I've been awake since 4 when Bill had to go to the bathroom (and made a big production of it) and the cat started walking on me. I tried to do this earlier, but the computer wouldn't cooperate. So I just surfed and drank coffee and now I'm ready to try again.

It hasn't been the best week. Bill is coughing up a storm. But, he's got no fever and his number are pretty good. O2 has been a little low at times, but comes back up. We've made some changes to our routine this week and while he doesn't like them much, they are for his benefit.

Our heat went out right after I turned it on last week-end. But between Ryan and Bryan, got it going again. It's been cool all week so maybe fall is finally here. I wish we would get a warmer sunny afternoon so that we could sit out on the stoop. Bill needs a little fresh air and sunshine. He hasn't left the house since we got home.

He has appointments with Dr. Threlkeld (infectious disease) and the nurse practitioner from Dr. Burbeck's (pulmonology) on Wednesday. They are both in the same building although on different floors and from 1 end to the other. But, I think we'll be OK. I still haven't heard from Stephanie, which is odd. Even if she is on vacation, someone should be covering her calls. So, I'll probably try again Monday. I need to know what the plan will be with the DVT.

Bill halfway fell the other night and hurt his right arm. He was trying to stand up and stood on his oxygen tubing and it pulled him back down onto the couch. I think he just put too much pressure on his arm. He said it's the muscle that hurts and it's not swollen or bruised or anything. And since he can use it, I don't think it's injured too badly.

I read a couple of very interesting articles this week that mirrors some of what we've been dealing with. One of them is about keeping patients from falling in hospitals, especially those over 70, and how they are much weaker when they are discharged than when they were admitted. It pretty much all boils down to money. They don't get re-imbursed as much from Medicare if patients fall, so hospitals go to the other extreme and keep patients immobile. It said that most patients, for a 5 day stay, even if they have been active and fully functioning at home, usually require 3 months of physical therapy, whether in-patient or in home, to get back to their pre-admission life. Sounds familiar!

The other dealt with early discharge. It had a series of questions to ask when discharge is brought up. And I can attest to the fact that they don't listen to the questions! When I read over the list I was like, did that, asked that, said that, and the result was a very weak patient going home!

With Bill, both of these articles tie together. He was kept pretty much confined to bed and he was discharged with a white count nearly as high as when he was admitted. Yet, they expect him to be able to walk at home, especially out of the car, up 3 steps into the house, and then walk around the house. So, maybe it's time to become an elder activist (as if I have enough time to do that!). I do know that I'm going to be much more forceful the next time, and I'm sure there's going to be a next time

We've decided that if he needs admitted for pneumonia again I am just going to take him to the local hospital. He was admitted there the first time. They can't handle the transplant meds, but didn't have a problem with me bringing them to him. They also worked with Mayo and consulted. He still was discharged too soon but that was mainly because the hospitalist and I didn't like each other. He's the one who decided that Bill was throwing up because it was his gall bladder and brought in the consult from Yale. I guess since I had played the Mayo card he thought he would trump me with that, but it was all because the surgeon he had consult went to Yale. And the surgeon agreed with me that it was not his gall bladder. After Bill declined the CT of his abdomen, he was discharged. That post is somewhere around the end of 2015 or 16. I can't remember exactly when it was now without looking it up. But, I've learned a lot more. It was so easy to work with the Mayo staff, as they require input from family. They are also willing to answer questions and they know that we know the patient best. For those that know me, you know how I hate confrontation! But, I'm getting better at it! So, this hospital, I believe, can handle pneumonia. I don't know how Memphis would react if I demanded that he not be sent to the transplant wing, but I think I would just be ignored...as usual. That is something I'll ask about in Memphis on Wednesday.

I think that's got the highlights of the week. I told my mother that when we go to Memphis, I'm going to make sure I've got my knitting this time. I usually take something but didn't the last time, so the 12 hours in ER were very frustrating for me. I didn't even have a book with me. This time I'll be more prepared! I don't know if I'll post Wednesday night or if I'll just wait until Saturday as usual. It will depend on what we find out. 

Hope everyone has a good week!