I often joke how Jack is still teaching me things, usually unintentionally, but here I go again.
Caregiving can be a tough gig. Generally I know I have it better than most. I have reliable help with Jack. The house is well equipped to deal with his disabilities. We have plenty of technology to help. He’s pretty independent generally.
But sometimes that independence gets him into trouble. His usual day out is Thursday. On April 15, I was working downstairs, had just mailed the last of the tax returns for which I am responsible and was just thinking I should check on his location with the ATT FamilyMap service when the phone rang.
It’s never good when the call starts with “I have a man in a wheelchair here, what is your relationship to him?”
It was the police at The Gallery, a mall in downtown Philadelphia and one of Jack’s favorite haunts. It appears that he went down three steps in his chair and ended up on his side, still strapped in the chair. I was told that an ambulance had been called, but I also had to make arrangements for his chair.
So I headed downtown in the van, accompanied by Tracey, who is our Jack help on Thursdays. We picked up the chair and headed to Jefferson Hospital where the ambulance had taken Jack.
They had him in the Trauma area, which was good because it was quiet compared to the rest of the ER. After about an hour or so we had the results, no head injury, but 4 cracked ribs, a broken scapula and a broken clavicle. All on the shoulder of Jack’s “bad” side. That is, the paralyzed side.
The verdict, keep him in overnight for observation. Sure. Except it was going to be at least 4 hours till they got him a bed in the monitoring unit upstairs. It was already 10pm. So I headed home.
I called down the next day and he was still in the ER waiting on a room. Holy moly! So I went down hoping to get a verdict on releasing him. We were also waiting on a physical therapy evaluation to get some more ideas about new transfer techniques.
About Jack and Transfers: Because Jack is paralyzed on the right side of his body, we usually bring him to a stand by supporting him under his right arm bringing him to a stand and then pivoting him to another chair. It’s a good solid method that works well with Jack, doesn’t strain the caregiver, allows Jack to help by keeping his left (good) side free to grab the chair where he is transferring or a walker, cane or bar.
Not being able to hold his right side at all because of the broken bones completely hosed our transfer techniques.
Jack finally got a room late Friday night. No physical therapy came in on Saturday or Sunday, despite that I was there for hours waiting and had the nurses get in touch with them to find out. Monday the two person team of an OT (occupational therapist) and a PT (physical therapist) come around.
They don’t give me a lot of options. They demonstrate a technique where the person transferring squats in front of Jack, blocks his knees, grabs his buttocks with both hands and pulls him to a stand, pivot and then ease back into a different chair. Talk about awkward! I tried it once and they said it look successfull, but it was so counterintuitive. Lorie was there too and it look very awkward to her too. The next day I had Lorie and Tracey come in to see the PT team about transfers.
The PT and OT then tried to stand Jack up to pull up his pants. No luck. What a mess. They hurt his knee because his skin is so thin sometimes just being rubbed by something is enough to cause a wound. They start talking about sending him to a rehab for a few weeks before heading home. I ask again about other techniques. They seem to think this is the ONLY way he can be transferred. They leave and I assemble “Team Jack” (me, Lorie & Tracey) We talked about all the mistakes the PT team had made and how we could deal with his situation at home. I talked to Jack about our ideas vs PT’s and he agreed he would be better at home.
It took until Wednesday before we were able to bring Jack home. With the help and input of Lorie and Tracey, I was able to counter the PT teams’ assertion that he go to rehab. We’re transferring using our own techniques and right now he needs two people to transfer. Jack seems to be recovering, he’s tolerating transfers well, he’s able to help more again using his good side. He’s got a follow up appointment with his doctor next Wednesday and then he’s still “grounded” until I return from my trip around May 15.
Oh, and the chair that fell down the 3 steps with Jack, no damage, still runs fine.