Archive | Stress

Mentally Passing A Driving Test

Nowadays, driving is considered as a very important skill. You could use this skill in cases of emergencies or even for something as simple as getting a change of scenery. Some people learned to drive by enrolling in driving schools while others were taught by their parents or friends. In any case, you would soon require a driver’s license to be considered as road-worthy. This can be accomplished by passing a driving test.

It is not surprising that you would become apprehensive when taking a driving test for the first time. Even if you are confident in you driving abilities, you may still feel nervous or anxious. This is quite normal especially if you are one of those people who hate failing in anything. On the other hand, the seriousness of the test can naturally make you worry. Aside from passing a written exam, you will also have to succeed in the practical test. Becoming apprehensive would certainly make you look unprepared.

Driving tests are relatively easy to pass as long as you have prepared for it physically and psychologically.

When preparing for a driving test, you should try getting enough sleep the night before to help you fell refreshed and relaxed the following day. Getting enough sleep would guarantee that your concentration is at its best. To be mentally prepared for your driving test, you should review what you have learned at least two days before. You can even ask a friend to help you with your reviews.

Aside from these, you will have to deal with your nervousness and anxiety. They can be managed through relaxing techniques such as breathing deeply, exercising or meditating. Once you are relaxed you can focus on your driving test effectively. In some cases, the anxiety is so intense that you might feel like you will never be able to finish the written driving test and perform well in the practical part. If this happens, you can always try hypnotherapy before taking the test.

A relatively new technique n treating anxiety, hypnotherapy involves hypnotizing the person and making suggestions to the subconscious. It is believed that when a person is hypnotized, the subconscious is more receptive of ideas. A qualified hypnotist can determine the cause of your anxiety and try to manage it. As soon as you wake up, you will be less anxious of the driving test. Hypnotherapy works best if you undergo at least three sessions.

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How to Increase Your Male Libido Naturally

To increase male libido naturally, you should try the supplements outlined here – not only will they increase male libido they will also make you feel happier and healthier.

So here are the best supplements for increasing male libido:

· L argentine

This nutrient is highly important for peak sexual performance. In fact, it is probably the most effective natural supplement for increasing male libido.

Current studies support the use of argentine supplements to ensure that nitric oxide secretion is sufficient to keep blood flowing to the penis.

Nitric oxide insufficiency can stop the penis from becoming erect, as it relaxes smooth muscles in the penis during sexual stimulation, allowing increased blood flow to the penis – so it’s needed to produce and sustain an erection.

A study published in 1994 showed an 80 percent improvement in the erectile function of men given 2.8 grams of argentine a day for two weeks.

· L Tyrosine

Supports and assists neurotransmitters in the brain. Reduced levels of L-Tyrosine are present when your body’s under stress, aged, or tired.

L-Tyrosine supplementation helps reduce stress, improves mental alertness, and enhances mood, which in many instances manifests itself in increased male libido.

· Gingko Bilbao

Used to improve blood flow around the body, and functions as an anti-oxidant in the body.

Ginkgo is a standard herbal remedy for male sexual dysfunction and increasing male libido, due to its affect on blood circulation.

· Ginseng

Korean Ginseng – used in China as a sexual balancer and revitalizing tonic for over 7000 years – an adaptogen, and believed to help maintain balance in the body and help the body adapt to stress.

Korean Ginseng is widely known for its ability to boost energy (including sex drive) and support the immune system.

As an adaptogen, it also helps you adapt to physical or emotional stress and fatigue.

Ginseng also has a normalizing effect on hormone imbalances, and boosts metabolic rate, as well as improving blood flow to the genitals.

· Selenium

Selenium – believed to be good for sperm production and mobility – nearly 50% of the selenium in a man is in the testes and seminal ducts; men lose selenium in their semen.

Getting enough selenium is therefore vital for peak sexual performance and male libido.

· Zinc

Zinc is required for the production of testosterone, and the zinc content of the prostate gland and sperm, is higher than in any other body tissues.

A deficiency of zinc is associated with numerous sexual problems, including sperm abnormalities and prostate disease.

Zinc not only helps produce testosterone, but also helps to maintain semen volume and adequate levels of testosterone, therefore maintaining sex drive and keeping sperm healthy.

· Magnesium

Magnesium is a trace mineral that is important for the production of sex hormones such as androgen, estrogen and neurotransmitters that modulate the sex drive – such as dopamine and nor epinephrine.

· Essential Vitamins

Vitamin A

Helps regulate the synthesis of the sex hormone progesterone.

Vitamin B1

Thiamine (B1) is essential for optimal nerve transmission and energy production throughout the body – which means it’s essential for sex.

Vitamin C

Participates in the synthesis of hormones that are involved in sex and fertility: androgen, estrogen and progesterone

Vitamin E

Often referred to as the sex vitamin, is a powerful anti-aging antioxidant that protects cell membranes from free-radical damage.

Vitamin E is also required for the synthesis of hormones, and hormone like substances known as prostaglandin.

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Different Uses Of Menthol Crystals

Menthol is a minty product, which is available in white crystals form that’s extracted synthetically from peppermint essential oil. It contains 70% of menthol, which make it so, beneficial for your health. It has antibacterial and anti-fungal properties, which make it highly demanded in various pharmaceuticals and cosmetic industries. It is also known for its sweet aroma, minty flavor, and cooling effects. It is originally known as Japanese mint. It has so many health benefits and uses in various applications. Some of its different uses, which you never heard before, are as follows.

Food Production: Don’t be surprised, from the ancient times; it is used as a flavor enhancer in food production. It not only enhances the taste of your mouth, but also gives your mouth a cooling sensation. This is widely used to make candies.

Beverages: Yes, you can also use this menthol crystal to add flavor in your beverages. This is widely used in various cold drinks, wines, and many other sweet drinks or other beverages.

Pharmaceuticals: It has antibacterial property, which helps to fight with various health diseases. Therefore, these menthol crystals widely used in various pharmaceutical industries. This is a proven solution to get relief from a headache, stomachache, nausea, sinus, headache, common fever, cold & cough, asthma and many other diseases.

Cosmetic: Due to its sweet aroma, this is widely used in cosmetic industries. It helps to enhance the smell of your favorite perfume and used in various beauty products such as shampoos, conditioners, lip balms, creams, and lotions and so on that helps to enhance your skin.

Oral hygiene: These menthol crystals also help to eliminate the bad breath and give your mouth a cooling sensation; therefore, it is widely used in manufacturing toothpaste, mouthwash or many other oral hygiene products.

Aromatherapies: These are also used in aromatherapies because of its cooling effect or sweet odor. It is really helpful to give relief from stress, anxiety, depression or many other problems. This is the only reason why aromatherapies can do what they do.

There are so many other ways to use this mint product, which has countless benefits. So, what are you waiting for? You should buy this outstanding mint product now from reputed Menthol Crystal Manufacturers at a wallet-friendly price. One thing to keep in mind is that don’t use it on sensitive areas of the skin, otherwise, it may be harmful. It is a very good product if you use it with complete guidance.

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A Comprehensive New Employee Orientation Program – 5 Reasons Why You Need One Now!

In a nutshell, a comprehensive New Employee Orientation Program increases employee engagement and retention. Increased employee engagement and retention let’s you keep and earn more money. In other words, happy, loyal employees mean happy, loyal customers. On the other hand, a typical ad hoc “first day” will increase expenses. In fact, 4% of new employees will leave after the first day! And you’re left to start all over again.

Specifically, a carefully designed and delivered New Employee Orientation Program will: 1. Reduce new employee start-up costs

2. Help make the new employee independently productive as quickly as possible

3. Provide your new employees with relevant information when they need to know it

4. Set realistic expectations and goals for both employee and

5. Encourage a positive attitude

Reduce new employee start-up costs

After you’ve spent what surely seems like too much time and money during the selection and hiring process looking for the right candidate, we don’t want you to compound that expense by leaving individual departments to “reinvent the wheel” and create an entirely New Employee Orientation Program for each new staff member. That wastes your company’s time, energy, and resources. And, we certainly don’t want you or your managers trying to do it all on the Friday before the new person arrives on Monday. A successful New Employee Orientation Program is planned well in advance of the employee arriving and is easily duplicated for each new employee and so saves you time, money and stress.

Help make the new employee independently productive as quickly as possible

Depending on the type of work they’ve been hired to do, your new employee can take a few days to be “up and running” or several months. But, by providing your new employees with clear and concise job descriptions, the necessary tools to do the job and effective On-the-Job training, you’ll greatly reduce the time it takes for your new employees to become not only productive but also to excel. A well designed New Employee Orientation Program ensures that your new employees are provided with these essentials for success. You employees will become confident, capable and top-performers in your organization. And if your employees are succeeding, so are you.

Provide relevant information at the most appropriate time

Without a clearly defined New Employee Orientation Program, the first day on the job is often an ad hoc “brain dump” of everything their manager thinks this poor person might need to know for years to come. First days are stressful enough without overloading your new employee with information they don’t need immediately. For example, a person probably needs to know how to activate their voice mail/email accounts and understand how the documents they will be using are stored and shared. They probably don’t need to know how to complete their month-end timesheet yet. Try this tip: show your new employee how to use their calendar software by creating an appointment with you (or their manager) at the end of the month to go over timesheet procedures. Giving them information before it’s relevant will only add to their “First Day” anxiety and they will probably have forgotten the information by month’s end when they need it anyway. A clear and concise New Employee Orientation Program schedules the necessary training at the appropriate time. Don’t waste time and money training and retraining.

Set realistic expectations and goals

Everyone’s expectations need to be clear upfront. Both the manager and your new employee must be made aware of the standard to which your new staff member is expected to work and how long it is expected that he or she will take to reach that level. If the manager doesn’t expect your new employee to be completely independent for several months, then make sure that the employee knows this. Otherwise, your new employee may be placing too much pressure on themselves by working to reach an unrealistic goal and become frustrated in the attempt. A carefully planned New Employee Orientation Program provides explicit standards and timeframes for achievement and so relieves everyone of the unnecessary stress. Remember, happy, stress free employees make happy, stress free customers.

Encourage positive attitude

It’s said that, “People will do satisfactory work because they have to. People do superior work because they want to.” Building employee engagement is key to fostering the kind of superior performance you need from your employees that keeps your customers coming back. “Achieving results through other people” has become the catchall description of a manager’s job but those results can’t be achieved if the people involved are not committed to the goal and the organization. Building this commitment starts on Day One of your new employee’s introduction to the organization and nurturing that commitment continues as your employee proceeds through your New Employee Orientation Program, On-the-Job Training Program, while working with their Buddy and Coach, and through regular performance feedback and recognition programs.

New employee orientation is a critical time. Your New Employee Orientation Program is the employee’s first real impression of your organization and continues the process of introducing the new employee to your organization’s culture, goals, mission, and expectations that you began during the selection and hiring process. A well-run first day goes a long way in making that first impression a positive one.

A clearly well organized New Employee Orientation will also send the message that you are in control and that your company has clear and definite standards. A program that ensures everything and everyone is ready for your new employee’s arrival reduces everyone’s stress and frustration by eliminating surprises and last-minute panic.

Remember, a comprehensive New Employee Orientation Program increases employee engagement and retention. Increased employee engagement and retention let’s you keep and earn more money.

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Cure Depersonalization Disorder and Symptoms of Derealization

In order to truly cure depersonalization disorder (including symptoms of derealization) you have to attack it at a number of different levels. If you don’t heed this advice, you could be stuck with the disorder for years, or even decades.

Depersonalization is caused by disorganized attachment, emotional abuse, dysfunctional family systems, interpersonal trauma, chronic stress, exposure to traumatic events, obsessive and distorted thought patterns, and use of specific drugs such as marijuana and hallucinogens. A number of these factors (but not necessarily all) will be present in anyone who acquires depersonalization disorder (DPD).

Each level needs to be addressed in order for full recovery to take place.

Let’s start with the first item on the list:

Develop Earned Security

A disorganized attachment style is caused by suboptimal parenting during a child’s early infancy. This pattern of attachment creates a tendency inside of a child towards dissociation when faced with stressful circumstances. When this child grows older, he will likely dissociate if he encounters a strong enough stressor.

You may be wondering, “if I have disorganized attachment, can I doing anything about it?”. The answer is absolutely yes.

You have to acquire secure attachment. Secure, also known as autonomous attachment, can be acquired in adulthood. This is known by attachment therapists as “earned security”.

Engage in Emotional Expression to Overcome Emotional Abuse

In order to overcome emotional abuse, you must first become aware of the fact that you suffered emotional abuse in childhood. Many sufferers of emotional abuse are not even aware that this occurred. Second, you must engage in emotional expression, also known as emotional discharge. Expressing suppressed emotions can often instantly get rid of feelings of derealization.

Overcome the Legacy of Your Dysfunctional Family System

Most people with depersonalization come from dysfunctional family systems. In the most general sense, a dysfunctional family is one in which one parent has a problem and all other family members are forced to adapt their thinking, feeling, and behaving to conform to the problem of this one person. These ways of being become ingrained in each family member, so that even if they leave the family system, they have dysfunctions in their thinking, feeling, and behaving. Most people with depersonalization have suffered from these environments, and still haven’t corrected these problems.

The four main types of dysfunctional families are the alcoholic or chemically dependent family system, the emotionally or psychologically disturbed family system, the physically or sexually abusing family system, the religious fundamentalist or rigidly dogmatic family system. The four “rules” shared by each of these systems are rigidity, denial, silence, and isolation. In these families, it is hard for the children to develop a strong sense of self. Dissociation is often a way for children of these families to cut off from the pain.

Co-dependence, enmeshment, perfectionism, low self-esteem and narcissistic grandiosity are other problems for people from dysfunctional families. All of these problems contribute immensely to duration and intensity of depersonalization and derealization.

Become Assertive to Avoid Future Interpersonal Trauma

Interpersonal trauma is frequently more severe than traumatic events. Interpersonal trauma is also seen in people who suffer Borderline Personality Disorder (BPD), which is frequently co-morbid with depersonalization disorder. Assertive communication is important for people with DP to learn. By becoming assertive, rather than submissive or aggressive, you can learn to interact with the social world in a healthy way.

Learn to Eliminate Chronic Stress

Anxiety is intricately related with DP. Learning relaxation techniques such as abdominal breathing, progressive muscle relaxation, peaceful visualizations, and paying attention to your emotional needs are essential skills in avoiding stress, which acts like fuel for DP. In modern society, stress is chronic. It’s extremely important to take a break from goal-related activity. 20 minutes of mindfulness meditation can be extremely therapeutic. Eliminating caffeine and other stimulants is important in reducing stress.

Likewise, increase your consumption of protein, and eat more whole vegetables and fruits. It is also important to combine aerobic and anaerobic exercise regimens to optimize the stress-reducing benefits of exercise.

30 minutes of moderately intense running 3 times a week, in addition to a weightlifting schedule can drastically reduce levels of stress hormones (cortisol, adrenaline, etc.). Studies on mice have found that exercise produces resilience against stress, which can help reduce anxiety.

Heal a Wounded Self

In Depersonalization Disorder, there is a rupture in a person’s sense of self. When this missing piece becomes brought back into a person’s awareness, they can feel repersonalized. Co-dependence is where a person is addicted to changing others, rather than changing themselves.

There is a case reported in the literature of an African-American woman becoming depersonalized due to growing up in a white family and never talking about being black. There is likely an element of the self that has been disowned or suppressed because it causes shame or pain. This element of the self must be brought into awareness and reintegrated into a person’s sense of self.

The self could have been wounded in a traumatic event, or by doing something that was interpreted to be shameful, or out of character.

Correct Obsessive and Distorted Thought Patterns

Depersonalization is on the obsessive-compulsive spectrum, and is often made worse by obsessive self-rumination and distorted thought patterns. Learning distraction techniques can help eradicate self focus.

Self-focus makes depersonalization worse. Obsessing about philosophical issues such as the meaning of life, eternity, questions of space, and contemplating insoluble existential issues makes depersonalization worse. These issues are actually ways for people with DP to avoid and ignore their own true needs.

It’s crucial to focus on your life goals, and not on existential issues.

Cognitive Behavioral Therapy (CBT) is also helpful for overcoming illogical thoughts. Emotional reasoning is the most common thought distortion among people with depersonalization. This is where feelings are used as justifications for thoughts. For example, if you feel unreal, you then may assume that you in fact aren’t real and will question aspects of your existence. This is illogical.

Perceive the World as Normal

People with depersonalization find things “strange” and “weird”. When you view everything as normal, you eliminate this source of anxiety. Everything is normal. Nothing is strange or weird. Things are only perceived as strange or weird when they go against our preconceptions.

If your preconception is that the earth is flat, then you realize is is in fact round, you may think this is “weird”, when in fact it is normal.

If your preconception is that matter is completely solid, and you find out that atoms are mostly empty space, you may conclude that this is “weird”.

Realizing that everything in the universe is in fact normal can help eliminate existential fear and anxiety.

Develop Goals and Accomplish Priorities

It’s extremely important to work on developing personal goals and to set priorities. By adopting an optimistic attitude and focusing on things you truly want to accomplish, you can generate a sense of purpose inside yourself that repels feelings of depersonalization.

In order to achieve what you want to achieve, it’s necessary that you break tasks into small, manageable pieces, and that you tackle the most important priorities before less important goals. By having a sense of direction in your life you will feel much more grounded in reality.

By following the above advice, you will develop a fully integrated sense of self, which will lead to the eradication of the symptoms of both depersonalization and derealization.

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Fasting And Bad Breath

Halitosis, or bad breath, is commonly experienced by almost every single person around. While few experience it occasionally, some people have it on a regular basis. It causes humiliation to those suffering from the condition especially when the person is in close proximity to someone else. For those who are fasting, bad breath is a very common experience. Fasting and bad breath are strongly correlated because the body’s digestive juices are still attempting to mutliply and process, even without any food there to be digested.

Bad breath is caused by several factors some of which include teeth and gum problems, gastrointestinal tract and stomach problems such as gastritis, acidity, dyspepsia (digestive problems), reflux, etc, upper respiratory tract problems, lung problems and some illnesses such as colds, infections, fever, etc.

Some people may suffer from intermittent episodes of temporary or slight halitosis due to drying of the mouth (xerostomia), poor oral hygiene and during illness. Temporary bad breath may also be observed if the person is fasting and is on an empty stomach for a long time.

In the absence of food, there is the release of digestive juices that begins to break down and also has an effect on the lining of the stomach that can result in foul odor which smells like stale food.

Fasting also results in reduction in salivary flow in the mouth leading to dryness of the oral cavity that can end up causing a smell. This is due to the bacterial buildup that occurs as the saliva is not present to swill out the bacteria from the surfaces of the teeth and the tongue. This coupled with the rise of digestive juices adds up to the terrible odor emanating from the breath.

When a person goes without eating for a long time, the absence of food causes the body begins to break down the fat reserves. This breakdown of fat causes the release of ketones which are pushed out along with the breath and gives a foul odor that resembles the stench of sour apples.

When a person is about to go for a special occasion or if he/she is under a lot of stress and if they are fasting for a long time, there is an increase in the drying of the mouth and increased release of digestive juices because of the stress that will lead to bad breath.

If the person has habits such as smoking, then this is not considered halitosis, but it can certainly contribute to halitosis problems. Even the consumption of alcoholic drinks on an empty stomach can increase the incidence of problems.

To avoid bad breath associated with fasting, avoid being on an empty stomach for long lengths of time. Even if it is not possible to consume a full course meal, it will help if you make sure to have a small snack or even just a lot of water. This is usually very helpful when the person is experiencing anxiety before a special occasion.

When fasting, the use of some mint, chewing gum or lozenges can help because this increases the flow of saliva in the mouth and helps in better flushing out of the bacteria that causes bad breath.

Fasting for a long time is not a good idea, as it can have harmful effects on the digestive tract and also cause the breakdown of body fat reserves, all of which will lead to having a very smelly breath. Fasting and bad breath can be avoided with a simple combination of treatments and lots of water.

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Hypnosis to Forget Someone – Getting Over an Ex

Have you been obsessing over an ex boyfriend or girlfriend and can’t seem to get over the relationship? We all know that breaking up with someone can be deeply painful, make us feel depressed and cause terrible mood swings. In my hypnotherapy practice, it’s quite normal to receive frantic phone calls from both men and women, requesting hypnosis to get over a relationship.

If you are experiencing emotional pain over the break up, it’s important to understand what factors might be contributing to your emotions. While hypnosis can be highly effective in improving your self esteem and confidence; in my opinion, being hypnotized to forget about another person is just not practical.

How can Hypnosis Help Get Past a Relationship?

Hypnosis is a tool which can be used to help you make powerful and healthy changes in your own thinking. According to cognitive behavioral therapy, our thoughts contribute highly to our emotions and stress levels. This is why it’s a much better idea to be hypnotized to love your self again, rather than try to erase the memories of someone else. I’ll bet there was once a time, not so long ago, when would go out with friends, engaged in things you liked to do, and have a lot of fun.

That interesting, and lovable person is still there, but right now, your conscious mind is too fixated on the break up. Our conscious mind is constantly analyzing situations and is always working. Sometimes, our conscious even comes up with false labels to describe a given situation; such as: I’ll never be happy again or, he was the only person who will ever love me. It isn’t long before these distorted thoughts stop you from being happy on your own. Hypnosis works by challenging your own irrational distortions, and by making positive, healthy suggestions to your subconscious. After a hypnotic session, you will begin to see the other person for who they really are, instead of who you want them to be.

How does Hypnosis Work?

Hypnosis isn’t some kind of voodoo or magic trick. In fact, most of us have naturally experienced hypnosis in our own lives in one manner or another. Hypnosis is nothing more than a deeply relaxed, highly focused state of mind, by where the hypnotist makes suggestions to your subconscious. While you are in trance-like state, your conscious mind is tranquil, rather than judging and critiquing. A person in hypnosis can wake up at anytime, and can’t be made to act in a way which goes against their natural behavior. Likewise, a person under hypnosis isn’t a zombie, and doesn’t behave like a robot. If you are going to have hypnosis for relationship problems, the hypnotist will probably try to lower your stress levels, by having you focus on something peaceful and serene. Once your mind is calm, the hypnotist can talk to the non-judgmental part of your mind-the subconscious. You can be hypnotized to look at your ex as someone who doesn’t deserve your love, or someone that isn’t worth your time. This is a far more healthy alternative than trying to pretend you never met in the first place.

Relationship Addiction

A good hypnotherapist will explore the reasons you are having so much trouble coping with the loss of a relationship and use hypnosis to boost your self confidence. For a moment, look at your past relationships. Do you see a pattern where you seem to date the same type of people? Do you hang on to the relationship, even when you know it’s not healthy? When one relationship ends, do you jump right into the next? In fancy psychological terms, this phenomenon is known as co-dependency or relationship addiction. Often relationship addiction can be a learned behavior, or stem from unresolved issues from the past; such as a parents divorce or being abandon either physically or emotionally as a child. The worst fear in the world for the co-dependent person is the thought of being alone. In hypnosis therapy, the hypnotist helps the individual learn healthy coping skills and new behaviors in an effort to not repeat the same unhealthy pattern.

It’s normal to feel bad after a relationship has ended. However; if you find yourself chronically depressed after the break up, and can’t find the motivation to function, it might be a good idea to seek professional help. You will be loved by someone again one day and love someone else-it just takes a little time. Hypnosis can be used to help you get over an ex, simply by changing the way you see your ex, and more importantly, how you see yourself.

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In Search of Yesterday – Memories of the Black Watch in Cyprus 1958 to 1960

The 1st Battalion Black Watch left Edinburgh by train one evening, perhaps in October of 1958. We wore drill order which consisted of kilt and TOS etc. We always travelled in kilts in those days. It’s such a long time ago that I forget which port we embarked from. I imagine it was Portsmouth. Certainly in the south of England. We spent about twelve days on a very old slow moving troopship to get to Cyprus. There were short stops at Gibraltar and Malta where I went ashore. Dress was trews and blue bonnets. Most of the day was spent in bars drinking. No tourist type sightseeing. A few days later the whole battalion was paraded for inspection to see that we had picked up no social diseases. The journey through the Med was not unpleasant. Not much to do. A lot of lying around being lazy. Rather overcrowded living quarters. The trick was to get up and wash and shave before everyone else.

When we arrived off Limassol we disembarked onto lighters which took us ashore. Dressed in drill order, kilt and TOS, we were greeted by a pipe band of the Argyll & Sutherland Highlanders. We then got on buses of all things and were taken to our camp at Polis which was in the North West corner of the island.

Life in camp. That winter we lived in eight man tents. Somewhere in the camp was a primitive shower which I might have visited once or twice. We washed and shaved out of mess tins. I remember I bought a small burner to heat my water. When I’d finished, the same water went around the tent. I then ate out of the same tin. I also bought a portable radio. I think everyone else was National Service and therefore broke. I know my pay when I started was about three pounds a week. When I finished it was just over five pounds. We were paid in cash every Friday, although when we were on operations or out of camp it was held over, but cigarettes and razor blades were handed out free. Sometimes we got a rum ration when we were in the hills. The other National Servicemen got about thirty bob a week with a ten shilling marriage allowance for those with wives and there were many. They married at eighteen or nineteen in those days.I was in the signals platoon. In the next lines were the regimental band and the pipes and drums. We still had two bands in those days. As we worked around the clock we often had to catch up on sleep during the day to the sweet lullabies of the bandsmen practicing on their instruments.

The regiment having a long association with India, when we arrived in Cyprus we were joined by the regimental caterers from the colonial days, Gulam Nhabi. This very enterprising gentleman set up shop. His employees would do the rounds of the tents in the morning at reveille with buns and tea. I detested tea but it meant we didn’t have to go off to breakfast. Later operating in the hills one would sometimes find oneself dying of thirst, forbidden to use one’s water bottle, and out of nowhere would appear a cha walla with a tea urn on his back; Gunga Din be praised.

I can remember switching on the light at night and seeing the floor thick with cockroaches which must have been living beneath the wooden floor boards. In that winter the camp was thick with mud. I suffered from terrible constipation. The field latrines took some getting used to. One officer dropped his revolver down one and had to fish it out himself.

On night duty we would take a blanket along and probably nod off most of the time. The officers or sergeants on duty never seemed to bother us. Radio transmission was poor to nonexistent. Having just arrived in camp I found myself on duty the following morning, my first day in Cyprus. A message came in from brigade to send in our sitrep. I’d never heard the term before. There was a certain confusion over radio procedures. Our main intercompany radio was the Mark 19 set if I recollect. It had seen better days with the eighth army in North Africa. If all else failed a hefty boot in its side often set it to rights. The rifle battalions switched from the .303 to the Belgian FN on arriving. The HQ Company still kept their old and trusty Lee Enfield’s. A lovely rifle that I always remember with nostalgia.

Patrols would have a bren-gunner in the open turret of the three quarter ton truck. He would wear a flak jacket. Nobody else ever wore one. None were issued in any case. We had helmets but they were never worn. That winter dress was very relaxed and there was virtually no bull. No parades either. No parade ground. If there was an alert at night one would go out with the emergency patrol. One company was always on standby. Others were posted to outlying stations. That New Years Eve or Hogmany most people got rather drunk. The stand by company was kept sober. The drivers and signalers were not billeted with them however and it is doubtful if the drivers could have navigated the gates. One of our signalers was brought in the next morning on a stretcher from an outlying post, rigor mortis not quite having set in. The regimental band played airs suitable for the occasion.

There was to be an operation in the Troodos Mountains; Mare’s Nest it was called. The first assault was to be sent in by helicopter. One day we were suddenly ordered to put on full kit with rifles and to report to the air strip for training. A light spotter plane would fly over this from time to time and drop our mail out. A helicopter arrived. We got in, were taken for a spin, a rope was thrown out, we were ordered to climb down. Only one broken leg. We were then fully trained.

On the actual day of the operation the helicopters were sent in. They were to be followed the next morning by lorry born infantry. It was too windy to land the troops, except for one luckless fellow who had been the first to descend, without his rifle. He spent a night on the mountain before being relieved the next morning. Promoted to lance-corporal.

We went up by road. I was in the signals van. It got stuck somewhere. That night a corporal and I had to spend the night guarding it. Very lonely. I was only nineteen at the time. I spent a few days at our base camp. Very small. I’d got hold of some coffee so was able to brew my own. Detesting tea this was a godsend. It was very difficult for me to function in a nation of tea drinkers. The food seemed to consist of mutton scotch style. There were C rations or was it K. I can never remember which were British and which were American. Russian salad, corned beef, bars of chocolate. All very good. I can remember deciding to get a bath. There was a mountain stream a hundred yards from the camp so I went off to it and swam around in this freezing water for a while. I must have been tough in those days. I never wore socks either. The sergeant had told me one day a year before to either darn my socks or not wear any. Being cussedly stubborn I’d stopped wearing them. Our highland hose didn’t have any feet on them either so it seemed logical. Arriving back in camp I realized I’d left my rifle by the stream. One of those moments of panic. Luckily I was able to get hold of it before there was a problem. One fellow in our platoon had dropped a single round of .303 on the ground on descending from a truck after an operation and not noticed it. He was put on a charge and lost thirty days pay. Another fellow in a rifle company had lost a bayonet scabbard, not the bayonet, and there was a court of inquiry. When a bren gun had been lost by some nameless regiment two battalions were turned out to search for it.

The Suffolk Regiment had a small base camp next to ours. This was in a small vale high up in the Troodos Mountains. A corporal put his hand into his tent to pick up his Sterling sub-machine gun. The trigger caught in a guy rope and he shot himself through the chest. Our medical officer tried to save him but he died. A company had been supplied with donkeys for supply purposes. At other times aircraft would fly over dropping us supplies.

I went to join Don Company. From there I went to an outpost which consisted of a corporal, two privates and me as radio operator. We were all alone on our own observation post far from everyone. The ideal place to soldier in. We had a small Australian radio which fitted onto the belt. It used Morse, so I spent a lot of my time there communicating in Morse with our HQ. One night there was a terrible storm. The wind howled through the mountains, the thunder crashed like cannon, the lightning flashed. We only had two small two man tents. I can remember being on guard duty after midnight. Under a tree, bayonet fixed, a round in the chamber, safety catch off, I’d have shot anything that appeared. Who had ever heard of precautions to take during a storm?

Sometime later two privates in a rifle company had irritated the colonel. The incident had taken place in our main battalion base but he had them brought up to him somewhere in the mud of the Troodos. They had to appear i n full review order, kilt, white spats and sporran and all. They both got fourteen days.

In the spring we moved up to relieve the Royal Welsh Fusiliers at Xeros. I was in the advance party. It was always agreeable to be detached from the regiment. There were some Royal Signals on this base who wore civilian clothes. When the battalion arrived, our RSM, Patterson by name and a giant of a man, nearly went through the roof. I’d always felt that when he roared even the gods in their heavens trembled. There were to be no civilian clothes in his camp. We were still in tents, but there was a parade ground so we wore khaki drill and started to look smart again. I have photos of us in review order, kilts and blue bonnets, white spats and sporrans etc.

The nearby village was Turkish, was it called Lefka? Occasionally we were allowed out there. Trews and blue bonnets. The local money was piastres. The beer was bad, the wine worse, but both very cheap. We had not had a real break for six months so it was decided to let us visit Nicosia, a company at a time. I was not with the first company. The commander of the Military Police in Nicosia said afterwards that he had never seen so much damage done by a single company in all his years of service. Well, the Black Watch had a reputation to maintain.

I was detached to a post in some Greek town. This was in the period leading up to independence. The Greeks paraded past our post with flags flying calling for independence. I can’t remember much about that period as the politics of the situation did not really concern me. When my mother died five years ago and we were clearing out her things I found my two old copies of Bitter Lemons, by Lawrence Durrell, and Grivas and the story of EOKA by W. Byford Jones, and although I probably read these after the events concerned I could not really have been without interest. At Polis we had had an interpreter. He was a student of Greek at Glasgow University and largely sympathized with them. The Black Watch were very Gung Ho and couldn’t really give a damn for Greek Cypriot sensitivities. If I remember the Gordons had had five men burnt to death in one operation. The Argylls had rather terminally messed up some captured Cypriot suspects after two British women had been gunned down. We were quite friendly with the Turks whom we considered stout fellows although one of them accidentally discharged his shot gun into the stomach of one of our fellows one day. Another private lost his eye on parade whilst unfixing bayonets with the new FNs. As usual accidents were far more common than battlefield casualties.

Perhaps our habit of moving into a church to search it and the bren gunner placing his machine gun on the pulpit to cover the worshippers was overly aggressive. When out we would help ourselves to whatever fruit we found. One night we had an accident and slept where it had happened. In the morning we found ourselves in a water melon field so that took care of breakfast. I can remember taking my rifle and going through orchards helping myself to oranges. An order went out to the motor platoon to try to stop driving over so many animals. I think there was a competition amongst the drivers to see who had the highest kill rate in a month. It must seem strange today that during my three years in the army I cannot recollect ever seeing a tank. The battalion was equipped with two armoured vehicles, a Ferret and a Dingo.

And as for Archbishop Makarios and Grivas or was it Dighenis. They were for generals and politicians to worry about, not the rank and file.

As the situation became more peaceful the battalion created its own beach where one could stay overnight, get moderately drunk and spend the day swimming and sun bathing. No swim suits or anything. No women either. In my three years apart from seeing no tanks I can’t recollect ever seeing a female soldier. Were they called WRACs or something? In camp we began the day at five o’clock and finished at lunch time. One was able to take leave. I spent a month in Turkey and the Aegean. The Turks were very friendly, the Greeks lukewarm. In Cyprus there was no fraternization with the local population at all. I was there eighteen months and in all that time never spoke to one female. When I was on leave I did fall madly in love with e beautiful Armenian in Istanbul but she was chaperoned and I could never be alone with her. In Khios in the Aegean I found a Greek girl from Egypt. Chaperoned also. Never alone either.

Towards the end of 1959 the battalion moved down to the new British enclave of Dhekelia in the South East of the island. This had a brand new barracks in it with all the regimental bull that went with it. The old colonel and RSM had moved on to other postings, the troubles were over and it was more or less a return to routine garrison life. There was a riding school nearby which meant I could take up one of my passions again. I remember one incident. A group of us were out riding and we’d started a rather wild gallop. My horse pulled ahead which was fine by me. Then I saw a very wide ditch ahead and decided it was too big to jump so tried to pull the horse up; except that I no longer had it under control and couldn’t so I thought what the heck we’ll have to jump it. At the last moment the horse saw it and dug his hoofs in and came to a sudden halt. I went flying over his head, cleared the ditch, did a parachute roll on the other side and came up on my feet with no broken neck. I then tried to remount but the horse was very nervous and my knees none too steady. The Second in Command of the battalion, an old 2nd Battalion India army man rode up and said the damn fool (me) can’t mount.

Authority and I never really got on. I was far too independent. So a private I remained. One of my best friends was a corporal. Ian Holden by name. He’d been sent down from Saint Andrews University because he’d been too brilliant to bother to study. He became a corporal which I should have done also, but that would have meant conforming which I was too independent to do. We often went out together which was frowned on. However he was always in trouble because we used Christian names with each other. It was absolutely detrimental to the maintenance of good conduct and military order that such things should happen. There is a most delightful passage about that in Robert Graves’ “Goodbye to all that”. His book of course refers to The Royal Welsh Fusiliers in the First World War.

Lord Mountbatten came by and a Guard of Honour in full dress turned out for him. As I am typing this I notice my computer queries the spelling of honour. I once wrote to the Times about their spelling of that word. They had used the American form of Honor Guard. They said it was all the same nowadays. I disagree. I was part of the old army. I was a three year volunteer. More than half the people in the battalion were National Service men. We still had church parades. We were woken up on the fifteenth of each month by the Pipes and Drums playing The Crimean Long Reveille. Drum Major Dear was one of the finest men I knew along with RSM Patterson and our company CSM whom I only remember by the name of Gobby but who had won an MM in Normandy. There was also my platoon commander, Captain McMicking, who went on to command the battalion. He was always very decent to me and I was doubtless a trial for him.

In 1960 I went back to the depot in Perth Scotland to be demobbed. Again a slow trip by sea. Perhaps the same ship. I kept a bottle of whisky in my bunk to help pass the time. When it was finished I put a note in it and threw it overboard. Some months later a girl wrote to me in the Bahamas which was then my home but I never answered. Life had moved on. Now looking back after half a century one gets nostalgic for the past, but the past is no longer there. Old friends have died off. The Black Watch which was raised in 1739 and could trace its roots back to 1725 has disappeared. The highland regiments, all the Scottish regiments for that matter have been amalgamated out of existence. So have the old Irish, Welsh and English regiments for that matter. They only exist in history books and the memories of old soldiers.

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Interview Tips For Waiter and Waitressing Jobs – Part 1 – Pre Interview Preparation

In part 1 of Server Interview Tips for Waiter and Waitressing Jobs we’ll cover the preparation needed prior to going in for an interview. People get nervous about interviews because they’re face-to-face with somebody and have to answer questions on the spot. People get this anxiety for a variety of other reasons, but being prepared, can take away a lot of that anxiety.

If you want a waiter or waitressing job where you average over $20 dollars an hour in tips, these interview tips will help you get over that anxiety and give you an advantage over your competition.

A lot of people don’t think you’re interviewed until after you’ve filled out an application and then get a call back from management. In reality, most restaurants won’t let you take applications home. You’ll fill it out on the spot and immediately have your first interview. If your first interview goes well, then you’ll get a call back for a second interview with another manager.

Therefore, you have to be ready to interview before you even fill out an application. The second you walk through those restaurant doors, impressions are being made and you have to be prepared to give management a reason to call you back for a second interview.

Here’s my waiter/waitress checklist for interview preparation:

  1. Your physical appearance is the first thing people will notice. Gentlemen, this means being clean cut and well dressed. Ladies, this means look professional, with a personal sense of style. There’s nothing wrong with being overdressed, it shows that making a good impression is important to you.
  2. Physical demeanor is another attribute that ‘s noticed right off the bat. Good posture, eye contact and a solid handshake are all signs of strength and confidence that managers look for in a waiter or waitress.
  3. Personality traits are another important factor. Remember to turn that smile on all the way and spread that positive energy. Enthusiasm and desire to learn are traits that restaurant managers look for because you can teach somebody to be a good waiter. You can’t make somebody want to learn and you can’t make somebody enthusiastic.
  4. You’ve done your research about the specific restaurant. You’re familiar with their food, drinks and philosophy.
  5. We have a killer resume.
  6. We’ve read, Interview Tips for Waiter and Waitressing Jobs – Part 2 – Questions to Prepare For
  7. We’ve read, Interview Tips for Waiter and Waitressing Jobs – Part 3 – Good Questions and Humor Help Build Relationships

Remember that knowledge is the key. If you do your research and come fully prepared, you’ll rock that interview and be well on your way to that $20 an hour waitressing job.

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Missed Diagnosis – This is My Story, It Could Save Your Life

My story begins late one night in December 2008. I’d just come home from a long and wonderful trip to Bhutan, Nepal and India and was in the midst of moving in with a man I’d met and fallen in love with two summers before. We’re both in good health, exercise regularly and keep our diet on the light side. But this night we’d been out to a fancy restaurant. We were in a high mood, planning a celebration for our 70 and 75th birthdays as one big party in February. A few hours after I’d gone to sleep, an intense cramping in my lower left side awakened me. My abdomen was bloated. My stomach felt hard as a rock. I couldn’t lie still so I stood up. I immediately bent over in pain. Feeling pretty weak I supported myself with the back of a bedroom chair. Sitting or lying down felt worse. That night, I walked around and around and around the living room wondering what was wrong and what to do. I’d suffered digestive discomfort for years but never anything like this. It was logical to believe I’d picked up a bug in India. As I walked, I took GasX. About ten minutes later, I felt better and was able to go back to sleep. I thought that was the end of it but it was just the beginning.

I’m a psychologist who hears many clients describe digestive discomfort, especially after a meal out in a restaurant. I’ve listened to many women describe similar nightly walkabouts in which all they could do was wait for gastrointestinal pain to subside. One woman told me her mother had been having attacks for years and tried every home remedy and medical prescription in the book with no sustainable relief. It’s common to hear people report getting so frightened by the pain that they believe they’re having a heart attack. They go to an ER, lay around on a gurney for hours and come home with a diagnosis of indigestion. Still, since the pain was extreme, I called my internist the next day and got an appointment a few days later. He sent me for scans of my liver, kidneys, gall bladder and esophagus, gave me an ECG in his office and prescribed Prevacid for indigestion. All the tests came back normal.

But nothing was normal. I continued to have severe digestive discomfort and painful spasms every few nights. I searched the Internet hoping to understand my symptoms better. I kept coming up with GERD (gastro esophageal reflux disease) and IBS (irritable bowel syndrome). Each search described many of my symptoms but there was little mention of the pressure from gas that I was experiencing or the pain. I saw a nutritionist who was convinced that my gall bladder was malfunctioning. Her dietary recommendations didn’t work but she heightened my awareness of the importance of diet. In particular, I learned that carbohydrates produce gas and overeating at any particular meal puts extra stress on the stomach. I started a low carb diet and ate small frequent meals. I also stopped eating anything after six pm. Even though my alcohol habit consisted of little more than a glass of wine with dinner, I stopped drinking any alcohol. A glass of wine seemed to set off a spasm. Same with my morning cup of coffee. Taking these measures slowed down how often I experienced these episodes of intense pain but did not affect the intensity once one got rolling. Modifying my eating habits certainly helped but didn’t solve the problem.

Next I saw a gastroenterologist who was convinced I had SIBO (small intestinal bacterial overgrowth). He prescribed Xyfaxan, an antibiotic that targets bacteria in the intestine in order to restore proper balance and cease pain caused by spasms of the gut. I did several series of this antibiotic over the next months. The third, pulling out all stops, was for three weeks. He also prescribed Levsin, an antispasmodic medication. The antibiotics seemed to lessen the frequency of occurrences and the Levsin was a godsend. My symptoms were increasing and the episodes becoming more frequent, more unpredictable. It’s hard to describe how disturbing it was to be clueless about when an episode might occur. If I had an afternoon of clients, I ate a light breakfast with no carbs and skipped lunch. It was the only way I could be sure I wouldn’t crash in the middle of a session with a client. With Levsin in my pocket, I felt more in control but when I wanted to be sure I wouldn’t get an attack I just didn’t eat.

Oddly, when I was fine, I was fine and that was most of the time. Difficult to predict, symptoms often came out of the blue and while very intense, passed within minutes. I learned that I could avert an episode by taking Levsin at the first sign of symptoms and even stop a rising spasm on its way to full bloom if I acted quickly. Because Levsin worked and because the antibiotics seemed to be working, I had confidence that the GI doctor knew what he was doing and felt confident he would solve the problem. I began to keep a journal of what I was eating and when I had symptoms. Eating carbs and eating too much at one meal continued to be major culprits. They led to gas, bloating, abdominal cramping, heartburn and scratchy throat. As months passed, I sometimes felt an intense pressure pushing on my diaphragm and rising to the center of my chest. I sometimes felt a hot spot behind my sternum, pain in one or both arms and soreness under my ears. I took Levsin everywhere with me. On a walk, to the movies, to bed.

Adding to my difficulties, I felt depressed, tired and annoyed. So many interactions in life revolve around food. “Let’s get together for lunch” became a challenge. Not being able to eat freely meant playing a game when we went out with friends. I began a blind man’s game of not seeing food on the table, on my plate or on a menu in order to enjoy myself. At least in California where I live, restaurants are used to people customizing their meals but I only had one diet I knew worked. When it didn’t fit the occasion, I cancelled. It’s an education to notice how central food is to so many ordinary things we do in a day. Being so restricted often secretly stole the fun out of a get together for me but I couldn’t risk a build-up of pressure.

On occasion, symptoms got started and subsided on their own. But mostly, the only thing that made a spasm bearable was Levsin. GasX always helped. Sometimes Gaviscon or Prevacid helped. I tried PPI acid suppressors (proto pump inhibitors) but with little reliable effect. On my low carb diet, I lost weight, 20 lbs from 138 to 118 in eight months. In a society where “one is never too thin”, I was looking good and getting lots of compliments but I did not feel good. It’s one thing to modify life to live around symptoms, another to think of living with an imposed restriction day in and day out for the rest of my life. As time wore on without a diagnosis, I began to think the painful episodes were here to stay.

My spasms felt like contractions in childbirth, horribly intense but subsiding in minutes. Resolved to their intrusion, at least I knew they would end. Like a woman giving birth, I went with the pain, breathed as rhythmically as I could and held the faith that I could get through it. I leaned against a couch, a fence or a wall depending on where I was when they happened. Since I felt like a pregnant woman with too much pressure on her stomach, I slept on a wedge to keep my head elevated to alleviate weight on my digestive tract. Keeping my upper body elevated while I slept helped me feel better but it didn’t prevent pressure from building up. Sometimes I woke up in the middle of a nightmare dreaming that I was being strangled or crushed or worse. To combat this invisible foe, I did everything I could, but to no avail.

Since I believed my symptoms were clues, I described them numerous times to numerous doctors, each with a different specialty, hoping one of them – internist, nutritionist, cardiologist, gastroenterologist and holistic md – would recognize what I could only sense. I kept asking questions, kept looking to them for answers. What’s causing all this? Where’s all the gas coming from? If it’s acid reflux, GERD and/or IBS, why doesn’t elimination of the usual culprits – gluten, dairy products, chocolate, wheat, red meat and alcohol – make a difference? If it’s SIBO (small intestinal bacterial overgrowth), why aren’t the antibiotics working? And, bottom-line, how does pressure from intestinal gas cause a cramp in my chest? Since my problems started the week after I came back from a trip to India, doctors and friends joined me in speculating that I’d brought back an obscure bug. That added to the mystery but it still didn’t explain how indigestion was related to spasms.

Did I take tests? Of course. Blood tests, electrocardiograms (ECG), scans and scopes of the upper and lower GI tract. They ruled out esophageal problems, gall bladder, liver and kidney problems, heart problems – or so I thought. Did I follow doctor’s instructions? Of course. Three rounds of intestinal antibiotics. Did I talk to people? Of course. Smartest friends in the room. Everyone had their own experience and/or someone close to them who had similar symptoms. They also had lots of advice. Apparently, there are millions of Americans suffering from chronic bouts of indigestion that they’re treating with billions of dollars of digestive aids. But no one pieced together the combination of symptoms I was describing into a diagnosis.

To add to my confusion about what was happening and, in hindsight, to the hidden danger of a missed diagnosis, I had a para-thyroidectomy in December 2008. I had been diagnosed with parathyroid dysfunction during an annual checkup with my internist before my trip to India. There was some speculation about whether it could be a cause of my digestive discomfort. Not likely but a possibility. Apparently faulty calcium regulation can contribute to digestive problems. The surgery required – of course – blood tests and another ECG. Fortunately (especially in hindsight), I flew through the surgery with flying colors. But it further confused the picture. After my calcium levels were restored, I enjoyed an upsurge of energy. When I was not actually experiencing an episode or its aftermath the next day, I felt better than I had in years.

Incidentally, in January 2009, I saw a cardiologist. It was a routine visit, like seeing a gynecologist. It was simply part of my overall pursuit of greater health appropriate to my age. My cholesterol levels were a bit high (LDL 120) and I was considering statins. I did, of course, describe my symptoms to him, including the fact that I was seeing a GI doctor. During the exam, he thought he noticed a murmur and recommended I get a stress-echo test to complete my work up. “Nothing urgent”, he assured me. Nothing that couldn’t wait until after a spring trip my partner and I were planning to Paris. In fact, none of my doctors expressed any caution about traveling for six weeks out of the country or any urgency regarding any other tests.

In August 2009 – after eight months of mind-numbing episodes of pain — I did find the answer. Persistent questioning – and, I believe, lady luck was on my side. We came home from Paris mid-June and I made an appointment to complete my cardiology workup with a stress echo test at the first opportunity. That would be August 7. By this time I was afraid my digestive difficulties were burdening my heart. I thought I might not be able to complete the stress echo well enough for accurate results. But by August, I was a pro at dealing with my attacks and felt confident I could get through it even if I felt one coming on. Exertion at this time was the least of my concerns.

Even though I knew that going up a steep sidewalk, swimming 4 short laps in a row or spending ten minutes on the elliptical trainer could arouse symptoms signaling the likelihood of an attack, I could work around it. I’d learned to pace my walking, slow down my exercising and not lift anything heavy. On the stress echo treadmill, it didn’t surprise me that I was fine for 4 ½ minutes, 134 heartbeats. At that point I began to feel the usual pressure in my stomach, a light-headedness, pain behind my ears and a desperate need to rest. I’d been told 138 heartbeats was the target so when the monitor flashed a red 141, I figured I’d more than accomplished the target. I gasped for breath and asked the nurse, “Is that it? Can I stop now?” And she answered, “Only if you want to.” She didn’t bat an eyelash at my obvious distress. I’ve since discovered that people like to challenge the treadmill when they take the test so I guess that’s what she was used to. Then I did what I usually did when I was faced with an imminent attack. I calmed myself down. I breathed, meditated and thought pleasant thoughts while the nurse scurried around getting her numbers.

I was completely unaware of what had just happened. Customary for me, by the time I got to the waiting room, I felt fine. In this case, I felt pleased that I’d recovered without taking a Levsin. As I waited for the cardiologist, I was in a good mood, sure that – one more time – the test showed nothing definitive. My blood test numbers looked better than ever. They had all dropped dramatically from the year before. Total Cholesterol — 202 (from 247), Triglycerides — 61 (from 95), HDL 79 (108), LDL 111 (from 120). Clear proof that diet can affect your cholesterol — in case you had any doubt!

This was Friday afternoon. I was reading these results when the cardiologist came in. I was fully expecting a smile on his face. Instead, the look on his face was dead serious. He was very careful with his words. His words. “You have angina. Your reaction to the stress echo test is one of the most extreme we’ve had here in quite awhile.” My brain. “Is this something new, different or related to my problem?” He wanted to schedule me for an angioplasty as soon as possible. He asked me “Were you frightened while you were taking the stress-echo?” Wryly I answered, “No, I’ve felt similar spasms hundreds of times since December.” I had no idea what he was talking about. He was the first person to mention the word ‘angina’. First to indicate that I should be very concerned, even alarmed. He scheduled an angioplasty for Monday. I had a vague idea of what an angioplasty was but I had no grasp on angina. I certainly wasn’t thinking what I should’ve been thinking. ‘Good grief, I’m lucky I’m not dead.’

The cardiologist knew, of course, what I didn’t know – that the angina I had experienced on the treadmill was a life threatening aspect of blockage of the arteries in my heart. He continued to talk while I continued to blur. He assured me that the beta-blockers and nitroglycerin he was prescribing would, as he put it, “make sure I got through the weekend without an incident”. After not worrying for months, I now had to fret the weekend? Blur. As it turned out (and as usual), I had attacks both nights. And I used the nitroglycerin both times and it worked very quickly. I guess the good and the bad of the nitroglycerin was that it worked. It was evidence that the condition of my heart was the root cause of my painful episodes.

Fear blocked the big picture, distracting me from the warning my body was giving me that something very serious was wrong. Pain swept me off, like Dorothy in the Wizard of Oz, into a foreign land of medical expertise desperately in search of an answer to my symptoms. For eight long months, I had been swept away by a tornado of puzzling pain into the medical specialty of gastroenterology. As much trust as I’d put in the wizards of medicine, as conscientiously as I’d sought answers from them to show me the way home to health, the man behind the curtain didn’t have the answers.

Now, after the fact, I’ve learned that the information my doctors needed for a differential diagnosis for a woman has been all but excluded from medical research until recently. According to Harvard Health Letter (Vol. 34, 9/09), medical research on heart disease has steadfastly overlooked women because maleness has been considered the top risk factor. There is precious little published, even for doctors, indicating that gastrointestinal distress is a possible much less definitive symptom of heart disease in women. Furthermore, according to the same Harvard Health Letter, even when diagnosed, a woman still must be “a little more aggressive in getting the care” she needs. I can attest that I passed from doctor to doctor in Los Angeles, seeing some of the best doctors in the country without arousing the slightest expression of urgency about what they were seeing and hearing.

Medically speaking, I had angina pectoris. The spasms radiating to my arms finally made sense. After the fact, everyone seemed to know that angina causes pain when the heart experiences competition for its oxygen from digestion. I can’t imagine what would’ve been required to alert anyone of my doctors to imminent danger while I was traveling the yellow brick road of doctor’s appointments. What more could I have done? I even had an attack during an appointment with the GI doctor. As it was, the diagnosis did not get made until after I nearly set off a heart attack during a routine stress echocardiogram. Who were these doctors seeing in their examination room?

Angina is dangerous. It typically sets in motion a quadruple by-pass. I was diagnosed on a Friday, went in for angioplasty on Monday. In an extraordinary procedure that is now so standard it takes your breath away, a surgeon weaved a little camera up through an artery in my groin to my heart and discovered a 90% blockage. Instantly, he inserted a stent. Saved my life. That’s the only way to say it. I was very very lucky. Any untoward event. Any slight fender bender. A heated argument. Sudden anxiety. Traumatic surprise event – to me, a member of my family or one of my friends. Any unexpected stress that would’ve demanded more than 10% flow to my heart and I’d be dead. It’s a humbling thought.

The first thing my friends say when they hear my story is “That’s great. You’re going to be fine now.” And then there’s a pause, a second take. The next thing they say is ‘Ohmigawd, 90% blockage, you could be dead. That’s weird. How could your doctors miss that?’

I know I tell a harrowing truth that’s hard to believe. No one, not one doctor, friend or family member ever mentioned the word ‘angina’ to me in eight months of suffering. Angina was not in anyone’s vocabulary. Angina was never mentioned until my cardiologist said the word to me after the stress echocardiogram, a test ordered because he’d thought he heard a slight murmur in my earlier exam. Maybe my heart was murmuring to him, telling us to check out my heart and discover the angina behind my digestive distress.

Further in the ‘believe it or not’ department and to my complete delight, I’ve experienced a complete erasure of digestive distress since my angioplasty. All of my digestive problems have cleared up. I can eat anything I want. Drink wine and indulge in desert. My choice for the first time in almost a year.

But more important. Missing the diagnosis was extremely dangerous. Angina is as close as you can come to having a heart attack without having one. Angina is a build-up of plague in an artery of the heart – called atherosclerosis – that interferes with blood flow. Angina attacks don’t kill heart muscle but angina is a ticking bomb, ready to set off a heart attack with just the right amount of pressure – from stress, exertion, excitement. I’ve run across an impressive anecdote about angina written in 1790. Before the tests of modern medicine, Dr. John Hunter showed himself to be an astute observer of his own angina pectoris when he wrote, “My life is in the hands of any rascal who chooses to annoy or tease me.” What he knew is that an imbalance between the metabolic demands of the heart and the adequacy of one’s coronary circulation to provide oxygen causes pain. I wish I had had his insight. I experienced surges of physical symptoms when I got angry, upset or frightened or ate too much but I had no inkling what it meant. Now I know, angina interferes with the flow of blood when we need it the most. Not during an ECG when the heart’s at rest. If my heart had needed more than 10% blood flow to deal with a sudden jolt of fear, heavy lifting or – as with the stress echo – running, I’d have had a heart attack.

Time to ask the big question. But before I do, I’d like to make a qualifying statement. Even though it’s clear to me, after the fact, that my doctor’s lack of insight endangered my life, I’d like to make it clear that I’m not blaming my doctors for missing my diagnosis. I’m grateful for their continued concern and, ultimately, thankful for to their expertise. As I said, they saved my life. But why didn’t the absence of a source for the relentless distress I was experiencing arouse a sense of urgency in my doctors?

Recent news headlines about being in charge of your own health care have taken on new meaning for me. Here are some thoughts to ponder, more frightening than they seem when one’s life is at stake.

1) It’s no secret that there’s a breakdown in the health system that doesn’t encourage communication between specialties. I don’t have statistics but, as in my case, it could be critical if lady luck isn’t on your side. My cardiologist believed I was in good hands for digestive distress and stayed his course until a stress echo that put me squarely in his ballpark. When my GI doctor tapped the bottom of his bag of tricks, he didn’t have a policy directive to pick up the phone and call my cardiologist even though he was seeing symptoms indicating a crossover. My internist, persistent and conscientious, is not a coordinator of services.

2) Medical training is not oriented to educate patients as partners in finding a diagnosis. Yet patients need help now. We need to know how to go beyond the walls of a particular specialty. Even my ability to ask in-depth relevant ‘doctor to doctor’ questions did not uncover my diagnosis. Not one of my doctors expressed the need for a stress echocardiogram. Though I’d seen the cardiologist initially in January, his response was routine. My internist, who I saw often, first in December and last in June, mentioned in passing “if you’d like to move your appointment (for the stress echo) up from August, you probably could.” I took that to mean the stress-echo was one more elimination test.

3) Where does the fabric of integrity underlying the medical field as a whole come into action? My GI doctor, with whom I was in continuous contact, agreed with my plan to finish up my cardiac workup after I got back from France. But he expressed no sense of urgency and no possible explanation of how my heart might be related to my digestive problems. Is that an appropriate end to his responsibility? Did he suspect a connection between digestion and the heart and not say so? Or if not, why not? If the patient is the lynch pin, the only one carrying information from specialty to specialty, they need education as much as elimination to find a diagnosis.

True, I didn’t fit the picture for Coronary Heart Disease (CHD). I had no markers, as they call the signs of CHD in medical circles. My numbers are good. I’m a happy 70 year old in a relationship, slim and in general good health. I stretch, walk, and workout daily. I’ve followed a fairly good diet for years. And I had my heart checked. I’d had two ECG’s. I’d had surgery, a high heart stressor. And I’d seen a cardiologist. I also felt fine when I wasn’t having an attack. No doctor objected to my taking a long trip out of the country even though we didn’t know what was causing my problem. No one explained I might need more than an ECG – or insist on a stress echocardiogram or a nuclear cardiogram, the tests that take pictures of your heart in action and when increased blood flow is needed – to determine whether my heart was okay. Even the idea that blood flow might be related to my spasms and/or digestive problems did not enter the equation until after the fact.

It seems more important than ever to see oneself as a detective hot on the trail of your own case. Or, a Dorothy who has pulled back the curtain and knows a doctor is just a person, not a god. It’s pretty much a medical fact these days that each doctor who sees you looks from their own particular specialty and that there’s little crossover from one specialty to another. As I heard one cardiologist put it “When you’re a hammer, everything you see is a nail”. Makes it not only good but necessary, I believe, to track your own clues. As if you were finding fingerprints, you can identify a pattern running through one appointment after another even when logic is missing and everyone is looking in the wrong direction. As hidden as it may be, a magical through line exists. On the road, a tin man without a heart, a scarecrow without a brain, a lion without courage all became more than when they started. Even though nothing made sense, I persisted, never lost my curiosity and, in the end, I found the answer. Like a murder mystery without the murder, my tale would make a captivating adaptation of the Wizard of Oz.

The moral of my story? Don’t hand over your ruby red shoes. Doctors are ordinary people. It has to make sense to you before it makes any sense at all. Put angina in your vocabulary alongside heart attack and stroke. No reason to wait and wonder if your heart might be the heart of the matter. Check it out. Don’t wait for your doctor to tell you it’s urgent. And don’t settle for a test that won’t give you the full picture of your heart at work. It’s when it has to go to work that your life depends on it.

I’ve lived my life citing a couple mantras. One from Bob Dylan — “Those not busy being born are busy dyin’.” Another from Yevgeny Yevtusheko — ‘Don’t die before you’re dead’. I’ve never had my life saved before. Now death is more than a metaphor. Perhaps old age is the age of miracles. Or at least the profound realization of life as miracle. Take it to heart. Literally.

By Jane Alexander Stewart, Ph.D.

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