Month: August 2012

August 28, 2012 AM

Busy day so far. Janet popped her eyes open as soon as I said good morning. She was in a half Houdieno move and gave me a little smile. Christi came in and we cleaned her up and changed her. Janet is a favorite of so many nurses, it’s pretty cool. Christi did mention Janet’s heart rate was up a little, around 104. She checked back in the chart a ways and it appears Janet is often in the 90’s and low 100’s. I asked Dr. Price about it and he says it’s likely a switch in her brain stem telling the heart to beat faster. As long as it doesn’t sustain at 120 or 130 he’s not worried about it.

Because of her high heart rate I let Janet rest a little before starting our stretching routine. Tom came in later on and we put Janet on her tummy. She tolerated it very well with little change to her heart rate and lots of good movement from her. She even helped me roll her over after 45 minutes. After a short rest I sat her up for some standing then Christi and I weighed her. She gained almost a kilo from last week. Good news!

We did some more work on talking and signing etc. No luck on the talking yet and Janet refused to do the sign language thing today but she repeatedly closed her hand to a fist then lifted her pointer finger as instructed. She seems fascinated by her hand and fingers so maybe that’s the way to go for yes and no.

Heidi came in to read with Janet and I took off to deal with LTC financial issues. Thanks to Laurel I’m going to Nanaimo tomorrow to see my parents. Praying for immediate and full healing and the ability to talk.

August 27, 2012 PM

From Laurel

Mom was in her chair when I arrived this afternoon but looking somewhat uncomfortable so was fairly quickly put back to bed. She had a good snooze once in bed, and then woke up for some chatting and reading. I felt she looked more “focused” on listening as I got to some particularly good parts in Anne of Green Gables today, but that may have been an overly optimistic impression on my part. She didn’t want to try any writing/scribbling today, but when I gave her the hairbrush and asked her to brush her hair she quite quickly used it to appropriately stroke the side of her head. Nice job, Mom! She also was very quick and “on target” with her high fives today. She later had another nap and then woke up for a nice visit from Wendy. We did some stretching and then it was time to say goodnight.

Oh, and good news of the day…the lab test indicated C Diff is gone! Apparently we are to keep the gowns and gloves on for another couple of days, but the end is in sight!

August 27, 2012 AM

Sleepy day so far for Janet. She was in Houdieno mode when I arrived and her nurse came in to clean her up. A test is being done to see if the C diff. is gone. Sure hope so. Started stretching Janet and despite being quite tight to begin she loosened up quite well. Likely due to her falling asleep half way through the workout. I waited for Tom with Janet all limbered up and ready to go but by 10:30 I had not even seen him on the ward yet so I sat Janet up on the side of the bed and did some standing with her. I also just let her sit there for about fifteen minutes and each time she leaned over to the right too far she would grab my arm or shoulder and correct herself. Nice. Got her into the new wheelchair using the sliding board and was already for a drive around the ward and back to sleep she went. I sat with her for a few minutes to see if it was just a power snooze then Tom came in. He used the sliding board to get her back on the bed and she woke up as soon as he started working with her. Seeing Tom work the sliding board was good for me as I now know to put Janet’s arm out way farther than I was so she can pull herself more than lift and slide. I put Janet into the regular chair after her workout as she was sleepy again.

I went roaming in search of Dr. McCann and saw Cathryn. She is still working on the rehab criteria. Progress is being made on the LTC rates thanks to lots of help from the Access Coordinator. Had a chat with this week’s Hospitalist and he was pleased to hear of Janet’s progress. He actually had an aneurysm that was diagnosed before it ruptured. Obviously he was treated successfully and I look forward to talking to him about it some more.

Praying for full healing.

August 26, 2012 PM

Janet was raring to go when I arrived just before three. She was in Houdieno mode and very bright. Even bright enough to smile at me a couple times. The smile quickly vanished as I started stretching her as the left hip/pelvis and leg are still tighter than I think they should be now with the Botox. She started smiling again when I sat her up on the edge of the bed then did some “standing”. She really does enjoy sitting by herself especially when I help straighten her back. Her face lights up each time. She even brushed her hair a few times. We went for our customary walk to the beach with Janet wheeling her chair from her room to the elevators in record time. By the time we were at the beach Janet was clearly not comfortable. She was leaning forward a lot to grab her left knee and move that leg to the right. She seemed better as long as we were moving but I did cut the walk short and as I sat her on the edge of the bed she very deliberately put her left arm down and started to lean over clearly “saying” she wanted to lay down. She seemed relieved almost immediately.

After a short rest we called Heather and Janet was focused on her voice most of the time. She looked perplexed sometimes too but that is a common expression people have when listening to Heather.

School was in for a while next. Janet seemed very interested when I wrote her name on the iPad using iblackboard. Maybe she recognized her name or maybe my writing, nevertheless it was a good reaction and I will try other words with it next. Tried to get her to write or draw something on it but only got a few taps out of her. I played a couple speech therapy songs for her and she seemed to watch each one very closely.

I had lots of interaction with Janet today. Lots of eye contact, touching, it even felt like she leaned in to give me a kiss once. She fell asleep by six and was still snoring at 7:30 when I left but the time she was awake she was very awake.

Praying for a productive day tomorrow.

August 26, 2012 AM

From Laurel

A quiet morning with Mom. She appeared to be asleep when I arrived, but opened her eyes as soon as I began talking. Worked a lot with her right arm, making it reach around to touch other parts of her body and helping her to move it around. She appears very focused when this is happening, although I don’t know on what. I again gave her the pen and paper, and with some prompting she made some more scribbles. She doesn’t ever want to do it for long, but she doesn’t seem to mind it as she’s doing it. I used her hand to write a (very messy) sentence – thought it was worth a try. Later, Mom was put in her wheelchair but fell alseep just as we were about to head out. Fortunately, she woke up as we got to the elevators and Suzanne stepped out for a visit. Nice timing! We went outside for a little, but Mom needed to be back for lunch, and on the way back she fell alseep. Proceeded to sleep for almost two hours before I decided to head home for some lunch. Hopefully Larry can have some more awake time when he arrives this afternoon!

August 25, 2012 PM

It turned out to be a fairly bright day for Janet. Her morning nap was brief and we did some reading, writing, grooming, talking and gawking over lunch. When Janet wakes up she is usually a little slow to get going so I gave her a magazine to look at first. She leafed through a bunch of pages first then went one by one till she found a very colorful ad on one page and she really looked at that for a while. She also paused at a half page photo of Ellen and I reminded her who that was but I think she recognized her. I tried with the pen and paper thing again with no luck but Janet did finally brush her hair! Just a couple strokes and not well aimed but she did it without coaching or hesitating. I sensed she was quite bright so I tried to get her to say something like hi or aah. She will open her mouth on command now sometimes but there was no real effort to speak today. Janet is getting better with the sign language as she now will mimic the sign for yes consistently. I used the speech therapy mirror with her as well but I don’t think she sees well enough to really know what she’s looking at. She was comfortable touching the mirror today so that is a good step.

After lunch it was back to bed for a stretch and some sitting/standing. Janet stayed awake through that so into the new wheelchair she went. By far her best effort at driving today. Long spurts of wheeling and way more confident in the chair. I can walk beside and in front of her now and she’ll follow where if I did that before she seemed scared to do anything. Good progress.

I drove as we walked to the beach and back. The sun felt good and Janet was looking around a lot. I stopped a few times where she could look closely and touch some flowers. Previously she would be startled a little to touch something like that but she seems more confident now. I put her into bed to wait for Laurel and headed home for lunch.

Laurel reports that her mom slept till about 4:30 then was quite active the rest of her shift. Laurel was successful in getting Janet to write on some paper! Well, scribble, but still. Apparently the pen I was giving Janet was not good enough for her as she loved the clicky pen Laurel gave her. She started clicking it right away and when Laurel held a piece of paper out in front of her she put the pen to it and made scribbly marks. Cool.

Praying for a restful and healing night and a communicative day tomorrow.

August 25, 2012 AM

Much brighter start today. Janet woke up as I came into the room and was quite intent on listening to me chat to her. She was really looking at me, had a smiley face on and often reached out to rub my arm or shoulder. Her nurse came in and we got her medicated, cleaned and dressed then it was time for some stretching. That went reasonably well but Janet is still kinda tight on the left hip/pelvis and hamstring. The right arm is better today and the more we can exercise it the better. Janet was exploring the fingers on her right hand this morning using her left hand to lift each one up and rub it a little. First time I’ve seen that.

We attempted to go for a walk but once Janet was in the wheelchair sitting in the sun waiting for me to change out of my gloves and gown, she fell asleep.

Praying for brighter and brighter days.

August 24, 2012 PM

A pretty good afternoon shift for Janet. I had her all ready for Jane just after two and we got her into the new wheelchair using the sliding board. Janet instinctively used her left arm to balance and try to move herself and I can see that with a shorter and slipperier board she could learn to do this on her own. She also needs to gain control of her left leg as well and hopefully with lots of experience like this she will get it going. Wayne arrived for a visit just as Janet started wheeling out the door. He was out of Team Save Janet uniform and I think that motivated Janet to wheel harder toward him. Jane was happy with Janet’s performance but I know she can do better as she was just breaking out of her slumber. Jane suggested I have a talk with Dr. McCann re Janet’s progress and I will next week for sure. Again, I’m not getting my hopes up but will keep praying that Janet makes enough progress to avoid LTC.

We went for a little walk after the session with Jane and Janet got more and more alert as the afternoon went on. She was really watching cars and people and looking at me with a quizzical look from time to time. One time she even made an obvious gesture that she was annoyed with the cigarette smoke wafting over from some patient smoking just off the property. She rubbed her nose, frowned and looked at me like “eew”. I continue to try and get her to say hi or give me the sign for yes. She mimicked that well once today and you can really see her thinking and trying to figure things out when asked to talk or sign. During one signing attempt she seemed to be counting her fingers, bringing them up one at a time from a fist. That’s a first that I’ve seen.

She had a nap during most of her dinner and that gave me time to work on the LTC money issue. Hopefully will get this resolved next week. We did a little sitting up and reading and talking before I stretched her out for bed. No sign of C diff. since a change first thing this morning. Yay!

Praying for a restful and healing night. A safe drive from Calgary for Laurel and a progressive day tomorrow.

August 24, 2012 AM

Another sleepy start to the day. Janet was being changed when I arrived and the girls wanted to change her whole bed so I let them put Janet in the wheelchair. Of course she went right back to sleep and stayed that way till Tom showed up at 10:30. We put her on the tilt table and that sure woke her up. I had no chance to stretch her before that and Tom went pretty easy on her before raising her on the table. She had a real sweaty workout “standing” there for forty minutes and showed us that that is about her limit. When Tom let her down she was quite uncomfortable and her legs were shaking and her back was arched. I was quite concerned but Tom explained how hard that table is and how little padding Janet has so the pressure of being on there that long was uncomfortable. As soon as we flew her back to bed she relaxed and everything loosened up. By then it was lunch time so of course she went to sleep.

The dietician stopped by to discuss her formula and wants to switch to the high calorie formula again even with the C diff. still present. She tried telling me that Janet’s weight is stable but I told her she lost some since the last weigh in. We checked the chart and Janet’s weight was incorrectly entered as being the same as the last two times. I told her the correct weight and that I know because I did it twice that day. Grrrr. The dietician also mentioned that Janet’s phosphorus count is climbing again. Not potassium as previously reported. The new formula will correct that as well. I asked how the phosphorus is measured and she said blood work once a week. I explained the high frequency of vampire visits lately and that the Hospitalist had put a stop to that. She promised to inform me what gets ordered for that. I actually stopped a vampire from entering Janet’s room today. I asked her if she was going in to see Janet and she said yes. We went to the nurses station to confirm and turns out the vampire had the wrong name and room number. I’m hoping that if I wasn’t there to stop her she would have realized her error when she checked the wrist band. Would be interesting to know.

Still working on the LTC situation and making some progress.

Jane the OT is going to work with Janet in the new wheelchair this afternoon and also with a large mirror. Should be fun. Praying Janet is awake and at her brightest.