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Tuesday, July 30, 2013

Haiku based on 'Zeal' and 'After'


All his waking life
With zealous application
Did the best he could

With a fervent zeal
He exercised her body
Never turned to love

Boundless energy of youth
Empty zeal of age

Martyred for the cause
Another zealot blows up
Religious hatred


Yesterday we bathed
Bodies floating together
Afternoon delight

In the aftermath
They combined their resources
Survival tactic

Basic truth of life
After all is said and done
Lot more said than done

Monday, July 29, 2013

The Monday Free .pdf Download: Media and Suicide

This paper was an early synthesis of what we know about Media Influences in Suicide. It raised the specific issue of how we could use this knowledge to prevent copycat suicides after a high profile suicide, based on the experience of Kurt Cobain and his partner Courtney Love.

As I noted in the introduction: "This review explores the influence to suicide in print and electronic media, and considers both real and fictional deaths. The conclusion appears inescapable that reports about celebrities which are multi-modal, repeated, explicit, front page, glorify the suicide, and describe the method lead to an increase in deaths from suicide, particularly in the region in which reports are published. The paper argues that even if there was multi-national agreement to international guidelines, media will continue to report suicide when it is considered to be “a matter of public interest”. What appears crucial is a collaborative approach between professionals and the media to promote a negative attitude toward suicide without increasing stigma toward those with mental health problems." 
Martin G., 1998.  Media Influence to Suicide; the search for solutions.  Archives of Suicide Research, 4:1,1-12.
Then 'Resources'
Then 'Download here:"

Sunday, July 28, 2013

On Diet and Transverse Myelitis (2)

Within a few hours of my sending my last blog on diet to various TM Facebook Lists, there was a post about Vitamin D, and then a small avalanche of comments. Clearly diet is a hot topic. I guess it reflects the complexity of our lives when we are challenged by a neurological illness for which few physicians can give us clear answers in response to questions:
Why did this happen? (there appear to be many possible causes)
Is there something wrong with me as a person? (probably not)
Am I being punished? (probably not)
How do I manage the symptoms? (come to terms with them, get all the help you can, work hard at physiotherapy)
There must be something you can do to fix this? (Sorry, no magic yet)
There must be something I can do to fix this? (If there is, I am not sure what that may be...)
Is it my diet? (Maybe...)
Transverse Myelitis is 'some sort of damage' (or inflammation, or immune problem) which affects the myelin sheath of nerves at a level in the spinal cord. We all have slightly different levels affected, and different parts of the spine affected (front, side, or back, or a mix) so we all have different patterns of involvement of motor and sensory and pain pathways. But the essence of it is that the myelin sheath of nerves becomes damaged, and even if nerves try to regenerate through the blockage, the sheath may not be good. The sheath allows conduction of signals; poor sheath poor signals.
So is there another similar problem from which we can learn? Of course, there is. Multiple Sclerosis (MS) is a much more common illness with some similar neurological problems. It is much more extensive, often much more damaging to lives, may affect the brain and not just the spinal cord, and can lead to death. A small percentage of people presenting with TM may later develop MS. The research on MS has been extensive over the years, and there are now some 'truths' emerging that may help us, while we are waiting for research to answer our TM questions.
One of the best longterm studies (whatever our modern scientific criticisms) is that by Prof. Roy Swank from Oregon in the US, beginning in 1949. Based on other work showing that MS was geographically distributed, Swank concluded that the distribution matched how much saturated fat we all had in our diet - which had been, and still is, steadily increasing in the Western world. He collected 150 MS patients and started them on a very low fat diet. Some people stuck to it and others did not. When he published in 1990, the results were dramatic. The good dieters, whatever their level of disability, did not deteriorate at anywhere near the rate of those who were unable to keep to the diet. Benefits of the diet were there whatever level of disability people started with. Of course the result 34 years later was best for those who started off with 'mild' MS, but was still obvious in those who began with 'moderate' or 'severe' MS. The death rate in the 'poor' dieters was statistically much higher.
The 'good dieters' were eating about 16gms of saturated fat a day. Even the 'poor dieters' were only eating 38gms a day (compared to the starting point of 125 gms per day. Swank followed his dieters up for 50 years (almost unheard of in medicine). of the 63 survivors, 47 had been 'good dieters'.
So YOU want to TAKE CHARGE of your own illness?
Go back to the diet I briefly described yesterday, and begin to think about how to change your own diet. Get help from a good dietitian. It may not be fun, but it may help your TM. Is there any evidence for that yet? No, not really. Someone needs to be doing this. BUT, will you come to harm? No, probably not. Your weight may drop over time, your blood pressure may reduce, your chances of getting diabetes will be much lower, your chances of getting a heart attack may be reduced, you may be less prone to depression. There is a danger, if you are not eating red meat, that you may reduce your iron intake - not good for pregnant women, or those with heavy periods. You may need to take a supplement. Check it out with your dietitian.
Swank, RL & Dugan, BB, (1990). Effect of low saturated fat diet in early and late cases of multiple sclerosis. Lancet, 336: 37-39
An Australian site for recent Dietary Guidelines

Haiku based on 'Vex' and 'Year'


Vexatious client
Lose the case and they sue you
The lawyer's nightmare

Grumpy in Winter
Change in the light vexes me
Life's brighter come Spring

You do worry me
Hassling over vexed questions
That can't be resolved


Year of surprises
Accolades, bouquets and love
Two thousand thirteen

Year in and year out
Your constant love and care glows
Lighting up my life

Love your changing skin
It has softened with the years
But still smells the same

Saturday, July 27, 2013

On Diet and Transverse Myelitis (1)

I recently came across a couple of articles, in magazines to do with Transverse Myelitis, about vitamins and how they may be important for recovery in our damaged nerves. I have become intrigued, and as a psychiatrist who dabbles in ideas about diet (mainly because I am married to a dietitian), I have been wondering more and more about what it might mean to my personal future recovery. Then of course there is the question of what it might mean to you the reader, assuming that you are reading this blog because you have TM.
The first thing to say is that no-one has really said (yet) that problems in our diet may actually cause Transverse Myelitis. However, we have known for many years that there may be a connection between gross and severe dietary problems and neurological function: in fairly extreme cases of things missing from a diet, part of the picture may be a form of peripheral neuropathy. So, the old sailors who discovered America and Australia knew about Scurvy, caused by the chronic absence of Vitamin C (citrus fruits, vegetables) in the diet while at sea. Lethargy, depression, skin problems, bleeding from the gums, and later neuropathy, jaundice, and even death. Key words here are ‘chronic’ and  ‘later’ - it takes a long time for the body to run down its resources. Another illness caused by lack of a vitamin is Beriberi, which has several forms. We have all seen the pictures of starving children with big tummies, skinny limbs, and gross malaise. Another form is that caused by chronic alcoholism in which you can get somewhat familiar symptoms of what has been called ‘endemic neuritis’ - tingling and loss of sensation in hands and feet, loss of muscle function and paralysis of the lower limbs, pain and a heap of other things. This is due to the loss of thiamine (vitamin B1). Now I am not saying any of us are 18th century sailors, or chronic alcoholics. But we do have a whole lot of symptoms that could make us think we might have deficiencies. And then you can begin to wonder whether some supplement or the other will begin to help, or even cure us.
I think there are problems in this for all of us. First, when you start to read about these things online, all the articles are full of long biochemical names and even longer scientific explanations, confusing statements that seem to be ‘advice’ but don’t quite seem to apply to you, lots of ‘ifs’ and ‘buts’, or conversely the author has a particular passion for persuading you that this is definitely the answer, and their company has just the right supplement (at a large cost, of course).
We are all different. There is no “one size fits all”. But there are some matters of interest that may make you think hard about your diet, and I would like to try and make some sense of them for you. I cannot do this in one blog. It may take me some weeks or months to make sense of it all, and get the green light from my wife to tell you about it. Whatever I say to you, I would recommend you talk to your physician. Some are knowledgeable, and have had a good training in, or have good knowledge of, how diet can affect us. Others think they know, but may not have been sufficiently trained to know the whole story. Make up your own mind, and then ask to see a dietitian who uses straightforward language to explain things and can give you a good plan.
Let me just say this to begin with. ‘All things in moderation’. You may have some idea of taking a supplement to help your symptoms. It may help you. But if you take too much, that is you take things to extremes, then you may cause yourself more harm than you needed. There is an old rule in medicine, which is: “First do no harm.” You must apply that to yourself....
There is good evidence that a diet low in saturated fats, moderate in intake of carbohydrates and sugars, and high in whole grain cereal foods (breads, rice and pasta), lean meats or poultry and fish, green and orange vegetables, beans and legumes, darker coloured fresh fruits, dairy or soy products, and a variety of nuts, will keep you as healthy as you can be. To this we should add keep the intake of alcohol as low as possible. I said there was good evidence, and I will come back to this in a later blog.
We all have special needs that may come from digestive problems, diabetes, sensitivities or allergies. So you clearly need to take all this into account. There may be things you cannot eat that contain really important nutrients for a complete diet. This is where your doctor or a dietitian may come in.
Frustratingly (but to allow me to do some more detailed research, and have further discussions with the ‘boss’) I will come back to the issue of supplements in later blogs.
The final word is ‘breakouts’ (no, not zits!). I said ‘in moderation’ earlier, but we all need to have a treat once in a while. I have a thing about a biscuit or two with afternoon tea. I also have a thing about ice cream; I manage to get to a tub about once a fortnight or so, and I do make the most of it. I am not sure it does me any good, but it makes me feel good for a short time.
In all of this, if you know something upsets your legs or your balance, then don’t eat it. Trust your body, even though it has sort of let you down.

Any comments or discussion will be welcomed.

Friday, July 26, 2013

New Haiku based on prompt words 'Tease' and 'Use'


Last night's dreams tease me
Grading to 3rd Dan black belt
Power and control

Sudoku teases
Only nine numbers to place
But complicated

Winter is ending
Delicate flowers emerge
Cold snap teases them

You strip at night time
And I watch the show, aching
Teased by your body


Would it be OK?
If I used your sweet body
To meld it with mine

In pitch black of night
Other senses get used more
Hearing, smell and touch

You use; what, Heroin?
No, I'm a people user
Addicted to it...

Autumn and Winter
Use more electricity
Than Spring and Summer

Monday, July 22, 2013

My free Monday pdf download: Correlates of Fire-setting

This paper was based on findings from the first wave of a longitudinal study of 2596 South Australian 1st year high school students from 27 schools. Initially we developed the research as a longitudinal study of precursors to suicidality in adolescents. We  reasoned that if rates of suicide begin to rise after the age of 15, there may be some markers in 13 year olds (1st Year High School in Australia) that would allow us to develop in-school prevention programs.

The paper describes some intriguing findings from the first wave.

Martin, G., Bergen, H., Richardson, A., Allison, S. & Roeger, L., 2004. Correlates of firesetting in a community sample of young adolescents.  Australian and New Zealand Journal of Psychiatry. 38:148-154.

Go to Family Concern Publishing

Then 'Resources'
Then 'Download here: Correlates of Firesetting'

Sunday, July 21, 2013

Sunday Haiku: Reflections on 'Ravage' and 'Search'


Face ravaged by grief
She lent into the coffin
Parting kiss of death

Martian landscape
Was it ravaged by a drought?
A lesson for Earth?

Devastated land
Ravaged by atomic war


Jury searched their hearts
Heard direction from the judge
Voted 'not guilty'

Searched rugged bushland
Cold hikers found huddled up
Winched out to safety

Twelve troops left the base
A search and destroy mission
IED killed three

Saturday, July 20, 2013

Haiku associations to 'Pick' and 'Quest'


He took up his pick
Stroked his axe into a chord
Guitar gently weeps

Picked a summer peck
Pickled pepper in winter
Peter Piper's plan

Picky little bloke
My old school English teacher
Would not like Haiku


You've been on a quest
Now you want another quest
Put in a re-quest...

Quest for sanity
Lies in the depths of psyche
Not medication

If you want to know
The purpose of your life's quest
Just ask the question

Friday, July 19, 2013

On Dreams and Transverse Myelitis: A personal reflection

I have had a couple of dreams in the last few days that have made me revisit how I am relating to having Transverse Myelitis, but also what I think about dreams and whether they have meaning. I thought I might share, knowing dreams are intensely personal, and mine may have no meaning at all for you, the reader. But it may provoke discussion.
The first was three days ago. Brilliant dream in colour, with exquisite detail. I was doing my 3rd Dan black belt grading in Goju Karate. I was aware of each movement I was doing in the Kata, and whether my limbs were in the correct position, whether I was moving fluidly enough, how I felt. Of course I was aware that I was being watched to see whether I had achieved the correct standard. But it felt good. I felt good. I was surprised that my body was able to do so well, given my handicaps. I was satisfied by my own performance and achievements.
The backdrop to this is that, after 22 years of Karate, I was a 2nd Dan black belt in my own club, grading about a year before I contracted TM. I did try on several occasions afterward to go back to sessions, but I got so tired after 20 minutes of exercise, and just had to sit down and watch. I was unable to do many things - particularly using my legs. I felt stupid, a fraud! I had been a good teacher with my own small class close to my home and, in fact, had been teaching the night before my symptoms appeared. My sensei (my middle son Rod, a 5th Dan black belt graded in Japan), lovely man, got me up teaching, and that allowed me to stand relatively still and correct other lower grade students, but I still felt a fraud because when they made errors with leg movements I could not demonstrate the correct movement. Dispirited, I gave up. But I have held on to the dream of returning for the last three years, even though I have deteriorated somewhat, AND lost considerable muscle bulk....
Another piece of the context is that my son, his wife (a 4th Dan black belt graded in Japan), my granddaughter (brown belt with with 2 black tips) and my grandson (who trains when the mood suits him) all went to Japan last Sunday for two weeks  of intensive training. I envy them. I loved training in Japan with Japanese masters. I loved the rigour, the high expectations. I guess Karate and gradings and expectations were on my mind. As I say I envied them, while wishing them well.
So what was this dream about? Was it wishful thinking? Maybe... Was it just coincidence - me remembering what used to be, a very pleasant memory of times past, perhaps an acceptance that I am what I am now - and it is OK? Was it an unconscious challenge? "C'mon, its time, you should be working harder at the exercises. You could do so much better that if you really tried you COULD do your 3rd Dan grading."
Dreams are said to be meaningful, and this one certainly had meaning for me. IT IS HARD COMING  TO TERMS WITH THIS CRUEL NEUROLOGICAL DISORDER THAT STRIPS YOU OF PHYSICAL CAPACITY. Transverse Myelitis can lead to depression, with all the implications of that. Am I depressed that I can't do Karate? No, not really - after all, I am 69, and you have to give up some time.... Am I depressed about other limitations? Yes, of course, but NOT clinically (luckily).
And this dream was not depressing. It was joyous. I was succeeding. I felt good.
Has it made a difference? To tell you the truth, life has been so busy, I have been very lax. I know I should exercise more, but like many of us, I just can't do it on some days. So, the dream was not prophetic, just a happy construction of mind, an exquisite moment before waking.
Now, having got that off my chest, I AM going on the bike for 30 minutes. LOL

Tuesday, July 16, 2013

Tuesday Haiku: Reflections on 'Niggle' and 'Overt'


Just scratching my head
Niggle at back of my mind
Can't quite remember

Niggle of chest pain
Walk like an old man

On the motorway
Lights niggle in my mirror
One more four wheel drive


Overt little lies
Used to cover covert truths
In sensitive souls

Went undercover
Overtly a dumb waiter
Covert spymaster

A mask on her face
Hiding all the pain within
Overtly happy