Rhythms of the day

Life here in rehab runs on a schedule that we patients don’t control, but we adapt to it. Staff shifts change at 6am, 2pm, and 10pm and the aide or sometimes a nurse will take our vital signs in the first hour of the shift. They wake you up at 4am to take blood if the doctor ordered tests. In theory, the aide come around to help us get out of bed, to the bathroom, and get dressed. Sometimes that doesn’t happen. Those who are more independent can and do most of that for ourselves, but others need help get out of bed much less do anything else. I’ve been there so I understand, and am determined to do all I can to take care of things for myself. Except the shoes.

Meals are theoretically on a schedule for 7:30am breakfast, lunch at noon, and dinner by 5:30pm, but that all depends on the staffing levels. The nurse goes around early with morning medicine, but also sometimes at meals if meds need to be taken with food. The food is not great and we’re not all that hungry anyway because we’re not working hard enough to generate an appetite. The concierge staff at the front desk bakes fresh cookies at 1:00pm and some of us make a point of checking that out soon after.

The big driver of our day is therapy. We get 1.5-2 hours/day of PT and OT, sometimes all in one lump in the morning or afternoon, or some of us split it with some before and after lunch to break up the time. We’re never quite sure when it actually starts; the therapist comes down to our rooms to get us. We’d all like to be there when it’s not full since it’s easier to get access to some of the equipment and have more one-on-one time with the therapists.

I’m usually asleep by 9:30pm, tho it depends on when they give me my final meds, and wake up around 5:30am. And get up several times a night to put on those ugly green gripper socks, use walker to wheelchair, and go pee (especially if they give me my water pill too late in the day, which happens more than I’d like – and yes, I’ve discussed it with the Director of Nursing).

But weekends we have no therapy and our days are big blocks of nothing time. I roll my chair around for several laps up and down the halls for upper body work, and try to walk some with the walker in my pod if the AFO velcro straps are behaving; right now they have new applications of Gorilla tape and I’m giving them time to really bond before trying to use them again.

My friend Jan went home about 10 days ago and she reported today that her days are so unstructured that she’s having trouble adjusting. I want to be home so much but my days will also be highlty unstructured since I won’t be going to the office or daily therapy sessions twice a day. I’m not sure how often I’ll have outpatient PT or if I can or should arrange for in-home physical therapy to get that one-on-one attention that made such a big difference at the Olympic Center. If you have experience making that choice, I’d love to hear from you.

Then there are rhythms of the week, including fun things like laundry. My neighbor Mildred and I have taken to doing our own wash during the day, just having an aide pushing the button above our level that sends the soap down. We monitor the machines and move clothes from one to another using our Reacher tools. By doing it ourselves, we’re sure that we take out everything that’s ours and that things are washed/dried on settings other than Cotton/High Heat.

Administration also has weekly rhythms. At the Olympic Center, there was a weekly conference on Tuesdays when doctors and therapists discussed patients’ progress and determined discharge dates. Here at Meadow Lake (and probably all rehab places) there is a weekly Medicare meeting where patients’ progress is reviewed against Medicare guidelines (I think – at least I know it’s close enough). When Medicare stops covering you, you are discharged after a short notification period.

Last week – just last week! – I went for my home visit on a Tuesday afternoon, which was after the weekly Medicare meeting. But I’ve had another week of therapy and progress, plus information from the home visit to inform the team what I’m going home to. So I’m expecting that my progress and timeline will be discussed at the meeting this Tuesday. Which means, I hope, that I might have an idea soon about my timeline here.

I’m ready to go home. And I think – except for the shoe problem – that I can do it safely. There are still things to learn and improve, and I can and will keep doing that. But oh, wouldn’t it be nice to have a realistic timeframe?