Nikki continues to do well in rehab. 3+ hours per day (except Sundays) of physical and occupational therapy, plus daily Average Daily Life skills. Due to her very good mobility, there's some talk of discharging her within a week, to continue her occupational therapy as an outpatient. She would also need outpatient care for her skin grafts, although Dad will probably handle the routine wraps and bandages at home (with some training).
Nikki's appetite is doing very well, and she's really scarfing down the food that we bring in to her. She is also enjoying a LOT of visitors; so many, that she has to schedule them, in order to keep from filling up the room. The nurses are very supportive of visitors, and don't enforce any kind of quantity or time limits. She spends a lot of time on her phone, sometimes using the speakerphone, but increasingly using the handset.
I've got the ball rolling for Social Security Disability and Medicaid Disability for her. I have a Medicaid interview Tuesday, and then Social Security does a phone interview with her on Wednesday. As Nikki's insurance runs out next month, these are very important for her future care. Remember, she still faces several plastic surgeries. There's a good chance she'll have a surgery on her eyelid before discharge.
I was expecting to start back to work at Sears on Monday, but there's been a snag. My district manager was pleased when I told him two weeks ago that I was ready to come back, a week earlier than my leave called for. He visited my store on Friday morning, and was making plans with my assistant manager for my return. Then on Friday afternoon, I got a call from him, telling me that I would have to interview for my job again! This apparently comes from the V.P. of sales, and I think it caught my DM by surprise as much as it did me. I have to interview with both the DM and the V.P., which is unusual. This had never been mentioned anywhere during my leave process, and I'm concerned about it popping up now. There have been a lot of organizational changes in my division this past year, and I hope that someone isn't looking for an excuse to make a change at my store. This also hurts us financially, as I need to get some income going pretty quickly, and this will cost me at least another week- if not more. I have little choice but to go along with it, though.
That's all for now- more later.
09/22/2004
The first days of rehab for Nikki have been busy ones. She has physical therapy and occupational therapy scheduled throughout the day. The sessions take place in one of Dodd Hall's 4 gyms. In between sessions, she has appointments with her various doctors and support staff. So far, she's been visited by the burn team, oral & maxillofacial, nutrition, physical medicine, general plastic surgery, ocular plastic surgery (specializing in eye repair), rehab psychology and a burn rehab specialist... all in her first two days!
Nikki is a little overwhelmed by all the attention. This is a busy place, and there's a lot of work to be done, so they cram a lot of activity into a small amount of time. From 8:30am until around 4:00pm, it's hard to find her. All of the physical work is on the first floor, while many specialists have offices on the second. Thank goodness her daily schedule is posted on the unit for anyone to find her by.
Today, Nikki had a very thorough review by a physiatrist specializing in burn rehab for more than 20 years. He dictated an amazing amount of observations and treatment recommendations during her 30 minute exam. Her skin grafts are starting to constrict, and this has a marked effect on her mobility and appearance. Her arms and right hand have limited mobility at all of the joints, requiring a lot of focused exercise to relax. Some areas may require surgical releases to enable the desired range of motion. Pressure garments are already in the works, to help reduce future scarring. Custom made for the patient by in-house specialists, these garments can be designed to cover every body area that has skin grafts. They exert pressure evenly over the grafts, preventing the skin from bubbling and wrinkling. Using these garments early and often can make a huge difference in long-term appearance. The grafts on Nikki's right neck and face are also constricting, causing her to lean her head to the right and pulling down her right eyelid and right side of her mouth. A special neck and head support is being made that will hold her head in the proper (neutral) position. She's been warned that it's not real comfortable, but is crucial for future mobility and appearance. Nikki was a little down during this session, as the amount of information being presented to her was overwhelming, as well as a little scary. Hearing about so many things that need correcting on your body can be depressing. We had a brief crying session afterwards, followed by a conveniently scheduled appointment with the rehab psychiatrist. She felt a lot better afterwards, and so did I. No signs of clinical depression or post traumatic stress syndrome, and a good overall attitude about getting better.
Ophthalmology and the ocular plastic surgeon visited Nikki today. The plastics guy liked the work done on her bottom right eyelid. However, the graft constrictures are pulling the lid down enough to keep the eyeball exposed all of the time. She wears a moisture barrier to maintain proper lubrication, but that's a short term solution. Plastics wants to work on her eyelid soon, releasing the constricture & also raising the eyelid to provide better coverage. They feel that the integrity of the eyeball is at risk, and they want to move pretty quickly on this- probably within a week.
Nutrition is also a concern for a burn patient. Lots of protein is the key, and it can be a chore getting enough into her. Nikki is a picky eater, and doesn't care for much hospital food. We bring a lot of food in for her, and her unit also offers some favorites, such as canned pastas and the like. She loves this stuff, and can just help herself any time she wants. They are also working on finding an oral nutritional supplement that she likes.... good luck!
Small advances are already being made. Nikki can now brush her teeth on her own, as well as feed herself and get a drink. The staff equipped her room with a speakerphone, so she can answer and make calls on her own- a HUGE morale booster. She's now wearing several nice athletic suits during the day, which I'm sure make her feel more normal. She handles her own laundry in the unit's laundry room. Whenever she wants a snack, she just wanders down to the pantry and helps herself to an amazingly large stock of convenience foods, adding to her feeling of independence. She also has a menu for local restaurants that will deliver food to her.
Things are going well, if hectic. I'll try to keep everyone up to date as things develop. If you'd like to send a card to Nikki, here's her temporary address:
OSU Medical Center
Dodd Hall, 4th Floor
The staff at Dodd Hall is amazed at the amount of cards, posters and stuffed animals that are in Nikki's room after only two days.
Thanks for your interest in Nikki's progress- more later!
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