Wednesday, March 4, 2015

Happy Homecoming

Luckily the house did not look like this today.  We hit near the freezing mark and got some rain, so the snow actually melted a bit.   Before I left to pick up TBG, I broke up some more ice and spread ice-melt.  My fear of him slipping on his way in was never realized.  All of the way home, he kept telling me that he couldn't wait to just see the house.  Being away for nine stressful days was manifested in many ways by him missing our physical residence.

Home is a special place -- and not just because the toilet is clean and the food is good, it's the comfort of knowing you are where you belong.  Along with the soiled bathroom story, he told me how they bought him his yogurt snack one night but there was no spoon with it.  The nurse said she'd be back with one.  An hour later, he rang for a nurse and asked again.  He finally got the spoon two hours later.  Then one night they forgot to put his compression/ice packs on.  He called them after 10PM and then again at 11.  No one remembered or was able to put them on until almost 1AM.  And as for his compression machines, today a guy came in and emptied the first one but the second one was on the other side of the bed.  He told Tommy he would be back to get that -- and never did.  I had to move the bed and crawl around to unplug it.  I got there at 8:30 and started packing his things.  He was supposed to be discharged at 9AM, but his meds still hadn't arrive.  We asked for them but the regular nurse didn't show up until 9:30 -- and told us if she'd known, she'd have been there earlier.  Really???  They told me he could walk out, which was fine.  But I had two ice/compression machines, his bag, a bag of dirty laundry, two leg braces plus a few other things... no one offered to help and I had to ask them to bring me a cart. 

Once he was successfully liberated, we went to see the surgeon.  His staples were removed and the verdict was that he'd done amazingly well and accomplished a lot.  Wanting to get out was a powerful  motivator -- plus, the actual physical and occupational therapy was one component of the experience that was not lacking.  After the doctor, we got coffee and a bagel in the car so he could eat something real on the way home.  I got him settled, re-taped some of the surgical stickies that came off when he took his sweats off, then set him up with his out patient rehab. Friends came to visit with a second walker for downstairs and then I picked up his meds.

The first time he had a knee scoped was in 2003.  He was sent home with a bottle of oxycodone that had three refills.  He couldn't wait to get off the stuff and never refilled it.  This time, the medical community is wiser.  The doctor was very emphatic about his pill schedule and how he was to shift to extra strength Tylenol, and be off the prescription within the week.  Now that makes sense.  He was also very particular about where we went for PT and the time to be out of work.  The guy is pretty no-nonsense.  We will see him again in one month.

We are lucky to have all the gear we need.  That seat that I found for seven bucks sells for $55 new.  I'll get compression socks on-line.   While we weren't as prepared for what cam our way as we could have been, it's all working out as we go.  It can only go up from here!

Tuesday, March 3, 2015

Potty Time!

The bathroom is all set up and the timing was perfect.  My Walmart items arrived today -- with the exception of the peddle exerciser.  Since that is not a safety item, I'm not worried.  The storage unit that normally sits in the right corner is out to make it "walker" accessible.  The toilet seat is raised 5 inches.  The seat is in the shower and the bath rug is off the floor.  I kept a bathmat in the shower and we'll play that by ear.
I tested the grab bar and it seems stable. We'll still be careful the first time he holds on to it.   There is one walker in the car and we'll get a second tomorrow.  That way there is one for upstairs and one for downstairs.  Stairs are actually not a problem for him.  I also have to get him a plastic urinal jug.  But you know, if stairs aren't a problem and I can keep the back stoop clear, he could always go out with Teddy to pee...

He gets sprung tomorrow at 9AM -- earlier than planned.  His surgeon wants to see him as one shin area had turned very red the last few days and was bothering him.  We were told not to worry because sometimes blood accumulates under the skin after surgery and it comes to the top layers.  That might be true since by today it had started to disperse and now there are ugly bruises on the outsides of his calves.  The doctor from our GP came in today to have a look and assured him it had no appearances of an infection.  But his surgeon wants to see him anyway.  So I'll get there early, help him clean up and pack him and his various devices up and head over to the doctor's office.  If he feels up to it, there is a NY Style deli we'll eat at on the way home. I suspect he'll be wiped out.

This was an exhausting adventure and we still have work to do. Having the ability to vent and get support was a big help so thank you all.  I might not be religious but I think prayer is a powerful symbol of support.  It shows people care and it's a great feeling to know people are praying for you.

After this, we have one more appointment on Friday to remove the staples.  We'll get Physical Therapy set up too and I hope to be able to bring him three nights a week for the first few weeks. I'll also help him with exercises.  The belt that is hanging on the towel bar in the first picture is there to help me if I need to assist him getting up or down -- and also to use for exercises.

He has done very well but it has been frustrating.  Being young and in shape has made his progress faster -- in spite of the psychological trauma of it all.  Adversity either makes you give up or gives you a reason to be stronger.  I'm fortunate to be married to a man who goes for strength over pity.  While he would like to be better right away, I suspect he'll sorta enjoy the fact that he is making himself stronger and that all his hard work is getting him somewhere.

But best of all, he's coming home!

Monday, March 2, 2015

I got mad.....

I complained to the the hospital system that owns the facility about the condition in TBGs room.  I also filled out a form at the state level.  TBG actually let loose during his PT session this morning as well.  The PT doesn't want him to be discharged until Wednesday and my guy was refusing to stay any longer than today or tomorrow.  When he told the guy why, the man went right to the head nurse after his session and got him moved to another room.

While I could have gone up the correct chain of command, I was at work and didn't have time to mess around.  As it is, I am embarrassed that we let it get this bad but I am also sure that being concerned about a serious health issue like this is not unfounded. What I did not realize until this morning, was that maintenance hadn't cleaned the bathroom Sunday morning, my husband did.  I had cleaned the toilet seat a few times myself.  I am totally ashamed to admit that too, as I should have been more aware and done something sooner.  I was trying mostly to keep Tommy's spirits up.

I can't adequately express how embarrassed and humiliated I am that I did not act more quickly.  TBG didn't want to complain and have the people who were caring for him get mad at him.   Having been in two other facilities owned by the organization, I just assumed that they were all of the same quality.  It may very well be that what happened in my husband's situation was unique but he gave up asking for things after the first day or so because no one remembered anything he requested.

Moving him at this point is pointless.  Had I not been afraid of the whole insurance process and been confident that I could have him transferred to another facility, I'd have done that.  Our system is so confusing and one mistake can cause months of headaches.  So again, I suggest that if you are thinking of using a facility, visit it first.

I am truly hopeful that the next two days will be uneventful, I am too eager to have my guy home and can't wait until Wednesday.




Sunday, March 1, 2015

Working Towards Homecoming

I got the walkway down to pavement today.  The trek into the house is what worries me the most and that meant I had to break through a lot of ice.  Home Depot was out of ice melt and the greeter cheerily told me "hope for spring!"  Idiot.  It's not something you go out to buy on a lark.  Luckily I was able to get a 25 pound bag at Tops.  I went in there to get whole grain frozen waffles.  They are my comfort food.  There have been plenty of nights in the past week where I got home exhausted and had no time for a real meal and had to just get stuff done and get to bed.  Waffles to the rescue.  If I feel I am in a low-sugar grump, I eat them with almonds, chia seeds, butter and maple syrup.  For breakfast, it's been with blueberries and vanilla yogurt.

Today I was able to make a fresh fruit salad for TBG along with a liverwurst and cheese sandwich.  The food at the facility is almost uneatable.  He is working hard and I want him to eat healthy fresh food.

Many have been after me to get a seat for the bathroom and I hesitated because our tub is so small.  I found this one at Goodwill for seven bucks.  It probably is too big but I'll see if TBG can use it.  For that price, it's not such a big deal if it doesn't work out.

Poor guy is gunning to be home and wants so much to be released tomorrow but I think he needs at least another day.  His roommate is a challenge.  Either he's moaning and whining all night that he's dying, or his friends are visiting and they are all laughing and carrying on.  On Friday, one woman mentioned how she'd been really sick and in the bathroom the day and night before.  Great, bringing germs in.  And they bough in a big greasy pizza.  The pizza apparently gave roommate explosive results and it soiled the bathroom.  This kept TBG up all night as the guy was also moaning that he was in horrible pain.  Nobody cleaned up the bathroom until the morning.

I am taking on all personal cleaning responsibilities for my husband because no one on staff has time to do it.  Granted, this is also part of his OT therapy, but he can't clean himself up completely and there is no help for him but me.

His roommate (who had been in the room already when TBG was admitted) has a broken foot and a couple of pins and doesn't seem to be able to do anything unassisted -- so he calls for help constantly and then complains when it takes time.  Tommy is getting up and taking himself to the bathroom and making sure to keep up with that so he can do it himself at home.  He still has to take a wheel chair to rehab and can't walk freely.

Our new neighbor stopped me today to give me his phone number and told me I should call if I need help. His fiance lives in the house too and she is studying to be a nurse.  While the PT is good at this place, I'm afraid if Tommy stays there much longer, he will get sick.

Once he is home I am writing the hospital system to complain.  I do not blame the staff because they are trying very hard but there just is not enough of them.   At this point, it is not worth it to get a transfer.  I wanted to do that the first day but we couldn't even imagine where to begin to get that cleared with insurance and how much extra authorizations, etc., would be involved.  One lesson we learned is never agree to use a facility until you have visited it.  Hopefully, we will not be in this spot again for a very long time!


Saturday, February 28, 2015

One of the Knees

I took a picture of TBGs right knee.  I hope this doesn't gross anyone out -- but I think it looks good.  The right knee was in the worst condition.  The nurse changing his bandages today told me that the smaller staples are from where they put a scope in.

It's nice to be able to visit on a weekend day because I got in first thing and helped him get cleaned up.  Tonight I helped him in the bathroom again.  The nurses told me he is doing great and he's their hottest patient -- well, OK, he's the youngest too so maybe that has something to do with it.  I have been told that for a person with a double replacement, that he's doing very well.  PT has helped and he can handle stairs.  That was the most important part of him being able to come home.

I went to CVS today and picked up more bandages and tape.  Being as frugal as I am, it was nice to find that there was a sale for BO-1/2 off.  With a $10 off $40 and $4 of Extra Care bucks, the sale helped me a lot.  My discount Mojo had to be working pretty good because I was also able to get five trays of marked down chicken backs for the pup.

A friend gave me a walker and then remembered his mother had a second one.  That's great because I wanted one for upstairs and downstairs.  The health aids I ordered on-line through Walmart should be here soon too.  I went to Amvet's to see if I could find a shower seat but had no luck.  I actually think he will be fine with the suction grab bar I ordered.  I am glad I ordered the small peddling device.  He has used one for his arms in PT and that knocked him out the first time (at six minutes) and he did more today (12 minutes) plus they have him on a bike.  So that will get some good use once he's at home.   He also gets to keep the cold water/ice compression pumps.  His sister sent him two big wrap around ice packs and a book to read.

I am now quite encouraged about how things are going.  He has worked hard and never complains about his condition.  The transfer to rehab was very hard on him but the work his PT has done with him has made so much of a difference that we both know we are on the way up.

I brought him coffee from Tim Horton's this morning and will do the same tomorrow -- it's his favorite coffee.  I'm also going to bring him lunch.  I think that will be a liverwurst sammich and potato salad.  Of all the meals he gets, breakfast is the least offensive.  I am lucky to have so many people who read the blog that keep my spirits up.  His family is great too.  His next oldest sister calls and sends him stuff and wants to know everything.  His honorary "Little Sister" -- his bike buddy, calls him and makes him laugh.  Our friends in town have been great -- especially our buddy who has the walkers for us.  We are just very lucky people and having a caring support network both on-line, on the phone, and in town means we never have to feel we are alone.

This surgery was tough but I am so glad we did it.  I see much more progress occurring at a fast pace and am looking forward to seeing my bionic husband in action soon!

Friday, February 27, 2015

Rehab is Working...

Well, TBG's facility might be rough around the edges and severely understaffed, but he's got a good PT and made great progress today.   Also, since our Primary Care medical practice has privileges at the affiliated hospital and are a few blocks away, one of the physicians checked on him today. It was nice to actually have a doctor familiar with his medical history check on him. 

His wound looks good.  It seems he raises a fever every night and they need to remember to keep him on Tylenol for that.  It would seem he might be home Monday or Tuesday if he can achieve a 90 degree bend of both knees.  In order to obtain a full and healthy way of walking, he has to remaster the entire task.  The PT doesn't think he's actually straightened or locked his knees for a very long time and with his new set, that is something he has to learn to do.

I helped him hobble to the bathroom and it was hard work.  He had two PT sessions today and one OT session and they worked him hard.  This was something he did not mind and I could see a real turn-around in his spirits and his ability to move.  Mentally, the place is tough.  He calls his room "My Own Private Idaho," as his roommate is somewhat strange old guy who normally lives in a group home (probably has most of his adult life) and has a lot of his group home friends over to visit. When his friends aren't there, he talks almost non-stop.  TBG's television is broken and no one seems to remember to deal with that.  David has his set on all day and I think Tommy has had his fill of "Judge Judy" and "Wheel of Fortune."  But then again, that is a tolerance level easy to exceed.

The thing is, this is the reality of skilled care -- with the lack of funding and facilities and the low wages paid to workers, this rough around the edges facility is going to be the norm, not an oddity in the next decade or so as more people age into their population.  With more people becoming insured, providing better quality health care will hopefully be possible because less patients will default on their bills -- but it won't be enough if young people are not encouraged to pursue health related jobs. However, if those jobs don't pay well and the required schooling becomes prohibitively expensive, not much is going to improve.  The PT TBG has is in his 40's, well skilled and doing a good job. Even if his facility is short on everything, this is a person who has a skill, trade, talent and ability and is helping people while providing a living for him.  Health care professions, IMO, can help the dwindling number of people considered "middle class" in this country and they can also provide a good educational pathway for those who are just starting out.  I really hope that something is done so that the health facilities people in my age group will have to rely are staffed and maintained at a higher level. 

The people taking care of Tommy are very nice and working very hard.  It's too bad there aren't more of them and they aren't higher paid.  But at least he is getting better!

Thursday, February 26, 2015

Rehab

TBG made it to rehab having gotten there by a local transport van service.  He is running a slight fever but ate dinner and resigned himself to being in a "facility."  I would love to report he is happy there but he can't wait to get out because he is about 30 years younger than everyone else and it isn't the most modern building.  He chose it for my convenience and that was nice of him, so he'll just have to over look the less than luxurious amenities.  As long as they have therapists who can work him, that will be fine.  I can also spend a lot of time with him this weekend.  If his first meal was any indication, I'll need to bring him a few extra meals or snacks to keep his spirits and energy level up.

As for his doctor's questions after surgery, he was wondering if TBG was ever diagnosed with gout as that can make arthritis worse.  I guess he was wondering because his knees were so bad.  That was never mentioned to him at all and he didn't have any of the typical symptoms for it.  I just think he had cruddy knees and having a blue collar job beat them up all the more.  We'll find out more when he goes back to have the staples out.  Apparently, he has many nasty scars and lots of staples to remove.

Again, I want to say that the kinds words of encouragement and thoughtful comments from everyone have made a difference.  I am optimistic that he will heal well but it won't be a snap.  As long as I have a way to get him upstairs when he gets home, that will be a good start.  We don't have a bathroom on the first floor so I hope I can let him stay upstairs with a cooler of food and other supplies.  Going in, his doctor made it sound a lot simpler and we wanted to think of it in a positive light.  Now we just have to keep that up even though we are at the tough part.  I have to admit that the worst part about it was that when I got to the facility, I thought of it being just the type of place my mom used to stay in.  One medicare, I expected her facilities to be a little less than lush, but I guess that is the way a lot of rehab facilities are.  We did not plan ahead and so there was no shopping around.  My main job now is to keep his spirits up.   Besides, the type of person you are is not best judged when everything is going well, it's the type of person you are when things are tough.  This is a tough spot for him but he'll get through it and be better for it too.

A couple of months from now, I plan to take a really long nap!