07 November 2015

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.

06 November 2015

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.




04 November 2015


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.

02 November 2015

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.