A couple of weeks ago, I made the somewhat premature, and possibly ill-advised, decision to book myself onto a yoga class, and I have to admit that, all things considered, it was quite an odd thing to do taking into account that I am currently unable to even manage the most basic of asanas well. I remain puzzled about what on earth was going through my mind at this particular point in time, but as with the majority of my ‘decisions’ of late, I had a fair level of reassurance that I would most likely bail at the last minute anyway – ‘unreliable’ has become my middle name over the past few years. I’d even gone as far as to phone the teacher beforehand to warn her of my various physical limitations, perhaps in the hope that she would refuse her consent to me attending because I could turn out to be the biggest liability she’d ever had to deal with; however, no joy there either, and she suggested I came along to give it a whirl. Meanwhile, my head was busy reassuring itself that I still had numerous reasons for not showing up: waking up and getting up on time is still quite a major achievement for me, swiftly followed by the level of pain and stiffness first thing, whether the pills kick in on time, and when they do whether I’ll be too wasted to do anything much at all. And even if I managed all of the above, I would presumably have raging anxiety levels which would make it impossible for me to go somewhere I’d never been before and be surrounded by complete strangers. So, I slept well that night, safe in the knowledge that I had numerous genuine reasons and lame excuses already in place, and assumed I simply wouldn’t manage it which would probably be the best outcome for all involved.
Yoga is interesting stuff, and I’ve practised it intermittently for many years. I should, perhaps, add here that I’ve never felt the physical / psychological / spiritual/ transformational uplift which many yogis / yoginis apparently do experience, but in the past my relatively brief periods of doing yoga regularly have produced positive physical and psychological results. I first tried it during late pregnancy, and found it helped with respiration, relaxation and flexibility. I tried it again a few years later, having discovered that I would need to wait many years before my knee replacement surgery could be performed so to try to retain as much flexion within my leg as possible in the meantime, and then again a respectable period of time after surgery. And finally, I drifted back into it a few years ago, during a more frantic search for some level of reassurance that my body wasn’t escalating wildly out of control, before having to admit that actually it was and I needed more surgery. It seems that there has always been some benefit in my practising yoga on a regular basis, so why do I never stick at it? If memory serves correctly, it is a combination of things – firstly, and perhaps inevitably, the changing levels of mobility and pain due to my arthritic condition; secondly, my psychological issues with depression and the accompanying lethargy, lack of motivation and decreased energy levels are hardly conducive to such practices; and finally, dare I say that perhaps it’s my personality which is at odds with it, my impatience and my lifelong inability to stick at anything for very long before flitting off and diving into my next fad?
Anyone who has ever tried yoga will probably tell you that it’s hard work – really bloody hard work. Yes, it all looks very lovely and a bit freaky, but just because no-one ever leaves a class with a scarlet sweating face and gasping for breath doesn’t mean that it isn’t a major body work-out. Again, this is what puzzled me about why I booked myself onto a class – surely, after all the aches and pains of the past few months, why would I want to put my body through something like this?! I guess the answer lies in the fact that I am so totally sick of doctors, surgeons, hospitals, physios, and all things clinical. I think the answer is that I realised that I needed to do more to get my body working better, to build more stamina, to strengthen core muscles etc but also that what I wanted was something which was interesting, nurturing, and was more holistic than the traditional post-surgery recuperation strategies. One of the purposes of this blog has always been to consider a more humane perception of the physical and psychological impact of arthritic conditions and treatments, and how clinical approaches to recuperation are limited simply to physiological expertise rather than a more supportive and holistic approach.
So, did I actually get myself to the class? Yes! Much to my amazement, I did manage to get myself there, and have attended a further two since then, although it would be fair to say that one was far more suitable than the other. I even managed to complete some of the asanas with varying degrees of success, and am now trying out various local classes to find something which works best for me at the present time and with my current physical limitations. It’s tough and I feel absolutely battered for a couple of days afterwards, but I have learnt a lot about the current condition of my body and its limitations. I have also learnt something rather curious about my psychological state of mind. As often happens with me, my anticipation of how I will respond to any given circumstance or situation is not necessarily correct, and this is precisely what happened with the first yoga class; I expected to be too shy / nervous / anxious to attend, but actually the opposite happened. As I have said previously, I don’t really do ‘anxiety’ or if I do it’s usually a specific situation, most often if I have to go somewhere I don’t know and where I don’t know anyone. The first yoga class had all the elements I avoid like the plague whenever possible, however, I did manage this with relative ease, most likely because the state of my depression is, at present, in the “couldn’t care less about anything” phase; it was by exploiting this which enabled me to get there and do that thing. I’ve figured that this is actually something really useful to be aware of, and if I genuinely don’t care, whatever happens or if something goes badly pear-shaped, it won’t bother me because it doesn’t actually matter. It’s empowering, although for all the wrong reasons, but is progress of sorts I think.
My habitual hunt for interesting images today produced the pic above – yes, it’s unusual for a yoga photo, and thankfully, no effortless flexibility or smugness here. The image in itself spoke volumes to me about my own shortcomings regarding yoga practice, but the article is also worth a read. Rage Yoga, if you haven’t heard of it before, is the complete antithesis of the usual practice of yoga, and I’m both ashamed and possibly proud to say that maybe this is a type of yoga that I should consider and start tweaking my practice to accommodate a lot more swearing and regular beer breaks?
So, tomorrow I will be back again at my local, very calm and polite class – forcing my body to do stuff it really would rather not given the choice, channelling my anger and frustration into asanas, and trying not to swear out loud. To any yogis and yoginis out there who might be reading this, “Namaste”. And to anyone else who happens to practise Rage Yoga, “Namaste, Motherfu*kers!”
I don’t know about anyone else, but I find the world to be an incessantly noisy place. And it isn’t just the usual suspects such as the internet, social media, mobile phones and generic media, but people too seem to have become extremely noisy over the past decade or so, almost like they are no longer capable of dealing with stillness or, worse still, silence. I really enjoy both stillness and silence, I enjoy being alone, I am entirely comfortable in my own space, and can easily spend long periods of time alone, quite comfortable in my own company, so much so that I actually prefer it a lot of the time. However, I am not immune to everything and there is one area of my life where I feel a desperate lack of interaction and a need for something to change.
I struggled to find an appropriate picture to accompany this post. I find this curious considering how much stuff is floating around out there, and yet I have spotted a screaming black hole in the relentless services of Google images. The intention of this post is to discuss the link between physical pain and mental health issues, yet all the internet seems able to provide visually are some cringeworthy memes which appear to place physical and psychological health issues in some strange kind of competition with one another, rather than accept that, in many cases, they are inextricably connected. More disturbing still is the fact that this attitude is too often reiterated in real life, with medical professionals consistently failing to assess the impact of mental health issues on patients with chronic physical conditions and vice versa.
Historically, the wearing of a hair shirt was a form of public and private self-punishment, an itchy and uncomfortable garment for the purposes of cleansing the soul of its many sins and instilling humility into the wearer. In the weeks following surgery, there is invariably a period of time which I refer to as The Wearing of The Hair Shirt which will be discussed below, alongside concerns relating to whether this post-surgery period (when, let’s face it, you feel really seriously shit and are already dealing with mobility issues, pain and trauma) is a good time to be putting yourself through the misery of abiding by the strict rules of hair shirt wearing.
Tomorrow is the first day that I can avoid this no longer; tomorrow my bandage will be taken off, sutures removed and there it will be, in all its hideous glory, The Big Bruiser #2. This time last year was the first of these wounds that I’d seen, so I’m assuming and hoping it won’t be as much of a shock this time around. It was bigger than I expected, as well as lumpier, uglier and more bruised, but what really stuck in my mind was how like a lump of raw battered meat it looked. My daughter came along to photograph it – yes, we’re close like that, we enjoy sharing gory stuff – and even now those first photos of it fill me with a feeling of extreme nausea. But, then again, as I keep telling myself, it’ll be much easier this time round because not only have I done this before, it was also very recent. Which begs the question, why aren’t I handling the whole situation better?
By freedom, I mean being able to be independent, to drive wherever I want whenever I want, to do stuff alone without having to have someone with me to help me do the most basic and mundane of tasks, to have some semblance of control over what goes on and what is possible, and to not be housebound and needing someone else’s co-operation, permission or approval to venture out. For me, this is the stuff of nightmares. I hate being dependent on anyone, really hate it; it embarrasses me, humiliates me, frustrates and angers me. I’ve never been especially good at asking for help, which is probably why I find this so difficult, but there’s a big difference between the normal scenario of asking for help with tasks which no mere mortal could manage alone, and asking for help to get up or down from a chair, to support you as you attempt to go up or downstairs at snail’s pace, and to ask for help getting on shoes, socks and even knickers. The latter situation will be my joyless existence for the next few weeks, and I feel massively irritated at the prospect already.
knee joint, had spread into both hips and my lower spine. It was sufficiently severe to require an immediate total hip replacement in my left hip. I was extremely shaken by this unwelcome news, and was still struggling to understand how this had happened, and perhaps just as importantly, how this had happened without my being aware of it even by the time when the surgery went ahead. A year on, and I am still rattled by this and have continued to worry and wonder about what could possibly have created such a situation? After all, I’ve spent many years struggling with pain, waited a long time for a knee replacement which offered the prospect of normal levels of mobility and an end to the pain, and yet here I am, after several decades, feeling like I’ve not only made very little progress, but am actually further away than ever in achieving a relatively mobile and pain-free existence. I suppose I’m a ‘logical’ kind of person, one who requires cogent reasons and hard facts to make sense of things, and I have never been able to accept “ah well, that’s just how it is” as any sort of explanation for anything. I decided to write this blog for a couple of reasons. Firstly, to get all this stuff out of me and written down, so I could take a closer look at what had happened and try to figure out why – if I can find the source of the problem, maybe I can find a solution or at least manage the situation better. I really don’t want any more nasty surprises like last year, and by gathering all the information together does it actually make it easier for me to make sense of it all? Secondly, I’m very aware that I have a huge amount of anger about having developed OA, most of which is suppressed, but some escapes into the real world every now and then; I hoped that by blogging I would manage to remove some of this anger, but so far I have found that in writing everything down alongside doing online research, I have actually created a complex jigsaw of events and situations which, at times, actually makes my anger worse.
This image shows a healthy, normal hip joint, and if you have been diagnosed with arthritis in your hip(s), the clinician will have noted that rather than there being a nice healthy space in the ball-and-socket joint such as in this image, there will be a narrowing, or if you’re really unlucky, no space left at all and bone-on-bone contact. The arthritis in my left hip was discovered late, too late really, and was immediately classified as ‘severe’ so I’m afraid I haven’t seen any images of the gradual deterioration and intermediate phases which occur; however, what I have seen is an image of my hip from a few years earlier which has been incredibly useful for comparisons of ‘then’ and ‘now’. In my case, my hip changed from something similar to the image above, to something akin to the image below in approximately 5 years. Without wishing to alarm anyone or to incite some kind of arthritic hysteria, I can assure you that this is not the normal rate at which the disease progresses, and the majority of OA sufferers experience a much slower deterioration over a period of a decade or much longer before surgery becomes necessary. It appears that my OA is aggressive, and judging by the flustered responses of specialist clinicians to my test results, I suspect that it is unusual in its enthusiasm and pace. 
The previous one, a few years earlier, had been a ticking time-bomb for many years so was entirely expected; eventually, my life ground to a complete halt, and I found myself unable to walk, drive or work, so surgery was duly performed. This more recent crisis was different. Firstly, it was unexpected. After all, I’d finally got the much-anticipated new knee joint, and although it wasn’t as amazing as I’d hoped, it worked far better than my creaky bones had done before. My GP had gently advised that I would most likely always have some issues within that knee or leg, but to keep taking the tablets was all that could be done. I took this as reassurance that the worst was now over, and that my then-existing levels of mobility (which were OK and enabled me to have some semblance to a normal life) was what I could reasonably expect until the replacement wore out in 10-15 years’ time. Apart from Bastard Knee / Stupid Leg and depressive episodes (most often related to pain management issues) my health was very good, I seldom even caught a cold, and only rarely visited my GP for any other health problems. Secondly, this crisis episode was more subtle, gradual, sneaky even. Gradually, over a period of a months, all manner of strange ailments slowly appeared but didn’t disappear with time, as I’d hoped they would. I started experiencing widespread aches and pains all over my body, suddenly both legs seemed to be unstable, weak and achy, and my arms were especially painful, with shooting pains going their full length right into my fingertips throughout the day and night. My limp became more pronounced, although I was no longer sure which leg I was actually limping on, my arms hung limp and heavy by my sides because it really hurt just to raise them, I dragged my body around like a leaden weight, my depression level plummeted back into ‘severe’, and I felt completely exhausted most of the time.
By now, my health and mobility had been slowly but surely deteriorating for around 2 years and with no sign of any solution from anyone anywhere. However, one cold dark January morning this all changed – not because of some medical genius intervention, but because I somehow managed to accidentally overdose on my opioids that morning whilst getting ready for work. I’ve never been a ‘morning person’ and am damned useless until around lunchtime anyway, but I got extra confused that morning about how many and which pills I’d taken; the pain was horrific so I must’ve concluded that I hadn’t taken the opioids yet so took more, and ended up taking double my normal dose. I realised as soon as I got to work, and ended up going home again to sleep it off, no harm done. But, this incident acted as a real wake-up call for me – it was partly the realisation that I was so bombed out all the time on opioids that I had little idea of what I was doing or memory of what I had recently (even within the past hour) actually done, and partly that I was experiencing horrific pain which was actually getting worse despite a massive increase in dosage compared to previously, and the pain clearly wasn’t going anywhere. So, I did what I always do at such times, I had a massive tantrum and decided I wasn’t going to keep taking the damned tablets, I was going to stop, there and then. And I did, just like that – which was a huge surprise to me because, having been taking opioids for around two decades, I did suspect that I was probably addicted to them by now and would find it difficult, if not impossible, to give them up. The other interesting thing which happened, which took me completely by surprise, were my expectations of myself, my mobility and my pain having made this somewhat desperate decision. Here, I will make a brief diversion – please bear with me…
chapters to write before we do get there. Reaching The Present and being able to write about what’s actually going on currently still feels just out of reach. It’s interesting how frustrating this can feel. In my head, I’m aware that my experiences of Osteoarthritis have gone on for a very long time, but somehow I have had this mistaken belief that I can just write it all down quickly before moving on to the present day, where my thoughts, feelings and experiences will be a lot easier to record since they are part of my present. Somehow it hasn’t worked like that. Dredging up memories and trying to assemble them into a combination of complex and accurate facts and a readable tale isn’t as simple as it would seem, and it’s something of an emotional roller-coaster as I find myself reliving times and experiences which, if I’m honest, I would prefer to forget. I continue to be amazed at how much and the level of detail that I do remember.
Bare Bones 