Posts Tagged ‘hip fracture without surgery’

LONELINESS FILLED MY DREAMS

March 17, 2011

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My mother before I was born.

“My mother will be fine with physical therapy”

I went to meet my mom at an appointment with the same orthopedic doctor she saw for a “second opinion” a month ago. He was very nice.

He looked at all the x-rays, and showed both my mother and me where the x-ray indicated her fractured hipbone was healing. He said it would only continue to become stronger over time.

My mother demonstrated movement by easily lifting both her legs without any pain. I mentioned that it was the “weight bearing” exercises that worried the physical therapist at her facility so much because my mom “grimaced.” He said a grimace was understandable and part of the process.

The doctor said that my mother would be fine with 50% weight-bearing exercises for two weeks and then full, weight-bearing exercises after that. He said it might be hard to do the 50%, but even a little at 100% would be okay.

He said the risk was slight, and he wanted another x-ray taken in two weeks time to make certain there wasn’t any displacement.

My mom was crying when she arrived at the appointment due to extreme confusion.

I was able to calm her and bring her back to reality, but it wasn’t easy. When the doctor explained to her that her hip was healing, she understood the implications. After the appointment, she was beaming.

I was really glad to see her relaxed and happy again, despite her struggle with dementia.

Who is this couple? Oh yeah, my parents!

I’ve decided the aging process is unbelievably painful for the entire family when it involves dementia.

“I could feel her grief”

I was definitely wearing a “Super Daughter cape” as I left my mother following her appointment. I wrestled with the “demon of dementia” and had won. My mother went from tears to joy as I steadily convinced her of the reality.

As I drove home, however, I still had the familiar, gnawing pain inside me. I wondered why I wasn’t more joyful that my mother had beaten the odds and survived her hip fracture without having surgery!

I decided that although I had a lot of things to do at home, I would stop and treat myself to a manicure. Since I bit my nails almost all my life, I marvel at the nails I started growing last July. Having a manicure is a way to reward myself and appreciate their beauty.

I realized with the difficult economy, the nail salon was certainly suffering since many people would consider a manicure a luxury to do without. It was one reason I had put it off.

I wrote a story a few months ago about a certain manicurist at the salon near my home. Her name was Thao, and she was Vietnamese. WHAT IS LEFT SINCE YOU DIED

Sure enough, the salon was empty when I went inside. Thao raced over to me, and I was glad to see her. She told me she had listened to the CD I had given her, but her player was now broken.

She was still very sad. Her eyes were large and despair was deep within. I could feel her grief.

As she worked on my nails, I asked her to tell me about the brother she loved so much who had died. She told me how he used to sing and play guitar. I asked her if she liked to sing too, but she said she couldn’t because it was too painful for her.

It turned out the date of his death was in a few weeks and that had certainly intensified her sadness. She said it would be two years since he died.

I asked her what she planned to do on that day. She said she would cook his favorite meal; she missed cooking for him. Then she told me in her halting English, “I want to cry all the time, but I don’t.”

I told her that those tears were important to release. I remembered that well. I said to her softly, “You know, letting those tears out allows for joy to come in. Not allowing pain, does not allow for pleasure either. Plus, it takes so much energy to hold tears in!”

Before I left, she ran to the back of the salon and brought out a picture to show me of her and her brother. Then, she insisted I take something home for lunch; it was a container of fried rice. I didn’t know what to do, because even though I don’t usually eat rice – I didn’t want to say no.

I also realized she had probably given away her own lunch. But she said to me, “Judy, you’ve done so much for me and I want to do something for you!”

I came home and tasted the rice. Steam started coming out of my ears, but I was grinning.

I could taste her appreciation.

© Judy Unger and http://www.myjourneysinsight.com 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Judy Unger with appropriate and specific direction to the original content.

EVEN IF YOU’RE NOT AWARE

March 10, 2011

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A card I received from my mom when things were different – I’ve saved so many!

“I was discouraged”

The nursing facility told me my mom would not be allowed physical therapy. My father was broken down about how the caregivers he paid for would not be allowed to assist my mother at mealtime.

My frustration was obvious when I sent out an email update to my friends and family. I received this message back from my friend, Sam, who is a physician.

On Mar 8, 2011, Sam wrote:

Judy, OK, let’s just all take a step back….

With regard to physical therapy, your mom’s dementia could make this very difficult…we certainly do not want her to be in pain, and it might be hard for her to follow a program that would eventually enable her to walk…furthermore, she could be at even greater risk if she did walk… for falls, confusion as to where she is, etc.

As far as eating, I’m not aware of any evidence showing that her condition will be improved if she eats more…most patients with dementia eventually lose interest in food, whether or not someone helps feed them.  What will change is how quickly you and your family are faced with the decision of whether or not to put in a G-tube for nutrition and hydration.  As you have told me, if your mom is happy and comfortable, that is the key thing.

I don’t want to see you, your brothers, and particularly your Dad, be upset, depressed or angry over your mom’s condition…your mom is doing the best that she possibly can…and all of you are doing the best that you can.  Even the facility is probably doing the best that a home facility can (though it may not seem like it).

Do the best that you can for your Mom, but primarily spend time with her and try to enjoy the awareness that she still does have.  Keep her comfortable and happy…but please don’t tear yourselves up over this.  Professional advocacy, or adversarial relations probably won’t change much for your mom in the long run, but will significantly increase your own stress and discomfort.

I know it’s a very difficult situation, and continue to wish you all the best!…Sam

Hi Sam,

Thanks so much for writing this! It is very, very helpful for me.I’m really glad I’m going hiking today. I think being outdoors and “taking a break” from all of this is what I need to feel more centered again. I was actually looking into advocacy and you’re right – it won’t make a difference and could make things worse.

The sad part for me is that my mom does look forward to meals and despite her weight loss; she enjoys eating (though, briefly). It’s like they’re taking away one of the few things she has!

The physical therapy represented another thing that she was hopeful about. She wanted so badly to do those exercises!

Thanks for putting this in perspective. I hope we’re not faced with the G-tube possibility; I don’t want to think about that because we don’t plan to ever go that route with her again.

I think it’s so wonderful how I’ve been able to share my journey with you, which includes hearing about my friends’ ailments and my reconnecting with Carol. Maybe your ears will be burning today!

Everyone enjoys your messages, too. Thank you and have a great day!

Judy

Dear Judy,

I must say, Sam has hit the nail on the head and has articulated, beautifully, the important things here. You are lucky to have his insight as a physician who is also a friend.

I sure look forward to today with you and Joni; it is stunning outside! See you very soon!

Love, Carol

Hi Carol,

I feel much better about everything. I know our hike today will put things in perspective for me!

Tomorrow, I have a meeting. I’m going to see my mom earlier and enjoy the time with her. I don’t feel like I will allow the meeting to “get me down.”

It is “what it is” and my attitude is very important to everyone around me.

Love, Jude

Ps. Watch out – I might be singing as we gather lettuce today!

On Mar 9, Carol wrote:

Let’s see, what songs could you sing? Lettuce Entertain You…Greensleeves…I’m Looking Over A Four-Leaf Clover…Where Have All The Flowers Gone…Oh What a Beautiful Morning…oh, yeah, I could go on and on until you puke!

On Mar 9, Susan wrote:

…..Parsley, Sage, Rosemary and Thyme. Mares eat oats and does eat oats and little lambs eat ivy, a kid will eat ivy, too, wouldn’t you? Coming through the Rye, The Wind That Shakes the Barley, The Autumn Leaves, I heard it through the Grapevine, You say Tomato, and I Say Tomahto…

I can’t keep up with such good puns – I conseed!

Actually, I have a voice lesson with Peaches on Friday. I’ll call my lesson – Peaches and HERB.

Love, Judy

A coffee table book Carol received from her husband last week for her birthday. It was full of their photos of favorite foods. I love the book jacket with the Chanterelle mushrooms on the back! 

A photo I took yesterday of a portion of Carol’s exquisite gardens.

“She is the one who has kept me alive!”

My father was too depressed to attend the meeting this time.

It was a smaller group of people from her facility than the last time; there were six other people. Everyone was friendly and smiling.

The same familiar issues about my mom were discussed. It still seemed unimaginable to everyone there that my mother did not take pain medication for her “unrepaired,” fractured hip.

A physical therapist told me she had never worked with someone who had a fracture without a surgical repair – she was not comfortable when she saw my mother “grimace.” This was despite my mom verbally expressing that she did not have pain. My mother would not receive any physical therapy. An appointment was made for her to see the orthopedic doctor again.

My mom’s grimace didn’t seem a clear indication of pain to me; it seemed to me that this was more about the therapist’s discomfort of working with someone who did not have hip surgery. I decided patience was warranted, since my mother had an appointment next week with the orthopedic doctor. His decision would over-ride this.

It was very uplifting to hear my mother’s doctor speak. He looked me right in the eye and said, “I have to say your mother has defied the odds. She has done better than I expected. She may actually recover much of her prior function.”

I expressed myself articulately, without emotion. I had many questions. I asked whether my mom could be taken out of the facility as she had been allowed to in the past.

I was told she could leave the facility once she was “signed out.” I asked if her caregiver/companion, Miriam, would be allowed to take her out. That caused some confusion and a discussion followed about who would help put my mom into the car. Then it occurred to everyone that no one from the facility would be there at the other end to take her out of the car!

Finally, I was told it was allowed and I felt relieved. Certainly, it was important to see if my mom was even up for it.

However, it would be very exciting and uplifting for her to look forward to such an outing.

My father told me, “I don’t want her going anywhere – it’s too hard!”

Miriam told me, “I can’t wait to take her to the places she loved before. It’s no trouble for me at all!”

Miriam and I both decided – we wouldn’t worry my father, so instead we would tell him after any outing how it went.

Before I left the meeting, I spoke with a nurse practitioner about my mom’s dementia. She gave me a lot of advice about how to approach my mother’s “confusion.” My term “dance” of dementia fit her philosophy perfectly; dancing was a “lighter” approach versus “correcting.” So I was definitely doing something positive all along by dancing with my mom, in that regard!

Miriam and my mother were waiting for me. I had bought lunch for the three of us. The weather was beautiful and we sat at a shady table outside the dining room. I told Miriam, “You are allowed to feed my mom whenever a family member is there; when you are with me or my dad it’s no problem.”

Prior to that, Miriam told me she did not think it was allowed.

I noticed my visit had lifted not only my mother’s spirits, but Miriam’s as well. I had played my guitar for both her and my mother in the garden earlier in the morning. Miriam was humming along to my songs and it was obvious that she knew my songs by heart. How wonderful that was for me!

When I first arrived, Miriam’s eyes were downcast. Now her eyes were bright and she looked happy. She said, “When you are here I feel like I am not alone. I want to do so much for your mom! But there’s less and less that I can do!”

I reminded her to focus on what she could do rather than what she could not.

My mom ate her lunch with relish – I couldn’t help but throw in a pun; I had brought her a hot dog for lunch! She did not need anyone to help her eat the hot dog or the French fries. It was great to see her eating.

During most of my visit, my mom didn’t make much sense. But her happiness was very apparent and I held onto that instead.

It was time for me to leave; my mom began to fumble with her purse. I knew she was looking for money. I told her how appreciative I was, that I had used her credit card to pay for our lunch. Hearing that made her beam.

Suddenly she turned to Miriam and said, “Where did I ever find my daughter? How did I find such a daughter? She is the one who has kept me alive!”

Miriam’s eyes were shining as she listened. “Judy, please put that in your blog – promise me!”

I hugged my mom and reminded her that god has been looking after her and has kept her alive. Her will to live was remarkable and my goal was simply to keep her as comfortable as possible.

I left and immediately listened to music. I realized I had eaten far too much lunch, but decided to be gentle with myself.

Clicking on this makes it larger.

This sign really spoke to me. It was at the trailhead where I hiked, yesterday.

© Judy Unger and http://www.myjourneysinsight.com 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Judy Unger with appropriate and specific direction to the original content.

I PICKED YOU UP WHEN YOU FELL DOWN

February 2, 2011

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My mom was exhausted from sitting in her wheelchair all morning. She needed the bathroom, but had to use her diaper since it was far too difficult to take her to the bathroom in the medical building.

I had just shared some fantastic news with my mom’s caregiver, Miriam. Her eyes were dancing with joy as she squeezed my hand.

I thought it might be best to let my mom sleep while waiting for the transport team to take her from the medical office back to her nursing facility. It had been a long morning for her, as she waited well over an hour to see the doctor who would deliver a “second opinion.” My expectations of anything uplifting from this appointment were very low. We were seeing a surgeon, so I simply assumed I’d get another recommendation that my mother needed surgery.

I kissed my mom goodbye, and exited the building into the sunshine. As I walked to my car, I had a sensation of my feet leaving the ground; I felt like I could fly! When I was a young girl, I used to feel like I could fly in my dreams. I listened to my music and my heart felt as if it might burst.

I noticed there was a Subway near my car, so I stopped and purchased some chicken soup. I went back to where my mom was and gave the soup to Miriam. My mom might be too tired to make it to the lunchroom when she’d return.

As I drove home I savored the feeling. Life was good – so very good at that moment!

My mom is showing me off to her sister in this still.

When I performed my new song, You Were There, on 1/24/11 my voice broke when I sang the words, “I picked you up when you fell down.”

VIDEO PERFORMANCE OF “YOU WERE THERE” AT KULAK’S WOODSHED – 1/24/11

LIST OF WHAT I WAS TOLD WHEN MY MOM FELL AND FRACTURED HER HIP:

1. Without surgery she would be in extreme pain.

2. Her mortality rate was extremely high; She was already on the schedule to have surgery the morning before New Year’s Eve; the doctor told me he would not be available again for three days. Without surgery, there was a chance she’d die over the weekend. She became a candidate for hospice.

3. My mother would never be allowed any kind of physical therapy involving walking.

4. My mother would never walk again.

5. Only one patient had refused to have surgery with this surgeon in seven years, that patient soon died.

6. Without surgery, my mother would not have a quality of life – she would be immobile.

7. The fact that my mom was on a respirator for seven weeks following surgery a year ago did not put her at risk for hip surgery.

Email message sent out today:

I just got back from an appt. with my mom regarding her hip fracture. This was a second opinion with an orthopedic surgeon.

This doctor said that the ball of her hip, although fractured is somewhat “impacted.” In five years of seeing hundreds of patients, he’s only had three patients with this condition who opted not to have surgery. He said that with a fracture like this, 2/3 of the time it can actually heal without surgery.

Since my mom was not in extreme pain and could lift her leg up while sitting in her wheelchair, he felt she was well on her way to healing. He said it takes about six weeks; then she could begin therapy. She will be allowed to walk!

This doctor wondered why she was put on hospice, since she looked good to him. He ordered another x-ray to be done in three weeks, and at my suggestion will not have my mom transported to him unless something has changed. She was exhausted from the appointment.

Although my mom’s dementia has been more increased lately, she was quite aware of the impact of this appt. She said she’d be a “good girl” and not do anything risky for the next few weeks. She’s excited about having therapy.

I am elated.

Judy

This is how I truly feel.

© Judy Unger and http://www.myjourneysinsight.com 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Judy Unger with appropriate and specific direction to the original content.

I NEVER DREAMED IT’D HAPPEN

January 15, 2011

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I couldn’t believe I found this picture of my mom! I remember while growing up she told me she was hurt badly on a swing when she was a young girl.

“A few nights ago”

I was saying goodnight on the phone to my mother. Her voice was soft and she sounded very tired. I was about to hang up, and she said, “Honey, I want to ask you something.”

I waited and wondered what it was she wanted to ask me. She said, “I wish I could get stronger. Do you think there is a way for me to do that?”

My heart ached as I told her to give it more time. At that moment, I had tremendous admiration for my mother and significant pain for doubting that she would keep trying.

My mother was not about to let the ravages of old age prevent her from giving up hope!

“The next morning”

Miriam called me – I could tell by her voice that she was trying to contain her anxiety.

“Judy, you must talk with your mother – she is angry at everyone including me. She cannot understand why she is not allowed to walk!”

The phone was given to my mother. I explained to her how she could actually harm the healing process; she must accept that walking would come later. I told my mom not to be angry with Miriam. When our call was over, I could tell my mother was crying.

After that I began to make calls. I spoke with a nurse practitioner and it was explained to me that no weight was allowed on my mom’s unrepaired hip. My mother would not have any physical therapy for several months.

It sounded discouraging to me.

Then I spoke with a nursing supervisor and I asked if my mother could stand up to use a toilet. My mother might not be allowed to walk, but she could stand on her “good leg” to use a toilet. The supervisor told me a commode that was the correct height for my mother would need to be ordered. It would take a day or two for it to arrive.

When my mother fell and broke her hip, I was told that without surgery she might die over the weekend. Now my mother had no pain and wanted to walk!

I began to realize that my mother’s hospice services were not as helpful as I thought they would be.

All medical decisions had to go through the hospice department. I still did not hear back after a week about obtaining a “prescription” so my mother could have a seatbelt. Otherwise, she was close to sliding out of her enormous wheelchair. I decided to let that go.

For several weeks, I had left messages and spoken with numerous medical personnel about obtaining an antidepressant medication for my mother. My father had been against it for such a long time, but I decided my mom’s fall was actually a result of her depression and frustration.

My mom’s dementia was a demon that she was also aware of. I was incredulous when I received a call back from a hospice nurse. She said, “What makes you think your mom is depressed? Please tell me why you think she’s depressed.”

I cannot write anymore about this without feeling like I am in a tragic, comedy show!

It did not seem possible that anyone could be more depressed than my mother over her predicament! My mother had always been such an optimistic person, and her unhappiness radiated from her much of the time. I couldn’t believe I had to explain it!

I articulated my mother’s situation to this hospice nurse.

She told me this, “Your mother’s sadness is based only on her situation and therefore would not be treatable with an antidepressant!”

I was absolutely astounded to hear this! How quickly my mom would be prescribed Morphine and Vicodin without a second thought. My mom’s “mental anguish” however, was far worse for her than any physical pain. My mother-in-law gave up on her life due to her mental anguish. I saw first-hand the result of deep depression.

This nurse told me to think about discontinuing Hospice. I felt embarrassed for all the paperwork I had generated. It was such a waste of time, and what if I ended up needing it in the near future?

After being told to “think about it for a few days,” I did just that. I plan to have it discontinued.

This is such a great memory. My mom loved playing blackjack with me. This was taken while we were on vacation together in Vegas at a “swim up” blackjack table.

“I was shopping”

I had a list from Miriam of things I could buy for my mom. I was at Sears buying socks when Miriam called.

She said that the special commode had arrived and my mom had used it.

We were both crying and laughing – for my mom to use a toilet was a huge step for her dignity! HUGE!

I shook my head and felt much more resolute about discontinuing hospice.

“My hypnotherapy experience”

I needed to find an alternative thought to replace what I had just blurted out to Connie.

I had said, “Oh my god, my doubt about the decision around my mom having surgery is KILLING ME!”

I came up with a replacement first for the word “doubt.” Far better than saying “doubt” was saying “uncertainty.” Of course it meant the same thing, but Connie and I agreed it was a “lighter” approach.

The “killing me” part slipped out before I knew it.

It was definitely a painful admission. I talked about it with Connie, and explained how human I was. Despite feeling “courageous” and inspirational, it was still very difficult to counter so many people in the medical field.

However, nothing was actually “killing me” badly enough. I can honestly say, that I have been dancing through my life, lately. I’ve had no “stomach issues,” which usually are a manifestation of stress in my life.

That’s amazing because I still have teenagers, too!

Connie had taken a lot of notes. She said she would give my own words back to me. My replacement sentence (using my own words) for the doubt around my decision killing me was:

“With uncertainty, came beautiful surprises that were completely unexpected!”

“Lunchtime with my mom”

It had been two days since I had visited. I had stopped by at night, but I didn’t count that because my mother was asleep. I had dropped off all the new items that I had bought for her.

My mother ate her lunch and beamed at my presence. Miriam enjoyed feeding her one of her favorite lunches – deli food. I nibbled at leftovers and smiled at all the residents that now knew me as the “musical lady!”

I was ready to leave and Miriam gave me a warm hug. She told me how my mom once again used the commode and had no pain. It was still a huge production to wheel her special wheelchair toward the bathroom. The size of the wheelchair left little area to maneuver. Tremendous patience and energy was needed to pull this off.

I had no doubt that Miriam was up to the challenge.

Then she whispered something to me. She said, “Judy, I couldn’t stop her. She stood and walked two steps.”

This picture is of my mom and her first grandchild, Marisa.

© Judy Unger and http://www.myjourneysinsight.com 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Judy Unger with appropriate and specific direction to the original content.


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