Year of the Pelvis

Stiff-necked, weak-kneed, cold-blooded, thin-skinned tenderfoot. It seems an apt extended figure of speech to characterize me since arriving in the city of my retirement. Still stubborn, occasionally pusillanimous, and wantonly passive-aggressive, especially in new surroundings. I have experienced all these qualities as temperamental states during the past three years. But more importantly as physical symptoms. As a new arrival I had some acclimatization to do. The average winter temperature in these regions hovers about 15 degrees below what I was used to for over a decade. So for me “cold blood” does not connote violent premeditation; instead it simply describes the feeling of inadequate circulation. To be sure, I am no more emotionally flexible than before, but now “stiff neck” is a condition that could arise in any setting from reading in bed to backing out the car. I make no claim to extraordinary courage, but my knees are quite literally shaky. The rules governing Olympic race walking now apply perforce to me. There is scant temptation to lift both feet from the ground simultaneously, since I know that gravity will punish me around the patella on my return.

Since 2019, the Earth has completed almost three circuits of the sun, and the calendar recently reminded millions worldwide to welcome the Year of the Rabbit. Last time around in 2022 it was the Year of the Water Tiger. You can find a flattering description of the Tiger’s traits online–“extremely competitive people, known for their courage and ambition. Tigers are ambitious, but they’re also extremely generous with a drive to help others”–but don’t overlook the moderating influence of Water. “He’ll also be full of ideas, one plan one week another the next – they’re normally well conceived, too, just never actioned. He’s positive, he’s kind, he’s adorable, he’s loveable, but he does need one thing – a little guidance.” (The US Sun, Aug 4 2022). This suggests impulsive behavior–think Tom Cruise, apparently–something I have never embraced or been recognized for. But no such careful parsing is needed because my year 2022 was wholly overshadowed by other events. It can only be called The Year of the Pelvis.

For one thing, the creaking in my knees migrated unambiguously to my hips. I had already been aware of recurrent discomfort on one side; it occasionally disturbed my sleep. But now the connection is clear. Any shock to the hinge in my knee will eventually be felt in my sacrum. So far I have avoided any diagnosis of “abnormal” arthritis, and I am hoping to dodge hip replacement surgery–although I don’t know why: all my contemporaries swear by it. As for something more insidious, like “sciatica” or “lumbago,” I’d prefer to consign that possibility to the mythical past inhabited by Uncle Joe, who moved “kinda slow” around Petticoat Junction.

I have certainly become more sensitive to suggestions that I’m physically not up to a particular task. When I bought an inflatable boat last year, I almost relished the process of blowing it up with a manual pump. This did nothing for my stiff neck, of course. Solicitous relatives showered me with auxiliary equipment–waterproof socks, layers, hat–to counteract the effects of venturing onto a pond that had barely thawed. But once they had witnessed me inflate the vessel–like a man toiling on a railway handcar or one of those bobbing flamingos over a water glass–their generosity immediately extended to a battery-powered pump. And their loving concern was not misplaced. Whatever aerobic benefit I might have derived from preparing to launch by hand, there was no point in embarking in a state of near-exhaustion. If the objective is to head off further deterioration of the sacroiliac through exercise, this is not the way to start.

One final threat lurks, however: the danger that my epidermis is not up to the challenge. Unlike my cetacean and pinniped cousins, of course, I had no stock of blubber to insulate me. But now even my outermost layer was proving insufficient, in every season, thinning to the point of translucency in some places. Yearly visits to the dermatologist had persuaded me that vigilance was necessary to avoid sun damage, but I had never thought much about the skin’s minimal function of resisting friction or puncture. It turns out that it’s not just the glutes that respond negatively to prolonged contact with a rowing bench.

Still, I am appropriately grateful to the dermatologist. In fact, nothing that follows should be interpreted as griping about the medical profession. Whatever the cost, however partial the cure, it remains true that these folks are providing something that I cannot (if only for want of tools) do for myself. In due course, when my pelvic issues advanced to the next level, I got acquainted with several new members of my “care team.” The vascular surgeon was summarily dismissed–by Medicare, not by me–and it’s not clear that operating on “incompetent” veins in my leg would have done anything to relieve throbbing in my upper thigh. But that episode did mark the beginning of my relationship with ultrasound. [It also led to a comical encounter with the scanning technician. This might get me tagged for online porn, so apologies in advance to any surfers who are disappointed. I was surprised on my first visit by her casual familiarity with my lower extremities, including the turgid saphenous vein snaking around my knee. Lifting the sheet that covered my nakedness, she remarked sympathetically, “That is a big one.”] From then onward, sonography became a part of my regular routine.

It was the exciting round of elder male complaints that kept my pelvis occupied for the rest of the year. Again, I’m thankful for the progress that has been made in detecting prostate and bladder cancer. I’m only skeptical of the online algorithms that seem to gleefully predict it. Since I first googled ‘bladder’, my computer screen has been constantly adorned with ads, reputed studies, and (worst of all) CGIs of the urinary tract. I did not need to rely on these artistic renderings, of course, because I had my own personal images. I’ve come to understand the protocol for every visit: arrive with a full bladder, attempt to empty it, have an ultrasound to rate your success. Now the trick is timing one’s arrival. This series of appointments began when I was preparing for a different outdoor adventure, a modest hiking vacation that demanded I reacquaint my legs with traversing terrain more varied than our carpeted living room floor over distances longer than the walk from coffee maker to couch. On one occasion, I allowed my ‘workout’ to encompass not only lifting a few weights but also riding a bike on rollers for half an hour. The result–and retrospectively I’m convinced this unaccustomed exertion was the cause–appeared in urine dyed with a drop or two of blood. (It spreads like no watercolor set you ever had.)

When the lab sample returned with no evidence of ongoing hematuria–I’m so glad I retain traces of a Classical education–I naturally felt relief. The urologist also performed the mandatory prodding with a gloved finger. Again, things seemed satisfactory. But thoroughness required further examination. Within a few minutes I was on my back, my pelvis being introduced to another form of investigation, this one a good deal more intrusive than ultrasound. Being in the hands of a female nurse for much of this procedure reminded me forcefully of what my wife had said about the indignities visited on every OB/GYN patient before there were women gynecologists. Getting to watch the inside of my bladder onscreen–and more importantly, being assured there was nothing abnormal about it–was only partial compensation. It didn’t end there, of course. A couple of weeks later I had my first CT scan.

This was the big one. Not only would it detect problems with my kidneys and other urinary apparatus, it would provide a panorama of my pelvis. It seemed a fitting way to wind up the year. I didn’t get to see the picture this time, but I’m reliably informed that it was “unremarkable,” right up to my liver. I like the sound of that, since all the new symptoms of this year are really only a sideline to a deeper concern about what my pelvis might be hiding. There is a history of colon cancer in the family, which raises disturbing thoughts that even the regular cycle of colonoscopy does not fully allay. In the case of so many disorders, it seems, it’s silence that’s deadly. So I don’t mind complaints–gurgles, pangs, twinges–if they help head off something worse.

Goodbye, then, to the Year of the Pelvis. I doubt there are any bodily systems whose truancy I would happily tolerate. But one complaint I have eluded both in reality and in metaphor is short-sightedness. I can clearly foresee a time down the road when some organs will cease to do their routine work, with fatal consequences. The brain, if I am lucky, will be the last to go.


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