Even after a pretty sleepless night, and a very early morning, I've made some decisions and feel at peace with them. One of the places he was referred to is a long-term acute care hospital with an extensive rehab program. They are also wound care specialists. I feel that he still needs the acute placement over the skilled nursing. I'm going to try to go by this afternoon and speak with the case manager that was contacted yesterday. I also just saw one of the physical therapists here who really got Bill moving and he thinks that in a skilled nursing center he would just get pushed aside.

My main concerns now are the medical problems and not the physical disabilities. And, whether it be insurance or the hospital itself, Mayo is a speciality hospital. They don't have just a "regular" floor for sick people. So, from their point of view, Bill does not need to be here.

I talked to him about it a little while ago and I think he understands.I also told him that it's not a nursing home but a place that can care for all his "stuff" and still help him get stronger. I told him I was going to go by today and he said he was just going to sleep this afternoon anyway, so it was ok with him.

He started out having a great morning. He was very alert when I got here and we put his valve on and he started talking up a storm. His nurse and PCT are both named Lisa, so it won't be hard to remember who he has. We've had the tech before, when he had the LVAD and she's a gem. They got him up early and in his chair, but he started complaining of pain. He also said he needed to use the bathroom but didn't want the bedpan because it hurt. So, we brought out the bedside comode and he used it. But, he really started complaining of pain in his belly and groin and was really nauseous for awhile. Dr. Hosenpud has ordered, or is going to order, some meds for that. He's had a Percocet and is feeling better back in bed. He keeps going to sleep and then his O2 sats drop and he starts beeping. He just can't win!

Thanks to those who voiced an opinion. They really helped and I feel peaceful about the decision. Hopefully they can take him. Dr. Hosenpud said that if we have to wait until Tuesday since it was all done so late on a Friday that it would be fine.

Bill's getting gurgly so I'd better go suction up the secretions. I'll keep you posted.