When this old fool focuses on mercy, love and forgiveness, that is no cause for alarm. Instead, it is a cause for joy.
Indeed, the world admires well the refreshing change in him, and encourages his new life. Yet this old fool never shall abandon the life of service offered to him.
Months ago as he listened to the pretty saleswoman give her priceless sales pitch before selling a jar of perfume to him, he realized his error in offering to buy it without listening to the woman.
Her story about the perfume only increased its worth when she was finished.
"Will you take fifty-five pieces of silver?" he asked. "I would offer more but that's all I have."
Instead of answering, the sales woman talked with her partner, who was just as pretty as her, saying, "He offers fifty-five but would offer more. What should we do?"
To which her partner replied, "I'll take it from here, Sarah."
"Of course, Diana, please do."
This old fool felt for his purse, and silver coins jingled in it. "Fifty-five is my only offer," said he with enthusiasm.
"The offer is fine, but we'd like to drop by to instruct you on the perfume's use."
"I know how to apply this perfume," replied the man. "It's like any other perfume, then?"
"No, this perfume has many different uses. If we let you go on your way without careful instructions, then you might end up smelling too pretty for the neighbours."
The man looked perturbed. "Is this a special perfume then?"
"You might say that it is. It's not like you could put a dab behind each ear and be done with it." Sarah smiled at the old fool.
"Ok, if it is a special perfume needing instruction while visited by you and your lovely friend, I'll pay now."
"That's ok," replied Sarah. "We'll instruct you on its use over several weeks to ensure it isn't wasted or misused. Then we'll take installments on your offer."
"Eh? This is new. You sold me on the perfume and now you want me to pay in installments? Are you trying to cheat me?"
"No," replied Diana. "After our instructions, you would be more than willing to pay by installments."
"Okay then," said the old fool. "I live at the foot of the hill near the meandering creek. It's a short jaunt from here. When's best for your arrival in a week, is it?"
"We'll be there in a week, and spend but an hour to instruct you on your perfume's use."
Over a period of two months, the two women instructed this old fool about the perfume. Then they took the first installment payment of a piece of silver. "Every month, we shall be back for payment, but shall continue to visit you weekly. However, let's now apply that perfume."
So they asked him to open the jar of perfume and he did. It had a mild rose-like smell. Instead of daubing his ear with a dollop of it, they daubed the soles of his feet.
"What kind of perfume is this that you rub it on the soles of my feet?" he asked them.
"You shall soon see," Diana replied, and looked at Sarah who said, "The soles of the feet are where this perfume works its magic."
Within minutes, this old fool felt calm and refreshed. "What sort of magic is this?"
Sarah said, "It's not really magic or trickery. This is a perfume that requires us to instruct you on its use. We anoint you with it, because of its special properties. Merely dabbing it behind your ears does nothing."
And this old fool just relaxed, and nodded. The perfume was doing its magic with him, for his calm and sedate mood left him happy and full of joy.
"We now leave you, sir!" they said in unison.
Each week, more instructions were given to the man by Diana and Sarah. A year later, he had paid off his fee for the jar of perfume, of which over half remained. So that must have been a big jar, indeed.
By then, this old fool had come to know and love both women like his daughters, if he was married. Yet being an old fool, he had chosen the virgin lifehood over marriage.
Three weeks into the new year, he was paid up but offered to buy a second jar of perfume. They accepted and more visits and instructions occurred. This old fool was a happy camper, for he had met with Diana and Sarah for over a year now, and they were now like family.
Eventually, this old fool discovered that the perfume had rejuvenating powers. His grey hair had vanished, and his memory was better than it was when he first met those saleswomen. So when they came to visit 23 weeks later, he made them a deal.
"I am so much enthralled by these jars of perfume that I want to learn to make them and sell them too."
To this, Diana said "We make this perfume with our father." Sarah added, "And we use special herbs and spices in its making."
"I promise to keep secret the formula," said the old fool.
"We'll ask our father," said both women.
A week later, they returned with 20 jars in a cart and their brother Joe. "We'll set up a kiosk with Joe's help."
Within two weeks, Joe had sold all the jars, and was also instructing ten customers. As years passed by this old fool became a rich man. He was beloved by all his customers, and Diana and Sarah decided to share the formula with him.
His batch of perfume was even better than the original, due to the special herbs he used in addition to the original formula. Not only were his customers rejuvenated but they also went on to sell his jars of perfume and also prospered. In due time, everyone was a happy camper, selling jars of perfume to more customers.
Diana and Sarah never objected to the change in the perfume's formula. It meant more profits for them too, because this old fool gave them 10% of his profits.
Ultimately, everyone became healthy and quick witted and lived a long life. They were also very rich, but always kindhearted and loving towards their neighbours and customers.
Here was a man who showed mercy, love and forgiveness did he prosper after meeting those pretty saleswomen, all due to the power of unconditional love.
Showing posts with label mythologization of one's life. Show all posts
Showing posts with label mythologization of one's life. Show all posts
20130208
A Prudent Old Fool (poem)
A prudent old fool be I
Who chose scarcity,
Over marrying a wife,
And basic goodness
By living a modest life.
Who chose scarcity,
Over marrying a wife,
And basic goodness
By living a modest life.
20110728
A Worthy Struggle for Life as It is (poem)
Sometimes I make the mistake in
trying to live life as it should be,
only to realize the misery
that causes me and the people
who matter most in my life.
Sometimes it gets me down.
It's not others who get me down
as much as I get myself
stuck in the chains of my undoing.
Be it habit of mind or tendencies,
my behavior is in my hands,
though sometimes I regress.
Yet I can bounce right back
when the heartache has gone away -
all it takes is the willingness
to accept what cannot be changed
with a peaceful heart and clear mind,
and gracefully carry on.
Bravely do I carry on, accepting
what I am responsible for.
Living day by day helps me
to keep focused on the task:
to live my life as I see fit -
a worthy struggle for life as it is.
trying to live life as it should be,
only to realize the misery
that causes me and the people
who matter most in my life.
Sometimes it gets me down.
It's not others who get me down
as much as I get myself
stuck in the chains of my undoing.
Be it habit of mind or tendencies,
my behavior is in my hands,
though sometimes I regress.
Yet I can bounce right back
when the heartache has gone away -
all it takes is the willingness
to accept what cannot be changed
with a peaceful heart and clear mind,
and gracefully carry on.
Bravely do I carry on, accepting
what I am responsible for.
Living day by day helps me
to keep focused on the task:
to live my life as I see fit -
a worthy struggle for life as it is.
20110127
Dragons and Serpents: Water as The Mythopoëtic Symbol for Life
Serpents and dragons get short shrift in Western culture. In actual fact, they symbolize the life-giving properties of water, fertility and immortality.
In certain aspects of world culture, serpents represent immortality as seen by the water cycle of where evaporation of water from bodies of water such as rivers, lakes, streams, and the sea causes clouds to form and then rain to fall, only for the raindrops to mingle into many streams which flow into many rivers into the sea.
In Chinese mythology, Nüwa is said to have created humankind. She is also a repairer of the four pillars that are said to hold up the heavens (the sky); a wife or sister, and usually depicted ass what the Indians call a naga, a half-human, half-snake demigod; and a goddess of the Miao people.
In Chinese symbology, the serpent and especially the dragon represent water, especially clouds, rain and rivers. Its association with fertility has to do with the life-giving properties of water, without which all life on Earth would perish.
With Nüwa being half serpent and half human, this represents fertility and reproduction. As well, Nüwa may also be viewed as a dragon. Yet this is mythopoëtic language, which includes also the snake's association with the Tree of Life from Greek and earlier Babylonian mythology and the Tree of Knowledge and Immortality in Judeo-Christian symbology.
In ancient Egyptian symbology, a serpent represents the land and its fertility as governed by the waters of the Nile. The common theme of Renenutet and Wadj have is the serpent as a symbol. The most ancient of Egyptian goddesses is Wadjet (or Wadj), the Green One of Lower Egypt, yet even more ancient is Renenutet, the Snake Goddess who represents birth and child-rearing, as well as the true name of the soul (Ren).
Renenutet is seen as a symbol of fertility, harvests, and thus of good fortune and riches, while Wadj is associated with Bast, the fierce warrior goddess, usually depicted with a cat's head in ancient Egyptian art.
What Nüwa and the Egyptian goddesses Renenutet and Wadj share in common is the serpent i.e. Nüwa and her brother are half-human and half-serpent, while both Egyptian goddesses' symbol is the cobra.
Regarding Nüwa and association with the naga, the Nagas as a race supposedly worshipped the Indian cobra, which has a weak association with Wadj. In ancient times, an ancient king of Egypt had laid siege to the ancient Indus Valley city-state of Mohenjo-Daro in the Late Harappan period circa 1900 BCE. This civilization might be a collaborative effort between Babylonian, Mediterranean and Dravidian people.
This is more indicative of a serpent totem than a race of half-serpent, half-human peoples. Naga represents freedom, because a snake cannot be tamed.
In Indochina mythology (Cambodia, Laos and Thailand), the Rocket Festival in mid-May is a reminder of the Sky God to honor his peace treaty with the bodhisattva known as the Toad King. In this myth of the Toad King, the Toad King angered the Sky King with his popular sermons, thus causing the people to neglect their worship of the sky. In response, the Sky King withheld the rain, instructing the Rain Princess to stop letting water fall on the land. Acting without authority and support of the Toad King, the Naga King Mekong declared war on the Sky King, only to lose. Once persuaded to act by Mekong, the Toad King got termites to build mounds to the heavens so that centipedes and scorpions could pester the Sky King and bring him and the sky down to earth. Once on the earth, the Sky King sued for peace. In celebration, rockets were fired. Now every year throughout Southeast Asia the Rocket Festival is performed to remind the Sky King to honor his promise of rain. Indeed, the Rocket Festival happens during the first rains of mid-May.
Reference:
In certain aspects of world culture, serpents represent immortality as seen by the water cycle of where evaporation of water from bodies of water such as rivers, lakes, streams, and the sea causes clouds to form and then rain to fall, only for the raindrops to mingle into many streams which flow into many rivers into the sea.
In Chinese mythology, Nüwa is said to have created humankind. She is also a repairer of the four pillars that are said to hold up the heavens (the sky); a wife or sister, and usually depicted ass what the Indians call a naga, a half-human, half-snake demigod; and a goddess of the Miao people.
In Chinese symbology, the serpent and especially the dragon represent water, especially clouds, rain and rivers. Its association with fertility has to do with the life-giving properties of water, without which all life on Earth would perish.
With Nüwa being half serpent and half human, this represents fertility and reproduction. As well, Nüwa may also be viewed as a dragon. Yet this is mythopoëtic language, which includes also the snake's association with the Tree of Life from Greek and earlier Babylonian mythology and the Tree of Knowledge and Immortality in Judeo-Christian symbology.
In ancient Egyptian symbology, a serpent represents the land and its fertility as governed by the waters of the Nile. The common theme of Renenutet and Wadj have is the serpent as a symbol. The most ancient of Egyptian goddesses is Wadjet (or Wadj), the Green One of Lower Egypt, yet even more ancient is Renenutet, the Snake Goddess who represents birth and child-rearing, as well as the true name of the soul (Ren).
Renenutet is seen as a symbol of fertility, harvests, and thus of good fortune and riches, while Wadj is associated with Bast, the fierce warrior goddess, usually depicted with a cat's head in ancient Egyptian art.
What Nüwa and the Egyptian goddesses Renenutet and Wadj share in common is the serpent i.e. Nüwa and her brother are half-human and half-serpent, while both Egyptian goddesses' symbol is the cobra.
Regarding Nüwa and association with the naga, the Nagas as a race supposedly worshipped the Indian cobra, which has a weak association with Wadj. In ancient times, an ancient king of Egypt had laid siege to the ancient Indus Valley city-state of Mohenjo-Daro in the Late Harappan period circa 1900 BCE. This civilization might be a collaborative effort between Babylonian, Mediterranean and Dravidian people.
This is more indicative of a serpent totem than a race of half-serpent, half-human peoples. Naga represents freedom, because a snake cannot be tamed.
In Indochina mythology (Cambodia, Laos and Thailand), the Rocket Festival in mid-May is a reminder of the Sky God to honor his peace treaty with the bodhisattva known as the Toad King. In this myth of the Toad King, the Toad King angered the Sky King with his popular sermons, thus causing the people to neglect their worship of the sky. In response, the Sky King withheld the rain, instructing the Rain Princess to stop letting water fall on the land. Acting without authority and support of the Toad King, the Naga King Mekong declared war on the Sky King, only to lose. Once persuaded to act by Mekong, the Toad King got termites to build mounds to the heavens so that centipedes and scorpions could pester the Sky King and bring him and the sky down to earth. Once on the earth, the Sky King sued for peace. In celebration, rockets were fired. Now every year throughout Southeast Asia the Rocket Festival is performed to remind the Sky King to honor his promise of rain. Indeed, the Rocket Festival happens during the first rains of mid-May.
Reference:
- Ancient Egyptian Mythology:
- Nüwa: http://en.wikipedia.org/wiki/Nüwa
- Wadjet: http://en.wikipedia.org/wiki/Wadjet
- Renenutet: http://en.wikipedia.org/wiki/Renenutet
- Bast: http://en.wikipedia.org/wiki/Bast
- Nüwa: http://en.wikipedia.org/wiki/Nüwa
- Indus Valley Civilization: http://en.wikipedia.org/wiki/Indus_Valley_Civilisation
Nagas and their relation to Babylonian and Mediterranean people:- http://en.wikipedia.org/wiki/N%C4%81ga
- http://en.wikipedia.org/wiki/Serpent_%28symbolism%29#Nagas
- http://en.wikipedia.org/wiki/N%C4%81ga
- Serpent totem: http://en.wikipedia.org/wiki/Nagavanshi#Serpent_Totem_and_Naga_race
Myth of the Toad King: http://en.wikipedia.org/wiki/Rocket_Festival#The_Myth_of_the_Toad_King
20101121
The Authentic Self: Changing the Script
Each of us shares in this drama called Life, living by the script we each learn from birth until the day we die.
"The script" is a metaphor for behavioral and psychological negativities including cognitive distortions which lead to neuroses and sometimes, psychoses.
Indeed, the script can be summed up by this definition of insanity: when I keep doing the same thing all the time, expecting different results.
Yet it doesn't have to be like that.
Indeed, whenever I act differently from the day before, the script is being rewritten by me with the help of others.
This is why we share our lives with friends and family: to help rewrite that script, based on our shared experiences, to regain our sanity, one day at a time.
While we cannot change our life experience, we can still gain wisdom from it.
For the script is what we can change, just for today.
We can change the things we can by the grace of God as we know him, be it the 12-Step group, a prayer group, or simply two or more people sharing their lives with each other; within Japanese New Religion, Oyasama — which means "Greatly Honoured Parent" — also refers to the Higher Power, be it the Buddha or another spiritual entity.
This change is vital to, and a result of, spiritual growth which brings us closer to the authentic self.
Thus, living authentically is to live in the present moment, letting what each day offer each of us the chance to act to the best of our ability.
Provided that we play our part in Life, and be willing to change the script, it is possible to regains ties to the authentic self.
For more notes on the authentic self, click on the link at the head of this article: http://gandhara.blogspot.com/2010/12/notes-on-being-mentally-captive-and.html
"The script" is a metaphor for behavioral and psychological negativities including cognitive distortions which lead to neuroses and sometimes, psychoses.
Indeed, the script can be summed up by this definition of insanity: when I keep doing the same thing all the time, expecting different results.
Yet it doesn't have to be like that.
Indeed, whenever I act differently from the day before, the script is being rewritten by me with the help of others.
This is why we share our lives with friends and family: to help rewrite that script, based on our shared experiences, to regain our sanity, one day at a time.
While we cannot change our life experience, we can still gain wisdom from it.
For the script is what we can change, just for today.
We can change the things we can by the grace of God as we know him, be it the 12-Step group, a prayer group, or simply two or more people sharing their lives with each other; within Japanese New Religion, Oyasama — which means "Greatly Honoured Parent" — also refers to the Higher Power, be it the Buddha or another spiritual entity.
This change is vital to, and a result of, spiritual growth which brings us closer to the authentic self.
Thus, living authentically is to live in the present moment, letting what each day offer each of us the chance to act to the best of our ability.
Provided that we play our part in Life, and be willing to change the script, it is possible to regains ties to the authentic self.
For more notes on the authentic self, click on the link at the head of this article: http://gandhara.blogspot.com/2010/12/notes-on-being-mentally-captive-and.html
20100522
A Week and a Day With Mirtazapine
On May 11, 2010, I attended my appointment with Dr. "A", the pdoc (psychiatrist). Most of my behavior with him is consistent with borderline personality disorder: giving out details not related to self to related to family of origin, but being vague about my own complaints.
At the conclusion of my first interview with Dr. "A", he writes me a script for mirtazapine at 15 mg to be taken at 1-2 pills nightly for one month (60 pills). He then states that serotonin may cause nausea, and I get the impression would have similar effects to Selective Serotonin Re-uptake Inhibitor (SSRI) antidepressants.
When the pdoc came to medication, I selected mirtazapine because my initial on-line research gave it a good safety profile for the average North American, which I am not.
For I am a Japanese-Canadian person, 51 years old, and male. IMHO the cultural and genetic (ethnic) background of all the mirtazapine test groups probably did not include a lot of Asians, but it should because of the Asian sensitivity to psychopharmaceuticals (psychiatric medication or pmeds). (See Ethnicity and psychopharmacology APT(1999), vol.5,p.91; A Psychiatric Residency Curriculum About Asian-American Issues Academic Psychiatry 26:225-236, December 2002)
On the other hand, my pdoc is Anglo-Canadian, and landed immigrant from the UK. Schooled in Western psychiatry, he's been trained to overlook my ethnic background and treat only my brain. Yet his faith in the "magic" of psychiatric medication had led him to assume my brain, physiologically, is like any other brain.
However, the following week only proves to me that my brain and my body is not made to take pmeds at the recommended doses.
In the following journal entries, I've redacted MHC professionals names to letters of the alphabet to protect their privacy. As well, when I need to comment on a journal entry, the commentary is quite obvious.
According to BC provincial health protocol for mental health, a mental health consumer (me) is assigned a case worker with a Bachelor's of Social Work at the local office, a pdoc to figure out which medication is prescribed, and a pyschotherapist with the expertise and qualification to handle the particular issue (integration of person of color into Western culture with focus on family of origin).
Even though there may be opinionated statements in this article, in no way do they reflect upon the professionals in a negative light. Any reader naïve to my style of hyperbole and its multifaceted confabulation should take a lot of salt to what they are about to digest...
SHK 20100522.0605
---
Tuesday, May 11, 9:08 PM
I read up on Mirtazapine, and according to what I've read, it does not cause nausea. In fact, it relieves nausea. The antihistamine effect is stronger than hydroxyzine, though.
Reference: http://en.wikipedia.org/wiki/Mirtazapine
Tuesday, May 11, 9:40 PM
At 9:30 PM, I've taken the first mirtazapine dose (15 mg). Within the past ten minutes, I felt "better", which may be due to the antihistamine effect.
Also, the pain from a cold sore on my upper lip and earache in the right ear have faded somewhat. This may be due to moderate peripheral α1 adrenergic antagonism. [Commentary: It's actually due to the antihistamine effect.]
Tuesday, May 11, 9:51 PM: Hopefully the hypotension will be manageable. I just feel relaxed because of the antihistamine's effect. None of the nausea appeared at all, which proves that it is not a side effect.
Tuesday, May 11, 10:05 PM
The mellowness is a plus, though I have moderate difficulty in forming my thoughts.
Yet there is no real anxiety about this. I really like this effect, but feel that it's preventing me from freely expressing myself in the journal.
Currently, I just want to meditate while on mirtazapine. The more I focus on concentrating, the less I want to use that concentration to write.
There is very little anxiety, and if there is anxiety, then I do not feel it impeding my thoughts.
Tuesday, May 11, 10:17 PM
I ate a donut, and had a multivitamin. The mirtazapine's effects are still happening: calmness, mellowness, a sense of joy, serendipity, serenity... these words barely describe the feeling.
Yet not a tinge of nausea is present.
Tuesday, May 11, 10:36 PM
Oh, yes! I finished a bottle of water without thinking, thanks to mirtazapine.
[Commentary: Within an hour, I've turned off my computer because the sedative effect of 15 mg of mirtazapine has overtaken me.]
Wednesday, May 12, 12:21 PM
This morning I got up at around 10 AM. I spent the morning writing, but wrote only briefly about Buddha Nature. It seemed easily to read than it did to write. Though I am not surprised by the mood swing side effect, IMHO it should be easier to control because of experience with my changes in mood.
[Commentary: "mood swing side effect" refers to agitation, restlessness, irritability, aggression. On waking up at around 9 AM, I felt malaise or lassitude. After shaking off this feeling, I wrote in my Spiritual Journal about Buddha Nature, which will be added to my Buddhist notes as Buddhahood.]
Thursday, May 13, 9:52 AM
The mirtazapine appears to have worsened the cold sore and mouth cankers I had on the day I filled my prescription. I have fever blisters on my upper lip, and my mouth has been dry on waking.
I am getting mouth and skin rash/lesions because of side effect of Mirtazapine.
http://doublecheckmd.com/EffectsDetail.do?dname=mirtazapine&sid=13590&eid=6621#selist
I also have enlarged lymph nodes as a result of infection.
The 30 mg dose also makes me feel more aggressive, angry, hostile, and mean. Though, I'm sure that what it actually does is moderate impulse control negatively.
Friday, May 14, 9:11 AM
Today I called the MHC (Mental Health Centre) and reported the symptoms I've been experiencing, which now includes fever and swollen upper lip.
The medication causing these symptoms is mirtazapine. Tuesday evening, I took 15 mg at bedtime; and Wednesday evening, 30 mg.
After experiencing the physical symptoms, the use of mirtazapine was discontinued Thursday, but the only medication used Thursday evening was one 10 mg dose of hydroxyzine to act as a sedative.
So the physical symptoms are fever, sore throat, mouth ulcers, skin lesions, and fever blisters.
The psychological symptoms are: depression, aggression, agitation. There also is a negative self image due to skin lesions on the face.
Friday, May 14, 10:46 AM
Dr. "A" called back, and I gave him the list of symptoms I had. He confirmed that I had discontinued mirtazapine as of Thursday. While he stated that hydroxyzine may be too expensive for me to use, and that he may be recommending other medication, since I have 8 capsules left, IF the swollen upper lip and face becomes a problem, then I will take hydroxyzine tonight at bedtime.
[Commentary: the pdoc also claimed that mirtazapine usually never has that effect. This is true, but it did contribute to a change in body chemistry which IMHO lowered my WBC rapidly enough for the zoster virus to activate as shingles. It also indirectly worsened my psychoneurotic behaviorisms I exhibit when not able to express myself by either read, writing, and writing in my journal on the computer.]
Friday, May 14, 2:23 PM
Since I am able to tolerate the pain, I want to tough out the symptoms. The reason is, I am not in very much discomfort. This is why when the roommate expressed her concern, I wasn't willing to agree that it needs a doctor to be looked after properly.
IMHO, swollen lymph nodes mean that my body is fighting off the infection. Fever means that the infection is bad, but not life threatening.
However, before deciding to act, the symptoms need to be much worse than this.
[Commentary: Between 3:00 PM and 6:00 PM I visit Emergency Ward at the local hospital.]
Friday, May 14, 6:03 PM
It turns out that the mirtazapine may have reactivated the herpes zoster virus (chicken pox) as shingles.
http://en.wikipedia.org/wiki/Herpes_zoster
After getting my condition diagnosed at the hospital, the emergency doctor gave me a prescription for acyclovir, a potent antiviral drug, which is to be taken 5 x daily for 7 days.
So I have to take 5 times daily Acyclovir for a week, religiously, and preferably with food, from May 14 until May 20.
Friday, May 14, 6:14 PM
The lesions and fever blisters are due to herpes simplex zoster (originally chicken pox), which reactivated as shingles. Most likely, mirtazapine played an indirect part in reactivating it.
IMHO influenza may have reactivated the herpes virus, and both hydroxyzine and mirtazapine may have been the most recent trigger, due to their effect on the immune system via histamine suppression.
When I took my first dose, Mirtazapine had a strong histamine rebound effect on me.
Friday, May 14, 7:46 PM
On Monday (May 16) I intend to call Dr. "A" to update him about the symptoms I previously attributed to mirtazapine.
It turns out that the dormant herpes zoster virus reactivated, IMHO due to a combination of stress, including the use of hydroxyzine & recently mirtazapine.
After getting my condition diagnosed at the hospital, the emergency doctor gave me a prescription for acyclovir, a potent antiviral drug, which is to be taken 5 x daily for 7 days.
[Commentary: when I compare the name of my pdoc in this entry with the previous entry on Fri, May 14, 10:46 AM, his name has changed in this entry. Nine hours have passed by this point.]
Saturday, May 15, 11:40 PM
One side effect of recovery from mirtazapine I noticed was mild hallucinations where I see a comic book. [Commentary: though this can be attributed to having finished inventory on the last 30 comics in my collection. These hallucinations only occur when I am tired, IMHO as a reminder from my subconscious to take a break from whatever I am doing at the moment and rest. I also have a dream later on that night, though 72 hours later, no recall of details of that dream remain, due to it being trivial in nature.]
Sunday, May 16, 1:54 PM
The right side of my face is slightly swollen. There are two lesions under the eye near the nose, two across the cheek, three on the right side of the nose, and one large one at the top of the middle of the upper lip. They all follow a serpentine pattern from eye to upper lip. This is the symptom of shingles.
http://en.wikipedia.org/wiki/Dermatomic_area
Monday, May 17, 10:58 AM
At 10:41 AM I called up the MHC, and got Dr. "A" surname wrong. After the initial confusion experienced with the receptionist, I left a message for my caseworker, "B", mentioned the herpes (shingles), being medicated for it, being on hydroxyzine, and asking if I could return to mirtazapine at 7.5 mg on May 23 after the hydroxyzine runs out.
Monday, May 17, 6:08 PM
Quite possibly the activation of shingles (herpes zoster) was precipitated by a rapid onset of neutropenia.
This is similar to the case study online:
http://psy.psychiatryonline.org/cgi/content/full/50/3/299?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=mirtazapine&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
Tuesday, May 18, 8:32 AM
I just thought of something: improvement of my neutrophil count, to lower the risk of mirtazapine causing a bad reaction.
For now, it's in my best interest to get a baseline blood test done.
[Commentary: this entry is important to explain the next entry.
Eating a lot more than I usually do when not ill should improve the neutrophil count, as well as taking the antiviral medication.]
Tuesday, May 18, 6:50 PM
After updating "B" Monday through voice-mail, there's been no response from Dr. "A" regarding returning to Mirtazapine. Also, my research on-line about mirtazapine indicates that returning to the drug may reduce my ANC (absolute neutrophil count) and WBC (white blood count). The symptoms of being on Mirtazapine from May 11 to 12, were similar to hypomania. [Commentary: IMHO it seems similar to cyclothymia. However, when I've been isolated on the computer for more than 4 hours, I may become mute and may show irritability to interruption of my current activity. This is probably one of the symptoms of the borderline personality disorder.]
From Friday May 14 until Sunday May 16 it felt more like a return to depression, but I attribute that feeling to change in self-image due to the temporary disfigurement shingles causes when it affects the face.
Self-care has been reduced, and every second or third day I spend too much time behind the computer, in an attempt to avoid facing with the reality effectively.
[Commentary: Actually, being on the computer almost continuously for almost 10 hours had led to a deterioration of mood and behavior around 6:30 PM.]
Recommendations:
From pdoc, ask for SCID-DSMIV diagnosis.
Request starting dose of mirtazapine at 3.75 mg indefinitely.
From GP, ask for blood test to get baseline.
Friday, May 21, 9:38 PM
Update: so I called the MHC, inform the receptionist of what I've learned about mirtazapine, and the shingles which results from its use. 15 minutes later the psychologist calls back to tell me to discuss it with my GP.
After talking to my GP, he told me that he can't approve of any reduction in dosage for mirtazapine, and that the pdoc will have to try another medication. At this point, I replied "I really rather stick with mirtazapine at the lowest dose ( less than 3.75 mg) possible than try an SSRI!"
Why? Because the pdoc made it seem like he'll be playing SSRI roulette until we find the correct dose, or even better, stuck on Seroquel or olanzapine because of a calculated risk with an SSRI.
Regarding Remeron, I've read its monograph from Health Canada, and it states that mirtazapine has antidepressant activity at 0.5 and 1.0 mg.
So, obviously, going from 15 to 30 mg over 48 hours precipitated the shingles (varicella zoster virus aka VZV ) reaction to rapid changes in my WBC.
Had I wisely titrated from 3.75 mg over a week, I wouldn't have gone through a week of pain to endure a few days of depressive psychosis ("I feel too self-conscious with this painful, blistering skin rash - and the painful neuralgia!"), only to recover a few days later, and make my psychologist's first interview.
Saturday, May 22, 5:02 AM
Addendum: If my math skills are up to snuff, it appears that mirtazapine's clinical trials have given enough statistics to help me calculate the number needed to cause harm.
That number is 17, but the odds are 1.25-1.75 to 1 that you'd get any one of the side effects. With paxil, the number needed to harm is 50, but the odds are like 2 to 1 i.e. you are twice a likely to get any side effect than you would with placebo.
Therefore, mirtazapine evens the odds ever so slightly. The only benefits in exchange for risk of lowering WBC that is appealing is its ability to tolerate nausea, and the lack of serotonin withdrawal symptoms which the SSRI and SNRI medications have in spades.
So I am going to build tolerance to mirtazapine by titrating using the hydration method i.e. dissolve 3.75 mg of the drug in about 250 ml water, let it sit for a few hours, and then sip it slowly.
Since that much water takes about 4-5 sips, I could titrate the drug over 4 hours, rather than ingest one half dose at bedtime. The only risk here is that of waking dreams, which the literature calls "hallucinations".
---
References:
Ethnopsychopharmacology: http://en.wikipedia.org/wiki/Ethnopsychopharmacology
Varicella Zoster virus: http://en.wikipedia.org/wiki/Varicella_zoster_virus
Zoster reactivation worst case: http://www.hivinsite.org/InSite?page=kb-05-03-01
Statistics involving pharmacology:
Number needed to harm: http://en.wikipedia.org/wiki/Number_needed_to_harm
Health Canada Database for Drugs:
http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index-eng.php
Both hydroxyzine and mirtazapine have lots of pages about their pharmacology and toxicology. The Health Canada website should have the main monograph to make the probability statistics.
At the conclusion of my first interview with Dr. "A", he writes me a script for mirtazapine at 15 mg to be taken at 1-2 pills nightly for one month (60 pills). He then states that serotonin may cause nausea, and I get the impression would have similar effects to Selective Serotonin Re-uptake Inhibitor (SSRI) antidepressants.
When the pdoc came to medication, I selected mirtazapine because my initial on-line research gave it a good safety profile for the average North American, which I am not.
For I am a Japanese-Canadian person, 51 years old, and male. IMHO the cultural and genetic (ethnic) background of all the mirtazapine test groups probably did not include a lot of Asians, but it should because of the Asian sensitivity to psychopharmaceuticals (psychiatric medication or pmeds). (See Ethnicity and psychopharmacology APT(1999), vol.5,p.91; A Psychiatric Residency Curriculum About Asian-American Issues Academic Psychiatry 26:225-236, December 2002)
On the other hand, my pdoc is Anglo-Canadian, and landed immigrant from the UK. Schooled in Western psychiatry, he's been trained to overlook my ethnic background and treat only my brain. Yet his faith in the "magic" of psychiatric medication had led him to assume my brain, physiologically, is like any other brain.
However, the following week only proves to me that my brain and my body is not made to take pmeds at the recommended doses.
In the following journal entries, I've redacted MHC professionals names to letters of the alphabet to protect their privacy. As well, when I need to comment on a journal entry, the commentary is quite obvious.
According to BC provincial health protocol for mental health, a mental health consumer (me) is assigned a case worker with a Bachelor's of Social Work at the local office, a pdoc to figure out which medication is prescribed, and a pyschotherapist with the expertise and qualification to handle the particular issue (integration of person of color into Western culture with focus on family of origin).
Even though there may be opinionated statements in this article, in no way do they reflect upon the professionals in a negative light. Any reader naïve to my style of hyperbole and its multifaceted confabulation should take a lot of salt to what they are about to digest...
SHK 20100522.0605
---
Tuesday, May 11, 9:08 PM
I read up on Mirtazapine, and according to what I've read, it does not cause nausea. In fact, it relieves nausea. The antihistamine effect is stronger than hydroxyzine, though.
Reference: http://en.wikipedia.org/wiki/Mirtazapine
Tuesday, May 11, 9:40 PM
At 9:30 PM, I've taken the first mirtazapine dose (15 mg). Within the past ten minutes, I felt "better", which may be due to the antihistamine effect.
Also, the pain from a cold sore on my upper lip and earache in the right ear have faded somewhat. This may be due to moderate peripheral α1 adrenergic antagonism. [Commentary: It's actually due to the antihistamine effect.]
Tuesday, May 11, 9:51 PM: Hopefully the hypotension will be manageable. I just feel relaxed because of the antihistamine's effect. None of the nausea appeared at all, which proves that it is not a side effect.
Tuesday, May 11, 10:05 PM
The mellowness is a plus, though I have moderate difficulty in forming my thoughts.
Yet there is no real anxiety about this. I really like this effect, but feel that it's preventing me from freely expressing myself in the journal.
Currently, I just want to meditate while on mirtazapine. The more I focus on concentrating, the less I want to use that concentration to write.
There is very little anxiety, and if there is anxiety, then I do not feel it impeding my thoughts.
Tuesday, May 11, 10:17 PM
I ate a donut, and had a multivitamin. The mirtazapine's effects are still happening: calmness, mellowness, a sense of joy, serendipity, serenity... these words barely describe the feeling.
Yet not a tinge of nausea is present.
Tuesday, May 11, 10:36 PM
Oh, yes! I finished a bottle of water without thinking, thanks to mirtazapine.
[Commentary: Within an hour, I've turned off my computer because the sedative effect of 15 mg of mirtazapine has overtaken me.]
Wednesday, May 12, 12:21 PM
This morning I got up at around 10 AM. I spent the morning writing, but wrote only briefly about Buddha Nature. It seemed easily to read than it did to write. Though I am not surprised by the mood swing side effect, IMHO it should be easier to control because of experience with my changes in mood.
[Commentary: "mood swing side effect" refers to agitation, restlessness, irritability, aggression. On waking up at around 9 AM, I felt malaise or lassitude. After shaking off this feeling, I wrote in my Spiritual Journal about Buddha Nature, which will be added to my Buddhist notes as Buddhahood.]
Thursday, May 13, 9:52 AM
The mirtazapine appears to have worsened the cold sore and mouth cankers I had on the day I filled my prescription. I have fever blisters on my upper lip, and my mouth has been dry on waking.
I am getting mouth and skin rash/lesions because of side effect of Mirtazapine.
http://doublecheckmd.com/EffectsDetail.do?dname=mirtazapine&sid=13590&eid=6621#selist
I also have enlarged lymph nodes as a result of infection.
The 30 mg dose also makes me feel more aggressive, angry, hostile, and mean. Though, I'm sure that what it actually does is moderate impulse control negatively.
Friday, May 14, 9:11 AM
Today I called the MHC (Mental Health Centre) and reported the symptoms I've been experiencing, which now includes fever and swollen upper lip.
The medication causing these symptoms is mirtazapine. Tuesday evening, I took 15 mg at bedtime; and Wednesday evening, 30 mg.
After experiencing the physical symptoms, the use of mirtazapine was discontinued Thursday, but the only medication used Thursday evening was one 10 mg dose of hydroxyzine to act as a sedative.
So the physical symptoms are fever, sore throat, mouth ulcers, skin lesions, and fever blisters.
The psychological symptoms are: depression, aggression, agitation. There also is a negative self image due to skin lesions on the face.
Friday, May 14, 10:46 AM
Dr. "A" called back, and I gave him the list of symptoms I had. He confirmed that I had discontinued mirtazapine as of Thursday. While he stated that hydroxyzine may be too expensive for me to use, and that he may be recommending other medication, since I have 8 capsules left, IF the swollen upper lip and face becomes a problem, then I will take hydroxyzine tonight at bedtime.
[Commentary: the pdoc also claimed that mirtazapine usually never has that effect. This is true, but it did contribute to a change in body chemistry which IMHO lowered my WBC rapidly enough for the zoster virus to activate as shingles. It also indirectly worsened my psychoneurotic behaviorisms I exhibit when not able to express myself by either read, writing, and writing in my journal on the computer.]
Friday, May 14, 2:23 PM
Since I am able to tolerate the pain, I want to tough out the symptoms. The reason is, I am not in very much discomfort. This is why when the roommate expressed her concern, I wasn't willing to agree that it needs a doctor to be looked after properly.
IMHO, swollen lymph nodes mean that my body is fighting off the infection. Fever means that the infection is bad, but not life threatening.
However, before deciding to act, the symptoms need to be much worse than this.
[Commentary: Between 3:00 PM and 6:00 PM I visit Emergency Ward at the local hospital.]
Friday, May 14, 6:03 PM
It turns out that the mirtazapine may have reactivated the herpes zoster virus (chicken pox) as shingles.
http://en.wikipedia.org/wiki/Herpes_zoster
After getting my condition diagnosed at the hospital, the emergency doctor gave me a prescription for acyclovir, a potent antiviral drug, which is to be taken 5 x daily for 7 days.
So I have to take 5 times daily Acyclovir for a week, religiously, and preferably with food, from May 14 until May 20.
Friday, May 14, 6:14 PM
The lesions and fever blisters are due to herpes simplex zoster (originally chicken pox), which reactivated as shingles. Most likely, mirtazapine played an indirect part in reactivating it.
IMHO influenza may have reactivated the herpes virus, and both hydroxyzine and mirtazapine may have been the most recent trigger, due to their effect on the immune system via histamine suppression.
When I took my first dose, Mirtazapine had a strong histamine rebound effect on me.
Friday, May 14, 7:46 PM
On Monday (May 16) I intend to call Dr. "A" to update him about the symptoms I previously attributed to mirtazapine.
It turns out that the dormant herpes zoster virus reactivated, IMHO due to a combination of stress, including the use of hydroxyzine & recently mirtazapine.
After getting my condition diagnosed at the hospital, the emergency doctor gave me a prescription for acyclovir, a potent antiviral drug, which is to be taken 5 x daily for 7 days.
[Commentary: when I compare the name of my pdoc in this entry with the previous entry on Fri, May 14, 10:46 AM, his name has changed in this entry. Nine hours have passed by this point.]
Saturday, May 15, 11:40 PM
One side effect of recovery from mirtazapine I noticed was mild hallucinations where I see a comic book. [Commentary: though this can be attributed to having finished inventory on the last 30 comics in my collection. These hallucinations only occur when I am tired, IMHO as a reminder from my subconscious to take a break from whatever I am doing at the moment and rest. I also have a dream later on that night, though 72 hours later, no recall of details of that dream remain, due to it being trivial in nature.]
Sunday, May 16, 1:54 PM
The right side of my face is slightly swollen. There are two lesions under the eye near the nose, two across the cheek, three on the right side of the nose, and one large one at the top of the middle of the upper lip. They all follow a serpentine pattern from eye to upper lip. This is the symptom of shingles.
http://en.wikipedia.org/wiki/Dermatomic_area
Monday, May 17, 10:58 AM
At 10:41 AM I called up the MHC, and got Dr. "A" surname wrong. After the initial confusion experienced with the receptionist, I left a message for my caseworker, "B", mentioned the herpes (shingles), being medicated for it, being on hydroxyzine, and asking if I could return to mirtazapine at 7.5 mg on May 23 after the hydroxyzine runs out.
Monday, May 17, 6:08 PM
Quite possibly the activation of shingles (herpes zoster) was precipitated by a rapid onset of neutropenia.
This is similar to the case study online:
http://psy.psychiatryonline.org/cgi/content/full/50/3/299?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=mirtazapine&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
Tuesday, May 18, 8:32 AM
I just thought of something: improvement of my neutrophil count, to lower the risk of mirtazapine causing a bad reaction.
For now, it's in my best interest to get a baseline blood test done.
[Commentary: this entry is important to explain the next entry.
Eating a lot more than I usually do when not ill should improve the neutrophil count, as well as taking the antiviral medication.]
Tuesday, May 18, 6:50 PM
After updating "B" Monday through voice-mail, there's been no response from Dr. "A" regarding returning to Mirtazapine. Also, my research on-line about mirtazapine indicates that returning to the drug may reduce my ANC (absolute neutrophil count) and WBC (white blood count). The symptoms of being on Mirtazapine from May 11 to 12, were similar to hypomania. [Commentary: IMHO it seems similar to cyclothymia. However, when I've been isolated on the computer for more than 4 hours, I may become mute and may show irritability to interruption of my current activity. This is probably one of the symptoms of the borderline personality disorder.]
From Friday May 14 until Sunday May 16 it felt more like a return to depression, but I attribute that feeling to change in self-image due to the temporary disfigurement shingles causes when it affects the face.
Self-care has been reduced, and every second or third day I spend too much time behind the computer, in an attempt to avoid facing with the reality effectively.
[Commentary: Actually, being on the computer almost continuously for almost 10 hours had led to a deterioration of mood and behavior around 6:30 PM.]
Recommendations:
From pdoc, ask for SCID-DSMIV diagnosis.
Request starting dose of mirtazapine at 3.75 mg indefinitely.
From GP, ask for blood test to get baseline.
Friday, May 21, 9:38 PM
Update: so I called the MHC, inform the receptionist of what I've learned about mirtazapine, and the shingles which results from its use. 15 minutes later the psychologist calls back to tell me to discuss it with my GP.
After talking to my GP, he told me that he can't approve of any reduction in dosage for mirtazapine, and that the pdoc will have to try another medication. At this point, I replied "I really rather stick with mirtazapine at the lowest dose ( less than 3.75 mg) possible than try an SSRI!"
Why? Because the pdoc made it seem like he'll be playing SSRI roulette until we find the correct dose, or even better, stuck on Seroquel or olanzapine because of a calculated risk with an SSRI.
Regarding Remeron, I've read its monograph from Health Canada, and it states that mirtazapine has antidepressant activity at 0.5 and 1.0 mg.
So, obviously, going from 15 to 30 mg over 48 hours precipitated the shingles (varicella zoster virus aka VZV ) reaction to rapid changes in my WBC.
Had I wisely titrated from 3.75 mg over a week, I wouldn't have gone through a week of pain to endure a few days of depressive psychosis ("I feel too self-conscious with this painful, blistering skin rash - and the painful neuralgia!"), only to recover a few days later, and make my psychologist's first interview.
Saturday, May 22, 5:02 AM
Addendum: If my math skills are up to snuff, it appears that mirtazapine's clinical trials have given enough statistics to help me calculate the number needed to cause harm.
That number is 17, but the odds are 1.25-1.75 to 1 that you'd get any one of the side effects. With paxil, the number needed to harm is 50, but the odds are like 2 to 1 i.e. you are twice a likely to get any side effect than you would with placebo.
Therefore, mirtazapine evens the odds ever so slightly. The only benefits in exchange for risk of lowering WBC that is appealing is its ability to tolerate nausea, and the lack of serotonin withdrawal symptoms which the SSRI and SNRI medications have in spades.
So I am going to build tolerance to mirtazapine by titrating using the hydration method i.e. dissolve 3.75 mg of the drug in about 250 ml water, let it sit for a few hours, and then sip it slowly.
Since that much water takes about 4-5 sips, I could titrate the drug over 4 hours, rather than ingest one half dose at bedtime. The only risk here is that of waking dreams, which the literature calls "hallucinations".
---
References:
- Ethnicity and psychopharmacology APT(1999), vol.5,p.91: http://apt.rcpsych.org/cgi/reprint/5/2/89.pdf
- A Psychiatric Residency Curriculum About Asian-American Issues : http://ap.psychiatryonline.org/cgi/content/full/26/4/225
Ethnopsychopharmacology: http://en.wikipedia.org/wiki/Ethnopsychopharmacology
Varicella Zoster virus: http://en.wikipedia.org/wiki/Varicella_zoster_virus
Zoster reactivation worst case: http://www.hivinsite.org/InSite?page=kb-05-03-01
Statistics involving pharmacology:
Number needed to harm: http://en.wikipedia.org/wiki/Number_needed_to_harm
Health Canada Database for Drugs:
http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index-eng.php
Both hydroxyzine and mirtazapine have lots of pages about their pharmacology and toxicology. The Health Canada website should have the main monograph to make the probability statistics.
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