May 15, 2006
A busy day. First Gary got the trache tube completely removed. “Finally!” he exclaimed hoarsely but with feeling, pumping a fist in victory. He mentioned several times during the day how glad it was gone, one less discomfort to bear. To help project his voice, he now holds a finger over his trache hole (which has a gauze bandage over it). He still can’t speak for long and has to take big pauses, but things are moving in the right direction. He is still getting extra oxygen but now through tubing that extends just into the tips of his nostrils.
For some strange reason they forgot to bring him breakfast; when I told his nurse and at the same time asked when he would get more solid food, she came back with the information that he could start on solids at lunch today. Breakfast was similar to what he’d had before – grits, juice, yogurt, tea. I got him a “bold tall” at Starbucks; he smacked his lips at the taste but couldn’t drink much of it. For lunch he had a “regular” meal, southern barbecue style I’d call it – barbecued pork, barbecued bread (which he skipped), baked beans, corn, potato salad, peach cobbler. He very much enjoyed his meal.
An occupational therapist came by and replaced his big ol’ cast with a very light splint. He can now move all his fingers except for the broken one, though the other fingers of his hand are stiff – from not having moved for so long, we guess.
The person from the Shepherd Center came at midday. We liked her a lot. She explained some about the program, how it would be intensive and get him ready for daily living and for his return to his job – Gary told her his number one goal is to be teaching his classes on the first day of the fall semester.
They will also give us information about modifying our house, though that won’t come until toward the end of the rehab period when it becomes more clear what Gary can and cannot do.
The major sticking points right now to starting rehab are the restrictions due to his inability to put weight on the right hand and due to the bedsore – he cannot, for example, learn transitioning from bed to chair, etc., because he can’t be sliding along surfaces on his bootie. In fact he can’t even learn how to balance himself in an upright sitting position because he can’t put any pressure on the sore. BC/BS wants to send him to a sub-acute facility – which would probably be along the lines of a nursing home – until he is ready for rehab. The problem is, such places are not going to doing anything in terms of advancing his rehab. The ideal would be for him to go into Shepherd’s acute medical level of care, where rehab as tolerated would be incorporated, but BC/BS has not seen it this way (a similar proposal was put forth by Spain Rehab here in B’ham, but BC/BS didn’t go for it). The Shepherd person is going to recommend the acute medical level of care and push for it for us, but has told us it would also be a good idea to call Auburn University and try to get them to go to bat for Gary on this point. So tomorrow we are going to call Human Resources at the University (she thought that might be where to start), to see if they will advocate for Gary with BC/BS in order to send him to Shepherd’s acute medical level of care and not a subacute skilled nursing facility. We are hoping Gary’s 32 years of service at AU and his desire to return to his job ASAP will hold some sway with AU’s willingness to be his advocate, even if it’s not in the University’s BC/BS policy.
The Shepherd person said if BC/BS can be so persuaded, Gary could be moved to Shepherd as soon as Thursday. If not, we’ll end up at some subacute place until he can go to Shepherd.
I took a bunch of notes at our meeting with the Shepherd person, and as I get time I will relate more of it.
A busy day. First Gary got the trache tube completely removed. “Finally!” he exclaimed hoarsely but with feeling, pumping a fist in victory. He mentioned several times during the day how glad it was gone, one less discomfort to bear. To help project his voice, he now holds a finger over his trache hole (which has a gauze bandage over it). He still can’t speak for long and has to take big pauses, but things are moving in the right direction. He is still getting extra oxygen but now through tubing that extends just into the tips of his nostrils.
For some strange reason they forgot to bring him breakfast; when I told his nurse and at the same time asked when he would get more solid food, she came back with the information that he could start on solids at lunch today. Breakfast was similar to what he’d had before – grits, juice, yogurt, tea. I got him a “bold tall” at Starbucks; he smacked his lips at the taste but couldn’t drink much of it. For lunch he had a “regular” meal, southern barbecue style I’d call it – barbecued pork, barbecued bread (which he skipped), baked beans, corn, potato salad, peach cobbler. He very much enjoyed his meal.
An occupational therapist came by and replaced his big ol’ cast with a very light splint. He can now move all his fingers except for the broken one, though the other fingers of his hand are stiff – from not having moved for so long, we guess.
The person from the Shepherd Center came at midday. We liked her a lot. She explained some about the program, how it would be intensive and get him ready for daily living and for his return to his job – Gary told her his number one goal is to be teaching his classes on the first day of the fall semester.
They will also give us information about modifying our house, though that won’t come until toward the end of the rehab period when it becomes more clear what Gary can and cannot do.
The major sticking points right now to starting rehab are the restrictions due to his inability to put weight on the right hand and due to the bedsore – he cannot, for example, learn transitioning from bed to chair, etc., because he can’t be sliding along surfaces on his bootie. In fact he can’t even learn how to balance himself in an upright sitting position because he can’t put any pressure on the sore. BC/BS wants to send him to a sub-acute facility – which would probably be along the lines of a nursing home – until he is ready for rehab. The problem is, such places are not going to doing anything in terms of advancing his rehab. The ideal would be for him to go into Shepherd’s acute medical level of care, where rehab as tolerated would be incorporated, but BC/BS has not seen it this way (a similar proposal was put forth by Spain Rehab here in B’ham, but BC/BS didn’t go for it). The Shepherd person is going to recommend the acute medical level of care and push for it for us, but has told us it would also be a good idea to call Auburn University and try to get them to go to bat for Gary on this point. So tomorrow we are going to call Human Resources at the University (she thought that might be where to start), to see if they will advocate for Gary with BC/BS in order to send him to Shepherd’s acute medical level of care and not a subacute skilled nursing facility. We are hoping Gary’s 32 years of service at AU and his desire to return to his job ASAP will hold some sway with AU’s willingness to be his advocate, even if it’s not in the University’s BC/BS policy.
The Shepherd person said if BC/BS can be so persuaded, Gary could be moved to Shepherd as soon as Thursday. If not, we’ll end up at some subacute place until he can go to Shepherd.
I took a bunch of notes at our meeting with the Shepherd person, and as I get time I will relate more of it.
posted by Peg Daniels at 4:53 PM
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