Days 35 & 36 ~ Merry Christmas!

Red Meat
   Bob's anemia is still plaguing him. One of his wound nurses said he needs to eat some good ol' red meat! So on Christmas Eve, we ran to Downtown Produce (just 5 minutes away), went in, bought 4 NY strip steaks and some fresh broccoli, and were back home in under 20 minutes. It was Bob's first official "outing" (can't count doctor's appointments) since the surgery debacle began.

Bob headed straight for the meat case. 

Hoping to get a little more color into that pale skin.

Christmas dinner
   What a great Christmas gift - having a steak dinner at home with Bob by my side.

Wishing the happiest of Hanukkahs and merriest of Christmases to everyone! 

Day 34

Wound Healing   

   As previously shared in this blog, we've been keeping track of the wound measurements taken during wound-vac dressing changes. I don't post the actual (graphic) pictures of the wound here, but for those of you interested, here's a chart Bob asked me to make. He wants to see the trend of growth and be able to visualize the actual improvements. 

Impatient

   Some days are harder than others now - healing, re-growing tissue and building back muscle can be a slow and tiring effort. Bob continues walking daily, his appetite's slowly improving, and he's getting lots of rest, but I think he's becoming impatient with the pace of his recuperation. Small steps every day. I remind him this is still part of the marathon; this was never a sprint.

Watching YouTube TV on his phone.

Days 29 & 30

Saw the Surgeon Tuesday
   Bob is healing well and doesn't have to go back to see his surgeon for a month now! No more weekly appointments.

Healing 
   He's walking more, slowly getting stronger, building his endurance, and only has pain if he's been sitting up too long or has to have the wound-vac dressing changed. Every day is a little bit better than the day before.

Still anemic...
   ...but his hemoglobin is up to 8.9 now - the highest it's been since this surgery journey began a month ago. We're pushing protein so his body can continue to heal.

It's so nice that I just have a few happy bits to share, and no long, drawn out narrative of worries and bad vital signs to be posted. We're really starting to feel like he's on the other side of this thing for good.

Ready for his morning walk. There's 38 pounds less of Bob now!

Waiting to see the surgeon. If you couldn't guess, Bob really dislikes his "tether".

Days 27 & 28

First Weekend Back Home

   We're working towards some normalcy around the house. Life seems to still be moving at an unnatural rhythm, but we're focusing on mastering the everyday typical stuff (showering, meals, etc), to try to get back into the swing of things.

Saturday

   Kindred Home Health came and did their initial assessments (nursing and physical therapy). Each activity needs a followup rest and/or nap, which is a healthy and necessary trade-off.

Wound nurse trying to stop a slight wound-vac leak.

Physical therapist assessing Bob's balance strength.

Sunday

   We took a 15-minute walk down our cul-de-sac this morning. Bob's walking pace is half as fast as it used to be, which is perfect for me, since now he walks at the same speed I always have! He insisted on checking the mailbox; again, striving to get back to "normal" life. (You can really see his 35-pound weight loss in these photos: his clothes are literally hanging off him now)

This coming week will have wound care visiting us on M/W/F, a surgeon's post-op office visit on Tuesday, and some physical therapy visits (either two or three times). Maybe, if we're able, a tiny bit of Amazon Christmas shopping, too.

Grateful and Thankful!

So many people have been so wonderful through this entire experience. Meals, cards, gifts, emails, visits, pictures, phone calls, notes, facebook posts, chore-doers, dog-sitters, lawn-mowers, house-cleaners...the list goes on and on. We've been blessed with such outpourings of kindness, support and love. We're forever thankful and grateful for all of our family and friends and co-workers that have lifted us up, and appreciate the continued good thoughts as Bob keeps healing and improving. 

Thank you, each and every one of you, for keeping us in your hearts!

Day 26, Home!

Finally!
   Hard to believe Bob's condition was critical with sepsis, a fever of 105F, tachycardia, dangerously low BP, an open, infected abdominal cavity and 18 pounds of extra fluid filling his body, all just 21 days ago! We've started talking about everything he went through, and he's really astonished to hear about it. He's got strong memories about trying to get that ventilator tube out of his throat (he said his mind kept telling him they didn't put it in right), but other than that, most of those ICU days are lost to him. I'm very thankful for that!

Here's a few photos to sum up our day so far:

Waiting for discharge, after dressing change done

and transfer to home wound-vac unit complete.

Ready to go! 

Except they had to go find a wheelchair to bring him out to the car...

😦

Bob got all armored up with a pillow over his belly,

but an excited Dingo was a good boy and just gave him a few kisses 

and got lots of rubs and pats - no jumps.

   So we're back home, waiting for the hospital bed to be delivered early this evening. In the meantime, Bob's been relaxing in his recliner. We'll now be transitioning to the weeks of home health care. Life is very, very good!

Update (7pm): 

   Best recuperating spot in the entire house! Only a few steps from a bathroom, adjustable lounging hospital bed, huge TV screen just a few feet away, a computer and cell phone on one side table and a wound-vac pump on the other. Plus, weeks of wound dressing supplies stacked neatly in boxes on the mantle - how festive!

Recuperating room (fka TV room)

The most comfortable Bob's been in a long time.

Day 25 ~ Room 125, 4pm

Flurry of Activity 

   Today Bob had his last hours of inpatient OT and PT at Sea Pines. He will still have home health care coming to the house to provide therapy, and may possibly continue to attend outpatient therapy at Sea Pines, too.

   The representative from Kindred Hospital met with us today to confirm they will be providing wound care for Bob at home. His nurse will come to assess on Saturday, and the regular visits for dressing changes will begin next week Monday (changes will still happen three times a week, M/W/F).

   The representative from KCI (the vac therapy company) met with us today, assigned the portable vacuum unit to us, and trained us on how to operate the ActiVAC model that will be going home with Bob tomorrow. In addition to the unit, he also gave us supplies for 5 dressing changes. The boxes are large, but very light. I brought home as much as I could from his room today, so that we won't have too much to carry besides these boxes with us tomorrow.

Our "to-go" wound vac pile for Friday.

Wound Vac Therapy
  Quite a few people have asked us about the wound vac therapy and how/why it's effective. Below is a 3-minute animated video that explains how the dressings are applied and how the system promotes faster healing while greatly reducing chance of infection. Bob's wound is still 18.3cm/7.2" long x 5.8cm/2.3" wide x 1.7cm/.67" deep, so when the sponge is removed and then replaced, he still has considerable pain, especially when the vacuum is turned back on over the newly packed dressing. 

   Considering Bob's wound itself has already reduced 2.1cm/0.83" in width and 2.3cm/0.9" in depth over the past weeks using wound vac therapy, with no infection at all, I think the system is great!

Promise, only animation, no real stuff.

Day 24 ~ Room 125, 6pm

Thankful for Visitors

   Today Bob had his OT from 9-10, his first PT session from 10-11, and his second PT after lunch, from 1-2. Some visitors from work caught him out and about, walking without assistance!

Tim and Bob as the patient *walks himself* to PT!

   Then, after a full day of therapy, a shower followed by a very thorough wound clean and a sponge-vac change, Bob had a few more visitors this evening. This entire experience has really emphasized how fortunate we are to have so many good friends and caring family members in our lives!

Terry visiting with Bob...who's already in bed after a busy day.

Wound-Vac Dressing Change #7 

   For those keeping track 😉, below are the latest measurements:

   *Dressing change #7 (12/13, today): 18.3cm long x 5.8cm wide x 1.7cm deep

   *Dressing change #6 (12/11, Mon): 18.5cm long x 7cm wide x 1.7cm deep

Getting Ready

   I spent a large part of my day today arranging things for Bob's Friday discharge. I scheduled his final inpatient wound dressing change at Sea Pines to happen Friday morning at 10am so he could be home hopefully by lunchtime. I also made sure that today's and Friday's dressing changes were being done by one specific nurse instead of another. (I had to meet with the charge nurse, nursing supervisor, case manager and finally the wound-care supervisor, but my request to remove one of the two wound-care nurses from Bob's care was coordinated and I felt so much better after that- every once in a while you come across a health care worker who should really be doing something other than providing health care, you know?)
   I also arranged a hospital bed to be delivered at home on Friday and scheduled the 3-times-a-week home health care visits for wound dressing changes starting next week Monday. I confirmed with our case manager and our insurance company that the portable wound-vac unit ordered yesterday wound be delivered tomorrow (Thur) to Sea Pines so Bob will leave the rehab hospital connected to his own home wound vac system when he leaves on Friday. I setup Bob's next two weekly post-op appt's with his surgeon, and also stopped and picked up an XL mattress topper, sheets, etc for the hospital bed.
   Absolutely no complaints here! Would rather be making all of these plans and arrangements than feeling heartbroken and helpless with him critical in the ICU. He's come a long, long way in a relatively short time! ~ Talk about blessings ~

Day 23 ~ Room 125, 5pm

Waiting

   One of Bob's least favorite pastimes is waiting. Wait for the dietician to bring food. Wait for the nurse to answer the call bell. Wait for the transport van to pick you up and take you to your doctor's appt. Wait in your surgeon's office for him to come in and examine you, while your muscles are aching and you're exhausted just from the trip.

Hating the waiting at the surgeon's office today.

   And more waiting today: Wait for the care team's weekly meeting to determine a discharge date.Then they decided Bob will be able to go home this Friday! So in our house, Christmas is coming a little early... We'll be doing our happy dance (or maybe just some jazz hands) on  Friday, December 15th!

Home Health Care
   Bob will be going to outpatient OT and PT, and home health care will be coming to do vacuum wound dressing changes at home on M/W/F. No word yet on how much longer he'll be using the negative pressure wound healing system.

Weight Loss
   I do not recommend Bob's weight loss method that was utilized over the last 22 days, and neither does he. He's lost 29 pounds! Unfortunately, some of that was muscle, but he'll be working on getting back into shape.

Day 22 ~ Room 125, 3pm

Wound-Vac Dressing Change #6 

   Great news! Bob's wound is shortening/closing VERY nicely! No pictures here (as promised), but the measurements below show the improvement over the past 4 days:

   *Dressing change #6 (12/11, today): 18.5cm long x 7cm wide x 1.7cm deep

   *Dressing change #5 (12/7, Thur): 20.5cm long x 7.2cm wide x 1.7cm deep

   Removal of the sponge (right at the beginning) and re-initiating the negative pressure suction (right at the end) are the two most painful parts of the process, which takes about 30-45 minutes total. Bob experiences so much pain each time. Can't wait for this wound to close up.

The items required for the dressing change.

Physical Therapy

   Bob's still somewhat weak, but is building up his endurance and increasing strength. Today they OK'd him to walk without a walker, as long as he is being "supervised"! I visited him at PT and snapped a few pics to share...

His trusty vac-pac bag hanging over his shoulder and 

his vacuum tubing hanging around his neck.

Didn't think about the photo angle - 

surviving sepsis apparently leads to duck feet...

🤣

Day 21 ~ Room 125, 6pm

Smiles 

   Slowly but surely, Bob's plodding along. He's still anemic and therefore still tiring very easily. He's having some aches and pains in the muscles he's rebuilding, especially in his abdomen. Tylenol seems to be enough, unless it's a Wound-Vac dressing change day, and then he also takes Lortab. I'm arriving in late mornings, staying through most lunches and dinners with him each day (when he has visitors I might step out for a while) because he's becoming a bit lonely and needs encouragement. Watching his favorite football team and winning at Fantasy Football helped boost his spirits today.

Watched Minnesota Vikings play today

while tracking his fantasy team at the same time.

Recommendations?

   Bob's case manager met with us today and is ordering a Wound-Vac system to be used at home. They might let Bob return back home in as little as one more week, if we can have the house set up correctly to accommodate his needs. They can do dressing changes and also arrange to have Kindred Care come to do physical and occupational therapy sessions at home.
   So on that note, local friends, we're looking for references for a reputable, experienced & trustworthy carpenter/handyman to install permanent handicap grab bars in our bathroom and tiled shower. Please share contact info if you have any good recommendations. (Bob has the skills, but obviously right now isn't capable).   
   Thank you ~ much appreciated!

Smiles are good for the soul.

Day 20 ~ Room 125, 6pm

Plum Tuckered Out 
   Please continue to keep Bob in your thoughts. He's having to work hard to regain strength and endurance and gets tired so easily. It's difficult for him to have to spend his days realizing how weak he is from his sepsis and ICU stay. He hates having to sit waiting in his wheelchair for a transporter to come and bring him from therapy back to his room. And he's becoming frustrated at having to constantly depend on assistance from somebody else to get out of bed, use the bathroom, etc. It's hard to not be independent. I continue to encourage him and remind him how every day he's making great strides, and he'll be back at home before he knows it.

He's slowly regaining an appetite.

Thanks to everyone for your continued support and good wishes!

Day 19 ~ Room 125, 3pm

It's Time for a Christmas Tree!

He's strong enough to hold up his festive little decorated evergreen!

First Full Day of Therapy
   We're trying to adjust to a new schedule now with Bob relocated to Sea Pines. He had his first full therapy sessions today. He said he is shocked how weak he is and how little endurance he has. Once back to his room, he is in bed and asleep within just a few minutes of watching a little YouTube TV on his phone. I keep reminding him that his body needs to heal and rebuild, and his immune system is still on overdrive, keeping that belly wound free of infection and making new tissue. I keep reminding him how far he's come already, and that it's going to take small steps some days, but he's still moving in a positive direction.

Absorption
   Bob's digestive system is doing very little absorbing yet. Most of what he eats is vacated very rapidly. They removed around 18"-22" of intestine overall, but his entire digestive system has to heal and re-learn to process food efficiently. They've added some additional probiotics to help those intestines function better. They're also giving him glutamine and arginine supplements, iron (he is anemic, only 8.5, and for men normal is 13), Juven (therapeutic nutrition drink) and Ensure (nutrition supplement) to improve his overall health. It's going to take time for his digestive system to start correctly absorbing essential nutrients again. He also has no appetite, which is largely due to his shrunken stomach. He'll eat a half banana and about 2 ounces of meat and then he's full. They're going to work on him having supplements during the day when it isn't mealtime, to try to encourage more nutrient absorption.

We'll see what tomorrow (Saturday) brings. 

So happy to be able to look forward to another day!

Headphones in, TV on his phone...time for a nap!

Day 18 ~ Room 125, 7pm

Most important: Bob got to have a shower today! After 17 days!

His arms are getting a little skinny,

but his hair's been washed and his body's been showered!

Successful Relocation

   Bob is now moved into the inpatient rehab hospital, Sea Pines. It was not a simple move to make thanks to the insurance red tape. Our insurance company gave me a list of several rehab facilities, and based on their infection rates and overall individual ratings, I narrowed it down to 8 that were a possibility, and then only 3 that I would consider after speaking to a few friends of mine who are health care professionals. But we hit a snag: the insurance company would only approve Bob to transfer to a "Skilled Nursing Facility", which provides a lower level of care versus an "Acute Inpatient Rehabilitation Hospital". Yet none of the insurance-approved facilities would accept Bob with his wound care requirement!

   I explained to our insurance that it didn't matter what facility they "approved" if none of them would accept Bob as a patient due to his needs. He had to go to an inpatient facility that was also an actual hospital, with a complete hospital staff. Sea Pines had already accepted him and was simply waiting for an authorization. The insurance company said if Sea Pines is what we "wanted", it would cost us between $2,000 - $2,500 a day out of pocket. I immediately began dealing with a supervisor and initiated an appeal process. It didn't take long for me to explain, very respectfully but firmly, that it was not a personal preference; if Bob didn't get the correct level of care at the correct facility because our insurance company would not provide proper placement, I assured them that any out-of-pocket expense on our part would eventually be repaid back to us by them, but more importantly, any risk to Bob's health from inadequate care he received would also be their responsibility. Once I was able to speak to someone who understood the above-normal level of care Bob needed, we were approved and he got transferred to Sea Pines Rehabilitation Hospital. It can take so much effort sometimes, but you have to advocate for what's right.

Bob's new home away from home for the next few weeks.

Holistic Team

   Bob now has a team of health care professionals that will provide him the opportunity to readjust his entire health back to 'normal'. He is currently in his 'recovery phase' and will transition to his 'therapy phase' the longer he stays. Today we met with the medical director, the hospitalist, the charge nurse, the pharmacist, the dietician, the respiratory therapist, the wound care specialist, and his floor nurse. We were advised that Bob won't be rushed out of there; the goal is for him to build up his endurance, balance and strength at a pace that is successful for him. It will be interesting to see what they think about Bob's 'pace' once he gets going. I told him no more over-doing it like last night. I'm still recovering from his other scares over the last 16 days. 

Visitors

   Bob can certainly have visitors now. He's at Sea Pines, in Room 125, bed B. Visitation ends at 8pm, and we ask that everyone keep his therapy schedule in mind if planning to stop by.

Therapy Schedule

Bob will receive therapy every day, adhering to a strict schedule. 

   9a - 10a: Occupational Therapy

   10a - 11a: Physical Therapy

   1p - 2p: Physical Therapy

This fixed schedule helps to set goals and measure progress. He'll be plenty tuckered out once his therapy sessions have been completed for the day.

Wound Care

   A quick note about Bob's midline abdominal wound: it's healing wonderfully already! They removed the vacuum dressing this morning at the hospital, packed him with a wet-to-dry dressing for the trip, then reapplied a new vacuum sponge when he got to Sea Pines. The vacuum pump is now portable and can move with Bob from his room, to the wheelchair, and to the therapy rooms. The wound nurse estimated it will be an 8 - 12 week recovery time for a complete closure. 

   Here's the latest measurements:

   *Dressing change #1 (11/29, Wed): 21cm(8.5") long x 7.9cm(3") wide x 4cm(1.5") deep 
   *Dressing change #2 (12/1, Fri): 20.5cm long x 7.6cm wide x 3.8cm deep

   *Dressing change #3 (12/4, Mon): 20.5cm long x 7.4cm wide x 2cm deep

   *Dressing change #4 (12/6, Wed): not measured

   *Dressing change #5 (12/7, Thur): 20.5cm long x 7.2cm wide x 1.7cm deep

The portable wound-vac negative-pressure pump.

Thank you - from Me 
   Tonight I realized I am utterly exhausted. I went home this afternoon to get Bob his clothes for therapy, his phone and headphone chargers, toiletries, etc, and on my way back up to Sea Pines, I realized I've been running on adrenaline for over two weeks straight. From home, I woke up twice each night (midnight and 4am) to call the hospital and check on him. I stayed with him until 9 each night (many times later) and was back with him again between 7-8 each morning. I was constantly watching, asking questions, intervening when necessary, assisting, helping, communicating, coordinating, researching, working with care plans and social workers and insurance reps. Blogging was a release for me, helping me to realize all that's happened and allowing me to share my worries and my celebrations. I'll keep blogging until Bob's back to a regular daily routine; until then, I'll continue to update his progress. It's good for him to see and it's good for me to know he just keeps moving forward.
   I need to thank everyone, for everything. For your prayers, good vibes, tribal dances and any other method of choice that you've used to ask the universe to bless us. For your support, words of encouragement, kind cards, thoughtful emails and text messages. For the wonderfully delicious meals that have given me the freedom to never worry about dinner each night or lunch the next day. For the flowers, balloons, gift certificates and chocolate covered fruit! For your help with our house, our yard, our pool, our pets and anything else anyone has done for us. We are so fortunate to have so many wonderful people in our lives that truly care about us and have supported us like this. Thank you!

Day 18 ~ Moving on!

Sea Pines Rehabilitation Hospital 

   Bob is moving to an acute care inpatient rehabilitation hospital today! I'll update this blog with detailed information this evening after I'm back home, but wanted everyone to know he's leaving Holmes Regional Medical Center and moving on to the next phase of his getting-well journey.  More tonight!

Leaving HRMC 4th floor after 17 days!

Loading up and heading out!

Day 17 ~ Room 401, 9pm

Overdid It 
   Bob was feeling really motivated today, and was in and out of bed four times. He also took some steps using a walker while a physical therapist held him with a mobilization belt! However, he was a bit over-zealous, and a few hours after his PT and the wound-vac dressing change, he began complaining of an ache in his right flank area. The 5-inch incision from his initial surgery (11/20) had bled slightly, and that area of his abdomen started to swell and felt firmer than the rest of his belly. His temperature was 98F throughout the day, but tonight it was up to 99.7F. They placed an ice pack on his side, and are giving him pain medication and Tylenol throughout the remainder of the night. To be super over-cautious, they're going to run a few labs tonight, too.
   Since Bob's mentally 100% with it again, he's eager to move on to the next phase of this journey, which is transitioning from HRMC to an inpatient rehabilitation hospital. Because of that, I think he physically pushed himself too hard today, and his body had to remind him that he might have been trying to do too much too soon. This afternoon and this evening, he was pale, asking for pain meds, and completely spent, even skipping supper. I stayed late with him to be sure he finally fell asleep, and I'll be checking in with his nurse around midnight and again at 4am. Likely it's nothing serious to be concerned about - probably a pulled muscle or a little subcutaneous tear, but understandably I'm overcautious right now, considering the past 16 days!
   Looking forward to a new day tomorrow with less pain and more forward progress.

Not feeling too great tonight -

sometimes it's two steps forward, one step back.

Day 17 ~ Room 401, 3pm

Wound-Vac dressing change:

   Today was change #4 of the vacuum sponge in Bob's abdominal wound. It is managed by a wound care specialist who removes and replaces the vacuum dressing every Mon, Wed & Fri of each week. They anticipate it may take anywhere from 4-12 weeks for the defect to completely grow closed. Bob arranged pain medicine in advance with his nurse, but he said even with 4cc Morphine and 15mg Norco, the procedure was still terribly painful. Hoping that once the nerve endings begin to heal and granulation tissue continues to fill the wound, the pain during these vacuum sponge changes will decrease.

Wound Measurements: 

   *Dressing change #1 (11/29, Wed): 21cm/8.5" long x 7.9cm/3" wide x 4cm/1.5" deep 
   *Dressing change #2 (12/1, Fri): 20.5cm long x 7.6cm wide x 3.8cm deep

   *Dressing change #3 (12/4, Mon): 20.5cm long x 7.4cm wide x 2cm deep

    Now that Bob's wound care isn't being managed in the ICU, even though the dressing is changed on M/W/F, they will only be measuring the wound's actual size every Monday. But just looking at it visually today, it is apparent that the depth is decreasing as his body fills in from the inside out.

The sponge before it is measured to fit inside the wound.

The unused sponge pieces left over after the wound has been packed.

The pump that is connected to the wound sponge and creates

negative pressure which continuously pulls fluids out of the wound site.

   If anyone would like to see pictures of the actual wound, I do have them, and will share via private message with those who are interested. I find the healing functions of the human body to be fascinating, but I know not everyone shares in my fascination. It is pretty amazing that we can live with parts of us not yet closed up!

Day 16 ~ Room 401, 6pm

Lung Update: 

   The congestion in Bob's right lung is almost gone! Hoping soon his breathing treatments won't be needed as frequently (every 4 hours). The audible coarseness in his left lung is all gone, and in the right lung is extremely faint.

Not many more of these treatments left to do!

Standing!
   There's so many things our bodies do automatically each day without a second thought. Today I watched Bob working on re-training his weakened muscles how to stand up again, without any assistance. He tried a few times before he succeeded, and when I think back to just 13 days ago, I'm still in shock as to how grave his condition was and how quickly he's coming back. I promise I won't post a video of every little accomplishment he makes in therapy, but this particular achievement was a big deal, for him, for me and for his caregivers; he really, really wants to be walking around very soon!

Day 16 ~ Room 401, noon

ADL's: 

   A huge part of Bob's rehabilitation will be his ability to independently complete his ADL's, which are Activities of Daily Living. Things we do without even thinking each day, like getting out of bed, taking a shower, brushing our teeth, putting on clothes, etc. With the negative pressure wound vac dressing, he's not permitted to fully submerse under water, so instead he had a warmed shower cap with shampoo and conditioner massaged into his scalp for 5 minutes, and then a complete head-to-toe scrub down this morning. He was even able to brush his own teeth, with only a minimal hand tremor compared to yesterday. Even with the improving steadiness of his hands today, they decided to have a nurse handle the razor and shave his face. He said he feels human again.

No more IJ (Internal Jugular) Central Line:

   What was once a direct portal into a major blood vessel that literally pumped life saving antibiotics into Bob's body, is now just scars from three sutures. Each day he is less tethered.

Day 15 ~ Room 401, noon

Up and At 'Em!:

   Out of bed for the first time in almost 2 weeks! Bob's shocked at how weak he is, especially his legs. He said this first time was incredibly difficult. He told me now he understands why he will be transferring to an inpatient skilled nursing facility for a short time after he is discharged from the hospital.

  Occupational Therapy (OT) worked on his hands and arms this morning. He has about a 20° lag in the range of motion of his upper appendages. His right side is slightly stronger than his left, but she said he has a good amount of work ahead of him.

  Physical Therapy (PT) evaluated his lower body, got him sitting up (with assistance) and even shuffled him a step over to his "recliner". It's too early to determine what degree of lag his lower appendages have, but she said he'll likely have more work to do on his lower half than on his upper body.

   Respiratory Therapy (RT) wants him to sit vertically for an hour at least three times today. He still has congestion and coarseness in both lungs (more in the right) and the sitting will definitely help with that. They're continuing his breathing treatments every 4 hours.

Wound-Vac dressing change:

   Today will be change #3 of the vacuum sponge in the abdominal defect. Bob's got pain medicine already on board in anticipation... He remembers last Friday's dressing change, and he said that the process is excruciatingly painful.

Edit: 

   Wound Measurements: 

   *Measurements at dressing change #1 (11/29): 21cm long x 7.9cm wide x 4cm deep
   *Measurements at dressing change #2 (12/1): 20.5cm long x 7.6cm wide x 3.8cm deep

   *Measurements at dressing change #3 (12/4): 20.5cm long x 7.4cm wide x 2cm deep

One last thing...

   When asked by the physical therapist how long he's been here, Bob told her two months. I told him it had been a day over two weeks, not two months, and he said he didn't believe it was only 15 days. He was serious when he said he was sure it had been two months...he's still got a bit of confusion to work through.