Why is it?

Why is it that Tom's biggest health challenges seem to come in the middle of the night, or on the weekend, or when the doctor is out? About 3:30 this morning I heard Tom stirring. When I got out to the den, he was panicked that he couldn't get up. My thought is that he has so much fluid in his abdomen and legs, he simply cannot lift himself up. His response was "I don't know", which I've been hearing a lot lately. I worked from home today so that I could help him get up when needed. Mostly it's his legs and he can't move them on and off of the ottoman. I called Dr. Rutland's office as soon as they opened to beg him to arrange for Tom to get a paracentesis. Dr. Rutland normally works half days on Thursdays but today he wasn't in at all. The nurse called back and told me to double the amount of lasix Tom was taking - which they had already doubled yesterday. We were told if Tom was not better tomorrow that he would need to be admitted to the hospital and get IV lasix. Tom already had an appointment to get bloodwork done late this afternoon. I reminded him of this about 10:30 am. He told me he would need to take a shower. I thought yeah, right, he's not going to be able to do that. But, he did! I told him to sit down and rest afterwards and then we would go to the doctors office. He decided he wanted to go right then, so we did. While I was waiting on Tom to get his blood drawn, UAB Liver Center returned his call from yesterday (he had called them himself to ask about the fluid problem). I told the wonderful nurse that is so helpful and does all the MELD calculations, where we were, what was going on with Tom and Dr. Rutland's plans. She told me she would call Dr. Eckhoff and then call me back, which she did 20 minutes later. She told me we needed to be at UAB at 6:30 am on Tuesday for lab work and at 7:30 am, Tom would have a paracentesis. Then, she said we would need to be at the Kirklin Clinic at noon on Wednesday for an appointment with Dr. Eckhoff so he could check the shunt. So, the reservations are made, the house/dog sitter has been booked and I've moved some work stuff around. The only thing not rescheduled is my hair appointment - which is pretty important too :-) Now, we just have to make it until Tuesday - prayers are needed here. Tom still cannot lift his legs on and off the ottoman which means I need to stay with him pretty much all the time. He could put his legs down but that makes his feet swell even more so we're kind of stuck between a rock and a hard place right now but we'll get through it. I am so relieved that we have a plan of ACTION! As inconvenient as it is to go to Birmingham in the middle of the week, I think this will make a huge difference in how Tom feels (it better). I'm still worried about the shunt, I really want it to be working and I have no idea what will happen if they determine that it is not. Two of my devotions this morning talked about taking things one day at a time so I will focus on today. Tom has really been discouraged (translation: in a bad mood) lately. I think news of a plan has helped. The biggest gift was a visit from his friend Dave on Sunday night. It really lifted Tom's spirits. Tom still has some itching from an unexplained rash but it's not as bad as it was. He's been really cold again too which has been miserable for me - I can't sleep when it's that hot. I wonder if that's related to the fluid? The heat and lack of sleep allowed me to get a good bit of work done today, I'm pretty excited about that. I was on a roll this morning and again this evening - it feels good to accomplish something! Ok, it's past my bedtime so I'll sign off. Thanks for keeping us in your thoughts and prayers.