Monday and Tuesday Update

July 28 and 29
By Linda and Karen

Monday morning we discovered no nasal-gastric tube in Mom's nose for feeding when we arrived. She had taken it out sometime over the night hours and since no nutrition had ever been started through it, they decided not to reinsert it. The nausea seemed to have diminished and she was more alert on the new medications so the doctor decided to go back to liquid IV nutrition with some renewed effort to eat more regular meals by mouth. He also precscribed a medication to stimulate her appetite. We are still hoping to avoid the more permanent feeding tube, so they are trying many different strategies before jumping to that treatment option.

(Note--Unfortunately, the nutritional IV was not actually started until Tuesday morning and Mom still ate merely bites of food on Monday. That means by Tuesday morning she had spent four entire days with barely any nutritional intake! She is one pretty tired and weak wife/momma/grandma.)

During the day Monday, three new therapists made assessments of Mom's condition and began to create plans for her therapeutic needs. She will participate in physical, occupational, and speech therapy each day. She will meet individually with each therapist one time daily for anywhere from 30 minutes to an hour. The schedule will be adapted to her each day according to her energy and progress toward goals.

Highlights of the assessment and therapeutic process on Monday and Tuesday included Mom walking using the parallel bars for support, "pedaling" a crank-wheel bike kind of thing with her feet and then with both the left and right hands, and answering a wide assortment of questions with a mixture of frankness and dry wit. For example, the interview with the speech therapist included things like:
Speech Therapist: Doreen, what is a robin?
Doreen: A robin is a harbinger of spring. It is a kind of bird that shows the changing of seasons. It has a red, no, a rust-red breast and the rest of it is brown.
ST: What is an apple?
Doreen: It is a fruit that grows on trees. It can have a variety of skin colors - red, yellow, green. It is good for making applesauce. And it's also good with peanut butter on it for a snack.
(Remember that her speech is slow and deliberate, she pauses before answering, she often has her eyes closed, and some words are not clearly nor distinctly spoken.)

--A little later in the discussion...
ST: Imagine you are at a restaurant and after eating, you realize you have no money or credit cards. What would you do?
Doreen: I would ask my husband to pay with his credit card or money from his wallet.
ST: What if your husband wasn't with you?
Doreen: I would ask them if they would accept my credit card number and information verbally, because I know it by heart. (She then proceded to correctly tell us her 16-digit credit card number and expiration date then added the security code on the back!)

She seemed more tired on Tuesday than on Monday, but we were not alarmed by this. She had just begun therapy again with new therapists in a new environment, and she had received no nutrition to speak of for four days. We know that would make anyone tired!

The adjustment to this new hospital is now getting more settled and Mom can begin to wear her own clothes, travel to the therapy room in a wheelchair, use the bedside commode, and the staff are encouraging her to do more things for herself. She was able to interact with Becky and David Waas when they visited this afternoon and they noted how much more she looked like herself than when they saw her about a week ago.

We end the day on Tuesday feeling good about the hospital and its staff. It is clear that Mom's medical AND rehabilitative needs will be addressed.