PAIN vs. PALLIATION

Due to omnifarious reasons, mostly inflammatory arthritis from my lupus, my right hand was operated on 4 moths ago.  The surgery entailed a joint reconstruction of basal thumb, a trigger finder, a pinched nerve and carpal tunnel repair.  There are four incisions.  It was not heroism to have my right hand cut.  It was of dire functions and survival.  And it was brutal--the pain.  And I am no slouch.

I was determined to be my own physical therapist, occupational therapist and rehabilitation officer afterwards.  With a soft cast covering the right thumb and wrist, I performed on the piano 9 days after surgery, with 9 fingers.  It was borderline insanity and stupidity.   Yet, through the misery, I am recovering from the savaging knives.  Nonetheless, the overall arthritis of the hands, fingers, and other major and minor joints is unrelenting. 

Audiences cannot tell the difference in my piano/organ playing.  I can.  My hands and fingers feel differently: more tightness, tension and less spontaneity. 

I have long accepted a life of malady.  With it comes the misery of sensory communications of what is wrong--pain.  It is my body's way of letting me know something is terribly amiss.  I accepted that fate long ago.  There is no mercy.  Only surrender.  

I was once asked about chronic pain.  I replied, "I don't remember not having pain, ever."

I liken the protracted monster to a bad car engine.  When a car starts swiftly, runs smoothly, accelerates spontaneously and has no hesitations, no one ever thinks about the engine until one hears a noise.  Pain is noisy.  Yet one often gets accustomed to it helplessly. As for myself, I have been on a physical de-sensitization course for decades.  

Once I was caught in a tender moment of vulnerability, I was told that I was crying in my sleep--I had no recollection of that.  Obviously my subconscious sighs and grieves for me.  My lupus, though does not define me, is my chassis.  I accept the challenges, the limitations, the throes, and the knowledge that harsh medicines including chemotherapy will remain my life-long companions.  These companions steal my wares whenever they want.  I will then have to live without.

A recent reunion with a childhood friend gave me a taste of a better presence.  She practices Qigong and acupressure.  There was a bit of respite after her offering.  I am once afresh to take charge of my pain management as I had almost given up.  I have choices: PT, heat, massage, ultra-sound, gentle exercise, reflexology and acupressure.

A paraffin bath will arrive next week for my hands and feet.  Massage therapy will be explored.  I might even learn Tai Chi.

With fervency, I decided to wage an encore bet with my pain.  When offense is not attainable; defense ain't so bad. 

The game is on.  Hope and strategy--in high gear.

Ceramic Hips and May’s Bucket List In Progress

Today is January 2^nd, 2014.  My loyal, extremely hard working, and assiduous second pair hip prostheses for the last 16 years, has spoken in the most utterly deafening mode.  They have made it crystal clear to me that they want nothing more to do with me.  They have clicked, creaked, crackled, and clamored for my immediate as well as 24/7 attention.  At times, the pain, yes, the pain, calls for my surrender.  They want out.  And I want them out!

As I am sitting in the car in the parking lot at Bridal Veil Falls, Yosemite, I ponder, as well as pontificate on the inevitability of surgery and subsequent recovery of my third pair of artificial hips.  I am surrounded by the magic of this gobsmacking glacier and stately rock compositions.  Images of enjoying a somewhat pain-free existence: hiking among the woods on snowy/icing trails (plenty of snow and ice here today) and surveying and partaking such massive, serene and majestic granite landscape, dance in my head.  All of a sudden, every trail beckons my humanity.  What angst!  What longing!  It will be a rebirth to raise a step quietly, confidently, and comfortably again in 2014.

There is hope that my lupus flare might stabilize and the operation can take place in 2014 or, later, whenever I stabilize.  Total hip replacements are brutal—ask any orthpod.  And revisions are beyond brutal, something more ghastly than gross—both in difficulty for the surgeon and roughness for the patient.  It is more gory than road kill.  Replacing the femur head/shaft and the acetabulum in hip revisions is Craftsman Tools time, friends…  Details not need to be shared. 

Recovery and rehabilitation will be lengthier, I suspect, after all, this will be the 4^th time my hips will be opened up, hacked on, invaded upon, replaced and screwed together again.  Long racing stripes (scars) will be reutilized and reopened.  Many medical and technological improvements have been discovered and brought to practice since my last pair.  Many of them are much kinder and more patient-friendly.  I expect ceramic, but I will stay open, as I may not be the right candidate for ceramic.  It will take 6 months to a year after surgery before I get fully accustomed to and be comfortable in walking distances again.  O how I have missed my walks!

Retreat in nature births renewal of spirit.  Magnificent quietude offers laser-sharp clarity.  Contemplation becomes default rather than deliberation.  The faintest Bucket List crawls into my psyche.  I am in awe of the power of my desires.

Where:

1.  Mount Whitney—I must come and climb you again.  A deep sense of remorse and guilt I had felt in hiking you last time, also my first time.  I failed to respect you.  I failed to train.  I failed to have fun.  I failed in every aspect.  This time, I will train and I will breathe into the grandeur of your essence.  I will treasure each step instead of tread.

2. Australia/New Zealand—It is time.  That’s all.

3. Nashville, Tennessee—Soak up the music, May.

4. The Silk Route and then some—Nepal, Bhutan, Xizhuang, Miramar & more China

5. South Pacific Islands/Southeast Asia—Teach piano, voice, Chinese and English abroad

What:

1.  Start or rejoin a chamber music ensemble—the “high” from playing and performing a Brahms’ piano quartet (and other literature like it) is life changing and life lifting.  Endorphins flow for days, months and years.  And that’s a good thing!

2.  Purge my wardrobe—I have finally exhausted myself to no end by evaluating the good and the bad of never out-growing and out-wearing my clothes for the past 40 years.  Geez, they all still fit!!  Guess what?  I still wear them!  Sorry, I need to catch up with clothes of today.  It is not about fashion.  It is about my “habitual” and “unintentional” dressing.  I must tend to this life detail with more forethought, and possibly, more passion, more diligence.

3.  Simplify/reduce my “stuff”.  As a dear friend once said to me, “May, we think we own our stuff; but ultimately it is the stuff that owns us.”

4.  Study Chinese herbal medicine—go back to school, likely.

This list is a living, breathing one.  I may not accomplish any in 2014.  I will tweak.  No Desperation.  No need.

It is a good beginning. 

In this very moment, pain does no occupying—just at this moment.

The difference between hope and anticipation is that anticipation is active and the former is passive.  Hope is in one’s trusted longing whereas anticipation is in one’s act of obtaining and discovering.

So, I await.  I anticipate.