Fun-loving Buddha

Well, I signed up for a course on The Artist's Way last weekend, knowing I really need to de-stress more.  It hasn't started yet, but I got out the book, which is graced by my comments and underlining from whoa, 1995, at which time doing the morning pages led me into channeling a novel written by my cat - Sherlock Here: Memoirs of the World's Most Educated Cat.  Flipping through The Artist's Way yesterday I noticed an exercise toward the back on having fun, and this morning I got up with it in my head.

I got warmed up as I answered the six questions.  When I took a break for 8:00 a.m. pills - immunosuppressants, which suppressed my immune system so much that I ended up in the ER twice over Christmas, and have had to take 3 (three) big antibiotics in a row, so you can see I need some fun in my life.

Inspired, I started creamed hard-boiled eggs for breakfast, as I had remembered how much I used to enjoy cooking, and haven't made those for years.  My answers turned up a kind of cute childlike desire to put together a cool spring wardrobe - I got more and more drab as I got too sick to bother.  I thought of compiling a list of my 100 favorite songs from teen years. (Born in 1942, I was just on the cusp of rock 'n roll, a great place to be.)  Maybe doing my version of those songs, harmonizing with myself - there's a spiritual idea.  Learning to take and edit video.

Fun.  Fun-loving Buddha.  It sounds weird, doesn't it?  Maybe it's the fact that I have practiced only in the Zen tradition - I have a sense Tibetans are less restrained - but it seems like people think being spiritual is a very serious matter.  (I am trying to imagine a laughing Kanzeon.)  You're supposed to be calm.  How do you have fun being calm? I wondered.

"What do you do for fun?"  Somewhere in this mess I have a book in which an older Japanese Zen Master writes about not having fun, never, not even knowing WTF fun is.  He seemed annoyed that a student would ask such a dumb question.  I can't find this book, though I don't remember burning it while dancing around the flames, no, I would never burn a book.  But I suppose the idea is that an enlightened person finds all of life delightful and joyous.  They talk a lot about Joy in Buddhism, but the only person I know of who's talking about fun is James Baraz, who advocates laughter and music.  And Lama Surya Das has reminded a student that playing jazz is his practice.  I bought the Baraz book last year, but read it while in the uremic haze of advanced renal failure, so I don't remember much.  It wasn't working for me, though it looks like the in-person classes would.  After all, isn't it amusing to think of studying fun with a book?  Study fun:  an oxymoron.

Time for my 9:30 pills.  I think there are 19 of them now that I added acidopholus to invite some friendly bacteria to my digestive system, after the onslaught of all those antibiotics.  And cranberry supplement to try to make my bladder unfriendly to colonizing e-coli. You can see, can't you, why I need more fun in my life?

Playing on the shore of karma

Much news from here.  I haven't blogged since last Tuesday - too much to be coherent.  On Wednesday I was stunned when a good friend told me she, too, would like to donate a kidney to me.  So if it doesn't work out with Laurie, she's there.

Saturday I picked up my latest blood tests.  Uh-oh.  I have dropped from 8% to 7%.  Even having this prospect of the golden plum, a real transplant, the drop scared me.  I remember a kidney doctor telling me, "When you're at 5% you'll beg for dialysis."  On the other hand, the drop in function could be what they call "a laboratory variable," not really meaningful.  

I didn't worry about it as much as I would have a month ago.  My friend's offer has slowly reformatted my brain once again. My sense of the universe - it's a sort of image off in the right brain - was that a solid foundation is there now, like a floor where there had been no floor until then.  I knew Laurie's gift could easily go wrong at so many points.  And indeed, when I talked to her on Sunday, she was concerned.  The nurse had told her that because she had many blood transfusions many years ago, her blood might be full of antibodies, and that might interfere with the transplant.

Sigh.  Home we went, Tom and I, and to our computers.  We both tooled around on some of the same reputable web sites, like Johns Hopkins, and became convinced that this is an issue that applies only to the recipient.  If the recipient has had transfusions, she might have antibodies that will want to reject the kidney.  But suddenly it had become clear that anything can happen, that even two donors might not be enough.

Last night I walked 1/2 mile!  The Chinese doctor had gently suggested that I needed to get in shape for the transplant.  It is calming to walk in the evening, not trying to be aerobic, just build muscle, but the least little rise makes me short of breath, I guess that's what they mean by "aerobic".  I was asleep when Tom came to bed, and slept 11 hours.

I woke up okay with it all, realizing once again that karma is a huge force.  Not implacable or unstoppable.  What is the adjective?  A little research shows me that there are the usual dualing isms - firm/yielding, like that.  Well, the great river of cause and effect, this sea, so many causes back there have led to the causes of today, the things producing this moment in Laurie's health and mine and in what's going on in this arena of transplant, who's who in the transplant center . . . There is not much use in me focusing a lot of Want! on it, though that's not hard to do.  My favorite thing to imagine is that this poor, sludgy brain will be rinsed clean, and I will once again write, write! only better than before, much better for having gone through these hard, slow years in which I mostly studied writing rather than actually doing the hard work.

Or I can imagine the trip.  Tom and I missed out on the traveling many people do when they first retire.  But now, with me doing better, having the energy to plan, we could drive that great circle tour of our country.  With a good working kidney, it might seem possible.  You just need to have the fallback plan, what you will do in case it goes into rejection, where the good tx centers are.

Dream on.  It's so much easier to deal with the life we've got right here.  At 1:00 we are going grocery shopping together.  I had a shower today.  First, I swept the bathroom floor, and the worst part of the kitchen floor.  If I get a kidney, when I get a kidney, that will be nothing, it will be easy to sweep a floor and take a shower on my way to having a life.
~~~~~~~
p.s. Coming across this post a year later, I must comment, How wrong I was.  A whole new raft of health problems arising from the immunosuppressants themselves and an old body in which only one organ was replaced, not the muscles and bones. Just to set the record straight.

 

Getting a life

This morning my e-mail led me to an article on cognitive decline in hemodialysis patients. Technical detail: Hemo is the common type of dialysis you think of, in which you sit in a clinic for several hours hooked up to a machine that removes, filters, and returns your blood. It is usually done 3 types a week and seldom keeps people at full functioning. My own poor failing kidneys are still able to work for me without dialysis - today - and I am waiting for my living donor to pass her evaluation. But these overworked kidneys could fail dramatically today, and there I'd be, in the hospital, getting an emergency access through a port in my chest.

Looking at this study made me briefly put my face in my hands, the way you do when you just aren't up to dealing with something. "This study demonstrates that cognitive function deteriorates in hemodialysis patients over a 2-year time period." Of course. It's not like you don't know that. Physical function deteriorates on hemo, which is simply not as good as what kidneys do for you - they are a miracle of bodily function, filtering out waste. Mental decline is just one more reason to dread hemo. The article also talks about the side effects of the drugs that try to keep phosphates from building up in the blood, drugs I have in fact been taking for years.

There is this ray of sunshine - This "decline can be halted, and even reversed, by transplantation."That's the very hard place I'm in right now - waiting and hoping for that transplant.

Yesterday I broke down in the office of a kind doctor who was adjusting my medication in hopes that this transplant goes through. There is the kind of crying that is inarticulate, just a well . . . an overflow when the walls against grief let go. I told him what he didn't know, how these last years - since 1997, in fact - have been so hard, breast cancer, my father, mother, brother dying, Tom having to retire on disability. All these things hard and complicated. Then having my life eroded by this kidney failure, which drastically limits what I can do. It limits my mental abilities, I was already aware of that. I'm just not sharp enough or energetic enough to work on the novel I somehow managed to envision a couple of months ago. To work on marketing the stuff I already have, written before I was this sick, even to send out some poems is a big event. It happens to almost everyone with this illness - you can't work. That's more important to some people than to others, but you know, everyone wants to be useful, to live a meaningful life. To be able to work, to write seriously again was the first thing that flashed into my mind when I learned Laura had come forward.

This possibility of a good transplant, the best kind, from a living donor, cracks open a door behind which there is golden light - I could have a life again. To have a life, to wake up to days in which you can do something beyond just staying well. To be alive, to have a life. It means having the energy to change the bed. To take a walk with the camera. To plan and cook decent meals, not all this awful prepared stuff. To keep the house clean - that should be easy with this simple, small house, but I can't do it. Energy to meditate - mostly gone since my kidney function dropped to 8 percent in December. As for going on retreat? Impossible for a couple of years now.

Somehow I told the doctor that Buddhism gave me an edge in this. That after all, the Buddha's primary discovery was that human life is difficult, that we must expect sickness and old age. I am in a better place in that than I was in 1997 when I was astonished to be diagnosed with breast cancer and thought it was unfair. That was then I grasped meditation and then Buddhism like lifelines. They have been something to hold on to, but only enough to keep me from sinking, it sometimes seems. I am still in a raging sea, and I am not meeting these difficulties with unshakable serenity.

Not all loss is the same. The old cat I loved so much has been replaced by another old cat with a cranky personality. She keeps me company, and that has helped immeasurably. My mother is gone, but I have an older friend who has a gentle, kind attitude of caring toward me. But when you lose your youth and vitality nothing comes in to replace it. You struggle just to meet daily needs, just to exercise, to get out and around people enough to keep you from being too lonely. To find interesting low-energy activities, something besides watching TV. This is me, this is my life now. No wonder when James told me his wife wants to give me a kidney, I burst into a fit of crying that must have astonished everyone.

Transplant is an amazing treatment. It is a very rare opportunity, to be restored to health. You don't get that chance with a lot of degenerative illnesses. Despite its wonderful opportunities, it is still a dim and sometimes frightening path, a tricky major surgery, what can be a long convalescence, fallout from the anti-rejection drugs that have powerful side effects. But it's a life.
[image: fallen flowers of the catalpa tree]

The last tulip, not photoshopped

We picked up a copy of my most recent blood tests today. My poor little kidneys are holding their own! - hemoglobin stable at 10, in other words, I'm still making red blood cells. eGFR stable at 8. It's not a good number - 8% of kidney function - but I can live with it and not go on dialysis. One of these days I need to explain why I so don't want that, do want a transplant instead.

After reading the numbers in the van I burst into a spring shower of tears. Relief. After that I had such energy! I didn't think I was depressed over the weekend, waiting for these results, but I was. I go through this every month. It's been four months now since my eGFR suddenly dropped from 12 to 8 for no reason anyone can figure out. When kidneys are this weak, doing their job is hard on them. It's easier to see how sick a person is when their lungs are only functioning at 8%, or their heart.

We went on to the health club, as planned, and I got up to 23 minutes, 1400 steps on the Nustep. (Goal, 30 minutes) Did three of the strength machines (abdomen, chest, back) at a higher level than before. Did my PT exercises to build strength in that left leg that got so weak last year when I was off my feet. I still can't climb a flight of stairs.

There are things you know, but don't realize deeply. Today I realized a cluster of things: that it would benefit me to be stronger, and I can achieve it by doing these exercises, and that it's work, not fun. So part of me wants to add, So get over it.

And let's see - what would be a bit more fun as an image? A picture from about a month ago. This tulip was blown-out, getting near to dropping its petals. It is sitting by the front door in the morning light. I am still very far from using Photoshop or a cheap imitation, though I do have a book now. When I look through the book, I don't think they're necessarily improving the pictures when they "manipulate" them (sounds unpleasant, doesn't it?). I like things that look like they actually do look, a mark perhaps of my generation. I think before you go about changing things, you ought to make sure you know how they actually look.

What you can get away with.

The list on the silver bulletin board on my refrigerator door reads

food
rest
exercise
meditate
fun in its many forms

If I had to narrow it down to what's necessary for survival, I'd put

food
rest
exercise

. . . much as I love fun, you can go a whole lifetime without it. Some people do.

(Strictly speaking, you don't have to exercise to stay alive, but if you find yourselves comatose in a hospital, someone will move your limbs around and massage them, by hand or mechanical pumps, or before very long you'd be quite unable to stand or use any muscles. As for meditation, many people never do it after infancy when it seems to come naturally in the form of rapt absorption in an object, seeing the world in one's toes, or repeating endlessly a mantra, such as "mine, mine, MINE.")

Many people recognize Eat, Pray, Love as the title of a best-selling book. I haven't read it, but I imagine the author also rested and moved about. I don't think that book's about survival. More like "finding happiness," I guess, which we Americans believe in profoundly, that happiness is an object, a treasure, that can be found somewhere. Somewhere else. Like an Easter egg hunt.

What gave rise to my little list was a decline in my happiness last night, a muzzy, bored mood, a fatigue coupled with insomnia, and a desire to eat all kinds of things at 1:00 in the morning. That could read "things I should not eat," which is most everything for someone with kidney disease. Certainly on that Don't list are cashews and all the potato chips in the house. Fortunately, there weren't too many.

Faithful readers know I have kidney failure, and am very close to needing dialysis or a transplant. Kidneys are really the center and soul of your body, in charge of your cells getting the nourishment they need. Whatever you eat, the kidneys sort out, and send the excess along the trash conveyors of your elimination system. A piece of this is keeping your electrolytes in balance. To do this, healthy kidneys discard extra salt and phosphates (as found in Dove ice cream bars) and potassium (as found in potato chips). Pathetic little kidneys like mine do their best, but can't keep up at all with the standard American diet. So my body informed me this morning when I woke up with a familiar headache and a salty taste in my mouth.

Thus we have again a new vow, yes, maybe it's deeper than that - maybe it's a realization that there's no way to get away with eating the way I've been eating lately.

I don't think any of the sweet and spiritually advanced people who read my blog would at this moment feel haughtily superior to me. We all know about problems with food. I myself once knew an eating problem intimately, when I gained a lot of weight, so much that I decided I had to "go on a diet" to even stand being around myself.

I believed, and still do, that to lose weight I have to burn more than I eat. Back then that meant eat less than I burned, because I was as far from physically active as you can get and still climb stairs. I went on that diet rigidly. That was it. No "cheating." I knew that every mouthful actually counts, including the crumbs in the Oreo package. From somewhere I had gleaned a slogan:

A moment on the lips, a lifetime on the hips.

I set myself to eat 1200 calories a day, which meant I was always hungry. I was obsessive about measuring and writing down what I ate. I carried lunch to work - I recall peanut-butter and applesauce sandwiches. A yogurt for breakfast. I counted the tablespoon of cream I used in the coffee I drank a lot of back then. I allowed 150 calories for the one treat of the day, 1/2 cup of ice cream before bed, which I ate with a reverence I have seldom brought to prayer. I did.not.ever.cheat. Living like this (and smoking cigarettes) I lost 1 1/2 pounds a week. Taking off thirty pounds was thus very very slow. But I did it.

Wouldn't you say a person like that could manage a renal (kidney) diet? It is not even calorie limited. You can have all the organic shortbread cookies you want. All the white bread. A lot of vegetables, if you're careful to check their potassium level - no binging on guacamole, for instance, very little tomato, no potatoes. Even in chip form. Especially in chip form, dusted with salt. Did I say, no salt?

That radical dieter was the person I was some thirty years ago. Rigid systems suited me more at that time, a personal preference that has melted around the edges. Now what I have to count on to keep me on track is an understanding of cause and effect.

That about sums that up. Today I am back on the renal diet with a new ferocity, aware of another decline in kidney function on my last labs, as well as my subjective experience. Maybe meditation practice can help me stay in touch with the reality here.

In one of his recorded talks, Jack Kornfield says that a student summed up karma pretty well: "You don't get away with nothing."

When I first heard that I laughed. I thought it was a joke.

Giving in

Article in today's NYTimes about how people head for their internet connections to the outside world first thing in the morning. Kids sleep with their phones in hand. Of course, this is deplored as taking us away from the traditional morning activities of a certain privileged demographic (us), like walking the dog or helping the kids find their homework. Yes, I think the dog should be walked. I also think there's a certain Luddite resistance to change.

If I tell you I remember when television came in, you will think I am 66 11/12 years old, and so last century. I try to think of it as accumulated wisdom, or at least experience. Television. We were all fascinated by it, stunned by the availability of entertainment. Until then I had been lucky to go to the local movies once a week, where I would patiently sit through an entire double feature, even cowboy movies. They were movies. I loved them.

I had a girlfriend whose household had the magic box, and she and I used to watch all the sitcoms we possibly could. It all pleased us, though it was aimed at adults, and I suppose we didn't understand most of what went on. We liked Topper, and My Favorite Bachelor. I knew a kid who actually sat and watched test patterns, waiting for the programming to start. Parents, surly about the whole phenomenon ("Radio was good enough for me"), became fixated on watching the evening news with Walter Cronkite. Then, hearing other grownups talk about actually indulging in TV, my own parents allowed themselves to watch Sid Caesar and the Ed Sullivan show. Thus I got to see the American debut of an English singing sensation.

I have a point here and I am wandering toward it as you can when you have no editors to please. It is this - let us stop berating email and texting and Facebook and admit it - we like this stuff. What's wrong with that? A Zen Teacher I used to work with had a way of saying things that struck home for me. In one talk he referred to simple desires, and he shocked some earnest vegetarians by saying, "If you want a Big Mac, go ahead and have one, and enjoy it. Be with it all the way." The idea was, it doesn't have to be a big thing.

Doesn't it sometimes seem like we spend our lives resisting ourselves? There are impulses well worth resisting, arson, infidelity, just one cigarette, but that doesn't mean goodness is purchased through self-denial. Sometimes I think about the string of stupid diets I've been on in my life, thinking that being slimmer or abstractly "healthier" would translate into happiness. It didn't.

I hate thinking about that self-denial. I mean, one of these diets, prescribed by an alternative MD, had me off all gluten, dairy, and sugar. You could hardly find gluten-free products at the time. When this doctor intuited that I should stop eating potatoes and drinking water, I finally said No. But I had wasted months concocting unpleasant milkshakes with all sorts of stuff in them. I regret that now that my kidneys are wearing out, because I really do have to follow a diet, no choice. The experience of the last years confirms the medical wisdom: limit potassium, phosphates, protein and, God help me, salt. I can't binge on this diet. Eating the wrong things overloads my poor kidneys, and I get a major congestion headache or an episode of arrythmia, or lie awake all night feeling the ribs I treated myself to because it was my birthday.

There actually is more to life than food, that's just one example. In fact, we Americans obviously do indulge too much in food, mindlessly, I think. The real thing is to become intimate with yourself and your cravings. Does this circle me back to the fact that I, too, get up, make coffee, and check my e-mail? Yes. Facebook, yes. Maybe someone else is online at 5:00 a.m.

I can make a logical argument for all this internet connection, but it really isn't about logic - it's about enjoying what we decide to do. This can be a challenge when it comes to eating that Big Mac, which I did not long ago. In reality, it is precooked and never warm enough. But eating it reminded me of these realities, and stopped the craving for that ideal Big Mac they advertise, at least for a while.

What to do when the resurrection is cancelled

We had our nine-year old grandson, Otto, over the weekend, and as always, played board games and card games. Then he suggested Jenga, which we have played together for years. In this classic game you build a tower of finely milled hardwood blocks, which you remove one at a time and stack on top, trying not to topple the tower. But it inevitably does fall with a wonderful crash, and you are never quite expecting it, so you scream. Blocks go everywhere, on the table and floor. Cats don't like it, Otto does. I like that we played it as a cooperative game, all three of us trying to beat our personal group best (32 levels).

As we played, I thought how this game is like the crash and rebuilding of the self, our ego. Something happens, our trip stops working. Today we might say, Time to Reformat. Robert Aitken comments that Zen teachers consider this an auspicious condition, though he didn't know that when it happened to him.

I happen to be noticing my crash right now - last week I talked with an OSU transplant surgeon about my bad reaction to cortisone. A shot in my hip for bursitis in late January led to moodswings that ended only recently (if they have indeed ended). Now I am "on hold" on the list - that is, they have not removed me (that will probably take a committee meeting), but I will not be matched when a kidney comes in.

I thought OSU had gone to a "steroid-free protocol." They're trying. But the first week after a transplant, it is still necessary to load every patient with steroids to prevent the rejection the body is trying so hard to bring off. Every day the dose would be fifty times the dose of that shot in the hip - which sent me into moodswings for several months. Ten percent of transplant patients end up having to stay on steroids. Anyone who goes into rejection syndrome is put on steroids. In other words, there is no avoiding them. (This story is the same at Cleveland Clinic.)

The doctor told me he has been working with kidney transplant for fifteen years, and he has seen what both of us avoided calling by its true name, "steroid psychosis." He was sincere in explaining that you don't want that to happen. No, I really, really don't. The moodswings of this winter and spring sometimes had me just sitting in a brown sludge weeping gently, thinking I'd rather be dead.

The odd thing about being taken off the list was that I did not have an emotional reaction to it, beyond mild shock. No drama, no need to stuff it down with chocolate cake. I kept wondering about that until this morning, when I realized the more complex nature of my reaction - I am no longer waiting for the call that can come any moment and lead to - maybe - a new life. Sometimes transplant works stunningly; that's why I was willing to be on the list and contemplate a life on immunosuppressants. I kept wondering hopefully, Who will I be when I have more energy? It seems to me now just a bit like a remnant of the fairy tales I loved as a child - the girl waiting for the prince to come and rescue her.

This morning I am realizing that I have responded to this event with a new sense of being right here in my life, in this body in the present moment. The bright future has been cancelled (though Tom reminds me there is all sorts of research coming down the pike, wearable kidneys, growing a new kidney from your own skin cells - anything can happen).

Maybe it was the sense of this new blank page that impelled me to ask a friend to move everything out of the big closet in my study that I call my toy closet the day after that appointment, and put in in a metal shelving unit. This study now looks like I just moved in, boxes everywhere. This room was my last priority when we moved in here, and I was worn out and careless. I stuffed in this huge closet all the stuff I didn't sort in the move, all the stuff I didn't let go of. Every single draft of old pre-computer manuscripts, for instance. Old journals and letters. All those photographs. Old books. A pristine Cabbage Patch doll (whose adoption certificate is somewhere in one of these boxes.)

My path seems clear all the way out to the horizon. I can't hold my breath waiting for the call that will change my life. I'll have to just breathe in and out, pay attention to the body I have, and start sorting.

Spiritual growth, Ow!

I know I'm stealing a cliche, but I can't help myself - Spiritual growth is not for sissies. It is hard. It means you give up mental stuff - and think how we sometimes balk at just giving up regular stuff, like our favorite flannel shirt, even though it is frayed, even torn. Spiritual growth comes from dancing with your demons, a metaphor I am drawn to, coming from a childhood informed by myth and fairy tales. Another way to put it is, you have to stop clinging to your illusions and delusions if you are to live comfortably in reality. That's the way the tradition I practice in sees it.

I think most people begin a meditation practice with the idea that it can bring peace of mind. (Here's an interesting side fact: one of the most effective psychotherapies, Dialectical Behavior Therapy, was created by Marsha Linehan, a very long-time meditator, and is based on techniques Zen teachers use.) Well, in the beginning meditation can feel very good; on one tape, Pema Chodron says there is a saying that spiritual practice begins in bliss and ends in bliss, but the road inbetween is hell. Teachers don't emphasize that, but try to inspire us to stay on the path by telling us how good life will be. Eventually. Keep sitting.

Yesterday I was on that craggy, dry, horrible part of the road. Depressed. I know better, but I tried to figure it out, and couldn't. Eventually - in the evening - I talked to Tom about how old I feel, how discouraging this foot thing is, and cried. This morning, the sun keeps coming out, making Ohio a worthwhile place to live, and I am singing little songs like - I'm not kidding - Three Little Birds. ("Don't worry 'bout a thing, 'cause every little thing gonna be alright.")

I can't seem to keep up with my health, and my fears about it. I can't seem to give up worrying about the next damn thing, knowing worry does no good. I push worry away, and it just goes underground. For instance, the transplant center called to make an appointment with the transplant surgeon in July, a routine re-evaluation. But what if I flunk? I just want a kidney, okay? Every time the phone rings it could be a kidney. . . next week I get full labs again, and I will hone in on that magic number, the GFR, the amount of your kidney function. Please don't fall. Please don't make me start thinking again about whether I will undertake dialysis again or just die. Always something to worry about.

I don't exactly worry about the damn feet, but they are absolutely handicapping. And as it is a temporary handicap, I am not set up with the kind of services you need, a housekeeper, transportation, an electric scooter. I rely on Tom too much. He is very supportive. Even so, it is a daily struggle. Cheery people want you to call it "a challenge," as if it were a Sudoku. I suppose on one level of abstraction, it is. One small life in the river of time, one blade of grass. Still, I am a sentient being and I feel pain as well as anxiety. Yesterday I absolutely couldn't get the new ankle support system comfortable. Then there was, and is, the pain in the hip from these major adjustments in footwear. Take tramadol or just Tylenol? I really should research tramadol . . .

I have been working with bone edema and ankle pain since January. Now I am out of the boot at last, but still wearing an air cast on the right foot, and a sort of little athletic supporter on the left ankle. They throw off the fit of all my shoes, and make my feet itch. Yesterday I got online and tried to find pretty all-cotton socks that would fit my big feet, and this was just one more source of pain - I could not find them in pretty colors. Big feet, you wear black or white. I know, there is an answer, dye them, paint them, sew beads on the cuffs. Sigh.

I need new orthotics the doctor said, but the physical therapist who specializes in that is on vacation, so I have to hobble around in the old ones for a couple more weeks. But that's okay, in a sense, because I'm not supposed to hobble, I am still supposed to stay off my feet. And not drive. Rest the ankles. I have thought of making a list of all the things you don't have to do when you're not supposed to stand or walk around, but the idea of trying to cheer myself up really did get me down.

So . . . yesterday all this was too much for me to really be with. The depression came up, a brown filter between me and all these frightening and frustrating realities. Today, much better. And a little closer to reality, more willing to follow doctor's orders, eat a good breakfast, write to a friend. Interested in life again.

Being depressed was a form of dancing with that particular foggy-brown demon, one I knew very well earlier in my life, one who used to come in and stay for months on end. Coming out of depression so quickly, I lay that down to continuing practice, meditating badly, reading dharma talks even as I grumbled. Maybe the most important thing was being being willing to let go of the resentment and depression, to be open to morning, to let my mood and attitude change and change again.
[the image: my current reading]

Pretty shoes

Feet. It is as if every woman’s issue is contained there. Years ago Robin Williams did a comic routine in which he seemed to catch himself about to refer to “Lll . . .” and self-corrects, “Women in comfortable shoes.” There it was, a simple observation that women who are not in the heterosexual culture wear shoes you can walk or run in. Women who are, don’t.

I notice women’s shoes. There are those released by old age who wear their New Balance or Drew oxfords, like me, and that’s that. There are also many in my generation who still sport pretty sandals over their Supp-hose, still paint their toenails red. I don't begrudge them that.

I loved sandals myself, though I became painfully conscious in adolescence that I did not have perfect feet. Ten years ago, on a visit to California I bought a pair of blue suede Clark’s in a sandal shop in La Jolla - I loved that, a whole store devoted to sandals! and I wore those things until the sole separated from the shoe, and they were in every way disreputable. Maybe I bought a pair to replace them, I don’t recall, but soon after that things happened, one thing after another. A stress fracture, a broken toe, a traumatized nail. I learned to feel what was on my feet, how sandals do not support the foot at all. Even in a Clark, the foot slides around, and it is easy to twist an ankle.

Getting into SAS Free Times, and now a more supportive oxford, P. C. Minor, became necessary when custom orthotics were prescribed to stop the stress fractures. But the change still took me several years. Lace-up shoes don’t go with any skirt I own. I used to get away with a pair of black SAS that were cut lower, sort of like dance shoes, worn with maybe black hose, though these are frankly much less supportive. Now, peripheral neuropathy (nerve pain in the feet) has led me to adopt cushy diabetic socks. They come in white. They are curiously like the bobby socks of my youth. Back then I had rubber doughnuts you put around your ankle and then rolled the socks down. Like I said, I was a fashion maven. I didn't care if I could walk in that.

Over the decades I collected the usual number of shoes, I suppose, though almost never the right shoe, it seemed. After the second stress fracture I moved all my heels to the guest room closet. Tried them on once and knew they were impossible now. But I didn’t give away my red alligator high heels until they were covered with dust. I don’t think I actually got tears in my eyes.

In retrospect, it was not such a big deal. Stay tuned, there is worse to come as you age. Today I am wearing on my left foot, even as I sit in my study at 7:44 a.m., an inflatable “boot” with velcro straps. It is navy blue, and looks rather like an astronaut's boot. It does not go well with the yoga pants I wear most of the time now because my stomach . . . never mind.

The boot is immobilizing a wretched ankle that is unable to repair the ordinary microscopic bone loss of everyday, a result of my kidney disease. Now you're talking problems. I am using a fabulous wheeled walker to keep me from limping; it also has a bench, so I can sit down any time. I am supposed to sit down, not walk, to rest the ankle for the next two months, to be responsive to my pain instead of gobbling Tylenol, and believe me, swollen bone hurts when you walk on it.

Not walking hurts in another way, enforcing mindfulness. In the last half hour I have not popped up to get my lymphedema sleeve, forgotten in the bedroom, or take my synthroid, forgotten when I made my coffee. You don’t pop up and take 20 unnecessary steps on an ankle that feels like this. And if this doesn't work, a cast and crutches or a scooter is the next step. I don’t like that idea even more than I don’t like walking now.

What do pretty shoes have to do with all this? Nothing, and I mean it. I’m so over that. Though I do mean to pick up some rainbow shoelaces if I can find them.

How the Chinese doctor sees it

"It" being the sort of chaos I'm experiencing - especially the frustrated anger that had me wide awake at 3 a.m.

It is absolutely not hard to find things to be frustrated about in my life. Kidney function significantly worse, despite a lot of efforts and expense - and suddenly, the imminent threat of dialysis. Still limping with pain in the left foot, yet still suffering moodswings caused by the corticosteroid shots that were supposed to fix that flareup. (Still getting used to having significant arthritis.) Still anemic, and without what I need to monitor my own hemaglobin and give myself EPO shots. Can't see kidney doctor for over two more weeks. Forgot to do my PT exercises last night until I was in bed.

And all this chronic illness, and Tom's, is mostly invisible, not dramatic; when I go to church, someone usually tells me "You're looking good." I don't argue with them. So the recycle piles up in the garage while I rest the foot, and my car hasn't been cleaned in a year. I used to be able to do these trivial things myself, but with a low red blood count and a uremic burden, running the Roomba is too much effort. I know people who are dying, and courageously, so I usually try not to whine.

It was the stubborn pain in the foot, coupled with my decision to refuse more corticosteroids, that got me to make an emergency appointment with my acupuncturist yesterday. Dr. Wang fit me in at 8:30 this morning, and I had it all aced, dressed, checkbook in purse, out to car at 8:00 a.m. - and my car wouldn't even turn over. The battery is only a month old, but the lights had been left on. My little Civic chimes to remind me to turn them off but, I told myself, it isn't idiot-proof. By then, I was focused on my goal, and didn't even bother to get mad, just got in the van and backed it out, chewing up the lawn the way I do. The driveway is narrow, the van is large, I do my best.

I had started my morning writing in my journal about how I don't like to be told to look on the bright side. I can stand it if people want to falsify their own feelings, but I hate it when they try to get me to do it. So I didn't try to generate any positive thoughts about running my car battery down, just focused on the task and drove to the doctor's office, not getting in a wreck.

He listened to my recital, asked a few questions, gently palpated the foot. Then he said, "Which problem is bothering you most?"

I surprised myself by saying, "The anger." It had trumped the foot as I lay awake in the night contemplating the meanness of the dialysis nurse in charge of my care last time. I should have called her up before the licensing board, but I didn't have the energy.

He nodded. "Then we will concentrate on that."

As he applied the alcohol and then the needles, I said, "But it's all one, isn't it?" The idea of a holistic self is foundational in Chinese medicine, which makes it so different from the Western medicine with its specialists in pieces and parts and chemicals that haven't been adequately studied.

"Yes," he said, speaking clearly, because I had, of course, forgotten my hearing aids. He went on. "Spring is the time of wood, and wood opens the Liver, where anger is stored. So it is very easy to get angry right now."

This clicked in place for me as an interested student of medical systems. I knew that Wood is the creative energy. And I had already written two poems that morning, literally woke up with one going in my head.

"Too much wood," I said. "Is the antidote metal?" Yes.

Traditional Chinese medicine (TCM) is based on an elaborate theory of energies, and includes a theory of constitutions: we are made of combinations of five elements. Years ago I determined that I was a person who benefitted from the element metal when I felt scattered - which translates in daily life as structure, schedule, calm activities.

So here I am, much improved by the treatment and determined to make lists, meditate, and read unexciting things. It is working. I do not feel in nearly so much danger of sending out furious e-mails and initiating lawsuits. Though I like to think I might when I get organized.

Demons

[Spinning wheel, Blood, Sweat and Tears, posted on YouTube by flutooth.]

I was going to write a post on my current experience with steroids titled "Two weeks in another town," but it is looking like more than two weeks. Before you kick me out of the Football Hall of Fame, let me explain.

Two weeks and two days ago I let the musculo-skeletal doctor ("sports doc") inject my ankle and hip with two half-doses of a gluticosteroid. I know I'm reactive to steroids, and I won't take them orally, but I had gone in limping with what turned out to be a magnificent flareup of arthritis and bursitis in two locations. And this doctor has done good things for me before. So I took the shots.

And my, I felt good, once I got over two nights of serious sleep disturbance. Interested in life, creative, generous, and - this is important - the pain reduced radically. I didn't mind a bit that my instructions were to "take it easy" the first week. As a poetic type, I've spent my life looking for an authority figure to tell me that.

I didn't realize I was up until after my mood switched. A couple of days of being too apathetic to run the Roomba found me telling Tom, "I have a sense that I'm coming closer to death, that I don't have long." Then the mood switched back last Sunday night, around 9:00. Hello, come on in!

As moodswings go, this one will. (I couldn't resist.) Seriously, as moodswings go, this has been okay, more like being a boat in a lock, the water rising, then back down, not like the biggest roller coaster in the world. There were also days in this little trip where I found myself in the blue lagoon, balanced, calm, happy, interested in everything, tending to use the adjective "beautiful." Sort of like we feel on those magical days in spring.

I once saw moodswings as a demon that popped its trollish head into my pleasant cave, or more accurately, did a home invasion. Now I think a mood is a mood, and the demon is more general than that. Around its neck it wears a name tag that says Attachment. Attaching to the high, attaching to the peaceful moment of balance, attaching to the idea of how I like to feel, seeing that preference as terribly important.

Shunryu Suzuki says we are given just enough problems (83). This morning I picked up the results of my last blood tests. My serum creatinine is high, which indicates lowered kidney function. Tom reminded me that this has happened before, and I recovered from an incipient drama that stars me being reintroduced to dialysis. The good thing, Tom reminded me, is that things always change. Yes, and sometimes for the better. In this case, my fresh problem took my mind off my mind.

No contrast dyes!

The internet thinks Mark Twain originated the saying: "I've seen many troubles in my time, only half of which ever came true." Or maybe Josh Billings or Alfred North Whitehead. I thought it came from a Native American and began, "I'm an old woman, and I've seen many troubles, most of which never happened. "

In teaching meditation, many of us like to say, "Try it for six months or a year, see how it works for you." This is so unAmerican, isn't it? We want to be happy now! And the truth is, ten years is a better trial period. Then the change in you begins to show up at odd moments.

This morning I had an odd moment, registering for a CT scan at 7:30 a.m. I was given the usual multipage form to fill out, which led my mind idly down the path of One-of-these-days they're going to get this computerized. All this information about my surgeries and medications and allergies is in fact in the OSU computer system, from the extensive workup for the transplant list. But radiology can't get there.

Filling out forms is repetitive, inefficient. I remember how I used to get mad - frustrated, really- but I didn't this morning. However, my ears went up at the questions about the use of contrast dye.

There it is on the medical info sheet I carry with me, No Contrast Dyes, highlighted in yellow. This is because these dyes could further harm my kidneys, and there's not much left to lose. Hmm, I thought. Well, they're going to have to talk to my kidney doctor before I take a contrast dye. I might have to reschedule. That didn't make me mad, either. Waste of my time, I would have once thought. I used to feel so overloaded, so stressed, to have to go without my morning coffee like this, to waste two hours, that would make me crazy. Now I'm in touch with reality: if you are going to deal with a big western medical system, you are going to run into inefficiencies. That doesn't have to mean people are careless or stupid.

I took the form up to the receptionist, who told me the technician would talk to me about the contrast dye. He came for me in a few moments, and assured me we weren't planning to use one. It's just that everyone gets the same form. In a few moments, I had been scanned, having made the required joke, the one he hears 40 times a day, "Where's the cat?" ("They run around in the machine") and was on my way home to a really satisfying cup of coffee.

What was equally satisfying was thinking how different I am from the person who got practically hysterical just four years ago, when I happened to have a nuclear stress test scheduled on election morning. In fact, I got so frustrated waiting for that test in a cold, inefficient office that I walked out, which turned out to be a good idea; anger can sometimes lead to useful action.

But you can walk out quietly, without hysterics, as I was contemplating this morning.

I still have anxiety about medical procedures, going all the way back to a couple of gruesome childhood experiences. I'd had a little nightmare in the night, and slept fitfully after that. (Maybe if I live to meditate another eleven years, I won't have that.) But this anxiety is nowhere near the level it once was, even for a quick, noninvasive test like this.

My first thought was to credit meditation and Buddhist thought. I can think of myriad ways it has impacted my reactions, mostly by teaching me that they're just my reactions. Emotions brought forth by thoughts and memories, which are mental emissions that will pass if you let them. Sitting quite still in retreat, we learn not to scratch an itch, to watch our impulses pass.

Then there's the Buddhist emphasis on "skillful means," which is not usually whirling in a frenzy of rage like the Tasmanian Devil. Ah yes, he used to be one of my favorite cartoon characters. It's only fairly recently that I took him off my bookshelves, but I didn't throw him away. You never know when he might be just the skillful means you need.

Was it just meditation that turned a nightmare into an errand this pleasant morning? Not at all. These last years I have worked to cultivate a low-stress, nourishing life, and done intensive therapy regarding those childhood issues. Truly taking ownership of your body and your feelings is not just a spiritual matter, but involves psychological growth as well. Well, that's as abstract as I want to get today.

If you are an American, enjoy voting. We are privileged.

Lost Horizons

Landscape with Cows, Ralph Blakelock. [Curiously, this painting, which I arrived at searching for cows at twilight, is owned by the Butler Art Museum in Youngstown, Ohio, a few blocks from the house I grew up in.]

Today, according to the way we figure age in the Western tradition, I turned 66, turned, as if you turned a corner and now are looking at—can it be? 70.
In my circles I am practically an authority on old age. Three years ahead of the first Baby Boomer; and aged physically and mentally by chronic kidney disease so that I feel ten years older than I am. So, what is this old age like?

I think it is not entirely unlike the old age of our mothers; you realize that the shining city that lies just over the horizon, that makes the edge glow . . . that city isn’t there. The world of opportunities, the better future. You have already experienced so many times that the marvelous job comes down to grading a huge stack of tediously conceived and written papers. That falling in love couldn't save you. That no Teacher is infallible and no book can tell you what you need to do. You have not really improved yourself much. At best, you have become more what you are.

So instead of finding yourself facing that bright horizon, strikiing out on that purposeful road, you are in this big field. It is not astroturf, but dirt, pebbles, the occasional dog doo, clumps of harsh grass. I do suppose it also has its patch of sunflowers gone to seed, and the goldfinches hanging upside down, busily having lunch.

When you are old, what is all around you is not really a horizon or an edge, just more of same. Distant mountains? The thought of climbing them is not appealing. You go to all that effort to at last stand at the summit — everyone knows that you don’t spend long there. You can see seven counties, or the next state, or Tibet. Soon you are bored. It's time to start back down. They tell you the point is not getting somewhere, but enjoying the climb. Not any more. It takes too much out of you. Fact is, you can see the same view in elegant comfort from the revolving lounge at the top of a big-city hotel. And you have. And you don’t fit your black silk dress anymore, so going to that lounge isn’t all that appealing. You’d have to find some way to dress up.

In age, what a rambling mind you have. Your cows roam in a wide field, having no special purpose to their day but to munch grass, drink water, stay alive; and at evening, as twilight descends, to follow the bell cow slowly home to the comfortable barn, where you expect to be warm and enclosed, shielded from the cold light of the stars.