The marathon of life

The Jerusalem Post Magazine - - PSYCHOLOGY - • DR. BATYA L. LUDMAN

Afew months ago I de­cided I’d train for a marathon. I knew it would be chal­leng­ing, but as a psy­chol­o­gist, de­nial had been part of my game plan. I’d been de­bat­ing this for years – Should I or shouldn’t I? “Too young, bet­ter to wait un­til older,” I’d been told for years. A friend asked, “Don’t you want that qual­ity of life now, in­stead of wait­ing un­til you’re older?” I sure did. Why suf­fer now, if I don’t have to?

So, hav­ing made up my mind, I was sched­uled for a to­tal knee re­place­ment. If this was go­ing to be like a marathon (never hav­ing run one!), I knew I had to pre­pare emo­tion­ally, phys­i­cally and prac­ti­cally. While the Mag­a­zine lately has had so many col­umns deal­ing with sto­ries of ill health, I hope this will be an in­spi­ra­tion to those striv­ing for “well-be­ing,” as were my breast can­cer col­umns back in 2014.

As the proud owner of a new ti­ta­nium knee joint, I hope these re­flec­tions will be help­ful for those con­sid­er­ing any surgery (or other med­i­cal in­ter­ven­tion), and for their loved ones, who are so im­por­tant in the heal­ing process.

Be­fore surgery

1. Pre­pare. This is a marathon. Good run­ners don’t just wake up on race day and run; they train! Be in­formed when­ever pos­si­ble. Choose a med­i­cal team you have faith in and trust. De­cide who will help you in the train­ing (prepa­ra­tion) and post-marathon (re­cov­ery) phases – your care­givers. You’ll feel blessed by their pres­ence and grate­ful for all they do and ap­pre­ci­ate their be­ing your ad­vo­cates in the hospi­tal and at home. Do what­ever you can be­fore­hand to strengthen your body. Ex­er­cise, a healthy diet, read­ing up on what to ex­pect and pre­par­ing your post­sur­gi­cal en­vi­ron­ment in ad­vance are es­sen­tial to your re­cov­ery.

2. Re­mind your­self every morn­ing how ap­pre­cia­tive you are for the progress you made yes­ter­day. Each small step gets you that much closer to where you want to be.

There’s much to do: pre­op­er­a­tive tests, in­sur­ance forms, prepa­ra­tion for re­turn­ing home, fam­ily, work, and many other is­sues that can be­come over­whelm­ing and take over your life.

3. You must go into surgery feel­ing calm. While this may sound im­pos­si­ble, it re­ally isn’t. Make time to learn proper breath­ing tech­niques. They’ll help you. Be pos­i­tive, think about calm­ing scenes, your grand­chil­dren or peo­ple who make you smile. Be in the mo­ment, re­lax and leave it to the ex­perts.

It’s per­fectly nor­mal to feel some­what anx­ious. We of­ten fear the un­known. Make peace with your fears in ad­vance so that you can lower your anx­i­ety.

Af­ter surgery

4. Re­mind your­self that you did it! In many ways the worst is be­hind you, even if you feel run over by a truck and to­tally de­pen­dent on oth­ers. Be proud of your­self. There’s still much work to be done, and you’ll need en­durance, but you’re well on your way to be­com­ing a cham­pion. The marathon’s still un­der way, but you’ve come this far and are in for the long haul.

5. Keep in­formed. Learn about the drugs you’ll be of­fered and de­cide what’s right for you. Though you’ll want to take what you need, drugs have side ef­fects. There’s a fine bal­ance be­tween tak­ing what you need in or­der to par­tic­i­pate in your re­ha­bil­i­ta­tion, do post­sur­gi­cal ex­er­cises, and not be in pain, but not so much that you feel un­well or too tired to move.

You need to learn about your body’s re­sponse to pain and know that you’ll do bet­ter by tak­ing med­i­ca­tion at the ear­li­est signs of pain rather than wait­ing un­til it be­comes un­bear­able. You want to be on top of your pain.

Still, you don’t want to take more than you need. I ob­served in the hospi­tal that the more anx­ious the pa­tient, the more med­i­ca­tion they needed, and the less well they per­formed their ex­er­cises. It is im­por­tant not to fear pain but rather to work with it, through breath­ing. Your state of calm will greatly af­fect your jour­ney into heal­ing.

6. Be pa­tient with your­self. Your body’s been through a ma­jor trauma and bod­ily func­tions slow down. Your ini­tial in­abil­ity to do seem­ingly sim­ple things may sur­prise you. You can’t imag­ine how ex­haust­ing surgery, and be­ing in the hospi­tal, are and how much men­tal and phys­i­cal en­ergy you’ve ex­pended. I was shocked that for a few days I could barely lift my leg. It felt like a dead weight. There’s much you can plan for and much you can’t be pre­pared for, and you may not know which will be which. You can only con­trol things so much. Go easy on your­self. It’s not un­usual to feel down or even de­pressed.

7. Fo­cus on the pos­i­tive. While there may be many things you can’t do cur­rently, there are many things that you can do. Re­mem­ber, you’re es­sen­tially a healthy per­son who un­der­went a sur­gi­cal pro­ce­dure.

Not every day will be great; some days you may need to take things hour by hour. Make sure your ex­pec­ta­tions are re­al­is­tic.

At home

8. Nor­mal­ize. Rou­tine is im­por­tant. Get up, shower, dress in “real” clothes, put on lip­stick, open the win­dows and “fake it till you make it.” The more you see your­self as a “poor me” pa­tient, the less fo­cused you’ll be on mov­ing on. Re­mind your­self that this phase shall pass.

9. Com­pete with your­self try­ing to do more each day, but rec­og­nize that some­times the heal­ing process in­volves two steps for­ward and one step back.

Just be­fore surgery, I saw a video on my or­tho­pe­dist’s Face­book page of a woman danc­ing with her hus­band three days af­ter surgery. Ar­riv­ing home late af­ter be­ing dis­charged from the hospi­tal on day three, I was des­per­ate to climb into bed, when I re­mem­bered this video. I so did not feel like her, but was de­ter­mined to send our chil­dren a video of their par­ents danc­ing. I hardly moved my feet but the chil­dren thought this was amaz­ing. The next day, I could barely move!

10. Small things can feel big, and big ac­com­plish­ments may go un­no­ticed. Re­al­iz­ing I couldn’t get in and out of bed with­out wak­ing my hus­band to lift my leg, my amaz­ing phys­io­ther­a­pist taught me to use a belt, tie or towel un­der my foot to lift my leg. The re­sult­ing new­found in­de­pen­dence felt amaz­ing. A bas­ket on my walker en­abled me to carry things from place to place.

One day I couldn’t stand the dirt on my floor; while no one else no­ticed, I did. On the scale of im­por­tance it didn’t regis­ter, but I man­aged to take my walker to the broom closet and clean, mak­ing me very happy.

11. Choose good care­givers. They are es­sen­tial to your re­cov­ery, so en­sure you treat them well. They, too, need care, as look­ing af­ter us, even for a short

Com­pete with your­self try­ing to do more each day, but rec­og­nize that some­times the heal­ing process in­volves two steps for­ward and one step back

time, is phys­i­cally and emo­tion­ally ex­haust­ing.

We joke that we’d never have guessed it, but my hus­band was amaz­ing. Sure, he lost it when, al­ready hav­ing no time for him­self, I re­quested one thing too many. That’s to be ex­pected. Ini­tially, you may not be able to do much and will be very de­pen­dent, but your goal is to be­come in­de­pen­dent as quickly as pos­si­ble. I promise; it’s the best thing for you and every­one else.

12. Peo­ple want to visit, you may want them to, and it’s good for you. You can’t imag­ine, though, how ex­haust­ing it can be to carry on a con­ver­sa­tion or sit in one place for 20 min­utes when you first come home. Limit the num­ber of vis­its and keep them short at first, be­cause you need time to rest, ex­er­cise and heal. By night­time you may be quite un­com­fort­able and not up for visi­tors. Take peo­ple up on their of­fers to help, shop, bring you what­ever you need, or to walk with you. You’ll need it. Ask visi­tors to call ahead as things come up, or you may be tired.

Don’t let peo­ple visit you if they or their fam­ily are un­well. Get­ting sick now is not what you need. If visi­tors seem pressed for time or con­stantly on their phones, you may not feel good and won­der why they ac­tu­ally came over.

13. You’ll ex­pe­ri­ence acts of kind­ness from peo­ple you might ex­pect would act this way to­ward you, but also from peo­ple who will sur­prise you, whom you barely know. An­gels ar­rived daily with home-cooked meals, healthy food, cook­ies, choco­late, lo­tions and po­tions, a story, or a hug, just to help a bit and make me feel bet­ter.

Some visi­tors sat right next to me and ab­sorbed every word of con­ver­sa­tion. They were amaz­ing lis­ten­ers. Ini­tially af­ter surgery, you may find your­self quite bor­ing, re­peat­ing your story to any­one who asks, but as you heal you’ll be happy to get out­side of your­self and ac­tu­ally lis­ten to oth­ers. That’s real progress! Fo­cus on notic­ing all that oth­ers are do­ing to help you. It’s so easy to take it for granted.

RE­COV­ERY IS a slow process that takes more time than we think it will or are pre­pared for. It’s easy and nat­u­ral to get frus­trated and make un­rea­son­able de­mands on your­self and oth­ers.

Don’t let the sto­ries and tra­jec­tory of oth­ers up­set you. Every­one is in­di­vid­ual in his or her re­sponse to pain, and heal­ing. By be­ing aware of the many fac­tors in­volved in your heal­ing, you’ll be on your way to bet­ter health.

My goal of run­ning the marathon was to cross the fin­ish line, not to come in first place. As you com­plete your per­sonal chal­lenge, you are in­deed a win­ner.

The writer is a li­censed clin­i­cal psy­chol­o­gist in pri­vate

prac­tice in Ra’anana, and au­thor of the book Life’s Jour­ney: Ex­plor­ing Re­la­tion­ships – Re­solv­ing Con­flicts. She has writ­ten about psy­chol­ogy in The Jerusalem Post since 2000. [email protected]­; www.dr­batyalud­


BE­FORE SURGERY: ‘Pre­pare. This is a marathon.’(Pho­tos:

‘YOU NEED to learn about your body’s re­sponse to pain and know that you’ll do bet­ter by tak­ing med­i­ca­tion at the ear­li­est signs of it.’

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