Good-enough bones

No house lasts forever, including our own bodies. We keep moving as long as we can.

5 minute read
View from below the wooden framing of a house under construction, against a bright blue sky.
(Photo by Kier in Sight Archives on Unsplash.)

She was already old when I spotted her back in 1999, a crone of a house with a scalloped-shingle bodice, narrow hips, and sturdy calves of Wissahickon schist planted in a little patch of West Mt. Airy.

A non-binary dwelling, I might say now; we didn’t have those words back then. What we had was love-at-first-glance, a house I felt so certain should be ours that I faxed a blurry photo to my partner—she was still in Portland, Oregon, the city where we met and fell in love—and told her I wanted to make an offer.

Later, the inspector poked under cabinets, tapped walls for studs, traced wires that writhed across the basement ceiling. You could see where the nearly-century-old house had spawned an extra bathroom. You could see the old umbilical, a dried-up tap where, once upon a time, she fueled her lights with natural gas.

Finally, he shook our hands. “Mazel tov. She has good bones.”

Standing, still

The Wynnewood house where I grew up had a wooden shed appended to the back; it’s where we kept the sled, the rakes, the stiff green knot of hose. One day we spotted insects crawling there. My mother did some research. Termites.

I don’t remember what came next—exterminators? Deconstruction of the shed?—but I recall, as if it were contagious, my mother’s sense of doom. A nauseated terror: something was eating our walls from the inside. Would our house eventually buckle to its weakened knees?

We—or, rather, the professionals who do such things—stopped the termites in their tracks. The house stood strong—is standing, still—but the trauma lingered. For months after the infestation, when my parents and I played what-do-you-see-in-the-clouds, my dad and I envisioned turtles, dragons, sheep. “That one,” my mom said, pointing to a grayish blob, “looks like a termite.”

Bones in motion

There are 206 bones in the human body. The largest is the workhorse femur, the tiniest caches in the internal ear. Bones help us move; they form protective guardrails for the organs that gleam and pulse within.

We think of skeletons as static, bone as less dynamic than, say, skin or hair. But that’s not true. Obviously, bones grow; otherwise, we’d all remain the size of infants. What’s news is that our skeletons keep growing even once we’ve reached full size.

The body continually breaks down old bone tissue and rebuilds. There are construction workers: cells called osteoblasts. The wrecking crew: osteoclasts. And osteocytes, the mediators, whose task is to maintain bone tissue.

These osteo-specialists essentially rebuild each bone from scratch every 10 years. But when the balance tips—when breakdown happens faster than replacement—the result is osteoporosis. Fragile, brittle bones. A house weakened from the inside out.

The skeleton of my self

I had my first DEXA scan—dual X-ray absorptiometry, for the medical geeks among us—at age 55, just before the pandemic we didn’t know was coming. My numbers weren’t good. Osteopenia (the preview act to osteoporosis) in my hip; full-on trouble in my spine. That meant a higher risk of fracture—any fracture—if I were to fall.

But then, a slew of bigger worries—my mother’s health, my daughter’s Covid-19-altered college years, cops killing Black people, the climate-chaos world. I upped my calcium dose. I walked and ran. Mostly, I forgot to remember about my thinning bones.

Until a new doctor ordered a second DEXA scan last fall, and an endocrinologist made a case for potent medication that would restore my bones instead of only putting a stop-work order on the teardown.

Twelve injections, once monthly for a year, then a maintenance drug to preserve the restoration. I did some research: was this like calling scabs to do the work of on-strike osteoblasts? Was I courting greater risk (one study showed a higher rate of stroke and heart attack in women on the drug) than a fractured wrist or rib?

A view from above of two legs, the left foot in a sock and the right foot in an orthopedic boot.
A writer gets the boot. (Photo by Anndee Hochman.)

Then a stabbing pain began in my right foot each time the pad hit pavement. X-rays showed a stress fracture and a bunch of terminology I had to look up on

The upshot: my bones are not so good at being bones. Why? Genetics, probably: a long line of age-shrunk matriarchs. My demographic—small-framed, white, post-menopause—puts me at risk. I eat yogurt every day, but years of panic attacks sent stress hormones riling through my system; cortisol can mess with bone-rebuilding and calcium absorption.

Oh, and more: I swallowed steroids, which also erode bone—once, twice, how many times?—in an effort to shrink inflammation in my sinuses and regain my sense of smell. No one warned me I was taking sandpaper to the studs, gnawing away the very skeleton of my self.

Built to move, not to last

I am a 60-year-old woman who lives in a 113-year-old house, gimping in her orthopedic boot up Market Street for a first injection of the medicine that will, I hope, augment that inner osteo-team.

I know, I know, no matter what we do, our dwellings will outlive us. We humans aren’t built to last. But I’d like to keep moving, fracture-free, for at least another 30 years. The drug seems like my best chance.

Close-up on a hand holding a small brown and black plush platypus.
Platydos to the rescue. (Photo by Anndee Hochman.)

Joe, my nurse, is kind: Would you like a blanket? Some ice water? Does your … is that a platypus … have a name? Yes, I say, it’s Platydos, the black-billed, palm-sized stuffed animal that I bring to scary medical appointments.

The shots go in my belly—one throbs; the other stings. Two Band-Aids and I’m good to go. Later, my abdomen aches as if I’ve done 100 crunches.

I imagine my weary osteoblasts being shown up by the newbies—see, here’s how it’s done—while the cells that break down bone get furloughed. I think of how it’s all enlaced—not just the child’s rhyme, knee-bone-connected-to-the-thigh-bone—but in a bigger sense: genetic tendencies kicked into gear by environmental stressors and private and communal loss prompting panic, unleashing cortisol, eroding the armature in places we can’t even see.

I look at the clouds: lion, swan, an armadillo. I clutch Platydos in my left hand. I imagine being old—not as aged as our queer Victorian of a house, but several decades on, still hoofing through this scorched and stunning world, an old woman with good-enough bones.

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