Joshua

He danced with his arms flung out

There was no sound, not a note to be heard

Yet he turned round and round,

head thrown back — feet stepping high

ascending an unseen stairway — to nowhere

To the primal beat intertwined

Voices of the Angels lifted in song —

What Angels?

Wondering, watching

His face dripping unknown pain

And joy

Twisting him into some demonic thing

With a werewolf’s smile

Dragon fight

— Can I see me through your eyes —

What image is it that you have created for me?

— When I look into your eyes I see swirls

of mercury… tossing like waves

over my entire body, drenching me —

and I shiver… seek out the warmth

of your skin… which must radiate from the cold silver flame in your eyes

and they way you always

smell like flowers… brown sugar.

— She was strong when you were weak —

Her eyes were dry when you wept —

she made you a man — the man you are —

Now she is tired and she weeps — can you care for her?

Will you?

— Did you hear what he said about us?

Symbiotic and sickly clinging…

My God–

You are a new kind of parasite and all

you owe me is nothing you can give —

though you feed me your poison —

to make me your nourishment —

So that you may thrive and I may cry

out in my darkness, flickering candlelight

casts my writhing shadow on a wall —

from where the spectators gather to watch —

Our Battle…

Do you feel the drip in your throat —

the thudding… this is the taste, this

is the surge — of unbridled aggression.

And so begin circling one another —

heads down, eyes glaring, tails risen —

high up in the air, forked and deadly with

points sharp as daggers —

Waiting to strike — our circle grows closer

with each turn, until we are intertwined…

One now, so only one will emerge alive —

Victorious!

Thrashing together and apart!

Wounding and wounded, both of us —

Fire sprays in all direction around us…

and the watchers draw back — gasping —

We screech in agony and rage —

A bite on the back of the neck…

And it is done… We separate now —

You — fall dead to the ground — and so

the battlefield tastes its blood…

wallows in it… so I spit —

and walk away… In disgust —

yet exalted and gratified —

because —

It is finally over!

Hands

Their lines, soft and harsh

Their resilience, texture, and strength

How gentle they can be,

the intimacy they hold…

Windows to and from the heart,

They can caress, tickles, stroke, and touch.

Tell all with not a word spoken.

Arousing passion by mere sight and

memory of what they show…

Holding the secrets of our souls,

All that we are and will be,

The tenderness we feel and hard work

we do — in care of those near and dear…

Encompassing all, weighty

with emotion and brimming —

with exaltation for our cherished.

Trembling sometimes with the

fierce intensity of our swoon…

Touching, wanting to touch, unable —

to touch, they ache as our —

souls, hearts and minds do…

They are a spiritual thing about us —

more than bone and flesh and blood…

The Cost of Negative Heatlth Behaviors

This is not a full article, as it was merely a discussion topic response in my health class, but it is particularly relevant at the moment. So I am posting it tonight.

As previously stated, the CDC, NDIC, HCUP cumulatively estimate healthcare costs linked with negative health behaviors to be nearly 6 billion annually. While this number is inarguably shocking, the host of chronic illnesses linked to these behaviors makes it becomes easy to accept when one begins to research the prices for associated medications and treatments.

 

According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA), division of the National Institute of Health (NIH), heavy drinkers have a greater risk of liver disease, heart disease, sleep disorders, depression, stroke, bleeding from the stomach, sexually transmitted infections from unsafe sex, and several types of cancer. They may have problems managing diabetes, high blood pressure, and other conditions” (NIAAA). The Centers for Disease Control (CDC) report that tobacco usage causes lung diseases such as emphysema, lung cancer, bronchitis, and chronic airway obstruction. Smoking also causes coronary heart disease, stroke, and abdominal aortic aneurysm wherein the aorta is enlarged or compromised at the point where it runs through the abdomen (CDC). Obesity is linked with high cholesterol and triglycerides, type 2 diabetes, high blood pressure, metabolic syndrome, heart disease, stroke, cancer (including cancer of the uterus, cervix, ovaries, breast, colon, rectum and prostate), sleep apnea, depression, gallbladder disease, gynecologic problems, erectile dysfunction and sexual health issues, nonalcoholic fatty liver disease, osteoarthritis and skin problems.

With each of these primarily avoidable illnesses comes a built in expense for exams medications, and surgery. More specifically: breathing machines for sleep apnea, testing supplies for diabetes along with the potential need for prosthetic replacements for amputated limbs; oxygen machines/tanks, nebulizers, canulas, and inhalers for lung diseases; chemotherapy, radiation, and surgery for cancer; physical therapy, wheel chairs, hospital beds and in home care after a stroke, heart attack, or cancer.

While varying widely in expense, none of these items is inexpensive and are often not covered even when the patient has medical insurance. Even when they have insurance, it is likely an HMO, which is the most popular choice in the United States. In the event that the HMO does cover the items, we then have to question the fairness such coverage when these organizations typically charge premiums based upon age and those who have avoided negative health behaviors will pay the same amount as those in their age group who have indulged. HMOs operate for profit, most of which comes from many who pay for it and never, or rarely, use it. The more the insurance is utilized for treatment and the greater the number of subscribers seeking treatment, the higher the premiums must be in order for the organization to continue making profit. Should people making healthy choices, in effect, pay for the unhealthy choices of others? I do not believe they should. Regardless of difficulty, whether or not to engage in unhealthy behavior is a choice. Many people make healthy choices despite the overwhelming complexities involved.

 

Major Depressive Disorder

Major depressive disorder is a serious, pervasive condition in which symptoms are overwhelming and debilitating.

According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, symptoms include a despondent state “as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)”; noticeably reduced interest or gratification in all, or almost all, activities; a substantial decrease in weight without dieting or increase in weight, or diminished or increased in appetite nearly every day; an inability to sleep or excessive sleeping; lethargy or decreased vigor; feelings of inadequacy or disproportionate/ inappropriate self-reproach; reduced capacity to think or concentrate, or uncertainty; persistent thoughts of death, intermittent suicidal ideation without a particular plan, or a suicide attempt or a definite plan for achieving suicide. Five or more of the aforementioned symptoms must be present most of the day, nearly every day, for at least two weeks. Symptoms must also cause significant difficulties functioning in daily life (American Psychiatric Association 2013.

A person with this disorder would appear listless, exhausted or uncaring. S/he might have red, glassy or wet looking eyes, with a lack of focus and the tendency to be downcast or avoiding eye contact. General appearance would likely be unkempt with an obvious lack of interest in self-care. Movements are sluggish and appear slow or exaggerated. Speech may be muted, slow and lacking in expressiveness. The person might seem bored or irritated in conversation. My former physician of 20 years (before retirement) notated in my medical record that I was experiencing MDD when I had little to report as happening in my life, as compared with a previous visit. 

I do not think the media has sensationalized the disorder, but coverage is far from unbiased.  Depression is heavily stigmatized as laziness or attention seeking behavior or it is summarily dismissed as a flaw in perception. Even if depression is acknowledged, the individual is expected to “snap out of it” or change the way he or she thinks. I cannot support this assessment with any specific examples other than my own experience, with nurses, friends and social media. 

Medication has been shown to be an effective treatment for MDD. 

According to Barlow and Durand, “[f]our basic types of antidepressant medications are used to treat depressive disorders: selective-serotonin reuptake inhibi– tors (SSRIs), mixed reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase (MAO) inhibitors” (2014, p. 246). They go on to say that approximately half of the patients prescribed antidepressants find some relief, while half of those achieve normal or nearly normal levels of functioning (Barlow and Durand, 2014, p. 247)

 

 

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, fifth edition [Ebrary Reader version] Retrieved from http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/full/10.1176/appi.books.9780890425596.dsm04#BCFEJHED

 

Barlow D.H. & M. Durand (2014).  Abnormal Psychology: An Integrative Approach, zSeventh Edition [Ebrary Reader version] Retrieved from https://online.vitalsource.com/#/books/9781285755618/cfi/246!/4/4@0.00:0.00