Wednesday, June 30, 2010

Worn Out

Since returning from France on June 16, I have had a debilitating cough. For the first week and a half, it was a dry cough. I would hack and hack as if I were going to cough up my kidneys, but nothing was expelled.

Last week I saw a GP who prescribed antibiotics. They didn't seem to do anything, so I visited another GP a few days ago. He felt I don't have an infection but rather heartburn. He said that sometimes heartburn manifests as a dry cough. This didn't ring true to me; this sure seemed like an infection.

On Monday I saw my acupuncturist, Dr. Mai, who diagnosed it as a wind-dryness syndrome. He treated me with needles and moxibustion, saying that there was a lot of congestion in my lungs, whereas the GP had said there was none. The acupuncturist made a whole lot more sense to me. He gave me herbs too. By that night, I was already feeling my chest loosen up, as if it might be possible some day to expel some phlegm.

The last few nights have been rough, with a tremendous amount of coughing, but not that violent, wretching-up-my-innards cough. A manageable cough.

I so want to get over this infection so that I can get back to cardiac rehab. I want my heart to be in top shape for transplant surgery, which I am still hoping will take place this summer.

Friday, June 25, 2010

Unhappiness, the Unrecognized Component of America's Obesity Problem

So much is being written and pontificated about obesity these days, but something very basic is missing from the discussion. Unhappiness. People who overeat, who know they are damaging their bodies and yet continue to do so, who do not like what they see in the mirror yet can't stop contributing to the problem, must on some level be unhappy. If they felt better about themselves, they wouldn't want to be heavy, just like someone who feels good about herself makes sure she bathes every day and changes her shirt.

If Americans were happy with their lives, they wouldn't overeat. In the heart of every overweight person is someone who is not happy with who he or she is. The only exception I can think of is my friend Carol. She has been struggling with her weight for a long time, and yet she is one of the most well-adjusted people I've ever known. But then Carol is what I think of as German massage therapist heavy, the kind of woman who is solid, big-boned perhaps, but not fat. She plays golf several times a week and is in a walking group. She gets plenty of exercise and so she's toned. And she has one of the best attitudes around.

But besides Carol, I think I'm onto something. Every time I've seen an overweight person interviewed about his or her weight problem, I always get the screaming message of unhappiness. The person talks about ostracization, loneliness, feeling apart from others, and yet these issues are not addressed, only a plan to get the person to eat more sensibly.

I am a case in point. I was a fat kid. I had no friends, and so I isolated myself indoors and ate, which isolated me even more. Kids made fun of me and threw rocks at me, and so I hid away and ate. I didn't get any pleasure from eating, I just did it. Perhaps I knew on some level that this was unhealthy, and I was trying to bring about my end. Life was difficult, and I wanted out. When I was diagnosed with Type 1 diabetes at age 13, I was given a dietary plan, but I received no emotional counseling, and so I simply cheated on my diet. Throughout my teens and early adulthood, I cheated, with disasterous effects on my health.

Then about eight years ago, following an extremely challenging and tumultuous time in my life, I decided to be happy. I was so sick and tired of being sad. I simply refocused my attention away from lack and problems and toward what was beautiful about my life. And I began the process by giving up coffee. My son had been working for my favorite coffeehouse, and when he was let go, I stopped going out for coffee. By giving up one harmful substance, my body became cleaner and it no longer craved other unhealthy substances. So my desire for Cheetos and candy bars and ice cream and the occasional slice of coconut cream pie from Coco's also fell away.

Simultaneously, I was finding happiness within, not looking for it outside me. From an outsider's point of view, my life is much more difficult today than it was eight years ago, but from my viewpoint, I am so much happier. Eight years ago, like now, I had no husband or boyfriend, but I perhaps had more than one date a year, as seems to be my average these days. Eight years ago, I was making more money than I am today. And eight years ago, I did not yet have heart disease and I was not on kidney dialysis. Of course, I would love to be in a healthy, passionate, fun-loving relationship with a great guy. Of course, I would love to be making more money. Of course, I would love to have a body that is completely free of disease. But my happiness is not dependent on love or money or health.

And so today I am 5'8", 145 pounds, rather than the 165 or so of eight years ago. I'm not skinny, but remember that I am always carrying about two litres (4.4 pounds) of dialysis solution. If I weren't doing dialysis, I'd probably weigh around 135, since the dialysis solution itself adds between 50 and 65 grams of carbohydrates to my intake each night.

The message I want to give all those who think they can't bear to give up junk food is this: If you quit junk food today, a month from now, after a good four weeks of eating right, you're going to wonder why you ever craved that crap. It'll be like a bad relationship; once you leave it, really leave it, you're going to shake your head, amazed at how stupid you once were. Junk food will no longer taste good. You'll really fall in love with crunchy salads and lean meat and fresh fruit. You'll turn up your nose at Big Macs. You'll no longer need your salt and sugar fix.

So, all that I'm saying is that every time I see a heavy person, I think, "There's another unhappy American." Of course, not all thin or healthy-weight persons are happy; anorexia is a clear counterexample. But except for a few Carols, I venture a guess that most of the overweight have low self-esteem. What they need is emotional counseling, not just a diet plan. Any government or nonprofit efforts to simply get people to eat healthier are doomed to failure, as low self-esteem and unhappiness cannot be cured through diet.

Sunday, June 20, 2010

How About Charging for Excess Passenger Weight, Not for Checked Bags?

On my way to LA from Newark, I sat next to a woman who must have weighed 350 pounds. I had to sit sideways in my seat to accommodate her. Why should I have to do this!

As we took off, I wondered, With all the overweight people on this plane, will we be able to stay in the air?

Then it hit me that the reason airlines are charging for checked bags is that they are too chicken to ask the overweight to pay for their poundage. After all, the airlines claim that this is to offset fuel costs, and most Americans are carrying around a lot more extra weight than the weight of my checked bags. Just think that my checked bag maybe weighs 40 pounds, but many Americans are way over 40 pounds overweight.

Helene told me that in all her years with Air Canada, only twice did she charge a passenger for two seats--and it was the same passenger.

What would be so hard about every passenger standing on a scale when they checked in. Their weight would only be displayed to the clerk, so that information would remain private. Then they could do one of the following to mitigate the increased fuel costs of these hefty passengers:

* Set a cap for female and male weight, perhaps 160 for women and 190 for men. Anyone over that weight would pay a surcharge. Passengers who were grossly overweight, perhaps 280 and up, would have to buy two seats.

* Have a graduated fee schedule, say, $25 for up to 25 pounds overweight, $35 for up to 50, and so on.

* Charge $1 per pound of excess weight.

* Those people who are, say, 100 pounds or lighter would receive a break on their ticket.

* The excess-weight surcharge would not be based on body mass index. True, body builders and other athletes might be more than the cut-off weight and, true, their weight would be due to muscle not to fat, but if the surcharge is about excess weight, it doesn't matter whether the weight takes the form of fat or muscle.

Instead of everyone, fat and skinny and in between, having to pay for the excesses of some, why not make those who are responsible for the extra weight pay? This might have the added benefit of giving people an incentive to lose weight. Money is a great incentive.

A Narrow Focus on Physical Well-Being

When I first realized that dialysis was inevitable, I thought that the peritoneal dialysis clinic would be a helpmate, a resource, a place where I could turn if I had questions. Very soon I saw how naive that kind of thinking was. I received contradictory advice or nurses were afraid to give advice or they had the blanket response for everything--go to the emergency room. So I have tried to figure things out for myself and avoid the clinic as much as possible, except for my required monthly visit.

Let me cite one example of the craziness of dealing with the PD clinic. When I was training to do home dialysis in early February of last year, I must have asked a dozen times what I was supposed to do in order to get to the bathroom at night, as I was attached to the dialysis machine by a 9-foot cord. Nine feet was not nearly enough length for me to get to the toilet. All I kept hearing was that I should not disconnect myself as this would be unsanitary. I asked if I could put an extension cord on the electrical outlet, but that idea was nixed as it could shortcircuit the machine. So what I was left with was pulling the therapy cart as far as possible toward the bathroom, stretching the electrical cord and the patient line to the max. Once this resulted in the dialysis bags falling off the cart and pulling out of their connective tubing. This of course created a major risk of infection, plus I had to stop the treatment and start all over with new bags.

As part of the work-up for the transplant, I had to undergo all kinds of tests, including a colonoscopy. What was I supposed to do about going to the bathroom now? I'd be getting up many times during the night before the procedure. Finally, a nurse told me that there were patient extension lines that could be attached to the normal patient line, thereby extending it another 12 feet. Why hadn't this ever been mentioned before! Since then I have continued to use the extensions.

Then a month ago I was in a hospital in Fontana. I had to stay overnight, so dialysis supplies were provided. The nurse gave me a cassette that had an extra long patient line built in. This way I would not have to connect an extension, a good thing, since with every connection that is made, there is a potential avenue for infection. Why, why, why hadn't my own PD clinic told me about this over a year ago!

The answer I have come up with is that most health care professionals don't think of the patient as a real human being. Rather, they think something like, "Well, she should be happy she's alive. She doesn't need to have mobility, comfort, a social life, a sex life, a relationship, etc. She's alive. That's enough." And so they are very narrowly focused on the patient's physical well-being. What drugs can we give her to stop this symptom? What change in her dialysis solution do we need to make? They never take the time to wrap their minds around how they would feel if they were hooked up via a 9-foot cord to a machine for 10 hours every night. They think of their job as very narrowly about pills and protocol and covering their ass.

Ego Puts Patient Lives in Danger

When I was in France, I received an email from Janet, my neighbor who is my unmatched donor. She said that she had spoken with her coordinator at UCLA, who claimed she knew nothing about the paired donation we had arranged with Bob and Maria. I emailed Bob. What's up? I wondered. He wrote back that Maria had been told the same thing by the coordinator--that she knew nothing about our arrangement, nothing about Heidi and Janet. Under further questioning, however, she said that it was her job to arrange donations, not the patient's job and that we should have let her make the arrangements.

Can you believe that! Instead of saying, "Oh, how beautiful that you four found each other! That makes my job easier," she was prepared to thwart the arrangement because her ego had been bruised. It's like c'mon, lady, people's lives are at stake!

Once again, if the four of us were not on top of this, we could have been placed on the bottom of everyone's to-do list. It's amazing, with all that patients have to put up with, with the physical, emotional, and social challenges of being on dialysis, that we also have to deal with difficult health professionals who supposedly are being paid to help us.

On the List!

Finally, finally, finally, I am on the transplant list! As of June 16, I am on the national kidney transplant list.

I was told on April 29 and a few other times after that, that the only thing UCLA had to confirm was that I have health insurance. It took them 48 days to do that! Unbelievable. This just goes to show, once again, how the so-called health care professionals are just doing a job, not thinking about the emotional strain that they are putting on patients. They could care less if it took 48 months to verify that I have insurance. It also points out again how a passive patient, one who just waited for other people to act, would still be waiting for an intial appointment with UCLA. If I weren't as assertive, if I didn't make all the phone calls I have to get people moving, to get people to do their jobs, I would never have gotten on the list. Whether you're on the list perhaps has more to do with chutzpah than with your overall health.

Trip Recap

First, I am so thankful for Helene's invitation. She used her 25th anniversary of service to Air Canada award of guaranteed first-class tickets. I also appreciate her arranging for the apartment in Paris and her muscle power in carrying my suitcases. And an especially big thanks to her for introducing me to her friends Marie and Stefania in Paris and for introducing me to Khadidja last summer when we were both in Nova Scotia.

Marie, Stefania, Khadidja, and Helene are all terrific women. They pick up and travel to exotic locales without a male escort. They are intelligent and multi-lingual and fun to be with. They're open to new ideas and new experiences. They are all pretty and stylish in their individual ways. Like so many wonderful women, they do not have a steady man in their lives or any man at all. Unfortunately, not many men are interested in confident, intelligent, self-sufficent women. Most men still would prefer a woman who is needy in some way. I sometimes wonder if the 2012 transition will also issue in a shift in men's consciousness, that they will begin to appreciate a relationship that is formed between two strong and amazing people. God, let's hope so!

Architectural Tour

Sunday, June 13, our last morning in Monton. We toured Khadidja's sister's house, a few houses away from Khadidja's. Amina's cellars were given an award for the best cellar in Monton. Three levels deep. She still stores wine and vegetables there, though not as extensively as in the old days.







Here's a photo of one of Anima's bedrooms in which the old beam figures prominently.



Khadidja's mom's place was right next door to Khadidja's. In fact, the two houses are so close that you can hop from one exterior staircase to the other. Jeanne is quite a gal--83 and still gardens every day. Just as in medieval times, the gardens are located outside what was once the city walls. She's also caring for a distant relative on her late husband's side. The 12-year-old girl is a little slow, and so her family sent her back to Algeria to fend for herself. When Jeanne rescued her, she was working under slave conditins as a maid.

Jeanne's house contains walls that were part of the castle built in 1060. This page from one of her childhood books shows the castle that became her house.



The houses are so close together that Jeanne's kitchen protrudes into Khadidja's house.



And here's a cupboard that was hollowed out of the wall.



The timbers in these old houses have been used many times over for many different purposes. Jeanne has one timber in her living room that has rungs on it, what was no doubt once a ladder. The beams are also of various widths, as shown here.



L to R: Jeanne, her cousin who is staying with her for a month, Heidi, Gabriel, Helene



L to R: Jeanne, Khadidja, cousin, Heidi



Before we left for the train station, Jeanne gave us a cherry custard she'd made from the cherries in the garden. That is the kind of easy back and forth between people in Monton, as the day before a neighbor had given us some cherries.

We then took the 12:45 train from Clermont back to Paris. I for one was sorry to leave this beautiful area. Khadidja had been such a warm and attentive host. She is quite a gal too.

We spent the night at Marie's, then flew from Paris at 1 p.m. the next day.

Saturday, June 19, 2010

An Artist in the Family, Cave Dwellings, and Knives

Saturday morning the 12th, we drove to Les Martes de Veyre, where Khadidja's ex-husband Scott Martin lives. Gabriel has always lived with her, including her years overseas teaching in Nova Scotia and North Dakota. This is the first time in 21 years that Gabriel is living with his father.



Scott is a Canadian who has been living in France for 20 years. His French is flawless. He is an IT guy, but also a photographer who manipulates his photos to enhance the colors and the depth. Quite beautiful. Scott generously gave Helene and me several of his photos.



Back in Monton, Gabriel took us on a tour of a convent that has been converted into a B&B and of the cave dwellings. During the religious wars of the 17th and 18th centuries, people started living in these caves. They were occupied until the 1950s, then by refugees from eastern Europe.





For lunch we had grated carrots and beets, bread, butter, tomatoes, sausage, cheese, yogurt, and strawberries.

In the afternoon, we drove to Thiers, what had once been a thriving knife-producing city. Though some of its factories are in ruins, many still remain open. We toured the knife museum and a workshop. The guide explained how, in the old days, men would lie on their stomachs over a grindstone for hours at a time. Dogs would lie on their legs to keep them warm. Also, as the dogs got up and repositioned themselves, the men would in effect get a mini-massage to keep the circulation in their legs going.



Thiers also had a few fine examples of medieval architecture.











Though no one else seemed excited about the factories by the river that were in ruins, I certainly was. I love photographing ruins.



Monton Magic

Monton was so darn cute. I just must show you more of its beauty. First, my favorite image. Even when I took it, I said aloud, "This is going to be my best shot."































Farmers, Churches, Black Madonnas

Saturday's breakfast, like all the meals Khadidja made for us, was simple, wholesome, and delicious. Homemade yogurt. Cherry, apricot, and quince jams made by Khadidja's mom. Hearty bread.



We bought a few things at the farmers' market in Clermont. Fresh milk and cream from a man who treats his cows with homeopathic remedies, not antibiotics. He also sold bread and butter, slicing off what was needed from a large tray and from a 4-5 kg loaf. I bought two organic honey-almond nougats to take home as gifts.



We visited Notre Dame du Port, a fine example of Romanesque architecture, and the cathedral. Both tauted black Madonnas, a common icon in the area. I especially was touched by the descent to the crypt, the oldest region of the church and cold as it is underground. Seemed more mystical and otherworldly than even the silent presence that infused the diffuse light of the churches themselves.



We also dropped into a wine store that had two cellars and glacieres in the bottom floor. These are holes deep into the earth that were once used to store ice from the mountains and make ice cream. Naturally occurring ones can be found in the mountains, the byproduct of volcanic activity.







We took a circuitous route back to Monton so that we could delight in the little villages around Puy de Dome. When Khadidja and her son, Gabriel, were training for their Nepal trek, they could climb the mountain in 15 minutes. Impressive!



On the outside wall of the Romanesque church in Orcival are shackles. A souvenir of the Inquisition? A reminder that we are in bondage to this earthly form until liberated by the grace of God? No explanatory placard made that clear.





Upon our return to Monton, Khadidja offered us a snack--organic strawberries with fresh cream. Yummy! For dinner, we had organic farm-raised trout with scallions and wild herbs, broccoli, carrots, bread, and for dessert, strawberries with curds and whey.

A Rude Parisian and We're Off to Monton

On Thursday, June 10, we left our apartment for the last time and departed Paris via train. In the station, a woman yelled at Helene for not giving her seat up quickly enough so that an elderly woman could sit down. She berated Helene so violently; this was really uncalled for.



The 3 1/2-hour train ride sped us through the French countryside, usually too quickly to take it all in. Lots of cute towns with gray, tan, and beige stucco houses with red tile roofs.



We arrived in Clermont-Ferrand, a city of approximately 150,000, about 5 p.m. Khadidja was there to meet us. We drove about 15 minutes to get to her home in the village of Monton. She lives in a three-story house that dates back hundreds of years. Her mother's house is next door, and it contains walls that were part of the castle of the 11th century. What a lovely home Khadidja has! From the kitchen table, we could look out her front door and see the white statue of the Virgin and Child that watches over the town, as well as the caves in the hillside that were used as dwellings up until the 1950s. The view from her third-story veranda is equally lovely and includes the nearby church tower and the roofs of the village.







After settling in, we went to the top of the hill to visit the Madonna and Child. The wind was quite intense. Already by this time, I knew that I was going to love it here. Wonderful as Paris is, the French countryside is downright magical.



For dinner that night, Khadidja served homemade vegetable soup with a dollop of fresh cream, roast beef with fennil and potatoes, thick wheat-rye bread, and local cheeses. Khadidja is really into locally grown, organic food. She is part of an AMAP (Association pour le maintien ole l'Agriculturre paysanne), basically an association for the preservation of local agriculture. There is a big movement in France to resist genetically modified food. The difference in taste is amazing. Vegetables taste like vegetables. They have a rich flavor, unlike most of the produce here in the U.S.

Followers

About Me

Southern California, United States
Perhaps my friend Mark summed me up best when he called me "a mystical grammarian." I am quite a mix--otherworldly, ethereal and in touch with "the beyond," yet prone to being very precise and logical, when need be. Romantic in the big-canvas meaning of the word, I see the world as an adventure, as a love poem, as a realm of beauty and wonder.

Blog Archive