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Hemi-Arthroplasty Zauberflote's Mom, Dementia & Hip Replacement

zauberflöte

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she made it! This will be interesting, because she doesn't even know we chose surgery. She didn't even know that was on the table.
Now we have to gentle her through post-op pain. Rehab.... urrgh....
 

Pumpkln

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Welcome your Mother to the other side.

Here are the Hip Recovery Guidelines, the articles are short and will not take long to read.

Hip Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access these pages on the website

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
 

Pumpkln

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@zauberflöte
Reading back through your pre op thread, it sounds like your Mom had a partial hip arthroplasty, vs arthroscopy. Post which surgery so we can up date your prefix to THR.

Hope your Mom is doing well and is out of recovery.
 

Mojo333

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Big relief...big hugs.
Do take care of yourself too, Zaub.
:friends:
 
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zauberflöte

zauberflöte

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@Pumpkln you are right, partial arthroplasty. My bad, sorry!
Sitting up here in our shiny nice private ortho wing room, Mom more or less on the way. Mayhem may ensue but Superman ("perfect brother", no worries we all agree on that ) is on his way.
Probably I will be clueless about posterior! Guaranteed clueless about dementia and drugs. @Jaycey was it you, BTDT? Any advice besides watch like a hawk?
 

alexthecat

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I've changed your thread prefix to reflect that she had a hemiarthroplasty (sometimes called a partial hip arthroplasty).

A hip fracture is a tough injury. Best wishes to both of you. Don't forget to take care of yourself too.
 

CricketHip

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Glad to hear that she is through the surgery, oh my, I wish you all the best, you may be in for a bumpy ride.
bless your mother's heart, she will be so confused. She is so lucky to have you and Superman by her side.
 

Jamie

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Good news, but now the really hard work begins. I cannot imagine dealing with this in someone who has dementia. My heart goes out to you and your brother and I hope this is easier than you think it's going to be. Please let us know how things go.
 
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zauberflöte

zauberflöte

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I've changed your thread prefix to reflect that she had a hemiarthroplasty (sometimes called a partial hip arthroplasty).
Yes thanks Alex! Hemi is indeed what it was termed.
@Layla as soon as I brief bro I will be going home. The poor man has enough teenage daughters problems at home, and now this! We'll work out a schedule. We have a list of private duty sitters from hospice, and would like to have a 12 hr night shift so bro can go home and I can do days.
They anticipated a Saturday discharge, but they were just trying to lure me into false contentment. We all know that Monday would be much more realistic. And a night time discharge to a totally unfamiliar rehab.... can we say if she is not sundowning now, that's one way to start it! Ugh.
Thank you so much for dropping by @Jamie ! Thanks for your good wishes. We can hope. She's currently still zonked out. We shall see.
 

Jaycey

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@zauberflöte Yes, dementia and post op can be tricky. Watch for any signs of delirium or confusion. The balance of drugs for these patients is so tricky. In most cases they can't just have what everyone else is taking.

A private duty sitter would be a great help. Staff on orthopaedic wards are already stretched. Add to the mix a patient with special needs - well it just doesn't work. Peace of mind for you as well.

We went through this same scenario with my MIL. My heart goes out to you. So difficult when someone doesn't even know why they are in the hospital.
 
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zauberflöte

zauberflöte

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@Jaycey thanks! Yes, my MIL went for several hospitalizations but I was part of a 4-woman sisterhood plus an already beloved 24/7 set of caregivers. She had only the memory loss, never declined much farther mentally. And she'd always been content to sit back and watch her family be boisterous. Whole different ballgame here. We fear Mom will become so disoriented that she won't know she's home when she gets there eventually.
As to drugs. She woke up in pain and agitated at 10 last night. She got some morphine and fresh ice and a tormented position change to get weight off rear. This ortho ward has a FREEZER in each room for ice. I am ver pleased!
Had to stop them from beginning regime of x3hr finger pricks to treat Mom's untreated diabetes. Wonder what else we'll run into.
 

Jaycey

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Hang in there my friend @zauberflöte ! Were you able to arrange for carers at night? Such a good idea. We didn't have that option.
 
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zauberflöte

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@Jaycey not yet but God has been sending exactly the right people at exactly the right times today, and so we are not doing rehab, we are doing a combo of 24/7 care (that we'll engage) plus home health, with the same agency that does our hospice, at Mom's place! Hopefully she will remember the love there, which will certainly aid the healing/recovery mountain's reduction.

While bro was here, OS PA came in. "It all looks like it should". Emphasized 90 degree rule. Very good circulation in op side foot. Incision looks good. Says, the proof will be in the pudding, as in, how well she responds to PT today and tomorrow. Was encouraging about our choice to have done this. Bro writes, he sounded an awful lot like we did yesterday (trying to decide, he, sis, and I).

Also with bro, PT came in. Did not go well. Mom an anxious demented very elderly lady at the best of times! And her body often does the opposite of what you ask. Or she doesn't understand what was asked, or did but it doesn't get to the movement part of the brain correctly. Or she's getting Parkinson's. Who knows. They will try again tomorrow, and OT will coordinate with them so Mom only gets worked up once. .

We saw OT but Mom was asleep. She seemed very perspicacious and helped us a great deal. Therapy team's criterion for discharge is, that Mom be a one-person transfer to chair or commode, or higher functioning. Since we ALL know that walking is all Mom needs for rehab anyway, and she will relearn that by doing it at home, we are good. All her ADLs that she can't do are managed at her place as needed. OT said it's her experience that the second day is usually better for the patient. That is not necessarily how I remember it in the pain department, but surely clearing out the GA for 24 more hours will be good.

Thanks all for circling round the wagons for me! I don't see this going over well on my dementia forum
 

Layla

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You know the old saying, "it's very early days". And that it is.
I'm sure there are lots of prayers going up, good vibes being sent and all that great stuff.
One Day At A Time.
We're here for you...that is for sure.
Big hugs :console2:
@zauberflöte
 
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zauberflöte

zauberflöte

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Thanks @Layla ! There's been mostly sleeping today except for an unsuccessful visit from PT. They propped her up on the edge of the bed by main force, to hear it told, and she vigorously protested out of anxiety, fright, and disorientation-- and maybe pain, who knows. She did, however, have a good, happy half hour awake with bro before I arrived to spell him.

It is indeed discouraging to watch your mother more or less perpetually zonked out, not taking fluids when put on a little swab and offered, sleeping with her mouth open, for three entire days. She's not getting much pain med-- they are using morphine in the IV, and her last dose was almost 11 hours ago. I don't know whether she hurts and has taken herself away, or doesn't hurt. She can't use her mouth very well in forming words, but sometimes you can make things out by her intonations. Yes is "ah-ah?" like "mm-hm", no is "ah-ah!" like "nuh-uh". Only the "ah"s are more "ung"s.
Well! There, to make me a liar, I took advantage of a small coughing fit, got a yes to a water offer 4 times running. A teaspoon from the little green swabby thing. Better than nothing. Then she actually said something more than yes, no, or sure ("ah!"). It was a whole sentence. Ah ah ah ah ah ah ah ah ah. Now I'm discouraged all over again.
 

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Oh hon.....my heart goes out to you. How rough it must be to see your dear mother this way. And to not know if she needs something or not.

Jaycey was right about the way the anesthetics and pain meds impact an older person and especially one with dementia. I went through the same with my mother back in the mid-90's. She was 84 and the level of anesthetic they gave her was frankly too much for her little body. She was so disoriented and angry at times. Back then I wasn't as smart about these things as I am now and we didn't have anyone with her 24/7. So you are very smart to do that. It only takes one time of her thinking she can get up and you have big problems.

I know on some level there is great comfort with you and your brother there. Please know you're doing a great job and being a very caring and supportive daughter. I hope things start to improve so you can see the light at the end of the tunnel (and know it's not a train). (((HUGS)))
 

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@zauberflöte You have a gift for describing what you see and feel so vividly, your dilemmas land in the very pit of my stomach and make my heart ache. I am searching for something of value to offer from my experience caring for my mother, post-stroke, as we tried to get her treatment for a circulatory problem that turned her toes black, and eventually resulted in a fractured pelvis. It isn’t much, but here it is: I am convinced that love is communicated and matters more than anything else. I would guess that you know many love languages - touch, sound, smell. They all work. I know the anxiety about pain medication when you can’t be certain if they’re in pain. A nurse taught me to watch breathing: shallow, deep, slow fast, regular, irregular and use those cues to judge pain levels. Remember to pace yourself, as this is a marathon, not a sprint. Finally: there’s no way to do this right, but equally no way to do it wrong.
 

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Thanks for keeping us updated. Yes, I think once the GA clears from her body and the pain meds are sorted things will improve. She is probably so confused with all this. It will be great to get her back home with familiar people.

I hope things improve today!
 

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