Zest for life

Two broken hips couldn’t keep 90-year-old Mary Beth Alexander down. Love of family—and a Korean boy band—fueled her recovery.

Zest for life

The 33-second video “BTS Grammy” shows a sunny silver-haired woman grinning from her perch in a hospital bed, surrounded by pictures and dolls of her favorite band, BTS.

The video’s star, known to her grandchildren—and now to @btsgrammy1930’s 32,000 followers on the TikTok video-sharing platform—as “Grammy,” is Mary Beth Alexander, a dynamic widow from Aurora, Ohio.

Alexander, 90, has devoted her life to meaningful work and relationships.

A skilled poet who used to write verse for the American Greetings card company, she also spent decades selling her original wildlife paintings and raising four daughters with her beloved husband, Jay.

She later cared for Jay at home during his long years of decline.

In early 2021, Alexander found herself under the care of others, as she fought her way back from bilateral hip fractures.

Her rehab journey prompted the video, which celebrates both Alexander’s spunk and her love for the seven-member boy band from South Korea.

“I’ve never been a groupie before,” she said. But after her daughter Colleen introduced her to the K-pop band three years ago, she became “smitten” and learned all she could about the BTS crew and Korean culture.

“In fact, we had tickets to go to South Korea,” she said. “And then of course COVID hit and we had to cancel our trip.”

Two broken hips

In the midst of the pandemic, Alexander faced another huge hurdle.

She lost her balance on a small step and fell, breaking both hips and four ribs.

The fall happened at the home of her daughter and son-in-law, Wende and Chris Clark, of Grand Rapids, Michigan, where she had planned to spend a few weeks over the holiday season.

Weeks turned into months, thanks to Alexander’s devastating tumble. On Jan. 5, she landed in Spectrum Health Butterworth Hospital’s ICU in extreme pain.

After running scans and X-rays to reveal the extent of Alexander’s injuries, members of the acute care and orthopedic trauma teams met with her and Wende to explain the treatment options.

Because of her advanced age and complex injuries, the medical team couldn’t offer the family a clear-cut decision.

“The first thing we do is … individualize the patient’s care,” explained Medardo Maroto, MD, the orthopedic trauma surgeon on call when Alexander arrived. “What are their needs? What are their expectations?”

In Alexander’s case, the team offered two possible pathways: surgery to repair the two hips or palliative care to keep her comfortable as she lived out her days.

In sharing this information, Dr. Maroto said, he and his colleagues tried to paint a clear, honest picture of what the future could look like under either option.

If Alexander chose to undergo surgery, recovery wouldn’t be easy, he said. To get back on her feet, she would have to pour herself into physical and occupational therapy.

But her positive attitude and underlying good health would take her a long way.

“You’re probably not going to be perfect after this, and you’re going to be slow,” Dr. Maroto told her, explaining that bilateral hip fractures are challenging and rare.

If she chose palliative care, she would be restricted to bed, with medications on board to manage the pain. As commonly happens with patients her age, she would likely die of pneumonia or another complication of inactivity after a few months, her doctors said.

At first Alexander expressed concern about the notion of surgery.

She questioned whether she would pull through and worried how her decision and its aftermath might affect her family.

Yet, after taking time to talk with her children, Alexander realized she still had so much to live for—including her first great-grandchild, who would soon turn 1.

“I kind of wanted to be around to watch him grow up,” she said. Plus, “they told me what the alternative would be, and I didn’t like it.”

So the day after her fall, Dr. Maroto took her into surgery, where he repaired first one side and then the other, inserting rods in both thigh bones.

Though there are risks to fixing two hips in a single surgery, the team kept a close eye on Alexander’s vitals and found it safe to go ahead.

“We proceeded and everything went well—and she ended up being a rock star,” Dr. Maroto said.

Challenging rehab

Once Alexander opted for surgery, the medical team’s No. 1 goal became helping her make a meaningful recovery—getting her “back to doing the things that she loves with the people that she loves,” said Elizabeth Steensma, MD, an acute care surgeon and intensive care/trauma specialist who cared for Alexander throughout her time at Butterworth Hospital.

Though Alexander had a couple of rough post-op days in the ICU, she bounced back and set her mind on working with the hospital therapy staff.

“She was one of those patients that you knew in your heart of hearts she was going to do well because she wanted to do well,” Dr. Steensma said.

“She was bound and determined that she was going to impress the therapists so that she could go to acute rehab.”

The plan worked.

A week after her surgery, Alexander transferred to the Inpatient Rehabilitation Center at Spectrum Health Blodgett Hospital.

But not before introducing her Butterworth Hospital care team to BTS.

“She taught me who they were—I didn’t even know,” Dr. Steensma said.

“She had a different pair of (BTS) socks for every day of the week. And she would just light up every time you would talk about it.”

Meeting a new team of physical and occupational therapists at Blodgett Hospital gave Alexander a new opportunity to share the K-pop love.

“We would listen to BTS every single day during therapy … once she could get up and move and jam out a little bit,” Lauren Van Seters, PTA, said.

“It was adorable to see how excited she got.”

During her six weeks of inpatient rehab, Alexander progressed from needing at least two people to help her with everything—getting out of bed, standing, taking a few steps—to requiring minimal assistance from a single person.

She came off her pain medications.

She moved from using a Rifton Pacer—a weight-bearing gait trainer—to using a walker with forearm platforms to a standard four-wheeled walker.

She went from being able to take six steps, with assistance, to taking 53.

Every day she added to the number until she topped 100 steps.

“It was gradual, and I got cheered for every advancement,” Alexander said. “It was heartening.”

That kind of progress is a big deal at age 90, Van Seters said.

“As far as I know, we have never seen someone her age … have bilateral hip fractures and survive it and come to therapy,” she said.

“That alone kind of tells you how much fight she has in her.”

Travel ahead?

Once discharged to Wende’s house, Alexander hired in-home physical therapy services to keep pushing her forward.

A contest with her 1-year-old great-grandson kept her motivated: Who would be the first to walk without assistance?

Alexander’s ultimate goal is to move home to Ohio, where her husband lies buried and her friends await her return.

Wende’s goal? To reschedule their mother-daughter trip to South Korea.

Alexander isn’t so sure about that, nor is Dr. Maroto.

But he won’t rule it out.

“If she keeps moving forward at the pace that she is, maybe she will prove me wrong,” he said. “I hope she does.”

Source : Health Beat More   

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Conflict in the Gaza Strip Could Lead to a New COVID-19 Surge

As conflict between Israel and the Palestinian militant group Hamas continues to claim lives in the Gaza Strip, health experts are calling attention to another potential crisis: a worsening COVID-19 outbreak in the area. The number of COVID-19 infections in Gaza was “just leveling off, and then this hit,” a United Nations official told the…

Conflict in the Gaza Strip Could Lead to a New COVID-19 Surge

As conflict between Israel and the Palestinian militant group Hamas continues to claim lives in the Gaza Strip, health experts are calling attention to another potential crisis: a worsening COVID-19 outbreak in the area.

The number of COVID-19 infections in Gaza was “just leveling off, and then this hit,” a United Nations official told the New York Times on May 16. “It is a grim situation.”

On May 3, before the conflict began, Doctors Without Borders warned of an “extraordinary” rise in COVID-19 cases in Gaza, the strip of land between Israel and Egypt that is governed by the militant group Hamas and is home to about 2 million Palestinians. Mostly spared in the early months of the pandemic, the COVID-19 outbreak in Gaza worsened considerably in April, driven by spread of the more transmissible B.1.1.7 variant. Between March and April, new COVID-19 diagnoses in Gaza rose from less than 1,000 each week to more than 1,000 each day, according to Doctors Without Borders.

It’s not clear how many people are being infected each day now. Violence between Israel and Hamas—which has so far killed more than 200 Palestinians and 12 Israelis, —has also all but shut down COVID-19 testing and care in Gaza, making it near-impossible to get an accurate picture of the outbreak..

“The number of positive cases is really underestimated. It doesn’t reflect the reality,” says Ely Sok, who leads Doctors Without Borders’ mission in the Palestinian territories of the West Bank, the Gaza Strip, and East Jerusalem. “We are expecting the number of severe cases requiring hospitalizations will increase.”

Health services in Gaza were already lacking prior to the most recent violence. Even during times of relative peace, medical centers there are often “overstretched” and limited by frequent power outages, the UN says. Limitations on imports and movement across the border also frequently led to supply and medication shortages, and there are often not enough doctors to meet demand.

In recent days, Israeli airstrikes have reportedly destroyed Hala Al Shwa Primary Healthcare Centre, which provided COVID-19 testing and vaccinations to Gaza residents; damaged the road leading to al-Shifa Hospital in Gaza City; and temporarily forced Gaza’s only laboratory for processing COVID-19 tests to close. Dr. Ayman Abu Elouf, who ran COVID-19 response at al-Shifa, was reportedly also killed in a bombing. All COVID-19 vaccinations have been halted in Gaza, according to the UN, and the nearly 60,000 Palestinians displaced by the conflict are in many cases huddling together in makeshift shelters that could become super-spreader sites. “It really harms the whole functioning of the medical system there,” says Hadas Ziv, head of projects and ethics at the nonprofit Physicians for Human Rights, based in Jaffa, Israel. “COVID-19 is somewhat pushed aside because there are wounded and dead. Limited capacity to deal with COVID is now non-existent, almost.”

Now, due to the deadly combination of bombing injuries and COVID-19 cases, hospital beds are running out and doctors are scrambling to keep up. Electricity, water and sanitation systems are also damaged in many areas, further compromising care.

Just across the border, Israelis are living in a different reality. More than 60% of Israel’s population has gotten at least one vaccine dose. COVID-19 cases have dropped low enough for the country to suspend outdoor mask mandates and resume many pre-pandemic activities.

In Gaza, by contrast, only about 2% of people have received a dose. Gaza and the West Bank have received about 60,000 vaccines from the World Health Organization-backed COVAX facility and are still waiting on some 100,000 more, but additional shipments aren’t coming any time soon. Even if they did, Ziv says, there wouldn’t be adequate infrastructure to store and distribute them during the conflict.

“Even if now they get the vaccines, it will be difficult to handle a big operation and keep them refrigerated,” she says. “It’s impossible to both deal with an armed conflict and the virus.”

Security concerns, both for patients and providers, also make it near-impossible to offer all but the most critical care, Sok says. “You can do whatever you want, but if the patient cannot access it because of the shelling, it’s completely useless,” he says. “Only a cease-fire will solve the security issue.”

Source : Time More   

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