Sometimes . . .

I just want to scream!

Tom still seemed "out of it" to me today.  He is getting the same dose of pain medicine that he gets at home but he is able to take it more often.  He has refused to take it a couple of times because his pain was not bad enough at the time - good for him!

His ammonia level is up to 145 today, no explanation.  That certainly had a lot to do with the lethargy.  When he talks, he makes sense but I do question what he is telling me.  For instance, he told me that today he walked without a walker.  I didn't believe him.  So, he got up to the side of the bed, asked me to raise it some, stood up, grabbed my had and walked forward about 5 steps and then backed up to the bed!!!!!  I am so proud of him.  A slap in my face for not believing him.  Dr. Rutland did not come by while I was here this morning.  Tom told me later that Dr. Rutland wanted to try to send him home tomorrow.  When I got here this afternoon, Tom did not look comfortable (I kinda had a feeling this tech was not going to be that good).  After he walked, he stood up again so that I could change the wet (from fluid) sheets and his gown.  I noticed that his lower leg was red and warm (cellulitis) so I called for the nurse.  She gets points for coming in to see it and then calling Dr. Rutland.  He came back over this evening to look for himself.  This gave me a chance to talk to him about extra physical that for Tom (even if I have to pay for it myself).  He gave his blessing with gusto.  He asked me if social work had talked to me, I said no.  Apparently they are trying to get Tom into a more intense rehab place - hallelujah!  I jumped on that.  I really do want Tom to come home but he needs more intense therapy for a while - whether it's inpatient or outpatient.  I'm not sure Tom was really getting the whole conversation.  I did tell Dr. Rutland about the walking and even he was surprised.  So, prayers that Tom can get some time in an intense rehab.  I'm still going to pursue extra therapy at home though.

Tomorrow I will call off the UAB visit.  Maybe we can reschedule for next month.

Still concerned about the ammonia and cellulitis but at least they are monitoring it.