Stability For Our Time

Sorry I haven't written in the last few days, but we've been keeping the Facebook page updated. Luke is still doing very well, so well that even doctors are using the "m" word. He's off the ventilator (30 hours as of right now) and handling it fine. He responds to all commands and is able to move his arms, legs, finger, and toes when asked. He's shown a full range of emotions, from anger and sorrow, to humor and love. He's still very groggy due to heavy sedation, and the doctor who examined him yesterday says he sees some signs of brain damage in his motions and posture, bu that he believes that any damage can be corrected by therapy and time.

And that brings me to the point of today's post. Luke is now well enough to leave the ICU, but not well enough to go to a standard room. They used the term LTACC, which stands for Long Term Acute Critical Care. I was not a big fan of that label, as long term sounds very ominous, and not at all in line with what we've seen from Luke, but I was relieved when the doctor explained that in this case, long term means a time measured in weeks instead of days. If they thought he would be ready for Patricia Neal or other full rehab facilities in a few days then they would move him to a floor room, but he believes Luke will need a little more time than that to get his trach out and to be weaned from the high level of sedation he's on. UT no longer maintains beds for transitional patients like Luke, so they're presenting options to the insurance company for the next phase of his care.

I met with representatives from the two facilities in Luke's room today to assess their programs, capabilities, and see how well Luke would fit in.

The rep from Facility A was an RN with 20 years of experience in a hospital setting in various capacities. She was familiar with Luke's history, and had read his chart in full. She was aware of some of the unique features of his stay here at UT, and outlined a multi-pronged strategy to perform rehab on his brain and his lungs, including stimulation of the damaged nuerons. Facility A is located within a hospital setting, with doctors on site 24/7, and is fully capable of handling any contingency in house.

The rep from Facility B was a respiratory technician who looked like he finished his training sometime last week. He didn't know anything about Luke's case, not even basic information, like how long he'd been in the ICU, or the extent of his injuries, or even that there was a brain trauma involved. He said they were very good at weaning patients off of ventilators. I pointed to Luke and said that he was already off the ventilator, and the rep said that was okay, they were good at weaning patients off of trachs as well. Facility B is located in a nursing home. and the rep very proudly assured me that they kept a RN and a respiratory therapist on site 24/7. I asked him how many beds they had and he said 16.

One RN for 16 beds. Luke is too sick to be in a regular hospital room with one nurse to four beds, and some clown wants to send him to a facility with one nurse for 16 beds.

I don't think so.

I asked how they would handle an emergency, and he said they had a doctor on call, but if the emergency were severe, they could call 911.

Let's just say that I know where I want Luke to go, and if the insurance company picks Facility B, there will be a bit of a ruckus. I'll bring him home first.