Tuesday, January 21, 2014

Comfortably Numb

Today marks the start of week two on the prednisone regime.  I started with three pills a day for five days.  This is now the third day of two pills a day.  After that there are five more days for weaning off the drug with one pill a day.  No cure will be had.  But perhaps the inflammation will have subsided enough to return closer to normalcy (typing with both hands, for example).  In the meantime, it has forced its own accommodations.  And coupled with the dislocation imposed by our house renovation, it has encouraged me to think through some of my habits and whether they support what I want to be doing with my time or if instead those habits remain as vestiges of a different time when perhaps they served a needed purpose but are hurting me now.

The main adjustments have come from hanging out on campus during the day rather than staying at home.  This impacted the rhythm of eating - no snacks between meals and no fridge raids for breakfast or lunch.  Where eating is concerned, a sensible approach will only follow for me if a lead-us-not-into-temptation philosophy is implemented first.  When I was single, I might have done that in my condo simply by not keeping junk food in the place and not having a bunch of leftovers hanging around.  Now, getting away from home during the day looks to be the safety play.  It is not clear to me yet whether I'll maintain the resolve to do that once I can return to my home office, with the annoying construction noise no longer present.  But it is a question I've been asking myself the last few days.  Is this a wake up call for the rest of my life?

The other big change regards alcohol consumption.  With the prednisone I stopped drinking - almost.  I don't know if this is generally true or not, but for me there is a negative feedback loop between  drinking and eating during the evening, with more of one encouraging more of the other.  This past week I've been a good boy for the most part and lost 7 pounds, I believe totally a consequence of reduced volume in consumption and not at all about a different mixture of foods consumed.  Do that for four or five more weeks and I will reattain my weight in high school, for nine or ten weeks the weight when I was married.  While achieving both of those milestones would be rewarding, what I'd really like to know is how much weight loss is needed so that the bulk of the pain in my hips and lower back is no longer present.  I'm hoping that's of the same order of magnitude.

The pain is the result of arthritis and bone spurs, and on occasion radiates down further in the legs.  Yesterday it was comparatively mild outside, almost 40 degrees, so I opted to go for a walk.  My route started out of BIF, then south on Sixth Street to Pennsylvania, and then east to Lincoln, the point that should be about halfway for the round trip, not quite a mile from where I started.  I felt a bit of pain during this but it is not too bad and I was able to keep a steady pace, with my hopes rising that if I just keep at it the pain would not interfere further.  While turning north on Lincoln headed to Nevada, I began to tire and the pain gradually increased as a result, both in the lower back and in my neck/left shoulder.  The walking became more labored.  By the time I was headed west on Nevada I knew I was not going to make it all the way back to BIF without taking a break, so I planned for a place where I could crash for a few minutes and recuperate.  I opted for the first floor lounge of the Foreign Language Building.  If memory serves, it has comfortable padded chairs.  Alas, FLB was locked, it being a school holiday, Martin Luther King Day.  By the time I discovered that I had hardly any reserve left so opted for a quick and dirty solution.  I sat on the low flat stone benches outside of FLB for about ten minutes before making it back to BIF.  In the summer this would have been no big deal at all.  In January it felt a little weird.

Partly for this reason I've opted to do most of my walking as of late on the treadmill.  (The other reasons are to avoid the inclement weather, to go a little faster where I hope to get some aerobic benefit as a consequence, and once in a while because I'm into a program for which we have the DVDs and want to watch an episode.)  My habit when doing the treadmill is to have both hands on the handrails.  This helps with keeping balance.  It also lets my arms bear some of my body weight that my back would have to bear otherwise.  Until recently, it has worked reasonably well.

The first several days of prednisone had been quite effective.  By Saturday I was feeling almost no pain at all.  So I opted to do the treadmill in the manner I described in the previous paragraph.  This was a horrible mistake.  Since making it I've concluded that the prednisone is very good in clearing up an inflammation already created.  But it does nothing to address the source of the inflammation itself, so that whenever the arthritis gets itself riled up, and doing the treadmill as I did was more than sufficient to accomplish that, then the cycle repeats itself.  A couple of hours after finishing the treadmill my left shoulder started to hurt.  As that intensified my willpower started to break down.  That evening I had a few martinis, whether as consolation prize or distraction.  But I've been back on the straight and narrow since.

There is one more component to offer up for a full description of the abyss, before I can discuss the return from it and how that might be possible.  This regards sleep, really lack thereof.  Pain blocks it from happening and also can cause me to awaken in the middle of the night, when what had been a comfortable position no longer is.  With this recent episode, the pain migrates, making staying asleep more of a challenge.  The drink may help with getting to sleep initially, but it has to be making the sleep less restorative, thereby perpetuating the rest of the negative feedback loop.  I can't say that I've solved the sleep-through-the-night issue but I do feel more clear headed now and far less fatigued during the day.  It's not been long enough to know if those feelings will sustain provided I adhere to the more healthful regime.  But if that's possible and post prednisone the pain remains manageable, then the preconditions will exist for a viable alternative path for me.

Not all acts of providing comfort, whether vegging out in front of the TV, having a good meal with family, or relaxing over a drink with friends need be part of a descending spiral.  At this juncture most people will talk about finding balance - moderation in all things.  That matters, of course.  But the reason for seeking comfort matters too.  Having belabored consideration of physical pain as a reason, let's briefly consider a couple of others.  One is to recharge batteries - mentally and physically.  We can't always be on and after putting in an intensive effort over a sustained period it's time for some rest and relaxtion.  It would be nice for that to include some vigorous exercise as a component.  But really, it should run the full gamut because the variety aids in the re-invigoration.  The other possibility is to use comfort to offset an apparent stress.  If the source of stress is temporary and the obstacle is then overcome, why not celebrate that a little?  But if there is ongoing frustration with no sign it will relent, then it may take more and more of the food and drink to feel properly compensated for having to endure the stress.  What may start out innocently enough can then descend into a vicious cycle.

My experience as an academic is that the two sources are temporally separated.  In teaching or in giving a talk at a seminar, I as presenter would get keyed up and would stay that way for perhaps a few hours after.  In that interval of coming down, going for a walk, having a treat with a friend to talk about whatever the friend wants to discuss, or doing some interaction other than one's own research is perfectly okay.  Research for me demanded entire weekends or if not that then a full day with nothing else on the agenda.  And since the paper I'd be writing would take months in coming up with the full model, in order to not reinvent the wheel each time I resumed working on the paper I'd have to find a good place to leave it rest, with the interim results well in hand.  All of that took considerable effort and relaxing after made a lot of sense.  The real stress, especially for an assistant professor, is about whether tenure will be granted.  Writing early papers that stress is pretty much out of mind.  And if you are lucky enough to get some good placements with those first papers, it may remain out of mind when crafting subsequent papers.  During the year when your case is considered, the stress is unavoidable and becoming neurotic is a natural byproduct.  This is a time for excessive pampering.  But it is also likely to be temporary, especially if tenure is granted.

It is different being an administrator.  There are many more balls being juggled.  One does not have the option of returning to a cocoon-like existence (though see Frank Bruni's column today for how even the President of the United States wants to do just that).  If a ball drops the blame will soon follow.  Progress can still be a source of great satisfaction.  But gridlock coupled with animosity among the participants can rip you up inside.  This is when hardly any source of comfort is sufficient. 

Though I made plenty of mistakes in juggling balls at work, the greatest error by far was not attending well to my physical health.  I had been something of a jogger since starting at Illinois and it helped maintain my well being into the late 1990s, though I did begin to put on weight when the kids were young, perhaps beginning in 1995.  Jogging was a great equilibrator and the whole experience - getting to the gym, doing the run, having a shower and sauna after, and then getting back to the office - would take less than two hours, so could be managed at one end of the day or the other.  But eventually my knees started to hurt and jogging stopped being the solution.  Several people suggested swimming, fine in theory though I'm not much of a swimmer.  Better for me would have been to take up a mixed regime - power walking, stationary bike, rowing machine, some light weights, etc.  That would have helped to keep the weight off.  Instead, as I threw myself into the administrative work, I went cold turkey on this sort of exercise, other than shooting a few hoops on the driveway at our old house.  That was hardly enough.  Requiring increasing comfort (my friend Deanna will tell stories that while going to have coffee with me to discuss our campus business I would invariably shred a couple of paper napkins in the process as a way to keep my hands busy and let out some of the emotion that was bottled inside) and not getting sufficient exercise is a recipe for disaster.  I'm still paying the price. 

Over the last several weeks, as the health challenges have seemed to mount (could the arthritis spread to yet other parts of the body and cause more pain?) I simultaneously have gained a larger sense of purpose as to what I should be doing with my time.  This has followed my experiences with teaching the last couple of years, a recent reading of What the Best College Students Do, which I critiqued in a prior post, and my current reading of Creativity: Flow and the Psychology of Invention, which I'm enjoying more.  This purpose is to advance the cause for ordinary students, particularly those studying social science, such as the Econ majors I teach, to embrace creativity in their own lives, in and out of their classroom, as a way to give them a sense of purpose and something they want to be doing.  Classes themselves don't go far enough in this direction and there is so much pressure within the system that pushes students the other way, toward becoming automatons.  So I don't yet have a blueprint for how achieve this goal.  But given my disposition, my prior experiences, and that this agenda doesn't seem to be driving other folks who care about learning, this gives me a sense of what I should be about. 

And the operative question I'm asking myself here is whether I can get healthy enough to pursue this goal fully.  Let the un-numbing begin. 

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