Convalescence: From patient (noun) to patient (adjective)

This entry is part 3 of 3 in the series The Doctor Who Gave Up Drugs. 

Convalescence¹ – an old-fashioned word that doesn’t seem to be used any more. We tend to use “recovery”² which is approximately the same, but “convalescence” has a more definite feeling of a process over time. You may have followed Dennis’ story of injury, illness and recovery in the previous two articles in this series.  If so you will know that Dennis has made remarkable come-backs from a serious car accident and from sepsis. But he went through a planned period of convalescence. This is the story of his convalescence from sepsis – life-threatening infection.

Fresh air, nutritious diet, plenty of rest. All sounds rather twee and Jane Austen doesn’t it? But whenever Dennis was frustrated at not being up to doing something (which happened quite often) he had to remember that we used to send people to Italy or Switzerland for months at a time to recover from serious illness and “build up their strength”. To Sanatoriums, Nursing Homes, Convalescent Homes – giving people time to get their strength back. Sure we have painkillers, anti-inflammatories, antibiotics, but although they make you “better” they don’t make you who you used to be.

And maybe we don’t use that period of healing any more in the way that we could. Life is binary – we are working or we are not. We are ill or we are not. We are in pain or we are not. Convalescence is a period when you are not ill but you are not well. Life seems very secure to us compared to recent generations. Tom Jones spent a year in bed at home as a child because of suspected TB – a year in bed waiting to get better! It seems unthinkable now. If your child had a chest x-ray which showed a shadow, and you were told to take them home and put them to bed for a year, try imagining right now what you would be saying to the doctor (if you hadn’t lost the power of speech). Is this what will happen with antibiotic resistance?

So what was Dennis’ plan for convalesence? There were two prongs to his attack: Physical and Mental

Physical: Rest and Sleep, Nutrition, Movement, Fresh air – being outdoors

Mental: Quietness, Reassurance, Acceptance

Let’s take it one by one:

Physical aspects of convalescence:

Rest – it was important to lie down completely regularly during the day. Not necessarily go to sleep, but allow the body’s systems (particularly circulation) to work with minimal effort so that the healing process had a chance to keep going.

Sleep – going to bed (very) early rather than trying to stay up in the evening in an attempt to be “normal”. The power of sleep to heal the body is obvious, but we often overlook it in adults. We allow young children regular nap times because their brains and bodies are developing and growing. But the convalescent body is also going through an intense period of growth as cells and tissues are repairing, restructuring, rebuilding.

Nutrition – both old age and new age techniques here. In addition to a nutritious, easily digested, appetising diet we used Chinese Soup and Blending. The aim was to provide the building blocks for damaged, inflamed tissue, in a way that was most accessible to the body.

Soup – the Chinese have a vast repertoire of soups and foods for healing, tailored to the malady or injury being treated. It’s not just the combination of herbs, but also the preparation, timing, and temperature that all work together. For example, cooking bones gently in the correct amount of water for the correct length of time so that the tendons, gristle, marrow all dissolve into the soup. Then drinking it hot enough so that the fragrance raises the spirits and the stomach relaxes.

Juicing/blending – eating can be a chore when you’re still feeling unwell. Blending fresh fruit and vegetables and adding probiotic powder provided Dennis with a nutritional boost without the effort of chewing and digesting raw salads and chunks of apple. Include nuts and seeds to provide healthy fats and minerals. This is not eating for pleasure or taste, this is taking in nutrition for healing and repair.

Movement – the contrast of rest with movement provided balance to the day and stopped circulation becoming too sluggish. Mentally it returned feelings of independence, and confidence that this time would pass and strength would return. Using walking sticks and crutches might seem too embarrassing but it is better to be moving around with them than not at all.

Outdoors – The body responds to being outdoors in open spaces. The eyes fill with full natural light, the skin tries to work out what the temperature is and fires up our mammalian systems to maintain balance. Being outdoors reminded Dennis that he was “still alive”, and reminded his body that it needed to keep up with the business of thermo-regulation. Admittedly this can be challenging and we are busy erasing the memory of a rather cold day at the Chelsea Flower Show with Dennis in a wheelchair miserably looking at the rear ends of the many other visitors in front of him.

Mental aspects of convalescence:

Quietness – Good old-fashioned “peace and quiet”. Times without excitement that would drain low energy reserves.  After serious illness the energy tank is close to empty but in modern-day living we are often used to the feeling of “running on empty”. Recovery uses a great deal of our bodies’ resources. Using up too much energy trying to feel “normal” can prolong or even defer altogether.

Reassurance – The nurses were experts at reassurance, vigilant against any complications or setbacks. Their cheerfulness was refreshing on days when normality seemed a long time coming, but they also insisted on patience.  Their faith in their patient made him more patient. Which was just as well – some days they were horrified to find Dennis trying too hard to take on the world again. And then after they had gone, he could be reminded of their admonitions not to “overdo things”.

Acceptance – Being impatient was no use and a waste of energy – energy that could be used for healing. Fatigue at this stage is the body calling for time to rest not a sign of weakness. So a major part of convalescence is accepting that it is a process to go through, that it needs to be given time.

How long does it take?

Ah, that’s a problem. It takes as long as it takes – the time-frame reflects the severity of the illness. Great strides can be made early on, but there is a relatively long tail-end where it is easy to do too much and end up weaker. Planning incremental expectations (physical and mental) has definitely helped to avoid major setbacks. Dennis was back working fairly quickly. He loves teaching, and the nature of his schedule helped to keep it manageable with plenty of support. But there was lots of recovery “work” going on in between.

Taking a long-term view

Dennis wanted his recovery to not only put him back on his feet, but to make him stronger and healthier than ever. Going through the process of convalescence means reviewing all your choices, making new discoveries, learning new ways of being patient, finding out what matters most. We know that the plan sounds all lovely and life is busy and we have other family members to look after and work to go to. But if nothing else, accept that planning your recovery will make you stronger in the long run, and ask those around you be patient as they will benefit too.

As sports coaches say: “Make a plan. Then execute it. That’s winning.”

 

 

 

¹ You can check out the decline of the word “convalescence: on this Google Ngram

² And the rising usage of the word “recovery” on this Google Ngram  – though I guess we don’t use “convalescence” when discussing the economy!