Category Archives: hope

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Reaction

On Monday I walked with a group of friends. First I walked down from my house to the coffee shop, walked with them, walked back. It was cold but I was well layered. I want to see if I can up my exercise in spite of Long Covid and muscle weirdness. The initial reaction was fatigue. I took a nap on the couch from 2 to 6 pm and then went to bed at 7. I woke at 5. Fourteen hours of sleep.

That is not totally reassuring. Tuesday I did not feel particularly sore or tired. Wednesday, though, was bad. I started have muscle aches all over and I could not get my hands or feet warm. I lay down under an enormous pile of blankets and eventually went to sleep, starting at about 2 pm. I woke at 9 pm and then went back to sleep, warmer but aching, until 4 am. So that is another 14 hours.

This morning nausea and headache, but less soreness.

So, here is an article: https://www.nature.com/articles/s41467-023-44432-3 about the post-exertional malaise in people with Long Covid. They took people with Long Covid, matched them with people who have recovered from Covid-19, and then did muscle biopsies in both groups before and after maximal exercise. Results? “We show that skeletal muscle structure is associated with a lower exercise capacity in patients and that local and systemic metabolic disturbances, severe exercise-induced myopathy and tissue infiltration of amyloid-containing deposits in skeletal muscles of patients with long COVID worsen after induction of post-exertional malaise.”

Both groups were healthy before Covid-19 and physically active. The study uses many different techniques to measure muscle oxygen use and look at the muscles themselves at the microscopic level. As previous studies have shown, none of our current imaging, like x-rays and CT scan and MRI, can see the problems. This is at a microscopic and cell level in the muscles.

So I am having a post-infection or Long Covid flare the last couple of days, because I pushed too far against my limits. They have not done brain studies but the suspicion is that something similar has been going on. I have been spending a lot of time contacting temp companies and doing job searches, so I am going to take a few days off from that as well. Let the brain and muscles heal.

I still think of Long Covid as immune system PTSD, where the immune system is trying to protect me from further infection, though not necessarily in a way that I like. If the immune system makes me stay home and rest, well, I shouldn’t catch anything, right? Our immune systems are as diverse and complicated as we are, so the patterns are highly variable.

My immune system can’t bamboozle me. It wants me to stay home and take it easy. I get the message. Have a wonderful day.

Cats respond to drugs differently too. Sol Duc is quiet and contemplative on catnip. Elwha, well, guess.

For the Ragtag Daily Prompt: bamboozle.

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Give love

Martin Luther King’s birthday and a federal holiday. To be blunt, we need to stop killing each other and hating each other. And an awful lot of hate is based on fear: fear of others, fear of losing money or status or standing.

Give love.

For the Ragtag Daily Prompt: blunt.

The photograph is from September 2022, from my road trip with my friend Maline Robinson. She is second from the right in the photograph. We visited her in-laws in Beloit, Wisconsin on a road trip, going to visit her old friends and family. Her husband George Harrell had died of lung cancer in 2015. Maline died in February 2023.

I am the short one, in the skirt.

Let peace and love spread over the world, justice and an end to discrimination.

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Thanks

And no thanks do I get
for thirty years in medicine
for thirty years of rural work
for working alone without a net
not a whisper from officials

The thanks I get are on the street
in the shops, at live music
at Gallery Walk, at thrift stores
walking through town, from friends
from patients or spouses or mothers or fathers
who thank me and update me

Thank you, Beloved, for my odd career
for leading me rural, leading me to primary care
endless learning daily and people
they are all interesting, all different
all have depths that none would guess
all of your beautiful people, Beloved

Thank you for all of it

For the Ragtag Daily Prompt: tiara.

This is one of those poems where I started grumpy and did not know where it was going until it went there. The light at the end of the tunnel photograph is on the Metro in Washington, DC last week.

Tiaras probably quality as stuff.

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We change

In clinic, a very common complaint was, “My body has changed!” This was often with shock or annoyance or betrayal. Weight up, a knee hurting, headaches, menses behaving badly as menopause approached, gentlemen with their own problems.

My muscles are getting stronger but are really grumpy. I am starting to rebuild muscle and endurance but my muscles and joint complain. I think that pain is the pain of wisdom. I am clearly very very wise, if that pain is wisdom pain. It feels better to frame it as wisdom than as “Oh, I am old.” Also it’s fun to watch people when I say, “My wisdom is really acting up today.” They get a funny look on their faces.

Medicine changes all the time too. Isn’t that a little unsettling? Science changes, ideas change, frames change. A treatment that I used 15 years ago would not be done for the same problem now. And we can treat hepatitis B and C! Hepatitis C was still named “Non A, non B hepatitis” back when I was in residency in the early 1990s. Hoorah for some things getting better.

It’s been interesting watching the changing ideas about Long Covid. Over the last year they’ve said, “Better in nine months.” “Mostly better by a year.” “Better by two years, mostly.” Also the estimates of people affected in the US have ranged from 3% to 7.4%. There is not even agreement about the definition, with the CDC talking about symptoms staying present after four weeks. Meanwhile the World Health Organization says, “It is defined as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation.” Here: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition. CDC here: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html.

I hope that we vote grown ups into office. I hope we aren’t tempted by the childish want to be dictators who say, “I can fix anything, I can do what I want, I am so great. I can make YOU great too.” I think the pandemic was very frightening and the temptation is to try to hide in an imaginary past or freeze the future or think that if we make everyone behave a certain way, no further pandemics will come. I do not think that will work, people. Vote for adults.

The photograph is from the US Botanic Gardens. Here is the model, inside:

The sculpture faces are over each arch. Here is a close up.

I think the carved face will last the longest, then probably me, then the one on the model. The model looks like it would be delicious for various smaller creatures.

For the Ragtag Daily Prompt: change.

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Decorated stick

Elwha watched me decorate my stick with soft ornaments and paper ornaments.

Both cats helped, removing ornaments when they were not pleased with the placement. Including ones near the top.

I think the decoration will continue to change and evolve right through Christmas.

For the Ragtag Daily Prompt: stick.

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Stockings

The stockings are ready!

This is from last year. I forgot to bring my stocking this year. I will have to use a sock! Well, Santa will surely understand.

My ex says happy chanakwanschristmasfeliznavidad. All one word. And love, joy and peace to you and yours too.

For the Ragtag Daily Prompt: holiday.

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child

some people say
they just want their children to be happy

not me
I don’t understand that
to want a child to be happy
fixed in amber
with one emotion

I want my children
to feel what they feel
to feel happy, unhappy, sad, angry
gloomy, ecstatic, joyous, jealous
snarky, sarcastic, silly, relaxed
to feel the full gamut
the full rainbow
of emotions

In my mother’s family
they pack their sorrows in their saddlebags
and ride forth singing

the trouble is
the saddlebags get heavier over time
weighted with grief and fear and anger
or whatever is unacceptable
to the family
until the horse staggers under the weight
falls over
dead

then they must try to drag the saddlebags
too heavy for the horse
through their lives

I am gifted my mother’s letters
when my mother is in the hospital
the tuberculosis sanatorium
the first letter a month
after I am born

My mother is cheerful in the letters
a little snarky about her roommate
a little lonely

But what stands out is what’s missing
She barely mentions me
in some letters not at all
her first baby
who misses her
and who she can only see outside
through a window

And what was in her saddlebags?
When she coughed blood 22 years old
and eight months pregnant
she thinks she has lung cancer
and will die

She says this without emotion
lightly
almost as a joke
a relief when it was tuberculosis
even though that meant six months
in the sanatorium
separate from her young husband
and baby
at least she was not dying

She doesn’t get to hold me again
until I am nine months
and I have no idea who she is.

The worst thing anyone can tell me
is that I should not feel the way I feel.

I shut down.
I don’t stop feeling how I feel
but that person is locked out.
I will not trust them with my feelings
for a long time
I am an expert at hiding my feelings
raised in an emotionally dangerous
household
and physician training as well.

Once on the boat
my daughter says, “Mom, I’m scared.”
My father says, “Don’t be scared or go below.”
“No.” I say, “Come here. What are you scared about?”
We have run aground.
Too impatient to wait for the tide
we are trying to winch ourselves off.
“I am scared we are trapped.” says my daughter.
“How far is shore?” I say.
We are in the marina.
“Not far.” she says.
“Could we get to shore?”
“Yes.”
“Are you still scared?”
“No.”
Soon a rowboat comes and takes the kids
to shore to play.

“Don’t be scared or go below.”
That was my childhood.
Emotions as monsters.
I went below.
I chose to make friends with the monsters.
I feel what I feel.
One friend says, “Of anyone I know,
you process your feelings in real time.”
and I laugh, but am honored,
because it took years
to reach this.

Don’t share your feelings with fools.
Don’t share your feelings with people
who want you a certain way,
or who try to control you.
You have a right to your feelings
as they are.

And this is what I want for my children.

The photograph is my mother and me in March 1963. I do not know who took it, perhaps my father. I would have been right around 2 years old and my mother was 24. I did not see these photographs from when I was first back with my parents until after they both died.