Mom had a couple setbacks. Fortunately, they were relatively minor.
Day Two (Thursday) went pretty well. Mom was still coming out of the medications, so when I rolled the cart with the big, clunky CPM machine (see Part 7) out of the bathroom, she didn't even recognize it and said she didn't know what it was. But the nurse assured me that PT hooked her up to the passive motion machine at bedtime until early morning, and it was just the remnants of the medication that made her forget about it.
She was up twice, both times using the walker from the bed to the hallway, to the bathroom and back to the chair. She was totally wiped out, between the surgery and the fact she had been using the wheelchair with almost no exercise for the last month before surgery. As the medications were finally flushing out of her body, some of the pain and exhaustion took over. At this point, she was still on an IV and oxygen.
Day Three (Friday) was a bit different. The doctor made his rounds early and announced that mom's blood work showed problems and she needed a transfusion. We knew immediately that meant she wouldn't be moving to rehab later in the day as we'd hoped. In addition, she had a rash on her leg, just above the surgical bandages, and the doctor he wanted to have see her wasn't available until Saturday.
Since she has lots of contact allergies, we figured the rash wasn't worth being concerned about, but the doctor didn't want to take a chance. We have had several cases of "Methicillin-resistant Staphylococcus aureus (MRSA, often pronounced "mersa) in our area, including a death of a high school student. I forgot to mention in the Pre-Admissions post that the hospital does a screening test now for MRSA. It is a swab that is used to collect samples from just inside each nostril.
Fortunately, neither the transfusion nor the rash proved to be a problem and when I arrived early Saturday morning, mom looked better than she had all week. Her eyes were bright, she looked happy and even her coloring was better. I think she had just gotten too worn down over the last few months of struggling to walk and the pain had just been too much. I was also pleased to learn that even with not eating the day of the surgery and the lingering nausea problems (any heavy pain medication gives her nausea), she had only lost one pound during her stay.
RECAP -
Expect Ups and Downs - The day of surgery will be rough on everyone. Day One will be kind of a lost day. The patient may be aware at the time you speak to them, but may forget it all by the next day. This is why you should be around the day after surgery to be sure nothing falls through the cracks because the patient couldn't remember.
Day Two, the activity begins. Physical therapy starts in earnest and as the anesthesia wears off, your loved one will be feeling more of the actual pain of the incision, even though the painful joint won'e be hurting anymore.
Day Three is when many people, those in very good physical condition before surgery or much younger, will probably be going home or to a rehab center. For my mother, the low oxygen content of her blood made her tire to easily and she didn't improve until after the transfusion.
(SUGGESTION - Get copies of your medical and lab reports, and have your doctor or nurse go over them with you so you learn how to read them, what the acceptable ranges are and what to do if they are not right. Remember, your doctor may have hundreds of patients and the lab results are going to come in a week or more after he saw you last. If you always ask that the lab orders contain a note to send one copy to the doctor and one to the patient, you can look it over when it arrives in the mail. It is also a good way for you to see for yourself if there has been a change since the last tests, and when necessary, bring it to your doctor's attention. In most cases, you can just call and leave a message for the doctor's nurse. Say you noticed something that concerned you on the lab results, say what you are worried about, and ask that the nurse ask the doctor if this is something you should follow-up on.)
REHAB - If you haven't already, by Day Two have the hospital case manager contact the rehab facility you will be using to give them an estimate of when the patient will be transfered and keep in touch if there are any changes.
REMEMBER - The hospital stay is only the beginning. Once the tubes, wires, and beeping machines are gone, the real work of physical therapy begins. Our doctor estimates that within 5 to 6 weeks, mom should be back to within 80% of how she felt before the arthritis got so bad. By 6 months, she will be doing so well she will have forgotten she had it done.
Of course, everyone kept telling her that, even at 86, she would be up dancing soon. Considering this lady taught line dancing 3 nights a week up until she was 81, I would dearly love to see her that mobile again.
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Ah, 9:10 PM and I'm hearing the fireworks show from Disney World. We're that close, 12 miles by car, closer in a straight line. For the first few weeks, I thought it was distant thunder. I'll miss our home here but we're going to have to think about selling (see sidebar) and moving near one of daughters because we don't know how much longer we can live here with our medical problems without family nearby. There are days I wonder which of us the caregiver and which is the patient, but you take care of each other, smile and have a laugh here and there, and live life one beautiful day at a time.
Tomorrow, Part 9 - Moving to Rehab
Kathy
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