i am so lame

Neither of my grandparents used a cane, I don’t think, nor did my mother, who was content to simply slink through her final years of boozy ill health. After brain surgery, my dad was in a wheelchair for a while but skipped the cane step, preferring instead to Frankenstein around from then on, lurching into walls and knocking over lamps.

People with canes, I used to think (if I ever actually wondered about it), were weak or frail (as if holding onto a cane would keep a brittle leaf of an old woman from being bowled over by a stiff wind) or slightly wobbly on only two legs (the reason stools have three). I assumed a grey-haired man would lean on a cane while wishing there were a bench nearby for a quick sit rather like a younger fellow might rely on a high counter with his elbows to give his back a rest. I imagined a cane was for boosting a heavily hunched person or steadying someone at a tilt, maybe for adding an inch to a too-short leg. People walking with canes were slow and they took up the middles of aisles, but they did so nicely. Using a cane, to me, was like wearing a badge of age-induced infirmity, of benign ricketiness. I had never associated any of the infirmities a cane-user might have with actual pain. It isn’t as though old people who use canes are wincing with every off-step as they tap-tap down the sidewalk. And if I had witnessed an occasional grimace, I figured, well, geriatric folks grimace about a lot of things because they can sometimes be cranky. It hadn’t seemed at all as if they were hurting, just slightly unsteady.

Then, in the last few years of her life, my stepmother Margery used a cane (and sometimes a wheelchair) for long stretches of time, sometimes months.  After her Billy (my dad) died, she lost her captive audience. A lifetime of smoking and asthma clamped down on her lungs and deprived her brain of oxygen. She had always craved attention and she knew that people with visible maladies got a lot of it. Also, although she wasn’t thinking all that clearly (what an understatement), she was adamant there wasn’t a thing wrong with her that some orthopedic magician couldn’t cure. Combining these things became a nightmare.

One of her ankles developed a probem that kept her from wearing shoes with high heels just after her 80th birthday. She found a surgeon who was doing  - revolutionary! first ever! – ankle joint replacements and signed herself right up. Then she had to have a new hip like all her friends were getting, despite the fact that both her hips were reasonably good. Then there were revision surgeries – do-overs – once on the ankle and twice on the hip, finding doctors farther and farther from her town who took her fudged/smudged intake history and didn’t bother to have a copy of her medical records forwarded to them. They operated on her again and again, as she insisted they must, although she had terrible pulmonary complications and a MRSA infection in the ankle wound that required three more hospitalizations. All of this plus: neither her ankle nor her hip was ever better afterward than it had been before. Her background as a nurse and her charm helped convince them, I guess, plus the ability to bill Medicare, the State of California retirees’ insurer and TriCare (my dad had been a naval officer) for all those fees. Stubborn, in denial about a long list of sad truths and suffering from increasing periods of hypoxia and dementia, when she wasn’t in a hospital room receiving visitors and flowers and cards like a queen in her audience chamber, she stomped around her little town, barging into people and whacking things with what she called her walking stick. A grande dame of a woman with bright blue eyes, a cute hat, a booming voice and a big cane making a Watch This entrance into a restaurant gets every head to turn, and she seemed to need that as much as – or more than - her next breath. I hated her canes and wheelchairs, symbols of her defiant and humiliating scenery-chewing, her irrationality and belligerence, her refusal/inability to still be the woman I had loved so much, the Before Bad Times Margery.

She died four years ago at the age of 88, and I’ve spent much of that time trying to forget what she looked like during the great decline so I could remember her, instead, doing her model-walk in some dishy outfit or dancing in a pair of high-heeled cowboy boots. Her loathsome cane went in the Goodwill pile when I cleaned out her condo for the new owners. I had turned 60 on my birthday in the spring of that year, and I didn’t think for one second about keeping it around just in case.

Fast-forward to last February. My left hip, an occasional annoyance for about a year, had become a continuous, increasing pain in my actual ass. Since I finally had decent medical insurance coverage without a zillion-dollar deductible (thanks, Obama!), I decided to have it looked at by the local orthopedic docs. A few x-rays, consults, cortisone shots, intensive physical therapy and some sudden (but not unusual, I’m told) deterioration of the remaining tattered scrap of cartilage in there, and I am on the surgery schedule in late September for a Total Hip Arthroplasty ‘cuz there’s nothing I like better than an acronym that sounds like a tongue/teeth mistake: THA.

I now have my own cane that is never farther away from me than an arm’s length. If I don't have it, I can’t move because – big surprise for me, the inveterate cane-basher – having a hip joint so bum it qualifies to be replaced by a mechanical substitute hurts like, well, a motherfucker.

It feels like there is a softball-size rotten tooth in my hip joint, a capsule of sticky inflammation packed with bits of broken glass way down in there. The ache reaches up and back toward the lowest curve of my spine and down to my knee, and on bad days and at night into my calf; it throbs with my heartbeat, fires into tendons and muscles, pinches nerves that scream. The bones themselves, femur and pelvis and tibia, grip the pain as if it is what glues their chalk together; it hurts from deep inside all the way out to the skin. It hurts so much that I move my leg – one degree of rotation, slide an inch left, then right – trying to find some position it likes, even though I know that moving it at all makes the pain worse; it is diabolical. I saw Words and Pictures, a movie in which Juliette Binoche plays a woman with rheumatoid arthritis who can’t open an Rx bottle of pain pills with her aching, swollen hands, so, her face a floodplain of tears, she smashes it with a hammer. It hurts exactly like that.

I take pills. Naproxen, an anti-inflammatory, at high (but allowable) doses was enough for a while. When it wasn’t, I took more and then still more until red freckles started appearing on my forearms and the backs of my hands, burst capillaries, and I knew I had to stop the triple overdosing. A couple weeks ago was a bad spell, and one night in bed I wondered if amputation was an option. I had taken an AI, then another full dose, then a painkiller, all without the slightest relief. I got up, took another painkiller and a random sleeping pill i scrounged from the back of the medicine cabinet, figuring that was way too much but if it took me down, at least I'd be unconscious when it happened. The next day I told the mirror: You have to drive and deal with Mack and All The Things, plus you're all too aware of how easily you could be an addict (and there are three months to wait), so big-time opioids are out. Last year Tramadol made me feel like I was on Mars so I wouldn't take it, but now I’m happy to go there on a once-a-day, timed-release ride. The normal-dose NSAID and semi-opioid, I hope, will hold me until mid-September when they nix the Naproxen for potential-blood-loss reasons. Those last two weeks might get ugly.

I rely entirely on my cane to get up out of a chair or the driver’s seat of my car. I lean heavily on it with my right hand whenever my left foot touches the ground. The cane bears my weight, holds me up, allows me to move. Without it, I couldn’t make it from my office to the kitchen. That's a long way from last January when I strode 30 blocks from the East Village to meet friends at a deli for lunch, loping happily along those New York sidewalks on a sunny winter morning. Now I sympathize with Margery’s disdain at having to wear what she called Buster Browns, but canes and flat shoes go together, not canes and high heels. I grumble but am resigned to plod heel-less until September.

The literature says severe osteoarthritis of the hip is caused by obesity or overuse. I prefer to think (those 20 pounds notwithstanding) that I put my hips to frequent and strenuous good use – dancing, of course – that has worn them out, and now it’s time to fix them and move on. To this end, I will even be a compliant and not-grouchy cane-user, but not on a $19.95 adjustable metal-and-plastic Made in China special from CVS, oh, no.

A lovely woman who makes custom canes out of strong, beautiful wood is designing one for me. The new cane will have a grip of tiger maple, shaped to fit my hand, that sits above a cocobolo collar and a padauk shaft. It will hold me up until my new left hip heals, and shortly after that (I have learned the miserable lesson of what happens when you wait too long) it will migrate to my other hand while the right hip is THA’d. Once I am fully bionic and back to my hip-swinging, heel-wearing, block-striding self, I plan to hang this beautiful cane somewhere in Casa de Swell as wall art.