It's Been a Blue, Blue Day..."

Arnold, is that really you?  This is Bob Bartlett, Robert was what you called me 50 years ago.  Fifsty years!  CAn  you believe it!  I could believe it even though I would never have recognizd the voicae or he speech patterns.  But last year during  a trip to Utah I had made a special effort to visi his brotherReed and share a dinner so graciously set by Reed amd jos wofe Afton.  Afton wasn't sure she remembered me even though and Reed had double daated  with me and my wife.  The boys had lived across the street from us all through grades k ==-12 and into collevge.  Reed was a ear older thab nem /rkbert a gear  younger.As often happens with threesomes, I was often tight with one while on the outs witiih the oher.



So begins the Country-Western hit by ____________  which describes a syndrome common in the higher latttitudesnbut not so well known closer to the equator - Seasonal Affective Disorder or SAD for short.  SAD is one of those mental illnesses that are difficlt to someone supervising a SAD oersib ti aacceot.  But trdrstvhrttd hsvr frrtminrf yhsy proplr who seasonally get less and less sunlight suffer depressioin,listlessness, .  And in many cases, streatment with light psrimarily blue spectssru , will find smany of these symptsoms decresing and even disappearing.

What is the treatment for seasonal affective disorder?

http://www.medicinenet.com/seasonal_affective_disorder_sad/page2.htm

In addition to being key in the prevention of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with this disorder when it presents during the fall and winter. The light treatment is used daily in the morning and evening for best results. Temporarily changing locations to a climate that is characterized by bright light (such as the Caribbean) can achieve similar results. Light treatment has also been called phototherapy. Individuals who suffer from seasonal affective disorder will also likely benefit from increased social support during vulnerable times of the year.

Phototherapy is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. Contrary to prior theories, the light does not need to be actual daylight from the sun. It seems that it is quantity, not necessarily quality of light that matters in the light therapy of seasonal affective disorder. The most common possible side effects associated with phototherapy include irritability, insomnia, headaches, and eyestrain.

Antidepressant medications, particularly those from the serotoninselective reuptake inhibitor family (SSRI) family, have been found effective treatment for seasonal affective disorder that presents during summer as well as that which tends to occur during the fall or winter. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), andcitalopram (Celexa). Common side effects for this class of medications include insomnia, nausea, diarrhea, and decreased sex drive or performance. As with any other mood disorder, psychotherapy tends to accentuate the effectiveness of medical treatment and therefore should be included in the approach to addressing this disorder. In individuals who are perhaps vulnerable to the development of bipolar disorder, either light therapy or antidepressant medication can cause a manic episode as a side effect.

Since stimulant medications like modafin

Three easy pieces

Reading others’ adventures sometimes makes me wonder if life is passing me by.  I decided that I needed to write a little just to remind myself that isn’t so.  Here are a couple of snippets of the most recent 10 days of my life in no particular order or importance:

Get Well!

When was the last time you got a Get Well card?   From your hospital?  Maybe even they are beginning to think I’ve seen too much of the inside  of our hospital  lately.   In any case I’m taking it at face value and consider it a class act.

Drop Your Pants

I’m told that members of our culture  have many dreams in common.  In one common dream we find ourselves naked or nearly so while family, friends, and relations around us are completely clothed.  Last week I went one better. 

Carolyn and I attended a “Broadway quality” production of “The Book of Mormon” in downtown Sacramento.  It was a rainy evening and we had used my little travel scooter too much.  It finally ran out of juice just as we reached the theater box office.  As Carolyn pushed the battery-dead scooter, we could see we weren’t going to have time for a last minute run to the restroom. **

The play, the sounds of rain outside, the excitement of the crowd all made it impossible to ignore the call of nature.  We were on our feet the moment the house lights came on for Intermission.  We and a few hundred others headed to the doorway for relief. Suddenly,  I felt a distinct draft around my knees and more difficulty than normal moving my feet.  Yup, you guessed it. My wardrobe (specifically my suspenders) had malfunctioned.  With only a slight delay, we adjusted our hand holds (remember we were trying to carry 2 umbrellas, a cane, and my pants) and dragged me to the nearest men’s room where I desperately tried to layer enough  cloth in the suspender clamp mechanism to keep my pants up for the rest of the evening. 

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The Book of Mormon

Speaking of “the Book of Mormon”, I think the Church played a P/R card that was as brilliant as It was unexpected.  In the past the church may have sponsored pickets, nuisance lawsuits, or blanket letters to the editor when something as potentially offensive as “the Book of Mormon” surfaced.  This time the Church ran 3 full-page ads in the program.  The face coming off the page in the first ad  says “I’ve read the Book’; the second ad, “THE Book is always better;, and the third “You’ve seen the play… now read the Book.” It looks as if the Church is partially sponsoring the play.

              I predict that t there will be as many opinions about the play as the number of people who see it.  And the ratio of people offended to those who weren’t  will be unpredictable.  If you are offended by street language and crude descriptions you’ll have trouble with this play.  If you feel that no one, even God, is beyond  criticism(see Fiddler on the Roof”) you will find much to agree with.   But in all cases you will get more out of seeing it than avoiding  it.  Sort of like reading the original ”Book of Mormon”.

Night at the (Wax) Museum

Thinking way outside the box, the Mission Elementary School put on a play adapted from the movie
“Midnight at the Museum” which was adapted from a children’s book of the same name.  The plot, in case you missed it, involves historical characters represented in the museum coming to life and doing battle (small skirmishes, actually) with some children from the present who happen to get stuck in the museum overnight.  The play/show/book avoids dry history by posing interesting questions such as  relative firepower of pirates versus renegade cowboys.

Some very talented local musicians adapted a musical score and the way it was adapted to the stage allowed for few cast members or dozens, singers or not, dancers or not.  And the kids had to learn history like it or not.  Great selection and wonderful performance. 

**A couple days ago, I discovered a useful word in the Urban Dictionary that seems almost made for my situation:

   ========================= 
|| bladderdash ||

   ====================

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1.       a mad run and/or sprint to the bathroom before your bladder explodes.

2.      the quick sprint or ‘dash’ to the toilet due to the combination of excessive drinking and poor planning
Julia made a bladderdash after she drank a whole two liter bottle of soda.

Faith in Humanity

Faith in Humanity

Two recent incidents have reaffirmed my belief in the basic goodness of people:

#1

Downtown Sacramento, lunchtime, one of the busiest pedestrian intersections in the city.  I was carrying a wallet overstuffed with 9 credit cards, drivers license.ID and $400 cash from $20’ s to $1’s to provide tips on our anticipated trip to New Orleans.  Carolyn & I had attended an office fund-raiser and had left to return home without even noticing that my wallet was missing.

Shortly after getting home our phone rang.  It was our dentist’s office asking if I had lost a wallet.  The question was so absurd that I answered “No” before checking. I patted an empty pocket and immediately changed my answer. The dentist’s receptionist explained that she had gotten a call from a young man who had seen and retrieved the wallet and was now trying to contact the owner.   We immediately called the number passed to us by the receptionist and arranged a time and place.  I could imagine all he trouble we were going to have cancelling and replacing all the credit cards and the drivers license.  Trying to fly while getting new ID would be a real pain and absorbing the loss of $400 would not be insignificant.

When we got back downtown, the young man was waiting for us. He handed us the wallet and wished us a happy weekend. Without even looking at the contents of the wallet, we offered him a reward. He wouldn’t accept it.  We finally got him to accept $40 tor lunch.

As Carolyn drove us back home, I checked the wallet’s contents. I couldn’t see that anything was missing or even out of place. The man had been totally honest.

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#2 

Two days later, original travel plans still intact; we boarded a plane for New Orleans.  This was a time-share trade that we would either have to “use it or lose it” .  Carolyn was anxious to start her “retirement travel mode” having spent the past two months doing all the little thins around the house that had been awaiting her retirement. 

I, on the other hand, was more than a little hesitant.  You might be aware that I have Parkinson’s Disease, one symptom of which is difficulty in walking straight. As tourists we would need to transfer from our tour bus to a small boat or trolley or swamp boat, etc.  Even if Carolyn helped me, I was going to look drunk.  At our first transfer the tour guide called out, “We need someone to help this gentlemen.” No fewer than 6 members of our tour group, all strangers until now, immediately stepped forward.  One young woman took two steps forward, placed my hand on her arm and introduced herself, “Hi, I’m Amanda and I’ll be your guide today.”  During the whole week, I always had plenty of help getting where I needed to go-usually from perfect strangers who live half a continent away from my home.

By the way, New Orleans is a great place to visit!

Retirement Planning

The Planning 

With enthusiasm and a willing heart, Carolyn undertook the task of moving her planned retirement date to 2015 instead of 2025.  What was "sometime in the future" was now "NOW".  Years shriveled into months, weeks or even days.

Coming to grips with such a goal change was not an easy task.  Carolyn had to change some internal goals about positions and responsibilities.  She would aim for and discuss those revised  targets.  She had to review long range plans with appropriate outside consultants to ensure  that they didn't have unrealistic expectations about her part in them past 2015.    Of course no one can guarantee their own future availability but groups can develop a sense of future direction.

Carolyn also began discussions with CalPERS to tie down dates and assumptions.  Although many employees find this activity exciting, for Caarolyn it meant making major changes in her plans, Carolyn  found it difficult.  But she perservered.  Fortunately things turned out close to revised expectations.  

I continued to hold my breath.  Not until Carolyn showed up with official retirement papers did I r\believe it was going to happen. Even at her retirement party, I had my doubts.

The Move

There's a certain finality in clearing out your desk and saying goodbye to your colleagues.  You expect them to say they'll be in touch and really mean it but they're not as interested in our opinion on a decisions as they were two weeks earlier.  Your (former) boss , your co-workers, your buddies, all now seem much busier than you.  You didn't need to plan for so much time to wrap things up as you had expected.

Moving into your home/office also goes faster than planned but you find that your husband and all the people you want to call have busy schedules and they want to move on.  You pull out your trusty smart phone and To Do List and start jotting down the three things you remembered in the last 10 minutes.  You'll find that moving home to retire is both quicker and slower than expected.

And frightening.

Changing

Everyone retires a little differently.  Many people take off a mandatory 30 days or 6 months then come back into consulting positions that look identical to the position they just vacated.  Others, like me, take on a whole different list of job duties, salary structure, and work hours.  Carolyn wasn't exactly sure of what her situation was going to be but we expected major changes.

For one thing, we wanted to spend more time together.  She can't spend 40 hours a week in the office.  For another, my care needs continue to escalate which reduces her availabilities.  'Third, the job she stepped out of will necessarily change making it more difficult for Carolyn to just slide back into place.  

Retirement? What's Retirement?

Oh, and just one other "minor " change between now and 20 months ago.  It may turn out to be the most significant.  Yup.  Carolyn has retired!

The Decision

Carolyn has talked "retirement" ever since she started working outside the home.   But her career consisted of several bis and pieces covering almost as many specialties as employers  It's hard to make long range plans when you have no long range investments.

But when I retired in 2011 Carolyn had finally gotten a toe-hold with the Department of Childhood Education,  Not only was she now a part of the mature and well-known California Personnel Employees Retirement System Cal-PERS) but she is now in a major, professionally run retirement program.  w vested, diversely invest and a projected .  Her earliest retirement date that would be within her lifetime.  Because PERS is a defined benefit plan she could, by working until 2015, have a retirement  of 20% of her salary.  And 10 years later she could count on 40% benefit if she continued working.  And part of her medical insurance premium wold be covered as well.  Carolyn was trilled at having this benefit and began mentioning it in our family long range discussions.  What I didn't notice was that as my retirement date of 2011 became firmer, her retirement date was becoming more 2025 and less 2015.  After all, the benefit was much better , she loved her job, and she had a future.  She had beaten cancer 3 times now so she was even a winner in that aspect.

With my increasingly fragile healh, I was  beginning to question our assumption of how long we colud enjoy retirement together.  Just when Carolyn was seeing after 2025 s as golden ones I was afraid that I would be dead or severely disabled b 2025.  After a couple of serious discussions, we both decided that an earlier retirement might be called for.  

Gamely shifting gears, Carolyn began  targeting 2015 for retirement.

Whatever happened to 2014 (and most of 2015)?

If you look at this blog in a sequential or linear way, you'll probably notice a laarge gap between this entry and the one before.  There are many reasons for that ranging from being way too busy to fearing that I may suffer from overexposure.  I'm at heart a very private person but I also like to share information , thoughts, and ideas with others.  That produces a bit of a contradiction.  What if people read my blog and treat me differently because of what they read?  I sense that could be a real problem in my DMV series.   I don't know if my case would have gone differently without my blog but there's every reason to believe it might.

But I'm rapidly reaching the point in my life when it won't matter.  Not having a paid job I can't be fired or have my salary cut.  After I stop driving it won't matter whether I have a license or not.  Perhaps then I'll be free to be more open once again.

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First, I'd like to dust off the old resume and quickly bring you up to speed about my health situation.  The easiest way to do that is look at my condition on January 26, 2014 about 20  months ago.

My vital statistics, "measurements of life" haven't changed worth noting.  Its nice to know that my weight loss has remained but not so nice that bursitis has also.  I still have Parkinson's but its beginning to get on my nerves.  I can still drive but I'm more nervous about doing so.

My various responsibilities and "jobs" on the other hand, have changed considerably..  The biggest change is completely resigning from the regional center consulting.  It was beginning to get difficult for me to honestly claim that I was earning my fee.  Another responsibility was playing the piano for Sunday church meetings - a responsibility I added this year and have just resigned.  Finally, I realized that the church newsletter I was editing was getting stale and taking too much energy to publish even in a poorly rendered state.  I will soon no longer be in town enough to keep up the paper so it too had to go. dOn the increase side I have gotten more involved as a Support Group Facilitator and I am definitely doing more as the Treasurer for the local branch Friends of the LIbrary. Overall, I would say my activity level could be as much as 50% less tha2 years ago.

My chances of dying took a significant jump recently when I was diagnosed with atrial fibulation or incomplete and inefficient beating of the ventricular atrium.  Left unattended this condition increases my chance for a stroke by 2.5 times and by a hemorhage maybe double.  Of course that's all theoretical if I die from a heart attack.  We'll speak in greater detail about this in another post.

I think of greater concern to me is mental agility or dementia.  I had understood that it was a minor portion of Parkinsons patients which have to deal with dementia, maybe 10% or so, like the general public.  But now I'm hearing numbers like 70% and I'm beginning to see that happening in my own world.  Ending the regional center contract was primarily a matter of forgetting from week to the next what I was doing or how I did it.  I see more and more of that with other things I do on the computer.  I will analyze this in more depth in an upcoming blog post.

++++++++++
need to research % of PP folks with dementia
risk of death with a-fib
impact of Carolyn's retirement

State of the Self - February 2, 2014

Presidents give state of the Union messages, governors do state of the state.  It's only logical that I come out with a state of the self message.  Here goes:

As of January 26, 2014 and for a man in my condition I'm in great shape.  My weight is almost exactly where it should be although it’s not distributed quite the way I'd like.  My blood pressure, pulse, and most other measurements are with normal limits of normal standards.  I do have sporadic sleep apnea, edema of my left leg, bursitis in my left shoulder, peripheral neuropathy in my feet, receding gums, cluttered vision, stiffness in my fingers, GERD, 20% hearing loss.  Oh, and did I mention I have Parkinsons Disease?  That supposedly explains why I can't walk or stand without assistance, freeze while walking or moving my arms, garble my words or speak so softly that you can't hear me anyway, am impotent and slightly incontinent, and have spells when I fall asleep uncontrollably. 

On the other hand I can still safely drive a car under good weather and traffic conditions,

play the piano for congregational singing, cook a simple meal or bake a batch of cookies, can ride a recumbent tricycle 25 to 30 miles at an average speed of 10 mph, chair a patient support group meeting, maintain a small web site, keep the books for a branch of the Friends of the Sacramento Library, and publish a monthly church newsletter.

My chances of dying are only slightly elevated from an average man my age, the elevation coming from swallowing difficulties associated with Parkinsons. With my poor swallowing ability I could easily aspirate food or water into my lungs and drown within minutes.  They tell me that like most people my age I will live for several more years becoming less and less capable and more and more dependent, that my mental functioning will increasingly limit my ability to interact with and enjoy friends and family.  After I am finally, thoroughly, and obnoxiously dependent I will die, probably timing my death for maximum inconvenience for the family.

I had appointments with my GP and with my throat surgeon last Wednesday so this is about as up to date as it gets.

Let's all have a happy year, okay?