Fall…

Physical therapy has become a lot more challenging and today I fell. I fell well, not on my face, and I got up by myself (small victories). Still it upset me a lot more than I wanted to let on, and it upset my therapist. I think it really upset the poor one-legged guy who, today, was walking between the parallel bars.

My left leg isn’t just shorter than the right one, it’s weaker and — if this makes any sense at all — it’s afraid. As we were doing the first exercise I “saw” that leg for what it is. We used the thing in the featured photo, just like this, but the exercise was putting one foot on it and doing a sort of lunge. For whatever reason, or reasons, my leg is just plain scared as if it has an emotional center and little brain of its own.

When I go back on Thursday I’m going to ask for the opportunity to do the same things, but more slowly. I think I need to feel what’s going on to fully understand it and move forward from this place in my psyche and life. I felt bad for my therapist. I am sure she was more upset than I was.

I have a friend who was on the Italian Olympic Gymnastics Team in the 80s. He’s also a world class mountaineer. Balance is huge for him. I wrote him a month or so ago about the falls and how freaked out I was/am. He said something very wise, and I passed it on to my therapist. He said, “People fall.”

I truly don’t expect never to fall again for that very reason. People fall. I said to her, “This is ok. It was a good fall. I didn’t fall on my face, and I didn’t fall alone at home. I got up by myself, and I fell here while I was challenging myself.” Logically, it made total sense and had an element of progress. Babies learning to walk fall all the time. We talked about my bad knee which is out of alignment and how my muscles compensate for that. We both agreed that knee replacement surgery is something to avoid if I can; it comes with its own limitations and problems that are, in my opinion, worse than I’m dealing with now. My therapist agreed with that, but there’s also the possibility that I’m lying to myself.

I felt so many emotions I can’t even identify, including disappointment. I really wanted to cry and quit. It’s just so fucking complex and inchoate. I asked her, “Am I going to get it?” She nodded yes.

We did a couple more exercises and I left. The minute I got home, I got Bear, and we headed out to the Refuge. In other days I’d have contended with emotions like this by grabbing a dog and running up and down some hills. I guess we kind of did that since a sharp cold wind is a lot like a hill and we walked into such a wind. Beautiful, wind-scoured afternoon with some cranes and lots of snow drama over both mountain ranges. It was close enough to running up hills and I realized that this is where I am now.

Thanks for listening. ❤

Falling Update # Something

Here’s my Nymbl (balance exercise) calendar. I’ve been at this since the day after I fell, January 19. My cracked rib still hurts if I move a certain way, but it’s a lot better. The stars represent days I did the exercises. The two yellow stars are the number of days I’ve been at my current level.

Roughly every week, this Nymbl app gives me a new challenge. One of the new Nymbl exercises makes no sense to me, so who knows if I’m doing it right. Having one leg shorter than the other presents some challenges as done a friable knee on which my physical therapist and I have both decided some exercises are not a good idea.

In PT yesterday we did something I found fun and strangely nostalgic — we played catch. I stood on a cut-off balance ball thing that was spongy and meant to challenge my footing and balance. It was a little challenging. Then my therapist got a ball and we played catch. Since I once really loved baseball (playing) it was good and suddenly I was playing centerfield and standing solidly and well balanced. This said a couple of things to me. 1) I have good reflexes, 2) I still like to play catch, 3) not thinking about balance and having that forward moving action helps me.

I don’t know if what I’m doing is worth doing. I don’t know if it will help me prevent falls. Maybe it’s melodrama, I don’t know. Like a lot of other things in life, it’s a gamble. Yesterday the other client at physical therapy was a woman who was relearning how to use her hands and brain together. My guess is she’d had a mild stroke. I think, “Martha what do you have to be so freaked out about? A lot of people have bigger challenges than you.”

But do they? I thought back to when I had a major depressive crisis some 30 years ago. At some point after that I realized that I — me, myself, I — was the biggest risk to my own life. Since then I’ve been a quiet supporter of people with invisible disabilities who are trying to hold their shit together.

I also thought of 2020 when sane people were waiting for a vaccine. The lesson was (for me) that my responsibility to myself and others was not to get sick or make others sick, the idea that we each have a responsibility to our own life. A fall could kill me or injure me more seriously than I’ve been injured so far, so I don’t think it’s melodrama to persist. Besides I might get to play catch again!

Falling Update

The fall where I broke my glasses and bruised my rib was a month ago tomorrow. I’ve been doing Nymbl practice for a few days short of a month now. I’ve used every miracle advantage on my fancy and expensive Mickey Mouse watch. I have learned to love it and rely on as a useful tool.

Last week I went to my first physical therapy which was an evaluation for the therapist to see what I needed, so it was kind of odd. I didn’t want to go. I spent a lot of time there after my hip surgery 4 years ago. But the therapist and I talked about the power of fear over our ability to move forward (ha ha) in life and that struck a chord with me because I have definitely been afraid. Today we talked about that a little more and I told her about Nymbl. She checked it out and was really impressed by it.

Today was a real work day and she worked me pretty hard, taking me through a routine of movement I realized I have unconsciously avoided — including lunges. I have severe arthritis in both knees — it doesn’t hurt, but no one wants to hear the sound that arthritic joints make when they’re working. Basically, I did a bunch of lunges in front of a parallel bar along with the one-legged guy who is learning to walk.

I like working with him nearby somehow. I know he’s a nice guy, stoical enough and with a sense of humor. Today they had to take off his prosthesis and adjust the flex in the foot. He then proceeded to take a step forward and a step back. ❤

I got home with only one thought. Those falls were not bad for me. They have taken me exactly where I need to be. As I worked I realized how I have protected myself as a result of joint damage, joint replacement, falls. Without knowing it, I’ve limited myself out of the fear of the pain that all those things have caused in my life. Those experiences were real and there’s no way to guarantee there won’t be more, but that self-limitation — of which I’ve been unaware — has caused its own problems.

My therapist is a rodeo rider, goat-roper, cattle roper and barrel racer. I respect that so much. A lot of people have negative view of rodeo, but (outside of bull riding) I’ve seen all those skills actually USED in real life. Barrel racing shows the incredible bond between horse and rider. Anyway, a physical therapist who is an athlete? For me, that’s a good thing.

Results

I’ve had more physical therapy than ever imagined possible, but I can walk 3 mph (on pavement) and I’m using my hip joint like a legit walker. I’m standing up straighter and dreaming about X-country skiing.

I’ve also faced some realities. My therapist is applying to Medicare for an extension on my therapy. Even though I’ve achieved the stated goals of a person after hip replacement, I have not yet achieved MY goals in rehabilitation. It’s a win-win thing. They need my business and I’m very happy to have a personal trainer (who is also a person I like) and an almost private gym.

I’m the ideal physical therapy patient. I WANT to improve. I understand physical activity, I’m movitated to follow instructions and try things. I went into it with certain goals (and a few dreams) but my recent physical therapy induced existential meltdown a couple weeks ago led me to the place where I am now.

I’m probably not going to run again or do lots of severe hills. Somewhere in my mind and heart this has been working itself out in the realization that for the past few years, in severe pain, I’ve had a good time walking my dogs 1 mile an hour around a small loop trail in one little place. I had enormous pleasure just in that small “hike” (not the pain part). As all that was going on, I was being taught by my own self things I had not begun to be aware of.

Our bodies ARE our minds.

So today I had a sit-down with my therapist. “We need to talk,” I said. Half-joking. I’d been reticent about asking what we are doing now and thought we might actually BE breaking up. He explained how the Medicare thing would work, and I explained my realizations about the objective reality of my age-related physical limitations. We both agreed that I’ve done incredibly well, but I want (and can achieve) more in terms of flexibility and strength for the purpose of being safer on an uneven mountain trail. Pain creates a little “being” of its own in our mind/body and the main drive of that “being” is fear as a self-protection tool. Fear stiffens us where we’re weak. It’s human nature. It’s the same thing as a kid not wanting to try learning something new for fear of failing, or a guy not wanting to ask out a pretty girl for fear of rejection, in a way. I’m fighting that and physical therapy helps me fight it. Not all the limitations are purely physical. As I said, our bodies ARE our minds.

So we spent my session today moving forward, literally.

https://ragtagcommunity.wordpress.com/2018/08/19/rdp80-reticent/

Pain and Pleasure

Yesterday at physical therapy I was standing there doing tug-o-war with my therapist. Yeah, it’s an exercise. I’m supposed to hold still while he attempts to move me away from my center by pulling in one direction or the other. It’s a hip strengthening and stabilizing exercise. The tool involved is stretchy. Once that was finished, we moved on to his pulling me (using the same stretchy tool) from the front. I was thinking about how great it’s been to be able to safely do so many things I want (and more that I don’t want, like yard work) so quickly after surgery thanks all the physical work I did before the surgery, the miles and miles on the bike-to-nowhere, the dog walks that were often excruciating.

“You need to give me a challenge,” I said to Ron, grinning. “I’m pretty strong.”

“You are,” he said. “You know, I think you’re ready to walk on uneven ground.”

“I have been.”

“Where?” I told him about our walks out at Shriver/Wright Wildlife Refuge with the heat the the horseflies, how beautiful it was, how silent and empty (because who wants to walk in heat with horseflies? Only a dedicated idiot stoic like me, I guess). “It’s mostly flat, but there are some little — very little — hills.” My new thing is finding hills. Not big hills, but hills.

I had been thinking that I’m now able to walk my dogs at the slough and do a lot of other things because of the way I was raised. I felt grateful to those “cowboys” who raised me to be tough and to have a sense of humor about it. There wasn’t a lot of indulgence in the Kennedy household. In my mind’s “ear” I heard my mom say, “Quit yer bellyaching,” followed by a slap across the face as enforcement.

I literally grew up expecting pain. One friend a long time ago called me a masochist, but that’s not it at all. A masochist LIKES pain. I don’t like it, but it doesn’t surprise me. What has surprised me is NOT feeling pain. That’s amazing.

I wonder how I would have raised children to expect both pain and pleasure and take neither for granted, to understand pain enough to know that it may be transitory but maybe not; it may need to be dealt with. Still, it’s universal to all people and so should inspire compassion. I would want to raise them to understand pleasure is also transitory and somewhat random, but can be the fruit of their kindness to others — which is intentional and which they can choose and can ameliorate a lot of the pain in the world.

All in all, the cowboy stoicism with which I was raised seems to have been a good thing, though I could’ve done without the slaps. It looks like I’ll be doing that mountain hike two months earlier than originally projected. ❤ Thanks mom.

Stoicism: an ancient Greek school of philosophy founded at Athens by Zeno of Citium. The school taught that virtue, the highest good, is based on knowledge, and that the wise live in harmony with the divine Reason (also identified with Fate and Providence) that governs nature, and are indifferent to the vicissitudes of fortune and to pleasure and pain.

https://ragtagcommunity.wordpress.com/2018/06/27/rdp-27-indulgence/

Stayin’ Alive

Yesterday I had tea with my nextdoor neighbor. She recently had some surgery on her eyes to repair the ravages of time. She looks good and can see better already. I sat with my operated leg forward because I’m always aware of what you (dear readers) may not be aware of, and that is the 90 degree rule. I’m not going to explain it. If you get there and have to learn about it, you will enter a world of new awkwardness. A week ago as I took my walk, another neighbor came out of her house to join me. We talked about our friend’s upcoming eye surgery and that led, of course to the subject of cataracts. It’s a small town and we all have the same eye doctor. “He said maybe next year,” she said, “but I’m not doing it until I have to.”

We’re just a bunch of high-mileage cars at this point.

Meanwhile, almost every waking moment of my life is directed toward regaining my physical strength and coordination so I can go hiking. My physical therapist is on my team, and yesterday we did different exercises to teach my hip joint what its job is.

At physical therapy was what my uncle Hank would call an “old boy.” He was riding “my” bike though it’s not my bike any more since I can get on my bike here at home. When he was finished, he started flirting with me. I thought, “Wow. Old people hook up at physical therapy.” You have to remember we’re from the Hey babe, what’s your sign?” Generation. It’s surreal.

“I used to be a DJ in Denver; I did the news in the 70s,” he said.

“What station?” I asked.

He mentioned a station I vaguely remembered, then said, “I moved on to KIMN.”

“I listed to that, in my car, until my radio broke.”

“People today don’t think of the Carpenters as rock, but everything was rock,” he said.

“It was a big genre back then,” I said.

The conversation went on, and then he told a joke. The joke is the reason I’m writing this blog post.

A turtle came out of a bar, a sheet or two to the wind. It had been raining and the sidewalk was slippery. The turtle tripped and flipped over on his back. It wasn’t long until the snails had come out and started crawling on him. He was helpless. Then a cop came along, saw the situation and righted the turtle. “What happened,” he asked.

“I don’t know,” said the turtle. “It all happened so fast.”

 

 

https://ragtagcommunity.wordpress.com/2018/06/15/cataract/

PT Poetry

“Did I tell you about my skis?”

“No. Here, now do some bridges, engage that core and keep squeezing the basketball between your knees.”

“That’s four things!”

“You can do it, Martha. The anesthesia is about gone by now. Your brain can maybe manage it.”

I laughed.

“Now what about your skis?”

“Oh I was at that flea market on the 285 with some friends. We went into the back room part there and I was looking around and there was a pair of skis exactly like the ones I had when I moved to California from Colorado in the 80s. Back country skis.”

“They called to you, didn’t they?”

“They did. My friends looked at me with pity, so I just put them back, but later on, I went back by myself. I looked them over, and the left one, you know like this?” I pointed to my recently repaired hip, “it’s pretty badly delaminated. That’s why I bought them. They are like me.”

“Like you were delaminated.”

“Yeah.”

“So it just needs to be fixed, some epoxy, stuff.”

“Yeah.”

“Did you get it repaired yet?”

“No. I’m waiting until…”

“I’ll fix them for you.”

“You fix skis?”

“Yeah. I’m a ski guy.”

I kept bridging, “The tips are kind of messed up, too.”

“Probably need a rivet.”

“Yeah.” Then he handed me a Theraband. “OK now very gently move your knees outward. Not too far. All we’re doing is teaching that new joint how it works.”

“You see the poetry in that?” I knew he would.

“Your left hip and your left ski?”

“Yeah, but you’re helping me learn to walk well again and make this new joint work so I can do what I want and you’re fixing my skis.”

I told him about my plans to hike the San Franscisco Creek Trail, too. Around here people call it “Frisco Creek” but I can’t do that. No one in California calls San Francisco “Frisco” — it seems like an abomination. I’ll get over it, maybe, but I kind of like St. Francis.

 

San Francisco Creek Trail (upper part)

 

“Maybe next year,” he said.

“Yeah but…”

“You can do the lower part, though.”

“I’m thinking November to give it a try.”

“That’ll be possible, a couple of miles, I think. It’s kind of like this,” he moved his hand to show up hill and down hill. “But nothing too steep those first couple of miles. You’ll be able to do that.”

“I’m good with it taking time. When I first lived in California I was in terrible shape. I didn’t know where to go, what to do, how to live there, then I found a place. At first — well it was me and a five-month old puppy — I could only go half a mile. But then, I kept going and, yeah. I love that. I love the whole thing of becoming better at something, able to go farther, being stronger. Anyway, however long it takes, at the top is an alpine lake and some peaks.”

“We’ll get you there,” he said.

And I believe him.

Back at the “Gym” — Flexibility

Kind of a big day for me. I returned to physical therapy this morning — the real deal — not just the guy coming to my house to make sure I’m moving around. As it happens, yesterday they moved into their own facility. They were sharing space in the local gym. Their new space is beautiful and includes a lot of new equipment, including a semi-recumbent bike a lot like the one in the picture above. I rode it today. I was so happy to “ride.” Since I cannot yet get safely on my Sainted Airdyne, I haven’t had anything approaching aerobic exercise since my surgery. I took my archaic iPod (“Online? What’s that?”) out of my pocket and listened to my anthem (Running Up that Hill) then to Bruce Springsteen singing about not surrendering. I could’ve kept riding godnose how long, but since it’s been a month, I thought I should be prudent.

Then my therapist, Ron — whom I like, respect and trust very much — put me on a table and tried to get me to “let go” of the operated leg, to relax it so it would fall over the edge. It was so difficult. I could feel all kinds of fear clinging to that joint. I’m lucky in that my body is VERY articulate in transmitting messages to my mind. It said very clearly, “I’m scared!!!!” I said to Ron, “There’s all kinds of stuff going on down there.” He nodded. He knew. “It’s scared,” Ron nodded again. I sent a message to my joint that said, “Let go. It’s OK.” It did, just like that, relaxed. The reward was a massage of my quads and the IT band.

Then we went out to the parallel bars and I basically “practiced” walking without walking, using all the muscles and working on balance. Then we went back to the table where I did muscle response exercises.

One of the wonders of this is that I stand up straight.

Before we started, Ron interviewed me about how the surgery had gone, how I was feeling, what worked and what didn’t and then he said, “What are your goals? What do you want to be able to do when we finish here?”

My eyes filled with tears and I said, “I’m going to cry.” I don’t know why that struck me so intensely. “OK, on July 15 the Rio Grande Wildlife Area opens again. I want to be able to walk 2 miles with my dogs. With this, that’s OK,” I lifted my cane.

“You should use that, definitely, everyone should on uneven ground,” he said. “We can do that. That’s completely possible. What do we have, six weeks? Plenty of time. Let’s get to it.”

And we did.

RDP #5: FLEXIBILITY

Hiplift

Old ladies write — and talk — about their health challenges. Ah well… There is no talisman against time.

Yesterday I went to my third physical therapy session. My PT guy is on vacation (spring break) so I had a different therapist. I liked him, too.

Today I saw my neighbors. They are a decade or so older than I. B had surgery to repair his thumb. Part of a tendon in his wrist was cut out to replace worn cartilage in his thumb. He’s cruising around with a cast holding his thumb in place.

It’s pretty miraculous. I thought of Mrs. Thornton, my piano teacher when I was in 6th and 7th grade. The arthritis in her hands was so bad she was in constant pain and couldn’t play. To add to the pain she already suffered was all of our bad playing. She just hit us when we made mistakes, or dragged our hands against the keys if we fucked up an arpeggio. No one was repairing arthritic hands back in the 60s.

At the moment it seems like the main focus of my life is on preparing for a new hip. It really does take a lot of time and, the morning after PT can be quite painful. This morning I woke up wondering why I’m doing it. There is no fountain of youth. I thought, “This is my version of a facelift.”

https://dailypost.wordpress.com/prompts/talisman/

Physical Therapy and the Big Picture

Yesterday I went to my first pre-surgery physical therapy appointment. I didn’t want to go. Like a lot of this stuff I’m going through, I’ve “been there; done that.” But not really.

Last time I had physical therapy (2005) it was to address a condition I didn’t have. I went twice a week for three months and my hip (the right hip) just got more and more painful. Why? Because my “doctor” at the time had not diagnosed the problem correctly.

This time is NOT last time.

Every time I drive to the slough with the dogs I pass the gym which is known as “Monte Vista Athletic Club.” It looks like a barn which is not notable as the most popular building style where I live is big buildings with steel siding; lots of buildings look like barns including barns. It’s beautiful inside; it’s a gorgeous gym. I’m not a gym person, but I’ve been in several and this one is great. I told the person at the counter I was there for physical therapy and he guided me back to the corner of the “barn”. I was checked in and met my therapist — I like him! — a guy named Ron Muhlenhauser (good Swiss name). He sat me down.

The first thing he said when he looked at my chart was, “You don’t look that old.”

I thought, “Huh? Flattery? But why?” I think I look old, but maybe not. It’s a comparative thing, anyway. I explained I’d had hip surgery already on the other hip eleven years ago.

“You’re kidding,” he said.

“No. I…” I didn’t finish. We talked about accidents I might have had that could have caused the hip problem, and I rattled off a litany of sports related injuries.

“So sports, then,” he wrote on his paper. Then he asked me questions about the pain in my hip and how long I’d had it. I don’t think I was too good at the answers, but finally he said, “What are your goals?”

I said, “Hip surgery and the ability to walk better.” I still didn’t know what I was doing there other than fulfilling Medicare requirements. I didn’t think there was any reason beyond that, but I was very, very wrong.

“Here are your doctor’s goals,” and he read them to me. Of course, they were better, clearer and more articulate than mine. They are improving my posture, gait and the the development of good muscles and tendons in my hip. This means, basically, lengthening them so they will work with a new hip joint and so I can stand up straight. “You want to be good from the getgo after your surgery. Your left leg might be a little longer afterward, too. It’s likely.” It’s 1/2 inch shorter at the moment.

I was taught some exercises, and Ron gave me great explanations all the way along. I paid attention, practiced, and, all the while, thought about what I was being told. It began to sink in.

Then he said, “You’ve got the best doctor. Dr. S is the one who can handle the really tough cases. He’s the best there is.”

“Dr. Hunter (surgeon in Salida) recommended him.”

“See?” said Ron. “We’re going to try to teach your joint and your back to straighten up, to lengthen those muscles and teach those tendons to quit protecting your joint.” Ron showed me an exercise to lengthen thigh muscles and said, “You know runners. When they run, the back leg kicks way far back, so far it seems like it’s flying behind the runner, right?”

I visualized that and saw running in a completely new way.  We kept working and Ron explained how the tissues in our bodies replace themselves so that every three months we have all new tissue. I then understood that the purpose behind the cortisone shot is so that these exercises will not hurt me, because, otherwise, I couldn’t possibly do them.

I understood then why the surgery will be three months from now at the soonest. With that realization, suddenly, I got it. I really wanted to cry. My surgeon and the physical therapist are working together to help me emerge from this crysalis of pain and disability into a, yes, older Martha who can still be who the eternal Martha (inside herself) knows herself to be.

The shoes? Well, they’re trail running shoes. I got them on eBay last week. I’ve been wearing Salomon trail running shoes since the early 2000s. They were developed for people who race in the mountains. They were amazing, but they lasted me only about 3 months. Toward the end of the 2000s, Salomon sold the shoe to Adidas, and Adidas changed the way they are made as well as making various models. They are more durable, but less responsive (IMO) Still, they’re the best I know. I didn’t want to fork out the $$$ for brand new ones because I don’t know how this is going to pan out, and they’re expensive. When these arrived, I just hoped they’d have some time left. It turns out they are almost new. I think the previous owner might have worn them twice. I wore them yesterday to PT. They’re going with me the whole way. 🙂