Thought we were in the clear, but there might be complications. Might not be. Have to wait.

Looks like everything is good physically now. She was transferred from the children's hospital to a psychiatric facility for a few days. Not sure how effective that will be, but there's not really any choice in the matter.

Mom is now over the pneumonia and pulmonary edema. The last of that recovery happened in a skilled nursing home which has begun the process of recovery from weeks of bed rest. A woman who used to work out 6 days a week (including lifting weights), sung in a senior rock and roll choir, and was part of a bunch of reading and discussion groups can no longer walk long distances by any means, can only walk short distances with the aid of a walker and until tonight lacked energy to even read a book or watch TV.

She has just begun to be able to use a walker to go short distances and still needs assistance in and out of bed, and in going to the bathroom. And now they want to discharge her. They say she no longer needs a skilled nursing home. :But from investigaion, a few weeks in this nursing home getting daily physical therapy could get her a whole lot further. Outpaitient treatment, getting PT two or trhee (at most) times per week could take months. At any rate if they try it I"m going to try to appeal. I think I"ve got an argument against the lack of medical neccisty. Their pont is that lots of people are discharged in worse shape than she is now. Yup.but lots of people are admitted in better shape than she is now! The question is not whether a lower level of care can keep her alive. If the level of care they offer is needed to help her recover to the point where she is less fragile in weeks rather than months, forcing her to take the months long option is not giving her anything like the best possible care. PLus she is still fragile, so sending her out to take outpatient treatment in this state would be risking her life. For example she all the physical therapists agree she can probably be weaned from oxygen. :They already tried once. That failed but she was able to reduce O2 use from 2 liters per second to 1. The current thinking is going from 2 liters to room air was too sudden for a woman her age (94) but that gradual weaning a half liter at a time, followed by alternating between external oxygen and room air, followed by complete weaning from oxygen would probably work. Now this certainly sounds like skilled nursing. My current opinion is that once they have weaned her from oxygen (or determine that it is not practical) got her strength up to the point where she can take a flight of stairs and hopefully got to the point where she can use a bathroom independently , from there on we can get the rest of her strength back and home. If anyone else can suggest arguments to use in the appeals process it would be welcome. The key point though is that if she can still benefit from skilled nursing, and alternatives to skilled nursing put her at risk that medical necessity to keep her in the skilled nursing facility exists.

Em's coming home this afternoon! Just heard literally right now.

Wow. You guys sent us an Amazon gift certificate. I never expected anything like that and that's incredibly nice. I'm just sort of shocked. Thank you. Between the medical expenses and needing to do a lot of securing of things in the house, that will come in handy, though you didn't need to do that. Again thanks.

Thanks again for the other gift certificate. You guys really didn't need to do that, but it is appreciated.

Sorry to mainly vent and run, but pressure of Mom being sick is just beyond what I can describe. Latest episode: The insurer wants to end Ruth's stay in the nursing home and return her home Monday morning. Because she is still so weak and progressing so fast from physical therapy six days a week, she wants to stay longer until she gets stronger and less liable to a relapse. BTW, premature discharge from hospitals and nursing homes is a major problem in medicine today; Ruth is not alone in facing this. I have filed an appeal, but have been told not be optimistic about results. (The person who told me this worked for the nursing home, so I'm not giving up hope, but I'm sure that patients winning appeals is not common.) So I hope we win the appeal, and if we don't I hope the progress Ruth has already made will be sufficient to see her through a full recovery at home. (Note: we even looked at borrowing the money to get her four extra days at the nursing home with private pay: but the home won't offer the same level of PT to private patients as to insured patients. So if she doesn't the win the appeal she is down to less frequent PT while still so weak she can't even stand to read or watch TV and an appetite so poor that she is mainly being kept alive via boost - this from a woman who was a hearty and adventurous eater before she got sick.)

I just adulted SO HARD, work-wise. I could use some unspecified ~ma that it pays off.

Would you please send whatever ~ma you can towards the emergency animal hospital tonight? Lucky, the most awesome cat in the world, had a stroke tonight. They're doing a blood panel now and we'll have a better idea in a few hours what the treatment plan will be. Needless to say they're keeping her overnight at the least. She was Rob's cat initially so there's lots of emotions tied into this. I'm not ready to lose her.

I could use some ~ma for my dad right now. He's just been taken in by 911 for the third time this week. His magnesium and calcium levels keep cratering and he's too weak to stand or walk safely. Today though, he was also being really incoherent, asking questions that made no sense and thinking there were other people here. It's not a stroke but outside of that we really don't know what's going on.