Friday, September 16, 2011

Fran, September 16

I have missed a lot of days of blogging.  Fran's fall was a serious setback.  She spent a couple of days in the hospital and then was moved to the Rehabilitation Center as an inpatient.  It proved difficult to manage her pain, and she is still in constant pain.  In spite of the fractured pelvic bone, there are no restrictions on weight bearing.  Except for one, the pain. She can stand and move a couple of steps, but it is very difficult.

She was discharged from Rehab on Monday the 12th, and has been home all week.  She has lost a lot of independence, and her care is more challenging. She is improving gradually and the pain, though still severe, is considerably better.  Her courage and determination are still there and she will recover.

Our caregivers, Isela, Katerina, and Cindy have been wonderful, as has been the support of Fran's friends, especially Alice and Jerry Rost and Barbara and David Binns.  Marshall and Ana and Maliq and Rachel have been there for Fran as well.

I am pretty busy. I am doing an hour webinar on Tuesday, entitled Measuring Performance, Damned if You Do and Damned if You Don't, with a paid (not much) audience of about 75 around the world.  I am also taking a class in web design at Mira Costa College, and I am finding it to be a real challenge.



Wednesday, August 31, 2011

Fran, August 31

A bigger setback than we thought.  Daughter-in-law Rachel, an experienced nurse, noted that Fran had excessive pain in the left hip.  She suspected a hip fracture and we took Fran to the Scripps Encinitas emergency room again.  Rachel was correct.  Fran has hairline fractures of the pelvic bone.  This does not require surgery, but she cannot put weight on it until it is healed.  She is hospitalized there in room 271. We are really not capable of caring for her at home at this time. By the way, they also discovered hairline rib fractures, which were missed on Monday. Her spirits are good, expecially after she got enough medication to knock down the severe pain.



Tuesday, August 30, 2011

Fran, August 30

A temporary setback.  Fran fell yesterday, while getting up without calling for a spotter.  She hurt herself very badly, apparently landing on the buckle of her gate belt. Four and one half hours in the emergency room demonstrated no serious injury but she is in terrible pain and essentially can't move. Even breathing hurts. We expect rapid improvement, but at the present, she is very unhappy Of course, the quality that is driving her recovery, pushing the limits, sometimes puts her in jeopardy.


Monday, August 22, 2011

Fran, August 22

Sorry for the inactivity.  Anita Arkin finally goaded me into action.

Fran continues to improve, amazing the therapists who dealt with her in the early days.  I see two significant developments in the past month:

1.  The hospital bed is gone from our house. Fran now sleeps with me in our bed. I cannot tell you how much better the room feels when it does not contain a hospital bed! Perhaps hospitals would be more pleasant if...

2. Fran can walk with no assistance.  We still require that she have a spotter, but the spotter has never had to act.  She does not need the cane or anything else.

In the next few weeks Fran will be caring for grandson Miles while Maliq and Rachel attend a wedding out of town.  Fran, and many of her friends, are delirious about the prospect.


Tuesday, July 26, 2011

Fran, July 26

Yesterday, Fran reached a real milestone.  Karen Salant was visiting from Oregon.  They announced that they were going to lunch at the Del Mar Plaza, sans wheelchair.  Karen helped Fran into the car, put Fran's cane in the trunk, and they set out.  They returned about 2 hours later.  According to Karen, they parked in the garage.  Fran walked from the garage to the sidewalk, and then up the ramp to The Breeze, where they had a leisurely lunch with a nice glass of Chardonnay.  Then they returned to the car on the same path and drove home. Fran was a bit tired and took a nice nap, but was extremely pleased with her demonstration of independence.


Thursday, July 14, 2011

Fran, July 14

Sorry for the absence of posting.  Progress is very gradual and we are very busy.  My thanks to Anita who called and suggested (emphatically) that it was time.

The process is very positive.  Fran walked about 200 feet in one stretch today with her quad cane and another 50 feet with no cane.  She is even beginning to get some use from her left arm.  I estimate that she will be relatively independent within six months.  In the meantime, my deepest gratitude goes to her friends, particularly (but not only) Alice, Barbara, and Deborah, and her caregivers, Isela, Katerina, and Cindy. Their love and support has made this possible. And most of all, I am grateful to Fran, who will not quit and who absolutely will succeed.


Friday, June 24, 2011

Fran, June 24

Fran began as an outpatient this week at Scripps Encinitas Rehab, where she had been an inpatient about a month ago. The staff members who had treated her as an inpatient were very impressed with her progress.  The goal of the current treatment is to make her independent, so she can get around the house without assistance. She is determined and I expect she will get there in the next couple of months.

Jerry and Alice turned me on to a wonderful book, My Stroke of Insight. It is the story of a relatively young (37) brain scientist, Dr. Jill Bolte Taylor, who had a severe left-brain stroke.  She recounts in great detail, her experience of the stroke and her process of recovery.  She achieved complete recovery over an 8 year period.

This book is a must read for anyone who is providing care or who has a close relationship with a stroke patient.  In an appendix she lists "the 40 things I needed the most," beginning with "I am not stupid, I am wounded.  Please respect me."

It is not only a must read, but also a good read.


Thursday, June 16, 2011

Fran Carder, June 16

This is getting like reporting the progress of the hour hand.  It is not exciting moment to moment. But the movement is there.  Fran can pretty much walk, using a quad cane.  Of course someone has to be there ready to support her, should she lose her balance. But this is a rather dramatic change from the time she started rehab. It looks like she will not even need a brace for her left leg.

She does have some pain in the left leg.  Apparently this is a common problem as the nerves "wake up." Dr. Kocharian is considering a botox injection, which is one way to treat this.

Next Tuesday Fran will have her first sessions as an outpatient at Scripps Encinitas Rehab.  I expect they will be shocked by her progress.  Trish, the physical therapist who brought Fran along while she was treated here in our home, is really good.  She combines professional competence with a personal manner that is powerfully motivating.  Trish is in her early 50's and motivates herself sufficiently to do triathelons. It was great to watch her with Fran.


Friday, June 10, 2011

Fran Carder, June 10

Sorry about the lack of blogs, but news has been somewhat slow.  Slow but good.  The therapists who have been coming to the house agree that Fran should graduate to outpatient status and Dr. Kocharian has written an order to send her to Scripps Encinitas Rehab.  The therapists have also recommended a leg brace to assist Fran's walking, and Dr. Kocharian will arrange that as well.

On Monday of this week, Fran had a major outing.  We had an appointment with Dr. Savage at Scripps Encinitas.  Afterword we went to Target on Leucadia Blvd and Fran had a major shopping experience, buying sheets.

The upshot of the Dr. Savage appointment is that we no longer have to inject Lovenox.  Fran is now on coumadin, an oral medication. The one drawback is that she has to have blood drawn once a week to measure clotting time, to make sure she is in the right range. It appears that Fran will continue on this for a very long time.

Fran is exercising every day.  She is getting stronger and her balance is improving.  I think we can look forward to her being mobile within the next few months.


Sunday, June 5, 2011

Fran, June 5

The weekend has not been too eventful (so far). One measure of Fran's progress however, is that Cindy, our weekend caregiver, is able to transfer Fran with no help, except for Fran's help of course. This is a major development. It means that Fran will no longer need two caregivers at all times.

Simon and Gloria are coming for dinner tonight.  Tomorrow we have an appointment with the pulmonologist. If you recall from earlier blogs, they are in charge of thromboses (clots). We are hoping to end the need for the daily injections of Lovenox that we are now administering.

After the doc, Fran will get her first post-stroke shopping experience, if she is not too tired.


Friday, June 3, 2011

Fran, June 3

This afternoon Fran received the quad cane we had ordered.  In spite of the fact that she was tired after a busy day, she insisted on trying it out.  With some help from Isela, she was able to navigate down the hall.  Not surprisingly, Fran is determined to achieve independence and is working very hard at it.


Thursday, June 2, 2011

Fran, June 2

The big news is that I got the pictures of Miles into the previous posts. Here they are again.

I made an eagle today on the par 5 18th at Encinitas Ranch Golf Course, sinking a smooth 7-iron from about 135 yards. That is a rare bird for me.

Fran is doing so well that the therapists want her to become an outpatient back at Scripps, Encinitas.  She does not have to be limited to visits in the home.


Wednesday, June 1, 2011

Fran, June 1

Fran has had several chances now to visit with Grandson Miles.  Maliq and Rachel are bringing Miles here for dinner tonight and I am ordering in Chinese food.

Here is a picture of Fran's most recent visit with Miles. In case you do not know them, Son Maliq and his wife Rachel are there too.


Monday, May 30, 2011

Fran, May 30

Fran walked three laps around the kitchen island today, and demonstrated clear extension control of her left leg at the knee.  Trish, the physical therapist, was very excited by the phenomenal progress Fran has made in the past few days.

PLUS, we have this photo of baby Miles. More in coming blogs.


Saturday, May 28, 2011

Fran, May 28

Developments now are gradual, so I am not posting as often.  Fran continues to develop her walking.  Yesterday one of the therapists suggested locations for some railings, which would enable Fran to get around the house.  The therapist also had me order a quad cane, so we are optimistic about walking soon. (The cane is for Fran, not me.)

Last night Jerry and Alice brought over another great Ina Garten meal, a fusili pasta with tomato, lemon and arugula. Plus Jerry brought his skill at Martini making. It was another lovely evening. Tonight we are reprising the burgers from the party on Wednesday, but with the pickles and cheese slices that were left out last time.  We also have the benefit of experience.

Isela and husband Brent dropped by with their two younger children Kyrie and DD.  The kids said they wanted to move in here, which Fran approved immediately.  They are impossibly cute.  Unfortunately, Isela and Brent insisted on keeping them.


Wednesday, May 25, 2011

Fran, May 25

Yesterday we had our reunion with Dr. Kocharian.  She was great.  She wants Fran to progress faster.  Isela and Katerina are on the same page, and had Fran walking laps around the island in the kitchen this morning. Fran has an old knee brace, which enables her to bear weight on the left leg, so she can pretty much make it around unassisted.

Dr. Kocharian ordered a scan to make sure Fran had no bleeding in the stroke area.  We got the scan today and everything was fine.

Today, we hosted Deborah's birthday party, created by Gale, for about 10 people.  In addition to the cake we had grass-fed hamburgers from a recipe from Food and Wine. Fun party and good food.


Monday, May 23, 2011

Fran, May 23

Today was a really big day.  We loaded into the car and drove to Scripps Encinitas. Grandma Fran met Grandbaby Miles and held him close.  Miles is in the neonatal ICU under observation because of a bug he acquired when Rachel was in labor for over 20 hours after her water broke.  Meanwhile, Miles is handsome and looks very healthy.  But he will have to stay in the unit for 7 days.

This afternoon Trish, the physical therapist, came and had Fran walking along the counter for a few steps.  Fran can swing her left leg forward, but it cannot yet bear her weight.  The progress is huge though, and we all cheered (all is me, Isela, Katerina, and I think Barbara was there too.)

Tmorrow we visit Dr. Kocharian, our wonderful neurologist.


Saturday, May 21, 2011

Fran, May 21

Franma is now really a Grandma.  Miles Warfield was delivered via C-section this afternoon, at about 9 3/4 pounds. Maliq is already thinking about the best way to assist Miles in getting to the NBA.  Congratulations Maliq and Rachel.  Rachel did most of the work of course, including over 24 hours of labor at the end.

Fran is proud and happy to be a grandma, and is continuing to improve. She did some "walking" yesterday with the physical therapist.  This consisted of moving along a counter, and represents an important step.

Jerry and Alice Rost brought us dinner last night, baby-back ribs.  Alice again did a great job.  They also made martinis, which was part of the reason I did not post last night.

Both Susan Taylor and Gloria Khoury sent me emails about an exciting new device, developed at MIT (by nerds, I expect, my kinfolk). It is called myomo (my own motion) that uses movement and biofeedback to help people learn to control paralyzed arms.  We will be discussing this with Dr. Kocharian when we see her on Tuesday.

Thursday, May 19, 2011

Fran, May 19

Lots of visitors today and a good day for Fran.  She did well at standing and increased her left leg movement.  She even moved her left arm.  The physical therapist says they will attempt a step tomorrow.  I am not sure exactly what that means, but the therapist says it is a big deal.


Wednesday, May 18, 2011

Fran, May 18

Fran had a big day.  We left the house to see Dr. Savage, a hematologist, at 10:30 this morning. We needed a decision on what to do with Fran's clotting. Dr. Savage ordered an ultrasound study.  Rather than come back, we decided to wait for the available appointment at 1:00 PM. We returned home just before 3:00, a very long outing for Fran.  She was great.  By the way, the study suggested no change in her condition, which I think is good.

We arrived home just in time for five visitors, which Fran enjoyed.  She has just gone to bed and I am sure she will sleep well.

Grandson Miles has not arrived yet.


Tuesday, May 17, 2011

Fran, May 17th

Big day today, our first outing.  We went to see Dr. Peter Sacks, Fran's primary care doc, whom we have not seen since the stroke.  We resolved most of the prescription problems we had. She was taking a blood pressure med (beta blocker) at too high a dose and it was dangerous.  I had cut the dose and he agreed that is what we should do.  He also agreed that there was no reason for her to take Lipitor.  Finally, he liked our choice of Dr. Kocharian as Fran's neurologist, and I subsequently made an appointment with her for next week.  Those of you who met her will know why we chose her.

I was concerned about getting Fran in and out of the car, but Isela did a great job and we had no difficulty.

In the afternoon several of Fran's artist friends arrived at our house for a visit.  Having arranged it earlier, Bronle and Theresa brought dinner. I know what a good cook Theresa is, because we did a dinner party together.  Bronle is in the same league, as it turns out. The meal was very elegant and very good. We started with a roasted red pepper soup, which was followed by a vegetable tart, a bit like a quiche. The crust contained more butter than the dairy case at Von's.  We finished with a berry tart.  Each dish was superb, as was the 2009 Callaway Voignier they matched with the meal.

We are so lucky to have the wonderful friends we have.


Sunday, May 15, 2011

Fran, May 15

Not much in the way of news. K. J. Choi won The Players and we enjoyed watching LeBron's butt being kicked by the Chicago Bulls. Fran was pretty sleepy today, but did well at the things she needed to do. Our weekend caregiver did a great job, and made things easy for me. We had lots of visitors on Saturday, but not today. We have a big week next week with two Dr. appointments.  We have not been in the car since I drove her home from the hospital. It is a bit tricky getting her into the car, because of the low roof line.  But thank goodness for Marshall's ramp.

I was making chicken soup today. I checked email at about noon and found an email from our friend Cathy saying she was making chicken soup and would be happy to bring some by. Drat. Cathy is a great cook, but my soup was  great too.



Friday, May 13, 2011

Fran, May 13

The Google blogosphere was down yesterday, so I could not post.  Not much news anyway.  Fran continues to progress slowly but surely.  She has a slight ability to move her left leg. She retains her dry humor. She has a good time with visitors, but she also gets tired. Next week we will be traveling to doctors, which will be an adventure.

I took some time off today and played golf with Marshall, Christian Wells, and Cyriaque. This is a great form of relaxation for me. It seemed less relaxing for them, as we had a "who stole my ball" controversy erupt on the third hole.  On the first hole, a 340 yard par 4, Marshall said he hit his best drive ever, but he could not find it.  We did find a ball about 10 yards from the green, but mistakenly determined that it was not Marshall's. Christian pocketed the ball.  On the third hole Christian teed it up.  Marshall looked down and saw that Christian was teeing up with the lost ball from hole #1.  Marshall went off like an IED and it took several holes and a couple of double bogeys for peace to be restored.

This weekend Isela and Katerina are off and I will have a "professional" caregiver from an agency for Saturday and Sunday. I will miss them, as they are terrific.

Tonight Alice and Jerry Rost brought dinner to us and we had a dinner party.  Alice had prepared a wonderful chicken dish from an Ina Garten recipe and Jerry crafted excellent martinis. 


Wednesday, May 11, 2011

Fran, May 11

The day started out poorly.  We were all tired, and barely able to get Fran up.  When Isela arrived, I escaped for a short bike ride and felt a bit better.  Then Trish the Physical Therapist arrived and things changed dramatically for the better. 

Trish was able to get Fran to demonstrate repeated, voluntary movement of her left leg. Fran is not ready to walk, mind you, but this is wonderful progress. Trish showed us better ways to work with Fran, and completely revised our daily routine.  She wanted Fran up and out of bed more. We selected a comfortable chair in the dining room where Fran can sit.  Fran much prefers this to the wheelchair. Speaking of wheelchairs, Trish even had Fran propelling her wheelchair around the house, paddling with her right foot.

Yesterday Allison brought in a mattress pad for Fran's uncomfortable hospital bed, which was very much appreciated.  It certainly enabled Fran to sleep better.


Monday, May 9, 2011

Fran, May 9

Check out time at the rehab center is at 11 AM.   We were ready to leave when we heard Dr. Rosenberg speaking loudly.  I went out to the nurse's area and discovered that an important ball had been fumbled. Fran has some ongoing clotting problems and Dr. Rosenberg had suggested a filter.  In the meantime Fran had been getting anti-coagulant injection every day.  I did not know this and there was no provision to continue it in our discharge instruction. Fortunately, Dr. Rosenberg noticed this.

Apparently, Dr. Stone, who had been in charge of Fran, had left rather abruptly, for what reason I do not know.  But that is where the ball seems to have hit the turf.  So they brought in a pulmonologist, Dr. Savage, to figure out what to do.  (Plumonologists are in charge of clotting, except for clotting in hemophiliacs, which is owned by hematologists.) He ordered an ultrasound study to see what was happening currently, and ultimately decided we should continue the injections. 

We left for home at about 3 PM with about 10 prescriptions and a carload of flowers. Isela and Katerina did a great job with Fran at the house, I cooked up some angel hair pasta, we all had some wine, and Fran is very happy to be home.  Needless to say, I am equally happy to have her here.


Sunday, May 8, 2011

Fran, May 8

Fran had a nice Mother's Day with lots of visitors, most importantly Maliq and Rachel. They brought dim sum, as Fran had mentioned she was hungry for it.

Tomorrow is D-day and I think we are ready.  Marshall and Cyriaque came over to the house and painted the ramp, Ana helped me move furniture, and their dog Mumu tore up my bed trying, without success, to find Natasha, our cat.

I have described the ramp to Fran and she wants a street sign for it.

I suggest no visits on Monday, as we will be trying to get settled.


Saturday, May 7, 2011

Fran, May 7

Not a very eventful day.  I got some more training, Fran was in a good mood, and we are pretty much ready for the discharge on Monday.  Fran is anxious to come home.

All the therapists were new to Fran today. The techniques they used were a bit different, so it was a good learning experience for me.

I do not expect tomorrow to be very eventful either, but Monday will be a BIG event. Stay tuned.


Friday, May 6, 2011

Fran, May 6

Today son Marshall built a majestic ramp up the front steps to the house in preparation for Fran's homecoming.  The ramp would support a fully-loaded semi, and will certainly ease Fran's entry.

Delivered to our house was all the equipment we need.  Our caregivers practiced their moves at the hospital and I think we are ready here.

Fran was in great form today, and I expect the hospital will miss her when she leaves on Monday.


Thursday, May 5, 2011

Fran, cinco de mayo

Today we put Fran in the car, drove to our home, and tested the facilities.  All the caregivers were there, with two hospital staff, Marshall and our granddaughters. Everything worked, though getting Fran into the shower will be tricky.  There are two steps into the house, which were not too difficult to negotiate in the wheelchair, but son Marshall is building a ramp. All the caregivers got to practice helping Fran, with Doug, the instructor present.

Dog Wesley was overjoyed to see Fran and tried to follow us back to the hospital. Cat Natasha was nowhere to be seen.  Too many people.

Doug has ordered all the equipment we will need, to be delivered to the house tomorrow.  D-day is Monday, and I think we will be quite ready.


Wednesday, May 4, 2011

Fran, May 4

Fran's discharge date has been moved to Monday, May 9th.  Tomorrow we will take Fran to the house with an expert from the Rehab Unit to determine what equipment and techniques will be necessary.

All the staff at the Rehab Unit tell me that Fran has improved dramatically in the last few days in terms of the ease with which she can be moved from bed to wheelchair, etc.  According to Rachel, Fran was able to move her left arm one time, and according to one of the therapists, she is beginning to have some slight response in her left leg. So optimism is appropriate.  

Fran is definitely looking forward to coming home and to my cooking.  I am equally looking forward to having her here and also to not spending quite so much time at the hospital.


Monday, May 2, 2011

Fran, May 2

Fran is coming home on Friday. I spent my time today training on how to help Fran move from one situation to another, like from the wheelchair to the bed and back.  I have a lot to learn, but I can do it.  As Fran learns to help more it will be much easier.

I hired Katerina and Esella (sp?) to help at the house, and will talk to an agency tomorrow for more help.  The hospital is promising to arrange for all the equipment we will be needing.

There were few visitors and fewer flowers today.


Sunday, May 1, 2011

Fran, May 1

Today was a day of visits. Our friends Ed and Bonnie came and brought some lovely flowers. Then Ana and Olivia came and brought more lovely flowers.  At the end of the day, our nephew Noah and wife Amy came with baby Tegan and brought even more flowers.  So we put all three together arrangements and took a picture for you. You can see it at the bottom of the page. They were all lovely and very much appreciated. And I am not putting you on.

Fran had some rest today, with no therapy on Sunday.  Next week is a big week, getting ready to bring her home on Friday.  We need equipment, we need to make sure that the house will accommodate a wheelchair, I need more training, etc.  Fran is very excited about coming home, and I am excited to have her back.  We will need lots of help, but I am certain we will get it.


Don't forget the picture of the flowers.

Saturday, April 30, 2011

Fran, April 30

Fran got some rest and was much better today. Her awareness level was as good or better than any time since the stroke.  Her mood was pretty good as well. I spent time learning some of the things I will need to know to care for her. Some of it is not very hard, like moving her between the wheelchair and the bed. Some of the other stuff is pretty difficult.  Both Fran and I will need to improve.

Fran has some sensation and some muscle responses on the left side, but no voluntary movement.  Her awareness of the area to her left is getting a lot better.  Originally, that part of the world did not seem to exist for her.

We are looking for live-in help.  Ana has some good leads and is working on the project.

Fran and I were unfortunately not able to attend today's celebration of life for our recently deceased friend, Ed Arkin. He was a good man and we will miss him.


Friday, April 29, 2011

Fran, April 29

Fran had a bit of a setback today.  I think she was tired from so many visitors yesterday.  She did not perform well in her therapy. She perked up in the afternoon after some rest.

We had the family meeting today with the staff, and I thought it was very positive. Her tentative release date was set for a week from today.  There is a large amount of work to do before then.  She will be coming home.  We will need equipment, training, and help.  She will continue with outpatient therapy at the rehab center.

With the recent trend, I am expecting considerable improvement over the next week.  I am not expecting much help from her left side, but I do expect big improvement in her ability to use her strong right side effectively.


Thursday, April 28, 2011

Fran, April 28

Dramatic improvement in awareness.  Fran is almost completely there. She is more talkative, and picks up better on what you are saying.  She also graduated to regular food and liquids.  She is off dietary restriction.

Tomorrow is the big meeting with the staff and our family to assess her progress and lay out what is next.  This will include her rehab doctor, some therapists, the case manager, and the social worker, along with Fran, me, Maliq, Rachel, Marshall, and Ana. 

Wednesday, April 27, 2011

Fran, April 26th and 27th

Sorry I missed last night.

Yesterday they found that Fran had a DVT (clot) in her leg that was inactive, but constituted some risk. We determined that they would put in a filter to prevent any clots from rising to the lung.

Today was major progress in her physical therapy.  Fran had a transfer from wheelchair to bed that would be classified as moderate assistance, a big jump.  She began at total and had moved to max assistance.  Based on the continued progress the therapist said she would recommend that Fran stay an additional week past the May 3 date.

Fran also made progress in what is called "speech therapy," but for Fran, is about swallowing. Fran's swallowing is now very good, and it appears that her dietary and liquid restrictions will soon be lifted.


Monday, April 25, 2011

Fran, April 25

The visitors over the weekend must have been very therapeutic. Fran was more alert and energetic than at any time after the stroke. I did not speak with the physical therapist, but I did see the speech therapist, and Fran appears to be progressing on her swallowing.  She drank some water without incident.

We have scheduled a "family conference" on Friday.  There the chief physician and the staff will explain where we are, where we need to go, etc. Fran's current release date is May 3, but that is not carved in cement.  We will know more about that on Friday.


Sunday, April 24, 2011

Fran, April 24

Today was a day of rest and visitors.  Out of town visitors included Anita Arikin, Marty Rubenstein, Karen and Peter Salant, and Sid and Barbara Finkelstein. Sid had been paralyzed by an incompetent chiropractor, and talked with Fran about his process of regaining function.

Fran ate in her room and ate much more than she had been eating in the dining room, confirming yesterday's discovery that she is not comfortable in the dining room.

She began the day very tired, but finished with some energy.

The most significant thing is that she appears to have some sensation from her left arm and leg. If this is real, it is new and very important.


Saturday, April 23, 2011

Fran, April 23

When it rains it pours. Today they discovered that Fran has a urinary tract infection sponsored by a resistant strain of e-coli.  They (the staff, not the e-coli) moved out her room mate and now requires anyone who enters to wear a yellow smock.  They are not restricting visits, except for people who do not look good in pale yellow.  They are administering an antibiotic that their testing indicates will be effective with this particular bug.

Fran was especially tired yesterday and today, which is likely do to this infection, which should be cleared up soon.

Because of the inconvenience, she ate in her room. She ate more than I have ever seen her eat.  When I asked her about it I found that she is not comfortable in the dining room.  So she can eat in privacy and then go out in her wheelchair on a tour.

Tomorrow is an off day for therapy.


Friday, April 22, 2011

Fran, April 22

Today we solved the mystery of the cat scan.  We could not figure out who ordered it or why.  I asked Dr. Stone and he said he did not know.  He came to me a few minutes later and apologized, saying that he had ordered it.  He had been extremely busy, as he supervises the whole rehab facility. The reason for the scan was that he wanted to use a mild anti coagulant to prevent future strokes, but he had to make sure there was no more bleeding.  In fact there was no bleeding, so he can go forward.

Fran was very tired this morning, but better this afternoon.  There were no more leaps of progress, but no setbacks either.


Thursday, April 21, 2011

Fran, April

By all accounts, Fran continues to make excellent progress.

Up to this point I have encouraged all visits.  However, the therapy staff is concerned .  They explained that her sessions are quite strenuous, which is evident to me.  I can see how tired she is following a session.  She needs to rest between sessions.  The staff feels that the visitors are preventing her from resting sufficiently.  They have asked that people come after 3 PM on weekdays.  On weekends, any time is OK.

I hate to do this because I know Fran enjoys the visits, but I trust the staff and want to follow their wishes.

Wednesday, April 20, 2011

Fran, April 20

Lots of visitors today.  The most notable thing for me was that Fran's mood seemed much better and she was not as fatigued. Others noticed this also.

Fran had a visit with Alice's dog, Sasha yesterday and today Cyriaque and Raquel brought their Beagle to visit.  We can take Fran in her wheelchair to the yard outside the front entrance for these visits. She likes this a lot.

Her therapy session continue, with a focus on finding center, balance, standing, and taking a few steps.  I did not see any of the sessions, but Fran said she did OK. She also had some work with reading and other visual tasks. Her acuity needs improvement, but I think this will come back very well.


Tuesday, April 19, 2011

March 25

For those who do not yet know, Fran suffered a stroke on Wednesday.  She went immediately by ambulance to Scripps Memorial Hospital, where she has received world class care.  On Thursday she underwent surgery, via catheter, to remove blockages from her brain.  The surgery, which took 4 1/2 hours, was successful. She is now under heavy sedation in the ICU, where she will remain under constant observation for several more days.  The neurologist is optimistic about her recovery.  The problems are on the right side of the brain and she has weakness on the left side. She is undergoing tests to discover why this happened, so we can prevent a recurrence.

She is under what may be the world's best care.  I will try to keep you updated as we know more.  I am sure this list is not complete, and I will add to it as I collect emails.

Thanks for all of your expressions of care and concern, and offers of help.  There is not much any of us can do right now but hope and pray for her speedy recovery.


March 28

Progress is good.  They have taken Fran off sedatives and she is slowly waking up.  They will probably take out the breathing tube tonight or in the morning. They found a small irregularity in her aorta which is the probable source of the clot, and they will be able to deal with it.  I will know much more tomorrow about her condition and plans going forward.

Thanks again for all your support.


March 30

Progress is steady but very slow.  Fran is more alert and responsive and can open her eyes a bit.  They are testing her respiration to see if she is ready to have her breathing tube removed.  so far, she is passing, so they might remove the tube tomorrow.  They do not want to do it prematurely, as the repeated insertion can cause some problems.

They wheeled a patient out today.  Why? I asked.  I was told that he was "too sick" to be in the ICU.  That creates perspective. (He went to the cardiac care unit)

Fran's next stop will be the rehabilitation unit...soon I hope.


March 31

Today was a day of rest and testing.  They are making sure that she can breathe on her own prior to removing her breathing tube.  She is doing fine and hopefully the tube will be removed tomorrow.

She is more responsive each day and very well aware of who is there and what is going on.  When Rachel (her pregnant daughter-in-law) is there. Fran puts her hand on Rachel's belly.

More tomorrow.


April 1

Today was a day of slow progress.  In all her tests Fran can breathe on her own.  The question is can she cough forcefully enough to clear her airway. Dr. Dhupa will decide tomorrow morning if she is ready to have the breathing tube removed.  They do not want to take it out and then have to put it back in, as it can cause irritation and even damage.

Fran is fairly conscious some of the time and is starting to open her eyes. Even at this level, her personality is there.

Hoping for good news tomorrow.


April 4

Another day of slow but steady progress.   She can talk but it is very she writes...a lot.  At one point she noted that "the suction tube tastes like poison."

She did not do quite well enough on her swallowing test to get off tube feeding, but I expect her to pass tomorrow.

I expect her to be out of the ICU tomorrow or Wednesday and in rehab by the weekend.I hope that prediction is more accurate than was my bracket.

She mentioned that when visitors come, they should not try to get her to respond.  She is very aware and will respond when she wants to.


April 6

More slow progress.  The pulmonary doc said he was finally confident of Fran's breathing. Her white cell count is OK and she has no fever so the upper respiratory infection seems to have abated. More of her speech is now audible. However, she did not pass the swallow test. She was tired today, and is very anxious to get some real food and drink.  She is now getting brief physical therapy.

Hopefully tomorrow we can spring her from the ICU.


April 7

Nothing was dramatic today.  Fran's breathing is solid.  She is talking more, and is generally more alert.  She did not pass the swallow test, but that should not prevent her from getting out of the ICU.  The docs are all happy with her progress.

She says thumbs up to visitors.  Suggest you call me to coordinate. 858-775-9224.


April 9

More little bits of progress.  Fran passed swallowing, level 1.  She can eat purees, so I made her favorite, split pea soup.

She made a phone call to Barbara Binns, which rather surprised Barbara. I think she wanted Barbara to take her somewhere. I don't blame her.

Her consciousness level is improving (Fran's not Barbara's) and she can carry on a brief conversation. She gets fatigued quickly.

I think she is going to leave the ICU tomorrow and will get to rehab sometime next week.


April 12

Fran is now in the Scripps Encinitas Rehabilitation Center.  It is simply the best.  Dr Kocharian had to fight to get her in. Bless her. Fran was delivered by ambulance at about 3:45 Pm today. They will evaluate her in the morning and start her therapy.

Fran is getting into phone conversations.  She had lengthy calls with Maliq and Deborah today.

She will have to work very hard at the Center, but she is the one to do that. 


April 13

Day 1 at Encinitas Rehab was a grueling series of evaluations.  The staff is really excellent at establishing rapport with the patients. Fran already trusts them.  And they work her very hard. They will be coming up with a set of goals and a treatment plan in the next few days.  Meantime Fran continues to improve slowly.  Her alertness level is better, and her ability to communicate is better.

I actually like the pureed food, but she does not.  So I will make her a smoothie in the morning.

I am convinced that she is in the right place.


April 14

Fran got her last tube out today. It was a feeding tube that went in through her nose and dangled in front of her face with some colored stoppers.  Marshall told her she looked better without the tube.  "It wasn't my color," said Fran.

She is really being tested by the rigors of the rehab facility. She has physical therapy, occupational therapy (which is stuff like teeth brushing, showering, etc.), and speech therapy (which for Fran is mostly swallowing). After each session she is pretty tired.

I am getting more optimistic daily about what they can do there. She has a very long way to go, but she is in the right place to get there.


April 15

Another upgrade today.  Fran has gone from honey-thick to nectar-thick liquids, and from pureed to chopped food.  Let me tell you, the chopped food is better.

She is getting quite a workout in her sessions and she does not feel she is making enough progress.  But Fran has NEVER felt she was making enough progress. The therapists say progress is OK.

She is enjoying her visitors, but sometimes she gets tired and needs to rest. But overall, the visitors are very important to her.


Fran, April 17

Fran took her first steps today.  Of course, she did not saunter off down the hall.  She needed a lot of support from the physical therapist.  But the progress was real and large.  Because of the shut down of her left side, she has to learn a very different set of responses.  What her brain thinks is standing straight is no longer straight.  She has to look in a mirror and correct. But she is learning how to do it.

Her mood is better, her eating is good, and she looks great.

We had lots of visitors today, and she liked it a lot.


Fran, Monday April 18

Today was another day like yesterday, with a lot of hard work and slow progress.Dr. Stone, the neurologist in charge of the unit sat down with us at breakfast and told Fran that her progress had been remarkable in the week that she had been there.

She is getting more hours of instruction, between 3 and 4 hours a day, combining physical therapy, occupational therapy, and speech therapy (swallowing).  She is quite tired at the end of the day. I think life for her is like it would be for you if gravity were not constantly in the same direction.  She has to completely relearn her orientation in space.

She is eating more and her sense of humor is still strong.


Fran, Tuesday April 19

Another exhausting but successful day for Fran.  Dr. Stone told her that she had done in one week, what took most patients two weeks.  And she got her first chance at real food, a tuna salad sandwich.  She said it was "mighty good."

Alice brought her  little puppy Sasha and Fran was allowed to go into the front yard of the hospital to meet them.

Fran's dear friend Karen Salant arrived this afternoon for a long visit.

Fran is trying to learn where her "center" is, a concept that we take for granted, since it is built in.  Now she has to learn it all over again.