by Judy Handley | Aug 2, 2024 | 2024 Life Logs |
2024 Life Logs, Day 215: Successful Transfer from Hospital to Rehab
Date: Friday, August 2, 2024
Weather: Sunny and Hot, Thunderstorm Early Evening; High Temp 94, Low 71 degrees F
Location: At Home with Nephew Tommy & Marilou in Huntersville, NC
When I arrived at the hospital this morning, Patsy was so much better than yesterday. The oxygen had been removed, which was a really good sign, but she was just sitting there looking at her breakfast tray but not attempting to eat. I helped feed her at first, and then turned that job over to her. Maybe it is just sitting in a hospital bed that makes her believe she can’t feed herself. At least, I hope that is all it is. Then the hospital doctor came in and announced that she was being released today. He explained that when she spiked a fever during the early hours of yesterday, they cultured a sample and found she had a raging urinary tract infection. That helps explain her behavior yesterday. Knowing she would be leaving the hospital today, I rushed to Terra Bella to pick up her clothes and other things she will need in rehab. While there, I got the call that she would be picked up between 12 and 1 to be taken to rehab, so I high tailed it back. They came around 12:15 and by 1:30 she was settled nicely in Autumn Care. Tommy came and sat in on a 3:30 meeting I had with the Business Manager, Facilities Director, and the Social Worker. The administrative staff here seems really good, but the more hours I sit here, the more I see that the floor personal are not as responsive. They are supposed to check on clients every two hours, but that just hasn’t happened. If Patsy would push the red button for help, I think they would come, but she will not do that. So, I am glad I have people lined up to be with her for a part of the day and overnight when I leave, hopefully on Sunday. The companions can advocate for her.
I have decided to go to my nephew Tommy’s for the night. It is much closer than Mooresville where I was going to stay. I am going to check on flights home when I get to Tommy’s tonight. My friend, Lynne, who has been with Shadow for the past week, had to leave this morning. I only got to visit with her for one day before I left to come here, fully planning to return on Tuesday. But here I am and Lynne is now in New York visiting with family there before returning to Michigan. Somehow, I hope to be able to visit with her before she returns to New Zealand. Lynne, thank you from the bottom of my heart for taking care of my Shadow while I had to remain here in North Carolina. You are the best!
by Judy Handley | Aug 1, 2024 | 2024 Life Logs |
2024 Life Logs, Day 214: Roller Coaster Ride
Date: Thursday, August 1, 2024
Weather: Sunny and Hot; High Temp 94, Low 73 degrees F
Location: At Home in an Airbnb in Mooresville, NC
Down–Today was a day of ups and downs. I felt like I was on a roller coaster ride. When I made the choice of a rehab facility, I assumed that was all set. But at 8 am this morning I got a call from the hospital Case Manager telling me that because of the kind of insurance Patsy has, it could be four or five days before she gets approval. My heart sunk. She said not to worry as even after Patsy is released from the hospital, she can stay there until her insurance company approves the rehab. Evidently Blue Cross-Blue Shield Medicare Advantage is just very slow.
Down–I got to the hospital just before 9 am and found Patsy in a dark room, fast asleep, with her breakfast tray untouched. I found the floor nurse to ask what was happening. Evidently after I left last night, she got even more agitated than she had been most of the evening and the further they go into the night, the more agitated she became. I was told that she did not sleep a wink. But during the 7 am change of shifts, the daytime floor nurse tried to convince her that she really needed to sleep. He tried to get her to eat breakfast first, but she refused to eat. Then she did go to into a deep sleep.
Up–I was there for an hour when Kate, the case manager, burst into the room with a great big smile. After our earlier phone call, she called the Administrative Director of Autumn Care facilities in North Carolina and she dug deeper into Patsy’s insurance and found that her particular Blue Cross-Blue Shield Advantage is administered by naviHealth. Kate had no idea why, but I didn’t care because they approved Patsy’s placement with one phone call from the administrator.
Down–So we were back to being released late today and moving to Autumn Care tomorrow. But not unless Patsy perked up a bit. I then learned that not only did she not sleep last night, she spiked a fever and had to be given Tylenol. And her oxygen level is still continually dipping even while she is being given oxygen. No one has any idea why. So now the doctor is saying that she has to stay in the hospital at least until the issues resolve.
Up—One of Patsy’s Home Helper companions came to spend time with Patsy and brought her flowers. That perked Patsy up, and Brenda was able to get her to eat her whole lunch and assisted with her physical therapy regimen. She did all of the exercises twice and got out of bed twice to stand on one foot. Her blood sugar has finally normalized. And I got her to eat her entire dinner.
When I left tonight she was sleeping restlessly. I have no idea what tomorrow will bring and no idea if she might be released tomorrow or Saturday. So we are playin
by Judy Handley | Jul 31, 2024 | 2024 Life Logs |
2024 Life Logs, Day 213: The Search for a Rehab Facility
Date: Wednesday, July 31, 2024
Weather: Sunny Day, Rainy Evening; High Temp 90, Low 70 degrees F
Location: At Home in an Airbnb in Mooresville, NC
Today was all about the search for a rehabilitation facility where my sister can go when she is released from the hospital. I have heard people talk about going to rehab for years and getting skilled nursing care there, but I truly never realized that being in a short-term rehab facility is often in the same building as a long-term nursing home. (Note to my nursing friends—Am I right about this?) I know you must be thinking, where have I been that I didn’t know this? Wherever, I now know. At least in this area, every rehab skilled nursing care rehabilitation facility is in the same building as long-term nursing care, and they are not separated. Depending on room availability you could go in for rehab but be in a wing with all long-term nursing care residents. Some of these homes have only private rooms, but some have shared rooms. Some come with television and phone service, but many have television, but you have to have a phone line installed. Some take Medicare Advantage and some do not. And unfortunately, the facility I wanted for my sister does not accept Medicare Blue (Blue Cross-Blue Shield) as it is an Advantage program. When I asked them if we could pay cash, they said they had never been asked that question before. But no, they have no private pay rooms.
Today, my crash course in local rehab facilities led me to only two choices. I visited both and then it was obvious that there was only one choice. One facility had only double rooms available and there is no way I would put my sister in that situation. So, the choice is made. Patsy will be released from the hospital tomorrow if her oxygen level normalizes and she will go to a place called Autumn Care. If the oxygen level does not normalize, she will be in the hospital until it does or until they identify the cause. I know her oxygen level was normal all day yesterday prior to the surgery because I watched the monitor all day long.
Tonight, I had a nice diversion. Patsy’s son-in-law came to be with her at dinner time and my nephew Tommy and friends Brian and Judy Thompson invited me out to dinner. I had Mediterranean Red Snapper and it was absolutely delicious. Afterwards, it was back to the hospital for a couple of hours of breathing exercises that the nurse asked me do with Patsy before I left for the night. What I discovered is that she can exhale just fine, but she inhales very lightly.
My goal is to get Patsy settled in rehab as soon as possible, hire the extra help that is going to be needed, and then fly home on Sunday. I would then return when she transitions from rehab back to Terra Bella. But that is just my goal. Who knows what will happen tomorrow to adjust that goal?
by Judy Handley | Jul 30, 2024 | 2024 Life Logs |
2024 Life Logs, Day 212: Happy Birthday to Coco and Congrats to My Sister
Date: Tuesday, July 30, 2024
Weather: Sunny Day, Rainy Evening; High Temp 86, Low 68 degrees F
Location: At Home in an Airbnb in Mooresville, NC
Coco turned 12 years old today. Happy, happy birthday to my one and only very special granddaughter!
And congratulations to my sister Patsy. She came through her surgery tonight like a superstar. The surgery was supposed to be between 3:00 and 4:00, but they didn’t take us to pre-op until 4:00. We waited until 5:00 when we were told that the doctor was still in the OR with a surgery that was taking much longer than expected. Then at 6:00 we were told that he was still in the OR, but nearly finished. The nurse thought we would have to wait another hour, but the doctor came straight out of OR to talk to us, and by 7:04 pm I got the call from an OR nurse telling me the surgery had started and that Patsy was doing great. The surgery took only an hour and when the doctor called me just after 8 pm, he also said she was doing great. But he added that the hard work begins now. He does not want her stand on that leg for at least 6 weeks. No weight bearing. Due to her age and lack of upper body strength, he thinks she will need to be in a wheel chair and have help moving from place to place. I’m still trying to wrap my head around how that is going to work. But after 17 hours at the hospital, my brain is fried. Maybe tomorrow that won’t seem as difficult as it seems tonight.
Prior to going down to pre-op at 4 pm, Patsy chatted with visitors and on the phone all day. Brian came around 9:30 and at 1 o’clock, Brenda, one of Patsy’s Home Helper companions came to visit. And then Bill came. I told Patsy we were having a party and she enjoyed every minute of it. When she got back to the room at 10 pm tonight after the surgery, she was cheery and wide awake while I was about to pass out. So, I headed home which is an Airbnb about 4 minutes from the hospital. It feels so good to be in my own space after days of being at Terra Bella and at the hospital today. Thank you, Heather, for arranging this stay so close to the hospital. And now to bed.
by Judy Handley | Jul 29, 2024 | 2024 Life Logs |
2024 Life Logs, Day 211: Life Happens
Date: Monday, July 29, 2024
Weather: Rainy Day; High Temp 83, Low 70 degrees F
Location: Alone in My Sister’s Apt, Mooresville, NC
Once more I quote my friend Lynne Kirwin, who happens to be at my house dog sitting. “You make plans and then life happens.” I was busy, busy today doing the last things for my sister, fully preparing to fly home tomorrow. I bought her a new mattress, made arrangements for delivery this Thursday, went to Walmart to buy a new mattress cover, and went to the laundromat to wash and dry it. While there, I got a call from my sister’s afternoon Home Helper, Renee. Patsy had fallen and I needed to get home as soon as possible. It was a terrible connection, so I knew nothing more. I grabbed the mattress cover from the dryer and headed home as quickly as possible. When I arrived, Patsy was sitting in the kitchen floor with her legs extended. She was talking away to the Med Tech and Renee and seemed fine, but I was told that EMTs were on the way. The top of her right leg hurt a little, but it was not painful. The EMTs asked some questions of her, evaluated the leg, and said she needed to go to the hospital for x-rays. None of us thought it was very serious because she really seemed fine. So off to the hospital she went with me driving along behind. The first thing that was done was an x-ray and the result was not good. She has a fracture running vertically from her hip down about four inches (my estimate from seeing the xray). The ER physician told me she would need a hip replacement and that an orthopedic surgeon would come to talk to me in an hour or so. In the meantime, they did all the tests for pre-op, put in an IV and catheter, and on and on. As the evening wore on, I could see her energy draining and her emotional outlook went from sunny to cloudy. The nurses were not allow to let her sit upright, so eating or drinking anything was very difficult. But an internal medicine doctor came in and announced that she was cleared for surgery. Then the orthopedic surgeon arrived and told us that she would not be having a hip replacement. She needs an intramedullary nailing, meaning a rod inserted in her femur. Here is the full description from the web of what will be done: “The procedure where a rod is put into a fractured femur bone is called intramedullary nailing. It’s a type of surgery called open reduction and internal fixation (ORIF), which is usually required to heal a broken femur:
1. The surgeon makes a small incision in the hip or knee
2. A specially designed metal rod, usually made of titanium, is inserted into the center canal of the femur, also known as the intramedullary space
3. The rod passes across the fracture line to keep it in place
4. Screws are placed above and below the fracture to hold the leg in alignment while the bone heals
The rod helps support the bone until it heals. Other devices that may be used during ORIF include plates, wires, or nails. The surgery usually takes place while the patient is asleep under general anesthesia and may take a few hours. While most people do well after ORIF, complications can occur, including infection, bleeding, nerve damage, and blood clots.”
Recovery is easier than a hip replacement, but no surgery is easy when you are 91. The surgeon told me that a decision on whether it will be done tomorrow or Wednesday will be made between 7 and 8 pm in the morning. He suggested I be there, so I headed home. I hated leaving Patsy alone, but she has to spend the night in the ER as there are no rooms available and there was no room for me in the ER room. I stood outside her room for most of the four hours I was there, and no way was I going to sleep in folding chair!
I have cancelled tomorrow’s flight, extended my car rental, and Heather has found an Airbnb for me near the hospital where I will have a kitchen and can cook. I have eaten nothing healthy since leaving home on Friday. Hopefully I’ll have a successful surgery story to share tomorrow night.
