SENIOR CHALLENGES & OPPORTUNITIES (June 30, 2023)

THROWN OFF TRACK

            I was adapting well to my CPAP routine. Hooking up every night to the breath-regulating machine was definitely unpleasant. But my doctors said it could be my best protection against recurring sleep apnea, a probable contributor to last fall’s heart failure. Still, I never enjoyed wearing the mask and looked forward most mornings to taking it off. Ditto to turning on my side for a final rest. When wearing the mask, I had to sleep on my back.

            Thursday morning at 5:45am, I was waking slowly, lying on my left side without my mask. Suddenly, I felt my head jerked farther to my left. The jolt was so powerful, I thought it might be an earthquake. Stunned and nauseous, I managed to roll onto my back. No relief. Opening my eyes, I tracked the ceiling lights streaming right-to-left, like small flying saucers in tight formation. I couldn’t slow or halt their movement. They progressed independently, pulling me with them. If I’d followed their lead, I’d have rolled out of bed. I felt seasick, light-headed, with a woozy sensation under my scalp.  Worse than the dizziness was the lack of control over my own body and consciousness. Not just physically disoriented, but emotionally shaken.  

            I lurched to Nancy’s bedroom and blurted out my problem. We thought we could identify a possible cause.  Two years before, she’d experienced rapid-onset dizziness and loss of balance. After weeks of intermittent discomfort, she’d been diagnosed with positional vertigo, brought on by dislodged crystals in the inner ear, greatly increasing sensitivity to head-position changes. This condition mainly occurs when lying down; seniors are particularly susceptible. Her treatment, once she’d gotten to an ENT specialist, had been a set of simple exercises turning torso and head. The dislodged particles were relocated and normal balance restored. We’d learned that this highly successful “Epley Maneuver” had been around for 40 years and was regularly employed in standard practice.

            On the morning of my attack, we agreed I should sit quietly in our apartment, keep hydrated, and see if my wooziness subsided. After a second session of vertigo on lying down for an after-lunch nap, I reached out with Nancy’s encouragement to our Retirement Community nurses. They came running. My vital signs still normal. No indications of heart problems or stroke. They encouraged me to try to see our Primary Care team ASAP.

            Given Stanford Health teams’ fully booked calendars, I was lucky to see Zhi-fang Tsun, our Primary Care Physician’s Assistant the following day. (By that time, a third episode had occurred. Thankfully, all were when lying down. If I’d toppled while standing, I might have suffered an injury.) Zhi’s diagnosis was straightforward and immediate: benign paroxysmal positional vertigo (“BPPV”). Since my implanted defibrillator discouraged major torso shifts, she instead led me through a sequence of prone neck and head turns. She and Nancy could readily discern my oscillating eye movements (nystagmus). What I’d been experiencing as a steady right-to-left stream was actually rapid back-and-forth repetitions. Within moments of completing these simple exercises, my eyes had settled down. Zhi prescribed a steroidal nasal spray to free up my blocked sinus passages which were probably contributing to my wooziness. In and out in 30 minutes, I returned home with instructions on how to repeat these re-stabilizing exercises on my own.

            I was delighted to have confirmation of the cause of my seismic affliction, plus a simple DIY regimen for reestablishing equilibrium. The downside was that this incident was forcing us to cancel a long-planned Sierras road trip. It just seemed too risky to head for remote highlands before we could be confident that I was fully cured. We called our mountain lodgings and backed out, just before costly penalties were incurred.

BACK IN BALANCE

            We started the weekend closely monitoring my recuperation. I kept up my daily repositioning exercises and new medication. We were sure that cancelling the week-long vacation had been prudent. Still, we were both feeling discouraged and disappointed. As my condition steadily improved, we began to wonder whether I might be able to continue my recuperation during a briefer excursion to a closer, substitute destination. Costanoa Resort seemed a promising candidate. Located mid-way between Santa Cruz and Half-Moon Bay on the Pacific Coast Highway, it was reachable within two hours from our Retirement Community, even with our preferred direct route closed by winter-storm damage. Nancy and I had enjoyed meals at Costanoa’s distinctive restaurant. But we’d never overnighted in its attractive lodge. It was a long-shot that they’d have space available on such short notice, especially during peak tourism season. But we gave it a try. To our pleasant surprise, they could offer us a room for three mid-week nights.

            Costanoa is difficult to find if you don’t know exactly where to look. Only a modest roadside sign signals the turn-in. Then a shaded half-mile lane leads to the low-key resort. Once you arrive, the 41-acre campus opens out, encompassing an ambitious variety of accommodations. In addition to the flagship lodge, there are cabins, tent bungalows and a large KOA campground with RV slots and a designated area for backpackers’ tents. The whole property is nicely laid out and maintained, on a level plain below the coastal range. (We later learned that a labor force of 150 is responsible for management, on-site services and upkeep.)  

            The resort has a complex and colorful history, not atypical of this stretch of California’s central coast. (The saga reminded me of Sea Ranch, the subject of a prior post, April 30, 2021.) In 1983, the owners of the sprawling Cascade Ranch offered a 4,080-acre parcel for sale. There followed 15 years of intensive negotiations, divisions and “legal shuffles” among public- and private-sector entities, environmental and development advocates. The ultimate agreement was approved, with support from the San Mateo County Board of Supervisors, by the California Department of Parks & Recreation, the State Coastal Conservancy and the California Coastal Commission. The compromise dedicated 3,000 acres for a new State Park linking adjacent Ano Nuevo, Butano and Big Basin Parks. Six hundred acres were reserved for “agricultural enhancement.” And 480 acres were designated for environmentally-respectful commercial and tourism development. To date, only 41 acres of the latter 480 have been purchased and developed: Costanoa Resort. After opening in June 1999, the resort changed hands several times. The current owner is Reynolds Resorts, a father/son Laguna Beach firm operating other properties in Mexico, Southern California and Shasta County.

            The Costanoa campus and its surroundings invited hiking, horseback-riding and biking trails. Ano Nuevo State Park’s northern extension was just across the highway. Nancy and I were there for rest and recuperation, but even for sedentary book-readers, the natural setting was handsome and restorative.

            Since the resort was so isolated, we appreciated having Costanoa’s first-rate Cascade Restaurant available for three meals a day, a hundred yards from our Lodge. Three features of this cuisine reminded me of our years of dining pleasure in Italy: inventive seasonal recipes; fresh, locally sourced raw materials; and skillful cooking. The menu was wide-ranging to attract and appeal to a diversity of clients: overnight guests, pausing motorists and area residents. We sampled linguini with clams, roast tomato bisque, pork and vegetarian empanadas, eggs benedict with shallots and kale, pappardelle with beef ragout. On the weekly Locals Night, we all savored crusted fried chicken, lively cole slaw, whipped potatoes and just-baked biscuits with local honey. Wines and beers were mostly from the region, with foreign choices also available.

            On our last morning, we enjoyed a cordial table-side chat with Day Chef Bernice Gomez. With evening counterparts, she supervises a kitchen and serving staff of 30. (The Resort owns the restaurant and also operates a summer pizza-and-barbecue snack-bar in its campground.) She informed us that COVID took a terrible toll on the restaurant’s viability. They closed completely for a time, then literally opened one dining-room window to pass through take-away meals. Now they’re back up to speed. Catering for on-site weddings and corporate retreats is an added revenue stream. Despite other small businesses’ post-pandemic labor shortages, Cascade is fully staffed, with no recruitment problems. We asked about the Big Basin Fire of 2022, because the burn scars were still distressingly evident all along the ridgeline. She said that when winds shifted in the resort’s direction, the managers had rushed to evacuate all personnel and horses. Then they put up the staff for two weeks in San Francisco Bay Area hotels.

            I spent hours on our Lodge-room balcony. The sweeping vista was therapeutic. But I most enjoyed the bold House Finches who’d expropriated our balcony railing as a communal perch. I’ve since read that this species comes in several colors, depending on their diet of local seeds and grasses. Ours boasted rich orange breasts and brows. Undeterred by my presence, the birds rested, sunned, chirped and launched. Between flights, they rotated amazingly flexible necks to snatch chest- and back-burrowing mites.

            On our first day, a trio of fledglings turned up to test their wings. Two ventured trial runs with no fanfare. The third was not sure he was ready. One and then both parents provided encouragement, even sweetening the deal with morsels of food. The youngster was committed in principle. He flapped furiously for lift-off. But he also hedged his bets, hunkering down on the railing to maintain maximum contact. His equivocation took me back to my own childhood, hovering on an unsteady diving-board. I knew I could do it. A cannonball splash was much simpler than a dive. I didn’t have to listen to my taunting pals. The water surface wasn’t that far below. I wanted to tell the hesitant fledgling that anything is easy once you know how. But your first time, your worst time, no one else can do it for you. You’ve got to take your own plunge.

            After three healing days and nights, Nancy and I left Costanoa for home. There’s no guarantee that my vertigo won’t recur. If it does, I’m still practicing my Epley Maneuver. On this initial occasion, grasping an opportunity for coastal respite helped me steer through an unsettling medical challenge.

Sincere thanks to Nancy Swing and Shutterstock.com for their photos.

Readers’ Homework for September

I’d like to offer an invitation. Which three to five persons whom you know would you most like to join you if you were stranded on a desert island? And why would you select them? Not celebrities but personal acquaintances. Omit surnames, if you wish, for privacy. Explain your strategy for converting a senior challenge to an opportunity. Keep it short: 200 words max. Submissions due by July 31; responses’ publication in the August 31 post. Be prepared and practical. You never know when a hurricane might pick you up and set you down. rbs@agileaging.net .