Life, Death and Rebirth 2019

Note paperThe envelope is lying right here on my left, now looking altogether spooky. It is even stamped and addressed; that’s how close I was to getting a note into the mail.

Then the phone rang. The note was to begin, “So, how are things going? How’s Gerry? How are you holding up?” The envelope is addressed to Gerry’s wife Kathy.

Several months ago our old, dear friend Gerry, age 75, was looking after the horses on their beautiful Southern California ranch when his heart failed. They got him to the hospital, but then came the bad news: his heart could not be revived or repaired. His only option would be a transplant. The good news? Because he was strong and otherwise healthy, he was a good candidate for a new heart. The further bad news? In order to be on the transplant list he would need to remain in the hospital, in intensive care, ready.Heart in circle

Kathy and Gerry are what I would call salt-of-the-earth Good People. They are deeply religious, clean-living and hard-working, and committed to living lives of service and gratitude. Within a few days of Gerry’s diagnosis they found themselves in the unenviable position of waiting for someone, somewhere, to die. Some generous someone who had signed agreements for his organs to be donated. (It would presumably be a ‘he,’ as Gerry is a fairly big guy, and would need a heart coming from someone roughly of equal size and weight.) After talking with Kathy early on in this saga I found myself also having queasy thoughts: How hard should I pray for some good person – do bad people sign organ donor forms? – to die in order for Gerry to live? It is an across-the-board existential dilemma.

The longer he remained in intensive care, the further Gerry’s condition deteriorated. This  presented a scary picture but pushed him higher on the recipient list. In other words, the worse he got, the more urgent his need, the higher his spot on the transplant list. Another existentially fraught situation.

They waited.

New life - typewriterOn August 15 (or perhaps the hours before August 15 dawned,) a 34-year-old man died in another state. A man who was on life support in a hospital because at some earlier point he had taken the generous step of signing organ donor forms. One of Gerry’s doctors flew to that hospital, examined the heart, confirmed it to be a very good match for Gerry, and boarded another jet plane back to Southern California. Gerry was already opened up, his original heart beating – with a lot of help from outside sources – outside his body.

He is already back home. Part of the somehow endearing characteristics of these two old friends of ours is that they do not have email or participate in any social media. So it’s taken Kathy time to get around to calling friends with this lovely update.

Somewhere in the southwest a grieving family is saying goodbye to a 34-year-old they had not expected to lose. “Gerry cries every time he thinks of him,” Kathy says. “There are just no words.”Birthday candles

Other than these: “August 15th is his new birthday.”

 

To Have (or maybe not) a Stroke

Heart attack

“You’re not leaving here with your blood pressure that high,” the doctor said. It was 189 over something equally ridiculous. It was not interested in coming down. Finally she said, “Okay, pick up this prescription on your way out and take it the minute you get home.”

Vividly running through my head were images of my mother, who suffered a series of strokes that eventually killed her in her 70th year. Plus images of assorted aunts and others who suffered debilitating strokes and often early deaths.

“But . . . but,” I said to the doctor, as I have repeatedly said since my carefree youth; “I don’t have high blood pressure. My three older sisters? They all had high blood pressure. They also all had beautiful auburn curls, while I got the utterly straight, dishwater blond hair. So, shortly into our adulthood, I took to saying, ‘OK, keep your gorgeous curly hair, I’ve got the good blood pressure.’ It seemed like a pretty fair trade.” My physician said, not unsympathetically, “Those genes may have caught up with you.” And just like that, I joined the ranks of the hypertensive. That great mass of humanity waiting apprehensively for the stroke or heart attack that might swoop in and end it all.

By the time I got home I was visualizing an immediate demise.

Unlike my mother’s generation, though, today’s hypertensives have internet encyclopedias worth of information and an arsenal of drugs bewildering enough to induce a small stroke if you really try to figure them all out. Beta blockers. Diuretics. Angiotensin II receptor blockers. Vasodilators. A good doctor, whose advice you can follow, at least on which meds to take, is a great boon. french fries

The rest of the try-not-to-have-a-stroke business is fairly straightforward. Quit with the nicotine, and moderate the booze (or quit that too.) Watch the weight – extra poundage, especially around the midsection, can increase your stroke probability rather dramatically. Walk for at least 30 minutes a day, increasing the distance as you can. (Swim, bike, exercise.) Salt can do you in fast; if you’re trying to stay within the recommended 1,000 to 2,000 mg per day, a large order of fries (350 mg) might not be a wise choice.

This writer is good with most of the above – excepting an occasional uncontrollable urge for a small order of fries. Plus whatever that was I picked up from the Kaiser pharmacy definitely worked. One tiny little pill, and the next day my blood pressure was 114 over 85.

Maybe I’ll stick around for a while.

Fear (and the high cost) of falling

My husband was face down on the floor of the breakfast room, stretched below the table with one hand resting beside a chair he had pushed into the corner. As I came up from the garage, returning from a long opera just before midnight, he called out, hoping to spare me from alarm or a heart attack of my own. This is the sort of scene that tends to cause alarm at any age. According to an article in last Sunday’s New York Times, a similar scene occurs with alarming frequency: more than one-third of people ages 65 or older fall each year, writes Steve Lohr in an “Unboxed” feature, “Watch the Walk and Prevent a Fall.”

In our recent case, all was soon well. My husband had lost his balance while setting dinner on our not-too-sturdy table, and more or less slid to the floor. Still recovering from spinal fusion surgery 8 months earlier, he had done everything possible not to break anything — old bones or new rods and bolts that is; he wasn’t worried about the china — as he went down. But once down, getting back up was not an easy assingment. You know those awful “I’ve fallen, and I can’t get up” ads? Believe them. He tried shoving a chair into the corner to gain traction, but soon realized there was not enough strength in his lower legs to do the job, and decided just to wait. (Some people do carry cell phones… but that’s another story.) At 6’3″ and over 200 pounds, Bud outweighs me approximately two to one, so my getting him up was, we already knew, not an option. Happily we have a neighbor who seldom goes to bed early. Once he came over and the three of us strategized a while we were able to set my husband upright again. More specifically, John and Bud accomplished the deed; I supervised. Bud was tired and hungry, but otherwise fine.

Most of the falling elderly are not so lucky. About one fall in 10 results in serious injury such as a hip fracture, according to the Times story. Some 20 percent of older adult victims of hip fractures die within a year. If that weren’t enough to get one’s attention, reporter Lohr writes that “the estimated economic cost of falls ranges widely, up to $75 billion a year in the United States, if fall-related home care and assisted living costs are added to medical expenses.”

The last time I fractured my ankle, which I tend to do with dismaying frequency, I grumbled to a friend about “that dumb accident.” There are no smart accidents, she replied. (I was running late, and carrying a very large empty computer box down the stairs.) And this is a good thing to keep in mind. Somewhere not far past the age of 50 (I throw that in for all those weekend soccer-playing dads) bone breakage gets easier and healing begins to take longer. Somewhere a little farther along in the aging process, falling takes over from dumb accidents as #1 cause.

“Watch the Walk and Prevent a Fall” focuses on early research, backed by the National Institute on Aging, into the relationship between activity patterns and falls. “Fall prevention also promises to be part of an emerging — and potentially large — worldwide industry  of helping older people live independently in their homes longer,” Lohr writes. New technologies such as sensors that track behavioral and activity patterns will play growing roles in fall prevention, along with customized exercise programs and close attention to the role of medications.

Considering the risks and the cost, fall prevention may fast claim serious attention. But for now, especially if you’re over 65: get up slowly, watch your balance, and be careful setting your dinner plate down on a wobbly table.