in death to distrust life
I bought a flat screen tv and a couch to recover
now every night again requires no commitment
every day that is how I live my life
alone in this world, we dream of another
beyond our grasp, but kept in our sight

Victor Schwartzman

victors@mts.net

Thursday, April 26, 2007

Poem: Questions to ask the government when it wants you to kill people

Questions to ask the government

when it wants you to kill people


Following? are helpful questions

to ask the government

when it wants you to kill people--

for example, if you are in

the armed forces

or police agencies

or an environmental protection agency that doesn’t protect

or a disaster response department that doesn’t respond:


Who does the government want you to kill?

Does the government know these people?

Does the government know why it wants them dead?

Does this have to do with someone getting rich?

Did the government negotiate or does it just want them dead?

Did the government warn them or does it just want them dead?

Will the government respect you the next morning?

Why does the government want YOU to kill them?

Why don’t the politicians do it themselves?


Instructions:

Wait for the government

to ask you to kill people.

It will.

Then submit your questions.

Submit the same questions to yourself.

Wait for answers

before you kill anyone.


Victor Schwartzman

victors@mts.net

Poem: Paneling and the end of the road

Today I got the call

home care phoned

about paneling her

mom is 90

aging is a relentless demon

stripping her naked

no dignity no privacy no independence

she knows what is happening to her

but then, thankfully, she forgets


We talked, home care and I

I suggested it

it

that mom be paneled

paneling is the review process

for moving her

from her retirement community

to a nursing home

to the end of the road

the road with the no exit sign

the road with the no exist sign

paneled—boarded—boarded up


Victor Schwartzman

victors@mts.net

Monday, April 23, 2007

Poem: Here's a funny story about Godzilla

Godzilla, that cheesy monster movie

was Americanized from Gojira.

The original’s director, Ishiro Honda

traveled through Hiroshima

as a returning Japanese soldier

saw the devastation of nuclear war

and decided to make a film

about the horror of atomic bombing.


The A-Bomb’s fire storm

became Godzilla’s deadly radioactive breath

Hiroshima being flattened by a nuke

became Tokyo after Godzilla stomped it.

The first boat Godzilla destroys

was based on the Lucky Seven

a tuna boat too close to the first H Bomb test

(Americans in the area were warned

but Japanese were not so…lucky.)

The boat’s radio operator got sick

American doctors would not help

his agonizing death took a year.

He was the first victim of the H Bomb.


Japanese audiences watching Gojira

saw a nuclear allegory about America,

Americans watching Godzilla

saw Japanese killed by a monster.

Talk about your culture clash.

Isn’t that funny?

Why aren’t the Japanese laughing?



Victor Schwartzman

victors@mts.net

Saturday, April 21, 2007

Poem: Holy smokes, I'm gonna get hit by lightning for this one!

On a clear day, can you see God?

Got one of those emails today:

if I did not repost it

the next seven years would suck.

In sex, sucking is good

in fate, it ain’t so hot.


Luck got me thinking about God

I see trees, I believe in them

I don’t see luck, I don't see God.

There are too many dead soldiers and starving poor

too many short cuts to heaven.


So many religions, so many Gods

all demanding and vindictive

all versions of people I don't like.

I want my money back

I’m too short for this ride.

Victor Schwartzman
Victors@mts.net

Friday, April 20, 2007

Hypertension 47: More Whining

Yes, I have not posted very much in the last while about Hypertension. Put up some poems, yep. But mostly, been mulling it all over. About, mostly, repeating myself.

It's easy to get sick and tired about side effects, because that is mostly what they do for you: make you sick and tired.

The studies I'm aware of show that by taking the powerful prescription medications I am taking, I increase my chances of avoiding a heart attack or stroke by about 5%. That is not much to begin with, and even less when placed in context: 82% of unmedicated people with my level of high blood pressure will not have a stroke or heart attack in the next ten years (maybe it's only five year, but in this society it'll seem like ten), while 87% of medicated people won't suffer those effects.

The odds are truly excellent I won't suffer anything really bad in the next ten years to begin with--yet, ironically, I seem to be increasing my odds of suffering bad stuff from taking the medications.

I have made another appointment next week with the WMD. I am also waiting to hear from the third specialist about an appointment.

When I started the prescription medications last fall, I weighed around 214 or so. It fluctuated, yes, but it was under 220. Today I weigh 230. I still exercise regularly (although it is hard to do it every other day while I work full time), I still watch what I eat, but I've gained 15 pounds, and have definitely moved into the obese category.

Why? My understanding is that it is two factors: the medications lower my metabolic rate so I burn less calories off, while at the same time I tend to eat more to give me some energy because the same medications make me feel so tired.

I'm 61, but these days feel more like 71 or 81. If I stand for an hour, my legs begin to ache and I get tired. My wife worries that this may also be due to decreased circulation to my legs. Two hours on my feet, shopping or doing anything else, and I'm pretty tired and cranky.

I went to a stress workshop on Thursday. It was an all day affair. A good workshop, interesting points about stress in the workplace. But just sitting there and concentrating and participating all day long left me wobbling and struggling to stay awake in the last hour.

Is this worth the 5% improvement? Is it worth bringing my blood pressure under 140 almost all the time?

It's that ol' quality of life issue. It takes a while to realize what happens with these medications. Or perhaps it is the cumulative impact of taking them every day. I don't know. It's hard to find a doctor to explain it to me.

But it is now becoming an issue of whether the weight gain is more damaging than staying off the pills. Being obese also increases the risk of heart attack and stroke, along with other serious medical conditions. At what point do I pass the point of no return? At what point does it make more sense to give up the prescription medications and take my chances, lowering my weight?

Try looking for an answer on this one through Google or Wikipedia. Good luck, mates!!

Why, when so many people suffer the same situation, are there so few answers?

Poem: Participatory Democracy

I started out volunteering

for the left wing candidate

I was young and wanted change

stars in my eyes


He was elected

but changed nothing

I asked him why

and he said once elected

he represented everyone

and could not put into place his own policies.

I stopped volunteering for him

light bulbs in my eyes


Years later

I volunteered for the right wing candidate

I had a house and job

knew what I had

had what I knew.

I had learned

fear


He was elected

but changed nothing

I asked him why

and he said once elected

he represented everyone

and could not put into place his own policies.

I stopped volunteering for him

candles in my eyes


The poor get poorer

the air and water get dirtier

I no longer volunteer

I can change nothing

I weep for my lost hope

I weep for my lost soul

darkness in my eyes

darkness for us all


Victor Schwartzman

victors@mts.net

Monday, April 16, 2007

Agit Prop Poems

Although a lot of my writing is about "real life" issues, as opposed to what it's like to be a poet, to write a poem, how much I drank last night, my sex life, etc., I began feeling a couple of weeks ago that I should be writing something that is far more direct about the problems our society is currently grappling with.

So, here are four. As with anything that I write that is so new, I'll probably want to rewrite and change it later, but in the meantime, it looks ok:

How My SUV helped me

I liked being selfish

I liked fitting in

I loved our society

and cashing in life coupons for deals

as if the world was my own big box store


Sure, I didn’t like breathing

when there were air quality warnings

or drinking the tap water

when toxic crap spilled into the reservoir again

but hell: into each life some acid rain must fall, eh?


Once in a while I felt bad we shipped production

to countries with no environmental laws

but somebody’s got to make consumer goods

and my stocks soared

I was able to buy a really cool suv


But there’s no justice in this world

the parking brake broke on my beloved suv

and it rolled down the driveway and killed me.

On the positive side

the treadmarks gave my forehead a thoughtful look

like my brow was furrowed from thinking

Victor Schwartzman

victors@mts.net


Breathing 9/11

On 9/11 I was in a nearby office building

I did not see the planes hit

but sure heard and felt them

everything trembled

I trembled


Later, I was outside getting lunch

when the first building collapsed

a poisonous white cloud

raced towards me

I ran but not fast enough

and the white death dust covered me


The next day I stayed home

but then the government said

everyone should go back to work

the economy should keep moving

it is good for business


So I returned to work

and did my part for business

but I breathed some more

breathing was a mistake

it would have been okay

if only I had not breathed


Now I have lung cancer

and breathing is hard

I want to scream

when I scream at the liars

at the terrorists I voted for

I can’t breath afterwards

it feels good to scream


Now I buy medicine

to keep me alive

a few more years, or months

no one knows

but the medicine I buy--

it’s good for business


victors@mts.net


Swept Away By The Flood

I had a nice house in New Orleans

till Katrina washed it clean away

bodies floated in the water

dead eyes looking for help


They predicted the dikes would fail

them politicians talked and talked

better emergency service since 9/11, yep

my home’s gone, bodies float in the front yard


The feds pay $24 a foot to haul away my dirt but

there's subcontracting 'till the guy hauling gets $3 a foot

someone’s making money on my lost home

meanwhile, I live in Houston


Them emergency homes sit vacant

no one put in plumbing so you can’t take a leak

funny, emergency homes with no water, in a flood

but I don’t hear no one laughing


I had faith in the big words

faith in the politicians

faith in the lies, the teleprompter speeches

faith swept away by the flood


Saved From The Streets

I was headed for juvie

a few break and enters

some stolen cars, one armed robbery.

The Army was my best way out

before I ended on the street for good


I enlisted as an Engineer

got a $5000 bonus

the recruiting sergeant was real nice.

He said I’d build roads in Iraq

And that I’d never have to kill nobody


When I got to Iraq I didn’t build no roads

I was put on top of a humvee

with a 50 calibre machine gun.

Under the hot burning sun

there were many shadows


An rpg blew up our humvee and my mates

the round came out of nowhere

and pierced the humvee armor.

Then it pierced my body armor

then it pierced me


One soldier asked the Secretary of Defence

why we had such lousy armour

he said, you go to war with what you have.

He resigned to the golf course

I can’t applaud his disgrace with no arms


When I was wounded my pay was cut

I live in a cheap little room

it’s real clear I’m no longer needed.

Politicians ignore me except for parades

but hell, they saved me from the street

Friday, April 06, 2007

Hypertension 46: Never getting used to the side effects

As I've often written, the big problem with Hypertension is not Hypertension. That condition is one of the future, not the present--it's what could happen to you (a stroke, a heart attack) not really what is happening to you.

The big problem with Hypertension is the treatment.

I've already written enough about this, of course. To the point of obsession (well, almost obsession but not quite getting there--I hope). I started heavy duty prescription medications in September, 2006, then in early October was upgraded to Teveten Plus and Caduet XL and Lipitor. In mid November, the Caduet XL was changed to Adalat XL, and in March I was taken off Lipitor. The change from Caduet to Adalat definitely helped--while I want to take a nap each day, I no longer have to.

So, with a bit over half a year's experience with very strong prescription medications, where am I?

The meds (perhaps in combination with regular exercise) have kept my blood pressure below 140 systolic, except on rare occasions. I think if something really horrible happened, say if I had to give George W. Bush a campaign donation, even then my blood pressure would not go up. It's been above 150 systolic only a handful of times.

But I don't think it is possible to ever get used to the side effects of the medications.

I am often dizzy or light headed during the day, especially when I get up after sitting for a while. A few times I've actually had to put a hand against a wall, to support myself for a moment. My days have to be planned carefully in terms of activities, especially physical activities. If I just sit and read reports or make phone calls, it's okay. But getting up and sitting down a lot, driving off to do an interview, and being in person-to-person interview situations: those all drain my energy pretty fast. On such days, by the late afternoon I'm groggy...irritable..forgetful. Going home and having a nap doesn't help that much, and if I do take a late nap, then I'm up too late, and then I'm tired the next morning because I have not gotten enough sleep.

Try as I can, it's hard to adjust to getting so tired so easily. It's hard to adjust to feeling dizzy or lightheaded so much. It's hard to adjust to some short term memory loss.

Right now I have nine "cases" at work--I asked for more, and got three more. I think I could handle more than ten. But, when it gets to fifteen, and especially to twenty...I don't like having to say this about myself, but I don't think I could juggle all those "cases". I'd end up sitting there, looking at all the files. And feeling tired.

I know it improves my chances of not having a stroke or heart attack by about five percent, and I guess it's worth it....

Hypertension 45: Waiting for Dr. Godot

Getting the right doctor, without appearing to be "doctor shopping", is always a big challenge for someone with an ongoing medical condition.

The interpersonal politics are significant, at least underneath the surface. You depend on your doctor to give you the right medications, to support you in life and workplace issues, to keep an eye towards your future. You need a decent personal relationship for those reasons. Cheese off your doctor, and you have problems. Also, if you're going to get down and dirty about very private matters, at least you should have a rapport with the person on the other side of the desk.

Yet, if you start changing doctors, you are looked upon with suspicion. Other doctors, and in particular your employer if your medical condition affects your work, start to wonder: are you doctor shopping--continually changing doctors until you find one which will not only stick a needle in your ass but kiss it (the ass, not the needle)? It is a delicate balance--finding and keeping what you need, weighed against what will work with your employer and other doctors.

Doctors are business people, most especially general practitioners. They rely on a steady stream of clients. Apart from all the normal human niceties (is that a word?) of wanting to keep their customers happy and healthy, the doctors also want a happy and healthy cash flow.

For specialists, the elite, this is not a big issue--they have a steady flow of referrals. But for the general practitioner, clients can often be lost to other family doctors. Even when a family doctor is relatively well booked, it still can't be good to lose a client. As a result, general practitioners often appear to be much more vulnerable to patient demands.

Patient demands as in: I need a week off work, gimme a note.

I've seen it happen. It is why the word of a general practitioner in legal issues is helpful, but never nearly as good as that of a specialist. Of course, every g.p. is different. Some are more resistant to pressures than others.

Specialists are another breed. They are the elite. They, in particular, can often appear suspicious of their own clients, and of being manipulated. Ain't no one going to tell a specialist what to do--which is why their evidence is more respected.

I actually had one specialist (none of the ones mentioned in these posts) who appeared to be anti client. I told him that I felt sick and needed a couple of days off work. He was an internist in a medical clinic, I saw him thru the luck of the draw. He almost sneered and refused the sick note request, and only took a throat swab when I insisted. A few days later, the throat swab results came back and I was called in--I had strep throat. He started to talk about how good it was he'd gotten the swab, as if it had been his idea and he was Dr. Kildare. When I pointed out that I had to insist he swab my thorat, and he'd refused me time off work, he actually got angry. I never went back to that guy.

And he is a guy...a human being...even if he is a doctor.

Anyway, I am waiting for a specialist on Hypertension. And it ain't doctor shopping.

The last time I saw my WMD, I gave him a 'diary' he'd asked for about my work experiences. It listed about ten negative side effects. He did not ask a single question about any of the diary, including the side effects. Then I told him I had aching legs, and he did the right thing, ordering a blood test and taking me off Lipitor (no aching legs since then, by the way). I'd gotten his attention in my ten minutes with him. But he never asked a single question about the other nine side effects.

I needed a specialist, someone who would spend more time with me, in particular on the side effects. The prescription meds I'm taking have been very successful in bringing my blood pressure down to "near normal" levels. It's feeling dizzy a lot, forgetting things, getting exhausted easily--that's what I need help with.

My first specialist moved to Alberta. The second was in a hospital clinic who normally did not do follow-ups.

The WMD apparently has done the referral, perhaps a month or so ago, and now I am waiting to hear back. I think in the States it would happen a lot quicker, but maybe not--I do not live in a major population centre, I live in a small city in a small province. There aren't that many specialists to go around. It isn't the fault of socialized medicine, it's the fault of not living in Toronto or Vancouver.

Saturday, March 31, 2007

Poem by Rob Plath: 140 Over 95

Rob Plath contacted me on My Space, and sent me this poem. He's agreed to let me post it here. I'm still not sure how My Space works, but he has a pretty cool site there. Check it out, and the poem below:


dear victor,

i wrote his a while ago but it is my rebellious and perhaps stupid stand against doctors and medicine. thought you might get a kick out of it. i haven’t had it checked since then! i've been writing 5-8 poems a day recently. maybe i'm days, weeks , months away from being on the other side of the dirt! oh well. Schopenhauer said life is a mistake anyway...take care! hope you're feeling well! i feel fine but may not be!

rob


140 Over 95

The universe
was once hot
and young

I read in a science
book the other
night

it has grown a lot
colder, it said

one day it will
collapse

be reduced to a field
of frozen radiation
never to return

my blood pressure is
borderline, the doctor said
at my latest visit

LOW sodium, she said
NO alcohol
NO RED MEAT
not ONE more cigar
DECAF coffee
DECAF tea
exercise

then she suggested
blood work
an EKG
even though I had
no health insurance

of course I rejected
the tests

I imagined some modern
day witch in a lab
hovering over the centrifuge
as it separated my blood
the lab casting a spell
over me

trying to get me to
be a paranoid patient
a fucking scared little rabbit
hypochondriac nut

at least come back for a reading
next month, she said

after I left
I went home to
my subterranean apartment
stood in my tiny kitchen
in the dying universe
and boiled turkish coffee
lit a fat cigar
and poured a glass
of wine

and sat on
my ass
in the cloud of smoke
shielded from their
spells

Friday, March 30, 2007

Rant: Squeezing the Juice

Here is a rant, first published on the OW site:

Squeezing the Juice: What is Wrong with Mainstream Publishing




We all know the the sorry story.

OJ Simpson, former football player and occasional movie actor in the aptly titled The Naked gun, was charged with the brutal murder of his ex-wife and her boyfriend. The jury acquited him, but he was later found liable for their deaths in a civil trial and ordered to cough up $33.5 millions.

Years later, Judith Regan, head of ReaganBooks, an imprint of HarperCollins, (guess they didn't include in the budget money for spaces between words), cut a deal with OJ for a book entitled "If I Did It" (as in, "If I Murdered My Ex-Wife and Her Boyfriend"). As the book was on the verge of publication, the books printed and ready for shelves everywhere, a good ol' firestorm of indignation broke out. The books were withdrawn and destroyed, Regan eventually fired, and outraged commentators patted themselves on the back for the issue being completely resolved. The system had worked!

Had it?

The system worked...not.

It is typical of how our society's self-appointed 'protectors' (uh, that's not me, of course!) miss the boat--they saw the ice cube, but did not see the ice berg. What a titanic mistake! it's enough to give one a sinking feeling!

Eliminating one person from mainstream publishing does not resolve the fundamental problems which led to "If I Did It" getting as far as almost doing it. There were and are built in flaws which enabled the OJ book to almost be published. None of those flaws appear to have been addressed (or mailed or even sent by courier). Another OJ style book can easily be published...a few years down the road...once the issue has cooled off, and a publisher thinks the public will pay out big bucks for sensationalism.

Judith Regan only had to get a general okay from HarperCollins for the basic idea of the OJ book to win approval. As a starting point, one has to wonder about the internal politics that allowed Regan to go on with the project. Was it simply she had a great track record for raking in the dollars? Why would anyone have agreed to publish a book where OJ would describe how he had murdered two people, "if" he had done it?

Anyway, other people than Regan were involved from the start, to approve the project.

And, OJ apparently did not write the book. It was "ghost edited", but not of course by the ghosts of his ex-wife or Ronald Goldman (what would THEY have written?). Someone was the ghost editor, someone hired the ghost editor, someone probably edited the ghost editor.

Books in large publishing houses go through a committee structure. Some group of people approved the book, approved the detailed outline, approved the choices of people who worked on the book, and then approved their work. It may have been mostly Judith Regan's decision, but she did not do the work all by herself. She probably delegated responsibilities: to whom?

The mother ship, HarperCollins, which had approved the general idea of the book, must also have approved the final version--and possibly the various drafts leading up to the final version. And the cover art.

In short: many people were involved in making "If I Did It" not an "If", but a reality. Judith Regan deserves a lot of blame, but she has also become a scapegoat, and no one talks about all the people around her.

It is reasonable to suggest that one reason "If I Did It" almost did it was because of how modern mainstream publishing functions. The biggest houses are often part of a larger corporation--rather than being independent publishing houses, they are a "division" and must maintain corporate profits. Where smaller (or even larger) publishers used to be independent, used to have a focus, used to publish books just because they should be published, today's "division' publishers of necessity are often focussed on the bottom line, to justify their corporate status. Vertical integration does not produce a lot of quality literature.

A book such as "If I Did It"--heck, you can practically hear those cash registers working! The tastelessness of the book was obviously a second consideration compared with the money it could make.

None of this system, as far as anyone outside it knows, has changed. And it is hardly HarperCollins that is the problem. It is all the large "mainstream" publishers which carry large bureaucracies and feel pressure to bring in the scheckels.

So nothing in the long term has really been fixed by dumping Judith Regan. The structure that allowed her to get as far as she did remains. The greed which prompted the OJ book remains. The lack of the people involved in taking personal responsibility remains.

There not only are no guarantees another OJ-style book is nolt around the corner, it is virtually guaranteed there eventually will be one. There is money to be made in sensationally exploiting tragedies.

Are there a lot of good people in mainstream publishing? I think so, yes. Do a lot of people in mainstream publishing want to publish good, thought provoking books? I think so, yes. And some thought provoking books are definitely published. But the internal politics, the pressure to mass market, to bring in money, over rules everything.

So I'm not applauding. Not yet. When the thought provoking books get the same publicity budgets as the sensational crap books, then maybe I'll start clapping. A little.

Rant: Pet Food and Publishing

The following "rant" was written a short time ago for the Outsider Writers' "Naked Opinion" section. It also seems to fit here, since I do get cranky at times....


What does wet, chunky dog and cat food have in common with modern mainstream publishing?

Both come out of a can and both are something humans should not consume.

Dog and cat owners went through a huge scare recently when some pets got sick—and a few even died--after eating wet and chunky food products made by Menu Foods. To quote from its website, Menu Foods is the “leading North American private-label/contract manufacturer of wet pet food products sold by supermarket retailers, mass merchandisers, pet specialty retailers, and other retail and wholesale outlets.” It produced, apparently, the same products for dogs and cats, using over 90 separate names—names including everything from Best Choice to Great Choice to President’s Choice.

Of course, there actually was no choice.

The issue is not only with pet food. Throughout our society what appears to be a choice is no choice at all. We’ve heard this before--that all VCRs and DVD players are made by the same four companies. And here it is again, in our pet bowls.

Now think about the largest mainstream publishers, which are often departments themselves of much larger conglomerates. Is a thriller from Random House really any different than one from HarperCollins? Do they not churn out the same “products”.

And think of ReganBooks and other “imprints”. They appear to be from different publishers, but actually, like the wet and chunky pet food, they are simply corporate subdivisions of a larger publisher. Is there any real difference in personality or style? Are not the multitude of “imprints” from each major publisher simply a relabelling of the same “product”? Are not the novels, poetry and non-fiction produced by the “imprints” just like Menu Foods’ creations: all the same, “product” and not art?

How did we get from Chaucer to here?

When you aim for the mass market, when money is your bottom line, is anything else truly possible?

Publishing used to be dominated by independent publishers, each with their own vision. Some were big, some small, but none were a link in a long chain. Now you have large bureaucracies where decisions are made by committees. A book decided upon by committees will--surprise!--look like a book decided upon by committees. It will be the product not of individual editors with individual visions, but a “product” that survives the internal politics of the bureaucracy. The very process reduces the writing to the lowest common denominator--what will sell to the most people--leaving writing which has had any sense of reality shredded from it.

Pollyanna, sunny vision of the mainstream, smiles even when her legs are broken.

Readers deserve more than dog food. They deserve more than wet chunky stuff that will make them sick.

Thursday, March 29, 2007

Story: Fast Food Heaven

One Summer afternoon, as Frank placed his old newspapers in the blue recycling bin in his back yard, he yet again had the disquieting experience of watching his little Shitzhu perform her own version of recycling, creating waste from one end and then gobbling it back up with the other. It certainly was part of the cycle of life, although not to everyone’s taste.

Taking a cue from how fast food chickens are raised, Frank purchased a large barn with a lot of small cages, brought in a truckload of small dogs, and then packaged and marketed their produce as the ultimate fast food:

Protein, minerals, but no transfats

Edible package, so it doesn’t have to be opened and you don’t have to look at it

Available in chunky or smooth

Predigested

Not having to open the package before eating was clever, but Frank showed his genius with pre-digested, which turned out to be the biggest selling point for fast food fans. Government regulation was not a problem—politicians and Health Department officials were among his hungriest customers.

Hypertension 44: Back In The Saddle Again?

Posts to this blog have certainly gotten a bit spottier since I returned to work—less time to blather on about my poor, troubled self! Also, I became up to date on my journey through Medical Land a few weeks ago, so there was no need to write something every day. But I do miss not doing it every day…(can I blame the meds for that?)….

Life has settled into a Predictable Patient’s Pattern. Each morning I wake up (well, thank goodness for that!), take my medications, try to get the dog to poop outside so she won’t poop on the floor while I’m away, and go off to work. At work, after settling in, I take my blood pressure with the home device. I do not bother taking it three times a day any longer, which is a relief—not that it was hard taking the pressure multiple times, it was just medicalizing me, making me think about being a patient. Plus, my blood pressure has stabilized, with even stressful situations not making it rise above 160. Heck, I could think about George W. Bush running for a third time and it wouldn’t—ugh—wait—my heart, help me!

Work is ok. although virtually every assignment is full of human tragedy. I have a greatly reduced workload, and in fact have even asked for a few more cases, now that I’ve settled in. As long as I pace myself, although I’m tired all the time, and light headed about half the time, I’m ok. When I am only reading files, typing memos, talking on the phone, everything is okay. I feel “gray” a lot, and achy at times, but I’m trying to get used to that. Lots of people have worse things to get used to.

When I have to interview people in person, that takes a lot of energy. The longer the interview, the more I have to push for information, the less energy I have coming out the other side. Two and a half hour interviews are exhausting. Driving out to interviews is draining. The more I do physically, the less energy I have for anything, it seems. Days involving interviews, driving, pushing to get something done on a deadline—when I go home all I can do is dumbly watch tv waiting until I can go to sleep with some self respect (if you go to sleep at 7 pm, aren’t you a weenie?)

Exercising three times a week is a real challenge when you work full time. Fitting that in with work, and still “having a life” isn’t easy—but, again, lotsa people have it far worse!

I have to do the exercising after work, so that makes for a long day, even when I go to the gym straight after leaving work at 4:30 (after picking up my wife from her workplace and dropping her off at home). Including travel time, the whole exercise bit takes two and a half hours: undressing & putting on gym clothes, the treadmill for forty minutes, using the weights and doing “stomach crunches” (how aptly named!) and so on for another twenty, then undressing, hitting the showers with a lot of smelly naked men, dressing, driving home.

With luck, I get home by 7:30 pm and then can have dinner. If I try to have dinner before exercising, I won’t be home until 8:30 or 9. When I get home that late, all I really have time to do is pet the dog, say hello to my daughter, and go to sleep.

Before they told me I was sick, I used to stay up until midnight or even one am, writing. These days, I start to fade by 9 pm, should be asleep by 10, and will pay for it the next day if I’m still awake at 11. A couple of days ago, with the spouse outta town and the daughter in Vancouver, I was up until 12:30 watching a terrific film directed by Tommy Lee Jones, The Three Burials of (don’t remember the first name) Estrada. Great, sensitive, modern western, with some fine politics—great all around package!

The next morning, I got up at 7 am, and only six hours of sleep was bad news. Aches all over! Dragged out all day, my brain a puddle.

It was nice when I could stay up late, like any adult.


Monday, March 19, 2007

Hypertension 43: Statins

This is a post about Statins. It is not a biography of Harold Statin and his family. I think Harold Statin was a Vice Presidential candidate in the United States. Probably you have never heard of Harold Statin. Don't feel bad: back in his own time, not that many people knew of him.

If you think that joke about Statins was bad, check out the last post & the biblical pun.

I started taking Lipitor in early October, 2006, when I was put on much more powerful prescription medications for Hypertension. Lowering blood cholesterol was part of the deal. I knew the medication could cause liver damage, but at that point medicating myself was on my mind (did Willie Nelson ever sing that song?)

About two or three months later, I began to notice aches in my legs. Sometimes it was just an annoying ache, in the background. Sometimes, in particular when I walked briskly to the fast food court in the mall near work (stop laughing at me, I got nice Japanese food at the fast food court...well okay I also got healthy Chinese food or it would be healthy without all those fattening sauces on it...and I rarely got a mozza burger which I really like, especially with those onion rings, and...where was I?) my legs began to ache painfully. I used to do that ten or fifteen minute walk each way with no problems. Suddenly the aching would be so painful I actually had to stop until the pain went away a little.

I mentioned this to my wife, who mentioned there were well known concerns (except to patients, of course) about statins. When I saw my family doctor, the WMD, and mentioned the aches, he ordered a blood test and, as something of an afterthought, took me off Lipitor. It's been perhaps three weeks now, and the aches in my legs have gone away.

No more Lipitor for me!

Here is an article in a recent Sunday Telegraph, a UK newspaper. It was brought to my attention by a very helpful reader. I'm sure it is copyrighted by them, and although I did not ask permission to reprint it here, I'm sure they won't mind. Buy the Sunday Telegraph. And maybe become a patient of Dr. James LeFanu! And respond to his request for more information at the bottom of the article--patients around the world, unite!


"If you want to feel younger, forget your statins

"By Dr James LeFanu

"A doctor accused of wittingly prescribing useless or possibly lethal drugs would vehemently, and understandably, deny it. This makes it rather difficult to oppose the prevailing medical consensus on statins, the cholesterol-lowering drugs prescribed to four million people in Britain at a cost of £1 billion a year.Thats quite a sum. It could pay the salaries of 700,000 nurses or build two spanking new teaching hospitals.

"An even bigger sum is £15 billion. That is the profit the pharmaceutical industry made last year from this, the most profitable class of drugs ever invented. They are so profitable that the latest statins to reach the market came with a £600 million promotion budget to push the notion to family doctors and policymakers that the lower the cholesterol the better, and that at least half the population would benefit from the drugs.

"But it is not so.

"Statins are useless for 95 per cent of those taking them, while exposing all to the hazard of serious side-effects. Hence my ever-growing file of letters from those whove regrettably had to find this out for themselves, illustrated by this all-too-typical tale from Roger Andrews of Hertfordshire who was first prescribed statins after an operation for an aortic aneurism (that he had cleverly diagnosed himself).

"Over the past few years, Mr Andrews had become increasingly decrepit (what can one expect at 74?) with pain and stiffness in the legs and burning sensations in the hands so bad that when flying to his son's wedding in Hawaii he needed walking sticks and a wheelchair at the transfer stops. However, he forgot to pack his statins, and felt so much better after his three-week holiday that when he got home he decided to continue the inadvertent experimentof not taking them. Since October, most if not all of his crippling side-effects have gone.

"Several friends can tell a similar story, and they have friends too.

"The take-home message is that statins are only of value in those with a strong family history of heart disease or men with a history of heart attacks. For everyone else they are best avoided as they seriously interfere with the functioning of the nerve cells, affecting mental function, and muscles.

"This is all wittily explained in a recent book by a Cheshire family doctor, Malcolm Kendrick, The Great Cholesterol Con (John Blake Publishing, £9.99). There are, I suspect, many out there, like Mr Andrews, wrongly attributing their decrepitude to Anno Domini, when the real culprits are statins.

"I would be more than interested to hear from anyone who finds that giving them a resteffects a similarly miraculous transformation."
James.LeFanu@telegraph.co.uk

Saturday, March 17, 2007

Hypertension 42: The Facts Can Be Harder To Take Than The Prescription Medications

Remember the study quotes in Hypertension 41? No, that study does not apply to me. I’m worse.

The study quoted in Hypertension 41 involved people with mild Hypertension. Very generally that would mean people with a systolic pressure under 160. For those people, the best approach might be to avoid medications, and instead exercise five times a week, avoid salt, and eat a lot better. Stroke and heart attacks appear to be the negative outcomes. Eyesight problems and kidney damage are extremely rare.

The study that applies to me is located in the Cochrane Library (http://www.cochrane.org/). That site features medical studies and information. The abstracts, quoted here, are copyright the Cochrane Library, and are available free of charge. If you want the actual studies, there is a small fee. Thank you for this service, Cochrane Library!!!

The study I was pointed towards? C Mulrow, J Lau, J Cornell, M Brand, Pharmacotherapy for hypertension in the elderly. Cochrane Database of Systematic Reviews 1998, Issue 2.

One view of the studies I have been advised of, from someone who has read the entire studies, not the abstracts:

“The drug treatment increased average overall survival over 5 years from 87% to 88.8%. Drug treatment increased stroke-free, heart attack-free and heart failure-free survival over 5 years from 82% to 87%. Stated another way this means that 20 patients have to be treated with drugs for 5 years to prevent one heart attack, stroke or hospitalization for heart failure. Withdrawals due to adverse effects was similar to mild hypertension, about one withdrawal for every 10 patients treated.

“You asked about other outcomes such as loss of vision or kidney damage. These events are very infrequent with elevated blood pressure so would not change the above evidence.

“I believe that all patients who are being considered for long-term preventive treatment should be informed of the evidence and make their decision regarding treatment based on an understanding of the evidence.

“I hope this helps…and you are welcome to post this on your website.”

And, a further addition from the same very helpful & kind person:

"Over many years I have come to the realization that we always present medical information focusing on the empty part of the cup. That is why I presented the fact that if you don’t do anything you have an 82% chance of not being harmed by your hypertension in the next 5 years. If you do what you are doing in taking drugs to lower your blood pressure you can increase that to 87%. I would hope that that gives you a more comfortable perspective than what you had before. In other words your cup is pretty full and taking your pills fills it up even more. It should also provide the realization that the drugs are only modestly effective and you could have a good or bad outcome independent of what you do."

The kind and helpful person is, actually, Jim Wright, Coordinating Editor, Cochrane Hypertension Group. He provided this information, including directing me to the study quoted below, in his role as Coordinating Editor.

Thank you Jim!!

Want to read the facts for yourself? Okay, be pushy! Some of it is confusing for a layperson, so feel free to help me out if I’ve gotten anything wrong. But in terms of facts, here we go!

Most fascinating for me: only four of the fifteen studies kept track of patients who dropped out. Of the four trials, the drop out rates due to negative side effects was as high as one in four. That is, one person out of four left the study because of the negative side effects of the medications. There was no indication of how drop-outs impacted on the statistical analysis.

What does it come down to?

If you have "mild" Hypertension, where your systolic pressure is generally always under 160 "points" (does anyone really know what the actual measurement means?), avoid all the medications. You can do just as well by committing to lifestyle changes: exercise regularly (ohmigod), less salt (Lots a luck--my first Biblical pun), lose weight. In my experience, the common negative side effects of the medications, with their resulting impact on your quality of life, are not worth it. You really are better off not popping pills and taking the easy way out.

If you have moderate to severe Hypertension, as I do, it is a more difficult question. Basically, it does seem to come down to a 5% improvement in your chances of not croaking (or suffering a less serious health risk, like the kind you might get from watching Fox News too much). That's tough. 5% is more significant, and you'd feel pretty stupid if you then did have a stroke, eh? In that situation, it depends on a case by case situation--how bad the side effects are, for example, for you in particular. Of course, that also depends on whether you are grabbing your life situation by the neck and not just being a sit on the couch wuss. Are you exercising, losing weight, less salt, watching less aggravating television such as President Bush news conferences (well okay, maybe his press conferences do have a surreal entertainment value).

Here is a portion of the abstract.

General abstract:
Medications to treat high blood pressure are effective in preventing serious complications, such as stroke or heart attack, in elderly people. Hypertension (high blood pressure) is common among elderly people and increases the risk of serious problems such as heart disease and stroke. Several medications are used to try to lower blood pressure and reduce the risk of complications, but relatively few studies have examined treatments for hypertension in people over 60 years of age. The review found that medications to lower blood pressure were highly effective in preventing complications such as stroke and heart attack in elderly people. However, effects of treatment in very old people or people with other problems like diabetes are not clear. More research is needed.

Fifteen trials including 21,908 elderly subjects were identified. The average prevalence of cardiovascular risk factors, cardiovascular disease, and competing co morbid diseases was lower among trial participants than the general population of hypertensive elderly persons. Most subjects were 60 to 80 years old. Most trials were conducted in Western, industrialized countries and evaluated diuretic and beta-blocker therapies. Event rates per 1000 participants over approximately 5 years indicated that antihypertensive drug therapy was beneficial. Cardiovascular morbidity and mortality was reduced from 177 to 126 events (95% CI of the difference 31 to 73). Cardiovascular mortality was reduced from 69 to 50 deaths (95% CI of the difference 9 to 31). Total mortality was reduced from 129 to 111 deaths (95% CI of difference 4 to 28). The data from the three trials restricted to persons with isolated systolic hypertension indicated a significant benefit: cardiovascular morbidity and mortality over approximately 5 years was reduced from 157 to 104 events per 1000 participants (95% CI of the difference 12 to 89). Numbers of participants who dropped out of trials secondary to adverse drug effects were often not reported. The four trials that did report this data showed a wide variation in drop out rates ranging from no significant differences between treatment and control groups to as many as one out of four patients dropping out due to side effects of treatment.

Authors' conclusions
Randomized controlled trials establish that treating healthy older persons with hypertension is highly efficacious. Benefits of treatment with low dose diuretics or beta-blockers are clear for persons in their 60s to 70s with either diastolic or systolic hypertension. Differential treatment effects based on patient risk factors, pre-existing cardiovascular disease and competing co-morbidities could not be established from the published trial data.

Thursday, March 15, 2007

Story: Zoltan

After a subway wreck young baby crawled from the ruins and went deep into the tunnels and was soon enough adopted by a society of rats. He grew big and strong. The rats named him Zoltan. He loved his little rat comrades, who taught him everything he needed to know about life in the big city.

Eventually Zoltan went above ground and into municipal politics. In the mayoral election, he appealed to human voters with his ecological attitude—but he never forgot that his real constituency was the rats. He was elected by a large majority.

After he became Mayor, he proceeded to do everything possible to make life better for his rat friends. All of the skyscrapers were torn down in favour of small wooden houses. The people liked it, even though the project denuded the surrounding area of forests (no plan is perfect). Cement sidewalks and asphalt streets were removed to reveal the earth below, dogs and cats were allowed to run wild, and garbage was dumped in large open pits. Flowers grew. So did disease.

The rats flourished in the wooden houses and dirt streets, enjoying life and being rats. Many people died in the inevitable plagues. Zoltan felt that was reasonable natural selection. Despite everything, while the surviving citizens regretted having elected Zoltan, in the next election they voted him in again, figuring that at least with him they knew what they had.

Story: A Good Dinner is Hard to Find

A stock broker was sitting on a park bench one afternoon when a mosquito lit upon his arm and asked for lunch. The stock broker replied, “I need my blood for myself. But I am always open to a deal.”

The mosquito contemplated. “I happen to have many viruses. I will share them with you. Perhaps one of them will end up like penicillin and make you richer than you already are.”

Being richer than he already was fundamental to his life motivation, so the stockbroker allowed the tiny insect to suck out a few drops of his blood. She nodded her thanks and flew away.

A few days later, her daughter returned, with a few hundred relatives. The stock broker gladly rolled up his sleeves, even though he knew it was a high risk transaction. "The bigger the deal, the bigger the profit,” he chortled.

"The insect sisterhood appreciates the many new lives we can create with your blood,” they said as they ate their fill.

Day by day he traded his blood for the possibility of receiving a beneficial virus. Three weeks later, he sat on the bench suffering from malaria, West Nile Virus, anemia and other dreadful conditions. Thousands of mosquitoes descended on him, all descendants of the original insect, all from his own blood.

As the insects drank the remainder of his blood, the stock broker moaned, "This deal did not work out. I’m dieing."

One of the great great great great granddaughters of the original mosquito nodded. "You should have sold short," she said, and finished him off.

Monday, March 12, 2007

Call for Submissions for an Anthology to Help the West Memphis Three

I am posting this call for submissions as a public service, and to support what Misti is doing. Does this have anything to do with Hypertension? Well, what has happened to The West Memphis Three has definitely caused my blood pressure to rise!

Anthology To Benefit The West Memphis Three.

I still haven't decided on a title for the anthology. I will be taking submissions until June.

If you are interested, please send three poems and a bio pasted into the message to me at mistirainwaterlites@yahoo.com.

If you are not familiar with the West Memphis story, please educate yourself before inquiring or sending me poems.

My vision for this anthology is to include at least fifty poets. With three poems from each contributor, the book will contain at least 150 pages. Depending on the base production price at lulu.com, I will set the royalties at two or three dollars. I want to be able to send at least $100 to the defense fund. That is my goal.

If you know even a few things about the case, you know what an important fight this is. It involves every compassionate citizen not just of America but of the world. Three little boys were brutally murdered. Three dirt poor teenagers were convicted of the horrible triple homicide based on "Satanic panic" and gossip. How can we send someone to Death Row in the United States of America WITHOUT ANY EVIDENCE? Damien is on Death Row. Jason and Jessie are in for life.I want to see those three innocent men set free and I want to see them receive millions of dollars from the state of Arkansas for the pain they have suffered for over a decade. I've read that Damien has been raped in prison. I don't know about Jason and Jessie but I'm sure they've also been brutalized in various ways.

It's good to send letters to the three men. They appreciate letters of support and encouragement. Writing letters is not good enough for me, however. I'd like to do more.I have tremendous hope for this anthology. Please spread the word and contribute if you can. Thank you.

Misti Rainwater-Liteshttp://ebulliencepress.blogspot.com

Sunday, March 11, 2007

Hypertension 41: The Therapeutics Initiative

My wife, a women’s health advocate, brought the Therapeutics Initiative, from the University of British Columbia, to my attention. The current issue of the “Therapeutics Letter” (www.ti.ubc.ca) addresses how physicians should make decisions, with their patients, about using prescription medications to treat mild Hypertension.

The Therapeutics Initiative believes that “health care professionals should try to practice evidence based medicine and shared-informed decision making whenever possible.” Who would disagree with that?

Read on, though it does get a bit technical.

The specific question the Therapeutics Initiative addressed: “How much does antihypertensive drug therapy as compared to placebo or no treatment change mortality and morbidity in randomized controlled trials of men with BP in the range of 140-160/90-100 mmHg?”

It quotes the results of five randomized clinical trials of people with mild hypertension, comparing regular medical treatments versus placebos. “In these trials 23,000 people were studied, 54% male, average age 51 years, the average baseline BP was 160/98 mmHg and most subjects had no evidence of cardiovascular disease. The first-line drugs studied were thiazides in all 5 RCTs, the only exception being one RCT which also had a beta blocker arm. The average duration of follow-up was 5 years.”

The results from the five trials? “Removing the first-line beta blocker arm did not materially change the estimates…. In the 5 trials there was no benefit in terms of total mortality, but there was a reduction in total strokes and heart attacks from 4% to 3.2%. [not a huge difference, eh?] The magnitude of the absolute reduction was 0.8%, meaning that 125 people like [the patient in question] would have to be treated for 5 years to prevent one heart attack or stroke. On the harm side there was a 9% absolute increase in withdrawals due to adverse effects with drug treatment as compared to placebo. That means that for every 11 people treated one would stop the drug because of a side effect. That side effect would resolve after the drug was stopped.”

Well.

Of course, the study did not cover everything. For example, there are other harmful effects of Hypertension than strokes and heart attacks. The studies covered only people with mild Hypertension. And there was no indication whether the damaging effects of Hypertension would increase over time—maybe there was no reduction at a lower age, but after ten years of non-treatment, perhaps the statistics would change.

But as a person who only has “mild” Hypertension after taking three strong prescription medications each morning, the information in the Therapeutics Initiative certainly had resonance for me. I had always wondered whether these prescription medications, which had strong negative side effects and which cost around $250 per month, actually did any good. “Common” or “mainstream” medical practice says yes.

Actual facts appear to say, at the very least, not really.

Thursday, March 08, 2007

Poem: Pornography, Nazis and the Internet

When the Nazis came to power
they outlawed pornography:
it is difficult to plan conquering the world
while you are jerking off.
But after they invaded a country
they spread pornography there
it is hard to fight your oppressor
if you are busy stroking yourself.

Now, look at the internet today.
Pornography has spread everywhere.
We were invaded years ago
but were too busy pleasuring ourselves

to notice or to ask
who are today's Nazis?

Wednesday, March 07, 2007

Hypertension 39: Western V. Chinese Medical Experiences #2...or, Western Medical Doctor--What Does WMD Remind You Of?

Yesterday, I saw my Western Medical Doctor. Today, my Chinese Medical Doctor. I am inspired to write a second posting about the different experiences.

Yesterday's appointment with my Western Medical Doctor (WMD, which is suspiciously like WMD as in Weapons of Mass Destruction) was originally scheduled for two weeks from now--basically, to meet the doctor so he could order a blood test to see if Lipitor was rotting my liver. However, I pushed it up because I was getting leg aches, and my wife the nurse was concerned that research involving statins (which, I gather, is what Lipitor is one of) indicated statins can, as a rare side effect, create permanent muscle damage.

I prepared for the meeting by printing out all the blood pressure measurements I'd taken since my return to work (which my WMD had asked me to do), and a short diary of my return to work experiences, including a list of apparently negative side effects from the prescription medications I was taking (he had also asked me to prepare the diary). The list of blood pressure measurements probably ran ten pages, as I took them three times a day, and three times each time (you're not supposed to do one measurement at a time, but take several--usually the readings go down a bit, the longer you sit quietly seeing if you're gonna have a heart attack). The diary was only one page. Half of it were the side effects.

The appointment was for 3:15, so I left work and arrived at around 3:00, hoping I might get in early. I checked in at the front desk and was told to have a seat. There were plenty of people there--the WMD shares the offices with three other physicians. The walls were a pale colour, with forgetable prints on them. I looked at the magazines--all fashion magazines about a year old, with a couple of older sports magazines, and some free magazines from drug companies--and fell asleep. Well, I can do that, I have sleep apnea. My snoring woke me up. Several times.

I was in the waiting room for about fifty minutes, so when I was finally called in it was about half an hour after the scheduled appointment. For ten minutes, I then waited in the "patient room", feeling patient, and looking at the posters on the walls: one was for irritable bowel syndrome, and had drawings of colons, while the other was about panic attacks, and showed a scared woman running out of an elevator. I started to fall asleep again.

The WMD came in. I think he remembered who I was, but since sometimes he does not, I reminded him that I had Hypertension and had just returned to work. He looked at my chart, bringing himself up to date, in about thirty seconds.

I told him why I'd pushed up the meeting--concerns about the statins and other side effects--and handed him the blood pressure readings and diary which he had wanted me to do. He read the diary, then looked at the first three pages of the readings (which would have taken him back a week or so, but certainly not the almost four weeks I'd been back at work). He commented that my blood pressure was stable, which it generally was.

I told him my return to work seemed to be going well, although I felt lightheaded much of the time. I mentioned about pushing up the meeting and described the ache. One thing I could not figure out was why my legs ached in particular when I did some brisk walking during lunch in Winnipeg's skywalks, while they did not ache when I walked at the same brisk pace on a treadmill at the gym.

He responded well to the leg ache, said that statins have muscle ache as a known side effect, and that a blood test would tell us if that was the problem. Secondly, he said, if the test in particular turned up negative, the other method was to simply stop taking Lipitor and see if the aches went away. He did not say anything about why I should have leg aches walking in the mall but not in the gym. I got the impression he was not always listgening. He said the blood tests could take a couple of weeks to get back to him, and started to leave.

I asked him about the second method about knowing whether the aches camp from Lipitor. He seemed to have forgotten about that, because he said something like "Oh yes" and sat down again. He told me to stop taking Lipitor for six weeks.

Then he got up and the WMD then left. We'd been together perhaps ten minutes.

Apart from my raising the ache issue and his responding to it, I did not have the time to ask about the other side effects--lightheadedness, blurry vision, blood when I blew my nose, bleeding gums when I brushed my teeth, and so on. Why should I bore you with the list? He did not want to hear about it, why should you? Maybe the WMD was rushing off to look for WMDs.

I wanted to ask him how to understand if the diastolic measurements were too high, but he was already gone, off to see patient X-23, in room six ("I'm not a prisoner, I'm a free man!")

Back at work, I kinda decided I'd had enough of waiting to get information from my personal WMD.

I phoned the specialist's office who had kept me off work, recommended I return to less stressful work, and had changed some of my meds. My plan was to book another appointment with him, to get my questions answered. He worked in a hospital clinic. Unfortunately, his secretary told me that normally he sees patients only once, and then lets the family physician take over. I would have to call the WMD and ask him to write a second referral letter, to see the specialist again.

As I did not want to call the WMD again, and probably have to make another appointment with him just to get the referral letter written, I phoned a doctor I knew who was an Occupational Health specialist. He's a very friendly fellow. He said the biggest problem doctors have with hypertension patients is getting "compliance" with the medications, because of the side effects. He said he'd see if he could find another physician to recommend to me.

Then I went to the CMD--the Chinese Medical Doctor. It was not for a treatment, actually. I had been helping her on a volunteer basis with her parents' humanitarian immigration application so they could become landed immigrants here. My certification as a Commissioner for Oaths had arrived, so I could certify, as part of the application, that her marriage and citizenship documents, among others, were authentic.

I went to the CMD after work. The assistant behind the counter smiled and asked how I was. The CMD came out and we had a hug. She asked me how I was feeling. Given I was stuck with prescription meds for the time being, she suggested she could still continue to stick needles in me. She asked how my daughter was, and offered some herbs. On the wall were new drawings by her children. Her parents were there, and thanked me for helping with the application. Her husband also showed up. We all chatted and had a rather nice time.

It looked as if we could be done, but I suggested I double check online the document lists necessary, to ensure that everything was done, and that I would return Friday. Actually, I think I just did that because it was so nice there I wanted to come back again.

The WMD I don't want to see again.

Thursday, March 01, 2007

Hypertension 38: I'm Tired, So This May Not Make Sense, But At Least I'm Not Invading Iraq

It's 10:48 p.m. My day started at 6:50 a.m., when the alarm woke me. Outta bed, shower, remember to take my blood pressure, remember to eat breakfast, remember to wait on drinking coffee until I get to work, remember to take my meds. Drive my lovely daughter to high school, my lovely wife drives me to work because she is sick and going to the doctor.

At work set up my laptop, turn on my work computer, set out chocolate to encourage staff to come by and visit. Pour a cup of coffee. Sit down on the thick pillow with flowers on it that I bought yesterday (one of the biggest problems returning to work has been, of all things, a sore butt: too much time sitting on comfy chairs for six months has not prepared my bottom for sitting all day in an office chair).

I'm about to start typing up the notes from an interview with a client late yesterday, it ended at around 4:30 so I did not type them then. The phone rings: another client. We talk. I get a phone number for him, and call back on his cell and leave a message, with the number. I type a memo to file about the calls, recording his information. I email my manager with a query based on the new information. Then I type the notes from yesterday. Then I make two follow up calls from the notes, arranging a meeting with a witness for next week. I memo the file about those calls. Then I follow up a letter from a client received yesterday with a phone call to the client, which leads to another call involving that client, to set up a meeting for next week. I put notes on those calls in the file. I look up. Two and a half hours have passed.

I go to get lunch. My legs ache. Lately they've been aching, and my wife worries it's a reaction to the statins I'm taking which could lead to permanent leg damage--I push up a doctor's appointment from three weeks to next week. Eat lunch at my desk, take out Japanese, very good. Go back to work, reading a new file. I write and send out letters to the two clients associated with the file. Then I begin to prepare an investigation plan based on the file--what the issues are, what questions to ask. The plan involves detailing all the issues on the file, what parts of the law they involve, the positions of either side, what questions I must ask, what documents I must seek.

My wife phones. She went to the doctor, she has mild pneumonia and is on antibiotics. I tell her don't drive downtown to pick me up, I'll take the bus. I look up, about to continue with the investigation plan: it's already 4:30.

I pack up, trudge, no heck let's be cheerful I sorta skip, through the snow to the bus stop. Yes, it's snowing. I think maybe I'm starting to feel sorry for myself. I take the bus home, grab my gym bag. My daughter asks if we can go shopping. I'm kinda grumpy about that request, given I'm about to go out and exercise, which I'm not fond of.

I drive to the gym, change clothes, and spend forty minutes on the elliptical treadmill. Check my weight: 225, I've gained a couple of pounds (I've been eating ice cream since returning to work--have to cut that out). Phone my daughter, tell her I'll take her shopping if when I get home she's ready to go. Drive home, she's ready to go. We have a good time shopping. There is always something to buy.

Come home. Wife is going upstairs to sleep. I make two low calorie frozen meals for dinner, have them with a glass of milk. Spend two and a half hours on emails, my book review blog, the time goes fast. Now it's bed time, and to sleep. For an hour or two: since starting the new meds, I seem to wake up every two or three hours.

Tomorrow I'll spend the evening after work with my 90 year old mom. She is a great woman, but is 90. She does not remember what's happened during the day very much, and often drifts off during conversations, so being with her is both pleasant and sad. Once she babysat me, now I babysit her, and I worry about how that sounds to you, but it's true. Maybe we'll watch The Departed, the Scorsese film, on DVD, which is about living someone else's life.

Hey, she's still alive. I'm still alive. I earn good money, I live in a great country, where it is relatively safe and peaceful. Plus I have cable and a cell phone.

There is more to be grateful for than to whine about.

We have to be careful not to trudge through life, but to waltz. Even when our legs ache.

Saturday, February 24, 2007

Story: The Fox and the Chicken

A famished Fox raided a barnyard one morning and picked out a plump Chicken to serve as his dinner companion. After she was taken back to his lair, the frightened Chicken pled for her life.

“O spare me!” she clucked.

The Fox considered. “Most certainly. You have my word as a Fox—if you first do something for me.”

“And what is that?”

“My lair is a frightful mess. Clean it up, then bring in some herbs from my garden, and we will have dinner together.”

The Chicken immediately got to work, to save her life. After the kitchen and everything in it sparkling, she cleaned the rest of the lair, washed the floors, mowed the rug and got the herbs. When she finished, the Fox picked up a newly cleaned sharp knife and asked, “Do you prefer being roasted or fried?”

“But you can’t!” cried the Chicken. “You gave me your word!”

“How can a Fox’s word ever be good to a Chicken?”

The dinner was superb. The Fox decided that the herbs brought out the best that the Chicken had to offer him.

Victor Schwartzman
victors@mts.net

Poem: The Winter of the Great Grandmother

It is the winter of my falls
the road is harder to walk on, easier to fall on
broken and fractured bones.
What has become of me?

After a fall I press the necklace alarm
to alert the young staff
who rush in to pick me up.
I can not raise myself.

My friends are long gone
my parents and sisters memories
I sit alone in a retirement community suite
warehoused.

I was raised to believe
my children would live near me
I would raise my grandchildren
but they all live so many miles away.

I can not remember yesterday
today is a blur
tomorrow means nothing.
The golden age of retirement
they never said it was Fool’s gold.

Every fall brings me closer to that hole in the earth
every day I lose more of my past
every day I have less to enjoy of the future.
Soon no one will remember me
even I will not remember me.
What has become of me?

Victor Schwartzman
victors@mts.net

Hypertension 37: More Dreck :)

Hypertension/Disabilities: just when you think it is safe to go back in the water and relax, there always is something else wandering into your life to keep you on edge. With any disability, little is ever settled permanently.

Or perhaps it is that it has been a week since my last post. Maybe I’m just writing this to put up something new—write something fast, even if it ends up being short. Because, apart from worrying about Hypertension, and worrying that maybe I’ll have to eat healthy tofu for the rest of my life, now I have to worry about losing my fans.

Assuming that I have any fans.

But actually I’m not all that worried about any of YOU, because who even knows if you even EXIST? The only way I’d really know, I mean really really know for sure that you are real is if right now you take a ten dollar bill and put it into an envelope and mail it to Victor Schwartzman, 596 Spruce Street, Winnipeg, Manitoba, R3G 2Y9, Canada. Only after I get your money in the mail can I be sure you are there.

Really, you must admit there is no other way you can prove you exist.

Now that we have that cleared up, I do have one more worry…about me: that, eventually, due to the very helpful treatment I am getting for Hypertension, my legs may fall off.

It is Saturday. I have just finished my second week back at work. It’s gone well, actually. I feel as if I am on top of my work. Of course, I returned to significantly less work than usual, to a level of work relatively easy to handle. Less to juggle, less to remember.

I have been a bit dizzy, it is true. Not very dizzy. More like the you’ve been sitting too long and suddenly get up dizzy. More of a tired dizzy. Not the dizzy that makes you fall over. Generally dizzy, generally tired—but more focused at work than I thought I’d be.

In fact, the biggest problem I have “suffered” on my return to work has been my…ass. Yep: all that sitting, day after day, in an office chair, makes my (lovely) buttocks sore. I’ve become too used to the couch. Yes yes yes: you might say this is an asinine situation, that I am really bottoming out--so all I can rebut with is the obvious: butt out. You’re being cheeky.

During lunch, I walk through Winnipeg’s skywalk system. When it is -30 Celsius in the Winter you need a protected environment as much as possible, so Winnipeg has a network of enclosed, heated walkways allowing you to wander freely from one shopping environment to another. Hey, it’s good for business.

Before I left on medical leave, I would briskly walk to a mall food court 15 minutes or so away, get some fattening food to go, and then briskly walk back—talk about a health jaunt! I felt fine. Especially after eating those deep fried chicken wings!

But this past week I began noticing that my legs ached when I walked briskly. Really ached. I thought maybe it’s because of the extra weight of my overcoat (needed to get to the mall system), the snow boots, etc. But that did not make much sense--before I returned to work I exercised in the gym every other day on an elliptical treadmill, walking very briskly for forty minutes, and had no aches at all. Yet now my legs ache. Why?

I mentioned this to my spouse the nurse and she advises that the latest information about statins, one of the prescription medications I take, is that a very rare side effect could be such aching. If so, the aching could be caused because the statin medication is causing the blood flow to my legs to lessen, which in turn leads to muscle damage, which in turn can be permanent, which in turn can lead to permanent pain in my legs. Okay: maybe they would not fall off, but at that point would I care?

Hey. This has been a long post, after all.

Sunday, February 18, 2007

Hypertension 36: Really Gross Stuff

WARNING: this post contains graphic descriptions of bloody nasal discharges. If you do not have a fetish about boogers and blood, read a gardening blog instead.

Yes, this is another side effects sad sack whiny story. As it is gross, I will try to keep it short. However, if you are turned on by gross stuff, by all means reread it several times.


Like anyone, on rare occasions when I’d blow my nose there would be a little blood on the hanky. Nothing unusual. However, since starting the combination of Teveten Plus, Adalat XL and Lipitor (none of which may be responsible—and one problem is, who knows?—I also take ‘baby’ aspirin to help prevent a stroke)…uh, where was I?

Oh yeah. I started that combination of meds November 22, 2006. Staring in early January, 2007, I began to notice that when I blew my nose (which has always felt stuffed up) there was blood on the tissue. Not just a speck here, a bit there. Nope. Fairly large splotches of bright red blood on the pure white tissue. I also began to notice, as I, uh, felt around in my nose, hard crusts. The hard crusts were congealed blood. This is disturbing.

I must add: I do NOT like digging around in my nose. Normally I do NOT look at what I blow out of my nose. And, if you are thinking the worst, nor do I eat it.

In addition to Hypertension, I have sleep apnea. That condition involves you not breathing for significant amounts of time while asleep. In my case, I was tested in a hospital and stopped breathing for a minute at a time. This condition, if untreated, can lead to congestive heart failure and other problems, not to mention you’re tired all the time because you ain’t sleeping so good. The treatment is not a medication, but instead a breathing machine. The machine at your bedside, pumps air through a face mask into your nose all night long. When going to bed, say good-bye to romance and hello to Elephant Man.

It appears that, possibly, the constant air pressure through the breathing mask, combined with the prescription medications opening up my blood vessels, leads to some rawness inside my nasal passages. This irritation leads to some bleeding, and crusts forming. Hence, when I apply pressure by blowing my nose, the blood on the tissue. Followed by the large pieces of bloody crusts.

(If you are reading this and getting off on it, ugh.)

So one very unpleasant side effect of the medications I am taking (which have indeed significantly decreased my blood pressure, I hasten to add!) appears to be blowing up blood. When, that is, I blow my nose.

While we’re at it, I may not have mentioned occasional eye sight problems. Apart from ‘floaters’ (black spidery dots in the corner of your vision, which can occur at my age), sometimes when I wake up in the morning everything is blurry. I have three pairs of glasses: reading, computer glasses (a form of progressive lens), and distance glasses (a bifocal with the lower portion adjusted for reading). None of the three help. Everything remains blurry. I can read, yes, but it takes an effort. Watching television is much less enjoyable.

There is no predicting when this will happen. Normally, my eyesight can get a bit blurry when I’m very tired. But this particular blurryosity happens whether I feel stressed or calm, fine or unfine. I gather, again, it has something to do with the blood pressure affecting my eyes internally, with the focal length changing as the blood pressure changes. It happens once every two or three weeks. Usually it lasts for much of the day.

And oh yeah, my gums are still inflamed--but not as much.

I know the medications are worth it, and that playing the odds I won’t have a stroke by suffering these side effects is worth it. I know that. Know it know it know it. Yep, I am grateful for what the medications are doing for me, and, yes, I know that life is a bowl of bloody tissues…ooops, cherries!

Saturday, February 17, 2007

Hypertension 35: Why Haven't I Written Anything Lately?

Regular readers of this blog--if there actually are any (To this moment, after 97 days of tracking, there are 845 'unique' visitors and 265 'reloads', for a total of 1110 visits; 413 visits from the US, 239 from Canada, 63 from the UK, with the remainder from the rest of the world--ain't the internet amazing?)--may be wondering: "Where has he been?" The last post was February 9, and today is February 17.

Previously I have been writing and posting regularly, several times a week. Why am I no longer writing and posting regularly? Have I been on vacation? Did the high blood pressure finally get to me and give me a stroke (or since we all need the good kind of strokes, at least a pat on the head?)

The answer will be familiar to so many writers who have a day job: I was back at "work"--i.e., paid employment (where they have to pay you to do it, unlike this blog). In a tragic turn of events for blogdom, the blogosphere, blogoscety or whatever, after six months' medical leave I returned to my full time employment this past Monday, February 12. It was and was not a graduated return to employment, as I returned full time, five days a week, but to less work.

This post, which is kinda on the long side, should make up for my absenteeism from this blog. Hey, friends, it ain't like you're paying for it, eh? On the other hand, writing this blog is obviously important to me, and daddy missed his baby. Returning to work full time after such a delay was hard emotionally and physically. You may weep for me now.

Why hard emotionally? The type of governmental investigation work I do can be demanding and stressful. I investigate complaints that a certain law has been contravened. The law itself is complex. All facts must be weighed against the law itself, my employer's policies, and court rulings. That alone is hard enough, getting it all correct.

As a neutral investigator I can not automatically believe anyone is telling the truth--if the truth were obvious, an investigation would not be necessary. So I must start out by being suspicious of the "Complainant" and the "Respondent" and the information they have provided. Taking nothing for granted, being suspicious, is a fundamental part of the job. And what you do eight hours a day, five days a week, affects how you see people and life after a while, eh? Especially after 19 years. So, that I find difficult. It is difficult for the suspicion not to leak over into the rest of your life. It is difficult avoiding having your mind poisoned by it.

It is my job to interview everyone involved in a complaint file, interview witnesses, review relevant documents. Think the tv show "House", but without saving anyone's life. You're kind of a Sherlock Holmes, digging for the facts. And it can be easy, like Dr. House does, to conclude that the "patients" often lie. This can colour your view of humanity, which I again find hard. Dr. House, also, can be sarcastic with everyone around him. I, like most of us, can not.

Most people DO tell the truth--but it is the truth from THEIR perspective, of course. We all see events from our own point of view. No one person's version is usually completely accurate, because of self-interest, because of seeing only part of the whole picture. Roshomon, anyone?

What makes it more difficult emotionally is that you have to make a recommendation, once the investigation is completed, as to whether the law was contravened. One side is right, or at least more right, than the other. Meaning, using simple arithmetic, that half the main parties will be real unhappy with you. If you recommend the complaint was substantiated (proven), then the "Respondent" is angry. If you recommend that the complaint was not proven, then the "Complainant' is angry. Either way, if you are a sensitive person (and golly, that is me!--heck, I'm a writer, so by definition I'm sensitive...or at least unpleasant to eat with) it is difficult.

Believe it or not, at times neither party is happy with you. As an example, once my investigation supported a person who complained. So, the "Respondent" was upset. But then the Complainant complained to my Director that my report did not support him strongly enough. Go figure! Sometimes you can't win.

And, of course, it always seems to be open season on civil servants.

(Does this sound like whining? Well, are you not whining about me whining? Instead of whining at you, would you prefer I was wining and dining you? If so, do you prefer red or white? Actually, a drink doesn't sound so bad right about now.)

Also, for me anyway, people take a lot of energy I'd rather divert to writing. While I was at home on sick leave, my contact with people was relatively limited. Okay, yes, I may not be the most social person in the world. For example, I've been involved with the local science fiction convention since 1995 but have yet to attend any of the convention's two yearly "socials" (a Manitoba type of big party). Missed all 22 of them. So, okay, yes, I'm a hermit. And I'm something of a misanthrope (well, actually I am an optimist about people who is very frequently disappointed--is that the definition of a misanthrope?)

I find relating to people takes up energy, even when I enjoy it. And I do enjoy people, pretty much. But at home for six months, I related to people in a limited way, and concentrated on writing, which was fabulous. Isn't it ironic that writing is about people? Now I'm back in a situation where people are around me all the time. It isn't "quiet". Where is my room of my own (well, I do have an office and I can close the door. On the other hand, I leave the door open, and bring in chocolate to work to encourage staff to come in and talk to me 'cause I'm no good at going into the coffee room and chatting there)?

Uh, maybe I'm giving you the wrong impression about what I think of other people.

I do have a friend. Or two. Well, actually I'm not sure I have any friends, but I do have a lot of acquaintances! And, uh, well, I've been married for 31 years. I have two grown or growing children. My dog wags its butt when I come home. The cockatiel sits on my shoulder and poops on me.

Why have you put me on the defensive?

In terms of it being hard to return to work, there is also the physical component. For six months, I carefully controlled what I did and when I did it. I could take naps in the afternoon if I got tired (which was pretty much every day, given the prescription medications I am taking). My physical activity was limited. I'd wake up, drive my daughter to school and my wife to work, and then be alone to take my meds, read and write, make lunch. I'd go exercise, but you don't have to talk to a treadmill. And all the people exercising in the gym listen to music on headphones, so there's no chance of an idle conversation. I could control my environment and direct my energy towards where it was most needed.

However, when you return to work, heck: you can't control much.

I'd get phone calls (although it took a week to get my original phone line back, so I'd get calls but could not easily get messages), friendly staff would come in and chat, I'd write investigation plans for the new work I was assigned, do phone interviews--it all took some energy. Getting up to go to the printer, the fax, the photocopier. And by the end of the day, I'd feel drained after 'pumping it up' for work all day. And, as the work starts to become more complex the deeper I get into each file--not just reviewing a file and writing a plan, but starting to field phone calls from the parties, interviewing witnesses and so on--juggling the six new cases I have been assigned becomes incrementally more difficult. One result? No energy to write when I got home each night.

Is my job or situation the hardest in the world? Nope. Not by a long shot. Children around the world live in poverty, some people have horrendous jobs that drive them mad, people are poisoned by toxic waste. But for me, it's difficult. Is this like "the pain of my cut finger is far worse than the death of ten thousand people in another country?" Yes. Such is humanity and how it works.

This does sound like whining, doesn't it?

So.

Yes, Victor DID make it through the week. But it leaves me wondering what next week will be like, and what the week after that will be like. How long will I last, watching the destruction of the successful hard work I did in bringing my blood pressure down? I am watching my recovery's progress slowly disappear, bit by bit, each day.

I am taking my blood pressure at work regularly, as per my doctor's orders. When I am just sitting reviewing a file and typing up an investigation plan, my blood pressure is usually no higher than 145 systolic (before my return it was steadily well under 135 or so; in the mornings before I go to work, it can be 125). However, when I am talking with a client on the phone, doing an interview, or dealing with, uh, certain administrative issues, my bp rises to above 150 systolic. Once it was 161, and it hasn't been that high for months.

Am I being a bit evasive about some of the issues at work which appear to be increasing my blood pressure? Well, internet blogs are available to anyone. Does my evasiveness about work sound familiar to anyone else who works?

Anyway. At least I can get this writing done because it is Saturday, and I have the weekend. Of course, now I have to go out and run on a treadmill to nowhere. Yeah yeah, tell me I'm running to good health. No wonder I'm a misanthrope, with remarks like that!

You are allowed to weep for me now, if your eyes are not already bloodshot and aching from reading all this.

Friday, February 09, 2007

Story: Understanding Sex

There was so much he did not understand about sex.

Why did it have to be so wet? Whether on the bed, couch or floor, there was always a wet spot; sometimes, a puddle. He tried tissues, towels, dehumidifiers. Nothing worked. And it was only worse with someone else.

He did not understand what attracted him to a woman or what attracted women to him. He did not understand why breasts attracted anyone other than hungry babies. And he did not get buttocks at all. He did not understand all the movement, pushing and sweat.

Giving the woman some attention, or something, seemed necessary before having sex, but after the first time, why do it all over again?

Unfortunately, all his questions remained unanswered as he never had sex with anyone a second time, except for himself.

Victor Schwartzman
victors@mts.net

Poem: How Many Ways Do You Masturbate?

How many ways do you masturbate?
So many, I run out of fingers counting them:
having sex with someone who really loves you
proposing your brilliant ideas at a meeting
talking about giving the poor money
sending emails to friends when your short story is published
looking into the mirror as you try different comb-overs
reading Joyce when someone else is looking
taking dates to movies with subtitles
rooting for the team that is winning
telling parents about that possible promotion
owning an SUV
wearing the latest fashions
attending the best parties
going to the gym to sculpt your body


See? I’m starting to run out of toes now.
writing a poem

Victor Schwartzman
victors@mts.net

Friday, February 02, 2007

Hypertension 34: Emotional Balance

One of the toughest parts of taking some prescription meds is knowing what you are really doing. Who you really are. What impact you are really having on the people around you.

I always used to think I was calm and collected. It took years to realize I was not all that calm, not so collected. In fact, I eventually came to realize I am downright intense. And when I am in tents, it usually rains. And when it rains, it pours. Maybe that's why I'm in tents, to avoid the rain. One thing leads to another.

Okay, although I'm writing this, I'm avoiding it.

I expect I've always had a tough time seeing myself as everyone around me does. Yes, when I got angry I would know it. Usually. Mostly. Well, not always. But I would always recognize it afterwards. And apologize.

In particular, it has always been hard to know when I am being too pushy, too intense (when people stay in tents in the park, they are assaulted by bears, which I find unbearable, often because when you are in a tent you're bare). I get 'enthusiastic' and push an issue. But maybe that was just my cultural upbringing. I was born and raised in Brooklyn, after all.

My parents loved to argue. They were Communists, actually--idealists from the Golden Age of the Worker. Workers had every right to expect a Golden Age, but all they really got was Golden Arches. As idealistic commies, argument was their lifeblood, a way of exercising their religion.

So I enjoy a good argument. And that has not always gone down well in Canada. People here are very polite. Someone who argues is...of concern. Aggression here is not appreciated.

But it was a lot worse--hindsight tells me--after I started taking prescription medications for Hypertension. Perhaps it was exacerbated by a feeling of weakness, dizziness, difficulty in concentrating. Who knows?

At the time, it all seemed normal enough. But looking back, I was irritable almost all the time. Though I thought I was taking everything in my stride, in fact I took almost nothing in my stride (unless by that I mean walking all over it, stomping on it, and then kicking it a little).

And: combine drug-induced irritability with fear to really goose up the anger factor. Fear. Fear about whether I would croak from a heart attack, get paralyzed by a stroke. Fear about losing my eyesight.

It is hard to know what's going on with an underbelly of fear. It's not like the underbelly is an overbelly.

It was like washing with sandpaper, rubbing me raw.

And without having a clue about what was really going on. Always thinking I was being reasonable, that everyone else was not getting it. Reality never kicking in--at least, not until later.

This is not an excuse, just an explanation. I take full responsibility...even though it was the medications, of course, the meds!!

Thursday, February 01, 2007

Hypertension 33: Could I Afford Hypertension Without Socialized Medicine?

32% of this blog’s readers live in Canada. 48% live in the United States, the other 20% live elsewhere. The way I'm feeling at the moment, I need to say to the 68% living outside Canada: socialized medicine works.

You get the doctors you want, you get the services you want. You pay once, through your taxes. There are some waiting lists where I live, but my Province is rural--it only has one million people, and not the resources necessary to maintain a large number of specialists.

I did not have a family doctor when it was suggested I had Hypertension. I found a doctor by calling a government help line, where I was given the names of three family doctors. If I did not like any of those, the line would give three more names.

Don’t believe anyone who tells you that the government medical system in Canada forces a doctor on you. Ain't true.

All of my physician expenses are paid. Yes, I pay for it through taxes. I have not done a study to determine if I pay more than I would in the US, with private medical care such as an HMO. But I can say my taxes are not much higher than those in the U.S., and that they do not go up, no matter how often I get medical care.

To give my fellow Americans an idea, in particular: the second time I had kidney stones, I was in a hospital emergency room twice. The first visit, I was seen by a doctor, had X-rays, was given medications, and was discharged with pain medications. When that did not work I returned to the emergency room, had more X-Rays and medications, and then had minor surgery (the doctors went in and got the stones--don't ask).

Total cost? Nothing—it was all covered.

A relative in the U.S., who works in medical administration, was astounded. She told me you can’t breathe the air in a U.S. emergency room for less than $1000. How many people go into hospital in the US and are saddled with huge medical bills? How many life savings are wiped out?

When my mother first came to Canada five years ago, after hip replacement surgery, she fell and dislocated her elbow. She went to another hospital here, had two sets of X-Rays, was seen by a doctor and an orthopedic surgeon, and had her dislocated elbow repaired. She was legally a “visitor”, so she was charged—a total of $175. What would that cost in the U.S.?

Now that she is a "landed immigrant", her medical costs are completely covered.

Just thought I’d make these points, as there is a lot of misunderstanding and misinformation in the U.S. about the Canadian health care system.

Monday, January 29, 2007

Story: You Can Change

On January 2, Janet put her New Year’s resolution into effect at work. The resolution was made after she saw her manager stiffen as she had described her concerns about a rule he had just implemented. Thinking about it, she had an epiphany: something in her manner had put him off. She knew what to do.

On March 4, none of Janet’s colleagues supported her ideas during a meeting, even though they were much better ideas. Thinking about it afterwards, Janet had an epiphany: she had not talked up each colleague before the meeting. She knew what to do.

On May 6, Janet lost a promotion to another colleague, even though she knew her work was superior. That evening, going over her employment history, Janet had an epiphany: she realized that she never went out to lunch with any of her colleagues, socializing. She knew what to do.

On July 8, Janet

Later that night, looking at a full moon, Janet

When Janet looked into a mirror, she saw someone else.

Story: The Man Who Learned To Lie

Harry came out of the womb quite honest.

But growing up, watching his mother and father, he learned the value of small lies. Lies about weight to not hurt feelings, lies about relatives they pretended to like, and, when he asked why they lied, lying about lying.

As an adult he also found periodic lies very useful. Truth hurt people. It was easier and less disruptive to lie--and if not to lie, at least to avoid the truth. Everyone felt better if he avoided the truth.

He learned further lies, and picked up some excellent techniques, by watching television commercials, listening to politicians, and reading newspapers, novels and almost everything on the internet. Lies were normal.

But although everyone felt better because of the lies, he eventually realized that if he was lying to other people, they were all lying to him. Harry began to get depressed. He did not know who to trust, or what anyone really felt about him. People who smile at him whether they liked him or hated his guts.

He began using drugs.

When his doctor told him to stop, he lied to his doctor and said he had stopped. He then lied to himself that he would stop. He continued lying to himself right up to the day he died from an overdose.

Hypertension 32: Returning To Work

Today I met with my Executive Director, my union representative, and someone from Human Resources. (You may recall I have written that I am a civil servant, of sorts.) The purpose? Organizing my return to the workplace on or around February 12, after being off work on medical leave for five months.

Everyone was very nice. My E.D. discussed me returning to a greatly reduced work load (let's say I investigate individual cases alleging rights abuses), which was appropriate and welcome. The Human Resources person was supportive. Both agreed I should check with my doctors about the return to work plan, to avoid medical problems. The idea was to see how I did, and if I did okay initially, to gradually increase my work load.

Even within that positive context, however, I have worries. The worries are the same anyone would have on returning to work from an extended medical leave, and while still on powerful prescription medications. Such worries are an important issue, given part of the treatment for Hypertension is to reduce stress. Worrying ain't good. It's counterproductive. But it seems to come with this territory.

What am I worried about?

Well, it's easy to be worried that I will not be able to do the work I used to be able to do. My work requires focus, attention to details, a solid memory, being on top of it. Some days, these days, on top of it isn't how I feel. Will I remember everything I have to? In my work I interview people, and it is considered bad form to return a second/third/fourth time to ask additional questions. Will I cover everything the first time around? I used to be able to do that. Can I still do that?

What about controlling my temper? My work involves being diplomatic, appearing relaxed, in control of the situation. Will I get tired and fed up and yell?

In my work situation, and at home, one of the most troubling aspects of my meds was that they seemed to prompt me to be irritable, leading abruptly into anger. That also appears to come with the territory of feeling weak much of the time. One problem with such emotional outbursts is that, when you are in the moment, you think you are being reasonable and normal. It is only through hindsight that you slowly come to accept that you were over the top.

The emotional cues and miscues are subtle, easy to miss--and the people around you do not appreciate it, for some reason, when you get angry with them. I have had to learn through experience what was happening to my mind and my relations with other people. In fact, it was really only after I began taking three prescription medications at once, and the emotional impact was unmistakeable, that I finally began to realize how much I had been losing my anger, and how tough it had been on the people around me, whether at home or at work.

Would I know if I was over-reacting at work, before it got out of hand?

I have no worries about being accepted at work, at fitting in--at least, as much as I have ever fit in, being something of a misanthrope. People like me at work. I give away candy. But I do have worries about remembering appointments and about being "work perky"--y'know, where it's important to be positive and friendly all the time.

And, of course, I worry that although I may start out okay, what would it be like to return to a 37.5 hour week, after five months at home, doing what I felt like (including naps)? I'd certainly have to adjust. And how would I be, focussing and being energetic, five days a week, full time? Would I last a week?

Sounds like I should take a pill, eh? Ah, our society!

Hypertension 31: Disability Lite

I feel guilty.

Guilt has bothering me since I wrote a post comparing my disability with other disabilities when I wrote about workplace issues. Also, it bothered me after writing a post about having Hypertension and how awful it was (well, actually, all the posts are about that!). Most recently the guilt reached a peak as I started to read other blogs and websites which have disabilities as their main focus.

The disability I have, compared with many others, is "Disability Lite".

Although Hypertension can be extremely serious, it is still Disability Lite when placed in the context of many other disabilities.

Shall I be explicit?:

1. If I'm careful, it won't kill me or further disable me. Some disabilities leave you with no choices--unless a miracle occurs, they progressively lead to worsening impacts on your body, until you croak. With Hypertension, you can manage, to a large degree, the course of the disability. Dieting, exercise and medication will normally bring your blood pressure down to a reasonable level. Many disabilities do not come with such options. You can not modify or 'cure' them by living a healthier life. Which leads me to:

2. If you have Hypertension, you have a chance to 'cure' it. Through a combination of medications and life style changes there is the real possibility you can reduce your blood pressure readings to "normal" levels. Probably nine times out of ten--sometimes genetics gets in the way. But there is almost always some hope that one day the disability will be a memory. With many other disabilities, there is no cure. You're stuck with it, you must learn to live with it. Which leads me to:

3. If you can't cure it, at least you can manage the degree of the negative impact on you, avoiding the worst case scenarios. If you have a serious sight impairment that renders you blind, there may be no way for you to regain your sight. A mobility impairment that prevents you from using your legs may leave you with no chance to improve your situation. At least with Hypertension, you can often modify the impact, reducing the worst aspects and dangers. Which leads me to:

4. The day to day impact of Hypertension is manageable, even with the medications. Yes, at times, the impact of the meds is extreme, but you can at least change the meds and hope to find one that won't make you sleep half the day. But sleeping a lot, feeling weak most of the time, ain't nearly as bad as screeching bad migraines or the abrupt loss of certain bodily functions, or even being unable to get out of bed--either by yourself, or at all.

One further interesting point. Many individuals who have specific disabilities are part of a larger community of other people with such disabilities. At times, unique and rewarding cultures are formed--I am thinking in particular of the deaf community. It is not an issue of shared experience, really, but of the disability creating an entirely different way of looking at and experiencing life.

With Hypertension, forget it. Getting together a community around blood pressure patients is like trying to organize the unemployed (which I once spent a few years trying to do). It is impossible to organize the unemployed to protect inequities because, a) unemployed people (like those with high blood pressure) do not want to be identified as being unemployed people, and therefore reject the notion of them being in a community... and b) unemployed people are "temporary"--they are unemployed today but when they get a job tomorrow, they're outta here. It is no different with a Hypertension patient who manages to get his or her blood pressure readings down to "normal"... and c) Hypertension patients see no value whatsoever in having high blood pressure, and unemployed people also see no value at all in being out of work.

Thursday, January 25, 2007

Hypertension 30: Juggling As A Life Style

Ever watched a juggler who is working hard? A juggler juggling juggle-type things—knives, chainsaws, flamethrowers—while maintaining your balance standing on a wooden board supported by two rolly polly metal cylinders? Maybe while on a small boat in the middle of a storm? And not wanting to do any of it, but there is no choice?

Welcome to life with Hypertension: dangerous, unpredictable, requiring total focus.

Dangerous? If you do not juggle your things properly (does that sound quite right?), you could end up with a stroke, heart attack, kidney failure—the list is pretty long.

Unpredictable? No one knows how a medication will affect you until you gulp it down like a guinea pig. And how you eat and when you eat it can give you energy or not, fatten you up or not. And if your teenage daughter keeps talking to you while you are trying to write something like this—will you take it with good humour, or get furious?

Focus? It is easy to drive through a stop sign, eat too much, forget to take your medications, lose your cool.

Sure: say I’m overdoing it. But: does not Hypertension come, in part, from overdoing it? From being stressed out so much that your intensities raise your blood pressure? Perhaps it’s in my nature. Perhaps I should strip myself of the intensity, go au naturel, buff it up and face the naked truth. Easier said than done.

You must balance eating and what you eat, sleeping and when you are awake, when to take the pills, when to move around, when to lie still.

Used to be, I never ate breakfast, but would have a cup of coffee in the morning and then eat a decent lunch at 11 am. These days if I wait until 11 to eat, I’ll need a nap.

No, hungry or not, I have to eat something first thing in the morning. Then I have some energy. However, if I do too much physically—say, go shopping and stay on my feet for two hours—I’m worn out. I have to pace myself. But I’m not ninety, I’m sixty-one. (Okay, you’re twenty-one? Bite me. (I’ve never understood that phrase, “Bite me.” How does inviting someone to hurt you qualify as a comeback?))

Then there is eating, one of life’s great pleasures. But you always have to balance how much you eat with what you see on the scale. The medications make me feel weak, so naturally I want to eat more, to get energy. But I am supposed to lose weight—made doubly hard because the medications also lower my metabolic rate. So how weak should I start to feel before eating something? And what should I eat? The answer is not three squares a day, but six or seven much smaller meals during the day. But none of it includes rich ice cream, which fattening-wise is like eating a glob of lard.

If I am careful, balancing how much I do physically with when and what I eat with not too much coffee with not too much physical activity with enough sleep the night before, I can make it through the entire day without a nap—but then I’m ready for bed at 9 pm (instead of when my former 11 pm).

It is like being in a cage. And that is another balancing act, keeping the different frustrations in check so they do not become overwhelming. Irritability leads to anger, weakness leads to depression. If you’re not watching, it sneaks up on you before you know it has arrived.

Does this sound like whining? Maybe it is. Reasonable concern or whining, whining or reasonable concern—it’s a juggling act, I tell you….

Thanks for listening, because, frankly, no one else want to hear it--right? been there?

Thursday, January 18, 2007

Story: The Lawyer Who Loved Money

Melvin loved money. A successful commercial attorney, at first he enjoyed making the money he made from law suits into suits. He would stare at himself in the mirror, dressed in a nice three piece made of twenties, and feel a thrill. In time, he grew to love money so much that he ate it. He preferred hundreds, nicely washed with a taste of Caesar dressing.

His unusual dietary habits actually attracted clients. They figured anyone that hungry for money was their kind of lawyer. Sadly, it was doomed. He could not keep himself from eating, and as it grew worse he began dining on withdrawals from his clients’ accounts. He kept putting off his clients, giving them table scraps, but one day several of their new lawyers turned up angrily at his office. Melvin shoved thousands of dollars into his mouth in front of them until he turned green and paper thin and anti-counterfeiting measures appeared across his face and then Melvin was lying on the floor, brittle and wrinkled.

The other attorneys looked at Melvin a long time, then took him to the park and had a lovely and delicious picnic.

Story: The Politician Who Got Smarter

When Charly Humble was elected to Parliament, his IQ was 134. After eight years in office it dropped to 129. When he was elected Prime Minister, it sank to 98.6.

But then a terrorist blew up a building. Charly toured the wreckage, made a speech and looked strong. His approval ratings shot up, and something remarkable happened: the higher his approval ratings climbed, the smarter Charly became. His IQ was 98.6 on the day of the bombing, but after showing up at the site and looking like a leader, it rose to 115. After speaking on tv about standing up to the terrorists, it rose until he became almost as smart as he had been before he entered public life.

Using his new intelligence, Charly realized the connection between his ratings and increased brainpower. Knowing that if there were only a few more events, he would become a genius, he decided to start a war. It worked--but only at first. The war dragged on until his poll results plummeted, followed of course by a similar sharp drop in Charly’s intelligence. When he became an idiot he did the smart thing and stopped the war.

He eventually retired. An honourary degree stabilized his intelligence, and his public pension was significant.

Tuesday, January 16, 2007

Hypertension 29: Playing By The Numbers

Wait for it: more than many other medical conditions, Hypertension (including weight/fat) are weighted down by weighty numbers. Tom Waits should sing about it.

Last week, just before I got the flu, I met with a phys/ed person at my speciality gym to get the results of my stress test. The stress test, taken in December, involving having my chest shaved so electrodes could be attached, and then putting me on a treadmill and making me walk fast until I almost wet my pants--at least I was panting a lot. They also took some blood, and measured my blood pressure. I should add that they were very nice about it.

The objective of the stress test was to see what kind of shape I was in, and whether I needed any specific programmes. For the results, I met for an hour with one of the phys/ed persons. She explained everything. In the end, it was all about the numbers.

To wit:

My cardiovascular endurance, measured in METS, was 7.3. This was average for someone in my shape, including my weight. According to the paper she gave me, "One MET represents the rate oxygen is consumed per kg. of body weight per minute at rest--i.e. 10 mets is 10 times oxygen consumed at rest." Got that?

My heart rates, per minute? Resting, 71. Maximum (when I was plugging away on the treadmill, bravely telling the young women watching me I was okay and they did not have to slow it down--would I have been as brave if they were young men?), 131. Sub Maximum was (6.4) 118. Submaximum rates are "valuable indicators" for the effects of exercising. Again, my numbers were about average, given my physical shape (round).

To achieve optimal aerobic capacity, I was encouraged to work towards a target heart rate range of 70-85% of my maximum, or between 95 to 115 beats per minute, or 16 to 19 beats per second.

My weight in kilograms was 102 (remember, I'd been gaining weight as the new meds make me less energetic while reducing my metabolic rate--get that look off your face!). My BMI (weight to height squared) was 34. My waist was a waste. It was 112 centimetres (NOT inches!), with an immediate goal of reducing it to 108. My waist/hip ratio, "F-<0.8/M-<1.0" (huh?) was .99.

The analysis of my blood yielded more numbers.

My cholesterol was at the top end, but not completely desperate: 5.2. The anti-cholesterol drugs had something to do with that. My good cholesterol, the HDL stuff, which should be between 1 - 2.6 mol/L, was 1.1 That had to go up. The cholesterol/HDL ratio (<4.5 mmol/L) (huh?) was 4.7, while my bad cholesterol, the LDL stuf, which should be no higher than 3.4, was 3.1. The bad number should go down.

Triglycerides? Should be 1.7, was 2.25. Blood glucose levels, which should be between 3.1 - 6.4 mmol/L, was 5.6. Hemoglobin was 144.

Finally, the blood pressure I had just before starting the stress test was 126/92. The 126 was fine, but she wanted me to get the diastolic reading down to 80 (remember when one specialist told me that, after the age of 42, that number did not matter?).

Basically, all that means I'm too fat and have too much junk in my blood.

Or: my number(s)('s) up. Hahahaha. The good news is, I'm not dead yet. But next week I will probably have to start lifting weights (that is supposed to increase my metabolic rate--and I DON'T want to know what that number is!)

Oh yeah: I now have to exercise forty minutes, at least three times a week, up from thirty minutes. Yes: more numbers!

Friday, January 12, 2007

Hypertension 28: Search Engine Key Words

Today, home in bed with the flu, and it being -34 outside--hey! it's dropped down from -35 C or is that risen up to -34C?...and...at these temperatures...who cares?--I have time on my hands.

This blog is tracked by a free counter from Extreme DM (why not give them a plug, the counter is free). This morning, I checked "referral" sources through the tracker, to discover what turns Google searches onto this blog. Knowing what generates a Google "hit" is important, because a reader finds your blog/web site through "key word" searches.

So, for example, the tracker turned up one reader who'd typed in "spitting up blood" and ended up here (because of a description of spitting up blood when brushing my teeth). Interestingly, the person was in China, judging from the Chinese characters on the top of the page. In this person's search, a number of pages which mentioned "spitting up blood" also popped up. Some of them were about other diseases, some were about, well, naughty things. Google does not discriminate!

This got me to thinking, which can often be dangerous.

I do want people reading this blog, both to inflate my ego and to spread information about Hypertension (guess which is more important to me). And certain selected key words will cause this blog to come up on Google. So the more "key words" that I have on this blog which will generate Google "hits", the better!

Therefore, I have now written this post, for the sole purpose of containing a list of key words which are guaranteed to generate a "hit".

Some words belong here. Some are just here to generate a hit.

Also: I've noticed that some illiterates (like me) on occasion spell Hypertension "Hypertenson", generating further hits. Hey, anyone can have hy blud pressyur. Is spelling properlee a good idea, then? Which is witch? While it may be an oxymoron to appeal to readers who can not read (okay, can not spell, it is not the right definition of oxymoron, just ironically call me Alanis), but the need for fifteen minutes of fame is too intoxicating to ignore.

So here's the list:

Hypertension
Hypertenson
Hypertensdaughter
Blood
Blood Pressure
High Blood Pressure
Stoned Blood Pressure
Medicine
Meds a sin
Prescription Medication
Over The Counter Medication
Jump Over The Counter To Get The Medication
Counter The Medication To Make Sure You Goter All The Pills
Sick
Sex
Sick sex
Stress
Breasts
Stressed Breasts
Tension
Breasts
Tense Breasts
Anxiety
Breasts
Anxious Breasts
Worry
Ass
President George W. Bush
Worried Head In Ass (we're back to President George W. Bush)

Hypertension 27: Medical Condition vs. Medical Condition

At this very moment, I am sitting in bed, laptop on my lap, nose stuffed up from a flu which my spouse graciously passed on to me. Outside, it is -35 Celsius, with a windchill bringing the temperature to around -48 C--but living in Winnipeg is a whole other tale. Right now, while eating some beans, my foggy brain began to compare Hypertension with other diseases.

I may have even written of this before. There was some of it in the posting about Hypertension being a disease of fear. There was also a bit of a comparison with other serious medical conditions in the post about the workplace (and I felt bad about comparing one disability to another in terms of impact). But, right now Scarlett, I am blowing my nose & don't care if I am repeating myself. I consider myself lucky to be conscious.

So here is a list....

With many medication conditions:

1. You can be cured. Hypertension, so Western medicine says, you must live with. Yes, you can eventually get better by dieting down to 120 pounds, but that's kind of a long shot.

2. You know the cause (which means you have an idea how to cure it, if possible): a virus, an accident, etc.. With Hypertension, one specialist told me that in 90% of the diagnoses, the doctors have no idea where the high blood pressure came from. Overweight? Genetics? Diet? Lack of exercise? Stress? Hey: one guess is good as another.

3. You can blame the condition. With Hypertension, you are often left thinking you should blame yourself (please see item #2).

4. The treatment does not involve seriously altering your lifestyle--often you can take medication & that's that. With Hypertension, a "lifestyle condition", you must not only take the meds, you must make life changes. Stop eating what you obviously enjoyed because it isn't good for you. Exercise regularly in a facility or by rowing to nowhere on the floor of your living room. Emotional changes--not getting upset.

5. You do not worry it will get worse: the condition is there, you got it, no matter how horrible it is you know what to do and can cope. But with Hypertension, your blood pressure can always go up. Worse, Hypertension can directly contribute to a worse condition that can further disable you--a stroke, heart attack, sight impairment, kidney disfunction (or dat function).

6. You do not have to deal with yentas. Do you not know what a yenta is? A yenta is a kvetch, your Aunt Matilda or Uncle Morris who, well meaning, burrows into your life with good advice. So, if you have smallpox (I have picked an extinct disease, not a condition, so as not to offend anyone who has the disease/condition) they leave you alone. But with Hypertension, you get: "You're eating THAT?", "You look like you're putting on weight, shouldn't you be losing it?", "Why didn't you go to the gym yesterday?", "Don't get so angry about what I did...it'll just make you sicker", and so on.

Wednesday, January 10, 2007

Story: The Best Laid Plans

The country’s birth rate was dropping. A forward-looking Government, worried about the shrinking population, developed a fertility serum. The Government, eager to create a new society, encouraged people to have more children by offering them the fertility serum for free, providing pregnancy bonuses and renting hotel rooms for qualified couples.

Many took the Government up on its project. It did a fine job of public relations and soon the birth rate was set to rise dramatically. But then a disturbing truth surfaced. When taken in combination with certain foods the serum made anyone who took it sterile.

On the positive side, in the government’s new society there were fewer ulcers and, eventually, none at all.

Victor Schwartzman
victors@mts.net

Story: Downsized

When international competition cut the profits of The Soft Flower Company, the CEO knew it was time to be mean and for someone else to be lean. None of the long time employees knew exactly what was planned for them. Theirs had been a pleasant company to work for.

It was still kind of pleasant after thirty percent of the workers were laid off, even though production increased ten percent. After overtime pay was eliminated and sick time was reduced, however, it turned grim. The remaining employees did not complain, glad to keep their jobs.

Profits rose. The remaining employees, who were stockholders, were happy. The managers were happy with their bonuses. For his own bonus, the CEO bought a third house and the airplane to fly there.

He could have stopped, but by now the CEO was enjoying himself. He decided that the natural progression of his new management plan was to not just make the employees feel smaller, but to actually make them smaller as people. So the next week he introduced random drug testing, then he placed video cameras in employee washrooms, and by the end of the month had all the employees in cubicles.

The changes eventually had the desired effect.

Soon each employee shrank psychologically until they were in a unique way downsized. Even their immediate families shrank morally and then ethically, in a trickle down effect. It was not all bad, however, as new employment opportunities opened up for the morally stunted employees. For example, an HMO needed people of a certain stature for its Board of Directors, and several Soft Flower employees made the short list.

Victor Schwartzman
victors@mts.net

Wednesday, December 27, 2006

Hypertension 26: Leaders and Diseases

Leaders and diseases. They have so much in common.

You can probably guess where this is going, especially if you keep up on current affairs.

One of the nastier parts of Hypertension is that you have to give up all the great (but awful) stuff that probably helped develop your Hypertension to begin with--not that anyone actually knows where your (or my) Hypertension comes from, just to complicate matters. One specialist told me that 90% of the time no one can tell a patient where her or his high blood pressure came from. It could be lifestyle, genetic, weight...who knows?

Neither does anyone know where our Leaders come from, except I suspect they are manufactured in a special basement room of an ivy league school in Hell.

Despite our lack of specific knowledge, it is fair to write that Hypertension probably comes in part from enjoying all those great things of life:

eating crap
lying on a couch avoiding physical effort of any kind

Well, okay. Those are only two of life's great things.

But we all enjoy eating crap, aka processed food: chips and dip, ice cream, fast food fried chicken (which is morally repugnant, especially if you are a chicken), junk burgers, pizza...the list does go on. It's all food for the soul, to make us feel better. And since our society is soul destroying, we need that food a lot--which is why it is so popular.

For example, frozen chicken pot pies. Used to love those, especially when I had a cold. Great combination of pastry and chicken gravy (or whatever it was) with bits of what could have once been chicken, along with what may once have been vegetables. Unfortunately, look at the label and you'll see each tiny pie has around 27 grams of fat and the nutritional value of a bag of broken glass.

As for the other great life thing: yes, lying on the couch, watching idiots on tv being paid enormous salaries to entertain us. Or, reading a book/listening to music (if you want to be some kind of intellectual). In short: doing nothing physical. Doing something physical is hard work. Apart from sex, who needs that? And even with sex you sometimes have to wonder, especially with all the wet spots afterwards.

Why should it be wrong to drive to a grocery store a block away to buy a tub of extra rich ice cream? Is this not where the entire thrust of Western Industrial Civilization has led us? Is this not what our Leaders have given us?

But we all know that Life is unfair. If Life was fair, there would be no diseases. There would also be no Leaders to start wars, no Leaders who've never fought in a war who send someone else's children to fight, no Leaders who use soldiers who have died to justify more soldiers dieing.

Who said we get the leaders--and diseases--we deserve???

Apparently, Life does.

Where is my ice cream? The couch calls to me.

Late night update. It's December 29, 2007. Saddam Hussein was executed today. He was a truly evil despot. The U.S. invaded Iraq to install a democracy and get rid of him (it tried to kill him, first, through a 'shock and awe' bombing attack, but only killed a lot of civilian neighbours instead). The installed democracy killed Saddam, as punishment for him having other people killed. Sadam executed other people, the democracy executed him. Does murder stop murder? Is it me, or does murder seem to be a vicious circle?

Saturday, December 23, 2006

Hypertenson 25: Living In Fear

Having any medical condition creates fear in the patient. Hypertension creates more fear than most, however. It is a disability of fear.

Unlike almost all other serious health conditions, you usually feel fine if you have Hypertension. The only tip-off that you have it comes when you are diagnosed. I had no idea I had Hypertension until I was in the emergency room with kidney stones, and the nurse took my blood pressure. The issue with Hypertension is what it can do to you in the future, not what it is doing to you now. That is where the fear factor comes in. Fear of the future.

Hypertension increases your odds of getting a stroke, a heart attack, damage to your eye sight, kidney problems--the list is kinda long. The higher your blood pressure, the worse the odds get that Hypertension will create or contribute to health bad news. This creates fear. The higher your blood pressure numbers, the worse the fear.

This is horrible to write, but with diabetes, you know what you have, and you feel it right away. If you have a mobility problem, from polio or another medical condition, again you know what you have. You then worry about how to cope with the condition itself. With Hypertension, the symptoms are all hidden. You feel fine. You are not worried about coping with the condition as such, and the drastic impact it can have on your life. It is awful to write this, but if you have a problem with your legs not working, at least you know what you got & what you got to cope with & what you got to do. It is "concrete". With Hypertension, you're never at such a "practical" stage. You worry about what could be, not what is.

Hypertension leads to fear, also, at work. With a clear cut physical disability--sight impairment, for example--again you know what you have, and how it should be accommodated in the workplace. The situation is concrete, the solutions clear. The case law is substantial, to help you. If you have carpel tunnel, you know what you have to do in terms of repetitive strain. You can cut back on certain work, get an ergonomic keyboard, take other steps.

With Hypertension there are no such simple solutions. Again, it troubles me to write "simple" about such difficult health conditions as repetitive strain injuries or sight impairments. But at least those are concrete, with concrete approaches to resolve workplace difficulties. With Hypertension, you can be afraid to raise the issue with your employer.

That is because in the workplace, the way to "treat" Hypertension is to reduce stress. Reduce stress, you lower your blood pressure, at least temporarily. This creates enormous problems in today's workplaces because stress is often the name of the game. Yes, Hypertension requires changes in your entire lifestyle--in what and how much you eat, in exercising, in reducing stress at home. But as noted in another post on this blog, we spend about half our conscious time at work. What happens at work has an enormous impact on our lives.

Raising any disability issue at work can put you into conflict with your employer. Having any disability can put you at risk. But the law recognizes physical solutions to disabilities. Hypertension is in another category.

In workplaces these days, there is a huge pressure these days to produce, to be "competitive", to avoid having your job "outsourced" to another country, moved to another Province or State where the business can get a better deal, given to an unemployed person eager for a job. Union representation has been dropping for decades, and without a collective agreement workers must rely on labour laws. Labour laws are very weak. Where I live, an employer can legally fire you for almost any reason--how you comb your hair--and your only recourse is a civil law suit. Civil law suits are expensive, with no guarantee of success.

To eliminate stress at work is to often put you into direct conflict with your employer--it can mean reducing your productivity, for example, which is the opposite of what the employer wants. And if your employer reduces your productivity to accommodate you, then heck & by gosh them proverbial ol' floodgates open up and every worker will want to work less (or so the manager's fairy tale goes).

Helping someone with stress is not as simple as getting a better computer monitor or building a ramp over some stairs. That stuff is concrete. But stress? Everyone is stressed at work these days. If they complain, they risk being terminated (a much better word for it than "fired", don't you think?). That is, again, where the fear factor raises its nasty fangs. You are afraid to seek solutions because chances are those solutions will put you into direct conflict with your manager. You will be seen as non-productive, as avoiding work, as weak. Lowered productivity makes the manager look bad, to add to the problem.

This makes Hypertension a condition of fear. You worry about what it could do to you in the future. Raise it as an issue at work, and you risk losing your job. And, ironically...you've seen this coming...all that fear...creates more stress...which makes your Hypertension work.

The whole thing is a vicious circle.

I need some ice cream.

Except it will increase my weight.

Note: Yes, 'Hypertension' is spelled incorrectly in the title of this post. I had not spelled it correctly in a much earlier post, which I discovered when I misspelled Hypertension as 'Hypertenson' when typing it into Google to see if my blog was listed. 'Hypertenson' caused this blog to make the first page of Google--if someone typed 'Hypertenson' instead of 'Hypertension'. I corrected that spelling...but since then I have thought, should I not appeal to people who can not spell?

Okay okay okay. Frankly, it's fun being on the first page of Google--just ask Frank if you don't believe me.

Friday, December 22, 2006

Hypertension 24: Have A Disability? Do You Work?

Most people do not understand their rights in the workplace when they have a mental or physical disability. This post will give you some basic information about such workplace issues, including the process of being hired, what happens on the job, and what happens should you lose your job.

Although my information relates specifically to Canada, our laws are almost identical to those in the United States. In Canada we especially follow US law, just like we eagerly take its money. It does not always work quite that way in reverse--try cashing a cheque in a US bank. Human rights law in Europe is similar, but my knowledge of the law outside North America is weak.

Human rights is defined, in the context of North American law, as being being treated differently from other people because you are a member of a "group". That is, with respect to work: you are not hired, do not get a promotion, or get the lousy shifts because of your age...your gender...your religion...your sexual orientation...and so on.

Similarly, in human rights, you have some protections if you are treated because you have a physical (or mental) disability--i.e., if because of the disability you do not get hired...get that promotion...and so on. To ensure that you are not treated unfairly because of your disability, the law can require an employer to "reasonably accommodate" you. "Reasonably" is never definited, as it is specific to the individual circumstances. Accommodate means to take a positive action which eliminates the negative impact of the disability.

Various issues are addressed in reasonable accommodation. For example, even getting into the workplace (you can not make it up the stairs), use the workplace washrooms (not large enough or no hand grips built into the wall), having an inappropriately laid out workspace making it hard or impossible to do your job, and so on.

What is a disability? A physical or mental health condition which prevents you from enjoying the same benefits of life as a person without the condition. As noted earlier, how to "reasonably" accommodate a disability depends on the circumstances.

For example, say you have a mobility impairment. The building where you want to work has stairs in the front. It may be unreasonable not to offer you a job simply because you can not get up the stairs--if a simple ramp costing $1000 would do the trick. This is especially the case if the building itself is open to the general public--the law requires that if it is open to the general public, it should be open to everyone. This is why buildings built over the last several decades have ramps automatically constructed next to the front steps.

However, say you can get into the building by using a ramp, but the only place where you can work is on the third floor. There are internal stairs, no other way to get up to the third floor. The only way to overcome the internal stairs would be to install an elevator. Building an internal elevator can easily cost $150,000 or more. That kind of cost would normally be considered unreasonable--prohibitive.

One exclusion from such a cost could be if it is a government building. It is harder for a government to claim it can not afford an improvement--all it has to do is raise taxes. A private employer is different--the smaller a business, the less can be expected of it. Everything in any law lies in the details. Or is it the Devil that is in the details? Or both?

What if you have a disability when applying for a job?

The first issue: you must be qualified to do the job. If you use a wheelchair and are applying for a job in an orchestra as the 'concert master' (lead violin), then you gotta play the violin real real good. However, if you play violin like a wildcat, but are denied a job because of the wheelchair (the orchestra rejects you because it thinks it would be too 'difficult' to arrange your travel or hotel), then it may have broken the law. The orchestra may owe you the job, or compensation (including for lost salary).

What if the work makes you disabled, or if you become disabled while employed? Did you develop neck problems because your computer work station is not ergonomic? Then your employer would probably have to improve your work station--the cost of a proper computer desk, monitor, etc., is not great. Nor is the cost of an ergonomic keyboard if you have repetitive strain injuries in your wrists.

What if you need extra washroom breaks because of a medical condition? A 'reasonable' number of breaks should be no problem--the real issue should be, can you keep up the required productivity? If you need a break every ten minutes, then your employer may have to let you go. But it is not quite that simple--could the employer place you somewhere else in the business--without firing someone to make room for you?

Do you have Hypertension, as I do? Any doctor will tell you that stress is a factor in high blood pressure. Don't be misled into the argument about whether or not stress is caused by Hypertension. That is not relevant. What is relevant is whether stress exacerbates your Hypertension--makes it worse. In that case, your employer may be required to find you less stressful job duties. This is a current major workplace issue, as people work more overtime, have to produce more, have to work harder.

Something else that is important: no matter what the disability is, if you are taking prescription medications, then the side effects of the medication become a legitimate issue. If the medications slow you down, your employer may be required to accommodate you--rather than criticize you or even fire you for slowing you down. This is a tricky issue. Side effects can be subtle. Your employer may think you are a liar.

If you have a disability, and can relate not getting a job or having problems in the workplace to that disability, you should consult your local human rights organization immediately (there are deadlines for filing a complaint).

Tuesday, December 19, 2006

Story: They Talked About Everything, Except What Mattered

He and his elderly mother talked about the weather, about the food in the retirement home, about remembering Dad--they talked about everything, except what mattered.

As she closed in on ninety, their morning phone calls went from discussions to something else. She started asking questions, just questions. After a few minutes of conversation she ran out of steam, and about all she could say would be “What else?” They ended up talking about every topic except the ones which mattered.

Her putting the electric kettle on the stove and turning the stove burner on, that was what mattered. Her forgetting when his wife was flying back and asking him three times in five minutes when she was returning, that was what mattered. Her telling him she had to pick up some pain killers and hemorrhoid cream because she had run out but no she still had some but it was not important and he did not have to worry about it she did not even know why she brought it up she had been up all night with irritable bowel syndrome and she woke up with a runny discharge from her nose every morning did he have a runny discharge in the morning so don’t worry about the pain killers she could do it herself she’ll take a cab, and he reminded her it was winter and too icy for her walker so he said he would pick it up, but she said it was not a problem she did not even know why she had brought it up she can just take a cab and get it with her walker and when he said they could deliver it she asked why he said that was he trying to make her feel guilty and besides she did not think they delivered pain killers but he should not worry and he should stop asking her how many painkillers she had left what did that have to do with anything she was not sure she had none no maybe she had a few left why was he getting so upset and what does he mean he has done this before he has never done this before.
And then he told her it was his mistake. They talked about his mistake, but not about what mattered.

At moments she cried, told him she was losing it and wondering what was becoming of her. She saw the end of her life every morning. She saw herself petering out as half-remembered thoughts in a retirement warehouse.

They talked about everything, except what mattered.

How could they talk about that?

Victor Schwartzman
victors@mts.net

Story: The Triumph of Media

The manager of a rock music radio station was no longer content with previewing hit singles before they were released. Instead he got a major jump on his competition by playing songs before they were recorded. This was not easy for him to do, but it was worth the effort. His radio station became wildly successful, and dominated the market playing songs that had never been sung. Rock groups became famous before the musicians had even met each other. The station eventually became famous for "pre nostalgia" and its audience pined for good old days that never existed.

The songs themselves were not very good, but that did not matter. People were too excited at hearing songs that seemed to be new.

Emboldened, and needing to keep his play list fresh, the station manager then started to play songs performed by artists who had yet not been born. Golden Oldies were aired years before the musical instruments on the songs were invented. Soon the station became famous for "non-nostalgia". Virtually everyone listened to it, which was unfortunately bad news because the audience became so involved in songs that never existed that the listeners ceased to exist themselves.

Victor Schwartzman

Sunday, December 17, 2006

Hypertension 23: The 12 Christmas Ways Hypertension Makes Me Grumpy (or is that Sneezy? Why can't it be Dopey?)

Christmas, 2007 is approaching, so it seems fitting to list the Twelve Ways Hypertension Makes Me Grumpy. This list is in no particular order, partly because my spouse keeps asking me questions while I write, because soon we have to go out and buy a Christmas tree (actually, given our family, it will be a hybrid Christmas Tree, Chanukah Bush, Christian Science Shrub and Pagan Bonzai), clear the living room for the various decorations, moving my medications to make room for a Christmas wreath, asking why I keep review copies of books on the floor, etc.

Actually, the paragraph above is Grumpy 12. It has nothing in particular to do with Hypertension, apart from the difficulties in dealing with several things happening at once, when you are on difficult prescription medications and are supposed to avoid stress.

11: patches on my chest and side itching from where they were shaved of what little hair I have left. The shaving was for a stress test at the speciality gym. I was put on a treadmill until I huffed and puffed, so see how close I could come to a heart attack. Blood was also taken, and now I wait until January for the results, which will help the gym prepare an exercise programme for me.

10: exercising. Has anyone kept track of the number of exercise fanatics who have had heart attacks while jogging? Can we exorcise excersising? Do the heads of fitness instructors spin around 360 degrees, and then spit pea soup?

9: dieting. There may be a point to continuing to live even though you can not eat anything. Maybe someone can tell me. I hunger for this knowledge.

8: medications v. dieting. My recovery regimes are in a state of civil war. I am supposed to eat less, but the medications make me tired, so I eat more, to get some energy. However, the medications also lower my metabolic rate, so it's a double whammy: I eat more and burn it off less. Please talk to the bulge in my stomach about this.

7: worry #1. Hypertension is a condition where you often feel just fine. Its real impact is that it makes you worry. Worry about a stroke, heart attack, sight impairment. There is quite the long list.

6: worry #2. Apart from the medications making me tired, now because of an anti-cholesterol agent I need a blood test every three months to see if my liver is being damaged. What are the odds my liver, to which I am quite attached, will be damaged? Will the blood test catch the damage in time?

5: guinea pig. No one knows how the medications will work on you until you take them. It is sort of like Russian roulette, but without the Russians or the pistol. You can add to this that the doctors often poo-poo the side effects of the medications. They will say you'll get over the tiredness, when apparently you may NEVER get over the tiredness.

4: confusion in medical advice. One doctor says this, another says that, the 'alternative' doctor says something else. Yet they all say similar things, the differences are often in the details. One doctor says Hypertension can help create 'floaters', small spidery dots in the corner of my vision, the other doctor says hahahaha.

3: pacing yourself/premature aging. Heck, I used to do whatever I wanted. Work, go shopping, write, check out a movie. Now it's like: when do I make room for my afternoon nap?

2: controlling stress when it can not be controlled. A key to Hypertension treatment is to lower the stress in your life. Do you have a 17 year old daughter? Is lowering stress possible? I have to keep working, how do I reduce the stress there? My mom is 90, and yesterday we had to buy her a wheelchair because she was not getting into the dining room at her "retirement community" on time for dinner, and was ending up eating sandwiches instead of a full meal because the kitchen was closed.

1: I can't remember so good no more, eh what? As in, leaving my car in the airport parking lot with the keys in the ignition and the motor running. What is it like when everything seems normal, and you get a wake up call like that? Can I trust what I'm doing and seeing? How long will I have to keep making notes each morning to remind myself what I should do during the day? Did my spouse really tell me to take out the page of the newspaper listing the best Christmas light displays in town--did I forget or did she?

Y'know, I thought a list of twelve items would be very hard to come by....

Merry holidays, whatever your religion. There is no reason to think 2007 will be any better, but I'm hoping anyway.

0: elder care. I wrote the above post this morning, and finished it around 9:30. I then spent about an hour clearing a path in the basement to the small room where we store the Christmas stuff, and had gotten one box of ornaments up when the phone rang. It was the retirement community my mother lived in. My mom, who is 90, had fallen in her suite. They could not get her up.

My wife and I rushed over there (this is not the first time she fell, the last time she ended up spending two weeks in the hospital until they were sure she was okay and there were 'home care' arrangements for her through our socialized medical system). Mom seemed okay but my wife (a former nurse) and the home care nurse both were concerned she may have at least fractured something. So we called an ambulance.

I spent the rest of the day with mom in the hospital, while my wife and daughter looked after getting a Christmas tree etc. That was from about 11 am until 7 pm, when they released her. Mom was fine and safe to be released, although shakey. My wife came by with our station wagon and we took Mom back to her suite, and spent another couple of hours with her, getting her in bed, with a home care aide providing support. I just got home. It was about ten hours with Mom today.

One of the issues people my age--61--face is caring for their parents. It takes a significant amount of time from my daily work, just to get her to and from medical appointments. That is in addition to phoning her every day and seeing her at least once a week for dinner.

There are so many stresses in this life. The Golden Age of Retirement is a major one, both for the retirees and their children.

I'm now back at home, and am going to drink some very fine Scotch.

Tuesday, December 12, 2006

Hypertension 22: Where Is The Patients' Voice?

I just went through Amazon.com on the subject of Hypertension. There were three pages--three pages of books promoting diets and non-medical approaches to Hypertension, a doctor's 3D kit explaining Hypertension, and one unexplained audio CD, 'Ten Years of Hypertension.' It was not clear if the CD takes ten years to listen to. But there was no book from a Hypertension patient.

I've been through Google numerous times, searching for web sites about Hypertension, to get information. There are many listings. There is the main Hypertension listing, but there are also sublistings under various categories, including 'for patients'. The listings generally all come from government health or university departments, service organizations, or for-profit companies (such as drug companies or medical news services).

To date, I've found nothing from actual Hypertension patients.

Where is the patients' voice?

Apparently one in five of us has Hypertension, according to one web site. That is one heck of a lot of people. With numbers like that, there is plenty o' money to be made in Hypertension. Money for pharmaceutical companies, for alternative healing proponents, for Hypertension cookbooks. Money for researchers, physicians, University professors. It's a good living. :)

But, where is the patients' voice?

None of the web sites I have seen have chat rooms for patients, nor are any of the hits from patients. None of the hits are from patients. No matter how much patience you have looking, you find nada from patients. There is a huge amount of information, much of it technical, some of it dumbed down for laypeople. But nothing at all about what it is like to have Hypertension, what it is like to deal with the medical system.

Type "Hypertension" into Google and there are over, if I read this right, 32 million 'hits' and over 1,000 pages of websites. I have not been able to go through all 32 million this morning, but from what I've seen all of the hits are from organizations and people making a good living out of Hypertension. And, more power to them. If you have to make a living, why not make a living on sickness? Hahahaha, he laughed.

But, where is the patients' voice?

It feels, from a patients' perspective, as if you type in 'automobile' and instead of getting information from other auto owners, you only hear from used car salespeople.

It is typical of our entire medical system that the patients' voice is lost, just like the car owners'. Who is driving this puppy? And why does the driver--the patient--get lost in the shuffle?

Monday, December 11, 2006

Story: Pot Luck

A group of elephants, thinking themselves wisest of all the beasts, decided to form a society. They needed a leader, and rather than decide on one themselves, they asked the Wise Old Elephant what to do. She wondered why they could not make their own decision, and to make them think, asked why they could not create their own leader. They did not understand her question, and instead created a King.

He was not a very good King but they followed his orders. Their society suffered but they thought that was just their fate. Eventually, their King died. They had gotten used to someone making their decisions for them, but the King had no children to pass on his Kingosity, so once again the Elephants decided to seek the advice of the Wise Old Elephant.

Frustrated that they had learned nothing, the Wise Old Elephant told them that they should choose a King who would not die. The elephants cheered, for that was exactly the advice they wanted to hear, and they wanted to be told what to do. The Wise Old Elephant then suggested they choose Death as their King. After all, Death was the only being who could not die.

The elephants eagerly followed her advice. But Death, after becoming their King, claimed them as his subjects. As they died, they asked the Wise Old Elephant why she had given them such bad advice.

She replied, because they were willing to follow it.


Victor Schwartzman
victors@mts.net

Story: Bad Words

One day when he was yelling at her he saw the worst of his words fly out of his mouth and bruise her. The first word stuck to her lips, the next her right cheek, the third her nose. He was appalled, and apologized immediately. When he took the words back, the bruises faded, mostly.

But then he got really angry again, because eventually something always made him angry again, and increasingly his words stayed with her, the dark bruises remaining on her cheeks and lips and neck for longer. She would smile and appear to forget the words. He thought she did, it made him feel better.

But one day he found her using make-up over the bruises. She told him he could not take some words back. She stopped using make-up, to show him. Over the weeks the dark patches spread across her throat and chin, her eyes and cheeks, her arms, her legs. Her eyes were surrounded by his darkness, and then he did not see even her eyes. She was covered with his words.

That was when she left him. She told him she did not know why it had taken her so long. Her told her to stay. She ignored him.

He watched as she walked past him with a suitcase. As she approached the front door a large dark bruise on her face suddenly flew off and struck him in the eye. A bruise from her neck slapped his face as she opened the front door. Another bruise from her arm hit him as she closed the door behind her forever.

He was stunned. His words had never struck him before.

Only then did he yell angrily, but she was gone. His words hit the door and bounced back at him. He could not stop his anger and kept yelling until he was covered with bruises and his own darkness and his eyes and lips and ears were sealed shut and he lay on the floor shaking, his anger nothing without her.

Victor Schwartzman

victors@mts.net

Friday, December 08, 2006

Hypertension 21: New Specialist Supports Less Stress At Work

Stress in any workplace, and its impact on workers, is a controversial issue. Ask any union representative. These days, many workplaces are dominated by pressure to produce. That can be fair enough, hey we have to compete, or provide good service to clients, or whatever--although at times the human element can be lost. Workers are people, not robots.

I think Scott Adams, who writes Dilbert, would agree.

Stress related to a disability is also controversial, although you'd think that there is a clear medical/scientific connection between the disability, the stress, and a negative impact on the patient. I had been cautioned most specialists would stay away from making a connection between Hypertension and workplace stress. In part this is because treatment of Hypertension involves one's entire lifestyle. It is not, as you have read on this blog, just a matter of popping pills. Treating Hypertension involves exercise, dieting and calming one's life generally--i.e. where possible, reducing stress.

It never made sense to me that stress in the workplace should not be linked with Hypertension. Anxiety can, temporarily, increase blood pressure. Who could doubt that? Whose heart has not 'pounded' in one's chest during a crisis? Does not a crisis include pressure to produce more and more (ask any worker who's producing more, and working more overtime, in the hope that his or her job will not be outsourced overseas)?

My friends, we spend about half our waking hours at work. How can it be that what happens at work does not have a direct impact on us? Think about it. We sleep for eight hours. We work for eight hours. That only leaves eight more hours for everything else, including shopping, eating, driving to and from work, and watching television to relax after working.

Denial that workplace stress has an impact on the worker, arguing that Hypertension is a 'lifestyle' issue with no relation to the workplace--that position certainly helps the employer avoid any responsibility for any negative workplace situations. Helps the employer but doesn't help the rest of us.

I'm writing this because today my union forwarded to me the letter sent by specialist number two. The letter I'd been waiting for. A short letter. Here is the key part:

"Mr. Schwartzman has a medical condition that is exacerbated by high levels of stress at work and this makes the treatment plan difficult. He is certainly adherent to our suggetions and follows our recommendations for treatment. It would be appreciated if there was an alternate arrangement such that there are lower levels of stress at work which would hopefully make the treatment plan more efficacious as well. We thank you for your cooperation in advance."

This should be the information my employer and union say theyneed to make a change in my workplace situation. If you have Hypertension, I hope it gives you something to look forward to, as well.

Thursday, December 07, 2006

Hypertension 20: The New Specialist

I'm not bored, I could write about me all day. But why are you still reading? Is it late? Have you been drinking? I will admit, at times it is difficult for me to understand the blogosphere. Maybe I should have a blogoscomy.

Be that as it may....

An earlier post mentioned the change in prescription medications in November, along with a change in specialists. Here is the whole story.

Specialist #1 was one swell fella. We got along fine, he was knowledgable about the Chinese herbal treatments and approved of them (as long as they continued to work), and he wore the most-in-need-of-a-wash labcoat I'd ever seen. He saw me on October 4, 2006, and felt I needed significantly more medication (sigh) and much more time off work (okay!). I saw him again three weeks later, at the end of October. At which time, we said good-bye because he was moving to Alberta.

Alberta is not a shampoo company, but another province in Canada.

I don't think he moved because of something I said. He was going up in the world, to a University position, and more power to him!

This meant proceeding to another specialist. My family doctor was fine, but I wanted a physician who lived, breathed, ate and was obsessed by Hypertension. Well, okay, also a specialist because my employer would not be all that interested in a family doctor's recommendations. Specialists carry more weight. I knew that from my work.

He recommended, at my request, another specialist, who was in the Adult Cardiac unit of a local hospital. It took several weeks for the appointment, in part because first my family doctor had to make the referral--that is how the system works. Civilians can not just phone up and make the appointment on their own.

The weeks went by. Down to the hospital I went, where I registered and actually was given a white plastic wrist band for while I was there. Then I went up to the unit, waited a relatively short time, and was called into a waiting room. Where, of course, I waited.

Not for long. A nurse came in, took my blood pressure, interviewed me, and then said the doctor would come in. A few minuts later, a quite nice student doctor came in. He explained he was a student, or intern, or resident, or at least "not quite" a full doctor. He was very efficient, to the point of being brusque: but very politely brusque. This is Canada, after all. He took my blood pressure again, examined me, asked more questions. Then he explained he would leave, review everything with the specialist, and they would both come back in.

I was absolutely wallowing in attention.

A short time later the student and the specialist came back in. The specialist asked some more questions. He reviewed the side effects which I had mentioned to the nurse and intern. He asked the intern what changes should be made. The intern suggested increasing the Tevetin. The specialist said no, that would increase the negative side effects. It went back and forth like that for a little while. I commented to them it was like being in an episode of "House", and we all had a rather jolly laugh.

Eventually the specialist changed the caduet I had been prescribed, giving me two new prescription drugs instead, adalat and lipitor (which I had heard on from the relentless tv ads). He said the new combination should help with the feelings of weakness. He recommended continuing exercising. Regarding dieting, he had no recommendation to my query about the circular nature of feeling weak so I ate more, except to note the new medications should leave me less weak, so that should certainly help.

He was quite done when I noted to him my last concern. In a couple of months, after continued exercise, dieting and adjusting to yet more new medications, I would return to work. My concern was that the stressful nature of my work would bop up my blood pressure again as soon as I returned. To my surprise--stress and high blood pressure are controversial, at least for employers and their human resource departments--he and the intern completely agreed, and said they would write a letter to my union, recommending I be given less stressful work on my return.

For the first time in a long long time: really good news!

Sunday, December 03, 2006

Hypertension 19: Meds vs. Meds vs. Dieting

There are many conflicts involved in being treated for Hypertension, and speaking of being treated I wish there were treats. Halloween candy would be very nice. But too often there are just tricks. Eggs on your windows, and the yolk is on you.

Generally, all doctors agree part of treating Hypertension is that you should lose weight and exercise. After that, agreements end. There can be conflicts between family doctors and specialists, between specialists, between different Western medicine and "alternative" treatments.

Many of these conflicts stem from differing opinons on the medications.

It isn't even just between different new meds. There are new meds and old meds, and every physician has his/her preferences. Some physicians listen well to patients, some think they know best and the patient should just lvie with it. A relative of mine has taken Western Hypertension medications for many years. He was concerned that his older medications created problems for him, compared with the newer stuff. His doctor thinks those meds are just fine, and won't change them. My relative is now in therapy for depression (one of the known side effects of those meds).

The side effects can have unexpected impacts. For example, on weight loss (dieting).

A previous post addressed dieting. Speaking of that, I wish I could really address dieting, preferably out of State. Or stamp it--out--or just plain stamp it and mail it somewhere else.

Where was I? Ah. The previous post looked at the less obvious problem--sodium in prepared foods. In writing that post, I figured that we all know about the truly awful "eating less" part of dieting, so why write about it?

But there was more. Losing weight is not as simple as getting your head around eating better foods (is there a better food? is a Hazlenut torte truly not as good as a whole wheat noodle that tastes like cardboard?), or eating less. There was an insidious side to losing weight in my situation.

By early October I was down to around 208 pounds, depending on where and how I was weighed.

Now, I really must stop here for a moment and talk about getting weighed, which is a weighty topic about the way to go in waiting to lower high blood pressure, as Tom Waits once sang. Ahem.

Have you ever weighed yourself on a scale in your bathroom, then later that day been weighed in the doctor's office and chugged in several pounds heavier? Feeling embarrassed as you tell the doctor's assistant you were lighter this morning, and she struggles not to roll her eyes? Then you say when you weighed yourself you were wearing, well, your birthday suit, and now you're wearing all these clothes, so that's why you are heavier, and she does roll her eyes?

I actually changed my bathroom scale, figuring that was the problem. It was not.

I can now state, based on my encounters with the superduper scale in my speciality gym, that being fully clothed can add three to five pounds to your weight. No doctor's assistant will believe this, but it is the truth.

Anyway. After I was put on a total of four prescription medications in early October, my weight began to go back up again. Right now, on December 2, it is up to 218 from the early October 208, which actually is down from 222 in November. Is that clear?

Here is what happened.

The new prescription medications lowered my blood pressure, indeed they did. At some points lately it has even been down to 110 systolic (I am still on four, but two of them are different, more on that eventually), and 110 for me similar to being embalmed. However, lowering my bp was not their only impact.

After waking at 7 am, driving my daughter to high school and then my wife to work, taking the meds, eating breakfast and spending a couple of hours reading or writing or watching some film I could never watch with in the presence of either my daughter or spouse (you have a dirty mind, I am talking, actually, of old Boris Karloff movies), by 11 am it was snooze time. That's right. Four hours of being awake and I would start feeling the need for a nap. Not just wanting a nap, or feeling tired. Needing a nap.

I do have sleep apnea, so I'm always ready for a snooze. But the CPAP machine I use each night generally gives me enough rest. This tiredness was different. I had experienced it at times before, as noted in earlier posts. It was not as bad as it had been. One medication left me unwilling to even get out of bed. These meds were better, but by 1 pm I had to nap because it was difficult to stay awake.

But I was tired of being tired. I wanted to stay awake.

Without really thinking it through, I began to eat more. Not ice cream, not chocolate. Just...more. The more I ate, the more energy I felt, and I could stay awake. Heck, even until 9 pm!

The medications created a vicious circle. They made me tired, I ate to feel energized, I then gained weight, for which I would end up needing more meds. Was this a plot of the military industrial medical pharmaceutical complex?

Although I would like to blame everyone else, including a paranoid X Files conspiracy directed against me, it was pretty simple: medications v. weight loss. The solution? Specialist number two (t