Kabir Kadre
Kabir Kadre
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Back in the saddle…

Kabir kadre|4 months, 8 days ago

I’m writing this morning from a somewhat liminal space of feeling. After spending the day in bed yesterday, my blood pressure is a little “coming and going” as my body reaclimates to an upright position. This translates to vision… Not quite fuzzy, but not quite precise either. A few minutes ago my hearing was a little deaf, but that has returned to normal as I now rest in this work with my familiar friendly windchimes singing their encouragement through the open window.

Another fresh and bright sunny day adds to the innumerable good fortunes I am privileged to enjoy here in the Southern California summer. The windows and doors of the house stand open, filling the shaded space with the easy breeze of late morning.

I’m grateful today for my friend Elisa who stepped in yesterday to keep the online face of this daily Journal alive. My fortunes yesterday morning to me down a rather intense path of rest and recuperation for the day. I had hoped to imagine some way of writing from bed, but that was not to be – my energy and bodily condition remained ultimately insufficient to the task. Fortunately, kind hands stepped in and carried that torch for a moment on my behalf. The offering was sweet and simple and beautiful and I encourage you to view her post, timely as it is.

Yesterday morning at about 4 AM as I was chuckling in my dream, in some friendly banter with Bob Dylan on a ski lift in a bright, warm, and airy atmosphere, autonomic dysreflexia kicked in and I could feel the intense sensation sweeping through my body. In little more than a literal second I was wide awake, eyes open, and alert for any additional information about my condition.

For about nine years now, my friend Greg has been performing my periodic suprapubic catheter changes and overseeing the care of the stoma through which it travels. He left that context of our engagement at the end of February this year to focus on completing his masters degree in pursuit of a PhD in clinical psychology and those duties were taken over by an in home health nursing service while we organized someone in-house to step into that skilled position.

The catheter is something I usually change about twice a month, and in the early hours of yesterday morning it had been just over three weeks since the last servicing. This stint is not common, but also not entirely unfamiliar and well within the bounds of protocol. I had been in communication with Greg about visiting this coming Tuesday to do a recorded training of his process and wisdom on the matter.

After a couple of days of discomfort however, I thought it prudent at that 4 o’clock hour to send a quick text just in case he might be free that morning as a change of the catheter is one of the prominent areas to investigate when autonomic dysreflexia persists.

In my startled nervous state I was sure I would be awake the rest of the morning, but by good fortune managed to drift off back to sleep. A few minutes after 7 AM, I was again awoken by the same shuddering sensation. Sitting upright in bed, I was relieved to see the text from Greg from a quarter to the hour, “leaving in 30 minutes.”

Greg arrived, the first time we had seen each other since he had brought me home from the hospital on the last day in February. We spent about an hour catching up, my bodily discomfort was not persistent and I think we both anticipated a fairly simple procedure for getting on with our respective days. Caitlin arrived to film and assist and after a little further catching up together, I reclined the bed and we got underway.

Everything seemed rather normal, the catheter showing its age, and a few details that Greg observed he could share with team to improve care going forward. And then…

The old catheter removed, and just as the fresh instrument penetrated through the stroma in the belly and into the bladder, blood, and lots of it. Old and dark and clotted… Blood coming out of the stoma, the catheter, and the urethra, for about 10 minutes this persisted, and my physical discomfort elevated to among the most intense experiences I have had.

In the end the blood loss was minor, perhaps 400 mL or so, very little of it fresh in appearance and gradually and returned to my senses from land of intense waves of headache and physical anxiety.

In my experience, catheter changes are uncomfortable for me about 50% of the time. As this one had begun there was a little discomfort and I was using that to train my meditation to cut through the vicissitudes of reifying “outward” experience and maintain equanimity of awareness in the face of sensory grab.

This was all going rather well, or so I thought, until the sensation overwhelmed me like a tidal wave and I let wholly go of the practice and returned my narrow attentions of “what the heck is going on here!?” 🙂

Greg and Caitlin worked exquisitely, led by Greg’s cool head under pressure and the new catheter was quickly secured, urine flowing properly and easily. For the next few hours there was an ongoing cleanup of residual blood, maintenance, and observation of the emerging situation. Our great care partner, my doctor, Mike dropped what he was doing and jumped on a video call with us early on in the process, complementing Greg for his handling of the process, and sharing or video (yes we had been filming 🙂 directly with the urologists nurse, Marianne would call later and schedule us for a deeper investigation this coming Thursday.

At the end of the ordeal I was exhausted and tender, the slightest touch on my abdomen raising ire in my nervous system for the next few hours. I let myself drop into sleep, resting my mind somewhat aware, but my body deeply relaxing, focusing on the healing process now at hand.

Today brings to close a week of subtle violent trauma in my body.

Four days ago I wrote on the subject of observing violence in the world, noticing the movement towards violence in myself, and the realization of wounding, expressive of violence, in my flesh.

The smashing quality of yesterday’s events drew me to further contemplate the experience of projected vision of the world and my introjected experience of realizing suffering within my self.

This morning I feel strong and healthy, if a little liminal in the recovery, I have yet to reorient the process of never ending unfolding work that I continue to re-create and lay out before myself. I have yet to check the news, to learn the status of our waves of pandemic, and pain of violence and separation from one another. Funny, isn’t it, that I expect only bad news from the news?

I look forward to catching up on correspondence. Later today I will enjoy the precious gathering of our little care team over video conference, still practicing social distancing, and later may find myself gathering again with our local integral community to reflect on the learnings and invitation of the global gathering of that community, just recently past.


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