And The Judge Rules....

...in our favor! And denied the defenses' plea for a "continuance".  So our court trial date is back on track for July.

That means I got two months to lose 10 lbs, buy a new "court" wardrobe and get my hair cut!!!

Meanwhile, Chris has been stranded at home, for two weeks, as her power wheelchair died. Which means I have no sitter for Bob and thus have been stranded at home too. Today, Bob has another doctor's appointment, so I'm having the wheelchair transport pick us up after that and then cart us both to the pharmacy to pick up his pain meds, after which, we will have to wait for another transport to take us home. Looks like a long and exhausting day ahead, for both of us...

And The Plot Thickens

So The Defense submits their "expert witness" list, of which they have eleven (count em!) eleven paid "experts" all from different parts of the country....

From looking at this list, which includes a synopsis of the "experts'" planned testimony, one begins to see the tactic which The Defense will use to attack us, which looks basically like "fling mud everywhere, in every direction, and see where it sticks".

It looks like they plan to do all of the following:

a) argue the nurses did nothing wrong
b) argue it was the doctor's (who did the surgery) fault instead of the nurses
c) argue that Bob's stroke was "acute" in "onset, nature and duration" so that even if the nurse had notified a doctor right away, it would not have made any difference
d) argue that because Bob was on Social Security Disability prior to this stroke, he was in as bad of shape when he checked into the hospital as he is now
e) argue that since Bob had neuropathy, plus is a cancer survivor and a stroke survivor, that his life expectancy is low, and he will be dead soon, so they shouldn't have to pay very much for his life care
f) submit their own "life care plan" taking out everything they view as "not necessary" or "not their responsibility" because they will argue that Bob, because of his prior disability, already needed the  24/7 nursing care/medical care/medical equipment/etc. that he needs now.

Of course, all of the above is complete BS.

And, if you ask me, it's all very mind boggling: as it seems they first say the nurses are not guilty, and then, admit they are.  I mean, if the nurses are "not guilty" why are they even talking about paying some of the cost of Bob's care? Or having someone testify that the stroke was "so acute" it wouldn't have mattered when the nurse notified the doctor?

Which makes me wonder what a jury will think?

Point B is especially telling of just what kind of corporation/hospital we are dealing with -- that they actually plan to throw their own surgeon under the bus. And this is a award-winning surgeon who has been affiliated with their hospital for over 30 years (who also serves on the hospital's Board of Directors).  And, if they actually convince a jury to accept this theory, i.e. that the doctor is responsible not the hospital  -- we won't see one dime. As we are not suing the surgeon, but the hospital....

All I can say is: jeepers. I know we have a strong case, but it looks like we're in for a nasty fight.

And it makes me sick to think that this health care provider (i.e. hospital) would treat one of their patients this way. Whatever happened to the "care" part of "health care"?

Grrrrrrr.......

So The Hospital has again made a motion "to continue" the trial, meaning they want another delay as they say they need more time and so, right now, our court date is up in the air.

The judge will hear their arguments next Monday.... of course, we will protest.

End of a Dream

So the good news here is that Bob got accepted back into Physical Therapy in Outpatient Rehab at the charity hospital -- and, with just one phone call, the financial aid office is happily picking up the $45.00 per visit co-pay.  Amazing, how easy that was -- this time, now that I know which hoops to jump!

Anyway, Bob had his first PT appointment today, for an evaluation, and it was one of the same PT's that he had a year ago.  Which was nice. To see a familiar face.

As always, with the first PT appointment, we had to "set goals" and this time, the PT pretty much stated matter-of-factly that Bob will never walk again. That really, walking as a goal was beyond any expectation...

Now I know this is true. I think I've known this for a long time. But I always liked to have a dream, you know, a little hope for a miracle, that maybe, just maybe, we could get him back on his feet again...

But, this time PT goals will be trying to get his neck more flexible and stop the twisting of his spine which is happening because of the post-stroke dystonia. And strengthen his torso muscles. So that he may be able to make transfers from wheelchair to bed more easily, and make things like washing his hair and dressing easier (and I will admit all of this has gotten harder this past year and I will admit, his spine is twisting...) and, as the PT said, the goal is just try to improve Bob's "quality of life"....

And I know this is the reality of the situation. I do understand. But, man, it's really hard to give up that dream of walking, you know, of being, sort of, close to normal... and to just think about "goals" being only "quality of life" issues, which by-the-by sounds like something you think about before you put a dog down--- jeepers, and right now, I hate to say,  I have tears in my eyes.... 

Anything You Say Can and Will Be Held Against You...

I tell you, sometimes I feel like I'm the one on trial here...

Case in point, the other day I was reading through yet another doctor's deposition, and near the end, the attorney for The Hospital asks the doc to turn to page such-and-such in his medical records. And there, on that page, the attorney points out that under "hand dominance" someone has circled "both". And, because this form was filled out in 2013, the attorney then tries to make the case that Bob is now using both his hands and so therefore is no longer paralyzed!

And I'm reading this, thinking, huh? Whose the idiot who filled out that form? Because, truth be told, Bob has never recovered any voluntary movement in his right arm/hand...

So I contact our attorney and ask if I can see those medical records in question, and they send them to me.


Then I find the page in question and immediately recognize the handwriting -- because GA! it's mine! 


It's one of those pre-admission forms, you know the forms you fill out in the waiting room before you see a doctor, asking about Medical History, etc., and that particular section in which I circled "both" was entitled "Social History" and I emphasize that this is history, and because Bob was one time right-handed and now left-handed, I circled "both", because, indeed, that's his social history.

Jeepers.

I tell you, I will never look at another medical form again the same way. In fact, Medicare just sent Bob some kind of survey to fill out, and I started to fill it out then I remembered the "hand dominance" fiasco and I promptly threw the survey away. I mean, one small mistake, or one thing they can take out of context, and The Hospital will jump on it like a free breakfast buffet.

Who'd ever thought it would come to this? I find it all incredibly absurd...

I also just found out that our July court date is scheduled for two full weeks. Two weeks! And what am I supposed to do with Bob during all that time?

Acute Rehab Hospital

Back in February, we went to see Bob's neurologist. The purpose of this visit was discuss another Botox injection for Bob's neck and also to get some physical therapy on board, as home health care therapy bowed out in January....

At that time, the doctor decided Botox wasn't working and nixed the idea of continued injections. The doctor also wanted Bob to receive some sort of "specialized" and "intensive" therapy, to get him back on track and to help with his dystonia symptoms. He didn't think home health therapy was "intensive" enough and didn't feel the outpatient rehab at the charity hospital was "specialized" enough. The doctor and his PA said they would research some alternatives for an intensive and specialized therapy and get back to me. At that time, I did mention cost would be factor as Bob's insurance requires a $45/session copay for PT and we certainly cannot afford to pay for 2-3 sessions a week for many weeks. And, I explained, that's the reason we always went to the charity hospital, because it was free. The PA promised she'd look into programs that might qualify for grants, etc.

OK. I must admit I was a bit excited about this! I was imagining a fancy specialized outpatient facility with the latest highest tech equipment and latest therapy protocols! You know, a place Bob could go to 2-3 times a week and use cool robotic walking devices, etc., or maybe even aqua therapy for Bob's dystonia!

So imagine my surprise when, in March, I receive a call from an acute rehab hospital telling me that they have received a referral from Bob's neurologist to admit Bob, as an inpatient, to their facility.

This was not at all what I expected... I expected something totally outpatient. And Bob had been in an acute rehab hospital in 2010, and that experience was far from pleasant.. And I knew, it would take a lot of convincing on my part to get Bob to agree to staying inpatient in a facility.

My main concern was also that overnight stay. For different reasons. Would Bob be well cared for? Would they have enough nurses? Could Bob, with his aphasia, even manage the "nurse call" button? Would they understand what he needed when he can't articulate very well? And would he end up with infection after infection, and pneumonia, as he did the last time he was in acute rehab hospital?

But I told myself to keep an open mind, as the woman who called from the facility bragged about how great they were, told me that they had "all the new high technology" therapy equipment.  So the hospital sent three therapists to our house (PT/ST/OT) plus a nurse to do a pre-admission evaluation. That was in March.

Meanwhile, I decided to do some online research on this hospital, and found a couple of pretty bad reviews that validated my worse fears. The first one commenting on the poor nurse to patient ratio and slow response time when nursing assistance was needed. The second review commenting that the facility was terribly understaffed and there was not even enough therapists for the patient population and patients had to wait their turn, while the therapists ran between patients, trying to juggle 3-4 patients at time. Hmmmm?  Then I found a 2008 State Attorney's investigation on "Battery on the Elderly" at the facility.  Jeepers.

Then the Admission office from the hospital called and told me the co-pay for Bob's stay would be $1675.00.

So that whole idea was pretty much dead in the water, and I must admit, I was almost relieved. But when I contacted the PA at the neurologist's office to tell her the deal was off, she told me that she would make some calls and see if she could come up with some funding. And when I told her that I wasn't quite so sure if this was the place for Bob because of what I learned online, she told me to call the facility and schedule a tour, and maybe that would change my mind...

Last Friday, we did just that. Bob and I went to the rehab hospital for a tour.

Now this a small place, 70 beds, and located out of town. The transport took 45 minutes to get there. (I wondered if The Green Machine survive this trip! Daily. For a few weeks!) The facility was nice enough looking, for a hospital, but was very small.  We were met at the lobby by a nurse and one of the "supervisors" for our tour.

Armed with my internet research, I asked a lot of questions. Including the nurse-to-patient ratio, which was sadly 8-1, much lower than the recommended standard of 5-1 for a rehab facility. When I asked what the CNA to patient ratio was, the supervisor couldn't even tell me. She said, "Oh, we have enough."

If those responses were not enough red flags, the next BIG red flag that went up my flagpole was the "therapy room".

I tell you, we walked in there and I thought, at first, a large, noisy meeting was taking place. There were at least 20-30 patients with wheelchairs or walkers, seated around the perimeter of this small room and at a table. These patients appeared to be doing nothing but sitting there, talking amongst themselves. That's when the tour guide told us this was "the afternoon therapy session". Huh? I didn't see anyone doing any therapy! Then I looked a little closer, and noticed that one of the five patients at the table was actually stacking colored cones on top of other colored cones, so I guess that's an OT session right there. Then I noticed one Nu-Step in the corner, though no one was using it. And also a exercise bicycle thing, also not being used. We walked through the room and, wow, I saw an actual therapist helping someone work with therapy bands. Then another therapist helping someone work with some pulleys connected to the wall, but that was it. So what were all these other patients doing? Waiting their turn, evidently, just like that one review stated.

And I also saw, one fellow in a wheelchair, sort of pushed into the corner, all alone. He looked about 30 years old, paralyzed from the neck down--from what I could tell, and he looked so sad. My heart went out to him. So sad and alone and no one minding him or giving him any attention... No one even talking to him. I don't think I'll ever forget the very sad, haunting way he looked at me when we walked by on that tour.

Then I stood there, listening to the tour guide, rambling on about how great it was that their patients get an hour and half therapy session in the morning, and another hour and half therapy session in the afternoon, five days a week (they take weekends off), and I asked her, "So this is it?" (meaning one Nu-Step, one bicycle thing and some pulleys on the wall? and 3 or 4 therapists? for all these people?) and she told me they had two other therapy rooms, beside this one.

Oh-kay.

Then I asked, "Are all the sessions group sessions?"

She said, "No, we do give individualized therapy, if needed."

Then I asked what type of "specialized, intensive" therapy they would have for Bob, as his neurologist seemed to think this facility was equipped for "specialized, intensive therapy" especially for stroke and dystonia. She couldn't tell me, but said she'd get one of the therapists to talk to me.

So a woman comes over, and she is introduced as the supervisor in charge of therapy, and I ask her what type of therapy they could offer my husband, and she basically told me that the only thing they could do for Bob's dystonia was some neck stretching exercises and maybe a neck brace. And other than that, you know, the usual parallel bars type walking therapy.

So I asked if they offered Art Therapy.

No.

I asked if they offered Music Therapy.

No.

I asked if they had Aqua Therapy.

No.

I asked if they had any special aphasia therapy.

And she said that they had speech therapy. (Well, whoopee, been there, done that, and not the same thing...)

I then asked the tour guide to show us the other therapy rooms. Both of which were unoccupied. One did have one set of parallel bars, not being used. And they both had some exercise mats. And, oh yeah, one pretty cool looking machine which was a combination of a standing machine and a treadmill, so basically the patient in a seating position would be pulled to standing, then feet clamped on peddles, the machine would actually move the legs in a walking simulation -- so yeah, that was pretty cool, but again, no one was using it. 

Before we left, we saw a speech therapy session, which was, once again, a group session.

And, as we left, I asked Bob what he thought of the place.

He said, "NO WAY!"

That makes two of us.

I called the PA and said thanks but no thanks -- and told her that I thought Bob would get more 1-on-1 therapy at the charity hospital's outpatient facility. And she's going to send a script. And I'll have to contact the financial aid office and hopefully, Bob will be approved once again.

A Scary Couple of Days...

...with the cat. Ten days into the antibiotic treatment, Zenith developed diarrhea, then began vomiting copious amounts. Then she stopped eating... And me -- worried sick.

Yesterday, the vet arrived again and gave her two shots. One to stop the vomiting. The other: an antibiotic shot, as I had to take her off the oral antibiotic which was causing her to have diarrhea/vomiting/nausea.

Two days without eating. Then finally, today, I coaxed her into eating a bit of tuna with some probiotic powder in it.

So add these worries on top of the usual stuff, plus add the fact that one of Bob's doctors wanted to admit him into a hospital (more on that later!) my plate has been fuller than normal.

Good news is Zenith is using the litter box again.

So fingers crossed....