Getting Closer to One Goal

Earlier this month the PT had set 4 goals for Jon before he went home...getting rid of the feeding tube, off the trach, the wound vac and oxygen. He is not using the feeding tube for anything, including medications but he has to be stable for 6 weeks afterwards before they will remove it. He is off the wound vac which leaves the trach and oxygen.

We finally made it to an Eye, Nose, Throat doctor to map a plan to get rid of Jon's trach. He agreed it was past time to downgrade the size of the trach and replaced it with a size 4 Shilley. While we were there he also checked Jon's ears and said he had a lot of wax in both ears and started to clean out the left one. It was rather like watching a dentist at work. He had a long, skinny instrument that he used to pull out pieces of wax, wipe them on his cloth and then go in for more. Jon would wince a couple of times and then let out a loud ow! He had pulled out a piece the size of your little fingernail which looked like dried tar. He didn't do the left ear which he said was even worse but would do it on the next visit when he would probably removed the trach. He suggested putting a couple drops of hydrogen peroxide in the ears periodically and let it bubble to loosen dried wax and let plenty of soapy water get in them while showering. Even though I told him of the numerous time Jon has had aspirational pneumonia he didn't think a swallowing test was necessary. However, the speech therapist had noticed the number of times that Jon coughed during meals and has always wanted to know exactly what was going on so she has ordered a swallowing test for tomorrow.

When setting up the appointment she informed me of still more new changes in Medicaid. If you remember the four things$3.91 @ day was to supposed to cover (therapy, medication, transportation and wheelchairs) it wouldn't surprise any of you to know that starting in October we may have to start paying transportation costs for trips outside the Center. It was supposed to go into effect tomorrow but the Admission Director said emails had been flying all day and the last word was No, the charge wouldn't be passed on to residents. However, what are the odds?

That's all for now, thanks for checking in.