Monthly Archives: March 2013

A good day to live (aka the clean MRI Scan)

Did it take so long last time? I have had a few, but did it last for “at least half an hour”? Maybe my attention was directed on going into the tunnel previously. I have had MRI Scans at 3 different hospitals now. At Stellenbosch when I was admitted following my first seizure in May 2012, then Somerset-West due to the super-duper scanner to aid diagnosis, another prior to my operation and finally at Panorama to mark out the mask I was due to wear during radiotherapy. Now it came full circle. I am back at  radiology in Stellenbosch to re-scan, 7 months after my craniotomy and the surgery to remove my unwanted Oligodendroglioma. I know, it sounds like a tumour with a degree and a shotgun.

Dressed in a purple frock I lay under the bright hospital lights. An aweful pop songs plays out in the background. The scanner table supporting me feels narrow, the blanket over me soothing. But it does not calm my fear. I grip the tube leading to the small rubber balloon that resembles the pumpy bit of a sphygmomanometer (that measures blood pressure). However in this setting “Pumpy” is my weapon against claustrophobia. You did not know? Yes, I am scared of small spaces – have always been. And while I am at it, I might as well admit my fear of heights. This dates back to before my sense of invincibility was shattered in 2012. Before I was struck out of the blue with the scan images that showed the tumour in my left frontal lobe.

MRI ScannerShe is friendly, reassuring but professional. Her words of support are balanced by skipping through the instructions and a final question about anxiety. “Occasionally”, I lied, feeling the slight dampness in my hand holding the panic button. “We are just behind the glass”. Her smile was more reassuring than her words. I breathe and close my eyes. I will not repeat my previous mistake. Don’t keep your eyes open while sliding into the scanner. Not again! Even though the flat table is mounted low when you get on, it raises up before moving electronically into the tunnel. The closeness to the “roof” triggered my anxieties before and it was only moments between the closing of my chest, my heart kicking against my ribs and my fingers closing in on the panic button for escape. So I close my eyes and feel movement into the open mouth of the machine.

Apart from the “button”, I rely on breathing to calm me down and my imagination to drift into creative ventures. My mind’s eye luckily opens up colours at first, then ideas and memories. I feel my body resting heavier on the surface beneath me, while I am surrounded my noises that sound like a broken drum machine.

Without warning I was moving out. The light on my eyelids told me I was out in the open. Through my ear-plugs I could hear a mumbling voice. These are good to keep the thumping and humming noises at bay during scanning, but do not benefit communication. Furthermore is difficult to make the words out as my head is kept steady with two rests on both sides. Oh yes, time for the injection of “contrast material” that enables a sharper contrast on the scan. Again I close my eyes after the cool sensation in my arm replaces the sharp sting. Breath. Think colours. Drift away to a foreign place out of tunnel-land. Relax.

I carry the CD containing images of my brain in my bag for the next 24 hours. Unopened it stayed. Strangely it did not concern me much. Anneén and I spoke before going to bed about the upcoming appointment with Martin (my neurosurgeon) and both felt at peace. We go over the facts. I have not had further seizures since the first ones; my language skills appear to be intact, no significant praxis problems and my executive functions (i.e. multi-tasking, planning, taking initiative) is as bad as it has always been! And through writing my blog and steadily increasing my running distance I feel a sense of achievement and connection with the world around me. Maybe it was our talk, maybe the awareness that I had no control over the messages encrypted on the CD, but I slept like a baby prior to the day of the big reveal.

Martin is younger than us, but he carries calmness in his eyes and words. I don’t doubt his knowledge or expertise. The fact that he has been inside my head twice before does forge a strange connection. He does not rush when he opens the scan images, both from yesterday’s scan and the ones from before surgery. “It looks very good” he says, “There is a little scaring from the operation and the radiotherapy, but no sign of tumour”. We look closely at the computer screen as he indicates a ventricle that has returned to normal seize and to where the brain has pushed towards the front where the tumour was removed “to fill up the empty space”. I ask what I need to do from here on. Should I scrutinize my diet? Should I watch my alcohol intake? Do I continue to take Epilim? Martin reassures, “Continue with the medication and complete the chemotherapy, but live your life as if you are cured” After all we have been through, this fantastic news seep in slowly. It is gone, no tumour left.

I often look at brain scans with my psychiatrist colleagues at work.
However it is different knowing the one looking back is your own.

I wish I can paint a smile on it.

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Filed under My Brain Tumour and I, This thing called life

Stories in late summer

I see it as an honour. I know it is my profession, but I never take for granted that people share personal and intimate stories of their lives with me. It is often under the label or description of “depression” or “anxiety” or “loss”. But as with all labels, they reflect a limited part of the surface. And people’s lives, personalities and relationships have much more depth and texture.  The stories that are weaved between these areas are filled with even more detail, emotion, memories and unconscious material. To tell their stories bring them in touch with Imagewhat happens in their lives, but also with who they are. Often the telling of their stories is a liberating experience, to be able to unburden their load or to break a weighty secret that keeps pulling them down. As Leonard Cohen once sang, “I need to tell my story said one of them so bold. I need to tell my story before I turn into gold

Often the (conscious or unconscious) request that arrives with these stories is for pain or suffering to end. And who would not want that? Especially in our western culture where fantasies of health, wealth, wellness and youth are sold on magazine covers, labels of medicine bottles, pop culture and social media? Who wants to be forever young? Well, the advertisers and those behind the fat wallets are pushing hard to make the sell to us. And within that fantasy the enemies are pain, suffering and ageing. Even on cover of my monthly Runner’s World edition, those smiling with their white teeth and their bodies embraced by the latest running gear are all seemingly in their 20’s, white and healthy. But when I line up for a race or fun run, these front cover “athletes” appear to be in the minority. And still, on public display and in the hearts of people I see in therapy, there is a wish that all problems and those threats to a positive view of life and being human can be solved. Even in my own heart that fantasy does arise.

In part I agree. Pain in its physical form should be investigated and treated.

However, suffering is an intense discomfort that we all face on our life journeys and one without a quick fix or delete button. The death of a love one, the diagnosis of a brain tumour or a friend’s cancer, the unhappiness that crept into a marital relationship over the past 10 years or the awareness that you are not happier since you got that big promotion opens the door to internal turmoil and a collapse of the card-house of positive fantasies. This often happens after you established a family, a career and settled circle of friends. But that platform of ambition and dreams can become a distraction of the realities of life. We all grow older, we all suffer losses and we all drink at the well where the water became stagnant and bitter. It does not spare us. There is no cure for life. As Scott Fitzgerald once said, “In a real dark night of the soul, it is always three o’clock in the morning …” Tragedy is inevitability.

What then do we do with suffering when our distractions, cognitive strategies, helpful friends and intake of medication or alcohol do not bring relieve? How do we approach suffering that cannot be switched off? Maybe that is the point where you stop running, stop bargaining and stop self-medicating. The point where suffering is not the enemy, Wandererbut the door we need to pass through in order to learn about the life we are living and this person we are. Then suffering becomes more that just discomfort and an unwanted emotional experience (which it will remain). Then it might become about meaning, about purpose, about becoming the full complicated, eccentric, individual we are meant to be. This is something that several great leaders have embraced and through their suffering found ways of being that made them larger than life.

It is a relationship with suffering that can bring us to meaning. The knowledge that while suffering is real, so is my life and that whom we are can be expanded through this experience. When we find meaning, pleasure and connections in our hospital beds, while on medication and during the process of picking up the broken pieces. When it is possible to cry about the threat to our health and youth, while holding  onto new aspects of relationships with a partner and friends that open up. When the bereavement process reminds us of all the aspects that we loved about our grandparents, a friend or a brother. How precious are these moments in contrast to the fleeting moments of pop culture, the hard lines of fundamentalism or the fantasy that we can take away life’s pain and suffering.

February was a special month to me. I ran the Gino’s 10 km Night Race through the streets of Stellenbosch and survived! I wrote a piece called “Finding Sugarman” about the music and influence of Rodriquez in South Africa following the movie “Searching for Sugarman”, which appeared on the official Rodriquez website (http://sugarman.org/). My moment of international fame! But tomorrow a MRI Brain Scan is scheduled followed by appointments with my neurosurgeon and oncologist on Wednesday. I am grateful that I can have both, even though I wish the brain tumour never came into my life. But both aspects are part of where I am at present and through embracing both do I find parts of the essence of the journey that we call life.

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Filed under Psychology Reflections, This thing called life