Learning how to be a Stoic

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This is the morning of the second day. So far, I think I am already living a bit like a Stoic – a lot to learn, of course. The reason? Because learning to live with a chronic illness which limits your ability to behave as you always have tends to make one more patient, more able to focus on things that really matter, and to let go things that once upon a time would have dominated one’s thoughts and used up much energy. I don’t like to hear about people fighting their chronic illness, because I feel this is not the best way to manage something you really have no control over. Better to find ways to live with the situation. In my case, for a long time I’ve envisioned my illness (polymyalgia rheumatica) and my medication (prednisone) as two dragons, which my job is to control so they go in the same direction, which I hope will be towards healing. I don’t know if this is the best analogy, but years ago in this blog I wrote about prednisone being a two-faced friend. Some people go into remission in a couple of years, others, like me it seems, end up in this situation for the long haul. I have no choice but to treat this in a stoical manner, accepting that I cannot change the fact that this illness has weakened me, stolen my energy and capacity to do things, but also realizing it won’t kill me, and with the right medication I can live a good life and still enjoy many of the things I like to do. I can control how I feel about the situation, and do what I can to relieve suffering by treating myself kindly and taking my medicine, but the fact of the illness is beyond my control and I cannot fight that.

Planet Earth faces an Existential Crisis

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 What can we little humans do, we vulnerable little animals who have overrun the planet and now threaten its very life support systems. Can politicians really do anything to get us out of this mess? Let us start at home, with Canada and its various leveIs of government. It’s imperative that any viable political party gets “green” asap or we are doomed. I thought the eponymous Green party should be focused on the environment, not on racial or gender inclusivity, which in the existential situation the planet (and all its passenger species) is now in, is a distraction, politically incorrect though this view may be. We are all in this mess together, never mind who’s at fault and who’s in power. Rich and poor, black or melanin-challenged, human or other, we co-exist on the same planet.

What a Difference a Year Makes

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Unfortunately, a year has made not enough difference. A year ago I thought we’d be through the pandemic and hoped our feet would be set on a path towards a better world. Instead we see a virus mutating and continuing to overwhelm us. And instead of shedding our differences it seems we are intent upon emphasizing them, fragmenting society into ever smaller and smaller units. It is hard to look beyond this apparent disintegration to a new and better world. Perhaps this is a stage we must navigate before we can make progress but if you are living in a shattering snow globe it’s impossible to see a positive outcome.

We Live in a Science Fiction World

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A strange elongated asteroid approaches Earth. It is not an asteroid. Is it a comet? It doesn’t circle the sun, but goes back the way it came. Oumuamua continues to puzzle us. Sometime later Earth is narrowly missed by an asteroid, undetected until it was nearly upon us. Then a pandemic selectively starts killing the aged and other vulnerable humans. Whatever the powers are, they do not want to destroy Earth, but to save her.

My Pandemic Project

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It all started, I thought, at the end of April with my right leg suddenly buckling as I ran down a slope to catch a walk signal. There was a sharp pain at the outside of my right knee and a sudden inability to run any more. I don’t think at first I connected that moment with the pain I was feeling by the middle of May as I attempted to continue my daily walks. I tried to do exercises I’d been given in the past, involving lifting ankle weights and found I could not manage with my right leg. Hmm, I though, I must be getting weak because of activity changes with the pandemic lockdown. On the last Saturday of May I had a virtual visit with my physiotherapist and she gave me some exercises as I asked, to help me get those muscles back in shape again. I did them that evening, and again on Sunday morning and thought, they are helping already!

Then just before we left to have lunch with our “bubble” family I decided to get summer clothes out from an under-the-bed box. I pushed another one out thinking as I did so, I must make sure to push that back out of the way so hubby doesn’t trip over it. However I apparently have the attention span of a mayfly. Just then I noticed the window wasn’t open, went to open the window and promptly tripped over the box, slamming my left knee down on the floor as hard as I could. Painful much!

I walked downstairs to the parking garage, got in the car, and we drove the five minutes to our son’s home. By the time we got there I couldn’t get out of the car or up the steps without help. We ate lunch but I think I was going into a bit of shock. Later I realized my mouth had gone really dry which was why I couldn’t eat much. I was given a little ice pack for the knee and after the meal everyone insisted I go to the emergency department. I wouldn’t be long, I was assured, hardly anyone is going there these days with the pandemic. To the emergency department we went. Although at that point masks weren’t yet required I wore one. I sent hubby home to fetch my Kobo so I’d have something to read, and settled down to what I thought would be a short wait.

I suppose I kept being triaged down the list. About five hours later the doctor saw me. Told me the orthopedic specialist was in that evening and she would ask him to look at the knee. She said I shouldn’t have anything to eat or drink, except water, in case I needed emergency surgery. A couple of hours later I was taken to be x-rayed. Some time after that the orthopod looked at the knee. By then I would cheerfully have murdered for a cup of tea. When he came in I was using the ice out of the water I’d been given to help with the swollen knee. He was very nice, told me it didn’t look like anything was broken but they would put me in a plaster splint to go home and he would see me in the outpatient clinic on Wednesday. I told him how much my right knee had been bothering me and he said he would have it x-rayed at the same time as the left knee was checked later; he did say something about an MRI and when the time came I should have been a bit more strong-minded and asked him to please go ahead with an MRI. A bit more time went by. Then the man with the plaster arrived and wrapped me up in what I would have called a cast but is called a splint. He told me I could not put weight on the leg.

A little more time when by and then, over ten hours since I had arrived at the emergency department, it was almost tomorrow, a wheelchair and attendant arrived to take me to the entrance to be collected. It was the kind of wheelchair with no way for me to rest a leg completely straight in plaster. I was asked to hold the leg up. As I was there in the first place because I couldn’t use the leg that was no go. Could I rest it on the edge of the foot rest if they folded the foot rest up? That seemed a bit risky to me. And by then I was starving and dehydrated and getting cross and probably irrational. I got out of the wheelchair and, using it as a support, hopped on the right leg, the one that hurt so much I was doing physio for it, quite a distance to where hubby was waiting in the car. I had to hop a bit more until we got crutches in the morning.

Hubby had made tomato soup for supper. Starving as I was I demanded yoghurt in the soup and bread on the side, and several cups of tea. That night and for some time afterwards I slept half sitting up in a chair in the living room with my legs up on an ottoman. After supper the next night I wondered why I was feeling so shaky, and then it occurred to me that I was probably literally starving. Supper was some sort of braised celery! I demanded calories and more calories!

The left knee healed. The plaster came off on Wednesday and after that I wore a brace, rather an ill-fitting one, for two weeks, and then just walked with care. Meanwhile right knee was being over-used. Nevertheless by the seven week visit when both knees were x-rayed, I must have had enough rest that I wasn’t demanding enough to have the right knee cared for. X-ray showed osteoarthritis in both knees, worse in the left than in the right. No broken bones in the foot,

Time went by. Sometimes I could hardly walk, other times I felt nearly all right. But there was a definite slow trend down and eventually I thought, maybe I need a brace to stabilize this right knee so that I can go for proper walks. In late October I attempted to get a brace. I am so thin now it’s hard to fit me. Then my skin reacted to the one which might have worked for me, if any brace was actually what I needed. The brace already kept slipping, and after I had to wear a cotton sleeve to protect my skin I had to strap it on so tight I think I was harming my circulation. Nevertheless I persisted with the trial and at the end of November (remember, this all started in April) I walked from the ferry terminal in Halifax all the way to a bookstore near the Public Gardens, and back again. Half of this walk is on a hill, first up and then down. By the time I was home, near the ferry terminal on the other side of the harbour, I was practically crippled. I had thought the brace would stop that from happening, but in fact the brace did nothing for me at all. I needed to break out the crutches for a day after that walk.

Then I – finally – plugged this question into Google: why, if I hurt the right side of my knee, does the inside hurt. The answer – ACL injury! It was like a light bulb going off. Someone had mentioned that when she had a minor ACL injury when skiing she’d worn a brace which kept her knee straight for a while. I decided to not bend my knee as I walked, and to be very careful not to go down slopes or navigate anything other than necessary steps even when the knee felt better. I did this for several weeks, right through Christmas and into the new year.

I asked the orthotist if I had presented with the same symptoms but no OA would she have been able to fit me with anything else. She said no, only a kind of sleeve, which we had tried and which I’d found uncomfortable, and I would have reacted to its material anyway. I phoned my soon to be former doctor (she was moving, I wasn’t leaving her) and asked for a referral to an orthopod, but she told me to let the “new man” deal with that. All this time she’d been somewhat unhelpful. At my request she’d given me prescriptions for physio and for the brace, and had only diflofenac rub to suggest as a treatment. I read the package insert and realized not only is Voltaren not recommended for people over 60 it is actually contraindicated for people like me who have already had stomach bleeds.

After about a month’s break for Christmas I went back to the physiotherapist with my bright idea about the ACL. She examined the knee very carefully and said there was no sign of ACL issues. However by then I’d been doing my no knee bend walking for weeks, and I could tell things were better inside the joint although still too much swelling. It was about this time I learned that all that extra fluid actually damages bones, erodes joints. I did not know this. I’d have been more assiduous about elevating the leg and icing the knee during the day as well as only at bedtime.

I phoned the new doctor and asked for an MRI and referral to a specialist. He suggested I had gout. I humoured him by letting him send me for the appropriate tests, and he humoured me by agreeing to send me for an MRI and to seek a specialist referral. I do not have gout. However he was very interested in some blood results and said he wanted to see me. I don’t know how he did it. I went to my appointment expecting to have a date (or not) for the MRI, and a copy of the x-ray report, and instead he took my blood pressure and pulse and listened to my chest. Later I realized he never even looked at my knee. He talked about wanting to run a complete blood panel (whatever that is) and I just sat there like a bump on a log and didn’t even ask what he was looking for. I did have the presence of mind to say at the end that all I wanted was to be able to take walks again. I feel that I am losing life expectancy by not being able to walk properly.

Just before I left the building I remembered I hadn’t even asked for a copy of the x-ray report so I ran (well, slowly walked with my urban poles) back in and the receptionist printed it off for me to take to my physiotherapist. And I still don’t know how long I will have to wait for an MRI, or if it’s worth getting one done privately. The doctor wants me to taper my prednisone down to 1.5 mg, from 3, then take in the new blood requisition. So I suppose in about a month or six weeks I’ll have another visit and this time I shall have to direct his attention back to what is concerning me – my injured knee, my need for exercise to maintain health. Not his searching for some interesting ailment which may or may not be of significance but which right now is just something I need to keep putting out of my mind so I don’t worry.

And was the beginning really that moment as I ran down the hill? I think it went back to the days of late 2019 when I did not get to the store to buy new sneakers, and my footwear was no longer properly supporting my feet. My right foot had started to hurt me. I’d got exercises for my feet as well as the knee at that first virtual physio appointment, and they helped very quickly. I also remembered a pair of sneakers I’d had from before and kept only for using on our treadmill in our former home, and with some orthotics in them I was now looking after my feet better.

Even before that, we’d moved in early 2019 and now with no stairs of our own I’d made a point of going in and out at least a couple of times a day and nearly always using the stairs. With the covid lockdown I only went out once a day, and that meant much less physical activity.

So I suppose it all began with covid.

Sunset

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If an artist had painted this evening’s sunset s/he would have been accused of being unrealistic. Golden clouds, with bands of turquoise sky. Water in the harbour and marina gold, and as the sky deepened to pink became copper. Sailboats docked for the night bobbed on a sea of molten copper.

The Great Pause

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I posted this today on Facebook:

Be kind to yourself. You have done the best you could with the information you had at the time. I like to draw and am quite good at it, though not “artist grade”. When I go to classes and hear people beat themselves up because they think they’re no good, I tell them, you’re in the class to learn. If you already knew everything you wouldn’t be here, or you would be the teacher. I think life is like that. We all look back and think “If only….” But we did what we thought was right at the time. We did what we were ready to do at the time.

Now we are all in a different space. Everyone on the planet is living a life different than we expected just a couple of months ago, and for none of us in this generation will things ever be the same. Every single one of us is to one degree or another looking back and thinking, did I do right? And if we take time now to reflect on what we can change about ourselves so that we emerge from The Great Pause more in tune with our people, with our environment, then we’ll have learned a great lesson.

The past exists only in our memory. The future is yet to be. All we have is the present moment, and the gift of life on an incredibly beautiful planet.

The house is on fire

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To protect my own health I’ve actively avoided stress for the past few years, although certain situations (home renovations, moving, anyone?) haven’t always cooperated.  Nevertheless there is a difference between walking along a path and enjoying sunshine, birdsong, glimpses of ocean, burgeoning wildflowers, and shutting out the reality of the world we live in which we have helped to create.  Young Greta Thunberg has shouted out to the world that our home is on fire, if we hope to save anything we must act, and act now.  Even an old grandfather snoozing under the village tree would, I am sure, wake up and run to help save what he could if his or his neighbour’s hut was on fire, or if a flood was about to drown his village.