About ten years before my hip replacement operation I began to become less tolerant of hard sleeping surfaces. It started with my Therma-rest camping bed not being enough. Nights in bed became uncomfortable enough we added a memory foam layer to the bed. This was pre-diagnosis, I just chalked it up to getting older. Five years before my operation I began to lose the ability to squat. Instead of bending my knees to get to the floor I was bending over. I thought what was happening was the loss of strength, I didn’t actually think it was pain that was slowing me down. I tried to exercise, use it or lose it, but I kept losing it. Eventually the pain got me to a doctor who shook her head and announced my life sentence. That was five years pre-op.
Creeping Disability
Gradually the flexibility started to go. Osteoarthritis is a progressive process. First no more touching my toes, then it got harder to tie my shoes. Eventually I switched to shoes and sneakers that didn’t need tying and fell in love with the boa closure system https://www.boatechnology.com/products . I moved fairly rapidly down the path from annoyance to disability. Favorite activities dropped away. Tennis became too painful. I learned soccer was off the list following an immense bolt of pain that shot that through me following a particularly solid kick. Hikes became shorter and less challenging. Long walks became short car rides. Getting out of a seat required the use of my hands, getting into the car meant sitting on the seat then swinging my legs. I really began to appreciate banisters.
As I got much worse strange things started to happen. I swayed as I walked and I’d bump into people. I’d swear I was walking in a straight line and – whack -I’d swat some surprised person with my hip. Sometimes I would get a nasty look from someone who thought I was doing it on purpose. I became an expert at finding elevators, benches and chairs. I started to prefer aisle seats. I had to sleep with a pillow between my knees since my legs were permanently pried apart.
Some losses were really surprising. Bodysurfing went because swimming became impossible – kicking in the water is as painful as kicking on land. I could no longer sit crosslegged in a chair. I couldn’t stand in line. In the last year before my operation I needed assistance to walk. I got a set of Canadian crutches, those short things that go over your wrists. Great for waiting in line and better than the under-the-arm kind for walking a block or two. As a frequent flier I ended up in a wheelchair at the airport – some airports are just ridiculous, Heathrow and the customs area in Miami come to mind as particularly trying. Putting on socks became an ordeal, I would wedge my leg into a position and lunge at my toes with the open part of the sock.
There were two activities I was able to continue to the end – bike riding and a limited range of weightlifting. On a bicycle there is no stress in the direction of the disability and the range of motion is right in the osteo sweet spot. Getting on required me to put my bike on the ground, stepping over it and picking it up. Getting off, at least, continued to be a graceful dismount, swinging your legs back doesn’t require bending in the wrong places. Landing could be tough. I could ride for a couple of miles at a time, not the 50 I might do a couple of years before. The bike was a lifesaver, really. It provided personal mobility and some feeling of capability. People didn’t know I was disabled until I stopped and walked a step.
Getting disabled wasn’t all bad. In some respects it is a game, how can I accomplish this or that thing with the least pain. I would take pleasure in what were before mundane accomplishments. Doing more with less is a challenge and challenges can be fun. Disability and loss did not automatically amount to suffering.
Psychological Disability
It was all very gradual but it constituted a reshaping of my lifestyle. Unexpectedly, It also reshaped myself –perception and my mind. As my horizons narrowed my thoughts changed . Friends would go on some outdoor trip I’d think I may never do that again. As activities disappeared, my mind generalized hopeless desperation into other areas. Instead of being robust and capable I became tentative and fragile. I was less inclined to try new things, even ones that did not involve physical stress. It even affected my internal feeling of longevity, I might not live till 80 after all I began to think. It was insidious and the full extent of my accommodation did not become evident until after my recovery.
I resisted applying for a handicapped placard figuring that was going to further define me. Fact of the matter was, placard or not, I was a compromised human being and it was obvious to all around me. Strangers offered me help at airports. Kids stared. Once I was using crutches regularly I was really defined as “needy”.
Despite my belief that I was a really conscious guy, it turned out I was unable to follow the trails of disability deep inside myself. What I thought was a smaller activity universe was actually diminished psychological space. If you are trying to understand the irrational [or somatic] interface between mind and body there is nothing like losing capacity to show you how sticky the connection is between one and the other.
Then there is entitlement. Because I was in pain or disabled was I entitled to special treatment? I had gotten used to having someone put my socks on for me. I got used to great parking spots and sitting all day at the parking meter without fear. I expected people to make way for me. I became “special”.
The narrowed space and expanded ego crept up on me. I was not absolutely blind to them but I would not say I did the best job of avoiding them. Instead I can look back and understand just how hard it can be to retain consciousness when your physical world is falling apart. As soon as I was post-op I knew that I had been subject to the short steep course in getting old and I would need to excise these newly ingrained patterns in order to achieve maximum youthfulness. New hardware does not automatically change habits acquired over years of stepping carefully and avoiding risk. Those habits were reinforced by pain and we know from Pavlov take the pain away and the behavior persists.
Reversing Psychological Disability
In my recovery I watched closely in order to excise my osteoarthritis adaptive behaviors. I realized banisters are toxic and stopped touching them. It took months for that one to fully sink in. I stopped scanning the area for chairs. I confronted thoughts of limitation. On the entitlement side I stopped limping a full month before my handicapped placard expired but I used it to the very last day. Then I took it and all that “privilege” out of my car.
The flip side of accommodation was my recovery allowed for a kind of optimism to upwell that I had not felt in years. It is incredible what the removal of obstacles can do. A few months after my operation I turned 60. When I was growing up 60 was the definition of old . The way I relate to 60 now is I am redefining the stereotype. I like being old without feeling, thinking or acting old. I really am so much wiser than half a lifetime ago, Old is good, decrepit sucks. Wisdom and capability, that’s how I’m defining my present 60 something life.
My whole attitude towards ageing is different from than those who say that getting old sucks. If getting crippled didn’t suck and was ultimately just a big game of how to best adjust to a changing reality then moving up in years should be similar adventure in discovery.
No Regrets
I get asked if I regret the years of disability and pain. You know, I really don’t, they were the experience of my late 50’s. After my operation I understood I had been given insight into the body of the old and frail. I got to test my spirit against difficult circumstances. I got to be in the world as a cripple and experience what it is like to be at the receiving end of the pity, indifference and kindness of strangers. I learned the coping strategies the disabled use for navigating in public. I even grew some empathy I did not have before.
Disability does not give you an excuse to be miserable either inside yourself or to others. Disability, like anything in life, can be a wonderful teacher. Perception is never set in stone.
