On Wednesday, 6/18/08, Barb suffered a bike accident and broke her hip. I will use this page as a day by day diary, showing all that happens during her ordeal. Although the break was pretty bad we fully expect her to make a complete recovery, although it will take multiple months. Sorry, this will be in LIFO order so the most recent day will be at the top of the list. I prefer top posting and, since it's my diary, I get to do it my way :-)
Current Status: Barb is progressing really well, still needs the crutch to get around for long times but she is actually walking around for short distances completely unaided. Phone calls and visitors are more than welcome.
Here it is Monday and things just keep getting better. She's been walking around the house without using the crutches at all, just short distances and never far from a ledge to hold on to just in case but that's pretty impressive. Phone calls and vistors are both welcome, there's no danger of tiring her out.
Barb's home and going to spend the night on the couch, the thought of navigating the stairs to the bed room is a little daunting right now. Having said that, her mobility is infinitely better than after the last operation. She can move around unaided on crutches and just needs help getting up and down. With any kind of luck she'll be fully mobile in a day or two.
The biggest problem is recovering from the anaesthesia, no surprises here. Having trouble keeping anything down today but I expect that that will get better by tomorrow.
My energy level is rebounding - still get tired but now that I can drive I feel liberated! Don was gone last week and Meaghan was at school from 7 - 7 and I survived being on my own all day.
My biggest regret is that summer slipped away and I already feel fall in the air. Don and I slept late every day and had breakfast and the newspaper on the back deck. Now we get up early and it is just barely light and too cool to eat outside. Oh well. There is always next summer!!
I have glimpsed "old age" and it isn't pretty -- the key is to stay active and maintain friendships!
I'll see the surgeon a week from today and Don will undoubtedly post the newest x-rays. I know I am healing so they don't mean that much to me. My next landmark will be the ability to run and jump (still a long way off - but getting closer day by day).
I've said it before - but thank you to everyone for helping me keep up my spirits, keep dinner on our table and send healing thoughts and prayers my way.
Love to you all.
We try to walk in the evening when the heat lets up (Denver/Boulder is having record heat and drought). But I don't get too far -- it is uphill on the way out and all downhill on the way home. I am trying to build up my stamina but it is a slow go -- both because my body is still healing and because I had a pretty low red blood count (hematocrit) that I am still working on.
I am almost done watching all the seasons of "West Wing" and now I can watch hours of Olympics and when that's done there will be the Democratic Convention. How convenient that I have all this free time!
Keep me in your thoughts -- and if you are in the area please stop in -- I get pretty bored!!
Then Monday I was able to start putting a little weight on my left foot (25% of body weight). Tuesday the physical therapist worked me over really good and told me to stop using the walker (aw shucks - I was getting really attached to it) and only use crutches. That has made life a little easier in some respects - I can move a little faster now. But won't be winning any races any time soon.
Wednesday my treat was to finally get my legs waxed. Now I don't look like a orangutan. But I still wear those silly TEDs.
Thursday at PT I actually got to ride the stationary bike for about 15 minutes and even broke a sweat!!! And she told me as soon as I can comfortably get in and out of the car I can start to drive -- thank goodness one of our cars in an automatic. Of course that is the car that Meaghan has been driving all summer as if it is hers alone since Mom can't drive it yet.
This weekend will be another exciting expedition - to Costco. Think we'll use the wheelchair -- too big for me to tackle with just crutches at this point.
I really appreciate the calls and visits. I get pretty bored - but am fulfilling a long time ambition - watching all the seasons of West Wing. (I never watched it when it was broadcast so have hours of entertainment ahead). I figure it's timely with this being an election year!
We have had some wonderful meals. And we are being treated to some gourmet meals cooked right in our own home (guess I better try to clean up the kitchen a little!!).
Thanks to everyone for your prayers, good thoughts and encouragement. I feel so much better and more positive as I start to really be able to move my leg more and get some strength back.
Have a great weekend. Love to all -- Barb
Next week I'll start outpatient physical therapy and that will be really hard work. And soon I'll try water running in the therapy pool and maybe riding a stationary (definitely stationary) bike for brief periods.
I am still pretty tired most of the time and have low energy, but I am eating really well- We have gotten some wonderful meals from so many great folks. Thanks to all of you I am gaining back some weight and hopefully will stay healthy.
My "Denver" bestest friends came up over the weekend and we actually had an outing to the Pearl Street Mall - I learned that a wheelchair can get really hot in the back of the car even in a few minutes!!! Yikes. But it was fun to get out of the house and people watch.
And then my good buddies Cheryl and Stacy treated me to an in-home mani/pedicure on Monday. My fingers and toes look lovely - but of course I still have to wear these lovely TED stockings (they only come in white -- no fashion sense) so no one sees my toes!!
I'll have in home physical therapy this week and then I hope to start outpatient PT next week for twice a week. I am cleared to get in the pool (the rehab center has a really nice heated one with a ramp for entry) so maybe next week I'll try that for a short while.
My biggest problem now is stamina - I just get tired with very little exertion. So this week I'll try to go a little further each day on my walker -- within the next few weeks I hope to advance to just crutches!! Yea!!
Thanks again to everyone who is calling, sending good wishes and meals. We are all grateful to you.
I have learned a lot through this experience. And believe me it was a hard way to learn some of these things. Some of them I already knew but never voiced.
I apologize to anyone that I may have offended when I was on drugs(apparently I lost several days of my life and had conversations I don't recall). IF I was horribly whiny and ridiculously maudlin I apologize for that too. I don't have a life threatening disease or a permanent disability (PLEASE wear BIKE HELMETS) -- I will recover and that is more than I can say for so many people who get hurt. I try to focus on that as my goal.
I learned again why I fell in love with my husband 25 years ago - he was tender and loving and patient with me when I didn't always deserve his kindness. And he continues to be wonderful here at home. His way of doing things may not be the same as mine but I am trying hard to bite my tongue and let him rule the roost for now.
I learned something else that I already knew - I have a wonderful group of family and friends who care for me and were there for me when I needed them - I may not remember your calls or visits - but they helped me get through my misery. I did get in trouble near the end for having so many visitors one day - but hey. You all kept me sane. So thanks to all who called, stopped in, sent cards, notes, flowers, chocolate and other gifts and kept me in your thoughts and prayers.
Now that I am home don't forget me - short phone call makes me smile and a quick visit would be welcome. Right now I am pretty bored!
Now for fun stuff -- ANNOUNCING THE FIRST ANNUAL (hopefully the last) PIMP MY RIDE --WALKER VERSION.
Entries will be judged based on originality, practicality (I do have to use the dang thing after all), and just plain silliness. Submit your entries by email or in person no later than midnite July 13 ( I hope to be done with this darn thing by then but who knows).
Thanks to everyone for sticking by me! Barb
We checked out of the hospital at 1PM and did the short ride home with no problem at all. The biggest problem at the house is things are a lot farther away. Funny how the trips to the bathroom are a lot longer in your home than they are in a small hospital room. Anyway, the distance is a small price to pay for being back in familiar territory.
Barb was fine all afternoon but we pushed it just a little bit. After seeing some visitors out the front door (on second thought maybe she should have stayed on the couch and let me show them out) she just kind of pooped out on the way back. Not a problem, I just moved the piano bench over so she could sit down, got out a TV dinner stand and fed her some chicken noodle soup right in the hallway. She perked up dramatically and, ignoring some significant burps, we had a nice, quiet evening at home.
Barb is much better on the lower pain medication. She is mainly using the Tylenol with just a little help from the Vicodin. The pain level is just a little higher but she is much more herself.
Looks like we'll have a home nurse check in on us for a week or so, starting on July 4th (the case worker was surprised, yet again the Intel insurance comes through). We'll also have home PT for a week or so until we then progress to out-patient PT.
They delivered our rental wheel chair in the afternoon. It's a little narrower then the one we've been using but Barb is very excited about it, she is really looking forward to getting out and about this weekend, there's an art fair at the 29th Street mall that she is really looking forward to seeing.
The move from Oxycontin to Vicodin seems to be a success, the lower med is handling the pain and Barb is much more alert during the day. She is moving real well with the walker and even the crutches, on level ground, are not giving her any problems. We even did a car transfer, in and out of the rehab center's Subaru wagon (the same car that we have), with no problem.
We'd been thinking about how to get a wheel chair for those times when we wanted to do something like go to a street fair (it is summer after all) and had been thinking about seeing about renting one on a daily basis, if possible, when needed. Out of the blue one of the therapists came up and wanted a decision from us about renting a wheel chair, $45 for a week or $95 for a month or not at all. Easy decision, we told her we'd rent one for a week, it wasn't that expensive. Turns out she came back later that day to tell us that our insurance would pay for that rental (thank you Intel insurance, good job).
The other fun task was that the incision staples came out that day. The engineer in me was intrigued by the process (they use a small pair of pliers that bends the staples so that the points are vertical and, theoretically, come out easily and painlessly). The husband in me had a hard time as not all of the staples came out painlessly (so much for theory) and it was no fun to watch Barb in pain. Fortunately, it didn't take too long and now the staples are out.
The day started out with a shower and the bench that the OT person used worked well so we will order the same bench for home.
First PT session, even though later in the day, was pretty low energy, but even so Barb was able to get through the entire session (didn't complete all the isometric exercises, she has that to look forward to in the afternoon). Talked to Dr. B. and she said that the staples look `ripe'. Hopefully that's a good term as it looks like the staples will come out tomorrow. Also talked about pain meds and Barb says she's not feeling any pain to which Dr. B. replies maybe that's because she's on Oxycontin. Anyway, we decide to let her go through tonight on Oxycontin and go down a notch to Vicodin tomorrow, hopefully that will handle the pain without making her so tired in the morning.
Afternoon sessions were fine although I missed the first one, doing errands with Meg to do things like make sure she didn't overdraw her debit card overseas and pick up a loaner pair of crutches from a local grocery store. Who'd have thought you could borrow crutches from a grocery store? The report from Barb was that the session went fine, the therapist worked her on crutches, walking and going up and down stairs. The last session of the day was more isometrics, tiring but she did them fine.
The really good news is the infectious disease doctor came by and said her latest cultures came back fine and it was OK to take her off the IV. Of course, he didn't come by until 5 minutes after they started the last IV bottle so we had to wait an extra 30 minutes but the IV is gone.
The infectious disease doctor came by to talk about the results of the last culture (no real infection, just some cultures that indicated contamination in the sample). Even though there is no indication of infection she wants to keep the IV antibiotics going for a full 3 days. This means the IV doesn't come out until tomorrow - sigh.
Given that the IV comes out tomorrow and given the progress Barb is making, especially on the stairs, it is looking very promising that Wed., 7/2, will be her last day in rehab. Fingers firmly crossed on that.
Second session was a `Group OT' session. I asked one of the nurses what this was all about and she had no idea, she'd never heard of a group session. I went out and did some errands but Barb described the session as her sitting around with all the old people and they passed bean bags and a balloon among the patients. Pretty low key for an active woman like Barb but it served to kill around 45 minutes. My guess is that it was a slow Sunday, there weren't enough OT therapists around to give everyone individual sessions so they created a group session just to get everyone's hours in - whatever.
The afternoon PT sessions were very good, did some very tiring strength exercises on the surgery leg and got Barb to go up and down the 4 step practice stairway three times in a row. She is looking really good on the stairs, slow but she is getting the technique. It's astonishing the subtle techniques you have to watch out for when using a crutch to go up and down the stairs (lead with the good leg going up and then reversing it to lead with the bad leg going down, make sure the crutch is always on the lower step no matter which direction you go, ...).
In the evening I brought our daughter, Meaghan, home from the airport (she finally got back from her 10 day trip to Paris) for a visit. This made Barb really happy (although it was a little hard to tell through the tears).
NB: Thanks to all the people who sent the flowers, especially the lillies. The scent from those flowers is wonderful and the smell is permeating the entire floor. One of the therapists came by to compliment Barb on the smell and thank her for making the floor a more pleasant place.
Even though she was feeling the effects of the Ambian the morning PT's went well. She walked 135' all the way out to the lobby area. We sat there for a few minutes and the therapist had her do a few exercises there on the sofa.
The second session was a major improvement. The therapist started out by having Barb walk around using crutches, which she handled very well. Then we got her to walk up 5 stairs. Given that this is one of the requirements before we can go home this was really great. Barb didn't feel that good about it because it was so hard and she was so slow but, believe me, this was great.
A new infectious disease doctor came by and let us know that her last urine sample was completely clean, nothing in it at all (although they still want to culture it and see if anything hidden is there). It looks like the UTI is gone and she'll be off the IV the next day. There are a couple of possibilities for why things cleaned up so quickly. One is that the doctor from yesterday explained that being drug resistent in the lab doesn't mean that the infection is resistent in the body, but if it is resistent in the lab they have to treat it more aggressively. The other possibility is that one of our nurses realized that the original sample was not a `clean catch' (don't you just love these technical medical terms :-) so it's possible that the original sample was contaminted by the tubing (a common breeding ground for UTI's). Who knows. I'm just happy that it looks like Barb is clean and, with luck, the IV comes out tomorrow.
The afternoon PT session was very hard. The therapist put her down on a flat bench and made her do some new exercises, including a straight knee leg lift. Very good progress, the therapist is pushing her because she is doing so well but it was very hard (and a few tears were shed).
Started out kind of badly with the first PT session. Unfortunately, probably because of all the effort she had expended yesterday, Barb had a lot of trouble with this session. She couldn't make it through all the reps of the exercises (push your knee down, pull your heel back and forth, raise your lower leg, ...) and basically had to cut the session short. This was a bummer but the remaining sessions for the day were much better (including using the walker in one of the afternoon sessions to walk 78', a new record). One problem is we started some pain killers a little too late, getting the medications right is a hard problem.
The OT session was really good, we got to go outside for the first time. Took a wheel chair down to the first floor and went out for 5 minutes, that was a real treat.
More good news is that the case worker came by and told us that the insurance company has approved her rehab stay until 7/2. The case worker (who is someone who will fight hard for the patient, I wouldn't want to get on her bad side) said that we will review things around 7/2 and, if Barb needs to stay in rehab longer, she's confident she can arrange it.
Major bummer of the day was when Dr. B. came in and informed us that the urinary tract infection from the previous day turns out to be drug resistent and, because of that, she was calling for an infectious disease specialist to come in and look at things. Although the infection was relatively small she was concerned because infections really like to latch onto hardware that has been inserted into the body and she didn't want that to happen to Barb. Toward the end of the day the specialist got there and explained the details on the UTI. Although he was not too concerned about it he wanted to start her on a different, intravenous penicillin based drug. More poking holes in veins, which is becoming a little hard, but that regimen has been started.
In the evening we had visitors bearing ice cream so that helped to lighten up the day a bit. Funny how a little ice cream makes anything feel better.
Fortunately, I was there when the doctor came by and we talked about the fact that Barb was a little loopy because of the OxyIR. Dr. B. said "no problem, we'll make sure that doesn't happen again" and she removed OxyIR from the approved drugs for Barb. Now the nurses can no longer give this to her so we shouldn't have that happen again.
(NB: Interesting tidbit about hospital protocols that I was not aware of. The doctors prescribe the medications but it's the nurses that are in charge of administering the actual doses. If you have a med that is prescribed `as needed' to deal with pain then the nurses talk to the patients and decide when to actually administer the drug, or when not to administer it. If you are ever in a hospital looking after someone pay real close attention to the nurses, they don't really make mistakes but it is easy for communication errors to occur, especially when you consider there are multiple doctors involved and upwards of 12 different nurses - 3 shifts of nurse & aide plus a change in guard over the weekend.)
A nice surprise was when one of the instructors from Rally Sport showed up for a visit. She brought a get well card signed by a lot of the people that Barb works out with at the club. Totally unexpected and very welcome.
Yet another problem, of course. Probably due to having a catheter in for over a week Barb succeeded in getting a urinary track infection. Interestingly enough, this is a relatively common occurance and is referred to as a `silent infection' as there were no external symptoms. Anyway, they caught on to it and started Barb on anti-biotics that should solve the problem.
The afternoon was MUCH better. Barb was alert, did all of her PT sessions with minimal difficulties, it was almost like my wife had actually returned. She ate a very good dinner (taste buds are returning) and afterward had a long visit with one of her friends. During the visit she actually sent me out for a Root Beer Float, which she even ate.
Lots of PT/OT today which is very tiring. When you suffer an injury like this it's hard to realize just how much effort you have to put into what seems like little results. She was able to walk a full 20' with the walker which doesn't seem all that far but she was just exhausted aftwards.
This is basically an evaluation day where they see where Barb is. Pretty much she is not doing very well. Her pain medications are making her groggy & light headed so it's difficult to do the therapy sessions.
We talk with Dr. B. and the concensus is that Barb is being a little over medicated to deal with the pain. She's been getting OxyIR (Instant Relief - that's not really what the IR stands for but it's a good description) shortly before her therapy sessions. This is a fast acting, strong pain killer that only lasts for a few hours (but is very effective during those hours). The problem is Barb's sensitivity to this drug is making her groggy and light headed during her therapy sessions. The decision is to switch to Oxycontin, a drug that lasts for 12 hours so you only get it twice a day and, hopefully, it won't have such serious side effects on Barb. Let's hope this works.
Barb now asks how they will move her and the answer is wheel chair. This does not please Barb as this means she will have to get out of the bed, something she hasn't done yet. Funny how hospitals give you very little say in things, they do put her in a wheel chair (a few ouches but not as bad as Barb was expecting) and wheel her up 2 floors.
We get to the airport in plenty of time, escort the kids to the gate and then leave the airport at around 12:30PM so I can rush back to the hospital. I get to the hospital just in time, about 5 minutes before they take Barb in, so I at least have time to hold her hand and give her a kiss before they start the surgery. Two hours later the doctor comes out and let's us know that everything went fine, she put in a `nail' that goes from just below her hip to just above her knee and all we have to do is wait for her to come out of post-op, which she does about 2 hours later (should have been quicker but Barb does not respond well to anaesthesia).
Now it's just a matter of waiting on the hospital floor until Barb recovers enough to go up to rehab. Fortunately, the in patient rehab center is on the 4th floor of the same building so the transfer will be pretty simple.
And now the pictures showing the results of the operation. This first view shows the top of the nail with the screw that goes into the ball of the hip joint. This is the part of the nail that provides stability for the actual break.
Now a view of the nail running the full length of the femur, from the hip to just above the knee.
Finally, a look at the bottom of the nail with a screw that holds the bottom in place.
A lot of hardware but the surgeon explained that you need it to provide the stability needed.
The police & ambulance arrive, get her loaded up (after very carefully checking for head and spinal issues - there were none) and take off for Boulder Community Hospital, about 1/2 mile away. I load up the unscratched bike (the chain was off the gears, that's about all I could see wrong with it) and take off for BCH, beating the ambulance there - go figure, who needs sirens.
Barb arrives and gets wheeled into ER. We still are hoping that it's just a bruise until they take her in for X-Rays. After looking at the pictures the X-Ray tech says, no, it is a break, in fact it's a pretty bad one. Barb, needless to say, loses it at that point (there goes all her plans for the summer) but what can you do. The ER doc then explains that she'll have to have surgery and do we have an orthopedic surgeon we'd like to use? Since Meaghan had already had wrist surgery we though of that doctor but he only does wrists. The ER doc suggested his partner but Barb caught something in the tone of voice and said "Well, if it were your hip who would you use"? The ER doc then suggested Dr. Fulkerson and we say "Works for us, sign her up".
Next we get wheeled up to the hospital floor and wait for Dr. Fulkerson. She comes by that afternoon and says that, unfortunately, due to her schedule and OR room schedules she won't be able to do the operation today, we'll have to wait until tomorrow. (Funny story, while Dr. Fulkerson is talking to us my daughter gets there. The doctor looks at Meaghan and says "You look familiar", Meaghan looks at the doctor and says "You look familiar also". Turns out, Dr. Fulkerson is the mother of one of Meaghan's first boy friends in middle school :-) Dr. Fulkerson explains the Barb has a comminuted fracture (the break has created multiple separate pieces of bone) a pretty serious break but fixable.
Barb now has a miserable night waiting for the operation, including putting her leg in traction - which is a good thing. The issue is that the muscles want stability, which they can't get from the broken bones, so they tighten up around the break, causing a lot of pain. The traction (just a 5lb weight they hang off the bed attached to a special boot on Barb's foot) provides the stability that causes the muscles to relax, a little, making it easier for Barb.
And here, for your viewing pleasure, are the x-rays they took right after the accident. This first one is looking down as she lays on her back. You can't tell very well (at least my untrained eyes can't tell very well) but the femur on the left hip (right side of the picture) is where the break occurred.
This picture, looking at things from the side, gives you a better view. That jagged bone on the bottom side is the break and, looking closely, you can see the lines of the other breaks above and to the right of that jagged edge.