Allow Me
From: James Algiers
Date: September 15, 2012 9:59:21 AM CDT
To: Louis
Subject: Allow me
Dear Louie,
We take so much for granted; awakening in the a.m., getting up, dressing, and going about our "chores,” and as we age… just going about. Recently, I’ve been troubled with symptoms of spinal stenosis, which cause distress - greater distress than I would like to acknowledge. I have sought relief from the low back pain, the radiation into the anterior lateral thighs, down the legs, the fatigue into the mid and low back, and in essence, the "Pain in the A--.”
Many years ago (at least), after a long trip to California, I developed a backache and was treated with epidural steroids. I remained quite well until this year of gardening.
The garden this year was great - beans, lettuce, and later bright red tasty tomatoes. But during the season, I noted a backache, which has progressed along with the ripening of the tomatoes, and now as I dug up, pulled out the plants, I stooped and hoped that with the cleaning out of the garden, I just might remove cancer like claws of the spinal stenosis. Oh, if it had only worked that way; associative removal of the low back pain along with the removal of the dried-up tomato plants; If only one might associate cause and effect and with the removal of one, a transmission to the effect might result in ablation of the low back syndrome. Poor thinking, I would say.
However, if sticking needles into dermatomes - the Acupuncture avenue of pain relief - works, why cannot other mind-convincing methods equally apply? Why, if the tending of the "crops" produces the pain, why not see the pain just go away when the activity ceases?
And I believed that might be accomplished. That is until I looked at the MRI image of my low back. I was astounded.
Each morning when shaving, I note a face that I recognize, but when compared to a picture from the past, a different face, slowly changing, drooping, and sliding into age-related features. The transition has been so slow and steady that one grows older unaware of the daily gravity pull on the cheeks, forehead, and jowls. The eyes sag, and tears flow and trickle down, not from sadness, but from the gravity pull of the circumferential ocular muscle producing the crying ectropion of the aged. That is a given, a product of living, a race of length of time, and a fight for survival. A given.
But let me tell you of the shock of viewing the lower spinal column. I'd like to explain the lack of self-recognition when one gazes at a washed-out curvilinear one on one stack of mashed-down vertebral bodies. What a shock… what an advertisement for calcium and vitamin D. The pain and discomfort are all explained, the realization sets in, and acupuncture, belts, exercises, and even surgical approaches become a probability. All one seeks is time and freedom from pain to seek treatment from the Medicare carrier. And that is where I am this morning. Going in for the second of the epidural triad of injections, going in with hope and more hope, having removed the cause, the damn tomato plants, from the equation of causality.
So now, as I type this email from a standing position, as sitting is too damn pain provoking, I will try to live on and stop this damn bitching about aging. I am tired of myself, and I am sure Dorothy is tired of my complaining. So allow me this last moment to bitch age-related changes and smile with the bright sunshine of this day. No more shall I write of aging. I will, as the Nuns of St. Kilian's would say, "Offer it Up."
Keep the faith, Louie.
Jim
ALLOW ME
PART TWO
From: James Algiers
To: Louis
Subject: Planning for the Future
Dear Louie,
It was a pleasure to have spoken to you yesterday. Your voice resonated over the tele; there was a resilience and quality, which was good to hear. I felt that, despite your loss, you were again functioning quite well. Glad to learn that the girls visit frequently, along with their animals. I am beginning to feel the pleasure of the aged, a visit from one's children, be it ever so brief. And to think that when the shoe was on the other foot when we were the visitors instead of being the visitee, we were so casual and many times not attentive. My how many times it might have made a difference just to spend a few minutes with "the folks."
This all sets me to think of the social state introduced to us over the past few years, slowly but surely, just a bit at a time. The wheel of aging rolls over all of us if we are allowed to live long enough. Only those who die young are spared the adjustments of aging. I occasionally think of some of our classmates who never were fortunate to have aged, some even to miss the progress of soma and psyche into their late teens. And I suppose those of us who have taken advantage of our investment in Social Security, who have been fortunate to have lived and prospered, now have the benefit of longevity and all that is associated with longevity, the good and the bad.
For the past number of months, my vocabulary has gradually been rekindled to include words with meaning, words such as independent living, assisted living, total care, respite care, family visits, location, finances, and whatever is next. These are the descriptors of aging, along with "plots," preplanning, and daily reading of the obits. It seems as though the writing today is more depressing, and it probably is.
But the theme is so real and is easily overlooked and ignored. Since my last letter, or at least since one of the last letters, one in which I described my back pain, I have thought of "the future." I have allowed myself to speak to the issue of "ongoing care," of living locations, room sizes, meals on wheels, home assistance, and of "homes." I have become more familiar with "future planners" of care centers, of "campuses," and of the questions which plague all those who are in fair health but are aging.
It is time for planning, for review of plans which have been made, and for thoughts that were discarded.
I well recall the Nursing Home on North Main Street in the late 1950s. It was in old folks' home; on the first floor and consisted of three rooms, eight old women aged 68 to 79, all seated in reed-backed wheelchairs with large clumsy wheels, high backs, and lap straps. Imagine six clumsy wheelchairs, six beds in rows tucked around the room's periphery, and cold linoleum floors. For meals, three times a day, they were wheeled to the dining area, placed around the large central table, bibbed, and fed; fed a nutritious meal of potatoes, meat, salad, pie, and coffee. The calories were adequate, the rooms were surprisingly clean, and the floors were cold. Three women attended, wheeled the ladies to the lawn in the summer, and attended all with care and interest.
Mrs. Wenzel, the proprietress, was aggressive, interested in all, and knowledgeable of families and situations. The patients were attended to very nicely and seemed happy, despite a few State requirements. The average age was about 72. Few reached 75 or 80. The appearance was of age, and the description was of "childish" ladies. The medical literature was just beginning to speak to Alzheimer's Aging and memory loss and confusion in the aged. Old folks became childish. And then came progress, slow but progressive. We in the area were most fortunate. We sat near the incubator of “care for the elderly.”
And then, change came in the form of the Cedar Lake Nursing Home under the directorship of Rev. Louis Reich. He was an early genius in long-term care, in the infancy of organized, progressive care for the elderly. As far as this area is concerned, Rev. Reich and the increasing number of elderly was the Perfect Storm care setting for the elderly. Certainly, more homes came aboard as the number of elderly increased, but locally and with some national influence, Reich was the leader, and that leadership has continued for the Cedar Campuses—a marvelous pacesetting institution. Recently I have investigated long-term care facilities and now encourage the elderly to learn more about care options. Not all facilities are created equally or are managed carefully, securely, and empathetically.
As we age, as chronic illness begins to affect our lives, we must make changes in living arrangements—many plans for these eventual changes, but many do not. A whole new vocabulary of terms enters our planning schemes. Terms to describe concepts of Institutional Care, Independent Living Arrangements, Personal Care, Assisted Living, Senior Care, of Home Care enter into the conversation of living, and plans have been schemed. Many words are spoken, and many plans are made, but just like downsizing, not all is turned into action.
Some Seniors are successful in planning to move into easier-managed living quarters, but I subscribe to most plans and move only when forced by circumstance forcing change.
And so, Louie, on the days of low back distress, the stimulus for change is present, but as the days warm, as the grass greens, as the earth blooms, the golf clubs have greater attraction than the action of downsizing for future moves.
So, my friend, we await spring and fear the winter which will again come.
Some things are inevitable.
Keep the faith,
Jim
