Archive for the ‘aging’ Category

Anatomy of a fall

Posted: September 8, 2011 in aging, health

Every year, thousands of post-menopausal women are seriously injured in falls. Don’t be one of them.

Saturday, July 16: I’m at the airport in Minneapolis, waiting for the last leg of my flight home. I’ve spent the last four days visiting my delightful eight-month-old grandson. I’m rushing out of a restroom stall, just having congratulated myself on never having broken a bone (I am not making this up), when the combination of an unstable wheeled carry-on bag and a stylish but equally unstable pair of platform wedges that no sane 50+ woman should be wearing makes me lose my balance. I stumble across the aisle, half-twisting and gaining momentum as I fall, and I end up smack on my fanny in front of the opposing toilet, which, thankfully, was unoccupied. I hit the cold cement HARD. I am writhing on the floor, almost incoherent with pain. After I come to my senses and can sit up (and change my frackin’ shoes), I am helped to my feet by a female security officer. I wave off any assistance, except for a cart ride to my gate, and somehow endure the flight home on nothing but Tylenol and copious amounts of caffeine.

Monday, July 18: After spending Sunday in bed, being waited upon by my most excellent and sympathetic Spouse (a true Tender Mercy), I get up and go to work. Seriously. (Because I’m a martyr and an idiot.) Just getting showered and dressed reawakens the pain, which has pretty much driven in the entire buffalo herd and staked a claim on my lower back. I go home early and endure the rest of the day on an ice pack.

Tuesday, July 19: An x-ray at the doctor’s office shows that one of my lumbar vertebrae looks significantly shorter, especially when compared with a past x-ray. My doctor prescribes hydrocodone and and suggests — but doesn’t insist — that I get a MRI. “You could just monitor your pain for a week or two, and then decide,” he says. So I crawl away, fill the script and… Honestly, I can’t tell you much about the next two weeks because I am gorked-out on pain pills. My discomfort eases up some, but doesn’t go away. Any effort — taking a brief walk, trying to do the laundry, going up a flight of stairs — is painful.

Thursday, Aug. 4: I arrive at the local hospital for the MRI I didn’t want to have. Although I’ve managed to grit my teeth and get through the previous two days without a pain pill,  a half hour lying motionless in that cold silver coffin sends me back to the bottle. A specialist will look at the results, so I don’t expect to hear from my doctor until Monday.

Friday, Aug. 5: The phone wakes me up at 7 a.m. It’s my doc, calling to tell me that I have an acute lumbar fracture with a 25 percent reduction in the height of the vertebrae. And it’s fresh, so it’s most likely the result of my little gymnastics routine in Minneapolis. No lifting of any kind, he says. None. Calcium and Vitamin D supplements for life. Sit up and walk straight so the fracture heals properly. Schedule a bone density scan, although the last one showed no bone loss. Get up and walk around, even if it hurts. (It does.) And seriously consider having the fracture “glued” together, he says. (It’s called a vertebroplasty, the x-ray-guided injection of a cement polymer into the fracture, and it’s gotten mixed reviews.) It isn’t a cure, but it might reduce the pain. I promptly google “lumbar fracture.” I am not pleased. According to Medscape, “Vertebral compression fractures are associated with significant performance impairments in physical, functional and psychosocial domains in older women.” Gee, no kidding? I’m in persistent pain, I can’t do much of anything, and I am depressed.

Wednesday, Aug. 10: I ask my doc for a non-narcotic pain medication, since I’m becoming much too fond of the hydrocodone. (I’m right to worry: According to this Associated Press story,  it is the nation’s “second-most abused medicine, linked to murders, celebrity overdoses and a rising tide of violent pharmacy robberies.”) I admit I’m still on the fence about the vertebroplasty. Shouldn’t I be able to find some way to to manage the pain? “I think you’re just being brave,” he says. (I am.)

Thursday, Aug. 18: I meet with an interventional radiologist who shows me the images from the MRI. The vertebrae in question is seriously misshapen when compared to the rest of my spine, and bone splinters are clearly visible.  But the angle of the injury makes me a good candidate for the vertebroplasty, and he believes that I have a better-that-good chance of being pain-free and regaining most of my lost ability.

Thursday, Sept. 1:  I arrive at the hospital, where I am lightly sedated and placed face down on a narrow table in an operating suite. The radiologist, guided by a fluoroscope, drills two ten penny nail-size incisions into my first lumbar vertebrae and injects the cement substance, which hardens almost immediately. After regaining my wits, I am sent home with instructions on how to deal with the two incision points (no stitches) and a warning not to lift anything substantial (like my grandchildren). Other than that, I’m done. No rehab, no therapy. Within a couple of days, the inflammation from the procedure is gone, and my back pain is reduced, but not gone. I plan to patiently work on getting rid of the last of the pain with as little medication as possible. Light exercise seems to help, and in a month or so, I plan to visit my chiropractor.

But the experience leaves me utterly, completely terrified of falling again.

Conclusion: Quit hurrying. Get rid of your “stupid” shoes. (You know which ones I’m talking about.) Use handrails. Stay alert. Exercise. Get your bone density measured. Take supplements, if necessary. And stop telling yourself that it will never happen to you.

Last Leap

Posted: August 26, 2011 in aging, mental health

I had cheerier things I was going to blog about, but I’m haunted today by a story from the SF Bay Citizen via the NYTimes:

On Wednesday, May 25, at 8:05 p.m. Barbara Sue Beaver stood on the Golden Gate Bridge and used her cellphone to e-mail Denis Morella, her Oakland neighbor and best friend.

“Can you come and check on Jondi for me?” she wrote, referring to her affectionate pit bull.

Then, at 8:07 p.m., Ms. Beaver, 55, jumped off the bridge to her death.

“I’m just too lazy to navigate further,” said a letter found at her home, which had been left tidy and mostly emptied of belongings. Notes detailed how she had settled her affairs.

“She didn’t want her death to be a burden to anyone,” Mr. Morella said.

I nearly wept. Her picture showed an attractive, intelligent-looking woman.  Ms. Beaver, who worked in the book industry until it began collapsing, had been unemployed for two years and was without insurance. I seriously doubt she was “lazy.” While the article didn’t mention any family, it described a circle of affectionate friends whom she called her “dollbuckets.” She wasn’t a recluse. While clearly depressed, she doesn’t sound mentally ill. She had just somehow reached her limit, or thought she had.

She’s the case study in a story about growing numbers of suicides reported at the Bridge and on the CalTrain transit system, a trend some experts blame on the economy:

“We have noticed many more people mentioning the economy,” said Eve Meyer, executive director of San Francisco Suicide Prevention, a nonprofit group that operates the city’s suicide hot line.

“We constantly hear, ‘I’m going to be homeless; I would rather be dead than be homeless,’ ” Ms. Meyer said.

Studies have shown that suicide rates tend to increase about 18 months after an economic decline. “Benefits run out and the crises begin to multiply,” she said.

Apparently there is a plan in motion to put a multimillion dollar safety net along the Bridge to catch the growing number of jumpers. But the article contained a stat that depressed me even further: “Suicide rates in the United States tend to be highest among people age 65 and older.” We’ve had a few murder-suicides locally in the last year, all with a heartbreaking familiarity: One elderly spouse desperately ill, the other at the end of his or her abilities to care for them.

I understand despair, those dark nights of the soul when pain and loneliness magnify mistakes and failures so that they blot out any successes. I’ve lived through depression and anxiety. I’ve worried about disability and dependence. But I cannot imagine, in the midst of that darkness, methodically organizing your life and navigating yourself to a site with the full intent of never returning. She cleaned her apartment, gave away most of her possessions, wrote and left letters of explanation, and exited her home. What did she wear? Was it something red, her favorite color? Did she put on makeup and do her hair before she left? Did she enjoy a final meal, a glass of wine? Did she drive there, passing familiar landmarks and places she’d loved and enjoyed? Or did she take public transportation, sitting elbow to elbow and maybe even exchanging polite but meaningless pleasantries with other passengers who would never know they were among her last human contacts? Was she conscious that she was doing all these thing for the last time?

I see her walking out onto the bridge, passing the usual tourists and joggers, maybe even a police patrolman. Did she make eye contact with any of them, exchange a hello? Where did she stop along that long, windy span? Did she look out at that magnificent vista, and at the cold, rough water so far below? At some point, she stopped and called a friend to make one final bequest, a kindness for her dog who was witness to her despair and to her careful preparations and who was likely still at the door, waiting for her to come back. Did she crawl over the rail and stand on the exterior railing before stepping off, or did she leap from the top of the rail? Did she hesitate, even for a moment? Did anyone try to stop her?

And — once she was airborne, was she sorry? I watched an equally disturbing documentary on the Golden Gate Bridge last year that included a tantalizing little fact: Of the handful of people who jumped from the Bridge and who survived, ALL of them said that, once they let go, they were immediately overcome with a sense that their lives weren’t really so bad and that they could still fix them if they had the chance. Was she one with them? And did anyone find her body, or did she disappear completely, as she wished?

I have no answers.

Go with God, Barbara Sue Beaver. I’m so terribly sorry that our society had no safety net to catch you. I hope you have found peace.

Aging with Style

Posted: August 22, 2011 in aging, beauty, style

Someone has managed to put a dollar figure to the vanity of the Baby Boomers, says the NYTimes today:

The market research firm Global Industry Analysts projects that a boomer-fueled consumer base, “seeking to keep the dreaded signs of aging at bay,” will push the U.S. market for anti-aging products from about $80 billion now to more than $114 billion by 2015.

That’s a chunk of change, especially if it gets spent on of snake-oil — and there’s LOTS of snake oil out there, as anyone who watches cable television advertisements can attest. Fortunately, the experts quoted by the Times extol the old basics:

“Our culture places great value on staying young, but aging is normal,” the [National Institute on Aging] says. “Despite claims about pills or treatments that lead to endless youth, no treatments have been proven to slow or reverse the aging process.”

Its advice for aging well is basic: Eat a healthy diet, exercise regularly, don’t smoke.

“If someone is promising you today that you can slow, stop or reverse aging, they’re likely trying hard to separate you from your money,” said S. Jay Olshansky, a professor at the University of Illinois-Chicago’s School of Public Health who has written extensively about aging.

“It’s always the same message: ‘Aging is your fault and we’ve got the cure,'” Olshansky said. “Invest in yourself, in the simple things we know work. Get a good pair of running or walking shoes and a health club membership, and eat more fruits and vegetables.”

I reject the notion that aging is a pathology that can somehow be cured. It’s okay to use hormone therapy or even a little botox if it really makes us feel better, but we have to get over the idea that growing older makes us less. Less useful, less admirable, less human. What about wisdom, experience, life skills, friendships? They all grow stronger and deeper with time. I feel richer every day.

Come on, Boomers! Let’s show ’em how it’s done! Let’s be nothing but fabulous, regardless of our condition!

The Way We Were — and Are Now

Posted: August 17, 2011 in aging

Facebook provides a perfect platform for reaching out to high school friends. But do we really want to?

One of the more social media-savvy members of my high school graduating class created an exclusive Facebook site where we former Tigers can gather electronically, swap life stories and revel in the good old times. The site has grown quickly, and it has turned into a bit of a brag rag where we list our many accomplishments (spouses/children/grandchildren/jobs/homes/travels/honors) since our big graduation celebration in May 1970.

Most of the women in my class are recognizable in the accompanying photos (perhaps because it’s socially correct for us to keep ourselves up), but I strain to recognize many of the balding, paunchy, red-faced men as the young studs we all swooned over so many years ago. Yeah, Time’s beaten me up pretty badly, too, but my blonde hair and blue eyes still give me away. I don’t think you need to find a yearbook to figure out who I am/was.

The very curious thing about the site is that, despite the savagery of time, we’re still those very same 18-year-olds — to one another. Like ants trapped in amber, we haven’t changed. The labels seem still to be in place: jocks, homecoming queens, rich kids, brains, band (or choir) geeks, clowns, babes, misfits, drunks. In particular, the social strata that we were locked into in high school clearly still exist, especially to those who sat on top of that pecking order. The people who are the most active on the new site seem to be those who peaked somewhere around the 12th grade.

And, as a result, while I found the first few weeks of the site interesting and even fun, I’m now avoiding it.

Looking back, I knew I could never be a babe or a beauty, so I became a brain. I was well-enough liked, I suppose. There was always a girlfriend to share a locker with, or sit by at lunch or at an assembly, or stand around with at the after-game dances. But to the boys in my class, I wasn’t a dazzler. I was good for a telephone study group or for a few jokes in class, but I just wasn’t someone a guy wanted to be seen with. I attended a few awkward parties, and I asked a couple of “safe” boys to the girl’s choice dances, but I didn’t date until I got to college. Most of the time all I ever got from the high school boys was a muted “Hi” in passing. If that.

But I left high school laden with scholarships, graduated from college, traveled abroad and went to work. I married happily, became the mother of sons and made some warm bonds with male friends and colleagues over the years. And I thought I put all that high school social crap behind me.

A member of our class recently died from cancer, and his death really lit up the conversation on the Facebook site. What a great guy. Everybody’s friend. He make everyone feel better about themselves. Do you remember when he…? What a riot! We were all lucky to have known him. Didn’t you just love him?

Really? Although we had plenty of mutual friends, including my pretty and popular locker-mate, this guy never gave me a second glance. I don’t ever remember having any sort of conversation with him. He was one of the ones who didn’t want to be seen with someone like me.

As I read that online conversation, for just a brief distressing moment, I was back in high school, walking down A Hall, hoping the bell would ring and I wouldn’t have to talk — or not talk — with anyone. I exited Facebook immediately. Those high school memories are bad enough without having to experience that angst all over again.

I don’t mind looking back, but I’d prefer to use it as a way to look ahead. While some others on the site have been trying to reassert their high school superiority, I’ve been reading between the posted lines, and it’s pretty compelling stuff. Some of us have triumphed while some could use a little help, and some of us have stories that need to be told, and remembered, like:

• The twice-divorced beauty queen who is hoping for another chance at love by returning to an old, familiar playing field.

• The candidate for student body president who finally lost a very public battle with the bottle, but who managed to reconcile with his family near the end.

• The seemingly aloof young man (who was in reality cripplingly shy) who somehow found the courage to move out of himself and find a life, and who wants to connect now with friends that he was incapable of having as a teenager.

• The now-old men who are haunted by the memory of Vietnam, either from their own tours or from their memories of friends and family members who never came back, and who would like to talk about it and exorcise old ghosts.

• The drunks and misfits who pulled themselves together, overcame the challenges that formed their teen-aged years and went on to have successful lives and families, and who want to recast their old profiles.

• The formerly fit and seemingly immortal class members who are now facing frightening health challenges, and who clearly need support and encouragement.

• And, of course, the 60-something woman blogger who wants to forgive — but certainly not forget — the past, savor the present and embrace the future.

I’m ready, even eager to participate in that conversation, online or in-person.

HagSag, the Continuing Saga

Posted: August 11, 2011 in aging, beauty

Oh, good grief. Something else to worry/feel bad about: cleavage wrinkles. Just kill me now…

The Limits of Entitlement

Posted: August 11, 2011 in aging, Money

Nearly every British blogger I follow has had some experience with the riots that began in London’s East End with a dispute over a police action and that have now spread to several major cities in the UK: smashing storefronts on the high streets, brazenly looting (one account described looters exiting a Debenhams carrying their merchandise in the distinctive Debenham shopping bags), burning cars and buildings, and targeting specific racial groups and their businesses.  The stylish British Teddy Boy hooligans of the 20th century seem to have been replaced by a new, more menacing hoodlum, one with too little money, too much time on his hands, and a poisoned sense of entitlement.

I’ve long been a fan of Theodore Dalrymple, a British physician and writer who has been one of the sharpest and most eloquent critics of the British dole, and his spot-on description of the roots of the current rebellion make me wonder about our public programs. The question, he says, isn’t why is this happening in Britain, but why it hasn’t happened sooner:

The riots are the apotheosis of the welfare state and popular culture in their British form. A population thinks (because it has often been told so by intellectuals and the political class) that it is entitled to a high standard of consumption, irrespective of its personal efforts; and therefore it regards the fact that it does not receive that high standard, by comparison with the rest of society, as a sign of injustice. It believes itself deprived, even though each member of it has received an education costing $80,000, toward which neither he nor—quite likely—any member of his family has made much of a contribution; indeed, he may well have lived his entire life at others’ expense, such that every mouthful of food he has ever eaten, every shirt he has ever worn, every television he has ever watched, has been provided by others.

And don’t expect someone to be grateful for such largesse, since “dependency does not provoke gratitude.” (My experience exactly. With some people, no good deed goes unpunished.)

At the same time, his expensive education will have equipped him for nothing. His labor, even supposing that he were inclined to work, would not be worth its cost to any employer—partly because of the social charges necessary to keep others such as he in a state of permanent idleness, and partly because of his own characteristics. And so unskilled labor is performed in England by foreigners, while an indigenous class of permanently unemployed is subsidized.

One of our family secrets when I was younger was my mother’s cousin Amelia, who lived in a big, gloomy old house with her daughter and who was semi-permanently on welfare. Amelia wasn’t ill or disabled. She was just, well, incapable, someone who today would be called a displaced homemaker. It was clearly a shameful thing for Mother, and I was told not to mention it to anyone. During one of our visits, the daughter showed me her new glasses, which had been purchased by one of the welfare agencies.

“I’m going to get prescription sunglasses, too,” she said, gazing at herself in the mirror admiringly. “I mean, my friends all have prescription sunglasses. Why shouldn’t I?”

I may have been 12 years old, but I knew even then that there was a difference between glasses and sunglasses. It wouldn’t have occurred to me to ask for prescription sunglasses, and we paid cash for everything in those days. But she and her mother seemed to think that they somehow deserved those extras, even though neither of them did anything much to support themselves. Amelia and her daughter told themselves—or perhaps were told by others—that they were entitled to what they wanted but hadn’t earned.

Dalrymple believes the British anger and unrest is due to the gap between what the British underclass has been taught that it should have (whether it has earned it or not) and what it actually experiences. It is a cautionary tale for any society with a welfare class and high unemployment, and it could happen here.

According to several sources, including ABC News, youth gangs are already causing havoc in some major American cities, with at least one reported death at the hands of a young mob.

“The age range is interesting—of most of these riots, it tends to be in the teenage to early 20s by in large,” Frank Farley, a psychologist at Temple University, told ABC News. “That’s a big age for thrill seeking and risk-taking.”

Adding to the contagion for the young people participating in such wanton destruction are the bleak economic outlook, seemingly unending high unemployment and a deep distrust of government.

We live, it is increasingly clear, in interesting times.

ABC News consultant Brad Garret, who was an FBI agent in Washington, D.C. for 30 years, says that he’s not sure if he’s seen a combination of conditions like today’s facing the youth of America.

“When you get people on the edge anyway, and you pull one brick out of their wall, it can collapse,” he said.

There are signs of hope for the U.S. though. The chaos seen in Britain is less likely to occur here, because American cities are generally less segregated than Britain’s. In addition, police forces in America have gotten much better at fighting and preventing crime and anti-social behavior.

In any case, rioting continues on both sides of the pond. Stay tuned.

The unkindest cut of all

Posted: August 8, 2011 in aging

During my usual morning scan of the NYTimes, this popped up:

[A growing number of] septuagenarians, octogenarians and even nonagenarians…are burnishing their golden years with help from the plastic surgeon. According to the American Society for Aesthetic Plastic Surgery, in 2010 there were 84,685 surgical procedures among patients age 65 and older. They included 26,635 face-lifts; 24,783 cosmetic eyelid operations; 6,469 liposuctions; 5,874 breast reductions; 3,875 forehead lifts; 3,339 breast lifts and 2,414 breast augmentations.

Those numbers might sound impressive, but when I think of the potential millions of seniors out there, it doesn’t exactly sound like a surgical tsunami. Yet.

Except for a brief turndown during the recession, those numbers have been rising for years now, and experts say the trend seems likely to accelerate as baby boomers begin to pass age 65.

The story has the requisite pretty photos and stories of those women (and men) who-look-50-but-are-actually-70, who say things like “I want to look as young as I feel” and “Why not look as good as you can when you can?” Why not indeed?

Of course, there’s the dark side:

But the increase also has raised concerns about safety and the propriety of performing invasive elective surgery on older patients, who may suffer unintended physical and psychological consequences… Any operation poses risks, but surprisingly few studies have focused on older patients and cosmetic enhancements. One report, published in the journal Plastic and Reconstructive Surgery in June, found that the hazards in people over age 65 are no greater than in the younger population.

“You know there are biases because of the underreporting of negative findings,” said James Hughes, executive director of the Institute for Ethics and Emerging Technologies, a nonprofit research group in Hartford. “The doctors have more or less financial incentives to do these procedures, and that often leads them to understate alternative kinds of treatments or medical advice.”

Surgical complications aside, this suggestion of restored youth is pure catnip to the felines in my generation. We’re Forever Young. We’re hip, we belong, and we won’t left behind, we who have always led the way. And there’s the rub: We don’t want to be ignored. We’ve hogged the spotlight so long that we can’t bear to leave the stage. We can’t to be thought of as less in any way, and if there is a solution that only requires money and a little discomfort, then pull out the checkbook and the charge cards! Borrow against that 401K! Bring on the knives and the needles! Retread me, and I’ll be good for another 50,000 miles!

I may sound brave and dismissive, but I no longer kid myself that I would never dance that two-step. I’d maintained for years that I don’t need “help,” that those who indulge in such things are stupid and narcissistic. I would just age gracefully and gratefully, I said. But mirrors and other reminders of my disappearing youth are getting harder to avoid. My face is literally sliding off my skull, I’ve developed a third chin, and I’ve got spiders all over my legs. And I hate it, particularly since there is a part of me inside that is still 19 and fresh and who still thinks that anything is possible. She’s the one who will seize the moment, who will try new things (like starting a new blog), who wants to go and try and do and be. I don’t want her to die, and my physical self increasingly belies her existence. What’s a girl to do?

Actually, all this hand-wringing is moot. I don’t have $10,000 in my desk drawer just waiting to be spent, and the beating my investments have taken in the last week won’t allow for such indulgences. Those deep pockets that marketers have depended on for so long just got surgically sewn shut. The only cuts I’m entertaining are in our household budget and my spending. I’ll have to make do with at little generic Renova and some Nice and Easy — and a major change in attitude, I think. What seems like a solution to some of the problems of aging may be out there, but it’s now even further away.

And that may be the unkindest cut of all.

Update: Do me a favor. Google “plastic surgery” (or click here) and look through the images. Yikes. If celebrities with all their millions to spend and their access to the best surgeons can have such TERRIBLE results, maybe we should rethink the whole thing…