So, The Hands, continued.

Nearly three weeks after the surgery on my left hand, it's noticeably better than it was, is better than my right hand, and less painful, so I'm pretty happy. It is, on the other hand, still numb, particularly in the middle finger, which affects the typing.  It's a very strange thing to be unable to feel whether shampoo is rinsed out of what little hair I have, or soap off my body in the shower.  It's odd reach out and touch someone and miss the sensation of  the texture of their arm or cheek. At least the surgery prevented further damage.  And it gives me even more hope for my right hand, the procedure for which is16 November, a week from Monday.  Then another week and a half of bandages--then two and a half more weeks keeping (at least the right hand) out of the pool and the ocean and other potentially germy standing water and I'll be free to experience the unsanitary world without worrying about incisions.  Then I'll figure out what's next.

It's no surprise that the medical profession is intentionally specialized.  Their approach to the hand is really like the "The Five Blind Men and the Elephant."  (If you don't know the story, each has a different perspective: the elephant is like a snake, the elephant is like a hose, elephants are like walls, elephants are like tree trunks.)  The jury's still out, at least for me, on whether there's an adequate payoff for specialization.  It's slow and expensive.  And each specialist tells me different stories about my hands.  I'm sure each of them evokes a slightly different story from me about what I'm experiencing. And for the most part it's been difficult to schedule consecutive appointments close together--hence the now going on four month process since my hands went abruptly numb in England.  And when I do have appointments during consecutive days, then I try to dodge the hour-plus each way of rush hour traffic and pamper the hands before and after because they don't like the steering wheel.  that's how (at least this phase of) this all began.

(1999 illustration by Jason Hunt)

On the other hand, I feel confident knowing that the surgeon's done more than five thousand of these cuts.  He seems to have it down, and is really personable.  I didn't really expect that of a surgeon. My general care doctor really does have the big picture.  But he's afraid of pain medication.

Pain.  The 1-10 chart.  The pictures are a little more helpful. But it changes.  And as there's a degree of difference between sharp, dull, throbbing, aching, piercing--and their overlap--those are subjective too for the teller and the hearer--there's no good way to treat it.  I can't take NSAIDs (aspirin, naproxen sodium, ibuprofen) during the week before or after the surgery--they thin the blood. But the other go-to medications for pain, the opiates Oxycodone and Hydrocodone (I like Hydrocodone better--it's gentler and seems to work better for me) freak the medical establishment out.  If you ask for it, you're heading down the slippery slope of dependence, and they look at you with suspicion if not outright hostility.  I really haven't experienced this much, personally, but I've seen other people respond--and be responded to--that way.  It doesn't help that in the media, like last Sunday's Sixty Minutes which featured the suburban heroin epidemic, reporters and parents and nurses sensationalize the medical opiates as a gateway drug for opium and heroin.  What they don't mention is that one of the reasons people turn to illicit drugs is that the medical establishment, in it's own fear, unreasonably restricts the use of legitimate pain medications, cutting patients off too soon.  And they make it embarrassing to ask for in the first place so you self-censor. Nor do they take responsibility for their children, who were on pain medication in the first place because they played unreasonably and increasingly limb-and-joint-threatening sports in high school, and experienced much more unmanageable pain than did most kids in previous generations.

The discomfort in my hands mutates into pain if I do too much, if I carry luggage or groceries, if I chop a few too many vegetables,  if I type for too long, or when I wake up in the morning of the first few hours of the day.  At it's worst, every couple or three day, it's about the same as when I had knee surgery ten years ago.  It's manageable.  It's certainly not anywhere near as bad as that of my friends who have had cancers. It can be debilitating:  when I discover I can't open a jar or a door--or a pain medication bottle--and have to steel myself and think it through.  More troubling to me is that it's distracting.  Sometimes very distracting.  So I lose my focus, my train of thought.  It also makes me afraid of doing things to exacerbate it and it's root causes. Now I'm afraid of bike riding.  Of lifting weights in the gym (Oh yeah, you need your hands and wrists for that and my fingers won't close into a fist.  Boxing's out. And gyms are germy places, too) It's definitely, if I'm to be honest, more than an annoying numbness and tingling, which is how I'd always thought of CPS.

And of course, because I've used it (a great deal), my insurance is going up to 500$ a month, with a $6,000 deductible.  Twelve thousand a year off the top, out of pocket. But more on that on a later post.

Go See The Martian While It's Still in Theaters.
And Go See All is Lost on DVD When You're Done.

My hands are killing me.  I'm going to write more about that tomorrow or the next day. Don't worry.  I'm surviving and I'm in pretty good spirits.  Buy, as I'd started to say couple of days go there are two movies you really should see.  And this will be short. I saw The Martian starring Matt Damon (and he really does star) in Friday Harbor a few weeks ago.  I saw All is Lost with Robert Redford, a few months ago on DVD.  I'm sorry I missed it in the theaters, though I'm not sure it made it to Hawaii, which is ironic I guess.

Both of these movies are about an individual, solitary and beyond the help of human aid.  They're spare in narrative, and simple in palette, the silver gray of the ocean, the oxidized red of the Martian desert. There's no deus in or ex machina  here.  If these two men are to survive, they're going to have to figure it out on their own and they're going to have to execute their own salvation.  Redford's character is alone in the Indian Ocean on a small, increasingly incapacitated cruising sail boat.  Damon's is marooned at an abandoned station and disabled launch vehicle in the deserts of Mars.  There's very little dialogue in either, though internal monologues are either broadcast, or brilliantly--and entirely acted with facial and bodily expression--in All is Lost.

Obviously The Martian is more of a spectacle and is, in its way, a worthy sequel to 2013's Gravity--another epic of solitary problem solving.  But beyond special effects, the spectacle lies in watching Damon's self-deprecating, handsome-without-being-pretty face register every shadow of hope and every devastating, impossible set-back. It's elegantly acted in the midst of the inevitable entropy of all technological solutions to his challenge--to get back to earth before the last of his resources--internal and technological--fail.

Redford is sailing alone across the Indian ocean on his private boat when he encounters a storm that partially disables his vessel.  A sequence of misfortunes turn frustration into desperation into hopelessness and in the face of each, he recovers, reshapes his resources and stays under the heavens with increasing exposure and on top of the water.  His character--in his face and posture--register in another elegant, understated, but extremely subtle performance of an endless sequence of creative choices rather than the more typical simple alternatives.

In both narratives, the single, lone protagonist is heroic, at least in the fact of his own persistence and  solitary reliance on limited and diminishing resources. In All is Lost the poster tag-line is "Never give up."  In The Martian it's alternatively the slightly misleading "Help is only 140 million miles away." or "Bring him home."  In the end they have to get themselves home. The stories are both about just doing it. They're both riveting.

Everest and The Green Inferno

My chances of seeing movies here in Hawaii before most people I know elsewhere see them are pretty slim.  Movies come slow to Hawaii, don't stay long, and often don't make it at all if there's not a wide, popular audience.  There is only one IMAX theater and that's an hour's drive away near downtown Honolulu, and it generally only shows large format, 3D movies only for a week.  I do like spectacle.  I also tend to wait until I can see movies with Robin, who's only here a week or so out of there month or occasionally with my friend Mark, who lives here in Makaha.

So my purpose in talking about movies here is to articulate to myself what I thought, and, maybe, to give friends who read this, who go to movies, or rent them, even more hesitantly than I do, an idea whether they want to go to the trouble. Or just to open up a conversation.

A few weeks ago--nearly month now, I went to see Everest because I was interested in the subject, it was going to be leaving the theater in Kapolei, only a half hour away, and I wanted to see it in 3D.  Robin had seen it in IMAX on a layover in Seattle and really urged me to see it.  He'd read John Krakauer's Into Thin Air a few years ago and his subsequent books as they came out; I read Thin Air after seeing the film along with Missoula and Under the Banner of Heaven in the last month.  I have stuff to say about him, and about his particular brand of book-length journalism, but I'll do it elsewhere. While Everest isn't based on the Krakauer book, it's impossible to think about the film without refering to Krakauer, who's a major character in the film and inevitably the foundation of what happened on the mountain in April 1996--now, incredibly, almost twenty years ago.

As it happened, I was feeling a little sorry for myself and incapacitated by the troubles I've been having with my hands, so after doing a few other errands in Kapolei, the closest town with a variety of suppliers of groceries, laundry, and household things and services (I'm working hard not to use the word "shopping" as I don't like to think of myself as a shopper) {I'm going to write about Kapolei another time, too--it's kind of a strange place} I went back to the theater after seeing Everest to see Eli Roth's The Green Inferno.  I'd seen Hostel, also by Roth, and knew I took a kind of scab-picking fascination with movies about pain and fear--at least the kind he makes.

At first blush the movies couldn't be more different.  Everest, in it's glaring, high altitude light and cold, is practically monochromatic in the Himalayan setting of most of the movie.  Inferno is, as the title suggests, green, humid lush and hot.  There's a lot of bright red gore , in addition to the cloying green in Inferno, too. Everest is ostensibly about heroism--there's precious little heroism in Inferno.  Everest has a big star cast and spectacular--in every sense of the word--production.

But I was shocked to find myself on the drive home pondering how much the two movies shared.  In both a group of relative strangers leave the first world for a place beyond the third. The protagonists in both depend on native people for their survival. In both movies there are survivors of life-threatening challenges (This shouldn't be a spoiler, by the way.) In both movies affable, less-than-major characters die horribly.  The protagonists have good intentions. The protagonists' good intentions are complicated and conflicted. In both the deus ex machina, in the form of it's own "machina," plays a critical role in survival. Both movies are "over the top" literally and figuratively.

Both movies are worth seeing with big "ifs."  Don't go to see Everest--especially in 3D or large format--if you suffer from vertigo.  Or in the winter. The movie is all about fear of falling and cold.  Though it's based on actual events, the movie allows itself a lot of latitude in interpreting events and--partly because of the compressed time in cinema--does real disservice to some of the characters who are reduced to the caricatures of a morality play--most notably Jake Gyllenhall's character,  Scott Fisher.  If you get a personal kind of heroism (one that's primarily concerned with self-interest) and  understand why someone would risk life and limb--again, literally, and I do get it--to pursue extreme sports (and this is genuinely extreme), then watch it. And man, it is spectacular, though much of the spectacle you can see in the preview. If you're after subtlety, read the (related) book.

The Green Inferno's is an even more specialized audience.  You have to appreciate horror and have a stomach for gross. And  you have to have a taste, as it were, for the particular kind of horror that Eli Roth represents.  That, and if you can get past the grotesque politically and anthropologically incorrect cannibalistic caricatures of Amazonian natives, than by all means have a look.  It's pretty good at what it intended to do: horrify and gross-out with surprisingly few surprises.

So, the hands.

It turns out that I have a lot to learn about "Blogger."  I assumed that I could copy and paste text and images from other sources (like my composition in Word, like my images in iPhoto) I still haven't learned out to use Photo.  That's why some of my posts have been virtually invisible. All evidence to the contrary, I'm not that fond of change and am learning slowly.  And what has this to do with "the hands"? 

Well typing, while getting a little better, a little easier, after surgery number one, is still cumbersome. The middle finger on my left hand still does what it wants to do without communicating with my brain, so it can miss letters altogether--especially d, c, and e--or it replaces one for another as it {fliws over the keyboard, if I'm not looking, and i van gwt somrthing like this.}  But handwriting is even worse, more painful, and doesn't solve the web log problem anyway.

So right now I'll write about my hands as they float through the medical world.  Or don't.  The surgery two weeks ago today was guardedly successful.  It turns out that the surgeon's caution was appropriate and that the damage to my median nerves were of a much older etiology than I'd first thought.  After carefully going over my medical history, it seems possible that I originally injured both hands during the California AIDS Rides, "Lifecycle," in 2008 and 2009. I didn't adequately prepare either year.  I figured I'd just get on the seat and pedal.  And I did.  I completed the 565 or so miles from San Francisco to Los Angeles both years.  But my hands got numb.  (My butt got numb, too, and I shudder, literally and figuratively, what that has in store for me.)  And apparently it's the vibration as the pressure that injures the nerve. They've mildly tingled off and on ever since, but the rheumatologist and surgeon believe that injury was just under the radar and then holding my hands in the unfamiliar positions driving on the left side of the road in the right side of the car for fairly long periods of time in England may well have pushed me--them--over some edge, or threshold.

My left hand, which had been noticeably worse than my right, is now marginally better than my right hand two weeks after surgery.  They told me I wouldn't be sure of the results until after a month.  So that's a good sign.  Much of the day (except when I'm typing) I leave the incision un-bandaged, so it can dry and callous, and leave the braces off (unless I'm typing or driving or sleeping).

The surgeon is a self-described "sanitary nut" (I envisioned a cashew in a jar of bleach.),  and insists that I keep my hand out of water--the pool, the ocean, dish-water; showers are OK--for a month after the surgery.  By which time I'll have the second "Carpal Tunnel Release" surgery (on 16 November) and have to wait another month before I can swim.  What I've been doing is reading by the pool and whenever it gets too warm, or I want to talk to someone swimming, I get in shallower than the 4' middle section of then pool and wade with my arm raised. Day after day I have to assure people that, no, I'm not waving at them, until they see the bandage, and I'm not as creepily friendly as I appear. I'm really not.  I've also been walking, further and faster, every pretty much ever day since the day of the surgery. So though I'm kind of vegetating, I'm not merely vegetating like a slug.

I'm occasionally taking hydrocodone in the evening which does reduce the pain in my hands, lets me relax and sleep.  I refuse to feel guilty about this, even with the parents on Sixty Minutes last night saying that people should put up with pain and not take these "gateway drugs" to heroin.  I'll let you know if I become a junky.  (I really will.) But it's looking unlikely.

If this below is TMI, avert your eyes.

Coming down onto the Western Slope off Wolf Creek Pass, November 1997

"My November Guest"

Robert Frost

My Sorrow, when she's here with me,

  Thinks these dark days of autumn rain

Are beautiful as days can be;

She loves the bare, the withered tree;

  She walks the sodden pasture lane.

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Her pleasure will not let me stay.

  She talks and I am fain to  list:

She's glad the birds are gone away,

She's glad her simple worsted gray

  Is silver now with clinging mist.

The desolate, deserted trees,

  The faded earth, there heavy sky,

The beauties she so truly sees,

She thinks I have no eye for these,

  And vexes me for reason why.

Not yesterday I learn4e to know

  The love of bare November days

Before the coming of the snow,

But it were vain to tell her so,

  And they are better for her praise.

Maine, November 1979

 An early November climb of Mt. Adams, NH

Sleeping Ute Mountain from the North, our dining room, McElmo Canyon

Spring and Fall

Gerard Manly Hopkins

to a young Child

Margaret are you grieving

Over Goldngrove unleaving?

Leaves like the things of man, you

With your fresh thoughts care for, can you?

A! as the heart grows older

It will come to such sights colder

By and by, nor spare a sigh

Though worlds of wanwood leaf meal lie;

And yet you will weep and know why.

Now no matter, child the name:

Sorrow's springs are the same

Nor mouth had, no nor mind, expressed

What heart heard of, ghost guessed:

It is the blight man was born for,

It is Margaret you mourn for.

The West Mancos Overlook, 1992

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View of the Montezuma Valley from Shark's Tooth Trail, 1992

Some pictures: this week on Puget Sound

It was a rainy day out of Anacortes  and Robin and I took turns watching the bags and wandering around the brand new, mostly deserted San Juan Island Ferry, Samish.

Robin looking in from the rain.

The long wake in Puget Sound, Ferry Samish, through the San Juan Islands

Our friend's deck near Friday Harbor

From our friend's deck

Down below our friend's house.  I had no idea that cold ocean water could be this clear.  We went out crabbing later, today, and could watch the pot sink down ten fathoms.  What a beautiful place.

The little beach below our friend's house.

Near Friday Harbor on San Juann Island.

The horizon disappeared by this morning and the sky and ocean were bands of pearl, gray and white. It seems to me the American luminosity would have loved to have painted here., but not many artists around here in the middle of the nineteenth century.

Moss on the roof edge above the gutter in the rain.

Robin and I on the deck.

Robin and Amy.  Friends for 35 years.

Amy's yoga studio.

The lawn, house and yoga studio, San Juan Island.

Brush burning in th rain in the cedar woods.  Massive incense.

Robin at the barn.

Robin and Amy at the barn.  Old friends redux.

A madrona tree int the midst of the cedars..  I never knew they grew so tall and straight.  I also never knew they produced rough bark when they got mature.  I always thought of them as brush, bushy plants that grew by thew ager and had smooth bark of red that peeled away to lime green.  Beautiful trees, young and old.

 

Moss  in the cedar forest.

I couldn't figure out how to get the green and gray and brown I was seeing  But I was absorbed by the depth of the forest being endless trunks.

A lamp made by Amy's former husband.

Dining room.  We at well in beautiful light inside and out.

What's going on with my hands...

            So I've dedicated the last year and a half to going to the doctors. I came back from China for primarily medical reasons (more on that another time) and because I felt I needed to have more comprehensive medical care than I had in Beijing.  More on that at another time, too, but my health insurance was only good in Asia.

            The most recent gauntlet of specialists has been addressing, since 1 July, the: knee pain; the discomfort that turned into sciatica that turned into a snake writhing from deep in my right butt cheek, eating it's way through my thigh and my already delicate knee, and down my shin and finally sinking it's fangs into the inside of my right ankle; the tingling, then numbness in my hands and fingers, and then pain in my palms and wrists and forearms; the depression--against which plenty of love and help I seem to have minimal defenses--that accompanies my little physical ailments.  It seemed to begin all at once, driving down the M1 in England, when I couldn’t get my hands and arms and legs and hips comfortable. I'm perfectly aware that--in the midst of my troubles, good friends have had breast and thyroid cancer and many others have had health problems this year--there are far more serious health problems people face in the world every day.  These issues, while uncomfortable, don't stop me from taking pleasure in life, don't stop me from traveling, and only stop me from working when I let them.  (Sometimes I'm willing to let them.) But they are besetting and they're getting worse.

           My general practice doctor thought maybe carpal tunnel especially as I came up positive for the antibody. or whatever it is that comes up in a blood test, for Rheumatoid Arthritis.  So he sent me to a rheumatologist, who, after further blood tests for Rheumatoid Arthritis, Lyme Disease, HIV, and half a dozen other things including thyroid, said, nope, no rheumatoid factor.  I'm healthy.  Which in rheumatologist-speak means: "You don't have what I tested you for." He sent me on to a Neurologist (and, you know, "It takes forever to get an appointment with a neurologist.") whom I saw a month later. He said, "Looks like carpal tunnel."  "We'll do an EMG (Electromyogram) in which after determining a baseline of how your legs and arms carry electricity by increasing levels of electroshock up and down your legs, hands and feet, we’ll place small needles in your muscles and determine how the nerves carry impulses down your legs and arms into your hands and feet."  But that test couldn't be scheduled for another three weeks.

            Three weeks later he expresses astonishment that I laugh, rather than jump and groan and complain, when he sticks needles into my thighs and biceps and watches a readout and listens to a speaker track electricity as it works it's way into my fingers and toes.  But then he doesn't know me very well. I told him I was surprised it was the neurologist instead of a tech who was doing this. He explained that it took extensive, particular training and it was hard to learn to nerve impulses.  We had a brief conversation about sex toys.

            "Listen?" I ask.

            "Your legs sounds good."  That's a relief. "Your hands are bad.  Bad Bad,  You have bad carpal tunnel."

            "Let's see if it gets better in a couple of months, and maybe look into surgery."

            "Lets check into surgery now.  I have a $6,000 deductible that I've burned through with these tests, and I'd like to do any further procedures on this year's tab."

            Three days later I'm at the surgeon's. "Well, looking at the test results and the neurologist's report, You have severe carpal tunnel, and the only thing that will relieve it is surgery."

            "It will get better?"

            "No, you already have severe nerve damage"

            "So it will make the tingling and pain go away?"

            "No, it will prevent further damage." He went into a parable about a garden hose (my median nerve) which waters the grass (my ring, middle, index fingers and thumb).  "Your grass is yellowed to brown, almost dead. See that muscle at the base of your thumb?  See how mine's nice and round [he had a nice, round muscle]?  And see how yours is flat?"  He paused to let me ponder my pathetic lawn/thumb-base muscle.

            "Fine." I said, a little embarrassed about my poor gardening/physique.  Will it make the pain in my palm and wrist and arm go away?"

            "No. That's something else.  We can refer you to sports medicine.  It looks like tendonitis."

            "So it won't fix anything except keep the lawn from dying?"

            "Right."

           

            Next day back at the neurologist, the first thing he says is, "Throw away the letter I wrote to you about your issues."

            "Pardon me?"

            "I got the neurologist's report, and just read the first half that said your legs were fine so I wrote to tell you that you were fine."

            "Uhh..."

            "Just throw it away. I think I was distracted.  I guess I'm over-worked.  I only read the first half of the report."

            "Not knowing quite the polite thing to say, I asked him about the surgeon's prognosis.  He agreed.  Carpal Tunnel.  Severe.  No, don't wait." and "No it won't fix the pain or the numbness, but it will keep it from getting worse."         

            So I'm having surgery (not arthroscopic--"more complications") on my left (the marginally worse) hand (hence the insane trouble with d's, e's and c's and pretty much any other letter I type with my left hand)(You should hear what the surgeon said about gyms.)) later this month, and the right hand later in November.  I can't go into the ocean or pool or gym until the middle of December so I'm making up for it like crazy this week. Waah, Waah, right?

            Oh, and to add injury to insult, Rheumatologist said, "You should have taken care of this right away."

            When I said that I'd been trying to see doctors and get appointments and had three MRIs (my spine's worn but in great shape, otherwise, you'll be happy to know), since July 1st, he shrugged.

            And none of the three has an observation as to why or how this happened.  Not their job. Maybe bicycling on the California Lifecycle ride in 2008? 

            "Oh, and no bicycling."

            

One Art

BY ELIZABETH BISHOP

The art of losing isn’t hard to master;

so many things seem filled with the intent

to be lost that their loss is no disaster.

Lose something every day. Accept the fluster

of lost door keys, the hour badly spent.

The art of losing isn’t hard to master.

Then practice losing farther, losing faster:

places, and names, and where it was you meant

to travel. None of these will bring disaster.

I lost my mother’s watch. And look! my last, or

next-to-last, of three loved houses went.

The art of losing isn’t hard to master.

I lost two cities, lovely ones. And, vaster,

some realms I owned, two rivers, a continent.

I miss them, but it wasn’t a disaster.

—Even losing you (the joking voice, a gesture

I love) I shan’t have lied. It’s evident

the art of losing’s not too hard to master

though it may look like (Write it!) like disaster.

The Waking

BY THEODORE ROETHKE

I wake to sleep, and take my waking slow.  

I feel my fate in what I cannot fear.   

I learn by going where I have to go.

We think by feeling. What is there to know?  

I hear my being dance from ear to ear.  

I wake to sleep, and take my waking slow.

Of those so close beside me, which are you?  

God bless the Ground!   I shall walk softly there,  

And learn by going where I have to go.

Light takes the Tree; but who can tell us how?  

The lowly worm climbs up a winding stair;  

I wake to sleep, and take my waking slow.

Great Nature has another thing to do  

To you and me; so take the lively air,  

And, lovely, learn by going where to go.

This shaking keeps me steady. I should know.  

What falls away is always. And is near.  

I wake to sleep, and take my waking slow.  

I learn by going where I have to go.