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Office

I spend a lot of my professional life dealing with anxious people. Of course, there are many ways to deal (or not) with anxiety.  There are two general approaches: a) suppress it or b) mitigate it. The latter is preferable for it actually ‘deals’ with anxiety. Unfortunately this takes time, energy – and courage – to master. Counseling, meditation, yoga, guided imagery, and breathing /relaxation techniques all have efficacy in the treatment of anxiety disorders. Unfortunately they take time, effort -and courage. Alas, it seems fewer patients are interested or willing to do so. *

When I diagnose a patient with anxiety I always point out the conservative option of non-pharmaceuticals such as cognitive behavioral therapy for their condition.

Most of the patients opt for tranquilizers.

Tranquilizers such as Ativan, Xanax,Klonopin, and Valium are in the benzodiazepine family, They work in the ‘a’ category viz. they suppress the sympathetic nervous system (the ‘accelerator”)

Non-pharmaceuticals work mostly by strengthening the parasympathetic nervous system (the ’brakes”).

To be frank, I don’t like working with tranquilizers. Thems that take ‘benzos’ are often very intolerant of feeling any anxiousness; they want it stamped out which often means desiring to take as much valium/xanax etc. as possible.  There is constant haggling to get more. I have to constantly police the refills to make sure patients are not taking more than prescribed. Because the patients are often not dealing with their issues, attempts at suppressing anxiety through medication (and habit forming ones at that) don’t often quite work enough.

There is more data coming-out long time regular use of benzodiazepine medications like xanax leads to earlier onset of dementia and puts one at risk for falls. Normally if I bring up ‘long time risks’ of medication this  evokes “Oh! I don’t want to take that then!”  Not so with tranquilizers. “But I need xanax!” is what I often hear when I propose they may not need them anymore.

The treatment of chronic anxiety is slowly assimilating the philosophy of chronic pain. The goal there is not to eliminate pain but to get it down to a dull roar and have the patient learn to live with pain and not let it consume or dominate.  Patients with chronic mood disorders are more accepting of this notion than patients with anxiety.

I’d be curious to find the statistics of how many tranquilizers are consumed in the USA compared to other countries.  We seem to be a very anxious nation, and we deal with it using drugs/alcohol, pills and foolish activities. In my job I try to get people to find better means. And for those who opt for prescriptions only, I set limits on expectations – and count the xanax pills as they go out.

 

* Of course there is a certain bias in the type of patient who comes to me. I see the types either ‘open to the notion of medication’ or seeking that.  People ‘against meds’ and/or  interested in non-pharmaceutical treatments for mood/anxiety aren’t coming in usually. They go to counseling, yoga class, etc.

Someone is off to some sort of Super Bowl soiree. He is ushering until late this evening.  I don’t envy him either the job or the post-party traffic as he winds his way home. He is doing several other events this weekend, so I will be home alone a lot.  In the past few days the streets seem more congested, which I suspect is Super Bowl related.  I have a great desire to crawl into a ball hedgehog-like and wake up on Monday after the fuss is over.  I think I will spend the weekend reading and sewing. I will turn on the game to hear who is mangling The National Anthem but that’s about it. Off hand I can’t remember who is playing. I suspect few care. It is the party/food and hype around the spectacle which is the point. That, and the commercials. Nowadays they are posted on Youtube so even they are not enough to keep the tele on.

The weather turned inclement; it is rainy, misty, cloudy and high in the upper 50s. I am feeling sorry for the out-of-towners who are probably expecting sunny skies and 70s. It feels just like the Pacific Northwest. I hear the Seattle Seahawks are playing in the game. They should feel right at home. I wonder if the Washington weather heralds a Seahawk victory?

Later – Someone came home and told me all about the drunken rude Super Bowel customers he had to keep in line at last night’s hoedown.  Apparently the Seahawks are playing the Patriots – try to tell as many people as you can in town.

I still plan on having a low-key weekend. On Saturday I will get a shave, hair cut, and beard trim (always a treat). When I am not making shirts I will be enscounced in a chair with a hot cup of tea and some reading.  And there will be silence, lovely silence. The only event I plan on watching is the falling rain while I sit still. I can not think of a better arrangement.  Perhaps if things are quiet The Muses may finally visit me and grace me with something proper upon which to write. Perhaps not. They will probably be at the game. I hear the Fates are having a tailgate party not to be missed. The Norns are apparently cheering on the Patriots (go figure). As for The Skanks? Goodness knows what they are doing this weekend.

 

 

office-phone-call-ringing_phoneSomeone is quite cross and I don’t blame him. An insurance company I will call “X” * keeps faxing the house trying to get a renewal fax for a patient’s medication. I don’t know how X got hold of our home fax number, but there it is. For the past two days X has continually called and faxed requests.  Someone has called X a few times to complain, pointing out this is not merely a mistake but it violates HIPPA laws for him to see the patient’s name and information. Just as we think it’s been corrected we get another call.  Someone doesn’t have to work with these dastards, so he gets to the use choice words I only think of using.

Telephone calls used to be a positive things, for they portended someone you hoped would call, but that went out with the rotaries. Today no one calls but they send texts or emails. Nowadays the callers are invariably telemarketers. I don’t know why he does it, but Someone tends to pick up the phone rather than let the machine screen the call. After saying hello there is the dreaded silence as he is listens to someone at the other end starting their schtick. Then he says something coldly polite and he hangs up. I am not so gracious.  As soon as I connect the dots it’s a telemarketer call quickly I hang up without further adieu.

For some time we have considered disconnecting the landline in favor of cellphones, but it is hard to abandon something integral after fifty years. I also fear I will lose my cellphone and become cut off from society. As I type that out it doesn’t sound so dreadful. In fact it sounds quite pleasant. I shall start by yanking out the fax line.

 

 

* Humana Health Care to be exact but I changed their name to protect their privacy.

Twice this week I have started blog entries at work only to forget to save them at WordPress. As a consequence, when I arrive home I am bereft of my industry and I am too tired usually to recreate them. This is the sine qua non of my being:  starting things only to not finish them. At times it is infuriating. I think one of the entries was my preference for hot and spicy things to sweets. I recall the other one was about something I found under the bed while I went looking for lost socks.(1)

Today 27 January is Mozart’s birthday; I am marking the occasion by singing arias from Die Zauberflote. I have all the attributes of a great opera singer but for voice, but I don’t think Herr M will mind my attempts. I like to sing along with Herr Pagageno for his tunes are relatively easy. Sometimes I do Pamina’s “Ach, Ich fuhls” for it remains one of the saddest tunes I know – and in the middle of a comedy!   I promised Someone I won’t attempt anymore to do “The Revenge Aria” as it hurts Harper’s ears. For my Mozart finale, I will change CDs and do Il Commendatore and drag Mr. Giovanni down to hell in a properly with fire and demons and stomping around the house in a ponderous manner.(2)

I need to remember when is the birthday of Mr. Poulenc, for my favorite opera is “Dialogues of the Carmelites” and I like to iron the shirts while singing Sister Constance. Another aria in my repertoire of which I am most fond is “Wotan’s farewell” from The Ring Cycle (jolly good fun!) . I have the voice range to rival that of Yuma Sumac.  Of course I can do “Quando men vo” – after all, I am an opera queen. (3)

I am working on “From the Gutter”, but it is hard to sing multiple voices and Someone would rather eat rats in Tewkesbury than do/hear/see “Peter Grimes”. It is near grounds for separation.

 

 

Alas is it getting late and I have an early day tomorrow’; there will be no more arias for this evening.  Or maybe one more: tonight we had a rather spicy dinner which included a lot of beans and a bottle of wine. Perhaps “Nessum Dorma” will be done. (4)

 

opera-singer-9150149

 

(1)  Turns out, not much. I think I will delete this one.

(2) Again I am told to knock it off it is upsetting the dog.  Harper prefers Puccini.

(3) Sometimes the orchestra and I go off into different keys, but other than that my rendition is brilliant.

(4)  in E-flat

Some demon has possessed Someone for he shaved off his beard. What else would explain such a possession?  He didn’t ask for my input on the matter.  I admit he looks younger – most men do when the shear themselves – but I find the glabrous look unsettling.  He came home from ushering the other day, dressed in black trousers, white shirt, and black tie. I mistook him for a Mormon and nearly slammed the door on him.

My chin and sides are quite gray, which makes me look like an Ewok. From a distance people think I have a goatee.  I too would look much younger if I shaved but I like looking pilose.  In my  old is preferred to looking fresh out of med school; it is better to emulate Gandalf the Gray than Doogie Houser.

Dyeing the beard has the advantage I can look younger but remain hirsute. I’ve done it on occasion. I don’t know if it ‘works’.  No one has had the heart (or nerve) to tell me I look silly and I am fooling nobody.  I usually give it up after awhile for it is a lot of fuss.

I hear younger men are decorating their chin-hairs with day-glo colors Kelly green and cherry red. I suspect I am too old to have my beard the colour of Froot-loops.  Still, if Someone can change his looks, why can’t I?  Should I do this myself or should I go to a hair stylist I wonder?

Perhaps I should make an appointment with Olga –  “Jungle red, one coat or two? “

th0KLBL6K1

I spoke with my parents yesterday; they asked me what was new and exciting. Later that night I ran into chums whom I have not seen in ages and they too asked me for all my news and updates. In both encounters I drew a blank coming up with something noteworthy to tell. I work, exercise, read a bit, wash and repeat.

For some time I’ve wanted to write something weighty and numinous. For an equal amount of time I’ve waited for something interesting or recondite to come along to provide me with a topic. Life is an adventureless tale. I wrestle with no inner demons; my main worries in life is getting deadlines met and when are we going to fix the hole in the laundry room ceiling.  There is nothing ‘coming up’ like the annual winter holiday.  It is hardly worth writing about.

I prescribe to some podcasts; two of them are along the line of male self improvement. I suspect their target audience is men younger than I; I don’t need advice on how to establish a career or how to win friends and influence people or (worse) how to pick up the babes. What I want is a podcast for fifty year olds who are trying not to become frumps.

This morning I decided to shake things up a bit and cook something new and adventuresome. I split some superannuated avocados in half, scooped out the pits, cracked open some eggs into their recesses and baked the lot for 15 minutes. I’ve already learned:

a) Next time use less ripe avocados

b) Scoop out a bit of the flesh to make room

c) Discard some of the egg white. Or use smaller eggs

d) Leave the skins on !

e) Don’t presume Someone wants one.

 

images

This oatmeal-less breakfast is probably the highlight of my day; the rest is downhill.

As uncle used to say “I lead a dull life”.   🙂

Video SnapshotIt’s 5AM on Saturday. I went to bed last night about 830AM, having gorged on super nachos and shrimp fajitas. By the time I arrived home I was feeling a bloated goat and I went right to sleep. I’ve turned into one of those superannuated somebodies they feed at 5PM and put to sleep by seven.

Someone volunteered to usher all day long at various pre-Super Bowl soirees. He leaves around eight and he comes home tonight after ten. This leaves me ‘home alone’ as it were. I am looking forward to it for I seldom have the house to myself.  Spo-fans with gutter thoughts may be imagining Urs Truly dancing around in his drawers channeling Risky Business thinking of lascivious and clandestine rendezvous.* Not to be worrying I lead a dull life. The day will be a quite quiet.

Speaking of quiet, the first thing to do is turn off the TV, for it is continuously on for Someone’s sake. Ah! Solitude! I want to get the weekend paperwork done right away. Then it is off to the gym for a very long work out – no need to rush home!  The afternoon sees the House of Spo transformed into a sweat shop. I have several shirts in the making; it’s time to get cracking. It’s hard for me to concentrate on my stitches with the TV blasting; the quiet will be most salutary to sewing.  Actually it won’t be that quiet. I will put on various music Someone doesn’t like**.

Harper is not used to Someone away and I at home. In her vexation she will want in and out a dozen times. Sometimes I think she does this out of spite. She’s learned tapping at the door drives me to distraction and I will let her in/out. She seems to be always on the wrong side of every door.

I plan to make something exciting and new for my supper, I haven’t yet figured what – something with artichoke hearts, for we have a few jars of the stuff and Someone doesn’t like them. Neither of us remembers how on earth they got into the pantry in the first place.  It is a food push.

By evening my knees will be aching from standing all day, cutting cloth. Time for a dog-walk and then a sit-down with a nice cup of tea and a good book. ***

If all goes well, Someone will come home about 10PM to find me already asleep and wondering what debauched doings went on that day.  He might notice the discarded artichoke jars and the hanging garments. Harper will be ecstatic to see him and be let out again.

 

 

* I suppose if Spo-fans happen to be in the area, I would make an exception; do drop by for line dancing and a cup of tea.

** Which is most of it.  We do not have the same tastes in music. He dares to mock The Goddess in all of my favorite forms : Enya, Loreena, Eartha, et. al.

*** “The Moon is a Harsh Mistress”, by Robert Heinlein.

I am “in mood” as Brother #2  would say about me whenever I was cross or petulant. My present disconsolate temper stems from having had a very long work day. It was followed by a night of more work. I am a consultant on an endless medical case. In my fatigue I went to the grocery to get something awful; I dragged along Someone to curtail any excessive emotional acting-out purchases. I came home with a jar of salsa and a bag of chips*, which were gone in no time. So – here I sit, bloated and feeling the guilt one only gets after consuming something you shouldn’t in lieu of something prudent and sensible. Oh the degradation.**

Oh but there’s work to be done this weekend. I need to get cracking on several sewing projects. While Someone spends Saturday doing an ushering marathon I will transform the living room into a sweatshop. I also need to do all the homework I neglected doing this evening in order to make love to the tortilla chips. I wish I were back in the Midwest. There is nothing so cozy and convenient than cold weather and snowstorms to justify staying home. Alas, it’s sunny and near 70, which makes me feel guilty for staying indoors hunched over the Husqvarna. I will do my best. Someone will have the car, which will keep me in and away from the grocery store. This is all very good but I will insist on have a water break every two hours.

 

 

* Nasty Tostitos-brand rounds.

** Someone – no saint himself – is in the other room watching a rather stentorian movie while consuming Ritz crackers and peanut butter.

20 January is the Eve of St. Agnes. It is traditionally the coldest night of the year; after this things get warmer and brighter. On this minor holiday I light some candles, wrap myself in a white terry robe and read (for the umpteenth time) “St. Agnes Eve” by Keats.  The feel of the feast day is a bit marred by living in Phoenix, for it was near 70 degrees today. It takes all the fun out of it.

On this most gelid evening Mr. President delivered his SOTU (state of the union) and Mr. Penguin delivered his SOTB (state of the blog). I enjoyed the later more than the former. I don’t have a SOTB address of my own but here is an impromptu: I am content with it; I hope it keeps going. I don’t see why not, so long as The Muses et. al. continue to put out inspiration and the Board of Directors Here at Spo-Reflections doesn’t shut it down or the blog is consumed in a hostile takeover by another blogger.*

Super Bowl Sunday is coming up and the I realize the debacle occurs just down the road (101 to be exact) in Glendale. I wonder if I can rent out the guest room. This sounds like a  nice way to make some quick cash, but I fear I would get some Yahoo who snores or turns truculent if his team looses.  Harper would be upset to have a stranger in the house, and I am not at all sure how Henrik would react.

At Christmas I gave Someone a Christmas prize for a weekend getaway to Flagstaff, AZ. It was scheduled to be the weekend of the Super Bowl, but it had to moved for Someone is planning on helping out with the half time party. He is volunteering to be one of Katy Perry’s minions during her show. Sooner I would eat rats in Tewkesbury than be part of that nonsense. I will stay home and read Keats out loud to Harper and Henrik.

 

 

* Although I wouldn’t mind being ravished by a few bloggers. Names provided by request and for reasonable attorney’s fees.

thNobody called me last weekend. I wasn’t expecting anyone to do so, but this morning I realize I was hoping someone had. Not even any of my myriad relations bothered to pick up the phone. Some of them were engrossed in football, and most of them were tending their immediate family soirees.  The parents (in theory) have plenty of free time to gab but have lost interest in their eldest grandchild-less son.  Mother is too polite to come out plainly to say “Sorry, I’m busy. I’d rather get back to my (fill in the blank) than talk to you, could you call back later, like next week?”

I confess: I telephone primarily to settle a business-like matter such as getting directions or inquiring when theatre starts.*  Therefore, I shouldn’t expect others to call me out of the blue to announce they are thinking of me and wonder what I am doing etc.

Nowadays when someone calls me this evokes annoyance rather than ebullience for they are invariably telemarketersor fund raisers, easily identified by a pregnant pause while I repeat “Hello? Hello?” before they go into their spiel.

Texting is more readily available but I haven’t gotten the hang of it viz. it is mainly for inane and desultory comments or a means to converse intelligently? Nephew #1 informs me no one of his generation ‘calls anyone’ but they text, their fingers flying across the keypad quick as quarter notes in a Mozart piano concerto. When I send text messages they are designed to make the recipient smile a bit. This hardly enhances deep process or clarifies when the theatre starts.*

Email suffers from a similar identity disorder. Email appeals to my desire to compose prose. Someone once worked in a work world where email was king of communications. My field (medicine) loathes email; it tries to avoid it at all costs. I use email in my private life for ersatz letter writing.

How ironic there are more and more means with which to communicate but I seem to be doing less of it and feel more awkward to do so.  I vote for going back to rotary phones; with them I knew what I was doing.  And theatre was always at eight.

 

* 8PM. Theatre is always at eight.

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