Saturday, June 25, 2011

Do we blame dementia for the hearing difficulties in the old?

While I was in rehab, I noticed the majority of patients were older. They would do what they were told, but often the therapist had to tell them 2-3 times before they heard the instruction clearly. This slowed down what they could accomplish in an hour.

Very few were proactive. One of the few was a vivacious 92-year-old woman who had fallen and broken her hip. She has always been active, and the fall and resulting break frightened her.

"I'm staying here as long as I can," she said. I don't blame her.

My therapist said he loved to see me coming because I was proactive. As we were going through a set of exercises one day, I talked to him about that.

"It seems to me one of your biggest problems is loss of hearing," I observed.

He said it was, but more than that, it was what it led to.

"People who can't hear tend to become passive and just go along to remain a part of things socially," he said. "They are embarassed to keep saying 'I can't hear you' and they also fear, quite realistically, that if they do, people will just quit trying to talk to them."

The habit is so engrained, he said, that it takes a while for them to realize the physical therapist isn't going to give up--if they even notice their habits by then.

(I remember the first morning in therapy I was walking with a therapist who smiled and pointed. "Why aren't you bending your knee?" she asked.

Right. I was walking the way I had before surgery and I was there to learn to walk differently.)

The therapist I talked to about hearing problems had more to say.

He said that when patients really don't hear well, he then has to determine if the problem he is working with is poor hearing, diminished mental capacity, or both.
This takes time. So the therapy I was able to do in a week usually takes them two weeks.

A few weeks ago, I heard a paper on dementia that said 40 percent of those who reach their 80s will develop dementia of some kind. But that means 60 percent will not. And we are talking 80s here, not 70s.

However, I know quite a few in their 70s who are deaf as posts.

It makes me wonder if a lot of the dottiness of old age is actually more attributable to hearing than diminished ability to think.

One thing I noticed about the oldsters in my classes--they were tough. Most did the exercises required without grumbling, whimpering or protest. Waiting for the next exercise, they would talk among themselves.

"This your first?"

"No, this is my second hip. I did the knees 10 years ago."

Then they would enumerate the heart surgeries, the appendix, the gall bladders before day surgery, and on and on. They would smile grimly at each other.

They knew full well they were survivors.

And I, doing my knee raises, or peddling, or whatever, just listened, marveled, and muttered to my Creator, "Lord, if it is possible, I don't wanna be that tough."

And it's time again for a bout of my daily exercises.

Tuesday, June 21, 2011

Looking Forward to Better Times

Surgery has been a really social event for me. Most of it has gone extremely well, and I've had a lot of good company at the hospital and now at home. I had a couple or three really bad hours the second day when the femoral nerve block faded and the pain took its place.

About two hours into that, my friends from Oregon called. Blake completed his second knee replacement in December. Blake and Jo Ann were both on the phone, and without even saying hello, Jo Ann told me,"Charlotte, we want you to know the pain never gets worse than this." And Blake agreed. They timed it perfectly, and I relaxed. An hour later, all was well.

The rehab hospital was everything I had hoped. Three hours a day, I had physical or occupational therapy. From the third day, I walked down two long halls to therapy, unassisted on my walker. I came home after a week because by the third day, I had reached 100 degrees of motion and could hold the knee down flat. And that is a tribute to the hours of therapy I put into prepapring for this. I didn't even need help dressing the second day!

In rehab, I saw many patients of other doctors. Some had the white compression stockings. I think some used the machine that straightens, then bends the knee automatically. I don't think it matters too much, so long as we exercise and get no infections.

Yeah, it's still sore. Since the surgery, though, I am standing differently and my lower back no longer hurts. I trundle the walker down the drive to pick up the paper, then again to get the mail. A therapist comes 3 times a week and the nurse comes twice a week. I run through exercises twice every day.

I see the doctor July 5 and hope then I will be able to drive and stop taking the damn coumadin. I am beginning to get hints of the change in my life that is coming. With only one knee repaired, I will be able to do so much more. When I do the second knee next summer, it will move my internal clock back years. Wow.

I suspect one reason so many older people are living quality lives so much longer today is due to knee and hip replacements. I know my orthopedist believes that.

Matt mentioned that it was a REALLY bad knee. I understand one can, if one wishes, see a knee replacement operation on YouTube. Now, I used to be a medical writer. Saw a bunch of operations and wrote about them. One of my doctor's operating staff wandered in the third day and said more than I really wanted to hear about extreme hammering and chiseling. I know the whole leg was black and blue, and my surgeon prides himself on not leaving much brusing.

Nope, I don't really need to know more.

I have a few things else I want to say, though, so I'll probably post a couple more times on knee replacements and me before getting on to something else.