Category: Essays

 

In January Matt and I took a class with the local beekeeper’s association.  Slides presentations and talks but not exactly hands on since bees don’t come out in the winter.  They like to huddle in the hive to keep warm.  There were over 100 people taking the class.  Beekeeping has become the trendy hobby.

After we graduated, I started to have second thoughts.  This seemed like a lot of work and, as Matt says, around here it is very much survival of the fittest.  If you can’t survive on your own, good luck, because I have been known to forget to feed the cats, water the plants and generally ignore my duties.  If the bees were not able to fend for themselves, it could get ugly pretty quick.

What do bees need?  Feeding mostly.  Spring is great.  For a month or two, they can feed off the land until the dearth comes.  In about July when it gets hot and nothing is really blooming, they get mighty testy because they get hungry.  So they need to be fed sugar syrup, a mixture of sugar and water of varying proportions depending on the time of year.  A sated bee is a happy bee.

As you have all heard, bees are also very fragile because of various pests that can kill them, primarily varroa mites.  To counter it, the hives need to be treated with fumigants to chase the bugs away. There are other diseases as well.  But the mites are the big killer.  They can kill off a hive in a matter of weeks.

Then there is the queen.  She also needs to be happy or there will be no bees to keep the hive alive.  If she fails, she needs to be replaced by the beekeeper buying and introducing a new queen to the existing hive, or, if you have patience, by letting the bees take care of it by producing a new queen.  They know how to do this but some people do want to wait for them to figure it out.  If the hive is too large or just wants to move with the queen, they split and swarm looking for a new place to hang out.  A lot of beekeepers try to prevent this.  Some chase down swarms to add to their colonies.

Honey harvesting occurs during a very intense period in June when they are just storing nectar like crazy.

Other beekeepers do a lot more but these are the basics.  We talked to a lot of beekeepers and some of them are very hands on.  Others really just let the bees do their thing.   We were assured that if we took off on vacation for weeks, the bees would figure it out.  I still hesitated.  If we took them, then they were our responsibility and I am not big on that either.  The cats are the most I can tolerate on the caring-for-animals front.  I don’t even want to be burdened with a dog to walk.

We went to some hands on classes in the spring for me to get a little more used to the idea of bees and to see if I really wanted to do this.  To determine if we could remain calm and find joy in bees, as every beekeeper does, we went to a bee yard and just followed a beekeeper around as he opened up boxes and showed us bees on the frames.  There is nothing quite like standing in a cloud of bees.  The noise and energy is quite exhilarating.  But I felt pretty confident.  I had the protective gear, bee jacket with protective hat and veil, and gloves.  And I have been stung by a bee so I knew what to expect if it happened.

The most important thing to remember with bees, and indeed with any animal, is that they sense your feelings.  So if you are in a tizzy, they will be too.  With bees, you have to go into Zen mode.  Calm and quiet.  Slow movements.  They get riled up after a while but you can keep them fairly calm if you don’t get too excited yourself.

There is also smoke.  We learned how to use a smoker.  The smoke keeps the bees calm by making it difficult for them to smell the alarm pheromones being emitted by the bees who are guarding the hive.  I could write a completely different post about bee behavior but basically the most important thing to a bee is to protect the queen and the honey stores.  They will die stinging someone to protect their hive.  So they take it pretty seriously when a beekeeper opens up the hive for any reasons.

After the visit to the bee yard, I said to heck with it.  Let’s do it.  They can take care of themselves for the most part.  We just check on them and do a little maintenance.  By the time I made this decision, it was May and that is very late to start a hive.  But we bought some bees anyway and hoped for the best.

What is it like to drive bees home in the back of your car?  Kind of weird but the beekeeper told us the box was quite safe and they could not escape.  We had bought all the equipment we needed—things like wooden boxes, frames for the bees to build up wax comb and store the honey.  We were as ready as we ever could be I guess.  So we took our little nucleus of bees, moved the frames into the hive boxes and hoped for the best.

Beekeepers are an odd bunch.  You know, bees sting and that sting hurts, don’t let anyone tell you different.  But for some reason there is this macho code that beekeepers can wear a veil and maybe a jacket but never gloves.  Beekeepers don’t wear gloves.  I could not understand this but they swear that it is better to work with bees if you can feel what you are doing.  Hey, if you get stung, so what?  I have seen pictures of beekeepers wearing shorts, short sleeves and no veil at all.  I think they are idiotic.

I decided to compromise and buy a pair of leather gloves but cut off the finger tips so I could still have some feeling of what I was doing.  Matt said, no way, I’m wearing gloves.

On the second visit to the hive, a bee stung my exposed knuckle and the finger blew up.  It turned a lovely shade of red and resembled a small sausage.  It also hurt.  A lot.  It itched too.  It took about a week for it to clear up but I moved on.  Then I was stung again and I said, okay, forget it.  I’m wearing gloves.  I’m no lemming.

The beekeeper group really let us down in terms of giving us a mentor so we ended up having to read and read and read to learn what to do.  We also watched some videos.  At this point we are kind of muddling through.  We have a strong hive and the bees seem happy because we keep them fed.  We treated them for mites and now we have to see if they will make it through the winter.  That is the big test.  Then we will need to figure out how to harvest the honey.  We have the winter to figure it out.

 

To the average person, it’s the big toe. The little piggy that went to market. To the medical profession it is the Hallux or the “Great Toe.” After three years, Matt is not so sure it is all that great.

In 2011, we were at the beach doing what we always do, frolicking in the water and riding the surf on our boogie boards. At some point, Matt stopped. He was jumping around in pain yelling, “I jammed my toe in the sand!” Well, okay, he had stubbed his right toe or jammed it. Whatever it was, he had hurt his toe pretty good. He limped around for the rest of our stay.

We got home and went on with our lives but the pain in Matt’s toe never really stopped. Bending the toe was a real challenge. So we made an appointment with a podiatrist. He took an x-ray and did not see anything in particular. It was not broken. It was not obviously injured. His theory was that perhaps Matt had jammed it hard enough to have a bone bruise, which takes a long time to resolve. We’d have to wait. We went home no closer to resolving the problem.

He began having trouble wearing shoes because they pinched his toe. The inside of his toe, that spot where you slide in the toe grabber on a flip flop, was sensitive even to touch

He went to another podiatrist who had no real idea why his toe hurt. He thought he might have a bunion problem. He thought he might have tendinitis in his toe joint. He thought he might have turf toe. Whatever it was, he created a shoe insert that would prevent his toe from bending in an impactful way. We searched and found new shoes that gave him some toe room. These were not fashionable shoes, but your basic black, orthopedic person-with-foot-problem shoes. They were tennis shoes in style, but black and neutral enough that he could wear them to work and even with suits. He hated being unfashionable but he had no choice.

By this time he was on pain pills that kept the pain at bay but did not really stop it. The insert kind of helped but did not really make the pain go away either. When he walked he favored his right foot causing him to put more stress on his left. Then one day, his left ankle began to hurt. He was double limping. The podiatrist took an x-ray. He ordered an MRI. Matt had torn the peroneal tendon in his ankle. This tendon is a stabilizer, responsible for making sure your ankle doesn’t bow out or roll. This is often injured if you twist your ankle.

In March 2012, now almost a year to the date of his injury and a week before we moved to our new house, he had surgery to repair the tendon. He had to be on crutches for several weeks. He went to therapy, he wore an ankle brace, and did all the right things. But for some reason, the ankle continued to hurt. The doctor thought the pain would go away with time and he encouraged Matt to wait it out.

Now that his ankle was repaired, we went back to trying to fix his toe. The doctor really did not know why it hurt. He thought it was tendinitis but it was not clear what was causing it. He focused in on a small bone at the bottom of the toe called the sesamoid (not the same as the sesamoid on the bottom of big toe joint). He thought this tiny pea size bone might be rubbing on the tendon. He also thought that some of the pain was coming from a bone spur on the big toe knuckle itself. So he proposed to remove the sesamoid and shave off the bone spur and in October of 2012, Matt had another surgery. He was once again on crutches for a while, then special shoes, then finally, therapy.

After months of treatment and two surgeries, his left ankle was still hurting and the surgery on the right toe did nothing to relieve the pain.

When you walk, the bottom of your foot sort of rolls and your big toe bends at the bunion as you move along. The bending became incredibly painful and he was having trouble walking long distances.

Matt was also living in an ankle boot to protect his ankle. He was more comfortable when it was stable. He was using a cane and limping along in a boot. It was almost as if it had either gotten worse, or certainly had not improved at all.

By the beginning of 2013, we decided to think outside the box. We went to a doctor specializing in more cutting edge treatments like platelet rich plasma (prp) injections to calm and heal the tendons in the toe. The doctor removed more bone spurs. He injected various remedies in various spots around his ankle. None of it provided any relief. At one point using ultrasound on Matt’s ankle he said he saw a lot of scar tissue and he could see the suture wire that was used to repair the tendon. He mentioned something about this particular suture being known for tearing soft tissue. He was just guessing but he felt that this could be a source of much of Matt’s ankle issues. But he knew of no way to get rid of that suture. It was not going to dissolve. It was made of a polymer wire and he had never heard of surgery to remove it. By now, this doctor was pretty much out of ideas.

It was the middle of 2013 and we determined to move on to what I considered the Lourdes of ankle and foot repair—the Foot and Ankle Institute in Baltimore. If these people did not know what was wrong with Matt’s toe and ankle, then no one would.

As it turns out, this doctor had no idea what was wrong with Matt’s toe. We had been through every option she could think of. The MRI revealed nothing. One option was that a very small tendon was torn but that was inoperable.

The ankle could be fixed. She was pretty certain that an MRI would show that his ankle surgery had “failed” and he would need to have the surgery done all over again. But this time it was even more complicated. Now two tendons were torn and one was torn so badly, she was pretty sure she would have to remove a large part of it and attach what was left to an adjacent tendon, a procedure called “tenodesis.”

We scheduled the surgery and in September 2013, Matt had the ligatures in his ankle reconstructed. She had warned us that this was a complex surgery and the recovery would be very long. No weight bearing for twelve weeks. We bought him a leg scooter. These are contraptions that allow a person to get around by pushing along with one foot, the healing leg resting on the scooter, going along for a ride. We set up a ramp to a side door in the garage so he could get in and out of the house. Because our stairs are winding and narrow, the only way he could get up and down the stairs was to scoot on his butt.

While the doctor was performing the reconstruction, she made a startling discovery. During the first surgery, a major nerve had been caught in a stitch. The doctor freed the nerve during the reconstruction, but it had been trapped for over a year. Matt had been experiencing shooting pains in his ankle and this would certainly have explained why. She directed us to a peripheral nerve surgeon. We have something called peripheral nerves, which give us sensation in our periphery—the arms, legs, hands and feet. These nerves are often the main drivers of pain and they have surgical techniques to relieve that pain by removing the nerves. The idea was to see if he could do anything to de-enervate the nerve. By that I mean, stop the nerve from working and sending pain signals. This doctor was skeptical from the start and said there was nothing he could do about the pain. He was not convinced the toe pain was from a damaged nerve and he felt that doing anything about the ankle was premature.

We reported back and the ankle surgeon suggested we wait to see if the nerve would rebound. So we waited. It did not get better. If anything, the shooting pains increased. At this point, she had no recommendations. For the toe, she believed that if the pain was caused by a torn tendon or ligament, it was not something she could do anything about. It would require microsurgery and she had never heard of such surgery on a toe tendon. For the ankle, she had no idea what to do. She had hoped the pain would resolve and the nerve would recover but it didn’t.

We had exhausted her as someone who might solve Matt’s pain.

But she had said something that intrigued me. If the toe ligament was damaged and repairing it would be micro-surgery, what if I found a micro-surgeon? I started searching the internet for micro-surgeons. Micro-surgeons perform delicate surgery that involves very complex reconstruction. These are the guys who will sew your finger back on if you cut it off. Many are plastic surgeons.

I found a website and emailed a doctor in California. I explained Matt’s plight and asked him if he thought there was anything that could be done. He answered almost immediately telling me that one of the best micro-surgeons in the country was up the street in Baltimore and he could probably help.

So I called. This surgeon pioneered a technique to relieve trapped nerves and in many cases, he has worked to resolve pain and damaged nerves by removing them. He was kind of a kooky guy and he insisted that we see his orthopedic surgeon/podiatrist to be sure there were no options from that perspective. We did and the doctor confirmed that we had tried everything possible.

Then we learned something that puts terror in the hearts of all Americans—the micro-surgeon did not take insurance. We would have to pay. If we could not, we could see his younger associate, also a micro-surgeon, to see if he could help.

The doctor, Eric Williams, felt that this would work for the toe and he agreed to do the surgery. We were absolutely relieved. The doctor removed the nerve that serves the great toe, the superficial peroneal nerve. This nerve goes straight to the big toe from the calf. As part of the surgery, the end of the nerve is buried in muscle to protect it, so the surgical opening was made in the shin. And hallelujah, it kind of half worked. Some of his toe is numb and some of the pain was gone. But not all.

Nerves are funny things. They are webs in our body and they can grow, like tentacles, into areas where they sense something might be wrong in the communication between brain and body part. The other funny thing about nerves is that it is not always easy to tell where pain is coming from. While the doctor had blocked the nerves ahead of time to test which nerves needed attention, that test did not reveal all.

For some reason, another nerve appears to have branched into the toe area to give signals to a part of the toe. Even worse, Matt could now clearly feel sharp pain in the area where the first podiatrist had done the surgery to shave bone from the bunion. So another nerve has to be removed to cut off the sensation to the bunion and the toe. We are awaiting that surgery.

In the mean time Matt’s ankle needed attention. The shooting pains were increasing and he was having trouble walking pain free. The ankle surgeon suggested we talk to the micro-surgeon and we did. He was surprised that the nerve had been caught in a stitch and he assured us that after all this time, it was not coming back. Those jolts of pain were signs that the nerve was damaged.

Matt headed into more nerve surgery, this time to remove the sural nerve, which feeds into the ankle and that was stitched during the first ankle surgery. The sural nerve is in the calf and goes down to below the ankle joint. Again the surgeon had to remove the nerve and bury it in a muscle. So he started a little below the back of the knee and buried it deep in the calf muscle. Matt’s outside calf is now numb. This surgery seems to have done the trick. The shooting pains are slowly dissipating and he is in much less pain.

There will be more to come. Another nerve to the toe needs to be removed and there is some residual pain emanating from the ankle that is likely tendinitis from walking funny for years. We hope these will clear up.

So that is the long tale of Matt’s Great Toe and the side kick, the pain-in-the-ankle. And this is why our life seem different than it was before. We are a little consumed with the world of medicine.

 

 

Post script:

During this time, Matt really wanted to try and help out.  Here he is putting away his laundry.  I guess head transport is one way to take care of it.

 

Until I saw “The Tallest Tree in the Forest,” I knew nothing about  Paul Robeson and we should all know about him.  Long forgotten, he was an early civil rights pioneer and activist.  The play presented his astounding and complicated history in ninety minutes.  A one man show by Daniel Beatty tells the story of Robeson’s rise as a singer, most famously he sang Ol’ Man River in Showboat, to his becoming a vocal activist for civil rights and social justice.

This is a very short summary of his life.  It is way more involved than this and I encourage you to go to the wiki link or here.  The title, “The Tallest Tree in the Forest” comes from a quote by Mary McLeod Bethune who said  Robeson was “the tallest tree in our forest.”

Robeson attended college at Rutgers, being both valedictorian and star football player.  He got a law degree from Columbia but because of discrimination, he was unable to find work.  He then discovered that he could make money singing. He came to the attention of the playwright Eugene O’Neill who wanted him to star in his plays, “All God’s Chillum Have Wings” and “The Emperor Jones.”  He was a huge success and then landed a role in a broadway show, Showboat, which he starred in for many years in England and the U.S.. Despite many who criticized  his role as a slave as demeaning, he kept on because it gave him freedom and because he felt that he played the character in a way that created sympathy for the plight of slaves.  I am not sure that is true but he was so successful that he was able to produce and star on Broadway in Othello.  He was the first black man to play Othello, in a show he produced himself.   By then he was probably the most famous black man of his time.

But while he was a famous entertainer, he was also an activist for economic justice and civil rights.   He sought anti-lynching legislation in one of the first civil rights efforts, but President Truman turned him down.

He argued over freedom for Africa, for Australian aborigines, for poor, mistreated Welsh miners.  His strong views on society and justice also brought him trouble.  After he visited the Soviet Union and gave them glowing reviews as an equal society, he was branded a communist sympathizer. He ended up on Hoover’s black list, and was called before the House Un-American Activities Committee which he denounced in public.  Robeson accused them, “YOU are the un-Americans!”  When  asked why he did not go and live in the Soviet Union, Robeson thundered: “Because my father was a slave, and my people died to build this country and I am going to stand here and have a part of it just like you.”

Then Robeson made speech that was the beginning of the end.  He was so angry at the discrimination in the U.S., that he said African-Americans should not go to war on behalf of the U.S. because of the way they were treated.  People started to distance themselves from him.  At some point a civil rights leader said, the tallest tree in our forest needs to be cut down.  When he refused to also denounce Joseph Stalin for his own extermination of Jews and pretty much everyone who disagreed with him, Robeson was abandoned even by liberals.

For much of his popular life, he had lived and made his living in Europe and when his passport was revoked because of his Soviet sympathies, his life started to spin out of control.  He became ill and lost favor with just about everyone.  He eventually died a forgotten and under-appreciated activist who is only now being rediscovered.

The play told me all of this.  It was a wonderful, moving and sad story about a man who should not be forgotten.

Matt and I agreed not to exchange presents this year because we bought a new television.  And then he bought me little things anyway.  It was nice of him but it brought back memories of my mother and how she slowly changed Christmas over the years.

When we were kids she bought lots of presents and we decorated the house with fake holy, a tree, lots of lights and Christmas cards from family and friends taped to the pantry door.  As we got older, she seemed to lose interest.  By the time I was in high school, and she was about the age I am now, she really stopped caring.  If we were going to decorate and have a tree I had to make it happen because I was the only one still living at home.    My dad not really participate at all so he was no help.

As for presents, she would hand me money and say go buy gifts and make sure you get something for yourself.  I went shopping and then wrapped all the gifts, including my own.  Hey, why not?   She insisted she really had everything she needed and she did not want presents.  We bought them for her anyway, usually clothes we thought she needed and maybe a knick knack.  She tried to be excited but more than anything she just fussed about how nothing fit and she didn’t need that new blouse or sweater anyway.  What she had was fine.

As I was facing Christmas this year, I began to think that I might be arriving where my mother was.  First, like my mom, I have come to the point that I just don’t need anything.  One hundred and fourteen catalogs arrived in my mailbox in one week, selling all sorts of trinkets and googaws.  As I leafed through them, all I could think was–have it, have it, have it, don’t need it, don’t need it, don’t need it. There is no longer the allure of objects, or jewelry, or anything else they are selling.  If I am interested in something, usually having to do with cooking  I just buy it for myself.(I bought cheesemaking kits this year.)

Then there are the traditions of Christmas.  There was an article in the paper recently written by some young mother who confessed that she and her friends were killing themselves trying to be everything at Christmas–baking cookies, decorating, buying presents, sending cards and trying to keep up generations of traditions.  They felt that if they did not do all of those things, somehow their kids would suffer and where were the spouses?  I just thought, man, you need to relax!  Stick to the priorities. Figure out what is worth doing and forget the rest.  All that stuff does not bring true meaning to Christmas anymore than a giant diamond wedding ring ensures a good marriage.

I think that I have sorted through everything that is important to me and have concluded that  I like the tree and outdoor lights.  That is really what matters to me.  So I have reduced my decorating inside to putting up a tree.  I have an entire collections of Santas and snow men that I used to display.  Now I don’t take the trouble.  It just disrupts my house, it takes time to put them up and take them down and in the end, what difference does it make?   Does it make Christmas any more special?  Honestly, I don’t think so. I think that for my mom, it was not the decorating that was important, or even the gifts.  She wanted us to be at home making noise and laughing.  That was what mattered to her.  The rest was just piffle.

Is it nice to give presents?  Of course.  And really, isn’t giving so much better than getting?  That sure is how I feel.  But somehow Matt and I carry on without exchanging gifts.  Some years we do buy presents for each other, it depends on how we feel.  When I am inspired I might buy presents for my family, or even strangers through organizations that set up gift giving for those in need.  I have no set plan.  Mostly, I prefer that we just enjoy each other with some good food, some good wine and lots and lots of talking and laughing with people we love.