COVID-19: OMG! A compassionate memoir by an Anxiety Disorder & Health Psychologist.

3/16/20

When there are more unknowns than knowns in an emerging public health crisis, self-care for all is critical. Bilateral stimulation and behavioral activation helps induce calm, combats flight-fight-freeze-faint so we can make informed decisions. Create a meaningful routine in solitude or with virtual or distant connection.

Know that many of us are thinking aloud in emergency situation mode, particulary since we engage in shallow chest breathing, which makes it even more conducive to do so. Diaphragmatic breathing exercises, on an as needed basis for prevention of escalating anxiety symptoms. When there are more unknowns than knowns in an emerging public health crisis, self-care for all is critical. Some who are prone to escalating anxiety, panic or related distress may need to work harder through extra self-care. Some of us are more easily “hijacked” by the amydala when anxious, so it is most preferable to make informed decisions, engage in a routine that will feel increasingly normal when alone, more distant or online to stay connected with your purpose. Regulate media exposure and screen for only reputable news sources, including scientific ones that publish on COVID-19. Bilateral stimulation (tapping on both sides of the body), and behavioral activation helps induce calm, combats flight-fight-freeze-faint so we can make informed decisions. Create a meaningful daily/weekly/monthly routine in solitude or with virtual or distant connection.

A wise shaman wrote that during this public health crisis, we are learning through paradoxes. To add to that, remember, many public venues, services and facilities are closed or working on limited hours FOR NOW to best serve us, the public. 🙂


Later this evening:
So a cousin of mine in China wrote the following in our vitual correspondence re: easing up on lockdown requirements from what I’ve been reading online. I don’t know what’s real, sensational or fake news these days. Upon my inquiry, the following is an excerpt of what he wrote:

“In Hangzhou, where I live, the local government required businesses to apply for restarting work and permits were issued based on priority of business – starting with essential services. Number of staffs allowed to return was limited as well and gradually released in batches – don’t have exact figures but was about 30% for first 2 weeks.

On top of that, they issued a “green code” – a QR code for the citizens. This allowed “safe” people to move around. The code was based on AI research- encroached privacy but was efficient and brought convenience to safe population rather than a blanket quarantine during the early days.

So …. privacy is a double edged sword.”

Thoughts on govt. issued QR codes to maximize public health safety based on AI research? Oh boy. How do you think that would work in the “free” states of the West?


It was reviewed and got back my green code though in like half and hour.”

Wow, codes for citizens to move around in their country. Thoughts?

COVID-19: OMG! A compassionate memoir by an Anxiety Disorder & Health Psychologist.

Legal disclaimer: My blog is not a subsititue for or an agreement to particpate in medical and/or mental health treatment. My content is for educational purposes only. Should you need or continue to need professional care from a health practitioner of any type, please consult with or seek them.

3/15/2020

Oh my God! Eyebrows rose after learning about COVID-19 in China, then we hear about a national lockdown in Italy— “We don’t have any time. The numbers are showing that there has been a significant growth in infections, people in intensive care and deaths,” announced Prime Minister Giuseppe Conte of Italy in his national lockdown speech. “Our habits have to change right now. We must give things up for Italy.” Huh? Whispers are turning into confusion and escalate into intense anxiety, preparation, some panicing intermittently when Cristina Higgins, an American who currently lives in Italy, painted a daunting picture of the devastating spread of COVID-19 infection spread among the Italian population, the hospital healthcare system with its triage, nurses collapsing at work with their masks on during the national lockdown in Italy.

So, a little about me: I’m a health and gerospsychologist in NYC. Upon entering the long and short term care facility at work, I’m screened with questions and for a fever before going beyong security. My patients and their families and friends have strong, mixed reactions to the visitor ban. OMG. My patients are lonely and do not know when and in some cases, IF they will ever see their loved ones again. In my 10 years of geropsychological work, I have NEVER seen such drastic and severe changes in such a short amount of time. With older parents who have underlying health conditions, I’m qite concerned. Heck, I have underlying health conditions and will be 50 in less than a month. Holy moly. Is this real?

An escalation of scientific articles online, some questionable “is this sensational or fake news” articles (such as China claiming that COVID-19 is “airborne”, date Sept 2, 2020 and posted on about March 14, 2020 haha wink wink), a barrage of updates from Mayors, Senators, and Federal officials concerning the ramifications of the virus in every aspect of our lives that is removing ourselves from our benchmark of normalcy at pace with which we can barely keep up! One day Mayor De Blasio of NYC insists that the ppublic schools will NOT close with his reasons, people demanding he reverse his stance, Governor Cuomo of New York insisting that the schools close and voila! Today, at about 5:41pm Sundnay night, the Mayor announces that the public school system will be shut town starting MMonday March 16th 2020 until at LEAST April 20th, 2020. Also, tonight at around 10:15, bars and restaruants and cafes will only be able to offer take out and delivery services while nightclubs, movie theaters, small thereater houses and concert venues will be shut down by his Executive Order on Tuesday March 17th! Unprecedented and unfamomable not only to those born after the H1N1 influenza post 1918-1919, but to all of us just about 4-5 days prior. What a humbling experience not only for the public, but given the conflicting, falllse and undetermined factors that coincide with COVID-19, humbling to the medical and scientific communities, political and overall health care industries as well. Which leads me to my next point…..

This gives each and every one of us to push the “reset” button for the greater good on every level as we know it. Be safe and well everyone. Let’s take care of ourselves, each other, and the planet.

When an apocalypse feels like it’s at the tip of your fingertips, waiting to usurp you and those you care about, remember this: informed decisions and preparation help regulate the nervous system. Panic mode is a train wreck waiting to happen. #frazzleandfrenzyfreeamidcovid19/20!

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. Day 39



3/2/20

39 days to fifty years 39 juicy days!

“A wonkey eye is a good symbol of a life that has gone awry.”— Dr. Manju

So here I am creeping ever not so slowly into 50 years old. They weren’t kidding wwhen they said that time goes faster as you get older. Apparently, it has something to do with living more years, so the more time you have behind you, the faster it seems to go since time is so familiar. Meh.

Today I went to Quest Diagnostics for a routine procedure and although it was a warm day for Febraury in New York City, I felt my wonkey, wandering wall right eye giving me grief. It was hard to focus. The swollen feeling in the eyeball, the surrounding muscles not being tame and in sync with the muscles surrounding my left eye. It was discombobulating, annoying, making me wonder how to fix this? God forbid I get a stroke, would my intermittent wandering right eye be permanent? That would make me look wonky forever. Willy Wonka didn’t have a wonkey eye. Why should I?
I could feel my 50s approaching. While reading a number out loud at Quest Diagnostics, I had to verify it a second time, walking slower as I approached the woman who helped me, feeling my ailing eyesight requiring more time and patience, at least on my behalf.

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. Day 40 “Even if you believe everything is meaningless and a random series of events by chance, your ability to make meaning out of what happens is Divine.”— Dr. Manju

3/1/2020 40 days to fifty

“Even if you believe everything is meaningless and a random series of events by chance, your ability to make meaning out of what happens is Divine.”— Dr. Manju

This is so true! I see other people making milestones in their lives at the lifespan trajectory continues, yet here I am…still strategizing about my career and wishing things were better. It “should” (should statements are cognitive distortions), have been better, hell even easier than this.

I see these sci-fi movies making major leaps in the box office. Hmmm. As a newly claimed “child of the cosmos”, my response to anyone who immediately asks, “Where are you from?” without knowing a smidgeon of my humanity. These cosmic, sentient forces that people can relate with…not so far fetched from the different manifestations of Brahma via all the Gods, Goddessess and hybrids of humans and animals. Surely premonitions, intuition, “close calls”, deja vus… all by random chance without explanation, even explanation beyond human reasoning? Well, even if everything is meaninglesss and random, my ability to make meaning out of what happens is amazing. In fact, it is Divine.

And so it is 40 days to 50 years of age for me. That makes me relfect on letting go of my 40’s with love. Bittersweet. A friend of mine and I were talking about heterosexual relationships and she clued me in to the preconceived notion that women in their 40’s are nymphs. Looking back at that conversation, that is (sort of) funny, in a sitcom way. I wonder, what will the 50s be like? Older women 50 and beyond used to tell mme that “When you’re over 50, you’re invisible.” A patient of mine at a group practice told me this as she discussed being layed off from her job. I remember jumping in and saying (as an almost 39-year old), slightly defensively to downplay the advantges of female youth, “Even when you’re 40.” No, my 40s were a gift with a lot of pain. Looking for Mr.Right to start a family. Calling adoption agencies, hoping that the prospects of adopting a child from Nepal would brighten. Perhaps other foreign countries would lessen the requiremments that appeared even more difficult for single wwomen to adopt? Going to fertility clinics and attending Single Women by Choice meetings, considering having a child without a man. Heckk, I even sponsored a child in Nepal only to learn that her biological mother murdered her and her brother due to family strife. This is unheard of among Sherpas, so that was mortifying, not only tragic. For my plethora of health issues, I couldn’t have a child of my own without being partnered. I wonder how I will feel about that after 50, on my deathbed? Flashbacks of one of my patients who had flesh eating syndrome, also had been recovering in subacute physical therapy and with a chronic medical condition I have as well, told me of her miscarriage. She was in her apartment, screaming while witnessing her baby’s umbilical cord come out of her body. That memory burned into my soul.
Another patient who was very cognitively impaired looked at me before our session formally began. I do not disclose my personal life very much with patients, so it is amazing what her higher self picked up without my disclosure while working with her. She said, “You feel bad that you never married and had children.” Thhen she continued compassionately, “There is a lot of problems that happen when you marry and have kids. God knew that was too much for you to handle. So, don’t feel bad about it.” My patient, married twice and bore 4 children, was not even being condescending, pitying or self-righteoous. It seemed as if she were channeling in to a higher force and delivering a message as a medium. She conveyed that my singledom and childlessness was an act of compassion by God.

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. “To live in regret and relief at the same time is a living paradox, just like what defines so many of us complicated types.” —Dr. Manju Day 41

2/29/20 41 days to 50


So a nice segue into today’s post is about a very irritating, to say the least, experience I had with calling a restaurant about a complaint.. Although they refunded the soup that they could not provide, generously paid for by my boyfriend as a loving gift, they did not get his permission before sending the order. So I called and complained. The guy at the other end accused me of having “White privilege”. That was the most ridiculous statement, given he had no idea what race I was over the phone and that I’m not White. He really shouldn’t have said that. “I’m NOT White!” I exclaimed. He had no idea about the intense racial-cultural processing and personal development in addition to clinical training I had as a psychologist! If only he knew. Then my boyfriend, who IS White and I discussed it. He was not happy with what happened, but admittedly, we do differ in perspective as to whether White privilege is an accusation or simply a fact in America. White America. Eminem. I love him. I love the song White America. Breaking taboo topics by one who owns his White privilege. Kudos to my friend Josephine who posted a pic of Eminem on her facebook page today! Okay enough of the digression related to Eminem.

Admittedly, I have hesitated to bring up and elaborate on such controversial and deep thoughts about race on my blog. But I do not believe in a manufactured polyanna presentation. Race matters. Race and its relationship with aging in America matter. Turning 50 is a real experience, life is not polyanna upon honest expression and dialogue. So, at (almost) 50, I see the transcending taboo topic of race and not seeing Whiteness as a race, dissipating. I appreciate that. I don’t appreciate being told that I have White privillege by a stranger over the phone as a South Asian woman, who has been invalidated by my race since birth in many ways, though. What an odd experience. I told the manager that I wanted to show up at the restaurant and tell the guy who told me that I have White privilege say the same to my face on video. As a manager, he knew that would open up a can of worms he would regret at his restaurant, deesclatated my fury by saying he would take the guy aside and talk to him. Had I had more energy, I would have probably gone there and fulfilled my wish anyway. Perhaps being almost 50 is having me guard my anger and save my resources even more. Wise? Cowardly? I don’t know.

Today a facebook friend, male and Nepalese, married with a child, posted a NY TImes article that read: Unmarried, Happily Ever After..https://www.nytimes.com/2020/02/15/fashion/weddings/unmarried-happily-ever-after.html?fbclid=IwAR2H0O5KcTDKWfWKrRcPJvGgWhksSAoZT4–1mWz1NBvHQ8pvua55JLLV5E

Okay so I am in a stealth relationship, my boyfriend and I choose not to advertise our relationship for many reasons that work for the both of us. So I am not exactly single. But I am definitely unmarried, and we talk about simply being together without marriage, marriage, cohabitating, living separately but in close proximity, many options. It’s nice to have options. I am thinking, I wonder what it would have been like to be naturally more traditional as a woman and done the marriage and kiddie thing? (I specifically identify that I am an INTJ preference based on the MBTI because that is the most rare type for women worldwide.) I wanted a child. Just one. It didn’t happen. And yes, I am still working through that. Not having children is my biggest regret and relief to date. It’s a feeling I can’t explain beyond that.

My 88 year old foley catheter patient told me she dated a nice man but they never married. At 88, able to ambulate with a rollater, catastrophic and intrusive thoughts of being buried alive in a coffin, having to feel she is a bother to others to change her foley bag leaves her wondering whether she should have married and had children? It was hard for her to find a compatible partner, however. Coming from a conventional Catholic family, she often reassures herself and explains to me she was never promiscuous, despite only citing one or two men she has dated. Will I be reassuring myself that I tried to fit the conventional heterocis standard with a modern twist, just as so many of my friends and family members have successfully done? Will I find myself explaining my life choices to a psychologist at a nursing home? I doubt it.

Upon reflection on romantic relationships from the past, the topic of goodbyes without closure comes to mind. Door slam? At times. Circumstantial without intent? Sure, that happened too. But I think goodbyes without closure can be particularly peculiar for those who need it, (J for judgment, as opposed to judgmental on the MBTI preference scale tend to need closure). “Beauty is truth, truth is beauty…all that you know, and all that you need to know on this Earth” says Bono, quoting the poet John Keats as I listen to Bono’s prelude to the song “Bad” in a band performance in Rome. Another tangent tonight. That is all I need to know? Do I find beauty in the uncommunicated words, sentiments and feelings in the clearly marked or undefined goodbyes without closure moments? I am not speaking about the lifelong process of grief through expected loss of a loved one, but an abrupt goodbye that did not feel like they took a natural course, per se. They too, have been major regrets and reliefs of my time. Yes, there is beauty in what was communicated through non communication. I love paradoxes, too. I am a living paradox, in fact. And I am more accepting of that as I approach 50 years old. Even if truth, an abstract concept that I personally believe is subjective, dynamic and multiple, not objective alone, my ability to create meaning out of those goodbyes without closure is Divine. Perhaps more on goodbyes without closure later. I am drawing a blank right now.

Good night.

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. “Never mess with a men-oh-pause, oh please (eye roll) woman.”—Dr. Manju Day 42

2/28/20
42 days to 50

Let’s pause: Speaking of power and privilege, a theme on my blog and how it relates to turning 50, pardon the heterocis language. I own my immediate biases and unearned power and privilege as a heterocis woman.

Looking back from my post yesterday (written less than an hour ago got to catch up haha): Being 50 definitely is going to have its quirks. I’m okay with using my intermittent menopausal resurgence of chagning hormonal levels to use the real “don’t fuck with me attitude” with others. When pissed, I can rightfully pull off the “Honey, I have lived and will be living life, so don’t fuck with me. I can see through your bullshit. Cut the crap and cut it now.” While I’ve always maintained this stance, I can back it up with my years. 🙂

Sarcasm, mockery, imitation about the absurdity of one’s behavior, thinking and judgment is exaggerated for me to make a point with more brazenness and confidence, given the years behind me.

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. “Today is the oldest you’ve ever been, and the youngest you’ll ever be again.”—Eleanor Roosevelt Day 43

43 Days to 50.

Vulnerability and aging. It’s really 2/28/20 going into 2/29/20. I”M countinng. 😉

My 74 year-old patient was seen for paranoia, which I thought was going to lead into a conversation about racism and his perceived forfeited authority as a successful White male and in a short-lived career as a police officer. Trauma from being on-duty came about, to my surprise I did not know he had shot and killed what seemed to be a very paranoid middle-aged Black male, reportedly from Bellevue on the street who asked him, “What are you doing?” Apparently, my patient was doing a mundane task of documenting what he was doing while patrolling, and sadly, patrolling alone, which is typically against the rules. Before my patient could respond, the guy unexpectedly took out a pipe from behind and struck my patient on the head, to which my patient instinctively responded by taking out his gun and shot him i self-defense for his life. So, my patient’s beliefs about “uneducated people,” “justice,” and suvival instincts in a nursing home came about. Towards the end of the session, my patient became teary-eyed, during the emergency hospital visit in which he had to get 14 stitches on his head after the blow by the guy with the pipe, his father told his mother he was “too tired” to go to the hospital. His mother tried to expolain such strange behavior by saying his father “might have not been feeling well” at the time. According to my patient, his father was an alcoholic. Was his mother using code words for drunk? Neither my patient nor I will ever know.

Justice. Aging. How does that fit together in a long term facility? How does that fit even when independent and in reasonable health 50 and beyond? This is where I try to clutch onto my “old age of youth” in my very dwindling days as a” 40 year-old something” to dear life. Oh God. Are my 40’s really slipping away from the tips of my fingers? Yes they are. I have to stay in the moment. I’m going to modify Eleanor Roosevelt’s quote from above: “This moment is the youngest I will ever be for the rest of my dear life as I blend into my 50’s in spacetime.” 😮

Being 50 definitely is going to have its quirks. I’m okay with using my intermittent menopausal resurgence of chagning hormonal levels to use the real “don’t fuck with me attitude” with others. When pissed, I can rightfully pull off the “Honey, I have lived and will be living life, so don’t fuck with me. I can see through your bullshit. Cut the crap and cut it now.” While I’ve always maintained this stance, I can back it up with my years. 🙂

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. “Forty is the old age of youth, fifty is the youth of old age.” —Victor Hugo Day 44

2/26/20

44 Days to 50. Wow the days are really shrinking, it’s starting to feel MORE real. Speaking of feeling more real, there’s nothing more unreal than the real feeling of having your period on a day that you wish you could just erase your responsibilities. Everything is so much harder on those kind of days; simply getting ready and going out the door is that much effortful on a physical and mental level. But I did it. And in so doing, I felt old. Lower back ache, digestive issues, bloating, everything in slower and more resistant motion. Blah.

Flash forward to a patient toward the end of the day. At 70 something years old, he’s telling me how funny it is to be in an “old people’s home.” Was is that much more unfathomable to him, with a prosthetic knee, open knee lesion and now requiring a gerichair to leave his room and attend activities for enrichment? I will have to explore this further with him.

An 88 year old woman with a catheter foley is in emergency crisis mode because it had taken a third catheter to finally work on her after not urinating “enough”. Catastrophic thoughts of toxins building up in her body and dying instantly plague her mind, body, spirit and soul. Reframinng what she sees as a clunky, burdensome and awkward catheter to an instrumment that helps her health to keep her alive is a work in progress. Her panic. Her broken record thoughts. Reassurance seeking that going to the ER to have a catheter replacement monthly will sustain her until the end. Fragility. Emotional and physical and mental fragility. Reconciling youthful strength and vigor with wisdom, a new type of strength, agility and resilience… but also an accompanying visible fragility. No. A paradoxical puzzle that never end for all of humanity?

So another patient in her mid 70’s, wheelchair bound with MS and psychosis and confusion secondary to dementia tells her husbannd and me of the challenges in being on the other side of the power differntial. Once a high ranked VP at a bank and now at a long term facility, at what she believes to be in the mercy of others’ hands for her activities of daily living, is an unrelenting experience for her. How anxiety over the physical strength of others whom one depends on can have one project dark beliefs– such as “they” would hurt her if “they thought they could get away with it,” given their intimidating presentation and approach. Vulnerability at 360 degrees. Switch in power differential relationships. Power. Privilege, earned or not within context of race, ethnicity, sexual orientation, gender expression gender neutrality, social class, ability cisgenderism, what did I miss?. With wisdom and using street smarts, my patient learns to work with her fear for self-protection. Could I do that, given my ailments and fragility that comes out to those I trust or when I’m most distressed? As a South Asian, Nepalese-American heterocis, upper middle class woman, how will I face my inner and the social structural demons to navigate whatever aging throws my way past 50?

Quote of the Day “Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.: —RIP Steve Jobs.

Feeling trapped regardless of age is an unappealing existence. Subsistence. Jobs’ quote makes it easier to live in the moment as I approach 50. Maybe I’ll just go naked; wherever you go, there you are, says Jon Kabat-Zinn. 🙂

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. “Forty is the old age of youth, fifty is the youth of old age.” —Victor Hugo Day 45

2/25/20

45 days to 50 It’s actually 2/26/20 but I was too busy or tired to type earlier; better late than never? Perhaps a new trend in my tribute to 50 years. Menstruation is a real drainer, downer, depleter. I could barely make it to work but I did! Tea helps. Great patients help. Being able to reconcile with my boyfriend over the need for space helps. So, I read a fantastic article on how space is the sixth love language that is so overlooked. I agree, it’s paradoxical in our Hollywood, fairytale and commercial narratives. But the ability to voice the need for space and grant it reveals such a strong, loving bond that yields without clinging, smothering and window dressing for society. Ok I’m tired. Good night.

Here’s my reference: https://psiloveyou.xyz/the-6th-love-language-89e699d6e66e It’s validating for introverts, too!
❤ BTW: I have INTJ preferences according on the infamous MBTI! More on that at a later date/entry.

A Woman’s Personal Fifty Days to Fifty Years: A Loving Tribute as a Geropsychologist. “Forty is the old age of youth, fifty is the youth of old age.” —Victor Hugo

Day 46 2/24/20 46 days to 50 years old hooray 12:48pm EST USA: So I’m “hearing” and reading information that in the U.K. 40% of people over age 50 have some sort of hearing loss. Oh Lordie.
To add insult to injury for kicks, in an online research source by the National Center for Biotechnology Information (NCBI) entitled, “Screening for Hearing Loss in Adults Ages 50 Years and Older: A Review of the Evidence for the U.S. Preventive Services Task Force [Internet]” the targeted population entails people over 50 in primary care settings.

As a woman who hears the knock of 50 years old loud and clear on my door and with multiple ailments and who has been working in geriatric care for a decade, the prospect of actually becoming resident at a nursing home feels much more real. Yeah. So this is when the need to be happy goes out the window and I embrace the need for equanimity. It brings me back to the memory in my mid thirties when a consultant on aging for women told me she asks women who attend her workshops, “At what age would you want to die before turning 50?” Hmmm. Now that 50 years is entering my doorstep, I would reply…I am not sure, maybe die AT 50? What a perfect, even age to live with equanimity. I have a strange sense of humor, I know. At my age, I feel I have earned it. :p

1:02pm So I word find on facebook pops up by the soul vibe sancturary, forwarded to an Abraham Hicks page with a post that reads, “What is your vibe right now?” The first word I found was “completion”. Yes, I’m attracting completion. Thank you. “I complete me.” “We complete me.” Ha ha ha. I don’t even drink alcohol.