Dr. Yaszemski came in bright and early today to tell Karl he wanted him to stay in his Clinitron bed to heal. The large amount of steroids Karl is on causes him to heal a little more slowly than most. The steroids are also the reason Karl's skin breaks down so easily when stressed. The internal medicine doctors think the added stress on his body is causing his heart rate to jump. To counter that, they've given him more steroids and a bolus of fluid. It's a Catch 22. Even with that, Dr. Y feels Karl's incisions are healing well and he said he'd like to try to get him out of here by the end of the week. Yay!
Dr. Y also told Karl he is not concerned about the new bug (staph coagulen negative) they found. In fact, he thinks it may be a contaminated sample because it grew on only one of four cultures they took and it also started growing well after the enterococius (strep) they feel is the major culprit. When they discharge Karl, he will probably need 6-8 weeks of daily IV antibiotic therapy, which brings us to other challenges the staff is working on.
Medicare will not pay for at-home IV therapy. They WILL pay for IV therapy at a hospital. This makes little sense. It's neither cost-effective for Medicare (nor you and I as tax payers) nor convenient for Karl. Daily trips to Herrick for the next 6-8 weeks will probably not be good for his rear end, but he'll do what he has to do. Another issue is Karl's special bed and mattress, which provides Karl constant air movement and pressure relief. The problem is, Medicare mandates that Karl have a stage IV pressure ulcer (to the bone/metal) in order for him to keep it for more than three months. They apparently are not thinking of prevention.
So Kelly, the unit CNS, is going to draft a letter to Medicare asking them to make an exception with all of the reasons mentioned above, plus all the medical jargon explaining Karl's situation. She will then run it by Dr. Y and he will sign, hopefully as Assistant to the Assistant US Surgeon General, Air Force Brigadier General and Mayo Surgeon. It's so good to have him on our side.
Now for a special prayer request: Karl's neighbor in the room next door, Jolene, a 31-year-old mother of two, who is also a patient of Dr. Schuetze's in Michigan and who had a hemi-pelvectomy recently, isn't doing so well. If you could send a few prayers up for her, we'd all surely appreciate it.
I'll let you know as soon as we know anything.
Love and blessings,
Kerry
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