After patients are released, some medical insurance supplies home therapy--not just physical therapy and exercises. An occupational therapist may visit the home and point out steps, narrow walkways, objects in the way of walkers, and tough cabinets to reach.
The therapist and the patient will soon discover some ongoing problems that aren't simple.
1. Things That Plug. Even when I worked as a decorator, I was never in a home that had the electric plugs at no-bend height except in the kitchen and bath. Shaving plugs, yes. Computer plugs - lotsa luck. Somewhere in some catalog is a long gizmo that fastens a plug-extender at waist height so I can actually plug and unplug the laptop every time the tech says " just unplug it and then plug it in again."
2. Dishwashers. Waist-height ovens are available for those of us who still dare eat pie. The Barbie and Ken bending from the hip really doesn't help put the pie making dishes in the DW or cover all the acrobatics of re-organizing the dishwasher load until the door will close.
3. The trunk of the car and most of the SUV load space. Even the things we can reach are probably too heavy or too far down in the trunk or too far back in the SUV. You can buy a six-speed car here, but the local auto parts places have not found me a gizmo that makes the trunk floor high enough for me to lift my less-than-10- pound belongings.
4. Groceries. Eighteen people have suggested the wire cart that rolls food home. None of them can figure how I would get the food out of the bottom of the cart without bending. I think I know how the cart should be modified, but I don't have a teen-ager handy to rig it up for me.
5. Child car seats. The acrobatics needed to install and uninstall a child from a vehicle are entirely outside of what we're allowed to do. The people who ask you to baby sit will be unaware of this. And borrowing your grandchild will be tough.
Yes, there's plenty I've figured out how to do. There's a mob of us, however, who don't need a wheelchair or a lift. The industrial design world hasn't even scratched the surface of what we do need for the only back we're going to get.
Wednesday, November 28, 2012
Tuesday, November 27, 2012
SPINE FUSION - rehab - Stayin' alive Part 2
More about "home alone."
My bedroom looks spacious because when I was able to do floor work, I left open space for my great exercise mat. Somehow one room holds: two file cabinets, a desk, an end table for drawer space and to hold a lamp. (The spine problem was diagnosed before I moved here. My daughter gave me or helped me choose things that don't require a lot of bending.)
At night, I roll my desk chair to bedside, and use it for a night stand - there's a basket complete with flashlight, a little Tylenol, ear plugs, maybe some lotion, etc. I like a flashlight when I have to get up at night, instead of turning on the bright light. The walker is right beside the foot of the bed, in case I don't get my land legs right away.
With The Grabber, I'll be able to pull the covers up more or less neatly for daytime, though it's not a photo oppportunity.
I've liked my shoes on the floor, so I could just slip into them. But I do own two shoe hanging bags with open-end compartments so all shoes are visible and not so dusty.
My daughter got me these wonderful compartments that hang on the closet rod. I can see all the undies, tee shirts, etc. so no need for a chest of drawers (couldn't reach the bottom drawers anyway.)
My bedroom looks spacious because when I was able to do floor work, I left open space for my great exercise mat. Somehow one room holds: two file cabinets, a desk, an end table for drawer space and to hold a lamp. (The spine problem was diagnosed before I moved here. My daughter gave me or helped me choose things that don't require a lot of bending.)
At night, I roll my desk chair to bedside, and use it for a night stand - there's a basket complete with flashlight, a little Tylenol, ear plugs, maybe some lotion, etc. I like a flashlight when I have to get up at night, instead of turning on the bright light. The walker is right beside the foot of the bed, in case I don't get my land legs right away.
With The Grabber, I'll be able to pull the covers up more or less neatly for daytime, though it's not a photo oppportunity.
I've liked my shoes on the floor, so I could just slip into them. But I do own two shoe hanging bags with open-end compartments so all shoes are visible and not so dusty.
My daughter got me these wonderful compartments that hang on the closet rod. I can see all the undies, tee shirts, etc. so no need for a chest of drawers (couldn't reach the bottom drawers anyway.)
Sunday, November 25, 2012
SPINE FUSION acute rehab - Occupational therapy = Stayin' alive
Today, as I get used to the idea of going home, an Occupational Therapist I've never seen before comes in. I describe my room and bath and the apartment they're in, almost step by step, for her.
The bath Has room for the walker to sit in there safely.
The tub has shower doors--not useful for stability.
I have a bubble mat on the tub floor with a shower chair on it. A towel goes on the floor outside the tub on the faucet side, for firm footing. The back of the toilet is just inches from the tub--something to stabilize me as I get out of the tub area. The other towels are right on the other shower door. When I'm clean, the grabber will pick up the towel/mat so I can hang it up.
There is a vanity right beside the toilet, if I need stability getting up. The toilet is exactly the right height for me, since my legs are short.
I keep my cosmetics, soap, tooth stuff, etc., on the vanity top so I don't have to bend down to the cupboard underneath. It is only a couple steps to the bedroom - good for safe passage at night.
The living/dining area has a generous aisle leading to the kitchen. On the living room side, there is room for the walker to move from the dining room or the bedroom area to the front door. Then only one step from the outside landing down to the lower landing and then down to the courtyard.
In the kitchen I keep some of my dishes on the counter top, and a couple of clean pans on the cooktop. Some food goes in a little upper cupboard I can reach without leaning. The refrigerator at least has glass shelves, so I can see what I can't reach in the back and on the lower shelf. The dishwasher is off limits now, being mostly too low for me. If could drive, of course, I'd hunt for a black dish dryer rack, but . . .
Every inch counts in the bedroom. The desktop is easy to reach, and so is the top of my folding shelf rack. So, things get moved from desk top to bed to desk top as necessary. The thick carpet keeps my rolling desk chair from rolling (I had that same trouble where I worked.) I rigged up a sort of end table from black file boxes, and another on the hidden side of my posture chair. I can reach my coffee, water, note pad, book, morning pills and so on from the chair. It has an ottoman in front of it, for resting my feet, since the chair (great support back) is too tall.
More on the bedroom in the next installment
The bath Has room for the walker to sit in there safely.
The tub has shower doors--not useful for stability.
I have a bubble mat on the tub floor with a shower chair on it. A towel goes on the floor outside the tub on the faucet side, for firm footing. The back of the toilet is just inches from the tub--something to stabilize me as I get out of the tub area. The other towels are right on the other shower door. When I'm clean, the grabber will pick up the towel/mat so I can hang it up.
There is a vanity right beside the toilet, if I need stability getting up. The toilet is exactly the right height for me, since my legs are short.
I keep my cosmetics, soap, tooth stuff, etc., on the vanity top so I don't have to bend down to the cupboard underneath. It is only a couple steps to the bedroom - good for safe passage at night.
The living/dining area has a generous aisle leading to the kitchen. On the living room side, there is room for the walker to move from the dining room or the bedroom area to the front door. Then only one step from the outside landing down to the lower landing and then down to the courtyard.
In the kitchen I keep some of my dishes on the counter top, and a couple of clean pans on the cooktop. Some food goes in a little upper cupboard I can reach without leaning. The refrigerator at least has glass shelves, so I can see what I can't reach in the back and on the lower shelf. The dishwasher is off limits now, being mostly too low for me. If could drive, of course, I'd hunt for a black dish dryer rack, but . . .
Every inch counts in the bedroom. The desktop is easy to reach, and so is the top of my folding shelf rack. So, things get moved from desk top to bed to desk top as necessary. The thick carpet keeps my rolling desk chair from rolling (I had that same trouble where I worked.) I rigged up a sort of end table from black file boxes, and another on the hidden side of my posture chair. I can reach my coffee, water, note pad, book, morning pills and so on from the chair. It has an ottoman in front of it, for resting my feet, since the chair (great support back) is too tall.
More on the bedroom in the next installment
Wednesday, November 21, 2012
SPINE FUSION Acute rehab- what do you mean, go home?
There must be some mistake. I'm not allowed to get out of bed alone, take a shower, go into the bathroom alone. . . and you think I'm ready to go home alone? And as for walking with a cane? There's no one home with one of those canvas safety belts to catch me.
Nevertheless, the top PT is here again with the cane. We not only go into the garden, but we walk around with the cane. We go out through the gate and practice stepping onto and off the curb with the cane. I note that the curb here in the parking lot is rather low and safe looking. It's too hot for a really prolonged walk thru the garden - much of it is not shaded.
Back inside and into the event room. No, there's another room here called gym. It has a tiny step stool that I still doubt I'll ever use. And THE STAIRS. Someone has made a set of four wooden stairs with handrails--looks like it was once a stage set. I go up a couple steps with the cane and the hand rail. Then the PT sends me to the top and tells me to come down alone with the cane and NO touching the hand rails, not even steadying myself by touching them with a shoulder. She stands near the bottom, encouraging me. I decide if I ever get out this place, I'm definitely never going down any stairs with a cane.
They want me to go home Friday. I panic. Loudly. My daughter is not coming to town until the 23rd. I live alone. And I definitely will have to get out of bed alone, go to the bathroom alone, get cleaned up alone, fix food alone.
The next morning there are five people in my room including the head doctor. They give me the Medicare rules, which are incomprehensible. It's either go home or go to a nursing home. We finally agree that I can wait until my daughter comes to get me on Sunday. I have some time to consider how to get food when I get home.
Nevertheless, the top PT is here again with the cane. We not only go into the garden, but we walk around with the cane. We go out through the gate and practice stepping onto and off the curb with the cane. I note that the curb here in the parking lot is rather low and safe looking. It's too hot for a really prolonged walk thru the garden - much of it is not shaded.
Back inside and into the event room. No, there's another room here called gym. It has a tiny step stool that I still doubt I'll ever use. And THE STAIRS. Someone has made a set of four wooden stairs with handrails--looks like it was once a stage set. I go up a couple steps with the cane and the hand rail. Then the PT sends me to the top and tells me to come down alone with the cane and NO touching the hand rails, not even steadying myself by touching them with a shoulder. She stands near the bottom, encouraging me. I decide if I ever get out this place, I'm definitely never going down any stairs with a cane.
They want me to go home Friday. I panic. Loudly. My daughter is not coming to town until the 23rd. I live alone. And I definitely will have to get out of bed alone, go to the bathroom alone, get cleaned up alone, fix food alone.
The next morning there are five people in my room including the head doctor. They give me the Medicare rules, which are incomprehensible. It's either go home or go to a nursing home. We finally agree that I can wait until my daughter comes to get me on Sunday. I have some time to consider how to get food when I get home.
Sunday, November 18, 2012
SPINE FUSION - Rehab - the home stretch?
Did I already mention the mystery neurologist who insisted on knowing all the pressures in my life outside rehab. I still wonder why that phrase "not doing your best" came up again.
Things have started speeding up; I'm getting little pieces of paper with the day's schedule of as many as six occupational and physical therapy appointments, sometimes back to back. The OTs also have some exercises for me, but no shower.
And my walks are getting longer. Today the hallway leads us right into an elevator and, imagine, right out into the hospital garden! There is a long wall with plaques about the history of the hospital. The long walk in front of it is blessedly in the shade, so we walk along there with my walker. Bliss. A hospital garden that the patients actually get to use! Of course, I'm not allowed out here alone. There should be a photo to send back to that hospital with the not-so-accessible koi pond.
A friend visited me in the Glendale hospital right after my surgery and brought me a copy of Vogue. I had a little trouble identifying with fashion mags right then. Now I leaf through the photos. There, believe it or not, is a model wearing what I'm sure is a shockingly expensive black leather belt that looks so much like my brace (except for the velcro) that I don't know whether to laugh or ... laugh.
Today brings a new and scary addition to my PT! A cane. All of a sudden I wish I had done more of those balance exercises, like the standing on one foot position, for instance. After those first few days in the hospital in July, since I couldn't drive with that unreliable right leg, I would walk 2 blocks to the market. The bag person would hang my two grocery bags on the walker, and I'd make my way safely back to my room.
Now it takes me about two seconds to confirm that the cane is not that secure. What if my right leg has one of its weak moments? Even going out in the hall where there's no bed to fall into takes a minute to get ready for. The PT puts the canvas belt around my waist, but she's littler than I am, and I wonder if she really can catch me with it if I fall. (Of course, right now, she's a lot stronger than I am.) Most people are.
Things have started speeding up; I'm getting little pieces of paper with the day's schedule of as many as six occupational and physical therapy appointments, sometimes back to back. The OTs also have some exercises for me, but no shower.
And my walks are getting longer. Today the hallway leads us right into an elevator and, imagine, right out into the hospital garden! There is a long wall with plaques about the history of the hospital. The long walk in front of it is blessedly in the shade, so we walk along there with my walker. Bliss. A hospital garden that the patients actually get to use! Of course, I'm not allowed out here alone. There should be a photo to send back to that hospital with the not-so-accessible koi pond.
A friend visited me in the Glendale hospital right after my surgery and brought me a copy of Vogue. I had a little trouble identifying with fashion mags right then. Now I leaf through the photos. There, believe it or not, is a model wearing what I'm sure is a shockingly expensive black leather belt that looks so much like my brace (except for the velcro) that I don't know whether to laugh or ... laugh.
Today brings a new and scary addition to my PT! A cane. All of a sudden I wish I had done more of those balance exercises, like the standing on one foot position, for instance. After those first few days in the hospital in July, since I couldn't drive with that unreliable right leg, I would walk 2 blocks to the market. The bag person would hang my two grocery bags on the walker, and I'd make my way safely back to my room.
Now it takes me about two seconds to confirm that the cane is not that secure. What if my right leg has one of its weak moments? Even going out in the hall where there's no bed to fall into takes a minute to get ready for. The PT puts the canvas belt around my waist, but she's littler than I am, and I wonder if she really can catch me with it if I fall. (Of course, right now, she's a lot stronger than I am.) Most people are.
Friday, November 16, 2012
SPINE FUSION acute rehab - what to take to rehab
After the surgery, in the other hospital, I was in no condition to put on clothes. I had been given a list, so bought two big summer robe/housecoat things and slippers, which were instantly rejected by the physical therapists at rehab. And forget going to the bathroom wearing the housecoats = wrapped around my neck perhaps?
I had arrived for the surgery wearing some above the ankle knit pants with an elastic waist. Since the brace is the thickness of a long cat wrapped around the waist, I can only wear elastic-waist pants with it. (It sort of scrunches up the cotton lounge/bag dress things I brought, so way too much leg shows.) The knit pants have to do for all purposes this week. Since they were new, they still seem fairly fresh. I hope.
I wish I had hidden certain prescription creams in my medicine pouch. There have been unpleasant discussions all week about who decides which of my regular meds I get, and who gives them to me, and when, and how often. My primary physician is not here to get involved in these talks. And a couple of really bad episodes with a certain cream that I did NOT enjoy explaining to a college age boy from the hospital pharmacy. Most of the stress has been blamed on some Medicare rule. Okay, now you know how old I am.
I also need some things to cheer me up. I wish I had more pictures of happy times in my wallet. Even pictures of things I made, to remind me that I can still draw or make a model of a design while I'm wearing the brace, once I escape from this bed and the painful, too-tall, perma-lock wheelchair and get to a place with an actual table. Somehow, when I get my instructions in the wheelchair, and when the meals cart is near, the nurse has to leave before I think to ask her to hand me some paper and to move my pen closer to me.
Just let me say that the nurses are all kind and some are truly friendly. It's the schedule, the crowded room, the iffy medicine-schedule computer, and the furniture moving that make things tough on nurses and patients.
Luckily, the ambulance guys who brought me to rehab also brought the fabulous orchid plant in its very heavy little planter. And luckily it's some variety of orchid that stays alive whether I get there with any water or not.
I had arrived for the surgery wearing some above the ankle knit pants with an elastic waist. Since the brace is the thickness of a long cat wrapped around the waist, I can only wear elastic-waist pants with it. (It sort of scrunches up the cotton lounge/bag dress things I brought, so way too much leg shows.) The knit pants have to do for all purposes this week. Since they were new, they still seem fairly fresh. I hope.
I wish I had hidden certain prescription creams in my medicine pouch. There have been unpleasant discussions all week about who decides which of my regular meds I get, and who gives them to me, and when, and how often. My primary physician is not here to get involved in these talks. And a couple of really bad episodes with a certain cream that I did NOT enjoy explaining to a college age boy from the hospital pharmacy. Most of the stress has been blamed on some Medicare rule. Okay, now you know how old I am.
I also need some things to cheer me up. I wish I had more pictures of happy times in my wallet. Even pictures of things I made, to remind me that I can still draw or make a model of a design while I'm wearing the brace, once I escape from this bed and the painful, too-tall, perma-lock wheelchair and get to a place with an actual table. Somehow, when I get my instructions in the wheelchair, and when the meals cart is near, the nurse has to leave before I think to ask her to hand me some paper and to move my pen closer to me.
Just let me say that the nurses are all kind and some are truly friendly. It's the schedule, the crowded room, the iffy medicine-schedule computer, and the furniture moving that make things tough on nurses and patients.
Luckily, the ambulance guys who brought me to rehab also brought the fabulous orchid plant in its very heavy little planter. And luckily it's some variety of orchid that stays alive whether I get there with any water or not.
Wednesday, November 14, 2012
SPINE FUSION Acute Rehab. Why Occupational Therapy?
We've pretty much nailed down the possibilities of the sponge bath. A word has been added to the whiteboard: independent. Who are they kidding--I'm not supposed to get out of bed or out of the wheelchair when I'm alone, so I haven't been to the bathroom alone. By the way, I was the one who suggested letting me use the bathroom. There isn't much ventilation in there. I don't want to faint again; I need the door open. I have met at least one stranger with the door open, but modesty is the first to go in a hospital.
And in the bathroom, here's that latest safety-design, curbless shower that I haven't used. Am I not cleared by the doctor to shower? Of course, I didn't get any list telling me to bring shower shoes. . .
But ignore the future or not, I will be going home. Even if we don't live alone, there are a couple hundred ways to mess up our remodeled spines at home. The family will be at work or at school much of the time. All the things we put where we wanted them at home are now things we won't be able to reach with the Barbie Bend. Or with this delicate "grabber" that will pick up a fried egg, but won't pick up the frying pan off the bottom shelf.
The occupational therapist (OT) is working with me on doing things by myself. She takes me to the event room/lunch room/toy room. There is a bathtub. It doesn't have shower doors, which I'll be dealing with at home. Luckily talking with my hands is my specialty. I show her where the imaginary shower doors are, and what I can grab onto at home, like the flat-top toilet tank, so I'll never unconsciously grab for those unstable doors when getting out of the tub. I even get into the tub to show her I can step that high.
I make a mental note to buy a strong, long-handled bath brush to scrub my calves and feet. This toy long-handled sponge I had to buy at the other hospital will last about two weeks.
We do some walking and stepping exercises and again I'm shocked by how fast I get tired. And of course we practice getting up off the low, low sofa. She hands me some cute lime green two-pound, Head-Start dumbbells and assures me Target has them. I doubt that Target delivers them. I enjoy them and I'm glad I can lift something besides my fork. . .
The room here is crowded, and since the wheelchair sitting is part of rehab, something is always moved to make room for it. The meals cart/bedside cart is usually what gets moved away from me. Or my walker. The real bedside table is somewhere else, to make room for all the moveable stuff, so the purse and phone and call button and my book are often in the bed and falling out of the bed. Often I forget to remind the nurses and aides before they leave that I have to be able to reach my water and hopefully my glasses and my book and a tissue. Helpless.
It's hopeless trying to write in bed.
All along, I notice most hospital folk I meet have not gone through this surgery and they can't really picture what it is like not to be unable to reach the call button that fell thru the cute plastic side rails and is tangled up down there. I call "somebody!" Repeatedly. Helpless.
I think about that movie, where the doctor recovered from his cancer makes all the newbie doctors take all the nasty tests patients have to take.
It's a blessing that my daughter will come down here to get me started at home. A big blessing. (I am unable to think beyond that day, and how I will manage when she goes home.)
And in the bathroom, here's that latest safety-design, curbless shower that I haven't used. Am I not cleared by the doctor to shower? Of course, I didn't get any list telling me to bring shower shoes. . .
But ignore the future or not, I will be going home. Even if we don't live alone, there are a couple hundred ways to mess up our remodeled spines at home. The family will be at work or at school much of the time. All the things we put where we wanted them at home are now things we won't be able to reach with the Barbie Bend. Or with this delicate "grabber" that will pick up a fried egg, but won't pick up the frying pan off the bottom shelf.
The occupational therapist (OT) is working with me on doing things by myself. She takes me to the event room/lunch room/toy room. There is a bathtub. It doesn't have shower doors, which I'll be dealing with at home. Luckily talking with my hands is my specialty. I show her where the imaginary shower doors are, and what I can grab onto at home, like the flat-top toilet tank, so I'll never unconsciously grab for those unstable doors when getting out of the tub. I even get into the tub to show her I can step that high.
I make a mental note to buy a strong, long-handled bath brush to scrub my calves and feet. This toy long-handled sponge I had to buy at the other hospital will last about two weeks.
We do some walking and stepping exercises and again I'm shocked by how fast I get tired. And of course we practice getting up off the low, low sofa. She hands me some cute lime green two-pound, Head-Start dumbbells and assures me Target has them. I doubt that Target delivers them. I enjoy them and I'm glad I can lift something besides my fork. . .
The room here is crowded, and since the wheelchair sitting is part of rehab, something is always moved to make room for it. The meals cart/bedside cart is usually what gets moved away from me. Or my walker. The real bedside table is somewhere else, to make room for all the moveable stuff, so the purse and phone and call button and my book are often in the bed and falling out of the bed. Often I forget to remind the nurses and aides before they leave that I have to be able to reach my water and hopefully my glasses and my book and a tissue. Helpless.
It's hopeless trying to write in bed.
All along, I notice most hospital folk I meet have not gone through this surgery and they can't really picture what it is like not to be unable to reach the call button that fell thru the cute plastic side rails and is tangled up down there. I call "somebody!" Repeatedly. Helpless.
I think about that movie, where the doctor recovered from his cancer makes all the newbie doctors take all the nasty tests patients have to take.
It's a blessing that my daughter will come down here to get me started at home. A big blessing. (I am unable to think beyond that day, and how I will manage when she goes home.)
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