The Mom Recovery Blog Post
The Mom Recovery Blog Post
Here we shall continually update and note mom’s recovery. The latest news will always be at the top of the Timeline. Be sure to check back in regularly for daily updates, tales, hopes, gains, inspirations, and more.
And thank you all for following along – as well as for the countless texts, emails, & calls!!!!
The Central Figure: Mom
Most of you know mom, but for those who don’t, here are some of her tales and adventures including her workout routine when turning 90 in August 2019.
Mom’s health remained this same basic level until the weekend before her hospitalization on 19 October 2020. Yes, THAT year -2020.
The Timeline
Here is the timeline of mom’s recovery from open-heart surgery at the age of 91. The newest entries are at the top…
Please continue to follow mom’s recovery:
Part 2 – Feb 18, 2021 Onwards
Wed, Feb 17 (1:25am) – And Then The Rain Stopped
Well, while the rest of the country is mostly buried in snow, we finally got a break from all the rain. So (on Tuesday) mom and Pastor took advantage of the nicer weather and walked around the block in the late morning. All in all, mom had a fairly active day. She did her bed exercises, prepared her own tea and did some basic kitchen duties, and made a road trip out to Pastor’s house where she did a walking tour of the house and yard.
Then, in the evening, we did did some balance poses, footwork training, and body stretches, especially for the lower leg (calf and shin) – as those muscles are a bit immobilized from the boots.
Here are just a few quick shots….
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Finally, as usual, when the day is over at around 8:30p, I know of no person more pleased to sneak into bed than this lady….
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Mon, Feb 15 (9:45pm) – Once a Nurse Always a Nurse
Mom had a very solid day today: good appetite, good exercise, good initiative, good wound healing, & more.
A few days ago, a dear family friend’s 20-year-old (approx) grandson was undergoing terrible pain – it was a real mystery – and when mom was informed about the symptoms, she tagged it as a gallbladder issue. The final diagnosis was made today: gallbladder. The best news is that our young lad should be fine and well, with no lingering issues. Word also went around that mom called it. Hence the phrase, “Once a nurse always a nurse.”
Here is mom at PT today doing a different type of engagement on this balance machine. It was a constant endeavor of shifting her weight to manipulate the screen. Mom was pretty good at it!!
Here below mom is doing well standing on an unstable surface – the blue sponge pad, yet is keeping her balance as she glances side to side….
Sun, Feb 14 (3:50pm) – Hunkering Down
Mom and I are doing just fine – just not able to get out this weekend for our walks as it is wet, cloudy, overcast, chilly etc. So we have been mostly indoors. But mom is taking on more engagements around the house: opening and closing the shades in the kitchen (which is akin to drawing the sails on an 18th century sailing ship), doing light food prep, getting on the computer, and yes, soaking up the Sunday Times.
Mom nearly pulled an all-nighter last night watching BBC murder mysteries. She is their biggest fan and watches with an unblinking stare.
Not much else to report here, except that the climate is ideal for this type of homemade soup – come on over and join us!!!
Miso based with broccoli, carrots, zucchini, celery, cilantro, and pasta.
P.S. Oh, we did get the lab results from mom’s blood work and things look really, really good….👍👍
Sat, Feb 13 (12:30am) – A Few Scenes from PT
Friday was a good all around day….it was quite chilly and the afternoon kind of got away from us so we did not walk outside, but as you can see below mom had a solid PT session. Plus mom was responsible for closing all the blinds in the kitchen once it got dark.
Here is one of the many rounds mom did on an unstable surface. Some with the eyes open, and some with the eyes closed; some with the feet wider, and some with the ankles together.
Thurs, Feb 11 (11:35pm) – Three Cheers for Volunteers: The Vaccine Experience
Mom had a normal morning and directly after my corporate yoga class we headed out to the UNC Friday Center (think convention center) for her covid appointment. It was raining hard and we had the rollator so after I cruised through the parking lots it seemed best to let mom off in front and then figure it out from there. Well, we got mom out in the pouring rain and she had to walk about 60 feet to enter the center. Before we could even formulate a plan a volunteer said, “Let me bring you a wheelchair.” (Note: it was just on Monday that we returned the wheelchair we had on loan thinking we were done with it.)
I talked with the volunteer for a few seconds, realized he was legit, and left mom in his care as I went off to park the car. Within a matter of minutes I was running up to and entering the building, and mom had already made it past the initial entrance staging area (there was a line) and she was with that same volunteer and getting registered beyond the first checkpoint. A policeman saw me – gave me clearance to cut the line – and I joined mom. From there we went through a system of about six stages from beginning to end – all wonderfully organized with lots and lots of volunteers keeping things tidy and moving along. The place was like clockwork so even through there were hundreds of people there it never felt crowded, overwhelming, or confusing.
We made it through the whole process in about an hour or just over, and that includes a 30 min post-shot holding tank to ensure there were no bad reactions. The place was fantastic. Mom got a Pfizer shot which had already been allocated for her with her name and code on it. I asked about getting a shot, but there were no loose ends in this place. They were tight, courteous, and efficient so I had no scope of rolling up my sleeve and getting hold of a stray shot.
Here is one of the initial waiting lines we were on as we passed from station to station.
And below is our “holding tank” where we remained for 30 min after the shot to ensure mom was ok. And the end of that period, we were given a ticket and appointment time for mom’s follow-up shot.
After doing all that, and taking care of some house duties for the later afternoon, we dipped into our creative bag of tricks to make mom a special dinner. Fried potato slices with pan steamed broccoli on toasted bread with shredded raw carrots, cilantro, and avocado slices. Mom gave it a top score. The fried potato is the base part of the open-faced sandwich, and she got an extra one that is on the back part of the plate with some avocado on it.
Wed, Feb 10 (11:35pm) – Making Coffee + PT Videos + Vaccination Day Tomorrow!!
Another great day for the record books!!
Mom made the coffee and put up all the shades in the kitchen – without using her rollator or ski poles – ooops!! To be honest, I missed most of the action, but Pastor had the situation under close eye.
The other great thing that unfolded in the morning was that we got mom’s vaccination appointment set for tomorrow. Here is how it unfolded. Went to the website – no appointment available. I called up and actually was put on hold as opposed to being told to call back. I was #70 on line and waited a full 45 minutes until a very kind person came on the phone. Given the long line I was expecting to get an appointment in 3-weeks time, instead and much to my surprise they had every time-slot available for the very next day!! Amazing!! I heard from another party later that morning that UNC got a full shipment this morning. Sounds like we hit the timing just right. I am going to see if they will also vaccinate me as her primary care-giver. Let’s see if some smooth talking skills can get me over the hump (wrong age group, wrong state, wrong everything).
Mom had another great session at PT – she was the star as usual. We did not even use the rollator to get in there; mom used her ski poles which was a workout in itself!! When mom finished ten-minutes on the reclining walking machine (see Feb 9 video) the therapist asked her what was more difficult – doing the machine or walking in with ski poles. Mom said walking in with ski poles.
Here are some new things mom did in PT today:
Tue, Feb 9 (11:20pm) – “I think I’ll Get A Subaru” + Vascular Dr Update
On our way driving to our 1:40pm appointment with the vascular podiatrist, mom was checking out the road and said, “I think the next car I buy will be a Subaru.” 😂 She added that that’s all they have up in Vermont, and she said that Subaru only makes 4-wheel drive cars and that is good when it is snowy and icy. All very true (mostly). That said, we are in NC, and it was 67 degrees and sunny on our way driving to the doctor – mind you in early February. Not to mention that at the moment mom is not really in the market for a new car. Nonetheless, planning ahead is good. 👍
Let me tell you, going anywhere with mom now is a breeze – she can get in and out of the car quite easily, and needs very little help along the way. In the past we went to these appointments with her wheelchair – no longer. Now her rollator fits the bill for these outings. The vascular team was quite impressed with her upright arrival!!
As for the visit itself, here it is in a nutshell:
(a) They thought mom’s feet looked really great, and that we should just keep doing what we’re doing.
(b) Mom has graduated. She is no longer acute care, but chronic care. So when she goes back next month she will not see the vascular surgeon, but will instead see the wound care person.
(c) Mom’s appeal to wear other shoes was shot down. She has to keep using her famed black shoes. (Even then when we got home this evening she was giving me instructions on getting out two different pairs of slippers!!)
(d) They said mom’s healing process could go on for months, and they said they saw no sign of auto-amputation starting, and did not rule out the possibility that mom might possibly keep everything.
(e) All in all, it was a short and sweet visit and when they were done with us on the 3rd floor we stopped in at the 2nd floor to get some blood work done.
So mom and I moved through the medical center quite seamlessly. Every day she just seems to get better and better and is generally eager to do more.
Once we got back I prepared this snack for mom, but to be honest she was not thrilled about it 🥴, as she wanted pistachios instead. Well, in this house you can eat your avocado toast and have your pistachios too!! She ate 75% of her avocado toast and four carrot sticks and pronounced that she could eat no more. I took her plate away and promptly served her a good-sized serving of pistachio nuts 😋 which she quickly devoured.
Just to close out here. Mom is progressing using the ski poles in the house – getting more comfortable with them, and tonight we had an awesome home yoga balance session as well. Mom was really really good!!! 😎
Tue, Feb 9 (8:15am) – A Few Breakthroughs
Yesterday, mom was sitting at the kitchen table and said, “I think I would like some tea.” And we were like, “Good, get up and get it yourself!” And she did! The teapot on the stove still had some water in it (unfortunately!!!), so she did not have to refill that, but she opened a kitchen cabinet for the first time since her surgery and got herself a tea bag and prepared her tea, and then managed to get herself, her cup of tea, and her rollator over to the kitchen table to sit back down. Going forward, when we are not in a rush (such as not before a yoga class or dr’s appt etc) we will focus on more doing more and more simple tasks in the kitchen.
Mom did get her outside walk in yesterday – actually it was a walking date with her dear friend Maggie whom she traveled to Patagonia with just a few years ago.
The other breakthrough is that we are now officially into ski-pole training. Mom has a great set of high-tech, adjustable hiking poles and yesterday we worked on that while getting around the house. Actually, it all started with her PT session yesterday – and the one prior – where mom experimented with an old, donated set of hiking poles / ski poles that they had onsite. And when we came home from the session yesterday I got out mom’s high-tech pair. And that is what we used yesterday afternoon and evening to get around in the house – not outside. She is a bit unsteady with them so we use the PT belt and support / spot her from behind, but this is definitely the next step. Make no mistake, she now prefers her rollator, but I told her to start waving her rollator good-bye unless she is outside or going to the bathroom. So all major movements in the house will be done with ski poles going forward.
Yesterday at PT, they did not get any balance work in so mom and I did a session on our own in the evening. When Pastor is there to spot her then I can guide her through more dynamic sequencing, but if I have to lead and spot it is a little limiting, but nonetheless we can get some really good work done one-on-one.
Here are some scenes from PT yesterday:
In this first video mom was aiming to keep her steps per second above 50, which she basically did for ten minutes without getting tired.
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Sun, Feb 7 (10:15pm) – Hang Loose Day
Well, we kind of had our sights set on reaching the mail room, but it was a Sunday after all. And besides, the mailroom is a bit of a hike and probably out of our range for the near term. But mom is thinking about it because before leaving for our walk she says let’s get the mail and always asks to make sure I have the key. But we did do our walk around the block for the 8th day in a row!! It was done at a pretty contemplative pace, and we were going to go a bit further but….albeit we literally did go just a bit further, like one house extra. Here the point is that even when we are not so speedy or energetic, with perhaps some pain in the 4th tow, still we made it around the block!
The rest of the day was pretty relaxed – not a whole lot on the agenda. But mom took charge of getting herself through the day, and she had plenty to eat!! Let’s see now…Pastor was slipping her cookies at breakfast; she had an ice-cream sandwich after lunch; she had a freshly baked blueberry muffin in the afternoon that the next-door neighbor brought over; and, she had an ice cream mocha chip on stick after dinner. Toss in a big smoothie, breakfast, PB & J, pistachios, carrot sticks, and Chinese take-out then you get a sense that mom did not go hungry – oh and did I remind you that mom has not had any appetite-stimulant meds in the month of Feb. So her system is working well, and we are focusing on endurance.
Sun, Feb 7 (12:45am) – Weekend Update Part 1
Mom expanded her boundaries today by walking a good portion of the way to the mailroom. I was out dealing with internet stuff for the house, so it was Pastor and mom on that one. At this point, Pastor is with us from 8am to noon.
In the evening, mom and I did a balance session together. Her basic center of gravity is quite solid so there is a lot of scope for her to become a real pro again.
Lunch was one I would have liked, but I am not quite sure mom did so tried to make up for it with a decent dinner….all in all a fairly event-less day, just more of mom regaining her independence.
Fri, Feb 5 (11:15pm) – Hardcore & PT Session #2
It was nearing 6pm and mom still had not gotten in her walk around the block. I opened the front door, and from 10 – 15 feet aways she said it did not look very inviting. I thought, “Ok, no walk today.” Then a few seconds later mom looks down the hallway of the house and sees her coat on the back of a chair. Then she says, “I can put my coat on and go for a walk.” So be it. That was how mom extended her streak of walking around the block to 6 days in row. Yes, it was a little chilly, and yes it was kind of dark, but mom enjoyed every moment of it and had a huge smile on her face when she was finishing up, noting that it was good to get out and walk. In a word, “Hardcore.” Let it be known that mom is not just some fair-weather walker.
We did go to PT today and I am going to go over that, but here are a few things of note:
(a) Mom has not taken the appetite stimulant since Jan 31 and her appetite is as strong as ever.
(b) Mom is dressing and changing her clothes 99.9% independently.
(c) Mom’s entry into the car is quite smooth. Getting out is a touch trickier, but not a major issue by any means.
PT went very well today. The session was dynamic and active, and one key theme was to not use the rollator at all, though she impressed upon us to always use the rollator when walking outside. Anyway, mom engaged in some strengthening exercises for the lower leg muscles since the shoes basically handcuff that group of muscles. Then a fair bit of time was spent on balance exercises, and the therapist was duly impressed with mom’s balance. We mentioned that we’ve been working on that at home, and at one point the PT asked me directly what we were doing. I quickly demoed half-a-dozen or so, and she seemed a touch open-jawed by the difficulty, especially the lateral balance leg swing that we do. She said, “Really!”
Anyway, here below is an interesting one that she did with mom. They did numerous rounds and styles, and I just caught a quick clip here. Mom did quite well with it.
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Towards the end of the session mom got on this machine, and I could not believe how readily and easily she took to it, as if she had been doing it her whole life. All in all, mom did it for 10 minutes.
Thurs, Feb 4 (9:15pm) – The New Norm
Yep, walked around the block today – 5th day in a row – but this time we added a little extra. And that is the plan: To continue to build up more and more. She saw some of her friends out on the street and they were all excited to see her on the move.
Today she showered and dressed herself without any help. Pastor was there to watch, but he did not lend any support. So each day mom is reclaiming more and more of her independence. Actually, there is more to the tale than that. When she got up this morning, one of the first things she told me is that she is going to shower herself today. Little by little we got things in place but I am not her shower person so when I told Pastor about it over the phone, he said to wait until he got there. So we aborted the plan – mom is always quick to relent if we ask her even if she seems determined to do something. But sure enough, true to her word, later on mom fulfilled her destiny!!
All else is just fine…still queued up for mom’s covid vaccine, but the line does not seem to be moving all that much.
Wed, Feb 3 (10:38pm) – Shoe This!?! + 1st Day of PT
When mom was getting into bed this evening she effortlessly lifted her shin up to her sternum as she was seated on the bed and unstrapped her shoe – like it was a piece of cake!! I was both flabbergasted and awed, and she looked at me quietly and said, “I have been taking my shoes on and off all day!” The point here is that she is just cruising along and realizing day by day all the new things she can do, mind you without training for that specific task per se, but just because her overall condition is so much better. This shoe thing has been an encumbrance for a while, and now, just like that (snap of the fingers), it is gone – a non-issue.
Not only that, mom also sprinted across her bathroom this evening without any support of any kind – I saw her midway on her journey and told her never to do that again – until we are really at that point in our progress!! Anyway, just further evidence that she is feeling pretty good (maybe too good!!! 😯) about her abilities.
We also went to PT today and I was in there with her the entire time. It was a great, great session. The therapist was both knowledgeable and dynamic and neatly met mom right where she was and held a strong vision of where mom can go. We also showed her videos of mom prior to the surgery, and the therapist quickly understood that mom has high aims to regain her prior form. At one point, the therapist also said, “I think I have seen you in the gym!” And she probably has as mom’s gym is on the back side of this building. The therapist stressed the importance of regular and challenging workouts to increase mom’s stamina, range, and endurance. One aspect of this is that instead of doing it twice a week we are switching to three times. She was also keen on our continuing to push the distance of mom’s walks – no problem there!!
When we left she said to be sure to drink water when we got home and then take rest as needed. When we pulled into the driveway, mom and I figured that since we were already dressed then why not do our walk now, so we did our lap around the block then and there!! Four days and counting of walking around the block!!
All in all a really positive day. Here are some clips of mom at PT:
Wed, Feb 3 (2:30am) – Hardcore Walker
It was the late afternoon on Tuesday and the prior two days mom had walked around the block but had yet to do so today (Tuesday). She was cozied up in her black chair and a gusty wind was swirling outside. I had asked mom a couple times, and she was non-committal about it. The sun was setting and it was now 5:30pm, and all of a sudden she says, “Well, I guess I better go on that walk.” I was quite shocked. So we got out the wind pants she took to Patagonia, and she bundled up and by that time I had gotten involved in some other works and Pastor had just arrived so the two of them went out, braved the elements, and did the walk. So mom’s streak is up to three days in a row of walking around the block.
Tue, Feb 2 (6pm) – Yoga Balance & Stretches
Here are photos & videos of mom’s morning yoga routine and walking.
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Mon, Feb 1 (7:45pm) – Scoutin’ Out the Fridge
Lots of great things happened today: Yes, mom did walk around the block again; yes, mom had a great call with her primary care doctor; yes, mom was checking out potential vacation hot spots; but, far and away the biggest thing that happened is that mom made her way over to the fridge and opened it to see what was inside!! She has been home since Dec 9, and this is the first time she made her way over to the kitchen appliances. The tables are turning; step by step, she is reclaiming her house.
Mom and I had a 40-minute call with her doctor today. We talked about all kinds of things in a comfortable and casual manner – funny anecdotal accounts were shared as well as good info. One outcome of the call is that we are going to try and take mom off the appetite stimulant and see how she does. The doctor was very, very happy with mom’s stellar BP numbers. And, by and large, it was just good to touch base, and the next call will happen in two months.
Now here are some photos of the day….
Here is mom on her walk around the block; something we aim to make into a daily happening.
Next we see the “leftover jar” of today’s morning smoothie. Each morning we make a massive bowl that serves several portions. This particular one had approx 10 – 12 clementines, 1 large mango, 1 banana, and vanilla protein powder. This is our standard except for the mango which was making a guest appearance, so we left the 2nd banana out.
Below is lunch: pan-fried marinated tofu (tamari, fresh ginger, balsamic vinegar), avocado, nuritional yeast, and lacinato kale on a quality toasted 3-seeded bread. Initially, mom gave it a thumbs up, but later on offered a more reserved opinion. That said, I thought it was wonderful!!!
Sun, Jan 31 (8:15pm) – Sunday Evening Workout
Here are two brief clips of mom’s Sunday evening regimen. First mom is doing reps #4 – 7 of her quad-glute stand-up exercises (she had to do ten total):
Next, mom is engaging in some dynamic lateral balance work and weight transfer.
Sun, Jan 31 (5:50pm) – Cold, Wet Sunday
No chance of getting outside today so when we completed our regular morning engagements (wake-up, wash, breakfast, newspaper, nap) then we jumped into a quick balance routine wherein mom did very well. She was willing to go (successfully) out on an edge.
Later on, at some point, mom had a piping hot potato salad for lunch: diced potatoes (red, Yukon gold, russet) steamed in a pan along with diced carrots, and chopped lacinato kale (added later on), and spiced & topped with fresh ginger, black pepper, sea salt, ground flax seeds, infused balsamic vinegar, tamari, nutritional yeast, and ground coriander.
After that mom sat in her black recliner and immersed herself in the Sunday NY Times. Not a bad way to spend a cold, wet Sunday, especially if you have a blanket and an ice cream.
For a long, long time mom only ate So Delicious ice cream sandwiches, and while we still get those, mom has also branched out in other directions. The below is mom’s latest foray into the wild offerings of ice cream pops.
Sat, Jan 30 (3pm) – Rock Around the Block
Well, well, lookee’ here….guess who just took a walk around the block!! Just her and the rollator!! It was impressive to see how good her stamina was. It was one of those unplanned events. We were going to use the wheelchair to get the mail. But there is no benefit for mom to sit in the wheelchair so we ditched that idea. So we walked out the front door with the rollator and I asked mom if she could make it to the corner and she said, “Oh yeah!!”. As if to say, why are you even asking me. So we just kept going to the next corner…and the next corner etc… until we reached our garage….
Fri, Jan 29 (8:30pm) – The Olympian
Mom just did great today – her walking was as smooth as silk – free standing!! There was one video which I thought I was taking but really wasn’t. But mom was just cruising along without support, just with Pastor as a spotter. As for the lost video, not to worry as this entry is filled with photos – and there will be a quiz so be sure to see them ALL!!
Another thing: Today was the first day that I was able to work with mom on her balance. We did two short sessions. One in the afternoon and another in the evening. She did a stellar job on both occasions. Actually, she did far better than the below photos portray. It is very difficult to lead / guide and take photos / videos, and when she sees me reach for the phone then naturally she gets a bit distracted as well. But I was really impressed with how well she was able to hold herself and shift her weight. We worked on upright stances, lateral movement, dynamic balance poses, and wide angle stands.
Again, the below photos do not do justice to all the hard work mom put in. Pastor was behind her spotting using the PT belt, but he never really had to apply any leverage, and we were putting mom in some challenging stances, places she did not want to go, but she pulled them off just about flawlessly. It was very evident to both Pastor and I just how far she has come – and mom too was clearly pleased with her progress and abilities.
After such a tough workout, it was time for a most hearty bowl of soup – made from scratch (but of course!!). And yes, there was a So Delicious ice cream sandwich afterwards…
On my way to the mailroom I came across these two dudes. One had gotten a lot of mail and the other not, so they had a bit of a falling out and could not bear looking at each other. With a little bit of coaxing, I was able to get them back to a place of basic agreement, and they were “big” enough to share the letters between them.
Thurs, Jan 28 (10:30pm) – Feet
After last Thursday’s update (1/21/21 5:15p), which showed a non-close up yet first public photo of mom’s feet, one person offered that they had “imagined mom’s feet looking much worse”, and they were relieved. In contrast, the other day on a video call mom showed a closeup of her foot to a friend and they were shocked and could hardly stomach it, but then gradually became ok with it during the call. For us, we think the wound look beautiful.
At this point, it is amazing to see how the body is continuing to reclaim the base and mid-section of the toes. And the wound remains quite dry, for the most part. Now that we know that the foot is going to be functional, I will organize all my photos and post some key shots so there is a public record of the recovery. The thing is this type of vascular issue is such a wait-and-see event that medical specialists cannot give an accurate prediction – so they tend to withhold making any, unless you ask them point-blank what their thoughts are.
All else is well here – no major developments, other than waking up to a wintry-looking morning.
Wed, Jan 27 (9:15pm) – PT All Set & “I already ate lunch”
One of the first things done today was to arrange our PT with our new outfit. And now that is all done. Starting next week, we have a series of 10 – 12 sessions lined up with two therapists who will alternate working with mom. And YES, I am able to attend all sessions. That way I can take notes, ask questions, take photos / videos, and be a silent observer. That should make our practice sessions at home more fruitful.
Mom slept very well last night – she always sleeps well – but on this morning she did not wake up till almost 9am. That’s a pretty good night’s sleep when you hit the hay at 8:30pm the evening before. Anyway, once up mom washed and made her way down to breakfast. Then in the late morning or perhaps just after noon, she took rest in bed again. Quite normal. And when she got up at 1:35pm, the first words out of her mouth were, “I would like an ice cream.” I said, “You can have an ice-cream, but first you have to have your lunch.” Then mom deadpanned and said, “I ate lunch.” …..Noooooo…..
You have to understand that with full certainty and in a simple voice mom regularly makes such claims, but then quickly accepts without any push-back if we tell her that she did not have lunch. Where this happens the most is with her appetite stimulant formula which she takes every day just before or after lunch. Every time I come over with it, then in all earnestness and seriousness, mom says, “I took that already.” 😂😂 At the beginning, way back when, Pastor and I would consider her remarks with some seriousness – no longer. So later on when I conveyed to Pastor (he had left during the day for some hours) about mom waking up, wanting ice cream, and saying she already had lunch, he just laughed.
It was a splendid day so mom and I took advantage of the good weather and headed up to the mailroom together. She first said she wanted to walk there, but it is still a good bit out of her range (maybe 1/4 to 1/2 mile) – hopefully by spring – so she acquiesced and transferred over to the wheelchair. Mom enjoyed getting out in the sunny weather – temp about mid-fifties.
Evening was mellow for mom as she was in her recliner while I taught my classes. During that time, she was browsing through a Talbots catalogue and I asked her what she was looking for, she said, “Shoes.” Duh!! 😂
She was in bed by 8pm and has been watching an awesome nature show on the wildlife of the Alps in winter, and now some sort of history show…
Tue, Jan 26 (11:50pm) – “I’ll get the takeout”
No major (or minor) events today…so just passing along this video.
Oh yes, mom sent me to get her Malaysian takeout, but before my leaving she suggested that if I preferred to stay home then she would go pick it up. She was just not sure if her driver’s license was still valid. 😂😂
Pastor and I explained to her that she will do it, just not tonight – maybe in a month or two. And when we went over all the steps it would take for her to go and do the pick-up, she did not find it very inviting. But sure enough, in the foreseeable future, we fully expect her to pull off this type of thing without a hitch…
(Pardon the vacuuming noise; meant to overlay some music.)
Mon, Jan 25 (9:07pm) – Physical Therapy Update + Dessert & Pistachio Monster
So the big event that we were looking forward to today was our first appointment of out-patient PT. Mom got to her 11am appointment on time, and the session went ok. The catch is that per their policy they did not allow me to enter and accompany mom. So while mom was inside doing her PT, I rapid-fire researched other PT facilities that would allow me to be present in her sessions. After speaking with mom, Andrew, and Pastor, it became evident that it is a no-go for us if someone cannot be there with her. So we have a new spot in mind which we shall get shored up tomorrow.
As everyone knows, PT only works if you do the exercises at home on your own. So we need to see first-hand what mom is doing in PT in order maximize the outcome of her rehab. So that is the approach we shall take. Fortunately for us, mom does not have any injury per se; she just needs total body reconditioning that stretches and strengthens her from head to toe and enhances her balance. Yes, I am right there with you – sounds a lot like yoga.
All else is going well. Mom is of sound mind and a body on the mend so we are in good shape….see more below….
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Here I have to make a declaration. Mom is a pistachio nut and dessert-eating monster. She has two or three desserts a day, if you include the invariable cookie(s) that Pastor slips her during breakfast. I even saw her eating oreos at the breakfast table the other morning, after she had already had her daily smoothie, coffee, and main course. But I was like oreos at breakfast time (!!) – that never happened at 120 Bon Air. Funny how the rules change later in life!! Her usual dessert has long been So Delicious ice cream bars, which you all knew as per the Nov 28 3:05pm entry that detailed the care package drop-off at the in-patient rehab. But more recently mom has branched off into So Delicious ice cream pops with salted carmel cashew on the inside. Many thanks also for the cakes and cookies that get dropped off as mom has stepped up her game in that department as well. After lunch, we gave her a big honking piece of cake today which she promptly picked up and ate even before her tea was ready. This was the first time she beat Pastor by a mile when it came to finishing her dessert. She may not finish her main meal, but she always finishes dessert!!!
So despite my only posting photos of veggie meals, that girl fills her days with desserts and…..pistachios, which we bring her by the bowlful once or twice a day. And each time she gives a look of sheer surprise and delight as if she has never seen a pistachio nut before!! And yes, I am still bolstering her plate with avocados because no matter what we serve her she chows that down first!!
Sun, Jan 24 (10pm) – Weekend Wrap-Up
Mom is really making gains and can more easily manage many of the needed transitions in the house: bed to toilet; bedroom to kitchen chair; recliner in family room to bedroom. Pastor has begun tapering down his hours with us as mom becomes increasingly more capable. The two main events we rely on for Pastor are showering and wound-care, but even with the showering mom is almost independent.
Tomorrow we have our first out-patient PT session with a highly sought after therapist (Nancy) who knows mom and her case. It will be interesting to get her assessment. I think we are going to surprise her with mom’s progress, unless she has already heard about it from others in the community. Way back when, when we were considering in-patient rehab centers back in late Nov, we did call Nancy for her thoughts, but since then we have not had direct contact with her.
Just for the record, here is a video and a photo from the day:
Sat, Jan 23 (9:55pm) – Life = Walking + Eating
Here is mom working her walking magic – it looks like we will be skipping the cane stage as she does not seem all that keen towards it.
And next up is dinner: our newly-minted and soon to be famed Japanese buckwheat noodle miso soup bowl.
Fri, Jan 22 (7:20pm) – “Let’s Do Lunch!”
Someone “overslept” this morning and got stranded in her bedroom till 10am when the morning yoga classes ended – breakfast had to wait. That said, all attendees enjoyed watching mom take the trip during our social time after class. Mom strolled down in full view of the camera.
Shortly after taking breakfast mom thought it would be nice to go out for lunch today. So just after noon, Mom, Aunt Connie, and Pastor went out on the town and did lunch!! When mom arrived back home, she just moseyed into the house like a cool cat as if “situation normal”. During her outing she did not use her walker, nor a wheelchair, nor a cane. Pastor gave her support as needed. The fact is the mom is getting stronger and more confident in her movements every day.
Here below is mom doing a few laps at 11:30am this morning.
Thurs, Jan 21 (5:15pm) – A+ Report Card from the Dr.
Today we went to the vascular podiatrist in follow-up to the blog update of 1/19 2:10pm with the possible appearance of puss on the 4th toe of the right foot. So, when we got to the doctor’s office, mom the RN (btw all the nurses love her initials) got straight to work on making an assessment.
Once she was done, then all the nurses and docs came in – and we got really good news. First off, the drainage was not puss and now the foot is completely dry. The vascular podiatrist said there was zero sign of infection anywhere!! So that was really good. Plus, he told us that the x-ray from last week indicated that there was no infection in the bone. That means even the bone in the big toe is infection-free with no sign of necrosis. So he just said that we should let the body to continue to heal. When I raised the point of possible auto-amputation, he said it would take two more months or more for that to occur, if in fact that comes to pass. But even then, it is evident that each and every day the body is reclaiming more and more of those toes!!
With all that good news we could not contain ourselves, so upon our return we did a few laps around the house!!
Thurs, Jan 21 (9:55am) – Mom to the Rescue!!
Mom and Pastor were at the kitchen table, and I had just completed the morning meditation class when we saw are bird at the feeder. The feeder had probably not been filled since early or mid fall so Pastor went to the garage to get the feed, and I went into one of the backrooms to take care of things. When I came out of the room 15 minutes later, I heard Pastor saying, “Oh, you did it! That was so good!” And I was curious to know what mom had done.
Well, the bird feeder is in the courtyard / patio and there are windows on three sides of the house facing towards the courtyard. The kitchen table is situated by one set of those large windows. Mom watched Pastor go out the kitchen door to the patio / courtyard to fill the feeder. But that door is a tricky door, and Pastor closed it behind him, only to have locked himself out. So when he finished filling the feeder he could not get back inside the house! And mom was sitting there at the kitchen table watching him in full view, and I was in the back room. Pastor called me on my phone but I had the ringer off as I had just completed teaching the meditation class. So there was a stalemate for a bit. Then mom jumped into action. She got herself up from the kitchen table, pushed back the chair, secured her rollator, and made her way over to the door to let Pastor in!! Pastor watched this process unfold step by step, and when mom had successfully completed the operation, he said, “You did it!” And that was when I arrived onto the scene, too late to have done anything or even know what was doing on. So mom took matters into her own hands.
Just a short while ago that would not have been possible – she would not even have been able to get herself up out of her chair. So Pastor got the reap the benefits of having helped get mom back on her feet during this period of recovery!!
Wed, Jan 20 (11:50am) – Well-Deserved Breakfast
I went in to see mom at 6am and she was still sleeping. When I made my return at 7:15am, I noticed a light shining out of her door – uh-oh trouble. Because I knew that light was one she could not reach from her bed. When I arrived, she was comfortably lying in bed, but there were signs things had been going on. And sure enough, mom had gotten up and gone to to the bathroom without pressing the call button. She just took it upon herself to go. A new phase.
Thereafter, after completing her morning duties etc, she marched down to breakfast unassisted. Note: Before I started filming mom was walking with both hands together in her center-style pocket, like a kid moseying out to the ball-field.
Then she moved on to her daily smoothie of Mandarin clementines, a touch of banana, and organic vanilla protein powder.
She then had her main course, coffee, and a side of almond butter toast and peanut butter toast.
Tue, Jan 19 (3pm) – Pre-Ice Cream Walk
Right now we are in home PT mode, as our first official outpatient PT was scheduled to start on Feb 1. But, we just got a call and the physical therapist has an opening next Monday (Jan 25). So that is a positive development. Till then, we shall continue to have mom doing her bed, chair, and standing exercises and walking. Mom is also on the list for her covid vaccine, just waiting to hear back about the exact day and time.
Here is mom doing a little assisted and unassisted walking, before getting her ice-cream, of course!
Tue, Jan 19 (2:15pm) – Food Photos
Here is last night’s home-made miso soup:
Here is today’s sweet potato toast (sweet potato, cilantro, avocado, ground flax seed, nutritional yeast, olive oil, tamari, sea salt):
Tue, Jan 19 (2:10pm) – Important Right Foot Update
Yesterday (Mon 1/18), a touch of puss emerged from the 4th toe, slightly lower down on the toe from the base of the nail. And the tip of that toe, including the nail bed, is now loose. And today, the opening has increased and the tip of the toe is more loose. We do have a call in to the vascular team. First guess is that this might be the beginning of some type of auto-amputation, but we were expecting it to be dry, not wet. Either way, it is not painful and will not hinder her ability to walk. The main thing is to avoid any infection. Let’s see how this unfolds.
Mon, Jan 18 (3am) – Finger Food + Walking Videos
Am up way too late – was actaully on pace to get to bed at a reasonable hour then weird things started happening like smoke alarm batteries running low and their incessant beeping and me getting out ladders and climbing up to try and see which smoke alarm it was. After trial and error, it turned out to be one that is plugged into an outlet six inches off of the ground!! Life always has something.
Here are two recent light fare evening meals prepared for mom. Through experimentation I discovered that avocado works extremely well. She reaches for it first and eats it all so I basically decided to put avocado on everything!! A sampling of flavors and colors also seems to suit her. But really speaking, mom has been really good about taking in lots of food throughout the day. With her new scale, we are seeing her weigh in at about 96.5 lbs, without shoes but with flannel pajamas (in the morning before breakfast). We need to put on another 10 – 15 lbs – we’ll get there. Basically she eats three solid meals, plus cake breaks, ice cream desserts, 1 bowl or more of pistachios, and then some.
The below spread is made from: silken tofu, avocado, minced lacinato kale & carrot, tahini, flax seed, nutritional yeast, tamari, balsamic vinegar, and sea salt. And no, I had never made that before. I basically just fill the refrigerator with random, wholesome ingredients and see what comes in the mind.
Here below are two walking videos from Sunday (1/17):
Sat, Jan 16 (8:40pm) – Solid Saturday
Just a good Saturday…not too much more to report than that. Great appetite – good effort in exercises – and fine tidings on the whole.
Fri, Jan 15 (9:20pm) – Daredevil
Mom had wrapped up her evening and was heading down to her living quarters. As per normal, we went into the bathroom, and she got herself situated on the toilet and I left the bathroom. I told her to call me (i.e. press the call button) when she was ready. Here it should be noted that we have two call buttons on lanyards. One stays on or near her bed and she wears that around her neck when she goes to sleep, and the other call button is secured onto the permanent support bar adjacent to the toilet. Anyway, mom was on the toilet and I was standing in her room, just outside the bathroom door. She does not always call so every so often I would crack the door, sneak a peek at the vanity mirror, and see where mom was in her process. She was taking a while so I ended up cracking the door open three times and each time she was either seated or standing by the toilet – and she ended up sitting back down on the toilet. All good – no problem. More time goes by, so I open the door again and was shocked to see that she was free-standing / shuffling her feet in the middle of her large bathroom. The rollator was still by the toilet, and there was nothing within 5 or 6 feet for her to hold onto. Not only that, her pants were a touch low like how some of today’s youths wear them, and she was trying to get to the wastebasket which was on the polar opposite side of the room from the toilet!!! Totally crazy endeavor!! I gave her a good shakedown after that, moved the wastebasket next to the toilet, and told her to use / press the dang call button – regardless of the circumstances.
So you see, we have a total renegade on our hands – I think she is getting back at me for cutting so many classes my senior year of high school (see entry of Dec 1 at 5:45pm).
Thurs, Jan 14 (6:25pm) – Doctor Visits & Walking Videos
We went to the doctor both yesterday and today to have mom’s feet assessed by the vascular team. One new thing we learned yesterday is that mom still has a dissected aorta on the descending portion, which I termed as “the downspout”. That was news to us. We knew the critical point of the aortic dissection was on the ascending portion up to the arch and in the open heart surgery they replaced the valve and reinforced that portion of the aorta. Anyway, the dissection on the descending aspect is relatively small and has been stable for the last 2 months. The key point is to keep her systolic blood pressure at 120 or less and they will scan it every six months.
Now to the foot news. Yesterday, the vascular doctor / professor of vascular surgery basically liked what he saw with the foot, yet also told us that the big toe was basically dead, and he brought up the option of surgical amputation vs auto-amputation or part of the big toe and perhaps tips of other toes. We had basically thought that there was no need for surgery, but he said if there is an auto-amputation it may or may not be clean and there could be a bone sticking out etc. This brought up a whole new concern for us. We also talked to him about keeping the black boots or using other shoes, and he said the black boots are the best footwear as they keep the pressure off of the toes. That was basically what we got yesterday, and he referred us to podiatry, and much to my surprise we got an appointment for today – and we just returned from that visit.
The doctor at the vascular center of podiatry took a good look at mom’s feet this afternoon, and he very much affirmed we are heading in the right direction and quelled some of our concerns from yesterday:
(a) The mummification or necrosis is very dry – which is a good sign.
(b) The daily dressing we (Pastor) have been doing is excellent.
(c) There was no need for surgery so long as it is dry.
(d) If it goes to auto-amputation there is no sign that it would be an open wound with a protruding bone. He was quite confident it would be a closed healing.
(e) We showed him photos of 1 and 2 months ago, and he was impressed at how the body had retaken control of much of the foot and toes, and he said we should continue to wait and see how much the body can continue to produce new skin. But he did qualify that the dark portion on the bottom of the foot was a bit more superficial than the dark portion engulfing the big toe and around the tips of the other toes.
(f) He also sent us to x-ray which we had done on the way home because it was impossible to know by sight if the bone in the big toe was necrotic or not.
(g) He gave us the big thumbs up for the way they foot has been healing, and he just said to keep doing what we were doing. He did trim back the nails just a touch, using a device most similar to a wire-cutter. And he confirmed we should continue to use the black boots as they enable the toes to heal by keeping pressure off of the toes and giving them plenty of space.
(h) We will see him again in 3 weeks for a follow-up so he can continue to monitor the foot.
Note: The above is all about the right foot. The left foot has just a few superficial spots that are healing on their own. Mom will probably lose a few toenails (which may or may not grow back) but the left foot is medically fine.
So that is the low-down on the feet.
Here below are two videos. The first is mom walking into the x-ray clinic. And the second is mom getting situated in her black chair upon her return home after the x-ray.
Thurs, Jan 14 (11:45am) – Repose & Activity
Here is mom in a state of repose in her newly gifted evening outfit ; she was in her room as I finished up teaching my class last night.
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Here is mom walking this morning – this video was at the very end of her morning exercise routine…
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Tue, Jan 12 (9:20pm) – Two Videos
Here are two videos from the day. The weather was great so mom got in the wheelchair and went for an extended tour outside with Pastor. Mom is eating up a storm and took only a very short nap after breakfast.
Both the PT and OT final assessments were done today (most paperwork etc) so now mom is fully cleared of all home visits so we booked her up for all of Feb with outpatient PT. If they get an opening before then they will let us know. But there is no rush as we have plenty to do with mom already to keep her on the path of progress….
Now to today’s video……
Mon, Jan 11 (8pm) – Walking Free (Mostly)
Mom woke up today determined not to nap during the day – and she made it!! Usually, she would take two (or more) power naps, but she made it the whole day without going back to bed.
All in all, mom is doing well – she knows she is getting better, and she just about ate her way through the day. She essentially does three things: eat, sleep, and exercise. Those are the building blocks of her day so when you take away the naps then we supplemented that with more food breaks!!
Here below are two videos: In the first she is using a cane, and in the second mom is walking freely!!
Sun, Jan 10 (6:30pm) – Weekend Update & Walking Outside
So mom had a busy and productive weekend of catching up on her to-do’s….
One of the first things on the list was to clear all the cards off the dining room table which was FULL of cards. So here is how she did it. She carefully examined the front of each card and then read every syllable written inside. It was a very deliberate and thorough process – and then each card was saved in a box. In the below photo mom is about two-thirds of the way through this endeavor; the box on the far left corner of the table is where each card is carefully deposited.
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Along with her exercises and catching up on her life, one of mom’s main things these days is E-A-T-I-N-G!! Here below is her Sunday lunch. Hearty rustic organic whole wheat bread with fresh avocado and nutritional yeast (she ate 3 halves), tri-color organic quinoa, and an organic stir fry of potato, green cabbage, tofu, and kale (lacinato & green). Mom ate it up!!
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On Sunday, mom also went for her first walk outside!! On Saturday she and Pastor went to the mailroom (1/3 mile) via wheelchair, but this afternoon mom went for an actual Sunday stroll. We did not go a long way – consider it a building block for the future. Walking outside is a whole different dynamic from her smooth wood floors. So it was a good outing – on multiple levels, from fresh air to the challenge of cruising on the sidewalk.
Sat, Jan 9 (1:30am) – The Bed Dance + Joyous Rollator
Mom is still on the uptick. First off, she is just chowing down, and that is giving her plenty of energy to manage her days. She still naps and sleeps early, but when up she is active. And she is definitely getting pretty savvy in handling her dressing and bathroom needs. It is getting easier and more normal every day.
One drama we go through every night is getting into bed. I really do not help her at all. She can sit down on the side of the bed, and draw her torso into a place of repose, and basically get her legs up on the bed. When she finishes this maneuver though, she looks like a compass needle making a diagonal line across the bed. She is a little lady in a big bed. And when in that position she often starts laughing at her predicament and needs to rest. And then she does her “dance”. Bend the knees, press the feet, raise the hips, and shift herself. She does this multiple times, and it is exhausting, until she is straight. The only thing I do at the very end is slide her up in bed.
As you can see below – mom was not too keen today on using the cane (note: we are getting her a 4-prong cane – good suggestion.) Right when she stopped at the end of the video, we got her the Rollator, and her face lit up – and she just went on her merry way!! Never saw anyone so happy to have their rollator; it was like meeting up with a long, lost friend!!!
Thurs, Jan 7 (9:46pm) – Holding Strong & Cards
No major news today. Mom did her final home PT visit today. After next week’s final assessments for PT and OT we will up our game and pursue out-patient PT.
Mom is becoming much more facile in her movements around the house, especially navigating the intricacies her various duties in the bathroom / shower etc. She is basically independent, but with always a close eye on her. One call button stays in the bathroom so she uses that to alert us that she is finished with a particular event and that now we should come in to watch her safe transition / exit.
She also goes longer periods without sleeping, and during awake hours she is more alert and engaged.
We do not spend too much time talking about the course of events from October to the present. It might come up as a reference point, but we do not have too many ongoing discussions about it. But somehow it came up this evening for a while, and it reached the point wherein I showed mom some of the photos from her early days of the ICU. And when I showed her this photo of her medicines and treatments, she was pretty awed / shocked by it. She was not overly emotional as she was a nurse for 52 years, but she certainly understood what she was looking at!!!
And that was just one side of the bed!!!
Anyway, those days are long behind us – thanks in no small part to all your care, support, and wishes from afar. Mom reads all the cards and texts (most). Here below is a shot from today where mom reading cards that continue to arrive!! She appreciates them all!!!
And today she did her walking with old faithful – the rollator, not the cane…..
Wed, Jan 6 (1:40am) – Bring on the Cane!!
We are just riding the wave of progress these days. Mom is eating well and often; it is amazing to see how well the appetite stimulant has worked. Without it, things were looking a bit grim. And in the nine days mom has taken it there has been a dramatic uptick on so many levels. Perhaps none more important than the fact that she feels that she is getting better and stronger. She is well aware that she can do more and that fuels her internal drive. The road ahead is still long, but not so murky.
We had our last in-home OT session – and maybe last OT session period. As we wind down everything next week with mom’s final home assessments, it looks like we will be focusing on exclusively PT – no OT, and no nursing / medical needs.
Mom is pretty savvy with the Rollator, and now she is keen to move towards a cane. So she did a trial walk today (video below) – no two ways about it, it is challenging for her. But she’ll get it.
Andrew rolled into town today, and he’ll be here a few days. He was very impressed with mom’s overall presentation and progress, and felt that all the systems / protocols in place around here made for an ideal rehab / recovery setting.
p.s. That is dad’s old sweatsuit which is why it fits so well!! 😂
Mon, Jan 4 (2pm) – Graduation – Off to Out-Patient PT We Go!!
Mom is just doing great – we have really come into a good flow of her recovery!! Here’s why:
(a) The nurse came today and decided that this would be her final visit. She thinks mom’s foot looks so well cared for, and that medically mom is doing very well. (Note: there is just so much fresh, pink skin coming in on the bottom side of the foot, so while we await recovery with the big toe, primarily, as well as with the tips of the other toes of the right foot, her overall foot looks very clean and and vibrant.)
(b) The PT came today and switched us over to out-patient. We will have one more in-home visit this week, and then the same main PT guy comes next week to sign her out.
(c) And the OT people will be in-step with this arrangement as well.
(d) Once the above is done (and it should be next week) then we will graduate into out-patient PT where mom can do more rigorous exercises and therapies.
(e) Mom’s appetite has been good for a week, and has really picked up that last 24 – 36 hours. She is eating three meals – not huge meals but reasonable portions – and then taking a variety of light-fare items throughout the day to supplement her caloric intake. Also, now she no longer has to rest her head on the table, rather she is generally reading the paper while she eats. The act of chewing no longer consumes all her energy; she is much more comfortable eating which enables her to eat larger portions.
(f) Mom’s overall energy level is better – less sleeping and more doing. And she is being very pro-active in planning which therapy (chair, standing, walking, bed) she will do and when.
(g) And mentally she is more and more like her old self in terms of how she wants to manage her life.
Here below mom is doing a few bed PT exercises. Just simple stuff and mom is not pushing it – just casually doing things so you may not feel that she is in triathlete mode (as the above report hints at), but in general mom is struggling a lot less and managing things in her own easy flow as her baseline of strength improves.
Sat, Jan 2 (11:30pm) – Auspicious Start & New Bathroom Approach
Well, the year got off to an auspicious start as at 11pm on Jan 1 the power cut in the house. Mom had just finished watching one of Strauss’s marches on full blast and was fast asleep. At first the power was flickering and every second it would trigger mom’s call button to emit a signal and the bell was going on and off and on and off. Finally, it stayed off – both the power and the call button. My i-Mac was connected to a battery back-up so I shut it down and slept on the floor in mom’s room till the power came back on (just 2 hours later) just in case she needed something because there was no other way for her to contact me. All in all, the loss of power did not impact us too much.
Mom’s appetite was good today, and she was in full-on exercise mode. That means she was actively planning on when she would do her various exercise routines. Although, we did catch her dishing us a curve ball as at one point she started saying that this would be a good time to do her bed PT exercises, but we could tell her main aim was to go take one of her patented power naps!! 😂😂 So we called her out on it and instead she and Pastor went outside for a quick wheelchair tour of the neighborhood.
We put up a new hand rail in the bathroom today. This allows mom to leave her walker behind and walk straight in towards the toilet, as opposed to using the walker and having to back in. This should be much safer, but we still have to refine the process wherein mom gets the right angle of entry so it goes smoothly.
Mom’s itching has subsided, and we have pretty much concluded that it was not due to dry skin but a reaction (uggh) to the CT scan with contrast. No doubt they tried their best (and it was not nearly as bad as when mom had that allergic reaction in the hospital after the last scan), but even 12 hrs of prep could not to prevent mom from having some type of reaction to the iodine. She will have to get this type of CT scan every 6 months for the next two years so they really have to get it right so mom does not have to go through this every time.
Here is a shot of mom doing a bit of walking today….
Fri, Jan 1 (8:30am) – Happy New Year!! (Revisited)
When I went in to see mom this morning while she was still in bed, I was lying near her on top of the covers, and we were just talking casually…
(a) She asked me if I had stayed up till midnight, and I said I had. She replied, “I didn’t make it.” As if she had gotten really close and was gunning for it, but fell just short of the mark!!!! 😂😂😂😂 (Note: See below entry to see what time she went to sleep.)
She also said that she did not hear any sounds (her hearing aids were not in), but nonetheless her point was well-taken. This whole area was as quiet as a mouse. Back home in MD, the houses are much further apart, but every year from 10p or so till about 1a there is a torrent of fireworks. I did not mind missing that this year.
(b) Among other things, mom said she was glad it did not snow as she is under strict orders not to lift more than three pounds – as if had she not been under that restriction she could or would have been out there shoveling snow!!! 😂😂😂😂
All that said, I have full confidence that on next January 1 mom will have stayed up till midnight on New Year’s eve and be fully ready to shovel herself out of the biggest snowstorm imaginable!!!
Fri, Jan 1 (2:20am) – Happy New Year!!
Greetings all and Happy New Year!! Mom made it all the way to 9:02pm, not bad considering the awful programing one cable station was airing. If I was watching that I would have only made it to 8:58pm. Early bedtimes aside, Dec 31st was a good day. Mom’s energy level was solid, and her food intake was also good. In addition, she had a successful visit to the doctor’s office. Mom likes her primary care doctor, and we felt it would be good to have the doc set eyes on mom. We actually had an online appt with her last week, but mom got shuttled off to the ER that morning so we rescheduled for an in-person appointment for Dec 31 at 11:30am.
Since I had a corporate yoga class to teach at noon, I only got to hear the beginning when the nurse was in the room with mom for vitals etc. Here is how we worked it. Pastor took mom to the doctor’s office, and at 11:30 we had a conference call with Andrew, Pastor, and I wherein Pastor put his phone on speaker so we could hear what was going on during the appointment, but I had to cut out from the call early. Andrew documented all the key aspects of the visit and sent that to me so I got a pretty good sense of things, and he and I spoke after the appointment anyway.
Here was our cheat-sheet going into the visit:
(a) Feet
(b) Itchy torso: dry skin or reaction to contrast
(c) Albumin levels
(d) Upcoming visit with Vascular on Jan 13
(e) List of her “medications” – most of which she does not take
(f) Pain in right hand
(g) Amount of sleep (9 – 10 hrs per night, after meals, between activities)
(h) Appetite – which seems to be getting better
And believe it or not, all those points were addressed in a fairly thorough manner. The doctor was great and spent over an hour with mom: catching up personally about the past two months (she already had been following mom’s chart), laying eyes on and examining the feet, addressing all our queries and concerns, and offering guidelines and resources for moving ahead. The feeding tube point was pretty much put to rest for the time being barring any serious downturn, but what was suggested was an online review with her / UNC nutritionist. So that we will do to see how else we can boost mom’s caloric intake – powders etc. Already it seemed like we were involved with most of the things the doctor suggested, but let’s see what micro-suggestions that the nutritionist has. This is all towards weight gain as all mom’s levels (including albumin, which is related with protein intake) were quite satisfactory as of last week, and her food intake was grown dramatically since then.
Perhaps, more than anything else, the visit served as a way for her doctor to see mom and become the manager of her case. Otherwise, we were just bouncing around from one wing to another without anyone local professional really steering the ship. So now we have that. And mom felt very reassured by that visit so that was another very positive outcome.
Beyond that we just did our normal course of things around here: eating, sleeping, exercise, TV time, and the like.
Hope you had a great New Year’s!!!
Thurs, Dec 31 (3am) – About Those Feet & Overall Assessment
The most notable thing that happened on Wednesday was the nurse’s visit, and her assessment of mom’s feet. She was really pleased with how they are coming along and the degree of pink skin that is emerging. The endgame is still up in the air, but the pinky toe is showing some nice signs, and it is the pinky and big toes that have been most concerning. For that matter, the outside of the big toe is also coming along. We also discussed mom’s itchiness (back / torso), and while there is not a rash like last time, this may be a result of the iodine contrast, even though she got the pre-treatment.
The OT supervisor also came today and extended the OT visits with the aim of mom becoming more self-sufficient in getting herself dressed independently. When showing the OT how she uses the bathroom, mom had a rare slip-up. There was no fall or anything, but an awkward off-balance movement. That remains a spot where mom needs close attention as she has to back herself in towards the toilet. This weekend we are adding two new safety bars that will be permanent additions. Even though there is already a big disability railing on the left and support stand (see photo of 12/7 at 6p), the new bars will allow her an easier and more supported way to access the toilet.
Mom had a solid appetite today (good news!), yet that was countered by distinctly less physical energy than yesterday. This aspect seems to be an up-and-down ride. In closing out the day, after brushing her teeth and while walking to her bed, mom whispered, “I wonder if I am ever going to get better.” For someone who was so incredibly independent and remarkably agile and fleet afoot, all of the tenuous transfers from one position to the next can just seem like a never-ending array of arduous obstacles throughout the day. Naturally, she will improve, but we will have to see at what rate and over what time period. We are in this for the long haul obviously, and on that time-frame by June 1 we should have a pretty good idea of where things stand. Till then, we shall do the daily grind and check-off our micro-victories as they occur.
Tue, Dec 29 (9:10pm) – Regaining Our Stride
We seem to be getting back our mojo after that rough weekend. Today mom was active, active, active…and she ate a decent amount of food including coming up with the idea to get takeout from a local favorite Malaysian restaurant.
But let’s start from the beginning. Mom slept through the night last night (no call bells) and was at breakfast by 8am or so. Read the paper and ate / drank slowly till about 8:50. During Chair Yoga she was back in her room, and then the PT came at 10. Mom had a good session of walking, doing squats, and some balance work.
The afternoon was interspersed with some rest, but also a solid dose of rehab including bed exercises, walking laps, and chair exercises. Along the way, she had some tea and snack breaks (apple slices, pistachios, chocolate covered pretzel sticks). Her energy level was very good.
All in all, a very positive day as mom was nicely engaged. When she rested she rested; and, when active she was active. Whereas, over the weekend sleep bled into and consumed every endeavor. So the first two days of the week have served as a solid comeback.
One thing though is that Mom has had a terrible case of itchy dry skin so we have been applying lotion to gain relief. Will raise this with the doctor on Thursday. Tomorrow features a nurse visit early on and an OT assessment later in the morning.
So the thought of the day is this. When the PT was leaving today I asked him his thoughts in general about mom’s condition. His reply was that he felt she was too weak, too off-balance, and too dependent in order to ever get off the rollator. He said, “Don’t get me wrong I hope she does, but I just do not see it happening.” Our response: We got’em right where we want’em. In the hospital the PT said mom would never walk, and four days later she was walking. Mom is early on in her recovery, and we feel there is no doubt she will nicely graduate from using the rollator in due course. Over the weeks and months, she will eat, train, and gain strength from head to toe, and that will naturally make walking easier.
But see for yourself….she is walking relatively smoothly here, and she is stopping because she is just casually going from one side to the other; she is not in training per se or trying to do her very best. Also the slow dismount at the end is because she normally does not sit in that location. So we kinda feel she is cruisin’ along….a short stage in her ongoing continuum towards walking freely, unassisted.
Note: The PT coming the last two days is not the “wicker chair guy”…. and the person in the below video is our faithful helper Pastor.
Mon, Dec 28 (6:22pm) – Solid Rebound
Mom has had a very solid comeback today. She ate more than the prior days (soon she will sit down for dinner), and she did a very good job in both OT and PT. She walked very fluidly in OT, and in PT she ditched the rollator and circled the kitchen using a cane and the countertop. She also did a few good squats using the lip of the kitchen sink and the seat of the rollator. So we saw a nice little rebound today.
Side by side, we are watching her appetite like a hawk. We will be seeing her primary care doc (who knows mom well) on Thursday, and we have a referral to a gastroenterologist that can be used or not. Let’s see how the visit goes on Thursday.
All mom’s vitals were right on the mark today, and she gained a pound or so. Going forward, mom and I will document her weight every morning while in her pjs so we have a clear comparison; plus it will provide a bit of incentive to see how much she can increase her weight on a day-to-day, week-to-week basis.
Mon, Dec 28 (3am) – Appetite Issue + Source of Joy + Who Rang
The last two – three days have been a bit of a regression. Mom’s appetite has gone from minimal to near nil. She did have some spoonfuls on Sunday evening, but she really needs to be eating quite a bit more. This is evidenced by her desire for more and more sleep and disappearing ability to engage in her PT. We did start her on an appetite stimulant on Saturday evening, but those things do not work wonders in the short-term. Truly speaking, I have not seen mom have an appetite since I got her on Oct 19. Eating any amount of food is always a struggle, save for one time. I brought her a cheese Danish from Starbucks when she was in the ER last week and she excitedly took a huge bite out of it. I was completely shocked as I forgot she could even eat like that. Naturally, your thought would be, “Well, give her more Danishes.” Let me just say, mom has been gifted every type of cookie, cake, bakery delight, sweet, loaf imaginable – and….nope. I could go on and on about this, but it is an urgent work in progress and we have even discussed and considered the possibility of a feeding tube. Andrew will be consulting with two experts in the field on Monday (today morning).
One source of joy that mom never fails to smile at and derive great comfort from is warmth. She lights up with a big smile every time she gets under the covers, and her eyes grow wide and her mouth forms into a small circle with anticipation when I ask her if she wants her hand-warmer (pictured below). We charge it all the time, and it lasts about 2 – 3 hours (and it gets quite hot), but each time we give it to her she is astonished and thrilled over the moon to have it. (Aside: And yes, her low body heat or tendency to chill is no doubt connected to her lack of caloric intake – but this para was about joy.)
Mom and I are generally up once in the night together – for instance, on this night we had our session just an hour or so back. She pushes her call button, and it triggers a double doorbell sound (a la the Avon Lady commercials of the 70s) out of two speakers. Well, the other night I was dead to the world sleeping and I hear the call button and I jump up and go running because one time she had to go and we really did not quite get there in time – kind of yes and kind of no. On that particular occasion, when Pastor arrived in the morning he was wondering why her pjs were red on top and blue on bottom. Anyway, I digress. So the other night the call button goes off at about 3:30am, and I go running down there. She’s up, I’m there, she has the urge to go to the bathroom – all the pieces are in play, and she says, “I did not press the button.” Total mystery. Then she says, “I did not hear the bell go off.” Double mystery. Yet here we are. We have all the requisite factors: she is awake, I am there, and she has to go to the bathroom. Yet she is insisting she did not press the call button – and that she did not hear it. I am not much of a sleuth, but when I took note of her hearing aids in the charger, I deemed her “guilty as charged!!”
Fri, Dec 25 (5:07pm) – Dressed for an X-Mas Day Drive
Mom was feeling like she needed to get outta dodge, so we went for a Sunday drive. (Pastor snapped this shot while he was assisting her so it was taken on the fly.)
Thurs, Dec 24 (11:55pm) – Watch Your Feet-tees / Feeties
Let’s face it…mom was never hip / cool in any sort of way. Rather, she would make up weird rhymes that were just embarrassing in public – and use them up to eternity: infant to toddler, toddler to primary school, primary school to high school, high school to college, and on and on – the same ones, depending on the situation. A case in point…
As a very young kid, when going to the beach or pool, she would say things like, “Put your feet-tees in the water.” Or if my feet were cold or got bumped, she would say, “Ohhh, are your feet-tees ok?” And when putting on my bottom pj’s before bed she would say, “Put your feet-tees through.”
So here we are decades upon decades later, and as I am in and out of yoga classes I am often barefoot. Side by side, with her recovery, mom cruises around more and more with her rollator, and sometimes she is moderately or very aggressive with it in order to get over the bump into or out of the bathroom etc. And when I am walking with her, and she is about to ram the thing through the doorway she will say in all earnestness, “Watch your feet-tees.” I hear this not once but throughout the day – everyday. Even when she is dog tired and going to bed, as she pushes her rollator around, in a barely audible voice she will say, “Watch your feet-tees.” It comes out like clockwork – never joking, always very serious. I have tried to sneak in or camouflage myself to see if she says this to Pastor as well, but I have never heard it. But as soon as I come on to the scene, it invariably emerges, “Watch your feet-tees.” Yet, my feet are never in danger and never get hit or hurt.
Today we were sitting around the table, and her rollator was parked with the brakes on, and she asked for something that was across the room, and I get up from the table, take a quick few steps / trots as I am apt to do, and totally bam, jam, and slam my 4th toe (i.e. feet-tees) into the rugged back wheel of the rollator.
So on the eve of this holiday, I say to you all, “Watch your feet-tees!!!”
Thurs, Dec 24 (7:45pm) – On The Upswing
After a moderate plateau and short ER visit, mom seems to be making strong gains forward. Her appetite is growing; her energy level is increasing; and, her abilities are expanding. It sounds simple, but she is now able to get her shoes off and on, and she is much safer in most of her movements. There is always the possibility of a slip or fall so we watch her carefully, but she needs very little actual support these days – just a little guidance.
Mom passes along her holiday wishes to one and all and says to keep striving to be your very best!!
Wed, Dec 23 (10am) – Two Small Victories
When mom pressed the call button to alert me that she needed something I found her sitting up in bed. That was a first!! Normally, I have to help her sit up. Second, today she finished her breakfast: hot cereal with blueberries and pecans, freshly blended orange / vanilla juice, coffee, and then she also had some biscotti. That see feels the desire to eat more is a solid win.
Wed, Dec 23 (6:15am) – Back HOME!!
Mom and I arrived back home a short while ago, at 5:30am…
So our ER mission was largely a success. A success in that mom left the hospital with great lab work and a solid result on her CT scan. We really could have come home hours and hours ago save for the fact that mom is allergic to the iodine used in the contrast so it needed a 12-hr prep, as explained in the prior entries. Basically, everything went like clockwork, or even better. They put the Benadryl IV in at 1:30am, by 2:45am she was in for her CT scan, between 3:30am & 4am the doc reviewed the scan and talked with us, and then we did a quick “test-walk”, and we packed up, left the ER, and mom was back home in bed by 5:35am. Upon our return I texted Pastor, and he said he would be here at around 8:15am. So we will try for another day and see how it goes!!
Here are a few notable anecdotes from our visit – there just seems to be something about being in hospitals that gets folks a touch confused…
(a) When the tech woke us up to wheel mom out for the CT scan at about 2:40am, mom said, “Wait, hold on, get the nurse, they forgot one of the steps!!” 😮😮__ 😂😂 …. I was like, “Mom they did not forget anything – that’s why we’ve been here for the last so many 14 hours – they did everything!!” 😂😂 In all fairness to mom, she said she thought she was supposed to drink something, i.e. the Benadryl potion (initially I thought that as well), but it was an IV.
(b) When the doc came by at 3:45am or so with the CT results, mom and I both woke up, and mom did not have her hearing aids in. I was on the opposite side of the bed from where the doc was standing and mom’s hearing aids were in the charger near where the doc was standing. So I asked him to give mom her hearing aids. He hands them to her; she puts them in; and, the doc begins giving us the results and an overview etc. After some minutes go by and the doc and I are going back and forth a bit, then mom begins mentioning something about six thousand dollars, and it dawned on me that she had not been following along with the conversation at all and she thought that she had lost her hearing aids somewhere along the way and this nice man had shown up on the scene to return her expensive $6,000 hearing aids to her – and she was very grateful!! 😂😂 We spent the next few minutes getting mom up to speed with what was going on, and the doc did say, “Well, you had just gotten up and you were startled by my presence” – mom had been sleeping facing towards my side and when she awakened and rolled over she jumped about six inches out of bed when she saw him standing there. Anyway, mom came up to speed, and she was well-oriented soon enough.
(c) She did get one thing totally spot on while we were there. I was sleeping in a simple metal padded chair (I can sleep anywhere at anytime), but at some point in the night when the nurse came over, she told them to bring me a recliner. I really did not think they had one. And lo’ and behold, they brought one of my dear friends!! – the exact style recliner that they had in the ICU!!! Once I had that then I was in great shape!! Besides, during her short stay there, mom had somehow accumulated upwards of 14 blankets (which at one point I had folded up by her side), so she could spare me one. Although broken into pieces, I did manage to get quality sleep in short spurts, along the way – and returned home relatively rested.
Tue, Dec 22 (5:30pm) – The Same Nurse!!
I put Andrew on the phone with the ER nurse, and she reviewed all the tests, scans, and info she had and did a great job of fielding the call. Andrew thanked her at the end of the call, and she said, “Oh, you and I have spoken many times. I was the nurse who was with your mom when she first came to the ER back on Oct 19. It is great to see and hear how well your mom has been doing after all she has been through over the past 2 months!!”
Tue, Dec 22 (4pm) – ER Timing
So mom took her first prednisone at 1:30pm; she will take her 2nd prednisone at 7:30pm. Then at 1:30am she will get her Benadryl, and at 2:30am they will do the CT scan, which takes 10 minutes. Thereafter we will wait till the team is able to review the scan and give us the results. Most likely we will leave here in the early to mid-morning.
Just now the nurse told us that all mom’s lab work came back just fine.
Tue, Dec 22 (3:10pm) – At Ease in the ER
Mom is doing fine and napping at the moment. She was up earlier and sent me to the Starbucks in the main lobby – she drank a big cup of tea and ate half a Danish. I had some pistachio nuts in my bag and she ate some of those as well.
When mom was sleeping her O2 saturation level dropped into the high 80’s so they put her on a low-flow of O2.
Medically, she seems ok. Just involved in the steroid-Benadryl lead-in for the CT scan with contrast tonight. That will tell us if anything serious is going on. But it does not seem so.
Since all is well, I shall step out from 6p to 8p to hold the evening yoga class and then return back here…
Tue, Dec 22 (12:30pm) – 911 Call, But Stable
Sitting here in the ER as I type this….
Mom had her usual wake-up routine and breakfast, and then just before 9am she was walking back to her room from the kitchen. I had just begun admitting folks for the yoga class on Zoom, and Pastor was with mom, when at the halfway point she was too tired to continue. This NEVER happens. So Pastor got mom to turn around so she could sit on her walker, and he began pushing her to her room when she suddenly lost consciousness. I was only ten feet away and had been watching everything so I quickly called 911. Poor yoga students watching / hearing this unfold….muted my end.
As I was hurriedly talking to the 911 dispatcher, I got the report from Pastor that she was still breathing, and when back in bed or just before, mom regained consciousness. By this time the dispatcher had taken at least half of the report from me, and she stayed on the line as I continued to update her as to what was going on. Soon the paramedics arrived, and they hooked mom up to some type of heart monitor. The report showed that mom had a “right bundle branch block”, which is not all that critical, and perhaps not significant. (Update: While in the ER we looked at mom’s old scans / results on the computer and she had that right bundle branch block earlier as well, so that is not a new development.)
We discussed with the paramedics what to do – actually as they took the history they were amazed that a 91-year-old was not on any meds. They were like, “Oh I see, there is no stopping this woman”, as they were wondering why a 91-year-old was even on the back-end of a recent open-heart surgery. The point of deliberation was whether to have them take her to the ER. Mom was feeling weak, and she had a virtual appointment with her GP / primary care doctor this afternoon, and the paramedics were saying that if they did not take her now, then they would just get called back later in the day to get her. I did get mom’s GP office on the line and they said absolutely she should go now. So the paramedics took mom away out the front door for a non-siren trip over to the ER.
Note: Mom was talking and fully conscious when getting in the ambulance. Most likely it as a case of vasovagal syncope.
I wrapped things up at the house for a shot while, spoke with Andrew, and got over here an hour or two ago, and have been with mom ever since. I think the main thing we are going to have done here is a CT scan with contrast, but a mom is allergic to the iodine, so we are going to get the magic Benadryl-cum-steroid potion beforehand, wait the 12 hrs, and then get the CT scan done in the evening – and hopefully home tomorrow.
Watch for an early evening updated…..
Mon, Dec 21 (10:30pm) – Monday Catching Up on Sunday
When I teach yoga classes at renyoga south, I essentially split mom’s house in half, and there is no getting to the other side once class starts. So every so often mom and her helper of the day are kept in hostage at the kitchen table with a strict warning not to talk or move. At that point, they are just on the other side of the camera, i.e. quite close to me. The basic formula is: If breakfast is not completed in time then they get stranded at the table, but it is just for the 20 min abs class. Thereafter, there is a short break and they can hightail it to the other side of the house that has her bedroom suite. When the abs class ended today, I brought the laptop over to her at the kitchen table, and she got to say hello to everyone. Indeed, all those who went “dark” for me suddenly perked up and flashed on their cameras to say hello to mom!! She enjoyed that, and it was a great way to start the day!!
The visit from the nurse went well today: vitals, wound care, sternum check, and I think that was about it. But she does a solid job with it, and mom approves. We will just have to see about the foot. Touching the right toe is akin to touching a rock. The bright spot is that there is new pink skin emerging at and around the base of the toes. The OT visit in the afternoon was the usual. We did weigh mom today and she came in at 94.5 lbs, same as the other day. Her appetite is next to zilch, and we have an electronic visit with her personal doctor tomorrow. We may need something to kick-start that appetite, as she was taking in the hospital.
Nowadays, mom is good, stable, fairly easily fatigued, and a bit contemplative about where this will all end up. We are not seeing any major gains on a day-to-day basis; most likely, this will be one of those cases where every so often we get reach a new plateau, and then stay there for a while. However it plays out, we are building the foundation for an extended recovery.
What Monday afternoons are for….finishing up the Sunday NY Times…. 📰 !!!
Mon, Dec 21 (2:30am) – Weekend Wrap-Up
Had a great weekend of no visitations, but that all changes soon with both the nurse (👍) and the OT (_) coming mid-morning and mid-afternoon today.
At this point we really do not have any looming concerns. Mom’s appetite is absolutely minuscule, but she is eager to have her meal, just she hardly eats anything. Hopefully, that will turnaround soon. Then, every so often she surprises us and eats more than expected. One thing that we have been trying lately and never seems to fail is pistachio nuts, so went out today and got a jumbo-sized bag. The morning blended protein juice remains a big hit, and on some afternoons she has a shot of another, thicker smoothie. Naturally, her diet includes lots of solid food etc, and she always eats some, usually enjoys it, but does not eat a lot.
Her exercise workout routine is being nicely maintained, and she is definitely improving. She is getting more stable in her movements, but still does not go anywhere unattended.
One thing I can say is that I do not think I have seen anyone so purely full of happiness and joy by getting into bed and under the covers!! And it is a good thing too, because she does it 3 – 5 times in any 24-hour period!! 😊 🥱 😴
Sun, Dec 20 (12:20pm) – Mom’s New Toy II
Mom is just like Rocky Balboa. She wakes up in the morning and pumps some iron – even on Sundays!!!
Sat, Dec 19 (10:55pm) – Mom’s New Toy
Well, we did not have any appointments today – that was a bit of a relief. Nobody came here; and, we did not have to go anywhere. So it was a perfect day to try out mom’s new toy – gifted to her by Aunt Diana. It arrived yesterday; Pastor assembled it last night; and, this morning mom tried it out. Let it be known that the experiments have only begun!! There are a zillion and one ways to use this to stretch, strengthen, balance, twist, exert, and pump.
This is the Resistance Chair with the overhead accessory; the rowing accessory is on the way.
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Here is mom doing one of her earliest trials on the Resistance Chair on the morning of day #1 of using it.
Fri, Dec 18 (9:20pm) – What Did the Doctor Say
After the morning yoga classes, we headed off to see the vascular surgeon at UNC Meadowmont Facility for an 11am appointment. Actually, we were supposed to have a CT scan at a different facility at 9am, but we cancelled that one as mom is allergic to the contrast / iodine. So mom, Pastor, and I (The Three Musketeers) headed off into the sunshine and arrived on time. And I have to say having two people to take mom makes things easier and faster. Once we entered the lobby we were told that only 1 person could accompany mom to the appointment. So mom and I went up to the 3rd floor, checked in, and got ourselves seated and settled in the waiting area. Within a minute, mom tells me she has to go to the bathroom. And as she and I have discovered, often when she has to go she really has to go – as in now. So we hightailed it to the ladies room; I announced my presence to whoever was in the various stalls; and mom, me, and her wheelchair squeezed into the only disability stall just in the nick of time. Once I knew she was safe then I stood outside the stall. It all went smoothly – mission accomplished.
Soon we were called in for the appointment. Basically, it was all about the feet. We saw a familiar face in the form of a resident, and then the main doc came in. At this point, Andrew was on speaker phone and handled most of the talk with the doc. The first thing we hashed out was the need to schedule the CT scan with contrast and they would provide a magic potion (steroids and Benadryl etc) to ensure mom would not undergo a reaction from the iodine. They said the scan was needed to ensure mom was not getting an aneurysm in her aorta. They need to check for this every 6 months for 2 years, and then annually. We got on board with the program.
Then the feet – and they really liked with they saw. It was clean, dry, not infected, and under control. So the home-care with the feet has been a success – all credit to Pastor. They basically said there would be no need for a surgical intervention so long as she was not developing a fever or an infection that was spreading into the rest of the foot. But they did not rule out the possibility of an auto-amputation of the big toe. Basically, they said wait and see. So long as pink skin grows underneath we should be fine, and that is what we are seeing thus far. But again, it seemingly could go either way.
By the time it was all said and done, we returned home at about 1:30pm. Mom spent the afternoon eating (her appetite is picking up), watching old B & W movies, and getting her full PT program in with Pastor in the early evening. After doing some walking, chair PT, and more walking, then Pastor said, “Now we will go to the bed.” Mom immediately perked up and said, “Oh good!” Pastor and I laughed and said, “You are not going there to sleep but to finish your other PT exercises.” Mom uttered a deflated, “Oh.” But she did them and came back out for dinner, and by that point she had had it. She received a few phone calls and could hardly manage, ate dinner – Pastor left – and mom and I did her pre-bed routine and she was in bed by 8pm – and life could not be better – warm and cozy. She fell asleep watching TV, only to awaken again at 9 to watch X-mas songs. I can still hear it, but I will be in to check again soon, because I can’t imagine her being awake much longer…
Here is a small glimpse of some of mom’s many efforts at PT and strength / conditioning:
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Fri, Dec 18 (1:50am) – Near Demolition of Dad’s Wicker Chair
When he walked in the house his left shoe was not just untied, but 8+ inches of the laces on each side were dragging on the floor. He had just entered mom’s bedroom, which is just off the front door, when I alerted him of the issue. He looked down and began contemplating what to do. He came across as being a bit too oversized to simply bend over and tie it, and the prospect of kneeling down did not seem much better. He glanced around and over his left shoulder he spied a chair that had a sweater folded on the seat, but one small corner of the chair was bare. So he made his way over there and plastered the left foot of his 300+ lb frame on the chair. But still he could not reach to tie it, and he was pressing mightily on the chair. Over the course of the next eternity, as it seemed to me, he was shaking and pressing and gasping and trying many times with his full force on the corner of the chair that Dad had beautifully refurbished and caned himself. It is a real beauty of a chair, and I was certain that in the next second or two it would be blown to smithereens. Then, by divine intervention, his shoe was tied and he placed his foot back onto the floor. Phew!! This is our physical therapist – sent by medicare. I had not met him the day prior save for a quick minute, as I had a class when he came. So “today”, (Thursday at 10:40am), we became acquainted. Not very inspiring – and perhaps even less effective, and there were other incidents as well. After he left, then our OT came. I have a good mind to cancel them both; only out of mom’s politeness and desire not to make waves shall we continue to allow them to pit-stop here. Fortunately, we are in good shape without them.
Mom’s feet looked comparatively very good “today”, even the underside. And later today (11am Friday) we have an appointment with the vascular team physician. It will be interesting to hear his assessment, as he has not see the feet in many weeks.
By and large, Thursday went well. There were hot pear-banana-peanut butter smoothies in the morning, and a double-feature of old-time movies that mom watched in the afternoon. And she did her full routine with Pastor as well. She napped less (but still napped some), and by the end of the day – upon eating some of her buckwheat soba noodles, mom was exhausted and ready for bed. It was 8pm. Let’s see what “tomorrow” (Friday) brings.
Wed, Dec 16 (11:50pm) – Way Ahead Of The Game
“She’s way ahead of the game!!”, so said the PT who came for his first home visit with us this evening. He added, “She’s far more advanced than my other patients – I won’t need to come here long.” That said, he’s coming back tomorrow 🙂!! They need to get two in a week etc. But as has been the case all along, we are already doing just about everything they offer. Fortunately, our home program is rolling right along!!
Basically, mom can do everything “on her own” (dressing, most bathroom duties etc) but needs a little support or watching. The one thing she hadn’t done at all was put on her shoes, and so we tackled that one first thing in the morning – and she did well it. And when we tried it in the afternoon she did even better – taking some very active maneuvers. And when I asked if she wanted to put her shoes on herself before dinner she wanted no part of it. And that’s fair. She had a busy day, and we got offer to a solid day #1 with regards to shoes.
The most striking development of the day is the feet. There is clearly more and more daylight on the underside of the toes. Still, we are cautious with our expectations, but without a doubt there is some meaningful regeneration going on!!
Naps after meals and after exercise are pretty standard fare. But every day she is more and more active. She is able to manage better at the table and no longer needs to put her head down, and she and Pastor have a very active exercise routine going – and sometimes I jump into the fray (when I am allowed out of the kitchen!!). BTW, a mostly very successful food regimen today – top reviews for breakfast and lunch, while dinner was a bit of a quick melange and mom’s nightcap to a long day.
Here below is a small sample of mom’s walking from this afternoon – maybe not her best walk ever, but a reasonable showing…you have to understand that when mom walks she is in perpetual examination of the house, checking it all out. It is not like being in the gym etc where one looks dead center and focuses on the finish line. When she walks at home she is keeping a keen eye on everything, but not always her destination…hence her frequent stops. She is not tired, but surveying the scene… 
Wed, Dec 16 (1:25am) – Routine Day
Mom has now been home a week, and things are becoming more routine – more predictable. Her basic baseline of safety has risen quite a bit over the course of 7 days. Mom can be depended upon doing certain actions in a dependable manner. At the same time, we are keen not to slip into any sloppy mistakes.
Mom’s energy was pretty good from morning to night; and, she is always keen to get her exercises and walking done. The afternoon did feature a very unspectacular OT visit; it sure is good we have our own program going on for mom’s recovery because what we are getting through medicare thus far is not going to help anyone regain their independence. The OT assessment last week was good; the OT session with our actual therapist was – well, I said it already. It seemed like a light-weight PT session; not sure why it was thought of as being OT. Moreover, we did not even get any exercises or initiatives to work on. “Tomorrow” (Wed afternoon), we have our first PT session. Last week’s PT assessment was awful, so hopefully we see a big turnaround with our actual therapist. But as I say, we have our home-program rolling right along here so we will do fine regardless.
The menu planning and food program is going well. Trying to keep things varied and interesting. Tonight’s meal got high marks: Double kale (green & lacinto) / carot salad with homemade sesame / peanut sauce, spiced vinagrette dressing, which mom gave a big thumbs up on. That was served with home-baked french-fried potatoes (not actually fried at all) and spaghetti squash. Mom took a pass on dessert.
Routine days bring boring blog entries….yet offer stunning flowers!!!
Mon, Dec 14 (11:05pm) – A Great Feat
“Wow, I can’t believe these are the same feet!!”, so said the nurse who had come on Friday and returned today for her follow-up. She was completely amazed by the transformation.
Here it should be noted that we are talking about baby steps, and there is not a soul on the planet who would want these feet in their current condition. But we did see some very encouraging signs as there appears to be healthy pink skin emerging on the bottom and side of the great / grand / big toe. It is still a wait-and-see type of event, but it is the most promising development yet as this big toe has been stagnant for so long. So we are looking for a great feat from these feet!
Another first is that we are officially off of night duty. Pastor left at 7:30pm, and then it was just mom and I for the rest of the evening. In the family area, she watched the Biden speech, and then news coverage till about 9pm or so. Mom was already in her pj’s so we made the trek down the hall and into her bathroom where she did her toileting herself and then went to the sink and brushed her teeth. I just remained close by to ensure she is safe, but she can basically do it herself. Then she walked over to her bed, put herself into position, and got into bed, which is more difficult than it sounds as her bed stands above her hips so she has to exert some energy to do this. The only thing she cannot do on her own is take off her shoes, but I think we will explore ways to do this tomorrow. To date, we have not worked on it. All in all, a very successful evening.
And all this is coming on the heels of mom looking and feeling quite worn-out in the morning. She seemed fatigued, her walking was stilted, and her breathing was more labored than usual. Even then, she trudged on and did some computer work in the morning and attended to other duties. In a nice turn of events, she gained steam as the afternoon advanced.
During the 5-week stay in the hospital, I was with mom attending to many aspects of her daily needs and wants. And then she went to rehab for 2 weeks. Upon her return home last Tuesday, it has been Pastor who has been handling those needs, support, and training, while I had more of a managerial role (appointments, coordination, orders etc) as well as kitchen detail (shopping, prepping, cooking, and cleaning) for both mom and staff. Pastor did a very nice job as he was very keen to support mom in a way where she could gradually and safely gain her independence, rather than become more dependent.
Finally, as mom was contemplating things just before bed, she was wondering if her open-heart surgery would impede her longevity. From my own very ill-informed platform, I emphatically declared that it would not in any way diminish her longevity of life. Rather, she was now quite stable with no pressing or life-threatening medical issues. She said she was glad to hear this because she was very happy, and she liked living.
Sun, Dec 13 (10:50pm) – Social Sunday
Mom’s Sunday was smooth and normal. Her walking around the house has become quite facile as she has a pretty fluid gait, in her best moments. Still she is most comfortable using the rollator, but that piece may not make it through the end of the year.
After passing much of the late morning in her e-z chair immersing herself in the NY Times while I taught a yoga class a mere 8 – 10 feet away (she was on the other side of the camera), she had lunch, took a nap, and woke up just in time for her 3p Zoom call with some of her nieces. Thereafter, we wheelchaired up the block and over to the gazebo to meet her good friend and traveling companion, Maggie. So mom had a fine afternoon of catching up with folks and swapping tales and news.
When attending to her feet today, there was the first sign of life on the underside of her right big toe. That was a big breakthrough, though obviously I am no expert so don’t take this as a given that it will be all perfect. It does look like an encouraging sign though. Believe it or not, the nurse who was here on Friday is coming again tomorrow so let’s see what she says when she sees it.
After dinner – another successful feast for Pastor & I while mom did fine with her smaller portions – mom had her sights set on Masterpiece Theatre (or a show of a similar title). Anyway, she set herself down to watch a bit on the early side, and although I am not a betting man, if I were I would take odds on the fact that mom was the oldest person on the planet attentively watching the Charlie Brown Christmas special!!!
Sun, Dec 13 (2:22am) – New Maneuvers
The most novel part of the day was the variety of new maneuvers mom was making. Case instance #1: Unsupported transfer from the rollator (this ain’t your grandma’s walker) to the kitchen chair. Case instance #2: Unsupported rise from a deep e-z chair to the rollator. Case instance #3: Unsupported transfer from the rollator into bed.
Here the point is that mom’s abilities are fast on the rise. True, she needs watching and reminding here and there, but she is rapidly increasing her repertoire. While she does work on her game, these new maneuvers are not being practiced over and over again, rather they are just part of her natural progression. Who knows what the coming day or week will bring.
The other positive point is that if you take away the mask and the rollator or wheelchair, i.e. when mom is comfortably seated, you would never guess in a million years that she is 91, or that she had open-heart surgery less than 2 months ago, or that this is day #5 at home after a 7-week hospital-rehab stay. Her overall constitution did not take a hit, as happens so often. Her overall degree of vital energy remains as it was.
Things to work on: As the right foot is in need of some support and revival as has been mentioned numerous times (and is well photo-documented), her right hand, though to a far lesser degree, could use a bit of a revival. To the naked eye it looks fine and well, unlike the foot, but it does not feel quite right. If you ask mom if she has any pain she will say no. If you ask her if any part of the body is bothersome, she will say her right pinky toe when she walks and her right hand as a matter of course. For the record.
Finally, here are some scenes from the day…
Here mom is standin’ and walkin’ tall with her rollator!! Don’t you wish you had one!! BTW, if you are lookin’ for a solid deal on a lightly used rollator, call us in a few weeks!!
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We went for a nice afternoon cruise ’round the neighborhood with our lightweight wheelchair.
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Opening course for Saturday evening’s meal – nicely spiced butternut squash soup. And don’t forget if you are ever looking to give a tad more substance to your squash soup, get a potato in there.
Fri, Dec 11 (9pm) – A Sunday Stroll on Friday
Just a great, great day today – no slip-ups or incompetents in any way (reference to 11/10 at 11:50pm, 3rd para).
So where to start…First and foremost, mom did not use the call button at all last night. So we will taper-down the hours of private home-care, gradually. Mom had a fine breakfast – including fresh juice as usual, which is now her new normal. Then she hung out in her room with staff while I taught the morning yoga classes. They came out at the end and were walking on the other side of the divider. I thought they might make a guest appearance, but alas, no such luck!!
At 10:30am, we had our first OT visit, and she was excellent. Even though she was just doing an initial assessment, she was very solid in her approach. She watched mom make all the necessary maneuvers in the bathroom, up and down from the toilet and shower chair, and the visit went well. She concluded she would send an OT twice a week for the next three weeks – fine by us!!
After mom’s famed peanut butter open-faced sandwich lunch, we did our chair PT session together. And then the big hit of the day – a wheelchair stroll around the neighborhood. Initially, mom was not keen to do it, but it was such a nice day we forced it on her, and she loved it. We went out the front door, up the block, over and across, and down the alley to the back of the house, and lo’ & behold, the weekly alley get-together was just getting started. Folks sit in outdoor chairs in a driveway, 8-feet apart, with masks. By pure serendipity, we were the first to arrive, and within a few minutes mom got the chance to chat with many of her neighbors, and they were so glad to see her!!
Later on in the afternoon, we had our first home-care nursing visit. The nurse was really good, and she was awed by mom, the house set-up, the support, and the organized way we are running the rehab. And she definitely could not believe mom was 91. Early on in the visit, we told her how the house was built for dad who was disabled, and as the conversation shifted towards mom, she (the nurse) very innocently said that with all the open space etc the house was perfect for someone disabled, and right on cue mom calmly said, “I am not disabled.” B-I-N-G-O!! The nurse was great and had not done anything wrong per se, just mom did a great job of setting the tone about where we are headed. And by the end of the visit, the nurse was totally on board!! (It did not hurt that I did all my usual bragging about mom and told the nurse she could not leave without watching mom’s 90th b-day workout routine. And indeed she watched it before I let her out the front door.)
About those feet: The nurse did look at, dress, and document the feet. And she admired Pastor’s ability to wrap the right foot nicely, and she had him do that part. The left foot is basically a non-medical issue at this point – it does not look normal, but it is not serious. The right foot is a work in progress. No one knows the final answer – just we keep it clean and dry.
Mom is getting better and better before our eyes – rather remarkable. When Pastor arrived today at 3pm, he was walking with mom down the hall, and he immediately noticed, “Wow, your walking is much better today.” Now when mom gets the walker, off she goes…she just pushes it forward, and it is your job to keep up. Whereas in the past, i.e 24 – 48 hours ago etc, she was more hesitant and keen to ensure she was being supported. The way things are going she will kick all of us out of the house before the end of the year!!
Sorry, no action photos today, too busy being an active participant. That said, you all have greatly enhanced the aesthetic value of the house with all the flowers – which mom loves!!!
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Thurs, Dec 10 (11:50pm) – What a Day!!
On a day when the “big appointment” went so wrong, the main thing went so right that the entry had to be titled, “What a Day!” After yesterday’s entry of how long this recovery would take, mom zipped ahead big-time in the last 24hrs. Her stamina, mobility, energy level, overall alertness, and engagement improved a lot. Now true enough, she did take a nap in the mid-afternoon and awaken only to tell everyone, “Good Morning!!”, and she did do a big power snooze after breakfast, but she was really engaged today in many new ways.
She and Pastor put a bunch of clothes away in her closet, and they jointly attacked the laundry needs with mom calling the shots!! They were a good duo. Mom also jumped on the computer for a long while to get at her bloated inbox – only 843 messages left to sift through. Also when at the table this evening, she did not have to put her head down, but was involved in conversation. And prior to dinner, mom went into her “family room” (for lack of a better term as anyone who has been to mom’s house knows it does not have “rooms”) to sit and watch the news etc.
The home-care / Medicare PT guy came today for an assessment and just dropped the ball – (note: overly colorful description deleted upon review 5 hrs later) – just a drawn out questionnaire done 2 + hours too late – anyways it was a dud! But our actual assigned PT guy who starts coming next week is someone different so that is the bright side. The OT person called this evening to come tomorrow at 10:30am – (note: overly colorful description deleted upon review 5 hrs later) – hopefully that will go nicely. To be honest, (note: overly colorful description deleted upon review 5 hrs later) mom is getting better daily, just on her own, and I think both Pastor and I can help mom get back to form. (note: overly colorful description deleted upon review 5 hrs later) Naturally, some well-conducted PT / OT sessions will be a solid boost.
Finally, here are some scenes from the day…
Whoever is up and about or coming and going in the morning gets freshly blended Mandarin Orange juice (it is blended not juiced so the entire fruit is used and consumed) – we blend about 12 oranges, with a touch of banana (today but not always), with a shake or more of organic vanilla protein powder. Everyone drinks it up – and is welcome to multiple glasses.
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Here below is mom with Pastor hard at work doing her PT on the bed, not to be confused with in bed.
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Here is mom enjoying being home – kicking her feet up in front of a fire as she takes in the evening news in her favorite chair. Remember me telling about Pastor’s resourcefulness?? Well, I had carted out a variety of specialty pillows and foam sit pads etc that were mom’s from her hospital stay, and Pastor used them to perfection to make the chair both accessible and comfortable for mom.
Thurs, Dec 10 (1:40am) – Simple Joys & Reality Strikes
Once again, writing an update after midnight…hope to break out of this cycle tomorrow, er make that later today.
Wednesday was a day a great gains and some stark realities as well. First and foremost, mom took her first shower this morning in nearly two months. Gone are the days of sponge baths in bed. She sat in her shower chair and washed head to toe with Pastor’s help, and she looked just great afterwards – and she said it felt even better. The only measure we had to take was to put a plastic bag over her right foot to ensure it stayed dry.
What are some of the other plus points from the day, i.e. Wed Dec 9. Well mom did an excellent job of doing her supine PT routine. Basically, mom has some PT to do in a chair, and some from a lying position, which essentially means in a bed given her condition – as opposed to on the floor using an exercise mat. But doing it on the bed is not easy because it is soft. That didn’t stop mom though; she did very well with it.
Another plus from the day is that mom seems to be more facile in moving around the house, and using the walker to her advantage. And yet another plus is that mom is basically off all meds – no pain meds (she was taking one low dose as needed in rehab but has not taken one since being home), no hypertension meds (which she was on prior to the surgery), and no med of any kind. Mom kept asking what meds she had to take until finally we called and spoke with the nurse at the rehab facility and she said no meds!!
And I am sure there are other pluses, but I shall conclude with this one – timing. Mom is out of rehab and home – just in the nick of time!! Andrew is on the “mailing list” for family alerts from the rehab facility and the covid there is spreading. They have reached the point where they are taking infected patients from other wings and placing them in the quarantine wing. I know, a pretty shaky plus: The plus is that mom is home, and the obvious tragedy lies with those who are unable to leave and are getting infected.
Now let’s get to some of the realities. The first is that this rehab journey looks like it will be a long one as this surgery was a strong blow to her overall fitness. She commented tonight that the strength it takes to chew her food feels like a workout for her heart. The fact of the matter is that mom is easily fatigued. After doing 10 – 15 minutes of PT, she is prone to go back to bed and sleep for upwards of 90 minutes or more, which is fine as she obviously needs the recuperative powers of sleep. Yet these are not your average power naps, a few times today mom woke up and said good morning to everyone thinking that it was the next day! But that’s ok, she says it with such cheer!!
We will just build up her stamina brick-by-brick. The good part is that she has no real medical issues, and she is very happy being home. So that will make for a happy road of recovery, no matter the time.
As for the foot, it definitely looks better, but the big toe and pinky toe are still questionable. We will just have to see, and we are not going to bend towards any surgery, we will just plug along and see what happens.
Finally, here are some scenes from the day…
Here is mom getting her walk in with Pastor. Fortunately, this house has a long hallway / walkway so despite being confined to the house she is able to get a decent walk in.
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Isn’t this a just a great medical prop they make for working on the feet. But no, this is a stand for reading in bed. Pastor is just a very resourceful home-care aid who is excellent at finding things that suit our needs for care and recovery.
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Lastly, thank you all so much for the flowers, treats, letters, cards, colorful texts with lots of emojis, simple texts with no emojis, and other ways you are reaching out. We are trying to get back to everyone, but invariably we get a bit behind. Just know we read and receive everything – and appreciate them all!!!
Wed, Dec 9 (1:40am) – Home Sweet Home!!
Wow!! 7 weeks to the day and mom is back home!! 5 weeks in the hospital (2 1/2 in ICU & 2 1/2 in Step Down) and then 2 weeks in rehab. Mom really, really enjoyed being back on day 1!!
As with all transitions, the day kind of got away from me hence this after-midnight / near 2am update. But everyone else in the house seemed to do rather well with it!!
Once in the house, mom had a cup of tea and then got right into doing all her rehab exercises and walking. Then she took a short, little rest, and then we dove into changing mom’s dressing, as it was not done in the rehab this morning. It kind of took all three of our brains to get things together with it, and Pastor did a fine job of manifesting it with his hands. Thereafter, we all had lunch – Pastor, mom, and I. As the day unfolded, the delegation of duties became quite clear. Commissary is definitely one of the hats I’ve got. Lunch was mildly-spiced sesame noodles with tofu and lacinato kale. It went over just fine. And dinner was quinoa with a diced potato and broccoli dish, with Soy delicious ice cream bars for dessert – Jamie (introduced below) was all in on it – so much so that she also opted to dig in to lunch’s leftovers just to see what that was all about also.
The day was a mixture of getting oriented and testing out how things were going to go. The new intercom / call button was a big hit (see Dec 6 9pm). We got it set-up right away, tested it, and mom keeps it around her neck. And sure enough after going to bed at 10:45pm or so she pushed it and I and Jamie (Pastor’s niece) came running in, and mom needed to use the restroom. Mission accomplished. Another big-hit was the mandarin orange (85%), banana (15%), and vanilla powder (organic) juice smoothie in the afternoon.
So we are going with 24-hour care for the first 3 days or so. Pastor was on till 7pm, and Jamie came on at 7pm and will leave at 8am. Both Pastor and Jamie have a solid skill-set as home-health aides, and they know well how to use the equipment around the house, including the awesome walker that mom picked up in rehab. Pastor is pictured sitting on it down below. Pastor also immediately recognized the gold we had in the form of Medline Washable Underpads (a.k.a chux), absolutely perfect for adjusting / sliding mom around in her bed, so she can sit-up etc.
Mom’s walking is pretty smooth with regards to her gait, but her posture is still a work in progress, but we are tackling it. She is certainly much safer and more competent in comparison to 2 weeks ago when I last saw her. And she will no doubt continue to improve. It will take time. Andrew and I were talking this evening – reviewing the situation – and the overall timing of mom’s return seems just about perfect. She is very stable and can do everything at about 60%, and the other 40% where she needs support / safety precautions should dissipate pretty quickly, though full-on independent living is a ways away. But the main thing for the moment is that mom is definitely pleased to be back home!!
All in all, we are figuring things out, but it is not that difficult of a puzzle. A few more reps and we should be in quite good shape.
Mon, Dec 7 (6pm) – She’s Coming Home!!
Before classes began this morning, at 7:45am I called Rex Rehab and left a message with the social worker that we would like mom discharged tomorrow. And by the time classes were over by 10:10am or so, I had received a message from the social worker stating that everything was in motion!! After a few more phone calls and consults with the PTs etc, it was determined that a medical transport would not be needed and that I could simply drive over and pick her up. And that is exactly what I am going to do tomorrow morning when the Chair Yoga class concludes at 9:45am. I told them to expect me between 10:30am and 11am. And yes, mom is thrilled!! And once home, Pastor will be here to greet us and get mom inside.
As soon as that was all arranged, I called Fearrington Cares – it is a community, medical support office about 1 mile or less from mom’s house that is right behind the local swim club and gathering hall. They have lots and lots of medical supplies for Fearrington residents to use – at no charge, just we return it when we are done. Heck, when I went over there I did not even have to sign anything; the staff had gotten mom’s name from me over the phone and that was it. When I got there all the things I requested – lightweight wheelchair, walker (brand new!), portable commode – were out front. Then the nurse whom I had spoken to on the phone came out, and she could not have been nicer. We talked things through a bit, and we added a grabber and a shower chair. They were just super helpful and accommodating, and in a matter of minutes I had nearly everything we needed:
But there was one key piece that was missing – support bars for the toilet. That was one thing that Fearrington Cares no longer carried so I went to the local CVS as folks told me CVS had that. No such luck. But they did have this nifty (as Dad used to say) handle that I picked up. This piece can be put anywhere and then removed in an instant, and then again placed in a new spot. It may come in handy!! Nifty – right?!? (Note: We never opened this and ended up returning it.)
So then the search was on for the handle bars for the toilet. I called various medical supply stores and the best shop seemed to be Gurley’s in Durham – the same place where I had reserved the hospital bed weeks earlier (see entries Nov 11 – 13). They were extremely helpful over the phone, offered good pricing, and began setting up the various models. When I reached there 30 minutes later, they took me right over to the models (not floor displays) but new ones they had just put together for me to see and compare. And I selected one that was free-standing and had adjustable settings for the height of the bars – and brought it home. Here is how it is set-up in mom’s bathroom.
I tried it out and it works great – sturdy, strong, and stable. This is actually one of the most important things that mom needs. The bars across the floor in the front run underneath the front portion of the bowl so there is no question of tripping on them, and the base bars along the sides on the floor are plenty long to give excellent support. (Note: You might notice that there is a disability bar built into the wall; that was for Dad who was highly dependent upon his left arm. While mom could use that bar, it is a bit high for her and would thus be hard to push off to get to a standing position – not to mention that there is only a bar on one side of the toilet, as Dad’s right arm was fused and lacked power.) So with this new piece I think we are all set. That was the only thing we had to buy.
Here is the shower stool in the shower. And as you can see the shower will be very safe for mom as well, as there are a few disability bars built into it, and there is no step to get into the shower. At this point, mom probably has the ability to stand if she prefers, but sitting will certainly be safer for the initial period.
So the place is all set for mom’s arrival!! We also have this below piece (bedside commode) but I really do not think we will need it….
And, as fortune would have it, the timing seems to be perfect. If we had brought mom home three weeks ago as we had initially planned, it would have been a far more arduous undertaking that would have required a hospital bed and all the things that come with it: rolling the patient, watching for bed sores, attending to bed hygiene and changings etc. We would have been running a nursing care facility, whereas now it is just a basic rehab operation for a person regaining their stamina and walking ability – much, much easier. The other aspect of the timing is that covid is spreading at the rehab center. Now 11 patients and 9 staff members have it – none in mom’s wing. Nonetheless we are quite happy that we are getting her out of there tomorrow!!!
So that is the whole package – we are looking forward to the celebratory and eventful return tomorrow!! Thanks so much for all your care and support the whole way through!!!
Sun, Dec 6 (9pm) – New Portable Intercom
Sunday Evening Delivery: Here is our new system for keeping communication from one end of the house to the other!! It has two components: one is stationary and plugs into the wall, and the other is portable and stays with you. Let’s see if it does the job!!
Sun, Dec 6 (6:15pm) – Planning Mom’s Return
So mom’s feet are getting better. Last night she said her toes look, “Splendid!” And today also she called especially to talk about the toes. She says the 2nd, 3rd, & 4th toes look mostly normal. The big or grand toe still needs some work / time, but some pink is starting to show through, while the pinky toe is still in a of bit troubled waters.
After talking late last night, Andrew and I settled on the idea that Pastor (mom’s devoted fix-it man and trained home care aide) will stay with us on day 1. He lives alone, communicates with his family only by phone, and stays / works at an elderly woman’s house at night as a home care aide. So we are comfortable with him coming and staying in the house. Andrew is going to call the social worker at the rehab facility early Monday morning and tell them that we want mom discharged on Tuesday. I will spend Monday finalizing the house for mom’s return, and then the plan is for a medical van to bring mom home on Tuesday. Pastor will be here with me to receive her. And then in the next 24 – 48 hrs we will see how much we need Pastor. This is his speciality so he should be able to give us a pretty accurate and speedy assessment. (Note: More about Pastor on 11/10 9:30p 3rd para).
So that is where things stand – none of this is in writing yet – but a simple phone call in the morning should get the plan in action, unless they need more time to provide transport etc. Barring that, we seem to be on the cusp of a new phase!!
Sat, Dec 5 (7:35pm) – Better & Winding Up Rehab
Spoke to mom on a normal call in the morning, and she sounded very good. My main message to mom was to absolutely wear a mask when anyone enters her room. Aside from that, I think we pretty much settled on the idea that mom will come home on Tuesday. We had considered Monday, but this way we can talk to the social worker on Monday and get all mom’s affairs in order at the site, and have them arrange transport home. Plus I still need to get a few things ready at the house.
Andrew also got some good info about the 7 staff covid-infected members. 5 were on a wards different from mom’s, and they had no contact with her. One had not been on site for a while (or something like that), and the final one was a PT who had never worked with mom. So hopefully we are in the clear!! And we are not going to tempt fate much longer.
Then in the afternoon mom and I had a video call (photos appended below)…
And here is some key measurable, empirical data that definitely shows that mom is doing better: (a) she was able to remain standing in one spot without the support of a walker for 6 minutes; (b) she is now self-sufficient in the bathroom; (c) after initially saying “it is so good to see you” (on the call), mom told me numerous times to “trim my beard”; (d) she has her vision fixed on her upcoming departure and return home.
So there you have it…normal does not get much more normal than that. Every day she continues to gain strength and confidence in her abilities. Now the only thing left is to settle on the exact home-care arrangements in terms of staffing and support. We really want to minimize the number of people coming into the house, yet (obviously) do not want to sacrifice mom’s care and safety. I think we have settled on the idea that I will do the dressing of mom’s feet, and if really she is stable in the bathroom by herself then we might be able to get away without anyone else, except for the nurse and PT visits during the week. That said, having 24-hour coverage for the first 2 or 3 days would certainly be a good way to go – and the obvious choice if there were no covid.
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Fri, Dec 4 (6:30pm) – “All Things Considered” + Covid Alert
A solid report from mom today. Despite what we heard about her big toe earlier in the week, she says that the big toe on her right foot continues to improve. Already, the 2nd, 3rd, & 4th toes are looking quite good, so now we are primarily concerned about the pinky toe. But this is not to say that the big toe is really in the clear. However, it is encouraging that she continues to see positive changes with the big toe. Mom says she is doing a lot of walking, and she attributes the walking to the continued improvement in her feet.
When I asked her more about her walking, she says that her gait is better – longer and smoother strides. Then I asked how heavily she is reliant on the walker, and she said, “Pretty heavily.” But that will certainly improve over time – weeks and months. Once she get perfectly smooth with the walker, we will explore her walking without the walker.
Needless to say, mom is keen to return home. She is not looking forward to another boring weekend at the rehab facility when things are noticeably slower. But she did say that at the very least someone will be there to get her walking. Once the weekend passes, we will only have a few more days left in rehab.
The call closed with another one of mom’s regular and classic lines, “All things considered, everything is good.”
Just Now Covid Update: They still have just the four patients with covid – as far as they know, but now seven staff members have tested positive for covid. We found out about this just this afternoon, and it is more than a bit concerning. We are seriously thinking to maybe pull mom this weekend. Trying to get more news about this…and the feasibility of getting her home sooner.
Thurs, Dec 3 (6:30pm) – “Take it Easy”
Well, we seem to have settled on the notion that mom will ride it out there in rehab for one more week. When considering the covid ordeal, as Andrew said, there really is no algorithm for this. We did learn that there are two more covid cases at her rehab facility, bringing the total up to four. Bear in mind mom is in the fourth wing, which is on the other side of the compound from the other three wings, which are closer together. The third wing is the one with all four covid cases, and they are way down at the end of the hall. That wing is now quarantined off, and staff do not mix between the wings. Go figure – they seem to be on top of it. We are hoping it works, and mom can manage there for another week.
As noted earlier, bringing her back here early, when she will need more staffing, does not make it risk-free of covid. And there is the outside chance that I can manage alone with mom when she comes next week. I hope so.
On other fronts, as you may recall, yours truly, misplaced mom’s phone. Have no idea what happened to it etc. And her crummy little room phone only lets her call locally. So I do not even need to call mom anymore. She calls 2 – 3 times a day just to check-in and see what is going on!! And she sounds quite strong and good on the phone. She details her therapy, talks about the terrible food, and always wants me to tell her “all the news” – and, I tell her the same thing I have been telling her for the past seven weeks: “YOU are the news! People all over the country are contacting me to find out how YOU are doing. You are the storyline!” But even then she says, “So tell me all your gossip.”
She is focused on maximizing her final week at the facility, and, side by side, planning her return. She reminds me about what equipment we may need – which, by the way I did buy an intercom system today instead of going with her 1950’s suggestion of having some dinky bell (see entry 11/10 9:30p). Aside from that, mom gives guidance about the house etc, and she always (like every time) asks me if I am warm enough. So she is keenly keeping her mind focused all multiple fronts.
That is the update for the for now….save for the fact that at the end of our final phone conversation of the day, mom closed the call with these words, “Take it easy.” I felt like I was wrapping up a call with one of my guys from decades back.
p.s. Sorry, no photos today – will do a video call tomorrow!!
—
Wed, Dec 2 (5:55pm) – Crossroads
Just a lot going on today…
(A) Spoke to mom around midday on a regular phone call and she sounded very good and told that her walking is better better and better. She sounded upbeat and positive, and also contemplated, not for the first time, “How did this happen to me?” Another point she raised was about her feet, as the chief medical doc from the 7th floor was at the rehab facility and looked at her feet. Mom said that, “Apparently he does not think my feet are looking as good as I do”, and he mentioned probable amputation of the pinky toe and part of the big toe.” We talked a bit more, and I told mom that I had a video call (photo appended below) lined up with her today at 3:45pm
(B) At around 1p or so, Andrew texted and called to tell me that he had spoken with the chief doc and case manager, and that there were a few things of note. First and foremost, there have been two covid cases at the facility, but not in mom’s wing. And later I spoke with the social worker as well and she said everyone in mom’s wing was given a rapid covid test and every one came back negative. Apparently, a night nurse had gotten covid and spread it to two patients in a different wing of the facility, which has since been quarantined off.
Based on this, the chief doc was recommending that everyone that could go home should go home, including mom. By and large the chief doc was very pleased with mom’s improvement and recovery. In contrast, the case manager offered that they would like to keep mom another 7 – 10 days; her point is that they view mom as someone who is going to be living independently in the near future, and she felt that in the next 10 days mom would become essentially independent in managing her bathroom needs. At present, she does most of that herself, but still an assistant is needed to be there with her and watch over her. Andrew and I briefly discussed the pros and cons, and thought we should go over it more tonight when we both had more time.
One thing to note is that bringing mom home immediately does not mean completely avoiding the covid threat as there will be a number of people coming to the house for her care and treatment, including a 24/7 aide for the initial arrival period. Whereas, if we stay there another 5 days or week, we may not even need a home-care aide, i.e. less possible exposure for covid.
(C) At 3:45pm mom and I had our video call and the main thing we discussed (obviously) were the various options. If there was no covid issue, then it would be a relatively easy decision to stay another week. Anyway, here we are again with a decision before us…after teaching a couple yoga classes (starting now) hopefully we can come to a point of clarity about what to do.
Tues, Dec 1 (5:45pm) – Recalcitrant Mom
I spoke with mom a few times today, neither were video calls so no photos. But her voice sounded strong, and she could maintain the call much more easily than she could last week. So that was a positive sign. And she keeps telling me that her feet are looking better and better; the wound care nurse is off on Tuesdays, but Andrew intends on checking in with her tomorrow.
PT seems to be coming along fine – mostly walking and some other leg exercises. I suppose we are still assessing her stay there and trying to get educated on how her days are going and what expectations the team has for her discharge. As soon as we know more, we shall share that….
(phone call)
….Andrew just got off the phone with mom, and mom said that nobody knows this but she got up without telling anyone, went to the bathroom, washed her hands, and went back to her bed. And she is not supposed to do that. Go mom!! Now finally I got something on her as she still brings up the point how I cut so many classes my senior year of high school. It got so bad that she and Dad were called in for an impromptu meeting with a team of administrators / teachers etc, and they pulled me from my class and brought me in for that surprise affair. Thanks to a strong defense from my French teacher, I was able to snake my way out of it. But it was a very close call. Both mom and dad said my excuses sounded absolutely ridiculous.
Beyond that, mom detailed all that she does there and made her case to Andrew that she could easily do all this at home. She recounted her PT regime, her OT engagements, and how they do the dressing on her foot. Given her background, to her it all seems pretty basic. She repeatedly said she is ready to come home and get back to her regular life. But she is so sweet that she does not demand it – she merely makes a polite appeal to see if we approve. Andrew has a list of people to speak with tomorrow including the medical chief, and we are going to again give this a serious review. Specifically, what do they have to offer that we could not do at home, as well as what do they want to see from her in order to feel that she “graduated” from their program.
Mon, Nov 30 (4:20pm) – Mom Relaxed & in Repose
Here are some shots of mom (appended below) from our 2p video call today. As you can see she is cool as a cucumber! She said she was just resting up for her next PT where she was going to have to work hard. She said that in her morning PT session today she walked 165 feet before she had to rest, and then walked another 140 feet. Here walking means using a walker with someone trailing her with some type of wheelchair or recliner for when she needs to rest. She reported that her posture has gotten better, and that she is going strong and “not on vacation here.” And apparently her therapist was impressed. So strides are being made.
This blog post is a work in action. I do not have the answers ahead of time – it is real-time reporting. The name itself – The Mom Recovery Blog Post – was given when it was not quite so certain this would be a recovery. But that is what we were shooting for, and now she is clearly in recovery mode. The point being that the situation is constantly evolving. To piggy-back onto yesterday’s entry (Sun 11/29 4:20p), we’ve chosen to be patient and wait for their formal medical assessment / exit strategy for mom where they evaluate her current condition and create a plan with expected outcomes of where they would like her to be in order to be discharged. That should happen in the next few days. For the time being mom is clearly safe and well. And although mom wants to come home, she wholeheartedly agreed with this strategy and said it makes sense.
Now back to our call of today, mom said that her feet are really getting better, especially she commented on the 3rd & 4th toes of the right foot. She said the “grand toe” (a new term for me as growing up she always called it the big toe) and the pinky toe on that foot still need some work / time. I am going to try and “meet up” with the wound care nurse tomorrow morning – fingers crossed.
We did talk about the food today, and I believe the term she had for it was “spooked”, and not as good as the food we had at the hospital, which I have to say was pretty darn good – see photos below of 10/26 & 11/7. So I told her just to polish off all those coconut milk ice cream bars I dropped off on Saturday, and she said that she has had a few. She did report that she is up to 99 lbs – so she is gaining weight and “bulking up”.
As you can see by the photo mom looks very relaxed and well cared for. As noted above, in this moment she was just taking it easy and gearing up for her next PT session. She says that every day she feels she’s getting better and stronger.
So that’s the latests and greatest – keep on truckin’ ma!!!!
Sun, Nov 29 (4:20pm) – To Stay or To Go?
Tried to arrange a video call with mom today, but they lacked the staffing to do that. So I just called mom on her room phone, and she sounded good; her voice was quite strong. But she does get tired holding the phone.
The weekend nurse in charge of dressing mom’s feet was in the room when I phoned, and she unwrapped mom’s feet and described them to me, but it was difficult to get a sense of what was going on. The weekend nurse did not know what they used to look like and I had not seen them for a week – nor had she treated feet like that before. In addition, she was unable to send me a photo. Mom says her feet are recovering. Hope to get a better sense of things tomorrow.
Mom’s main message continues to be that she would prefer to come home. And now I too am thinking this might be a better pathway. She said all the meals are overcooked and dry, and she struggles to get them down. Her weight yesterday was 94 lbs and today it was 95 lbs, so they say she gained a pound. But that is neither here nor there – who knows what she ate in the last 24hrs and if the food had been digested properly, what she was wearing, and various other factors. So gaining a pound is not anything of note in my mind. When mom gains 6 or 8 pounds that will be meaningful. But how is that going to happen when she struggles to swallow any of their food.
On Sunday there is no PT, and it seems like most or all of what what they are doing in PT could be done here – only much more frequently. Though Mom did say that at some point they were going to use some machines to help get her stronger.
Anyway, now again, I am starting to think that maybe she would be better off at home. Discussed this with my sister Sherry who is a nurse and has done this type of care, and she seemed to think we could manage mom’s needs at home, as there is nothing technical involved, and mom is stable medically. Will talk to Andrew tonight about it. We do have to consider that for the first half of this week mom was in quarantine, and the second half was Thanksgiving and a holiday weekend. Perhaps, week #2 will be better, but still many of their limitations are baked into their program: food quality, frequency of PT etc. And those are the key factors for getting mom stronger, not to mention her morale.
So that is where we are – back to deliberating where mom would be best served.
Sat, Nov 28 (8:15pm) – New Feature: Texting Hall of Fame
OK, so here I am starting a new recurring feature called the “Texting Hall of Fame”. After every update, I generally get a lovely and very welcomed barrage of text replies – all of which are very wonderful, yet some shall qualify for the newly minted “Texting Hall of Fame”. And those shall be highlighted in this recurring feature. I only hope this does not lead to bickering or disappointment. Remember, all texted expressions are loved, but the Hall of Fame is the Hall of Fame for a reason. Qualification shall depend on a variety of undisclosed factors. If you think something you texted should qualify but did not, a petition may be made.
Here then is the first induction of HOF texts:
* Abbye: You should definitely go to her window, tell them that’s what you’re doing and then you can talk on the phone while hanging in her window! [Note: This was in reply to point #4 of the 11/28 3:05pm update]
* Stephanie: Btw- Erin and Claudia made oatmeal cookies that we’ll send to Ruth tomorrow.
Sat, Nov 28 (3:05pm) – Resupply Day!
“PT is here so I am probably going to have to go and walk.” Those were mom’s last words as she hung up the phone just now. Sounds to me like rehab is working!!
Mom also gave me a very positive report about her feet. She says they keep getting better and better. I asked her if this was her opinion or that of the wound care nurse. She said it was hers and that a different nurse dresses her feet every day so there is no continuity on that end. But this is Thanksgiving week / weekend so it may not be the ideal time to evaluate the level of continuity. Hopefully come Monday, the same wound care nurse will be looking at mom’s feet every day.
Mom sounds fine on the phone – it was just her normal room phone, not a video call. So no photos of mom today. But I called her to tell her about my resupply mission, and I have those photos!! Without further ado, here they are:
#1: Here are there three cargo supplies that I delivered:
…And now let’s take a look at what is inside…
#2: Here is what is inside the shoulder bag on the left:
Hopefully mom likes the selection!!
#3: Next we look at what is inside the red cooler:
That’s right!!! Two boxes of her favorite ice-cream bars!!!
#3: The suitcase contains the next load of mom’s clothing needs for rehab – workout pants and whatever else I thought she might want. So now she has two moderate-sized suitcases worth of clothing there. And I also tucked in the latest batch of get-well cards that just arrived.
#4: Here below is a view of the outside of the facility. As you can see it is all on one level. I was tempted to run around it until I came upon mom’s room. But someone probably would have called the cops on me reporting a strange guy outside their window!!
Fri, Nov 27 (4:25pm) – Doing the Program – Sort Of
Ok….so mom cleared the covid quarantine and is out and about – no longer confined to her room.
Just got off of a video call with mom (screenshot / photo appended below), but before getting into our call, I want to share the points that Andrew has raised with the staff.
Last night, Andrew brought three points to the attention of staff: (a) mom’s food intake and the need for her to eat snacks and enhance her nutrition in between meals, (b) teeth brushing, and (c) dental nightguard. The staff were attentive to those concerns and are implementing measures to ensure they are attended to. Then Andrew called this morning to speak with mom and by that point in the day she had already done her PT / OT sessions, so she had the rest of the day “off”. Andrew immediately called in and requested an extra PT session for mom in the afternoon which they have implemented starting today and would continue M – F. Here the point is that a little advocacy goes a long way, and give the staff credit too for hearing and taking quick action on those concerns / requests.
My video call with mom touched on a few things. First and foremost, mom expressed how she was ready to transition back home. Now you have to remember that when we have a video call, the staff is holding the tablet and pointing it at mom, so they are obviously privy to the call. Yesterday, the staff person was a silent observer, for the most part. Today when I called there were at least two staff members (the head PT & an aid) in the room with mom, and they were actively participating in the call, even responding to mom’s wishes of wanting to go home, which was fine. And right now, mom needs this program. Her stamina is almost nil. When she does an “hour” of PT the large chunk of that time is spent resting. And actually Andrew and I just discussed how maybe they could break up the PT into 15 minute segments to maximize her engagement throughout the day. That would help her build strength and stamina. The other key issue is her weight which has dropped from 113 lbs to 97 lbs or so. And a lot of that lost weight was muscle mass. So although mom wants to come home, if we can keep refining her daily regimen then this rehab facility is the best place for her recovery. In addition to her PT / OT, a wound care nurse comes in every morning to dress mom’s feet. Then there is staff that help her with her various personal needs: hygiene, getting dressed etc.
We also discussed a care package for mom. Of course, when I asked mom what she wanted she could not think of anything. At home, she eats a “So Delicious” coconut milk ice cream sandwich every evening, and the staff said that they have the freezer space, so I will bring her a couple boxes tomorrow along with more workout clothing and some shirts. If anyone needs to hitch a ride from Pittsboro to Apex, tomorrow is the day for it!!
By and large, mom sounds and looks well. It seems the road to recovery is going to be a longer one – the reconditioning of her body will take time. Fortunately, her medical needs are few, with the right foot being the most concerning issue. She says the right foot is looking better, but she can only see the top / dorsal side. I raised the matter of the underside of the toes but did not get any response. Maybe, I / Andrew will check-in with the wound care nurse about that.
Well, I cannot think of much else. If anyone has any grand ideas of what to put in mom’s care package, pass ’em along so I can stock mom’s cupboards!!
Thurs, Nov 26 (2:20pm) – Happy Thanksgiving from Mom!!!
Just got off of a video call with mom that was arranged via the staff – they have a few tablets that residents can use with staff assistance.
It was great to see mom and hear her voice, and she could hear me very well. So the communication was smooth and easy. She clearly understood why I am unable to visit etc, and on the whole she seemed very comfortable. In short, it was just like any other conversation I have had with her over the last twenty years. Aside: I have to say that the staff at this facility is excellent. No matter who I speak with they are kind, aware about mom, and ever-ready to help.
Mom said that the PT / OT is going well and that they had today off, but they will have PT / OT both tomorrow and Saturday. One development is that now – with staff assistance – she is able to get to the bathroom. So no more bed pans etc. At the same time, mom stressed that she is not ready to try this on her own just yet, as she said her balance is still shaky and she had some near falls, but staff was there to spot and support her – so she was safe.
Mom did say that she was looking forward to coming home at the end of the week (or so), but she will probably be there a bit longer than that! However, things will pick-up a bit as tomorrow mom’s 2nd covid test should be back which would end her quarantine. That means she will be able to go to PT and other venues around the facility, as well as interact with other residents. So that will make life a bit more active and social.
She had her Thanksgiving meal at lunchtime today, and she wishes all of you a Happy Thanksgiving. Also, I read / repeated the Thanksgiving messages to mom that a number of you had conveyed, either by text or phone.
The below photo is not the greatest – it is just a screenshot taken during the call; I did not tell mom ahead of time that I was taking it. But by the image it is evident that she is well cared for, and she clearly feels comfortable as she slings one arm back over her head.
So there you have it – wishing you a Happy & Joyous Thanksgiving from Rex Rehab Facility in Apex, NC!!!
Wed, Nov 25 (2pm) – Phone Call Confusion & More
Mom has a very hard time hearing anyone using the room phone – and this theory has been tested plenty…in addition, using the phone is exhausting for her, unfortunately.
Last night, mom was a real trooper in bearing with me through a 3-way call to address a credit card issue. Thought we had addressed all those a week or two back from the hospital room, but apparently one fell through the cracks. Now resolved. Throughout the call I was pushing and pressing the agent to manage the situation more speedily and efficiently, and she did well with it and was especially sympathetic to mom. It is very, very apparent that it takes all mom’s energy to produce any sound on the phone. Then today, I had mom on the phone for a 3-way call with Google Fi (her cell phone carrier) in an attempt to resolve the issue, i.e. my misplacing her cell phone. We could not quite get the issue resolved, but for the whole first part of that 3-way call all mom wanted to talk about was whether I would be visiting her today (not realizing that the Google rep was also on the call)…and in fact through this series of calls, one simply ended with her saying, “I can’t hear you, but I will hang up with the hope that you will be visiting me this afternoon.” I then had to call the case manager and asked her to go down to mom’s room and explain very clearly to mom the visitation rules etc.
There actually is a bright side to all of this…
Just a little while ago I got a call from mom’s nurse asking me to call mom in her room – and the nurse was also there with her. Still mom could not hear me very well, but we were able to get a few things settled, by having the nurse come on the phone. Mom’s initial query was whether I was arranging a visit or not. Now she understands that I cannot even go online to schedule a visit until the results come back from her 2nd covid test. We should get those results on Friday. But even when I get clearance to try and schedule a visit, there is a massive visitation back log (see visitation bullet from 11/24 update).
The nurse and I also discussed mom’s sleeping and eating. They will give her melatonin, just as the hospital did, to help her sleep at night. On the food side of things, mom typically eats half of her meal or less, but that is nothing new and I explained that to the nurse.
Next, the nurse and I talked about mom’s physical condition and PT regimen. To set the bar high, I told the nurse how mom was in very good shape, and she said, “Oh, I can see that by her legs – she is very strong!” We also discussed mom’s PT session from this morning. All mom could do was walk 15 feet, i.e. the length of her room – the reason being that she is in quarantine and is not able to leave her room until the 2nd covid test comes back. Apparently, she did walk across the room a few times. I suppose her real PT sessions will begin on Friday. And she will have her OT later this afternoon.
Mom has repeatedly expressed two desires: my coming for a visit and her wish to go home. She told the nurses that she can go home because Pastor and his family will look after her, and that Andrew and I approve of her leaving rehab. I do not think anyone onsite is taking this as a discharge order (smile). The nurse and I discussed how the tools and specialists available at the rehab facility will be far superior to any semblance of home-made rehab center that we could conjure up – and that this is the key time for mom to rehab and build strength and stamina. And I think mom ultimately understands this and will continue on – giving her all to the program there.
The nurse is extremely nice and personable, and she will be mom’s nurse throughout her stay. And the nurse repeatedly told that I could call her anytime if I had questions, concerns, or needed to get something settled with mom. Also, till I gain access for visitation, I will get a video call set up with mom using Google Duo on one of the facility’s tablets. In fact, I will email them right now to get that set-up.
So that is the state of things, as best as I can garner.
Tue, Nov 24 (6:15pm) – Rehab: Rules of the Game
So we had a 2:30p conference call with mom, the social worker, the nurse, and the PT. And here is the outcome of that call:
- Duration of Stay: At this point, they cannot say when mom will be ready to leave, but typically rehab cases run 3+ weeks. It depends on her progress etc.
- Daily Regimen: Mom will have 1 hr of PT and 1 hr of OT per day. I am not quite sure how the rest of the day is spent.
- Outcome & Potential: During the call Andrew & I stressed again and again that this is not a typical 91 year-old and that the expected outcome should not be a low bar. To support our point, we sent the blog link of mom’s workout routine from when she turned 90 and insisted that it be forwarded to all of the physical therapists and that they watch it – and they readily agreed to this. Moreover, we mentioned that the following were also regular elements of mom’s life: trail hiking, daily walks, swimming, international travel, driving (local errands and trips to Maryland), hospice care to local residents – in addition to her gym workouts. We wanted to give them a full picture and what to shoot for.
- Foot Update: There is a designated wound care nurse (not present on the call) who is attending to mom’s feet. That nurse told mom that she has seen many cases like this and often they result in a favorable outcome. Mom was quite heartened hearing this. And mom said that the tops of her feet were improving (that’s the only side she can see). And that is very consistent with what we had been seeing of late. It is the tips of the toes and the underside of the toes that is so very concerning.
- Phone Calls: They allow incoming calls to mom’s room, but mom says that speaking on the phone is exhausting so we figure we may need to wait a little while for that.
- Cards / Packages: Some of you asked about cards and packages – that’s fine. Those can be sent to: UNC Rex Rehab & Nursing, Attn: Ruth Nicholson, 911 S Hughes St, Apex, NC 27502
- Visitation: Once mom passes her second covid test – should have the result by Friday – then we can try and arrange a visit. But it is not easy, as they have over 100 residents, many of whom are there full-time and have not seen their families for months and months as visitation just started a few weeks ago. The visit is 30 min; only one resident can have a visit at any given time; there is a designated room with a plexiglass barrier; and, that room gets cleaned in between visits. So you can see how scheduling will be very tight. But mom is keen to have a visitor so I will try and get on the calendar.
I think that about sums it up….
Tue, Nov 24 (8:30am) – Landing in Rehab
So yesterday afternoon I drove over to mom’s rehab spot with a moderate-sized suitcase of personal items, including the latest batch of get well cards. Already there was another party standing outside. It was a guy who was bringing belongings for his 91 year-old grandma. I told him that we were probably related as my 91 year-old mom was also inside. After a few minutes, staff members emerged from inside the double doors. One was a cheery and engaging administrator on her way home for the day, and the other was a staffer who came to collect the belongings. We simply handed them over to her – no paperwork, no nothing. So I repeated mom’s name a few times, and she smiled at me and said, “Ruth Nicholson – I know who she is.”
I should note that the grounds and place looks extremely well tended to on the outside, and it is in a quiet location, which is fairly easy to get to, about 25 – 30 min from mom’s place. It is a sprawling one-floor complex, kind of like that set-up of those old style motels where everyone parks outside their own room etc, except this is a modern looking place.
After returning home, I spoke with Andrew and he had already spoken with mom at her new site. And he spoke with some of the staff and administrators as well. And here is what they had to say, mind you mom had only been there for a matter of hours. The intake nurse commented that she had gone through mom’s chart and was amazed that she was still alive given all that she had been through. Another person told my brother, “Oh I love her, she is just so cute”, and then added, “And she is very motivated too!” We were impressed with how familiar they were with mom already.
Not only that, at 2:30pm today they are having a meeting to discuss mom’s case – and both Andrew and I will be joining in by conference call. The team will include a social worker, mom’s nurse, a therapist, and other staff / specialists – maybe a doctor, totaling six people. So they are taking her rehab seriously – that this is indeed rehab and not just a makeover of a nursing home. And we think that they are very keen to tap into mom’s motivation to make this a very successful venture. They seem intent on utilizing the time and getting the job done.
I did speak with mom later in the evening to ensure she had received her suitcase and the latest batch of get well cards. She had. And she said the place was very nice; she has her own room; and, she seemed comfortable with the surroundings and the staff – and ready to attend to the task at hand.
So we feel very fortunate that this has worked out the way it did. We could never recreate this type of structured environment at home where a variety of specialists and staff are with her throughout the day to manage her personal care, address the wound care on her feet, oversee and manage her physical and occupational therapy, and manage her medical charts etc. I think we are in the right spot.
Mon, Nov 23 (3:10pm) – Grand Farewell – Successful Transfer
The timing today was just perfect…I called in at 8am and they told me that it was all but certain that mom would be transferred today. With that thought in mind I taught my yoga classes till 10am, and then attended to some follow-up work. Just prior to 11am I began wondering what was happening, and as I picked up my phone and started calling around the case manager reached out to me. She told me that mom had to be at the Rex Rehab by 3p, and that she had arranged transport to pick her up between 12:30p and 1p.
I hustled over to the hospital – got there at 11:30am, and we had a few minutes together, and then her lunch arrived. Just as mom was finishing her dessert, the doctor – who is both the medical consultant on the 7th floor and at Rex – entered mom’s room. We had always missed each other in the past, so this was great. He stayed with us for 20 minutes or so, looking at her feet, going over legalities, and talking about what life will be like over at the rehab facility. His team of nurses is over at the rehab just about all the time, and he goes over there 3 days a week and interacts with all the residents / patients. So he said he definitely would be watching mom’s progress. He added that the average length of stay is two weeks, but naturally there is some variation. One key factor is whether a patient has a safe home living situation where they can get the care they need. He also discussed how visitation is by appointment only in a special room with a plexiglass divider. All in all, it was a very fine interaction, and it made me feel good about where mom was headed and what type of facility it was.
Shortly after the doctor left mom’s room the transport people arrived. By then I had collected all of mom’s personal items, and we gave only mom’s big boots to the transfer folks. Sure enough, we slid mom off of her bed and onto their high-performance stretcher. And mom was rolled out of her room. The nurse lamented, “Oh, I have seen her here for so long but this is the first time I was assigned as her caregiver and it is the day she is leaving!” All the nurses at the nursing station called out to mom and cheered, and the transport guy said, “Wow, she is really popular!!” And with that, mom made her exit.
I have since called over to Rex to arrange the drop-off of mom’s personal belongings, and they confirmed with me that she had indeed arrived. So there you have it: Respiratory Clinic => ER => OR => ICU => Thoracic Step-Down => Rex Rehab Facility…
…and we all know where the next stop is….it is only a matter of when.
Sun, Nov 22 (10:15pm) – Joyous Reunion
Wow!! One of our three main PAs from across the hall, i.e. the ICU, was wandering our area and happened to peek in the room and she was so surprised and overjoyed to see us. She told the nurse outside, “Oh I just gotta go in there, I love these people.” Then she repeatedly and emphatically told mom, “Don’t tell anyone, but you were our favorite over there – we all loved you!” She was amazed at how good mom looked and told how she was on way back to health. And indeed, it was so great to see her as well. It was like a family reunion. We had so much to talk about and catch up on…
…then we also got into the weeds as well, and we had her give a lookover of mom’s feet and talk shop a while about the various options and possibilities. She was very generous with her time and stayed with us a good while.
And actually, we had an equally warm, but more toned down, reunion with another ICU PA the prior night, as she was also roaming our halls, and I had her come into mom’s room to say hello.
Mom remembered them both. Would really enjoy catching up with a number of folks from the ICU!!!
Sun, Nov 22 (10:02pm) – Not To Be Confused: Infection vs Amputation
Yes, it is wonderful that mom’s right foot is not infected, and we got a lot of very positive and joyous responses about that in the last two hours.
Here I only wish to clarify that the fact that the right foot is not infected does not by any means mean that amputation is now off the table. There is still every real possibility that mom may need some type of surgery not only on the right foot, but the left as well.
So yes, we are pleased there is no infection at present, but we are far from in the clear on this one. The menacing clouds of amputation still hover above.
Sun, Nov 22 (7:35pm) – Right Foot Update
They have begun changing the dressings on mom’s right foot each shift, i.e. 2x per day. They are placing special strips in between her toes to keep the foot as dry as possible and avoid infection. They took an x-ray of the foot this morning to ensure there was no bone infection. That x-ray came back negative. At this point, they do not seem to think that the foot is infected at all.
Sun, Nov 22 (7:05pm) – Planning the Transition
We called Rex Rehab in Apex today to scout out the scene: Should mom bring / have regular clothes? Do they have a way to conduct Zoom sessions? Who determines the length of the stay? Do they have a bed available?
The woman who answered was very nice and fielded all our queries and then some. So that was a good start. Today she was acting as the lead nurse, and she said tomorrow she will be the intake nurse. So she well may do the intake with mom tomorrow, if everything comes together as planned.
If Monday turns out to be the transfer day, then I shall hustle over there in the afternoon with mom’s clothes and personal items. And in answer to the other queries: yes, they have a tablet for video calls; the doctors and therapists give their recommendations on length of stay, though mom can choose to leave at any time; and, yes, they do have a bed available.
Let’s see what tomorrow brings – the case manager is the key person who gets this whole thing in motion…
Addendum: We did speak about visitation, and they are opening privileges, but those will first go (understandably) to their permanent residents as they have not seen their family members for months. Besides, mom will be in quarantine for her first several days there, until she passes her second covid test.
Sun, Nov 22 (6:35pm) – Good Walk & Hiccup at End
The below video is mom’s 2nd walk of the day. Her first walk was very solid – a long jaunt, which I was not present for. But the staff raved about her.
Here in this second walk mom does a good job of powering through, and at the very end it is very apparent why a hands-on spotter is absolutely necessary. This is her 6th day of walking.
Sat, Nov 21 (10:45pm) – Fatigue & Fancy Footwork
After dinner and after a long day, mom felt that she did not have the energy to go for her third walk – even though she had called the nurse explicitly to go for a walk. But she was just exhausted, and the nurse did a fine job of reassuring her that sometimes rest is best, and that she was not letting anyone down by not going for a walk. We told her that we are in this for the long journey, not a short sprint. Mom did get up on her feet however, and she did a nice job of repositioning herself from the recliner over to the bed.
On the medical side, just documenting that mom’s right foot is no longer dry. Last night it showed signs of leakage, and this evening it was draining whereby it warranted a dressing wrap.
Sat, Nov 21 (7:35pm) – Transfer Recalibration
So we are still aiming to head out to a rehab on Monday / Tuesday, but it looks like we are now shooting for the UNC REX Rehabilitation and Nursing Care Center of Apex. We feel this will best suit mom’s needs, and we have gotten a number of very good reports about this place. The doctor from the 7th floor is a consultant there; some of the nurses on this floor have friends who work there; and, a local PT told us that the Rex rehabs are very good – there are two, one in Apex & one in Raleigh. So this is our updated plan. In preparation for our upcoming departure, mom will get a covid test tomorrow.
Sat, Nov 21 (6:35pm) – A New Record!!
Here below is mom’s second walk of the day – her afternoon stroll – when she set her new record of 150 feet. I was given the duty to follow from behind with the recliner – hence the camera angle from the rear. This is just day #5 of walking.
Fri, Nov 20 (10:05pm) – Mark That Chart!
Whenever mom walks, she is very keen on getting the box checked. That makes it official!! FWIW, I checked the 2nd and 3rd boxes today. Mom’s 3rd walk (not videoed) went quite well. Mom is also very proactive in securing staff for the next upcoming walk.
Fri, Nov 20 (7:45pm) – A Sense of Clarity
We seem to have emerged from the deliberative haze….
The 7th floor is no longer on the table so it is either go home or transfer to a low-intensity rehabilitation facility. All along we have pretty much written off the idea of going to a low-intensity rehab facility as they generally double as nursing homes and do not allow visitors. However…
….We seemed to have had a change of heart, and here’s why. Andrew has had numerous talks with a doctor who is a consultant to the 7th floor high-intensive rehab. And that same doctor is also a consultant for two low-intensity rehab facilities. And he vouched for their quality and repeatedly said mom would be a perfect match there. She would get two hours of PT / OT per day, without the pressure of having to perform at a particular level or for the full time period.
In addition, we spoke with the intake coordinator at Parkview (the facility we are considering), and they seem to run a very tight ship. So we feel she would be safe and well-cared for, and mom is open to trying it out for a few days. At this point in her recovery, she is making great strides; going to a facility geared towards rehab at a level suitable for her would enable mom to continue to build that base of strength. The more strength and independence she achieves before going home the better off she will be (we will all be!).
Parkview has beds available on Monday. So the basic thought is to get things set-up for a transfer there on Monday…and come Sunday evening should we opt out or mom veto the plan then so be it. So let’s see how the weekend goes and where this ends up, as our plans seem to change on a daily basis….
Fri, Nov 20 (6:55pm) – Video: Great Afternoon Walk!!
Mom did absolutely fantastically well on her afternoon walk. There was just so much progress. Her steps were more fluid, and she went three times as far. And she was essentially independent. So this was a very positive development. This is just day #4 of walking!!!
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Thurs, Nov 19 (9:10pm) – The Formidable Brown Line
There are a few things to report and consider…
First things first: Mom went on three walks today. And she also got up from the bed to use the bathroom and the commode. So that was a lot of progress. I was not present for the first two walks, but I did witness the third. When I saw her, she was walking freely with a walker – no human support. There was a guy behind her pushing the recliner chair in the event that she needed it. But mom was able to power herself forward – and she reached the goal of making it to the formidable brown line in the floor. On a separate occasion, I also saw her stand up out of the chair by herself and navigate a few feet over towards the bed. All of this takes tremendous energy and is exhausting for her, but she smiles heartily when she attains her goal. I did video this but because I had to hold one of mom’s medical connections the footage is not all the great as I had to remain close to her, but for the record I will try and upload those videos here.
Technical note about videos: The below two videos (from entry 11/19 1am) were uploaded directly onto my website – as opposed to using youtube etc. Most folks could watch them fine; some had trouble viewing them on their phone. For the next set of videos I may use youtube to see if that works better for folks.
Second things second: We are in a state of flux of how our future may play out. We are still in the running for the 7th floor, but they continue to express that greater stamina is needed. Side by side, mom’s present bed is in an acute care unit, but she is no longer an acute care patient. So….they want us to at least explore back-up plans.
Andrew spoke with the doctor who is a consultant for the 7th floor rehab facility, and he is also a consultant to a low-intensive nursing care / rehab facility that he says is excellent. And the doctor feels mom would thrive there. (Of note: this doctor has also been our best advocate for gaining entry into the 7th floor so he is not pushing us away.) He just thinks that it is a solid second option. That said, there are no visitation privileges there, which we have been against from the get-go. One thought however is that mom could try it for a day or so and then leave if she does not like it. And, of course, our third option is to go home and do rehab there. These are the same options we’ve been mulling around for a week or so, but when the dynamics change then it becomes necessary to reevaluate things afresh. And that is where we are right now.
Thurs, Nov 19 (6pm) – Thank YOU!!
Thanks so much to all of you who are following along with mom’s recovery, sending loving thoughts, offering encouragement, responding with support, and watching for mom’s welfare. We greatly appreciate all of it. One of her favorite things is to hear all the wonderful replies that you all are sending. Your concern and care are food and impetus for her further recovery!!!
Thurs, Nov 19 (1am) – Walking Videos: Starting Point
Here are two videos of mom’s second day of walking, i.e. Wed Nov 18. These provide two valuable perspectives: (a) how far she has come in the last month, and (b) how far she still has to go.
As you can see there is serious work to do, but fortunately each day she is progressing. Some PTs saw her on Wednesday and one had not seen her since her ICU days, and she was astonished that this was even the same person. At the same time, in order to be accepted onto the 7th floor for intensive rehab she will have to up her game (i.e. stamina) – and she will. And, of course, just to manage life and independent living, there are strides to be made. These videos document the starting point of this journey.
The two key challenges are her overall conditioning in the aftermath of a highly invasive operation and 4 weeks in bed, and the condition of her feet (see the Nov 9 6pm entry.)
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Note: After the second video, she reclined back fully in her chair and they pushed her in reverse direction back into her room – and she thoroughly enjoyed the ride!! Really wish I had that on video – she was smiling ear to ear as she easily glided back into her room after all that hard work!!
Wed, Nov 18 (3:15pm) – A Walkin’ We Will Go
Mom has taken two walks today – and we hope to get a third in soon. Not bad for someone who some thought would never walk again. Now, don’t get me wrong, there is work to do and progress to be made. Her jaunts are supported endeavors with staff by her side and a walker in play. But it is a start, and everyone is very impressed by how far she has come at her age. This is only day 2 of walking, and she improved from yesterday. So we have to keep practicing and see how far she can progress. I took some videos which I may upload later this evening to give a sense of what we mean by walking at this early stage of mom’s recovery.
Wed, Nov 18 (9am) – Bright & Cheery Morning
Since mom gave me the evening off yesterday and I had no morning classes today, I thought I would come in early and made a 7:20am arrival at mom’s bedside. It sounds like one doctor beat me to the chase (mom says she was too tired to interact with him), but I have been privy to the early morning nursing care.
The main news is that the medical team seems noticeably upbeat about her feet. The old black blistered portion is peeling off, and nice new skin is growing underneath. There is still a ways to go but things seems to be headed in the right direction.
When I brought mom’s emory boards over she had a big smile on her face, and she got to work right away. And later when I asked mom how she was feeling she said that, “I feel like I am getting better fast.” A few minutes later she added, “I know I am getting better because I am now producing saliva, which I wasn’t earlier.”
And indeed, it is amazing to see how at 91 mom’s body does seem to be regenerating at a good rate, on a daily basis. Her overall level of vitality is quite good. Just we have to work on that endurance for sustained engagement in PT / OT.
Tue, Nov 17 (4:10pm) – Just Takin’ A Stroll
Arrived a few hours ago and was jaw-dropped to learn that mom was up and walking today – it was the first time she had taken steps of any significance as she walked out of the room and over to the nursing station. I did not even think she could do this. Apparently everyone cheered when they saw her emerge from the room.
Mom was wearing her black boots (photo below – see Nov 7) and was using a walker – with staff on either side of her. In addition, staff followed behind with a rolling recliner in case she got tired. So that was a big step forward!
Really this is remarkable because no one has been really sure just how far and to what degree mom would recover. Nothing was a given – all cards were on the table with professionals offering a range of assessments. The overriding theme has been to watch and see. Well, that is what is happening. We are watching and seeing, and hoping for mom’s continued rapid advancement!!
In addition, mom heard from the intake specialist for the famed 7th floor. He has been getting full reports on all she is doing, and he emphasized that it was important to have solid stamina to keep up with the pace of the 7th floor rehab. So mom’s job is to really crank out her PT and OT sessions in these coming days.
Here is a photo of mom sometime after she completed her first walk…..
Mon, Nov 16 (8:30pm) – Slam Dunk…Almost
The absolute crown jewel of rehab in the state of NC is exactly three floors above us. When we talked to our chief surgeon way back when about the possibility of getting onto the famed 7th floor he replied: “Oh, that is a moonshot. I never get my patients in there….the whole hospital and UNC system and folks from far and wide are aiming for those few slots – it is virtually impossible.”
Well, this is the story of how we find ourselves (gasp) almost in the door!!!
The chart posted down below at 12:50pm today really fueled our desire that it was all or nothing. We really had to get into a rehabilitative hospital. So began the phone calls….
One key phone call was the one Andrew had with the intake officer for the 7th floor rehab. That set things in motion as he gave us some key advice for how to put the rubber to the road – which Andrew did. Case manager, file a request, etc.
Side by side…
I was a tad bit late getting out of the house today and was rushing over to the hospital. I parked and went through the walkway and entry checkpoint and was hustling through the lobby when the phone rang. It was Andrew. And immediately we began strategizing how I should be there if and when the 7th floor rehab physician came by to evaluate mom. As I was snaking my way through the various halls of the hospital to reach the elevator, Andrew told that he was getting a call from a doctor. I hung up.
In a matter of minutes I was up in mom’s room and she was pointing and indicating at something. I asked what was going on, and she said the doctor was just with her and I should find him out in the hallway. I went in and out of the room three times and asked all the staff and nurses. They confirmed that there was a doctor in the room, but they could not say more than that – and had no idea where he had gone.
I called Andrew – no answer. Probably talking to the doctor. And as we would soon find out that was exactly what was going on. I had just missed the top rehab doc from the 7th floor who had come to evaluate mom. As soon as he left mom’s room he called Andrew from his office. They talked for a good while. The doctor was deliberating between low-intensive (nursing home style) and high-intensive (7th floor) rehab. And by the time he got off the phone with Andrew it was a near (and I emphasize near) slam dunk that they would take mom in the crown jewel 7th floor rehab.
Quickly, we quizzed mom about what had transpired and what she had done. She explained how she sat up, edged herself to the bed, and did her best to stand up as the doctor helped her. The doctor did an intake interview with her, and would later comment to Andrew on the phone that he would never have guessed that mom was 91 and especially commented on her skin…he had her tagged at 70 – just like everyone else in the medical system had.
All in all, from the initial phone call to the intake officer to the doctor’s assessment of mom, the whole episode had transpired within just a few hours. If this miracle ticket comes through for us, mom would move up to the famed 7th floor in the next 2 -3 days. She would have a semi-private room and engage in high-intensive rehab for 3 hours and day and stay for approximately 2 weeks, whereby she would either be up and walking or had experienced a “flat-line” in her progress.
Mom is amped up to do it and strut her stuff. She said she would give it her all, and I would adjust my schedule to be there for her early morning workouts etc. But it is not set in stone yet…but our golden invite is all so very close.
Hope to report soon that it is a lock.
Mon, Nov 16 (2:30pm) – Sitting Tight
Given that mom is still relatively new out of highly invasive surgery and that she is in a dynamic state of recovery, we have pretty much decided to keep her “as is” until we get directed towards the right resources within the hospital system. Those acute care rehabilitation centers have a lot to offer mom – and if we were to “pack up and go home” we would be both operating from a deficit as well as unable to regain access. So that is what we are setting our sights on. Andrew is a pro at navigating and doggedly pursuing those channels – and speaking with the right people.
Mon, Nov 16 (12:50pm) – Rehab Centers: An Important Distinction
Here is a key distinction between the types of rehabs…and combine this with the fact that in this era of covid that the right side column does not offer visitation privileges (to see just what the heck is going on) and the left side does, it is very clear where mom needs to go. The problem is getting a spot….the one at UNC where she is now is in extremely high demand – the chief surgeon himself told us he can rarely get his patients accepted – plus given mom’s present condition it is probably more intense than she can handle as she still needs a good bit of bed rest. That said, mom is gaining strength daily and may soon be ready for that type of intensive rehab.
Mon, Nov 16 (11:30am) – Decisions….Decisions….
The rehab facility did NOT have a bed available, and they do not expect to have a bed available until Friday, and even then there is no guarantee that mom would get that bed (for a variety of reasons which I will not get into here.) If we take mom home then that rehab will not accept her; she has to go there from a hospital. The question is what are we missing out on by not using that rehab facility. And we feel that there would be a fairly substantial loss of access to equipment and therapists if we brought her straight home. We do not believe we could replicate that type of PT / OT in our own house – given all the other things we would have to provide mom. At the very least, we would have to hire a private PT person to bolster the visits provided by Medicare. It seems to be a no-brainer that any rehab facility would be the next best option, but with covid all those traditional rehab centers are not allowing visitors. Just a tough spot to be in as we think this through.
Sun, Nov 15 (9:30pm) – Odds ‘n Ends
Ok, well here is a sure sign of progress. Mom’s signature has normalized. Pun very much intended!!! All kidding aside, it is true. When mom signed her election ballot on Nov 1 or so, it was a mighty rough looking signature. But tonight we opened up her business office to pay a few bills, and she was pretty fluid in signing those checks.
We also did a foot-check this evening. Videoed it to note the progress. Both feet point and flex quite nicely showing a solid range of motion. She can also wiggle and move all the toes, though they tend to move in groups of five, instead of each toe wiggling freely on its own.
Heading out a little earlier than usual this evening, as mom is clearly fine and in good hands. Let’s all hope we get that bed tomorrow in that rehab facility.
Sun, Nov 15 (5:15pm) – Getting Stronger, But No Sleuth
Mom had a successful Sunday morning spending three hours in the recliner chair. She was notably better in making the transfer from the bed to the recliner. That was the report I got. Apparently mom also noticed her heightened ability and said, “I am doing better aren’t I.” So that is a big step that her mobility and strength is making solid strides on a daily basis. All this stands as reason why it will be very key to get mom into that rehab facility tomorrow morning.
All else is very good. Mom is on “room air” (i.e. no oxygen), and her O2 saturation is 96 at this very moment. And even when she sleeps her oxygen saturation remains in the 90s. So she is quite stable on this front.
Mom also feels like her right foot is a bit more pinkish. I have not looked at it yet today as I usually check it at 9:30pm or so. The right foot is the main sticking point so seeing daily improvement is vital.
Oh so ask what is on for the evening? Dinner and another PBS murder mystery by the British playhouse / BBC. Last night, we caught an epic two-part murder mystery which mom was unable to solve before the fateful end. However, she can be pardoned as these mysteries weave a complex web of whodunnits and whys.
Sun, Nov 15 (4:50pm) – Icelandic Landscape / Seascape
Mom’s grandniece, Erin, painted this watercolor get well card: a reminder of their explorations together in Iceland.
Sat, Nov 14 (5:45pm) – Boring Stability
Mostly an uneventful day, but that is a plus point when you are in the hospital. Because mom is not hooked up to anything – no drips, no machines, no oxygen etc – there is not much for the nurses / staff to do with her other than hygienic needs. On this last point, mom is pretty good at keeping folks running. She always feels badly about it, but I have to say that the staff (all of them) are so good about reassuring mom. Really, they have all been excellent about this. They act like it is most natural thing in the world, and they project the feeling that they are ready to come back as many times as needed. There is never even a hint of a moan or groan; always they are 100% supportive and cheery about it.
In a break from the norm, Mom did not go in the recliner today, but since she seems quite comfortable in bed we may just keep her there. We did do a few exercises (leg lifts, foot flexion, hip / quad stretch) but nothing too rigorous. Mom said she practiced in the morning too.
At present, mom is not even on pain meds for her feet, whereas in the past (those ICU days) her foot pain was chronic and severe. So this is a big change. Mom also says she can move her toes more and that her feet are warmer. So long as we continue to see positive changes every 24hrs, we can hold hope that we somehow escape this foot nightmare. Aside from the feet and basic conditioning, mom is ready to be a fully-functioning human being again.
By and large, the weekends are quieter at the hospital, and I suppose that suits us just fine. I think mostly we are ready for a change of scenery. Let’s hope we can secure that transfer to the rehab facility on Monday.
p.s. I came here today thinking we might post some type of “hello to everyone” video, but we are not quite there yet – but soon!!
Fri, Nov 13 (10:15pm) – Hospital or Hotel
Mom is feeling so relaxed, comfortable, and carefree at this point, it kind of feels like the two of us are just hanging out in a hotel room together.
Fri, Nov 13 (6:15pm) – Hunkering Down
Well, we did not get into the rehab today as beds become free at 9am and we found out about the facility after that time. So we are hunkering down here at the hospital for the weekend as beds will not open up again till Monday at the rehab spot.
Apparently, there are 26 rehab centers within 20 miles of mom’s house, and our case manager knew about 9 of them so Andrew had her call the other 17 to find out about visiting privileges. And they all were a big NO, except for this one, as it is an acute care center with a small rehab unit. The key point now is how competitive it is to get in and if there is a waiting list. Needless to say, we will be honing in on them and letting them know of our keen interest in their facility.
Placement aside, mom is doing great. Her energy level is solid, and she is getting a little stronger every day. Her feet continue to be a waiting game; slowly but surely, however, she is able to do more with them. All in all, it is a wait and see scenario – both in terms of the feet and gaining access to this rehab facility.
Fri, Nov 13 (11:07am) – Hold Your Horses – Potential Redirect
Possible change of course!!! Just put the hospital bed delivery on hold (yet again!!) – the guy was totally relaxed about it considering it was due to come in an hour or so!! We got word that mom is doing great today – as I am still at the house as I just finished my morning classes. So why the possible switch-around? Well, our new home care agency called Andrew to tell us they were coming by today – i.e. to the house – and that was obviously the wrong date as mom is still in the hospital, but they got to talking – and one thing led to another – and Andrew explained to her our decision why to forgo rehab (due to no visitation) – and the nurse promptly said that she works in a great rehab place that is a satellite hospital of UNC that offers PT twice a day and OT once a day. She also said that the therapists there are wonderful, and there is a gym and a variety of professional tools and props for rehab….AND AND AND….they offer full visitation privileges!! So yes, if we can get a bed there then we are aiming to get mom placed in that facility. It would be about 25 minutes from her house. What a serendipitous turn of events. Hopefully they can take her!!
Thurs, Nov 12 (7pm) – Standing & Weight-Bearing
Mom has had just a stellar day. When I arrived this afternoon she had just finished working with the occupational therapist, and they had been practicing standing up from the recliner chair and sitting back down. The OT was impressed with how much stronger mom had gotten. She said mom was able to provide a measurable amount of the force needed to make it to a standing position. And, very importantly, she was able to weight bear on her feet while standing, and it did not give her much discomfort at all. Rather she felt pretty good.
Later on in the day, I watched two aides transfer mom from the recliner back to the bed, and mom was able to be an active participant in the process. In contrast, just five days ago it was an entirely different scene (see entry “Herculean Effort”).
Mom has also been off oxygen all day and is keeping her O2 saturation at a relatively solid (low to mid 90s). And they feel that as she exercises more that number will rise. So now she is medication-free; the only thing she does take are pain meds for the short-term. But as far as her vitals etc, nothing at all.
Everyone feels like she is really on her way, and if she can replicate this tomorrow then we can consider Saturday as a transfer home day. Tomorrow, I will be meeting with the OTs and PTs to learn and get trained on techniques to help mom. And once home, there will be regular visits by an RN, OT, & PT.
Perhaps the main thing is that mom is very alert, comfortable, and looking more like her old self. She regularly says, “I am getting better.” So if we get another stellar day like this one, we may well be off and running on Saturday!!
Thurs, Nov 12 (1:15pm) – Homeostasis Achieved
Ok…looks like we have found our stride. The medical team saw mom today and were duly impressed with mom’s energy level and awareness – a much different person from yesterday. So they are ready to discharge her once we all agree and are confident that mom is consistently able to maintain herself at this level. The real kicker seems to have been getting her off all meds, save for the low-flow (1 liter) of oxygen, and that too she may be off of by now. Andrew talked with all top medical personnel today and everyone is on the same page. No one is being rushed or pressured. When we all feel she is showing consistency then we will make the transfer home. In all likelihood that means seeing if she can match today’s standard of health all through tomorrow, in which case it would be a possible transfer home on Saturday. But we will all watch this and decide collectively. Having reached this point is a major point of relief for us.
Just completed my corporate class, so I will head over shortly to see mom and stay through the late evening as normal, and tomorrow we will set up mom’s room for her arrival as all needed home-care equipment is due for delivery by Friday noon.
Thurs, Nov 12 (9:30am) – Calling Mom + Change of Plans
Every so often in a period of pause the unconscious desire arises in the mind to give mom a call – just to check-in and see what is going on. Then a millisecond later reality sets in: That I am in NC and she is unreachable in the hospital, as opposed to normal life of me in MD and mom at home in NC.
Everything is in a state of flux. This morning I put today’s delivery of the hospital bed on hold. Then I called the case manager and said that we are not ready for mom’s discharge tomorrow because it does not seem that those overseeing her care are ready for her to be discharged. At 11am, Andrew will speak with the RN to get this settled and hopefully rewire the lines of communication so that we do not get another false start from the case manager.
To add insult to injury, mom has developed a fairly wide-scale body rash, most likely due to the contrast (special concoction) used for the CT scan she had on Tuesday. So she was quite uncomfortable late yesterday evening; it is being treated with topical cream and benadryl, which kind of knocks her into slow motion and extreme fatigue.
Wed, Nov 11 (5:10pm) – Hurry Up & Wait
Today has been a day of making arrangements. We ordered a hospital bed to be delivered Friday, ahead of a potential discharge on Saturday or early next week. And lots of time was spent ordering the right type of pads for the bed. Then the case manager called and said that the discharge day would be Friday or Saturday, with the doctors tending towards Friday. She advised me to bump up the delivery day of that hospital bed. Done. The hospital bed will be delivered tomorrow at 3p. With a few more particulars arranged I left the house and came to the hospital.
Mom has been lethargic, low-energy, and tired all day. The nurse who is the head of the unit came in (she has been very helpful and good all along) and we had a group talk including Andrew. And the nurse expressed concern about mom going home. Meanwhile, all week long – or more specifically the last 35 hours we have been checking in with anyone and everyone about whether we could manage mom’s care at home – and everyone was giving us the green light. So I kinda jumped on her for a second or two, not because I was insisting that mom must go home ASAP, but because why are we only hearing this now.
From there, the call proceeded more cooly and positively with she and Andrew going back and forth on speaker phone. She came to understand what resources we had ready and waiting for mom’s return, and she definitely understood why we had rejected the rehab option. We also impressed upon her that we are not at all interested in taking mom home prematurely. Rather, as long as the hospital wished to keep her that was fine with us.
The long and short of it is that I came to the hospital this afternoon thinking that mom was all but being discharged on Friday, and now it seems there is still a deliberative process going on, including concerns about potentially decreased lung capacity so they have scheduled a speech specialist to come on in tomorrow morning to perform a swallowing test to ensure there is no fluid accumulation in the depth of the lungs.
So that is where we are hurry up and wait…. (I learned that phrase up in Alaskas when we would all get ready super fast for a flight with the bush pilots or helicopter, only to have to sit and wait for a weather clearing.)
Wed, Nov 11 (8:30am) – Normalcy
Life seems to be getting back to normal as mom wants me to bring her emory boards today.
Tue, Nov 10 (9:30pm) – Homeward Bound (Almost)
Quite quickly it became clear that all of the rehab facilities either do not offer visitation at all or have extremely limited privileges for visitation. And that was all we needed to hear to decide that we would prefer not to go that route.
Dozens of phone calls were made today – Andrew from MD and me here. We spoke with case managers, rehab facilities, charge nurse, home-care providers, physical therapists etc. And we basically decided that the next stage of mom’s recovery will occur at home. Medically, she is free and clear. At present, she is not on any meds, and she is only on 1 liter of oxygen – and they will probably take her off of the O2 shortly. Even then, we can easily set her up with O2 at home if needed.
What it comes down to is that the main thing we would need at home is soft nursing skills, i.e. bedside care. And we basically have a team of people lined up to do that, spearheaded by mom’s longterm handyman whose 1st profession is that of a home-care provider. From the get go, he has been saying that, “I will take care of mama.” He is a very kind and gentle man who has a lot of love for mom, and mom really likes and trusts him. And she has mentioned to me on more than one occasion during this hospitalization that when she goes home then Pastor will take care of her. We seem to have now reached that point.
We have pretty much had all the requisite conversations so now we are in the mode of getting the house ready to receive mom: hospital bed, heavy-duty recliner (possibly), all bedding / bathing supplies, and whatever else is necessary. Side by side, medicare will provide the needed visits by an OT, PT, and RN each week.
So that is where things stand, and naturally we have discussed all this with mom, starting last night and throughout the day today. Actually, last night I talked to mom about the possibility that if she went to rehab then we would not be able to visit her there. The look of concern on her face when I said that was enough of an answer. So when we confirmed the rehab visitation policy this morning with various facilities that only sealed the deal.
Now, Mom is more than on board with the plan, and, after all, she herself is a wealth of information given all the home-care she has given over the years – both as a hospice nurse and as a caregiver for dad. And the more we talk about it the more she sees it as an imminent event – even adding that, “We will have to get a bell.” Her suggestion was rejected out-of-hand in favor of an intercom system. So we are paving the way forward. And about 30 minutes ago when I was going over the various arrangements with mom, then she smiled and said, “We will be a team.”
So a team we shall be, and let’s see how quickly we can bring this to fruition….stay tuned.
Mon, Nov 9 (6pm) – Healthy Yet Grim Assessment
There has been a lot of action today. First and foremost, mom is graduating from the CTSU (Cardiothoracic Stepdown Unit) and getting ready for transfer by week’s end to a rehab facility. We have been given a list of 7 rehab places that are ready and willing to accept mom. So we will do due diligence to ensure the rehab spot we choose is going to be an active and engaging facility, and not just a nursing home in the name of rehab.
Secondly, the heart surgeon spoke with Andrew and the long and short of it is as follows. He says that medically mom is in excellent condition – hence the transfer to rehab. They are very pleased with her recovery from the surgery. That said, he does expect that mom will have to undergo some degree of amputation due to the vascular issues from the meds etc. However, there is no rush to do this. We will wait to gain a maximum degree of recovery in the feet before finally assessing the possibility of surgery / amputation. I suppose only if the pain is too great or it hampers her rehab will we be forced to take action sooner. I know – not the news we all wanted to hear, but let’s see just how this plays out…
…and remember some very common issues from open-heart surgery include kidney failure, stroke, heart-attack, and cognitive impairment. Fortunately, we dodged those bullets.
Mon, Nov 9 (2:30am) – Thumbs Up & Shiny Knees
When you are in a hospital bed for three weeks and do not always feeling like talking, you get pretty good at conveying your thoughts and feelings through facial expressions and hand gestures. Well, mom has this unique and special way of doing thumbs up where only the very small upper section of the thumb emerges from the fist and the hand might be pointed in any number of angles, but definitely not downwards. So when she flashes her signature thumbs up sign, then the nurses (male or female) think it is the sweetest thing they have ever seen – their heart melts. And they either go “Awww”, smile widely, or start giggling. It never fails.
After examining mom’s feet late Sunday evening and watching her do her leg exercises, her hospital gown was up above her knee. And I said to our awesome night nurse (his 4th day out of 5 with us before he is off for 9 days – he will definitely be missed!!!), “Does that look like the knee / shin of a 90 year-old.” It was shiny without a wrinkle or loose piece of skin in sight, and he immediately laughed and replied, “You know, I was just going to comment on that!! I might have to go to a plant-based diet! How long have you been doing that?!?”
Sun, Nov 8 (10:07pm) – Put Your Best Foot Forward
We seem to have gotten in the pattern of looking at mom’s feet every 24 hrs, i.e. in the late evening. The rest of the time mom’s feet are either in those groovy, light blue, treaded hospital socks or her new boots (photo below). What is encouraging though is that we are seeing distinct differences (i.e. positive change) over the course of this period.
The left foot is clearly out of the woods; it looks very good. There is just a touch of discoloration. The right foot is also better, but it still has a ways to go. However, the way the feet are changing there seems to be cause for hope.
One positive point is that mom has good touch and temperature sensation on the bottom of her feet. Another good sign is that the feet appear to be less painful than earlier.
So with each passing 24 hours we are waiting and watching for greater recovery of those feet, especially the right one.
Sun, Nov 8 (6pm) – Normal Is As Normal Does
No major news here to report (been here the last 3+ hrs). Mom continues to say, “I’m getting better.” So she is convinced that her recovery is underway, and I think one of the keys to this is that she says she feels stronger. Her vitals are very stable; she is only on a low-flow of O2. The respiratory therapists come in 4 times a day for treatment, but they feel she is very clear, and that she is ready to come off of this treatment. Just we are waiting on the doctor’s orders for that. Her appetite has been growing and she is drinking plenty. I have not yet laid eyes on her feet today, but she showed fairly decent movement with her feet (point and flex) while sitting in her recliner.
Mom does get a fairly steady number of nurses, therapists, and aides coming through her room, and she did have a PT person come in this morning, but I did not hear much about that other than the physical therapist gave her some exercises to do.
Sun, Nov 8 (2:15am) – Hospital Wisdom
In her 52 years as a practicing nurse, mom has accumulated a wealth of medical knowledge and wisdom about hospital life. For instance, yesterday she told that the laundry room in any hospital is a grand repository of eyeglasses, hearing aids, dentures, mouth guards, and the like. Because those things get dropped and rolled into the sheets etc. Mom concluded, “That’s why I always keep track of where my things are.”
Sun, Nov 8 (1:15am) – Follow Up: Herculean Effort + Foot Report
I showed the video of the below Herculean transfer from the recliner to the bed to my brother, and he could not believe how good and capable mom looked. He had seen her exactly one week ago, and to him she looked like an entirely different person. I also showed him a photo of mom’s foot from this evening, and he was very taken by how much better it had gotten – just in the last 24 – 36 hours! So from his perspective, he felt he was looking at someone who was undergoing a very rapid recovery. So let’s see what tomorrow (i.e. later today) brings.
Other scenes and points of note:
– In the evening on Saturday, the night nurse and an aide were in the room in preparation for doing some kind of action and they asked mom if she was ready and she said, “I’m always ready.” And they that was totally great. They were laughing and saying all kinds of things back to her.
– One other point that has proven to be helpful is that over the course of this hospitalization, I have shown mom’s workout video from when she was 90 (see link at top of this page) to almost everyone of significance who has worked with her. And I explain to them that what they see in this video is exactly what she was like up to three days before her hospitalization, and this seems to give them a vision of what she is capable of doing. Not only are they impressed by her ability for her age, but in some cases it actually changes the way that they work with her and what strategies and initiatives they employ.
Sat, Nov 7 (11:00pm) – Herculean Effort + Foot Report
Mom had been seated in her recliner chair for essentially the entire day. Then after dinner we made the plan to transfer back to the bed. The distance between the recliner and the bed is less than ten inches. Theoretically, all that needed to be done was for her to stand up, shuffle her feet around, and then sit down on the bed, which is a litter higher than that recliner. Our awesome night nurse strategized with mom about how to manage the maneuver. When the time came to go, it was shocking to see how little (almost nothing) mom could do. She ended up being like dead weight in his arms. So she has some serious rehabbing to do.
Once in bed that same awesome night nurse removed mom’s new boots and we looked at her feet. Somehow the feet seem a bit better. Mom can move the toes – more on the left than the right – and she can flex the feet. So that was encouraging. She also had good touch sensation on the bottom side of the toes of the right food. When the nurse gently touched those toes mom could detect it. So that was positive.
Signing off for the evening…
Sat, Nov 7 (8:05pm) – Mom’s Saturday Night Dinner
My oh my, standard hospital fare!!!
Mediterranean Plate: Homemade hummus, toasted pita, quinoa tabbouleh, Greek yogurt tzatziki, classic mini Greek salad, with Greek yogurt and feta vinaigrette.
Sat, Nov 7 (6:55pm) – Mom’s New Boots
These therapeutic boots (described in earlier updates) will help mom be more comfortable and active….just what we need!!
Sat, Nov 7 (5:30pm) – A Fine Saturday!!
When I got here at around 1:30pm or so, mom was out of bed and sitting up in the recliner, fully alert, upbeat, and wearing her new boots. She likes these therapeutic boots as they help keep her feet pointed in the right direction, i.e. upwards. She was also fully in the know about the election news, and was keen to know all the news about everyone else, i.e. you – or as she put it, “Come sit and tell me the gossip of the day.” 🙂
She then proceeded to give me assessment of her morning: 5am X-ray, 6:30am rounds, 7:30am breakfast and bath etc. Then a little physical therapy. She said she had been busy all day! And sure enough, when I checked in with the nurses, that is exactly what happened. I am very impressed mom keeps such a keen mental record of the timing of all these events, especially the early morning wake-up for the x-ray.
She feels upbeat, and she knows she is on the path to getting back home. She is also fully aware medically about her foot situation, and very even-keeled emotionally at this point, neither anxious nor worried. Her appetite has been growing, and I saw her eat a fairly big lunch today. She says that all she does in this place is sleep and eat – and go to the bathroom!!
The respiratory therapist was just in and he was very impressed with how clear mom’s lungs were. From top to bottom, aside from the feet, mom is clearly on the fast-track to recovery. And she says she is feeling better and recovering….
Sat, Nov 7 (4:30pm) – More on Foot Issue
Andrew spoke with the 2nd year resident of vascular surgery yesterday and he used a few key terms that describe mom’s foot condition: (a) Blue Toe Syndrome & (b) microembolic disease. This doctor presented a somewhat grim picture in that he thought there would be an 80% chance of surgery (i.e. amputation). But we are in a waiting game…and the waiting game is this….
So long mom is not in dire, dire foot pain that cannot be controlled by meds, and so long as the toes do not become completely black (i.e. necrotic) then we can wait for them to hopefully slowly heal. Or, if still surgery is needed down the road it might be less than if she were to go to surgery now.
At present, mom is wearing a new set of black shoes that are specially made for this type of condition. And she told me that that was able to stand up in the boots with the help of a walker.
Essentially, we will have to see what kind of comeback we can make with these feet, and again it is the right foot that is in a more severe state than the left.
Fri, Nov 6 (10:20pm) – Mom’s House Transformed
The transformation is complete!! I showed mom the below photo and asked her if she recognized the place. She looked at it for a while, shook her head, and said she did not recognize it. I have successfully commandeered her home.
Fri, Nov 6 (10:10pm) – About Friday Arrival
When you get to the hospital there are greeters outside on the sidewalk who give you a fresh face mask (offered with tongs) and ask you covid questions (e.b. Have you experienced loss of taste or smell? nausea? fever? etc) and then they take your temperature. If you pass then you may go into the entryway where they ask which patient you are seeing.
The outside greeters are different every day. Anyway, when arrived today I was going through the Q & A exchange with the greeter & getting my temp taken, when another greeter came over, waved her hand, and said, “Oh, he is here all the time!” For the record, we are now at 19 straight days of extended hospital visits – best part of my day!!
Fri, Nov 6 (9:45pm) – Photo Documentation
I have been keeping photo documentation of the feet for the last ten days or so. And by a little lookover of the feet this evening, it seems like there is a bit more pink in certain key areas by the base of the bit toe. The nurse indicated that the next 3 – 4 days would be the timeframe to make an initial comparison.
Fri, Nov 6 (9:30pm): Foot Issue – Possible Amputation
Despite my grave concerns yesterday of landing in the CTSU (Cardiothoracic Stepdown Unit), it has become clear over the last 24 hours that we are indeed in the right spot. They are pros at dealing with patients coming out of ICU, and they are serving mom well. It just took us a few hours to catch our stride here. And it looks like we will be here for about a week or so.
Before getting into the nitty-gritty with the feet, here I just thought enlist some of the bullets mom did dodge. First, many who go in for open-heart surgery never make it through. But mom did! Next, some of the other harsh outcomes are kidney failure, stroke, heart attack, and cognitive disability. To varying degrees, these are very possible dangers related with open-heart surgery. Mom successfully escaped them all. In fact, they are quite surprised how her kidneys came through in perfect shape!! Thereafter, mom successfully came off the ventilator, had all four chest tubes removed, and her vitals are stable. All that speaks to a fantastic outcome.
Now let’s get to the main issue – mom’s feet.
The presser meds which are used to support the heart after surgery can lead to vascular issues. And, because mom was on them for a long while in the ICU, unfortunately, that is what we are dealing with. Mom’s left foot took a modest blow, while the right foot took quite a heavy hit. They have been dark purple, sensitive, and painful for days. And right now they are in a tenuous position. Her feet could recover by simply watching and waiting, or they could take a turn for the worse wherein we are looking at partial amputation. The amputation would not be of the entire foot, but toes and perhaps a little more. But this is all hanging in the balance. And barring any truly dramatic downturn, nothing will be done in the very immediate future (i.e. hours & days). It is waiting game…
At this point we have been off the pressers for around 40 hours, and now would be the time for beginning any type of revival.
Mom is very aware of this possible outcome of amputation, and we are taking it moment to moment….and she is holding strong.
Fri, Nov 6 (12:10am)
Who is that unmasked man? About ten days ago a guy walked into our ICU room, and I asked, “Are you a new nurse?” He replied, “I am your surgeon.” As I started to apologize he said, “That’s ok; it is hard to recognize people behind these masks.” Then just earlier this evening I approached the nursing station but could not quite recognize the guy. As I neared him, he quickly put his mask back on – then I realized this was the nurse I had been speaking to all evening. He had noticed me peering at him inquisitively, and we laughed as I told him, “I could not recognize you with your mask off!”
Thurs, Nov 5 (10:45pm)
Phew! After a rough day of transition, we seemed to have caught some daylight in these evening hours. Mom was just up a moment ago and I said to her you are getting better, and she said, “I know I am.” When the patient feels better, we all feel better.
We have an excellent night nurse this evening and he really helped change the course of things. He has been extremely engaging medically and personally, and did a through checkover of mom. Let us not forget that mom was a nurse for 52 years and did staff development so she knows good care when she sees it.
Our night nurse also gave a very positive vision about her feet. He said he has seen way worse, and he emphasized that he has worked with patients with feet similar to mom’s who got a fine recovery. He acted like that was fairly common. Moreover, he is also on with her the next five nights, and he is keen to ensure she gets good rest at night and then have her up early to eat and get ready for the day’s activities.
Thurs, Nov 5 (6:30pm)
We are officially out of the CVTICU (Cardiovascular & Thoracic Intensive Care Unit). Mom was transferred over to the CTSU (Cardiothoracic Stepdown Unit) about four hours ago, and I seemed to have arrived just minutes after her placement here. The Stepdown Unit is aptly named – on multiple levels. To be honest, it feels like we are in a different hospital in a different country, when in fact we are only just across the hall.
At this point, the heart seems good, though mom is very fatigued. I asked her if it was because of the meds, and she says it is because of her heart. Or it could be just being on day 18 / 19 of a tough hospital stay. The main concern at this point is her feet. Had we not had this complication with her feet, mom would be up and moving around by now. But instead, we are bed bound, and that creates all kinds of issues. Various specialists have been involved with and are monitoring her feet, especially the right foot, but the common answer they are all giving is, “There is nothing to be done at this point except to wait.” Alas, we are in a holding patter. Sorry folks, wish I had a glowing report to give, but we are just not there at the moment.
All in all a bit of a tough day of transfer: Instead of being a day of celebration for graduating from the ICU, we are in a state of doubt and concern.
Thurs, Nov 5 (8:45am)
Mom’s Voice: When mom was first extubated two weeks ago her voice was extremely hoarse. And ever since it has fluctuated quite a bit – but is never normal. On days when she is very weak or out of it due to meds, I essentially have to put my ear over her mouth to hear what she is saying. Other days it is a soft whisper, and, in general, it varies between degrees of hoarseness. Last night while we were looking for her hearing aids, I had my back towards her as I was searching in her cabinet, and all of a sudden I heard this voice that was all too familiar. Mom spoke at about 80% – 90% of her normal volume and tenor – not something I had heard for quite a while. I kind of turned back around towards her to see just how she had managed that. She was unmoved by it and the search for the hearing aids continued. We found ’em – all $6,000 worth!!
Will be back over with her in a few hours just after my midday corporate class. Should have an early afternoon updated for you….
Wed, Nov 4 (7:45pm)
I am home now (i.e. at mom’s house) as I returned back to teach my evening yoga classes. And soon will head back over to the hospital. Just I wanted to check-in and say that at 3:30p – a little longer than we wanted – the respiratory specialist came by and removed that elephant-sized high flow oxygen tube from her nostrils and inserted a simple nasal cannula at 2 liters. So that was a very welcome step downward. Spoke to the PA after that and they really feel that mom is doing great and mom was holding strong and feeling pretty fine. So will monitor her for the next 24 – 36 hours and when they are confident that her vitals are truly stable, then we may ship put across the hall to the step-down unit, as much as we will miss our dear ICU team, which includes a veritable legion of nurses, support staff, and a few PAs. They all rotate through to take care of mom.
Wed, Nov 4 (3pm)
Well, today has been better. Mom had a productive morning (before I got here) featuring breakfast, a bit of PT where she stood up while bear-hugging the therapist, and a transfer from her bed to the recliner. She is not fully weight bearing on her feet as they are still quite sore, a touch swollen, and discolored – especially the right foot. She remains off all of the “presser” meds (yay!!), and today her vitals (BP & pulse) are holding nicely. So that is all quite positive.
When I arrived she gave me the thumbs up and was looking good. She was a bit fatigued, but the real kicker that we are working on this very instant is this high oxygen flow (30 liters) that she is on. The tubes are fat and big, and irritating her nostrils something fiercely. We are literally counting the seconds and minutes as they check the tests to see if she can come off this high flow O2 and get back on a nasal cannula. They said 30 minutes, but more time than that has gone by – so we are sitting here and waiting with bated breath for them to come and remove this tube.
Stay tuned….
Locked Out!!: I managed to lock myself out of mom’s house on Tuesday at 11:40am, just about 80 minutes before I had to go live for an interview / podcast on yogic fasting. Was running around the neighborhood trying to find a key that worked – to no avail. Ultimately, we had to call the fire department as they have access to a special box on mom’s house that holds a key. They came relatively swiftly and I got in 20 minutes before I had to be online for the podcast!!
Tue, Nov 3 (11:10pm)
Today was one of those proverbial “one-step backwards” days. Mom had been taken off all of the presser meds and did fine over the night from Monday into Tuesday, but then an incident arose on Monday morning. They think it was more meds related (with an overcorrection of amiodarone) than an actual medical issue wherein her pulse dropped way down to around 30, and her BP dropped as well. So they had to do some intervention wherein mom had to wear a CPAP mask for most of the day (very uncomfortable and no eating) and in general she was very weak. During the course of the day they boosted her back up and by evening the mask was off, and they are watching her carefully. Mom is alert and fully cognizant, but this type of instability with her vitals will invariably extend her stay in the ICU. We are actually fine with being in the ICU as the care is so phenomenal, but we would like to escape those ICU-like symptoms etc.
Mon, Nov 2 (7:10pm)
Wow – what a difference a day makes!! Yesterday mom was weak, exhausted, and in terrible pain. Was not sure what to expect when I arrived here this afternoon – (my morning was spent in part at the BOE getting her vote counted!!!)
But lo’ & behold, there she was – sitting upright, smiling, feeling good, and she had a grand feast of a lunch in front of her….plus she was flashing me the thumbs up!!! So we just jumped right into lunch, and she did well with it.
But the good news did not stop there. During the course of the afternoon they took out her last chest tube, took her off the vaso (so now only on .01 of epi), and did a scan and measured her EF.
- “Ejection fraction (EF) is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction….A normal heart’s ejection fraction may be between 50 and 70 percent.” (Heart.org)
Before her surgery, mom’s EF was 55 which is fantastic for a 91 year-old. Post-op it was 15, which is essentially heart failure. Slowly, the heart gained steam and made it back to 45. And now today mom is rocking a 50-55% EF, which is absolutely great!!
Also today her case manager called to review mom’s upcoming departure from the ICU to a step-down unit. And while that is certainly positive news, this ICU was been top-notch all the way around and we will miss them. Most likely, mom will leave the ICU in the next 24 – 36 hours….stay tuned!!!
Tue, 27 Oct – Sun, 01 Nov
This has been an amazing week of ups and downs. Of course, it would be great to chart mom’s “progress”, but it just is not that straightforward. Each day is its own chapter, seemingly independent from the prior one – one day up and the next down. Despite the best of intentions, I did not make individual entries during this period, and rather than recount all that transpired, let me offer where we are at present.
As I sit here to write this it is 5am on Monday, Nov 2, and I last left mom at 10:30pm last night. We have now completed 2 weeks in the ICU. The nursing staff at UNC (Chapel Hill) hospital has been absolutely phenomenal, and the room is great. And mom is coming along well. The reason why she is still in the ICU is two-fold. First, she is not yet off of all the heart medications. That means her heart is still unable to function properly and maintain the requisite blood pressure on its own. To be released from the ICU she must be off all such meds (epinephrine, vasopressures, dobutamine, dopamine etc). The good news is that mom is only on 2 of those meds at present, and the dosage is quite low. Second, due to these “presser” meds, mom has developed severe issues with her feet wherein they are swollen, severely discolored, and very tender and painful. Ultrasound sound scans and regular doppler checks indicate that her blood flow is excellent, and hopefully as soon as she is off of the meds the foot issues will clear up as the two are interrelated (talk to med professional). Finally, mom is down from 4 chest tubes to 1.
Mom’s mental status is excellent. Despite a 2-week stay in the ICU which is enough to throw anyone for a loop, she is fully cognizant and has all faculties intact. However, being in an ICU bed is not without its mental challenges. Naturally, there are times of discouragement and encouragement. Bearing the 24-hour cycle of pain in her feet has been one of the biggest hurdles. Another is appetite. Mom has always been an avid eater, but never a big eater. When healthy she eats like a bird. These days her appetite is little to none. During a good meal she might have 10 spoonfuls, and other times considerably less. For instance, last night for dinner she ate one single piece of vegetarian sushi. We know that she needs to “eat her way out of this hospital”, but with constant pain, an array of meds, and sheer exhaustion, eating is a difficult task. Despite all this, mom has been the queen of the ICU – loved by the entire staff – and she remains determined to persevere, taking one moment at a time.
– Sweet Scene: Gradually, mom has been gaining greater use of her arms, and a few days ago the nurse came in and was smiling and pointing at mom from a few feet from the bed, saying that she looks so sweet and comfortable. And verily, mom looked like she was hanging out at the beach at Club Med: Both hands were clasped behind her head and she was tilted back in bed at the perfect angle. She was sitting there as if nothing was wrong and she hadn’t a care in the world.
– Fortuitous Covid Timing: We were fortunate on two points of the covid timeline. First, I have had full access to mom spending anywhere between 8 to 18 hours a day with her in her room. Had this occurred earlier in the pandemic we might not have been able to see her at all. Second, because of covid (as opposed to no pandemic at all), my entire schedule went virtual with all classes being conducted remotely which enables me to remain here with mom indefinitely, i.e. until she is well-situated.
– Forecast: It looks like we may be in the ICU for another few days, barring any dramatic upswing. Thereafter, we would enter a “step-down” unit within the hospital where she would begin her PT. After that, there will probably be a number of options for us to consider such as continuing on at a rehab hospital or returning home with support staff etc. That is just too far down the line to make any type of assessment at this point.
Mon, 26 Oct
Hard to believe this actually hospital food! This was the first evening meal where mom ate a measurable amount of solid food. In addition to eating some potatoes and asparagus, she had hummus and a bit of pita bread. After eating, mom said she felt better and more energy. Her talking and overall awareness and engagement were better today. Hopefully we are starting to turn the corner a bit.
Mon, 26 Oct
Today I arrived with something that drew great interest from mom. Her eyes lit up and she reached for it immediately – her hairbrush!
Mon, 26 Oct
When I stepped into the entryway of the hospital, after taking my temp they asked the usual question. I mentioned mom and the year of her birth – 1929. The attendant said, “1989” – and I thought do I look like someone who has a mom born in 1989 (which happens to be the year I graduated college). I again repeated “1929”, and she gave a surprised “oh”, as if she does not hear that year very often.
Wed, 21 Oct (From email of 10/21)
Tues, 20 Oct (From email of 10/20)
~ The Gallery ~
Thank you for this Satyam…this is a journey we all want to travel with you, in support of our Ren Yoga Mom, you, and your whole family♥️♥️♥️🙏
Holding everyone close in our hearts❣️
Thanks so much Annie & Kirk!!!
You have been there every step of the way and it is not only appreciated but essential!!
Oh! My thanks for the update and heartfelt wishes for your mom’s recovery!
☺💗🌄
Hey Catrina –
Wonderful hearing from you – thanks for your kind and loving thoughts!!
Reading between all of these lines I see a wonderful tribute to your Mom’s strength and endurance! Please know that the prayers keep winging across the country for you both. Stay well,
Jane, Colorado Springs
Wow Jane….
What a treat – thanks for following along – amidst all those 14’ers in CO you are our eye (& heart) in the sky!!
Much gratitude for your support!!!
Ruth, Keith and Andrew — Lookin for the
tuesday chair class I found the blog that Keith has been doing. It is so reassuring to know exactly what has happened during Ruth’s trip to be tested for the virus.Wow. Please keep on letting us know how your Mom is progressing.
Ruth, all the children –Laura, Peter, Sarah, Suzie, Jim, Mary and their mother are so relieved and grateful that you are doing so well. We send our love and prayers for you and Keith and Andrew. Our energizer bunny is being recharged and we looked forward to when we can see you and safely socialize again.
Keith and Andrew – Ruth is so lucky and blessed to have you both. It is part of the circle of life for Ruth – having her sons be with her, cheering her on and loving her when she needs it most.
Fondly,
Thank you so much Jane for all your kind words…you are mom’s great supporter and true friend.
Sorry about the chair yoga mix-up – I did get that link to you and hope to have you there next week!!!
Wonderful news Satyam!!! It’s great to hear something positive and uplifting!!! She is an inspiration. I’ll keep praying for both of you.
Thanks so much Merinda!!
What great news! Your Mom is really a remarkable person.
Please give her our best and take care of yourself as you take care of her
Much love ❤️
Thanks Sharon!!
We seem to be getting there – a little bumpy but progress is being made!!!
Sending lots of positive vibes to you and your mom, Satyam. She is such an amazing lady and she is so lucky to have you by her side. Stay strong!
Thanks Susanne!! Your support is greatly appreciated!!
Satyam, I’ve been catching up on your blog and was inspired by your dear mom’s progress. I hope she’s keeping her spirits up and will continue to improve.
Thinking of and praying for you and your family.
Miss you (and classmates),
Nancy
Hi Nancy,
So great hearing from you – and appreciate your reaching out – you too have been missed!!
Hope the 7th floor comes through for her. Fingers Crossed!
Thanks so much Sharon!!! That is definitely our target!!
She looks WONDERFUL!!! Huge progress!
Still refreshing this page every day or two and so impressed by your mom’s determined progress and her bright smile! It’s a lovely chronicle.
Thanks so much for following along Catrina!!
Mom will keep on trying so keep on refreshing that page!!
Dear Satyam,
It sounds like your mom has been through quite an ordeal. I’m happy to hear that she is almost ready to return home. I know how difficult it is for a loved one to be in this situation and how much all they want is the comfort of home. My husband has been in rehab twice in the last 10 years, both for about 45 days. I’m also pleased to see that you are able to maintain a somewhat normal routine in your life as well. I struggled quite a bit with that in my situation.
It is distressing to hear about her feet, and, of course, I pray for a full recovery. She seems so vibrant and I would hate to see anything interfere with her desire to continue working out the way she was before surgery.
I send my best and prayers for blessings for both of you.
With love,
Sandy
Greetings Sandy,
Thank you so much for your kind words of support. At this point we feel that she is in a good place as each and every day she is making big strides towards a solid recovery. It will take some more time, but she’ll get there!!
Satyam
Yeah! So glad your mom is coming home. You’ve done a great job getting the necessary equipment and you and your brother have been wonderful advocates for your mom. Good job and good luck with the continued recovery work. xo, Sara
Thanks so much Sara!!
Every day seems to present a new scenario, but things are on the up and up!!
Yay! So glad mom’s doing so well! How wonderful that her toe is showing signs of life! Thanks for keeping us up on things. It’s like a real life After School Special! Very inspiring! 😊
Thanks for the kind words of support Birgit!!
Indeed, the right foot is coming ’round – we hope!!!
That machine is pretty nifty!! She seems to be doing pretty well with it, Go Mom!
Keep getting stronger everyday!
😀
Your mom looks great, very inspiring. Never a complaint from her lips, what a pleasant personality. Wishing your family all the best in the New Year and Happy Holidays:)
Thank you so much Rebecca!! Appreciate your kind words…
My best to you and the family!!
Your mom looks great and her positive approach to her recovery is such an inspiration. Don’t get discouraged by the PT’s assessment — I think they lean toward the poorer outcome. Sort of like restaurants who tell you there’s a 45 minute wait so you’ll be happy when you get seated in just 30 minutes (remember when we used to eat in restaurants?). Happy New Year to you and all your family.
Thanks Susanne!!
We are not ones to get deterred by PT assessments…and appreciate your support!!!
Like reading about and seeing your mother’s progress. How often are you posting the blog? I can’t always find it. I am not very computer literate.
Thank you for all that you do.
Happy New Year!
Marilyn
Hi Marilyn,
I update the blog almost daily – and it is the same web address. It the same blog post, i.e. the one up above….
Your Mom is amazing, she is such an inspiration. She will probably kick you out soon! ha ha just kidding!!
Thanks for the soup suggestion, I like the idea of using miso as a base for the broth. Also, thanks for the message of the day, it really spoke to me this morning, words to live by.
Yes, I fully expect to be homeless soon!!
Glad the message spoke to you, and also good to hear that you found the miso suggestion helpful…
Interesting how in my movement from MD to NC, I have changed so much of my cooking endeavors….
Thanks for all your support and kind words!!
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