Tuesday, March 20, 2012

My Little Town (and the one next door!)

  Unbelievably, it is supposed to be in the 70s--near 80--for the next few days.  I remind you that it is March and this is Maine.  I know plenty of people who are thrilled to have this weather and plenty more who wish they could have it.  If I could send it to them so I do not have to experience it, I would do it.  Alas, I cannot, so I simply have to act like it is summer.  I am planning cold suppers for the next couple of days, I dug out my lace socks, and got out the summer clothes.
    This morning we left at about 9 to walk over to Topsham, the town next door where Bill works.  He wanted to walk partway to his place of employment so he could see how he felt and how much time it took.  We took the walking bridge over the Androscoggin River.  On one side is Brunswick and on the other is Topsham.  The bridge is about a 10 or 15 minute walk from our home.  We ended up walking about half the distance to work and then came home a different way, taking a different bridge a little further down the river.  Bill felt good and figures he can get to work in about an hour on foot.  We both thought that he would not be able to do it if he was still on the diltiazem, so we were reminded again about how glad we were that he is off it now.
   We stopped on the second bridge and watched and listened to the water of the river roaring underneath us and I thought about how peaceful I felt here.  I had noticed last week that I seem to be entering my usual spring depression early this year.  It usually arrives in April as it starts to feel like spring and I know that the hell of summer is almost upon me, but this year it had already started, so I decided I had better take some steps to mitigate the effects.  I cannot avoid summer, although I would if I could, and I am unlikely to ever truly like it, but I also can't wallow in my misery.  I started volunteering at the food bank last week and will be doing that twice a week from now on.  That will help, I think, because it feels like I am doing something useful there, and I will be observing and analyzing a topic that I find exceedingly interesting--keeps my mind busy :-)  What I learned today, though, is that I also need to make it a point to get outside and walk around my little town even if I don't have to be anywhere.  I have set up my life so that I can walk to the places I need to be--grocery store, library, etc.  That is good and it works well for me.  But I also need to walk to the river just to look at it or wander around to look at the scenery, even if I don't have to be anywhere.  This is harder for me because I tend to want to just sit still and not move in the summer, since moving means sweating.  But I lived for a long time before Brunswick in a place that depressed the hell out of me, in part because it seemed dead--lots of brown and dried up looking stuff.  I am lucky to live in this lovely little town and I need to make sure that I appreciate it.
   Bill and I took a ride to Westbrook yesterday afternoon, where we picked up a cheapo computer monitor that ad been advertised on Craigslist.  The screen on his laptop went black and he needed a monitor to still be able to use it.  We had to drive through Portland.  Both of us got tense and I got my usual bad vibe.  I don't like cities.  I never really have, but it seems like I have less tolerance for them now.  Portland, Maine is not a big city by any stretch of the imagination, but it gives me the same tensed up and unpleasant feeling that I always get.  Both of us try--pretty successfully--to avoid it.  When we first came to Maine, we thought we might live there.  I knew on the very first day that I did not want to do that and when we got to Brunsiwck a week later, I knew that this is where we needed to stay.  I am glad we ended up here.  It won't be forever--no place ever is with me.  But I am here now.  I do not have to love summer, but I can be grateful that I am here instead of where I used to be, that I am not in a city, and that it is green and pretty and not dead.

Thursday, March 8, 2012

Too Low

We just got back from an appointment with the cardiologist.  It's been a month since the last one.  Bill's INR is getting regular, so he has been on the same coumadin regimen for a few weeks now.  Today his blood pressure was way too low, though, so doc took him off the diltiazem.  I am glad.  I was never comfortable with him taking that pill.  They started giving it to him on the Monday he was in the hospital.  All weekend, the hospitalist talked with us very clearly about his a-fib and blood pressure.  The former had probably been going on for years and was unlikely to change now, he said, and although his BP was high when he came in, that's normal during a stroke and that's how they want it.  He kept watching it all weekend and declared it "beautiful" on his last visit, which was on a Sunday.  The next day there was a new hospitalist and suddenly there was some issue with the a-fib, his heart rate, and the blood pressure.  The cardiologist was called in.  The first one was OK, but I didn't care for him much in terms of his ability to be clear with his answers and recommendations.  He is the one who decided to start Bill on the diltiazem.  He had a dose in the evening and then another one in the middle of the night.  An hour after the second one, he felt funny.  He mentioned this to the nurse, who didn't seem concerned.  Bill saw the current cardiologist on his last day in the hospital and he agreed with his colleague about the medication, but this guy was so much better about explaining and answering questions clearly that we stayed with him for the follow-up care. 
    So Bill had been taking his diltiazem in the morning and almost every day he had the same funny feeling a couple of hours afterward.  He says he finds it difficult to explain, but it is unpleasant.  We tried making sure he takes it after he eats and that hasn't really worked.  Because of the way it all played out, I was apprehensive about this pill from the start.  I understand what it is for, but no one really could explain to me why they thought it was necessary for him to take it when the first doctor did not feel he needed it.  So today, the BP is too low and he is off the pill.  He does not have to go back to see the cardiologist for 3 months.
   Poor Bill--he was so tired as we were walking the 1.5 miles to the hospital.  He is tired a lot--not sleepy, but fatigued.  I told him it was probably a combination of things--he is still recovering from the stroke, even though it was small; his heart rate is slower than it used to be and his blood pressure was lower, since two of the meds he was on lower the BP.  I said, "Your body probably has to get used to these changes."  Who knew that his BP was far too low?  No wonder he was exhausted!  We stopped a couple of times on the way home and now we can wait for the drug to leave his system and see if he is less fatigued as a result.

Saturday, March 3, 2012

Left Neglect

The last book to leap from the "staff picks" shelf at the library and into my hands was Left Neglected by Lisa Genova.  It is a novel,but the author has a PhD in neuroscience, so I figured the descriptions of the condition would be pretty accurate.  Yes, that is an actual medical condition--Left Neglect.  I had never really heard of this--at least in a way that stuck with me--until the lunatic neurologist at the hospital described someone who had the condition.  So in the book the main character is an overscheduled overachiever who went to Harvard Business School, got a job with some consulting firm, got married, had three kids, and then tried to keep all her balls in the air.  Needless to say, things did not go well.  One day, while she was feeling pretty happy because her husband was taking the kids to school and she figured she'd be able to get to work early, she decided to rummage in her voluminous bag for her phone on the highway, driving 70 mph in the rain.  Well, you know what happened next--car crash, traumatic brain injury, left neglect.  In terms of plot, the book was pretty predictable and I could see where it would end up well before the end.   Given Bill's recent experience, though, and my observations, I related to parts of it in a new way--particularly the descriptions of the occupational and physical therapy--the scanning and word search puzzles were a feature of his recovery, too.  What I found really fascinating, though, was the fact of this left neglect issue.  When someone suffers from this condition, the brain literally does not register "left" or anything that exists on the left as a concept.  In the book, it was not that her left side was numb or that she could not see properly.  It was that her brain did not realize that "left" existed, so for her, it didn't!  She did not know there was a spoon on her tray to eat her soup, for example, because it was on the left.  She could not find her left arm or leg, even though she knew she must have them.  She tried to read to her daughter and it was a jumble because she was not seeing words on the left side of the page.  She could not even turn her head to the left because when one of the medical people asked her to do so, she would say, "What is left?"  She could not walk on her own because she never knew where her left leg was.  Eventually and with training, she was able to gain more functioning through various exercises that helped her brain to consciously remember to "scan left." 

At one point, the author has this character thinking about her injury and responding, "Wow."  That is how I felt reading this.  The people who deal with this condition live in a completely different reality that their brain has created.  According to the author, not much is known about what causes left neglect and how to "fix" it, other than to retrain the brain.  I was left again marveling at the human brain, how it has evolved, and what it--and by extension, we--are capable of doing. 

So while the story was fairly predictable in some ways, it was a book worth reading simply for the description of what life is like for someone who has this condition.  It was also another reminder about how we often go along in an unconscious fog through life and sometimes it takes a major unexpected life event to make us wake up and take stock.

Friday, March 2, 2012

The Joy of the Unexpected

Our local library has a shelf for "staff picks."  These are books that are not brand new (these are shelved in a different place, divided into sections for fiction, large print, and non-fiction), but are usually not really old either.  Last week Bill and I went to the library and he headed up to the fireplace room to read some magazines and newspapers.  I dropped off some book donations and placed some magazines in the exchange rack, then wandered over to the "staff picks" shelf, where I suddenly found that a few books were leaping off the shelf and into my hands.  This always happens.  I am never sure how exactly, because I seem to go into some kind of wonderful trance as soon as I enter a library.  This time, I ended up with a few books I had never even heard of--one was about this guy who was miserable and decided to write 365 thank -you notes in a year.  It was pretty good--a memoir organized around his growing realization that maybe if he did not always look for the black cloud behind the silver lining, he could be a happier person and in the process enrich the lives of others as well.  Bill is reading it now.  He tends to be someone who is always looking for--and finding--the black cloud.  I am a silver lining kind of gal, so I suppose we balance each other out.

Yesterday I read the Penelope Lively book that also came home with me.  I have read some of her fiction in the past and enjoyed it, but this was a work of non-fiction.  She was writing about large social issues of the 20th century in Britain and Europe--class structure, WW II, gender issues, rural/urban divide, changes in Russia, etc--but she did it using her grandmother's large country home and the items that were in it as jumping off points.  So in a chapter about a sampler that her grandmother had made, she talked about her grandmother's amazing needlework skills, but also about children who had been evacuated from more urban areas to the rural ones during World War II (the sampler contained images of these children).  A chapter about utensils contained a bit about her family history as purveyors of a certain brand of silver cleaner and other househiold cleaning products, but also a discussion about how households have changed and how her own daughters and granddaughters had no idea what some of the silver utemsils were supposed to be used for. 

I found it a fascinating book.  This is probably not surprising, since it included most of the topics I am interested in--social institutions, class, gender, religion, women's domestic labor, and life stories.  The book is called A House Unlocked and I had never heard of it until it jumped from the "staff picks" shelf into my hands at the library last week.  I am glad it found me!