Childlike Defiance

Now that I'm recovering from a broken leg, I get scolded every time I stand on the step-stool to reach something on the high shelf.  "Mom! Get down! Ask Dad to get that for you!"

This brings back a memory of Mom and me. Two or three years ago, Mom came out in the kitchen while I was on the step-stool.

"Oh," she said, "I need to borrow that." A frail 97-year-old lady needs to borrow a step-stool?

"What for?" I asked.

"If I tell  you, you won't let me borrow it."

True enough. She eventually confessed that she wanted to clean the tops of her kitchenette cabinets. 

"Mom, I can do that for you. I don't want you getting up on this thing."

"Why not?"

"Because you could fall and break something."

"Anybody could fall and break a bone," she countered.

True enough.

"Besides," she went on, "I have never fallen." She forgot she'd already told me about the time she landed in the rose bush while cleaning the garage window, back in Meadville.

To demonstrate her agility and superior sense of balance, she stood on the lower step and flapped her arms defiantly. She looked like a bird about to take flight. 

"Mom, get down!"

She got down, pleased to see that she had riled me up.

She did not get to borrow the step-stool

Games Our Minds Play

This is just crazy!

Yesterday morning I was reading about Mrs. Clarence Thomas and Liberty Central, her new political-action group. As a former employee of the federal government, I remembered that we employees had certain restrictions on our political activity. (Not that this has anything to do with Mrs. Thomas, mind you. I'm just saying.) I asked my soon-to-retire husband the name of the act that limited our politicking. 

He couldn't remember. 

Then the strangest thing happened. 

The mental image of a guy I knew at work floated into my mind, but I couldn't remember his name either! 

Just then, my husband hit on the answer. "The Hatch Act!"

Yep. My mental image was that of a guy named David Hatch. I ask you: why must our brains play hide-n-seek like this?

If You Can't Build Your Bones, Build Your Vocabulary

Ladies, did you know that you can no longer build bone after menopause? Once you reach that splendid milestone, you've stuck with the bones you've got. Oh, sure, I know that ads for drugs such as Boniva promise that you can stop and even "reverse" bone loss, but you'll never get back the bones you had when you were a giddy young thing in your twenties.

I was diagnosed with osteoporosis in April, 2000, when I was 59. I was put on Fosamax (10 mg/day) and stayed on it for nearly 10 years. The day my sister fractured her left femur in mid-November by bumping into a wheelchair ( it was parked by the door to be returned to the rental store two months after her foot surgery), I vaguely remembered a report I'd read in the summer of 2008 suggesting that long-term use of Fosamax appeared to be associated with "low-energy" femur fractures like my sister's. As soon as the anesthetic from her femur surgery wore off, my sister was sitting up in bed with her laptop,  busily researching femur fractures on the internet. When I fractured my own femur two weeks later,  I became just as interested as she was in finding out all I could about Fosamax and femur fractures. Fortunately, my sister sent me about a dozen articles by doctors who are researching the Fosamax/femur-fracture connection.

The most notable quote from the stack of articles: "Their physician had them on Fosamax believing it was a relatively benign drug used to treat osteoporosis," says Dr. Lorich. "What we found was that the patients having these fractures had been on the bisphosphonate for several years, and it was turning their bone off from healing." From Orthopaedic Trauma Today, Premier Issue, Spring 2008.

My industrious sister also found an on-line support group of 30 women and 1 man who had all taken Fosamax for at least four years and who had all all sustained low-energy fractures of their femurs (some bilateral). One unfortunate person experienced both bilateral femur fractures and osteonecrosis (jaw bone death), another suspected side-effect of long-term Fosamax use.

Anyway, medical dictionary in hand, I have carefully read all the articles and the stories provided by  the members of the online support group and have learned many new words:

bisphosphonates:   drugs such as Fosamax, Boniva, Actonel

bone turnover:  the breakdown of old bone (by osteoclasts) and the creation of new (by osteoblasts). Bisphosphanates are thought to interfere with this natural process.

comminuted:  a fracture in which the bone breaks into many small pieces

cortex:  the outer layer of the bone

diaphyseal:  refers to a fracture of the shaft of the femur

femur:  the thigh bone

hypertrophy: overgrowth, thickening (of the cortex). The bone may appear strong on a bone scan, but actually be quite brittle.            

IM rod: intramedullary rod. Metal rod implanted surgically that replaces the marrow of the femur and stabilizes the bone

low-energy fracture: a fracture that occurs from a standing height or less, which normally would not happen unless the bone were severely diseased or very brittle

osteoblast: cells that build up new bone

osteoclast: cells that break down old bone

osteonecrosis: bone death. In the bisphosphonate context, jaw-bone death. Merck, the maker of Fosamax, has been sued by dental patients who took Fosamax and whose jaw bones collapsed or developed open wounds after dental procedures.

osteopenia: the thinning of bones that occurs naturally with aging, which may progress to osteoporosis in time.

stress reaction: a microscopic disruption in the bone that is not repaired, eventually resulting in a fracture

subtrochanteric:  refers to to a femur fracture occuring below the lesser trochanter. See trochanter.

trochanter: bony structure(s) on top of thigh bone shaft, close to the hip. There are actually two trochanters, the greater and the lesser. 

Home Sweet Home

Today is two weeks post surgery. The visiting nurse will remove the staples this afternoon. I am told it's simple and painless, but I've had my doubts after seeing what a staple remover does to a piece of paper.

I had surgery to insert a hip-to-knee titanium-alloy rod to stabilize my fractured right femur on December 3rd. I was due to be transferred to the hospital's rehabilitation department on Sunday, December 6th, but no bed was available. On Monday, the physical therapist asked me if I would be willing to continue therapy at home. YES!

We didn't get home until around 8 PM. I was ready to fall into bed. Brushing my teeth for the first time in a week with my beloved electric toothbrush, I was surprised that the toothpaste tasted so awful. "Oh, well, " I thought, "maybe the Oxycodone I'm on is making it taste funny." The next morning I saw that I had brushed my teeth with hydrocortisone cream. YUK!

WAH!

During my week at the hospital, I spent a lot of time contemplating my wrist band. Name, admission date, admitting doctor's name, birth date. Over in the corner: "WAH."  What was this? An indication of my emotional state at the time of admission? On Day Six, the light dawned. WAH = Washington Adventist Hospital.

Bone of My Bones and Flesh of My Flesh

On Saturday, I received a "bad news" e-mail from my brother-in-law. My sister, Barbara (not one of my three half-sisters), tripped and broke her femur (upper thigh bone), She was in the hospital, scheduled for surgery on Sunday morning. Barbara's was a "low energy" fracture, caused by slight trauma such as a bump or a fall, rather than a major trauma, such as a car accident. Still, it was more than a hairline fracture. The bone fragments were misaligned, so she was in surgery longer than anticipated. The surgeon said the bone was "dense, but brittle."

As soon as I received Ron's e-mail, I remembered news releases about fractured femurs in women who had been on Fosamax ("Fossil-max," as Phil calls it) for many years. I've been on Fosamax or its generic form for over 12 years.

Although anyone in the world could tell at a glance that Barbara and I are sisters, we are not clones of each other. Barbara, who is two years younger than I,  was diagnosed with osteopenia (thinning bones) about five years ago and started taking Fosamax then. I was diagnosed with osteoporosis when I went off hormone replacement therapy (HRT) on a whim about 12 years ago because of annoying side effects. A bone scan showed advanced osteoporosis at age 57, despite my having been on HRT for seven years! My case was considered so serious that I was urged to resume HRT, so for about 3 or 4 years, I was on both Fosamax and Premarin. Then, in 2002, the bad news came out about HRT and I quit hormone therapy abruptly, but continued taking Fosamax. Two or three bone density scans have shown only a marginal improvement. However, there has been no further bone loss in hip or spine, which is cause for celebration.

A class-action suit has been brought against Merck, the manufacturer of Fosamax, by women suffering sudden "low energy" fractures like my sister's.  Barbara is considering joining the suit, not for the money, but to bolster the statistics. She said that the patient-information literature mentions pain as a possible side effect,  but does not tell the patient to contact her doctor immediately. Barbara had experienced severe pain in her left thigh for months. When I saw her at our niece's wedding in August, she was limping badly. The doctor could find no reason for her pain.

Yesterday I found this statement on the Internet, from a July 25, 2008  article in the New York Times: "Notably, studies suggest there is little extra benefit in taking the bone drugs more than five years."

ARGGGH. What to do? The slightest ache or pain in my legs is now making me paranoid. Broken hip or broken leg? Broken spine or broken leg?  Speak, Crystal Ball.

Death of a Tenant

We received "Norma's" obituary last month from our neighbor in Ohio. "Norma" was never actually our tenant. Our niece inherited the part of the farm where the old house stood.  Then again, maybe "Norma" wasn't really a tenant at all. Don't tenants usually pay rent?  "Norma" and "Ralph" were living in a decrepit old house down the road when Dad died in 1983.  After the funeral, they asked if they could move into the old farmhouse. "Until we get back on our feet" was the way "Ralph" put it.

Somehow they never managed to get back on their feet.  Maybe the loss of Ralph's foot to diabetes had something to do with it. Anyway, Ralph lived there--rent-free--for the rest of his life, probably ten or twelve years.  Norma continued to live there alone until 1999. The insurance company refused to renew the insurance, so our niece let the local fire company burn the house down as a training exercise in 2001.

Norma and Ralph  knew how to live off the land, even though it wasn't their land. Ralph gathered all the wild ginseng he could find and sold it to dealers. He also trapped a wild turkey and broke its wing, proudly explaining to my sister-in-law that he was using it as a decoy to lure other turkeys. My sister-in-law was furious. After she threatened to report him to the game warden, the turkey quietly disappeared. Ralph and Norma disingenuously asked my husband if he had made off with their turkey.  Before its disappearance, it guarded the place ferociously. When my husband once rolled down his car window to talk to Ralph, the turkey rushed up and pecked him on the arm.

Which brings me to Joey, who was first their dog and then ours. Joey actually lived with their son, Eddie, who had a mobile home across the pond. Eddie kept Joey tied up outside and threw dogfood on the ground when he thought of it. Eddie had a girlfriend in town, so he wasn't home much. One day he told Dad that he could no longer keep Joey and had taken him to the pound. Dad sprung him in the nick of time and he became our dog. When my husband went out to Ohio to plant trees, he'd take Joey along. On one of these visits, he stopped the car to talk to Ralph.  "There's my old pal!" Ralph boomed, reaching into the car to pet him. "Grrrrrrrr," said Joey, backing away.

During the eighties and nineties, no one in our family allowed deer hunting on the farm. We found out later, however, that Norma issued hunting "permits" behind our backs, collecting fees from all comers. My husband never knew about this until the game warden called him in Maryland to ask him if he wanted to press charges against a group of about 2 dozen hunters he caught trespassing on our land.  Norma was playing a risky game. One guy--a local legend-- refused to pay her fee.  When Norma told him he couldn't hunt, he cooly raised the barrel of the gun and pointed it straight at her.

Even after she moved into an assisted living facility, Norma continued to share ownership of the land with us in her own peculiar way. Our sister-in-law recently asked a group of strangers what they were doing on her land. They said, "Oh, Norma told us that we could hunt for mushrooms here."

Off to Peek 'n Peak Tomorrow

Tomorrow I'm driving to Peek 'n Peak, a family resort in southwestern New York state, to attend my niece's wedding. I'm looking forward to a reunion with my four sisters. Three are actually half sisters, but they are all sisters to me.

First stop along the way will be Valencia, PA, to visit BF. She is the sweet woman who boarded a Greyhound near Pittsburgh three times during the past 18 months to come down to stay with Mom while the Tree Hugger and I went away for long weekends. I'm giving her Mom's service-for-six sterling silver.

We won't discuss politics. The last time the TH picked BF up at the bus station (October 2008), he said, "Might as well tell you. We have an Obama sign in our front yard."
"Oh, said she, "he's a Muslim."
"No, he's not."
"Yes,he is."
"So I suppose you're voting for McCain."
"Yes, but I'm not that crazy about him. I really like Sarah Palin though. If Hillary had won the nomination, I would have voted for her."

Since we won't be discussing politics, we won't be discussing health care reform either. BF has private insurance, but she's not happy with it. "They don't pay jackshit," she says.

Then on to Meadville, where I'll visit my 90-year-old Aunt Virginia, who's in the Assisted Living Center at Wesbury United Methodist Community. Aunt Virginia, who's about 90, lived alone until this June, when my cousin, Harry, realized that she was getting forgetful. Pots boiled dry on the stove, bills unpaid, etc. Mom and I used to stay with Aunt Virginia when we came up to Meadville so Mom could visit her friends. I wonder if Aunt Virginia will still recognize me.

Finally Peek 'n Peak. The wedding is Saturday evening. On Sunday, we'll regroup in Erie, PA, at the home of one of the sisters.

On Monday, my sister Barbara and I will visit our mothers' graves at Greendale Cemetery in Meadville. Both our birth mother and my stepmother are buried there. It will be the first time I've seen Mom's grave since her death in December. She's buried beside our dad. Our birth mother, who died ten years ago, is buried beside her second husband.

I'll be home by Monday night. Summer day camp will have ended for our grandson and school won't have started, so he'll be with me all week. Maybe we'll go see the dinosaurs at the Museum of Natural History.

Grandma Goes Grey

Actually, I began going grey long before I was a grandmother. It was really annoying, because the best feature of my fine, limp hair was its shine and color. I called it dark brown. My friend insisted it was black. "No, " I said, "I'll tell you who has black hair. It's your sister, Dodie." "That's what I mean, " she replied. "Your hair is black, just like Dodie's." Whatever.

In my thirties, I started using Clairol's shampoo-in haircolor. By my forties, I was having semi-permanent haircolor applied at a salon. By my sixties, I had become so grey I needed a stronger product. The question was: could my baby-fine hair withstand the harsh chemicals? After two or three months and much breakage, I had my answer. My stylist cut it as short as she could for the growing-out phase. As new silver-grey hair came in during the next six or seven months, the remaining color faded from brown to an ugly orange. I was a sight. My sister took one look at me and laughed. "Now you have hair just like Ginger's," she said. Ginger was Barbara's orange-and-white Brittany spaniel.

Meanwhile, at work, our team had enjoyed a small success. We were invited to brief an important agency official on our project, along with teams from eight other offices. I went first. After my 3-minute talk (with slides!) was over, the Big Chief said, "I have to leave the room for a minute. I need everyone to hold their questions until I get back."

When he returned, he forgot all about the questions and went on to the second briefer. Later, I told my team chief that I was a little disappointed about that. "Oh," replied Kurt, "He just wanted to spare your feelings. He knew the question everyone was dying to ask was, 'What the hell have you done with your hair?' "