Friday’s Poem: Coming To/Coming Back

It’s not the time of suffering that lingers.

Like all animals who fall, wounded,

I acquiesced to the howling lameness

that demanded laying down

my bones and sinew.

And, then, again.

Again. Again. Every step a boobytrap.

But it is incremental, the resurgence of life

juice trembling in my anemic blood.

I watch the black-red iron drip from

pouch to vein and pray for power returned.

It is rarely the shock of the earliest days

that chases me in daylight

or permeates my dreaming.

It is this rolling aftermath of

complications, the coming to, coming back

as mind and soul are prodded to more work.

I peer into the long blue line

of the distance, looking for myself.

The leg that was strong has been hobbled.

Can I recall its nimble sleekness as I danced?

The strength that carried me deep into mountains?

The boldness when making a trail where there was none?

Before the carving out of my own-ness

and replacing that with titanium–as if

I wanted my knee to outlive me.

But if it must be a balancing act,

foot to ground, hand to heart,

it is what I will learn to do. Blast those days before;

this is what I have, what is given.

It’s the present that inhabits me, directs the way;

the deficits, progress, minute degrees of change.

I will seek my body singing.

I will own and praise it.

Take to smooth or rutted trails,

walk off the ache and embrace the views.

I command my knee to bend,

my leg to swing out, up, down.

Imagine myself a whole woman,

a woman welcoming herself,

better than yesterday,

as good as before:

I am still a traveller on a pilgrimmage.

I know how to root out truth and brook no lies.

The bare facts of living here and now set me free.

Yet it is like this: flailing forward

as if through brambles then having to pull back,

then striking out again even as

each blackberry scar softens, fades.

The ones left by the surgeon’s robot

chill me even now: the things that

happen beyond our control.

How was I remade into someone unsure?

Not born afraid but curious.

And so I am going, watch me try to go

unnoticed, not missing a beat.

Just a part of the moment,

a brush of wings into leaves and light.

So there she is/I am, the river’s breath

ribboning my hair, voluptuous flowers

bobbing as I pass, and the leg that is

not my best leg (but begs to be mine entirely)

rising up, stomping through swirling pollen,

that sky as potent and open as God’s Eye,

my body listing, leaning into the bravery

that comes with summer.

This body shimmies, strides, stumbles.

My awkward crooked salvaged leg

is alive at every juncture of the path,

will become more itself right down to the marrow,

and in these gaps between desire, hope and healing.

Pt. IV: Tales from a Surprising Knee Surgery (Leaning In, Looking Forward)

Relieved to be back home, I was able to return to our second floor without gasping for breath or feeling that strange chill of too little blood flow to head and extremiities. It signalled a new phase, I hoped, and was pleased to feel able to further right my world by tidying a bit like an ordinary person. I lay down on my blue quilt, staring out windows that framed dark green pines towering above my view. It felt luxurious. As if I had stepped into an unreal, happy vignette. Could this be a better life? Marc made a pleasing meal and we watched a little TV, but then I was ready to turn in. The balm of sleep at last!

The same day following my return home, Naomi and her partner, Adam, came by. He’d flown in from Colorado the night before; it was an earlier planned visit like my daughter’s. And it also happened that my brother and sister-in-law were coming for a couple of days on their way back from an L.A. photography workshop. I had expected before surgery to be in good shape by March, not limping along, poorly recovered. And I wasn’t confident about having visitors yet. But it was a happy occasion to be with my family. Everything worked out well enough. I sat alot rather than head out for energetic jaunts as would have been usual.

Mid-week we had a bigger family meal before folks flew out. Naomi and Adam generously shopped and prepared food. My lovely sister-in-law pitched in. It was a bit tiring yet relaxing, ultimately a replenishment–such is the presence of palpable love. They were pleased I was upright, independently mobile, and interactive despite the sore, knotty knee. Despite troublesome weeks. I didn’t bother to try to pretend it had been otherwise. We could all see progress being made. Even if I was still very pale and bleary-eyed.

A physical therapy session also took place the day after I returned. I was grateful the therapist was easier on me after I explained what happened. The following sessions we got back on track. I did more work, faster, than I had before. I nearly hit the 120 degrees of flexibility. That felt triumphant.

I saw my orthopedic surgeon, Dr. G., two days after the discharge. He knew about the hopsitalization and noted I’d had challenges. I had wanted to share my litany of horrors. Tell him how I had sometimes just hung on. But he had done this work for 35 years and simply examined my leg and knee and declared everything in good shape–the incision well healed, and the blood clot properly addressed. He was done with me in ten minutes. I wanted to be angry with him and to feel “dismissed” although I knew this is more typical than not.

This surgeon has garnered many accolades; when a friend recommended him before an imminent retirement (he retired since that check up), I’d booked my apointment. Dr. G. didn’t create the steady stream of complications. I was medically “unlucky”, experiencing problems a small percentage do. There are risks to any major surgery. In the end, he told me I was ahead of the usual schedule with great knee flexibility and stamina at just five weeks. I could drive again; I could take longer walks. It thrilled me to hear and I sailed out of the office.

I saw Dr. Patrick, my cardiologist, the next week. I was informed I’d be on the Eliquis, a blood thinner, for several months at least but no aspirin (as it is another blood thinner). I imagined the blood in my veins rushing and roiling like a spring creek with such a thinning out…Then we decided to change an old beta blocker to a newer one to see if the break-through arrythmias diminished. Rather than report on all of the next ten days, the summary: the opposite effects occurred than what was to happen–of course, one more thing— and I returned to my old medication without further issues. Chronic pain, exhaustion and general stress can upset the heart. I dearly hoped mine would calm down. And it has.

As I write this, it has been another five weeks since the transfusions and critical repair. Nothing else terrible has happened. The longer I feel better, though, I also wonder if something else is about to go wrong–then pull myself back from that precipice. The worst times of moaning and crying are receding little by little. The experiences are embedded in my brain, but in time they will just be another small portion of the remarkable landscape of memory.

I awaken not feeling worry but anticipation of a decent day. I do check my knee as soon as my eyes open–is it too hot, painful or sensitive? The answer has been “negative” so I get going. I remain anemic; the numbers I want to see are distant. But the hemoglobin was last at 9.2, an improvement though not the 11.2 that’s a low but acceptable number. Red blood cells are still lagging; I have another blood test soon. I’ve been assurred it takes awhile for them to repopulate after such a loss. I am tired after doing chores and breathless when I climb stairs or take walks–some days. But this is less so than three weeks ago, than even last week. Some nights that healing knee desires to bend more, to stretch better and turn and twist–then twinges and shocks awaken me. But I know healing is happening without my full knowledge. The bone, sinew and blood are reparative in action, doing complex work every moment. This generates heat, soreness, swelling even as the prognosis improves.

I still talk to my knee. I apply lotion, smooth out tight bands of muscle, the long reddish scar. I say: you are something to behold; you are a miracle of rejuvenation; a testament to God’s powerful creativity; a blessing to this body.

My oldest Oregon friend, Brenda, toughened by her challenging life– yet possessed of a great tender heart– checks in often. She was so anxious about my state of health that she contacted me daily. She has endured many surgeries and survived difficult illnesses. But she recovers enough, gets back on her feet. She still works full time–counseling prisoners. She possesses soul, gusto, and is one of my heroines. “We’re still here; we’re in that crazy company of long-term survivors. We’re older, crustier; we have to be here for each other.”

I’ve been kept safe during tidal waves of fear and confoundment by indomitable forces of caring. I even am fortunate to have three newer women friends who have visited, checked in, brought me homebaked muffins, full dinners and flowers, and who continue to cheer me on. None of them are free from crises; none are defeated by difficulties yet. We fall and rise and fall. One friend–a serious adventuress– has gone walking with me despite having been hospitalized for a respiratory virus and lingering asthma. We look for opportunities to enjoy ourselves. Being seventy-ish is certainly not the end of good times. Age is barely noted as we embrace each day. Today we are hiking at a state park. I am not sure how well I will do–but we’re heading out. I know I will love every moment.

It is good to be beloved by friends and family. To know that the universe which holds a world so often harsh and cruel is also redemptive and restorative. That there is a synchronicity and symbiosis we must respect. That amazes. We are here to do the work we can do and to find it beautiful and valuable enough. For me, living is predicated upon the connection I have to a boundless energy of love known as Divine Creator, Almighty God.

I can walk the greenery-lined paths now, bracing for hills, keeping eyes on sky and trees. I’m a little clumsy; my right leg can oppose my intentions in an instant. I’m pleased I can climb up and down steps one foot after another; manage a shower in record time; get up, sit down; do daily tasks that were not long ago too taxing. And driving my little red car with the sun roof open to the bright air! I’m able to meet a friend for croissants and a mocha, or just take care of business. Self sufficiency is a tonic to the soul.

Spring blossoms send me into quiet elation. I’ve been down to the river to view its turbulance and tranquility, to hear nature’s wild, harmonious music. I’ve sat in a sliver of sunshine on the balcony, watched pine and maple branches shimmy. I’ve wondered over our hummers at the feeder–such powerful, tiny bodies that put mine to shame. They don’t quit; even rain and wind don’t deter their flight and daily endeavors. If in need of rest, they sit on the feeder under the eaves and simply rest, watchful but calm. What a delight it is to be on the periphery of their world, to watch and learn.

Loss can sharpen the human need to value life more. And to share it more generously. From the depths can arise a new semblance of wholeness. The good thing about being unwell is what it feels like to get better: scrubbed of illness and with it, so many trivialities. Extraneousness and superficiality are poorly tolerated.

I’ve embraced an extreme passion for life ever since childhood. My young friends could find me a bit too intense. I often felt like a poet-vagabond in a world of constructs that meant nothing to me compared to constellations spanning the beyond. I thought I might burn out by thirty, the flame within was so hot. But intensity also fuels a stubborn desire to keep on despite the odds against success. I will keep exploring the soul’s mysteries, remain present within depths of mind and heart. To celebrate the perfection of bones, the heavenly earthiness of blood, skin and nerves. This tent I live in has been torn and repaired often. There is enough common sense combined with courage to utilize, after all. Hope remains a golden wellspring. I was born to the revelations and nuances of this journey, and one day–not today, I pray– will take my leave convinced this human life is a miracle to be believed.

I would very much hope the same for you.

(Click on photos for captions, if desired.)

Pt.lll: Notes from a Surprising Knee Sugery (Slipping Away, Heading Back)

The appointment was just a check-in regarding the blood clot and attendant ER visit. The atmosphere became easier, calmer when Dr. S. entered the chilly room. He asked specific questions about all post-surgery events, listened closely and checked my electronic medical file. His accented warm voice gave me pause a few times so I leaned in to better understand him. He seemed to possess two sought-after qualities: compassion and investigative skills. As a consequence, I felt safe sharing authentic experiences.

He was openly irritated that I’d been unable to meet with my primary care doctor after surgery, considering the crises. He spoke of the great responsibility to patients and how that can be misplaced amid hectic days and administrative work. But he and a few other like-minded doctors in the clinics kept open appointments for patients unable to see their own doctors, those who needed help sooner not later. I thanked him for this viewpoint and his availability but he demurred; it was his life work, what was necessary. He looked away a moment.

As the time came to an end Dr. S. asked me to remove my mask. He edged his stool closer, studied my face.

“You are much too pale, Mrs. Richardson. Your eyes do not look good. You look quite anemic. Please go to the lab immediately to get blood work done. I will let you know the results today.”

His adamance gave rise to anxiety that I set aside. It was a blood draw. I had had many recently. He might find I was a bit anemic; it had shown up sporadically over the years. And I had lost weight after surgery though was doing better with food.

At dinner time, Marc and I were chatting when I noticed there were two voice messages on my phone from 2-3 hours earlier. I’d forgotten to turn the sound on following my appointment.

The message shook me. Marc watched my face and put down his fork.

“Mrs. Richardson, I have been trying to get in touch with you. Your blood work indicates you have seriously low hemoglobin. You are in danger. You must go to the ER immediately to get blood transfusions. Please do this now; you could pass out or far worse.”

I played the message for Marc. We abandoned dinner, put on shoes and coats and left for another ER visit. I was, this time, frightened; we didn’t speak much on the way. I had told him Dr. S. was special. Now I sensed it was no mistake I saw him and no one else, and also when I did. I prayed for strength as my body trembled. I insisted Marc take me to the very best hospital, though it was 10 minutes farther and the highway was busy.

Inside, the numbers of people waiting to be seen was overwhelming. They stood in clumps; they lined the hall in various states of dress and degrees of composure. I couldn’t think of how long we’d wait. After I checked in and gave the details, I had more blood drawn. Then we were directed to an area to wait to be called. We passed large groups and lonely individuals in cordoned-off areas, many coughing or moaning, leaning against each other, some lying on gurneys shielding their eyes from the flourescent glare. I wondered how many had Covid or worse. Heart-rending children’s cries pierced me. As minutes ticked by, I was starting to feel more light-headed, oddly out-of-body. I leaned my forehead on a chair’s back as Marc held on to my shoulders. My operative knee complained much more; there was nowhere to prop it comfortably.

In an hour a nurse came for me, and in the ER room action was immediate. The lab results were in. My hemoglobin was noted after Dr. S’s initial lab visit as being 6.5. At the ER it was at 6.2. The standard range for this is 11.2-15.7. A doctor said I was bleeding internally. There were too few red blood cells to carry oxygen from lungs to my other organs, then the carbon dioxide back to the lungs to be exhaled. Hence, my sense that I’d fall down. But I was in a bed; I was hooked up to fluids and the nurse was calling for two bags of blood from the blood bank. Transfusions ASAP.

A blood bank… I mused. Where people’s donated/deposited blood is kept safe for withdrawal for the next patient in need. A precious commidity. A treasure to protect. A crucial lifeline, yes? I fell into a dreamy state punctuated by spikes of alarm.

I have rarely been so worried in an ER. I wasn’t sure about getting someone else’s blood; it was foreign to my body, a desperate act. I signed papers agreeing to it as well as a consenting to intervention for cardiac arrest if needed. The dimmed lights added to the sense of being captive in between states yet soothed my body. My mind drifted. Marc stood by; we had run out of talk. But I chatted with the nurses, joked sardonically–“Third time in an ER in just over 4 weeks, I’m setting my new record!” They were calmly focused, repeated it was a critical situation. I would, however, feel better in a few hours, they insisted. If all went well.

I was in that cave of a room for about 24 hours. I was taken off aspirin and Eliquis, a blood thinner for the blood clot in my calf. Another ultrasound showed the clot was no bigger and hadn’t moved. Within a couple hours a donor’s hearty blood was mixed with my unwell blood. I was informed that some people cannot tolerate other blood, had allergic reactions. A nurse had to wait with me for fifteen muntes to ensure my safety. I sighed–I so often had reactioons…but waited to feel it enter my arm and bloodstream. There was a burning sensation, then a coldness that eased as it mingled and coursed through me. It would be okay. I began to doze. More doctors and nurses came and went. I woke up when at one point there were 8 physicians and medical residents crowded in the room. St. Vincent’s is a teaching hospital. I don’t recall what they said. I was floating; words sounded empty of value. I was at last transferred to an intermediary care unit until it was determined if I needed full admittance. The hope was that I’d be treated in a more limited capacity. It turned into 4 days.

A private room; a shadowy, clean, quiet room. Safety of a sort. A nice recliner for Marc to doze in. The nurse assigned was soft spoken, moving gracefully about. I was told I could not eat or drink anything as next on the agenda was an endoscopy to view my stomach, and after that, if no bleeding site was found, a colonoscopy would be scheduled. I have had both several times in my life due to digestion illness since my teens, so this was not unnerving. It was imperative to find and repair the bleed–but it was more to cope with and I wondered how I could manage it. I could sleep a month. Of course, in a hospital nobody really sleeps.

That same day I went admitted to the Clinical Decision Unit was, coincidentally, was the very day my oldest daughter, Naomi, flew in from the East coast for a planned week’s visit. And so, her first sight of me after 9 months was in a hospital bed with IV lines, disheleveled, wane and yes, likely frail-looking. It was not a joyous occasion as had been expected with a giant hug proffered and returned. She gently placed her arms about me. I wondered if she thought: well, mom is really old now, isn’t she?…

I wanted to pull the covers over my head. One of the hardest things about the post surgical complications was that my children and grandchildren might think me terribly diminished. It wasn’t vanity but a fear that they’d iamgine me less than before, as not the same woman/mother/grandmother. Weaker, less able-bodied and mentally and spiritually capable.

She said, in keeping with her ways, “Sprang a leak, huh, mom?” Her bleary eyes and soft voice betrayed worry and sadness. One of her four sisters accompanied her; they provided support to each other. It was Naomi and Aimee, then Naomi and Alexandra. They kept Marc company, took him to the cafeteria for a lunch break. They chatted with me, hands laid upon my foot, arm. I was getting frequent texts from the rest of my big family and good friends. My son texted a drawing depicting healing paths for my body: me, being filled with light and love. I appreciated everyone reaching out. But tossed, turned and dozed, trying to mentally prepare for the early morning endoscopy.

Which, when it was done, showed no sign of bleeding.

My stomach even looked surprisingly good; an earlier diagnosis from years ago was no longer substantiated. I should have been more pleased. But it meant the problem was intestinal. Already depleted, with a throbbing surgical knee, the colonoscopy prep was rough but manageable.

And if the second procedure didn’t illuminate the issue, I would swallow a capsule with a camera in it so a view of the small intestine could be gotten. The very thought flummoxed me.

I prayed with and without words for clarity and safe treatment, smart doctors and any one else who held my life into their hands. We needed an answer. Two transfusions might not be enough; maybe I’d not be discharged soon. A bright spot was that within 48 hours I was feeling more energy–my hands and feet warmed up, my brain was clicking away. The nurses had said those additional red blood cells infused one with new life and enouraged me with words and gentle touch.

Blood–a miracle elixer that mainatains and saves our lives every day.

I’d had little idea until I felt better how perilously ill I had become, saomething every one must experience. When you are at low ebb so long, it is strange to move past that state, like moving from shadow to light.

I’d sensed things were not right but should have known that faintness when walking across a room or even rising from a chair were bad signs. I might have admitted the increasing exhaustion with higher heart rates, unusually cold hands and feet were were clanging alarms. The oxygenated blood wasn’t reaching my extremities; it was feeding vital organs first and foremost, as it always will do. I didn’t see convincing evidence of bleeding that I was told to be watchful of while using the blood thinner. I had questions and once called the surgeon’s office; he said “Not sure this is alarming but stay aware.” Later I learned that older blood appears black or n early so. I felt as though I’d failed to be smart enough. I’d failed to face a possbility of more harm occurring, to take charge when all was starting to unravel. Perhaps I was just too tired.

How much can the body take? Much, much more than one thinks possible. Much more than I was prepared to believe or accept. When I wanted to yell “Enough!”, I instead daily learned more patience. Even when difficulty is gnawing at your last nerve, patience holds you steadier: wait until this passes, endure then wait to see what comes.

The procedure successfully located an AVM, ateriovenus malformation, a significant cause of colon bleeds. The blood thinners (I was still on aspirin until then) triggered faster blood loss. The spot was cauterized and bleeding stopped. I wept in the recovery room. More doctors, blood tests. Instructions, opinions, prognoses (AVMS can bleed more than once; stay cognizant of signs). I drank tumblers of water and paper cups of tepid tea, ate the hospital food hungrily. Communicated with family and friends with happy words.

The next day, a Sunday, I was discharged. My very relieved husband and I were practically singing “Hallelujah!” on the way out. My knee even seemed to celebrate; it hurt less than it had in awhile.

And Providence St. Vincent’s Medical Center would keep humming along, busier than ever repairing and saving others–and caring for those who did not survive. I was one of the very fortunate ones. Rescued from crisis, provided a useful solution and hope. But, too, what was next? Life had come to feel more and more perilous. I hadn’t felt that in decades, since my heart attack at 51 as I hiked blithely along a familiar path. Peril arrives on a ghost horse; you often do not hear it coming.

But then I recalled how God shows up in the smile, hands, in the basic or brilliant acts of humans. How we have such power to help or hinder, love or deny, accept or defy. Those few days at the hospital restored a part of my missing faith in our species. In the medical system.

I had learned even as a child that life held signature characteristics like inconsistency and mystery– and trouble. But tamping down a frisson of anxiety that underlay relief, I opened a car window. Encouraged a damp rush of air to sweep through my hair. Took restorative breaths of nature’s array of perfumes. I was going home, my body salvaged again.

***Next week, the conclusion of Notes from a Surprisng Knee Surgery.***

Pt.II: Tales from a Surprising Knee Surgery (Into a Land of Unreality)

The fourth night home from the surgical center, my heart went into A-fibrillation, the arrythmia that can be an aggravation or a deadly event. I was exhausted, felt ill and my chest hurt so I called 911. Breathless as the heart rapped out its syncopated, galloping beats, and pain radiating everywhere from the knee. The medics couldn’t get me downstairs from the second floor with a gurney and so carried me to outdoor steps, whereupon they asked if I could get down them if they held me under my armpits. I half-walked to the ambulance. Marc followed us in his car.

The hospital ER was quiet, oddly; I was seen quickly. The staff seemed almost listless. But the ER doctor gave me the correct medicines for both nausea and A-fib; things got manageable. I felt more safe to return home after four hours. However, the last moments left a sour taste.

The RN said there were no wheelchairs with feet rests that could be lifted so my legs– the operative one being stiff– could be held straight up. He said in an offhand manner, “We can improvise with a broom on the wheelchair I have, like this”–he showed me how he’d try to rig it, absurdly– “and you can put your leg on top of the broom that you sit on. Or walk to your car.”

I was shocked. My knee stabbed with pain as I walked down the corridors and to Marc in the car. I grumbled about such inefficiency in the ER. Shortly, the RN opened the car door for me, slammed it shut and left without another word.

I was to call 911 two more times in the first 6 weeks due to A-fib. Luckily, things settled before greater intervention was required. My thudding heart went awry in response to pain, nausea, new medicine and lack of sleep.

That night in emergency I had also presented a newly sore, strange looking interior of my mouth, thinking it might be thrush. I had had thrush decades prior after taking three antibiotics for a resistant dental infection, so I knew antibiotics are a common cause. My ER doctor, though, had thought not. But I had been given an infusion of strong antibiotics during knee surgery and again the day afterwards. Antibiotics can wipe out good bacteria, and the effects include fungal infections. I spoke with my dentist. Amazingly, though she was on a CO. ski trip, she concurred with me. She prescribed a strong anti-fungal…though it would likely cause more nausea with GI disturbances.

In the end I declined to take it–enough stomach troubles!– but worried. I could taste nothing, my tongue was so tender that drinking water felt wrong. This was more reason to eat little to nothing. Applesauce. A piece of banana. I lost 6 pounds in 10 days. How was I to start healing if I felt badly every minute? Not to say weaker.

I have a friend, a retired medical professional; she offered a suggestion. She said to try steeping black tea bags several minutes, soaking a cloth in the tea, then wiping my mouth and tongue gently. Black tea, I learned, is anti-fungal and antiseptic. I gave it a try 3-5 times a day. In four days the thrush was gone. I tried to eat, my tastebuds still off. But matters improved each day.

I took anti-nausea medicine longer. The pain from the surgical site robbed me not only of energy and much coherent thought, but my appetite. It was an act of will to drink fruit smoothies, eat more solid food. I had begun to stop the tramadol, the moderate pain killer. (It had created intestinal blockage as noted before; my gastroentrologist helped me get through that.) So, Tylenol was the best I could do. It barely alleviated discomfort. I was becoming slightly accustomed to the deep burn of hurt in knee and leg. But I learned to use a walker when I had to get up.

My life was literally rearranged during this time. I now slept in the living room on a twin bed we moved there. There was no way I could daily get to the second floor and primary bedroom, or back down those stairs. So Marc slept nearby in a recliner. Every night. If I awakened, he heard me stir and was at my side. If I needed to use the bathroom, he was up and at my elbow. If I bolted up in bed at four a.m. racked with tears of agony and despair, he held me. If I began to protest, told him to get needed rest, I was just a mess but I’d be ok, he did not move. He knew I wasn’t going to be okay. Not like before all this had transpired. Not for a long time, perhaps.

It was disorienting at first lying in that bed in the main room, watching night cloak the space in soft shadow and then rays of sunlight seep and spread. And watching juncoes, wrens and sparrows pecking at the suet block under the balcony roof. It was the thing I waited for each day: to observe nature at work. I was thrilled when I got a close up view of a flicker. I gazed through dark emerald pines and bare maples, glimpsed purplish mountains beyond– if it didn’t rain. It nearly always rained part of the day. It even snowed a few days, transforming the view with radiant white. It all comforted me, especially the watery drumming on all like a lullaby.

It seemed like a movie set, the whole thing. I was… myself yet not myself, at all, wandering through a spiral of time beyond time, but captive by my howling body. I drowsed, half-dreamed, twitched and turned with each stimulus of myriad reminders: cut tissue; rearranged muscle, tendons and ligaments; the hammered bones, the titanium objects that made a new and improved knee. Was it? How could all this fall out convince me? My flesh felt heavier at night. Confounding. Something I wished to cast off even as I felt compassion for the animal it was. I was.

But then, hummingbirds– Anna’s hummingbird, the only one remaining through Oregon winters. They hovered at the sliding glass door, peering in while I looked out from bed or recliner. Tears filled my tired eyes when I first saw them come to their feeder. They were used to me sitting or standing outdoors near them. They usually came to greet me and hover before my face , gape at me as I gaped back: gorgeous black shining eyes, surprising plummage. They seemed a good omen. That they’d look inside and see me waving was a joy. Maybe I’d manage to heal, stand on the balcony as they came to vibrate bright air between us. Some day.

In the midst of this, half-helpless the moment my knee was ransacked and replaced, there was physical therapy. No excuses; I had to go even though I didn;t sleep or eat well. Within a week post-surgery, I attended my first session. I had no idea what was going to occur in that tidy room or I might have left.

The PT studied my leg, then grasped it carefully but firmly, saying, “This will be hard; you’ll hate me now but love me later. Your leg looks pretty good but it can’t stay straight, it must bend.”

I have known several hard times medically and violent assaults in the long ago past–but never before have I known that new level of misery. K. slowly but with considerable might began to bend my intensely resistant knee. Ot felt like it screemed. Or it was me as tears flooded my cheeks. I clamped my mouth shut. She paused and handed me a tissue box and said, “It’s ok, cry it out. You will get through it…. it’s just the beginning. “

That would become thefirst thing to get beyond three then two times a week. And the knee with swollen tissue and shocked bones began to relent under her calm extertions. There were degrees of flex we needed to reach each week, before scar tissue built up and impeded range of motion. Not a good thing to allow, sometimes requiring more surgery. She was right; I very much disliked seeing her and was relieved when assistants took her place and I could move onto the next thing. But the worst was not going to happen if I could help it. Some sessions I came close to the degrees we needed; other times I lost ground.

At almost five weeks my bent knee reached the 120 degrees angle K. expected to occur, and it was like winning a grueling event. I’d done it; we’d succeeded. I texted my family and groups of friends. I was fianlly able to see progress.

Meanwhile, there are other exercises to get done. At home I pushed myself hard and learned that taking many deep breaths helped with a prayer. But in time the therapy imbued me with not only soreness but relief and gratitude. I was getting stronger. I was no longer utterly helpless; each action tackled gave me hope. I found unexpected sources of energy and endurance. When I was depleted, it was just there more often than not. I did my exercises every day. Every single thing that hurt so much informed me: do not look back, keep going. Every momentary failure addressed me: just keep going. Each morning I awakened with greater tender swelling so I applied ice packs several times a day. And it concentrated my mind set: don’t you give up; work; recover; be brave–find the courage despite pain and uncertainty. Marc held his breath when I cried out but I shook my head at him: no comfort neeeded now, I was going to be alright.

Pray. That’s what I did every day, too. Sometimes prayers don’t manifest in words. They are formed by soul sounds uttered softly. Or in echoing depths of silence. And I talked to my knee: oh my beautiful, beautiful, blessed knee, may you be brave with me. Does it seem strange to do this? It was necessary. My hands soothed it tenderly after staples were removed and the long wound closed. I let warm water fall over it, a tiny tropical river from the shower as I sat bent over on a shower chair. I felt so old. Frail at those moments. Small, humbled, to be brought to this. But it is not true that one is stripped of dignity when challenged much. Things change and then survival reigns. Dignity is the soul coming forward and embracing the sharp brokeness until it all yields, mends, and one finds a way to become a resilient whole again. No matter what that may look like, at first. There is a complicated harmony within the body’s own mastery and the greater mind that is forgotten in darkest times. More potent than malaise, that sacred symmetry can be restored, secretly, in minute ways. And that is a wonder.

But it was a place I never thought to be. I mean, small, weak and exposed as my husband waited to aid me with every basic need. When did I ever lean on him or anyone else to such an extent? I had to surrender. It was important to have routines. Each morning, afternoon or night, the flow of warm water seemed an annointing. Putting on fresh clothing eased discomfort. It would have been easier to give and an lay in bed, not try harder. But I’d get through the movements and then, eyes closed, I held tight the threads of hope God and I had spun. The ruined knee was learning to bend, the joint and sinew had to resurrect at an invisible cellular level to regenerate stamina. Power. Gratitude mixed with common exhaustion shaped my hours more often.

Without progress I would not make it in this world. I must be able to be outside any time I can choose. To walk and breathe freely. I had to hike again. I had to absorb, face to face, flowers’ breath, run my fingers over sponge of mosses, gaze at the pines swaying in gusts, my long grey hair tossed and tangled: God lived out there as well as within. So I had to move past previously unfathomable hardships. Just deal with a new clumsiness. How strange that one leg would not do what its encouraging twin did with ease.

I placed my healthy leg against the wounded one and instructed: “Heal.” I touched my lips and cheek atop offended knee and felt its heat, which told me that though it was still dealing with invasions from surgeon and the sci-fi-like robotic assists, it was rebuilding.

And my body did its work despite worry or resignation. I felt a stirring of optimism. I told everyone I felt better, smiled more–because I really did.

Then, at not quite three weeks, I felt a more tender, oddly swollen spot on my operative leg’s lower calf and thought: I have a blood clot.

I was right. After an ultrasound I was whisked to ER once more and treated for the small blood clot with a potent blood thinner. I had hoped for a magic shot of a clot buster and then out the door. I was told I was lucky to have a clot in the calf, not above the knee, where it more easily moved up, up, to the lungd, heart or brain. I wondered about the strong blood thinner. I was already taking aspirin for a twenty year diagnosis of coronary artery disease. I’d also had a very bad experience with a previous RX blood thinner. But no one wants a blood clot to migrate upwards. The new medication would help stabilize the clot and keep more from forming. Hopefully. The only thing I had to keep an eye on was any sign of internal bleeding. Otherwise, in a few months the clot would be reabsorbed and no longer deemed any threat.

Does one feel grateful about such pronuncements? I was. I was no longer very shocked by every surprise. Given pause, sure–really, how much more? But I accepted it for what it was: another hurdle now better surmounted.

I went home feeling reassurred. I could keep up my exercises. Time slipped by as I continued on the daily work, as well, of mental well-being–reading, meditating to music, getting outside as the weather allowed, even to stand in the open air. I was busy visualizing healing and wholeness. I was open to all prayers offered. I had visits from friends and family. There were times I felt a sweep of great love fill me.

Marc was less anxious about me as progress was noted. However, I still felt wiped out every day. I often was overcome with a bone-deep weariness accompanied by breathlessness and a cold sensation of sudden weakening as I leaned against the dining room table or sat down on the steps leading to my bedroom. Why was I not feeling more energetic yet? I was sleeping and eating better. My digestion seemed ok with no apparent bleeding–I watched for it. My hands and feet got way too cold, fingertips and toes could go white and numb. I at times felt light headed, almost empty in a physical and mental way. But I was managing alright, otherwise. I checked in with my surgeon’s team regularly and spoke as needed with the GI team. (I could not talk to my primary care provider because she was too busy, no appointments open for weeks, which angered me.)

But something important wasn’t right. I needed more help. The realization filled me with a creeping anxiety. But I did not fully realize what the odd symptoms signalled. Maybe I had to believe that I was going to be well and was in denial. But the next event would be beyond anything the knee replacement experience had presented: a life threatening state.

It was fate– or more likely a bona fide miracle– that a soft spoken, attentive doctor I had never met happened to have an immediate time slot available for a follow-up of the last ER visit. And what he said and did changed everything.

(Next time, Part III of this tale)

Part I: Tales of a Surprising Knee Surgery (Back from Another Brink)

Never did I think this would come to pass, me being a hearty hiker and not so terribly old: now an owner of a fantastic titanium knee. What a marvel! It may nudge me to minor super woman status, even if only in my own mind.

On second thought, not yet. Not even close. I know of many who’ve had knee replacement surgery and after a couple of months are pleased with the result. They get out and about and insist pain is minimal and they look forward to doing more than ever before. I am in awe of such unbridled optimism and growing ese.

But my story is not that story. My story has been harrowing at worst, mildly encouraging at best. A doorway that has led me into territory disturbing and amazing and not fully comprehended. I still am not sure who I was the last couple of months; it was as if I took leave of myself entirely some days. And I am putting myslef back together, still uncertain who this woman is becoming now.

I couldn’t write of it before. There were no concise words, and no will to consider it closely and put it into a structured viewpoint that made sense. It is still a complicated experience that demands new skills and not always appreciated actions of me. Recently there has been a gradual easing of difficulties. It isn’t at all over, but I feel stronger, and am able to clear mind and spirit enough for a pale brightness seep through the veils of darkness, more often than not. And writing enables me to define the path traversed since late January. It assuages a little of the grief and pain as I move through an arduous recovery.

I’m sure there are those who have had worse outcomes of knee replacement surgey. But this has been enough. To even breathe more normally again–literally, symbolically–is a fine gift. And there have been others presented recently.

It has been almost two months since I was thrust from the ordinary world intp another iteration of my life. The commonplace dawn of one early morning when I entered an outpatient surgical center gave way to a miasma of deeply foreign felings and states, then sent me through maze-like passages I had feared but hoped to never know. I am still making my way.

All this for a total knee replacement for a worn out, cranky and unstable right knee. It’s more common that I knew, especially for older persons or driven athletes or those who’ve endured accidents. Many people have confidence in their surgeons, then heal well and move on. But I wasn’t sure til the last moment I even wanted to do this. I asked myself: Why am I doing this? I don’t even want to do it. My body felt so resistant as I took daily walks, as usual, though my right knee sparked with pain off and on. Then I talked myself into it. I determined I need to enjoy many more years of outdoor adventures. As in: until truly decrepit. There has been quite a need for a stronger, more functional knee joint– that, or risk more injury and weakening. I would get it finished, be on beautiful trails by spring.

It usually is worth it for recipients of this elective but major surgery. I tamped down the fear, uncertainty. Yet how would I fare with relentless pain I’d been warned about, and some new medicines? I am known by my doctors as one who has side effects few people get, some bad enough to make me seriously ill. And I don’t do well with opioids for pain control. Plus, I am in recovery, as well.

It was to be a partial knee replacement, that was the good news, so it would be easier to heal. Surprise number one: there was much more damage to cartilage and bone than first assessed, so it became a full one as the surgical team, including a robot, poked around. This was the first thing I heard when coming out of anesthesia. I thought I had misheard the nurse but my husband, Marc, stated it was a fact, both of us stunned.

Above and below my knee are the blurred star-shaped scars left by robotic-assist with surgery. They’re still burgundy red. They carry a smudge of memory as if holding onto the violent action I blissfully missed while afloat far below normal consciousness. The knee scar itself is remarkably better that when first viewed, when the skin was heavily bunched then stapled closed under a very long bandage. Just as if a Frankenstein experiment took place and this was the evidence to be reckoned with from now on. But skin tends to heal fairly quickly. The hard ridge running over my kneecap–is it mine, still, really?–has flattened and faded already. The scar will fade but remain. Vanity is irrelevant; it is what it is.

That early morning it was as if I was yanked from the known world and set spinning away to a place I could not longer navigate. When I surfaced, the air I breathed was shaped by a rough breathlessness, my being and flesh so raw it was shocking. I was imbued with a sensation of earth having tried to pry me from gravity, that I was just hanging on at a distant blue curvature. I was not of myself, nor in myself, not fully within or outside flesh and spirit. Yet I knew my life would never be the same. I felt it hover, sink, gasp, many voices meaningless, the light too harsh, my head spinning with vertigo that would settle in for days, even with medication.

In those first hours as medical staff monitored and aided me, then helped me move from one space to another as was necessary, I just fell into their arms and expertise. My heart went into A-fib, an arrythmia that can become deadly but this time it was not. The nausea and blurriness was central to all. I thought: it is worse than I feared. I vaguely wondered: perhaps death will come, perhaps I will be free of this, but the children will be hurt irrevocably, so must live. Searing pain demanded release as anesthesia wore off despite a spinal and a knee nerve block. But how to banish it? No, it was settling in right in tissue-deep, bone-deep, mind-deep.

I cannot take most pain medicines due to side effects (as I would discover again fully, soon). Not even ibuprophen which my cardiologist forbids. I was lifted up and moved by my armpits, tried to walk to use the bathhoom and demonstrate I was awake and able to take steps. It seemed mad that I’d nbe commanded to get up andstep onto those legs beneath me despite the havoc wrought on my right limb only a couple hours earlier. I did not do well. I was kept there as late as possible at the outpatient surgical center, folded into the car seat.

So as darkness descended, home I went. The post-surgery experience was in earnest, and would become protracted. Unexpected. Despite understanding it was major surgery, the result was nowhere near what had been explained to me.

Then, on the ride home, my husband Marc was so distressed and worried that I had to remind him how to get there, pointing, babbling directions. And I heard my son’s voice in my mind the last time I saw him: Is this the right option for you, Mama? I’d looked at him closely. He felt it, too, the intense reluctance, his own intuition flaring. I said, “I’ll get through it.” But we both somehow knew that something very hard was soon to come.

How could I know for sure that there would be relentless nausea for the first few days and then the gastrointestinal impact of round the clock use for several days of opioid medication (causes constipation). I’d insisted on taking a milder one, tramadol rather than than oxycodone than most patients use. It eased pain just a bit but ultimately left my in great misery until resolved–real life stuff here– with emergency intervention of marathon laxative ingestion. That period the first week, still unable to walk much, was its own sort of hell. I lost 6 pounds in 10 days as I could barely eat even soft foods. I weakened, and using a necessary walker was arduous. How could I know that many events a surgeon hopes will not happen to a patient were still ahead for me? GI troubles were in the end the least of it.

We each have a visceral knowing that brings a strong sense of things. I ignored mine, which tends to lead to unhappiness. I was swept along on a medically informed trajectory that told me: this will lead to a good difference. I needed to surrender and believe it was best so I did. Like a car that is broken down enters a repair shop so it can be made anew–I had to do it. Ten more years to climb the rainforest heights and descend its root-bound paths with security and vitality–this was all I longed to happen.

I had prayed for clarity. I prayed for success of the surgeon and his team and my knee’s willingness to be remade. Body of blood and light, hold me up and carry me on. Mind, heart and spirit, surrender to big change, to even pain, to a healing process that is largely unknown.

One major insight discovered was that post-operative suffering can reach limits not imagined or understood. It can rob your sense of self, alter your perspective of many aspects of life, demand mammoth effort at a big price. It can slash hope and drive a person to anguish that cannot even be voiced. It can wake you up in the night and force you to look at yourself and what you see may be disturbing, even foreign. For powerlessness is frightening. Unless one can give up a bare semblance of control to God and whoever else can help in the smallest ways. And I can tell you my husband was there as never before, attending to me without ceasing, missing work for three weeks, coming to my side when I felt I could not bear another moment. (This sort of dependence on him, which I’d rarely if ever had to experience, strips bare and alters a relationship. More on that later.) I wanted to be braver. But there are moments that bravery is a sham. You simply hang on.

It was just a routine, major surgery. A needed bridge to a reasonably strong and secure stride back into the world–and forests, beaches, wetlands and meadows and mountains. To greater joy in movement. Does this story have a good outcome? Each hurdle has presented itself and has had to be faced. I began to believe I could not only stay alive but find ways to retrieve my own self for the cave of despair and become more whole. It was a goal that wasn’t always clear. But as long as I get through each day, it has been possible to imagine.

Because I have not been truly alone with all this: family, friends and God’s constancy have carried me, do carry me still, as ever. It’s not the first time I have had to call on others for great aid. Trauma has been no stranger to me and it leaves its imprint even as healing occurs. But this is a quite different physical event than I’ve known before. Who seeks out a physically invasive procedure that can help, yes– yet has great risks? Sometimes there seems to be no other decent choice.

Have you, dear readers, ever had a knee replacement, or other joint surgery? Was it successful or are you still struggling? Then you know it is harder than you could anticipate. And if there are surprises that take you to your knees, it is something you cannot even respond to rationally at first. I think of you as I write this. My heart opens to your suffering, wants to make things better for you even if only by saying I care. And utilizing honest words to share my own perspective as I experience this long recovery. None of it is meant to discourage others form getting knee replacements. It is only my offering up of where I’ve been, what I’ve thought over these weeks.

Stay with me and I will share how it has come to be that I can finally begin to walk, if inelegantly, the knee usually resisting, though sometimes agreeing it is time to get much better. Still, accompanied by deep aches and shooting pains of ongoing nerve regeneration. I have a long way to go. But I am making peace with this experience and even expect better times at some point; a hike in seaside forests or the Columbia Gorge; a power walk along our many beautiful rivers; normal playtimes with my twin granddaughters; laughter and love shared with family and friends without wincing or excusing myself for a long rest or quick release of private tears.

I see the daffodils, cherry blossoms, forsythia and more opening to the warmth and grace of spring’s early sunshine. My swollen knee will get better than this. Will it not? I will turn my face upward, too, and hope that my best may come forth.