Category Archives: Caregiving

easy holiday preparation

Spaghetti Wednesday is our favorite holiday around here. Mark was finally walking without crutches. It’s the first year since 2014 that I wasn’t also taking care of my aunt so I was happy to host the dinner for the 21st year in a row.

It was a late night and then a low-key, us-only Thanksgiving but I was wiped out. No doubt, the four previous months of intense caregiving contributed to my fatigue but I honestly didn’t expect it.

The question is: how to prepare for Christmas? It’s easy for me during Advent to prepare spiritually. I have no trouble slowing down and putting off the rush and crush, but when everyone around you expects holiday activity, it’s a little overwhelming.

I stopped sending cards a few years ago. It was getting to be a chore that I no longer enjoyed. The kids got ornery about posing for photos. It’s difficult to genuinely send “best wishes, peace and joy” when you’re resentful (never of the people, just the activity). So I don’t. I still think about and pray for people. I give others credit for continuing to send us cards. I still enjoy seeing the photos every year.

I love christmas lights in the house but Mark always takes care of the lights outside. The sweetest neighbor offered to help with that but we declined the offer. Mark was able to do most of his usual light hanging. My brother went up the ladder to hang the big wreath on the side of the house.

To be honest, Mark welcomed the non-strenuous activity, the weather was pretty mild and he finished everything outside in a couple of hours over two days.

Inside, I’ve just been taking my time and getting one project/area out at a time. I have the time and have enjoyed doing it at a leisurely pace. Little Mark is elf-like. I have referred to him as joy boy, which is still true. He’s always up for holly and jolly. I find myself waiting until he’s home for certain tasks just because they’re more fun with his help.

So, my advice for facing the holidays when you’re tired or overwhelmed is to abbreviate and get out one thing at a time. You’ll probably realize that a little bit of glow is enough.

Bilateral Patellar Tendon Recovery~ Pt. 3

Recovering from bilateral patellar tendon rupture

Welcome to part 3 of this series. You can read parts 1 and 2 to get you up to speed.

This is where things (meaning Mark) got going (finally). Things seemed to progress so quickly during this time period (from complete dependence for just about everything to almost complete independence) that it’s hard to remember what happened when but I’ll do my best.

Mark was scheduled to meet with the surgeon for the third time 4 weeks after his staples were removed. The transportation company cancelled at the last minute and we had to reschedule for the following week. Since his appointment was on a Thursday, it took almost another full week to schedule the initial consultation with a physical therapist who was highly recommended for this injury. My point is, your circumstances might put you a little ahead of Mark’s progress when you account for weekends and our delay.

We continued with the bending therapy in the meantime. The surgeon added heel slides. This engaged Mark’s quads. They sound easy but weren’t. Same set-up with locked leg resting on the ottoman. Mark sat on the edge of the chair with his other heel (unbraced leg) resting on a sliding board (sock or other cloth to reduce friction) and used his quad to pull the heel back, bending at the knee. This was another exercise that showed slow but definite progress. He got stronger and more steady by the day. This exercise also showed how much his quads had atrophied and couldn’t possibly support his body in a standing position. Crazy!

It’s important to note that we relied on a transportation company with a wheelchair van for all follow-up and therapy appointments until a couple of weeks into formal physical therapy. Luckily, worker’s comp covered this with no issue.

Weeks 6-12

Mark went to therapy at least 3 times before they had him stand (with crutches still locked in extension).

During these sessions, they moved his knee cap around, stretched him, measured his range of motion, loosened the quad muscles using a thing that resembled a butter knife and did e stim and ice.

Mark was also able to get into the pool with help of a lift. We chose this facility specifically for access to the pool. I have no doubt that this accellerated Mark’s progress. His ability to move freely in the water without braces improved his range of motion and leg strength without the risk of falling or unnecessary stress on his knees. It also helped with Mark’s stability. If you can rehab at a place with a pool, definitely choose that option.

On October 3, which was 2 months to the day after his surgery, Mark was on his feet for the first time. The blood rush to his feet was so uncomfortable and distracting that it was hard for him to focus on his balance.

Mark was so wobbly that first time that it was hard to imagine him walking again. But the therapists explained that his brain just had to remember what this standing was all about. They brought a full length mirror over to help the brain make the connection.

Fear is another factor here. He was on crutches with a therapist on either side but you have no confidence that your legs/knees won’t collapse.

Two days later, they got Mark on his feet for a few isometric and balance exercises. He was a lot more steady and a lot less fearful. He was confident enough to do a round at home. So, by his fourth day of therapy (weekend and days in-between) he was on his feet for exercises only. He was still locked in extension, so picture Frankenstein. Also, we still relied on the wheelchair to get anywhere in the house. It was another week before he was pivot transferring to and from the wheelchair instead of sliding or scooting into the chair.

By the end of the second week of therapy, he was allowed to take his braces off at night for sleeping and when he was just sitting around at home. His legs still didn’t bend easily on their own so he mostly still used the ottoman but would sit with his legs bent and resting on the floor for increasingly longer periods of time.

By his second full week of therapy, his sessions were 3-4 hours long. He worked in the gym standing, stretching, doing isometrics and other manipulations with a therapist nearly constantly at his side. They unlocked his braces to 30 degress and started letting him walk at therapy with crutches. If he buckled or tripped (which he didn’t), his legs wouldn’t bend more than 30 degrees. The crutches were more for stability than weight-bearing. He also did pool work (mini squats, walking, bicycles while floating in an inner tube, step-ups and downs, side steps) for 60-90 minutes then back to the gym for ice and estim for 30 minutes.

I accompanied him to therapy (driving him after he could sit in a car) because he needed help changing after his pool work. Remember, at this point, he wasn’t supposed to stand without the braces which makes it hard to undress and dress-especially when you’re wet.

Mark was able to manage by himself even after the pool sessions (freeing up my days and weeks considerably) at about the 12 week mark. HALLELUJA! It was just about at this time that Mark was cleared to do stairs and was finally able to sleep in our bed upstairs.

Some Final Random Notes:

This time period definitely saw the most notable progress. Mark got more independent by the day. We’re a few days from the 4 month anniversary. He still notices sustained but slow progress.

Mark’s knees are sore after therapy because they work him constantly. Ice and rest helps. He’s been walking without braces and crutches for about 3 weeks. He’s been showering (with a bench in our tub) since right around the 12 week mark. He still walks pretty stiff-legged, gets fatigued easily with too much walking or standing and has experienced swelling in the ankles for the same reason.

We took Luke to a tournament in New Jersey the weekend of November 12 (3 months and 1 week post-op). Mark had been cleared to drive but could only do so for about an hour before he got too stiff and sore. Also, his ankles were swollen when we got back. Probably 6 hours in a car and watching two long matches before that. Other than that, Mark can run errands on his own and drives himself to therapy.

Mark’s left knee is still behind the right in terms of range of motion and pain. Nobody seems to be concerned about it. As my friend (a PT) explained, you would never expect two injuries to respond exactly the same way, even in the same knee or joint. That makes sense but it’s frustrating and a little scary for him.

It’s too early to tell when Mark can return to work. If he had a desk job, it would be sooner. As a tennis pro, he’s typically on his feet 6-10 hours a day. That’s not possible at this point. Plus he needs the extensive therapy to continue to progress.

I don’t intend to write another whole post but will likely add a footnote to this one when he’s finally back to normal just to give you an idea of how long the process was for him beginning to end.

If you have any specific questions about this injury, caregiving, progress you can find my contact information by clicking the “contact” tab at the top of the page.

Bilateral Patellar Tendon Rupture~Recovery Pt. 1

bilateral patellar tendon rupture and recovery

Warning: This is a LONG post. If you or someone you know has suffered this rare injury, I hope it helps. That’s pretty much the point of it. The post will bore everyone else. This is the first of 3 parts. Part 2 covers weeks 2-6. In part 3, I talk about Mark’s experience during weeks 6-12.

It’s important to note that your experience might be completely different depending on your ability to rehab at home after the surgery, your age, weight, whether you have someone at home with you 24/7 (our situation) and the type of repair that was done. Mark did not require cadaver tendons which might have affected the healing timeline on the front end.

This post contains affiliate links to products we used (and are using). If you purchase a product I receive a small commission at no additional cost to you. I took the time to include links for your convenience, too. You probably have a lot going on.

Here goes…

It’s been three months since Mark got hurt at work. It seems like we are just coming up for air. Though, he still has a long road of recovery ahead.

Mark wasn’t cleared by the surgeon to try to stand at therapy until 2 months after the surgery. He was completely NON-WEIGHT-BEARING and LEGS LOCKED IN EXTENSION for two full months.

Since blowing both tendons is so rare (even the health professionals kept forgetting the ramifications), there’s very little information on the internet about recovery.

Non-weight-bearing means a completely different thing when you have one good leg. Logistically and therapeutically.

Weeks 1 & 2: Care and Comfort

The first week was all about pain management, getting regular (KWIM), comfort and avoiding blood clots.

Since I was helping Mark with every single maneuver and task in the first few weeks, it was great that friends and family (who really couldn’t do much else for him) brought meals and gift cards for the local grocery store. It made feeding everyone easy on the fly. (It’s not even possible to express how humbled, grateful and relieved I was to receive this type of support so I won’t even try. If you know someone going through this, it’s an excellent way to help).

Mark was pretty much finished with the pain killers within 7-10 days.

The hardest thing for him was getting comfortable with both legs locked in extension in braces.

Mark also experienced an almost constant tingling, numbness and coldness in his feet, especially from the ball of his foot and toes. The kids or I would squeeze his feet with light pressure to relieve this as often as he asked. It gave him very temporary relief. Now that he’s on his feet more, he doesn’t notice it as much. At least it doesn’t bother him if it is there.

One dose of Senekot at night worked great to get the pipes moving that were jammed up from pain killers. ‘Nuf said.

Otherwise, good food, hot coffee in the morning, a captivating book and “The Sopranos” (loaned by a neighbor) kept things bearable in the beginning. We are so lucky to have the most thoughtful and generous friends and family. People were so supportive and thought of ways to ease the burden and this terrifying turn of events.

Blood Clots

Mark was on Lovanox shots (in the stomach-super fun) for 3 weeks post-op then 325 mg of aspirin 2X per day.

Ten days after he was finished with the Lovanox, he experienced a sudden onset of back pain (kidney/lower lung) in his left side. Accompanied by an occassional catching when he tried to take a deep breath.

No other classic symptoms associated with blood clots (swelling, other shortness of breath, chest pain). His symptoms improved with ibuprofen and lasted about 12 hours. We wrote it off as muscle pain or strain.

Two weeks later, the same pain returned in his back on the right side. This was more severe, lasted longer and again improved with ibuprofen. Since it was the second episode, we went to the ER. (No easy task when you can’t get into a car-grateful for a good friend who jumped in with his wheelchair van.)

Turns out that he had a clot in each femoral artery and pulmonary emboli in his right lung.

Long story not short, the hemotologist put him on 15 mg of Xarelto 2X per day for 3 weeks then 20 mg once a day until at least 3 months after he is completely mobile and unrestricted. He has had no problems on Xarelto.

My advice, don’t mess around with aspirin after the Lovanox. Insurance company will resist because it’s supposedly expensive but beg the surgeon to campaign for it or get a hemotologist to confer before you leave the hospital.

Hopefully you can afford the copay. If not, get to the ER as soon as you get whiff of a symptom, no matter how difficult it is.

Miscellaneous Comfort Tips

We realized a day or two after Mark got home that he got a lot of relief by laying flat and resting his legs on bed pillows long-ways. Sometimes two under each leg. It relieved pressure in his lower back and reduced swelling in his feet, ankles and legs. It also got his heels off the bed.

Mark iced his knees fairly regularly in the first two weeks. I left the hospital with the ice packs and covers plus refill ice packs. These 8 gel packs can also be heated and have come in handy for stretching once therapy started outside the house.

Therapy

Healing. That’s it. One week post op, Mark had an appointment with the surgeon to remove the surgical bandage. The next week he went back to get the staples removed.

Transportation

Mark was unable to get into or ride in a normal car or van. Even if he could have gotten in without levitating, he wasn’t allowed to bend his legs. We were lucky that the worker’s comp covered all transportation costs until he was able to get into a car. They sent a wheelchair van for all doctor visits and therapy.

Equipment

Here is a list of “MUST-HAVES“: Mark was injured at work and the Worker’s Comp carrier has been great about getting him everything he needs to help with his comfort and recovery. We are lucky NOT to have co-pays.

If you have high deductibles and are blessed with family and friends who really want to help, maybe they would be willing to help you afford these things for a few months.

Urinal (get one before you leave hospital)
Wash basin (again, hospital)
Extra wide bedside commode (not the drop-arm model which would be a death trap)
Ramp if you have stairs to the first floor of your home
Sliding board
Reclining Wheelchair (if possible)
Case of wipes
Fully automatic hospital bed (this is an affiliate link but you won’t likely be able to afford this. Insurance probably will. Campaign for the fully automatic. But get whatever you can.)

Since I cared for my aunt in our home for two years prior to Mark’s accident, we were equipped with a ramp into the house, a bedroom on the first floor with a fully automatic hospital bed and an extra wide bedside commode.

Let’s Talk About The Commode

Mark’s not a big guy so he likely wouldn’t have been approved for the extra wide commode (insurance approval is based on weight)-but we had one. Knowing what I know now, I would have paid the difference or bought one outright. It makes sponge-bathing himself so much easier and more comfortable. Since we don’t have a shower on the first floor or even a walk-in, this is important. Even if we had an accessible shower on the first floor, getting in there would have been virtually impossible with his restrictions in the first 8 weeks.

Also, Mark avoided a bed pan by learning how to maneuver onto the commode. Sorry for the graphic detail but this would be important to a person facing this injury.

How to Transfer When You Can’t Bend or Stand On Either Leg

Being locked in extension (legs straight out in braces) and non-weight-bearing, made transfers (even to a wheelchair or commode) tricky.

Luckily the hospital PT showed him how to slide onto the commode and wheelchair while his legs were still supported on the bed. He scooted sideways on the bed then backed into either chair. See photo below to see what I mean: (sorry for the blurry pic but gives you an idea).

how to transfer to wheelchair with bilateral patellar tendon injury

In the wheelchair, he would slowly back out while I supported his braced legs until the wheelchair leg supports could be swung into place (either by him or one of the kids-yes, a 3 man operation at first). Another trick was bridging the leg supports with 2 sliding boards so his legs wouldn’t fall through or have to be strapped to the supports. See photo below:

Reclining wheelchair and bridge for legs

We have a chair in the living room with a weirdly large ottoman. Both are low and were easy for Mark to slide onto from the wheelchair. (Photo below) If not for this furniture, Mark would have been stuck in bed or the wheelchair for 8 weeks.

bilateral patellar tendon rupture recovery and support

Let’s talk about the wheelchair for a minute.

The equipment company sent a lightweight wheelchair sized according to Mark’s height and weight. As much as I appreciated the size for maneuverability through the house, the narrow seat was uncomfortable for Mark since his legs were locked straight out in front of him. Imagine sitting upright in any chair with your legs straight out.

After a couple of tries, they found him a reclining chair which was much more comfortable for long periods of time (trips to surgeon, ER and in a wheelchair van).

The seat base is wide and deep and the ability to recline the back even a little makes a big difference. If you can get your hands on one of these bad-boys, even if you have to buy it yourself and resell it on Amazon when you’re finished, you won’t be sorry.

Hospital Bed

As I mentioned above, we already have a hospital bed because I cared for my aunt before Mark was injured. I’m guessing most insurance companies will authorize a hospital bed because they were asking if we would need one when Mark was still in the hospital. Get one if you can. If you can get a fully automatic one, get it. The bed made sleeping on his back bearable.

Mark didn’t need the trapeze so we sent it back. A bigger person might need one.

This post is getting loooong so I’ll tell you about the next 4 weeks post-op (weeks 2-6) in the next installment. I hope this has been helpful.

In Sickness & In Health

wedding

So, Mark and I are celebrating our 23rd anniversary today. Just shy of 3 weeks after his physical catastrophe.

I’m not an overly emotional or sentimental person but I clearly remember my voice cracking only once during our vows…”in sickness and in health”. In an instant, I was overwhelmed by the thought of him being sick and vulnerable.

He’s had some minor surgeries (that dual hernia operation just before our 10th anniversary wasn’t too fun) but nothing as challenging as this.

The thing is, as challenging as this is physically, emotionally and probably financially, I know it isn’t even close to the worst that can happen to a couple. Not even close.

So I’m thankful that we work well together because just about everything he does, we do together. I’m thankful that we enjoy each other’s company (as long as he doesn’t try to tell jokes). I’m thankful that we trust each other to get through this. And yes, I’m thankful that we love and trust each other and even on our worst days, there still isn’t anyone I would rather spend time with (no offense to my children, who come second in that category).

I don’t feel all that much different than that day 23 years ago. Marrying Mark felt like the rightest, most natural thing. Helping him do just about everything feels just as right and natural (though, I have to keep reminding him the kids can fetch the this or the that when they’re here).

Happy Anniversary. Oh and Happy Birthday to Luke who was our 5th anniversary gift!

Crisis Mode

I WISH Mark’s room had a desk like that!

Mark blew out both knees last week. He’s a full-time tennis teaching pro. Yes, that’s his real job.

Truth be told, I can’t believe something like this hasn’t happened before this. He really wasn’t doing anything nutty or risky. He’s pretty conservative because his joints have always ached. He dislocated both shoulders before he graduated from college. Plus, teaching on a hard surface 8-10 hours a day for 30 years might lead to some wear-and-tear.

Here’s how I react to crisis:

My brain goes into hyper-efficiency lock-down. Do the bare minimum. Prune the unimportant, take care of only what’s necessary. The kids are at an age where they’re pretty self-sufficient and can help each other get where they need to go. I also have lots of family and good friends around who can help. (S/O to my brother John who took care of details at home when it happened).

The other thing my brain does which makes me hopeful and positive is to think about how much worse things could have been. In a weird, backwards way, it helps me be grateful even in what seems like a catastrophe.

Here’s what I’m talking about:

Mark had just returned from taking Luke to a tournament in Boston. He easily could have been walking fast or running for a flight and this could have happened. I can’t imagine how traumatized Luke would have been on top of managing this type of crisis long distance.
I’m glad it happened at work because…worker’s comp.
I’m grateful I don’t have the stress of managing a job outside the house on top of this.
I’m grateful I didn’t get the car crash call or the heart-attack-on-the-court call.
My mom can care for my aunt at her house while we get our bearings again. That means Mark has a hospital bed and a bathroom on the first floor because he won’t be able to bear weight on either leg for a while. My brain hasn’t quite caught up to that concept but we’ll deal with it.
Mark ran up to our cabin by himself the weekend before this happened to take care of some things. It’s remote and even if he remembers to take his phone with him, reception is sketchy. The nearest neighbor is not visible through the woods. Shudder.
Most surgeons haven’t seen a bilateral rupture of this type but it is repairable and they’re confident that he will be better than he ever was.

So, that’s how my brain works. You might think it’s pathetic denial but I’m sticking with it. It has given me a better outlook on what’s ahead.

My Theory About Why So Few People Truly Understand Caregiving

Being Home

Encouragement to help you make the most of being home