Water Therapy - It Works

                                                                                                
Mom's water therapy is finally starting to pay off.

She began her therapy for her back, actually, as she suffered a compression fracture last summer. Her back doc had not released her for land-based physical therapy, and I finally convinced her to give water therapy a try. From the beginning she loved being in the water, but after a few sessions, she fell again. She had been to lunch at the golf course and fallen, on the way out, for no apparent reason. She didn't think it warranted a visit to the doc, though. The next water session she mentioned the fall to her PT. She witnessed my mom's pain and tested her strength. Then said she would not treat her until she saw a doctor. An X-ray showed a big chip on the edge of the flange part. Remember, that is the same hip she broke, (snapped the ball clean off,) in February. Therapy changed then, to focus on strengthening that hip.

Let me share with you, the common drill on PT day:  At 9:00 I make a wake up call to mom, and I know now (after finding her still in bed an hour or two later,) that I need to say, Don't go back to sleep!  Then, about 1/2 hour before appointment time, I go over.  I'm almost always met with the comment that she's feeling bad, and that it's the worst she's felt in a long time.  She continues by saying she would skip therapy, but knows I won't let her.  She is right.

Getting out of bed, and dressing for therapy, is kind of a workout in itself, at this point.  I know she has a lot of real pain, but unless she gets moving, she'll not feel any better.  The situation is the epitome of use it, or lose it.

After she is dressed, we'll have some iced mocha, or juice, at which time she asks, Do you think this therapy is doing any good?  My response is the same each time, at the very least it is helping you not to decline further.  She always replies, Oh, that makes sense.

At therapy, she tells the therapist she feels great!  Her medication takes her from worst day ever to feeling great!  Sometimes I call this to her attention, because her tendency is to say
the meds Just don't work! or that her doc is not managing her pain at all!  But, more often, I don't mention it.

The therapist questions her on her pain level (on a scale of 0-10) upon waking, in the pool, and after. She has gotten pretty good at utilizing the scale she once deemed ridiculous. Her pain changed all the time, she said, and she could not rate it like that. Now she gives some thought to the question, and answers without looking at me with the look that says, Isn't this ridiculous?

Monday she had therapy and was re-evaluated.  In the past, these assessments were met with, not only, the look, but verbal disgust, as well. Both her PT and I explained, several times, that medicare won't continue to pay unless she is making gains, so the improvement must be documented.  At this point, she has been through PT enough to know complaining about the process won't change anything.

After this final assessment, we learned she has improved dramatically!  I was as thrilled as she was, and that carried us through the day. Today is Thursday, though, and she is not feeling well enough for therapy. Oh well, as soon as it stops raining, and warms up a bit, we can go for a walk...maybe.

The Poor Home

Mom and I have visited the 2 assisted living places I think she might consider, and she told me that Buffalo Hill Terrace is a far cry from the Poor Home back in her day. Old people went to Poor Home to die, she remembered. School children use to visit those folks to sing, or visit, but she said May Day was the best. Her eyes lit up when shared, kids would gather all the wild-flowers they could find, and arrange them in the paper baskets they had fashioned. The story ended when she smiled, saying, Those folk were just delighted when they received their baskets!

Then she asked me if I thought kids did this anymore. We've had the May Day conversation before. I'm sure, because I remember she was sort of disgusted that nothing is really done nowadays. With that in mind, I skirted the May Day issue. But I told her I remembered choir classes, from schools where I taught, often went to assisted living places to sing for the residents. She liked that kids still sang for old people.

We visited the 2nd option, the next day, and she was very taken with the fact they had a house dog. Dexter was a sweet little dog, and it surprised me that she remembered my son's dog had the same name. She agreed that it was homier than the 1st place, but thought the personal space lacked imagination, and let our host know that the colors were all wrong.  She tends to be opinionated.

She asked me if it bothered me that she would have go somewhere like that.....some day. I said it would make me sad because I knew how much she loved her house.  I had told her before, but continued by saying if it turns out I need to help her physically, any more than I already do, it wouldn't be safe for either of us.  She agreed wholeheartedly but she told me if things didn't change; if her health and capabilities remained the same as today, she would be able to stay at home, alone, until she died.  Mom also warned me that when that time came, if she griped, or bitched, we were to just ignore her.

Sure, I thought, easier said than done.

Phones, But Not Cell Phones

Mom is pretty much over the newness of the car, and has reminded me several times that she can't drive and therefore has no life. Her friends, she says, are far to busy to come see her so she won't invite them to stop by. Also, she points out, they initially showed concern, and talked about picking her up to do things like lunch etc, but have not phoned with specific plans. But, she hadn't heard from anyone for some time, and was down; on herself, her lack of life and her so-called friends.

Then I got a call from R (an old friend of hers) who said she had called mom's number several times with no answer. She had left messages that had not been returned, and had heard through the grapevine that friends were experiencing the same thing. They were worried.

I suggested she call mom the next day, while I was there. Then, I could make sure the phone was answered. She liked the idea, but told me not to let mom know we had made these plans. I'm not sure if it's a head injury thing, on my part, or a generational thing on her part, but I was amazed that it was so important to the friend that I remain secretive. I did what I almost always do in such situations, I ratted us out.

Before the call was to come in, I shared the information with mom, as if to say See, your friends are worried about you; they love you! She gave me the look that said You simply don't understand. When the call came in, the TV was off (it's the 1st thing I do when I get there, or I can't even hear myself,) and we heard the ring. I took the phone to her and a pleasant conversation followed. They even set up a lunch date for the following day.

One of mom's issue, as with many older people, is her hearing. Her TV is always on, with the volume set way loud, so often times she just doesn't hear the ring. To this statement, she would disagree, but I'll continue.  She said no one was leaving messages, therefore her phone must be broken. And because it was broken, she needed a new one. After a quick system check, I realized she was right, she had NO messages! 

I haven't had a real phone, or answering machine for ages so trying to get to the bottom of mom's techno mess was no easy feat. We started at Costco by buying a set new rechargeable cordless phones that looked vaguely familiar, and after bringing them home I realized why. They were the exact phones she already had. But, I rationalized, I would set these up and know exactly to use them, and therefore, I'd be better able to help her.

My first exercise was to get the phones plugged into the right places. I followed the instructions initially, then I got a wild idea; since they were the same, I would just hook the new phones up exactly like the current phones. The one in the kitchen was easy; it was just a plain old electrical outlet.  As I plugged it in, I read from the manual something like this: At the end of your call, push the end call button and return the handheld unit to the base for the unit to recharge.

This is fairly straight forward, I know, but I wanted her to hear it from the actual manual.  For years she has left phones off the hook, requiring my sister or myself to go search her home for the handset that wasn't hung up. Her response was just as I suspected, Sheesh! Of course I hang up and put it back!

The next phone was the base phone, and would need to be next to an actual phone outlet.  I what those looked like, so I didn't see any problem. To get to the outlet I had to crawl under the desk (housing both her computer, and TV) in her bedroom.  With my lack of agility, getting to, and working on my back, on the floor, is not an easy task. Then throw into the mix my sweating-profusely-under-any kind-of-stress/tension/anxiety condition, and you can imagine what kind of shape I was in. Back and forth I went, from reading the instructions to copying the previous set-up.

There was a small white phone outlet box next to the electrical outlet, but it's insertion spot, (the male part where the female part goes,) was on top of the box and not visible to me.  That's OK, I thought, I know how these work and I'll be able to feel which way the female part should be held in order to make the connection. Well, I tried every which direction, but was unable to make it click. As sweat poured into my eyes, I tried every direction again, and again, bonking my head on the solid desk more than once.

After many failures, I realized that the little white box was connected to the modem on top of the desk. That I could get to easily so I connected the new phone directly to the modem. And guess what?  I had a dial tone! But I wondered if this would be ok in the long run. To get the answer, I had to call the phone company who provided services to my mom. She had the package deal: phone, computer and TV all on one system. The company assured me that a lot of people connect directly to the modem, so I figured mom could be one of them.

Now mom had a working phone, but her answering machine/message issue was far from resolved. The manual told me how to set up my voicemail, which I did, and I found 17 unheard messages there! I was getting somewhere, now, and I was right!  She had been getting messages, but they were in her phone company voicemail, and not on the machine included with the phone.  

That was when I realized when she moved to be across the street from me, back in September, we didn't know her phone stuff was going to be different than it was at her old place. We knew nothing about retrieving messages from space because we assumed the machine connected to her phone was storing them. WRONG.

I learned how to retrieve messages, and even left one from my cell, retrieved it and showed her how it worked. All she does is dial her own number and she's in the voicemail system.  From there, she just listens and responds.  I watched her do it and was certain her problems had been solved, at least those problems.

And by the way, the lunch date went splendidly and she was very happy she had done it.

Driving Ms. Shirley

Mom recently took a fall and chipped a piece off her hip; the same hip she broke last February.  An X-ray showed the chip and a physicians' assistant (PA)  gave her the news. She refers to PAs as paras (probably because I worked as a special ed para educator.)  And because she knows it irritates me.

The Para tested her strength in the compromised leg and told her she shouldn't drive anymore.  I know, it's devastating to be told you can't drive, right?  It must make you feel so dependent, and almost trapped.  So, I was glad she had discovered this just as she was leaving for Oregon to visit grown children.  I knew, even before she left, that I needed to extract the key while she was gone, but the thievery didn't weigh too heavy on my mind. (What does that say about me?)

Just as we were loading up for the airport, she reached for her keys to pack them into her gigantic purse.  Quickly, I told her she wouldn't need them as I'd be picking her up when she came back. Three different attempts were thwarted, before we left.  The next day I returned to her house and nabbed the key.

She returned from Oregon, but didn't notice the  key was missing for a few days.  When she did, she phoned, incredulous about where it could be. I had my confession rehearsed, so it came splashing out and included all of the following.

• The para had tested her left leg strength and told her not to drive!
• All of my siblings had told me to do it!  (Boy, isn't that a wimpy excuse?)
• She really hadn't driven much recently.
• I'm just across the street and would drive her anywhere she wanted to go.
• It would leave room in her garage to go through unpacked boxes for the impending garage sale.(At that point, I was reaching for just about any up-side.)

After the initial shock, she recovered from the loss of driving privileges fairly well.  I told her we could trade in both of our cars, and get ourselves a new Subaru that would be safer.  She was thrilled with that idea and so a new Forester is how we tool around town.  She loves the car, and is quick to say so, each and every time we get into it, which is about 3 times a week, maybe more.

But to her, the Audi was the finest car she had ever driven, and continues by saying that driving a manual was the only way a driver could feel the car.  Hopefully she can feel the new Forester from the passenger seat, because all we want is to keep her safe,

Chapter 6 Home

The end of my stay in the 2nd hospital came sooner than anticipated.  There was a scramble with my insurance company to get the money to stay longer, but we lost. The doctor, therapists, my family, and husband didn't think I was ready to go home. And to tell you the truth, I didn't either.  In my final psychiatric session I revealed the fears I had about leaving the hospital. The doc was pleased that I was frightened, and explained my fear was evidence that I had grip on my situation.

How was I going to get up and down my stairs?  Would I be able to care for my kids?  Could I clean my house, or mow the lawn like I always had?  I remembered a trip into the desert to gather landscape rocks with my neighbor, and still thought there would be a time when I might do that again.

My family packed up my room; the get well cards, empty vases and every pillow I used during my stay.  A nurse told my parents, She paid for them, she might as well keep them.  The were flat, dead pillows with a lot of bad memories clinging to them and, soon after I got home, I threw them away.

My husband went through the same How questions I had, but he simply hired a nanny to care for the kids and I until more recovery was evident.  Claire, the nanny he hired, was here illegally from England, the relative of one of the agency's employees.  We were near Los Angeles so aliens without papers were nothing new to us. Hiring her was safer than the older woman with tuberculosis, our only other option.  So I went home, after almost 4 months, and I now had an English Nanny, to boot!  

Clair cooked, cleaned and also cared for my kids as I attended outpatient rehab. Overall she was fine, but I was appalled when I learned she taught my children, who still rode in car seats, to raise a hand above the back seat and flip the bird to rude drivers behind the car. It was NOT the way I handled road rage! I think she also played pool in seedy bars on her days off.  But I didn't have much to do with her, she was my husband's hire and I was using every ounce of energy is an attempt to navigate a new world with with compromises I wasn't even aware, at that time, I had.

My parents were there for my release from the hospital, and my ex prepared a surprise party at our favorite restaurant.  I was not in anyway capable of interacting with a roomful of friends and family, so I was guided to my place at a table and people came to me to congratulate me on 1) my survival 2) my returning home and 3) my perfect, gleaming white smile.

I went to a house across the street from Northridge (my 2nd hospital) for rehab. I spent my days there practicing real life, and continuing therapies I started at Northridge. My husband dropped me off before his work day, and then picked me up to take me home at the day's end.  He packed lunches for me that included frozen hamburgers and I relearned how to use a microwave oven. I also had to interact with other patients, as well as the therapists.

Physical therapy sessions also happened at The House, and the equipment included a smallish Universal Gym that I recognized from my high school years.  My long term memories were there, it was my short term memory that was shot.  There wasn't much I could do on that little, all encompassing gym, though, with 1/2 my body compromised. So I started a tactic, (I have used ever since that moment,) to navigate through life; I figured out how to do things differently, using my compromised body however I could. 

When I tried push ups, I could not fully open, and lay my hand flat on the floor as the exercise requires. Even though I wore a brace to keep my bad hand open at night  (and remind my brain, HEY! Relax that hand. Therapists continued to encourage me to lay my hand flat but it was virtually impossible.  So there I was, struggling to achieve the proper hand position when I noticed a the young man next to me. He was a high school athlete, football quarterback I think, who had suffered a head injury too.  Football really is a violent game.  And he was also doing push ups.  

His athletic brain had made the correct accommodation.  One of his hands remained in a fist while he pushed up from the prone position on the floor.  They weren't even trying to get him to do it properly, so I thought I'd give it a try.  When I was able to achieve the needed position, but was too weak to actually push myself up, I remembered that I hadn't been able to do a push ups in many years!

At the house, I also continued playing the computer game Where in the World is Carmen San Diego for cognition. But when my children were old enough to play that particular game, I had only fleeting memories of the game I had once mastered.  Or maybe I hadn't mastered it, and only thought I did.  When I played at Northridge no one checked on me, and I don't remember changing levels, or winning for that matter.

I was fortunate that I was able to stay at home for OT (occupational therapy) because my therapist from the hospital lived near me.  Not necessarily close, but we both lived in California's high desert, which was quite a distance from Northridge.  She agreed to make OT house calls at the end of her work day.  Occupational therapy has to do with being productive in your job, but I was a stay at home mom so my job was running the home.  A huge part of what I did was caring for the kids and getting them fed so she taught me how to make mac and cheese for their dinner.  I hadn't looked at those directions for what seemed like forever, but now I needed to, and I actually had to time the noodles!

She also got me on the floor cleaning tiles in the kitchen because I told her that is how I had done it pre head injury.  Let me say for the record, before my TBI I fit in the OCD category of housekeepers.  No longer, however.  She should have showed me ways to compromise with a Swiffer!!!  Oh, those probably weren't around yet.

She was a help, don't get me wrong, but when I look back on those days I think that I would have benefitted for help dealing with my compromised condition.  Occasionally I feel like the expectation, regarding my recovery was that it would be complete since they were teaching me to do things the way I had did prior to my accident.  

I never did return to that place, physically, or mentally.  And I wonder if I didn't work hard enough.  But then I tell myself I did my best...and I am happy.