#454: Fixing The Plumbing

Original image at Dreamstime

An old college wag used to charm homely freshmen with the line, "Oh, hunny... you're just as pretty as you can be." I was reminded of this when a dear friend at the Y counseled me to stop thinking about "getting well" all the time. "You just keep hammering yourself with that, and you'll never be able to move on." "Wow," I thought to myself. "I'm just as sane as I can be."

I once took a course called Education for Ministry. One of the most important parts of the class was the TR: Theological Reflection. It was a way of analyzing any issue within the biblical framework of Creation, Sin, Judgement, and Redemption. You start by looking at an event or story or scripture and ask, "what is that like?" You develop a metaphor, then through the lens of the paradigm, you find insights into the source material.

So, here is the story:

While driving today, I thought, "I'm having such a hard time isolating why I feel so badly. So, when was the last time I felt really well? Mentally?" My imagination began the long, slow rewind, and came to rest at the most shocking, absurd place imaginable. It is a sunny afternoon. The breeze dances with the curtains in the open windows. Outside, kids are screeching. Dogs barking. Birds singing. Inside, I lie on my bed, looking out into the bright, July air. I am shivering. Thinking of Mrs P. Of Shakespeare. Of running. I am dying of cancer.

I have often wondered why I didn't get depressed during my cancer. It wasn't until my treatment was finished that I felt the wait of loneliness and shadow closing itself around my irradiated heart. Suddenly my day was no longer about this treatment or this bag of drugs or this feeding. It was about waiting for October when the scan would show if I was going to get well, or have to fight another round. When the news of my clear scan finally came... that's when the real funk began. I felt hollow and empty. The battle that had been my life's purpose for so long was over. What the hell was I supposed to do now? After a few weeks of apparently grieving because I was not going to die of cancer, I did two things: I made a date with a therapist, and I joined a gym. 

And in many ways, this current episode feels like the last chapter of a story that started on that day back in July of 2010: the last time I felt really sane.

Now, to find a metaphor. I bounced a lot of ideas around as I drove. What was it like to have something not work, to know that it once did, and to have to figure out how to make it work again? My mind zeroed in on our old house on the North End of Lexington. The previous owners had been big on Do It Yourself, but not so much on Know What You're Doing. The plumbing in the house was a disastrous combination of materials and Jerry-rigged solutions to simple problems. Consequently, it would fail pretty frequently on two particular occasions: when we had guests coming over; or when we were preparing to celebrate a major holiday. Mrs P once rinsed and prepared the Thanksgiving turkey in a stationary tub in the basement, because my midnight efforts to fix the kitchen sink had resulted in a broken pipe and a flooded cellar.

When the plumbing would go wonky, it was always tempting to try a short-cut. Pour something toxic into it. Shove a straightened hanger down the drain. Grab a rubber mallet and bang the pipes in frustration. In the end though, only two solutions ever worked. You could either call Roto-rooter, or you could carefully take the whole mess apart, snake out the gunk, bathe yourself in whatever black ooze gushed out of it, and then put it all back together again. After three or four tries at that, if you were lucky, it all worked good as new again.

And there we have it. A psychotic break is gunked up mental plumbing.

Creation
As they were originally designed, the pipes carried water and waste flawlessly, smoothly, silently. The pipes were clean and balanced. They hung straight and true at just the right grade. Lots of fluid  moved easily with only gravity pulling it along toward the treatment plant and ultimately back to the ocean. You just didn't give them a second thought.

And that's the way a healthy mind works, too. Ideas and intuitions flow smoothly through the mind. Waste is carried away. Thoughts and perceptions are clear and move with quiet efficiency as the mind carries them along, learning, gleaning, observing, and then releasing them into the great, universal ocean of thought. When it isn't broken, you don't even think about your mind.

Sin
But sometimes, even well-designed plumbing can go south on you. Maybe you pour some bacon grease into the sink, or you accidentally flush a wash cloth or a toothbrush down the toilet. A block forms. Crud gathers. Hair. Cat food. Vegetable peels. Gunk. The space inside the pipe gets smaller. Less water can flow through, and because of the smaller opening, more pressure is created when it does flow. Joints are strained. Long runs are thrown out of balance. Eventually, the pinch point closes completely. Nothing can get through.

Crud can accumulate on the passageways of your mind, too. Memories of failures past. The dread of repeating painful losses. Shame for falling short and letting down the people you love. These little blobs start to cluster together inside your mind like balls of grease and hair in the trap under your kitchen sink. Ideas get stuck. Obsessive thoughts begin to grow. You begin to look for quick, easy fixes - toxic thoughts to pour into your brain and blow the clogs out. And finally, like the clogged pipe, your mind can have so much fear stuck inside that no healthy idea can pass through.

Judgement
And what does this sin filled world of plumbing look like? Wet. Dirty. Stinky. Cold, soapy water in the kitchen sink that won't drain. Black ooze dripping out at elbows and joints. Sewage floating in the bathtub. These are the consequences of allowing your plumbing to fill with sticky goo.

The mind also springs leaks. Good ideas trickle away unnoticed under the strain of keeping something flowing around the clogs. Soon, the smell of fear is so overpowering that nothing else can cut through. The focus is no longer on moving ideas, learning, observing, growing. Now all energy is focused on the blockage. Emotions explode outward, or are crammed inward in an attempt to force the negativity away. But as time passes, the clog becomes all that there is. The ball of fear not only stops healthy thought, it actually transforms it into fear. Unchecked, this once tiny clot of fear will consume the entire vessel. The mind grows sick and dies.

Redemption
How then, can the holiday dinner be saved? There is only one way, really. First, stop. Don't panic. Look. Listen. Touch. Smell. Where do you think the problem is? Now, get the tools you need. The wrench. The saw. The glue. The bucket. Rags. Lots of rags. Then, carefully, one step at a time, start taking things apart until you find the blockage. Assume that it won't be in the first place you look. Keep trying. Eventually, you'll get to something that you can reach in with a glove or a screwdriver or a snake and shove out into your bucket. Cold nasty gunk will gush out onto your glasses and up your sleeve. That's OK. That's part of it, too. Now, put everything back together. Careful. Don't hurry. Don't over tighten and break anything. Have Mrs P turn on the water upstairs. It will leak. You knew it would. That's OK. That's part of it. Gently start tightening things until the drips stop. Turn the water on hard, again. Of course it will leak again. Move the bucket and sit down on the step for a while. When you are calm, snug up the wet joints one more time. Keep it up, carefully, calmly, until the pipes run the way they were designed to run. Flawlessly. Smoothly. Without a second thought.

And wouldn't it be great if you could fix your sick mind with a screwdriver and a greasy scrub bucket? There are many more parts here. Stuff you don't want to lose. If you're smart, you'll learn the difference between a Do It Yourself project that you can knock out in a weekend, and a serious problem that you will make a hundred times worse if you try to fix it without help. And sooner or later, you will need help. You can't just ram a snake through your mind and shove damaging thoughts out the other end into a dirty pail. You need to go carefully. There's a lot of pieces, remember? Things you don't want to lose. Things you love. Things you're proud of. Things you can teach to someone who needs them. Getting rid of a clog of fear means identifying the thing. What is it made of? Loneliness? Failure? Humiliation? Judgement? You can't just close your eyes when you clean our your mind. You have to look at the stuff, like a surgeon snipping out cancer around an artery. You're going to have to see things for what they are. Phantoms. Ghosts. Booger Men that you made up in your mind so your fears would make sense. The Things That Might Happen that overshadow the things that actually ARE.

Sometimes it takes more than just cleaning out the junk thoughts. Sometimes you have to change the kind of stuff you're putting into your mind in the first place. Look for physical comfort in exercise instead of substances. Find stimulation from carefully crafted ideas instead of cynical sound bites. Embrace the creature God made you to be, instead of struggling to become the fictional character you think will please someone else. Will yourself to ask for help instead of insisting on going it alone. Replace self-loathing with self-respect.

And that's how a greasy clog taught me the way back to sanity. It isn't going to be easy. Pipes are going to crack and leak. My shirt is going to get ruined. Dinner is going to be late. But if I am careful... and humble... and gentle... and loving with myself, I will be able to clean away the phantoms and ghosts that are blocking my mind. I'm going to make mistakes. I'll probably lose some things that I treasure along the way. I may even feel like I'm going backwards, sometimes.

But I believe in that dying man on his bed who dreamed of running a marathon. I remember him. He was barely awake, but his mind was clear. He knew why God had created him, and he didn't let anything else pull his attention away from that purpose... not even death.

Here on my bed, when I look out my window, I see men and women with cancer. Some of them are dying. Some will beat it. Some are already gone. They are alone and afraid that life is never going to feel good again, that their bodies will never feel like their own again. They are out there, outside my curtains, waiting patiently for me to heal so I can help them find their own way. That's why God saved me. That's why I'm not going to let a sick mind kill me any more than some sick cells could.

Because I need them as much as they need me.

And one day soon, I'll have another tee-shirt in my wardrobe.

One leaky pipe at a time.

Peace,
Pennsy

Fat Man, Heal thy Heel

The low grade soreness in my right Achilles tendon has lasted long enough to get my attention. it isn’t painful, just sore. Warming up usually loosens it up and it isn’t preventing me from working out, though I have had to shorten my stride considerably on the treadmill. I don’t want it to get worse, so I did some homework.

As you can see from this drawing that I found on eOrthopod.com, the Achilles tendon is really big. It attaches the calf muscles to the very short lever at the back of the heel and allows the foot to flex. If you can stand on your toes, thank Achilles. This is one butch rope of tissue.

According to Dr. Stephen Pribut, DPM (that's a foot doc for the acronymically challenged), "Soreness” in a tendon is not something to ignore or "run through". Tendons don’t get sore like muscles do. Tendons hurt when they are injured. In other words, the discomfort I'm feeling isn't the result of normal exertion like when I lift heavy weights and my muscles feel especially "present" the next day. If a tendon hurts, that's not soreness, that's pain. A painful injured Achilles tendon is something to take seriously and requires immediate attention. Otherwise it will just get worse. The tendon can even rupture (tear) and break completely leaving a runner with months of expensive rehab and NO running while the surgically repaired tissue heals. A ruptured Achilles sucks most profoundly.

Like everything else involving health and the internet, there is plenty of controversy about what to do about Achilles pain, but these seem to be consensus opinions.

LEAVE THE MACHISMO IN YOUR LOCKER
Dr Pribut's first instruction is one everyone agrees with: rest. You don’t have to stop exercising, but slow down. Ease up on things that put particular strain on the tendon: Hill running, Sprinting, Deep stretches of the calf muscles. Shoes with too soft a heel can also cause the Achilles to stretch too far after the foot's initial impact when you're running or walking. Running on your toes instead of your heels will wack you up. I think mine may be the result of too long a stride. Shortening up and taking more smaller steps is helping me. This tendon is terrifically strong because it sustains tremendous force, even during something as simple as walking. Like the cable and pulley on a weight machine, the Achilles is always under strain whenever the foot is in motion. So rule one is - go easy .

FIRE AND ICE (AND A NICE RUB DOWN)

In an article in the Jewish World Review , Marlene Cimons (who lacks an acronym, but does her homework) reports that ice after exercise and heat before bed will help control inflamation and relax the gastrocnemius which is a very impressive word for calf muscle. A non-steroidal anti-inflammatory can help - cortisone is wicked bad. Don't let the doc shoot you with it to ease the pain. Cortisone will make you feel better for a while, but it also weakens the fibers in the tendon making it even more prone to tear or rupture.

Massaging the calf can also help. Heel lifts, tape, and elastic braces can get you through the day, but still, only rest will allow the injury to heal.

CAREFUL, GENTLE STRETCHING
CoolRunning has some good stretches for prevention and maintenance for runners. When returning from an Achilles injury, wall pushups and hamstring stretches are especially important. I have had some really bad results from the towel around the foot thing. I think I actually aggravated the injury by pulling too hard. Your mileage may vary.


DON'T CROSS TRAIN AT CROSS PURPOSES

The amazingly named achillestendon.com, recommends some common sense things (stay fit, go easy, check for injury after your workout) and one really interesting one. When you do strength training and run on the same day - run first. Strength training is based on microscopic injury and healing of muscles. Running after weakening your muscles with resistance training just sets you up for further injury.

NO PAIN, NO PAIN

In a wise and funny essay called How Not to Treat and Achilles Injury by a writer named Wiltsey, this advice makes a lot of sense to me:

“Pain sucks”--This might seem obvious, but if it hurts, back off. Cut down your workout to minimal, preferably rest. Although this is anathema to most training athletes, better to miss a couple weeks than your entire season, like me.

My doctor gave me a simple rule to live by- “Let pain be your guide.” Simply, if it hurts, don’t do it and back off. A good recovery program is a must. Consult your coach, or begin with 5 minute sets of walking and every few days add thirty seconds of light jogging.

Achilles pain is really easy to fix unless you get stupid. Then it's really easy to make really really bad. Take it seriously and take it easy until it gets better.

That's what I learned in school today..

WORKOUT UPDATE
My big meeting concluded on Thursday and I went straight to the gym. I had a lot of steam to blow off.

I did a light warm up on the treadmill, then spent a long time stretching. I’m not noticing any increase in flexibility yet - but I am definitely feeling a much shorter recovery time so I can tell that stretching after warmups and after the workout itself is making a difference.

I worked out with the resistance bands and really tried to hold my form while going as fast as I could, snapping each rep against the resistance of the band. It still feels ridiculous when I do it, but my doubts all disappear the next day when my body lets me know that the exercises have done their work. I’m going to do a session with machines and some free weights on Saturday to measure my progress and keep my chops up.

And I guess I better spend some more time on the elliptical for a while.

Peace,
Pennsy

The Fat Man Rides Again!!

Saturday I got really depressed about not being able to work out. My beloved Mrs P held my hand, wiped my face, and then took me out to the Indian buffet. Nothing lifts a mopey boy's spirits like a good woman's love and all the curry he can eat.

I slept my blues away and on Sunday made my first trip to the gym since the big slip. My toe hurt to bend, but had stopped throbbing. I didn't want to put any stress on it, so I didn't lift weights. That left walking, but I could not imagine the cardio benefit of limping on a treadmill. The elliptical machine remained a mystery to my feet, so I decided to try the recumbent bike.

I figured out how to move the seat and checked out the console. All the trails and mountains and whatnot made no sense to me. How can you talk about miles on a bike that stands still? I finally settled on a program called "cardio" and put Meat Loaf on my headphones. Before I knew it, I was pedaling like a bat out of, well, you know. I spun the pedals for an hour while the console coached "Keep Pedaling!-----Need Heart Rate!---Grab Handles!----Who's Your Daddy?" It was a little weird.

The program adjusts resistance to keep your heart rate at the training level you set, so it has to monitor your pulse constantly. I was surprised at what a good workout it turned out to be. I was not surprised that I could barely move when I was done. I stretched, finished my water, and made my way to the locker room. When I took of my sock, I was shocked. My toe looked like a plum. The bruise went from the joint almost up to the nail and more than three-quarters of the way around my toe. Forgive me, but I've decided to spare you photos.

Monday the bruise had faded, but was still pretty ugly. I made it through the work day without it feeling any worse, and by evening, the bruise was a much less angry color. I went to bed early and decided to try once again to wake up and go to the gym early Tuesday morning.

For some reason, the alarm woke me. Usually I just give it a well intentioned wack on the snooze button, then go back to sleep. Instead I tip-toed out of the bed and made my way to the car. There were a LOT of people at the gym at 6:00! I changed and found an empty bike. This time I had a chance to look around a little. There were not many familiar faces, but plenty of very determined ones. I am continually amazed and inspired by the way the people around me work. I got a chance to really watch some people on elliptical machines and started to make sense of what their legs were doing. Of course, you don't really want to spend too much time watching people at the gym. You start to feel like a stalker.

Work was just painful. The toe was ok, but the legs were screaming. Turns out I still haven't reached that magic place where a workout gives you more energy. The funny thing was, by mid afternoon, I was really jonesing to get back. I went right after work, and lifted weights for the first time in a week. I stepped down the reps and stepped up the weights on all the machines. I also tried the elliptical for a cool-down. It went pretty well, and I felt like I really started getting the hang of it.

This morning I did not go to the gym early, but I felt GREAT all day. Maybe that energy boost is on a delay? After work, I did an hour on the elliptical. I used the "Cardio" program and yes, it was a real workout. On both the bike and the elliptical I could feel different muscles working - especially after I was done.

Right now, I should be in bed, but I'm so happy to be back to work. I just wanted to let you know.

The heart, the mind, and the toe are all bruised but unbroken -- and the healing goes on.

Peace,
Pennsy

The Gospel according to AIDS

The end of all things is near; therefore be serious and discipline yourselves for the sake of your prayers. Above all, maintain constant love for one another, for love covers a multitude of sins. Be hospitable to one another without complaining. Like good stewards of the manifold grace of God, serve one another with whatever gift each of you has received. Whoever speaks must do so as one speaking the very words of God; whoever serves must do so with the strength that God supplies, so that God may be glorified in all things through Jesus Christ. To him belong the glory and the power forever and ever. Amen. Beloved, do not be surprised at the fiery ordeal that is taking place among you to test you, as though something strange were happening to you. But rejoice insofar as you are sharing Christ's sufferings, so that you may also be glad and shout for joy when his glory is revealed.
1 Peter 4:7-13 (NRSV)

As usual, the wisdom of the lectionary amazes me. This is part of the epistle from today's Daily Office.

Today is World AIDS Day. I remember the first article I read in Time or USNews about some sort of "gay cancer" that was killing young men in terrible ways. The connection between the community and the suffering gave license to many of our culture's deepest fears and prejudices. The problem was not the disease - the problem was the behavior. Righteousness distracted us from doing right.

And so many, too many died without the church's loving presence.


Now things are different. Celebrities have kept AIDS in the public's consciousness. Experience has taught us that HIV doesn't just kill gay men. Decades of research have made "living with AIDS" more than just a euphemism. Like so many cruel diseases, there still isn't a cure - but there is more hope and less ignorance than there used to be.

Peter was not writing about a disease, he was writing to a persecuted church who suffered at the hands of righteous people. His counsel? Love one another. Cover one another's sins with the love of God. Be stewards of one another, for the steward of another's heart cares for a child of God. Offer holy hospitality, speak godly words, serve as Christ did, with all the strength God gives you because serving one another gives glory to God.

So much of the church's initial response to AIDS was not about the disease either. It was about sins and sinners. Many offered shame in the place of service - condemnation instead of compassion. As a consequence, the people who needed Christ's church the most were pushed away. Such failure of charity grieves God's heart.

Peter's exhortation to rejoice in suffering is a tough pill to swallow. On the one hand, we feel ashamed to compare our suffering to Christ's. At the same time, few of us are faithful enough to keep our eyes on Jesus when our own bodies or minds are in pain.

A friend of mine who lives with deep depression episodes once told me that the one thing that comforted her at her darkest hour was knowing that the darkness would not last forever. Our suffering, and the pain of those who love us is not an eternal curse. In the glory of God our trials will come to an end.

While Peter seems to joyfully anticipate the end of the world, he also gives good counsel for the time between now and then. As long as it is possible to glorify God, it is possible to rejoice, even in our own brokenness.

As they were leaving Jericho, a large crowd followed him. There were two blind men sitting by the roadside. When they heard that Jesus was passing by, they shouted, "Lord, have mercy on us, Son of David!" The crowd sternly ordered them to be quiet; but they shouted even more loudly, "Have mercy on us, Lord, Son of David!" Jesus stood still and called them, saying, "What do you want me to do for you?" They said to him, "Lord, let our eyes be opened." Moved with compassion, Jesus touched their eyes. Immediately they regained their sight and followed him.
Matthew 20:29-34 (NRSV)

The blind men in today's gospel remind me of two things - persistence and faith. I have had friends who refused to let the disease define them. They were not victims of HIV, and they did not allow themselves to be labeled as people with AIDS. They found the courage to insist on living - the virus was incidental, not central to their lives. Their strength and will to go on was not a cry for mercy, but a demand to be allowed to exist. Like the blind men from Jericho, they refused to be discouraged or shouted down. They knew that Jesus would feel their suffering. They believed in life, and many of them believed in Jesus. Though their bodies failed them. their faith never did, and I believe Jesus never did either.

Our compassionate savior suffers with us and desires the health of our hearts as well as our minds and bodies. My friends' hearts are no longer under my stewardship, they are in the arms of Jesus. I pray that God will judge my service to them to have been faithful.

Peace,
b

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The beautiful portrait of Jesus is by horseman. Please visit http://www.jesusweptart.blogspot.com/