Losing control

by Richard L. Weaver II, Ph.D.   

When we took my father-in-law for a regularly scheduled doctor’s appointment, it was clear that he had symptoms that merited the appointment although he was only slightly aware of his degenerating condition.  His shuffling around had become more pronounced, his loss of balance was happening more often, just walking across a room created shortness of breath, fatigue increased, and his ankles and feet had swollen to such a degree that he had to put on old shoes, but he could not lace them.  The doctor came outside the examining room to talk with my wife and me, and his diagnosis was clear and distinct: acute congestive heart failure.  Edgar needed to be hospitalized at once so that treatment could begin immediately.
    
We learned later that it was a single comment that Edgar made to the doctor that prompted the need for immediate hospitalization.  Asked what he wanted as the outcome of this doctor’s appointment, he said, “I want to improve.”  At 96-years-old, and totally in control of and actively exercising his mental abilities, this revealed all that was necessary to the doctor.
    
Searching for information on congestive heart failure on the Internet, one of the first web sites offered the following information.  Carl Bianco, M.D., at the web site, Howstuffworks.com, in his essay entitled, “How congestive heart failure works,” opens with the following paragraph: “Heart failure, or congestive heart failure (CHF), is a very common disease, afflicting approximately 4.8 million Americans. While many other forms of heart disease have become less common in recent years, CHF has been increasing steadily. This may be because more people with other forms of heart disease survive longer but are left with damaged hearts, which leads to CHF. Also, as the elderly population increases, there are more people at high risk of developing CHF. Approximately 400,000 new CHF cases occur each year, and it is the most common diagnosis in hospital patients over 65.”
    
Acute congestive heart failure began a succession of “loss of control” episodes.  There were three such episodes—enormously important occurrences—that preceded the CHF diagnosis.  The first took place about two years prior when Edgar lost his wife.  Married and living together for close to 70 years, this loss caused a grave blow.  Having never had to cook, do laundry, or clean up after himself, he was left bereft of the important matters of everyday existence; however, he quickly learned to “make do” and care for himself as he lived alone in the three-bedroom, rather spacious house, they had occupied for well over 50 years.
    
A second episode happened when he was driving.  A car sideswiped him while he was waiting at a stoplight and caused several thousand dollars damage to his car.  It was a hit-and-run accident and clearly not Edgar’s fault; however, the accident (fully covered by his insurance) prompted him to think about his driving acumen.  After the car was fully repaired and returned to his garage, Edgar said, “I’ve made a decision.  I’ve decided to take myself off the road.”
    
This episode, as anyone who has been through it knows, is a major development in anyone’s life.  It represents more than simply a loss of control; it signifies as well, a loss of independence.  To go to church, buy groceries, run errands, etc., now would require asking someone else to shuttle him around.  Depending on others—especially for an elderly man who had lived his entire life independently (notwithstanding, of course, the contributions his wife made to him and to his lifestyle)—was not something he took lightly.  One can just imagine the mental anguish he experienced to come to this decision to take himself off the road.
    
There was a third episode as well, and although not as significant or noteworthy as the previous three (I’m including his CHF here), nonetheless, it mattered a great deal in the progression of “loss of control.”  His Siamese cat, Coco, had created a number of problems for him.  It was going to the bathroom anywhere it chose downstairs in the laundry room.  This caused a smell in the house, and a neighbor and friend would come in on a daily basis to clean up the mess.  In addition, the hair on the cat had lost its previous luster—which is a symptom of illness.  It was a sudden decision (by Edgar), and he decided to have the cat put to sleep.  The importance of this is reflected in the number of years he had the cat, how close the two had become (it was like having a roommate), and how he cared for the cat’s needs throughout its life.
    
The diagnosis of acute congestive heart failure (CHF) brought on additional situations that created a loss of control.  For example, Edgar was hospitalized for several days so that a regular regimen of medicine could be administered and his condition could be closely monitored.  When released he came to our house for five days, and then, the ultimate in loss of control occurred.  We took him to a residential, apartment complex for senior citizens where he received regular meals, a close monitoring, continuance, and administration of the pill regimen begun in the hospital.  Soon after, too, he had a bi-ventricular pacemaker installed to stimulate and regulate the beating of his heart.  For Edgar, his universe had changed.
    
Although still with all of his mental faculties in place and his physical health returning to “normal,” Edgar still believed that he could live by himself, at his home, and self-administer his meds.  Perhaps that dream of independence and self-sufficiency provided him a modicum of comfort even though his older son, a retired family doctor, his own doctor, and everyone else we talked with knew that living in this residential care facility was not just important, but imperative.
    
There is no question that people have the power to change their lives, and the essays I write not only support that contention but offer specific and practical methods for doing so. On the other hand, however, people do not have the power to prevent life from happening to them.  Of course Edgar would change things dramatically if he had control.  Loss of control happened in small steps, albeit steps that took place rather rapidly.
    
When life began happening to him, as much as he resisted the changes, all that he could do—and is still in the process of doing, I might add—is change his attitude.  He has said, “I am just too old,” but at least he is aware of the problem.  Now, he has to face even more steps in the progression of losing control.  His younger son is turning his taxes over to an accountant, and Edgar is resisting such a move, having prepared his own taxes throughout his life.  He is actively looking for ways to maintain control.  On a recent trip, for example, he wanted to take only his cane and not his walker—because a walker conveys to others the impression of an invalid or one not in control of his life.  A cane, on the other hand, represents more independence, freedom of movement, and a person still in control.
    
Losing control is a frightening prospect but one most people will have to face.  Rather than lamenting the loss, one can only change his or her attitude.  It is not easy to do, and some would rather die than change.  But, unfortunately, that is the only recourse, because those who say, “I’d rather die than change,” often do.*

*I need to add a footnote to this essay.  Edgar overcame congestive heart failure.  He is now 98 years old, very healthy, and living at Kingston Residence, Apartment 226, 300 East Boundary Street, Perrysburg, OH 43551.  I add this information in case you wish to drop him a note.  He is an avid reader, follows University of Michigan football as well as all Detroit team sports, and, with the exception of meals and a bit of exercising, spends all his time in his apartment.
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 At Cancer.net there is a great essay, “Coping With Fear of Recurrence,” which discusses seven specific tips for coping: 1) Accept your fears, 2) don’t worry alone, 3) talk with your doctor about regular follow-up care, 4) be well informed, 5) adopt a healthy lifestyle, 6) reduce stress, and 7) where to go for more help.  This is excellent information.

In his ezine@rticle, “Surviving a stroke: Hope and progress,”  Kenneth John offers a supportive, encouraging, optimistic short essay that is worth a read.  He writes, “The good news is that a huge amount of expertise has gone into the study of improved living for stroke survivors and those close to them. Many quality of life studies involving physicians, neurologists and rehabilitation researchers, have yielded a wealth of knowledge about improving quality of life following a stroke.”
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Copyright August, 2011, by And Then Some Publishing, LLC.