Saturday, April 13, 2019

Keith's progress at home, five days in

Five days home, Keith is sleeping better, taking a few steps without the walker, mostly using the wheelchair to get around his office and bedroom, going outside every day with the walker, and sometimes going on errands (with me or Holly driving and helpking). He met a contractor at Marty's house, and he's been to the bank, to outpatient rehab, and a doctor's appointment. He got as pneumonia vaccine, on the pharmacist's recommendation.

Keith says he feels strong, but tires easily and his balance isn't as sure as usual. He's doing lots of things as well as he did before, but there are some lags. There are plans and projects he doesn't remember. He had put half a dozen big rocks all in one place (on a sidewalk in back, near where he had laid in a couple of flat rocks where a hole had been). I moved them onto the grass so the mattress delivery guys could get by. Keith asked where the rocks came from. He doesn't remember, and he hadn't told me, so I can't help him.

Playing Dr. Mario on the Nintendo 64 has been a test for us in the past. We've played until my stupifying drugs kicked in, on dental-surgery days. It cut down my anxiety to play happily until I quit moving pills, and Keith knew I was ready to go. We've joked that it's an Alzheimer's test—if one of us forgets how to play, that will be time to tell the doctor to check for Alzheimer's. Keith is playing Dr. Mario as well as ever. You might think "...or he's not, and Sandra has Alzheimer's", but Holly played with us too, and we were all winning some, and Holly won slightly more.

We play Five Crowns, a game with 116 cards. Keith can't shuffle or deal well. He said he has some fine-motor-skill catching up to do. It hardly shows, when nobody's asking him to shuffle cards. So others are shuffling and dealing, and that's fine.

For the next five weeks (and maybe more) he will go to Encompass Outpatient Rehab (same gym he was in when he was a patient there) twice a week, for two 45-minute sessions back-to-back. Physical therapy and occupational.

He's not nearly well, but he's getting there, slowly.

Monday, April 08, 2019

Keith is home, but things are still...

Keith is home and that's good. We stopped at Marty's to see the new stucco job. It looks nice.

We went to Albertson's to leave the list of prescriptions, and Keith talked to the pharmacist a while.

We came back and unpacked and rearranged, Holly helped, we had some Golden Pride ribs and coleslaw (not much, but Keith's first non-institutional food for a while, not counting yogurt), on the table that's now in Keith's bedroom (so he can eat there, or do things at a table while he watches TV).

The pharmacy called and I went to hear warnings and cautions, hear how to set up the insulin pen, and then came home to try to figure out how to use the blood pressure cuff (lining up some line I couldn't find with some artery I'm not familiar with). Then Keith figured it out. I wasted my time reading and thinking. :-)

Keith's resting on the New Matrees with the same old cat, who must be very happy to see him.

Other changes to that room: Grab bars / handles on the toilet and a removable shower head. Holly and Marty helped with those kinds of projects, over the past few days. Paul and Dave helped setting up the base of the bed, again, before the new mattress came. Brie helped clean up high—top of the "headboard" (big piece of furniture), before that.

For those who are curious or know and care, here are the things we got from the pharmacy today:
blood pressure cuff with an electronic screen that will give heart rate, blood pressure, and another thing or two maybe
pill cutter

levemir (insulin cartridges and pre-filled syringes) for which insurance paid $388.26 and we paid $0.
pen needles, for that above ($31.54 we didn't pay)

glipizide
metformin extended release tablets

lisinopril (to lower blood pressure)
metroprolol (ditto)
atorvistatin (for cholesterol)
clopidogrel (to protect the stents, I think—to prevent heart attacks)
amiodarone (to keep his heartbeat regular, and it's something never given as a home prescription, except after hospitalization)

He can get from the bed to the wheelchair, or get to the toilet with a walker. He can get to his desk chair/computer, or the refrigerator, easily. Mostly, though, for starters, he's wanting to be still and quiet in his own bed a while, I think.


P.S. Keith notes that he lost 25.5 lbs since he fell that day. He weighed himself March 1, and was 229 lbs. Today, home again, 203.5

Tuesday, April 9, 11:00 a.m.


Keith is home! Still recuperating, still taking serious meds (eight things), but he slept a long time, and can get around easily in two big rooms, so good!

I charted how long he was where, this morning. 36.5 days not home. Of those, sixteen were in intensive care (ICU).




Sunday, April 07, 2019

Edging toward home

updated Monday morning, April 8, 2019

The weekend was supposed to be slack time. I visited Saturday morning and we played recorders a while. Holly was coming to have lunch with her dad, so I went on errands by late morning.

On Sunday, Kirby, Destiny, Devyn and baby Kirby went to have lunch in the cafeteria, with Keith, and hung out afterwards until the baby was restless.

Keith expected the rest of the time to be just working on taxes or playing video games (he has his iPad now), but he had three assessments by therapists—speech, OT and PT all did evaluations, in preparation for his (planned, scheduled, predicted) departure on Monday.

I'll go up there at 8:00 or so Monday/tomorrow (/today/whenever it was, for those who read this later).

Five weeks and a day, since March 3. Recovery will continue at home, if all goes well, starting mid-day Monday. I'll update below when more happens!

Monday morning, April 8, 2019

Keith's stuff is all packed up in a big rolling suitcase. He's in the homegoing wheelchair. The doctor came by early, the case worker/coordinator came by, we played Five Crowns in the break room next door to pass time, and the pharmacist is the last character in the play. I think. I believe that after the pharmacists visits, we can go home.






4, 5, 6, 6, 6, 6, 5, 6, 7, 7, 7, 7, 7 All Natural

(My hand, on the final round, kings.)

Still waiting, 11:10. Impatient. Keith was arranging for transport of a tent to Outlandish, and then called Needham to talk about some things to see between Colorado and Minneapolis. We drove that (westward) with three kids, long ago.

A nurse just came in to talk to him about how to take his drugs at home, so this might take the place of the pharmacist's visit.


Home on Monday afternoon!

Tuesday, April 02, 2019

Keith still in Rehab

UPDATED FRIDAY NIGHT, April 5 (update before that was Wednesday—I slacked)

Rehab hospital continues, Days 4-8

Monday, April 1, 2019

Keith's brother Gerry had visited him in the morning, and Keith missed lunch talking to Gerry, which disturbed his caretakers.
Later his blood sugar was low enough that they didn't give him an insulin shot, but maybe because he missed lunch.

At night, I visited and we worked on bills and taxes. I took his dirty laundry home. SO BORING! Good, huh?

Tuesday, April 2, 2019, Day 5

Keith had two physical therapy sessions in the morning that kicked his ass, he said.

Mid-day, Kirby took Keith a third pair of glasses from the house. The first two were falling apart. If these don't last, there's one more pair in the garage. Keith said it was a good visit, with Kirby.

Back at the house, we had a big electrical repair/upgrade all morning, and baby Kirby ws here in the afternoon. Holly helped with her after a while. I called Keith at the hospital to see if there was anything I should bring other than the clean clothes, and he said he had lots of company and I didn't need to come. Paul, Dave, Lori and Mark were all there together. Tomorrow, though, Keith wants me to come and go with him to an appointment with the cardiology doctor at UNMH. I get to ride in the van; Keith will be transported in a wheelchair.

Wednesday, April 3, 2019

Biggest news is that the projected discharge date has been moved to Monday, April 8 (from Friday-the-5th).

Successful visit to Cardiac Device Clinic at UNMH (Fifth floor, but not the same 5th floor Keith was on before.) We know more about the defibrillator. If his heart goes below 60, it will "pacemake" him quietly.

If he gets crazy heart beats, it will shock him hard. WAIT! NOT JUST ANY. If he has ventricular tachycardia, for just a few heart beats, it won't shock him, though it will be seen the next time they review the records that will be transmitted from the house to the clinic. If there are 20 heartbeats, though, that are dangerous, it will shock him then.

If he feels fine after the shock, we're to call Armando Sanchez (a physician's assistant; we met him today) and he'll see him the same day. If after the shock Keith feels unwell, then we call 911. If the monitor makes a noise like a European siren ("the auditory alert"), it means something is wrong with the equipment.

The battery might last 11 years. The amount left on it shows on the monitor at the clinic. When it gets to the red mark, it will mean he has three months left, and they'll schedule a replacement surgery.

Then we were driving back, in the rehab center's van, with Keith in the wheelchair strapped in all directions, me in the front. Dinner. Salmon and wild & brown rice. Really not bad at all.

Keith's really tired, so I'm going home and he's going to sleep.


Friday, April 5, 2019

Keith has rehab sessions three hours a day—one physical therapy, one occupational therapy, and one speech pathologist doing various evaluations sneakily worked around playing games or asking odd questions or having conversations. Stealth stuff.

Wednesday, there was a meeting about Keith, and he was given a copy of an evaluation sheet that goes from "Dependent" (needing 100% Assistance) through some other descriptions to "Independent." Let's think of it as school grades. That's easy. The only A's he had were eating and expression. Some A- (Mod I— "with a device, or needs extra time"):
  • wheelchair (can go 150 ft. with his feet because they don't let him use his hands, because of broken sternum and not-yet-healed chest implant)
  • comprehension
  • problem solving
  • memory/orientation

I am not used to Keith not being zippy with those things, but he'll catch back up, I'm pretty sure. Sometimes he does forget conversations or details, even from things this week. But after the haircut, he also discovered a numb place on he back of his head (kinda sore, but not discolored). The PT thinks maybe bone bruise. I suppose it's where he hit his head when he first fell back, in the park. Nobody bothered to care about a head bump, given all he rest. And maybe that's going to take some time to heal.

He didn't have any of the two "lowest scores".

Thursday, I visited and we played Five Crowns, and ate dinner together. He got his mattress replaced. A few days prior, he had been given an air-rearranging mattress to prevent bed sores, based on a score involving age and injury and time in the hospital and I don't know what all. But for three nights, it randomly aired-up here and there, and kept him awake and uncomfortable. Then a nurse figured out it was set up wrong and wasn't working. When she had it set up right, it looked like a soft roundy trough, and would have been hard for Keith to get in and out of. The lad nurse told him he could refuse it, and so he did. They switched it out nearly immediately.

Friday I was there for his physical therapy session, so I could learn about how to help him with some of the exercises, and to remind him about some things involving walkers, and for the therapist to look at some photos of the shower and toilet and the ramp, and to give us some ideas and reminders. No rugs in the bathrooms for a while.

Keith said that Thursday night he slept six hours, on the regular bed. When he gets home, he'll have a new mattress. It's here, but still airing out, and the base needs a tweak (Marty's coming Saturday to help me with that).

Before Keith fell, he was nearly through with our taxes, and told me that morning (March 3) that he just needed to check the numbers and we could sign it. Because he's still in the hospital, and they don't do rehab on the weekends, I took him all the papers, bundled and marked to match numbers on photos of each end of the table where the stacks of paper were—9 stacks. He worked on it a while, messaged me to bring him another form tomorrow (found it online easily; printed two copies, but this is the bad part: He doesn't remember any of that project. None of it looks familiar.

When his memory did start working again, when he knew where he was, usually, a couple of weeks ago, he couldn't remember anything past February 27. I thought that might change, but it hasn't, much. There are a couple of incidents he remembers, or remembers hearing about, but others are gone entirely. That's nearly a week.

I took a photo today, of something outside in one of the courtyards. They're physical therapy areas, extensions of the gym, with practice stairs, and a ramp, and a car (to practice getting in and out of) in one, and walkways and tables and a basketball hoop in the other, but there's also beauty, in colors, and some furniture, and many blossoms and blooms this month. I also did a sneaky photo of Keith, practicing on their steep ramp.

One more thing, for the record. It's from Wednesday, when we were at the cardiac device clinic. Keith had four cardiac arrests, because the incident on Tuesday, March 12, counted, too. His heart stopped between shocks (between two of the eight shocks that day), but the 260 beats per minute and the irregularity of them was what one doctor called "a lethal rhythm." He wouldn't have recovered from that naturally. Armando Sanchez said that they wouldn't have shocked him if they didn't consider it to be that. So Keith had four cardiac arrests—three on March 3 and one on March 12. Being a little slow to remember something, or not really speedy with a walker yet, isn't so bad. I think today will have been his last formal therapy sessions over there. Unless there's some major objection from one department or another, he'll be released Monday. Maybe he will have finished the taxes by then, poor guy. Good thing his room there has a desk, and he can sit in the chair about as long as he wants to, now.

April 6-8, in rehab

Saturday, March 30, 2019

Keith, Encompass, the weekend

Saturday:

This is an end-of-the-day summary. Now that Keith has his phone, we have communicated that way, and it's nice.

Keith got a visit today from the fire department captain from Day 1 / March 3, who swims at Sandia Pool where Keith swims (did, will) in the mornings and who recognized Keith while his guys were doing CPR.

There was an OT session in the gym in the morning, Keith ate very little lunch but didn't want me to send any food to him; said he wasn't hungry.

Holly took all the clothes Keith had requested. He's been feeling cold.
Bela was visiting while Holly was there, too, and Holly said they were talking SCA stuff.

Kirby, Destiny, Devyn and little Kirby went and had dinner with Keith in the cafeteria there. Keith said he fed the baby half his mashed potatoes and gravy. He was happy to be feeding her.

This is the first time there are no medical details. That's progress!

Tomorrow is our anniversary. Thirty-five years. Six before the wedding, if anyone's really counting everything.



Sunday:

Marty and Ashlee visited from about 9:30 to 10:00 and wheeled Keith to the gym for his only scheduled session of the day, which was to play Taboo (a game where people guess a word, but you can't use any of the clues on the list on the card). There were five players. I slipped in there pretty early on.

I ate with Keith in the cafeteria there. It was good, and not at all expensive. $5 or so per guest Mine was less. Depends what you order.

We went back to the room and I showed Keith the photos, on the blog posts of this last month. He texted with Gerry, his brother, about a Monday visit. Beau and Laurie came with recorders, and the fours of us played for an hour, in the meeting room next to Keith's room. It was good, and it was fun. Keith sounded great, even though he said his wind wasn't good, and he couldn't manage the tenor, but he wasn't missing the ends of notes and phrases. Probably way better therapy than that little plastic deal to breathe in and hold your breath, that they give post-surgical patients sometimes.

Keith isn't finding a great position for sleeping, because of the broken ribs. Also a big place on the back of his head is sensitive and sore. Probably it's good that I didn't manage to get his hair untangled. It would have hurt for me to mess wih a comb back there, as I turns out. Maybe it's where he hit his head when he fell, four weeks ago.

It's Sunday, and this started on a Sunday, so four weeks have passed.

I sent him a text, to see if there was info to add here; I came home because Marty was coming to help me with some of the bedroom rearrangements. Either Keith is asleep or off at dinner. Either one sounds very nice.

Monday through Friday, April 1-5

Friday, March 29, 2019

Keith at Encompass Rehab, Friday

UPDATED 9:30 PM, Friday, March 29, 2019

(missed) PM, Thursday, March 28, 2019

I had planned to write here when I got home from visiting Keith in his new-temporary home, but I was tired, and Holly was home with stories, and I forgot. Sorry.

It's a big room, people are energetic and attentive all around him, and he was going to have a shower, when I left. When I got home, he had texted that the shower went well.

Oh! I forgot to say that finally, that last day he was in the hospital (Thursday) he finally agreed to keep his phone and glasses.

8:39 AM, Friday, March 29, 2019

Another shower already! Part of the therapy is helping him regain skills and the ability to take care of himself so they can send him home.

Their target date for release is April 5, next Friday. Good, I guess, because that's the day the new mattress is arriving, in the morning.

He has three hours of therapy scheduled every day. This shower and him dressing himself is part of it, today. He said he dressed himself this morning for breakfast. I saw him stand up to transfer from a wheelchair to the shower chair, and he stood up on his own for maybe 20 seconds, holding to a door, but not a walker. They didn't send that walker with him from UNMH.

9:30 AM, Friday, March 29, 2019

Unexpected problem. Finally I was able to try to get tangles out of Keith's hair. For over two weeks, I've been carrying spray detangler and a very forgiving comb, in my backpack. So today, I tried. I couldn't get more than a few ends out of this:


After I tried with fingers for a while, and was not making it better, Keith suggested maybe giving up and cutting it. I thought about how difficult it would be for him to take care of it even if I did somehow manage to untangle it. He had another physical therapy session in less than an hour and a half. It just so happened that one of the few things Keith had asked me to bring from the house yesterday was a little pair of scissors, very sharp Fiskars, from his bathroom. He said cut it, so I started working on that. The big mass of tangle came off without even dropping hair. Then I trimmed the rest up.


The texture of what's left is really soft, and it's various colors.
The beard had been trimmed before the implant surgery on Wednesday.



"It will grow back."

Keith had a big breakfast and doesn't even want the Chobani yogurt drink I brought. He had eggs with cheese and green chile, a bit of French toast, coffee, cranberry juice, some fruit cup. The coffee gave him low blood pressure, seems, but he didn't get dizzy. All that dizziness and nausea from standing up and doing things at the hospital isn't happening here. Very cool.


9:30 PM, Friday, March 29, 2019

After Devyn's gym class, I took her to see Keith, and we met the rest of her family there (Kirby, Destiny, and the little-baby Kirby). We arrived just as they did. The purpose of the gathering was so that Keith could see this special announcement:


I had known for a whole three hours or so, myself. :-)



Notes on the weekend, March 30 and 31

Wednesday, March 27, 2019

Implantation of ICD, and (maybe) the last few days at UNMH

UPDATED 5:52 PM, Thursday, March 28, 2019

6:15 AM, Wednesday, March 27, 2019

Keith called me at 6:15 to say they brought him the release papers to sign, and he's first on the list, not last, today, in the surgery.

I was planning to go up there, and I still might, if he calls me back and says he's in the room and recovered enough (if I could get back home in time to babysit mid-day). If it all takes longer, I'll go see him after 6:00.

He cut his beard short (last I heard—maybe shaved it off), so visitors should be prepared to see him look like his brother, Gerry. Maybe only family will know he looks like Gerry. :-) (Hi, Gerry.)

They shaved his chest, too. The plan is to put the icd on the upper right, because of his left-handedness. Plans don't always work as well as they might there, or anywhere, I guess, but it might be nice not to limit his movement so much on the left. Eventually he can move all around, but for the first some days or weeks, he's not supposed to lift his arm high near that device, and not have repetitive motion on that side (ever). One doctor assured him that splitting wood wasn't repetetive motion, nor was swimming. So I'm not sure what they consider to be repetitive motion, in a shoulder or arm.

10:18 AM, Wednesday, March 27, 2019

Keith called, back from surgery. They installed it on the right. He was asleep but not deeply sedated. There was serious local anesthesia.

A nurse said Keith could experience gaps in his memory about/after/because of this morning's procedure and anesthesia.

10:35 AM, Wednesday, March 27, 2019

Keith said they did ask one question, when he was already on the table, that hadn't come up before. "Do you use a rifle?" Maybe if he had said yes, they would have considered putting it on the opposite side of his dominant hand, but... they already WERE supposed to put it on the "wrong"/less normal side. The organiation of information acquisition and delivery, about that device, has been the worst of all the experiences in the hospital.

The first week, I was super impressed with everyone and every thing. From about the 10th day on, I became less enchanted, until now on day 25, I react too quickly and sharply. Partly, surely, it's me getting tired, and frustrations building up, a bit. Nothing that people do now that seems wrong or neglectful can be the first or second incident. But partly, because Keith is no longer dying, he's way down on the priorities. It's a world of triage, where requests about a urine bottle someone is able to fill on his own (but not empty), or a box or tissues, or a drink of water... no urgency. The nurse call lights on the bed don't work, and haven't worked for years. I didn't know that when I pressed one because Keith was throwing up, last week. It's still lit, because they don't know how to turn it off. They're using the nurse call button on the TV remote now, but those others are still on the bed, looking like they ought to be good for something. And they light up! ...on the bed.

But Keith is alive, the defibrillator is installed, and though we've heard conflicting info on what it will and should do, perhaps there will be some actual paperwork somewhere, before he leaves, about exactly what was installed and what settings it has.

5:15 PM, Wednesday, March 27, 2019

Keith says when the physical therapist came by, she said she wanted to rescind her recommendation of skilled nursing, and send him to inpatient rehab. There are only two in town—Lovelace and Encompass.

Barb, a discharge planner, came to talk to him. She contacted Encompass,and someone from there will come and talk to Keith. I don't know if that's to evaluate him or what, but if it's tomorrow, I might be there, and will report here. :-)

10:25 PM, Wednesday, March 27, 2019

I was with Keith for a few hours. I took him strawberry rhubarb yogurt. He likes strawberry rhubarb pie, and was happy to find a yogurt. I got it there in time for him to count it on his dinner carbs count. Yay.

He had the papers, official box (with a same-weight and size defibrullator like the implant, for him to play with and show his friends, I guess...), lots of booklets, THE booklet that goes with it, two pamphlets. I read nearly every word. That's tiring. I read the interesting or new parts to him. He can't use a chainsaw anymore.

I'll go back in the morning.


9:20 AM, Thursday, March 28, 2019

Two days ago Keith and I were talking about how now that all the personnel have phones, there aren't loudspeaker calls for doctors and such.
Yesterday I heard one, though, that said "New patient arriving, room 5-something." So I told Keith I heard one.

I had just arrived on the 5th a bit ago and heard "Denny, you're needed in 560."

Keith's room is 560. Denny was the nurse yesterday. And today, turns out. I thought I would rush over there and help Keith with whatever he needed from Denny, but [SPOILER: Keith is fine] when I got to the door, Denny was in. And another guy was in. And Keith was on the floor. But they were all cheery, and Denny looked at me and said "He didn't fall."

Gabe, the tech, the other guy, had been helping Keith move from the commode chair to a sitting chair, so he could eat breakfast from a chair, but Keith felt light-headed, and said he felt like he was falling asleep. I think it's called passing out. So the best Gabe could do was gently get him on his back while he was "falling asleep."
Here is how I spelled that: I asked Siri "How do you spell the heart medication metopolo?" Because that's what I had written down when Denny said it might be (that).

I should've been asking Siri all this time!
Denny said it could be the Metroprolol. I asked what that was and he said a blood pressure medicine, and it could make him light headed.

Keith was totally sweaty, there on the floor, but was able to propose a plan by which those two guys could help him stand up to get on the bed, and it worked.

He ate nearly everything on the breakfast tray, plus a bottle of yogurt drink I had brought. Cool.

Then he called the roofing company to make the final payment on the roof at Marty's house.

Keith says they're keeping his blood pressure unnaturally low. He doesn't know why. Before this, I would have asked, and written it down, and looked things up, but now I don't care as much as long as he gets out of here at some point.

5:02 PM, Thursday, March 28, 2019

I'm home, but Holly's with Keith and he's being moved from UNMH to Encompass Health Rehabilitation Hospital.

More info later.

5:52 PM, Thursday, March 28, 2019

Holly says he's in his room there, recovering from the transfer. The facility sent a wheelchair van, and (I think) they picked him up from the room, and took him by wheelchair. For some facilities transfers, it's gurney and ambulance, but this wasn't. I'll visit tonight, and maybe later tomorrow I'll understand more what can be recommended for visits or assistance, if any/anything. Don't visit without checking, please, until we know more. Thanks!

Early on at the Rehab