I woke this morning and told myself that it's going to be different today, and so far so good. I turned the TV on for less than an hour, then turned it off. OK, to be totally truthful, it's still on, but it's not something that needs to be watched to appreciate: I have the TV tuned to one of the Sirius classical music stations (Symphony Hall, Sirius 80). I have DISH network, and as an added bonus when you're a DISH subscriber, you get most, if not all of the Sirius music stations. No call-in talk shows (thank God), no political shows (thank God), no news (thank God) and also none of the mindless drivel stations, like the Martha Stewart channel (Thank God). Don't get me wrong here, I'm a big fan of Martha, I love her work. She has given me more inspiration in how I cook and keep my home than any other popular icon of her ilk. I'm not sure if there really is anyone else in her league, with the breadth and depth of knowledge, and her many practical hints, tips and ideas that make it easier for one to make their home beautiful.
I also know her pimples: she is supposedly a horrid neighbor. I have a friend that grew up very close to her, this was when she was living on the CT shore, and Martha at that time was well-known to take flowers and other plants from her neighbor's gardens. But if somebody accidently turned up her private road (lost their direction), I'm told that she would come barreling out of her home, and come running down the road, cursing, waving her fists, just generally being a bitch. She is well-known to steal ideas from people and sell them as her own, no credit given to the originator of the idea. Allegedly, if she is out being Martha, sees something that she likes - good food, beautiful arts and/or crafts or household tips, for example, and she likes what she sees well enough, you may be invited on her show to share your ideas, otherwise know as your intellectual property. Thing is, when you do go on her show, you have to sign a release giving Martha carte blanche to use said intellectual property as her own: publishing it, sharing it through her media outlets, etc., and she can take claim for it being her idea. Many times when she has tried to pull this, the originator of the idea tells her nicely to go jump into a lake, only to get treated to a viewing of Bad Martha, the one that chases cars down Turkey Hill Road. The one that will bite off the head of anyone who is in her employ for the slightest infraction. She is the Anna Wintour of domestic arts, if you will.
So now as I lay here, with Devienne's Bassoon Quartet #1 playing in the background, I am actually writing. I finished a book this morning (Promised Land: Thirteen Books That Changed America by Jay Parini), and was going to start a Michael Pollan book, but as I plotted out my day, I decided to get up (check), take care of the dogs, cat and fish (check), do my daily morning meditation (check), then have a little breakfast and a mug of tea and start writing (check). But I guess I should backtrack and explain why I'm holed up in my bedroom, my right leg elevated on a mountain of pillows and my calf wrapped in a heating pad.
Maybe 3-4 weeks ago, I started getting all kinds of weird bruising, and it was all below my waist. Then I had this big area (maybe 10-12 cm) on my lateral left thigh, just above the knee that started out looking like a bruise, and hurt like one, but within a couple of days, it got hard, hot, and red. I thought I may have gotten an insect bite. I react very badly to spider bites - it is a big deal if I get one. I don't get an allergic reaction, but every time I've been bitten, I've gotten a major infection from it. After a couple of days, it the area got very hyper-pigmented, turning a dark brownish purple; a sort of aubergine, if you will. It was still slightly painful, but now, it's almost completely normal. My PA (Physician's Assistant) put me on some biggish gun antibiotics for 10 days, and I thought that was the end of it, sort of.
I continued in the intervening time to get a lot of bruising on both legs, attributing that to a low platelet count, and then, 3 days ago, what had happened to my left thigh started happening on my right calf, starting just a couple of cm above my ankle and circumventing my calf up about halfway to my knee. This didn't start out a bruise, it just went straight to red, hot and swollen, and by Wednesday evening, it was all I could do to hobble around the house. I started to get a lot of edema (swelling caused by a buildup of fluid under the skin), and that lower leg was noticeably bigger in circumference to my lower left leg, maybe by a half. I got a bit more concerned about this event than when it had happened on my left thigh, since everything was more localized with that event. This time, it was covering more surface area, circumventing my leg and creeping slowly up toward the knee. This was looking like classic cellulitis (a closed infection in skin - very difficult to treat), so I called the doctor's office before they closed and got an appointment for the next morning.. I elevated that leg on pillows all night and went to bed.
I woke up Thursday morning to find that elevating the leg had brought the swelling down appreciably, but the leg still looked bigger around than my left leg. It was also still very inflammed, hot as a torch, and painful to even the slightest touch. (I forgot to mention, the pain had also started on Wednesday evening, but I was chalking it up to being on my feet too much that day). That morning I got my butt on a BART train and headed into the City to see my PA. He looked at it, shook his head, and said it was a good thing I came in. I told him that he never needs to worry about that. Even though I'm an RN, I am not a know-it-all, and I know when I'm over my head. I don't screw around with something like that. Infections like this one can easily turn into sepsis (infection in the blood), pneumonia, amputation, some other catastrophic secondary infection, and at its worst, it can kill you.
Cellulitis by its nature is very difficult to treat since your skin is really not that vascular. Your body was wisely designed to dedicate most of the blood supply to your brain, heart and other vital organs. The skin is merely a protective shield, and so it doesn't neet as much blood supply. The bad part of that equation is that when you get a cellulitis, or a closed skin infection, it is far more difficult to treat than an infection in almost any internal organ. If it's an open wound infection it is much easier to treat. You can do a lot of aggressive wound care, put in drains, flush out the wound, etc. With a closed infection your're relying on a limited blood supply in a poorly perfused organ, and that in itself is why cellulitis is a big deal. Cellulitis is what turns into gangrene. That can happen in open wounds as well, but it's catastrophic in closed infections. What this means is that you have to use bigger-gun antibiotics, often more than one, put someone on bedrest and have them keep the affected limb elevated to drain the edema (skin pulled tight with edema is much harder to get a good blood supply to), and put a lot of heat on it. As much as you can take for as long as you can take it. This is counter intuitive at first glance maybe. With any musculoskeletal inflammatory process the conventional wisdom is ice, ice and more ice to keep the swelling down. With a closed infection what you're using the heat for is to increase blood supply. Your blood vessels will expand with heat - it's how they get rid of the excess heat, and bigger vessels mean more blood which means more oxygen, nutrients and antibiotics get to the infection site and work more quickly and efficiently.
Thus, the remainder of Thursday and most of the day today, I've been in bed, leg elevated on a tall mound of pillows with my calf wrapped in a heating pad. It looks like it's paying off; as I'm writing this now, at 9:20 pm on Friday, the leg already looks perhaps 50% better than it did Wednesday evening or yesterday (I say perhaps, since I'm really not that good at quanitfying things like that, it seems arbitrary and probably inaccurate. I would rather look at objective, easily quantifiable data: temperature of the affected area, change in size, amount of pain and the patient's general feeling of well-being. Yesterday, I felt like I had the flu: I was completely drained, no second wind to be found, lethargic, and aching all over. I knew this wasn't the flu. I've had enough serious bacterial infections to know how they affect the body as a whole. My assessment was shown to be accurate, since as my infected area has started to decrease in size, the skin decrease in temperature and pain and the skin color turning more normal (or transiently becoming hyper-pigmented, the aubergine I described with my other leg), that seemed to be the best indicator of healing. But the pigmentation likes to hang around like the houseguest who won't leave; reminding one of their infirmity and giving one something to obsess on. Though everything was on the mend, it was 2-3 weeks before the pigmentation went back to normal.
I am definitely on the mend though - I feel a lot better than I did on Wednesday. The affected area is shrinking in size and the edema is slightly improved, though still noticeably present. I'm still a bit gun shy about being on my feet for too long. Every time I do, within an hour, the swelling and pain are getting worse and the area starts to heat up, which is the most ominous sign. I fully expect that tomorrow I'll try to spend a bit more time bearing weight on the leg, but I'll do it judiciously and observantly. Bearing weight causes the most pain, enough that it's necessitated me having a cane on standby. It's kind of pathetic to see me hobbling around with a cane, but that cane also decreases discomfort greatly by allowing me to take weight-bearing duties off of that leg and distribute that load down through the cane.
You know, if this whole debacle of the last year has done anything good for me, it's that it has forced me to let go of my pride and allow myself to show my vulnerabilities and Achilles heels that the infirmities have inflicted on me. I've had to go out in public with a face mask when my white count was low and my immunity severely compromised. It's forced me to slow down to a snail's pace most of the time, something that I'm not used to. Even if I'm limited in my energy and strength, I can usually not show it. There have been times over the last year that it's been so bad that I couldn't cover up my weakness. Now, with the cane, yet another indignity has been forced upon me, and I'm forced to display some weakness, wear my own scarlet letter. I never considered myself a terribly proud person, but get your pride snatched from you, and you'll find out just how proud of a person you are. It's a great reality check.
As I'm reading back on my writing so far (I do my first edit while I'm writing, usually writing no more than three paragraphs ahead of copy that I've edited), I really like seeing that I've been able to let go of a lot of my hubris and show my vulnerabilities. That's new for me; I don't like to talk about my health with people, even people close to me. I've always tried to show as little vulnerability as possible, preferably none. I don't like a lot of attention on me. I duck the spotlight as much as possible, it's part of my social phobia.
This new state of affairs has not only kept my hubris in check, I've found that I'm actually able to deal psychologically with the entirety of the what this last year has thrown in my lap, and not just deal with it, deal with it in a way that makes me feel better about myself. Being able to keep my depression and negative thinking in check has had a great deal to do with my ability to navigate this experience and keep my wits about me. This revelation alone has been enough for me to extoll the merit of the experiences and not dwell on the unpleasant parts.
I don't know what this is all about, but the last three antibiotics that I've taken (cephalexin, Bactrim and doxycycline), have been leaving me with the nastiest taste in my mouth, kind of like my mouth is full of tarnished metal. I know it's the antibiotics, because when I finished the course of antibiotics with the first leg infection, within a couple of days, the bad taste was gone. Now that I'm back on them, deja vu, I'm right back in the bad taste zone. If the drugs themselves (like the HIV drugs and the Ribavirin) aren't enough of an appetite killer, a metallic-tasting mouth will finish the job toot sweet. Even here though, there is a big silver lining: I've been able to indulge myself in rich desserts and not care a whit about the calories. As long as the rest of what I eat is healthy and comprises a complete and balanced diet, I'm not worrying about enjoying a nice big gluttonous bowl of ice cream, or whatever sweet is striking my fancy. As long as desserts are not making up the lion's share of my diet, I'm not going to worry about a little extra fat and sugar from my gastronomical indulgances, and as long as I maintain meticulous oral hygiene, which for the most part I do, then I'll do any necessary self-absolution.
This anorexia against my choice has also really helped me in reprogramming back into my brain the common-sense approach that I used to have about my diet, rather than having my choices dictated by laziness or fad. Also, eating without paying attention to your eating behaviors is an invitation to gluttony and other bad choices. My basic philosophy of eating is as follows:
- Eat whole foods, not manufactured food-like products.
- All things in moderation, especially more empty-calorie foods. I don't have to deprive myself, I just need to check myself if I start going overboard.
- Eat only when you are hungry and stop when you are full (satiated, not gorged). For me, this means that I eat 5-6 times a day at least, but by the end of the day, I've still not taken in more calories than I've expended. When you are eating, pay attention to it, rather than just stuffing food in your face with a book in your other hand, or eating with the TV on. One of the activities can wait, you choose. Be present in the moment, savor the experience, and listen when your body tells you "enough".
- Eat and shop seasonally and locally. Farmer's markets, farm stands and local ranchers provide meat and plant foods that are far superior in taste and healthiness to anything found at a traditional supermarket. And stay away from places like Whole Foods, or as I like to call it, Whole Paycheck. Go in sometime and see how much locally-produced food you can find. It's really sad, and expensively so. It is very true, eating right is more expensive than eating chemically laden crap to survive, a lot more expensive, but that expense pays off over the long term, when you watch yourself age more slowly and gracefully than most of your contemporaries, and outlive most of them as well.
- Eat a variety of foods. Eat less meat and dairy and more plant-based foods. Meat and dairy have their place in a balanced diet, but they shouldn't capitalize it. Additionally, meat, especially beef, leaves a huge carbon footprint. Have you ever driven past a stockyard? Did you like the smell of the 5000 cows farting? Not only is the smell disgusting, but the methane gas that they expel contributes greatly to global warming.
I don't want to sound like a food evangelist, savior, authority figure or expert. These are the very people that have sent the proverbial car down the road with a brick on the gas pedal and nobody in the driver's seat. It's why we're a nation of obese, overfed and undernourished nutritional no-nothings. As in so many other facets of modern Amercan society, ignorance is glamorized. We've become a nation that is the sanctuary for no-nothings, and we're proud of it - that's the only way that I can rationalize the appeal of George Bush, Sarah Palin, Glen Beck, Rush Limbaugh and Bill O'Reilly. The NASCARs and the teabaggers and all the other members of the NeoCon-loving freak show like them because they don't feel intellectually intimidated by them. Well, that, and there is always the lunatic fringe law of attraction: Shrill seems to beget and attract shrill. Screaming is a lot easier than thinking for yourself or reading a book. Gore Vidal once called our nation The United States of Amnesia, and I can think of no better representation of the truth to that supposition than the above-mentioned members of The Angry Mob. Back in the early 1960's Richard Nixon called the predecessors to these freaks of today "The Great Silent Majority". Oh my God, what I wouldn't give to have these Fox News-loving, "Obama is Hitler"-screaming baboons shut up. Nice thought, but it won't happen. When you're intellectually stunted, yelling and self-righteous indignation are about all you have as a voice. Well, that and your guns.
Lest you think I'm totally partisan here, my own lovely Democratic party has it's share of shrill no-nothings, though certainly in a ratio far below that of the right. If you were to ask me what the biggest problem is with my party, I'll say that there are two that immediately come to mind: 1) Hubris. The perfect illustration of this is the recent Massachusetts Senate race to fill Ted Kennedy's seat, a seat that a liberal/progressive Democrat held for over 50 years. That election should have never been lost to a Republican, unless the Democratic candidate was a puppy-kicking, Mom-hating pedophile; and 2) Inability to play nicely and share their toys. When these bozos up on The Hill can't even keep their own party members together, united and committed to cooperating with each other to get health care reform passed, then what are the chances that they can answer with an authoritative, resounding and unified voice when they're dealing with the party of "no"?
I really can't honestly label the American democracy experiment as staying faithful to the importance of a two (or more) party system of governance. We are now a one party society, with nut jobs at both ends of the spectrum. If you think that Barack Obama is a progressive Democrat, then let me give you a reality check: He is far more akin to the pre-God Squad Republican party, the party of fiscal conservatism wed to social progressiveness that died about the time that Watergate happened. That is much closer to his politics than the old New Deal Democratic party is, a party which was both socially and fiscally progressive. It was the party of the WPA, Medicare, Head Start and AFDC, all admirable additions to American society, and all socialist programs.
Head Start helped make sure that young children were getting more nourishing food to feed a rapidly developing brain. AFDC makes sure that families with babies and toddlers who are living at, near or below the poverty line at least get some of the basic foodstuffs needed to give a child a fighting chance for his future to be successful. Medicare is the one thing that our country has gotten right in dealing with health care. Ask any senior citizen if they are willing to give up Medicare, even though it is a socialistic program. If they say yes, they are either stinking rich or lying. Even the ridiculously wealthy seniors use and like their Medicare.
OK, I'm not really sure how I got here. I started with confinement to bed, then I visited Martha Stewart. After that it was on to cellulitis, followed by anorexia, then food choices and now I've landed in the land of "How Do You Fix a Broken Democracy?" I'm not going to try to explain myself or rationalize my writing style, other than to say it's tangential and often a victim to a writer prone to ranting; one with a tenuous grasp of many of the basic principles of correct writing style. It's all probably true in one way or another, but you have to admit: agree or disagree with me, love me or hate me, I still make you think, and think more in the tradition Socratic learning, less on the spoon-feeding "facts" method of learning that is so popular now. If you want to get spoon-fed your beliefs, go to church or watch Fox News and believe that their journalism is credible. I'm not anti-religion; anyone who knows me knows that is about as far from the truth as it could possibly be, but I am not impressed by any religion (or cult, to be more accurate) that asks for your unwavering faith, ability to suspend belief even when what you are being told seems ludicrous and/or any belief system where one authority figure is the repository of all the knowledge and doctrinal authority, and has a direct phone line to God to boot (hello Pope Benedict).
We want our future leaders to have a basic grasp of the 3 R's, but don't stop there and forget to teach critical thinking skills and instilling a desire to question convention. This has been my experience in talking with high school and college aged kids (or young adults, if you're bristling at me calling them kids): The public education system today is far less concerned with teaching your children how to think than it is concerned with controlling an overcrowded classroom full of poorly mannered and hormone-driven teenagers. While all this is going on, our teachers are managing (barely) to cram enough facts in their skulls so that the children they are responsible for teaching can pass a competency exam and move onto the next grade. Nowadays, it seems quite ordinary to hold kids back. When I was a kid, I can remember one, maybe two kids being held back a grade in my classrooms, and this was over a 12 year span of living and learning by the old-fashioned, public school education system, one where you were expected to care enough to at least learn enough to graduate up to the next grade, and that was the bare minimum expectation. My teachers always expected me and my classmates to excel, not to pass. Being held back was embarrassing beyond measure, and a student would either avoid it, or in rare cases, drop out of school. Yes, we did have dropouts back then, but even the dropouts at least tended to have a better reason for dropping out than just saying "I didn't like it so I quit". Look at it this way: I'm kicking it old-school with my way of looking at and navigating modern society. Even though I'm all over the place, pretty much all of the time, there still is a thread that connects every part of my philosopy, no matter how frayed or tenuous that thread might be.
And with that, there's really only one thing I can say that will tie all of this together: Think for yourself. Don't be a sheep, stand up for yourself. Stick to your convictions, but also never stop questioning them. Be in tune with and follow your moral compass; never compromise on your guiding principles. To me, this is the beauty of incorporating a philosophy into your life: There is no right answer, only a lot of questions, and if you're being a good member of society, you're both asking and thinking about the big questions. Don't stop doing that, please.
Doggydad's Life Now: The Viral Monologues by Parry Tallmadge is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Based on a work at doggydad.blogspot.com.
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