Monday, December 28, 2009

Sunday, December 27

We had a fairly quiet weekend in Atlanta.  The hospital was running on a skeleton crew so there weren't really any therapists popping in to make Bill work.  He continues to sit in the chair and is doing it not only willingly, but diligently.  He is supposed to increase his time in the chair by 30 minutes each day.  Everyone says more would be great, but he is sticking with the 30 minute guideline.  Yesterday his nurse came by to help get him back in bed about 20 minutes before the end of his goal time (which was 3 hours!) and he told her to come back when he had gone the whole time.

There was talk of moving him to a regular room on "the floor" last night and I think the impetus for that move was for Bill's psychological benefit.  He has been isolated in ICU rooms this whole time and that's tough.  I've been telling him about people I see in the Shepherd Center and I think he really needs some social contact.  Because of the danger of pressure sores, whenever Bill sits in the wheelchair he does a what is called  a weight shift every 15 minutes.  The whole chair tilts so his hips and knees remain bent at near-right angles, but he tilts back until his back is parallel to the floor.  This allows the blood to move around in his body.  Anyway, I told him that when I was eating Christmas dinner in the cafeteria last week I saw a patient eating with his family and they stopped the meal partway through to do a weight shift.  He has asked me about that a couple of times so I think that he is probably really yearning for something normal and to know that there are people like him doing normal things like eating with their families is encouraging.  To make a long story short, he did not actually transfer to a regular room last night after all.  He had a lot of secretions build up in his lungs yesterday and at the end of the day they decided to keep in him the ICU a little longer so that they can stay on top of suctioning out his bronchioles.  The secretions should subside at some point, but like everything else no one knows when.

I think that Bill's mood and attitude are better here.  I'm not sure how much of that can be attributed to different meds and how much of it is a shift in Bill himself.  He is a bit frightened by the idea of full-time rehab and I think he's worried about not being able to do much.  At the same time though I see him struggle to rise up above that fear, acknowledge it, and then tell me he wants to get going.  I know that this will be brutally hard work for him and that there will be bad days and setbacks but I am hopeful that he can keep his chin up and not give up.  Yesterday morning when I went into his room he told me to lift his left arm out from under the blanket and then he showed me that he can rotate his forearm in both directions.  He said that he just regained that ability the night before and he was visibly excited by it.

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