Rehabilitation

I’ve not always had decent heath care, but since eligibile for Medicare, I’ve been OK with what I have. I have a small pension from one job that I devoted to health care, and stayed on a reasonable keel for the last  decade. Only this year has my health insurance cost outstripped that little pension. The weakest part of my plan is the rehab, but I’ve always looked around for money to cover that cost, when necessary, and, all in all, been satisfied.

Fast forward to the April weekend when Beth and Ruth drove my comatose self to the hospital in Akron. The hospital, Akron General, has been my standard of care my entire life. In the recent round of hospital wars, it was acquired by Cleveland Clinic, and some company is making a fortune adding an enormous Cleveland Clinic logo at the top, and dropping the other identifiers a line. Imagine how far down the Edwin Shaw sign has descended. That was my destination and I was almost there.

I spent the weekend at General, and was transported to Shaw on Monday morning. After some preliminaries, I was slipped into the therapy production line. Three main venues occupied my days: Physical therapy, occupational therapy, and speech therapy. I was surprised at the value of speech therapy, mostly about problem solving.

I had not walked in four weeks. The first time I stood, using a walker, my knees buckled. Nor was the therapy as easy a road back as therapy from the stroke. Actually, shame on me for comparing the two. The physios pointed out, over and over, my deficits were stroke residual, not the craniotomy for the subdural hematoma. Couldn’t blame it on the fractured skull. It’s easy to see now; I coasted for ten years keeping even with the stroke damage, not working harder to get ahead.

Live and learn. Haha.

I had one setback in rehab, that still has me concerned and something I must learn more about.  Two of my physios were concerned that my speech was slurring, and I couldn’t stay awake. I returned from every session, skipped the meal and went to sleep. It’s called hyperammonemia. I don’t know if I’m over it or what else I should know about it. The good news is, these two women recognized and reported it. The worst news, in my case, is that it subtracted two good days of physical therapy from my schedule, and this kind of insurance is unforgiving about physical therapy. Nine days per incident and off you go.

I have been working on my own now, scheduling my life. This week coming up I have appointments with the neurologist on Thursday, my same physiologist who was so disappointed with my stroke progress ten years ago on Wednesday, and various others on Tuesday and Friday.

I got a hair cut over the weekend. Melanie had little good to say about Washington General’s sense of style. “They have none, though they did a decent job of parting half to one side and shaving it.” There was no sense in reducing the left side to match the stubble on the right. The left is trimmed and the right must catch up. Pictures may follow.

Why I recently discharged myself from two excellent medical hospitals. I don’t recommend it highly, but sometimes it’s the required jump start.

I was hospitalized from March 26^th through April 28. I was in George Washington Memorial Hospital in Washington, DC, though April 14^th; in Cleveland Clinic (Akron General) for the April 15/16 weekend, and on to Cleveland Clinic (Edwin Shaw rehab) on April 17. Laura stayed with Aunt Beth and Caroline for the rest of the holiday, then with a school mate for two weeks, then with Aunt Janice, living from her suitcase.

There is no universal hospital system in this country. For all the grand talk of the last thirty odd years, computers do not talk to each other.  Nor do doctors. When my brother-in-law retired, my sister refused to move to southern Ohio for Tom to be closer to his family. Old truck drivers don’t get it; the doctors, the hospitals, the rehab is not out in the corn fields, nor is he. Jan and Tom still live in our doctor central, and amid all their friends.

When I had sorted through enough grey cells, and begun asking questions, I knew it was decision time. The DC doctors appeared once a day, and I realized they were talking to me about not leaving. They would transfer me to rehab in DC. They pretended to, or perhaps actually knew nothing about Edwin Shaw rehab clinics in Ohio. I’ve gone to these since my hip was replaced in 2003. I was there last the day before we left, and scheduled our return for Thursday, so I could keep my Friday appointment.

The fact I had responsibilities in Ohio made no nevermind to the DC docs. I have a granddaughter in school. I have a job. I have a home, with expenses to pay.  I have family and friends. I have a cat. I was well enough to move on to rehab. The DC docs wouldn’t even look up “Edwin Shaw rehab.”

When the DC docs left the room, I called my clinic and had a nice chat.  I left my therapist a message, and  told them I would be there to start rehab on Monday. There were logistics, of course. New patients are admitted on Monday. I was in no shape to spend any time out of the hospital, so I arranged to show up at Akron General, be admitted through emergency on Friday, and on to Edwin Shaw on Monday.

The Edwin Shaw folks were a bit incredulous, but said if I actually arrived, of course I would be admitted. I called my daughter, told her I was being discharged Friday, and could she come down from Cleveland to drive me back from DC.  When she arrived, she fell in with the plan, more or less. Like me, she found the reasons to leave far outweighed any reasons to stay. They are a post themselves.

The DC docs put together some unhappy discharge paperwork, I was rolled into Beth’s car, with Grandma Ruth riding shotgun in the back seat, and we were off. We arrived at Akron General’s emergency room, and politely took our place in line. I dozed, and completely gave up my plan to get Beth and Ruth on their way.  I knew my name and knew I could raise my hand when it was called. But, they would not budge, and so be it.

Eventually I was asleep in a warm, soft bed, with new tags around my wrist and Beth and Ruth back on the road, north to Cleveland. I had home just down the road, the weekend off and the beginning of the next phase of recovery looking decent.

Minors on the town

        

Good to their word, the girls called Aunt Beth, while grandma drifted through bead land. I have no idea what made the sound I fixed on, but it made the dreams work out. The doctors kept me unconscious for four days. In that time I had a right craniotomy for subdural hematoma evacuation of my encounter with the grill.

I can say this: if someone volunteers to perform my very own craniotomy, I’d probably decline. But, the most pain, post-procedure, was the little slice into a groin artery to thread a drain to my brain to evacuate two hematomas, a nice big one from the sudden stop against the grill, and a smaller one just a couple of months old that I bet a sudden stop against my own cupboard door left. The surgery left me unable to talk or walk, but the nice surgeons drifted in every few hours to tell me I was doing a good job, before sending me back to beads and park rangers.

My daughter Beth came to claim the girls, and her husband Bill came to drive home my car. When they called her, Beth told them to Uber back to the motel, order in a pizza, and not create a disturbance. Oh, yes, and order a new room key with the best story they could muster. Beth checked them periodically, and was satisfied all was well. At least the phone was answered, as expected.

The very next day the girls expressed their disappointment at missing the Jefferson memorial and the tidal basin boats by grandmas’ sudden stop. Good for them! Beth took them back to view the marble they missed, before heading back to Ohio, the next morning.

As they left the hotel the next morning, the girls suggested a quick trip to Starbucks, across the road,  and Beth led the expedition. Before the doors closed behind them, the wait staff were out from behind the counters. “There you are! We’ve been talking about you! How’s your grandma? We’re so worried about her.”

“Grandma will be just fine,” Caroline announced. “Mom’s taking us home and coming back for grandma.” Thirteen year old minds deal beautifully with time and place. Beth exited behind a latte and a chocolate with double whipped cream, smiling.

Grandma did leave, a couple of weeks later, though not discharged. It was a fine adventure, and I doubt my grandchildren will realize it for several more years.

Vacation images

For the longest time I just heard the beads, click, click, clicking, and watched the picture forming, building from the bottom to the top. When I was tired, all the beads slid from the bottom and new beads fell to start a new picture. The pictures were Disneyish, but not Disney. They were pictures I’d seen during the day. Cherry blossoms, of course. Children. Families. People who understood the meaning and use of etiquette. People who had no idea.

A ranger would say, quietly into an ear, “This is a national monument, sir. Please remove your cap, take your smoking materials to the other side of the perimeter; take your argument with your friend there, too.  I had to smile; I didn’t remember hearing so much during the day, but there they all were, back again. I smiled. We are one rude nation.

I was tired; the girls and I had been on their feet most on the day. Caroline and I consulted, decided to go back to the Union Station for some supper, and come back to see our last monument, the Jefferson Memorial. They could ride the paddle boats for a bit, then back to the hotel and a good night’s sleep for Mt. Vernon and Montpelier. It was a bit of a hike down the hill to the red bus, but we were among the first on. These red busses fascinated me; on anywhere they stopped and off anywhere they stopped, for a buck.

A look around and I was beginning to sit down, when the bus exchanged its snooze at the curb for a dash to the center lane. I fell to my shoulder and sped pell-mell down the aisle, until my head crashed into a metal grill. I brushed off Laura and Caroline, who were up at once to help. I got up, got to the seat, and took a look at myself and at the bus. “I need to go somewhere to clean up,” I said. The girls said nothing.

The bus pulled back to the curb. Police came on; passengers left. I wondered for a second about their dollars. But the police were down to business, collecting information. We, obviously, were going nowhere. I considered my granddaughters, more mature than minors, but minors nevertheless. 

I picked a policeman from the group, and told him he was in charge of them for the time being. I told the girls the same; the policeman was in charge until he handed them off to a new person in charge. I told Caroline to call her mother. Then I stopped remembering.

My Mystery Grandmother

My name is Francis; apparently, some of you know me as France. My grandmother has had quite the adventure and will be telling you about it probably before next week is over, so hang tight. Rest assured she is doing alright. In the meantime, if you'd like, check out my blog at www.summitventure.co and/or Facebook at www.facebook.com/summitventure. You might not have heard about the tail end of my trip, but I came out the other end of my adventure in one piece!

Cheers, Francis