Tuesday, December 4, 2012

Winter 2012 update

Dang! A cowboy's work is never done!

A lot has happened since I last wrote a post, and although it hasn't all been pretty, I've learned a lot and think I'll be able to serve my patients that much better going forward.

First and foremost, my appendix ruptured July 14th. Ten days later* I submitted to my patient wife's gentle suggestions and went to see my physician, who rapidly diagnosed my condition and sent me to the emergency room. A few hours later I was the proud owner of a gigantic vertical scar on the midline of my belly, and I have now made an almost complete recovery -- in fact, I am as insufferable as I have been in years. I would like to thank my excellent doctor, Larry Ginsburg, of Lewisburg, PA; my skillful surgeon, Gary Ayers, also of Lewisburg; and the friendly, efficient and no-nonsense staff at Evangelical Community Hospital in Lewisburg. We are very fortunate to have such a fine facility in our little town, and I am very lucky to have such wonderful doctors looking out for me.

I hope you understand that I intend to use this adventure as my excuse for being offline for so long.

But never mind my sloth, here's some of what I learned and would like to share with you. First of all, I don't know whether to be proud of being so tough (see: cowboy reference above and Aggie reference below) or ashamed of being so out of touch with my own body (see: title of blog, with attendant reasonable expectation of some level of self-awareness, healthy habits and sensitivity to self and others). Maybe I have experienced more intense pain than I care to recall and so have become inured to it (Blessed is humanity's poor memory for pain! Thank you, Mama, for continuing on after my older brother was born!!), but the pain I experienced with my acute appendicitis wasn't anything so special. I mean, my stomach hurt and I didn't feel like going to the amusement park, but I frequently don't feel like going to the amusement park. So the first thing I learned is that appendicitis doesn't necessarily cripple you with pain.

If not for the persistent fever over the next ten days, I might've thought the malaise and discomfort were just a lingering hangover (although I hadn't had a drink in 4 months), or possibly the effects of a bad conscience. As it was, I initially thought I was just constipated, and when I continued to feel poorly after moving my bowels, assumed I was dying of pancreatic cancer, like my late brother. Honestly, it was the combination of my wife's pleas with the tearful awake-all-night planning of what I would say to my three young sons that got me to the doctor. Thank God and Goddess that my melodramatic, paranoid and guilty assumption was wrong. I would describe this as the second thing that I learned, but based on a lifetime of evidence, "Get some help, dummy!" is something that I haven't yet gotten a handle on.

Finally, perhaps the most important thing I learned is based on the aftermath of the surgery. After I was all healed up and had gotten my legs back underneath me, I experienced something very unusual for me. Although it reflects very poorly on my vain and superficial character, for the first time that I can remember, after my surgery I didn't feel sexy and attractive. I didn't particularly think of my belly as an erogenous zone or a particularly attractive part of my body, but once it had a long, dark red, zig-zagging seam up its middle, I didn't much feel like taking my shirt off. I certainly am not feeling like I want to proposition anyone or strut my stuff anywhere. Fortunately my wife still finds me attractive (and I have always felt like I am getting away with something, being allowed to be intimate with such a beautiful, vivacious and talented woman), but it has been a shock, how much this healing experience has left me feeling maimed and undesirable.

Besides saving my life, this realization has been the most valuable part of the experience for me. Many of my patients have had hysterectomies, C-sections and other abdominal surgeries, and many of them have reported feeling undesirable and emotionally disconnected from their sexuality after such surgeries. I only understood it in the abstract before, but now I understand in a much more personal way. It doesn't matter if the car works -- on some true level, if it doesn't LOOK good, it's not much fun to drive. Oh, it will get you to the grocery store and back, but you don't feel much like cruising the Strip or dragging a stranger at a stop light.

I'm sure I'll learn something else after some time has gone by and I've gotten used to my scar -- probably something about thankfulness and letting go (or maybe something about the pleasures of winning races in a beat up Buick with a tank of nitrous under the hood). But for now I am feeling for everyone who has gotten to middle age and then something happened on the outside -- Pffft! -- and everything changed on the inside. It's kind of the opposite of a mid-life crisis, or maybe it's my first experience with an end of life experience(!). Things feel hopelessly, inexorably sober. Responsibility is no longer an option, but the norm. I am fully a father and an adult. I'm not depressed (I know -- I've been depressed), but gravity definitely has a stronger hold on me.

It sucks, but there are worse things.

And soon it will be spring!

February 10**, 2013 on the Chinese calendar. I'll write again then.

*This reminds me of an Aggie joke, and as the child of an Aggie I feel comfortable telling it: A minute before half-time of the annual Texas A&M and University of Texas football game, someone in the crowd threw a firecracker. The Longhorns, thinking it was the gun announcing halftime, filed off the field and into the locker room. Three plays later, the Aggies scored.

** If you read this before today (12/18/12), I had the wrong date... oops, sorry!

Tuesday, May 15, 2012

Summer 2012

The first day of summer on the Chinese calendar this year was May 4. Summer's element is Fire. The color of the Fire element is red, its organs are the Heart and Small Intestine, its flavor is bitter (scorched) and its emotion is joy (whose negative aspect is anxiety). I am late with this brief posting, because after years of anxiety caused by being sucked dry by property I couldn't afford, I sold my house a month ago. Having unloaded a seductive but stagnant pile of steaming earth, my heart is slowly re-filling with joy. New anxieties will probably come to replace the old, but for now I am relaxing into the early summer here in central PA. I believe I'll set up the hammock tonight. I encourage you to do the same. Burn your obligations; become weightless. So what if it doesn't last? Nothing lasts. Enjoy it while it's here, is the lesson of Summer.

Change is in the wind

As the son of an English professor and a life-long lover of the bon mot, I have always tried to avoid cliches and stereotypical figures of speech. However, once I started working with bodies as an exercise therapist, it became immediately apparent how much truth there is in many well-worn phrases. As someone who has always suffered from knee problems, I can tell you, ruefully, that there is truth in the phrase "weak-kneed." Not that everyone who has weak knees is a coward, but rather that having chronic knee problems can make one physically timid, which ironically can contribute to the continuation and extension of knee problems. Urge someone with knee pain to be brave in their workouts and you'll have a good result. On another hand, people with chronic back problems frequently "don't have a leg to stand on" -- either they chronically exert themselves physically without situating their legs under them, or they frequently over-reach their boundaries and keep running when the ground has disappeared under their feet, like Wile E. Coyote. This makes them either lift with their back, not with their legs, or causes them to crash and burn, neither of which is good for spinal health.

When I started studying Chinese medicine, and especially as I have practiced it for the last 12 years, I have seen and appreciated how the Chinese have taken this technique many steps further and deeper. They have transcended words to identify and describe universal concepts, patterns or tendencies -- these descriptions include language, but also flavors, emotions, internal organs, external seasons, specific pathogens and spiritual states or emotional tendencies. Today, at the end of spring in the yang Black Dragon year 4709 on the Chinese calendar, I'd like to talk some more about the wood element and its climatic factor, wind.

Like always in Chinese descriptions of natural laws or movements, there is no right or wrong, illness or health implied in any particular substance, emotion or thought. They simply are, and can be in balance and appropriately expressed and manifested, or can be out of balance and inappropriately or destructively expressed or manifested. Wind is said to be the carrier of hundreds of diseases, but wind is also synonymous with change. The liver and gall bladder are the organs associated with the wood element, anger is the emotion, sour is the flavor and spring is the season. I have had an experience this spring which has brought all of these different aspects of wood and wind together in a way that is still making me feel awe and chagrin, but which I think is taking me further forward in my understanding of Chinese medicine, nature and myself.

Since I was about 18 years old, I have had bumps on my scalp. There were about a dozen of them, and they used to be about the size of a pea. However, in the last few years several of them got bigger and bigger. They would poke out through my hair, making me very self-conscious, especially at the swimming pool, where small children would say, "Mommy, what's that on that man's head?" They looked like cartoon bumps that are the aftermath of falling anvils, and I couldn't figure out a clever way to explain them away or disguise them. So I went to a plastic surgeon this spring, at the end of March, and had them cut out. Although the fee for this surgery was very reasonable, it was still a lot for me to pay; and although the procedure was described as minimal ("You can drive yourself home," and I did), it was a lot more traumatic than I expected. My head felt like a soccer ball that was being repaired -- lots of cutting, tugging and sewing -- when I had been expecting a kind of glorified pimple-popping. Besides the physical discomfort and wooziness, though, the biggest shock was seeing the cysts themselves after they were removed. Again, I was expecting some kind of cheesy, pimple-like goo, but instead they looked like miniature internal organs -- pinkish-grey, firm, with rubbery membranes and in some cases with skin, hair or other tissue still attached to the cyst. Sorry if I'm turning your stomach, but I bet my stomach was turned more. Especially because the sight of the cysts immediately confirmed one of my suspicions about the source of the cysts, and as it happened, it was the darkest, least flattering and least innocent of the various suspicions I had entertained.

Among other things, the Chinese say that the liver's qi rises to the vertex of the skull -- this usually is associated with things like headaches, vertigo and high blood pressure -- excess or un-anchored yang qi flying chaotically upward, in Chinese terms, or "liver yang rising." However, the liver is also harmed by excess dampness, and my cysts were very clearly pathologically damp in nature. Dampness in the liver is caused by consuming excess fats, sugars, medications or, as in my case, alcohol. Everyone in my family is a drinker, and I started in earnest when I was about 16. Although several of my relatives were pretty clearly alcoholics, and although I quit drinking entirely for a couple of years in my mid-twenties in response to dear friends who accused me of being an abusive drunk (they were right), I have been a pretty dedicated drinker for the last 35 years. In the last 9 years, since leaving the city I loved out of a sense of duty to my family, and after intimately watching three of those family members die, I will freely confess that I was drinking too much, and I was drinking inappropriately. I was never drunk at work or in situations that put myself or my family at risk, but I had a hangover many, many mornings, and I knew that I was drinking without joy and at an unsustainable rate.

I want to make clear: I will defend the right of people to live and die in whatever way they see fit -- I am not making an addict's confession, nor am I judging anyone else or myself for their habits and lifestyle, self-destructive or otherwise, past or future. I think laws of prohibition and philosophies of self-denial cause a lot more harm than good. I would rather describe things in universal terms, offer my own example, and let others make their own judgments and decisions. If some of you judge me harshly and others cut me lots of slack, neither really matters much to me -- what is important to me is understanding how things work and making personal judgments based on that understanding.

Curiously, alcohol is said to move blood, and obviously blood needs to move for life to continue; but after awhile, alcohol creates changes to tissues and blood vessels, literally pickling them, and this hardening limits the movement of blood and qi and makes the body less resilient and the spirit less flexible. None of us will make it out of this world alive, but we do have some choices about how we spend our time, whether we age gracefully or not, and how we die. At this point in my life, with three young sons, a young wife, many interesting patients ahead of me, and lots of happy party time behind me, I am much more interested in living longer than in trying to have a party every day.

Faced with the evidence that was hidden under my scalp, I first had to say, "Whew! Thank goodness my liver was smart enough to divert all that dampness away from itself and up to my scalp, where I would notice it but not be harmed by it!" And then had to follow up with, "Gee, maybe I better not push my luck that my liver will be able to continue doing that." And finally followed THAT up with, "Maybe I've had enough to drink." It's been a bit over a month and, except for about half an hour at dinner time, I can honestly say I don't miss alcohol one bit. I'm a little disappointed that I don't spring out of bed every morning more bushy-tailed and bright-eyed, and my wife's glass of Pinot Noir smells really good sometimes, but I am relieved to no longer be pickling my guts and hardening my habits.

Life is long and life is short. I want to enjoy it as much as I can, but I don't want to overstay my welcome at any party. Sometimes to remain in balance we have to change in little ways, and sometimes we have to change in big ways. Sometimes what is a small change for one person is an enormous change for someone else. Sometimes what is an enormous change at one time of life is a small change for another time of life. It is the easiest (and most unkind and useless) thing in the world to look at someone and say, "Well, if they only changed that they'd be much better off." And it is the hardest thing in the world to look at ourselves and say, "Holy cow! It's time to change this!" It's hard to know sometimes what the right thing is to do, but sometimes we're lucky and get confirmation from the inside and the outside that the changes we are making are necessary and worthwhile.

I think part of why we die is because our lives change out from under us and we're not able to keep up. None of us can see the future, but sometimes you can see the road just up ahead. I would feel really bad and embarrassed if I saw clearly that the road ahead was turning but I insisted on following my predetermined path right off a cliff. I'm grateful for the wind that blows me, even though sometimes it blows me off course (in a frustrating way) and sometimes on (in an embarrassing way).

Movement is life; stillness is death. I'd rather be moving and embarrassed than still and cool.

Friday, February 3, 2012

Chinese Spring 2012

Saturday, February 4th is the first day of spring on the Chinese calendar this year. If you got my email last spring, I made a mistake -- New Year's Day is NOT the first day of spring on the Chinese calendar. The New Year is determined by the lunar calendar, falling on the second (or sometimes third) new moon after the winter solstice. However, the first day of spring is based on the solar calendar, and occurs each year at "lichun," when the sun is at 315 degrees in the sky -- usually around February 4th. This means that sometimes spring starts before the new year does; furthermore, according to the Chinese Almanac the new zodiacal year doesn’t start until the first day of spring. This raises an interesting question regarding the status of people born between New Year’s Day and the first day of spring – to which year do they belong? Are you last year’s Rabbit, or this year’s Dragon? Maybe I’ll understand by next year, and will be able to correct this year’s mistakes then.

The element associated with springtime is the Wood element. The Wood element's emotion is anger, including frustration and impatience, and it hates being hemmed in or constrained. Wood’s positive attributes include drive, focus and ambition. Its color is green, its flavor is sour and its organs are the gall bladder and liver, which the Chinese call the "Free and Easy Wanderer." At the change of season is a good time to treat seasonal issues or issues associated with the season's element. Usually in the springtime it’s easy to see how people are becoming impatient with being cooped up all winter – “cabin fever” is a very Chinese description of a seasonal ailment – and it’s fairly easy to soothe people and re-channel their impatience and feelings of constraint into something that will give them a constructive outlet for their drive and ambition. Cleaning their fishing gear, preparing their garden plan, etc.

However, it is also important to make a smooth transition from one season to the next. Winter’s emotion is fear, and it can be kind of difficult to see how fear gives birth to anger, much less how to smooth the transition between the two. This year I have had a personal understanding of how this dynamic works, and I’m hoping this will help me to make smoother transitions between Winter and Spring.

As some of you know, I have become quite involved in local politics in the last few years and have even run for state office twice. Having been beaten soundly both times, I was content to hang up my state-wide political ambitions. However, I have been fearful about the future recently, both in personal terms (“How am I going to pay my mortgage?”) and in a larger sense (“What’s going to happen to our state with fracking? What’s going to happen to our democracy with the obscene amounts being spent on political campaigns?”). These fearful questions led me to angry feelings, which led to a desire to DO something so I didn’t feel so trapped and helpless. The main action I came up with, though, was to run for office again, as an anti-fracking, anti-money-in-campaigns candidate. Although I believe that both are noble and sensible positions, and although I hope that someone (actually, a LOT of someones) start to run on such platforms, it would be suicidal for me to do so. Although fracking isn’t having the generally enriching effect on north-central PA that was promised, some people have made a lot of money from it. Also, as indicated in the movie “There Will Be Blood,” the people who run the petroleum industry are rich and powerful and used to getting their way. Not only would I kill any future political aspirations I might have, I would also likely kill my acupuncture practice and might even be actually killed if I were to stick my neck out like this.

So I’m trying to come up with an alternative course of action that acknowledges my legitimate feelings, helps alleviate my fear and anger, and takes into account the seasons’ influence on the whole thing. It ain’t easy. But acupuncture doesn’t promise ease – just an understanding of nature’s patterns, which can help us avoid nature’s pitfalls. Because frankly, nature doesn’t care if I destroy myself – it’s only my family, friends and patients who will mind.

If you find yourself in a similar suicidal rage, consider the possibility that your fear is feeding your anger in a way that makes you blind to the consequences. “Blind rage” can lead you straight off a cliff. “Clear, cold-eyed fury” is more likely to have a positive outcome, at least for you. The target of your fury, that’s another matter, but maybe they need to learn to quit using fear as a political tool and to quit inciting anger to achieve their political and economic goals.

If you suffer from seasonal allergies in the spring, if you have liver or gall bladder ailments (including migraines, dizziness, high blood pressure or vertigo), if you feel a need to cleanse after over-indulging at the holidays, or if you have a serious case of cabin fever from being cooped up all winter, now is a good time for an acupuncture treatment. Me, I'm focusing on reassuring myself about my financial obligations and keeping my political feet on the ground. Otherwise, fear might combine with anger to fuel an outrageous act that has no constructive outcome.

Then who would write this blog?

Chinese New Year 2012

This year the Chinese New Year begins January 23, 2012. It will be the year of the Black (Water) Male (Yang) Dragon. The Chinese calendar is lunar, so New Year's Day changes from year to year, but it is on the new moon in late January or early February. The first day of Spring, however, is determined by the sun, and occurs every year at "lichun," which is around February 4th.

The dragon and lion dances that are well-known in China and Chinatowns throughout the world are intended to chase out the bad luck and bad spirits of the past year. In general, "Good riddance!" seems to be the common Chinese perspective on the recent past. It is also customary to thoroughly clean house before the end of the old year, so that you aren't setting out into a new year with a bunch of junk and garbage weighing you down. Finally, it is the custom to give red envelopes of cash to children -- red is the color associated with good luck and with the shen, the fire spirit of summer. The cash implies a hope for prosperity in the coming year, and the red envelope represents the hope that spiritual growth and progress will accompany material comfort.

Family reunions, new clothes and feasts with specific traditional dishes are also associated with the New Year. In my family, we have a big bonfire on Chinese New Year's Eve. This is partly to defy the cold and dark of winter with an outdoor party, but is also to burn the flood debris, downed limbs and my neighbor's old receipts and unwanted paperwork that end up in my bonfire every year. I've got to think that it would be better luck for her to burn her own garbage, but she's not very Chinese in her outlook -- more Yankee thrift than Oriental soul. Still, we lighten our load before the New Year starts, and make a pretty big noise while we do so.

Happy 4709!