Friday picture

 

My uncle Johnny posted this picture to Facebook.

"Today is the best so far since Tuesday."

Guest Book Fixed

I replaced the guest book setup so if you had trouble posting to it, go ahead and try again; it should work now.  Thanks.

Request from Grandpa

Grandpa added that he appreciates all the kind words, well wishes, and prayers this week, but he asks that people do not bring him meals as he has more than he can handle right now.

If you're eager to help, I'll try to see if there are any specific ways Grandpa could use it, but I think he's okay for the moment.

Andrei and Grandma (Wednesday)

Grandma saying 'bye to Andrei Wednesday afternoon.  She was tired, but when Joyce told her they were leaving, she lifted her arm to pat Andrei goodbye.  So sweet!

Photo from Joyce

Wednesday and Thursday

Yesterday we had a sort-of snow storm come through the DC area and while the day of rest at home was good and I was glad to at least not be at work, I really wanted to be back in Annapolis... but had to remind myself that Grandpa had both Joyce and Johnny with him throughout the day and Grandma was stable and being cared for so there was little I could have done except perhaps get status updates first hand.

In any case I've now spoken (this afternoon) with Joyce, Grandpa, and my mom (Rosemary) and here's the gist of the last two days:  (If you read this Mom/Joyce/Grandpa and I've made some errors, let me know and I'll correct them.)

Wednesday 

Joyce was with Grandpa in the morning through afternoon, and Johnny arrived from New Hampshire in the afternoon and stayed the night with Grandpa.

I'm told Grandma was much sleepier on Wednesday than on Tuesday, so she didn't talk as much and Johnny said he had some trouble understanding her at times.  She was also not swallowing so she did not get normal food like she did on Tuesday.  However, Joyce tells me that as someone new came in to the room (like the doctor or their church pastor) she would perk up and lift her head a little.  

My mom also reports there was a visit from the cardio doctor who was "very negative" in her words, about the fact that Grandma wasn't swallowing again this day.  (The consensus seems to be that this doctor has a terrible bedside manner, so who knows what his deal is.)  Being able to keep up the swallowing shows progress, but with Grandma so sleepy they can't give her anything.

Joyce and Grandpa also visited the rehab facility in Heritage Harbor.  Joyce thought it was "very nice" and Grandpa liked that it was close enough that he could walk there.  The ultimate plan will be for Grandma to move to a rehab facility like this and get a variety of rehab therapies once we know what kind of deficiencies she has.

Thursday (today)

Grandpa and Johnny went out to the hospital this morning and were home for lunch when I spoke with Grandpa and then Joyce. 

Today, Grandma has a bit of a fever (101 F I think), which is not good.  The doctors are investigating the cause today.  I think they took some blood and a chest X-ray to see if perhaps she has developed pneumonia.  Should have the results of that by the time I talk to someone next.  If it is pneumonia, they will start her immediately on some antibiotics; if it's not, we'll see what it is. Fingers crossed.

Grandma was a bit more alert today.  She was still so sleepy and unable to get normal food, but the therapist said she would try back later to see if perhaps Grandma was more alert then.

They cannot give Grandma water (the fear is that she won't swallow it and it'll go down her lungs) so Johnny swabbed her mouth a little with a wet cloth and Grandma loved that... She's probably hungry for real food, and I'm sure her mouth gets a bit dry.  I think Grandpa said she joked with Johnny about "sneaking in" a banana for her, but she knows she's not to have food yet.

Downgrade to Special Care Unit 

Also, sometime in the last two days (Wednesday maybe?), Grandma was downgraded to the Special Care Unit, which is a step down from Critical Care.  The difference is that in Critical Care you're hooked up to a monitor of vital signs 24 hours and they check your vital signs every hour, but in Special Care she is not hooked up to the monitor and the nurse checks her vitals every hour.  This is a good thing; Grandma is considered "stable" as far as her vitals, so it's probably good they  feel comfortable sending her down a level.

One complication of this though is that when she was in critical care she had a machine to squeeze her legs and feet help prevent blood pooling and increase circulation in her legs to prevent a clot, but they didn't hook her up to that in Special Care.  Grandma was a bit restless today, complaining of cramped legs, so Grandpa and Johnny asked this morning if she could have that again.  Her sleepiness today might be related from having the leg cramps... I think the blood tests they're doing today might also include a test for her potassium levels.

So that's what I have right now.  Will probably talk to someone this evening and if there's more to say then, I'll post again.

Thanks,
Christina

* I have not yet heard how the "rehab evaluation" test that I thought Grandma was supposed to have on Wednesday went.  She was sleepy, so maybe they held off.  I'll try to ask this evening.

Making Early Progress!

Update, 6PM Tuesday Evening.

More good news!

Soon after I sent that last message, the Speech and Swallowing Therapist came by. Grandma did REALLY well.  She asked Grandma her first name, how to spell it, her last name, how to spell it, if she knew the month and year (Grandma couldn't remember "March" but remembered it was the third month, and wasn't sure of the year, but she knows it's Tuesday and has told us she remembers Andrei just had his birthday, so, not too bad).  The therapist then asked us and Grandma some questions about her speech: Grandma says she doesn't think she has much trouble with finding words, but more difficulty with getting them out and realizes she has trouble speaking clearly.

The nurse then had her make some faces, stick out her tongue and point it different ways, make a kiss face, blow out her lips, stick her tongue in her cheek, etc. and she did all of those things really well.

Grandma was then given some ice chips to melt and swallow so the nurse could check her swallowing.  It was a little tricky but she did this fine.  Then she gave Grandma a few spoons of applesauce, which Grandma handled fine.  In between bites she made her say "aaah," and Grandma was even like, "I don't know why you're having me do these things..." and the nurse explained she has to make sure she swallowed all the way and there wasn't anything left in her throat and Grandma understood immediately. [Ohhhhhh okay, yeah]

Then!! The nurse had Grandma take the spoon and Grandma did just fine with it! (Even tapping the spoon a little on the applesauce cup so it wouldn't spill!)  She was great with the spoon, turning it to get the sauce in the corners of the cup, etc. I mean, she was a bit slow with all of this, of course, but the nurse was super-impressed, asking whether Occupational Therapy had come in already, which they hadn't. (Go Grandma!!)  While she worked on the applesauce cup, I had Grandpa replace me in the room and I'm told she also "drank" some syrupy thing they gave her to see that she could grasp and use a cup.  (Something with the consistency of honey; they don't give patients water right away because if they can't control swallowing perfectly it could wind up in their lungs.)

Through all of this Grandma was a bit more alert (they had her bed in a sitting-upright position so she wasn't dozing in and out like she'd been doing when I saw her midmorning) and was following all of our conversations, laughing a little, etc.  Mom/Rosemary was telling Grandma how AMAZING she was doing, and bragging to the nurse about what an AMAZING woman she is, etc. and Grandma was acting like, "Eh. Maybe. *shrug* I'm ok. Not that amazing." You know, her usual modest silly self. :)  We asked her if it was yummy and she said, "Eh, yummy maybe. Not delicious, but yummy I guess." I think she's craving sugar... :)

A bit after all this one of their church pastors dropped in for a visit and Mom/Rosemary and I prepared to leave (beat rush hour and this weird weather we're expecting) but I dropped in briefly before we left to say 'bye and I snagged a few pictures which I'll post/email soon. Prooomise.

After I got home, Joyce called me- she said that because the swallow test went well, they brought her some FOOD! Yay! Of course everything's pureed right now, but still better than nothing (Grandma's been asking about food since they brought her in)  Pureed potatoes, cranberry stuff, turkey they think, and green beans.  The nurses added that it is REALLY GOOD that she can eat, most stroke patients aren't eating so soon, so that is awesome.

Joyce also tells me that when she arrived with Andrei she was asking whether Andrei had homework or anything, and I recall earlier today she even asked me whether I had work [No grandma I left work early yesterday and took today off] [Oh okay, yeah *something about all of us making a fuss over her*]. So she's pretty "with it." She even expressed to the pastor that she was disappointed she'd be missing choir practice this week since I guess she really likes this new piece they're starting.

Yay. So all of this is really, really good news. 

KEEP UP THE HAPPY THOUGHTS!

Much love,

Christina

PS- Everyone getting messages ok? Anyone I'm missing?

I have been passing your messages on to G+G and everyone. <3

"Give me a big, big smile"

"Do you feel good?"

"Yeah."

"Are you comfortable?"

"Mmm, yeah."

"Are you happy?"

"Yeah. I'm happy."

Speech and Swallowing Therapist Visit

Grandma taking the spoon and eating applesauce with the therapist and Rosemary/cheerleader <3

Big Status Update

Update, 1:30 PM Tuesday.

(Man it takes me like an hour or more to write these emails with the TV on in this waiting room. They've got Pawn Stars and American Pickers on! and this patient advocate lady keeps trying to chat with me...)

We got to the hospital around 10:30 or so.  Grandma says she slept well and is alert and resting a lot, but we all talked with her some this morning.  She knows where she is, she knows what happened, and was pretty chatty (considering), asking how we were, asking for whoever of us wasn't in the room (still only 2 visitors at a time in this Critical Care Unit), which is all really good. 

The CAT scan came back and shows no change from last night, which is good.  The little blood leak she had yesterday has stopped, which is super fantastic, since the leak was apparently deep enough in the brain that they couldn't safely reach it to fix the leak yesterday.  What blood is there will re-absorb, so if it's causing her trouble/confusion it should eventually subside, I think.  Her blood pressure is also way down from last night which is awesome.  (260/110 down to 157/79, considered back to a good/normal BP for her)  Heart rate is a little irregular, but they say that's not too worrisome.  Other vitals look fine. The only meds she's on today is 2 doses of the blood pressure meds and the anti-nausea stuff.  No more plasma to clean out the coumadin, no more vitamin K.

Grandma still shows an ever so slight weakness on her right side (droopy around her mouth, has a little trouble really controlling her right arm), but she is able to move all four limbs, says she can see us ok, and does recognize all of us.  She can't make out the digital clock across the room from her, though, but keeps trying.  Sometimes she does have some trouble with words, but that's to be expected right now.  (For instance I told her I was emailing with all the cousins [Oh? Oh wow, yeah! Good.] and I think she was saying that it's really great we all keep in touch and when she threw the word "education" in there I think she was talking about how great it is we have all this "technology.")  

She knows that she hasn't eaten anything since she got there, and apparently she kind of wanted Grandpa's cookie from lunch yesterday (no surprise the lady wants cookies), but she understood when we told her she had to be NPO for now. They've been giving her some anti-nausea and antacid stuff for that, and even though she threw up last night (not unusual) she said she kind of felt better afterward.  The nurses here are really sweet and cleaned her up really well before bed.

We all know she's pretty feisty and I-can-do-that-myself; apparently last night when I wasn't in the room my Mom tried to help her blow her nose but she wouldn't have it and took the tissue and did it herself! She also had some tubes running across her neck and torso this morning and she pulled them out of the way, lifted her head and tugged at her pillow when it had shifted, will grab her blankets and tug on them and adjust her feet... you can so tell she's her normal feisty self, albeit slower and sleeping a lot right now while they have her rest. 

She's also really aware of other things going on in life... last night she asked something about Thursday afternoon, and we found a paper at home about a seminar she had planned to go to and was probably trying to tell Grandpa something about not being able to make it to that. She asked Grandpa this morning if he had gotten the mail yesterday and was pleased when I told her he put the trash out last night for pickup this morning. :) When we told her Andrei's birthday was yesterday, she said, "Oh? Yeah! Yeah, mmhm."

Around 11:30 AM, Mom, Joyce and Grandpa met with the discharge planning nurse. It sounds like the plan for the next day or so is to allow her to continue to rest, keep watching her condition (considered stable), and then evaluate her swallowing (affect her ability to eat).  She'l have a rehab evaluation tomorrow as well, to see what kind of deficits she has and what kind of rehab she'll need.  A speech therapist will be in every day starting tomorrow.  We're not sure yet how long she'll remain here at Anne Arundel Medical Center (maybe a couple more days in CCU and then a week max in a regular room), but for rehab she'll be moved to another facility, and there's a really good chance they can move her to the facility in Heritage Harbor (grandma and grandpa's neighborhood).  I think Joyce said insurance will cover her for about three weeks there.  After that, they can hopefully move her back home and if necessary get a nurse to help out at home.

Grandpa is feeling pretty good about things.  He might be in a little bit of denial that it might be weeks until she's back home (we told him Giant called with a prescription was ready, and he was like, "Ah, mom takes care of those things") but I think the meeting with the discharge nurse was reassuring; that she could be close to home.

So yeah. That's where things are now.  We had lunch, Joyce left to get Andrei home from school, and Mom and I are headed back to Virginia this afternoon before the rain/sleet/snow starts.  Joyce and Andrei will stay with Grandpa overnight, and then Johnny is coming down from New Hampshire tomorrow.

Oh- Grandpa just came out. Said the Coumadin doctor they see in this facility dropped by, looked over her chart said she was "very impressed." She said Grandma looked really good and that they definitely got her in to treatment early so that's fantastic.

I'm in the room now with Mom. She asked Grandma if she's happy and she said she was. :) Mom asked her if she wanted tea and sugar and she chuckled a little.  I think they chatted her up some before I came in so she's a little fatigued and talking through sleep, and I think I caught her humming a little earlier. Such a cutie.

More when I have it.  Of course we're going home soon so I'll try to keep in touch and remain a point of contact even after I get home...

Christina

No news is good news

Update, 10 am Tuesday.

I called the nurse at the hospital this morning. She said that nothing was new from last night, she is still resting and sleeping. This is good; nothing has gotten worse. They took her in for a CAT scan this morning but when I called they did not yet have the results back. We are on our way to the hospital now, and maybe by then they will have the results.

I will let you know when I have more to tell. Keep up the good thoughts!

Christina