Summer in West Africa

Of deaths and diagnoses

It's a well known fact that death usually brings grief in its wake. Most of us have experienced the death of a friend, family member, or even a beloved pet, and been aware of the sense of sadness and loss that it brings. And grief doesn't only happen when we lose a person or pet. We can also experience grief when we lose a place; when I left Cape Town to return to Europe, I experienced a strange feeling of grief and loss that kept popping its head up over my first few years back in Europe. It took time for Spain to become my new home, so that the grief of leaving South Africa gradually faded into the past.

What's not so well known is that, apart from the normal grief that's caused by a death or a loss,  there's a similar kind of grief that comes from a diagnosis. Hearing that a parent has Alzheimer's or that a friend has been diagnosed with cancer, brings a different kind of grieving that's linked with the uncertainty of not knowing how much longer we will have that person in our lives. It's a sort of anticipated grief. Or if you yourself happen to be person with the diagnosis, there's a grieving that comes over you as you accept the loss of the life you used to know, and embrace the reality of your new situation: that you'll never walk again, that you're slowly going blind, that your cancer is terminal…. or whatever the diagnosis happened to be.

I recently came to realise that I've experienced a double case of diagnosis-grief over the past month: one to do with my cat and the other to do with myself. When I went to the doctor because the cough and chest pain of pleurisy seemed to be lingering on, I honestly didn't expect to hear that the cough might never go away completely and may be just a symptom of my underlying lung weakness. I didn't expect to hear that the chest pains I experience when I lie down in bed at night may have nothing to do with my lungs, but be yet a further symptom of the arthritis that has affected various parts of my body over the past twelve years. And I certainly didn't expect to hear that I possibly have a problem with high blood pressure…. when I've been known for my unusually low blood pressure throughout my whole lifetime.

I feel almost embarrassed to admit that it was the blood pressure diagnosis that provoked a deep sense of grief. It seems so insignificant compared to someone who's diagnosed with cancer or with multiple sclerosis. But, for some reason, it just felt like one thing too much, on top of the lung issues, heart murmur, and osteoarthritis with fibromyalgia that I've learned to deal with over the years. Everything within me just seemed to shrink away from the idea of having to take blood pressure meds on top of everything else, and the tears seemed to be welling up at the most inopportune moments. I needed to lean on the Lord and remind myself that a diagnosis is not the same as a death. I honestly don't know how things will develop with my lungs, or arthritis or blood pressure….. and so it's important for me to live life to the full, right now, and not waste my sorrows dwelling on what further limitations I may experience in the future.

And the same thing goes for my pets. I didn't experience too much death-grief when I had to put my Tamba to sleep last month. I'd been expecting it for a while and when I discovered she had diabetes and kidney failure, I knew that it was the kindest thing to do for her. But I realise that I've been experiencing diagnosis-grief since having Teddi's blood tested and discovering that he had hyperthyroidism. Having made the decision to treat it with medication, it was a relief to see his thyroid levels return to normal… but then came a new experience of diagnosis-grief on discovering that the condition had already begun to have an effect on his kidneys. He's a relatively young cat, full of life and fun, and it's sad to think that he may not be around for much longer. On the other hand, he could live quite happily for another couple of years. You just never know with renal insufficiency.

I've watched people grieve for years when a family member, human or animal, is given some kind of terminal diagnosis. It's a normal response, as we feel sad for "what could have been" and begin to anticipate the loss of that person or place or pet. But there's a danger of letting our attention focus so much on the sad future that we fail to enjoy the joy of the present.

I well remember the day in Cape Town when the vet called us into his office and sat us down to break bad news to us. In a scene reminiscent of  informing a patient's relatives in the hospital, he told us that our border collie, Zola, at only two years old, had very severe arthritis. We already knew that we weren't going to put her through invasive surgery, and decided instead to make the most of the years we had left with her. In fact, little Zola lived happily for another four years.

I don't know how much longer my Teddi will live if his kidneys have begun to fail. I feel at peace about treating his hyperthyroidism with medication, as this will help protect his heart and kidney function…. but I know that, in one sense, the countdown has begun and he's not going to live to be an old cat. However, I don't want my diagnosis-grief or anticipation of loss to cause me to miss out on the fun that I can have with my boy in the present. And so we've decided it's time to upload a new video to YouTube and let Teddi show off a little with some of the new tricks he's been learning. Here, for your entertainment, is one of Teddi's latest tricks. It's called leg- weaving. Hope you enjoy it.

Giving your all… while doing things by halves

This morning, reading in the second half of Acts chapter eight, I came to the account of Philip and the government official from Ethiopia. What, I wondered, would God have to show me today from such a well known story?

As I began to read, the first thing that stood out to me was that Philip left an exciting revival in Samaria and went to a desert place - for the sake of just one man. We never really know how important one individual’s response can be in God’s “big picture.”

I remember, some years back, my housemate Ada, said to me that if God had brought me to Spain uniquely for her sake, then it had been worth it. And I’ve also thought at times that if my being in Spain would be the catalyst that brings one of my neighbours to know the Lord, then it would all be worth it. Spain feels like home now, but it felt like a desert place of exile in the early days of missing South Africa.

So Philip's experience speaks deeply to me when I think of my plans for Africa this summer. An unexpected change of international scheduling meant that there was a date conflict between the Planting Together outreach in Senegal and the Fortify leadership workshop in the Ivory Coast. I confess that I felt some reluctance about flying up to Senegal right in the middle of Fortify.... and then having to leave in the middle of Planting Together to fly back down to Ivory Coast for the end of Fortify and the start of leadership meetings. I’m not someone who likes to do things by halves and I would never intentionally plan to be at only half of something, as there’s a kind of inner frustration provoked by not being there for the whole thing. I won’t even watch a movie if I’ve already missed the first ten minutes of it... or if I know that I’ll need to leave before the end!

So I considered not going to Planting Together this year, even though I’ve been one of the pioneers of it and have been involved from the very beginning. Opting out wasn’t really a viable option, however, as I had made a commitment to be the programme director for the orientation camp.... and circumstances meant that I was now the only French speaker in the leadership team, and was needed for several days of meetings with government officials, even before the participants arrive for the camp and outreach.

At the end of Acts chapter 8, the Holy Spirit “snatched Philip away” as soon as he had finished baptising the Ethiopian; he wasn’t even able to hang around a little longer in order to disciple the man further. A sober reminder that everything depends on God and not on us.

And so, faced with the unavoidable reality of “having to do things by halves” this summer, I guess I can take heart from the example of Philip and know that it’s possible to give my all, even when doing things by halves! God can always take and use our 100% investment, even when circumstances make us feel as though we're betraying our life philosophy. He did it for Philip, so I guess He can do it for me.

Of health and healing

I’ve been reading recently in the New Testament book of Acts. It’s exciting to see how the Holy Spirit led the early believers and how supernatural expressions of His presence, like healing or other miracles, were a common occurence. This week as I was reading in Acts chapters 6 and 7 about the life of Stephen and the price that he paid for his faith, I was challenged by his uncompromising boldness. After healing the sick and preaching to the religious leaders of the day, Stephen encountered much opposition and became the first New Testament Christian to die for his faith. 

It made me reflect for a moment on my own life and I was shocked to see that our enemy can be so subtle in the way he intimidates us and robs us of confidence. I’m rarely in situations where speaking about Jesus would cost me my life, and to be honest, I doubt that such a threat would hold me back. But this week I became aware of a different and more subtle hindrance. Twice over the past week, my neighbour has felt suddently and strangely unwell, such that she was unable to go out to the nursing home to visit her mother in the evening.  While my natural response would usually be to ask, “Can I pray for you?,” I felt myself pulling back from that, and on Monday this week I realised why. It’s because of my own health issues in recent months. I wasn’t instantly and amazingly healed of my pleurisy and, after fourteen weeks of battling with it, I realised that something within me was hesitating to pray for a sceptic - just in case she wasn’t healed and it gave her further reason to doubt the reality of God.

On Monday night as I was walking the dog, I felt the Lord challenge me about that. Who am I to think that I need to look after God’s reputation for Him? He’s more than able to do that for Himself. But He commanded us to pray for the sick, and that’s reason enough to pray for my neighbour when she’s not well. The outcome is God’s responsibility, not mine.

An hour later, when I got home from walking the dog on the hilside, I asked my neighbour, “Can I pray for you?” and I was surprised how readily she said yes. In my less than perfect Spanish, I simply prayed for God to touch her with His love and healing. Then she thanked me and gave me a hug.

The next day, amidst my own diagnoses of degenerating arthritis and chronic lung condition, not to mention the news of my cat’s failing kidneys, my neighbour came to me with great enthusiasm, telling me that she felt completely better now and had all her strength back again. Since then, she keeps mentioning how much better she feels now.  It’s obviously an answer to prayer, but I have no satisfactory explanation for why my neighbour would be so remarkably healed, while my cat and myself face rather daunting medical diagnoses.

All I know is that I can’t allow such unanswered questions of life to prevent me from stepping out in obedience to God. He told us to lay hands on the sick and to pray for them, and it’s important for me to obey that, without rationalising and wondering how the person will take it.

We may not be in situations where we’d be martyred for our faith like Stephen was... but we can run into a whole lot of other situations where the enemy will attempt to discourage us, silence us or steal our confidence. That’s when we need to remember that God is bigger and that we simply need to trust Him in every situation.

Teddi's progress

I mentioned a couple of days ago that I needed to take Teddi back for another blood test. Well, the vet phoned last night with some mixed news. The GOOD news is that his hyperthyroidism is under control now. A normal thyroid reading should be between 19 and 51. His was 320!! After a month on meds, it has dropped to only 34 - a tenth of what it was previously, and well within the acceptable range. That's a big relief, as hyperthyroidism can eventually put strain on a cat's heart and kidneys.

The not so good news is that his kidneys do seem to have deteriorated a little bit. A normal kidney reading is between 10 and 50; Teddi's was 55, which is not too bad yet, and now, a month later, it's 62 - which is a sign that his kidney function is slowly deteriorating. However, it's what they call kidney "insufficiency" and not yet what they'd classify as kidney "failure." With his thyroid under control, he could happily live several more years before showing any symptoms of kidney disease. The vet says he really appears outwardly normal, healthy and alert. (Tamba too was fine until the last few days of vomiting, and then it went very fast at the end when her kidneys really failed.)

So I guess I've got my boy at least for a bit more time. I'm not in favour of prolonging the agony if an animal is really ill, but I couldn't bring myself to think of ending his life when he was outwardly so normal and friendly.. and apparently healthy. At least I know now that he can live a bit longer with the thyroid pills, and I trust I'll be able to tell when his time is up and it's kinder to say goodbye. For now, he's just his normal self, so it's a relief to hear that the meds have worked for him.

Medical check ups

Today was a day of medical check ups - for myself in the morning and for Teddi in the evening. In my case, I had an appointment with the doctor to have my lungs checked. It's been fourteen weeks now since I was diagnosed with pleurisy and I wanted to ask if it was normal that I was still coughing a little and having some chest pain. 

Well, I didn't expect to spend four hours at the doctor's surgery this morning. What a pain! The doctor began by checking my lungs and saying that they seem to be clear of infection; the lingering, annoying cough is an aftermath of the pleurisy, due to my underlying lung condition (bronchiectasis.) I've to take an anti-phlegm product for five or six months, or until the cough starts to settle down.

The chest pain on the other hand seems to have a different origin. The doctor says she thinks it's not from my lungs any more, but rather is muscle pain from the deterioration of the arthritis in my spine. Yes, it hurts when I cough, but it's also sensitive to touch and is sore after exercise. I asked her if it could perhaps be a lingering effect of the antibiotic that caused me weeks of cramps and soaring blood pressure, but she feels it's more likely that it's a symptom of arthritis. She did check my blood pressure, though, as it had hovered around 170 during the weeks immediately after taking levaquin, before finally stabilising around its usual, rather low 118 or 120.

To our shock, my blood pressure was 165/103. That's really high for me, as I've had unusually low blood pressure my whole life. She packed me off down to the emergency department where they gave me a pill and injected me with some muscle-relaxing potion. Then I had to sit around for an hour until they tested my pressure again and found it had returned to its normal 120/60. So the verdict is that the high blood pressure has probably been provoked by living with several months of pain and disrupted sleep. I've to monitor it for a couple of weeks and see if it generally stays normal again.

I think the doctors were a little baffled, as I'm the poster child for low blood pressure: I don't smoke tobacco, drink alcohol, eat a lot of salt, fat or red meat. I only drink one cup of coffee per day, I have a healthy pace of life, normal body weight, sufficient daily exercise and seemingly adequate amounts of sleep. I never feel tired or depressed. The only anomaly is my arthritis/fibromyalgia pain and the fact that it sometimes disrupts my sleep. The doctor said that living with pain can put stress on the body and perhaps I need to take more pain killers instead of putting up with discomfort…. and even take something to help me sleep if I'm lying awake for no obvious reason. (As you can imagine, I didn't feel very positive about that idea!) Then they'll monitor whether sleeping better and having less pain keeps my blood pressure at its normal, stable level. What a nuisance! Needless to say, I feel suitably geriatric.

My other reason for going to the doctor was to get a prescription for my malaria tablets, as it's only two weeks now before I leave for my extended trip to West Africa. At least it's good to know that my lungs are relatively fine again before I leave… and I'm praying that the air conditioning in planes and airports won't provoke any further problems this time.

This evening it was Teddi's turn, as we had to go back to the vet to take blood so that they can check his kidneys and his thyroid level again. The poor boy hates going in the car, and I feel horrible doing that to him. I realise that I've been subconsciously grieving him and anticipating the possibility of losing him…. yet it seems unreasonable to consider putting him to sleep when he seems just as happy and healthy as he has always been. This past weekend, after a month on his thyroid medication, I begin to wonder if I was at last noticing a change in his coat - whether it was slowly beginning to become silky and shiny again, instead of matted and greasy. It's hard to tell, though, and I won't get the results of his blood test until later this week. So we need to wait and see.

(See 29th June for the outcome of Teddi's blood test.)

International food

This week has felt a little bit like international culinary week. On Monday I cooked Pad Thai, a spicy Asian noodle dish with prawns, for my neighbour and me. Then, last night, I cooked Indonesian food (nasi goreng and chicken satay), which I enjoyed with an English friend who's recently moved to Spain. Tonight, I'll join with friends of six different nationalities for Mexican food (enchiladas) to celebrate the 30th birthday of Antonio, our wonderful Mexican cook at the retreat centre.

This morning, I walked the dog in a different part of town from usual, so that I could pop in to the open air market and stock up on some fresh fruit and vegetables. Nectarines, plums, avocados and beetroot were my choices for today. The avos can be used to make guacamole  for our Mexican meal , although I'm also planning to try out a new recipe for chocolate avocado pudding. The plums and nectarines are just for eating, and the beetroot is for making juice. Delicious!