Friday, November 6, 2009

Maybe home, maybe rehab facility

Dear Family and Friends,

By now it seems clear that Francis will be discharged from the hospital next Tuesday after his last radiation appointment. But it's not clear yet where he'll go -- home (our big preference) or the rehab wing of a nursing home.

My last cherry note yesterday was written in the afternoon, before I saw Francis. After observing his great difficulty standing up from his chair, even with help, I came home worried about his weakness. So this morning I wrote a note to a handful of close friends some of whom are doctors.

One of them, Dr. Jim Melloh, the family practice doctor from Lewiston (who taught geriatrics) and who has visited Francis several times, wrote: "Your thought that blood pressure drops are related to deconditioning are probably on target. For every day in bed, we go 3 days backward in terms of time it takes to recover that strength. Plus with his nutritional intake Francis has lost much muscle mass which will take time and conscious effort to recover. Unfortunately, in the hospital he goes backwards daily. It is one of the greatest shortcomings of our hospital system. We need to be actively rehabing him......"

So that's why I went to the hospital right after lunch today, -- to give Dr. Katz a copy of Dr. Melloh's detailed note, and to get Francis started on strengthening exercises. Linda his hospital PT came just in time to share some excellent techniques I might not have thought about.

The other big item on the agenda was making plans for Francis' hospital discharge. It took a lot of back and forth phone calls to iron out details, e.g. the hospital's PCA (patient control analgesic) machine is in IV form, but Francis' "fanny pack" would be subcutaneous. AND, in Maine, that switch cannot be made before he leaves the hospital, but only when or after he leaves!

I felt discouraged when I left the hospital, specifically because his erratic blood pressure problem hasn't been resolved. The awful burn -- (I'm glad he can't see it -- ) a big circle on his back where the radiation exits.... is so disheartening! It's almost worse looking than the front where it enters.)

His nurse also said she thought he should go to rehab because of his high pain med doses. But later when there was "a little accident" she whispered to me that THAT was really why she had recommended a nursing home. "Some people don't want to do this work," she said as she handed me some rubber gloves. I immediately told this to Francis and added, out loud, that I WANT to take care of Francis!

In any case, when I left the hospital I felt our sweet dear man was fighting for his life. At one point during all the back and forth Francis looked at me and said, -- "We don't know what will happen." He's right. But I also reminded him that my mother in her early 80's, also debilitated by a stay in the hospital, came home and regained her strength! So I told Francis he could do that too! But I was very sad, wondering if he'll ever come home again.

I shed tears talking with Eileen who had come earlier to bring dinner, and with Lori who will take care of the chickens in the next two days. Nance will check them after school on Monday since Lori works -- because I plan to spend much of the next three days IN the hospital with Francis doing some PT, trimming his beard and nails, giving him a foot massage, doing some more PT, and going to Portland Yoga Studio for a nap or two during the day. (It's an 8 minute walk from the hospital.) Francis and I are both determined to build up his strength so that by Tuesday he'll be stronger and ready for anything, -- hopefully, home!

So I was sad. But the reason I'm smiling now is that Francis called me about an hour ago to tell me he had had a NORMAL very good looking you know what!! So that little "accident" was not a sign something weird was going wrong when both ends were working at the same time!! It was a sign that the popcorn and the rice pecan bread was doing its fibrous thing! When enemas begin to seem a way of life, signs of normality returning are, as I said in another update, cause celebre!

Pray for home!


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