At last! Ambulatory enough for an office visit with a doctor

November 6, 2015. We had a good night. I didn’t hear Dad cough once, and I was able to sleep uninterrupted for five hours. I was slow in getting up, though, and didn’t start to work until 4:15 A.M. Dad and Michell were also slow to rise, not getting up until after 6:00 A.M.

cross7We received a steady stream of visitors today, starting with Janet, Dad’s occupational therapist. She and Dad had another good workout today, and I could hear them chatting nonstop during their session. Before she left, Janet said that because Dad was progressing so well toward his goals, she would set new goals for him and extend his treatment for another month.

After Janet had left, Dad took a short nap so that he would be well rested when Brenda arrived for his physical therapy session. Brenda wanted to start working with Dad on transfers to the shower. The bathroom could be a dangerous place, and she had recommended that we install grab bars in the shower, a suggestion that was not well received. Shortly after she arrived, Brenda encouraged us to consider adding permanent grab bars in the showers. I asked if we could use the suction-cup bars, and she was adamant that this was not just a bad idea, but an unsafe one, too. With Dad’s trach, I told her, anything producing sheetrock or tile dust was off the table. After a few minutes of discussion, she suggested an alternate plan that would require only an anti-slip bath mat, which was a more palatable solution for Dad. I told her that I would obtain one as soon as possible.

walkerSince Brenda’s last visit with us, the monstrosity known as the Hoyer lift had been delivered and was in our garage. Brenda showed us how to place the Hoyer lift sling in the wheelchair so that it could be used when Dad arrived at the dialysis clinic. She also had Dad use the walker. He first walked 28 feet and then she had him walk an additional 48 feet. Shortly after she left, Stephanie, the nurse, arrived to check his vitals and his bed sore. Dad was pretty tired after all the exercise and he napped away the afternoon while I worked.

After dinner we played Oh Hell, and I won for a change. As we were moving toward the bedroom, I realized that I had forgotten that I was supposed to change Dad’s trach today. I didn’t like changing it on dialysis days and I didn’t want to wait until Sunday, so I set up my TV trays and performed that most-dreaded chore at bedtime. Dad was still confused about what I was doing to him during the trach change and would become a little apprehensive as I prepared for the procedure. It could have been that he was apprehensive because he sensed my nervousness. Ironically, he would often fall asleep before I was finished.

Fortunately, we had ended our game-playing early. I was finished with tonight’s respiratory therapy activities shortly after 8:00 P.M. and was in bed by 8:30 P.M. Back in Houston, Stan was at a poker game, so we had to forgo our nightly phone call and be satisfied with texting each other good night.

cross9November 7. Although it was Saturday, we still had to prepare Dad for dialysis. I didn’t have to get up quite as early as for work, so I slept until 4:00 A.M., which was when I needed to wake Dad and Michell. It had been raining earlier this morning and we had already received a couple of inches of rain. To ensure that we could get Dad transported to the ambulance without him getting wet, I moved one of the cars out of the garage so that the ambulance could back in. The EMS dispatcher called us at 6:00 A.M. and told us that they were running late and would arrive around 6:20 A.M. At 6:22 A.M., we heard a knock on the door to the garage, and we opened it to find two EMTs. As we did every dialysis morning, we watched for the ambulance and we couldn’t understand how we had missed their arrival. We didn’t even hear them back into the garage. We had two personable female EMTs again today and they enthusiastically helped Dad onto the gurney.

Stan arrived around noon. We had heard on the news that the weather was bad between Houston and central Texas, and he had driven in the rain for most of the trip.

Michell and Dad arrived home from dialysis around 1:15 P.M., which was a little late, but wasn’t unusual for rainy days. For the second time, we had the same two EMTs for the return trip.

Shortly after lunch, Mom walked out to the mailbox to retrieve the mail. She had received a bill yesterday from Scott & White EMS and today opened a much larger one from the CCH, for $650. Compared to the original bill, the amount was small. However, the postal carrier seemed to deliver another medical bill every day, and opening the mail was becoming Mom’s daily aggravation.

I needed to purchase some items for my photography class in Houston, so Stan and I drove to the local Hobby Lobby to see if they carried what I needed. After driving 160 miles, driving around town wasn’t much fun for Stan, but it felt good to get away from the house and spend some time alone with him. I found what I wanted, but it was much more expensive than my art store in Houston, so I decided to wait until I got home.

cross6When Stan and I returned home, we found that everyone was napping. Michell had fallen asleep in a chair in Dad’s room and Mom was sleeping in a chair in the living room. At 3:45 P.M., I heard familiar creaking noises from the baby monitor and entered the bedroom as Dad was trying to get out of bed. I didn’t know if he couldn’t remember that he couldn’t walk or if he was taking everyone’s comments to heart about how well he was doing, but he just would not ask for help when he wanted to get out of bed.

The five of us visited for happy hour before dinner. After dinner, we played another two games of Oh Hell, and Stan and Michell were tonight’s big winners. By 8:30 P.M., Dad was in bed and ready for me to administer trach care and meds.

November 8. Dad had another great night, which meant that Michell, Stan, and I were able to get some much-needed rest. Dad woke up once and had Michell help him to the bathroom, but after that, he stayed in bed until 8:00 A.M.

Dad might have been slow to get up, but when he zipped around the corner in his wheelchair, he was clean, shiny, and perky. I escorted him back to his room for some quick trach care and meds, but after that, he was raring to get the day started.

walkerWhen Mom and I returned from church, Stan and Michell were walking with him with the walker, and he walked 68 steps. We couldn’t convince him to walk again, but he was out and about in his wheelchair for most of the day. Michell was also able to get him to do some of the exercises prescribed by the therapists.

Around the time that Stan was planning to leave, Jo, our next door neighbor, stopped by to see Dad. He had just drifted off to sleep, but we woke him for her visit. She had been very concerned about Dad during the past few months. She was about to leave town for a few days, and Mom and I couldn’t deny her a chance to see Dad. After Jo had left, Stan and Dad played a couple of games of cribbage, and Dad won both games. These guys loved to play cribbage, but most of the time, Dad won.

cross11After Stan had left, Dad seemed a bit down. He commented that the therapists didn’t seem like they were “interested in moving him along.” We did our best to convince him that they had a plan and he was executing it well. I suspected that he was apprehensive about the appointment with the wound care specialist tomorrow, which didn’t help his mood. I also didn’t think that Dad judged his progress relative to his condition when he was discharged from the hospital, but rather from his condition before the surgery.

After dinner, the four of us played a couple of games of Oh Hell, and Mom and Dad won. Since Dad had been home, I had been keeping score. Evidently, I wasn’t such a great scorekeeper because I seldom won.

Although we played a couple of games, Dad started getting ready for bed at 7:45 P.M. I was finished with the trach care and meds and ready to call Stan by 8:30 P.M.

November 9. I woke up at my usual time and wasted no time getting started with my work day. Today would be our first appointment in a doctor’s office since Dad’s return home. I suspected that I would be away from work every bit of two hours. I would need to make the best use of my shortened work day.

Dad had a great night, but he wasn’t feeling great when he woke up at 6:30 A.M. He seemed to feel better by the time that I had administered his trach care and morning meds.

He and Mom joined me in the office for a few minutes to see if they could log on to their bank’s website. Before he was hospitalized six months earlier, Dad had handled most of their banking online. Not surprisingly, he had forgotten the passwords during that time. Mom and I had tried to log on to their accounts a few weeks earlier but had managed to lock up the accounts after multiple unsuccessful attempts. After a few failed attempts of his own, Dad realized that he would need to call the bank to regain access to his accounts.

The fun times on the computer were cut short when Janet arrived at 11:25 A.M. for Dad’s occupational therapy session. She usually visited on Fridays, but because of vacation plans, she had asked to change our appointed time to Monday this week.

I called Brian at EMS and protested the last bill that we had received for the transit service. Since October 24, Scott & White EMS had been providing gurney transit but billing us for wheelchair transit. He made it sound like they were doing us a favor by providing us with a reduced rate, but I had been under the impression that we’d receive gurney transit, which was covered by Medicare, until we had the Hoyer sling. I figured that I wasn’t going to win this battle, but I told him that it was never my understanding that we would pay for wheelchair transit before we started using the Hoyer sling. He apologized for the misunderstanding and said that he would refund us for these charges for the week in question.

After Janet left, Dad took a short nap while the rest of us ate lunch. The EMS wheelchair transit arrived at 1:45 P.M. to take Dad and Michell to the Wound Care Clinic. The transit driver predicted that we’d be there for a couple of hours. Based on the glacial speed that he moved, he was probably correct. Michell and I kept looking at each other while rolling our eyes. I had never seen an able-bodied person move so slow. I drove my car and arrived before the EMS transit. I was able to get Dad signed in and complete the new-patient paperwork by the time that he and Michell arrived. It took longer than it should have to get Dad into the waiting room because the transit driver escorted Dad and Michell through the wrong door.

cross10The waiting room was packed, and as I looked around the waiting room, Dad seemed to look healthier than the rest of the patients. The exam rooms were pretty small. Between Dad, a wheelchair, Michell, the doctor, a nurse, and me, there wasn’t much room to move. We had to perform some Rubix Cube moves to open the door to let the nurse and aides in and out of the room.

Dr. Robert Plemmons said that Dad was healing well and was in better condition than he had anticipated. However, he said that we should limit Dad’s time in the wheelchair to two hours a day. Furthermore, when Dad was in bed, we should relieve pressure on the sore by rotating him 30 degrees laterally. The doctor seemed startled when I said that “that wouldn’t happen” and that “Dad needed to spend as much time out of bed as possible.” Furthermore, “I want to limit Dad’s time in the bed to two hours.”

The doctor insisted that we had to find some way to relieve pressure on the bed sore. I asked about a donut cushion, but he said that they weren’t useful. He looked at Dad’s egg crate foam cushion and asked if he could cut out a V shape. After we had agreed, he pulled out a knife and went to town on Dad’s cushion. When he was finished, Dad had an altered cushion that satisfied all of us. Before we left, the nurse showed Michell how she wanted her to start dressing the wound.

We were finally finished with our 2:30 P.M. appointment at 4:05 P.M. I called the EMS dispatch office and told them that we were ready for our return trip home. I then scheduled Dad’s follow-up appointment. It was a nice day, so I suggested that Michell and Dad wait outside for the wheelchair transit. I had some errands to run, so I left them. When I returned home at 4:40 P.M., I was shocked that they weren’t home yet. When I called Michell, she said that the transit van had had a problem with the lift, which took them more than 15 minutes to fix. No longer in the sun, a strong breeze had picked up, and she and Dad were now cold. They finally arrived home at 5:10 P.M.

We had a short happy-hour visit before dinner and told Mom about the trip to the wound center. Michell said that she was shocked when I disagreed with the doctor. I had reached the point where I was not going to blindly follow doctors’ orders, especially ridiculous ones. All of his other care givers were adamant that Dad needed to get out of the bed. It never ceased to amaze me how doctors could be so focused on a tiny area of the body and not consider the whole person when making their prognostications.

While Mom, Michell, and I ate dinner, Dad took a short nap. He was a little tired from his road trip to the wound center. After dinner, we played cards, and Michell won again. We were finished with cards by 8:00 P.M., and I was finished with Dad’s trach care and meds by 8:30 P.M. I hoped that Dad would sleep well again tonight.

cross6This day had been another major milestone: a trip to a doctor’s office, something that would not have been possible just a few weeks earlier. After six months with this bedsore, which was started by a fall in the hospital in May, it seemed that Dad was well on his way to being healed. One issue down, two big ones to go: swallowing, which would enable us to get rid of the G-tube, oxygen, and trach, and his mobility.

 

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