Thursday, May 18, 2006

Last Blast

Today I'm taking Mom out in the minivan for her last big outing before my surgery next Tuesday. She probably won't leave her residence for 4-5 weeks after this, until her doctor's appointment on June 12, but I don't tell her this.
Though we are supposed to arrive at Beverly Hills Prosthetics and Orthotics at 11 am, I have tried to cram too many errands into my morning before arriving to pick Mom up. It's my last day to do everything because John and I leave tomorrow with Marie for his cousin's daughter's wedding in Chicago, returning Monday night just before my Tuesday morning surgery.
I'm feeling pressured because I need to return Mom to her residence in time for me to attend a meeting of the local violence prevention coalition, arriving with snacks and copies of last month's minutes.
At any rate, I am not feeling calm or patient when I arrive at 10:30 am. If only Jona were still working the day shift with Mom, so she could have Mom ready at the door when I arrive.
Instead I have to go to Mom's floor, assist her to the toilet, and wheel her down to my parked car.
"I have to have my purse! My fur coat!" Mom cries as I try to wheel her out the door of her room.
The purse is a charade; I keep her Blue Cross card and checkbook in my wallet, but she fumbles with her purse whenever we pay for something. The fur coat is actually a sweater trimmed with rabbit fur.
"Here you go, but it's not cold out. You don't need to put the sweater on," I argue.
"My blood is colder than your blood," she retorts, trying to pull it on over the pink sweater and blouse she is already wearing.
"Okay!" I say crossly. She has one sleeve on and I roughly pull on the other.
She looks rumpled and odd with two sweaters on. Because the second sweater is angora wool, she will be slippery in my hands when I lift her out of the wheelchair and into the car. I've argued this point with her before, but I don't try today.
Soon we are flying down the freeway, taking the La Cienega exit at 11 am. I am trying to remember whether I turn right or left on Wilshire Boulevard to find Beverly Hills P- O Inc.
After locating a handicapped parking place, getting Mom into the wheelchair (slippery sweater and all), and getting up the elevator, we enter the elegant office.
David Cooley, PT, CPO, is wonderfully kind even though it is 11:15 am and we have thrown his next appointments off schedule.
We saw him for the first time last January, when he recommended that Mom wear a wool-lined boot at night to keep the inversion of her feet from getting worse. At that time he suggested not buying the malleable retrocalcineal passive resistive ankle-foot orthotics (PRAFOs) at a cost of $325 for each foot because we could get a similar boot at any medical equipment store, so we passed on the fancy PRAFOs and just ordered a lesser boot from Wishing Well.
It soon became apparent, however, that making Mom sleep with the cheaper model on was pointless. During the night the boot's velcro ripped away from the cross piece meant to keep the boot in a vertical position. Eventually my sister Emily recommended that we go back to the orthotics guy, where we are today.
"Evelyn has contractures of the hip, knee, ankle, and Achilles tendon," David reports after rotating Mom's feet. "Her foot cannot rest flat on the floor. She has a 40-45 degree equinus contracture with a varus component. We can't improve the contracture of her ankle and foot, but we can arrest it."
He explains that the equino contracture means she can't extend her foot down, while varus means her foot turns in. He says the varus actually can be reduced but not the equinus.
Then David explains the purchase options, again suggesting that we not buy the boots that cost $325 each. Another option is bilateral AFOs, splints inserted into her shoes to keep her feet straighter, only useful when she is actually walking.
With the level of medical terminology and decision-making clearly beyond my reach, I call Emily, who has a Master's in physical therapy, and miraculously reach her on her cell.
"Okay, Emily, could you talk with this gentleman about orthotics and let me know what you think we should do?"
After a short but technical consultation with David, Emily concludes that the PRAFOs are definitely the way to go, but that we should get them through brother Bill, a doctor working at Fort Lewis Army Base near Tacoma. He can probably get them for next to nothing.
"Okay," I say. "But I don't know... I'm leaving for Chicago tomorrow and then having surgery. I can't be in charge of getting these boots through Bill."
"Do whatever you want," she says.
"I like the red ones and the white ones--the tan ones are all right too," Mom says. She is talking about her SAS shoes of various colors.
I tell David, "We'll take the PRAFOs now. We'll write a check and see whether we can get reimbursement from Blue Cross."
By this time it's almost noon, and he needs to go to his next appointment, but he shuffles around in his closet, finds two of the things, and spends ten minutes fitting them for Mom's feet.
They are to be worn at night and when she is resting in her recliner, to keep her toes pointed up to the ceiling and her ankle flexed as close to a right angle as possible.
We make a trip to the bathroom and head back to Santa Irena.
As we wheel back to the car, Mom is happy because she is holding a big shiny bag with her new shoes and the words Beverly Hills Prosthetics Orthotics embossed on the side.
She asks for an ice cream cone, but the best I can do is a frozen ice cream drumstick from the pharmacy in the building.
Then we go to the dry cleaners and another ice cream shop on the way home.
She is back to Ocean View by 2 pm, but it's 3 pm by the time I leave the building and head for my next appointment.
To her this excursion meant lots of fun and attention. Good--but it's her last until mid-June.

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