Saturday, November 7, 2009

Encouraged on both fronts

Dear Family and Friends:

Since I've had no experience with rehab facilities at nursing homes (Each of my parents died at Mercy Hospital after a one week stay,) I needed to be straightened out on that front. And thanks to four of you, I now see more than the negative aspects of rehab/nursing homes on which I was fixated -- institutional food (Much of it is processed, and therefore stripped of its nutrients.) and the danger of infection.

But as Mike said, there's another side:
"I cannot say enough good things about the rehab tours. The staff in every location pushed the patient to their limit and beyond if they felt that good progress could be made and the patient discharged to home. There were regular assessments with family regarding the progress and discharge plans for the patient.

I know you want Francis home. I know you WANT to care for him at home. This is an act of pure love. I suspect Francis wants to be home too. A rehab wing is NOT giving up on Francis coming home but giving Francis the concentrated care in one location, probably more consistent than he would get at home with visiting PT."

So when I went to the hospital today I asked to speak to the discharge planner. Since the person on duty yesterday said nothing about a location I gave her the names of two places Mike recommended.
It's a matter of getting a place ahead of time IN CASE. People cancel at the last minute all the time, I learned.

Francis looked so pale and thin as he slept in early afternoon after barely eating lunch because of a bit of nausea, -- I thought to myself walking to the car for... believe it or not -- a really refreshing 1 hour nap, that for sure he'd need to go for rehab.

But he awoke refreshed around 4:30 and had not only good color again but a very good appetite! To top it off, after his after supper snack on popcorn I learned from his nurse that his blood pressure was much better today -- almost normal! AND, he was eager to do some PT. I wrote out a plan for him -- simple things to do while sitting, standing and even reclining. A very important one is strengthening the buttock muscles.

I learned something from Linda the PT person yesterday that I never heard quite this way before, -- that the front thigh (quad) muscles are important, yes, but strong buttock muscles are even more key in standing erect when rising from a chair. Reflecting on this I deduced that good buttock strength could also prevent bowel mishaps while urinating.

Francis was very quick to learn how to contract his buttocks -- very weakly at first, but each repetition showed an improvement. One thing teaching yoga showed me is that strength can be built up pretty quickly, unlike releasing long held contracted muscles; that takes long practice. There's another exercise that Dr. Jim Melloh suggested that strengthens the same: bending forward at the hip while holding on to stable structures and lifting one leg up from behind, leading with the heel. That's very much like a yoga posture Francis has done many times, -- Warrior III (Virabhadrasana III for the yoga practitioners.)

So I'm encouraged by Francis' eagerness to get strong and the fact that his past yoga practice is still there in his body. Yesterday he readily did another pose Linda showed him while sitting, because there's memory of it in him.

At the end of our phone conversation on Friday, when Jane and I were going back on forth about options she put it in a nutshell: "The important thing is to have an open mind." Thanks to you who opened my eyes, my mind will now be more open when Francis and I have to make the decision, with the doctors' input, early next week. Even though I'd prefer his coming home (and the diet is a big part of it,) I'm at ease now about either option.

My deep gratitude to all of you for help of all kind. And this one -- enlightening a friend -- is not the least of it!


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