Month: October 2012

Klingon

Janet was wide awake and quite chatty when I returned. I asked her nurses if she slept at all and the consensus is that she is not really sleeping during the day. Lunchtime is mostly just relaxing, maybe reading a magazine or something like that but no sleep. That would explain her nodding off around 6:30 or 7:00 the last few nights.

To my surprise when I asked her what she wanted to do this afternoon she responded with “go outside”. In English, not Klingon. A little stretch and out we went. Too windy for the beach we walked around the neighborhood a bit and Janet collected a nice bouquet of colorful leaves. I chose them of course but she happily held onto them the whole time we were out. I had to coax her into driving down the long hallway again but she did fine once she started and only needed help staying straight going over The Bump.

Back at rehab it was a little too early for dinner and Janet wanted to lay down for a bit so I climbed onto the bed with her and read a chapter of Anne 2. Janet held the book with me and when I ran out to move my car I asked her to hang onto it and I’d continue reading when I got back. She hardly moved while I was gone and didn’t even turn a page. She seemed to be reading the book herself. Before we could finish, roommate #4 arrived with her entourage. They were quite loud while they moved in and I was disappointed in the staff that brought her in as they paid no attention to Janet and I at all. Not sure where they were from but glad Janet is not there. The lady who is now sharing Janet’s room is quite demanding but I guess you can be that way when you don’t have any legs.

I took Janet out to sit near the men to have dinner and we chatted for a while and once when I asked her to repeat what she said she burped. There was no reaction from her at all until I said, “you burped in my ear”, she laughed out loud. Thanks. She got tired and uncomfortable by a little after six so I put her into bed for the rest of dinner. I knelt beside her practicing speech but the more Klingon she spoke the more frustrated she got even bursting into tears at not being understood. If any of you have suggestions as to how to help with this, I’m open.

With eyes closing at 6:45 I stretched her legs out, got her dressed for bed and prayed with her then said goodnight at 7:10 and she smiled and closed her eyes. Looking forward to tomorrow.

No!

Good thing Janet is a sports fan as this morning she was sitting with the guys watching some World Cup Qualifying soccer as I arrived. She seemed pretty content, much more so than when she was with the old ladies. The nurse that got her up this morning said she got an out loud NO in response to some question I can’t remember. She got a bunch of whispers as well. Cool.

Our stretching routine went well with Janet’s left leg being a little tight but nothing serious. I wheeled her off to physio but couldn’t stay as I had arranged to take Janet’s car in for servicing and to go get my Big White ski pass. Ready for snow!

After my errands were complete I was able to stop by as Janet was finishing Speech. Connie gave a very positive report on Janet and seems genuinely please with Janet’s progress. Today she was able to count from two to five without modelling, touch her nose, eyes, hair, eye brows, chin, ears, and a few others. She had trouble with shoulder and elbow but showed a big improvement. The swallowing was around the four to six second mark and Connie is please that it is consistent with no more fifteen plus instances. She will try Janet on some pudding Monday as it is a thicker consistency and more like food. Janet is not a pudding fan but maybe the taste of chocolate will inspire her. Janet said a very audible bye and gave Connie a nice wave as we left.

After a little break in the sun window I left Janet with Nathan who is subbing for Jessica again today. He was looking for ideas so I suggested they work on hair brushing as Janet only does a couple strokes right along her left ear and also kicking with the left leg. I’d like to see more action there to try and loosen it up some.

Praying for an active afternoon.

One Last Time

Janet greeted me with a nice smile when I returned this afternoon and was very chatty, actually initiating conversation. Unfortunately I think she speaks Klingon now as I can’t understand one word. She is very deliberate and purposeful even knocking it back to one or two words when asked, but still Klingon. I went to find Connie to see if she could decipher or tell me how I might understand Janet better but she had a patient with her so we’ll have to wait for another time.

I got a debrief from Moira who said Janet did well standing in the sling and was “walked” around the gym twice. The way that worked was Janet was suspended in the sling with it taking ninety five percent of her weight and Rachel standing in front of her moving her legs in a walking motion with Moira operating the ceiling lift. I’ll try and get some video next time. Sounds like fun.

After a long chat I finally got Janet into the wheelchair and out into the sunshine. It was quite a bit cooler today and Janet handed me her zip up right away but we did find a spot at the beach that was worthy of fifteen minutes for our final tanning session of the year. I had to move my car again so took Janet for a ride. It was very tempting to take her to the house but she didn’t seem too interested in riding anywhere far so we turned around after a couple blocks then parked at the beach. After a quick walk around to the KGH main entrance it was Janet’s time to drive the long hallway. She was reluctant to start but once she got going she did very well and gave a good effort at “the bump”.

We sat out in the dining area for twenty minutes or so to give Janet a little taste of the busyness that goes on there. She started looking stressed and I asked her if she was tired and she gave a very demonstrative nod yes accompanied by a little crying as if it was a bad thing to be tired. She settled into bed quickly and I figured she had enough energy to video Skype her sister Leslie. Janet smiled a few times and was happy to see and hear her sister and Gavin. She gave a nice wave goodbye on cue and we look forward to seeing them again.

I tried a few chewing exercises using some fruit gummy type things that Nicole gave us. Janet chewed and swallowed well I thought but still seems to be making funny faces to taste. The lolly pop was a big hit again and her tongue got a good workout. I noticed throughout the day that Janet is licking her lips more and moving her tongue around a lot more and that is a really good thing. She had no interest in doing any talking after that and I asked her if she was tired and she gave an even more demonstrative nod yes than before. She was eyes closed before I could finish getting her ready for bed and was pretty much asleep when I left at 6:30. An early night for me and the end of a strong day for Janet.

Praying for continued healing of Janet’s right shoulder and arm and legs and for my ability to understand her talking.

Going Solo

Janet was showered and dressed and sitting out in the dining area this morning when I arrived. She seemed quite happy sitting with a guy and his caregiver and looking at trashy magazines. The nurse that showered her mentioned Janet had started to cry as they were heading for the shower and calmed down once the shower started. We sat at the table together till 8:40 then I told Janet it was time to get ready for Physio, she pushed her chair away from the table and off we went to stretch. Her right hand, wrist and forearm were quite tight but I got good results there then I tried raising her right arm to see how that shoulder was. I went really slow and watching for the least sign of pain from Janet. I got none but could only get to about eighty degrees that first time. Second time I got to ninety and was holding her arm as straight as it would go then there was a sudden jolt from her right shoulder that pushed her upper arm out towards me. It startled me but it felt like she deliberately did it and that’s what I asked her. She looked at me a little surprised then started crying. I think there was some pain there but the cry was more of a frustrated one as she was really trying to talk during it. I told her we would talk to Moira about it and she would help.

Janet was quite chatty this morning with a few vocalizations, unfortunately I can’t understand what she is saying but am really glad she is trying. She did repeat a lot of words I gave and laughed at a few silly ones. When we arrived at Physio, Moira said hi to Janet and Janet said hi and something else with some vocalization but neither of us could understand what it was. Moira was excited anyways. I told her about the jolting shoulder and she wondered if something was displaced yesterday and that’s what was causing the pain. She noted it seems much looser today and she’ll have a closer look during the session.

I made the difficult decision to leave Janet on her own this morning and told all the therapists my plan. Moira was going to use a sling to get Janet to stand, Connie was going to have Janet try some thickened Ginger Ale and Jessica couldn’t stop talking about her trip to Canmore so I have no idea what she has planned but I’m sure it will be good.

Looking forward to another afternoon of tanning and learning.

Big Brother

As Nicole and I were getting Janet changed after lunch some tall dude from the east barged into her room without knocking and pretty much caught Janet with her pants down. Luckily he’s blind as a bat and when he realized he was in BC and we aren’t that rude here he disappeared. I got Janet’s shoes on and then put her into her wheelchair and we quietly headed out to see if that weirdo was still about. Sure enough he was sitting just around the corner from her room and we had a good shot at scaring him but I forgot Janet’s right foot sits over the edge of her footrest and it hit the chair beside the guy before we could try anything. Janet greeted her brother with a nice smile and almost a tear. She even leaned over to give him a kiss. I could tell she was very pleased to see Mike. As expected he generated some serious laughs from Janet including a krinkled nose that I haven’t seen since forever and some genuine belly laughs to go along with some whispers. It was really nice to see her feeling so good.

We took Mike down to the beach and the walk down there was a little shady so Janet held up her zip up as a cue for me to put it on for her. She wouldn’t let me put her right arm into it though. Apparently it’s still sore. We then went for a long walk in the sun and Mike even admitted he now understands why we moved here.

Janet enjoyed another day of tanning and the wise cracks and loudness of her “little brother” and we got back in time for a little more visiting before Mike had to leave and I had to go to the dentist.

As we left I asked Nicole to keep and eye on Janet as I thought it was too early for her to go back to bed. When I got back an hour and a half later I was pleasantly surprised to see Janet still in the dining area all plugged in and having dinner. She apparently wasn’t too happy about it though as she started crying almost as soon as I sat down beside her. I’m not sure why but am going to go with the fact the table we left her at ended up with some of the more elderly patients sitting there for dinner and Janet maybe thought she was in a LTC facility instead of rehab. She kept looking around during her cry like, “you left me sitting hear with these old people”. After a lot of reassurance and encouragement she agreed to move down to where we more often sit for the rest of dinner and to wait for a visit from Brenda.

Brenda arrived and had a nice chat with Janet and read a little of Anne 2 to her. Dinner was done about a half hour later and so was Janet. You could see her fading although she did manage to drive her wheelchair back to her room and wave goodbye to Brenda. I think the driving was more a determination to get into bed as before I even finished a quick stretch on her the eyes were closing. This is the second day in a row where I don’t think Janet slept more than an hour during the day. Glad she is busy and awake.

Praying for a restful night that brings healing to Janet’s right shoulder and arm.

Fighter

It’s always nice to be greeted with a smile and that’s exactly what I got when I walked into Janet’s room this morning. Unfortunately I managed to change that smile into a cry as her right arm was very stiff at the shoulder this morning and she was obviously in pain as soon as I got it raised to about forty five degrees. To make sure there was pain I asked her to show me where it hurt and she immediately moved her left hand over to her right shoulder. I stopped and told her we would talk to Moira about it this morning. The rest of her stretching went well and I even got a few whispers and a nice moment of prayer before we headed off to physio.

Moira and I tried getting Janet on her tummy a few different ways but she was just too sore in that right shoulder so we flipped her over and Moira put a heating pad on Janet’s shoulder for the remainder of the session in hopes that would loosen things up. Janet did well with some leg work and the chance to relax with that heating pad. Moira decided to leave the arm and shoulder alone for the rest of the day and see what it’s like tomorrow.

We were a few minutes late for Speech so Connie and Nicole were raring to go as soon as we arrived. Nicole had some dried apricot wrapped in some material and had Janet chew on it to get the taste and trigger a swallow. Both Nicole and Connie were very pleased with Janet’s performance! We tried getting Janet to whisper right after that but I think she was a little overwhelmed with the busy morning so far. Connie had her do the swallowing thing with some apple flavored goo and Janet’s scores were similar to yesterday with her taking control of the spoon for the last three attempts. Janet did very well showing fingers using Connie as a model but still isn’t getting it without the model. She did touch her nose, ears, chin, cheek and hair on command and had to be shown her eye brow, shoulder and thumb. The best part came right at the end when Connie asked her to say some M words. Janet got on a real roll and was quite audible for some. Connie seemed real excited about that.

We had a short break in the sun window then Janet drove off to OT. Nathan informed me he was going to range Janet’s arm but I told him no as it was too sore today. I’m sure Janet would have made it obvious soon enough that it was sore but shouldn’t there be some communication between departments here? What if I wasn’t there to tell him? I left Janet with Nathan and she seemed very happy to be folding towels with him. I asked Amy to put her to bed for lunch afterwards. Janet fought hard this morning and hopefully she is well rested and ready to laugh when Uncle Monkey arrives this afternoon.

Praying for healing in that right arm and shoulder and a fun afternoon.

Sourire

It sure does pay to get second and third opinions on major projects. Steve from Advanced Mobility Products came by the house this afternoon and knew exactly what he was talking about and also what I was talking about. How about that? He’s so good he even came up with a third option that may actually be the best. He will make a repeat visit soon with a contractor so he can give me the low down on all three possible methods of creating access to the house for Janet. Steve is living this as well as knowing it. His wife has MS and he installed a porch lift at their house for her. Seems like the guy to work with.

Janet was wide awake when I got back around 2:30 and greeted me with a big smile. After a quick stretch we headed out into the sunshine. First stop was my car as I had left my phone in it so I put Janet in the passenger seat and we called Mary/Gaga from there. Janet had a smile on her face pretty much the whole time her mom was talking and whispered hi and bye but too soft to really be heard on the phone. It was a nice start to our outing. We walked in the sunshine long enough that when we got back it was time for me to move my car out of the two hour parking area and since Janet seemed so comfy sitting in the car earlier I decided to take her for a ride. We only went a couple hundred meters to the beach but she was noticeably entertained by riding in a car for the first time in five months. As I opened her door to start getting her out Sandrine appeared. She had seen us driving off from the two hour zone and was concerned that we were really going somewhere as she had arranged for a visit with me. She ran down to where we parked at the beach and Janet has never been so excited to see anyone since this all started. She was like a little kid with a huge smile on her face and eyes lit up like the sun. Her posture changed and everything. Very cool. The smile never left her face as we walked up to the rehab area where I left the two of them to visit. Sandrine brought Janet in to the dining area about twenty minutes later and got a very audible whisper “bye” as she left.

It was not quite dinner time so I had Janet drive around the rehab unit for a bit of exercise. Her driving ability is increasing steadily and once she gets going she no longer seems to need the constant encouragement to keep going. I elected to serve dinner in bed as Janet had been in the wheelchair quite a while and I wanted to have some Speech lessons with her during that time. I attempted the swallowing test but did a horrible job making the tea as I let it steep way too long and Janet let me know it showing a face of disgust for about ten minutes after tasting it. I did much better leading her through some imitating as she whispered a lot of M, N and P words. I was able to finally use an app I had downloaded a long time ago that shows you a picture of something that starts with the letter P and you have to say what it is. I would ask Janet what it was, wait for a response, say what it was then listen for her to repeat that word. She did very well but shocked me when she actually answered correctly for Pizza, Pencil, Popsicle and Dog (the word was Puppy). Huge high five! Connie wants her to practice saying the vowels as a way to kick start her vocal cords. Apparently you use your vocal cords to make vowel sounds but you don’t for most consonants. First up was A and Janet practically sung the letter out loud! I couldn’t get her to repeat it but wow. She got E pretty good maybe with a little voice but only whispers on the others. I asked her about another vocal exercise and she really started trying to speak to me. I couldn’t understand her at all but asked her if she wanted to stop. She gave me the most animated head nod yet. She was tired out.

We read a chapter of Anne 2 after Janet had agreed to my suggestion to do so, then I stretched her out before Kiko arrived to paint her nails and hang out for a bit. Great day!

Praying for a restful night and God’s continued blessing.

Progress

I feel like we have started a new phase in Janet’s recovery. She opened her eyes when I greeted her this morning and was bright right away, smiling and raising her brow. The first task of the day was teeth brushing and after that I asked her to say something. She was a little slow to start and not as clear as last night but eventually I was getting good imitating from her. It was then on to stretching. Janet got very emotional as I was working on her right leg, maybe triggered by pain but most likely the frustration of not being able to move it and needing me to stretch it like that. It was quite a prolonged cry and I ended up agreeing to stop the stretch session there.

Janet drove down to physio and was extremely bright and responsive for Moira, smiling as I started to tell the story of last night as if she totally knew what I was going to say and was pleased about it. I wasn’t going to stay at all this morning but because of Janet’s emotional outburst I decided to linger and see how things went. After our five minute chat to start things off with Moira I was confident Janet would do well on the tilt table, especially after she whispered hi to Moira, so I left to go spread the whispering word. First person I saw was Chantelle from OT and she was so excited for Janet. She asked permission to spread the word on 4B and I said go for it. I also saw Dr. McCann. His reaction wasn’t as enthusiastic as I had hoped but I think it was mostly due to his busyness. He did seem pleased and is looking forward to a good week. I went back to check on Janet and she was hanging out at sixty five degrees quite comfortably. She did some left arm reaching for Moira and allowed her to work her right arm pretty good. Her feet were nice and flat on the deck so it was a good stretch despite the shortened warm up this morning. Janet had a little emotional outburst near the end of the session and was for sure trying to tell us something but we couldn’t figure out what.

Still in bright mode I had Janet drive over to Speech and Connie was pleasantly surprised to hear the news. She got right to it trying to get Janet to say a bunch of different words. Janet was a little slow to respond but when I put my ear up to her mouth she went for it all out going right through a list of six or seven M words that Connie gave her. Even though Janet was whispering into my ear Connie could hear her and see the mouth movements. She didn’t want to overwork Janet on that so we moved on to swallowing. Connie mentioned that whispering is great but does not involve the vocal cords so she gave me some suggestions of sounds to have Janet try and make to encourage the vocal cords to come into play. Janet had her best swallowing effort to date with consistent scores of 4-6 seconds. I now have permission to have Janet try swallowing each day on my own to see if we can speed the progress. While Connie and I were talking Janet reached out and grabbed my water bottle and took a drink. Connie motioned to stop her then saw I wasn’t trying to stop her so we watched Janet take a nice sip of water and swallow it immediately. Connie is still nervous about Janet drinking thin fluids as we don’t know if she is silently aspirating or not. I bet on not. I talked to Nicole from Speech (she gave us the lip exercises to do earlier) and she is going to test Janet on chewing this week. Exciting stuff. Connie asked Janet to show her one thru five fingers and she did with modelling but not without so that is another homework assignment. She also had her touch her nose, ear and chin but Janet only got the nose. It was clear she was getting a little worn out by this time so off to the “sun window” we went for a break.

After the short drive to OT, I left Janet with Nathan and came home to meet with another mobility equipment guy in regards to getting Janet in and out of the house. Hopefully this guy knows more than the last one.

Praying for a fun afternoon of progress.

The Best Thanksgiving Ever

I could not wait to write this update but found it very difficult to pull myself away from Janet tonight but I finally did and before I do anything else, here goes.

When I got back from lunch she was sleeping peacefully and not even a Prince Charming kiss could wake her this time. Finally at 3:30 she stirred. I stretched her a little then got her into the wheelchair to head to the beach. The spectacular weather continues and we enjoyed some nice minutes in the sun. Because it was late we headed for the Centennial Building as I wanted Janet to conquer that long hallway, it had been a while. Apparently the break from there did her well as she set a speed record and went farther than I asked her too as well. High five! It was also her best effort at the infamous bump, clearing the front wheels without assistance and needing me only to keep her straight to get the rear wheels over. She gave a herculean effort and if I had done a better job of keeping her straight she would have made it.

Dinner was held in the dining area with Molly and Bea. They were not impressed with their mac and cheese and were a little jealous that Janet’s meal tasted as good as it always does. We tried some matching exercises while Janet dined and she did ok at it. I tried getting her to draw on various media but she wasn’t into that at all. She burst into tears at one point and calmed down five minutes later. No doubt in my mind she was frustrated at the time as she kept looking at me with a “I’m trying to tell you” look on her face. With about twenty minutes left she was getting restless and I had to really work at convincing her to stay till dinner was done. She did and I got her into bed right away and she was instantly happy.

I read Tim’s Thanksgiving Day column to her and asked her afterwards if he had made some good points. She quickly pointed to the paper with her pointing finger. I laughed and said “you just pointed”, she pointed again. This is new as it has always taken a fair bit of coaching to get her to do anything resembling pointing and it’s never been as deliberate as this. High five!

As a joke I asked her to whisper in my ear “I love you Larry”. I put my right ear to her mouth and waited. To my shock SHE WHISPERED “I LOVE YOU LARRY”. Not kidding and no I wasn’t hearing things. I thought I might be so I asked her to say some other stuff that I can’t remember right now but everything I asked her to say she did in a soft but understandable whisper. I went and got her nurse, Amy, to try it in case I was hearing things and she heard and saw Janet repeat “I love you”. I also asked her to say “Janet” with Amy there and she did. She will note it in her chart and leave a note for Connie as well. I should note that Janet is not initiating the speech but whispering what I ask her to say or answering very obvious questions like “is your name Janet?”, “what’s your favorite color”, “is your dog’s name Nash?”. One interesting question I asked her was “how long have you been able to whisper?” She said nothing, then I asked “could you whisper yesterday?” and she said “yes”. Janet and I had tears, and smiles and hugs and kisses and I did not know what to do with myself but I finally pulled myself together and gave her the bedtime stretch and had her brush her teeth then I tried to say goodnight. She was still all smiles and laughter and knew I was having trouble leaving but at about 8:10 I finally got a sense that I could go.

Still flying high and praising my Lord and Savior for everything I have been blessed with. There is nothing I am more thankful for today than His grace and Janet’s love.

Short and Sweet

A short visit for me this morning as Laurel went in early for one last visit with her mom before heading back to Cowtown. She said Janet was awake when she arrived at 7:30 and seemed sad in knowing Laurel was leaving. They had a few crying sessions which would happen regardless of Janet’s condition so no surprise there. Laurel did give Janet a stretch but didn’t want to be too rough on her and then leave.

I saw the “kids” off then headed in to find Janet doing her Sleeping Beauty impression complete with an eye opening upon my kiss to the cheek. We had a little chat to kind of get caught up then I set about to start stretching her a little. I had to rearrange the bed and some other things before I could position Janet for stretching and after I had moved her I apologized for having to shift her around so much. She started to cry I’m sure out of frustration at being in her mind, helpless. As I comforted her and reassured her she initiated a hug and some kisses that were very appreciated and made me confident she is really starting to understand her situation.

The stretching went well and I am actually quite pleased with how much range is being maintained. I laid her on her tummy for a little over twenty minutes and got a real good stretch on her left hamstring and was even able to massage her legs really well. You could feel everything loosen up quite nicely. Janet managed some left leg lifts before I flipped her back over to get her standing a little bit. That went well with Janet standing real nice and tall even for her. I couldn’t see any evidence of Janet being given her Nystatin so far today so I asked her to stick out her tongue so I could see, she did so, farther than I’ve seen ever before. Laurel’s lolly pop exercises are working! A little while later a nurse came by and I asked her about the Nystatin and she said Pharmacy won’t give her anymore as she has been on it for so long. There is still evidence of thrush on her tongue and Janet stuck her tongue out for the nurse to see as well. We will consult the Hospitalist about this and see if there is some other way of getting rid of the thrush.

Before I knew it it was lunch time for Janet so I got her in the chair and out into the dining area then plugged in for lunch and she fell asleep. There was only about thirty minutes worth of formula in the bottle so I decided to wait it out and see if she woke up, she did twenty minutes later. I asked her if she wanted to go back to bed and she nodded yes. I got her all settled in and her feed restarted then took off for my lunch. Looking forward to a longer visit this afternoon.