Janet was being changed as I arrived this morning and didn’t seem too happy about it. This is the third day in a row she has needed changing after getting dressed in the morning and her nurse, Robert, said he would check her chart to see if there was some clue there as to what’s going on. I’d been here before with Nicole and others with no result so I was not hopeful. Janet seemed a little listless as we started stretching and in fact closed her eyes after a few minutes of whispering to me in Klingon.

The stretching of her right arm went well and I held it straight out on the bed for a couple minutes and was able to open and close her hand quite easily. I then bent her arm back and laid her hand on her chest and lifted her pointer finger, her eyes popped open, she almost out loud said “Ow” and started to cry. When asked to show me where it hurt she went right to her right shoulder. Doesn’t make any sense to me how straightening her finger can hurt her shoulder but there is no denying it did. After she calmed down I worked on her legs and was very pleased with how that went.

I got her sitting on the edge of the bed and Janet immediately showed signs of livening up. I straightened her back for her and while I was holding her there she started whispering in Klingon again. She brightened up even more when she got into the wheelchair and as I was brushing her hair, Connie stopped by. She was all excited to tell me that Janet had written her name yesterday. Connie held her hand twice to do it and then let Janet try on her own. Using one large piece of paper for each letter she wrote her name. Nice of Connie to stop in and tell me that and Janet seemed happy to hear how well she had done. Connie asked her if she would write my name today and I took that opportunity to ask Janet my name. She hesitated then Connie asked her what my name is and Janet said in a loud whisper, “that’s Larry”. Finally!

Janet drove down to Physio and greeted Moira with a smile. Her smile got bigger as Moira complimented Janet on her new hair do. Women. I told Moira about the shoulder pain this morning and she will follow up with Dr. McCann re treatment. Today’s physio session was to involve Janet standing on a wedge. Janet seemed quite excited and ready for her workout.

As I was leaving I asked Robert if had found anything in Janet’s chart to suggest a cause for the tummy problems. Apparently she has been given a stool softener for the past few days as part of the protocol for coming off of a pain med. Another case of lack of communication as those working directly with Janet know the last thing she needs is a stool softener. That order is now off the chart. Thanks Robert.

Looking forward to an active afternoon in the sun.

I got back to find Houdieno trying to climb out of the left side of her bed with lunch still pumping into her. She gave me a laughing smile like “I know I’m not supposed to do this”. She laid back down and I tried to have her tell me what she did while I was gone. Her Klingon is getting better and she actually said “I went to Physio”. The rest of it was garbled but she was sure telling me a story. Heidi visited while I was gone and I trust that went well as Janet gave a little smile when I asked her about it.

After some minor stretching and sitting on the edge of the bed, I got her into the wheelchair and we tried calling Mary Gaga but her line was busy for at least twenty minutes so we headed out for some sunshine before Chelsea arrived to cut Janet’s hair. Chelsea met us just outside as we were soaking up some rays and Janet gave her a nice smile and a “hi Chelsea”. We went back to Janet’s room and Chelsea went to work.

I left the two of them alone for most of the time but each time I was in the room I was surprised at how Janet seemed to be really enjoying the experience. She sat nice and straight and still the whole time and smiled at me each time I came in to see how it was going. Chelsea was able to even things out a lot and says there are just two small areas that need to grow in a bit more then Janet will be able to go for the new style she had in mind before all this started. I think Chelsea did a great job today and I believe Janet does too.

On one of my ventures out during Janet’s salon time I stopped Dr. Miller in the hallway and asked him further about possible depression in Janet. He said it is likely to occur to some degree as she becomes more aware but he does not want to treat it until it is affecting her recovery. If she stops wanting to do things then he will consider treatment but fears that going that route too soon would impede her progress. So far Janet is participating well in everything she is asked to do and everyone at this morning’s meeting is in agreement that Janet is progressing and that KGH Rehab is the best place for her right now. I asked him about the three to four week timeline and he said that is totally arbitrary and as long as Janet is progressing at a reasonable rate she stays.

With Janet all cute in her new do, we made another attempt to call Mary Gaga and this time we were successful. Janet whispered “hi mom” into the phone loud enough for her mom to hear this time and that is a first. Pretty cool. Janet enjoyed listening to her mom and even gave her a kiss at the end. It was actually more like spitting on the phone but we know the intent. We had time for a little drive around the unit while we waited for Jack to visit. He met us in the hallway and Janet had quite a pleasant surprise look on her face. I know she loves Jack and his booming voice so they had a nice visit with Jack reading some of Anne 2 to her.

I asked Janet if she wanted dinner out in the dining area or in her bed, she said “in my bed”, so into bed she went and after chatting for a few minutes her eyes were starting to close. She was probably tired of me asking her my name, which she still hasn’t got by the way. I was Andrew again and Paul and Science among many Klingon names. I didn’t think she was actually going into a deep sleep so I told her I’d hang out for dinner then stretch her and get her dressed for bed. I put the Presidential Debate on the iPad and she kind of watched and kind of didn’t. Same with me so I turned it off after the first question and just curled up with her until dinner was done. Then the tears started. I had a really good stretch going on her right arm and was holding it down on the bed and she started crying. She wouldn’t or couldn’t tell me why for the longest time then all of a sudden her whispers turned into pretty much her real voice for about three or four teary Klingon words. I told her how nice it was to hear her but sorry I couldn’t understand. She stopped crying but clearly wanted to get up so with no socks or shoes on I helped her get up on the side of the bed. She was immediately happy but couldn’t tell me why. Her right leg was shaking like crazy at first but after five minutes was nice and relaxed as was the rest of her. I told her it was bedtime and she needed to lay down now and she did. I got her changed for bed and she thought I was pretty funny fumbling around like I do. This is one part of nursing I’m still not good at. We said our prayer and I said goodnight telling her “I love you”. She said “I love you too”. That’s the first time she’s done that and by adding the “too” tells me she was really saying it not just mimicking like she does with a lot of other things. She may not know my name but I don’t care.

Praying for another day of progress tomorrow.

I was surprised to find Janet still in bed at 8:30 this morning. She greeted me with a nice smile and some Klingon but seemed a little flushed and judging by her state of cleanliness was not feeling all that great. I got her nurses to clean her up and dress her and asked that the formula be reassessed as it seems to be going right through her the last couple of days.

Once Janet was up we had a little chat. She counted to ten and named the days of the week without help and she knew today was Tuesday after I told her yesterday was Monday and tomorrow is Wednesday. She knew the color of her shirt is pink and that my water bottle is red. Apparently my name is Andrew now though. She thought that was funny but she kept calling me Andrew. Pretty good start to the day. Before we knew it it was time for Physio so off we went. Moira was late as the meeting with Dr. McCann ran late. They talk about each patient in room number order and Janet is now last on the list. Moira still had time to get Janet into the sling for some “walking” around the gym. I headed home to get some yard work done.

Before I left I was able to have a brief chat with Dr. McCann. He says Janet will stay in rehab for “a few more weeks”. Best I could get out of him was three to four more then look at a facility like Connect in Lake Country. Of course if Janet is still progressing she will stay where she is. I think her rate of progress is key here as Dr. McCann said the gains she has made recently are good but they are small and a place like Connect that is geared to slower recovery times may be better for her at some point. I presume this would mean Ponoka is possible as well and I have asked Cathryn to join Dr. McCann and I for a detailed discussion on Thursday afternoon. As far as Janet’s right shoulder is concerned Dr. McCann will look into Botox or Cortizone as a possible treatment soon.

Looking forward to an active afternoon.

Janet was hanging out in her new room when I got back this afternoon. I looked in on her from outside but couldn’t get her attention, she was holding her left knee up and just kind of staring ahead maybe on one of her trips to the Bahamas. When I got inside it only took me asking if she liked her new room or not to start the crying machine. I asked her, “isn’t this a better place?” She shook her head and said “it’s a worse place”. Really cool that she answered that way but I saw no reason for that feeling. I explained everything to her and am convinced she didn’t realize she was still in rehab and only a few steps away from where she was. Once she calmed down I started asking her questions to get her mind off the situation. We ran through all the family names with her getting most of them without help, she didn’t remember Nash’s name though. When I finally asked her “what’s my name?” She repeatedly said “Robert”. At first I thought she said “bummer” and we had a good laugh about that but then she insisted my name was Robert even after I told her it was Larry. She finally agreed with me but wouldn’t tell me who Robert is.

Despite the clouds coming back Janet wanted to go for a walk so up she got and before I could help her into the wheelchair she was trying to stand up. Moira had suggested she try using her quads to lift her butt off the bed as more of a challenge to the other sitting exercises we were doing and she didn’t need any coaching from me to start. She really wants to stand and I would assume walk. I got her into the chair and out we went. The beach was too quiet so we headed off to the south for a change of scenery then came back and moved the car together. We then walked past the B&B right near the beach that has nice flowers outside of it and I had Janet repeat some colors for me. Later on I had her telling me colors of the cars we passed. She repeated black and silver then when we got to a white one she said “I don’t want to play anymore”. I asked what she wanted to do and she said “just walk around”. Amazing how she comes up with these statements sometimes yet still speaks a lot of Klingon. I challenged her to drive the long hallway in the Centennial Building and she conquered it making it all the way to the Strathcona entrance including her best effort over The Bump yet.

Back at rehab I asked her if she wanted to stay in the dining area for a while and she said “go to my room”. Into bed she went and the eye lids started drooping so I used that opportunity to start her dinner feed and set up her room. By the time I was done she was awake enough to let me read some of Anne 2 to her but I had to listen to some Klingon first. Not sure what she was on about but she thought it was pretty funny. She was rubbing her hand through my hair at the time so maybe she’s seeing some grey? After reading and a little more chatting dinner was done and she was closing her eyes again but I really wanted to stretch her so I did. I went slow with both legs and got them straightened out nicely. I went super slow with her right arm and managed to get it flat onto the bed with the hand open and even got it raised to about sixty degrees. Could have gone higher maybe but Janet was so calm I didn’t want to disturb her anymore. She helped me get her dressed for bed then we prayed and I read an email from her dad and Joan where Joan reminded her of her nick name. She gave that a big raised brow and a bit of an eye roll.

Praying for a night of healing for Janet’s right shoulder and arm and strengthening of her legs and an increase in her ability to communicate.

When I arrived this morning Janet was hanging out at a table in the dining area with her former roommate Trish and some other chatty ladies. They made Janet feel very welcome as she greeted me with a smile and seemed happy to be there. She was in no hurry to go anywhere, especially for a stretch, and luckily for her her bed was getting changed so we couldn’t go back there. I had her drive around the unit for a warm up and she was happy to do so. We got to the end of the west hallway and bumped into the glass emergency exit. I like taking her down there for the view out to the lake. She reached for the bar and wanted to go out but I told her we couldn’t as it’s for emergencies only. She said “open the door”. I love how she is talking more but she better not try giving me orders.

We arrived at Physio in time to warm up with some bicep curls. Janet easily did ten reps of three, four and five pound weights, I think I will up things a little tomorrow. Janet greeted Moira with a smile and a Hi. I gave Moira the run down on Janet’s tightness and soreness and she elected to get Janet onto the tilt table to stretch the legs and get some weight on the feet. As for Janet’s right shoulder and arm, she will discuss that with Dr. McCann at tomorrow’s weekly meeting. Janet seemed comfortable at seventy five degrees today for about twenty minutes. Moira had her reaching with her left arm and trying to grab playing cards and colored bean bags. Still trying to figure out Janet’s vision challenges and it is very obvious she has some.

Connie had chocolate pudding ready for Janet’s Speech session this morning and it was interesting to watch Janet chew it a little before swallowing. She was still around four to seven seconds with each swallow but Connie was pleased with that as it is much thicker than what she had tried before. The Speech session went really well with Janet counting to ten on her own, naming the days of the week after one practice run and naming the months of the year after one practice run. Connie asked her how she was doing and Janet answered “fine”. Connie was very excited about that as it came totally from Janet. I asked about Janet speaking in Klingon and Connie said to be patient, praise her for speaking and ask her to slow down, speak up, say one or two words only and try and guess what she’s saying. All things I’ve been doing. She also said to keep her talking as much as possible by asking her to name things etc. A good session.

As we headed back to the sun window for a break Dr. Miller stopped us to see how things are going. He could see a big difference in Janet and I told him my concern about the emotional outbursts. He agreed that as Janet becomes more aware she will get frustrated and that is something we all have to watch as we don’t want it to go to a depression situation. He believes she is in the right place now (rehab) and was pleased to hear of the progress I reported to him. He will be in the weekly meeting with the rest of the team tomorrow and they will try and get a collective sense as to how long Janet can be there. His feeling is as long as she is progressing, she stays. It was a good conversation and I will try and build that relationship as I think he’s going to be an important factor down the road.

Jessica is back as Janet’s OT today after a few sick days. She was very excited to hear about Janet moving her right leg and talking more. I asked her to look at Janet’s mattress to see if it’s really doing what it’s intended and she will do so this week. I think it’s too soft but I’m not the expert. One goal Jessica has for Janet is increased mobility in the wheelchair so today she tried having Janet use her left leg to propel and steer herself a bit. The chair needs to be lower so Jessica is looking for a replacement for her. Janet seemed to understand what she was supposed to do and Jessica commented that Janet is following commands much better than even a week ago.

As I was heading to pick Janet up from OT I noticed the nurses changing names around on the two big white boards that display everyone’s therapy schedules. I asked why Janet’s name had been moved and Naomi told me Janet is being moved to a private room. A few weeks ago I would have been thrilled about that but I’m not sure it really is better for Janet or not now. Most of her roommates so far have been a positive experience and the activity I think is good for Janet. I think the current roommate is not a good fit and may be keeping Janet awake a little so we will try the private room and see how it goes. Naomi and another nurse and I had that discussion and they said if it’s not good for Janet she can be moved to semi private again with no big problem.

Janet’s new room is 130. As you enter the rehab unit from the outside, turn right and it is the first room on the right.

Thankful for a busy and successful morning and looking forward to some fun in the sun this afternoon.

When I returned this afternoon Janet was awake and had taken her sock off again. She kind of laughed about it when I asked her why. I tried to get her to do the right foot but it was a no go. Janet got very chatty and I got feeling so bad about not being able to understand her that I went and talked to the nursing team to see if any of them could understand Klingon. They were all sympathetic and said it’s different with every patient and they had no way of deciphering what Janet was saying if I couldn’t. Maybe Connie or Nicole will have some insight tomorrow.

I was going to stretch Janet a little but she made it very clear she did not want to so I declared today a rest day. It will be interesting to see how she is tomorrow. I had Janet drive around the rehab unit a bit to get the blood flowing then I asked her if she wanted a Pepsi, she said yes. I thickened a little bit up and she didn’t react quite as badly as she has with other things but still a little funny face before swallowing. She was from five to ten seconds on her swallowing today and I reminded her she needs to be at two seconds to start eating real food. I think she understood that. We looked at some pictures on the iPad and I asked her to identify people in each picture. She did very well and either said Janet or pointed to her chest when she saw herself. The weather cleared off nicely and we headed out for an unexpected walk to the beach and around the neighborhood. Janet kept me company while I moved the car out of the two hour zone and down to the beach. She didn’t want to drive anywhere. Someday I’ll get her home. Shortly into our walk she motioned to put her hood on and I asked her if she was OK. She said, “I’m cold”. I asked her if she wanted to keep walking or go back to her room. She said “keep walking”.

Half way through our walk we saw a car virtually buried in leaves and thought it looked Fall enough for a picture.

Back inside I asked Janet if she wanted to stay in the dining area for a while or go back to her room. She said, “go back to room”. Her speech is definitely getting clearer when she is prompted to talk, the Klingon dominates when she is initiating the conversation.

Janet was looking pretty sleepy as soon as she hit the pillow, I started her dinner and talked to her a little, trying to convince her to let me read to her but by 5:30 she was asleep and I was on my way home.

Praying for a restful night and a day full of learning and progress tomorrow.

I was all excited heading in to see Janet this morning after yesterday’s events and expecting to find a bright and smiley Janet. Less than a minute after I greeted her she started crying. For sure not from pain as she was all dressed and I had yet to start stretching her. She stopped after a few minutes of encouraging words and I asked her what she’d like to do. She said “take off socks”. Strange but true. She got her left leg pulled up close to her and got eighty percent of her sock off, I help with the last bit. She moved her right leg closer to her next but kind of got tangled with the left one so wasn’t able to reach her sock very well. I took that one off and gave them both to her and she tried folding them together to put them away. Going barefoot is not an option so I pulled all her socks out and asked her which ones she wanted to wear. She chose a pair and did a pretty good job putting the left one on with my help, I did the right and she seemed happy after that.

It seemed best to give Janet a rest from stretching today so I did the bare minimum on her legs and left her arm alone completely. We went across the hall to practice talking using the Articulation Station app. She did very well! Nailing Pizza, Pickle, Dog (puppy), Pen, bear (panda) and Purse. We then had a Skype call with Leslie and Janet smiled and chuckled throughout.

Next up was a little exercise time and Janet went none stop for a good forty minutes wheeling through the various hallways around KGH. By far her best distance ever and she kept a pretty steady pace as well. That left arm is getting pretty strong.

Looking forward to an active and happy afternoon.

Suzanne visited Janet this afternoon and was there when I arrived playing basketball with Janet. They had a good visit that included some reading and chatting and playing catch with a mini basketball Suzanne brought in. Janet also spent time trying to sit up and take her sock off her left foot, something she has been doing a lot of lately. She seemed pleased that a friend dropped by and I think the basketball thing was fun for her and when I was there she only tried putting the ball in her right hand once. A definite improvement over the rock throwing.

After Suzanne left I gave Janet a quick stretch then got her in the chair to go across the hall where we could practice some picture matching and eat some Fresca. The picture matching was interesting as she clearly recognizes some things and repeats the words easily but has trouble putting the same pictures together. Seems to be not only a vision thing but a conceptual thing too. Or maybe it was just an off day for that today. We moved onto eating some Fresca and I thought this was by far the best tasting goo she has been given but Janet still made a funny face and took around eight seconds to swallow each time. Getting back to talking I tried her on the Articulation Station app and she did very well repeating H words that I gave her and nailed “house” all on her own. We then tried a few tongue exercises with a two toned lollypop and she wasn’t interested at all. I tried really hard and ended up saying “I’ll have to eat all the lollypops then”. She smiled and said “eat them”. Later on when I went to actually have a fruity one I gave her one last chance to have some and she was all over it. Apparently she likes the fruity ones. Who would have thought?

I read a little of Anne 2 to her then headed off to church after starting her dinner feed. It didn’t seem like she was tiring out so when I returned I wasn’t surprised to find her wide awake and very chatty. She had all her covers off and her left leg bent up and crossing over her right one. I asked her what she was doing and she said “taking my socks off”. I told her OK take them off. She got the left one most of the way but couldn’t reach her toes so I helped then I asked her to get the right one. I thought I would get a blank stare to that but she gave it a real effort but she was still moving her left leg. I held her left leg and told her to forget it and try and move her right leg. SHE DID! It was laying with the knee out towards the right side of the bed and she bent it more than half way towards her. She did have her left hand on her right thigh as it moved so I asked her to do it again in case she had just pulled it. I held her left leg and arm this time and waited. I could see the concentration on her face and within a few seconds her right leg moved up towards her some more. I went and got two of her nurses, Jacquie and Caitlin to witness this feat but I think Janet was tuckered out or nervous about the audience as she only managed a slight move this time. It was a move none the less and both nurses were thrilled. Janet wasn’t as excited as I was as I think she’s been trying to do this for quite some time now. Every time I sit her up on the edge of the bed I ask her to move her left leg then her right closer to the edge. She of course moved the left and I thought tried to move the right and tonight she was successful! As I was congratulating her she started crying and not happy tears. She is still frustrated and I think sad about everything that’s happened to her.

Janet calmed down soon enough then I started her bedtime stretch. Her right arm was tight and I had to go real slow to get it up to ninety degrees but we managed and as I was letting it down the third time she started crying again. This time it was a sore right shoulder as she showed me when I asked her. The crying continued long after the soreness should have worn off and it took a lot of positive reinforcement to calm her down. We got there and after Jacquie changed her and I dressed her for bed she brushed her teeth and we said a prayer that she thought was quite funny. After I said all the mushy goodnight stuff I said “now I get to go home and do laundry”. She smiled and waved at me. Thanks.

Praying for a restful night and one that heals Janet’s right shoulder. Praising God for the healing he has already brought.

When I arrived this morning Janet had just been washed down and dressed and was letting loose with the Klingon. Whatever she was saying was good because she had a smile on her face. Still mostly a whisper but there are more frequent vocalizations. Her nurse, Diane, said Janet got quite emotional for a bit this morning and as Diane was telling me this Janet started crying again. It didn’t last long and I was able to stretch her out quite well. I went really slow with the right shoulder and eventually got to ninety degrees. Her left leg was pretty tight but we eventually got a good stretch on that as well.

Since there are no therapy sessions on the weekend we went right from the stretch into some sitting and standing exercises. Janet is so good at leaning to either side and pushing herself back up again that I wonder if it’s worth doing anymore. I think she needs a bigger challenge and will ask Moira on Monday. Leaning back and using her abs to sit back up is still a good one though and Janet managed about five of those. Whenever I sit Janet on the edge of the bed now she immediately begins trying to stand up. I feel bad for her knowing she can’t do that on her own and it takes a bit of set up before I can help her. She’s not happy about that. The first stand today was not good as her legs just would not straighten then on the second attempt we were up pretty good for about thirty seconds and Janet started crying. I asked her if she wanted to sit and she nodded. I asked if something hurt, she nodded. I asked her to show me where and she rubbed her left knee. I asked to confirm that it was her knee and she nodded. Another thing to talk to Moira about.

Kiko arrived shortly after ten to do a little music therapy with Janet. Emma let us use the multi purpose room across the hall and I left the two of them there to sing away. When they returned thirty minutes later I could tell Janet had fun. Kiko said Janet mostly sang in whispers and got the ABC Song up to around K then it gets a little too fast. When I asked Janet if she wanted Kiko to come back and do that again she gave a very enthusiastic nod and smile. Kiko has been doing some research on Aphasia. This article is quite useful for those of you planning to visit with Janet, in fact I would say it’s required reading.

To keep Janet busy until lunch we went for an inside drive and her left arm just keeps getting stronger and stronger. Hard for me to keep her wheelchair straight she pushes so hard now. We stopped by 4B to see who we could see and Carolyn and Kim had a nice little chat with Janet. I then plugged her in for lunch and rode up to retrieve her car and go home for a bit. Looking forward to a good afternoon of learning.