Chapter 402 - Speeding Downhill
Monday - Care Person from Wild Dog completed transfers by herself, commode from shower back to bedroom, pulled up knickers and pants by herself then transfer from bed to wheelchair. She did not wish to use the trolley, I was browned off, sulking, no one called me for help so I concentrated on breakfast preparation. Later that day, the physio D (she returns to West Beer hospital so we don't see her again) decided to have her transfer between the wheel chair and our car without pulling and shoving without using the slider board, which we demonstrated to physio D. Then four transfers to and from the car were accomplished without problems, although she feared falling into the gap between wheel chair and car. Elsewhere I think I was later able to have her transfer without the board about three times before I gave up and returned to the board method.
Tuesday - A flash of realisation had me rotate her bed end-end so that the commode or wheel chair can be positioned at the correct angle for her to position her right foot (the load bearing one) as directed by physio D who has been having her transfer between wheel chair and "bed" during physio sessions at the hospital. But as with the car, we seem unable to easily and correctly complete the task. Back to the slider board and/or pulling/or shoving.
Wednesday - Prior to taking her into Respite at Wild Dog I asked at reception for permission to view a standing lifter they used on the premises according to morning care ladies; I was directed to the office of L., a helpful bloke, who showed us a lifter which relied upon a wide belt around the patient to lift the body from chair etc to a standing position. Wild dog uses this device to transport and/or transport whereas slings are only for transfers. Next day I called back twice to get a model number of the device but L's office was locked and phone calls were not answered.
Friday - Her follow up visit to Neurosurgeon Dr M for her stenosis surgery. He did not seem surprised that his handiwork has not resulted in any improvement in her left leg. We discussed the matter at some length. He wants to see her again in February, after she has another MRI on the L5 area. On the referral for the MRI is written "Progress after lumbar decompression. No symptomatic improvement". He said there was no reason for not having the MRI performed in Hot Air City, quoting the number of Teslas etc, when I mentioned that Dr F. at West Beer directed her to have MRI's done up there for reasons of resolution. And two $700 all day round trips up there and back by Wild Dog. Dr M. was surprised that no one had suggested she use an AFO, Ankle Foot Orthosis, to hold her left foot in position, rather than drag on its side on the floor. Dr M. said the heaviness in her leg may indicate nerve repair is happening, although sometimes such sensations imply the opposite.
Then we drove over to MovementIssues to see a demonstration of a standing lifter, similar to the one we saw at Wild Dog. Although she became somewhat "dyskinetic" (stress initiated), they were able to lift her. I was not very impressed; the staff seemed less than enthusiastic. They are willing to demonstrate the device in our home. They also had a sling lifter there as well but I said the legs were too large for manoeuvring inside our house and it is not intended for transportation. I am to decide by Monday morning how we intend to proceed because our 4 weeks rental for the trolley expires next Tuesday. My query about an AFO resulted in contact details for a Prosthetist/Orthotist with whom I will arrange an appointment.
Saturday - Before she went to Wild Dog for respite I reduced the pump rate from 4.9 to 4.7 ml/hour. When I collected her at 1530 she felt stiff and slow so I raised the rate to 4.8. I decided to run the pump overnight so at 2100 I replaced the cassette with a new one before reducing the flow rate to 4.0 ml/hour.
Sunday - At 0720 our usual bed to commode transfer, into the bathroom to remove the incontinence bloomers then onto the loo and I set the pump flow rate back to 4.8. There was mild leg dyskinesia, feet and lower legs tingling, no pain, head clear (although she "seemed" sluggish) and her mouth was "dry as saw dust". She found it easier to get out of bed. She believed she didn't move much during the night. After showering she had difficulty standing to transfer from commode to trolley, then transferring to sitting on the bed was easier enough but standing to pull up her pants and standing/sitting on the trolley was difficult, much more than previous mornings. Then transferring her from the trolley to the wheel chair out in the eating area was more difficult than usual. Before eating breakfast she had a bloated feeling.
Mid-morning I set up the video camera to record her transferring between wheel chair and the trolley but she was unable to sit-stand, even when I placed a padded belt around her chest in an attempt to assist her standing. I had told MovementIssues that we intended practising transfers with the trolley to make a decision by Monday morning. Now on Sunday afternoon I cannot decide. The contrast between the afternoon in MovementIssues' showroom some weeks ago and her performance today is quite marked, although I have clouded the results with pump changes. What appears to be dyskinesia in her legs is her reaction to stress and fear rather than dyskinesia (which may or may not be present at the same time), in that the movements are seen to grow and wane as she attempts to stand and then sit on the trolley. The staff at MovementIssues noted this when she was lifted in their show room on Friday.
As for me, my right hip has sharp pains as day proceeds until I'm limping by bed time. At the beginning of each day hardly a twinge happens. I presume this is due to the effort of lifting and twisting when assisting with transfers. The cold I had has passed, yet there is a persisting infection in my throat and my left hand trigger finger continues to bother me and the grooves caused by my wedding ring persist. I have begun vibrating Voltaren Osteo Gel into my right hip, seems to help.
I'm becoming angry and tired. Stuff it all!!!
Tuesday - A flash of realisation had me rotate her bed end-end so that the commode or wheel chair can be positioned at the correct angle for her to position her right foot (the load bearing one) as directed by physio D who has been having her transfer between wheel chair and "bed" during physio sessions at the hospital. But as with the car, we seem unable to easily and correctly complete the task. Back to the slider board and/or pulling/or shoving.
Wednesday - Prior to taking her into Respite at Wild Dog I asked at reception for permission to view a standing lifter they used on the premises according to morning care ladies; I was directed to the office of L., a helpful bloke, who showed us a lifter which relied upon a wide belt around the patient to lift the body from chair etc to a standing position. Wild dog uses this device to transport and/or transport whereas slings are only for transfers. Next day I called back twice to get a model number of the device but L's office was locked and phone calls were not answered.
Friday - Her follow up visit to Neurosurgeon Dr M for her stenosis surgery. He did not seem surprised that his handiwork has not resulted in any improvement in her left leg. We discussed the matter at some length. He wants to see her again in February, after she has another MRI on the L5 area. On the referral for the MRI is written "Progress after lumbar decompression. No symptomatic improvement". He said there was no reason for not having the MRI performed in Hot Air City, quoting the number of Teslas etc, when I mentioned that Dr F. at West Beer directed her to have MRI's done up there for reasons of resolution. And two $700 all day round trips up there and back by Wild Dog. Dr M. was surprised that no one had suggested she use an AFO, Ankle Foot Orthosis, to hold her left foot in position, rather than drag on its side on the floor. Dr M. said the heaviness in her leg may indicate nerve repair is happening, although sometimes such sensations imply the opposite.
Then we drove over to MovementIssues to see a demonstration of a standing lifter, similar to the one we saw at Wild Dog. Although she became somewhat "dyskinetic" (stress initiated), they were able to lift her. I was not very impressed; the staff seemed less than enthusiastic. They are willing to demonstrate the device in our home. They also had a sling lifter there as well but I said the legs were too large for manoeuvring inside our house and it is not intended for transportation. I am to decide by Monday morning how we intend to proceed because our 4 weeks rental for the trolley expires next Tuesday. My query about an AFO resulted in contact details for a Prosthetist/Orthotist with whom I will arrange an appointment.
Saturday - Before she went to Wild Dog for respite I reduced the pump rate from 4.9 to 4.7 ml/hour. When I collected her at 1530 she felt stiff and slow so I raised the rate to 4.8. I decided to run the pump overnight so at 2100 I replaced the cassette with a new one before reducing the flow rate to 4.0 ml/hour.
Sunday - At 0720 our usual bed to commode transfer, into the bathroom to remove the incontinence bloomers then onto the loo and I set the pump flow rate back to 4.8. There was mild leg dyskinesia, feet and lower legs tingling, no pain, head clear (although she "seemed" sluggish) and her mouth was "dry as saw dust". She found it easier to get out of bed. She believed she didn't move much during the night. After showering she had difficulty standing to transfer from commode to trolley, then transferring to sitting on the bed was easier enough but standing to pull up her pants and standing/sitting on the trolley was difficult, much more than previous mornings. Then transferring her from the trolley to the wheel chair out in the eating area was more difficult than usual. Before eating breakfast she had a bloated feeling.
Mid-morning I set up the video camera to record her transferring between wheel chair and the trolley but she was unable to sit-stand, even when I placed a padded belt around her chest in an attempt to assist her standing. I had told MovementIssues that we intended practising transfers with the trolley to make a decision by Monday morning. Now on Sunday afternoon I cannot decide. The contrast between the afternoon in MovementIssues' showroom some weeks ago and her performance today is quite marked, although I have clouded the results with pump changes. What appears to be dyskinesia in her legs is her reaction to stress and fear rather than dyskinesia (which may or may not be present at the same time), in that the movements are seen to grow and wane as she attempts to stand and then sit on the trolley. The staff at MovementIssues noted this when she was lifted in their show room on Friday.
As for me, my right hip has sharp pains as day proceeds until I'm limping by bed time. At the beginning of each day hardly a twinge happens. I presume this is due to the effort of lifting and twisting when assisting with transfers. The cold I had has passed, yet there is a persisting infection in my throat and my left hand trigger finger continues to bother me and the grooves caused by my wedding ring persist. I have begun vibrating Voltaren Osteo Gel into my right hip, seems to help.
I'm becoming angry and tired. Stuff it all!!!
posted by Kilpike | 2:01 pm
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