Category Archives: Health

Follow the WaterCourse Way

Fall                                                                              New (Healing) Moon

Kate in the E.R., September 28th
Kate in the E.R., September 28th

Kate’s improved a lot. Bleeding stopped. Pain mostly gone. She’s getting some nutrition though a nasal tube and has eaten a bit. But, the nausea returned with eating. Damn. That’s so fucking disappointing. And, she’s been in bed so long that she may have to go to a rehab center after all. Not what either of us want, but if she’s too weak, then that’s what we’ll do.

After a visit to Kate last night, Jon, Ruth, Gabe, Annie and I went to G.B. Fish and Chips on Broadway, a Ruth and Gabe favorite. Family’s bond in many ways, but attending to a sick or injured member of the family is a strong one. And, it doesn’t stop with visits and care for the patient, but happens, too, in these after visit moments. G.B.’s motto is “In Cod We Trust.” Works for me.

Spent time yesterday in cyberspace, about an hour, with Paul in Maine, Bill and Mark in Minnesota, and, briefly, Tom in Santa Fe. Kate was an important part of our conversation since these guys have known her, and me, for 30 years.

taoismThere was some talk of how Zen my approach to all this has been. Thought about that. Really, wu wei. Often translated, inaccurately, as inaction. It’s a Taoist idea better expressed by Alan Watt’s book title, The Watercourse Way. Taoism and Buddhism in China created Chan Buddhism, the immediate influence on what Japanese Buddhist monks came to call Zen. Wu wei is a critical idea in that mix.

Going with the flow is not far off in understanding it, a direct link with the Watercourse Way notion. Essentially it means not trying to bend situations or force them in ways they won’t naturally go. Said positively it means following situations as they progress, trying to move with them, stay present. It does not mean there is no intervention, rather wu wei acknowledges the givenness of so much of what we encounter. Perhaps judo is a good example, where using the strength of the opponent against them is a main idea.

It doesn’t sound very Manifest Destiny, make the world free for democracy. We Americans, especially white male Americans, have this fantasy that we can bend the world to our will. Taoism is a direct counter to this, a way of revealing the fantasy nature of such impulses.

taoism wu weiInstead with wu wei I try to follow the path of the chi, where vital energy is flowing. If Kate needs medical care now, I take her to the emergency room. If she needs diagnostic procedures or interventionary procedures, I learn what I can about them to help make decisions, to help both of us understand the implications. I interact with and try to make all of this happen as easily and effectively as possible. I’m not trying to force her medical care in a direction in which I think it should go.

A good example right now is the rehab facility decision. I want her to come home. She wants to come home. We could be obstinate, try to bend the physicians to our will, but would that serve Kate? No. We need to know what they believe is best for her healing and to act on that as quickly and fully as we can.

I don’t know whether I’m saying this clearly, and much of it is retrospective, not conscious at the time, but an attitude cultivated over many, many years. Part of the inner posture is also a product of existentialism. That is, take the world as it comes, as it is, not as you might wish it be. See clearly. Listen well. Only then can we make decisions that are human, not dogmatic or blinkered by personal bias.

tao ma linWhat I can observe from this last week plus is that these attitudes, these ways of approaching Kate and mine’s current reality, has allowed me to sleep, not despair, not become anxious. In turn it means I’ve been able to show up in each instance where I was needed. To show up to what is actually going on, not what I wish was going on or what I think should be going on. Much, much simpler to follow the chi.

71 years have taught me somethings. This way of being, this wu wei, this following the chi has proved itself in the battle between my wilfulness and a difficult situation. And I’m grateful for that.

 

Let the day’s troubles be sufficient

Fall                                                                  Harvest Moon

This morning
This morning

A cool 32 degrees this morning. Some snow overnight, wintry mix. Anything to put moisture into these forests. Gray sky. Headed toward Samain. Harvest season slowing, the fallow time with bare deciduous trees is on its way. It is now, said Rudolf Steiner, that is the springtime of the soul.

Annie’s here. Glad she could come, help with her big sis. She got in yesterday morning.

Kate has been through so much since a week ago yesterday. The many tests, procedures, lines snaking in and out of her bed, her body. So much. And though the crisis seems to be over, a long recovery period will follow. The big hope we both have is that all this may have finally knocked back her persistent nausea. She needs to eat and eat routinely, not just when her stomach will allow it. As my great-aunt Mary used to say, “We need to put some meat on those bones.”

Shadow Mountain Drive, yesterday
Shadow Mountain Drive, yesterday

I’ll say a word again for living in the moment. It has been so helpful to me, to my own spiritual health, to stay with the worries of this day, knowing that tomorrow will bring worries of its own. That way, each day matters for its own reasons, its own occurrences, not clouded by fears or even hopes. As the paragraph above suggests, I’m allowing a little hopefulness to creep in, but I am not fooled. Whatever hope I have for tomorrow will only exist if we take action today.

And, a word for the dogs. Yes, they’ve called me home from the hospital, just as Kate has called me back to the hospital from home. Seems like a burden, having to take all four lives into account. But, no. The very act of caring for the dogs is immediate, in the moment. Their appreciation is, too. The house, with Kate’s absence, could have a hollow resonance, but it doesn’t, not with Gertie eyeballing the macaroni and cheese in the kitchen, Rigel jumping eagerly onto her couch after a long day outside, and Kep’s tail waving like a happy flag when I go to bed.  Taking other lives into account is what makes us human and I’m blessed to have each of these lives nearby.

Today: grocery store, yet more gas, business meeting stuff. Tomorrow: move the grandkid’s tv into our bedroom, consider some other logistics for Kate’s homecoming.

 

 

The Laramide Consolation

Fall                                                                          Harvest Moon

Shadow Mtn. Drive, about a mile from home. Black Mtn ahead
Shadow Mtn. Drive, about a mile from home. Black Mtn ahead

Reminded yet again of the evanescence of our human life span. As I’ve driven 285 down the hill into Englewood and back up again, some days two and three times in the last week (today is a week from Kate’s trip to the E.R.), I’ve become aware of the mountains in a new way. Always I pay attention to them, rocky outcroppings of gneiss and marble, sandstone, carved by small, powerful streams and covered with lodgepole pine, ponderosa, aspen, shrubby oak. The exposed layering, sometimes all aslant, sometimes straight up and down, and in at least one very beautiful, curious instance, curved like wooden planks bent for canoe hulls, lies open like a literal book of the ages.

The new part of my experience is this, motion and upheaval. Mountains are stolid, perhaps they define stolid in a way most earthly features do not. They stay there, the same each day, Black Mountain’s peak still in the same place as it has been since we moved here four years ago. But there is that spot, just before Hwy 470, where 285 slices between the hogbacks*, then the mountains are gone, receding in the mirror as I drive on east at the very end of the Midwest, the last hurrah of the great plains.

hogbackIt is there, right there. Between 80 and 85 million years ago the Laramide orogeny found tectonic plates crushing against each other in that slowest of slow dances, continental formation and reformation. The result here at the hogbacks and all along the long collection of peaks and valleys we know as the Rocky Mountains shoved formerly settled layers of the earth’s crust into the air, up from the subsurface. The power and violence of the orogeny ripples past me, past all of us on 285, especially at the cut just before it dips under 470.

Apparently immobile now, the hogbacks steeply upthrust layers show the direction of its unearthing, no longer laid down below an ancient ocean’s floor, but blinking slowly like a lithic lizard gazing at the unexpected sun. I have no trouble seeing it slowly emerge, pushed up, up, up as forces way beyond human imagining tore it out of its dark home. 80 million years ago.

And here we are, tiny creatures in small metal containers passing back and forth through it, living our 70 or 80 or 90 years, then disappearing from existence. Let’s say 80 years for ease of calculation. At 80 million years ago that’s 1,000,000 human lifetimes. I would have to live and die 1,000,000 times to know the earth like those hogbacks.

shiva nata raja, Shiva Lord of the Dance
shiva nata raja, Shiva Lord of the Dance

Four years ago I wrote about the consolation of Deer Creek Canyon during my episode of prostate cancer. It was a similar feeling and I’m calling this the Laramide Consolation. Our days are precious, our lives unique, our presence in the universe irreplaceable. Just like the hogbacks. We, all features of cosmic evolution, wink in and out of existence, even the Laramide Orogeny being a mayfly moment compared to the creation of our planet and its creation a blink compared to the creation of the solar system and so on back in infinite regress until that thunderous blaze of first light.

The consolation here, at least for me, is to know that our life and death expresses what the Hindus call Shiva, the ongoing destructive and creative forces that underlie all. Death is not, in other words, a cruel punctuation, but a delicate force that refreshes and renews. Our consciousness of it, of course, colors our experience but in no way changes its necessity and its pervasiveness. There will never, never be anything like true immortality, nor, if we are sane creatures, should we reach for it.

*In geology and geomorphology, a hogback or hog’s back is a long, narrow ridge or a series of hills with a narrow crest and steep slopes of nearly equal inclination on both flanks.

 

Still ongoing

Fall                                                                          Harvest Moon

Tuesday
Tuesday

Clouds have begun to creep down Black Mountain while sunlight bathes its slopes facing us, lighting up the golden patches of aspen. Another of Black Mountain’s infinite looks. She’s a lady who dresses for the season and often appears mysterious, as she does right now.

Kate had an abdominal x-ray, an ultrasound of her arm, and began to receive nutrition through a mid-line. I’m glad because she’s had no food, except one clear liquid meal, since last Thursday. Her hemoglobin was up yesterday though some bleeding was ongoing. Contradictory (at least to me), so not sure what to make of it.

Learned yesterday that she’ll not be coming straight home from the hospital but will go to a subacute (whatever that means) rehab center, probably one in Littleton. Again, not sure why, though I imagine it’s because she’s been in bed so long and will need some physical therapy.

Surgical waiting room on Sunday

I’m cautiously optimistic though so far it seems to be forward and backward with her. We’re still not sure why she bled or from where. The nausea, which has been a cruel insult given her past six months or so, seems to be from her bowels not functioning.

The surgeon ordered a sort of lidocaine bath for the surgery site, surrounding the bowels in this non-opiod pain reliever. She’d been getting dilaudid, but any opium derived pain reliever tends to impede bowel function. Complicated and tricky caring for her.

Mountain spirit visiting
Mountain spirit visiting

And, yes, I’m pretty weary. Annie, sister-in-law, will be here tomorrow. She will be able to manage the dogs so I’m not feeling I should be home when I’m at the hospital and at the hospital when I’m home. I have been eating well, sleeping as much as I can, trying to create a regular routine so the dogs have a semblance of normal. But, that’s all I’ve been doing. At some point I have to pay bills, exercise, do grocery shopping. I have done some laundry.

One really big plus this time around is that we have a functioning dishwasher. When Kate went in for shoulder surgery in April, our dishwasher had just died and it took almost her entire recovery period to replace it. Having dirty dishes in the sink was a drag on the heart.

That’s the Shadow Mountain report for yesterday, October 3rd.

Still ongoing

Fall                                                                               Harvest Moon

Kate in her birthday chair
Kate in her birthday chair

Not sure what’s happening to Kate post-op. Her hemoglobin has dropped some. She may have bled a bit, though whether the bleeding represents old blood or new seems in question. An important distinction.

She’s down. Makes sense. Since Friday morning she’s had 8 units of blood, had her miserable veins explored too often by needles and IV’s and now a mid-line, a CT, a colonoscopy, a nuclear imaging test for bleeding in the her bowels, an attempted embolization of the bleeding site which failed, then on Sunday, the bowel resection. Too much for anyone. Except to keep them alive. Which is, unfortunately, the situation for her.

I created a caringbridge website for her if you want more updates.

I got my first normal night’s sleep since last Wednesday. That feels good.

Jon’s car blew an engine and he’s having a rebuilt one installed. Means he has no vehicle right now, riding his bike to work. I picked him up yesterday and we went over to the hospital to see Kate. He’s worried about her. In order to get  home in time for a good night’s sleep (achieved) I bought us take out at Katsu Ramen, then took him over to his house on Florence in Aurora.

20181002_110908Had an experience yesterday that opened my eyes a bit to the world of micro-aggressions. Due to all the driving in and out I ate up the miles to my next oil change, but couldn’t get an appointment at Stevinson Toyota, so I went to a Mobile Express  here in Conifer. It’s run by a former Jefferson County Sheriff’s captain. I ponied up keys, said no to synthetic oil, and went over to the chairs along the wall.

The Captain said to a customer who asked how long he’d have to wait, “Sorry. The geriatric crowd is working today. Everybody’s over 50.” Folks laughed. He continued to make slighting comments about his own employees, all in this ageist vein. I wanted to speak up, point out that I was right there, being 71, but exhaustion and a desire not to be seen as a complainer kept my mouth shut. Those of you who know me well know I’m not one to be silenced, yet here I sat, embarrassed by my age, embarrassed that others saw me (us, really) this way. And I stayed quiet.

 

Surgery

Fall                                                                         Harvest Moon

Geez. Since Thursday evening when Kate started bleeding until now, she’s had only one tray of a clear liquid diet. Some sorbet, chicken broth, decaf coffee. It’s now Monday.

Yesterday was another tough day. She called me at 6 am saying she was being prepped for surgery. I fed and positioned the dogs, Gertie in the loft with Rigel and Kep outside, then drove in. She’d misread the situation. I stayed with her until noon or so, during which time she received her 8th unit of blood. And continued to bleed.

The waiting was to see if they could preserve the section of her colon with the bleeds. Though the embolization failed Saturday night, these bleeds do apparently stop on their own, sometimes never to restart. Hers didn’t.

Just as I walked out of her room, Kathy, her nurse, waved me back in, phone to her ear. The surgeons and the New West Physicians’ hospitalist had made a decision. A bowel resection. (From the Latin resectus, from resecare, meaning to trim, prune, cut back.) Dr. Streeter told me the surgery would start at 3:00 pm and last at least an hour and a half.

I had to get home to feed the dogs, let them all outside, lie down a bit. Did that. Back in. Up the third floor and the surgical waiting room where I’ve spent several hours over the past three days. The surgeon came out and explained to me that they had removed a section of her right colon and reattached the two ends. This is big because it means no colostomy.

However. He said, “When we do surgery on the bowel, we see it only from the outside. I don’t know if we got all the diverticuli.” WTF? Medicine is much more imprecise than we’d like to think. The nuclear imaging she had on Saturday found the bleeds in the right segment of colon, but it’s very general. That’s why, when the surgeon went in though a groin artery to emoblize the bleeding sites, he was able to find the right colon easily, but could see no bleeds. They had either stopped or they weren’t in the right place.

It’s possible, then, that the surgery didn’t cut out all the bleeding sites. Only time and Kate’s recovery will let us know. Not what I wanted to here.

BJ, Kate’s sister with the house in Idaho where we saw the eclipse last August, and her s.o., Shecky, flew in on Saturday for a long planned visit to see our house, see Kate and me. Instead they saw Kate in the hospital and took me out for sushi while Kate was in recovery after her surgery. It was really good to see them again and to have some family present.

The surgeon said Kate could be in the hospital another three to fourteen days. The bowel has to restart and her hemoglobin has to stabilize. After that, six weeks or so of recovery at home.

Three difficult, very difficult, days and more to come. I’m a little fried right now, but the CBE folks will help in any way they can. I’m not used to organizing folks to help with domestic life, something I’m going to have to figure out. Though. Since Kate’s shoulder surgery, I have picked up more and more of the household work and have routines that should make this transition less of a jolt.

Progress!

Fall                                                                          Harvest Moon

So. A source of the bleed, diverticulitis. Probably multiple episodes over the years. Good news.

To come home she still has to get her hemoglobin up and may have a surgical procedure related to the diverticuli and maybe the gall bladder. Not home tonight or tomorrow night, if surgery, then longer yet. We both feel cautiously optimistic about resolving the nausea and very happy about locating the source of the bleed. We also know, thanks to the multiple scopings of her GI tract, that she has no cancer anywhere from mouth to, well, the other end.

I’m home, taking care of the dogs now. Unless she calls, I’ll go back in tomorrow. She’ll see the GI doc that did the colonoscopy and a GI surgeon. Finally, a bit of progress.

A beautiful, red flag day in the neighborhood. High temps, wind and low humidity. A perfect combination if you’re a forest fire.

 

Kate News

Fall                                                                                 Harvest Moon

1000Kate and Charlie in EdenYesterday was tough. Kate’s still losing blood. She spent most of the day yesterday, from about 6:30 am to 2:30, in the E.R. They’re short of beds and wanted to see which department was the best for her. No word yet on the cause of the bleeding. G.I. doc ordered a colonoscopy for this morning at 10 am. She’s not able to eat though she did have a clear liquid meal while I was there in the afternoon. Delicious, she said. And, apparently meant it.

She’s remained in reasonably good spirits since she’s in an environment that she understands with people and procedures she also understands. That relieves a lot of hospitalization’s stress. Which is not to say that she’s happy or comfortable. She’s not. She’s been in and out of procedures for the last six months, the most recent one only this last Monday. No results from it yet. Too much poking, scoping. Except. No definitive explanation for her weight loss, nausea, and now the blood loss.

We both hope that this hospitalization will put enough focus on her to finally discover what’s been making her life miserable.

Her sister B.J. and her significant other Shecky are, by happenstance, coming into town today. Schecky has family in Aurora. B.J. will probably come to the hospital today.

Since I woke up at 3 am yesterday worried about Kate, then took her into the e.r. at 6, drove home, took care of the dogs, rested but didn’t sleep, and went back in at 2:30, returning here around 7 pm, I’m exhausted. Did get a very good 9 hours of sleep last night.

This is a marathon and requires pacing and attention to self care. I’m following, for now, the internal policy of not worrying about what I can’t control and about things I don’t know. So far that’s working well. I’m able to stay focused on what needs to happen. May that continue.

Fall seems to have settled in, at least for the moment, but we’re still without precipitation. The fire danger remains high to very high. Stage 1 fire ban went back into effect yesterday.

E.R.

Fall                                                                                 Harvest Moon

20180928_070937
ER Sign

Took Kate into the E.R. this morning. Unexplained blood loss, enough to make her woozy. May have exceeded the speed limit occasionally. When she got there, a good team took care of her and her color brightened. Nobody seems especially worried. Something to deal with. She’ll be in the hospital at least one night. Getting a blood transfusion right now.

This is getting old, she said. Yeah. More than that even. My hope is that this will result in enough investigation to finally nail down what’s been causing her nausea. She’s very thin and has little stamina.

ER Signs
ER Signs

On the upside we did our mussar session on rachamim. It was a glorious blue Colorado day so we were in the sukkah. Lots of examples of compassion, a lot of tears. It was a heartfelt time together. Some us really needed it.

Kate and I had our usual Vienna beef sandwiches from the Chicago joint in downtown Evergreen. This is a Thursday after mussar dinner for us. Something she can eat; something I really like.

Back home now. Fed the dogs, will wait until I get word from Kate as to where she’ll be. When I find out more, I’ll post it here. Right now, we know very little.

 

Oh

Lughnasa                                                             Harvest Moon

Black Mountain, yesterday. From Shadow Mtn. Drive
Black Mountain, yesterday. From Shadow Mtn. Drive

Tomorrow we peek over the transom toward the fallow season. Six more weeks of harvest,  the heart of the harvest season is now, then Samain, summer’s end. Up here the temperature cooled off overnight and we’re at 35 degrees right now, getting close to a first frost. There’s even a small hint of snow for next Wednesday. As I wrote earlier, Pike’s Peak and the much closer Mt. Rosalie had snow last week. Happy with the change.

Deb Brown, my personal trainer at On the Move Fitness, really made me feel good yesterday. “You move better than most of the 30 & 40 year olds I see. And, you’re strong.” She was sincere and I was touched. I told her about the odd finding I got from the 23&me folks; I have the same genetic muscle profile as elite power athletes. “Well, you’re capitalizing on it.” “My wife said, ‘What happened?” “Tell to her to ask you that again when you’re 108!” We laughed. Left me smiling.

book of lifeThe book of life closed on Wednesday. It was a fast day, unusual in Judaism which finds asceticism puzzling, but on this day, once a year, there is a fast for the whole of Yom Kippur*. That’s from evening to evening. The point is to make us tune into our bodies, to remember that the body carries our soul, and to make the final push for teshuvah, return to the holy soul our body carries.

OK. I’ll admit I surprised myself, right here, with this keyboard. It happens, but not often like this. I wrote “make us tune in to our bodies.” Oh. It may be, as Bill Schmidt suggested obliquely earlier this month, that this Jewish experience runs deeper than I’m admitting.

*“The purpose of fasting is to bring one to repent, and true repentance brings about a change in actions. However, repenting without fasting is not enough,” Jewish educator Aliza Bulow explains on Aish.com.

Although there are medical exceptions to fasting, the Yom Kippur tradition dates back to biblical times, according to Chabad.org. When the Jewish people were wandering in the desert for 40 years after enslavement in Egypt, they worshiped a golden calf — which is contradictory to the religion’s monotheistic tenets — and Moses went to Mt. Sinai to ask for God’s forgiveness. Moses came down from the mountain after God forgave (them) him, and that day became known as Yom Kippur. The tradition of Yom Kippur continued when the Jews reached the land of Israel — Jews gathered in the first two temples until they were destroyed — and persisted again when they were ultimately exiled and dispersed across the globe.Time