Trick or Treat

For the first time in the two months since dad's stroke, he was able to see his grand kids in person..... Halloween, after school and before going trick or treating we brought the kids by for a visit... Dressed up as a Jedi knight and a princess, Logan and Kaileigh cautiously walked into the facility clutching Karlene's hand tightly... They were both excited and nervous to see "Pappa" since he got sick... We had talked on the way over about how Pappa was doing, that he could not get out of bed but that he can talk...  But seeing him lying in bed was not familiar and were not sure what to do.... Naturally after showing off their costumes and getting candy from dad they warmed up, in the end spending nearly a hour hanging out in and around the facility. Dad was really happy to see them, telling them how much he missed them and loved them....

Logan the shy, more timid of the two spent most of the time playing games on Pappa's iPad... Kaileigh the more curious and restless spirit spent time running around outside with me, but also interested in what was happening to Pappa when the nurse came in to take vitals... Kaileigh even expressed interest in being a nurse when she grew up, her dad asking if she wanted to work with babies like Aunt Nancy!!!

We did go trick or treating Halloween evening, after carving pumpkins and eating dinner.... Logan racking up a very impressive 214 pieces of candy!! Kaileigh even more (some of that being the handful she put in from their stash before leaving).... They did have as much fun giving away candy as they did collecting, taking the buckets of candy out to the walkway to the kids before they actually came to the front door!!!!!

Au Revior San Francisco.....

Well the time finally arrived, dad said good bye to San Francisco...... He in a medical transport van, with mom and I following behind in my car made the long 400 or so mile journey to his new place of residence in Laguna Woods...

Surprisingly the easiest and smoothest trip down half the state I think I've ever had!! The two EMT's that accompanied dad were "nice young men" who were not at all thrown by the length of the journey. In fact one had just done a similar drive just a few weeks back for another patient from San Francisco to Santa Ana... Dad took the experience in stride, chatting with the EMT's and listening to his book on tape to pass the time... We made several stops along the way to stretch legs (sorry dad) and fuel up, us with In-N-Out and the vehicles with gas.... Making the complete journey in about 8 and a half hours!!!! Shocking but true...

Dad is all settled into his new residence and resting relatively comfortably, mom is home with her chatty kitties, and I am taking the week off.... Spending time with the family and one last week with dad before I drive back up to San Francisco and a new chapter of dad's recovery begins...

Bend and stretch.....

Exercise has never been a favorite of dads, now he is wishing he could.. If nothing else than to just MOVE.... Laying in bed for days has literally been a pain in the a**..... Sitting in the wheelchair has not been much of a relief, after a hour or so the pain sets in and laying in the bed feels like the more appealing option. We have tried various forms of stretching, but nothing seems to get to the root of the problem.... Due to dad's limited ability to move much with his left side, he finds himself twisted up trying to shift his body in an attempt to find a comfortable position... We can help him shift himself back if we are there, but if he is alone he finds himself stuck in awkward positions...

Today one of his therapists taught him some stretching techniques he could do while sitting in the wheelchair to help him, hoping to alleviate some of the tight muscles in his back.... Bending over to touch his toes, stretching his back in the process.. Again helped in the short term, but doesn't last very long.... Unless done on a consistent basis, ah exercise!! 

He is also up to two sessions a day with the occupational therapist, partially because his stamina has significantly increased and partially because they are concerned with this left arm... The nerves and muscles are "coming alive" but he is still unable to move on his own and the muscles have become very stiff.... We are helping him by stretching his arm and hand daily, trying to soften and loosen the muscles... But the pain of the tight tendons and muscles in his hand limits how long we can work our magic.. To this end one of the occupational therapists has created a solid "glove" of sorts that he will wear for 15 minutes at a time several times a day, to straighten his fingers and stretch the tendons and muscles... The plan is after a few days she will have him leaning on the left hand while wearing said glove to further the stretch and hopefully alleviate the pain and stimulate the muscles.... Just another form of torture I am sure...... 

Restless

Endless days and nights running together.... Minutes and hours slowly ticking by with the occasional outing to break up the monotony... A recipe for a restless body...

Dads progress is slow and steady, every day moving just a little bit more.. But he is tired of laying in bed..... Every inch is sore from muscles not stretching and joints not moving enough.. This past week the physical therapy focused on standing and trusting his balance.. His tendency to push or rely on this right arm is still a hindrance to his recovery... He understands that he needs to trust in his core while sitting or his legs while standing, but that darn right arm just wants to be there in the middle of everything!!! The torture device of the week (or so he thinks it looks like as such) is a table they can strap him to that has a foot rest. The table can then be raised head up to a full upright standing position, this allowing dad to stand safely and feel his full weight on his legs... He may say the table looks like a Medieval torture device, but he did enjoy standing feeling safe and secure on his own two legs... 

Hopefully soon such standing will occur without the assistance of the table or multiple assistants, hopefully soon standing will be on his own two feet.... 

PICC and push....

Wonderful surprise awaited us today when we arrived at the hospital, after a discussion with dads doctor Friday night they removed dads PICC line!!!! A heartwarming sign that dad is medically stable, and one step closer to freedom... For him not only is it one less reminder of how ill he was, it's also one less annoying itchy thing to deal with....

Recovery has been a long but relatively consistent process, gaining strength and stability as each day passes.. But dad has been coined " a pusher", a real term in the physical therapy world... His right side is so strong and he is so unsure of his left that he pushes with his right.. More than just leaning or favoring his right, he literally pushes with both his right arm and leg. Unfortunately this is actually a hindrance to his recovery....pushing his body to the left and finding it difficult to find balance in the middle.....

Sitting and scooting he does well, but the all important transition from a seated position to standing is his biggest challenge at the moment.... This transition, essentially doing a squat is essential in order for dad to move from bed to chair...or chair to chair for that matter. Something he needs to be able to do sooner than later, for independence in the long run.. But he will get there, with more work and persistence....

Do it myself......

As a child this was my favorite statement... Mom especially heard her fair share of this from my lips.... The torch has been passed, to my niece who can be as stubborn as I and today my father....

He wasn't saying this as much as living the expression.... Today he was able with minimal assistance sit on the edge of the bed and do things we all do without much thought... Putting on a shirt, brushing his teeth, combing his hair..... Now he has done these acts before this, but he required more assistance or had to be sitting up in the bed or in a wheelchair... But today he was strong and balanced enough to accomplish these tasks nearly on his own.. Obviously a huge accomplishment, and one more step towards independence..

Therapists are thrilled with his progress and determination... Reminding him often of how far he has come, even though he has far to go....

The pleasure of food.....

Pureed, soft, squishy foods be gone.... Strange thickened beverages and creepy thickened water au revoir..... At long last, dad can have REAL food again!!!! Following a barium swallow test today the speech therapist signed off on dads upgraded diet plan.... Real coffee, real tea, whole pieces of protein and real side dishes..... At last I can bring dad my homemade food, healthy and nourishing made from the heart, although I did bring him homemade applesauce last weekend. But now I can do more....

As all of you know I love to cook!!! Really love to cook... I also am practically unable to cook in small amounts, leftovers are definitely par for the course at our house.... Even tonight a meal made of leftovers became a winter squash and kale soup, enough to feed a small army!! But hey more leftovers to share!! Speaking of which, I did share some homemade vittles a couple days ago to a fellow patient on the floor. Dad's next door neighbor, a gentleman I met a few weeks earlier while he was out walking the floor. A gentleman who I discovered has been a personal chef for years, and not surprisingly is not at all impressed by hospital food. After a lovely discussion I offered, if he was interested to bring in some food I had made for him to enjoy.. Yesterday was that day, and though I was not there while he ate.... He did leave a very lovely note for the "Spicer Family", thanking us for the "superb" food and how much our sharing meant to him. He has been in the hospital for 8 months now and a taste of home meant a lot to him...

Now that I can bring food for dad, I will be cooking up a storm for dad and others to enjoy....

Watch out Rockettes!!!!!

Dad is kicking and ready to go!!!! Well almost..... He did "show off" to his physical therapist this morning, lifting and bending his left leg! Showing off his newly re-acquired skills..

In this past week he has been able to sit up on his own for 15 minutes, after being helped up to a seated position by his therapists!!! This is a HUGE improvement from just a few weeks ago, when sitting up on his own was not an option.. In addition he is able to right himself if he is not sitting centered, something that up until this point he had to be told to do. Now something he is catching and correcting in his own... This week was less about standing then "pre standing", working on and retraining the muscles for the transition from sitting to standing.. Essential to the future independence dad is working to achieve!

He still views his improvements as "fair" but, we and the those who have seen him since his first few critical days in ICU think he is doing astounding!!

Heart Strings

Karlene came to visit last weekend, necessary for her to be with dad and see his amazing progression.  But also difficult, leaving her energetic babies for the weekend!! This was compounded by dad's daily question "Are the kids here?" when she and mom arrived at the hospital.. Understandably he was disappointed but said in the end it was probably for the best..

Dad missing his two amazing little grand kids, a welcome sign to the family.. motivation for him to work hard in PT!!!  Logan and Kaileigh are too missing their Pappa, especially Kai who kissed the phone when Karlene showed her a picture of him last week....  Many cards and video's have been sent, and soon Facetime will be utilized so they can talk to and see their much beloved Pappa... But for now they remain in OC, in the capable loving hands of their father so Karlene can be with hers..

Memory serves......

Memory and cognitive assessments are a regular part of dads weekly treatments... Various therapists and nurses come through testing his ability to recall information and problem solve... Some of this to point out and make dad aware of his limitations, need to know the problem before one can fix it.... Some is to remind him of what has happened, and what he can remember of the situation....

From the begining dad has done quite well on these tests, able to remember most of his adventure in bits...and able to recall basic words, terms, skills..... He has been able to tell us some personal information and some business facts.. But he has had some difficulty finding the correct words to use, even if he could describe what the word would define.... This has been improving with time, and we imagine will continue to be so... 

This week working with one of the speech therapists that has been with him since the begining, he was able to tell us the story of August 28th..... A day we will never forget... He can recall leaving for work, and feeling "off"..... Just two turns from his house in Visalia on his short commute to the office, he pulled over to the side of the road... Someone passing by on foot noticed him slumped over and called 911.... Thank you kind stranger you quite possibly saved his life!! He says he can't quite recall the various ambulance rides and the helicopter lift to San Francisco, but there have been times he mentioned he thought he was in a motor home before coming to the hospital. Perhaps this is his recollection of the ambulance... 

Listening to his story his therapist was extremely impressed with his memory and ability to tell his story.... She explained how unusual this is, for many patients that suffer severe head trauma such as a stroke not only lose the memory of the "attack" but also the weeks leading up to the event... Amazing.....

How I spent my summer vacation

Dad used this term today while on a walk/ride with Karlene and I..... The wind suddenly picked up and lifted the sheet we had on him covering his legs from the intense SF sun. He said it was like a kite, and his sudden exclamation of "how I spent my summer vacation" sent both of us into giggles!!!!

Yeah dad one heck of a way to spend a summer vacation!!!!

E Ticket ride

Growing up we heard the term "e ticket ride" often.... Once upon a time Disneyland had booklets of tickets one used, it's wasn't until Magic Mountain opened that Disney went to a all inclusive admission fee.... The tickets started as A-C, A being the smallest and least popular.... Over the years D and E tickets were introduced, as new and exciting rides were added, the E ticket remained the highest attraction/ coupon designation for 20 years!!  The tickets are gone, but the association is not forgotten....

Particularly exciting experiences or situations over the years have been celebrated by being deemed an"E-Ticket ride"... My learning how to drive so many years ago was one of these exciting experiences I do believe..

The newest experience to gain this title, is the always thrilling sometimes heart skipping ride dad takes via the EZ Lift to get him in and out of the bed.... Shifting him can be done with the aid of  couple physical therapists or the lift team, but often it is the nurses left to this task. The EZ lift makes this process much safer for both aids and patients alike, but watching the process is quite the experience. A heavy canvas sling is slipped under dads body, each of the four corners is fitted with several heavy duty loops.. Black is he shortest, green the middle and deep red the longest.. Depending oh how they intend the patient to be situated at the end of the move, the appropriate loop is chosen to hook onto the lift. in shifting dad from the bed to the wheelchair they use the black loops on the top of the sling and the red loops on the bottom..

Once secured the lift does the "heavy lifting", easily shifting dad from the bed to the wheelchair with minor adjustments needed form the aids for proper placement... This is quite the sight to see, dad gliding through the air with the greatest of ease.... Dad's "E-Ticket ride", per his words......

Baby steps......

In physical therapy it's... Sit before you can stand, before you can walk.... In eating its thickened liquids, before soft dice, before solids and "real foods"..... Everything happens in baby steps. For infants and toddlers these are measured in weeks or months, for dad the process had been a bit more quickly....

In just over a week he has progressed from sitting up with significant assistance, to sitting up with minimal assistance... From not risking his frame to allow him to stand, to with assistance having him stand. Initially he defaulted to a "flamingo stance" coined by mom, standing with his left leg bent in a pose that was reminiscent of how a flamingo stands. To standing today and leaning against a wall for added support. But with both feet on the ground, accessing his own sense of balance, and feeling his own weight.

His dietary improvements have been equally as swift... From just over a week ago he has progressed from a continuous feeding regime, to an occasional trial of soft puréed foods. Now he has enjoyed several days of  stage 1 of "real foods" to a possibility of graduating to "stage 2" of soft diced foods in the next few days.... Quickly moving through the necessary stages to fully graduate!!!!

Dads nurses and therapists are very impressed, and although he may be frustrated that it's not fast enough... He is doing great, and will only continue to get better!!! Baby steps...

Steady as he goes...

The last few days have been remarkable, when asked this afternoon how he felt he was doing by the occupational therapist he said "fair" her response was "AWESOME".... Dads progress has been a steady trudge uphill, battling his way back to normal...

Since having the feeding tube changed just over a week ago, the improvement in his speach and swallow has been nothing short of amaxing, he is now allowed to have soft pureed foods (with supervision) for all meals.. This may be supplemented by the occasional tube feeding, if the nutritionist deems his caloric intake not sufficient enough for proper healing.... So far eggs and french toast have been the breakfast selections, he preferred the pureed french toast to the powdered eggs... and savory choices have been interesting to say the least... Chicken and broccoli souffle with mashed potatoes, pureed Salisbury steak with cauliflower, and pudding like sides... He says they taste alright, but not like my cooking (ok so I asked him, can you blame me), giving him a goal to work towards...

Strides made in physichal therapy have been equally as remarkable, sitting more centered with less assistance... Standing but briefly to feel his weight and work on his balance, a welcomed relief to all the hours lying in bed... Bending and stretching working with the therapists on reaching and moving (today using oval rings that reminded him of his grandkids toys)...Regular excursions out of doors for some fresh air, sunshine, and change of scenery...

What I find most encouraging is his awarness to the world around him, an occasional slip up here and there... But generally he is aware of what is happening around him, he is participating in conversations (even when we were trying to talk around him) and asking questions about the people in his life.... Even had the chance tonight to make decisions on his meals for tomorrow, a very positive sign indeed.....

One at a time.......

So Saturday turned out to be quite an adventure...... Arrived at the hospital in time to help the physical therapists dress dad, and shift him into his wheelchair.... He did quite well, listening to what the therapist was asking of him and following directions.. We were able to take a walk (roll) outside and enjoy the beautiful Indian Summer in San Francisco.. Warm sun and an refreshing cool breeze, perfect for a late morning stroll..... Spent a good half an hour out on the deck overlooking a neighborhood park, watching kids learn how to skateboard and doggies chasing one another in circles..but the wind was quite cool and dad decided he wanted to go back into the room...

After settling back into the room, I wandered off to get lunch for mom, Greg and myself from a local corner market.. Greg joined us for lunch, but then decided to have an adventure of his own... Needless to say it was convenient that the ER was just downstairs, l floor ride on the elevator.... After checking vitals, and administering multiple medications the decision was made to admit Greg. Naturally admitting him into the same hospital would have been too easy, so Greg once again took a ride to PAC the sister hospital to Davies.... I ran back upstairs to dads room to gather my belongings, to discover dad had caught wind of what was happening and was concerned for Greg.. He had heard my voice when I was speaking to the nurses asking for a wheelchair for Greg, and wanted to know how he was doing..... A wonderful sign of dads awareness for his surroundings, and of those around him..

Well, Greg is still at PAC, his cardiologist  is not sure what is going on exactly.. Does appear he had a minor heart attack, do not yet know why..... Hopefully we will find out more tomorrow, after more tests and an exploratory surgery.... Thank goodness for friends (family) in SF taking care of us !!!! Can't handle more than one at a time!!!!!!!!!

Do no harm........

I've been struggling to get through to dad that the therapists are not going to let him down.... They are not going to let him fall, to trust in them..... What I didn't know was that in his mind it was less the fear of falling, then of trusting that he would not hurt those trying to help him... Something I had not contemplated... He is truly worried that he is accidentally going to cause an injury to one of the therapists.. This is the reason he has been resisting, and struggling with the physical therapists (doesn't explain his I'm annoyed attitude with the occupational therapist) but that is a different story..... 

So we had a long conversation on the topic..... We discussed the therapists roll and that they are trained in how to work with all varieties of patients.. That they work in tandem for a reason, that they have tools such as belts to help them move and shift patients with limited mobility...  That his resisting and pushing back with his strong right side could actually cause more harm, to both he and the therapists potentially.. He is not pushing the therapists directly rather he is using the strength in his right arm to hold himself up, pushing his body over to what his brain believes is midline.....Rather than letting the therapists move him to his true center, letting his core strength do the hard work... 

He understood but is still apprehensive and resistant to letting go.... But not because he is afraid of getting hurt himself, but rather afraid of hurting others...... 

Brunch date.......

I arrived at the hospital this morning after running some errands and such.. To an amazing sight...Dad eating eggs and thickened coffee!!!!!! His first attempt at eating more solid foods!!! His speech therapist thought that his drive to have coffee, would motivate him to work harder... She was correct, almost.. He does want coffee, but the syrupy thick barely tastes like coffee did not exactly spark his interest... What did get him motivated was the chance to impress Mom and Karlene (and the rest of us with his eating skills).. To this I asked him to let me film him with my phone, he agreed and took several spoonfulls of eggs followed up by spoonfulls of coffee.... Maybe a bit to eager to impress, went a bit faster then he should have and had to work on fully finishing the process.. But he was pleased by his accomplishment and even flashed us a big smile in the end.....

Ironically he was not as interested in the coffee as the therapist thought he would be, (I suspect it was the quality, but then I am a coffee snob)... But the truth of the matter is he really is not that hungry... I know hard to imagine that someone that has not eaten solid foods in over three weeks is NOT hungry,  but truly he is not driven to eat..... In speaking with the therapist after the fact we came to the conclusion that the continuous drip feeding keeping his body fed, is hindering his need to eat the foods they are bringing him.... And ultimately a hindrance to improving his swallow and ability to graduate to the next level.... A talk with the dietitian will hopefully improve this, by changing his continuous drip to a bolus feeding.... Delivering to him the necessary calories and nutrition in several individual sessions as opposed to his current routine..

The hope is this change will then make him actually feel hungry in the mornings, when the speech therapists comes to work with him.. And ultimately drive him to work harder and improve his ability to swallow completely faster..... Looking forward to my next brunch date...

The art of letting go.....

Letting go....... Easy to say hard to accomplish if you are used to being in charge. Letting go.. Trusting in others to take care of you when taking care of yourself is a daunting task... Letting go... Sharing your emotions when you typically keep them to yourself... Letting go, and becoming yourself again.....

For someone that had has been in a position of control, independent, and kept their emotions in check..... Letting go is a challenge. It has been an interesting roller coaster watching dad learn struggle with the art of letting go... In physical therapy he has struggled letting himself trust in those around him to keep him up and straight... He wants to trust, but his mind/body is unsure of believing in others.... Sometimes an extra bit of encouragement from mom or me can help him move past this and let others in... Today I found myself stepping in when the physical therapist could not get through to him... He was fighting using his incredible muscle strength to hold himself up while the therapist was trying to have him let go and relax his body... The goal was to allow his body to bend (while sitting) to stretch his back, all the lying around has made his body stiff..... But he was resisting, afraid to bend and trust he would not fall forward..... But after a bit of a pep talk from me, that we were there and to trust us...that we would not let him down.... He let go and allowed himself to relax and bend.. The result was phenomenal, he relaxed his body and was able to bend..stretching a stiff back and learning to trust in others.... He and the therapist both were relieved and pleased....

Learning the art of letting go....

Every little move you make.....

Nothing is more hopeful than arriving at the hospital and walking in on a therapy session where the therapist is beaming as much as the patient.... That is what I walked into this afternoon!!!!! I have gone back to work, so I am only here a few hours a day... So imaging my surprise walking in to Dad's room to hear one of the therapists look up and say " I am so glad you are here"!!!! I expected her to then ask for me to assist with a task (this one likes for the family to be very involved with the process)..... But no she wanted me to see something that even took  her by surprise..... Dad without assistance moved not only his left leg BUT his left arm!!!!!!! She was stunned at his recent progress and astonished at his muscle tone!!!

This revelation brought tears to our eyes, dad himself crying happy tears that he could willingly move his limbs.... The therapy continued as the therapist asked him to move his arm up and down, now this took guidance and support. But he did multiple sets, one step closer to moving into the penthouse suite that is a room in Acute Therapy (where the real work begins) These are small subtle movements, but gives hope to a more independent life...

The downside to the story is this happened just after Mom left to go home for a few days... To visit with the grand kids who are missing her terribly, and take care of her own health (yes she is fine, but this has put all of us into a state of heightened awareness)..... And after a weekend with Karlene here to visit..... My theory is Dad is bound and determined to get moving, and after a short session standing today with the help of a frame... His mind and body are ready to start making the connections to fulfill that goal!!!! 

One last smile......

Short little sidebar.........

A while ago I mentioned another patient who challenged himself and succeeded, rescuing my keys from the floor where I dropped them... Since this encounter we have occasionally chatted when we were able and I checked on how much he had eaten of his meals, our little inside joke.. A couple days ago mom heard he was heading home soon... Today when I arrived at the hospital I was lucky enough to get a chance to say goodbye and tell his wife the story of the key rescue....  Tears came to her eyes as I recounted his determination to reach down and them up.... That his gentleman spirit is still alive and well, even if he has trouble saying the words...... She thanked me for sharing this with her, and said she wished we could have met sooner..... She was touched that I took the time to talk with her, and we wished each other the best of luck.....