5 May 2022
Yesterday after Sami the LVN did the dressing change, Rhonda the Physical Therapist came by. The law, she explains, requires in-home nursing to re-qualify a patient every time they are released from the hospital. That's why Dana the RN comes before Sami can resume visits and why Rhonda has to come before Julie the Physical Therapist can resume sessions.
Rhonda explained it has to do with fraud prevention and she felt horrible about having to come by for Joyce because Joyce has had frequent surgical debridements that really shouldn't interrupt home care. But it is what it is.
"Oh, we're just delighted to see you again," I joked.
She laughed. "Let's leave it at that then!"
I had noticed that Joyce has a rough time raising her left foot high enough to get into the passenger seat of the car.
But she always offers to answer any questions and ask if there's anything she can do for Joyce. So I tried to think something up. Just to, you know, make her feel better.
I had noticed that Joyce has a rough time raising her left foot high enough to get into the passenger seat of the car. She gets her toes on the running board and wiggled her foot until the heel is up there and then pushes her foot into the car.
That, it would seem, does not rely on the dead muscle in the back of her leg (the big one you can feel right above your knee and up to your seat). It relies on the front muscles. What can we do about that?
Rhonda explained that when one of the muscles has a problem, the other guys sympathize and refuse to leap into action. So you start favoring the other leg. And everything atrophies.
So she recommended a step stool. Just put it in front of you and raise your leg high enough to clear it. That's it. The whole exercise.
I got ours from the kitchen to see if it was the right height. "Perfect," Rhonda said. But if it's too high, you can use a few books or something shorter to start.
The idea is that when you have a visual goal, your mind kicks in and helps those muscles do the heavy lifting. It's like the difference between running fast by yourself or trying to catch someone, Rhonda explained.
This is one of those things we wouldn't have tried if the Wound VAC were still in use. But the wet-to-dry dressing makes it feasible. In fact, Joyce has twice walked to CVS about three blocks away since going wet-to-dry. It's been liberating.