Fall Risk

I’m pretty good at managing my POTS after four years, but sometimes it still gets me.

I recently had myself a Big Fall on the way to my neighborhood bodega. Not “fall” as in “autumn” but “fall” as in “I toppled head first onto the ground.” Actually, “fall” isn’t fully selling it. I passed out just walking down the street because of my Postural Orthostatic Tachycardia Syndrome (POTS). While it provided me with a perfect bookend to an essay I’m working on, and so I’ll count it as a literary win, it also supplied me with a lot of physical pain and emotional angst. I got road rash up the whole right side of my face. I lost the skin on my palms. My knees started bleeding immediately and swelled up like a couple of pufferfishes. I sprained my shoulder.

I’m pretty good at managing my POTS after four years. I wear compression socks to keep my blood from pooling in my feet, I drink so many electrolytes to keep my blood volume up, I take a beta blocker and an SSRI, I lie down flat for a not insignificant portion of my day. It’s something I have to keep in the forefront of my mind all the time. Like, watching sports? I absolutely cannot jump up in frustration or exhilaration, or I’m going right back down, unconscious. In fact, I really have to be careful throwing my arms up above my head while sitting down, because even that makes me woozy. (I think it’s because my autonomic nervous system can’t figure out where to send the blood? It’s supposed to go to my brain, but then why are my hands and arms suddenly in the air above my brain? Better pull the brain-blood back and rocket it up into those fingers!)

But man, falling over inside your own home and falling over outside on the New York City street are two completely different experiences, and not just because my floors are clean and who even knows what all is on those sidewalks. I wasn’t out for very long at all, but wow, I felt as vulnerable as a shell-less turtle when I came-to. Maybe it was some kind of evolutionary biological response. Like, if a bear had wandered up, everyone else would have simply had to outrun me, the middle-age lesbian on the ground. But probably, actually, it was my pride. I walk around like a real tough guy, protecting my neighborhood feral cat colonies, scooping up errant children careening toward traffic on their bikes and scooters, always ready to fight anyone who’s got something to say about my face mask. Lying on my back, bleeding like that: I did not feel very strong. I didn’t even feel sturdy.

The whole way I was dragging myself back home, I was practicing what I was going to say to my wife when I opened the front door, which was, “Don’t panic.” Ridiculous, of course, because I was bruised and limping and talking like someone who’d just smacked her jaw against the pavement.

What really messed me up was that my doctor kept calling me a “fall risk” in our conversations about the damage. I told my wife about it, putting on an oafish voice and going, “Fall risk fall risk fall risk” over and over. She cupped my scabbed cheek in her soft hand, oh so gently, and said, “You are a fall risk, you obstinate prince!”

And I am. I know I am. I was a fall risk even before I got Long COVID. My cervical spine is held together with titanium and dreams, so I’ve been forbidden by my neurosurgeon from climbing ladders or even step stools for years. But one of the main symptoms of my kind of POTS is dizziness and fainting, which makes falling while standing on solid ground a kind of common thing. The last time I was under anesthesia (getting a colonoscopy during which I talked dreamspeak about the WNBA the whole entire time to my gastroenterologist, apparently), I woke up with a FALL RISK bracelet on my wrist next to my hospital bracelet.

I was like, “Oh man, for real?”

My wife’s voice, hovering nearby said, “For real — and leave it on.”

When I was having extra trouble with the label last week, probably because I kept bleeding all over the place from where I lost all that skin, my knees still bruised, Stacy leaned into me on the couch, where I was holding Socks in my lap, and said, “You know, he’s actually the biggest fall risk in this family.”

And she’s right about that too. Socks is in veterinary journals for falling and NOT landing on his feet two separate times in a way that paralyzed him. We helped him rehab extensively both times, but now he can’t jump. Our house is a maze of cat-specific accessibility stairs and ramps, so he can get onto all the chairs and onto the couch and into all his favorite nooks and crannies. Every night I carry him up the stairs to the bedroom where he sleeps with exactly zero furniture, so he doesn’t try to climb while we’re asleep. And every morning, I scoop him up and carry him back downstairs with me. Despite all of his hardships, he remains the sweetest, cuddliest, funniest, most precious guy. He was born a feral cat and now he lives like a little god.

“We’re a lot alike,” I said, reaching down to run a finger over his soft nose while he let out an enormous snore. “Adorable and wobbly and stubborn.”

My wife grasped my knee and squeezed, and even though it stung because of the scabs and bruises from my fall, I didn’t wince. We’ve been together 15 years and I still get butterflies when she touches me. “You’re both perfect,” she said.

“Yeah,” I agreed, as Socks let out another snorffle, rolling onto his back, belly-up, his mouth falling open like an absolute doofus. “Yeah, that’s true. Adorable and wobbly and stubborn — and pretty much perfect.”