Reflections of an aging mind (and body)  . . .

Le Franschoek Hotel, Paarl, Western Cape, South Africa

View from Le Franschoek Hotel, Paarl, Western Cape, South Africa

 

I can’t believe how 2018 just flashed and disappeared before my eyes. It didn’t help that I was working three jobs (full time day job plus two evening jobs) which is why, I hope you can understand, I wrote so little here.

Unfortunately, in spite of giving up my evening jobs, 2019 seems to be no different. Here I am, writing to you but it’s already the middle of March. Where has the time gone?

This year started off well with me having some annual leave for the first time in about five years but then during the last two weeks of January everything seemed to go a little pear shaped. Let me give you a little background before I tell you why my year went a little pear shaped.

 

Lunch with friends

View from Rhodes Memorial Tea Room

 

Last year (2018) I had two very bad falls – in both cases my left knee took the brunt of the fall, so before my knee could heal properly from the first fall, I fell a second time, hurting the same knee causing more injury to an already injured knee. Nevertheless, I plodded along trying to keep as much weight off the knee, resting as much as possible in the hopes of healing coming eventually. That’s until the last two weeks in January 2019 when everything went pear shaped.

 

I started noticing more and more pain coming from my left knee and also noticed that I still had a bruise on the knee (my last fall now being 9 months ago – so this was not normal). I discussed this with my Physiotherapist who advised me to massage the bruise to see if it would go away naturally – in spite of the fact that this knee was now so painful that even just having my bed sheets touch it made me want to jump sky high. I tried massaging the bruise for about 3 days but nothing happened. I then tried to ignore the bruise but after a few days started noticing my knee becoming red and swollen.

 

Cellulitus, inflammation

What the knee looked like on 11 February 2019

 

Well, me being the person who tries to avoid going to the doctor at all costs, decided to ignore the fact that my knee was getting more red and swollen until that fateful day on Mon 11 February when I could no longer ignore the pain.

 

Side note: As I continued to try to ignore the pain, I was taken out for dinner on Mon 4 February by my cousin as it was my birthday and Saturday 9 February went out for lunch with my sister and her family to celebrate my birthday seeing as they could not see me on the actual day of my birthday.

 

I made an appointment to see a doctor on Tues 12 February but took the latest appointment I could get so I did not spend most of my working day waiting to see a doctor.

After examining my knee the diagnosis was Cellulitus which, as the doctor explained, was an inflammation in the tissue between the layers of skin around the knee and in addition to this, I had a slight fever.

According to the doctor, when there has been trauma to a particular area (in my case my knee probably as a result of the falls I had), fine tears develop in the tissue between the layers of skin and if any fluid – even just a few drops, drop into these tears, it causes an inflammation.

I was immediately hooked up to a drip and fed a dose of antibiotics through the drip (killing two birds with one stone). The doctor marked the area with a pen and took pictures so we could monitor the progress. I was told to come back the next day so we could see if the treatment worked (doctor assumed I would only need one drip and that I could go onto oral antibiotics from day two). I was booked off work for three days to give me time to rest the knee. The pain in my knee was unbearable to say the least.

 

Wed 13 February – pain still unbearable but back into the car and off to the doctor I went. Doctor was happy with the progress as there was clear movement from where the pen marks were and how the inflammation was drawing away from the pen marks but the treatment was not working as fast as the doctor hoped so he ordered me back on a drip (with antibiotics fed through) for another day with instructions to come back again the next day.

 

 

 

Day 3: Thurs 14 February (how I spent Valentine’s day): same as yesterday. Back on the drip with antibiotics fed through the only difference today is that the doctor decided he could now start me on oral antibiotics. Doctor gave me a script and was put on a double dose of antibiotic (Augmentin) twice a day (plus one antibiotic I had to only take once per day). He said that in spite of having an antibiotic through the drip, I should still start my oral antibiotics that evening as well. Doctor left me with instructions to see him again the next day.

Well, let me tell you this, having one kind of antibiotic fed through your drip, plus a double dose of Augmentin plus one other antibiotic all within a matter of hours, certainly had me bouncing off the walls that night. Do you think I could sleep that night? Noooooo . . . besides the pain keeping me awake, I now also had all this antibiotics in my system making me bounce off the walls.

There was also a new development . . . before getting into bed for the night, I noticed a “bump” forming on my knee right in the middle of my knee cap. As the night progressed, it started looking and feeling like an abscess which came with pain and tenderness of its own.

 

Friday 15 February – After only about two hours of sleep, still in pain, back in the car and off to doctor once more. Doctor was happy with progress and said there is no need for the drip any longer. I could now just continue with the oral meds until I finished the course but he still wanted to see me daily to monitor the progress.

I then pointed out the little “bump” on my knee which now was not so “little’ any longer and the doctor agreed that it definitely was an abscess which needed to be lanced to release whatever junk was building up, so off we went to the treatment room to find me a bed.

I was given a local anaesthetic into the knee which was a total waste of time because it had no effect on me whatsoever and the doctor proceeded with lancing anyway. Having an abscess drained from an inflamed knee is no joke I tell you.

The force and pressure this doctor used on both sides of my knee (left and right and then top and bottom) felt like he was trying to dislodge my knee cap with his bare hands. He did each side about 6 or 7 times – being forced to stop in-between to give me a chance to get my breath back. I tried all the breathing exercises they usually tell mothers giving birth to use but that did not help. Doctor offered me another dose of local anaesthetic which I refused because the first dose had no effect on me anyway so why bother?

The amount of fluid he got out of that abscess exploded like a volcano, he said was equivalent to half a litre of fluid and floating in that fluid was a blood clot which he says must have been the bruise that wouldn’t go away, that dislodged itself from my skin and became a blood clot floating around in the fluid.

By the time he was done with me I felt like a train had run over me. I struggled to get back to my car after that and finally made it home.

 

pleasure, entertainment

 

Saturday 16 and Sunday 17 February – my doctor was off for the weekend so he had another colleague take care of me for the weekend. Doctor was happy with the progress we were making with the medication and just told me to continue. I begged the doctor for a break from coming in every day (the pain and the exhaustion was really getting to me) and he reluctantly agreed to give me a break on Monday from coming in but said I definitely needed to come back on Tuesday to see my doctor.

 

Tues 19 February – doctor happy with progress – no sign of further inflammation, the wound from abscess still needed dressing, but told me to continue with the oral antibiotics until I completed the course.

The rest of my time on antibiotics left me feeling sick all the time. I really struggled to get through each day – walking around feeling nauseous the entire day is no joke. I really don’t know how women with “morning sickness” get through their pregnancy. Kudos to those who make it through!

 

Saturday 23 February (the day before my course of antibiotics was meant to finish), I woke up and found that my fridge had died sometime during the night. Fortunately what I had in the freezer was still frozen so I quickly got that out and got it into the communal fridge in the complex where I live. The rest of the stuff in my fridge had to be thrown out.

So . . .  I had to get myself another fridge. Ordered one online which would only be delivered on Thursday. This meant having to cope without a fridge for almost a whole week.

 

Wednesday 27 February – had a work Board meeting to attend. The boss arrives at my place as she is travelling with me. We’re in the car, ready to go . . . and my car won’t start. The immobilizer won’t deactivate. Get roadside assistance in, they are unable to sort the problem out due to the mechanical set up of the car so I need to be towed to a garage to have the problem fixed.

Car gets towed to garage. Fortunately, I work from home so go to my desk and get to work – nauseous, stressed and exhausted.

 

 

View from Bertha’s Restaurant, Simonstown, Cape Town, Western Cape, South Africa

 

Thursday 28 February – struggled to get out of bed due to nausea but managed to get through the day working somehow but was forced to stop working at around midday due to very bad stomach cramps. I shut down my computer and went to bed.  Spent most of the day throwing up – could not even hold water down, needless to say, could not really eat much either.

While in bed, the garage called to say my car is ready for collection but I explained I was too sick to get my car and said I would collect my car the next day.

I spent the rest of Thursday running to the bathroom to throw up, which I hoped would get rid of the cramps, but to no avail. Turns out I had a bad case of Diverticulitis (an inflammation or infection of small pouches called diverticula that develop along the walls of the intestines. The formation of the pouches themselves is a relatively benign condition called diverticulosis).

After what seemed like forever, I finally made it through the night.

Friday 1 March – Stomach cramps now a thing of the past, but stomach feeling very tender after the last two days. Managed to get my car, worked the rest of the day and then just went back to bed after the work day was done.

 

 

View from Chapman’s Peak Drive, Cape Town, Western Cape, South Africa

 

What happened between 1 March and now is just a blur. Apart from chasing work deadlines, nothing much has happened.

Hope this explains why there’s been so little posted here. I’m hoping to remedy that and get back to my weekly posts but hey . . . life happens!

Woman, Heal Thyself . . .

Starting today, I need to forget what’s gone,
Appreciate what still remains
And look forward to what’s coming next.
– Anonymous

In my last post I wrote about grieving, mourning and bereavement because this is the stage of life I am in right now. Everywhere I go, everyone wants to know how I am coping with my loss so this week I’m focusing on coping – how am I coping? Am I coping?

Ways of Coping:
Research has taught us that various approaches used in the coping process are grouped into eight coping factors:

Confrontive Coping: describes aggressive efforts to alter the situation and suggests some degree of hostility and risk-taking. (Anger)
Distancing: describes cognitive efforts to detach oneself and to minimize the significance of the situation. (Denial)
Self-Controlling: describes efforts to regulate one’s feelings and actions.
Seeking Social Support: describes efforts to seek informational support, tangible support, and emotional support.
Accepting Responsibility: acknowledges one’s own role in the problem with a concomitant theme of trying to put things right. (Acceptance)
Escape-Avoidance: describes wishful thinking and behavioral efforts to escape or avoid the problem. Items on this scale contrast with those on the Distancing scale, which suggest detachment. (Bargaining)
Planful Problem Solving: describes deliberate problem-focused efforts to alter the situation, coupled with an analytic approach to solving the problem. (Acceptance)
Positive Reappraisal: describes efforts to create positive meaning by focusing on personal growth. It often also has a religious dimension.

Candlelight

Elizabeth Kubler-Ross, in her 1969 book On Death & Dying (http://www.amazon.com/On-Death-Dying-Doctors-Families/dp/1476775540) described the following five well-known stages of grief:

Denial— “It can’t be happening.”—Ignore or discount the evidence.
Anger— “Why me? It’s not fair!”—Highlight the injustice. Blame someone or something else for the loss.
Bargaining— “Just let me live to see my children graduate.”—Negotiate a better deal, gain time.
Depression— “I’m so sad, why bother with anything?”—Act helpless.
Acceptance— “It’s going to be OK.”—Acknowledge the problem, understand and accept what you can and cannot change, and move on.

Responses at each stage that illustrate each of these styles could, for example be:

Confrontive coping approach: Shouting a profanity, slamming and kicking the refrigerator door before blaming someone (self, spouse, bad luck, always happens, the dog)
A distancing approach could be: reading the newspaper, turning on the TV, shining shoes, or doing other things to delay and distract from acknowledging the problem.
A self-controlling approach would be telling yourself: “now stay calm, it’s not the end of the world”, “it’s really no big deal” as you calm down enough to take problem-focused action.
Seeking social support – you might ask your spouse or significant other for sympathy, understanding or help.
Acknowledging approach – you accept responsibility for your actions which leads quickly to accurately recognising, acknowledging and solving the problem.
Escape-avoidance approach – you might shout “help me” with the vague hope someone will hear and respond to your call for help.
Planful Problem Solving – leads to the alternatives and solutions originally described above
Positive reappraisal – you may remind yourself that “whatever does not kill you, makes you stronger” or that God is testing you with this challenge/problem/struggle.

Health & Wellness Fruit Basket

Coping requires resources:
Our ability to cope depends on the resources (human and financial) we can apply to solving the problems. What might be trivial to someone with the necessary resources can become a matter of life and death to someone who does not have the necessary resources.

Resources to help in coping may include: intelligence, education, experience, creativity, money, tools, materials, social skills, emotional competency, perspective, perseverance, resolve, tranquility, serenity, tolerance, rest, supportive friends and family, charm, health and energy, optimism, time, patience, confidence, courage, judgment, ingenuity, and other personal strengths.

If resources are unavailable or become exhausted then coping becomes less effective, suspends, or stops altogether. Coping may resume if resources again become available.

A simple example of this is regaining strength and resolve from a good night’s sleep and hearty breakfast. A more complex example is the long wait for relief aid that refugees may face.

Stress is the word we use to describe the resources consumed by coping; these are the resources required to counteract a stressor.

So, how am I doing? I think I’m coping for now.

Life is not what it’s supposed to be
It is what it is
The way you cope with it is
What makes the difference.
– Virginia Satir

Two Aspects of Coping
There are two main aspects of coping:

1) Solving the material or physical problem (fixing what’s broken, in the case of illness – healing the person or moving heaven and earth to find a cure for whatever is causing the illness/pain/discomfort)
2) Addressing the accompanying emotions (an emotion-focussed coping approach) – this kicks in when the person who is ill cannot be cured/healed (chronic illness)

Effective coping accurately recognises what you can change (your behaviour/attitude/make the sick person as comfortable as possible etc) and what you cannot (you cannot cure/heal the sick person).

Ineffective coping confuses the two.

Table Mountain, Cape Town, Western Cape, South Africa

Table Mountain, Cape Town, Western Cape, South Africa

So, how have I been coping?

Well, I’ve been trying to get out into the wonderful South African sunshine as often as I can. I’ve been going for long drives along our coastline – my drives, however, are limited to weekends because during the week Monday – Friday I have a full time job which keeps me stuck in a concrete jungle for eight to nine hours per day.

One of the longest drives I’ve taken in the last few weeks has been to a little town called Darling.

Welcome to Darling

Welcome to Darling

Next, I visited a cousin on my mom’s side who lives in Gordon’s Bay . . .

Gordon's Bay on a cloudy day

Gordon’s Bay on a cloudy day

This was followed by a trip to Simonstown . . .

Just before entering Glencairn on your way to Simonstown

Just before entering Glencairn on your way to Simonstown

The last drive taken last week was to Hout Bay . . .

View from The Lookout Deck Restaurant in Hout Bay

View from The Lookout Deck Restaurant in Hout Bay

When something bad happens you have three choices.
You can either let it define you, destroy you
Or you can let it strengthen you.
– Anonymous

References
Stress and Emotion: A New Synthesis , by Richard S. Lazarus
Coping Theory and Research: Past, Present, and Future, Richard S. Lazarus, Psychosomatic Medicine 55:234-247 (1993)
http://www.emotionalcompetency.com/coping.htm