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Thread: My Father's New Injury-Have ?s

  1. #11
    Yes, unfortunately that is about all of acute rehab that Medicare will cover, and his secondary insurance will undoubtably only help with the Medicare 20% copay, not pay for additional days. This is one reason that I strongly encourage veterans to go to a VA SCI Center for rehab as they will not have these unreasonable restrictions on their length of stay, and can get much more equipment and other services than they would ever get in the private sector.

    We see patients all the time who get to us because we get a desparate call from their family or a discharge planner at a private sector rehab facility who says they are kicking the veteran out, and they will be sent to a nursing home unless we can take them at the VA immediately. Virtually all of them tell us they wished they had come to the VA first once they are here and see our program.

    (KLD)

  2. #12
    1Deltagirl,

    I am so sorry to read about your dad. You are smart to be asking questions, and lucky to have found Carecure this early.

    As for Santa Clara Valley Med Center - my son did his rehab there. Actually, he was transferred from a different rehab in the Bay Area to SCVMC's neurotrauma ICU, and later was moved downstairs to the rehab unit. He was on a ventilator at the time and we were told (by people at the first rehab) that there was a good chance he would never get off of it. Well, he did, and I give so much credit to the wonderful staff at SCVMC. I cannot say enough good things about them. Last I heard there had been some changes in the staff, but when my son was there he received top-notch care.

    Good luck to you and your father.

  3. #13
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    LFC- It's nice to hear from someone who has been to SCVMC. It seemed nice when I visited there today. Can I ask how long your son stayed there?

  4. #14
    1Deltagirl, my son was there for a total of 10 weeks. He was in RTC (Rehab Trauma Center - it was like an ICU) for a little over 4 weeks, and then spent the rest of the time downstairs in the actual rehab center. We had made the mistake of having him first go to a rehab that was primarily a brain injury rehab, then realized our mistake and pleaded with our insurance to transfer him. There was no comparison between the two. From the doctors to even the nursing aides, all were so skilled and ready to handle the problems my son had. (And he had plenty at first.) He has been fortunate to have had a good rehab experience (after the move) and a good recovery. Chosing a rehab is such a big decision, but it sounds like your two choices are both very good. If you have any other questions, I would be happy to answer them.

  5. #15
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    Smile

    A little update on my dad: He had a successful tracheostemy tonight and a PEG placed. And today as I held his right arm, he began to flex his bicep and pull it toward himself! (Up to this point, he had shoulder shrug movement on both sides and bicep control only on the left side.) I was so excited to see some more progress! One day at a time, huh?
    Jeanne

  6. #16
    Quote Originally Posted by 1deltagirl
    A little update on my dad: He had a successful tracheostemy tonight and a PEG placed. And today as I held his right arm, he began to flex his bicep and pull it toward himself! (Up to this point, he had shoulder shrug movement on both sides and bicep control only on the left side.) I was so excited to see some more progress! One day at a time, huh?
    Jeanne
    Jeanne, that is really exciting. Wise.

  7. #17
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    Question

    So, what can anyone tell me about MRSA? Drs told us today that my Dad has Methicillin-Resistant Staph Aureus of his chest sputum. They tried Cipro for treatment but moved on to Vancomycin, I believe. Is this serious? I read what I could on the web, but I'd like more "real" advice.

    He was a lot better today with the trach in place. We had an OT come from SCVMC today to evaluate him. Looks like if all goes as planned, they may be able to transfer him on Monday. I'd love to see that happen.
    Jeanne

  8. #18
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    Question

    One more thing...I'm just wondering about the progression of weaning off the ventilator. My dad was on the vent with tubes through his mouth for 10 days before they attempted a trach. Within this time, they began the weaning process and told us around day 8 that he was breathing unassisted with the vent only providing a safety assist (I don't remeber exactly how they described that.) The trach was successfully placed on day 11. Day 12 he has MRSA and now he is back on 100% assistance with the vent. Will they start weaning him again with the MRSA? Is that a factor? Or is the trach a factor? I've been told it would have been better for him to get the trach sooner. And that the longer he is on a vent, the harder it is to get him off of it. Are these things true?

  9. #19
    Yes, the longer you are on a vent, the more difficult it is to wean as the respiratory muscles get weaker when they don't have to work. The MRSA, if it is not just colonization, but a true infection, will not help either. Unfortunately ICUs are a great place to get MRSA, usually passed on from another patient due to poor hand hygiene or poor cleaning of equipment between patients by the staff. Powerful antibiotics are often needed to get rid of it. An infectious disease specialist consultation is strongly recommended.

    We generally want a trach instead of an ET tube after 7 days. Long use of an ET tube can increase risks for damage to the trachea.

    He has a rough road ahead getting weaned, but SCVMC will be much more expert at this with someone with a SCI compared to where he is now. They have an excellent reputation for both vent care and weaning programs and are considered one of the leaders in this area internationally. I am glad he is getting there soon.

    (KLD)

  10. #20
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    Hi all
    I wish I could be writing some encouraging news about my Dad's recovery but it seems like he has one problem after another! Two days ago he was to be transferred to Kindred Hospital into their vent weaning program after receiving approval. That morning he developed an irregular heart rhythm which was very alarming. They postponed the move and put him on Cordarone to stabilize the rhythm. This worked perfectly but they have yet to determine what is causing the irregularity. Then last night they discovered that his PEG was leaking what appeared to be his nutritional fluid. Along with this, his stomach has become severely distended and he has not been passing anything at all (gas or stools.) A CT scan showed that the feeding tube hadn't migrated but they don't know where the leakage is coming from or what caused it. I guess it could be leaking into his abdomen? The nurse tonight showed me the PEG and is concerned that the site is very red and possibly has some infection. Of course, they've told us they are minotioring my Dad "VERY closely". But what do you think of all this? On top of everything, he's on Vancomycin and also had a round of Zyvox for the MRSA pneumonia which hasn't improved that much. We just ask ourselves, what more can go wrong? This is so terribly difficult to watch!
    Lastly, the nurse tonight asked what we thought about starting my Dad on antidepressants. Should we be considering this?

    Sorry for going on so long!
    Jeanne

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