After Two Weeks of Rehab -- and All Tubes Out!

It's been an up-and-down two weeks, more up than down, thank goodness. The first weekend was very rocky -- they wouldn't feed Dad because his paperwork didn't indicate that he'd been getting anything other than bits of pureed food under the swallowing therapist's supervision, and then when his J-tube got blocked after a day and a half they were overly eager to send him straight back to the hospital to get it fixed! After Mom got over her initial shock she called them back and tried to talk them out of sending him there, and then she got the hospital involved, and they gave instructions on how to get it unblocked. Sarah visited that same day, and in the course of all this it came out that the rehab center thought he was 96 (!!), not 76, and we weren't completely convinced that they realized he was there for rehab, not as a permanent resident. But we got all that cleared up, and they got his tube unblocked, and once the regular staff came in during the week things began to settle down a bit. (And we snuck in some applesauce and yogurt over the weekend so that Dad wasn't limited only to hard ice chips in the meantime!) The swallowing therapist supervised Dad through a few meals and then started allowing him to eat three meals of pureed food a day. The food is pretty terrible -- it's bland, institutional food -- but it's better than the alternative of no food at all. They want him to get 3500 calories a day, which is an enormous amount, but Dad has been making a heroic effort.

On Monday of this past week he had his TPN (IV feeding) line removed! We were all pleased -- this line is an infection risk, not to mention an inconvenience to Dad. His food intake was enough that they thought with the stomach tube he was getting enough calories. Hooray!

Dad's physical therapy has been coming along slowly. For the first weekend they left him in bed the whole time, but early last week they started getting him into a wheelchair (very uncomfortable on his still-unhealed bedsore) and by the end of this week he was learning how to propel himself around in it (and he propelled himself to right next to Mom when she arrived! Isn't that cute?). They made him practice walking between a set of parallel bars, and this went so poorly that they really didn't believe us when we said he'd been walking substantial distances in the Sinai hallways before he was transferred. But once they got him a walker things went much more smoothly, and he's making steady if not exactly rapid progress.

He has had two trips back to the hospital since he first arrived. The first one occurred in the evening in the middle of the first week, and nobody called Mom to tell them he was going or anything! Poor Dad was stuck on a gurney (on that awful bedsore) in the ER for a substantial portion of the night before they finished treating him, so he had a lousy night with no sleep but the medical problems turned out to be minor. It took him several days to get his sleep cycles back to normal, from what I can tell. The attendant at the rehab center got a reprimand for failing to contact Mom -- he was full of excuses but very short on apologies!!!

The second visit occurred in the middle of this week. Dad has been upgraded to chopped food (which is very tiring for him to eat, after four months of no chewing, but at least it's usually recognizable) and a little bit went down the wrong way. His lungs were clear, but he had some chest pains which everyone guessed were nothing (no more than any of us would have after inhaling our food), but with his history of heart failure they couldn't take that risk and had to take him to the ER. This time Mom was there and was able to come along, and as we hoped, everything turned out to be normal. His blood pressure was a bit low, and his heart rate was very good, so they kept an eye on him for a little while and then sent him back to Manor Care.

Mom was worried that because of this they'd put Dad back on pureed food and delay the removal of his J-tube even further. But the next day, Dad's doctor came in and took a look at Dad's J-tube. It was still an oozing mess, so Mom said, "Why don't you just take the damn thing out!?" The doctor was amused but agreed to remove it if Dad would be very, very good and eat all the food he could stand. The doctor pulled it out (and was amazed it was so long) and said it would heal up quickly, perhaps within a day (ha! This man doesn't seem to understand the "expect complications" rule with Dad!). Dad wasn't allowed to eat for the rest of that day, and as a result he was very light-headed for the next day, but he is recovering from that. As of yesterday the site was still leaking a bit every time Dad ate, but we're hoping it will heal up eventually anyway.

I saw Dad when he was transferred to the rehab center, but now I'm back in Virginia for a while (at least until the baby arrives and we have some time to recover), so most of my news is second-hand, as usual. Nevertheless, I'll try to keep the blog updated a little more often than we have of late, at least with any major events!