Tuesday, September 21, 2010

Armed and Ready to Go!

By training, I am a litigator. Before every court appearance or mediation, I used to mentally "arm" myself for battle. I would don my suit of armor by familiarizing myself with the facts, and fill my arsenal of weapons with arguments and legal supports. I would examine my suit of armor from the perspective of my opponents, scrutinizing my case for any chinks in the armor. I would consider how an opponent might deflect my weapon assaults, and deploy the best strategies to corner my opponents with the tools in my arsenal.

Tonight, I am preparing for battle again...but this time, I plan to battle the Rehabilitation Unit at the hospital. We have a "family" meeting scheduled with the rehabilitation team for tomorrow at 1:00 pm to discuss my mother's status in the unit. We have already been informed that they plan to recommend releasing her on Thursday morning - regardless of the fact that several therapists believe she has more room to progress, or that half of her rehab time was wasted on medical challenges, or that insurance is willing to pay for more time. We have already informed them that we plan to fight them. I get the sense that the doctor on the unit is of the mindset that "well, she is dying anyway, why bother with rehabilitation?" I have a call set up for tomorrow morning with my mother's case manager at her insurance company, and we have recruited the help of a patient advocate from the hospital. Wish us luck...this is one battle I do not want to lose, and I think they have no idea how tenacious and stubborn we can be when we are fighting for what we think is right.

Our day started off in the normal fashion...baby waking up around 8:20 (because my mom called just to say hello and the phone woke her up!) and the babysitter showing up at 9 and getting Micah out of bed. We got Micah ready quickly (he wouldn't eat any breakfast) and off to class they went to class. DH stayed home today because the babysitter needed to be out of here by 5, and I did not want to be rushed home.

I arrived at the hospital around 11:30 and my mom was finishing up her therapy. My father had arrived early that morning to meet with the social work and take care of a few odds and ends. My father and I both did some "lobbying" of the therapists to try and gauge whether they would recommend extending her rehab stay. I went to the last part of physical therapy with my mother, and she was really doing well. We worked on transfers, and I heard she did more walking and standing again today. She also worked on sitting up straight unsupported, and she was doing a fantastic job. She still needs more work on holding herself to midlline without listing to the left, but she has not been able to do hold herself that well since she arrived at the hospital.

My mom made it back to her room around 12 and her stomach was hurting. I was impressed that she had been sitting in her wheelchair for over an hour and was still doing well. Unfortunately, she was again complaining of intestinal problems. All of the sudden, we realized it was 1:00 and my mom had not yet been picked up for radiation. We started to panic and run her down to radiation ourselves, but the nurse called down and learned that her appointment had been changed to 4:15.

At that time, we realized we had several hours left before radiation. My mother stayed in her wheelchair for another hour or so and then transferred back to the bed to relax for a while. My brother arrived around 3:00. My mother's intestinal issues continued, and we asked to speak to the resident again. Initially, she seemed willing to help out. She went to speak to the attending physician, and he came into my mom's room a few minutes later. He actually looked us in the eye and explained that my mom is not constipated, it was all in her head. My mom pointed out to him that, in fact, it was all in her ass, but he did not see the humor in the situation. He kept insisting that the problem was resolved and my mom was simply obsessing about her bowels for no good reason. We were pretty ticked at him, but he was quite convincing. Even my brother and I started to wonder if perhaps he was correct, but we still felt that they should be able to do something to relieve mom's discomfort.

Dr. "Suave" and his nurse stopped by for a visit. We talked to them a bit about our rehab conundrum, and Dr. "Suave" said he would put in a word recommending that my mother's stay be extended since she lost a week with the brain swelling and intestinal issues. It is nice to know we have some champions.

At 4:15, it became evident that the hospital transport would not be arriving, so we walked mom down to radiation. When we got there, she was doubled over in pain, and the nurses there began to talk to her about her intestinal issues. They could not believe that the rehab doctor would not prescribe anything more than colace and senna for her. Their nurse coordinator decided to intervene by calling up to the rehab floor, and she said that they would call in different medication tomorrow if the doctor continued to refuse. At this point, my brother and I were fairly worked up and angry at the doctor - we just could not understand why they were not doing more. We will be asking what happened to the gastro consult we requested last week. Radiation was running way behind, and it was after 5 before they took her back. Thankfully, the appointment was fast, and about 7 minutes later, my mom was ready to head back to the room.

Dinner arrived as we returned, and my father got ready to leave. Dinner was chaotic - my mother started to eat before they took her blood sugar, and we could not get her to pay attention to what she was eating - she had ordered coconut shrimp, and she kept eating the shrimp tails and gagging on them, and she was not letting us remove the tails or help her out. Then the nurse arrived to try and take her blood sugar, and mom wouldn't put down her fork to allow the nurse to do the stick. Her phone rang in the midst of the chaos, and mom took her bloody hand and tried to grab the phone. The nurse could not get a blood sugar reading and my mom was making a mess!! She then became confused about where the phone was (my brother was holding it up and mom seemed to think she had it in her hand). Unfortunately, we had to tell the callers that mom couldn't talk - it was just too much commotion at once.

My brother stayed for most of dinner before he had to leave, and I left after she finished her dinner and returned the calls. I arrived home to find that our cousin had delivered ANOTHER dinner - the last one, I believe. Micah did a great job eating the food (although it was hard to tell if he was wearing more than he ate). I was starving and scarfed the food quickly. We played with the children for a while, bathed them both and put them to bed.

Ever since then, I've been preparing for battle tomorrow. DH reached out to the hospital advocate who helped us obtain permission to bring the children into the hospital, and she agreed to join us tomorrow as our patient advocate. My father sent me the information for the insurance case manager, and I will speak to her in the morning. I've also been planning out our arguments and trying to consider other alternatives if this does not work out for us.

We are starting to line up caretakers, and we *may* have a place lined up near the hospital. We are working on identifying a wheelchair transport company. I may also see if, on Dr. "Suave's" recommendation, we could put mom in a different rehab, but we are not sure if we could transport her back to the hospital for radiation. Hopefully, we'll have a bit more time at the hospital, but we'll see what happens in the morning. Wish us luck! We need an army of supporters for this battle.

My father called tonight...apparently my mother is having serious problems with her intestines again, and needed to be disimpacted again. That rehab doctor is a complete idiot!! We'll be battling with him, too, tomorrow.

1 comment:

Chele said...

Hugs, I hope you won your battles today. +++++ thoughts and prayers for you and your family.