Friday, March 26, 2010

Rehab vs Skilled Nursing Facility: Could it Matter?

My husband, Steve Williams, is now a little over two weeks out from his twelve hour open heart surgery to replace his aortic valve and to perform a four-vessel bypass.

He's still on a ventilator, though he is making steady progress. Thankfully, his mind is present. This was confirmed when I asked him two days ago, "Are you a Democrat?" -- to which Steve noddded vigorously. He also nodded enthusiastic approval at the passage of the Health Care Reform Bill.

So, being the planner that I am, I asked his team about the next step. After he gets off the ventilator and goes to the regular telemetry unit, will he qualify for Rehab?

The Discharge Planner informed me that you must be physically able to do three or four hours of active physical and occupational therapy per day to be accepted into the Rehab Unit. Weak as a kitten at the moment, this goal admittedly seems distant.

"So, if he goes to a Skilled Nursing Facility, where will he get his dialysis?" I asked.

"If he goes to Rehab, he will get his dialysis at the hospital. If he goes to a Skilled Nursing Facility, he'll be transported to the Kidney Center and get his treatments there," I was told.

"We've been doing Home Hemodialysis for the last two-and-a-half years," I said. "This man went through a twelve hour surgery to save his heart. I'm not about to see him lose his emotional/spiritual heart -- and get colonized with MRSA! Let's make Rehab our goal."

The kind Discharge Planner said she'd make a note of my preference.

"It's not simply a preference; it's what is best for this patient."

The issues are complicated; the struggle is great. Steve has the strength to get throrugh, and we thank the many people who are pulling hard for his recovery.

Take care. Linda Gromko, MD


  1. 向小善致敬,它使人生旅程較為平順....................................

  2. I vote for the hospital rehab. and hope that can happen. The extra time and energy expended in being transported to and from a external dialysis center is exhausting and better spent on rehabilitating energy and strength.