Thursday, January 10, 2013

Staying the Course: "miles to go before I sleep."

"The woods are lovely, dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep."

          -- "Stopping by Woods on a Snowy Evening"
                              Robert Frost (1874-1963)

New Englander Robert Frost has always been my favorite poet. Although the natural world he encountered north of Boston differs greatly from my lifetime habitat south of Richmond, lines of his poems often pop into mind when I am on a long walk. In particular, I relate "miles to go before I sleep" to overcoming challenges that confront us in our senior years as we strive to keep moving along the trail. I don't pretend to be rendering a literary analysis of Frost's imagery. I am only saying what it means to me: Keep moving. Miles to go in this life. Don't give up.

Many folks face bigger challenges than do I in continuing to experience the joys of walking and hiking. Yet, mine have not been insignificant. I hope that in writing about them, I may offer some inspiration to others.

When I worked in the Inside-the-Beltway  of Northern Virginia just before my semi-retirement, I did a lot of walking from the Rosslyn Metro stop up a rather steep Wilson Boulevard to my think-tank office. In my first years there, the trek was rather exhilarating. I liked being in such a bustling urban environment just across the Potomac from our nation's capital. However, as time went on, that climb up Wilson became more and more a steep and painful challenge. My lower back hurt terribly, and the pain radiated down my legs.

It got so bad I could not walk more than a block without having to sit down. It hurt so badly I felt like crying, but the pain did subside after I sat for a while.

My doctor sent me for an MRI, and then to a back specialist. Diagnosis: I had (and still have) spinal stenosis, a narrowing of the spinal cord in the lumbar region that commonly produces symptoms after age 60. The back specialist sent me to a pain management specialist, who gave me a pain injection in the lower back. That was a frightful experience, an epidural to remember, but it helped not at all. There was some talk of the possibility of surgery. But then, almost as an afterthought, the docs referred me to physical therapy. That turned out to be a huge blessing.

My therapy started in an indoor community pool. Aqua therapy was a pleasant and fun, but my therapist, Michele Sellers, soon moved me to Gold's Gym for the real work in restoring my mobility. Michele said her objective was to prepare me to "dance at my daughter's wedding." She taught me exercises that I still pause and do during hikes to stretch out the back and ease the pain. She also gave me the motivation to lose weight. The more I can reasonably trim, the more I can relieve pressure on the spinal column. (Oh, and I did dance at my daughter's wedding.)

As that therapy was about to conclude, a routine appointment with a cardiologist delivered me the bombshell news that my aortic valve was leaking badly and my aortic root was greatly enlarged, and both needed replacing very soon. "Can they really do that?" I wondered when the cardio showed me a diagram of what a surgeon would have to do. Months later, my surgeon, Dr. Alan Speir at Inova Fairfax Hospital, did accomplish that task brilliantly, and soon thereafter I began my second round of therapy -- this time, cardiac rehabilitation at Potomac Hospital in Prince William County.

The cardiac rehab was also a valuable experience. I learned some more exercises. There was camaraderie among patients and nurses that helped ward off the depression that often follows heart surgery. And again I had hammered in my consciousness the desirability of losing weight and keeping it off.

Fast forward a few years, and we had moved in semi-retirement to the Blue Ridge Mountains of Virginia, about a dozen miles out of Roanoke. My right  knee collapsed when I was descending a steep set of basement stairs. The orthopedist found that I had torn the meniscus, which he was able to repair easily with laser surgery. However, in the process of examination, he found that my left knee was actually the dysfunctional one. Virtually all the cartilage has disappeared over the years from this knee, which was originally traumatized when I played football in school. More rounds of therapy post-op for the right knee in Roanoke and then the back after we moved to South Carolina had therapists shaking their heads and saying they couldn't do much more, given that my bone-on-bone left knee was the real problem (and hey you might want to consider going bionic with it).

So my challenges in continuing the miles I have to go before I sleep are threefold: the mended heart, which seems to doing just fine (no shortness of breath or chest pain), the back, and the knee. I have to admit that there are days the pain drains a little of the joy out of walking. The back and the knee seem to take turns in acting up. It may well be that I will need a knee replacement eventually (and maybe even a back surgery), but with or without one, I intend to keep moving. I still relish walking. It is central to my existence. I intend to keep my promises and stay the course.

My hope in writing this personal account is to reinforce the message that we can overcome all obstacles and pass our tests. With all that said, I want to accentuate the positive going forward.

© Robert G. Holland 2013

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