Special things

One of the earliest recommendations that I got from a therapist to help me deal with anxiety and depression flaring up was the use of the senses to ground you into the present, taking you out of the past where depression drags you and out of the future where anxiety pulls you.

Shutting your eyes and really listening to the sounds around you, all of the little noises that we blur into the background and don’t really hear, for instance, is a great place to start. Did you know that if you sit at the Collins St-Spring St tram stop and close your eyes (yes, you look like a dork!), or at least stare at the ground and open your ears in listening concentration, the flag stays along Collins St moving in the wind tinkle against the flag poles like little bells? I tried this strategy one day waiting for the tram after my meditation class and it was a revelation. I’ve been to that tram stop many times and never heard bells; they sound so pretty! And while you’re focusing on that, it’s hard to hear the thoughts in your head. Which is the point of the exercise. Of course you can turn up your headphones or stereo and try to blast the thoughts away, something like a pressure washer. It works. Pick a song with great lyrics, or a great beat, sing along loudly or bop along. It’s a great distraction. But as soon as you stop the thoughts are right back where you left them. Something about grounding yourself by listening is different, more of a therapy where it quietens the thoughts right back down to where you can hardly hear them. Standing in a forest and listening to all the little movements and creaks and birds and insects. Sitting by the ocean and listen to the crash and wash of the waves on the sand; those types of things. But you can do it anywhere. Try it at home.

Then there’s grounding using your sense of touch. Our meditation teacher gave us each a small stone when we finished our 8 week class. Mine has smooth sides and creases on other sides and lumps at each end so you can go where your mood takes you. Sometimes you’re in a problem-solving mood and try to iron out the creases with your thumb. Sometimes you need the soothing relief of rubbing the smooth sides. The corners and lumps pull focus from your mind. It’s actually been an invaluable gift for me and I’m very grateful. Figure out what you like: running the crease of your finger along a plastic ruler, rubbing my nose on something, massaging your own foot! Weird! But whatever works. I also have a smooth glass paperweight with a bubbled back that stays cool unlike the stone which warms up so it gives me options for my mood. Different methods for different days.

So that’s hearing and touch. I haven’t found sight to be that helpful, although having said that sitting and staring at the ocean is the closest I’ve come to getting absorbed in the present enough to forget my mind. We went today and man its beautiful! Maybe staring at my roses comes second, I just love them so much and looking at them, dead heading them and cutting them for the house is a precious hobby. Otherwise I find eyes are pretty fickle and dart around a bit much to be useful in this regard, but turns out there are a couple of good ideas after all. Maybe I should try looking at our local lake and other people’s gardens more often.

Then there’s taste. Examples I was given are savouring a creamy hot chocolate, or piece of smooth chocolate, letting it slowly dissolve in your mouth or slowly swilling the liquid around your mouth while you notice the finer points of the flavour that you usually don’t take the time to observe. Most of it is about slowing down and paying attention to life instead of missing it while obsessing about the past or fretting about what’s coming in the future. I haven’t used taste very much, I have enough trouble with eating too much and being overweight, however on the flipside eating more slowly should help with that and maybe you’ll eat less. It’s another strategy in any case.

We’ve talked about listening, touching, seeing, tasting so let’s talk about taking time to smell the roses, which is literally what this is all about. Maybe wearing a particular perfume that calms you, relaxes you, reminds you to slow down. Maybe sitting in a park and smelling the pine trees, or the cut grass. Maybe its getting a coffee and just breathing it in, or enjoying the smell of your favourite lunch. Whatever helps you take time out of your mind.

Grounding via the senses is a method used to help people break out of panic attacks, to help them relax when depression and anxiety are overcoming them, to maintain that relaxation, and just to feel good. It’s important and worth knowing about

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Touch is the sense I’m enjoying today. I bought this amazing blanket!! So amazing. I bought it on Facebook Marketplace, an awesome second hand market section of Facebook where anyone can buy and sell super easily. It’s way better than Ebay, and you can make the setting for items being sold within 5km of your house which I love because it saves me falling in love with something only to find its located in Point Cook! Which is far from my house by the way. Instead I’m happily buying my way through the eastern suburbs of Melbourne!

And now I have a mermaid blanket!!! Yep, a tubular blanket that you put your legs into which has a mermaid tail!! I’m so excited! I could just giggle out loud! And while it looked good online, it feels even better. It’s a lovely soft handmade blanket and I feel really lucky to have it. Someone somewhere made this specially and now its mine, and I’m wearing it every time it gets the slightest bit cold! Plus hubby says I can now swim to the kitchen and back! So that’s cool, lol. Point is, it looks awesome so that pleases my eyes and makes me smile. That’s two wins right there. AND it feels so soft to rub in my fingers and hands, and on my legs and feet. It’s the perfect happy day blankie!!


There’s a funny thing that you see over and over and over in healthcare: people who ignore their doctor’s advice, be it their GP or specialist, then come to the emergency department for help when they reach crisis. I guess there’s something human in us all that makes us think we’re above taking advice, even when the person giving advice has a level of expertise that we don’t. But when a complaining patient is only in ED through their own actions it can be hard to feel terrible for them. They still get the appropriate treatment, don’t get me wrong there, but when you’re done and dusted dealing with them you might share a roll of the eyes with their nurse or doctor over their behaviour.

You didn’t pay any attention to your doctor before when you were told how best to manage your condition, so why would you listen to us now? More to the point, are you going to listen now? Or maybe you will listen right now because you’ve scared yourself with how sick you’ve gotten, but how about next week, or next month? Will it be back to old habits? You got yourself into this, and now you think we would help you, because…? Of course, ethically we have to help you, even if we think you’re a dodo who has made their own bed and should possibly have to lie in it, but we spend a lot of time shaking our heads. There are a lot of sincerely needy patients: fractures, cancer patients, appendicitis, infections, many patients who have illnesses out of their own control. And when those patient’s beds are full of patients who could have avoided being there…well it grates on a few nerves is all. But we’re all only human, so we try to understand you, and anyway we’re health professionals so it’s our job to give you our best assistance regardless of our personal opinion. A professor at uni once gave this quotable quote:

“professionalism is a cloak for our personal problems”.

Compliance is the word of choice adopted by health professionals to discuss, at least in pharmacy terms, how well a patient manages to comply with the regimen of medications given to them. Do they take the medications prescribed, do they take them at the time/s prescribed, with or without food as prescribed, separate in time to other medications as prescribed, for the duration prescribed and so on? If so then they are described as compliant, if not then they are said to be non-compliant. There’s a bit of political correctness around which word you use because of the effect it might have on the patient if you “label” them. Adherence is another option, concurrence is almost never used and there’s one that I can’t think of that’s been ruled out. It applies in medicine terms as well as in other fields.

So a patient arrives at the emergency department. The presenting problem, that one main issue that has caused them to come to us right now? They have severe pain, 8/10 on the usual pain scale. And why? Well they have a chronic pain condition, whatever that is, and we know that they can relapse from time to time, but actually the reason for this relapse is that the patient stopped their pain meds. Okay, so you’ve come to the  emergency department for help: what exactly do you think we’re doing to do, other than restart your pain meds? Surely you could have worked that one out. I get that pain meds have a lot of side effects that can be hard to deal with. But wouldn’t it have been better to sit down with a doctor and work out a management plan instead of just stopping something yourself? Now, instead, you’re in worse shape than ever and we have to pour MORE pain meds into you just to get you back to where you were, not to mention the time that will take, time that you’re writhing in agony. It doesn’t make sense to me. If anyone knows how tedious and frustrating the side effects of medications are, I do. Seriously. I put on 20kg, was sedated for 4 years, couldn’t work for 2 and I sweat all. the. time!! And that’s just 1/3 of the list. But you don’t just stop your meds because you don’t like them. You go back to your doctor, talk about the problems, work with them to adjust your meds and try again. That’s my experience. And when people come to us having not been bothered to put in that work and short cutting the process, then screaming that they’re in pain which is the obvious outcome, it just doesn’t make sense. They have a lifelong pain problem, surely taking the effort of one doctor’s appointment isn’t too big an investment to make? This especially bugs me for people on insurance and worker’s compensation because those establishments will do anything to help get people back on their feet (and back to work, of course) including paying for doctor’s visits, therapy like physiotherapy, and medications. You just have to be willing to work with them. People do “get over” their condition and the ramifications of it, I get that; so do I! But you’re kind of stuck with it so sometimes you have to dig in and just work through it. Going off course just isn’t going to make it any better.

Another common presentation is asthma attack. That’s not so shocking, except when its because you didn’t bother to take your asthma preventer inhaler for the last 3 months; you “thought you didn’t need it”. What are you thinking now? Are you going to go home and take it now? Did you ever think that maybe you never had an asthma attack BECAUSE you were taking your asthma preventer, rather than that you didn’t have asthma and didn’t need it? Did you ask your GP to review your asthma and maybe check your respiratory function tests again before making changes? No, you thought you knew better. And if you start giving me that big pharma conspiracy rubbish about how GPs diagnose people with asthma and prescribe them asthma preventers to get kickbacks from some drug company, I’ll scream. They did it to save your life; asthma kills! Have you heard of the tragic thunderstorm asthma event of 2011? And that’s just what people hear about. People die all the time of asthma. It’s not just some kids disease, or a disease that doesn’t really matter, or one that can be treated every time it flares up if its been under poor control. That cough you get walking up the stairs? That’s your asthma. That tightness in your chest on a cold morning? That’s your asthma. You don’t have to have an audible wheeze to have symptoms of asthma. Take your preventer, get reviewed regularly by a doctor and you can control your disease. But take it seriously please. And FYI, when the label says take TWICE daily, that means two times, as in morning and night, not once a day. If you use your preventer once a day, it will only be in effect for 12 hours; the other half you are on your own. And if you use your Ventolin/Asmol inhaler more than twice/three times each week? Your asthma is NOT under control!

One of the worst examples of non-compliance is patients saying pure and simply “I didn’t take them”, especially antibiotics. Why did you bother to see a doctor if you then went ahead and ignored their advice? It’s kind of rude. And self-jeopardising. And for those patients who DO go ahead and take the antibiotics, did you know that almost no one actually takes their antibiotics as prescribed? If its prescribed three times a day they take less. If its prescribed for 7 days they take less. And YET, every time antibiotics are dispensed, patients are told how to take their antibiotics, and for how long, and to complete the course. It really is just up to them to take them. There are apps (e.g. NPS Medicine Wise) where you can enter your dose, and duration of antibiotic, and the app will send you a reminder each time you are due for a dose. You can use the alarm clock on your phone to remind you when your dose are due. You can have your pharmacy add the antibiotics to your Webster pack, or you can add them to your dosette box. Really there are a lot of different strategies you can use. But know that when you come into hospital, your pharmacist, and probably your doctor, and maybe the triage nurse will note the date you were prescribed your antibiotics, COUNT how many antibiotics you have left and do the math; it’s what we went to uni for! And non-compliant will be written on your chart. Just take them. Why go from a slight upper respiratory tract infection or small wound, to a full blown lower chest infection and disgusting weeping sore when you could have prevented it? Sometimes conditions progress anyway, but do your part at least. Plus incompletely taking a course of antibiotics, not killing off the bug fully, leads to it learning resistance to that antibiotic so that next time you take that antibiotic it won’t work as well as it should. If you spread that bug that has resistance to someone else, you’re spreading resistance. You really don’t want to be that person. Take them, take them as prescribed, and take all of your antibiotics.

Or there’s that person who hasn’t been bothering to take their cholesterol lowering tablet and is admitted with a myocardial infarction (heart attack) and has to have 3 main vessels in their heart unclogged! All because they thought their cholesterol level was “fine” and they didn’t need it. Did you ask your doctor about that before you committed to that course of action, triple bypass guy?

Or hasn’t been bothering with their blood pressure medication and their systolic blood pressure at the bedside is over 190 when it should be at least under 140 and ideally around 120. They insist that they have white coat hypertension which is where patient’s get nervous before their blood pressure is taken, or around doctors, and it causes their blood pressure to rise. Except it doesn’t ever cause it to rise that much, in-denial lady. Take your blood pressure tablets unless your blood pressure falls below 120, and even then keep taking it unless your doctor advises you not to. Yes your own blood pressure machine might tell you ONCE A DAY that your blood pressure is okay when you’re sitting around relaxed at home. But why did your doctor diagnose you and prescribe you tablets in the first place? So many people are so reluctant to take blood pressure tablets and I don’t know why. In most cases its one tablet once a day and the side effects are usually mild, it’s really not a big deal. And again, its not a big pharma conspiracy to get you to take tablets, it’s a lifesaving prevention strategy to stop you having a heart attack, killing your kidneys or bleeding your brain out…why not take your tablet??

Just take it, or talk to your doctor. Those are the main concepts here. Confusing?

Edit: I’m not perfect. No one is perfectly compliant with their medications. I know that. I miss doses of my tablets, in fact I missed last night’s meds cos I broke my routine. But one thing I don’t do is miss them on purpose. All I’m asking if for people to try to carry out their doctor’s directions, for their own good. I read a quote yesterday,

“No one is perfect. But if we aim for perfect, we might reach wonderful.”