“Happiness is not a matter of intensity but of balance, order, rhythm and harmony.”----Thomas Merton
To those of us teetering on the brink of Oblivion, Balance is a critical asset. We are compelled to locate it, nurture it, take it out to dinner and a movie, then share with it a post-coital cigarette. It’s tough to maintain a relationship with Balance because we are fidgety and Balance is not. We have a tendency to go too far above or below, wide left or wide right, too hot or too cold, while Balance is always waiting smack-dab in the middle. When we make foolish plans to visit the Kerguelen Islands, Balance will call and cancel our reservations. When we think about starting a ruckus in a biker bar, Balance will push the button on our ejector seat. If we consider moving to Kansas, Balance will take us behind the woodshed and whup us with an ugly stick. When we have Balance, all’s right with the world. When we don’t, well, they have places for people like that.
Karl Wallenda walked the high wire til age 73, only slightly overdressed.
Keeping Your Balance
There are many kinds of balance, all of them worthy of keeping in your rucksack. There is the balance of outlook mentioned above, balance in a work of art, balance of temperament, the balance we strike between security and freedom. In a different theater, there is the balance involved in physical equilibrium, a vital property. How many of us have had friends or family destroyed by its absence? Newt Simmons, an old Charlatan staffer and founder of the Out Of Sight Shop on St. Pete Beach became afflicted, forgot his trusty cane one day on a trip to The Dollar Store, fell and died in short order. Every one of us has a story. There are not enough candles at the altar to light in memory of the souls lost to falls. Broken hip, fractured pelvis, next thing you know you’re on the Midnight Train to Georgia. One in three adults over 65 takes a serious tumble every year. About 20% of women who fracture a hip become permanently disabled, another 20% die within one year. Health problems linked to hip fractures result in more women’s deaths each year than breast cancer does. Look it up.
Well, darn it, Bill, it’s just a matter of getting old, there’s nothing you can do about it. Au contraire, mon ami! Tell that to Karl Wallenda, who walked the tightrope until age 73. Like everything else, it’s just a matter of addressing the problem. Stand on one leg as long as you can, pressing your hands together to act as a balancing tool. Take a Tai Chi class. Practice squats without weights. Find a Yoga instructor, they’re everywhere. Or you could, like George Armistead of Boulder, Colorado, attach a large helium-filled balloon to your collar. Be careful, though. George unwittingly lost a few pounds and was last seen floating westward over Lulu Mountain.
Age And Balance
As we age, subtle changes begin to occur, some less noticeable than others. If there were no mirrors, no other ways of inspecting our countenances, and someone took photographs of our faces at 50 years old and again at 65, we’d be stunned at the changes. The common reaction being, “I don’t feel that different.” We are aware there is regression, but the degree of change is alarming. Things slip away from us as we sleep. Our immune systems weaken. Hairlines slowly recede. Organ fat increases. Then one day at the football game, we realize we are not quite as sure-footed negotiating the path to our seats. It’s a little harder to breathe climbing up to the 80th row. Four hours in the sun is more taxing. Alcohol is no longer a friend. At one time or another, it becomes obvious even to the most obtuse that measures must be taken, the retreat slowed, Balance restored.
We visit doctors, prowl the Vitamin Shop, join a gym, consider yoga. The doctors have answers, but which ones to follow? Testosterone is available, but how much to take? Despite being generally beneficial, there is some evidence testosterone contributes to prostate cancer, though proponents will argue the point. What about Human Growth Hormone? There are obvious restorative benefits to aging joints and muscles, to bone density, to exercise capacity, advantages which must be weighed against the possibilities of carpal tunnel syndrome, increased insulin resistance, edema in the arms and legs and the heartbreak of gynecomastia. What about statins, which help control cholesterol but sometimes cause excessive muscle soreness? Can I take Red Yeast Rice instead? What supplements are helpful? Which ones shouldn’t be mixed? It’s a lot of work, this search for Balance. Does the Community College hold classes?
We find ourselves contemplating heretofore unacceptable remedies. Acupuncture doesn’t hurt that much. Massage can be a boon to that aching back. Maybe homeopathic medicine has some answers nobody else has. Charlie joined a gym and he swears by the improvement. It wouldn’t kill me to take an hour’s walk around the neighborhood. More fish, less beef. Does anybody out there sell Haagen Dazs Lite? By hook or by crook, Balance must be achieved.
Almost The Ultimate Oops
Sometimes, in our quest for healthful outcomes, we make mistakes. We focus on the most direct enemy and neglect the ones hiding in the underbrush. We do not so much eschew Balance as forget it. When I was advised prostate cancer was on my horizon, I asked the urologist what we did to prevent it. Not much, I was told. We’d wait for it to manifest and then get rid of it. This sounded like something on the order of closing the barn door after the horse had escaped and it didn’t suit my temperament, which was to put up maximum resistance. I discovered a study operated by the University of Tennessee which was having positive results using a breast cancer drug called Toremifene. The company aiding in the study had offices at the Cascades building in Ocala. I went there, qualified for the study and began taking the pills. At the time I began, I was given some paperwork which advised that one of the side effects of Toremifene was blood clots in a small percent of users. All I saw was the overwheming majority who remained clotless. I had bigger fish to fry. I was on the verge of prostate cancer.
Guess what? Several months later, Siobhan and I were driving around Ocala and I felt a tiny bit sick to my stomach, nothing major. Also a very minor bit of soreness below the nipples, the kind of thing you sometimes get from overloading on the bench press. No sharp pains radiating down the arm, no elephants sitting on my chest. When it continued with no increase in pain after four hours, Siobhan insisted we visit my GP, who is also a cardiologist. He recommended a cardiac catheter test, but I demurred. Halfway home, after a twenty minute verbal battering by Siobhan, I acceded to her demands and agreed to the cardiac cath test the following morning at North Florida Regional Hospital. She immediately made the appointment.
When I awoke next morning, very sick to my stomach, I knew I was in trouble. I took a shower, got in the truck and Siobhan hauled ass into Gainesville. We got to the hospital 19 hours after the onset of symptoms and less than one hour before I would have been gathering dust in somebody’s urn. Since I was already scheduled, they were prepared to take me in immediately and quickly placed a stent in the left interior descending artery, where the clot was. Dr. Daniel Van Roy, who performed the procedure, said he felt obligated to succeed since Siobhan had told him she could not “just go out on the corner and find another Bill.” Which might be the nicest thing she ever said about me.
The same afternoon, Dr. Gregory Imperi, one of Van Roy’s partners stopped by the Intensive Care Unit and looked at the pill bottles on my bedside table which Siobhan had brought from the house. “What’s THIS?” he asked, staring at the Toremifene. After I explained, he took the bottle and told me never to touch the stuff again. “You have pristene arteries,” he said. “You should never have had a blood clot.”
So, there you go. More anecdotal evidence that leaving Balance out of the equation can be the road to ruin. You’ve got to see the forest and the trees. Luckily, I lived to tell about it. Probably wouldn’t have happened, of course, if there was a Bill on every corner.
A Day In The Life: The PET Test
Once you’ve had a heart attack, you have a permanent cardio team and a regular schedule. You visit your doctors for an examination at least once a year, have your prescriptions renewed or adjusted and submit to whatever tests seem appropriate. One year, there will be heart ultrasound, the next an echocardiogram. For me, every three years there is a chemical stress test. The cardio boys call it Positron Emission Tomography. I call it the No Fun test.
As with all such varmints, there are pre-test requirements. The first is that you arrive 30 minutes before your scheduled appointment time. What’s up with that? It’s getting to be a regular demand. Why not just make my appointment time a half-hour earlier? It’s because they want to make sure you don’t straggle in late and upset their carefully-planned schedules. Apparently, some people do this. It’s hard to imagine. Geez, Doc, sorry I’m late for my brain-replacement surgery, the traffic out there is just a caution. It’s appalling. These used brains don’t last forever, you know. You guys are screwing things up for the rest of us.
Oh, and you can’t eat for four hours before the PET, of course. If your test is at 7 a.m., that means you’ll have to polish off your chateaubriand by three. No caffeine, either. That one’s for 24 hours prior. Can’t you just see that guy you know who won’t even talk to anyone before he gulps down his morning joe? He’s out there in the waiting room chewing the stuffing out of the furniture. “Bring with you your rescue inhalers and breathing medications!” Oh-oh. What does that mean? Is my heart going to be racing faster than the William Tell Overture? Are licensed lung personnel standing by? “If you are on oxygen, please bring enough to last the duration of your visit and allow for extra travel time.” Extra travel time to where? I’m already at the hospital. Are there helicopters to the Mayo Clinic available?
I showed up early and meandered around the building. A large sign on one door screamed '”NUCLEAR MEDICINE.” That seems contradictory, right? They took me in right on time and told me to lay down on a long table just outside a huge scanning machine. Your arms are raised above your head and 5000 wires and tubes attached, one of which extends to the needle they insert into a vein. When the rest of your body enters the machine, your head and arms remain outside. This goes on for more than a half-hour, which is tough on elderly arms and shoulders. All the while, your eyes are about one inch from a sign with the imposing command: “STAY STILL!” If you try to scratch your nose with your elbow, they will have to do it all over again, so for God’s sake, refrain. Even if you are not itchy, you will be if you’re not allowed to move, so think about something else. Your girlfriend in the third grade. The Hindenburg disaster. Does your chewin’ gum lose its flavor on the bedpost overnight?
All this is mere foreplay to the big moment when they speed your heart up. This is weird business. I can run 7.5 miles an hour on the treadmill at the gym and my heart rate will reach about 130bpm with no concerns. I can feel the gradual increase, I can alter my breathing. With the PET, it’s almost instant. The technicians tell you they are about to perform the function and you should tell them if you are uncomfortable. The conversation goes something like this:
“Okay, I’m uncomfortable here.”
“Can you describe what that means?”
“Hey, YOU brought it up. I’m just responding to your request. How should I describe ‘uncomfortable?’ The absence of comfort?”
“It only lasts a little while. Do you have a headache?”
“Literally or figuratively? No, I guess not. I have general ookiness. I feel like I’m riding on an untethered balloon. I’m hoping to land soon.”
And so on. Fairly soon, the awkwardness recedes. You have ten minutes more to lie there in repose while the techs get the final info, then it’s disconnect the cables and done. They told me I was a good patient and barely moved. I bet they say that to all the girls. I gathered up all my earthlies and left, grateful to be on my way. Two days later, the doctor called and told me there had been no change in my heart since the last test three years ago. I smiled, grateful for the news. One organ still viable, I mused. Only four more to check out. That’s the way things go in Elderland.
That’s all, folks….
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