Tuesday, July 16, 2013

Who Am I Now That I'm Not Who I Was?

Ann writes to Emily, “ Do you feel…as strongly as I do that you don’t get any older inside but are always who you’ve been since birth?” She goes on to say she feels about eleven years old inside, then adds, “Who’s that old stranger in here with me?” These women are characters in my book club’s August selection*. Ann was stating something my mother had said to me when she was in her eighties. We were chatting on the phone, and I asked how she was feeling. Mother said, “My problem is that I have this sixteen-year-old girl trapped in my old body.” She went on to explain that inside she was youthful and full of life, but didn’t have enough energy to sustain that spirit. Although I understood what she was telling me intellectually, I certainly couldn’t feel what she was feeling. Now that I am in my eighties, I know I wouldn’t want to have the spirit of the sixteen-year-old girl I once was trapped in my body; that had not been a happy time for me.

Was there ever a moment when I felt any discontinuity about my aging body and a more youthful spirit?  If so, I don’t remember—maybe I wasn’t paying attention. There are similar questions I ponder. “Who am I now that I am old and have to give up things I used to enjoy because they’re no longer worth the effort they take? What supports or defines my identity?”

I like lists; in fact for most of my life I was addicted to them. As part of my process of working through grief and figuring out life as a single woman, I made lists of things I liked to do that didn’t require a partner. I love words so it is not surprising that my list included writing, reading (sometimes listening to audiobooks), and word puzzles. I greet a new crossword puzzle with glee and sometimes use it as a reward for something like cleaning the kitchen. “I’ll  wash these dishes and then I’ll go work on the puzzle.”

Drinking tea in the afternoon—especially with a friend—never fails to bring me joy. When I sit on my deck and eat a meal I’ve just prepared for myself, I feel a nice glow of satisfaction. Here I sit in the company of my dog, the birds and an assortment of squirrels, bunnies and chipmunks. In the busy years of youth and middle age, I relegated contemplation and prayer to bedtime, mealtime, and Sundays. In recent years I’ve had the luxury of enough time for meditation and reflection all week long.

At the top of my summertime pleasure list is puttering in my garden until I’m tired and then sitting in a comfortable chair in the shade and enjoying the view. Although I miss hiking through the woods nearby or following lonely paths on the other side of the river, several times a day I set out with my walking stick in one hand and Nigel’s leash in the other and find fulfillment on a paved country road.

After Bill died in 2003, I spent seven or eight years struggling with the meaning of my life without him to take care of and no desire to go on trying to save the world from terrible laws, congressional inaction, wars, and injustice. One day I had this small realization that I’m old enough to leave those problems to my children and grandchildren.

When I gave myself permission to step away from activities that required me to leave my home, I spent time reading the wisdom of mystics, meditators, and deep thinkers (Quakers, Episcopalians, Jews, Buddhists). I kept finding the same simple truth: it’s not so much what you do that matters, it’s who you are, and how present you can be to your life here and now. I am aware that I’m setting my own agenda, such as it is, and that now is my time to just BE.

As for the question I struggled with about who I am now that I’m old, I think Ann was right when she said we are always what we were at birth, but I believe we add in everything we lived through since. I can think of a few times my spirit got stuck in one place or age for a while. I find myself smiling with amusement about how much time I wasted worrying about stuff that never happened. Being old has its downside, but it also offers us the chance to tear up our lists and revel in what is right in front of us. I can’t remember if there was a specific moment when I stopped making lists for the future. I think it happened gradually as I learned to embrace the present, to be old, and to write about it.

*Reynolds Price, The Promise of Rest, New York, Scribner, 1995

Next  Post:  08/06/2013

Tuesday, July 2, 2013

My New Dance Is the Meal-Planner Shuffle

Remember all the fuss about Death Panels (so-named by Sarah Palin) during the early discussions on Obamacare? Well I just learned how that was finally resolved.

I was ushered into an exam room at the Celo Health Center for my annual physical or so I thought. The nurse took my blood pressure, then handed me a sheaf of papers to fill out. There were some lifestyle questions, but mostly the forms had to do with depression. I smiled as I kept checking the No boxes. I’m contented by nature and have frequent moments of happiness every day, so I had no anxiety about the questionnaire.

Liz, my excellent doctor, came in a few minutes later, took the papers, set them aside, and began checking notes on the computer. Suddenly she looked up and said, “Do we have your advance directives on file?” She knew I had done the paperwork but I hadn’t yet brought them to the health center for copying. So I replied that I'd take care of it the next day. I guess I looked quizzical because she paused her perusal of my computer file for a moment to explain that this exam—now called a wellness exam—is what remains of those wrongly-labeled Death Panels.

It’s no longer called an annual physical, and is not for the treatment of on-going health problems. Rather the purpose is to look at the whole person with a focus on wellness and prevention. (Here’s the Medicare link for details.) It is also provides an opportunity to look for signs of depression, and I suppose that could lead to openness about end-of-life concerns a patient might have.

I’m all for wellness and don’t really care what the check-up is called. I like the idea of a longer visit once a year to look at macro-concerns instead of a narrow focus on the problem of the moment. We covered a lot of ground, including dietary issues and available screenings, and then I hopped up on the table for a routine examination starting with heart and lungs.

Liz updated my prescriptions and filled out orders for lab work, including a blood panel and the fasting lipids test to check my cholesterol. When the results came back my pesky LDL (often dubbed the bad cholesterol) had increased six points. Liz sent me a typed note with dietary recommendations, underlining the words eat thirty grams of fiber a day. Then she instructed me to repeat the cholesterol panel in six months.

Now let me sidetrack and tell you about my dietary adventures. About forty years ago, I discovered I was mildly lactose intolerant. Since then I limit my intake to milk in my tea plus a little bit used in cooking and manage well with almond milk and goat cheese. Sometimes I indulge with a little Irish cheddar or creamy Brie, and rarely a crème brulee (my favorite dessert), but I always pay for it with mild indigestion. In 1998, an overwhelming set of symptoms led me to a gastroenterologist and a lot of spooky procedures that finally confirmed a diagnosis of acid reflux. The doctor gave me a list of foods that I should avoid. I quickly stopped eating things I didn’t care about like coffee, soda, and pizza, but as I got older and wiser I eliminated everything on the list including such favorites as citrus, cooked tomatoes, and spicy foods.

The next major change in my diet happened when an increase in problems with itchy eyelids and sinus congestion sent me to the Internet to search for an answer. I discovered a connection with gluten. As an experiment I went on a gluten-free diet and never looked back when I was miraculously free of those problems. It was empowering to discover that in exchange for the frustration of a limited diet, I could have greater control over my well-being.

The march of old age brought concerns about calcium. I learned from Liz that it is best to get as much as you can from dietary sources, and here I was avoiding dairy products. I increased my consumption of greens and other sources of this important mineral. More recently an unexpected sojourn with anemia brought the same advice about iron, “Get as much as you can from food.” I went back to Google and found another reason to eat more greens. However, I am now using a blood-thinner as stroke prevention, and there is a limit to how much green stuff I can eat without undermining the effect of that medicine.

Meal planning is my daily juggling act, and to that already complicated effort I am supposed to add more fiber. Well, I want to maintain good health and fully enjoy life as long as I’m given it, so I decided to get serious about slaying the bad cholesterol dragon with a sword made of fiber. Tammy helped with the research, and I got lists of high-fiber foods with menu suggestions and went to work on the numbers. I was shocked that there are not many foods that give a big fiber count per serving; legumes lead the parade, but they are filling. My appetite is not robust; I know I simply can’t consume enough food in a day to give me thirty grams of fiber and also provide the other nutrients I need.

But there is, I hope, a happy ending. Clearly, I have to cut out anything that isn’t contributing fiber, calcium, iron, protein, omega 3 fats, or other things needed for good health. Fortunately I like dried figs and apricots just as much as I like cookies and coffee cake. I know I’ll give into temptation from time to time, especially on social occasions. Meanwhile, I already have more energy and a smoother digestion. I figure it’s not hard to get used to something that makes you feel better.

Maybe Medicare is on to something with this wellness check-up. My recent experience included every point in the Medicare description. With gentle prodding from Liz I got my advanced directives scanned into my records and was reminded that I can be pro-active about my heart health by eating more lentils. Now what I need are delicious high fiber recipes that don’t contain gluten, cooked tomatoes, citrus, dairy, hot spices… well, you get the picture.
Comment below about your favorites or send me a recipe by email. Thanks.

Next Post 07/16/2013