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“Some Assembly Required”– The Most Terrifying Words Ever Written


Introduction by Bob Aronson

Story by Bob Huck

This is a humor column.   While normally we delve into those topics that are of great interest to the donation/transplantation community once in a while we take a break to have some fun.  This story is one with which we can all relate because there’s not a one of us that hasn’t been in a similar situation.  Perhaps not quite as dramatic but similar nonetheless.

Bob Huck and I were adversaries before we became friends.  Total opposites, we began our relationship on Facebook arguing political philosophy.  Two men could not be more different in their politics.  One day, though, we found common ground.  I won’t go into detail but from that discovery came others until it was obvious there was much to discuss and much upon which we agreed.  We set our differences aside and concentrated on developing a friendship and it worked.

Bob Huck is a fascinating man with a background rich in human experience.  His narrative here is dedicated to those who have had to assemble something for their kids and I guess that’s most of us.  “So easy a child can put it together” is a commonly used phrase.  Commonly used but inaccurate. 

When you read the words, “Some assembly required” It usually means you must reinvent the wheel and you can be guaranteed that the directions were translated from a foreign language by someone who does not speak yours. “Insert part B as seen on Illustration C and also on B14 in book 2” are common instructions that boggle the mind.  I’ll go no farther.  Here’s Bob Huck to tell you his story about assembling a simple kit for his kids.  One more note.  Bob is now fully recovered from the experience.

THE FLAT BOX  A Narrative Case History From The ICU

intensive careThe following tragic case history was dictated from the patient’s bed in an anonymous hospital intensive care unit. It has been recorded as a patient interview and except for the more profound interruptions, outlined in the parenthetical notes herein; most of the routine interruptions have been excluded as the patient’s voice was faltering and weak at best. He alternated frequently between extreme agitation and short bouts of catatonia throughout the interview process. Also, the patient would occasionally issue sounds rather than words. In such instances the sounds have been added as accurately as possible to the text in an effort to reflect the level of stress the patient was suffering at the time.

The following is the chronology of events as dictated by the patient. The interview was conducted over a period of several weeks as serious relapses followed by extended recovery periods were common.

Day One, The Morning

sunshiny morning“It was a bright Saturday morning. It started in a routine way. A quiet breakfast on the deck after sleeping in, a coffee and newspapersecond cup of coffee read the morning paper and plan for the day. Things like grass cutting, gutter cleaning and gardening were in my mind. It was a sunny day, the birds were singing, the air had the fresh smell of new summer flowers and I was looking forward to some pleasant time in the sun without much brain power required. All was well, really well.”

“My pleasant mood didn’t last.”

“About 9:30 or so there was an almost ominous knock at the door. (On hindsight I could swear I heard chains dragging across the front porch.)”

“The sound it made was a slow klunk… klunk… klunk…. I looked out the living room window on my way to the front door and noticed that the birds had stopped singing and the small, wild animals were all running for cover. The dog hid, the cat’s tail fluffed out, some of the fish floated to the top of the aquarium and the canary molted as I went toward the front door.”

“I opened the door.”

death two“There was a tall, pale boney person dressed in a long, hooded black cape framed in my front door and staring at me, not speaking. All could see of his face were those deep set, haunted eyes of someone too accustomed to witnessing horror.”

“The sun went behind a cloud.”

“I thought at first it was a Halloween promotion, but it was only June. man with blackboxThen I wondered who at the office was playing a practical joke. These fleeting, almost half thoughts, were interrupted when the person slowly reached out with both pale, bony hands and handed me a large flat box marked ‘1 of 25’.”

“He remained silent expect for his labored breathing which produced a profound groaning sound.”

boxes“I looked past the figure to the porch and sure enough there were twenty-four more large flat boxes. It was then thhearse and black horsesat I saw the caped person kind of glide away and drive slowly off in a hearse driven by four black horses.”

“The boxes contained the combination swing set, jungle gym and trampoline I had ordered for the kids from a home shopping television show. The large flat box I held in my hands, number 1 of 25, contained the instructions for putting it all together. The “Made in Madagascar” label was one of my first clues that this was not going to be a fun thing, at least for me.”

“I checked my liquor supply.”

two more bottles of gin“The two quarts of gin in my closet seemed to be more that enough, especially if I had to invite the neighbors to help me. And I had all weekend to build the thing so I thought I was in good shape.”

“Then I opened box 1 of 25.

(Note: There was a significant pause here as the patient seemed to blank out for several minutes – apparently the memory of this initial shock was too much. The dialogue continued after the bed was cleaned up and the drool was wiped off his face. It should be noted also that following most of these noted interruptions the patient’s voice was almost inaudible so some words may have been missed. We will never know for sure.)

“There were five very big volumes. Each wrapped very tightly in an overabundance of heavy gauge shrink big thick bookswrap and industrial strength duct tape and each labeled in a different language: one for English, one for French, one for German, one for Chinese and one for a language yet to be determined by the linguists at the United Nations. The so called English version was a 375 page volume entitled ‘Instructions for Assembly.’ Each flimsy page was printed in a 4 point font and single spaced. Small illustrations with strange markings and Greek lettering with metric dimensions attacked my senses.”

“I checked the liquor supply again.”

directions“The first 15 pages where on 17 by 22 inch foldouts printed on very flimsy paper. These pages contained the parts list, a lot of which was obscured by the folds in the flimsy paper. I took my first drink – well, it was approaching noon.”

(Note: The interview was stopped here as the patient began screaming and crying hysterically and the alarms on his medical monitoring units were all declaring an emergency. We were able to continue following the CPR and the injections to his heart.)

Day One, The Afternoon

“Where was I? Oh yeah, the gin exploded nicely and I felt a warm comfort. ‘After all, I have two engineering degrees, how hard could this be?’ I told myself in an effort to cover the terrible feeling of foreboding and pending doom which I could not seem to shake. But I knew I had to go on. I would not be defeated by a bunch of foreigners with a primitive printing press!”

“I began an intense study of the parts list. I noticed that there were picturesparts of each part. Most of the pictures were very small and blurred or smeared or where obscured by the folds in the flimsy paper so that similar parts looked the same. The distinction between metal screws and small bolts was blurred on the paper (as it turns out that was the easy part) so was the number of required individual parts. It seems that the printer had missed all but a few segments of the column listing how many of each part was to be in the kit.”

forklift with boxes“After a while I took a break. The eye strain was too much so I put the instructions away and started carrying the boxes, on a rented forklift, to my very large garage, which doubles as an indoor basketball court. I figured I could spread the parts out on the floor and try to match the parts to the instructions. It seemed like a good plan at the time.”

(Note: The patient started to become agitated here so the interview was interrupted briefly until his hyperventilation subsided.)

“I opened each box of the remaining twenty-four and found bags of screws, packages oplastic bags of washers, nuts, boltsf nuts and bolts, odd looking clamps, just plain weird looking washer like things   packaged in what looked like some kind of animal skin, assorted wooden and plastic pegs, large folded templates made of more flimsy paper, springs of all sizes and configurations (round, strange toolscoiled, flat, oblong and very long ones,) wheels, gears, cable clamps, assorted hairy little bugs that had invaded the packaging and a lot of strange looking items which I later determined to be tools – ‘tools of hell’ as I learned called them.”

“During the next few hours I unpacked 693 packages and 113 odd tools of hell.”

“After that I ran to the liquor cabinet and took a long pull straight from my gin bottle. It didn’t seem to have any impact on my strong desire to scream and cry. I considered taking a fist full of valium too but had been warned about mixing booze and valium so I restrained the urge and stuck to booze.”

“Now I had 693 packages and 113 odd tools of hell scattered in little man amidst boxes

\piles around my indoor basketball court.”

“I stepped back and suddenly to my horror I realized that I had not noted which box the packages came from!”

“Gack!”

(Note: The patient was able to continue after the seizure subsided.)

“Gasp, pant – I’m okay now. As I was to find out later this package, box and tool thing was critical.”

“I made an excuse to my wife and skipped dinner and went back to my instruction book to try to recover from my error. I was too nauseated to eat anyway.”

Day One, Late Evening

“During the next hours I struggled to match package to box and tool to box. At 9:30 or so I had matched 568 packages to boxes and had not yet started on the tools from hell.”

“My wife looked in on me and said she was a little worried about me. I told her it would just be a little while longer. I think she went to bed about midnight.”

“The burning in my stomach told me it was time for another drink. I needed the nourishment. full glass of ginThis time I did not fool around. I found a 12 ounce drinking glass, filled it with gin and gulped it down. That seemed to stop the uncontrolled facial tics and severe full body twitching but did not help the incredible feeling of panic that had descended on me. But I was ready to rejoin the fight. The primitives would not win! Wheeze.”

(Note: The patient became winded trying to raise his clenched fist into the air above his bed in a show of defiance. The interview continued after his brief bought with projectile vomiting and the hospital staff had applied restraints.)

“Finally, at 1:45 AM after much frantic searching, reading decoding and just wild guessing I had matched the packages to the boxes. But I seemed to have lost one package. No amount of searching helped. No amount of hopeful recounting helped. I felt like I was living in that horrible instant just before the head on collision! I felt I was now truly doomed.”

man sleeping on boxes“So, I did the only thing that made sense to me at the time, I finished the first quart of gin and passed out in a heap on top of my pile of packages. I must have slept for a few hours before the nightmares woke me up.”

 Day Two, Early Morning

 “It was 3:30 in the morning when I awakened, wiped the now dried drool from my unshaven face and staggered to my feet. I needed to finish matching the tools of hell to the boxes. I was driven.”

“My wife looked in on me again a little later to tell me that the neighbors had called to complain about all the loud swearing and banging noises coming from my garage. It was, after all, only 5:30 in the morning. I promised to mumble instead of scream and to place rather than throw the boxes and parts. I knew in my heart of hearts that while I would try, this was a hollow promise.”

more strange tools“I had my first real victory at 7:54 AM on day two. I had finished matching the tools of hell to their respective boxes. I tried to dance around in small victory circle but tripped over package number 58 of 89 from box number 12 of 25. I think it was then that I crushed the nerves at C-6 in my spine. My hands went numb and I was in pain. I took a fist full of aspirin (and a healthy slug from bottle of gin number 2 of 2) and in no time I felt like I was on the way to victory. I was told later that the internal bleeding would eventually be controllable.”

“I stepped back to survey and savor my victory. I felt a sharp burning pain huge screwas I was impaled by a large metal screw which penetrated my foot. Within an hour the flesh around the wound turned black, started to stink and show signs of necrosis. It had been one of those parts wrapped in the strange animal skin. So, I poured some gin on it, wrapped it with a greasy rag and continued my study of the plans.”

(Note: The patient interrupted the interview here and complained of pain in his now missing foot.)

“It was three hours later that I attempted the first step of the assembly process. Again, I experienced maximum chaos.”

placing screw in holeI had screw 13 1/2B12-3i from package 12 of 34 in box 2 of 25 as shown on page 2, paragraph xxiv, of the instructions in one shaking hand and a small fernoodledink as shown on page 2, paragraph xxiii in the other shaking hand. My hands seemed to shake even more wildly as I tried to insert the screw into the fernoodledink using the tool from hell shown on one of the large the foldout sheets. My hand slipped and screw 13 1/2B12-3i skittered across the floor into a crevice near a pile of packages. It was then that I experienced my first serious crying incident – there were to be many more. I removed the fernoodledink from my abdomen with one to the tools from hell, stuffed an old rag into the wound and began searching for the screw. It was an hour later when I realized victory again. I had found the screw. My second attempt at inserting the screw into the fernoodledink worked. Again, I danced, that is limped, around in a little victory circle. I was on fire to continue the challenge.”

(Note: There was a faint smile on the patient’s face as he recounted this part of his story. The interviewer was not to see further smiling incidents.)

“It was early afternoon of day two and I knew the gin would not last and that I would not finish this assembly before Monday morning in time to go to work. So I took a break,everclear left a message on the office answering machine – I noticed that my voice sounded like I was sobbing, but I paid no attention – and went to the liquor store for more gin and a little Everclear for backup.”

“The clerk noticed the blood trail I left on the floor. It seems the necrosis on my foot was a little more advanced than I thought. He covered his nose and averted his eyes in an effort to control the gagging noises he was making.”

car in bushes“When I returned to my driveway I was going a little too fast and drove across my newly landscaped lawn, ran over some bushes and crushed my new sprinkler system before skidding to a stop at or near the garage door – I think I heard a crashing noise. I opened the Everclear while I was still sitting in the car and took a long deep drink from the bottle. This time there was real pain in my stomach but I kept it down. I found two slightly soggy, semi-crushed and moldy cheese crackers wedged into the bottom of the glove box and ate them – I needed the nourishment. I was ready to go again. The pain from my abdominal wound subsided but my hands were still numb.”

(Note: The patient began to loose track of time here. He was not really certain about this time frame. The interviewer has estimated the chronology from here on.)

Day Two, Afternoon

“After some foggy looking around I found the next step in the  complex directions instructions package. It was the same old story: hysterical crying followed by a two hour search through the packages and tools from box 2 of 25. The crying stopped when I found metal screw (or was a bolt?) number 1265-76Aix C and tool from hell 45 of 113. My next victory seemed almost hollow. I had found the gizmogazelschpatzen which connected to the fernoodledink using screw number 1265-76Aix C and tool from hell 45 of 113.”

“As I pushed the gazelschpatzen gently into the fernoodledink I noticed that more force was required. So I pushed harder. Nothing happened. I put the assembly in a vice and nothing happened. I tried a bigger vice, same result. I then rigged up a 10 ton hydraulic jack to push the gazelschpatzen into the fernoodledink using screw number 1265-76Aix C and tool from hell 45 of 113. I thought I heard it snap into place just before the whole assembly exploded violently into lots of shrapnel. I was crying again, as I removed screw number 1265-76Aix C from deep in my left eye. It was a good thing it was not my right eye. I am right eye dominant you know.”

man with eye bandage“By now my screams had become high pitched, rasping gasps so nobody heard me as I used an old tire patch and some crazy glue to fix my left eye.”

“I began to loose track of time about here in the process. I think I passed out sometime during the late evening.”

 

Sometime Later

“As I came around for the first time I remember seeing the EMT through aparamedics attecn man kind of out of focus haze and hearing my wife sobbing in the background while they treated my more immediate hemorrhaging. I noticed a shoe on the floor with a foot in it. I wondered whose it was. I recall fighting the EMT’s to the point where they had to apply restraints. I did not want to go the hospital. I wanted to finish the job! I had to beat the primitives! Gurgle.”

man with head injuryMy last conscious recollection after being loaded in the ambulance was hearing an EMT screaming into his microphone over the siren noise, ‘I’ve got a Flat Box Syndrome, in shock, suffering blood lose, alcohol poisoning, and serious necrosis. He is not able to respond to oral commands and appears to have no feeling from C-6 downward and is blind in his left eye from a wound I have never seen before. His remaining pupil is dilated and not responsive. I can’t seem to remove a variety of strange tools which have penetrated his upper trunk in several locations. He also appears hazmat teamto be suffering from starvation and scurvy. We’re going to need the entire emergency room team to pull this one out! Also send a hazmat team. The cleanup here is going to take a long time, be sure to include biohazard suits! Better alert the terrorism units too!’ Funny how I remember those details so clearly from my out-of-body experience.”

 

Sometime Even Later

(Note: Nobody is sure how long the patient was unconscious after he passed out and before he was discovered. His wife thought he had left town on a business trip so the best we can estimate is that he was lying in the wreckage for about 3 days before the stench of rotting flesh attracted a neighbor’s attention.)

“Tghost at foot of bedhe next thing I remember is struggling to recover from the coma. It was as if everything was happening in slow motion. I was doing pretty well but then the memories came back and the nightmares began: the figure at my door on that Saturday morning seemed to be standing at the foot of my hospital bed beckoning me to come with him; large, ugly volumes of instructions were falling out of the sky and crushing me under a huge pile of paper; small fernoodledinks were swarming over me and a giant gazelschpatzen boiled up out of the ground and attacked me. It was horrible!”

“Sob!”

(Note: The excessive screaming brought the orderly and the session was stopped briefly while the restraints were tightened.)

“Whimper, then one day as I was coming out of it again I heard a doctor say,black boxes ‘Poor soul. Another flat box case. That’s 231 this month alone. We must do something about this flat box thing! Oh! Will the inhumanity never end? Get my senator and congressman on the phone. Call 60 Minutes. Call Ralph Nader and the ACLU. Get some truly horrid, stomach wrenching, vivid red and yellow color photos for publication on the Flat Box Syndrome website. It’s time to take action!’”

“I struggled mightily for the next several weeks to recover. I joined a flat box recovery group and shared my story with other victims. I even sponsored another victim for a while. I faced my fears and actually touched one of the tools of hell recovered as part of the clean up effort at my garage. It helped that I was blind in one eye and could not feel what I was touching.”

“I have a message for America. I am begging you! Please record this! It is a matter of national security!”

(Note: The interviewer, along with several internationally recognized medical reviewers, has become convinced that the Flat Box Syndrome is indeed cause for international alarm and needs to be brought forward as a social issue on a par with any other life threatening disease or potential terrorist attack. Therefore, the following was recorded exactly as dictated by the patient and may have been his last conscious expression.)

“People of the world, think before you – wretch, gasp – open thedeath door of your home to dark figure in a black, hooded – wheeze – cape carrying one or more flat boxes! America awaken! Everyone – choke – is vulnerable to this – gag – horrible plague! Don’t let – gurgle – it happen to you!”

 (Note: The patient lost consciousness again and was rushed into surgery.)

 This is a true story. It was recorded for posterity and to give warning as well as to protect the innocent.

-0-

Bob Huck – Bio

Bob Huck graduated from the Pennsylvania State University and conducted post graduate studies at Dartmouth College.

He has now retired from his career as a civil engineer (although he claims the civil part to come into question from time to time.) His career spanned most of the geography of North America and some of South America. But his specialty and passion was arctic engineering and remote site construction which kept him living and busy in Alaska beginning in 1963 and ending in 2000.

 He has written two books. “Alaska Letters” was written in 2013 and is a compilation of stories from his adventures in the arctic. And in 2011 he wrote  “Winnifred Mason Huck, Member 67th Congress 1922-1923; Prisoner #1558 1925” The latter is the biography of his grandmother who was the third woman to be elected to Congress, the first mother to be elected and the first woman to preside over either house of Congress.

 He has now settled down in Charlotte, North Carolina and when it snows there on rare occasions he threatens to move to the desert. And when he is not threatening to move to the desert he enjoys golf and writes things.

 -0-

Bob informal 3Bob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

Post-Transplant Depression — What It Is and What To Do.


This is a compilation of information from various sources.  It does not constitute medical advice.  Please consult your physician about your condition and base your treatment decision on his or her advice, not on what you read here.

Post-transplant depression is real.  There are no statistics of which I am aware that indicate the percentage of organ recipients that suffer from the malady but there are enough reports of the problem to suggest it is no small number.

The extent to which your emotional health is affected by a transplant depends on a complex interplay of your health status and personality, genetic factors, social support, financial situation, and other concerns.

For most people, emotions about their experience change and evolve over time. Typically, feelings of sadness or anxiety are transient. For some, however, these feelings may persist and interfere with daily life.

According to the Mayo Clinic Depression is more than just a bout of the blues.  It isn’t a weakness, nor is it something that you can simply “snap out” of. Depression is a chronic illness that usually requires long-term treatment, like diabetes or high blood pressure. http://www.mayoclinic.com/health/depression/DS00175

Depression is a complex disease and sometimes it is difficult if not impossible to find a reason for the problem.  One that I hear most often is guilt.  Some recipients feel guilt because, they say, someone had to die in order for them to live. Others feel guilt because they are doing well while other transplant recipients may not be so fortunate.  Those feelings sometimes proves to be a very heavy burden for many transplant recipients but it may be only one potential cause of their feelings. There are some other factors that may contribute to post transplant depression as well:

  • Anger or depression, because they don’t feel better as soon as they expected.
  • Frustration, because of chronic or lingering fatigue that keeps them from things they want to do or accomplish.
  • Mood changes caused by the drugs that must be taken following a transplant.
  • Dissatisfaction with old plans and goals. Identifying new priorities and making lifestyle changes may feel good, but can also be stressful.
  • Fear that the old illness might return and affect the new organ

Symptoms of depression include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Despite the feelings of gloom and doom, though, there is reason to be optimistic because most people with depression will eventually  feel better with medication, psychological counseling or other treatment.

Still another reason for post-transplant depression is Post Traumatic Stress Disorder (PTSD).  Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you’ve seen or experienced a traumatic event that involved the threat of injury or death.  Obviously getting an organ transplant falls into that definition. http://health.nytimes.com/health/guides/disease/post-traumatic-stress-disorder/overview.html

Symptoms of PTSD fall into three main categories:

1. “Reliving” the event, which upsets day-to-day activity

  • Flashback episodes, where you re-live the event so it seems to be happening again and again
  • Repeated traumatic memories of the event
  • Frequent nightmares of the event
  • Strong, uncomfortable reactions to reminders of the situation

2. Avoidance

  • Emotional “numbing,” or feeling as though you don’t care about anything
  • Feeling detached
  • Being unable to remember important aspects of the trauma
  • Lack of interest in normal activities
  • Hiding your moods
  • Avoiding places, people, thoughts or things that remind you of the trauma
  • Feeling as though you have no future

3. Arousal

  • Difficulty concentrating
  • Startling easily
  • An exaggerated response to things that startle you
  • Feeling more aware of negative things
  • Irritability and angry outbursts
  • Difficulty falling or staying asleep

If you have severe depression, a doctor, loved one or guardian may need to guide your care until you’re well enough to participate in decision making. You may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve. http://www.mayoclinic.com/health/depression/DS00175/DSECTION=treatments-and-drugs

Here’s a closer look at your depression treatment options.

Medications
A number of antidepressant medications are available to treat depression. There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring chemicals in your brain to change your mood. You can view the entire section on medications by following the above link to the Mayo clinic.

Types of antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs). These medications are safer and generally cause fewer bothersome side effects than do other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). The most common side effects include decreased sexual desire and delayed orgasm.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications include duloxetine (Cymbalta), venlafaxine (Effexor XR) and desvenlafaxine (Pristiq). Side effects are similar to those caused by SSRIs.
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs). Bupropion (Wellbutrin) falls into this category. It’s one of the few antidepressants that doesn’t cause sexual side effects.
  • Atypical antidepressants. These medications are called atypical because they don’t fit neatly into another antidepressant category. They include trazodone (Oleptro) and mirtazapine (Remeron). Both of these antidepressants are sedating and are usually taken in the evening. In some cases, one of these medications is added to other antidepressants to help with sleep. The newest medication in this class of drugs is vilazodone (Viibryd).
  • Tricyclic antidepressants. These antidepressants have been used for years and are generally as effective as newer medications. But because they tend to have more numerous and more-severe side effects, a tricyclic antidepressant generally isn’t prescribed unless you’ve tried an SSRI first without an improvement in your depression.
  • Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate) and phenelzine (Nardil) — are usually prescribed as a last resort, when other medications haven’t worked. That’s because MAOIs can have serious harmful side effects. They require a strict diet because of dangerous (or even deadly) interactions with foods, such as certain cheeses, pickles and wines, and some medications including decongestants. Selegiline (Emsam) is a newer MAOI that you stick on your skin as a patch rather than swallowing. It may cause fewer side effects than other MAOIs.
  • Other medication strategies. Your doctor may suggest other medications to treat your depression. These may include stimulants, mood-stabilizing medications, anti-anxiety medications or antipsychotic medications. In some cases, your doctor may recommend combining two or more antidepressants or other medications for better effect. This strategy is known as augmentation.

Finding the right medication
everyone’s different, so finding the right medication or medications for you will likely take some trial and error. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as your body adjusts. If you have bothersome side effects, don’t stop taking an antidepressant without talking to your doctor first.

Antidepressants and pregnancy
If you’re pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk to your doctor if you become pregnant or are planning on becoming pregnant.

Antidepressants and increased suicide risk
Although most antidepressants are generally safe, be careful when taking them. The Food and Drug Administration (FDA) now requires that all antidepressant medications carry black box warnings. These are the strictest warnings that the FDA can issue for prescription medications.

The antidepressant warnings note that in some cases, children, adolescents and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting an antidepressant or when the dose is changed. Because of this risk, people in these age groups must be closely monitored by loved ones, caregivers and health care providers while taking antidepressants. If you — or someone you know — have suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.

Psychotherapy
Psychological counseling is another key depression treatment. Psychotherapy is a general term for a way of treating depression by talking about your condition and related issues with a mental health provider.

Through these talk sessions, you learn about the causes of depression so that you can better understand it. You also learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life.

Hospitalization and residential treatment programs
In some people, depression is so severe that a hospital stay is needed. Inpatient hospitalization may be necessary if you aren’t able to care for yourself properly or when you’re in immediate danger of harming yourself or someone else. Getting psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

In this blog we have attempted to give you an overview of depression and its causes along with known effective treatment options.  Please remember, this is only a blog, it is not medical advice and we strongly suggest that you take no action based on what you read here.  See a qualified physician, ask a lot of questions and then make a decision.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Hepatitis C, Peter and Ashley. A Love Story.


For the past week or so I’ve been writing about Hepatitis C, mostly in clinical terms.  Today we begin to tell the human side of the story, the side that shows how devastating this disease can be and how it can bring out the very best in people.  It is the story of a Boston couple — each has the disease.  One far more seriously than the other.

Peter and Ashley Curran are my friends as a result of Facebook and Organ Transplant Initiative .  They are two of the dearest people I know not only because of how much they love each other but also because they are friends to all who are suffering from Hepatitis C, their caregivers and to everyone else in the donation/transplantation community.  These are two genuine, kind and loving people who face incredible adversity on a daily basis and never ask for anything.

The story you are about to read was written by Ashley at my request about her beloved Peter.  She writes only of Peter’s disease but doesn’t even begin to touch on the many other hardships they have faced nor those they are facing on a daily basis.  Ashley and Peter don’t have much,  but they have each other and by God in my book that makes them the richest people on earth.

If ever there was a story of love and compassion and of giving yes, giving (Ash and Peter give till it hurts) it is the Curran story.  Please, if you pray, say one or two for Peter and Ashley.  God gets distracted once in a while with all that’s going on in the world so let’s give him a nudge and remind him that Peter and Ashley could use a little of his grace.  It is people like Ashley and Peter who will get left behind as our national safety net gets ragged, torn and frayed.

More people in the United States now die from hepatitis C each year than from AIDS, according to a new report from the Centers for Disease Control and Prevention. More than 3.2 million Americans are currently infected with hepatitis C and the really bad news is that most people who have it don’t’ know it.

Let’s start with a definition.

According to the Mayo Clinic Hepatitis C is an infection caused by a virus that attacks the liver and leads to inflammation. Most people infected with the hepatitis C virus (HCV) have no symptoms. In fact, most people don’t know they have the hepatitis C infection until liver damage shows up, decades later, during routine medical tests.

Hepatitis C, Peter and Ashley.  A Love Story.

Written by Ashley Tenczar Curran

“You are going to need a transplant, your liver function is at about 10 percent”. I heard the words over the phone as my husband Peter and I were having our morning coffee. He had gestured for me to come over to the phone to listen in, and the words will never be extinguished from my mind.  I did not know then, in my shock and disbelief, that a shadow had fallen.

Peter and I met in 2000, a year that I was finally leaving my devastating drug addiction behind, and starting over. I had moved into a rooming house in South Boston, where Peter had been a tenant for about 7 years.  I wasn’t looking for love, especially in THIS wrong place. An overcrowded, “6 adults sharing the same bathroom” illegal “sober house” as it was advertised had enticed me because it was in good old “Southie”.

As I moved in, and was trying to carry my computer with one hand, doing a disastrous job of it, I heard a voice say “need some help?”  I realize how stupid this sounds, but I married Peter that instant.  He was 20 years older than me, and not my type at all. Laid back, calm, patient, and not overly talkative. I am the opposite.  He helped me plug in my computer, and left. I had been hit by some type of Divine thunderbolt, and I had not felt that feeling in a very long time.   We were facing insurmountable odds. He was just getting clean, tired of being “sick and tired”, and I was fresh out of a treatment program.
By all reasoning, we should have spent one week together and never seen each other again.

We should have died when we relapsed one time, several months after we met, to “try it one more time”, as if we had not destroyed out lives enough.  All I remember is waking up with a needle in my arm, and seeing Peter on the floor , with a needle in his arm.  We talked the next day, and loved each other enough to realize that we would lose each other if we used even one more time.  We finally, after some 15 years pursuing recovery, were unselfish enough to lay it down, and never return.

But the past always comes into the present, it is inevitable. I had been diagnosed with Hepatitis C, like most people I know, young and old, who have ever used a needle while doing drugs.  It is an epidemic of unimaginable proportions.
My virus was “undetectable” and remains that way to this day, 12+ years later.  Peter did not fare so well.

When we first started dating, I was amazed to listen to stories from other addicts, both active and in recovery, telling me that Peter is the kindest and most patient person they have ever met. I say this NOT for the purpose of this story, but my husband has some kind of way about him that instantly puts people at ease.  When my best friend Michelle overdosed in the room above ours, we tried to bring her back, and I wanted to kill the man who had given her the dope. Everyone who was there wanted to hang this man.   Everyone except Peter. He got the man some soda, gave him a cigarette, and sat him down to ask him what exactly had happened.

I remember the guy saying “Why are you being so nice to me?”

I have tried to model my behavior after my husband’s, being honest almost to a fault, and at the same time I am angry that I am not the one who is sick, that he , the patient and loving one has to be the one to go through the horrors of 22 medications several times a day, 3 years so far on the transplant list, (UNOS), and very little family support  (They were attentive and supportive at first, but now that the drama has settled, and they know it could be many more years before Peter gets his Gift of Life, they have gone on with their lives, and do not even invite him to family events anymore)
Peter does not get angry.

This is how I know that God will give him a transplant. This is not wishful thinking, because if you knew Peter, truly knew him, then you would know this also. He has a higher purpose, and God is not done with him yet.  He met a nurse, albeit a “disgraced” one, (me), who is 20 years younger than him, and who loved him from the first time she clamped eyes on him. He is my “Brad Pitt”, even in his weakened state.  I find I love him more , the sicker he gets.  The fight he puts up, the appointments, 4 in the past 2 weeks, and the humility he shows, the polite character he prides himself on, causing doctors and nurses to say over and over again “I wish I had 100 of HIM!”

Hepatitis C is overlooked. That is a FACT. So many young people are being diagnosed right as I type this, and the organ transplant lists, particularly the liver, are getting longer and longer. People are dying from a disease that is completely preventable, and that has a vaccination available!  Soon we will find that our young people are gravely ill, (we can see it now), and that scares me.  Peter said if he had a choice, he would give his liver transplant to a young person, as he has lived his life.

A lot of people think that “junkies” don’t deserve transplants, because “they did it to themselves!”

Well, to that I say “so cancer patients who chain smoked for years don’t deserve chemo and radiation, and costly experimental procedures because THEY “did it” to themselves?  So many diseases ARE the result of something “we have done wrong”.

The real shame is the stigma that society attaches to drug addicts. One person told me “taking pills is ONE thing, but putting HEROIN in your ARM with an IV? That is ridiculous!”   More people die from a combination of narcotic pills and another type of pill, typically a “benzo” like Valium than do from a heroin overdose (I.E. Oxycontin).

I don’t know what the future holds for my husband, or, for that matter, for me. But every day I remind him that God loves him, and I love him. We tell each other every day. Though we did that before he got sick, it resonates even louder now, because I could, in reality, be counting down the days that I get to hear his voice, and see his chest rise and fall, knowing he IS breathing, as I do so often.

Please consider being an organ donor.  There are so many people suffering like this, and putting their best foot forward to patiently wait for their turn. My husband, I believe, is the most patient “patient” that Beth Israel Hospital has ever had.

-0-

After three years on the waiting list, Peter and Ashley are considering looking for a living liver donor.  If you have an interest in helping this couple you may contact them directly on Facebook or leave a message here and I’ll make sure then get it.  Please everyone, if you pray,say one for Peter and Ashley.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

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