Sunday, September 28, 2014

An n of one

Another tough one to put down in words. On Monday I had a follow-up appointment with my neurologist to discuss my MRI and various other test results. There's a lot that's inconclusive - apparently my body doesn't follow the rules of how to be healthy, or how to have any particular illness! There's a lot that it's doing that's suggestive for MS, but a lot that isn't. Dr. T. believes I have something called neuromyelitis optica. It's similar to MS, but not quite - it affects the eyes and spinal cord rather than the brain (this is what my MRI shows) and is usually more aggressive (luckily, I haven't had the sort of acute transverse myelitis that some NMO patients have - that's what was giving him pause in making the diagnosis).

The statistics for NMO are terrifying. I made the mistake of going home from my appointment and reading medical journals. One of them gave a five-year survival for NMO. Lots of sources talk about percentages of people who are blind, paralyzed, and incontinent after five years. That's really different from MS, where everything I've read reassures that life expectancy is near normal, and pamphlets remind anxious patients and families that most people with MS actually don't need a wheelchair, or at least not for a long time. Reading those articles made for an emotional evening. After a few hours, all I could do was hold the largest cat, shake, and heave. Eventually I took a double dose of sleeping pills so I could just pass out.

I always tell my students to be suspicious of statistics. Many of them, especially those in the sciences, see primary sources or articles with numbers in them, and evaluate those sources as more reliable than ones without stats. I generally approach that by telling them all about how the 2012 PhD cohort in history was 100% left-handed; has a twin; sings opera; other details about me that are not universal among my peers. Eventually, they get suspicious, and I fess up that I'm the only student who started the program that year. I can try to draw big conclusions, but none will be particularly reliable with an n of one.

Luckily, a few people on an NMO Facebook group that I found told me that the prognosis statistics are far out of date, anyways. For those on a good treatment plan, those statistics basically don't apply. There's nothing current in the medical literature that will say how I'll fare in five years, ten years, twenty years. Once again, I'm an n of one. That's not exceptionally reassuring, but I'll take what I can get.

Saturday, September 6, 2014

Cats have belly-buttons too

Anybody who knows me, even a little bit, probably knows that I'm nuts about cats. I foster, and spend a reasonable amount of time at the cat rescue, conveniently down the street from me. This isn't a selfless act, really, but something I find immensely fulfilling.

Today was a hard day, but also the best day. We had an intake of 20+ cats, all arriving in a span of about 20 minutes, transferred from another rescue. What I anticipated being a quiet reception shift (taking inventories and greeting foster families as they picked up cat food - that sort of thing) was a whirlwind of cats, kittens, and more kittens. I spent most of the day looking after a litter of six kittens whose mother had become too sick to feed them; at just four weeks old, they needed to be bottle-fed, but were not strong enough to drink. Four of the six were very, very fragile, and we weren't sure if they'd survive the afternoon. Luckily, another volunteer was adept at syringe-feeding kittens, and probably saved their lives.

Nursing a litter of seriously ill kittens ought to be stressful. Yet, this spring, taking in newborn kittens and bottle feeding them has been a way I've coped with stress. There is something about the chaos of twenty cats, sick cats, fragile newborn cats, that oddly acts as a form of stress relief, obliterating all other stresses by their very needy, fuzzy presence. Nothing else mattered in the world today while I focused on these four little lives.

This spring, I was diagnosed with multiple sclerosis. Just days after receiving that overwhelming news, I was getting daily steroid infusions as an outpatient to help me go into remission. So I went home in the evening, picked up a litter of kittens, so small their umbilical cords were still attached, and bottle-fed them to keep me company overnight. I have good friends, but felt weird asking if any of them would sleep over to distract me through the maddening insomnia that comes with ridiculously high dosages of steroids. It's an odd juxtaposition (juxtaposkitten?), feeding palm-sized kittens with an IV line, but that's what kept me from losing (what remained of) my mind that week. They give a sense of normalcy - in what feels like an endless cycle, already, of unpredictable relapses and incomplete remissions, the needs of tiny kittens are constant and fairly reliable. Feed, help it pee (very young kittens need help with their rear-end bodily functions), burp, cuddle until it's purring and ready to go back to sleep. Repeat with next kitten. Four hours later, do it all again. It's OK that I wake up at least twice in the night to struggle to pee - so do they. They're a distraction through the monotony and heartache of being sick, and something to take care of, when I feel powerless to heal myself.

Even before MS, taking care of cats was a relief in my PhD-stressed life. History is depressing, and escaping from the troubles of the past by reading the news is necessary for some perspective on the present, but frankly it's equally stressful. Sometimes it feels overwhelming, how many problems there are - and I've struggled with the reality that I cannot single-handedly save the world. Working with cats doesn't quite allow me to sleep soundly. But at least there is a sense of fulfillment - one which is rare and fleeting in my academic work - that I've accomplished something, when a shy cat purrs and settles in for its dinner and warm bed.

But hey - cats don't just need people volunteering: they also need funds. Trouper was the first bottle baby I ever looked after, and he's now thriving in an adoptive home. You can donate to his fundraising page here. Warm fuzzy feelings all around!

Thus concludes an immensely navel-gazing essay about cats.