How I learned to stop worrying

Mandala

 

I think the artistic creation above is more attractive than a photo of my ankles, so you will have to imagine my peripheral edema.  Peripheral means on the outskirts of your body, usually your lower legs, as they sort of hang down all day, which encourages fluid to accumulate in them.  Edema is the visible swelling caused by that fluid.  I only make a point of this because I know many of you have a grandma in your life who has to go to the store in bedroom slippers, and you don't understand it.

Here's the thing:  it's not good when both ankles swell, but when just one is swollen, everyone worries.  So several weeks ago we saw my primary care doctor about it - this was on a Thursday - and he scheduled the soonest possible ultrasound, the next Monday, to rule out blood clots.  You really don't want a blood clot to form and travel to your heart or lungs.

But Friday night we noticed how bad the ankle looked, and Tom called our doctor's clinic about it, hoping for reassurance.  But the doctor on call said, of course we should go right to the ER and get it scanned, and not end up suing them for negligence. 

So we did, and this is getting to be a long story.  So I will skip the part about how they shut the ultrasound down at night and those people go home, so it was spend the night in the ER, having many other stupid tests done.  And finally the scan in the morning, and finally they said it was just fine.  I did not have a blood clot.

I'm trying to wind my way to now, several weeks later. We went back to primary care doc yesterday, because the damn swelling hadn't gone down, and I also suspected another UTI.  And this led to a thorough review of all the stupid tests done in the ER, which are right there on his laptop (!).  Blood draws, liver, kidney, and so on.  And everything looks fine.  This was a huge relief to us.  Nobody had told us to see him for a follow-through. This is modern American medicine at its best, unless you are very rich.

He explained that with age the arteries and veins can grow slack, and edema happens.  We could see a vascular specialist, but it was clear enough that the only thing that would accomplish would be to assure us further that nothing was wrong.  I should wear my compression stockings.

But most interesting, he had gone to some computer program with the extensive list of my medications, and returned with three pages detailing which meds are most likely to cause - guess what - peripheral edema.  When a doctor does things like this, you don't mind if he's wearing bespoke pants and Italian leather shoes.

And guess what?  One of the immunosuppressants (Rapamune) is a HUGE culprit in this, causing it in over 50% of the poor transplant patients who have to take it.  And furthermore, it commonly, their word, causes half a dozen other things, some of which I don't have yet, like headaches (but I'm thinking about it).  Nobody tells you these things.

You may have come to this post hoping I had a clue about how not to worry.  In a way, it's implicit in the story.  Identify the problem, take steps, get information, don't push it away.  It is easier to face your worries when you meditate; in fact, it is impossible not to, eventually.  Sometimes it's when the anxieties start to break through the bliss that people drop the practice.  But that's when it's started working.

[The image is me having fun with a recent photograph.  Now we're down to it - you can do so much with photography, the only reason to paint or draw is that you enjoy the feel and smell of the materials.  Which is a good reason, after all.]

Craving Enlightenment

Back when I practiced as though my hair were on fire it was because I was desperate.  First, I was afraid to die. I wanted to heal, not die from breast cancer. During that time I learned that the body is always fighting new invaders, that there are always cancer cells coming in. So I formed a visual meditation that had to do with T-cells, big spiky things, like those medieval weapons. I believed what I'd been taught, that my individual will could do anything, and if I failed to meet a goal, I was "a failure," and needed to try harder.  Obviously, I thought I was a noun. Like an object.

It's unpleasant to remember being so frightened and alone, grasping with all my might at control over the future, which I did not know is subject to many, many influences beyond me. I wrestled with it like Jacob with the Angel, thinking, reading, writing, meditating up in my second-floor study in the house on Aldrich Road, which I called "my ivory tower." I was sort of joking, but it was true; up there I was secluded from my daily life, studying and writing poetry.


But I'm taking the long way around to my point - as I learned about Buddhism, I began to think the answer to all this pain was enlightenment. I conceived this as a sea change into an unwavering state that was like being in a room filled with morning light.  I thought enlightened people had calm, loving, clear, untroubled minds, an unruffled certainty that everything was alright. I thought enlightened people were perfect, and I had always wanted that, actually.  Now the mess of me - a body that had developed cancer in secrecy - was a sort of stinky garbage dump.

I was a long way from understanding the way life is, the interconnection, the change, the calm of just doing what you are doing in reality and not doing a lot of other stuff in your mind.  I had seldom expeienced a bare, clear moment; my moments were incredibly messy, my mind busy with obligations and desires and standards and hurry.  The core that run up my spine was red hot with fear and desire.  Or take another metaphor: I felt like a cartoon character running madly, trailing flags of Things-to-do.  Or another metaphor:  as I stood at the kitchen sink washing lettuce, these things whirled round me.  I was always a couple of steps into the next moments, the day, the week.

So I was perhaps your basic neurotic. I'd gotten along with myself and my ordinary unhappiness until that diagnosis.  Teachers call the state I was in "a promising situation."  God knows I was motivated to practice.

Well, this is exhausting me to even write this. It was 1997, a long way back, and 1997 doesn't exist now, nor does that version of me.  These memories are merely mental emissions, pathways through my neurons, and have no real existence.  Neither do any of the numerous Big Problems I anxiously worked back then. I have new situations, but now I know that it's me that labels them My Problems. Me that prefers not to have problems.

Intrusion of reality - Tashi broke skin on my wrist a moment ago trying to convince me that it was 8:00 a.m. and time for my Neoral and, more importantly, her breakfast.  So I have to go wash with soap and hot water, rub with alcohol, put on antibiotic cream and a bandage.  There, that's the reality of being immune-suppressed.

I don't know.  I may have more to say on this.

Thank you, Pema

I suspect Pema Chodron is the second best-known Buddhist in America, for good reason - she is such a good teacher.  I have all her books, and used to listen to her on tapes.  Somewhere she told about her experience going through the long formal ceremony to become a Buddhist nun.  Afterward, she said, she was hot and tired, and had never been happier in her whole life. That struck me.  Really? I thought.

Today, Tom and I are both very tired - haven't caught up from the sleep lost Tuesday night when he was in the ER, though we've both had two good nights' sleep.  For me, fatigue from driving and walking those long halls.  Then there's the remaining uncertainty - was that fall caused by a seizure?  Is that possibility why the discharge instructions tell him not to drive until his followup with a neurologist? 

Wun used to have some mental structures around this kind of thing, believing, for instance, you won't be happy until you're well-rested.  I see in other people, too, that we tend to believe that maintaining a state of anxiety will protect us and maybe prevent the feared event, the next fall, the possible seizure.  I clearly remember my mother sitting by my brother's hospital bed when his back had blown out, staring at him fixedly for hours, frowning.  Magical thinking. 

Prayer can help, I know, though I believe the rules of the material world generally hold sway.  But I doubt that worrying and ruminating are of any help. And anxiety is not the same as caution, and may interfere with reasonable precautions.

Anyway, my take on it is that you don't have to have a perfectly desirable situation to be happy.  That's what Pema says, and I like it.
~~~~~
image:  Edge of our back yard last week, looking over the ravine.

What's wrong with that cat?!

[image: Sheba on her pillar in my study]
Monday morning we were out for about two hours, getting acupuncture. It's unusual for both of us to be out in the morning, but not unheard of. When we came home, we were meant by the loud lament of The Banshee Cat. 'Sup? I wondered, using my latest street vocab, learned from my grandson. Whassup, Sheba? Why do you need ten minutes of petfest and verbal reassurance to calm down?

It came together with many observations of this little old cat we adopted last summer. Her skittishness, her fear of all Others, cat or human. I thought she had what writers call a backstory, and I knew what it was. It was titled "Separation."

Sheba was eight or ten years old when she was left at a veterinarian's by the woman who brought her there. How long was she there in a cage, waiting to be picked up and taken back to her home territory?

But before that, I thought, she had experienced abandonment. I imagined she lived with an older woman who loved the cat dearly - Sheba has a great purr, the softest fur anywhere, loves to be petted. Her dainty, well-trained habits suggest someone worked with her - no scratching on the rug, no trying to run outdoors.

What if that woman got sick and was taken out, and never came back? Maybe Sheba survived for many days until some niece or sister came to the apartment to pick up some things, and there was the little cat, wailing piteously, out of water and food and scared to death by her person's disappearance. Abandoned and likely to die of dehydration or starvation.

We can hardly know what it feels like to be a nine-pound animal that cannot open a door or get water for itself, that is totally dependent on people who don't follow the schedule. One horrible experience with abandonment can train that animal to be forever easily frightened.

It's a good thing, I thought, that we've never gone on vacation since we had her. We did that when we had Sherlock, leaving him in the care of a reliable and attentive neighbor. Nevertheless, when we pulled in the drive coming home he was on the kitchen table letting out sustained, distressed meows, telling us over and over, I missed you, I didn't know if you were ever coming home.

Thing was, Sherlock was a big strong male cat with a lot of resilience and a naturally sociable fearless nature. He got over it, no credit to him I suppose. He didn't do therapy or meditate on it, just plunged forward into the present reality. That's the kind of cat he was. Sheba is another kind of cat altogether.

What made Sheba and Sherlock such different members of the same species really doesn't matter. Why, why we humans ask. Buddhism points out that we are better served by concentrating on the reality of now. Sheba does have something in her personality you could call separation anxiety. Knowing what caused it would not much help me deal with her. Following her attentively to one of her pillars and stroking her, that helps much more. All this, of course, does not apply to our Small-r relationships ™ with humans in our lives, how we might accept them. It's just about cats.

My anxiety

I feel so relaxed today, deep in my body, that a quick scan of the past doesn't turn up a comparison. Better than Valium, I think. Better than the phenobarbital I was given at one time for irritable bowel syndrome - that's when your gut can't stand the way you're living or, maybe, who you're living with. A relaxation as good as what I used to feel after doing yin yoga with Kit. That good.

The source of this peace and freedom from anxiety seems to be getting good lab results yesterday. Of the various things they check in my blood every month, two figures stand out: hemoglobin and eGFR. Hg is easy, red blood cells. My poor little kidneys are still producing enough of the hormone that makes them, no downward slide since the last test. Good news.

eGFR is something you probably don't know about unless your kidneys are failing - a number arrived at from plugging your creatinine into a formula. The number indicates about what percentage of kidneys you have left. Mine went up from 8 to 9 this month, not down. What a relief! (What is the new punctuation mark we're going to get that is a quiet sort of exclamation? I imagine the kids, texting, are going to invent it.) It means I don't have to get serious this month about preparing for dialysis.

Peace. It's wonderful. Wouldn't you think that 12-plus years meditating would make it possible for a person to call it forth at any time? I would have thought that, but it turns out not to be true in my case.

Americans underrate Karma, in my opinion. I mean, the reality that our personal will is not in charge, that a great many causes go into making us act the way we do. I wonder, if I had an identical twin turn up, would she be like me in myriad small ways? A person who tends to throw her clothes down instead of hanging them up, say. Or who has to try hard to be punctual. Who gets anxious about things when being anxious doesn't help a bit.

Anxiety is a lot like anger that way, I think. That is, it doesn't do any good, and in fact, probably gets in the way of a good outcome. But my experience is that anger has been easier to work with. Practice has impacted my tendency to get angry until these days I don't get mad. I may feel frustrated, but I can let that dissolve, the way you let stories dissolve when you're meditating.

My anxiety though exists on a deeper level. Maybe I need to do a Chod practice that has helped me with other things - sit down with that anxiety, personify it, name it (Ann Gzieti?), and give it what it needs. That's a serious full-bore approach.

The things I've done up till now have certainly taken it down quite a few notches. Yet, talking to myself about how dialysis is just a medical treatment, telling myself that it won't be what I imagine - nothing is - reminding myself that anxiety will not hold off reality - these intellectual strategies just involve the left brain. They have not gone to the deep layer of self or body where that kind of anxiety resides. Maybe it is something innate, a fear that is natural to us as vulnerable animals. Maybe I only notice it's still there because I meditate, and have become more sensitive to my feelings. Maybe, maybe.

There turned out to be a sure cure for my anxiety, the way there is a cure for the panic you feel when you dream you are confronted with a test in a subject you know nothing about. That is, to wake up. The anxiety was also a sort of dream running in the way-back movie theatre of my mind, and the way to stop it was to for reality to step forth and present good lab results. I couldn't make that happen, but here it is, a gift from a personal karma that has kept these faltering kidneys working for years longer than predicted. Last night I slept an amazing 11 hours. Today I feel the gratitude in my abdomen.

It is snowing here in Ohio, a persistent fall of small flakes, vertical, no wind. We are expected to get several more inches. I don't plan to go out today. My Appalachian friend might add, "the good Lord willing an' the creek don't rise." That is, we'll see what karma brings.