Yay...now I'm in real time. The week started out with learning that the patient with the lung mass unfortunately was discharged to the hospital. It is believed that the mass progressed to being cancerous and her illness is from this progression. Also, I learned that she has stated that she is okay with this situation and that she has lived a good life being 93 and all. This is very sad because she is a very sweet lady. But unfortunately, this is the nature of this type of facility. The patients here have very intense conditions. Some of the other patients I have met have hx of being a pedestrian who was hit by a car (2 patients in fact! one s/p TBI, the other is recovering from drug abuse, B tibial fxs, L humeral fx, CV2 fx, L hand edema), individual who recovered from a 3 yr coma from assault & has resulting all extremity contractures since he had no coma tx, female with dyskinesia from long hx of anti-psychotics, male who shot himself in the face 4 yrs ago and recovering from an infected facial reconstructive surgery...and so on. I'm sorry if these stories are too much; let me know please. These are just some of the crazy things that come to Caton Manor.
On the other hand, the other patients that I have are doing well and I'm seeing a positive progression in their abilities. For instance, the 99 y.o. woman...who is adorable...she can sit EOB unsupported for 15 min and can follow verbal cues to lean forward to relieve her back pain and not push backwards. And she remembers my "beautiful voice"...haha that made my day on Tuesday. Also, I had the best Max A transfer from W/C to bedside with her ever! The 59 y.o. woman with severe arthritis and L TKA and climb stairs safely. On Tuesday, I also got a new patient who my CI eval'd. She is an 82 y.o. woman hospitalized for severe asthma attack, who was D/C back to her apartment which had been flooded by a water heater explosion from upstairs, air dried by fans and then had to go to Caton Manor because of difficulty breathing. Rehab's vote is there is mold causing her problems. She is a sweet lady who I'm working with on increasing her endurance, etc.
I have another new patient who I eval'd today (Thursday). The patient is a 56 y.o. female with spinal stenosis s/p decompression and fusion for L2-L5, end-stage renal disease, kidney transplant x2, DM Type 2, OA, RA, HTN. She is very high functioning and going home on Saturday.
Alright, so back to Wednesday...wound rounds at 5:30 AM...oh man. I really don't like wounds too much. There were three patients who I remember in particular. The first patient of the morning was 50 y.o. woman who is obese, LE edema, decreased strength, severe keratinosis, and the largest sacral wound which was just scary. You could see things that you really wish you couldnt. And it just looked so painful. And it wasn't her only wound! She had another deep under her belly skin folds. Okay, the next memorable patient is my patient who is 53 y.o. man with neurosarcoidosis and resulting paraplegia. His skin is thinned because of his longstanding steroid txs resulting in many wounds. He had 4 wounds on his L LE, 2 on R LE and 3 on his sacrum. There were just so many that it because difficult for the wound MD to describe all of the locations. And finally, there was a 50 y.o. man who has heart & lung problems, hx of severely painful LE compartment syndrome, s/p B fasciotomy which the incision sites did not heal...there was even a skin graft that failed. The skin graft donor site has also remained open. Sooo painful. Anyways, it was interesting to see what % were granulation, slough or necrosis according to the MD.
On a fun note...I danced with a patient!! My 72 y.o. woman s/p multi-infarctions. I have danced/side-stepped to music with her yesterday and today :-) It was fun. She continuously would chuckle to herself about the fact that we were dancing. But she enjoyed it. She has the best smile about it too, haha. She is hard of hearing so she cannot really figure out the beat to the music...but no worries, its helping with her coordination. I still have to email Klima about this :-)
Hope you have been having a great week! Have a nice 4th of July weekend!! :-) I'll be heading back to CT again.
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