It was a Sunday afternoon when Keith came here (May 3). It's a Monday, so Week Four is on, for sure.
Keith ate lunch! Really ate. Drank all his chicken noodle soup. Ate almost all of a fair-sized piece of chicken breast with some sauce on it (and Mrs. Dash on all that), and some cooked carrots. Drank milk. Ate yogurt I had brought in.
He's able to rearrange himself in the bed really well. The only thing he's hooked to is oxygen, and that's an option. The machine is quieter with the little bit of extra oxygen. But if Keith wants to take that off, nobody will complain.
From the morning, I hoped I'd get to talk to the discharge counselor, and we waited a few hours, but at that time we thought it would be about Keith moving out to a rehab facility in a few days. Since then, some things have been learned.
A physical therapist came to work with him. He stood up and walked to the wall and back a couple of times, but he was dizzy, and so that's all they did. Because of this, the recommendation will be a skilled nursing facility when he leaves, and not rehab. She said inpatient rehab costs five times as much as skilled nursing, and the insurance companies don't like that. (And Ashlee pointed out later that the co-pays might be considerable.) Also the PT said that if Keith were to go prematurely to rehab, he could be "demoted" to skilled nursing, which would be another ambulance transfer, or if he got hurt or medically affected by the rehab, he might end up back here at UNMH. There is a possibility (likelihood?) of being at skilled nursing for a while and then transferring to inpatient rehab from there. She said I should advocate for that.
What we already did know about the difference between skilled nursing and rehab was that rehab expects one to have the stamina to do three hours of PT a day. Skilled nursing might only have one or two hours of physical therapy. When that was first said, it went with the idea that Keith might have to go to skilled nursing first if he still had any tubes in him (feeding, or drainage). With tubes gone, we thought rehab was a default, but he's dizzy.
The internal medicine lead came to talk to him and said that after he's out of the hospital, and out of rehab, there will still be at least three months of follow-up appointments with EP (Electro physiology), Cardiac, and his primary care physician.
Someone came by from cardiology to say that it will be Wednesday afternoon before they can implant the ICD, so his nothing-by-mouth starts tomorrow night, not tonight. (And he might still be bumped from the line, but she didn't say that this time. The last time she said if more pressing cases come along, he might be bumped.)
So at the moment, the vague plan is:
- Tuesday: More sitting up, maybe sitting to eat (though he's not eating much).
- Wednesday, no eating at all, surgery in the afternoon (with light sedation and local anesthesia)
- Thursday... maybe (MAYbe) moving to a skilled nursing facility, or not... or having surgery, or not...
I told Keith I'm hoping we will look back and say that he was in the hospital for nearly a month. Not "for a month."