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Tuesday, August 27, 2013

We'll Both Be OK.......Won't We? For anyone "just tuning in" this post may leave you wondering what the heck I am rambling about, I hope you take the time to go back and review my earlier posts so you can catch up with our story. For anyone who has been along for the whole wild ride - Thank you! I very much appreciate your thoughts and comments

Nearly seven hours into our five hour trip home I was finally able to loosen my grip on the steering wheel. Even though the snow was still pelting my windshield and the roads were still icy, I had quit worrying about ending up in a snow bank (or worse).

We still had an hour before we would be home, I had plenty of time to worry about other things.  Not being one to pass up such an opportunity, I shifted my concern and began worrying about the two steps mom would need to maneuver in order to get in to the house.

Even though  mom had undergone two major spine procedures in the last month, totaling nearly 16 hours of surgery, she seemed stronger.  I just wasn't sure of our abilities to complete the tasks we had before; I wasn't sure we could count on things being the same.

Before the surgeries, mom and I had developed a number of routines to get us through each day.   For example, we knew what it took to get in and out of the house safely.  I just hoped the stairs she had been practicing in rehab had been enough to prepare us for the "real thing".

Months before our departure, my brother and I had made sure every entrance was equipped with safety bars.  Although moms’ prosthetic knee had been wobbly and she wasn't quick, with a spotter mom could get up the steps without too much trouble.  At least she had been able to navigate the two steps BEFORE the surgeries.  I wasn't so sure now; I had an uneasy feeling.

I tried to think of someone who could help me get mom in to the house, everybody I could think of would be working.  As we rounded the corner leading in to the valley, I finally voiced my concerns to mom.  She didn't seem near as concerned as I was.  “It should be easier without the back pain” my mother had a point.  Without the pain limiting her abilities, it really should be easier.  After some discussion we came to the conclusion we could do it just like we had before; we just had to follow our routine.

My daughter - Showdown at Sundown triathlon
Unlike the dedicated routine of an athlete training for a triathlon, our routine required only a few simple steps:  I would unload moms’ walker and help her out of the car.  Mom, with her walker, would then walk the few steps to the door and park her walker at the bottom step, where she steady herself with the grab bar while I set the walker at the top of the steps and set the brakes.  The routine required me to be right behind mom to “spot” her as she climbed the two steps in to the house, just in case.

In my mind I went through the sequence we needed to follow and was feeling much more confident as we pulled in to the garage just after 6:00PM March 21st, 2013.  It had been over a month since we had attempted the steps but the stairs hadn't changed and mom was much better than she had been when we had left home in mid February.  We had this!

I ran through the required steps one more time, this time I recited the rote out loud.  I needed to make sure we were both clear on the routine; that we both remembered what was required to ensure moms' safety as we made our way in to the house before we made the attempt.  Once I was certain we were both on the same page, the routine began.

Step one was easy: I unloaded the walker.  Step two wasn't a problem: I helped mom out of the car to a standing position.  Three and four went fine also and moms’ walker was settled at the top step with the brakes set.  We were almost there.  “Hang on just a minute, mom” I wanted to unload moms wheelchair and close the hatch of my car so I could close the garage (it was cold and snow was blowing in).

I found out that day how true it was that even a slight deviation in our routine could upset the proverbial apple cart. 

My back hadn't been turned for more than a second or two when I heard moms foot clunk against the bottom step.  I turned just as my mother, seemingly in slow motion, was holding the grab bar and swinging herself around to a sitting position.  That was NOT part of the routine.  I sprinted back across the garage, unfortunately I must have also been in slow motion; I couldn't get there quick enough.

“I’m alright”, mom was sitting on the second step.  "My toe caught on the step", She was shaking and visibly scared, but didn't seem to have any apparent injuries.  She was pretty sure nothing was broken and her back seemed fine.  The gait belts were all packed in the car somewhere, we hadn't needed them until now.  If I could get mom to cooperate, I was sure I could improvise.

I told mom to put her arms around my neck so I could help her get up. "I can do it, but you have to trust me" I said as she hesitated.  Mom was afraid she "might" hurt me. I knew if she didn't trust I could get her up, I couldn't; we would likely both get hurt. "Why didn't you wait?", I couldn't hide my annoyance at our predicament.  Maybe it was more discomfort than annoyance.  We had only made one bathroom stop during our nearly eight hour drive; I had to pee!

Instead of answering my question, mom told me to call my brother.  Once again she assured me she was OK.  I reminded her that my brother was working out of town; it would take him hours to get there.  Mom looked dejected as I dialed my husband’s cell phone and began unpacking the car in search of the gait belts.  I couldn't leave mom just sitting there!  "I needed to go to the bathroom", mom finally answered my earlier question.  Just hearing her say "bathroom" nearly made me pee my pants.

"Will you be OK for a minute?", I asked mom and before she could answer, I shot past her.  It had been several hours since our last stop; there was no sense in both of us bursting our bladders!

Both my husband and son arrived within minutes of my call.  As my husband helped mom to her feet she explained why she hadn't waited for me to spot her before starting up the steps.  "I thought I could make it but my toe caught on the step", mom explained.  She then blushed and added, “I had to go to the bathroom”.  Snarkily, I asked how that had worked out for her. she shot me the mom look as she toddled on to the bathroom.

Mom and I had both learned valuable lessons that day.

The lesson I learned was that no matter how monotonous a routine can get, it was imperative the it was followed EXACTLY the same each time, at least until a new routine had been established!  Taking an extra few seconds to close the hatch had NOT been part of the routine!  Not following the routine had been a mistake.

Mom had learned, no matter how much better she was feeling since her surgery, she still needed help with some things.  She also learned she could get to the bathroom a lot faster if she waited for a spotter; waiting for someone to come get her up off the step takes a bit longer.

Thankfully, other than her ego and a couple of bruises, mom was going to be alright.

I also would be fine if I could get my heart to stop thumping so hard.

We'll both be OK.

Won't we?

Saturday, August 24, 2013

What else Could I Do? For anyone "just tuning in" this post may leave you wondering what the heck I am rambling about, I hope you take the time to go back and review my earlier posts so you can catch up with our story. For anyone who has been along for the whole wild ride - Thank you! I very much appreciate your thoughts and comments

What Could I Do?

I was thrilled at the progress my mother was making in therapy.  She worked hard every day.  They helped mom learn new ways to do as much as she could by herself without bending or twisting her spine. The therapists were great with her and accommodated her other limitations as best they could.  Everybody seemed to be impressed with moms’ progress; her motivation was inspiring.  As moms’ anticipated release date drew near I was, once again, approached by the social worker.

We went through the whole song and dance about moms’ placement AGAIN.  It didn't take long to convince the social worker no matter what she said, mom was NOT going to a Skilled Nursing Facility; we would manage at home with help from family and Home Health.  “She’ll need to be seen by her primary care doctor within……..” She hadn't finished the sentence when moms’ mouth dropped open and I offered a snide laugh.

“That’s never going to happen” I tried to explain to her the problems we had getting appointments with moms’ PC.  She insisted it “wouldn't be a problem” that they “had to reserve” so many appointments for hospital follow up visits.  “Well, they've never done it before”, I told her about waiting 3-4 weeks for past “hospital follow up visits”.  She made a remark about “just changing doctors” if we were really that unhappy – She said it as if she thought we hadn't considered that; hadn't been trying for years.  With a demeanor that suggested she questioned my abilities; thought I was a trouble maker, or just a drama queen, she told us she would make the appointment for us.  She later confided in mom how difficult it had been just to schedule that one appointment (I’ll have to tell you that story later).

After convincing the social worker that I was equipped to care for mom, she was discharged on March 21, 2013; one month after the first of two major spine surgeries and just two weeks after entering rehab.  Of course, mom had a long way to go and there were still a number of obstacles to overcome.

Her twenty five+/- year old prosthetic knee had not been in great condition before the spine problems; it was much worse since the overdose of neurontin she had received in October of 2012.  Before the gabapentin mom was still walking with her walker and was doing quite well, considering where she had been just a few months prior.  Since then mom could not put any weight on her right leg without the knee nearly buckling; I could hear the crunching with each step she attempted.  I still don’t know what happened and she doesn't remember; I only know that one morning she was able to walk the halls in the hospital with her walker and by afternoon (after the neurontin) mom could barely stand up.  I immediately called these changes to the attention of the medical personnel caring for mom; my concerns were dismissed.  Unfortunately, that was an obstacle that would have to wait.

Mom also needed to be weaned from the massive amounts of morphine she had required just to tolerate her constant pain.  With the pain in her spine all but eliminated, she no longer required 500-700mg of morphine a day.  The titration had begun in the hospital and mom had been doing quite well on 300-500mg a day for several days now.  The Palliative care team had assured us they would be with us through the reductions just as they had been during the increases of the medication.  This obstacle would be a work in progress for some time yet.  Our next worry was more immediate, but more of a bother than an obstacle.

My vehicle had been the easiest and one of the only cars my mother could get in to.  It was also the only car I currently had at my disposal.  With the restrictions mom had on stretching her back, she wasn't able to get in without something to push herself up with.  Fortunately, I only panicked for a second before mom came up with a plan for our immediate need.  Mom told me to pull her walker closer to her, “I can put my foot on the wheel and hoist myself”.  I did what she said and hoped she didn't pull her back.  Within a few minutes we were on the road and ready for our next obstacle.

Have I mentioned our terrible luck with winter driving?  Well, this trip was to be no exception.  We left the hospital with light snow falling.  It was actually very pretty outside and mom was thrilled to be heading for home.  She chattered as we drove across the city towards the mountains we would have to travel to reach our destination.

Mom fell silent as we started up the mountain.  The road was treacherous.  The snow was coming down so heavy I couldn't see the hood of my own car, much less any cars around me.  I didn't dare pull to the side of the road; I couldn't see the edge.  Even as slow as we were traveling, when I tapped my brakes the car began to slide.  I wasn't as worried about wrecking as I was about being stuck in a snow storm with mom.  I had to either make it home or turn around, I didn't have another choice.  Actually, I didn't have any choice; I couldn't see the exit ramps any better than I could see the road.  Besides, they had closed the road behind us.

I had to keep driving.

What else could I do?