Lunch with Mother

Going out for lunch on Saturday was a regular feature of my visits to Mom before she broke her hip. On Saturday, we resumed the custom. She wasn't too enthusiastic about going at first. She was upset about having an "accident" that morning,. and was feeling down in the dumps. Then shortly after I arrived a social worker came in to talk with her in preparation for Feb. 2's care conference. Mom once again said she knew she couldn't go home without assistance, and felt that going into assisted living would be okay. And that she wanted Byron and Colleen to pick out the place, because since they are the ones who live closest, it should be convenient for them. She felt St. Anne's Meade, which we visited in the fall, would be fine.She shared with the social worker her stories about working at the Sanders in Royal Oak and I'm sure she could have kept going all day had we -- and the social worker -- not had other things to do.

The social worker's visit perked her up considerably, as well as the sunny weather. I settled her into the Buick Lucerne I rented (her days of getting in and out of the TT are over), and went to a local Comerica branch to take care of some business (much more competent assistance than what I had encountered in Pleasant Ridge the previous Saturday). Things went smoothly, and her mood was positive, so we decided to go to lunch and opted for the Big Boy about a mile from Heartland where we split a patty melt platter and a piece of French silk pie. The picture is of her in the restaurant.

We got back a little too late for bingo. She's still concerned, as are my siblings and I, about what's going to happen next. We'll have a better idea after the care conference Tuesday afternoon, which is followed by an appointment at the wound clinic which I'll be taking her to (hanging on to the Lucerne for a few days). Good thing the weather has been cooperative.

Cold and cranky

When I arrived at Heartland this morning, Mom was sitting in her wheelchair with a book in her lap and her eyes closed. She complained about being cold, and insisted on going through her drawers to get them organized. "I don't know where anything is, I'm freezing, and I just don't understand any of this." Poor thing. It's possible she's cold and irritable because of her low hemoglobin. I checked with her nurse to see if she had a blood draw since the one early last week, but she had no record of it. It's also possible she's cold and irritable because her room isn't like a sauna; apparently her new roommate, Caroline, doesn't require the heat to be on full blast like her previous roommates.

Her life-long friend Priscilla visited yesterday, and she had a call from Dave just as I was leaving to run errands (don't get me going about Comerica Bank), so I know she had a couple positive things happen in the last couple days. She's apprehensive and afraid of what's going to happen when she's discharged from Heartland. It's too early to speculate much, but a lot might depend on the state of her pressure sore. Time will tell.

The trip to the wound clinic

Cozy in her new sky blue down coat, I took Mom to her Tuesday afternoon appointment at the Beaumont Wound Clinic. Pictures and measurements of her wound were taken and treatment discussed. Her hemoglobin was low again (8.6) as was her potassium, which are items of concern. In addition to Dr. Ordona, she was attended to by four nurses and an aide (it takes a village). The discharge nurse emphasized that she needs to eat more protein to help with the healing and also shift the pressure on the wound by standing for a few seconds every 15 minutes if she's sitting, and lie on her side when in bed. She goes back on Groundhog Day, at which time Dr. Ordona may decide whether to recommend her for hyperbaric oxygen therapy (the hyperbaric physicians make the final call on that). The accompanying picture is of Mom looking at the picture of her wound; she was stunned at how horrible it looks, although it looks better than it did the first time she went to the wound clinic.

Her room on the second floor of Heartland is nice, although it's about as far from the nurse's station as one can get (before, her room was right next to the nurse's station). Her roommate, also named Ruth, seems to not be quite all there and Mom hasn't been succesful engaging her in conversation, which is hard for her as playing six degrees of separation is one of her favorite pastimes. Mom seems to be in relatively good spirits, although she is still perplexed as to why the wound developed ("I always used Lysol and Pinesol to clean the bathroom") and misses Dave. Byron and Colleen continue to visit regularly and I'll be back on Saturday.

Monday January 18, 2010

Byron received word this morning that mom was being moved to the 2nd floor. She is currently in room 230-1 and her phone number is 248-729-4447. The 2nd floor, in addition to physical therapy, is more of a medical floor and they're better equipped to handle the wound care and ensuring she doesn't sit in her chair all day long. She was just a little upset that she was being moved but once she found out the staff on 2 is just as nice as the staff on 1 she was better. Byron & Colleen are on their way back from Cadillac and will be visiting with her shortly, and Val is coming down tomorrow to take her to her Doctors appointment. That's all I know today folks, stay turned for late breaking developments.

I spoke with Mom around 7:45 this evening. She was perturbed because late this afternoon she was asked if she would be willing to switch beds (not rooms) with another patient who needed the larger bed that she had ("there are a lot of big women here right now," she observed). She said she agreed to the exchange, as long as they made sure she had a specialty mattress. Well, the switch occurred, but they hadn't made up her bed yet, and she didn't want to get ready for bed until the bed was ready for her. She was going to buzz for the aide once we rang off.

She's on her own for a bit. Dave is back at his home in Kentucky Sunday afternoon, and Byron and Colleen will return from their weekend up north sometime on Monday. I'll be there Tuesday afternoon to chauffer her to her appointment at the wound clinic. The excitement never ends!

Back Where It All Began

Mom was discharged from Beaumont this morning around 11 a.m. and returned to one of her favorite places, Heartland, in Troy. She is in room 103 which is the room she was in when she was recuperating from her hip surgery. The phone number is 248.729.4341. She has unpacked and set up her area the way she likes it and has had a visitor already, with flowers! Thanks Janet

She will continue to receive antibiotics IV as well as her usual assortment of medications and patches. The wound will be treated twice a day, just like in Beaumont and will be seen by Dr Ordano on Tuesday. When asked, she doesn't admit to being in any pain or discomfort. They're currently looking for a different wheelchair for her with a pad, and I'm not sure if the mattress on her bed will suffice. She knows she needs to not keep pressure on the wound and turn/sleep on her side as much as possible. That's it medically.

When we arrived and requested assistance, one of her favorite aides, Kimberly, came out, gave her a big hug, welcomed her back and suddenly my presence didn't matter. (As Val pointed out, she's probably just as tired of seeing me as I am of her.)

When we arrived at her room and I started unpacking her things she was busy getting to know the family of the woman in the next bed, finding out all the stuff that she needs to know and expressing concern that she won't have a tray until the evening meal. A sandwich with tea were delivered and she was happy. I left her to complete unpacking and organizing her stuff to her satisfaction, returning about
5:30.

When I came in this evening she was sitting in her doorway, holding court with new residents since last week, getting reacquainted with others she knew before and in general being Ruth. It was great to see her smiling, animated and enjoying herself with others.

My car is packed and my plans are to sleep in my own bed tomorrow night. Byron & Colleen should be back in town tomorrow some time, Val will come down Tuesday for her Dr appointment and I'll be back in March.

Thanks for following along with Ruth's Great Adventure.

Anyone Have An Eraser?

I spoke with mom early this morning, reminded her that she is scheduled for discharge to Heartland as we've discussed and that all that needs to be done is the discharge paperwork.

She was in such a snit! After she ranted that she had no clothes to wear, she didn't know what was going on and that all her children wanted was for her to be out of her house. She calmed down after we discussed all her concerns, again, and I told her my plans to be there around 1 p.m.

When I arrived, she was sitting in her chair, finishing lunch and seemingly in a good mood. She said she found the clothes that were hanging in her closet, I reminded her again that we were waiting for discharge paperwork, the continuing care nurse came in, reinforced what I said and she responded with her usual "whatever".

When the doctor came in mom told her that she had had two more episodes of "her bowel problem". The doctor told her that means she'll be staying in Beaumont a little longer to allow time for that to clear up, explaining that if she was discharged with this problem, Heartland would send her back to the hospital and we'd be back where we started. Mom understood and said she didn't mind.

In anticipation of discharge today I had packed up some of her things so we unpacked and settled in for another day overlooking the atrium and fake foliage. After notifying Byron, Colleen & Val, I decided to return to Meadowlark and get this out.

As it stands right now, I suspect she will be in Beaumont through the weekend. I've checked with continuing care and Heartland is still holding a bed for her, should she be discharged this weekend.

I knew there was a reason I didn't wash the floors this morning. This blog is so therapeutic, thanks for reading.

Maybe We Can Pencil In Plans Today

When I spoke with mother earlier this morning she was in a snit because no one had come in to see her this morning, except to bring her breakfast, take her vitals and do daily blood work. She was having a wonderful time sitting on her pity pot and making herself miserable.

When I got there, about 30 minutes later, she was in bed, had her wound dressed and been to the bathroom, and still feeling sorry for herself. We talked for a while, spending time focusing on getting back to Heartland, reassuring her they do want her back and will have a bed for her. She seemed to be okay with that and was happy to see the Dr when she came in.

We are still waiting for the results of some samples that were sent to the lab, but all other indicators are fine. She feels strongly that mom may return to Heartland tomorrow, but that won't be for certain until the lab work is returned. Mom will continue to receive IV antibiotics at Heartland and the care instructions for her wound have been written already. I spoke with the continuing care nurse who assured mom that Heartland does have a bed for her, but it's on the second floor. We discussed the possibility of checking in around 2 tomorrow, if discharge is a go.

That's all we know so far today, I'll post any new developments later this afternoon.

When I returned to the hospital this afternoon Barb Deiss was visiting and mom was in a quandry. She is under the impression that Heartland doesn't have a bed available and she doesn't have any place to go. I told her what I knew and also reassured her that if she doesn't go to Heartland tomorrow, I'll be staying until she gets in.

Dinner was nice, she liked the dressing with the turkey and she has been sitting up most of the afternoon, feeling pretty good.

More will be revealed with the new dawn.

Her Bags Are Packed...She's Ready To Go

Okay, maybe today's title is a stretch, but those items mom needs at Heartland are packed and loaded in my car ready to be transported back to South Boulevard & Livernois.

After a rather explosive morning, it was determined that the antibiotics appear to be creating a small problem. I arrived early enough to talk with the Dr about several things. Starting with this mornings problem, her antibiotics have been changed and she is starting to receive Flagyl in an effort to counteract possible side affects. We discussed how much this will delay her discharge and she felt that based on tolerance of these changes, she may be discharged tomorrow or Friday. Her hemoglobin was 12 today and there doesn't appear to be any evidence of blood exiting her body. This leads to the next topic, the frequency of anemia and need for 4 blood transfusions since May.

Without doing invasive testing, I'll get back to this, she felt that there may be an ulcer that is slowly causing this problem. I discussed our concern about this situation and questioned if an endoscopy/colonoscopy would be the next step. Dr B said that right now, as the result of her heart attack in November, she is not a candidate, they prefer to wait at least three months before submitting her to these tests. She went on to add that should there be evidence of blood, causing concern, testing could be revisited.

So that's what is going on so far today. After she was cleaned up, calmed down and felt safe (but cold) I left for a few hours. Cousin Pat called about where to visit today and is planning on visiting mom this afternoon. When I spoke to mom a while ago, she said her friend Joyce was also coming to visit so I've decided to stretch my few hours to a few more and will return later today with her mail.

Those of you readers that are familiar with mom's logic, she doesn't want to eat for fear of another episode. The Dr, nurse, and I, have explained that the antibiotics appear to be the problem and it is important to the healing process and gaining strength to eat. Last night she complained about the fish and potatoes being too salty and her lunch of chicken cacciatore was too spicy. She declined something different last night, ate one piece of fish and her soup and fruit. Not sure what she's doing this afternoon but will mention tis to her nurse when I seem him this afternoon.

If there are further developments, I'll pass them along.

By the time I returned this afternoon, all her visitors had departed and she was quite animated. She had another eventful trip to the bathroom resulting in her wound being cleaned again. Byron came for a brief visit and assisted mom with her dinner. She has been sitting up a lot today and while there is some discomfort she is not in pain and comfortable

Thanks for reading

Tuesday - January 12, 2010 - The News Of The Day

When I arrived this morning mother informed me that they were kicking her out. I investigated this claim and learned that she is nearing discharge. I also learned that she does have a cracked rib as a result of time spent on her right side on that comfortable operating room gurney and for a while following surgery. She tells me that she is not in any pain right now and feels fine.

Dr Ordano contacted me with the good news from pathology. There is no infection, no evidence of tumor or malignancy and he cleared her for discharge back to Heartland. He also said he will continue to monitor her recovery in his office and I made an appointment for next Tuesday at 3:15. Her attending physician will have to write the final discharge paperwork, before she can move on.

I spoke with the continuing care nurse, Mary, about getting back in to Heartland. Their medical representative here at Beaumont checked her records and cleared her to be readmitted to Heartland when she's discharged. Mary has talked with Heartland and they look forward to her coming back.

It is anticipated that she will be discharged tomorrow or Thursday, depending on bed availability. Mom is anxious to move out of the hospital and back to Heartland, she isn't as active as she is used to and I think misses the company of the staff and other residents.

Her blood work is fine, her wound is healing. She's cold all the time and can control the temperature and has told me what to pack for her. She doesn't know that I've got her stuff together already, have ironed her blouses and am ready to load the car at a moments notice.

She had a great visit with her friend June and June's neighbor this afternoon and even though she found the food too salty tonight, doesn't want anything else to eat.

Pleasant dreams and drive safely.

Another Pleasant Beaumont Monday

When I arrived this afternoon, mom was sitting up in the chair, finishing lunch. She was pleased with her mail and enjoyed a nice card and letter. She mentioned that her derriere was sore and that she had been sitting up all day. I suggested she should consider getting back in bed on the soft mattress and after making her way to the bathroom, getting cleaned up and back that's what she did. Her nurse and NA were very attentive and kept a frequent watch on her. Byron received a call from the Dr earlier today requesting approval for a blood transfusion, apparently her hemoglobin level had dropped significantly and there was some concern. After getting the okay, they were finally able to get a new IV started for the transfusion and got it up and running about the time dinner arrived.

Reverend Miller visited for a while, we enjoyed talking about a variety of topics and I shared Byron's knowledge on the Olmacher questions posed earlier. Mother shared her familiarity with the Olmacher name and rattled off several other names associated with the early days of downtown Royal Oak business. It was quite pleasant.

She has been fed, had easy access to her phone and church directory as well as her call button. I think I'll take off soon to be back early and meet with the doctor.

Sunday In Beaumont With Ruth

It has been a pretty good day for Mom. She had several visitors, including all her children. She also enjoyed sitting up in a chair and reading the paper, and visiting with a friend from church (thanks for the flowers, Kathy). After she got back in bed she commented that she had been awake all day and she's in fine spirits even though she hasn't had a nap. When I arrived around 10:30 a.m., she and Val were in xray, checking out her ribs. She forgets she napped for an hour when she got back to the room.

I cornered Dr Ordano earlier this afternoon. He still feels Mom will be able to return to rehab, hopefully by the end of the week. The results of the biopsy will not be available until the middle of the week and I'm going to check with Continuing Care about getting her back into Heartland by the weekend. He also said he will follow up with her in the Wound Center and in a couple of weeks have her evaluated for the hyperbaric oxygen treatment.

I watched as her evening nurse changed the dressing and have to say as gross as it is, it looks a whole lot better than it did on Tuesday when we were at the Wound Center. It's not pretty, but it does look better with all the dead tissue gone.

I'll be taking off in about an hour and returning tomorrow afternoon. Thanks to everyone who called and visited today; she really appreciated it.

Another Saturday night with Lawrence

As I type Mom is watching the Lawrence Welk show, her favorite, on the PBS station (it's like a time warp to the mid 1970s). She's resting okay; her right ribs are still tender, and we learned just a few minutes ago that although an x-ray was ordered, it hasn't occurred yet. Cathy, her nurse, said the mobile x-ray unit has quite a backlog so it might be a while before it happens. I didn't notice any redness or bruising, which might be present if a rib were fractured. She winces whenever she has to move, but so far hasn't asked for any pain meds.

I haven't seen the wound, but Cathy, who changed the dressing twice today, said it was fairly deep and she was surprised that it got to that state. It made me wonder if we should have been more attentive to it when she was at Heartland. They were treating it, but obviously whatever they were doing wasn't effective. So here we are.

I arrived around 10:30 this morning. One of the first things she said to me (other than where's Dave) was that she still couldn't figure out why she was in the hospital. I explained to her what I knew, and she asked why her procedure couldn't have been done as an outpatient. Poor thing. At least she has a decent room this time. The south tower is like a Hilton. There are actually shelves for flowers (which reminds me, I should pick up something for her tomorrow), the rooms are bigger and the curtains between the beds provide more privacy, halls are carpeted to cut down on noise, and of course, she has the window and a lovely view of the atrium and the faux maple trees that are in a perpetual state of early fall.

She sat in the chair about an hour before and during lunch, then we got her back in bed for a nap. I left to have lunch with Dave, Byron, and Colleen, then ran some errands. By the time I returned she was finishing up dinner, and was happy when I reported that we had lunch together. But still a pretty sad gal. She's dismayed, confused, and frustrated that she's in the hospital. And since not many of her friends know she's here, she hasn't had any visitors and only one call that I know of. So if you're inclined to visit or call, please do; she definitely rises to the occasion when people other than us are around.

And where was Dave today? He had a much deserved day off. Not quite the same as being at home but I hope he enjoyed it.

Photo credit:
Beaumont Hospital South Tower atrium from HOK|ideas work,  http://tinyurl.com/y8p94bc

As The Sun Sets......January 8, 2010

Since returning to her room, mom has been sleeping on and off, mostly on. She did eat some of the chicken sandwich and salad that were brought in, but declined dinner.
She is in some pain/discomfort but not at the site where the procedure was performed. Her right side is very painful and she was concerned that she felt bone protruding. Her nurse checked her out, pointed out that during the procedure she had been on her right side, probably longer than she is used to, and her ribs protrude on both sides of her abdomen. I mentioned her pain tolerance to the nurse and wondered if a rib could have broken due in part to her osteoperosis. She didn't think so based on her physical examination of the area and administered her regular pain medication. So she's sleeping again.

I'm going to take off, head to the house and have a quiet evening, I hope. Val will be here tomorrow so I may take the day off and enjoy some of this fine Michigan weather.

Oh yeah, Reverend Miller mentioned that Royal Oak General had an earlier name, an article in Sunday's Daily Tribune mentioned Olmacher Hospital does that sound familiar to anyone? Ask mom.

As I was leaving and thanking her nurse and aide I was informed a portable xray has been ordered to check out the rib situation. Gotta love that response time.

Can you believe it? I've actually got internet access from Meadowlark. Go figure.

Well, We're Glad That's Over

Mom was wheeled into the OR about 1240 today. The usual questions were asked and answered, forms signed and explanations offered. Earlier today Reverend Miller came by to visit and stayed with us until we were informed of the delay. Mom was glad to see him, appreciated his prayers and kind words. I was able to get out of the surgical area long enough to kill a few lung cells, grab something to eat and return to the waiting area and get settled in when Dr Ordano came out to get me at about 1:15.

He reports that the wound did go to the bone and they were able to clean away all the dead tissue as well as the wound area. They took a sliver of the bone and a sample of the tissue and sent them to pathology for evaluation. It should be some time in the middle of the week before the results are in and mom will remain in Beaumont until then.

While in the hospital, mom will continue to receive antibiotics to fight infections and since he has put no restrictions on her, should be able to get up and walk about as much as she can tolerate. He also said it would be okay to return to Heartland and resume physical therapy adding the staff there should be able to continue to treat the wound side.

Dr Ordano said the healing process will be slow for mom due to the soft tissue necrosis he mentioned earlier. He also said that since the dead tissue has been removed there may be some discomfort or pain returning to the area. He has written orders for inject-able pain medication should that be necessary.

We also discussed the hyperbaric oxygen treatment he mentioned earlier. She will need to be evaluated before it can begin, if it starts it will last for 6 weeks and is a 2 hour treatment Monday - Friday. Since medicare is paying for this, there are stringent governmental criteria that must be met. (I'll spare readers my comment about the chamber Michael Jackson had.)

She should be out of recovery and back in her room by now so I'm going to post this and go see how she is doing. Thanks for your patience.

Thursday, January 7, 2010 - Addendum-Part 2

This just in! Surgery is on.

Cardiology just came in and cleared mom for surgery tomorrow. As previously reported, she is scheduled for 10:30 so they will be taking her down around 9:30 tomorrow morning.

That's all folks

Thursday, January 7, 2010 - Addendum

Tara from Dr Orando's office came in to check on things and told us that surgery is scheduled for 10:30 tomorrow. She reiterated that they are waiting for cardiology to clear her for surgery but our fingers are crossed. It was explained to mom that if they can't get her clearned for tomorrow, it will be Wednesday before they can get her done. Tara also expressed hope that cardiology will have cleared her by then.

I'm hoping cardiology will be here some time before I leave around 7 or very early in the morning.

Keep your fingers crossed.

Thursday, January 7 2010

When I arrived this morning, mom was back from xray and getting cleaned up. Xray of what you might wonder, I don't know and she didn't either. As the day progressed normal activity was carried out. Blood work, periodic checks of BP and temperature those items of normal activity. The chaplain for this area came by and spoke with mom for a while. I mentioned to her that mother has expressed being afraid. Afraid of what's currently going on, what's going to happen and about death. While they were discussing these topics I left to meet a friend for lunch in the cafeteria.

When I returned, mom was sleeping and Dr Raam with Dr Sandburgs group left a note indicating that she is on the schedule for surgery tomorrow dependent on clearence from cardiology. Her blood work is good, hemoglobin went up a little, she's eating well and making use of the facilities at her disposal.

The nurse from continuing care was in and the usual questions about living arrangements were answered. I patiently explained that she was sent here by Heartland where she was sent after being in patient here for 3 weeks and we'd like to have her go back there. She does need some additional PT and it is hoped we can get her back there next week. The continuing care nurse suggested we also have a backup plan.

She has been sleeping a lot today and whever she wakes she is disoriented. I was off the floor for a few minutes and when I came back she was all upset because someone had been in and lead her to believe she was going to get kicked out and they were calling Val because she couldn't find any of the phone numbers. Someone had given her the log book and she was going through it, finding the numbers and checking out what was in the book. Further questioning leads me to believe when she woke up, she was thinking about th CC nurse and when I checked with her nurse, she informed me that no one had been in that she was aware of.

When she wakes up from a nap she seems disoriented. Not sure why she is here, what's wrong and believing she is going to be kicked out. I've gently answered her questions, calmed her down and gotten her back to today. I'd like to get her up walking a little bit or at least doing some exercises while she's in bed but it hasn't happened yet.

That's about it for today. Drive safely



I'll check with the unit secretary after 8 p.m. for the time of her surgery tomorrow.

A room with a view

Mom was admitted to Beaumont this afternoon and is in room 6314, south tower. She's in the bed by the window and has a view of the atrium. Nurses, CNAs, PAs and Drs have been in to see her, the same questions have been answered again, and they were finally able to start an IV. Her phone number is 248-898-6314 and she has already received several calls. I spoke with the Dr regarding when surgery will be. He won't know until tomorrow some time, but hopes it will be on Friday.

On the drive from Heartland Mom talked about her fears. Fear of dying and fear of what's going to happen next. I suggested she talk to her God about it and maybe find some solace.

As the attention continued, her spirits seemed to lift. She's looking forward to dinner shortly and is glad she's on a regular diet.

That's it.

And so we're going back to Beaumont

Sorry I couldn't come up with a more clever title for today's entry. It does catch your eye though, doesn't it?

The NYE celebration at Heartland and subsequent days of parades, football games and visitors were pretty normal. Val, Colleen & I visited Saturday, a friend from church visited Saturday evening, and Byron & Colleen and I visited on Sunday. Yesterday she participated in physical therapy and had some good workouts. Today when I got here, her PT got her up and walking prior to leaving for the appointment at the Wound Center. Pretty regular stuff for Mom and she was feeling pretty good, raving about the vegetable soup she had for lunch.

Prior to the Dr looking at the wound (measured at 50 mm x 40 mm, which translates roughly 2" x 1.5"), the nurse explained what causes decubitus ulcers (bed sores), as well as problems associated with them. In her presence I made sure mom understood everything and let her know she didn't do anything to cause the problem. In talking with the nurse I expressed surprise that she hasn't been in any pain or discomfort, but learned that since this sore is in her sacrum (the location of the bone infarct), there are no nerves and hence no pain.

Dr. Ordona came in, took a look, asked some questions and then discussed the cobalt treatments she received all those decades ago, in the early 1960s. He pointed out that this is the long term affect of the cobalt and the issue is soft tissue radiation necrosis. Mom spoke up at that point, sharing that Dr. Schuneman (our family doctor of yore) told her the cobalt would probably wreck havoc on her body in 40-50 years. As luck would have it, Dr. Ordona remembers Dr. Schuneman's name, and also saw patients at Ardmore hospital, where Mom had her colon cancer surgery. I didn't think he was that old! Anyhow, it made Mom feel connected, always a plus.

At his recommendation, Mom is going to be admitted to Beaumont tomorrow and he is (hopefully) scheduling surgery for Friday. If it can't be scheduled for Friday, it will have to be on the following Wednesday (the 13th). The options presented were to go to the ER for admission right then, waiting for a hospitalist to be assigned, or let Dr. Ordona's office try to get a bed and have the hospital contact me tomorrow. I picked door #2 and brought her back to Heartland.

The procedure to be performed will consist of removing the dead tissue, possibly scraping the bone and testing for an infection in her bone. This will be done under mild sedation with a local anesthetic. Since she is in no pain and has no feeling in that area, that seems like the best thing to do. Her stay in the hospital will be 5-6 days following surgery and then discharge to some kind of nursing home.

Follow up care will consist of hyperbaric oxygen treatment daily. This treatment will take two hours a day. She will receive this treatment while in the hospital, I think, but will require it daily following hospitalization for at least six weeks.

One other option that was discussed was plastic surgery to fill in the hole, but the soft tissue radiation necrosis precludes that.

So that's it. The hospital is to contact me tomorrow. If I haven't heard from them by noon, I'm to contact the Wound Center for assistance. Hope I didn't forget anything.