Bad three months
It’s been a bad 3 months for us personally, and the country generally (which I’ll talk about in the next post). We were celebrating our 61st wedding anniversary in June when my wife fell and broke her hip. Recovery has been considered quite good by the assembled orthopedic surgeon, visiting nurses, physical therapists and occupational therapists, but it’s still quite slow and she only now is in the process of transitioning from walker to cane.
Fortunately, having spent decades taking care of the sick, I knew what to expect, but most people are unaware of just how debilitating physical trauma can be. Just a 55 mile ride for followup by the orthpod made her sleep from 5 to 8 PM when she got back. The near total lack of independence is extremely hard psychologically for people previously leading a fairly normal life (so be prepared for reactions to it).
Nutrition is important, but most aren’t hungry and ALL are in negative nitrogen balance (breaking down more protein than making new ones which the trauma patient needs to do). Back in my med school in the 60’s the chief of Surgery (Rhoads) and his chief resident (Dudrick) worked on high intensity nutrition (hyperalimentation) to put people into positive balance, but it must not have worked as my internist never heard of it.
Being married to a lifelong dieter was suddenly changed to pushing food. Let’s hear it for Ensure. Most of this was due to the trauma, but some was definitely due to the pain meds (particularly the opiates in the first week or so).
I’m sure that many cheerleaders getting out of high school, college etc. go in to PT, visiting nursing and OT. They are some of the most positive people I’ve met.
Do not disparage OT, as one of the most useful things done for us, was showing that the front wheels of the walker, could be placed on the inside, allowing her to get into her studio.
Finally, some history. In the 60s the mortality of a broken hip in an octagenarian was around 25%. Now it is under 5%. It wasn’t a miracle drug or better surgery. It was because we were keeping them in bed to let them rest and the fracture to heal, which to an 80 year old meant thrombophlebitis of the legs, hypostatic pneumonia and death. Now people are getting up the day of or the next day after surgery.
Next up — some social commentary on the events of the last 3 months, and after that how changing one nucleotide out of 2.7 billion in the horse genome (we have 3.2 billion) changed history. For want of a nail . . ., is now For presence of a different nucleotide . . .