My mobility problems were heightened by immobility: sitting at my desk or in a coffee shop or in a local library or driving for curbside pickup, mask on, trunk open, adjusting to isolation during the continuing pandemic. Our walks became shorter in time, distance, and frequency. I sometimes wobbled standing up, my balance unpredictable, shaky halfway through a walk, uncertain much of the way home. In March, my feet suddenly couldn't get out of one another's way and I fell flat on the paved trail near the university. In mid-May, at my annual appointment, a thorough check-over and a CT scan convinced our primary care physician I had spinal stenosis, specifically neurogenic claudication and needed an MRI for confirmation. At home I searched medical references online to better understand what I was going through.
Neurogenic claudication is "pain caused by too little blood flow to muscles during exercise," usually "occurs in the legs after walking at a certain pace and for a certain amount of time," and "because of narrowing in the spinal canal (stenosis) causing pressure on the spinal nerves." Stenosis is "often caused by age-related wear and tear," its symptoms pain, numbness, and muscle weakness. A CT scan (Computed Tomography) is a "quick, noninvasive" imaging technique using radiation (x-rays) to obtain pictures of tissues, organs, and skeletal structures. An MRI (Magnetic Resonance Imaging) works with magnets to obtain more detailed information about inner organs (e.g., the brain, skeletal system, reproductive system).
I'd been wedged into the tight tube of an MRI radiology machine before. The first time, a pacifying injection calmed me; another time, unpacified, I panicked from claustrophobia. This time, undrugged and less anxious by inserting earplugs and wearing heavy headphones over them, I lay prone, eyes tightly closed, silently counting numbers to myself while piped-in 1930s big band music was drowned out by constant thumping and pounding. The CT scan had lasted a few minutes on an open berth; the MRI ran thirty minutes in a boombox tomb. Each time the nurse checked on me, she left the room before the MRI came on again.
The clinic and my doctor both provided reports about the MRI and scheduled visits with a spine care specialist. In early June an Advanced Nurse Practitioner showed me detailed interior images of my spine, emphasizing where things seemed somewhat problematic. She arranged a series of sessions where a physical therapist coached me about repetitive daily exercises—arching and straightening my spine, bending and curling my legs, pressing my back to the floor. The next day, I did morning exercises and repeated one a second time near noon. Sue and I walked north, past a park playground and along an open field. When I paused to bend and straighten my legs, I couldn't move my feet well and fell over into the grass between the sidewalk and the road. I couldn't tell if the exercises had made my feet and ankles numb, but I seemed to do better when striding on the way home.
I tried to be conscientious about getting into those routines the recommended number of times each day. Two weeks later we walked through the nearby woods and across the river and back, roughly an hour of walking, formerly a customary outing. I felt the exercise in my legs and feet but had no difficulty completing the circuit and felt a little relieved. My internist gave me additional alternative exercises in later meetings and, by the middle of July, he approved of what I was doing, thought the exercises were helping, and updated some of them. He doubted I'd need further appointments after my next check-up.
In the interval we attended a family gathering on the Leelanau Peninsula, four hours of driving, four hours on the Lake Michigan Ferry. One day, with our daughters, son-in-law, and grandchildren, we hiked the Empire Bluff Trail, a 1.5-mile trek up and down very steep, very sandy, well-wooded terrain with a rewarding view of distant Sleeping Bear Dunes. Two days later a larger group of us walked five miles on the Mud Lake and Lake Michigan trails to the Manitou Overlook above Cathead Bay. None of that hiking bothered me, barely pained me.
At my final check-up yet another doctor reviewed my progress, scheduled no further appointments, and urged me to stay active and contact her if things worsened again. I'm theoretically no longer in need of consultations but I still need exercise.
For most of this year I've been conscious of mobility problems. Casually typing up an earlier longhand draft of this post, I wrote "mortality" instead of "mobility" and didn't realize it until I typed "immobility" further on. I didn't confuse it with "immortality." Glancing back, I corrected the spelling of "mobility." Since then, I haven't made that mistake again.