I stepped from Plank to Plank
A slow and cautious way
The Stars about my Head I felt
About my feet the Sea.

I knew not but the next
Would be my final inch -
This gave me that precarious Gait
Some call Experience.

Emily Dickinson, c. 1864

Sunday, January 15, 2017

Coping mechanisms

On top of Herman Saddle, Mt. Baker behind
I've been thinking for a day or two about what to write this morning, my Sunday morning ritual. Last week I wrote about technology and how it has changed our lives, but what has been on my mind most this week is how I get through difficulties. And why would that be on my mind? Chronic pain, both physical and psychological. You don't get to be my age without at least some of it, I don't think.

What brought this to the fore was a fall I took on the ice last Thursday. We knew that the trail where we would be hiking was likely to be covered with snow and ice, since we've had incredibly cold weather (for us) these past few weeks, and trails in town that are well used have turned to sheets of ice, at least in spots. Those of us who had purchased ice cleats strapped them onto our boots, and they worked really well. Unfortunately, I took them off before we ventured onto some "black ice" on the trail that was invisible to my eyes, but not to my equilibrium. I fell backwards and twisted my left knee, so hard that I wasn't sure I would be able to continue. I lay on my back, gritting my teeth, and waited for the first wave of pain to settle down.

I had ACL replacement surgery on that knee in 1994, more than twenty years ago, and it's given me pain now and then ever since. I had lost full flexion, being unable to pull my heel to my rear, even with help, and that's the way it bent. All the way to my butt, as I lay wedged between a rock and a hard place.

But I was out in the wilderness, with no choice except to get back up and try to walk. Fortunately I never hike without Ace bandages and knee braces, and after a few minutes I realized that I was going to be able to continue without having to be hauled out by my friends. My first steps told me that walking was actually the best thing I could be doing, because the tendons around my knee kept wanting to seize up to protect the injury. Eventually they calmed down, and I was walking almost normally within a short time. Not without pain, though.

It could have been worse. One Trailblazer told us of a friend who took a spill like that while skiing, and she hit her head on a rock and lost consciousness. Yes, a blow to the head is never a good thing, but especially when we are older. The woman came to and had no memory of what had happened and suffered memory lapses afterwards. And the older we get, the more we are at risk for falls. Leonard Cohen died recently after a fall, at the age of 82. Jeremy Faust at Slate wrote an article about it, The Major Fall. It's an interesting read.

I had my first yoga class of the winter season on Friday, and I was not sure whether I would be able to do the class, so I told the instructor about the knee injury and that if it hurt too much, I would simply stop, or modify the pose. The interesting thing was finding out what did and didn't hurt as I made my way through the class. One of the things we do while lying flat is to take a strap and pull the leg up and straighten it as much as possible. Wow, did that hurt, mostly on the back of the knee. I kept trying, though, and I was able to get it almost straight.

I noticed that after I did that, the pain in my knee was much less. I was able to do the rest of the postures without too much difficulty, and modified what I needed to. By the time I left the class, my knee was much better. Now I am convinced that the yoga poses are what have made my knees stronger and more pain free. If I had babied the knee, would it have been healing as quickly? Then yesterday morning I went walking with the ladies, my normal Saturday activity, and the knee was so much better I was amazed and very pleased.

I am never really pain free. It's a part of aging, whether I remain active or not. I want to maintain my ability to hike and walk and play outdoors for as long as I can, because I know the direction that we humans take as we age. I read a great article recently, by Erica Manfred on Senior Planet, called "I'm Not Aging "Well," I'm Getting Old, Dammit." She and I are the same age, and I know exactly what she means when she says,
People used to think of growing old as part of the natural progression of life from birth to death. Not anymore. Now we go directly from middle age to you’re-just-as-old-as-you-feel.
 “Old age” has been dropped from our vocabulary. “You’re not old!” people say when I describe myself that way. I’m 74 with an assortment of age-related ailments and a generous complement of sags and wrinkles. If I’m not old, who is?
Exactly. The fact that I can still accomplish all that I do is for at least two reasons: I keep at it and modify what I can do each and every day. I also pay attention to my body and don't dose myself with drugs to dull the pain. I find that if I take even ibuprofen when I'm hurting I tend to push harder than if I allow myself to feel the condition of my joints and muscles. My sister has arthritic ankles and had to give up running more than two decades ago, but she took up swimming instead and now swims a mile every day, then takes a three-mile walk for weight bearing exercise. She also golfs and at 71 is going strong, even if she's had to modify her activity.

This past year I also discovered another coping mechanism, just by chance. My friend John had both knees replaced and suffers from chronic pain. He started using marijuana tincture (legal in our state) to help with it, and I went down to the MJ store and talked with the budtender (isn't that a cool title?) about how to cope with insomnia and pain without getting high. He introduced me to a tincture that works very well, called "Crash" that is designed to help people sleep. I took a half dose to start, and when that didn't seem to affect me, I took a full 10-mg dose, and I slept like a baby. And I found another side effect: every single ache and pain in my body just went away! Some I didn't even realize I had, because I was so accustomed to them, like the pain in my hip where I broke it years ago. Gone. When I woke in the morning, they were all back again, but somehow they didn't bother me as much, since I knew I had a way to make them recede.

But, for the same reason that I don't take ibuprofen on a regular basis, I also don't take the tincture every night. Maybe once a week I'll treat myself to a pain-free sleep. And there doesn't seem to be the same effect when you ingest it as when you smoke it; at least I didn't notice any "high" feeling from the small amount I took. When marijuana became legal in Colorado, Maureen Dowd, a columnist with the New York Times, ate an entire candy bar (16 doses!) and freaked out and wrote about her experience here. She was warned that she should take a small amount and wait at least an hour before ingesting any more. She didn't listen, and it made me very convinced that as powerful a drug as this is, you must use it with caution.

Anyway, those are my coping mechanisms: exercise (plenty of it), fresh air and being in the outdoors, yoga, and small doses of drugs. I've modified my activities to fit my own situation. And I should probably add intellectual stimulation. I read a lot and I write blog posts, like this one. I have a full life and a community of friends to help as well. When I finish this post, I'll leap out of bed and start my day, with my usual latte with my friends at the coffee shop. I smile as I think of it.

And you, my dear readers. I'm aware of your presence as I sit here in my bed, keys clicking away as I write, with You Know Who sleeping next to me. I do hope that you will share your own coping mechanisms for difficulties you face with me in your comments. Please have a wonderful, pain-free and peaceful week before we meet again, right here, same time, same place next Sunday.


Rian said...

Great post, DJan. I think your *coping mechanisms* for aging are very good... and they stem from a very healthy psychological viewpoint. I believe that a lot depends on our attitude and I try to keep mine positive with a dose of gratitude. Having lost both my parents, sister, and brother over the years, I miss them terribly, but grateful that I've been given this time for whatever reason (and that I still have DH and my children).

I started to elaborate on this here, but it got too long. So I will share my own coping mechanisms on my next blog. Thanks again, friend, for sharing yours.

Mel said...

So sorry about your fall, hopefully you are on the mend and your knee will be as good as new. You have given me some good links for reading this afternoon, thank you. I struggle with arthritis pain in my joints and have yet to find the best coping mechanism. Yoga and stretching help, and I tend to shy away from meds and let chardonnay be my evening coping mechanism, which I know is not the best option. But as my ortho told me, wine is easier to titrate the dosage than prescriptions sometimes. I wish I lived in a state where I could visit a budtender for some sleep and ache aids! I am looking forward to Spring, so there are more options to stay active and let fresh air therapy do its magic! Hope you have a great week.

Marie Smith said...

I find new pains periodically, like the shoulder pain which started suddenly last night. Tiger balm helped so the day is pain free. The strong smell on the other hand clears the sinuses. Coping, adapting to aging is a challenge but there are lots of people who didn't reach this age. May as well make the most of every day.

Linda Reeder said...

I guess I have not even though of it as "coping". I just go and do. When something hurts, I analyze why, modify a bit, but keep going. When I can't sleep, which I hate, I self-talk that it will be fine, I can make it through a day with little sleep, and catch up when I am tired enough to not be able to stay awake.
As for emotional well being, I have always been a TV addict, and the evenings are down time when I can lose myself in some kind of entertainment. It gets harder to do, since I can't tolerate "junk' TV. HGTV often comes to the rescue.
I have always been an outdoors person. Going for a walk, or working in the garden always makes me feel better, even if they leave my body in more pain. And ibuprofen and naproxen are there on the shelf when I need then for flare ups of arthritis or overworked muscles.

Far Side of Fifty said...

I am glad you are able to cop with your newest injury. I think you should wear your knee brace or wrap it the next few hikes. (end of lecture). Your tincture sounds delightful...if only it were legal in Minnesota.
I usually don't have trouble sleeping...last night I did sleep for four hours and then woke up with shoulder pain (shoveling) Aleve works well for me and rest. I have an very old injury that I have dealt with since 1979...arthritis has set in now and makes it difficult some days...but when I say I cannot take another step without crutches then I rest...my corn bag is my best friend...warmed in the microwave it is pure heaven wrapped in a blanket under my feet.

I Hope you have a good week! Good to think of you going off to the coffee shop:)

Arkansas Patti said...

You are always taking the right direction. I firmly believe that we must move to keep moving. Lately I have stumbled on a neat tool. Epsom Salts with Lavender soaks before bed. It not only makes me sleep peacefully with out wake ups but suddenly I wake up in the AM without ONE pain. Think I may have been magnesium deficient. I use to be stove up for quite a while in the AM with back and hip pain. No more and no meds. I have also changed how I sleep. I now sleep diagonally using the whole bed instead of just the one small area which breaks a mattress down quickly. Don't know which is working--just know pain is gone and I'm rested and energetic. We just approved medical marijuana in Ar and I was going to give it a try but now I don't need it. Well maybe just once----

Linda Myers said...

Yes. Keep doing what you're doing. I keep doing what I'm doing. Even if I don't feel like it.

Elephant's Child said...

Love your healthy, positive coping mechanisms. I use denial (not just a river in Egypt) and when my body stops talking and starts shouting I take some time out. And then start again. My pain is misfiring nerves and doesn't (usually) relate to injury, so I can (again usually) treat it with ignore. Beauty and books and humour are great antidotes too.

Heidrun Khokhar, KleinsteMotte said...

Like Patti I find magnesium is very useful for general health improvement. I take is several forms. I have a form of silent arthritis in my fingers . It is painless but disfures and weaken what hand can do. I have no clue what caused it. My 95 year old aunt has had may falls over the past years and doctors are baffled by her survival. Never has fractures. I studied her diet. She eats 5 prunes and sone flax seeds every morning. A study do on fracture prevention has demonstrated that something in prunes allows bones to not become brittle. I now eat prunes regularly. She also drinks mineral water. In fact most Germans do. It is served in all food establishments when water is requested. Then she also regularly eats dark chocolate often at bedtime. I do not tolerate prepared dark chocolate so I make myself a warm beverage using a ½ teaspoon of pure cocoa powder and a tiny bit of cayenne powder and sweeten it with a 1/4 teaspoon of raw honey. It is heart healthy and better for me than coffee. when I sleep at night it is so deep the house could crash down around me. But there are times when it is hard to fall asleep. I turn on Enys on my iPad and I drift off. By contrast to walk I use Leonard Cohen as my pacer and motivator. Buddy like him too so I put the iPhone on speaker when he joins me. My pains are usually arounf my eyes as headaches and I will take a Tylenol 1 as needed. The only other med would be allerdryl 25mg when allergies hit and that has been my toughest issue. I easily have reactions to chemicals and They set off a father rapid heart rate at times alarmiming but with the med and a determination to stay calm and breath slowly thay usually works. There have been the odd trio to emerge over many years. But staying on a course to avoid what causes a flare up is the best coping way.
Now the stress I am hit with is more annoying. I get a bit angry and feel a bit od self pity but it is never for long.
What I miss is a girl friend network. I made Buddy my priority and the friends slowly drifted away. I do have nieces and nephewd who stay in touch and it helps to feel that love too.
Thanks for sharing this thought provoking post.

Heidrun Khokhar, KleinsteMotte said...

Sorry for my typos. Darn eyes are missing mistakes :(

Anonymous said...

I am never in pain, so I don't need to cope with it.
David, however, has severe pain from osteoarthritis, which is systemic throughout his body, even his hands. He has had surgeries and takes anti-inflammatory drugs.

The Furry Gnome said...

Oh Djan, there are so many things I could say in response to that post! With limited vision this week I'm suddenly thinking about how I would cope if I can't read easily, and can't drive. Our life would change dramatically! Hope that doesn't happen, but one additional coping mechanism is my morning coffees, and my blog reading/writing routine. And staying active. And meditating. Very thoughtful ppst.

Red said...

Somehow the elderly tend to fall backwards. I've had some nasty falls where I land on my back. Falls seem to rob us of our confidence and it takes a long time to get it back. I still haven't got my confidence back for stairs. The more coping strategies we have the better.

Trish and Rob MacGregor said...

Turmeric is the best treatment for any joint swelling etc, at least that I have found. Lucky that your state approves medical marijuana. Just add turmeric to your regimen and I think you'll notice the effects quickly. Sunday vitamins has a brand I take, but whole foods also has a brand with shellfish included. So if you're allergic to shellfish, avoid that one.

Tabor said...

Great post and thank you. Always important to learn how others cope. I am not so good at that. Years ago I had a fall and for months was in a lot of pain. I could ignore it until the end of the day and became depressed. Not good. I avoid taking any drugs unless I absolutely have to because masking does not let me know I might be healing. I do know from experience that sometimes it is good to push through pain and other time baby it and let it heal in its own slow way. Not ice walking for me anymore. I have osteoporosis and just need weight and isometric and caution

Carole said...

Chronic pain can be so difficult. I have struggled with a bad knee (arthritis) for a couple of years. Finally went to see ortho and received a cortisone injection. It's not a cure, but it worked really well for me. It delays the need to have knee replacement.

Cannabis is not legal in NY. But our governor is looking to decriminalize possession and use. It will still be illegal to sell it. I suppose it is a start.

The Broad said...

Reading about your fall, I must admit I let out a great groan of sympathy! But you are so positive and insistent with your attitude toward dealing with pain that I am stunned with admiration! While I do suffer with some minor age related aches and pains, I am fortunate that nothing is too serious. I am not, however, as active as I should be -- my usual activity of walking, and I really should do much much more.

Rita said...

I go cold turkey. No back up medication for pain since they quit making Darvocet. Took a long time for me to find that one. I get flu-like sick from most stronger pain medications and the weaker ones don't seem to do anything at all. The doctors had me on such high doses of ibuprofen for so long with my wrist/arm injury that I have problems taking that or anything like it anymore. (I swear it about ate my stomach out--had terrible heart burn for years afterwards.) So I basically use a heating pad on my lower back--feels wonderful. I just heard about turmeric for inflammation and plan to try that.

I just expect that it takes me 2-4 hours to thaw out in the mornings and that I have to get up and move and stretch about every hour on the hour all day long. And that my body/fibro is in charge (the more I fight it the more pain). I try to stay as positive and stress free as humanly possible. The second my muscles tense up from stress or worry the pain level ratchets up in my entire body. Basically--just live with it and do as much of things I enjoy as I can. Dagan and Leah keep reminding me that North Dakota just made marijuana legal and I should try that. Maybe I will one day.

troutbirder said...

Well said, DJan. My own experiences are very similar. Vertigo and dumb choice have led to many fall but modify,change and develop new interests keep me going in new direction at 74. Motivation help as well to keep going. My increasing role as a caretaker for my spouse helps keep my focus on keeping my health up as well. She insists I outlive her now as "others" would put her in the "care center". :)

John's Island said...

Hi DJan, I read Eye earlier this morning but before I could leave a comment got called out to breakfast and then, later, went out for my daily walk. While walking I was thinking about the prospects of falling and how easy it would be to simply mis-step and crash. Mother fell and broke her hip about 4 years before passing at 91. Older sister fell about 3 years ago and has been in a wheelchair ever since. I’m not really sure about what can help prevent falls other than just plain being aware and careful when moving around. I enjoyed reading the comments today, especially the one by Heidrun. Prunes and mineral water … sounds like something I should try for a while. :-) I enjoyed this post, as always, and thank you for sharing. Wishing you a fine week ahead!

Hilary said...

Well, I am sure you know about my hiking fall, head injury and subsequent surgeries. The headaches continue, 5.5 years later.........I also do not take drugs.....occasionally, when it is just over the top, and I've truly had it, I take Ibuprofen to take the edge off. That's it.
I do wonder about your tincture........it could be a life saver. I live in NY, but who knows.

C-ingspots said...

Your attitude is wonderful, and you're very inspiring to me. I am soon to turn 57, so no real chronic pain, but I do have occasional pain issues. My dogs (both big Labs) ran into me running full tilt and hit me in the side of my left knee. Knocked me to the ground and the pain took my breath away. I was about 2 miles from home and at the top of a big hill when it happened. I stayed down until the pain subsided enough for me to get home, and ever since I have occasional sharp pains and weakness from the tendons on the outside of that knee. I've also had a few back injuries over the years and have to be very careful of that. For me, being outside in the fresh air and daily exercise are vital to keeping me mentally in a good place, and that seems to play a major part in being able to deal with pain for me. Horseback riding is very good at keeping the back muscles flexible, and I am at my happiest when astride my horse, up in the mountains. I also take warm baths before bedtime with epsom salts and lavender oil when I have aches and that does help, as does the occasional glass of wine and a few puffs of weed. I have chronic kidney disease and cannot take ibuprofen or naproxen, so if I get a rare pain where I need something, I take tylenol. I would benefit from not sitting so much, but I sit at my job, so trying to get up every hour and stretch or walk around helps. One very important aspect I believe is, a social network of friends. That I don't have on a regular basis, so blogging is helpful for me. Very thought-provoking post again DJan! I think I have been guilty of telling you that you're not old. I say that because you are the youngest 74 year old I know! I know people much younger in years, but older acting, than you will ever be. I think you're doing all the right things and are an inspiration to living right and living well. Have a wonderful week, and I am so sorry you fell on that blasted ice! We have warmed up a lot, it's raining buckets and no more snow or ice. Be well...

b+ (Retire In Style Blog) said...

Very interesting...I had never thought of the tincture as a solution for sleep problems. I just returned from a visit to a ortho clinic here in Tucson. I am getting a diagnosis for knee pain. As I filled out the forms I realized that my life is not as perfect as I think it is. But on the upside the physician said I have beautiful knees! A scan will tell if I have something torn inside.

Keep on laughing and don't think too much. That thinking is always getting us in trouble. :)

Much love,