Archive for the ‘Nyel Stevens’ Category

The Sophisticated Farmer Nyel

Friday, March 22nd, 2019

It’s difficult to carry off any sort of savoir fair when you are spending your days in a hospital bed.  But, I’m here to tell you, that Nyel has managed to set the bar pretty high in the Sophistication Department at Ocean Beach Hospital!

First, let me say that ever since the St. Vincent’s Hospital crew filled him up with fluids and sent him off without a plan for getting him back to his “dry weight” as it is called in the world of Congestive Heart Failure, he has had no appetite whatsoever.  “I feel full up to here!” he says, gesturing well above his head.  “If I add one bite, I’ll be seriously sick to my stomach.”

So it is that he manages to choke down a little breakfast each day (yogurt and a fruit cup) and a lunch usually of the same ilk and refuses dinner no matter what.  The dietician has added Ensure to his nutritional requirements and is urging him to eat proteins so his bones can knit.  As for me – I have never, in the thirty-five years we’ve been together, seen Nyel refuse a meal – until now.  If I didn’t know how sick he is, his loss of appetite would be a huge indicator.

Yesterday, our friends Petra and Michael came visiting.  They called first and asked Nyel what they could bring him from the big city across the river.  “A nice baguette and some French brie,” was his immediate answer.  And, as soon as the bread was sliced and the brie removed from its wrappings, Nyel began to eat.

Sidewalk Cafe in Paris

Half the baguette and most of the brie later, he began to slow down a bit – even asking us if we wanted some.  We demurred and, although I can’t speak for P&M, it wasn’t because we didn’t want some.  It was the sure joy of watching Nyel eat that obviated all thoughts of joining in.

Wow!  I can’t think of any other circumstances in which a hospital room has been magically transformed into a Parisian sidewalk café.  The ambiance wasn’t quite the same, to be sure, but Nyel’s pleasure in the food was une joie de voir.  He comes home today and you can bet I’m dusting off my old copy of Julia Child’s Mastering the Art of French Cooking! 

Bon Appetit!

OBH even had Nyel’s dinner waiting!

Saturday, March 16th, 2019

Nyel’s Dinner

Dorothy had it SO right!  There is no place like home!!  When we finally rolled into the Ocean Beach Hospital in Ilwaco about 6:30 last night, Nyel had been “pre-admitted” (he only had to sign the paperwork) and they had kept his dinner warm for him!

Not that he had much appetite.  That’s been one of the sure signs that he is not a well man.  In thirty-five years, I’ve never known Nyel to willingly skip a meal but he’s passed on a number of them in the last few weeks.  He confided to me last night that he absolutely wasn’t hungry but he made a valiant try at eating out of sheer gratefulness.  He was, at last, on home territory!  People were greeting him by name!  Care by people who know him and truly want the best for HIM, What a concept!

The dinner menu was tilapia and Brussel sprouts – both of which Nyel really likes under ordinary circumstances.  He took a few bites, but he is still “up to here” in the feeling-full department – a direct result of his congestive heart failure.  He looks forward to improvement soon.  After all, food is one of the few pleasures open to him at the present time.  Plus, he knows he’ll have some hard work ahead in the physical therapy department and he’ll need nourishment and energy to help him through!

Nyel Tucks In

I drove home feeling better than I had for days.  Even his discharge form St. Vincent’s seemed to be a total cockup!  He had called me at eleven and said, “I’m outta here!  They are getting my discharge papers ready.”  I was at the designated pick-up spot by two.  Three or four phone calls and an hour and a half later, they finally wheeled him out to our car.  Apparently, the slowdown was due to Erica-the-nurse-of-the-moment.  “What was the problem?”  I wondered.  “I’m not sure.  She just seemed to have one speed… slow.”

It wouldn’t have mattered a twit except that Ocean Beach Hospital had asked that he arrive before the shift-change at 7:00.  We made it… but not by much.  I wouldn’t even be mentioning this last frustration except that it seemed the final irony.  Even getting Nyel discharged was difficult.  Well, never mind!  Onward and Upward!  I can’t wait to tell the chickens that Farmer Nyel is almost back home!

The Home Stretch

Friday, March 15th, 2019

Daffodils on Bay Avenue

What a difference a day makes!

Bright and early yesterday morning, after eleven days away from home, I headed for the beach to take care of a few necessities on the Homefront.  Like finally receiving delivery of our new, back-ordered-for-three-months stove and keeping an appointment or two of my own.  Nyel had given me a list of things to do and get for him, as well, and besides all that… we both felt that I had done all I could to get his care situation turned around.  It’s not that we had given up hope exactly… but we felt it might be time to let some dust settle on the hospital front.

My drive was uneventful weather and traffic-wise.  Until the home stretch!  I had stopped for a moment at the Ocean Park Library to pick up a book waiting for Nyel and then headed east on Bay Avenue, curious to see if Tom Downer’s daffodils were up and blooming.  Were they ever!  Hundreds of cheerful yellow blossoms filled the verge from Eric’s gallery to the Charles Nelson House at the corner of Bay and Sandridge.  Talk about a glorious welcome back to the beach!  OMG!

Better Than The Yellow Brick Road!

I arrived home about noon-thirty and called Nyel to see how it was going!  He hadn’t sounded so cheerful since my birthday night before TBH (The Broken Hip.)  Apparently, no sooner had I left but “everybody and his brother” – hospitalist, cardiologist, the orthopedic team, his current nurse, etc. etc. – crowded into his room.  No one called it the “Care Team Conference” (that we had been advocating for since Monday) but, that was what it seemed to be.  Everyone weighed into his progress, pro and con, and what the next steps should be!   YAY!

The decision was made to get him onto oral diuretics so he can be transferred to a rehab situation – maybe as early as today!!!  No sooner had they left than Nyel got a couple of phone calls – one from his cardiologist’s assistant in Seattle saying that his doctor was again offering to oversee his recovery (the heart aspects) long distance and, hard on the heels of that, a call from our Primary Caregiver in Ilwaco who said he would be comfortable working with the cardiologist and managing things from this end.  So… it looks as though Nyel might still wind up in rehab at the Ocean Beach Hospital in Ilwaco!  Double Yay!

The Rose City Mixed Quartet

About that time, the Rose City Mixed Quartet arrived to serenade Nyel (!!!) and the Physical Therapist who happened to be working with him right then (and who also belongs to a singing group in Portland) joined in on the madrigal “Paul and His Chickens.”  (Nyel said, “She later told me that it had been the BEST day of her entire working career!”)

When I checked back with Nyel in the evening, he said that the day just kept getting better and better.  Sue and Bill stopped by in the afternoon and stayed for a couple of hours.  “You have to share that chocolate,” I told him.  “How did you know they brought some?” he laughed.  “I know Sue and Bill…” was my response.

Waiting for Farmer Nyel

We realize that things can change in a trice, but we are both feeling so much more hopeful now than we were twenty-four hours ago.  “What do you think caused all the turn-arounds with the St. V’s people?” I asked Nyel.  “I haven’t a clue,” was his response.  As usual, they didn’t explain themselves and Nyel didn’t feel he had much part of the decision-making process.  But… that entire concern is moot for the moment.  I’m heading back to Portland and hope to return with the ever-patient patient before too many more clucks and cock-a-doodle-dos from Farmer Nyel’s flock.

Oh yes… the stove couldn’t be installed yesterday – they brought the wrong connecting parts…  But even that didn’t mar the joyous thought that things are finally turning around for Nyel.  And did I say that neighbors Carol and Tucker had me over for the best dinner I’ve had in since February 28th?  It really was a day to hold in my heart!

One Step Forward, Two Steps Back

Tuesday, March 12th, 2019

It’s a familiar dance step – one that goes with a variety of tunes.  Curiously, it doesn’t have a name – at least not one I can find among the 37 dances listed in the Oxford English Dictionary.  Not one dance from #1 “Pop Goes The Weasel” and #2 “The Virginia Reel” to #36 “The Rumba” and #37 “The Shimmy”  — not one is based on that familiar pattern of one step forward and two steps back.

But, even so, it is the step-pattern of choice here at St. Vincent’s Hospital.  There are a few variations, of course.  Sometimes there are three or even four steps back and, sometimes no step forward at all.  It’s all very confusing to the willing learners such as Nyel and myself.  And, the confusion is often compounded by the dance instructors (read doctors), themselves.  Not only do they disagree with one another, they often (apparently) disagree with themselves.

Take yesterday, for example.  A dance instructor (read doctor) from another dance team (read medical discipline) came in for a consultation.  His suggestions for a change in the dance pattern sounded terrific.  It seemed that his plan would soon have Nyel moving two or three steps forward without backward movements or even dips.  But, somehow, there was a change in his thinking after he left here and his original plan was scrapped.  Nyel’s dance routine was suddenly in a reversionary mode – steps that were tried days ago, and were found ineffective then, have been put back in his routine.

We’ve requested a conference with both dance instructors together.  Although both have agreed, they have come in separately.  That has happened twice this morning – they apparently don’t understand the terms “conference” and “together.” One comes and justifies one thing.  The other comes in and justifies something else.  Perhaps they are still trying to coordinate.  The only thing that seems consistent is that Nyel will not be leaving this dance studio for the foreseeable future.  Probably not for another week.

Through the magic of cyberspace, Nyel is in communication with his Number One Danseur in Seattle who has offered to consult with these St. Vincent’s’ hoofers if they initiate the request.  Neither Nyel nor I believe that they will consider doing that.  Stay tuned… if you can find the appropriate melody.

Hoping for Hip! Hip! Hooray!

Thursday, March 7th, 2019

Window Project, Oysterville Church 2019

When it comes to old structures like our house or the church across the street, I am in favor of repairing (if possible), restoring (if necessary) and replacing (never!)  I know there isn’t always a choice, but I love the old workmanship and, if it can’t be saved but replication is possible, then so be it.  But the choices aren’t so varied with people just yet – at least I don’t think so.

Nyel’s Hip Repair

These thoughts have come to mind in the last few days as many folks have kindly asked how Nyel is doing after his “hip replacement” and, I have to confess, I keep thinking of what friends have experienced after one or both hips have been “redone.”  So many people have sailed through – “back to work in a week” said one friend.  Don’t we wish.  (“Work”   meaning chicken duties in Farmer Nyel’s case, of course!)

As I understand it, the surgical procedure used to repair a broken hip can vary depending on a number of factors.  According to one website: In general, fractures of the very top of the thigh bone, called the femoral neck, are treated with replacement.   If the femoral neck fracture is not at all displaced, a repair of the break may be considered.  Apparently, that isn’t the problem or solution for Nyel.

Fractures below the neck of the femur, called intertrochanteric fractures, are treated with surgical repair using rods, plates, or screws. Nyel has  experienced a displaced subtrochanteric left hip fracture with full shaft width displacement.  For him it’s been the rod and screw treatment!

So, starting at the top of that long left leg:  a rod through the two parts of the  brokenhip, a connecting rod through his femur down to his kneejoint, held in place by two screws.  There, mid-leg, is his bionic knee.  Next comes the tibia and fibula – both broken in October.  The tibia was repaired with a plate and six screws – maybe more, says Nyel. The spiral fracture of the fibula has actually healed on its own.  So, there you have it.  Metal from hip to ankle!  I asked Nyel if that left leg felt heavier than his all-flesh-and-bone right leg.  “Maybe,” he said.  Maybe, indeed!

Full recovery from this hip repair may take up to a year and, according to many sources, only about 50 percent of people regain their full function.  The biggest challenges are mobility, strength, and balance.  In Nyel’s case, “full function” went out with the quadriceps surgeries seven and five years ago.  But we’ll be working hard to get him back to the best possible level of functionality. Step One:  Get him stabile enough to get out of here and get home to the chickens!  It’s in Oysterville that Farmer Nyel and his bionic parts really shine!

Underwhelmed at St. Vincent’s

Wednesday, March 6th, 2019

Nyel at St. Vincent’s 3-6-19

So far here at St. Vincent’s Hospital in Portland, it’s been a matter of hurry up and wait.  Nyel was ambulanced here from the Ocean Beach Hospital ER late Thursday night.  He had a badly broken hip.  His surgery took place Friday morning.  The surgeon called me during the procedure to ask if, prior to his fall, he had been complaining about his knee.  It was an inauspicious beginning.

The surgeon was unaware that Nyel has had two (ultimately unsuccessful) surgeries to repair his quadriceps which failed following a knee replacement in 2010.  “I just wondered if this break to his hip somehow caused an injury to his quadriceps,” he said.  Obviously, he didn’t get the patient’s medical history…

Since the surgery, Nyel’s blood pressure has plummeted to the point that they cannot safely have him stand so he can begin walking – an urgent priority, it seems, after hip surgery.  Over the last three days they have given him five units of blood, two boluses (intravenously delivered saline solutions) and encouraged him to drink fluids to the point that he felt sick and could not eat for two days.  All this to get his blood pressure up.

Broken Hip Repair

They have stopped getting him up to stand on the scales (because of lightheadedness from low blood pressure) but as of day before yesterday, he had gained 17 pounds of weight (from fluids) in twenty-four hours.  This morning: 25-pound weight gain over his ‘protocol’ weight at which point, in the normal course of events, his regular cardiologist wants him to double his ‘usual’ dosage of diuretics.  Here at St. Vincents, they have given him no diuretics, usual or otherwise – because of the blood pressure issue, they say.  “It’s a balancing act,” they tell us.

Since Sunday, I have requested that they bring a staff cardiologist in for a consult.  So far (this is Wednesday) that has not happened.  Because he has had congestive heart failure for five years and is on a strict protocol regarding weight gain from fluids, I’ve asked why they have stopped his regular regimen of diuretics.  “We are waiting to see…” is the answer.  “Could he please talk to a cardiologist?” I ask.   “Yes, we’ve noted your concern…” is the answer.  “Maybe today…”

First Steps

Always ‘The Plan’ seems to be “let’s wait to see if this transfusion (or this orange juice or this Gatorade) will help.”  They’ve taken hm off all pain meds and muscle relaxants though his pain level is elevated from muscle spasming.  “Analgesics tend to lower blood pressure.  Let’s see if eliminating them will help,” they say.  Each time I ask for a cardiologist’s input they say, “You have the absolute right to advocate for your loved one.”  (Duh!)  Somehow, my advocacy is going nowhere at all.

Nyel told me a few minutes ago that he’d like to be moved to the Seattle Medical Center where his cardiologist is.  If they can’t honor his request to bring a cardiologist in from another floor in this very hospital, I wonder what response he will get to the transfer request…

I keep thinking about the Hippocratic mantra, “Do no harm.”  I wonder where that fits into the St. Vincent’s picture.

Birthday Bash and Late Night Crash!

Tuesday, March 5th, 2019

Sydney’s Birthday Dinner

On balance… but that was part of the trouble.  My birthday began well enough.  Almost.  It was to be the Christmas we were unable to have with Charlie and Marta but only Charlie could come.  Still, Nyel made reservations at the Bridgewater Bistro, Cate filled in for Marta,and we met Patty and Noel for a marvelous dinner with visiting by Tony and Ann thrown in.  And Dave Drury and his trio played Happy Birthday!  To Me!

Andrew Emlen of the Skamokawa Swamp Opera

We got home about nine – pitchy black outside.  Nyel took the flashlight and went to check on the chickens.  It seemed to be taking him a long time.  I looked out the east window and could see his light but it wasn’t moving.  Just then my phone rang.  “I’ve fallen.  I think I broke my hip.”  I called 911.  Charlie grabbed blankets.  (It was below freezing but, fortunately, the grass where he had fallen was fairly dry.) Aid Car.  Ocean Beach Hospital ER.  X-rays.  Bad break. Yes, hip.

Charlie Visits Nyel at St. Vincents

Nyel was ambulanced to St. Vincent’s in Portland where he had surgery on Friday morning. Blood pressure plummeted.  Much concern.  Charlie and I feeling helpless at the hospital.  Sunday, no improvement.  Charlie and I went home to host an SRO House Concert for the Skamokawa Swamp Opera. (Fabulous!) Phone calls to the hospital before, during, after.  No improvement.  Transfusions.

One Step at a Time

Monday Charlie and I caravanned into Portland.  Nyel feeling lousy but sitting up and actually walking ever-so-slowly with a walker.  I am staying until he is ready to go home; Charlie said his goodbyes and back to L.A.  “I think we have to stop celebrating Christmas – no matter what time of year it is,” he said.  And we both remembered Christmas of 2016 when Nyel went into congestive heart failure and this merry minuet of hospital stays began.

Damn!  Damn!  Damn! This gentlest of gentlemen has had way more than his share.  We’d gladly give up Christmases and Birthdays, too, for Nyel’s good health.

By Degrees and All of a Sudden!

Saturday, February 2nd, 2019

Ossie Steiner’s standard “goodbye” words weren’t “see you later” or “’til next time” or any of the usual expressions.  It was always, “See you all of a sudden!” And around here, where you come across familiar faces no matter where you go, it was absolutely true.  At the store, at the library, at a restaurant or a play, you are likely to see almost anyone you know… all of a sudden!

In a totally different context, I felt that “all of a sudden” sort of surprise yesterday when I walked into our library and there was Nyel laying a fire!  With big chunks of firewood that he had carried from the woodpile to the porch and then into the house!  No wheelchair.  No walker.  Egad!  It seemed as though all of a sudden, he was back to almost normal!

Not really, of course.  There is the locking knee brace that he will always wear.  And the walker was nearby.  Ditto his cane (which he tells me he is going to try out today.) Bottom line, though – he was doing one of the Friday afternoon chores that I’ve been struggling with since he’s been out of commission.  To say I was thrilled beyond all measure is the understatement of the last four months!

I also discovered later that he had swept the front porch and had accomplished several other disparate tasks – his part of the usual preparations for our weekly Friday gatherings — his contributions that I’ve taken for granted for years.  Until lately, when I’ve had to do those things myself.

Isn’t that always the way?  When you are part of a team and you are concentrating on doing the best you can with your own part of things, you seldom think about the contributions that the other members make.  Until they can’t.  But when they are back on the job?  Wow!  Appreciation knows no bounds – in every single way.  Yes, recovery happens by degrees and by hard work and determination.  But it’s the “all-of-a-sudden” accomplishments that cause the clapping and cheering!

Truth to tell, I feel a little guilty about that.

Standing On His Own Two Feet!

Thursday, January 10th, 2019

First Stop!

I feel like calling out to the chickens, “Watch out, girls!  Here he comes!”  But it will probably be a while.  There are some logistics to work out – where and when for the locking knee brace, the walker, the cane, the wheelchair – all of which will play a part in Nyel’s ability to resume his Farmer duties.  But the very bottom line as of yesterday – he can now but weight on his “bad” leg.  Yay!

According to his surgeon, his broken leg has healed well.  That does not mean, of course, that he is in any less danger of falling than he has been since his second quadriceps surgery failed several years back.  “Falling” has been his middle name.  He is SO lucky that, in the dozens of times his knee has failed him and he has gone done without warning, this was the first real damage he has done to himself.  A mega wake-up call. So, now the re-learning work begins.

Of course, yesterday’s news was received with great relief – in more ways that one.  For the three months of “no weight-bearing,” my dignified husband has been dependent on what used to be known as “the truckdriver’s friend” – a pee bottle or a male urinal.  So, first stop yesterday was the men’s room at Rebound where he could actually ‘stand and deliver’ so to speak.

Six on the Floor

Today, he is using his knee-locking brace (almost happily!) and a walker to begin rebuilding strength in both legs.  Meanwhile, the wheelchair will probably be his main aid to mobility.  And, when he is confident that he can move around the house without problems, he’s looking forward to that knee scooter to get him down to the girls in nothing flat.

As for me – I’m clapping and cheering and trying not to hover! Woot!  Woot!

Cruising Toward 2019

Monday, December 10th, 2018

Today is a Red Letter Day of sorts.   Nyel is taking the driver’s seat!  Literally!  It will be the first time since his Big Fall on October 3rd – the one that resulted in his complicated leg break – even though his surgeon said that he could drive as long as he wasn’t taking opioid pain meds.  He hasn’t and isn’t and, though I am reluctant to admit it, I’ve been the one that has encouraged him to continue being chauffeured.  By me.

We both recognize that we are victims of one of those automatic hovering mothering mechanisms that kicks in whenever someone (other than me) in the household becomes impaired.  Nyel has learned that it’s easier to take a “whatever…” attitude than to deal with my fussing and, so it is, that I’ve been doing all the driving.  Until today.  When the EMTs arrive to transfer Nyel into the car, it will be to ease him behind the wheel!  He’s more than ready.  I am resigned.

I see it as one of those necessity things.  I have an eye appointment across the river – a biggee to check my glaucoma, dry eye, peripheral vision etc. etc.  There will be drops.  In the past it has been my experience that I do not see well enough to drive safely for twenty-four hours or so after such an appointment.  So… today is the day that Nyel re-enters the mainstream, so to speak.  I console myself that, after all, it’s his left leg that isn’t operable, plus we have an automatic transmission and cruise control.  No problem, right?

And besides all of the above, today marks the “less than a month to go” before his next appointment with his surgeon and, presumably, his release from this “non-weight-bearing on the left leg” sentence.  January 9th will be the next Red Letter Day!  Woot! Woot!