LIVING TO TELL ABOUT IT

An essay about aging and trying to die that doesn’t mention Depends once.

I could hardly believe it when I heard the knocking on my car window and saw people in uniform outside. I was not supposed to be alive. There had been the most careful planning. I was parked in a dark, shadowy spot at a shopping mall; a little knoll just in front of the car led down to a drainage ditch. I did want my Mini where it could be found readily.

I had done a lot of reverse engineering of drugs on the internet. Opioids were in the news, and I had quite a stash left from a long-ago hysterectomy; I regretted not keeping the plastic container, gotten after a fall in a theater had me in an emergency room. I read about alcohol as a booster and had a double margarita at a nearby pub; I had a mix of other meds expected to be effective. There was a danger of throwing up, so I had some Sprite and proceeded slowly to be sure I wasn’t developing an upset stomach.

I had a book — I don’t remember the title — on my iPad with something calling for minimal concentration, and I read. I had my walker in the trunk, the walker dating back to the fall about one and a half years prior where I did not keep my opioids. I intended to walk down the little knoll, but I was afraid I might fall and not be able to finish the meds if I went too early. So, it was important to maintain vigilance on my well-being: don’t get sick to your stomach; head down the little knoll while you can still get there, but not so soon that falling down would matter.

Alas, I had gone from being sleepy to being totally out pretty fast. So, alas some more, there I was in my little yellow Mini Cooper when the security folk came by. Some 15 hours later, I came to in a hospital and was being told about being Baker Acted. In Florida the Baker Act is the statute that provides for commitment to a mental hospital in the circumstances at hand. We’ll get back to the mental hospital.

The fact that I might want to take my life at some point was not new. I had told my two children, both grownups, and they seemed to agree or at least understand, that it seemed wrong to me that one is permitted to die only when medical science failed utterly to maintain “life.” I didn’t come close to meeting requirements in right-to-die states. “Living wills,” I had known for years, cover maybe the last five days of life, if that. End of life illness and care sit in my mind as a part of life filled with quality time, however loosely defined. (Overheard in a hospital waiting room a dozen years ago: “I know she’s better because they were able to get a popsicle in.”) It is also the final siphoning of senior assets because the Rube Goldberg machine that guides our lives does not afford a choice of exits.

“Quality of life” is prominent in the public discourse, and I buy into it — unless I am backed against a wall, where I now flail and twist. Without question, I have received wonderful medical care. Sometimes not so much. It can be funny; it can wreck what is left of your life. Even when the care is very good, I cannot miss the sense of being set up: wait until the next round.

Quality of life was high on the list when my dentist referred me for consideration of filling in the space that developed around a tooth implant. I listened as the procedure was explained: tissue from the roof of my mouth would be used to fill the space. It hit me, and I shouted, “Shades of Louis C.K!” I fled, not pausing to explain how frantic Louis C.K. became — “Tumors growing in her fucking head!” — at the calm explanation he got from his mother’s doctor about her tumors. I was running as fast as my walker could take me to my Mini and howling, “They want to take the roof of my mouth and stuff it in around my fucking teeth.” I exaggerate. What I said was it made me think of Louis C.K. and his mother’s tumors. I was hard put to extricate myself from the story; my oral surgeon, to his credit, just smiled. I probably need to make make another appointment.

Depression, I read and forever hear, is the most common cause of suicide. Most definitions have essentially the following:

“Depression. [F]eelings of severe despondency and dejection: self-doubt creeps in and that swiftly turns to depression. • Psychiatry a mental condition characterized by feelings of severe despondency and dejection, typically also with feelings of inadequacy and guilt, often accompanied by lack of energy and disturbance of appetite and sleep: she was referred by a psychiatrist treating her for depression.” (Internet, Dictionary, Version 2.3.0 (268), Copyright © 2005–2020 Apple Inc. Italics in original.)

Yet, the diagnosis of depression is the same whether it comes after the suicide or before. Why would anyone kill themselves if they were not depressed? Depression is the sine qua non for suicide. Get it? Not so fast.

It seems to me the moving force could as well be a resoluteness. What you get when you look with a hard eye is, thank God, a health care option. You don’t need to be depressed. You do need to be resolute.

I cannot identify a triggering event or circumstance that led to my plan for suicide, but if I had to name one, it would be Prolia. I had gotten the opioids that I did not keep a year prior. Surely, there was a general decline in health. Some months after the fall, I had a respiratory illness that I thought was lung cancer; it was cleaned up as an infection by a specialist I enjoy calling my paleontologist. The back pain, plaguing me since my teens, grew worse as the years went by. It is why the Prolia; I had never heard of the drug before. A shot of Prolia led within a day to many of the horrendous side effects you see in the tv ads. The Prolia ads even tell you when to see your doctor. I learned of Prolia’s half-life; just wait and it would be out of my system.

Little by little the jaw pain, dreadful sensations,cleared, but it worried me terribly as I read about Prolia and jaw bone necrosis. Did necrosis mean what I thought it did? I never had thigh breaks — thigh breaks? What the hell? — though they did hurt and badly from time to time. My legs are a different matter and have never recovered. They were roaring with pain months before I had my stroke. I’m talking about the big one, not the little recent ones.

The stroke was the kind that took away speech, but I went to a big stroke hospital. They told me of the magic med, to be delivered within four hours of the event; its use was fraught. But here I was, unable to string two words together and a stroke not likely to kill me. I like the image, as I look back, of the meds going in and words coming out. I had no numbness, and little to no remaing effects; no allergy to strokes, apparently.

Allergy. Here is a dictionary definition:

“[A] damaging immune response by the body to a substance, especially pollen, fur, a particular food, or dust, to which it has become hypersensitive.” (Internet, Dictionary, Version 2.3.0 (268), Copyright © 2005–2020 Apple Inc.)

Contrast the definition for side effects:

“[A] secondary, typically undesirable effect of a drug or medical treatment: many anticancer drugs now in use have toxic side effects.” (Internet, Dictionary, Version 2.3.0 (268), Copyright © 2005–2020 Apple Inc. Italics in original.)

Ah! Allergies.They’re my doing. Don’t take something if you are allergic to it. Don’t you know that? Didn’t we fucking tell you? Look at the ads! Stupid bitch.

I am no longer looking, but I found literally no protocols for eliminating side effects of Prolia. The company was ever kind, helpful, reassuring, half-life, half-life, half-life. Prolia is an allergy in my medical chart and remains so though I complain about it persistently. It was a long while until I connected the dots of the jaw-dropping miscommunication as my Prolia side effects metamorphosed into after effects of stroke. There were referrals to an endocrinologist (never mind the how long it took to get the appointment), and a neurologist. I saw that I had problems with “gait” on the medical form, but I always asserted my Prolia legs as my overarching concern. I can hardly believe how long it took me to realize that I had been receiving medical care for my stroke. It was a detail that did not even fall into place when the neurologist told me my gait was fine. I blamed him and not the context of my presentation and the absence of existing treatment for my real problem. Never mind my pleas for help with the pain in my legs, urging they predated the stroke and started the day after my Prolia shot.

It is clear to me that my bawling, miserable problems with Prolia are statistically insignificant. I later got calls from the endocrinologist telling me that I was due for another bone density test, and from my primary to schedule me for my second Prolia shot. I was outwardly fairly mild and questioning; I was confused. How could they ask me such a thing amidst my result? Shades of Charles Dickens and Oliver Twist: Would I like some more? Internally, I lost it. I have given up.

It was important, I thought as I planned to die, to avoid holidays. I felt that it would be rough on my children, also on my husband, though less so; possibly a shock and curiosity to my other rellies and friends. I picked a date but had to reschedule so that we could have a big surprise birthday party at our home for my niece.

Two things happened that set the place and date; and my sister passed away that month, which reduced one concern and probably made it easier. First, one of my husband’s sons was coming to visit. This meant someone would be here for my husband, which I thought was a good thing. The other thing was that my computer’s hard drive was going out and meant a trip to the Mac store so that it would be in good working order for my daughter.

Thus the date was set, and I left home in the morning, just going step by step. I sat in my car at the Mac store and called my kids. Nice conversations with both. I adored them. Then it was the margarita double and the place to park.

The psychiatrist and staff became the mainstay of my health care. My hospital roomie was a gem. “What are you in for?” she asked. I said maybe we could talk about it later; but when she went on to say that she tried to kill herself, I said, “Me too.” I was skittish about the men, flirting and touching, in particular one who came to our door. “Just go to sleep,” said my roomie. “The two of us can sure take care of a runt like that!” I don’t know whether or not he kept playing with the door–no locks–because I was asleep.

My niece of the birthday party and her husband came to see me. I talked to my children on the phone, both distressed beyond anything I had envisioned, and my daughter so angry she could barely talk to me. It had to do, I think, with a sneakiness that I was not proud of, but could not figure how to do without. My husband came daily, generally supportive of my well being. Never, from that day to this, did we have any discussion about the suicide attempt, beyond relaying his son’s observation that I never intended to carry it out as shown by the fact that I took my computer in for repair. I did try to explain about the new hard drive.

Please understand that I have had a pretty good life. Sometimes lonely, but likely no more than a usual amount. Great education and work life, awesome kids and grandkid. Migraines dated to pre-school, but went away with menopause. Good friends, nice home. I continued throughout to remain interested and involved in life. But I began in earnest to get my life in order: make sure the Living Trust is ok, details on finances laid out so that my trustee, my daughter, would know URLs and passwords, cremation contract in place, IRS information as up to date as possible for the year.

Life resumed much as it was before. I am glad to be alive because of my kids — the fact of the attempt was hard enough for them. Imagine if I had been successful. I still believe that I should be able to end my life under circumstances that I choose, and they agree. But my sense is that door has closed for me. My psychiatric health care people tell me of the suffering for parents of a child suicide and for children of a parent suicide. They are frequently tormented, and there may be no recovery.

With pain in my back and legs severe, I asked my primary care for a pain clinic referral. Off I went, clomping my walker to yet another doctor. The diagnosis was easy — there were nerves in the lower back with no function other than carrying pain messages to the brain. Nipping the nerves was easy too; the only downside was that pain relief might not be complete and the nerves could grow back. I left the office with a sheaf of papers and an appointment for the procedure a few days off. I no longer brook much criticism of Dr. Google, where I saw the bullet point (!) warning that the procedure may lead to loss of bladder and bowel control. I spotted the same bullet point in the sheaf of papers from the doctor, but damn, it was sure as hell not a hard call to make on quality of life. Help for my pain was on its way, and I missed getting it by a hair.

About eight years ago, I had cataracts removed from my eyes. So far, so good though I do continue to need glasses. I have had a correcting prism in my glasses for many years and now have four; I read lots. A few years ago, as I was developing double vision, I was referred to an opthamologist who specialized in such problems. I stopped beside the road leading out of the medical complex and cried when I realized that my temp prisms completely gave me back the a single view of road signs. Single everything else too, but more and more I go to audiobooks rather than the printed page. I read The New Yorker on my Thank God iPad. Glaucoma has been added but will remain under control as long as meds maintain eye pressure; sometimes they hurt a little.

I have known for years about my A-Fib; it is a precursor to heart attacks. I cleared a stress test, the old kind with running on a belt. Electrocardiograms showed barely a trace, until they did. Cardioversion worked, but didn’t hold. My cardiologist referred me to a cardiac surgeon who went over the detail of a possible correction, but I decided not to proceed. The surgery was nevertheless done on an emergency basis when I went to Urgent Care nearby to try to get a jump on flu that I thought I might be getting. Get some meds and then go eat Mexican food was the plan. The surgeon threaded a tube through the groin and nudged my heart, not initially responsive, into sinus rhythm.

My son and his wife were here visiting and had gone to Urgent Care with me. They say that, since I was not hurting, I would not have reported in to the emergency room at the hospital as I promised to do had they not been here. They don’t trust me. What’s the deal?

So — my heart’s A-fib was fixed, but the correction was lost, as expected, a few months ago during gallbladder surgery. I went to the hospital in terrible pain, with numbness in arms down to the elbows. It was the kind I could not address with anything I knew though some of it had a positive record: acupuncture, pain killers, physical therapy, massage, exercise, meditation, medical marijuana. Heart attack for sure, no? Well, no. No.

The gallbladder diagnosis was full of scary words. Cholecystitis. Perforated. Hemorrhagic. Gangrenous. There was Blood Poisoning, which came about from the perforated part. My surgeon said there might be liver damage, but we wouldn’t know until the gallbladder was removed.

“Hold everything.” I said. “Let’s stop right here.” I suggested the possibility that I be moved to hospice — let us be done with this. The surgeon explained that he knew of no hospice care that would take me as I was. Even if I just went home, the pain that brought me to the hospital would likely do so again. It was not bloodly likely that I could sit somewhere and die. Little to do but go ahead with gallbladder surgery and revisit my health then.

A panel of intervenous fluids ran into a rake of needles in my arm. My temp was high (“108,” I told my daughter. “That’s high, Mom,” she said), but it was not clear that my delirium, my hallucinations, were from fever or from — are you ready? Something else! I read doctors’ notes, how lucidity returned as fever dropped and the meds kicked in. I ruminated on how it did not, could not, factor a whit into the ballyhooed quality of life as we prepared to remove the hemorrhagic, gangrenous gall bladder.

There was no liver damage, and I left the hospital feeling better than I had in years. The Prolia legs were clear. Back pain at its same awful level. Tinnitus greatly reduced. Oh my, I haven’t mentioned the tinnitus. It makes me crazy. The ringing buzz is always. Sometimes it crackles, and my head feels heavy and foggy. Electrical zaps go about in the lower part of my head, usually in the early morning. They last about a half hour, and I could not possibly be upright, even sitting, while they are going on. Guess I can get a hearing aid. They sometimes help, but it’s hard, you know, to help someone who won’t cooperate with what is available to improve the quality of her life.

It took a few days, but the Prolia legs returned full force. I can stand for only a few moments without sitting down; walk only a few steps without a walker and not many with one. The cardioversion to get the heart’s sinus rhythm back in line after the gallbladder business didn’t work, but my heart lumbers along just fine at a regular rate.

I know, more or less, what I am looking at. The old back pain, ever worsening and not responding in any solid way to treatment. The Prolia legs. The actuality of the debilitating stroke or heart attack. Note that the word is not fatal but debilitating. Pretty hard to have a fatal stroke or heart attack. I mark the memory loss. My fear is being kept alive — “alive” — rather than being allowed, or allowing myself, to die although a slight ratcheting down from where I am at the moment would do it.

The most interesting volunteering that I have ever done was leading discussion groups on behalf of the county library at senior facilities. We choose a topic, read articles and poems and talk. Though I am no longer able to do it, I got a fair amount of exposure to senior facilities; and being a resident in a retirement, or nursing, home would be ok if it weren’t for the indignity of the asset siphon.

My daughter visits a lot. Fun, bright, detail oriented, living states away. This is good. My son has moved here to Cape Coral, FL, from Minneapolis. He fixes most of our meals, runs errands, is a delightful companion to me and our Westie, Mr. Peat Boggs. Never mind that I have told him again and again about the man and his wife who moved to Bismarck, ND, from their home on beautiful Calhoun Lake, Minneapolis, to care for parents. The parents died, the wife died, his old home on Calhoun Lake, or anything like it, was now beyond his means; he could not get back to Minneapolis. The move, the man said, was the biggest, dumbest mistake of his life. “But Mom,” says my kid, “this is different.”

A few weeks ago, I was leaving a restaurant and suddenly became dizzy; I saw objects around me as shadowy. I sat on a bench for awhile, and my vision had cleared entirely by the time I got home about five minutes later. It didn’t cross my mind that I had probably had a stroke until the next morning when areas in my face and my lips were numb. The numb spots in my face cleared over a few hours; the numbness in the lips was gone by the end of the day. A week or so later, I was again leaving a restaurant when I felt a loud pop with the sensation of ears having unplugged. I thought for a few seconds that the tinnitus was gone, but it was‘t and life rolled on. It was days before it occurred to me that the two events could be connected. Well, here’s my chance, huh? What if I didn’t hurt but could just sit around with numb spots in my face?

My primary care doctor has a prescribed an MRI and referred me to a neurologist. I know the drill. I must, must stay on it to guard against a debilitating event that could have been prevented. Weeks later, the MRI is coming up. The neurologist is not taking new patients, do I want to be on a waiting list? Impatient, as I mulled the question. Well, yes, put me on the waiting list. What, dear Reader, did you expect? What would you do?

-End-