Debbie is here!!

So very happy that Tom's sister, Debbie, has arrived.  I know Tom will be excited to see her - he's been asking about her every day!

Tom has been struggling with the ammonia level since moving to rehab.  It was in the 90's on Wednesday and probably not much better yesterday.  They don't test it every day - it's not really necessary.  He could communicate pretty well but was really lethargic a good bit of the time.  He is still complaining about "not feeling well" but I can't get anything more specific from him.  It's really a struggle.  He's not eating as much as I'd like him to either - probably because he doesn't feel well.  Debbie is going to take his recent blood work from the hospital so they can use it as a baseline for how Tom is doing.

I've talked to 3-4 people about his case - nurses, physical therapists, Dr. Richards and the case worker at NHC.  I contacted Dr. Richards' office yesterday because I wanted to know about his conversation with UAB.  Basically they told him they wanted to see Tom - thus the call from UAB on Tuesday to schedule the appointment Tom now has on the 19th.  Dr. Richards and I both agreed that if Tom needed to be hospitalized from rehab, we would work to see about getting him to UAB instead of Baptist.  I don't really know how to go about pulling that off.  I've left a message for the Blue Cross case manager - I'm guessing they would have to approve the transport.  I'm sure they will want him to go to Baptist first - seems like a lot of extra effort to me but they won't want to take any chances.  I have Dr. Richards' cell phone number now and he told me to call him at any time!

They put him on an air mattress bed today - similar to the beds in the hospital.  It is supposed to help with the leg wounds and hopefully prevent others until he is getting up and down more regularly.  The physical therapists called yesterday.  Tom sat up on the side of the bed but only for a short while.  That's another problem with the ammonia, he is not responsive enough to "work out" or stand up/balance/walk so that will be a problem for the therapists.  She wanted to schedule therapy every other day, but I suggested every day - I'm so mean!

I know Tom has been approved for 7 days of rehab.  Apparently that is normal to approve 7 days at a time.  He did get 21 days with the wound vac issue this summer!  The problem is, there are only so many days allowed and we are getting very close to the max.  I don't know if that is per calendar year or in a 12-month period so we could be in trouble if we run out.  I don't know what will happen then.  Every 7 days rehab will submit their reports and make recommendations.  Seven days is surely not enough for Tom to get strong enough to go home - especially being hampered by the confusion.  I still think something else is wrong - some kind of infection - his WBC was up a little from his last blood test at the hospital.

The wound care supervisor also called today and we discussed his leg wounds.  It sounds like they have a good team of people taking care of him.  I'm trying to let go and place Tom and his care in God's hands.