What is... just a quick update on Chuck.

I just wanted to update everyone and let them know what is going on with Dad. He is continuing to rehab at the outpatient clinic of Sheltering Arms in the Bonaire section of Richmond and so far seems to be doing pretty well. He is completely done with that awful feeding tube and is totally on solid foods. His appetite could be better but he hasn't lost his taste for peanut butter, ice cream, or that pleasant looking concoction he refers to as Irish oatmeal. Karen has made it for him a couple of time and although she says she followed the directions, I think she made enough to feed most of Ireland.

His day right now consists of getting up around 0530, getting dressed, eating, morning meds, and preparing for his van which comes to pick him up around 0700. We've started to get into a pretty good routine, and barring any unusual happenings, he is ready to roll in an hour. He really liked his driver the first morning (Mr. Washington) who's nephew just happened to be Fontell Mines who was a UVA grad and now plays for the Redskins. He didn't like his afternoon driver too well though so I've tried to get him off the list. In the evenings after dinner, we watch Wheel of Fortune and Jeopardy (*In case you didn't make the connection to the title of the post). Amazingly dad is still able to beat me (well that's not so amazing) but he's also beating many of the contestants to the correct answers, which to me is pretty awesome. After that a little ice cream or something and off to bed. He is sleeping pretty well, most mornings he is awake when I go into his room, but today he was still snoozing. He seems to be getting a little more comfortable with things. The biggest problem so far is that he wont let anyone else do much for him but me so that's causing a few glitches, but were working through them.
I know Mark posted my address the other day but my home phone is (804) 746-1178. If anyone would like to call him please feel free. The best times are probably between 6:00 and 8:00 p.m. or on the weekends. If anyone is in the area and wants to visit on a weekend I know Dad would love it. Just let me know your coming so we can straighten up (as required by my wife) and also if your from out of the area there's a Holiday Inn close by that works with me when there are rooms available.
Thank everyone who has written, called, or come to see Dad. The letters and visits have meant a lot to him. When he is in a positive mood it definitely helps motivate him with his therapy. I know he intends to thank everyone personally at a later date, but until then I would like to thank you all. I'll continue posting his progress every few days or if there is something new and exciting to tell. Dad has gone through a lot in the last two months and come a long way back in his recovery, but there are still hurdles to cross so please keep him in your thoughts and prayers as I know that means as much to him as anything.

New Milestone

Dad had his peg (feeding) tube taken out today. Everything went well. According to Dad, he had very little pain and the procedure went smoothly. Dad took the day off from rehab today to go to the appointment but will be back at rehab tomorrow. I guess this means eating REAL food is here to stay. Way to go Dad!!!!!! :)

Dad's First Day of Outpatient

Yesterday was Dad's first day of intensive outpatient treatment. I came to Richmond to take Dad and spend the day with him since Matt had spent the day before completing all of the necessary "stuff" associated with discharge from inpatient rehabilitation.

Dad's new "school" is an outpatient extension of Sheltering Arms, in another part of Richmond, Bon Air, a little over 20 miles from Matt's house. A family member is required to go with every new patient on their first day and spend the day with them. I arrived at Matt's house a little before 7 a.m. and Matt had things well in hand. He was helping Dad get dressed upstairs, Dad's lunch was packed and in the refrigerator, and his medicine was out and ready. Dad came downstairs with little trouble, made it to the breakfast table and began telling Matt what medication Matt needed to get for him. While he ate breakfast I gathered up the belongings Dad would need for the day. When it was almost time to leave we realized the pharmacy had not filled the one prescription Dad had to have at lunchtime. Matt quickly called the pharmacy and got the situation straightened out but had to run out to pick up the prescription. This left me getting Dad into the car. I spent most of Monday afternoon in the family training, where the inpatient staff taught Matt and I how to help Dad up and down stairs, in and out of the car, help him with dressing, transferring, and getting in and out of the tub. It was all fine and dandy when you had therapists, aides, and nurses standing by but now I had to do it myself. I don't know who was more nervous, Dad or me. We did great getting to the back door, o.k. down the steps to the wheelchair, and I rolled him out to the car. Then it got more difficult. They had taught Dad to get into the car from his walker but Dad was in his wheelchair. I tried to talk him into going from the wheelchair to the walker and then to the car but he would have none of it. He was determined to go straight from the wheelchair to the car--something he had never done before. I looked out for Matt--no Matt yet-- stalled a few minutes--still no Matt. Dad was starting to get a little impatient so I took a deep breath, said a quick prayer and told Dad, "O.k." It wasn't the most graceful transfer but we accomplished it. Matt arrived with the medicine and we were off--as Dad would say-- like a herd of turtles.

The day went well. Dad met with each therapist to have a new assessment completed on his current level of functioning. It made me realize how far he has come when I saw three patients still on tube feedings. Dad's walking was wonderful and he even did a few new things such as walking up a ramp, going down a curb with only his walker and walking down steps backwards. He continues to be impulsive in the way he does things often starting out before given directions. Probably the biggest challenge still to come has to do with Dad's apraxia (Apraxia is where a person loses the ability to execute or carry out skilled movements and gestures, despite having the desire and the physical ability to perform them). Dad would try as hard as possible to complete fine movements, such as picking up small objects, with his left hand but you could see him struggle as his face would wrinkle with concentration. The good news is that Dad is able to pick these things up it just takes about three to four times as long as with his right hand. More good news Dad's hand grip is equally as strong in both his right and left hand. The strength of his finger grip is much less in his left hand which would go along with his symptoms. Another part of apraxia is difficulty or inability to coordinate activities with multiple, sequential movements, such as dressing, and bathing. Again the good news is that Dad can do this but it is a slow struggle. Finally, they did a very interesting test much like you would see on psychological testing. They would show Dad a symbol at the top of a page and he had to match that symbol with one of four at the bottom of the page. Dad did this well. He started to have difficulty though when they took out parts of the symbol. For example an arc in a circle was missing. Dad had to point to how the symbol would look if all the lines were filled in. Dad missed about 50% of these. What I didn't realize is that our brains "fill in the pieces" when we see only "part" of an object. For example, we can visualize our coat in the closet by just seeing the sleeve sticking out. Even more importantly, we see a child's head over the hood of a car and realize a "whole child" is behind the parked car possible getting ready to run out into the street. The implications of this in our daily lives was staggering to me. Well, enough of the details.

Just as in Mechanicsville, the staff at Bon Air were wonderful. They were very patient with Dad who had a new audience to tell all of his stories to. The nurse, who is a die hard Hokie, didn't even hold it against Dad for being a Wahoo. After getting a full history she explained to Dad that one of the main goals of intensive day treatment is to rebuild his energy and to work as hard as possible, even during down time, to regain his lost skills. To that extent they are only allowed two 15 to 20 minute breaks a day and their lunchtime. During the other times when they are not in therapy they will practice the skills they've learned. This is done through games and activities in the day room. They even have a Wii to play. I think we will probably have to teach Dad a little about it first so he doesn't throw the controller through the T.V.

Dad and I left about 3 p.m. tired but a lot less nervous. It was nice driving back to Matt's house, talking about the day, the weather, and those small things that make up our lives. These are the moments that remind me of the miracle we have seen over the past several months. My father is truly a miracle, surviving against all odds and now not only surviving but making progress beyond what any of the professionals ever believed. As for me, he's my Daddy and I still believe, just like I did as a child, Daddy can do anything.

4/16/09 -- Out of the Hospital!

Dad's recovery from his stroke and subsequent surgery reached a major milestone yesterday when he was discharged from Sheltering Arms.  He will now be attending a 30-day outpatient program at an affiliate of Sheltering Arms, where he will continue to receive intensive therapy. This will, hopefully, permit his rehab to progress as far and as fast as possible. While attending the day program, he is staying with Matt, Karen and Austin at their home in suburban Richmond. The address there is:

6914 Pimlico Lane

Mechanicsville, VA 23111

Although Dad no longer requires in-patient care, he still has some medical issues to contend with.  So he will be seeing various doctors over the next few weeks, in addition to having several hours of strenuous rehab each day.  My guess is that he is going to be very tired at the end of most days, but also very happy to have taken one more step on the road to recovery.

Finally,  I know I speak for the whole family as well as all of Dad's friends when I say how fortunate we are that Matt and Karen are on the scene, and how much we appreciate their willingness to take on the substantial responsibilities of  helping care for Dad while he is attending the day program.  

4/12/09 (Easter Sunday) -- Faith of our Father

As long as I have known him, my father has been a man of faith.  Like many men of his generation, he came to the Church during war.  I have never heard him waiver in his devotion or question his faith.  I have, frankly, always admired this in him, particularly given the struggles I've had throughout my own life figuring out exactly what I do and do not believe.

One thing I do know is that Dad's faith has been a comfort to him throughout this ordeal, particularly in those moments early on when things seemed pretty bleak.  Today is Easter Sunday, a day of hope, and on this day it seems especially appropriate to note and appreciate this special aspect of our father's character.

Happy Easter, Dad.

And Happy Easter to all of you.

My Time with Dad

I've just spent the last three days with my father. I had this week off for spring break and decided to go to Richmond, and just spend time with Dad. I'm very tired but had a wonderful couple of days.

Mom and I arrived on Tuesday around lunch time, and Dad was in the dining room. When he saw me come through the door, the biggest grin broke out on his face! I get misty-eyed just thinking about it. I didn't think his smile could get any bigger until I told him Mom was waiting in his room. (I don't know if he was quite as happy with me after I participated in his therapies for the next couple of days; he called me his "drill sergeant" and "slave driver," but he said it with a smile).

Dad is now eating pretty much anything he wants. For lunch the first day I was there, Dad had chicken and lasagna as well as vegetables and fruit. He even had a pork chop for dinner one evening. According to Dad, his speech therapist will sneak up on him when he least expects it to make sure he is cutting his food in small-enough pieces, is chewing thoroughly, and swallows twice. He says the food is great, and I'm sure just to be eating has got to be wonderful. Dad is now totally off insulin. His blood sugar levels have been good.

According to the speech therapist, Dad's short-term memory -- which was initially affected by the stroke -- is back to about 90%. I can't tell any difference in his cognitive processing skills from before the stroke. For instance, one day he was talking with one of the therapists about how the stock market is set up so that it will self-correct, but not if there are crooks taking everyone's money! (For those of you that don't know, Dad was an economics major.) His attention and concentration are still not where we would like them to be, but they are so much better it is incredible. Actually, Dad is "hyper-concentrating" at times, which can be a problem. When he is told to do something, he sometimes concentrates so hard he doesn't hear any further directions until the first task is done. For example, when they tell him to walk up a set of stairs he focuses so hard on what he is doing he misses further instructions on how to do it more safely and effectively.

Sometimes it is good to see for yourself how someone is doing. When I've talked to Matt or Mark in the past couple of weeks they would tell me that he walked 120 steps, or 150 steps. I had thought this was as far as he was capable of walking. What I found out this week was Dad could walk a whole lot more, but there is only so much time to get everything accomplished. So, they normally have Dad walk once around the small physical therapy gym. This gives him exercise and warms him up for his other tasks.

The therapists are concerned that Dad shuffles when he walks but, as Mom says, he practically wore the carpet out shuffling before the stroke so I don't know how much that will change. Dad does great getting from a seated position to standing with his walker. There are more steps in the process of going from his walker to a seated position, however; and while he can do this, he doesn't always do it as well as we would want. Dad has the most difficulty going from his bed to a wheelchair, as this requires a great deal of upper-body strength and a number of fairly complex moves with each hand.

In occupational therapy, Dad is working very hard on dressing himself. Watching Dad do this makes me realize how much we take for granted. Just to put on a shirt has so many steps, and takes more time and effort than you would think.

I cannot say enough about how wonderful the staff is at Sheltering Arms. They put up with my many, many, many questions and my watching over their shoulders to see everything they did. Every therapist, aide, and nurse appeared to be as happy as Dad was when he made progress. They all seem to care about him as a person, not just doing their job.

Finally, the staff is beginning to talk about discharging him, with a tentative date set for next Wednesday. Because of the amount of progress Dad has made, they are recommending he attend their day treatment outpatient program, where he will continue to receive intense therapy and, hopefully, continue to make progress. This program is at another Sheltering Arms facility about twenty miles away. Because it is a short-term program, Dad and Mom will be staying with Matt for the next few weeks, with the rest of us coming in to help out on the weekends.

Dad's room looks like a Hallmark store. Thank you all for the continued cards, letters and prayers. Dad talked several times about wanting to write everyone and thank them for everything they have done. He knows he is not yet capable of doing this much writing so we made a deal that I will help the next time I come to see him. We may only get to one or two a visit but please know Dad is thinking of all of you and you are in his prayers.

4/04/09 -- Roast Beef and the Final Four

Today I saw Dad for the first time in ten days.  There is a lot to report, so this post will probably be longer and maybe a bit more clinical that usual.

The good news is that most of the news is good.  The progress that has occurred in most aspects of Dad's rehab during the last week and a half is remarkable.  This is nowhere more evident than in his voice.  In my post dated March 25th, I wrote that "the cadence of his speech and the timbre of his voice still betray the effects of the stroke . . ."  That is no longer the case.  About 95% of the time, there is no real suggestion of the stroke in his voice.  It is clear and strong, and sounds strikingly normal.

Dad's mind, likewise, is sharp.  His memory seems almost entirely intact, and he is very aware of current events.  His attention span and focus, while not perfect, have definitely improved. During my visit, Dad and I watched the first game of the NCAA Final Four, in which Michigan State defeated UConn.  We kept up a running conversation on all sorts of subjects (for example, I learned the origin of the nickname "Chuck") while at the same time Dad remained aware of what was going on with the game.   All in all, pretty impressive.

Perhaps the most profound change is that Dad is now receiving almost all of his nourishment and medication orally.  Tonight for dinner he had roast beef, vegetables, a roll and pie.  For someone who only a week ago could barely manage to swallow a little bit of liquid, this is amazing.  (Dad says, by the way, that the food at Sheltering Arms is "pretty good.")

Dad's attitude is also pretty good.  He seemed upbeat and energetic, which frankly I find amazing given what he has endured this past two months.  (Is it really possible that it's only been two months?)  His sense of humor is intact and, happily, the easy smile we all remember has returned.

On the physical side, things are more of a mixed bag.  On the plus side, the dexterity in Dad's left arm and hand, which were very affected by the stroke, is much improved.  This was particularly apparent when he took his medication.  He used his left hand to pick up each pill and put it in his mouth, while at the same time holding a cup of water in his right hand.  This is solid progress.

On the other hand, significant challenges remain.  Dad's strength is starting to return, but progress in that regard has been excruciatingly slow.  While he is working hard in rehab, he remains weak and is dependent on the staff for most everyday tasks.  His left arm and hand, while much improved, are still a long way from what they were before the stroke.  We all remain optimistic that there will be continued physical improvement, but it is impossible to know how fast and how far.  Where Dad goes from here very much depends on the answers to those questions.

    

3/31/09 -- Sausage and Eggs for Breakfast

Dad had sausage and eggs for breakfast today.   It is hard to overstate the significance of this seemingly little thing; it is a true milestone in his recovery.   He is now receiving about half of his nourishment the good old fashioned way -- he's eating it.  This is exceptionally good news, and we are all thrilled.

While I have not gotten a detailed report on the results of the meeting of Dad's therapy team, I understand that in general his rehab is progressing well on pretty much all fronts.  While Dad still has a good way to go, we will hopefully continue to see this kind of progress.   So, everyone, as Matt and Anne encouraged in their posts last night, knock wood, keep your fingers crossed, rub the rabbits foot and if you happen to find the random four-leaf clover, well, you may want to enclose it in your next "get well" card. 

The Post You've All Been Waiting For. Matt's First!!!

Just kidding about the title, but this is my first posting for a very good reason. I didn't want to jinx dad. I know that sounds superstitious... and it is. And yes I'm knocking on wood now as I type this. However, I witnessed two events today that made me feel it was worth breaking a couple mirrors to share with everyone who has been following this blog.

As everyone is aware, mom has been a bit under the weather for the past several days and has not seen dad since last Wednesday. While that may not seem like much to you and me, to mom and dad it must be like an eternity. I can't recall in my lifetime the two of them ever being separated for more than a few hours; maybe a day if dad were gone on one of his school conference trips to Wintergreen Resort. Since retirement, the most time they've been apart would be when mom would skip church or dad would go to Hot Springs to work out. I've always been envious that two people could spend that much time together and yet still seem to miss one another when they were apart for just a short while. Anyway, back to today's events. I left work today about 5:00 and went to see dad before going to pick mom up. When I walked into dad's room I was met with a big grin; a "hello son"; and a "guess what I get to do tomorrow? I get to eat my first real !" That's the most excited I've seen my father since all of this began. He then proceeded to tell me that his speech therapist says he is doing great and she is fixing him some type of hamburger dish tomorrow. He then started telling about three stories that she read to him and he had to answer questions pertaining to each story. He said he got every question correct. Dad said the speech therapist thinks his mental awareness has definitely improved over the past few days... namely since his blood transfusion. Lets all keep praying for his improvement.

I told dad I had to leave but if mom was up to it I would bring her back to see him. I didn't think I could see dad anymore excited then I did when he told me about getting to eat tomorrow. Well I was wrong. When dad saw mom walk through that door after not seeing her for the better part of a week, he looked like I always imagined the coyote would have if he had ever caught the road runner... grinning from ear to ear and trying to hold back tears all at the same time. I just told mom I'd be back in a while and shut the door, leaving the two of them to their reunion. As my kids would say, "that was one of the coolest things I've ever seen."

I'll let everyone know how the meal goes tomorrow. We should also be receiving dad's team report around the same time. Lets all keep our fingers crossed till then. Good Luck Dad!!!

He's on a roll----at last (hopefully) knock on wood and if God willing

Do you ever have the feeling if you say something positive you will jinx it? Well, this is where I am right now. My father is a wonderful Christian man, but this does not stop him from being one of the most superstitious people I know. If you have ever seen my father spill salt and have to throw it over his shoulder or walk across the street to avoid a black cat you would understand. This is how I feel now. I feel as if I should be knocking on wood and rubbing a rabbit's foot along with my prayers. My father has actually had several good days in a row--especially today. He was read three stories and remembered all of the details (way to go with the attention span), physical therapy is going well and he gets to eat a small meal tomorrow. Dad is proud of himself as we all are. I am just a little afraid to say anything, I might jinx it and he will start going down the roller coaster again. I know in my heart God understands and probably gets a laugh at me going through my den knocking on all my wood paneled walls.

3/28/09 to 3/29/09 -- A quiet weekend

I'm spending the weekend at home in Massachusetts celebrating my wife's birthday, so this post is courtesy primarily of daily e-mail updates from my brother Matt.  Matt has been truly doing yeoman work these last couple weeks; despite being very busy at work and at home, he has been shuttling back and forth to Sheltering Arms to visit Dad multiple times a day.  He and his family are also hosting Mom when she is in Richmond.  We are extremely fortunate to have him on the scene.

It has been a fairly quiet weekend for Dad, which I think we all agree is a good thing.  Matt reports that Dad seems to have more energy since the transfusion.  Because it's a weekend, Dad's rehab schedule has been light and there haven't been any new reports on how his rehab is progressing.  We should hear more on Tuesday.

Food From God's Wonderful Earth

Dad got to eat "real food" yesterday. He got to eat cantaloupe and pineapple and from what I've heard was in heaven!!!!!! He has been able to attend therapies every day since he has his blood transfusion. He still doesn't have a great deal of energy but compared to the fact he wasn't able to do therapy at all before the transfusions this is a hugh improvement.

Mom continues to recover from the flu. From what Matt tells us half of Richmond seems to have come down with this stuff. We are very lucky that Dad has not gotten it.

Terry did not have a chance last weekend to see Dad so she is making the trip to Richmond today. It is still rainy and yucky so I hope she is VERYYYYY careful going over Afton Mountain. Hannah is extremely upset at her mother (me) for not taking her to Richmond this weekend. Since Mom isn't feeling up to company I didn't want to have too many people descending on Dad and, while I know it sounds selfish, I've used all my sick leave and I don't want to take the chance of getting anyone in the family sick and having to be off work. I have one more week of work and then I'm off until after Easter so I keep telling myself that it's o.k. to take one weekend to get some very sorely needed chores done.

I want to thank everyone who has called and checked on Dad and who are following the blog. I have a list of people who I feel I need to call personally and I apologize to everyone who I've not called this week. It has been a busy week at work and I find I am not working at my usual speed and efficiency because part of my brain is always on the folks. Some days I come home so tired and when the choice is a nap or the phone I have been choosing the nap. Sorry everyone.... I'll try to do better this week.

The blog this morning is rambling.... again sorry everyone. As you can probably tell, my part of the blog reflects my mood and current emotions, which are normally pretty close to the surface. This morning my mood is just like the blog, rambling...... I hope everyone has a wonderful weekend and I will write more once I get a report from Terry today. God bless you all!!!!!!!

The Vampire Strikes Again

First, my brother's blog from yesterday is one of the most beautiful things I have ever read. It spoke to how we are all feeling. I am teaching Hannah to play bridge and she has already said she will help Grandpa play when he gets home. I am so blessed to have such a wonderful child.

They gave Dad two units of packed blood cells last night. His red blood cell count was below normal, his white cell count was slightly up, his hemoglobin was wayyyyy down, as was his albumin. Mom indicates Dad was anemic before he had his stroke but after everything he has been through it appears the anemia is much worse. They are running tests just to make sure he does not have an infection. Hopefully the blood will give him the energy he so desperately needs to get on with rehab.

Everyone in the family has had the stomach flu and now Mom has it. Mom is tired too from everything that has happened over the past couple months. Mom has been such a trooper and I think we have been so focused on Dad we sometimes forget about Mom. Please have Mom in your prayers too.

I will call this afternoon to check on Dad and will post an update on the blog as soon as I hear.

Thank you all for your prayers

3/25/09 -- Expectations and Bridge

Last night I saw Dad for the first time in two weeks.  (I've been away, traveling on business and taking care of things at home in Massachusetts.)  As a bonus, I got to see my Uncle T. C. and Aunt Dorothy, who were also in Richmond visiting Mom and Dad.

First, a word about Sheltering Arms.  This was my first time there, and I have to say I was impressed.  Dad's room is very nice, and the staff seems totally on top of things.  I particularly enjoyed meeting Nurse Wanda, who not only appears to be very competent, but can match Dad story for story. 

Turning to Dad,  I spent an hour and a half just sitting and talking with him.   The cadence of his speech and the timbre of his voice still betray the effects of the stroke, but everything he says is completely understandable.  Mentally he is pretty sharp.   When we talked, it was very much a back-and-forth conversation; the first real conversation I've had with Dad since we spoke on the phone two nights before his stroke.  We talked about U.Va. basketball (he does not understand why they fired Dave Leitao), about the AIG bonuses (is there anyone not talking about that?), about what my wife and kids are up to, and about all the cards, letters and well wishes he's received.   The best moment came when he told me he was looking forward to playing bridge with Mom, Anne, Matt and me, although "my plays might be a little slow."  After everything that's happened over the last six weeks, it's hard to describe how good it felt to be sitting there just casually chatting with him.   It was a joy.

Physically, well, Dad still has some real challenges.   On the plus side, he seems to be using the left side of his face much more and, as Anne has noted in previous posts, when he feels good and motivated he makes progress in his rehab.   On the other hand, he still has very limited use of his left arm and hand, and it is clear that he lost a lot of muscle tone during his last stint in the hospital.   My overwhelming impression was that he is very, very tired.  It seems like a long way back to the self-reliant man we all knew.      

As I drove home, I thought a lot about how important it is to enjoy what we have with Dad right now, and to be realistic in our expectations about his rehab and how fast and far it may progress.  "Miracle" is a much overused word these days.   But the more I learn about the severity of Dad's stroke and about the infection and surgery he subsequently endured, the more convinced I become that the fact he is with us at all is, if not a miracle, as close to one as I ever expect to come.  That realization has made me appreciate even more the chance to sit and talk with him, to listen to a story I've never heard, to laugh with him at a bad pun, to hear his advice on what sports my son should play. For me, for right now, those are gifts enough.

   

Weekly Team Meeting Time

Matt just heard from the rehab case manager. They had their weekly team meeting about how Dad is progressing. Sounds like there wasn't a whole lot of news but what there is, is good. They indicate Dad is making progress in all therapies. He is having some difficulty with speech because, when he talks so much, he is "pocketing" his food and then can choke on it. He was unable to complete therapies yesterday due to low blood pressure. They think his pressure was low because he was a little dehydrated. His blood sugar has also been very low several times. This is why we are glad he is in a acute rehab--they have the experience and facility to deal with medical issues as arise. Nothing more was said about a discharge date.

It is so nice to have a little bit of "quiet" for once. Hopefully Dad can continue with his progress and life can slow down for everyone.

Oh What a Difference a Week Can Make

This has been a wonderful weekend. First, my husband has been in "Food Heaven." We came to Millboro on Friday night and ate at Cracker Barrel on the way. Saturday morning on the way to Richmond we stopped at the Mill Creek Cafe for breakfast and then today we are headed out to the Maple Festival. All of this eating though made us late, as usual, to see Dad on Saturday. It was definitely worth the wait though. Dad is doing wonderfully. As Hannah would say, "AWESOME."

Dad was lying down when we got there.  Mom was at his side. Both looked rested and well. We talked to Dad for over two hours and only toward the end did he seem to tire a little. The first biggie we noticed was his ability to use his left hand. Hannah brought him a picture she had placed in an envelope. He was able to use his left hand to pick up the envelope and open it. Next, Dad was able to talk about the effects of his stroke and what is ahead in terms of therapies. He still hasn't quite made the connection of, "the harder you work the faster you'll get home," but he's getting there. 

Joe and I have been listening to a book on tape about the Korean War. Dad was full of stories about being a lieutenant in the army in charge of supply trucks and other vehicles. He told a great story about being the only vehicle unit in Korea that was unable to supply General Eisenhower with a jeep on his trip to Korea because it was too cold to get any of the jeeps started. That sounds like Dad. There has hardly been a major event in Dad's life where there has not been a vehicle snafu. He also told about a major inspection one time and several of his vehicles were dirty. Being ingenious Dad came up with the idea of having several of his best "goof offs" take the vehicles for a ride while the inspection was going on. What he didn't plan on were these men bringing the vehicles back, charging through camp, in the middle of the inspection. Poor Dad.

Dad's concentration is so much better it is hard to believe. He continues to talk wayyyyyyyy to much during therapies but I would rather have him talk too much than not be talking at all. You can still tell his brain is working very hard to compensate for the deficits caused by the stroke. Considering his right brain is basically "swiss cheese" from all the matter that died due to lack of oxygen it is amazing how well he is doing.

Toward the end of the visit, the physical therapist came to visit Dad. They worked on swallowing and Dad got to drink some water. I never realized how many muscles were involved in swallowing and how easily you can lose the muscle tone. The therapist indicates their goal is to have Dad eat a pureed meal by the end of the week.

They initially estimated Dad would be in rehab about three weeks. This gives up two more weeks to go. I can't wait to see how much progress he will continue to make. As always, thank you all for your prayers and cards. Dad's room looks like a hallmark store. All of these wonderful cards cheer him up, makes the room festive and every time someone comes in and comments on a card it gives Dad a chance to tell a wonderful story about the person who sent it. Without your prayers I do not believe Dad would be here today. He, and the whole family, are blessed.

We are Finally on a Roll

It seems like it has been so long since Dad has his stroke and so many uphill battles that it seems impossible we have had almost a week without a major medical crisis. But it is true. Today marks the one week anniversary of Dad being transferred to Sheltering Arms and so far so good.

Matt's report today was very positive. Dad walked around the gym (not sure what size the gym is) at Sheltering Arms twice today. He only had to sit down once. He did wonderfully in OT and in a BIGGIE he got to eat a little bit of oatmeal. If it had been me eating the oatmeal it would have been on the negative side of things because I HATE oatmeal but Dad loves it and it was the first solid food he's had to eat since February 8 ---Go Dad!!!!

Dad had visits from a deacon, a pastor, and a chaplain today. While I am sure he loved the visits Mom says he started talking and telling one of his stories right in the middle of the deacon praying. Sounds like his mouth is going as fast as his legs are. Oh well, Rome wasn't build in a day.

It is great for Dad to finally have a chance to get out of bed and begin to heal. They anticipate he will be at the Rehab about three weeks. I can't wait to see how much progress he can make.

Thank you all for your continued prayers and thank you Matt for taking such good care of Dad and Mom.

3/17/09 -- Live from New York

I've been in Boston (family) and New York (business) for the last ten days, so I haven't had a chance to see Dad since he was discharged from the hospital and transferred to Sheltering Arms.  This short update is therefore based mostly on reports I received today from Matt, who has seen Dad at least twice a day since he was moved.  (Thanks, Matt.)

Dad had a fairly good day of rehab today.  He appeared to be starting to regain some of the strength he lost during his recovery from surgery.  Additionally, and importantly, he appeared to be somewhat more focused, and less easily distracted.  The staff has come up with a plan that may help his sharpen attention and focus through medication.   Everyone keep your fingers crossed on that one.

As I've noted on several occasions in this blog, rehab is truly a roller-coaster ride.  While we all wish that Dad's recovery would consist of a series of steady, predictable, daily improvements, that's not the way these things seem to work.  All the more reason, then, to appreciate the good days, like today.

   

The Unseen Effects of Stroke

When my father had his stroke his official diagnosis was a massive right middle cerebral artery stroke. This meant little to us at the time. We all wondered at Dad's ability to remember stories from his childhood, early adult years and his retired life with my Mom and growing family of grandchildren. We were then thrown into the world of superbacteria, the devastating effects of c diff, and our father's emergency surgery. As Dad has gotten stronger we are beginning to see the effects of his stroke and I have learned much more about the temporal lobe, parietal lobe, and insular cortex than I ever wanted to know.

We are all getting to know a Dad who is very familiar to us and at the same time a stranger. Dad has always been a quiet reflective man, but now he talks up a storm. The torrent comes whether he is in one of his therapy sessions or talking with us. Dad has always been a dutiful man. He served in two wars, rarely took a day off from work, is devoted to my mother, and takes care of himself following whatever orders his doctor might give. He now shows disinterest in his therapies preferring to sleep or talk about his family. While Dad can verbalize his desire to be home and his feelings about having to stay in a hospital, when it comes to recognizing the emotions in others he draws a blank. He has difficulty maintaining his attention and concentration is a struggle. This lack of concentration affects everything he does, even interfering with swallowing. As I am sitting here I realize he talks freely about his touch and go c diff hospitalization but has not mentioned his stroke or it's effects and ignores us when we discuss it.

The doctors talk about aprosodia, anosognosia, and neglect. They discuss auditory comprehension, lability, and post-stroke fatigue. I am beginning to learn what the doctors are saying when they speak this "foreign language." In many ways I am grateful for the research that has been done so they can actually name stroke symptoms, tells us specifically what part of brain they come from, and develop a treatment plan to help either remediate or cope with the damage. On the other hand with these symptoms unnamed it is easier to just look at my father, listen to the stories, and pretend he is my Daddy once again.

After a Month Long Delay Dad Can Begin to Pick Oranges

Dad has a dear friend, Wharton Gaul. Dr. Gaul and my father went to Virginia Episcopal School together, went into the military together, and even contracted scarlet fever together while in the military. Dad has often talked about how, if Dr. Gaul had not gotten out of his own sick bed to care for my Dad, Dad probably would not have lived through the illness.

Ever since Dad's stroke Dr. Gaul has called me every Wednesday between 3 and 4 p.m. to ask how Dad is doing. This past week he told me an interesting story. According to Dr. Gaul, after Dad and Dr. Gaul got out of the "make shift" hospital in California for scarlet fever, they were sent to a rehab facility. What was unique about this facility was the fact that it was not a rehab facility at all, it was an orange grove, donated to the military by Bing Crosby. Dad and Dr. Gaul would get up every day, walk around the grove, pick oranges and recuperate. Despite Dad's many tales from his past this is one we had never heard. We asked Dad about it. He remembered it well. Dad said they told him he could have whatever he wanted to eat. Dad ate peach pie every day.

As I sat yesterday in Dad's new rehab I was reminded a little of this story--there is a big picture window in Dad's room and he has a wonderful view of the many pear trees blooming outside. There are courtyards for Dad to go out and get fresh air and the room--despite having the trapping of a hospital room--had wallpaper and a wonderful ledge at the window for plants and cards. You could hear talking throughout the rehab but there were no bells going off, announcements over the intercom or harsh lights. This may not be the orange grove of Dad and Dr. Gaul's memory but it seems to be a place of relative peace where he can begin to heal.

Dad is already looking better. He was up in a wheelchair when Mom and I arrived and was getting ready to have speech therapy. The speech therapist was asking Dad questions to assess his cognitive losses. I don't think the therapist quite knew what she was getting herself into. 

She started off with a very simple question--I can't remember the question but Dad got it wrong. She looked somewhat concerned and then asked Dad again. This time he got it right. After that he was off and running, "Do you put salt in your milk?" "NOOOOOOOO! of course not," Dad replied. "Are the sun and the moon in the sky at the same time?" "Yes," Dad replied, The therapist looked concerned. "Well I guess they can when there is an eclipse," she said. No Dad said, "it happens twice a month." "Which can go faster, a motorless car or a bicycle." "A motorless car," Dad replied. She again looked concerned. I did too--maybe there were more cognitive issues than we thought. "It's simple," Dad replied. "You put the car at the top of a hill and it rolls down the hill like a go-cart." I think that was pretty creative. They may have to rewrite this test after Dad's done with it. Meeting with the therapist after seeing Dad she indicated she did not see any cognitive issues--more issues of attention and concentration as well as Dad continuing to talk a LOT!!!!!!

I sometimes wonder how Dad feels after giving people psychological testing for so many years he is now having the testing done on him. I think he is actually having a little bit of fun with it.

Dad says his children are BOSSY. He still wants very much to go home and Matt had a talk with him about not going home until he completes rehab. He may not be happy with it but I think he is accepting of the fact--especially since Matt is so close he can see him several times a day.

Since Dad is finally feeling good, even though he is very weak, we now have a chance to see what progress he can make to recover from the stroke. This may not be Bing Crosby's orange grove but I have a very good feeling the results will be the same.