Transitioning

Sunday was my second full day in the hospital. I met with the physical therapist and walked around the ward a bit. The attending physician told me that I was still being kept for observation primarily because I wouldn’t be able to have an MRI done until Monday morning After that, they would decide where they would be releasing me. He did not give any indication as to which options they were weighing. I started thinking about the economic impact of all the nights I had paid to live in a motel that were going unused. If only I could have a prorated bill.

By 6:00 pm I had finished meeting with everyone. I had even gotten some exercise, and my balance was already getting better. Now I sat down to write my blog.. When I finished and put away my computer at 10:00 pm, I had finished my blog for the entire month of January. It was still the first week of January, so I settled into a new peace of mind. Now I would be able to focus on the tasks at hand, like rehabilitation, paperwork, a job, spending time with my dog, and securing housing. It felt like I could accomplish anything.

With the test being scheduled for the first thing in the morning, I wasn’t allowed to eat anything. I went online and tried to distract myself, because all I could think about now was food. There was nothing on TV, and I couldn’t really do anything else, since I was confined to the hospital. As hungry as I was, I was lucky that I had been working out so much lately. Since the stroke, when I am getting regular exercise, my appetite is not nearly as intense. I was eventually able to fall asleep.

The next morning, I was taken down to the MRI. The MRI technician remembered me from my visit the previous summer. He found similar music for me to listen to. I was anxious but relaxed. I needed this test to end quickly so I could go upstairs and eat. I listed to the heavy knocking sounds of the machinery and tried to lie perfectly still. After about twenty minutes, the test was over. The tech helped me back to my wheelchair outside the room and a transportation worker arrived to take me back upstairs.

Later that day, the doctor came in and told me that there was no cause for concern and that another stay in inpatient physical rehabilitation would not be required. Instead, I would be stepped down to transitional care. They didn’t feel as though I needed to be confined to a hospital, but they did not want me released somewhere where I could not receive medical supervision. This was a hybridized solution that would balance my need to be in a stable medical environment with my need to be out in the community.

That afternoon the staff began calling facilities around extreme southern Minneapolis and Edina in order to see who had space. This was not the area I requested; they were just operating from the last zip code they had on file. I really wanted to be north of Lake Street and west of 35W. This area was familiar to me and also had many businesses and restaurants in a compact area. However, I didn’t want to complicate the process by adding suggestions.

Between 2:00 and 6:00, they checked in every couple of hours to update me on their progress. The story was always the same: “We haven’t found anything, but we’re still looking.” At 6:00, they told me that I would be spending the night in the hospital. So I climbed back into bed and tried to get some sleep. About an hour later, they interrupted me to tell me that they had found a facility with a bed. I had to put my clothes on because transportation would be arriving in the hour.

“We couldn’t find anything in your area. So I’m not sure you’ll like it.”

“Where is it”

“2nd Avenue and 22nd Street.”

“I used to have an apartment on 1st and 24th. I miss that neighborhood!”

As I put my clothes on, I thought of all the reasons I loved the Whittier neighborhood. It was close to Uptown and downtown; it contains Eat Street, a few blocks of international restaurants; I would be close to everything I needed. I was in no condition to be walking around outside in winter, but hopefully I would be able to walk a few blocks in the summer.

When it came time to put on my shirt, I could not find it. I asked the CNA to help me look for it. She couldn’t find it either. Next, she offered to find me a shirt to wear out of the hospital. However, both of the shirts she returned with were size medium. I couldn’t wear anything that small. So I had to wear a gown.

I was still disoriented when I arrived at the nursing facility. I was on a gurney, and it was dark outside, so I could not tell where I was. The paramedics took me inside and to the elevator. When we came off the elevator on the 2nd floor, the worker’s at the nurses’ desk told them I was in room 203. They wheeled me down the hall and unloaded me on the side of the room with a bed.

A staffer came down to help me put my things away. I told her, “I have a doctor’s note to see my dog. Who do I give it to?”

“We don’t allow dogs.”

“I wasn’t asking for her to live here. I have a letter from a doctor saying that she’s my emotional support animal.”

“We don’t care about no doctor’s notes. We don’t allow dogs here. You gotta get rid o’ yo’ dog.”

At this point, I realized further conversation was futile. I was dealing with someone who didn’t know that medical law supersedes a building’s policy. I would wait until the professionals were here during business hours. They would know how to handle this.

I wasn’t sure what to expect from a skilled nursing facility, but I was not prepared for the lack of privacy. My living space was in a semi-private room with only a curtain separating the beds. My roommate was watching TV, and I realized that there would be no way to listen to anything I wanted to without earphones. I searched for an outlet; his television was plugged into it. There were no others on my side of the room, so I couldn’t plug in my CPAP and phone simultaneously. This was a problem as I always went to sleep with the CPAP and a YouTube video running. It was still early in the night, so I went out into the dayroom to plug in my phone.

There were two gentlemen watching TV in the dayroom. They showed me several places where I could plug in my phone. I asked them why they were not watching the national football championship game. They informed me that the house didn’t get ESPN. I wasn’t going to be upset if I didn’t see Georgia-Alabama, but it was something to do. Instead, I plugged in my charger and spent time talking to them.

They had each been here a couple of months, The facility workers were nice people, but that didn’t make the facility home. One said, “We been here long enough. It’s time to go.” I didn’t know what to expect of this place or how long I would be here. Do they automatically receive payment from Social Security? If so, how would I pay for my cellphone bill? Where would I board my dog? How would I pay for food and vet bills?

I tried my hardest to act as though none of this was bothering me. Basketball was on TV, so I talked about the game and where the other residents were from. The two guys were very friendly. The time passed quickly while we were talking. Before long, my phone was fully charged. The game ended and the other residents went off to bed. I wasn’t sleepy yet, so I switched on my phone and corresponded with people on Facebook. By midnight, I was finally able to lie down and sleep.

On my first morning at the skilled nursing facility, the staff woke me up for breakfast at 7:00. I felt so tired it was almost painful. This was three hours earlier than I normally wake up. I asked what time lunch would be. “11:30.” I would just get up then.

Around 10:00, I woke up for good. I hit the call light by my bed, and a CNA helped me to dress. I took my morning meds, used the restroom, and brushed my teeth. My roommate was sleeping with the television on, and it was too loud to think, so I grabbed my cellphone and earbuds, and went to the dayroom.

One of the gentlemen from the previous night was seated at the table. We talked briefly, and he told me that he had been here since he had a stroke four months before. He also explained that I would be getting physical therapy daily. This filled me with hope. I would be able to get aggressive therapy in a safe environment, and I wouldn’t even have to dress to go outside. This could be the best physical therapy experience I’d had since I was inpatient.

This patient’s stroke had been in October, so it had been more recent and less devastating than mine. He was still using a wheelchair, but they were trying to transition him out of it. I watched as a physical therapist came down the hallway to help him practice walking. Transitional care was what I needed too. I began wondering what might have been possible if I could have done something like this right after I left the hospital. Certainly, it would have been beneficial to move to a certified nursing facility after I was in the Minnesota healthcare insurance system.

By lunchtime, no one had come by to do an evaluation for rehabilitation therapy, so I decided to go down to the cafeteria to eat. My room was on the second floor and the cafeteria was on the first floor. I wanted to walk there, but I was still a bit unsteady. Reluctantly, I went downstairs in a spare wheelchair. I was a little disappointed in myself at not being able to walk, but my left leg felt too weak for me to walk around safely. Someday.

I came down at around 11:15. Food service wouldn’t start until 11:30, but the cafeteria was already pretty full. I noticed that I was one of the youngest patients in the room. Although I probably had a better chance of recovery of a more active life than most of them, they had probably gotten a chance to live through their forties and fifties with fully useful limbs. I was hopeful and tried not to dwell on how much time it might take before I could have what I deemed a normal life.

Since I was new here, I didn’t want to sit in anyone’s favorite chair. In order to avoid something awkward like this, I went toward the rear of the room and tried to find a seat against the wall. I introduced myself to the other people at my table. They were polite but not very talkative. My food came last. I assumed it was because I was new. I ate my food in relative silence, then returned to my room. Dinner would be the last meal I ate in a wheelchair.

The next morning, I was still getting used to the earlier schedule. A CNA had to wake me and help me get ready for breakfast. After I was dressed, she brought the wheelchair around. I told her I didn’t need it. She wheeled it out of the room, and I carefully walked to the elevator. As I strode off the elevator into the dining room, I felt as though the entire room took notice. My heart swelled with pride. I was entering the room like a new man.

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