Thanks to all of you for your interest and concern in my recovery from a bilateral hip replacement. I’ll be posting separately on the great performance of the Hospital for Special Surgery.
The short version is I was designated before I left NYC to return to Alabama as in the top 1% of hip replacement recoveries. At day 9, I was at the point most patients reach only by the end of the first month. Even the Alabama physical therapist who came to assess me and start my home program was stunned.
I attribute that result to extremely high pain tolerance, good general health, and doing what I could to maintain strength and flexibility up right up to the procedure. I had no surgical site pain (except when doing things that pulled hard on the tape over the incisions) with having only a normal tail-off of the epidural for the day and a half of the surgery and taking Tylenol for a tiny bit longer, when they kept offering it to me after that. The Hospital for Special Surgery doctors and nurses found it remarkable that I had no pain.
The big source of discomfort was sleeping on my back. It was all bound up before the surgery due to how I was compensating for my busted hips, made worse by the flight to NYC and then the position they put you into to do the procedure. And merely sleeping on your back will lead to back unhappiness if you can’t put a pillow under your knees (most assuredly not allowed!). My surgeon said that after the first day, sleeping on my side would not impede recovery, but it would be unpleasant to do so. He was right. I was so puffy in the entire area I didn’t even try for the first week (and it’s not nice smooth puffy but lots of weird big lumps). It wasn’t until the second night that it occurred to me to ask for hot packs to relax my back, which made a huge difference.
Having gotten off to a speedy start, I now feel like I am being held back. The New York and Alabama physical therapists are making me retain my gait. Mind you, I was seeing orthopedists as soon as I could walk and no one bothered trying to change how I compensate for some structural issues. So if I were allowed to walk any old way now, I’d be out and about. Instead I am having to walk slowly around the house with a walker (no weight on it, just to keep my upper body out of the equation for now), only 5 mins at a time but 5 sessions, going up to 6 tomorrow, concentrating hard so I do things differently. Grr. This plus >30 mins a day of other exercises.
I am sparing you the gory details of the story where two of our four aides, one the owner of a tiny agency, the other her employee, totally misbehaved while I was getting my hips done. And this with my brother here most of that time!
One of the aides regularly came late for her AM shift even though she was putting in for full time (and unlike other agencies in town, this one had no clock in/clock out procedure to verify her hours). Both aides abandoned my mother, one twice for an hour, the other for 40 minutes. Mind you, no agency in town allows that. Aides are supposed to stay with the client except when going on bathroom breaks or performing authorized tasks, like cleaning or errands. They aren’t even supposed to leave the room for personal calls unless it is urgent. One aide from a different agency was fired for walking off the property.
They also tried picking fights with our best aide, in a not-subtle effort to try to get her to quit and take her hours.
When my brother called the agency head to discuss performance issues, he didn’t even get to the abandonment before she started screaming at him (he prudently had a witness to the call). She then called me in the hospital, literally the day after I was out of surgery, to shriek at me about how my brother was lying, how she had recorded everything, how she couldn’t be fired, and how she was going to have me listen to his supposed lies. I have never heard so much venom in anyone’s voice before, including actresses.
I fired her and her partner in crime. She then threatened to send a false report to state adult protective services. So I had to quickly paper up that a disgruntled ex employee was threatening to make bogus allegations, and that a report of her misconduct was forthcoming (I sent that in too).
We had kept the agency head’s position open after she got Covid (and frankly looked to have exposed me and my mother; I attribute our not getting it to using twice the frequency of our usual povidone iodine gargles and nose spray for the following week, as well as using other prophylactics like Vitamin D and zinc). It appears she took that a sign of weakness.
My mother’s story is not so happy. She was listless on Sunday and got worse as the day went on. I had to assist getting her in the wheelchair to go to bed (fortunately I braced her while standing up straight, so no harm to new hips), and aide could not get her out of the wheelchair in the bathroom. So off to the ER.
She was diagnosed with an early case of pneumonia which the hospital was pretty sure it could knock out with antibiotics. She was also dehydrated (the aide and I kept pressing her to drink that evening and she kept refusing) and her blood pressure was high.
The next day, the aide that spent the day with her came back crying. My mother was “gone” and worse, hallucinating. The hospital was also only sending nurses in what seemed to be only once a shift. The evening aide found she needed her diaper changed (!!!) and they’d just left her dinner, and didn’t try to get her to eat it.
I called and had the nurses add to her notes that she needed a neurological exam for possible Lewy Body dementia (she has had body rigidity, another symptom, although when I reached one of my two friends who’d had a parent die from it, she said it usually shows up at a much younger age).
When I finally reached the MD, I had to browbeat a bit to get him to order an exam. He argued that old people often hallucinate when they get really sick, and it didn’t matter much what kind of dementia she had if she had dementia, since the (non)treatment would be the same. I called him out by saying Haldol could be prescribed to an Alzheimers patient but it would be detrimental to a Lewy Body patient. And what about having a baseline?
Today she was much more alert although she did tell the AM aide she was in Europe and it took some doing to persuade her otherwise. But the flip side is she recalled a lot of stuff from right before she went to the hospital, but has no memory of the day when she was hallucinating.
Things are now going to get tricky. My mother really wants to leave and thought she would be discharged Thursday. She will be in the hospital till at least Friday because she’s still weak. And she’s not going home.
Her big issue is she’s lost muscle mass due to refusing to walk again after a compression fracture of the spine in May last year. The MD says she also appears protein deficient, which he says is very common in old people (they just don’t eat enough normally even if they eat a lot of protein; may also be due to digestive issues). He’s doing a workup on that.
The doctor wants her to go to a rehab facility for 2-3 weeks. It sounds mean but that’s the only way she might do the work to gain enough strength to assist the aides minimally in her transfers to and from her wheelchair. She’s repeatedly sent physical therapists away when I’ve arranged for them to instruct her at home and also refused to perform even minimal exercises I devised for her.
When she is stood on her feet, she has lost the ability to sense where she ought to be in space. If she merely gets to the point where she can stand on her feet in a walker, that would help the aides enormously in transferring her (as in they can mainly pivot her). That is a modest enough goal that I hope will be attainable. Otherwise she’s a dead weight and would have to stay in mainly in bed and be lifted by a Hoyer hoist. I don’t think she’d want to live very long if she were permanently bedridden.
So with this background, I will need to visit her daily once she is in rehab. That means yet more time away from the site, between that and my own rehab. I hope I can get by with just having Lambert and Jerri cover Links all the time until I am back to a semblance of my old normal. So please be patient.