Tai Chi with a Leg Bag

As I approached 60, I felt pretty comfortable in my own skin. My midlife crisis had come and gone quite some time ago. The shaved head and earring were permanent fixtures. I was often told that I looked in good shape, maybe ten years younger than I actually was. I always tried to take care of myself and one of the ways was a daily Tai Chi routine. I rarely got sick, had no major aches or pains and was pretty supple. I hadn’t slowed down at my job as a physical therapist, and in fact, I was gaining more enthusiasm for it.

One day this all came to a screeching halt during a routine annual physical. My PSA nearly quadrupled since my last yearly visit. Prostate cancer! I couldn’t believe it! I had absolutely no symptoms, no difficulty with urination, no blood, no pain. Prostate cancer is what other men got, not me. A subsequent biopsy confirmed the diagnosis and revealed that the cancer was very small and most likely in its very early stages. People tried to reassure me by citing the examples of Rudy Giuliani and Joe Torre. Their cancers were caught early and now they were “just as good as new”.

Despite this encouragement, my spirits were already in free fall. I knew that I was too young for the “wait and watch” approach and that an invasive intervention was called for. My wife (who is an RN) and I did our research. Before choosing Sloan Kettering as my caregiver, we narrowed down the choices to surgery or radiation. Radiation meant no hospitalization. This was very appealing. Surgery required hospitalization, and to my horror, urinary catheterization for 2 weeks post op.

Having worked in hospitals, the thought of being a patient distressed me to no end. The majority of my 30 years as a therapist were in homecare, where I was my own boss, and could do things the way I deemed most appropriate. I didn’t have to meet someone’s quota. I enjoyed working with my patients in their home environment. I didn’t relish the idea of becoming a “good” patient. My personal autonomy was at stake. My biggest fear was the catheter. Even imagining it inside me sent a crawling, tingling sensation through my legs..

During this period I consulted the I Ching quite a few times in order to get a handle on why this was all happening. I kept getting told there was a lesson to be learned, and that I had to remain patient and let events run their course. I purchased a few recommended qiqong dvd’s from Plum to add to my Tai Chi routine, in order to strengthen me for the ordeal. Sorry to say, I viewed them but never followed up. My mind was too cluttered to take on something new.

More diagnostic tests followed. No orifice was off bounds. I felt like I joined the ranks of alien abductees. When all the results were finalized, the news was good. The cancer was indeed confined to the prostate. My wife and I chose the surgical route. The procedure was to be done laproscopically (minimally invasive), five small incisions through the abdomen. I was told that this was still considered to be major surgery. Later I found out that I was on the operating table for five hours.

My first clear memory post operatively was of being gently wakened by a nurse. A quick groggy scan revealed that I was catheterized, and hooked up to two IV lines in my arm and a drain coming out of my abdomen. I had no choice but to accept my situation. The nurse took my vitals. Next, she had to weigh me. I attempted to get up without letting her bring the head of the bed upright. That was a big mistake! I stopped cold in my tracks. It felt like the aftermath of the ab workout from hell! My dantien had been violated and my meridians short circuited. I let her bring the head of the bed up. She helped me to my feet. I was now 7 pounds heavier, despite having no food or liquids for the last 24 hrs. It was the result of the fluids that were pumped into me via IV’s during surgery. The nurse asked whether I would like to sit in a chair, or walk. I chose to walk. Even in my dulled state of mind I knew it would be better for me. I didn’t want to be hypocritical, having always preached the value of walking to my patients.

I started out in the hallway, my catheter bag in tow dangling from the rolling IV poll. Instantly I realized that I had become a “little old man”. I was hunched over, hanging on to the poll to steady myself. When I tried to straighten the abdominal pain rapidly increased. It felt as if a wide strip of thick duct tape was preventing me from coming erect. My sense of balance was also impaired. I alternated between holding on to the poll, and then trying to challenge myself by letting go, having my wife or daughter push it.

As I walked more often, the pain began to subside. I managed to downgrade from Vicodin to extra strength Tylenol. I would pause in the hallway and try to do something vaguely resembling cloud hands. With the IV lines, drain and catheter, who was I kidding? There would be time for that when I got home. I continued to walk.

Walking was relatively easy once I was upright. It was the decision to get in and out of bed that was difficult. The catheter was making me very reluctant to initiate any movement. It wasn’t painful, just uncomfortable. I would lay in a position for extended periods of time, no matter how uncomfortable, just “planning” to move. Somewhere in the back of my mind was the thought that if I moved the wrong way, I would pull the whole thing out.

I was in the hospital for two nights. A follow up outpatient visit was scheduled for ten days later. The catheter would be discontinued at that time. An hour before leaving we changed the regular catheter bag, for a leg bag. It was smaller, strapped to my calf, and could be concealed under my pant leg. I started to feel human again while I navigated the hallway in street clothes, sans IV poll.

Home at last! I was still weak. The next day I attempted the first third of the Cheng Man Ching form. My legs shook throughout the set. It took less then three minutes, but I actually had to sit down and rest for a while. As days went by I was able to do repeated sets. I wasn’t brave enough for the entire form. The catheter bugaboo held me back. I was especially afraid to do the lotus kick and snake creeps down. The catheter tube was flexible enough, but I still had this irrational fear. I gradually became less timid and managed to do the entire form with low kicks and a high snake creeps down.

My first out door walk with my wife was challenging. I reverted to the little old man once again, bent over, looking at the ground to aid my balance. I had the internal sense that the width of my shoulders was significantly decreased. I felt frail. The tables were turned. My wife asked if her pace was too fast for me.

Days later, the catheter was removed. I was able to resume doing the form twice daily as was my usual custom. I added standing in wuji at the suggestion of one of Ben Lo’s long time students. He told me that Ben credited this for his recovery from surgery seven years ago. If it was good enough for the master——–

I am now three weeks post op. I plan to resume working in a few weeks. I pass the time reading and watching endless episodes of Zatoichi, the blind swordsman. It feels wonderful to be free, but the catheter has been traded in for a diaper and pad. Once again, I’m the little old man. The surgery and catheterization cause temporary loss of bladder tone. Now, it’s snake creeps down and dribbles. The incontinence is normal and transitory.

As far as the I Ching’s lesson to be learned — I’m not sure yet. I certainly will be able to empathize more with my patients when I return to work. As I stand in line at Walmart waiting to pay for the pack of diaper pads in my hands, I realize that I’ve been given the gift of being able to walk in their shoes. Hopefully with time the entire lesson will be made clear to me.

Gary Shapiro is married, with two children, and is a former USAF navigator. He has been practicing Tai Chi for as long as he’s been a physical therapist- about 25 yrs- and is interested in applying the practical aspects of Tai Chi to benefit those with whom he works.

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