Lời nguyền của Gió

Niềm hứng khởi chưa nguôi, anh đã nhận được một hung tin, đúng là một hung tin đối với hoàn cảnh và địa vị của anh lúc này... anh vội vã lấy xe chạy đến bệnh viện, mọi việc ở đây xem ra vẫn bình thường, chú bảo vệ vui vẻ gật chào anh và anh cũng phải gượng cười lại mà lòng cứ rối bời. Anh lẩm bẩm một mình " không lẽ... hay là.. " " thôi kệ, cứ lên rồi sẽ biết !!"

Phòng hồi sức lạnh lẽo , những tiếng bíp bíp phát ra đều đặn đâu đây, trên đường tiến đến phòng hành chánh- một căn phòng đầy hồ sơ trải trên một cái bàn lớn kê ở giữa, một vài nhân viên đang hí hoáy viết trên những tập hồ sơ màu vàng nhạt, có những hồ sơ dầy cộm khiến tấm bìa mỏng như không còn đủ sức để ghì chặt lấy từng tấm phiếu xét nghiệm xanh đỏ đã dán chất chồng lên nhau. Anh tiến đến người bác sĩ nữ , khuôn mặt thanh tú ẩn sau cặp kinh cận, không biết cô cố tình giả vờ như không thấy anh hay thật tình vẫn không để ý đến anh, lúc này đối với anh cũng chẳng đáng để bận tâm

Anh hắng giọng chào " chào em , hôm nay em trực hả ?" " không anh, em đã trực đêm qua, em đang bổ sung một vài chi tiết trong bệnh án rồi mới về.." 

" thế tình hình bệnh nhân của anh thế nào ? " anh hỏi cô bác sỹ hồi sức mà lòng không khỏi bồn chôn..." bệnh nhân đêm qua đột nhiên trở nặng, có hiện tượng sốc và trụy tim mạch, kíp trực đêm qua đã hồi sức tích cực, bệnh nhân giờ đã... những vẫn phải theo dõi tích cực" cô khẽ thở dài, tuy rất nhỏ nhưng anh vẫn nhận ra, linh cảm một điều chẳng lành sắp xẳy đến, một linh cảm mơ hồ nhưng đang gậm nhấm linh hồn anh

Trong rừng cây thưa thớt. Bóng tối đêm khuya khiến anh phải dò dẫm từng bước , đôi mắt như căng ra để thu lấy chút ánh sáng còn sót lại trong đêm trường thanh vắng...anh chợt nhìn thấy những đốm sáng quắt đang di động và tiến ngày một lúc gần hơn... anh đã nhận ra giọng khìn khịt của lũ linh cẩu đang tỏ vẻ đùa cợt trước con mồi hay chì là bước thăm dò trước khi tung ra đợt tấn công đầu tiên . Tiếng vỗ cánh nặng nề của lũ kền kền đang đậu trên những cành cây khô khốc , lộ ra trên màn đêm nhạt nhoà như bóng hình của tử thẩn đang chực chờ thời khắc để đưa nạn nhân về bên kia thế giới. Bỗng phát ra một tiếng rống thật to của một loài ác thú to lớn, khiến cho lũ linh cẩu và kền kền như dừng hẳn lại...anh muốn trèo lên một cái cây gần đó, nhưng đôi chân của anh cứ nặng trĩu khiến anh không thể nhấc lên nổi...

Quá hãi sợ, anh choàng tỉnh sau cái lay gọi của mẹ. Đêm cuối năm tiết trời se lạnh, nhưng lưng anh vẫn ướt đẫm... anh nhìn mẹ xót xa, " con không sao đâu ...sao giờ này mẹ vẫn chưa ngủ ??" " tội nghiệp con tôi .." vòng tay gầy guộc như hai cành cây khô , ôm choàng lên đôi vai anh...

Những ngày sau, thì cái linh cảm kia đã thành sự thật. Anh cảm thấy mọi chuyện như sụp đổ . Báo lá cải được dịp tung tin với sự hậu thuẫn cuả những tay thầy kiện vô lương lấy danh nghiã phải bảo vệ người thấp cổ bé miệng. Bệnh viện tổ chức liên hồi các cuộc họp, có những cuộc họp bàn đến câu chuyện của anh, có cái không...Họ là ai ? Anh không còn biết, chỉ biết mình giờ đây chỉ là một con cá đang nằm trên thớt. Những lời chia sẽ , động viên, hiến kế thậm chí có cả những lời nguyền ruả dành cho lũ linh cẩu, kền kền đang rắp tâm hãm hại anh từ các đồng nghiệp biết hoặc không biết đến anh , giờ đây đối với anh cũng chỉ như những cơn gió yếu ớt cuối thu...

Anh kinh tởm những khuôn mặt đầy đặn , nét mặt u sầu từ bi như đang cùng đồng cảm và chia sẻ nỗi đau riêng cùng anh. Anh biết những kẻ đã đâm sau lưng anh một nhát chí mạng , xong lại giả như không biết gì, họ đã đến để xem vết thương kia đang rỉ máu ra sao ???

Rồi mọi thứ cũng qua.. nhưng vết thương kia sẽ mãi hằn sâu trong tâm trí anh. nhớ đến những lời nguyền rủa dành cho những kẻ tiểu nhân đã hãm hại mình. Anh khẽ nhếch mép " lời nguyền của gió..." mọi nghiệp chướng đều sẽ phải trả thôi..." anh ngao ngán, châm một điếu thuốc, hít thật sâu như thể cố nén lấy cơn đau, rồi phà ra những làn khói mờ đục đang hối hả thoát ra rồi tan biến dần vào hư vô...

                        Troy, MI Dec 26th, 2016

                               Paul Hunter

Tips for Getting a Good Night's Sleep

Getting enough sleep is good for your health.  Here are a few tips to improve your sleep:

Set a schedule – go to bed and wake up at the same time each day.

Exercise 20 to 30 minutes a day but no later than a few hours before going to bed.

Avoid caffeine and nicotine late in the day and alcoholic drinks before bed.

Relax before bed – try a warm bath, reading, or another relaxing routine.

Create a room for sleep – avoid bright lights and loud sounds, keep the room at a comfortable temperature, and don’t watch TV or have a computer in your bedroom.

Don’t lie in bed awake.  If you can’t get to sleep, do something else, like reading or listening to music, until you feel tired. 

See a doctor if you have a problem sleeping or if you feel unusually tired during the day.  Most sleep disorders can be treated effectively.

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Hope Through Research

Scientists continue to learn about the function and regulation of sleep.  A key focus of research is to understand the risks involved with being chronically sleep deprived and the relationship between sleep and disease.  People who are chronically sleep deprived are more likely to be overweight, have strokes and cardiovascular disease, infections, and certain types of cancer than those who get enough sleep.  Sleep disturbances are common among people with age-related neurological disorders such as Alzheimer’s disease and Parkinson’s disease.  Many mysteries remain about the association between sleep and these health problems.  Does the lack of sleep lead to certain disorders, or do certain diseases cause a lack of sleep?  These, and many other questions about sleep, represent the frontier of sleep research.

How Much Sleep Do You Need?

Your need for sleep and your sleep patterns change as you age, but this varies significantly across individuals of the same age.  There is no magic “number of sleep hours” that works for everybody of the same age.  Babies initially sleep as much as 16 to 18 hours per day, which may boost growth and development (especially of the brain).  School-age children and teens on average need about 9.5 hours of sleep per night.  Most adults need 7-9 hours of sleep a night, but after age 60, nighttime sleep tends to be shorter, lighter, and interrupted by multiple awakenings.  Elderly people are also more likely to take medications that interfere with sleep. 

In general, people are getting less sleep than they need due to longer work hours and the availability of round-the-clock entertainment and other activities. 

Many people feel they can "catch up" on missed sleep during the weekend but, depending on how sleep-deprived they are, sleeping longer on the weekends may not be adequate. 

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Dreaming

Everyone dreams.  You spend about 2 hours each night dreaming but may not remember most of your dreams.  Its exact purpose isn’t known, but dreaming may help you process your emotions.  Events from the day often invade your thoughts during sleep, and people suffering from stress or anxiety are more likely to have frightening dreams.  Dreams can be experienced in all stages of sleep but usually are most vivid in REM sleep.  Some people dream in color, while others only recall dreams in black and white.

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The Role of Genes and Neurotransmitters

Chemical signals to sleep      

Clusters of sleep-promoting neurons in many parts of the brain become more active as we get ready for bed.  Nerve-signaling chemicals called neurotransmitters can “switch off” or dampen the activity of cells that signal arousal or relaxation.  GABA is associated with sleep, muscle relaxation, and sedation.  Norepinephrine and orexin (also called hypocretin) keep some parts of the brain active while we are awake.  Other neurotransmitters that shape sleep and wakefulness include acetylcholine, histamine, adrenaline, cortisol, and serotonin.

Genes and sleep

Genes may play a significant role in how much sleep we need.  Scientists have identified several genes involved with sleep and sleep disorders, including genes that control the excitability of neurons, and "clock" genes such as Per, tim, and Cry that influence our circadian rhythms and the timing of sleep.  Genome-wide association studies have identified sites on various chromosomes that increase our susceptibility to sleep disorders.  Also, different genes have been identified with such sleep disorders as familial advanced sleep-phase disorder, narcolepsy, and restless legs syndrome.  Some of the genes expressed in the cerebral cortex and other brain areas change their level of expression between sleep and wake.  Several genetic models–including the worm, fruit fly, and zebrafish–are helping scientists to identify molecular mechanisms and genetic variants involved in normal sleep and sleep disorders.  Additional research will provide better understand of inherited sleep patterns and risks of circadian and sleep disorders. 

Sleep studies

Your health care provider may recommend a polysomnogram or other test to diagnose a sleep disorder.  A polysomnogram typically involves spending the night at a sleep lab or sleep center.  It records your breathing, oxygen levels, eye and limb movements, heart rate, and brain waves throughout the night.  Your sleep is also video and audio recorded.  The data can help a sleep specialist determine if you are reaching and proceeding properly through the various sleep stages.  Results may be used to develop a treatment plan or determine if further tests are needed. 

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Tracking Sleep Through Smart Technology

Millions of people are using smartphone apps, bedside monitors, and wearable items (including bracelets, smart watches, and headbands) to informally collect and analyze data about their sleep.  Smart technology can record sounds and movement during sleep, journal hours slept, and monitor heart beat and respiration.  Using a companion app, data from some devices can be synced to a smartphone or tablet, or uploaded to a PC.  Other apps and devices make white noise, produce light that stimulates melatonin production, and use gentle vibrations to help us sleep and wake.

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Seasonal Affective Disorder

Overview

Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. Depressive episodes linked to the summer can occur, but are much less common than winter episodes of SAD.

Signs and Symptoms

Seasonal Affective Disorder (SAD) is not considered as a separate disorder. It is a type of depression displaying a recurring seasonal pattern. To be diagnosed with SAD, people must meet full criteria for major depression coinciding with specific seasons (appearing in the winter or summer months) for at least 2 years. Seasonal depressions must be much more frequent than any non-seasonal depressions.

Symptoms of Major Depression

• Feeling depressed most of the day, nearly every day
• Feeling hopeless or worthless
• Having low energy
• Losing interest in activities you once enjoyed
• Having problems with sleep
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Having frequent thoughts of death or suicide.

Symptoms of the Winter Pattern of SAD include:

• Having low energy
• Hypersomnia
• Overeating
• Weight gain
• Craving for carbohydrates
• Social withdrawal (feel like “hibernating”)

Symptoms of the less frequently occurring summer seasonal affective disorder include:

• Poor appetite with associated weight loss
• Insomnia
• Agitation
• Restlessness
• Anxiety
• Episodes of violent behavior

Risk Factors

Attributes that may increase your risk of SAD include:

• Being female. SAD is diagnosed four times more often in women than men.
• Living far from the equator. SAD is more frequent in people who live far north or south of the equator. For example, 1 percent of those who live in Florida and 9 percent of those who live in New England or Alaska suffer from SAD.
• Family history. People with a family history of other types of depression are more likely to develop SAD than people who do not have a family history of depression.
• Having depression or bipolar disorder. The symptoms of depression may worsen with the seasons if you have one of these conditions (but SAD is diagnosed only if seasonal depressions are the most common).
• Younger Age. Younger adults have a higher risk of SAD than older adults. SAD has been reported even in children and teens.

The causes of SAD are unknown, but research has found some biological clues: 

• People with SAD may have trouble regulating one of the key neurotransmitters involved in mood, serotonin. One study found that people with SAD have 5 percent more serotonin transporter protein in winter months than summer months. Higher serotonin transporter protein leaves less serotonin available at the synapse because the function of the transporter is to recycle neurotransmitter back into the pre-synaptic neuron.
• People with SAD may overproduce the hormone melatonin. Darkness increases production of melatonin, which regulates sleep. As winter days become shorter, melatonin production increases, leaving people with SAD to feel sleepier and more lethargic, often with delayed circadian rhythms.
• People with SAD also may produce less Vitamin D.Vitamin D is believed to play a role in serotonin activity. Vitamin D insufficiency may be associated with clinically significant depression symptoms.

Treatments and Therapies

There are four major types of treatment for SAD:

• Medication
• Light therapy
• Psychotherapy
• Vitamin D

 These may be used alone or in combination.

Medication

Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat SAD. The FDA has also approved the use of bupropion, another type of antidepressant, for treating SAD.

As with other medications, there are side effects to SSRIs. Talk to your doctor about the possible risks of using this medication for your condition. You may need to try several different antidepressant medications before finding the one that improves your symptoms without causing problematic side effects. For basic information about SSRIs and other mental health medications, visit NIMH’s Medications webpage. Check the FDA’s website for the latest information on warnings, patient medication guides, or newly approved medications.

Light Therapy

Light therapy has been a mainstay of treatment for SAD since the 1980s. The idea behind light therapy is to replace the diminished sunshine of the fall and winter months using daily exposure to bright, artificial light. Symptoms of SAD may be relieved by sitting in front of a light box first thing in the morning, on a daily basis from the early fall until spring. Most typically, light boxes filter out the ultraviolet rays and require 20-60 minutes of exposure to 10,000 lux of cool-white fluorescent light, an amount that is about 20 times greater than ordinary indoor lighting.

Psychotherapy

Cognitive behavioral therapy (CBT) is type of psychotherapy that is effective for SAD. Traditional cognitive behavioral therapy has been adapted for use with SAD (CBT-SAD). CBT-SAD relies on basic techniques of CBT such as identifying negative thoughts and replacing them with more positive thoughts along with a technique called behavioral activation. Behavioral activation seeks to help the person identify activities that are engaging and pleasurable, whether indoors or outdoors, to improve coping with winter.

Vitamin D

At present, vitamin D supplementation by itself is not regarded as an effective SAD treatment. The reason behind its use is that low blood levels of vitamin D were found in people with SAD. The low levels are usually due to insufficient dietary intake or insufficient exposure to sunshine. However, the evidence for its use has been mixed. While some studies suggest vitamin D supplementation may be as effective as light therapy, others found vitamin D had no effect.

Join a Study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including seasonal affective disorder. During clinical trials, treatments might be new drugs or new combinations of drugs, new psychotherapies or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Please Note: Decisions about whether to apply for a clinical trial and which ones are best suited for a given individual are best made in collaboration with your licensed health professional.

Clinical Trials at NIMH/NIH

Scientists at the NIMH campus conduct research on numerous areas of study, including cognition, genetics, epidemiology, and psychiatry. The studies take place at the NIH Clinical Center in Bethesda, Maryland and usually require regular visits. After an initial phone interview to see if any of the clinical trials recruiting subjects are a good match for you, you will come to an appointment at the clinic and meet with a clinician. Visit the NIMH Clinical Trials — Participants or Join a Study for more information.

How Do I Find a Clinical Trial Near Me?

To find a clinical trial near you, you can visit ClinicalTrials.gov. This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world. ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations, and contact information for more details. This information should be used in conjunction with advice from your health provider.