First foot.

Threshold.  I’ve heard or seen this word a few times this week.  It’s New Year and my Mother belongs to a generation for whom the tradition of ‘first footing’ is still alive – crossing the threshold with items to bring good luck for the year ahead.  

The same word cropped up in a couple of other conversations over Christmas/New Year.  I was talking about MW’s condition with friends who I’ve not seen or spoken to for a while.  It struck me that a progressive condition like MS* can be looked at as a series of thresholds that have been crossed.  That is, each new symptoms felt or each lost ability to do something independently is viewed as a threshold crossed.  Or, in the most recent case: each new, more powerful medication required to alleviate the effects of symptoms on her body.

This year has already seen MW cross another threshold.  The neuropathic pain she feels has been so bad that she’s exhausted what the specialist nurse considers her first line of attack for pain relief, i.e. a combination of tramadol and pregabalin.  MW has now been prescribed buprenorphine patches – a very strong opioid analgesic.  In essence – morphine.

To me, morphine brings with it connotations of palliative care.  Not the kind of phrase that instils positivity, despite the fact that palliative care is something that is intended to help pain relief in a wide range of chronic conditions, not just those towards end of life.  The morphine is helping but the pain is tolerable rather than eradicated.  No-one’s actually said as such but the demeanours of both the nurse and GP, and the way the drug is handled by pharmacists, tell me that this is a fairly major development in MW’s condition and medication history.

Other “thresholds” have been crossed in the last few weeks.  MW is suffering more from weakness and tremor in her hands/arms.  Increasingly, there are times where she can’t hold/control cutlery and cups – particularly when tired – and I have to feed food and liquids to her.  I also have to “feed” meeds to her as she can’t hold and control anything as small as each tablet she has to take.  And MW’s inability to move is causing new pressure sores on her legs/feet.  Inflatable “boots” have been ordered to try and alleviate them thanks to a fortuitous surprise visit from a district nurse.

So, we first foot into another year of MS.  With a bit of luck there won’t be too many thresholds to cross during the year ahead.  

*Disclaimer:  Yes, I know that MS isn’t an automatically progressive condition but this blog pertains to MW’s condition which *is* progressive.  Why didn’t I clarify it?  I am doing.  This is the clarification!

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