Nov 20, 2006
Today was another jaunt up to Atlanta, this time for Gary’s six-month follow-up on his flap surgery. The doc said Gary’s butt looked great and pronounced him healed! (I had been noticing a marked improvement in the way the flap looks since Gary has been using the new chair, but the right side of the scar is still puffy and discolored and wide, so I wasn’t sure if that could be said to be healed; the doc said the difference between how the right, vertical side looks and how the other two, more horizontal sides look -- like thin smooth seams -- is a matter of pressure.)
The doctor lifted all restrictions (except, of course, weight shifts every 20 min., though possibly Gary can increase that to 30 minutes if his skin tolerates that). So now Gary can do any bending he wants, can have his butt submerged in water (like in a bathtub or a pool), can sit on a cut-out toilet seat, can lie on his back if he wants to (gradually working up to 4 hours at a time, though he’s not sure if he’ll do much lying on his back as his legs spasm and kick around whenever he does), and so forth.
This means that Gary should be able to do more dressing of himself, for one thing. And it also means he is ready for another round of Day Program. We spoke to the Day Program Manager after seeing the doc, and she is going to talk to the insurance company to see what they’ll pay for. The plan is for Gary to go to Day Program from Dec. 11-22. (I admit to be dreading the morning schedule, having to get up early and rush around to get him ready to go; we’ll be at the apartments again.)
At Day Program he’ll work on things he was restricted from, or limited on, or just hasn’t had enough practice on. I’ll bet a big thing will be floor transfers – how to get himself onto the floor from his wheelchair and vice versa. Also, one of the biggest things will be practicing how to maneuver in a double bed, so we can start weaning him off his dependency on the hospital bed (he loves those rails!) and so I hopefully won’t have to help him prone at night (so he can be more independent, eventually travel by himself, and so forth). I’ll bet he’ll also practice putting on trousers and socks and shoes while in his chair ( he has already been able to put on trousers and socks while in the bed). They’ll no doubt have him practice transfers to a cut-out commode seat, which he thinks is supposed to be a difficult transfer (hopefully, this will soon mean he won’t have to do any more bowel programs (“digs”) lying in bed – I think that’ll be the change that’ll make him happiest, assuming it decreases the time the program takes, which it should, since gravity will aid him). I imagine there will be more curb work – he hasn’t practiced any curbs since he’s been home. Maybe they’ll get him in the pool, though he says that would be a lot more enticing in the summer time.
Before leaving the flap doc, I asked him about Christopher Reeve. I told him I’d heard he died from an infected skin sore – that the infection had gone into his heart. The doc gave the proper terminology, saying Reeve had died from sepsis, as a result of his skin sore. I asked how that could happen to someone like that, someone who surely was taken care of round the clock and could afford the best of care – I wanted to know because it worried me that no matter how diligent we were at skin checks and pressure relief, that something like that could happen to Gary. The doc said he had no worry about something like that happening to Gary, that it had happened to Reeve because he hadn’t complied with the procedures for avoiding and treating skin sores (not a “good patient”). No chance of Gary that happening to Gary! (He and I both agreed Reeve should have been subjected to Tough Love.)
For Gary's reward for getting all restrictions cleared ;-), I bought him an Italian panini sandwich at Fresh Market before we headed home. This time I managed to be in the correct lanes at the right time. (We tried out the HOV lane for the first time -- the one for buses and car pools of at least two people. It was significantly faster. We couldn't figure out what "HOV" stands for, though, except we figure the V is for vehicle.)
After he transferred into bed this evening, I told him he should now be able to get his own shoes and trousers off, instead of me doing it for him as I have been doing. He said that he probably should -- but that he was too tired and didn't wanna ;-). So I told him, okay, no tough love tonight -- he could be a big baby ;-). He was happy to take me up on that.
Today was another jaunt up to Atlanta, this time for Gary’s six-month follow-up on his flap surgery. The doc said Gary’s butt looked great and pronounced him healed! (I had been noticing a marked improvement in the way the flap looks since Gary has been using the new chair, but the right side of the scar is still puffy and discolored and wide, so I wasn’t sure if that could be said to be healed; the doc said the difference between how the right, vertical side looks and how the other two, more horizontal sides look -- like thin smooth seams -- is a matter of pressure.)
The doctor lifted all restrictions (except, of course, weight shifts every 20 min., though possibly Gary can increase that to 30 minutes if his skin tolerates that). So now Gary can do any bending he wants, can have his butt submerged in water (like in a bathtub or a pool), can sit on a cut-out toilet seat, can lie on his back if he wants to (gradually working up to 4 hours at a time, though he’s not sure if he’ll do much lying on his back as his legs spasm and kick around whenever he does), and so forth.
This means that Gary should be able to do more dressing of himself, for one thing. And it also means he is ready for another round of Day Program. We spoke to the Day Program Manager after seeing the doc, and she is going to talk to the insurance company to see what they’ll pay for. The plan is for Gary to go to Day Program from Dec. 11-22. (I admit to be dreading the morning schedule, having to get up early and rush around to get him ready to go; we’ll be at the apartments again.)
At Day Program he’ll work on things he was restricted from, or limited on, or just hasn’t had enough practice on. I’ll bet a big thing will be floor transfers – how to get himself onto the floor from his wheelchair and vice versa. Also, one of the biggest things will be practicing how to maneuver in a double bed, so we can start weaning him off his dependency on the hospital bed (he loves those rails!) and so I hopefully won’t have to help him prone at night (so he can be more independent, eventually travel by himself, and so forth). I’ll bet he’ll also practice putting on trousers and socks and shoes while in his chair ( he has already been able to put on trousers and socks while in the bed). They’ll no doubt have him practice transfers to a cut-out commode seat, which he thinks is supposed to be a difficult transfer (hopefully, this will soon mean he won’t have to do any more bowel programs (“digs”) lying in bed – I think that’ll be the change that’ll make him happiest, assuming it decreases the time the program takes, which it should, since gravity will aid him). I imagine there will be more curb work – he hasn’t practiced any curbs since he’s been home. Maybe they’ll get him in the pool, though he says that would be a lot more enticing in the summer time.
Before leaving the flap doc, I asked him about Christopher Reeve. I told him I’d heard he died from an infected skin sore – that the infection had gone into his heart. The doc gave the proper terminology, saying Reeve had died from sepsis, as a result of his skin sore. I asked how that could happen to someone like that, someone who surely was taken care of round the clock and could afford the best of care – I wanted to know because it worried me that no matter how diligent we were at skin checks and pressure relief, that something like that could happen to Gary. The doc said he had no worry about something like that happening to Gary, that it had happened to Reeve because he hadn’t complied with the procedures for avoiding and treating skin sores (not a “good patient”). No chance of Gary that happening to Gary! (He and I both agreed Reeve should have been subjected to Tough Love.)
For Gary's reward for getting all restrictions cleared ;-), I bought him an Italian panini sandwich at Fresh Market before we headed home. This time I managed to be in the correct lanes at the right time. (We tried out the HOV lane for the first time -- the one for buses and car pools of at least two people. It was significantly faster. We couldn't figure out what "HOV" stands for, though, except we figure the V is for vehicle.)
After he transferred into bed this evening, I told him he should now be able to get his own shoes and trousers off, instead of me doing it for him as I have been doing. He said that he probably should -- but that he was too tired and didn't wanna ;-). So I told him, okay, no tough love tonight -- he could be a big baby ;-). He was happy to take me up on that.
posted by Peg Daniels at 7:52 PM
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