Home Again, Home Again, Jiggidy Jog
By Al Coon
June 17, 2011
My last update was written in the middle of the night after the day of Dotti's surgery. Here I am again, starting this at 2 am. Alas, it is hard to find a moment to get to my computer to work. Things have been busy.
Tuesday Dotti's best friend Tammy dropped by in the morning to bring some yogurt for Dotti, and to check on how she was doing. After I had gone home on Monday, she had come to be with Dotti in the evening, and that was so great! Dotti really enjoyed the company.
Getting dressed on Tuesday morning was a big deal. You can see how happy she was to be "feeling human" again. The occupational therapist had just finished going over the daily things you have to do (brushing teeth, washing up, getting dressed, etc.), and part of that was letting Dotti get out of that incredibly indecent, leave-your-dignity-at-the-door gown they shove patients into in the hospital, and slipping on a tee shirt and sweat pants.
Only moments after the Occupational Therapist left, the friendly Physical Therapist arrived. He made the whole exercise thing fun. He was positive and helpful and pulled Dotti's chair around behind him as he followed Dotti all the way "around the block" on her floor. I later paced off the distance to check it, and it was around 200 feet. That was in addition to walking to the door from her chair and back again.
Dotti's color was good throughout the walk, and she was not light headed at all. Her pain was very low, with the only real twinges occurring when she stepped wrong and got her balance off a bit, a couple of times. When that happened, she stopped, backed up, and did it again. All the pain was gone immediately. She was sweating a bit at the end, and when she got back to her room she took, a little nap.
During the pre-op class we took, they warned us that the surgery dressing would be huge, and so very loose fitting pants would be in order. So, Dotti bought sweats a size too big. The dressing turned out to be a "non-issue" for size, and the huge pants were not really needed, but they were comfy and way better than that gown had been.
The leggings she has on are hooked up to an air pump and it continually cycles air to squeeze the legs and then relax the pressure. Back and forth, to keep the blood moving in the legs to avoid blood clots. Dotti loved that chair and once they moved her over to it from the bed, she never went back to the bed. She slept in that chair and sat in it all day, when she wasn't up and exercising.
After the nap Dotti was as perky as ever. In the afternoon, the therapist came around again, and Dotti took the same walk once more. This time she did it a bit quicker, and there was no sweat or visible tiring. She was laughing and joking all the way around the loop. I was overjoyed to see her feeling so "up," especially after all those months of watching her suffer when she walked. She described her state as being on "an emotional high."
About dinner time, I was getting tired again. I was not sleeping well, and on the drive home from the hospital on day one, I had trouble staying awake at the wheel. I wasn't going to be able to do Dotti any good if I were in ICU from a car accident, or even walking around blurry-eyed when she needed something at home. And hey, the doctor was talking about sending Dotti home on Wednesday, rather than waiting until Thursday! So, Dotti told me to go home and get some rest, and she sent me off with a smile.
They were worried about her blood pressure and her red cell count, because there had been some blood loss during the surgery. Dotti called me and told me that her blood pressure had fallen again. But then they ran it again, and it was back up a bit. (Sometimes those readings vary by how the test is run, more than what the actual pressure is. And that may have been the actual cause of the one low reading.) They did blood work on Tuesday night/early Wednesday morning, and the nurses felt that the results indicated that she might need a transfusion.
Wednesday, I arrived very excited, a little before 8 am. I was planning on grabbing my insulated coffee cup and running down to the cafeteria to fill it up, as I had been doing during our time at the hospital. However, there was a sign on the door of Dotti's room that said CAM, and the door was closed. I had seen that sign on another door down the hall the day before and figured they were taking x-rays or something. I asked a nurse what the sign meant and she said CAM stood for Cognitive Assessment Monitoring.
After dealing with Mom's mental issues I was very familiar with the term cognitive and apparently the hospital was checking to see what issues were being caused by general anesthesia in the orthopedic surgery unit. I never saw any testing done but it might have been going on overnight, or they may have been observing behavior on the sly without letting the patients know. The door had been closed for privacy for Dotti's roommate, because she was getting dressed. It is incredible how much the attitude is improved by getting out of those gowns.
The morning was a busy one, and the time scooted by in a hurry. I arrived just before 8 am, and we were out the door and loading Dotti into the car before 11 am! I will be giving Dotti an anticoagulant shot every day, and so the nurse had me give the first one under her watchful eye. Dotti said the medicine burned but she didn't reach up and slap me for being sloppy, so I guess I did okay.
The doctor arrived soon and said that Dotti did not need a blood transfusion. If she should start having symptoms later they may do that, but for now she is totally free of any of the symptoms that a transfusion would be used to correct. (We are aggressively going after building up her blood through good eating and vitamins, etc.) The doctor also said she was ready to check out once the therapists cleared her. Yes!
Instead of a simple "around the block" for her PT, Dotti walked around to the Physical Therapy room at a good clip, laughing and joking with the therapist all the way. She was so happy and excited about her progress. (That makes two of us!) The therapist showed her how to safely go up stairs and how to do a couple of the exercises for her daily regimen, and then had her do these things herself. She did great!
We had just gotten back to the room when it was nearly time for Dotti's final group PT session before checking out. The occupational therapist unexpected showed up to quickly take care of showing us how to put on the special socks Dotti has to wear and a couple of other items, and a good friend showed up for a visit, and she joined us at the class. She had her knee replaced before and was familiar with the whole routine, and even spotted her old therapist in the hall walking a patient. She has made several very helpful suggestions over the time we have been planning for this surgery and we have been so thankful for her support!
Things started running at high speed at this point. We went over Dotti's meds and were handed a stack of papers that we had to take to the pharmacy to get a laundry list of meds. (I later made a spreadsheet with them listed, because the list was long enough to be confusing.) I was scrambling to get all Dotti's stuff into bags and I ran her suitcase down to the car, and came back, with a pretty large load of stuff still remaining to carry down as Dotti was wheeled downstairs, saying goodbye to all the staff as she passed them in the hall. (The hospital has a great corps of nurses and therapists, and Dotti, isn't what you would call a "wallflower" when it comes to meeting new people. We had one nurse come in specifically to say goodbye, even though she wasn't currently on Dotti's wing. She said they would reserve space for her in September when she does her next hip.)
Rain was pouring down as we came to the front door of the hospital. I left Dotti and the volunteer who was pushing her wheelchair, where they would remain dry, as I ran out to bring the car around after stashing balloons and bags, with other various and sundry collectables from the hospital stay into the back seat. Getting Dotti into the car was not much more difficult than it had been before the surgery. We had a system down:
We have been doing this for months. Before the surgery Dotti would cry out in pain if she had to lift her legs by herself. She literally could not lift the left leg without assistance. Either she would grab her pants, and lift it herself, or I would grab her ankle or pants and lift it for her. And we had to be careful, because that leg could not be moved to the left, out away from her other leg at all. Stabbing pain would be the reward for trying. (One of her exercises now is to move the left leg to the side, both while lying down and while standing up. She can actually do that now, which is incredible! There is no way that could have been done before the surgery. No way!)
- Dotti would back up to the open door.
- I would grab her hand and ease her down onto the seat.
- Dotti would reach up and grab the handle mounted on the interior roof above the door.
- Dotti would slide in a bit.
- I would grab her legs and lift them into the car.
- Dotti would finish positioning herself.
We just followed our normal Dotti car entry procedure to get her into the car. The only difference was she was in a wheelchair and we had to get her standing up and then positioned to do the rest. But it went very well.
We got into the car and both of us were elated! Leaving the hospital already!
Our first stop was at the pharmacy, just about two blocks away on the same road. I had a stack of prescription forms and I left Dotti in the car as I ran them inside, and dropped them off, letting them know I would be coming back soon to pick them up.
Next we had to go pick up some medical supplies for Dotti (anti-embolism socks and other doodads). We had been to Bates Primary Care Clinic before, to get a few items and knew right were it was. So, we drove there. Dotti said she wanted to go in. I must have asked her a half dozen times, "Are you sure?" She was sure.
She did not bring her temporary handicapped mirror tag to the hospital, so we couldn't park in the handicapped spot near the door, but I offered to take her there, drop her off and then park somewhere else. She said no, she wanted to walk from the car. "Are you sure?" She was sure.
It was raining and I drew the line at letting her get wet, so I took off my coat and put it on her until we got home. We got her out of the car and she was armed with her walker and ready to go. Frankly, I am still amazed that she did that.
Here she is, not only out of the car, getting ready to walk into the store, but smiling.
Needless to say, I was scouring the ground for any imperfections in the surface, and any debris that could hang up her wheels, or anything that could cause trouble in her walk. She had done all her practicing on a nice smooth floor, and this was not a nice smooth anything. They had resurfaced the parking lot not too long ago, from the look of it. That was a blessing. Still, I didn't really relax until she was in the store, safe and sound, and even then I worried about her overtiring herself. She didn't "walk the aisles." She walked over to the aisle where the socks were, and stood, while I ran around getting assistance as required and grabbing all the items and then going over to the counter to pay for it. Just standing there after walking in was a big deal after what she had been through, and she had only been out of surgery and the recovery room for just over 48 hours at that time!
After another trip across the parking lot, with me watching every square inch she crossed and making sure no cars came up to interfere with the trip, we did the car entry procedure for the last time that day.
We drove back to the pharmacy and I came out with an armload of shots and drugs for Dotti's recovery. Dotti was on the phone letting LeRoy and Tammy know what we were doing and that she was coming home already.
Finally we pulled into the driveway. I came in a little too fast, because the bump caused Dotti to say "ouch." She had not complained of pain in the car at all before, so it surprised me. The discomfort passed quickly and we were faced with the task of getting her inside.
We had already decided to use the front door, rather than the garage door. Both have steps, but the front door is more open and I could help if necessary. The disadvantage of that was the rain. It was coming down pretty hard by this time. I left Dotti in the car for a moment as I went inside and made sure everything was clear and ready for her entry. Then we got her out of the car, and started the walk down our walkway to the front door. The rain made Dotti squint and hunch her shoulders in an effort to ward off the drops. But she walked along well.
At the porch step, Dotti turned around and backed up to it. The therapist had used a memory aid to help with the stairs, "The good foot towards heaven." So, Dotti lifted her right foot first to step up backwards onto the porch, holding onto the walker for support. Next came the left foot and the walker and she had plenty of room to turn around and get to the door. The threshold was low enough to traverse without backing over it, but then we faced the stairs. There are 8 steps up between our front door and the main floor of our home. Dotti used "The good foot towards heaven," eight times in a row. She held onto the rail with her left hand and I had grabbed a cane for her to use in her right hand, as I followed along close behind to make sure there were no mishaps. It worked perfectly and soon we had Dotti upstairs, safe in our home.
I won't bore you with the details of my trying to figure out the written instructions on the medications and other odds and ends. Dotti and I were both spinning around with elation to have Dotti home and exhaustion from the let down of finally having all of that stuff behind us.
However, I must tell you, Dotti did one more unexpected thing: she cooked dinner. No, really. She did. I protested, but she insisted. (I know my cooking isn't great, but I don't think that was it. )
I took this picture on Thursday, with Dotti in the kitchen yet again.
We had a home nurse and a physical therapist come by on Thursday and I have been tracking all Dotti's meds. There are so many little things that have to be done and I have the washers (clothes and dish) going and something needing to be done almost all the time. So, I finally decided to sit down at 2 am to write this, because I am sure you wanted to know how Dotti is doing.
Dotti's wound is clear, with hardly any drainage, and her temperature is remaining normal. Her oxygen count in her blood, and her blood pressure both tested well yesterday when the nurse checked them, and right now, everything is as good or better than we could have expected. So, the answer to the question, "How is Dotti doing?" Is: Dotti is doing very well indeed!
I am still awake (perhaps not much longer though), and I hope I didn't put you to sleep.