GRATITUDE

So yes, they gave me a new hip. Remarkably, a week ago Monday, they had me out of surgery and on my feet within an hour... and home a couple of hours later.

I understand what they mean--those well-meaning friends, especially the ones who have experienced the same--when they say it's easy. It is. Remarkably. But the nitty-gritty truth is that it's also hard. There's a good deal of pain involved, though mine has been absolutely manageable. I took myself off the narcotic medication a couple of days after surgery without severe repercussion, and have done pretty well instead with regular doses of Tylenol. The sharp, burning pains that accompany awkward shifts in position have largely subsided now, eight days later; they have been replaced by a deeper, more persistent pain around the hip joint. None of which is surprising, given that the surgical team cut their way in through flesh and muscle, sawed off the old, grating joint, and hammered in a new, prosthetic one. Hardly the recipe for comfort.

Harder to manage is the difficulty moving and the (now decreasing!) need for help. Simple things that you normally take for granted--things like sitting down and standing up, getting in and out of bed--become huge challenges requiring inordinate amounts of time and effort, not to mention pain. To put on a pair of underpants or pants required, initially, the help of my wife, Ellie, because I had been cautioned not to bend. Within a few days I learned to operate the "grabber"--a stick that allows me to reach for things on the ground and manipulate them into place. With this, I can now once again manage to dress myself--a skill I surely learned at the age of two or three and have been doing these past 80 years without a break!

I think perhaps the hardest challenge I was confronted with in the first several days after surgery was the inability to get a decent night's sleep. Impossible, first, to even get into a comfortable position. I am used to sleeping on alternate sides; now, unable to sleep on either one and forced to attempt it on my back, I struggled to find a position where I could conquer the pain and fall asleep. This was complicated by the constant, almost hourly need to pee. I soon resorted (excuse this intimate detail!) to the use of a bottle, which filled up all too soon and left me with the need for an in-person visit to the bathroom. It was a twenty minute operation--I was about to say "ordeal"--to get myself out of bed and into the frame of my walker, across the bedroom floor to the bathroom and back and finally, painfully, inch by dreadful inch, back into bed. The first couple of nights I had to call for help from the ever-patient Ellie; but her need for sleep is no less than my own, so we found ways for me to negotiate this particular challenge without help.

It took, I'd say, about a week to be restored to some semblance of independent movement. For several days, while I could manage the stairs (fifteen of them, in our house, one at a time, right foot first, descending, left foot first ascending) I needed to have Ellie in front of me, going down, or behind me, going up, just in case I stumbled. Yesterday, for the first time, my visiting Physical Therapist conceded me the right to take on the stairs alone. And yesterday, for the first time, he helped me begin the transition from walker to cane. This morning, instead of hobbling along, I was striding along manfully with a cane! Well, at least making appreciable forward motion. So there's progress every day, increasing strength and mobility and decreasing pain. It's truly remarkable.

So yes, I have much to be grateful for. First for Kaiser and its orthopedic surgical team, who were brilliant from start to finish--from the people in the prep room, to the anesthesiologists and the surgical gang, to those in the recovery area who woke me up and got me on my feet. Everyone was kind, without being patronizing, respectful, appropriately informative, and efficient. I have nothing but good words for these dedicated people. And then there's Ellie, who has been with me all the way, supportive and loving, working twice as hard as usual--and that's a lot!--to keep up with things around the house and at the same time cater to my reluctant but unavoidable needs. At a time when I needed a trusty guardian angel, I had one close to hand. 

The improvement continues, the strength continues to return. I keep busy with my prescribed exercises and, under Ellie's watchful eye, take walks on the street outside our house. Today I learned how to navigate another of those tasks we perform every day without a second thought: getting in and out of the car. I have applied for a handicapped parking placard, and look forward to getting out and about before too long. I know it will be a while before I return to "normal", but at least I know I'm on the way!

FLOWERS!

 What a gorgeous bouquet! Sent by friends in metta. So much to be grateful for after surgery! Blessings to all

PALINDROME

I did not sleep well last night, and for a particularly ridiculous reason: I became obsessed with a palindrome. It started, I suspect, with a dream in which some genius wordsmith had come up with a palindromic version of a highly technical medical instruction--something to do with my imminent hip replacement surgery--which was a whole paragraph long, surely one of the longest palindromes ever created. I was so impressed with this prodigious act of alphabetical prestidigitation that I became obsessed, between dream and waking, with trying to remember and describe it. I must have settled on "prodigious act of alphabetical prestidigitation," because there it is. I was pretty pleased with myself for having come up, if not with the palindrome, at least with its description. But I lost a lot of sleep trying to work it all out.

TODAY IT STARTS

Today is the first in a five-day preparation for hip replacement surgery next week. It starts with the daily application of a disinfectant soap.

I will confess to having some anxiety about the surgery for which I'm scheduled next Monday (I have to show up at 5:30AM for the procedure!) I think I'm not so much concerned about the surgery itself; I am assured --and not only by the doctor who'll be performing it, but by numerous kind friends who know from experience--that it's an easy, fast, in-and-out process these days. They aim to have you on your feet and walking within an hour after surgery, and send you home as soon as possible once the effects of anesthesia have worn off. 

So, no, it's not so much the surgery, though I don't relish the thought of being drugged out of consciousness and sliced open with a scalpel. It's more the recovery period that I anticipate with some anxiety. And even then, not the pain. Pain is somehow private, a transaction between mind and body that I believe (hope?) I can negotiate with some dignity thanks to the years I have devoted to my meditation practice. What provokes the anxiety has more to do with the physical incapacity and dependence, the difficulty in getting around and performing simple, daily tasks without needing help. It is perhaps a rehearsal for still more advanced old age--though I trust, now, without the incontinence that can sometimes accompany that time of life and which I truly dread. (It would be a good time, perhaps, to re-read Ram Dass's book, Still Here, written after his debilitating stroke, in which he writes about the need to learn a dignified, even joyful acceptance of dependence). 

There's another, deeper fear. It's that the surgery will succeed in relieving me of the pain in that one part of the body, but leave me with the knowledge that the source of the pain I have been experiencing of late--physical, yes, but also (related, surely) emotional and spiritual--is more than just one wonky hip, and will not miraculously produce the bright, pain-free "new man" that well-meaning friends have been promising me. Suppose I find out that the "old man" walk--that slow, hesitant, tottering forward motion I have been observing in myself, to my distress--turns out to be endemic to my advancing years, and not merely attributable to that one bad hip? Suppose I find out that this old, deteriorating body is really who I am? And that I have to learn to live with it? 

So there's the rub. There's the source of the anxiety. Next challenge: to address it!

KNOTS

I found myself thinking, this morning, of the feats of manual dexterity required of me before being sent off, as a very young boy, to boarding school: I had to be able to tie my shoelaces and tie my tie. The shoes, of course, were the basic black leather Oxfords; and the tie was woolen, with horizontal black and white stripes, squared off at either end. 

It seems odd, from the long perspective of life today in contemporary California, where my 9 year-old grandson wears neither lace-up shoes nor tie and looks askance at me when I tell him that I did, that little boys should have been required to perform this daily ritual. But there you are. Every single day at school would start with the same ritual: once the underpants and prickly undershirt (the "vest") were on, and the grey short pants and the gray shirt, and the grey pullover with black and white trim, and the knee-length grey socks with the same black and white trim, it was time to tie the shoelaces and tie the tie. 

Shoelaces first, first right, then left. One lace over and under the other, pulled as tight as you could in opposite directions. Make a bow with one end and hold it firm while you circle it with the other, then poke the second bow through and under the first, pull tight again, and adjust. If it's too loose, of course, you have to start again. 

Then the tie. Flip up the collar of your shirt and slip the tie around your neck, then over and under, up and around and through and down and pull it tight, but not too tight--and not too loose, of course--to make the knot. Then slip the knot up to cover the top button of your shirt. Last thing, turn the collar down again all around the neck to cover the tie and check that the knot is neatly placed in the triangle made by the tips of the collar. Pull it up further if necessary to look neat. 

There, you're done. Ready to run down the long flights of stairs from the dormitory on the top floor to the dining room in the basement, where you'll find a steaming pot of porridge ready for you to fill your bowl for breakfast.