Giving Yourself Grace

The travails of being responsible

It is emotionally taxing when a family member is in pain and unable to fend for themselves. Your own life collapses to the demands and requirements of a full second life. At moments it seems like even more. After decades of solving problems, raising kids, and dealing with life’s challenges, we attempt to chalk it up to “just one more thing” and expect that the resiliency and fortitude that carried us through life will simply handle one-more hurdle.

Navigating hospital trips, insurance requirements, doctors’ inquiries, and follow-up appointments on top of an already busy schedule, responding to the demands of others who rely on your contributions, slowly builds stress. Unless we use our gained wisdom to grant ourselves a little bit of grace, we might get overwhelmed.

I’m spending a lot of time these days granting myself grace.

Mom fell a few weeks ago and broke a hip. Or more likely, her hip broke due to poor physical conditioning and advanced osteoporosis resulting in the fall, but arguing semantics doesn’t get her out of the hospital bed.

Each subsequent week, she’s managed, in confusion, fits of anger and defiance, or simply because she woke in the middle of the night and hadn’t gained enough awareness to know that she wasn’t at home, to pop the replacement hip out of the hip socket.

The processing of awareness at the nursing and rehabilitation center seems painfully slow and cumbersome, adding to my worry and stress. They get her returned to the bed, positioned as comfortably as possible, and order X-rays. I’m certain there are whole processes through insurance authorizations and billing offices before the request is dispatched, but I’m not privy to those details.

The tech shows up with the portable X-ray within 24 hours. (mobile X-rays are a great leap in technology from days of yore, but not the point at the moment.). The process is simple, the tech slips the digital receiver under her on the bed and zzzzzziit, zzzziiit, x-rays are completed. No lead vests or shielding seems to be necessary with the advanced technology.

As technicians aren’t allowed to interpret the results, the images are beamed off to a radiologist. Often it feels like the radiologist only gets involved after the tech returns to the office after visiting the string of nursing homes and other orders they have on their schedule.

The radiologist gets the scans, takes a look, and calls the nursing director at the home. Assuming it is business hours and they aren’t knee-deep in some other emergency, the nursing director and the LPN conclude that the hip is dislocated and a trip to the Emergency Room is warranted.

I’ve finally reached an agreement with the home to notify me so I’ll get a call about this time in the process. Seeing the phone numbers and identification of the nursing home on my phone is always a bit of a heart-in-the-throat moment. But they are forthright and direct, giving me the status update.

I have about a half hour to organize all the things I was going to do during the rest of the day, walk the puppy, and head off to the ER.

Then I get to sit in the rather cool hospital (I’m getting used to taking sweaters) and watch Mom sleep when she’s not grimacing in pain. The nurses follow their routine, blood samples, IV installed, and saline drip started.

We all wait for their X-ray (I’ve joked that mom has gotten so many X-rays she should get a frequent zapper card, 10 X-rays to a free Frosty or something). Once the new x-ray confirms the previous one the Orthopedic Docs on shift confirm and confer with her surgeon. This ranges from six to 13 hours from arrival at the ER, depending on the number of trauma patients who jump in line.

I put my emergency room mantra on speed dial. “If I’m in the ER and they make me wait, I’m okay. They are handling people who need professional attention much more than me.” It helps a bit, but by the 12th hour, maintaining a casual attitude is stressful.

Finally, they are ready to get the process completed.

In comes the doc who will do the sedation with the hospital administration closely on the heels for the glorious signing of the consent forms. Paperwork complete, a slew of people stream into the room. As the family member, I get booted at this point.

They explain that have too much history with family members assuring them of their fortitude and constitution becoming unwitting new patients by fainting (with huge amounts of additional paperwork for the staff).

Mom gets sedated, the doc performs their manipulations and after the sedatives are neutralizing, they‘ll come and talk with me.

Twice, it went in without a hitch.

The first time mom’s hip was put back in the socket and the sedatives were wearing off, she retorted, “It was the first time in a really long time that a man crawled up on top of me, and he was a really cute doctor!” You have to treasure the humorous moments when you can find them!

Yesterday didn’t go so well. I’m standing outside the room, hearing Mom yelling in pain, getting to the point where she’s swearing at the doctors because the LEGO pieces weren’t clicking. The Ortho admitted: “I’ve tried but can’t get it to go. Because she’s so frail, we don’t want to increase the sedation to relax her muscles enough and we don’t want to keep trying. We need to take her to the Operating Room (OR) where they can fully sedate her and relax the hip for reinsertion.”

At that point, my internal stress meter pinged and I knew it was time to give myself some grace. It is hard to leave a parent who is still in a stupor from sedation, but after hearing the shouting, I knew I just couldn’t hang around. I checked with the nurses and confirmed the plan and affirmed that they knew my phone numbers, I allowed myself to go home.

It isn’t easy to allow yourself the grace to leave. It isn’t going to get you any heroism in the face of enemy fire medals, but it is necessary.

I lumbered into the house. Thunderbutt, more properly known as Thor, provides his normal enthusiastic “Oh I am so glad you have returned, my world simply wasn’t complete waiting here not knowing just when we’d be reunited” wiggle. While quite the mood enhancer, it didn’t quite dispel the weariness of my soul.

Thor lay next to me while I took a nap on the couch.

The hospital called just after I woke to let me know that she was being transferred out of the ER to Narnia (the holding area before admission). By the time I got back to the hospital, she was in the surgery suite. Some really nice digs I must admit. The nurses were settling her in so I didn’t stay long.

This morning’s call at oh dark thirty (6:30 am for the rest of you) let me know she’s heading into surgery.

The morning has progressed with deafening silence. A call around 9:30 let me know that the attempt in OR hadn’t succeeded. The docs are supposedly conferring to determine the next possible options.

Mom’s been returned to the surgery suite and is comfortable and I continue to pace and try to calm my racing imagination.

It isn’t easy being the only caregiver and it is also worrying to wonder about my own future. Without kids, who is going to advocate, worry or simply be present when my own health dictates?

But giving myself grace, I have to remember not to borrow trouble. Stay focused on the current problem, and queue up the others for their due attention later.

Grace to myself and being grateful for the skills, words, wisdom, and people who are available to listen are the only way I’ll get through this.

These gifts and post-it notes, lots of post-it notes, will get me through. I’ve learned that calming my mind, and stopping the racing, is often accomplished by simply acknowledging the thought, then writing it down and posting it on the calendar.

Giving oneself grace is tough, particularly when you are the only human point of contact for someone lying in a hospital bed surrounded by kind strangers, but strangers nonetheless.

Continuing with Mom’s saga. A new surgeon called early on Saturday morning. Based on the CT scans and X-rays, he wanted to open the incision. The implant wasn’t seated right and was spinning when they were trying to get it set in the hip socket. He needed to replace the hip (AGAIN!) and clear out some of the offending tissue.

While it wasn’t the two-hour surgery he’d anticipated about 1:30 that afternoon, recovery called to say that Mom has come out of surgery just fine and was in recovery.

Got to see her Sunday morning and happened to be in the room when the physical therapist showed up to get her skinny old butt out of bed and to try walking a few steps. They got her to actually transfer to a recliner using a walker and a good amount of assistance.

She’ll likely be discharged tomorrow and she’ll return to the nursing and rehabilitation home to get the care she can’t get at home.

There are always a lot of irons in the fire. Distant family members to keep in the loop (geographically that is), various doctor's offices to connect with, anticipate a 45-minute wait on hold each time, and of course, the insurance company, the ultimate arbiter of what actions will or won’t be taken ’cause gosh durn it, everyone wants to get paid!

I work on each one as hard as I did while working, keeping notes and relying on the board plastered with post-its to adjust trajectories and schedules.

But I always remember to check in with myself. When a walk with Thor is needed, we leash up and head out. When a goofy movie is needed or even a few snarky comments on Twitter, I give myself permission.

I’ve learned in these years that I can’t be of assistance to others or make rational decisions if I’m tired, stressed, or simply hyper-focused in what is likely the wrong direction.