Better

It is really interesting to see how life changes when you are more or less ill. The worst time for me was when I was bedridden. The nerve pain meant sleep only happened when I was so physically worn out I was unable to go any longer. That is not a recipe for restful sleep, and as a direct result I was pathologically tired. I couldn't remember names, facts, dates. My body warped into new configurations at y joints, with swelling contorting the soft tissue and even the bone in my hands. During the past four years, I have had bed rest three times, ranging from one month to several. I am glad my memory of those times is vague due to the effects of LD and pain. It is not worth dredging up that sorrow.

I did not know if I wanted to go back to medical school. Why put myself through that hell? I had he'll on earth to live through.

I know, with the visceral gut deep confidence born of a thousand plus days, that I would not be here without my beloved M. He stood by my (bed)side, comforting, encouraging, believing that I would get better. Without him, I would have given up. I would be dead.

My current regimen of antibiotics has proven the best yet. I am spending my last month of freedom doing whatever my heart pleases--building fence, playing with my lambs, riding. It feels like I have a new lease on life, as if everything is brand new.

Certainly I grieve for the physical strength and balance I had before getting sick. How I could do so many things, so easily. But every day I can wake up with just a little bit of pain is a gift.

Days like this.

2012...Good Riddance!

This year has been horrific, and I cannot wait to wave goodbye to it in a few weeks. 

2012 was dotted with animal losses, creating a topographical map of sorrow.  I lost two schoolmasters to age and pasture injuries, lambs to illness, heat, and parasites, and my ancient inherited Siamese cat to ancient-ness.  It sucked. Horribly and absolutely, and I have not been in the mood to write or think or do much of anything, other than try and cope with being ill.

The only recent good news was my five day trial of Rocephin. 

Rocephin is interesting.  It was like Russian roulette, with the options being an amazingly wonderful energy filled day or something out of a horror movie, complete with me having to scream and cry simultaneously from the pain of stomach cramps.  Note: having two fabulously wonderful days made the painful days worth it. 

I have also had three migraines while on my course of Rocephin.  As I have a lot of neurological complaints, I think it makes sense to connect the dying of Lyme bugs in my head with the mind monsters.  I almost typed "headache" instead of migraine, but that is just so wrong on so many levels!

With the new year I will have more access to the Internet...and thus more writing.  In the meantime, I am counting the days.

Slow Going

The lack of posts is due to the overwhelming amount of stuff that I have had to deal with. Stuff. Ugh. So ridiculously inadquate to explain the monstrous storm of events in my life.

Anyway. Life goes on. Slowly.

I am in the midst of the absolute worst Lyme flare I have ever had. A quick ROS, since I am seeing my doctor on Wednesday and want to get everything in the forefront of my mind...
--pain: Horrible and undeniable 10/10 for nearly two weeks. Broken somewhat by the introduction of a gram of another antibiotic.
--word substitution. People I am around right now think it is funny. However, it is a sinister situation. To me, the word substitution is an indicator I am getting a resurgence of neurological thinking issues.
--joint swelling that is random and movable: First it started in my feet, then involved my hands, wrists, elbows, knees and pelvis. The additional abx served to magnify the joint swelling to one major joint per flare up. Mysteriously, the Lyme bugs choose one joint set to harass for a few days and then move on. For example, before Christmas, I was thoroughly convinced that my L knee had decided to break overnight. I had to literally lift my leg and bend the joint with my hands because the pain was so intense I could not simply bend it without assistance. Standing up from the couch, getting out of bed, going to the restroom, and even eating were tasks that now required careful planning.
--pain. Just have to mention that again. Thinking back over the relatively pain free six or eight months I have had makes me quietly envious of myself then--I had fatigue, I had joint pain, but it was nothing like this darkness.

Lesson learned: enjoy what you have, because you never know when it could be taken from you. (a distinct reference to pain free days...)

I have been having problems with school. Balancing the careful walk of panic attacks, panicky feelings, and the oncoming Doom of Changing Antibiotics During Break was horrible. To add a layer of complexity, I have been dying to go visit my doctor, but normally my father takes me to see her. He has been tied up with my grandmother a state and a half away as she is dealing with c. dif. A third piece of the school puzzle is excused absences...I have a standing letter from my doctor to excuse any and all absences I may accrue due to the nature of my illness. Somehow this is not working, leaving me to deal with the paralyzing shock of a lot of unexcused lab absences. I asked to apply for an Incomplete in the class--of course, the pain roared awake, and simply surviving the unending drum of its existence became the sum of my entire life for a week and change. I know there will be many angry emails to sift through, some of which are probably (quite rightly) regarding my lack of response.

I maintain that when you are thrown in the fire, you will burn. This week has been a matter of survival for me. I think a lot of Lyme patients can point to a certain time in their illness that was the worst. This is, without a doubt, mine. My Christmas break has been more of a Nightmare than I could have ever imagined. I have learned words and names and feelings for pain that I never thought existed.

I will address these emails later this morning, as it is 3 am. The gram of new abx is making me a complete insomniac.

---> Onto more pleasant things...

My little Pom has turned into a source of comfort for me. I have a lot of big dogs, and only the old female "gets it" that I can only touch her softly and tolerate her touch on my hands and fingertips. The other two big monsters, brash younger males, go into overdrive if I touch them more than a soft graze of my hand once or twice. My youngest dog, a little female Yorkie, is not a super cuddle bug. However, she is more than willing to sit on the couch with me. (How she has become mostly blind over the past month is another story for another post.)

Onto the Pompom, a small red male of middle age, whose previous elderly owner passed away. I suspect that he is reacting to my illness, as he has become extremely possessive of me since I have been in so much pain. I wonder about his life with his previous owner, and the mind of animals--he must recognize illness in me, the same way he recognized the failing health of his first love. It is a unique situation that the noses of dogs are used now to detect cancer, often before it can be shown on any test or screen. Would it be that far to jump to assume that he smells as well as sees illness?

A good litmus test was Christmas day, as he was toted up to the family gathering. In the past I have always brought my big dogs, but as they could not be relied upon to avoid hurting me, I was not willing to take them. Fitzig, named for the strange fluffy hairy red howling creature in the movie the Dark Crystal, reacted to my stepfather (who is dealing with a Gleason 6 prostate cancer) the same way he reacts to me. It was often hysterical--he hopped carefully on a vacant couch cushion next to him, and went through an entire repertoire of cute and cuter poses, getting more and more outrageous to everyone's laughter. He was sneakily affectionate with others--yes, pet me now, ok I am done, goodbye!--but the flirtatious behavior designed to get a laugh was saved for us.

He is very careful with how he expresses excitement--instead of banging on my legs with his front paws, he stands up on his hind legs and softly rests the pads of his feet on my calf. It is distinctly different than his other jumps for attention/excitement/sheer glee, some of which would scratch me if I was not stern.

The horse life...
The horses are turned out 24/7 on a huge pasture. They are brought in only in the case of rain turning to snow. They seem to be doing ok. I miss them desperately, and just the idea of them being up the mountain--so close but so far out of my reach--is devastating. It is necessary to get better, sure, but when you are stuck lying down and dreaming, you miss everything.

I am going to try and get the form filled out for the US Para Dressage Team at my doctor visit. It will be interesting to see what she thinks of the form and the amount of impairment I have right now.

Now, to wrap myself in the heated blanket and try to sleep, despite the nasty taste of the Evil Antibiotic that Starts with C.

Is that...anxiety?

I am going to admit something very dumb: I thought I really could not get afraid. I thought that afraid for me meant cold, flat, and distant, as the very few dangerous times I have encountered in my life caused that reaction. Every horse emergency aroused--or rather--flattened my emotions, so that I could not feel anything until well after the event.

Cue the computerized testing. Sans scratch paper.

Somehow this setup short circuited my brain, so that I am now intimately familiar with the depths of anxiety and the reality of panic attacks. There is some thought within the Lyme community as to how Lyme can affect the mood of its victims. Anxiety is one of those unfortunate things.

Add in all the stress of med school, having to deal with the whole scenario again because of illness, and you get a perfect storm. Of the anxiety sort.

Some compensation/comfort comes in pill form...I can feel when the drug kicks in, as if it almost physically turns back the dial on the white noise that accompanies the panic insanity.

Everyone always quotes that old saw to me about how doctors should be a patient for a week to understand what you have to go through. Honestly, though, I wish I did not understand this.

Uncertainty Principle

In three words I can sum up everything I have learned about life: it goes on.

~Robert Frost

A few weeks ago, a young man in the second year class chose to end his life. I knew him in passing, as I was part of that class until the Lyme woke up and knocked me down in the spring. I will never know what drove him to that brink, to the realization that it was better to end life rather than enduring it. Our demons are uniquely our own.

Today, one of the organizers of our clinical skills course passed away suddenly due to a heart attack. I think she was just 32. In lab I listened to how she and her husband walked their dog together every evening, and thought to myself of how those nows spent in her company may give her husband comfort in the future.

We all take for granted the plans we have laid out. However, life is finite--we were all born, and at some point, we are all going to die. In the meantime, all we have is this moment, this now, that we can do something with.

Given my never ending war with Lyme, I feel that I have a decent inroad on using my nows to the utmost of my ability. The events of the past few weeks have hammered this lesson into my mind even more. All we have is our collection of nows. It may seem easier to turn your head when dealing with something aggravating or unpleasant, but the bottom line is that this time is all we have. And if we choose not to experience it, not to live it, we are choosing oblivion.

Despite migraines, nausea, and overall high levels of nastiness, I rode three times last week. I am preparing for the 4 part Celebration of Learning on Friday with a clear sense of choice: I chose to live within the moments given to me. These endless stacks of papers, this coffee cup, that soft nose of my lamb: that is my life. And I will choose to continue living in my given moments until death and I meet.

Oh Kitty...

Kitten, the gray mare in my profile pic, is an odd horse. I picked her out of a field based on her gorgeous floating movement, despite the fact that she had not been handled for the entire 7 years of her life and desperately needed a lot of remedial hoof work.

Fast forward...what? Three years?

Kitten is very easy for me to handle. I can do anything I would like to with her. However...she doesn't necessarily like other people handling her. It is not a fear thing, but rather a mood issue...as if she wakes up on the wrong side of the bed and has 0 tolerance for other people.

Let me give you an example.
Thursday, my mother came over to drive me to a specialist appointment on Friday. I wanted to ride. I convinced her to go riding, as she rode a lot in her youth, but is troubled by stiffness and fear of injury. She wanted to ride Kit. I wanted her to ride the Old Man, my obnoxious PSG schoolmaster, who was actually in a good, sleepy mood. Kit had the 0 tolerance look to her: the hard, proud, alpha look (of course, she is the top mare right now with my big Holst still in VA).

Mom insisted. I finally gave in, with pissy facial expressions and muttered swearing.

Kit was willing to stand to be mounted, but did a small dophin impression when Mom swung on. I growled at her, and she cocked her head and looked at me, then did it again. I swore, and told Mom to get off right now. Mom stayed on for another moment, enough so that Kit did another dolphin impression, and then got off.

I was highly peeved at this point, as the situation I had seen brewing had just come to life. I stuck my arm through Kit's reins, and swung the Old Man over to the 3 step mounting block. After telling us all to bury her facing Texas, she got on. And they were fine.

Kit, on the other hand, was aggravated and borderline aggressive. In moods like this, she wants to do something, and do it now. I waved to my fiance M, his friend M, and the sister C (with her two little girls). Kit and I marched off down the driveway together, knowing that Mom would catch up.

After we walked the 300 yards to the end of the driveway, I positioned Mom facing us (up the driveway), and ran Kit through all the pre-mounting preparations that we do. She demands a routine, and gets annoyed if something deviates, but doesn't care where we are just as long as she has her routine. So I showed her what I was going to use to get up (two cement blocks), tugged softly on the saddle, checked the girth, pressed hard on the saddle for a few moments, and then swung up.

Of course, she was perfect. She cheerfully wandered along our trail ride with her eyes out sideways like an old plow horse. She didn't bat an eye over running cows, and coolly volunteered a lead past them when the Old Man was disturbed by their bucking and cavorting. She didn't raise a hair at the field of galloping and snorting horses, and (rather snidely, I thought) showed Old Man how perfectly she could walk in the very center of the road.

We walked to a relative's house and chit chatted for a while with the elderly gentleman while the horses ate clover.

The way back was uneventful, with the exception of Kit giving a small ego fit after I got off and stood for a moment talking to M. I pinched the edge of her nostril with my fingernails as she was rather obnoxious, jumping straight up into the air and then waving around a front foot. She grumpily snorted at me, and waited until I was finished talking.

The point of the post?
1. Know your damn horse. I can look at Kitty and tell what kind of day she is having at 200 feet away.
2. Know what you can expect of your horse. Kitty loves her routines, and if she is having a good day, she is willing to put up with more mistakes than usual. If she is having a bossy girl day (like above), then the only person that needs to be up on her is "her" person. I'd chuckled in the past over the idea of a one person horse, and still do, but there is something to be said about the level of competence required to ride a certain kind of horse. A tempermental hot mare may tolerate being handled by a beginner on a day when she is feeling relaxed, and is willing to trade pampering for some small offenses due to inexperience.
3. All my horse knowledge hasn't totally gone to shit despite being sick. I feel like I ride like a tapeworm, as I can feel every obnoxious crookedness in my body influencing my horse. Even though I am not very strong, I can still rely on my ability to observe my horse's moods and make appropriate decisions based on their personality and experience.
4. I do a good job training. Kitten hasn't been in consistent work since I got really sick. Despite that, she is always (for me) very purposeful in completing the tasks I give her. I almost used the word "quiet", but that is a misnomer...she is very determinedly doing what I asked her to do so she can get a reward. That is very different from a horse that is rather dull and ignoring what you want (often a definition of quiet). She is dead set on her task, and she wants her cookie afterwards (even if the cookie comes as a grazing reward during the ride, or even two handfulls of grain after she is in her stall).
5. I like my horses hot and temperamental. :)

Ah, fudge. And #$#@$@*&.

I sent my big Holsteiner mare out about a month ago to get a full reproductive exam. I have a contract on Colorado, the Elite Knab stallion with Avalon Equine, and I admit to having dreams of a little spotty baby.

But it seems that nature has other plans.

My big mare is a solid 4th level schoolmaster when she feels like it. At times, she does a great interpretation of pluggy greenbroke packmule. I was of the opinion that perhaps she just needed some time...I knew I needed some time to work on my overall physical strength, so what harm in her being a royal hay eating pest of mammoth proportions? I was considering possibly doing hock injections for her comfort when I built up enough strength to ride, as I feel like a wobbly neurologically impaired limp noodle / hot flaming mess*, but the main thing in my mind was to keep her comfy.
*for reference, my dear Lyme friend A tried to convince me to get on the whopping 13 hands of her Icey, and I wouldn't, as I was afraid of admitting to her and myself that I thought I would ooze up one side and down the other!*

Well...she has some whack issues. Psycho. Like holyshitdamn I am so freaking glad I sent her to get worked up, as she has a monstrous anaerobic and aerobic uterine infection that lit the culture on fire in 24 hours (instead of the normal 48). My exaggeration of course.

Add to that..
A slack R broad ligament that creates a lovely continual pool of fluid.
A slight pelvic tilt that allows for the possibility of fecal bacteria to enter the uterine environment.
A weird injury to her cervix, obviously sustained with her previous one and only foal.
And you get a perfect storm.

I feel slightly overwhelmed that I did not give my old she bear credit for hurting. I honestly thought it was something in her legs or back, and that taking a few months off to just loaf would be the best thing for her.

But I am looking at hitting her with 2 cc of oxytocin at the end of every heat cycle to encourage her body to shed that extra fluid...for the rest of her life. Of course she already has been sewn up back there to keep out the possibly re entry of fecal bacteria.

It gets better. The cervix has a blind outpouching in its very center--where it had to be poked by a torsional little hoof. And there was no freaking way to have found that out without all of this. There is some thought about taking her to VA Tech to literally nick the outside of the cervix...the opinion is that her cervix would be able to function perfectly well (and my thought...perhaps better without the blind pouch to harbor creepy stuff).

I am so glad I saved for this. Despite the reality that there will be no bouncing spotty baby next summer, my old queen will not be dealing with the pain of untreated raging infections! The vet and breeding manager both agree with me that a situation of this magnitude has to be 1) painful and 2) chronic.

I think this is a humongous breakthrough in understanding this mare, as she has been labeled a butthead (on good days) by many people. It is also a very sharp wake up call to me as well...given the fact I know pain so well, how was I so blind to what she was feeling? How could I simply have attributed her occasional erratic behavior to something other than pain? Why did I settle for the trite behavioral explanation? Honestly...this is why I love people medicine. Being able to ask how long has your back hurt?--since your last baby, perhaps? --is priceless. And so is being able to communicate that we are going to fix this, and you are going to finally feel better.



An illness is like a journey into a far country; it sifts all one's experience and removes it to a point so remote that is appears like a vision.
~Sholem Asch