June 25, 2015. The big day had finally arrived. Because the move was scheduled for 11:00 A.M., I decided to work for a few hours and then get to the hospital in time for Dad’s transfer. Mom arrived at the hospital at 8:00 A.M and was pleased to see that Dad was out of bed and in the chair. We were pleased when the nurse told her that he had been in the chair for two hours. Time in the chair helped his lungs and his endurance.
The doctor canceled the morning blood draw, but according to Dr. Velazco, the last blood draw showed that Dad’s hemoglobin level was up to 8.3, which meant that he wouldn’t need another unit of blood today. The doctor said that Dad appeared to be well enough to transfer to the Scott & White Continuing Care Hospital (CCH).
I was running late and didn’t arrive until 11:00 A.M., so I was surprised to see that Dad was in bed and sleeping, because I was expecting his transfer to be underway. Shortly thereafter, Laura, the case manager, called to say that Dad’s move was rescheduled for 1:00 P.M. I still needed to wrap up some things at work, so I left at noon, and Mom stayed behind.
I returned to the hospital at 1:45 P.M. Dad still hadn’t transferred. I helped Mom remove the last of Dad’s personal items from his room. The EMS team arrived at 2:05 P.M and started prepping Dad for his move. They were a real personable crew, and with all the positive energy in the room, it felt like we were moving toward better times. We were eager to move on, but truth be told, after 53 days here, I was going to miss some of the nurses and therapists.
Mom and I waited until they wheeled Dad out before we left. Then, instead of following the ambulance to the CCH, I followed Mom to a local auto body shop. A few days earlier, Mom had hit the passenger-side mirror of her beloved Chrysler LeBaron convertible when backing out of the garage. In addition to the added stress of having to deal with the car damage, she agonizes over every scratch and ding. You can’t buy body parts for this car, so the shop guys were going to scavenge for a replacement mirror. They removed the injured mirror from Mom’s car, and we headed for the CCH.
When we arrived at the CCH, the mood of the facility seemed different, calmer than that at Memorial. For starters, the parking lot was much smaller, every space was relatively close to the front door, and you didn’t need to engage in hand-to-hand combat to get a parking spot.
We found Dad in his room and a nurse and an aide were updating his chart and reviewing his recent medical history. We hadn’t been there very long when we saw Dr. White, one of the doctors from Memorial. He had been Mom’s doctor for a couple of days and then Dad’s doctor a couple of different times at Memorial. We hadn’t realized that he was part of the CCH doctor rotation. He told us that this was his final rotation at the CCH.
The primary rationale for transferring a patient from ICU to a continuing-care facility has to do with the environment—specifically, the light. We were told that that Dad needed exposure to more daylight and to a distinct daytime and nighttime. We hadn’t been at the CCH very long before I started wondering whether anyone from Memorial had ever set foot inside the CCH. Its odd-shaped rooms each had only one small window placed so awkwardly that I couldn’t see how the patient got any advantage from the much-vaunted changes in light.
Although the doctors at Memorial frequently referred to the CCH as “rehab,” the CCH personnel made it clear that they were not a rehabilitation facility, although they did provide occupational, physical, and speech therapy. After we arrived, we were told that rehab for Dad would come after he left the CCH—perhaps at a skilled nursing facility.
I questioned Dr. White about Dad’s plan of care while at the CCH. He said that he wanted to observe Dad for a couple of days before determining a plan.
June 26. Dad’s first full day at the CCH. It was also Friday, which meant that he had a date with dialysis. Because he received dialysis in his room at Memorial, we were always with him during these sessions. Mom assumed that she would also accompany him to dialysis at the CCH. The dialysis personnel let her enter, but they instructed her to don protective clothing. She soon realized that she was the only visitor. Dad slept most of the time that she was there, so she decided that going forward, she would not sit with him during dialysis. She would use this time to run errands and work around the house. She would ensure that she was in his room when he returned from dialysis.
After lunch I accompanied Mom back to the CCH. Shortly after I arrived, I asked the nurse for his lab results. She quickly told me that she could not release that information to the family, and I just as quickly told her that either I or my mother would be provided this information every day that they drew blood. Now that he was at the CCH, they drew blood at the start of his dialysis sessions. Our requests for his medical information weren’t questioned again.
Dad’s hemoglobin was up to 8.4 and his WBC count was down to 10.4. These lab results were good, but the great news came later that day when we learned that the wound care personnel would trim Dad’s finger and toe nails. It doesn’t seem like a big deal, but he had been hospitalized for 54 days, so nail trimming was huge. If only we could score a haircut. Dad was determined that he would not get a haircut until he could go see his barber, but he was starting to look a little shaggy.
Sometime during the day, Dad lost his left hearing aid. This wasn’t the first time that he lost a hearing aid, and it wouldn’t be the last time.
Being in a new facility meant that we had a whole new group of care providers to meet. We had developed so many positive and cooperative relationships at Memorial and looked forward to getting to know and trust the providers here. One that I would come to like and appreciate was Angela, a respiratory therapist. Dad wasn’t too wild about any of the respiratory therapists at either location, but some he really detested. Angela was a gentle touch, even when she had to administer deep breathing treatments or deep suctioning.
Mom and I visited until 4:00 P.M. and then left to buy some canning supplies. Those cucumbers weren’t going to become pickles by themselves.
June 27. Mom and I arrived around 8:45 A.M. It had rained quite a bit earlier in the morning, which was good news for pulling weeds in the vegetable garden. The first great news that we received was that the night nurse had found Dad’s hearing aid. It was Saturday, and not a dialysis day, so no blood was drawn for labs. The nurse mentioned that his electrolytes were down yesterday after dialysis but were better this morning.
Dr. White stopped by shortly before noon and said that he thought that Dad would probably move to the second floor in a week or two. The CCH is a two-story facility, and the sicker patients reside on the first floor. He also said that if Dad kept improving, they’d probably reduce the frequency of his lab work to twice a week. The doctor also said that occupational and physical therapy would start during the coming week. He didn’t mention speech therapy, and I hoped that it would be included, too. I didn’t learn until much later that the speech therapist at the CCH had already received his consult request and had reviewed Dad’s swallow therapy history from Memorial.
Dad had a bit of a strenuous afternoon. He coughed a lot, and each coughing spell seemed to leave him exhausted.
That night after dinner, Mom and I headed to the garden. I picked the remaining cucumbers and then pulled up the cucumber plants—as directed by my father—to make room for the cantaloupe vines. Mom and I then picked about six dozen tomatoes. This was the summer of the tomato sandwich and the bread & butter pickles. We just hoped that Dad would come home in time to enjoy the bounty of his garden.