Fire in the hole

Habaneros don’t keep well, so stores are often out. When Market of Choice didn’t have any today, I asked the produce manager about something he did have that was labeled “red-hot cherry bombs.” He said they were hotter than habaneros and offered me a slice. It might as well have been a jalapeño. I then biked over to Plaza Latina but they too were out. The Hispanic produce lady assured me that she had something even hotter in the back. She brought a green, globe-shaped pepper for me to sample. I couldn’t understand what she called it, but I wasn’t about to let a dusky maiden from the land of fiery tamales think I was a wimpy gringo, so I ate it whole. Her eyes widened in anticipation of my screams, but again, I might as well have eaten a jalapeño. She disappeared into the back a second time and came out with what she called a Thai pepper. It was ominously small (like every hot pepper I’ve had), and I ate it whole too. Hotter than a habanero? Ounce for ounce, maybe. My stomach burned for two hours. Peppers eaten alone are in a different category than peppers eaten with other foods. I didn’t scream though.

I started eating habaneros a year ago because I read they were good for arthritis and for Raynaud’s (a circulatory problem affecting the extremities). The Oxford American defines them this way: “Habanero, a small chili pepper that is the hottest variety available.” At first, even a quarter inch section made my eyes water, my face turn red, and heat race across my scalp like flames through gasoline. But they grew on me. Now, I eat three with every meal and even take them to potlucks. I can’t say for sure that they helped the arthritis, but they’ve reduced the severity of the Raynaud’s by two-thirds.

I wash after I handle them but I still don’t dare put my hands near my face. I even hold myself gingerly when I pee, but I often end up with a fiery crotch anyway. Peggy burned herself just by drinking grape juice from my glass last night. The night before, she did it on a sweet potato that I peeled. A few days before that, a bite of my banana sent her running for the milk jug (milk neutralizes the capsaicin somewhat). Peggy is most decidedly not a fan of hot peppers.

Now, why would I enjoy something that hot? Well, like I said, habaneros don’t taste that hot to me anymore. Think of them as like coffee. If someone who never drinks caffeine has a cup of coffee, it will give him the jitters, but a heavy coffee drinker will scarcely notice the same amount. Peppers are also like coffee in that they have a psychoactive effect. I haven’t been able to find validation for this, but I can vouch for it from experience. Habaneros boosted my mood sufficiently that I even stopped taking Lexapro.

Hopeless Chasms and Impossible Bridges

I sometimes express a desire to take on Peggy’s health problems. Peggy never expresses a desire to take on my health problems. I don’t interpret this to mean that I love her more, just that I love her differently.

Likewise, she sometimes treats the dogs in ways that seem insensitive to me, and I sometimes treat the dogs in ways that seem insensitive to her. In other ways, I am nicer to them, just as she is nicer to them in yet other ways. It’s not that one of us cares more; it’s simply that we possess different personalities and are at different places in our understanding. It takes a great deal of closeness to understand this and to let it be okay, and I have not found that closeness with anyone else.

My oldest and dearest friend told me recently that, after 22 years of doing so, he no longer wants to read my writing. He first said that this was because he has too little time to check his mail, but he later indicated that he simply doesn't find it sufficiently interesting. I was hurt and dismayed because no one can be close to me and not read my writing. I didn’t tell him this (I rather assumed he knew it) because what good would it have done? Would I really want him to do that which he had said he was opposed to?

I used to assume that all human difficulties could be resolved with adequate communication. Hardly. Our individual needs are too different and too contradictory. At another time in my life, I was prone to write people off as worthless if they let me down. That too was an extreme position. It is better to simply accept what others offer without complaint and without asking for much else.

I’m not saying that this is easy. As with my friend, I have yet to work out an acceptable way to relate to him at all, but he, not suspecting the depth of my disappointment (and never being terribly sensitive despite his training as a counselor), doesn’t appear to have registered the change.

What I have found from past experiences in which I have withdrawn to some extent from another person is that they sometimes respond by trying to draw closer to me. But there was no possibility of reciprocation on my part, chasms being more easily opened than bridged. So it was that we each had a cross to bear. Their cross was my withdrawal. My cross was the continuation of a friendship that served as a constant reminder of what I had lost.

The secret of a good life lays not so much in working through disappointments with other people as in learning to live gracefully in the presence of those disappointments.

I-Day

Saving the country seems like an awfully big job to lay at the feet of one man, but maybe that’s just how things work. Take the civil rights movement. Folklore has it that Martin Luther King, Jr. made it happen, and that Rosa Parks helped. I hate to think that’s true, but it might be. Sure, Schwerner, Chaney, and Goodman made a brief appearance, but they didn’t contribute so much by what they did as by the fact that they got shot and buried under a dam. Nobody thinks they were vital. Even Rosa Parks wasn’t vital; she just made good P.R. I know this because she wasn’t the first person to get arrested for refusing to give up her seat on a Montgomery bus; she was just the one selected to be the focus of the boycott. Why her? Because the first person was pregnant, single, and under eighteen. Oooh, bad P.R. Way bad P.R.

If, instead of individuals pulling together to accomplish a great work, history really is about charismatic visionaries and their expendable followers, that doesn’t leave a lot to be said for the rest of us. We can go along with someone else’s program or not, but we don’t ultimately matter. At best, we’re like individual privates in the military, mostly nameless, always expendable, and frequently dead. There were hundreds of thousands of WWII privates. Name five. There were a few hundred generals. Again, name five. See what I mean?

A part of me rebels against that. Maybe it’s a vain part that isn’t worth keeping, but I think of myself as more than somebody’s lackey. I also think that, well, if that’s the way the game is played, I don’t want to play it.

Maybe Obama truly is Kennedy and Roosevelt all rolled into one, and maybe we would be screwed without him. But that points to another of the problems with the charismatic leader theory of history. I mean, how can we trust that such leaders possess the goodness and wisdom to lead us someplace desirable? Look at Hitler. Germany adored him, and you know what happened to Germany. You might argue that Americans are smarter and more virtuous than Germans, but where’s your evidence?

I think those old Germans were simply people like us only in worse shape. They considered the future bleak, they felt desperate, and Hitler convinced them that he could restore them to greatness. No, I don’t mean to compare Obama to Hitler; I just mean to point out the danger of falling in line behind charismatic people. If you’re an optimist, you either have to trust charismatic leader types a lot more than I do, or you have to trust the thinking of the masses a lot more than I do. Maybe we really will prosper again someday, and maybe Obama really will be responsible for making that happen, but I hate it that we’re betting the farm on him because the next guy we bet the farm on might lead us to hell (which is pretty much what the last guy did). It makes my species look more than a little bad if this is the best way we can come up with to run things.

I plummet with Cliff

I don’t get on well with tolerant people. Don’t ask me why, but the more tolerant someone is, the less he is able to tolerate me. Likewise with loving people. As soon as someone starts talking about much they love the whole world, I lose any hope that they will find my company bearable.

I just took a walk with Cliff, the significant other (or shack-up honey, depending upon your level of tolerance) of a friend. First, he bemoaned the failure of society for letting a man freeze to death on the sidewalk, as recently happened here. I pointed out that the man hadn’t asked for shelter and had drunk himself unconscious on a night of record cold. Cliff could barely tolerate my callousness.

Then the subject of changing the name Centennial Boulevard to Martin Luther King Junior Boulevard came up. Cliff assumed that my objection was racist. I don’t know why he assumed this other than for the fact that I am from Mississippi, and tolerant people usually take this to mean that I just have to be racist. I don’t think I ever did convince him that my objection actually arose from my belief that no street name should be longer than four syllables. Martin Luther King Junior Boulevard has seven, not counting the three in boulevard. Cliff was right in arguing that everyone abbreviates it to MLK, but I thought that this proved my point. Take Eugene’s presidential streets. It’s not Ulysses Simpson Grant Street or James Knox Polk Street; it’s just plain old Grant Street and Polk Street, so why not King Boulevard?

Besides, when you look at the kind of people who are referred to by all three names, it’s serial killers for heaven’s sakes (Lee Boyd Malvo, John Allen Muhammad, David Parker Ray, John Wayne Gacy, George Walker Bush—need I continue?). Okay, Mark David Chapman and Lee Harvey Oswald weren’t serial killers, but at least they were killers. My point is that two names are adequate for everyone but murderers. Anybody know Christ’s middle name (his middle initial was H)? How about Mother Teresa’s (maybe it was Dear)?

Not content to let Cliff think I was but half an asshole when I could go for the full monty, I added that if someone's parents had the audacity to give them a name that was longer than three syllables, they should have the courtesy to abbreviate it. For example, how megalomaniacal do you have to be to expect everyone to call you Elizabeth when you could go by Liz, Beth, or Libbie? I mean, come on, how much of a person’s day do you expect them to spend saying your name?

If a person boasts of his tolerance but can only tolerate the opinions of people who agree with him, then how is he better than the rest of us? Or if he says he is loving but only loves those who love him, how is he more enlightened than you and I? Maybe I’ll ask Cliff about these things someday when we take a walk together, someday when hell freezes over and its drunks perish.

How it feels

I bore even myself with my health updates, yet of those who have read my preceding medical adventures, some might want the latest. My fellow sexagenarians will probably be the more interested because musculoskeletal problems befall us all even if we smoke Pall Mall, drink alcohol, snort aerosol, and bejewel one ball.

Peggy and I saw my new doc yesterday. I was tying a hangman’s noose when he walked in (the kind with the 13 windings). If I were a doctor, this would give me cause for alarm, and he did look alarmed and even clucked as he sat down. He needn’t have worried. I have loved knots for many a year, and I often turn to them when I am stressed. Its grisly connotation aside, the hangman’s knot is without peer, both for beauty and strength. It’s also fun to tie.

“Here’s the thing, doc, one of your fellow orthopedists says I have arthritis; one says impingement; and one says superior labrum anterior posterior. What do you say?”

“Yes.”

“Yes! What do you mean yes?”

“I mean they’re all right—they ARE doctors, you know. However, every problem isn’t contributing equally—if at all—to your pain.”

“So doc, if, being doctors, they’re all right and you’re right too, what do you plan to do about it?”

“Well, my handsome young patient, there’s choice A, and there’s choice B. Choice A is to stab you with an arthroscope and fix whatever is amiss. Choice B is to give you steroid shots in both shoulders, send you for some more physical therapy, and see how you feel in six weeks. I recommend Choice B, but you seem more than a trifle frustrated with non-surgical approaches, so it’s your call.”

I was frankly more worried about washing out with a fourth doctor (I have been to each of the three orthopedic groups in Eugene plus one loner doc) than of surgery (after 28 months of pain, I WANT surgery), so I was relieved that I liked Mark Fletcher. He listened well, took his time, seemed to care, gave me options, didn’t turn apoplectic when I called him Mark, and introduced himself to Peggy (doctors often ignore the patient’s spouse). Do I think shots and exercises will help? No, but I’ll give them a try rather than challenge his judgment. He is, after all, recommending a treatment that will cause him to miss out on a quick buck. Then too, the opinion of a surgeon who advises against surgery is not a thing to be sneezed at.

I’ve had three steroid shots to my neck, one to a knee, and one to a shoulder. None of them hurt much afterwards. These shots still hurt WAY MUCH. Without Percoet, I can scarcely move my arms, and I’m obliged to support one hand with the other when I do move them. I naturally wondered what went wrong that the other shots didn’t hurt and these do—is Mark yet another dud doc? An orthopedic website identified the problem as a cortisone flare, meaning that the drug crystallizes and stays that way for a day or two. It isn’t anyone’s fault. At least there’s that.

Ortho four

I wrote the following for my new orthopedist. He is the fourth I have seen. So, why is this worth putting in my blog? Because it illustrates what a circus a seemingly simple problem can become when put in the hands of the “experts.” These people have god knows how many years of training, yet the patient, who has no training at all, quickly sees their limitations and realizes that he must become the final authority over his own care.

You will note that I address the doctor by his first name instead of his title. This is because tokens of subordination stick in my throat. If I should be introduced to the queen someday, this could be a problem as I will refuse to so much as curtsy. Even if my resolve should weaken, and I should curtsy just to keep the old bag in good humor, my aged knees would probably become stuck, and I would have to spend the rest of my life curtsying to every man, woman, child, and dog that I met.

Osteonecrotic means dead bone.


Dear Mark,

I was overwhelmed by the prospect of verbally updating you on why I came here, so I decided to write it out.

In August of 2006, I began taking yoga for nine hours a week to strengthen an arthritic knee. A month later, I fell on my head while practicing a handstand. My neck felt compressed when I hit, but it didn’t bother me much afterwards. A week or two later, both shoulder joints started hurting almost overnight, and I was forced to give up yoga. My shoulder pain slowly got worse despite the fact that I drastically reduced my physical activity.

Nineteen months later (April 2008), I saw an orthopedist (Lisa Lamoreaux) who ordered x-rays and diagnosed the problem as arthritis. I questioned her diagnosis because the pain had started suddenly and at the same time in both shoulders.

In July 2008, I saw another orthopedist (Matthew Shapiro). He rejected Lamoreaux’s diagnosis, and said he suspected bilateral impingement. He ordered an MRI on both shoulders. He also gave me a cortisone shot in my left shoulder, and said that if I experienced relief, it would confirm his diagnosis. I experienced complete relief for about a month. He said that the MRI further confirmed his diagnosis.

I began taking an anti-inflammatory and going to a physical therapist (Lonnie Ward). I was given various band exercises to do, but they caused so much pain that I quit therapy altogether. A deep tissue massage that I got to relieve the pain made it much worse. I stopped doing anything involving my shoulders that I didn’t have to do, but the pain was so great that I was almost in tears for weeks. I was unable to even walk, bike, or drive for any distance, and sleep was nearly impossible. Shapiro prescribed Elavil, but it was woefully inadequate. By the time I obtained narcotics from another doctor, my pain level was going down, so I took very few of the pills.

Shapiro recommended subacromial decompression surgery, but said that a tingling problem in my right arm that had developed over the summer was caused by a nerve in my neck, so he wanted me to see a neurologist (Michael Balm) before he did surgery. Balm disagreed with Shapiro, saying that the tingling originated in my shoulder rather than my neck, and the tests he did in his office (EMG, NCS, etc.) seemed to confirm this. He said he would order a neck MRI anyway to reassure Shapiro. Based upon the results of the MRI, he ordered a CAT scan. Based upon the results of the CAT scan, he said that my C5 vertebra was probably malignant and speculated that the cancer had spread from my prostate.

A surgical neurologist (Andrea Halliday) biopsied the vertebra and determined that my C5 was not cancerous but osteonecrotic. Based upon the MRI that Balm ordered, she said that I had some nerves in the C6 area that were being squeezed where they left the vertebra, and she sent me to a physical medicine and rehabilitation specialist (James Kassube) for a series of cortisone shots. Halliday was confident that these shots would not only eliminate the tingling in my right arm, but would completely take care of my shoulder problems. The shots did eliminate the tingling but did nothing for the shoulders.

I went to a second physical therapist (Chris Besonis), and he prescribed isometic exercises. These also proved too painful for me to do.

I went to a third orthopedist (Thomas Peterson) because he advertised non-surgical treatments. Based upon a brief office exam, he rejected both Lamoreaux’s and Shapiro’s diagnoses, and said the problem was superior labrum anterior posterior. He gave me a numbing shot that he said would confirm his diagnosis if I got temporary pain relief, which I did. He prescribed prilotherapy injections. I didn’t consent to them because I couldn’t find evidence that they worked, and I had no idea if his diagnosis was correct.

Last week, I started going to a third physical therapist (Rachel Roach). She said that my symptoms aren’t consistent with shoulder impingement and prescribed yet another form of exercises. I don’t yet know how well they will work. I am scheduled to start Rolfing treatments this week in conjunction with physical therapy. I even went to a Japanese-style acupuncturist for two months last fall but got no benefit from it.

I have been in so much pain for so long that I would gladly consent to surgery if I could but have confidence that it would address the issue. As things stand, I have yet to find even two doctors who can agree as to what the problem is.