Do You Know...My Favorite Dinosaur is Cool? Do You Know Why This Matters?

Last night, we talked to Timothy and his mother for the first time in nearly two long months.  They had spent the day at a nearby lake and botanical gardens/park, and Timothy had LOTS to tell us.  He also had a lot to tell us about his birthday presents - and his dinosaurs... and the repetitive question was a dramatic, "Do you know... that my favorite dinousaur is cool?  I will show it to you!"  Of course, we could not see it on the telephone, but that didn't seem to matter.  And this was all important because????  The 30-minute conversation with our beloved three-year-old was a welcome respite from the focus on my grandmother and her deteriorating condition.

Wednesday and Thursday were remarkably "good" days for Mam-ma Polly.  She was clearer and put more sentences together than she has in months.  She told me about visitors and asked about a mutual friend who is suffering with Bells Palsy.  She said of this person, "I wish I was able to send her a note."   She is still thinking about others - even now.

However, my mom visited on Friday, and nothing was the same.  Mam-ma was virtually unresponsive.  Mom had to keep waking her to talk with her... and even then, she wasn't sure things registered.  And Mam-ma has a pressure wound on her right heel - the leg that is broken.  It's about the size of a quarter, and the Hospice nurse put padded "booties" on her feet to keep them from touching the sheets.  We are told by the nurses that this is the beginning of other problems... like more skin breakdown.  And even worse, Mam-ma is in pain.

We got the doctor to increase her pain medication from 2 times per day as needed to four times per day, as needed.  However, before the six hours is up she is begging and groaning in pain.  When I visited yesterday morning, I found her in a fetal position, clenching the bed rail with both hands, frowning deeply and groaning.  She was in a lot of pain.  We have not been able to reach a doctor this weekend, which I am not sure I understand.  But there are times when the Hydrocodone kicks in that Mam-ma is happy and laughing... it's just that last hour or so before the next pain pill - and then the hour afterward until it takes effect.  When you add them all up, that is a lot of time to be in pain.  Hopefully I can get to the bottom of it tomorrow and get either her dosage strength increased - or the frequency of administering the current amount.  I do not want my grandmother to be in pain at this point.

I know every day is different... and the challenges and frustrations may only increase as we go along.  For all who questioned at the beginning of this week whether Hospice was the right choice, I say, "Go visit her now."  We made the right choice.

At the same time, I am trying to pace myself... and if you are in the same boat - or a similar dinghy - I suggest you do the same.  Last Saturday, my best friend and I attended a party to celebrate the marriage of a mutual friend we have known since childhood.  We laughed, danced, and reminisced... and for a few hours, I didn't think about hospitals, pain, Hospice, or anything sad.  It felt great!  Yesterday, I fired up my sewing machine and made pillows for our front and back porches.  Sewing is my therapy... and I get lost in the beautiful fabrics and calculating yardage and creating something pretty... and I feel happy and peaceful.

In all of these challenges, we have to find balance.  So talking to Timothy last night was the icing on the cake.  Thinking about the carefree world of a three-year-old and his soon-to-be-one-year-old sister made us smile and laugh... something we haven't done often enough lately.  Tonight, if everything holds together, my husband and I plan to veg out on the couch and watch movies... one drama... and one comedy.

This seemingly sudden 180-degree turn with my grandmother should come as no surprise.  I know things can change quickly from here on out... but at the same time, it was a good reminder NOT to be surprised - or to take a "good" day/hour for granted.  I'm still keeping my house in some semblance of order and trying to stay ahead of meals and laundry... and basically keeping my "house" in order (literally and figuratively).  Nothing is certain... of that I am sure.  But I am taking things one day at a time, and relishing in the fact that dinosaurs really are cool... and I know a little boy who can tell me why!

And So We Wait...

The call I have dreaded, yet halfway expected, came Monday evening around 11:15, when the RN for the ALF notified me that Mam-ma Polly had fallen in her room, and her w lords to the aide on duty were, "I think my hip is broken."  An ambulance had been summoned, and the nurse said, "We're not moving her until the EMTs arrive, and they will do the minimum necessary to get her on a gurney and transport her."  She told me they hoped it was only a deep bruise, and we would return to the ALF and start therapy.  However, if it were broken, we were looking at immediate transport to Little Rock to another hospital.  "So gas up your car and get ready," she admonished me.

We arrived in the ER, where my favorite attending physician and nurse were on duty... answered prayer #1.  Dr. Bottorff took one look at her and said, "I'd be willing to bet it's broken - one leg appears to be much shorter than the other.  He was right... and the x-ray he showed me was astounding.  Mam-ma snapped her femur just below the ball and socket, leaving a sharp shard pointing downward, and jutting her femur (which resembled a spear) up above her hip ball and socket.  Thankfully, there is a surgeon on staff, and the ER staff admitted her to the hospital and placed her leg in traction to hopefully pull the leg bone back down into place and give her some relief.

We discussed the options, and the surgeon and hospitalist both told me that surgery was the only option... and they felt that Mam-ma was physically a good candidate.  To let her lie and heal without surgery would be risky, painful, and basically not an option.  So Monday afternoon around 3:30, Mam-ma was wheeled to the OR, where the leg was repositioned, and a rod was inserted and screwed into her leg near the hip ball and the knee.

Since then, we have been working on controlling her pain and getting her up; however, she has only sat up twice since surgery, and she cannot "walk" at all... cannot even move her "good" leg with prompting.  I am not certain at this point how much longer we will be in the hospital... the nurses say through this weekend... today's hospitalist just said she would go to the skilled care nursing facility as soon as tomorrow.  He was very pessimistic about her walking and recovering.  He did say IF her mind is clear (it is - or was) and she was mobile before (she was), she has a better chance of recovering... but he was still not encouraging.

The surgeon admonished me that "in the next three years, the fatality rate for hip surgery is as high as 50%, due to complications."  As one dear friend - and Hospice nurse - told me on Tuesday morning, "this may be the beginning of the end."  The worst is watching Mam-ma suffer.  She cries out almost constantly in pain.  Yet when you ask, "Are you hurting?" she replies, "No!"  However, the furrowed brow and her cries from her "sleep" belie this.

Meanwhile, my sister and I have been hospital sitting.  My husband was with me for the ER portion and much of the next day, and he is tremendous support.  I have already gained a reputation as a "bulldog" at the nurses' desk... one that doesn't bother me in the least.  I am looking out for my Mam-ma, and I will never apologize for that.  We have wonderful nursing care; however, things happen, and already I have been reminded how important it is to have someone overseeing things at all times.  We have not stayed with my grandmother overnight, but we have tucked her in each evening, and I am about two minutes from the hospital, with phone numbers and other info posted on her white board.  I don't know what lies ahead when we transfer to the skilled care facility.  I figure I am going to have to do a lot of monitoring... but also a lot of trusting.  I must remember to pace myself.  Thankfully, I have lots of loving folks who will remind me of this!

The nurses are gently telling us that Mam-ma probably won't get out of bed much, based on the "progress" these two days... that we most likely are looking at a permanent move to skilled care nursing, with possible "sit-up" sessions in a bedside chair or for the toilet. We know this is out of our hands... and beyond our control... but we know that Someone is completely in charge, and we are trusting His outcome. And so we wait.