Aging: My Journey | Part 4

Giving my granddaughter my vintage coat and hat!

I had now entered my third retirement.  I first retired in 2006 as president of Parkland College, my very favorite place to work; followed by my second retirement as Chancellor of St. Louis Community College in 2011, and finally, Pima Community College in 2014 when I was seventy-four years old.

I had planned to spend the rest of my life in Tucson, Arizona even before I stopped working there.  Tucson offered a great place to live and a day’s travel to visit two of my children and granddaughter who lived in California. And my daughter who lived on the East coast enjoyed the cleaner desert air and the mountains when she visited. However, living in Tucson did not remain the miracle I had experienced earlier.  In 2017, the arthritic pain unexpectedly crept back into my shoulders and back.  My neck pain became piercingly sharp from the hours I spent on the computer writing the annual report for the Links organization and editing papers for my son, who was in graduate school.  My neck pain was exacerbated by a trip I took in 2019 to South Africa, Zambia, and Zimbabwe.  After the trip, I landed in the hospital with neck pain that was a 20 on a 10-point scale.  My head was locked.  I could not move it.

I was in the hospital for nearly two weeks.  The doctors assumed I had a communicable disease because I had recently returned from Africa.  I was isolated.  Everyone who visited me had to wear yellow isolation gowns.  My pain grew.  Despite my many ardent requests, pain medication was not administered.  No one would help until a young doctor came into my room and I cried out, “I don’t want to live.  I can’t live with this pain.”  I finally received pain medication after 6 impossible days.  Eventually, I received a presumptive diagnosis of pseudogout in my neck.  My daughter, Cynthia, and stepdaughter, Stacy, a medical doctor specializing in physical medicine, spoke to eight doctors by phone who were gathered in my room for a meeting arranged by Cynthia. Stacy asked if rheumatology was involved.  The lead doctor said, “We were going to bring them in.”  Stacy continued “From the symptoms Zelema described it sounds like pseudogout.”  

Stacy emphasized during the telephone call this was not her specialty, but she remembered a class she took in medical school over twenty years prior.  That same day, a rheumatologist spoke with me and ordered additional tests.  It was his presumptive diagnosis that the pain and immobility in my neck were due to pseudogout, an inflammatory form of arthritis.  By this time, I had had two lumbar punctures, three MRI, blood work every few hours, and I was being administered three different kinds of antibiotics.  The nurse proudly announced to my family when they arrived that I had the Cadillac plan of antibiotics. It seemed that everyone at the hospital knew I had gone to Africa. One of the patient transporters asked why I had gone to Africa.    

The Rheumatologist prescribed 500 mg of Naproxen twice daily which provided some relief.  A soft neck collar helped to support the neck.  I was warned not to overuse the collar because it would weaken the muscles in my neck.

I was finally discharged after 10 days and started going to pain management.  I agreed to undergo a cervical ablation in 2020 to eliminate my neck pain.  The process destroys the nerves that carry pain.  The nerves grow back, but their path may be different.  Two weeks after the procedure, my neck returned to normal. The Pain Clinic in Tucson, AZ performed the procedure, and it is an excellent alternative to pain medication.   Cervical ablation has given me long-term relief.

I do not recall when I no longer wanted to live in Tucson.  The medical services did not meet my expectations. I was also finding it difficult to drive the 9 hours non-stop to LA.  I was 79 and my body, while strong, finally began to exhibit its age.  My last trip to CA in June 2019 was not easy for me. I became sleepy before arriving and had to pull over at a truck stop for a nap.  I decided this would be my last drive to LA.  I shared my decision with my son, Jay, and daughter, Cynthia who both lived in LA.   My driving in the city at night had become compromised.  The last time I picked up my granddaughter from school, I ran upon an unyielding embankment near the Hayvenhurst exit off the 118 Freeway.  It was dark, and the oncoming lights from the freeway had blinded me. Fortunately, my granddaughter only felt a slight bump.  I glanced in the rearview mirror.  My 13-year-old granddaughter’s head was down, looking at the screen on her iPad, unaware of the danger. I knew I could no longer drive my granddaughter from her rehearsals at night.

The two crucial decisions I had to make – no longer driving from Tucson to LA and not driving my granddaughter at night were a tremendous loss to me.  I was sad that I could no longer do the simple things I had done before.  I felt myself getting old.  It seemed to happen all at once.   I’d been a long-distance driver for most of my life.  I recall driving 17 straight hours from Las Cruces, New Mexico to Kansas City, Missouri with my young daughters and my loaded over-under combo shotgun/rifle for protection, in my grapefruit yellow 1972 Chevrolet K-5 Blazer, stopping for gas, restroom breaks and fishing into the cooler to get food I had prepared for me and the girls.  Our favorite food items were fried chicken drumsticks, slices of pound cake and an assortment of juices.  I made many long-distance trips, sleeping at Roadside Parks with the gun perched upright between me and the console, doors locked—one of my daughters keeping watch while I slept.  They said, even recently, they loved going on adventures with me.  Nine hours from Tucson to LA was nothing.  And now, I couldn’t even do that.  The truth is my body was changing.  It was no longer the strong body I had counted on.

Suddenly the advantages of living in Tucson disappeared.  Even though I had made great friends, Tucson no longer had the appeal that it once had.  It was time to sell the condo in Woodland Hills, CA. and perhaps my home in Tucson. 

As my dissatisfaction with living in Tucson grew, Covid struck.  The isolation gave me a chance to focus on the rest of my life.  I have a friend from St. Louis who lives in Tucson.  She was seeing a therapist who worked with older adults in their transition from work to retirement.  I needed someone outside the family to help me to validate how I wanted to spend the rest of my life. I made an appointment with the therapist, who held a PhD in psychology.  She asked me simple questions “How do you see yourself in the next few years?  Where do you want to live, and how do you want to spend your last years?”  I immediately said, “I see myself in East Texas in a large home with a vegetable and flower garden where my children and relatives can get away from their busy lives.  I see living alone with a couple of German Shepherds, not too far from medical services.  I could not tell my children of this vision.   I didn’t think they would understand or support my decision.  Finally, I got up enough nerve to talk with them.   I spoke to them during one of our regular Zoom meetings during the Covid Epidemic in December of 2020 and expressed my desire to live in Texas.  Surprisingly, their response was favorable.  I was relieved and happy they supported my decision.  Narissa and Jay said they would move to Texas. Jay was ready to leave California, and Narissa was prepared to move after living on the East Coast for over 20 years.  Narissa and Cynthia had strong ties to Texas. Both were born in Texas, and they visited and spent time with my mother in Beaumont, Texas, when they were young.   Cynthia said she would spend time in Texas but would not move to Texas from California.  Her daughter and life partner were both tied to Los Angeles.

In 2021 I decided to have my endoscopy and colonoscopy at M.D. Anderson in Houston.  I felt if anything were wrong, I would be in the right place for treatment. I suspected cancer.  I had lost a lot of weight, and none of my doctors in Tucson had an answer.  Fortunately, my suspicions were unfounded.  I did not have cancer.

While in Houston in April of 2021, I started house hunting with a capable realtor. I looked at homes in Cypress and condos in Houston.  The homes in Cypress gave me a feeling of loneliness.  The neighborhoods were too quiet.  I needed some noise and activity. When I lived in Tucson, Arizona, I was recently retired. I needed the gated suburban community where the noise was restricted, cars could not be on the street after midnight, and garage sales were prohibited – a beautiful, well planned, sterile community.

It was becoming clear that I needed to live in the city.  I needed easy access to medical services, the theater, excellent restaurants, and other entertainment venues.  I realized my dream of living in suburbia was unrealistic. I was now 81 with medical challenges and could not manage a large home. Still unclear on what decision to make, I asked the realtor to write the pros and cons of living in the city versus the suburbs.   He did an excellent job which helped me to decide to make an offer on a condo in a luxurious high rise, complete with a golden entryway, and many amenities, including valet parking and helpful, distinguished doormen, in the Medical Museum District.  I have not regretted my decision.  I am happy in Houston. 

It was not until I moved to Houston that I finally had one complete shoulder replacement. I am grateful to my orthopedic doctor, Dr. McCulloch, at Houston Methodist Hospital.  You can see the hospital and doctor’s office from my balcony. 

Dr. McCullock advised me that the surgery was elective. His patients decided to have surgery after they could no longer tolerate the pain. My right shoulder did not have any cartilage, and injections were no longer a possibility.  I had been having steroid injections for approximately five years.  The condition was now bone on bone.  There was not any space in the right shoulder for a needle to be inserted.  The left shoulder was not as deteriorated.

I had to get signoffs from both my primary and cardiology doctors.  My primary doctor warned me, and my children, that the surgery was complex, and at my age of 82, she would not advise it, but she would look at all the data and determine my risk level.  Listening to my doctor’s warning I began to doubt having the surgery, especially after she said, “if it were my mother, I would not advise her to have the surgery.” 

Later, after reviewing the blood work and the cardiologist’s report, she concluded that I was low risk.  Her determination that I was low risk for surgery boosted my confidence in having surgery.   I was not as concerned about the difficulty of recovering from the surgery. I did not want to die from a shoulder replacement.   

Still, I knew, no matter what, I couldn’t live with the pain.  I could not sleep.  My shoulders couldn’t touch the mattress. I tried several mattress toppers to cushion the pain.  I had to sleep on my back while my preference is to sleep on my side. When I was awake there was always some level of pain.  I had no other choice but to go through with it.  I am grateful the operation was a success.

Today, my right shoulder is pain-free with complete mobility.  The left shoulder was scheduled to be replaced in January 2023.  However, I cancelled the surgery because I no longer rely on my left shoulder, and it is practically pain free from nonuse– a 2 or 3 on a scale of 10.

My retirement life utilizes many of the skills I used in the work world – planning, interpreting complex data, making decisions when there is no simple answer, and researching thoroughly the professionals I will hire to perform surgery or serve in other capacities.  Now I have more time to focus on my medical needs.  How effective I am in managing that role is determined by the results of blood tests, weight, sleep, exercise, blood pressure, and heart rhythm.  All this information is entered on a spreadsheet I created – it includes a sheet where areas to be tested are placed horizontally and the results are placed under each area.  For example, I include Date, Time, Blood Pressure, Pulse, Weight, Exercise, Sleep.  In filling this out each day patterns emerge.

When I visit my doctor I can speak with knowledge about my blood pressure, weight or whatever is of concern.  I enjoy filling in my spreadsheet daily, coordinating doctor appointments, and filling my weekly pill box.  It seems that weeks pass more quickly now.  Sometimes I must check and double-check my pill box to ensure I have not wasted any pills.  The pills disappear quickly, leaving empty little squares in my weekly pill box.  These open pill spaces remind me of the days I have used up. I can never replace them.  I can place more pills in the empty spaces, but the pills I took yesterday are gone forever – a reminder that we cannot replace or duplicate days that have passed.  Each day is a special gift that we should embrace fully.  We can never get it back.

I have found it best not to discuss my maladies with others unless I want a barrage of advice.  While the advice is well intended it never fits my problem.  I tend not to give advice unless asked and I am quick to say something worked for me.  Friends have often discussed Prevagen with me and some are taking it. Prevagen is among the most purchased over-the-counter products by older adults.  Yet, its effectiveness is minimal at best.  According to an updated January 5, 2023, article in Forbes Health, the Federal Trade Commission (FTC) and the State of New York filed a claim in 2017 against Quincy Bioscience, which makes Prevagen, asserting that it made false and unsubstantiated claims in marketing its product.  The class action lawsuit was settled in 2020, allowing the company to continue marketing the product with a disclaimer.  The disclaimer reads, “based on a clinical study of subgroups of individuals who were cognitively normal or mildly impaired.”  Consumers do not pay much attention to the disclaimer or do not understand its implications.  They keep buying Prevagen.  The artfully done commercials tell us Prevagen works.

I have been reading various studies about memory enhancement products. An article in Harvard Health, on March 3, 2022, advises, “Don’t buy into brain health supplements.  There is no proof any of them work.”  Mayo Clinic Minute in a June 10, 2019, article, states, “Dietary supplements don’t reduce dementia risk, but three tips do.”  The article lists three tips physical activity, a healthy diet, and being intellectually active.  I am not sure if the intent of being intellectually active includes social connections.  More research indicates that having social relationships contributes to longevity.

One of the best books I have found on aging is Growing Old by Elizabeth Marshall Thomas.  She was eighty-seven when the book was published in 2020. Her perspective on aging is precisely what I needed to validate my own experiences and to learn about the accommodations she has made in her own life.  She points out that isolation is a serious problem for the aging.  Fortunately, I have watchful children who will never allow me to fall into that abyss.  In addition to my children, Jay and Narissa, who now live in Houston, I am home in Texas where I was born, with many relatives, some of whom I’m just meeting for the first time: great nieces and nephews; cousins; friends from college and my hometown of Beaumont.  I never have to be alone. 

I do believe there is a divine force that guides me to make these great decisions. Moving back to Texas is one of the best decisions I’ve ever made in my life.

Despite my personal experience of growing old, I am just beginning to look deeper into the process.  I read Being Mortal, a 2014 publication by Atul Gawande, a New York Times Bestseller.  He stresses how modern medicine has mishandled aging and death.  Medicine keeps us alive even when not in the patient's best interest. Quality of life is often denied to patients with terminal illnesses.  Perhaps the death of my best friend of fifty years exemplifies an ideal end-of-life experience.  My friend was 93 when she died in November of 2021.  She decided when it was time for hospice care.  She had been in and out of the hospital during the Covid Pandemic.  Working as a registered nurse for over 45 years, she was aware when she was nearing the end of her life.  We talked two months before she decided to go into hospice care.  We often spoke until she was too weak to talk.  The last time we spoke was a few days before she died. Our talks were always pleasurable.  She said I made her laugh.  I had typed the program for her funeral ten years earlier.  As we reviewed the program, we realized I was her only living friend on the program.  Even the minister who was to deliver the eulogy was no longer alive.  Finally, she decided not to have a funeral because of the pandemic, and she did not want to expose her family and others to Covid.  She died peacefully in her room surrounded by the things she loved – quits, sewing machine, bible, and two close relatives.  A hospice nurse was also with her to ensure her peaceful transition.  My friend prepared well for this natural part of life.  She accepted death as much as she embraced living.

My friend inspired me to live beyond my comfort zone; to do what makes me happy.  She was a beautiful woman – tall, well dressed, and graceful with rich brown skin and sultry dark eyes. One of my male friends said she was sensual.  After I moved to Houston, we discussed her coming to visit.  (She had visited me in four different states) She was already in hospice care.  She was careful not to say she could not come to visit.  She said, “Z, I have to talk to my doctor, and I’ll let you know.”  We both knew she was not coming to visit me. Neither one of us could admit what we knew to be true.    My only regret was not giving back to her what she had given to me.  I know she would have disagreed, but I still felt I needed more time to show her how much I loved and appreciated her.  She and her husband celebrated every major event in my life – from earning my doctorate to being named president of a community college.  My last pregnancy at 38 with my son, Jay was a major celebration.  She and her husband became Godparents.  I recall her slipping me three one-hundred-dollar bills when I was in graduate school to buy Christmas gifts for my two daughters.  She was a mainstay in my life for nearly 50 years.  The last advice she gave me after moving to Houston was “Z don’t try and save any money now.  It’s too late.  Spend it and enjoy yourself.”    Well, Rose. I am doing just that!

When I was young, I did not consider getting old.  I hoped I would live a long time.  I had dreams of what my life would be like from an early age.  I knew I would finish college, get a job that paid enough to help my family, not experience poverty, get married, and have a pretty, brown-skinned baby, preferably a little girl.  I had achieved those goals by the time I was 21.  I learned that progress is not always linear and that we can’t always hold on to what we have.  I also learned that optimism is not valued enough.   I have always embraced optimism, especially during the times when life reached a low point.  Optimism creates the energy and creativity needed to improve your condition.

I do not fear death and would even embrace death if I could share the experience.  It would be great to write about the dimming of the light and seeing images of my parents and loved ones.  But death will be the end.  Knowing this requires me to appreciate the life I have been given and to make a difference while I occupy space on Earth.  The love I give is unconditional.  There are no expectations for a heavenly reward.  The purity of this transaction is intense rapture.