on the quality of life

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Given the ease with which health infuses life with meaning and purpose, it is shocking how swiftly illness steals away those certainties. It was all I could do to get through each moment, and each moment felt like an endless hour, yet days slipped silently past. Time unused and only endured still vanishes, as if time itself is starving, and each day is swallowed whole, leaving no crumbs, no memory, no trace at all.
~ Elisabeth Tova Bailey
(The Sound of a Wild Snail Eating)

It’s hard to believe it’s been five years since I received my radiation proctitis diagnosis on January 3, 2020. It’s been a difficult journey, learning how to live with a chronic illness. I feel like Sisyphus, continually pushing a boulder up a hill, with no reasonable hope for relief.

I’ve learned that radiation proctitis is called pelvic radiation disease by the medical system in the United Kingdom, a much more comprehensive description than we have here in the United States.

In the last few decades radiotherapy was established as one of the best and most widely used treatment modalities for certain tumours. Unfortunately that came with a price. As more people with cancer survive longer an ever increasing number of patients are living with the complications of radiotherapy and have become, in certain cases, difficult to manage. Pelvic radiation disease (PRD) can result from ionising radiation-induced damage to surrounding non-cancerous tissues resulting in disruption of normal physiological functions and symptoms such as diarrhoea, tenesmus, incontinence and rectal bleeding. The burden of PRD-related symptoms, which impact on a patient’s quality of life, has been under appreciated and sub-optimally managed.
~ Kirsten AL Morris & Najib Y Haboubi
(World Journal of Gastrointestinal Surgery, November 27, 2015, “Pelvic radiation therapy: Between delight and disaster”)

Quality of life — how on earth can it be measured?

The necessary low fiber, low fodmap diet is terribly restrictive and makes eating with others and/or eating out in restaurants very awkward. I need to bring my own food.

The unpredictable and painful flare-ups of symptoms keeps me from making too many plans and the plans I do make need to be tentative. It’s frustrating, but the alternative is to never go out and do anything.

In my darkest moments I feel like this steep price paid for cheating death is not worth it.


The Heart asks Pleasure — first —
And then — excuse from Pain —
And then — those little Anodynes
That deaden suffering —

And then — to go to sleep —
And then — if it should be
The will of it’s Inquisitor
The privilege to die —

~ Emily Dickinson
(The Poems of Emily Dickinson, #588)


Coping mechanisms — there are quite a few…

Gathering information and helpful tips from my sympathetic gastroenterologists (both in Connecticut and North Carolina) — I’ve been lucky with that. (On the other hand, the radiologist and oncologist who dished out the radiotherapy were shockingly unsympathetic about the iatrogenic disease this cancer treatment caused.)

Finding the Pelvic Radiation Disease & Radiation Colitis support group on Facebook. It’s validating to know others who understand what it feels like to be living with this.

Working on my original 2020 goal “to take a walk in the woods.” Spending time with nature and capturing its wonders with my camera is very healing.

Reducing stress by practicing yoga, reading poetry and books, and listening to music. (I’m so grateful for the beautiful Chapel Hill Public Library and for my playlists on Spotify!)

Distraction = long hours of family history research.

Learning to say “no” (and trying not to feel guilty about it) when I need to rest and recuperate.

What a long strange trip it’s been these last five years, running concurrently with the pandemic in the beginning, and complicating our move to North Carolina. Most of all, I’m grateful for my husband. Tim lends a patient and supportive listening ear, bearing witness to my pain and struggle. I honestly don’t know how I would have gotten this far without him!

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wonder will arrive

“Christmas Tree Harvesting” by Jahn Ekenæs

Before the ice is in the pools —
Before the skaters go,
Or any cheek at nightfall
Is tarnished by the snow —

Before the fields have finished —
Before the Christmas tree,
Wonder opon wonder —
Will arrive to me!

~ Emily Dickinson
(The Poems of Emily Dickinson, #46)

winter in the garden

Yesterday we went to a winter craft market at the botanical garden and of course I couldn’t resist getting a few pictures outside. It finally feels like winter here, with low temperatures some mornings in the 20s. But it was a warm afternoon and it felt good strolling around, even if a host of white-throated sparrows foraging in the brush wouldn’t come out for a picture!

I prefer winter and fall, when you feel the bone structure of the landscape — the loneliness of it — the dead feeling of winter. Something waits beneath it — the whole story doesn’t show.
~ Andrew Wyeth
(LIFE, May 14, 1965, “Andrew Wyeth: An Interview”)

Winter under cultivation
Is as arable as Spring

~ Emily Dickinson
(The Poems of Emily Dickinson, #1720)

The Winter, most commonly, is so mild, that it looks like an Autumn, being now and then attended with clear and thin North-West Winds, that are sharp enough to regulate English Constitutions.
~ John Lawson
(A New Voyage to Carolina, 1709)

the warmth of the sun in winter
Carolina buckthorn
seasonal decor for the shrubs

Lots of folks are rushing around getting ready for the holidays, but I like to stay quiet this time of year, snuggling under my wool throw with a good book. I’ve started reading Clover Garden: A Carolinian’s Piedmont Memoir by Bland Simpson. The author lives not too far from us and I’m enjoying reading about the natural history of the local area.

as autumn becomes a memory

11.27.24 ~ North Carolina Botanical Garden
northern mockingbird

November ends. I come across a poem by my favorite poet — she describes the sense of loss and disconnect I had been feeling all month.

She could not live upon the Past
The Present did not know her
And so she sought this sweet at last
And nature gently owned her
The mother that has not a Knell
For either Duke or Robin

~ Emily Dickinson
(The Poems of Emily Dickinson, #1535)

I’m grateful for and encouraged by nature, poetry and my books, and family and friends, as I imagine most of us are. This squirrel came up to me on our last visit to the botanical garden, as if to say, “I’m here, too.”

The poorest experience is rich enough for all the purposes of expressing thought. Why covet a knowledge of new facts? Day and night, house and garden, a few books, a few actions, serve us as well as would all trades and all spectacles. We are far from having exhausted the significance of the symbols we use. We can come to use them yet with a terrible simplicity. It does not need that a poem should be long. Every word was once a poem.
~ Ralph Waldo Emerson
(The Poet)

hemlock cones
looking up
mountain witch-alder
spotted cucumber beetle on a New England aster
sweet-gum

simple healing in
watching a mourning dove feed
on the forest floor

~ Barbara Rodgers
(In the Woods)

yesterday and today flutter away

10.9.24 ~ Sarah P. Duke Gardens

It was a butterfly day! We got to see migrating monarchs for the first time since we moved down here to North Carolina! And some of their fellow pollinators. Interesting to note that North Carolina is home to 75 butterfly, more than 500 bee, and over 4,000 moth species.

three’s a crowd
monarch butterfly
sharing, or so it seems
fiery skipper butterfly on the left
American lady butterfly
complementary wing views
mallard
ruddy shelduck
fountain grass

Yesterday is History,
’Tis so far away —
Yesterday is Poetry — ’tis Philosophy —
Yesterday is mystery —
Where it is Today
While we shrewdly speculate
Flutter both away

~ Emily Dickinson
(The Poems of Emily Dickinson, #1290)

thunderstorm

“Approaching Thunderstorm on the Hudson River”
by Albert Bierstadt

A — Cap of Lead across the sky
Was tight and surly drawn
We could not find the mighty Face
The Figure was Withdrawn —

A Chill came up as from a shaft
Our noon became a well
A Thunder storm combines the charms
Of Winter and of Hell

~ Emily Dickinson
(The Poems of Emily Dickinson, #1735)

three quick pics

6.21.24 ~ North Carolina Botanical Garden
Coastal Plain Habitat boardwalk in June

It was too hot for a walk but I had to get my summer picture for Karma’s “same location for all 4 seasons” photo hunt. And my coastal plain habitat boardwalk picture for June. I darted into the botanical garden, got them, and then took two quick pics on my way back out.

fewflower milkweed
Horace’s duskywing

These Fevered Days — to take them to the Forest
Where Waters cool around the mosses crawl —
And shade is all that devastates the stillness
Seems it sometimes this would be all —

~ Emily Dickinson
(The Poems of Emily Dickinson, #1467)