Sunday, June 28, 2009

Never a Dull Moment



For those of you anxiously awaiting an update the last few days... my apologies. It would seem that it's hard to keep all of these balls in the air at once. Something had to give, so I spent some time with my mom and my family, instead of on the computer.Last Thursday, Claudia was discharged from the hospital and admitted to Orem Nursing and Rehab. My first impression of the place was terrible (I don't think my mom was impressed either). There were signs on the doors asking you not to let the residents outside even if they asked politely, and that horrible nursing home smell. The nurses and aids on staff that night were cold, inattentive, and moved at the speed of cold tar running uphill. It took a full 45 minutes to get the polar ice buckets filled. They lost her prescriptions for painkillers and blood thinners, which they didn't seem to care too much about. I never once saw them empty her catheter that night, and I was there for a long time. When I left her, I was worried, and she wasn't sure what she had gotten herself into. Thankfully, things picked up with the new day and the new shift of nurses. Friday, the PT team came to walk her down to the "workout gym" for her evaluation and to work her over. She made it successfully down the hall, into the right room, where they had her take a seat. She was feeling a little dizzy, and the next thing she knew, she was lying on a cot with her feet in the air. She passed out on them! YIKES! Someone called and told Averie what had happened (I was with a client). She relayed the message to me, and we took off. My client, Garrett Muse has a son Brock's age, so he took Brock to his house, while Corbin, Averie and I rushed to Claudia's side. By the time we arrived, she was happily eating her lunch like nothing had happened. After lunch, they decided to give PT another go. We were walking with her down the hall, when I realized I had missed a call from the Muse's, and now had a message waiting for me. I dialed up my messages, only to find out that Brock ran into a brick pillar and was for sure going to need stitches. Seriously, there is never a dull moment...





Cathy (Brock's friend's mom) met me at his pediatrician's office (who was able to get me right in) with a bleeding Brock. She had two bandages on his forehead, and he was dripping blood out of the bottom one. We went right back to the room and pulled off the band aids. He has two cuts above his left eye. One was about a half inch long with a puncture wound in the middle making it about a quarter inch deep and the other was maybe a quarter inch long and kind of gaping. He got six stitches, a couple of Tylenol, and we headed back to the rehab facility. By then, the nurses were concerned about how red and hot my mom's right leg had become. They had the wound specialist look at it and draw circles around it, and they were trying desperately to contact her doctor. The area continued to grow and was spreading up her thigh. After hours of unsuccessfully calling Dr. Jackson, it was finally late enough to call the on-call doctor. By this time, the nurses and I were both calling relentlessly, trying to make some kind of progress. Eventually, I got Dr. Fox who was kind, and listened intently to what was happening, but then decided he would need to discuss it with Dr. Jackson before making any decisions. He was thinking about sending her back to the hospital, and wanted to know what Jackson thought. After three and a half hours of waiting, I called him again to see what he'd decided. He couldn't find Dr. Jackson either, so he ordered an antibiotic and said that if there was no improvement by the morning, she would have to go back to Utah Valley Hospital. Later that night, Dr. Jackson did finally call. Turns out, he was camping with the scouts and wasn't getting great reception. He wasn't terribly worried about the infection, and dismissed it as cellulitis. The good news is that by the next morning, the red area had receded some and it was looking and feeling much better. YEAH ANTIBIOTICS!! She was able to do a lot of PT yesterday. They taught her some great tricks for getting around better with her legs, and she is feeling much more confident in herself. In fact, she even got in trouble with the nurses for getting up to go to the bathroom by herself (you have no idea what a big accomplishment this is!). Paul and Jeri stopped by with their kids to check on her after lunch. Jay and Josie came with Jenna, Nate and Preslie at dinner time. I'm sure she enjoyed seeing someone other than me and my kids. She called me this morning and asked me to do something for her. This is the first time she has asked me for anything, since we started on this journey. She asked me to stay home and enjoy my family today. She said it would be the last time I would have them to myself without her for a while, and she wanted me to make the most of it. What can I say? My hands are tied. Of course I will honor her request- it is the only thing she has asked me for. So, right now I am wasting precious time on this computer and I am going to stop. If you think about it, give her a call so she won't be too lonely. She is coming home tomorrow!







Thursday, June 25, 2009

A Rehab? Really?

I haven't been to the hospital yet today, but I have talked with Claudia a few times. This morning the pain specialists came and removed her femoral blocks. Woo-Hoo total feeling is just around the corner! The nurse took out both of her IV's yesterday, leaving her with just the catheter to lug around when she goes out for her twice daily walks (which, by the way, she is getting much better at). Yesterday, she was able to make it all the way around the nurses station with braces on both of her legs. Today, she did it again, minus the cumbersome braces. That is the first time she has been able to stand without the braces since the surgery Monday. Way to go Claud!!! She is going to kill me for mentioning this, but since it has been a fact of life lately, I'm going to throw it out there anyway... (spoiler: the following will contain discussion of a disgusting adult nature) Apparently, there has been some concern about whether or not her bowels are working properly, and some talk about nurses "helping her along". I am very happy to report that will no longer be necessary. While that is admittedly gross, it is a FANTASTIC sign, that means she is more ready to leave the hospital than she may realize. In fact, the hospital's official statement was something along these lines: If you are going home to your daughter's, we will wait and discharge you tomorrow. If you choose to go to a rehab facility, we can discharge you today. Based on the title of this post, what do you think she chose? That's right, people. She is headed to some rehab facility in Orem later today. Since she won't be reading this any time soon, I can tell you what I really think. I feel bad. I realize that she has to do what she thinks is best for her, but it makes me feel badly that she thinks this is better for her than letting me help her. I cannot imagine that a bunch of strangers can do a better job of taking care of my mother than I can. Part of my problem is that I am trying so hard to be so many things to so many people right now, that this is making me feel like a failure. I can't seem to balance my life right now, and I was hoping that getting her home would help that. (If it seems like I am speaking in tongues, let me try to explain.) I am trying to be a good mom to my kids and falling short- Brock told my mother in law that I don't love him anymore because he has to go to her house and I don't want him at the hospital. I'm not with them, because I am with my mom. I am trying to be a good wife, but honestly, right now, Scott is at the bottom of my list, because he is the most self-sufficient. He is picking up my slack at home as best he can. I am trying to be a good daughter by spending time with my mom and trying to help her with this, but because I am it, as far as our family goes, I feel like I also have to step up and try to fill my dad's shoes. That means, where the daughter in me would maybe hang out with her an hour or two, I feel pressure to stay longer- to not leave her alone too much. I am only one person. I CAN"T be in all those places at once. I was just hoping that I could get her home to my house, where all of the different roles I am playing right now can work together instead of clashing. I'm sure this rehab thing will turn out fine, and this is only a tiny speed bump in the road. I am over-reacting and wallowing in a little self-pity. I need to put on my happy face and go help her get transferred. She is happy about this change, and I will buck up and be happy for her (and cross my fingers that it is short lived).

Wednesday, June 24, 2009

One Step Forward... Two Steps Back...


I just got off the phone with my mom. She is having a harder time today, feeling a little depressed, and struggling with the pain. Apparently, when she decided that her spinal had worn off yesterday (because she wasn't itchy anymore) she was wrong. It really wore off last night. She could tell because of the horrible pain she suddenly found herself in. It would seem the femoral blocks by themselves don't actually block that much pain, or perhaps without them she would REALLY be a mess. She was beating herself up because she has regressed. She has reduced her bending to 60 degrees- 10 degrees less than she was doing yesterday, and she was only able to walk out to the nurses station- which a few posts ago I mentioned was just a stone's throw away. She is also having dizzy spells when she gets up. Mark, the PT says she is right on schedule for one knee, and is still doing phenomenally well for having both of them done, but she is still disappointed in herself. So, ladies and gentlemen, here is my thought: give her a call. Tell her she is doing GREAT! Let her know that you are thinking of her and pulling for her. Lift her spirits a little, and take her mind off of her problems for a few minutes. I'm sure that hearing from those she loves will buoy her up and help her get through this!

Tuesday, June 23, 2009

No Plopping!

Corbin and I went to the hospital and spent about four hours with Claudia. She is doing remarkably well. Her doctor has even told her that he will probably be sending her home Thursday or Friday, instead of Saturday like he had originally thought. She was also scheduled to phase off of her femoral blocks onto a morphine pump tomorrow, but they are going to forgo the pump and go straight to pain meds. That is GREAT news!! When we got there, she was eating and bending (gotta love the CPM- it's her new best friend). I have a sneaky feeling that will be what her life looks like for a while to come. She was ready and eager to go for her second walk of the day, but the PT kept putting her off because every time he came to her room, he would find someone else from the hospital staff had beat him to it. Quite frankly, I don't think there are too many employees left at Utah Valley Hospital that she hasn't met. She had the Occupational Therapist, the Physical Therapist, the Pain Specialists, the Discharge Nurse, the Hospital Bishopric members, her own doctor, her nurses (numbering 3), and the cute little girl who delivered her meals all visiting her at one time or another. Finally, things calmed down enough that her physical therapist, Mark, and his assistant of the day, felt they could come and take her for a walk. Before she could walk, she had to be prepared to walk, so they stretched and pulled and pushed her legs until she was ready. They tied her into a brace per leg to keep her legs from buckling underneath her and then spun her legs off of the bed. She put her feet down and the show began. She stood and began walking, or rather shuffling, but moving in a forward direction none the less. She cruised right out of her room and made it all the way down the hall before her leg buckled. Mark demanded she turn around immediately and return to her room, since she had already exceeded his expectations. When she got back to her bed, it became evident that the real issue was how she was going to bend her knees enough to sit back down. After thinking it over, she announced she was going to just plop backwards and let her legs pop up instead of trying to bend. Mark, his assistant, and I jumped in and screamed no right before she was able to put her ridiculous plan into action- thank heavens. We were able to brace her and steady her enough that she could sit, not quite like a normal person, but at least she didn't just plop. Since she is worried about losing her femoral blocks tomorrow, she is trying to push herself hard today while it isn't as painful. She had Mark put the CPM back on (he thought she should rest first) and upped the degree to 70. Needless to say, by the time we left, she was hating life. I switched the machine to her other leg (which the nurse did not really appreciate) and headed out the door. Hopefully, she took Mark's advice and rested after that last set. It should be interesting to see what tomorrow brings, with the feeling returning to her legs.

She Walks!

I was exhausted last night, so I didn't get around to updating again. By the end of the day yesterday, Claudia was doing better than anyone expected. She was lifting her legs up and twirling her toes around. The nurses were amazed. The physical therapist came in and put her on the continuous passive motion machine, one leg at a time. She tried to convince them to do both at the same time and to up her degree of bending beyond what her doctor recommended. They said no way! Not being able to feel your legs, tends to make you think you can do more than you really can. She was eating mushy foods and keeping everything down. In fact, she didn't throw up once- HURRAY!!! When I left her last night, she said she was going to crash and try to sleep off the anesthesia. I spoke with her this morning around 8:30. She was a million times more coherent than yesterday and doing great still. She was bursting with pride that she had just gotten up and been able to walk to the hallway (with only two people assisting her). She said that trying to stand created the weirdest sensation in her toes. It felt like the she was pushing the floor out from under her. She tried over and over to put her heels on the ground, but couldn't quite manage it. It seems to be a common problem, because the PT got her some braces designed to help with that and they were off. She told me it was a little frustrating to have your feet not keep up with the rest of you, but she was so happy to be able to start healing and improving. Her attitude is unbelievable! I wonder if it will still be that good when she can actually feel her legs... (all of the nerve blocks are still in place and working beautifully) She is hoping to be able to skip the morphine pump and go straight to pain meds for the pain she will soon be feeling. Her blood is done recycling, so they have disconnected her from the machine. That's awesome since it eliminates 3 of her tubes that keep tangling up. Also, they were able to quit monitoring her pulse ox levels, so she's actually down 4 tubes. That's making her life a little easier for now. The physical therapist is coming back between 12-3 for a second walk, and I intend to be there for the show. I'm off for now, so I don't miss it.

Monday, June 22, 2009

The Patient Has Arrived

Claudia is in her room now. They tried to settle her in as best they could, but she just wants them to leave her alone. We have decided that it is completely retarded that they wake you up to tell you to go back to sleep, only to wake you up again. She is having a hard time keeping her pulse ox level above 90 right now, so the machine keeps beeping at her waking her up. To add to that, she seems to be having a reaction to the spinal block they've given her, and she can't stop itching- especially her nose. The itching is made worse by the oxygen they have up her nose. It is a vicious circle: itch, yank out the oxygen to scratch, fall asleep, oxygen drops, machine beeps, wakes her up, puts the oxygen back in, itch, and around we go again. I had a similar reaction to the spinal block they gave me when I had Corbin. I keep telling her she needs to give in and get benadryl, but it is awfully difficult to reason with someone who is so drugged. She has all sorts of contraptions and tubes attached to her. There are the basic ones, like the IV, the catheter and the pressure cuff, and the more specific ones like the pumps on her feet, the ice machine circulating cool air on her legs, the wires feeding into her groin that are blocking her nerves, and the machine that is circulating her own blood out of her knees and back into her arm (that is kind of neat). True to form, as soon as she was awake enough to check, she pulled the covers back to check out the damage. She was disappointed to find her knees were too bandaged to see anything. She spoke to my kids for about 20 seconds- just long enough for them to know that she is okay then closed her eyes and drifted off. She can point and flex her feet, which I thought was almost as exciting as seeing a pig fly. Her toes keep changing colors- purple to pink. I guess she was right about not painting them before surgery. You know what they say... Mother knows best. For now I am going to let her rest and sneak off to the cafeteria. It has been a long time since 4:30 this morning.

We Have a Room!

Okay, so I still haven't seen her yet. In fact, I am not sure when she will be joining me in her teeny tiny closet, er, I mean hospital room. She is in room 480 East. The direct phone is 1 801 357 5480. The phone number to the hospital is 801 357 7850. I doubt if she will be up to taking your phone calls until a little later tonight though. She is almost right next to the nurses station. She's close enough that if she loses her nurse button she could just yell. She just arrived. I will post more later.

Off to Recovery-

Dr. Jackson just came out to speak with me. He says she is now "bionic"! He finished the operation successfully and they are finishing up getting the bandages on her right now. He says she will be off to recovery in a matter of minutes. They will keep her there for one to two hours and then find her a room. The knee replacement is so traumatic that they keep those patients in the recovery longer than they would for other procedures. That's okay with me, because it gives her more time to puke on them instead of me. The first 24-36 hours following this surgery, they do a nerve block to help manage the acute pain. Dr. Jackson said she should be pretty happy as far as pain managment goes, until that wears off. She will be in the hospital until Friday or Saturday and then it's home to Rita's Rehab Facility. Maybe I'll even let her borrow my mantra for a while- she can do this....she can do this....she can do this.....she can do this....she can do this...

Half Way Baby!!

Nurse Connie just graced me with her presence! She says they have finished with the left leg and began working on the right one at approximately 9:45. If the left is any indication, she should have another hour and fifteen minutes in surgery, then off to the recovery room (where I hope she will get all the vomiting she needs to do out of her system)! As of right now, she does not have a room assignment. I think they will try to find a space for her after she comes out of the O.R. Guess that means that I am stuck sitting in the waiting room with these strangers whose faces are becoming increasingly familiar to me. Does it make me a baby to say that I wish my dad were here to help me with this? All of the people in this room have someone with them. Someone to talk to- Someone to keep their spirits up- Someone to share the responsibility with- Here I sit and wait alone, (not that my kids wouldn't have loved to come with me- they would have, but it is not the same) eagerly waiting for the tiny bits of information they offer me every so often, watching the seconds hand pass on the clock. Let me just start to repeat my all too familiar mantra... I can do this.... I can do this.... I can do this..... I can do this.... I can do this....

Update Numero Uno

Ask and ye shall receive.... I asked to know something, anything, and Connie the liaison nurse showed up within minutes to update everyone in the waiting area. Apparently, the surgery began shortly before 8:00. They are working on her left leg right now. The total knee replacement can take anywhere from one to one and a half hours per leg (on average). Upon completion of the first knee, they have to remove everything from the OR and replace it with sterile equipment. That creates a lag time of 15-30 minutes between legs.
In lay man's terms, 50 minutes down, 2-3 hours to go. So far, so good. Connie says she will let me know when they finish the first knee. Can't wait....

...And We're Ready For Take-Off...

Here we go.... the journey to Claudia's new knees has begun. The kids and I spent the night at my mom's last night, so she and I could get up and make it to the hospital by 5:30 a.m. this morning. For those of you who are interested, we didn't make it. We were 10 minutes late, which the check in nurse was only too happy to remind of us when we arrived. My mom got her fashionable, blue bracelet and we sat down to wait. After the small fit about our tardiness, we fully expected that she would be whisked back to pre-op immediately, but no. We waited a good 20-30 minutes before my cell phone rang. That's how they do it these days... instead of walking out to the waiting room and calling your name, the nurse stays at her station and gives you a call. I just got a new phone Saturday, and couldn't figure out how to answer it (the ridiculously early hour may have contributed to my confusion) so the lazy nurse had to get up and come get us anyway. We trotted back to the weigh in/ blood pressure station to get the party started. She must have passed because from there we were shuffled down the hall to our very own room. Claudia stripped, put on her lovely blue gown, (to go with the jewelery they had just given her) and climbed into bed. A very kind nurse, named Nadine (just like my grandma) came in to start her IV, give her some meds, and keep her circulation going with snazzy foot pumps. She, was apparently a bit more skilled than the nurse my mom had on Friday, (for her clot filter procedure) because the IV went in easy as 1-2-3 on the first try (she was super happy about that since she looks like they used as a pincushion last time). Nadine left us alone, and we made stupid small talk... the kids this, and the kids that, instead of me telling her that I love her and need her, so she would know in case something were to happen. I don't know why I am such an emotional retard. I think I would tell her if I could go back and do it again. The incredibly handsome male nurse, Brigham, came to take her away to "holding", (which she said makes her sound like she's cattle,) where she was to hang out with her anesthesiologist until her surgery started at 7:30. I was redirected to the surgery waiting area. When I got here, there was one other person, now it is almost overflowing. Some in here are sullen, with worry lines creasing their faces, and others are joking, playing their game systems and eating greasy McDonalds take-out. I wonder where I fit in this room... Can these strangers see the panic I'm feeling written across my face like a cheap paperback novel? Know what stupid thing I said to my mother as they wheeled her away?!? "Be good Mom. Don't give 'em too much trouble." Why didn't I say I love you? Why didn't I remind her to come back to me in a few hours? What if something bad happens, and the last thing I got to say was "Be good"? Will I be able to live with myself? In case you can't tell, I have a lot of angst about this surgery. She is excited, and happy, and not nervous at all. I am nervous enough for the both of us. It is now 8:20. Nearly an hour since they started. I have not heard any updates yet. Nadine told me to call if they don't update me by 9:30. Only an hour to go until they can tell me something... anything...