Nightmare at Rehab

Yesterday was horrible. It started out okay, but when we got to Rehab, Bob had to immediately go to the bathroom. This is not unusual dealing with the neurogenic bladder problems that he has had, but once crammed inside the public restroom, while he was trying to urinate, he began to have a bowel movement.

This has been my worse fear, that he would have a bowel movement while we are "out and about", and I would have to change that kind of diaper while he's sitting in the wheelchair. I thought I was prepared, but honestly, I was not prepared for this. When he indicated he was done, I ripped the diaper down the sides thinking this would be the easiest way to remove a mess, and had him lift his seat up off the chair as high as he could, but lo and behold, there was nothing there. Which was odd. Because it certainly looked as if he had accomplished something. I could tell he was terribly uncomfortable and growing more so, by the second. On closer inspection, I found that a rock hard stool was stuck--half in and half out, as it were. And Lord almighty, if I didn't have to go in there myself and free him up. (Memo to myself: bring latex gloves!) When I finally got him clear, he still couldn't urinate. And he still seemed to have do the other, too. So, we're in the bathroom, clock ticking away, and it's closer and closer to his appointment time, and he is upset and growing more agitated by the minute, until he's finally crying. And I'm worried because I've ripped one good diaper and now have the other on him and he may soil that one too (Second memo to myself: bring more diapers!), but I finally get him settled down and dressed again, and we arrive for his appointment five minutes late.

I wheel him into the therapy room and we are greeted by his PT, but immediately Bob begins to cry and wants to return the bathroom. So, I take him into the bathroom, where he tries to urinate again with no luck and after ten minutes, we give up and go back to the therapist who is waiting for us. I am still worried about running out of diapers, so I decide to go across the street to the hospital where there is a small pharmacy, hoping they might have some there. So, I leave Bob with the therapist and head to the pharmacy only to find that they only stock women's Depends (weird) and only size "small" (even more weird), so I return empty-handed to find that Bob and Therapist are--gone.

I look all over but can't find them. Then, it hits. Oh no. I go to the restroom and there they are, the poor therapist trying to help Bob while he tries to urinate once again and Bob is (once again) in tears. The therapist takes me aside and tells me that he tried to get Bob to do some therapy, but Bob was too agitated and kept pointing at his crotch, so that's how they ended up in the bathroom. Then, the therapist says that if Bob is "medically unstable" they will have to discharge him from therapy. That they cannot work with a patient who is "medically unstable" and maybe I should think of having him sent to a hospital or nursing home where they can do inpatient therapy?

Lord, lord, lord. So, now I am freaking out. You know that Bob has been to the urologist who has prescribed a medication called Vesicare, which I am told takes 2 weeks to a month "kick in" and today it will have been three weeks, but the stuff does not seem to be working, or more correctly, I thought it was working at least somewhat, Bob did seem a little better, until all this happened.

So, to make a long story (somewhat) shorter, we spent the first full 45 minutes of therapy in the bathroom. He still could not go. And he was terribly upset, so I asked him if he just wanted to cancel the rest of the therapy sessions and go home, but he insisted on staying. And somehow we got through the day, with several unproductive trips to the bathroom. And finally, we got home. And I'm remembering the last time he had a spell like this, he couldn't urinate at all and at the same time was constipated, and I was almost ready to take him to the emergency ward to have him cathed, but then, he had a bowel movement and it was like an explosion on both ends. So, we got home and I dosed him with some milk of magnesia and about midnight, he had his "explosion" and finally went, all over, from both ends, which was quite a relief. In the middle of the night, he called me and presented me with an urinal that nearly overflowed to the top. So, I think he got it all out. We see his urologist again, in about two weeks, and I wish it were sooner, but I suppose the medication does take time to take effect....

Lord. If ain't one thing, it's another. We have Rehab again today and I am praying that things will go better.