Herd of elk

Yesterday, we took a drive up to a very small, mountain town. I love eating lunch at the restaurant there, it's a locals' type place and, as I listen to the old-timers sitting around the wood fire talking about the "wind last night" and the blown down trees, I am comfortingly reminded of times during childhood, listening to my Dad as he visited with the "old folks." The squeak of rocking chairs, long pauses between spoken thoughts, the ticking of the mantle clock, a deep-drawn sigh from an old hound dog lying on the twin bed that served as a couch, his head nestled on Uncle Amos' lap.

We'd had a light snow the night before. How exciting for me to notice a herd of cow elk grouped in a circle out in a white hay field. These are wild elk, not held in by fences. I snapped a few pictures, and later asked an old timer about the elk. He said that there are about 400 that winter in the valley.

Catching up...

I'd thought perhaps the little yearling who rests on the hill behind our house and which can be seen out my guest room window (where I spend much of each day) was the same deer that was struck and killed by a truck down by our mailbox on the road. But yesterday, she was back. So good to see her munching acorns again up under the naked oaks.

I went to see my new neurosurgeon (NSG) on Wednesday. I have been feeling the worst I've felt in a long time, apparently due to the trip to California a couple of weeks ago to see our son. The pain and weakness is so consuming and the oxycodone doesn't always touch it. All I can do is lie in bed and listen to the radio and sleep. Even reading a book, now, seems too much physical work.

Wednesday, the new doctor visit was very emotional for me. It seems at times that NSGs do not always have the best, bedside manner. This one was not the worst I've seen, but to me, it seemed he was brusque, he interrupted me and didn't seem to listen too well or to care a whole lot. I became very emotional with lots of tears running down my cheeks and my nose running. I could not help it!

I wanted to be stoic and strong and speak with him on some semblance of the same intellectual level, but all I could do was sob. This seems to be a long term effect from the post-concussion syndrome I have. I hate it. I am so out of control and I know people are looking at me and making judgments but there is nothing I can do about it.

"New NSG" said that there was nothing surgically he could do for me. I did feel very brushed off, because I know it will take longer than 45 minutes (the time I spent with him) to figure this out. I thought he was giving up on me already, and since I've experienced that a few times already, I reacted as I did.

In the end, the NSG said he'd have his colleagues also look at my imaging. He sent me downstairs for a set of cervical flexion and extension xrays and I am set up for a follow up appointment for Dec. 9.

On Thursday, I was back to feeling so badly, I couldn't move from bed. I just can't describe this pain, wish I could have to the doctor.

On Friday, I tried not drinking coffee, thinking perhaps the caffeine was affecting intracranial pressure and I, in fact, did feel better yesterday. But today, it all came sweeping back again.

Yesterday, the NSG's office called and said he wanted me to be set up for a new lumbar MRI and a "SPECT" scan of the Cspine. I've set those up for Dec. 2, again at OHSU in Portland. I never had heard of a SPECT scan so I looked that up. It's a form of nuclear testing where the patient is injected with some form of chemical and in two and a half hours, an MRI is done. It is supposed to afford a deeper look at things, and I am so hopeful that it does.

Of course, this made me feel much better about new NSG. If I could only have a doctor who WOULD look deeper and would take me on and try to figure out the source of these problems and pain, oh what a gift that would be!

The way the mind works...

The way my mind, challenged by constant, chronic central pain, works is this:

For most of the time, I hurt in such a deep way, it's nothing I can push past or ignore or even put a nice face on.

But, sometimes, the meds kick in just right and I get a few moments of "no pain." Like today.

I've sure been suffering since getting home from California. I'm not sure I can ever make that trip again. But, this afternoon, my pain meds seemed to be working for about 15 minutes.

When they did, my mind filled with things I'd like to do around the house, but I know enough not to start anything. I know this is a small window of opportunity and I don't want to drag out a bunch of stuff only to feel too poorly to put it all away.

I happened to remember a business I saw advertised down in central Oregon called "Cowgirl Cash." This woman bought and sold used cowboy boots and clothes and such. I remembered all the incredibly beautiful cowgirl shirts hanging in my closet...the ones I used to wear on stage back when I performed cowboy poetry around the West. I thought of the money I could raise selling these colorful, embroidered shirts.

I then looked into the closet and reasoned that I ought to try on the shirts to see if they fit me in any sense. Perhaps I'd wear them again somewhere, if so.

I started trying on shirts and was so happy to see that they all did fit, though some were sure tighter than I'd have liked. If I were to lose a few pounds...and if I were to have surgery one day and were to see improvement, maybe...well, maybe I would dare to think about returning to the stage again. You see, my level of pain was masked enough to allow those fleeting thoughts to cross my mind. Returning to the stage is something I never allow myself to think about, but today, I did.

But only for a few minutes. Then, the deeply seated physical pain came back and the incredible weakness, and it wasn't hard for me to lay that idea aside.

But, I'm still hanging onto the shirts.

For now.

While I was in California, I constantly thought about visiting the ranch where we'd lived and where my old horse, Shadow, still abides. He'd be 18 now. And I was only 13miles away.

But, I also imagined how bad I'd hurt (physically) IF the sight of my old friend caused me to cry really hard. Since that was not hard to imagine happening, I did not allow myself to entertain the idea of going to see him.

As if to affirm my reasoning, while I was there I received an email from the owners of the ranch, and who now own Shadow. They did not know I was in CA that weekend, and had sent me several pictures of him and his owner, with notes about the training they are doing together. Those wounds are somewhat fresh yet. What a silly child I can be, unable to get over this grief of losing horses, and that one Paint horse in particular.

Wednesday this week, I go see the new NSG. I guess I mentioned this yesterday. I do have hopes that this doctor will be able to help me, even if he IS the 6th NSG I have seen.

Some words rolled off my tongue this evening as I spoke to my husband, words I had not said before. I told him of my hopes to become "better" due to something (anything) this neurosurgeon has to offer, because, "It's not going to get better on its own. I know that now. It's been 5 and a half years. Things are simply not going to get better unless something is done."

Today, I had another "autonomic dysreflexia" event. They come every day. I think what prompted this one was the fact that I was wearing sweat pants. All day, I suffered through up-and-down temperature changes. I was either chilled or sweaty all day, putting on a jacket inside the house, or peeling it off in a rush.

I think it was during one of the "over-heated" times that I felt that burning crawl up the back of my neck, the burning "scalp crawl" that seems to set my head on fire, especially over my ears and on the back of the head. The skin on my head felt tight, and I was awash in that familiar weakness and I simply could not stand any clothing on.

By the time I'd peeled off the hot clothing and put on a tank top and shorts and turned on the fan in the office and gotten the BP monitor out of the closet and turned it on and got the cuff on, pumped up the cuff, etc, the reading was down to 130/109. I know it had to have been higher before I took the reading and was on its way back down.

Today, as every day, the swallowing is a tough issue. It is all getting worse. I'm praying for help, an SOS sent from a lonely island.

Yet, as I write this, I am so blessed because my frame of mind is good. I know my blessings, and I know they are so many. I do have an inner peace and happiness and am so thankful that I am not also battling depression.

However, at the same time I write this, I also must be truthful and say that at the times when the pain is the worst, at those times I do hope for the relief and release of death. I'm ready to go. I will not cause it to happen. That is all up to God. Oh, what joy to not fear death. To not be controlled in any way by a fear like that. Definitely, there were times in my life when I did own that fear. But not anymore. And that is a big, big gift in itself.

What an oxymoron I am! What a spiritual conundrum! How can one hurt so much that she wishes for death, yet still be able to say with all honesty and openness that she is not depressed and loves her life? I honestly did not have any comprehension that something like that is possible, never before in my life. But I do now.

and I speak of it here so that you can understand for yourself about loved ones you may know who are the same way...or perhaps yourself. I take no credit for it, it's just a frame of mind and a way of LIFE that came to me NOT of my doing, it's a gift given from God and perhaps that is what is meant when He said, "yea, though I walk through the valley of the shadow of death, I fear no evil, for thou art with me."

when you have your feet planted on the firm foundation of Jesus and you know what comes after this life, it kinda does some neat stuff in your mind and psyche. It all might not make sense to the human-ness of the world, but it makes perfect sense in a Godly way.

Pardon me for working through this as I write. I think I've figured it all out.

It all seems sort of confusing, yet now I've centered on what it is. The Spirit of God through Jesus has long ago been my companion. So, my days are filled with Him and all that He has taught me over these last 30 years.

Momentarily, when during the course of a day I am overcome with a pain so central and deep that I am consumed, I do not curse Him, but I give myself to Him. I yield to the promise of His Gift, the promise He will never leave me, nor forsake me.

How do earthly words describe spiritual, heavenly things? There are these things we cannot understand nor comprehend until we walk down that path. How do you describe the feeling of love, the sensation of love that you have for another human being? Is it even possible, even though the poets have struggled since time began to do so? Better lyricists than I have tried to capture the essence of His Spirit, His Peace.

So, I hope you can "see" what I am trying to write. That, in spite of physical pain or so many stories of grieving, still the sunshine of God's Love makes so many moments in my days beautiful.

It may not make much sense, but it is the way the mind works.

just a quick note

I know I should write more. I will soon, I hope.

I was gone for a week, we drove south to visit our son. I wasn't able to see any of my old friends down there, a few of whom read this blog. We were only there 3 days and I felt my strength wan and decrease as each hour went on. I had to ask that we go home sooner than I'd planned, just because of this. I didn't want my son to see me in really bad shape. So, we left early and I was so glad to get home. I spent all day today in bed in a lot of pain. It is so hard to describe how this affects every cell in my body. I can only lie in bed and pray for sleep. I feel better tonight, though, so will go to bed soon with prayers that tomorrow will be better.

I wanted to post about Lyrica. I am going to go off of it. I only got up to the "starting dosage" of 150 mg, but I started to experience some real problems in thinking. Perhaps the Lyrica, mixed with the Cymbalta I take plus the oxycodone, all add up together to give me problems with thinking...or maybe it shouldn't be given to someone with a brain injury. Whatever the situation, I'm going to wean myself off of it. I had a few times when I was awake and struggling with comprehension of where I was in the world. I don't need that!

I hope to post more soon, I have a lot I want to record and share. I am just praying for strength enough to do it. You've probably noticed that I sometimes post a lot. Those are the times I feel pretty good, and want to catch up with lots of thoughts.

Next Wednesday, I'll be in Portland, OR to see the new neurosurgeon at OHSU. I'm trying hard not to allow myself any expectations. But....those "hopes" still come!

thanks for reading!

Today's autonomic "event"...

So, as I've written previously, I've been having a lot of symptoms lately that really tell me the compression on my brainstem is increasing.

And I've just discussed dysautonomia and autonomic dysreflexia.

Today, while making our bed, I felt a very deep cold inside the core of my body, while at the same time, I was sweating on my head, above the C1 level of injury. I was not exerting at all at the time...no breath-holding...nothing out of the ordinary.

I've always been a good one to ignore pain and such, and to press on. So, I naturally went ahead with some light vacuuming. Very light, with a very light vac.

I have these episodes quite a bit. In fact, I've recorded some of them here on this blog. So, I immediately recognized that I was having an "autonomic episode." I walked calmly into my office, where I keep my BP "machine" and, slipping on the cuff, I pumped the bulb and waited while the reading came down to the point where it was ready to give me the reading. My normal BP is 120/70.

The reading came up 144/84. I knew this showed that I was indeed having fluctuations in my autonomic system. There was nothing I had been doing that would cause someone without problems or imbalances in the autonomic system to have a spike in BP. As I said, I have these episodes all the time. I can recognize when the symptoms are occurring. A few months ago, while just beginning to make the bed, I felt the old, familiar feeling of my head sweating, pain above the ears, a tight scalp, pilo-erection (hair follicles on end), flushed face, painful scalp "crawl"...so I took my BP and it read at that time 184/152! And that was a couple of minutes after the worst of the symptoms while I set up the BP machine.

So, this reading did not cause me concern, as I'm used to this. But it continues to "prove" that this stuff is going on.

After taking this first reading today, I went back and finished the little bit of vacuuming I was doing (I told you, I'm bullheaded) and then came back in to the office, sat in a resting position, and re-took my BP. This time, it was 137/87, with a pulse of 101, as before. This made sense. Things were evening out.

I turned around to my computer monitor then and for five minutes, I answered a non-emotional email. Out of nowhere, however, I felt that painful scalp crawl, the piloerection, the tightness and pain above each ear. I turned back around to my desk and slipped on the BP cuff that was right there after taking my last reading.

It read 149/91! With a pulse of 94. I have a feeling it had to have been higher before I got hooked up and ready to go with the BP monitor.

Five minutes before, it was 137/87. Five minutes of very calm resting (the reduced pulse showed that)...then the feeling I know oh-so-well...the symptoms that tell me things are wacky in my brainstem, quite frankly. I'm sort of shocked to see my BP has jumped up, just like that...for no obvious reason.

Next, I rested a good 10 minutes of typing emails. And, again, just for a baseline, I took my BP. No further symptoms were happening now. And my BP showed it. In 10 minutes, my BP had dropped to 128/84 and my pulse was 85.

And 30 minutes later, I took it again (just to record that baseline...to also prove to myself the monitor was working correctly) and my BP was pretty normal for me, 127/87, pulse 85 like before.

This all would be bad enough if this were a rare experience, but it happens to me every day, several times throughout the day. It can be brought on by leaning over to fill the dishwasher, or too-tight waistband on a pair of jeans, or allowing myself to experience too much humor or happiness...or witnessing something that might cause me to feel some anxiety, tension or stress (a car crossing lanes in front of us, for instance). Just every-day, common things, like making the bed, can trigger it.

I have no idea how dangerous this is. I mean, for it to be happening this often, every day. There is no cure, all I can do is try to avoid the things that trigger it. Perhaps, if it is caused by my cerebellar tonsils pressing against my brainstem, if THAT was decompressed, maybe these episodes would end? How wonderful that would be!

Until then, I have learned to live with it by God's Grace. It is what it is.

Let's get on with living.

Dysautonomia

I was diagnosed with dysautonomia in June, 2009. I was shown where my "acquired chiari" (cerebellar tonsils/herniation) is pressing against my brainstem. It was explained that if I do much activity or get too excited about things, it causes my blood pressure to rise, and that causes even more pressure inside of my head including the cerebral spinal fluid (CSF) and blood. That rise of fluid pressure inside my head causes tissue compression.

Here are some links regarding dysautonomia:

http://en.wikipedia.org/wiki/Dysautonomia
http://www.ndrf.org/ans.html
http://www.ninds.nih.gov/disorders/dysautonomia/dysautonomia.htm

Here is an excerpt from another website:

Dysautonomia
The autonomic nervous system is the "automatic" or "unconscious" nervous system. It controls and regulates virtually all of our body functions and systems, such as blood pressure, pulse, body temperature, breathing, sweating, bowel function and sleep patterns. The autonomic nervous system is made up of two parts: the sympathetic nervous system tends to increase and accelerate or speed up body functions, the parasympathetic nervous system tends to slow down, relax, and put the breaks on body functions. In a normal situation, the two divisions of the autonomic nervous system work together to control these functions in a continuous manner reacting normally to stimulus.


When the autonomic nervous system becomes "out of balance," it is similar to a car that needs a tune-up. When this occurs, these body functions may either speed up or slow down at inappropriate times with a very noticeable effect on the person. This may occur for no apparent reason. You may be sitting quietly at home reading or watching television, driving down the highway or shopping for groceries in a store. The autonomic nervous system suddenly decides to send out a burst of signals to speed up all body processes. When this occurs the symptoms may be extremely severe and frightening. This faulty regulation of the autonomic system is referred to as "dysautonomia." It may also occur as a response to stress whether it be emotional or physical. Such things as a severe illness, job stress, family problems, buying or building a house, a move cross country, going off to college, having a child and similar type occurrences in our life may trigger the autonomic system to react inappropriately. While these symptoms are extremely frightening, frustrating and uncomfortable, it is not life threatening. However, if left untreated, it may become lifestyle threatening.



There is also something called Autonomic Dysreflexia.

So, what is Autonomic Dysreflexia?

Most patients who are paraplegics and quadraplegics suffer AD. Here is some information on it...

Mild Dysreflexia:

Sweating. The first sign is usually profuse sweating on the face and neck - that is, above the level of the injury.

Mild Increase in Blood Pressure (Up to 140/90). Since the typical resting blood pressure (BP) for a quadriplegic is 90/60 (which is low normal), even a BP of 120/80 could suggest dysreflexia. Until the blood pressure reaches higher levels, the situation is not urgent, but it is important to try to identify and eliminate the cause before this happens.

Severe Dysreflexia - A Medical Emergency!

Hypertension. When the BP reaches 200/100 or higher, it should be considered an emergency because the sudden change from very low to very high blood pressure can lead to convulsions, stroke, hemorrhage or even death. The BP can rise quickly during an episode of dysreflexia, so it is important to check the BP frequently, at least every 5-10 minutes until the cause has been found and eliminated.

Pounding Headache. The headache is due to the sudden elevation of blood pressure; however, the severity of the headache is not necessarily related to the severity of the hypertension. Therefore, headache is not a reliable indicator of when the BP is dangerously high. A headache associated with normal blood pressure is not due to dysreflexia.

Heart Rate Changes. The heart rate can either be very slow (bradycardia) or very fast (tachycardia) during an episode, so heart rate alone does not help to make the diagnosis.

Flushing (Reddening) of the Face and Neck (above the level of SCI) associated with pale, cold skin on the trunk and extremities (below the SCI).

Less common symptoms include nasal congestion, anxiety, nausea, blurred vision, difficulty breathing, increased spasticity, chest pain and "goose bumps." However, these symptoms alone do not suggest dysreflexia. http://www.spinalcord.ar.gov/Fact%20Sheets%20html/dysreflexia.html

I would be somewhere between mild and severe. My symptoms from this list are: sweating, mild to high increase in blood pressure; heart rate changes; flushing; nasal congestion; anxiety; nausea; blurred vision; difficulty breathing; goose bumps.

Another site mentions "pilo-erection," the painful feeling on the scalp as the hair follicles go erect. If I brush against my hair at those times, it is quite painful.

What's the difference between the two, Dysautonomia and Autonomic Dysreflexia?

Well, I'm not sure. What I've read describes the former as being an out of balance autonomic system. Certain connective tissue diseases, like Marfans, Ehlers Danlos Syndrome and POTS are included as causes for Dysautonomia. Along with brain injury.

The AD, the causes are more trauma-related, and information explains that it is an interruption in the signals that are flowing up and down the spinal cord.

So, I think the two are at times related and have things in common...but at other times, you cannot simply substitute one for the other. I haven't seen anyone who seems to care enough to listen to figure this out for me. Oh, the nice neurologist who told me I have dysautonomia seemed to listen, and he did show me how the cerebellar tonsils are compressing the brainstem on my MRIs, BUT...I wasn't exactly sure that he understood what the AD was...and how that might relate to me.

Most of the time, I would say that it is AD that I suffer from.

My next post will explain why I was researching this out today...

but certainly, the episode I experienced today would fall right into line with the increased brainstem compression symptoms I've been having lately...

and perhaps...it really doesn't matter.

Again...I don't know. Someone knows out there. Some brilliant neurosurgeon who cares enough to listen to me and dig deeper and listen longer and care enough...

I haven't met him yet, though.

God's Grace and living with this instability!

Last night, lying in bed, I could feel every millimeter along the edge of the back of my skull, stretching from ear to ear. Like a big smiley face painted on the back of my head, this etching revealed itself in precisely-located pain.

And I know what I did...and I know the price is too high to pay, even for time spent in those woods that beckon me in those wiley whispers too hard to resist.

I've now been "upped" to 150 mgs of Lyrica, which I take at bedtime. This is not a high dose; it is, in fact, the starting dosage recommended. It seems to work to a small degree, but I'll take any improvement I can get!

Feeling a little better, on Saturday I snapped the leashes on the dogs and walked slowly down the woodsey trail, stopping at one point to lie in the sun on warm pine needles and watch a crow fly overhead. The dogs looked at me curiously, as if to question what was wrong that I would stop in the midst of a walk to recline upon a carpet of pine needles; once they were sure I was fine, they also laid down at my side though Mickey stayed alert and watched the woods, his wariness producing a regal posture, indeed.

Mickey is not yet well-trained to the leash and he is still young. So, I must gently jerk the choke chain back in order to remind him to stay beside me, or behind me if the trail is narrow. I KNOW that this action with my arm is NOT good for my skull base. Though it's not too uncomfortable at the time I do it, I know it is kinetically affecting the nerves in my upper C-spine...but I do it just the same. They are small jerks, not even "jerks" really. And remind me of the gentle tugs on the reins I'd given snaffle bit horses for most of my life. Such thoughts cause slight smiles to cross my face, and that feels good.

Sunday was another sunny, Autumn day, and I succumbed once again. Two days in a row. Yes, I succumbed and went the 15 minute loop through the oaks and Ponderosa Pine, needles and cones and wet leaves beneath my shoes.

Sunday night....the bill came.

Last week, I had a couple of episodes that surpassed the normal swallowing difficulties I experience. In one, I was eating, absent-mindedly, some Triscuits. Watching TV and breaking off little bites and putting those into my mouth, I failed to notice that the food wasn't going "down."

As I've written here before, one bite of food will usually move the previous bite on down the esophagus, but this time, it was all bunched up at the back of my mouth. Without a gag reflex, I was not choking or gagging and was completely oblivious to the accumulation of food, perhaps the equivalent of one and a half crackers.

By the time I became aware of it, it was a wet bolus of chewed-up cracker that was in the neverland between my mouth and the top of my esophagus (forgive me of there is a medical term for this area!). I could not swallow it, and I could not easily make it come back into my mouth. (for the squeamish, I apologize).

I was afraid to try to cough it back up, for fear that I would set off a spasm I could not control. I found that I could not breathe through my mouth and that caused a bit of anxiety, as nose-breathing wasn't doing too well, either. I got a little bit of water, and took tiny sips of it, which, thank God, started the food moving downward, a little bit at a time.

I could feel every bit of its journey south.

On Saturday, I aspirated. I have not done this in a long time. I was eating a small bit of licorice and when I swallowed, it went "the wrong way." We all know what that feels like! I did cough with this situation, coughing and coughing until I felt like I had coughed up whatever was possible to retrieve.

Aspiration is serious stuff. They say this is the #1 cause of death in stroke patients. Due to their brain injury, they also have difficulty swallowing, and some end up aspirating fluid into the lungs and develop pneumonia, which is becomes fatal. With no gag reflex, this is something I need to be on guard against. But whoever is 100% aware of the food they are eating and fluids they are swallowing 100% of the time?

Then, Sunday night. Last night, after the walk in the woods, which left me in so much painful weakness I was a blob in the recliner until the pain meds kicked in, I started noticing food was not "going down." Late in the evening, after taking the tiny oxycodone pill, it was lodged at the top of the esophagus, and wasn't going anywhere. I tried drinking water but that wasn't helping. I thought to take a small piece of bread or something to try to move the pill on down, but I was out of options. I knew the food wouldn't go down either. Finally, I (futilely, I mistakenly thought) took a little sip of water and that moved the pill south. I was able to go to bed, but as I wrote at the start of this post, I was SO hurting around the whole back-edge of my skull. After an hour, I finally did fall asleep.

1) This is brainstem stuff. No gag reflex. Swallowing problems like this. Having to sleep with a portable fan about 10" away from my face so it blows air into my open mouth and will keep me breathing all night.... I've continued to have this sore throat (since my injury...a long time!) but it is so much worse with talking. And I feel "sticking" of my diaphragm, but that has been a long-time complaint, as well.

2) If I feel up to walking in the woods again, I need to wear my CTO. I'm ashamed to say that I did not wear it because I can't handle a walking stick AND dog leashes, and with a CTO, I absolutely need a walking stick to feel my way so I don't take a tumble. This is just a deer trail with lots of limbs to step over, rocks in the trail, etc. I know falling would be disastrous for me. But, I need to be firm with myself about this: CTO if I go for walks! Even if it means I don't get the little endorphins from working with the dogs and being a trainer again.

God's Grace. The Bible tells us that the Lord gives us all the grace necessary in our time of need. We are told "His Grace is sufficient for us." And I believe this is true. I got to see it first-hand the other day...

I was talking to my Mom on the phone. And explaining to her again about how I have to be careful to control my emotions, to not allow myself to get "riled up," or too excited, or too happy, any sort of "high" emotion, because when I do, as I've written here before, I get very distinct symptoms including a jump in blood pressure which causes a flushed feeling all over my head, a painful "pilo-erection" of my scalp-hair follicles, sweating above the C1 level and over all painful weakness.

She commented, "How sad that you cannot allow yourself to feel exuberant joy!" and I truthfully replie, "Oh, that's okay, Mom. By this time, I've come to accept this as just the way things are. I have learned to deal with it as best I can."

I had my last phone interview with one of my work comp medical examiners, and this time it was the neuropsychologist. He asked, "Are you depressed? Do you feel sad when you think about your situation?"

And I honestly answered, "Is there a difference between emotionalism and depression? Because I do not feel depressed. I am very happy with my home and my life and my wonderful life partner/husband and the woods and scenery that surrounds us. I feel my blessings are abundant! But I do get emotional and even cry when I think about certain things, like my horse I left in California because I am too weak and sick to ride or care for him."

The doc said that he did feel there is a difference between depression and emotionalism. Maybe he was just being kind.

But I feel that this is all a sign, to me, of God's Grace at work. He has given me the Grace to accept things as they are, He has given me the strength to not be burdened with self-pity. If I can handle some of this with a smile, then it's all due to Him.

Every day that I am able to venture out of the yard to town, and I am wearing the CTO vest (which is every time I leave the yard), I must reply to various comments from the friendly folks in our town. Today, I heard from a passerby, "That musta hurt!"

I just smiled and said, "It was a long time ago."