Sunday, October 31, 2010

Latest and Greatest in the Continuing Saga of Ron...

Last Monday, I took him to see our family doctor. Dr. Alvarado was pretty concerned that he appeared to be doing worse than he'd done just a few weeks earlier. She gave him a pretty thorough checkup, drew blood to make sure his kidney function was OK, and referred us to a new orthopedic doctor (who is in town, instead of over 25 miles away - woo hoo!). She also gave us a referral for Home Health visit and evaluation. She expressed to me that she was concerned that if things didn't start going in the other direction for Ron, that he was looking at a skilled nursing facility or something. Problem with moving to a "residential" type of place is that I'm not old enough to live there.

We managed to get into the new ortho doctor Monday afternoon. He x-rayed Ron's left knee and left foot/ankle. After looking over the x-rays, and poking around on his foot and knee, the doctor told Ron that he had severe arthritis in the left knee and that the Charcot foot wasn't too bad right now (he's got some arthritis there too, and that's one reason why he feels the crunch when he walks). He said the treatment of choice for Ron's knee would be a total knee replacement, but due to his other health problems, he is not a candidate for that surgery. The doctor doesn't even want to do an arthroscope to look at the meniscus or anything else. He doesn't want to run the risk of introducing an opportunity for infection to get into Ron's system. He did have one option that we're doing, and that is an injection of some kind of substance that is made from the comb of a rooster. It's a series of five injections, one each week for five weeks. It's supposed to help in the lubrication of the joint, which is one of the areas the arthritis affects. He said most patients require the entire series before they notice any difference in the joint. Ron is hopeful; otherwise, he'll just have to learn to live with the pain and will have to increase his pain medication intake.

The Home Health nurse called Monday afternoon and we set up a Tuesday morning appointment. She came out about 9:00 am and was there for quite some time. We discussed all of the things going on with him, she looked at our adaptive equipment, and took note of the areas where we were lacking. She does not believe that her agency - or any other home visit type of service - can adequately help him restore strength and function. Yes, they can come out 2-3 days a week for medications, send PT/OT out for exercise and strength training, but without the proper equipment (parallel bars, exercise machines designed for wheelchair access, upper body machines, mats to lie down on for exercise, etc.) that he won't really be gaining too much. She would like to see him in an intensive in-patient program for 1-2 weeks and then, after he's regained some of what he's lost, have the therapists come to the house 2-3 days a week to maintain and (hopefully) continue his progress. Before she left our house, she called Dr. Alvarado's office and made her recommendations.

Dr. Alvarado then sent a referral and prescription to the rehab center where he was in August. I spoke to them on Wednesday afternoon and they were waiting on insurance approval. Because he's already been there for his leg, they can't admit him for that and would need to be approved for a Parkinson's rehab admission. First though, he has to "fail" the outpatient evaluation. The rehab center called Ron on Friday to let him know they were still waiting on authorization from insurance to schedule an outpatient evaluation. I told Ron that I don't want him to go in there with the attitude that he doesn't need them and that he can do everything, because he obviously cannot - and does not. He promised that he would not downplay his issues. We were going to have his son take him, but I think I want to be the one to go because I will have more to say than Ron (or his son).

His son did take him Thursday afternoon to have his prosthesis adjusted and it felt pretty good for about 24 hours. By Friday night, he was back to not being able to wear it because of the pressure on his shin. So, he called again to make another appointment for another adjustment.

So, that's where we currently are. He does seem to be doing better the past few days with transfers, so maybe the first injection did help a little bit. I've made him promise that he will get himself something to eat during the day so I don't have to worry that he's having a low blood sugar from not eating. I still call him about 1:00 pm and he says, "yes dear, I ate" when he answers. Good. That gives me a bit of relief.

As much as I don't want him to HAVE to go into rehab, I want him to have what he needs, and if in-patient rehab is it, then so be it. He agrees but he's not too happy about it. If we could find a used Bowflex in our price range (LOL - nearly free), then that would be awesome. We know of two people who have them, currently unused in their basements, but they're not willing to part with them. Too bad. I found another one but no way to get it here and her husband won't let her use his truck to deliver it (and I would pay for gas) because he said it was too far (they live 2 hours away). Ron could use an over-bed trapeze but they're fairly expensive, too once you add on the floor base. Insurance would pay 80% of one if we get a prescription for it. The last therapist didn't want him to have one because she wanted him to just "try harder" to get into the bed without it. That's great if you're sleeping on a slab of cement - you have something that doesn't "give" when you press down. But, our bed is considerably softer than a slab of cement and when he pushes down, the bed gives too much for him to be able to push himself up into the bed very well.

So - that's it in a fairly large nutshell. Will keep you all updated. Thanks so much for all of the prayers and good thoughts, well-wishes, and comments. You all help me get through some of my days.

4 comments:

Kathy's Klothesline said...

I wish I had some sage wisdom that would help, but I don't. Thinking of you, though .....

Green Girl in Wisconsin said...

Wow--I'm glad you have good medical advice--and I wish I had a bowflex to give you.

Nancy said...

Thinking and praying for you both.

Kristen said...

how on earth do you do it, girl? I am super wimp compared to you. But it is all for a reason, might not know it yet, someday you will.... sending you a virtual HUG!