February 17 thorugh February 19, 1999 update

Some big changes in the last couple of days, all for the good.

On Thursday Su transferred to her new facility. Nice new very modern (only 6 mos old) rehab center. The place is very nice. Her room is absolutely enormous which is great since it makes it very easy for her to get out of bed and move around as necessary without worrying about tripping over anything or having to move stuff around. She has a sink in the room where she can move her wheelchair under so she can wash her face and brush her teeth easily. The adjoining bathroom is huge also (she can roll her chair into there) and has its own sitdown shower so time and her endurance willing she can get a proper shower every night vice just a sponge bath.

The transfer could have gone smoother, we were held up by the VAIL bed issue and finally got transferred around 1400. In some ways I really hated leaving Stuart Circle, Su and I had gotten attached to some of the staff there, but it was time to move on. They still didn't have her bed there but they put her in a regular bed and assigned a staff member to watch over her until I got there, which made a very good impression on me. Of course I got lost trying to find this place and missed the exit from 64 to 295 coming from Richmond when it was blocked by a disabled Semi-. Once she was in her bed she was pretty tired so we just talked a bit then I got her ready for bed and she was out like a light. Talked to her new physician, ex-Navy Medical Officer, and we sorted out her medicines and previous treatments, just to make sure that nothing was missed in her record (heck it is about 5 inches thick at this point). He ordered another set of arm Xrays to check her right arm before they start some more aggressive therapy on that arm. By the time I got ready to leave they had already done most of the arm Xrays, gotten her a new wheelchair (a regular one vice the stretcher type) and put together her therapy schedule!

Friday was the first full day of therapy for her and it wore her out but good. She gets a dedicated assigned 4.5 hours of therapy a day at set times so she always knows where she is at and what is next. It was a bit hard for her since she isn't used to being up for that long of a period and they are still sorting out her meal schedule so it won't interfere with her therapy sessions. Watched her speech therapy session and she did pretty good, she was getting a bit pissed because they were asking a bunch of very basic questions (speech also covers cognitive skills) but I reminded her of the "gotta meet all the wickets" rule and asked the therapist to try something harder. The therapist was a bit doubtful but I told her she could read and by the end of the session she was reading and pointing to the answers for some SAT type questions and got them all right!

Physical therapy here is held in one of two big gyms. Su wasn't too happy with her new wheelchair (she hates the idea of having to use one) but once they showed her how she can move it using just her feet (her arms just don't have the flex to do it) you could see the lightbulb come on and I think that being able to self-propel made a big difference. She walked more Friday then she had about the whole week. Since she gets the dedicated 1.5 hours in one block they can afford to let her take a break and rebuild her strength between exercises. Plus there aren't any distractions in the gym. They even had her kick a big orange ball around a bit when they did the two person gait belt walking.

After therapy got her back to bed and then did a regular shower and got squeaky clean. She was pretty wiped out by that point.

Their nursing system is set-up in a very interesting way, she is assigned a primary nurse, just like a primary physician, who is responsible for her overall nursing care and is her usual daytime nurse. He is pretty good and asked me if it was possible to sit down and go over her record and give him pointers on how Su likes things done. So we are going to do that today. Her usual second shift nurse is the wife of her primary nurse! Sort of a family affair, they were back and forth on the phone a couple to times making sure that stuff didn't get missed and he kept checking on her. Her trach hole is just about closed up and isn't giving her any problems.

First team meeting is on Friday and the system is a bit different that Stuart Circle, they only allot 10-15 mins per patient and while families can attend they are held in the mornings vice the afternoon so it won't be possible for me to be there but they do provide a comprehensive report after each team meeting and Su patient rep is there so she asks questions for Su and I. Not the ideal system but given the parameters it is acceptable. They have already started probing for what the long term goals are...get her to the condition where she can safely go home, to a nursing home or something else. Once I mentioned that I really wanted her home but I also wanted her as far along the healing path as possible they mentioned that Su would probably do very well in their transitional program after a short stay in their regular rehab program. That would make it easier for her to make the jump to a day program and show her how to overcome whatever short term limitations she will have while she heals. I am already trying to figure out how to rip the house apart to make it easier to move through etc.

Directions to Sheltering Arms are as follows:

I64 West to I295 (towards DC), get off on the "Meadowbridge" exit (Exit 38B) and go about a mile down Meadowbridge, just follow the blue hospital signs til you get to the hospital complex, it is called Hanover Medical Park and it is Huge. Turn into the parking lot and the Rehab Hospital (not the Rehab Center) is around the far side of the complex. Her room number is 131. Mail should continue to be sent to her home address and I will bring it in to her, it saves about 3 days delivery time that way.

Visiting hours are from 1100-2100 but she doesn't get our of therapy until close to 1700 so there isn't much point in getting there any sooner during the weekday unless you want to stop by during her lunch break 1130-1300. Weekend visiting hours are the same but her therapy is only for 1.5 hours scattered through the day so just come when you can.

Finally got Tricare to give me an advocate to handle Su's billing snafu. TriCare had screwed up my billing for my emergency room visit and when my XO got involved after I got stonewalled he came up with a name of a manager in the billing company to talk to, she straighten mine out in about a minute, then said "I have been trying to get in touch, I have been assigned to help you sort out your wife's billing also. Here is my direct number and I these are my working hours." So starting Monday we will work through the bills a bit at a time. So for all the TriCare users out there the key seems to be "Get your command involved early, be very proactive about problems with billing (they won't just go away) and be prepared to scream loud and often if you aren't happy, remember these guys work for us and while some people may seem to think that the health benefit is a freebie it is factored into our compensation levels so we are paying for it though indirectly.

take care everyone

lawrence