Journal: Hemiarthroplasty and Other Things That Make Me Shiver

 

Last Tuesday when I pulled another armload of albums from the hope chest to carry them upstairs to scan, I found one that I had entitled “The Blink Album” and given to Lydia years ago.  It’s full of pictures I took of people – right when they blinked.  People look funny with one or both eyes at half-mast.  Everyone blinks, but if they happen to get caught on film like that, well, there they are, looking half there for all time.  When Lydia was 4 or 5 years old, she thought those pictures were totally hilarious.  Sooo... instead of throwing them away, I put them in an album and gave it to her.  She giggled and giggled over that book of funny pictures.

Anyway, this means I have one less album to scan. 

Wednesday was Bobby’s 42^nd birthday, but we wouldn’t have a chance to give him his gift for a few days, because I got a phone call from the nursing home that morning, telling me that Loren had been taken to the hospital. 

When a nurse went into his room that morning to tell him it was time for breakfast, she was surprised to find him still in bed and not up and dressed, his bed made, and ready for breakfast as he usually is.  He said his hip hurt, he couldn’t move his leg, and he couldn’t walk; so the nurse called 911.

I quickly got ready and went there.  On the way to Omaha, I met Larry coming back to Columbus with his boom truck and pup (trailer), fully loaded with the aluminum forms they use in making poured cement walls.  He’d been at a job in Blair.

I felt so sorry for Loren; he was in quite a lot of pain, and, thinking the pillow under his leg was causing it, asked me to move it.  I made a pretense of moving it a wee bit, and then Loren, not satisfied, got a grip on it and tugged – but that hurt him so much he quickly stopped. 

Yikes.  Made my hair stand straight up on end. 

I told him, “I don’t want to do any moving of you or your pillows!  I’m not cut out to be a nurse!  I’m not even cut out to be a veterinarian!” 

He laughed about that.  

After visiting with him for a while, I was getting really thirsty.  I walked into the hallway and asked a nurse where I could get a drink.  She directed me to a nook where there was a sensor-activated ice and water dispenser.  I got a cup, held it under the ice spigot, and ice came ker-plunking out.  Then I held it under the water spigot, got a few spoonfuls of water – and that was all.  I wiggled the cup around, bumped the cup into the dispenser here and there, then tried bumping and pressing my hand against the machine where there was a red oval just behind the spigot.  Nothing happened.

The nurse, still standing there, said, “Touch the sensor with the back of your hand.”

I did (again).  The machine gurgled and spluttered.

She reached over to show me.  The moment she touched that red oval, water poured into my cup.  However, her arm also touched the sensor for the ice dispenser.

Ice rattled out and shot around all over the little room.  The nurse jerked her hand back.

We laughed, and the nurse exited stage left.  I gave the water dispenser another try.  Nothing.  Not even a drip.  I kept trying.  The machine made ominous noises.  I moved to the side a bit, the better to try touching it with my other hand.  In so doing, I got a little too close to the sensor-activated paper-towel dispenser, and, with a buzz, paper towels came rolling out, putting a stream all the way to the floor.  🙄

I gave up, put more ice in the cup, and hoped it would melt quickly.  I was thirsty!

Loren thought he had hurt himself mowing.  He said he had been driving his riding lawn tractor through his yard when one of the wheels dropped into a grass-covered hole, and he knew from the way it jarred him that he had been injured.  Thirty minutes later, he told me he had stepped into a hole.  

He kept thinking he needed to get up and ‘go to work’ – but said that every time he tried, his hip hurt too much. 

“So I’ll just have to be patient, I guess,” he finished, and I agreed, that would be best.

I showed him Instagram pictures of our grandchildren and of our nephew Kelvin’s grandchildren, too.  He’s tickled that there’s a baby named Kelvin.

He was really happy when one of the nurses wrote my name on the whiteboard in his room, though it bugged him a bit that she only wrote ‘Sarah’ rather than ‘Sarah Lynn’.

He began wondering how he was going to manage to do all the things he needed to do, when he was in so much pain.  I told him how badly we all felt when we heard he’d gotten hurt. 

“We are all praying for you,” I said.  “And we know that God always gives us grace to bear whatever our trials might be – even if they might seem unbearable at the moment,” I said. 

He smiled, nodded, and answered, “I absolutely believe and know that!” and gave my hand a squeeze.

My nephew Kelvin told me there’s very good food in the hospital cafeteria, and the salmon is particularly good.  We ate there once or twice back when Norma was in that hospital; but I don’t much like eating out all by my lonesome.  I had brought a few snacks such as dried cranberries and mixed nuts to eat, but I discovered when I headed home that evening that I was totally starved, having had nothing but a bowl of cereal in the morning.  Furthermore, it was rush hour in Omaha – a silly moniker; it should be called ‘turtle hour’, since nobody can rush, and we all must crawl like turtles.

That removed any chance of getting home in time for the evening church service, so I bought a chef salad and a cup of fresh-cut pineapple at Love’s Truck Stop on the west side of Omaha, then stopped at Fremont Lakes State Park to eat it.  It’s a pretty place, and I don’t mind eating out alone, if it’s waaaay out – outside, that is.  

I got Larry a smoked turkey sandwich, and saved the remnants of my salad for him, too.  Good thing I’d brought a cooler with a freeze pack in it; it was hot that day.

Thursday, I talked with a nurse who told me Loren would be having surgery at 3:00 p.m.   It would likely take a couple of hours, and then it would be a while before the anesthesia wore off.  He was on pain medication and sleeping quite a lot.  She said he was doing all right unless they had to move him, and then he was in a lot of pain.  

“You can come if you want to,” she said, “or you could wait until tomorrow, when he’ll be more awake and feeling better.”  

She mentioned that then I wouldn’t have to drive home in the dark, or in mid-Omaha during rush hour on my way there.  So I decided to wait until the next day to go see him.

Loren’s surgeon called me a little before 6:00 p.m.  Surgery was done, and all had gone well.  The doctor had done a hemiarthroplasty, which is a replacement of half the hip joint.  Loren had broken off the ball, or femoral head, of the hip bone.  The fractured ball was replaced with a metal ball and a metal stem that runs down the inside of the thigh bone.  This procedure heals more quickly than a total hip replacement, and he would be able to start putting some weight on it in just a few days.  

“He shouldn’t be in nearly so much pain as he has been,” the doctor told me.

He would be in the hospital for a few more days, and then they will move him to a rehab center, until he is able to return to the nursing home.  They do have a physical therapy room there, and a therapist who works with the patients; but probably not with the intensity Loren will need for several days to come.

I’ve been reading about hemiarthroplasty and fractured hips, and found this:

One in three adults aged 50 and over dies within 12 months of suffering a hip fracture.  Older adults have a five-to-eight times higher risk of dying within the first three months of a hip fracture compared to those without a hip fracture.  90% of patients over 80 years old pass within 12 months.  This increased risk of death remains for almost ten years.

I knew the mortality rate increases significantly after a hip fracture, but didn’t realize it was that high of a percentage rate.  I also learned that elective hip replacement does not raise the mortality rate in the same way.

As for the reason this happens, here’s what it says on some of the online health/medical journals: 

Combined with the trauma of a fracture and surgery, an existing health condition may significantly increase the risk of death.  Death after a hip fracture may also be related to additional complications of the fracture, such as infections, internal bleeding, stroke, or heart failure. 

Another one says this: 

Several factors can contribute to death after a hip fracture.  These range from issues that led to the fall, such as cardiovascular, pulmonary, or neurological issues, to post-surgical complications like infections and pulmonary embolism.

Next, I read about restrictions after hip replacement: 

·                  Don’t cross your legs at the knees for at least 6 to 8 weeks.

·                  Don’t bring your knee up higher than your hip.

·                  Don’t lean forward while sitting or as you sit down.

·                  Don’t try to pick up something on the floor while you are sitting.

·                  Don’t turn your feet excessively inward or outward when you bend down.

·                  Don’t reach down to pull up blankets when lying in bed.

·                  Don’t bend at the waist beyond 90 degrees.

 

Loren won’t at all remember all that, but perhaps the pain might keep him from doing it.

That evening, Kelvin, who has been fighting colon cancer for well over 5 years now, told me that recent scans had shown that the cancer was gone out of his liver.  He will be able to stop chemotherapy, as long as his scans remain good.

It was so wonderful to hear that.  We’ve been praying for him daily for many years now.  This is such a relief, as the chemo always makes him sick.  We are very thankful.

I often say we have no trials but what we have some blessings, too.  Well, that’s our blessing to lighten the trials, right there.  At least, that’s one of them.  There are more.

We’ve had a lot of upheavals in the last couple of years due to Loren’s dementia, but none whatsoever since he went to the nursing home.  I think they should call his medicine ‘happy pills’.  Ha ... just kidding.  I knew we couldn’t give him pills like that when he was home alone, because they have so many side effects – including loss of balance.

I read everything I could find about it, and figured we’d just have to wait on medication until he was in a home, if and when that happened.

The first pills a doctor gave him, back in early 2020, were for Alzheimer’s, not Lewy Body Dementia.  That medication is known to make hallucinations worse – and indeed they did just that.  

Do you know, no doctor has ever once said he has Lewy Body Dementia?!  Just me, ol’ Mizz Quack Doctor Internet Diagnosticator.  In fact, the doctor who gave him those first pills did not even mention Alzheimer's, not once.  At least, not to me, he didn’t.

However, the nurses at Prairie Meadows are in full agreement with me – and many of them have had years of experience.

“It’s hard to believe he was driving such a short time ago,” remarked Kelvin.

“Yes,” I responded, “but... like Dr. Seuss said, ‘Oh, the places he’s been!’”  😄

Friday, I went to see Loren again.  He was asleep when I got there, so I quietly watched construction going on down at street level, from his eighth-floor window.  He awoke in ten or fifteen minutes, and smiled happily when he found me in his hospital room.  But he told me regretfully, “I haven’t gone to work yet today; I just wasn’t up to it.”  

(He retired in 2013, I think it was, when Janice was so sick with cancer, and he’d been partially retired for several years before that.)

He was doing better, and not in nearly so much pain.  I pulled up Instagram on my phone to see if there were any new pictures of our offspring since Wednesday – and there were.  Loren very much likes to see pictures of our grandchildren and Lura Kay’s great-grandchildren.  He’s learned to hold the phone by the edges and not touch the screen, or odd things happen.  One time a couple of months ago, he accidentally swiped the screen sideways and landed on ‘selfie’ mode.  He really laughed when suddenly there he was, looking at himself.

I did my usual bit in praising doctors, nurses, and the hospital, and saying how thankful we are that he is in one of the very best hospitals in the country.  (It’s true; he is.)  He readily agreed, and told me everyone treats him wonderfully.  I could see by the whiteboard that he had been up and walking with a walker and two assistants twice so far that day.

He likes his whiteboard, and every now and then he reads it to me in its entirety.  It lists his doctor, nurses, physical therapists.  It says he is to have a ‘regular’ diet – this makes him laugh, and he wonders what an ‘irregular’ diet would be.  I explain that that means he’s not allergic to any foods, so they can feed him anything on the menu.  I showed him the menu, and he was right properly amazed – it’s two full pages of a wide variety of yummy dishes.

That day, he figured out what the ‘POA’ behind my name meant.  Wednesday when he asked about that and several other abbreviations, I was a bit leery about letting him know I had Power of Attorney over his health decisions, so I said, “I’m not very well-versed in medical abbreviations!”  

Friday, however, having suddenly understood those letters, he seemed downright pleased about it.  I told him I had signed all the papers for him, giving the doctors permission to do his surgery, and the therapists permission to help him.  He was nothing but cheery appreciation.

He was happy because a nurse had found lots of beautiful scenic pictures for him to look at on his TV.  That may or may not have ever happened.  He often doesn’t like a TV, with all the noise and objectionable programming.  Perhaps he’s remembering the digital picture frame I gave him several months ago?  But who knows; maybe something from National Geographic was on.

The nurses remark on how pleasant Loren is – and how some of them, not knowing he has dementia, are totally fooled for a time when they first talk with Loren, as he carries on an intelligent and seemingly lucid conversation.  He seems so plausible! – but it’s only a matter of time before they realize that his stories are drawn almost solely from his own imagination.  And as he talks, he contradicts himself, or cannot recall a simple, easy word, and then his entire story peters out and gets lost in a mist.

Maybe that right there is why the family doctor never did really diagnose him as a dementia patient, even though the tests showed Loren’s cognitive skills were decreasing greatly.  The doctor didn’t argue with me when I told him what I thought.  On the contrary, he gave it thoughtful consideration.  And he did his best to help us when we were hunting for a nursing home for Loren.

We have encountered nothing but kindness from the staff at the nursing home, and now, from all the nurses I have met at the hospital.  Loren never neglects to thank anyone who does anything for him, anything at all.

As I traveled that day, I met a pump truck, two dry cement haulers, and a side-dumper, all belonging to friends of ours who own Heartland Cement Placement and Gehring Ready-Mix.

It was our 43^rd anniversary that day.  It’s been a long time... and it hasn’t been very long at all.

That morning, I received a notification telling me that the New York Beauty quilt has been accepted into the Des Moines AQS show, which will take place in September.

Saturday, Larry was able to come with me to see Loren for the first time since he got hurt.  First, though, we were going to meet his sister Rhonda at Panera Bread.  We hadn’t even gotten to North Bend before Larry was falling asleep, so I drove the rest of the way.

We gave Rhonda the quilt Norma had hand-embroidered and hand-quilted, several pieces of Norma’s costume jewelry, and the gold wedding bands and diamond ring that Larry’s father Lyle had given her when they were married in 1958.  Rhonda cried over those rings.

I knew exactly how she felt, because I cried over a pair of my mother’s eyeglasses when my sister and I were cleaning out her house, even though they were old glasses that I had not personally seen her wear.  However, I had an old picture of Mama with my older siblings, Loren, Lura Kay, and G.W., that I particularly loved, and she was wearing those glasses in the photo. 

Mama was in the hospital when I came upon the eyeglasses, and we knew she would not be coming home again.  So... there were those glasses... and I cried over them.

I also gave Rhonda a thumb drive with around 1,700 of Norma’s old family photos.  

Then we went to see Loren.  He was doing much better that evening.  He was happy to see us, and didn’t seem to be in any pain at all.  He was watching something on TV when we came in.  After a few minutes, he decided to turn it off so we could hear each other better. 

He pressed the red button.

On came the light and the bell to summon the nurse.  I went out to tell them it had been an accident.  I only found one nurse, and she was not at all worried about Loren’s light blinking and bell donging; whataya bet he’s done that time and time again?

As usual, he told us he hadn’t been able to go to work, “but I think I’ll be able to tomorrow,” he said. 

I worry that he might try to get up and fall again.   But he did read me the sign on his wall, “Call, Don’t Fall,” at least three times, though he was a little confused as to exactly what it meant, and somehow got it all tangled up with a story of flying Uncle Don’s airplane.

Uncle Don, Daddy’s oldest brother, never had an airplane.  However, Uncle Howard, Mama’s youngest brother, used to have a powerchute.  I told Loren of the time he’d had engine trouble and set it down in a field.  He was going to work on the engine, or maybe walk for help (back in the days before cellphones) – but suddenly he was surrounded by a herd of curious cows who started licking the frame and the wheels, and nibbling on the nylon wings.

Uncle Howard said, “I was afraid if I got out, they’d nibble on me!”  haha  (Of course he understood cows just fine, since his family had raised them, along with a menagerie of other animals, from the time he was a wee little boy.)  

Loren laughed and laughed over that story – and then wound up on some errant idea about helicopters.  We went with the flow, and discussed sightseeing at the Grand Canyon.  😆

I fixed my name on his whiteboard, adding ‘Lynn’ to ‘Sarah’.  Loren was highly impressed with the eraser.  “I never saw a chalkboard eraser work that well!” he said with a shake of his head.  “Techno-logy (pronounced like two separate words) just keeps —” he couldn’t think of the word he wanted (‘advancing’ was what he was looking for, probably), so he made upward stepping motions with his hands.  

I told him, “One of these days, you’ll be able to just talk to your whiteboard to write on it!”

Bah.  I just looked it up, and discovered it’s already been invented.  You can have one for a couple thousand bucks.  See, if I’d get my brain in gear and dream these things up before anybody else, I could be a multi-billionaire by now!

Methodist Hospital is huge.  The parking garage is huge.  I like to explore, so I take different routes into the building and up to the eighth floor each time I’m there.  If anyone looks at me funny, I speed up and go rushing along like I know exactly what I’m doing, where I’m going, and why.  I must not be interrupted!

Hopefully, if I ever get lost, I’ll be able to use my phone.  In the depths of that maze of a parking garage, there is no signal.

We parked clear up on the top level Saturday, right next to the helicopter pad.

The harvest has begun in the southern states, and Jensen Farms Custom Harvesting is on their way south.  These are huge pieces of farming machinery we saw on the way to Omaha.

On the way home, we stopped for banana splits from Dairy Queen, and ate them at the city park in Valley. 

A second person has died from that bad wreck west of Fremont a week ago, the one that caused me to detour several miles to the south.

As we headed home, Rhonda sent pictures of the quilt on her bed, writing, “It matches my bedspread!”

And it does. 😊

Sunday, the back seat of the Mercedes was full of a variety of things I wanted to give (or return to) the kids after church.  We managed to clear it all out except for “The Blink Album”, which I intend to give back to Lydia.

We gave Bobby his birthday gift:  four wooden sailboats with lots of canvas sails.  They used to be Loren’s.  We had given him the biggest one in 2006; Janice had taped the gift tag to the bottom.  We also gave Bobby a set of Menards tools with wooden handles.

We returned to Hester the dish in which she had given Larry the strawberry-rhubarb crisps, and also some brown dress shoes she originally gave to Kurt.  They didn’t fit him quite right, so he gave them to Larry (though I have ever since accused Larry of stealing them from him).  They look nice with Larry’s brown suit, but after wearing them a few times, he doesn’t want them, because the rubber soles make him trip.  He gave me a thorough demonstration of how he goes tripping up the aisle on the way to our pew at church, arms churning like a windmill.  🤣  He’s used to the smooth leather soles of his boots.  You’d think they’d be fine, since he has thick rubber soles on his work boots; but... nope.

Before heading off to church, I texted Hester, “We also have the brown shoes you gave Kurt, which Daddy then stole clean offa his feet; but they trip him up.  I was going to give them back to Kurt, but Victoria said to give them to you.  I wonder... Does Kurt have any say-so in this at all????? 😆”

Hester replied, “😆😆😆 I think she got him new ones.”

(She did; they were his Christmas gift from her.)

I wrote back, “I keep imagining Kurt padding home from church in his socks, and Daddy going home on all fours, boots on feet, shoes on hands.”

Hester: 😅

We also gave Oliver a set of onesies with koalas printed on them in the next bigger size, since he’s growing out of the ones we gave him when he was born.  

Of course I couldn’t give Oliver onesies without giving Keira something similar, so I gave her a pair of fluffy bedroom slippers with llama faces on them.  This turned out to be the perfect choice, because she had only recently grown out of or worn out her well-loved slippers, much to her dismay.

Shortly after we arrived home, Hester sent a couple of videos of Keira thanking me for the slippers:  “Thank you, Grandma; you’re the best!”  She blew me a kiss.  In the next video, she explained in a quick, business-like tone all about the old slippers and what had happened to them.  She finished by suddenly hopping up and down in Grand Exuberance and crying happily, “—but now I have NEWWWW ONNNES!!!!”

Today a friend, upon seeing some of my pictures, wrote and asked, “Were you driving and taking the photos?”

I immediately did what I could to set her mind at ease:  “No, I hired a squirrel for the job.”

Bedtime!