Tuesday, November 29, 2011

Doubting My Limits: Exercise, Nutrition and Midday Naps

In the early winter of 2008 my exceedingly slow, but steady journey back to health after a two-year battle with MAI stalled. (Those initials stand for micobacterium avium intercellulare, which is an atypical form of TB.) Just a few weeks before I was to leave for two months on Tybee Island, my moderate heart, lung and knee problems all took a turn for the worse. I was soon in a swirl of specialists, new medicines, side effects and a general sense of malaise and sadness. I was struggling with unexpected bouts of vertigo and weakness, often feeling faint. I had no stamina and no sense of vitality. I couldn’t get through the day without a two-hour nap and a very early bedtime. I missed the first ten days of my winter respite, but with family help I went ahead and made the trip. The several weeks I spent there alone were daunting.

The work on my book Decrescendo seemed to take up any energy left over from preparing meals, resting and taking a daily walk. I knew that I could not go on trying to live what for me was a normal life in that condition, even though all the things medically wrong with me were under control. If I could not regain my strength, I would have to revise my expectations. Some months earlier knowing how discouraged I was, my son Robin had passed on an issue of The New Yorker with a fascinating article on aging by Atul Gawande. He touted the importance of the perspective of geriatricians for older patients. I am devoted to my primary care doctor, but I thought perhaps it might be worthwhile to have a consultation with someone who specialized in geriatrics and get a global look at my lack of well-being. It turned out that my doctor agreed, feeling it might be helpful to her as she managed my care. She recommended a physician that I knew well and made the referral.

It was a different kind of examination starting with a very long intake interview covering everything that was a current concern, together with a substantial history and a discussion of my diet. This was followed by comprehensive muscle strength tests and observation of my walking, turning and balance. She ordered some additional tests, and told me she wanted to see the test results and give my situation some thought. She would see me again in a month. Then she gave me some dietary suggestions and expressed concern about the weakness in my right arm and hand. As she handed me printed instructions for a series of exercises, she smiled and said, “If you don’t increase the strength in your legs, you are going to wind up in one of those scooter chairs.”

The cardiologist, pulmonologist and my primary care physician had all been emphatic that walking was the most important exercise I could do. Despite the ongoing problems with my knee, I was walking at least a mile a day. In addition I was doing a set of exercises for flexibility that I had gotten from one of Celo’s yoga teachers. To these I added strength training. In order to make it part of my daily routine, I decided to do all the indoor exercises at 6:00 PM when the PBS News Hour comes on. That was the time that I always played fetch with my dog Nigel. I thought I’d change the play time, but he was not amenable. As soon as I stretched out on a mat on the floor he brought his little rubber tire for me to throw. So I decided Nigel would provide my warm-up, so every day at six, I begin with ten or fifteen minutes of throwing toys or playing tug.

I expected that the more I did, the more energy I would have, but that was not the case. Instead I began to feel that I was hostage to the daily routines of walking, exercise, naps and preparing nourishing meals. This necessary self-care encompassed both the bane and the joy of my existence. I loved the walks and the time with Nigel, found the therapeutic movement of my body very pleasant and was happy to have a better diet, but I felt exhausted all the time. I dreaded to see the hands of the clock moving toward 6:00 each afternoon. I had to give myself a pep talk to get started.

When I build a virtual misery heap out of dark emotions and perceived problems, I often dump it all on my daughter Melissa during her weekly call. One Sunday I was pouring out all my doubts about managing my recovery program, finishing my book, getting enough rest and whether I was even capable of getting any stronger. When I stopped for a breath, she told me she understood why I was discouraged and then said, “But if you need to doubt something then doubt your limits.”  She went on to say that it’s easy to question your abilities and potential and accept your limits, but that it should be the other way around. I immediately recognized that after an eight-year period of perpetual stress: caring for Bill, mourning his death, followed by my own illness and aging, I did indeed doubt my ability to restore my endurance and sparkle. I definitely needed an attitude adjustment.

A year later in 2009, I was thrilled when the doctor redid the strength testing and declared that I had improved noticeably. Since then I have continued my physical therapy program even as there have been new manifestations of aging. My knee replacement surgery last June was a temporary setback but a net gain. I am now walking a mile and a half a day with no pain. It also added additional exercises to the daily routine. In that first consultation when I looked at myself as a geriatric patient, I told the consulting doctor that if it was not likely that I would ever get better than I was then, I would have to make some major changes in my life. Now three years later, as I reviewed my journal entries from that time I was astounded to realize how much better I feel now.

I continue to doubt my limits and to believe that I can at the very least maintain the new vitality I feel—at least for part of the day—and perhaps increase it. As I have a little more stamina, I can cook more interesting meals and that in turn makes me feel stronger. As I turn eighty I know that I am actually healthier than I was at 70, even though I can’t climb on that virtual treadmill and keep going all day. In spite of scarred lungs, uneven heart rhythms and an uncertain digestion, I haven’t had a sick day for several years and generally feel well, as long as I take a midday nap. On the upside, I am reading, writing and spending time in contemplation more hours a day than I have done in years. Long before Bill died, Margot, my acupuncturist, urged me to start imagining the life I might have after his death. It was painful, but I did try. Little by little I am finally claiming that life.

Tuesday, November 22, 2011

Amazon River Fantasy: Keeping the Dream, Changing the Venue

Adventure, Exploration, Discovery: these words have been part of my self-image since I was old enough to have my own library card. I constantly chose books, both fiction and non-fiction, that took me on adventures—especially to rugged places. I still read them. I just finished Ann Patchett’s new page-turner State of  Wonder, set in the Amazon basin and full of native tribes and jungle life. It reminded me that for some thirty years of my life I nurtured the intention, or perhaps the fantasy, of a trip down the Amazon in a small launch.

The closest I ever got was when in 1975 my daughter Melissa and I took a trip overland from Guatemala through Belize to the Yucatan peninsula ending in Merida. We had a very tight budget. It was her senior year at Salem Academy, and she had a January Plan which allowed for an independent study. She chose to focus on the Mayan civilization as revealed through its major ruins. We flew into the Peten from Guatemala City planning to spend the first night in Flores, a small tropical town located in the middle of Lago Peten Itza. A rickety bus from the airport left us at the dock where we found an old man with a small weatherworn lancha. I negotiated a price and he ferried us to our pension, an inauspicious building, the siding moisture-aged to a rough gray, with a window shutter hanging loose on one hinge.

It was constantly hot and buggy during our trip. We climbed around many ruins and had good exposure to jungles, and rain forests, The wildlife at Tikal included agoutis, monkeys, parrots and toucans. We stayed at a series of minimalist pensiones, ate lots of rice and beans, and longed for a hot shower. Melissa was thrilled when we learned that there was a Lebanese community in Merida and we would be able to get yogurt, falafel and other Mideast food. When we learned that a bus trip through the undeveloped parts of Belize would take us twenty-four hours, we spent $12 each to fly to the Mexican border on a tiny plane that could take four passengers. We didn’t know there was actually no airport at our destination, no control tower or radio, and no taxis, or that we would be deposited with our luggage on a landing strip. Fortunately another passenger was met by a car and driver and he offered us a ride across the border. The next day we we toured Tulum, and emboldened by the experience at the air strip, we hitchhiked to the next town several hours to the north, rather than wait six hours in the sun for the bus. Chichen Itza, Uxmal and smaller sites near Merida were daunting but magnificent. It was a splendid adventure for us both.

I was 38 with three children still at home when I entered the workforce. I remember saying to my husband Bill, “I climb on to life’s treadmill at 6:30 AM and walk or run all day until I climb off at 10:00 PM and go to bed.” The truth is that I liked the fact that I could keep going all day and seemed to have boundless energy, as long as I got a good night’s sleep.

In 1998 I finished my last job, and I haven’t worked for remuneration since. But with volunteer work and caregiving for Bill. I still spent many hours on that activity treadmill, feeling good about how much I could still accomplish in a day. However, the last three and a half years of Bill’s life marked the beginning of my own Decrescendo. My obligations and desires steadily exceeded my physical resources. After he died in 2003, a lung infection that had been silently at work in my body for a number of years was made manifest. I was sick and mostly housebound for two years. Although since 2006 I have made slow, but steady progress in health and strength, I have bumped up against both the effects of the illness and the natural aging process that can affect eyesight,, joints, digestion, balance and other functions, each one bringing its own challenge. I have realized that to feel well, I have to manage well so that I can meet the physical challenges and have some energy left over for fun.

Bill and I visited many parts of the world mostly "traveling fourth class" (to quote him). I never made it to the Amazon, but I’ve had enough rugged experiences that my longing for that kind of adventure has been appeased. Along the way I learned that it is far easier to adjust your expectations of others than to change your expectations of yourself. Accomplishing that has been a large part of my journey since I began my life as a single woman living alone.

My goal now is to live expansively with contracting physical resources, to cultivate—as my friend Janey stated it—a spacious mind. This will be the adventure of my later years. I’m going to float down the river of my experience to explore where I have been and discover what is still possible.

Tuesday, November 15, 2011

Old Age: Is There an App for That?

When I get up in the morning, I have a series of routines. I turn up the heat if it’s cold, turn on NPR, visit the bathroom, drink a glass of water, put a coat or bathrobe on over my nightgown and take my dog Nigel for a walk. Sometimes I trudge my way through it, especially if it’s cold; sometimes I’m not really present on the walk because my mind is somewhere else. Perhaps it’s as mundane as reviewing what I have to do that day and other times I’m reveling in memories. Today was different. As I turned on to Grindstaff Road I felt that I was enveloped by the morning. The light was made gentle by a slight overcast as the surprisingly warm air caressed my face. There was a quiet breeze, but otherwise no sound except for the occasional scrabble of a small animal in the dry brown leaves. Not at all a typical November day, and my heart said, “Be present in this moment, we’ll not have many more like it until spring.”

A half a mile later I turned back into my driveway, feeling nurtured by the walk. Once in the house, I clicked back into routine: fixing Nigel’s breakfast, making the bed, putting the kettle on for tea, and setting out the bowl for the leftover gluten-free cereal that was in a pan ready to reheat once the tea was brewing. Then I went out on the deck to open the Nigel’s door, knowing he would soon want to go out again. As I stepped once more into that delicious air, I was suddenly flooded with happiness. It felt like an emotional fizzy drink with bubbles overflowing on the sides of the glass. I bent over to pull up the pet door, then straightened and filled my lungs with both fresh air and bubbles of joy. I came in and hunted up the words of Matthieu Ricard, a biologist and Tibetan monk whom I had referenced in my blog post on November 1. When asked to speak about happiness, he responded that it was an inner sense of flourishing, fulfillment and appreciation, not dependent on external circumstances. That was exactly what had it felt like on the deck. Then I noticed that under my Ricard notes I had written. “Does aging set you up for self-absorption?” Now some weeks later I wondered what that had to do with happiness.

I first set up this blog to help promote my book Decrescendo: A Memoir of Love and Caregiving. After several months of writing posts that were directly tied to the book in some way, I suddenly found I had nothing more to say. Bill’s nephew had died much too young and I needed to write about that. The post on December 7, 2010 was entitled Sometimes Words Fail. Since then I have been writing about my life: what I am thinking about, memories of childhood, and things that amuse or challenge me. I have come to think of it as a blog about my own Decrescendo years.

As I approach my eightieth birthday I find myself thinking about my life as an old person living happily with Nigel for company within a community of friends and family. It could end tomorrow or go on for twenty more years. I have lived a life directed toward others. I have been a caregiver not just to my husband Bill, but also to my parents, sometimes my siblings, my own children and beyond family to people in need in whatever community I was living. It was a natural outgrowth of my own temperament, my faith and the way I was raised. “If you are not part of the answer,” my mother often said, “then you are part of the problem.”

A little voice in my soul answers that statement so ingrained in my psyche, “This is your time now. You are the caregiver of yourself.” I have said to my children that I make my choices now based on my commitment to keep my self as healthy and strong as possible and to use my financial resources judicially so they will last as long as I do. That doesn’t mean I’ve forgotten about my neighbor, whom I am charged to love as I love myself. Rather it reflects a narrowing of the scope, not of the intention.

So that brings me back to my question about self-absorption. That is one among many questions I think about as I have set for myself the task of re-imagining my life in the context of aging, of diminishments,  and of fading from loud to soft while I try to keep the music playing.

For the next little while, I plan to risk the charge of self-absorption and share on this blog my thoughts, explorations and perhaps conclusions about getting old and living well by making different choices, while, I hope, not taking myself too seriously. I figure most of my readers will be old one day and everyone has older people in their lives, so it’s probably topical.

Tuesday, November 8, 2011

Going Against my Grain: A Paste Paper Party

My first effort might make some nice gift tags.

Paste paper is made by the application of colored paste (flour, glycerin and acrylic paint) to moist paper, followed by the creation of designs in the paste while it’s still wet. Once it dries out, the paper is ironed to smooth out wrinkles and make it ready for use.

There were ten of us, ranging in age from 42 to 80. We had worn old clothes as directed and were gathered in Penland School’s outreach classroom, a space usually filled with the chatter of fourth graders learning to make books and paste paper for covers and inside decoration. We were there to celebrate several benchmark birthdays in the group by learning a new skill and having fun together.

Our hostess Susan, now retired from a career as an administrator and fundraiser for nonprofits, supports a large and diverse list of local organizations mostly as a volunteer and sometimes as a paid consultant. She also turns up with her checkbook at fundraising events. At the local Montessori School Benefit Auction, she had purchased this Paste Paper Party. Three artists had offered  this four-hour event to the highest bidder. They were going to demonstrate the process and then assist us as we made paper to use in any way we choose. They also provided wine, tea, sparkling water, hors d’oeuvres, sweets and music to power our bodies and inspire our creativity.

The little back-story here is that Susan, Joyce (another one of the ten guests) and I have been working, playing and sometimes commiserating together for about 35 years; all three of us worked for various nonprofit organizations. Our birthdays are within a three-week span and we usually celebrate together if possible. This January I will be 80 and they will be marking younger birthdays divisible by five.

Susan started off this unusual party by announcing that all of our birthdays were significant and revealed everyone’s age before we toasted each other. She also toasted the 35th anniversary of the Toe River Arts Council. (Susan had been the director during its first 14 years.) As I looked around the room I saw artists who donate their work to benefit auctions and also serve on the boards of community organizations and turn up for their workdays. Other friends in the room volunteer for Habitat, Hospice, the hospital, schools, and animal shelters,. We could well have included a toast to nonprofits in general.

The ten of us paid close attention as two of the artists demonstrated this very messy technique that produces such beautiful results. Spread out on another table was colored paper of many hues and intensities. Our instructions were to choose our paper, moisten it, lay it on the table, smooth it with a sponge, add plops of colored paint and spread it with a brush or our hands. Then we could make designs with marking devices or our fingers. The presenters would carry finished work to another room to dry. We were urged to have fun, be creative, and make as much paste paper as possible. One of them told us to be like kids making mud pies.

This was the moment I dreaded because I had no design ideas. In addition, I have a congenital aversion to doing messy things, especially with my hands. I had been struggling a bit with the whole concept in the days leading up to the party. I am not artistic or creative in visual arts. I am a writer and have communicated ideas and information, and made pictures with words all my life. I also knit and sew, using patterns. I never made mud pies as a child. In fact, my mother was always after us to clean up. If a doorknob felt sticky she treated it like a calamity and checked my hands to see if I was the culprit.

When, as an adult, I took the left brain/right brain test, I was about 60/40 with the right side getting short shrift. On the other hand as I age I have tried to challenge the rigid parts of my psyche by being open to new ideas and experiences. I also exercise my body and brain in order to remain flexible and agile as long as possible. Going against my grain often has productive results. I get too weighed down by world events and know that it is a good thing to lighten up! I thought perhaps there was something primal in messing around in colored paste that I’ve been missing all these years. Hence, I went to the party with an open mind in spite of my doubts about producing anything usable.

As it turned out, I didn’t do anything messy and managed to keep my hands clean by quickly dipping them in the buckets of fresh hot water delivered to the tables at regular intervals. While others were making amazing abstract paintings by manipulating gooey messes with their hands and other devices, I stuck with the rollers that made strips of design. Then I used a small brush and contrasting colors to decorate them. It required so much concentration that it felt like a meditation. I was excited by the array of paper colors and paint choices: intense primary colors plus black, white and gray. I produced four paste papers that I will give them to my daughter-in-law Tammy. She has the soul of an artist and makes gorgeous pictures out of a platter of crudités or the baskets of produce she carries in from the garden. She’ll know what to do with them.

I was happy to be there with the other women— a few good friends and others I know well but seldom see. At the end I was amazed at what the others produced and satisfied with my own results. Yesterday I finished knitting a scarf with an attractive diagonal pattern. As I worked I enjoyed the feel of the soft wool moving through my hands and at the same time I relived the expansive feeling of being with those fine women who brought beauty out of a mess. But then, isn’t that what women have always done?

Tuesday, November 1, 2011

When Best-Laid Weekend Plans Went Astray

For months I’ve been looking forward to a visit from my niece Adrienne this past weekend, scheduled to coincide with the Andrew Glasgow Writers Residency at Penland School. This year’s resident is Barry Lopez, who happens to be a close friend of Adrienne and her husband Joel. The main event planned for the weekend was a Sunday brunch at my house for the writer and his wife Debra Gwartney, who is also an author. My son Robin, grandson Miles and their spouses Tammy and Polly were coming as well. But Adrienne’s trip was aborted when a strong October winter storm made the driving unsafe; she turned back after a scary hour on the road. Earlier in the week, I had gone to Penland to hear Barry speak about his work, both his approach to writing and his commitment to the physical landscape and human culture. I was fully engaged and often moved by what he had to say, and the word integrity filled my mind.  It's no surprise that I was excited at the prospect of conversation with him over the weekend. But it was not to be.

There was another event on my calendar last Saturday, a memorial service at Celo Friends Meeting for Tom Clark, a friend and neighbor in my mountain community who died recently. I learned of the sudden storm-driven change of plans just before I left home for the gathering. I carried my disappointment into the silence of the Meeting House and spent a few minutes being grateful that Adrienne was safe at home by her own fireside with a free weekend ahead of her. I reminded myself that there always seems to be a gift when circumstances shift. Then as Tom’s friends and relatives started to speak, I turned my attention to the present moment.

From many points of view there emerged a consistent picture of a man who was known for a deep commitment to service, simplicity, peace and social justice. His profound commitment to the environment was expressed through his practice of “reduce, reuse, recycle”, and that gave rise to amusing memories. People laughed and smiled as extreme, but endearing examples of reusing or recycling were shared. But there were also moving stories of the way he directly served his friends and communities throughout his life, often just turning up when he heard that someone was in need. Whether he was translating for Spanish-speaking Latino defendants in court, or witnessing and working for the end to wars, his words and actions conformed to his stated beliefs. This is the essence of integrity, and many of his friends used that word as they spoke about him.

I came home to my sparkling clean, uncluttered house with a refrigerator full of plentiful ingredients for the proposed brunch and other meals. It turned out that Barry and Debra both had things they needed to do and felt that since Adrienne was not coming, they should stay put on Sunday. The gift for them in the disappointing cancellation of festivities was time to catch up before another intense week of the residency. Robin decided we should shift the brunch venue to his house and enjoy the planned meal with Tammy, Miles, Polly and a friend of theirs. The gift for me was the leisurely meal, for which I had no responsibility, and the visit with three generations. The conversation ranged from silly and witty bantering to serious and value-laden discussions in which the word integrity continued to come into my mind. You might say all of the intended participants had reused or recycled the weekend.

Sunday morning I had gotten up before dawn to take my dog Nigel for a short cold walk by flashlight and came back to the warm house just in time to hear the radio show On Being. The guest was Matthieu Ricard, a biologist and Tibetan monk, who has been working with the Dalai Lama on the exploration of what the scientific study of the neuroplasticity of the brain is revealing about the tangible effects of meditation. Krista Tippett, the show’s host, asked the monk to talk about happiness. He responded that it was an inner sense of flourishing, fulfillment and appreciation, not dependent on external circumstances. The conversation was dense and the monk had a heavy accent, so later I downloaded the podcast and listened again. He made several references to spending twenty minutes a day cultivating compassion and altruism and how that would affect your brain, allowing you to better serve others. It was a coda to Barry’s presentation at Penland and the celebration of Tom’s life on Saturday, and perhaps a prelude to further contemplation since I now have many pages of notes in my journal to consider.