Thursday, October 20, 2011

UPDATES - Monday - Thursday

Sorry I have been a little MIA lately.  Things got a little busy once Mom was moved to the rehab unit and I started commuting back and forth to the hospital from Pasadena. I was keeping blog entries along the way, but had to do some revising before posting. Please see the posts below for updates on how Mom has been progessing throughout the week. Thanks for checking to see how Mom is doing!!

Fast Progress

I am always surprised at how well Mom looks and how well she is functioning every time I walk into her room in the morning.  The progress is happening so quickly that even I forget her surgery was just one short week ago. 

Mom's therapists and doctors met today to discuss her progress to this point.  They are all so impressed with how well she is doing that they have decided an appropriate discharge date is Saturday October 22nd.  This is very exciting news because Mom is starting to get some cabin fever just sitting in her tiny hospital room all day.  She is anxious to move on with her road to recovery.  She won't have therapy on the date of discharge, which means tomorrow is her last day of therapy. I am amazed at what just three days of therapy has done for her and I am so thankful she had the opportunity to learn all that she has in this short amount of time.  I know everything we have learned during the therapy sessions (I've attended most of the sessions with Mom) will help me to help her recover at home, so I am thankful to have had this opportunity as well.

Today occupational therapy consisted of learning her way around the kitchen. Mom was presented with the task of making tea for herself. She had to get around the therapy kitchen with her walker while getting all the supplies she needed (tea, mug and tea kettle) to make her tea.  It was very interesting to note how many things had to be modified just to make a cup of tea.  It is expected that Mom won't be required to use a walker around the house once she is discharged, but it is good to practice with in case she wants to use it for balance or so she feels more secure.  She seems to have a habit of reaching across her body to pick things up, which is something she needs to focus on changing because that simple action leads to the twisting of her torso. Mom also had to attend a disaster preparedness class so she could learn about the modifications needed for her in a disaster situation. This class was informative but somewhat redundent since Mom use to teach a disaster preparedness class for the Red Cross.

After her OT, Mom and I got to enjoy lunch at the Plaza Cafe because the Doctors gave her "Plaza priveleges", which means a family member can take her down to the Plaza level as long as she remains in a wheel chair. This was the first time Mom got to have a meal outside of her room since she entered the hospital on Monday October 10th.  Her stomach still isn't feeling great at all, so she didn't eat much, but it was nice for her to get out of her room and experience other parts of the hospital.

Mom got to enjoy a nice nap after lunch before having some more PT.  We went outside on the Plaza level for PT so that she could practice walking in more crowded areas and learn tips on what she should be looking for when going out in public in terms of places she can rest.  There are small things like looking for a bench with armrests to assist her with sitting or thinking about how to repurpose an outdoor object to better suit her needs.  Something else you might not immediately think about having to modify is opening a door.  First, the door may be too heavy for her at this point (the one at the hospital is definitely too heavy) and the simple act of opening the door usually causes you to twist your torso. Again, all things we take for granted in our every day lives.

Another notable accomplishment for today is that Mom was able to put her brace on all by herself. She has learned how to reach around back and thread the straps and pull them taught.  She learned how to do this all on her own, which is very impressive because even the person who delivered the brace says most patients have trouble doing this even when he teaches them how to do it. He joked that she should be the one teaching them how to do it. This is another example where Mom is absolutely exceeding expectations.

I feel that today was a great day of progress and I have the sweet taste of lemonade lingering on my lips.  Mom is an inspiration to me each day and I can't wait to witness her continued improvement in a more familiar environment - home sweet home :).

Wednesday, October 19, 2011

Lots of Therapy

Mom experienced an extensive amount of therapy today, but she learned an enormous amount and is already on the fast path to recovery.

She started the day with occupational therapy (OT). The occupational therapist (Katie) is in charge of teaching Mom about how to make modifications so she can return to doing all of her every day activities independently. These activities includes things like showering, putting clothes on, getting around the kitchen and things of that sort. Today Mom got to take her first shower since she's been in the hospital (she was previously getting sponge baths). She had to learn how to get in and out of a bathtub shower since that is what Dad has in his apartment in Pasadena. After learning about the various precautions she will need to take when showering, it was time for her to get dressed. As you can imagine, this can be difficult to do when you can't bend or twist. Mom will have a "reacher" (grabbing type device) and a "sock assister" to help her with getting dressed. After hearing about all the modifications she has to make just to get dressed, I have a new perspective on all of the "simple" tasks we all seem to take for granted.  Mom was very frustrated and emotional after her OT session because she felt defeated, exhausted and nauseous.  I think she was expecting to receive a little more help than she did, but Katie said she was doing so well that she didn't need to help Mom.  This is a situation in which Mom's expectations aren't in line with those of the medical professionals and she thinks she is doing much worse than she actually is. That being said, I can understand how it can be frustrating to have to adapt to a whole new way of living..

Next was physical therapy (PT) with Adrienne. Adrienne is really great with Mom and helped her to calm down with some breathing exercises.  After Mom was feeling a little better, she learned some various core exercises that she can do in bed without compromising her back at all. Adrienne also taught me how to stretch Mom's calves and hamstrings, which will help in her recovery process.  A lot of the exercises work many of the muscles Mom was previously using in Pilate's, but are modified so that the back is not used at all.  Because of Mom's Pilate's background, she is doing exceptionally well at all the exercises that are thrown her way.

After a break for lunch, Mom had another session of OT.  They have a room in the hospital with various areas that mimic what you would have in your house.  Mom learned about all of the modifications she has to make at her desk so that she can comfortably work in her office and on her computer while still respecting all of her spinal precautions.  I even learned a thing or two that will help me when setting up my workstation!  It is amazing the amount of knowledge all of these therapists have and the simple, yet not so obvious, modifications we can all make to be more comfortable in our everyday lives. 

Physical therapy was the last activity for the day.  Adrienne and I took Mom to the gym in a wheel chair because she was feeling a little fatigued, which is quite understandable.  She did 5 minutes on a bike machine that is low impact for her foot and back.  Next were varioius balancing exercises including walking on an unstable surface and doing squats on an upside down Bosu ball.  These exercises can be challenging for the average person, much less someone who has just undergone extensive back reconstruction and Mom did them remarkably well.  Her body is still getting used to doing activity, so this series of exercises was actually more tiring than she expected.  This made her feel discouraged, but again, I reminded her of her amazing progress considering she isn't even a week out of surgery.  She is having trouble keeping everything is perspective and realizing her astounding accomplishments along the way.

By the end of the day, I realized that overall we need to continue working on managing Mom's expecations of herself in comparison to the expectations that the Doctors and others have of her at this point in her recovery process.  I have learned that she will continue to struggle with recognizing and admiring her accomplishments and it will be my job to help her put things in perspective so that she can continue to progress at such a rapid rate.  I feel confident that tomorrow will be an even better day because I notice so much progress each time I come to visit her for the day.

Tuesday, October 18, 2011

Just the Beginning

Today was the first day of therapy for Mom.  The therapy that Mom will receive is designed to show her how to live every day life and how to strengthen key muscles while following spinal precautions.  The spinal precautions are no bending, no lifting and no twisting - easily remembered by BLT.  Mom mainly had baseline evaluations for both occupational therapy (OT) and physical therapy (PT) today.  She learned a few stretches and exercises during her physical therapy session that she can do on her own to start "waking up" the muscles again.

Mom got her new custom brace today and it is actually pretty comfortable considering it is basically a plastic mold of her torso.  I will try to put a picture up when I get a chance, but it basically looks like a strapless corset with a hole in the front middle part of it. There is a lambs wool type of insert that goes in the chest area of the brace to make it more comfortable. This insert can be replaced by a neoprene insert so that she can wear the brace in the shower.  This brace makes Mom feel a lot more secure and she has less pain with it. She has even taken to wearing it in bed because of the extra support it provides. She isn't required to wear a brace when laying down, but that is her preference for now.

Gramme and Grandaddy (Mom's parents for those of you that don't know) came to visit her in the hospital.  It was a nice visit because Mom was doing particularly well at the time they came to visit.  I think they were surprised to see how well she was doing and what good spirits she is in. It is absolutely remarkable that she is in the condition she is considering it hasn't even been a week since her major surgery.  I had the pleasure of going to dinner with Gramme and Grandaddy after their visit. It was great to be able to catch up and socialize a bit.

I am so glad Mom got into this program because it has been so informative already and she has only received the baseline evaluations so far. I look forward to the knowledge that tomorrow's therapy sessions will bring.

Monday, October 17, 2011

Moving Forward

Today was a day of change in a positive direction.  While Mom still had ups and downs throughout the day, overall she is headed in the right direction, which is something to be very happy about.Mom had a pretty rough night last night because she had a bad reaction to her pain medication at about 3am.  She had severe nausea, was shaking, got really hot and then cold and started sweating. This was likely because she is still on a clear liquid diet and didn't have anything to eat prior to taking the pain pills. The Dr. has since switched her to a soft food diet and she was able to eat with her most recent dose of pain medication, which seemed to help.

Mom was casted for her new brace this morning and she had to stand for 20 minutes which made her completely exhausted!!  She should get her custom brace tomorrow and will start using that full time.
I am happy to report that Mom was approved for the inpatient rehab program.  She will be moved to the rehab floor and will be there for 7-10 days depending on her progress. The rehab doctor (Dr. Rao) came to let us know that she got into the program and Mom talked with him about her frustration that she feels like everything is taking a long time in terms of progress and she feels like she takes one step forward and then five steps back.  Dr. Rao helped to put things in perspective for her and talked to her about managing expectations.  She is expecting much more out of herself than the doctors are expecting.  He said everything she is doing now is in line with what they expect at this point, so she has to cut herself some slack and have some patience.  She also needs to recognize the achievements she has made in such a short amount of time relatively speaking - her surgery was just last Thursday and today is only Monday.  Dr. Rao's "pep talk" helped Mom wrap her head around the fact that she should give her self more than 4 days post surgery to be able to get herself out of bed, bathe herself and do simple tasks that we all seem to take for granted.
The other area of frustration and discomfort continues to be Mom's stomach.  She finally gave in and allowed the doctors to give her stronger stomach medicine (for those of you that don't know, one of Mom's biggest phobias/fears is throwing up, so she was very resistant to taking heavy stomach medicine.)  The stronger meds helped to get things moving and she is feeling better!! She is also have to eat some regular food now, but she will remain on a soft food diet for the time being.

A bed in the rehab unit was available around 3pm.  Mom was transferred via wheel chair to her new room, which was MUCH smaller and more claustrophobic...this did not make Mom a happy camper at first. I've learned that Mom doesn't like change very much because she doesn't know what to expect.  Luckily I was able to help her focus on the positive part of what this portion of the journey will bring and she settled down and started accepting what was to come. 

Once she got to the rehab unit, we met her nurses and the explained a lot about what goes on in this unit.  Mom will have occupational and physical therapy up to 3 or 4 hours a day throughout the day with breaks in between.  The therapy usually takes place between 7am and 4pm and her schedule will vary each day.  The therapy sessions act as stepping stones to get her ready to go home. I think this program will be great for Mom and will also help me to learn about everything she will need once she gets home. 

When moving from the surgical care unit to the rehab unit they have to discharge her from one unit and admit her in the next unit. Because of this, she had to go through the admitting process all over again. I mention this because they had to take her weight for the first time since she was admitted to the hospital a week ago. She stepped on the scale and it said she weighed 15 pounds more than when she was admitted last Monday (Mom said it was OK for me to blog about this in case you were wondering ;)).  She quickly told the nurse that it couldn't possibly be the right weight because she was 15 pounds heavier than a week ago.  She stepped on again and got the same result.  The nurse took the scale from the room, weighed herself and came back to report that the scale is in fact accurate.  Mom was in disbelief and I was racking my brain to come up with reasons why she would weight that much more. I wanted to make her feel better because I could see she was clearly discouraged.  She couldn't believe she weighed that much more after being on a liquid diet for a week.  I personally think there is a lot of water weight involved because her feet are swollen and she's just a bit "puffier" in general.  I also thought that the hardware has to weigh a good amount, but when I looked up about how much it weighs on average, several websites said it probably weighs about 2-3 extra pounds. 
Regardless of her weight, Mom looks much slimmer because her torso is no longer scrunched up.  She is definitely taller after the surgery, which she is very excited about. We noticed that she "grew" when I was standing next to her in the mirror. I think she is taller than I am again, but we still haven't had a chance to take exact measurements.  Every time I am walking behind her, I can't believe that she is the same person that I had just seen scrunched together a week ago. She just looks so much straighter and taller!!  It was hard to know what to expect, but the results look much better than I could have ever imagined...I just never thought she could go back to looking how she did prior to shrinking so much.

Mom didn't have any therapy today because she got to the unit too late in the day. She will begin her therapy tomorrow and she is a little anxious about it, but she's looking forward to the knowledge she will gain.

Sunday, October 16, 2011

A Better Day

I am happy to report that today was a better day overall.  There is still a lot going on with Mom in terms of progressing and healing, but the Dr. said that her labs look good so it is time to start getting her off of IV medications and transitioning her to pill form.  While the IV medications are convenient, the Dr. said the risks and side effects are worse than the benefits of it at this point.  Because the liquid form of the medication is more potent and goes directly into her veins, it has more of an immediate effect, but it also has more of an immediate drop-off in effect once it wears off.  In contrast, the pain pills will provide her with more of a steady dose throughout the dosing period, which will allow for her comfort level to remain more consistent throughout the day.  She should also experience less ups and downs in terms of pain level and emotional reactions to the pain.

Today is the day that I've felt most helpless so far because her main ailment is still her stomach and there is nothing I can do to help her at this point.  Dr. Kim said that she has the "perfect storm" going on with her belly right now because she has Sjogrens, her stomach was actually stretched during the surgery because there is now more room for it again, the narcotics are doing a number on it, she has acid reflux and nothing is really moving around in there.  This obviously creates a lot of discomfort (her stomach is very distended) and unfortunately it is just a matter of time before she will feel better. The nurses and doctors are doing everything they can at this point to try to relieve the pain and get things moving again, but her body seems to be taking it's own sweet time to adjust to and recover from all it has been through in the past week.  Unfortunately, I think this may be something that has to resolve itself :(.

Mom got completely "unhooked" from all of the remaining lines she was connected to.  They removed her IV fluids and medicine in addition to the drain in her back.  The drain was collecting more fluid than blood, which was a good thing, so Dr. Pashman removed it (it was sutured in) and redressed her wound.  He also ripped off about half of the Steri-strips from her incision - Mom didn't like this at all (I can't blame her) and she still had some residual burning later in the day from where he removed the Steri-strips.

The best part of the day (in terms of progress) was that Mom was able to get up out of bed to brush her teeth, walk around and sit in a chair.  She got up a total of three times to walk, which is absolutely fantastic.  She was particularly motivated and determined on her third walk of the day. I kept asking her what her goal was and she kept picking longer goals along the way. First it was to the first exit sign, then it was around to the other side (the floor is set up in somewhat of a circle with nursing stations in the middle), then it was one exit sign after another until we finally completed a whole loop around the floor. To say I was impressed is an understatement! Mom continues to surprise me with her strength and determination.  I knew she would be able to do it, but I didn't expect to see her this strong this soon after her surgery.  While this is really great progress, she is trying to get into the rehab program at the hospital that will provide three hours of inpatient physical therapy every day for seven to ten days.  This physical therapy should expedite the healing process and will literally get her up and going much sooner.  Obviously, this program would be a great benefit to her, but she has to qualify and the pain management doctor said that if she is doing too well, then she won't qualify for the program through the insurance company.  She basically suggested that Mom should do the bare minimum so that the physical therapists reports don't show her doing too well for the program, so that is our plan from now on.

It was also a better day because Mom got to Skype with Wes, Jenn, Zack, Carson & Levi (their new dog) and Blake and Nicole came to visit.  It was nice to have visitors from near and far.  Mom's mood was quite upbeat and I loved to see her beautiful smile return to her face.  I was lucky enough to have the evening off (thanks for covering Dad :)), so I went to see Moneyball with Blake and Nicole and then we had a nice dinner out.  This was a nice break for me, but my thoughts were still with Mom and I checked in with Dad as soon as the movie was over.  Mom was doing well in the evening, so I had Blake drop me back off at my hotel where I have just finished packing up (my time at the hotel has come to an end - next I will be commuting from Pasadena) and will hopefully get a good night sleep.

Please continue to keep Mom in your thoughts and prayers as each day still seems to have plenty of ups and downs.

Saturday, October 15, 2011

Transitions

Mom experienced a lot of transitions today.  The transitions varied from changes in mood to a change in location.

The first notable transition of the day was the change in her overall mood.  She was still in a lot of pain and complained a lot about her stomach today, but we noticed a small smirk hear and there and by the end of the day she was even joking around a little bit. The joking is very limited because it is too painful for her to laugh.  She is extremely funny while under the influence of morphine, so I have to hold my laughter back as well so she won't laugh. I will often look away or stand behind her bed so she can't see me when I need to have a little laugh about what she is saying.

They also changed her dressing today. One of the surgeons (Dr. Kim) came in to check how she is doing and he changed her back dressing.  There was a ton of tape on it and removing it was the most painful part for mom because her muscles and skin are so sensitive from being manipulated for over 7 hours during her surgery.  I took a peak at her incision while the dressing was off and it looked much better than I had anticipated. She has a drain for excess fluid, so the incision wasn't oozing like I had anticipated it might be.  Her incision is about 12 inches long (I will measure it later when it has had a chance to heal - I have to know exact measurements...it's the accountant in me ;)) and it is very straight, which it should be, but I was a bit surprised since I'm not used to seeing anything straight on Mom's back.  The other neat thing is that her "hump" is gone.  For those of you that have seen Mom sometime over the past couple of years, you probably noticed a prominent "hump" as I lovingly referred to it on the left side of her mid-back.  This was her spine and muscle that had built around it. For some reason I didn't expect it to be completely gone, but that is a great thing!  She also has an arch in the lumbar area of her back - again, not something I am used to seeing at all. I'm sure there is swelling and such, so things may look different after she heals completely, but so far I think her back looks absolutely great and I am excited about the positive effects this huge transformation will have on her life.

They took Mom's central line out today and transitioned her to a "normal" IV in the arm. They had trouble finding a good vein, but they finally found one that will do.  

Mom transitioned from the bed to a nearby chair. She wasn't able to go far simply because she was limited by all of the lines she was attached to.  She claims she could have walked a longer distance today, but I think that may have been her medicine talking ;).  I know that she has the determination to walk a further distance if allowed, but for now it was a great accomplishment for her to sit in a chair where she remained for 2 plus hours.

The next transition had to do with her pain medication.  She has been on a constant drip of Morphine plus she had the option of giving herself and extra dose of Morphine by pushing her button.  Today they transitioned her to not having the constant drip anymore and just having the ability to push the button when she needs some pain medication. She can push the button every 8 minutes.  When she is in pain, she will push the button and then about 30 seconds later she asks me if it's been 8 minutes yet.  We are trying to get her to push the button on more of a routine basis so that she doesn't allow herself to get into too much pain as it is difficult for her to become comfortable again once she passes a certain pain threshold.  She doesn't like pushing the button because she doesn't like to be "out of it", it knocks her out when she wants to be talking to us, and she thinks it's adding to her stomach problems.  We are able to get her to push the button by saying that we will leave if she doesn't go to sleep - something we have to do because it is in her best interest to get some rest. She seems to be very fearful of us not being there when she wakes up and of us not returning when we go to lunch or back to the hotel for the night.  I'm thinking this might be the medicine talking, but I know it's not easy to be in a foreign place in pain without loved ones around so we try out best to be there with her the majority of the day. 

The last notable transition for the day was graduating from the ICU and being moved to "the floor" as they call it in hospital lingo.  Dr. Kim approved the move early in the day, but there wasn't a bed available until around 8:30pm.  Her new room is a gorgeous room with a nice sitting area for visitors (and Mom once she gets up and moving more).  The room is one of the biggest rooms they have at the hospital and they call it their celebrity room...so now Mom is a celebrity :). I like having her on the floor much more than in the ICU for obvious reasons, but also because she has a lot less cords and lines attached to her which makes her look a lot less sickly.  We aren't sure how long she'll be in the hospital, but prior to surgery the Dr. estimated that she would be in until about Wednesday or Thursday. 

Tomorrow is a new day and I'm looking forward to the progress that Mom will make. Let's hope her stomach is feeling better by tomorrow as that is causing her the greatest amount of pain right now.  I feel that if she could get the stomach pain under control then she could better focus on the tasks that need to be performed in order for her back to start healing. Thank you to everyone for your continued thoughts and prayers...I know the support is really helping Mom get through all of the tough times she is facing.

Friday, October 14, 2011

Quick Update: Day 1 Post-op

I'm just now getting back to the hotel after a long day with Mom and Dad in the ICU.  I know everyone is curious as to how her first day after surgery went, so I wanted to give a quick update.  It will be quick because I promised Mom we would show up early tomorrow after she told me and Dad "Don't leave me before my longest night ever."  Talk about giving us a guilt trip!! We can't spend the night with her in the ICU, so we didn't have any other choice but to leave.

Mom looked much better today (more color in her face), but she seemed to have a lot of pain all over her body.  She has a lot of stomach pain and nausea, headache and her left foot is swollen, hot and painful.  The doctor checked her feet late in the day and said that the left one has extra blood flowing through it, not something he usually sees.  He said the right one was the "normal" one (it was ice cold, but that is to be expected post surgery.)  He didn't seem too concerned and just told her to keep moving her left foot to avoid blood clots in the legs (this is in addition to having the leg cuffs on.)  Her back is the least of her pain complaints, which is surprising to me. The only time she complains about her back is when she is moved.  She has to be shifted into different positions throughout the day so she doesn't get too stiff and because movement is the best thing for her healing at this point. 

The milestone for today was that she stood up next to her bed.  She had the help of the physical therapist in addition to Dad and myself.  Upon standing, her blood pressure dropped and she felt dizzy, so she didn't do any walking today. She couldn't really walk far anyway because she is hooked up to so many things right now (oxygen, central line, IV, vital monitor, wound drain, etc...)  She sat back down and eventually got back to a comfortable position after the nurses shifted her all around and she yelped in pain. I must admit, the nurse she had today (Jason again) was very agressive when moving her. I realize he does this all the time, but every patient has different needs and Mom likes to take things slowly. Jason was a "mover and a shaker" as Mom referred to him and did things really fast.  Once the new nurses arrived for the night shift, Mom was like a different person when being shifted around.  I didn't even hear a peep from her when they were moving her and she kept thanking them profusely and telling them how nice they are and how Jason just didn't understand. It was kind of funny if you ask me :). These nurses made me feel much better about leaving her for the night because I think they will take good care of her.

Mom was supposed to be casted for a new back brace today, but that didn't end up happening for some reason (not really sure why.)  Nothing is really clear around here and each day is an adventure where we learn about things as we go. 

Mom had to get a blood transfusion today also.  Her hemoglobin was low, so they gave her one unit of blood this afternoon.  They were just about to give her another unit of blood when Dad and I were leaving tonight. It is expected that she won't need anymore after that.

I think I covered the major issues of the day, but I will try to update with more details if I have some time tomorrow.  Today was Mom's toughest day yet, but I am confident that all of the "lemons" being tossed her way will get less and less sour and will eventually turn to the lemonade that we are all hoping for!!

Let's hope for a better day tomorrow!!!!!

Thursday, October 13, 2011

What a Day!!!

Nothing could have prepared me for the waiting and emotional demands that today required.  I am happy that this day has finally come and will soon be over!  Dad and I waited in the waiting area from the beginning of the surgery, which started at 7:15am, and didn't hear word from the OR until around 2:30.  I was able to go to lunch with Nicole (Blake's girlfriend) and her Mom and sister as they were in the area.  This was a wonderful distraction as my anxiety seemed to be building quickly while sitting in the waiting area.  Mom went to recovery at 2:45pm and I was able to see her around 4pm.  I went to see her in recovery because Dad went to get some fresh air (and some time away from the somewhat annoying volunteers.) Later, I found out that he had actually fallen asleep on a bench outside.  I'm glad he got to catch a few Z's at least ;).  I visited with her in recovery for about 15 minutes and then they sent me away so they could get her over to the ICU building.  I didn't tell her this when I saw her, but she did look like a truck had hit her.  My heart shed a tear when I saw her, but my mind and words were very strong and positive for her. She had many complaints about pain, but said her head didn't hurt, which I hope is still true. I'm not sure if the back pain is so intense that she doesn't feel the head pain anymore or if she really doesn't have a headache. I guess we will find out soon enough.

The main surgeon (Dr. Pashman) said the surgery went well. Dad went to have lunch at a cafe in the hospital after hearing from the Dr. and coincidentally he ran into Dr. Pashman and his team in the restaurant.  The Dr. called Dad over after he had lunch and the whole team agreed that the surgery went as smooth as possible, which was very reassuring to hear. Additionally, he had the post-op x-rays with him and showed Dad the images.  Dad said there is a ton of hardware in her back and it looks like she has a zipper for a spine now.  Dr. Pashman said they had managed to take her curve from 60 degrees down to 15 degrees. 

Blake came to visit this afternoon after Mom made it to the ICU.  Blake, Dad and I were all able to visit Mom in the ICU for about a half hour.  Mom was looking much better than she did in the recovery area, but still looked miserable nonetheless.  She was chit chatting a lot about random things that I know she won't remember, but she provided a lot of comic relief for us as visitors, so that was kind of nice.  She didn't want us to leave, but I told her that Jason (her nurse) would take great care of her.  She made me promise that he would, so I did and then she was ok with us leaving. 

Dad and I are completely exhausted from the day.  We are going to get some dinner with Blake and Nicole and then come back to rest so we can be prepared for the days to come.  Mom should be moved from the ICU to a regular room sometime tomorrow. Dad and I plan to visit her tomorrow morning and I will try to update you with how she is doing when I get a chance.  It seems that the days go by painfully slow, but very fast when it comes to trying to update everyone. I appreciate everyone's concern, support and especially patience when waiting for updates!!


Wednesday, October 12, 2011

Progress...

Progress can be measured in many ways and today's progress was small, but progress nonetheless.  The first sign of progress was seen in Mom's face when I first walked into her room this morning.  Her face lit up just a little bit and there was a slight smile on her face.  There weren't any tears, which is a big improvement from yesterday when she was crying at the drop of a hat. I think the crying had a lot to do with the intense amount of pain and the pain medication.  Another step in the right direction was that her severe shaking/shivering from the pain had subsided. This happened a lot yesterday in combination with the crying.

The first thing I told her was that she looks much better today and her response was that she doesn't feel better :(. The headache was still very strong and bothersome.  Two of her surgeons came in shortly after my arrival and discussed their plan for surgery tomorrow.  They will take her in for surgery around 6:30am and the actual surgery is schedule for 7:15am.   They will use "nifty tools" to move her spine around and put some nice "hardware" in there.  They talked with a lot of confidence, which made me feel pretty good about the situation. The surgeons also mentioned that it would benefit her a great deal if she was able to get up and do some walking today in addition to doing the breathing exercises she had been assigned.  They said that they do these surgeries every week, but they recognize she doesn't have the surgery every week so they will talk her through it afterwards and make sure she is comfortable when recovering. To make sure she is as comfortable as possible, she will go to the ICU after surgery where she will have her own nurse that can tend to her in more of a timely manner than the nurses that have more than one patient. Dr. Pashman's parting words were: "You'll wake up and feel like you were hit by a truck, but the nurses will take good care of you and you'll be glad we did this."  Not sure those were the words she really needed or wanted to hear, but at least he was honest I guess.

Some more progress came in the form of Mom feeling up to working with physical therapy (PT) early in the morning. Rather than putting walking off time after time, she actually wanted to get up and moving earlier in the day, which I view to be a great sign.  She had a great physical therapist today that really made her feel comfortable and taught me some more about getting Mom's brace on and the best ways to help her out of bed.  Mom graduated to walking in the hallway today, which was another bright spot of progress.  She set a goal to walk to the "quiet sign", which is a sign to let you know you should be quiet in a particular area because they may be counting medication.  This sign is about 25 feet from her room, so she was able to walk about 50 feet in total.  She is currently being assisted by a walker, mainly because she is on pain medication and they want her to have balance in case she gets dizzy. The physical therapist and her nurses were so surprised at how well she is walking.  She looks much better and is more talkative when she is up and walking, which is something I really like to see!! 

Yesterday Mom was given a device called Triflo that she has to use for breathing exercises for her lungs so she avoids getting pneumonia. She has to inhale through the device, which causes three different balls to raise up depending on how much she inhales.  Yesterday she had difficulty to get all three balls to raise up, which is the ultimate goal.  Today she was able to get all three to raise in less tries...she was even inhaling a bunch of times in a row as if to show off. I had to slow her down so she wouldn't get light headed.  This is yet another sign of progress that I was very pleased to see. 

The most promising sign of progress came late in the evening when Mom actually asked to get up and walk.  I thought it was great that she took the initiative to ask if she could do some walking.  I was able to get her up and walking (which is surprisingly somewhat of a complicated and time consuming activity considering the task at hand). We went out to the hallway and Dad and I asked her what her goal was.  She said "the exit sign", which was about 50 feet away.  In unison, Dad and I both said "Are you sure, that seems a bit far" - especially since she had just received another dose of Morphine and the nurse had warned her of dizziness.  We suggested she go to the "quiet sign" again, which was about half the distance to the exit sign.  She did not respond and just started walking. As we approached the quiet sign, I asked if she wanted to turn around and her response was "I said the exit sign!"  I liked to hear the strength in her voice, so I just let her keep going. I was most concerned that she would tire out before we could get her back to her room, but she proved herself by completing her ambitious goal without even a hint of slowing down.

Dad and I got her all set up and ready for bed.  She didn't want to go to sleep, but she didn't really have a choice since the Morphine started to kick in quite nicely :).  As I said goodbye, she said "exit sign" and I just told her that I am so proud of her progress today, to which she responded "I walked to the exit sign." She was definitely very out of it, but I'm glad that she is able to recognize her great accomplishments.  The last words she said were: "I am afraid of the Monster trucks tomorrow", which was in direct reference to what the surgeon had said earlier. I think she chose Monster trucks as the ones to "hit" her tomorrow because she associates them with her wonderful grandchildren, Zack and Carson.  I assured her that I would take good care of her after the Monster trucks hit her, to which she responded with a slight smirk and then she was out cold.

The thing I admire so much about Mom is that when she is told that something will help her in her recovery (such as walking or using the breathing device), she is bound and determined to do it to the best of her ability considering her conditions and she has a great attitude about accomplishing each task assigned to her.   Unfortunately, tomorrow will be somewhat of a step backwards, but I am confident that her positive attitude and determination to heal will help her immensely to progress in her next stage of recovery.

Thank you again for all of your wonderful comments and words of encouragement for Mom and the rest of us helping her out.  The kind words help both me and Mom as we approach each challenge in this journey. Please continue the thoughts and prayers as Mom goes into surgery tomorrow.  I know tomorrow will be an emotionally challenging day for all of Mom's loved ones.  I better get some rest so I can face each challenge with as much strength as possible!! 

Tuesday, October 11, 2011

Baby Steps...

Mom was able to get out of bed and literally take some baby steps today. I am very proud of her because she has been in a tremendous amount of pain all day due to her headache and kept on telling the physical therapist that she couldn't move. For Mom, this means she is in so much pain that she doesn't want to move, but every time Mom said she couldn't move, the physical therapist said "Ok, I'll come back later."  I had to talk to Mom to let her know that she would benefit from at least sitting up in bed.  She got her positive mental attitude ready and the next time they came in she said she would try to sit up.  I felt like this was a small victory, but after sitting her up, they asked if she wanted to walk a little and to my surprise she said "yes"!!!! Another small victory.  She was able to shuffle along a little and eventually sat in a chair in the room. She was going to stay in the chair for about 45 minutes, but upon sitting, she immediately dozed off because they had given her extra pain medication to ease the pain while they sat her up.  Figuring she would be better off in bed, the physical therapist and I helped her back to bed and I learned how to take her back brace off (which was originally put on prior to her sitting up.)  She should be getting out of bed and sitting in a chair a couple times a day until her next surgery (at which point I would imagine we will have to build up to sitting, standing and walking again.) She looked much better after moving around a little bit - I think she was getting stiff in bed, so this seemed to benefit her more than I even thought it would.  I think it also helped her to sleep a little better because she has been asleep for almost an hour and a half, which is the longest stretch of time she has been able to stay asleep all day!

On a side note, the physical therapist says she has a great log roll (rolling your neck, back and legs all at the same time) and her response was "it's because I do Pilates 5 days a week!"  I'm glad to know that all of her hard work prior to surgery is paying off already!!

Overall, Mom had a great attitude about her first walking experience and I am very proud of the progress she made with her baby steps today. 

A New Day

Today is a new day with it's own set of issues and challenges for Mom.  Dad and I left her last night around 9pm in the hands of a nurse that we really liked and were comfortable with.  We came back at 7:30 this morning to find Mom in a tremendous amount of pain due to her headache. She said she had an awful night because they had to wake her up every two hours to check her vital signs. We got her some new refillable ice packs from CVS last night and I quickly filled them upon our arrival this morning. These seem to be doing a good job, although she still likes my glove ice packs also :).  After some encouraging, Mom agreed to push the button for extra doses of the pain medication.  After 3 pushes of the button over a period of about an hour and a half, she was feeling much better and proceeded to enter a deep sleep.  Mom is also having rib pain when she breathes deeply, which is obviously no fun.  She has a cut mouth and bruised and swollen lip from where they intubated her - I think her mouth was really dry when they took it out, which caused the cut.  All of these factors are adding to her discomfort and are items we are trying to address so she can feel better as soon as possible.

Today she will have to get out of bed and walk for the first time since her surgery.  The mere thought of it sends her into a crying state, so we are going to try a bit later after she gets some rest (she is sleeping as I write this.) 

I was able to get some rest last night and I'm ready to help Mom with all of the challenges ahead of her today.  Here is hoping for a glass of lemonade by the end of the day!!

I'll try to update later this afternoon.  Thank you to everyone for your continuous love and support. I have read your comments to Mom and she really appreciates everyone who is behind her during this challenging journey!!

Monday, October 10, 2011

Ice Pack

Mom has been wanting ice packs for her head and neck because they help to numb the pain a little bit. Well, the ice packs they provide are the puny little "pop-able" ice packs that stay cold for all of two seconds. Eventually my hands were colder than the ice packs from holding the cup of ice chips for so long. Mom kept grabbing my cold hand and putting it on her forehead...and I could feel the throbbing!!! Poor Mom!! I decided to get creative and I made my own ice pack for her. I scouted out where the ice machine was, filled a bucket and transferred the ice to a glove and tied it off like a water balloon (see below.) This was MUCH colder than the aforementioned poor excuse for an ice pack and it enabled me to have my hand back ;). I thought this type of ice pack was pretty appropriate considering halloween is right around the corner ;). The bonus is that I can get her an ice pack whenever she wants and we don't have to wait for the nurse to bring them anymore! Now everyone seems to be a lot happier - mission accomplished :)!

Pain, Pain Go Away!!!

Pain is yet another necessary evil in this journey to a healthier back. After recovery, Dad and I met mom in her private hospital room. As she entered, I could tell she was in pretty bad condition. She was obviously still very out of it from the "sleepy cocktail", but I could tell by the look on her face that she was in a lot of pain. Surprisingly, her biggest complaints were about the pain in her joints, her horrible headache and having an extremely dry mouth. All of these symptoms are consistent with the symptoms of Sjogren's Disease that have flared up since she went off of her pain medications two weeks ago. I was able to feed her some ice chips (Blake would appreciate the kind of ice they have here - crunchy pellets :)) and that seemed to help her dry mouth ever so slightly. As the nurses got Mom settled into her room, Dad and I went downstairs for a quick bite to eat, which helped my energy level. I think my nerves from waiting were suppressing my appetite!! When I got back up to the room, they still hadn't given Mom the pain medications the Dr. had ordered. She is on Diladin, which is a very potent form of Morphin, so we are hoping that will help the pain. Right before they were able to give her a dose of Diladin, she said her pain at the surgical site (her abdomen - right below her belly button) had increased a lot and the surrounding muscles were starting to ache as well. Another painful area is the lumbar part of her back because the Dr. said he "cranked the curve in her back." We believe this translates to creating a curve in her lower back...this needed to be done because Mom previously had a flat lower back and lacked the arch that most people have. In her dazed state, Mom tells me that they gave her a "J. Lo booty"...this definitely gave me a good laugh!! :). They finally gave her a dose of Diladin through her IV, but she is still in a lot of pain and we are waiting for a machine to administer the pain medication continuously. WIth this machine, she will also have the option of pressing a button to give her additional pain medication. She also has an ice pack for her head and neck, but it doesn't seem to be doing nearly enough for the pain. We are hopefuly the medication will come soon and relief will follow. Mom has enjoyed some lemon italian ice (which she really loved - surprise, surprise ;)) and now she is in and out of resting. Thank you to everyone for your kind comments, words of encouragement and support through this difficult time for Mom. I have passed on your well wishes to her and she appreciates them more than you know! We need to keep the positive flow of energy going as she has already expressed that she is dreading her surgery on Thursday. My heart goes out to her, and I just wish I could do more to alleviate the pain she has to endure!!!

Recovery

We got word from the Dr. that everything went well. Mom is currently in recovery and will be there for the next 40 minutes. Then she will be taken to her room where she will stay until her next surgery on Thursday. That is all I have to report for now, but I like to think that no major news is good news :)....

Waiting.....

Waiting is one of the hardest things to do, especially when you know a loved one is away being prepped for surgery!! Nonetheless, waiting is a necessary evil right now, so I better gain some patience quickly!!! This morning has gone relatively smoothly so far. We were up at 4:45am, got to Cedars-Sinai around 5:30 and waited to be called. Once called to admissions we waited in another waiting room. Then Mom gave all her insurance and other information and received her wristband. Then we went up to the 8th floor where Dad and I said a temporary goodbye as Mom went off to be prepped for surgery. Some more waiting ensued and after about an hour Dad and I got to go back to where a bunch of patients were prepped for surgery and say one last "goodbye for now". Mom shed some tears, but, as usual, she fought hard to hold the tears back as the anesthesiologist asked "are you ready for the cocktail?" A quick kiss on the cheek from Dad and me and away we went...to wait...and wait...and wait! This surgery is supposed to be about one and a half to two hours in length and it started around 7:30am. We met the nurse that will be in surgery with Mom and she said she will be the one to update us throughout the procedure, so I will let you know when I know more. Until then, please keep the positive thoughts and prayers flowing!!!

Thursday, October 6, 2011

Anticipation

I just wanted to give a quick update because many people have been wondering how Mom is doing as the surgeries approach.  In a nutshell, I would say she is doing as well as expected considering the circumstances. She continues to shine her bright smile and positive attitude to all those surrounding her, but I am in the unique position to see all the feelings that lie beneath her strength.

As you can probably imagine, Mom's anticipation about her surgery has been building exponentially over the past week.  This obviously makes it difficult for her to concentrate on much of anything, but what makes the time prior to surgery even worse are the headaches!!  After going off of her pain medications that she had relied upon for two years, she is now experiencing horrible withdrawal symptoms, the worst of which are severe headaches.  She is also experiencing pain in other parts of her body (joints and previously injured foot) because the pain medications were helping these areas more than she even realized they were.  We think the joint pain is due to her Sjogren's disease that she was diagnosed with earlier this year. This is the same disease that caused Venus Williams to withdrawal from the US Open just last month.  Mom is allowed to take Tylenol, which, as you can imagine, doesn't do too much for the pain when compared to her previous medications, but nonetheless it does help to take the edge off.  Heating pads and ice have also helped to reduce the amount of pain and to relax her muscles.  At this point, she is just ready to have the surgery and get it over with.

Mom and I are still in Paso Robles (I drove up from LA on Sunday to be with her) and we will be heading down to Pasadena on Saturday morning.  We will get settled into Dad's apartment and try our best to relax on Saturday.  Sunday evening we will head to a hotel near Cedars-Sinai because Mom's first surgery is on Monday (10/10) and she has to be there at 5:30am.

I will be sure to update you with how things go on Monday if I don't post sooner.  Thank you to everyone for your support, well wishes and encouragement!

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