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Aging Care Solutions
July 2018 Caregiver eLetter
      Vol. 21, No. 1
     The gauntlet was passed to us and we accepted it.
 Therefore we will cope, and in so doing, set an example 
 for our children, and the generations to follow.
Contact Kay at 972-839-0065 or
www.AgingCareSolutions.com or
kay@AgingCareSolutions.com or kay@kaypaggi.com
In this edition:
Aging Poem
Julie Andrews Turning 79
Mental Aerobics
Surgical Recovery
     In September of 2017 I had surgery to correct several spinal conditions. The first failed and led to a second, which also failed and led to the third in December 2017. This explains why there has not been an eLetter for several months. At the time of the first surgery, the surgeon expected a recovery time of 3 to 6 months. Due to the multiple procedures, I am still recovering.
     Over the course of the past several months, I learned a lot about surgical recovery. I want to share these insights with older adults and their families that may benefit from my experiences. My goal in the next eLetters is to give you current information about rehabilitation hospitals, the patient experience in rehab, types of therapists working with patients, tools for recovery, and Medicare options.
 Part One -The Surgeries 
    The original surgery was performed at the Carrell Clinic. The second was done at Presbyterian Hospital Dallas. As I came out of anesthesia, I had a brief episode of hospital-induced delirium. I remember dreaming that the man standing over me was hurting me, so I punched him. He (a physician) laughed and put both my hands into what appeared to be boxing gloves and tied me down for the next hour. I will not recommend Presbyterian hospital for my friends and clients in the future, or until the post-surgery department learns better protocols for dealing successfully with delirium. (See my article on Hospital Acquired Delirium,  The third surgery was done at the Carroll Clinic.
     Medicare requires a minimum of three midnights in a hospital to cover inpatient rehabilitation.  There are two types of rehabilitation hospitals; both are covered under Medicare Part A. One is done in a long term stay nursing home although the patient is not a resident. The other type is acute rehab, which is good for more active younger people recovering from an accident or surgery. Most acute rehab patients stay about 2 weeks and are discharged home. Acute rehab hospitals require a minimum of three hours of therapy daily. Patients there are issued a walker or wheelchair and recovery tools, and are taken home after discharge. The hospital is reimbursed by Medicare for the cost of this equipment (no cost to patient). However, patients in Health South at the time I was there were not taught how to use the tools. Health South does not have the option of communal meals; patients remain in their room for all three meals. This policy prevents mutual support among patients. I’ve had clients who did well at Health South, but it was a poor decision for me. Recently, Health South was purchased by Encompass. One hopes in-patient stays will improve with the new ownership.
    After my discharge home from Health South I fell multiple times while using the walker; clearly it was time for more therapy.

    Presbyterian Village North (PVN) has a newly completed inpatient rehab building. https://www.presvillagenorth.org/rehab   Differing from acute rehab, this type of rehabilitation, sometimes called ‘transitional care,’ requires only an hour of daily therapy. Most of the patients who come here are older adults that are admitted to rehab from the hospital following an operation or a fall. The average inpatient stay is 4 to 6 weeks. Sadly, many of my clients refuse this type of rehab because it happens in a 'SNF' (Skilled Nursing Facility). The rehab department in most of these communities is distinct from the long-term care areas.
    Physiatrists are physicians that follow patients during their stay in rehab. Part of their job is to manage their patients' pain so they can concentrate on working in rehab. It's difficult to do the physical exercises to improve when their pain is intense. These physicians coordinate with surgeons, oncologists and other physicians, as well as the therapists who work directly with rehab patients.

    In the next eLetters I'll discuss patients in rehabilitation, the staff at rehab hospitals, tools for recovery, medications, and the process of returning home. I am interested in your comments about your experiences with surgery and recovery.

Match the words with their meanings.
1. Barium
2. Bacteria
3. Congenital
4. Coronary
5. D&C
6. Dilate
7. Enema
8. Fibrillate
10. Hernia
11. Humerus
12. Node
13. Outpatient
14. Pap smear
15. Paradox 

(Answers below)         

a. live a long time
b. domesticated yellow bird
c. tell a small lie
d. two doctors
e. a person who has fainted
f. was aware of
g. some who plays the piano
h.back door of the cafeteria
i. a friendly person
j. opposite of a friend
k. slander your father
l. tell us what we want to hear
m.pertaining to a female's knee
n. non-Jew
o. what you do when the patient dies
 by Richard Quimby

Aging is good for wine and cheese
but doesn't do anything for your old knees.
Wine can sour and cheese get blue.
Don't let this happen to you.
Keep a smile on your face
as you slow down your pace.

Life's not a race, There's no win, show, or place.
When ask "How are you?"
"Okay" will do.
No one wants your pains and your aches
A really good laugh is all that it takes.
So laugh and have fun
and enjoy a good pun.
Maybe your aging isn't quite done.
Meet St. Peter with a smile and a grin.
He might just forget and let you come in.
But for better or worse,
Stay away from the man with a hearse!

Richard died at age 92, a week after he penned this poem.
Julie Andrews Turning 79 
To commemorate her birthday,actress/vocalist, Julie Andrews made a special appearance at Manhattan's Radio City Music Hall for a benefit. One of the musical numbers she performed was 'My Favorite Things' from the legendary movie 'Sound Of Music'. Here are the lyrics she used:  (Sing It!)  - If you sing it, it is especially hysterical!!! 
Botox and nose drops and needles for knitting, 
Walkers and handrails and new dental fittings, 
Bundles of magazines tied up in string, 
These are a few of my favorite things. 

Cadillac's and cataracts, hearing aids and glasses, 
Polident and Fixodent and false teeth in glasses, 
Pacemakers, golf carts and porches with swings, 
These are a few of my favorite things. 
When the pipes leak, When the bones creak, 
When the knees go bad, 
I simply remember my favorite things, 
And then I don't feel so bad. 
Hot tea and crumpets and corn pads for bunions, 
No spicy hot food or food cooked with onions, 
Bathrobes and heating pads and hot meals they bring, 
These are a few of my favorite things. 

Back pain, confused brains and no need for sinnin', 
Thin bones and fractures and hair that is thinnin', 
And we won't mention our short shrunken frames, 
When we remember our favorite things. 
When the joints ache, When the hips break, 
When the eyes grow dim, 
Then I remember the great life I've had, 
And then I don't feel so bad.

Ms. Andrews received a standing ovation from the crowd that lasted over four minutes and repeated encores. Please share Ms. Andrews' clever wit and humor with others who would appreciate it. 
Answers to Mental Aerobics
10. g
11. l
12. f
13. e
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