Evelyn email: eleeper@optonline.net
Leeper email: leepers@optonline.net
Thursday,
03/21/13 The Operation
Sunday, 03/24/13 The Guest of Honor Speaks Up
Monday, 03/25/13 Choosing a Rehab Center
Tuesday, 03/26/13 A Day of Sub-acute Rehab
Wednesday, 03/27/13 This May Be a Long Siege
Thursday, 03/28/13 Getting Used to the Routine
Friday, 03/29/13 Ordinary Day with Origami
Monday, 04/01/13 April Fools Day
Tuesday, 04/02/13 Evelyn Enters and Leaves a Car Twice
Wednesday 04/03/13 Graduating to a Walker
Thursday, 04/04/13 Social Worker Meeting and Summaries
Friday, 04/05/13 Evelyn Misses a Book Sale
Saturday, 04/06/13 Evelyn Visits the Outside World
Sunday, 04/07/13 Frustrating Sunday
Monday, 04/08/13 Evelyn's First Return Home
Tuesday, 04/09/13 Evelyn Goes for a Little Walk with her Walker
Wednesday, 04/10/13 Walking Without Support
Friday, 04/12/13 A Trip to the Orthopedist
Saturday,
04/13/13 Evelyn's Last Day At Rehab
Sunday, 04/14/13 Evelyn
Comes Home
Wednesday, 04/17/13 Progress After Four Weeks
Thursday, 04/18/13 No Additional Therapy Needed, Thank You
Friday, 04/19/13 A Surprise from the Library
Saturday, 04/20/13 Another Nice Card
Tuesday, 04/23/13 Getting Ready to Drive
Thursday, 04/25/13 New Travel Document
Sunday, 04/28/13 Evelyn Hits the Road
Wednesday, 05/08/13 Progess Is Slowing Down
Friday, 05/10/13 Back to the Orthopedist
Tuesday, 05/14/13 More of the Same
Sunday, 05/26/13 And the Bills Keep Rolling In
End
of file with most recent entries.
Wednesday, 03/20/13 Original Incident
I will write this in the form of a log because I get the most information written this way. Readers can skim for what they consider important.
I am writing you from the emergency room of Bayshore Hospital. Evelyn fell off the bottom step of the attic steps in our garage, hit her head, and it looks like she broke her hip. Right now I am waiting for her to return from the x-rays.
I do not yet know how long she will be in the hospital. I don't know how long recovery will be. I don't know much of anything at this point. At 2:45 she was descending the ladder to the attic, carrying a box of audio cassettes. She got to the bottom step with one foot and the floor with the other. The box started to spill the cassettes and she went to grab them, lost her balance and fell on the garage floor, landing on her back and hitting hear head. Luckily I was in the den and could hear her calling for me. I went to the garage and saw her lying on her back, her right foot turned outward. To her it felt like her right leg was resting on something between her foot and the floor but there was nothing but her shoe.
She could talk unimpaired, so I asked her if she needed an ambulance. She could not move her leg, so I said we needed to call for help. I called 911 and they dispatched a policeman and an ambulance. The policeman said that with her leg turned to the side it was probably a broken hip.
They took her to Bayshore Hospital. I canceled teaching and headed out to the hospital. At the hospital I did not learn much. Her leg hurt badly when she moved it and somewhat less if the leg held still.
At 4:45 I am waiting for her to come back from x-rays. OK, she is back. Now somebody has to interpret the pictures. Her doctor is Dr. Yu. (P.S. He was only her doctor for admission.)
OK, I have seen the x-rays and Evelyn has a clean break at the top of the hip. Just below where the hip widens to a knob there is a fracture straight across like it had been done with a knife. Evelyn will have surgery tomorrow morning. I have a 10:30 appointment with the pulmonologist and that is just two buildings away from the hospital. I will probably see him and then come directly to the hospital. I probably will get the news then about how the operation went.
Evelyn says her leg aches like it has been in one position too long. But moving it hurts a lot more. After she gets the injection she says she feels very strange. It is as if she is going to pass out, but it does not happen. It feels like the whole room is "scrolling." She is not sure she can describe it.
The orderly is going to slightly increase the pain medication. Evelyn will in room 331B. It should be easy to remember. Sherlock Holmes was at 221B and if you substitute 3s for 2s, you get the room.
About 7:05 they come in to give Evelyn a CAT scan. An orderly wheels her and I am told to follow along. Whenever anybody bumped their head in an accident they do a CAT scan. They wheeled her to a section of the hospital where they warn of a strong magnetic field and it says authorized people only. It is with some relief that the orderly tells me to wait outside in some chairs. I was worried for the electronics I carry around. I am more than happy to wait in the hallway. But the hallway must be safe. I see a room with terminals on the other side of the ribbon labeled "Danger." The magnetism must not be so bad there.
Evelyn is wheeled out of the CAT scan area by an orderly. The haircut is male, the voice seems male, but the shape is female. Neither of us wants to guess the gender. It does not matter. What matters is how good she is. The staff seems pretty good. Evelyn was put in 331A. I am not sure why the switch. Evelyn's phone is 732-739-5782.
Another switch is that have decided to do the operation tonight, not tomorrow morning. I am not sure why the switch.
Evelyn was bedded down and about 7:50 and a Dr. Lopez came in to explain what he is going to do. They will put a metal rod in her leg and have about five four-inch incisions to fasten it into place. Evelyn can start walking a little tomorrow with the aid of a walker and with physical therapy. I told Evelyn to call me as soon as she feels that she can. Dr. Lopez says that they probably will let me stay through the night to see her when she comes out of the operation. He estimates that he will operate on Evelyn around 10 PM. If the case before her takes too long it will be at 11 PM. That scares me a little. Tired men make mistakes.
These days a hospital at night sounds like there is always someone in the hallway playing pong. Two different carts come in at the same time. One it to measure obscure parameters like something called Pulsox. Another wants to collect information that has been collected earlier about where does she live and does she have a living will. We have been asked several times to recount how the accident happened.
There is a dry-erase board on the wall that seems calculated to make the stay feel like a hotel visit. It lists the room number and phone number. But it also has a number to call for "guest relations," "for your DINING PLEASURE please dial..." and "CONCIERGE CARE: Leave the rest to us. Please call..."
There is an ever-present chart of faces in varying degrees of pain, each with a number. You are supposed to rate your pain being like which round-faced cartoon. Mr. 0 is a happy smiling man without a care in the world. There is a broad smile on his face and two high-arched eyebrows. Mr. 2 has a smile not quite so broad. Mr. 10, the most pained man of all, has a big frown, tears running down his face, and eyebrows that look like the two sides of an open drawbridge. Above the pictures is the message "pain control is our top priority." Actually now that I look there is also a laminated sheet on the wall with the same six faces. They are called the Wong-Baker faces pain rating scale. Apparently it is a standard pain rating scale. There is also a sheet listing "Patient Rights for Pain Management." Seven rights are listed like "The right to participate actively in decisions about how to manage your pain." I cannot tell how Evelyn is managing her pain. She is listening to her iPod with her eyes closed or possibly sleeping. It is now about 9:30. I hope she is sleeping so she is not feeling pain.
The doctor tried to make it sound like the operation he is going to perform is one that is fairly routine. Of course he is probably right, but I cannot help being frightened.
They bring a woman in for the other side of the room, 331B. She has a broken shoulder. She also fell victim to a nasty fall. She tells the doctor she tripped on a bowl of cold cereal. I'm sorry that is all I heard. I think that is all she told the doctor and I am trying not to eavesdrop. How does somebody trip on a bowl of cold cereal? One of her family says he went to the Chinese restaurant Crown Palace and ordered Cold Noodle and Sesame Sauce. They were too disgusted to eat it saying it was a peanut butter sauce that they said looked like something a dog had left. Hey, Cold Noodle and Sesame Sauce is great. It just has a LOT of fat. Ah well, not everybody can appreciate the same things.
The staff all seems very friendly. I think over the past few years we have seen the rise of "friendly" in businesses. Both the employee and the customer seem to like the experience. Companies like NetFlix and L. L. Bean find really friendly staff gives them a competitive advantage. I think this is probably a well-run hospital.
It is now 11:30 PM. Evelyn has not been called. I try to sleep a little in a chair, but it does not work. Evelyn is getting more sleep than I am.
The nurse came in and said perhaps Evelyn's operation will be postponed until tomorrow. We had lunch about 2 and neither of us has eaten since. Evelyn is not supposed to and I have no way to. But she just came in a few minutes ago and said they still have not decided to postpone and the doctor is still in the operating room.
The call came about 11:40 PM. Evelyn suggested I go home, but I want to wait with her and be here when she resumes consciousness.
I started to go down in the elevator with Evelyn and Evelyn mentioned to the nurse I had not eaten since 2PM. The nurse found me a turkey sandwich in a room apparently stocked for such occasions. They also invited me into the preparation/recovery room to wait with Evelyn. Evelyn was shortly in a light sleep.
Thursday, 03/21/13 The Operation
Well, it is past midnight. Evelyn is still waiting to be brought into surgery. I can write a long log because so much time is spent just waiting.
Around 12:35 Dr. Lopez came over. We asked some questions about the monitors.
Things move very slowly but at 1 AM she is ready to go in for the operation. Well, that has been true for a while now. Now they are ready for her. They figure she will come out of surgery after a couple of hours, at about 3 AM.
Actually it was more like 4:10. In the mean time I waited in the surgical waiting room, worked on a film review, worked on a letter, and listened to iPod music. Come 4:10 AM or so one of the nurses came for me. (Actually I am not sure they have nurses. I can't remember all the titles they have these days. I call them orderlies or nurses and probably neither term is correct.)
Evelyn had a reddish tone to her face and she talked a little slowly. Both got more normal as I talked to her. She is just very tired. I guess sleeping under anesthesia when she had an operation is not all that restful. She is clearly not her old self yet, but neither am I. I have now been up for about 24 hours with no more than a second or two of sleep.
I drove home and got to bed at 5:30. I slept until 8. I was awake for just a couple minutes when Evelyn called. She sounds more herself.
I spent most of the day at here bedside. Much of it she was asleep. There was more that happened, but I did not find out until later.
Friday,
03/22/13 Not Ready for Prime Time
It took me a while to get in to Evelyn. I had skipped
exercise the day before because of my really weird hours the day
before. I slept till 6:30 AM, which is well past my usual
awaking time. I finally arrived at the hospital about
10:30. There is not a lot provided for someone like Evelyn to
do. They figure that the TV in the room is
entertainment. Evelyn and I are movie watchers but not
general TV watchers. There is not much on that would interest
her. PBS might have something after 8 PM, but by then she is
probably asleep. After an operation like she had the body
needs a lot of sleep. I have never seen that
explained. Part of it might be that she lost a lot of blood
and it takes a while for her to rehydrate and for the bone to make new
blood.
This leaves Evelyn very tired and she keeps falling off to
sleep. I was listening to a podcast that reviewed opening
films. One was FROM UP ON POPPY HILL, which we had both seen
and I had reviewed. I asked Evelyn if she wanted to hear the
review and she said that she did. I gave her the iPod and she
started listening and almost immediately fell asleep. After a
few minutes I went to take my iPod back and she said she was still
listening to the review. However, after a second she realized
they were talking about a totally different film.
I find a very common trait among people is that they deny falling
asleep while watching or listening to something. I do it as
much as anyone, but we will be watching a movie and I will see Evelyn
nod off and I will say gently "wake up." Evelyn will wake up
and deny she has been asleep. Or Evelyn might catch me
sleeping. Her wake-up call is not so gentle. But I
will claim I was awake. And it is a bald-faced lie.
Incidentally I think an iPod is one of the greatest sleep aids ever
discovered. When I go to sleep at the end of the day it puts
me out in under five minutes.
And speaking of going out quickly in the afternoon the physical
therapist came around to try to see if she could get Evelyn to stand up
with a walker for support. Evelyn was picked up and stood
there for a second or so, but it was too painful. They picked
her up and put her in a chair. She sat there for a moment or
two and her head rolled back and her eyes rolled up into her
head. I would say she did what I would call a "rag
doll." She went unconscious and totally limp.
They grabbed her and laid her on the bed. Evelyn opened her
eyes and said she did not remember moving back to the bed.
There was a good reason for that: she was totally
unconscious. The two people doing this called for a "rapid
response." This involved taking a room that was pretty full
with three people standing around and within about a minute packing it
with about eight more people and five rolling machines. This
included a heart defibrillation with two paddles. But in 90
seconds after being back on the bed her voice sounded normal.
Outside I don't think I was showing much of a reaction.
Inside was a different matter. I don't think it comes as much
of a surprise to the reader that when you see a loved one go limp like
a rag doll, it is a very scary sight.
Later that afternoon our friend Jo Paltin came up for a
visit. That was good because for one thing she is a much
better conversationalist than I am.
About 5 PM I headed home. I stopped on the way at Shanghai
Bun and had a large bowl of Spicy Beef Noodle Soup.
In the evening Evelyn called and I talked to her for a while.
On the phone she sounds like her normal self.
One of the decisions I made that evening was that it was worth a little
extra effort to put this log on line. I can put on updates
and people can check them out themselves. I will take a
camera to put Evelyn's happy, smiling face on the page.
Saturday,
03/23/13 Progress
I will not be able to see Evelyn until the afternoon. I have
my
tutoring at the library. This was a quiet morning because the
students are on Spring Break. I had three show up.
What
dedication! But it was mostly a quiet morning. She
did send
mail saying, "I think I am a lot better. I sat on the edge of
the
bed to have them take by blood pressure in that posture and it didn't
hurt nearly as much, and I was not dizzy, (I did not stand
up,
though.)" In other mail she said, "The surgeon (Dr. Lopez)
changed the dressing. This one is less bulky, which should
make
sleeping more comfortable. There are three incisions, with
about
15 or 20 staples total, They will be removed in a couple of
weeks.)" [Actually, it was closer to 30 staples.]
I got some written on this log around the few questions I
got. The father of one of the regulars came in with questions
on whether his son should take two honors courses in math or one, one
regular math course, and a an elective like Microsoft office.
Interesting coincidence. I was just telling him about
half-life of radioactivity. I told him the knowledge he got
of Microsoft Office has a half-life also. In five years half
of what he had would be useless. Another five years and half
of what was left would be gone. Though I kept protesting that
I was in no position to know detail or give opinions, they were
convinced I had given very good advice. I did say that if he
takes a lot of math, I will be around to help him through.
After leaving the library I returned home to call Evelyn and to pick up
things she wanted. I called her and she thinks things are
proceeding well. She had some physical training without
passing
out. We still do not know when she will be able to go home
soon. She may have to go to a rehabilitation facility.
We did get details about just what was done in the operation. Essentially there is a large titanium rod attached to a shorter rod on a hinge. This rod is bonded to the bone above and below the hinge. It then is a lot like a brace, but it is inside the leg rather than outside.
Another piece of the puzzle seems to be explained. Evelyn's
passing out and going rag doll on us may have been caused by
Percocet. She took that half an hour before the physical
therapy and it may have made her dizzy and lose consciousness.
We have been discussing whether Evelyn will be going home or to a rehab
facility as I suggested, but it depends on the rate of
repair. Apparently Evelyn feels a good deal better today than
she did yesterday.
In the afternoon we had guests (other than me, of course). We
had Mahendra Pratap, Jo Paltin, and Dale Skran. It was nice
to have people to talk to.
Jo suggested that Evelyn should get her own orthopedist to watch her
progress. But it turns out what is usual is that the
orthopedist who performed the operation intends to continue to be the
orthopedist even after Evelyn is discharged. It is true he
seems to be the person who would know Evelyn's leg best.
Evelyn's guests left at 4:30. I stayed until 6 PM.
Sunday, 03/24/13 The
Guest
of Honor Speaks Up
Evelyn asked me to bring a few items that she would need for her
hair. Mostly s brush, a comb, and some dry shampoo.
The latter I had to pick up from the drug store. I came in a
little after noon. Evelyn was rather pleased with her
performance on the morning physical therapy session. With a
walker she got halfway to the bathroom-about four feet. What
she can do seems to increase exponentially day by day.
Progress was slow at first but on each effort she gets more
improvement. But she did much better today from yesterday and
her rag doll episode was now two days ago. I will have her
relate her own progress. Though when she starts to write it
still wears her out and she falls asleep. Well, she probably
needs her sleep to recover.
Evelyn,
who knows best, can also contribute to this log. The
following
is from her.
Evelyn
here.
I've been busy the past few days ( :-) ) so I have left the writing to
Mark. I will try to add a few notes on things he may have
missed.
Since
breaking my hip four days ago I have had a ridiculous number of tests
and medications, often at ridiculous hours. For example, they
come around at 4:15AM to draw blood, and at 5:30AM with the first pill
of the day. In addition, the IV bag sometimes runs out at
night, so the buzzer on that wakes me up. They also take my
blood pressure frequently, as well as a daily EKG and an
electrocardiogram (an ultrasound of the heart), and a CAT scan shortly
after the fall.
Mark
described my passing out during physical therapy on Friday (almost
definitely exacerbated by the Percocet), but Saturday was much better,
and today even more so. Each therapist seems to have their
own routine to follow. The first (Friday) wanted me to sit up
at the edge of the bed, stand up, take a few steps, and sit in a
chair. Mark wrote about how well that went. :-) The
second (Saturday) had me sit up, stand up, take a few side-steps, and
then sit down again. That seemed to go better, but
was not very substantial. The third (today, Saturday) had me
do some foot flexes and leg swings before even sitting up.
Then I sat up and did some more leg swings. Only then did I
finally stand up (with a walker). Then I started taking short
steps, which required thinking about each one in a way one is not used
to doing. First I have to slide the walker forward, putting
my weight mostly on my left (good) leg and my arms. Then I
have to move my right (bad) leg forward, again putting my weight mostly
on my left leg and my arms, and also just using the ball of my right
foot, rather than putting any weight on the heel. Then comes
the tricky part: I need to put my weight mostly on my arms (without
achieving a "death grip" on the walker :-) ) and the ball of my right
foot, and move my left leg forward smoothly. Hopping is not
recommended!
The
bottom line is that it like learning to walk again, or perhaps a better
example is (re-)learning the piano. At first, you have to
think about where each finger goes, an how long to hold own each each,
and which foot pedal to use. Then eventually it becomes
second nature and you don't think about ti. (Or so I
assume--I don't play the piano.) Similarly here, the sequence
will become second nature and also the bad leg will get stronger and
need less babying. The theory is that eventually I will not
need a walker or presumably even a cane. Right now I would be
happy to be able to walk some distance with a walker without getting
tired or weak.
As
for pain killers, I probably has some right after the surgery, but
other than the Percocet, all I have had was two Tylenol today after the
various therapies and tests that involved moving around.
While most movement does not hurt, rotating the right leg can send a
sharp pain shooting up my thigh, and general sudden movements can also
cause pain. They are constantly asking me what my pain level
is on a scale of 1 to 10. My answer tends to be 1 or 2
gusting to 8, much like a wind forecast.
At
my request Mark picked up some dry shampoo at the store, and sprayed my
hair for me so I could actually wash it, since trying to wash it in bed
with water is not a great idea. So I guess I have a personal
hair stylist as well.
We
are busy trying to make revised Passover plans. Mine, alas,
seem to be to eat whatever foods on the hospital menu seem the least
hametz (non-Passover). Given that tomorrow night's choices
are macaroni and cheese or chicken cordon bleu, this is a losing
fight. I did ask Mark to being in matzoh and will try to use
that to replace the more obvious leavened breads. Mark will
be going to some friends' house for the first Seder, and then eating
either stuff I pre-made (like Passover turkey chili), or easy-to-make
things like omelettes and tuna stroganoff. He is also to
browse the frozen Passover foods at the grocery. We usually
eschew those in favor of home-cooked stuff, but this year is an
exception.
We
are still not sure what the plan is for the next few days.
While originally there was talk of my going home Sunday (today) I am
clearly not mobile enough for that. (I am not sure what their
criteria are, but I would assume that the ability to walk to the
bathroom, possibly with assistance, would be a minimum.)
Another possibility now being mentioned is spending some time at
Riverview Acute Rehabilitation Center in Red Bank and then going
home. I am assuming that would be just a few days, since I
think everyone's goal is to get people home as soon as possible, and
given that we have a ranch house and Mark is there basically all the
time, I should be going home soon either way.
Mark again: One issue we are discussing is what we are doing about
Passover. This is usually a project every year that goes
right up to the wire. It is better this year and
worse. We did not complete our preparations, but was also
cancelled the big first night meal that we usually have at our house
and have the Skrans come. I expect I can get all I need just
foraging on what stuff we have already brought or prepared.
It definitely is going to be a different experience than usual.
Monday,
03/25/13 Choosing a Rehab Center
For breakfast I had vegetarian beans, more of a British
breakfast. It also is sort of my last chance of non-KFP food
before Passover. I arrived at the hospital about 8:10.
The staff keep giving Evelyn tests. They had tried to take
her
blood. They wanted three vials, but could only take two and
half
of another. Evelyn has had trouble giving blood before.
This is not a big concern.
The good news is that she is probably ready to go to the rehab center,
probably at Riverview Medical Center. It is a question of
when
does a bed clear up there and if the insurance company will approve
it. It is a good thing because she will be more independent
faster and ready to come home. The drive time to Riverview is
a
lot more than it is to Bayshore. It is at least twice as far,
and
perhaps more. But I will not have to go as often.
I hear from our friend Charles Harris that this log is going beyond
just the few family members and friends I originally
expected. I
guess I had such narrow expectations because I did not expect others
would be interested. Apparently it is useful to some in the
medical profession to see this experience from the patient's (or more
accurately the patient's husband's) point of view. I
think Charles passed word on from someone he knows in the
medical profession that most people see a hip repair as fairly routine
and here they are seeing how it affects our lives.
And apparently some people may be finding the discussion with a Google
search. Whoever you are, whether I know you or not,
WELCOME. We would be thrilled to get a wider
readership. If
you like you can tell us of your presence by sending email to leepers@optonline.net.
If you want you can suggest aspects you want to know more
about.
We are not really knowledgeable about medicine, but we can answer
non-technical questions about Evelyn's experience.
Evelyn was saying that she wears cuffs on her thighs that pump the
blood and make up for the fact she is doing a lot of laying in
bed. But she says it feels like a weasel has crawled into bed
with her.
Evelyn is spending some time out of bed for the first time.
The
IV was taken out and she got out of the bed to sit on the
commode. And from there she was helped into a
chair. Some
time soon she will be going down stairs for physical therapy.
It is tough to get a lot written because there seem to be frequent
interruptions at the hospital. I guess that is better than
neglecting Evelyn.
It is 10:40 and Evelyn is finally going down to physical
therapy.
She is eased into a wheelchair and has an oxygen tube put under her
nose. And she is wheeled and de-elevated down two floors to
the
rehabilitation center. This is still a lot of sitting around
so
she will be ready to exert herself and then rest after. She
was
eased into a walker and she slowly walked a distance on the
floor. She walked a distance and then she sat down in a wheel
chair and was taken back to her sitting place. I paced the
distance she went as 11.5 paces.
11.5 paces * 2.5 feet/pace = ~29 feet
She was wheeled back to the wall leaving the walker behind. A
few
minutes later someone else who was using the space moved the walker out
of the way. So Evelyn has reached a milestone: She
can now
walk well enough to get in somebody else's way.
A while later she walked 40 feet. Well, that is progress.
And Evelyn has been out of the room, which had happened only once
before since she was first brought there. They took her for
an
echocardiogram (which is basically an ultrasound of the
heart).
But most of the time she is in the same room.
The
issue now seems to be coming down
to an appeal to the insurance company. She will be sent to
either
an acute rehabilitation facility (Riverview) or to a sub-acute
rehabilitation facility. The former will get her home sooner
by
giving her more exercise time with more rigorous physical training.
The question is they generally ask is whether she is being
readied to go home and hence should go to acute or if she is being
readied to go to a nursing home and hence can go to
sub-acute.
Everyone here would prefer acute but the insurance company, and that
only because it is more expensive. It comes down to a matter
of
money and whether Aetna thinks she is covered for the more expensive
treatment.
Back at the room she is trying to achieve a very magical sort of state
to be released home that I have dubbed "commode-ready". Even
better is an ethereal state called "toidy-ready."
OK, it is later in the day and Aetna has spoken. Evelyn must
have the sub-acute rehab. She just has to push herself a
little harder. I am disappointed, but I know this must have
cost Aetna a huge amount already. Later tonight about 6 PM
they will move Evelyn to the new facility. I will get detail
about name of facility, address, Evelyn's phone number, etc.
I will visit her some time like 10 AM tomorrow.
I returned to the house to update this log, to clean, to prepare food
for Passover. I got a call from Evelyn saying that she would
be moved that night to the sub-acute facility on the same street as the
hospital. That is a disappointment. I prepared to
go over to our friends, the Skrans, to have the first night of Passover
and the Seder with them. Toward the end of the evening I got
a call from Evelyn at the Skrans. When Evelyn was first
admitted to the hospital she was put into a hospital gown and I was
given her clothes to take home. Now she was in the rehab
facility she was still in just the hospital gown and she desperately
needed real clothes. Apparently wearing hospital gowns and
nothing else is some kind of social faux pas at the rehab
center. This year everyone is wearing street clothes that
afford more privacy and Evelyn would stick out like a sore thumb if she
were to sport about wearing just that old gown. She started
giving me a laundry list (literally) of what clothing she
needed. I told her to hold on, keep warm, and I would go
home. Then I could pick up the clothing she wanted as she
directed me over the phone. A telephone connection has much
greater bandwidth than a hastily written scrap of paper.
At home, over a period of 20 minutes, I filled a clothes basket with
the latest non-gown fashions and prepared to take it in the morning.
Complicating matters was the fact that we had a plumbing problem just
that evening that I will just call "toidy-not-ready." It had
picked a bad time to go bad, but it had to be fixed the next
day. It was too late to fool with. I did update the
log and took a look at on-line ads of the rehab center. It
looks like the medical center of a nursing home. The photos
of the place in the homepage showed a patient who was 20 years Evelyn's
senior.
I did not sleep well and I woke up about an hour early. I
suspect Evelyn did not sleep so well either.
Evelyn
adds:
Coming
from the hospital to the rehab facility was the first sub-optimal
aspect of this (other than actually breaking the hip). It was cold and
raining outside and the ambulance team did not cover me sufficiently
with blankets--my shoulders were covered only by the cotton hospital
gown. In addition, at the far end, I was "unloaded" not under an
awning, but in front of the entrance, and ended up being rained on for
ten or twenty seconds.
The other bad aspect of the transfer was that no one gave me any idea of what to have with me. For example, in a rehab facility, you need clothing, but all I had was the hospital gown. Luckily I could call Mark Monday evening with a list of what to bring early Tuesday morning. Some stuff was easy: pull-on pants, t-shirts, underwear. Some were more complicated: I needed shoes, but which ones? They had to have non-slip soles, but also (presumably) be easy to put on and take off, which somewhat rules out my walking shoes, which are a bit, snug. I ended up asking for a pair of loafers, a pair of canvas tennis shoes, and the walking shoes. Luckily the loafers passed muster, because those are obviously the easiest to put on and take off, at least until I can bend over far enough to tie laces.
Another problem was socks. The trail socks I love so much are so thick that they make the shoes harder to put on and take off. For now, I am using thinner dress socks--actually Mark's since I don't really have any good ones.
One
of the things they gave me was a
TB test. Apparently this is part
of their protocol for everyone admitted.
Tuesday, 03/26/13 A Day of Sub-acute Rehab
Actually
she slept better than at the hospital. People do not come
around so often in the night to check how she is doing. The
hospital had had inflating thigh cuffs massage Evelyn's legs to keep
the blood flowing in the legs while Evelyn remained in the
bed. I think she said she had missed them.
I came to the Rehab about 8:30. The front sitting area makes
it look a little like a nice motel. It is decorated and has
places to sit. Upstairs the place is a little drab.
It looks sufficient, but is somehow downbeat. It took a while
to get a chair into the room for me to sit on. Then it
appeared to be corroded. So some of the furniture appears to
be old and not of the highest quality. However the people I
talked to were very nice. I don't remember exactly what
function each did. I talked to a woman named Meena.
She is from Bombay. Evelyn and I discussed Indian
restaurants, food, culture, Bollywood, what were our experiences in
India. We enjoyed bringing up memories. I also met
Evelyn's physical therapist Joe. His last name was something
Hispanic, but he is Filipino.
I was with Evelyn when she went down to physical training.
She did not do as much walking as yesterday and did not go as far, but
she also was doing leg and arm strengthening exercises. And
some of the time she just sat and got her breath back. I
think the session was about 45 minutes. The physical
therapist gave Evelyn some exercises to do in the room. He
gave her a long wide ribbon of something elastic. She could
stretch it for strength exercise.
When Evelyn got back from training she said that her bed had not been
made
and they were a little slow to make up the room. Some time
around noonish Evelyn went to lunch. I went with her but did
not eat. You could choose a mean that was not so much kosher
for Passover as a food tribute to what they thought that Passover
was. They had Matzo Ball soup and honeycake for dessert among
the choices. The honeycake looked like yellowcake with honey
and walnuts for a topping. Their heart was in the right
place, but it did not look at all like honeycake.
About 1 PM I left and went to Costco to get a few things we needed and
got home about 2:15. I let Evelyn talk me on the phone to
find some papers she wanted brought to her room.
The latter part of the day was spent cleaning up the house. I
did
a little food preparation. I worked on this log. I
answered
email. After I had dinner I went back to spend some time with
Evelyn. I think she was not expecting this, but I wanted to
surprise her. She just likes being together. We may
be
doing different things but we like to have each other in the rooms with
us. We listened to film music.
After that I went home and multiprocessed a film with everything else I
was doing.
Evelyn
adds:
The physical therapy room is much smaller in the rehab facility than in the hospital, probably because there are not a lot of units in the sub-acute rehab section. (Most of the building is a nursing home, and the residents do not use the therapy room.)
I did a variety of exercises--heel lifts, ankle pumps, leg extensions, knee lifts, and armchair raises. Then I did getting out of the wheelchair onto the walker and walking. The first day here I walked a bit less than in the hospital, but there had been a gap in time, and also I was doing no other exercises in the hospital.
Wednesday,
03/27/13 This May Be a
Long Siege
I got to the facility about 8:30 AM. Evelyn is making
progress. A woman named Maggie took Evelyn into the bathroom
to
see if Evelyn could dress herself. Evelyn could do most by
herself. She could not lift her right leg enough to put a
sock
and shoe on. That was the only thing she could not do.
About 10:30 Evelyn was taken for physical therapy. I followed
along like I had done the day before, but as I entered Maggie was there
and she said that visitors were not allowed in the physical therapy
room, so I returned to Evelyn's room and worked on this log.
Evelyn had been awakened about 2 AM by someone playing their television
very loud that early in the morning. Just about whatever the
neighbors are doing, residents are sort of involved in the action also
because you cannot block out the noise. Right now the room
right
across the hall someone plays almost non-stop religious
music. It
is a straight-line walk to go from the back of Evelyn's room to the
back of the zealot's room. You sort of share a column of air
and
all the sound in it. So while Evelyn was in physical training
I
was hearing about how wonderful the Lord is. I was alone in
the
room so I figured I could just close the heavy wooden door.
That
worked. Until Evelyn's roommate came back and was disoriented
to
find her door closed. I was told by some functionary that
they
try to leave the doors open. Well, maybe Evelyn and I will
have
our Souls saved in this process.
Apparently things went reasonably well in training with Evelyn walking
about 40 feet. That was the best that she did in the hospital
two
days earlier. Still we would like to see more progress than
that.
Evelyn says that even with the sound she is getting better sleep here
than in the hospital where her care was uncomfortably
intensive.
She would be wakened several times a night to have the give her pills
or for some other reason.
A social working came to the room to talk to Evelyn about her stay and
the possibility of going home. She gave us the first real
estimate anybody would about when Evelyn might possibly be going
home. Until now the question was always answered with
sophistries
like "Everybody is different," "Circumstances
change." The
social worker thought Evelyn might be staying another month or so.
This
is, of course, bad news.
About 1 PM I headed back home.
Evelyn has a 2 PM appointment to get her hair shampooed in the facility. For this they charge a nominal fee. But I had assumed that the facility did what was necessary to provide for the people using the facility. That seems like it would include basic cleaning including shampoo. If someone refused to pay an additional beauty parlor bill would they just let the patient's hair deteriorate? [Well, no--the shampooing would have gotten done, though not as "luxuriously" as in the salon. And everything else the salon does--styling, haircuts, etc.--is not included. -ecl]
I called Evelyn and she was not in the room. I figured she was at dinner. I called her a half hour later and she was back. Mildred--that's Evelyn's roommate--had suggested that they go to dinner together. Mildred is probably 20 years older than Evelyn. Well, it got Evelyn out of the bed and exercising. Evelyn is going to need a lot of exercise to strengthen her bones. I worked around the house for most of the evening, but I had a chance to have some cheese for dinner and to watch a movie.
Evelyn
adds:
Different
exercises
today, then more walking--forty feet a couple of times, then thirty
feet. (Everything seems to be in groups of three.)
Thursday, 03/28/13 Getting Used to the Routine
I
woke early. I had
gotten about six hours of sleep. I have to get used to being
on
my own. This is a somber day. My father died nine
years ago
today, on the common calendar.
One metric I have forgotten to mention is the swelling of Evelyn's
right leg. Evelyn's right leg is 18 inches in circumference
and
her left (normal) leg is 16 inches. The swelling takes a
while to
come down, but it is correlated to the amount of pain she feels in the
leg. A week later the leg is still swollen.
There
is a lot to do in the house
doing Evelyn's and my tasks also. We have had a wash that has
been waiting to go in. Usually Evelyn would do it and it has
been
a while since I have. Last time I followed instructions from
Evelyn and I think I still have those instructions on my
palmtop.
The palmtop helps a lot so I can remember instructions from years ago
when Evelyn was going to Massachusetts to help her ailing
parents.
I will probably switch to visiting Evelyn in the afternoon.
For
one thing Evelyn has physical training in the morning. If I
cannot go with her to that it is pointless for me to be there that
hour. Evelyn is supposed to be exercising in the afternoon
and I
can watch and get her to do the exercises then.
Evelyn asked for me to bring in a lot more in to her.
Underwear. Books. An orange peeler. This
will all
have to fit into something to take her home so I am taking a strong
wastebasket liner. When she is ready to go home I can carry a
lot
of things in one bag.
My mother wrote me an e-mail saying that she was going to call me to
get Evelyn's status. However she check this log first and got
a
lot more information than I could have given her over the
phone.
I think I will just keep my HTML composer up all day and add to it when
I get the chance. But this way I am not having to keep
telling
people what happened and how Evelyn is doing.
I went to the library to teach yesterday and all the librarians know
about Evelyn's problem and were asking me how she was doing.
The
parents of two students who come to the sessions also wanted to know if
there was anything they could do to help.
The breakage is a common accident in women a few years older than
Evelyn. The figure I see is about three years
older. I have
a regular routine of exercise on an exercycle, and I have been trying
for years to get Evelyn to use it or to do some other
exercising.
Evelyn says that she gets enough exercise just taking care of the
house, but I wonder if she is doing the right sort of exercise to
strengthen her bones. I think I will set a reminder in my
palmtop
to some time around June start pressuring her to exercise
more. I
hope she will be in a condition to exercise more.
Today I am exploring the mysteries of the washing machine and drier. Evelyn got therapy earlier to day and seems to have walked a lot farther. I was kind of hoping she could walk to Freehold, NJ, but she was not that ambitious.
This morning in physical therapy (with Joe, the therapist of two days ago) Evelyn walked what I later estimated was 180 feet. Right now the goal I am setting for her is to walk into Red Bank. It can even be the nearest point of Red Bank.
I visited Evelyn at a little after noon and stayed about 105 minutes. Then I returned home and continued with the laundry and went to the grocery. Evelyn thinks that I should get more interesting food than I have on hand. Actually I am losing weight and am rather happy with that. I can be creative with the food we have. I have a recipe for pie crust that is kosher for Passover, and I make chocolate cream pie that really gets me through the week.
I will go back and visit at 6:30 this evening.
Evelyn
adds:
Yet another set of exercises today, including swinging my leg out to the right (while lying on a mat). There was some confusion. The occupational therapist showed up about 8:45 AM. Occupational therapy is learning to dress yourself, etc. Well, by the time she arrived I was all dressed except for the socks, and even then it as only the right sock that was a problem. She showed me how to use a "sock aid", and then suggested we go around with me in the wheelchair (learning how to maneuver, I assume). We met someone from physical therapy and in talking they asked if I wanted to go own then rather than waiting. The occupational therapist thought that was a good idea, so down we went. What neither of them (or I) knew was that their was a batch of pills I was supposed to take at 9 AM, but at 9 AM I was nowhere to be found near my room. Eventually they found me and I went and took all my pills and returned to physical therapy, where I walked about 180 feet with the walker. (This was a one-time walk, with no repetitions.)
Friday, 03/29/13 Ordinary Day with Origami
Mail from Evelyn this morning:
I
put both socks on today without
using the sock aid--progress! Basically I can now dress myself
completely, except that I still need someone there when I am standing,
and I'm a little nervous about pulling things over the staples.
They
removed the bandages from over
the staples, so they are exposed to air (well, under my pants). One
trick I've learned is that I need to remove any non-skid socks before
trying to pull the pants on. :-)
They're
here to take me to physical
therapy, so I'll sign off.
I don't have a lot to add. I visited Evelyn at about 12:30 and stayed until 4:30.
I gave Mildred, an origami Easter Lily. And then I took Evelyn around the building with a wheelchair. Evelyn had pointed me to a woman who was a Star Wars fan and I folded some origami for her from Star Wars and Star Trek. She said she would give it to her nephew. Good enough.
Coming back to the room Mildred was getting a Good Friday visit from her daughter and grandson. The latter was a four-year-old who was getting restless. Once again origami came in handy to keep him occupied. I folded him a total of three dinosaurs and one bird with flapping wings.
After he left I talked for a while to Mildred. I believe she said she was 92. My mother is also named Mildred and is 92. I talked to this Mildred for a while about how I had lost 60 pounds and about movies. Also I said that while I do not have much evidence to show for it, it certainly feels to me like cherry juice had pretty much eliminated the arthritis pain that I was getting a decade ago. I had been drinking it for the flavor (which is terrific, by the way) and had never heard that it was good for arthritis. When I did hear I realized that the pains had long since gone away. I do occasionally get pains in my knees while exercising. I make sure to drink some cherry juice and the pains do not repeat. My experience is consistent with the popular assertion that cherry juice has a powerful positive effect on arthritis. That is all I can say. Anyway I told her that.
Until now we did not say much to each other other than for me to say good-bye to her when I left. I guess origami was useful to break the ice.
Saturday, 03/30/13 Quiet Day
Today Evelyn was able to go from the bed with the back up to standing on the floor. She hits new milestones each day. The problem is that there are incredibly many accomplishments that are milestones. We are still hoping her day of liberation will be Saturday April 27. That is still a long time.
Evelyn and I have more or less decided that it is best if I visit her about 1 PM each day. She has her therapy in the morning, supposedly at 10:30 but it shifts all around. It is in the morning though. She will have her lunch in her room at 12 PM to 1 PM. This will be the best time to call her. Later in the afternoon she will feel she can leave the room so she might not be reachable. I will aim to visit her some time around 1 PM each day. We are something at a loss for what to do, but we are spending the time together. I guess in rehab, tedium and boredom is the name of the game. I showed her how to play Yahtzee on a palmtop. If she likes I will install it on her palmtop. She was a bit excited with the announcement of the Hugo Nominations.
At the suggestion of a reader I am going to take the pictures from our Italy and Southern Africa trips and give them to Evelyn to whittle down and make into a slideshow. That will give her something to do and will not require a lot of moving around. This was the suggestion of Art Stadlin, someone who when I started this log I never would have guessed would be reading it. Well, I am flattered at the number of people who want to read it.
The job of editing down
pictures from out
trips is something that never gets done. When we get back
home after a trip there is always a lot to get caught up on.
We have overflowing email mailboxes and podcasts and all sorts of web
sites to catch up on. So we say we will put off the picture
editing for just a week or two. It NEVER gets done.
This is something that Evelyn can do, even with the TV in the room
on. Evelyn's roommate Mildred is a pretty heavy television
watcher and it makes it a little hard to read with the TV
going. Choosing pictures is one thing Evelyn can do even with
the TV on.
I mentioned last Tuesday that I had gone to Costco. What I
really went for was to buy a printer for the Mac at home. I
got a Canon MX892, but since I got it, it has been sitting on the floor
staring at me accusingly. "How hard can I be to set
up? Lots of not very technical people set me up."
Those are the sort of taunts it throws at me. I wish it could
have been a little more civil. Saturday afternoon I did about
three-quarters of the setting up and it was really not too
bad. The last quarter I wanted to ask Evelyn about and did
have a technical problem. It was mostly that what they were
calling a USB cable they did not provide and I did not know it was USB
only at one end. They did not provided it, but it turned out
the printer I was replacing used the same sort of cable, so I had one
to use. I finished setting up the printer. I was
able to bring Evelyn a picture of herself, the one in the last Friday
log entry, printed on the printer. For the most part the
instructions were--to quote the film THE CAINE MUTINY--designed by
geniuses to be performed by idiots. And with the one
misunderstanding out of the way.
Sooooo any way... I went to visit Evelyn arriving at about 1:30 and
found our friends the Skrans were already there visiting. It
is nice to see them. We set up an outing next
Friday. Our favorite used book store, the Cranbury Bookworm,
has moved to a new location and Dale and will go see the new digs next
Friday. The Skrans have been really good friends through this
whole thing.
Also visiting later in the afternoon and giving up a piece of their
Easter to see Evelyn (thank you very much) were Don and Cheryl
Blosser. I was finding it very hard to carry on a
conversation with them because of all the distractions around
us. At one point it came up that we had not arranged our
monthly Dim Sum trip the Sunday before Evelyn fell. I knew we
were doing something else, but I could not bring it to mind and it had
happened just two weeks earlier. After they left I remembered
that had been Dale's Birthday and he invited his friends to a very nice
birthday dinner. I just fixated on how absentminded I sounded
through their whole visit and that only makes things worse.
Sorry Cheryl. Sorry Don. I plead extenuating
circumstances.
Evelyn did not have physical therapy that morning because this was
Easter and many of the staff were home. While we were talking
the therapy-master came along and said that Evelyn could have a session
in the afternoon. He had apparently given up his Easter to
make sure everybody got therapy even if it was at a shifted
time. I am not allowed in the therapy room so I waited about
an hour for Evelyn to return to her room. Some of the time I
spent talking to Mildred. She is someone with very little in
common with me, but it is a good exercise of my all too poor
conversation skills.
I left about five PM. I watched Sidney Lumet's BEFORE THE
DEVIL KNOWS YOU'RE DEAD for my evening's entertainment. Lumet
is usually pretty good and this was no exception.
(I have removed the x-ray picture I was using to represent what was
done during Evelyn's operation. It showed the rod, but it was
the wrong bone. It was an x-ray I got off of Google Images.)
Monday,
04/01/13 April
Fools Day
Evelyn says:
A
few notes about life in a rehab
facility/nursing home:
Televisions
are always on, usually
loud, so you get to hear what everyone is watching. This goes
on
all day and into the late evening. I am not sure if there is
an
official "quiet time", but if there is it starts too late.
Items
get lost easily. When a
meal tray arrives it occupies most of the table, so there is a tendency
to put things down on it, and when they take the trays away they do not
always check for excess items. Similarly, when they strip the
bed, they sort of bundle all the linens up together with seeing if
there is anything sitting on them.
And
our room heater is *really* noisy!
As
far as physical therapy goes, I do
not have the same therapist each day. Whether this is the
reason,
I get a different set of exercises each day. I do leg
extensions
every day, but knee lifts, thigh exercises, and various arm exercises
seem to vary. The one constant is walking, although some
therapists seem to encourage more walking than others. With
some,
if I do not say anything, we walk to the end of the hallway and
back. With others, when I get to the end, they will say that
is
enough and have me sit back down on the wheelchair. (The
first
set usually do not even bring the wheelchair with us.) Maybe
it
is just a question of the latter set learning what I can do.
Certainly each one has to learn separately that I can bring myself down
to physical therapy and return to my room on my own. Most
people
are wheeled down and returned to their rooms by a staff
member.
Then again, most people here are about twenty or thirty years older
than I am. (The only person here I figure is close to my age
is a
man with a partial leg amputation.)
Each
day I make progress.
Yesterday I switched to canvas tennis shoes (from loafers) and was able
to tie both of them on my own. (If I had had a hip
*replacement*
this would not be the case, as artificial hips have less range of
motion.) The fact that the therapist was surprised that I was
able to do this indicates that they do not necessarily look at the
details for everyone, so I have taken to telling each new therapist I
see which hip is the problem and that I have had a rod inserted, not an
artificial hip.
I
can now get in and out of bed on my
own, though I am not really allowed to. Ditto for using the
bathroom, and in this if I wait a few minutes after ringing and no one
shows up, I just go on my own. The most difficult part is
maneuvering the wheelchair with foot rests into the bathroom.
Without the foot rests it is much easier, but I still need the
footrests.
The
only problem with seizing the
initiative on getting out of bed is that the wheelchair is parked a
distance from the bed, and there is no good/safe way to get to
it. Since they do not want to be helping people out of bed,
etc.,
during breakfast delivery, this means I have to have them get me out of
bed before 7 AM, or wait until 8AM.
Well, Evelyn is making progress. I wish it were a little
faster,
but I guess that is why there is an "acute rehab" as opposed to this
which I guess you would call "obtuse rehab."
Evelyn's physical rehab was a lot of getting into and getting out of
chairs. She can pretty will now go to the bathroom herself,
but I think the facility prefers she have someone to watch
her. This was a nice day, at least in the afternoon so I
wheeled
her outside in a wheelchair so she could sit in the 60-ish weather. The
problem is that there is only one small area to do that and it attracts
people taking leaving the building for smoking breaks. We
stuck
it out because it was only one or two smokers at a time, but we did
inhale some tobacco. I then took Evelyn to the dayroom where
we
talked, I wrote a little, and I called to the bird. Polly was
not
really happy with crackers. I think the bird is a conure.
[P.S. No, it is a Peach-faced Lovebird.]
Thursday there will be a
meeting that Evelyn will have with the staff. I think that is
just to review her progress and make plans. Then a week from
Friday I will have to take Evelyn to Little Silver (that is a town) to
meet with Dr. Lopez. I spend a couple hours in Evelyn's room
talking and watching a little TV that Mildred had on. It was
as
little as possible. I went home at 5 PM when Evelyn was going
to
dinner.
Well, not a lot new to add here. Evelyn is practicing getting
into and out of chairs. I don't think she has mentioned
that. At home I made myself a fruit smoothie for
dinner. Things will be a little easier when Passover ends
Tuesday at sundown. I made a fruit smoothie and watched the
film THE YARDS. Not much of a feel-good film. If
Evelyn is not going to be released to come home until April 27 we are
really not even a third the way into this process. It has
been 12 days so far and we have 26 days to go.
Tuesday,
04/02/13 Evelyn Enters and Leaves a Car Twice
The morning was spent in housework and calling Evelyn to find out what
she wanted me to bring for her. I had planned to be at
Evelyn's
room at 1 PM. Evelyn told me that the therapist wanted Evelyn
to
try getting into the car and out on her own, and she wanted me to be
there. So I left a little early to get there early.
Understand that about every time I had come to rehab there was parking
out front. So far only once have all the spaces been filled
and I
had to part in the side lot, which is a little further away.
Today they must have had some sort of a sale on therapy. All
muscle exercised had to go to the bare walls. At least that
was
how it looked form the parking lot. Not a single
space.
Around in the side lot there was not a single parking space.
Around the back of the building it was the same story. This
is
great. I had to park maybe a seven-minute walk from the
building. Were we going to have to wheel Evelyn to the car?
Well finally we got together with the therapist and she said just to
bring the car out in front of the building. I had to walk but
at
least Evelyn did not. I parked in front of the building where
the
therapist suggested. Immediately I was in the way of someone
trying to back out. I finally positioned the car where it
would
be in nobody's way.
At this point Evelyn's left leg is perfectly good. But it has
been perfectly good. Her right leg will bear about half of
her
weight. She was wheeled by wheelchair to
the
car.
Getting in the car took about two minutes. She is still very
stiff and weak in her right leg. But if she is going to be
getting in the car on the right side, at least it is good that it is
her right leg that is having the problem. She was successful
from
both a walker and from a wheelchair. But at least I will be
able
to drive her to the orthopedist in Little Silver. She has an
appointment ten days hence.
After that we sat in the sunny entrance to the building and talked for
an hour or so. Then I took Evelyn back to her room.
There
is not much to do and sitting with Evelyn we get a lot of television
that Mildred likes to watch. It was a longish afternoon for
me
and I left at five when Evelyn was going to go for dinner.
On the way home I picked up a whole tuna sub and had it cut in
quarters. That will take care of four meals for me,
particularly
the one tonight at sundown when Passover is over and I can eat bread
again.
In the house I did housework and updated this log.
Karen Parker has identified the bird breed as a Peach-faced Love
Bird. That is as I had guessed a member of the parrot
family. This one is either friendly or angry and mean
depending
on how I interpret the bird's little pecks at my finger. His
name
is "Murphy," by the way.
I really am very pleased that an account that was intended to for
mostly just people who knew Evelyn well and wanted to know her status
it being read by a wider circle of people who seem to be
interested. Welcome Karen and anyone else who is following
Evelyn's recovery.
Wednesday
04/03/13
Graduating to a Walker
Evelyn wanted me to get some financial information for her off the net
and some I have been trying for days and keep getting locked
out.
It turns out Evelyn had given me a wrong log-name.
That is
one problem out of the way.
More progress from Evelyn. She took a shower on her own this
morning without help. That is a big step forward.
She is
also learning the ropes of operating a wheelchair. I never
gave
much thought that there was a lot to learn. But there are
tricks
like you face forward going uphill and face backward going
downhill. In other words you face uphill if are going uphill
or
downhill. That is because facing downhill you might possibly
fall
forward and out of the wheelchair. Then you could be in
trouble. If gravity is going to push you forward or back, you
want to be pushed into the back of the wheelchair.
Kate Pott has suggested that the bird is actually a conure.
As
she says, "I
have been trying to
identify the bird and was undecided between a Peach-faced lovebird and
a Red-masked Conure. The Conure would have blue pin feathers along the
rear flanks which I couldn't see. Still, I was hoping it wasn't a
lovebird as they mate for life and have a very intense bonding. The
fact that you only have one is heartbreaking."
My picture
does show some blue feathers to the right, and Evelyn mounted a tiny
expedition to check out the bird. Indeed it seems to have the
blue pinfeathers and is likely a Conure.
Evelyn is busy with therapy this morning and I am teaching this
afternoon, so I won't see Evelyn until about 6 PM.
I went to Costco and got printer cartridges for our new
printer.
I also got Evelyn some chocolate cupcakes to make her stay more
pleasant. I taught at the library from 3:30 to
5:15. Then I
stopped at the house for the mail and then went to the Healthcare
Center.
I found Evelyn at dinner and she had a surprise for me. She
is
now off the wheelchair and uses a walker. I won't say she is
fast. She still moves very slowly, but she is toidy-ready and
just needs some help to take a shower. She may be coming home
sooner than expected. She may need a chair with arms in the
den. We have a new office chair by the Mac, but it also is on
wheels and she may hold out for something more steady.
Murphy likes one guy who comes to the day room and it isn't
me.
The guy Murphy like shaves his head and maybe the attraction is that he
looks almost like he has a bird head.
I stayed with Evelyn until about 8. Tomorrow I have a meeting
with the social worker to help make the adjustment to going
home.
I am sure she will miss a nifty place like the Healthcare Center.
Thursday,
04/04/13 Social Worker Meeting and Summaries
Not that it is a big issue but I have received new information on
conures and lovebirds, from both Kate Pott and from Karen
Parker.
It seems that Murphy is too small to be a conure, which are in the
range of 13 inches long. A lovebird is more like 7 inches and
that is about right for Murphy. Independently Kate
did more
research and thinks that the blue rump feathers would seem to indicate
that he is indeed a lovebird. And Kate thinks that living by
himself he must indeed be a very sad and lonely lovebird since they
form very strong relationships.
Well today Evelyn and I have a 2 PM meeting with Karen, the social
worker, who will answer questions about Evelyn's return to the outside
world. Right now I do not have a lot of questions other than
perhaps when will it be legal and sensible for Evelyn to
drive.
Evelyn really values her independence and being in control.
She
really prefers to be the driver. But beyond that most
questions I
can think of we have a pretty good idea of the answer and for those we
don't there is Google. One of my catch-phrases is "Ask your
friend Google." The human race is becoming a hive-like mind
in
which people can call upon the experience of others quickly and
easily. That is no small change for the human race if you
think
of the implications.
Well, Evelyn is at a new milestone. They have given her blood
thinner each day. This is because she cannot move around
enough
to keep her blood flowing properly. This is administered by a
shot. Evelyn, like most of us, is not keen on getting
shots. Apparently the doctor has decided she is active enough
and
has given permission for her to refuse the shot and today she
did. That will make her somewhat more comfortable.
At this meeting with the social worker I hope to find out what is a
reasonable release criteria. At what point will Evelyn be
well
enough to go home? I don't expect her to be fully functional
for
a while, but she can do most of what she would have to do.
She
can dress herself; she can walk to the car with a walker; she can get
in the car. And I think she is ready to reach around and
shoot at
pursuers as I go barreling down the driveway. I think right
now
she has enough skills back that I could spring her. But just
because she could go home today it does not mean that she
should.
We would probably very soon find that there are other activities she is
not read for and she would still need more physical therapy.
I am
hoping to get a new release date somewhat nearer than the previous
estimate of 4/27.
The following is from email Evelyn is sending a friend:
I
am more cheerful--each day things
improve and I reach new milestones. Currently I am getting
around
on my own (i.e., don't need an attendant) with a walker, so I am fairly
independent. (Being able to go to the bathroom without having
to
call an aide is wonderful!) And because I'm walking, I don't
need
those Lovenox shots each morning that they give to people who are not
ambulatory.
This
afternoon we see what the
current plan is at a "family meeting", but honestly, if they kicked me
out today, I think we could manage okay. I'm not ready to
start
walking around the aisles at Costco or even necessarily getting the
mail (which involves kind of leaning out the front door), but I think
I'm doing okay.
The
occupational therapist
(translation: arms rather than legs) gave me a two-pound baton to use
for some exercises. I told her it felt like a toothpick and
that
I tended to shift 40-pound boxes of books around at home, so maybe we
should start with something a little heftier.
That is a
better summary than I could give.
Ahh, but Evelyn sent out a better summary since. Sorry for the redundancy. I got this only late in the day. Evelyn says:
Physical therapy is leg
exercises: bending
stretching, lifting, swinging out, etc. Needless to say, the
ones
with the right leg are harder! I take two Tylenol before the
session, but apparently that does not count as pain medication when
they ask if I am taking any pain medication. (They mean
Percocet
or stronger, I guess.) The only pain I have are sore muscles,
which is to be expected.
After
therapy is usually my computer
time (as you can see). Then lunch at noon (in the room), and
usually Mark arrives during that. In the afternoon we go to
the
day room, or down to the lobby (which has big glass windows).
If
the weather ever warms up we can sit outside. He usually
leaves
at dinner-time (5PM), which I take in the dining room (along with more
pills). In the evening I sit in the day room a while, and
usually
get into bed between 8PM and 9PM, though I stay up reading later.
We
are meeting this afternoon with
the social worker and therapists and will see what my current status
is. I suspect I will be able to take at least short trips out
(to
the movies or even home for a couple of hours at a time). The
staples come out Saturday; I see my orthopedist again April
12. I
am still officially only "partial-weight-bearing" on my right leg, and
the orthopedist is the only one who can change that, but he is actually
on vacation now. This probably means the insurance company
won't
disallow my staying longer, but if they did, I think we could
manage. Each day I feel the leg getting better and while
using
the walker means I can't carry a lot of stuff around, I am sure I could
manage at home reasonably well. (One possibility is
outpatient,
or even in-home therapy a few more times after I leave the rehab
facility.)
So
things are definitely looking
up. No prognosis on driving yet, which is probably the last
major
milestone. I will get there, but clearly I cannot do that
until I
have enough strength in my right leg to slam on the brakes if
necessary, so I'm not going to push for that sooner than reasonable.
Friday, 04/05/13 Evelyn Misses a Book Sale
At an earlier point in this log
I had previously put in a picture of an x-ray of a bone that had an
implant like Evelyn's. Don Blosser thought I was showing the
wrong bone, so I removed the picture. After some search I
think I
have found what I am more sure is the correct bone. This
sort of
an implant is called an "open
reduction
internal fixation."
Actually I don't like to think about it
much. The whole thing looks too much like carpentry for my
taste.
So I stand corrected. I may have been right the first time. I don't remember which bone Don said it was. I was calling it a hip bone and Don may have said "femur." The hip bone IS the the femur. I think the above is accurate.
Evelyn asked for some money the other day for a haircut from the beauty parlor run inside the care facility. What could I do? She looks so cute when she pleads. I gave her $20. But I expect to see a haircut. Of course $20 seems like a lot for a haircut and I think Evelyn really should pick another beauty parlor and recover enough to go to it. [If Mark thinks $20 is a lot for a woman's haircut, he hasn't gotten out much lately. -ecl]
I asked her yesterday what she had done in physical therapy. She was doing mat exercises, leg lifts, flexing, and swinging.
Evelyn has been doing some tallying and has discovered that the total price of her treatment is over $100,000. Of course, the insurance company does not pay that much. They negotiate a lower price. But there is no real control on the medical facilities charging huge amounts of money and those patients who have the costs paid for my insurance do not object because it does not appear to be their money. Healthcare costs are, of course, a very political issue. Evelyn's social worker complained that the government has screwed up healthcare. Somehow I do not think it is the government who put a $100,000 price tag on the good, but still not worth $100,000 services provided by the hospital and healthcare facility.
At 11:00 I will go with Dale Skran to the Cranbury Bookworm, the best used bookstore in Central New Jersey. They are moving a short distance to a smaller location and this will be the last time we will be in the big building. I am sure it is a disappointment to Evelyn that she will be missing today.
Later: We are such regulars at the Cranbury Bookworm that the guy there asked about Evelyn and we discussed her hip and the hospitalization. The guy there really knows us fairly well. (I just wish I could remember his name.) At $5 to fill two grocery bags full of books we could get a lot. I was skeptical that with the books so picked over there would be much left. In fact it was quite a bargain. Among other things I got was a hardback autobiography of film director Fred Zinneman (HIGH NOON, A MAN FOR ALL SEASONS) I got a still shrink-wrapped box of mathematics SAT flashcards I will be giving as a gift to someone I teach who is preparing. I got a history of mathematics. I got one of John Ciardi's books on word origins. There is too much to list here from memory.
We had lunch in Cranbury and then drove back to Dale's place and from there I went directly to the Healthcare Center. I arrived about 4:45. I sat with Evelyn while she had dinner. At 6 PM or so Charles Harris came for a visit, and we talked to him for quite a while. He left about 7:40 and I went home not long after.
I was wrong about the nature of the implant Evelyn had. I thought they attached it to the outside of the bone, more or less like a towel rack. That is not true. The rod is actually put inside the bone, which seems like a much more complex operation. I am not sure how they attach the screws then. Well, the important thing is that it works. Evelyn can now lie on her right side without it being too painful. This is another milestone. Of course, one thing we have aplenty is milestones and potential milestones. There are more that I would have guessed at the beginning of all this. Perhaps we should call them footstones.
Saturday, 04/06/13 Evelyn Visits the Outside World
I have not published here pictures of Evelyn's leg, which has been stapled shut in three places. Today the staples come out.
Evelyn is getting around fairly well now with just a walker and a lot of time. Now earlier this week the card reader we have on our Mac at home died of a bent pin. We could no longer use it. That meant that if I wrote about Evelyn on my palmtop I could not move it to the Mac in order to go into the log page. There are ways I could get new text in, but it was more work. I wanted to go to the Radio Shack near the Healthcare Center. Evelyn and I independently thought that it might be a good idea for Evelyn to get away from the Healthcare Center for an hour and go to the Radio Shack with me. Perhaps even eat out. Talking to her on the phone last night we both decided we would see how Evelyn could do in the real world.
But first this morning I had to teach at the library (10 AM to Noon), grab some lunch, and then get to the Healthcare Center.
I had a great time teaching. I have a really good bunch of kids this year. One I have been able to help a lot and in return she seems to think I am a "genius." That is her word and she is not being sarcastic. I would like to think at least I am a good teacher.
After lunch I wanted to try a Chinese restaurant I had never tried on Main Street in Matawan. I had a Chinese lunch with soup, main course, and a lot of fried rice, most of which I left behind but I did go searching for the little pieces of meat and vegetables.
I got to the Healthcare Center at about 12:45 and it took a while to get Evelyn ready to go--nothing is fast in the Healthcare Center. Evelyn was able to get in the car pretty much by herself with only the aid of a walker. I put the walker in the back seat. Radio Shack is right near by in a shopping center and Evelyn was able to navigate the parking lot finding a nice curb cut to allow her to move onto the sidewalk. That was fairly successful. We got the card reader. Then we visited a 99 Cent & Up store. Evelyn got a grasping tool, but I don't think it will do her much good. It does not have very much grasping power. The fingers barely move, so it will not pick up much. Oh well. What do I expect for $1.30 or so?
Evelyn wanted to eat something different from the pallid food at the Healthcare Center. There was a Chinese restaurant in the same shopping center. She knew I had just had Chinese lunch a few hours before, but I really think she wanted something with a lot of taste. She got Ma-Po Tofu. It was very soupy but it had flavor. I ordered fried vegetarian dumplings so she would not have to eat alone. (Ah, the sacrifices I make.) After that she wanted to go back to the Healthcare Center and rest. I found that a little strange since she had not been out and about for very long, but after being sedentary for a while or with one or two exercise sessions a day she was really lacking in stamina.
We returned to the Healthcare Center and sat in the room for a while. Evelyn watched what Mildred had on her TV and looked at books I had brought from the book sale. I think I actually fell asleep. Later we found a quiet place to talk and sat there talking for an hour or so. We did that have a whole lot to say. Tomorrow I will pick her up in the early afternoon and take her for a visit home where she can get access to our main home computer, the Mac.
At about 4:30 she went back to her room to get some rest before dinner, and I returned home. But the day is far from over. Some time this evening the staples will be removed from Evelyn's leg. This will make dressing a lot easier.
Meanwhile I have to straighten the house.
Sunday, 04/07/13 Frustrating Sunday
Well, this has been a frustrating day for both Evelyn and for me. It started last night when the nurse never came to remove the staples in Evelyn's leg as planned. They said that they would do it today.
Meanwhile I was preparing the house for Evelyn's visit today. I wanted to be sure it would be safe for her to walk around with her walker. I had a small breakfast since I thought I would be eating with Evelyn at the house. I left early to have more time with her. I have some idea how boring the Healthcare Center could be. On the way I stopped at Radio Shack. I had had some problems with what I had bought the day before and I took it back to get one that works properly.
I arrived at Evelyn's room at noon to discover Evelyn was just having lunch. Well, I had expected that. Evelyn told me that it had taken a long time for the nurse to come to remove her staples and then the operation took about 45 minutes because it kept being interrupted. Now the leg looks a lot better than it did. But apparently in waiting for the nurse and in the time the operation took she had missed two therapy sessions. She needed to make that up in the afternoon.
We went down to the therapy room to see if she could get started with one of the sessions. No, the trainer who would be taking her was still at lunch. We started back to the room and ran into Don and Cheryl Blosser who had come for a visit. We went a few steps further and in the same hallway we ran into the therapist Evelyn was waiting for. So Evelyn went back to therapy, and I walked around outside and sat in the shade with Don and Cheryl. After about 40 minutes we decided to see how Evelyn was doing. We ran into her just outside therapy. She has started climbing stairs, which will make things easier. We went back to Evelyn's room and talked for a good long while. Eventually they left. About five minutes later Evelyn a call from Dale Skran and Jo Paltin. I waited quietly in the background occasionally listening to one side of the conversations. I don't know how long the phone call lasted but about 4 PM I decided that Evelyn would be busy for a while longer on the phone and I was starting to get hungry. Evelyn would go to dinner at 5 PM so there really was not a lot of reason for me to stick around.
Evelyn had only one therapy session and did not leave the building. This was all a little frustrating to me. I went over to Costco and a slice of pizza. They did not have the fruit I was hoping they would have, so I left without buying anything (but the pizza). Overall, the slowness of getting the staples removed sort of screwed up the whole day. Evelyn didn't really need me to visit at all today.
I returned home to write of the day. I watched a movie on YouTube.
Monday, 04/08/13 Evelyn's First Return Home
We are still expecting that Evelyn will return home on April 15. However, Evelyn will have to get her orthopedist's approval on that and he is on vacation. He won't be back until Friday and Evelyn and I will drive to Little Silver to get his approval. Now the problem with that is that my pulmonologist has scheduled a sleep study for me on the night of April 15. And of course I cannot get through to either the sleep study people or my pulmonologist. It makes more sense to contact the sleep study people directly, but if you are medical staff you call through one channel and if you are just a patient you call through another channel. And we know which one gets the priority.
Of course, early release is a mixed blessing. While she is in the Healthcare Center there is a therapist who is paid to make sure Evelyn does her exercises and makes progress. If she gets sent home earlier she is sent with an assignment of what exercises she should be doing at home. It is like giving a kid a list of books to read over the summer. You start out with great intentions, but then you come in contact with the real world and you have one good reason after another to postpone exercises. Evelyn is very strong-willed. I have been trying for years to get her to use the exercycle. Well, as she points out she lifts some pretty heavy boxes of books. Besides, apparently the seat on the exercycle is very uncomfortable for her. I do not think she does a lot of lower body exercising. I think she might have needed that also. Well, I will try to make sure she is doing her exercises, but Evelyn has a very strong will. Or perhaps I am too accommodating.
So today is a big day for Evelyn. She gets to return home for a few hours. Not that she is incredibly homesick, but she can get a look at her mail and get on the computer. Access to home makes life a lot easier. She called about 11:50 and said she was done with her therapy and was ready to go out. It took about 15 minutes for me to get to the Healthcare Center and pick her up. She walks with a walker and can get in the car by herself, but she needs someone to put the walker in the back seat. That was me. She picked a nice day. It was about 65 degrees and sunny. I took her home and she got a chance to see our neighbor. She went in the house. The step up at the door was only about four inches and she made it easily with the walker for support.
I made lunch (thawing frozen chili) and through the afternoon I served snacks. I served coffee and a muffin and later I served plantain. She spent about three hours or so on the computer. Meanwhile I did a wash of her clothes and mine from the past week. It did not quite finish so I will take her clothes tomorrow. Now I am back home. I folded laundry and am working on the log.
Tuesday, 04/09/13 Evelyn Goes for a Little Walk with her Walker
Well, today I needed to know how to put a tight fitted sheet on a bed. After a little effort on my own I asked with Google and found a description that helped. Ah, the benefits of technology.
Evelyn was able to wash her hair herself and that makes her feel better. They would wash it for her or she could pay to have it washed in the beauty parlor, but now she can wash her hair whenever she wants. I don't know. Somehow being that much into getting your hair shampooed seems a little demented, but that is part of what makes her Evelyn.
Other accomplishments for Evelyn include rolling over to sleep on her stomach. She does note day by day it becomes easier to do the same exercises. What she still cannot do is to bend her right leg enough. She cannot squat or pull up her right leg if she wants to roll into a foetal position in bed. She cannot extend or bend it enough.
Evelyn sees the whole situation as ironic. Due to a scoliosis of her spine her left leg was longer than her right and she had to walk on a pad in her right shoe. Well, the operation of course changed her right leg. Now it is the longer leg. She will be moving the pad to the other shoe.
One thing Evelyn will not miss is how hard it is to sleep at night. The door is never closed. Light and conversations from the hallway make it really hard to sleep. I brought her an eye mask and she has an iPod and earplugs, but they do not make things a lot better.
After I arrived I exchange pleasantries with Mildred, Evelyn's roomie. This is Mildred who is 32 years older than Evelyn. There are very few people in the Healthcare Center who are not decades older than Evelyn. It really is more nursing home than Healthcare Center. Earlier I folded some origami for her and her family. At Evelyn's suggestion we also got some telephone cord from the dollar store and used it to replace the way-too-short cord on Mildred's phone. Now we are quite friendly with her.
The big event of the day for Evelyn was my visit (I think) and Evelyn's walk. There are two buildings together and one road that surrounds them. The day was sunny and nice so I suggested to Evelyn she could walk around the circuit. Evelyn was not sure she could do it, but I had walked the circuit with the Blossers. Evelyn walked it just fine with her walker. After, we were curious how far she walked. I asked at the front desk and they did not know how long the circuit is. To establish it I went out and paced it off. I got that the circuit was just about a half mile. Later Evelyn looked at it on Google maps and agreed with my estimate. It is not clear that walking so far is approved by her therapists. But they would want the orthopedist to approve and he is away on vacation. I think the more she can do the better.
I After the walk we sat in the sunroom and entrance to the building. In the afternoon we went to the dayroom where they served us pudding parfaits. They seem to have activities every day and frequently they concern snacking. I stayed until about ten minutes to 5 PM. Evelyn would be eating in the dining room and I had to get home to have my own dinner.
Wednesday, 04/10/13 Walking Without Support
I spent most of the day away from Evelyn. I had to teach at 3:30 - 5. There was no point in visiting Evelyn earlier since she could be taken out for therapy at any time. At 5 PM I went to dinner at McDonalds. I have not been to one in years, I think. (You mean there is no more dollar menu?) Then I went to visit Evelyn getting there about 5:30. I stayed till about 7:30 when the sky went very dramatically black and we got a doozy of a thunderstorm. Right at the moment I am working on the log. It takes a fair amount of time. More than I would have expected, but at least this way everybody who wants to know Evelyn's status can access it whenever they want. It is quite a community of people by this point. The milestone of the day is that Evelyn can really walk without her walker. The therapist is impressed, though she says Evelyn is not bending her knee enough. Those milestones are coming thick and fast.
Evelyn says:
One thing that is very annoying about this place is that they seem to have no sense of schedule. Even when they have a schedule, such as for when you would get a shower, they never tell you. Only today did I discover that one of my shower days is Wednesday (and I have no idea if I have another day each week or not). And it is impossible to have a schedule for therapy because they are constantly interrupted for evaluations, meetings, etc.
Now the latest rule is no occupational therapy in the therapy room in the mornings because it is too crowded. So today in the morning there were a few people there when I did physical therapy, but in the afternoon there was two dozen people in the room (patients, therapists, doctors, etc.). Go figure. (And one therapist said they got in trouble for having a patient come for occupational therapy at 11:45 AM!)
My leg was a bit sore from walking (a half mile yesterday), but I was still able to do all the exercises. During the occupational therapy we talked about the fact that I was going to have only a couple of days between when the doctor finally gets around to authorizing full weight-bearing on my right leg and when I am discharged. I suggested that maybe I should try taking a step or two at some point without the walker, and the end result was that when they went for a piece of equipment I stood between the parallel bars and marched in place without actually holding on to the bars. Then I walked a few steps, turned around and walked a few more, all without using a walker or any other support. (The fact that my balance is good, and that I am not overweight makes switching to weight-bearing less problematic.)
Now technically I am not supposed to do this. But even if some stickler for rules noticed, what could they do--throw me out? However, the therapist could get into trouble, so we went outside to the interior courtyard they have and I practiced walking a capella. I apparently need to work on actually bending my right knee rather than holding the leg stiff, and I am still walking a bit slower, etc., but I really think I am able to do pretty well even without support. (I probably still need a bit of support on steps.) I finished off by walking up and down the hall a couple of times, pushing the walker as a disguise, but not really using it. Again, this is a major milestone.
Speaking of showers, by the way, one thing that probably changes here for most people is body embarrassment. In THE SESSIONS, Helen Hunt plays a sex therapist who at one point goes to a mikvah. The mikvah lady tells her she has to take everything off, which she does with no hesitation, and the mikveh lady observes that most women hesitate, try to negotiate not taking everything off, etc. Well, in a hospital one becomes more like the Helen Hunt character--though only with the appropriate set of people. One doesn't want to run down the hall naked, but taking off one's clothes so that the aide can wash you in the shower is less of a problem that one thinks it would be.
Thursday, 04/11/13 A New Hope
Evelyn talked to the occupational therapist today and the therapist was under the impression that Evelyn would be sent home not on Monday, April 15 but on Saturday April 13. I guess this means I have to send all the nice young ladies home before Evelyn finds out. I think Evelyn is very hopeful that she will get back some place where she can get a good night's rest.
Later: Well, you know life is full of compromises. Evelyn is coming home this weekend, but not on Saturday or on Monday for all that. Her release date is Sunday. It will probably be something like noon.
She was talking to the therapist and other patients about good places to eat in the area. One recommended Pancho Villa's. That is where we are planning to have lunch today. That plan could change because there are gray clouds and it is an uneven and long walk from where the parking is, but Evelyn thinks she is up to it. I think she hears the call of Posole.
Evelyn says:
I am being discharged Sunday, 4/14. My current status is that I can actually walk a fair bit without a walker or cane, but I'm not ready to do long hikes or carry trays full of food.
I do now use the walker first thing in the morning when I get up until my muscles and joints get loosened up a bit. I actually use it here a bit more because technically I'm not cleared for not using it, but a couple of the therapists sort of hinted I was probably more than ready to do unassisted walking, so I have been kind of sneaking it in. The orthopedist has been on vacation and no one else seems able to re-classify me, or rather my leg, as "fully weight-bearing", which means that the therapists are not supposed to have me doing stairs or walking on my own, but this has lately been more honored in the breach, as they say. I see the orthopedist tomorrow.
Well the plan for today, brief though it may be, is to get Evelyn to have a little more joy out of life. I am taking her to one of her favorite Mexican restaurants Pancho Villa's. Though I have to admit, I think it is going a little downhill. When it first opened they were trying only for a Mexican clientele. They have a newer menu that is a little compromised with their non-Mexican guests. I think they have been seduced by the gringo side of the Force. And their prices have gone up a bit. Evelyn had Tamales and I had Chilis Rellenos. The ground from the lot to the restaurant is a little uneven, and Evelyn went it on a walker. The progression is wheelchair to walker to cane to hoofing it. They are releasing Evelyn before they have tried her on a cane.
From there it was to the house for three hours or so. She spend the time on the computer and on looking at her paper mail. I dropped her off at the healthcare facility about 5 PM and went to a meeting in Middletown.
Friday, 04/12/13 A Trip to the Orthopedist
Well, today the plan is to pick up Evelyn at the Healthcare Center and then to proceed on to the orthopedist. There is a little complication financially because Lopez is not "in network." He is still covered by the insurance because he operated in an emergency and Aetna covers his work--sort of. But he needs a deposit from us for his further service. Yesterday I put together about ten questions we should ask him.
A friend of ours who has several times had surgery says of the Healthcare Center:
Evelyn, I have gotten a pass to leave Rehab every time but the last one. As time has gone on, it's gotten increasing hard. The last time or two that they released me, it got more difficult to get permission and the length of time got shorter. The last time I asked & was denied, I was told that if I went my insurance would determine that I was ready to go home & tell me I had to be discharged. I told them that that was ridiculous because (1) I wanted to go home to see what I could & couldn't manage & (2) [My husband] would be with me but during the week he works fulltime. I think that the ability to leave may be based on it being an acute vs. sub-acute rehab.
Apparently Bayshore is a little more open.
Evelyn responds:
It all boils down to the fact that I was originally rated as "partial weight-bearing", then my orthopedist went on vacation and his locum would not reclassify me as "fully weight-bearing". The result was that the therapists were technically not allowed to do anything that required more than 50% weight-bearing. In actual fact, a couple of them recognized that the situation was crazy and had me do steps a couple of times, and some walking without the walker or a cane. (The latter was after I decided to give it a try between the parallel bars by just holding my hands above the bars ready to grab and taking a few steps.)
In any case, I think the cane will come into use for outdoor walking on uneven ground (e.g., parking lots). Trying to do that with a walker is probably more effort than doing it without the walker. In fact at one point I think I was walking holding the walker a few inches off the ground in case I needed it!
Well Evelyn will have to be spending some time walking from the car to buildings and back. Naturally we got the ugliest and rainiest day we have had this year. But Evelyn is getting around pretty well now. I picked her up at 9:30 AM and went to see the orthopedist who performed the operation on Evelyn.
Homeopathy is a system of medicine that involves treating the individual with highly diluted substances, given mainly in tablet form, with the aim of triggering the body's natural system of healing. They do not use homeopathy in the medical system here. (Thank goodness.) I guess the impression is the medicine has effect inversely proportional to the amount of the drug you take. The problem with that is that is you sniff one pill you will die of an overdose. But as I was saying they don't use homeopathy with drugs, but they do with doctors. We drove all the way to Little Silver for Evelyn to see Dr. Lopez. I think Evelyn and I both left convinced we had seen him, but he was not around enough to register on a camera. I think Evelyn saw him in one part of the room and I saw noticed him in a different part at a different time. I am not sure we both saw him at the same time, but I am willing to swear he was in that room at some point. We talked mostly to a nurse practitioner who was learning of Evelyn's existence for the first time.
Evelyn and I had assembled a list of questions that I collected and categorized. That sort of surprised the nurse practitioner. Most people are not that organized. But we got a lot of information.
[At this point I am waiting for Evelyn to write up the Q&A to include here.]
From there we went to a Korean restaurant where Evelyn had boiling soup Hae_Mul Sun_Du_Bu (spicy stew with soft tofu, seafood, vegetables, and egg, served very hot in an earthenware pot) and I had a Bul-Go-Ki Bento.
I drove Evelyn back to the outpatient clinic at Bayshore Hospital and they again x-rayed her leg. Evelyn saw the x-ray and was surprised how long the pin was that they put in her leg. It was pretty much the whole length of the femur. After this we both were a little wet and bedraggled. Evelyn can now get in the car herself including opening the backseat door to put her walker in. She is certainly making progress at the Healthcare Center.
Saturday, 04/13/13 Evelyn's Last Day At Rehab
I did not visit Evelyn until this evening. I taught mathematics at the library and worked around the house. Evelyn had therapy sessions in the morning and was visited by our friends the Goldsmiths so I knew she would not be bored.
At about 6 PM I went to visit her and ended up in a session folding origami for the women in the Day Room. Visiting hours were over at 8 PM, so I left at about 7:50.
We have borrowed a walker from our friend Charles Harris. I measured it to be sure it was the same height as the one Evelyn is using at the Healthcare Center, but it was the same. Evelyn wants it set to 33 inches and that is the lowest setting.
Evelyn has written up the Q&A session with the orthopedist's nurse practitioner, but we are having some problem getting it to a place where I can copy it to the log. I should have that on Sunday.
Sunday, 04/14/13 Evelyn Comes Home
I guess the big news of the morning is that Evelyn is home and walking around. She still takes the walker most places she goes. But with the help of the walker she was able to get around and even go to the grocery (though she is not ready to drive yet). Her leg is still fairly stiff. I, in fact, did pick her up and said good-bye to her roommate and some of the other people I had met there. Our first stop was the grocery and we got some stuff to re-provision the house. Then I took her home and she spent a fair amount of time on the computer. Now I am accessing the computer and the first thing I am doing is updating the log. I got Evelyn's write up of the question and answer session with the orthopedist's nurse practitioner
I saw the orthopedist today--or rather, he stuck his head in for less than five minutes while we spent a fair amount of time with the nurse practitioner. I explained I was unhappy with the idea that my weight-bearing status couldn't be upgraded while the doctor was on vacation. The N.P. explained that there were good reasons for the original surgeon to make that decision, but all that means is that the original surgeon shouldn't be going on vacation right after surgery.
We had a lot of questions:
- Was I total weight bearing? After today's x-rays were checked, yes, or rather "weight-bearing as tolerated."
- Why am I not using a cane? I need to be "weight-bearing as tolerated."
- When will I be back to normal? In about two months. Regarding driving, hitting the brake pedal requires 60 pounds of force. She suggested that when I think I am ready I go to an empty parking lot, get up to 30 mph and try hitting the brake pedal.
- Do I need a handicap tag? No.
- How do I handle airport security? She gave me a wallet card from the doctor showing the location of the rod, but it is not clear how much it will help.
- How will I know if I am exercising enough and correctly? Presumably the therapist will indicate what is appropriate.
- Will I do damage by pushing it? Possibly.
- Are there motions I should avoid? Not that she mentioned.
- How should I build up the bone? No real answer for this.
- What is the difference in length of the legs? The nurse practitioner said 4mm, but having it measured later at the rehab center, it was more like 2cm.
- Might the legs eventually even out? No.
- What kinds of shoes are okay? Preferably those with arch support and a wedge heel.
- Did the break cause the fall or vice-versa? No real way to tell.
- Will exercise strengthen the bone? She seemed to say not.
- Is it likely to happen to the other leg? No.
Basically, the answer to most questions was that I needed to build up my quad strength.
So that is it for the time being. Evelyn is still very stiff when she walks and occasionally needs the walker like in getting out of the bed in the morning.
I will periodically update this log.
Wednesday, 04/17/13 Progress After Four Weeks
Over the last few days Evelyn has gone from walking with a walker to walking with a cane, to walking with a limp (at least around the house). Yesterday morning I woke up and found that Evelyn had gotten out of bed at 4 AM and just skipped the walker and the cane probably not to bother me. But the point is she got around on her own even the first thing in the morning.
Evelyn will have physical therapy and we are hoping we can do it from home. A nurse came to the house yesterday and got her to answer a bunch of questions. That is a preliminary. A physical therapist was supposed to come today and check her out more, but we have not heard from her. We go out for lunch these days and Evelyn can make it around with a cane. The staff at Old Bridge Public Library have been very concerned about Evelyn and her progress so I suggested Evelyn might want to go to the library and show them that she has been recovering quickly. There was only Lisa and Rosemary there, but I expect the word will get around. When we go out Evelyn gets around fairly well, if slowly, with a cane.
Maybe I can shame Evelyn into writing some of the news directly in the log.
Today I started to do the clothes wash. Evelyn stopped me and said that she was up to taking back doing the wash.
Well, I've been home a few days now, and have been doing fairly well. I used the walker a friend lent us for a couple of days, but then it seemed more like an impediment than a help. Outside the house, I still use a cane, but more to signal people not to run into me or to expect me to jump out of their way. In stores, the shopping carts provide more than enough support.
We've been catching up on going to restaurants (Kimchi Sushi on the way back from the orthopedist last Friday, then Saladworks, Sichuan Cottage, and Thai Thai). We have also gone to the grocery store (twice), Costco, and the library.
The nurse from the at-home therapists came on Tuesday to evaluate me. She was training someone, but she said I was not as interesting or complicated as most patients she sees because other than the broken hip, I had no health problems or special history. (Then agin, most of her patients are probably twenty years older than me.)
The next step was the evalutation by the physical therapist, who came Thursday. His reaction when I walked into the room was, "Wow! What am I doing here?" After some discussion, he concluded he was saying goodbye and have a good life--I did not need at-home therapy, and probably did not even need outpatient surgery. He gave me three exercises to strengthen my right leg and also suggested walking. The exercycle is another possibility, though I find the seat really uncomfortable.
Ten Good Things about Coming Home from the Hospital
1. I get to sleep on my own comfortable mattress with my own comfortable pillow.
2. No one wakes me up at 5:30 AM to take a couple of pills that could easily wait until at least 7 AM.
3. I am not constantly subjected to the televisions of all the other residents (including my roommate's), set to many different stations, none of any interest.
4. I am not awakened by people yelling, "Nurse!" in the middle of the night instead of using their call buttons.
5. I am not awakened by loud conversations by the staff at 3AM outside my open door.
6. I am not kept awake all night by light coming in from the hallway through the door that must always be kept open.
7. I can eat real food that I like, not institutional food.
8. I can read for a long stretch of time, in silence, without being interrupted for pills, doctors, therapists, visitors, or anyone or anything else.
9. I have a choice of my entire wardrobe, not just the few pants and shirts that fit in the small dresser in the hospital.
10. And of course, what really should be listed first: Mark is there all the time, not just a few hours a day.
Thursday, 04/18/13 No Additional Therapy Needed, Thank You
In the morning we go to see our general practitioner. She is recovering well, but her blood pressure is up. Mostly the GP is handling that aspect.
The physical therapist came to the house today to start Evelyn's home treatment. I let him in and went to get Evelyn. Evelyn came walking down the hall, no walker, not cane. The therapist took one look and said, "Wow! What am I doing here?" The conclusion is that Evelyn is so far along toward recovery there is not much the therapist can do for her. She still limps and healing is still going on, but Evelyn is getting better each day and doing this much better this soon is very unexpected. Of course Evelyn is young for someone with a broken hip, but with the exception of a couple recommended exercises and the suggestion that she walk and use the exercycle--two things that I was trying to get her to do before the accident--there is not much he can do to help her. So we feel good about that.
Friday, 04/19/13 A Surprise from the Library
Evelyn improves a little each day and supposedly her recovery is very fast. To me it seems like it is taking a very long time. Tomorrow it will be one month since the accident and most people would not have guessed that Evelyn would be walking so well just one month later. Her blood pressure is down since yesterday. Evelyn had some new drugs to take so we went to Walgreen's.
From there we went to our local Vietnamese restaurant and we each has large bowls of pho. From there we went to Wal-Mart and got a softer seat for the exercycle. I have been wanting her to get some exercycle exercise, so I was pleased when the doctor gave her the same advice I did. From there it was back to Walgreen's to pick up the prescription and to get a tip for the bottom of the cane she wants to use. Then home.
The mailman brought a get well card signed by most of the staff of the library I think. It was very nice and it shows how much Evelyn (and I) are valued by the library. I thought that was just terrific.
Evelyn is now walking around with a cane when she goes out and she just walks in the house. She has a noticable limp, but she is a lot better each day. She was talking today that Sunday we should go to the high school parking lot and she could try a little driving. This is a very fast recovery from what everybody says.
The Healthcare Center called to find out how her recovery was going and and used words like "Wow!" in response.
Our entries may be shorter and farther between due to a distinct shortage of new milestones that we can think of. When she was at the Center they knew a very large and varied collections of possible milestones. Now we are suffering a shortage of milestones. It would be nice to have some more, because it feels so good when Evelyn passes one. (No, I am NOT going to make a pun about passing a kidney stone.) My prescription for Evelyn comes from the film THE OUTLAW JOSEY WALES. She should endeavor to persevere.
Thursday, 04/25/13 New Travel Document
Evelyn has a new document for when she flies. She is not going to be passing the metal detector screening. She is going to have that pin in her leg. But she has been giving a card to indicate that she cannot put her metal in a basket to be X-rayed.
Evelyn is getting most of her function back. One thing that is still not very good is squatting. She finds that very painful. It is hard for her to work with things on the floor.
Sunday, 04/28/13 Evelyn Hits the Road
Today after lunch I took Evelyn to the local high school parking lot so that she could try driving for the first time since her accident. When we went out about 1 PM. When we got there I asked her if she wanted to take over driving right away or did she want me to drive around a little before she took over. I was pleased that she wanted to get right to it. She drove around and slammed on her brakes two or three times. Then we headed for home. I let her drive. We were home by about 1:12 PM.
Right now her big deficiency is that it is painful for her to squat.
Wednesday, 05/08/13 Progess Is Slowing Down
Evelyn writes:
Today is seven weeks since I broke my hip. There is still progress, but obviously at a slower pace, since most everything is about as good as it is going to get. (I can't run a four-minute mile, but then, I never could.) My walking is pretty much back to normal, but it is still difficult to get to things on lower shelves and in lower cabinets. Turning over in bed occasionally sends a pain through my hip if it is twisted in some unusual way, and I still get pains in my right thigh and knee as they gradually heals around the rod.
Our friend who works in a nursing home said that the people there found the log very interesting. The physical therapists in particular were both amused and appalled that I was walking around "pushing the walker as a disguise, but not really using it." Apparently they are now looking more closely at the residents to make sure they are actually using the walkers!
I expect to be putting up a spreadsheet with a somewhat detailed breakdown what all this costs, with "list prices", "negotiated prices", and what I will actually end up paying after insurance is taken into account.
Evelyn says "everything is about as good as it is going to get." This was the first I knew that that was what she thought. The doctor the first day said that he expected full recovery, and Evelyn is a long way from what I would consider full recovery. She still walks with an very marked limp. She had a limp before has because of the scholiosis, but it is much more now. We had houseguests this last week and she has not been able to exercise, but I am hoping that she will fight this fight and make things as good as they can be under the circumstances. Before she healed quickly in large part because most people who have these problems are twenty years older. Her relative youth was in her favor. But she is going to have to invest some time and effort into getting things functioning.
Evelyn has been keeping close
track of
expenses to as to be able to show people who are curious what has been
charged. This is her spreadsheet.
Friday, 05/10/13 Back to the Orthopedist
Today Evelyn had an appointment
with her
orthopedist. And she did see him. I
think. Anyway, I saw him. He was down the hall from
us and I think he recognized us and waved. We talked to the
same nurse practitioner as the last time we came to see the orthopedist.
Evelyn was told she can now
pretty much do
exercises and they are definitely recommended. The one thing
she should avoid was squatting. That will take a good deal
longer. She can exercise to help her squat. She
should put her back on the wall and lower to a half-squat until the
muscles in her thighs tighten up, then lift herself again.
That is not really a squat, but it will help those muscles.
Other exercises are pretty much what she would to normally.
I want her to try exercycling again.
I would like to get her walking
around the block with me. Other than that
she should
exercise as she usually would. Actually I am more faithful
about exercising, and that because I can do it in front of the
television and watch good movies while I exercise. Evelyn is
a little less anxious and I may need to prompt her a little.
She has lumps where the three incisions were and those she should knead
to break up the scar tissue. Well, that is about it.
We stopped at a Korean restaurant on the way home.
Tuesday, 05/14/13 More of the Same
A few more
comments from Evelyn:
Another
thing I cannot do is put my
keys in my right-hand pants pocket, where I have always kept
them. This is because they end up rubbing my leg right where
the
scar tissue is from one of the incisions. I am assuming that
eventually this will stop being a problem. Massaging the
scar tissue is
supposed to help it go away, or at least diminish.
I
did manage to do some work in a
lower cabinet, but this involved sitting on the floor (and getting up
again), which is a somewhat complex operation if you do not squat at
any point in the process. For getting one or two items out, I
suspect kneeling will be easier, though I would probably want to throw
a towel or other cushion on the floor first. For what it's
worth,
the nurse practitioner at the orthopedist's office said that squatting
is a bad idea in any case, so I should not be trying to get back to
being able to do so. I think that means "duck-walking" around
the
attic is right out.
Speaking of the attic, all
this meant that
climbing up and down to the attic carrying things was not in the
forseeable future. Since I had a lot of books up there I was
selling on-line, we had to come up with a way to bring them down.
Our solution was that I went up with a bunch of canvas
shopping
bags hanging on my shoulder so both hands were free and put the books
in them (not too much in each one). Then I came down
empty-handed
and Mark went up and handed down each bag to me, and the empty bin at
the end. Then he came down empty-handed. (Then the
only
problem was where to put them!) Most of the rest of the stuff
up
there is not stuff we access--old issues of magazines and fanzines, old
yearbooks, Mark's graduation gown, old suitcases that we no longer use,
and all the usual stuff that people accumulate.
Leg pains (including knee
pains and hip
pains) come and go. I suspect the knee pains may be if I sit
on a
low couch, or drive some distance, with my leg bent for long periods of
time. There is less pain from twisting around, though, so it
seems things are improving. I can actually sleep on my side,
somewhat curled up (which had been my favorite position for sleeping
before all this).
As for the cost, it turns
out that the
orthopedist's cost includes follow-up visits for three months, hence
the blank entries in the spreadsheet. I had two visits, and
was
told I did not need any more (sort of like the visit from the physical
therapist). I still have not seen a specific bill from the
anesthesiologist, so there may be bills that dribble in.
Sunday, 05/26/13 And the Bills Keep Rolling In
More from Evelyn:
Yet more bills (all with zero for us to pay, since we have met the annual deductible): The ambulance from home to the hospital was $723 (with no insurance discount). The anesthesiologist was $2890 and the anesthesia was $340 (again, neither had an insurance discount). I am not sure why these bills have no negiotiated rates unless it is because they are out-of-network, so there has been no negotiation. At this point, the list price for everything is just under $100,000, with the negotiated costs being about $43,000. My share is a little over $3000.
{At this point, I think we might as well consider this log closed.}