Consider that I'm thinking out loud in this post.
    If you've visited the What's Next section on the Updates page and perused the To Do List you may have noticed a tick to myself about checking Lisa Alther's Kinflicks "for musings about my mother's death". Although I haven't yet looked this up or written on it, this post covers a related subject; musings about the spiritual/psychosomatic origins of my mother's dis-ease of iron deficiency anemia. I was prompted to think about her anemia from this perspective by an article I read yesterday in Beliefnet's weekly email newsletter: Caretaker! Take Care of Yourself! by Debbie E. Mandel, first mentioned a few posts previous. In the article Mandel introduces a caretaker who became so caught up in caretaking for her family that she martyred her life for several years. She "became dangerously anemic and no doctor could figure out why, until one hematologist suggested, 'It could be stress. Blood symbolizes family [italics mine], and your family is stressing you out!'" Once she grieved her mother's death (the object of her original caretaking mission which led her into caretaking for other members of her family after her mother's death), married her fiance, left her family, "...let go and live[d] her own life joyfully...", including releasing her guilt for having left her family to take care of herself, her hemoglobin rose and stabilized.
    I have no reason to doubt this. I have a vigorously nodding acquaintance with the "psycho" part of "psychosomatic" in regard to my mother. It wasn't the specific postulated reasons for the rallying of the caretaker's hemoglobin count that caught my attention, though. It was the association of blood with family and iron deficiency anemia with a family who was unwittingly and inconsiderately stressing the the anemic caretaker.
    It has set me to thinking about what the psychosomatic causes underlying my mother's persistent anemia might be. As I have been thinking out loud about this, here, I've been throwing these ideas out for my mother's consideration, as well. Although there are some interesting family dynamics [lack of contact being a major one since my mother's immediate family is very important to her and now contains most of her friend network (which has been a lifelong life style for her)] that could cause my mother to feel stressed about her immediate family, we've discussed these. She doesn't feel that these are causing her any stress or guilt and I believe her. She is, always has been, supremely philosophical and phlegmatic about the ebb and flow of family relations and I've never known her to be bothered by family dynamics, let alone stressed by them.
    It occurred to me as we, bit by bit, dismissed family=blood as a source of "stress", that perhaps in my mother's case the important "psycho-" element of her anemia isn't the blood=family factor but the iron=strength factor and that her personal strength has been sapped, perhaps by a member of her family, most likely me. So, we explored this. Here's what we came up with:
    Although my mother's anemia has only surfaced within the last year (probably around August of last year), other aspects of her health have been troublesome from the point of view of her personal strength (both -somatic and psycho-) for almost two and a half years. Although this jibes, more or less, with how long she's been on metformin it also jibes with a few other circumstances:

1. Her health coming under severe scrutiny and treatment by doctors on whom she has rarely had to rely;
2. As her lethargy developed and affected her ability attend to her personal business I began stepping in and taking over. Previous to this, although I was providing the service of handling her business for her I was also discussing it with her, talking with business people with her rather than in her stead and I always allowed her final say, even if it, occasionally, got us into trouble and we had to recant. Once lethargy gained a foothold, though, she not only deferred to me, she slowly bowed out of even discussing these matters with me or anyone else. I, without question, took over, including such things as carrying all the money, paper and cards, handling conversations on my own, making decisions on my own (although I still let her know what was and is going on and solicit her input; it's just that, for some time, she's waived input), etc., even turning off the ring on the phone to make sure she did not make a decision or agree to something of which I would be unaware but would affect us profoundly later and surprise the bejesus out of me.
3. Her ability to entertain herself also flagged (she's always been excellent at being able to entertain herself) and she got into the habit of looking to me for the entertainment factor in her life. If you've read any of the history you know that I have a strong loner streak and tend to consider socializing as 'up time' and being alone as 'down time' (to put it another way, socializing, for me, is a type of work, although a welcome one at which I'm good and that I enjoy; my real joy, though is to be left alone to my own devices to pursue my interests, most of which are decidedly solitary). So, I haven't been the best of entertainment providers for my mother and on occasion have sabotaged her efforts to get me to entertain her.

    While she completely rejected the blood=family connection, the iron=personal strength connection made some sense to her. As we talked we began to suggest ideas for how, now that her physical health is rebounding enough for her to look forward to having energy to burn, perhaps it is time for both of us to reinvolvee her at an easy pace in the accoutrements of her life; for us once again to be partners, as is reasonable, in her and my lived-together life.
    For instance: For the past two years she has been completely uninterested in working with her accountant on taxes. I suggested that next year we should go together again. For two years we have ignored our twice yearly visit with her stock broker and she has not discussed stocks with him, even during the rather critical period when her holdings were converted to an annuity. Time for us to reinstitute this tradition, I suggested. She enthusiastically accepted both these ideas.
    For a long time we have rarely hosted family in either of our residences for any reason. Time to start doing this again, once we do the repair and remodeling that have become necessary on both houses. Great idea, she thought. We should begin again to initiate visits rather than waiting to be asked as my mother feels up to it. Yes, good idea, she again confirmed. Mind you, all this enthusiasm for involvement in her life is actually a re-enthusiasm for re-involvement.
    Before I initiated this conversation with her this evening she decided to go to bed at 2130 which is a bit early for her. I insisted, though, that she couldn't go to bed without a thorough foot and leg rub. This was a good idea, as she has begun to retain water normally again within the last 12 hours or so. While she was not overly saturated, a good foot and leg rub keeps her body from refusing to release water. It was during this foot rub session that I started the above conversation. It became so animated and involved that she didn't go to bed for a little over another hour.
    I have no idea if her anemia will improve. I suspect that her numbers, while they may have rallied a bit for the Big Guns Draw on Friday, probably weren't yet back to normal. Something tells me, though, that since our discussion tonight (especially our consideration of strategies to reinvolve her in her life and the lives of those she loves, which should automatically increase her feeling of personal strength) I shouldn't be surprised if, at some point in the next month or so, her anemia recovers. I'm not going to outright expect this...I am circumspect, so is she. She thinks the psychosomatic ideas I am proposing are a bit "out there" and I know she's not going to count on them either. But, in her words, "We'll see." I think this consideration, tonight, of in-the-blood iron=personal strength might work at least as well as the accidental colonic that the ill-considered colonoscopy required. At least I am optimistic about this.
    In the meantime we are still planning on releasing ourselves, finger by finger, from the clutch of doctors, as we've agreed, for week or so, that "it's time" for this. We are still going to Prescott and Mom seems more up for this than she has in a long time. I will continue, overtly and surrepitiously, to monitor her with an eagle eye and seek out professional consideration if I think it's necessary. And, we'll both pay more attention to her personal strength quota. It certainly can't hurt.
    Although I intended to also write, tonight, on my observations and opinions of the current social concern over caretakers taking care of themselves I think I'll put that off until tomorrow. I've got an early call in the morning. We will be seeing the hematologist tomorrow and I still have some things to do before retiring tonight. Here's a teaser, though: I've lately begun to wonder why it is that, in this country's society, overall, at this time, we are not only depending on caretakers to take care of others but, now, we're charging them with the primary responsibility for taking care of themselves. I know that the current "personal health" fad dictates that one must be responsible for one's self as one is able. When I look at it from the imagery of a set of scales though, it looks more like what we are doing, in pushing this seemingly wise strategy so vociferously, is simply moving several more weights over to the already tipped plate then blaming the person struggling beneath the plate if they can't reach up around the lip, pull some of those weights off and move them to the lighter plate dangling high above their reach. Think about it. So will I.
    If events allow I'll write more on this tomorrow.
- posted by gail rae @ 21:26   email...this post