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Voice of Experience

Voice of Experience: September 2023

When the Patient Becomes the Caregiver, Redux

Stanley Peter Jaskiewicz

Summary

  • The author recounts their experience caring for their wife after a major outpatient joint replacement surgery. They express initial anxiety but also highlight the support and kindness they received from unexpected sources, including friends, family, and strangers.
When the Patient Becomes the Caregiver, Redux
istockphoto.com/Prathan Chorruangsak

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Two years ago, I wrote about what I learned while caring for my wife after surgery. 

This year, the world, with its inscrutable sense of humor, let me repeat that experience – except with major surgery.

She had a complete joint replacement, as an outpatient.

For those who have not had the pleasure of being treated with “what insurance will pay for” medical care, “outpatient” means you get to take your loved one home before the anesthesia has worn off.

Even before the procedure, I had anxiety about caring for my wife on my own at home.

Although I had done so after other surgeries, none would affect us both as much as a joint replacement.

But to counter that stress, we also quickly saw the grace that soon surrounded us.

When I mentioned to our office cleaner that I would be out for some time to care for my wife, she immediately assured me that things would be fine – and offered to keep us in her prayers. 

Similarly, when I mentioned to the pharmacy clerk that I was picking up my wife’s existing prescriptions after surgery, she offered to fill all of them, ahead of schedule. 

That thoughtfulness saved me a return trip and let me spend more time at home with my wife in the days immediately after her procedure.

Despite my misgivings, I soon appreciated the philosophy of avoiding an overnight stay. 

Hospitals have a lot of sick people, and rest and recovery occur more quickly in a friendly, familiar home, than in an institution.

From my own patient experience, I had learned the importance of movement as soon as physically possible after surgery.

At home, we could walk from room to room at our convenience – without having to wait for a nurse for accompaniment (as I had had to do after my own surgery).

But even though the surgical team had told us what to expect, reality “hit home” when we arrived after leaving the surgery center.

She immediately had to ascend small steps to enter from our garage. 

Fortunately, years earlier we had installed a grab bar by the door to help my wife’s late mother on her visits – almost as if anticipating our need 10 years in the future.

In addition, the surgery center’s excellent physical therapist had taught us what she could do at home, as well as how to do it.

The stair walking mantra “down on bad, up on good” is now burned into our memories. 

(The fact that we live next to a township named “Upper Gwynedd” made the “DBUG” mnemonic easier to remember in the moment.)

Yet some things were still surprising.

When I mentioned that we had a sleeper couch ready on our first floor, the therapist asked, “Why?”

She explained that my wife would sleep much more comfortably in her own bed, even though it would require climbing stairs to the second floor – and correctly assured us she would ascend stairs before leaving the therapy room that day. 

(She did help my wife practice walking stairs while using a cane before we left.)

Similarly, although I had taken extensive notes with the therapist, I did not have time to organize them immediately.  We were occupied with her medicine schedule and learning to get around the house.

As a result, for several days, we frantically scanned several pages of scribbled notes whenever we had questions about instruction we vaguely remembered.  Once things settled down, I transcribed them in an orderly way.  (By that time, however, we were doing fine without the notes.)

We also had to navigate a large box of over 10 prescription medications, and its day-by-day schedule of when to take each one.

Although dispensing her pills quickly became routine, it was a bit overwhelming the first day.

In retrospect, however, that box and checklist – and its color-coded bottles - saved us a lot of time.  We avoided multiple pharmacy trips – and alleviated my fear of not getting to our pharmacy before it closed for the evening of the procedure.  (Her surgery had been the last of the day at the surgery center.)

The surgery center’s sheet of times and dosage checkboxes, with a new sheet for each day, proved an easy way to keep track of the large quantities of pain and anti-inflammatory pills she needed over the first days after surgery.

My wife was reluctant, at first, to use two of the narcotic pain medications prescribed for her.

But when I saw she was uncomfortable, I insisted on a conversation with the “Nurse Navigator” on call.

She quickly persuaded my wife not only that the narcotics would help with her post-surgical discomfort, but that they would help her fall and stay asleep (and it worked!).

I think my wife resisted taking them because she was still lethargic from the effects of the anesthesia.  But I cannot discount the effect of frequent news reports of abuse of such strong medicines. 

(A family friend had died after overdosing on two of the medications prescribed for my wife.)

The nurse also reminded my wife that since her body had suffered drastic insults, the surgeon would not have prescribed the narcotics if she did not need them.

We experienced grace in many other unexpected places. 

“Mary,” who I had recently written about for Experience, unexpectedly called to see how my wife was doing (even though she was going through a stressful time in her own life). 

“Mary” had had the same procedure in the past and explained her recovery to my wife.

I once again faced my own challenges with food shopping.  

This time, however, other shoppers took pity on me.  One helped with my own ignorance of how to retrieve a deposit for a shopping cart.  Another demonstrated how to generate a price tag for fruit sold by weight.

Our son jumped in with help in many ways as well, particularly on a shopping trip.  With his help, I finished in half the time it took me alone.

Similarly, my prep school and Ivy League education had not prepared me for such home ec basics as planning meals.  I had to make multiple trips to the supermarket to restock perishables in the first few days.

But I was gratified to see a young man with a disability helping shoppers – in fact, this happened several times over the course of my wife’s recovery. 

The first time, however, I felt bad that I had prepacked my groceries in permanent shopping bags, leaving the clerk nothing to do. 

I even passed my personal “graduation” tests – I completed solo grocery shopping expeditions in the vast expanses of Costco and Wal-Mart, by myself, in under an hour.

(I usually measure the length of trips to the supermarket by the number of restroom breaks I need.)

By the end of the third week, however, my wife deserved time out of the house, as a reward for her hard rehab work – along with an opportunity to walk further than possible at home.

First, I took her to a local convenience store for her favorite coffee drink.  Next, we visited Starbucks.

Building on those successes, we visited the grocery store.  She enjoyed being “back to normal,” and cheerfully explained her cane to the clerks she regularly saw in the checkout lane.

As a result of all of this exercise, my wife was ready to resume another “joy” she had missed after her procedure - cleaning around the house.

I was glad to fetch everything she needed, especially items stored too low in cupboards for her to pick up without straining her repaired joint.

I had my own reward, as well.  When I stepped on a scale, I was surprised to see that my many trips up and down stairs had melted away ten pounds, without trying to do so.

(But my plan to market a “Hip Hip Hooray” quick weight loss plan probably would not work, because of the daunting “joiner fee.”)

Perhaps the most fitting duty I took on during my wife’s recuperation was kneeling before her each day. 

Each morning, I put on her socks and shoes, and then took them off that night.  (Bending down would have put too much strain on her surgical site.) 

I felt as if I, in my own small way, were recreating a Biblical hallmark of service to others.  John 13:1–17. 

In the words of noted writer on the “gift of years,” Joan D. Chittister, OSB: “Life is not meant to be a burden. Life is not a problem to be solved. It is a blessing to be celebrated.” 

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