Issue link: https://www.epageflip.net/i/58366
Wednesday, March 14, 2012 – Daily News FEATURES Infantile idiot irritates imminent in-law Dear Annie: I am get- ting married in May. My fiance, ''Stan,'' didn't like his last job, so my brother hired him. Stan has been working there for a year. I recently found out that Stan has been pulling nasty pranks on my brother. He never mentioned it to me. My brother works alone during the busiest part of the day, with the pressures from sales people, supervi- sors, repair people, etc. Stan works the evening shift and has a helper, but they are the only two in the building. Still, Stan is apparent- ly upset by things my brother does- n't get to during the day. I have seen the pictures of the pranks: cutting the fingertips off the gloves my brother uses for his work; putting spray powder and piles of wood on the chair my brother sits in. He hides tools and rags. The list is endless. has said he doesn't want to come to our wedding. I know he wouldn't miss it, but I'm sad he feels this way. — Disappointed in Pittsburgh Annie's Mailbox by Kathy Mitchell and Marcy Sugar Dear Pittsburgh: If it were up to us, there would be no wedding for your brother to miss. Stan is an immature idiot. He may think these pranks are funny, but we suspect the only rea- son your brother hasn't fired him is because he is engaged to you. Tell Stan to knock it off immediately and grow up. If he has a problem with management, he should discuss it like an adult. Dear Annie: My husband and I have been married for 20 years. He is in the military reserves and could be called up for active duty at any time. Six months ago, he did a 180- I think Stan is being disrespectful and childish. I have never treated his family members with such disre- spect. I am upset and disappointed. These pranks are ridiculous and uncalled for, and I am stuck in the middle. My brother is under enough stress. He hasn't said anything to Stan, but his wife told me it takes him an additional 40 minutes every morning to find the tools that are missing and get things ready for his day. Stan is a 39-year-old man. Should I intervene or let them work this out on their own? My brother degree turn. Now I feel like I am liv- ing with an alien in my home. He has totally detached himself from me. He is an excellent father to the children, but won't speak to me. He says if I ask him how his workday was, he will lie. His reasoning is that he does not want to put more stress on me, because I suffer from anxiety. He sees the anxiety as a weakness. He will not hug or kiss me, and intimacy is out of the ques- tion. He says he is happy ''coexist- ing.'' He refuses counseling and won't discuss it with his family. He will not go to the doctor for a physical. I finally broke down and gave him 30 days to change. He said he wants six months. My question is: How much can a person take? We are both in our 40s. I would love to know whether other military spouses understand this. — Lost in the USA Dear Lost: We have no idea what's going on with your husband. Is he stressed from the possibility of being deployed? Is he seeing someone else? Is he punishing you for some reason? If he won't address it and you are miserable, get counseling without him, and chart the best path for yourself and your children. Dear Annie: I am sorry that ''Amazed in Honolulu'' receives unwanted advances and inappropri- ate comments from male business associates. However, my gripe is about when she says the advances invariably come from ''a short, older, heavyset, balding guy.'' How rude to slam individuals based on physical characteristics. Shame on her. When we are born, we aren't given the option of being short or tall, getting bald or having thick hair, etc. She's missing out on a lot by having such a judgmental and shallow attitude. — D.S. Annie's Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please email your questions to anniesmailboxcomcast.net, or write to: Annie's Mailbox, c/o Creators Syndicate, 737 3rd Street, Hermosa Beach, CA 90254. Affordable Care Act demonstration The Centers for Medicare & Medicaid Ser- vices (CMS) Tuesday announced that California will join 10 other states and the District of Columbia as participants in the Medicaid Emergency Psychiatric Demonstration, established under the Affordable Care Act to test whether Medic- aid beneficiaries who are experiencing a psychiatric emergency get more imme- diate, appropriate care when institutions for mental dis- eases (IMDs) receive Med- icaid reimbursement. "This new demonstra- tion will help ensure patients receive appropriate, high-quality care when they need it most and save states money," said CMS Acting Administrator Marilyn Tavenner. This demonstration will provide up to $75 million in federal Medicaid matching funds over three years to 11 States—Alabama, Califor- nia, Connecticut, Illinois, Maine, Maryland, Missouri, North Carolina, Rhode Island, Washington, and West Virginia— and the District of Columbia, to enable private psychiatric hospitals, IMDs, to receive Medicaid reimbursement for emergency care provid- ed to Medicaid enrollees aged 21 to 64 who have an acute need for treatment. Historically, federal law has prohibited Medicaid from paying for IMD ser- vices provided to Medicaid enrollees between the ages of 21 and 64. As a result, when these particular Med- icaid beneficiaries need emergency psychiatric treatment, they may seek services in general hospital emergency departments where services may not be matched to their needs or in psychiatric hospitals where the care is appropriate but reimbursement is not pro- vided. This has been detri- mental to Medicaid benefi- ciaries, hospitals, and State Medicaid programs. CMS Acting Adminis- trator Marilyn Tavenner said that requiring the nearest emergency depart- ment to care for a person who is threatening to hurt himself or someone else "may not be an efficient use of health care dollars, and may be detrimental to vulnerable patients—espe- cially when they could immediately be treated in the setting with more appropriate care." The Medicaid Emer- gency Psychiatric Demon- stration will test whether Medicaid reimbursement to treat psychiatric emergen- cies in IMD settings will enable States to increase the quality of care for people experiencing mental illness at lower cost, and will also test whether such expanded coverage reduces the bur- den on general acute care hospital emergency depart- ments. The Demonstration will be administered by the Cen- ter for Medicare and Medic- aid Innovation, which was created by the Affordable Care Act to test innovative payment and service deliv- ery models that have the potential to reduce program expenditures while preserv- ing or enhancing the quality of care. The Affordable Care Act requires an evaluation of this demonstration program and a report to Congress. Additional information can be found at innova- tions.cms.gov/initiatives/me dicaid-emergency-psychi- atric-demo. Hypomania activity levels off the charts DEAR DOC- TOR K: I like to paint in my free time. Recently I've been staying up until 3 or 4 in the morning to work on my paint- ings. I know I should feel tired, but I don't. One of my friends said that I might be hypomanic. What is that? DEAR READER: Hypomania is an elevated mood or energy level — one higher than your nor- mal state. The decreased need for sleep that you describe is one of the hall- marks of hypomania. Some people who are hypomanic sleep only a few hours a day. But despite this, they say they feel rested from such little sleep. On the flip side, many creative people like you are naturally energetic when working on their art. This is especially true when a creative person is in the "flow." According to the diag- nostic manual used by mental-health profes- sionals, the "DSM-IV," a person has to have at least three of the follow- ing symptoms for at least four days to be consid- ered hypomanic: — Inflated self-esteem or grandiosity; sleep; ness; ideas; — Decreased need for — Increased talkative- — Racing thoughts or — Marked dis- tractibility; — Agitation or increased activity; — Excessive partici- pation in activities that are pleasurable but invite personal or fiscal harm (shopping sprees, sexual indiscretions, impulsive business investments and the like). Do you have any of the symptoms described above? Some of these can be observed by others. When I'm concerned that one of my patients may be hypomanic, I ask her if I may talk to someone who knows her well, like Dr. K by Anthony L. Komaroff, M.D. a spouse. Does the spouse think the patient has inflated self- esteem? In your case, does your spouse say you've been com- paring your art to Picasso's? The other question I ask the spouse about each of these features of hypomania is whether it is unusual. Does the spouse say, "He's just not himself recently"? Full hypomania is rarely a constant state; it's episodic. Someone may have always been energetic and talkative. That's still true, but now it's as if she can't ever be still. It's hard to understand what she's saying. She makes extremely risky decisions that she never would have made before. She's just not herself. If that's what others say, it's pos- sible the person is suffer- ing from hypomania. Another thing I try to assess is whether a per- son's possible hypoma- nia is seriously affecting his or her life at home or at work. Finally, I look for thinking that is clear- ly psychotic. He doesn't just think his art is the equal of Picasso's: Picas- so himself said he was his equal just last week. Serious problems at home or at work due to this new behavior, or frankly psychotic think- ing, indicate the person may have full-blown bipolar disorder (or manic depressive disor- der). The odds are that you're just a very ener- getic and creative person and don't have hypoma- nia or full-blown mania. But if any of the features of hypomania I've described might fit, talk to your doctor. Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com. PG&E outage safety tips for gusty and wet weather Special to the DN Weather forecasts are calling for gusty winds, rain and snow as low as 3,000 feet in the North State. To prepare for storms and minimize outages, PG&E has an extensive preventive maintenance and tree trimming pro- gram. Each year, the utili- ty inspects every mile of line in its service area – more than 130,000 miles total – and spends more than $180 million to reduce the hazards of trees and bushes. When outages do occur, PG&E employees remain focused on ensur- ing public safety, deter- mining the extent of the damage, providing cus- tomers with all available information, and restoring service as quickly as pos- sible. PG&E offers the fol- lowing suggestions to help customers prepare for the upcoming storm: Preparing for Power Outages •Have battery-operat- ed flashlights and radios with fresh batteries ready. Listen for updates on storm conditions and power outages. • If you have a tele- phone system that requires electricity to work, such as a cordless phone or answering machine, plan for alter- nate communication - have a standard telephone handset, cellular tele- phone or pager ready as a back-up. • Freeze plastic con- tainers filled with water to make blocks of ice that can be placed in your refrigerator/freezer during an outage to prevent foods from spoiling. Safety Tips •Treat all downed power lines as if they are "live" or energized. Keep yourself and others away from them. Call 911, then notify PG&E at 1-800- 743-5002. • Use battery-operated flashlights, not candles. • Customers with gen- erator should make sure they are properly installed by a licensed electrician. Improperly installed generators pose a significant danger to our crews. • Unplug or turn off all electric appliances to avoid overloading circuits and fire hazards when power is restored. Simply leave a single lamp on to alert you when power returns. Turn your appli- ances back on one at a time when conditions return to normal. Report a Power Out- age: 1-800-743-5002 • Before calling PG&E about a power outage, check to see if other neighbors are affected. This would confirm if an outage has occurred in just your residence or within the neighborhood area. • If only your residence is without power, check circuit breakers and/or fuse boxes to see if the problem is limited to the home electric system. • After performing the steps above, single or neighborhood outages can be reported to: PG&E's 24-Hour Emergency and Customer Service Line: 1-800-743-5002 Once your outage has been reported, you can call PG&E's Outage Information Line at 1- 800-743-5002 to get a sta- tus report on your outage and the anticipated time your power will be turned back on. 3B