Friday, 21 October 2016

Upward & Onward...

This week I brushed my hair for the first time in 10 ½ months without a brace in the way!
:)

When the x-ray technician (upon looking at the x-rays) asked if I’d been keeping my brace on 24/7 like I’m supposed to, I was sure that was an indicator that I’d be told another 6-week wait...
But, 
whilst the x-rays do show that there’s still a fair bit of healing needing to happen (so I’ll have more x-rays in January), there is suficient fusion for the neurosurgeon to be willing for me to start the weaning process…and, to go back on the rest of my meds.   !     He did make it clear that he’s not thrilled about the latter, but that it’s evident that my RA’s getting too much of an upper hand,  so it’s the necessary compromise (else he’s likely to see me for another fusion b/f this one’s done!). 
He warned me that this next phase won’t be easy w/ pain, spasms, etc, and I’ve at least 4 months of physio ahead of me, but it is nonetheless very nice to move on to the next stage!  (Not till well into physio will I know how much flexion I now have...for 'shoulder-checking' etc...oh, to be able to drive again!)
Resuming the rest of my meds will have its own challenges – Methotrexate is a chemo drug, so that means it’ll take a month or so of frequent nausea etc before I readjust, and even after only my first dose my hair is already filling both the brush and the shower drain again… but. But. But hopefully I will slowly get back to where I was about 2 ½ or 3 years ago, with energy, concentration, etc. Petit à petit. 

 The back of my head feels weird – it’s changed shape (mostly due to muscle loss I guess) – and my neck is pretty white with the exception of the circle in the front that wasn’t covered! I’ve got maybe 75% of my skull feeling back now. When the brace is off, sometimes the hair growing back in from the part shaved for surgery pokes out through the stuff on top, in a rather humorous version of 'rooster tail.' And now that my jaw has some periods of freedom, the severe jaw and ear pain (keeping me up for hours every night) has dropped significantly. Chelsea, the teen who’s lived with us since Feb, can’t stop staring at me when I do have the brace off – as she’s only ever known me with it on! She thinks I look really really different.  :)

'Hopefully this week's 'full-body' steroid shot is the last for quite a while...it hasn't really seemed to kick in this time round, so that dose may be losing efficacy on me anyways.
Focus, productivity, etc has def plummeted again, so please know, those many many of you out there, that I haven't 'forgotten', but am just trying to get back on track -- and it may take some time yet. In the big picture, crazy ventures like lecturing in Vancouver (September) are mental-&-emotional life-lines for me...but they are achieved in very 'stripped-down' fashion, and evenso, mean I've not much left in reserve for some time afterwards. I still do think it was def worth it, but I know it's not just me who then pays in consequence. (And honestly, when I look at a pict like below on a day like today, it seems like it must be a diff person! I include the pict b/c I know those two other smiles will make many of you, around the globe, smile: one of our groomsmen and one of our wedding readers...two of the reasons I decided the Vancouver trip was worth it.)

'Enjoying the two days of torrential rain drumming our metal roof, as we are still recovering from the drought,
even if it may hasten the end of some of this year's truly gorgeous autumnal colour 
('maple country' really is one of the best places to be in autumn!) --
with love to all,
and many many thanks for your care & prayers 

a gratefully healing Kirstin

Thursday, 8 September 2016

Summer's End

Dear All –

My apologies for taking so very long for this update – some of you have kindly tugged on my shirtsleeve to ask: how’d the x-ray & mtg with the neurologist go?

It went ok. 
The good news is that the healing is happening in the way it should – and it is happening. The less exciting news is that it is taking much longer than normal.
This is not at all surprising, because the healing has an uphill battle not only due to the RA (which causes white blood cells to go into overdrive, attacking all sorts of things they shouldn’t…not just joints, as many folk think, but cartilage, organs, tissues, eyes, blood vessels, etc), but also because of the RA meds which had to be reintroduced. I’m still not back on all of the RA meds, and shan’t be until the bone fusion is complete, as those meds will directly impede that fusion…but I am back on anti-inflammatories and my weekly anti-TNF injection, because the rest of my body was ceasing to be functional, and starting to be irreversibly damaged elsewhere. Whilst these meds make life livable, they are also slowing progress down a fair bit.

So, an appointment was made for 6 more weeks down the road with more x-rays and another appointment…which means I’m still 24/7 in the cervical collar (I’m now on replacement # 4, as they are not made to be worn this long – 9 months & 2 days thus far!). I won’t be able to begin physio until the fusion is complete…at which point I will have to “wean” my neck off of the support-dependency. (I had to have a photo taken for publication purposes recently, and I tried sitting perfectly still with the collar off, just as I do when Greg changes the collar pads after a shower etc, and 5 min without that support upon which my neck is now dependent was exhausting! It should be noted however that the very creative photographer managed to make me look fairly natural.).
The outcome of all of this is often confusing for people around me. I ‘rollercoaster’ physically…despite the higher doses of pain-meds (I’ve been on lesser doses of opiates every day for 17 years now), and the reintroduced meds, the RA still increasingly gets the upper hand until I have to give in and get another steroid shot. Then I suddenly have much more energy and ability, looking like I’m ‘much better’…. until the effects wear off (combined with strengthening 'unrepressed' RA symptoms), and I have to head in again. As time goes by, my body gets increasingly used to the steroids, and so they become less effective – meaning a rise in either amount, or of frequency. 
Mix in the fact that I am almost always “up” when people are around (adrenaline, endorphins, life-long habit, etc), it is confusing for some people -- who see me and assume that I’m clearly doing great -- to hear that I am just ‘ok.’ Add in that I might actually be worse than I was when they saw me 3 weeks before... it is just weird to wrap one's head around. 

I used the words (above) “have to give in” –> this is an intentional turn of phrase. To continue frankness in my updates: I have been at the receiving end of lectures numerous times, from several doctors, in the past month that – to quote one verbatim – “look: nobody’s going to give you a hero-prize” for taking less pain meds.
Ouch.
The medics comprehend (at least conceptually) the struggle of trying to balance brain efficacy (and general productivity) vrs pain-level, but they unanimously agree that I push it too far. They tell me that typically they have issues with patients taking too much pain medication, but that my (long-term) issue is that my pride gets in the way of me taking enough.
Again, ouch.
It’s true – of course it’s true.  Too much of my identity and sense of self is wrapped up in my verbal and written communication, in my thought process and observations, etc. Let alone in not being ‘weak’ (despite my intellectual cognisance of all the falsehoods here -- trust me: no need to convince me of the foolishness!). My ‘vocation,’ limited as it is, is dependent upon these things, and has struggled against the impediments of opiates and fatigue (for the pain itself can have similar effects…it’s a daily balance, a quotidian re-evaluation) for these 17 years. (Plenty of studies will point out the unavoidable accumulative fallout.) I deeply believe that ‘relational’ intelligence and effort is of far greater significance – especially in the academic world where this is an almost institutionalized blind-spot –  and that that part of me will always be more important…but the truth is that it is easier for me to occasionally take “more meds” so that I have the energy to engage with people (adding, frequently, to the misassumption that I’m doing well, ‘cause I look ‘good’), than it is when I’m sitting, staring at the screen, with absolutely no physical/mental/emotional energy to write/create/respond/hold-my-neck-&-arms-up. More meds will deal with the pain, but will only further impede the brain, so I put them off.
But, as a doctor said last week: “you need to suck it up and accept that you are going to have an even poorer functioning brain until all your normal meds kick in again, regardless of how far behind you are on work, correspondence, or whatever.”

Not easy. I am trying, really. I don’t like the fallout – an inflation of pre-exisiting challenges.  As all too many of you know, I’ve done almost no e-mail correspondence for months on end. Not even thank you notes, or ‘yes I am alive’ notes. I’ve pulled off a couple of random “gotta do it for work for others” emails, but even with those I am about 90% behind – despite negative ramifications for grants, for publications, for securing speakers, for holding-to-verbal-commitments, inconveniencing colleagues, etc. Let alone all of the relational-end-of-things. (and I daren’t say how long writing takes me -- even this note today is, well… it’s my ‘accomplishment of the day.’ Probably the week.)
I am doing my darndest these days to ‘suck-it-up’ – though Greg’ll attest that I’m not finding it easy.  J

I’ve got two big goals for a month from now: a talk at an Inklings conf, and a lecture for Arocha here in Ottawa. The physical cost of such endeavours is huge -- only Greg gets close to seeing how huge -- but they are also mental/emotional life-lines for me. Another steroid shot, and hopefully I pull it off. But I'm also deeply conscious of how deceptive the appearance of conquering these things will be. 
As both are versions of talks given previously (the first is a shortened version of Cambridge; the other is similar to what I gave in Hamilton last year), there’s not much brain-work to do – just to get there and present. Doing these things are life-shots (not the least for the friends I’ll be able to see at the events), despite the pretty big price to pay afterwards (in recovery etc). But they also mean that so many other things won’t get done in consequence. I am blessed with an awful lot of patient and grace-filled people in my life.

But, enough of explaining all that, and about my having been put in my place by the doctors…!

I can feel over 1/2 of my scalp again – hurrah! And I can sit at a table to eat again! 
After the last steroid shot I was even able to do a short canoe ride with some dear friends (I sat regally on cushions in the centre), and Greg & I managed a very short ride on our tandem [which is designed so I can simply sit, whilst Greg does all the work]. These both were wonderful and liberating events…but the latter in partic resulted in a few very bad neck nights/days afterwards…so it’ll be a bit yet b/f we try it again. A lot of my current neck pain is due to the fact that, b/c I am so much better than I was, I am accidentally moving my neck more, bending over, etc…so, while a literal pain, it is evidence of progression! (and general muscle wastage is a little less evident too!)


On the daily front, the resumption of university term means the diminishment of the incredible team of young folk who were around here all summer – tending the property and animals in ways I couldn’t [during the worst local drought on record no less], tending and entertaining me, distracting me with our weekly ‘book-&-movie’ group, beautifying the property with paintings, viewing platforms, garden fences, etc.  They were amazing. One of the last ‘jobs’ was the painting on our front hall wall the renowned quotation of Julian of Norwich: “but all shall be well, all shall be well, all manner of thing shall be well.” And it shall be – and in ways more wonderful than we can ask or imagine. I don’t understand the Grace that has made it so easy for me to believe and live in the reality of this, but I am deeply grateful for it. Although the ‘Windstone summer team” is largely gone, there is still no shortage of friends who check in on me daily, run errands, and do practicalities I can’t. 
If only for a magic wand to give me more quiet solo-hours in a day, more energy, more clarity, and thus more productivity….  – but really, who of us (at least those past 30!) does not long for the same. I am blessed with friends, family, husband whom I would never exchange. And these I treasure dearly – even when I am months, perhaps years, behind in telling you so!

Saturday, 30 July 2016

And (blessedly) Home Again

Dear all –

An update, post-UK trip…
Primarily, this is a confirmation that we (not just I) survived!

The plane rides were tough – particularly on the way there. I appreciated the distraction of inflight movies/documentaries…and knowing that the experience was of limited time. J  It was wonderful to be able to go straight from the airport to our friends’ home in Herne Hill, and then immediately horizontal. (Did I mention that the 1st wkd we stayed with an ‘Emergency/Intensive care’ medic, and the 2nd wkd split b/n her and a cardiologist & physio couple? We are blessed with so many medical friends – and ones who are very generous in their care.) I slept much of the wkd, whilst Greg visited with our friends, and then on Monday we travelled down to Cambridge – early, so that I could sleep & recover some more, before the conference began on Wednesday. Greg left me in the very capable hands of Ben K. for a couple of days – Ben had come along specifically to help look after me, and did a wonderful job! I should add too that the staff at Trinity Hall (7th oldest Cambridge college, founded in 1350) – scouts & porters in partic – were overwhelmingly kind and generous in making sure I was as comfortable as possible, voluntarily bringing me iced water twice a day, helping Ben print things for me, etc etc….really, they were amazing!

Wed was fortunately a short day, conference-wise. It was so wonderful to see friends & colleagues that sometimes I don’t see for years at a time. Already after the first hour I was so very glad to be there. But I was also glad to go to bed very early, and, throughout the conference, to be able to go back to my room (only a few metres away from the lecture hall) for naps during the frequent tea-breaks and meals – Ben faithfully wheeling me to & fro.

Thursday was the big day: my keynote lecture first thing; then a couple of talks by colleagues that I could not miss; then (after a long nap!) a punt ride on the River Cam [long-promised to me by the president of the Society, a seasoned Trinity Hall punter, if I actually succeeded in making it to the conf]; then (after another long nap) High Dinner…not only my first full meal in a ‘normal’ chair since the surgery, but even for months before that.
And,
I survived!  The lecture went really well – I dared to propose that biographical & cultural context could lend significant insight to (and illuminate the cohesion in) the MacDonald book CS Lewis claims ‘baptized his imagination’ – and attempted to show how. A lot of folk pick up Phantastes b/c of CSL’s claim, but everso many are stymied in their attempt to grasp (even, for many, to enjoy) it. The whole difficult endeavour of the trip was made absolutely worthwhile when fellow MacDonald scholars repeatedly came up afterwards to tell me that I’d absolutely convinced them… that a text some had studied for decades, but never ‘got’ as a whole, now made sense. Perhaps the greatest gift was when a former – now retired – professor (the first to ever teach me GMD, and someone I admire greatly), told me that she wished she could now teach the text again …
(Thank you to the GMD Soc for daring to hold open that keynote slot for me, despite the ambiguity over whether or not I’d actually be able to make it!)
The punt on the Cam was incredibly lovely – for both the boating and the company (from two teens to a senior scholar, representing England, Canada, USA, China, and Romania!) A cherished memory for us all…
And the High Dinner was glorious. Truly fine dining, and very special company. Greg arrived back in Cambridge in time (he’d been hiking in the Lake District with a godson), and we were sequestered at the far end with a small group of, yes, fellow scholars, but more importantly very dear life-friends. It was a treasured gift.
I lingered longer than I should have, of course…all too lovely!  And then paid for it all the next day.

Friday was very tough.  It was hard for me, throughout, not to be able to visit with friends, colleagues, even young scholars I’ve corresponded with over the years, during the breaks and meal times – but I really did have to lie down at every opportunity, and though I had desperately hoped for some engagement time on Friday, it just wasn’t possible.  I even had to miss out on a couple of papers.  There may have even been a few tears of pain and frustration as I tried to make my body start working in time to get to my former supervisor’s opening (and brilliant!) paper.   Friday  was  hard.  But for all I couldn’t do (and focus after the opening paper was seriously compromised), there remained the fact that I had made it and was there, and was soooo grateful. I could not have done it without Greg, Ben, or Margie (a friend who currently lives with us, and who gave a great paper!).
The conference itself was a definite success.  Solid papers; really good papers; exciting papers!  A grand combo/mix of keynotes.  Keen discussion; collegiality; the building of long-term relationships. It is brilliant to see/hear the work that is being done in this rapidly growing field, with important knock-on ramifications in many others.  And it is invigorating that the material is so often not merely academic, but actually stuff that can transform lives and communities.  And…the company is simply grand. Good folk end up working on, wrestling with, GMD…

Friday evening – after a delightful dinner (my second in a ‘normal’ chair!) with a dear friend from Regent days who we see far too seldom (and who has foolishly committed to speaking at a future Linlathen… Do beware being cornered by invalids in person! J) – we headed back to London. Another wkd of sleep, punctuated by visits with more wonderful godchildren and their families (we somehow managed to visit with 4 godchildren!!) … and then,
the flight home.
Survived, and over with, and now several days gone by. Much more sleeping, and now we begin to slowly ease back into old patterns. I’m still sleeping a lot, still tire out incredibly quickly/easily, but I’m moving doggedly towards pre-atlantoaxial-subluxation-me. It’ll still be a few months before RA drugs fully kick in, some time yet before I can even resume the last of my RA meds, let alone sit for any length of time at a keyboard to correspond, but we’re getting there. And, with the help of many dear people, we did Cambridge!!

This is probably (hopefully!) the penultimate entry on this blog…we’ll report back after the mid-August x-ray & appointment, when we find out if the graft is taking…and hopefully also the date on which I will be set free from my not-very-summer-friendly 24/7 cervical collar!

Until then,
Huge thanks and much love continuing,

kjj & gj