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 surgery for broken hip 
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Joined: Sat Dec 05, 2009 7:24 pm
Posts: 34
Location: Northern Minnesota
Post surgery for broken hip
My husband fell and broke his hip on December 28th, he was taken to the local hospital, and then transferred to a hospital in Duluth, MN, where he had surgery the following day. I was able to speak to the surgeon as well as the anesthesiologist, I requested that they not use a general anesthesia, and they were willing to abide by my request, a saddle block was used, although they did have to use fentanyl to keep him calm, and allow the surgery to be done. I found that most of the hospital personal were not familar with Lewy Body, although one of the hospitalist seemed to be, but I was not able to speak to him for more than a minute, when he had to leave.

My husband was transferred to a swing bed,in our local hospital, a week ago, and will now be transferred to the nursing home on Thursday of this week.
He is not responding to therapy as well as we would like, although they did make a break through, and I am hoping that he will continue doing well.

If any one has any suggestions one therapy I would appreciate hearing them.


Wed Jan 13, 2010 1:01 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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Good for you for advocating so strongly for your husband. So glad to know he did OK with the surgery.


Wed Jan 13, 2010 1:06 am
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Joined: Sun Oct 21, 2007 4:18 pm
Posts: 835
Location: Acton, MA
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Mary, Our experience in rehab was difficult. Frank was there only to strengthen and work on balance. They either couldn't wake him or he couldn't process what they were trying to get him to do. There were a few times that things clicked and he got a 45 min workout. They hesitated to let him go home, and when I got home he was out of it so I had to call a neighbor to help me get him into the house. We came home on Saturday and on Weds. we did a mile+ walk. I had hoped the problem at the rehab, nursing home, was just that it and everyone was unfamiliar and he would improve once he got home. Mentally he never came back from before his stay, but he is mobile. Good luck with your Husband's theropy, hopefully the break through will continue.

Take Care,
Gerry


Wed Jan 13, 2010 7:47 am
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Joined: Sat Dec 05, 2009 7:24 pm
Posts: 34
Location: Northern Minnesota
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We have one thing going for him in therapy, and that is he knows all the therapists, as he has been going to them for therapy for one thing or another for the past 11 years. There is one gal, who he really works well with, and I have requested that she be his therapist as much as possible. I will be talking to them today about that. The therapist was going to tell the gal that makes up the schedule, but I want to stop in and talk to her to re-enforce the request.

I think I told every nurse, and even the hospitalist that they should go to this site and learn about Lewy Body. The hospitalist was a condescending idiot. in my opinion, my daughter and I ask for the list of my husbands meds, and he did not want to give it to us. When he got done telling us that our looking up the meds was doing his job, my daughter said but I still want the list. He did give in and the nurse brought it to us sometime later. I can't help wonder tho, if the fact that our daughter is an attorney made a difference. My husband kept telling people that the night he fell, every time they did something he didn't like or that hurt, he would say "my daughter is an attorney in the Twin Cities.

It seems to make a difference, she noticed it when she broke her wrist, and they were just talking when she was asked what she did for a living, and when she told them, the care seemed to get better.

I'll use any help I can get, and if that helps so much the better.

Mary 73


Wed Jan 13, 2010 10:09 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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What a jerk! If you have the energy, I hope you will type up your post here and complain to the hospital about this egomaniac.


Wed Jan 13, 2010 12:33 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
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What kinds of experiences have others had with hospitalists? I did not had a good experience last summer when my dad was hospitalized. We have yet to get anyone to tell us whether he had a heart attack, a stroke, or just a huge downhill slide from LBD (which they never even mentioned, BTW). The hospitalists are supposed to cover 24/7 at the small local hosp. where my dad was. One day I waited 11 hours to meet with the hospitalist, after numerous calls from the nurse to the hospitalist that day asking them to come meet with the family. 11 hours later when she showed up and I said the nurse had told me to come in at 8 am and the hosp. would meet with us then (and it's now 7 pm), she said "It's Sunday. I don't come in early on Sundays" and looked at me like I had 3 heads. These are people who are supposed to be there 24/7 and she comes in late because it's Sunday?????!!!!!! Additionally, the ER hospitalist doesn't communicate with the hospitalists who work the patient floors, so no one on his floor had a clue why he was in the hospital room. He couldn't do ANYTHING for himself, and the nurses are telling him to "get up if you have to go to the bathroom." (he came into the hosp. because he fell and had no strength, couldn't stand up or sit up). They didn't know he had dementia, etc. etc. etc.
If you can possibly avoid it, I would NEVER go to a hospital that has moved to the hospitalist system. The only good it does is increase the no. of billable hours for the local physicians. It is the WORST for patients and their families.
Boy, did I just vent!


Fri Jan 29, 2010 5:08 pm
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Joined: Sat Dec 05, 2009 7:24 pm
Posts: 34
Location: Northern Minnesota
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Have to agree about the hospitalist, that one was really a jerk. Just got the itemized bill from hospital, 8 sinnemt tablets 25/100's cost $40.00, one Exelon 9.5 MG patch was 35.50, $25.00 for a transfer belt, Celebrex 200 MG $ 27.00 and so on for his meds. Total bill, from 12/29/09 to 1/4/2010 $34,256.38

Thank God and the Democrats for Medicare, just found out a few months ago that they were the ones that put Medicare through Congress. Our Medicare supplement will pick up most of what Medicare don't.


Fri Jan 29, 2010 5:29 pm
Profile YIM

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
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And here's another amazing thing about the huge charges for the meds. At the ALF where my dad is (this was true when he was in Rehab also) - all meds have to be blister-packed, increasing the charges immensely as well as bad for the environment. aThey won't let us order a 90 day supply, which is much cheaper than 3 30-day supplies because they "don't have room for all those meds". I say put them in his dresser drawer - he can't reach them anyway since he is not mobile!!! So we pay about 3 times what we were paying when he was home.....
Boy, do I wish I owned a nursing home or a pharmacy..... These people must be making mega bucks off the rest of us.....


Fri Jan 29, 2010 5:35 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
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Yep. Don't get me started! Most of the SNFs in this area are for-profit chains and the CNAs, who do all the work, only make about $10 an hour! :x They are typically top-heavy in quasi-administrative positions, too. All have a 'marketing director', in spite of the fact that most have waiting lists :roll:


Fri Jan 29, 2010 6:01 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
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MT - I thought it was a little strange that the ALF where my dad is has a "marketing director" too, since it is a pretty small place (total of 58 people) but she does a ton of other stuff too. I do think they oversell these places, and most places do have waiting lists, so I agree it's a little strange for most of them to have a marketing director.
Have you had the "no 90 day meds" situation? Anybody? I'm trying to figure a way around that.....


Fri Jan 29, 2010 6:29 pm
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Joined: Sat Dec 05, 2009 7:24 pm
Posts: 34
Location: Northern Minnesota
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Actually the charges I was talking about was from the hospital. I have no clue what the nursing home is charging for the meds. I expect I will find out soon. I will ask for an itemized list there also. I think they will let us go with the 90 day supply, the med passer said that they have some that are just in bottles. considering all the meds my husband takes they will need half a drawer just for his. They have them in the blister packs for most everyone. It will be interesting to see what they tell me at the staff meeting on him next week.

Mary73


Fri Jan 29, 2010 11:11 pm
Profile YIM

Joined: Sat Dec 05, 2009 7:24 pm
Posts: 34
Location: Northern Minnesota
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An update of several things, first off, I am able to bring in the meds we get mail order, (90 day supply) as long as they are not opened, I bring them in just as they come in the mail in the package. There are quite a few people in the nursing home that do the same thing.

My husband is not doing well, no longer can write his name, or feed himself, both of which he did when he came into the nursing home, He sleeps a lot of the time, he leans to the right,(a Lewy Body symptom) and we have a hard time getting him to sit up straight, and hold his head up straight. His speech is low, and not really intelligible, he seldom makes jokes with the aids, as he did at first. He was cut off Medicare after 30 days because he was not making progress, he can't not walk. Although the hip seems to have healed fine.

I think the dementia is worse, and his primary care doctor agrees, he hasn't seen a neurologist, in some time, and in the condition he is now in, I don't know what one could do for him. Any ideas there, do any of you think I should try to get him to a neurologist, the doctor he had has quit working, so he would be going to a totally new doctor.

I don't know if what he is experiencing is the start of the end stage, or not, It would help a lot if I could have some idea of what to expect. He has a sister that winters out of state, and if he actually is in the beginning of the end stage, I would like to advise her to come home as soon as possible. He is her only living family member left, as their parents and one sister have all died.

Any one with any ideas or insights I would be grateful to hear them.

Mary 73


Thu Feb 25, 2010 4:47 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
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My insights are speculative, at best, but it does sound like Hospice would not be premature, if you are considering it. Some, if not most, ALFs do permit Hospice to administer to their residents and, of course, his meds would be covered. So difficult to know if it's near the end. In my experience in Home Health and Hospice, most patients lived a matter of weeks, rather than months, after going on Hospice. Most families who could be receiving its benefits wait too long.

So often, surgery or illness, even if resolved, does tend to hasten the decline. I am so sorry this is happening and empathize with your difficult decisions. I shall probably be facing the same issues within the next year and I can learn from yours. We appreciate your keeping us up to date. --Pat


Thu Feb 25, 2010 5:10 pm
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Joined: Wed Dec 12, 2007 4:53 pm
Posts: 88
Location: Melbourne Beach, FL
Post Hospice
You are absolutely right, Pat. Most people wait too long to ask for hospice. I have never heard anyone say that they were sorry they went with hospice but plenty of us have said, I wish I had not waited so long.

Joy


Thu Feb 25, 2010 6:57 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
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Mary - your husband sounds like he is in the similar shape as my dad. I need to look into hospice as soon as I get back to MD. When I was there 2 weeks ago the snowstorms had just about everything shut down so I couldn't do it. Let me know how your meeting with hospice goes. thanks, Lynn


Thu Feb 25, 2010 7:41 pm
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