The Wonders of Recovery

Mark’s left hip replacement went well last Tuesday, January 26^th, despite the delay. It didn’t even get started until 5:30 PM due to difficulties with a prior surgery. Around 9:30 PM he was moved into a hospital room groggy, but awake. It made for a very long day and night. His appetite and strength have been very good. The main concern has been the dark, huge bruise from under his armpit to his waistline, not where we expected to see bruising after hip surgery, which makes me wonder what went on in that surgical room.

Wednesday, Mark had a radiation treatment to slow the bone growth in his hips, which is the cause of his joint problems. Thursday, he was released from the hospital to Rocky Mountain Care.

If you’ve experienced rehabilitation, you’re probably familiar with uncertainties like: How long will it take to recover? When will we realize the advantage of surgery? How much pain will have to be endured? These and possibly many more questions, along with the enormous desire to feel better right now are part of the recovering process.

Before Mark was discharged from the hospital with the right hip surgery last July, I visited six rehab centers in our area which were listed with the insurance company. I can’t imagine spending such an important and limited time in a facility without doing research first. With the doctors recommendation, we’d wanted Mark could go to HealthSouth for rehabilitation. They specialize in neurological problems and since Mark has a traumatic brain injury (TBI), I knew they had equipment which Mark would need for rehab. However, the insurance wouldn’t allow it because this rehab was based on a hip surgery and not TBI. Disappointed, yet determined to get Mark the best possible help with therapy, our second choice was Rocky Mountain Care. I was impressed with their homelike atmosphere, clean smell and they had more equipment than the other gyms I visited on the insurance approved list.

Mark’s TBI and physical limitations give him special needs. At home we have a standing frame and a roll-in shower along with a shower/commode chair which he uses daily. The rehab centers on our insurance list didn’t have either and since they’re important for his recovery, therapy plan and general health, I’m willing to bring them from home along with his custom walker. The challenge is finding a room which has space for it all, plus an extended bed for his height and a trapeze, which helps him change position while he’s in bed. Along with these essentials he needs the capability to maneuver his wheelchair in and out of the room. Wow, this list sounds pretty lengthy and must be why we don’t travel anymore.

Suite kitchen and my office area. Door in between goes to bedroom.

Suite living room

Fortunately, Rocky Mountain Care has a couple of rooms which can accommodate Mark’s needs and they’re willing to let us arrange the room to do so. In August and September of 2015, we were lucky enough to get a suite. It was beautifully furnished and definitely the nicest room in the building. The kitchen had a full-size fridge , small microwave and a solid wood dining table with six cushion chairs.

Suite living room with therapy balloons and balls.

Suite bathroom

The living room was furnished with a couch, two comfortable stuffed chairs separated by a table and lamp and a television on top of a beautiful wood stand. A large wood desk was in the back of this room by a glass sliding door which led out to a small patio. The view of the mountains from the living room and patio was spectacular.

The separate bedroom had two twin sized beds, a large dresser, a chest of drawers and a roomy closet. The bathroom had ceramic tiles with a roll-in shower and was perfect for the shower/commode chair or wheelchair. This is unlike any other room Mark’s ever had in a rehab center. We felt spoiled and a little guilty for having it.

Therapists, Brandi and Trish

The room was wonderful, but the biggest advantage to Rocky Mountain was the therapists. They were knowledgeable, caring and worked hard to improved Mark’s abilities. For this reason, they were our first choice this time around. It was nice to have the decision made before surgery and it actually decreased a day in the hospital because we made the arrangements beforehand.

Since Mark has a severe short-term memory problem, he is dependent on me to keep him oriented. Unfamiliar surroundings and routine make him feel unsettled and his memory is worse. He forgets what he’s supposed to be doing and where he is, which can make him agitated or anxious. Since I want him to get the full advantage and have the best experience with rehab, I prefer to stay with him. The suite made it easier, but because it’s a lot more costly than a regular room, we are not in the suite for this round of rehab. It’s been an adjustment and the difference is like being on a cruise verses camping complete with an air-mattress for me. It’s hard for me to go home because I worry he might have a seizure and the nursing or aide staff will not know. I wonder if he’ll be able to find or remember how to use the call button when he needs help and the waiting time for that help also concerns me.

Mark’s bed on the west wall.

Entrance to room

I like to be involved in Mark’s care—not to interfere, but rather assist while he is here. However, it’s awkward to step back since I’ve been taking care of him for so many years. I have to continually remind myself  that what seems so obvious or natural to me isn’t for the professional caregiver who has several patients at one time with all different levels of abilities. I’m realizing every rehab experience is different even with the same patient, therapists and caregiver staff.  But the goal is always the same—to get home stronger and better. We’re confident it will happen with the therapy and supported care we have here.

Mark’s standing frame and my work station. West and south wall.

East wall with my air-mattress standing up, which I lay down for sleeping.

 

 

 

 

 

 

 

We are grateful for all the well wishes and prayers. We feel blessed and amazed at Mark’s ability to heal and adapt to foreign implant objects. This along with all the love and care of others is the most wonderful part of recovery.

Hidden Blessings

Everyone can benefit from the encouragement of a promoter and believer in their abilities. I’m grateful for the activists in my life and therefore try to reciprocate by being supportive of others, especially Mark. Being his advocate is a responsibility I take seriously. I’ve witnessed the difference it makes not only in ours life, but in other’s lives as well. It boosts one’s drive to improve and changes their therapy and even the care they receive. Likewise, therapists and professional caregivers buoy up when they know there is a supporter on board. Being an advocate can feel heavy at times and weighs me down, but I see the blessing of improvement which comes from it.

Surgery or illness always brings more caregiving involvement due to the strength loss it brings and for Mark, another issue is his speech. Many people don’t take the time to understand him or they feel awkward when there is miscommunication. Some people are embarrassed to say they couldn’t grasp what he was saying. Mark realizes his speech is impaired and he is not upset by having to repeat himself. He’d rather do that than to be ignored or have someone not comprehend what he’s saying. With uncomfortable and pleading eyes others often look to me to interpret what he just said. Therefore, I feel the need to always be by his side to love, protect and encourage others to understand him. I see the blessing the blessing that comes from communication and when others get to know Mark’s fun personality.

I get lots of advice about what I should or should not do and I have to remind myself it’s generally coming because that person cares about our well-being. Some people think the level of dependency is unhealthy and wrong, while others praise the assistance. Ultimately, I’m just doing what I feel is best, which isn’t necessarily what I prefer to do. As most caregivers know, it isn’t about me. One of the blessings in all this is as I help Mark, my love for him grows and when I come to his aid with the right attitude, it becomes an honor to do so. Not all people can be caregivers, but I’m fortunate to have the health, strength and support which enables me to do so.

This year has brought some unusual difficulties in my caregiving journey. Starting with my large hernia, which was an easy fix with the obstacle being the six-week recovery time and finding someone dependable to care for Mark. Originally, I was in hopes to have my surgery right after Mark had his hip surgery. I thought it made perfect sense for me to recuperate while Mark was in the rehab center. Due to complications, Mark’s hip surgery was postponed and my recovery plan was ruined. Thank heaven for family and friends, especially a daughter who was willing and capable of moving in for the recovery time. It turned out to be a great blessing for all of us, bringing us closer together as we worked through those weeks.

After my recovery, Mark was approved and scheduled to have his surgery. Less than a week before the long-awaited date we were informed he would have to go a larger facility with an ICU due to the risk of complications. It became more frustrating when we were told the surgery date was now uncertain because they weren’t sure when they could fit the four-hour surgery on the bigger hospital’s schedule. Another hurdle was the surgeon wouldn’t start the surgery late in the afternoon. We anxiously waited until the day before surgery to get word whether Mark could be fit in or not. Fortunately the surgery was able to take place on the original scheduled date and having it done at the larger hospital proved to be a blessing. Mark needed one radiation treatment to hinder the excessive bone growth from recurring. This hospital has an oncology center so Mark didn’t have to go far the day after his surgery for the treatment.

I was disappointed when I learned Mark’s insurance plan wouldn’t allow him to go to the rehab center of our choice. I appealed to the insurance company and the doctor wrote a recommendation for an acute rehab center. There was no persuading the insurance company. Saddened by their decision, I searched for an alternative. I learned that not all rehab centers allow a family member to stay overnight with their loved one. I understood their concerns, but for our situation, I couldn’t abide by the rule. Although Rocky Mountain Care discourages overnight stays, they do allow it, so here we are. Another benefit of this place was that Mark had rehab here two years ago after three hospitalizations for blood clots. The admitting personnel and rehab coordinator were familiar with us. It has proven to be another blessing that we are here. We love the therapists. They work hard to help Mark gain improvement. We appreciate their knowledge and the equipment available. The in-house doctor, nurses and CNA’s are helpful. It may not have been my first choice, but I believe he is getting the best care possible.

Some days it feels like I’ve had more than my share of things not turning out the way I’ve planned, hoped for and worked diligently towards. However, when I look back on the end result, I realize it worked out for the best. I’m feeling fortunate as I recall these hidden blessings and realize there are many who support us. I’m grateful for each one of you and especially for our greatest advocator. He pleads for us and knows what is best.

Abs of Mesh

Image credit: healthcare.utah.edu

My successful hernia surgery was performed Tuesday, May 5, 2015. My sister-in-law, Dianne, took me to the new and beautiful U of U hospital located in Daybreak. After checking in and the dreaded weight scale, they directed me to a nice room. Unlike the older hospitals I’ve been in where the surgery waiting area is one large room with several beds in it with each bed sectioned off by curtains, I was directed to a small private room with a sliding glass door which was covered by a pulled curtain. I was handed a bag, asked to remove all my clothing and to put on this new wardrobe. I opened the bag and found a cap for my hair, some footsies and the traditional gown with only one snap for the entire open back. I thought about refusing because the gown was not only ugly, but disgustingly immodest. I’ve seen patients walking down the hallway in those silly outfits holding the back parts of the gown together with all the strength their weakened and awkward arms had while trying to manage an attached I.V. All I could think about was how ridiculous those gowns look. I’m normally not a vogue kind of gal, but these gowns are beneath even me. Finally, I came to my senses and remembered I was there for surgery, not a fashion show and changed into their requested attire. To compensate for the lack of apparel, the nurse offered the beloved warm blanket, which is the most comfortable part of any hospital stay.

Dianne and I only had time for a short visit before the nurse came in and started my I.V.  I met the anesthesiologist for the first time.

“Have you had surgery before?”

“Yes, thirty-one years ago,” I said.

“How did it go? Did you have any complications?”

“I got nauseated,” I explained.

“Well, the medication we use now is much different than those used thirty-one years ago,” he reassured me, “but we’ll give you some medicine to help with the nausea just in case.”

“Thanks,” I said, relieved there was something to offset those horrible symptoms.

He’d only been gone a few minutes before the general surgeon pushed the sliding door open and walked into the small room. She’s a pretty doctor with long, dark hair and I suppose a few years younger. She explained,“This surgery will treat your hernia by repairing the tear in the abdominal wall. An incision will be made so I have a direct view of the hernia and the repair will be done through this incision. To repair the defect, a special mesh material made of strong, flexible plastic which stays in the body will be used to patch the torn area. The mesh will be placed behind and in front of the tear. Over time, nearby tissues grow into the mesh to strengthen the repair.”

“So I guess this means I’ll have abs of mesh,” I asked with a chuckle.

She smiled, took her marker and drew on the lower part of my abdomen where the incision would be. I started feeling drowsy, but had one last request: “Please take out all the extra fatty tissue.” I remember her stating that was a common request as they pushed my bed towards the operating room, which I have no recollection of ever entering.

The next thing I knew I was asked to take a deep breath. My throat and the muscles in neck were sore. I was prepared to have a sore belly, but the throat and neck pain was a surprise. I was aware of the ice bag on my stomach, so I assumed the surgery was completed. “The surgery went well,” the nurse said. “Here are some crackers and ice water. Do you want a drink?”

She put a straw to my lips and I took a drink and started feeling nauseated. She shot something into my I.V. and said it would help, but it didn’t.

The nurse kept talking to me and I took that to mean my nap had been long enough. I supposed they wanted me to wake up and go home, so I tried to cooperate.

The more awake I became, the more nauseated I felt. Anxious to get the ride home over with, I asked Dianne to help me get dressed. What seemed to be thirty minutes was in reality six hours, which isn’t long when you consider the prep, surgery and recovery time. The nurse pushed me in a wheelchair to the front door with pain and nausea prescriptions in hand. Dianne pulled her car up to the front door and they both helped me get seated and belted in for the short drive home.

Before I knew it I was in the comfort of my own home, greeted by Mark and our daughter, Katie, who proved to be the best nurse I’d had all day.  She waited on my every need and quickly cleaned and replaced my barf bowls. It was the worst part of the surgery. I do not hold my anesthesia well and it was two days before I felt like I could hold down any food. I didn’t dare take my pain medication for fear it would only make me feel worse and the nausea medication given did nothing for me as far as I could tell.

My recovery after those two days has been comparably easy. The pain hasn’t been bad as long as I refrain from sneezing, coughing or laughing, which isn’t easy when you live with Mark, Katie, Eldin and their dog, Lizzy.  I’m hoping when my swelling goes down I’ll see that the doctor did as I asked in removing all unwanted fatty tissue. When my six week healing period is up I’ll be anxious to turn my abs of mesh into abs of steel.