As it turns out, Leah and I are the things that are falling apart.

Leah has continuing issues with pain; balance; and, I’m sorry to report, cognition. She has what is apparently a stress fracture in her right heel. I say “apparently” because when the medical people ask how it happened, we can’t point to a particular time, place, and event. They say, “Aha! Its a stress fracture,” because those can happen over time from overuse, or unconditioned use. In any case, her right heel, or driving heel, is fractured and it hurts, strangely enough, in places other than her heel. The orthopedist thinks she has some nerve disfunction that is preventing her heel from hurting as much as it should. As a result, she is using it more than she should.

The doctor also says the bone in her heel has apparently lost some density. He suspects she may have osteoporosis in other bones as well.

This was on top of her chronic pain from arthritis and some residual pain from her pinched nerve and the subsequent surgery to correct it.

The balance problem has been increasing for months. She is falling fairly often now, usually on her left side. She scrapes the skin off of her arm, and just about the time it has healed, she falls and scrapes more skin off. She is supposed to use a walker, but she usually leaves it some other place.

That is partly the result of her cognitive decline. Her memory is fading fast. She remembers things that did not happen, and doesn’t remember things that did happen. She asks the same question several times, minutes apart. I will tell her something (I hesitate to use the word “explain”) and she responds with, “You used to be able to explain things so that I could understand.” When we watch a television show, she has trouble following the plot and remembering the characters. It’s getting harder for her to find something that she is interested in. One of the worst parts of this is that she is aware of the decline.

The center cannot hold.

Only in this case, the problem is that the center is holding all too well. A couple of months ago I started noticing an annoying after-image in my right eye when I blinked. It got worse, and my vision started to blur. I made an appointment with my eye doctor, and he did some imaging that showed a distortion in the macula. He referred me to a retina specialist, who told me I have vitreomacular traction (let’s call that VMT). That means that the vitreous (people in the eye business use the word as a noun. I can’t help seeing it as an adjective, as in “vitreous gel,” the clear fluid in the eye. But, as I was saying, ) shrinks and doesn’t let go of the macula like it should. They (mainly google) tell me that the vitreous shrinks as we age, normally without symptoms or harm, but in some cases, it refuses to let go of the macula, with which it has been in intimate contact for many years. When that happens, it pulls the macula away from its proper position, causing visual distortion, blind spots, and eventually tears in the macula. The tears may actually be responsible for the blind spots; Google is silent on that issue. I now have a blind spot in the exact place that normally has the highest resolution. You know, the part you read with.

I have eye surgery scheduled for October 5 in Chattanooga, TN, about an hour and a half away from our home, depending on traffic. It would be hard enough if it were in our town, since Leah is not driving now. I am expecting to be gone a minimum of five hours, possibly more. Leah can’t drive now, possibly ever again, and I cannot leave her alone that long. Even if I could, she can’t handle Zoe, our big dog, and I will need someone to drive me home, and then back to Chattanooga again the next day for a post-op checkup.

My aunt has found a friend of her son who says he can drive me. He will soon learn that he will be driving Leah and two dogs as well. That’s the only solution I can think of to take care of her and the dogs. Fortunately, the weather should be cool enough in October that they can stay in the car for a while. I checked the surgery center on Google Earth, and it looks like there are shaded parking spots.

In addition to my VMT, I have a cataract in my left eye, which is now my good eye, but which used to be my not-good eye. It’s having to do double duty, seeing for itself and filling in the details that my right eye is missing. Unfortunately, the cataract is causing a slight bit of double vision, just enough to be annoying when i’m driving at night. So, soon after I get over the VMT surgery, called a vitrectomy, because they take out the vitreous, I will need cataract surgery. It seems that everyone my age has had cataract surgery, and it’s a breeze.

A vitrectomy is not quite a breeze, but it is a relatively short procedure. The recovery involves maintaining a face-down position for up to a week. That’s because the surgeon will inject a gas bubble into my eye intended to press against the macula and try to convince my body that the macula is supposed to be attached to the back of my eyeball. The gas bubble does no good if it’s pressing against the front of my eye, so I will need to be face down to keep it pressing against the back of my eye. The gas will eventually be absorbed by the body, and the eyeball will be filled with some sort of fluid that the body will generate. We all hope.

Various eye specialists, speaking through Google, tell me that the surgery has a reasonably good success rate. The first time I saw my specialist, he said if the VMT is caught early, surgery is 99 percent successful. The second time I saw him, he said it had an 85 percent success rate. I will not ask him again.

And, of course, success depends on your definition. The result of a successful vitrectomy is a gradual recovery in visual acuity. Although Google refuses to commit to a particular level of recovery, the strong implication is that my vision will never be as good as it was before VMT.

Google also tells me that if a person has VMT in one eye, the probability that they will have it in the other eye is greater than 50 percent.

It’s just barely possible that I have already had VMT in at least one eye, possibly my “good” eye. About two years ago I started noticing the after-image when I blinked. It was annoying but I didn’t worry too much about it. It gradually went away, and I didn’t even notice when it did. Was that VMT? I do not know. All that I know is that it was almost identical to what I experienced with a diagnosed VMT, and that in some cases VMT can spontaneously resolve without surgery.

Health issues are generally depressing. And, as anyone who has dealt with the cognitive decline of a loved one knows, that can also be depressing, and quite stressful. That’s one reason I have not been able to generate enough momentum to actually do anything lately, including write new blog posts. Maybe a few things will come back together in the not-too-distant future. Things not falling apart would be a nice change.