Myers Family Blog

Summer Update

2009-06-22T11:55:00.007-05:00

It goes without saying that it's been a long time since we've posted anything about Doreen and Carl. While the changes are not nearly as dramatic as they were a year ago, we continue to see improvement. Here are some tidbits to get you up to date.

What hasn’t changed:

1. Doreen is still living in the health care wing of Timbercrest, and Carl is living in an apartment in the Manor, although they regularly eat the noon and evening meals together in health care, and Carl spends most of his day in Doreen’s room. Carl eats breakfast in his dining room and then goes to Doreen’s wing. Mostly because he is an early riser and she likes to sleep in!

2. There has been no return of appetite or eating problems. (The photo below includes Darell and Liz Bowman (Clay's parents), Cameron, David Bowman (Clay's brother), Karen, Doreen and Carl.)

What is improving:

1. Doreen needs less and less help with eating. She still has a lot of challenges with steadiness of the hands, but she spills things much less often, and she can prepare much of her food without help.

2. She is using a walker more frequently and often goes to meals, to therapy, and to the bathroom using the walker instead of the wheelchair. Her left leg can be a challenge, though, and she needs to be reminded to slow down. A video of Doreen walking to therapy with Karen is posted below.

3. Alertness is no longer an issue most of the time. She does not seem to get as exhausted when she attends events, listens to stories told by family and friends, or watches television or movies.

4. She can read and follow the lines of the text, although it is tiring. She still feels like her eyes are not working quite right.

5. A few weeks ago, Judy attended church with Doreen and Carl, and Doreen was able to sing the hymns, follow the verses, and sing alto in tune! Let’s all sing Hallelujah!

6. Doreen and Carl are trying to resume some of their practice of sending cards to friends and family. It may be a little haphazard, but this desire shows a move away from an exclusive focus on themselves and Doreen’s recovery. They do care about you!

Difficult changes:

1. Being in a retirement community and living life as "eighty-somethings" has meant that there are many times of grief and loss. A friend who sat close to them in the dining room died several weeks ago. Last week their table companion in health care died. Recently Doreen’s roommate Jeanette died. An especially difficult death to accept was when Jim Garber died last week. He was a very good friend who was very supportive in the last year. He coordinated the transportation for Carl’s many trips to Ft. Wayne before Doreen moved to Timbercrest. We will all miss him.

2. For a while after Doreen’s roommate died, she was the only resident in her room. When she did get a new roommate, it was a person with a lot of needs that made it difficult for Doreen to sleep. So she moved across the hall with Ruth, a 94-year-old woman whom she likes very well. Both of them were offered a single room after they moved in together, but both decided to stay where they were. It's clear that they both enjoy each other’s company.

Please accept our apologies for the long gap in updates. Let us know if you have any questions. Thanks for your support! (Below is a video from the Myers-Bowman family's recent visit to Timbercrest.)

March 16 and 17 update

2009-03-18T23:18:00.000-05:00

March 16 and 17, 2009

Report from Doreen, Carl, and Judy—

On March 16, granddaughters Amanda and Kelsey came to visit from New York and New Jersey, respectively. Dick and Judy traveled up from Lafayette to visit with them and with Doreen and Carl. Here are some tidbits from the visits, many “dictated” by Doreen and sometimes Carl (their notes are in quotations).

- Doreen has named her wheelchair “Wheel-helmina.”

- The therapy aides report that Doreen’s walking with a walker has been going well. She has been walking only in the therapy room, though. Doreen called Judy on March 18, however, to say that she will now be walking to meals with her walker (after the aides are trained to do this and with someone following with a wheelchair). This is good news! It will help to build up Doreen’s strength and coordination!

- Doreen has now had cataracts removed in both eyes. The eye doctor told her not to wear her glasses for a while, because the prescription isn’t right any more, and it could confuse her brain to try to focus with them. That means that she can’t really read, and it gets difficult to see things. “We are hoping that when the lenses are changed, it will help with balance and dizziness.”

- Judy, Doreen, Carl, and Dick worked together on the St. Patrick’s Day crossword puzzle being circulated at Timbercreast. We did well, but what is the pagan religion converted by St. Patrick? And what is the name of another (female) saint celebrated in March?

- “We got encouraging news from the surgeon.”

- They are working on getting the annual letter out—although it hasn’t been annual for a while, and Doreen says that she will need to get back on her computer for that.

- “We continue to have great confidence in family supporting us so strongly.”

- Doreen—“Your dad has been so supportive. He eats his breakfast upstairs [note—they are on the same level, but they talk about upstairs and downstairs] and then is so faithful in coming to get me and take me to my breakfast..”

- Carl—“It is hard to select her clothes. She asks for her dark this or dark that. I try to be an encourager. It is a loving environment here.”

- “We have enjoyed the visits of our very favorite granddaughters. [note—their only granddaughters] All of our granddaughters are good kids.

All of us have been saddened to learn of the death of Egon Borgmann, Doreen and Carl’s first exchange student from 1953-54. We were all comforted by the fact that he apparently died in his sleep with no pain or struggling. He had so many ailments that it could have been much more difficult.

Thank you again for your ongoing support and prayers.

Doreen: Direct!

2009-02-17T21:00:00.002-06:00

Dictated by Doreen to Judy on February 15

Doreen: On February 12th I had one cataract removed. There is not a lot of difference in vision, but I think it might be helping the dizziness some. The next day I went back for a check-up and they noticed a little piece had broken off, so they did it again. The next eye will be done on Feb. 26.

I appreciate having some say in what my schedule is—what time to go to bed and what time to get up.

Carl’s addition: There seems to be a shortage of aides to respond when she needs something.

Doreen: That is everywhere—just like nurses.

Timbercrest had a Valentine’s Day party on Friday. Carl sang “Because” to me. [Note—that is the song he sang as Doreen came down the aisle in their wedding. Carl said he could sing only one verse this time, because he was getting too choked up.]

There are interesting people we have met at Timbercrest—all kinds. All kinds of interests and backgrounds. One aide has an 18-month-old and a 5-year-old. She isn’t married, but she has been with the father for 7 years.

Carl: the culture is that of a caring community.

Doreen: Daniel (our grandson) can come over to visit. He just dropped in ten days ago.

All the mail is appreciated.

I am anxious to get home and see what else I want to bring—furniture and clothes.

Judy’s note: Both Mom and Dad seem to be doing very well. Mom seemed very positive and very aware of what was happening. She had started a project that was very reminiscent of the past; she was writing different words to a familiar song. It was for Dad’s Valentine. As she put it, she was writing other words to the “very romantic song” Ten Little Indians. We didn’t finish rewriting her words (she had written them, but they were not very legible), but the song started with “1 year, 2 years, 3 and 4; 5 years, 10 years, 60 and more; You’ve been my Valentine and I’ve been yours…”

Life at Timbercrest

2009-01-28T16:36:00.002-06:00

(Note: Doreen got moved into Timbercrest back in December and continues to make great progress. We'll post updates and pictures on the family gathering at Christmas, but here are some more recent reflections from Judy.)
by Judy

On January 19, Judy went to North Manchester to visit Carl and Doreen and to take Doreen to an appointment with Dr. Kachmann, her neurosurgeon. She hadn’t seen him for a long time, and Lori Zimmerman, Carl and Doreen’s new physician, thought it would be good to check with him and see if he could make sure that the continuing dizziness was not related to the shunt or any other treatable brain conditions.

[By the way, Lori Zimmerman is the daughter of Gary Zimmerman, who was the academic advisor and mentor for Judy, Karen, and Amanda when each of them was at Manchester. In fact, Lori was the baby on the blanket in the child psychology course that Judy took from Gary. Lori, her sister, and her parents also took part in Karen’s wedding, so it seems natural at the same time it seems strange. I wonder how that baby could be her parents’ physician!]

The appointment in Ft. Wayne went smoothly. Judy, Doreen, and Carl drove together and were able to use a wheelchair at the Neurology Clinic. Dr. Kachmann and his nurse Brian greeted us like old friends, and they were very pleased to see the progress Doreen has made. They pronounced the shunt as functional and seemed to feel that there was nothing unexpected in Doreen’s progress. We really did not learn much there, but we were glad to see that they were pleased and that things were functioning the way they should. And Doreen made a point to thank both Dr. Kachmann and Brian for saving her life. She also apologized if she insulted them with her joking before the last surgery they performed. She has heard (although she doesn’t remember doing it) that she asked if they were going to use a chain saw for the surgery. Of course, Dr. Kachmann and Brian both said that they appreciated the sense of humor.

A theme in Doreen’s thinking during that day and since then came from a message given by Joe Mason at chapel on January 18: “strength for today and bright hope for tomorrow.” She has been singing Great is Thy Faithfulness in her head since then, and she feels it has worked. She feels that she has gotten promising feedback from several sources since then, and feels she is getting strength for the days.

After returning to Timbercrest, Judy shared some birthday presents, although Doreen’s birthday was actually on January 25th.

The next day, Doreen saw Lori Zimmerman again, and this time she was diagnosed with a sinus infection. It could that this infection has been a factor in the dizziness. She is now being treated for that, and we all are counting for the treatment to be “bright hope for tomorrow.”

A few days after that, Doreen went to Grossnickle Eye Clinic in Warsaw to see if they could give her any information about her problems with her eyesight. What she was told is that she has some cataracts that should be removed. Actually, she was told the same thing by her eye doctor in Illinois earlier. That doctor had told her that she would tell him when it was time to remove them. She is now agreeing that it is time. After the cataracts are removed in February, her prescription for her glasses will be checked. Then they will see if anything else needs to be done. So some more “bright hope for tomorrow.”

A couple of weeks ago, Doreen also had her hearing checked. Not surprisingly to anyone in the family, she has a hearing loss. Next month, the hearing specialist will start working on finding the right hearing aids—and will check Carl’s hearing more closely. Having assistive devices could make a huge difference for both of them! All of these things were put on hold after the emergency last spring, but now it is time to get on with them!

Last week was the final week for therapy for the time being, because Doreen had reached a plateau and was not showing continuing progress. Some of the lack of progress could be blamed on the dizziness and perhaps on a brief bout of the flu the week before last. But Doreen’s response is that she isn’t sure if it is a success or a failure that the therapy is stopping. Is it because she has a accomplished so much or because she is accomplishing too little? In any case, she is hoping for continuing restorative therapy to keep strengthening her hands, arms, and legs and to keep moving ahead.

For her birthday today, Doreen and Carl were able to attend church with the Manchester congregation, the first time they had do so without their daughters. Kurt Borgmann, pastor in Manchester and son of Carl and Doreen’s first exchange student in the 1950s, picked her up. After church, Daniel (Karen’s son who is attending Manchester) and the Borgmanns went out to eat with Carl and Doreen at a local restaurant. It is wonderful to be able to do these more “normal” and familiar activities, even if there are many reminders that things have changed. We are all very grateful that Doreen has celebrated another birthday and look forward to many more!

In case you don’t know, Doreen now has a phone in her room. Let us know if you would like to have her number.

Finally!

2008-12-03T09:41:00.005-06:00

The family just got confirmation on Tuesday that Doreen has been accepted and will be moving to Timbercrest on Monday, December 8th! Karen, Linda, and Judy will all be there to assist with the transition. I'm sure they will provide a much more detailed report next week.

However, Karen has still not been able to get in touch with Carl to tell him of the news. She's continuing to try and call this morning.

Thanks for all you thoughts and prayers over the past 6 months. Doreen has made wonderful progress since her move to the Rehab Hospital and while she will be sad to leave the kind people there, she is very much looking forward to being in North Manchester.

Dear Carl Myers Travelers

2008-12-03T09:30:00.002-06:00

by Jim Garber

After this week we will have been at the task of providing rides for Carl to Ft Wayne for 16 weeks. I hope you know how thankful Carl, Doreen, and the whole family are for your generous rides.

Now, in consultation with the family, we believe it is time change our strategy. It is our plan to move from a style which demands special trips to a plan which, hopefully, can take advantage of occasional journeys that can combine your needs to be in Fort Wayne when Carl can ride along.

Here’s what we are suggesting: When any of you find yourselves heading for Ft Wayne for shopping, medical visits, or whatever, we encourage you to invite Carl to be a passenger. He can be dropped off at the hospital (he no longer needs someone to stay with him), where he can visit with Doreen and then return with you to Timbercrest on your schedule.

I expect I will remind you each week to include Carl in your travel plans when it makes sense to you. You can simple call or email me or phone Carl to set up the trip. My observation is that we are traveling often enough to provide a fairly regular ride for Carl.

If this raises any questions or reactions , please let me know. In the meantime I will look forward to our continuing serving Carl and Doreen in this more informal way.

Right of Passage

2008-11-26T12:39:00.006-06:00

by Clay
You may remember the first time you got to mow the yard, at least I do. It was a highly anticipated and memorable moment when grandpa trusted me enough to let me MOW! And he allowed me to help years before my dad did.

Here's a video of Cameron's first experience mowing this past weekend. He's quite excited about it.

(That high pitched whine is me using the leaf blower in the garage.)

Planning for the Future

2008-11-23T22:33:00.002-06:00

by Judy

Judy picked up Carl in North Manchester, and the two of them visited with Doreen today. After getting help with a kind family driving who helped Judy change a flat tire, she stopped at Timbercrest and helped to set up some new telephone and clock equipment for Carl. Then they surprised Doreen, who didn’t know they were coming.

The reports had been that Doreen was making great progress at the Rehab Hospital, and Judy felt that was accurate. Therapy sessions were done for the day, but Doreen was choosing TV channels and resting. The things that Judy noticed were that she smiled spontaneously more often than before, that she seemed more aware of what was happening and when, and she seemed to have a broader picture. Judy and Doreen worked on filling out a survey form related to Covington Manor (the place she was in for two months, lasting until two weeks ago), and Doreen seemed to be able to separate the experience there from the current experience and reflected very realistically on her reactions.

An exciting advancement is that the stomach tube has finally been removed! Doreen said that the doctor just “pulled it out.” She said there was some pain for about one minute, but then it was fine. So now she has two belly buttons, but the tube is gone!

One clarification involved the broken bone from the fall a couple of weeks ago. Apparently the broken bone was the bottom knuckle on the index finger of the right hand. The knuckle is still somewhat swollen and sore, but everyone hopes that the splint will be removed on Dec. 1 when she sees the orthopedist again. Doreen said that, if the splint is not taken away, she will ask if it can be taken off at least when she eats. That planning and suggestion is a great indication of Doreen taking charge of some of her care.

Crosswords are very important to Doreen at this point. She wants to do them as often as possible, and she continues to improve her abilities. She has been able to give answers to the puzzles at times throughout the last six months, but she is now able to remember recent clues and anticipate how the words may cross each other. And she still does it almost entirely in her head, because it is hard to her to see the grid and the clues. Her eyes are improving, though. She read most of a card that Judy brought, but after reading a couple of paragraphs, she seemed to lose her place or find it difficult to focus.

Doreen also continues to talk about going home and wanting to do things related to her old life, but that reflection is no longer as unrealistic and impractical as before. She no longer thinks she slept in people’s homes, that she will be going to the National Older Adults Conference when she has not yet slept anywhere besides a hospital or treatments center, or asking where she should get gas tomorrow so she can drive home. Now when she talks about going home, she says she would like to be in her home again for a little while, but she realizes it wouldn’t be like before. She wants to talk about Christmas plans, but she is planning for events at Timbercrest rather than Elgin or Camp Emmaus.

There was quite a bit of discussion about the progress she is making. There was clearly a smile when she heard about what others thought she had achieved, but she also talked about how she wished it were faster. She has come a long way, but she adds that she has a long way to go.

Birthday with Daniel

2008-11-20T12:36:00.003-06:00

by Daniel Myers-Bowman (freshman at Manchester College)

On Sunday, I helped Grandpa Carl celebrate his birthday by taking him to visit Doreen in Ft. Wayne. A friend of mine was kind enough to lend us a car. We spent much of the day doing crosswords, which seem to be getting much easier for her. For Carl's birthday dinner, we brought in some Chinese food, which we all enjoyed very much. Doreen's condition gets better every time I see her. The Rehab hospital is able to meet all of her needs quite well, from what I could tell. The nurses responded very quickly whenever she needed help, and treat her with great care. I think she is in a good place for now, while we wait for her to be able to move to Timbercrest.

Birthday Greetings

2008-11-15T15:56:00.002-06:00

(The photo at right was taken during Carl and Doreen's 60th anniversary celebration during the summer of 2007.)

Tomorrow, Sunday, November 16, is Carl's birthday. If you get the chance, you can post a message here for him to read. My guess is that he'll be in church in the morning then headed to Fort Wayne to visit Doreen. All of us want to express our appreciation for all the support and encouragement you've given dad over the past 5 1/2 months.

Progress and Patience

2008-11-12T21:57:00.003-06:00

November 9 & 10, 2008
by Judy

(Doreen is pictured here with her roommate for the past several weeks.)
Another move! As of yesterday, Monday November 10, Doreen has moved to Lutheran Rehabilitation Hospital of Fort Wayne. We saw this as an exciting move ahead, but Doreen was not so sure. (This blog entry focuses on Judy’s experience with Doreen on Sunday and Monday morning.)

On Sunday Judy drove from Lafayette to see Doreen and help her pack. She arrived a little while before supper and found Doreen alert and visiting with fellow residents. Doreen was concerned about getting food for Judy and asked the staff to order a tray. Although the food was less than special, it was good to share the meal, and nice to see Doreen interested in taking care of other people’s needs. Doreen did well with feeding herself much of the time, although her movements were somewhat spastic and jerky. She was pleased that she didn’t spill anything! The splint on her right hand (from the fall and break from a couple of weeks ago) was largely responsible for the awkwardness.

Judy had not seen her mother for two weeks, and the change was remarkable! She moved around much more accurately and comfortably, she was talking well and sitting a bit more calmly, and she seemed to be much closer to the old Doreen. But she still has a long way to go!

Judy packed things and helped Doreen with crossword puzzles. She did very well with medium-level puzzles and wanted to keep working on them. She also asked to look at greeting cards as they were taken off the wall.

When Judy first called to say that she was coming, Doreen asked some questions about the move to the Rehab Hospital. She had talked with some former residents who said that they had been at the rehab hospital and that the staff make the residents work really hard. So Doreen asked if they would make her go to the bathroom alone and get herself in and out of bed alone. She was worried that she would be expected to do things she didn’t feel she was capable of doing. That nervousness was also an issue when she asked if she would get any help with eating. It seems that she doesn’t remember much of anything from her earlier stay at the Rehab Hospital, except maybe that she wasn’t ready to be there and felt pushed beyond her limits.

On Monday morning, Judy and Carl arrived at Covington Manor to get ready for the move. After packing up last-minute items, having an exit interview with someone from social services, getting discharge papers from the nurses, and taking one more trip to the “lost clothing room” (where we found none of her missing items), Doreen and Carl were picked up by the Rehab Hospital van, and Judy drove behind. We arrived at the hospital at the same time as Linda, who was coming from Illinois. Items were stored in drawers and the admissions and nursing staff asked questions. Then it was time for lunch and a very different dining room. Then the baton was passed to Linda.

November 1 update

2008-11-09T20:58:00.001-06:00

November 1
by Judy, Karen, & Linda

DOREEN’S RECENT “ADVENTURE”
On Monday, October 27, Judy got a call from Covington Manor that Mom had fallen out of her wheelchair. The report was that she hit her head and had a bump on her arm. They were taking her to the ER at Lutheran Hospital to be checked out, since a bump on the head was not something to ignore following 4 brain surgeries.

Judy headed to Ft. Wayne, picked up Dad in North Manchester, and the two of them traveled on to Covington Manor. When they arrived, they noticed that she had a splint on her arm. There was a bruise on her left temple, but the more significant outcome of the fall was that she caught herself with her right hand and broke a bone—the thumb bone closest to the wrist. The splint goes all the way up to her elbow, so it is rather awkward. But neither the head nor the arm was causing her a significant amount of pain.

The story of the fall is that Mom wanted to watch TV, but she dropped the list of channels. She bent over in her wheelchair to pick it up off the floor, and she fell out, hitting her head against the open bathroom door and catching herself with her hand. Like the last time she fell, she said, “I did a dumb thing.” Her roommate was gone when she fell, and there were no staff members in the room, so she scooted on the floor on her back up to the door to let someone know she needed help. Her chair alarm was going off, too, so she did get help. The fact that she could respond that quickly to ask for help is a very good sign!

Mom saw an orthopedic doctor on Wednesday and was told she will have to wear the splint for several weeks while the bone heals. We are pleased that it is a splint rather than a cast. It is removable for showering, etc. It makes it difficult to feed herself, but they have made special utensils available to her and she is able to feed herself.

During the rest of that day (Monday), much time was spent with crossword puzzles. We had hoped that therapists and activity staff would do puzzles with Mom regularly since we brought up that activity at the last Care Plan conference, but that has happened only twice. On Monday, Judy and Mom (with some contributions from Dad) completed 3—one easy, one medium, and one hard. Mom is still having difficulties with double vision, so all of her contributions to the puzzle completion were done verbally, but she is still capable of “seeing” the puzzles in her mind!

Monday evening Judy and Dad stayed until Mom got in bed. She was given two Tylenol PM, so she should have slept well that night, and we hope that the awkward splint was not too annoying. She would like to always have someone there when she goes to sleep. The family wishes we could fulfill that request.

NEXT STEP: TIMBERCREST?
On Tuesday morning, Judy joined 5 members of the Timbercrest staff/administration to discuss their current thinking regarding admitting Mom and to talk about Dad’s living situation. Karen and Linda joined the meeting by telephone conference call. Although we were hoping for a final decision, Timbercrest was not ready for that yet, but they did say are willing to admit Mom—just not quite yet. They generally do not admit residents directly to health care, but their census there is down right now. However, they have a few long-term residents who may need the open beds because they are facing health care issues. They said that they will be in touch with us in two weeks, if not before. And they still did not guarantee that we would know for sure in two weeks.

There was also discussion about Dad. The family reported that they think he is doing very well there and that his functioning has improved along with his sense of well-being since he has been a resident. Timbercrest is ready to admit him as a permanent resident, but we will not take that step until it is sure that Mom can join him at Timbercrest.

We are all hopeful that we are getting closer to finding a permanent, shared home for Mom and Dad. The support and positive thoughts sent that direction are very much appreciated!

Family Fun Time (with video!)

2008-10-19T20:25:00.009-05:00

It's been a long time since we posted an update: sorry for the delay. Karen, Linda and Judy are all back to work and don't see Mom and Dad very often. Plus, their situations have stabilized somewhat so there are fewer changes to report. However, this makes for a L-O-N-G entry this time.
by Linda, Judy, Karen

DOREEN’S FIRST FIELD TRIPS – OCT. 10 & 12
Last weekend was homecoming weekend for Manchester College and much of the family was able to gather in North Manchester. Karen, Clay and Cameron drove in from Kansas. Amanda and Aaron flew in from New York. Linda and Lee drove in from Elgin and picked up Parker in Chicago on their way. Judy and Dick drove in from Lafayette. Daniel is living in North Manchester as a student at the college. (Unfortunately, Kelsey, living in New Jersey, was not able to take time off from her new job and Stephen and Cosmo were not able to join us from California.)

For the first time since her brain hemorrhage, Mom got to go on a field trip! On Friday afternoon Karen and Clay took her from Ft. Wayne to North Manchester and she was able to see Carl’s apartment at Timbercrest Retirement Community for the first time. She enjoyed being there and immediately (within a few minutes) asked to sit in her recliner that had been brought from home, falling asleep within minutes (or so we thought: see video at end of post). Dad, Mom, Karen, and Clay had supper in a Timbercrest dining room, and then joined the rest of the family at a concert at Manchester College. The MC choir and band were joined by alumni. The choir included Daniel—a current choir member, Amanda—a 2003 alum, and Judy—a 1975 alum. It was a fun experience and Dad loved being able to show off his "date" to the many, many friends who greeted Mom.

She enjoyed the concert, but got restless pretty quickly. She is dealing with a sort of “restless body syndrome.” She often “rocks” back and forth in the wheelchair and/or asks to be walked around. By the end of the evening, she was tired, but felt good about the visit and wished she didn’t have to go back to the rehab center. On the way back to Covington Manor with Clay and Judy, she asked Judy to work on a crossword puzzle with her. She said that would help her relax, but she wanted to be left with a challenging clue so she would have something to think about as she went to sleep! For the entire 40 minute drive, Judy would read a clue and indicate how many letters were in the answer. It was amazing how many times mom would know the answer almost immediately. (She would often beat me to the answer: Clay)

On Sunday, Judy and Karen picked up Mom early so that she could be in North Manchester in time for church. She sat in her wheelchair in the back because she needed to move her chair back and forth or be walked around, but she appreciated the sermon and was again greeted by a long line of friendly and supportive people. After leaving church we went to Timbercrest for lunch. 13 family members and the five members of the Borgmann family (Kurt is pastor at the Manchester church and the son of Egon, an exchange student who lived with the Myers family in the 1950s) shared lunch, fellowship, and stories in Dad’s apartment and the lounge on Dad’s wing. Mom could sit in her recliner, watch TV, laugh at grandchildren, or sleep. We just “hung out,” and it felt good. Mom did very well and hopes to be with her family more often, but it was very difficult for her to go back to Covington to be alone again.

MOM’S “CONDITION”
Mom is having some challenges keeping her spirits up. She says she gets lonely at Covington. She also has begun to realize that she will not be able to do all the things she used to do. She told Karen, “I miss my life – I really loved my life!” It will come as no surprise to anyone who knows her that she feels like she needs to plan something. And she misses Elgin. While we are sad that she feels sad, this is a step forward. Even a few weeks ago, she was not truly aware enough of the situation to be sad. This is a great indication that her brain is healing!

On Friday afternoon (Oct. 10), Karen, Clay, and Judy attended a Care Plan meeting at Covington Manor for Mom. Some helpful information was shared, but the meeting was also rather frustrating for us, because the information we receive can be inconsistent. While her swallow study came back with the “all clear,” she is still having some trouble with occasional gagging. She is eating a regular diet but is quite tired of the limited selection (especially because she does not eat red meat and often ends up with a micro-waved and rubbery piece of chicken).

As those of you who facilitate Carl’s visits with her know, she often asks for fast food as a treat. She will then eat with gusto and enthusiasm – quite entertaining to watch. She will now and then announce she is done in the middle of her meal and then suddenly attack her meal again with verve. They have no good explanation for any of this.

During the Care Plan meeting, the staff reported what they called “impulsive” actions in her behavior. While she is doing very well with moving herself in the wheelchair with her feet, she does not steer accurately nor look carefully to be sure she will not run over something or someone. Earlier in the week, when she had been left by herself in the bathroom, she got impatient and decided to stand up on her own. Unfortunately, she fell and hit her head. Another report was that some aspects of her behavior are inconsistent—she is sometimes eager for working during therapy and other times wants to slack off. These concerns seem to hinge on her inability to consider consequences of her actions. As a result of the damage to her brain, she exists so much in the moment.

Concerns that the family has are: 1) this rather “negative” assessment of Mom’s behavior, 2) the lack of understanding of brain injury this seems to show, and 3) inconsistency and a seeming lack of coordination in the treatment at Covington Manor. In addition to the situations we described above, at the Care Plan meeting, the staff said that the PEG tube was no longer being used for feeding. However, that evening, a nurse came in the room with a bag of the “food” for administering overnight. We questioned her, and she looked at the chart and said that there was no order to stop the feeding. Apparently she was being fed through the PEG tube every night. We brought this inconsistency to the attention of the administration. Since then they have suspended the feeding and we have declined any further use of the tube. We wonder why and how often there is miscommunication.

THE FUTURE?
Considering our concerns, we are anxious to move Mom into a situation that is more supportive and with which we feel more confident about the level of care. Therefore, on Friday, Oct. 10, Karen met with administrators at Timbercrest to make the formal request of moving Mom there. She will need skilled nursing care and rehabilitation, so it will not work to have Mom and Dad in the same room yet, but it will be great to have them in the same community. We were told that there are some openings in the healthcare unit there and that they would evaluate the situation to determine whether Mom can make the move. The Director of Nursing visited Covington Manor on Thursday to review and evaluate Mom’s condition and needs. The administrative staff will meet on Monday to discuss what she found.

We should hear by the beginning of this week whether Mom may move to Timbercrest. It would be wonderful for Mom and Dad. He would be able to walk down the hallway to visit her! We are counting on everyone to send your thoughts, prayers, suggestions, and support in that direction.

The video is of Carl reading mom a letter he had received from Howard Royer. Near the end, even though it appears that she is sleeping, she asks in a shallow voice: "Who wrote that?" Listen all the way to the end!)

Weekly Update

2008-09-23T14:35:00.006-05:00

September 20, 2008
by Judy

On Saturday Judy, Daniel, and Carl visited Doreen. They discovered that Doreen had a new hairdo. Doreen said that she had her hair cut a couple of weeks ago, but Carl said Saturday was the first time he saw the style. Which one was accurate? Only her hairdresser knows for sure…

Doreen's intestinal challenges continued, but the elevated temperature was gone. She did have several tests on Wednesday. The nurses said that the only thing that was found was a urinary tract infection (UTI). They explained that UTIs in the elderly can have lots of other impacts, many of which Doreen showed. In addition, one nurse explained that the move away from the tube-feeding also could result in some of the intestinal discomfort. So hopefully things will improve as Doreen's body adjusts!

Because some of the therapy sessions were cancelled during the week due to Doreen's exhaustion and discomfort, she had some sessions on Saturday. Some happened before the family arrived Saturday, and the report was that she had worked hard. Later in the afternoon, the family watched as she rode a bike. It is a machine that can measure how much work is being done by each leg. The challenge is for the rider to make the bars on the display even. Doreen rode for 20 minutes. The substitute therapist was surprised that it looked like the left leg was stronger than the right. She thought that Doreen had a stroke that had affected the left side. Judy explained that the event was a brain hemorrhage rather than a stroke, and that Doreen had alternated between the right side and the left side being stronger from one time to another.

Then Doreen sat in her wheelchair, put her hands on her knees, leaned forward, and tried to lift a leg to move the foot in and out a few inches. It was hard work, and she tried to use her hand to help now and then, but there is definite progress occurring!

The discussion with the therapist seemed to lead Doreen to need to talk again about what had happened to her. So she and Judy discussed the brain hemorrhage again. We have all learned a lot about the issues, but this stretches the understanding of all of us!

Saturday's food request was Wendy's, so Daniel and Judy brought in food, and the four ate together in Doreen's room. She ate well, but not much, because she was dealing with some stomach cramps and didn't want to overdo it. At supper, Carl sat with her and helped her eat. The appetite stimulant has been discontinued, though, because the problem doesn't seem to be appetite any more. Unfortunately, some gagging has reoccurred, but hopefully that is just temporary.

(FYI: the Myers-Bowman family will be traveling to N. Manchester for MC Homecoming festivities on October 10-12. We'd love the opportunity to see friends during the day on Saturday. We're hoping to get there in time to hear Daniel and the A Capella Choir on Friday night. We'll also be spending time with mom in Ft. Wayne and trying to visit my new grand niece!- Clay)

Weekly Update

2008-09-17T20:56:00.003-05:00

Sept. 17 Update
by Judy

None of us has been to see Dad or Mom in person for a few days, but we have gotten some reports to post here. The reports come from staff at Covington Manor and from Dad by phone.

First, an exciting advancement occurred on Monday. Mom was taken to St. Joseph hospital for a swallow study. That involves sensors and X-rays to make sure things are going where they are supposed to go when she swallows. The study gave her a high grade—she is swallowing fine. So…she no longer needs thickening in everything she drinks! She can have regular thin tea, regular milk, water, and all other sorts of ordinary drinks. Hurray! She has been very patient with nectar-thick liquids, but she was really ready to move on!

A call from Covington Manor this morning indicated that Mom is eating well as long as she gets help. They stopped feeding her through the feeding tube last week, because she had been saying that she wasn’t hungry at mealtime. Apparently, that decision was a good one. She is eating better. One nurse said she fed Mom all weekend and that she ate virtually her entire meals as long as she had assistance with her meals. The Center wants to monitor Mom’s weight for another week and make sure she is stabilized before they remove the tube, but we may be getting close to the time that we can get rid of that thing!

Dad’s report from today was that Mom was weak and had extra problems with tremors and weakness in her arms, so more tests were done to identify the source of the problems. We will pass the results on when we know them.

Dad is doing well at Timbercrest, but he really would rather be in the same place as Mom. He has enjoyed movies and other programs, and he reports that it is a very supportive and family-oriented place. He has help with his medications and his eyedrops and gets lots of attention. If only we could find a place for both Mom and Dad to be under the same roof! Both of them have expressed that they have been lonely. The visits help, but we all want more for them. Thanks for the cards and messages. That all helps!

Weekend Update

2008-09-08T14:29:00.003-05:00

Saturday, Sept. 6
By Doreen (as told to Judy)

Doreen asked Judy to contact Clay to update the blog. (Note that she has not seen the blog much, but she knows about it and wants to keep it updated. We are looking forward to the day that she can write her own updates!) Judy asked what she thought should be reported on the blog, and below is what Doreen listed:

She walked about 100 feet using the walker on Friday. She also took about 60 steps through the parallel bars with minimal support. She wanted to tell you all that the therapist said that she was making exercises look easy that other people in her situation find really difficult.

She has used the T-Stim (an electronic stimulation tool to stimulate particular muscles with electrodes) a couple of times to improve her swallowing. She thought it was helping.
She is eating well, but she is getting a little tired of some of the food!

Judy’s report:
Mom is clearly getting stronger. The transfers from bed to wheelchair and back are smoother all the time. She requires only minimal lifting and assistance (depending on how tired she is at the moment). We took some walks in the hall, and she “walked” the wheelchair part of the time, but she does have to work extra-hard to get her left leg to do an equal amount of pushing.

On Saturday, Mom’s eyes were closed much of the time again, and she seemed quite tired. It may be that she needed to catch up from, working hard over the course of the week, or maybe she had not slept well the night before. She did express some frustration with being isolated from everyone, because she doesn’t have a phone. She does have a phone in the room, but she can’t reach it easily and would have difficulty with dialing and holding the receiver to her ear. Judy called some family members on her cell phone and let Doreen talk for a while. It helps for her to feel connected. The cards help with that, too.

Again, thank you for your continuing support. It makes a difference for all of us as we struggle through the uncertainty of the future.

Break the Habit

2008-09-03T17:08:00.003-05:00

Check out this site and sign up to break the bottled water habit.

Weekend Update

2008-09-02T16:06:00.008-05:00

Tuesday, September 2, 2008
by Clay

Karen, Cameron, and I returned late last night from a long weekend in Indiana. Our primary activity was to drop Daniel off at Manchester College for the start of his first year. We also spent lots of time with Carl and Doreen. Karen and her sisters are working on getting a much more thorough update, but I thought I'd give you a few observations, for a change.

The photo to the right really tells the whole story. It was taken after a walk outside with Carl and Daniel. Realizing that the sun was very bright, the only sunglasses available were ones that I use for running and biking. Doesn't Doreen look spiffy? At the time I took the photo, she was very tired from the walk: foot rests were forgotten and she needed to either pull herself along or lift her legs. I'm sure her abs and quads were sore the next day. She said that she really enjoyed being outside for a change and appreciated being able to just sit comfortably.

The other highlight (two really) was Doreen's appetite. I'm sure Karen will have a much more detailed account, but on Saturday, we brought in food from Taco Bell and ate with Doreen in a conference room. She exhibited a tremendous zeal in eating her chicken taco salad, chips, and cinnamon crisps. On Sunday, the family ordered Chinese food and ate together in a room adjoining the one from the previous day. The photo here is Daniel helping mom with balancing her food on the spork (a nearly useless utensil when eating a salad).

Talk about zeal!!! Doreen seemed to attack the noodles and other food with abandon (exhibiting little of her former decorum). According to Karen, her sisters, and Carl, they've not seen Doreen eat so much food since the hemorrhage.

Karen and I won't be returning to Indiana until Manchester's homecoming on October 11th. As Doreen continues her progress, your cards and visits will help fill in the gaps and keep Doreen focused and engaged in her recovery. Thanks for all the kind words and thoughts.

Monday Update

2008-08-26T08:04:00.002-05:00

August 25, 2008
By Judy

Today was another moving day, but this one was a move to a lot more independence! First, Doreen and Judy made the trip in her Honda. Nurse Sally wheeled her to the car and helped her into the passenger seat. Everyone said goodbyes. The seat belts were fastened, and Doreen held a small jar of flowers in her hands during the whole trip (almost half an hour).

After arriving at Covington Manor, a nurse from Covington Manor transferred her to a wheelchair again, and Doreen entered the rehab center. This center feels much less like a hospital and more like a place to work and socialize. The therapy room was full of people working hard on large and small muscles. When Judy left at lunchtime, residents were seated (many in wheelchairs) around square tables, waiting for their meals to be served.

The meals come on trays, but the staff serves the food to the residents like in a restaurant. Doreen’s concern was whether someone would help her eat. The lunch attendant assured her she would get help. It appears, though, that the participants are expected to do as much as they can for themselves. Apparently Doreen was expected to transport herself to and from meals. That is great exercise, but she may need to have a little more supervision at this point. At supper she had spilled some tea on herself. When she got back to her room, she fell from her wheelchair as she tried to change her pants. She didn’t get hurt, but the procedures will be a little more supervised for a while!

Doreen is in a semi-private room, but she does not have a roommate at this point. Visitors are welcome, but it would be good to coordinate and make sure that there are not too many visitors at once. And some of the visit may consist of watching therapy sessions, because much of her day will be spent in that way. Meals are at 8, 12, and 6.

Over the next couple of days, Carl’s younger brother Dick and wife Barbara will be visiting, so that will another fun distraction and also a reminder about the motivations for the work. Next weekend many families will be together for Labor Day and wishing Daniel a good send-off to Manchester College.

Sunday Update

2008-08-25T11:25:00.002-05:00

August 24, 2008
By Judy and Linda

My, my, my! What a whirlwind of emotion and activity this weekend. Mom's sudden improvements meant finding a new "home" after the acute care hospital that she no longer needs. She is more alert and conversant than we have seen her in a lo-o-ong time. Several skilled nursing facilities were toured so we could make an informed choice about moving Mom to more extensive rehabilitation and therapy services. We settled on the rehabilitation unit at Covington Manor at 5700 Wilke Road off west Jefferson in Ft. Wayne. It was difficult to decide from many wonderful options. We realized we could search and search for the perfect match forever. We opted to make a decision that was as good as possible in the time we had and relied on input from many sources before choosing a very respected facility for the next stage of Doreen's therapy. Covington came highly recommended and feels like a good next step. Judy will move her in (by transporting her in her car!—another first) on Monday morning.

We are excited to hear what the next accomplishments will be for Mom. At Covington Manor, they will not let her get away with asking to go back to bed. They do therapy 7 days a week, they expect residents to eat together in the dining room, and Mom will not be able to just ask to go back to bed without a lot of prodding and encouragement to keep working. They even have a Wii that is used for therapy!

We thought at first that this would be a step toward a more complete rehab facility, but this program is called Homeward Bound, and the expectation is that residents will go to their home setting after therapy here. So we hope this is the final address change before a final home that will bring Mom and Dad to the same address!

Dad has been enjoying Timbercrest. He has attended choir practice, has made a number of new friends and connected with many old ones, and is learning to negotiate the rhythms and routines of the Timbercrest community. There have been a few bumps in the road, but we hope to smooth those out.

One more thing we have done is to engage the services of a geriatric care specialist who will advocate for us and help to coordinate all the myriad services and agencies we still need to negotiate. Now that we all need to return to work and school, this specialist will also be able to be present when we can’t and can be a local person in case of emergencies. We wish we would have had this help earlier!

Let us know if you need more information about finding the new facility. And thanks to Jim Garber for helping to manage all your generous offers of help to carry Dad to see Mom!

Thursday Update

2008-08-21T22:07:00.008-05:00

August 21
by Karen

We have had quite a flurry of phone calls over the last several days and lots of information has flowed between the professionals in Fort Wayne and the 3 Myers daughters! Last week (Aug. 13) we were told that the Progressive Hospital staff expected Mom to need about 3 more weeks of care in their facility before she would be ready to move to the next step in her journey. Yesterday (Aug. 20), when they called to update me about Mom's progress, they indicated that she had made remarkable progress over the last week and is ready to move to another facility now. Wow! We felt a bit of whiplash with that news. We are not ready yet! Where will she go?! How do we know what is best for her?!

We are currently investigating the options available for Mom's care. We have been advised that she needs to go to a skilled nursing facility for awhile in order to build her strength and stamina to the level needed for her to return to a rehabilitation hospital. (Of course, we are having to pay CLOSE attention to the Medicare rules and regulations now that Mom has been in care for 84 days!)

Linda and Judy will both head to North Manchester and Fort Wayne this weekend to visit the potential next homes for Mom. The choice needs to be made as soon as possible, because Mom needs to move by Monday or Tuesday next week at the latest.

Stay tuned for the next episode of Search for (Doreen's) Tomorrow...

P.S. I apologize for all of the exclamation points. I guess that communicates some of the intensity of the emotions we are feeling right now.

Saturday Update

2008-08-17T21:27:00.001-05:00

August 16, 2008

On Friday, Carl had traveled to Progressive Hospital with good friends Dorotha and Joe Fry Mason. One of the positive aspects of the trip was that the doctor who had given such a gloomy prognosis several days before made a point to talk to Carl and say that he felt Doreen was doing very well and was making good progress. Carl wasn’t sure how much weight to put on that statement, but he appreciated the effort.

Judy and Dick traveled to North Manchester on Saturday to see Carl and to take him to see Doreen. They spent some time in the apartment to help get things arranged in a helpful and useful way and also did some shopping to get some helpful aids. After 3 ½ days in the apartment, Carl had an idea of some things that worked well and some other things that felt more awkward. It is challenging for someone who has not lived alone for decades to figure out how to manage schedules and spaces. Staff members at Timbercrest and all the family members have worked to find ways to accomplish that goal. And now that Carl has a phone, he feels that he can have contact with the people who are important to him. Contact a Myers family member if you would like his number. (And he has an answering machine, too.)

The trip to Ft. Wayne brought some new and welcome surprises. First, Doreen was behind the nurses’ station in a wheelchair when the family arrived. They said she had been singing for them. Apparently, she was singing Twinkle, Twinkle, Little Star, Jesus Loves Me, Amazing Grace, and some other selections. Although therapists do not come to the hospital on the weekends, this adventure served a therapeutic function. Singing exercises the vocal cords, and those muscles are closely related to muscles that control swallowing.

Another surprise was that Doreen had eaten two bowls of soup overnight. She couldn’t tell the family what kind of soup it was, though, because she didn’t remember eating it, but the accomplishment was clearly documented by the nurses. They also told the family that Doreen is now at the “one-person assist” level when getting in and out of bed and when using the bedside facilities. They said that she could almost do that alone if her balance was better. So she is getting stronger and we are moving ahead!

The family helped Doreen with supper, and the eating was not as good, although one nurse challenged her to eat two more bites after she thought she was full. This was a step up from the old challenge to eat one more bite. Actually, Doreen ate three more—of apples with peanut butter. And the wit was still sharp. When Judy asked the question she used to ask her children—“Do you want me to cut your sandwich into triangles or rectangles?” Doreen answered “Hexagons.” No, Judy did not do that.

One of the things that Judy and Dick had brought along was in response to an earlier request. She had asked if they could bring a copy of a video of Aaron and Amanda (Judy and Dick’s children) singing “The Prayer.” They had done that as a duet at Amanda’s senior recital at Manchester in 2003. After Doreen watched the DVD on a laptop computer, she said, “I will use the same statement my father used [after his great-grandchildren gave a Christmas program for the family]—It’s as close as you can get to heaven without being there.” Family means so much to Doreen, and so do friends. Thank you for being there for her and for Carl.

Tuesday Update

2008-08-13T09:24:00.003-05:00

August 12, 2008
by Judy

Today is primarily an update on Carl. This is the day when he became a Timbercrest resident. He is now living in B-7 of the community. He had medical exams and packed all the things that he had with him at the Bucher Bed & Breakfast (thanks for all the wonderful hospitality there!) and unpacked them in his new apartment. He found the Rose Garden dining room and began to learn the procedures there, met the nursing support staff, and even emptied his wastebaskets (after a few hours of being there). He has had greetings and visitors, and has already had an invitation to deliver a message at a worship service. This will be a wonderful home for him! We hope Doreen will join him soon.

Now that the Myers daughters are gone from N. Manchester for the next days, it will be important for others to help Carl visit Doreen. We are very grateful that Jim Garber offered to coordinate the schedule of those people who are willing to make that trip from Timbercrest to Progressive Hospital in Ft. Wayne. As we have said, the visits should generally be short. Now that Carl is in his new residential setting, he will need to notify the food service if he will miss a meal, and it is asked that he notify them 24 hours in advance. So a trip in the middle of the morning or afternoon would be fine. Three or four visits a week would be great. Please let Jim Garber or us know if you are willing to help with these trips.

Tomorrow’s update will provide more information on Doreen.

Sunday & Monday Update

2008-08-12T15:18:00.003-05:00

August 10 and 11, 2008
by Judy

On Sunday, Carl and Judy attended the Manchester church and then enjoyed being taken to dinner by a friend before going to the hospital. When they arrived, they found that Doreen was being fed the full 75 cc's an hour through the stomach tube. She was tolerating the process well. Her interest in food had not continued to grow, though. She was back to eating a few bites a meal, and she was not talking about cravings. This easily could have been because she was getting fed constantly through the PEG tube, so her stomach was full. Judy asked if the feeding through the tube could be stopped during meals, but the nurses said that the orders were for continuous feeding, and they could not change that. But they did say that they would pass our request on to the doctor, and some hinted that they agreed with our request.

Doreen was going back to wearing more normal clothes and fewer hospital gowns, so Carl and Judy went shopping for some more simple lounging clothes. They also looked for something that would meet the need of the latest request from Doreen--chocolate-covered, peanut-butter-filled pretzels. She insisted that she had found them the day before and that we just need to get them out of the cabinet. Actually, she had found them in May and brought them along on her trip to Indiana. The rest of us enjoyed that fact, and we finished eating those snacks a while ago. (Little did we know that we would get "caught.") But we looked for something simlar.

On Monday, Carl and Judy arrived in the morning shortly before the physical therapist. He worked on rolling back and forth, seeing if Doreen could do that on her own. He said she did much better than before, but that kind of motion is problemmatic for her. It causes her to feel some dizziness and vertigo. But she did not vomit, and she has not done so for a few days. That is getting better!

The doctor was also doing rounds when the family arrived, so Judy talked with him about the idea of stopping the feedings during mealtime to encourage appetite and the eating of regular food. His first response was that he would not do that, because she needed the feeding. He said he had done this many times, and that he knew better than we did. Judy said that he knew the medicine better than the family did, but that she knew Doreen better, and the she had seen interest in food in the past few days for the first time in weeks, and she wanted to take advantage of that. The doctor said that he would do whatever we wanted, but made it clear he thought it was wrong. Judy then asked how long he anticipated Doreen would be in Progressive, and he said she would be there for 25 days. She asked what kind of placement he thought she would be ready for when she left, and he said that she would need skilled nursing care for the rest of her life and suggested that she would not get much better than she is now. He said that she has severe brain damage. Unfortunately, Carl had walked up during this conversation and heard the doctor's statement.

These statements contradicted what we have heard from almost every other professional we have come in contact with. Yes, there was clearly brain trauma, and there will likely be lasting brain damage of some kind. But everyone has said that it will take a long time to find out what kind of damage has been done, and recovery is a very slow process. There is always hope, and hope is one of the most powerful medicines Doreen can receive at this time. Judy was not willing to accept the doctor's prognosis, but Carl was devastated by it and started to second-guess his decision to move into Timbercrest.

Judy talked to Carl afterward and pointed out that she felt those were very irresponsible statements. Some of the staff talked to Judy and Carl to check out how those statements had been received and also to point out that they were seeing real progress and didn't agree with the doctor, either. Kurt Borgmann came to visit, and he also talked about the long recovery and progress with his father after his auto accident and brain injury in March. He has seen amazing but slow and steady progress in his father and reminded us that progress is still be in our future. Later, the hospital administrator and head nurse had a conference with Carl and repeated many of the same reassuring comments. As frustrated and angry as we were with the doctor's comments, the responses and support from the rest of the staff were affirming and hopeful.

All three therapists--physical, occupational, and speech--came while Carl and Judy were there. Although Doreen had her eyes closed again for much of the day, she did very well in all of her therapies. She continues to amaze everyone with her memory. As Judy was filling out forms, Doreen was able to provide phone numbers, e-mail addresses, and zip codes from memory, impressing the speech therapist. During her speech therapy, she was building her speech and swallowing muscles by yawning, puckering, and smiling in succession. She had done that for a while when she called for Carl. He wasn't in the room at that moment, but Judy went to get him. When he came in, she used her index finger to beckon him. He asked what she wanted as he stood next to her, and she said, "I don't want all this puckering to be for nothing" He gave her a kiss, saying the first one was her idea, but then gave her another, saying it was his idea. Doreen did have a couple of food requests again--bagels, and lettuce spread with peanut butter.

Tuesday is the day for Carl to have a physical exam and to move into Timbercrest Retirement Community. It will probably not be possible to fit in a visit to Ft. Wayne. Wednesday, Judy needs to be at work in Lafayette. So we are counting on the loving hands of the Manchester community in Timbercrest and beyond to support and nurture Carl and Doreen and provide them with opportunities for contact. We will share information here in this forum by Tuesday evening or Wednesday about how the support will be coordinated. We rejoice in the way we have been enveloped in this caring community. Once again, thank you!

Saturday Update

2008-08-09T20:51:00.001-05:00

Saturday, August 9, 2008

Carl was not feeling well today, so Judy went to Ft. Wayne alone and let him rest and recover some level of strength. Other than that, this was a great day! Doreen was alert and very conversant. She complained of a little discomfort now and then in her stomach—especially when coughing and sneezing, but that makes sense after a surgical procedure. We referred to the stomach tube as an umbilical cord, and it serves much of the same function. But, as Doreen said, “they probably wouldn’t want to take stem cells from this one.”

The hospital personnel started the tube feeding overnight. They are giving her something very similar to baby formula. They pour it in a bag that that infulses the formula through a tube that looks like an IV tube, but it connects to her stomach tube (also called PEG tube). She was getting 30 cc’s an hour at first, but because she was tolerating it well, it was bumped up to 45 cc’s.

The best news of the day is that something seems to have stimulated Doreen’s appetite. Judy didn’t get the full story regarding the oatmeal that was requested yesterday, but Doreen did say that she got oatmeal either for supper or for breakfast. Judy tried to help Doreen eat her lunch, but she didn’t want much. Then she started talking about Chinese food. She seemed really hungry for that. The nurses checked with the kitchen, and they didn’t have anything like that available. Judy and Carl had been to a nearby Chinese restaurant the night before, though, so Judy suggested she make a run to get carry-out. Doreen then said that we should make a list. She came up with 5 dishes that we should get. Judy asked how many people we were feeding, and Doreen said she wasn’t sure. It ended up that Judy got 3 dishes, and Doreen wanted chopsticks, too. The bedside table was set up so that both of them could eat together, and Doreen probably had a half cup of food. She fed herself some of it with chopsticks (although she needed a little help)! When she was done, she said that she just didn’t want any more, but she also said it was very good. Some of the leftover food was put in the refrigerator for other meals or snacks. The daughter of another patient a few doors down had had the same experience with her mother, a woman who was not eating but who ended up eating 2/3rds of her daughter’s Italian carry-out meal. This trend doesn’t say much for the hospital food, but it provides a great strategy!

Doreen watched several events of the Olympics. Before Judy arrived, she was watching some of the equestrian events and was telling the hospital staff about how her father used to show Tennessee Walking Horses. She also watched some swimming, women’s saber fencing, and basketball. When she wasn’t watching TV or sleeping, she talked about needing a motorized wheelchair to attend the National Older Adult Conference; unfortunately, that conference occurs in two weeks, and she will clearly not be able to attend. Her response to hearing that she won’t be able to go was some frustration and also some puzzlement about the timing of everything. When Judy explained that Doreen really needed to work on sitting up to be able to do all the things she wants to do in a wheelchair, she said, “then I will work really hard on those exercises.”

After the dinner in the room, Doreen seemed to be exhausted. She fell deeply asleep. But after two days of her talking about food in a positive light, we are all encouraged and hope to see more steady changes. Once we stoke that engine again, though, we better watch out!

One final note—we heard from Timbercrest that Carl may move in on Tuesday after his doctor’s appointment. It will be great for him to be in a place of his own where he doesn’t feel that he is in someone else’s way—even though we have been welcomed with very open arms and treated like family. The hospitality has been genuine and humbling. We feel we have made new friends and have gained new family members. But it has always felt temporary. This move will allow Carl to begin to feel that he is home. And we look forward to continuing the strong new (and on-going) relationships as we move to another stage!

Wednesday-Friday Update

2008-08-08T21:38:00.000-05:00

Wednesday-Friday, August 6-8, 2008

On Wednesday, Judy needed to be in Lafayette, and Carl spent the day with friends in North Manchester. On Thursday, Carl was able to visit the hospital with Dorotha and Joe Fry Mason. The reports are that the therapy went very well both days.

Today (Friday) was the day for putting in a stomach tube to assist Doreen’s eating. Although we expected the procedure to be done at 10:30 a.m., we were told on Tuesday that the time was changed to 8:30. So we left North Manchester at 6:30 to get to the hospital by 7:30 to accompany Doreen. When we arrived, we found out that there were glitches in the plan, because Doreen apparently pulled out her PCC line overnight (although she was sure a nurse had done it—there was no record of that). Because the line was out, she did not get her IV nutrition most of the night. Because the IV nutrition is basically sugar water, it raises her blood-sugar level, which means she needs insulin. Because she did not get the IV nutrition beginning at 1:30 or so, she had gotten insulin she didn’t need, and her blood-sugar level was now too low. This is one of the benefits of the stomach tube—she should be able to get back to normal blood-sugar regulation!

After the hospital gave Doreen an injection of dextrose, we headed to another hospital (Parkview) to get the procedure done. When we got there, we ended up waiting a long time, until the doctor came to do the procedure at the time we were originally were told—10:30. But before they did the procedure, they found out the blood-sugar level was very low again, so they needed to give more dextrose. The procedure went very well, but it took a long time for Doreen to wake up. When she finally started to come back to the present, her blood-sugar had dropped again. But an advantage of that was that she did something she hadn’t done for weeks—talk about food! She talked about oatmeal and hash browns. (The hospital ordered oatmeal for her supper. We will ask tomorrow if she actually ate it.)

After talking with different doctors and trying other things, more dextrose was given, and Doreen really started to wake up, so after 6 ½ hours we got back to Progressive, even thought we expected the procedure and transport to take 45 minutes. Now we will see if the procedure will help with eating. She will still be able to take food by mouth, but they will provide a steady input of nutrition through the tube. If she takes enough by mouth, they can stop using the tube.

Carl and Judy will be able to visit daily for a few days now and will send updates as we see the progress.

Tuesday Update

2008-08-05T23:18:00.000-05:00

Tuesday, August 5

Today Judy, Dick, and Carl continued to deal with some of the business issues with Carl’s prescriptions and preparing for the move to Timbercrest. Then we traveled to Ft. Wayne.

It was a fairly quiet day after a very noisy night. Storms moved through North Manchester around midnight, so the Bucher clan and Judy and Dick moved to the basement of the Bucher’s home for a while. The basement is where Carl has been sleeping, but he missed the party and didn’t even realize we had come down. But the storm passed without damage.

Apparently, Doreen had another bout of nausea during physical therapy in the morning, but no other problems with it during the rest of the day. Occupational therapy went very well and included an audience part of the time—the Buchers and two of their grandsons. Unfortunately, speech therapy did not go as well. After starting well with lip and vocal cord exercises, Doreen fell asleep and was not able to wake for the end of the therapy session. She had worked hard in the other sessions, so maybe it was just too much to expect another. Her eating was similar to the past several days—about 10-15 bites per meal. All of the therapists commented on improvements they had seen in the last several days, in spite of the struggles. Slow and steady progress….

The final plans were set for the surgery to insert a feeding tube. It will be done on Friday at 10:30 in Parkview Hospital. Doreen will be treated as an outpatient, getting the treatment and moving right back to Progressive. Hopefully, the tube will help to free her from the IV feedings, keep her blood sugar more balanced, and allow her to build more strength to complete her recovery.

We will now be moving into a new stage of routines and different levels of support from the family. Judy, Linda, and Karen need to get back to work and other family responsibilities. Judy will be able to be present during the surgery on Friday, but there will be days when none of the daughters will be available. We appreciate the caring from the larger community who have been visiting Doreen and supporting Carl. We hope Carl will be able to move into Timbercrest by next week, but there are still a few tasks to complete before then. We are deeply grateful to Darlene and Gordon Bucher for housing all of us during all of this time, and also for being a support system for Carl when the rest of the family is not available over the next several days.

Many of you have offered to transport Carl to Ft. Wayne to visit Doreen. Your generosity is welcome and humbling. We do have some requests regarding how the visiting should be handled, however. First, it is not necessary for Carl to visit every day. The visits can be emotionally exhausting, and growth and improvements are not as obvious with very frequent visits. Also, we ask that Carl not be left at the hospital alone. It would be best for those who are willing to transport him to take him for short time and remain with him during that time. It would be fine to take him along on other errands and activities during the trip. We all need to be reminded that there is another world outside of the hospital! If you are interested in helping with some of these trips, please coordinate those trips through a family member at this point. Later, we hope to have a small group of friends at Timbercrest who can serve in this role. And we sincerely hope it will not be too much longer before Doreen and Carl can be in the same location!

Look for the next post on Friday night after the surgery, unless something dramatic happens between then and how. Thanks for all of your continuing care and support!

Sunday & Monday Update

2008-08-04T20:50:00.003-05:00

August 3 & 4

by Judy and Dick

(Judy and Dick thought they could bypass me and submit a post without getting their picture attached. They forgot that I'm the administrator of this blog! - Clay)

On Sunday, Judy and Carl went to church in Manchester, Karen and the boys drove back to Kansas, and Linda and Lee brought a truckload of furniture from Illinois. The apartment at Timbercrest looks great with chairs, a bed, end tables, and pictures on the walls (among many other things), and Lee and Linda did a great job of moving it into the truck and then into the apartment by themselves and arranging it as if it looks like it was always there. The Kansas group made it home in great time, and the church experience was very satisfying and included visits with many friends.

After church, Carl and Judy headed to Progressive to see Doreen. She was drowsy when they arrived, but seemed to perk up when the rest of the family arrived. The goal was for her to be awake when her brother Jay and his wife Peg arrived. They arrived right on the dot at 1:30, the appointed time. Actually, Doreen was anticipating the visit anxiously. During the night, she had squirmed out of bed, ended up on the floor, and pulled out her PCC line in the process. She thought she was going to her computer so she could catch up on the details of the visit. (She told us that she understood there was a lot of informaiton on the computer about Jay coming.) So we are still dealing with some confusion between dreams and reality, but she really was excited to see her brother!

Jay came with his cell phone and connected Doreen with her cousin Dot and her childhood and college friend who is also a Dot. He also came bearing gifts--a can of mandarine oranges. He has been reading the blog!

We had a great visit, and Doreen stayed aleart and witty during most of the time. She and Jay are not likely to stay away from teasing very long. As Carl, Jay, Peg, and Judy went to supper, Jay expressed how pleased he was to see how well Doreen was doing. It was a good day!

On Monday, Judy had an appointment in Lafayette, but Carl went with the Buchers to see his future apartment. He was pleased to see his furniture and to see how well things fit. They also worked on trying to get a physical exam set up for Carl so that he could be approved to move in. They didn't make much progress. When Judy and Dick arrived, she and Carl worked on some other issues with prescriptions, and the three of them stopped by Timbercrest to see the apartment and to get a copy of the form that needs to be completed. Then they went to Progressive to find Doreen fairly drowsy.

Monday had seen some good sessions with OT and PT and a more modest session with speech therapy. Lee and Linda visited when they dropped off the moving truck in Ft. Wayne. Doreen had eaten well--maybe 15 bites a meal and much of her tea. By the time the family arrived, she was pretty tired. Supper was not as successful. The family shared photos of the apartment with her, though, and she seemed interested, but had a hard time picturing it from the photos. A little later, she seemed to be thinking and quiet. Judy asked what she was thinking about, and she said she was thinking about what she wanted to do with the apartment. So she seems to be getting used to the idea of the move.

We also were told this evening that the decision has been made to do the stomach tube for feeding. We will find out tomorrow when that will be done. It feels discouraging, but there could be some positives. It may mean that she will not need the insulin shots that are necessary when she is given the dextrose through IV. And it may help her get her stomach in shape for more food. And it will mean she is not tied to an IV. So we continue with the slow and steady progress--keeping in mind that, though it be slow, it is steady.

Friday and Saturday Update

2008-08-03T12:02:00.002-05:00

August 1 & 2
by Karen and Daniel

Friday was another sleepy day for Doreen. They gave her a sleeping pill once again last night; therefore, she could barely wake up throughout the day. Only one therapist came to try to work with her. An occupational therapist woke her up by sitting her on the side of the bed. She then worked with her balance and led her through some arm exercises. Mom/G'ma had a hard time staying awake, but she persevered as well as she could. She showed her sense of humor throughout the session by teasing Daniel -- and anyone else in the room. She did wake up some in the afternoon. She held conversations with us for awhile, but was still rather foggy most of the time. The CEO worked with Mom/G'ma during meals again. She continued to get Mom/G'ma to eat more bites than we probably would have been able to get in her.

Parker came to visit again late in the afternoon. He stayed with Dad/G'pa while we went to Camp Mack to pick up Cameron from his week there. They had a nice dinner together and ran a few errands before heading back to North Manchester for the night. Judy also returned to North Manchester Friday night.

Saturday's visit was made by 5 members of the Myers clan - Dad/G'pa, Judy, Cameron and the two of us. When we arrived, we received the unwelcome news that Mom/G'ma had vomited when taking some medication this morning. (The medicine is a liquid that tastes very bitter. It is intended to stimulate her appetite!?) The good news is that she was awake most of the day! She had her eyes open and rested only periodically for short times here and there. It was great to be with her throughout the day and feel as though the real Doreen was with us. She asked lots of questions of the boys about their camp experiences. She asked Daniel to show her some things on the computer. She talked to us about what has happened over the last two months and about what is coming in the future. She was very playful with the occupational therapist when he visited. She had two more episodes of vomiting, but they were not overwhelming. She was able to control them and they did not get in the way of continuing with whatever activity she was in at the time. She also ate again today without complaining. She didn't consume much, but she ate what she could. All in all, this was a great day!

We got to speak with the doctor on Saturday morning. We asked that he discontinue the sleeping medications and the stimulants to see what Mom/G'ma can work out on her own. (It was frustrating to feel that she was always fighting the effects of one of the drugs - either fighting to stay awake through the effects of a sleeping pill that lasted too long or trying to relax and sleep despite the effects of the stimulant.) He agreed; therefore, we'll monitor how she does without these interventive medications over the next few days.

A note about Dad/G'pa -- He paid the deposit on a room at Timbercrest on Friday. Linda and Lee will bring a truckload of furniture and household items to North Manchester on Sunday. Dad/G'pa will move in to the one bedroom apartment (B7) as soon as he can get the required physician's exam completed. We will try to get that done ASAP so he can begin to have a place to call his own and move on into the next phase on his life.

Wednesday and Thursday Update

2008-07-31T22:24:00.003-05:00

July 30 & 31
by Karen and Daniel

We have encountered a very tired Doreen for the last two days. It seems that she has her days and nights switched right now - she is awake at night and then needs to sleep most of the day. This makes it difficult to meet the goals she is trying to reach of eating and regaining strength and skills through therapy. We are concerned about the use of medications to try to address this problem. We have asked that they consider taking her off of the stimulant and sleep aids to see if she can straighten this out on her own. We will see if our request is heeded by the physician.

On Wednesday, she was able to wake up enough to participate in physical, occupational and speech therapy sessions, but at reduced levels from the previous two days. On Thursday, however, she could barely stay awake enough to sit on the side of the bed, to move to a chair and to "ride" the bike pedals during physical therapy late morning. The speech therapist arrived around 2:00 for his session, but we couldn't get Mom/G'ma to wake up at all. We could tell that she was trying to rouse herself, but that she couldn't break through the fog of sleep. Luckily, the occupational therapist was not scheduled for today, because we feel confident that he would not have been successful in his efforts either.

The good news is that she ate better, especially on Thursday. The hospital's CEO has taken a personal interest in helping Mom/G'ma eat. She wants to do everything she can to help Mom/G'ma avoid the feeding tube - that decision will be made next Tuesday. Therefore, she came to Mom/G'ma's room for both lunch and supper on Wednesday to feed her herself. She got Mom/G'ma to eat about 8 bites at lunch and then 10-12 bites at supper. This also gave her the opportunity to talk to Mom/G'ma about what foods sound good to her and to try to learn what will help her eat more. Mom/G'ma told her that the food served at meals is too heavy. She would like something lighter to help her begin to eat again. By suppertime on Thursday, the CEO had arranged for Mom/G'ma to have a fruit plate with sliced apples, bananas, mandarin oranges, pineapple, plums and cottage cheese. When Mom/G'ma saw this, she smiled and she ate about 20-25% of her meal! We feel very lucky to have so much care and concern shown by the staff of Progressive - from the cusodial and secretarial staff, to the nurses and therapists, and even the top administrators.

Visitors always seem to help Mom/G'ma perk up. She opened her eyes and smiled to greet Katy McFadden on Wednesday afternoon. On Thursday, she became more interactive and alert when her grandson Parker showed up at the hospital unexpectedly. She also perks up for the "visits" she has through the continued flow of cards and greetings sent by all of you. These contacts continue to be the best way to help Mom/G'ma remember why she needs to work hard throughout this recovery period -- there are so many people who love her and need her in their lives. Thanks for keeping those encouraging thoughts coming our way! (It is also EXTREMELY helpful for Dad! He feels very blessed and humbled to have the support and prayers of so many loving friends and family members.)

Monday and Tuesday Update

2008-07-29T22:30:00.001-05:00

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.

Weekend Update

2008-07-27T22:43:00.003-05:00

July 26 & 27
by Karen

This weekend has been one filled with waiting. The weekend staff at Progressive continued to get to know Mom. They tried several different medications and other tactics for reducing her nausea and increasing her tolerance for food. It was especially successful on Sunday - there were no episodes of vomiting. They also were letting her rest - no therapies. They did get her up to sit in a chair several times on Sunday just to keep her moving and minimally active. However, because she has had no nutrition since the IV feeding was discontinued Friday morning, she is losing some strength and energy and has enjoyed the opportunity to rest.

On Sunday they put in a nasal-gastric tube. They will begin to feed Mom through that for awhile - hoping to abandon the IV feeding altogether. If it works sufficiently, they may be able to avoid a more permanent feeding tube, but right now that is a distinct possibility. That decision should be made sometime this coming week.

Linda returned to Indiana on Sunday, bringing Karen's older son (Daniel) along. He spent the last week at Camp Emmaus, but will stay in Indiana to be with his grandparents for the next week. He will return to North Manchester in August to begin college at Manchester. (Cameron left for Camp Mack for this week.) Mom really perked up when Linda and Daniel arrived. She has been quite alert the last several days and has held extensive conversations with Karen about relevant and timely topics. It's great to see the Doreen we know and love begin to reemerge in a more significant way than we have seen for quite awhile.

We look forward to Monday's visits from the speech, occupational and physical therapists. Once the entire team has had a chance to meet Mom and assess her needs, they will create a plan for her stay at Progressive. We will be glad to really get started on moving forward again.

Thursday and Friday Update

2008-07-25T21:49:00.001-05:00

July 24 & 25
by Karen

These two days have continued the roller coaster loop-d-loops. On Thursday morning we learned that the rehab team had determined that Mom needed to move to an acute care center. They had a hard time making the decision, but felt that her medical needs should receive top priority at this time. They told us that they hope she will return to the rehab hospital once the medical problems have stabilized - in a few weeks - to continue the progress she has been making. However, we would rather see her go into Timbercrest as the next step, if at all possible, so she and Dad are at the same place and to eliminate the drive from North Manchester to Fort Wayne.

Mom continued to complete 3 hours of therapy on Thursday, and those sessions continued to be successful (other than the vomiting episode during occupational therapy this morning). She walked 20 feet again today with the walker and the PT. The therapist remarked that Mom was relying less on her for balance and support - another bit of progress.

We took Mom to her check up with Dr. Kachmann (the neurosurgeon) Thursday afternoon. He was pleased with what he saw in her CT scan from Wednesday. He saw evidence that the shunt is working correctly and found nothing to concern him regarding her healing from the surgeries. This was good news. We were hoping to get some advice from him about her future treatment, but he clearly does not enter into that part of his patients' care.

Friday was move day. Mom was transported from the Rehab Hospital to Progressive Hospital of Fort Wayne at about 9:30 this morning. She rode in a wheelchair-accessible van. She seemed to tolerate the move well, until we transferred into her bed in her new room. At that time, she had a gagging incident. (Not such a great way to start her stay in a new facility.)

Once we were "settled" into the new building, not much happened today - no therapy or other sessions. Instead, we filled out lots of paperwork and retold the story again and again of Mom's journey since May 29. It was a difficult day for Dad and me. We had the distinct feeling that we were moving backwards instead of forwards. She is back in a hospital gown. No one was encouraging her to do things for herself. She was allowed to use the bedpan, rather than getting up to a bedside commode or to the bathroom. No therapists were encouraging her to eat or walk or use her vision, etc. A new doctor with many questions and no history with Mom and her needs. After two weeks of the rehabilitation focus, this felt odd to us. However, it seemed that it was a bit of a reprieve for Mom, at least for today. She showed relief at the opportunity to not work hard. That's understandable!

Mom welcomed the visits from Robin and Jeanette Lahman and Darlene and Gordon Bucher today. They all remarked that she was more alert and interactive today than they had seen her before, even a few days ago. We agree that she has been awake more fully and more often over the last few days. This is probably a result of the medications they are giving her, which also make it hard for her to sleep at night. Therefore, the doctor at Progressive is going to try a different medication to attempt to correct for this issue.

The address for sending Mom cards is now:

Doreen Myers
c/o Progressive Hospital of Fort Wayne
2626 Fairfield Ave.
Fort Wayne, IN 46807

For those of you coming to visit from N. Manchester, here are driving directions:

As you enter Fort Wayne from Rte. 24, go past the Lutheran Medical complex to the next stoplight. Turn right on Engle. You will need to follow Engle for 5 miles or so until you come to a "T" at Bluffton. Turn left onto Bluffton and follow it around a park to Broadway - turn right. Get into the left lane immediately so you can turn left onto Rudisill. Go to the third light and turn left onto Fairfield. Progressive Hospital is about half a mile farther, on the corner of Fairfield and Pontiac. It is on the lefthand side of the street. Turn in the driveway past the hospital and drive around to the west side of the building to park and then enter through the main doors. A receptionist will greet you at the front desk, ask you to sign in on a visitor's log and give you visitors'tags. Mom is in room 216.

Wednesday Update

2008-07-24T12:26:00.003-05:00

July 23
By Karen

(photo is Cameron and Karen at Universal Studies, Florida, this spring)

WOW! The roller coaster ride that we are on has reached a section of loop-d-loops! Mom had a terrific day today. She went to Lutheran Hospital for a CT Scan this morning; therefore, she was not in her room when Dad, Cameron and I arrived at about 10:00. When the nurse wheeled her in, Mom’s eyes were wide open and she was quite alert. This was a very welcome surprise for us. She greeted us all right away and began to ask questions about the day and to tell us about her excursion to the hospital. We discovered that they have discontinued the Valium and have begun to give her Provigil – a medication that will help stimulate her and encourage alertness. So far, it’s working!

Mom had a great session with the occupational therapist soon after she returned. This was exciting to watch, because the therapist conducted the same activity today as on the first day – matching the mosaic tiles to patterns on a card; however, this time she had the help of Cameron, Mom’s 11-year-old grandson. She began with the same pattern that she had given to Mom on the day of admission to the rehab hospital (red, green, red square tiles in a horizontal row to form a line). If you remember, Mom had seen a triple image of that pattern – a 3x3 square rather than a single line. This time Mom replicated the pattern easily. What a relief! This shows that her eyesight is improving. The therapist then moved on to more complicated patterns. With Cameron’s encouragement, she completed 3 more. As the patterns became more difficult, it took more energy and effort, but she kept with the task and showed the highest level of motivation for this type of task that we have seen so far.

Lunch consisted of a bite of pear that stimulated the gagging to which we are growing accustomed. It was not an especially distressing experience, but her inability to take in nourishment continues to worry us all.

During her physical therapy sessions she exhibited more improvement – even when compared to yesterday’s leaps ahead. The therapist taught Mom how to propel herself forward in her wheelchair by digging her heels into the floor and “walking” along the hallway in her wheelchair. This time she was responsible for all of her own forward movement – rather than the past attempts when the therapist actually did most of the work. Mom also was responsible for navigating her way. This meant that she ended up running into the wall on her left over and over, but she learned how to get out of that situation, as well as how to avoid it. This was gratifying enough for us to see; however, after she got herself to the gym, she walked with a walker and the therapist for 30 feet! This is a 50% increase from that first walk down the hallway she took yesterday. Throughout this entire session, Mom had her eyes open again. She seemed fascinated by the sights she was taking in. Her left leg often crossed the center line to the right, but she seemed to get the hang of it about half way through.

As you can imagine, all of these activities indicating Mom’s forward progress have raised the question of whether she really needs to leave the rehab hospital for an acute care facility. The team will meet tomorrow morning to review everything and they will let us know sometime after 10:30.

Another exciting moment was when I was sharing today’s greeting cards with Mom. For the first time she could read the words printed on the cards! She struggled with the handwriting, but the printing from the cards was clear and readable for her. This, coupled with the mosaic tile exercise today, shows us that her vision problems are beginning to improve.

In anticipation of a possible move, we visited the second acute care option in Fort Wayne, Progressive Hospital. It is a completely different atmosphere than what we experienced at Select, the facility we checked out yesterday. Progressive is in a newly renovated building and began accepting patients only in March. All of the rooms are private – they are spacious and beautiful. They also can easily accommodate the needs of the family members and friends when we visit. We feel strongly that this would be the better environment for Mom and our family. We’ll see what the outcome of tomorrow’s meeting will bring. Stay tuned…

Monday & Tuesday Update

2008-07-23T20:59:00.002-05:00

July 21 & 22
By Karen

(Note: this photo of Karen and Clay was taken in the Rockies two years ago. It seemed appropriate on a day that reached 100 degrees in Manhattan.)

The baton was passed from Linda back to Karen on Monday. Karen had returned to Kansas for a few days to attend the Friday and Saturday evening performances of the musical The Pajama Game, in which her son Daniel had the lead (Sid Sorokin). Then she brought Daniel and Cameron back with her – this time driving from Kansas to Illinois and then Indiana. She dropped Daniel at Camp Emmaus on Sunday for Senior High Youth Camp. She and Cam stayed overnight in Elgin, and then they arrived in Fort Wayne early Monday afternoon.

Monday and Tuesday have been full of ups and downs! Monday’s big occurrence was a surprise announcement late morning from the rehab hospital staff. They had determined that Mom is not meeting the criteria to remain in this facility. Her medical challenges (especially the nausea and inability to eat, the dizziness, and the lethargy) have been interfering with her ability to fully participate in the 3 required hours of therapy each day; therefore, she has not made the progress they would like to see. Mom has medical issues that they are unable to address adequately with the staff they have available at the rehab hospital. For instance, they think Mom should be seen by a GI specialist to determine if there are digestive issues causing her nausea and vomiting. They do not have the capabilities to investigate and treat GI problems at this facility. Therefore, they are recommending that we move Mom to an acute care hospital to provide her with the level of medical care she needs to build her strength. The hope is that she can then resume the level of rehab that she has been exposed to here – either by returning to the rehab hospital or at Timbercrest.

This announcement came as a surprise because of its timing. We knew that they held weekly conferences about each patient on Thursdays, but we had no idea they may make this kind of decision on a Monday. It was not especially surprising that they think her medical needs require further attention, however. We also have been feeling like we are fighting an uphill battle in order to get her to participate in so much therapy. This has been particularly exacerbated by the Valium, which does seem to help decrease the nausea, but makes her very sleepy and lethargic.

On Tuesday, Karen left North Manchester very early in order to “catch” the neurologist at the rehab hospital first thing in the morning. She was told to be here by 7:00 am if she wanted to be sure to meet with him. (He had been on vacation since the second day we arrived at rehab. Therefore, Mom’s case had been “overseen” by 4 other doctors from his practice, and none of them had communicated with us at all over those 10 days or so.) It was a good conversation. He helped to clarify what he saw as Mom’s biggest challenges and how the staff determines whether someone is making adequate progress. He made it very clear that he has Mom’s best interests in mind.

Dad and Cameron arrived about 10:00. Mom went through the day as usual. She had 2 vomiting episodes in the morning, but she was given some medication to prevent any more vomiting and she participated well in her therapy sessions throughout the day. She even walked about 20 feet with the assistance of a walker and of the physical therapist! Cameron provided great incentive for her. Having her youngest grandchild walk in front of her, encouraging her all the way reminded Mom of why it is important to work hard in the therapy sessions – she has a life outside the hospital to which she would like to return!

Dad, Karen and Cameron visited one of the two acute care facilities in Fort Wayne during the afternoon on Tuesday. We were pleased with the program and its focus; however, the facility itself is not very impressive. The rooms are very crowded and the nursing staff is forced to reside in the hallways. It was a loud atmosphere and seemed quite chaotic. We intend to visit the second facility tomorrow to consider and compare the strengths and challenges of each.

We are unsure of what the rest of the week will hold. Will we remain in the rehab hospital? Will we move to an acute care facility? Will we gain a better understanding of her medical needs? Will she make progress in her therapy sessions? Have we reached a plateau that we will not surpass? These questions are utmost on our minds and we will keep you updated as best we can. Thanks for your continued support!

Sunday Update

2008-07-21T08:42:00.002-05:00

July 20
By Linda

(Oops! We goofed. Uncle Jay and Aunt Peg are NOT here in Indiana this weekend. They are coming in August. Dad and I were so eager we jumped ahead too fast. We'll be tickled to visit with them in a few weeks.)

All the photos posted of me (with Kelsey, Parker, and Lee) this week have been from some event here in North Manchester over the last couple years. Way to go, Clay! You have now established a precedent. Can you sustain it?

Attending church here in North Manchester was such a kick. We knew BILLIONS of people there this morning whom we have known sometime during our 51 years in Northern Illinois (47 of those years in Elgin). Coworkers (Dad's and mine from each of our days at the church offices), camp director, elementary school principal, junior high cafeteria cook, music director, friends' parents, kids I babysat who are now parents, neighbors, yoga classmate, and on. The hugs and supportive atmosphere gave a really pleasant start to the day.

Mom had a reduced therapy schedule today because of Sunday staffing but progress was still achieved. We experienced the "Alexander" method (I'll have to google it) of respecting the way one uses one's body. Mom ate some part of all her supper offerings---salmon, rice, green and yellow beans, peaches, apple juice and hot tea (both thickened with modied corn starch to prevent choking--I'm not kidding). Then I was feeling glum about the amount Mom eats when I calculated that growing from 15 bites of food at yesteray's meals to 18 bites today is a 20% increase. That perspective gives me a whole lot different attitude about measuring forward steps. It has been a challenge each day to find the cup half full but I guess I was not always looking at the right cup.

I leave for Elgin tomorrow as Karen returns from Kansas to spend two weeks here in North Manchester. And Judy is back in the country after her 9-day trip to India. She and Dick came for the afternoon and evening. We will all be richocheting back and forth until our full-time school responsibilties resume. Our big project now is to see about establishing a real home here for Dad while the rehabilitation and healing continue for Mom.

Saturday Update

2008-07-20T12:32:00.002-05:00

July 19
By Linda

(I have to admit that part of my motivation for writing today is wanting to see what photo Clay finds to put with this when he posts it.)

Saturday staffing is completely different at the rehab center. Many of the nurses and therapists are unique to the weekends. Even the cafeteria is set up to feed just the patients but there is nothing really for family guests. I was concerned about being left in a holding pattern but I was pleasantly surprised how attentive and sensitive the "fill-in" staff could be. The therapy sessions were actually quite productive. Mom walked between the parallel bars 3 full lengths with the firm support of a kind of a sling around her back. She was engaged with the speech therapist and could repeat random sets of five numerals back to her after hearing each set just once. She sat on the edge of the table mat on her own for over half an hour, had her eyes fully open, and told the occupational therapist all about her children and details of each of her seven grandchildren, where they live, and what they are doing. (Who among you is at all surprised that she is most responsive when asked about her grandkids?) I am eager to see the main neurologist when he returns from vacation next week to see if we can't find something other than valium to work on her dizziness. She needs to be able to be fully engaged in her therapy process in order to gain back muscle strength. She is most alert and awake when the come around to give her the next ordered dose. That seems counterproductive, doesn't it?

Mom's brother Jay and his wife Peg come from Pennsylvania tomorrow afternoon. We are eager to spend some time together.

Friday Update

2008-07-19T09:19:00.002-05:00

July 18
By Linda

Therapy was the focus of the day. All six scheduled hours were completed in half hour segments with Mom fully involved and alert (except toward the end of the last session---she laid her head on the shoulder of the physical therapist and just snuggled there because she was so-o-o tired)!
She ate breakfast in the cafeteria with the speech therapist and consumed half a banana and the "ïnsides" of a piece of toast.

With the occupational therapist she stacked some plastic cup things with her left hand and placed wooden pegs in a large pegboard. [The personality of Mom shone through on that one. The therapist asked her to pick up one at a time from a plastic bin and place it in a row of the board. Mom continually picked up two or three pegs at once. That is clearly the way to save motion and she was not changing her logical way to approach the task for the purpose of therapy.]

She sat in the cafeteria again for lunch.

The physical therapist had Mom both sit on a padded table and stand in front of a mirror to work on posture as well as balance.

12 bites of supper were eaten in her room as she had finally earned a rest in bed after spending almost all of the day sitting in her wheelchair. (She wondered whose wheelchair she was in and then mentioned that she would need to have an electric wheelchair for when she goes shopping. I guess I'm glad she's thinking big!

Visitors continue to help inject some pleasant diversions into Dad's days of vigilant waiting. It is hard for him to see positive changes in Mom's condition when growth comes in small increments. We are ever so grateful for the kindness and support that has been offered to him and to the rest of the family. Our community of support (seen in the array of visitors and the wall where we have taped the get-well cards) is the talk of the hospital staff. We are deeply touched.

Thursday Update

2008-07-18T08:33:00.002-05:00

July 17
By Linda

Mom's eyes were open when we entered her room this morning and stayed alert for hours. What a nice surprise. She then sat for 3 1/4 hours in her wheelchair. Her neck and shoulder muscles are quite weak from so much time in bed so it was quite a feat. Everything is focused on getting her stronger and building more endurance.

She worked with the occupational therapist--finding her balance while sitting, handing balls back and forth with a variety of stretches, and persisting on a task.

She visited with her brothers- and sisters-in-law while sitting in her wheelchair--mostly listening but answering some questions and adding a few smiles.

She worked with a new speech therapist to retrain swallowing muscles. She got pills down again for the first time in several days (by drinking V-8 juice) and ate a dozen bites of lunch while sitting in the cafeteria.

She scooted down the hall using her feet some of the way (while the physical therapist pushed the wheelchair). Then she was able to kind of lean/stand/list between parallel bars in the gym with the physical therapist this afternoon.

After all this, she fell into an exhausted sleep by suppertime and could not have been less interested in my attempts to lure her into eating.

With all the participation in activities and the visits from his brothers, Dad feels much better today and his spirits seem renewed. He does certainly wonder what can be done to encourage Mom to eat more but we are trying to take pleasure in the accomplishments of the day. Maybe tomorrow will bring some more healing.

Wednesday Update

2008-07-17T09:34:00.001-05:00

June 16
By Linda

Today Karen tagged me as Parent Companion and went back to Kansas for a few days. After being away from Mom and Dad for 10 days, I find a few changes. The general atmosphere in the rehab hospital is less formal and rooms are sunnier which in turn makes for an encouraging and more hopeful spirit than in the neuroscience section of the larger hospital. Mom's hair on the right side of her head has grown to about a half inch and the surgical incisions are far less apparent and are healing nicely. Her cheeks are rosier and, even though she is often cat napping, she is occasionally able to participate and engage in conversations and therapy.

Unfortunately, many of our frustrations are the same. We don't get to see the neuorologist face to face (vacation, early morning calls, etc.) so we do not get the big picture. Therapy sessions are scheduled for half an hour to accomodate Mom's limited tolerance but two therapists might schedule their visits back to back. That means she still may fall asleep of wear out very quickly during the sessions she need in order to gain more strength. The nutrition issues are still difficult. She is receiving nutrients through an IV but who in the world wants to drink thick water (I can't even imagine getting it down) and the high level of dextrose sugars is throwing off her blood sugar levels. And Dad is constantly searching for the positive side20of situations where the negative impact is easier to see. Every decision seems to bump into another---dominos bumping over other dominos.

But we are encouraged by simple things. Mom worked with the occupational therapist to figure out how to take off and put on of her own knit shirt. This is a refreshing step forward from wearing hospital gowns. After having a very rocky start to the mrning today where she did not keep her breakfast down, a new medication (Zofran?) is working now to keep her stomach settled so she ate 5 bites of supper last evening. She sang Ämazing Grace" with the speech therapist.

Dad's two brothers arrived this evening for a visit which lifted his spirits immensely. It is difficult for him to want to engage in any activity besides sitting with Mom in the hospital and the more light-hearted diversion over supper was wonderful. The three brothers told boyhood stories and razzed each other and things seemed fairly "normal" for a few hours. They will all visit in Ft. Wayne with Mom tomorrow.

We approach each day with hope. We do what we can do. We take one step at a time on this challenging journey.

Tuesday Update

2008-07-15T18:04:00.001-05:00

July 15
By Karen

Today included both ups and downs for Doreen. As we entered the building this morning we were greeted by another rehab resident who was sitting outside reading the paper. She told us that she sat next to Mom at breakfast and that Mom was in good spirits. Next, the nurse told us that she ate a good breakfast (her whole bowl of mandarin oranges, a few bites of hot cereal, and a bite of Danish, but Mom wanted a roll with pecans). The nurse deliberately put Mom at a table with 2 women who held a conversation with each other across the table – she hoped that Mom would be stimulated by the interaction of these women. She said that this had worked and Mom had opened her eyes quite a bit to see what was going on around her.

The breakfast experience seemed to exhaust Mom. She slept through the attempts of the speech therapist to get Mom to wake up and work on her swallowing at 9:30. Donna already had planned to work with Mom over lunch and she rescheduled the morning appointment to the middle of the afternoon.

When the occupational therapist came to work with Mom at 10:00, she got her to awaken and transferred her into her wheelchair to work in the gym. Mom did a great job of sitting up on the edge of an elevated mat. She worked on her balance by picking up bean bags from a pile placed behind her back and handing them to me as I stood in front of her. She had to open her eyes to be able to hand them to me, and she did so of her own initiative. She even tried to toss one to me at one point! It was very satisfying to see her make this kind of move on her own.

Lunchtime was one of the biggest frustrations for us all today. The speech therapist sat with Mom to try to get her to eat. Unfortunately, with the first bite in her mouth, Mom began to gag and vomit. They ended up whisking her out of the cafeteria, taking her to her room to clean her up and change her clothes, and then putting her in bed. This experience completely wore Mom out. She slept for an hour or so to recover from this incident.

She had 3 successful therapy sessions this afternoon – 1 with the speech therapist and 2 with the physical therapist. She participated in her speech session with more enthusiasm and effort than we’ve seen for days. I was standing in the hallway outside of Mom’s room talking to my brother Stephen on the phone during this session, and I could hear Mom’s voice travel all the way out to me as she did the vocal exercises. This was exceptionally exciting! I ran into the room so that Stephen could hear her. He was extremely impressed to hear the strength of her voice. This was a real “up” for the day. The physical therapist worked with Mom on her leg strength to stand and transfer back and forth between the wheelchair and the bed and the wheelchair and toilet. Mom did quite well in these activities.

Supper resulted in no more than 2 bites of bread with margarine and apricot jelly and a few sips of water. She told me that she can’t think or talk about eating too much because it makes her nauseous. We are not pushing her too hard to eat at this point, because we need her to get over the nausea and think of eating in a positive way again.

Mom is continuing to show some signs of confusion. For example, she told me tonight that a friend of hers is pregnant. This is friend of hers from her Mt. Morris days in the late 50s and early 60s who has moved to N. Manchester with her husband during their retirement. I said, “Mom, she is not pregnant.” She replied, “Yes she is. She just told me during my therapy session this afternoon.” I said, “Mom, she is close to your age. Can she get pregnant now?” She said, “Yes.” I was startled by this answer, and asked, “Mom, can YOU get pregnant now?” She said, “Yes.” I said, “You and your friend are not able to get pregnant anymore, are you?” She said, “I know, but she is pregnant.” I asked more about where she got this information. She finally told me it was when her friend was helping her in the bathroom. Ah ha! Her physical therapist IS pregnant, and just shared that with us this afternoon. However, her name is Lisa and she is a young woman in her 20s, not a woman in her 70s.

Mom keeps us on our toes and we never know what each day will hold. I guess the one constant is – mandarin oranges! It’s nice to have something to rely on.

Monday Update

2008-07-15T09:27:00.002-05:00

July 14
by Karen
(pictured at right with Hjalti, our exchange student this past year)

When we got to the rehab hospital this morning, we found that Doreen was awake this morning. She began to be alert last night - after sleeping all day yesterday. She did have an episode of vomiting last night, but all in all we were told that she had a good night.

By the time we arrived at 8:40, she had already eaten 50% of her breakfast and was with the speech therapist. When Dad and I joined her in the speech therapy room, Mom had her eyes closed and seemed tired, but she was interacting with the therapist and was following her commands. They were working on swallowing exercises. They have determined that she should have thickened liquids (at the "nectar" consistency, for those of you who know about such things) to help her retrain her swallowing muscles. This should decrease the coughing that often accompanies her drinking. They are concerned that the coughing is a signal that some of the liquid is going down her wind pipe which can lead to pneumonia.

After an hour of speech therapy, Mom rested in bed for 30 minutes until the occupational therapist paid her a visit in her room. They worked mostly on balancing in a sitting position as she sat on the side of her bed. During this activity, Mom continued to say she was tired and wanted to lie down. The therapist allowed her to take a break about halfway through to lie down for a few minutes, but then she had Mom up again to continue the hard work. The therapist then let Mom sleep for an hour before she came back to get her into the wheelchair for a session in the gym working on her left arm.

For the first time, we ate in the cafeteria with Mom for lunch. It was exciting to think that this may indicate progress. Mom ate only about half a cup of mandarin oranges (surprise!) and a few bites of other foods. She continues to struggle with finding any interest in food and eating.

After lunch, Dad and I left the rehab hospital to travel to N. Manchester for an appointment with the nursing staff. Dad had to complete a "mini-mental" assessment before we can proceed with getting him in a one-bedroom apartment in the Manor at Timbercrest. It looks as though they have an apartment for him that would be ready within a week or 2 - as soon as he indicates his firm interest. We are very grateful that this option seems to be working out so well. Gordon and Darlene Bucher have been hosting Dad (and at least one of us) in their home in N. Manchester for about 6 weeks now. Their generosity has been incredible and our appreciation for their support cannot be adequately expressed! However, we are feeling as though it is important for Dad to settle into a place that he can call his own, with things from his home, where he can begin to move forward into this new stage in his life. It is difficult for him to think about moving to Timbercrest without Mom, but we continue to remind him that the plan includes Mom joining him at Timbercrest when she is able.

We took the rest of the day "off." We visited with Egon Borgmann and a few other Timbercrest residents and then spent the rest of the late afternoon and evening at the Buchers' relaxing and getting a few things done. We look forward to hearing how the rest of Doreen's day was when we return to the rehab hospital in the morning tomorrow.

Weekend Update

2008-07-14T10:12:00.003-05:00

July 12 & 13
By Karen

Saturday included a full therapy day for Doreen. She began with speech therapy for an hour in the morning. For the first time she was taken out of her room for this form of therapy. She also had a different therapist than she had been seeing. They held a long discussion about Mom’s activities and interests. Mom talked all about the crafts she makes for the Global Holiday Bazaar at the church, the Wednesday evening meals she makes at the church. And her love of word games and puzzles. Mom really seemed to enjoy this session. The therapist did a great job of drawing her out of her sleepiness by asking questions about topics that piqued Mom’s enthusiasm. (She had to take a little rest in the middle of the hour session, but she perked right up again after about 3 minutes.) The therapist also encouraged Mom to keep her head upright, rather than allowing it to loll to the left and back. This is an important exercise, because her sense of balance has been so severely impacted.

A physical therapist new to us visited with Mom for 2 half-hour sessions on Saturday. We discovered that she grew up in N. Manchester and has Brethren background. This created a nice connection between her and Mom. Mom was either in the bed or the wheelchair as they worked on her legs. The physical therapy work today consisted mainly of strength and flexibility exercises.

The occupational therapist saw Mom for only half an hour today. She took Mom into the gym and worked on balance while sitting and mobility with her left arm. We saw more movement in that arm today than we’ve seen so far! (Not great gains, but small and significant.) Mom had a hard time staying awake during this session, but she did the best she could.

Doreen still did not eat on Saturday, but the IV nutrition has calmed our worry about this for the time being. Saturday was the last day for antibiotics, so we hope that she will begin to regain her appetite and ability to taste in the next few days.

There is VERY LITTLE to report about Sunday. The Valium that they began giving to Mom on Wednesday, to ameliorate the balance and nausea problems, has apparently built up in her system and has completely knocked her out. She slept absolutely all day on Sunday. She was unable to respond with anything more than a slight nod the entire time Dad and I were with her (from noon until about 6:30). Luckily, no therapy had been scheduled for Sunday, because she would not have been able to participate. The only significant response we received was when we sang to her before we left. She sang with us for about one chorus and verse of “All Night, All Day.” That was great to see and it helped alleviate some of our disappointment with the day before we headed back to N. Manchester.

Dad is beginning to worry about what will happen next (in the big picture of things) and all of the work there is to do at the house in Elgin. It is difficult for him to travel to Ft. Wayne day after day and ride the roller coaster of Mom’s recovery without making what he sees as a real contribution to her progress. He knows that his presence is important to her, but would like to feel more involved as an active participant. We are considering what is best for him, as well as Mom, in the next few weeks. He is feeling as though he needs to return to Elgin for a little bit to “take care of business,” but he does not want to leave Mom. It provides quite an internal struggle for him.

Thursday and Friday Update

2008-07-12T11:29:00.001-05:00

July 10 & 11
By Karen

The first 2 full days at the rehab hospital have been very busy. Doreen is kept moving by the therapists and nursing staff – sometimes without her enthusiasm (to put it mildly). She has been scheduled for 1 hour of each kind of therapy (speech, occupational and physical) each day. Sometimes these sessions include leaving the room to go to the gym or to a therapy room, while other times they remain in her room to complete the set tasks. The staff also tries to get Mom out of bed other times, if possible – for example, to the cafeteria for a meal. She is no longer allowed to merely lie around to recover. She is now expected to be an active participant in her own healing process.

Doreen participates in the therapy pretty well for about half an hour at a time. When the therapists have attempted to hold hour-long sessions, she often becomes too tired to cooperate after the first half hour. She even falls asleep mid-sentence or in the middle of a set of exercises! She rests quite a bit in between the sessions. This indicates that she is working hard, but it also results in fewer opportunities for conversation and interaction with us (as compared to when we were in the hospital). This can leave Dad and me feeling like things are not moving forward, because our interactions with her have decreased. However, we continue to remind ourselves that the progress she is making now occurs as a result of the deliberate exercises within the therapy sessions rather than in our communication with her. We feel confident that she is in the right program and facility and that her progress, while agonizingly slow, will continue.

Doreen still has quite a bit of difficulty eating – in other words, she’s still not eating anything. Therefore, she is now receiving nutrition through an IV. It provides her with the calories, vitamins and minerals she needs. This is a great relief to us. (We discovered on Thursday that she had lost about 22 pounds since this adventure began.) Being tethered to an IV pole inhibits her mobility, but the trade off is worth it.

The neurologist who is now overseeing Mom’s care (Dr. Jody Neer) has indicated that he wants to address the vision/balance issue and the food intake/nutrition challenge before pushing too hard in therapy. He recognizes that these are foundational issues that we must solve in order for her to gain the strength and basic skill she needs to move forward with rigorous therapeutic efforts. We appreciate his approach and continue to watch for signs of improvement in these basic areas. Her course of antibiotics will be complete tomorrow (Saturday). This should help reduce some of the possible side effects (tin-like taste in the mouth, upset stomach, bowel irritation) that may be hampering her energy level and ability to eat. We hope to see improvement in these areas in a few days.

Mom continues to show quite a bit of confusion at times. As an example, we received a call from a rehab nurse Friday morning as we were traveling to Ft. Wayne. She told us that Mom had fallen out of bed during the night Thursday. Luckily, she was not injured in any way. She got her feet slung over the side of the bed and then pulled on the side rail enough to shift her weight in a way that caused her to slide off the bed onto her bottom. She ended in a sitting position up against the bed. There was an alarm on Mom’s bed that immediately alerted the staff of the situation. When they arrived in her room, she told them that she was sure that it was her brother Jay’s birthday and she needed to get up to check the calendar to confirm this idea. (Yes, July 11 is Jay’s birthday. We had talked about that during the day on Thursday when we were discussing the July 10 birthdays of several people who are close to Mom – Jessica and Hoa, for example.) The fall, of course, was distressing news to us. It was not all that surprising, because we have seen the confusion that leads to this behavior. However, the rehab staff indicated they would have someone sitting in Mom’s room overnight to help prevent this kind of incident. We were told there was a “sitter” in Mom’s room on Wednesday night, but they had seen nothing that caused them any concern, so they did not have a “sitter” on Thursday night. As you can imagine, there will a “sitter” in Mom’s room each night again until it is determined that she is no longer at risk.

We will continue to update the blog every few days, but we may not post an entry every day. The level of activity is such that we are kept quite busy along with Mom. Thanks for your continued love and support!

Wednesday Update

2008-07-10T19:09:00.000-05:00

July 9
By Karen

Today was a big day! Doreen is now in the Rehabilitation Hospital of Fort Wayne. She was moved from the neurological unit at the main hospital to the rehab hospital around 11:30 this morning. She was transferred in a wheelchair by accessible van. This was the first time she had been in a wheelchair. The only times she had sat up since May 29 had been in a chair in her room (maybe 5 times). We were surprised that they did not use a gurney, but it was encouraging to see that she could handle it.

Because she arrived at the rehab hospital before noon, the facility was required to try to get in the minimum 3 hours of therapy for the day. During these initial sessions they began to assess Doreen’s abilities so that the staff can create goals and care plans for her. The first therapist to see her was the physical therapist. She worked with her for a little over half an hour. She evaluated the strength, range of motion and control of Doreen’s legs. These are quite good, but are better in her right leg. She also helped her sit in a wheelchair to see how well she could propel herself down the hall by “walking” with her feet. Dad and I were pleased to see that she could do this – very slowly and with much effort, but she was able to move herself forward. They had her “walk” her wheelchair to the occupational therapy room for her second appointment. (I don’t want to give the impression that Mom was zooming down the hall on her own. She continued to “walk” with her feet, but the therapist provided most of the force as she traveled. Mom also had her eyes closed during the trip, because she said she was dizzy, which would have made it impossible for her to get anywhere by herself.)

The occupational therapist began by asking Mom to describe the kinds of activities and hobbies she enjoys. She then assessed Mom’s strength and ability in her arms. Her left arm can do very little. Her right arm shows less strength than before the hemorrhage, but is becoming more functional. Next, the therapist asked Mom to read a line of text on a card. She stared at the card for quite awhile. She finally said that she could identify the word “family,” but she indicated that she could not make out anything else. This was very difficult for Dad and me to watch. Mom has always been such an avid reader and a lover of word puzzles. I asked her to describe what she saw when she opened her eyes to look at the words. She said it was hard to describe, but things seem to swim in front of her. The therapist chose to investigate her visual and spatial ability further by having her recreate a pattern on a card with blocks. The pattern included a red square, a green square, and another red square that were side by side and created a horizontal line. Mom was then presented with a box of blocks from which to choose (of several colors and shapes). She gathered 4 or 5 red squares and 2 green squares and was trying to find more blocks when the therapist told her she didn’t need any more blocks. Mom kept trying to reach into the box, so the therapist moved it out of her reach and told her she already had too many blocks to make the pattern. She repeated the instructions to Mom to match the pattern on the card with the blocks. Mom said, “I would if I could have enough blocks. I need more.” I asked her to describe the pattern she saw on the card. She said she needed 9 blocks because she saw a 3x3 square with 3 red blocks on the left and right sides with 3 green blocks down the middle. This is a very important breakthrough regarding an explanation of why she keeps her eyes closed so much. She is seeing multiple images! It also helps us understand why she is so nauseous and has difficulty with her balance. So many of the issues Mom is struggling with are interrelated – vision, balance, appetite/nausea, strength, endurance, etc. The information about her vision will be shared with the team of rehab professionals as they decide how to proceed.

After the session with OT, Mom was exhausted. Therefore, when the speech therapist came in for her evaluation, Mom was sleeping. So, the ST decided to wait until tomorrow morning to work with Mom for her initial evaluation.

Mom did not eat more than a few bites again today, and that continues to be a major concern. We feel confident that the medical staff here at the rehab hospital will help to solve this problem. Mom needs to have sufficient nutritional intake to be able to fully participate in therapy and to make progress toward recovery.

Mom would like me to give you the address of the new facility:

Doreen Myers
c/o Rehabilitation Hospital of Fort Wayne
7970 W. Jefferson Blvd.
Fort Wayne, IN 46804

She also wants to invite anyone who is interested or available to visit. Because her therapy schedule includes sessions throughout the day and varies from day to day, the staff recommends that visitors come after 6:00 in the evening. This also suits Doreen well, because she is more awake and talkative in the afternoon and evening than in the morning.

For those who are interested in (or willing to read/hear) intimate details –
Mom wanted me to share that one of the major accomplishments of her day from her perspective was that she has begun to use a real toilet, rather than a bedpan. In order to do so, she must have the assistance of at least one staff member to transfer to a wheelchair, then transfer to the toilet. This really helps her feel more “normal.” However, all of this activity seems to induce the dizziness and nausea, and Mom has had bouts of vomiting during many of these trips. She is feeling frustrated with this pattern and hopes that we can figure something out very soon. (This pattern is also very difficult for Dad to witness. He is distressed about Mom’s inability to take in much nourishment and keep it down.)

Tuesday Update

2008-07-08T21:48:00.001-05:00

July 8
by Karen

We have news! Doreen will be transferred from Lutheran Hospital to the Rehabilitation Hospital of Ft. Wayne tomorrow morning. It is affiliated with Lutheran and is only about 2 blocks away from where she has been for almost 6 weeks now.

Carl and Karen visited the facility over lunch time today, but we had no idea she might move that soon. We were notified that she was accepted as a patient in that program late this afternoon. The facility is very nice and its whole focus is therapy; therefore, the program requires at least 3 hours of therapy every day. This includes physical, occupational and speech therapies. Patients are accepted only if they are evaluated as needing at least 2 of these and appropriate for that level of rehab. Doreen needs all 3 kinds of therapy and it was determined that she can meet the 3-hour expectation -- slowly at first, in intervals of 30 minutes, then moving to longer sessions as she gains strength and skill. We are very pleased that she has been accepted and will begin more intensive therapy. (However, we are not completely convinced that she is quite ready yet. Please send her all of the extra energy, stamina and determination you can spare!)

Her eating was a bit better today at lunch. She ate willingly and wanted to feed herself (soup, mandarin oranges, iced tea). That was great -- until it all came up when the physical therapist began his session with her by helping her sit on the side of the bed. She said she felt dizzy and then the nausea overcame her. This ended up stripping her of all of her energy and postponing any therapy until tomorrow. (Now we know that any therapy tomorrow will be in the rehab hospital and will include more than one chance a day.)

I will give you the address and other contact information for the rehab hospital in tomorrow's entry. I have been assured that anything that comes to Lutheran Hospital will continue to get delivered to her.

We hope to have good news to report tomorrow as we enter the next phase of our journey!

Monday Update

2008-07-08T07:50:00.002-05:00

July 7
by Karen

Word for the day: frustration.

We were hoping that by the end of today we would have some sense of what was happening next - for example, which facility would be the best next step for Doreen's rehabilitation, how much longer she would be taking the antibiotics, when we might expect to move Doreen to the next facility, etc. However, none of these questions received an answer today. We did speak with Dr. Kachmann (neurosurgeon), Sue (social worker), Dave (physical therapist), and Ann (occupational therapist); but we did not see the infectious diseases physician nor anyone from any of the rehab facilities. Without these individuals, we can not move forward with any plans. Therefore, we will return to the hospital tomorrow with hopes that more of this important information will come our way.

Doreen's lack of interest in eating is becoming more of a concern. We counted the bites of food she ate today: breakfast = 1 (a grape) + lunch = 0 + "snack" = 4 (3 slices of apple with peanut butter and a piece of lettuce with peanut butter) + dinner = 9 (1 bite of fish + 1 bite of asparagus + 1 bite of dinner roll + 2 bites of baked potato + 1 grape + 3 bites of carrot cake, for a total of 13. We are very concerned about her resistance to eating. She has lost at least 20 pounds and has very little strength. Of course, she has to eat in order to gain the energy she needs to fully participate in her recovery and rehabilitation. While it has been difficult, we continue to remind ourselves that she is not choosing to be stubborn. (This can be difficult to remember.) Rather, the damage in her brain is getting in the way of her clear thinking regarding this issue. She repeatedly tells us that she knows it is a problem and that she must eat, but she doesn't know what to do about this. She talked about how frustrated she feels because she has always loved to eat, but she has absolutely no appetite. She also finds that eating takes so much energy. We're looking for any and all ideas that might help us through this stage of our journey.

Her physical therapy session was the bright spot of the day for us. No therapists had been in to see her since last Thursday because of the holiday weekend. Therefore, the PT did not expect much from Doreen today. However, she did more for him today than she has done in any previous sessions. She sat on the left side of the bed for at least 7 minutes with very minimal support. (In fact, the PT left the room for several minutes while Karen steadied her with only one hand.) Next, we helped her to stand and then she "walked," with our significant assistance and using a walker, around the foot of the bed to a chair that was at the head of the bed on the right side. This was the longest "walk" she has taken so far. She showed great determination and strength for about the first two-thirds of the hike. After that, the PT and Karen were doing quite a bit of the work. (I discovered new muscles during this exercise.) Once she got to the chair, she sat for about 50 minutes without complaining or asking to lie down once! This was a welcome change from last Thursday. While the session with the PT was encouraging, it seemed to take all of Doreen's energy for the rest of the day. When the occupational therapist came in several hours later, she had a hard time getting Doreen to do much. However, she did remark that she noticed better strength and balance than when she saw her last Wednesday. She indicated that she will try to coordinate with the PT so that they can come in together tomorrow.

Doreen's family members have put all of the cards and notes she has received up on the walls of her hospital room (a total of about 125). Every day hospital staff members exclaim that they have never seen this many cards and remark about how this shows what a special and well-loved woman Doreen is. This is a great moment for Doreen each time it occurs. The highlight of her day is when the mail arrives. She cherishes the words of love and encouragement that many of you have sent. Your continued support is invaluable to her (and to us). If you would like to add to her wall of cards, but haven't found the prior message with the address of the hospital, here it is again:

Doreen Myers
c/o Lutheran Hospital
7950 W Jefferson Blvd
Ft. Wayne, IN 46804

We hope to have more of a report regarding future plans in the next entry. Mom and Dad wanted me to express their humble gratitude and love to all of you. Thanks for continuing to keep them in your thoughts and prayers.

Saturday Update

2008-07-05T20:54:00.001-05:00

July 5, 2008
By Karen

We have felt like we have been in a holding pattern for the last several days. We are waiting to make any sort of movement (in treatment, facility, therapy, etc.) and things have remained very similar ever since Thursday or so. (Thus, the lack of entries since Wednesday.)

Doreen has been cleared to begin rehab, but the long holiday weekend has slowed things down. Dr. Kachmann has requested for Doreen to stay in the Lutheran Medical Complex in Ft. Wayne until she is finished with the current round of antibiotics. They were prescribed in response to the fever of last weekend. Kachmann wants to monitor her condition in the few days after the course of antibiotics has ended to see whether the fever returns. If it does, then he will interpret that as an indication that there is an infection in the shunt, and he will need to remove the current shunt and then replace it. It would be okay with him for her to move to the rehab hospital on this campus, but he does not want Doreen to have to travel back and forth between North Manchester and Ft. Wayne; therefore, he wants her to stay here until it has been determined that her shunt is clear of infection rather than move immediately to Timbercrest in N. Manchester. However, we have had a hard time finding out how long her current course of antibiotics is to last. This morning, Linda spoke with the infectious diseases physician and we believe that the antibiotics should be finished sometime in the next week, but no clear timeline has been communicated to us. I guess we’ll have to wait until Monday to get any solid answers about what will happen next.

We are working diligently to get Doreen to eat more in order to avoid losing any more weight. Last night and today for lunch and dinner she has done much better! She has been more willing to try foods, has complained less and is no longer worried that the food will upset her stomach. This feels like a great accomplishment! It is very satisfying to see her enjoy eating again – even though the amounts are still very small. In fact, tonight at dinner she seemed proud to be able to feed Carl with her leftovers. Karen suggested that, while this may seem economical, Doreen needs to work toward feeding only one person with her meals – herself – so that she builds the strength she needs to learn to sit and stand again.

Doreen moves between times of great clarity – she gave very specific financial information to Karen and Carl this afternoon – and times of obvious confusion – she argued that she IS attending the Church of the Brethren Annual Conference in Richmond, VA next week: “They have wheelchairs!” she explained. It seems that she is struggling with determining the difference between her dreams and reality. We are trying to encourage her to open her eyes more often – they are closed almost exclusively. She says that it is very hard work to keep them open and that it wears her out; however, we believe that this will provide her with the needed information to sort out when she is awake and when she is asleep.

We’ll provide another update as soon as we have something new to report. Thanks for your continued love and support. She told the nurse the other morning that she could feel the prayers and thoughts of those who love her. Keep them coming! (The cards and letters help a lot too!)

Wednesday Update

2008-07-02T21:27:00.000-05:00

July 2, 2008

by Judy and Karen

When Judy and Carl arrived in the morning, the nurse informed them that Dr. Kachmann had been in and that he was recommending that Doreen begin rehabilitation in one of the Lutheran Hospital rehab facilities on the hospital campus. That would allow him to continue to monitor her for about a week to 10 days. It seemed that he was saying that she could be moved to that facility in the next few days, because she does not need the same level of nursing care as earlier, but she clearly needs to begin the therapy routine that will prepare her to move forward in her recovery. Dr. Kachmann is wanting to watch her progress over the next several days as she is given antibiotics, but he is not ready to do any more procedures with the shunt at this point.

The occupational and physical therapists came in together today. Doreen was alert, but several times during the session she said she really just wanted to lie down. This therapy is hard work! They did get her to sit on the edge of the bed, work on her balance, kick her legs, stand up, and use the walker to take a few steps and maneuver to the chair. She sat on the chair and stood up again a couple of times, and then she remained sitting for almost a half hour. She was worried about being nauseated, but she did not get sick. While she was working with these therapists, the speech therapist came in, but three therapists at once would probably create spontaneous combustion, so she said she would come back later. We did not see her the rest of the day, but hope she will come tomorrow.

Karen arrived around 3:30 and was very pleased to see Doreen more alert and responsive than when she left June 11. She is much easier to understand and conversations last much longer than they did 3 weeks ago. However, it was very clear to Karen that Doreen has lost quite a bit of weight. Eating is still a challenge. The dietitian is willing to try anything. Doreen has eaten very small amounts at each meal, but not enough to satisfy any of us, and probably not enough to satisfy her basic needs. Her best response was to watermelon and mandarine oranges, and she did have several sips of a root beer float. We want to start identifying some protein sources that are appetizing to her!

June 30 Update

2008-07-02T15:41:00.002-05:00

(This one is out of order: it is the update from Monday.)

Monday June 30th
by Amanda (with thoughts from Carl)

Grandpa, Kelsey and I arrived at the hospital around 10:00. We were very pleased to see that grandma was alert and had only a slight fever. She told us that during her session with the speech therapist that morning she had experienced an upset stomach. She told us she didn't feel badly, but that it had occurred after another coughing fit.

Soon after we arrived a representative from Peabody came to assess grandma. She asked her a number of questions and wanted to hear updates from us as well. Grandma did very well with responding, though when asked the date, she stated that it was "Saturday, June 28th." We believe that because she has been dealing with the fever during the past couple of days, she basically lost two days in her mental timeline.

Kelsey and I were very pleased with how well grandma was doing all morning. She was as alert as we had seen her, was very talkative and speaking more quickly and clearly. Though she didn't have an appetite for the breakfast she had ordered, we were able to get her to eat some fruit and she initiated holding her own cup and fork.

Grandma napped from around noon until 5pm. She seemed to be sleeping more comfortably. While she was sleeping Dr. Kachmann visited. He seemed surprised and concerned to hear that grandma had been feverish during the past days. He took some fluid from her head and ordered chest x-rays. He also asked the nurse to call the doctor for infectious diseases. He expressed that her symptoms could indicate that she was experiencing a shunt infection.

During her nap, Kelsey and I hung all of the cards we found in the room. We counted around 110 cards! The nurses that came in throughout the day said they had never seen so many cards in their hospital rooms. Our hope is that they will not only encourage grandma, but also represent to those working in the hospital how supported and loved this woman is.

The evening came with chest x-rays, a visit from the doctor for infectious diseases, and more upset stomach. Dr. Kachmann came back and told us he wanted to wait to get all of the test results back before taking any action with removing the shunt (a procedure that would have be performed if there is an infection).

We helped grandma eat some dinner (again, she did much of the work), sang some songs that she requested (she sang the alto part), and said our goodbyes for the day. As we were leaving, she asked that the TV be turned on. It seems that her long nap this afternoon energized her, which was very encouraging!

Reflections on the day as shared by Carl and recorded by Judy:
It was a discouraging day for him. He keeps hoping for continued improvement, and the up-and-down nature of the recovery has been very difficult for him. Some days he has glimpses of Doreen's mortality, and that is very sobering. But as he and Dr. Kachmann shared, she is a fighter, and we are all going to do what we can to help her get through this.

Carl had the opportunity to do some impromptu chaplain work today. He was in what is called the quiet room across the hall from Doreen's room. A woman in the room seemed distressed and sad, so Carl talked with her and encouraged her to look at the gifts she had to give to her family. Supporting others can be a very therapeutic activity for all of us.

Tuesday Update

2008-07-01T22:02:00.003-05:00

Note: June 30's entry will be contributed by Kelsey, Amanda, and Carl (Carl's contributions interpreted by Judy) and posted when the granddaughters return home to New Jersey and New York from their trip.

July 1, 2008

by Judy

This was a good day today! The ups and downs continue, and this was an up. Doreen was awake all day except for a short nap. and most of the time her eyes were open, she was engaged in conversation, and she was alert. Her temperature was basically back to normal. She saw the occupational therapist, who had her work on filling in a calendar. She saw the physical therapist, who had her stand up and use a walker to move to and sit in a chair for about 15 minutes. She saw the wound specialist, who checked out a yeast infection that is getting much better and the infectious disease specialist, who was encouraged that her fever was gone (at least for now). She also worked on crossword puzzles with Judy.

When Dr. Kachmann came in, he was also pleased about the disappearance of the fever, and he was glad that he had not moved too quickly to replace or remove the shunt. But he is not guaranteeing that it will not need to happen in the future. Because Doreen is on antibiotics, the blood culture could be less than accurate. The antibiotitics may attack any germs in the culture. So he wants to give the culture another day or two to see if anything grows. His plan is to see of the progress continues. He is suggesting they take away the antibiotics for a couple of days, and if the problems return, it is likely that the shunt is infected and needs some attention. In spite of these problems, though, he believes things are going very well.

Unfortunately, some of the issues with eating have not improved. Doreen continues to have very little appetite and has had trouble keeping her stomach settled. No one has a final answer for that problem (although it is common for hospitalized people), but everyone keeps encouraging her to eat in order to build up her strength and get her digestive system back to being close to normal. She says everything tastes like the hospital. That could be in part because of the IV fluids and medications she is getting.

As Doreen becomes more aware of what is happening, it has been interesting to see her attempts to come to grips with the situation. One statement she made this evening was interesting. She said she sometimes feels like she is outside of the situation and watching things that are happening to someone else. That seems to be consistent with all of the experiences of sleeping, half-sleeping, dreaming, being in an unfamiliar place, and so on. She also asked if the hospital would allow her and Carl to just go home overnight and then come back. It would be great if she could have a break like that from the stresses and strains of her hospitalization. Gradually, we hope she will be able to understand the situation without being overwhelmed by it or becoming depressed.

Sunday Update

2008-06-30T15:15:00.002-05:00

Today's edition of the blog is brought to you by Doreen's granddaughters Kelsey and Amanda.

Sunday morning we went with Lee, Linda, and Dick to spend a couple of hours with grandma. When we first arrived, she was fairly groggy, but as we talked to her and encouraged her to eat, she perked up quite a bit. We were told her temperature had been high again that morning, but it was closer to normal during our morning visit. We were able to get her to eat all of her serving of watermelon and banana which was a welcome change after a primarily liquid diet the day before. Grandma requested a sweet potato for dinner and eggs and hash browns for her breakfast for Monday. We left around 1:30 to attend the memorial service for Sandra Borgmann.

The service was a wonderful celebration of Sandra's life and we were very proud of grandpa, who was the soloist during the service. We were all very touched by his strength and the beauty of his voice especially during such an emotional time.

After the service we (Kelsey and Amanda) went back to the hospital to spend a couple of hours with grandma. (Giving our parents the opportunity to go home and grandpa a much needed rest.) When we arrived she was very warm to the touch and seemed to be in pain. We talked to the technician who said grandma had a fever again. Once the proper medications were administered her fever was drastically reduced and we saw grandma as grandma again. We were able to get her to eat some of her sweet potato and strawberries and we shared stories in a very conversational way. We were then pleased as she seemed to fall into a very comfortable sleep before we left (unlike any sleep we'd seen in the past two days).

We have been so moved by the outpouring of support through visitors, cards, calls, and kind words that we've witnessed during our visit and heard about during the past month. We are so thankful that our family is in such good hands, especially since we are currently living so far away.

Saturday Update

2008-06-28T19:01:00.002-05:00

June 28, 2008

by Judy

We have been told by many as we began this journey involving brain trauma to expect good days and bad days—2 steps forward and one step back. Well, today was at least one step back. The nurses could not wake Doreen enough to give her breakfast, and we could get almost no response from her. She had a slightly elevated temperature that became a fever as the day went on. The doctors decided to get another CT scan.

It is unfortunate that this “down” day came when two of the grandchildren came to visit. Kelsey and Amanda came from New Jersey and New York respectively to visit their grandmother (and their parents). There were some advantages to this situation, too, however, as the granddaughters were able to do some very basic care with their grandmother, including feeding her some Jello and ice cream, rubbing her legs, and trying to keep her appropriately warm without being too hot.

The family was still awaiting some explanation for why this lethargy occurred and what was causing the fever as the day ended. We were all thinking as we were reluctantly preparing to leave for the evening that steps sideways would be easier to handle emotionally than steps backwards. Then, amazingly, she wakened a bit, she looked at her granddaughters, she held their hands, and she talked a little bit. She also asked about any cards and listened (and commented) as they were read to her. Whew! It was a great relief for everyone after a day of inactivity and overt quietness. (And yes, don’t doubt that one can be overtly quiet.)

Friday Update

2008-06-27T20:27:00.003-05:00

June 27, 2008

by Judy

Today we began to see a bright light at the end of the tunnel! We can be fairly sure that no more surgeries lie ahead, and we said good-bye to intensive care. Doreen had 7 different visitors (in 3 groups) and a long phone call, and handled them all very well. She cooperated with the therapists and initiated some of the exercises herself. She fell asleep only a few times. We have lots of reasons to feel positive and optimistic!

When Dr. Kachmann came to see her in ICU, it took very little time for him to say it was time to get her out of that unit. He said it was time to get her closer to home. Clearly, the shunt surgery did what it was supposed to do, and he feels we are ready for the next step.

The therapists came to ICU before she was transferred, and they had Doreen sit on the edge of the bed, which she did with only minimal support, and she was able to correct her balance reasonably well. They had her lift her legs while sitting, and they had her push against resistance with her arms and her legs. Her left side is still clearly weaker, but she was able to lift her left arm by herself. To get it over her head, though, she needed help. When they asked her to comb her hair (what is left of it), the purpose was occupational therapy, but she wanted a wider-toothed comb. We are afraid there will need to be a little more attention to her hair before it will meet her standards.

Eating remains a concern. Anything that seems too heavy is difficult for her to handle. So she has more interest in fruit, Jello, and drinks than in main dishes. She does have a lot of flexibility in what they will allow her to eat, though, so we are continuing to look for new and appetizing options that will also be nutritious.

When Judy did a crossword puzzle with Doreen today, she was doing it very quickly. She did not get a confused about some of the clues as she had in the past few days. So it may be time to try harder puzzles, although it will get easier when she is better at using her vision. Some confusion still shows in the understanding of when things will or did occur in her social schedule. We will gradually try to help her understand the extent of interruption that is occurring in her life. The increased awareness and functioning is both an advantage and disadvantage as she remembers her plans and needs to be told what will not be possible.

This weekend will be a time to visit with some grandchilden and others. It is wonderful that she will be able to enjoy it more after these advances!

Thursday Update

2008-06-26T22:03:00.004-05:00

June 26, 2008

by Judy

We hope that today's surgery will be the last that Doreen will need for a very long time! For the fourth time in the last month, she had a neurosurgical procedure done. This time it was the installation of a shunt. Dr. Kachmann removed the drain and threaded a tube from that spot in her brain through her neck and chest to her abdomen. This will be permanent and self-regulating. When the pressure from the cerebrospinal fluid is too great, it will allow for drainage from the brain into the abdomen where it will be absorbed by the body. When the pressure is fine, the shunt will stay closed.

When Dr. Kachmann removed the drain, he said that a significant amount of fluid spurted out. This confirmed for him that Doreen needed the shunt. That build-up explains some of the concerns that we all had about Doreen's behavior over the past few days since the drain was clamped off. It will take some more days to see whether things really improve now, though.

In the pre-op area, Doreen said she did have a question for Dr. Kachmann. She asked him if he was planning to use a chain saw. We interpreted that to mean that she was relatively relaxed before the surgery!

After she returned to her room, she was in a quite a bit of pain. She said her head hurt, and that her mouth and throat were sore. She also indicated that her abdomen was sore where 3 small incisions were made for laparoscopic procedures to locate the output areas of the shunt. Some of the problem with her mouth and throat would be due to the fact that she had a tube in her throat during the procedure again.

Because she was in pain, the nurse offered pain medications. Several possibilities were offered by the doctor's prescriptions. A dose of Demorol was given IV at the lowest prescribed level, but it clearly was VERY strong for Doreen. After getting that injection, her heart rate, pressure, and respiration dropped lower than was comfortable for any of the rest of us. The nurse did several things to keep her alert and try to raise those levels. A couple of hours later, she was resting very peacefully and sleeping well--even if it was somewhat drug-induced.

Before the family left in the evening, the nurses pried her eyelids open to check her pupils and asked the usual questions of where she was, what year it was, and why she was there. She answered the questions very well, although in a very drowsy way. We look forward to tomorrow when the drugs continue fade so that we can measure the success of this latest intervention. It is possible that she could be moved from intensive care back to the other hospital unit tomorrow, and the surgeon is predicting that she will be discharged from the hospital next week, although no day was given. We are looking forward to a new setting closer to where we are staying!

Wednesday Update

2008-06-25T21:56:00.003-05:00

June 25, 2008

by Judy

Today Doreen seemed bright and alert when Judy and Carl arrived. But they found out that she had eaten very little breakfast. They tried to encourage her to eat more English muffin, and they filled each other in on the happenings of the previous day. When the mail came, Doreen read her own cards, although slowly. It was exciting to see her using her vision and processing the things around her by herself.

At lunch, she ate with a lot of help and encouragement. She did fairly well. When the occupational and physical therapists came, it was a struggle to get Doreen to participate. She leaned heavily on the support they provided, and she struggled to sit up and maintain her own balance. The goal was to get her to take a few steps with the walker (as she apparently did the day before), but she did not have enough strength. She kept saying that she wanted to lie down. The therapists finally got her to standing and had her take about two or three side-steps to move up futher on the bed, and then they let her rest. Doreen said that maybe she could cooperate more if she knew ahead of time that they were coming. They said that was very hard for them to do, and they also pointed out that she had done very well the previous day, and that was without any warning either. We hope this will get better in the future!

One thing that may have contributed to the poor performance was the discussion that Doreen and Judy had just before the therapists came. Doreen said that she really needed to go to the memorial service for Sandra, their good friend, on Sunday. Judy had to explain that it just could not happen. She would not be released from the hospital before then, and her needs would be too great. Doreen is a person who has always been able to make things happen when she wanted them. This disappointment is very difficult for her. Added to that is the brief discussion they have had about how unlikely it is that she will be able to live in her former home.

Shortly after all of this, Dr. Kachmann came in. When he saw the Doreen was listless, heard that she was not eating well, and heard that she went in and out of being alert, he instructed the nurses to put her on the schedule for Thursday morning to have the shunt put in. He explained that people of this age are not likely to become unconscious or totally unresponsive as an indicator that they have problems with the brain fluid build-up, but instead would show the pattern of being more and then less alert as she had shown. He also had another CT scan taken. We understand that it showed no change.

Please keep everyone in your thoughts and prayers as Doreen undergoes her fourth surgery on Thursday morning.

Tuesday Update

2008-06-24T21:36:00.002-05:00

June 24, 2008

by Judy

Today was a day to renew ourselves by taking a short break from hospital visits. Judy returned to Purdue and talked with 45 middle-school 4-Hers in two sessions about Living with Parents. Although the issues that teens face when living with parents are different from what Carl and Doreen's children are facing now, there are important overlapping themes of learning to understand and respect each other's needs and perspectives. Carl took a day to visit with many friends at Timbercrest. He estimated that two dozen people stopped to ask about his and Doreen's well-being at dinner. There are many friends who will welcome them when and if they can make that move! Thanks to all of you who made him feel so welcome.

Reports from nurses and phone calls with Doreen indicate that there is not much change from the last few days. She is not eating very well, and she goes from being very lucid and aware to showing some confusion about where she is and what is appropriate in that setting. She has requested items from her bag or her room, and she sometimes forgets she is in a hospital rather than in someone's home.

We think that the doctor did not visit Doreen today, and there is no surgery nor CT scan scheduled for tomorrow, although that may change. It is likely that the doctors and nurses need to observe her longer now that the drain has been clamped off to determine the next steps. The lack of having any scheduled procedures does mean, though, that her condition did not deteriorate enough to mean that something needed to be done immediately.

Some notes that were not in the last posting: Yesterday Doreen helped to complete a complete crossword puzzle. She provided all the answers after Judy read the clues. Although she did not look at the puzzle, she knew all the answers. Now we need to get her to look at the puzzle itself! It also is important to note how she is trying to understand and get some control of her care. When Dr. Kachmann visited on Monday, Doreen asked, "If I didn't have a stroke, what did I have? Was it an aneuriysm?" She had heard much of the discussion about her condition, but she is trying to work through more of the details. It also is telling to consider how she answered one of the questions from the cognitive assessment. The item was "What are the advantages and disadvantages of being a doctor?" The advantages she listed were that you could care for your family members and could understand your own health well. The disadvantage was the hours.

Sunday & Monday Update

2008-06-23T21:12:00.003-05:00

June 22 & 23, 2008

by Judy

On Sunday, Carl and Judy attended churches in North Manchester and Lafayette respectively, so they arrived later than usual at the hospital. Doreen was awake, wearing her glasses, and asking questions. She had been expressing concerns to the nurses that she had responsibilities for the memorial service for Sandra Borgmann. That memorial service will take place on June 29, and Doreen would have been involved with planning the service and reception, and she is not quite convinced that she will not be able to take that role.

Judy had not seen Doreen for a few days, and she found her to be stronger and more conversant than when they had last been together. It is important to mention that Doreen asked about Judy's health and wanted an update on issues she had dealt with. Doreen is still very much the caregiver.

On Monday, Doreen was still talking about what she needed to do to get ready for the memorial service. The family promised to try to record the service so that she can expeience it, but we acknowledged that it will be very difficult for her to miss this event. Later in the morning, Doreen talked with granddaughter Amanda on the phone (a very coherent conversation), and said that she hoped she and Grandpa Carl would be able to visit Amanda in New York on the way to or from the church's Annual Conference in July at Richmond, Virginia. We have not yet discussed the fact that she will not be able to attend that event, either. There are many disappointments that everyone will need to face over time.

Also on Monday, Dr. Kachmann visited and gave the order to clamp the drain. This will continue for 24 to 48 hours unless there is a need to do something different earlier. They will look for headaches, excessive drowsiness, or loss of the some of the gains Doreen has made. If any of those things occur, they will reopen the drain. We believe they will also do another CT scan on Tuesday (or later) to see if there is an accumulation of fluid. Either of those outcomes would provide evidence of the need of a shunt. If Doreen does well and shows no additional accumulation of fluid during this period (and maybe a little longer), they will assume that she does not need the shunt. So now we wait.

One of the challenges at this point is keeping Doreen eating. She does not have a lot of appetite, and she has lost weight. We continue to try to find things that interest her, and we continue to offer the magic mandarine oranges, but she does need more than that!

The speech therapist who visited on Monday focused on cognitive functioning rather than speaking and swallowing. Doreen did very well with correcting senctences that did not make sense and identifying the advantages and disadvantages of various situations. The area in which she struggled involved using her eyes. She continues to keep her eyes closed much of the time, and that seems to be causing some confusion. We realized that she was making a lot of assumptions from short glances and not carefully looking at the things around her or by not looking at all. So, for example, she said that there were 5 chairs in her room, even though there were only 2. So looking and interpreting things around her will be major tasks in the near future.

On Tuesday, Judy needs to be at work, so the family is taking a one-day break from visiting the hospital. Carl has been there every day since May 30, so family mimbers are encouraging him to think about other things and to further explore the Timbercrest Retirement Community. So he will be there spending time with friends, and he and Judy will check in with each other again in the evening and travel together to Ft. Wayne on Wednesday morning, hoping to hear the verdict after the drain was clamped. It is difficult to be away from Doreen, but it is also important that the family keep the rest of their lives in balance. Note that anyone who would like to visit the hospital may want to wait until Wednesday or later when family members will be available.

Saturday update

2008-06-22T22:55:00.004-05:00

by Linda

Doreen was newly curious today for an extended conversation with lots
of give and take. This was reassuring after the steps that felt either
backward or, at best, sideways. She has asked a few things before but
she started this morning asking a series of questions, one after
another, in a logical progression toward understanding "what happened
with my head." Time frames are very foggy and hard for her to put
together but she is working and thinking and trying to process the
situation a lot of the time now. She pulls some things from memory and
some things from the present and seems to combine them logically some
times and quite creatively other times. She was able to participate in
a conversation that was downright chatty with her brother Jay. She
spoke for 8-10 minutes with the telephone resting on her pillow. Her
speech was a bit slow and thick but she was on target. After she has
exerted herself like that, she hibernates for hours.

Eating continues to be a huge undertaking. She chose spaghetti today, a
challenge for her helpers to balance the wiggly stuff on the fork, as
she quite adeptly uses the fork to feed herself. It just simply takes a
long time. She waits to decide which food she wants for each bite,
chews slowly and deliberately, asks for sips of drinks, closes her eyes
for a bit, asks why she doesn't have Parmesan cheese or garlic bread,
and then LOVED the taste and texture of her dessert of cheesecake but
needed to have us hunt down some hot peppermint tea to have with it! It
was actually heartwarming to have that opinionated determination
surface again.

Tag---Judy's it. She is coming Sunday afternoon again as Linda and
Parker need to return to Illinois tonight. We are strongly encouraging
Carl to attend the morning church service in North Manchester with the
desire to return to some semblance of normal routines.

Friday update

2008-06-21T07:49:00.003-05:00

by Linda

10 steps for Doreen, a giant leap for peace-of-mind! This morning
before we arrived at the hospital, the physical therapist and nurse
helped Doreen take some steps (with a walker and their support) to a
chair where she sat for a couple hours! This major activity absolutely
exhausted her but we all felt so encouraged by the move out of bed
where she has spent nearly all her time for three weeks. After a good
long nap, she was eager to spend time with visiting family and several
dear friends from N. Manchester. She has an awkward grip on some of the
time sequences of the past weeks but a sure grip on some quick quips
and comments. "Mom, are you OK? You're making some really funny faces."
"I only have one face," she replied.

Doreen was able to use a spoon to eat half a bowl of tomato soup and
some jello and not one drop fell onto her "bib." I had never seen
someone chew a bite of jello for half a minute but she was savoring the
flavor and texture every moment. Eating takes a long stretch of time
and she exerts a lot of effort but she is taking more and more personal
care of her nutritional wants and needs.

We often need to remind her to open her eyes in order to help her
center her attention on a task like eating or exercising. She finds it
comforting to visually close out some of the things around her when she
is trying to concentrate but looking at what she is working on will
help her reinforce the brain pathways she needs to strengthen.
We are considering next steps----all the who, where, how kinds of
things. Now that we are out of the basic crisis mode, future questions
loom large. Moving from reactive to proactive decisions is a challenge
for the four of us offspring (and extended family) as we are stretched
around the country. We want both parents to be engaged in some kind of
enriching tasks and to be looking forward. Steps along the journey...

Wednesday/Thursday update

2008-06-19T22:41:00.002-05:00

by Judy

Wednesday was another coasting day for Doreen. She seems to need to
take some days to process all the things going on around her and simply
regroup and gain strength. She was inactive much of the day with her
eyes closed. We try to remember that each step of the journey is
another step along the journey.

Thursday has been a different day regarding activity. (And after four
days of being away, Linda clearly sees marked improvement as she takes
the baton of caring from Judy for a few days.) Doreen was helped by the
physical therapist to stand a few moments as she moved to a welcome new
piece of furniture--a potty chair. It was actually encouraging to hear
her complain of tired neck and shoulder muscles from so much physical
exertion! Carl noticed that she brightened considerably when grandson
Parker arrived for a visit. He was glad to be able to help her with
lunch. When he asked what she likes so much about the mandarin oranges,
she said she likes the juiciness. Occupational therapy induced good
responses with the left arm and some growth toward more balance as she
sits on the side of the bed for a minutes or so. We are being asked to
encourage her to practice using the left side. It's important to repeat
activities to strengthen the pathways in the brain that control each
movement.

Dr. Kachmann was so pleased with the different response from yesterday
that he questions whether or not he will need to insert the permanent
shunt. He will experiment with clamping off the drain on Monday to see
how she tolerates any fluid excess for a day and then decide from
there. We are eager to learn if she can avoid more surgical
intervention.

Doreen fed herself supper (mostly) and it was an adventure of catching
noodles and stabbing mandarin oranges with a fork. When Linda snitched
a bite of chicken saying she was making sure it was safe for Doreen to
eat, Doreen quiped that it would have been more helpful to have tested
the food before she had already eaten several bites. A point well made!
When she was given a choice of vanilla or chocolate pudding, she asked
for some of both with, of course, mandarin oranges on top.

She is humbled by the cards, visitors, calls, and all the love being
sent this way. We thank you.

Tuesday update

2008-06-17T21:21:00.002-05:00

June 17, 2008

by Judy

This was a good day! According to the nurses, Doreen fed herself part of her breakfast and sat on the edge of the bed before Judy and Carl arrived in the morning. Then she was tired and slept quite a bit. She got a lot of help with lunch. But as the afternoon went on, she visited with Timbercrest friends who came to see her, sat on the edge of the bed again, had a discussion with Lois and Dale Brown over the phone (and they could understand her fine!), and asked the family to go to Aldi's and get her some mandarine oranges. (The theme continues...)

At suppertime, she fed herself supper with almost no assistance, and she ate well. She thought her glasses may be helpful, and while wearing them she did seem to be more alert and to open her eyes more often. It is unclear, though, whether she needed her glasses because she was opening her eyes, or she found it easier to open her eyes because she was wearing her glasses and could see better. But there was progress! Conversations seemed to be longer and more coherent, and she is gaining strength in torso, legs, and arms. She can't yet balance herself very long when in a sitting position, though.

Another interesting discussion today was related to the telling of the story of May 29. As Carl was talking to a visitor about what happened, she explained her perspective and what she was doing at the soccer field. It may have been one of the first times that she heard and understood Carl's experience that evening. It will be interesting to see her continue to process those stories.

Today included more steps in the long journey we are undertaking together...

Monday Update

2008-06-16T21:32:00.002-05:00

June 16, 2008

by Judy

We saw the neurosurgeon, Dr. Rudy Kachmann (pronounced Cashman) today for the first time since the surgery. He continues to be pleased with the progress, but it is going to take a long time. He told us that he will keep Doreen on the drain for 7 to 10 days and then wants to put in the shunt. So we will be in intensive care at least the next 7 to 10 days. It is good to know that she is not there because she is not making progress, but because the type of treatment she is getting requires the equipment and attention that is provided in the ICU.

Visitors can see Doreen and the family while she is in ICU, but there are some restrictions on visiting. Visiting hours are from 9:00 a.m. until 2:30 p.m. and 4:30 p.m. until 9:00 p.m. During the 2:30 to 4:30 "quiet time" the family may not be easy to find, especially because cell phones don't work in the cafeteria. If you expect to visit during these hours, you will not be able to see Doreen, but you could let the family know to look for you.

Doreen was not quite as alert and strong today as yesterday, but she continues to show progress in a variety of ways. She wanted the credit card so she and Carl could go out for a special supper. She sang the good-night song with us again. Although her harmony was not as good as before, her voice was stronger. We look forward to her joining the choir as a full-fledged member soon!

Sunday Update

2008-06-15T21:29:00.002-05:00

Sunday, June 15, 2008

by Judy

Today gave us some encouragement and energy. Doreen remains in intensive care because of the drain, but the unit is now familiar to us, and we know many of the people there. One of of favorite nurses from the last ICU stay was on duty this afternoon and evening. When we arrived at the room this morning (after celebrating Father's Day--Judy, Linda, Lee, and Carl), we found that Doreen had been awake quite a bit in the course of the morning. The TV was on and was broadcasting the Golf Channel, because she had requested it (she loves Tiger Woods). But she wasn't watching much, and she was then tiring. We visited some and continued talk to her and get some short answers. We help with her simple lunch, but then needed to leave for "quiet time" between 2:30 and 4:30.

After that break, we saw much more alertness, and found that she opened her eyes and talked with us. She complained about a little bit of confusion, but still piped in to correct Carl as he tried to tell some stories to son Steve on the phone. She is very regularly ribbing the staff and family. Her sense of humor is likely to be very helpful as she moves through this process. And after a meager supper of applesauce and mashed potatoes, guess what she asked for. And the staff made sure she got what she wanted later--mandarine oranges!

One of the most promising signs was evident during her range-of-motion exercises. When we did them with her over the past 3 days, her left arm was basically dead weight, and that was discouraging, considering that she was showing increasing strength and cooperation before that. Today, though, Judy asked her to try to push back when moving her forearm up and down, and there was definite strength in that effort. Doreen was also able to rotate her forearm almost by herself. And she did her breathing exercises (blowing through a tube against pressure) with strength as well. So we are moving forward!

The nurses report that it is most likely that we will be in intensive care for at least 5 days, considering what they have seen from other patients. Unfortunately, we still have not seen the surgeon since the surgery took place. But we are confident that things seem to be going well. We expect to see daily progress now! Watch for the updates (which may shift back to every other day, unless significant changes or more dramatic events call for daily updates).

June 14 update

2008-06-14T21:08:00.003-05:00

by Judy & Linda

Today involved yet another surgery. As a result of reviewing yesterday's CT scane, the neurosurgeon felt is was important to reduce the pressure on the brain from excess cerebrospinal fluid, so he decided to insert a drain right away. Although we reported in yesterday's post that he wanted to put in a stent--which actually should have been referred to as a shunt (thanks to Gordon Bucher for the clarification!), he decided that we may or may not to have that procedure done. In his step-by-step approach, Dr. Kachmann (Rudy) felt the next step should be relieving that pressure and monitoring the output and nature of the fluid that is drained. It still may be possible that she will need a shunt, but it is also possible that she will not.

Carl and Judy were notified as soon as they arrived in the morning that this surgery would be taking place. It was necessary for Doreen to move back into intensive care to monitor the drain, so the family and the nurses needed to move all the "stuff"out of the room in which Doreen has been over the last week. Nothing is allowed in intensive care, so things were transferred to the car. Linda and Lee arrived at the hospital almost at the same time as Dorren being placed in the new ICU room. We were all very pleased to see Doreen somewhat awake and responsive, although that responsiveness increased as the afternoon went on. Over the course of the evening, Doreen began to ask whether it was good or bad that we wanted to get her back to feeling normal. She also talked about all the things that she thought should have been added to the broth she was given in order to make it tastier. It is probably important to note the mandarine oranges entered the conversation again!

It is unclear how long the stay in the ICU will last this time. There have been hints at a day or two all the way to 5 or 6 days. We do know that she will not be released from the hospital on Monday as was suggested earlier. For the second time in the past three days, she joined in the good-night song we have been singing together many of the evenings--All Night, All Day, Angels Watching Over Me, My Lord. This journey is not all over yet, but we are taking "baby steps." We are encouraged with the returning sense of humor and Doreen's increasing ability to enter into the flow of conversation, even if it is somewhat subdued. We go to bed tonight with lighter hearts and revitalized hope. We look forward to seeing what tomorrow brings.

update June 12 & 13

2008-06-13T21:05:00.003-05:00

Thursday, June 12 & Friday, June 13, 2008

by Judy

The primary accomplishment during these two days is that Doreen is eating better and is graduating to more normal foods rather than ground-up and pureed items. It has been a challenge to feed her things like vegetable soup while she is lying flat on her back, but we have figured it out! And we are figuring out what tasty things we should order for her meals.

The concern today that she was very lethargic and sleepy again (Friday). She showed no movement or response with her left hand, although she did move her left leg. She spent very little time with her eyes open. When the surgeon saw her in the late afternoon, he expressed dissatisfaction with her condition and suggested that he might need to take one more step. He is afraid that the brain has been unable to absorb the brain fluid (something that often happens with older people after they have had bleeding in the brain). His approach to treatment througout this time has been to do only as much as he knew was necessary at each point, but he feels it may be necessary to put in a stint to move excess cerebrospinal fluid from the brain. This would entail inserting a tube in the brain that would drain into the abdominal cavity where the fluid would be absorbed nomally by the body. The neurosurgeon would do the work in the brain, and another surgeon would work on the abdomen. He anticipated that the surgery would take about an hour and a half. He talked about doing this on Monday, but said that he was on call this weekend, and may do it sooner if it looks warranted. We hate to see yet another surgery, but we appreciate the surgeon's step-by-step approach, and clearly we want to maximize the chances that Doreen will be able to recover most or all of her capacities.

We also spent some time today looking at options for Doreen after discharge from the hospital. Although the first choice is Timbercrest, they have told us that they are not able to accept someone with her current medical needs at this time. That situation may change by the time Doreen is discharged (earliest date--Monday, June 16), but we need to have another option in mind. Judy and Carl visited Peabody Retirement Community in North Manchester today, and found that it was a pleasant place with many options for care. Some representatives of Peabody were already planning to visit Ft. Wayne today, so they came by the hospital and talked with the staff and Doreen. By the end of the day, they let us know that they would be happy to admit her when she is discharged from the hospital. So Peabody will be Doreen's next residential location unless something changes with Timbercrest before that time. The Peabody arrangements would be seen as temporary in any case, with the hope that something would open up as soon as possible, perhaps for both Carl and Doreen to move in to Timbercrest as their new permanent home.

Carl is continually impressed by the loving care Doreen is getting in the Lutheran Hospital environment. It is expressed not only to us but also to others. Each time a person comes to room, he is careful to tell him or her about his satisfaction.

Tornado Update

2008-06-12T21:08:00.004-05:00

by Clay

The tornado that hit Manhattan last night has been classified EF-4, with winds in excess of 170 mph. By the time it bounced across town to our neighborhood, it had diminished to an EF-1 or lower, which probably explains why our house wasn't severely damaged.

After a few hours of sleep we woke up this morning to find that most of the trees in our immediate neighborhood sustained irreparable damage. It's a not stretch to say that all the trees on our property sustained some damage, with only two able to be saved.

Piles of debris are already piled 10 feet and higher in front of homes all the way down the block. (Interestingly, two blocks away, you wouldn't even know there had been a storm, let alone a tornado.)

Amazingly, none of our homes suffered more than minor damage: a few shingles missing here, a gutter broken off there. After seeing the damage in the light, it's clear that at least part of the tornado hit on the side of our front yard (taking out a group of trees), bounced over the house, then tore through the back yard and into the ravine destroying dozens of trees and taking all the power and utility lines with them. The force was so strong on the lines that it snapped the utility pole at the corner of our property. It's this pole, and the tons of debris lying on the line that is causing the delay in restoring power and phone service. Several different tree crews have come to look at the situation, but all of them have left without doing any work.

The large blue spruce in our backyard (one of our favorite trees) fell toward the house and appears to have clipped the electric meter. No word yet on whether it's damaged. The other large tree in our backyard, a large silver maple, split in half and the tornado lifted a large part of it dozen or so feet into the ravine and is splayed across all of the other debris.

As we started walking around this morning, we started picking up debris including: a cancelled check from 1980, a business card from the Honda dealership that was devastated on the OTHER side of town, invoices, an intact test tube, photos, pages from a text book, game cards, insulation, shingles, and various other things used to build homes, businesses, and campus buildings. I've experienced this before when I worked for the Red Cross, but it's been surreal to have it happen to our house, our neighborhood, and our city.

Reports are that over 45 homes were completely destroyed on the west side of Manhattan where the tornado first touched down. We know that area well: some of our closest friends (the Haar's) live on the hardest hit street. They evacuated early this morning and are staying with friends.

As we continue without electricity for a second night, our nerves are starting to fray. It's been especially tough on Cameron who's had his life interrupted. We're hopeful that his summer theatre program is back in session tomorrow to give him some different scenery.

We're excited that Hjalti's brother is arriving tomorrow night, but hope that the electricity is back on by then. It's going to be quite a shock for someone who's never been to the U.S. before!

Thanks for your kinds words and good wishes. My mobile phone remains the best way to contact us.

www.myers-bowman.com
785 – four-one-zero-three-three-one-nine

Wednesday Update

2008-06-12T11:01:00.001-05:00

June 11, 2008
by Judy

This has been another eventful day! In the morning, Doreen and Carl's best friends for over 60 years, Lois and Dale Brown, came to visit. Their daughter Deanna and her husband Brian Harley also joined the get-together. It was a good visit and allowed the best briends to share stories and reminisce. After the visit, however, Doreen was quite tired, and she said later that the visit was not very satisfying--not a surprising assessment when a visit is spent flat on the back! The physical and occupational therapists were somewhat relaxed because of her exhaustion. Although the visit contributed to the lack of energy, it was not responsible in and of itself. Being easily tired out is par for the course. After the visit, Carl accompanied the Brown family to visit Timbercrest Retirement Community in North Manchester.

Around noon the surgeon returned and looked again at the incision. He continued to be concerned about the leakage of cerebrospinal fluid, so he recommended another surgery to take care of the leakage. This surgery went very well. He replaced some of the membrane around the brain and felt confident that it would take care of the leaking. (The replacement was treated pig membrane--making Doreen literally "pig-headed," according to an unnamed daughter.) He also did not see any bulging, which would have indicated an excess of fluid. So the assumption is that the fluid was leaking but not building up excess pressure.

When Doreen returned to her room around 7:00 or so, her eyes were wide open, and she was talking about what was happening. Her dinner had come while she was gone, and she thought that the root beer float she had asked for earlier sounded really good. She drank much of it. She said her head hurt some, but she seemed to feel good otherwise. Because the surgery involved the cerebrospinal fluid, she needs to remain flat for 48 hours in order to avoid a bad headache. That means that she needed to drink her float through a straw while lying on her side. She also asked for something cruncy and salty, but that is not yet her diet. It would be good if these requests are a sign that her appetite is improving!

We are hopeful that this surgery will help Doreen move ahead faster, although we will be happy with just steady progress. The support of the many people who have called and written and included her in thoughts and prayers is a big part of her healing!

Manhattan Tornado

2008-06-12T02:43:00.002-05:00

We're o.k. And safe. The tornado that hit manhattan last night lifted off the ground as it tore thru our neighborhood and over our house. We had just returned from picking up Karen from the KC airport when the sirens sounded and we headed to the basement. About 20 mintutes later we heard it swoosh by overhead. No damage to our house. Others were not so lucky. LOTS of trees down. One tore down the main phone and electric lines behind our house.

We'll report more once it's lite outside.

Use my mobile number to contact us.

Clay
Sent from my Treo
-----------
Clay Myers-Bowman
Manhattan, Kansas
www.myers-bowman.com

Monday & Tuesday Update

2008-06-10T22:09:00.003-05:00

Monday, June 9 and Tuesday, June 10
by Karen

Doreen has spent much of the last two days sleeping. It now seems to be a much more restful sleep than it was the first week of her hospitalization; therefore, it is a gratifying thing for us to see. When she is asleep, she is deeply asleep. This means that she is more alert when she is awake. Because of this, she is able to interact and converse in a way that is more satisfying (for her and for us). She has even held a few phone conversations with some of her children and grandchildren in which she could speak for herself (without the need for someone to "ïnterpret" her side of the conversation), as long as the person on the other end is listening very carefully.

She has moved from a diet of pureed foods to a soft, moist diet. This pleases her greatly. She was able to have those mandarin oranges she requested. She also has eaten a few bites of an egg salad sandwich, spaghetti, yogurt, and her favorite - strawberry and chocolate protein shakes! It is wonderful to see her eat again, even though it is a very tiring experience for her and she eats only a few bites at each meal.

Her physical and occupational therapists continue to be pleased with the small, but significant, improvements she makes each day. She sat on the side of the bed this afternoon without support from the therapist. She had to concentrate very hard to keep her balance (sometimes needing prompting and reminders from the therapist), but she could hold herself in a mostly upright position. Also, she is now able to lift her left leg to a horizontal position as she sits on the side of the bed. Regarding her upper body, she can wiggle her left fingers slightly and can bend her arm up at the elbow with only minimal assistance. These improvements are wonderful to see! The therapists predict that she will regain mobility, but the extent of that is to be determined over the next year or so.

The hospital doctor who oversees her medical care (the hospitalist) indicated that Doreen will be able to be released from the hospital into a nursing facility by the end of the week - as long as arrangements can be made with a facility that satisfactorily meets her needs for care and rehabilitation. We are currently working with Timbercrest (in North Manchester) in hopes that she will be able to receive the needed care and services there. This is the place she and Carl had chosen as their intended retirement community, and a large support system awaits to provide them with the needed love and encouragement.

FYI - At this stage of Doreen's recovery, we are planning to provide updates every two days instead of daily. Her condition has become quite stable, in a medical sense, and updates show less change every day. Plus, with just one of us here at a time (Karen is leaving to return to Kansas on Wednesday and Judy is back in Fort Wayne) it's quite a lot of work to manage the caregivers, administrators, future plans, and communications.

Also, Judy's cell phone is the one to contact for the on-site report beginning tomorrow (Wed.) afternoon.

Weekend Update

2008-06-08T22:31:00.002-05:00

Sunday, June 8
by Karen

Today Doreen has slept much of the day. She had a visit from the physical and occupational therapists this morning, and they reported to us that she worked very hard sitting on the edge of the bed (with significant support), lifting both legs, and concentrating very hard to keep her balance. She also completed exercises (with the help of a daughter) several times – and each time she got just a little bit stronger. After finishing the required number of repetitions, she often will do several more on her own (with her stronger right side).

She has not been very excited about the pureed foods. They are not quite up to her culinary standards. In fact, if we can get her to take a few “bites” (she objects to the use of this word with food in this form), we feel successful. Several times today she requested foods more to her liking – toast with jelly and mandarin oranges, for example.

Many of you have asked how Carl is doing throughout this situation. His attitude has been extremely positive and he has been lovingly attentive to Doreen each and every day. The details of the experience are often difficult for him to recall and navigating the hospital corridors has proven to be a significant challenge. We have been staying in North Manchester every night, which means that we are on the road for about 40 minutes every morning and every evening. He is rather weary from all of the travel, stress and worry, but he remains very optimistic and hopeful.

Now, as we read back through the entries from the last few days, we realize that our perspective from seeing her every day may lead us to report her progress as faster and farther than it may appear to others who did not see where she started 10 days ago. We tend to focus on the positive steps we see each day, because they are so exciting to us, but we probably need to clarify that these have been “baby steps.” While she is able to communicate with us in a coherent (and even conversational) manner, her speech is slow and in a low whisper. She knows that she is in the hospital and that she had brain surgery, but she is still confused about where she is. (She has asked several times today whether we are in Elgin and she has requested that we bring her some mandarin oranges from her cupboards.) And, while she is able to show some small movements with her left hand and while she is able to move her left leg during exercises, these occur only with great effort and concentration. Her right side has been much stronger than her left, but even her movements with this side are difficult and take much thought and effort.

We just want to make it clear that this is going to be a LONG process of recovery (maybe a year or so), and that it is likely that she will not return to the same level of physical ability that she exhibited before the hemorrhage and surgery. However, we remain very optimistic and encouraged by the baby steps we see her take every day. She continues to inspire us with her effort and determination!

Thank you for all of your inquiries, cards, calls and visits. She feels quite loved and supported and she wants us to pass along her gratitude. She can have visitors, but they should be limited to only a few at a time.

FYI – Linda and Lee returned to Elgin this morning because of work commitments, and Judy and Dick are going back to Lafayette for their employment duties. Therefore, if you want to contact Carl or Doreen, Karen’s mobile phone would be the one to use until Wednesday. At that time, Judy will come back to Fort Wayne as Karen returns to Kansas for a while to be with her family and to finish teaching a class that has been covered by one of her colleagues while she’s been in Indiana.

Saturday Update

2008-06-07T22:00:00.001-05:00

Saturday, June 7
by Linda

HAPPY ANNIVERSARY!! The question of the day is: Which is longer? 61 years of marriage or a week in the hospital with a loved one in critical care? Dad’s answer is that it is all part of the same commitment and the question is, therefore, irrelevant. Cards and flowers added to our celebration. It was wonderful to celebrate the date.

Weekends are not hotbeds of activity in the regular care unit. The physical therapist worked with Mom through her arm and leg exercises and the speech therapist stopped by for a few minutes. Mom’s big forward progression of the day was eating some pureed food bites. The dietary staff takes the blended glop and creates formed replicas of the food from whence it came. In other words, they squeeze peach puree into peach slice look-a-likes, green beans into a blob with green bean shapes molded into the mound, etc. After tasting a bit of her Turkey Manhattan, it is understandable that Mom ate only a little! The mashed potatoes were great. Actually, she gets stronger with each meal.

Her other muscles are gaining strength bit by bit, too. Each repetition of the arm and leg exercises involves more of Mom’s own movement. She is helping more and more with lifting, bending, and twisting the left arm while someone provides basic support.

Friday Update

2008-06-06T21:43:00.001-05:00

Friday, June 6

When we arrived at the hospital this morning, Mom had her eyes open and was whisper-talking with the speech therapist who had come to check on her swallowing again. She did so well with the ice chips, water and applesauce that she is now cleared to receive nourishment orally (in a pureed form, through a straw, as long as she is alert at the time). The speech therapist says the breakfast choices on this particular menu are really good. Her favorites are the cinnamon roll and the pancakes. (Doesn’t that sound great – pureed cinnamon roll?!) We hope she will be able to begin this new process tomorrow morning.

Dr. Kachmann (the neurosurgeon) came to visit this morning as well. He indicated that he is very pleased with her progress and explained more about her surgical procedure. We were encouraged by his optimism regarding her recovery.

Good news – she has moved out of ICU into a room in the neurological surgical unit. Her room number is now 359. This means that she no longer has to be monitored as closely as she was in ICU. She also should be able to get more rest, because the nurses will disturb her less frequently.

The most exciting news of the day is that Mom has shown some movement on her left side. Up until now we have seen very little – especially on command. However, today she was able to turn her wrist and show slight movement in her fingers as we were going through the recommended exercises with her left arm. We are to complete each exercise in sets of 10. We are trying to count aloud, but sometimes we seem to miscount, because she immediately corrects us.

While she is still very tired and rarely has her eyes open, Mom has been asking quite a few questions today in a weak, but deliberate, whisper. For example: 1) she has been curious about the presidential democratic nomination (she specifically wanted to know what happened in Florida); 2) she asked about her grandson’s (Parker) job interview; 3) she wanted to make sure the crafts group at Highland Avenue is set to “go” without her; and 4) when she heard Fazoli’s was serving food at the hospital today, she said, “I like Fazoli’s,” but then she said she thought it didn’t sound good as a meal through a straw.

We are now sitting in her room watching the severe thunderstorms run through the area. We hope they pass us (and you) by without any damage.

Thursday Update

2008-06-05T23:28:00.001-05:00

Thursday, June 5

Today has been a rather quiet day. This is related to the fact that Doreen had been very annoyed by and uncomfortable with the hiccoughs yesterday. In order to control them, the doctors ordered a medicine that proved to have a strong impact on her ability to stay involved and connected with what was going on around her (in other words, stay awake). Because of that, the speech therapist was not able to rouse her enough to do a swallow study in the morning. The physical therapy and occupational therapy staff came to do an assessment, and she was in many ways a rag doll. This is due in part to some lost muscle tone, but it was also due to the medication. In the afternoon, another therapist did some swallowing assessments, and this time she did much better. She handled ice chips and applesauce with very little difficulty. The medication is beginning to wear off, but it may take some more time.

An exciting part of the day is that all of her physicians approved her moving out of intensive care to another room. This evening, we are just waiting for that move to take place. It depends on whether a room is available, but we hope it will take place soon. We reassured her that we would stay close; they can’t get rid of us. Karen said we would “stay on their tails.” Doreen then asked, “Are you sure they have tails?” Her sense of humor is still intact! Of course, the delivery of the one-liners will work better when we can hear her better!

We were pleased and thankful to get a number of greeting cards today. We shared them all with Doreen, and she thanks all of you for them. For those of you who do not have the hospital address and would like it, it is:

Doreen Myers c/o Lutheran Hospital
7950 W. Jefferson
Fort Wayne, IN 46804

We hope to tell you her new room number tomorrow!

Wednesday Update

2008-06-04T16:02:00.002-05:00

It’s been another good day! Mom’s condition has remained very much the same today as it was yesterday. She has continued to communicate with us in a very quiet whisper and by nodding or shaking her head in response to a question. She has smiled and even “corrected” a story Dad was telling. (~Clay: That never happens.)

Yesterday, we discovered that her memory is still remarkably sharp. She remembers everything up until the surgery. When she realized what day it was, she remarked that it felt like she just got here yesterday. (Thankfully, she may not have to remember any of the really difficult days.) She also could recall all the activities in her schedule. She inquired about whether or not she might be home by Friday. If not, we were to contact people about canceling some of her appointments. (Sounds like the Doreen we all know and love!!)

She's been pretty groggy and tired throughout the day. We assume this may be a result of all of the excitement and activity of yesterday. Also, ICU gives very little opportunity for sleep. She has professionals checking on her at least once every hour and sometimes more often than that.

Today she has been seen by a speech therapist, Kelli, to evaluate her swallowing capability. Her evaluation yesterday indicated that she was not yet ready to swallow. She choked on the ice chips and sips of water they offered her. Today, however, she handled the ice chips and sips of water very well. She even had a little applesauce. Kelli told us that this is a great sign. It probably means that she has not suffered brain damage regarding her swallowing ability. Instead, her throat just needs to heal from having the breathing tube in for so many days.

A nurse from the neurosurgeon’s office also visited. He was very pleased with her progress. Her left side is causing some concern, because she has not been able to move her left arm at all since the surgery. However, she was able to move her left leg when he asked. (This is an improvement from yesterday.) He also detected some movement (though slight) in her hand when he asked her to squeeze his hand. This is very encouraging. He indicated that even the slightest movement is an indication that recovery can be achieved. It is when there is no movement at all that we assume nothing will occur in the future. In Doreen’s case, she is showing only good signs!

The cardiologist has weaned her from the medications she was being given to regulate her heartbeat (its steady beat and its speed). Instead, she is now receiving medications orally (through a nasal-gastric tube). This frees her to be discharged from ICU. We anticipate a move to the “regular” neurological unit tomorrow.

As stated at the beginning of today’s entry – another GREAT day!

FYI – For those of you in the Fort Wayne area, she is able to receive visitors, but please be aware that she needs her rest and is not ready to do much visiting. We all look forward to when she’ll be ready to entertain again!

Catch Up

2008-06-03T15:01:00.003-05:00

I've finally gotten a pretty thorough overview of the situation from Karen and her sisters. I've split up each day into a different post, so start at the bottom and work your way up. As we get new information, I'll post it.

Clay
http://myers-bowman.blogspot.com/

Tuesday Details

2008-06-03T14:59:00.004-05:00

Tuesday, June 3

It was Linda's turn to stay close, so she slept at a friend's near the hospital in case she was needed overnight. She arrived at the hospital around 9:00 a.m., and found that Doreen was about the same as the previous day: she acknowledged Linda's presence, but still had the breathing tube in. She stayed with her until the rest of the family arrived.

Judy, Karen and Carl joined Linda at the hospital around 11:00 a.m. When we walked into the room she immediately opened her eyes and acknowledged our presence by nodding and squeezing. She indicated that she was not in pain, but was having trouble lying still because she felt restless. (Can you imagine, Doreen is having trouble keeping still?!)

At around 1:00 p.m. we were shooed out of the room so they could remove the breathing tube. All went well with the removal. She is now breathing on her own. She has a very sore throat and will be coughing up all of the stuff that has built up over the last several days.

She is trying to communicate, but it is difficult. However, she can clearly indicate yes and no and she can even tell us simple things.

THIS IS A GOOD DAY! We are all feeling very thankful!

Details from Monday

2008-06-03T14:59:00.001-05:00

Monday, June 2, 2008

On Monday morning, Judy called the hospital and found out that other emergencies had kept the surgeon from completing the procedure during the night. He had decided to let the original surgeon make the decision to do that or not. The nurse also asked for permission to put in a PICC line—a line that goes through a vein in the arm to the space just above the heart. This allows the medical staff to eliminate most or all of the IVs and to draw blood without needing to stick the patient again. The family provided permission for that.

When Judy arrived at the hospital, Doreen was much more alert than on Saturday or Sunday. She opened her eyes several times and squeezed hands and moved body parts in response to commands. As the family members interacted with her, she communicated yes and no and showed emotion. It was possible to communicate with her in a way that had not been possible for several days, and she seemed like herself again.

This was a day with lots of activity, though. Respiratory students studied her ventilation tubes, nurses inserted the pick line, a portable X-ray machine was brought in to check the position of the line, the neurosurgeon ordered a new CT scan, and friends and family members visited. As she became more conscious, some of the procedures and especially the ventilation tube seemed to bother Doreen more and more. This caused another increase in her heart rate. The medical staff decided that maybe she was TOO alert, so they gave pain medication to help her relax. When she did wake up, though, she continued to show some good alertness.
Carl, Karen, Linda and Judy left the hospital sometime after 10:00 to get some sleep.

Details from Sunday

2008-06-03T14:58:00.001-05:00

Sunday, June 1

On Sunday morning, Linda, Lee, Judy and Carl came to relieve Karen. Karen went to the home of a friend who lives 4 miles from the hospital to try to get some sleep. It was a quiet day, as Doreen was sedated with pain medication and others to regulate her heart rate and blood pressure. The neurosurgeon (the one on duty on the weekend—the son of the surgeon who did the original surgery) asked for another CT scan and that Doreen should have a drain inserted, which would require another simple surgical procedure that could be completed in her room. Linda and Lee headed for Elgin around 11:15 am, because Lee had to go to work on Monday. Carl, Judy and Karen waited all day hear when (and whether) that surgery would take place. At the end of the day, it was decided that one family member (it was Judy’s turn) would stay close to the hospital at the home of a friend in case someone was needed. When Judy called the hospital at 11:15 that night, the procedure had still not been completed.

Details from the first two days

2008-06-03T14:57:00.003-05:00

Friday, May 30

Judy and Dick traveled by car from W. Lafayette, IN to Fort Wayne Thursday night. They arrived just as the surgeon was emerging from surgery. Karen left her home at 2:30 am (CDT) driving from Manhattan, KS to Kansas City. She flew from KC to O’Hare (unfortunately experiencing a 2-hour delay in landing because of wind shear warnings), finally arriving by 10:00 am. Linda, Lee and Carl picked her up at O’Hare and they drove to Fort Wayne arriving by 4:00 pm (EDT).

The report from the surgeon right after surgery was that things had gone well. He removed a large clot from the outside of the cerebellum at the back of the head. He said it seemed to be as good a situation as could be expected. The cerebellum is the most “forgiving” of the areas of the brain, because traumas to that section can often be accommodated for by another part of that section. He said that recovery would be a long process. He did not put a drain in at that point, but completed some procedures that would make it simple to do so if necessary.

During that first day, family began to visit with Doreen around 7:30 a.m., about the time she roused from the anesthesia. Judy and Dick were the first to visit (after trying to sleep in the hospital hallway), and they found that she showed recognition when they first greeted her by trying to open her eyes and squeezing hands, in spite of having a breathing tube in her throat. She seemed to be somewhat less responsive after that, but each time a new family member came in the room and greeted her, she would turn toward that person to show recognition, even though she very rarely opened her eyes. She was clearly exhausted and still dealing with the after-effects of the operation and sedation. Because we had not slept the night before, all of the family members left the hospital around 11:00 pm and drove to N. Manchester for some sleep.

Details from last week

2008-06-03T14:57:00.002-05:00

Saturday, May 31

The family slept in on Saturday so that we could function that day. We got to the hospital just after noon. It was a day when there was little response from Doreen. She did not respond much to commands from the medical professionals, nor from us, to open her eyes or squeeze hands and she slept a lot. This is expected after brain surgery. The swelling often reaches a peak 2-5 days after surgery. The challenging issue Doreen faced on Saturday was high blood pressure. The hospital staff tried several strategies to try to lower her BP, but none was successful. This remained a concern all throughout the day.

The family was getting adjusted to what had occurred and began to think about possibilities, options, and many questions. The hospital staff has been wonderfully supportive and has dealt with the Myers clan and its assertiveness (how’s that for a nice word?) gracefully.

The family returned to North Manchester that evening, arriving around 10:30. Approximately 15 or 20 minutes after arriving in the home where they were staying, the hospital called to say, “Mrs. Myers is not doing very well right now. It would be good if you could return to the hospital.” This was a very distressing and unsettling experience. The family drove back very quickly, afraid of the worst. When they arrived, they found that Doreen’s heart rate was erratic and much too elevated, reminiscent of the situation she faced in Pennsylvania four years ago when she was diagnosed with a severe kidney infection and pneumonia. It seems that this may be a response of her circulatory system when she is experiencing a serious illness. It is a serious concern in Doreen’s current condition, because elevated blood pressure and high heart rates increase the likelihood of hemorrhage. A cardiologist was brought in and was doing everything in his power to stabilize her condition.

The family decided that one member (Karen) would stay with Doreen throughout the night to monitor her status and keep the family apprised of any new information. Karen stayed in her room all night to hold her hand, rub her feet and hands, get the nurses’ attention when needed and try to keep her from squirming out of her IVs, tubes and other devices. Her heart rate and blood pressure finally stabilized at 4:05 am. After that she was able to relax (as was the family).

Details from last week

2008-06-03T14:55:00.000-05:00

Thursday, May 29

Doreen traveled from Elgin, IL to N. Manchester, IN to attend the 60th reunion with her classmates from Manchester College. She also was planning to help her grandson, Parker, move his things home since he graduated from Manchester on May 18.

Around 7:00 pm she was at the soccer fields helping the team Parker was coaching celebrate the last practice. (In fine Doreen fashion, she had brought watermelon for all the kids.) Kurt Borgmann, whose son is on the team, went to the field to pick up his son at about 7:20 pm. When he arrived, he saw Doreen sitting on a cooler looking as though she was not feeling well. He inquired about how she was doing, and she indicated that she was experiencing nausea and dizziness. When she did not improve over the next several minutes, Kurt called a physician friend who lives near the soccer field. He came right over and suggested that they call an ambulance to take Doreen to the hospital in Fort Wayne immediately. He had identified several symptoms that may indicate a stroke and he wanted her to be under medical care as soon as possible. She was accompanied to the hospital by Kurt, who rode in the ambulance, and Parker, who followed in a car.

Once at the hospital, it was identified that she had experienced a severe brain hemorrhage at the back of the brain. Surgery was immediately necessary to attempt to prevent her death from this incident. She was out of surgery by 1:45 am EDT, Friday, and we were told that the surgery went well.

Updates on Doreen

2008-06-01T20:53:00.001-05:00

I'll try and post daily updates on Doreen's status and progress as she recovers from the brain hemorrhage she suffered late last week. I hope to get information from the family that is gathered in Fort Wayne. As of Sunday evening, June 1, Carl, Karen, & Judy are present. Everyone else is waiting for more information. More later.

Clay
myers-bowman.blogspot.com