Don't Ask, Don't Tell

For going on three months now, we've had a closer relationship with the medical community than anyone should ever want. However, it has been generally as positive and professional as one could hope for. But I suppose it is inevitable that an occasional bump in the road should occur...and one did on Monday.

That was the day Bettie was to have an injection in her hip to relieve arthritic pain, and hopefully free her up to make more progress toward normal walking. When we arrived at the imaging clinic to check in, I mentioned in passing, that Bettie was on a blood thinner (Coumadin), just in case that was an issue. It turns out to be a big issue, and they can't do the injection until she has been off the thinner for at least four days.

This was my third contact with the clinic, the previous two being by phone, confirming the appointment, etc. In neither of those calls did they ask about her medications, nor did I think it important to tell them. In addition, the appointment was set up by a referral from another doctor's office and that office didn't tell (although they knew), nor did the imaging clinic ask. Maybe I'm just making excuses for myself, but it seems like if there is a restriction on a clinical procedure to be performed, the performing clinic should ask if that restricting condition exists, at the time the appointment is first set.

The result of this lapse is a reschedule of the appointment for next Tuesday, eight days later than it would have been. Eight days of additional pain...all because no body asked, and nobody told.

If it Isn't One Thing...

Right... it's something else. And the something else turns out to be arthritis.

A couple of weeks ago Bettie had a follow-up visit with Dr. Sultana, the director of the Acute Rehab Center at Auburn Regional Medical Center. While going through the standard stuff: "What is your name...show me two fingers...point to your nose" etc., he asked her to take a few steps. He noted that she had a slight limp, which the rest of us just thought was stroke related. "I want that right hip x-rayed" he said, "There's something going on there".

He was correct. The subsequent x-ray shows that she has moderate to severe degradation in the right hip joint and is a prime candidate for a hip replacement...but not in her present condition. She needs to be stronger and just generally more stable, medically speaking.

So it appears that the pain in the right side resulting from the gall bladder drain tube has indeed been subsiding, but the pain from bone-on-bone contact in her hip has been increasing. Because of her inability to be very specific about just what hurts, it was easy for those of us close to her to assume the right side pain was a continuation of the drain issue. In fact, it now appears to be mostly, or maybe even entirely, hip pain. It always hurts when she walks, and always stops when she lies down. In hindsight, it is not so hard to diagnose.

So, what to do? Here's the plan: Monday she will have an imaging-directed shot of Cortizone (or something like it) injected directly where it will (hopefully) do the most good. This should give her two weeks to a month of freedom from pain. The shot can be repeated a limited number of times. This buys time for her to gain strength and weight so that we can seriously consider hip replacement.

Though there is still pain in her life, and it is still limiting how much progress she can make with some of the physical things like walking, it is a relief that the issue isn't some mysterious internal problem with the gall bladder, gizzard, or whatever, in her insides.

Since she can't get on the treadmill just yet, I asked my son Tim to move the weight bench into our master bedroom so she can start working on strength training. She realizes the need for "getting in shape" and is taking to it very well. She can do leg lifts without hip pain. She's up to thirty pounds, and climbing. And that's not all.

Bettie is driving again!

Yesterday, for the second time in the last week or so, we made a trip to the Fred Meyer store in Covington. For the convenience of handicapped customers, they have drivable electric grocery carts. She got one one, and off she went. The only thing she found difficult was getting off when it was time to leave. When we finished at Fred Meyer, we went (practically next door) to Costco. There she quickly mastered the Costco cart, which naturally had a much bigger basket.

Having these electric carts for free use by customers is a great boon to caregivers like me. It is a big help in my new role as the primary grocery shopper, because she knows where everything is, what brands, and sizes we use, etc. It is good for her to get out and do something meaningful and fun. It also gives her an informal opportunity to get comfortable interacting with people.

And to prove this last point, in both stores we ran into people we knew. Ah, let me change that...we bumped into...no, no,...we saw, people we knew. That's better. Anyway, in Fred Meyer, it was Dora Darby, the woman I sat next to in church last week. In Costco, it was Bobbie and Chuck Stocton, old friends from the church we attended previously. Both interactions were warm and supportive...just what she needs.