Friday, June 23, 2017

June 23, 2017: What's important now

Tonight is my last night at the "home."  I've made quite a few friends here.  I started a little group that I call the lucidity club.  There's 4 of us who eat meals together.  We have a lot in common: we all have injuries that need rehab and we still have most of our marbles.  We even played cards a few times.  I'll miss seeing them every day.

I decided that I would move from my apartment at Marvel 29.  It's still full of a lot of boxes.  There is only a bathtub, no accessible walk-in shower.  I did put a riser on the toilet but that is not enough for safety.  I'm just not all that steady on my feet yet.  I have progressed to a 4 wheel walker that has a seat, basket and hand brakes.  It's mine to keep.  Since I got it, I haven't used the wheelchair anymore.

I have practiced using a ramp here.  The ramp at Marvel 29 is pretty scary.  It's steep and is close to a busy intersection.  I don't know when I can drive my car again.  That means I would be home bound and alone most of the time.

I decided to break my lease and move to an over 55 independent living community, Russellville Park.  The average age there is about 80.  I'll bring the average down a little bit.  My doctor wrote a letter stating that I needed a safer environment.  Hopefully I can get out of my lease without penalty.

The only 2 bedroom apartment available is a remodeled unit with all the fancy bells and whistles - fireplace, corner location, washer and dryer, etc.  It's a lot more than I'd like to pay but I will be safe there.  There are 4 alarm cords in each unit plus someone checks on you once a day.  The complex has a physical therapist on staff plus a heated pool.

As I get better I will be looking for a permanent home.  I prefer a condo because I do not want to do yard work.  Houses here are tiny and very expensive.  I'm sure that I will love living in a community like Russellville Park.  Unfortunately, it would devour my savings quickly.

Kevin will pick me up tomorrow.  We'll go to Marvel 29.  I have to pick up my important papers and whatever else I can carry.  I need to get Stella kitty into her cat carrier.  She and I will move to Russellville Park.  I don't know when my things will get moved.  I'm going to rent a bed in the new place.  It has air conditioning.  Tomorrow it is supposed to get to 101 degrees in Portland.  My Marvel 29 apartment does not have a/c and neither does Kevin's house.  But Stella and I will sleep comfortably in our rented bed in an empty apartment.

Sweetsie can move in after I improve.  I miss her but I'm not ready to take her outside using my walker.  I'll have to train her to walk on my right side and stay away from the wheels.

Wednesday, June 21, 2017

June 21, 2015: Woo hoo I won!

Me vs Medicare


I don't think the office workers at my surgeon's office ever gave him my message.  I never did receive a call back and neither did the social worker at the home.

I had an appointment on Monday the 19th with Dr Barney, one of the trauma surgeons who worked on me when I was brought to Legacy Emanuel Hospital.

She examined me and I told her about the problems with Dr Vande Zanschulp's staff.  She said she felt comfortable recommending that I stay in the staffed nursing facility until my surgeon said I was ready to be discharged.  She suggested that I make an appointment with Dr Vande Zanschulp  for re-evaluation next week.

When I got back to the home I gave the doctor's handwritten progress notes to Emily, the social worker.  She had received the typed progress notes from this doctor before I even arrived back at the home.  She faxed the letter to insurance.  I asked her to make my follow up appointment with the surgeon.

As of today neither Emily nor I have heard back from Dr Vande Zanschulp's office. They really do their jobs poorly at this office.  I have an appointment in July and I'll be sure to inform him.

Yesterday afternoon I received a call from the company reviewing my appeal and they said that they agreed with Medicare's decision and denied my appeal.  I was not surprised.

Then a couple of hours later Emily brought over a letter she received via fax from Aetna that approved my stay for 3 more days.  That means 6 more physical and occupational therapy!  Yay!  Therapy is the only way that I'll get better.

I don't know what happens after I leave.  No one has informed me.  Hopefully I will get home health care and some home therapy.    Therapy won't be twice a day like in the home unfortunately.  I will have to figure out some safe exercises on my own.

Yesterday afternoon my rollator (4 wheeled walker) was delivered.  I've been working on going up and down ramps and curbs with it.  The curbs are especially scary.  Tomorrow I am supposed to work on going up and down stairs using only one handrail.  That was hard for me before with my bad knee.  I hope I can do it now with two bad legs.

Monday, June 19, 2017

June 19, 2017: just kvetching

This morning I called Dr Vande Zanschulbe (my surgeon) one more time.  I had already left several messages and received no reply after I heard that Aetna was booting me out of the "home." Today at noon was the deadline to appeal that decision.
I finally got a live person at the doctor's at 10 AM.  I told her my problem and she gave me his assistant, Brittany's voicemail.  At 11 AM I called again and said it was an emergency.  Brittany spoke to me for a few minutes.  Then Monica gets on and explains about insurance and therapy, etc, etc.  She must have repeated herself 10 times.  She told me that I just did not understand.  Finally I told her to please listen to me.  I was not asking for their office to get involved with Aetna.  All I wanted was the doctor to write in his progress notes what he told me during my appointment.  He told me that I needed one to two months more of supervised care.  She started up again with her same spiel about insurance.  I told her that his note was all I wanted from her, nothing more.

Monica then told me that such a note was impossible because there wasn't enough time.  I told her if someone had called me back when I started leaving messages that there would have been plenty of time.  Then she lied to me.  I just HATE being lied to.  She said that if the doctor did write a note that it would have to be transcribed, typed up and submitted and it would take a couple of weeks.  I then told her that I was holding in my hand the progress notes that he wrote during my appointment.  They were handwritten by the doctor.  Unfortunately,  I didn't know that his progress notes were in the envelope I was given as I left.

That office never did supply the progress notes, not to me and not to my case manager.  Maybe they never even mentioned my request to the doctor.  I did not receive a phone call from them.

I  realize that the odds of my appeal to Medicare only has a 10% chance of succeeding.  But without the doctor's input my odds are even lower.

Emily, the social worker at the home, told me that I could call in my appeal and that she would have until 5 PM to fax in the accompanying paperwork.  So, I called the case reviewer employed by Medicare and said I was worried about going to an apartment that hadn't been set up and was full of boxes.  I also told her that I live alone.

I just happened to have an appointment with a trauma doctor this afternoon.  I told her about my problem.  She wrote in her notes that I should stay in the "home" until the surgeon reevaluated me.  She told me to make an appointment with him for next week.  She typed up the notes herself and her office faxed it to Emily.

Maybe my appeal has a chance.  I want to stay here where I get physical and occupational therapy every day.  If I go back to my apartment, maybe I'll be allowed to have a therapist come into my home for an hour or two per week.

If I go to my apartment I will be alone most of the time.  I won't be able to take a shower because there is only a tub in the apartment.  If I fall while using a regular toilet, there will be no one to hear my screams, no call button to push, no person checking on me periodically.

Yes, I'm scared to return to an apartment that I've only spent 3 nights in.  I'm returning with a major trauma to my right hip in addition to my handicapped left leg.

It makes sense to let me get stronger in a controlled environment for at least a few more days.  I work hard at therapy.  The therapists' records of my progress can prove that.

If my efforts don't work and I'm sent home, so be it.

June 18, 2017: The Denizens of the "Home"

The first week that I was here in the home I could not get into a wheelchair.  The activity calendar listed most of the activities as being in the rotunda.  I couldn't wait to get out there.

The rotunda is actually small and is the hub of the 5 hallways here.  It is round but calling it a rotunda is a bit of a stretch.

There are several patients who hang out at the rotunda.  The nurses must take them there hoping that they will socialize a little bit.  These people are pretty out of touch with reality.  Mostly they hang down their heads and nap.  One dude sits there calling out "Can I talk to you?  Excuse me..."  He is trying to get one of the workers to talk to him.  He then asks them things like "when's lunch,"  "what time is it" etc.  At least he interacts.

I have to go through the rotunda to get to the therapy room and dining room.  One day while I was in therapy a woman (Liz) came in looking for someone to draw her a salmon.  I volunteered and now she and I hang out together - have lunch together in the dining room, play bingo.  It's nice to have a friend here.  She's getting the boot on Wednesday also.  Medicaid is sending her to a less expensive facility.  She had heart surgery and also has a broken back.  I hope her next place treats her well.

Liz seems to know everyone here.  She even talks to the patients who don't seem to be lucid.  But they are happy to get some attention.  I try and be pleasant to everyone but I'm not as patient as Liz.

There is a lady at the end of my hallway who must live here full time.  Her room is very decorated.  She even has her Christmas tree up in there.  She can't seem to figure out how to use her call light.  So, she just hollers out - "I want my light off,"  "Please turn on my TV."  She has a loud gravelly voice.  The staff are very patient with her.  I've heard them repeatedly explaining the call button to her.

I spoke to  her one day and she told me she had a boyfriend.  The next night the 2 of them were having dinner together.  He sits with his head hanging low.  He raises it to yell out answers to her questions.  He looks terrible - skinny and decrepit.  I overheard her tell him that she couldn't keep her eyes off him.  Oh my!  Another time, in his very loud voice, he started talking about his penis.  It must be true what I've heard about nursing homes.  It's full of sex maniacs.

I truly hope I die before I get as demented as those 2 lovebirds.

I suggested to the activity director that we have a lucidity club.  We could get together and play games or just talk.  She said that she's tried that in the past but didn't get much of a positive response.  Most of the lucid people have their meals in their rooms and stay to themselves.  I think it's because of the stigma associated with being a patient in a nursing home.

It's too bad.  I think getting together would lift everyone's spirits and help pass the time.

Another woman, C, used to walk around all the halls with a big smile on her face.  She thought she lived here permanently.  But, she found out that she has to leave on Wednesday also.  Now she is so worried.  She says her kids treat her like she is crazy.  She has told me how she is worried about her dog several times now.  I closed my door to keep her out.  But she came in anyway and started up on her dog worries again.  She needs some reassurance from her grown children.  I don't think she is getting it.

Liz and I now eat dinner with a pleasant guy in a big neck brace.  He had to have some of his vertebrae fused in his neck.  He has a hard time swallowing.  He had a couple of surgeries and they left him weak.  He has to wait for someone to push his wheelchair back to his room.

The dining room was very depressing until I started eating with Liz.  The patients who need lots of help are gathered there.  Some need to be spoon fed, some refuse to eat, some keep trying to get up out of their wheelchairs.  It's unfortunate that the lucid people don't get together for meals.

I wanted to write about the patients before I leave here and the memories fade.  I hope I stay lucid when I have to be a permanent nursing home resident.  The confused patients seems so worried and unhappy.  The future is scary.  I think we should be able to make a legal document in which we can ask for an easy death before our dementia becomes too bad.  It's crazy how our society doesn't let us at least choose when we die.  There will soon be so many baby boomers with dementia.  It will be hard to give all of us the necessary care.  If some of us would like to leave this world, I think we should be able.

Sunday, June 18, 2017

June 18, 2017: Genghis Khan

My son, Andy says that I was Genghis Khan in my last life.  So, I have to atone for all of Khan's (mine) brutality by suffering in this life.  That makes as much sense as any other theory.  I've certainly have had more than my fair share.

Andy came in Friday afternoon to visit me from Houston.  He said I looked better than he thought I would after being hit by a bus.  He took the redeye flight.  He stayed just for a short time on Friday and then went to Kevin's for the night.  Kenny and Miho love to play with their uncle.

We tried to go look at a respite care place yesterday but I entered the wrong address in GPS.  We ended up at a Home Depot.

I'd love to go to respite after the "home."  My surgeon told me at my appointment on Monday that I need one to two months more care in a facility.  But he failed to write it in his progress notes.  I tried leaving messages at his office.  I have until Monday at noon to file a protest with my insurance company.  There is little hope for a positive outcome without his notes.

The supreme ruler of my health care, the insurance company, has decreed that I am well enough to go home on Wednesday.  Plus, I walk too far with a walker so Medicare won't provide me with a wheelchair.  I'm not allowed to walk alone with a walker in the "home".  Obviously, that means by Wednesday I miraculously will no longer need a wheelchair.

Yes, I'm angry and upset.  Two days ago I was crying and depressed.  Angry is a big improvement.  I'm scared to be left alone in my apartment.  I'll deal with it - what other choice do I have.

Andy and I were going to go to the movies and just have fun yesterday.  But I wanted to check out my apartment first.  I was able to get in just a few feet.  The apartment is FULL of boxes.  Every room has boxes everywhere.  I rented a two bedroom apartment and I thought all of my boxes would fit in there.  The second bedroom is piled to the ceiling with boxes.  Plus, my dresser is in there because it wouldn't fit in the other bedroom with a bed in it.  And, I only brought a twin sized bed.  Obviously,  I have problems understanding how an apartment can be SO small.

I will need to get rid of tons more stuff.  I already donated over half of my house' belongings.  My house didn't look overly full.  My apartment should be featured on that hoarder's program.

My lawyer told me to hire unpackers.  No way.  First I need to be able to at least get to the bedroom and bathroom.  Andy worked on my apartment Sunday until he had to leave.  He said that it's neater and that I should be able to get around a bit better when I return.

I didn't mean to blog all these current problems but I'm all upset again.  I'll have to write another post later.  I actually have been busy.  I don't like to blog when I'm depressed.  When I'm not depressed I roll around in my chair visiting the other inmates.  I have to enjoy being with people while I can.  I'll be stuck alone 90% of the time in my apartment when I leave here.

Monday, June 12, 2017

2017-06-12

Today I had my follow up appointment with the surgeon.  I guess I've been in denial about my injury. It is really, really bad.  I have a metal rod all the way down my thigh with a nail into my hip.  I snapped a photo of my x-ray today.
So now I'm really feeling down in the dumps.  I should have known it was this bad.  After all I was hit by a huge bus.  These buses in Portland have been known to kill people.  I'm suffering but I'm alive.

Here I am living in a city where pedestrians have the right of way.  If you see a person at a crosswalk, it's mandatory that the cars stop.  Who would have thought that the city buses are exempt from this law?  My bus didn't even stop for a stop sign.

I'll be in the "home" for a few more weeks.  I'm not sure what I should do about the apartment I'm renting.  I guess I'll get a moving company to put everything in a storage unit.  I'll have to fight the apartment management to not make me pay a penalty for getting out of my lease early.  I've spent only 3 nights in the apartment.  My poor kitty cat is in there all alone amidst piles of unopened boxes.  No one has seen her.  Tomoko goes every other day to feed her.  So we know Stella is alive and eating.  She must be so scared and lonely there.

My Sweetsie is okay living with Kevin but she's not all that happy.  The kids chase her around and their big shepherd dominates her.

I feel like I abandoned my babies (pets).  It makes me so sad.  I'm responsible for them and I can't take care of them.

I'll get past this.  I'm working as hard as I can at physical and occupational therapy.  Eventually I will graduate from the wheelchair.  I can already walk a short distance with a walker.

Wouldn't it be lovely if life were fair?  I've already had more than my fair share of horrible crap happen to me.  The rest of my life should be a breeze.  No more pain, no worry of dementia would be my future in a equitable world.

Thursday, June 8, 2017

June 8 2017

I finished with my therapies by 11 AM today. 11 is really early since I'm scheduled for 85 minutes/day.
So, now I'm bored.
They are now letting me have ibuprofen and I'm feeling better.  It's funny that feeling better leads to boredom.  I have my computer, kindle and TV for entertainment.  I had hoped to be exploring Portland during June, not recuperating.

I laid down from 11-12:30.  My butt hurt so bad from the lumpy mattress that I got into my wheelchair.  I sat outside for awhile. Now I'm in the dining room waiting for bingo to start.  I hope it's not too too lame.

Bingo was okay. Play is slow for the more handicapped people.

I've engaged a lawyer to help me with the bus company responsible for my injury.  She has a good reputation.  It's an Oregon law that cases do not drag on for years.

This is the third time that my life was changed in an instant.  In 1969 a car rammed my car into a tree.  I lost my kneecap causing a permanent injury.  At the time of the accident I was midway in my second year in college.  I had to miss 2 semesters to recuperate.

In 2010 my husband and best friend fell injuring his spinal cord and became quadriplegic.  My life as I had known it ended.  For months I took care of him and my elderly mother.  Besides the amount of work I also was suffering from a kind of post traumatic stress disorder.  Visiting TIRR, the specialty hospital for spinal cord injuries, exposed me to so much pain and suffering.  Young wives would be pushing baby carriages next to their husbands in wheelchairs.  There were  people suffering brain injuries screaming and crying.  Then, of course, I had to learn how to take care of my permanently paralyzed husband. (It turned out that he also had a brain injury.  Subsequently, he decided he never loved me and we were divorced.)

Now it's 2017.  I worked so so hard to move to Portland.  I had to sort all my possessions.  Pack up what I could and sell my house.  I arrived in Portland on May 19, 2017 ready to make a new life for myself.  3 days later I was walking my dog and was hit by a city bus.  My hip was broken, suffered a concussion and many cuts and bruises.  I had emergency surgery and stayed at a trauma hospital for 4 days.  Now I'm in my third week at a skilled nursing facility.  I am thrilled that I did not suffer a brain or spinal cord injury.  Nonetheless, my life has been changed and set on a different course.

I now have a permanently injured right hip.  I'm learning how to walk with a walker.  I'm using some of the same equipment here that was used at TIRR.  I'm surrounded by injured people.  It's very difficult for me.  I can't help but relive some of the memories of the pain I suffered during my husband's stay at TIRR.

I am working hard at rehab.  It hurts- a lot.  But, that's the only way that I can recuperate.  I don't know how much of a disability this injury will cause me.

This is definitely not how I imagined my life would be like in Portland.  The injury will make my transition so much more difficult.  I can't go out and explore the city.  I'm lucky that I can use the walker to make it down the hall.

Maybe this will be the last major life altering incident that will happen to me.  But, then again, maybe not.