No longer hip: losing my balance and adapting to what ails me

Abstract

Viewing personal narrative as a way to cope with personal issues and public troubles, as well as to provide companionship and comparative life experiences for those going through their own troubles, the author tells a story about adapting to the chronic pain and deterioration of osteoarthritis of the hip. Coping with degenerative but non-life-threatening aches and pain, which are likely to increase as baby boomers age, is an important part of our lived experience of health and ageing, and worthy of examination in our research and stories. Calling on medical and psychosocial literature, the author contextualises her story of learning to live with arthritis as a relational and bodily process with implications for ageing well. Her goal is to incorporate arthritis into her storyline, rather than fighting it or giving in to it. She hopes to stimulate conversation about our ‘conditions’ as a way to work through and cope well with what ails us rather than letting our ailments become who we are – to ourselves and with others.

Keywords:

• osteoarthritis
• autoethnography
• personal narrative
• ageing
• chronic pain
• biographical disruption

Acknowledgements

Thanks to Arthur Bochner, Keith Berry, Tom Frentz, Tony Adams and Brett Smith for assistance with this article. Thanks also to Buddy Goodall, whose blog during the last 14 months of his life provided a model for how to adapt gracefully to whatever situation we find ourselves in and for how to live as well as we can for as long as we live.

Notes

1. Bury (1982) notes that a diagnosis of illness often brings a sense of relief in that it provides a legitimate reason for the pain.

2. Osteoarthritis is different from diseases that have a definite marker, such as heart sounds or chemical markers in the blood, or are associated with a particular event, such as a seizure. Clinical research shows that x-rays of osteoarthritis are often a poor predictor of experienced symptoms (Sanders et al. 2002).

3. I was unaware that arthritis of the hip often causes a pain in the groin. See Khan et al. (2004).

4. I was unaware that there likely is an inverse relationship between osteoporosis and osteoarthritis. The relationship is complex and perhaps weight-bearing activities benefit peak bone mass while increasing damage to cartilage, or high bone mass density may present a heavier load for weight-bearing joints (Amin 2002, p. 134; see also Antoniades et al. 2000, Dequeker et al. 2003).

5. Though findings are contradictory, laypeople, physicians and researchers alike attribute pain and chronic illness, including that of osteoporosis, to getting older (Kee 1998). Many people view osteoarthritis as a normal part of ageing (Blaxter 1983), even while it disrupts their lives and biographical continuity (Sanders et al. 2002). Though pain is assumed to be a natural part of getting older, many studies have not found a direct relationship between ageing and chronic pain. These studies show that reports of pain increase significantly with age, up until the beginning or mid-60s, and then increase only slightly or even decrease (see, e.g. National Centers for Health Statistics 2006, Brown 2012, Thielke et al. 2012).

6. Clark (1987) notes that in a relationship sympathy is more likely to be given by the person perceived to be in the more powerful position.

7. Leder (1990, p. 73–76) describes the functioning body as absent, while the problematic body reappears, calling out and seizing the person’s attention.

8. See Leder (1990) for a more in-depth discussion of this idea.

9. Numerous studies and reviews suggest that social psychological factors affect pain management. See, for example, the study by Kee (1998), who examines socio-economic status, and the review by Backman (2006), who reports such factors as self efficacy, active coping and readiness to change.

10. Charmaz (1991) discusses the role of concealment and disclosure that chronically ill people use to protect themselves.

11. Bury (1982); Lavie-Ajayi et al. (2012); and Frank (1995) discuss how chronic pain and illness assault one’s identity and are difficult to integrate into one’s life story. Bury (1982) says it leads to biographical disruption, interfering with daily life and future planning, as well as relationships. See also Sanders et al. (2002) who discuss disrupted biography and uncertainty for older people with osteoarthritis, even those who think of arthritis as a normal part of ageing. Charmaz (1991) examines illness as an opportunity to reconstitute one’s self and relationships in a reflexive manner.

12. According to Kee (1998, p. 19) and studies she examined, most people will have osteoarthritis by age 80, though only 35–50% will show clinical signs and experience symptoms of the disease.

13. Lavie-Ajayi et al. (2012) note the juxtaposition of the felt experience of pain while at the same time it is “elusive and deceptive”, sometimes invisible and de-legitimated by others. The tension leads to “narratological distress” in which people struggle to come up with a story to tell.

14. Kleinman (1988) and Frank (2000) discuss how demoralising illness can be. Kleinman (p. 247) discusses the importance of grief work, which helps establish a distance from a former emotional state, and of having an empathic witness to help in the remoralisation process (p. 54). Frank (2000, p. 355) emphasises how telling stories of illness can be part of the remoralisation process.