Monthly Archives: January 2014

Absence and Presence

“Life Happens … sometimes, with great insistence on PAYING

Calendar 2013 was not kind to the household I live in, or to my family, or to many friends.

To that end, I spent far more time dealing with off-line events than I did paying attention on-line.  Oh, I kept writing (as mentioned elsewhere, I write like I breathe…), but my awareness was very much focused on physical and immediate matters of existence.  Friends and family facing cancer, loss of loved ones, and in one case a Parkinson’s-afflicted household member’s broken hip leading via surgery to long-term residence in a nursing facility (now expected to be permanent relocation).  More about that last in a bit…

Some of my creative outlets went away as well.  Others lost my regular attention as matters requiring focus and physical presence consumed my thoughts, time, and energies.

That all said, “I’m back!” and I have a backlog of commentary upon life, the universe, and everything to put into something like a permanent form of expression now.

That should account for my renewed presence in an on-line sense.

About that broken hip:  Parkinson’s Disease is a progressive and ultimately fatal condition, and some of how it affects the patient is all the more nasty because it is relatively slow in the onset of symptoms — and those symptoms may be mis-attributed or conflated with other medical events.  Add in the general declines associated with aging, the deterioration in muscle response, and stubborn (human!, after all) insistence upon maintaining as much of the daily routine as possible, THEN serve up a few lesser-known “Gotcha!” side effects.

There are other terms / descriptions that may be more medically-correct, but I will call one of those Parkinson’s “Gotcha” effects “anesthesia senility”.  Three and a half years ago I’d never heard of this, but it seems that there is a significant segment of the Parkinsons Disease patient population which reacts very poorly to general anesthesia.  Observed effects are that upon emergence from anesthesia, the patient exhibits marked decline in mental acuity and other symptoms generally associated with dementia and senility:  full-blown hallucinations, anger, diminished capacity for communication, and so forth.  Even worse, the impact appears to worsen with subsequent anesthesia events.

In the immediate instance, the household member I am helping to care for, a mistake in judgment led to a fall after a shower – a hook on the back of a door placed before physical decline was just THAT much out of reach – and a fractured hip.  General anesthesia, partial replacement of the joint, and off from the hospital to a skilled nursing / rehabilitation facility.  Fast-forward a week, and the rebuilt joint is recognized as being dislocated.  Back to the hospital, return to general anesthesia to allow a closed reduction of the dislocation (the physician was able to put the ball back in the socket without repeating the surgery).

The physical effects would have been hard enough to deal with all on their own.  Adding in the sudden mental deterioration was simply too much, with an end result of what is now expected to be end-of-life permanent residence in a nursing facility.  Physical therapy failed to regain any useful mobility in the affected leg.  General physical weakness, and a prior shoulder surgery, made other common alternatives unavailable or unwarranted, particularly in combination with the mental deterioration.

Parkinsons sucks.  Parkinsons combined with broken hip sucks far worse.