the pre-race pile/susan ito

The Last Time

You’re often completely unaware it’s happening.

First car. First apartment. First sex. First time eating an artichoke (The Nut Tree, while visiting my California cousin when I was sixteen). First time running a half marathon (Las Vegas, the year I turned fifty). First time meeting someone. We roll those firsts around in our memories, embellishing and savoring or cringing.

But so often we don’t know when we are experiencing a last something. Unless it’s a milestone we are expecting, like high school graduation. Last time I open my locker across from the chemistry classroom. More often, the Last Times happen when we are unaware, and it is only in retrospect or memory that we realize it, and it takes on a huge, new poignancy.

In March, I ran my second half marathon of 2013, and the fourth of my life. I thought it would be the second of several that I would complete this year. But after that race, my off-and-on hip pain of the past year turned into on and on and ON pain, relentless pain, pain that made me wince when I was walking, that woke me up in the middle of the night, that made me hesitate before getting into a car. It was joint pain like I’ve never had before.

I ignored it for a while, hoping it would go away, like it always had before. I foam rolled it. I bought what felt like a special, magic softball that I sat on and leaned into until it made me cry but then say ahhhh with relief. Maybe that was it. The softball cure. But it didn’t last more than a few hours. I found a sports physical therapy center, and the therapist wrapped canvas belts around my leg and then his own waist, and he leaned away, opening up space in the joint.

Another physical therapy friend laid on her intuitive hands. It’s your fibroids, she said. There’s not enough room in your bony bowl of a pelvis, and it’s pressing on your femoral nerve. Or maybe the obturator nerve. She was my classmate back when we were in physical therapy school, when she got the best grades and I got the worst.

I Googled “fibroids” + “hip pain” and lo and behold, they seemed to indicate a definite connection. I went to my gynecologist and she nodded and said it was indeed possible. I filled up my bladder and went to get a uterine ultrasound. I remembered getting those over and over when I was pregnant, years ago, and I missed seeing the little body in there, the beating heart. This time, only white ominous fibroid lumps, the size of a six month pregnancy, she said. But although they were huge, they were no huger than my last ultrasound four years ago. Go see an orthopedist, she said.

I went to an orthopedist. I got an X-ray of my pelvis. He pointed at the angle of the femoral head, the way it was thicker than it’s supposed to be. The little arrow pointed at what he called bone spurs. He said, I’m sorry, but you’re going to have to have a total hip replacement. I whispered, What about running?

He shook his head. No more, he said. You can ride a century bike race, a hundred miles. I started crying. I don’t like bicycle riding. Even though I’ve done an Olympic triathlon, the bike part was by far the worst and most dreaded. NO MORE RUNNING?

Listen, he said. A porcelain or metal or fiberglass hip will last thirty years. If you take care of it, like a car. You know those little grannies who keep their car in a garage, and only take it out once a week to drive to their hairdresser appointment? The car will last fifty years. But if you drive it around on rough roads and beat it up, it will only last ten. A hip is like that. The more you use it, the rougher you are, the faster it is going to break down. If you want to have just one hip replacement and not two, you’re going to have to find something else to do.

I left his office snuffling into a lump of Kleenex. I had to drive to work. I drove right past the park in Alameda where I’d run my last 5k race, the See Jane Run series. I had such sentimental feelings about this race. Back in 2009 — at the age of 50, newly diagnosed with type II diabetes, I had fought my way to the finish line after completing the “couch to 5k” training program. I was so proud of the little medal they hung around my neck. This mostly women’s race gave all finishers an engraved champagne glass and squares of fine chocolate. I was so proud of my “I Run for Champagne and Chocolate” T-shirt.

See Jane Run 5k, 2009

This year I had registered for the See Jane Run half marathon, hoping it would be my third of 2013. I was had felt so honored and excited to be nominated as a “SuperJane” ambassador by the See Jane Run organization, featured on their website as a role model for beginning runners. But by the time June came around, my hip had been hurting so much I downgraded to a 5k. I was disappointed, but I was still pleased to complete the race with one of my best times. I believed I would have many opportunities to do this half marathon in the future.

Not if I need to preserve a porcelain and metal hip. Devastated by the orthopedist’s assessment of my running future, I stared out across the lawn where the finish arc had stood. Then I began wailing out of control. Had this been the scene of my last race, my last run of my life? I couldn’t bear the thought of it.

When he was 76 years old, my father was diagnosed with an aortic aneurism that was on the verge of bursting and killing him. He was rushed into vascular surgery to repair the biggest blood vessel in his body, to remove the delicate part that had ballooned inside him, and replace it with a Teflon tube. The surgery, a complicated and difficult one, and during those ten hours the nerves to his lower extremities died from lack of blood supply. He emerged from that crisis as a paraplegic, and would never be able to walk on his own again, for the remaining five years of his life.

I’ll never forget my father’s last steps, the ones that he took from the hospital elevator to the lobby where he would say goodbye to me the night before his surgery. I had flown from California to New York to see him before the operation, and he was, in spite of the ticking time bomb in his torso, full of energy and good spirits. He shuffled out to bid me goodnight in his rubber zori, pushing his pre-op IV pole on wheels.

My father had always been a brisk walker, and the rest of us scurried to keep up with him. He was a traveling salesman with a huge territory, with things to do and people to see. He always wore the same polished black leather laced shoes, that he buffed with a round brush and a tin of black polish every night. He only ever wore two other kinds of shoes: rubber zori to the beach or shower (or hospital), and white-soled sneakers to go fishing or to play tennis. His thick calves were powerful and solid. I didn’t know that night that those calves would grow as slender as twigs with disuse, that he would never stride as energetically again. Those were the last strong steps of his life, but of course neither of us was remotely aware of it in that moment.

It is possible that I may have run my last steps, in my last race. It’s possible that I might defy medical advice and try to sneak in just one more race before I go under the scalpel. It’s possible that I might find alternate treatments that could help me avoid surgery altogether. I don’t know what is going to happen. But just realizing that it could have been the last time has made it even more precious to me, and this knowledge has seeped into other moments as well.

We never know when we will speak to a loved one for the very last time. It could be a tender, heartfelt moment, or it could be “Could you stop and get toilet paper on the way home?” We never know when we leave a place, if we will ever see it again. This week I may have experienced a thousand potentially last moments. This could be the last piece I ever write. I hope not. I have a lot more to say, and a lot more to do. But I’m glad for the reminder.