Hello and good morning.  Welcome to another Thursday.  Please wipe your feet on your way in.

Just kidding.  It’s all crap here, anyway; don’t worry about wiping your feet.

I don’t have much to say today.  I don’t think I do, anyway.  Not that such a thing has tended to stop me in the past, but I don’t know.  I feel that maybe it’s at least slightly different this time.

Let’s see…updates.  I took my third small-dose of lithium this morning.  We’ll see how it goes.  I don’t think one would expect to see any major effects already, so be patient.  I tend to be patient, at least about some things.  What’s a doctor without patience, right?

Oh, yesterday afternoon, I had a near episode of esophageal spasm.  I’ve had that before‒the first big time it got me to the ER (I was already working in the hospital, so it wasn’t far to go), where I was checked for potential heart attack, which it was not, of course.

It wasn’t one yesterday, either, in case you’re worried.  It responded, albeit somewhat stubbornly, to drinking warmish water (and finally some Coke) to help soothe and relax my esophagus.  I don’t think anyone else in the office even noticed.

If it had been like the first time they would have noticed!  That time I had an apparent vaso-vagal response and my blood pressure went down way low, and I almost fainted.  That was part of why they brought me downstairs:  a BP of 80 over 40 in a 29 year old man who did have a history of heart surgery is somewhat concerning, and when you’re a medical resident at the hospital, they tend to treat you with urgency.

Okay, well, I think my esophagus yesterday had been irritated by my recent upper GI illness.  It’s not impossible, I guess, that lithium could have been involved.  I have noticed that, if I accidentally take too many multivitamins‒i.e., more than one in a day‒I am prone to esophageal spasm.  Perhaps electrolytes (etc.) are involved in at least increasing the chances of it happening.

I doubt they would be enough to trigger it all by themselves, though in severely misadjusted amounts they could cause severe pathologies of various kinds.  I wouldn’t be at all surprised if I found out electrolyte “imbalances” had caused such a thing all by themselves if they were off enough.  I don’t think that’s the case with me, though.  I have no other signs or symptoms of electrolyte dysfunction that I have noticed.

Okay, that’s enough discussion of that for the moment.  I don’t want to trigger an event by thinking about it too much, but since my upper GI tract is still a bit sensitive, it’s not impossible that I could accidentally do that.  “The mind is its own place, and of itself / can make a Hell of Heaven, a Heaven of Hell”, as someone said.

I think I may try to do another audio post today.  The few that I did recently seemed surprisingly popular, and conversely, my readership numbers have been going down pretty steadily since the last time I did one.  Maybe doing them in the first place was a bad idea, like giving a dog a taste of human food so that now it doesn’t want to eat its usual stuff.

Of course, dogs are practical, about food at least.  They rarely avoid their usual meals because they get treats.  They just eat them both.  At least, that’s how the dogs I have known have behaved.

Cats are a little more persnickety.  There are situations in which cats really will go dangerously hungry because the food on offer is not their favorite.  I would do that with eggplant.  It’s not the only food about which I could say that, but it’s the worst.

Anyway, again, I may do an audio today, partly as an experiment.  That may even become the subject of the audio, but I don’t think I’ll leave it at that (knowing me, which I do, at least a bit).  That would be kind of lame.  I guess we’ll see.

I might as well do something though.  I haven’t played or sang (or really listened to) any music in nearly two weeks, and I haven’t been reading, and I certainly haven’t been writing fiction.  I haven’t even been doing any exercises on Brilliant dot org.  And I’m possibly writing worse blog posts lately, and it’s causing people to stop reading.

I don’t know, maybe the declining readership numbers are related to the fact that I’ve been posting a bit earlier in the morning.  My insomnia has been generally increasing, and I’m getting up earlier and earlier, and so going to the office earlier and earlier.  Some people might just miss the posts because they’re arriving before they look at their notices (or email, or what have you) and other things follow and drown my little whimpers out.

So, if you’re interested, keep your eyes (and ears) open today for my possible audio thingy.  I’ll try not to disappoint, even though that’s something I just tend to do ceteris paribus.

Whatever the case, I hope you all have a truly good day.

TTFN