Sunday Socialite!

Grandma had a busy visitor schedule today!

In the morning she had Physical Therapy.  Grandpa was there for about an hour or so before my husband (Jason) and I arrived at maybe 11:45.  Joyce came after lunch.  Then there was the Speech and Swallowing therapist, a lady from church (Marion) with the flowers from the service that morning, the President of the Heritage Harbor chorus grandma sings in (Maggie), and their church pastor (Bill Hathaway)!  And I believe Sally (Dolley's daughter) was going to visit this evening after we left, too.  I told Grandma that one of the nice things about being in the hospital is that she's probably seen more of us family in the last week than she has since Christmas, and all of her friends come to her! She thought that was pretty amusing.

Keep in mind I didn't see Grandma Saturday and this was the first time I saw her since Tuesday, but I thought she looked great today.  Tremendous progress from last Tuesday, and even Grandpa thought she was a little better than Saturday.  Fantastic last few days in contrast to the not-so-great Wednesday and Thursday.

Vitals are stable, medication for infection is working.  Nurse didn't say anything about her temperature or BP today, just that "everything looks good" so I imagine that includes her fever having gone away. Yay!

Grandma was a chatterbox today!  She is talking longer and more clearly.  Where earlier she was only speaking in short sentences or a few words at a time, she was speaking in fuller sentences, a few at a time today.  She continues to follow the conversations in the room, looks around the room pretty easily now, and stays awake and alert for longer periods of time.

Joyce is going to give the Discharge Coordination nurse a call tomorrow to see when they think Grandma might be moved to that rehab facility in Heritage Harbor and check with the facility Admissions lady about what else needs to be done on our end to ensure there is a room available for her when that time comes, but that is at least several days off I think.

Speech and Swallowing update

• This therapist comes in every day to see how Grandma is doing with speaking and with swallowing, since the muscles on her right (stroke) side are a bit weaker than her left, and it will take some practice for her to work back up to "normal."
• Grandma was given a little sponge on a stick and asked to "brush" her teeth and tongue with it and she did this very well.  I'm sure that felt pretty good!
• The therapist worked with Grandma to eat some applesauce on her own and swallowing.  She did great, and the therapist says she is cleared for snacks (e.g. applesauce, pudding, mashed potatoes, mashed-up banana, other puréed food, honey-thick liquids) whenever she wants them! (So long as a nurse is around.) Another milestone accomplished!
• Since she appears to be swallowing pretty well (acknowledging that her right side is weaker) the next step is to work on her endurance.  That is, Grandma needs to be able to keep up the energy and use of her muscles to eat a meal.  When she is at the point where she can eat her meals and meet her caloric needs on her own, then they can take the NG tube out of her nose, but until then they want to make sure she is getting enough calories by being fed through that tube.
• In a few days they will do a swallowing xray to check how her throat muscles are doing.

Attitude

When asked how she's doing, Grandma was pretty upbeat today.  "I'm not complaining at all," she said. She noted repeatedly, "Most people don't make it to this age," and that she felt pretty positively about how things were going.  Although she doesn't remember everything fromt he first few days of her time in the hospital, she is encouraged when we remind her of how far she has come, comparing earlier in the week with where she is now. "Even I am surprised," she said, in reference to how well she was making progress with everything.  She added that "some people have this stroke and they don't live through it," and that others "don't do as well after," trying to keep things in perspective.  Grandpa said he reminded her this morning that they have been together for so many years and he would like to continue with that... and Grandma agreed.  Considering how she sometimes gets depressed by her limitations with getting older, this is great to hear and I think it is good to keep her thinking positively. <3

Cute anecdotes:

• Sometime when I was out of the room for a moment, Joyce asked Grandma if she was interested in having some music brought in sometime, and Grandma started SINGING. "I make my own music!" (I'm so sad I missed this!)
• Grandma was so talkative today that the Speech and Swallowing Therapist at some point had to tell Grandma, "I'd love to hear more of your stories, but we have to get through this test...!" Sounds like the Lena we all know, chatting people up!
• At the end of her visit, the Speech and Swallowing therapist assured Grandma, "Believe me, you won't have this forever, things will definitely improve," to which Grandma responded emphatically, "Yeah, I hope not!!"
• I announced to Grandma that my mom had text messaged me asking, "How is the Queen of Everything doing today??" Grandma thought that was funny.  I told her that I contemplated bringing in the tiara I wore for my bachelorette weekend in May so that everyone would know that "the Queen is here" but none of us were expecting Grandma to say, "Nah, don't really need that... Everyone knows it anyway!" I thought Grandpa might fall over, he was laughing so hard. :)
• We put on the TV in her room for a little while and came across a channel that was showing a motocross race, which I guess Grandma had never really seen before.  She kind of shrieked at the crazy jumps the riders were making.  So sweet to see her excited by this.
• As we were leaving, I asked Grandpa if there was anything he needed help with at home before we left for Virginia, like dishes, laundry, or cleaning.  He said no, but confided, "In all of our years together, I have never had to do the laundry. Your uncle John the other day showed me how to do it, and even made some labels on the machine, 'Step 1', 'Step 2'... And actually, it's kind of easy... I got everything washed, ran the dryer, sorted things...!" He seemed kind of proud of himself. I told him, "Yeah this must make you appreciate all the things Grandma has taken care of all these years!" He agreed, said it was kind of humbling. :)  <3

I think that's about all I have.  I have some pictures myself, and Grandpa just sent me his... I think I'll post those tomorrow.

Thanks again so much for all the prayers, positive thoughts, good vibes, etc.  I do pass your messages along and Grandma is just so humbled to hear about everyone who is thinking of her!

-Christina

Saturday Pictures 1

My mom/Rosemary sent these pictures along from her visit from yesterday (Saturday).

Sitting in a chair! Working with one of the nurses I think.

Resting

The Presbyterian Women of the Congregation at church brought by a handmade "prayer shawl" on Friday. What a sweet label they put on it!

Elizabeth saying goodnight before going back home.

Sitting Pretty Saturday

Sorry this post was delayed; I spoke to my mom/Rosemary late in the day about her visit Saturday and was too pooped to finish up chores, write, AND make it to bed at a decent hour for our visit today. But at least it's good news! -Christina


On Saturday, Grandma got to sit up in a fancy lounge chair for most of the day, rather than lying in the hospital bed!  Probably a nice change of scenery for her.

My mom/Rosemary went to the hospital this day with my sister Elizabeth, who was unable to visit earlier in the week since she had ben fighting off an infection (cold or flu I think).

Grandma looked great this day!   She is no longer hooked up to any IVs, just the NG tube down her nose/throat, and a port for medications in her arm. The nurses check her vital signs manually every few hours (as opposed to in Critical Care when she was hooked up to machines that checked everything constantly) and her vital signs have been great: blood pressure back down, fever was down, and she was responding very well to the antibiotics she had been given for the urinary tract infection.  Sounds like it was another good day.

Although she still takes a lot of naps during the day, Grandma is able to spend more time awake and alert; last week when I saw her on Tuesday she would last about 15-30 minutes before feeling sleepy and taking a nap, but on Saturday my mom reports Grandma was able to sit and chat and "socialize" for an hour, hour and a half at a time!  It is still important that we let her rest when she gets tired because she needs that time to heal, but it is great that her "endurance" if you will is improving.  (Entertaining all these guests is hard work! ha!)

Mom reports that a Physical Therapist came by to check how Grandma was doing as far as movement. She can bend her knees, move her legs around, can shrug both shoulders, and point her toes!  Although she has some trouble raising her right arm (the stroke side), she can fully extend it with some encouragement.  Awesome!

When I first saw Grandma on Monday afternoon, she had a hard time keeping her eyes all the way open and was "in-and-out," talking a bit and then napping again.  Saturday I'm told her eyes are much more open, and she can move her eyes around a lot better, even looking to her right (stroke site), which is terrific.  On Tuesday she had trouble seeing the clock on the wall in her room; Mom told me Grandma can now see the clock just fine. (She is able to look around better which is probably a contributing factor in that progress.)

I think Grandma is eager to get moving again.  She has been a little restless, wiggling her legs around.  (She's not one to sit still for long, and she's now been in the hospital almost a week!) She continues to get some cramps in her legs, but as she starts using those muscles again that should go away.

As far as Grandma's attitude, I think she has good times and not-so-good times, which is rather understandable.  She acknowledges that she is 90 years old and "not many people make it to this age," and when we tell her how her progress is going beautifully she feels pretty encouraged by this news, but I think she also has her moments where she feels like, "I'm not sure if I can do this."  Thus, it has been really important for us to remind her that things will get easier and will get better.  How she is now is not how things will be forever; this is just a step.  Sometimes it can be a challenge to keep her spirits up, but I think the past couple days' progress have been so encouraging, both for Grandma AND Grandpa that even though there might be "good" days and "bad" days, the general trend is one of improvement!

(Mom, let me know if I missed anything or if there are any other little anecdotes to add...?)

I'll post on my visit today (Sunday) very soon. <3

"Everything good happened today!!!"

My mom/Rosemary went to Annapolis again today and just sent me a very encouraging email! Here's most of it:

----

Hi Teenbelle, Joyce and Elizabeth,

I love you girls. Here goes, a very long status update:

I am glad I did not talk with you last night, Christina…. apparently yesterday was another very discouraging day according to Johnny and dad.  Johnny and daddy came home very disappointed.  First that stupid cardio doc came in and acted like he did not want to really talk about anything and was very negative, then he left.

Mom was sleepy all day, and very quiet. She had a fever in the morning.  Well it was discovered that she did INDEED have a UTI for two days at minimum. So she is on antibiotics now.

She also has a small NG tube for food. She can eat food though. She ate today.

Everything good happened today!!! (They knew I was coming) -- the neuro guy came early; I do not know if Johnny and daddy were there, but they shared that the neuro doctor ran some tests on mom's brain. That information came back very good.

The crappy skinny short measily cardio doc had the day off, so another cardio doc came and Johnny and dad said he was very pleasant and wanted to answer any questions. He was easy to talk with, and encouraging!!

So that was good. I arrived at 11:00.

While I was there, we also had a visit from the Speech and Swallowing therapist and mom ate food, as explained above.

She had a visit from the Occupational Therapy (OT) lady, we got mom sitting up. She was excellent. The OT told me that the OT at the Heritage Harbor rehab center is her friend and she is excellent at rehab. After this sitting up exercise, stretching legs attempt, wiggling feet, mom's BP was kinda high, 170/90 I think…

We learned that we really need to make an effort to stand on mom's right side and get her to move her head and roll her eyes over to the right.  She looks left. That is the stroke, her right side weakness. The OT girl was marvelous.

We met with a Care Coordinator. She discussed what goals need to be met in the immediate time frame, mainly stabilization and treating the infection, and how we should go ahead now and insist on a private room for mom at HHRC because that is what daddy wants.  She said we should keep pressing for that.

We also discovered that mom contracts her right leg in bed, then when trying to straighten it out we got a horrible gracillis muscle spasm which took a long time to massage out, at least 5 minutes of my massaging and rubbing. I think that will be a constant issue until she gets more tone in her right leg. If you push on the ball of her right foot, she is likely to contract her entire leg, so I feel like she needs massage therapy to get those muscles loose.

Okay what else, what a full day.

OH! She got a package from the church. They made her a prayer shawl. [In her favorite colors, Mom says! -CHA]  I opened it for her. She looked at it and touched it, and said "oh, oh" so sweetly about 100 times. She loved it. Mom is so sweet. Then she finally with her left hand picked it up and I thought she wanted to cover her self in it, but no, she attempted quite well to wrap it around her neck, so daddy and I helped her, then Johnny got some pics. [Will try to get one of those this weekend -CHA]

While we were at lunch (mom was sleeping soundly) apparently Physical Therapy showed up. I was told the got her up on the side of the bed again.  Well, when we came in the room, I asked mom how it was going, and she told me that someone came and made her sit up again, and then she sounded very VERY discouraged. She said, "I do not know why my blood pressure goes so high, I don't know why." I told her not to worry, it would get better. She was quite sad, so opening up the package with the shawl was a great diversion.

I think we will see more improvement as the UTI is treated and she feels better. I would believe that the past few days of lethargy has a lot to do with that.

----

So yay!  After two more discouraging days it's wonderful that today went so well!

I hear that Shelley and Sally also went out today, and Johnny is headed home tomorrow morning.  Elizabeth is finally over her virus/cold (yay!) so she, her fiancé Jerome, and Mom will be going to Annapolis tomorrow (Saturday).  Jason and I plan to go out on Sunday. What a popular lady! ;)

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