My goal for a sensible sleep schedule.
-- Go to sleep at 11 PM
-- Wake up at 6:00 AM.
What follows are my efforts at implementation.
Nine years ago, when I was a graduate student at Penn State, I had a series of problems relating to the fact that:
I am a paraplegic
I was experiencing considerable pain in my right shoulder which I had dislocated following a serious fall.
I was/am in my 60s having problems maintaining energy required for my work.
The fact that I had survived cancer (Hodgkin’s disease after receiving high doses of radiation.
I was having trouble sleeping.
Bed on the floor of my small second bedroom. Devoting this bed to sleep should help me meet my objective: Asleep by 11 PM; awake at 6 A.M.
Dr. Jeffrey Jackson, a State College psychologist, decided to concentrate to the importance of establishing a sensible sleep schedule. He said it is a myth that as one gets older one requires less sleep. Indeed, sleep deprivation for the elderly is a serious health problem.
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Yoga exercise before sleep:
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Dr. Jackson, who is a behavioral psychologist, made the following suggestions:
Sleep in a room that is separate from the one in which I work.
Confine my activities in bed exclusively to sleep and making love.
Establish a sleep regime and ritual.
Reduce coffee consumption.
For nine years, I have failed to follow his excellent advice. My current health problems [3] require I make the reforms he suggested.
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Establish a sleep ritual
Put on pajamas to indicate it is time for bed. Hitherto, I have been sleeping in my clothes. Or throwing on a t-shirt. A formal garment meant to indicate: This is what one traditionally wears when sleeping as opposed to: These are the clothes I wear when awake.
2. Establish a prayer schedule to differentiate night from day
a) This is the prayer I say when I awake. This is my favorite Hebrew prayer.
“I thank You, living and eternal King, for giving me back my soul in mercy. Great is your faithfulness.” ++++
As a child my beautiful mother Miriam recited Hebrew prayers with me.
My mother when she was 20.--shortly before she became pregnant with me. When in June of 1947, she graduated from Hunter College, under Mother's undergraduate robes, I was noticing cooking inside her womb. Hunter was famous for Margorie Morningstar, the then City College of New York school for women. Natalie Wood played Margorie Morningstar in the popular film baseed on Leon Uris 'bestselling novel. Mother said frequently, "I attended Hunter College with Margorie Morningstar." In the same month that Mother received her bacheloor's degree in Arts from Hunter, Mother also received a bachelor's degree in Hebrew from a Hebrew college. My maternal grandmother complained frequently that Mother's dual bachelor's degrees while pregnant with me was "overdoing it."
The Hebrew prayer I said with my mother each night from the time I was 3 until I was 10 was the Shema.
Wikipedia on the Shema : “Shema Yisrael (or Sh’ma Yisrael; Hebrew: שְׁמַע יִשְׂרָאֵל; “Hear, [O] Israel”) are the first two words of a section of the Torah, and is the title (sometimes shortened to simply Shema) of a prayer that serves as a centerpiece of the morning and evening Jewish prayer services.
“The first verse encapsulates the monotheistic essence of Judaism: “Hear, O Israel: the LORD our God, the LORD is one” (Hebrew: שְׁמַע יִשְׂרָאֵל ה’ אֱלֹהֵינוּ ה’ אֶחָד), found in Deuteronomy 6:4, sometimes alternatively translated as “The LORD is our God, the LORD alone.” Observant Jews consider the Shema to be the most important part of the prayer service in Judaism, and its twice-daily recitation as a mitzvah (religious commandment).
“It is traditional for Jews to say the Shema as their last words, and for parents to teach their children to say it before they go to sleep at night.”
When it comes to prayer, my background is so intense I cannot imagine praying to God in any language but Hebrew. When I was 3 I was able to say the first two words of the Shema. I quickly memorized the three lengthy Hebrew paragraphs that represent a complete recitation of the Shema.
Here is a definitive sentence from the Book of Numbers from which portions of the Shema are taken. [See also Deutoronomy 6:4.]
Notice the vowels under and within the Hebrew letters. This is how this sentence looks without vowels. [Except for poetry, Hebrew books, magazine articles, and written language in Israel (and indeed in the Torah) are not reproduced with vowels.
“The earliest examples of written Paleo-Hebrew date from the 10th century BCE. ” –Wikipedia
אני יהוה אלהכם אשר הוזתי אתכם מארץ מזרים להיות לאלהים אני יהוה אלהכם
Doris Day’s memorable good night song.
“When I was just a little girl I asked my mother what will I be Will I be pretty will I be rich Here’s what she said to me/
“Que Sera Sera Whatever will be will be The future’s not ours to see Que Sera Sera What will be will be/”
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Current impediments to remaining faithful to this critical sleep schedule
I am currently recovering from a dangerous MERSA infection. This is the third time I have had this infection. The first two times I was hospitalized . Once this summer. Once in October. The infection currently takes the form of manifesting itself in the form of truly disgusting boils. The boils are painful.
The summer’s boil appeared under my right arm. I was hospitalized at Mt. Nittany Medical Center. My physician lanced the boil. I was also given massive doses of antibiotics. At first the antibiotic Clindamycin was administered intravenously. Then, after the wound had healed and I was released from the hospital I was proscribed 300 MG every six hours. During the period I religious took the medication, I felt massive exhaustion. For over a week, I felt as if every waking moment was an exercise in swing under water with bricks tied to my feet.
When my daughter Amelia was born, I Decided to frame the pieces of art I wanted to see on the wall. “Monk Erasing a Song of Sappho.” From Cream of the Jest by James Branch Cabell.
Art and music make me feel better.
The above illustration by Frank C. Papé (1878-1972) helps me right now when my pain level is an 8 on a scale of 1-10. How Papé’s art helps is the subject of this on-going post.
Having been in the hospital multiple times in 2015, I am convinced that art and music should be omnipresent in health care facilities. As I progress, I will be seeking ways of making my conviction a reality. Your help and suggestions are welcome.
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Frank_C._Papé career began to flourish in the early 1920s through his illustrations for a number of books by James Branch Cabell and Anatole France two writers.
Several months after I attended an office Christmas party at the home of Rep. John Jenrette (R-South Carolina) and Rita, Rita found $7,000 in cash in her husband’s custom-made shoe. Upon closer examination the closet contained $25,000 in hundred dollars bills.
Rita Jenrette four years after we worked together at Congress’s Office of Technology Assessment
When Rita found the money, she reported it to the police thus beginning media accounts of the Abscam scandal.In the wake of Watergate, Abscam was one of those scandals–like Koreagate— that failed to interest the public. A group of FBI agents, posing as Arab businessmen, had bribed several members of Congress and one senator. The bribed public servants were convicted. No one outside the Beltway cared. Following is Wikipedia’s account of how Rita’s husband reacted when offered a bribe.
“John Jenrette was one of the few who resigned before they were expelled from the House. During the operation, Jenrette was asked by an undercover FBI agent if he would take the bribe from the Sheikh. He replied, ‘I’ve got larceny in my blood. I’d take it in a goddamn minute.'”
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Wikipedia on Rita Jenrette, whom I knew by her maiden name when we worked together at the Office of Technology Assessment (OTA) chaired by Senators Hubert Humphrey and Ted Kennedy:
“Rita Jenrette, born Rita Carpenter, November 25, 1949 in San Antonio, Texas is an American celebrity, actor, television journalist, and real estate executive. She is most famous for the interview she gave about her marriage to U.S. RepresentativeJohn Jenrette following his conviction in the Abscam scandal and her accompanying semi-nude pictorial in Playboy magazine.
“In 1977, Jenrette worked as a research associate at the Office of Technology Assessment under the co-chairmanship of SenatorsHubert H. Humphrey and Edward M. Kennedy. She co-authored a report, with Ray Hoehle, on the Food for Peace program, which was presented to the Presidential Commission on World Food Hunger….On September 10, 1976, she married freshman Democratic whip John Jenrette of South Carolina, 18 months after meeting him on Capitol Hill. She was also a Clairol model.
“Her husband, John, was convicted for taking a bribe during the Abscam investigation in October 1980. She appeared on the Phil Donahue Show and he called in live to join the conversation. At his trial she testified in her husband’s defense….She gave an interview to Playboy that appeared in the April 1981 issue, accompanied by a nude pictorial. The article’s revelation that she and her husband had sex on the steps of the U.S. Capitol during a break in an all-night House session caused a hoopla. She claimed that the couple were still “happily married” at the time the Playboy pictorial was photographed,although they had separated by the time it was published. The comedy group “Capitol Steps” takes its name from this escapade. Jenrette again appeared in Playboy in the May 1984 issue on the cover and in a pictorial.“
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Wikipedia: Abscam
Abscam—sometimes written ABSCAM—was a Federal Bureau of Investigation (FBI) sting operationthat took place in the late 1970s and early 1980s that led to the convictions of seven members of the United States Congress, among others.[1] The two-year investigation was directed from the FBI’s office in Hauppauge, New York, and was under the supervision of Assistant Director Neil J. Welch, who headed the bureau’s New York division, and Thomas P. Puccio, head of the Justice Department’s Organized Crime Strike Force for the Eastern District of New York. The operation initially targeted trafficking in stolen property and corruption of prestigious businessmen, but was later converted to a public corruption investigation. The FBI, aided by the Justice Department and a convicted con-man, videotaped politicians accepting bribes from a fraudulent Arabian company in return for various political favors.[2]
I first met Rita in 1976 shortly after I had completed my second round of radiation treatment for Hodgkin’s disease, a cancer of the lymphatic system. I was anything but well, but did not realize I was unfit for the “real world” even though I was obliged to make a living.
The article convinced a friend who worked for OTA to hire me as a consultant writing a report on the Women, Infants, and Children (WIC) program. Upon being hired, I met Rita who struck me as being first extremely vulnerable and second very beautiful. She was working on the Food for Peace Program for which I envied her. My envy was reduced considerably by the fact that she was so pleasant and friendly. At the time I was blissfully monogamous with a beautiful woman. I recognized there were other women in the world, but surprisingly, I did not care.
Except for the Christmas party at Rita’s house, which was a lot of fun, my only real encounter with her concerned eye surgery. She had cut her eye on a contact lens and several of us in the office were sympathetic. The last I heard of her (until deciding to write this post) was an article in the late lamented Washington Star discussing how she had found Jesus.
I could tell you about Rita’s husband John Jenrette, whose membership on the Oilseeds and Rice Subcommittee of the House, but there is not much to say. I spent weeks covering the hearings on the rice bill watching John pretending to work. Before John Jenrette, I had not realized that a member of Congress could be that devoid of talent and intelligence.
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Note: Just to give you a taste for the Abscam scandal, I am publishing this video. Rep. Jenrette is somewhere in the complete tapes. If you care, see You Tube. Meanwhile, here is some slime.
“Unmerited divine assistance given humans for their regeneration or sanctification.” –Miriam-Webster’s fist definition of GRACE
“Man is born broken. He lives by mending. The grace of God is glue.” –Eugene O’Neil
Learning to manage pain
This is part of the story of how I am learning to manage pain. At first, I thought of this as a “war story.” After all, I am a 68 year-old paraplegic. I live in an independent residence for 100 disabled and elderly residents. It is commonplace for us to sit in the bingo parlor across from my apartment and talk about our complaints. “It hurts here. It hurts there.”
Then I sought to describe the physical therapy life has imposed on me. It was with a catalog of exercises in mind that I mistakenly began this posting in January. Yes, there are exercises here–exercises to be performed daily.
Today is March first. Yet I have not obtained mastery of movement as I continue to revise. Slowly, I am learning how gentle continual movement is key to transforming pain. I have been impatient to describe truths that seem all-encompassing. Now I realize the most difficult truth is how to narrow my focus to the achievable while recognizing there are limits to limitation.
No longer do I think of this post as a personal filing cabinet, a tool for organizing handouts from physical and occupational therapists–the consequence of physicians issuing prescriptions to conform to tedious Medicare regulations. Now I realize what I truly require:
Grace
Joy
Doing the tango from a wheelchair
Fred Astaire wearing spats dancing with Ginger Rogers who reveals a lot of leg.
Sadly, this or a similar frequently used scale for measuring pain does not solve the problem. Defining the "problem" of pain and providing a solution is the central focus of this essay. I recognize that what works for me might not work for you. I do hope that my efforts may provide comfort to my fellow chronic pain sufferers.
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In October, 2014, the pain in my deteriorating spine became crippling. Crippling it has remained. Daily the pain level is 7. 5 on a scale of one to 10. This is a frequently used scale, one with faces, shown in emergency rooms, hospitals, doctors offices. Anything over 5 is serious. If you reach 7, you are entitled to morphine–initially quick acting and wonderful. Yet 45 minutes of 4 mg is wonderful once. After the initial for 4 mg you want 6; I want 6; 8 mg 45 mg 45 minutes later. You can’t always get what you want.
Music helps
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The safer bet is Oxycodene or Percocet, another flavor of the same drug. Herein the Commonwealth of Pennsylvania, Oxycodone–vanilla or chocolate–is the favorite illegal drug, more popular than heroin. My friend Ben said he read in the Atlantic or Harper’s that religious fanatics who worship snakes have been too high to bother.
Dancing helps even when it seems impossible
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For me the alternative is New York City where Memorial Sloan Kettering Cancer Center referred me to Columbia Medical Center at 168th Street for a spinal stimulator. This technology has been available since the Sixties. Soon spinal stimulator inserted with the remarkable skill of Dr. Christopher J. Winfree will be available. Soon is not now. Despite medication and steroid injections, there are days when I roll up in a ball, clutching my legs–an infant of 68 rolling on the floor in a fetal position. Yet, even then there is hope. One source is technology.
“Courage is grace under pressure,” Hemingway said famously and incorrectly.
What I am writing here has nothing to do with courage. Yes, it is difficult to write about pain without mentioning pain hurts. As with so many limitations of post-Tower-of-Babel language, the lexicon requires revision. I am not being brave. I am solving a problem. Here with discussion of pain rating charts that tell me I am experiencing “great pain,” the information has limited utility. When the nurse asks for a rating (how bad is the pain?), the answer helps her because if I say “seven” she administers medication; “two” no medication. For me the question is more complicated. What am I doing here? Isn’t my presence in an emergency room a riddle I have yet to figure out. Clearly, I require reform. Yes, I will write about the spiritual aspect of pain.
Language fails. The urgency to find relief sometimes fails because I did not understand the larger implications. Expressions such as “fighting pain” are dangerous because the key is not battle. Yes, at times like these, I regard pain as evil. Fighting evil idirectly is counterproductive.
Seven months ago the intensity of the pain was so great, I called 911, an ambulance arrived, and I was wheeled on a gurney to the Emergency Room at Mount Nittany Medical Center.
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Going to the Emergency Room for pain, even State College’s pleasant and well run ER is a mistake for a variety of reasons.
Isadora Duncan, co-founder of the modern dance movement, demonstrates her belief that human beings should move freely and without restriction (such as ballet slippers).
Most significantly an ER is a mistake because pain medication is temporary. What is required is a different mind set–a perspective to managing pain that incorporates movement, joyous continuous movement.
The spinal pain is the worst. It is a consequence of the massive radiation which cured me of Hodgkin’s disease, cancer of the lymphatic system, preventing me from dying at age 30 .
To relieve spinal pain.Alicia J. Spence, physical therapist extraordinary, Phoenix Rehab recommends my ing basic stretches to relieve tight, tense shoulders due to bad posture, slouching or sitting for long periods of time.
I believe the disabled and elderly should be encouraged to develop their talents, overcome obstacles, and be productive. In the 21 years since I became a paraplegic, I have been beset by health problems. I have close to death so often Joanna, my elder daughter tells me, “Nothing can kill you, Dad.” Yet a lot can slow me down.
Sigmand Freud may not be your flavor of the month. Yet, he expressed this truth: “Love and work… work and love, that’s all there is.” Despite having survived cancer three times, I could live another thirty years, In April I will be a grandfather. In August Amelia Altalena, my younger daughter marries. There are friends and loved ones who surround me. I publish regularly. I have dreams I would like to build into communities.
The time to think of the disabled and elderly as a drain on resources is over. The Baby Boomers, smart, educated, firm believers that “if I am not for myself who is for me. Together, my landsmen and I will change our world for the better. First, however, I have to learn to manage my pain. To move continually with joy. To reform including making a healthy sleep schedule (asleep by 11 pm; greating the morning at 6 a reality and not merely a resolution. Think of me as a a guinea pig–your gunia pig.
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Hilman’s Stretches for Back Pain Relief, How to Stretch Routine, Beginners Home Yoga”
–Philo Vance, S.S. Van Dine’s eccentric detective. Scarlet Murder Case.
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Jen Hilman says about her stretches for back pain, “Incredibly relaxing and stress melting, this yoga for flexibility will be your favorite video yet. Feel some back pain relief after following along to this stretch routine.”http://www.JenHilman.com
To manage the intensity of pain so I can exercise:
I must use pain medication such as Oxycodone and steroid injections.
Each medication may have dangerous long term consequences. Instead, at the suggestion of State College pain specialist Dr. Todd B. Cousins, he suggested I can eliminate medication by going to a specialist in NYC to insert a spinal stimulator, [5]
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Dislocating my right shoulder is a story I told on WPSU radio.
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Maimonides says the highest form of charity is to give a gift, loan, or partnership that will result in the recipient supporting himself instead of living upon others.
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Inflamed feet
When I broke my left ankle in August, my feet and legs became painfully inflamed.
To prevent an ugly condition called “pitting” Phoenix Rehab’s Alicia prescribed:
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1. Elevating my feet above my heart to reduce intimation to my lower extremities.
Example B: Motion for reducing swelling. Here, I am leaning against a large pillow on the wall adjacent to my bed. My legs are stretched across the bed so they reach the scooter. The scooter is locked so the seat will not rotate. I push the bottom of my feet against the rigid scooter chair. Focusing on reaching the pressure point, I push out hard.
https://www.youtube.com/watch?v=W8wEORnZxdg
Arthritis
When I went to the emergency room for spinal pain considerably higher than 8 on a scale where 10 is highest, I was x-rayed. Arthritis in the neck and shoulders.
There are useful head rotation exercises I will tell you about.
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Previously dislocated shoulder
Twenty years ago when I became unable to walk, I fell over my toes, hit the sofa and dislocated my shoulder. Several times my shoulder dislocated again not healing properly. Now stretching not only alleviates pain, stretching preserves my ability to dress myself. The following link to WPSU-FM tells the story. http://legacy.wpsu.org/radio/single_entry/LL-1756/
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Before using the pulleys, I must prepare by doing these exercises Alicia handed me. I just paused writing to clasp my arms together, slowly raise them above my head, lean back including my head_neck in the stretch, then returning to this post .
My son-in-law former Marine Jade Phillips installed this pulley which I had purchased from Phoenix Rehab.
Friend and neighbor John Harris photographs me using the pulley.
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Crawling as exercise
Crawling, photograph by Elaine Meder-Wilgus at Webster’s Bookstore and Cafe
Therapists
Allicia J. Spence, Phoenix Rehab, State College, PA
The physical and occupational therapists at HealthSouth, Pleasant Gap, PA.
Phoenix Rehab’s brilliant and elegant therapist Alicia J. Spence helps me use fore-armed crutches to walk. With the proper movement performed religiously each day (and the use of a device that directs electricity to my ankles (see footnote 12) I might be able to walk someday. First, however, I have to master the pain. Alicia suggested a wonderful exercise that slowly reduces spinal pain when I lie on m stomach.
October 27, 2015 HealthSouth Physical Rehabilitation Hospital, Pleasant Gap, PA. Occupational Therapist Megan Brown considers the problems involved with driving my mobility device into the bathroom.
Meanwhile:
Dancing helps
Isadora Duncan, co-founder [with Martha Graham] of the modern dance movement, demonstrates her belief that human beings should move freely and without restriction (such as ballet slippers.
You should see me dancing while sitting in my power operated scooter.
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Footnotes
Joy of Motion [1] is essential for managing my pain
I am writing this because I believe the disabled and elderly should be encouraged to develop their talents, overcome obstacles, and be productive.
When I was born, Hodgkin’s, a cancer of the lymphatic system, was regarded as universally fatal. The linear accelerator which cured me in 1976 is regarded today as primitive. The radiologist who treated me was killed by exposure to his own machine.
For twenty years I have been a paraplegic as a consequence of radiation burning a hole in my spinal cord. Now the radiation caused devastation to my spine has produced pain beyond description–eclipsing the other sources of pain which are part of my daily life.
A nurse took a photograph of my back immediately after surgery. So skillfully did Dr. Winfree insert the test stimulator that on December 22nd upon examining my back, Geisginger internist Sepana Menali could find no surgical scar.
References
http://www.drugs.com/oxycodone.html
McGonigal, Phd. Yoga for Pain Relief [2009]. Oakland, CA. New Harbinger Publications, Inc.
!["I thank You, living and eternal King, for giving me back my soul in mercy. Great is your faithfulness." [see footnote #]](https://joelsolkoff.com/blog/wp-content/uploads/2016/01/image-6.jpeg)
Example B: Motion for reducing swelling. Here, I am leaning against a large pillow on the wall adjacent to my bed. My legs are stretched across the bed so they reach the scooter. The scooter is locked so the seat will not rotate. I push the bottom of my feet against the rigid scooter chair. Focusing on reaching the pressure point, I push out hard.
