New haircuts

Wise words on evaluating information, beliefs, and knowledge.

Thanks to my old friend Debbie Ling for sharing these wise words with me. A lot of this resonates with the literature on clinical decision-making, and what philosophers say about logical thinking and the scientific method. I get excited when similar recommendations come from diverse sources - it suggests, to me at least, that they reveal basic  truths about our world

Kalama Sutta

Do not simply believe what you hear just because you have heard it for a long time

Do not follow tradition blindly merely because it has been practiced in that way for many generations

Do not be quick to listen to rumours

Do not confirm anything just because it agrees with your scriptures

Do not foolishly make assumptions

Do not abruptly draw conclusions by what you see and hear

Do not be fooled by outward appearances

Do not hold on tightly to any view or idea just because you are comfortable with it

Do not accept as fact anything that you yourself find to be logical

Do not be convinced of anything out of respect and deference to your spiritual teachers

You should go beyond opinion and belief.  You can rightly reject anything which when accepted, practiced and perfected leads to more aversion, more craving and more delusion.  They are not beneficial and are to be avoided.

Conversely, you can rightly accept anything which when accepted and practiced leads to unconditional love, contentment and wisdom.  These things allow you time and space to develop a happy and peaceful mind.

This should be your criteria on what is and what is not the truth; on what should be and what should not be the spiritual practice.

THE BUDDHA.

Another summary of it from Wikipedia:

The Kalama Sutta states:

   Do not go upon what has been acquired by repeated hearing,

   nor upon tradition,

   nor upon rumor,

   nor upon what is in a scripture,

   nor upon surmise,

   nor upon an axiom,

   nor upon specious reasoning,

   nor upon a bias towards a notion that has been pondered over,

   nor upon another's seeming ability,

   nor upon the consideration, 

"The monk is our teacher." [emphasis added]

   Kalamas, when you yourselves know: "These things are good; these things are not blamable; these things are praised by the wise; undertaken and observed, these things lead to benefit and happiness," enter on and abide in them.'

Thus, the Buddha named ten specific sources which knowledge should not be immediately viewed as truthful without further investigation to avoid fallacies:

   Oral history

   Traditional

   News sources

   Scriptures or other official texts

   Suppositional reasoning

   Philosophical dogmatism

   Common sense

   One's own opinions

   Experts

   Authorities or one's own teacher

Instead, the Buddha says, only when one personally knows that a certain teaching is skillful, blameless, praiseworthy, and conducive to happiness, and that it is praised by the wise, should one then accept it as true and practice it. Thus, as stated by Soma Thera, the Kalama Sutta is just that; the Buddha's charter of free inquiry:

“     The instruction of the Kalamas (Kalama Sutta) is justly famous for its encouragement of free inquiry; the spirit of the sutta signifies a teaching that is exempt from fanaticism, bigotry, dogmatism, and intolerance.[4]     ”

However, as stated by Bhikkhu Bodhi, this teaching is not intended as an endorsement for either radical skepticism or as for the creation of unreasonable personal truth:

“     On the basis of a single passage, quoted out of context, the Buddha has been made out to be a pragmatic empiricist who dismisses all doctrine and faith, and whose Dhamma is simply a freethinker's kit to truth which invites each one to accept and reject whatever he likes.[5]

link to updated reflections on what patients want and neuropsychology

http://neuropsychbookworm.blogspot.com.au/2014/06/neuropsychology-and-what-patients-want.html

Visitors welcome, and a revelation about the perils of looking back

The main purpose of this blog post is to invite family or friends from interstate to come and stay with us for a few days, in exchange for company, conversation, driving a manual car, and helping with the cooking. You'd only have to pay your own airfares. We have enough beds for four extra people (one queen-size bed in the bedroom upstairs, one downstairs), and the upstairs room has its own bathroom. Despite all the dramas I've been through, I'm feeling remarkably well, and feel even better when I have people to talk to. So if you're interested in a short break in Launceston, email me and we can talk about dates.

I've been having a lovely week with an interstate visitor this week. Debbie Ling came over to stay on Monday, and will be leaving on Friday. Deb and I were housemates from 1990-95 in Barkly St, Carlton, where we talked for hours on the staircase the first time we met. We were up talking until 10 on Monday, had breakfast and did some shopping in town yesterday, and today we're home being domestic. Nathaniel is home too with a virus, he's reading at the moment, but I'm going to take him through Bill Handley's Teach your children multiplication in the hope that he will be able to multiply numbers in his head by the end of the day. Having him home means that Deb and I won't be able to have the open and frank wide-ranging philosophical conversations about life, the universe, and everything that we've been having for the past two days, but I'm hoping we'll be able to get two bookcases reorganised, and finally clear off the dining room table.

It's so good having Deb here, I hadn't fully appreciated how housebound or socially isolated I've become. Not being able to drive is an impediment, but my recent experience of pain and nausea have made me reluctant to journey out alone. As it was, I was utterly exhausted with walking a few blocks in Launceston yesterday, but I felt more able to do so with Debbie there for company. I'm so out of condition from my recent 3 weeks in hospital, my legs felt very weak and I had to sit down a couple of times. Despite getting so tired, I didn't sleep very well last night, my tummy was still hurting a little, and I couldn't get comfortable. I'm feeling sleepy and unwell this morning, wish I could crawl back into bed, but I want to get Nathaniel doing the multiplication work, and to tidy up, even if it's only a little bit. I'm also trying to process life without my work, I'm grieving for it a little, because I'm not sure that I will be able to return to the job I did before. Emotionally, I'll need a lot of therapy to be able to cope with hearing stories of other people's illnesses. Cognitively, I don't know if I have the concentration and endurance to analyse and interpret neuropsychological data, let alone to collect it. This would also affect my ability to supervise students, as it requires hearing patient stories and interpreting data. It's too early to worry about such things at the moment. I still have to recuperate from my recent surgery and get my strength back. I should be feeling much better in a year.

I learnt a valuable lesson this morning - never look back. I had a look at a couple of posts from early September last year, around the time of my diagnosis and surgery for the brain tumours. It made me feel quite distressed, seeing myself optimistically giving thanks that things had been caught before too much damage was done, that the tumours were where they were, that it wasn't far worse. I have a feeling that this is how I'm coping, by maintaining a sense of optimism, hope, and gratitude, and skating over the thin ice rather than stopping and seeing it splinter and crack beneath me. I could probably become overwhelmed if I were to look at the enormity of what has happened, and the possible ramifications, but if I keep on skating and trying to find positive things in the journey, it doesn't allow me to freeze in fear. Maybe my strategy is a sophisticated form of denial, but I don't think so. I know I'm metaphorically skating on thin ice, I know what is underneath, and I don't want to fall. I trust that I will get to solid ground at some stage, I just need to keep going. So I won't be looking at old blog posts again. I admire the fortitude of those who continue to read it. Just don't let it give you a false impression that I'm not doing well. I'm still enthusiastic about life, I'm not unwell or dying yet, and hopefully won't be for a very long time. We're all going to pass from this earthly realm at some stage, so we have to seize each day and stay in contact with our family and friends, and fearlessly embrace the life and opportunities that we are given.

I know, believe me, that it's very hard to visit someone affected by a serious illness, it brings us face to face with all our fears and memories related to illness, grief, suffering, loss and dying. But to avoid seeing people because of our fears is to deny both them, and ourselves, of the opportunity to share pleasant memories together, or even to share the simple companionship of sitting together in silence. Avoidance can also set us up for regrets. I didn't create enough memories of Dad's final months because I was too busy feeling grief-stricken at the thought of losing him. I'm glad I was able to gather the strength to see him just before he passed, but I still feel bad for all the chances I missed. The time for grieving is after they've gone. Getting consumed by grief beforehand is understandable, but not helpful. Life needs to be celebrated, particularly when we know how precious and transitory it is.

That doesn't sound particularly happy, I know, but it's 9 months since my GBMs were discovered, they haven't progressed, my bloods are stable, and I'm getting better each day. I'm still very much alive and eager to see people.

scheduling another mastectomy and feeling a communication difficulty with some doctors

I rang my surgeon's rooms today to make an appointment to see her. The first available was in two weeks' time. I rang back and asked them to tell her that I want to have a prophylactic mastectomy on the other breast as soon as possible. We'd discussed it in hospital a couple of weeks ago, and seemed reserved, despite listening to my reasoning,  (there was a suspicious area on the last mammogram, and the MRI also showed an area of contrast uptake; doing a biopsy on the area under mammography will be painful and technically difficult, and may miss any cancerous cells; if there's something there, whether its ductal carcinoma in situ or  invasive breast cancer, I'd still want it out; I can't tolerate any more chemotherapy due to my bone marrow suppression; I was going to have the other breast removed anyway, for peace of mind). She chuckled when I said I wasn't going to beat the brain tumours only to be snookered by metastatic breast disease…

I may be over-interpreting, but I increasingly think the radiologist who rang me after looking at all my MRI scans when we returned from Hobart was advising me against having a stereotactic breast biopsy the next day because her impression, from seeing the scans, was "here is a 46 yo mother with two children who has an aggressive brain cancer that is likely to kill her very soon". She even said words to the effect of "it wouldn't be fair to put you through a painful biopsy and another operation that would take you away from your family". She insisted that the MRI didn't show any areas of enhancement that would suggest invasive disease, but her report said there was an "area of increased contrast uptake." I know how radiologists speak. That means enhancement. I am probably overgeneralising when I suspect that my surgeon's colleagues who advised her to "wait and see" were thinking along the same lines. They can't help it. It's the way they're trained.

I understand this line of reasoning, but the radiologist and other surgeons have never met me, and can't assume they know what is best for me. While GBM was rapidly progressive in the past, the use of Valcyte has been shown to dramatically slow down progression, and to improve survival odds. I had the horrid realisation today that I was put on valacyclovir, used to prevent herpes simplex infection, in January, and went off Valcyte until I looked them up and realised they were different drugs. That might be why there appeared to be two extra lesions on the second-last scan, and why they had decreased in size on the next scan in March, when I'd restarted the Valcyte. I feel rather shaken, it shows me just what I'm dealing with, and bloody happy that we checked and took the Valcyte again.

Clinicians can sometimes be overly pessimistic and morbid when faced with difficult diagnoses. They sometimes jump to conclusions that further treatment is futile, based on the seriousness of the person's condition, without considering the person's wishes. Clinicians are human, after-all, and aren't immune from shying away from dreaded diagnoses, or from having their reasoning clouded by the awfulness of patients' plights.

If I wasn't motivated to get the best possible outcome in this, if I wasn't informed and able to advocate for myself, if I wasn't health literate, if I was depressed or lacking in hope, I might just give up trying and accept the overriding impression I get from some people that it's all just too hard, that my situation is hopeless, that it's not worth going through another mastectomy because it will put me in hospital for another week, and I'll probably die from the brain tumours anyway.

I'm not dying at the moment. I'm recovering well from the surgery, the pain is getting less, and a medically-trained friend says I'm looking very well. I was 96kg at the end of last year, thanks to the steroids, I'm now 77kg thanks to my 3 weeks in hospital with the twisted bowel. Being closer to my healthy weight range is good for my health and recovery.

With the kids being at school, hospital isn't a bad place to be, especially if it's ridding my body of an unwelcome visitor that could. Ben brings the boys to visit in the morning and evening, and they've got into a good routine with school and homework. I won't have to worry about that breast again, and they'll hopefully catch anything before it spreads. If the lump (which I can't feel) is cancerous, I'll need radiotherapy to that breast, but if it's not cancerous, I won't.

I'm feeling like swearing at the moment. I can see how some cancer patients die because pessimistic clinicians think that some treatments are futile. Though I've also heard of some dying patients being treated beyond what is possible - care for people with life-threatening illnesses is obviously a very difficult area, personally, emotionally, ethically, and clinically. I'm not meaning to judge anyone here. But I'm alive and kicking, and am not going to give up anytime soon.

Post-script to my recent post on what patients want from a Neuropsych assessment

I neglected to mention other types of patient who may be distressed by a Neuropsych assessment.  Firstly, there are some patients who have insight into their cognitive difficulties, and who find it confronting to not perform as well as they expected on formal testing. I've seen a few patients who came wanting to know that everything was okay, despite their history of neurological injury or disease.   Being presented with evidence of minor weaknesses with things like memory or concentration, was sometimes hard for them to tolerate. In hindsight, the referrals weren't clinically necessary, they were more to satisfy the patients own curiosity or to allay their anxieties. Two patients were dissatisfied with results that confirmed their fears of cognitive weaknesses, they had convinced themselves they were okay, and they'd hoped the assessment would prove others concerns were unfounded. This outcome might have been circumvented by being clear on their reason for the assessment, and talking through the possible outcomes of an assessment before commencing it - how would they feel if the results were worse than they expected? Are they willing to proceed knowing that the assessment might reveal unknown difficulties? Of course, if an assessment is required for return to work purposes, or capacity assessments, the results of our testing are often not welcomed by the patient, but the patient is often not the client in these third-party cases, which creates a totally different dynamic to the curious self-funded or public patient who essentially wants to hear that there is nothing wrong with their memory or cognition despite a history or ABI or MS. Accepting referrals without a clear clinical indication puts the clinician at risk of having a dissatisfied patient who is angry with the clinician for their test results. 

 Secondly, some patients who get distressed have struggled with cognitive issues for some time, and find relief and validation through having an assessment. I recall an elderly woman with epilepsy who burst into tears after struggling with the WMS. She said she wished her husband had been there to see how hard she had found it, because he didn't believe her memory was as bad as she thought it was. For her, the experience of being tested and finding it difficult validated her everyday memory problems, and her distress was from years of being harangued and berated by her husband for not trying hard enough. She was grateful to finally have independent evidence of memory impairment, and to receive education and advice about the causes and strategies to deal with it.

Finally, there are people who have had brain conditions who may be distressed by our assessments because it makes them more aware of the difficulties they have been having. Sometimes these assessments are necessary, other times they are not.  I'd put myself in this category. I know I'm not as sharp as I was before, and I don't want to know how much function I've lost. There is no clinical need for me to have an assessment at the moment. I am on extended sick leave from my job, and my oncologist writes reports for my income protection insurance every three months to say I'm not yet ready to return to work. Having a neuropsych assessment would only make me anxious beforehand, and possibly depressed afterwards. There is not clinical need at present. 

I know my working memory is not as good as it used to be.  I find it harder to multitask and find it easier to focus on just one thing at a time. Being distracted from something before I've finished it is like mentally slipping into neutral while going up a hill and trying to re-engage the gears. I get easily rattled by multiple sources of noise or flashing lights. Music in cafés really annoys me sometimes, and I'm glad to have a bottle of clonazepam in my bag - it's meant to prevent me having more seizures, but it's been useful once or twice in loud and noisy settings. If I can't maintain a peaceful environment, I sometimes get quite irritable, especially if I'm hungry, nauseous or tired, or more recently, in pain. I have only had a couple of memory lapses, where I forgot things completely, like having been to the school auditorium after my surgery last year, only to have the memory slip back into my awareness later. I don't think I'm more disinhibited than I was before (I was always a bit open free with expressing my thoughts), though it's different now, and not the kind of insightless disinhibition seen with brain injuries. Having dealt with a number of life-threatening conditions over the last 15 months, I'm less inclined to hold back when I feel I have something important to say to the people I care about. I'm aware that I sometimes disclosing more personal information than other people might do, but it helps keep me sane, and if we hide away how illness affects people, how are they ever going to understand what people go through? I realise this is probably confronting for some people, and  upsetting for others, or both. Writing is a way for me to process my experiences, and to deal with the social isolation imposed on me through being unable to work or to drive, from living in a town with more aquaintances than friends, and having had six or seven weeks in hospital this year. 

Having gone through all of this has been a transformative experience. I'm more aware of the important things in life, more exasperated by the trivial - and more adept at ignoring them, and more appreciative of the preciousness of family, friends, health, happiness, and existence. I'm acutely aware of my own mortality and hope I still have much to share with people, and much time in which to do it. 

Perhaps I should be exploring all these thoughts with a counsellor or pastoral care worker? I've seen someone a couple of times, but end up feeling exhausted and more lonely than I was before. It's probably time to see a psychologist. I'm finding it increasingly hard to deal with the changes, losses, and uncertainty about the future on my own. Being deconditioned and in pain doesn't help - my sadness is more a state than a trait at the moment, which was given temporary relief by calling some friends.  I feel like I'm violating societal taboos by writing about all this, but I'm not forcing anyone to read it, you're presumably here by choice. Thanks for your support.

Time for some lunch and more pain relief. and a nap before the kids come home. 

Domestic bliss - first night back home after laparotomy.

I came home after lunch at the hospital today, and had a long nap on the couch in the warm winter sun. It was wonderful.
The pain is easing up, I have a choice of di-gesic, panadol, or Endone for pain relief, so slow-release oxycontin, though I think it made me dopey after my mastectomy last year. The Di-gesic seems to be working, so I'll stick to that. I probably should keep a chart so I can know when I've taken them, it's hard to remember, especially overnight. I asked for some this morning, and was told I'd just had them. It was 530, and I'd had them at 145. I had to wait 15 minutes before I could have some more.

The food in the private hospital was good. I enjoyed the flavour and texture, and found that my appetite had come back. I still don't like very strongly flavoured food, and I felt a bit nauseous after dinner tonight, but I didn't vomit, which was reassuring. I have a long, neat scar that starts just above my belly button and travels down to the pubic bone. It's healed very well, and he used invisible, dissolvable stitches, so I just need to keep my belly button clean while it heals. I still find myself walking with a hand supporting each side of my tummy, but sitting up and standing is becoming less painful each day.

It was so lovely to see Ben and the boys at home tonight. Nathaniel's piano teacher had called me earlier to discuss the timing of his lessons. He always goes with her and enjoys it, but he worries that he's missing out on class time. She checks with his teacher, who says it's okay, and she told me it's fine if he doesn't practice between lessons at this stage, he's doing so well when she does see him. Same for doing music homework at the moment. He learnt notation and the treble clef from his recorder last year, and picks it up quickly. He's reading the notes on the staves, and was trusting his fingers to play the right notes while he was reading the music the other day- an ability that can take some years to master. She thinks he feels a certain pressure to play piano because it's my instrument, but says he has the hands for cello. So my plan is to spend some time each weekend messing around on the piano with him, and maybe getting myself a recorder so that we can play together. I've shown him a couple of youtube videos of two cellos, a European duo who play modern rock pieces on cello, and he like the sound. He's always loved music, and used to bring me musical toys to listen to even when he was a baby, nodding his head in time to the music and looking intensely involved with it. I hope I can help cultivate his interest into something he can use, he's a passionate little soul who would benefit a lot from being able to get absorbed in music.

We all sat together watching the Big Bang theory this evening, and I treasured every moment of being  with my family, they boys leaning up against me, Ben relaxing on the couch. It was a perfect evening,  even with a few petty grievances. I've resolved to appreciate the perfection in each moment from now on. By being totally present in the moment, time passes more slowly, and I can appreciate every instant, even the little things that we get irked about. Making time slow down in this way stops me from worrying about the future, and regretting things from the past. It allows me to make the most of each instant- it felt a little like the scene from the matrix, where bullets passed by as bubbles through water.

Everyone's asleep now, time for me to join them. I want to enjoy every moment of tomorrow as well.
Thanks for reading and staying with me.

Recovery report - going home soon

Five days after surgery and the pain is settling down. Should be home tomorrow or Friday. I Slept deeply last night, apart from an annoying dream in which I kept pressing the nurse-call button to ask for pain relief, and they didn't bring it. Problem sorted when I woke up and made a real request for pain relief and was given it. 

Then I went to sleep again and dreamt that I was trying to get ready for a conference presentation that I'd promised to do, but I couldn't get my clothes on properly, and nurses kept wanting to take my obs, and I couldn't find my presentation files, they were all messed up and kept falling on the floor. 

Problem solved when Alison Standen came by for a quick visit. It was so good to see her again, for the third time since 1985. We only had two years at school together and lost touch after then, seeing each other again for the first time last year. Each time I see her I feel so happy, and would love to sit and talk for hours, there are so many things to talk about. I'm sad that we were out of touch for so long, but glad to be seeing her again now, along with other old school friends here in Tasmania - Jennifer Catenacci,  Philippa Durante, Edwina Mullenger, Sarah Gunn, Fiona  Payton, and my dear cousins Stephanie Byard, Fran Williams and Christine Bennett. When I'm out of hospital, I'm having long-overdue coffees with  Jane Wardlaw,  Bridget Campbell, and Brooke Bell, and would like to catch up with people from work as well.

I'm pooped now from writing that, and from an earlier walki up and down the hallway. I'll have a nap in my recliner and do some more walking around lunchtime. It's nice to be able to sit up without too much assistance and pain. Sitting out of bed, and walking each day, seems to be helping with my recovery. (Lying in bed isn't very comfortable with a sore abdomen)

I'm looking forward to going home. My old housemate Debbie is coming over to stay on the 16th, which will be fantastic, for her company, and for some practical help.

I hope this is my second-last visit to hospital. The last being a prophylactic mastectomy when I'm recovered from all this.  Keep your fingers crossed for me.

PS feeling sad at the news that Angels singer Doc Neeson died from a brain tumour recently. The Angels played at our Queen's College ball in 1987 or '88, at the Melbourne Town Hall. I remember dancing right in front to the stage, between the speakers, with my hands over my ears because it was so damned loud ( very daggy 80s dancing, swaying mostly). Then I realised that Doc was staring right at me, mirroring my dancing. Making eye contact with him broke me out of my reverie, and I felt simultaneously embarrassed, exposed, vulnerable, and not sure what to do next. It was like I'd been picked up, turned around, and put on the floor again. He gave me a grin and kept singing. There was kindness and curiosity in his smile (I wasn't a fan girl),  and I feel for his family and loved ones at their time of loss. 

Pain and pastoral care

I'm on alternating doses of paracetamol and Endone now. They had me on phentinol for a few days, which made me very dopey. Not so good when I need to get up and walking each day, and because I didn't like observing myself nodding off like a granny in my reclining armchair. The snorting snores were embarrassing.

My surgeon says it usually takes about five days for the postoperative pain to settle, meaning tomorrow. So I can go home when the pain is gone, and when my bowels are moving normally. Probably some time after Wednesday.

I said to the surgeon that I didn't know what I'd done to deserve all this. He wryly said it was like I'd won the trifecta by now, so it was unlikely that I'd get another big win (meaning that nothing else should happen now). I thanked him for removing my appendix, which means I'll never be able to get appendicitis now.

I've been feeling a bit up and down today. I slept very deeply last night and had some amusingly bizarre dreams. The pain wasn't great when I woke, but responded well to Endone. I watched a bit of ABC news 24 and caught up on other news feeds on Facebook. Then the pastoral care worker came, I didn't really feel like talking to her, and I found myself crying my heart out over the news coverage of the 25 th anniversay of the Tianmen Square massacre that was on the tv. She asked if I'd been involved (ha! Unlikely! Why should someone have to be involved to be distressed by an atrocity.?) I said it had affected me deeply at the time. I couldn't really articulate why it upset me so much. I was only 22, and the images of the peaceful protestors standing to face the tanks and the horrors that ensued have always distressed me, and I have avoided being reminded of it as much as possible. The same applies to the atrocities in Rwanda, East Timor, our treatment of asylum seekers, colonial treatment of indigenous peoples, and any other historical or recent episodes where force and cruelty have been used to persecute people whose only "crime" is to make a stand for liberty, freedom, justice.

Some family and friends get a little impatient with me when I get upset about such things, and tell me I'm wallowing in it, as if I'm being self-indulgent. I find such comments insensitive and unhelpful. I'm not seeking out these emotions, I don't seek out stories or memories of distressing events. I avoid them as much as possible because I know I usually get upset, then admonished by others for being upset at injustice,cruelty, persecution, and violence, or tragedies like earthquakes, floods, and tsnunamis that wreak havoc and suffering on a monstrous scale. I know I can't do anything to change what has happened, but the amount of suffering caused by these events causes my heart to break for those affected, and it makes me so angry to be told not to feel that way. I don't go around moping for days about it, I get over it after a little while, and I meditate on peace and freedom from suffering for all sentient beings, and that all people might become compassionate and caring about all living things. 

Having people tell me I'm being silly or self-indulgent in feeling sad for all those who have suffered doesn't help me. I understand that family or friends might not like seeing me upset, but telling me I'm stupid to be upset about terrible things is insensitive and patronising. How hard is it to comfort someone who is distressed? How hard is it to sit next to them,hold their hand, put an arm around their shoulders, or simply sit with them while they have a good cry? That's all I need, acceptance and a place to sit and let the feelings pass. Not judgment and impatience because I'm not getting over it quickly enough. 

I'm not trying to make myself depressed. I could have got depressed at any time over the past two years after dad died in February 2012, when my cousin Marita was dying from cancer all that year, when Ben was going to move back to Melbourne for work before I was diagnosed at the start of last year, (he changed his mind)... after all of the health complications I've had... If I wanted to get depressed, I could have done it by now. Getting upset about massacres and tragedy isn't self-indulgent - On some level, maybe I find it easier to cry over the unfairness of such things because it feels self-indulgent to get upset over what has happened to me. Despite everything, I still feel very blessed and grateful for all the good things that have happened to me, that I am still alive and recovering, and full of hope that I will continue to recover and grow strong. Crying about my bad luck isn't going to help. I don't want to give in to feeling sorry for myself. I just want to get better and get on with life. 

Sometimes, though, something will break through my defences and the tears flow, or I get irritated by my mother's insatiable curiosity (why the need for all the questions, to look at what I had for lunch? Can't she ever sit still?) and I feel guilty for being impatient with the people I love the most.

I didn't really feel like talking to the pastoral care worker this morning. I could have said so, but it would have felt impolite. I've become skilled at taking refuge in my self, in creating a peaceful place where time passes slowly, where I feel calm and serene, where I can meditate on being healthy and filled with love and loving wishes for others. Ironic that being pulled from that place causes feeling of irritation and impatience. Am I doing something wrong? Or is my happy place a retreat from a reality where I'm  cranky and irritable, and I'm just deluding myself?

 Another person I know would say I'm thinking too much at the moment.  Not very helpful. When you spend all day in a hospital room, the choices are limited: sleep, chat to the nurses, read, watch tv and feel my brain going numb, listen to music; talk to my family when they visit and feel guilty when I start to feel irritated from overstimulation; mediate, visualise good health and happiness; walk up and down the corridor, try to stay awake, watch the news, write this blog. Thinking and writing are the most creative things I can do at the moment. I don't have the energy to talk for long... It's hard to concentrate on having a conversation, and that makes me feel guilty. I should feel better tomorrow. I need to sleep.

Recovering on Monday

It's a beautiful sunny day in Launceston, I can see the autumn leaves in the park at St. John's, and can hear the regular croaking call of a crow, against the background of gentle traffic noise.

My tummy is still sore from the surgery, but I was able to sit myself up in bed today(very slowly), had a shower, did two laps of the hallway, and have been sitting in my armchair since then, passing the time by meditating with a relaxation soundtrack on in the background. 

I'm allowed to progress up from a clear fluids diet, now that gas is moving around down there, and the surgeon says I'll be in for another 2-3 days, once the pain has settled. I'm feeling very blessed and grateful that they were able to correct my twisted bowel without removing any, and that there weren't any complications. 

Mum lost over 12 inches of bowel when hers was twisted from adhesions over 10 years ago. Another cousin lost his father to the condition. It's not just incredibly painful, it's potentially lethal as well.

I just need to sleep on my back, or on my left side, to encourage mine to stay in place. The stitches will appreciate it if I do

I have no idea what I've done to deserve all these health problems. I'm not going to spend valuable time wondering why, or feeling guilty for things I could have done differently. I'm going to take myself and my IV fluids very gingerly to the bathroom, and then I'm going to do two more careful laps of the corridor. Onwards and upwards!