The Third Third

A New Wrinkle

Until four days ago, I was sure I was an exception.  Acting on trusted medical counsel, I was confident I could, with my genes and a bit of luck, escape the highly -- and routinely -- publicized [risks of hormone replacement therapy][1]. I could stave off post-menopausal hot flashes, wrinkles, vaginal dryness, and loss of bone density -- for 20 years -- protected somehow from the hazards of heart disease, strokes, blood clots, or breast cancer.  I was rational about it.  That is, I did the math:  the women studied (until the study was canceled because it was judged too dangerous to continue) weren’t my age, didn’t fit my profile, weren’t taking the same ratios of estrogen and progestin, weren’t looking protection from osteoporosis and colon cancer, as I was.  And I was irrational: with my hormones at such “good” levels, my disposition was remarkably upbeat, I was much nicer to be around, and I looked, well, good, or at least not necessarily like an ancient 63 year-old grandmother.  I don’t consider what happened to me this week my personal come-uppance. But it is, perhaps, a warning for those of us for whom exceptionalism can be an innate, generational character flaw.  We may not in fact be exempt from the good, the bad, or the ugly, least of all from the normal vicissitudes of aging.  How do I know?  I fainted this week (and I am not a woman who faints!) and was diagnosed and am now being treated for a textbook incidence of pulmonary embolism, i.e., a blood clot in my lung.  In many ways, the doctors believe it was a perfect storm:  not only was I still taking HRT, but I had recently begun wearing a brace custom-designed to remedy my foot drop which collaterally immobilized my calf muscles where the clot is believed to have formed.  No brace, no clot.  No HRT, no clot.  But together the risk was apparently compounded, and my life was suddenly and decidedly threatened.  I can’t help but feel foolish for thinking a few wrinkles might matter. Needless to say, I’ve gone cold-turkey. No more hormones. I’m being treated with blood thinners, and my doctors and I are developing new beyond-the-brace strategies for dealing with my foot.  I should be just fine. In the meantime, the what-if’s are still haunting me.  What if, for example, I had been driving the car -- to the neighborhood grocery store, or down the Interstate to visit my kids -- instead of finishing up my toilette when I blacked out?  What if I had not called the doctor and instead insisted I was fine, just fine, as is my wont?  What if the doctor had not said he needed to see me, had not ordered the EKG, or not recognized the symptoms, or not taken my fainting seriously, or not sent me to the Emergency Room?  What if the ER doctors had not been so thorough and diligent with their tests, had not found the clot?  What if they had sent me home, untreated?  We don’t want to go there.   And at the more macro level, what if I didn’t have health insurance?  Or access to smart, caring health care professionals? I was very lucky.  But I was also willful and in denial.  I wasn’t ignorant; I was stupid.  I didn’t think I could get in trouble with my hormones because I didn’t want to.  I didn’t think of myself as “at-risk” because I simply failed to take my real age into consideration. And even when I did,  I insisted a “young 63” was about the same as, well, maybe 45.   I don’t want to live old or scared.  I don’t want to have to be so careful I’m no fun at all.  I want to put this entire incident behind me and move on with as much energy as I have gratitude for having more days to seize, more trails to hike, more love to share.  I hope I’ve taken the lesson to heart (literally and figuratively):  I am not invincible.   Neither, alas, are you.  (Which is why I am posting this tale.) [1]:
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