Lots and lots of details about why we are still in the hospital

Good news! Robert was up and walking today, on his own, without the walker, and even up and down stairs! In fact, he was better at going up stairs this morning than he was before the surgery. We had both sort of forgotten that that was the point of this whole thing, to improve his physical functions.


The physical therapist has more or less convinced us that we would be better off bringing Robert straight home rather than going into rehab. Yes, I've been wishin' and hopin' for the move to rehab, but the physical therapist pointed out that the exact things that are hindering Robert from getting better at the hospital will also be true in rehab. Just like the hospital staff, the rehab staff will manage his insulin in the same one-size-fits-none approach. He'll be woken up every 45 minutes by his roommate, the cleaners, cell phones going off, and the staff yelling pleasantries to the more hard of hearing customers. The risk of infection will be much greater around other patients.She convinced us both that home will be a much better environment for his well being. He will get assistance at home from a physical therapist and home health aid, so professional care will continue.


Seeing him walking around -- standing straighter and walking more briskly than he did before the surgery -- was a revelation. "Rehab is supposed to get you to this point and then send you home,' said the physical therapist. "Robert did all that work here, with you, and he's ready to go home."


Yet another hematology doctor wants to look Robert's blood before giving him the okay to go home. This after two hematology doctors gave the thumbs up. I'm starting to think that they view his blood as an especially tantalizing mystery they look forward to examining each morning, and they are loathe to let this source of excitement leave their lives.

More background for those who like this sort of thing: What is the big mystery about his blood? His platelets dropped dramatically after the surgery, gradually bounced back, and they can't figure out why. In a practical sense, the reason why matters because they don't want it to happen again-- low platelets means increased risk of blood clots. But I am starting to think that the wizards of hematology are so fascinated by Robert's humours that they have conspired to strengthen the spell of hospitalization and thwart the lovely princess who gallantly tries to free him (that would be me).


Okay, not really.

And the final problem -- managing his blood sugar -- I think I finally figured out a way to deal with that problem. All along, Robert has been ordering meals based on what he feels like eating, and then eating more or less of it depending on how yummy or ghastly it turned out to be. Meanwhile, the nurses have been giving him insulin based on a one-size-fits-all scale, like "Dinner is 15 units of insulin." I'm oversimplifying, but that's the problem: they use a math formula to figure out his insulin before anyone has a good idea of what he will really eat. His food and his insulin have not been coordinated well, and it's made for a roller coaster of glucose highs and lows.

As of today, I am testing his blood hourly with our tester kit and cracking the whip on how much food Robert eats. At home, he would give himself the right amount of insulin for what he knows he is going to eat. Here, we can't do that. So he'll have to do the opposite, and eat the amount of food that is appropriate for the insulin the nurses have already given him.

I started this blog entry at about 10 am this morning and I have been writing and erasing and writing all day. I hope we've settled down for the evening.  It's been a busy day: I've counted a lot of carbs, advocated for my patient like a fiercesome warrior,  and gleefully jumped up and down when I saw Robert walk up the stairs.