Vicissitude

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	12.9	13-17	^
Platelets	186	140-375	^
ANC	3740	1800-8300	^
Ferritin	1311	My goal <1000	^
CD4 Cells	209	My goal > 200	v

Vicissitude. This is a word I know well but don’t use in conversation much.  I like the sound of it, but Jill often tells me I use too many words with which some people are not familiar. In case you are not conversant with “vicissitude,” it reminds me of the old joke about the elevator operator who, when asked how he liked his job, said, “It has its ups and downs.” 

Here’s a little quote from Merriam-Webster.com:

"Change is not made without inconvenience, even from worse to better," wrote British theologian Richard Hooker in the 16th century. That observation may shed some light on vicissitude, a word that can refer simply to the fact of change, or to an instance of it, but that often refers specifically to hardship or difficulty brought about by change. To survive "the vicissitudes of life" is thus to survive life's ups and downs, with special emphasis on the downs. Vicissitude is a descendant of the Latin noun vicis, meaning "change" or "alternation," and it has been a part of the English language since the 16th century. In contemporary usage, it most often occurs in the plural."

If you have experienced significant change in your lifetime, and who hasn’t, you may be able to identify with Richard Hooker’s statement. 

In our nearly quarter-century of marriage, Jill and I have had the privilege of speaking into the lives of others, especially during the fifteen or so years in which we were involved in a ministry called “marriage mentoring.” One of the things that we often discussed with couples is the fact that every change comes with a modicum of grief. What I mean by that is this. Even when things get better, the very fact of change is in some ways inconvenient and requires us to expend extra energy to make adjustment to what these days is commonly referred to as “the new normal.” We were rolling along, living life in a familiar pattern, when suddenly things are different. We can no longer operate on “autopilot.” It used to be so easy, but now we have to think about our actions with more deliberateness. 

In the case of a change for the better, we often are more tolerant of the need to adjust. Nevertheless, the stressors that newlyweds encounter in adjusting to “wedded bliss” are not always easy. We used to advise couples that even in their joy of being husband and wife, they would be called upon to grieve the loss of their singleness. It sounds a little crazy, but it is real and if people are not expecting the grief, they often think something like, “Oh, my goodness; what have I done? I’m not sure I want to be married. It’s too hard; I didn’t sign up for this.” This is the beginning of the grieving of this major lifestyle change. Counselors recognize several phases of the grieving process. You may have heard of the Kübler-Ross model:

1. Denial - this isn’t really happening to me
2. Anger - why should I have to go through this, no fair
3. Bargaining - what have I done; how can I get out of this
4. Depression - I can’t face other people; I will withdraw
5. Acceptance - OK, this is the new normal; I need to learn how to live here

When I was diagnosed with leukemia, there was a sea change in our lifestyle. Instead of living at home, I lived for weeks at a time in a hospital. Jill, sweet thing that she is, had her life turned upside down. She found herself commuting 120 miles round-trip every day to be with me. Thank God we have an amazing care team who helped us through our grieving process. They laid out in detail what we could expect and how to cope with the changes. Happily, we didn’t experience many of the negative eventualities that they described, but still, our life was changed instantaneously, and we had to grieve what we had lost and learn to live in a new reality. 

The Lord has dealt very gently with us through this season. As I mentioned not everything we were told to expect came to pass. I never had all the fevers they told us about. I never struggled with the nausea and vomitting. I did experience weakness, lightheadedness, weigh loss, hair loss. And we DID experience quarantine. Including the quarantine that the pandemic brought, we have lived the past five years for the most part severely curtailing social contact with others. 

What I have described above is the down side of the vicissitudes of our life. We are about to move into the upside. And I must tell you, that is not without its own challenges. We anticipate going through the grieving process again:

1. Denial - We can’t really expect life ever to be the same as it was, can we? After five years of being trained first by the government and then by our medical team that other people are a threat to our well-being, how can we ever trust them?
2. Anger - We missed so much of our grandchildren’s growing up years; no fair. We will never be able to catch up. Even when quarantine is not part of our lives, how can you expect us to pick up where we left off?
3. Bargaining - We have become so accustomed to enjoying life in our lovely home, maybe we should just keep doing that. 
4. Depression - This is going to be a difficult adjustment. It means we will be exposed to other people. We will have to relearn how to trust them. 
5. Acceptance - This is actually what we have been longing for. Sure, it will take some time to adjust to a more normal social life, but it will be well worth it, when we get together with friends; attend our grandkids’ life events; go to church regularly… and so much more freedom. 

We met with Dr. Brow last week and everything is looking good. I now only have to have a blood draw every six weeks and I will see the NP at Skyline clinic in May. I’m not sure how often I will see a provider after that. Based on our meeting last week, I won’t be surprised if that is reduced to once a quarter. I’m feeling great, but I still have to have therapeutic phlebotomy every 6 weeks to lower my Ferritin. That’s not a big deal, and on the other hand, my CD4 cell count has been above 200 on two consecutive checks. That means I no longer have to take Bactrim, a rather nasty antibiotic that has given me some uncomfortable moments in the past. I have been taking it since last June.  

What is a big deal is keeping track of the days, now that our weeks are not filled with medical stuff. We used to keep track of the days of the week based on what medical procedures were scheduled. Thirty-nine days from today is my first transplant anniversary...my new birthday! I will have to go to OHSU sometime near May 8th for a blood draw as part of the Optimize study that Dr. Meyers is doing. But after that, I get the feeling that both Kaiser and OHSU will pretty much consider me to be past history!! On May 8th, I will have no lifestyle no-nos to avoid. I can even work in the yard.

Our plan for May 8th is to take care of any medical stuff that may be needed, and then head for the nursery. We are now planning our summer garden. I sit in my chair and look out into the backyard, and it’s all I can do to keep myself from going out and digging or raking or trimming something…just 39 more days. Somehow, I think our May 8, 2025 vicissitude will be more palatable than the one we had on June 25, 2021. (See “Who Knew?”)