Cover Image: A Few Minor Adjustments

A Few Minor Adjustments

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Let me preface this by saying I have a bleep-ton of health issues and this was a really relatable story, even though I was otherwise nothing like the characters!

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Fascinating story of triumph through suffering. Very enjoyable read.

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Cherie Kephart’s memoir begins in 2004 in a bathroom shower stall. As the water rains down upon the then 33-year old, she experiences neck and arm pain so intense she drops to the floor. Willpower alone gets her to the phone. She summons her boyfriend who takes her to the emergency room of a local hospital—a place she had visited a mere two weeks before, afflicted with similar mysterious pain. The physician who had attended her then noted a highly irregular EKG—which would eventually lead to a diagnosis of SVT: supraventricular tachycardia—due to Wolff-Parkinson-White Syndrome. That first E.R. doctor had also recommended that she see her primary care doctor and be referred to a cardiologist and a neurologist. Now, two weeks later, with the referrals to specialists in the queue for approval by her health insurance company, the second E.R. doctor can only tell her she is in the wrong place: the emergency room is for trauma victims, not those with chronic illnesses. Rest and take ibuprofen, he tells her.

A Few Minor Adjustments documents the long and painful ordeal Cherie Kephart endured in order to get a diagnosis and treatment for her mysterious, debilitating condition. In crisp, often humorous chapters that travel back in time a decade or more (before 2004), Kephart tells stories of the adventurous life she lived before severe chronic illness took her hostage. She had studied in Hull, England during her college years, spent time in Zambia with the Peace Corps as a 23-year-old (where an atypical case of malaria took such intractable hold of her that she was forced to return to the U.S. to recover), and resided in Auckland, New Zealand to attend graduate school.

Kephart describes the illnesses and personal challenges she faced in each of these locations. With each detail she provides, the mystery of her “presenting complaints” in 2004 only deepens for the reader. Her story is a genuine medical mystery that had me perpetually revising my amateur differential diagnoses. Was this mysterious illness a lingering case of malaria or due to some unusual African virus or intestinal parasite? Could it be Hepatitis? H.I.V? A psychosomatic condition associated with the violent assault she had endured many years before but did not properly “process”? The residual physical effects of a serious car accident that had required a year of physical therapy, or some sort of autoimmune disorder like lupus or multiple sclerosis?

Kephart attended appointments with innumerable specialists (46 of them by October 2008)—among them: a neurologist, a cardiologist, a physiatrist, and an infectious disease expert. She’d been submitted to five CT scans, seven MRIs, and 10 ultrasounds, undergone a multitude of lab tests, and filled an abundance of prescriptions—to no effect. (She also dabbled in alternative medicine and had money siphoned away by a few quacks.) Some clinicians offered “catch-all” (or wastebasket) diagnoses like fibromyalgia or chronic fatigue syndrome. One physician told Kephart that she needed to face the fact that her illness might all be in her head.

It is an unfortunate truth that many results-oriented physicians grow impatient when confronted with difficult, ambiguous cases like Kephart’s, dismissing the patient as a malingerer, a basket case, or a time-waster. Pressed for time, burdened with heavy patient loads, or simply burned out from years of demanding work with sick people, they may lack the interest or stamina to investigate conditions that don’t yield to easy interpretations.

In addition to the physical and emotional costs of chronic illness, there are social ones. Friendships fray, and many are lost. The author marvels that her boyfriend, Alex, stays the course. She often feels tremendous guilt at how her condition limits his life, however.

Kephart generally writes in a lively manner, injecting humour to leaven the sometimes heavy subject matter. However, there is some unfortunate overblown figurative language. For example, a friend’s pale skin is said to be “adorned with a Milky Way of freckles”. There is also some problematic word choice. The author mentions “easement” of suffering (“easing” would be the better word). She says she feels “endearing gratitude” when what she really means is gratitude to an “endearing” friend or gratitude of an “enduring” kind. A sports bra is described as “enterprising”(!) when the author appears to mean it is of good quality, and the word “robust” is used incorrectly fairly consistently. A good editor should have assisted with these distracting infelicities.

Kephart also assigns her many doctors comical monickers based on their most salient physical or character traits. Along the way, readers meet “Dr. Perfect “, “Dr. Friendly“, “Dr. Nose Hair“, and “Dr. Godlike “—among others. I understand the author’s desire to inject some levity into a personal narrative made of many unfortunate events, but the snideness can interfere with tone at times. Sometimes it’s perfectly appropriate for an author to be serious! Moments of intense psychological distress also don’t come off quite right and read a bit too melodramatically. Recreated or remembered verbal exchanges, in particular, often sound mechanical and unconvincing. Less would have been more where dialogue is concerned.

My reservations aside, I enjoyed A Few Minor Adjustments . It is an engaging and often surprisingly entertaining read that I would recommend to others who enjoy memoir and autobiography, travel narratives, or nonfiction on medical themes. The author does get a diagnosis and treatment eventually, but I’ll leave that to potential readers to discover on their own.

I thank the author, publisher, and Net Galley for providing me with an advance reading copy of this book.

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This is the memoir of the Cherie Kephart's battle with mysterious chronic and nearly-fatal illness after traveling abroad with the Peace Corps. I will forewarn that the book is not for the faint-hearted, as she goes into detail of her various ailments, including the Putzi fly larvae that burrow into the flesh of her buttocks. If you don't mind a few gory details, you'll probably whiz right through the book.

Kephart spends years following her return from international travel in one medical office after another, trying to obtain a diagnosis for her obscure and worsening illness. This story is so relatable to me, having gone through a similar ordeal with what will ultimately be an autoimmune diagnosis.

It was an interesting and inspiring read that started off as a fast-paced read but, for me, lost momentum at the halfway point. I'm glad I finished it though because I was curious if she'd ever figure out what her true diagnosis was and whether she'd find relief from pain and sickness.

*I received an advance reading copy from the publisher in exchange for my honest review. All opinions expressed are my own.*

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I read this book really quickly as it flowed well and was engaging and interesting. Emotionally I found it hard to read in places as having an illness which Doctors cannot diagnose must be truly awful. I admire Cherie's strength and courage in pushing the boundaries to find an answer. To continue living when life is so bad takes a strength of character that many do not have. I hope Cherie's life continues to get better and I wish her well in the future.

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A very heartwarming read ideal for those lost in life and looking for inspiration.

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I enjoyed the Peace Corp adventures but then the plot made a big turn into chronic undiagnosed illness. It was painful to read through those chapters without ever getting a definitive answer/reason for the pain. I am sure that is exactly how Cherie felt as well, so perhaps the book is successful if it teaches empathy for those with unexplained chronic pain and disability.

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This book started out great, I wanted to read it in one sitting. The author's time in the Peace Corps was very interesting. About halfway through, the story lost momentum and the further I read, the more I just wanted this book to end. It did not keep my interest as the first half of the book had.

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Wanting to make her life meaningful Cherie the author signs up for the peace corps and is sent to Africa, to a remote village in Zambia, on a water sanitation and health education project. Not long after getting there, and starting her project, she comes down with debilitating stomach problems, something she is there to try and make better for the people in this village, time and time again she is sent to the peace corps headquarters in the area and looked over by their doctors. One thing they do find is Malaria, but the rest of her symptoms are a mystery. After returning to her village , she is once again struck by stomach pains and Diarrhea, she is finally told that she is going to be sent back to the U.S. Until she is completely cured. This never occurs and Cherie develops more symptoms, and see many specialist and healers over the next many years trying to find out what is going on with her body. Thank goodness for a faithful boyfriend, family and good friends who see her through the worst days of her life.
This story was hard to read at times but it was also a story that you could not put down, as you want to know if she is finally able to get a diagnosis for all that ails her. It was fascinating to see what she went through, and the treatments that she was put through to find a solution. I really admire how she was so persistent and still fairly upbeat as she went through all of this, and she is definitely a good example of strength for people who are going through similar undiagnosed illnesses.
Well written, with a lot of good stories about her life. This was a book that was worth reading.
I would like to thank NeGalley and Bazi Publishing for the ARC of this book.

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Such a beautifully written book with so much honesty and emotion!

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This book starts out in Africa while the author is a Peace Corps volunteer in Zambia. During the time she becomes ill with stomach pains and diarrhea I was really able to relate, as I was preparing my own body for a colonoscopy. The author resigns from the Peace Corps and goes on to travel more, however she becomes weak and sick with an illness that no one can find the cause of. Due to her lengthy illness, she gives up much in her life in order to visit all kinds of doctors and healers.

Written with candor, Kephart's story is one that I wouldn't wish upon anyone. She doesn't wallow in her sad story, but tells it like it is. The humor she brings to her writing with just enough detail in her descriptions, makes her story an entertaining and captivating read. The author is a strong and intelligent woman who through her story, can motivate others going through debilitating illnesses to stay positive and not give up.

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A Few Minor Ajustments is a memoir and tells the story of the authors journey of pain with an undiagnosed illness. This journey is inspiring as the author finds a way to heal herself.

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This is a story about a daughter, a sister, a B.A and an M.A holder, a Peace Corps volunteer and most of all a survivor. For more than a decade, the writer struggle with a mysterious illness that left most of her doctors baffled. After countless diagnosis, the doctors decided that there's nothing wrong with her. But the writer never gives up and finally, she received the result of her mysterious illness and can start her road to being healthy again.

This relatively compelling short memoir is indeed an eye opener for me. The writer's vivid descriptions of her stint in Zambia and also her hardship really touch my heart and brought a tear to my eyes. I commend her for being so strong despite all that she's been through. She is indeed an amazing woman!

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This book was an eye-opening read. What an incredible tyrant the body can be at times! How much courage and determination it takes to not give up on oneself! I'm so grateful to the author for sharing her story.

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