Monday, April 22, 2019

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.

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 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)

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