Return to normal

It was David's third day on room air only.  The oxygen is in reserve just in case but things have been going well without it.  He is using a cane to get around stores and when visiting but not in the house.  He is now remembering that cold hands have poor circulation and hence low O2 % and he warms up his hands before trying to monitor his O2.  Weight has been steady, no water gains or losses.  I've no idea when he can begin to walk 30 minutes again but will try to monitor him during my two weeks before the semester starts.  Since his kidneys have been on the edge of health, he is unable to take most pain killers.  He was taking Tylenol but his liver functions are now a problem so that is off the table. Mimi made him an oil extraction and I give him a couple of drops under his tongue about 9 pm and it should allow him to sleep.  His pain in the groin muscle seems to be gone completely.  I guess the only thing to watch out for are the liver functions which are going to be tested next week.  Then it is just building up to his 30 minutes of walking each day...and mine too.
Thanks for your prayers that allowed us to have a good close to 2016.

David's pain is gone.  He's been resting, using the oxygen and is totally bored.  I am decorating cookies like crazy and occasionally he will come over to admire them.  We tried to play Scrabble but he could not think of words.  To be fair he had no vowels.  I had no consonants.  I think we will try again this afternoon with a new game and really shake up those tiles.  Tomorrow he has his first PT and then sees our primary care doctor, Dr. Clemo.  If he feels OK after than, we'll swing by the Men's Wearhouse and pick up his suit, blazer and slacks that we bought before Thanksgiving but had to be altered.
His oxygen percent worries me.  The cannula doesn't stay in his nose but slips to his left cheek where he has no feeling.  I adjust it a lot.  He feels around for it and moves it to his nose when he thinks about it.  Low oxygen makes him sleepy.  We'll see what Dr. Clemo recommends.  He has two portable setups.  One is a small tank in a sling/pouch and the other one is a big tank on wheels.  I'm going to ask about getting the small tank refilled OR getting a small compressor like the big one we have in the house from Medicare.  I checked on Amazon and the portable ones go from $400 to several thousand dollars.  We'd need one with a battery with a several hours capacity that can be charged in the car.  With David using the walker, he is not able to negotiate the large tank on wheels too.  Even the small tank is heavy so a battery with the concentrator unit may be similar in weight.  I'd like to go to Ginter Gardens to see their outdoor (walk through) light display and anticipate using his wheelchair so I may be able to rig something for the oxygen tank on that.  We need a minivan to transport all of this stuff!!  I guess we will just take it as it comes.  Yesterday's readings were about patience and generosity so I am practicing.

Our former neighbor, Dr. Anne Truong has a rehabilitation practice and she saw David today.  Her background is sports medicine and rehab.  After reviewing the CT, other records, etc. she examined David and moved his leg like he was a 28 year old quarter back...namely pushed and pulled in 360 degrees and bent.  She said based on what did not hurt, the pain did not come from either arthritis or stenosis.  Another motion elicited a big reaction and she said AH, torn groin muscle.  We can treat it with aggressive physical therapy.  Stop the narcotics, they cause confusion in the elderly.  He can have lots of Tylenol and nothing else.  He will start PT with her group next Wednesday.  Meanwhile he is to rest and use heat on the area.  He has a hating pad on the area after three tylenols and is on the couch watching MSNBS...all good signe.  Both of us appreciate her approach and her diagnosis.  No other doctor examined him as thoroughly and with such confidence.  They treated him like fragile, antique China.  I'm looking forward to his recovery.  He sees Dr. Clemo next Wednesday too and we'll see about the O2 for the congestive heart failure which is a distinctly separate issue.  So far the heat and Tylenol are keeping him somewhat comfortable.  That's all we can do until the PT.

David was at Mary Washington hospital since Monday with severe leg pain, low oxygen and aspiration pneumonia.  He finally came home about 6:30 tonight expecting to have home health tomorrow with a nurse (coming mid day), Physical therapist (unknown time but probably coming) and home oxygen.  He had a little tank for the trip.  Along about 7:30 a guy from the oxygen supply company called and said they would be unable to deliver the oxygen because the doctor at the hospital wrote the order wrong and Medicare would not pay for it.  He assured me that David's oxygen was 100% on room oxygen when rest in.  I disagreed. We went back and forth. I said that David could die and that I was taking him back to the emergency room.  David had taken the oxygen off to go to the bathroom and his level dropped to 80% but went back up when we replaced the O2.  I hung up and the guy called back later offering to bring a tank for 75.00 that I would get back when the paperwork got straight tomorrow morning.  I declined because getting refunds is always a huge deal and I was exhausted and frustrated.  David went in to get a shower and the guy called back again offering to give me a tank if I met him in Stafford in an hour.  I declined because I couldn't leave David and finally caved and said I'd pay the money for a tank of O2.  So the service technician called me and said he lived in Chesterfield Va and it would be about 1 1/2 hours to get here.  I gave him directions.  He showed up with the entire set-up to compress room air and make it more concentrated with O2, two travel/emergency tanks and lots of tubing.  David can move 50 feet without moving the compressor.  The compressor has wheels so we can move it if necessary.  He was extremely nice and at 11:15 David had a reliable source of O2.  There is an adapter to moisturizer the air but we did not install it right away.  The valves are more complex than the gas for the grill but I got it figured out before the guy left.
The shower exhausted David and I had to use the wheelchair to get him back to the couch in the family room.  He just had his midnight pain medicine and is finishing up a recorded show.  I will get him into bed and then try to sleep myself.  The O2 compressor is actually kind of soothing.
Tomorrow we take the disk of his CT showing the stenosis of the spine and osteoarthritis (and him) to the Pain clinic for an evaluation and treatment plan.  The IV steroids helped the pain and the hospitalist thinks that steroid injections to the spine will be very useful to eliminate pain.  He is definitely not a candidate for surgery.  He is logarithmically better than when he left here in the ambulance on Monday and if he continues to improve this fast, he should be back doing 30 minute walks and going to Silver Sneakers before the new year.

After 24 hours of two acetaminophen with codeine every 8 hours, the pain has not subsided when he tries to use his leg.  He can be pain free in bed in a weird position.  He wanted me to call the doctor.  I got the one on call who predictably said, transport him to the hospital by ambulance.  He wants to wait until Monday and call Dr. Clemo.  So he remains in the weird position in bed.  I'm very worried.

New problem surfaced slowly progressed fast

For the last several months David has complained about a pain in his hip and taken Tylenol.  He mentioned it to Dr. Clemo and she OK'd the Tylenol every four hours.  That stopped being effective and he started needing a cane yesterday.  He saw Dr. Clemo again yesterday and she ordered X-Rays which he immediately got.  She also referred him to our old neighbor, Anne Truong, who is a pain and joint doctor.  Today he cannot put weight on his right leg and is in bed.  Sitting is equally painful.  He has an appointment with Dr. Truong on Tuesday.  Meanwhile the pain is terrible but he did not ask for additional pain meds yesterday.  So now he needs something and I called Dr. Clemo's office twice without success.  Finally her nurse called Tylenol with Codiene into Costso and I picked it up.  There is a faculty meeting out at Locust Grove (45 minutes away) and I've sent in my "excuse" for not attending and emailed a friend to give me info after the meeting.  With budget cuts in VA I wish that I could attend and participate in the discussion.  David comes first.
The X-ray did not show bone damage.  So we'll see what Dr. Truong can do.   Dr. Truong is the local guru for stem cell joint treatment and friends have recovered fully and easily from that compared to open surgery/replacement.  BUT insurance does not cover stem cell treatment.  It does cover the PT after the treatment and the protein rich platelet follow ups.  Plus you have to have some cartilage in the joint to be a candidate for the stem cell treatment.
He's had the new pain med and is in bed watching TV with the electric blanket on high.  I expect that he will take a nap.
So keep us in your prayers as David faces one more challenge with an aging body.