Out of ICU, into Intermediate Care . . .

Busy day yesterday (Tuesday). Bob was transferred from his bed to a chair for a good hour or so. Helluva process, I called it "airlifting . . ." basically strapped the sheet underneath him to an overhead contraption and mechanically lifted him from the bed to the chair. Incredibly painful, Bob cried out the entire time he was airborn, and even for a few minutes after he was settled in the chair, but eventually the pain slowly subsided. He didn't look particularly comfortable in the chair, but he said it did feel good to move positions and have a change of scenery for a while. There's no way he can do that himself yet; he can't even roll over to his side without assistance from two nurses at this point, but the orders are to get him out of bed and slowly move him into a more upright sitting position, little by little. Right now, he's been at about a 45 degree sitting angle, not completely upright, which is all he can tolerate, without pain.

Had the NG tube (the one running from his nose to his stomach) and the Foley cath (drains urine from bladder) removed yesterday afternoon, but still had orders for no food, very little liquid, as they still want to take that slowly, too. Thank god he had an extra 25 pounds to fall back on . . . I constantly think about where he was three months ago, when his surgery was rescheduled for the second time. How emaciated he was, absolutely no reserves to tap into. At 105 lbs., I don't even know if he could have made it through the surgery, much less five days without food afterward. . .

Finally, around 6 or so last night, Bob was moved from ICU into Intermediate Care Unit. His ICU nurse called it a "step down," I said, "Hey, that's a matter of perspective—I'd call it a "step up—Bob's moving up in the world . . . " Bob was somewhat apprehensive about that decision; felt it's too soon, but there is nothing critical going on with him to warrant the ICU stay, his heart is strong and stable, almost all tubes, IVs, etc. are removed except for a line in his jugular vein . . . better to get out of ICU and on the path to recovery as soon as he can, scary as it is . . .He was feeling painfully bloated, nauseous all afternoon yesterday and into the evening . . . I gave the litany of symptoms that I'd observed to his new nurse to keep an eye on—swelling in his right leg and pelvic area, redness around wound site, bloating, nausea . . I stayed with him till almost 8 last night, helped him get settled in his new room. No roommate as of last night, so hopefully he'll get a good night's sleep.

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Wednesday morning . . . left 15 minutes later than usual this a.m. and got clogged in hellish traffic on my way in. Astounding, that just a few minutes makes such a dramatic difference in the timing, even with my incredible rush-hour driving prowess. Took over 45 minutes to get to the U this morning, but thank god for moms to talk to on the way and the drive more tolerable . . .

Tough night last night, Bob told me when I got into his room this morning. Said the nausea got so bad, he eventually threw up. No wonder, he hasn't eaten in five days, had taken all his meds on an empty stomach last night. . . the Foley cath was also reinserted because right now, he has no sensation in his pelvic area, can't tell if he needs to go to the bathroom. But, at least he's producing and moving urine. The S1, S2 and S3 nerves on both sides of his body control the functions of the pelvis; he lost 1/2 of those nerves with the removal of the tumor, and the left side nerves that are still intact were stretched and moved during surgery, so it'll take time to see if his left side will recover and compensate for the loss.

At some point today, he'll be "airlifted" to a chair again, probably more PT and OT . . . last night, when he was transferred to 6B, the internal doc on staff said he'd begin the request to move Bob to an intensive rehab program once he's ready to leave the hospital. This would be more involved than transitional care; lots of intense therapy, rehab, to get Bob back on his feet, literally and figuratively, so he can move toward a "new normal" way of life . . . whatever that is.