Here's What I'm Thinking/Update

Yesterday the DR said Jim might have to go back in the hospital for IV treatment/monitoring. Jim said emphatically today that he is not going back. I asked my PT Bruiser today whether hospice does IVs at home. She said yes. I started thinking about moving Jim to hospice to get a higher level of medical care at home, and hiring private duty PT for him. I have to talk to his PT David to see whether he does any private-duty work. If he does, it would likely only be on the weekends, so that may not be enough.

(I guess I also should ask the home health agency whether they do IVs.)

I would likely choose the hospice (Vitas) that said they try hard to treat at home rather than send someone to the hospital. The intake person said that their philosophy is to keep end-stage patients at home, even if it takes 24-hour care from them.

Jim is almost the same today as yesterday; maybe a touch stronger. I worked him hard with arm and leg exercises on the couch to try to get his BP up. After lunch, we walked the 6 stairs up and down once. Don't tell him but on the 4th stair up I thought I was going to drop him. I told him to push down on his right leg to bring his left foot up to the next step, and kept pushing himself back. I need to ask David what to do to prevent a fall. Going up the stairs, Jim is above me and has 50 pounds on me; I not sure I could push him forward. Jim is napping now; the stairs wore him out. I hear him snoring on the monitor.

Jim joked around a little today, so that's a sign he's feeling better.

I am starting, I think, to kind of, sort of, maybe understand the relationship between blood sodium and dietary sodium. Jim has low blood sodium and this page seems to describe it--hyponatremia. It's his water intake that is the problem, although we have him on a severly restricted fluid intake diet. It also explains why the DR is messing with Jim's directic medicines. It also adds to Jim's mental confusion, like we need that. But it seems to me we can mess with the diet a little. The bottom line is that it all comes from his failed liver, and the ever failing kidneys he has.

I might try some electrolyte replacement fluids, instead of the protein drinks I have been giving him. Although the DR and nutrotionist were keen on the protein drinks (Boost, Ensure), from what I've read the less protein in his diet the better. His body doesn't process protein well; it needs carbs for sustained energy.

I saw the radiation oncologist this morning about my burns. He said it looks like I am through the worst of it and it is starting to heal. PT Bruiser suggested I cut away the arm hole of the little boy A-shirts I am wearing so that there is less abrasion to the area. DR did give me a scrip for pain medication.

Oh, and yes, we are getting Patrick 4 nights a week. Tuesday (today), Thursday, Friday, and Sunday. Excellent!!