If You Don't Ask, They Won't Tell

The Mamas and the Papas think we can’t trust Mondays. I'm not sure what's so shady about them but they definitely have an air of superiority.... as if they have the monopoly on dread. There is something I can trust about them though. I know they'll be swamped. There is always a Monday morning line-up of patients outside the clinic, anxiously awaiting 8:00 am. We can almost hear the customers chanting “open, open, open” like the old Mervyn’s commercial. After spending the weekend coughing or vomiting or hurting, they can hardly wait for the doors to open, heralding hopes of a quick fix or a definitive diagnosis.

This busy Monday morning was no exception. Except that my first patient wasn’t there for illness. Belinda was there to go over lab results from our initial visit. They were mostly normal, which [usually] lends itself to a cut-and-dried appointment, something my next three sick visits, already waiting, would be thankful for.
Your Vitamin D level is low….” I said, “so I would like you to……”
I stopped mid-sentence and took a good long look at the hollow, deadpan eyes staring back at me. The person I was talking to was not the same person I met two weeks ago. Something was off. Really off.
Is everything ok?” I asked, sincerely and softly, abandoning the topic of Vitamin D, which suddenly seemed banal.
Today is the one year anniversary of my son’s death….he needs me to be with him.”
What do you mean?” I implored, aware of the instant chill down my spine.
I mean that I don’t want to be here any more…I can’t do it anymore….I want to be with my son.”
What about your other children and husband, who live with you? Do you want to be with them?"
They will be just fine without me….” she said flatly.
As we talked, I learned she had been stockpiling sleeping pills, which she was planning to swallow after going home and cleaning her house. “I want it to be spotless when I go.” She reached for her purse and pulled out a tattered wallet-sized picture of her angel son along with a two-page goodbye letter to her family. She assured me of being at peace with taking her life. "God knows my pain. He will forgive me."
I told her she needed to go to the hospital and get some help. She obstinately refused. “I am NOT going. I hate hospitals. I hate psychiatrists. I do not need help. Please, don’t make me go.”
We have a counselor here today," I volunteered. “Would you at least be willing to talk to him for a little while?”
Thankfully, she agreed, which allowed me an excuse to leave the exam room. I immediately summoned Rafael, a LCSW, who luckily didn’t have a patient in his office. He introduced himself to Belinda and settled in for a crucial conversation. Meanwhile, I called 911, knowing confidently this was what I had to do. And yet, a little part of me felt a sting of angst, knowing I had just betrayed her confidence, and she would forever swear my name.
I was sad and hopeful for her, and now very behind. Monday, Monday.
Later in the day, Rafael stopped by my office.
He explained that Belinda was very upset when the police officer walked into the roomShe just kept saying ‘I trusted Dr. Fisher…how could she do this to me?!’
But you know what?” Rafael continued. “You really did something good today….I am convinced she was serious and ready to kill herself. In fact, I think she had already taken some pills….she was starting to slur her speech and couldn’t tell me the day or date.”
Six weeks later, I was surprised to see Belinda back in my exam room. The empty gray haze in her affect was gone. She smiled. She twinkled. And she said this:
I want to thank you…. I got some medicine and am seeing a therapist. I am doing so much better. I can't thank you enough from the bottom of my heart. I was so mad at you at first, but I’m so glad you sent me to the hospital. I know that you really care about me.”
What if I had not asked her if everything was ok that gloomy Monday?
What if….
If you don’t ask, patients won’t tell.


My Philosophy on Aging the Day I Begin the Back Nine

Moving to New Mexico has changed me in a lot of ways (right around 50 or so ways 2B exact).  

I think the biggest influencer has been my job, and the wonderful patients I am privileged to take care of: people of all ages in all stages of health and illness. One of the things I have learned is that there is a lot of heartburn here.  #longlivegreenchili #buystockinOmeprazole

The other resounding lesson I've learned is that "our past and present habits will become evident with aging ailments and medical conditions" (Anita Joy). Our bodies are a reflection of our thoughts and lifestyle (and genetics). The care you give now can spare so much pain later. Sure uncontrollable stuff happens. But we can stack the odds. 

I'm no different than others, who in the middle of middle-age has a mid-life crisis. It's sobering to wake-up one day and realize that trampolines are torture. And right around the corner is arthritis and down the street, cataracts. Aging is tough. It ain't for sissies. I see the challenges daily. It could be very easy to be depressed today, my birthday, knowing the potential horizon. 

Instead it's motivated me to step up my game, do what I can to be more mentally and physically healthy and focus on what is good about this back nine of my life. And I wanted to share that!! If I could help one person make a healthy change, all my time, effort and embarrassment will have been worth it! (See #50changes on my Instagram: jennifisher66)

You see....from my vantage point, "middle-age" seems to be a real sweet spot. (Although every age has benefits with things to learn.) The 20s are spent convincing others to love us. The 30s learning to love others, the 40s learning to love ourselves. The 50s and 60s+ are golden, when all that comes together: less proving, more giving and living. Not yet challenged with hearing loss, incontinence, daily arthritis pain, impaired mobility, or other struggles of aging, but with more freedoms that come with established careers, empty nests, and self-acceptance.

Cameron Diaz has a book called "LONGEVITY-- the science of aging, the biology of strength, the privilege of time."  I love her tagline and way to think about aging. I don't like the negative tone of the ubiquitous phrase "anti-aging" as if growing older is an enemy to fight against. You can't hold back a sunset. And those who want to let it happen naturally, without dying the gray or Botoxing the wrinkles, shouldn't be made to feel they are anti anti-aging. I also don't love the term pro-aging as if we are promoting tickets to a carnival ride. 

Years tick by like a moving train. It's pointless to be for (pro) or against (anti) that. Whether we slow down the train, or promote it along the way, the train, unless derailed, WILL get to the station. Being anti or pro-aging assigns value to something that just is. It is what it is. 

Plus, let's be honest, my pro or anti stance varies with the low back pain of the day. Some days I holler, "bring it on" loving the wealth of wisdom birthdays bring. Other days (usually after seeing an infirm 85 yr old), I adamantly want to stop the train. I want to get off and picnic forever in the nearby field of paintbrush and poppies, never ever re-boarding the age train headed to Dementia Town. 

Forget pro or anti-aging. How about choosing to simply find joy in aging, however that resonates in the moment. Your soul is rooting for this.

Joy in aging. Joyaging. Joyaging!! (I can make up my own words... it's my birthday). 

I'm grateful for the perspective and charisma that comes with 49 years of experience + 1 yr of sleeping (=50). Aging is a doomed privilege. Maybe I'm not lucky enough for forever. But I am lucky enough for now. For now, I'm basking in this golden time, that soft magic hour before the sun sets. 

We'll see what I say about all this when I turn 80. I'll probably need a new word, like constipatience!



.......... 43/50 SKINCARE Part C ..........

Here is my PM routine:

1. Cleanse: If I am wearing make-up, I use Clinique Take the Day Off Cleansing Balm. Easily handles face/eye make-up. Or Tata Harper Regenerating Cleanser.  Followed by 2nd cleanse with micellar water. If I'm not wearing make-up, I just use the micellar water with a cotton pad. Trendy product...it's all the rage. Attracts/traps dirt due to micelles, tiny oil molecules suspended in water. Was using Garnier Micellar Water (much cheaper dupe for the holy grail Bioderma) but it has ingredients I didn't love so switched to Caudalie.

2. Serums: again the serums are what do the work. I pick products with actives such as niacinamides, peptides, and fruit acids (glycolic or lactic acid). On half of my face (the half with Retin-A), I'm using Drunk Elephant Framboos Glycolic Night Serum (great name, cool packaging, cult following) It has both AHA and BHA (two types of acids). Listed as 12% glycolic.

On the drug-store half of my face, the best comparable I could find is the ProX Olay Nightly Purifying Night Peel, which may be about 10% glycolic acid.

I'm able to use both an acid (night) and a retinoid (day) because my skin is used to it. May be too much exfoliation for sensitive or virgin skin.

3. Moisturizer: the expensive half of the face gets Dermalogica (won't re-use when this runs out) or Mad Hippie (delightful natural cream with safer ingred). Drugstore half gets Olay Regenerist Micro-Sculpting Cream. A great product, pleasure to use. One of the industry's and Olay's best seller of all time. For a reason.

Skin Treats: once or twice a month I use Dead Sea Mud Mask by Pure Body Naturals. 4.5 stars with over 8,000 reviews on Amazon 😱!! This is especially good for acne, rosacea or irritated skin. I just like using it....it makes me feel all spa-ish and fancy.

I use the PMD Personal Micro-Derm tool 1-2x /month.

Glycolic peel (30%) after the PMD. * Do NOT use with active cold sores. Caution with dormant HSV.

Obviously you can see, I employ both chemical and physical exfoliation.

Finally: love, love the luxurious Mahalo line: the company, philosophy, branding, packaging, name, everything about it. And opening a package from them is pure awesomeness! Check out their beautiful IG feed! I'm not a big fan of oils...but if I'm especially dry and feeling indulgent... this is the oil I reach for.

My two-sided experiment isn't perfect. There are lots of influencing variables....but I can definitely see a difference between the two sides of my face. Which side do you think is looking better?

Thanks for stopping by.... let me know if you have any questions, comments or suggestions!

Ms Fish


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