People in wheelchairs learn to get old early, or at least I did. What I mean by this is that many of the issues that wheelchair users face at any juncture in their lives – from bodily failures and adjustments to often being patronized and treated as a lesser – are the same our senior citizens face. I know this. I am verging on senior citizenship myself and can see the parallels everywhere.
Which is why I honed in on a recent article in the Science section of the New York Times by the Jared Diamond (“Guns, Germs, and Steel”), the highly acclaimed geographer, historian, and all-around brainiac. Dr. Diamond, himself 75, addressed what he considered some important keys to longevity for people his age, but from my view, could just as well been talking about the secrets of longevity and a less aggravating life for a paralytic like me.
His thesis, in a nutshell, is that what most often kills and injures us in our later years are the kind of everyday activities we take for granted and do mindlessly. In his words, a sane way to live is to grasp ”the importance of being attentive to hazards that carry a low risk each time but are encountered frequently.” Low risk + high frequency = much higher risk. His main example is slipping in the shower. Slipping is falling and at least for the old, falling can lead to permanent impairment and even death. And since Dr. Diamond will be taking thousands of showers in the future, he understands that, however extreme the odds of falling (he puts it at 1000 to one), the mere frequency of his showering makes him vulnerable.
Like many things in life, it comes down to simple math. I’ll use transferring as a common denominator. Let’s say you are a midsection paralytic like me and transfer from chair to bed or chair to toilet or chair to car or chair to Lazy-Boy an accumulative 20 times a day. That adds up to 7,300 low risk transfers a year or 146,000 in the next twenty years, if you plan on living that long. If your risk of hitting an ankle or knee and breaking the skin during these transfers is as little as Dr. Diamond’s ratio of 1 in a 1000, that means you will cause some kind of skin breakage 7.3 times a year. That’s a lot of problem wounds in a year.
Case in point: last year I bumped my ankle getting out of a bathtub carelessly. Big deal: a little blood, a slow healing process. No, it was in fact an unironic Big Deal, a big, nasty, painful deal. That passing bump led to a bacterial invasion that caused cellulitis up and down my leg and eleven days of life wasted in the hospital fighting it off. Maybe that wouldn’t happen on all of my average seven bumps a year, but who wants to chance more 103 degree temperatures, headaches, chills, nausea, and all that bad hospital food? Not me.
The moment I came back home, I got a lot more vigilant about bumping my legs. And yet, six months later, after another bump on my protruding left knee bone, I had another attack of cellulitis and another stint in the infirmary. My learning curve is not that steep, I guess. And this while under the weekly care of a wound specialist! Bacteria, like rust, never sleep.
Diamond goes on to note that our attention, our mindfulness, is often misplaced. “We exaggerate,” he says, “the risks of events that are beyond our control, that cause many deaths at once or that kills in spectacular ways – crazy gunmen, terrorists, plane crashes, nuclear radiation, genetically modified crops…” Alternately we overlook the statistically greater risk of “showers, stepladders, staircases, and wet or uneven sidewalks.”
I don’t know about you, but stepladders and staircases don’t apply to me. On the other hand, uneven sidewalks have often been my downfall, no pun intended. You’re whizzing down a sidewalk, the endorphins pumping and your mind on last night’s episode of “Downtown Abbey,” and one little crack catches one of your front wheels and sends you flying. All the way to the ground, you’re saying to yourself, “You idiot, watch where you are going!”
Diamond coins a term for the right mental state for avoiding the low-risk but potentially damaging screw-up: constructive paranoia. This is a form of paranoia that is good for you, that exaggerates common circumstances to the point that you can see ahead of time what might take you down. It’s a hyper vigilant attitude that sees all risks as high risks. I now see a simple transfer into a car as an occasion to crack my knee on a doorframe or God forbid, slip and crack my tailbone. I try to be relaxed but wary, not always an easy mix.
My constructive paranoia now involves new body armor, for my piece of mind, if nothing else. I now wear the thickest kind of soccer-sock-like compression hose I can find along with basketball-styled knee pads on both knees. If I could find some kind of ankle pad, I’d wear that, too.
So far, so good, but you never know. That’s the thing about paranoia. You never run out of things to be paranoid about.
© 2013 Allen Rucker |
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The Best Seat in the House:
How I Woke Up One Tuesday and Was Paralyzed for Life