Sunday, July 17, 2011
By Suzanne Finnamore
By the time you realize you are for all practical purposes lame, a year has gone by, a year marked by all the stages of loss. It begins with daily discomfort (denial) moving on to daily but manageable pain (bargaining) proceeding to near total immobility (depression, rage). When you eventually consult the experts and are shown the X-ray that proves that your hip has no cartilage left to cushion the constant friction of bone against bone, you would think that would be the turning point. It is not.
While the orthopedic surgeon describes total hip replacement surgery, you look at him as though he is a bad psychic, and you feel the beginnings of hatred for him and his implacable kind. Shock has nullified the diagnosis; you begin to cast about for ways of avoiding the surgery. You know there is no avoiding it but you make the attempt, at least in your mind. You hobble away with the first inkling of an awful truth (grief); you see that the line between middle age and seniority has been crossed, not at a run but at a halting, grotesque pace.
Luckily, the pain gets worse and even light housework or a trip to the supermarket becomes mild agony. You schedule the surgery. But it's not going to happen right away; there is a process involved, and humiliation to absorb before you go under the knife. There is the overwhelming fear of getting old that is now more than a fear; it is a presence knocking at your door. Banging with the pain stick. "LET ME IN, BABY!," it cries. And of course you do. For people like me- the weak and the egotistical - pain is the only teacher. We will not listen to reason, but pain gets our attention, in the fullness of time it wins.
The fact that I resisted my lameness for so long points to pathology, neurosis, and the fear of not just becoming old, but the fear of being grouped with old people themselves. Prior to becoming lame I had dealt, I thought, rather brilliantly with my phobia with the use of hair color, a breast lift that was a nightmare of pain but which I brooked voluntarily and with real vigor, and social media.
But that was all over now.
The term for this fear is Gerontophobia; I know because I Googled it. Much like the system that my right hip relied upon for getting around, the belief system that purported the theory that if I could Google things I was still young is a broken system.
There was information on my phobia; I found the following at a site called FearOfStuff.com
“For those who are aging the phobia is expressed in resisting the natural process of life. This could be expressed in multiple cosmetic surgeries and hair dyes or simply expressed in anger that life is unfair. They may seem bitter and may review their past with regret.
Ken Dychtwald identifies seven signs that seem to be true of both those who fear the elderly and the elderly who fear aging.
If young is good, then old is bad
If the young have it all, the old are losing it
If the young are creative, the old are dull
If the young are beautiful then the old are unattractive
If the young are stimulating, then the old are boring
If the young are full of passion, then the old are beyond caring
If the children are tomorrow, the old represent yesterday”
Was I bitter? Did I view my past with regret? Yes and no. I was bitter that I was in chronic pain just shy of my fiftieth birthday; I felt the warranty on my hip should have covered this well into my seventies. I felt bitter that at the half-century mark I had not become Madonna, I had become Richard The Third. Did I view my past with regret? Oh hell no. I viewed my past with nostalgia, which is nothing like regret, although they are kissing cousins. I looked back fondly at a time – just a year ago -- when I could take stairs two at a time and outrun every child (three) in my house. When I could swagger down the street in high heels, instead of clutching a banister as though my life depended on it. When the term “walker” referred, in my mind, to someone who walked.
The first person to politely ask me if I needed a walker was at a spa in California. My inner response was to contemplate swift ways to kill myself before lunch, my outer response was a calm, equally polite " No thank you." It was then that I decided that it was time to avail myself of painkillers, coupled that very afternoon with a frosty Piña Colada, a drink I'd not ordered since the eighties. In a way, I surrendered to the inevitable, which was a necessary saving grace; yet in another way I gave up. I stopped acting as though I could walk: no one had been fooled, but I'd needed time to absorb the psychic blow that lameness delivers. Temporary lameness is nothing like chronic lameness-- one can thoughtlessly limp around for days on blistered feet that danced all day in tight shoes at a wedding. One can, while pregnant, accept sciatica: people expect a hugely pregnant woman to look in pain and to lurch around. This is nothing like that.
You begin to contemplate major surgery, which is going to make things dramatically worse before they get better. The surgeon’s office calls with bright, vital details regarding a tri-level portable potty (bedpan) a wheeled walker, a raised toilet seat, a cane, and support hosiery. Pain Management is discussed: a euphemism for Torture You Can Rely On. You realize that you are going to have to rely on your husband and son to help you defecate and urinate; you're going to have to rely on them to feed you and dress you. Like someone who has suffered a massive stroke. You can't stand it but you are going to have to stand it. Well meaning friends say it's nothing, that you'll be up and around in no time, but not one of them would trade places with you for even an hour. They are silently relieved that this is not their hip replacement surgery, it's yours.
In a semifinal blow, someone tells you that Jane Fonda has had both her hips replaced. Your humiliation is now complete. You are, therefore, ready to be cut. You begin to look forward to surgery, because it's better than everything that had been leading up to the surgery. By now the muscles surrounding your diseased hip are weak and flabby, you gave gained several pounds from inactivity, and you feel like Marlon Brando, not Jane Fonda. You are ready for the surgery, now.
But first, a few more weeks of hearing your own stumpy uneven footsteps on the hardwood floors, a few more weeks of degeneration. You still can't believe this is happening to you; physical strength and independence were your bywords until just last summer. Or was it the summer before. You ignored the pain, you walked slower, you lied, you got depressed and became sedentary -- so the exact time you could walk normally is hazy. In your Vicodin miasma and your chronic pain and shame, you decided you would rather be considered lazy than crippled. (You only start taking Vicodin at the very end, after you can't get out of the car without anguish, and even then you limit yourself to one a day, because you don't want to become a drug addict on top of being lame. That seems more than you can stand. But of course, if you want more, there is always more.)
At the Pre Op appointments, you sign many disclaimers, in case you die on the table. Blood clots are a particular concern. You are asked if you have a living will. You sign away all rights while your husband, outside the hospital, strides around shouting into his cell phone at people in offices, far away. You see that the two of you live in completely separate worlds: the abled and the disabled. He will come to the hospital for the surgery; they have WiFi. This will be very helpful. Once you emerge from the surgery suite, you plan to send him home. He will be relieved but he will make sure not to show that he is relieved. And you will be relieved: You won't have to act as though everything's stupendous. For the first time in a long time, you will be able to just be broken, without the soft shoe and the small talk and the very real impression that -- exactly like childbirth, menopause, and other such procedures -- you are completely alone except for the nurses. Nurses understand, they never rush off to take a call and instead of hurriedly asking "Do you need anything?" Nurses simply bring you what you need.
You can't wait for the surgery now. If only to be around people who inhabit and understand the world of the-- temporarily or otherwise -- disabled. You are ready to enter the magician's box, not in a sequined tight dress but naked , and be sawed in half at the pelvis. It shouldn't be possible, but thankfully it is. In six months, the whole grisly act will probably be over.
You decide that having a handicap placard for your car will be lovely, just the right accessory to go with your walker and raised toilet seat. In a time that seems very long ago you thought that you couldn't bear any of this because you're still very young, very hale, but you're not. You're having a hip replaced; osteoarthritis is a disease of the elderly. No one can stop it, you can't pay someone to take care of it for you nor can you put it off any longer. You know you are lucky to arrive with health insurance and the benefit of such complicated surgery -- and a complimentary tri level porta poddy.
You are officially elderly. Welcome to total joint replacement.
Unfortunately, surgery does not fade with time, although all bromides about Feeling Better When It's Just Done quickly fade when anyone sees your scar, which looks like a long malevolent zipper, much bigger than a C Section, except a baby doesn't come out. Your bones come out.
Nor is it like riding a bike, because one does forget, and it's a blanket of forgetting; I've forgotten everything good or important I ever knew, and meanwhile I recall even the most childish or tedious slight from childhood. Also, I've lost plenty of blood and bone, I have no appetite -- yet I am gaining weight steadily. Each morning at a wee hour, I wake myself up laughing; nonetheless, a steady sense of ennui surrounds me like a thin candy shell. I can't quite believe they removed a diseased hip and femur but I know they did: there are exactly 26 steel staples closing the incision, one for each letter of the alphabet. When they're extracted on the 18th, I will have no desire to do something creative with them. I hope to forget them altogether but pain is so persuasive, so compelling and specific. The feeling of having crumbly bones sawed off and then cemented back together, I can assure you , is completely unique and will never be confused with a different event.
However, all major surgeries , in my lookout, have one thing in common: Upon emerging from anesthesia, you will need to beg to receive anything but the most cursory pain medication. Asking is not enough: they need you to beg, and then some time has to pass before anything approaching relief will occur. Meanwhile, you may struggle to understand why masochists and sadists conspire to create these daily hospital scenarios- why, in a time when so many forms of medication are at our generation's fingertips, why must these agonizing dramas be enacted with such zeal and regularity? I don;t know, but suspect it has to do with Liability and money.
Even more strange is the pride that certain tough minded individuals take in their personal pain events, how they cherish their own levels of pain tolerance while exuding a plumed sanctimonious contempt for the pain of other, lesser beings. They will often equate it with being associated with a Farm at some point in their life, but not always...sometimes it is simply their physical (read: psychic) superiority that trumps all, that enables these protean beings to have an appendectomy done Au Natural in a Chinese food delivery cab, or to walk briskly away from a bone marrow transplant with a plastic baggie of Tylenol..."just in case." (Be assured that they will have no Period of Recovery, they will simply resume covering without an interruption. And by all means go on removing those pesky wisdom teeth with a sledge hammer but as for our anesthesiologists, we'd prefer less Clark Kent and more Woody Allen.)
So: if I could give but two pieces of advice to anyone having surgery it would be 1. When asked, the pain is always a Ten. 2. It's never too early to beg.