Saturday, November 28, 2009

The Wheelchair War Days

I debated whether to title this post The 7 Stages of Grief because the Wheelchair Wars were an outgrowth of  my grieving.  To lose so much of one's physical function is so consummately devastating that grieving must be done. As I went through the stages of the grieving process I recognized many of them from previous readings I had done on death of a loved one. Below,  I took the liberty of changing words about death and  loss of a loved one and replacing them with words fitting to my loss of physical function.

7 Stages of Grief...

1. SHOCK & DENIAL-
You will probably react to learning of the loss with numbed disbelief. You may deny the reality of the loss at some level, in order to avoid the pain. Shock provides emotional protection from being overwhelmed all at once. This may last for weeks.

In the CCU my first brush with denial was when I asked my neurologist if I would ever regain my physical functions I'd lost.  He said it is different for everyone, but what I do regain   will  come within the first 2 years .  Well, I said to myself, "Not so, I will get it all back before that! Permanent disability is NOT going to be me!""  I hung onto that denial for months before I yielded to reality.  I do believe, however, that as long as I keep working at my physical therapy, my brain will continue to heal and I will continue to make incredibly slow progress over the rest of my life.  I have to believe this.  The alternative is grim.   Perhaps this is still denial, I don't know.  Guess the future will show me.

2. PAIN & GUILT-
As the shock wears off, it is replaced with the suffering of unbelievable pain. Although excruciating and almost unbearable, it is important that you experience the pain fully, and not hide it, avoid it or escape from it with alcohol or drugs.


Relentless tears marked these days, punctuated with what I call my "never" statements:  "I'll never do this again, or that again."  While there are somethings I will probably never do again. I've learned I can relearn to do many things again, albeit, differently from before and I also can learn to do and enjoy new things I never did before because they weren't of primary interest to me.

3. ANGER & BARGAINING-
Frustration gives way to anger, and you may lash out and lay unwarranted blame for the death/loss on someone else. Please try to control this, as permanent damage to your relationships may result. This is a time for the release of bottled up emotion.

You may rail against fate, questioning "Why me?" You may also try to bargain in vain with the powers that be for a way out of your despair ("I will never drink again if you just bring him/function back")
 

During this stage I inflicted damage to the walls and door jams of our house by slamming the wheelchair back and forth, especially when I got stuck while navigating around corners and hallways.  These fits of rage were always followed by a torrent of angry tears and pathetic wailing grief.  I screamed the questions, "Why me?"  This is not fair!  I did all the right things, ate right was the strongest and most fit I'd ever been in my life!  Why not someone else who smokes and is over weight and out of shape?"  These fits were very difficult for Pete to witness for he was powerless to do anything to alleviate my despair.  Finally, he said while I resumed destroying the walls.  "You can keep doing this but it will change nothing.  When you're finished you'll be right back here with the same problems And you'll feel  guilty when you see the damage you're doing to the walls. " He was right and gradually the frequency of these fits lessened as I began to move on.

4. "DEPRESSION", REFLECTION, LONELINESS-
Just when your friends may think you should be getting on with your life, a long period of sad reflection will likely overtake you. This is a normal stage of grief, so do not be "talked out of it" by well-meaning outsiders. Encouragement from others is not helpful to you during this stage of grieving.

During this time, you finally realize the true magnitude of your loss, and it depresses you. You may isolate yourself on purpose, reflect on things you did before your loss, and focus on memories of the past. You may sense feelings of emptiness or despair. 

I felt all of this and still do at times.  I was taking an antidepressant before my stroke and the doctor had upped the milligrams to keep this inevitable depression at a manageable level....Better life through Chemistry?  Rather than isolate, I threw everything I could at my stroke:  Aquatic therapy, physical therapy, acupuncture, deep tissue message, counseling, and adapted pilates.  I did therapy everyday often twice a day.  Remember I was going to be all back in under 2 years.  Denial, still strong and healthy. I exhausted myself daily and slept like the dead at night.

5. THE UPWARD TURN-
As you start to adjust to life without normal function, your life becomes a little calmer and more organized.  Your "depression" begins to lift slightly.
 

A turning point for me was getting my driver's license back as this gave me more independence and lightened Pete's burden.  Another upturn for me was when I returned to school to teach albeit only 1 class period a day.  I now teach 3.  One of my greatest fears was that I would never be able to do anything meaningful again.  I am so glad I still can.

6. RECONSTRUCTION & WORKING THROUGH-
As you become more functional, your mind starts working again, and you will find yourself seeking realistic solutions to problems posed by life with limited physical function. You will start to work on practical and financial problems and reconstructing yourself and your life without it.

 

This I did.  I was balanced enough to begin tackling the logistics of negotiating my life as a disable person.  I began my quest of solutions to the many problems facing me everyday.

How to open a can or bottle of wine.
How to put on a bra.
How to chop veggies so they don't roll around
 how to open jars
How to carry a cup of coffee to my classroom from the car.
The list is endless.
With each solution came a real sense of accomplishment and increased sense of independence.  The quest for solutions continues everyday.

7. ACCEPTANCE & HOPE-
During this, the last of the seven stages in this grief model, you learn to accept and deal with the reality of your situation. Acceptance does not necessarily mean instant happiness. Given the pain and turmoil you have experienced, you can never return to the carefree, untroubled YOU that existed before this tragedy. But you will find a way forward. 

This is where I am today.  I have days when I am quite happy and content and others that are angst filled.  The thing I've noticed about the grieving process is that it is not linear.  Many of the stages revisit me in no recognizable order. I can get so angry  but I know if I indulge it I will damage something and since we are remodeling, & repairing & repainting the damage I inflicted over the past 3 years, I know that is not a constructive response to my anger.  I still cry bitter tears.  I fight depression.  But I do try to be grateful for what I  still have.  With acceptance of this "new normal" comes more peace.


The link to the 7 Stages of Grief 


3 comments:

  1. Well done. What a powerful statement.

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  2. Excellent application of the the "stages of grief". I am astounded
    by the fact that all of us are grief-stricken for one reason or another.

    It has occurred to me many times, as I watch your progress Marian, that grief is not linear, as you stated. It is a life-long unfolding or revelation of "living without". With each revelation we mourn our loss. It helps to have a list of stages to refer to to make some sense of why we may feel or behave the way we do.

    What also astounds me is that the pain of loss "blooms eternal" in the sense that "it can still hurt" even after much time has passed.

    I have questioned the idea that the pain of grief should not be masked with medication. Personally, I am afraid to "go cold turkey" and look at my pain full in the face. It has been said, however, that the process of healing is only delayed if this is not done. I do know that pain is frightening, as I care for people who have undergone surgery and are coming out of anesthesia. Regarding pain, our primary goal is to "get it under control" or make it "bearable".

    There are many elements of care, in addition to administering medication, that are applied to reach this goal. Some are repositioning, distraction and emotional support.

    As I write, I realize that as friends, we apply these elements to one another, We reposition by offering perspective through conversation and empathy. We distract with laughter and good times together. We provide emotional support with kindness and validation.

    These things help us get our pain "under control" and/or "bearable".

    The single, most important thing, that grief has taught me is that everyone we meet throughout our day is grieving. It is important to be kind to others and to be slow to anger as we do not know what burden they bear.

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  3. A great book on grief is Joan Didion's "A Year of Magical Thinking."

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