Sleeplessness

It’s a chilly Labor Day, too soon to start the furnace, but too cold to be comfortable without it. I am wearing both a sweater and a light jacket.

Two weeks ago, I postponed shoulder surgery, partly because I was afraid it either wouldn’t help or leave me worse off, partly because I dreaded the long recuperation (for the first ten weeks, my arm wouldn’t even be able to support its own weight), and partly because I wanted to give physical therapy another month or two. At the time, I showed little progress with therapy, and, to tell the truth, couldn’t actually say but what it was hurting more than it was helping. Since then, I’ve deteriorated greatly—a deep massage plus my reluctance to forego exercise seems to have triggered my decline—and now I don’t dare exercise at all.

Shoulder pain keeps me from sleeping on either side, and now my back is hurting me as much as my shoulders. Since my sleep apnea mask doesn’t allow me to sleep on my stomach, I’m challenged to get any sleep at all. An Ambien, plus an anti-inflammatory, plus Tylenol, plus heating pads and ice packs, enable me to sleep, at most, for a few hours before I awaken in pain. They also make me nauseous. Even if I went ahead and had the surgery, I would feel worse for weeks if not months before I felt better—and that on one side only—and I don’t see how I could bear it.

Of such problems as I have had, sleeplessness is the worst. To be so tired yet be unable to rest engenders a feeling very near panic. Just the thought of lying down fills me with dread although I can scarcely stay awake.

I suppose I will try a chiropractor and maybe an acupuncturist, although I can find little evidence to support them. But then the evidence for surgery is mixed too. My particular surgeon boasts of a 96% success rate (how would he know?), but the average seems to be more on the order of 80%.

I wish to god that I knew what to do. I am finding it hard to direct my actions from moment to moment much less to make major decisions.

Bears, Mountain Lions, and Surgery

The best times to go to the woods are in late spring and early summer when the most flowers are in bloom, and in mid to late summer when the berries are ripe. On our last trip, we dined on raspberries, dewberries, blackberries, thimbleberries, red huckleberries, salal, and even the strange tasting Oregon grape. My favorite, the lush orange salmonberry, was all gone, and I will grieve its loss until next summer. When we go to the woods again (we venture out once a week), we will take berrying buckets and stock our freezer.

The coast range has far more berries than the Cascades, and far more bears to show for it. On our last bike trip before Peggy’s mother died, an adult bear crossed the road 300 feet in front of us. As I grew abreast of the spot, a movement caught my eye, and I spied its cub frantically climbing a small tree no more than ten feet away. “Oh, look at the little baby bear,” I cooed to Peggy—who had not seen it. She made no response, and when I looked back at where she had been, she was disappearing down the mountain in a cloud of dust, and I was unable to catch up with her for quite some time. When I finally did, I said simply, “You were going for help, I suppose,” knowing full well that Peggy had considered it a case of every man, woman, and dog for itself—her being powerfully afraid of bears. My only terror is of mountain lions, and I worry mostly about our dogs because the question in my mind is not whether a mountain lion would eat them, but why wouldn’t a mountain lion eat them.

Peggy took a spill last weekend, and came away with some bruises and road burns. Logging roads are often paved with poorly packed rocks of uneven size, so it is not unusual for our wheels to be thrown several inches to the side. No one can bike in such places without an occasional wreck.

I am scheduled for rotator cuff surgery toward the end of the month. I can hardly sleep for fear, only fear is too weak a word. I try to calm myself by reciting poetry, but I can scarcely focus long enough to get through a single verse. My days are less terrible than my nights only because I can at least distract myself with work, even if I am so panicked that I make one stupid mistake after another. One might think that with all the surgeries I’ve had, I would handle myself better, but the reverse is true. Even when I have confidence in my surgeon, I have no confidence in my luck. It’s not that I consider myself unlucky, but that so much can go wrong, and so much of what can go wrong can never be made right. How many times have I wished I could have screamed “Don’t do it!” at myself as I walked to the hospital for knee surgery, even that short walk being longer than most of the ones I have made in the years since. My intention was to prolong my hiking years, not to end them altogether. Now I can but bike, and I won’t even be able to do that for four months after my next surgery. I won’t be allowed to so much as lift my arm for six weeks, and nothing more than my arm for another month.

Some might interpret my terror as a premonition, but I have little to no faith in premonitions. What I do have faith in is my ability to made prudent decisions, but no matter how prudent I try to be, there is always uncertainty, and there is always the possibility that I will learn something after the fact that would have led me to choose differently. Oddly enough, the more fearful I become, the harder it would be for me to back out of surgery in the absence of a really good reason to do so.

I have spent hours combing the Internet for alternative treatments, but the trouble with alternative treatments is that they are seldom supported by hard data. I can find study after study about surgery, but no studies whatsoever about Rolfing, Tragering, acupuncture, chiropractic, and so forth. If they could but offer me some reason to believe in them (other than their own authority and the anonymous testimonials of their patients), I would jump at the chance. Yes, medical doctors sometimes kill their patients whereas homoeopathists never do; and, yes, medical doctors are glorified parts’ technicians whereas alternative therapists treat the whole person. But I see no other option. I can have surgery now, or I can have surgery later. Or—as I’m told—I can have surgery now, and still have surgery later since an enlarged tendon can’t be reduced. The most that a surgeon can do is to remove some of the risk factors that might lead to a tear.