Photo by Marcelo Leal / Unsplash

Single? Aging alone?  What a topple off my porch has taught me about advocacy and community

In the comedy that is life, I have written a lot about falls among the elderly. I am not elderly per se, but I am 70, an athlete, but also someone recovering from a number of recent reconstructive procedures. Two of them were on my feet. Each of those takes a year to full recovery; one foot is eight months in, the other four.

Neither is particularly dependable. By this I mean I often quite literally cannot feel my feet. Wherever I am headed, sometimes they are still rooted in place like a pair of recalcitrant mules. I wonder if that's where the footwear term originated, but I digress. That has led, up until last Monday, to a number of near-disasters.  Monday I had the real thing.

Because my feet failed to do as instructed, I took a header off my porch onto the pebbled aggregate, right onto my left hip. At the time I couldn't tell that I'd done any major damage. Like the determined fool I can be at times, I walked around gingerly for three days until it barked enough to get it checked. The fall was mid-morning last Monday; it is now six days later, Sunday afternoon, at the second hospital this week.

This is provided first, as a good poke in the ribs at myself for not being careful what I ask for. And second, a powerful proviso for those of you who, like me, are aging alone and need to know what to plan for and what to plan against. Not just the system but worse, as in my case, from ourselves.

Third, and this is pointed squarely at yours truly, to take such things far more seriously, and look for the pony in the poop pile. More on that in a moment.

First and foremost, it could have been so much worse. The fracture, which for many frail elderly could have been a death sentence was comparatively minor. I can still walk, but the hip needs repair because one missed step...well. So off I went Thursday morning with little more than my purse and a phone to get checked.

I didn't take a well-stocked bag full of what I'd need for an emergency surgery. Who knew that was coming, right? From 6:30 am until 4 pm I was pummeled with confusing instructions, information, demands and recommendations.

For a reminder of where we stand as it relates to ER care and the risks we run, please see this:

Diagnostic Errors in the Emergency Department: A Systematic Review
Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the E…

All day I was told variously DON'T MOVE AN INCH YOU'RE UNSTABLE to GO HOME FOR THREE DAYS YOU'RE STABLE, to very imaginable thing in between, including "go home and you'll probably heal just fine on your own."

Surgery was at five NO WAIT it's mid-afternoon, here sign the consent form, NO WAIT it's in three days NO WAIT go home take your meds NO WAIT stay here, go home you don't need surgery, don't leave wait-we don't have the meds you need.... Nobody's fault.

The reason is that when I explained that I have a mild bleeding disorder, the walls fell down,  the roof blew away, the wheels came off. The letter that I have to inform the medical community was, in this case, not helpful. It's supposed to advocate for effective care.

I had asked my VA primary care provider early that very Monday morning to update the letter. She refused, saying that all a doctor would need was history. That just isn't the case. Now, that letter, which had been critical to care, actually prevented it because it gave no protocol for emergency surgery.

When we are out of commission or in extremis, all kinds of things can be done to the body which can severely alter our lives later. As single people, do we have emergency contacts listed in our phones? I don't. Do we have a Living Will? I do but it's in my safety deposit box. Do we have people who can competently speak on our behalf if we cannot? I'm embarrassed to admit, I haven't even considered that.

By the end of Thursday, stuck at the hospital with nothing but my phone and no clear care plan in sight, I decided to discharge myself and take my care in hand.

In hindsight that was precisely the right thing to do. Nothing like an emergency to galvanize action and reveal the gaps which exist in our plans and intentions.

I spent the next day talking to the VA about what I could do. This was a fine lesson in discovering all the services the VA has for those of us who may need them; none of which I'd required before and which my very fat ego resisted even asking about because, well, WHO ME? I'm never going to need any of that.

Really now.

As soon as I have surgery, a slew of services become available, and all of them are going to be very helpful. Learn to say yes, right? It's okay to need help. Right now I am bloody well going to need help. What about twenty years from now?

With the active life I've had I simply couldn't countenance a life not scaling mountains or riding fine horses. Like too many of us I assumed that much of my long term care plan included healthy eating, exercise, attitude, purpose. Yeah, but.

To be fair, I have recently begun researching what kind of insurance plans I need as I get older, but each one requires a good bit of research on my part before I can get good answers and make financial decisions. I've been looking at the design of my house and what I might need if I'm not mobile, and talking to a handyman about it. I've been doing that research when I took the tumble.  

Like so many of us, my emotional future did not make space for the grace of old age, even as I have written about it, discussed it with friends thinking that I was prepared.

Not me, right?

Yeah you, sister.

Step two was to set my home up for post-op safety. Since I've been unpacking umpteen boxes and and setting up the house, it's an obstacle course from one end to the other. Everything had to be out of the way of a walker.

Then I let friends and neighbors know I would need help. Many of them, having read about my fall, had kindly already offered, another prime lesson in humility.

I think nothing of offering such help, but NEEDING IT?

Oops!
Photo by Mathew Schwartz / Unsplash


WHO ME?

I write about this stuff. This stuff happens to Other People, not me, right?

Like death, like decrepitude, like all other things, life comes to us in our turn, not in our personal plan. Honestly, I am marvelously fortunate if only for one reason alone: I've trained. I might injure, I do stupid things, by god, but I've trained. So if nothing else, at least I have a good shot at recovery, and fast, even if I am clumsy as a drunk donkey.

But wait, there's more. Back to the poor beleaguered hospital(s).

I checked back in yesterday morning to the other big hospital in town. Waited all day for a room. You get hungry, waiting all day.

So if the health care doesn't kill you off, hospital food will. I've had more sugar in the last three days through the hospital food- not by request- than I've had in a year. It's hard to heal when hospital food is so bad. Creamer, margarine, sugar-laced desserts, bad bread and way, way, way too much salt in everything.

After many hours of waiting I was given sugary yogurt, a turkey "sandwich" consisting of poor-quality bread, a thin slice of processed turkey, a single limp lettuce leaf and plenty of mayo to make it all better. I tossed all but the turkey, which was so salty as to make it inedible. I actually washed it in the sink first.

So many people fill these beds because of their lifestyle habits, not because of an injury from activity.

Still, good news. Repairs are straightforward and there is a high probability I'll get all the use of my hip back.

This is what it looks like I'll be getting:

https://www.youtube.com/watch?v=geKD2gmtH4U

You will pardon the terrible joke but after nearly five years of no sex, tomorrow, if all goes as stated, I am going to get righteously screwed. In the hip, but hey, better than nothing at all.

Post surgery you're encouraged to move around. That's not my problem. I move too much, which ends up in the condition I now find myself. So the greater challenge is to sit my butt down on a lawn chair, mind my movements, read more, write more, and just slow the hell down.

Yes, said this before. Yes, this is hard. I resist being in healing mode. There's so much life to be lived, which disregards the absolute truth that healing is also life in full.

Speaking of hard.

One of my favorite t-shirts comes from Duluth Trading Company, Alaskan Hard Gear. It's silly, actually, but the beefy cotton and great fit are terrific. I have it with me for warmth in this cold hospital room. Here's the vague imprint on the collar:

"Life Life Less Soft"

As appealing as this meme is, that's not my problem. It's just the opposite.

At the risk of stating the obvious, which Dear Reader can most certainly see even if my pig-headedness gets in my way,  healing mode requires soft.

So. Do I mind that I lost a whole day Thursday? Not really.

I learned a great deal more about being an advocate for yourself, being clear, how easy it is to get railroaded when we are in extremis, and how much we can lose if we allow others to force us into irreversible decisions.

The other harder, deeper lesson here, which my buddy Melissa has been trying to drill into my skull, is that I also need to advocate for myself, TO myself.

I need to set boundaries with myself, FOR myself.

Especially to those parts which are so impatient to get back to the level of play I miss so dearly.

The gift, and it is a gift, of this last bump is that it created a dialogue with my local VA to discover services which, no matter how many miles I run, no matter how many mountains I climb or whatever feats to which I aspire, there will come a time when I may need services. Will need services. Like right now.

The biggest gap was that I wasn't taking my future aging seriously enough. I thought I was, but I wasn't. That's both embarrassing and freeing. We cannot fix what we refuse to face, and this writer is just as guilty of this as everyone else is.

I believe wholeheartedly that aging begins with attitude. While true, there's a danger in allowing that attitude to convince us that while yes, we feel, act and are youthful, and while those things better gift us with quality of aging, those same attitudes can become roadblocks to dealing honestly with an aging body. I didn't see how much I was invested in attitude at the expense of dealing soberly with an absolute reality. No matter how buoyant I might be, if I fall, I am still going to break. Did break.

You can't imagine how grateful I am to be made finally to see it and in plenty of time to do much about it.

I will end with a story. Last year my friend Melissa, who has been in body work for years, had a big shoulder surgery. Before the procedure, she made a list of what she was going to need in order to stay at home and independent. She reached out to friends and neighbors, gave them a calendar, and asked for help, which allowed folks to sign up for what worked for them.

The response, she reports, was deeply humbling. In no time people had committed to help her out with all aspects of personal and home care. It was a powerful lesson in how much we all need to feel needed, necessary, and useful. And how, when we ask for help, people graciously step up, even without our asking.

My neighbor Alice reached out to me right away when she saw I'd fallen, and asked if I needed help with groceries, before I knew I had broken my hip. The next thing I knew she was sprinkling water on my potted plants to make sure they don't die in this heat. Other neighbors have similarly offered to assist.

I am humbled, grateful, and nearly reduced to tears at such generosity and kindness. Again, of course I would do this for any and all of them.

We don't get what we don't ask for. In this often too-toxic "I don't need anybody" culture, we all too often cut ourselves off from what we most need. My hand is way up here, and I am actively changing that part of my life.

I am also humbled, grateful and nearly reduced to tears at all the generous offers of help from Dear Reader ( I see you Warren and Jim) and the warm words of encouragement, shared hilarity and recognition that we really are all in this aging boat together.

A bright red Flight for Life helicopter has just launched from the roof of this hospital. Someone, somewhere, is in trouble. You and I will get our turn. Are we ready to advocate? Are our papers in order? Do we have someone who can speak for us, with love and respect, down to our final wishes?

I found gaps this week which I need to address. But not in community, nutrition, exercise or purpose. My gap was not taking preparation for my later years as seriously as I thought I was. Yeah, I'm strong, healthy and resilient. But those are not enough.

Hip surgery is 7:30 pm if all goes as planned. See you on the other side- with the rest of my beloved community. Thank you for the support.

Photo by JAFAR AHMED / Unsplash

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