Here we are, once again.  Winter time. 

Snowy beauty this morning in the mountains as I shoveled the driveway and a path around to the back of the house.  Bernard isn’t able to have these glorious outdoor moments right now, stuck in bed as he is, and I worry about that. 

We all get a lot less sunlight at this time of year, in this part of the world.  The rates of Seasonal Affective Disorder (SAD) run between 2-3% of the population here in Canada, with a milder form of the problem, Subsyndromal Seasonal Affective Disorder up even higher, around 15%.  Even on this bright snow day, clouds cover the sun and prevent it from entering my eyes directly.  Luckily, the snow reflects the available light and I received a good dose of the light stuff.  Bernard is pretty much stuck inside for most of this season, and this could dampen his mood and energy as well as his circadian rhythm.  Researchers think that lack of sunlight can affect our internal clocks, changing the timing of hormones and causing the symptoms of Seasonal Affective Disorder. 

The Canadian Mental Health Association sites the symptoms common to SAD:

change in appetite
cravings for sweet or starchy foods
weight gain
decreased energy
fatigue
oversleeping
difficulty concentrating
irritability
avoidance of social situations
feelings of anxiety and despair

Obviously you should follow the advice of your doctor in treating symptoms  that seem like SAD.  One of the main treatments for these seasonal symptoms, and to correct mussed up circadian rhythms is light therapy.  Last month, in preparation for the winter ahead, I researched and purchased a full spectrum light.

There are a number of companies and types of lamps to choose from (if you’re ordering online).  I went with the ‘Day Light’ from Uplift Technologies, mostly because it was available in town and was on sale.  It’s about 18″ tall by 12″ wide, with three high quality non-flickering flourescent bulbs which emit 10 000 lux at 12″ away, with negligable ultraviolet radiation. 

10 000 lux is generally used for light therapy.  If you use a weaker light, or you are located farther away, then the light is much less effective.  This is because light intensity is inversely proportional to the square of the distance (meaning: if you double the distance, you only get one quarter the light, or lux, and if you triple the distance you only get one ninth!). 

Some examples of illuminance 

• Full moon overhead at tropical latitudes = 1 lux
• Office lighting = 320-500 lux
• Overcast day = 1000 lux
• Direct sunlight = 32,000-120,000 lux!

Our experience with the light has been positive.  Bernard feels it can initially stress him out with its intensity, but that mostly it makes everything brighter and more cheerful.  I’ve been using it mornings while I have coffee and sit at the computer.  And, once I get over the initial shock of brightness, it’s wonderfully refreshing.  I’m a little bit light drunk by the time I’m done.

Since it’s very difficult for Bernard to get to the doctor’s office, I go and talk with our physician on his behalf.  This works - for things like paperwork and prescription refills. 

Sometimes however, real physical tests must occur, so last week the local health nurse came to the house to do some blood work.  It’s great that they can do this, and I’m thankful that our local clinic helps us facilitate these things.  Unfortunately, the tests show that Bernard has some other health issues that need attention.  This will likely mean more medication and/or vitamins to take, something that’s been quite difficult lately because pain meds are so hard on the stomach.  But, at least we’re aware of the situation now and can try to remedy the problem. 

It must be very very difficult for disabled people to get the health care that we all require if they don’t have an advocate to help the process along.  Even with assistance from me, there are some things, like eye care for instance, that are being neglected with Bernard because we haven’t figured out the logistics.  The system is not set up to accomodate this type of disability.  And oh boy B really needs new glasses!

Bernard wore contacts for years, but that’s too difficult right now, so he’s wearing a rather tatty old pair of large, 80’s style specs that are so incrediably far out that they’re almost back in!  I’m sick of having to look through them to see my sweetie!!  

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Bernard claims that they’re good glasses.

 ”…they have so much lens to look out of, more lens bang for your buck!” 

I say they’re only good for a laugh.  Seriously though, the prescription badly needs updating, so a new pair would be a ‘two birds with one stone’ kind of deal.  I’m going to go to one of the local Optometrists and see if we can figure something out, though I don’t think there is an easy answer to this.

Anyways, I just think it’s hard for people who are hurt and alone to get the health care that they need.  Maybe you know someone needing a bit of help getting to where they need to go, or figuring out a different way to get the health care they require.

[Nkole]

Turning things upside down…

 
The Nordic Track ‘Revitalize’ Inversion system was on sale in the Sears catalogue a few months ago, so we decided to give it a try.  When it arrived I took on the task of assembly, daunting considering the number of pieces and the lack of precision they used in drilling the holes in the metal for the many bolts.  But, once it was assembled, it was obviously a sturdy piece of equipment.  We added a plank accross the lower bar, to allow some pillows to be placed under Bernard’s knees, hoping this would ease pressure on the lumbar curve.

It takes up a lot of space, and looks bloody impressive, like it ought be able to offer assistance.

This ‘Invertor’ is said to allow the discs to decompress a little by taking the body’s weight off of the spine, letting it stretch and return to a more natural spacing.  The key is to be very gentle, starting with 15 degrees of inversion and to work up to 45 or 60 degrees, if appropriate, over some weeks. 

It’s not going to cure the disc degeneration or spondylolisthesis, but perhaps it can help with some temporary pain relief, if it takes a bit of pressure off the compressed nerves. 

Bernard tried it a few weeks ago.  We proceded carefully.  There are some small adjustments to make so that it’s set at the correct levels for his height, and it’s an intense and nervous thing when you know that even slight errors in movement cause him major problems at this point.   

[Bernard]

It may take a while to ease into.  This first time, I could not perceive any stretching in the lumbar area.  My main experience was of a few varieties of substantial discomfort and some unaccustomed and borderline alarming sensations of motion in the spine.  I was numb almost to the knees for an hour afterwards from the ankle compression cuffs, which didn’t quite suit my foot shape.  I’m going to try it without shoes, contrary to the printed instructions, since there is no way my big feet are going to slip through these very tight-fitting cuffs.

I’ve always kept my calves and hamstrings well stretched, going back to my karate training 20+ years ago.  In the last year the stances required for that stretching have become impossible, and additionally there is a pronounced tightening in the calves that often accompanies nerve compression and its attendant leg pain.  I periodically try to stretch my calves by angling my toes upward towards the knees as I lie on my back.  This yields some benefit in comfort, but is hardly a full stretch.  This first time on the machine I felt a very strong stretching down the entire backs of both legs.  We went very slowly, Nkole rotating the bed in small increments, with lengthy pauses to allow my muscles to adjust.  

There is a strong element of danger involved, and the benefits may be only very slight, but at this point gaining a fraction of a millimentre for a few days could equal precious relief.