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Friday, August 30, 2013

Preparing for Another Surgery (I hope)

Bob's second foot surgery was scheduled for August 26, but was canceled by the foot surgeon as the pre-op tests picked up a urinary tract infection. This after the primary care doctor gave the "go ahead" for the surgery. The primary care doctor didn't think a UTI was reason to cancel surgery, but the foot surgeon nixed the whole idea. Bob's been on antibiotics since and I just collected another urine sample for the lab yesterday.

Now, this surgery is scheduled for next week, September 6th. If the urine sample comes out clean...

Trouble is, we won't know if the urine sample is clean until the lab results come back and that takes 72 hours. And we are approaching a weekend and a holiday.

And I'm supposed to take him off warfarin five days in advance. Then start the Lovenox shots again. Which would all start on Sunday.

When I talked to the nurse at the doctor's office about this dilemma, her suggestion was to reschedule the surgery, again.

Which I don't want to do. I want this surgery done and over with. I want Bob "back to normal" and free of pain as soon as possible.

Bob's foot, between surgeries. Three straight toes, two still curled.

So I talked to the lab tech and he suggested I call his office on Sunday morning, leave a message with the answering service which will contact him, and then he'll call the lab and get the results for me.

Let's pray this all works. Let's pray that sample is "clean". Because I'm at my wit's end.

I can't even begin to explain how trying this blasted foot problem has been.  How stressful the days and nights have been for me. How much pain Bob is in. How every single day, the morning starts off with Bob complaining and crying about that foot and the pain seems to worsen as the day goes on. And I am constantly applying ice or adjusting pillows or giving extra pain meds. How this problem has wrecked all the good things he was accomplishing in therapy. And how weak he's become because of that. How everytime we see a doctor, any doctor, Bob begs and pleads for them to "chop it off" and when they say they cannot chop his foot off, he starts crying, shaking all over and saying "pain, pain, pain" over and over and over. How those scenes bring me to tears. How some days, Bob refuses even to get out of bed because the pain is so great. And this has been going on for months now...

And I am tired. Very tired of it all. And just want the whole thing over with.

I tell you, if we don't get this surgery soon, I'll be the one wielding the axe.... and not to chop off Bob's foot, but aimed toward a certain doctor's neck!

Sunday, August 25, 2013

The Pleasures of Dealing with Bureaucracy

Earlier this week, Bob received a glossy brochure in the mail from the insurance company. The brochure read: Thousands of United Healthcare Medicare Advantage members save $104.90 a month in Medicare Part B Premiums! It's easy to see if you qualify! Then, in two large colored boxes:

To qualify if you're single:
Your gross monthly income must be under $1,456.25 with less than $13,300.00 in assets.

To qualify as a couple:
Your gross monthly income must be under $1,958.75 with less than $26, 5840 in assets.

And I'm reading this, thinking, wow, he now qualifies for this! I had heard about this program before, but last I checked it, he didn't qualify because his income was too high. So they must've changed the income guidelines. And I'm thinking wouldn't it be nice to not have to pay that $104.90 Medicare premium every month?!! We really could use a break.

The bottom of the brochure reads: Call today to see if you might qualify! so I call the toll-free number and I get connected to a "social service coordinator" and I tell this guy that we received this brochure from United Healthcare regarding saving $104.90 a month in Medicare premiums and it looks like my husband qualifies for this program. And I tell him right up front the amount of Bob's SSD check and ask him if he needs my husband's United Healthcare member ID number.

He tells me no, that he's already got that information, and then he rattles off Bob's full name and address, and I'm figuring, okay, Caller ID and United Healthcare's computer system must've picked up that information and put it on the guy's computer screen already.

Then, he tells me that he cannot talk to me, that he must talk to Bob.

I tell him that I have authorization on file to speak in my husband's behalf, because my husband has aphasia and does not speak well.

He tells me that authorization is with United Healthcare and he is not with United Healthcare but with a company contracted through United Healthcare. So that authorization does not apply.

So I tell him, I have power of attorney, too.

He tells me that I will have send a copy of the power of attorney to their office before they can speak to me.

I tell him that document is 15 pages long. Which means I would have to hire a sitter for my husband, go photocopy 15 pages of a legal size document, then buy a legal size envelope and go to the post office to have it weighed and mailed to you, and you want me to do all of this just to talk to you?

He says, yes.

I tell him, really, I just want to know how to apply for this program, because it looks like he now qualifies as the income limits have changed.

And he tells me, that in order to apply for this program, he (the social service coordinator) must determine first that he (Bob) qualifies.

So I say, well, my husband can give you verbal permission to talk to me. Would that work?

He says, yes, that would work.

I tell him, you'll have to ask him "yes" and "no" questions. He can answer "yes" and "no" questions.

He tells me that he cannot ask "yes" and "no" questions. That Bob must be able to state his full name, date of birth and his address before he can give me permission to talk on his behalf.

So I tell him that's not possible, Bob is never going to be able to say all that stuff.

He tells me to write it all down on a piece of paper and have Bob read it to him.

Which is not going to work. Not at all. I know this. And I tell him, in so many words, that's not going work.

He tells me in that case, I'll just have to copy off that POA document and send it to them.

So now I'm a bit frustrated, so I tell him that I'll give it a try and give me a minute. So I get a big piece of paper and write in large letters Bob's full name, our address and his birthdate. I tell Bob I'm going to give him the phone and needs to tell this guy this information. Bob says, "I'll try."

So I hand the phone to Bob.

I'm sitting next to him, pointing at the words on the piece of paper. Bob listens on the phone, and he tries to say his name but all that comes out is the last syllable of our last name.

Then Bob says, "Three. Three. Three." which,  by the way, has nothing to do with our address. And then Bob says, "Avenue".  Which is actually one part of our address. And then he gets tongue tied and just starts making strange noises....

Then there is a pause.

And Bob says, "Nineteen twenty." Which has nothing to do with anything.

And Bob says, "Yes" and hands the phone back to me.

I say, "Well, that didn't work."

The social service coordinator says, "He tried."

I figured that was the end of it and now I would have to send off the POA papers--when the guy surprises me and asks for Bob's monthly check amount.

I tell him the amount. Which, by the way, I had already told him at the beginning of the conversation. But I tell him it, again.

Then he asks if Bob has a copy of his benefits statement from Social Security.

I tell him, yes. Do I need to get it out? (Thinking he needs some number or something off of it.)

He says, no, he just needs to verify that Bob has "read" it. (Like, yeah, right...)

And then he tells me that Bob does NOT qualify. That his income is too high.

And I tell him that according to the amounts listed on the brochure he DOES qualify.

That's when he tells me that the brochure has THE WRONG INCOME AMOUNTS on it,


So then, just the other day, Bob gets a letter from United Healthcare which states We have received notice that one of your addresses may have changed. And he needs to contact their office with the new address. And I'm thinking, what the f--? Because our address hasn't changed. Heck, we've lived in the same house for ten years.

So I call United Healthcare and, I hate to admit, I am not the nicest person in the world. Because, what is their problem? And where'd they come up with this weird information? Probably the same place they found those income amounts for that brochure.

Anway, the customer service rep tells me that they were notified by a certain government agency that Bob had a change of address. And she gives me the government agency's number and tells me that I should call them right away, otherwise Bob might be in danger of losing his benefits.

And I'm thinking, jeepers! Because we need those benefits. So I call the government agency, and after being on hold for 45 minutes, which gives me plenty of time to think, I decide I am not going through that whole fiasco I did with that social service coordinator.  If Bob's benefits are at stake, I have to get to the bottom of this and there is no time for copying and sending 15 pages of POA documents because the mortgage is due on the first and we are down to $56.00 in the bank account.... So I go into a survival mode and do what must be done. Which is this: I become Bob.

I mean, my voice is on the lower end of the scale. And I figure if I just speak slowly and try to keep very monotone and don't screw up and say the wrong thing like "my husband"....

Finally, an agent comes on the line and I give her Bob's social security number.

And she looks up the file and asks, "Is this Robert? Or someone calling on his behalf?"

And I actually I tell her I'm Robert. And, truth be told, I can't believe I'm doing this.

And I don't think she believes me either, because she asks me for our address, phone number, then PLACE OF BIRTH, then MOTHER'S MAIDEN NAME, which makes me quite nervous but I sail through those security questions without a hitch.

Then I tell her, very slowly and in a monotone voice, about United Healthcare saying they were notified by this agency that our address may have changed and they said that MY benefits might be at risk, and that "my wife and I" have lived in the same house for over ten years and we certainly have not moved and I want to make sure that there ain't a problem here, etc. etc.

And halfway through my speech, I am horrified to realize I am suddenly speaking with a Southern Accent! That I am saying things like "ain't" and "mighty fine" and "you all" and "yes, ma'am" and "much obliged" and GA! Where did THAT come from?

And, after all of that, I find out that that agency hadn't notified anyone of any address change...

As if life isn't hard enough---so do I really need to deal with all this bunk?

Speaking of which, Bob's foot surgery has been rescheduled for September as his pre-op lab tests showed he has a UTI and he's been prescribed an antibiotic and we have to redo the pre-op tests this week. And the doctor's office did not inform me of all of this until AFTER I took Bob off the warfarin and started the lovenox shots. The reason for the delay in calling me? They LOST THE FAX from the lab....

Enough said.

Tuesday, August 20, 2013

Sleep: Glorious Sleep

This morning, I could not wake up. Though I tried to wake up. Kept opening my eyes and seeing, without my glasses, those blurry red numbers on the digital clock warning me it was just after 6:00 a.m.

Sleep kept slipping in sideways. Pulling me back. Even though I knew I had to get up. The home draw technician was due at 8:00 a.m. and before he arrived, I had to disconnect the feeding pump and flush Bob’s tube. Then crush and dissolve Bob’s morning medications and syringe those into his tube. Not to mention, change his bed pad and make him comfortable. And walk the dog. And feed the dog. And take my bath and get dressed. All before the lab technician arrives at 8:00 a.m. to draw blood from Bob.

But sleep has a magic power. A sort of slipping down into the gentle darkness that one cannot resist. A melting into the memory foam mattress pad on my bed.  And I grasped the safety edge of sleep and let it pull me back into the beautiful dark. Into a dream.

A dream where Bob walked and talked like he used to. Where he stood tall next to me and put his arms around me and looked down at me with those blue-blue eyes.  Where he remembered my name and brought me coffee in bed and took out the trash.  And I thought, in that dream, I just want to stay here. Stay here in this dream forever.

But my eyes fluttered open and the blurry red numbers on the digital clock read 6:15. And I thought, no, I must go back to that dream. Just for a little while, just a few more minutes. I can take the dog for a shorter walk. I just need to get back to that dream.

And I closed my eyes and let sleep take me down, down, down into the dream. Where Bob opened the car door of The Green Machine so I could climb into the passenger seat. He always did that. Not just because he was a gentleman, but because the lock on the driver’s side does not work, so I needed to get in first to open his door from the inside. Which is what I did, in that dream. Open his door and he got in. And he turned to me and said, "Where to, Sweets?" And I said, "Anywhere but here, Bucky. Anywhere else, but here." Then we were driving on a bridge over sparkling blue waters and the sun was shining and the car windows rolled down and I stretched my arm out the open window and caught the wind in my hand...

My eyes flutter open and the blurry red numbers on the digital clock read 6:28. And I thought I must go back to that dream.  I can take the dog for a very short walk. I can take my bath after the home draw tech leaves. I closed my eyes and let sleep overtake me once again.

But the dream was gone. And now I was dreaming that I was in a shopping mall, in a store that sold only blue jeans, and I was searching for Bob. But I couldn’t find him. I couldn’t find him anywhere.

I woke up with a start. The blurry red numbers on the digital clock read 6:55. I shot out of bed because, oh crap,  the home draw technician was due to arrive at 8:00 a.m. And I still have to disconnect the feeding pump and flush Bob's tube and crush his meds and syringe those into his tube and walk the dog and feed the dog and change Bob's bed pad and take a bath and get dressed and boy-oh-boy I am behind schedule!

Lately, I just want to sleep and dream forever….

Monday, August 19, 2013

appointments, appointments, appointments...

Last week was a busy week. Monday was Pain Management, where the doc decided to order a new compounded pain medication that is applied topically. Unfortunately, the specialty pharmacy called yesterday to inform me that this medication is not covered by Bob's insurance and would I like to pay cash? How much, I ask. And am told it's $30.00 for a two day supply! Well, jeepers, forget that...

Then Tuesday, we were back to see the high-speed urologist, who zoomed into the room and ordered another ultrasound and zoomed away. This time, the ultrasound showed Bob retaining only 215 ml of urine. So the doc zooms back in and tells us everything is good, good, good! So it must've been the Vesicare, after all! And see me in six months! And off he zooms. Big sigh of relief here.

Wednesday morning, Chris came to sit with Bob so I could run around and try to find Bob's pain patches. Fortunately, I was able to obtain both at one pharmacy. Which is nothing short of a miracle.  And that also gave me time to pick up some groceries then gas up The Green Machine and dash to the bank and get back in time to get Bob ready for Wednesday afternoon PT.  I must admit that Bob has been very cooperative and the therapist has been timely in arrivals... But, man, are we going through the Ben Gay.

On Thursday, we were back at the foot surgeon's office to have Bob's pins pulled and where they took yet another x-ray and I was rather shocked to see there is a BIG METAL SCREW in Bob's big toe which is permanent. So I guess we will be setting off metal detectors in the future. We also got all set up for another foot surgery on the 26th... The doc says he'll remove the knuckles and pin those two little toes this time, plus he has to do an additional "resection" on the smallest toe. Which all sounds quite painful. I do hope this works. I tell you, I am tired of dealing with this foot problem. And heartbroken every time we encounter this doctor and Bob begs him to "chop it off!"....

Friday was PT re-evaluation, where Bob got approved for 13 more sessions.

And maybe, one day, I'll be able to wake up in the morning and not be already exhausted...

Truth be told, I am beat.  And this week's schedule looks just as busy...

Sunday, August 11, 2013

Just in the nick of time...

It's been a busy week, heck, it's turning into a busy month. It's only the 11th of August and Bob has already had five doctors appointments this month. With three more next week and two more the following week, then the second foot surgery on August 26th and another doctor's appointment at the end of that week. Add to that, twice weekly physical therapy.

It's enough to make your head spin.

Most of these doctor's appointments are pre-op (and post-op) for the foot surgeries. Then there is the urologist, with two appointments this month, so far.  And, of course, we have our usual suspects, like Pain Management and the neurologist and the primary care doc.

The other day, I was looking at the calendar and feeling quite stressed out. "Quite stressed out" is probably an understatement, as I was rather sick to my stomach and close to tears. Because each one of those specialists charge a $35.00 copay. And ten specialist appointments in one month equals $350! Not to mention the $8 each round trip wheelchair transport ride and ten rides equals $80. Not to mention the $250.00 upfront copay for the second surgery.

Jeepers. The medical bills are higher than the mortgage payment this month! And that's not even counting the other copays for the pre-op tests and lab work and, god-knows-what-else for these two foot surgeries.

And just when I was feeling really low, when I had spent too many nights, alone, on the front porch crying my eyes out after Bob had fallen to sleep, when I started wandering about the house, tearfully looking for something to sell for some quick cash -- just in the nick of time...

Out of the blue, Bob's mother sends us a check for $100. Then Chris arrives and pays me back the $100 that I loaned her last year (to pay for her dog's surgery after it was bit by the neighbor's pitbull). Then my mom and dad send a check to cover Bob's entire foot surgery copay! And just Friday, one of the wheelchair transport drivers hands me two $40 pre-paid cards that will cover the cost of ten round-trip rides! He had gotten the cards from a former client who moved and no longer used their service. That former client had told him to 'give them to someone who needs them'.

And yesterday, I got a letter in the mail from our credit card announcing they've upped our credit limit on our maxed-out card by $1000!

So, phew! We'll get through this month. By the skin of our teeth.

Though I do wonder how other people manage it....

Tuesday, August 6, 2013

And now, Bladder Trouble...

Yesterday, I took Bob to see the urologist. This was strictly a follow-up appointment, and I didn't have a lot of concerns, though I wanted to ask about our condom catheter blow-out problems and discuss his medications.

Bob had gotten a letter last month from the urologist informing us that his urologist was now retired and we would be seeing a new doctor. So I'm thinking, new doctor, maybe some new ideas. As Bob has been on several different bladder medications and none of them really seem to work that well.

So, anyway, we get there and the new doctor zooms into room and introduces himself. And I mean he zooms! He's this little Asian fellow and he talks really fast. He moves really fast. And I am mean really, really fast. I had a hard time understanding him and had to keep asking him to repeat himself. And the guy couldn't seem to sit still and kept jumping up and down and from subject to subject.

The first thing I ask this new doctor is about Bob's medications. And I pretty much just get the question out of my mouth and the doctor announces, "Let's do an ultrasound!"

Okay... though I'm not sure what brought this on. And the doctor zooms out of the room and the nurse comes in with a very small, portable ultrasound machine. When the nurse is finished, the doctor zooms back into the room, and he says, something like this:

"He's retaining urine! The ultrasound shows 300 cc though usually that ultrasound is not right, usually it underestimates, so if it's saying 300 cc it's probably really more like 500 cc and that is dangerous. Very, very dangerous! He could go into septic shock! That could be fatal! He's going to need intermittent catheterizations! And he's going to need a pacemaker in his bladder or an indwelling catheter, the pacemaker only has about a 50-50 chance of being effective, I can give you a DVD to watch, but we could also do a supra-pubic catheter! Do you know how to do an intermittent catheterization? You'll need to do this four times daily! If you collect more than 200 cc each time, then we have a real problem! All stroke survivors ultimately end up with this problem, I see it all the time, but this is bad! I've never seen it quite so bad!"

OK, by now, I am in shock. And don't know what to say. Because this has caught me completely by surprise. Plus, I can't get a word in edgewise. I do manage to sputter something about emptying around 2000 ml from the bed bag every morning, so it seems like he is passing fluid--and the doctor interrupts me with something like this:

"It doesn't matter how much urine comes out! It's how much stays in! The kidneys can operate at 20% of their capacity and you wouldn't even know anything is wrong until it's too late! Then it's septic shock! Which will be fatal! Or needing to go on renal dialysis! Because the kidneys shut down! And it doesn't  matter how much comes out! It's how much is retained! If his kidneys shut down, he'll die! Understand? And you'll need to do an intermittent catheterization four times a day, to empty his bladder four times a day! And, as I stated before, if it's less than 200 cc, you don't have to worry! But if it's more! Well, that is dangerous! Very, very dangerous!"

Me, I'm still in shock and I don't say anything. Truth be told, I'm probably looking rather stupefied. But I'm thinking, four times day? Intermittent catheterizations four times a day?!!! Holy crap. Because that sounds like a real pain in the butt, not to mention, how expensive is this going to be? Because those catheters are single use only and just ten of them cost around $30.00 for the co-pay. And what about the condom cath? I'd have to remove that four times a day? And those are single use only.... and septic shock? renal dialysis? jeepers!  This can't be happening.

And the doctor says something like this:

"You look like you don't believe me! Don't you believe me? You want to get a second opinion? Go and get a second opinion if that is what you want! But don't take too long! Because this is a dangerous situation!" Then he opens Bob's chart and shows me the results of the urodynamics test that Bob had done two years ago and he points to some pink colored squiggles on the chart and says, "See this. This shows his bladder is paralyzed. And this is not going to get better. It can only get worse. Worse and worse then it's pacemakers, I can give you a DVD, or a catheter or dialysis!"

Then Bob pipes up and says, "Hey, one, two..." and he's counting on his fingers.

The doc says, "What's he saying? What's he trying to say?"

I say, "I'm not sure."

Bob, still counting on his fingers, says, "One... two.... one... two... how much?"

The doc says, "What's he mean? What's he mean?"

Because I've become an expert on Bob-speak, I say, "I think he means he just urinated 1 to 2 hours ago."

Bob says, "Exactly!"

The doc says, "Well, that doesn't matter! It's not what comes out! It's what stays in!" Then the doctor stops and looks again at the chart, then he says, "Vesicare? He's taking Vesicare?!"

Which is the overactive bladder medication that the old urologist had prescribed.

And the doctor says, "Vesicare can cause urinary retention! Take him off the Vesicare immediately! Then bring him back here in a week, we'll do another ultrasound. Maybe it's just the Vesicare. Let's hope it's just the Vesicare! Vesicare will stay in the body for 72 hours so bring him back in a week!"

And I say, "What about the four times a day intermittent catheterizations?"

He says, "Don't worry about that right now! It might be just the Vesicare! We'll know, next week!"

The doctor zooms out of the room. The nurse comes in and drains Bob's bladder and gets 400 cc out. And we make an appointment for next week.

All I can say is, jeepers, and pray it's just the Vesicare...

Friday, August 2, 2013

To Continue PT or Not Continue PT....?

That is the question.  But first,

The Battle: Part 3


So the PT came again and Bob, bless his soul, was cooperative and did all the exercises without complaint. Even though I could tell that he was in a lot of pain. So, dropping the nursing home bomb worked on Bob, at least for now. The therapist was only 15 minutes late and stayed 45 minutes, this time. Which is better than two hours late and staying 30 minutes as she did the first time. But not as good as the second time, when she was on time and stayed a full hour.... I hope this is not becoming a trend.

I do begin to wonder if we should even be continuing with the PT right now. It seems such a torture for Bob and that is mainly because of his foot. But the therapy was prescribed for post-Botox treatment of his neck and hamstring, you know, stretch those muscles out and try to get him a bit more range of motion. His neck is still very, very tight, though that hamstring seems a little more relaxed. And though he does complain that the neck massage and stretching "hurts", he is mostly complaining about that darn foot.

Yesterday, we went back to see the foot surgeon. We had a 9:25 a.m. appointment, and I tell you, I hate those morning appointments, because that means I have to get up at 5:00 a.m. and rush around like a madwoman to get us both ready for 8:30 a.m. transport. After all of that, the foot surgeon, of course, was running behind schedule. Once again, a tech came in and x-rayed his foot.

Finally, the doctor arrived and said the x-rays look "good", but then Bob piped up with "CUT! CUT!" and "OFF! OFF!" meaning he wanted that doctor to amputate his toes, right then and there. I was rather shocked by this outbreak, as Bob and I had discussed this appointment before hand, as we always do--mainly because I need to know exactly what he wants from the doctor before we go, as most doctors do not have the patience to listen to Bob while he tries to find the right words to express his desires. Well, we certainly had not talked about amputation! To me, that seemed a rather drastic solution to the problem. And I tell you, the doctor was pretty shocked by this too.

So the doctor squatted down by Bob's foot and pointed to each toe and asked him if it was that toe which hurt. Bob indicated that every toe hurt and he wanted them all cut off! Yikes. By now, I'm quite baffled because before hand, when Bob and I had discussed this at length, I was under the impression that the first three toes were "better" (Bob's word) and it was those two little toes which were the problem. So, I pipe up then and tell the doctor this, and Bob points an accusing finger at me and snarls, "NO! WRONG!"


The doctor seemed just as baffled as me, saying that the three big toes looked like they were healing well and stating that he was "sure" he could "straighten out" the two little toes with another surgery. This time, however, instead of just cutting the tendon, he would remove those "knuckles" and put pins in them.  Hearing this, Bob said, "NO! CUT! OFF!"

And the doctor said that he thought amputation was quite drastic, although, if the surgery did not work, he would consider it. But he really thought the surgery would be the least drastic measure here and should be tried first.

By then, Bob is nearly in tears. Heck, I'm nearly in tears. But I ask the doctor how soon we could have this surgery, because, really let's get it done as fast as we can. He asked when the pins were scheduled to be removed and I told him August 15. And he said, he could probably "take out the pins and do the second surgery at the same time".

So I ask the doctor if we can do the surgery at the hospital (where Bob gets financial aid) instead of the surgery center. And I mention that the anesthesiologist had said we should not have been at the surgery center, but at the hospital, as the surgery center has no emergency equipment etc. if there is a problem. But the doctor pooh-poohs this idea, telling me that he doesn't have "privileges" at the hospital and he would get "bumped" and have to do surgery "after 6:00 p.m." plus he doesn't like their facility and equipment and, he said, that since Bob had no trouble with the first surgery, there was no reason to think he would have trouble with the second as it is a less intensive operation....

So, we are looking at the second surgery around August 15th. And we'll have to pay another $250 up front. But I hope he doesn't have to go through all the pre-op testing again. I'm waiting for the scheduler person to call and set it all up.

But back to the PT question. Which is do we continue with it now? Or wait until after the second surgery?

But if we wait, will Bob completely lose any effect from the Botox?

And if we continue with it, will the insurance pay for more therapy AFTER the surgery?

So far, I have backed the PT down to two times/per week instead of three. I figure this way, 20 visits should take us clean through the end of September.... As I really think Bob needs to start moving, he is getting so weak, and most days doesn't even want to get out of bed, so at least with the therapist coming twice weekly, it will be better than nothing....and I don't understand why stretching his neck and leg should bother his toes, it's not like she's making him stand up or anything. 

But still, I do hate to torture him... and even though he didn't complain at the last session, I could tell he was in a lot of pain and not very happy.

She's scheduled to come tomorrow. Right now, I'm just taking it day by day. See how it goes. But believe me, this question is on my mind...