The remote NEOM desert environment sets the scene for spectacular stargazing, Hisma Desert – NEOM, Saudi Arabia.
Photo by NEOM / Unsplash

It was supposed to be funny. Here's why at times, it's not

Dear Reader: I am going to discuss health issues in this article which may step into areas which are uncomfortable for some. However if you're past forty, some of these issues touch you directly. They aren't just for the over sixty crowd. You're invited, but kindly be forewarned.

The laugh line about I've fallen down and I can't get up is only funny assuming you CAN  get up. Those of us who make way too much noise from floor to upright are being informed by our bodies that there's work to do.

Kindly, it doesn't improve from here on out unless we do.

This post is about  much more than just getting up, Turkish getups or otherwise.

It's about how we can fall down even when we are doing everything right, or think we are. It's also about the cost of denial, that certain things are just never going to happen to us.

"It can't happen to me" can come back to bite us. Bit me. Hard. I'm going to touch on a couple of those bites and what I learned from them, starting with my hip fracture from this past July.

First, here are some awful statistics:

Facts on Hip Fractures: They’re Very Common But Treatable and Preventable | Resource | Baptist Health South Florida

Young people fracture their hips too, usually either from car accidents or sports. About 30% die as a result, and that statistic includes fifty-year-olds.

Why hip fractures in the elderly are often a death sentence
Breaking a bone is never a good thing, but breaking a hip is particularly bad. One in three older adults who break a hip will die within 12 months of the injury.

At 70 now, I had the conceit that a hip fracture WOULD NEVER HAPPEN TO ME. I was careful, did balance work, worked out. I take calcium, eat dairy, and until this last year of multiple surgeries, did plenty of weight-bearing exercises.

A year of little walking, running, etc. will weaken anyone's bone density. I knew it was likely, but I still didn't see it happening to me. The adventure athlete, right?

Honestly, saying that to ourselves is almost an invitation for the Universe to deliver that if for no other reason than to humble us thoroughly.

Well, I have been humbled.

Foot surgery has rendered both my feet into numb blocks which will be out of touch with my nervous system until the nerves grow back. For my left foot, that's April 2024. For my right, November 2025.

Meanwhile, if I want to avoid having another accident, I need to be mindful of where I put my dogs. No big scree-covered mountains for a while, even with poles. And slow the hell down, even if I feel like the Energizer Bunny.

A recent DEXA scan revealed that the last year did indeed cost me in hip bone density. Reversible, which is great news. That's why I'm back doing stairs. But it's also why my hip broke; it isn't as strong as it could have been due to a year plus of not enough weight-bearing work.

In so many ways as I prepared for my adventure travel, I also prepared for last year's many surgeries, and in a weird way, for a hip fracture. It could have been far worse.

Therein lies the message of regular workouts, weight-bearing work for our bones, eating right and all the right nutrition. If and when we do bust something, we have a far better chance to survive it.

I want to thank Saga Supporter Leo Notenboom for providing two, TWO different walkers, one of which is doing extra duty in my living room for post-op exercises. This is a HUGE shout out to Leo for his enormous generosity. The VA couldn't manage to deliver the necessary gear in time. Leo did.

But that's just one story. Here's another.

Photo by Sasun Bughdaryan / Unsplash

This next might be TMI but there's a purpose behind it.

I've been experiencing some escalating and very disconcerting symptoms which I assumed were kidney or bladder-related. I had reason to believe that from past history. I was wrong.

This past week I found out that I had severe...uh, backups in the sewage system shall we say.... despite drinking lots of water, eating plenty of fiber and taking psyllium supplements.

All the things, right?

How the hell did that happen?

Turns out I'm full of shit.

Okay well, you could have told me that, but I really am full of shit in both senses of the phrase.

The culprit? Again, all those surgeries this past year, not enough cardio and all the pain medications I took to manage the post-surgical pain.

That's another thing I swore WOULD NEVER HAPPEN TO ME.

I was never going to develop GI tract issues from pain meds. Not me.

Truth, when the ER doctor told me I nearly fell off the exam table laughing. He was terribly perplexed until I told him that I'd take that very fixable issue over a kidney stone any day.

Barring the hilarity, however, the problem with misdiagnoses is real. One VA urologist had prescribed a medication which had a side effect of....you guessed it,

constipation.  

In other words, by not doing the sleuthing, this particular urologist defaulted to the easiest answer, a pill for overactive bladder, which could have exacerbated an already problematic situation.

In fact two doctors prescribed the pill. I looked the medication up, never filled the script. Good thing. Because it appears that the kidneys/bladder weren't the culprits.

Even with all the preparations, even with the fiber supplements, all the right foods, water and the like, the combination of being sedentary for too damned long and taking pain meds -any pain meds, actually, including Tylenol for some- people can develop gastrointestinal issues.

I mean, hell. I eat an entire wicker swing set for breakfast. Isn't that enough fiber?

That  could never happen to me, until, of course, it did.

Honestly, I'm not sure what else I could have done.  In my case, all I need is a big container of you-know-what and directions to remain close to the porcelain throne for a few days until my body moves the mail. I'm lucky.

We're going to make mistakes, doctor and patient alike. Let's look at this please:

Constipation
Constipation is a condition in which a person has uncomfortable or infrequent bowel movements. Generally, a person is considered to be constipated when bowel movements result in passage of small amounts of hard, dry stool.

Four million Americans suffer from constipation, especially the elderly. In some cases it can be so bad as to require surgical interventions. Bad food, sedentary habits and polypharmacy are all contributors.

By assuming that couldn't possibly happen to me, I cut off an avenue of investigation and concentrated on the wrong issue. It was a fine - and frankly funny- lesson in not being so damned sure I know what's going on.

Truth, we're still investigating, as my ER doctor said that this is just the first step to see if asking Elvis to leave the building results in relief in other areas.

Right about the time I am SO SURE about something is right about the time I get proven wrong.

A broken hip, which is never going to happen to me.

Severe constipation as the result of pain medication, which is never going to happen to me.

Until they did.

The author in 2017

And one more thing. In 2017 I was in THE best shape of my life. I remember thinking that I'd always be in that kind of shape, I'd never gain weight again, that I'd always be able to hit the trails, the gym, leap out of airplanes and ride spicy horses.

That was the year that one horse threw me and stomped my shoulder in Turkey, another threw me at a dead run in Kazakhstan and I broke eight bones in my back.

The following year started with the first of twelve surgeries over five years to remake my body so that I could even hike again, much less all the other sports I love.

I gained about 20 lbs:

The author in January 2023

Not going to happen to me.

Until it did.

In all fairness, I'm down eighteen of those pounds, and am well on my way to getting both my strength and my guns back. It's not all bad news; if anything having much of this taken away has taught me a lot about being awfully grateful for what you have when you have it.

What I also appreciate very much is how much more empathy I have with anyone who suffers an injury, a disease, or gets sidetracked from their program. I know what it's like now to watch with a certain horror the work you put in slip away. Even though I know you can regain much if not all of it, and even surpass what you had if you're willing to do the labor, it still stings. Hard.

The problem with denial

If those things did happen to me, does that mean I'm no longer who I want to believe I am? Was I denying their reality because those didn't fit with my carefully- curated story?

Does my very fond photo of myself as adventure athlete come under fire? Good question. Truth is that I can still be all that and still break a hip, and be full of shit. All those things can be true simultaneously.

I still think that's funny. If nothing else, there's permission to be achingly human here.

But there is a terribly serious side to this.

Since I alluded to this in the title, here's the death sentence piece.

In Denial: Why Do We Often Ignore Medical Symptoms, When We Know Better?
Putting off a visit to the doctor, even to check what could be a sign of a serious illness, is surprisingly common, experts say.

This excerpt got me right in the chest:

Dr. Chris Simpson, chief of cardiology at Queen’s University and past-president of the Canadian Medical Association, says for those without these concerns, using busyness as a reason to put off getting help can be another form of denial. “People will say ‘I’ll deal with it once X or Y is done, then I’ll be in a better place to take some time to look after it.’ It’s a way of ordering things in your head that allows you to cope.”

He says younger generations have a particularly tough time coming to terms with the signs of a life-threatening illness. “They’ll deny the symptoms, then they’ll deny the diagnosis as they try to cope with it,” he says. “They’ll say things like, ‘I did everything right. I eat right, I exercise, I’m in good shape – how can I have this?’ It’s almost a grief reaction.”

Younger generations aren't the only ones. I said these very things in the paragraphs above.

I did everything right. How could this happen?

Of course it's a grief reaction.

We are every single day faced with a new truth about what we are losing, especially when we age past sixty. Some things change forever, others shift towards hope, others drop towards despair.

Despair when we face the great inevitability of our own demise, preceded perhaps by some version of the little losses and changes which demand that we adjust our inner story about ourselves or those we love.

Years ago I comforted one of my closest friends whose mother's encroaching dementia was causing her terrible pain. She expected her mother to recover. I told her that there comes a point when she isn't going to get better. Age, time, all the things change us. There are some aspects of our lives we have to leave behind each new door we walk through.

Often we've walked through a door and think we're still in a room that moved us out years ago.

She accepted that, in time, and that acceptance allowed her to attend her mother in a level of grace and kindness of which I have never seen the equal. So might we do such kindness for ourselves.

When it comes our turn, it's not so easy. What's offered is making peace with the changes which are necessary for our future health and welfare.

In my case, maybe not riding the craziest horse in the stable. Giving ourselves full permission to let go of ego-based identities or parts of them, so that we can form new ones. Putting a bannister up on my slippery porch stairs and remembering to toss sand on the garden's stone steps in the winter.

Denial of life's important changes can keep us from taking care of ourselves as we are, rather than as we imagine ourselves to be.

Exploring this can be so terribly fraught and painful. As I heal and train to get back in tip-top shape, I look to a fuzzy future full of promises as well as some changes.

Wait. There are thumb prints on my lenses. There. Well, crap. The future is still fuzzy.

Still, I'm excited. That said, I temper that excitement with the recognition that for me, too, age and time will eventually, as necessary, remove bits and pieces here and there. We develop far more rapidly as we age than ever we did as toddlers.

It's up to us to fill those open spots with something new and different. Denying immutable realities simply delays the different journey, the path towards who we can become next.

What part of adventure travel still calls to me? What part of gardening or spending time camping in Oregon or caring for a dog also calls to me?

I have no idea. What I do know is that the gift of a broken hip, discovering that I was full of shit -I'm sorry, I still find that very funny- were an invitation to consider bigger issues.

It's time for me to head out on the last September day of 2023, to look at dinner tables and chairs, to buy squash soup at Trader Joe's, to huddle up on a cooler-than-usual fall day. To see the changing leaves and note the nip in the air.

I am in the October of my life.

Winter will come soon enough. It's up to me to be brave enough to walk right into it.

Photo by Alfred Schrock / Unsplash

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