Happy Thursday

Rosemary again, reporting on Queen Lena.
I went to see mom and dad on Tuesday and mom seemed much more alert.
The doctor cut out two pills and cut back on one pill.
These were medicines that mom needed for her recovery in the hospital but we are past that now, so it is time to get off of some of these medicines and make some adjustments to ones she is taking





 We brought her to the dining room to eat lunch with the others.
She enjoyed it!
We could not go outside today because it was raining, but we had a nice time together indoors.



Here are a few shots of mom doing her arm exercises in bed.

 

She was doing a lot more than the therapist required... about 6 more and then the therapist said "okay you can stop now, Lena" haha
Dad was doing them with her!

My dad is such a great man. I am so proud of his courage
and dedication to his beloved Leni (Lena)

Mom, Daddy and I have a group meeting with the team of nurses and care givers tomorrow.
I will let you know the result of that as soon as possible.

Saturday update on Lena

Rosemary here updating:
My sister Joyce and I went to see mom and dad on Friday.
Mom seems to be coming out of the fog after the removal of two medicines she was taking. She seemed more alert, and happy. While we were there, she did not suddenly fall into a deep sleep as she was earlier.
She is enjoying pureed foods, and continues to do well with the speech therapist with the mechanical soft.
Physical therapy took a decline last week with those medications, so this week and over the next few weeks it will be catch up. However this week-end she has her favorite physical therapist, Jonathan, so hopefully he will boost her confidence.
A big surprise for Joyce on Friday was to see mom pull herself up in bed and turn herself to the edge, then put both of her feet on the floor!
Here are some pictures from Friday.
It was a great day.

mom's lunch

pureed potatoes, pureed spinach, pureed something meat

vanilla pudding and thickened cranberry juice

 mom and dad having a discussion

 mom having a physical therapy session with two therapists

 out for a walk

mom, Joyce, daddy

Sally came for a visit on Thursday afternoon

 Mom, me and Joyce

encouraging mom to eat a lot

 Joyce and mom

two beautiful ladies

Lena with her nursing student

A good day all around.
Lena is much more alert today. I think the medicine that was making mom so
dizzy and drowsy is finally getting out of her system!

Yes, Lena is looking rather thin. We are working on that!
I (Rosemary) am going to see my mom and dad tomorrow.

Update On Lena -- finally

Greetings friends and family
So sorry it has been so many days since there has been a post.
Not to worry. all is going well with Lena. She is improving every day.

We did have a couple of stumbles these past 10 days. We discovered that Lena is taking two medications that make her very sleepy. These medications are not ones that she must take, they are for her comfort.
One was for restless legs. We do not know who prescribed this medicine. Lena did not take this before her stroke!
This medicine had some side effects that interfered with Lena's alertness, and physical stability.
The other was a medicine for depression but it was given to her with the intention to alleviate any anxiety she was having with physical therapy.
Together, they were a bad mix. 

We had to take some bold steps this week to discontinue these medicines. We felt that the medicine that Lena was taking for the restless legs was actually causing some of her recovery anxiety, and also nausea which decreased her appetite. The combination of these two medicines together was creating a very drowsy sleepy situation and mom's blood pressure became extremely low. So low, her physical therapy sessions were cancelled completely!

So, we are moving ahead now. Hopefully we will continue to see Lena get more energy now that she is off of these medicines.

Lena is still having a feeding tube at night to supplement her calories. She can eat pureed food on her own and doing well with that. She also has one meal a day that is called "mechanical soft". That is soft food that mom has to work a little bit more in her mouth before swallowing, like small peaches, cottage cheese, and ground foods. She is doing well with this one meal that is supervised daily by the speech therapist.

Every day John is with Lena. They have had many opportunities to go outside for walks, John pushing the wheel chair.  Lena has enjoyed this greatly.

We will try to keep the blog updated more often. Really, we only had about 7 other things going on at the same time and also being intensely involved with Lena, and helping John manage the household at their home. Everything is going so great.
Thank you so much for the continued prayers.
We really appreciate your devoted attention.
I promise to have more photos in the next post.
Love always, Rosemary

ps: I am typing this post because Christina, the lovely daughter of mine that started Lena's Recovery Blog, --- went on a cruise, on a boat. She is having a fun time.

Other Sunday 4-14 Notes

A few other things from my perspective I wrote about on Sunday but forgot to post:

- Grandma had some good moments and some depressed moments today; a little bit up and down throughout the day. I'm told she woke feeling kind of bummed, but Grandpa said a walk this morning was nice. She took a nap and was very happy to see Joyce, Andrei, and I when she woke, and was very chatty for quite awhile. In the beginning, she spoke a little less clearly than normal (clarity of actual speech was fine; but she would use some weird words from time to time or hesitate for awhile while trying to figure out how to say something), but as she became more awake she was more and more with it, happy to hear about the CPR/AED training I did yesterday (and we discussed changes in medical guidelines over the last several decades for awhile), hear about what Jason was up to, and Andrei's scouting stuff... but then she would start to get in one of those moods where she was acted like she wasn't sure how much better I can get, and how-can-you-be-so-sure-of-that. And when we helped her get into her wheelchair for an afternoon walk, there were some complications (we forgot to undo her food tube before helping her move to the chair and at some point it came undone, made a little mess... and then it was a three-person operation to adjust her pants which in all the scooting to the edge of the bed had twisted and ridden up so high Joyce thought they were shorts or pedal pushers.. and Grandma had a moment where she kind of whimpered about what "an operation" this was and felt discouraged "having to live like this," but we were able to encourage her away from maybe crying a little by reminding her that this wasn't it and that every time we see her she's improved, and that we love to help her in her recovery, etc. And then we went on a walk and she was a little bitt cocky again. We asked her about things she might want to do in the future and she said things like, "Well who SAYS I wouldn't be able to go [to the Annapolis Greek Festival this June]??" or "Well. I can do those things. It's all in your head!" So, up and down today.

- At some point primarily Joyce and Grandpa had a talk with Grandma about maybe trying an antidepressant -- this was while Grandma was in a bit of an ambivalent mood. She reiterated her spiel about "medications are the last thing I need," but understood a bit that an antidepressant might help her have more positive days and that would be helpful to her healing, and that she did not expect physical side effects and only expressed a concern for the mental side effects (I think she was afraid that they might affect her "personality")... but ultimately said (at that time) that she might be willing to try it. I'm not sure how convinced she was of this and don't know she would feel the same way if you asked her about it tomorrow or the next day as she was in one of those "You have to do what you can" and "It's worth a try" and "We can see what happens" type moods, but considering her typically strong anti-medication stance, I think this is worth noting. I don't recall what the doctors have recommended about that, but I do know that that antidepressants are not unusual in the course of stroke recovery because they do help in coping with discouragement, etc. But then, I think some of us know from experience that some antidepressants can make you feel a little flat or weird... *shrug* Guess we'll wait on that one.

- Still very good to remind Grandma of goals. She feels confident she will attend Elizabeth's wedding. She looks forward to a day when she can go by to see the house, but expressed some concern about getting the wheelchair over that step in the front sidewalk. (I was surprised she remembered it had a front step; I definitely did not!) She thought the idea of having a picnic on the rear lawn of the rehab center would be fun. She does look forward to being able to go home and cook what she wants (She definitely questions the nutritional quality of the meals she is given at HHRC) and she said she sort of missed having a glass of wine with dinner (I told her when she gets home and can have wine again, that first glass is going to be SO GOOD and she laughed and agreed about that, haha.)

- There was some discussion in subsequent emails among relatives about Grandma's likely feelings of lack of CONTROL, and I completely agreed.  I tried to do some things today that would help her feel more in control.  Had her choose what color sweater to wear when we went out (pink is springy, but she liked the idea of wearing the purple one because I mentioned Dolley liked red and purple and she was wearing a red tee shirt), and when we went for our walk I made her choose what direction we went in.  Giving her choices helps her feel more in control of her fate and less like everything is decided for her.  This is something they teach you to do when helping people who are depressed, too -- even just making them decide simple things like what to wear or what to do (go for a walk, or stay inside and talk some more) can be even a little bit empowering.

- We also talked with her a bit about maybe seeing if we can adjust her breakfast menu, since she doesn't like things like eggs and prefers bananas and yogurt for breakfast... Adjusting what foods she gets might help encourage her to eat more of her meals. :)


- Grandpa is the most wonderful, sweet, encourager ever. Seriously. He is so, so good. :) I just wanted to hug him all day!  (My favorite part was we were on a walk outside and Grandma started to hang her head at some point, so Grandpa said to her, "Keep your head up, Meik*! The Queen has to keep her head up high, not looking down...!" Adorable.)   (*Meik is Grandpa's nickname for Grandma; it comes from the Dutch word for a little girl.)

Overall an ok day. :)

Christina's Sunday 4-14 Pictures

Lunch

Happy to be in the sunshine!

Found a forsythia bush to pose with -- Grandma struggled a moment to remember the name of them, but did recall that they have several of these bushes on the side of their house.

Cute chat with church friend Julie, who has been at HHRC (nursing home portion, not rehab) for two years.

Sunday 4-14 with The Purple Ladies

Grandpa's update:

Lena started the day in a depressed mood, but Andrei & Joyce & Christina, as well as the nice weather managed to cheer her up. 

She did not eat much at breakfast, but commented favorably on the lunch & dinner. 

Thanks very much, Joyce & Christina, both Lena & I appreciated your visit and your help very much and Andrei, you are always one of grandma's favorite people to see!

** A reminder from Christina: If you click on the pictures they will open in a large slideshow view so you can see them better. **

Lunch: Beef, mashed potatoes, peas, and in the dish: dessert (marble cake, pureed).  Grandma has about the same meal as others at HHRC, but hers is just pureed.

Note that we're all wearing purple -- completely unplanned!

Visiting Julie (friend from church who has been a long-time patient at HH rehab) -- Grandma was surprised to learn Julie is only 66, yet has been at HHRC for two years, and yet Grandma is 90 and will probably eventually walk and be sent home!

Dinner: Chicken (or Turkey?) salad, beets, tomato soup, and I'm not sure what was in the small bowl. Apple sauce maybe.

Thursday 4-11 and Pictures

Some news I forgot to include from last Thursday. From Grandpa:

When I came in this morning about 9:00, mom was happy to see me, but complained she had been awakened at 6:00 ("That's the middle of the niiiight!") to go to the doctor. She claimed she had gone there, but as the wait was long she had given up & gone back. 

Anyhow she claimed also that at breakfast she had eaten a whole banana! I could not believe this, but later saw the speech therapist who confirmed that this was true! The therapist said that this was quite a milestone, but she stressed that such eating of rather solid food should only be in her (the therapist's) presence only. 

Then mom settled back in a rather noncomittal mood, leaving uncertain where the day would go, but i tried to liven her up with some music, and when the therapists came she agreed to be cooperative. 

After some exercises in bed with the one therapist (lifting the arms, and also with a 2 lb weight), they helped her move into the chair, and she helped rolling the chair to the exercise room where they had her stand up in a contraption she had been in before. She seemed pleased with the accomplishment but again scared them with stating she felt dizzy and breaking out in a sweat. However, her vital signs were OK and they took her to the middle of the room for a rest while they observed her sitting there with a rather absent look. However, she then suddenly broke the spell by saying, "Can anybody tell a good joke?" I then suggested she sing something she had composed, which she did, a happy tune. 

The PT (Annabelle) then worked for a while with her on exercises of her right leg, and indicated she was satisfied. The PT asked me however to discuss with Dr Chopra this frequent almost seeming to black out. 

Mom & I then sat in the room for at least another half an hour until she asked to be back in the bed which seemed deserved after the good work she had done. 

While we sat there, this doctor W (?) came by and said that he was making a slight change in her medicine, so as to correct her soda level which he stated was 129 and should be <135. 

All in all this was a good morning.

Although not overly enthusiastic, Lena agreed to be moved to the chair (4/11/13)

With her left arm & left foot she helped move the chair to the exercise room 

Resting from having stood up (assisted in special contraption)

Practicing lifting right leg

Lifting right knee

Saturday 4/13 and Pics

Per an email from Grandpa:

• When he arrived, Grandma still had her breakfast in front of her.  She had eaten some of the oatmeal but had no banana as there is no speech therapist on weekends. She seemed to feel good, and when the nurses came to clean her up she agreed readily to be transferred to the chair.
• Jonathan arrived, a favorite physical therapist, and this morning he did two new things with her.
• "He had her work on the NuStep bicycle. She was at first hesitant, but improved as she went along. As you all know, mom is often a kind of combination of being negative and a moment later cocky. When he installed her in that machine she gave her usual talk of her right leg not having been any more of use even before the stroke. But once she got going, she got better & better, and then said that such machines were below her dignity. Anyway she did more than 10 minutes on it."  -- Grandma is so funny!!
• "He had her stand up between 2 bars where she supported herself with her left arm on a bar. At first when she did this, she acted like she might faint, an experience other PTs have had with her. However she recovered almost immediately and indicated that she had had a tremendous fear she could not do this. But she tried this a second time and did better."
• After all this she was tired, and about 11 she went back to lie on her bed and take a nap. 
• Today is kind of cool, so we'll see how she feels this afternoon about going outside. 

She did more than 10 minutes

Standing up with help by Jonathan

Friday 4/12 and Pics

Per an email from Grandpa:

• Nothing very exciting to-day, but progress seemed to continue.
• Grandma had a banana and a drink for breakfast. :)  I know she likes bananas for breakfast, so she's probably pretty happy to be able to eat them again.
• Occupational Therapy came in the morning.  Grandpa says Grandma "was not overly cooperative," for instance when the PT wanted her to count her repetitions of an exercise, she was reluctant to do so, saying, "that's not my department, that's my husband's department..." Always a feisty one, she is.
• Grandma spent the rest of her morning in the wheelchair, and Grandpa wheeled her around the facility, but not outside since it was raining.  By about noon she was tired again and wanted to rest in bed, so Grandpa left for lunch.
• Grandpa came back to find Grandma had 2 visitors from the church "circle" Grandma belongs to.  
• She didn't eat very much of her lunch, but she is getting at least some of her daily calories by eating on her own, so this is great progress. :)
• She had some Physical Therapy later in the day (leg bending, lifting her behind, etc.) with Annabel, and did well. Yay!
• In the afternoon Grandma was complaining of being bored, and thankfully it had stopped raining, so Grandpa took her around outside for an hour and a half or so!   Wow!  Grandpa reported that this long second "walk" shows Grandma's increasing ability to keep herself sitting up and alert.  Hooray! 
• Someone told Grandpa later that a neighbor, 95 year old Gene across the street, who is in a wheelchair, accompanied by her care taker, Brenda, had visited Grandma on Thursday midday.  Grandma confirmed this information when Grandpa asked her -- I would think this is good progress with Grandma's short term memory, since previously she has had trouble remembering days or even hours earlier.