Please Don't Hurt Those Broken Hips!

Thank goodness it’s Saturday. I know I probably went to sleep last night with a smile on my face knowing that when I woke up, there would be no one here but Mother, the cat, and me. Mom’s peacefully dozing, the cat's curled up at the window, the house is calm and blissfully quiet, and I can move quickly from one job to another without being interrupted to the point that I never accomplish one thing. There’s a lot that has to be done here in a day just to keep up with Mom’s care, and all the other things I’m responsible for have to be sandwiched in between, or after, she’s seen to. Add a new aide to the mix, and as quickly as their coming and going here, and believe me, things are quickly out of control. People keep asking how in the world I handle it all and my response is that I’m sure I went crazy a long, long time ago and just haven’t slowed down long enough to know it because I know no sane person could deal with it. If that is the case, it’s was a blessing, but I prefer to think it’s by no more than shear determination, and thinking about what the alternative would bring to Mom if I didn’t.

So that you don’t think I make mountain out of molehills when it comes to Mom’s care, I’m going to try to explain why most of what is done for her has to be done in specific ways. She’s not the kind of patient that someone can walk in the door and start caring for. To begin with, I’ve been told her condition is more advanced than that of someone who is cared for at home because most caregivers, especially someone who has to do it alone, have usually cried uncle by now and found a nursing home. Don’t get the wrong idea. She definitely is not at death’s door. I always say that with hesitation because something could crop up today that changes that and I know it. She has a problem now with her stomach that concerns me and that I’m hoping yesterday’s blood work will lend a clue to, but her vitals are good, her weight is good, her skin is in better condition than mine, and she’s so full of pee and vinegar that she doesn’t know what to do with herself. But her broken, but mended hips, and the contracted legs that are attached to those hips mean that you have to respect her limitations and then move and position her in specific ways.

I have read, and been told, that the average life span of someone Mom’s age with just one broken hip is one year, if they don’t die within hours, days or weeks after it happens. Both of her hips were broken three years ago and miraculously she is still here. She received no emergency treatment that I can determine when it happened in the hospital, and I brought her home without knowing what was wrong. It was seven weeks later that I learned of the fractures, even though I’d begged hospice all that time to have x-rays taken so I’d know why she was in so much pain and so I’d have direction as to how to turn her, even touch her, without hurting her more. Throughout those seven weeks, she was handled by numerous hospice nurses and me, and even made to lay propped on her side when she had wound care for the growing bed sore, or even when changing her pants, all the while with two broken hips. That was inhumane and I will never forget it. But that’s another story for later.

Not one doctor or nurse, no one, ever explained how to handle her once the truth was known. In fact, I learned about the fractures during a hospital stay for an unrelated problem when a rude, arrogant, and obviously burned out orthopedic surgeon came to see her to determine if she was a good candidate for double hip surgery. When I asked why in the world for, he said because she had two broken hips. It knocked the wind out of me and painful images of her propped on her side all those weeks flooded my mind. I was in total disbelief, angry, hurt and ashamed to think of what she’d gone through because of my ignorance and hospice’s avoidance. After the surgeon saying she obviously wasn’t a candidate because of her deteriorated condition and asking in an accusing tone of voice how it had happened, I gathered myself together and said that before I told him something he probably wouldn’t want to know, I would like to know first just who in the hell he was because he’d never introduced himself. Turned out he was a senior orthopedic hospital doctor and after hearing that it happened in ICU right there in that hospital, he said it didn’t, that they were old injuries, which implied it had happened at home and, boy, did I tell him differently. He started to leave and I said the least he could do was tell me where to place my hands and how to turn her. His response as he brushed me away with his hand? “Just do what you have to do and let her lay.” With that, he turned and walked out and it took all I had to keep from chasing him down and cold-cocking him, even if he was bigger than me! He’s on my people-to-pay-a-visit-to after our journey here ends.

I brought Mom home determined to put together the story of what had happened to her in ICU and even more determined to learn how to safely handle her, and to protect her. I brought her x-rays and radiology reports home even before she was released so I could see where the fractures were. I only managed to get them that quickly by saying I needed them for a second opinion. I just didn’t tell them it was mine. If I hadn’t fibbed a little, I would have waited weeks for them to be released.

I once managed a radiology practice so x-rays and reports were nothing new to me. I didn’t know much, but at least they weren’t new to me. I saw for myself the femoral neck fractures on both the right and left just inside the hip bone, and learned for the first time of the identified object in her pelvic area, which was noted in the radiologists report. I have a theory about how it got there, which I’ll explain in another post. Luckily the fractures were clean, not splintered or ajar, which I’m sure has a lot to do with why she’s still here.

I spent hours visiting every reputable orthopedic site on the Internet and reading about hip fractures and contracted legs. What I learned concerning life expectancy and resulting life-threatening health issues was terrifying, but I knew that being well informed was my only chance of not adding to her misery. I learned about keeping her flat as much as possible, about lifting both legs as a unit and never forcing them apart, about not rotating her hips and torso or make any movement that might cause grinding of the joints, which could cause a bone splinter that could puncture or sever a blood vessel, just the basics that I could read and understand. Those things combined with common sense, like not gripping her hip and applying pressure to it when I turn her up, or supporting the small of her back once she’s turned, just plain common sense, plus Mom’s help in letting me know what hurt and what didn’t has played a large part in us making it as far as we have. Her hips are healed now, although improperly and forever weakened, and she has relative comfort as long as you take a few simple precautions when you handle her, especially when turning her. It hurts her when you don’t and you are risking breaking those hips again, or something else, if you don’t understand the reason for and necessity of memorizing those few simple steps. That’s why I stay around the clock with her when she’s in the hospital because I have yet to meet a nurse, or their aides, or, believe it or not, a doctor who seems to know them, or if they do, follows them. And that’s in a darn hospital!

That’s also why I hold my breath each and every time a new aide walks through our door because if they don’t listen, don’t have the reasoning skills to understand the logic of what I’m explaining and demonstrating, and the ability, sometimes even the concern, to do what I so carefully show them to do, Mom will be at risk any time they work with her. Add that to also having to teach them how straight to set her up before putting anything in her mouth that will result in swallowing, what aspiration is and what to do should she gag or choke (Please!), how to REALLY wash a bottom, how to straighten her body out when they pull her up so she’s not left to ache in an uncomfortable position, just the simplest things, and you can understand why I love weekends. And why I don’t want her in a nursing home where I can’t be there to watch over all those things. I don’t want her to relive the pain of broken hips, or die from it.

Poor thing. Do you know what I think of when I look at what she goes through every time someone is trying to learn to change her pants? Have you ever taken a CPR course? If you have, you’ll know what I’m talking about. If not, I’ll explain. People practice on a life-sized, soft rubber dummy. It has a mouth that’s open, a tongue, and nostrils, and when you hold its nose and breathe into its mouth, its chest rises and falls, just like a real person. That’s poor Mother, rolled around like a sack of potatoes, gripped awkwardly in all the wrong places, ending up in positions she shouldn’t. I feel like she should be stamped all over with For Demonstration Purposes Only. I just wish I was Wonder Woman again and could take care of her by myself like I did for the first four years she was sick. But I can’t. ICU saw to that. I’m older now and she’s physically harder to care for, and I just can’t. But, oh, how I wish I could, for both our sakes.

Till next time,
Sharon