Pride of pwnership

I transferred my prescription to a new pharmacy today. When I was asked about existing conditions, I said, “CRPS – Complex Regional Pain Syndrome – and fibromyalgia.” My tone, I realized, was firm and proud.

At first, that freaked me out. Proud? To have CRPS? Just how far have I come to identify myself with this disease? 

It bothered me, but not as much as it should have. I put it on a back burner to mull for a bit.

I did some paperwork and watched a movie: Mulan, and I don’t think that’s irrelevant.

I realized that it’s not having CRPS and fibromyalgia that I’m proud of. It’s having CRPS and fibromyalgia, and still being alive – still hugely engaged – still moving to a new place, still sorting out my paperwork, still finding a new adventure, and still organizing that adventure even as it unfolds. 

I identify with whatever it took to develop the nerve, courage, and modicum of grace that got me this far. I identify with what it took to discover those who kept me alive, and made that life worth living. I identify with having gotten to the point where the things that I think about, much of the time, have nothing to do with pain, frailty, and other losses. I have this ridiculously awful disease, but that's not where my life is. 

I have CRPS, but the verb "to have" has a number of meanings: to possess, to be in relationship to, to be required, to have a duty or need, and so on. If you've ever done any translation, you know what a headache the verb "to have" can be. 

In this case, it might just mean that I own the disease, in the way that hackers mean when they spell "own" with a P: pwn. To pwn something (a device, troublesome software, the CIA mainframe) is to figure out how to dominate it, because you know exactly how to make it play ball -- whether that's legal, approved, or otherwise. 

As it happens, that's pretty much what I intend to do with CRPS.

I'm okay with being proud about that.

Tern to the present

This is the third major purge of my possessions in 7 years. 

The first time, I decided that anything that I was keeping for sentimental value had to trigger only good feelings; I'd keep nothing that made me unhappy.

The second time, I moved onto the boat, so everything had to have at least two uses.

Now, I'm eliminating everything that isn't easy to handle, as well as being useful and pleasing.


That meme is extending into the realm of perception. Images and events that used to trigger emotional cascades, because of memories and associations, are finally losing their sickening zap. Associations fall away, and images and events stand out  in simple splendor as just what they are: unlayered, transient, colorful, done.

For instance, I used to hate terns, because their cry sounds exactly like a drowning cat. I blame their awful caw for my not being aware that my cat was in jeopardy when he died. For a couple years now, I've gotten snarly at tern-time, when they come here to breed. But, with this shift in my perspective, a tern is just a tern. My excellent companion was still an excellent companion -- and, obviously, a kindred spirit.

A tern is not about the past or the future. It's here now. It's just that, at this moment, one is floating past with its strange sharp wings twinkling; then it hovers and wiggles for a moment; twists, plunges, spears the water; bobs up again, looking smug, with a little fish in its mouth; takes off and disappears.

Usually, there is no fish. But right now, there goes a pleased tern, enjoying the moment.

It's just a tern, and it's doing tern things in a ternish kind of way. Tomorrow it will do tern stuff in a slightly different, but still ternish way. Doesn't matter. It's just a tern -- nothing more nor less.

There is no furry friend dying alone.

There is just a bird.

Gorgeous photo: Geert Wilders at http://www.freerepublic.com/focus/f-chat/2426290/posts

And I want credit for resisting the obvious urge to make a crack about taking a tern for the worse.

Oops...

Anyway.

I stumbled across a quote that seemed shiningly appropriate:

"To live here and now, you must train yourself: in the seen there will be just the seen, in the heard just the heard, in the sensed just the sensed, in the thought just the thought. That is the end of  sorrow." - Gautama Buddha

I don't know about the end of sorrow, but it's true that it is far easier to manage my moods, notice my body's signals, and do what I need to do, when I keep things in this charmingly simple, deceptively rigorous perspective.

It's rigorous because it goes against all my socialization about the importance of hair-trigger reactions and emotional responses: Am I an ice-queen? Don't I care about things? Aren't I human? What's wrong with me?

I've gotten all of those remarks in my time, when I strove for calm in former years -- especially from mere acquaintances and random strangers, which always shocked me. How I, and those around me, survived my 13th-23rd years is unimaginable at this distance of time and self-certainty, but falling into the reactivity trap was one good way not to get verbally assaulted.

One advantage of being plumply middle-aged is that, for one thing, people watch you less; for another, a degree of equanimity seems to be less ... annoying.


Exqueeze me?!?

I've had it up to here with emotional reactions. CRPS is a roller coaster par excellence, for emotional reactions. I'm quite done, thank you, and I'd like to get off now.

Actually, I think I just did.

And now, a tern is just a tern. For better ... or worse.

Getting it right

H'mm... Struggling with the recurring message from the world around me that I can't do this, I can't cure this case of cold chronic CRPS. It's twinned with the message that, whatever I'm doing, it's wrong. I'm not interested in whining, because, as my CRPS cohorts know, this nonsense is par for the course... but every now and then, it's good to step back and do a reality check.

Let's take a good look at this thinking:

- On the conventional medicine side, I walked into a new doctor's office with my tabulated timeline of years of a complex case, pictures showing the evolution of the disease in this body, and documentation about what works and what doesn't. The response: "You spend way too much time thinking about this!"

Don't waste time trying to find any upside to that remark. It surprised me especially because most of my docs (the best in the biz) loved my documentation. Now I know that the really good doctors love it, and the ones who don't love it are either one-trick ponies or second-rate. This one was a one-trick pony, and once he'd done his job, I was gone.

Let's back up and pretend this guy asked, "Wow, that's a boatload of well-crafted, thoughtful documentation. Why did you go to so much apparent effort?"

I'd say, "I was a nurse so the concepts are easy, and I was a tech writer so the structure is even easier. This is a cakewalk for me. If I CAN'T document what's going on, check for a pulse!

"Moreover," I'd go on, assuming the doctor cared about my well-being, "tracking this stuff frees up my attention by letting me plonk it down in black & white and then put it out of my head. That leaves the rest of my time free for meditating, friends, bathing, housework, and so on.

"Besides," I'd add, if the doctor looked like one who could take a joke, "most docs find this case hopelessly confusing, and I don't need you wasting my time by asking the same questions 3 times and still getting it all wrong in the end, just like the one other doc who refused to look at this!" Ha ha.

Seriously, physicians, that's how to handle an expert patient: Ask, then listen. Saves time.

- The alt-health folks are liable to tell me, first, that I'm sick because I think the wrong thoughts; then, if they ask about my mental habits, it's obviously because I eat toxic foods; if they want to get straightened out about that, it's clear, dear, that you're too attached to this disease and there's nothing anyone can do to help.

My fellow CRPSers are thinking exactly the same things as me right now.

Besides the sheer cruelty of that response, the fact is that spontaneous remission from CC-CRPS (cold chronic CRPS) after the first 3 years is even rarer than spontaneous remission in cancer or AIDS. I've heard of it happening once as late as 7 years; I've had it for roughly 10; average survival is 30 years after onset. If any of you has more optimistic data, I'd love to see it!

Here are some things I've learned about how what you think and what you do REALLY affect the course of your CRPS:

- Those who stick exclusively with the conventional model and submit to their doctors without question, especially when they have noxious drug reactions (as I do), tend to suffer much and die young.
That's what happens when you're a passive patient with a disease that few doctors understand.

- Those who become well-informed and educate their doctors, have better results and do considerably better for much longer.
That's what happens when you open your eyes and take initiative regarding a very rare and complex disease.

- Those who research and implement changes to diet and lifestyle most vigorously, have the best results from their care and use a lot less medication with much better results, higher function, and lower disability.
That's what happens when you shoulder real responsibility for what you do and how it affects your life.

- Those who are active in the online communities, seeking support and providing support to others and sharing information, tend to beat the odds.
That's what happens when you constructively engage with your community.

(One day I'll have an open-source database that lets me pull up all the articles I've read over the years to support those statements.)

I'm looking for something I'm not doing yet. I will figure it out, hunt it down and I will do it.

CRPS is an incredibly hard disease, in every conceivable way. Where there is any spontaneous remission at all, there is something to work with. I just haven't figured out what yet.

I can't help thinking that Norman Cousins was an amateur! If he was looking for miracles ...

Since I still have CRPS, I find those recurring messages a little intimidating. I  don't yet have hard data to throw back against the key message. I can see that, when others say I'm doing things wrong, the statements tend to be presumptuous and ill-informed, but the fact is, I still haven't cured my own case of CRPS ...

Yet.

Balance

I recently had a sequence of conversations that showed me where I really stand.

In one, I answered a series of health questions in a linear, rational, consensus-reality style: this did that, the other happened, and this twisted disease all makes sense to the crowd outside Wendy's.

In another, I discussed the comparative neurogenetics of mice and men like a hardcore science geek, all Cartesian assumptions and classical physics.

Then there was Firefly and Terry Pratchett, fine examples of satire that manage to be curiously strengthening rather than cutting anyone down.

Then a writer friend asked about the 2012 thing (maybe I should capitalize that: The 2012 Thing) and that led to a little discourse on Mayan numerics and calendar theory, galactic astronomy, and the quantum physics behind astrology.

For one thing, I've found that reality is a lot weirder than I was ever told. For another, I rather like being what I am: a translator. I can explain neonatal cardiology to a soccer mom, Hunab Ku to a lawyer, international politics to a meth head.

So where do I stand? It just dawned on me that I stand on understanding. (Look at that again, because I just did: stand...on...under...standing. I love it when patterns emerge, even if they're Moebius strips.) That stance often puts me between two extremes, bridging them with the clarity of the best words I can find at the time.

I don't need a creed of my own beyond "do no intentional harm", "we're all part of something larger (details vary)", and the like. This adogmatic flexibility is where my balance is. That's pretty cool. Not normal -- normal doesn't seem to work for me. But that's fine. This does.

EM-hmmmm

Last year, I could tell exactly when the fallout from Japan got here, because my hands and arms swelled up the moment I stepped outside. I could tell which gloves had been left in the rain, because they made my fingertips go numb when I touched them.

Who needs Geiger counters when you've got cold chronic CRPS?

So I took off for the summer & went East until September, when the air and sunlight had calmed down quite a bit. However, the entire SF Bay is simply carpeted with wifi, radio, EM, and a whole lot of other stuff in the band that's so noxious to CRPS -- at least, in me ... And in almost everyone I know who has CRPS who has taken the time to reflect on what triggers swelling, autonomia and pain.

I had staggering improvements from a trip I got to a hot springs, where I did hot & cold plunges. In all my life, it was the most amazingly recuperative experience that didn't involve persuading someone else to work on me. That low emotional overhead has a certain appeal, in these dysregulated times. But I do look forward to finding lots of good company along the way.

I'm clearing the boat for sale then taking off on an extended tour of hot springs. I have no idea where it'll take me, but what a trip! I expect you'll read quite a lot about van camping, because remember, I'm on Disability and that doesn't leave much for hotels.

New glasses, renewed perspective

I used to have remarkably acute vision (20/15, if you're curious) and exceptional color perception to go with it. It used to make me happy just to look. Turning my sweet eagle's eyes on a treetop and picking out each leaf really felt good. Noticing the individual speckles on a falcon overhead made my heart sing.

I liked to see.

That has been changing for some years; I remember when I could no longer see the star at the center of the sparkle in the night sky, for instance. With more pressing matters (food, rent, keeping CRPS under control) I've adapted and adapted and adapted to my worsening vision, using pattern-matching skills (another 5-star category in my old brain) to replace actual perception.

It is an excellent adaptation to use, leveraging a primitive part of the brain that is very hard to screw up. However, it does have its limits.

My housemate, the excellent R. (I avoid using personal names without permission), finally confessed that my driving scared him because he really thought I couldn't see well enough to manage it safely. He worried even more when he wasn't in the car. That made me think.

And then I scared myself today on the road, and decided that was the last time. I called the ocular shop and they squeezed me in at 4 o'clock on a Sunday.

My visual acuity had deteriorated from 20/15 to 20/80.

Some things should not be adapted to.

I'm now a member of the four-eyed fraternity.

I think my nose was red because I almost cried.

I wear my polycarbonate steel-rimmed cheaters as if they were portals into heaven, because they are. I spent an hour and a half simply strolling around, agog, with the whole world smacking me squarely in the eyeballs.

First thing I noticed is, everything has an edge. I had forgotten that; more precisely, I had taken it so much for granted when I could see, that I didn't notice when it faded from view. It's like the resolution on the world is turned up to infinity. (...It is, in case you're wondering.)

The next humdinger was the warping effect. Looking through the lenses is hunky-dory, but it gets a bit weird at the very edges, and beyond the rims there is no correction at all -- the world is a palid mess, off to the sides and around the bottom, right where my feet and hands are most of the time.

I twisted my head slowly around, expecting wa-wa noises and doppler effects to accompany the dizzying twist of light around the margins of my sight.

I stumbled until I figured out that my feet were just where I'd left them, and I'd have to treat them just the same as I did before the glasses.

I was sure the pavement was breathing.

I've never taken hallucinogens (apart from exhaustion, surgery and chronic pain). I have nothing against them, I just felt no need to. There might be a reason why: all it takes is a pair of new glasses and I'm nearly there.

I went down to the beach and saw two boys in red shirts. I was riveted. My ocular nerve itself was stained, the color was so intense. Did you know red is the color of healthy, living blood? Red so glorious and alive that it almost quivered was all over street signs, cars, carts -- shirts.

When I noticed that, I noticed that all the colors were darker, richer, more alive. The dim shapes of the SF Peninsula across the Bay were purple, dark steel and deep amber. I had no idea. It was spectacular, in a tasteful and slightly intimidating palette.

Then the shapes and colors came together for me as I looked up at the sky. The clouds didn't just drift stately by, they floated in a tender dance of radiant whites and silvers, caressing the air with fingertips trailing Chantilly lace and oxygen.

As I saw that, I realized that the movement of things had taken on new poetry. Palm trees shifted in the breeze with the distracted grace of mermaids playing with their hair. Every frond was alive and had a finger of wind wrapped around it. Who knew?

I walked until I could bear to focus on a path, could do head checks without headspins, and generally felt able to drive more safely. It was still a stunning trip home, and I got here just as the sun touched the top of the Marin Headlands and dropped out of sight, staining the sky with farewell colors. I said thanks to it, right out loud.

I'm told it will take another day to adapt, and by then I'll know what my world will look like from now on. The hallucinatory wonder will probably be replaced by something I can talk about in public ("Didja see that? Looked like the Goodyear blimp!") but, from my personal history as a visual junkie of ocular delight, this intense thrill of LOOKING will probably be mine again forever -- or for as long as I keep my prescription up to date.

I'm pretty motivated. This cuts into my car-buying budget, but I do think it's worth it. Being able to survive driving is not a bad idea at all.

Gluten exposure and recovery - Testing myself (silly me)

Gluten: really is that bad

Yesterday, I walked past the bread display at Trader Joe’s three times, breathing deeply. It smelled good, but not as good as I remembered. That was odd.

As I left the store about ten minutes later, my face turned beet-red and puffed up, my brain went into a deep white fog, colors faded to pastels, and the pain left my arms and foot briefly to return, five minutes later, to every joint in my body.

I was in full neurological gluten reaction. From inhaling near a bread display!

I did that in the first place because I just could not believe I was that sensitive to something I’ve eaten – and really enjoyed – all my life until last summer.

I know there’s a difference between the kind of food sensitivity where, if you avoid that food most of the time, you can tolerate a little now and then with no trouble; it’s about keeping the contact down below a certain minimum. Then there are the sensitivities where, if you eat a bit on a regular basis, your body retains an ability to deal with it and you don’t get a reaction (vegetarians who go back to eating meat are familiar with this – it takes awhile for the body to readjust.) And then there are the sensitivities that amount to true allergies, where any contact causes a reaction and the reaction can get intense enough to create a crisis.

That was an intense reaction. I’m not interested in seeing how much more my face can inflate.

It’s true that I used to eat wheat regularly and experienced nothing as dramatic. Would it be less dramatic if I ate a little on a regular basis?

Considering how quickly my health was slipping while I was eating gluten, and the fact that I continue to get sicker but I appreciate that it’s at a slower rate, I don’t see any real point in making the experiment.

Moreover, the literature on gluten allergies does not support that. The science indicates that, if your body has trouble with that particular protein, then the further you can stay from it, the better off you are.

I called my acupuncturonaturohomeopath. He gave me a recipe for gluten exposure, which is mostly about buffering the heck out of the molecule. I cobbled together a gluten exposure kit from my talk with him and my nursing background.

Gluten Exposure Kit:

-          2 Alka Seltzer tablets,
-          4 Tums,
-          500 mg body-friendly Vitamin C (not more),
-          10-15 capsules of activated carbon, to soak up any toxins in the gut. (More for eating it by accident, but it can’t hurt. I think it cleared a few things up, in fact.)

Just add water! And plenty of it.

Keep it in snack-baggies in key places: glove compartment, purse, first aid kit, desk drawer.

I turned normal Isy color almost immediately and then had a great, rippling burp every 10 minutes for about half an hour – feeling considerably more human each time. A day later, I’m not quite up to where I was before exposing myself, but am LOTS better than I’d expect to be, without that treatment. A reaction like that usually puts me down & out for about three days. Drooling Barbie doll. It’s awful.

Why so little Vitamin C? Doesn't your body just wash away the excess?

Actually, if you take in excess Vitamin C, your body washes away all of it that it can still get hold of. 500 mg seems to be the sweet spot of maximum absorption and minimum waste. I used to megadose it, but with a frail system, that's intolerable. 500 mg lets me take in and use every bit of it. If I need more, I just take it 3 times a day instead of twice.

Meditation and Reiki: really is that good

Today, I had to test myself on the value of my mental disciplines. I’m not sure why I’m testing myself so much; I doubt myself, perhaps. There is something surreal about what this disease does to you; I suppose the occasional reality check makes sense.

I didn’t meditate last night or this morning. The emotional surges are quite noticeable, but I’m well aware that they are what they are, which is not me.

After my gluten experiment, I feel no need to push this farther.

I’m now perfectly convinced that my relentless internal work does keep the rudder in line, the engine tuned, the brake pads operational, etc. Basically, it keeps CRPS from taking over my brain.

Dammit. I wanted to be normal again. Though, to quote the fabulous Stockard Channing in Practical Magic, “Darling, when are you going to learn that being normal is not a virtue? It rather denotes a lack of ambition!”

Friends & other forms of support

I have the help I need.
I can't believe I'm writing those words, but I think it should be said. It won't last forever and there are some rough spots, but let's put this in perspective.
I can no longer wash dishes because I don't have a water heater and the touch of cold water has become utterly unbearable. I got back from my shower this afternoon to find the dishes washed -- and the galley & front step picked up, a wholly unlooked-for bonus.
My excellent friend R. was living on the smaller boat and helping me with the boat-fixing and laundry. He set up the sale of that boat (completed today) and is moving onto Voyager. He's taking my old cubbyhole in the quarterberth and (thanks to him moving the tools and lumber out) I'm finally moving into the forepeak -- that is, the room at the pointy end of the boat. For the first time in years, I have a bedroom door that closes.
After watching me constantly overestimate my capacities (which are constantly changing), he wisely introduced the Pinky Rule: if I'm not confident of being able to pick it up or handle it with just my pinky finger, I don't pick it up or handle it.
This doesn't render me the complete nonentity that pure helplessness does -- which helpful men are wont to suggest, with the best of intentions. (Yeah, I'll sit back and do nothing if you let me lop off yours before lopping off mine.)
But, like the Elbow Rule I gave kids who came into my ER with things stuck in their ears and noses ("only stick things in there if they're bigger than your elbow"), it has a certain brainless simplicity that's hard to argue with. It is turning out to be an excellent guideline. You'd be amazed at what I can lift with a pinky.
In the fullness of time, his busy life will carry him onwards. In the meantime, I have a wise and helpful friend who is making this chicane of my own life a whole lot smoother.
It's difficult, but strangely peaceful, to learn to share my life without the inherent drama or forced weight of romance. I'm honored to have the opportunity and I could never have imagined a better partner to learn this dance with.
I have to say, if there's one thing CRPS teaches, it's that Hollywood doesn't have the answers; real life is a lot more subtle and inflected.
There is more than one way to love someone. This one comes with clever solutions. Others come with passing kisses. Which would you choose -- really?
I could even learn to live with the bits of loose tobacco that find their way into everything. He rolls his own, and the stuff is more intrusive than stray tape. But we'll find a peaceful solution there, too. I'm absolutely sure of it.

Mind: more useful than you think

The power we have over our own minds is so often underestimated -- or misinterpreted. The "you're sick because you obviously don't think the right thoughts" frame of mind makes me livid -- it's inexcusable.
But mental & emotional discipline is absolutely key to my function and survival. I know every moment I take to notice enjoyment, my brain gets a shot of pain-reducing endorphins and decision-improving dopamine. Every time I grab my brain when it wants to go to pain-lashed catastrophizing, and stop and do a reality check and look for good things, I know I'm cutting the pro-inflammatory cycle and reducing a pain-spiking dose of cortisol.
It's bloody hard to remember to do at times, but practice makes perfect and I do get better the more I work at it.
... Speaking of neurotransmitters ...
I've been meaning to write a primer on brain chemistry and neurotransmitters. It's so convoluted I don't know where to start. I'm thinking of setting up the table (or 3-d matrix!) of chemicals, body parts & functions, then writing about one segment of that at a time. As my Mom says, cut large tasks into bite-sized pieces, then go after them one by one.

Leaping

I'm finally putting a book together for publication. I sent the first part out to readers for feedback, coasting that post-prep phase of being certain it's practically perfect and totally wonderful.
Unlike the delightfully daft P. G. Wodehouse, I only think my work is perfect for about half a day. Then, with no warning, everything changes: my heart hits my feet and I become certain that what I've just thrown out all naked and unprotected into the world, is nothing more than a puerile squall which will soon be riddled with well-deserved flaming arrows.
I'm eating too much sugar (for which I'll pay the price in pain, don't worry) and trying to settle down for a bit of brain-soothing meditation. Then a bit of light boatwork, maybe some laundry ... and then a couple of hours on the next part of the book. Because what I think of it doesn't matter.