When I returned this afternoon Janet was close to finishing her lunch feed and the nurses were hovering wanting to get her ready to go to her swallow X-ray. With me there she was allowed to relax and finish lunch and I transferred her to the stretcher once the Porter arrived. I wasn’t allowed to stay in the room during the X-ray but I got Janet into the “electric” chair and sat just outside the door so I could hear what was happening. Connie was her usual enthusiastic self and later reported that Janet did well. There were no issues with aspiration or choking. Her swallowing rate varied from 3.5 to 22.3 seconds which Connie seemed pleased with, and not surprised by, considering the amount and variety of “food” she had to eat. Janet did use some secondary swallows to completely clear her mouth and there was a little residue in her throat which apparently indicates things aren’t working quite as fast as they should be. With all that said, Janet is now allowed to eat some real food such as yogurt, pudding, pureed fruit, or anything else that is pureed. She can even drink some water from a spoon. Connie noted that Janet swallowed better when she took all the “food” from a spoon instead of just a portion of it. Connie will meet Janet at breakfast time tomorrow morning in the dining area and help her eat some breakfast. For now the tube feeds will continue but once Janet is settled into the real food, the tube feed quantity will be reduced accordingly. Connie will now work harder with Janet on chewing and tongue movement to improve her ability to eat. This is a big step.
Janet surprised me afterwards by electing to go into the wheelchair rather than back to bed. She didn’t know what she wanted to do so I got her dressed up warm and we went out for some fresh air. As we were sitting at the beach a few unforcasted rain drops started falling so we headed inside and walked around the all too familiar hallways for a while. We chatted with Moira who told me Janet did well in the Arjo machine this morning but didn’t go pee. I didn’t think she would but the standing up to get to the bathroom is good for her.
Jessica had arranged to meet us back in Janet’s room to discuss a fancy splint she has put on Janet’s right arm. The concern is the positioning of her wrist and this splint does hold it in a nice neutral position and since it’s soft Janet seems to tolerate it well. Jessica recommends leaving it on most of the time except for when in PT or OT. She also tried out a couple of weird contraptions that would keep the fingers on Janet’s right hand open and spread apart but neither model fit Janet very well at all so we are sticking with the rolled up face cloth for now. We also discussed Janet’s positioning in bed and what might be done to keep her legs straighter. Jessica was glad that she could see Janet with the bed at various heights and angles and can now better pursue a solution.
As Janet and I were chatting afterwards we noticed the sun had come out and we thought we’d run out and catch some of it before Brenda’s scheduled visit. Brenda met us at the door and joined us for the three or four minutes the clouds let us have. Felt good. I asked Brenda to do some vocal exercises with Janet as she had been rather quiet today. Brenda later said Janet had done well and even sang along with her. I walked in at one point to a duet of the Happy Birthday Song. Nice. Janet seemed to really enjoy the visit and surprised me by staying awake the whole time as once again she did not nap today. She gave Brenda a nice smile as she left then motioned for me to lay on the bed with her. She shut her eyes almost immediately but not to sleep just to rest. She definitely was winding down though and as her dinner finished I cut the finger nails on her right hand so they don’t dig into her palm when she is clenching, gave her right arm a stretch and got a really good stretch on her legs. I said goodnight after a very busy and successful day for Janet.
Praying for a restful night and a great day of eating tomorrow.