Tuesday, January 28, 2014

Ice, Ice, Maybe



The last few weeks here on the East Coast have revealed to me just how much I loathe winter. I used to love it, with its downhill and cross-country skiing, sledding, tubing, snowman-building, and frosty morning hikes with the dogs. Hey, I’ve even gone ice-skating once or twice.
       In fact, I used to think of winter as downright magical. Some of my best memories are of the kids and me stomping our way inside the house after playing in the cold. We’d hoot and holler about how good it felt to be warm, and after I removed the kids’ snow pants, wiped their runny noses, and picked ice balls from the dogs’ paws, we’d make hot cocoa with marshmallows. As we gathered ‘round the fire, I’d sigh with contentment at my kids’ ruddy cheeks and twinkling eyes. Ah, the charms of winter!
       Yeah, well, fuck that. I have a fake leg now, which means winter completely sucks. Any day I dare venture out in snow or ice is a day of drama. Why? Because it’s nearly impossible to walk on slippery surfaces with a prosthetic foot and a mechanical knee and ankle joint. In recent weeks, I’ve had to cancel two doctor’s appointments, a meeting with my attorney, a night out to listen to live music, and plans to see a movie. Outings I couldn’t cancel – getting documents notarized, going to the FedEx store, and taking my car to the garage to get the brakes repaired – were so frustrating and scary I was near tears.
I know sometimes I’m prone to exaggeration, but seriously, going out in the ice or snow with a prosthetic leg can be a life or death proposition. Let me explain.
Like all of us born with two healthy, strong legs, I never appreciated the exquisitely complex way the toes, ankles, knees, and hips work to keep us humans upright and allow us to do stuff like ski, sled, and hike. These joints, in concert with bones, muscles, and connective tissue, give us all kinds of options for movements big and small. We can walk. We can pivot. We can dance. Then there’s bending, balancing, squeezing, running, compensating, leaning, jumping, stretching, pushing, marching, pressing, lifting, kicking, standing, leaping  . . .  it’s mind-boggling, really. Did you know that the human foot is a biomechanical wonderland of 26 bones, 33 joints, and more than one hundred muscles, ligaments, and tendons? That’s why we can adjust for bumpy terrain, recover from a sudden loss of balance, or change direction in a hurry. All without even thinking about it.
Oh, I think about it now. All the nuances of biology below my left thigh have been replaced by carbon-fiber composites, plastic, and steel. I am not complaining. I am damn lucky to have good insurance, a top-of-the line prosthetic, and devoted medical professionals to help me learn to use it. But I will never again have the security of a real left leg.
In the snow with Finney and Guinness, 2001
I will talk much more about my prosthetic leg in future posts, but I think at this point I should give you an idea what I mean by “top-of-the-line.” My new knee houses a microchip, uses LCD battery power, and is equipped with Bluetooth technology. The socket that fits over my thigh is a complex three-layer system that slides onto my leg and creates an airtight seal. My ankle joint allows me to lean forward to stretch. My foot is adjustable should I ever want to wear sensible heels. All this technology was expensive. My leg cost more than a car, and I’m talking about a brand-new turbocharged BMW 5-series kind of car.
But you know what? As great as it is, my prosthetic device will never be able to duplicate the precise function of the biological leg, knee, ankle, and foot that I was blessed with for fifty years. If it’s icy outside and I forget that fact – even for a second – I’ve got problems.
Best-case scenario: I end up flat on my ass in the Home Depot parking lot with cuts on my elbows and slush jammed down the back of my jeans. Worst-case scenario: I break that $45,000 leg and/or seriously injure my human parts.
I learned this the hard way. I had been warned that it might be impossible to venture out in bad weather. I was told that if I absolutely had to go out I needed to wear sturdy, treaded shoes and use extra caution. No problem. My balance had always been excellent. I could hold the tree pose longer than most everyone in my yoga class! And I had great shoes. Pssshaw. I was all over it.
Turns out the only thing I was “all over” was the pavement.
About a year ago, in January 2013, I finished up at an appointment and decided to swing by the grocery on the way home to pick up a few things. The weather was starting to look iffy. After parking my car, I noticed that there were still patches of old ice and snow all over the lot, so I took care to place my feet and cane on the dry spots. By the time I got out of the supermarket, the pavement was covered in a thin sheen of ice, but I figured I would be fine since I was puttering out in one of the store’s little motorized shopping carts (see “Hell On Wheels” blog entry from 1/5/15.) I parked near my car, stood up, opened the car door, placed the groceries inside and – what the hell?
My fake foot shot across the ice like Apollo Ono on ‘roids. I went flying. In a move worthy of a Looney Tunes classic cartoon, I became nothing but a blur of wind milling arms. I heard my cane crash and heard myself scream. This commotion was followed by a loud thud. Then there was silence. I stared at the salt-caked tire of my SUV, now two inches from my face. I saw that my head barely missed slamming into the motorized cart. I did a mental check of what body parts hurt the most. Then I scanned my surroundings.
Here were my options. I could rescue myself and avoid a great deal of humiliation, or I could flag down the first unsuspecting, physically robust male shopper who passed by. I decided to do it myself.
I won’t burden you with the particulars. The whole thing was ugly. And mortifying. It involved me scooting along the parking lot on my ass, dragging my fake leg along, and using the SUV’s running board to hoist myself up into the seat.
Somehow, I got in. I noticed my palms were bleeding. My biologically intact ankle was bleeding. I was trembling with adrenaline. And my butt felt like a frozen Butterball turkey.
But I was alive, with a new respect for the limits of my prosthetic leg – and a vehement dislike for winter.
The next day was sunny, so I decided to go to my dentist’s appointment as planned. As I walked in the reception room, my prosthetic leg bent at an odd angle. A screw fell out of the bottom of my pant leg and rolled across the floor. Yep – I had messed up my fabulously expensive technological wonder by falling in the ice. Luckily, I live in a small town and my friend Frank was in the dentist’s waiting room when all this happened. He made sure I got in my car safely and made it home. My leg spent two weeks in the shop.
        My prosthetic is as good as new, but I fear my mind is permanently scarred. Now I’m obsessed with weather. If the chance of snow is more than 40%, I stay home. If I’m out to dinner with friends and glance out the window to see an unexpected snow shower, I’m immediately filled with dread. I begin a mental calculation for how I’m going to get from the restaurant to my car without killing myself. I’m so terrified of even the hint of ice that it can take me fifteen minutes to walk a hundred feet. Anyone remember Tim Conway’s shuffling old-man character from The Carol Burnett Show? That’s who I’ve become on slippery surfaces.
        I was leaving a concert the other night. As my friend got the car and pulled it as close to the building as possible, two strangers grabbed my elbows and helped me along. The bitterly cold wind pounded us while I took excruciatingly tiny Tim Conway steps across the ice.
         Sometimes, I feel strangled by the embarrassment winter weather causes me. I feel ridiculous. I’m only 52, but when it’s slippery I move like a woman in her nineties.  To be honest, if the weather isn’t perfect, it’s just better for everyone if I grab a hot cup of tea, get in my PJs, and crawl into bed at 8 o’clock.
That’s really saying something for an extrovert like me. In my two-legged past, I was at home in the world. I would chat it up with anyone, anywhere, anytime. I was almost always up for exploring a new place or trying something I’d never done before. The weather didn’t even cross my mind.
Now that I have only one leg, winter has become the season of my discontent. This social butterfly’s wings have been clipped.


Saturday, January 18, 2014

Thanks, That Was Fun




It was another case of hurry up and wait.
The skin graft seemed to be holding. My pain was being managed better, though I couldn’t bear anything making contact with either of my legs – not even the brush of a bed sheet. To put it mildly, I was antsy. And grumpy. And impatient. I wanted to get back to my hometown, finish rehab, and go home. But I couldn’t be discharged until a bed became available on my local hospital’s rehabilitation unit.
During these insufferably long days, I became a fan of TV cooking shows  – it was somehow soothing to watch people chop and sauté stuff in butter.  I still couldn’t read, because my hands shook too much and all the drugs had left me with the attention span of a fruit fly. I enjoyed brief phone conversations with friends, until I became too exhausted to talk. Occasionally, I had visitors. I continued with physical therapy. I listened to my iPod until it gave me a headache. But mostly I just stared, visualizing how my surgical and graft sites were healing one cell at a time. I’d check the clock and dream of the day I could pet my dogs, open the windows for fresh air, and maybe even enjoy a glass of Pinot noir.
Oh, and I cried a lot.
Then one day, a nurse came in and asked if I’d like to be visited by a fellow amputee, a woman who had been through a similar crisis and was now doing fine. The woman was volunteering on the trauma unit that day, representing a nationwide support group for people with limb loss.
I hesitated. My initial reaction was that I didn’t want to be part of any kind of group that had the word “amputee” in it, thank you very much. Despite the fact that anyone could see I was missing most of my left leg, I hated that word. I didn’t want to be thought of as an amputee.
On the other hand, I knew I was facing a great unknown. I was exhausted and worried. I was sick of crying. Maybe it would be good for me to hear some encouraging words from someone who had hopped a mile in my shoe, so to speak.
So I agreed to the visit “Sure. Why not? What could it hurt?”
A little while later, a woman poked her head through the doorway. She was tall and lanky and for some reason she reminded me of Martina Navratilova. (It was probably the pain meds.)
“Hello,” she said.
From my hospital bed I returned the greeting and gestured for her to come on in. As this chick glided into the room I examined her from hair to shoes. I was puzzled. From what I could tell, she wasn’t missing anything. She had both arms, both legs, both hands, and all her fingers. It even looked like she had all her teeth.
She took a seat in a visitor’s chair against the wall and crossed her legs. She looked at me blankly. Then she rummaged around inside a canvas carryall and pulled out some brochures. “So, you’re an AKA?”
Huh? The only kind of “AKA” I was familiar with was the police scanner abbreviation for “also known as.”  Was Ms. Navratilova asking me if I had committed any felonies under an alias? Or was she curious whether I wrote under a penname? The confusion must have been all over my face.
“AKA means above-the-knee-amputee,” she explained.
“Oh.” Jeesh, human beings abbreviate everything. “Yes, I guess so.”
She nodded.
OK, this visit was more than a little awkward. This lady was a stranger and not a very gregarious one, at that. She got up and handed me brochures for the support group. I couldn’t help but stare at her when she moved, still completely baffled about her amputee status.
She sat down again and sighed. “I was in a car accident a year ago and lost the big toe and the two adjacent toes on my left foot. I’m waiting for my prosthesis, but in the meantime I stuff the end of my shoe with a sweat sock.”
Silence. I had no idea what to do with that information. I almost exploded with laughter. I almost screamed at her and called her names and told her that she needed to get her seven-toed self the hell out of my hospital room. In my mind, an ugly, mean-spirited temper tantrum raged: “Fucking toes? You lost three fucking toes and you’re in here telling me what it’s like to go through life as an amputee? Toes? Seriously? What I wouldn’t give to only have lost a few fucking toes! Try a fucking leg! Now that’s a real amputation, bitch!”
(I truly apologize for my brain. It has been known to resort to lowbrow vulgarity in times of extreme stress.)
I sat in stunned silence with my eyeballs bugging out, which was probably impolite of me. My visitor felt compelled to defend herself.
“People think it’s no big deal to lose three toes, but they’re wrong. I got fired from my job because I was expected to be on my feet for hours at a time. I lost my health insurance. I lost my car, went on food stamps and Medicaid, and declared bankruptcy.  My boyfriend and I went to the beach for a week and when we got home, he dumped me. He said he couldn’t handle everything that went with dating me. My house was foreclosed on and I had to move in with my parents, who are supporting me.”
A rumbling began deep in my soul. It was fury. It was pure, stark fear. I started choking on a cosmic-sized serving of horror and dread. And all I could think was, if all that happened to her because of a few toes, what kind of hell awaited me?
 “I think you need to leave,” I whispered. Really, I just wanted her gone. I knew I was about to have a big-assed meltdown/breakdown/smackdown, whatever you want to call it, and I needed privacy.
My hands shook. My thoughts began to race. My mind composed the litany of loss that surely awaited me in my new life.
My house? But I loved my house! I’d just remodeled my kitchen and both bathrooms!
My car? I needed my car! What would I do without a car? How would I get anywhere with no leg and no car? Rickshaw?
Insurance? Oh, God, my self-employed health insurance was so expensive! What if I couldn’t continue to pay for it? How would I get the continued medical care I would need?
My job? What kind of work could I do if I could no longer write? Would I become a Walmart greeter?
Food stamps? Medicaid? Who would take me in? My father was gone and my mother was in a nursing home! Where would I go? What about my kids? My dogs? My hydrangeas?
“I didn’t mean to upset you,” said my friend the motivational speaker. “I guess you weren’t ready to hear my truth.”
I started yelling for the nurse.
Once my visitor was escorted out, I started sobbing so intensely I feared I’d never be able to stop. Great gulping spasms slammed into me. I couldn’t catch my breath. Tears were flying. I tried to explain to the nurses what had me so upset but the words came out a garbled and gurgling mess.
Maybe I’m not strong enough. Maybe I can’t do this.
It was the first time that thought entered my mind. It was the first time I said it out loud.
           Martina’s visit left such a bad taste in my mouth that I didn’t want to be involved with that support group. But in the fall of 2013, things had gotten so difficult that I reached out to them. I filled out one of their email forms, leaving my contact information and a short description of my situation. I explained that I needed a mentor, someone who had an AKA and had gone on to lead an active and full life. I requested someone who had managed to stay optimistic and determined over the long haul. I even admitted that my most recent wave of setbacks had worn me down so much that I was losing faith.
          I didn't mention the ill-fated hospital visit. I had come to understand that Ms. Navratilova had the best of intentions, but I was simply too fragile to hear what she had to say. I also didn’t mention the fact that my life now bore a striking resemblance to the horror story she’d shared with me. Hey, maybe one day I’d trust my future mentor enough to reveal that bitter irony.
          I never heard back from the support group. No call. No email. No mentor. No joke.



Wednesday, January 15, 2014

Ballad of the Fleshy Thigh



We’ve all been there. We wait breathlessly for that BIG MOMENT, the instant that will change everything. A wedding, a graduation, the birth of a child . . . these events draw bold lines through our lives. On one side of the line is the way we used to live, and on the other is a completely new way of seeing life. Giving birth to my first child was a real mind-blower.  One instant I was writhing in agony thinking I want; I need; me, me, me . . . and the next a tiny, pink, screaming human being was placed in my arms. In the blink of an eye I had become someone’s mother. It wasn’t about me anymore. It was about him — what he wanted and needed. And two years later, it also would be about her, my daughter, an even tinier, pinker, louder human placed in my arms.
Being felled by a killer infection was another BIG MOMENT, though not a joyful one and sure as hell not one I anticipated breathlessly. Let’s be real. If I’d known what was coming I’d have doubled-down on disability insurance, taken a trip around the world, and dumped the soulless hottie in advance. Plus, I would’ve cleaned my house and caught up on the laundry, since nearly dying when your house is a mess is akin to being in an accident while wearing old underwear. But no. Advance notice wasn’t an option. In fact, part of why mental heath providers came up with the term “catastrophic life event” to describe this kind of thing is because no one expects it will happen to them. You know, kind of like the Spanish Inquisition.
So there I was, mostly dead in a hospital bed, knowing on some level that my life had just been divided in two: everything that had come before this illness and everything that would come after. In the beginning, I didn’t worry about the “after” part. I only wanted to live. Each day was a battle to survive, even if the war was waged semi-consciously in the depths of my own mind. But as time went on and my awareness increased, the fears tried to take over. I pushed them back. Seriously, why worry about the theoretical difficulties of my future one-legged life when I could barely sit up in bed? Why fret about whether I could continue to make a living as a writer when I referred to my cell phone as a “television?” Why get myself worked up about my bills when I couldn’t remember the name of my bank, my street, or the publishing house I’d been with for a decade?
I remember telling my loved ones that being critically ill had reduced the million-and-one details of life into a single pinpoint of truth: I am still alive and so are you. The rest didn’t matter. Material things can be replaced or released. Situations can be altered. So what if I wouldn’t be able to come up with my mortgage payment six months down the line? So what if I missed my next book deadline, and the one after that – and the one after that? So what if my health insurance only paid some of my humongous hospital bill? There wasn’t a damn thing I’d ever be able to do about any of it until I got well.
And slowly – s-l-o-w-l-y – I did start to get well. After months of hospitalization and dozens of surgical procedures, I finally got the green light for what I had decided would be the BIG MOMENT to end all BIG MOMENTS: A skin graft.
In the early hours of February 12, 2012, the trauma surgery resident and his entourage came into my room to examine my amputation site. I held my breath. Nearly every morning for the prior two weeks (since I’d returned from my near-death sabbatical at Dr. Kevorkian’s Party Palace) doctors had checked the wound to see if it was healed and dry enough to close with a layer of my own skin. And every time the answer had been an unqualified “no.”
But on this morning, the surgical resident’s eyebrows shot up with surprise. “It’s looking real good. Let’s see what Dr. O’Toole thinks.”
I peered into the hallway, expecting to see the orthopedic trauma surgeon who headed up my treatment team. He wasn’t there. I listened, but didn’t hear his voice. I turned to the resident. “Is he here this morning?”
“Nah,” he said, pulling out his iPhone. He then took several flash photos of my amputation site from a variety of angles and forwarded them to Dr. Robert O’Toole.
I kid you not. Which got me thinking . . . if texting photos of our scantily clad bodies is called “sexting,” what should we call this? “Diagnexting?”
So as we all waited for the chime of an incoming text, I wondered . . . could this be it? Dare I hope? Am I finally on my way out of this damn hospital?
The resident read Dr. O’Toole’s response and then smiled at me. “He says you’re ready. We just have to reserve the O.R.”
I wanted to dance. I wanted to cry. I wanted to call everyone I knew to tell them the BIG MOMENT had finally arrived! I was so freakin’ excited!
Then, doctors started giving me the particulars of the surgery. I learned exactly where they were going to get this so-called “skin flap” and exactly how they planned to get it. My enthusiasm came to a screeching halt. It turned out the “split-thickness skin graft” procedure required large segments of skin of varying thicknesses to be peeled off the top of my healthy thigh with something resembling a cheese slicer.
Oh, holy shit. That sounded painful.

Cheese Slicer

The resident added, “Unfortunately, many patients say that the skin harvesting site is more painful than the surgery itself.”
Now, that was hard to believe.
“Luckily, your upper thigh is quite large.”
“Excuse me?” I wasn't sure I could handle any more of this conversation. Not only had I just learned I’d be carved up like a Virginia ham, but I had been informed that I was built like one, too.
“Uh.” He laughed nervously. “What I meant to say is that you have ample flesh on your thigh. We’ll be able to harvest the entire flap from one location. Patients with smaller thighs sometimes have to have segments removed from other locations as well.”
Well, damn. I knew there was a reason I’d always been blessed with fleshy thighs!

My Sliced-Up Fleshy Thigh, at the Gym
Four Months Post-Surgery

Two days later, on Valentine’s Day, 2012, I had my final surgery at University of Maryland Medical Center. When Dr. O’Toole checked on me the next morning, he said everything went extremely well and the graft looked perfect. But he cautioned that skin grafts don’t always take. Healing can be uneven and additional surgeries are often required, he said.
I remember thinking – not this girl, Dr. Bob. That graft is going to hold and I’m gettin’ the hell outta here!
It wasn’t long until I found myself in a familiar pickle. My insurance company wanted me moved from Shock Trauma, and they were going to ship me off to a nursing home unless I could prove I was ready for physical therapy at my local hospital.
I remember sitting on the edge of the hospital bed talking with my sweet and kind University of Maryland physical therapist. Despite the meds, my pain was so severe I thought I was going to throw up. And though what remained of my left leg was swaddled tighter than a Russian newborn, lightening-hot flashes of pain raced through my body. But that was nothing compared to what was going on with my Virginia ham thigh. The surgical resident had been correct – that sucker hurt worse than anything I had ever experienced in my life.
I glanced down at my right leg. The top of the thigh was covered in a rectangle of sticky, yellowish gauze rimmed in blood. Nurses had already explained to me that the substance was called “Tagamet,” and it accelerated healing by bonding to the exposed flesh beneath. As the wound site healed, the gauze would dry out and peel away, the nurses told me.
All I knew was that every time I inhaled or exhaled – every time I coughed or moved or got up to use the bedside commode – the substance would tug at the raw flesh underneath. The pain would leave me breathless. Blood would seep out around the edges. It would hurt so much I thought I would faint.
And now my insurance company wanted me to get up and jump around on this excruciating mofo?
I looked at my physical therapist. “Exactly what do I have to do to qualify for the rehab unit?”
She smiled at me apologetically. “Well, I have to be able to document that you stood up, held onto the walker, and took one step forward.”
I was having Déjà vu, big time.
           So, I had a choice to make. I could admit defeat and let them ship me off to another nursing home, or, I could just take a deep breath and get up, grab the walker, and get this shit over with. But my mind would have to be stronger than the pain, at least for a few seconds, and I wasn’t sure I could pull it off. This pain was the real deal, and everything I’d been through had left me physically, emotionally, and psychologically depleted. But maybe if I reached deep enough, I’d find just a little more strength left.
It was a very BIG MOMENT. I grabbed onto the walker and hoisted myself up on a numb and weak right leg. Rivulets of blood ran down my shin. I trembled from head to toe. The pain was so awful it knocked the wind from me.
But I did it.
Nearly two years have passed, and I look back on that version of myself with bittersweet compassion. I was brave. I was stubborn. I would do anything to get out of the hospital and through rehab so that I could go home. That had become the BIGGEST MOMENT of them all, because I believed that once I got home the worst of this nightmare would be behind me.
It’s a good thing I was naïve. If I’d known the truth – that getting “the worst” behind me would be a minute-by-minute, day-by-day battle that would continue for years – I might have chosen the nursing home.
I might be there still.







    



Sunday, January 5, 2014

Hell On Wheels



A decade before my illness, I had my first experience with one of those electric carts for disabled shoppers. My late mother, Beverly, dealt with scoliosis most of her life, and began using a walker in her seventies. One day she got a hankering to go to the local Kmart, so off we went, and upon arrival, she decided it would be fun to drive a cart around the store. I had my doubts. Beverly had never been what you would call a “savvy” driver. Many of our all-time favorite family stories revolve around her creative approach to owning and/or operating moving vehicles.
          For example, there was the day my mother decided to drive from our Cincinnati suburb to Dayton, where my older sister lived at the time. She took the exit for Interstate 71 North, but when she spied the road sign that proclaimed Columbus 95 mi she panicked. “Oh, my God! We’re trapped on this highway all the way to Columbus! I don’t want to go to Columbus!”
Fast-forward thirty-five years to that day at Kmart. Though I knew my mother’s electric cart adventure might turn into one of “those” stories, I got her situated and showed her how to work the forward and backward hand controls. Within seconds, she’d bulldozed an entire underwear display rack, sending a polyester tsunami of bras and panties into the jewelry department. She gasped. “Oh, hell, Susan! I think that was the reverse!”
As much as it pains me to admit, I have now had a few motorized cart moments of my own. Ironically, my favorite occurred in that very Kmart just weeks ago, while I was Christmas shopping. You may wonder why I use a cart if I have a prosthetic leg. The answer is complicated, and I’ll devote many blogs to what it’s like to live with a prosthesis, but for the purposes of this particular story I’ll sum it up this way: the leg hasn’t always fit correctly and had a tendency to fall off at inopportune moments; it is exhausting and time-consuming for me to walk through a big store; and if it’s crowded, riding in a cart is the safest option. Before I get to my Kmart Kristmas Kart Katastrophe, here are some of my other favorite motorized memories.
About two months after I got home from the hospital, I decided to make my first solo visit to the grocery store. It was a very big deal, one that required advance planning, stubbornness, and luck. I had just received my first temporary prosthetic leg, a very low-tech contraption I barely knew how to wrangle, and was using crutches to keep me upright. I made it down the steps to the driveway, opened the car door, hobbled inside, drove five minutes up the road, made it safely from the parking lot to the entrance of the grocery, found a motorized cart, fell into the seat, unplugged the cord, hoisted my dead-weight fake leg on board, drove off slowly and cautiously to the customer service desk where I left my crutches for safekeeping, then headed to the produce section, where I promptly backed into a display of hothouse tomatoes.
“Oh, shit!” I hissed.
Yes, I’d become my mother. It was a humbling moment.
Let me be honest. I rely on these mobility carts and they contribute to my independence. But I hate the suckers. I’m only now letting go of the embarrassment and shame I’ve felt while at the controls of one of these things. I admit that in the past I've avoided eye contact with people smiling down on me with empathy or granting me access to the soup aisle with the flourish of a matador. Now I just try to smile back. Some days are easier than others.
There is one aspect of motorized shopping that I despise more than words can express, and that is the shrieking alarm that activates whenever the cart is put in reverse. The decibel level is more suited to a sixteen-wheeler backing into a loading dock, and in my mind, the cringe-worthy sound warns shoppers to grab their children and seek shelter in the nearest alcove because the out-of-control disabled lady is about to crash into their asses.
But since I need them, my retail choices are no longer based on location, merchandise quality, or price, but on whether they have a stable of motorized carts. If I pull into a familiar store and find most of the handicapped parking spots filled, I turn around and leave. There won't be any carts available.  If it’s a store I haven’t shopped in since my illness, I will call in advance to make sure it’s not a wasted trip. Unfortunately, more than once I’ve shown up at a pre-certified shop to find every one of their carts out of order, heaped together in a corner near the Coinstar kiosk, electric cords lifeless and flaccid, as disturbing a sight as the “Island of Misfit Toys” from the Rudolph the Red-Nosed Reindeer cartoon of my childhood.
While driving a cart, I have been known to avoid acquaintances I haven’t seen since my illness, just so I won’t have to answer their inquiries. It’s difficult to respond with the usual “I’m fabulous! Crazy busy!” as I’m reaching for the marinated artichokes from a seated position. It’s even worse when someone I haven’t seen in years approaches with a look of horror and I have to explain what happened to me. Seriously, sometimes a girl just wants to grab laundry detergent and milk and go home without being asked to bare her soul.

Shopping for Boston ferns 

There was one event that helped me to let go of my shame. My friend Martin and I needed to get ingredients for a cookout and went to the grocery together. Because he knew I was embarrassed about using a cart, he hopped on one, too. We spent the next half-hour selecting produce, racing through the bakery department, and laughing. In a turn of events I will remember the rest of my life, I had just made eye contact with a gynecologist’s wife I used to socialize with when Martin chased me into the pharmacy section shouting, “Don’t forget the KY Jelly! Get the economy-sized bottle!”
After surviving that level of embarrassment, what could possibly bother me?
Ah. Let’s go back to Kmart, shall we?
Yes, it was unwise to attempt last-minute Christmas shopping, but I really had no choice. Unfortunately, we were moving to a new house during the holidays, and life was so chaotic that gift shopping wasn’t a top priority. But eventually it was a do-or-die situation, so I set out to Kmart. Because they had motorized carts.
           Things got weird almost immediately. A woman talking on her cell phone was leaning against what appeared to be the store’s only available motorized cart, her rather large butt pressed against the wire basket. I tried to get her attention. “Excuse me, I’d like to use this.”
She turned briefly, looked at me, then went back to her phone call.
“Uh, excuse me. I need this cart, please.”
“Hold on,” she said into the phone. She turned around again and rolled her eyes, sighing, then moved just enough that I could lower myself into the seat without brushing my forehead against her right butt cheek. I fantasized about running her over, then putting the cart in reverse and running over her again, but somehow restrained myself.
So I cruised out into the Kmart aisles, alarmed to find the place packed with merchandise and irritable last-minute shoppers such as myself. The cart was exceptionally slow, which frustrated not only me but anyone stuck behind me. I heard many an impatient exhale as I chugged through the kitchen accessories and the curtain rods. By this time, I started to get a bad feeling. Maybe this hadn't been such a great idea.
I grabbed the step stool I needed. I found some glassware. I found a few little stocking stuffers. But I still needed to buy lights for our Christmas tree, as our stash was damaged during the move. Of course, the Christmas décor was at the very back of the store, in an attached greenhouse used for lawn and garden merchandise in warmer months. The cart began to whine and tremble, but I made it through the automatic doors to the greenhouse, grabbed a roll of 400 mini lights, and headed back into the main store. The cart died on the threshold, and I couldn’t move forward or backward. The doors began to open and close in automated confusion, banging up against the base of the cart over and over again. So there I was, trapped in the doorway, getting the crap beaten out of me by large glass and steel doors, my cart overflowing with merchandise made in China. 
I spied a store employee and called for help. He yanked me clear of the jaws of death and went to get another cart. Fifteen minutes later, he returned, explaining that he had to wait for one to become available, but that he was pretty sure this one had enough battery power to get me checked out and to the parking lot.
Not wanting to risk another dead cart – and since I was dangerously close to tears and/or hysterical laughter – I made a beeline for the cashier. After waiting another fifteen minutes, it was my turn to pay. With the cart parked in the narrow lane between my cashier and the cashier working the adjacent register,  I began to place items on the belt. Suddenly, the cashier beside me turned and jammed her elbow into the back of my skull. I was stunned -- a "bird-crashing-into-a-picture-window" kind of stunned. I saw stars.
“Sorry about that, hon! I didn’t see you down there. Could you move so I can go get a price check?”
Eventually I made it to my car and tossed my Kmart cornucopia in the trunk. Only after I was safely on my way home did I start to laugh. Oh, how I missed my mother at that moment! I wanted a few more minutes in her company so that I could tell her this story. She'd enjoy knowing the baton had been passed.