Monday, May 18, 2015

Choices: To Be Or Not To Be Via the OR

There are plenty of choices each of us are facing who are in the senior category. These run the gamut from whether one should get married again to whether one should sign a pull the plug document...and continue to fan outwards from there. Tonight I am thinking about a certain kind of choice that most of us are facing though and that choice is surgery. Increasingly we are told of one or another type of surgery that we need to seriously consider getting and there we are: To be cut or not to be cut? We will probably not be if we don't get cut is the worst of it.

I am generally good at going ahead and saying yes and getting it done. With the knee, however, I put it off for years and tried to handle it by getting various shots to handle the pain. I ended up with a hell of a vision problem as a result. The cortisone for my knees ended up in my eyes and caused a horrible swelling and loss of vision. For a short while I was thought to be going blind. Today I am still working on the vision problem but it is much, much better. And I finally got the knee done. As you know, that has not been a good event overall.

I had boned up on some of the complications of these knee replacements before the surgery. One woman I met did experience the blood clot complication. She lived but some do not who get the blood clots. Another man posted on a knee forum that both of his testicles had swollen to abnormal size after the knee surgery and he was confined to a rehab center for a long time until the testicular swelling came down. He was in total agony. It was an unusual complication but it has happened before. Just about every complication has occurred with this major knee surgery. Then there are those who have no complications at all and are quickly back to normal life. One woman in an online forum was so pleased with the way her first knee had gone so flawlessly that she had the second knee done only six months later. With that one she got major complications and was still hard at work trying to fix some of them. So there is no telling where your experience will fall on the spectrum of outcomes. Some of these people were wondering if any of these were malpractice cases but it seems unlikely. This surgery has lots of listed complications and are included in the risks you agree to undertake in having this surgery.

My foot was frozen in a down position and hung at an odd angle. The toes would not go up at all. I have worked my butt off on exercising this leg and within the last week the foot came back some. I can now lift my foot up again. That foot has a long way still to go but since it was not paralyzed, it was considered probable that it would come back. I am more hopeful than at any time since I woke up from the operation about my leg. However, I do need to also get the other knee done at some point in the future. A few months ago when I was in the first throes of this I thought to myself, Well, maybe you'll just die of something else before the 2nd knee surgery comes due. And that cheered me up!

I have also talked to quite a number of you who are also waiting for one surgery or another or in some cases several surgeries and are getting them arranged in order of priority. Some of you have to get your blood pressure numbers in better shape or your iron or potassium levels improved or fulfill some other medical demand that makes you surgery ready. You don't know whether to love the reprieve or hate the waiting. In the end it will be a crashing bore getting there and then a lot of pain getting out of there.

I have stopped worrying about the anesthesia killing me. I used to worry about this but I have my papers in order so that my plug can be pulled. There are so many worse things that can happen to me in terms of complications of surgery at this older age that at least with anesthesia I can say, "Ok, that one is handled and there isn't anything else you can do about it. You won't know about it if it does happen. Case closed."

Why are so many of us facing these choices? It is quite simple. We outlasted the rest of our generation. It is in general our time to join them but medical science is so much better that we are given one chance after another to lengthen it out some more. Let's just do some time jumps. In 1900 life expectancy for a woman was 48.3 years. I will turn 67 in August. I would be dead if I were living then and it would have been for awhile. By 1950 the number changed to 71.1. I'm now getting awfully close to that 1950 age and I would be in countdown mode most likely. By 2000 that had increased to 79.49 which gave me a nice extra breather, over a decade more. In 2015 that increased to 82.19. I picked up 15 potential extra years. All told, in 115 years as an American woman I have gained 33.89 years of potential life. Did I really think I was going to get that without having any surgery or replacement parts?! Fat chance!

There are 173 nations in which I am already past their life expectancies. Those nations have a number of problems such as poor medical care, diseases, starvation, famine, wars, civil unrest and so forth. As a sampling, South Africa comes in the lowest, where life expectancy has not even reached the age of 50. It is 49.72. In Afghanistan, I can expect only 50.87 but, of course, it is almost constantly at war. Here's the chart. The lighter your color of green, the fewer the years you get. The darker the color, the longer the years.

If you go over to the actual web page, every place you position your cursor will show you the exact life expectancy underneath your cursor. Go here. Most of the places with the long life expectancies have people more like us than unlike us. Australia, Canada, and western and northern Europe have very long life spans. Africa is clearly the worst. Moving east across Europe in general is not so hot either. We also keep our diseases in better check. We do not have most major infectious diseases rampaging through our population. We have vaccines for the worst of these diseases and more on the way. There is one ebola vaccine now applying for release and it looks like it might get it. I will certainly not be resisting getting it.

So, okay, more surgery, more tests, more medicines, more of all of this endless medical adventure, including most likely Leg #2. A crashing bore, a lot of pain, endless personnel I'd like to strangle and yet.... 33.89 more years is nothing to just take for granted. It can be seen as one extra life span, especially when one takes in these American life expectancy figures found here:
1750-1800: 36 years
1800-1850: 37 years
1850-1900: 40 years

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