The whole recovery enterprise is very interesting. If you had asked me seven months ago what I would accomplish if I didn't have to go to work for five months, I would have laid out wonders: a couple hours a day on the viola, maybe pick the banjo back up, a little bit of time for weaving, taking care of Ellie, exercise and probably I would have time to cook delicious complicated nightly meals and freeze half of what I cooked for when I have to go back to work, maybe some travel and lots of reading. Instead, a typical day like today consists of a little weaving, a lot of napping, some journal reading, a little grocery shopping so that I can hopefully do some cooking Tuesday or Wednesday, some Ellie care and a 1.9 mile walk.
I was trying to figure out what I *do* with all this time, so every time today I was not *doing* something, I tried to notice what I was doing. I realized that I often find myself staring into middle space, daydreaming about nothing in particular. I think I told you that one of the nurses gave me the definition of tired as "you have to really make yourself do things." This is about as good as I've heard. Even though if you asked me if I were tired, I would say "no," yet I find myself acting as though I'm tired. Is it my mind that is tired? Is it all over tiredness because I'm anemic and I can't recognize it somehow? Is my mind just having a hard time focussing? There is something to this recovery stuff; the reason they give you time off from work to do it is that it's like a full time job!
I am getting stronger. You can imagine how much I hated it when I climbed two flights of stairs and had to lie on the bed, panting for a few minutes to recover. Today, I climbed the stairs carrying a blanket and was able to spread it out when I got to the top without having to stop for a break. A lot of panting was heard, however. I also can walk 1.9 miles which is a nice distance. On the uphill part through downtown, I go so slowly that I am expecting some one to rush out from one of the stores with their walker and say, "Here, you need this more than me." On the flat and the downhill, I am getting closer to a normal pace. When I first left the hospital, I had to walk so slowly for everything. The cars would stop for me when I'd walk downtown and I literally could not hurry across the street to get out of their way faster. These signs of improvement are extremely welcome. I have a hard time with being less than 100% independent. This has been a tough five months for me.
Maggie is about 70% back to normal. She spent her whole day lying on the couch, but did get up to greet people as they came home so that is progress. The vet said to feed her two tablespoons of bland diet ("here's how to cook the rice and chicken"--actually, that's not happening. Her kibble is rice and chicken) every four hours (that's not happening. I'll feed her six times a day during the hours I am awake). It's a good thing I am more compliant with my own care than Maggie's. She said to do this for four days (also not happening--four days into 12 tablespoons of food a day, Maggie would be eating the furniture). Anyway, she's getting better with the semi-vet ordered diet so that's what we have.
Wanna hear what's good in this week's NEJM? (11/15/12) There is a nice article about the "Reciprocity of Recognition" by Rita Charon (the narrative medicine person) who talks about how a medical encounter "provides the ground for reciprocal recognition. Each comes to know things about the other that help the other, while being granted a view of self. Through the power of attentive medical practice, patients will see themselves in their doctor's gaze." I think this is absolutely right and very beautiful. That it is reciprocal is part of the real charm of medicine. Go read the whole thing.
There is a nice article about Lyme disease. If some one gets a second round of erythema migrans is it a relapse or a re-infection? The researchers sequenced the DNA of the B. burgdorferi in each of 22 cases and it was always a new strain, so it seems a second episode is much more likely to be a new infection than a relapse. Another hit to the folks who prescribe ceftriaxone for three years at a time.
There is a great CPC which illustrates why general internal medicine is the coolest. It really demonstrates that general internal medicine is a real branch of internal medicine with special skills. I really enjoyed it.
For tomorrow, I am hoping for continued recovery for myself. For you, I will hope for any recovery you would like to progress in your life.