Human Fatigue and Canine Anxiety

I have the feeling that I’ll have more energy today. The energy business is difficult. When I lack it, when fatigue really falls like a leaden blanket, I’m left defenseless. The standard issue Ikea chair beckons to me. And I’m reduced to nodding off while doing nothing in particular. It affects everything about my experience of the day. It’s the difference between just sitting limply in the chair and responding enthusiastically to e-mails, between dragging myself up the stairs and ascending with gusto, between reading with engaged interest and succumbing to sleep before I know whether Levin will go meet Kitty at her sister’s country residence. Fatigue is not some additional thing to deal with in the day; it’s the way the day is experienced.

I’m glad that I was warned about it. Otherwise I’d have been seriously worried when the blanket fell unannounced. The nurse who coordinates the transplants spoke with me a couple of weeks ago about fatigue as she advised me on all aspects of life after a transplant. She said it comes seemingly randomly and that there is no good biological explanation of the cause when it smothers a person. There’s nothing to be done really, but to check out, put all plans on hold, and hope that no one is disappointed and no deadlines are blown.

I had a long string of good days last week. So good that I began to think her advice seemed kind of quaint. I was now beyond such concerns. But I’ve heard it said that, “Pride goeth before destruction, and an haughty spirit before a fall.” Sunday arrived and I was confined to the Ikea chair. I rebounded enough on Monday to get some work done and to exercise.

Tuesday began well enough. I attended my first ever hospital Yoga class, which in itself was an exercise in humility. It was also socially interesting. There were only four of us in the class, two of us still bald. Although we were all four from different countries, we were also all veterans of the hematology/oncology department. We shared a comradery, like soldiers who had been in the same battle. We understood better than most people what the other had been through. There was a natural closeness between us, unusual between strangers.

The appointment at the clinic dragged on as the doctor expressed concern that my Creatinine level at 2.1 was way too high, I run chronically high in this regard in any case, but clearly my kidneys were being stressed by a combination of some medication and my failure to drink enough. He ordered a change of medication and sent me off to the day clinic to receive a hydration IV. The whole experience at the hospital lasted about seven hours. Another day offered in sacrifice for longevity. It left me chastened. I need to keep track of my fluid intake, just like the nurses required of me in the transplant unit. At home I had quickly shrugged of that imposed discipline—I prefer my discipline self-imposed—for a more “intuitive” approach, which not surprisingly was insufficient.

At my request on my way back home the taxi driver dropped me off at the pharmacy. From there I walked about a kilometer home. As I approached our house, it was clear that The Dog was a having a bad day too. I could hear him howling from the road along which our row of houses sits. Anxiety had set in at some point, and I wondered how long he’d been in such a panic. How do dogs experience anxiety? Is it imagining some future all alone, the pack never returning? That seems unlikely. Epictetus’s diagnosis that anxiety is caused by allowing images of an uncertain future to worry us seems to require more powers of projection than dogs possess. Is it just the absence of companions in the present that becomes intolerable? Maybe the voice of the BBC broadcaster, which I leave on for him, after a while fails to soothe. But why, then, does it only happen after some period of time passes? Given our common mammalian heritage, interpreting the behavior as anxiety analogous to what humans experience seems right. But how analogous?

I worried a little about complaints from one set of particularly sensitive neighbors. But not that much. These are the unfortunate ones whose evening is ruined every time we use our gas grill. Usually they let me know of their misery by yelling at me as I grill.

By the time I got settled at home I had about an hour’s worth of energy to work on a manuscript before the crushing weight of fatigue sent me to the chair. Fortunately BF had already volunteered to cook dinner and with almost no grumbling MF was convinced to the walk The Dog. So, I had the rest of the time before dinner and all of it afterwards to consider the contours of the chair before hauling myself upstairs to bed. After ten or so hours of sleep, I feel well-rested today.

One consequence of the new medication regime is that I am back to a twice a week schedule of visiting the doctor for the next couple of weeks. I’ve laid-off an anti-viral pill in favor of an antiprotozoal substance that is ingested by means of a vaporizer. It is administered at the hospital on a weekly basis at first and thereafter less often. So, I go back to the doctor again on Friday to breathe it all in. I’m sorry for The Dog. I hope to make it home before the anxiety starts up. I just can’t seem to talk him out of it before hand.

The Hospital Bill

Inching Towards Normalcy