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.