As usual, just when you think things are settled into a nice pattern, the bottom falls out, or the top explodes, or something happens. That was the day yesterday. It was more my day than Bill's. He had a good day!

His breakfast was late and therapy came, but they said they would wait until later. When it finally came, it was all served on a paper plate, with styrofoam glasses and only a fork. Even his oatmeal was on the plate. It's a good thing I brought back the plastic utensils we had for the party. It got him a cup of coffee and an extra cup and scraped his oatmeal into it. I mixed the bacon powder into the gravy and then dumped it on to the plate since he didn't have a biscuit. I don't know what the deal is with mornings now. All the other meals are on regular plates with regular utensils. You would think that that breakfast would be the easiest to have regular plates as they have all night to get them washed and sanitized. But, maybe that's the problem, the staff is leaving before that job is complete. I don't understand businesses that us the philosophy that when your shift is over you just leave insteaf of making sure your job is done first, even if you have to stay over. But, that's just me.

Anyway, they were working in Bill's bathroom, repairing a wall where the soap dispenser had been so I went down the hall to the bathroom and when I got back speech therapy was there doing memory exercises. He did pretty well, only needing prompting a few times for memory recall.

I had planned to run a couple of errands while he was in therapy but I did those closer to lunch time so that I could just pick up lunch while I was out. And, his lunch was late. Occupational therapy came at 1 and he still had not gotten his tray. When it came I felt really sorry for the aide that brought it because she also had another tray and as she set Bill's down the other one slipped and it went flying. Most of the food ended up on the extra bed, which luckily didn't have any linen on it, but I felt bad for her. So, housekeeping had to come and clean all of that mess up. The aide had gathered the food, but everything had to be washed and mopped.

When physical therapy came I asked if he could walk first and they agreed. I watched how far he got down the hallway and it was far enough to get him from his chair to the bathroom or bedroom here at home. They said he walked almost all the way back, I think she said 70 feet, which would get him into the kitchen. I just needed to know that he would be able to make those needed distances. He then worked with OT, and all of the therapists got to watch him use the bathroom and clean himself and were pleased that he needed only minimal help now. He still needs to be monitored, and not go alone, but that's a big improvement too.

After all that, he was done and pretty much done in. We did take a stroll around and if I had taken him a jacket, we could have gone outside for a bit. It was a lovely day, 60 and sunny, but who wants to take a chance on pneumonia again at this stage. I had talked to Tammy the nurse practitioner for the facility and he said his white count has gone down to normal again. She had restarted the breathing treatments, but I don't think he got one yesterday, so maybe they have gone back to as needed.

I took his small tanks with me, but we can't use them. It's a Medicare rule that you can't use any personal medical aids while an inpatient. I understand that and we will comply, but it seems like it's arbitrary and maybe needs to be revisited. But, it would be so much easier. So, Margo and I both told him if he wants to leave the room after I leave just to call them and they will turn his tank on and swap him over. He usually just wants to get into bed by then anyway.

Now, for the problems of the day. I had talked to Tricare again Monday and was told that a claim they receive from Baptist for 11/1 had indicated other insurance. So, I called Baptist and spoke to billing and they did not show a claim for 11/1 (and I know he was inpatient on that date) and aside from the latest stay which hadn't been submitted yet, his account had a zero balance. Yesterday morning, after I finished updating this, I again looked at the online account to check a claim and lo and behold, under other insurance it now shows a Medicare Supplement, with an unknown company, with a start and end date of...11/1/18!  Tricare had to have entered that information as I am the only other person with access to the account. Bill doesn't even know the password, especially since I had changed it the day before and I sure as heck didn't do it. So now Tricare is trying to cover themselves. I didn't get a chance to call them yesterday, but I was so mad. I'm ready to contact our senators, one of which is a veteran and I can't stand him as he is a hypocrite, but the other one is a very effective advocate for veterans and their care. So, if it is not removed within the next day or two and claims that were denied start getting paid, they will get a call to the local office, and a letter. I just wish I had a screenshot with the insurance not listed and one with it listed.

The other major problem really angered me and it made a decision very easy to make. Priscilla finally talked to Chandra in Memphis and was told that it was never their intention to monitor his meds, the discharge orders were wrong! She said that WE chose to use Mayo instead of Memphis and they were not going to monitor him, but if she wanted to send the information to her, she would look at it THIS time. She said that the level of Prograf was at a therapeutic level all of the time and Priscilla knew better from the numbers I had given her as her former husband was a transplant recipient. Priscilla told her not to bother and called Stephanie. She was off, but Pam was covering and took all the information and what Chandra had said and they will start monitoring his meds again. This, coupled with the statement made to the social worker in Restorative Care that "he really isn't our patient" made the decision to terminate all contact with Memphis very easy. Now you may be wondering what we will do if he should get really sick again and the answer is that I will have him flown to the transplant hospital in Little Rock. Of course it will take me almost 3 hours to get there, but Memphis is not going to treat him again. I don't have a problem with any of the other specialities, but they all defer to Dr. Edwards and I won't have him treating Bill. He had decided from day one of this last admission that he was doomed, and if he had just been interested in getting to know the patient and treat the patient and not just the symptoms, he would have gotten to know Bill's will to live. So, even with my "make no waves" personality, I have no regrets letting Bill sign the waiver to eat, and the only reason he will go back to Memphis is to thank the nurses and let them know that he won't be back under their excellent care again. I'm also going to write a letter to the hospital administrator. I can't complain to the head of the transplant program, since Dr. Edwards is the head of the program, so I guess I'll have to go over his head. And, I'll have to include Chandra in this letter and probably Kim who wrote the discharge orders. She's also the one who sent the script for one of his meds that was needed immediately to the mail-order pharmacy with instructions to pick it up...in St. Louis! As a precaution, I downloaded Bill's complete medical record, just in case anyone decided to alter anything/remove anything to cover their own behind. It was 1159 pages, and that was just the preview! And to my chaplain friend Joseph, you were and are one of the bright spots of our stay. I know I'm talking about your colleagues, but, this blog has always been an honest account of feelings and facts. I hope you will continue reading it and keeping up with Bill's recovery. You blessed me so many times with your concern and prayers.

So, that was my part of the day. I didn't take my blood pressure until I got home, because it was sky high yesterday morning after seeing the entry in Tricare. But, it was normal last night and again this morning.

Add computer problems to the mix and yesterday I really wanted a do-over. And I have a red error banner across the top of this page now telling me that the post couldn't be saved so AT&T must be at it again. Oh the joys of technology!