Friday, March 7, 2008

Latest Updates

IV News

The on-call nurse came last night and watched me do the entire IV from start to finish. I was a bit confused in a couple of places but I figured it out. I think I made it a bit harder to prime the line; I may do it on the kitchen counter tonight so I can have the air and beginning drops flow into the sink instead of trying to hold it over a trash can and keep everything sterile.

I’ve been doing the evening IV but I haven’t had to prime the line as the morning nurse has done that. Since we’re cutting back on our home health visits, I will be switching out the tubing every night and having to prime the line.

This batch of IV solution is in a different bag and it seemed to flow much better last night. I didn’t have to re-set the volume halfway through the cycle.

We’ve switched to me doing both daily IV doses on the weekend, plus Tuesday, Wednesday, and Thursday, and then the evening dose on Monday and Friday. Our insurance will only cover so many home health visits per year and we have to save as many as we can for the wound vac changes. The nurse will be coming on Monday morning and Friday morning to change the wound vac and do the IV. Wednesday is when we’ve been trying to get all of the foot appointments so it can be changed at the doctor’s office. If not, we’ll have to have an additional visit by the home health nurse to get it changed.

Wound vac:

We got a letter from the wound vac company. The daily charge is $134, plus the cost of supplies. The estimate is that patients will go through two cases of canisters ($245 each) and three cases of the dressings ($350 each) every month. Our insurance will pay 80% of "reasonable and customary" and we're responsible for the rest - no write-off. I figure the cost is around $5700 per month. No real clue what our portion will be but I expect the total bill to run into the thousands. I know they take payments. LOL! I just finished paying them off in September from his 2006 surgery. (On a side-note: we got the hospital bill statement yesterday and it’s actually not as high as I thought it would be. It’s “only” $39,769.96.)


There is a tunnel that runs under the skin and the doctor left the skin intact so it would fill in with the new tissue. The plan is that the wound vac will stimulate growth of new tissue (scar tissue). The doctor said Wednesday that he noticed the bone is no longer visible so there is some change. Ron's blood sugars are very good so that should help healing. Although the 'tuh' looks better, the doctor says it's too early to stop the antibiotics. His foot smelled horrible, almost like something had died. He said he'd been smelling himself for a couple of days but because he can't just jump in the shower without me going through a convoluted setup to get him in and keep the equipment out, he actually thought he just needed a shower. Ron cleaned up as best he could while I was at work, but still thought the funk was coming from body odor he couldn't get to with just a wash cloth. It wasn't until we got into the doctor's office and they unwrapped his foot that we realized the smell was coming from there. I’ve smelled skunks that didn’t stink this bad. Dr. Heady wasn't concerned at all and said that sometimes wound vac areas would develop a funky smell. He cleaned it up, cut off some more dead tissue, and made the wound bleed a lot.

Upcoming appointments:

Monday, 3/10 – I have a cardiologist consult on Monday (3/10) at 9:40 AM. I have to figure a way to be to work at 8:00 and leaving at 9:00 – and then returning after the appointment. I’ll have to stay as late as I can on Monday but I have to do things at home, too. There was a little abnormality in my thallium treadmill so my doctor wants me to see the cardiologist. Oh joy, just what I have time for.

Wednesday, 3/12 – Ron back to the foot specialist. His appointment is for 3:30 so I’ll work until 2:00. That gets me home in time to help him get dressed and out the door by 2:45 as it takes us a full 45 minutes to get there. With the IV schedule, I won’t be able to go into work any earlier.

Friday, 3/14 – Ron to the kidney specialist. That appointment is at 10:20 up by the hospital. If the Friday wound vac gets changed in time, I can work 7:30 or so until 9:00, leave and take him in and then go back after he’s finished. I’ll also stay as late as I can that night.

Since the IVs are every 12 hours I have to kind of juggle things around that allow enough time between his treatments. Just looking at this schedule has me exhausted. Anyone want to come and live my life for a while? Anyone want to see yesterday’s picture? LOL, it’s truly lovely.

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