health – The Curious Canuck

November 5, 2011

Zen

Lately I’ve been thinking that I need to make some changes in my life. I am concerned about my stress levels. One of the biggest causes of stress is the organization of the 2012 Ted Powell Memorial Race weekend at Calabogie Motorsports Park. It’s been an uphill battle for months. There are many major issues that need to be resolved.

Additionally, I have felt unfocused and scattered. I need a way to find calm, learn to relax and focus, and deal with the issues at hand.

I also just finished reading Steve Jobs by Walter Isaacson. Steve practiced Buddhist meditation, although he did not seem to live a Buddhist life – he was a fantastically talented asshole. But he was also incredibly focused. I wondered if Buddhism was a key to that focus.

A week ago, I found that the White Wind Zen Centre was offering an Introduction to Zen Workshop, so I signed up after some hesitation. The course was today.

The information page asked the participants to wear comfortable, dark clothes that will not cut-off circulation while sitting. I gave this much thought and decided to buy a pair of medical scrubs. I always wanted a pair. When I was in high school the cool kids wore scrubs. I found that only one place in Ottawa sells scrubs so I headed there. They had many different colours but I chose a pair of black bottoms. They were so comfortable. They only had V-neck tops, which I am not comfortable wearing, so I had to find a top. I headed to the new Walmart on Baseline. The parking was a nightmare – they don’t appear to have enough spaces. I bought a simple dark-grey button-up shirt.

Then I left for downtown.

The White Wind Zen Centre is in Sandy Hill, surrounded by a tall hedge. It also has a monastic name: Honzan Dainen-ji. When I arrived, there were two other participants waiting outside on the porch. The centre is a heritage building with a large wrap-around porch. There was a small pond with a waterfall beside the Centre. There was a multitude of birds eating and bathing in the water. The biggest grey squirrel I have ever seen was exploring in the front yard. It was so peaceful; I could have just sat on the porch for hours taking in nature.  At precisely 1:30PM, the front door was opened and one of the monks allowed us to enter. We had to remove our shoes and socks upon entering. I changed into my new purchases.

There were 6 participants. Our training was conducted by two monks. Both had cleanly shaved heads and wore simple dark tunics. We had a short introduction in the kitchen before we entered the zendo.

In the zendo or meditation room, we were introduced to the basics of zazen. This is a sitting practice. Everyone sits on a zabuton (like a large flat throw cushion) and zafu (round meditation cushion). During zazen it is important to sit up straight. The key is to form a stable base by creating a triangle with the butt and knees. For example, most people know the lotus or half-lotus position. I was not able to use either so I chose to tuck my feet behind the opposite knee. Our hands must also be positioned correctly.

Once everyone is seated, the zazen begins with three strikes on a bell. The zazen participant will breathe deeply and bow with the strikes.

Zazen is a 30-minute sitting meditation, with eyes open. One must experience all of the sensations. This includes the feeling of breathing, the feel of sitting, the feeling of your clothes, the sounds of the room and what you can see without looking around. It was important not to get lost in thought about the sensations. The purpose was just to experience the sensations without a mental commentary. The zazen ends with another strike of the bell.

Between the 30-minute zazen sessions was a 10-minute walking practice called kinhin. This is a slow walk around the periphery of the room. It also focused on the physical experience, including breathing, the feel of your feet on the wooden floor, the feeling of your clothes, the sounds and so forth.

The first two zazen were done facing the room. The last zazen was facing a wall, which is the normal (non-novice) practice. This was more difficult for me, as my eyes hurt. Although I was at the correct distance, my eyes strained to find focus on the white, textureless surface of the wall.

After three sessions of zazen and kinhin, we left the zendo and went to the kitchen for a question and answer session.

During the practice, I did not understanding the theory behind zazen and kinhin. I was expecting it would be more trance-like, an unguided daydreaming state. Instead we were told to focus on just the physical sensations and not on the mind.

It took a while to really understand this. The purpose is to attain mindfulness. There is much about our lives that are just ideas running around in our heads. Stress and worry are created only within ourselves. Although external influences cause us to feel bad, our emotions are only what we feel in our mind.

The first Buddha started with what is known as the First Noble Truth – that there is suffering and sorrow in the world. We experience pain and sorrow when we contemplate that our life is not as we wish it would be. Although we rarely think about it consciously, we are also afraid of our inevitable death. No matter how hard we wish it, it is not possible to achieve the life we desire for ourselves. The dichotomy is a source of internal suffering.

The Buddha concluded that suffering was not caused by the nature of the world, but rather our reaction to the dichotomy.

The Buddha realized that by being honest with oneself and understanding that everything is impermanent. Our possessions, our desires, our thoughts and our lives are fleeting on the scale of the universe. This understanding is the path to Buddhist enlightenment.

By concentrating on only the physical sensations available, zazen is a starting point to this understanding. Although we think we feel emotions and thoughts, in reality we can only sense (feel) our immediate physical surroundings. All else is created in our minds. This understanding comes from experiencing the physical world without an analysis in our minds.

The teachings of Buddha are much deeper than this, and include the Four Noble Truths and the Noble Eightfold Path. The course at the Zen Centre covered only the smallest fraction of Buddhism.

Now that I have taken the course, and have completed some supplementary reading, I need to think about this some more. I need to understand how this fits into my mental framework, and how I can incorporate what I find valuable. My goal is still to achieve a more balanced, focused life and to reduce the stress and worry that I feel.

November 26, 2010

The passing of my father-in-law

Papa has been in the hospital since he was admitted a week ago. Through the week, the staff continued to work on this sodium levels. They were hovering around 119, and the normal range is 135-145.

This sodium deficiency has been confounding. Tests indicated that his kidneys were ok, and his thyroid levels were ok too. So no one was sure why the sodium was so low or why it was not increasing.

Throughout the week, we would visit before and after work, and Mama would stay all day. She helped feed him and clean him, as he lost the use of his hands more than a year ago (rheumatoid arthritis). Each day, we would check if there was an estimate when he could come home. Each day, we were told it would be many days minimum.

Today, his condition deteriorated rapidly. He was scheduled for an MRI around 10:45AM. His nurse called Rosa at 10:30AM and said his condition was serious and that she should come in. She called me and we agreed that she would go to see him and call me if I was needed. About 20 minutes later, she called me and told me to come in immediately.

When I arrived, Papa was partly on his side, propped into a comfortable position with extra pillows. This position helped his breathing – he had been having difficulties over the past week. He was on an oxygen tube. He had been given some pain medication and some medication to calm and relax him. It was clear that it was very serious.

We talked with the nurses and they gave us a booklet on preparing for a family loss. Rosa and I went through part of the booklet and made some agreements on our course of action. I called the Tubman funeral home next door to the Queensway Carleton Hospital and made an appointment for 3:00pm.

And we waited.

Rosa needed to go back to the office to gather a few things, so she left for a little while. The nurse came in around 1:45pm to bring a warmer blanket. When the sheets were pulled back, she said that it would not be much longer, based on the mottled colour of his skin. I immediately called Rosa and said she needed to hurry back.

His breathing was averaging once every 8 to 9 seconds. But with the medications and oxygen therapy, he was actually sleeping much better than he had in a long time. At some point in the afternoon, he closed his eyes, or perhaps Mama closed them for him. He looked more peaceful than he had been in a long time.

Nothing seemed to change for the next hour, so I went to my short appointment with the funeral home. I wrote some notes, and gave the background information to the consultant, but I was anxious being away from the hospital room for any length of time. I hurried back to the hospital after 20 minutes.

Papa’s condition did not change for the rest of the afternoon. Rosa and I discussed what to do. No one could guess how much longer it might be. It could be soon, or it could be the next day. Mama wanted to stay all night if she could.

As the sun set, Rosa and I prepared to leave for supper. She went to the washroom. Mama and I were sitting by the bedside.

Suddenly, Papa’s breathing changed. It increased to 25-30 seconds between breaths. When Rosa returned, I motioned for her to come immediately.

We didn’t know what do to. Every pause in his breathing was an eternity. Papa had a thin chain around his neck holding an icon of the Virgin Mary. His pulse would cause it to flicker in the light.

In about 3 minutes, with Mama, Rosa and I around him, Papa passed away. He took his final breath after 75 years; the chain around his neck stopped its flicker.

I leaned in and whispered to Rosa, “He just passed.”

And then we all started crying.

I went out of the room and told the nurse. She and another nurse each confirmed there was no heartbeat, which is the standard procedure. They comforted us and we comforted each other.

We were very sad, but there was also a sense of release, not for us, but for Papa. He has lived in such terrible pain for years and years. He was free from that now.

Two acquaintances from the Institute where Papa and Mama worked in Lanzhou arrived, too late to see Papa before he passed away. They looked shocked and sad too. They talked with Mama for some time, and were near tears. I called the funeral home and let them know about the death.

We asked the nurse if there was anything else we needed to do. She said that the funeral home will contact the hospital and will take possession of the body overnight or in the morning. There was nothing else for us to do. We gathered all our belongings.

And then Mama, Rosa and I left.

November 21, 2010

Papa's not quite a stroke

On Friday, Rosa called me around noon to tell me that there was a problem at home. Mama had called her and said that Papa was behaving strangely and was confused. He was not able to answer any questions. It had started on Tuesday, and even though Rosa asked Mama twice since then if everything was ok, Mama said yes it was ok until out-of-the-blue this morning it’s not ok. This is one of the fundamental challenges to sanity in the household – the continuously changing story about what’s going on.

I told Rosa I would leave work as soon as I could, which was later in the afternoon. If the problem started on Tuesday and has not changed since Tuesday, then it was not an emergency situation yet.

When I arrived, Papa seemed ok physically. Mama said he was sleeping more than usual (he already sleeps about 18 hours a day), but that’s not a cause for concern (yet). She said he gave strange answers to questions. My problem is that I do not speak Mandarin, and even if I did, I would not be able to interpret his mumblings. He mumbles because his jaw joint has changed due to the advanced rheumatoid arthritis.

I watched him through the evening, but I could not see any issues and I felt I could not make a good assessment on his mental cognition because communication was nearly impossible. I had to wait until Rosa returned home in order to make a better assessment.

When she arrived home, we spoke with Mama and Papa. It seemed that Papa was very confused. We debated if we should take him to the hospital. Rosa had the brilliant idea about calling TeleHealth Ontario and talk with a nurse. It was nearly midnight when we reached a nurse. After about 10 minutes of discussions, the nurse said that an ambulance would be called to bring him into the hospital.

We ran around to get a few things packed for what might be a long night. The ambulance arrived and they also assessed Papa. Asking, through Rosa and then Mama, if Papa knew where he was or where he was born. His answers kept changing and were confused. They bundled him up and took him downstairs to the ambulance.

We arrived at Queensway Carleton Hospital close to 1:00am. Rosa came in her car separately. We planned that she would help with the check-in and assessment, and then go home to get sleep and relieve me in the morning.

We waited a long time – there were other patients who needed more urgent attention, including a car accident victim and a girl who had had a severe food allergy. Around 2:00am, we decided that Rosa would leave as I was feeling better equipped to deal with Papa, now that I understood what questions needed to be asked to evaluate his cognition (where are you, where were you born, what is your wife’s name). I can do this with Mama’s help.

As shifts changed and specialists were called, we saw 3 doctors in total. We agreed that he had symptoms of a stroke, so he was X-Rayed and had a CT Scan. The results came a few hours later – nothing was visible. This means that it was not a stroke. The blood work indicated a severe sodium imbalance, which might also cause the results we were seeing. So he was hooked up to an IV drip – 2 litres in the first 2 hours, which is a lot considering he weighs less than 90 pounds. More IVs were given later, but at a much lower rate. His demeanour changed and he was able to understand much better. Everyone could see the difference in his face after even the first IV.

However, it was decided to check him in to a hospital room for further observation. The doctors were concerned about his weight – he is literally (not figuratively) a bag of skin and bones. He also seemed to have a sleep problem like sleep apnea – he breathing would appear to stop. They wanted to take some CT Scans of his chest, as they were concerned about his persistent cough. The cough started in both Mama and Papa about 4 years ago after they returned from 3 months in China.

In the morning, Rosa and I decided that she would go to the Les Petits Ballets rehearsals – her performance is only 3 weeks away. She would come in the afternoon to relieve me at the hospital and help with any further paperwork for the check-in.

She arrived just after 1:00pm. We grabbed a quick lunch and went to see Papa. There was no room upstairs for him yet, so he was still in the emergency area. We checked with the nurses, and there was nothing we could do and there was nothing left to be done to check him in. I left the hospital to get some sleep and Rosa went back to rehearsals, leaving Mama to watch over Papa.

I got about 4 hours of sleep before they both arrived home in the evening. Rosa and I went to the NAC to see the Toronto Symphony Orchestra present an evening in celebration of Slavic composers (Dvořák, etc). I left my cell phone number with the nurses, should something come up.

Last night, I got over 10 hours of much needed sleep.

This morning, Rosa called the hospital and found that Papa would not be discharged today. I’ll go to the hospital in about 30 minutes to check in on him.

October 5, 2010

Sleep Study Redux

Today I went back to the Queensway Carleton Hospital for a second sleep study. This time it was during the day.

I arrived at 8:30am and signed in. I was shown to my room and the very nice nurse wired me up. This time they only needed to wire up my head and two on my chest to measure my heart rate.

The study was actually four naps of 15 to 20 minutes each, with about 90 minutes between sessions.

The first nap was around 9am. It was much easier to nap than when I was here a month ago for the full night sleep study. The room was not as cold or noisy. The hospital bed was still very hard, but it did not bother me as much because the session was shorter; I could get up and move around between sessions.

The second session was at 11:30. Afterwards I had a small lunch. The third session was 1:15, and the final one was 2:45. I was free to go after that. The nurse helped me comb out the wax used to secure the wires to my skull.

I headed into work. I needed to be in the office to run a tool that only works when I am physically on the corporate network. It took much longer, and I didn’t leave the office until after 11pm.

August 19, 2010

Sleep study

Last night, I had an appointment with the Sleep Clinic at Queensway Carleton Hospital.

Rosa has told me that I sometimes stop breathing when I sleep, which is a characteristic of sleep apnea. I am often tired (but functional) during the day, and always assumed that this was because of my long work hours. I am frequently working late into the evening – I have conference calls twice a week with the team in Beijing that last until 11:30pm.

I called my doctor to see what can be done. He set up an appointment with the Sleep Clinic at the Queensway Carleton Hospital (QCH). The appointment took a little over a week before I went in to the clinic.

I arrived at 9:30pm, checked in and filled out the required forms. Around 10pm, I was led into a room with a bed and lots of equipment and wires. Once I change into my sleep clothes, two technicians started applying the wires. I had two wires on each leg, one on each shoulder, one behind each ear, one on the top of my head, two on my forehead and one on each check. These would pick up the electrical activity from my muscles moving. They secured a strap around my chest and one around my stomach to check my breathing. They put a heart rate monitor on my finger. Lastly, they added a tube with two projections that fit below my nose that measures if I am breathing. In one corner by the ceiling was a video camera that presumably would see in the dark.

Once wired up, I was helped into the bed to go to sleep. It was hard to sleep. The bed was hard, especially under my shoulders. It was surprisingly cold, and I had to ask for another blanket – the A/C was blasting out full! The noise of the fan was also distracting. On top of all of that, I was worried about accidentally pulling out all of the wires, so I could not move around to get comfortable. Normally, I’ll turn on one side and then the other and finally on my back before I fall asleep.

I woke up a number of times during the night. Three times there were balloons that popped just outside my room, as one of the staff had had a birthday earlier in the day shift. During the night, I could feel my headache from the previous day returning. This was partly because I was stiff from not moving, and because the bed under my shoulders felt very hard.

By the time morning arrived, I had a migraine. Wake up was just before 6:00am.

The technicians came back in the room to remove the wires and other measuring devices. I got dressed and walked to the bathroom. I had considered going in to work after the sleep study, but I decided against it before coming to the QCH. I’m grateful for that, because when I looked at myself in the bathroom mirror, I discovered that the wires had been attached to my scalp with this horrible, gooey soft-wax-like substance. My hair (what little I have) was matted and stuck out – I looked like a crazy homeless person in dress slacks.

I tried to pull as much of the goo out by hand, but it made little difference. I just wanted to get enough out that I could walk out to my car without everyone staring at me.

I drove home, took a hot shower to wash my hair and went to bed to get about 30 minutes of sleep before the alarm went off.

I hope that the technicians will find something. They said that they are only there to count the data points (such as survey my breathing rate, count how many times I toss and turn, etc). They send that data to a sleep specialist who will sent a report to my doctor in a few weeks.

Thinking about the night, I don’t think I slept well enough to be able to see some of the issues that Rosa was reporting to me.

June 15, 2010

So then I fainted…

I’ve been feeling sick since Saturday, and I got worse on Sunday. My throat and nose were sore and burning. By Monday, I thought perhaps it was a reaction to the smog. The burning sensation is uncharacteristic of a cold or flu.

During the day Monday, I debated what to do: should I see a doctor or just get some rest and wait to see if I would get better.

After talking with Rosa, I decided to see a doctor. I had to call my (business) travel insurance provider. They sent me to a care facility in the city. I went and the doctor looked me over, listened with his stethoscope and prescribed some antibiotics and cough syrup.

Two hours later, I went out to supper with two co-workers, Roddric and Theirry. I ordered a pound of snow crab legs. I normally would not order them because of the mess and cost, but I thought I should treat myself – the company would cover the meal. I love crab.

I was still not feeling well though. I started to eat but had only eaten a single leg before I started feeling much, much worse.

I stopped eating for a moment but I was still getting worse. I was feeling light-headed. I waited for it to clear, but it just got worse. I knew that something was very wrong, and told my co-workers that I was feeling light-headed. As I was seated on the inside of the both, I could not sit down to get my head between my knees, so I slid down in my chair to lower my head.

So then I fainted…

When I came to, Roddric had already called an ambulance. I was immediately coherent and I told everyone the current date and that I knew were I was and that I had passed out. My face streaming with sweat for some reason, even though I did not feel hot.

The ambulance and a firetruck arrived in less than 5 minutes. The paramedics asked me what happened and looked me over. They checked my blood sugar. They hooked me to a portable EKG machine I think. They offered to take me to a hospital and after thinking about it, I agreed. I hoped that my travel insurance would cover the costs, but decided that my health was important and that if they did not, it was still the right decision. The paramedics would not allow me to walk to the ambulance in case I passed out again and hit my head. They strapped me to a stretcher and pushed me outside through the crowded restaurant. I hated that. I was embarrassed.

The ambulance trip took about 10 minutes. I was wheeled into the emergency room.

The doctor came to speak with me after I had been checked-in. He told me that they would run some tests. Everyone asked me if I had a seafood allergy, which I do not. I was hooked up to an IV drip, had my blood taken, and a more extensive EKG taken. A chest X-ray was also taken.

The tests confirmed that I did not have a heart attack or stroke, and did not have low blood sugar. But the doctor was not able to determine the root cause for me fainting. We doubted that I had had a reaction to the antibiotics either.

The doctor explained that the fainting was caused by vascular dilation, meaning that all my blood vessels dilated open. This very rapidly decreased my blood pressure and drained blood from the brain. I felt the process starting when I felt lightheaded. He said that this was the body’s way of ensuring that the person lay down, and it is a involuntary reaction.

He also thought that I had a virus inflection, so the antibiotics would not be effective. Unfortunately, there are no medications for viral inflections. I just have to wait it out.

I was supposed to go to work at the customer switch for the maintenance window starting at midnight. My co-workers called my manager and director back in Ottawa. The director said that I was not to go into the switch, and that someone had to stay with me in case I had another problem. I made a compromise that I would connect from my hotel room and that one co-worker with a backup room key was just down the hall in case I needed something.

I was able to talk with Rosa from the hospital for about 15 seconds before the batteries in the cell phone died. I told her that I was fine. I was so worried that she would be worried about me when I was already feeling much better.

It was an interesting experience. I’ve never fainted before. I remember the sensations as I started to pass out, and I’m glad I had enough sense to say something and attempt to lower my head before I blacked out.

I still have to deal with getting over my illness, which is not really diagnosed. I just need lots of sleep. I’ll keep up with the antibiotics though, as they should not do any harm.

April 13, 2010

Cancer scare

I had a cancer scare starting last weekend. I had a tenderness for 2 days and self-examined while taking a shower and discovered a pea-sized mass where there shouldn’t be one. I booked an appointment to see the doctor as soon as I could, and was able to see him Monday afternoon.

Today, I went in for an ultra-sound of the area. The examination took about 30 minutes, longer than I expected. The room lights were very low so I just lay there with my eyes closed basically ignoring what was going on, except for when I was asked to breath-in deeply and hold my breath. I asked the ultra-sound technician what which frequency the ultra-sound operates – he replied that it’s about 12. I asked 12Khz? No, he replied, 12Mhz.

The results will be reviewed by a radiologist and sent back to my doctor to give me the diagnosis, but it is possible that it is not cancer but rather just a blood clot. That would seem to fit the evidence, as the tenderness that triggered this adventure only lasted 2 days instead of persisting. I hope that is the case. I am hopeful of a simple explanation. If it is bad news, then at least there is a very high (>98%) survival rate when caught early.

April 12, 2010

Pneumonia

I’ve been feeling really crappy over the last number of days. It might have started on Tuesday with a general lethargy at the end of the day. By Thursday, it had changed to a migraine headache, fever, muscle aches and what seemed like a chest cold. The migraine lasted almost 2 days and was the worst I’ve had in about 15-20 years. I believed that the cause of the migraine was that my back muscles were cramping because I was shivering due to the chills induced by the fever.

Once the migraine was reduced to a reoccurring pounding headache (Tylenol 3), I hoped I would get over the other symptoms. I even started feeling pretty good for a few hours on Friday.

My condition did not improve over the weekend. I had much difficulty sleeping due to my lungs being filled and continued muscle aches. Sometimes the fever would come back.

So this morning, instead of going to the doctor, I went straight to the emergency room. The theory was that if I would need chest x-rays or blood work, then they could all be done at once, instead of seeing a doctor, then going somewhere else for the tests, then back to the doctor.

Once I signed in, I was put into a separate waiting room with a sign outside indicating that it was an isolation room and only people who were asked to sit there should even enter the room. I was given a mask to wear.

I waited about 2.5 hours, catching a nap, and doing some light reading. Around noon, I was finally admitted into one of the examination rooms. There was a sign posted on the outside indicating “droplet warning” and that anyone entering the room had to wear a full face guard. Upon later reflection, this was likely because of the H1H1 flu policies.

The doctor came in and briefly checked me out and then sent me for chest x-rays to confirm the suspicion that it was pneumonia. I was beginning to suspect that might be the diagnosis because a chest cold does usually include a fever.

After the x-ray, the blood work was taken, and I was hooked up to an IV system. I wasn’t expecting the IV, but was interested in how it all worked. I could feel it when it started as my arm started getting cooler – the IV would be room temperature (say 25) but body temperature is about 37. I later heard the doctor outside my room indicating that she ordered the IV because my heart rate was 115 bpm. I didn’t realize it was so high. Adding saline solution will dilute the blood and lower the body temperature and bring down the heart rate (which it did).

The final diagnosis confirmed pneumonia. I was possibly still contagious, so I was told not to go to work for the rest of this week. I finally left the hospital about 7.5 hours after checking-in.

Overheard from the sign-in desk next to the waiting room:

1. “I have an infection on my (elbow/leg) and I am on antibotics. I was told to come to the emergency room if it got worse in case I needed IV antibotics.” I heard this twice in 2.5 hours. Is it really that common?

2. “I just returned from Cuba, where I was raped. Do you have a rape kit? Is a rape kit useful after 24-hours?” The woman left immediately after. It really got me thinking about what a terrible time she must be having. Can you imagine flying home with that on your mind? And I can’t understand why some men are so awful. I just don’t understand people.

3. “My father was in earlier and was sent to go get an MRI. I just wanted to let you know that they found a 5-centimeter growth in his brain. I wasn’t sure if you needed to know that for your records.” Again, another tragic story told in three sentences.