November 15, 2011

Reflections on My Summer Setback: Lessons Learned

So far, I've been blessed with good health and few ailments. Sure, I've been diagnosed with Parkinson's disease and prostate cancer. But the PD was only diagnosed a couple of years ago, and so far the symptoms are pretty easy to deal with. As for the cancer, my prostate was removed in January, 1995, the month after I retired. Post-operative PSA readings indicated that some cancer cells remained, but in the 16 years since then, the semi-annual checkups have shown a slow rise to 4.0 up to this spring. I'd almost forgotten about this cancer until my PSA jumped to 9 in September.

The compressed fracture of the vertebrae from the August car crash was my first experience with extended pain. Finally, just last week, I stopped using pain killers and wearing the back brace. Progress!

Still, this issue was a minor setback compared to what I've seen others deal with, particularly when I recall the deaths from AIDS of so many close friends, and the more recent courageous fights that several of my contemporaries now wage against life-threatening and chronic illnesses.

With my PD and prostate cancer, I know more setbacks lie ahead. Now that I feel I'm moving forward again after the crash, I've been reflecting on what I've learned from this experience, and how those lessons might help me down the road.

Lessons Learned
Even the best doctors and hospitals can make serious mistakes. Get second opinions!
After the accident, I was taken to the trauma unit at George Washington Hospital, a highly regarded hospital affiliated with GW University. During my two days there, I was given an extensive array of tests, including an MRI and a follow up X-ray for a suspected neck injury. My doctor insisted I wear a neck brace, which I did for a week. Then I stopped wearing it, over the doctor's objection, because my gut instinct told me the problem was a back injury, not a neck injury.

The orthopedist recommended by my primary doctor wasn't immediately available, so I saw his assistant. A back X-ray showed a compressed fracture at the L-1 vertebrae. Coincidentally, the doubling of my PSA reading at my regular September checkup with my urologist caused him to send me to Sibley Hospital (my favorite DC hospital) for a bone scan and a pelvic CAT scan. Fortunately, the bone scan showed no evidence that my cancer had spread to the bones. The pelvic scan confirmed  the L-1 vertebrae fracture.

What I needed to recover from this fracture was a back brace, worn 24/7, except for sleeping. A neck brace would only have jeopardized my recovery from the back injury.

So, if in the future my gut tells me one thing and a doctor tells me something else, I'll get a second opinion.

The Importance of Exercise 
Exercise: it's the most frequently mentioned health suggestion on this blog. My experience these past few months reconfirms its importance.

The fractured vertebrae made walking and standing very painful. Fortunately, I had little pain while sitting or lying down. I say "fortunately" because a friend with the same fracture experienced pain only when sitting or lying down!

Exercise, especially biking, has always been a big part of my life. When Parkinson's made biking risky, I started walking -- which I have loved, especially along the streets of my beloved neighborhood.

I've never gone so long with so little exercise as I did in the six weeks after the accident. And the inactivity took its toll: I became depressed and lethargic. Since walking was so painful, I took my physical therapist's suggestion and bought an exercise bike, which helped a little. My orthopedist urged me to "walk through the pain." So I did just that, and now wish I started sooner.

Walking got me out of the house, and I feel like I benefit more from exercise outdoors. I canceled my gym membership ten years ago, because I'd rather be outside, biking or walking. I love the time I spend on my back porch -- it's good for the spirit -- because I feel like I'm outdoors... watching the birds at the feeders, seeing the fish in the pond, listening to my own little waterfall, enjoying my ever-expanding garden plantings. And thank heavens for screens; without them, the summer mosquitoes around here would have kept me indoors.

A new phrase, "nature deficit disorder," has recently come into vogue. It describes the range of physical and emotional ailments people suffer (especially the young and old) when they are disconnected from nature. Amen to that. I suspect I had a touch of if during my home-bound weeks after the crash. 

Special Therapeutic Exercise Is Important 
After my Parkinson's diagnosis, I signed up for training in the special "BIG" exercises for people with Parkinson's. It was devised by the same group -- the Lee Silverman Voice Treatment -- that started the "LOUD" program (designed to addres the typical voice weakening common among people with Parkinson's). The BIG program incorporates some LOUD features -- like shouting out the exercise count as loud as possible.

My injuries kept me from doing these exercises. As a consequence, I find I'm having more problems with balance, and my voice shows signs of weakening. But my orthopedist has given me the OK to resume four of the seven BIG exercises, and I'm hollering out the counts to beat the band.

FINALLY I'm Starting To Learn the Joy of Doing Nothing 
Sixteen years into my "retirement" and I'm finally seeing the light! I've always subscribed to Mae West's maxim: "Anything worth doing is worth overdoing." I've always been go-go-go.

My son says he's sure he got his ADD from me. My good friend and boss Bill Beltz cautioned me about my tendency to "shoot from the hip"... to attack problems that -- if left alone -- might resolve themselves with better outcomes. I'm sure I drove my staffers nuts by charging in with new ideas and programs... and then getting bored with the essential follow-up and moving on to something new.

During this recuperation, I experienced low energy. To my delight, I've started to enjoy being more contemplative, and less "busy." I'm hopeful there's a trend here.

For decades, my day started with the tyranny of the must-read Washington Post with breakfast. Now, I'm trying to discipline myself to do nothing when eating... except to enjoy the meal. Who says multi-tasking is always good? Yesterday morning, for example, was a beautiful, unusually warm November day -- surely one of the last in 2011 when I'll be able to sit comfortably outside on the back porch. So I said  -- to hell with the morning paper! I'll just sit here and enjoy this rare morning. What was even more rare, probably first ever, was that I spent nearly two hours doing NOTHING.

What a great way to start the day!


Brian Lockett said...

Great thoughts, per usual. Good advice to us all to work on our "nature deficit disorder." 

Drpaudyal said...

God bless you with enough strength to cope with this pd and prostate cancer, hope to read another blog saying you have prevailed fighting these.

Patandruth said...

Well, John, you are really learning to live, aren't you?  Pat and I have found that nice leisurely walks are fantastic.  Looking at a beautiful sunset, watching the birds, butterflies, rabbits, and squirrels.  The time flies by.  Enjoy, enjoy, enjoy.  Stay in the wonderful mood that you are now having.  Best wishes,  Ruth & Pat

Anne Goodwin said...

John, so beautifully put. It is truly difficult to sit and do "nothing".....but in appreciating nature and creation, you are really doing yeoman's work. You took the time!

Larry Evans said...

John--  Something to think about while on your porch:  

When I Heard the Learn’d AstronomerBY WALT WHITMANWhen I heard the learn’d astronomer,When the proofs, the figures, were ranged in columns before me,When I was shown the charts and diagrams, to add, divide, and measure them,When I sitting heard the astronomer where he lectured with much applause in the lecture-room,How soon unaccountable I became tired and sick,Till rising and gliding out I wander’d off by myself,In the mystical moist night-air, and from time to time,Look’d up in perfect silence at the stars.

Larry Evans said...

When I posted that, it destroyed all the line breaks.  
Just google the Whitman poem.  You will like it.  Take care.

Baelwood said...

Interesting and very useful John. Thanks.

Mpswords said...

Thanks for sharing, John!  Isn't it wonderful that we can continue to discover new aspects of ourselves as we move through this life!  Sure keeps it interesting, and rewarding.
I hadn't realized that you had been in so much pain these last few months.  Glad that you are on the mend and that you are back out in nature!

John said...

So am I!

John said...

We remedied that by making Walt a full-fledged post. It's received a lot of hits and comments. So thanks!

John said...

I had a similar experience today as I describe in my Friday post

John said...

As I said in the post I just did, somehow I often experience more joy during an ordinary day than I  do even when looking at the Taj Maha or the ceiling of the Sistine Chapel

John said...

Thanks, Deepak. Hope you and Sarmilla are well.

John said...

You probably are at the bottom of the list of my friends who might have nature deficit disorder! You're an inspiration to the rest of us.

Madhav said...

John, thanks for sharing this. It is hard for me to go through all the part...but it is amazing to hear the story of nothingness. It sounds familiar to me,... I sometimes wish I had time to go visit friends like you. Anyway, looking forward to next post.

John said...

Hope you and your wife are doing well. I'd love to see you both visit Washington sometime. Let's see if we can arrange something in the spring.