Ingridients:
Water, chocolate, wool, chlorophyll and additives.
Ingrid doesn't like spam
email: i(at)jamver.id.au
 moon phase |
Subscribe
Subscribe to a syndicated feed of my weblog,
brought to you by the wonders of RSS.
Flavours
There's more than one way to view this weblog; try these flavours on
for size.
Archives
Links
These are a few of my favourite links.
Mon, 28 May 2007
It's the silly crazy season, but I did want to mention that I'd finished Of two minds: The growing disorder in American Psychiatry by T.M. Luhrmann.
Luhrmann is an anthropologist who spent something like five years hanging out with psychiatrists, finding out how they see what they're doing, and what it all means.
Her study turned out to happen at an interesting time: she started by looking at the dichotomy between the biomedical "find the right drug to fix them" model of mental illness, and the psychotherapeutic "get them to understand themselves" model. As it turned out, the take-over of medicine by HMOs meant the increasing loss of the psychotherapeutic angle, and she argues that this is a significant loss for mental health.
I particularly enjoyed the beginning and end of the book and felt it lagged a bit in the middle, although I guess she is trying to supply supporting evidence for her viewpoint there.
My major discrepancy with the book is that she presents, and apparently believes to be true, these two extremely dichotomous views of mental illness as what is available to psychiatrists, and what they work with, alternating between them as needed. My experience with trying to understand mental illness is that there is value from both viewpoints, and that it doesn't take long before one forms a hybrid model, hard to verbalise admittedly, but requiring data from either model to be modified before it can be used.
Part of the difference between us might be that the psychotherapy she looks at is largely that derived from psychoanalysis, whereas I see psychoanalysis as an interesting first attempt at psychotherapy, but not particularly practical. Psychoanalysis does seem to require a very extreme frame of mind, and is a process that seems to run a high risk of damaging the patient further. Newer psychotherapies strike me as being far lower-risk. For example, exposure therapy for phobias seems to work extremely well, provided the exposure is gradual, and the judge of that gradualness is the phobic. This is, I think, quite unlike psychoanalysis, which has (to me) always had the weakness that the analyst is always right, and the patient can either agree or be labelled repressed. As far as I can understand Luhrmann, a good analyst needs to be open to their own mistakes, and even the analysand perhaps pointing out the analyst's repressions, but that sounds like a very difficult and time-consuming place to get to.
I am also coming to appreciate that however much I may be in favour of more recent types of psychotherapy, with clinical trials and brain-mind models of how the psychotherapy might actually work, not all that many psychiatrists are actually familiar with them and practice them. I hope what that means is that in the long run, psychotherapy will not vanish in favour of medicating mental illness, but that the newer, less time-consuming psychotherapies will "come on board" and hopefully get funded by the HMOs.
Because I do agree with her overall conclusion: attempting to treat mental illness only with drugs, ignoring the person and their volition, does not work particularly well.
Yesterday I played squash for the first time in over a year. I played with Birgit who has played very little squash (but a lot of tennis) so we were roughly equally hopeless, and we had fun. I of course sweated like nobody's business, and James thought I looked like I'd just stepped out of a pool.
Today, of course, I'm getting a few messages from various muscles. My left tricep, deltoid, and trapezius, not surprisingly, but mainly my glutes. Now when I go running for the first time after a break, it's my quads and adductors that have something to say, so clearly squash running is rather different from running running. I suspect it's all the lunging for the ball.
Now, James has been having some thigh and lower-back trouble, and his physiotherapist discovered that a major cause of the problem was that James basically had no glutes. I was seeing the podiatrist in the same complex, so I can vouch for the fact that for the first half an hour or so that James tried to contract his left glute, nothing happened (or his hamstring contracted). He's been practising diligently, and he now definitely has more glutes than he used to.
But James plays squash regularly, preferably five times a week. The boggle is this: How on earth has he been getting around the court without glutes? How has he managed for so long without noticing, or having worse problems than he does?
I think I can understand the principle of muscles that have never been engaged, so they just don't work, but glutes are big important muscles, pretty basic to getting around, and based on my experience, essential for playing squash.
We've moved the dance mats down into the shiny new downstairs area, and James has StepMania on his laptop, so we can do computer dance silliness again, even if it's not the final version (there will eventually be a PC down there, rather than having to take the laptop up and down).
Yesterday, Sarah and Michael (and Aidan, but he didn't dance) and Ian came over and curry and cake and gingernuts were eaten, and much jumping around on dance mats was accomplished. I was a bit worried I wouldn't get as much of a go as I wanted with five people taking turns on two mats, but luckily everyone else wore out before me, so the last hour or so I basically had one mat to myself and the other three (Ian had gone home by then) took turns on the other.
I'm quite pleased with myself as there were several five-foot (difficulty level) songs I managed okay on, and I got more of the half-beats that you see in the more complicated routines. This was partly because we re-set the note "skins" to monotone colours, so the whole-beat steps are red, half-step blue, and quarter (or other?) are yellow. This is making getting used to half-beats much easier for me, and I'll be able to eventually go back to the default out-of-synch changing colours eventually. And I'm also getting to the stage that two-foot songs are becoming mostly pointless (apart from the mislabelled ones).
We made some jokes about how many good DDR songs start with B (Butterfly, Boom Boom Dollar, Bad Girls, Boys, Bumblebee, Bye Bye Baby Balloon). And Sarah saved me with 9 seconds to go on the "select song" clock when she remembered that Sway has a title in parentheses first - so I wasn't going to find it under S, it was under "Other", and is recorded as (Mucho Mambo) Sway.
I didn't even get around to my all-time favourite DDR song (Aqua's Cartoon Heroes) but I had so much fun I didn't mind.
I stretched afterwards, and that seems to have been wise. I don't have any aftereffects today apart from slightly tight calves. I have to remember that seeing as DDR is a lot more "on the toes" than running that I have much more need to stretch my calves afterwards.
Went for a longish'er run this morning - while I'm happy with my fitness for 4k runs, I seem to run out of oomph past that, and I'd like to get back to being able to do 10k runs without having to walk part of the way.
I ran out of oomph after about 3.5k, but that was because I was nearly up the top of Mt Ommaney Drive, and I was able to get going again once it wasn't so steep, along the riverwalk, and I think I did about 7k all up.
While I was running along the river, surrounded by lush greenness, and listening to whipbirds, I was reminded of one of my favourite bits of poetry, from Andrew Marvell's The Garden:
Annihilating all that's madeI don't know if I'm in favour of annihilating everything, but sometimes, annihilating all my thoughts to green ones is very good.
To a green thought in a green shade
I went for a 4k run this morning that even though it felt like hard work, felt like fit-me hard work.
I had been running regularly last year up to around our holiday. Then with Christmas and Zeki being a bit of a pain (he's not allowed in the bedroom at night anymore) and various other bits and bods, I got out of the habit, and worse, I started going to bed late and thus getting up too late to go running. In summer, basically 5:30 to 7:30 am is the only suitable running time most days.
The last few weeks, I've been making a concerted effort to get to bed earlier, and getting up and running even if I didn't feel like it. The first few runs were very unpleasant; about the only thing that kept me going was knowing that it would pass, and that if I didn't run now, it would just make more runs more unpleasant in future.
So, by this morning, it feels like I'm back in a normal running zone. Yay! for persistence, and for knowing my body well enough to read all the signs correctly. Not so yay for getting into that state in the first place, but I've dealt with it now.
Also I did the second coat of paint on the bit of the balcony where the air conditioner is going. The air conditioning guy, Paul, is currently installing the back balcony air conditioner.
James has to go sing at a wedding this afternoon, time to help him get ready.
James and I went rock climbing for the first time last night at Urban Climb. You hire harness and shoes, you go through a rather thorough safety/how to do it instruction, and off you go.
The set-up consists of a fake rock wall with regular holes in it, that plastic knobs of various sizes, shapes and colours can be attached to. There are rope anchors at regular intervals, attached at the top and near the bottom of the wall. Each floor anchor has a little card attached to it, telling you which colour routes belong to this rope, and their difficulty level.
Yellows are the easy routes, blue next, then pink, green, orange, and black. Based on the dates on the cards I read, it looks like the routes get changed and re-designed regularly. There were two or three routes for each rope - the ropes with easy routes tend to have fewer routes, because the easy routes need more plastic knobs on the wall. I usually had to look really carefully to see the black routes - most of the knobs seemed about the size of a 50c piece, and well separated.
I only made it to the top of yellow routes; I tended to either run out of upper body strength, or get stuck on a bit trying to figure out where to head next without cheating (using plastic knobs of a different colour) for too long to get to the top of any blue routes. James got up several blue routes and had a go at a pink one, I think.
I discovered that my whole Problem With Down wasn't really an issue, partly because it's all about up, and I've never had a problem with up, and partly because I was so focussed on the bits of plastic within half a meter of my reach that I didn't really notice anything else. At the top, your belayer lets you down, abseiling style, and that wasn't a problem either, once I got over my initial tendency to try to hang on to the knobs as I passed them.
I also think contact lenses rather than glasses was a really good idea for me. James climbed in glasses and had no problem, but his frames are more robust than mine and my prescription is strong enough that I get edge effects.
James is really keen to go back, and I'm certainly happy to give it several more goes, but I am wondering if I have the shoulder and finger strength to get very far. I noticed that all the female rock climbers who looked like they knew what they were doing were petite: short, light, and relatively wiry, with not much difference between arm and leg circumference. Whereas I am built like the women who line up for the 100m and 200m sprint finals. The less fit version of course, but still that basic build.
James and I went climbing at Urban Climb for the second time yesterday. We both made some progress - I finally got all the way up some of the shorter, easier blue routes, and James made it up some pink routes.
The thing that's affecting me most at the moment is that I have to put a lot of effort into particular moves, particularly the "step up", using the quad muscles, including lots of thinking beforehand. That means I'm spending rather too much time hanging on by my fingers, and I don't make it to the top. I expect I'll be able to do it a lot faster once it becomes more habitual.
Successful rock climbing seems to involve speed and momentum, so your fingers don't have time to get tired, and you don't have time to fall off when you shift your weight in odd directions or scrabble up the blank rock face. It's still funny when James decides he doesn't like where any of the pink knobs are and tries to make like a fly.
I'm really pleased I'm onto blue routes. There's far more of a selection of routes than for yellow. I'm keen to do this rock climbing some more.
I went for my first ever ultrasound yesterday, which was an interesting experience. The most uncomfortable part was definitely having to have a full bladder for an hour beforehand. Well, you were meant to drink a litre of water an hour beforehand, but it appears I was sufficiently well-hydrated that it went straight through. Fortunately, I got to empty my bladder after the first round, the second lot of investigation was done with an empty bladder.
They very thoughtfully have a monitor set up above the examination table, letting you see your insides live. I couldn't make much sense of the imagery, but it's excellent for keeping you both distracted and involved at the same time.
There wasn't anything obvious relating to my menstrual cramps - I have fibroids, but Susie the technician implied they're common as dirt and harmless (at least at the size I have them). I have to take my actual test results back to my GP and get her interpretation.
However, it turns out I have a small ureterocele on my left side. This means that during my fetal development, the tube from my kidney to my bladder (ureter) didn't finish developing properly, and so I have a cyst inside my bladder that is an extension of the ureter.
From lurching around the internet, I've learnt that they're more common in caucasians, and occur in something between 1 in 500 and 1 in 4000 people, depending on who's counting and what they're counting. There may be a genetic component, as there are siblings with the condition, and "more common in caucasians" also suggests some genetic component to me. Ureteroceles are more common in women (four-six times) and possibly more common on the left side, so I'm bog-typical. Well, bog-typical for someone with a ureterocele, anyway.
It appears that ureteroceles come in two broad categories:
A Usually large ones, that interfere significantly with normal kidney and bladder function, often from birth. They often cause problems like failure to thrive, as well as all kinds of things like recurrent bladder and/or kidney infections, and were extremely hard to diagnose because of the wide variety of symptoms. These days, they're often picked up during pregnancy ultrasounds, and with further checks of the newborn, are more easily managed.
B Small ones that don't interfere significantly with normal functioning, which are not uncommonly discovered accidentally in the course of looking for something else in otherwise healthy adults during pelvic ultrasounds; or during autopsies.
In case you hadn't guessed, ultrasounds are the single best way to diagnose suspected ureteroceles; conversely, if you've got one, during an ultrasound is when you'll find out about it.
As far as I can tell, the fact that I've reached this age, oblivious to any urinary tract problems, means that my ureterocele is mainly a cute piece of trivia. However, if I ever get kidney stones, I may need more aggressive intervention, as they may not get through the left ureter by themselves.
This was my main reference, but note that the language used is aimed at medicos. The ultrasound in picture 2 looks a lot like mine. This page uses easier terminology, however, it is aimed at parents of children with problematic uretoroceles. It has a nice clear medical diagram. Unsurprisingly, there isn't much information specifically about ureteroceles that aren't causing any bother.
