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Week of 8 July 2002

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Monday, 8 July 2002

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On Hiatus

11:05 - Yesterday started out routinely. My mother ordinarily sleeps until 10:30 or 11:00 a.m. I woke her yesterday at 11:00 and brought her coffee and juice to her. I was in the kitchen making her breakfast when I heard her yell. I went tearing down the hall and into her room, and found her on the floor. She said the walker had tipped over when she was trying to get to the potty chair. She was obviously in terrible pain, so I called 911. The ambulance showed up a few minutes later. They started a drip and got her into the ambulance and off to the hospital. I followed them down and sat with my mom while they ran her through the emergency room, radiology, etc.

Eventually, the doctor told us she'd broken her right leg just above the knee. We had two choices, he said. Do nothing, which would eliminate any possibility of her ever having any mobility, or operate. But he said there was no guarantee they'd be able to fix the problem, because her leg bone had been so badly broken. "Powdered" was the word he used. My mom was completely out of it by this point, and told me to decide. I asked the doctor if there was any downside to operating, other than the obvious dangers of infection and anesthesia. He said there wasn't, and that if it turned out he couldn't repair the damage she'd be no worse off than she would be if he didn't try at all. So I told them to go ahead and operate. The doctor said she'd be in the hospital for a week or so, and then would need to go to a nursing home for at least 90 days for therapy and so on. He said there were no guarantees, and he thought it quite likely that she'd need to remain in a nursing home permanently.

They operated from 6:00 to 7:30 p.m. and the surgery went as well as could be expected. When the doctor came out to talk to me, he said that there wasn't much to work with because my mother's bones are like eggshells. He did manage to install a plate, screws, and wires that reconnect her leg bone to the knee. He told me that, barring a miracle, my mom would never be able to walk again at all, even to take the two steps from her lift chair to the potty chair, and that he was almost certain she'd have to go into a nursing home for the rest of her life.

I got home about 9:30 or 10:00, expecting that the dogs would have had accidents all over the place. Amazingly, there wasn't a single accident. So I took them out to give them a chance. I then called my brother and left a message. My mother didn't want him to come over, because he's in the midst of some problems of his own. His wife was rear-ended not long ago, and the insurance company of the person who caused the wreck is refusing to pay for their car or for his wife's medical expenses. So my brother has his hands full at the moment, and my mother didn't want him to drop everything and come running over here. I also had to call my mother's friend Betty Conover. They've been best friends, almost sisters, for more than 65 years. Betty was very upset, of course.

And then I had to decide whether to tell Barbara what was going on. My mother didn't want me to tell her at all, because she was afraid Barbara would abandon the trip and come running home. I thought I could talk Barbara out of doing that, but I didn't want to ruin her trip. So I called our friend Bonnie Richardson and asked her what to do. She said that Barbara would want to know. So I called Barbara last night to tell her what had happened. She'd have come home if I needed her, but there's really nothing she could do here, so she will continue with the trip.

Then I decided I'd better get some sleep. I'd almost gotten to sleep around 12:30, when my brother called back. I told him what was going on, and he reluctantly agreed not to come over. He's off this weekend, so he'll head over then. I got back to sleep, but some moron called me at 3:30 this morning, was verbally abusive when I told him he'd dialed the wrong number, and then slammed the phone down. Then at 5:45 this morning, the nurse called from my mother's floor to ask what medications she was on. I managed to get back to sleep, and finally woke up about 9:30. I called and spoke to my mother and told her I had a few things to do and would then come down with some books and other stuff she wanted.

I'm going on hiatus for now. I won't be updating my journal for a while, possibly not until Barbara returns on the 23rd. I will be checking email periodically, but I won't have time to respond to much of it. Things are going to be pretty hectic around here.

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Tuesday, 9 July 2002

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22:05 - Thanks to everyone who has sent messages of sympathy.

It's been rough the last three days, with more yet to come. My mother is doing somewhat better, although she's still in a great deal of pain, and is of course still terrified that she's going to be sent to a nursing home to die. She's 83 years old, and this situation can't help but remind her of her mother, whom my brother and I called "mom" because that's what my mother called her.

My grandmother lived on her own in her own home until she was 83 years old. One day, going to the small grocery store across the street from her house, she fell. That was in 1968, when I was 15. She lived with us for the next six years, but eventually my mother could no longer care for her properly, so they had to move her to a nursing home. She lasted only three weeks in the nursing home, going downhill rapidly almost from the day she arrived. When she died, my mother of course thought that putting her in the nursing home had killed her.

So, my mother has now lived with us for just over 10 years. She's fallen and broken her leg, and the doctor has told her that once she leaves the hospital she'll have to go to a nursing home for at least 90 days of therapy. Although he hasn't told her, he told me that barring a miracle she'll never be able to live at our home again. So my mother now knows that she's going to have to go to a nursing home, and I'm sure she believes that she'll die after three weeks just as her mother did. She sees this as a death sentence, and for all we know she may be right. These things have a way of becoming self-fulfilling prophecies.

So my job is to convince my mother that she should not give up hope. I'm spending a fair amount of time at the hospital. About 12 hours Sunday, eight or nine hours yesterday, and eight today. I'd spend more time there, but I really need to be at home at least part of the time for the dogs. They've been extremely good, despite being left for long periods. Not one single accident so far, although when I do get home and open the door they don't get much more than 10 feet out the door before lifting their legs. What's surprising is that they don't pester me to death when I get home. I've played hall ball with Malcolm for a while since I got home, but right now he's lying on his side asleep in front of the television.

I can't believe how tiring it is to visit the hospital. It sounds stupid, because mostly I'm just sitting in a recliner near my mother's bed. But it is one of the most wearing things I've ever done. I did the same when my father was hospitalized before his death in 1990, but I don't remember it being this exhausting.

I guess part of the reason for that is that my mother is in a great deal of pain, particularly when they come in to do physical therapy on her leg. She understands on one level that they have to do this if she is to have any chance of regaining even minimal mobility, but understandably she just wants the pain to stop. When they were manipulating her leg today, she was screaming and asking them to kill her. They'd given her a Darvocet pill about five or 10 minutes before they started, which I don't think was enough for it to take effect. They got her moved from her bed to a wheelchair, and told her that she needed to move the leg to prevent blood clots and that she needed to be upright to prevent pneumonia. She sat in the wheelchair for an hour or so, and then they moved her back to the bed. That was considerably less traumatic, presumably because the pain killer had had time to take effect.

Today, she had her first visit from Christy, a nice young woman who is a Physician's Assistant with the practice of which my mother's surgeon is a partner. Christy is 23 years old, and by her own statement appears to be about 16. My mother was surprised to learn that Christy can do nearly anything a physician can do, other than being the primary surgeon during an operation. I told Christy about the problem with physical therapy and asked if she could order morphine (or at least something potent and injectable) before my mother's next session tomorrow. She ordered that, and also told my mother that she could ask for additional painkillers whenever she needed them.

Christy is from Erie, Pennsylvania, which is only 90 minutes or so north of where we used to live. The three of us chatted for a while about "home" and during the conversation I asked her how one got to be a PA. She said that differed between Pennsylvania and North Carolina. Here, one gets a four-year college degree and then attends a two-year PA course. In Pennsylvania, one can start PA school right out of high school. PA school there runs for four years, and at the end of it one is a Certified PA. Basically, it sounds to me as though they crunch medical school and residency into four years, and that someone who comes out of that course is about 90% to being a physician. In fact, since med school admissions are no longer based solely on competitive testing, my guess is that the better PAs are probably as good as the guys who graduated last in their classes from med school, if not better.

At any rate, I think Christy had a good effect on my mother. Mom perked up quite a bit, and we spent the remainder of the afternoon and early evening talking about various stuff. She seemed almost back to normal in terms of her outlook. She's still worried about going to the nursing home, though. She thinks she'll never be able to watch television or talk to her friends on the phone again. I told her that wasn't going to happen, and that if for some reason she couldn't have a phone in her room, I'd bring over a cell phone and let her call her friends on that.

So things are looking up a bit anyway., although there's still a lot to get through. My brother will be over this weekend, so I'll get a break then. Until then, I'll manage. After that, they may be moving my mother to a nursing home, although they haven't yet said anything about when they'd do that, other than the statement the doctor made the first night about her staying in the hospital for five days or a week and then being moved. Presumably they're going to see how she does before deciding to move her.

Once again, thanks to everyone who has sent messages of sympathy. I wish I had time to reply individually to all of them but I don't, so I'll say thank you here. I'm sure it cheers my mother when I tell her that she's getting sympathy email from people all over the world.

 

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Wednesday, 10 July 2002

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See 13 July.

 

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Thursday, 11 July 2002

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See 13 July.

 

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Friday, 12 July 2002

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See 13 July.

 

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Saturday, 13 July 2002

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9:30 - Once again, thanks to everyone who has sent messages of sympathy. My inbox is chock full of them. I'm sorry that I haven't had time to reply to them, but I know you'll all understand. Things have been a bit hectic. Fortunately, the dogs have been good, except that Malcolm and Duncan get into fights if I don't separate them. Understandable, I suppose, because I haven't been around much to pay attention to them. During the day and evening while I'm at the hospital, I've been leaving Malcolm and Kerry upstairs and Duncan downstairs in my mother's apartment area.

Amazingly enough, there have been no accidents in the house, despite my leaving them for as long as 11 hours at a stretch. Wednesday, our friend Nancy Jackson stopped by in late afternoon and walked them. Thursday, I went down to the hospital in the morning, came back for a couple hours for dinner and to pay some attention to the guys, and then went back down to the hospital from 6:00 p.m. until 10:00 or so. Yesterday, I had to spend the morning at the county Social Services department doing paperwork for mom for the nursing home. I came back home around 11:30 for about 90 minutes to pay attention to the guys, and then headed down to the hospital and stayed until about 8:00. My brother may be coming over today, or it may be tomorrow. At least that'll give me (and the dogs) a bit of a break.

This morning, I got two email messages from Barbara, which she'd sent last night from an Internet kiosk at the hotel. That means I can't reply to them, since the reply-to address is Barbara's own email address here. They're at Banff in the Canadian Rockies, and it's hot, something near 90F. Ironic, considering that here in the sunny South the temperature is currently 71F, and I don't think it's gotten higher than the 70's for the last couple of days. They're staying at a 1900-vintage hotel in downtown Banff. Neither the hotel nor most of the stores has air conditioning, so it's difficult to cool off.

Of course, Barbara feels guilty enjoying herself while I'm dealing with all this, but there's no reason for her to feel that way. Ordinarily, she takes care of all the routine stuff, leaving me free to work. She deserves a break.

As far as my mother, she seems to be doing quite a bit better. She's still in pain, but much less so than she was. The doctor came in yesterday and told me that he'd decided not to operate on her left leg. That leg broke just above her artificial knee, and the end of the bone impacted the knee replacement device. Apparently, it's seated in there, and the doctor said that attempting to repair it would have little benefit for my mother and would simply traumatic for her. So they're going to splint it and use traction until it fuses.

We've spoken to representatives of three of the four nursing homes we listed as our choices, and I think mom has impressed all of them with her personality. The lady from the fourth nursing home left a message on my answering machine at home, but I didn't get that until I got home last night, so I'll have to call her Monday. All four of the nursing homes are near our home. The farthest away is The Oaks, which adjoins the hospital where my mom is staying now. That's only a fifteen-minute drive from our house, and the other three are all within 10 minutes. One is only about 5 minutes from here. Barbara's sister Frances stopped by again yesterday before I got to the hospital, and she and mom talked more about nursing homes (and probably everything else under the sun).

Mom is upset that she'll have to go directly to the nursing home from the hospital. Last night, she told me that she wanted to come home first to spend the night. I explained that she couldn't do that for many reasons, not least of which is that we can't transport her and that we don't have the hospital bed she needs. She thought she could stay in her lift chair, but I explained that that wasn't an option. She then asked if she could at least come home and spend a few hours. I told her that she couldn't do that now because of her legs, but that once her legs were recovered somewhat we'd be able to check her out of the nursing home for day visits to our home. She started crying because she thinks she'll never see home or the dogs again, so I explained that that wasn't true. In the first place, we can bring the dogs to visit her at the nursing home, and in the second, she's not going to be forbidden to leave the nursing home for short visits elsewhere once she's recovered a bit.

I think between me, Frances, the nursing home representatives, and others telling her about the good aspects of a nursing home that she's finally becoming convinced that it won't be as bad as she feared. What she wants, of course, is some assurance that she'll eventually be able to come back home, and I can't give her that. I thought about lying to her and saying that she'd only be at the nursing home until she recovered and then we'd bring her back home, but I think lying to her is a bad idea. It would give her some temporary solace, but in the long run it'd upset her more. Some people are holding out hope that her nursing home stay won't be permanent, and I've told her that. Right now, I'm telling her that we just don't know and have to take things day by day. It's important for her to work hard on her therapy, and this gives her a reason to work. Of course, if she works hard and still doesn't regain enough mobility to return home, it's going to be hard for her.

But I'm hoping that she'll adapt well to the nursing home and decide she actually likes being there with other people her age. The lady from Bryan Center told us yesterday that they'd just had one client who had recovered enough to go home. She ended up coming back to the nursing home because she liked it better there than living on her own at home. I hope my mother will feel the same way. Barbara and I, of course, will make every effort to help her settle in. We'll visit her frequently, and take the dogs over to see her. We'll check her out of the nursing home to take her shopping, or out to dinner, or over to our house. I hope things will work out, and at this point I'm reasonably optimistic that they will.

Well, I have a few things to do here, and then I'm going to head down to the hospital. Once again, thanks for all the get-well messages. Today, I can tell my mother that she now has get-well messages from all continents, because one came in from Antarctica yesterday.

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Sunday, 14 July 2002

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9:34 - Rain last night and this morning. We got about 0.4" (1 cm) last night, and it's still raining gently this morning. It'll take a lot more than this to make up for the four-year drought we've suffered, with a total deficit of something like 40" (1 metre) of rain during that period. Still, the grass, trees, and bushes like what we're getting now.

My brother arrived from Raleigh about dinner time last night. He headed down to the hospital while I ran his laundry for him. He got back here about 9:30 p.m. and said that my mother seemed to be feeling pretty good. I'm sure that seeing him helped raise her spirits. The dogs also enjoyed his visit, and for once I was able just to sit around and relax for a few hours. I suppose that's the hardest part, always having something that needs to be done, whether for mom or the dogs, and not having much time for myself. Barbara is due back in nine days, though, and I can do this for nine more days easily. Also, things will lighten up a bit once they move mom to a nursing home. At that point, we can focus on getting her settled in, and I won't be spending all day and all evening visiting.

Well, I'd better go get the dogs out for a while, take my shower, and head on down to the hospital.

 

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