What can I say? Judi has exceeded all of the therapists' expectations this week. I, of course was not surprised and did resist the urge to yell out "I told you so!" She has worked so hard that it is truly inspiring to see.
She is eating again and has progressed to the point where she can start eating enough to be part of her overall nutrition instead of just therapy. Hopefully she will tolerate this well and we can drive towards removing the feeding tube and a normal diet.
Her trach is capped and we plan to leave it that way through the weekend. As long as she has no issues, we will remove it on Monday. We have been a little surprised that she hasn't started talking yet, but she is VERY close and it may take the trach removal to push her over the edge. She makes a lot of sounds and routinely mouths words. She also had a laugh during one of her therapies that was wonderful to hear. Just a good reminder that she is in there and we just need to help her come back to us.
She is doing well in Physical Therapy (PT) and getting stronger every day. She is standing up in the "standing machine" for about 30 mins at a time. This helps her in many ways. We continue to work on strengthening her abdominal muscles to provide support for her when she sits without something behind her. Once she can sit unsupported it makes moving her to/from a wheel chair much easier (and comfortable). Her neck muscles are also a focus area. The neck brace always creates an issue with weakening muscles from lack of use and Judi had to wear one for a long time. We need her to get that strength so she can safely ride in a car or something similar that does not have a specific support. All of you know that Judi loves to be "on the go" so both of these areas are important to her physically as well as from a quality of life perspective. Just to make sure everyone understands, the wheelchair is an interim step while Judi recovers her muscle strength and coordination. I fully expect her to be walking and throwing a bowling ball in the future.
Occupational Therapy (OT) continues to be the biggest challenge for her. This deals a lot with doing tasks that we take for granted in our everyday lives like brushing your teeth, feeding yourself, etc. These present the most difficulty at this point due to the fact it requires a lot of eye hand coordination, fine motor skills, etc. that just take time to get back. Judi is chipping away at these, but the going is slow due to the combined effects of the brain injury and muscle recovery. I have no doubt that she will continue to pick up momentum here as well.
Judi is following commands better and I have her counting with her fingers as well. She is still working on yes/no type responses which continue to be impacted by her limited ability to process information at multiple level of the brain. I continue to believe she just needs time here since she has steadily improved.
I am getting everything ready for her to come home soon. We are still not sure how long she will stay in rehab this time. That will be determined by what is right for her from the big picture. We have no desire to force her through therapy that doesn't truly provide value for her at this time. At some point we need to let her mental state recover sufficiently so that she can understand what she is being asked to do and not be presented with a bunch of tasks that only serve to frustrate her. A familiar environment, some quality social time and my cooking are sure to bring her up to speed in a hurry. Many of you have offered to help with some tasks along the way and I may need a little help once I get her home initially. With Jessica working full time at school, it will only be me for a while and I will have to stay with her at all times.
Thanx again for the prayers (they are working) and all the other support as well,
Steve
Thursday, August 27, 2009
Monday, August 24, 2009
Busy Days
Judi continues to work her butt off to get stronger and recover.
She went about eight hours with her trach capped and had no issues keeping her O2 levels up. By the end of that period though, she was tired from the combination of breathing normally and rehab activities. We'll keep letting her grow stronger until she goes about 48 hours with no issues and then remove the trach. Should be on track for late this week or early next week.
She goes for a swallow study tomorrow which evaluates how well she manages to swallow different consistencies of food. After the study, we'll know what types of foods she can handle and let her start eating regularly. At first, it will be small amounts primarily for therapy and then build up to the point where she gets her nutrition from what she eats. Once she is eating and drinking well enough, we can remove the feeding tube from her stomach. That will be another big day for us. I was joking with a nurse the other day that Judi would pitch a fit if she knew that you were giving her 500 calories in an 8 oz can of anything. Those of you in her Weight Watchers group know how far she (you) can make 500 calories go. I was always impressed with her discipline in this area. That same discipline is already paying dividends for her today.
Physical therapy continues to go well and she is obviously getting stronger. She stood up today with the aid of a machine that slowly lifts her and shifts the weight to her legs/feet. She was pretty excited and VERY tired after that. This is intended to provide feedback from the nerves in her legs/feet/joints to the brain to stimulate the process associated with controlling them. Although this sounds like a simple evolution, it took five people (me included) to get her in position and then support her. This is why I wanted to get her in a REAL rehab facility so bad. It takes a lot of people that know what they are doing to provide this type of therapy.
I continue to be humbled and eternally grateful for all of the support we have received from so many. The prayers and well wishes keep us strong spiritually. Many of my co-workers at SRS have even donated their precious vacation time to me so that I could stay by Judi's side and not worry about how I would pay the bills. We have received "care packages" from numerous folks and organizations. The list goes on and on and I could never list all of the things people have done for us.
Thanx for the continued support,
Steve, Judi and Jess
She went about eight hours with her trach capped and had no issues keeping her O2 levels up. By the end of that period though, she was tired from the combination of breathing normally and rehab activities. We'll keep letting her grow stronger until she goes about 48 hours with no issues and then remove the trach. Should be on track for late this week or early next week.
She goes for a swallow study tomorrow which evaluates how well she manages to swallow different consistencies of food. After the study, we'll know what types of foods she can handle and let her start eating regularly. At first, it will be small amounts primarily for therapy and then build up to the point where she gets her nutrition from what she eats. Once she is eating and drinking well enough, we can remove the feeding tube from her stomach. That will be another big day for us. I was joking with a nurse the other day that Judi would pitch a fit if she knew that you were giving her 500 calories in an 8 oz can of anything. Those of you in her Weight Watchers group know how far she (you) can make 500 calories go. I was always impressed with her discipline in this area. That same discipline is already paying dividends for her today.
Physical therapy continues to go well and she is obviously getting stronger. She stood up today with the aid of a machine that slowly lifts her and shifts the weight to her legs/feet. She was pretty excited and VERY tired after that. This is intended to provide feedback from the nerves in her legs/feet/joints to the brain to stimulate the process associated with controlling them. Although this sounds like a simple evolution, it took five people (me included) to get her in position and then support her. This is why I wanted to get her in a REAL rehab facility so bad. It takes a lot of people that know what they are doing to provide this type of therapy.
I continue to be humbled and eternally grateful for all of the support we have received from so many. The prayers and well wishes keep us strong spiritually. Many of my co-workers at SRS have even donated their precious vacation time to me so that I could stay by Judi's side and not worry about how I would pay the bills. We have received "care packages" from numerous folks and organizations. The list goes on and on and I could never list all of the things people have done for us.
Thanx for the continued support,
Steve, Judi and Jess
Friday, August 21, 2009
Back in Rehab
Well, we moved back to Walton Rehab late Thursday and got Judi all settled in. Today was a big day since it was the first time she was able to participate without all of the "gadgets" we had to contend with the last time. Gone is the hated back brace. Gone is the hated neck brace. Gone is the hated helmet as well. Judi is a totally different patient this time and she seems to be picking up where she left off as opposed to starting all over.
I believe she will be talking very soon. She is working on making sounds and she mouths words at times. Her vocal chords are weak from lack of use (never thought that would be an issue for my girl) and she needs to regain strength in her diaphragm. She is also trying to figure out how to manage all the aspects of actually speaking (air flow, tongue, lips, etc.). We were able to give her some applesauce and "honey thick" cranberry juice today and she thoroughly enjoyed that. As you may recall, she had just been able to start eating a little the day before we had to go back to MCG. I can only imagine how good it tasted to have something that wasn't antiseptic tasting in her mouth for a change. At this point, it is more for speech therapy than for nutritional purposes, but it won't take too long before she can begin eating regularly again.
She spent a couple of hours in the wheel chair today and was very comfortable. This is where the lack of gadgets really paid off. She never got hot and her heart rate stayed steady throughout. We are building slowly here since we still need to develop her muscle strength to support her in the sitting position, allow her to get acclimated to the difference in her back from the surgery and allow her neck muscles to strengthen from having the neck brace on for so long. She is doing awesome as anticipated.
We have already begun trials with "capping" her trach for short periods of time and she tolerated that very well. I suspect that we will finally have the trach out next week sometime. Again, you may recall we were going to remove her trach the morning we had to go back to MCG. I will be VERY happy to see this source of infection eliminated and it greatly simplifies many of her rehab activities as well.
Judi also has a new doctor that recently joined Walton Rehab (Andrew Dennison) who is a brain injury specialist. In just a few conversations with him it is obvious he has his act together and is already evaluating some different treatment options for Judi's mental recovery.
I continue to have faith that we will be able to get Judi back to her old self, but I also realize that it is going to take some time for that process to occur. The next week or so will determine if we continue down the high intensity rehab path or bring Judi home for a while to allow her to get stronger (mentally and physically). There are merits to both and we'll make the decision that is best for Judi. She can have visitors here, but the hours are limited and must be integrated into her rehab schedule. Give us a few days to get in the groove and see how tired she is at the end of the day. After that, we'll see what we can fit in. Thanx for being patient.
Hopefully this gives everyone a good feel for where we are. Keep praying for us and you never know when you might get a phone call from Judi.
Steve
I believe she will be talking very soon. She is working on making sounds and she mouths words at times. Her vocal chords are weak from lack of use (never thought that would be an issue for my girl) and she needs to regain strength in her diaphragm. She is also trying to figure out how to manage all the aspects of actually speaking (air flow, tongue, lips, etc.). We were able to give her some applesauce and "honey thick" cranberry juice today and she thoroughly enjoyed that. As you may recall, she had just been able to start eating a little the day before we had to go back to MCG. I can only imagine how good it tasted to have something that wasn't antiseptic tasting in her mouth for a change. At this point, it is more for speech therapy than for nutritional purposes, but it won't take too long before she can begin eating regularly again.
She spent a couple of hours in the wheel chair today and was very comfortable. This is where the lack of gadgets really paid off. She never got hot and her heart rate stayed steady throughout. We are building slowly here since we still need to develop her muscle strength to support her in the sitting position, allow her to get acclimated to the difference in her back from the surgery and allow her neck muscles to strengthen from having the neck brace on for so long. She is doing awesome as anticipated.
We have already begun trials with "capping" her trach for short periods of time and she tolerated that very well. I suspect that we will finally have the trach out next week sometime. Again, you may recall we were going to remove her trach the morning we had to go back to MCG. I will be VERY happy to see this source of infection eliminated and it greatly simplifies many of her rehab activities as well.
Judi also has a new doctor that recently joined Walton Rehab (Andrew Dennison) who is a brain injury specialist. In just a few conversations with him it is obvious he has his act together and is already evaluating some different treatment options for Judi's mental recovery.
I continue to have faith that we will be able to get Judi back to her old self, but I also realize that it is going to take some time for that process to occur. The next week or so will determine if we continue down the high intensity rehab path or bring Judi home for a while to allow her to get stronger (mentally and physically). There are merits to both and we'll make the decision that is best for Judi. She can have visitors here, but the hours are limited and must be integrated into her rehab schedule. Give us a few days to get in the groove and see how tired she is at the end of the day. After that, we'll see what we can fit in. Thanx for being patient.
Hopefully this gives everyone a good feel for where we are. Keep praying for us and you never know when you might get a phone call from Judi.
Steve
Tuesday, August 18, 2009
Out of ICU
A quick update.
Judi was discharged from the ICU today and transferred to the Neuro floor unit. Everything is looking good from the surgery so far. Her awareness level has increased significantly and she is moving around much more than she has in the past. We hope to be moving to rehab soon and see how she does. I'll do a better update once we have a clearer picture.
Steve
Judi was discharged from the ICU today and transferred to the Neuro floor unit. Everything is looking good from the surgery so far. Her awareness level has increased significantly and she is moving around much more than she has in the past. We hope to be moving to rehab soon and see how she does. I'll do a better update once we have a clearer picture.
Steve
Friday, August 14, 2009
Last Surgery in the Books
Judi had her surgery today to replace the bone flap removed back in April. Her surgeon said all went well and there were no surprises. Using his words: "It was a boring surgery." She was placed on the ventilator long enough to perform the surgery and then immediately taken off after she was stable. She never missed a beat and has been breathing on her own every since. Over the next few days we will be monitoring the fluid restoration to the new cavity and the brain position as it is allowed to return to its natural position. The possibility exists that we may have to close off the shunt for a period of time to allow the fluid to buildup in her head, but that does not involve another head surgery if it becomes necessary.
Hopefully this is the last surgery Judi will have to go through. I have been reminded countless times throughout this journey what a truly special lady I am married to. She has been through more than we could ever describe in words here and has consistently shown she is made of the "right stuff." Unfortunately, she has a lot of work in front of her to complete her recovery. We'll have a better idea of what's next over the next few days and weeks as she recovers from the last couple of surgeries. The initial focus will be to get her off the trach completely and back to eating/drinking normally. During this process, we will be able to see if she is ready for acute rehab (traditionally defined as three hours per day) or if she just needs to come home and rest for a while.
Once we have her out of ICU here and on the way to recovery, I know she would love to visit with the members of "Team Judi." We'll have to make sure we don't overload her so I'll come up with some way to make sure we have the appropriate controls for visiting in place. Please keep us in your prayers as we head down the next leg of the recovery path and thanx again for the tremendous support you have already given us.
Steve
Hopefully this is the last surgery Judi will have to go through. I have been reminded countless times throughout this journey what a truly special lady I am married to. She has been through more than we could ever describe in words here and has consistently shown she is made of the "right stuff." Unfortunately, she has a lot of work in front of her to complete her recovery. We'll have a better idea of what's next over the next few days and weeks as she recovers from the last couple of surgeries. The initial focus will be to get her off the trach completely and back to eating/drinking normally. During this process, we will be able to see if she is ready for acute rehab (traditionally defined as three hours per day) or if she just needs to come home and rest for a while.
Once we have her out of ICU here and on the way to recovery, I know she would love to visit with the members of "Team Judi." We'll have to make sure we don't overload her so I'll come up with some way to make sure we have the appropriate controls for visiting in place. Please keep us in your prayers as we head down the next leg of the recovery path and thanx again for the tremendous support you have already given us.
Steve
Wednesday, August 12, 2009
Not Yet
Just a quick update since I know many are anxiously awaiting news. Judi is still waiting for surgery. We had two false starts, but we knew this was a possibility and we'll just have to remain patient a bit longer. I'll update again as soon as there is any new news.
Thursday, August 6, 2009
Looking Up!
Jessica is wide open getting ready to embark on her new career as a school teacher (teaching eighth grade math at Grovetown Middle School) so I am going to do my best to keep the blog updated for a while. This post will be a little longer than usual as I try and bring you up to date with all that has happened this week.
Judi is off the ventilator! The standard protocols were just not working for her and it did not appear that she was having any real trouble breathing on her own. We finally just took her off the ventilator (under intense observation) and she never missed a beat. I will admit that it took a couple of days before I could relax and not count every breath she took.
We were also able to get her cleared from the neck brace after all. Kudos to the MCG team for that! They kept evaluating her condition and determined it was safe and beneficial for her to start regaining strength in her neck muscles. She is still exploring that new freedom and we are watching her closely to ensure she doesn't over do it.
Judi's movement of her hands and feet continue to improve as well. She is strongest on her right side which is expected since the majority of her brain injury manifested itself on the right side. Most of you know that the right side of the body is controlled by the left side of the brain and vice versa. This was the reason we were so concerned that the shunt had to be installed in the left side of her brain since there had not been any visible damage there.
We have made the decision to put the bone flap back in that was removed during her craniotomy back in April. We believe this will allow her brain to move back to its "natural" orientation and provide the best environment for it to continue to heal. It will also be much safer for Judi as she continues the recovery process. This will be a long surgery for Judi and we anticipate that there will be some issues restoring the fluid balance in her head following the replacement. This could require additional surgery and/or manipulation of the shunt that was installed, but we'll deal with that as necessary. I also anticipate that this will be one of those emotional roller coasters from a scheduling perspective in the Operating Room. Since it will be a long surgery, it will be difficult to get and maintain an open window due to all of the critical cases that come to MCG. We will also have to put Judi back on the ventilator for the surgery. I am confident though that she will continue to be the fighter she has been from the start and continue to step up when she needs to.
There has been a lot of good news this week, but we have a long way to go. Judi is still in the ICU and needs all of your prayers. I don't have the words to describe how critical they have been to our family. I can say that there have been several days that I only made it by drawing on the strength of those prayers and it is obvious that God is watching over Judi as she recovers.
Thanx for the continued support,
Steve
Judi is off the ventilator! The standard protocols were just not working for her and it did not appear that she was having any real trouble breathing on her own. We finally just took her off the ventilator (under intense observation) and she never missed a beat. I will admit that it took a couple of days before I could relax and not count every breath she took.
We were also able to get her cleared from the neck brace after all. Kudos to the MCG team for that! They kept evaluating her condition and determined it was safe and beneficial for her to start regaining strength in her neck muscles. She is still exploring that new freedom and we are watching her closely to ensure she doesn't over do it.
Judi's movement of her hands and feet continue to improve as well. She is strongest on her right side which is expected since the majority of her brain injury manifested itself on the right side. Most of you know that the right side of the body is controlled by the left side of the brain and vice versa. This was the reason we were so concerned that the shunt had to be installed in the left side of her brain since there had not been any visible damage there.
We have made the decision to put the bone flap back in that was removed during her craniotomy back in April. We believe this will allow her brain to move back to its "natural" orientation and provide the best environment for it to continue to heal. It will also be much safer for Judi as she continues the recovery process. This will be a long surgery for Judi and we anticipate that there will be some issues restoring the fluid balance in her head following the replacement. This could require additional surgery and/or manipulation of the shunt that was installed, but we'll deal with that as necessary. I also anticipate that this will be one of those emotional roller coasters from a scheduling perspective in the Operating Room. Since it will be a long surgery, it will be difficult to get and maintain an open window due to all of the critical cases that come to MCG. We will also have to put Judi back on the ventilator for the surgery. I am confident though that she will continue to be the fighter she has been from the start and continue to step up when she needs to.
There has been a lot of good news this week, but we have a long way to go. Judi is still in the ICU and needs all of your prayers. I don't have the words to describe how critical they have been to our family. I can say that there have been several days that I only made it by drawing on the strength of those prayers and it is obvious that God is watching over Judi as she recovers.
Thanx for the continued support,
Steve
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