Wednesday, January 03, 2007

An Accidental Omelet

I can't believe that after 54 years on this planet, I finally learned how to make an omelet. And completely by accident.

I was making Jim scrambled egg beaters with a little cheese in them. Just as I had poured the egg beaters into the 9" teflon frying pan and sprinkled the cheese on top, Jim called me for a bathroom run. I put the lid on the pan and moved it off the heated burner and went down to the dungeon. When I got back up to the kitchen, I had a PERFECT fluffy, nicely browned omelet.

I've done it three times since, with PERFECT results. I am so proud of myself.

Slowly, things are looking up a bit. I increased Jim's lactulose from 15cc to 20cc twice a day, and it seems to have helped his cognition without having too much additional laxative action. (I told Jim's GP about this after I did it, and he had no argument.) Jim also has an eczema on his back and chest that I am treating with Benedryl and hydrocortosine cream (per the DR). His blood pressure continues to be way low, and he had Patrick wake me last night with the news Jim wasn't feeling well. I could not register a BP on him. We did some exercises together for about 10 minutes and he felt well enough to go back to sleep, with a BP of 82/60. We also exercised today.

We may have a show down with the home health agency tomorrow. They are supposed to come in to draw blood. The nurse said she is ready to discharge Jim, after showing me tomorrow how to do the sterile change of his PICC line dressing. I am not comfortable with that. I am an accountant, not a nurse. I have been flushing the lines, and that's getting hard enough. (The nurse from the company that provides the line maintenance supplies said it sounds like the IV line is becoming clogged and that I should flush both lines with heparin--a blood thinner--twice a day.)

I called Medicare to explain my discomfort with the situation. I was told that the DR discharges the patient, not the agency. So when I spoke to the DR yesterday, I told him that he may need to have another conversation with Jim about Hospice. He also said he did not want Jim discharged from home health until at least he sees the results of the Thursday blood draw on Friday. He said that Jim may be stable enough to remove the PICC line, which the home health nurse could do. I'm not comfortable with that either. I want that PICC line to stay in because Jim's veins are still collapsed and a veinous blood draw would continue to be difficult and painful. If Jim goes into Hospice, they would not approve the insertion of a PICC line, but they would maintain one that is already in.

Jim's badly bruised hands are starting to heal up some. Places that were bright purple 2 weeks ago are a pale lavender now. One of the home health nurses said that it is because he is off the prednisone. She said that was what was causing the bruising. Funny, I thought it was his liver disease/platelet count.

We have arranged with Patrick and his agency that instead of using him 4 nights a week, we will use him 7 nights over 2 weeks--every other night. That way (unless there is a holiday week), I won't have to take care of Jim more than one night in a row, and we won't have to pay for Patrick more than one night in a row.

I also found some time today to call around about Adult Day Care, and I've found an assisted living facility that takes in a few people every day for that service. Because the day care people are "mixed" with the assisted living population, for activities and meals, the facility does not qualify for state licensing as an Adult Day Care. I gave the director all the bad news about Jim--that he needs assistance on his walker, that he needs assistance toileting, that he can sleep quite a bit during the day and for that I would prefer him in a recliner or bed, and that he is mentally confused and physically weak with all the weight he has lost. It didn't seem to scare her off. I did also explain that he generally is not combative in his dementia.

We are going to visit this place on Friday, after Jim's GP appointment. The director said they could fit Jim in 3 days a week. She also said I could pack his lunch so that he remains on very low sodium and they would feed it to him. And the best news is it's only $75 for 8 hours, 1/2 of what we are paying for Patrick's 8 hours. This IS going to happen because I need to get him out of the house so that I can work. He also needs to get out of the dungeon, get some ambulation, and some socialization.

Hopefully, if Jim grows stronger with the increased ambulation, I can set it up so that the state's handicapped transportation van (Paratransit, which Jim already is signed up for) will take him there and bring him home. That way, I won't have to spend the--maybe--1.5 hours a day it would take to transport and transfer him. The only thing is that the Paratransit will only assist Jim onto and out of the van, either using the steps or through the lift, from the curb. They will not take him from the house to the van, or from the facility to the van. Maybe this facility can send someone out to the curb to bring him in and take him out.

1 comment:

Alice said...

Things sound like they are looking up. Glad you can make omelets now. I bet Jim loves them. Take care.