health

Keep Busy, Don’t You Know!

~ Roger JG Albert ~ 8 Comments

In my last post I mentioned that I’ve put together one hundred and fifty thousand words on my blog since I was diagnosed with multiple myeloma in the fall of 2019. 

Looking back on my many posts, I’m now concluding that I’ve said pretty much all I want to say about my relationship with myeloma. There may be a few more details I can profitably address such as increasing levels of pain, and Its location, but I have myeloma, there’s no question about that, and it’s going to kill me. Now that I’m palliative and not under the care of any oncologists, I feel that all I have left to do is take a schwack of pain meds and wait to die. 

Thursday, Jan. 12, 2023 –  ~ 11 AM

This morning I got up at 7 or so in anticipation of going to the hospital for a lab visit. I was feeling just fine until I went into the bathroom to ablute. I got my gear out, but while I was doing that, I felt a twinge of pain in my ‘gut’ area (generally in my midsection, right through my body.) Soon, that twinge developed into generalized pain severe enough to take my breath away). Then it ramped up to a 9 or so on the 10-point scale. As soon as I realized that the pain had got to a 5 or 6, I started taking hydromorphone breakthrough meds. I took three times as much as I would normally take. I also took some dexamethasone (8 mgs). I was supposed to take 4 mgs). I also took some acetaminophen (1000 mgs). 

It took an hour to an hour and a half to settle the pain down to a 4-5 on the 5-point scale although at the time I thought that the pain would never attenuate. I thought that dying at that point might be a good idea.  

Pain, in and of itself is not a bad thing. It signals that something is wrong in the body that needs correcting. (This is a perspective inherent in the pathological end of the medical spectrum.) Pain may never be eliminated from a body. 

Earlier I wrote that: ‘Now that I’m palliative and not under the care of any oncologists, I feel that all I have left to do is take a schwack of pain meds and wait to die.’ Well, what of that? 

We all wait to die. But we’re not supposed to do that, don’t you know? It just isn’t right. We’re not supposed to just sit around waiting to die. Actually, it’s downright immoral to just wait around for anything, especially for dying. As humans we’re meant to move around, to get ‘er done! Ironically, we go on vacation every once in a while with a major goal of sitting or lying around doing nothing. There’s a contradiction there, but we can ignore it if we turn away and don’t pay any attention to it.

People do get freaked out when they see people in care homes not doing a lot of anything. “Look at all the crumblies, laying around, just waiting to die! They aren’t productive. They can’t even clean their own bums.” We’re supposed to DO something, anything. “The devil makes work for idle hands” don’t you know? 

Yes, true on all counts. But before we get all self-righteous, we should consider what is so morally superior about doing things. I’ve already written somewhere that, following Ernest Becker, we think of wealth and health as the two most important moral imperatives in our lives and in our civilization (although we very seldom think in those kinds of abstract categories). 

Since we’re already primed for thinking about things on a ten-point scale, can we think about morality and health on a scale? Maybe using a scale where a 5 is average (the mean in statistical language) and the extremes are at 1 and 10? What would morality and health look like on a scale of 1 to 10? Caution: this analysis is simplistic in the extreme but it works on a very basic, silly way.

The scale would look something like this I think: If you’re a 10 you’re buzzing with activity. You can’t stop. You run marathons every week. You have two jobs, or you make money by investing in stocks and bonds. The downside about being a 10 is that you’re possibly on your third marriage because nobody can stand to live with you for any length of time. Thus, if you’re not actively pursuing wealth and are not super healthy, buff and running marathons, you probably suck. At 1 you suck a lot, at 3, yeah, you suck, but not irretrievably. If you’re a 5 you’re probably normal in our world. You probably have a decent job, and you do some exercise. Nobody’s going to look up to you, but, conversely, nobody is going to look down on you either. 

If you’re a 1, you’re a slob, a poor slob. (Wink, wink, nudge, nudge). 

Let’s look at this ‘distribution’ statistically.* If you draw a random sample of the population on a characteristic like height. you should come up with about 68.2% of the population who ‘fit’ within one standard deviation from the mean, or the average. Leaving aside height for a moment, in moral terms, if you’re on the left side of this histogram, you tend to the sucky side of life. On the other side of the mean you tend to the above normal side of life. You’re nothing special, but you’re a nice, positive person. You know, nice and positive. Further up the scale and we can detect sugar dripping from your lips. 

From: http://openbooks.library.umass.edu/p132-lab-manual/  Physics 132 Lab Manual by Brokk Toggerson and Aidan Philbin.

The further you get on the left side of the distribution, the suckier you get until you dissolve into a slimy pile of suck. It’s good that not very many people fit into that category because wading through slimy piles of suck could be downright tiring at times. The fewer of those around the better. Rain puddles are way better, in my opinion. 

Well, this is all well and good. We judge people all the time, even the way we die. We live in a very strange world if you haven’t noticed yet. We are a very strange species. 

If you want to stay on the good side of your civilization, keep busy and try not to let your knuckles drag while you walk down the street. 

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*I wouldn’t take ‘statistically’ very seriously here. Just having a bit of fun. Oh, the histogram is fine, but fitting morality and health into it may not be so fitting. 

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January 13, 2023. 

Today is the fifth anniversary of my mother’s death. She died in 2018 at the age of 94. I miss her even though I barely saw her at all in the last few years of her life. 

What the hell is the ‘quality of life?’ Part 2

~ Roger JG Albert

So, as I noted in my last post I’ve been thinking a lot about the concept of quality of life. People use it in many different ways; it’s easy to establish this observation by just entering ‘quality of life’ in a Google search. It’s often associated with medical issues and how the quality of life is diminished with, say, the need for blood dialysis. That said, without dialysis, there is death. Take your pick, a reduced quality of life or death. I’m thinking most people would chose the former option although their opinions may change if they ever find themselves on dialysis. There is a dialysis centre close to where I live so it would be less of a hardship for me to attend it than for someone who lives a long way from a dialysis centre. But there are lots of other ways that medical conditions are thought to reduce the quality of life. Blindness, deafness, the loss of a limb and cancer are a few things I can think of that many people would argue reduce the quality of life. Maybe they do. I’m not entirely sure. I’ve had cancer and lost a kidney because of it but I’m not convinced that my quality of life was reduced because of it. Of course, I had a great medical plan and an understanding employer at the time. If I had been unemployed and poor 11 years ago when I was diagnosed with kidney cell cancer, things would have turned out very differently, I surmise. I have a lot of ‘cultural capital’ too. That means that with my Master’s degree and social status, I was able to access services and information that people with less education might have found difficult if not impossible to access or even know about. Knowing how to do research is a key to my quality of life, I can assure you. Poverty sucks! I was poor once and I’m still not wealthy by any means but I haven’t forgotten about the time when our children were very young and I didn’t get a teaching contract I expected. I had to go to the ‘welfare office.’ They turned us down. It was very difficult. Good thing we had (and have) a very supportive family. Family came to the rescue more than once for us in the days before I got a full-time teaching contract.
Quality of life is not a static thing. It comes and goes. Great quality of life very seldom ever lasts forever I would think, but poor quality of life resulting from poverty or ill health can be a life sentence for some.
I’ve been thinking a lot lately about my former students. I had thousands of students over the 36 years I was a college instructor, 29 of those at North Island College on Vancouver Island in British Columbia. I’m still in contact with a few of them. Some I know are now lawyers and doctors, probation officers and nurses. Some, in more recent times, have arrived at NIC from India and Africa, mostly Nigeria. They traveled a long way in an attempt to improve their education and consequently their quality of life and their life chances in general. A few of them have gone of to Saskatchewan to continue their studies. From Port Harcourt in Nigeria to Saskatoon. Now there’s a change of climate for you. It’s a good thing humans are so adaptable. The Nigerian students I had demonstrated a wonderful sense of determination and enthusiasm. They were game too. I took two of them to the lake here a couple of summers ago and they were able to paddle my canoe around (with an outrigger attached, mind you). They had a great time.
Other students I had came from the local area, the majority of course. Many of those have gone off to university here and there but some have gone north to work in the oil and gas fields in BC and Alberta. They’ve left the Comox Valley and Campbell River because there is very little work here that pays a decent wage. Those students of mine who stay here to work have limited choice where employment goes. I wonder if my students who found it necessary to travel away from here to work (as thousands of men and some women have done leaving the East coast maritime provinces to work in Alberta at Fort McMurray in the tar sands industry), feel that their quality of life is improved or diminished because of what they’ve done to get work. People have migrated in search of wealth and work for centuries. Is that a worse fate than staying in one place for a lifetime?
More yet to come…

Quality of Life – What the hell is that?

~ Roger JG Albert ~ 6 Comments

So, as I engage in producing the 2013 Quality of Life report for the Comox Valley Social Planning Society I’m struck with the number of questions I have about just what quality of life means. I’ve determined that it’s not about comfort or serenity, the lack of problems or adversity, happiness or the lack of it, wealth, health, recreation, culture, fast cars, sex, food or much of anything else.  It’s not even only about personal, individual feelings and circumstances. So what is it about?  There are a number of organizations that have produced quality of life indices and reports.  The UN is into it: (http://hdr.undp.org/en/statistics/).  The Canadian Index of Wellbeing (CIW)(https://uwaterloo.ca/canadian-index-wellbeing/) has determined that the quality of life in Canada is declining regardless of the fact that the Gross Domestic Product may be rising.  We are obviously into contiua here.  The UN rates countries on a continuum of quality of life using a large number of indicators in three categories, heath, education and living standards.  The CIW uses dozens of indicators and eight domains or categories: community vitality, demographic engagement, education, environment, healthy populations, leisure and culture, living standards and time use.  Some of these domains address individual dimensions of wellbeing, others how community affects personal wellbeing.  The CIW is on to something here, I find.  On a continuum of wretchedness to bliss, I expect that a person living on the streets of Kolkata would be at the wretchedness end of the scale while someone living in a fancy house on the beach in Comox would be on the other (blissful) end without being too categorical about it. However, the world is never as simple as it seems and I’m not a good judge of the quality of life of a person living on the streets anywhere, especially India. 

To me, some self-determination is important in thinking about quality of life as is sociality.  So, for me, life in a prison isolation cell would qualify as extremely wretched even though health, sanitation and food would not necessarily be issues.  And there are tradeoffs.  Idleness due to unemployment may adversely affect income, but there is a certain liberation in not having to go to work.  Problem is, we have developed strong moral, legal and political objections to unemployment to the point where the unemployed are considered morally weak, self-indulgent, lazy and worse.  So not working (for the employable) carries a stigma and the unemployed suffer opprobrium.  

I suppose, for me, quality of life hinges on a number of factors including basic health, a roof over my head, access to effective sanitation, enough money to keep food on the table, clothes on my back and maybe go out the odd evening to a movie, a day in the park or on the beach, a visit to a library or an art gallery, having friends over for tea, being able to move about without too much difficulty, and community support when things go sideways.  Emergency services, then, take on more importance than they might otherwise in determining quality of life.  The question is, can I count on the help of others in the community if I get sick, lose my source of income, my house burns down, I get beat up on the street or bullied at work?  

Of course, comparison is the foundation of quality of life studies and indices.  How do I measure my wellbeing?  Well, it will be good or bad in comparison to the person next to me or in the next town, city, province or country.  If I have nothing to compare my life to others, the whole question of quality of life is meaningless.  As for the Comox Valley, what makes this place unique in terms of quality of life?  I’m not sure there is a basis for comparison with other similar sized communities on Vancouver Island.  

These are just some of the thoughts I’ve been having recently on the subject of quality of life. There’s lots more…for later.