A tale from a nursing home

[Russell Williams]

Also, today, at 9 AM Louise is supposed to be discharged from this nursing home and will then be able to read everything herself.

She asked to see the internal manual guidelines to the staff for infectious procedures since Louise's case management form simply said that the staff should follow infectious procedure instructions. She was told that A: the staff manual was a private document and that B: it was technical and Louise was probably not smart enough to be able to understand what it said.

If it had been a manual telling how to take a 12 V alternator and step the voltage up to 24 V, Louise might have agreed. But to tell Louise that she would be unable to read a set of instructions on how to clean a bathroom is not the way to produce a happy Louise.

[Webmaster]

To claim that something is a proprietary document not to be shared I can understand. But telling someone they are not smart enough to read a document seems almost unthinkable rude and hostile in today's society, unless it was implied rather than said directly.

[Yakatori]

Originally Posted by Russell Williams

"... at 9 AM Louise is supposed to be discharged from this nursing home.."

To go home? Or to another facility?

Maybe, for them, that was the point all along. For her not to get too comfortable and lose motivation to leave. That's what it seemed like, to me, when my mom was last in the hospital (ICU). It was like they thought she was "milking-it."

I mean, hospitals are great for some things. But, I think, when people have the proper support, they tend to do even better at home. Especially as their primary care-providers/advocates (in this case, you) aren't dealing with the constant stress of traveling back and forth and worrying the whole time they're not in contact and negotiating with staff over every little detail.

So, if that's the case, that she's going home, you'll have a much easier/simpler time just being able to clean things to your own liking and not have to deal with all that...bureaucracy. I recommend, if you can find it, this product in particular. It's concentrated; so, not only can you smell just how strong it is, but it won't splash all over and ruin your colors.

[CastingPearls]

Originally Posted by Russell Williams

Also, today, at 9 AM Louise is supposed to be discharged from this nursing home and will then be able to read everything herself.

She asked to see the internal manual guidelines to the staff for infectious procedures since Louise's case management form simply said that the staff should follow infectious procedure instructions. She was told that A: the staff manual was a private document and that B: it was technical and Louise was probably not smart enough to be able to understand what it said.

If it had been a manual telling how to take a 12 V alternator and step the voltage up to 24 V, Louise might have agreed. But to tell Louise that she would be unable to read a set of instructions on how to clean a bathroom is not the way to produce a happy Louise.

Russell, you can have you brother the attorney demand to see the protocol unless you don't see any point to pushing this further now that Louise is leaving (or has left).

They're unbelievably rude and condescending, not to mention unethical.

Is she going to a new facility or home?

[Russell Williams]

Tuesday Louise came home from the Julia Manor nursing home (I will here mention that all of my comments so far about Julia Manner are the best of my knowledge and belief and based on information I was either given or personally observed. Where other people have different interpretations, recollections, or beliefs about the data I have provided I would not it want to be automatically assumed that my interpretations, recollections, or beliefs, were more accurate than theirs). Did I mention that my brother is a lawyer?

I had suggested to Louise that people would like to hear Louise's comments about some of the things that have been posted in this thread. Tuesday Louise said that she would probably do it on Wednesday but Tuesday night she was just so tired and then we she wanted to organize things she would need and get to bed.

Wednesday the computer was down the whole day because a friend of mine was kind enough to purchase and install the equipment necessary to make our TV handle Netflix. Wednesday was a wonderful day for Louise and I (and a English majors out there who could tell me if the proper pronoun should be "me". )We both went to the monthly luncheon that retired Smithsburg teachers and their spouses are invited to. Louise had a wonderful time talking with the people there, after the luncheon we went to see the infectious disease Dr. who gave Louise and overall good report and then we went home and enjoyed each other's company and went to bed.

I believe it was Wednesday that someone from Julia Manor called and asked Louise if she would recommend Julia Manor to a friend. Louise responded, "I would not recommend Julia Manor to my worst enemy."

Thursday Louise got up, we got things organized, we went to the appointment with the primary care physician who, while worried about Louise's wounds was not really upset by them. We went to the drugstore to get Louise's new prescription for antibiotics and then Louise said the following:

" Russell, I did not tell you before because I did not want to worry you. You have noticed I've been doing a lot of belching. I am also experiencing a heaviness in my chest. I have taken one of my nitroglycerins and the situation has not improved. I think we should go to the emergency room."

We did and she is now on 24 hour observation status. Her white cell count is 11,000 which is probably due to the infection she still has and a whole lot of better than the 28,000 that it was when she went in about a month ago. The tests they have done to see if Louise has any of the chemicals in her bloodstream that would indicate heart damage have come back negative. I spent some time watching her bedside EKG. In about a half an hour only three or four times did I see something that would suggest that a particular heartbeat had been initiated in her ventricles. I cannot say she was in normal sinus rhythm because, about two months ago, she was first diagnosed with atrial fibrillation. But, other than the varying lengths of time between heartbeats and the lack of clearly indicated, least to me, P waves there is nothing in the heartbeat that I, working on my experience from 30 years ago of being a paramedic a volunteer with the local ambulance service, saw that would cause me to worry.

In conversation from the hospital Louise told me that she's hoping to be home soon and in the very near future to post her answers and her thank you's to the many people who have been providing helpful information and asking concerned questions in this thread.

[Webmaster]

Having lived through similarly exhausting, scary and frustrating situations, all I can say is that I wish that the two of you finally get a break and can return to a normal life. While Dimensions cannot directly do anything other than be a place where people can share, vent and comment, I hope in some small way that helps. In addition, of course, to the valuable help, suggestions and information other posters often provide.

[EMH1701]

Originally Posted by Russell Williams

I believe it was Wednesday that someone from Julia Manor called and asked Louise if she would recommend Julia Manor to a friend. Louise responded, "I would not recommend Julia Manor to my worst enemy."

I seriously have to wonder about the training that nursing home staff received and their lack of professional behavior.

My grandmother is now in a nursing home. It's in a small town. I worry about her, but my aunts are posting photos of her regularly of Facebook as they visit and take her out and about. So at least I know she is as okay as she can be for all of her issues (memory problems & having to be in a wheelchair).

[Russell Williams]

The wound on Louise's leg was, at first, the size of a dime. Now it is the size of a quarter. Louise has just been told that it is a Mersa infection.

[moore2me]

Originally Posted by Russell Williams

The wound on Louise's leg was, at first, the size of a dime. Now it is the size of a quarter. Louise has just been told that it is a Mersa infection.

Son of a ************!!!!!

CDC info on MRSA (methicillin-resistant Staphylococcus aureus )

http://www.cdc.gov/mrsa/

[Russell Williams]

In early November of 2007 Louise's sister, the brilliant Mary Jane Wolfe, had a wound on her leg. Mersa got into the wound. About 7:30 PM on the second Thursday of November 2007 Louise was called out of a meeting and told that her sister, Mary Jane Wolfe, had been killed by the Mersa infection.

[Russell Williams]

I am sitting here, thoughtfully reading the material in the links that have been kindly provided to me and suddenly I realize, as I am reading them, that I am in a cold sweat.

My tension level is high and is difficult for me to relax yet, I must stay healthy in order to be of as much assistance as I can to Louise.

[moore2me]

Russell,

I agree Louise needs you to take care of yourself. I notice you were reading and posting in the middle of the night. This is not taking care of yourself. Get 8 hours of sleep to be at your best. Worry will not help. Education will, but sleep is important too. If you need, get some Ambien (generic) for sleeping pills - I take them when I can't sleep.

Keep your faith too.

[CastingPearls]

Originally Posted by Russell Williams

In early November of 2007 Louise's sister, the brilliant Mary Jane Wolfe, had a wound on her leg. Mersa got into the wound. About 7:30 PM on the second Thursday of November 2007 Louise was called out of a meeting and told that her sister, Mary Jane Wolfe, had been killed by the Mersa infection.

Russell, listen to me, I survived a horrific case of MRSA and so can Louise. I know that people are lost to it everyday, and it nearly took my whole body and did disfigure me, but I made it. This is not a death sentence for Louise. You said yourself that she's a tough cookie. The road is long and hard but neither of you are at the end of it by a long shot. This is one more speedbump but Louise can survive it.

The generic for Ambien is called Zolpidem. Talk to your doctor about a mild dose to help you get some rest, Russell.

[Russell Williams]

Louise has now been officially admitted to the hospital. She is now taking oral vancomycin for her C diff and intravenous vancomycin for her Mersa. Flagel does not work for Louise's C diff. Vancomycin does. Vancomycin appears to be one of the few drugs left that is somewhat effective against Mersa. One of Louise's doctors is Dr. John Bartlett http://sciencespeaksblog.org/2011/05...#axzz1yjezaI3F

he explained to us, as best I remember, that vancomycin taken orally does not get into the bloodstream. He said several tests showed that a person taking oral vancomycin had none of the drug in their bloodstream. He explained that the molecule is too large to get through the intestinal wall. I asked him about C diff developing a resistance to vancomycin. As best I remember he said that that would not happen because of the size of the vancomycin molecules. I did not ask for a detailed explanation. Whether the same applies to Mersa I do not know. I did not ask because at the time I was talking with Dr. Bartlett about this Louise did not have Mersa.

I have not actually looked at the wound since Thursday. Louise has no fever. She does not know what her white cell count is. When I go visit today I hope to get more information from the nurse. Again, I thank all of the people who have been reading this and have been giving helpful suggestions and links.

[Russell Williams]

Originally Posted by moore2me

Russell -
3. Where would you like your medical knowledge certificate sent? I assume you will be awarded at least a Master's Degree?

4. I also assume Louise should also be awarded a citizen's version of the Purple Heart medal for her bravery, persistence, and composure under such difficult medical procedures and treatments.

Thanks for the advice. Love your sense of humor. No Purple Heart yet.
Louise (Yes, I really exist.)

[Russell Williams]

Originally Posted by cinnamitch

Couple of quick suggestions. Ask for a bedside commode. For her hip wound have they considered a wound vac? Also if she is not in a nursing homes Transitional Care Unit, she needs to be on one. Lower staff to patient ratios and nurses more qualified in post surgical wound care.

I offered to bring in my own bedside commode and they refused. I was in the short term "rehabilitation" unit after I transferred from the luxury unit that cost an extra $150 per month.

Thanks for the advice. Louise Wolfe

[Russell Williams]

(Is the nursing home run by Moe, Larry, and Curly or by Simon Legree?)[/quote]

We.re not sure since her title was simply "The Aministrator". Despite all my many complaints I never met her.

Thanks for all your valuable information. Louise Wolfe

[Russell Williams]

Originally Posted by Diana_Prince245

Yes, gowns, gloves, and handwashing until the course of vanco is complete and there are three days of negative stool samples in a row.

But the problem with C Diff is once its under control, they will not test any samples that are no longer watery diarhhea. Just like Russell and I had to wait 3 days after we were sure I had C Diff before my stool was watery enough to be tested. Louise Wolfe

[Russell Williams]

I am finally home again and feeling much safer under the loving care of my dear husband, Russell.

Thank you so much for all of your helpful advice and support. You have all built up a lot of good karma.

I do plan to pursue an official complaint (no, compaints!) against the nursing home. Will keep you posted.

Louise Wolfe

[Russell Williams]

Last night I used my hands to hold the inside of Louise's upper arm and joyously snuggled my face into the outside of her upper arm. I commented to Louise i worked very hard to keep her healthy. With a loving and mischievous smile on her face she said that I deserve to enjoy the benefits of my hard work.

Russell Williams who has the honor of being married to the beautiful brilliant and wonderful Louise Wolfe.

[Russell Williams]

An update on Louise as of July 10.

Louise is now been out of the nursing home for two weeks which of late is, unfortunately, a record.

She did not tell me that addition to having MRSA in her leg wound she also had MRSA in the abscess over her new hip joint and she had MRSA in her blood. I found out this information on a visit with Louise to the wound clinic. Louise was getting a very strong antibiotic but it was only prescribed for 10 days because it is not only hard on MRSA it is also hard on many body parts. They are now prescribing a different antibiotic but it has been tested and found effective against the type of MRSA that Louise has in the three places.

For the last two weeks she has had no fever, her blood sugars are about normal, and her white cell count, as far as I know, is not elevated so she probably no longer has MRSA in her bloodstream. When we went to the wound clinic yesterday the doctor said that the abscess over top of her new hip joint seems to have completely healed. The only remaining wound is one on her calf which is a little smaller than a quarter and is about two quarters deep. A week ago the widest circumference was 1.7 (I think it was 1.7 and not 2.7) and yesterday the widest circumference was 1.3 cm. I am changing the dressing twice a day and putting Silvidane in each time I change the dressing.

She is doing her exercises and gaining strength daily. Sunday for the first time in perhaps three years she was able to leave her scooter at the back of the church and use a cane to walk down to the front of the church were Louise and I and Lori usually sit. After church we went to a place called Pen Mar where they have ballroom dancing. When the song "I just called to say I love you.", was being played Louise and I stood up and I pulled her close to me and we swayed back and forth. It felt wonderful. Later on, two different times, when faster ballroom music was being played, we both stood up and, facing each other while holding onto the Walker, we proceeded to move our feet more or less in time with the music.

It was wonderful to be able once again to hold her close and to dance with her.

[Yakatori]

Just awesome....

But what about the probiotics and fiber and such? Did the doctor get into any of that?

[CastingPearls]

Russell, you need to check with the infectious disease specialist whether Louise is colonized or not. That means that anytime she would have a wound or infection, MRSA would jump in because it's living on her body. You can battle it, knock it back, etc. but it remains on the body even after a wound is healed. You need to know this info; knowledge is power and if she is colonized you both have to be very careful even with innocuous things like papercuts.

[Yakatori]

Why not just assume that she is? I mean, isn't like 1/3 of the population?

[CastingPearls]

Originally Posted by Yakatori

Why not just assume that she is? I mean, isn't like 1/3 of the population?

I think it's smarter to not assume anything, don't you?

MRSA is prevalent in nursing homes and hospitals so it could be the environment and not the individual. If you remove the individual from the environment and they're recovering, (as I was) there's a risk that they're colonized but it's also possible they weren't. I wasn't, thankfully. I was sent home with active MRSA but pretty much kept isolated and everything was virtually sterilized (as much as possible in a home, it's not like the cats walked around in spacesuits) but visiting nurses had to suit up. In fact, my medical team told me I was safer at home with the infection than in the hospital.

It wasn't until I had small cuts and scrapes that the scare was over. More recently (three years later), I had another scare involving my original illness and there was no infection present at all.