In what may be her best move yet, Houdieno made it out of her bed this afternoon and was found by the nursing staff SITTING on the fall mat beside the bed! Not laying on the floor but SITTING all nice and calm as if nothing was out of the ordinary and maybe she was doing some yoga. The girls were just getting her back to bed when I walked in and as they told me about it Janet had a smile on her face so I gave her a high five and we all laughed. What else can you do.
I would guess Janet spent most of her lunch time perfecting her move so was a little tired once she was back in bed. I just hung out with her for a while and waited for Dr. McCann. While we were waiting the dietitian dropped by in response to our concern with the formula from a couple of weeks ago. Nice response time. I told her what had happened with the stool softener and that all seemed fine now. She was interested to hear of a possible swallowing X-ray and will chat with Connie about that. I told her it could happen next week so she better hurry up. Not really, but sheesh.
Dr. McCann arrived on time and asked if I would bring Janet down to EMG (Electromyography). I did and that is where he stabbed her multiple times with Botox. The EMG allows the doctor to hear muscle activity so he can more accurately apply a drug. Cool to watch. Janet received 400 units of Botox in her right shoulder and right upper arm. That was how much she got in the legs previously so the effect should be greater in these smaller muscles. The hope is to eliminate the pain and tone she is experiencing now and allow the therapists and myself to get some range of motion going with the right arm again. It should take a week or so to really kick in and we can continue to work her forearm and hand until we notice less tone there, then we can try the shoulder. Janet handled the procedure very well. Dr. McCann said the X-ray showed nothing major, just some calcification around the rotator cuff. There is some subluxation of her humerus which Dr. McCann presented as old news and the focus now is to get her range of motion back and to keep stretching lots. I asked him again about an eye exam and he said the problem is that to test accurately Janet would have to respond immediately when she saw something and she is not ready to do that yet. He explained his theory on her vision issues as; she likely has spaces in her view that are blacked out. definitely the right peripheral and most likely dead centre as well. Imagine your field of view with black to the right side and a black space in the middle. It could be permanent or it may not be. I asked about the deviation between the eyes and he had a fancy name for it which I can’t remember but same thing. Could improve, may not. I think it has improved since her eyes first opened so I’ll go with it will improve. I also asked about her incontinence and if there was a switch turned off somewhere causing it or is it just lack of awareness. He felt awareness was the bigger issue and thinks Janet can go onto a program where the nurses get her onto a commode or something at a certain time each day and try to encourage her to go. As her awareness increases we should be able to “train” her. Janet did for the first time tell me she was wet when I asked her yesterday so I will keep asking.
When we got back to Janet’s room, Janet F. had arrived for a visit. I gave them some space and when I returned Janet had drawn a nice picture of herself on the whiteboard. Janet seemed please to have her friend visit but I felt she needed some physical activity so we went for an inside walk. Janet drove down to the Royal Building elevators where I gave her the option of fourth floor or big hallway. She chose fourth floor and I’m glad she did. She drove right into the nurses station at 4B and surprised a whole bunch of them sitting there. They all loudly greeted Janet with big smiles. Janet was a little surprised and overwhelmed despite my warning her people would be excited to see her. They truly were and I think it did Janet some good.
She chose to have dinner in the dining area and I’m not sure why. I found it noisy which made it difficult to talk to her and she seemed uncomfortable the whole time but she insisted on staying until 6:15 when I said we had to go back to get changed before the nurses changed shifts. Once again I was able to get a pretty good stretch on her before leaving as she relaxed with her eyes mostly closed. I saw Cathryn as I was saying goodnight to the night crew and told them all about Houdieno. Cathryn is pleased with Janet’s drive and her increased awareness.
Praying for the Botox to be effective, for Janet to use her “loud voice” all the time and for an active day tomorrow.