Charlie has been in the Veterans Administration’s home-based care program for about two months. To say we have been impressed with the care and compassion shown by the people administering the program would be an understatement. But this week we had occasion to find out just how good they really are.

Charlie woke up Sunday morning with pain in his lower back. The pain continued throughout the day and was exacerbated by feelings of general malaise and lack of appetite. He didn’t even ask for his usual glass of wine. I gave him a couple of Tylenol and chalked it up to an arthritic problem.

Monday came and went with little change in his condition. By Tuesday, it was apparent that there was something more than arthritis going on. I took his temperature that evening, and, sure enough, his temperature was 102.8.

Wednesday morning I put in a call to his nurse at the VA. Within two hours, the RN and a nurse practitioner arrived and took a history, gave him a thorough check-up, drew blood and acquired a urine sample. They suspected Charlie was suffering from a urinary tract infection (UTI).

Two hours later, we had the test results back; no UTI.

Blood work did show that he is quite anemic—a condition we have been treating for some time with B-12 supplements. His iron level was also low enough to cause some alarm, but neither of these conditions should cause the elevated temperature Charlie was exhibiting. The VA team was puzzled, but determined to get to the bottom of the problem.

The nurse and a different NP showed up again on Wednesday morning. This time, a more thorough examination of his lungs revealed rales, or crackling, rattling sounds, consistent with pneumonia—an “aha” moment. However, we still don’t have an answer to the back pain that started this whole scenario. Nor does it explain his low iron and anemia. The team is concerned that something more serious may be going on and will be keeping close watch on his lab tests for the foreseeable future. In the meantime, he has been placed on an antibiotic, something for gastritis, and thiamine.

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I was extremely impressed with the thoroughness of the team and the quick return of the lab results. I expect within a day or two the pneumonia will be on the run. As for the other symptoms, I know we have a competent, determined team working to get to the bottom of Charlie’s problems. Furthermore, it is a team that is considerate of our wishes when it comes to choosing a course of treatment.
I was given the option of admitting Charlie to the hospital for treatment or caring for him at home. We chose to keep him home since his condition did not appear to be critical. I elected to pick up his antibiotic at a local pharmacy rather than make the 20-minute drive to the huge VA facility pharmacy; and the antibiotic was not the most expensive treatment being pushed by some big pharmaceutical company. With our prescription plan, it was only $3.50. The non-critical prescriptions will be shipped directly to our home from the local VA facility.

That’s all anyone can ask for when it comes to medical care. It is my understanding that, in this area, the home based care program is under-used. Apparently the word has not gotten out about how great a program it is for home-bound veterans and their families.