Humbling invitation

I’ve been invited to ride in the funeral cortége of the man I helped code last week. It’s a semi-public occasion, as he was a semi-public figure (which is why I’ve been cagey about details), so “yes” is not as simple as it sounds.

I seek public exposure the way other people seek whooping cough — every now and then, it hits, but fortunately, it’s rare, and generally causes no lasting damage.

I was silly enough to mention that I have a sub-par central nervous system to the extremely kindly person arranging the event — who was also my CPR partner at about this time last week. He nearly withdrew the offer on the spot, possibly raw over the possibility of another medical event.

It’s a bit strange to have someone else worrying more about my body’s reactions than I do. Kind of refreshing… but definitely strange. This disability has been so invisible for so long — a fact assisted by the sturdy stoicism so many of us live by — that I simply have no idea how to handle someone else’s concern.

To mitigate any need for worry on anyone’s part, I’m preparing for CNS stress on Monday. Here’s how…

I have found, absolutely consistently, that the key to preparing for extra events is all about berries and vegetables. All the vitamins in the world — which I think I’ve tried — can’t do quite as much good as half a bucketful of organic greens and half a basket of good berries per day. I just had a big farmer’s-market-fresh salad; I’ll have kale for dinner, and there’s steamed summer squash awaiting the next moment when I can handle a few bites. Wild blackberries are set for breakfast.

I’ll boost my multivitamins and antioxidants only slightly, since I already take about as much as my body can absorb. I’ll keep lemon balm (for pain flares and dysautonomia) and yerba santa (for nausea and nerviness) in my pockets.

I’ll do extra brain-training, which I’ll talk more about one day, but it’s basically about learning how to calm the central nervous system by sheer will. And t’ai chi. Lots of t’ai chi. Mental practice, if not much physical. I see a couple of Epsom baths in my future, stocking my system up on magnesium and sulphur to buffer this body a bit.

Funerals are for the living, though we think so hard about what the deceased would appreciate. I’m not sure why that works, but it does.

The peacocks left us a glorious side-feather.

peacock_sidefeather

It might come with me. It might not come back. I’ll see what it feels like the deceased would appreciate.

Move slowly, stay happy… except when pushing one and a half to two inches straight down on the lower half of the sternum

We went to a great farmer’s market, where J got me a ceviche tostada that had to be tasted to be believed. I got a flat of outstanding organic peaches to dry for the winter. All this is much easier said than done, because today, for some reason, is pretty harsh as pain days go.

J wanted to know, in his brusque-backwards way, what I intend to do about it.

I replied that I’d probably trim his hair, then lie down for a bit, then watch a silly show, then come help with the wood — which means, bringing cold drinks and looking on admiringly.

I said, “Managing pain days is basically a matter of, move slowly and stay happy — to the extent that that’s possible.”

He liked that. He added jovially, “Used to be more like, move quick so I can get away from people — then I could stay happy,” he said, veteran of a socially hideous region.

We both laughed.

matchgrins-horsenwoman_decamps-pauline_4blog

Moments later, we saw people beside the road, one lying down. I saw CPR.

CPR

I barked, “Pull over NOW!” J knows my voice, and he’d never heard that tone before. He did. Instantly.

A first responder was doing chest compressions, and getting tired. CPR is incredibly hard work; if Mr. Universe did CPR, he’d tire even quicker.

I got down and planted my less-injured hand on the responder’s stacked palms and between us, we made a strong enough compression to create a pulse in the patient’s leg. This is what you want to do: create an artificial pulse, to sustain the vital organs until the heart itself can be restarted.

The runner had felt chest pains 5 minutes before, according to his workout partner. Then he went over. Just like that.

I won’t go into messy details, but by the time the helicopter was landing and I’d brushed myself off to come home again, I was aware of how strange it was to do this outside the ER, to snap into lifesaving mode from a standing start, and to find myself — without the mental shield of my work-badge and trusty stethoscope — turning away from a still-blue figure and not knowing if he’d make it.

J said of the man behind us, in his elliptical way, “He didn’t look like a jerk.”

I said quietly, “No. He had a really nice face.”

I’m sure he had good medical care. He worked out to keep fit, and had the muscle tone to show for it. He had a bit of chest pain 5 minutes before, then keeled over.

It’s not fair.

I took my clothes off carefully, keeping the dirt off me and turning them inside-out before dropping them in the laundry. I washed my hands and arms to above the elbows. I used to do that on coming home from work, every time. But I’m not able to work, and those weren’t scrubs.

I have some additional prayers to make now, and a body of my own to manage.

I have to move slowly, and stay happy, to the extent that that’s possible. There’s nothing else that could possibly help, because I’m no longer in the ER. I’m a 13-year veteran of the worst pain disease known to medicine, and I helped do CPR today.

I wrote this in the hope of coming to some conclusion that would make it easier to move on from this shell-shocked state of mental mumbling. I haven’t, yet… but let me add one thing.

This man had every chance, once he went down. CPR was started within a minute. The ambulance arrived within 5. He should be getting definitive care within 15 or 20 minutes of hitting the dirt. This is how it’s supposed to go.

In honor of this man who was given every chance, and in honor of my father who never had any, please learn CPR.

Even if your bones are too frail, as mine are, you can still provide the extra push that’s needed.

Even if you can’t risk infection from someone else’s fluids, you can still check for a pulse while others do the dirty work.

Even if all you can do is puff your chair a little closer, you can still direct the able-bodied, because it really helps to have a cool head looking over the whole scene.

Please learn CPR. You’d be amazed at what you can do with it. Those of us with disabilities get too much of the message that boils down to “can’t”, but when it comes to working to save a life, if you know the protocol and what to look for well enough, then there’s usually a “can” that you can go for.

I gave the police my name and number, and I hope to find out if our guy made it. (NB: Details were changed to protect his privacy… but I’m sure prayers and meditations and good thoughts will get through just the same.) I’ll post a comment to let you know.

In the meantime, here are a few links.

My ANS is going to be vibrating for awhile. I’ll start with lemon balm and see what else I can remember to do.

T’ai chi and emotional pain

When I’m out in the world, my reflex is to shove grief into a bundle and push it aside, and try to act as if I don’t feel it.

It’s always surprising how much energy that actually takes. When I’m doing anything else that takes much effort, it’s nearly impossible. It makes me forgetful and clumsy, just like a pain flare.

When I was at t’ai chi class yesterday, shoving and pushing one way with my mind while I was shoving and pushing another way with my body was so exhausting that I was wringing wet with sweat. Then I remembered something I’d tried briefly before, and decided to try it for the rest of the class.

I mentally drew the grief into my whole body. The grief turned to sadness and stretched out into every muscle fiber, every moving part. And I did t’ai chi with a body that was swarming with sadness.

It was, above all, peaceful.

I certainly wasn’t as tired. The sweat vanished as if by magic. I don’t even remember it drying on me.

The important thing is, I wasn’t expressing sadness in any deliberate way. I didn’t move more slowly, or try for any effect. I moved more deliberately and with better focus, because I was integrated. My body was filled with sadness, and I moved that body through the t’ai chi form.

The point of t’ai chi is to clear things up, straighten out what needs straightening, and separate muddled body parts and muddled energies into their proper alignments. Therefore, the sadness got a heck of a massage, and by the end of class, it was like it had been processed into something more wholesome. There wasn’t nearly as much sadness, as such. There was a lot more peace. There was a sense of strength I can’t put a name to.

I must add, as a footnote, that it’s been a long time since my feelings were capable of unshadowed joy. I have learned to cultivate a certain shallowness of mind at times, so I can be insulated from the deeps and be simply happy in the moment.

Therefore, when I say that I was happy as I left class, understand that it was a deep happiness. The shadows were very much a part of it, but that was fine. They were in the right place.

My guts are gallivanting

The past few weeks have been… interesting.

me_wrysmile
Oh, dear.

I seem to have gastroparesis, because after every bite or two of food, I felt like I’d swallowed a cannonball, I’d still taste it up to five hours later, and even the thought of food made me nauseous.

At the same time, I seem to have wasting syndrome, because the other end of my GI system was working double-time and overtime. I was exploding on the toilet long after there was anything to explode with, whether I had eaten or not.

Toilet stall with graffiti covered with brown, yes, brown paint
It’s not what it looks like…

The weight loss has been a boon to my knees and hips, but the ground-in weakness is annoying.

The usual treatment is a “low-residue” diet, a shameful pile of poor nutrition and monotonous eating, consisting largely of things that I’m allergic or sensitive to — and steamed vegetables, which I can usually eat by the plateful, but can now barely manage a bite of, they’re so heavy with water.

I thought it over.

The Thinker, Auguste Rodin
Rodin’s “The Thinker”, looking very apt.

Both gastroparesis and diarrhea indicate an intestinal lining that is starving for antioxidants, and probably inflamed. Therefore, anything I eat is going to have to have antioxidants, because that is first-line treatment for tissues starved for antioxidants. Many antioxidant-rich foods are anti-inflammatory, so it’s useful for me to lean towards those.

The sluggish-to-trudging pace of intestinal motion, or peristalsis, is liable to under-stimulate the release of digestive juices, so anything I eat had better be easy to digest — or, better still, partly digested already.

Since I could only eat one or two bites at a time (and still feel rather ghastly afterwards), every single bite — in terms of both nutrition and flavor — had darn well better be worth the trouble of eating it!

Woman with eyes closed about to bite a cherry
Fabulous cherry by Jiri Ruzek.

I’ve been interested in good food since forever. My mother has been an outstanding cook all my life, and time spent helping in the kitchen was never wasted. She’s always been good at shoehorning a bit of extra nutrition into something in a way that improves the flavor. Dad would eat anything, so failed experiments were never wasted.

Because of my upbringing (traveling widely with a good cook on one side and a walking disposer on the other) I’m a fearless cook and a promiscuous eater, happy to try anything from anywhere, as long as it’s good in both senses of the word.

Earth with Place Setting. Photo of formal place setting from Hopefulromntic, images of Earth and Moon from NASA
Photo of formal place setting from Hopefulromntic, images of Earth and Moon from NASA.

On my sudden return from abroad in 2006, terribly weak, badly sick with CRPS, and having my heart broken in umpteen pieces by the most traumatic, trouble-ridden, devastating trip of my entire life, I found sanctuary with my friend L and her family. It took ten days even to notice which end was up, but then L said, as I snacked on something homemade from a jar, “It’s normal to eat a lot of raw food when your system has been deprived for so long. Give it another week and your appetite will get more normal.”

I considered being embarrassed, but I was too busy absorbing the impact of what she had said. I had heard her talking about “raw food” since I’d arrived, and I understood it meant cold-processed food that was carefully jacked to boost its nutritional value and digestibility.

I didn’t realize I was devouring it on an industrial scale.

backhoe, by Antti Leppänen
Veggie-loving backhoe by Antti Leppänen.

Knowing what I know now about the devastation at the cellular level that this disease can wreak — and the depth of disruption that even occasional trauma can cause, let alone a relentless, months-long parade of traumas — I’m not surprised. At the time, I found my attention sinking deeper and deeper into my body, and noticing a curiously profound ravenousness that only L’s un-cooking seemed to satisfy.

It actually took four and a half weeks… of grated beets lightly marinated in balsamic vinegar; young spinach dressed with fresh lemon juice and flax oil; pepitas dried with tamari and spices; crispy sesame-kale flakes; yogurt made from sprouted cashews; homemade nut milk; juice from apples picked an hour before they met their fate; tomato-leather from the garden’s surplus, stowed in the deep-freezer to make tomato paste and soup base in the winter. It was a feast of discoveries, or a discovery of feasts.

feast of beautiful food, most of it raw
Beautiful feast photo by Incase.

At that point, L asked if I’d mind kicking into the grocery budget. (I turned bright red, smacked my foggy forehead, and started taking my turn at the grocery store.) I did my feeble best, but I’ll never be able to pay back the real value of what they gave me, in terms of sustenance for the body, balance for the mind, and stability for the soul. L let me know when she had had enough of gratitude, so at this point, I just do my best to pass it on.

I recently replaced my blender, as the old one was blowing smoke, and I got a dehydrator too. In light of my nutritional status, I put them to use.

Here’s an example of the sippy-cup-sized shakes that I make in the blender…

Blender cup with ingredients for small, mostly raw, shake next to it.
My mini-shake makings, with an aperitif of bitters to get my gut to gear up.

… and the partially re-created flax-cracker recipe we’d invented all those years ago — the ones that smell like hot-dogs and taste like junk-food, and have more minerals and omega-3s than you could shake a Triscuit at. Mine aren’t quite hot-doggy yet (I used a lot of sesame), but they are, wow, really good just the same. Especially with a touch of grassfed butter, when they’re out of this world.

food_myflaxcrackers
Homemade flax-sesame cracker, with grassfed butter. Mmmmmm.

It has been almost 3 weeks, and I can finally eat a small meal once a day without significant repercussions. Also, I can be more than an hour from a toilet without fearing for my trousers.

I’m so far successfully denying the fact that the endocrine shenanigans of this disease have made it so that I can’t drop this excess weight unless I’m literally starving. I don’t think I’ve gotten above 1,000 calories per day more than 3 times since this started.

I’ll think about that later. Right now I have a sliver of raw goat-milk cheddar and a sprouted sesame-flax cracker waiting for me.

baby goats under their dam. One goat looking at us, one nursing.
Cute kids from Fir0002.

Define “invasive”

I was a Registered Nurse for 8 years — in one of the first HIV specialist units in the country, in the only public ER of one of the murder capitals of the US, in cardiac telemetry, in home care. It was a good, demanding, well-rounded career, if a bit short for my taste.

I’ve often wanted to re-educate my nursing self in light of my experience as a patient.
me-tongue-out
Here’s one of the most outstanding, outrageous lies we tell ourselves as clinicians: medications are not invasive.

That statement bears no resemblance to the reality of those being treated. It relates entirely and exclusively to the clinician’s experience. The clinician’s unstated assumption is, “I’m not hanging onto the thing that’s getting under your skin; therefore, what I’m doing is not invasive.”

News flash: Treatment is not about the clinician. It’s about the person being treated.
me_wrysmile
Medications get taken into the whole body, not just the ill part. Injections go right past the first barrier against infection and assault, the skin. Oral medications go through the mouth, descend into the stomach, and there meet the second barrier to infection and assault, the GI system… which they either aren’t bothered by, or can resist.

They’re then taken up by the blood, which goes everywhere.
circulation-allbody-Anna_Fischer-Dückelmann_1856–1917
They are all processed in the liver (it’s called “phosphorylation” and, privately, I suspect that’s why we tend to have trouble with phosphorus issues when we’re on lots of meds.) This is why too many meds for too long can lead, or contribute, to liver failure.

What goes through the liver goes through the spleen and kidneys, because that’s how it works. This is why some drugs can cause kidney damage.

What hangs out in the blood can, all too often, hang out in the brain. This is why some medications for organ issues or even a simple infection can cause deafness.

Blood circulation exchanges fluids with lymphatic circulation. Blood and lymph communicate with the central nervous system via the blood/brain barrier and the sheath around the spinal cord. The blood/brain barrier provides partial, rather temperamental protection, but it can be suborned by anything that makes the tissues fragile — fever, illness, injury… and some kinds of medication.

What is in the blood goes everywhere.
circulation-allbody-Anna_Fischer-Dückelmann_1856–1917
How is that not invasive?

I’m watching my partner fading with weakness after only a week on a couple of cardiac meds. I’m certain his heart has not gotten worse in a measly 7 days. The only thing that has changed is that he is seeing doctors and taking medication — for nearly the first time in his life. (“No side effects,” my left foot.)

How much of that weariness is stress, how much of it is the past couple of years catching up with him, how much of it is heart disease (actually, that part is pretty clear) and how much of it is medications? Each of these things has some part in it, there’s no question, but drawing the line between them is more than I can really do. I know the meds are part of it, but how much?

Medications are intimately, unavoidably invasive. There is no completely safe dose, and there is nothing that helps you for free.

Everything — meds, interventions, surgeries — EVERYTHING has side effects. There is no single thing you can do to your body, or allow others to do, that doesn’t affect every part of you in some way.

My years as a CRPSer, where the consequences of every change are so exaggerated, makes this pitilessly clear to me.

Given that there is no free ride, we have to look at the tradeoffs. Knowing that there are issues with absolutely everything, however “natural” or “close to our bodies’ own chemicals” it may be, we have to balance that against whatever benefits it may have.

Herbs are included, by the way. My increased sun sensitivity (which my disease causes a bit of anyway) and impairment of birth control (which I don’t take — what, mess with these chaotic hormones?) are side effects I shoulder with my eyes open, so that I can have the neurotransmitter support of the St. John’s wort herb I take twice a day.
St._Johns-wort_(Hypericum_tetrapetalum)_(6316227601)
I review all my medications twice a year at least, to see how I can tread the narrow path between optimum benefit and minimal confusion. Doing this from a chronically slightly confused state is, naturally, a whole different kind of fun. Working out which part of the daffiness is disease and which part is meds and supplements is really my most important task.

My partner has to choose between cautiously building back up some heart strength and circulation — and meanwhile have a life that is a small fraction of what he used to have for energy and activity, unless and until the medications and rehab really work; or risking the total loss of death by having a surgery which would leave him in pain and in rehab for awhile — but, afterwards, bring him back a lot closer to his normal, with many good years ahead.

Wait and see and work and hope, or take a leap and — if you live — work and probably win?

In a way, I envy him. If there were a procedure to do a bypass graft to eliminate CRPS, I’d be in the OR already. I’ve had enough of a twilit life, of exhaustion and fog. I want to get back into the full sun.

I miss running, too.

But it’s his heart, not mine. I do my best to explain things, listen carefully so as not to run over his real thoughts, and grab hold of my anxiety with both hands, so that any decision made is truly his. As it has to be.

Until then, he has to peer through the fog and work through the weariness of these “non-invasive” medications, to make his choices and his appointments. I’m just there to help — and to make sure he’s taken seriously, which is a real drawback to looking as fit as he does.
J-playing-on-treadmill
But that issue is another post…

Just like Hemingway (no, really)

I read, years ago, something from Ernest Hemingway about his process. (I can’t wait to see which of my literary friends will be able to tell me where he wrote this.)

He took off, for months or years at a time, to live. In his terms, that meant running with the bulls, or falling down mountains, or shaking his sweat off into the sea. He had what most of us would call adventures, big hairy spans of eventfulness, in which he’d get immersed past the reach of words, and soak up sheer experience.
boat-bittenbycrocodile
He said, mindfully, that it took weeks or months to regain his command of his wordcraft, but if he didn’t take the time out from writing in order to take time to live, there would be nothing to write about.

Needless to say, I’m envious that he had the choice. Lucky swine.

It’s safe to say that I’ve been living — if not in Hemingway’s terms, then certainly in my own — occasionally even past the reach of words, or at least past the desire to use them.
me-fingers-2up
Some experiences are beyond words, but not beyond gestures.

Some things are a lot more entertaining in retrospect, and if it takes a few weeks or a few months to be able to write about them in the way I want to, well, the time will pass anyway.

Meanwhile, we are working simultaneously on getting me back my brain and getting darling J back his heart. Both are turning out to be a bit trickier than we’d thought.
sketc h of excessively happy doctor running with a hypodermic needle

I’m sorry, Dave. I’m afraid I can’t do that.

Interesting metaphor for this, um, ratfink disease.

Interviewer:
HAL, you have an enormous responsibility on this mission, in many ways perhaps the greatest responsibility of any single mission element. You’re the brain and central nervous system of the ship…

Poole:
Unfortunately, that sounds a little like famous last words.

I had the pleasure of explaining CRPS to a doctor who isn’t mine, who really wanted to understand. After listening to me for 15 minutes nonstop, he summarized it perfectly.

He said, “It’s a bit like HAL, in 2001.”

I asked if I could borrow that.

I’ve culled movie quotes off the web and my CRPS compatriots can say how breathtakingly parallel they are. In no particular order:

Dr. Frank Poole:
… That would pretty well wrap it up as far as HAL was concerned, wouldn’t it?
Dave Bowman:
Well, we’d be in very serious trouble.
Frank Poole:
We would, wouldn’t we. What the hell could we do?
Dave Bowman: [sigh]
Well, we wouldn’t have too many alternatives.
Frank Poole:
I don’t think we’d have any alternatives. There isn’t a single aspect of ship operations that isn’t under his control.

And that, ladies and gentlemen, is the central nervous system in a nutshell.

Dave Bowman:
All right, HAL; I’ll go in through the emergency airlock.
HAL:
Without your space helmet, Dave, you’re going to find that rather difficult.
Dave Bowman:
HAL, I won’t argue with you any more! Open the doors!
HAL:
Dave, this conversation can serve no purpose anymore. Goodbye.

We’ve all had that happen!

HAL:
Just what do you think you’re doing, Dave?

Um, trying to survive?

[Regarding an apparent problem which HAL itself falsified]
HAL:
It can only be attributable to human error.

Swine. YOU did this, CRPS!

HAL:
I know I’ve made some very poor decisions recently, but I can give you my complete assurance that my work will be back to normal. I’ve still got the greatest enthusiasm and confidence in the mission. And I want to help you.

This reminds me of the “you have CRPS because you think wrong” school of thought. Right… thanks for the help… next time, suck the oxygen out of my atmosphere; that’d be a real help.

Dave Bowman:
Hello, HAL. Do you read me, HAL?
HAL:
Affirmative, Dave. I read you.
Dave Bowman:
Open the pod bay doors, HAL.
HAL:
I’m sorry, Dave. I’m afraid I can’t do that.

Because sometimes this system seems to get input, but it just won’t generate any output.

On providers trying to assess from outside:

Mission Controller:
X-ray delta one, this is Mission Control. Roger your two-zero-one-three. Sorry you fellows are having a bit of trouble. We are reviewing telemetric information in our mission simulator and will advise.

On trying different treatments:

Dr. Frank Poole:
Let’s see, king… anyway, Queen takes Pawn. Okay.
HAL:
Bishop takes Knight’s Pawn.
Frank Poole:
Huh, lousy move. Um, Rook to King 1.
HAL:
I’m sorry, Frank, I think you missed it. Queen to Bishop 3, Bishop takes Queen, Knight takes Bishop. Mate.
Frank Poole:
Huh. Yeah, it looks like you’re right. I resign.
HAL:
Thank you for a very enjoyable game.
Frank Poole:
Yeah, thank you.

Yeah, thank you. Sooooooo much.
me-fingers-2up

This movie says everything you need to know about what it takes to deal with this disease:

  • It’s hard. Breathtakingly hard.
  • We don’t really know where it came from, and we really don’t understand why.
  • It’s crazy, and it does its best to make us crazy — and those around us.
  • It takes away more than we knew we had to lose.
  • We have to out-think it, even though it seems to stay 3 steps ahead of us.
  • Persistence — unvarnished, absolute, bloody-minded persistence — is key. Even when you feel you can’t, take a breath and make the next move. Keep working.
  • It seems impossible. It’s a harrowing thing to face, and has killed so many of us, in different ways.
  • It sabotages our efforts to improve things.
  • It’s worse than we could have imagined.

It really is like HAL.

So … Let’s remember who won.

Now a bit of Youtube for dessert, and a hopeful image for all in search of remission. Let’s pop those modules, one by one.

Acute pain, chronic brain, and naming this ratfink disease

Complex Regional Pain Syndrome is the latest in a long line of names for this disease. Some of the older names have been recast to cover aspects of it, or versions of it, or special cases, and of course there are overpaid people who argue about it intensely. I’m going to go out on a limb and list a few sometime-names, sorta-names, and related-names to go on with:

  • Complex Regional Pain Syndrome
    Until recently, there were two subtypes: Type 1 had no visible nerve damage, Type 2 did. However, with chronic CRPS, there is extensive and pervasive nerve damage, and it makes no difference in treatment after the acute stage, so this subtyping is widely considered irrelevant.
  • Sudeck’s atrophy
    No longer used; atrophy of bone and muscle is really symptomatic, and not always present.
  • Causalgia
    No longer used, except as an old name for CRPS type 2.
  • Reflex Sympathetic Dystrophy
    Used by old-timers and sometimes for CRPS type 1, although CRPS-1 is not necessarily maintained by the sympathetic nervous system.
  • Algodystrophy
    More often used in Europe; also, neuroalgodystrophy. Problematic because it implies that this is the result of autosuggestion. I know I could not have made this up in a million years; moreover, extensive analyses of the literature show that there is simply no truth to that.
  • Neurodystrophy
    More often used in Europe. It’s a perfectly good name, but not the one that the IISP paid a bunch of specialists to come up with)
  • Reflex neurovascular dystrophy
    RND; no longer used, because it only addresses vascular changes, not neurology or systemic issues.
  • Shoulder-hand syndrome
    No longer used, except to refer to upper-body chronic neuropathic pain while dodging a CRPS diagnosis.
  • Peripheral trophoneurosis
    Good one, eh? No longer used, both because it may spread out of the periphery, and it’s not about neurosis. See “algodystrophy” above.

For more on comparative naming and different nations’ approaches over the years, check out the RSD Canada site.

A certain amount of acute CRPS does clear up (or go into remission) before it’s even diagnosed. Since it can take years to get diagnosed, there’s not a good way of figuring out what those numbers might be. Even after diagnosis, acute CRPS can go into full remission and never show up again, before it becomes the ground-in form of trouble I call chronic CRPS.

In its chronic form, CRPS is a disease of dysregulation — of everything being thrown off balance. Our efforts to push back against any given part of that are quite likely to throw our systems off balance in some other way.

The body doesn’t balance simply, like a seesaw; it dances in 4-D homeostasis, which I’ve explained here. It’s a bit more like this:
Trapeze_artists_trimmed
Now imagine pushing one of those trapeze bars the wrong way.

Adjustments need to be carefully incremental in order not to distort the system further, but often need to be done quickly because the situation is so horrible to be in.

It’s a conundrum.
Sketch of brain, with bits falling off and popping out, and a bandaid over the worst
Personally, I’d like to have different names for acute and chronic CRPS. Here’s why:

Acute CRPS is all about the pain, with swelling and dystonia and circulatory high-jinks playing second fiddle. With acute CRPS, good results are consistently found with vitamin C (500 mg twice or three times daily is the usual dose range) and also with activity plus pain control, both quite aggressive.

Apart from that, therapies vary widely as to what will work with whom, but chances of remission in the first few months are very good, and in the first few years are still comparatively good.

After that, the whole situation changes.

With chronic CRPS, you realize that you have to find a way to live around the pain because so many other things are going wrong, life itself has to take center stage at some point, and pain has to take its turn in the wings.

Once the brain plasticity has gotten going, it’s no longer just a pain disease, but a disease of dysregulation, as the signals change and the body’s responses to the signals change and the brain’s ability to even recognize appropriate responses to temperature, circulation demands, sensation, perception, and so forth, all slide downhill.
Bosch_painting_of_Hell_(582x800)
In acute CRPS, having the word “pain” in the name is absolutely appropriate, because that must be addressed to let the brain reboot and get back to normal.

In chronic CRPS, pain often remains a huge part of it, but the central brain-changes are what creates and sustains the disease state. Pain is, clinically speaking, a ghastly distraction.

It’s a key symptom, a good guide (since muscle weakness, sweat and circulatory changes all tend to track to it at least some of the time), but it is not the driving force of the disease. The brain changes are.
poison_skull
Pain is terribly seductive to researchers, because people who don’t have chronic CRPS think they “get it” about pain (hah!) and, since that’s easier to relate to than the word “complex,” let alone the hopelessly misunderstood terms “regional” and “syndrome”, what they focus on is the pain.

The real problem is the brain, not the pain.

In my private internal world of reason and order, chronic CRPS is actually known as Complex Neuro-plastic Dysregulation, CND.

My eyes make words out of letter groups, usually just by adding a vowel. What comes to mind for me is, if you don’t win at CR[a]PS, you get C[a]ND.
craps-tshirt-front
Makes all kinds of sense to me 🙂

Threads on the loom: bereavement and CRPS

When I was 4, we moved to New Jersey from Turkey, as my parents thought their kids should get a feel for their native land. Our new backfence neighbors were a large and lovely family from Virginia, so I learned to spell “dog” both with and without a “w” by the time I was six.

The youngest daughter got me going on poetry. We read A. A. Milne and Louis Untermeyer in between dips in the kiddie pool. Her Mom, Mrs P, gave me drawing lessons when I was about 9.

My Mom was very maternal in her genuine enthusiasm for all my art. (I found that frustrating, because I knew it could be better and had no idea how to make it so.)

Mrs P did not have that problem with me… Her key edicts make reasonable rules for living: For one thing, I should not draw the whole scene until I was capable enough (don’t let things overwhelm you.) I had to pick the parts that were most important or that caught my eye, keep it simple, and do it right – or else there’d be erasing, and, if you erase too much, the surface gets harder to work on. (Isn’t that the truth.)

She was also good for the reality check. She quickly eliminated my grade-school habit of drawing red apples and brown trees, but made me look at a real apple and draw that; hold my colored pencils up to the tree and see which colors really matched.

See what’s really there, not what I expect or what I’ve been told things should look like.

The biggest note of approval I ever got from her was, “not bad.” By the time I was 6 weeks in, I was able to collect a “not bad” or two almost every lesson, which pleased me no end.

CRPS took away the link between brain and hand that let me make art, but one thing really stuck with me …

Why settle for good or even great, when you could aim for making it absolutely right?

“Good” and “great” are about others’ opinions, but “absolutely right” is something ageless that stands on its own.

Later that year, our parents sat us down to have a family meeting. Dad had been offered a job in Cairo, Egypt. He wanted to know what we thought about moving to Egypt in a few months. Mom and Dad discussed pros (long list) and cons (short list.) Older Brother asked about schooling (very good) and the social scene (unknown, but probably interesting.) Younger Brother piped up with characteristic curiosity and adaptability.

It seemed like a done deal, but I was wrong. Dad looked at me and said, “What do you think, Isy?” I must have looked surprised. He said, “You have a good sense of people. I don’t want to finalize this decision until I hear what you think it’ll do to us, either way.”

Should I be nice? My first instinct was to be nice, to stick up for the shabby underdog (in this case, New Jersey), to do what I thought was expected of me … but it stuck in my craw. Perhaps Mrs P’s lessons on seeing things as they really are had sunk in.
I said, quite honestly, that New Jersey was not being good for any of us (except maybe Younger Brother) and that Egypt would be new and interesting. We all liked new and interesting. So, as far as I could see, it was hard to see a downside to going, and hard to see an upside to staying.

So we went. And I got an early lesson in the value of calling it like I see it.

Our vacations were dreamlike, because we were close to some of the most striking sights in the world:

  • El Alamein and the remains of fallen soldiers from 5 continents;
  • The Red Sea, when it was still the most outstandingly varied and brilliant source of sea life on Earth (it’s still good in spots, as that video shows);
  • The southwest coast of Turkey when Bodrum (formerly known as Halicarnassus) was still a fishing town and their medieval castle the tallest building in it;
  • And, of course, the remains of roughly 8,000 years of Egyptian history from before the Old Kingdom, down through all those Rameses, Greek absorption, Roman annexation, Medieval flowering and Mameluk co-optation, the French and British tradeoffs, modernization as the royal family fell and the secular dictatorship accepted Nazi help to fend off the British return, the flowering of art and writing as the world wars faded and the newly mobile masses could collect like runoff from the tortured continent to the north. The Ancient history is only the beginning…

During the day, I learned about path-finding, history, and sea life, and in the evenings my mother read to us from local literature such as the Odyssey, the Iliad, My Family and Other Animals, even A Connecticut Yankee in King Arthur’s Court (the sharpest satire on jingoism and culture shock ever written.)

My parents had a gift for making the most of teachable moments.

The move turned out to be an excellent choice for all of us: Older Brother became a track star on the international circuit, I found a crop of kindred spirits, Younger Brother’s precocious historicity kept growing, Mom became a successful working photographer (and, as it happened, a role model of working womanhood for every intelligent female friend I had), and Dad got paid to help people – then towns – then governments get better and better at handling their money and improving their chances for a sustainable future.

The day I drafted this is the 38th anniversary of that move.

Dad was great at practical stuff. He genuinely liked humans, despite being such a historian. He often said that people are like table wine. Each one is a blend of different strains: good and bad, clever and foolish, creative and not, good with money and profligate, nice and otherwise… and each person’s blend is a little bit different. If you can accept each of them as the blend they are, and not try to change them – into a different blend, or even into beer, for instance – then you could really come to appreciate the variety that this world has to offer.

People are what they are. Accepting that makes for better connections.

The first time he taught me to drive was when we were on vacation in France, which was cheaper to get to than the US. We had rented a historical farmhouse that was about to become a gîte (at which point the price would go up), so we got all the benefits – a fireplace Younger Brother could stand up in, window sills two feet thick to sit on, a lush yard going down to a creek at the bottom with a moat up one side of the yard, a line of stately chestnut trees, twittering birds, fresh eggs and raw milk from the neighbor – for considerably less than we should have paid.

The rental car looked like it came straight out of a matchbox, but it was a real, rattly little French Renault. Dad sat in the passenger seat and directed me to the driver’s seat. He told me about the brake, the gas and clutch, the gear shift, the friction point, and how it all came together. I got the friction point coordinated and tested it a few times.

Then he said, “Okay, here we go.” I checked the friction point again and then stopped. He said, “No, I want you to go. Go ahead and drive across the yard.”

Oh, okay then. I can do this.

I grabbed the wheel tightly, engaged the gear, and eased past the friction point.

The car snorted briefly, pawed the ground, took the bit firmly between its teeth, and off it went. Or so it seemed to me.

The car charged off the gravel, kicking it up behind. It careened over the lush yard, carrying us past (fortunately) the huge stone house. It rocked and bounced off of molehills, scoring crazy tracks through the soft green earth.

I noticed my Dad was yelling, but he never yelled, so that was confusing. I didn’t understand a word of it, anyway.

Completely out of its metallic mind, the car charged past the trees, heading straight for the neatly-dug moat.

I was helpless to stop it. My own involvement had escaped my awareness completely. I simply hung onto the steering wheel for dear life, eyes wider than ever, completely absent to the fact that MY FOOT WAS ON THE GAS.

All at once, Dad finally got his full-grown leg around the gear shift and kicked my foot off the gas pedal and stamped on the brake in one astoundingly swift move.

The car sputtered, died, rocked to a standstill.

Its front wheels were on the lip of the moat. Below us, three feet of water and unimaginable depths of sticky mud glittered silently.

Little clods of earth trickled out from under the front tires and dropped in, stirring tiny clouds as each one descended through the water and into the mud.

All was quiet. Even the birds were too shocked to peep.

I sat there, frozen, hands locked on the wheel. I was alive. And dry. It was shocking.

I didn’t dare to move.

I heard Dad take a breath, and then take another. I felt, even with my head still turned away, two completely different speeches considered, then thrown away before he even made a sound.

I turned to see what he’d finally settle on, and whether it would finally involve a pair of hands wrapped around my throat – something I’d never seen him do yet, but you never knew, especially after a performance like that.

A pair of blue lasers drilled me to my seat.

Very quietly, very clearly, very firmly, he said, pronouncing each word distinctly:

“When what you’re doing doesn’t work… Try. Something. Different.”

Words to live by.

It was years until I was anywhere as green as Bordeaux. I lived along the Mohawk Trail in my 20’s. My excellent friend Paul was the hub of a wide circle of friends who, even if we couldn’t always stand each other individually, felt strangely as if we were still part of the same tribe: Paul’s tribe – or, as we called it at the time (such was his gift for invisible influence) The Tribe.

Paul was a master of appreciating people just as they were – even if that was not necessarily what the person in question wanted to be. He was the first to say, in assured tones,

“You’ll figure it out, Bella.”

He wasn’t kidding, either. He had complete faith in me, in spite of the evidence. I don’t know why. It sure helped, though.
My Dad died in early February 1999 while swimming in Egypt. I still remember the way the word “No” echoed off the walls of my little room at 4:08 am, when I got the call. The second flight on my 3-legged trip back East was overbooked, and I was going to get bumped.

I went up to the desk with my untucked button-down shirt, uncombed hair, and my own pair of blue lasers. Very quietly, very clearly, very firmly, I said, pronouncing each word distinctly, “My father is dead. I’m going back to bury him. I will be. On. That. Plane.”

And I was.

On January 23rd the following year, Paul decided to sleep late, and never woke up. On the plane to his funeral, I wrote to the father of one of my oldest friends from Egypt days, who had end-stage cancer. It started something like this:

“I’m on my way to a dear friend’s memorial, and I’m keenly aware that life is short and time is passing. Even though I don’t know you well, because you were my friend’s father rather than my friend directly, you matter to me. I want to let you know how important you’ve been throughout my life.” And then I told him about the ways his life had intersected mine over the years, brightening it along the way.

It was the last letter he received in this life.

Deathiversaries.

That’s my word for those days that sneak up on the calendar, dropping shards of stabbing tears out of a clear blue sky, breaking my knees for a moment as the agony of the unfillable absence hits me anew.

Now, not to strain the violins further, but the period that encompassed the deaths of my father, Paul, and my friend’s father also encompassed several other bereavements, a crippling stroke of my grandmother’s, the heartbreaking failure of my almost-marriage, the end of my nursing career due to illness, being too sickly-weak to make it to the mailbox and back for months, starting a new tech career from nothing but raw talent and pure luck, and moving.

And I really hate moving.

That was all in 18 months. I was a different person at the end of it. I’m sorry to say that it was someone who could face the devastation of CRPS with a lot more poise, but it still sucks.

Last Monday, January 20th, my old neighbor and teacher Mrs P died in her sleep. I haven’t seen her in 38 years (minus a week) but something as sharp and bright as faceted crystal slid out of my world.

My kitten Ari was a comfort to me, flinging himself firmly onto my body, as if to shove his strength and warmth into me.

He was enormous in every way: 10 pounds at 10 months and all of it lanky muscle, enormous love, enormous cheer, enormous charm, enormous athleticism, enormous independence, enormous courage, enormous confidence, enormous sense of humor … he was enormously unusual, even for a cat. He was an enormous invitation to life, just by the way he lived it.

Four nights after that, Ari disappeared. The following morning he was found on the road, dead and cold. Our Lovely Neighbors got us through, from finding his body to explaining to J to telling me. (I’m weaker now. It’s the buckling knees I remember.)
Partner J dug a perfect meter-deep grave, bedded it 6” deep in sprigs of fresh California bay while I blew sage smoke in, and I carried my kitten down to his final spot in the sun, at the bend in the path where he played with our dog and the Lovely Neighbors’ numerous cats.

I took the loss hard.

I’m an old hand at grieving. I can walk through the stages and the process in my sleep, although my body handles it worse all the time.

  1. The initial devastation and shock.
  2. The tasks:
    1. communicating the news,
    2. planning the funerary rites,
    3. preparing the final rest,
    4. performing the rites one needs to lay the deceased, as well as life with the deceased, to rest,
    5. cleaning up their things,
    6. comforting each other,
    7. getting something to eat,
    8. reminding everyone to be extra careful and remember to drink lots of water, which we tend to forget nevertheless.
  3. The reactions:
    • Noticing the way sunshine lands on my skin and birds sing in the trees but it seems to come from a world that’s not quite the one I’m in.
    • The way I have casual surges of wishful thinking: wouldn’t a bullet in the brain be nice about now? This isn’t suicidality (I promise), it’s my mind’s way of signaling that it’s overwhelmed by horrible feelings that it can’t do anything about, and it’s tired and doesn’t know what to do.
    • Re-learn the daily habits that this person (of however many feet) used to be involved in. That’s so dislocating. I don’t need to eyeball a certain corner of the bed before moving my feet now. I’m not even awake when I do that. It’s so horribly weird to wake up by realizing I don’t have to look.

Then the misnamed “stages” of grief, which are really nodes, which can be visited in any order.

  • The anguish, where life without that person has to be faced.
  • The anger, like, why couldn’t that little cuss cross under the bridge as usual, instead of testing one more damned limit and crossing over?
  • The bargaining, although I stopped bargaining years ago. I don’t seem to do that now. Too many unanswered prayers wept and bled into silence.
  • The sweet memories that stab like a ray of sun in my eyes, bringing tears that gradually wane over time, until those memories bring mostly sunshine.
  • Finding a new pattern beginning to emerge in my life, one that encompasses that absence without filling it, but making it less of an obstacle over time. They call that “acceptance”, but I think that’s a bit of a misnomer. I’d call it adapting.

I’ve only realized how very deep and interconnected life is by losing parts of mine. In that 18-month period of multiple losses, I found myself mulling the image of a complex weave on a loom, where each person and each influence in my life was a thread.

Some threads were solid and stable, some were wildly colorful, some thick with burrs, some wove in and out of the pattern, some were knotty and strange, some were pure gold.

When a major thread, or a lot of threads of any size, were ripped off the loom, then the fabric was distorted and there was a visible gap in it for a long time. I could weave on, but that band of the fabric was weaker – sometimes for years, sometimes for a lifetime. It takes a very long time to rebuild from the loss of enough warp threads.

It takes time to work new threads into the weave of life, and longer still to see which ones work in the overall pattern, and which ones fall out on their own – or need to be pulled out, for the damage they do to the rest.

Some people and influences are part of the warp, as they’re meant to stay in the weave for its length and are made to be strong. Career, close family, good friends, matters of identity – these are all warp threads which usually shape and color our lives all along its length. Each one has its own color and texture and breadth, which varies from person to person, and each contributes a depth of color and texture to the weaving that nothing else can provide.

In life, unlike fabric, the warp threads are highly individual.

When one of those gets ripped out, the whole weave … well … warps.

Some people and influences are weft threads, and are easier to change out. Doctors are usually weft threads, although the need for medical care is a warp thread for some of us. Jobs are weft, while careers are usually warp.

I lost a number of warp threads in that 18-month period. Between the end of January and the second week of February, the closest bereavements hit, year after year. The weave of my life has warped, over and over, in the armpit of winter.

I shift my stance from relying unthinkingly on having a lot of strength inside and out, to being mindful and precise about where to put my diminishing attention and energy.

I’ve learned to be more and more aware of good times, genuine love, beautiful days, radiant people, perfect moments, delicious food …

When I look back, I have far fewer regrets when I really noticed good things at the time.

I didn’t expect to have that kitten in the first place.
Even in this season of bereavement, I didn’t expect to lose him so soon.

But when he was here, keeping me permanently in a mild state of befuddlement because he was so much larger than life but still so very young, I sure noticed.

One day, that should be a comfort.

Meanwhile, as CRPS continues to change the game on me, I’m trying to learn to handle bereavement-amidst-deathiversaries with this new and different body-system.

My autonomic system is normally in a state that maps most closely to that of someone who’s being continually beaten with a live cattle prod, but years of practice have taught me when to ignore it and how to manage the results somewhat.

It gets better and worse from time to time. Stress, uncertainty, poor diet, missed meds, solar flares (believe it or not), and injuries, all crank up the volume on my oscillating central nervous system.

Bereavement is stressful, unpredictable, and contributes to poor diet, missed meds, and injuries. (Possibly solar flares for all I know.) Deathiversaries are a hardwired physical memory of bereavements. Having both at once is like being hit from both sides at once. Double oscillations that don’t cancel each other out, but feed into each other and magnify their effects.

All right… What’s an oscillating nervous system like?

Right now, the skin on my face is so raw that my partner’s nice springy beard feels sharper than a cheese-grater. My left lower leg wants to turn into a lump of Dacron, impenetrable and basically useless. My wrists and forearms, well, the less said the better, but I have to hold my mug with both hands to avoid wearing what’s in it. I went outside in soft shoes today (I usually wear hiking shoes) and the friendly little stones in the yard slowed me down considerably, as each one wanted to get way too personal with my foot-bones.

That’s the physical side of CRPS.

Because of the brain changes that make that stuff happen, there’s a parallel process that happens on the emotional side. Imagine the same degree of relentless rawness and unquenchable pain inside the heart and mind, and you’ll have some idea what it’s like.

I’ll give you a minute, if you like.

I don’t mean to whine, it’s just a fact of life with this disease. It takes a lot of managing, because my mental state wants to default to, well… how distressing and upsetting it is to be beaten continually with a live cattle prod.

How do you deal with an oscillating nervous system?

When your world is being purged, it’s important to replenish and nourish. This means extra antioxidants, extra meditation/biofeedback, extra hugs, and – if possible – someone else to clean the house and help with laundry and cooking.

One must eat, clean, and cope, and if it takes help, then I ask for help.

Herbal lemon balm extract helps cut the flared nerve pain. Chamomile and lavender tea, maybe with tulsi, helps me get to sleep. Some people do well with vervain or ashwaganda.

Homeopathics like ignatia amara and hypericum ease other parts of my nervous system responses. Also, I use an essential oil blend from Young Living called Valor, to reduce the hotwired panic reflex and hyper-alertness.

In case it isn’t obvious …

I don’t care what academics say, I only care what works for me. Empiricism is the only form of science that matters in the individual case.

I keep busy in order to keep my mind from exploding over the surfeit of losses and memories of losses, while CRPS takes the brakes off of all the feelings – physical and emotional alike.

This leaves me to manage the resulting inward chaos with whatever poise I can fake, because I know that a certain part of it is grief but a certain part of it is simply brain damage.

Either way, it will ease up in time.

So I keep busy, take my supplements, comfort the dog (whose heartsick look would make a stone weep), try not to draw attention to my partner’s look of not knowing what hit him, and wait …

Mostly, I wait for the balm of time, because it doesn’t change the loss, but it helps me learn to live with it.

Also, it moves the deathiversaries into my rearview mirror for another year. Until then, I’ll hold the love and leave the pain as much as I can.

Lastly, I wait for the fierce oscillations of my nervous system, humming and shaking like a five-foot-high tuning fork, to decrease and diminish and eventually …
quiet down …
to … a …
stop.

There is always an afterwards. Survival is simply a matter of getting to it.

Managing CRPS under this kind of duress is not magic, it’s persistence.

I keep breathing and let the awful moments pass. I’m old enough, both as a person and a CRPSer, to know that there are better ones ahead.

All I have to do is get there.

Happy Everything!

Now that the December holidays are within a couple days of being totally over, I hope it’s safe and amusing (rather than triggering and insensitive) to talk about them from my idiosyncratic point of view 🙂

We left the U.S. in January of 1976 for tropical countries, shortly before my 10th birthday, and didn’t move back for about 7 years. (This is relevant. Hang on.)
airplane_Abu_Dhabi_Boeing_747jpg
This means my entire pubescence and adolescence was spent in countries where, at the time, Christianity was an amiably tolerated oddity, and Western-style Christmas was weird almost beyond belief… but the pragmatism of shopkeepers is the same the world over: It’s all money!

And, of course, the legendary sweetness of Egyptians (outside of politics) made it all a sort of good-natured sport:
“Tell me what is ‘Christmas tree’ and I’ll get it — for you, special price, my friend! You my friend! Special price!” (The last part is indispensible.)

For you, my friend, special price!
For you, my friend, special price!

Then it was a matter of watching them try to keep a straight face, as you:

  • Try to obtain a cold-weather evergreen … in a hot desert country;
  • Subsequently drape that evergreen in colors of snow and blood … in order to celebrate a god of peace;
  • Who came to earth in — yup — the desert … where it snows less than once a century;
  • Which is all somehow tied up with celebrating a Northern solar event, which doesn’t matter near the equator

… And then there’s the obligatory gift-giving. This was even a bigger trip to explain.

The Cultural Gap on Gift-Giving

“Everyone?” I remember one man asking Mom, in deep confusion. In his life, the only people who got gifts were those who deserved it, and little children on their birthdays.

“Well, not everyone,” she temporized.

“Who do you have to give things to?” he asked, really wanting to understand.

She did her best to explain, as a good cultural ambassador should. “Your husband or wife and children, of course.”

ALL the children?” he asked, in shock.

“Well, yes.”

“Even if they’ve been bad, or broke the car, or spoiled the crops? Cost you a lot of money? You still buy them presents?”

Mom had to stop a minute. This is where practice bears no relation to theory. “You can try not giving evenly to the children, but they’ll let you know. Mine let me know, as a group, if they think it wasn’t perfectly even.” We did, too. She went on, “And I send presents back to my brother and his wife and family –”

He interrupted, “Where are they?”

She said, “In America.” Where he knew we hadn’t been in a few years.

He tipped his chin to one side, in that “as you wish” gesture of the Middle East, which was a polite way of indicating, “yeah, this doesn’t seem silly. Much.”

She went on, “We also send gifts to my husband’s brother and sister and her children — she’s divorced, so we don’t have to buy for her husband any more.”

His eyebrows popped, but he held his tongue. Why would you buy gifts for nieces and nephews thousands of miles away? What have they ever done to deserve that much effort? — And divorced?? A woman, divorced, still embraced by her famiily? And these foreigners push off the guy instead — odd, but probably praiseworthy. Okay. Nice. Weird, but nice. Moving right along.

But he didn’t say any of that aloud.

Mom went on, “And my mother, of course. My husband’s parents and my father are no longer living, so we don’t have to buy for them.”

I thought he murmured, “I’m surprised.” Maybe it was just his limpid expression.

She went on, “Oh, and we get something for the servants, plus a bonus of money. [Eyebrows up: nice deal, a bonus for your boss’s religion]. And Tom gives his boss a gift, small but nice, and the office pitches in and gets something for each of the secretaries, but Tom still gets something extra for the ones he works with [visibly wondering about those secretaries]… And then of course our friends.”

He was beginning to sound weary, or possibly just relieved that it wasn’t him. “All your friends?”

Mom said, “You get nice things for those you’re close to, less valuable things for friends further out.”

He nodded. At least that made sense. He asked, like the socially sensitive person he clearly was, “What happens if they’re not equal — if you get a nicer present than you give, or the other way around?”

“Well,” said my mother frankly, “That can be a little embarrassing. It happens sometimes, but we try to be polite about it. I’ve gone back and gotten someone something more, to even up the balance.”

Another gracious tip of the chin, this time probably meaning, “Smart move in a crazy system.”

Mom added, “And, if someone invites you to a party, it’s considered good manners to bring them a small gift, or at least a bottle of wine.” How suitable — in a traditionally non-drinking country.

He shook his head slowly and said, “And that’s not everybody?”

Mom finally laughed. “Well, not quite.”

It really makes you wonder, when you look at it from the outside.

"Oh no, I couldn't take another thing!"
“Oh no, I couldn’t take another thing!”

Blowing scads of money every single year on a bunch of ill-thought-out purchases, mostly for people you hardly know, who are getting inundated with them anyway, to celebrate the birth of someone who told you that love matters more than money … or possibly because it was the armpit of winter, so let’s all go indoors and eat ourselves sick until the sun shows up again … in the desert.

I never sneer when someone uses the terms “religion” and “mythology” interchangeably, even when they’re talking about mine. I know for a fact that it’s simply a matter of perspective.

Back to the tree question.

Our first year in Egypt, we did try buying a spruce and, well, sprucing it up. The result was pathetic even beyond my father’s generous taste for “trees with personality”. It was the quintessential Charlie Brown tree, but slightly taller. The poor straggly little thing was quite overwhelmed by even the few decorations we dared hang on it, and was almost crushed by a single strand of lights.

That was that for traditional trees (and none of us cared for the plastic ones.)
ChristmasTree_NOT
So we had to come up with non-traditional trees.

Each year, my feverishly creative mother outdid herself in coming up with some fabulous representation of a Christmas “tree”, appropriately gaudy and festive, festooned with merry decorations and strung with whatever we felt like stringing it with. (I remember learning just how tedious crafts could be, the year we decided to string popcorn.)

She was especially fond of the stacked poinsettias, perched on benches and boxes at several levels, but I liked every single year’s distinctive creation as much as the others.

I only wish I could remember them in any detail; it was a pleasant part of the backdrop of life, as far as I was concerned at the time. We take so much for granted at that age!

She finally called it quits on our first Christmas in Bangladesh. She was fed to the back teeth with coming up with something every year and decided to “rest on her laurels” — a nice way of saying that she was plumb out of ideas.

I was home from boarding school in the US (there were no accredited high schools in Dhaka at the time) and was still blossoming under the influence of tropical warmth, so notably absent from Massachusetts in December.
woman-with-sitar
I found a red-and-white canvas plant hanger (this was back when plant hangers were made of fabric rather than plastic) and fastened it to the wooden screen between the living room and sun room. A few bent wire coat-hangers later, we had a Christmas tree to decorate.

I even whittled a couple of reindeer out of Ivory soap and fashioned a little sleigh for them to pull out of unlined 3×5 card and toothpicks. Our little elfin Santa perched in it quite happily.

I have no idea how I pulled it off, but it was easy to do at the time.

So, as you can see, my notion of the holidays involved a lot of flexibility from very early on. This probably explains a lot. I celebrate Yule, Solstice, Christmas, and if I’m invited to any other spiritual observance, I do my best to participate with my best manners and heartfelt good will.

Normally. This disease does change things; most obviously, one’s social activities.

All last year, I sent off presents whenever I found them, things I really thought the recipient would absolutely love. Nothing thoughtless and nothing I couldn’t afford, and no waiting and storing and wrapping to deal with. It was a nice change! Not everyone I love got something, but everything I sent was right, and everyone else knows I love them just the same — I simply didn’t find the right gift yet. Next year, it’ll be a different mix.

At home, there was no noticeable festivity, but there was a cozy little trailer filled with love and care. That was all we were up to, and it was fine.

Next year, J and I think, there will be lights and color and a bit of show. In our own little way, we will celebrate anything we have a mind to, and it will probably involve lights and candles and sweet smudge. Whatever we do, it will still be in a little home full of love and care.

Because love is more important than money.

Postscript
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