Fear

Fear is poison in combat. Something we all felt but didn't show it. You can't. It's destrcitive. It's contagious.   -Band dof Brothers.

，是典型的腕隧道症候群，正中神經經過腕部時，受到覆蓋其上的韌帶擠壓所造成的。平時我們的腕部神經“尺、撓、正中”三條神經，是走在八個小腕骨所形成的空間中，那些容納神經經過的空間我們稱之為隧道，神經就走在這些隧道中。隧道因為各有韌帶固定，是相當穩定的結構，所以我們平時無論怎麼用力抓握、撐壓、扭旋，神經都不會被擠壓而產生症狀，所以會發生腕部隧道症候群，都是隧道變形了！

腕部由八個小腕骨構成，分成兩排，上面是以尺撓骨關節面為基座，下面接著五根掌骨。尺撓骨的關節面因尺撓韌帶固定，活動中瞬間變形不大，而腕骨掌骨的可動性很大，因此腕部可以由尺撓關節分成上下兩段。腕隧道的改變，主要是由於下臂肌肉不正常不均衡的收縮，造成尺撓關節面上下兩段的脫位。脫位時，腕骨無法對位上尺撓骨，等於底面積改變，腕骨無法正常排列，隧道因而變形。

腕部上下關節面對位不良，會出現好幾種症狀，如果腕骨排列仍齊，只有脫位，張力集中在腕撓側，會造成媽媽手（撓骨莖突肌腱炎），如果因手指個別用力太多，單條屈指肌收縮過大，則會造成腕骨排列不齊，變成腕隧道症候群。 （這部分肌肉骨頭相對位置變化太過複雜，還必需同時考慮尺撓骨、肩帶、上胸廓的變化，寫在文末補注，有興趣的再去細看）

師母背僵，經常提重物，買菜量頗大，肩帶肌肉僵硬，頸胸椎交界處骨頭後凸卡住，腰椎坐時明顯輕度內陷，體軸旋轉，雙肩頸不等高。預計分兩三次處理。第一次先理開上半身。

先拆手，尺撓骨，對位肩帶。比較特別的是拆開鎖死的肩帶花了很多時間力氣，最後是用對側肋骨挪動才使胸廓胛骨上臂肌群對上。用平拖方式對位肩帶和上臂肌群時，如果肌肉僵緊一直對位不上，一大半是由於上胸廓不平整，肋骨不齊，肩胛骨無法平貼回胸廓肋骨上造成。當低頭抬頭的造弧動作都無法其對上，就表示肋骨鎖死不能動，這時要由對側的上端肋骨下手。

比如要調右側肩帶，醫者坐在患者背後略靠右，用右手平拖患者右側肩帶，左手置於患者左腋下，感受左側肋骨走向，或低頭或抬頭，必需順著體軸方向動，使整個肋排變順、平，再試著左右旋動患者，可以找到使肋骨整排變得平整的角度，當左側肋排平整時，右側肋排也就跟著順很多，這時來自體軸遠端的張力消失，右手平拖、輕旋手臂再加上左手配合挪動體軸的旋轉，可清楚感受上臂肌群不斷滑回，尺撓骨逐漸鬆開，肱二三頭肌逐漸變軟。完成沒有，以低頭右上方肋骨平整，肩胛骨貼平回去，岡下肌平整張力消失為準。當兩側肩帶都調平，胸椎才可動，胸椎可動，兩側肋骨才能每根都可動，體軸才能真正改變（這也是整脊認為藉著調整脊椎骨盤，就可以改變身體的盲點）。

鬆開體軸（還沒有調回體軸，因骨盤未調，上胸頸椎仍凸但可動），二三頭肌鬆開大半，尺撓骨也可以調開，下臂屈肌張力恢復正常，師母握拳很開心的說，好久沒有這種感覺，手可以鬆開出力了，本來一直緊緊脹脹，很不舒服。治療前後半個小時多一些。我想須要給身體一點適應時間，其他問題下次再處理。

相隔十二天，大年初十早上，再去看師母，師母說手還會麻，但是時間程度都減輕了！仔細再觸診檢查，因為上胸脊椎仍後凸，所以撓側系統肌肉張力仍未還原; 骨盤未調，仍有旋轉，所以腹內外斜肌張力就仍存在，肋骨雖可動，但肋排仍會有旋轉張力（體軸未旋正），因而肋排胛骨會有個小落差，三頭肌張力就不能還原。

師母主要歪在右腳，正在（坐姿）調右腳脛腓骨時，問師母右腳什麼時候受傷，師母說不記得，但是右大腿外側痛了很久，
輕壓就痛。調開兩腳，旋正骨盤，再請師母試試，師母再壓大轉子附近，就沒有痛感了！當體軸旋正，上胸頸椎可以陷入可動，我知道快大功告成。

最後處理腕部及手掌時，一直覺得怪怪的，因為腕骨的可動性仍不夠好，轉動手腕及個別挪動腕骨，總是有黏滯感。仔細檢查了一下，才知道拇指食指太僵，也就是兩指的屈指深淺肌卡死，努力轉動手指好一陣子才解開指肌，果然，腕骨的互動性就好多了，每個腕骨動態清清楚楚。這次治療又花了半個多鐘頭。用各種方式角度檢查，師母都覺得正常。後來再打電話問師母，師母說她已經忘記麻這件事了！

傷科治療的原則是還原，但是像小腕骨這種極複雜的情況，根本無法摸清關節面，操作中自然就沒有所謂的骨頭對位，只能依張力跟可動性來替代，只要關節裡張力消失，每個小關節微細的可動性都順暢無阻，就可以當作還原，因為這必需肌肉歸位、韌帶平整才能做到。

…………………………

附註:

腕部上下關節面的對位不良，源自於尺撓骨相對位置的改變（尺撓骨輕微錯位），改變的張力有來自於肱二頭三頭肌的，有來自於下臂屈肌的。

腕部上下關節面的對位不良，臨床觸診檢查時，主要呈現在下臂由前旋向後旋時，手掌的張力會持續變大，無法完全順著尺撓骨的力線走，醫者拉者大拇指側會關節面略施壓再後旋時更明顯（會有卡住翻不到底的感覺）;還有，由撓側順撓骨往下滑觸時，上下關節面會有不能順接的突兀感。這必須兩手對比來觸摸才會明白。

由於下臂的功能主要是抓握，肌肉經日常生活不斷使用，即使在放鬆的狀態下，屈肌會比伸肌收縮的張力大很多，這會使得腕部及手掌持續往前旋方向扭轉，如果張力過大（尤其是撓側屈腕肌及屈姆長短肌），上下就會因為這種扭轉而脫位。

肱二頭肌的止點在撓骨內側，如果張力過大，處在收縮狀態，會把撓骨往下臂腹面拉出而略往撓側旋轉，這時會頂住下臂伸肌群，使其略往尺側偏旋，容易發生網球肘;而且撓骨旋轉方式容易使莖突突出，如果再加上撓側屈肌過度收縮，使腕一下前旋加大，莖突更突出，就會發生媽媽手。

這裡面肱二三頭肌的張力，還牽涉到肩胛骨和體壁對位的問題。由骨盤往上的體軸旋轉方向，未必跟雙手用力的方向配合。如果體軸往上，在上半身是順時針方向，則慣用右手的問題小一點，稱為順勢，反之稱為逆勢。因為如果右手為慣用手，則該側的胸肌、肩帶肌肉、二三頭肌的收縮都會大於非慣用的左手，這樣會使得右肩胛骨前方的肋骨變得緊一點，往前陷一點，對比兩側肩帶肌肉，會覺得是往右前下滑移一些。如果體軸是順時針方向旋轉，和右側肩帶肌肉牽引的方向是一致的，問題小一點;如果體軸的旋轉方向是逆時針，那123三根肋骨就會和456肋產生很大落差，肩胛骨會往前滑移厲害，肱三頭肌張力會變得很大，鶯嘴歪斜，下臂尺側問題就很難解決，像腕不能後旋，不能出力扭轉，不能用手掌撐身體之類的。

尺撓骨如果對位不良，則下臂屈肌張力無法消失，繃緊的一束束肌肉，怎麼按摩處理也無法鬆開。而下臂背側的伸肌，在下臂後旋時，會繃緊浮凸，良好對位的，後旋時，伸肌不會隨動作繃緊。

在上面說的這些整體變化下，整個系統張力增加，結構繃緊繃緊，如果其中的手指個別肌肉張力增加，如食指滑鼠用過度，就會使腕骨排列不齊，發生腕隧道症候群。平時手指用滑鼠或智慧型手機過度，也會發生腕隧道症候群，可是如果沒有上述系統變化形成共構，休息就會好，如果形成錯位共構，就不是休息可以復原的了！

，是典型的腕隧道症候群，正中神經經過腕部時，受到覆蓋其上的韌帶擠壓所造成的。平時我們的腕部神經“尺、撓、正中”三條神經，是走在八個小腕骨所形成的空間中，那些容納神經經過的空間我們稱之為隧道，神經就走在這些隧道中。隧道因為各有韌帶固定，是相當穩定的結構，所以我們平時無論怎麼用力抓握、撐壓、扭旋，神經都不會被擠壓而產生症狀，所以會發生腕部隧道症候群，都是隧道變形了！

腕部由八個小腕骨構成，分成兩排，上面是以尺撓骨關節面為基座，下面接著五根掌骨。尺撓骨的關節面因尺撓韌帶固定，活動中瞬間變形不大，而腕骨掌骨的可動性很大，因此腕部可以由尺撓關節分成上下兩段。腕隧道的改變，主要是由於下臂肌肉不正常不均衡的收縮，造成尺撓關節面上下兩段的脫位。脫位時，腕骨無法對位上尺撓骨，等於底面積改變，腕骨無法正常排列，隧道因而變形。

腕部上下關節面對位不良，會出現好幾種症狀，如果腕骨排列仍齊，只有脫位，張力集中在腕撓側，會造成媽媽手（撓骨莖突肌腱炎），如果因手指個別用力太多，單條屈指肌收縮過大，則會造成腕骨排列不齊，變成腕隧道症候群。 （這部分肌肉骨頭相對位置變化太過複雜，還必需同時考慮尺撓骨、肩帶、上胸廓的變化，寫在文末補注，有興趣的再去細看）

why does it feel so good to get rid of thing? 
Maybe when we see how little we need to survive, it makes us see how powerful we actually are. 
To strip down to only what we need, to hang on what we need, what we want, not to survive, but to fly. 

Grey's Anatomy S10-15

He is peddling hope. There is nothing more addictive than it.   Law and Order S13:21

個人慘痛經驗，分享出來希望能提醒大家將來注意。
我幾年來都有服用中藥，但極少服用西藥。一向身體也沒大問題。
今年六月開始服用西藥，我有告知開中藥的醫生我服用的是什麼藥(只有一種）。因為這位中西醫師（現在醫院的四十左右及更年輕的中醫師都是中西醫師，有西醫執照的）開藥都是很多複方加一堆小藥，所以我有小心翼翼繞著彎和他說:　我現在開始服用這一項西藥，你開藥時看看是否不要開到可能有衝突的藥。（因為這位醫生心高氣傲，對他說話要分外小心，不然會得到"啊，你不要再來了，我不會看啦"
他當時有應，但時不時說:“你不要吃西藥啦，你根本就沒什麼病"
幾個月來人一直腫上去，他看到我時就會念:”你為什麼水腫，你吃西藥那麼毒的藥..."
到了前天，我在網上看其他資訊時，逛到kingnet 醫藥問答，看到如下:
一、磺胺類藥物
磺 胺類藥物 (如sulfadiazine等) 不宜與含有豐富有機酸的中藥或其複方制劑 (如烏梅、山楂、山萸肉、五味子及烏梅丸、參麥飲、五味消毒飲、川芎茶調散等 )合用，因為大量有機酸可使乙醯化後的磺胺溶解度減低，易在腎小管內析出結晶，阻塞和損傷腎臟，引起血尿、尿閉，甚至急性腎功能衰竭。(1,4)
磺胺類藥物不宜與含鞣質類中藥 (如地榆、石榴皮、五倍子、訶子、大黃、虎杖等) 同服，因為鞣質可與磺胺類藥物結合，影響其排泄，導致血及肝內磺胺藥濃度增高，嚴重者可發生中毒性肝炎。(1,2)
  而大黃這項就是我五六個月來吃的藥裡一定有的。有時是單項，有時是在複方裡（桃核承氣湯etc) 
我大驚之下，昨天回診拿著印出來的資料（後來發現這是很普通的知識，台北市立聯合醫院網頁和中藥大廠港香蘭網頁及很多藥學相關網站都有）給中醫師看。
他看了說:“啊，你不要來了，我不會看"　我:就只有請你注意以後開藥不要有大黃這味就好"
結果，昨天的藥出現了一項之前沒見過的複方。上網一查，依然有大黃。

結論就是，在現在醫療環境裡，真正用藥把關的人，是自己。我早該在開始服西藥時，就上網查一查中西藥服用禁忌。而不是只做個負責認真的病人，告知醫生我吃什麼其他的藥，請你注意不要有衝突。

五個月來對肝腎的傷害（五個月重了五公斤，復健師每週看到我三次都會說:你腫腫的），是在我身上。概括承受的，是我。

Q: a million dollars apartment is just peripheral benifits?
A: In our world, it is.
Q: In our world, it's called a bribe.
A: In our earth, it is a gift.
Q: A gift is giving without consideration, there is no quid pro quo.  You receive an apartment in exchange for....        Law and Order S13:20

'Time heals almost everything. Give time time.

Written by Regina Brett, 90 years old, of the Plain Dealer, Cleveland, Ohio .

"To celebrate growing older, I once wrote the 45 lessons life taught me. It is the most requested column I've ever written.

My odometer rolled over to 90 in August, so here is the column once more:

1. Life isn't fair, but it's still good.

2. When in doubt, just take the next small step.

3. Life is too short – enjoy it.

4. Your job won't take care of you when you are sick. Your friends and family will.

5. Pay off your credit cards every month.

6. You don't have to win every argument. Stay true to yourself.

7. Cry with someone. It's more healing than crying alone.

8. It's OK to get angry with God. He can take it.

9. Save for retirement starting with your first paycheck.

10. When it comes to chocolate, resistance is futile.

11. Make peace with your past so it won't screw up the present.

12. It's OK to let your children see you cry.

13. Don't compare your life to others. You have no idea what their journey is all about.

14. If a relationship has to be a secret, you shouldn't be in it.

15. Everything can change in the blink of an eye, but don't worry, God never blinks.

16.. Take a deep breath. It calms the mind.

17. Get rid of anything that isn't useful. Clutter weighs you down in many ways.

18. Whatever doesn't kill you really does make you stronger.

19.. It's never too late to be happy. But it’s all up to you and no one else.

20. When it comes to going after what you love in life, don't take no for an answer.

21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don't save it for a special occasion. Today is special.

22. Over prepare, then go with the flow.

23. Be eccentric now. Don't wait for old age to wear purple.

24. The most important sex organ is the brain.

25. No one is in charge of your happiness but you.

26. Frame every so-called disaster with these words 'In five years, will this matter?'

27. Always choose life.

28. Forgive

29. What other people think of you is none of your business.

30. Time heals almost everything. Give time time.

31. However good or bad a situation is, it will change.

32. Don't take yourself so seriously. No one else does.

33. Believe in miracles.

34. God loves you because of who God is, not because of anything you did or didn't do.

35. Don't audit life. Show up and make the most of it now.

36. Growing old beats the alternative of dying young.

37. Your children get only one childhood.

38. All that truly matters in the end is that you loved.

39. Get outside every day. Miracles are waiting everywhere.

40. If we all threw our problems in a pile and saw everyone else's, we'd grab ours back.

41. Envy is a waste of time. Accept what you already have, not what you need

42. The best is yet to come...

43. No matter how you feel, get up, dress up and show up.

44. Yield.

45. Life isn't tied with a bow, but it's still a gift."

隱性心理模型

我們每個人都有的隱性心理模型會過濾我們隨時隨地獲得的感知，並且預先判斷我們的處境。而且沒錯，它們很可能影響到我們各式各樣的態度和信念-不管是針對自己或別人。隱性心理模式的呈現可能是一種身體的感覺，一種情緒反應，一種偏頗的感知，或一種行為反應模式。我們不會察覺自己是因為過去經驗而產生偏見，反而堅信我們的信念和反應都是根據當下的明智判斷而來。　　---第七感

當我們面對造成自身現況的事件和影響，便會發現那些阻礙我們達成渴望目標的惰性和習慣。真相往往讓我們不安。

一般而言，我們是痛苦到忍無可忍的時候，才會開始改變。那時我們才會頓悟人生不能排練，沒有重來的機會。人生在世雖然充滿了不確定，生命卻是有限的。每天都有各個年齡層的人死去，大多數都有未了的心願。
                                                                   Never stop Dancing. 

The mind holds out hope that the body can be whole again.  And the mind will always fight for hope, tooth and nail. until it finds a way of understanding this new reality and accepts that what's gone is gone forever. 

Grey's Anatomy S9-12

The body does not know the difference between nerves and excitement. panic and doubt, the beginning and the end. the body just tells you to get the hell out.  Sometimes you ignore it, that's the reasonable thing to do.  But sometimes you listen to it.  You are supposed to trust your gut, right?  When you body says run.  RUN.

Grey's Anatomy.  S9-9

這種”這算沒有東西也總有辦法”的感覺，一旦經驗過了，一下子就會變得輕鬆。

--怦然心動的人生整理魔法　

自己真正喜歡的事物根源，就算時間流逝也不會改變。而且，整理絕對可以幫助你發現這個根源。......你擁有的東西，會正確地訴說你自己的選擇歷史。因此，整理也是為了發現自己喜歡事物的自我盤點。　　　　　-怦然心動的人生整理魔法　

"不心動的東西就丟掉" 相信試過的人都發現"心動"和"不心動"的判斷，其實沒那麼困難。因為在碰觸東西的那一瞬間，心中的答案就已經揭曉。困難的是要做出"丟掉"的決定。因為總是有各種理由阻撓我們丟東西: ....... 但是，如果深入追究就會發現，其實無法丟東西的原因其實只有兩個，就是"對過去的執著" 和"對未來的不安"。

擁有什麼東西，就等同於你的生活態度。而"對過去的執著" 和"對未來的不安"，不僅可以了解你擁有物品的方式，還能從中發現你在做一切選擇時的共通原具，如與人交往的方式，或選擇工作的方法等。

 --怦然心動的人生整理魔法

"碰觸時是否怦然心動?"把東西一個一個拿在手裡，留下令你心動的東西，丟掉不心動的東西。請想像一下只被心動的東西所圍繞的生活，這才是你想擁有的理想人生，不是嗎?只留下令你怦然心動的東西，剩下的全部毅然決然地丟掉。如此一來，從這一刻起ｍ，過去的人生會重新啟動，全新的人生就要開始。   --怦然心動的人生整理魔法，近田麻理惠

透過用手觸摸帶著回憶的物品，才能與過去面對面。若是一直放在衣櫃抽屜和紙箱裡，不管過了多 久，都還是會被過去的回憶所牽制，而這些東西或許就會在不知不覺間變成現在的包袱。     -- 怦然心動的人生整理魔法

Patience

I believe these things happen to me for a reason.  I just have to have the patience to wait for the reason to reveal itself. 

Medium.

The few wonders of the world only exist while there are those with the sight to see them.
- Charles de Lint

Maybe I do believe it.  All these 'meant-to-be' stuffs.  Why not believe it, really? Who wouldn't want more romance in their lives?
Maybe it's up to us to make it happen.  To show up and be meant to each other.

Grey's Anotomy S9-7

Time is priceless. Yet it costs us nothing. You can do anything you want with it but to own it.  You can spend it, but you can't keep it. Once you lost it, there is no getting it back.  It's just gone. 

It could be scary to find out that you have been wrong about something.  But we can't be afraid to change our minds. To accept that things are different. That they will never be the same.  For better or for worse. We have to be willing to give up what we used to believe. The more we're willing to accept what is and not what we thought, we will find ourselves exactly where we belong.  

Intuitions, always have our best interests at heart. But too often, we become distracted by fears, doubts, or own stubborn hopes, to refuse to listen. 

Because when you know who you are, it's easier to know what you are about.  And ultimately, what you really need.   --Grey's Anatomy S9,E4

Sometime there is nothing more exciting than getting back what you had and lost. - Dextor

when we follow our hearts, when we choose not to settle, A weight lifts, the sun shines little brighter.  And for a brief moment at least, we find a little peace.    Grey's Anatomy. S9-3
 

• ‎'Slumps are like a soft bed. They're easy to get into and hard to get out of.'
  Johnny Bench.

emotion

'perception is the key to transformation'

'how you feel determines your view to the world'

'it would be a terrible thing not able to trust your own mind.' -Fringe

 each choice we make creates a new reality.  

matters are energy waiting to happen.

the only way we grow

'letting go is the easy part. It's the moving on that's painful. so sometimes we fight.  to keep everything the same.  but things can't stay the same. at some point you have to let go. because no matter how painful it is, it's the only way we grow '

'We are all alone in this world. Anybody tells you otherwise is lying to you or trying to sell you something.

Grey's anatomy

Rather than imagine a new life, I pretended about the old one.

But along the way I have made more mistakes than that one. Probably the biggest of them was not accepting the inevitability of change more than twenty years ago.  Rather than imagine a new life, I pretended about the old one.  And for that I have surely paid a price.  In my darker moods, I feel the cost has been too high, that fate has exacted an unfair revenge.  But most of the time, when I think of how much worse it all could have turned out, I realize I have been lucky.  It does not matter, though.  I am going on.  I have never doubted that.

The Innocent. Scot Turow.

the voice in your head

you can seek the advice of others, surround yourself with trusted advisers.but in the end, the decision is always yours. and yours alone. And when it's time to act and you are all alone, with your back to the wall, the only voice that matters is the one in your head. the one that telling you what you probably already knew.  the one that is almost always right.

Grey's Anatomy