Keith update (nearly normal!)

In the same way the personnel at UNMH seemed surprised that Keith lived, the follow-up doctors seem surprised he's doing as well as he is.

Dr. Hai, a DaVita cardiologist, second visit.

Echocardiogram, on June 24, showed the heart flow was 45-50 cpm. Dr. Hai says that's 90% of normal. People without heart attack history are 50-55. People who have had heart attacks are usually 30-35.

Results of a heart monitor he wore for three days a month ago showed no abnormalities in heartbeat. Over the course of three days, it skipped a beat a couple of times, but that's normal for anyone. There was nothing in that test to indicate problems.

Hemoglobin appears low.
Cholesterol looks good.
They had failed to do A1C, so he ordered one.

Lowered the dose of Amiodarone from 800 mg daily to 200 mg daily.

Next checkup in six months.

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Note from Sandra: It would be nice to know more from the inserted monitor/defibrilator, but at the first appointment, it wasn't set up to upload data yet. We had another appointment scheduled for three months later, but it was pushed out from three months to four and a half. That's a long time to go without feedback, I think, so I'm glad that Dr. Hai ordered the external monitor. It bothered me at first for being duplication, but UNM doesn't communicate with DaVita.

Keith got copies of the records from his stay at UNM. 400 pages. Dr. Hai kept that to photocopy some parts.

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Jacqueline Reeve, primary care, follow-up, third visit.

She wants to see the 400 pages of records from UNM, too.

Keith had blood tests right away for hemoglobin, A1C, and "an iron study."
Keith's been taking an iron supplement for a couple of months, just informally, on the physical therapist's recommendation. Reeve will make a recommendation when the lab work is back.

She listened to his heart just quietly for a long time and said she heard nothing like a murmur, and all was strong and good.

The kidney specialist, Dr. Chen, had recommended Saw Palmetto (capsules, over the counter) to help with an enlarged prostate, but she didn't say how much or how often. Reeve looked it up and recommends 160 mg twice a day. That's unrelated to heart problems, but when there's a big emergency, people seem to stop paying attention to anything else. He's well enough that they're looking at things other than his heart now, which is nice. They sent him to the kidney specialist (I think, it seemed) to make sure there wasn't kidney damage from the cardiac arrests, or from the effects of the ICU treatments.

Keith's wonderful recovery

Keith's progress is remarkable, so here I am to remark. :-)

This week, he has been out of the hospital as long as he was in. And Wednesday's out-patient physical therapy was the last of the set of ten. He doesn't need to go back.

In June, I might start driving him to the pool weekday mornings early. He will daytrip to Outlandish with Paul/Lavan, before then.

Things are good.

Keith update!

Keith is doing well, using a cane sometimes, probably won't re-up for another set of physical and occupational out-patient therapy sessions, even if they're offered.

He's been to another cardiologist (one of DaVita's) who wants to do some tests over the next month or two, and he went to a kidney specialist, at the request of his "primary physician." The primary physician he has seen twice is a nurse practitioner who saw him because he regular nurse practitioner was too heavily scheduled. He also had another consult with the pharmacist, who rearranged his drug-taking schedule a bit.

The cardiologist asked him to stop taking the blood pressure lowering med, because Keith was in there in the clinic, and reading 80 over I forget what—too low. But to Keith's request to stop taking the blood thinner for a week so the pain clinic would give him a steroid cocktail shot for his lower back pain, the doctor said it was too dangerous in the first six months. Oh, and the kidney specialist told him not to take over-the-counter pain killers for it, because they're bad for his liver.

When he was in the hospital, it seemed too many departments were pulling him one way and another without regard for what the others needed/wanted/had ordered. Now that he's home, UNM and Davita, and their various departments, are doing a similar scattery stretch on him. After this current round of tests and visits, I think I'll contact the insurance company to ask for some coordination of care.

That's what I thought this morning, and told Keith, too.

Then the mail came. These were probably mailed on May-last-Friday, May 3. That would've been two months after the initial cardiac arrest. Do you think they wait two months to be polite? Or did it take them this long to get this together? The only bill we've had so far was the ambulance. Thirty-seven envelopes saying "Physician's statement" have all arrived at once. They might not be bills, and we might not need to pay them if they are (someone we went to said Keith's deductible has been met for the year), but it's a scary-looking pile. :-)



I've been opening them as the photo loaded, and yeah... bills.

charges / payment-adjustment / patient balance

Still... it's good that Keith is alive to pay these. :-) Or at least to ask the insurance company which ones he should be paying. It might be the total of this pile that makes his deductible.

Thanks again for the sympathy and encouragement of friends and relatives. Keith's still frustrated, gets tired easily, and sometimes doesn't feel great, but other times he's strong, cheerful and whole!

Two weeks home, seven weeks post-incident

Keith is doing better every day. His balance is improving, he's walking with just a cane, mostly (still uses the wheelchair in the bedroom and his office, because it's more comfortable and he doesn't get as tired). Today he and Holly went to Costco, and he used the cart as a walker. :-) He gets tired easily, still—from a combination of muscle atrophy and of difficulty breathing.

The upper back side of his head above his left ear is still numb. That injury, nobody cared about earlier. It's probably where he hit his head when he fell back downhill on March 3. Because his long hair was all matted up there for a month, it wasn't noticeable until the hair was cut.

There are a few little oddities that will probably go away. He has kerosene cans with a side cut out, flat with the hendle out, as drawers on shelves in the garage, and though he used to know what they all were, now he needs to look in them. He might label them, or his memories might come back. That's not the sort of thing they could have tested him for in rehab—"What's in those cans in the garage?" He said when he's playing music, he's having a hard time not just with breath (lungs, ribs, sternum—that would affect air), but with fingering and rhythm. I think that could be weak muscles, and playing recorder uses muscles way up the arm, on lower notes, especially an alto or tenor, and he's still weak in the shoulders and chest.

This will come back too, but his speaking voice isn't strong, and he can't sing well or right, yet. I fell in love with him for his singing, and his musical ability, and now that's messed up!? Good thing that over the years I've found other lovable things about him. :-)

This morning we went and watched Ivan for an hour at Marty & Ashlee's house. Yesterday, Devyn was over to eat and hunt eggs, and baby Kirby was here. She'll be here tomorrow for a while, too. So he's able to do his grandfatherly duty, which is sweet. :-)

We still play Dr. Mario nearly every day, and we've been playing Five Crowns. Yesterday we played two games of Azul with Kirby and Destiny, and they left the game for me and Keith to play. We will.

It will still take a few months for Keith to get back to his own strong singing self, but he's doing well.

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.

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 Matress 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.

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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

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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).

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.

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Home on Monday afternoon!