Friday, August 14, 2009

Current events

The one I'm selfishly, obsessively focused on is the surgery.

Nick's right -- I really have no choice. It's gotten worse in the last month or so, so bad that sometimes I can't even stand up straight. Getting out of bed is the worst part; it's not only the pain and stiffness but weakness so great that I have to hold on to the bedposts, to Nick's shoe rack, to the wall, to anything that will support me. Nights are bad now. I roll over in my sleep and the pain that causes wakes me up. I'm awake a couple of hours a night now, usually from 3 or so til 5. Not awake enough to get up and start the day, which I've been known to do at that hour, sleepy but too uncomfortable to either get up or go back to sleep.

People are now telling me that they're praying for me, which is disturbing on at least two levels, both of them obvious to anyone who knows me.

Less than 3 weeks to go.

The pain has become part of me. I think often of the narrator in Doestoevsky's Notes from the Underground, who feels pleasure in pain, pleasure in the moans that escape him. It isn't pleasure in the ordinary sense of pleasure and it isn't pleasure in the pain itself. it's pleasure in the consciousness and expression of the pain. I understand it now.

The pain has another benefit -- it's sharpening my mind. I feel the way I did when I first learned to play guitar and read music. I'm focused and can concentrate. My mind doesn't skip around the way it always has, taking non-linear paths, jumping restlessly from thing to thing, making instant connections so fast and so bizarre that sometimes I find it interesting to stop and retrace how I got from here to there. Or there to here. Or usually there to there. I'm reading more and the things I'm reading are denser and harder. I'm writing, which I love to do (not just in the Dorothy Parker sense of "I hate writing but I love having written"; I love the writing part.) My ability to focus on everything related to work and kids and family and friends and politics and everything else that interests me related is infinite. But on the down side, it's enervating. It saps my energy and leaves me tired most of the time (made worse by and indistinguishable from the sleeplessness.)

Less than 3 weeks to go.

And the surgery looms. And it scares me -- the fear is more disabling than the pain. I can't easily parse what's causing the fear. It's a muddy combination of things including these: it's open surgery, an overnight hospital stay, a difficult recovery, the fact that it's my spine. All of these are pooling to create a well of fear that occasionally bubbles up and washes over all my reason. I know one thing it isn't - - fear of the unknown. I've researched and read so much that lack of knowledge isn't the problem. Maybe it's the surfeit of knowledge that's making it worse. I even know about the growing medical tourism industry in places like India and Costa Rica for cut-rate high-quality surgery.

I do worry a lot about the aftermath of the surgery, about what it will really be like to come home and manage through the first days. Here my research isn't terribly helpful. Either the info is clinical and detached (clearly written by the surgeons and not the patients) or just plain alarming. I found an article the other day that compared cervical and lumbar decompression surgeries. It would have been reassuring had I been facing the cervical version. It said it's not that painful. But of the lumbar version it said that this is one of the most painful surgeries that one can have, what with the size of the muscles involved and the amount of manipulation required.

Less than 3 weeks to go.

We were talking just last night about how I'll get up the stairs when I get home. I was thinking past that, to just being stuck in bed for days. But I didn't process until last night what will be involved with just getting upstairs and into bed the first time. Maybe, maybe they'll give me a nerve block that will deaden everything for the first day. That's what happened with the hip arthroscopy, where I felt fine for 24 hours, wondered what all the post-op fuss was about, and then got slammed by the arrival of the actual pain.

Less than 3 weeks to go.

I have always used a mental process so I can evaluate my pain and see if it's really bad or can be fought through. When I was a kid, I used a simple secret filter: if the future of the world depending on my ability to do what's expected me, would this pain/illness/discomfort stand in my way? The answer was invariably no. As I got older and grew interested in life under totalitarian regimes (mostly the Nazis and the Soviet Union under Stalin, with occasional thoughts of Pol Pot and Shining Path) the filter changed. Then I started comparing what I was feeling with what the sufferers in those situation must have felt, and that filter gave me perspective and I could usually kick back and put in its place what was bothering me. These techniques -- bizarre to some, no doubt -- worked well for me because they let me see and evaluate what was happening in a larger, quasi-historical context of true human suffering and see my problem as smaller, lesser, less severe and less important.

The technique is failing me in this round. With this pain the answer is most often now no: no, I couldn' t save the world when the pain is at its worst; no, I couldn't do whatever physical requirements were demanded of me. A very sobering thought. It's now a struggle because the pain is real and severe and none of my usual approaches are much help as I try to minimize and mitigate it, and put it into a perspective that in it's own dark way I've always found reassuring.

Less than 3 weeks to go.

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