Freda, six days after the fall

Hi Everybody,
Thanks for your concern and good wishes. So far the situation with Elfreda's hip is good.

She fell on Wednesday, got stabilized, and finally had surgery on Sunday. With the help of a great anesthesia team she was able to have a spinal, rather than general anesthesia, so she emerged from the partial hip replacement wide awake, pain-free (no narcotic pain meds) and looking better than she'd looked in days. Steve bought champagne for dinner that night.

But of course getting to the top of the mountain is only half the trip. We were told that the first 48 hours post-surgery were critical. Steve and I stayed with her all day yesterday and today. The improvement has been marked. For one thing, she'd lost her voice (because her throat was so dry from mouth breathing) and was so weak that she couldn't hold a pen to write messages. Today she held a pen, wrote messages with exclamation points (another night??!!) and demanded her New Yorker and her mail. When we prepared to leave at 8pm, she wrote that the ward (4 beds, the level just under ICU) turned into a bordello after 9pm, indicating that the nurses were a lot more free and easy when the visitors left.

She's totally on-board with re-hab so far, and has sat up with her legs hanging down for 15 minutes though it tires her. Tomorrow they're going to try to get her on her feet. No pain so far.

The biggest obstacle right now is that her swallowing mechanism is compromised. It's odd--she lost the ability to swallow right after the accident: she couldn't swallow in the emergency room. Apparently swallowing is a delicate mechanism and trauma can throw it out of whack in the frail elderly. The good news is that when it goes suddenly, it usually comes back. Also, NYU has a nationally recognized swallowing unit. Who knew? The bad news is that she needs a nasal feeding tube for the short term--we hope just a few days--because she needs to eat in order to get some strength back. She hasn't had any sustenance since April 29.

She's also under the care of a gerontologist (at last) who's very forceful about getting tubes and catheters and needles out of her ASAP, and getting her on her feet. Another setback, predictably, is pneumonia. It's not too serious according to the docs and the sooner she's upright the better.

Her spirits are pretty good. The whole process is exhausting and she often looks wiped-out, but she never for a moment wants to throw in the towel. She puts on her big silver ring and silver mesh bracelet every morning, keeps her handbag by her side (it has become something of a security blanket) and tonight we brought her favorite cane at her request. The nurses are fairly stunned at her ability to handle pain and discomfort (the pokes, needle sticks, tubes, and for that matter, the fact that she had to be turned on her side, with a broken femur, to get the spinal) without any complaint. Not a peep.

We're eager to get her into a private room since the sounds of the sub-acute care room are like a cross between a casino and a charnel house; it's not a healing atmosphere but the monitoring is necessary for now. No visitors, but if you'd like to send a letter or card, I'm bringing her mail from home every day (201 E. 17th St., #23B, NY, NY 10003).

Obviously the situation can change very fast. I will post every night but if things go well we're looking at a week to ten days in the hospital and then on to a rehab facility. Mary Manning Walsh and Amsterdam are at the top of the list since we don't think she'll be able to manage the 3 hours of daily rehab required by Rusk, though who knows? She's not a garden variety 101-year-old.