One Journey After Diabetic Coma

(Tricia)   We were very lucky that, C.diff or no C.diff, the gastroenterology office at SSM agreed to see Linda virtually this time around. Thank goodness—I did not want Linda to have to wait for this appointment any longer. This afternoon, I went over to nursing facility with my laptop, so that we could meet with the gastroenterology practice’s nurse practitioner. But the virtual appointment had hardly started when the nursing facility’s doctor came into the room like a whirlwind. She took over the conversation fully, in an exchange that went something like this: Doctor: We need to do something! This woman has had C.diff five times while she has been here! NP: Um, well, how often have you tested? Doctor: Maybe once a month! NP: Well, you're supposed to test no more frequently than once every three months, so that you can give the infection time to — Doctor: That's not the issue! The issue is that we have to help this woman! Nurse Practitioner: Um, OK...So, you ’re not admini...

(Tricia) Marilyn said that it was quite the morning today. Linda’s bloodwork came back, and Dr. Ramanathan had called it: Type 1. It was all hands on deck. As Marilyn was walking out this morning, she came across the doctor talking to several NHC staff, saying “That woman cannot continue to live like this!”  Marilyn guessed that they might be talking about Linda, and she was right. The doctor called her over and brought her into the conversation. According to NHC’s doctor, the way they were giving her insulin will stop immediately—apparently, that was doing her no good (understatement). NHC’s doctor will now work with Dr. Ramanathan to come up with a new more regimented treatment plan. Unlike Type 2 diabetes, Type 1 diabetes is not affected by a person’s diet, weight, or lifestyle. It is an autoimmune condition that requires a different type of monitoring and insulin administration. But as I said in a previous post, doctors are often highly unlikely to suspect Type 1 in a senior a...

 (Marilyn) I spent the morning with Linda and she was supposed to have restorative therapy.  I saw the therapist walking around, chatting with co-workers, etc., but he avoided us.  So I stopped him and asked if he was coming and he said he had other priorities before he could come to Linda.  What the heck??? So it is clear to me that they don't want us there and I don't get it.  So anyway, it is now time to forge ahead on our search.  Tricia already toured Sunrise and I'm going to go for a tour. this week. Linda was in fairly good form this morning.  She kept talking about being tired from her many trips to Savannah.  And she kept trying really hard to remember words.  So it was a good morning.

(Tricia) We are trying a new schedule of visits for Linda this week, to give Marilyn some time to heal from the tumble she took! For at least the next week, I will be seeing Linda in the morning and Ed will be visiting her in the evenings.  Because I’ll be there during the day, I’m also hoping to speak to the physical therapy team about how we can get Linda the rehab she needs. Now that insurance has stopped covering Linda’s care, the facility will provide only three “restorative” PT sessions each week, compared to the six she was receiving before. The problem? Linda is refusing to participate! She is maddening. Marilyn spoke to Tyler, one of the physical therapists, on Saturday, to ask whether she was receiving these PT sessions. Tyler said for the most part, no. He explained that one day, he and Justin went in and begged her to do her therapy. She was, in Tyler’s words, “downright rude.” He said that he didn’t want to repeat what she said, but that she was so nasty she made poor ...

(Marilyn) Well, we talk about Linda falling, but a week ago Saturday I fell flat on my face on concrete.  Broke my nose, sprained my wrist and little finger, twisted my knee and bruised my ribs.  I hurt all over.  Was in ER all day for x-rays, CT scans, etc.  Got some codeine. Good grief. Then today I arrive at NHC and the nurse tells me that Linda fell again this morning.  When I got there, she was in bed and refusing food.  Some days it is just hard to cope.

(Tricia) Now that we have moved to a private pay situation for Linda, her room has become much, much quieter. Although we were told by the facility's case manager that Linda would still receive three sessions of week of "restorative therapy" (therapy meant to help her maintain her current abilities), she has, as far as we know, received no therapy at all for the past week. I now have a message to the case manager to ask how the restorative therapy will work and how much skilled therapy, if we wished to add that service on, will cost. It is exhausting to try to keep up with it all. At the same time, we have toured two other facilities to see if we might find more consistent care elsewhere. So far, though, we have not been reassured. We toured one facility, The Boulevard in St. Charles, and it was beautiful. The rooms and facilities seemed luxurious, almost like they would be at a nice hotel or resort, compared to NHC St. Charles' more clinical, hospital-like environmen...

 (Marilyn) The last few days have been a blur.  Linda has been kind of out of it in the mornings when I'm there and much more alert and lucid in the evenings when Tricia and Ed are there.   The Medicare insurance has ended so we are heading into private pay.  Very expensive.  So Tricia and I have been doing tours of other local Memory Care facilities which has been exhausting. They will very soon be moving Linda to a different room at NHC. Tricia will probably post something soon but we're both a bit stressed.

(Marilyn) Well, the insurance has finally ended so we are in a transition period.  Linda will be transferred to the Long Term section of NHC. Whenever that is, we will be involved in moving her stuff and making her as comfortable as possible in her new surroundings. At least she will get rid of the screaming woman and let's hope there's not a screaming lady in her new spot ... LOL.  Today she was extremely talkative but none of it made any sense.  She told me a very long story about a guy named Roy (I'm thinking Roy Rogers?) who rode a horse and didn't want women riding horses and every time he saw a woman on a horse he stopped and made her get off the horse and then he got back on his horse until he saw another woman  on a horse, etc.  Tricia arranged an appointment with an endocrinologist which is coming up soon.  Linda's sugar still keeps bouncing all around and we are hoping we can get it under control.  

 (Marilyn) Even though Tricia has been working tirelessly to stretch out the insurance as long as possible, they now have officially brought it to the end.  Starting today, we have to pay for Linda's room, board and any necessary care ourselves. This will be a short post.  In the next few days they will be moving her to the more "permanent" wing.  We're not sure what to expect.   I'm sure Linda will be glad to not see the physical therapy people any more (most of the time she refuses their sessions anyway).  She is her own worst enemy. Stay tuned.