Three weeks ago my husband suffered a kneecapping. His injury was not a malicious wounding as the I.R.A. and the mafia historically imposed on those who’d earned their ire. No. His was an ordinary, run-of-the-mill broken kneecap sustained from a simple fall on the hard cement sidewalk near our local grocery store. Nothing could have been more prosaic. The results, however, have been a life lesson for both of us.
When he fell, he also hit his head and nose on the cement, splattering blood all over and alarming the shocked onlookers gathered around him to help. An ambulance took him to the Lions Gate Hospital in North Vancouver. Two hours later, he was released. The good news was that he had no concussion and no broken nose; the bad news was that his kneecap was broken and he had to wear a velcro leg stabilizer to keep his leg perfectly straight until it could be seen by an orthopaedic surgeon. Six days later, he saw the surgeon who ordered day surgery for the next day.
That Friday, he was last on the list to have his knee cap wired, stapled, pinned and stitched together, as only surgeons can do, and was told to keep the leg straight in the velcro stabilizer for six weeks. When we left the day surgery unit, it was 9:30 at night, the lights in the ward were low, all the beds but that of my husband were empty, the intravenous poles were herded together for the next day, and two staff (nurses or aides, we had no idea) were behind the desk. When they finally pronounced him fit to leave, they rolled him down to the car in a wheelchair, he pulled himself and his prone mended leg into the back seat as best he could, and we headed home.
We left the hospital as proverbial babes in the woods. The hospital provided a set of crutches, a prescription for painkillers (which only made us recall with horror a previous very negative experience with side-effects of high-powered opioids), and instructions to schedule a post-op with the surgeon two weeks hence. We had planned a return to Toronto by that time; obviously that was not going to happen. We had no idea what would happen, nor what we would be required to manage.
The past two weeks have been a crash course in “Basic Care 101.” Part A: for the caregiver, and Part B: for the care receiver. Although we did not know it at the time, our first big mistake was leaving the hospital (probably due to the late hour) without any referral to an Occupational Therapist, Home Care Assessor, or to the Red Cross (which apparently loans all sorts of medical equipment to people recovering from hospital stays, all on referral from the hospital or a doctor). We had no family doctor on the west coast, and no referral for that, either. We had to manage as best we could, by trial and error, as the situation evolved.
We soon ditched the crutches and rented a walker, bought a raised toilet seat, and set about to make my husband as comfortable as possible. In a totally understandable post-surgical stupor, strategically sedated with painkillers, he developed bedsores, a bad sign we thought. The remedy? “Keep them clean,” and “Cover them with Mepore pads,” said the pharmacist who sold me a half-dozen dressings. A friend brought some Tegaderm film she had used to good effect for her long-deceased mother years ago. The bed sores healed as my husband became more mobile.
In the meantime, an 89-year-old neighbour who lives on the sixth floor and who has been a full-time caregiver for her wheelchair-bound husband for the past three and a half years, gave me the telephone number (604-215-4700) of a publicly accessible nurse whom she assured me is “always helpful… even in the middle of the night.” That we had a phone number to reach some medical help if necessary was immensely reassuring.
Our biggest mistake was our failure to buy or rent a “Bed Assist” that would help my hubby get up from his bed and onto his walker. Who would have guessed that it would be so difficult? First, I was the ballast as he grabbed the walker to pull himself up. That was difficult and hardly confidence-building. Then, we tried arranging cushions beside him in various configurations to act as risers. That was better, but a nuisance. Ultimately, our next-door neighbour, well into her nineties, who uses a walker, demonstrated on her own bed how she uses her upper arms, wrists and fists to push herself up and how she places her head to get the necessary momentum. If she can do it with such agility, so can my hubby. After two weeks, we finally rented a “Bed Assist,” a curved bedside bar attached to two long metal anchors that go between the mattress and the box spring. Problem solved, at least in the bedroom. Getting off cushions piled on the chesterfield in the living room still requires some care. Getting out of the back seat of the car, using the seat belt and the door for leverage, requires the strongest possible strength in the upper arms. Where are those strong shoulder muscles and biceps when you need them?
At first, we were in a state of shock, overwhelmed by our frequent miscommunications, my husband’s justifiable fear of falling again, my expectation (which he didn’t initially discourage) that I needed to do everything, and our clear incompetence. Neither of us was sleeping at night, except with heavy-duty sleeping pills which were running out. When our dishwasher was overflowing with suds just as the new cleaning woman arrived (because I had used the wrong detergent), that was the last straw. The mistake reflected my state of mind.
It seemed as if this event was a foretaste of the future. Would this mean we’d have to sell our Toronto house (if only to get rid of the steps)? Or give up our Vancouver cottage (because our primary health care providers are in Ontario)? Must I abandon my writing, just when I’m on the verge of learning what the craft is all about? Apart from the love and devotion caregiving requires, the professional skills involved and the constant attention are bloody hard. I know the statistic that caregivers often succumb before the person they care for. Being a caregiver is a high-risk occupation.
All that has now changed. A friend who is a professional social worker invited me for coffee, gave me space to vent and shared some practical referrals she could recommend from experience. I have now visited the walk-in clinic she suggested, and had excellent service for my own needs. The doctor sent me to a local LifeLabs where I can get access to the test results myself on the internet. We saw the surgeon for a post-op on Wednesday and, as well as having the staples removed and proclaiming the knee nicely on its way to healing, he gave us all that we asked. We had a long list: renewals of sleeping pills, written orders for physiotherapy, a referral to the Red Cross for medical equipment, and a date for the next visit.
The physiotherapist from local community health came Thursday, showed us how to manage the brace, what exercises to do, which furniture adaptations and equipment additions would work best, how to install new shower heads… altogether a most helpful consultation. On Friday, we secured from the Red Cross Loan Program a shower stool and a tub transfer bench, two possible means to get proper showers. That same day, we plugged into a Home Care Service for a personal service worker or attendant who can help my husband with his bathing routine. And my hubby never even complained. Truth be told, we both came to exactly the same conclusion about our mutual needs at the same time.
Our neighbours, who are nearly twenty years our senior, carry on their caregiving and their personal health challenges with relentless good humour and energy. Who are we to complain?
My hubby is feeling better; he wants to get some exercise, and resume cooking. He has ample time to browse the cookbooks (one of his favourite past-times), can push his walker around the grocery store as he does his shopping, and can manage cooking in the small confines of our galley kitchen. Already he has bought dozens of exotic spices so he can cook from the Jerusalem cookbook a friend gave us. On Thursday, he actually walked all the way home from the grocery store pushing his walker and paying very careful attention to the contours of the sidewalk. The physiotherapist had told us about the practical consequences of neuropathy in the feet, something which may account for his fall and which we should have known before. This successful spurt left him in great good humour. I have resumed writing, taken up walking again and returned to the gym. Friday morning, at 6:00 a.m., I met my Caregiver neighbour on the Seawalk. We are now bosom buddies.
It will be at least another month before we return to Toronto, but the new norm seems manageable after all. And with the sun finally coming out in Vancouver, and the cherry blossoms, early rhododendrons, ornamental tulips in the latest fashion colours, bright yellow and spritely white daffodils, who could want for anything more?