Friday, April 5, 2013

Wednesday Update from Annapolis

Good morning, family:  Here are a few stories from Wenesday and Grandma's progress.
 
HIGHLIGHTS from Wednesday, April 3:
-Speech Therapist made a very early morning visit to Grandma
-Grandma worked with Occupational/Physical Therapists to build control of her "core" and manage her balance
-She visited the hallways in a wheelchair with Grandpa
-Lizzie gave Grandma a foot and leg massage, which she liked
 
Details:
Yesterday, Grandma reports that she was woken very early - as Grandpa wrote in his email - for a "test." We think Grandma may mean the Speech Therapist (Kristen), who came at 7:45 AM ("the middle of the night" according to Grandma) to officially begin her on a puree diet. Like Grandpa reported last night, Grandma did great! She ate 80% of her oatmeal and showed wonderful progress. Grandma needs to strengthen the muscles in her throat to swallow faster. This will allow her to progress in her diet and eat more of her favorite foods.
 
NOTE: To answer your questions, I asked the Head Nurse (Anina) why the sign about "NPO" was posted in her room yesterday. Grandma is beginning this puree diet, but only the Speech Therapist can bring her food for now. She still has some nutrition given to her by IV/tube. Once Grandma is set to eat on her own (right now the Speech Therapist stays with her while she eats), the nurses will bring food instead of only the ST. My understanding is that the NPO sign was simply a warning to the nurses.
 
Grandpa wrote a good summary of the therapy sessions that followed yesterday morning. These include putting the same brain pathway stimulator machine on her right leg/foot as well as getting used to the wheelchair. The nurses took her weight on a fancy scale in the "Bath Room" across from the dining hall. When I arrived to the Rehab Center, Grandma, Grandpa, and two Occupational Therapists (Jess and Annabelle) were working with Grandma in the large therapy room. She was sitting on the edge of a large, padded bed-like bench and looking into a mirror. Jess and Annabelle supported her back and shoulders, but the exercises that followed were truly to help build Grandma's "core" - including her abdomen muscles - and get a feel for her balance while sitting.
 
Jess sat on Grandma's right. She handed Grandma a series of colored plastic cones and asked Grandma to lean and reach with her left hand, grab the cone, then place that cone on her left side - gradually stacking these items. The exercise required a balance of many things simultaneously: Grandma worked on keeping her head up instead of letting it drop down to her chest. She worked on shifting her weight from the right, center, and left while using her core muscles to "ground" herself. She also attempted to maintain a good posture and test out her hand-eye coordination. The mirror helped with all of these movements, and the PT/OT's encouraged her to check herself in the mirror.
 
Grandma seemed a little bewildered and amazed during this activity, and noted it was very difficult. We explained that some of the difficulty was from resting in bed for 1 month. "The muscles in your stomach are sleepy," we said. The PT/OT's also noted that strokes can affect your balance and part of the recovery is working to restore strength in all of the muscles that help you stay balanced. Jess told Grandma that before she can walk, she must first build up strength to sit up tall by herself.
 
After the session, Grandma returned to her chair and her room. Instead of climbing back into bed, we encouraged her to stay in her chair, which she said she liked. The three of us had some good chats together, and Grandma seemed in pretty good spirits. She asked about how everyone was doing - dad, Jerome, my work, etc. and remembered that I was getting married "at the end of the year." Grandma joked, "you and Jerome can try to compete with 65 years." I thought it was very impressive that after all the activity of the morning, she was able to pull those details out. Go Grandma!
 
While on the topic of Grandma's memory, she remembered many other things. She recited her address correctly as well as little phrases in German and Dutch. "Although it seems much of me has been 'shaken up,' somehow the languages remain!" she exclaimed. Given how much joy Grandma gains from knowing and studying languages, this is certainly a blessing. Grandma still says she struggles with short-term memory - particularly with recalling the day's events, especially if they are early in the morning. "I fade in and out," she notes.
 
Next, Grandpa suggested that Grandma take a ride in the hallways in her chair. She agreed, and Grandpa pushed her the length of the entire 1st floor wing of Heritage Harbous Rehab Center. Grandma remarked on the beautiful pictures on the walls, and enjoyed peeking out the windows at the end of each corridor. Still an extrovert and social butterfly, she waved to the nurses and several other patients. Throughout this experience, Grandma did a great job keeping her pretty head up.
 
After visiting in the hallways, Grandma returned to her bed. We returned home for some lunch and when we visited again at the Rehab Center, Grandma said she had tried for a long time to grab her blanket, but that she was having difficulty propping herself up enough to reach for certain items. It seems that helping her to regain strength in her arms and core/abdomen will alleviate some of the frustration she feels. To help her relax, I gave her a foot and leg massage, which really cheered her up.
 
Grandpa and I begin to wonder if a stroke can cause changes in one's eyesight. Grandma looked at some comics in the newspaper toward the end of the day, but she observed that things were blurry. Grandpa read some outloud to her. However, Grandpa said that she usually looks at the paper with a magnifying glass. She still has doubts that the glasses she has are the most recent pair.
 
Some nurses came in to check on Grandma's glucose levels. Her sugar levels are great, and in normal/healthy ranges. I also noticed that Grandma didn't experience a big drop in blood pressure or become unresponsive after all the therapy - but was able to keep herself in good spirits during the majority of the day. The nurses encourage Grandma to push herself to "fight" the drowsiness she feels, saying that she needs to stay awake as long as possible. We will continue to encourage her, because she is making progress everyday.
 
*****
Love to you all!

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