On February 25th, 2010, President Barack Obama and the US Congress held a Health Care Summit. While I am still looking for a workable way to show the entire summit here on my site to make it easier, I found 2 links that will take you to C-SPAN to watch the entire summit, which is broken down into a morning and afternoon session.
Enjoy, but beware, each session is very long and the entire summit lasted over 6 hours!
Dany
White House Health Care Summit morning session (2 hours and 54 minutes)
White House Health Care Summit afternoon session (3 hours and 24 minutes)
Vicodin is like Heroin-Lite. The only difference is that, while everyone and anyone will tell you how dangerous and addicting and horrible heroin is, vicodin is prescribed by your doctor to help you. Here is this wonderful, caring person, who has eight years of schooling and four or more years of internships and specialized training under his or her belt, and they’re giving you this little white oval shaped pill and telling you it will take away your pain. What they’re not telling you is that it is highly addictive, and if you become addicted, you’ll go through all seven levels of hell to get off of it. So much for the hippocratic oath.
You take your medicine like a good little girl or boy and eventually you run out, or you decide to quit on your own. And then a magic surprise happens. You feel terrible. Depending on how long and how regularly you’ve been taking vicodin your terrible can range from “I feel kinda blue and tired today” to “I’m having a panic attack and my entire body is in excrutiating pain and I can’t sleep and I really just want to cry and throw up and die all at the same time!” Most people ask, since it’s so wonderful and so readily available, either by prescription or through that friend of a friend of a friend, why bother to quit at all?
We all know that vicodin causes euphoria, happiness, and just a darn good time. What most people don’t know is that it can also cause heart palpitations, nausea, altered mental status, seizures, hallucinations, severe weakness, jaundice, bleeding, bruising, stomach pain, sweating, hot flashes, itching, and, according to wikipedia, “liver damage can manifest ranging from abdominal pain to outright liver failure, and can necessitate a liver transplant to avoid death.”
Sounds like a good idea to quit right? Right. Until the withdrawls kick in. Then you’re thinking, “A liver transplant can’t be that bad, wonder if Uncle BillyBobRay or Aunt LouAnne will give me part of theirs?” As I stated before, withdrawals from opiates (including vicodin, percocet, oxycontin, etc) can range from the mild blues and slight achyness that most people who have taken it for longer than a day will experience, to total opiate withdrawal. John Lennon wasn’t lying when he wrote “Cold Turkey”.
Some of the wonderful things this author has experienced when trying to quit are: nausea, vomiting, feeling really cold all the time, headaches, pupil dilation causing light sensitivity (at one point the glow around traffic lights seemed to extend to about 10 feet around each individual light), cold sweats, severe and debilitating anxiety, restlessness, pain so severe it feels like one has been thrown out of a second story window (the worst part is the bone pain, it literally feels like breaking a bone), severe depression, shaky hands, exhaustion to the point of not being able to sit up straight, panic attacks, diarreah (too severe to describe), restless leg syndrom, insomnia, runny nose and other cold symptoms, and the inevitable random other illness that usually shows up about a week after quitting, just for funsies.
Enter stage right: Suboxone. In my next installment I will tell you, the reader, all about the “miracle” drug suboxone and how it’s used to treat opiate addiction. I will also tell you how it is working for a certain person who has found themselves addicted to prescription painkillers.
Last Saturday’s Stribe (Star Tribune) included an article called “On Paws and Needles“, which described the growing practice of pet acupuncture in the Twin Cities. I have very little faith in acupuncture for humans and about the same amount of faith in anecdotal evidence, but that’s what author Kristin Tillotson asks us to accept when she writes
“Whether or not you’re ready to embrace the concept of chi flowing through your body, it’s tough to argue with pet owners who have seen their beloveds go from listless and limping to perky and playful.”
Tillotson does let us know that there is some controversy surrounding pet acupuncture with her section entitled “Not enough proof?” (here, I fixed it for you: “Not enough proof?.), but the quote from Dr. Craig Smith is brief, and I get the impression that the author included it so she could argue that she has presented a fair and balanced look at the issue. She quotes Dr. Smith:
Most studies that have shown benefits have been for muscular-skeletal pain. But for seizures and asthma, we do not have the evidence at this time that it’s as beneficial as drugs can be.
However, she follows this logical assertion with a description of ONE CASE that begs to differ. And she also lists an extensive group of local veterinary practices where one can find pet acupuncture.
Dr. Smith reasons that there probably isn’t a push by Big (Vet?) Pharma to incorporate acupuncture sessions into mainstream veterinary practice, as needles are inexpensive. However, at $75 a session and an ability to prescribe as many sessions as an owner will let you get away with, I can see where there might be other financial incentives that could help select for an increase in the occurence of pet acupuncture.
One statement in the article that interests me is a quote by Dr. Keum Hwa Choi, a practitioner of veterinary CAM (complementary and alternative medicine) who started a Vet CAM service at the University of Minnesota eight years ago:
“Dogs don’t experience any placebo effect like humans can. Their brains don’t tell them, ‘Gee, I got these needles stuck in me so I must be better.’ They either feel better or they don’t.”
Hmmm…placebo effects in animals…??? Interesting thought exercise. Although, if not placebo effect, perhaps another variable? I imagine that an acupuncture session is fairly relaxing for the pet - the article indicates that the animal is the center of attention during these exercises – they are petted, nuzzled, spoken to in calming adult-cooing baby language, placed on warm blankets with candle light and soft music, perhaps? One woman reported that her cat’s bp dropped from 220 to 169 by the end of a 10-minute HEAT LASER treatment (apparently, cranky 17 year-old Annie isn’t having any of that sharp sh*t poked in her head, so the vet uses heat lasers rather than “dry needles” to complete the treatment. But don’t worry, I have a very strong suspicion that the two treatments do exactly the same thing…that is…nothing). Apparently, giving your pet attention – petting it, being nice to it, keeping it warm - encourages a calm and happy demeanor. Do needles or frickin’ lasers really add anything to that experience?
And just for fun, here’s a picture of a puppy with pins in his head. Poor little PinHead.source: http://www.habitatboise.com/custom_content/5558_acupuncture.html
After every exhilarating experience, is the period of being brought back down. This week has been that for me. I am working diligently to get my first class series on the way, but as many realities set in, I’m getting tired. Not tired of working on things, just tired. I am ready to start a little bit of advertising though, and that is exciting.
Otherwise, we have our 5th big snow of the last two months. I have to be honest here and say I am tired of that – beyond tired. I had to get out in it yesterday and take myself to the doctor, which required a little hike to the vehicle. Then, I had to drive 20 miles an hour, which is extremely hard for my wound up self to do. John told me about 50 times to be careful and not rush. I said that I wasn’t setting out to get myself hurt, but to go to the doctor. We laughed.
So, it was no surprise to me that by the time I reached the doctor in the next county, that my blood pressure was a bit elevated, and I had the beginnings of a headache. I have been having these headaches that radiate up the back of my head, and my neck constantly feels stiff. The cold that I have been battling for nine days now hasn’t helped. It wasn’t long before my doctor was writing a prescription for some new medicine for tension, and of course recommending more sleep. I don’t stay up late and I don’t wake up too early. I don’t know where my rest is getting off to. I looked up the medicine on Kelly Mom and it is an L3 for lactation. This means there could be some risk. Ivy didn’t nurse for a little over two days, but for the last two days she has nursed two or three times. I’m not sure if I should take the medicine, but I am looking for something to relieve this pressure in my head. I hate taking pharmaceuticals. If anyone has any ideas, please send them my way. Yeah, I know, you’re thinking – a yogini having a problem with tension, that stuff must not really work. I say, yeah, you’d think, but I’m still “practicing” and it is what relieves me most days. It’s like magic.
The girls have decided that they don’t like snow. Deladis is not happy at the large flakes falling today. She said it’s too cold and she is ready for Spring. Aren’t we all? I’m pulling all the stops to keep them going through the days without too many meltdowns, but the last few have been harrowing. Both of the girls have began their first period of tears shortly after waking the last two mornings. Typically, I don’t have to think about that until the late afternoon.
Today, I pulled the rocking horse out of their bedroom, hoping to help them release some energy.
It helped for about 10 minutes.
Honestly, I don’t think any of us has too much energy left aside from the anxious kind.
This post seems like one big long whine. I’m sorry. I’m just tired. I am also very grateful. I am grateful for the ebb and flow of life, because there is no way we could last through any one period forever without becoming numb. I am grateful for my two little girls and their leaps and bounds everyday. I am grateful for a loving husband and best friend who takes taking care of us very seriously. I am grateful that Spring is on the way and soon I won’t be blowing my nose a hundred times a day. We will be planting a garden, playing on the back patio, and existing in Mother Nature beyond the 900 square feet of cabin.
Thank you to the highly organised team who coordinated the search for this beautiful yellow and gold Nobel prize winning yarn. As we read about the history of genetics, we noticed a cluster of Nobel prizes in the field between the late 1950’s and the mid 1960’s, when the genetic code was understood. Here they are:
1957 – Alexander Robertus Todd received the Nobel Prize for chemistry for synthesising chemicals leading to the discovery of the structure of DNA.
1958 – Beadle and Tatum received the Nobel Prize for medicine and physiology for demonstrating that one gene controls the production of one enzyme.
1959 – Arthur Kornberg received the Nobel Prize for medicine and physiology for demonstrating that DNA can copy itself.
1962 – Watson and Crick received the Nobel Prize for medicine and physiology for their discovery of the structure of DNA.
1965 – Jacob and Monod received the Nobel Prize for medicine and physiology for demonstrating how genes are switched on and off.
As some of you may (not) know, I’m doing my acute medicine rotation as part of my 2-year internal medicine core training. This means the temporary shitty shifts, and the struggle for survival of 13 hour back to back on-calls for 7 days in a row. 3 days then 4 nights, a weekend off, and a string of 13 hour on-call days.
One of the lucky times we got to snooze in the Mess. So cute!
Night shifts are unpredictable, so you can have no-one to see, or all of a sudden 6 people waiting to be seen and sorted. You may have 1 really ill one, or 6 crap admissions. Or people going off everywhere. Up to you to prioritise, and young(er) docs tend to be perfectionist and want to see and sort everything before going on their breaks. Bad idea. You’ll find it’s 8am in the morning before you’ve had a pee.
*Tip: know what can wait and what can’t.
So knackered we fell asleep despite Family Guy on TV
I hate that part of the rota, but the trade-off is off-days on weekdays and 2 week holiday blocks. Woo hoo!
The other good thing about nights is not having to deal with administrative bollocks. And it being simpler to prioritise what can wait and what cannot wait based simply on the fact that your consultants are asleep, and no, you cannot do an MRI in the middle of the night, and no, there are no surgeons to deal with un-sensational abdomens. (ie. not about to rupture any minute)
You must be thinking what a nice life we have, but I don't take the camera out when we're life-saving...
Goodbye for now! Next shift after the weekend: Mon-fri 13-hour on-call days.
PRESS RELEASE FOR IMMEDIATE RELEASE Aloma Urgent Care Achieves Urgent Care Center Accreditation
Winter Park, FL – Aloma Urgent Care, an Urgent Care clinic in Winter Park, Florida has achieved Urgent Care Center Accreditation from the American Academy of Urgent Care Medicine (AAUCM). Aloma Urgent Care is a well-run Urgent Care center with the capability to treat a wide array of injuries and illnesses.
Accreditation is a voluntary process through which an Urgent Care Center is able to measure the quality of its services and performance against nationally recognized standards. The AAUCM Urgent Care Center Accreditation (UCCA) Program recognizes outstanding facilities which demonstrate the highest level of commitment to patient care and the practice of Urgent Care Medicine. This Accreditation serves as a benchmark of quality, not only to those involved in the healthcare industry, but to the general public as well. The UCCA Program accomplishes the accreditation of Urgent Care centers by setting standards, measuring performance, and providing consultation and education where needed. Accreditation is ultimately awarded to those urgent care centers that are found to be in compliance with the AAUCM standards. Urgent care organizations value accreditation as a measure of professional achievement and quality of care. This mirrors the missions and goals of the AAUCM.
The American Academy of Urgent Care Medicine (AAUCM) is a national organization which represents thousands of physicians who practice urgent care medicine in various clinical settings throughout the United States. The purpose of the AAUCM is to contribute to the field of urgent care medicine in the areas of professional growth, scientific and medical research, and medical education, all to improve the overall quality of medical care. Our mission is to advance the profession of urgent care medicine by elevating its standards through education, basic and advanced training, and to encourage physicians to seek board certification in urgent care medicine.
I can’t decide whether I love or hate nights. There’s a strange sense of calm in the hospital. There’s just a skeleton staff, the corridors are quiet, voices hushed, the doctors room deserted. And that’s what I like. Less people harrassing you, no consultants demanding instant scans, no nurses demanding instant discharges just medicine stuff. Well, I’m getting carried away. There’s always something else. The patient who intent on “GETTING OUT OF THEIR BED and CATCHING THE BUS HOME BECAUSE OF COURSE THEY’RE NOT IN A FREAKING HOSPITAL YOU FOOL.” Often alcoholics withdrawing or little old demented ladies, both of whom tend to choose the early hours of the morning to go off the wall (at times literally off the walls). But then it dies down. Wards are dark. A shaft of light from the nurses station gives a calming glow, not too hard on the eyes. But in the depth of nights decisions are hard, thoughts are often skewed and undoubtedly a sick patient always seems much worse than in the cold light of day. When I stumble around a patient’s bedside in the dark (if only the NHS provided working bulbs in bedside lights I would have noticably fewer bruises on my poor thighs) nights are frustrating, but the chance to sit doing paperwork at the computer with the radio on softly is something which can only be captured on nights and as the sun comes up, I can stand up, stretch and take a peek at the sunrise stretching over the city out to sea, the glowing reds and yellows marking the start of a new day. In an hour or so, the day staff drift in, lights are switched on, patients wake and the day’s in full swing. And then I write myhandover list, present the night’s take and breathe a deep sigh of relief as I realise bed is within reach. As everyone is starting the day…rushing to drop children at school, get to work on time, chase after the ward round (inevitably a consultants legs no matter how short they may look go at 10 times the speed of any normal human) but me, I wander home, collapse on the sofa and before I know it, it’s six in the evening and it’s my turn to start the day. That half light of dawn and dusk is difficult to beat.
I would like to ask a basic question that has domestic violence as its subject.Who teaches that domestic violence is wrong? Who teaches a father or a mother that they should not belt their kids? Who teaches a father or a mother to allay their fears, their panic, their anguish and do not reap them on their children?
Who handles the ill effects of a childhood beaten by parents?
Certainly religion is not an adequate teaching mechanism
States, governments, do not either.
We are left with a huge gap between those people in our societies who need psychological help and those that are psychiatric cases.
The problem is that we do not have enough good shrinks at hand to treat everyone. The trouble is that SOCIETY prefers not to bother with this problem that is so common.
We have not discussed the body violation of moms and dads upon their children either at this stage.
It is fortunate that people start to talk about these serious problems, instead of keeping it under the blankets and saying “that it only happens to others”
Of the thousands of people who I have known so far, I can tell you that about half of that number have a case of beatings, of domestic violence of sexual abuse, men or women combined.
I talk to people from all walks of life. What do I see?
I see so many women who send their children or their husbands to see psychologists. The problem is that going to see a shrink is still closely linked with women’s emotions: “it’s a woman’s thing”.
Most MEN have not taken control of their lives by admitting that they also need serious life reference points other than the ones that their fathers gave them that are often faulty.
Why is that?
Mothers and women are principally the educators. The fathers are often no longer existent in a household and their notions of socializing their own children is often lacking.
The American Cancer Society estimates there were a total of 254,650 new diagnoses of breast cancer in 2009 (actual records are only available until 2005; newer information has not been compiled). As a member of the female population, I am very aware of these numbers. Television commercials, full-page magazine ads, and a virtual who’s who of celebrity sponsors make it hard not to be. Everywhere I look is the ACS “pink warning,” in ribbons, scarves, posters, bumper stickers, etc., trying to “raise awareness” about breast cancer. (Personally, I’m wondering what rock a person could be living under to not be aware.) And, as usual, I felt the need to question the authorities that be and look into these numbers more closely.
First off, let’s take that number of expected new diagnoses – 254,650 – for the 2009 calendar year and compare it to the female population of 2009: 154,000,000 (roughly, estimated from Census Bureau population charts). So with no more than a pocket calculator, I can conclude that, in 2009, any given female’s chance of being found to have breast cancer was essentially 0.00165%. There are other factors, of course, especially age and family history, but this wasn’t exactly the death sentence I was expecting. From all the media hype and social awareness I had expected much higher numbers. But 0.00165%? That means you’d have to get 1,000,000 women together to find 17 with new breast cancers (and that’s rounding up). That means if the entire metropolitan area of Memphis, Tennessee, were female, less than twenty would have been diagnosed with breast cancer during the year. I’m as likely to be killed in a freak accident involving jalapeno poppers and a road grader. Okay, maybe not, but it’s still pretty remote.
Now before anyone gets their bra in a bunch, I understand that it should not be dismissed. Like any disease, I think it should be kept in the back of your mind and those more likely to be affected (women over 45, smokers, of African heritage, or with family history of breast cancer) should take whatever steps they feel are necessary to protect or treat themselves. Breast cancer contributes to some 40,000 deaths each year; that cannot be ignored. Period. But I don’t believe it’s the plague it is played up to be. For instance, according to the National Safety Council, women under age 45 are more likely to die of accidental poisoning than to develop breast cancer.
So – to continue poking around these ACS estimates – women under 45 were expected to comprise only 25,100 of the new diagnoses. Which drops the chances to a whopping 0.00027%. Did you catch that extra zero in there? Now scrounging up 27 new diagnoses would require 10,000,000 women. That’s only slighty less than the entire Paris metropolitan complex … or the populations of Los Angeles, Chicago, Houston, and Phoenix combined. And this is supposed to be a major concern? I’m more likely to be shot; to drown in a swimming pool; to die in a plane crash or from heatstroke; or even to suffocate in bed (according to the National Safety Council). I don’t see a lot of warnings about the dangers of bed-clothes. But maybe Martha Stewart has more up her sleeve than white sales and stock tips, eh?
The American Cancer Society’s own documents state, “95% of new cases and 97% of breast cancer deaths occurred in women aged 40 and older.” In fact, most breast cancers occur in women 70 and older, when chances of being diagnosed “skyrocket” to 0.016%. And one last percentage to throw at you … taken as a whole, over an entire lifetime, the average woman has a 0.125% chance of being diagnosed with breast cancer.
So why the media frenzy? Why the pink and celebrity sponsors and full-page ads? Why are they worrying college students and the MTV generation about something that really begins to pose a threat only at retirement age?
I don’t know, but it has provoked me to look into other concerns and do some digging. Consider this post the first of a series exploring medical concerns. And remember to take media “warnings” with a grain of salt.
When last we encountered the non-fiction feminist book on sexuality by sexologist by Dr. Leonore Tiefer, Sex is Not a Natural Act and Other Essays, we had just wrapped up reading the first section on my new-to-me (slightly used) Kindle. The book is a real challenge, heavy on academia & theory as it relates to feminism and sexuality. However I’m relieved to say that the chapters in the second section, Popular Writings on the Theme feel less academic, and so it’s a bit more accessible to the general public. Although it contains 6 sub-chapters, Popular Writings on the Theme is shorter and feels shorter than the first section – I didn’t have to use the Kindle’s built-in dictionary feature as often, and I didn’t need to re-read as many passages to absorb their messages. In these essays, Tiefer was writing for a different audience, so she decreased the frequency with which she used postmodernist language.
I also found this second section of the book funnier than the first section, but unfortunately, the humor is not because I found Tiefer’s writing in and of itself funny… No, rather, I often found it funny due to the large gulfs separating Tiefer’s reality and the one in which I live. The grins I made were due to my jaw cynically clenching, my laughter a hoarse, half-choked “Lolsob.”
The first chapter of the second section consists of a series of sexuality columns written for the New York Daily News back in 1980-1981. That’s 30 years ago, waaaay before the internet was readily accessible and long before printed media started to enter its death throes. Most of these essays would probably be helpful to someone who is brand-new to studying sexuality, or who is looking for general sex life advice. Unfortunately, as of the book’s second printing in 2004, these columns are showing their age, and provided very little new material to me. By the time I got around to reading the essays re-printed from the newspaper, I had already encountered elsewhere most of the ideas contained in Tiefer’s old columns. Yes I know sexual spontaneity can be hindrance to a fully enjoyable sexual experience, yes I know that when we (and especially the media) think of “Sex,” our definition is likely very intercourse-centric and that it’s helpful to expand the definition of sex, etc. etc. etc.
But I found myself getting hung up on some changes that have happened since the essays were first printed. For one example, (There’s several other examples I could pick out…) when Tiefer talks about the joys of petting, she states, “It’s joyless and burdensome to cuddle and embrace with someone you neither know well nor want to know better” (Location 875.) But wait, aren’t there cuddle parties nowadays where folks who have never met before can come together and learn to do exactly that? Cuddle parties are designed to be non-sexual, but they may still involve embracing, and that’s not meant to be joyless at all – quite the opposite, from what I understand.
One of the funniest newspaper essays is “Free Love and Free Enterprise,” and the humor comes from how dated the situation described now is. (This essay might be worth burning through your available Google Book preview. You need to be careful with how much you use the GB previews because eventually it will prevent you from going any further. I’ve been able to “Go-around” this limitation by using a second computer or my mobile device, but not everyone has that option…) Tiefer takes the reader through a hypothetical tour of “A sex show at the New York Coliseum“ (location 934,) with the goal of showing the reader who stands to profit from the sexual revolution and how… and that includes sex toy retailers, by taking advantage of consumers. Oh, consumers may well benefit, she concedes at the end of the essay, but only as a side-effect.
As I was reading, I thought to myself, “That hypothetical sex convention sounds awesome! How do I get in on that? How do I RSVP for the next show?” Then I remembered – we HAVE a sex & sex toy convention open 24/7 – it’s the internet! Just replace the use of the word “Booth” (used over & over again) with “website/GoodVibes/Babeland/Craigslist.”
Plus, some of the fears Tiefer expressed in this chapter didn’t come to fruition even 30 years later, while others were prescient:
“The next booth moves us into the world of stuff. Under the banner ‘Bare-handed sex is boring,’ we find equipment to enhance the senses and the imagination. Massage oils and flavored lotions lie next to vibrators and dildoes. Alarming displays of bondage equipment are shown along with phony organ enlargers. There are life-size ’sex partners’ in different colors of plastic” (location 944.) [It goes on in that manner for a few more paragraphs.]
Now, I did a Google search for the term, “Bare-handed sex is boring,” and as of today, I got nothin’. (Chances are that in a few days one result will link back to this blog entry.) Who would try to sell sex toys under this slogan? Would something so negative even move any stock out the door? I looked up this expression, because in all my sex toy shopping, I have never encountered a sentiment like that from a retailer – have you?
I’ve definitely seen retailers push G-spot toys in particular… but in terms of tactile sensations & calling outright certain sexual activities boring?
Maybe I’m not looking at the right retailers, since I prefer to patronize organizations that market themselves as woman-friendly and sex-positive.
As for the rest – I’m not understanding what message I’m supposed to take away from these passages… am I supposed to be reluctant to explore my sexuality with what’s available to me now because of the motivations behind the companies that sell sexual advice and devices? Am I still doin’ it wrong? Am I supposed to feel sexually inhibited at the conclusion of this essay?
The next few chapters touch upon the symbolism behind sex, sexual acts and sexual medicine, notably Viagra.
Ily already beat me to the chapter on the anthropological approach to kissing, which also explores symbolic kissing in art. For anyone curious as to the contents of this chapter, a slightly different version appears for free at this Kinsey Institute page, so go knock yourselves out. I don’t have much to say on this chapter.
The next chapter talks about how hard it is to have frank & open dialogs about sexuality, even in a sexual relationship. I’m certainly open to talking about how hard it is to frankly talk about sex too, but, I’m still getting tripped up on some of the finer details, particularly the passage about the asexual couple.
Tiefer then goes on to talk about Viagra a a symbol – symbolically, it’s looked at as magic pill that can fix all non-pain sexual problems (Tiefer doesn’t mention anything about sexual pain in this chapter; location 1100.) In reality, the drug isn’t perfect, and it may cause unpleasant, potentially dangerous side effects.
I have no idea what Tiefer was trying to say about Viagra when she then included a Viagra user’s own words followed by her analysis of his situation, because the following passages threw me into rage-rage-rage mode. I think she was trying to make a point about side effects or something:
I am a 37 year old man with erectile problems for 2 years. I have used 50 mg. Viagra 4 times. All of those times have resulted in a very good erection and intercourse. The side effects are headache, upset stomach, stuffy nose, and facial flushing… About 30 mins after taking Viagra I take 2 Tylenol and a Tums and start drinking water. After about 15 mins I take another Tums and use a nasal spray for my stuffiness. I will continue this combination and it will work for me.
This sounds more like a Jackie Gleason routine rather than a romantic evening, but I think it is close to the reality of what life with these drugs will be like… How does his sexual partner feel about the whole drama with the Tums and the nasal spray and the Tylenol? (Location 1109)
Woah, woah woah, waaaait a minute. Hold the phone. Jackie Glea… Jackie…. Gleason? Like, from the Honeymooners?
What the f…
Is that supposed to be a joke? Is this Tiefer’s idea of humor? This essay was given as a lecture in 1999; did Tiefer pause for applause & laughter when she finished reciting this passage?
Since when is Tiefer is the arbiter of what constitutes a romantic evening? Didn’t Tiefer state not a few chapters earlier that actively thinking about and taking steps toward making sex happen is a healthy thing? Is this the same person who said “Some people complain that all this groundwork is too mechanical and time-consuming. Working at sex, they say, defeats the whole purpose,“ (location 853,) when she debunked the myth of spontaneity? What happened to that?
You know, for someone who claims to want to expand the frank & open dialog of sexuality, Tiefer sure doesn’t make it easy to talk about physical problems and potential treatments for them… that’s a hangup I’m having with her social constructionist approach, it sacrifices biology. I still have the impression that it’s “Either/or” for Tiefer, but not both, and both is what I need.
Okay, someone needs to sit down and explain to me, in great detail, exactly how a guy who uses Viagra in order to maintain an erection for intercourse, and who has found ways to manage the side effects, is like re-enacting a Jackie Gleason comedy routine. I don’t get it.
We don’t have much else to go by as to the background of this person who left himself open & vulnerable by talking about his Viagra use. For all we know, he and his sex partner already incorporated an expanded definition of sex into their lives, and, like myself, decided that that definition was not completely incompatible with occasional intercourse. I say, using Viagra or other prescription drugs, treatments and devices is not necessarily in conflict with a healthy sex life. If using medical treatments leads to a satisfactory sex life, how is that an inherently bad thing?
And if it is an inherently bad thing, then what does that say about me? Is my sex life a big joke to Tiefer? Who am I to her – Lucille Ball? After all, when my partner and I decide we want to try PIV intercourse, I have to go through a routine involving pelvic floor stretching, lubricant and dilators. Am I supposed to feel embarrassed about doing this in front of my partner? Or about openly talking about it?
There’s not much left of the chapter after that Jackie Gleason bit. Which is good, because I remained in rage-rage-rage mode for the rest of the chapter and was unable to absorb anything more from it. Something about sexual education outside of the US, I don’t know.
The next chapter, The Opposite of Sex, is another free-to-the-public article originally published online. It consists of Moria Brennan interviewing Dr. Tiefer. It’s part PR for Sex is not a Natural Act, part feminist discussion, part sexuality discussion. The most interesting part of the discussion comes when Brennan asked, “Do you think our understanding of sex also affects our understanding of gender?”:
lt: Gender affirmation is a phenomenally important element in the current construction of sexuality–at least for heterosexuals, who have been the bulk of my clients. Reproduction used to be the essence of gender affirmation for women. And for men it was employment. Now there are fewer and fewer ways of proving gender, and yet it’s as important as it ever was. So how do you prove your gender? You’ve got to be able to have sex–not just any old sex, but coitus. Talking about this in the context of feminism is crucial. It’s men’s investment in a particular kind of masculinity that is fueling Viagra. Part of the work of feminists has been to question accepted notions about masculinity, whereas you could say Viagra is affirming them.
…
Not being able to have an orgasm is like the epitome of not being normal. It’s the epitome of not being a man or not being a woman. So I would tell them that there are ways to cope with this. Let’s be a man in other ways. No, they couldn’t accept that. To them, this was the proof. (Tiefer, online.)
This isn’t an unfounded idea – I’ve heard this sentiment elsewhere… there’s something familiar about it… I remember; it was that 20/20 segment on vulvodynia. One of the patients interviewed said something about, part of being a woman, is having female parts. Of course, it’s so much more than that. But it’s hard to get that message out, about gender, that it’s more than biology as destiny. So that’s something worth exploring.
The next chapter, the McDonalization of Sex, talks about the standardization (McDonalization – the description on this wiki page matches what’s in the book, so it’s probably a good place to start if you haven’t heard that term before) of the everyone’s sex lives. Although this chapter is not heavy on academia, I still needed to re-read it a few times before I could understand it… it’s not academic, but it’s difficult because Tiefer jumps around a lot in this chapter. It feels disorganized.
Tiefer identifies two forces behind the McDonalization of sex – mainstream media and medicine. Ever see very similiar but unrealistic sex lives depicted on TV or hear about it in song? There’s a right way & a wrong way to have sex & be sexy, and if you don’t match what’s in the media, you automatically have a dysfunction. If you’re familiar with this sort of depiction of sex in the media, then that’s an example of McDonaldization.
But in real life I’m not seeing medicine participating in this phenomenon… This is where the gulf between my reality & Tiefer’s is the most pronounced. For example, with regard to how McDonaldization comes from the medical profession, Tiefer claims that,
“There’s another source of the new standards that you may be less aware of. It’s the medical profession, with its new men’s sexual health clinics and the even newer women’s sexual health clinics. These things are popping up all over, almost as fast as new McDonald’s. And they really are fast-fod franchises that specialize in efficiency, predictability, numbers, and control. Everyone who comes in with a sexual complaint gets an expensive workup with genital measurements that seems superscientific. But nine times out of ten, the customer walks out with a prescription for Viagra, and since in the future there will be a dozen or two dozen such sex drugs – for both men and women – if the first one doesn’t work the patient – or is it now merely a customer – will be encouraged to try another and another.” (Location 1270.)
And I’m like… where do I find one of these geometrically growing sexual health clinics? Who are we talking about, what should I be looking for, and how do I get their phone number? Are any of these clinics local? If so, when is their next available appointment? How do I get in on this?
Tiefer doesn’t provide any hard examples of who she’s referring to so I’m left wondering – general OB/GYN practices? Vulvovaginal specialists? (Which, in my experience, are hard to find, especially if you’re not nearby a major metropolitan area…) Planned Parenthood? I typed “Sexual health clinic” into my Google Maps but the nearest results – which are questionable at best – would still take me close to two hours to get to at best.
I guess I’m the odd one out again, because if you consider the vulvovaginal specialist I visited to be a sexual health clinic, I never got a prescription for Viagra (I wonder how I can verify that 9 o ut of 10 statistic claim?) – but I did get a prescription for generic valium (no refills) that’s about $10 a bottle under my insurance plan, and I needed that for general anxiety anyway. At the specialist’s office, we didn’t take genital measurements… although we did use a device to figure out how much pain I was in; does that count? And a hormonal blood test revealed that the birth control pill I was on at the time certainly wasn’t doing me any favors. And I’m still wondering where my two dozen sex drugs are… right now vulvodynia patients, at least, have fairly limited options when it comes to oral medication, and at least two of those options are off-label use anyway. And I’m surprised Tiefer left out the mention of non-drug interventions that sexual health clinic doctors might suggest, including but not limited to diet & exercise, or, perhaps for a very few patients such as myself, surgery.
Indeed, the NVA lists several books of interest that do talk about expanding the definition of sex beyond biology. However the NVA is not in and of itself a sexual health clinic…
Tiefer’s solution is more comprehensive sex education.
The last chapter, Doing the Viagra Tango, is another free-and-available-to-the-public essay (I’m glad I paid only $20 for the Kindle edition of this e-Book instead of $40 for the paperback version! I’m finding several of the essays re-printed elsewhere.) The Tango in the title has two meanings – it’s referring to an old Viagra commercial featuring a couple doing a tango,and Tiefer frequently uses dance as a metaphor for sex. Here, she raises philosophical questions about Viagra – What effects will it have in many areas of life? She raises concerns about negative unintended consequences of Viagra (though I’m not fond of these passages, particularly the line that states that “In the worst-case scenario… The drug eliminates [women's] sense of desirability and sexual efficacy,” (Tiefer, online) because if someone is taking Viagra, then isn’t it just possible that in a heterosexual relationship, the woman may already be feeling like she is not as desirable, due to her partner’s difficulty in maintaining an erection? Tiefer is not interested in exploring ways in which this family of drugs may be helpful, she is mainly concerned its potential dangers.) She also explores problems in pharmecutical research, problems with insurance in general brought to light by Viagra, and even politics.
And that’s the way the second section of Sex is Not a Natural Act ends. We’re almost 40% of the way done.
At times, passages from Popular Writings on the Theme seem to contradict statements that were made earlier in the book. For example, Tiefer explicitly uses the words “Effective stimulation” in the greater context of the passage that says, regarding sexual activity, “There’s no way but trial and error to identify forms of effective stimulation” (location 907.) But wait, at locations 672 and 684, didn’t Tiefer herself question the value of the terms “Effective stimulation” when used by Masters & Johnson in their Human Sexual Response Cycle study?
One of the biggest questions I’m left with is, if the essays were written today, would they look the same?
I’ve already started chipping away at the 3rd section, which goes into detail about feminism and sexology – it’s a return to academia so I’ve got a ways to go yet before I finish slogging through.
Back on the auxiliary police beat, after a two-week break away from the uniform. Another way auxiliary policing is kind of like medicine: you risk losing the details you study so hard if you take too long a break away. Especially on those things you need to be instant recall for, like dispatch codes. The radio crackles the first call of the night, “Respond to a 911 call, neighbours reporting a 10-95 in progress at [address]” Uh… sure. What’s a 10-95 again? Oh right – domestic disturbance.
(10-codes vary from department to department, which can make that memorisation all the harder if you start getting into shows like Cops or Law and Order and they’re using different radio protocols than here. At least if you’re in medicine and a House or ER junkie, a tumour is still a tumour and leprosy is still leprosy, whether it’s in Princeton-Plainsboro Teaching Hospital or County General or the Dr Everett Chalmers here in Fredericton.)
Guess I could’ve figured it out by the address – not the first time we’re heading out that way, and definitely not the first time for the same thing, a 10-95. I guess it’s a sort of reassuring welcome back after holidays – no matter what happens in the world, the N family will still be at it, tearing themselves apart. Not so much a “family”, but a “situation”, really. Things haven’t changed the past fortnight, I haven’t missed an episode.
“10-4″. We start making our way over, following the posted 50km/h limit, stopping at every light along the way. No blues and twos – it’s actually surprisingly rare how often we use the lights and sirens to respond to a call. If you saw us on the road, the only way you could tell we were actually going somewhere is that we’re not like heads bopping at a tennis game, scanning every licence plate and doorway as we drive – which is how patrol usually goes, trawling for anything suspicious.
It’s a tough spot, that N family. If they were my patients, their charts would be a textbook of socioeconomic challenges: single unemployed mum, measures her days in cigarettes and beer cans. Non-supportive estranged father – with an alleged history of abuse, his very absence is probably the most supportive thing he’s done. 10- and 11-year-old boys at home, both with extensive records of behavioural problems; both with features of foetal alcohol spectrum disorder and ADHD, but neither interested in or compliant with social or medical assistance.
Neighbours report screaming; not an unusual sound to come across their paper-thin duplex walls, they’re finally moving away at the end of the month, not a moment too soon. Tonight, sounds like the 10-year-old is swinging a pair of scissors at the 11-year-old, because he didn’t share his cigarette. Or is the other way around? Last time it was the elder attacking, but using the cigarette itself and lunging at his little brother’s neck.
I like to think I’ve been in medicine long enough not to be shocked about situations like this. You see the same across the country, whether it’s on the buzzing streets of Downtown Toronto, the chilling solitude of Arctic Inuvik, or the lush greenery of west coast Masset: the vast majority of disease and illness affects the segment of society that can least afford it. So it goes with crime and violence too – part of the appeal of both medicine and policing, the opportunity to try to be there for people who need it most. To bring justice.
We pull up, slide out across the iced-over driveway, and let ourselves in through the open front door. The 10-year-old is in the backyard, visible through the back door, smoking away. The 11-year-old is sitting in the living room, watching Entertainment Tonight. He nods welcome. Where’s your mum? “I dunno, what do you want?” We heard there was fighting. He nods again. “I want to watch TV, go away.”
Mum comes down. Apparently everything is “under control”, we can leave now. The 10-year-old got his cigarette, so all is well in the world again.
And that’s pretty much that. The social workers will come and do their rounds again Monday afternoon after school. Kids look healthy, well-fed and, most importantly, unbruised and unscratched. We make sure the month’s heating assistance credit and welfare cheques are still working out. We ask if mum’s found a job yet: “no”, because then she’d lose her welfare and have to find a sitter. We ask if the kids have seen the psychiatrist they’ve been planning: “no”, because there’s no transport, and even if the doctors could do anything there’s no money for meds anyway, and even if there was, the kids wouldn’t take them.
We wish the Ns the best.
And we’ll be back again next weekend.
Add it to the list, more ways policing is just like medicine: you can engage, advise and hear out your patients as best you can; try to earn their trust through a repeated, long-term supportive relationship; elicit their Feelings, Ideas about the problem, the problem’s Functional impacts, and their Expectations from you; keep your door open to them, and be at their call when they ask; offer to tap them support, try to connect them with other resources, and show them a path forward – but actually taking those steps, it’s all up to them.
Pleasant surprises happen, sometimes, and you’re on top of the world when they do, but they’re few and far between. Now I’ve only been with the police for a few weeks now, but the general trend is looking not all that different from medicine – every time you see your “regulars”, week to week or month to month, you’re more likely to be disappointed than not.
And whether you look at it through the eyes of a doctor, or an auxiliary police constable – you lose sleep over it.
Vicodin is like Heroin-Lite. The only difference is that, while everyone and anyone will tell you how dangerous and addicting and horrible heroin is, vicodin is prescribed by your doctor to help you. Here is this wonderful, caring person, who has eight years of schooling and four or more years of internships and specialized training under his or her belt, and they’re giving you this little white oval shaped pill and telling you it will take away your pain. What they’re not telling you is that it is highly addictive, and if you become addicted, you’ll go through all seven levels of hell to get off of it. So much for the hippocratic oath.
You take your medicine like a good little girl or boy and eventually you run out, or you decide to quit on your own. And then a magic surprise happens. You feel terrible. Depending on how long and how regularly you’ve been taking vicodin your terrible can range from “I feel kinda blue and tired today” to “I’m having a panic attack and my entire body is in excrutiating pain and I can’t sleep and I really just want to cry and throw up and die all at the same time!” Most people ask, since it’s so wonderful and so readily available, either by prescription or through that friend of a friend of a friend, why bother to quit at all?
We all know that vicodin causes euphoria, happiness, and just a darn good time. What most people don’t know is that it can also cause heart palpitations, nausea, altered mental status, seizures, hallucinations, severe weakness, jaundice, bleeding, bruising, stomach pain, sweating, hot flashes, itching, and, according to wikipedia, “liver damage can manifest ranging from abdominal pain to outright liver failure, and can necessitate a liver transplant to avoid death.”
Sounds like a good idea to quit right? Right. Until the withdrawls kick in. Then you’re thinking, “A liver transplant can’t be that bad, wonder if Uncle BillyBobRay or Aunt LouAnne will give me part of theirs?” As I stated before, withdrawals from opiates (including vicodin, percocet, oxycontin, etc) can range from the mild blues and slight achyness that most people who have taken it for longer than a day will experience, to total opiate withdrawal. John Lennon wasn’t lying when he wrote “Cold Turkey”.
Some of the wonderful things this author has experienced when trying to quit are: nausea, vomiting, feeling really cold all the time, headaches, pupil dilation causing light sensitivity (at one point the glow around traffic lights seemed to extend to about 10 feet around each individual light), cold sweats, severe and debilitating anxiety, restlessness, pain so severe it feels like one has been thrown out of a second story window (the worst part is the bone pain, it literally feels like breaking a bone), severe depression, shaky hands, exhaustion to the point of not being able to sit up straight, panic attacks, diarreah (too severe to describe), restless leg syndrom, insomnia, runny nose and other cold symptoms, and the inevitable random other illness that usually shows up about a week after quitting, just for funsies.
Enter stage right: Suboxone. In my next installment I will tell you, the reader, all about the “miracle” drug suboxone and how it’s used to treat opiate addiction. I will also tell you how it is working for a certain person who has found themselves addicted to prescription painkillers.
source: http://www.habitatboise.com/custom_content/5558_acupuncture.html
