2022 A Year of Daunting Challenges

What a year 2022 was! Yet, it is just a continuation of the personal traumas Lea has struggled with since her initial illness in 2005. In the previous post, I mentioned that we had moved back to our hometown to be closer to her siblings, with the expectation that Lea would be able to interact with her family a lot more frequently than in all the years we lived “away.” What we didn’t factor in was that her siblings had gotten as old and feeble as we were. Visits were few and far between. Couple this with Lea’s ongoing clinical depression, and feeling that she was always too tired to get out of bed, our move “back home” didn’t quite pan out to be all we expected.

In fact, all the previous year she seemed to struggle with worsening general health. She experienced lightheadedness, ongoing fatigue, and wanted to sleep most of the time. It took special effort to get her interested in getting out of bed to do something . . . anything, really. She even lost interest in her longtime hobby, quilting, for which she had an ongoing passion. She started losing her memory, exhibited neuropathy in her hands, and became incontinent. We even traveled, with great difficulty, to my son’s home in Hawaii for a Christmas fortnight. She, however, was in bed nearly the entire time, without enough energy to get out of bed.

By February 2022, I asked her endocrinologist to examine her overall medicine schedule to see if there were any conflicts or side effects that could be worsening Lea’s condition. After some time reviewing the list, the doctor recommended dropping several vitamin supplements, stating that too many vitamins can be as harmful as not getting enough. So, I began weaning her off the supplements. Her overall condition, however, didn’t seem to improve over the next few weeks. Her confusion and memory worsened somewhat, to the point that she forgot very basic things, like how to take a photo or make a call with her phone.

She was no longer able to keep her balance by using a cane for support and began using a rollator walker, which has brakes and a seat with a storage compartment. Still, even with the rollator to help with her balance, she fell probably 40 times during a twelve-month period. Most of the time I was able to catch her because I would walk beside her with a grip on her gait belt or garment. Even so, I would estimate that she fell to the floor a dozen or more times during that year, mostly by falling backward into a wall, after standing and sliding down to the floor. A few times, when there wasn’t a wall behind her, she fell on her buttocks or back.

On March 5th, early morning, I got her out of bed, to go to the bathroom, got her freshened up, into clean pajamas, and back to bed. This was my general routine on mornings when I was going to the grocery store to pick up my grocery order. The store is less than 5 minutes away, and I have very rarely spent more than a very few minutes waiting for my order. So, I was usually back home within 15-20 minutes, as was the case in this instance. This time, however, was different.

Before unloading the groceries, I rushed to her bedroom just to check on her and found her, in pajamas, laying on her back on the floor between the closet and her bed, the rollator folded up on the floor nearby, and some clean clothing scattered around on the floor. She was sobbing, held her arms out to me, and said, “Help me up! I fell!” I knelt down over her, and asked, “Can you bend your legs up at the knees to help me stand you up?” She said, “I can’t feel my legs.” I told her to lay back and rest covered her with a blanket from the bed next to her, and dialed 911.

She had decided, after I left to go to the grocery store, to get up and dress. She hadn’t been able to do that for months but decided she could that morning. She got out of bed and walked in her rollator over to the closet, a distance of perhaps 8 feet, reached up to retrieve some clean clothing from an overhead shelf in the closet, got lightheaded, fainted to her right, and fell backward into a chest of drawers at the end of the closet. Her head collided with the metal handle on the third drawer down, breaking the handle into several pieces and cracking the wooden front panel of the drawer. The force of the fall created a deep palm-sized hematoma on the back of her head. A hematoma is a bad bruise that happens when an injury causes blood to collect and pool under the skin. When Emergency Medical Services arrived I told them that she would need a cervical collar and a backboard. After they ascertained that was indeed what was needed, she was quickly transported to the local hospital.

While in the Hannibal MO Hospital emergency room, the hematoma continued to enlarge, and over the next few hours we observed that her arms folded over her chest and her hands bent inward at the wrist. She was in and out of consciousness throughout the day, and they were controlling her pain with successively heavier doses of sedatives through her IV. That evening the ER physician said that it had been determined that her condition was severe enough that an airlift would be too risky with the present weather conditions, so a call had gone out to find an EMS crew to transport her to University Hospital in Columbia by ambulance. That transfer began mid-afternoon.

Upon arrival she was taken to the Emergency Room and placed in the Neurosciences Intensive Care Unit, after X-rays were completed, it was determined that she had fractured three of the vertebrae in her neck and that the hematoma was draining into the spinal column, causing paralysis. The attending surgeon recommended immediate surgery to give her a chance to recover the use of her limbs. The surgery started at about midnight and was completed a little after three o’clock the next morning. She was placed in a rigid chin-to-waist brace that kept her head from moving.

She remained in University Hospital for several days before being transferred to an acute nursing facility, where she received rehabilitative therapy to regain the use of her limbs, reduction of the resulting neuropathy in her hands, and speech therapy to relieve symptoms of dementia and other cognitive skill losses. She was in that facility for three months before being released into a home health visiting nurse-and-therapists program. At this point, she had recovered about 80% use of her right leg and 30% of her left. She was confined to a wheelchair and incontinent. The trauma to her physical and mental systems was substantial.

The home health nurse and therapists were top-notch and soon had Lea making progress in all areas. But then, in early July, she contracted a UTI and became very ill. Once again she had to be taken to the emergency room and then admitted for treatment. After a three-day stay, she was discharged, but not released to go home. The attending physician said that she had to go back into acute nursing because I wouldn’t be able to properly care for her during this recovery.

The hospital’s social worker contacted the nursing facilities in Hannibal, and none would take her due to the complexity of the problems she was battling. She needed acute nursing. One nursing home in Louisiana, Missouri accepted her, on condition that she go into isolation for 6 days because she had not received the 4th Covid booster shot. I drove her the thirty miles on a Friday afternoon to get her settled for what became an extended stay with daily physical and speech therapy.

As her strength improved, I was able to check her out of the nursing home to take her to lunch occasionally. After a four-week stay, the staff informed me that she had improved to the point that she no longer qualified for acute nursing assistance, but that no nursing home in the Hannibal area had an opening for her. Since she was being released, they contacted an area home health agency to give me assistance in caring for her at home.

The home care we received included a weekly visit by an RN to check her vitals and check for any needs we might have, a physical therapist who visited twice a week to help Lea improve her confidence and physical strength, and an occupational therapist who assisted Lea in her bath twice a week. The team we were assigned was excellent. Lea, however, suffered from incontinence and a constant bloated feeling.

After a few more doctor visits, and no solution in sight, we got a referral to a urologist who tested her rigorously, and recommended a Foley catheter for 30 days to see if evacuating the bladder regularly would relieve her discomfort. It did, but it also caused UTIs, even though we worked very carefully to avoid them. By October, the repeated UTIs were determined to be caused by the catheter itself, and a suprapubic catheter was surgically installed. It goes through the abdomen wall directly into the bladder, eliminating the previous pathway for infection.

She began to improve right away, and by the following January, she no longer had any pain in her abdomen. She still had very little control of her left leg and only partial use of her right leg. She is in a wheelchair when she isn’t in bed and has not regained the passion she had for her former hobby. She was always a talented crafter of various skills, so we are working to help her regain those interests.

As we enter 2023, we continue to be grateful and thankful that we are still together after 59 years of marriage, and still able to be mostly independent. I am glad that I’ve been granted the health to be able to take care of her and provide for her needs. What God has in store for us in the future we can only surmise. But, we are at peace with what may come. We know that no one gets out of this life alive, and we know that in the end, when our journey here is done, we will be at Home with Him. Amen.