When I arrived this morning at 8:45, Michele was sleeping soundly. She woke up a little later and was very stiff and it looked as though she had spit up on the sheet to her right side. Shannon came in at that point, so we changed Michele's clothes and got her all freshened up. Donna and Shelly (PT) told Michele that they were going to put her into her chair with the standing lift (they had a special name for it, but I don't remember what it was called.) Michele didn't like that one bit, but we pressed forward. They strapped the belt around her waist, and lifted her up to a standing position with the machine. Then, they pivoted her and sat her down in her chair.
Niki came in to give Michele her morning "cocktail"" of meds, which as of last night no longer includes Robitussin, the brucella antibiotic, one of the stimulants and the folic acid. She's still on the anti-seizure meds, and John wants to keep her on them since she is doing so well. Don't want to take a step back. While in the chair, Michele began rubbing her left temple and pinching the upper part of her nose - like she had sinus pain. Niki gave her Tylenol with codeine, and PT began in front on Michele's mirror at her sink.
While sitting there, Michele put her fingers up to her trach hole and was looking at it. Shelly told her that it is healing up really well. Shelly had her brush her teeth, brush her hair, put deodorant on, and put chapstick on. Michele was having a hard time unclenching her right hand. She can do it - Shelly was just new to Michele's situation, I think.
Donna mentioned to me that Michele doesn't always get up for afternoon PT in her chair, and that in order for us to get to the next stage and get her to Craig, she needs to tolerate more chair time. I told Michele that in order for her to reach our goal, moving to her chair twice per day is so important. She promised me she'd do it, but Caregivers, please help Michele with this process in the afternoon. While sometimes she might be super sick (where you might want to cut her some slack) most of the time she can certainly tolerate it. John is going to talk to the staff about not asking Michele in the afternoon, but telling her that it's time to move to her chair. I know this seems harsh, but it's the only way we're going to get her progressing steps closer to getting home. It's much easier to lie in bed, but she has definitely proven that she can work . . . read on .
We went to the PT room and Michele sat on the side of the bed near the bars, facing them. Shelly was trying to physically open up Michele's right hand, but Michele was frustrated by this. I told Michele to just relax and stretch out her fingers like she always does, and this amazing person stretched out her fingers on her own, beautifully. Shelly was amazed and said that this was "active" use of the hand and not just relaxation. Michele was also proud of herself.
Her feet were nice and flat on the floor, and we got her all prepped to stand up while holding the bar. Of course, I didn't have my camera this time, but let me tell you, it is so amazing to see her stand! I know how much muscle strength it takes her to accomplish this, and even though she shakes just a little, she pushes through it. (Heather from Kindred would be so proud!!) Donna and Shelly were supporting her, so I got in front of her - eye to eye - and reminded her of our goal. She nodded her head "yes" and I told her that this is how we were going to get there.
Then, she sat down and Shelly asked her to support herself on the bed with her hands. Shelly moved away from Michele, and Michele supported herself in a seated position for a FULL 5 MINUTES while we talked about her and John, among other things. I was right in front of her again, just watching how she used her core strength to keep herself balanced. She would often self-correct and lift up her head and body so she was sitting up straight. It was quite amazing to see. I said, "see how I told you that you can do this" and she gave me some "Michele attitude" back, like "yeah, yeah, yeah." Priceless.
She stood up once more, and then she was back in her chair. She was using her legs to push herself back into her chair, so she is definitely gaining muscle strength. By then it was 10:00 - just in time for Price is Right, so we zoomed back to her room to get us there in time! JShe asked for her eye patch, and at 10:30 asked for her nebulizer treatment. That girl knows her schedule! We called the nurse in at 10:45 (as I had to leave) so we could get things in motion to get her back to her bed. Since I was on a time crunch, I put the call button and the bucket next to her in case she needed them and told them to push the button again if they weren't in there in 5 minutes. John was coming to take her to her appointment this afternoon. She did SOOOOO well today.
Thursday
I had a great morning with Michele. She worked VERY hard today! Donna and Sonja came in at 9:15 and moved her to her chair - without the board. Michele put her feet on the floor for a few moments to aide in the pivot and transfer. We got to the PT room where Carla joined us - it was a big group effort today!
Michele sat unassisted for a bit . . . what a great accomplishment! (see the first picture - that's Donna behind her trying to get out of the way while I snapped the photo - Michele is supporting herself on her own!). She also put deodorant on for herself (after saying "deodorant" and removing the cap herself), brushed her own teeth, brushed her own hair, washed her own face, and put chapstick on. With each of these tasks, she had to say the word . . . like brush, or chapstick before she used the item. She did REALLY well. You can see her grimacing in some of these photos since she was obviously working hard! (Amy her nails look FABULOUS in the pic of her putting the cap back on her chapstick) - that takes a lot of dexterity and she did it with ease! Sonja thought that in the next week or so they could try doing these things by her sink in her room so that she'd have her mirror and all of her supplies in front of her.
Carla fed Michele some thickened water from a spoon and also had her try some vanilla pudding. She didn't like the taste of that, but was able to FEED HERSELF NUMEROUS TIMES! It was amazing to see the control she had as she lifted the spoon into her mouth. Absolutely incredible. I told her that soon we could go across the street to that Gelato shop! JCarla is working on getting the swallow test scheduled for next week. She's ready.
We were all amazed by the progress she has made in just the last few weeks! After the session, Michele and I headed back to her room to get our sunglasses before going outside. Tracey came over for a surprise visit, so the three of us headed outside to soak in some sun. Michele took her sunglasses out of her case and put them on herself! The three of us were out there 'til 11, and then Michele got to bed at 11:15, got some Tylenol with C at 11:30 (said her head was hurting) and I put her boots on shortly after. She's looking really good, and the two of us made a secret agreement that she'd be walking by the end of November. She said she thought she could do it by then . . . I have no doubt!
Friday
Without a doubt, Michele is on a completely new track. When I walked in at 2:55 today, I pointed at the clock and she pointed at the clock with a huge smile. It's Dr. Phil time! Before I turned on the show I reminded her of our "walk by the end of November" goal. She smiled and nodded her head. I reminded her how much her muscles had atrophied, so we decided to put together a workout plan for my visit. During each commercial of Dr. Phil and more than half of Oprah, we did leg exercises. Not much at a time, just 5 sets on each leg each time, but she did it! She would lift each leg and touch my hand with her foot. (See the picture of her workout move, attached). She is much stronger with her left leg than she is with her right. Then, I had her bend her knee and straighten her leg as she pushed her foot against my hand. She's got a lot of strength. She's also got a very strong will, so with this goal in mind, I know she's going to work hard.
Kenzie called and she talked to her on speaker, and Mom called and she spoke to her by holding the phone up to her own ear. She said very clear words to both of her callers. Mid-Oprah, Donna (RN) came in to change out Michele's food. Donna was getting ready to leave and Michele looked over at her and said something to her. I said, "Donna, Michele wanted to tell you something." Michele started waving her hands and making lots of noises. I was getting ready for the frustrating game of trying to figure out what she wanted but that didn't happen. Donna asked her if she wanted Tylenol, and Michele shook her head no. I asked her if she was in pain, and she shook her head no. She was pointing to her mouth and I said, "Oh, is it time for your nebulizer treatment?" She said yes! It was a great accomplishment for us to figure this out so quickly. Donna told Michele that she could have more than 2 treatments per day if she wanted to . . . good to know.
There was a portable toilet in the room but Michele said she hadn't used it. Perhaps they are getting ready to start working with that. I had Michele try and work the remote . . . she pushed channel 5 with the greatest of ease (that's The Price is Right and Dr. Phil!!) Funny!
When I was getting ready to leave I asked her if she knew if John was coming tonight. She shrugged her shoulder so I decided to call him and put him on speaker. As soon as he started talking, she got a huge smile on her face. He asked her if she wanted him to bring her earrings to wear so her holes wouldn't close up. She said, loud and clear, "no". I said she'd be home soon enough and she could wear all of her jewelry. JI left shortly after 5 and she wanted to listen to her music.
She is going home for the day on Sunday again. If you are coming by next week and want to drop off some bagged candy, the Manor is having trick-or-treating for kids, and the residents are giving out the candy. You can just leave a bag or two at the front desk.
Love,
C
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