Bodies are weird. Nothing shocking there.
What is shocking, or at least revealing, is the way they reveal their inner weirdness over time. Things that are in your control, things that are out of your control. Things that can be in your control for a time, then out of your control later, or you can keep some part of it in your control, but all told, it's random? Is that comforting?
Prompting by Patrick having a doctor visit where he was told all the running and salads in the world won't fix his genetics, Patrick and Rob share a few stories from the pharmaceutical front lines.
Patrick: I often joke that while the sudden heart attack of my father has made me acutely nervous about the state of my heart and everything surrounding it, the fact that I care about it at all when my dad rarely could be bothered to give it a second thought means I’m far more likely to be taken out by, well, literally anything else. But that literally anything else is unknowable, while the prospect of any number of heart disease complications because of a nasty history on both sides of my family means I just keep throwing darts at heart disease and let the chips fall.
The part that frustrates me, my brother, and my mom in the years since he passed, though, is what you can control and can’t control. Heart attacks nab seemingly healthy people out of nowhere all the time. Sometimes, your number is up and shit happens. But you can also stack the deck against your favor, which is basically what my dad did when he was repeatedly warned by his doctor about taking various things more seriously. He would say the right things, of course, but when it came to making serious life-changing decisions, he’d err on the side of enjoying his life, rather than upending it. (With distance, I can respect some of that approach.)
I bring all of this up because while I do not deny myself a good burger or a third (or fourth) beer when the mood strikes me, I do work out regularly, emphasize salads over other meals during the week, and take other basic steps towards being whatever metrics one is told is healthy or healthy-ish as I push into my 40s. But I also had a doctor appointment in the past week where one of my cholesterol-related tests spiked enough that my doctor’s response was to immediately start me on the kind of medication that is something you’re taking daily not just today, tomorrow, or whenever the numbers look better, but this is one you’re taking forever.
The text accompanying the recommendation in my patient portal was almost comforting, repeatedly insisting that “this isn’t your fault” and “you are doing everything in your power” as it adds up to letting you know that, in this specific instance, the genetics gods have cursed you.
Cursed is a strong word, I guess. We all have our genetic burdens. And, in theory, this tiny pill that I’ll start taking every night brings a number on a mysterious blood test down and basically nothing in my life changes. I keep running. I keep trying to eat salads. And I keep joking to other people that something else is gonna take me out before my ticker stops going. But it is weird to be hitting an age where you start hitting markers where it’s like “well, it’s no longer about doing the good or better thing, there are just new markers in the road and the choices are limited.”
The real annoying thing is that I’m supposed to take this pill at night, right before bed. I take all my other pills—multi-vitamins and the like—in the morning, as I leave the shower. I’m already pre-emptively annoyed at how often I’m going to forget taking this, even with a phone reminder!
Anything bugging you like this these days?
Rob: I had two cholesterol tests show up as mildly elevated on two tests like six months apart and my doctor put me on a statin inhibitor and that took care of the problem… for now. But I cannot tell you how much it changed me when my back went out about fifteen years ago now. Slipped disc that started as a slight twinge. "Hey what the hell is that? Feels like I need to pop my back but, no, that's not it. Hmm. Maybe I'll go lie down." And then three hours later, screaming in pain as I tried to get out of bed. And I'm lying there, debating the merits of simply pissing myself and the bed rather than trying to stand again because honestly it sounds less awful than that lightning bolt of pain I felt through my body and the pain is not abating so I feel like whenever I do move it's going to be worse. And for a minute I'm like, "What if this is it? What if life had a 'before' that I was living in and now I'm in the 'after?'"
And you know, once my wife called a friend of ours who was a nurse in a hospital inpatient PT wing, we got some good advice and I started to crawl out of that dark well of despair. Turns out when you have back pain like that you have to get your ass on your feet ASAP and stay on your feet as much as humanly possible, that sitting or lying down will just cause everything to stiffen up and that's the part that hurts so terribly. That disc was locked in place against a bundle of nerves and it was going to work itself into a better position if I kept moving around, but my instinct was to make the pain stop by getting off my feet. However, even after I recovered, I now had a cool new chronic back issue. I could manage it, I could do things that lowered the odds of it recurring, but I could not do anything to make it disappear. There really was no going back to "before" but the "after" could have been far, far worse. And someday, it probably will be.
Before I moved out to Boston I heard this interview with John Mellencamp on Fresh Air and that's where I first heard his song "Longest Days". This one verse hit me as hard as that spear of back pain a few years later:
"Nothing lasts forever
And your best efforts don't always pay
Sometimes you get sick and you don't get better
That's when life is short even in its longest days"
Now he was in his fifties when he gave this interview, and the song was inspired by something his grandmother said in her last years. But he also made the point that this wasn't new territory for him, that this wasn't a song he only wrote because he was getting up there in years. It's always been a part of his work. "Jack & Diane" sounds like a poppy anthem, but the chorus is built around, "Ooh yeah life goes on / long after the thrill / of living is gone".
Cut to a few years later we're at a wedding and MK's grandmother is there and we make our greetings and ask, "How are you doing?" And she was always prickly I guess, but that day she was just a little tired of the question and the way people want older folks to perform when they ask it. To reassure us that they're doing well, that they're still with us and not going anywhere. So she spits us with a look and says, "I'm dying, if I'm lucky." Then she softens and explains, "At this age, honey, you're never doing well. Something happens and you just stop fully recovering and then there's something else. But it's okay. Because you also stop worrying about dying and you start wishing it would hurry up."
Now I'm on a few different medications for this, that, and the other thing. Here's the pill that helps me find the energy to get my shoes on and get the dogs out the door. Here's the pill that keeps the cholesterol at bay. Here's the thing for my reflux. But here's the thing: time was you just didn't test or treat this stuff. You'd just white-knuckle a lot of this stuff or you'd assume that you were in good shape, taking care of yourself, and you were good for another thirty years without much of a fuss and your doctor would look at you say, "Yeah nothing to worry about, Patrick! In fact you could stand to gain a few pounds!"
We're cursed with greater awareness of our mortality and infirmity because medical science is better at detecting and treating a lot of things before they land you in the back of an ambulance that's going to turn off its lights and siren as soon as it's two blocks from your house and family. But despite the fact that we're more acutely aware that the hands of the clock are sweeping towards midnight, we're incredibly lucky that in that awareness we might be able to slow their progression. But the cost is that you can't live in denial about the process of aging. You're closer to that point where life is short but the days are long. There was a time before you needed a pill, now you're in the after. If that's all you need? Brother you're going to look back at these years and say, "Damn, maybe those were my prime." Enjoy them.
Patrick: The first time something like this happened, I was so excited because my mom was old enough to quality for the first wave of COVID-19 vaccine shots. Like, the ones where you drove out to a giant warehouse and the military was involved.
My mom has never been a confident driver and the spot was 45 minutes away, so my mom asked if I could drive her. About halfway there, I noticed that I couldn't really feel my left leg. I mean, I could feel it, but imagine if your foot fell asleep—except it was your whole leg. That semi-numbness was up and down my leg.
Concerning, right? Concerning. But we were headed to my mom's first COVID shot, so she was already anxious. Not in an anti-vaxxer sort of way, but in a pretty understandable "this is yet another set of extraordinary circumstances and it feels weird" sort of way. The last thing I was going to do was pipe up and say "hey, isn't it weird I can't feel my leg?" We didn't need the drive to get any weirder, honestly.
I dropped her off, walked around the parking lot, and the tingling sensation went away. Hooray! Except it came back when I was in the car on the drive back. I kept quiet, told my wife what was going on, and she immediately clocked it; she'd had something similar happened when she was recovering from her first pregnancy: a herniated disc. All she had to do was a few exercises, though, and the discomfort vanished entirely. When I went to a physical therapist, they were pretty clear with me: none of this is concerning now, but if you don't take physical therapy and upkeep seriously, you will eventually probably have back surgery and no one has a single back surgery, it's always the start of a long journey towards your next one.
Fortunately, a month of physical therapy later and it was gone. Once a year, I can feel a tightness in my back and it's time for another month of exercises, at which point it vanishes again. One time, though, I ignored the tightness and the pain I felt while trying to stand up—either out of a car or out of my chair—was so bad that it was honestly easier to fall on the floor and slowly pull myself up. Lesson learned.
Sadly, no tiny little pill for that one.