on the quality of life

🍂

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!

🍂

to the blessed light that comes

“Woodland Stream in a Winter Landscape”
by John Henry Twachtman

I cannot tell you
how the light comes.
What I know
is that it is more ancient
than imagining.
That it travels
across an astounding expanse
to reach us.
That it loves
searching out
what is hidden
what is lost
what is forgotten
or in peril
or in pain.
That it has a fondness
for the body
for finding its way
toward flesh
for tracing the edges
of form
for shining forth
through the eye,
the hand,
the heart.
I cannot tell you
how the light comes,
but that it does.
That it will.
That it works its way
into the deepest dark
that enfolds you,
though it may seem
long ages in coming
or arrive in a shape
you did not foresee.
And so
may we this day
turn ourselves toward it.
May we lift our faces
to let it find us.
May we bend our bodies
to follow the arc it makes.
May we open
and open more
and open still
to the blessed light
that comes.

~ Jan Richardson
(How the Light Comes)

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)

in the slanting light

10.18.24 ~ Pritchard Park
Chapel Hill, North Carolina

There’s hardly a spot of color on the hardwood trees in our yard, but the light is glorious, as it always is in October, and the signs of fall are unmistakable. ….. Always, when nature works as nature must, there are joys for every grief, a recompense for every sorrow. ….. Night falls earlier with each passing day now, but the recompense of shorter days is the glorious light of October. I wish you could see what happens to the magnificent colors of berry and bird and flower in the slanting light of October.
~ Margaret Renkl
(The New York Times, October 14, 2024, “Growing Darkness, October Light: A Backyard Census”)

These pictures were taken on Friday morning, the day we stood in line at the Chapel Hill Public Library to vote. Afterwards we took a walk on the trails in the woods surrounding the library. North Carolina has early voting, something new to us. Before we left Connecticut we had voted in favor of bringing early voting to our old state. I wonder if it passed. Our habit was to get up early on election day and get to the polling place before it opened. We were always near first in line.

Something new for the citizens of NC is having to show a photo ID when they check in to vote. We always had to do that back in CT. It’s so interesting getting to know the different ways the governments of different states run things, something I never thought about before, having lived in only one state my whole life.

As I stood in line I reflected on how encouraging it was to learn that our 39th President, Jimmy Carter, made the effort to vote while in hospice care at the age of 100. He was the first president I ever voted for. My thoughts also returned to the sacrifice so many of our ancestors made for us in the Revolutionary War, so that we could have the right to vote today. As the granddaughter of Ukrainian immigrants on one side and the descendant of several Mayflower passengers on the other, my complex place in American history has always fascinated me. While appreciating the myriads of reasons Europeans have crossed the Atlantic over the centuries to make better lives for themselves here, I also feel deep regret for the harm they have caused to the original people who lived, and still live here.

When we moved down here I started looking for southern nature writers who might help me get acquainted with my new environment. I’ve become a big fan of Margaret Renkl, who lives in Tennessee at the same southern latitude as we do. Her lyrical writings resonate with the seasonal observations I’m experiencing here. I’ve read three of her books, checked out from the same beautiful library where we voted, and enjoy her occasional editorials in the New York Times.

I tried to capture some of the slanting light of October to match Renkl’s words. This is our second autumn down south and the way it is unfolding feels much more familiar now, it’s starting to feel more like home.

sculpure at Chapel Hill Public Library parking lot

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)

at the autumn equinox

“Apple Gatherers” by Camille Pissarro

At the Autumn Equinox, as with the spring, we take this moment of equal day and night to focus on a point of balance. In the mellowness of early autumn, we can quietly observe this brief stillness. There is a certain relief in letting go of the hectic growth of summer. With the slowing that autumn brings comes a certain restfulness and acceptance.
~ Maria Ede-Weaving
(The Essential Book of Druidry: Connect with the Spirit of Nature)

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)

as we mark the longest day

“Summer Landscape” by Pierre-Auguste Renoir

Counting one’s blessings has a particular poignancy at this festival because, as we mark the longest day, we are reminded that from this point the year will begin to wane and the days will gradually shorten. Transience is a reality for all of us and so we learn that our capacity for joy and happiness — like an inner sun — must radiate from within. It’s worth taking a moment to ponder the mystery that at the height of summer winter plants its own seed.
~ Maria Ede-Weaving
(The Essential Book of Druidry: Connect with the Spirit of Nature)