Have you been to confession lately? Fr. Pavone is human, and like you, he is capable of sinning. Like you, he is capable of acting in willful disregard of the law of God. He’s also, like you, capable of acting in culpable ignorance. We who view from the outside cannot know the state of Fr. Pavone’s soul; we can, however, inform our consciences to the point that we can perceive when an objectively sinful act has been committed.
Now it is likely that in his tactics Fr. Pavone sinned against the virtues of prudence and temperance; certainly his bishops have found it so. For the remainder of this essay I’m setting that aside, already dealt with extensively elsewhere. We are going to look only at the sin against the cardinal virtue of justice. Did Fr. Pavone give God His due?
What is the Purpose of the Altar?
In our spiritual lives we often invoke the image of the sacred altar. We speak of uniting our sufferings with Christ on the Cross, and Christ in the Holy Sacrifice of the Mass. When we offer up a Mass for a given intention, we might say that we placed that intention on the altar. You’ll often notice when you attend Mass that the priest will have a card right there on the altar reminding him of the intention for that Mass.
Thus we can understand how someone — anyone — might have the natural instinct to place some significant object on the altar in an act of devotion and offering.
To avoid sin, however, requires obedience to supernatural instincts.
The altar of the Mass is the place where heaven meets earth. We who enter a Catholic church are entering the Holy of Holies. We are people who, at the moment of the Consecration, see God and live. We are so used to this sacred privilege that we forget how unspeakably privileged we are. The daily duty of caring for the parish church can create an over-familiarity with sacred things, to the point that we start to forget they are honest-to-God sacred.
Our Strength is in the Lord
Time and again in the Old Testament, we see the Lord do valorous deeds for the people of Israel. That miraculous action didn’t end with the Incarnation: We can cite miracle after miracle in the long history of the saints down to our present day. These miracles are not mere emotional adjustments. God acts in the physical and social world, at times miraculously delivering physical healing, political victory, and military protection.
These miracles happen not on our schedule but on God’s. They also follow a pattern, and it’s a pattern that illuminates the nature of Fr. Pavone’s error. Step 1: We turn to God for His miraculous provision. We acknowledge our complete dependence on God’s saving hand, and abandon ourselves entirely to His divine will. Our help is the Lord who made heaven and earth. Step 2: God intervenes for the good of His people when and how He pleases.
In the beginning there was God, and then He made heaven and earth. The sacred altar belongs to that First thing. It is a holy place set aside for the Presence of God in the shockingly same way God Is, outside of all time and space.
Righting the Sacred Order
God wills the protection of all innocent lives. He wills an end to abortion. It is the desire of God that men would freely act to end this atrocity. It cannot but be the desire of God to come to our assistance in the work of protecting and defending the most vulnerable among us. These facts are incontrovertible.
We must charitably assume that Fr. Pavone’s recent actions were motivated by a sincere desire to serve God. All the same, he committed an act of sacrilege. We can defend him with mercy, for who among us is not also a wretched sinner, but we can’t defend his action with approval. To do so would require contortions along the lines of proposing that first God made heaven and earth, and then the next day He Is.
No no no. It must always be the other way around. It is unable to be otherwise.
The objective gravity of Fr. Pavone’s sin was in putting a second thing first. He failed to remember the supreme sacredness of the altar.
You have probably done that once or twice, if only in thought if not in word or deed. You may have heard about, if not witnessed yourself, reprehensible violations along these lines committed by clergy and others who ought to know better. We humans are woefully fallible.
Mercy and Reparation
Fortunately, there are remedies. Begin by forming your conscience as to the sacredness of the altar of the Sacrifice of the Mass. If you do not live in a parish where the sacred altar is treated with due reverence, make a pilgrimage to a place where it is. Lex orandi lex credendi.
Then proceed with prayer and fasting for the reparation of every rent in the sacred relationship between God and man. Contemplate our Lord’s mercy on us sinners. One of the missions of Priests for Life is bringing healing to those who, knowingly or unknowingly, committed a grave offense against God and man in the act of abortion. As it is for abortion, so it is for every sin: No one who desires to repent is beyond the reach of the Lord’s infinite mercy.
FYI for those who are wondering about my recent absence from this blog and social media, no, I haven’t been extra prayerful in advance. I switched around my schedule to very good effect, but have ended up not quite making it to the PC at the end of the day. More blogging is on the horizon.
Among conservative Catholic Republicans on Facebook, there’s a meme being passed around that keeps ending up in front of people like myself and Scott Eric Alt, though neither of us can possibly be the intended target. The argument is that the popularity of novels such as 50 Shades of Grey proves that women don’t, in fact, object to Donald Trump’s lewd behavior; any objections are political calculus.
Oh yes. And I opposed him, and criticized him, at the time. Anyone else who did so must, in order to be morally consistent, do likewise with Trump. If you don’t, it just sends a message that you never really cared about sexual abuse of women, but were just appropriating morality in order to make your opposing team look bad.
Before my next sentence, let me reiterate: I do not think you should vote for Donald Trump.
Next sentence: There is some validity to the observation that Donald Trump’s lewd behavior is indeed representative of the American public at large. I said so here. This is a representative democracy, and our two candidates do in fact represent America.
Dear friends, if Hilary Clinton or Donald Trump represents you? You can change that.
You can’t change the candidates, but you can change yourself. You don’t have to be a person who winks at sin. You don’t have to be a person who creates convoluted defenses of BDSM. You don’t have to be that person who justifies exposing kids to porn.
You can stop that now. You do not have to be enslaved to the person you were yesterday.
Pro-life friends, another minute of politics: When people give sorry mealy-mouthed justifications for voting for a pro-abortion candidate by explaining that solving poverty or immigration or global warming will somehow fix abortion, those people are dangerously deluding themselves. There exists a hierarchy of priorities, and cold-blooded murder is a far graver and more pressing issue than good roads or good tax policy. When someone says I don’t like abortion but I’m voting for the person who advocates tirelessly for abortion, what I hear is: Actually, I’m fine with abortion.
I understand, therefore, the Republican Impulse.
I have grave reservations about Donald Trump’s sincerity on pro-life issues, however, because his life is one long series of promotions of the actual, real-live causes of abortion.
Food stamps don’t cause abortion. Adultery? That causes abortion.
Quick aside on modesty.
When people like me talk about “modesty” we tend to hit a few topics related to girls’ clothing. That matters, of course. But for those who are trying to get their heads around about what immodesty looks like in someone who is neither female nor scantily-clad, Donald Trump is the poster boy. He models immodesty not just with regards to sexuality, but also with regards to wealth, power, and personal accomplishments.
It is easy to excuse his unseemly boastfulness by saying that he needs to prove his leadership potential or share his legitimate accomplishments with voters. Not so. It is possible to communicate one’s ability to lead without behaving immodestly.
Below in the links I include some examples of SC’s governor Nikki Haley in action, for other reasons. But in her hurricane Matthew press conferences, she’s a vivid example of the counterpoint: A leader who is both a strong, decisive, competent leader, but who also conducts herself with modesty.
Link Round-up. Here are all kinds of loosely related links. At the bottom are a few of mine, but first here’s the pile I extracted from my reading list.
Many young conservatives have been disheartened to see the leaders of their movement endorse Donald Trump. I am one of the disheartened ones. Let me explain what these leaders taught me and why their endorsement of Trump betrays those principles.
5 years old – In my own backyard. I was stopped by a man in a car in the alley behind my house who showed me “what (he had) in his pants” and then offered me the opportunity to put my mouth on it. I declined but never told anyone because I had no idea that it was anything but just gross. . . .
12 years old – On my paper route, I was collecting for the monthly bill. An old man who had been very kindly toward me and had several grandchildren that he looked after, grabbed my breasts (which were more impressive than they were when I was 8) and humped me. He told me I was a good girl and he’d take good care of me. I quit carrying papers that month. I never told anyone because I figured that no one would believe me. . . .
(Tip: If you skim ahead to the Q&A’s with the whole executive branch team, a few of the press conferences contain striking examples of the linguistic diversity among educated, standard-English speaking southerners. And that’s just a beginning. Armchair linguists, this place is a treasure trove.)
A friend of mine attempted to defend Trump by pointing to his daughter’s respect for him and saying that he must be a good father. I don’t care what she says. I don’t care how marvelous he was every single time he was with her. Owning strip clubs makes you a bad father. Being a serial adulterer makes you a bad father. Treating women like objects for your sexual gratification makes you a bad father. And it will make him a bad president.
But 2016 is a year in which two prominent Catholics – a sitting vice president, and the next vice presidential nominee of his party — both seem to publicly ignore or invent the content of their Catholic faith as they go along. And meanwhile, both candidates for the nation’s top residence, the White House, have astonishing flaws.
This is depressing and liberating at the same time. Depressing, because it’s proof of how polarized the nation has become. Liberating, because for the honest voter, it’s much easier this year to ignore the routine tribal loyalty chants of both the Democratic and Republican camps. I’ve been a registered independent for a long time and never more happily so than in this election season. Both major candidates are – what’s the right word? so problematic – that neither is clearly better than the other.
And to close, here’s my report from the field on how our Trump-Clinton society plays out among middle schoolers. In Sexual Bravado vs. Sexual Maturity, I share some of the real-world evidence parents like to ignore, then discuss the underlying issue:
In our popular culture, sex-status is the big thing. The kids have learned from their parents that the purpose of sex is to gratify one’s desires, and that a girl’s worth is measured in sexiness. The kids have adopted that philosophy wholesale. . . .
. . . Why is there such a market for teenage girls in a sleepy Bible Belt town, to the point that pimps are willing to risk kidnapping charges and worse in order to abduct upper class girls and sell them locally?
You can almost hear the eighth grade boys scoffing at those pathetic men who have to pay for what they can get the girls to give them for free.
There is no magic remedy that will guarantee your teens will live chastely and stay out of harm’s way. But you can be certain that if your understanding of human sexuality is all about the quest for gratification and sexual status, your children are going to learn that from you.
A little living history: You can see the I-26 lane reversal in action by going to http://www.511sc.org/ and selecting the traffic camera you’d like to view. Each camera icon will pull up a list of nearby camera locations. Click on the location you’d like to see, then hit the “play” and “fullscreen” icons.
I’ve noticed some of the locations are a little glitchy — I assume everyone and their brother wants to see I-26 westbound at I-526 (except, of course, the people who have to be driving there), so that one’s not functioning at this writing. But there are other locations of interest.
Admit it: It’s pretty crazy seeing the westbound traffic on the eastbound side of the interstate. Quit acting all nonchalant. Just because we make it look easy doesn’t mean it isn’t epic.
SC State Flag courtesy of Wikimedia, Public Domain.
And in that moment, I can tell by her face that no one has updated the chart. It still says Conversion on the line for diagnosis. Nobody has put in the test results and new diagnosis from last October. I can see it as plainly as I can see that her eyes are brown. We’re still suspect, and this still isn’t over.
Feeling proud about what I had accomplished through daily exercise, I shared my marathon story with one of the intern doctors who was assigned to me. Rather than congratulating me, he basically accused me of faking my asthma. His words were ” There’s no way you could’ve walked a marathon if you have severe asthma.” I found out later that in my chart he actually wrote, “patient presents with factitious asthma, claims he walked a marathon“. That probably explains why some of the nurses were treating me so strange during the hospitalization. A rumor had spread that my asthma was very mild and probably psychosomatic in nature. I remember some of the medical staff trying to convince me that my breathing difficulties were all in my head and that I had some kind of generalized anxiety disorder. Are you freaking kidding me! And even scarier, this happened at a well respected teaching hospital.
That incident caused me a lot of grief and took over 3 years with lots of letter writing by my pulmonologists to have that false information removed from my medical record. The reality is that these are the kinds of screwy preconceived generalizations that people have about the way sick people should look and behave. And if I want to be completely honest here, there have been times when I’ve guilty of the same.
For background: Gaudet is a respiratory therapist who is treated by one of the top pulmonologists in the nation.
Just about every Dysautonomia patient with whom I’ve spoken over the last few years has, at one time or another, been told that the symptoms they were experiencing were all in their head. Diagnoses such as Anxiety disorders, Depression, Conversion or Somatoform disorders, and even Bipolar disorder are haphazardly applied to patients when no clear aetiology can be discovered to explain their symptoms. Normal reactions to abnormal situations, and purely medical/physiological symptoms are over-pathologised or misdiagnosed with alarming regularity, and to the detriment of the patient.
When unfounded these diagnoses leave a mark on the patient, a wound which if left untended will follow and influence all future relationships with the medical professionals. It also leaves a glaring mark on medical records that will be incorporated into future investigations and the overall diagnostic process. Even when unsubstantiated or proven to be untrue following psychological assessment, it can prove extremely difficult to remove such diagnoses from a patient’s medical file.
It is possible that what may be interpreted as “red flags” of Munchausen’s may alternatively be attributed to the demands and anxiety related to care of a very sick child. For example, anxious parents may not give a good history, or may “doctor shop” because they are unsatisfied and may be unhappy with the care their child is getting, especially when they feel that no one can actually diagnose, treat or understand the problem. Certain conditions, especially mitochondrial disease, will present with intermittent symptoms, and it will take a skilled and patient clinician to arrive at the right diagnosis – one that is an illness not Munchausen’s by proxy.
Psychologists have described that the population of patients and parents of children with Mitochondrial Disease are much more vulnerable to a false Munchausen’s by proxy accusation simply due to the nature of the disease. In fact, a hallmark characteristic of mitochondrial disease is the presentation of several unrelated symptoms that together, “don’t make sense”. Clinicians who feel that a parent is intentionally making symptoms appear, is behaving to insure that the illness continues, and consults multiple physicians may suspect Munchausen’s – but should still “trust, then verify.” In other words, believe the parents, run appropriate diagnostic tests, seek the input of every part of the child’s team, and take very seriously the responsibility to the child to act as an advocate and do no harm.
Non-psychiatric misdiagnoses happen, too, of course. It is frustrating when a physician (or team of physcians) flubs a diagnosis through honest error — we humans aren’t ominiscient, so it’s bound to happen. It’s galling when the misdiagnosis involves dismissing serious serious symptoms as some much more benign illness that doesn’t fit with the case history. But pushing off a poorly-substantiated mental health label on a patient with an atypical presentation is both physically and emotionally harmful to the patient.
Unfortunately, this dangerous habit is actually enshrined in medical practice.
I Guess You’re Just Nuts, Then?
Many misdiagnoses are just idiocy. Some popular lazy-diagnoses include fibromyalgia, depression, and anxiety disorders. All of these disorders have specific criteria you can use to evaluate yourself (or your patient) and see if they apply. It’s almost helpful when a physician throws out with confidence, “I think it’s probably just ________” and inserts some illness utterly outside his or her specialty, and which a quick Google search would immediately rule out. Then you know you have a stupid doctor, done. It’s wearying, and can put you off the medical profession for a while, but it’s possible to come to a definitive conclusion one way or another.
There’s at least one mental health diagnosis, however, that can’t be ruled out by logic and good medicine.
Conversion Disorder, which is what Ella Frech was persistently misdiagnosed with (despite presenting with symptoms of a known side effect of one of the medications she was taking), is where modern medical practice bares its hubris.
Many of you would argue that I didn’t go nearly far enough- that there should be no ‘Somatic Symptom Disorder’ at all in DSM 5 because there is no substantial body of evidence to support either its reliability or its validity.
. . . I am sympathetic to this view, but realized that it would have no traction with the work group and chose instead to lobby for what seemed to be clearly essential and relatively easy changes that would solve most, if not all, of the problem.
. . . My letter cautioned DSM 5 that it was invading dangerous territory. Here was my warning to the DSM 5 work group:
• ‘Clearly you have paid close attention only to the need to reduce false negatives, but have not protected sufficiently against the serious problem of creating false positives. You are not alone in this blind spot—in my experience, inattention to false positive risk is an endemic problem for all experts in any field. But your prior oversight needs urgent correction before you go to press with a criteria set that is so unbalanced that it will cause grave harms.’
• ‘When psychiatric problems are misdiagnosed in the medically ill, the patients are stigmatized as ‘crocks’ and the possible underlying medical causes of their problems are much more likely to be missed.’
• ‘Continuing with your current loose wording will be bad for the patients who are mislabeled and will also be extremely harmful to DSM 5, to APA, and to your own professional reputations.’
I also raised the point that this could lead to a boycott of DSM 5. Pretty strong stuff, I thought. But totally ineffective.
Somatic Symptom Disorder (which is the umbrella term in the current terminology under which Conversion Disorder falls) is thus a particularly hazardous diagnosis because it has no symptoms of its own.
It is literally a disorder whose defining symptom is, “We the physicians don’t know what you have. Therefore, it must be psychological.” This is an awkward assertion for a profession that has evolved more in the past century than any other field of human endeavor. The developments in medical research just in the past twenty years are astonishing and marvelous. My children’s high school biology textbooks are utterly different than mine, because the depth and scope of our knowledge about human cells and the chemistry of the human body is orders of magnitude past what we knew a generation ago.
It seems, therefore, ludicrous that any sane person could hold that our knowledge of medicine is now perfectly complete. But this is the implicit assertion of somatic symptom disorders.
I sometimes joke that idiopathic means that you and your doctor both agree the other person is an idiot. But really it just means we don’t know. That happens. Humans aren’t all-knowing. What is the sane response to ignorance? It isn’t to fabricate some fanciful explanation to cover over your lapse. The sane response is to humbly admit, “I’m sorry I don’t know.” And, where the stakes are high, the sane person adds, “And we should keep investigating until we get a solid answer.”
The kids started school! 3/4’s are being farmed out to TOTAL STRANGERS, and 1/4 is home with me, thriving in the silence that comes from emptying the house each day. So I was offline for a bit, focusing on the transition and all that.
Then 1/4 of the children came down with the wicked nasty evil virus you don’t want. Thank goodness it was the homeschooled child, I think I would have cried if I had to pull a kid out of school for a week with an uncontrollable fever during the child’s first week of school ever ever ever. Instead: Documentaries were watched.
Then 1/2 of the parents caught it (me). Not as badly, actually! More tropical depression than cat 5 hurricane.
So all that sucked up three weeks right there! Whoohoo!
I’m doing better now, thanks for asking, but am having to catch up on all the regular-life business that got neglected, and continue the transition to school year activities. (Example: This week, I’m going to REMEMBER THAT ORCHESTRA STARTED and actually bring my children! That will be neat! Teachers love it when you do that.)
That’s all I’ve got time to say now. Headed to Adoration this afternoon while a child is at PE, and as always I keep my readers in my prayers! I will write soon, I think.
PS: Let me just say that if you have the option of sending your child to a good Catholic school or a good Catholic homeschool? Do that.
Fittingly, when I made that observation I was laying in bed with the iBreviary resting on the mattress next to my face, just barely awake enough to pray. I might be saint-material yet. I’ve got the “before” thing going on, anyway.
Photo via Wikimedia, CC 2.0. This week finds me in greater metro Portland, OR for my niece’s wedding. We went to the coast, where there were no seals, but I have been doing my best baby-seal imitation in my sister’s backyard since I got back. Little icons of the apostles, that’s what we baby seals are.
What’s with the radio silence? Let me just tell you.
But first, the reason I’m breaking it: My friend Sarah Reinhard asked me to blog on Theology of the Body stuff in the lead-up to this fall’sTheology of the Body Congress, which you should attend if you have the opportunity. The line-up of speakers is stellar, and yes I would go myself if I possibly could. So put that on your calendar.
The expression Theology of the Body among Catholics is a bit of a code word for, “Let’s talk about sex now.” I usually stick to code on these things. But there’s more to your body than just the parts and processes that make you a boy or a girl, as Susan Windley-Daoust will remind you periodically. I’m going to write not-about-sex today, and come back to racier topics here and over at Patheos in the next few weeks.
Now back on topic. A little Applied Theology and the answer to the question, “Why on earth has Jen Fitz completely dropped off the internet?”
Short answer is: I’m not doing as well, physically, as I would need to be doing in order to both take care of my primary vocation (marriage, parenthood) and this secondary vocation as a writer. So first things get to be first, and the rest has to wait.
The very, very, long answer:
But here is something completely cool, because God is like this: Just in time for me to have something someone really wants me to write about (instead of just me running my mouth off, which is my usual niche), I can totally sit at the computer and not be light-headed! Isn’t that cool?! I keep forgetting this new fact, and thus my e-mail is way behind. June was a pretty long month, computing-wise.
I theorize in part it was positional, which means I probably need to rearrange the workstation. Here’s an interesting link about cartoid sinus hypersensitivity, which might cause you to suspect I’m really an old man just posing as a pleasantly-plump middle-aged housewife, but you’ve seen the photos, so whom do you believe? Sports Illustrated or my cartoid sinus barocepter? Anyway, my parlor-trick for June was that I could drop my pulse twenty points just by, um, taking my pulse. No true cartoid sinus massage needed, just touch the thing.
It quit doing that, though, as far as I can tell.
Some other interesting body-things for this summer:
Dang it I can’t talk anymore again. The speaking-part works fine, don’t panic, it’s the getting light-headed while I do it that is at about 80% of the time. This is pretty common in tachycardia-themed autonomic dysfunction. (POTS people talk about this all the time in conversation, even though it never seems to make any list of medical descriptions, not sure why there’s that disconnect in the medical literature.) 80% isn’t 100%. On a good day I’m completely normal, on a lousy day I’ve given up even lip-syncing at Mass.
–> Autonomic dysfunction creates these weird eddies of backward expectations. Mass is pretty much my least pleasant activity, because it involves sitting still then standing still, with positional head changes (bad — I keep being reminded not to bow the head, just don’t do it), combined with talking. So on a miserable Sunday I can feel extremely overwhelmingly bad by the end of the hour. But because the problem is not at all with my heart’s ability to pump blood or my blood’s ability to hold oxygen, I’m the person who’s desperate to lay down while standing still, but will then escape without difficulty at full speed to the car and feel better as a result of the vigorous activity.
Basically I have this cardiovascular problem that makes being still feel worse and being active feel better.
Patients might be able to muster adequate energy for periods of time but it is usually short-lived and they tire quickly, not unlike a battery that discharges too rapidly. . . . A period of rest or sleep is generally required before energy levels are restored. Following rest a patient may demonstrate apparently normal stamina and a clinician will not detect weakness on examination . . . .
This is me completely: Do something, then flop on the floor utterly exhausted, and then in a bit I’m fine again. Happens hour-by-hour, and then also from day-to-day. More on that below.
I don’t know whether or not I have a mitochondrial disorder (very difficult to diagnose) but I get this, too:
Impaired oxidative phosphorylation [don’t know my cause] not only causes muscle fatigue but also muscle cramping with or without tenderness, or a feeling of extreme heaviness in the muscles. These symptoms are especially severe in those muscle groups being used, and patients often complain of discomfort in the legs or even muscle spasms.The discomfort may be felt immediately following the activity or later on, waking up the patient from sleep.
Funny story: I mentioned to a relatively new acquaintance that I’m prone to decrepitude, and the question she asked was, “So are you basically in pain all the time?”
The answer is that at this writing, no I am not. But I have picked up what is turning out to be mild-but-intractable intermittent pain (in my legs, if you’re curious), and yes it keeps me from sleeping well, and yes, I’ve tried all the things, and the things help quite a lot. (Other than deep breathing to relax, like the kind that works so well for childbirth — used to be my go-to, but now it just gives me a headache. Which stinks, because it’s a good method if your autonomic nervous system functions properly.) But I think it’s very funny because the words “every day” and “intractable” do apply even if the pain itself is not very bad. So if you use those adjectives, it sounds way worse than it is. I think most other people can also use those adjectives.
[By “intractable” I mean “intractable using means that don’t require a prescription.” I haven’t gotten around to being bothered enough to plead for the good drugs. So no, nothing to worry about at this time.]
And this cracked me up, because every receptionist I’ve ever met knows this about me now:
Exercise intolerance is not restricted to the large muscle groups in the body but can also involve the small muscles. Writing can be a challenge; too much writing leads to fatigue and/or cramping or spasms. The quality of penmanship can be observed to deteriorate over the course of a writing assignment with letter formation becoming more erratic and messy.
This is why you don’t want to receive handwritten correspondence from me. Nothing new, story of my life. Interestingly, I always take handwritten notes in classes, and if I don’t have a computer I’ll do my other writing longhand — but the writing degenerates fast into this baseline scrawl that’s just barely legible to me, and only because I already know what’s written there. Once it gets down to worst-level, I can sustain it for a long time.
And one last one which caught my attention, from the same source:
. . . Debilitating fatigue can occur with infectious illnesses, may outlast the other symptoms of the infection, and the recovery time can be very prolonged.
This thing I hate. I never know whether a cold is going to cost me a few days or six weeks. Weirdly, I used to go into nasty bronchitis every few years following a cold, and knock on wood that hasn’t been a problem lately. I just get all the fatigue. (Um, and I always have a cough. So, gosh, I don’t know. Don’t make me laugh and we’re good.)
Exercise does help. The supreme challenge is in figuring out how much to do. Too little, and you sleep poorly and lose conditioning. Too much, unfortunately, is not evident during the exercise. I can work out and feel great and be sure I’ve figured out a great balance between rest and exercise, and then at the end of the week completely collapse and require days and days of recovery before I’m functional again.
–> The convenient thing here is that I can in fact borrow time. If I know I want to be up for something, I can plan ahead, build up reserves, stretch them during the event through the clever use of pharmaceuticals, and plan to pay back afterwards. Difficulty being that the mortgage interest is steep. There’s no getting more out of the body than it has to give.
The inconvenience is that all the things I do are exercise, but some exercises are more valuable than others. So if I want to work on my core muscle strength, which is key to preventing the injuries to which I am prone, then I have to not work on helping you out with that thing you wanted me to do. Your thing is also exercise, but it’s a lower priority exercises, so out it goes.
Yes, I tried that thing you suggested.Not being snarky there. I’ve had a number of good friends recommend possible ways to improve the situation, and some of the ideas have been very helpful. (Even if the idea came after I’d already come across that suggestion and tried it, and thus could immediately report, “Yes! Thanks! That does help! Excellent idea, glad you mentioned it!”) Some things people have suggested and that I tried did not help for the reason proposed (I am not, for example, allergic to wheat) but do help for a different reason (minimizing wheat products makes more room in the diet for intensely potassium-rich foods, which help a ton).
So a thing that’s got me occupied this summer is obsessively managing all the micro-factors that can make the situation as better as possible. I think (but can’t be certain) that I’ve got the diet tuned to a spot where I can happily live off the things I seem to do best with, but also get away with deviating from the Ideal Thing at food-themed social events and no disaster ensues. If all that proves to be true, I’ll chat about it later. It might be just lucky coincidence.
Meanwhile, here’s the surprise of the summer:
It took me a long, long time to figure this out. Here’s the difficulty: The heat doesn’t bother me.
I live in a warm climate. I don’t mind being sweaty. I know how to dress for the heat, how to acclimatize as the hot season arrives, and how to get the most use out of a hot day. Since I cultivated these skills, I’ve never had any difficulty with the heat whatsoever, other than some mild irritation about the truly obnoxious portion of sauna-season, which you just have to deal with and move on. I even know the trick about watching for Seasonal Affective Disorder when the heat starts getting so annoying you hide indoors despite yourself. (Same solution as per winter – bright light & vitamin D).
The problem I had in figuring out this one is that (a) I’m still functional above the temperatures when people from up north start whining profusely, (b) I still don’t mind the heat or being hot, and (c) since I have any number of other things that also make me feel terrible, it’s not like I was able to say to myself, “Gee, I feel wonderful all the time except if I’m someplace hot.”
It’s a perfectly manageable problem, it just came as a bit of a surprise. Amusingly, my cold intolerance is getting worse, too.
The hardest thing: Not being able to concentrate. Since I’m a master-complainer, I don’t know that we’d call this my “chief complaint.” But it’s certainly my loudest. As in: If I told you I NEEDED the house to be QUIET so I could do this thing, that’s what I meant so please go OUTSIDE. This is the #1 reason I haven’t been writing. I’m home all day with four kids. There’s noise. There are interruptions. Note that my entire career as a writer has been carried out under these exact same conditions.
What happens therefore is that I drift through the day doing tasks that are super-easy, and then if I find myself in some unexpected situation like trying to cook while other people are in the room, it’s alarming to everyone just how badly things go (until I communicate my distress so emphatically that everyone goes and hides). And then I go back to easy things, and wonder why things that take my full attention just never get done.
So that’s the answer to the perennial, “How’s it going, Jen?” topic on this blog. I’ll emphasize here that as much I just used my crotchety trans-old lady powers to moan about the ailment for very many words, it’s not as bad as all that. But here’s a story that sort of sums up the situation:
Yesterday I was halfway through this post when I had to leave and get ready to go to a social thing at the lake. Sunday had been horrible, Monday was not that great, and Tuesday wasn’t impressing me. I was only going to this thing because (a) I wanted to go to it, and (b) my kids really, really, really wanted to go to it, and they’d done all the things I told them they had to do if they wanted to go.
So we went. And I was fine. Dreamy fine. No problems. Felt completely normal for the full three hours I was there, conversing, walking around, standing around, watching kids, etc. Some of the time, I’m completely, totally fine.
Moments like that can make you think you’re crazy. Maybe I just need to relax at the lake more often? Two reality checks:
Part of being fine was that I aggressively managed as many factors (fluid intake, electrolytes, staying out of the direct sun) as I could.
If it comes as a surprise to you that you went to an enjoyable, relaxing, time-limited social event and had no experience of illness during all three hours, probably the fact that this was an unexpected occurrence tells you something.
So we can add this to my list of signs something is not normal: If you get to where it’s a surprising occurrence when you feel well, we can infer that there’s a problem.
And dang my legs were like lead when I dropped a kid off at VBS this morning. So yeah, CAWOG. I’m rolling with it.
I figured since this was the All About Me post, if you made it this far you’re the type of person who wants to see my new haircut. (Hi Mom!) The third one is me posing in front of the dog’s blanket, which is still hanging up to dry on the screen porch a week after I told a kid to put it there. I guess it’s dry now. But I needed the contrast because I kept getting photos where the new haircut looked exactly like the SI photo shoot.
First the backstory, from my post-pulmonology report last Friday, which some of you have already seen on FB:
. . . A pulmonary stress test is actually kinda fun. Until you hit your anaerobic threshold. But then they stop. So, fun.
Why fun? Because you have no clues. Especially after they take your glasses away. No real feedback on how hard you are going, so no depressing awareness of how hard you are breathing at pitifully minimal efforts. And hard exercise does feel good. Also, they ramp you up fast – just a minute at each level, so it’s over pretty quickly.
. . . Dr. M thinks it’s probably tachycardia of unknown origin, maybe caused by the special kind of hyperthyroid that doesn’t show up on the initial screen for thyroid stuff and for which I have none of the symptoms other than tachycardia.
He also vaguely mentioned “stress”, which people always feel compelled to mention. Funny story: A good friend in passing made reference to the “scare” I’d had this spring. And though I don’t quibble with word choice in casual conversation (because: casual conversation, don’t put deep meaning into offhand comments) . . . I was thinking to myself: I wasn’t scared. It doesn’t count as a “scare” if you aren’t scared.
To clarify: the prospect of dying is intimidating, because that is well known for its unpleasantness. And I’m a total whiner about unpleasantness, so long painful illnesses, no thank you. But actual death — the part that comes after the unpleasant part? Sure, I have a healthy concern for the state of my soul, no presumption there. But I’m also aware that it’s not like I’m suddenly going to get amazingly holy when I turn 85, either. Pray for the gift of final perseverance, do your best to report for duty at holiness-school each morning, not much else for it.
But I always find it comical when someone (as was not the case in this comment, I don’t think, it was just a random word, not a deep thought) gives me the emotional pat on the back because surely I’m so anxious about xyz situation, and I’m thinking . . . you get anxious about this stuff, but I don’t. Weirdly, no one ever reassures me about the things that do make me anxious.
Continuing with the pulmonology update:
. . . We ruled out weird variant asthma pretty roundly. Lung function better after exercise than before. Hard not to like that. Hereby excused from the evil dreaded methocholine test. Victory.
. . . More or less ruled out structural heart things, because O2 sats never dived, which they will if you have, say, a valve problem that occurs under load.
. . . So the new experiment is to try a beta-blocker to bring down the heart rate, see if that works and thus allows me to do normal things (like: exercise!), without dropping the BP so low I do abnormal things (like: faint!). As experiments go, I’m good with this one, because prescription = $3.38 at Walgreens. I’d spend a full four bucks on this if it came to it.
Drug in question is propranolol, picked because you can take it selectively (such as before exercise) rather than all the time. Little pink pill.
So I got home from Mass today, tired tired. Not super-bad tired, but not perky. I don’t do perky very much lately. Took pink pill at noon, ate lunch. 1pm decided it was time to do a test and see if this thing worked. Spouse asked me how I felt.
“My head feels a little funny, but that could be whatever.”
“What do you mean, it feels funny?”
“Like I want a beer and a coffee.”
“So it could just be Sunday afternoon?”
Took my pulse before I went out, and it was bobbling around in the “normal” zone, 70’s-80’s, which is about as good as it ever gets. Walked down the street to the track at the school. Walked a mile and some.
Yeah. A mile and some.
No super fast, but not slow either. Wasn’t tired. Not at all. Not short of breath. Chatted with a lady about her puppy towards the end of that mile.
Made myself come home so I didn’t give myself some @#$%^& injury from over-doing it. Back home again by 1:30, so I was in that normal walking-speed range, which I would not normally consider a fitness-y pace by any stretch of the imagination, but I figured for someone who last took a walk in late January, start easy. HR stayed below 120 the whole time. Not out of breath. At all.
–> In contrast, Friday afternoon on the treadmill, after two minutes of walking, one minute at 1.0 mph and one minute at 2.0 mph, my heart rate was at 126 and I was already feeling like I was exerting myself.
So then, sit-ups.
I check in with the spouse when I come in (not winded, at all, or tired, or anything), and then since I’m restless but determined not to do anything really stupid, I decide I’ll sneak back to the bedroom and do some sit-ups.
[This is my favorite exercise because there are only muscles involved. So I can do them without injuring things. All the other exercises involve tendons and nerves and who-knows-what, and I’m constantly on the brink of pulverizing something. I have good muscles but bad everything else. Sit-ups I can do. I love sit-ups.]
So all spring the routine goes like this:
Lay down flat on back, wait for pulse to come down to the low eighty’s.
Do a set of ten, or maybe even twenty if I’m feeling crazy. Be totally winded.
Wait a minute or two for HR to come back down.
Do another set.
Wait another minute.
So it takes like 10 or 15 minutes to do 110 sit-ups, because otherwise I’d explode.
Except today: Wonder drug. I go back there. Do fifty, pause for ten seconds because: muscle burn. 30 more, another ten-second break, then finish. Done. In a few minutes. Done. Not tired. Not winded. At all. At all.
Just wow. That was a good benchmark for better-living-through-chemistry analysis, because unlike going for a walk, I had a really clear idea of how much effort was involved in doing sit-ups because I could actually do them all spring, with the modified approach.
The pre-pill / post-pill difference was kind of like the difference in effort between walking up the side of a mountain with a 60lb pack on your back versus walking down the sidewalk with no pack, except that in reality, if you are fit, walking up the side of a mountain with a 60lb pack on your back is not that hard. You’d never get anywhere if you had to stop every thirty seconds for a minute break.
So yeah. Nobel prize for James W. Black, earned. And a big shiny star for Dr. Maybe. I’ve got to find out what kind of beer he drinks. Or scotch? Scotch.
The answer to, “How’s it going, Jen?” remains, “Pretty well, thanks!” I resurrected the Nine Annoying Things Novena over at the blorg last week, and the pray-ers did well. Hence today’s story:
So I go see Dr. Maybe yesterday, and they did the dreaded Six Minute Walk. And here is the very, very, What is wrong with people? situation: I did almost as well as predicted.
Seriously? Is this really all they expect out of pleasantly-plump 40-somethings? You’re kidding me.
You do the walk with a pulse oximeter, which means you can cheat and watch your heart rate. This is handy if you are the kind of person who knows at about what heart rate the gasping kicks in (see archives below for the secret), and thus you can maximize your distance by walking right at that special speed where you’re coughing a bit and your head feels like you just tossed back two glasses of champagne on an empty stomach, but hey, you aren’t going to faint, and even though death feels like the perfect next step, you can do it for six minutes. Or at least, you can do it that long if a stern nurse in pink scrubs gives you a face like she’ll spank you if you quit early.
It appears the pulmonologists aren’t big believers in pedestrian transportation.
Anyhow, I like the new guy, whose brain jumps around so much I finally pulled out a notebook and made a list of all the tests and appointments he was rattling off, because I had a feeling one or two might get lost in the shuffle if no one wrote them down, stat.
Ruled out again this morning — for good, this time? — pulmonary embolisms. Sent away three vials of blood — I’m not sure he’s quite to the point of looking for tropical diseases (I’ve never been to the tropics), but he’s almost there. More interesting tests coming along soon, looking for weird variants on regular asthma and exercise-induced asthma, and also he’s going to see if he can get my heart rate up high enough (on a treadmill, not with those evil chemicals) that the O2 levels drop, or something else interesting happens that gives us a clue.
We’re having real problems with finding clues. The trouble we’re having is that I’m dreadfully healthy for someone who’s sucking wind and coughing while ambling at grocery-store pace, minus the cart.
Blorging over the past couple weeks, for those who don’t subscribe:
May 3, 2014 Guns in Church: The Divide Boils Down to Subsidiarity – I don’t much write about gun stuff. But when the Archbishop of Gunlandia does something to tick off all his redneck parishioners, someone has to get out some catechism quotes, right? FYI – post includes a link to my A/C article where I say there, concisely, what I’ve said here, verbosely: This is a topic on which Catholics of good will can disagree, and catechists need to leave their agendas at home.
April 29, 2014 Heart Rate Training for Fitness in Chronic Illness – This is actually a useful post. It’s how I managed to nearly pass the 6-minute walk, despite being seriously seriously not well. And if I’d taken the walk two days earlier, I would’ve aced it out of sheer racing-preparation common sense.
April 24, 2014 A Deadly Faith – Gospel Reflection @CatholicMom.com – I had forgotten all about writing this, but then I read it, and it was really good. Surprisingly good. Follow this to get the link to the CMom piece, and yes pastors, you may run it as a reprint in your bulletin next time Holy Week comes around. Or whenever.