Tuesday, June 23, 2009

The Rehab fiasco

Well after haggling back and forth over the weekend, all day Monday and Tuesday morning; we decided to stay at the original facility. I was starting to feel uncomfortable with the pushiness of the other facility and every time I talked to them they would say something to the effect, "I worked there for 15 years and I am so glad I came here; they just don't do a good job there." I just don't think that it is good business practice to put down the competitor and it certainly is not ethical. I spoke to patients in this facility and they are all very happy with the care and say that they are especially happy with the therapy departments. I was told by one patient that "you shouldn't have come in on a weekend, the weekend staff only work weekends and don't usually know how everything works". Then she told me that the progress they have make with her in the therapy department is remarkable and that she couldn't be happier with the results. She said "they work you hard but it's worth it!" I asked Marc to make the final decision as to whether to change facilities and he opted to stay here.

I am very impressed with the therapy staff: occupational, physical and speech. They focus primarily on neurological problems and are very experienced. I especially liked the way they encouraged Marc when he really didn't want to continue. The nursing staff has come around and are very attentive to Marc now. I guess being the squeaky wheel helped some.

I am discouraged with Marc as he doesn't seem to have the drive that he has always had. It concerns me a great deal. I just think he is so tired of being sick that he would just rather lie in bed than get up and try to do anything. That just isn't Marc! If any of you out there have any ideas on how to perk him up I would appreciate any and all suggestions. I left today for about 4 hours, ran some errands, got a haircut and had lunch with an old friend. I think it was good for Marc not to have me hovering while he was in therapy. I am hoping that he will try a little harder if I am not there. I am going to go back to work on Thursday, so he will be here without anyone but the staff to watch over him during the day. I will continue to spend the nights here, so I will at least be with him a few hours every day. I think it also did me some good to get away for a while but I just can't help worrying about him while I am away. Care giving to a loved one is so difficult, it is so hard to be objective and you second guess all of your decisions. Marc was my rock and now I have to make decisions that may effect the outcome of this illness. I pray every day that I make the right decisions. I want more than anything for Marc to pull through this hurdle and not have any more obstacles.

I did talk to the Dr. here this afternoon and told him I would really like a full evaluation to figure out just why Marc is having the respiratory issues as he has never had any in the past. He is scheduled for a sleep study on July 1st and the staff pulmonologist will be evaluating him prior to that. I just hope they can figure out the cause of this last episode. We don't go back to MD Anderson until July 27 and 28 and will not have another MRI until the 27th. I pray that the MRI remains clear.

Thank all of you for your comments to the blog and the encouraging e-mails. I will try to post more later in the week.

Saturday, June 20, 2009

Now in rehab . . . it seems like we're never going to get ahead!

Just a little history to update you on Marc's status. He had been active and was even mowing the yard with the riding mower. He was walking with his cane and getting around pretty good. I had gone back to work and everything seemed to be going well. About 2 weeks ago he started getting progressively weaker. The first week I would come home from work and find him in his recliner and he told me he just wasn't feeling good, that the muscles in his abdomen hurt like he had pulled them. I tried calling his Dr. on Friday morning and left several messages on the 'damned' voice mail system and no one ever called me back. That weekend I couldn't get him up to do anything, he would just go between his recliner and the bed and wouldn't eat. I called the neighbor and her daughter agreed to come to the house and stay with Marc every day while I worked. Although I felt much better having someone stay with Marc I still was uncomfortable with his failure to improve. He felt so bad that he didn't even want to go to speech therapy and that is one thing that always perked him up. I did finally get a hold of someone in his Dr's office on Monday and found that the Doc was out all week and they couldn't get him in until the 24th. They did offer me an appointment with the PA but I had seen her before and was not impressed.

So I was stuck with no Dr. and Marc needed to be seen. I called Steve's Dr. and they worked him in on Wednesday morning. After taking a thorough history and examining Marc the Doc felt Marc may have a systemic infection causing the extreme fatigue and weakness. Marc's blood pressure was very low and his oxygen saturation at the office was at 77%. That wasn't good. So the Doc sent us to the ER.

We were only in the ER for about 3 hours before we were admitted. All the testing revealed only a low Potassium level, a low white blood count and low O2 sats. So they gave him IV fluids, Potassium and put him on oxygen. A CT scan of his chest was negative as was an Xray of his abdomen. Physical therapy finally got him out of bed on Thursday afternoon and walked him about 20 feet using a walker. On Friday morning his labs were normal and he had walked a little more with physical therapy's assistance. Respiratory therapy assessed his oxygen sats while he was sleeping and the were all over the place, suggesting severe sleep apnea. We knew that from his last admission but Marc had refused a CPAP. The Dr. said he no longer needed to be hospitalized but did need oxygen all the time, needed a full evaluation for sleep apnea and felt that Marc would benefit from admission to a rehabilitation facility. I agreed, as I knew it would be too much for me to take care of him at home with minimal assistance from home health.

I was left to choose what facility to send Marc to. We have 2 facilities within 2 miles of our house, one is new and the other one has been here for at least 17 years (it was here when we moved to Texas). I asked if I would be able to stay with Marc and was told that I could stay in the older facility but in the new facility they asked family to go home at night; so I choose the older facility. I guess the place is probably OK but my first impressions were not good. I just did not have a good feeling about it. For example, on admission last night we were told that Marc would have physical therapy and speech therapy over the weekend but they gave me no information as to when the therapy would begin. Well this morning Marc was up early and wanted a shower, so I asked for towels and took him to the shower. The nurse brought me towels but did not offer to assist and did not tell me that the occupational therapist would be in to assess Marc's skill level (which included helping him take a shower). Well when the OT came in at 10 am and told me she was going to do her assessment on Marc and would start by taking him to the shower to see how he would do. I lost it! They had known all along that this is what would happen but didn't bother to tell me. I let it be known that I was not happy.

I was so upset that I called Steve to come stay with Marc and I took clothes home to wash. I then got on the internet and looked up the newer rehab facility and called them. They were more than happy to admit Marc there and offered me a tour "any time of the day or night". The supervisor I talked to put me in touch with the admissions supervisor. I was told that I needed to request that the Dr. (whom we had yet to see) write an order to have Reliant come to assess Marc so that he could be transferred. So I talked to Marc's nurse at Health South and was told I had to talk to the charge nurse. When I called the charge nurse she was not available. I then called the Reliant admissions supervisor and she contacted the liaison with Health South who then called me. She as much as told me I wasn't giving them a chance and they would not do anything. Well if you know me, that did not set well. I went to the Reliant facility and was given a tour. I met with the admission's supervisor, who came in on her day off to talk to me. Long story short, we have to wait until Monday morning and call the insurance company to get approval before we can do anything else.

When I got back, everyone was bending over backward to please me. The case manager came in from home to talk to me. I just told her "you have until Monday to change my mind". I don't think they will but I will give them a chance.

Needless to say, it has been a very frustrating experience and one I don't wish on anyone. I just pray that the rehab helps Marc and he gets back to where he has some independence again. I know that it has to be devastating for him and I just can't imagine how he feels. He still cannot say more that 3 or 4 words and can't get out the one word that would complete the sentence, so that leaves me guessing to what he is trying to say. He will try to write what he wants but usually leaves out key letters and I still don't know what he is trying to tell me. He then just gets so frustrated he says "I don't know" and will just quit trying.

I ask you to continue to pray for Marc's recovery. I will post again next week.