Rickety Contrivances of Doing Good

My weaving and spinning guild meets once a month, in various locations.  Today we met at a farm north of Reno, just over the California line, where a woman named Doris raises sheep.  She had a twenty-one-baby lambing season this year, and had promised that we’d be able to bottlefeed lambs if we wanted to. (Note: click on any picture for a larger image.)

My friend Sheila picked me up in her Prius and we set out; the farm’s a little remote, on a dirt road with tricky directions, so she was glad to have a navigator and I was glad to have a ride.  She’d picked up a bag of gluten-free bread mix for me, which was very thoughtful and much appreciated.  As we jounced over one of the dirt roads to Doris’ farm, we stopped to admire a goat.  There were other goats: in fact, there were many baby goats, who hop and skip just like those adorable videos you always see of baby goats.  I’m sorry I got no pictures of them; a dog was herding them and drove them away from the road and our car, which was a sensible, protective kind of thing to do.

After several more – and progressively rougher – dirt roads, we got to Doris’ farm and saw our first lambs, who were indeed adorable.  The babies came in various sizes and colors; some were in fenced fields with their mamas, but the bottle babies were in a barn. The adult sheep wore canvas coats.  We thought maybe they’d been recently sheared and this was to protect them from sunburn, but Doris explained that it’s to keep their wool clean.  They wear the coats all the time, and as their wool grows, Doris has to take off the smaller coats and put on larger ones.  Each sheep has four coats.

I didn’t get a picture of the grown-up sheep in their coats because I was so focused on the lambs.  I loved the lambs.  Of course I saw lambs in petting zoos when I was a kid, and probably even bottlefed a few, but I don’t remember being this enchanted with them.  I wanted to take them home.

The littlest lamb came when we called her and tried to nurse on our fingers.  During the guild meeting – held outside, in a circle, as people knitted or spun – I sat close to the barn door, and whenever the littlest lamb came to the barn fence and baaaaed, I got up and gave her a bottle (Doris had left several in the barn).

Sometimes when I came into the barn she’d just look up at me, with an expression that said “Feed me!” but would refuse both the bottle and stroking.  She was testing me, I guess.

Sheila and I both especially admired the black sheep and lambs, many of whom had white blazes on their foreheads and were even cuter than the white ones.  This lamb was a bit pushy, as you can see, and as befits the reputation of black sheep.

It was really hot outside, so Sheila and I each took a few minutes’ refuge in Doris’ wonderful weaving studio, which I wanted to take home with me (with several lambs inside), and which Sheila called a “womancave.”  Sheila did take home the guild’s seven-foot triloom.  She’s going to use it to weave a shawl and then lend it to me so I can weave a shawl. This will be much easier than weaving smaller triangles and trying to sew them together in any attractive fashion, a task which has proven beyond me.

It was a lovely morning, although all that outside time has kicked my allergies into overdrive, and I’m very sleepy and sneezy.  Completely worth it, though.  If you ever get the chance to bottlefeed a lamb, do.

And my, didn’t the cats think I smelled interesting when I got home!

Today I went to see my acupuncturist, who's also a western-trained MD, for the third time. The first time I saw him, he sternly advised me to get back on western stomach meds and then used his needles to work on my sinuses, which indeed felt better. The second time I saw him, I mentioned writer's block and frustration and he did a longer session, something called "detox acupuncture," which I'd ordinarily scoff at, except that it also made me feel better.

That was at the end of June, right before my state-employee health insurance crashed and burned on July 1. (Our family deductible has now gone up to $3,800, which means that if I'm lucky, I could get through the entire year without insurance covering anything.) "Next time," I told the good doc, "I'll have to pay your full fee, not just the $25 copay."

He pondered this. "I charge $130 for a private session. I really think you should have one more detox session, and then you can start coming to the clinics." He offers acupuncture clinics where he'll treat a group of people at once, for only $40 apiece. "But you have to decide what you can afford."

I talked to Gary about it; the treatment really had made me feel better, and Gary said, "If it's just once, and it helps, then pay the $130."

So I went back today. Before we got to the needles, I asked the good doc about adrenal fatigue, which I know is highly controversial in allopathic circles. Does he believe in it? He pondered this and offered a thoughtful and carefully nuanced version of "no." (That's why I love this guy: he really does combine the best of both worlds, and so far he's never made me feel like I'm asking a stupid question.)

So then we got to the needles. "Last time we detoxified the front of your body," he told me. "This time we'll be doing the back. The front works on internal dragons; the back works on external dragons."

"Mmmmph?" I said, already lying on my stomach on very comfy cushions, which meant I was talking into one of those donut pillows massage therapists use. "Dragons?"

"Chinese dragons," he said. "They're good dragons. They chase away evil. The internal dragons chase away internal evil; the external dragons chase away external evil."

"Ah," I said, and he inserted the needles and left me to "cook" for a few minutes, as he put it, and then came back to check on me.

"How you doing?"

"Fine," I said into the donut pillow.

"Remember the dragons."

"I'm trying to visualize them."

There was a short pause -- I'm sure he was pondering -- and then he said, "They have long mustaches, and they're slightly iridescent, and they like to drink tea and don't eat peanuts."

"Ah," I said.

"No peanuts," he said, and left the room again, leaving me to reflect on what has to be the strangest conversation I've ever had with a medical professional. But I was all comfy and feeling very nice, except that my hands kept falling asleep, and I still couldn't visualize the dragons, although I did have a vivid mental image of a sleek black panther lounging by the side of the massage table. (What the heck was in those needles? I hear you asking.)

When he came back in, I mentioned the circulation issue, and he removed the needles so I'd be able to move around again, and I told him about the panther, wondering if he'd laugh. He didn't bat an eye. "Well, the dragons are just a metaphor. Your dragon might be a panther. Someone else's might be an eagle." I suspect my panther had more to do with watching Crystal the were-panther on True Blood the other night than with anything else, but that's okay; I'm a champ at metaphor, after all, and I was all relaxed and happy-like, so I floated out the door to pay my $130.

I like this doctor a lot. I do not like his young front-office person one bit. I'm sure she's a lovely human being, adored by her family and friends, but every time I've been there she's struck me as supercilious, with a tendency to lecture, and with the uncanny ability to look down her nose at me even when she's sitting down and I'm standing up.

"That will be a $25 copay," she said.

"No, actually --"

"I need you to pay that," she snapped, as if I'd been planning to offer her my firstborn child or barter with a stick of Juicy Fruit instead.

"Actually, I need to pay more," I said, trying not to snap back. "It's after July 1. My insurance just changed. So I need to pay the $130."

She scowled. "You can't pay the $130 if you have insurance."

"No, my deductible's $3,800, so --"

She slid into lecture mode. "The $130 is for private-pay patients without insurance. I'll have to see what the bill will be with insurance." She got up, went into another room, came back with a sheaf of papers, typed on her computer for a bit, and then said, "If we bill your insurance company, that will be $289."

"Excuse me? Two hundred and eighty-nine dollars?"

She flashed me a phony smile. "At least you'll pay your deductible sooner!" Mentally, I was trying to sic panthers and dragons on her. I know it's not her fault, but couldn't she be just a little bit sympathetic and acknowledge the utter absurdity of the system?

"I came here prepared to pay $130. That's what my husband and I budgeted."

She resumed looking down her nose. "If you pay the $130, we won't bill your insurance and it won't count towards your deductible."

Reader, I paid the $130. If I go to any of the clinics, that $40 fee won't count towards insurance either. It seems absolutely insane to me that with insurance, the treatment costs more than twice as much as it would without: the extra money goes into administrative expenses, no doubt.

Dragons and panthers and bills, oh my.

Yeah. You know I couldn't resist that one. Anyway, I was feeling a bit less floaty when I left, thinking in annoyance that the dragons and panthers hadn't worked very effectively against the evil of the billing system. As we all know, though, American healthcare is one heckuva job even for the most potent metaphorical ninja-beasts. Or maybe somebody slipped the dragons some peanuts; as Gary observed, they're probably allergic.

A dragon in anaphylactic shock: now there's an image.

Right. I'm clearly punchy. Must go work on the book. With material like this, who needs to write SF/F?

I'm back, after a rather more inconvenient trip home than my very easy one out. Flying East always seems to go more smoothly than flying West.

I haven't been able to get myself going today. While I enjoyed Mythcon a great deal (and have already registered for next year in Berkeley), the hotel was horrendous. I was allergic to something in the AC, and the bed was too soft for me, and they didn't have an espresso machine so I had to take the hotel shuttle to Starbucks to get my brain in gear each morning -- the shuttle folks were very nice about this, but it was still a hassle -- and there was, I swear, not one comfortable chair in the entire place. The wifi in my room was erratic. The laundry I delivered to the front desk the first morning (getting everything into carry-on was predicated on being able to do laundry) was never picked up, so I had to do the laundry myself, and the front desk was out of laundry soap, so I had to buy some. At least they had a small laundromat onsite and the machines worked, although someone else doing a load told me the hotel staff had warned her not to run both dryers at once.

There were also bizarre issues like my housekeeping tip being apparently stolen out of the room the first day, vanishing hours before any housekeeping was done, and the fact that two of us in my hallway returned from evening programming to find washcloths wrapped around our outside doorknobs, while the people across from me found their door open, although nothing was missing. The front desk staff had no interest in any of this. Someone Googled the hotel and learned that it has a reputation for theft, and while there may have been some perfectly logical and harmless explanation for the little strangenesses, I found myself on edge. (One of the conference attendees was indeed robbed, but I think she may have been staying at another hotel.)

You get the idea. Travel's tiring, and so's being ill at ease in a strange place. (One of the shuttle drivers told me the Reno Aces stay at that hotel when they're in Albuquerque. Gary's response to this was, "Yeah, that's how they know they aren't the majors.") I think it's a testament to my exercise regimen and my chiropractor that my back held up during all of this, but I'm still a lot more worn out and fuzzy-brained today than I usually am after a trip. Maybe it's dehydration. Maybe it's my age showing. Whatever it is, I have no energy -- although I did exercise for an hour -- and I've gotten no writing done yet today.

Yeah, I know. Okay, Susan. Stop whining. Go write!

Driving to church today -- a route that takes me through a flat, ugly part of town, with lots of dismal strip malls -- I happened to glance to my left and saw, standing at a fence . . . two llamas! I goggled at them for a minute, thinking maybe they were huge, misshapen dogs, but quickly realized my error. I think maybe they'd been sheared recently; one reason they looked so weird is that large swathes of hair were missing.

I wonder if somebody around here is making llama yarn. Although, given the recent heat, they might have needed a shave to cool off, poor things. Anyway, they were grazing in a nice little enclosed meadow which, when I scrutinized the area as closely as I could on my drive-by, included some barn-looking outbuildings. I've never noticed this before. A lot of Reno used to be farm or ranchland, and there are still pockets of grazing land where you least expect them: a herd of cows munching away next to a bottling plant or self-storage place, say.

On my way back from church, I drove by the meadow again to see if I could get a photo of the llamas (llami?), but I didn't see them. I'll keep looking.

I turned the heel on my mother-in-law's first sock today. I'm afraid I may have made it a smidgen too long, and the thing looks huge anyway because it's made from relatively inelastic yarn, but I've learned that socks that look too big often fit fine. I hope to have them finished and mailed off to her by the time I leave for Albuquerque in twelve days.

The socks have created a delay in the scarf-weaving project. However, last night I had an epiphany and realized that instead of using thirty different bobbins for the warp (talk about a headache!), I can use a smaller notched piece of cardboard as a roller for all thirty warp threads at once. If that works, it will greatly simplify things. The moderator of the small-looms group on Ravelry thinks it should work, so that's heartening.

I'm still toiling away on the book, of course. For some reason, my left hip's been killing me for the last two days -- usually my right one's the culprit -- and I think that too much sitting time may be part of the problem, so I'm trying to get up and move around (limping like Quasimodo) at least every half hour. Swimming and using the elliptical has helped somewhat. I've also temporarily traded in my backpack for an extremely tiny pouch purse to lighten my load. I have to lug a fairly heavy backpack around when I go to Albuquerque (which I'm determined to do without checking, and paying for, luggage), so I want all the muscles rested and healed before then. I'll also have a rolling bag, of course, but I can't fit everything in there, and the backpack's the next best thing, as long as I'm walking okay.

Ah, aging. Remember when you bounded out of bed in the morning with no thought as to whether your joints would behave themselves? I'm infinitely happier now than I was in my twenties, but I could still do without the achy-creakies.

Our local paper's been updating Amtrak crash news several times a day. The death toll's now at least six, with five passengers still unaccounted for.

The conductor who died was a 68-year old woman named Laurette Lee who lived in South Lake Tahoe. She sounds like a genuine character. You can read moving tributes to her here and here.

The truck driver's name hasn't been released yet, but that part of the story keeps getting stranger. He was leading a three-truck convoy: the other two saw the train and expected him to stop, but he didn't. He tried to brake, though, because there were major skid marks. So the "unconscious at the wheel" theory is out, and I guess we're back to the distraction theory, although everyone said the train was very visible. You can see a long way in the desert.

I don't think I'd be following this so closely if I hadn't met one of the people on the train, but now I feel connected to the story. I hope the guy I talked to is okay, and I really hope the person he carried to safety is okay.

In writing news, I've been churning out 1,800 words a day (a bit over six pages) for almost three weeks now. That's a lot, at least for me, but I have to maintain this pace if I'm going to have a complete draft by August. No one's holding a gun to my head -- my editor's very understanding and patient -- but I want the blasted manuscript off my desk and on someone else's, and I know I'll have to do at least one rewrite after I finish the draft.

At church today, I got a key for the next knitting night this Wednesday. One of the people who was there last week can't make it for the next two weeks, though, so I hope other people show up!

No Kahlua yet. Last night I felt like tea instead. Tonight my back's bothering me -- I worked out for an hour both yesterday and today, and may have overdone it -- and I took a Relafen, which I don't want to mix with alcohol. But the Kahlua will keep.

My pretty twin-leaf lace scarf is done. Time to go block it!

Today I went to see the new doctor, who's also a medical acupuncturist. (He told me that in fact, the insurance companies are pulling him off primary-care panels and listing him as a specialist, which means that I should list his nurse-practitioner as my primary-care person.) I like him a lot. He took notes and checked my records on a laptop, but made plenty of eye contact. When I told him why I wanted acupuncture -- for sinus and gastric issues, two of the conditions for which the World Health Organization recommends acupuncture -- he promptly asked for the history on both. When he found out that I'm not taking an acid blocker because I'm nervous about osteoporosis, he said, "The risk of not taking the pills is greater than the risk of taking them," and then he told me that not all of them interfere with calcium absorbtion at the same level. He said that Zantac is pretty benign that way, especially if I also take both calcium and Vitamin D -- which I already do -- so I'm back on that as of this evening.

After he took my medical history, he asked me what I do for a living, and then what I do for fun. As he was positioning the needles for the acupuncture, he said, "So, do you feel as if you've been able to do what you've wanted with your life?"

Nobody's ever asked me that broad a question: not psychologists, let alone any kind of internist. I was very impressed. This guy seems to have a firm grasp on both Western and Eastern medicine, is comfortable using both, and also pays attention to the Whole Person. My only quibble is that his voice is so soft that I often can't hear him, but I'll just have to ask him to speak up. (He works out of a medical spa, which has a very cushy waiting room with aromatherapy and soothing music and deep, fluffy chairs: it feels like the lobby of a high-end hotel. That's different from my usual experience, too, as was the fact that he came out to get me himself and conducted the entire visit without a nurse.)

The acupuncture was fine. He's very deft at needle insertion and was very solicitous about whether I was comfortable, putting a pillow under my knees and covering my feet with a blanket because they were a bit chilly. I'm going back for another acupuncture session in three weeks. I don't notice any effects from it yet, but I think it takes a while.

So that went well, I think. I also found the office much more easily on this second visit!

On a less happy note, this evening I facilitated a Literature & Medicine session at the VA and learned from some fellow knitters there that my favorite yarn shop is closing. This is really terrible news, and I hadn't even known about it. Evidently everything's half price, so I'm going to go over there tomorrow morning and load up on whatever's left (I still have part of a gift certificate my sister gave me for my birthday, but I'm sure I'll go over that).

Yesterday I saw my chiropractor and asked if she could recommend a new PCP. She immediately gave me a list of names of doctors her own patients love. One of the people she recommended very highly is a Nurse Practitioner who works with an MD who's also trained in medical acupuncture. I'd already heard good things about him and had been considering checking him out -- here's his bio, which I find both honest and compelling (I especially like his definition of illness as "the human experience of disease," which is a precise and helpful distinction) -- so that was an easy sell, especially since he's on my insurance! I've had good results from acupuncture for my sinusitis, although I'm skeptical about a lot of "energy work," especially Reiki.

When I got home yesterday I called and got an appointment with the NP for 10:30 this morning. How convenient is that? As a plus, she's considerably closer to my house than my old PCP (although the office park where she's located is an absolute maze, and I kept getting lost).

I think she's great: warm, personable, empathetic, a great listener. She looked at me instead of at her computer, although like everyone else these days, the practice uses electronic medical records. She had, for a wonder, heard of Narrative Medicine! She shares my skepticism about the energy stuff and says she's had a hard time wrapping her head around acupuncture, but she keeps seeing patients respond really well to it, so that's convinced her. She adores the doctor. When I said, "I've decided that allopathic medicine is great for acute illness and life-threatening stuff like cancer and heart disease, but holistic medicine is better at treating chronic problems," she nodded vigorously and said, "That's so well put. I'm going to use that."

She recommended a new orthopedist, a knee specialist who's doing her own knee replacement next week. (Ouch!)

She talked about the fact that normal lab values -- while they can reassure you that you don't have cancer or whatever -- aren't a reason to dismiss complaints that people aren't feeling well. (My old doc's response tends to be, "You're fine. Your bloodwork's splendid.") She said, "You don't need more lab work or pharmaceuticals. You need to be treated as a whole person. We need to monitor your depression to make sure it doesn't become a problem, and we need to help you work through your grief." She asked if I was currently in therapy; I said I've stopped getting good results from talk therapy, although I process a lot through the blog, and that led us into a discussion of writing and healing. She hadn't known about James Pennebaker's research -- here's his writing and health homepage -- and was fascinated.

So her recommendation is that I see the doctor for a consultation; I have an appointment with him for June 9. When I left, she both shook my hand and hugged me. My old doctor's fallen into a pattern of walking away without a backward glance, not even responding to "thank you" or "good bye."

So I'm feeling vastly relieved and cautiously optimistic. A small voice in my head is saying, "You know these folks will burn out in five years, just like everybody else you've seen," but I'm trying to ignore it. And even if it's true, five years is better than nothing. So thank you to all of you who urged me not to settle for a doctor with whom I'd become uncomfortable!

In other news, today's my last fiddle lesson with Charlene. Her husband has a job in Madison, Wisconsin, which of course is one of the coolest places on earth, and has a much better music scene than Reno does. They're moving later this month.

I'm hoping, at some point today, to finish the extraordinarily rough first draft of Mending the Moon, and then to start revising like a maniac. I'd love to have it done by Mythcon, although that may be overly optimistic.

in 2002 or 2003, I went to urgent care with sudden scary knee pain, had x-rays, and was diagnosed with osteoarthritis and a worn meniscus.

Since then, many medical folks have told me that worn meniscus can't be diagnosed with x-rays, but have confirmed that I have arthritis based on pain, popping sounds when I move the joint, and so forth. My rheumatologist agreed with the arthritis dx and gave me Relafen as an NSAID, because ibuprofen chews up my stomach too much.

Then my pharmacist told me that Relafen isn't an NSAID; he says it's a muscle relaxant.

Today, my orthopedist said I don't have arthritis but do have patellar tracking disorder: my kneecaps in both knees are off-kilter and don't move where they're supposed to, causing wear and tear and pain, although my right knee is much worse than my left. (He also says Relafen is an NSAID, and the All-Knowing Internet seems to agree; I'll tell my pharmacist this when I see him, since he was treating me a little like a drug addict for taking the stuff.) Orthodoc claims the condition's strictly structural and due to genetics, and says the only effective treatment of the cause -- rather than the symptoms -- is arthoscopic knee surgery to release the lateral ligaments.

First he said that surgery was a last resort, to be used only when the steroid shots don't work anymore. (He gave me shot #2 today, although shot #1 was nine months ago, which doesn't seem like a bad record.) Then, when I asked more questions, he said it was actually better to have the surgery sooner rather than later, because the longer you wait, the more damage is caused by the kneecap moving the wrong way. He said there's no downside to the surgery and that recovery time is quick. He had his nurse give me my diagnosis code and the surgical procedure code, so I could call my insurance company to find out what it would cost.

Important note: Orthodoc's retiring in a month -- he's been driven out of the business by the difficulty of trying to run a solo practice in today's insurance environment -- so he wouldn't be performing the surgery even if I had it. He has no financial incentive to push surgery, in other words (plus I was referred to him by a friend who says he's conservative in terms of surgery).

However, internet research suggests that this surgery a) actually is a last resort, b) often doesn't work (and may actually destabilize the knee), and c) involves lots of agonizing postop pain and weeks or months of PT even when it does work. The sites I've read say that full recovery can take up to a year.

No thanks.

Meanwhile, I think Orthodoc's nurse gave me the wrong codes, because when I Googled them, they were about meniscus tears and surgical repair of same, rather than kneecap issues.

My brain hurts. Thanks to the shot, my knee hurts less than it did, although not as much less as it did after shot #1. We'll see how it does over the next few weeks, though.

My grades are in, and I'm celebrating with a round of doctor's appointments. Sigh.

Ever since the migraine from the Black Lagoon, which after all was over a month ago, I've had annoying headaches. So today I hied myself to my friendly Primary Care Provider, who called in a script for antibiotics. He agrees with my assessment that it may be a sinus infection.

Meanwhile, my right knee has gotten really crunchy again, and stairs are once again a challenge, so tomorrow I'm returning to my friendly Orthopod for another cortisone shot. I was complaining about this to my PCP -- between my back, my knee, and various other creaky bits, the pain-somewhere-every-day thing makes me feel more like I'm eighty than like I'm fifty -- but he wasn't very interested. Without taking his eyes off his PDA, he said that I just have to keep up my exercise, or I'll feel even worse.

Lovely.

Also, I seem to have gained back the few pounds I'd lost, which is more than a little discouraging. I told the PCP about that, too, but he just grunted (still looking at the PDA). I'm sure he hears such complaints all the time; still, I've started to hate having to see him for anything, since the contact feels so impersonal. I'm not sure any other primary-care folks in town are any better, though. It seems to be the nature of the territory.

The Orthopod is more personable, or was the last time I saw him, anyway. My chiropractor's infinitely more personable; she spends no longer with me per appointment than my PCP does (an average of ten minutes), but I feel like she sees me as a whole person, not just a presenting symptom. Of course, she sees me every week, which makes a difference. She also makes much more eye contact, with makes a huge difference.

Elsewhere in health news, my current CPAP mask has started to ooze blue silicone goo, so I got online to order another and discovered that my favorite mask's being discontinued. Horrors! So I ordered three. The website where I buy them now requires a prescription even for a mask. What in the world? Is there a big black market in CPAP masks? Are people using them to snort illicit substances? I can't imagine why access to these things needs to be controlled.

But it does, evidently. Conveniently, the website offers to contact your doctor for the script, so I entered my pulmonologist's name . . . and up popped her group-practice name, address and phone number. These folks are good!

With any luck, my knee will feel markedly better tomorrow, and my head will feel markedly better within the next ten days, and my back will remain at the not-happy-but-not-screaming level. Then maybe I'll start to feel a few decades younger.

My current decrepitude is so frustrating at least partly because I feel like I do so much right. I don't smoke; I drink hardly anything (an inch of wine every two weeks, at most); I take my vitamins, wear my seatbelt, eat pretty darn well, and exercise religiously. But, like the good doc said, I guess there's no way to know how much worse I'd feel otherwise.

Tomorrow we're getting our new awning, which will make sitting outside much easier than it is now. Sunshine will help.

I've been very bad about posting, largely because, while there's a lot going on -- notably family medical concerns and an annoying situation with an alarming student -- most of it's stuff I can't discuss in any detail here. Let's just say that, while I'm glad classes are over, I've had better weeks.

Among other things, I've been entirely too conscious of non-stop Mother's Day advertising, which makes me miss Mom. My new church runs a very busy food pantry, and they solicited donations in honor of mothers, so I made one in memory of my mother and in thanksgiving for Gary's mom (who'll get a nice card from the church). That helped a little bit, but I'll be glad when the holiday's over for another year.

On the bright side:

Classes are over, except for the final I'm giving next week.

I've been chipping away at the book manuscript, mostly managing to write 1,000 words a day. I'm not happy with the results, but at least I have something to revise.

I've been exercising a lot, and have managed to lose a few pounds. I'm no longer officially-according-to-my-BMI overweight, although I'd like to lose a lot more (if only to give my back and knee a break: both have been complaining mightily lately).

I'm reading a wonderful book: Chris Adrian's new novel The Great Night.

Gary and I attended an astonishingly accomplished graduate viola recital last night.

Speaking of violas, I've started practicing mine again, and I'm having fun with it, even if the results aren't even remotely accomplished.

Gary and I just finished watching the first season of David Simon's new series Treme, which we loved (and I don't even like jazz!). I found the post-Katrina New Orleans setting especially poignant because my father still lived on the Gulf Coast when all of that was happening.

Last week I covered a class for a colleague who was dealing with a family emergency. This wasn't a big deal, especially since it was a really fun class. It's the kind of thing all of us do for each other whenever it's necessary. Colleagues covered for me when my parents died, for instance. Everybody hopes it won't be necessary, because you don't want your co-workers to be dealing with crises, but I don't think anyone expects any acknowledgment except a simple "thanks so much" (and depending on circumstances, even that's optional).

The colleague for whom I covered has a really impressive jewelry collection -- and this is coming from me, so that's saying something -- and we've periodically admired each other's pieces. I don't remember talking to her about turtles, but at some point she must have picked up on how much I like them, because earlier this week I discovered in my mailbox a thank-you card taped to a box containing this stunning item.

I was very nearly speechless (and coming from me, that's saying something!).

I've worn the pendant several times already and have gotten lots of compliments on it. Right now, the turtle's an especially timely reminder of things I need to remember:

* Hiding under your shell is fine, but you need to stick your neck out to get anywhere.
* It's okay to go slowly as long as you keep moving.
* Only carry as much as you need.

So that was my week, o gentle readers. How are all of you?

. . . but I'm posting anyway.

So far I've used the elliptical half an hour a day; two of those days, I've also done half an hour of laps in the pool. More would probably be better, but this is more than I was doing before we got the elliptical. Baby steps. I've decided that the most important thing is to make sure that I enjoy each workout, even if I'm not breaking any Olympic records, so I'll keep doing it. I'm having fun listening to music on my BlackBerry while I work the machine.

Mom died a year ago today. I'm sad.

In the past week or so I've written two new CHR columns and my Maundy Thursday homily; I'm fairly happy about all of that, but would be happier were I getting any fiction written.

The baby sweater continues. I'm now working on the first sleeve. This is a top-down project, which means you leave stitches on waste yarn for the shoulders of the sleeves and pick up stitches for the underarm. My first two sleeve attempts were disasters, because when I picked up the number of stitches specified in the pattern, I had huge holes. I increased the number of pick-up stitches and now have something that looks halfway plausible, I think. Whether this item will fit a human child when it's finished is anyone's guess.

Next week, the guy who built our deck last summer will make some minor repairs, and also pressure-wash and seal it for the summer. Today Gary met with the guy who's constructing and installing our 17'x13' retractable awning; that should be done in ten to twenty days. Of course, the minute everything's finished and we put the deck furniture out, we'll have a blizzard. (It snowed here on May 22 last year.)

We're going to try to pretend that our deck is the deck of a cruise ship. We're both in major jonesing-for-another-cruise mode, which isn't very practical given the financial realities of sabbatical (or of life in Nevada right now). But I still find myself obsessively searching Vacations to Go, and Holland America keeps sending us glossy brochures -- cruise porn -- which doesn't help.

That's my dull life right now, but there are worse things than dull.

Well, I'm still a little headachy and a little nauseous, but -- after a very slow and discombobulated day -- I managed to swim for half an hour this evening. Since I hadn't exercised since Saturday (skipping my Sunday workout may have been one of the causes of the Tuesday migraine), I feel as if I'm now getting back on track.

And just in time, since our new elliptical arrives tomorrow! Yay! I'm so looking forward to being able to work out at home without having to gather all my gym gear (although I'll still use the pool at the gym). Gary's looking forward to being able to work out at home when bad weather prevents hiking. We're both curious about how the cats will respond to the new intruder; I foresee initial alarm, especially when the thing's moving, but I'm sure they'll adjust.

On Monday, the guy who built our deck is coming over to fix a loose post. We're going to find out how much he'd charge to do the annual pressure washing and resealing.

Our shade canopy collapsed in a rainstorm last autumn and was wrecked beyond repair, so we're going to invest in a large custom retractable awning (with a manual crank, not one of the motorized ones, which brings the price down at least a little bit). This is a large chunk of change, but it's also a big improvement to our living space. We spend a lot of time out on the deck in warm weather -- I effectively move my office out there for at least part of the day, and we like to entertain there too -- and adequate shade's essential. (This is the driest, sunniest state in the country, and we're also at altitude, so UV protection is a real issue.)

The awning plus the elliptical add up to a lot of money when I'm about to a) have my pay cut and b) go onto two-thirds of the lower salary because of the sabbatical. But since I'm staying home during the sabbatical, home needs to be as pleasant and workable as we can make it, and I think these two items will really help.

Here's the most dramatic botched-IV bruise. This puppy's two and a half inches long. Luckily, it's much less painful than it looks.

Note: Posting a photo of the bruise was Gary's idea, so complain to him if you find it distasteful!

I still have a bit of a headache, and very sore muscles from the GI excitement and the uncomfortable urgent-care table, but I managed to muddle through work today. I just hope I can finally shake the headache tomorrow.

Yesterday UNR announced a new list of possible budget cuts, including the elimination of the Philosophy Department. The mood at work is not good. My personal mood isn't stellar right now either. Monday will be a year since Mom died, so I've been very aware of the events that led up to that.

Maybe it wasn't too surprising, then, that today I woke up with a migraine. I haven't had one of those for years. I did what I usually do: have a bland breakfast, take Tylenol, drink some coffee, and hope it doesn't all come back up.

It came back up. It kept coming back up. The tiny sips of water I took to try to rehydrate came up too. All in all, we had four very unpleasant episodes of Coming Back Up, between which I lay in bed, literally moaning in pain. This was very unusual. Usually stuff comes back up once, I take a nap, and when I wake up I feel all better. Not today.

So I made other arrangements for the class I was supposed to teach today, covering for a colleague who's on bereavement leave after a very tragic loss (have I mentioned that the mood at work isn't good?), and -- after a phone call to a nurse hotline, which advised me to be seen within four hours, and to my primary-care doc, who couldn't get me in today -- arranged for a friend to drive me to a local Urgent Care. The Urgent Care I usually go to is moderately far away, so I was pleased to discover that my medical group has one much closer, right across the street from the assisted-living place where Dad used to live. (It's a measure of how whacked-out I was by the migraine that at first I didn't even recognize the name of the street.)

I'm not sure I'll be going back there, though.

Here's the procedure I'm used to: you walk in, you're checked in right away, you're seen by a triage nurse within a few minutes, and then you're sent out to wait more minutes or hours, depending on what else is going on. At this place, I didn't even get checked in for half an hour. There appeared to be no triage nurse. Half an hour after I was checked in, I felt cruddy enough to actually lie down across two seats in the waiting room, at which point my friend Linda went up to the desk and said, "My friend really feels awful. When will she be seen?"

Well, after that they took me immediately back to a room, let me lie down, gave me a blanket, cooed over me, and dimmed the lights. A medical assistant took my vitals, which were fine, and then a Nurse Practitioner came in, asked me what was going on, and gave me the most thorough physical I've had in years. She actually touched my body! My primary-care doc never does that anymore. She decided that I could use some IV rehydration, which was exactly why I'd gone in.

Then the fun started. The medical assistant tried to start an IV in my right arm and blew the vein. This was a slow, bizarre process: she had to go in and out of the room about fifty times to collect the supplies even to start the thing, and then she kept anxiously peering at various bits of paraphernalia, and I kept anxiously peering at her long, painted fingernails, which, for hygiene reasons, would never be allowed in the hospital where I volunteer. After she'd placed the IV, she had another staff member come in and inspect her work. The two of them peered, poked, prodded, bit their lips while staring up at the IV bag, which wasn't dripping properly, ascertained from me that the IV site was indeed burning, and decided to pull the IV and start again.

Medical assistant #2 decided to start the new IV in my right hand. (Both of them had assured me cheerfully that I had nice fat veins.) This was an inordinately painful process that didn't work out any better than the first one had, so they pulled that, too.

Then the Nurse Practitioner showed up. All three of them examined my left arm, making helpful comments like, "These are nasty veins." I commented that the downside of Urgent Care is that they probably don't have to start many IVs and therefore aren't adept at it. The Nurse Practitioner told me that they start lots of IVs! Two or three a day! (I thought, but didn't say, lady, where I usually hang out, that would be two or three a minute.) The NP decided that she was going to attempt the IV in the left arm; she'd been an ICU nurse before she became an NP, she told me, and was very good at IVs.

She got the needle in fine, but then she couldn't get the IV tube attached to it. "This is a new kind," she said. "I don't know how this works." Oh, terrific. She finally, with a lot of painful twisting of the needle, got the tube connected. Everyone recommenced staring anxiously at the IV bag, which once again refused to drip properly, and I complained about burning at this IV site too, so IV #3 was a bust. (I now have very colorful bruises on both arms, especially the left one.)

"We're not going to poke you again," the NP said soothingly, as MA #1 brought me a warm blanket. (I'd told her that they needed blanket warmers like the ER has; she put my blanket in a microwave to warm it up for me, which was very sweet.) "We're just going to give you a GI cocktail and a lot of water to drink and see if you keep it down."

I kept it down. My head still hurt like nobody's business -- probably, at this point, because I'd had nothing to eat all day and it was almost dinnertime -- so the NP decided to give me a shot of Toradol. She was very patient with the questions I fired at her after researching the drug on my BlackBerry. About half an hour after the injection -- three and a half hours after getting to the Urgent Care place -- I was finally feeling a bit better, and they let me leave.

I don't believe there was a doctor in the building. I only saw four staff members: NP, the two MAs, and a young woman whose role I never determined, but who looked about twelve. They were all very sweet; they all apologized copiously for the blown veins, praised me for my sense of humor through the ordeal, and told me repeatedly that they hope I feel better.

I still don't think I'll be going back there.

I'm now, as per NP's orders, pushing diluted Gatorade. If I can't get a certain amount of that down by 9 PM, or if I start vomiting again, I'm to go to an Emergency Room, where the staff will presumably be better at starting IVs. I don't think I'll need to go to the ER, although I'm not sure I'll be going to work tomorrow.

I'm going to bed early, that's for sure.

On the bright side:

My friend Inez can come to WorldCon after all!

An acquaintance from college called last night, and we had a long and pleasant chat.

I've actually started knitting my first sweater! It's for a baby, but it's still a sweater!

Noodling around Amazon, I discovered that Shelter is already available on Kindle, even though The Necessary Beggar -- published first -- still isn't slated for e-book release until December 2012.

The ways of publishers are strange.

In any case, Shelter's a great choice for an e-book, because it's a big heavy brick of a print book and would add several pounds to any piece of luggage, but it will add no weight to your Kindle at all. Magic!

Also, did you know that you can now buy Kindle books as gifts for other people? Recipients don't even need a Kindle to read the gift: they can read it on their PC, their iPad, or their Blackberry. I believe Amazon will soon be releasing Kindle apps for microwave-oven doors and digital watches. Surely you know someone who has a birthday coming up soon and would welcome the gift of a book that's weightless even though it's over 500 pages long?

Weightless books! The future has arrived! Get 'em a copy of War and Peace while you're at it! (Seriously: if I'd had my Kindle ten years ago, I might not be having back problems now.)

In other news, I'm glad to report that the anniversary of my dad's death went fine, mostly. I was a little foggy-brained, but that's business-as-usual for the week after break, and for several weeks after that. In fact, I'll probably be foggy-brained until the end of the semester (and maybe much longer; it may simply be a permanent condition at this point).

All right. Clearly I'm punchy and need to go to bed. Good night!

Tomorrow's the second anniversary of my father's death, and the first day back to work after Spring Break: not an especially auspicious combination! I've felt tired and sad all day, although I did swim for an hour this afternoon. My weight basically held steady on the cruise -- I ate too much chocolate, but I also ate lots of fish and fruit, and got a decent amount of exercise -- but I still need to work on shedding some of it.

I'll probably be too busy tomorrow to think much about Dad, but I'll still be glad when the day's over. We got home yesterday to find a lovely note from Fran, marking the anniversary and talking about how much she loved Dad. That meant a lot to me. It's good to know that someone else is aware of the date, too, and thinks about him. I'll call Fran tomorrow if I have time.

It snowed most of today, which didn't help my mood. I believe we expect nasty weather through mid-week. Yuck.

Our second day in PV has been a bit of a bust. We slept late, rolled off the boat around ten, and ambled down to the docks to see if we could find a short whale-watching trip. The only one we found was from one to five, though, and the boat's leaving at 3:30, so that didn't work. The tour operator offered us a private trip for $200. I know buyers are expected to bargain in Mexico, but I just wasn't up to it, so we told him we weren't interested.

Walking back to the cruise pier, we saw two Mexican soldiers with machine guns and grenades casually guarding the tourist docks. Mind you, this is inside the cruise complex, which is surrounded by fencing topped with barbed wire and guarded by private security guards who check cruise ID at the gates. (Getting off the boat, one of the HAL crew had told me, "Be careful with your belongings!") After seeing the machine guns, Gary decided that he wasn't up to exploring. I'd wanted to amble around old PV when I thought I could get there on foot, but having to take a cab -- and not being sure how reliably I could get one back -- made me chicken out, too. If I had more energy today, and if we'd had more time, I'd have gone for it anyhow, but I'm exhausted. I've been having a lot of nightmares on this trip (the nuclear news from Japan certainly hasn't helped), and last night's was a long, complicated dream about losing my job, so I didn't wake up feeling very refreshed.

So what did we do? We crossed the street and, heaven help us, went to the mall, where I bought a Nike swimsuit I've wanted and hadn't been able to find in the States. Then we went to the Starbucks and had iced coffee. I used my tiny bit of Spanish only to apologize for the fact that I speak only a tiny bit of Spanish. The Nike saleswoman and I communicated largely with hand gestures.

On our way back to the ship, it occurred to me that one isn't supposed to drink iced beverages in Mexico. I just hadn't been thinking: we were in an American-style mall, buying from an American chain, surrounded by Americans on their laptops, but that doesn't change the fact that the fauna's different down here. I'd committed the very definition of a stupid tourist mistake. Whoops. Back on board, I talked to a member of the crew, who rolled her eyes and told me I'd probably be fine, but that if I got sick I should call the medical department.

So far we're okay, but the crew member said it takes twenty-four hours. In the meantime, we ate lunch. Gary's pacing the deck; I'm blogging. I wanted to take a nap, but our stateroom's right above the showroom, where there's a rehearsal for some extravaganza with thunderously loud bass, so that wasn't going to happen.

The ship's internet cafe is ten decks up. From up here, the view's lovely, and I just saw two pelicans fly by. That's the highlight of the day so far.

I'm so glad we have an excursion booked for Cabo tomorrow. I just hope we're healthy for it.

This morning I met with my rector; we had a very pleasant chat, and he invited me to preach on Maundy Thursday and on May 29 (Memorial Day Weekend). I'm really looking forward to writing homilies again, and I'm honored to be preaching during Holy Week.

I ate my brown-bag lunch at church, raced to the gym and swam for thirty minutes, and then drove to the family shelter to teach my poetry class. I absolutely loved it. You can read about it on the UNR Poetry Project blog. The eight weeks of classes will culminate with a gallery show, probably at the university, and one of today's students has already given permission for her poem to be displayed (which makes me very happy, because it's a gorgeous piece of work).

It was incredibly moving to hear people in such tough circumstances express so much love for their families. As a side note, I was also very impressed with the physical plant; I'd been to the medical clinic downstairs to donate my father's meds after he died, but I'd never been inside the family shelter. It's clean and spacious, and seems very comfortable. Each family has its own room, and I loved looking at the kids' artwork posted on the doors.

When I got home, Gary and I decided to dash out to a store in Sparks that sells sports optics; we were hoping to get prescription snorkel masks. The store sells them, but they cost about $200 each, which is way too much money for an activity we indulge in once a year if we're lucky. So we're going to look for less expensive options. The cruise line supplies equipment, but we don't know if they'll have optical masks.

The store was fairly close to the fancy mall with the big sports store where I bought my wetsuit, so while we were in the neighborhood, we decided to go look at ellipticals. And, mirabile dictu, we found one! We hope to very soon be the proud owners of a Horizon Ex-59, which -- at its sale price of $599 -- was the second-least-expensive machine in the store. It seems really solid and smooth, though, and the online reviews we've seen have been good. We could have ordered a slightly older model, the Ex-57, from Amazon: less money, no tax. But after reading about people spending two or three hours assembling their machines, and winding up covered in grease, we've decided to spring for the tax, since if we buy from the store we'll get free delivery and installation, and they'll handle any necessary repairs. Right now the store only has the floor model in stock, but the sales guy is going to call me tomorrow about when they expect more in.

Of course, this is an even larger investment than the masks (and yes, I was conscious of the irony of embarking on this project right after a visit with homeless families), but we'll use it a lot more often. I hope to use it for at least a little while most mornings; I'll be able to work out in my PJs, which means I can give myself a serotonin boost on those mornings when crawling into clothing to crawl into the car to crawl to the gym is just too much effort. Gary dislikes most gym equipment but was very impressed with this, and he can use it when weather keeps him from hiking. So, yeah: big outlay, but I think the price is reasonable for what we'll be getting, and I think it will help with my health goals. My ultimate goal is to work up to using the elliptical half an hour in the morning and then swimming half an hour in the afternoon. That way, I'll get both weight-bearing exercise and the swimming I love, and I'll be able to rest between them. This may be too ambitious, of course, but if I could manage that even a few times a week, I'd be happy.

It was dark when we left the mall. I don't know Sparks very well, and I got lost. We wound up on a long highway without traffic lights. I couldn't see familiar city lights. I couldn't even tell which way we were driving. Finally I pulled up to a supermarket and told a lady there that we were lost. She laughed -- she's gotten lost there too, it turns out -- and offered to lead us back to town.

Talk about angels in disguise. I never would have found my way on my own; we weren't even close to my best foggy guess of our location. Thank you, lady in the silver Cadillac!

After that adventure, we'd have gotten home later than Gary likes to start cooking, so we went out for pizza, to the place that has gluten-free crust and soy cheese. It was very yummy. I'm very grateful to be able to eat pizza again.

So I've decided that the new funk probably is a resurgence of depression; the question is what to do about it. The immediate answer is to exercise more, since I'd gotten somewhat lax about that. Since Saturday, I've gone to the gym every day, and I'm indeed feeling a bit better.

One of my goals here is to stay off meds, at least until after my sabbatical. There are three reasons for this:

1) Meds suppress creativity, at least for me, and while the funk has too -- although, again since Saturday, I've been managing to write a bit every day -- I can't afford a solution I know will mess with my writing. I need to get a lot of writing done during sabbatical.

2) I suspect the mild chronic pain I've been in since October, from my back, is one factor in the funk (although the pain's slooooowly getting better with exercise and chiropractic treatment). I'm positive that the extra ten or twenty pounds I'm carrying around haven't been helping my back, and I gain weight on meds.

3) Meds are expensive, and will undoubtedly become more so when our medical benefits crash and burn on July 1, which is also when I'll be on reduced sabbatical salary.

(Note: In "meds" here, I'm including herbal treatments like St. John's Wort, which I've been told by clinicians are just naturally occuring, under-regulated versions of the same chemicals Big Pharma puts in antidepressants.)

One obvious and time-honored alternative would be therapy. However, I've done a lot of therapy in my life, and I know pretty much all the cognitive strategies out there, and I can talk circles around anybody or anything. My most recent therapist acknowledged this in our final session; both of us felt that the sessions had been more like very pleasant conversations than like therapy sessions, but he said that was basically because I already had all the insights other people come to therapy to get. (This isn't because I have any special qualities; it's because I've spent decades in therapists' offices.)

So today I began, yet again, a search for a therapist around here who does something other than cognitive talk-centered stuff. My sister helped out with a websearch and found a local Jungian whose name she sent me; I found another local Jungian who's particularly interested in spiritual issues; a psychologist friend suggested yet another local Jungian.

Not a one of them is on my insurance. Aaargh! Not that insurance will be a heckuva lot of help once the sabbatical starts, anyway (see point three above), especially since therapy is more expensive than meds, which is one reason why meds are so popular.

I'll keep doing research, and in the meantime, I'll do my best to stick to my exercise schedule. I'm even considering buying an elliptical for the house, so I can work out on days when I don't feel up to dragging myself to the gym. To my disappointment, the good machines are both very pricey and too large to fit easily in the house. Gary said we could clear out room in the garage, but exercising in a windowless space, among boxes and dust bunnies and spiders, just doesn't appeal to me. I'd want the thing near a window, to combine light therapy with the workout.

Picky, picky! Yes, I know. Aren't chronic invisible illnesses fun? But with a bit of luck, continued exercise will get me over this hump. I know it will help the back and the weight, and my gym membership's already built into our budget (that's one thing I'm definitely not giving up during my sabbatical). Keep your fingers crossed for me, please.

As I've noted here before, February 20 is the anniversary of the day I was offered the job at UNR (in 1997), the day of my very unexpected and grace-filled first communion (some months before I was baptized, in 2000), and the day when we learned that my mother's lung-cancer surgery had been so successful that she needed neither chemo nor radiation (in 2004). I believe it was also the day (in 2006?), when Rita Charon spoke at UNR, sparking my interest in narrative medicine. In any case, it's a day when many nice things have happened to me, a day I tend to expect to go well.

Today, alas, was a little disappointing. I finally booked the ninety-minute massage my sister gave me for my birthday, and was looking forward to it tremendously. I'm glad I got it -- I certainly needed it -- but I think my massage therapist was having a bad day, because she seemed very terse and untalkative, and also worked on me so fiercely that I'm still sore. (To be fair, she told me I should let her know if she was applying too much pressure; it felt okay at the time, and I'm sure I'll be fine tomorrow.) I used to have long, warm conversations with my old massage therapist, who left to go to nursing school, and although I was fine not talking today, it felt odd that this therapist didn't even respond to my tentative openings. She wasn't exactly rude, but the interaction felt brisk and impersonal.

Also, halfway through the massage, I developed a stomachache that lasted a good four or five hours. It's gone now, thank heavens. I don't think the massage had anything to do with it. Still, this definitely wasn't one of my better February 20ths.

Better luck next year.