Saturday, January 27, 2018

Facilitating in My Dreams

This past week has been a rough one for me healthwise. 

I contracted a cold in mid-December and have been trying to shake a residual cough ever since. While I had the presence of mind to get a flu shot back in October, there has been a lot of respiratory distress in and around Duluth (maybe everywhere) and my coughing degraded into pneumonia after a weeklong trip to Boston that ended Jan 18 (at 2:30 am).

Last Saturday I felt crummy and didn't eat anything solid. When Susan popped a thermometer under my tongue that evening I was up to 100.5 and she was concerned. (Because of my multiple myeloma I'm somewhat immune compromised and therefore more susceptible to catching crud.) Prudently, she called the on-call oncologist (which has a nice ring to it) at St Luke's Hospital where I get my cancer treated and was advised that I was probably OK if the fever didn't go higher.

My temperature was down Sunday morning, but so was I. After another desultory day of moping around (Susan was struggling as well—though she didn't run a fever, she was later diagnosed with bronchitis and the house sounded like a tuberculosis ward), she tried my temperature again and I'd spiked at 101.6. Uh oh. Time to go to the ER. 

While my natural inclination is to think I can handle sickness on my own (and stay out of hospitals), I didn't fight Susan's firm guidance and it was good that I didn't. I arrived hypoxic (low on oxygen), with diarrhea, and with pneumonia in both lungs. No wonder I was weak and coughing so much. They immediately started me on oxygen and respiratory treatments to begin clearing the fluids out of my lungs. I was admitted to the hospital and happy to give myself over to their expert ministrations.

Fortunately, I responded strongly to the treatments and my symptoms starting moving in the right direction immediately. By Tuesday morning I was off oxygen and doing laps in the hallway to regain muscle strength after lying abed for 40 hours. They gave me a double round of antibiotics, a prescription for an inhaler, and sent me home.

Today—four days out of the hospital—I've recovered enough that I'll be departing in a few hours for a 12-day road trip to the West Coast and work with back-to-back clients. Fortunately, work is energizing for me, it's not aerobically straining, and I expect to be fine.

When I return (Feb 8) I'll start a new protocol for treating my multiple myeloma, switching from infusion therapy (with Kyprolis) to an oral treatment (a combination of Dexamethasone, Revlimid, and Ninlaro). My oncologist thinks this will be more potent in suppressing the cancer, which is creeping back, and will allow me to continue my active travel schedule without treatment interruption (I have to be in Duluth for outpatient infusion therapy, but can take pills with me wherever I go).

• • •
Meanwhile, I want to share an interesting phenomenon that I discovered this past week while trying to make it through the night with minimal coughing. Whenever I get prone there's an adjustment in my lungs to the lower angle and I cough more. Obviously, that's not very restful (for either me or Susan) and it can take a while to find equilibrium. 

I don't breathe as deeply while lying down, to avoid triggering a cough reflex, and that contributes to the hypoxia and shortened REM cycles as my lungs gradually accumulate fluid and another coughing round is set off. Ugh. This means that I go through a shallow sleep/dream state throughout the night which is somewhat like hallucinating.

I was amused to discover that I go through a pattern. First I go over the work ahead of me in the next day or two. By virtue of "seeing" my schedule and making a rough plan for how I'll handle things, I calm down. Where others count sheep, I rely on logistics. 

Next, as I start to drift off to sleep, I start thinking about issues in my life or imagining work ahead of me and what it will take to deliver excellent product for that client. (As it happens, I'm juggling work with 10 clients right now—all to be delivered in the next three months—so there's plenty to chew on.)

While this imagining of future work may or not be insightful, it tends to be restful. But the most interesting part is that is that I'll next drop into something deeper and create a dream in which I'm actually facilitating—not thinking about facilitating. Maybe it's what all facilitators do at night—who knows. In any event, my tendency is to create scenarios in which I'm wrestling with something sketchy and cantankerous, and I wake up disoriented and with an elevated heart rate. I'm having a facilitation nightmare! And it takes me a few moments to realize that I don't have to be there. I get up, have a drink of water, and consciously back myself out of the mess I awoke in. Then I lie back down and start another cycle.

What am I doing? What am I trying to work out? In what universe does this pattern help me heal? I realize that I'm so deeply associated with facilitation now (after 30 years) that I can't actually turn it off. It's who I am.

This isn't necessarily a bad thing. But who's in control? What a fascinating thing our brains are.

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