Listening to the Body aka “I've Fallen, and I CAN Get Up!"

On January 7th, in one of those moments that can alter the life of a 76-year-old, I fell on my way to a faculty meeting at school before start of the new term.  Rested and relaxed after the holidays, enjoying a sunny day and a quick commute, I missed the last step going down the stairs from the train.  As I crumpled to the landing, my right knee bent under my full weight much more tightly than it should and my nose pressed to meet it.  Surrender was the only option. “Give,” I pleaded through tan corduroy stretching over the joint, and I heard a tiny pop near the surface of it.  Not good.  My entire focus zoned into that knee, into the hip I found myself sitting on, into my lower back and the hand I’d used to break the fall.  But before I could assess the damage, a man was hoisting me by the armpit.  “Wait!”  I put him off, then stood cautiously and assured him I could manage. 

And manage I did, hobbled the two blocks to school and propped my leg on a chair during the round table discussion. I hardly heard a word that was spoken for the “chatter” that was going on in every cell of my body.  I think that’s part of what shock is, an overload of the information system and the exhaustion that comes from trying to sort it all out.  I found an ice pack in the teachers’ fridge to apply during an hour or so of training for the new campus website.  I was busy the whole time replaying and analyzing the fall in my mind, in slo-mo, like a sports mishap on TV.  There had been no impact and no torque or twist to the joint; it was just the deepest plié I’d done in 30 years.  There was practically no swelling and no discoloration.  Pain came only when I moved.  

Nevertheless, by mid-afternoon, I was a wreck.  Standing completely still, it felt like I had no knee to hold me up, nothing at all.  When I walked, commanding my leg to stiffen like a splint, it really hurt.  My husband came to get me, brought a cane, and got me home where I spent the evening Resting, Icing, Compressing and Elevating.  I lay there imagining my supportive colleagues wheeling me from class to class in a chair, or on a gurney.  (A certain sense of drama is a useful quality in a teacher.)  Surgery for a torn ligament, even a knee replacement did not seem out of the realm of possibility.

But I slept okay that first night without Ibuprofen.  The next morning, I was surprised there was still only minor swelling and no general discomfort, but the joint still felt like a bowl of Jell-O.  Cut to the diagnosis which I hastened to get from an X-ray within 48 hours:  a stable, hairline fracture of the patella that would likely heal completely on its own within 4 to 6 weeks – unless I did something really stupid. 

At the time of this writing, about half way through the miraculous healing process of which all our bodies are fully capable, I am teaching, walking normally indoors and out, taking stairs slowly, and pondering the odds – my odds – according to recent statistics selected from a government website:

·        One out of three adults age 65 and older falls each year.

·        Among older adults (those 65 or older), falls are the leading cause of injury death.

·        Rates of fall-related fractures among older women are more than twice those for men.

·        People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.

Not me!  That’s not the life change I’m looking for, not yet. 

I’m back at the gym today for a gentle spin on the stationary bike and some easy stretching.  I welcome the gift of acupuncture sessions from a friend even though I’m needle-phobic.  And I will listen, listen, listen to every single little signal my body sends to tell me what it wants and needs, where it does and does not want to go.  And therein lies the secret of my knee healing like a youngster’s.

A long history of dance training prepared me well for this.  I learned the truth of “use it or lose it” before it became a cliché and I honor the need faithfully.  I do 3 or maybe 4 twenty-minute sets on a bike at the gym each week, and with very low resistance.  I do other lower body work to keep the leg muscles tuned, but I hardly break a sweat.  If I skip my workout (for reasons of illness or a holiday) I start to “lose it” in about two weeks, meaning that I feel unbalanced, less energetic, prone to kinks in my neck and fatigue in my back from sitting.  Digestion is affected, too.

But I am astonished by how little “using it” is necessary to maintain ownership of my body.  It seems I have completely underestimated the edge my modest, regular attendance to exercise has given me.  Along with the ever so slightly broken bone, an MRI revealed that my right knee has developed considerable arthritis.

“How can that be?” I exclaimed defensively to the PA on the phone.  “It’s completely asymptomatic.  I haven’t had a moment’s trouble with that knee until I fell.” 

She had no good answer, and I really want to know why the “arth” part of my condition shows in an MRI while the “itis” part is non-existent.  I wonder if the “arth” part of arthritis, a thickening of the bone, just comes with age.  Maybe avoiding the painful, inflammatory part is more of a choice many of us already make and many more of us could make, without drugs.  It’s abundantly logical that keeping the sinew strong will undercut the pull of gravity and reduce abrasion of bone on bone.  To make a stronger case for the long term benefits of “using it,” why aren’t there studies of the incidence of asymptomatic arthritis and the lifestyle choices of older people who have this but function perfectly well and do get up from the occasional embarrassing spill?

I think young people, middle-aged people, and older people are put off by unrealistic images and daunting regimens from doing the simple, little things that make a difference.  My acupuncturer (as I have dubbed her) makes a house call, slips in a needle and agrees: 

“There’s got to be some ground between ‘couch potato’ and ‘six packs galore’.” 

I’m not watching her, and I welcome the distraction, because I really don’t like the idea of needles.  I ’m showing up for this because even with all I know about the body I live in, there are many wondrous and mysterious things to learn.  A wake-up call, like the fall I took, is a chance to open up new possibilities.

On the table, a towel over my eyes, I report an extraordinary sensation, a slight fluttering of the diaphragm.  I associate this with a reaction I sometimes have listening to certain singers, or a live chorus.  I feel tremendous energy, but it is diffuse, directed to no purpose.  I am very relaxed.  It seems as if every cell in me is communicating with every other.  The next day, my knee feels much stronger and I succeed at three movements I have not attempted since the injury. What‘s the connection? I do not know.  I don’t have to.

I just have to pay attention.  I only need to trust the subtle cues that tell me it’s okay to rise up on my tiptoes again, that the twinge I feel in my knee as I carry the groceries home is a necessary stretch and not a harbinger of more trouble.  I must heed the larger message that – having survived a potential calamity rather well – every moment of the day from now on is going to feel a little more like a gift. 

  

http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Lynn Donovan McCann is the Author of "The Anti-Diet: Learning to be in the moment with food"