Friday, February 27

My Grandpa at a child`s point of view

For the past few weeks I have been told great news about my Grandpa getting better. Until now..... As I write this, the surgeons are deciding whether to give Grandpa surgery or to let him live through it and pass away. I love my Grandpa so much, to see him like this just breaks my heart.

I keep on saying to myself whatever the lord does it is what's best for Grandpa. If Grandpa does pass away all of us will be with him someday. I want my Granpa on earth a little longer though.

We all have bumps on the road in life and right now we have got a huge bump.

Keep on praying for him.......


Hannah

2/20/09 to 2/27/09 -- One Step Forward, Two Steps Back

As noted in my post of last Friday, February 20, and Anne's post of Sunday, February 22, just a week ago Dad was alert, telling stories, entertaining the nurses and therapists with his jokes, and reveling in U.Va.'s recent defeat of Va. Tech on the basketball court. His rehabilitation appeared to be moving forward well, and the HealthSouth staff had even talked about a potential return home as early as the middle of March.

Today, only a week later, Dad is, as one of his doctors told Anne this morning, a very sick man. The infection that hit him last weekend is very serious, and is causing issues with a number of systems in his body. He is back at U.Va. Medical Center, having been admitted through the emergency department on Wednesday, and is being treated for the infection.

We have been told we will likely have a good idea of how things are going to go in the next 24 t0 48 hours. If you believe that there is power in prayer, now would be a good time to bring it to bear.

Wednesday, February 25

Wednesday February 25, 2009

Finally a Few Answers - As I write this Dad is on his way back to UVA Medical Center. They got the results of testing back this afternoon and found that he has C Diff, short for Clostridium difficile. It's a nasty bacteria most frequently brought on by killing the natural bacteria in a person's stomach with antibiotics. It is often found in hospitals and nursing homes. The good news is they began treating him for it last night even before they got the results of the test. Due to the concern of monitoring him more closely and the fact that he isn't able to participate in rehab, feeling so bad, they decided to transfer him back to the regular hospital.

They have pretty much ruling out an infection in his heart since they found out he had C Diff. He also won't have to be transported back and forth for testing, etc.  He has to be admitted through the emergency room. What a bummer. (I don't like roller coasters at amusement parks and I definitely don't like feeling as if I'm on one with my Dad). There's nothing we can do though so I guess we'll all just hold on.

Matt, bless him, is on his way from Richmond to the hospital now.

We'll keep everyone updated. Thanks for your support!!!!!

Tuesday, February 24

Tuesday February 24, 2009

Dad continues to feel pretty rough. I spoke with the Doctor today and they definitely think he has an infection. Until they can get the infection cleared up they won't know where he stands on his progress with rehabilitation. I feel comfortable his Doctor is covering all the bases for every possible thing that might be causing problems. Unfortunately, it means more trips (by ambulance) for tests, scans, etc. Hopefully there won't be another transportation fiasco.

Dad continues to want a drink of water more than just about anything. He told Mom this evening, "If Anne was here she'd get me ice chips." He's probably right. When he was in the acute hospital I would sneak him an ice chip or two on the pink swabs for his mouth. It's cool he remembered.

Monday, February 23

Monday February 23, 2009

Today marks one full week of Dad being in rehab. I'm not counting the first weekend since they didn't begin working with him full time until last Monday. Last Monday we met wtih the social worker at the rehab, discussed our hopes for Dad and the treatment team's goals. We have had a few glitches along the way and today was another one. When we talked with the social worker today we found out some good news (Dad's CT scan from Friday was negatiave) and some not so positive news - they are looking at several medical issues they need to resolve before Dad will be able to make full use of his rehab time. They have been testing, checking lab work, blood sugar and the like to make the very best plan for Dad's care. They are making changes in his tube feeding, increasing some medications and decreasing others. It is hard being so far away. Without seeing Dad it is hard to truly assess how he is doing. When Dad gets better we're going to have to have a talk about what an inconvenient time he chose to have a stroke. If he had had it in the summer I would have been off and could have been there all the time. (How's that for being a selfish daughter). I hope to be able to talk with Dad's doctor, Dr. Diamond, tomorrow and get some of my medical questions answered. We'll keep you posted. Keep Dad in your prayers.

Sunday, February 22

Sunday February 22, 2009

I got to see Dad yesterday for the first time since Monday. He appears to be making great strides in his recovery. I cannot get over how much stronger he looks. His face is less drawn and he is showing significant improvement in the use of his left side. He is receiving, as part of his speech therapy, electronic stimulation to his throat. They hope this will help him regain function in the muscles that affect his swallowing. Dad is able to transfer with very little assistance from his bed to his wheelchair and back. He continues to be very tired. With all the activity he has during the day I'd be tired too and I haven't had a stroke.

Dad is feeling well enough to complain. He has several goals for himself ---to get out of rehab, to get out of rehab and to get out of rehab. Seriously though, Dad wants very much to get home to our Mom so they can begin to rebuild their lives. He wants to have a drink of water so badly and he wants to get his purple wrist band. (The purple wrist band means it is safe to go about the rehab center by yourself without the risk of falling). I think Dad's goals are the ones we all have for him.

This morning on the way to church I was anxious, tearful, and sad. I felt so overwhelmed. I kept thinking, what if Dad doesn't get to the point he can swallow, what if his short term memory does not improve, what if he goes home, stumbles and falls? After snapping at Joe and sitting in the parking lot of the church for a few moments crying, I walked into church. A feeling of peace began to come over me. It was the same peace my father told me about when we would talk going back and forth to college/work thirty years ago, the same peace that has kept my father the rock of the family throughout the years. Dad would always say, "Anne have you prayed?" At the time, I didn't understand, now I do. We are only alone and lost when we try to carry on by ourselves and forget God's love for us. I was reminded that you only have to look at my father and know that God's outpouring of love is shown through him.

Saturday, February 21

2/20/09 -- Friday Night Stories

Today was another somewhat mixed bag.  The low point was the second transportation snafu in as many days, which resulted in Dad having to wait two hours for a ride back to the rehab hospital following a test, and consequently missing a portion of his scheduled rehab.  (Anne, Matt and I have all had increasingly pointed conversations with the hospital, and hopefully this will not happen again.) 

On the positive side, when Matt, Austin, Mom and I visited Dad last evening,  he was awake, alert, and in a talkative mood.  His voice in increasingly strong and clear.  After jokingly noting that the therapists "seem to take a perverse pleasure in tiring me out" he again began to tell stories, this time for well over an hour.  The subjects ranged from his days at prep school with his brother Sam, to his time in Korea, to techniques for catching live bass bait, to his favorite late night snacks when he attended U. Va.

As to how Dad's physical rehab is progressing, I haven't had the opportunity to speak with any of his therapists for the last few days, so I don't have much to report.  We should get an update on Monday when his treatment teams holds its weekly meeting.
 

Thursday, February 19

Thursday 2/19/2009

Today has not been the best of days. When Dad had his stroke he fell and "tore up" his arm. He had an appointment with a plastic surgeon this morning to see whether his arm was healing and whether he would need skin grafts. The hospital had him transported to the appointment and Matt rode in the ambulance with him. After waiting over an hour for his appointment he then had to wait three more hours for transportation to come back and get him. I can't believe Dad had his stroke less than two weeks ago and had to sit in a doctor's office most of the day. Not only did he have to sit in the office all day but he missed a day of rehab. According to his nurse, he was very tired when he got back to his room.

On the positive side, the doctor said his arm was healing well and nothing further was needed. U.Va. won last night which made Dad very happy and it's almost the weekend so we can all go and see him. Finally, it is wonderful not to be in this alone. I am so thankful for my brothers, sister, and sister-in-laws. All of our unique talents have blended together to form a united front in working to help my parents and help each other cope. We are all so different but all so much the same. I love each of them dearly.

Wednesday, February 18

2/18/09 -- Small Moments

It goes without saying that there is nothing good about a close family member suffering a stroke.  The life of both the patient and his (or her) family is changed, suddenly and irrevocably. Literally overnight, you are thrust into a new and foreign world of medical jargon, test after test, doctors and nurses, therapists and pathologists, medication upon medication and, most of all, worry.   

Yet along the way there are small, unexpected moments that make all the rest of it just a little easier to handle.  One of those moments happened for me last Saturday.  It was Dad's first full day in the rehab hospital, and I was alone with him.  (The other members of my family -- who had been with Dad almost continuously since his stroke -- had either gone home for some well deserved rest or were starting the work of preparing my parent's home for Dad's eventual return.)   It was a holiday weekend and the hospital was fairly quiet.  For most of the day, I simply sat next to Dad's bed, watching him sleep and reading the stacks of stroke-related material we had accumulated.   Occasionally, Dad would wake up and we would talk for a while. One of those times, Dad started telling stories, mainly about his time in Korea.  This was really surprising, because over the years I had seldom heard him talk of those days.  For almost half an hour, he talked and I listened.  

 A small moment, but one I will always remember.

Wednesday Update

The nurse reports Dad is doing well except he is still having trouble controlling his blood sugar. It was higher this morning than yesterday! Dad's chest x-ray was negative for pneumonia and his white count is down to the high normal range today. When I called at noon his nurse, Amy, told me they were getting ready to let him lie down for a while. They normally don't allow him to lie down until all of his therapy is done for the day but Dad was adamant that he needed his rest because he was going to watch the game tonight with his sons.

Mom is taking a well deserved day of rest. She has been a real trooper through everything--holding up for Dad and for us. They have set a tentative discharge date of March 10, 2009 and their goal is for him to need only verbal reminders and assistance in all areas of daily living. We all hope and pray he is able to reach this goal.

Tuesday, February 17

Today's Update II

I've not yet learned how to manipulate the intricacies of this blog very well so Part I of Today's Update was posted without finishing it and without checking for misspellings or grammatical errors. Sorry!!!! To get back to Dad. Hopefully they will be able to start the electrical stimulation tomorrow. Since Dad is not able to swallow they placed a small tube in his stomach for feeding. He is fed a liquid "food" four times a day. They are having a great deal of trouble stabilizing his blood sugar levels.  They made some changes to his "food" and his insulin and today his numbers were a little better. Hopefully they are on the right track. Dad hit his arm and "roughed it up" pretty badly when he fell following the stroke. Tomorrow he sees a plastic surgeon to provide assistance with how best to help this area heal. The doctors completed a chest xray today as Dad's white blood count is higher than it should be. They are fairly sure he doesn't have pneumonia but we won't know the full results until tomorrow. As yesterday, Mom left Dad exhausted from his hard day at Rehab. He was sleeping so soundly he was difficult to wake. We are seeing tremendous progress every day. Hopefully this progress will continue and we will have Dad home soon. Mark and Matt are going to visit tomorrow evening to watch Virginia play Tech. Go Hoos!!!!!! and GO DAD!!!!!!

Today's Update

Today is Dad's second "full day" in Rehab. Yesterday Dad had physical therapy. They found he did better walking with a walker than getting around in a wheelchair. Today was even better. Dad walked, without a walker, from physical therapy, up and down the hall, exercised on an exercise bicycle and then walked back to his room. The occupational therapist works with him every morning on basic tasks such as bathing and dressing. Due to the left sided neglect and weakness it appears these are going to be much harder to master. Dad completed a swallow test yesterday with the speech therapist and it was found he was still not swallowing at all. They were going to start electrical stimulation on his throat today to assist in redeveloping his ability to swallow. They had to wait until tomorrow though because he had to have his face newly shaved in order to place the electrodes.

A Little Background

The stroke team and the staff at the University of Virginia Hospital were wonderful to Dad and our whole family. The doctors worked hard to answer the question, "what caused the stroke?" After numerous doctor visits, several MRI's, CT scans, and more tests than we could count, it was determined that Dad had a right middle cerebral artery stroke, likely cardioembolic in etiology secondary to new onset atrial fibrillation. In people terms, he had a stroke in the right hemisphere of his brain most likely caused by a blood clot from blood pooling in his heart due to atrial fibrillation. The good news is atrial fibrillation can be treated so hopefully this won't be a problem in the future. The bad news is Dad didn't have any symptoms that could pinpoint a problem prior to the stroke.

The effects have been typical for a right hemisphere stroke. The most significant effect has been Dad's inability to swallow. If he attempts to drink or eat anything, without the ability to swallow, the food/drink will go directly into his lungs which in turn can lead to pneumonia. Dad has asked for so little throughout this whole ordeal it has been difficult to deny his simple request for a sip of water. Other effects have been left sided weakness and neglect which causes him to "forget" or "ignore" objects or people on his left side. He has more weakness in his arm and face than in his leg. Dad has shown some difficulty with short-term memory, he can be difficult to understand due to slurring his works, and he struggles with many of his activities of daily living.

Despite these struggles we have been blessed with the fact that "Dad has remained Dad." He recognizes and knows all of his family including Ingmar, Melinda's cat. The wonderful memories and stories of his life are intact and we have all had the luxury of sitting at his bedside hearing stories long forgotten of his childhood and adult life. Dad has found a new audience for some of his "worst" jokes and has brought a smile to just about every nurse, doctor, therapist, and staff member who have had the pleasure of meeting him.

Monday, February 16

02/16/09 -- My Father's Stroke

On Sunday morning, February 8, 2009, my father, Chuck Hileman, suffered a severe stroke.  He was take by ambulance to Bath County Community Hospital in Hot Springs, Va., and was transferred almost immediately to the stroke unit at the University of Virginia Medical Center in Charlottesville, Va.   Several days later, he was moved to UVa/HealthSouth Rehabilitation Hospital in Charlottesville, where he is presently undergoing a program of intensive and comprehensive rehab which is expected to last several weeks.

In this blog, my sisters, my brother, and I will be following our father's recovery and rehabilitation.  We will also be sharing some of our thoughts about this exceptional man who fought in two wars, earned three degrees from his beloved University of Virginia, forged a decades long career during which he helped thousands of young Virginians obtain an education, and recently celebrated his 53rd wedding anniversary.