September 28, 2006
Today’s adventure was trying to go a little bit farther down the driveway. Gary’s goal is to be able to get to the mailbox, and, a harder task ;-), back up the drive with the mail. He has a ways to go – he lost control of his chair on the way down – but, of course, I had had my hands lightly on the handles, so I simply grabbed them harder to stop his chair.
September 29, 2006
Today was Gary’s 6 week follow-up appointment with his rehab doctor at Shepherd (whose pic you saw on the blog). We had to get our routine started an hour earlier than usual, and it was going to be a long day, with me driving us there and back, so naturally I slept lousy, getting about four hours of sleep. I made it a thousand times worse by doing something stupid. Last nightI started to feel tense about the prospect of the trip , so I “lost it” and ate a big bowl of Gary’s cereal, and, adding insult to injury, had it with milk. I woke up at 3 a.m. with a monstrous headache, feeling sick to my guts. I kept the headache and the sick feeling the entire day, and it will probably take several days to get back to “normal.”
On the way to Shepherd, Gary commented that he’d been there so long, this felt like going home. I teased him about wanting to check back in, and he said it would have its definite advantages – the nurses could take care of his bowel program and do his ICs for him, while he could just lounge. I told him that with his luck, he’d probably have to share the room with three other patients with speaker-phones turned up loud. That and the fact that he wouldn’t get much sleep during the night seemed enough to dissuade him from taking up occupancy there again. ;-)
On our way into the building, Gary told me that at least I wouldn’t have to be embarrassed about someone seeing me not helping him with the doors. “No one helps you here,” he noted. I’m not sure he was being entirely complimentary. ;-)
We had gotten there a little early, and he went off to do an IC (which was a whole lot easier than doing it in the car while I was driving, which is what he would have done had we gotten there later). Meanwhile, I went out to the garden. Yup! My graffiti sign is still there! I then went to the library and took out my laptop to while away a few minutes. I discovered that since Gary had been in residence, they’d put in wireless. (Not sure if it’s in all the patients’ rooms – it wasn’t available in the exam room we went to after this.) So, I looked at my email then worked on my story until Gary came to collect me.
The exam room surprised me – the exam table was very narrow, and it didn’t lower to the height of a wheelchair. No coddling of quads and paras here! Gary and I did the transfer, me giving the maximum help of “under the sitting bones” and having to help him regain his balance and get him farther back on the table. I’d been telling him he needs to practice his transfers more (with me), because he hasn’t made a whole lot of progress in becoming independent with them. It seemed evident to me that this “uneven height” transfer showed the lack of practice.
Once he got on the table, I weighed his chair – the nurse had weighed his chair with him in it a few moments earlier. He is about the same in weight, maybe slightly lighter. He took this as evidence that I should take him out to the local ice cream parlor more often.
The doctor first checked out his flap. He said it was looking good. I said, “So, then it’s okay that every night when I check it after he transfers into bed it looks purple and swollen?” Okay, maybe that sounds like a dumb question to you, but I couldn’t understand why the doctor thought it was healing fine when to me it doesn’t look like it’s improved in weeks. Anyway, Gary said it was a good thing I’d said that, because the doctor replied, “No, that’s not okay,” and thought maybe it still had something to do with Gary’s chair, since Gary has been diligent about doing his weight shifts, and said he’d go look at the chair while Gary was getting dressed.
He then asked if Gary had any other concerns. Gary said that he was concerned about the bowel program pattern his body has gotten into – nothing for two days (while still having to spend the 20-25 minutes doing digital stimulation) then having to spend 1 1/4 to 1 3/4 hours for “everything to come out” on the third day. The doctor suggested he try doing the digital stimulation every other day, since the transit time was so long, and using a stool softener. On the days Gary isn’t scheduled to do the digital stimulation, he would still do a rectal check (stick the finger in and feel around), and if “all’s clear,” he can skip doing the digital stimulation; otherwise he’d have to do it, of course, to avoid having “an involuntary” later on in the day. So, Gary is going to try that. If that doesn’t give good results, the doctor said it might indicate Gary’s colon is weak, the muscles not propelling hard enough, and that the next step is to try senna. I dunno, he’s the doctor, but Gary and I thought trying a regular addition of prune juice or magnesium oxide or citrate tablet (not every day) might be better than the harsher, habit-forming senna (the doctor did say if Gary went the senna route, he’d have to be weaned off of it as the body becomes dependent on it). In this second case, Gary would have to go back to doing the bowel program every day because if it’s the case that the colon is weak and not simply that the transit time is slow and things are “too high up,” then “things could get backed up.”
The doctor corrected Gary when Gary called the digital stimulation program “the dil program,” which is what all the Shepherd nurses call it (even though we were warned that no one outside of Shepherd calls it this). He told Gary that “we scientific types have to stick together,” that “‘dil’ is short for ‘dilatation’ and is therefore not correct because we are not dilating the rectum. This has nothing to do with pickles.” Gary and I later came up with the possibility of shortening “digital stimulation” to “dig” – yes, pronounced “dig,” not “dij.” Seems apt ;-).
Gary’s final question concerned the t.e.d. hose. He asked if it’d be all right to change to the knee-highs instead of the thigh-highs – so I don’t have to struggle so hard every morning to put them on him! Since Gary’s swelling is in his feet and ankles, the doctor said this would be all right.
The doctor told Gary to get dressed, and he and I went out to look at Gary’s chair. The doctor immediately noticed that the foam at the bottom of the chair’s back, where Gary’s “bony butt” (that’s doctor talk ;-)) presses, is not as thick as at the top. He told me we should go to someplace like Home Depot and buy some foam to put into the bottom of the back pad of the chair (it zips open).
We went back into the exam room, and the doctor chided Gary for still being laid out on his side with his pants down, saying, “What, you still have your wife put your pants on for you?” I thought this was vastly unfair and said Gary could put them on himself, that, in fact, his being able to do so was a recent accomplishment but that he couldn’t do it on such a narrow exam table because he needed to roll from side to side. I am usually (unfortunately) diffident around doctors (otherwise I would have told this one that I had a name, it was “Peg,” and to quit referring to me as if I wasn’t standing right there, always saying, “your wife,” to Gary whenever I was being referred to), but this I couldn’t let him get away with.
So, that was pretty much it. The doctor handed me some forms to take up front, and left. I then got Gary’s pants on him – it was hard for ME to do it with that narrow table – and then we got him transferred into his chair. Gary made a follow-up appointment for six months from now, and then we went to the apothecary to get the new t.e.d. hose, a couple “reachers,” and a new long-handled bath sponge, his original one having never rematerialized after our return home.
We next made a stop at Fresh Market, where I picked up Gary an Italian panini sandwich for lunch. Then we headed home. I was just thinking I was handling this journey back home much better than the last time (the last time, the traffic had me on the edge of my seat), when Gary called out, “You’re supposed to take that exit!” Fortunately there was a break in traffic and I zoomed across four lanes, just making the exit. Turned out I had missed where 75-85 split into the separate expressways and had stayed on 75 instead of getting onto 85, so I then had to take 285 for a while. Other than that, the journey home was uneventful. I did decide Gary deserved an ice cream, so we stopped for that when we were close to home.
At dinnertime, Gary brought up that he hadn’t asked about something I had thought he should – namely why he now always coughs while he’s eating – things get stuck in his throat. I said, “Yeah, I almost asked him myself, ‘How long am I going to have to put up with this annoying new habit he has?’” Gary told me to remember that I was a saint, and saints don’t whine. I told him I was turning in my halo ;-).
But Gary thinks the coughing is due to something that they did in Birmingham – he thinks some little “pouch” was (accidently) created when they put in the trache. He’s never done this coughing thing before.
Gary then asked me how I was doing, and I gave a little shrug. “Okay, considering,” he interpreted, then continued, “Well, that’s better than this morning when I radioed you on the walkie-talkie and you answered by saying, ‘Somebody just shoot me.’”
I’d forgotten about that. ;-)
Today’s adventure was trying to go a little bit farther down the driveway. Gary’s goal is to be able to get to the mailbox, and, a harder task ;-), back up the drive with the mail. He has a ways to go – he lost control of his chair on the way down – but, of course, I had had my hands lightly on the handles, so I simply grabbed them harder to stop his chair.
September 29, 2006
Today was Gary’s 6 week follow-up appointment with his rehab doctor at Shepherd (whose pic you saw on the blog). We had to get our routine started an hour earlier than usual, and it was going to be a long day, with me driving us there and back, so naturally I slept lousy, getting about four hours of sleep. I made it a thousand times worse by doing something stupid. Last nightI started to feel tense about the prospect of the trip , so I “lost it” and ate a big bowl of Gary’s cereal, and, adding insult to injury, had it with milk. I woke up at 3 a.m. with a monstrous headache, feeling sick to my guts. I kept the headache and the sick feeling the entire day, and it will probably take several days to get back to “normal.”
On the way to Shepherd, Gary commented that he’d been there so long, this felt like going home. I teased him about wanting to check back in, and he said it would have its definite advantages – the nurses could take care of his bowel program and do his ICs for him, while he could just lounge. I told him that with his luck, he’d probably have to share the room with three other patients with speaker-phones turned up loud. That and the fact that he wouldn’t get much sleep during the night seemed enough to dissuade him from taking up occupancy there again. ;-)
On our way into the building, Gary told me that at least I wouldn’t have to be embarrassed about someone seeing me not helping him with the doors. “No one helps you here,” he noted. I’m not sure he was being entirely complimentary. ;-)
We had gotten there a little early, and he went off to do an IC (which was a whole lot easier than doing it in the car while I was driving, which is what he would have done had we gotten there later). Meanwhile, I went out to the garden. Yup! My graffiti sign is still there! I then went to the library and took out my laptop to while away a few minutes. I discovered that since Gary had been in residence, they’d put in wireless. (Not sure if it’s in all the patients’ rooms – it wasn’t available in the exam room we went to after this.) So, I looked at my email then worked on my story until Gary came to collect me.
The exam room surprised me – the exam table was very narrow, and it didn’t lower to the height of a wheelchair. No coddling of quads and paras here! Gary and I did the transfer, me giving the maximum help of “under the sitting bones” and having to help him regain his balance and get him farther back on the table. I’d been telling him he needs to practice his transfers more (with me), because he hasn’t made a whole lot of progress in becoming independent with them. It seemed evident to me that this “uneven height” transfer showed the lack of practice.
Once he got on the table, I weighed his chair – the nurse had weighed his chair with him in it a few moments earlier. He is about the same in weight, maybe slightly lighter. He took this as evidence that I should take him out to the local ice cream parlor more often.
The doctor first checked out his flap. He said it was looking good. I said, “So, then it’s okay that every night when I check it after he transfers into bed it looks purple and swollen?” Okay, maybe that sounds like a dumb question to you, but I couldn’t understand why the doctor thought it was healing fine when to me it doesn’t look like it’s improved in weeks. Anyway, Gary said it was a good thing I’d said that, because the doctor replied, “No, that’s not okay,” and thought maybe it still had something to do with Gary’s chair, since Gary has been diligent about doing his weight shifts, and said he’d go look at the chair while Gary was getting dressed.
He then asked if Gary had any other concerns. Gary said that he was concerned about the bowel program pattern his body has gotten into – nothing for two days (while still having to spend the 20-25 minutes doing digital stimulation) then having to spend 1 1/4 to 1 3/4 hours for “everything to come out” on the third day. The doctor suggested he try doing the digital stimulation every other day, since the transit time was so long, and using a stool softener. On the days Gary isn’t scheduled to do the digital stimulation, he would still do a rectal check (stick the finger in and feel around), and if “all’s clear,” he can skip doing the digital stimulation; otherwise he’d have to do it, of course, to avoid having “an involuntary” later on in the day. So, Gary is going to try that. If that doesn’t give good results, the doctor said it might indicate Gary’s colon is weak, the muscles not propelling hard enough, and that the next step is to try senna. I dunno, he’s the doctor, but Gary and I thought trying a regular addition of prune juice or magnesium oxide or citrate tablet (not every day) might be better than the harsher, habit-forming senna (the doctor did say if Gary went the senna route, he’d have to be weaned off of it as the body becomes dependent on it). In this second case, Gary would have to go back to doing the bowel program every day because if it’s the case that the colon is weak and not simply that the transit time is slow and things are “too high up,” then “things could get backed up.”
The doctor corrected Gary when Gary called the digital stimulation program “the dil program,” which is what all the Shepherd nurses call it (even though we were warned that no one outside of Shepherd calls it this). He told Gary that “we scientific types have to stick together,” that “‘dil’ is short for ‘dilatation’ and is therefore not correct because we are not dilating the rectum. This has nothing to do with pickles.” Gary and I later came up with the possibility of shortening “digital stimulation” to “dig” – yes, pronounced “dig,” not “dij.” Seems apt ;-).
Gary’s final question concerned the t.e.d. hose. He asked if it’d be all right to change to the knee-highs instead of the thigh-highs – so I don’t have to struggle so hard every morning to put them on him! Since Gary’s swelling is in his feet and ankles, the doctor said this would be all right.
The doctor told Gary to get dressed, and he and I went out to look at Gary’s chair. The doctor immediately noticed that the foam at the bottom of the chair’s back, where Gary’s “bony butt” (that’s doctor talk ;-)) presses, is not as thick as at the top. He told me we should go to someplace like Home Depot and buy some foam to put into the bottom of the back pad of the chair (it zips open).
We went back into the exam room, and the doctor chided Gary for still being laid out on his side with his pants down, saying, “What, you still have your wife put your pants on for you?” I thought this was vastly unfair and said Gary could put them on himself, that, in fact, his being able to do so was a recent accomplishment but that he couldn’t do it on such a narrow exam table because he needed to roll from side to side. I am usually (unfortunately) diffident around doctors (otherwise I would have told this one that I had a name, it was “Peg,” and to quit referring to me as if I wasn’t standing right there, always saying, “your wife,” to Gary whenever I was being referred to), but this I couldn’t let him get away with.
So, that was pretty much it. The doctor handed me some forms to take up front, and left. I then got Gary’s pants on him – it was hard for ME to do it with that narrow table – and then we got him transferred into his chair. Gary made a follow-up appointment for six months from now, and then we went to the apothecary to get the new t.e.d. hose, a couple “reachers,” and a new long-handled bath sponge, his original one having never rematerialized after our return home.
We next made a stop at Fresh Market, where I picked up Gary an Italian panini sandwich for lunch. Then we headed home. I was just thinking I was handling this journey back home much better than the last time (the last time, the traffic had me on the edge of my seat), when Gary called out, “You’re supposed to take that exit!” Fortunately there was a break in traffic and I zoomed across four lanes, just making the exit. Turned out I had missed where 75-85 split into the separate expressways and had stayed on 75 instead of getting onto 85, so I then had to take 285 for a while. Other than that, the journey home was uneventful. I did decide Gary deserved an ice cream, so we stopped for that when we were close to home.
At dinnertime, Gary brought up that he hadn’t asked about something I had thought he should – namely why he now always coughs while he’s eating – things get stuck in his throat. I said, “Yeah, I almost asked him myself, ‘How long am I going to have to put up with this annoying new habit he has?’” Gary told me to remember that I was a saint, and saints don’t whine. I told him I was turning in my halo ;-).
But Gary thinks the coughing is due to something that they did in Birmingham – he thinks some little “pouch” was (accidently) created when they put in the trache. He’s never done this coughing thing before.
Gary then asked me how I was doing, and I gave a little shrug. “Okay, considering,” he interpreted, then continued, “Well, that’s better than this morning when I radioed you on the walkie-talkie and you answered by saying, ‘Somebody just shoot me.’”
I’d forgotten about that. ;-)
posted by Peg Daniels at 7:36 PM
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