Back to step one.  At least Mary was admitted directly into emergency and given more pain medication which knocked her out for a couple of hours.  Then came some specialists in wrapping wounds and they cleaned and dressed Mary's open wounds from the shingles and the radiation.  They gave her what would pass for a gauze bustier.  Then the nurse came in to take pictures of the wound. Needless to say, the photo will have to wait for wound wrap change time.

Mary was admitted to the hospital at five and the rest of the evening was spent confirming medicines and documenting what had been done and what needed to be done.
 

When I got to the hospital Mary was adjusting her bed and the TV, a first since 5 January .  She did not fall asleep all the time I was with her and I left at 9 PM. We're in the same room that we had when first admitted in January and have had a couple of the same nurses.  They couldn't believe the changes. When I am with Mary all the time, it is hard to notice the changes, but if I step back (mentally) I can see definite progress even though she cannot stand as yet. She can move herself slightly in bed, she can roll onto her side, after being helped to a seated position, she can hold herself upright for a limited time.  From that seated position, she can scoot forward to make transfer to a wheelchair easier.  These and other things that are so easy to us all were impossible for Mary a month ago, and now she can do them.
 

I got a chance to talk to the hospitalist.  He couldn't believe how well Mary was doing. (He had tended her before and after surgery).  He asked to have a pain specialist come in to see about changing Mary's pain medicine and he wanted to try a medicine especially for the shingles.  Pain seemed much better today.  Less frequent and less severe.
 

On the bright side, when Mary finished her therapy she was helped to a wheel chair and remained there for about 3 hours.  The more they can get her to remain in a sitting position the better.  Early in the day she is capable of more than later in the day.
 

Mary ate more of her dinner and drank two small cans of Ensure while I was there.  This should help. While she seems to be getting stronger, she still cannot stand, even with assistance.
 

Mary finally returned and did some therapy  and then tried to eat some lunch, but it was not very good.  She has started bulking up on Ensure if she doesn't like the meal. Her pain returned and she got a shot for it.  This knocked her out until dinner time.  She ate part of my dinner (some shrimp) that a friend had brought. But that spoiled her and she didn't want the hospital's fish (which was very plain - no sauce, vinegar or lemon).  She did eat all of her chicken noodle soup and her Ensure.
 

Eating continues to be a problem.  Mary says that she still feels some throat pain when she swallows and that the process of eating initiates the pain associated with the shingles.

The oncologist came by and will come again tomorrow morning to begin another round of chemo.  Problem is that the chemicals will make Mary weaker. She's being pulled both ways and the insurance is demanding progress.
 

Mary seemed in better spirits today when I arrived. Perhaps it was the unit of blood that they gave her.  I will have to find out why it was necessary. When therapy came by, she had just received an injection of pain killer which makes her tired, so she did not have any professional therapy.  Later I worked with her as best as I could while she was in bed.  There are more things that she could do in the wheel chair, but I didn't want to risk moving her by myself.

She ate fairly well at dinner, eating half the beef on her plate and most of the zucchini. She also drank a nutritional supplement that they had given her. 
 

Blue Cross just sent me the papers telling that Mary was to be transferred yesterday to an assisted health facility.  If she is not accepted into the acute rehab at the hospital, I fear she will have to go back to where she was before on Monday.  Hopefully the doctor was able to get us more time at the hospital.  She did not like it there.
 

Mary stood with assistance four times today during her therapy session.  As usually happens, I had just finished a half hour of therapy with Mary when her therapist arrived.  Her session with the therapist was for 45 minutes. I hope this impresses someone downstairs to accept Mary for acute rehabilitation.  Those sessions last approximately three hours and Mary is dreading the possibility of having to return to an assisted care facility.

Mary seemed in less pain today, but the pain specialist is going to try a different type of medicine tomorrow.  As I was getting ready to leave, she was having some severe episodes of pain. We will see what tomorrow brings.
 

Mary continued practicing standing and stood for 30 seconds on 7 occasions,  She is still not able to lift herself off of the bed without assistance, but can roll over and sit up at the edge of the bed on her own. The person from therapy did little other than get her to stand, but she worked hard with me for two half hour sessions.

She was given an epidural injection this morning - the biggest needle that I have ever seen.  The purpose of the injection was to limit the pain, but he said it might take 24 hours to take effect.  After 12 hours, Mary was still feeling pain.  The nurse on duty for Mary said that she suffers from shingles pain and that it is more prevalent when she is very tired.  -- That might explain Mary's pain at about 7 every evening.

A friend fixed some sancocho for Mary and she was able to drink the broth, but was not able to eat much of the meat, platano or yuca.  It shows that Mary's lack of eating is not due to dislike of the food.  She normally would have eaten quite a bit of the sancocho.
 

Later the insurance representative came and we talked about what happens next. He said they are going to evaluate Mary to see if she is sufficiently ready for acute rehab which requires three hours of therapy per day.  Mary is enthusiastic about the possibility and it would keep her close as it is in the same hospital. He also authorized the payment of the same oncologist that we have been seeing at the hospital even if we go somewhere else.  The oncologist was similarly pleased and came to talk to us. Mary is presently on phase two of the chemotherapy. 

What will tomorrow bring?
 

Mary hopes were dampened but her spirits were lifted when Carlos Murrilos came by to wish her well and played the harp for her.  Needless to say the door to her room was a favorite loitering place for a while.  While Mary is not happy with the decision being made for her (us), we need to look at the move as a step in the direction which may lead us back to acute rehab as she continues to gain strength. 

Each day is a new challenge.