Start of Intense Therapy

Today was Karen's first full day(3 hours) of acute physical and occupational therapy. The therapists appear to be tough taskmasters, but this is the only way she can expect to regain the use of her legs. Without going into a lot of detail, suffice to say the blood clots in her legs cause any motions to be quite painful. If sufficient progress, as measured by Medicare, isn't made, it will probably result in a forced exit from the acute therapy wing in the hospital. She knows she will have to gut her way through these sessions, but it will be difficult.

There is no longer any concern with her kidney function nor any infections. Her speech is returning to normal with occasional lapses into confusion. Breathing therapy may be discontinued sometime this week. She will remain on oxygen 24/7 for the rest of her life. She will undoubtedly be taking cumadin or other blood thinner for the rest of her life also. The three blood clot occurrences in the last 3 years make that decision an easy one. Her blood will have to be checked routinely to insure it remains at the proper coagulant level.

She isn't too enthralled with hospital food. It's too dry, and she doesn't want to eat much of what they put before her. I am into bringing her food I know she likes and which meets the restrictions imposed by her doctors and dietician. Everything has to be sugar free and easily digested.

She is still unable to stand and hasn't walked since five weeks ago as today is her fifth week "anniversary" of being admitted into the hospital. She longs to come home, but knows it will take a lot of effort to get to that point.

As she still has many things going on in her days, I would continue to ask that no calls or visits with her be made until I advise everyone that she can take calls and have visitors.

Both Karen and I thank everyone for the cards, letters, thoughts, and prayers which have been so forthcoming from our friends and relatives. We know prayer has helped her to this point, and we ask for it to continue as she faces the battle of her life to return to the kind of lifestyle she wants and deserves.

I'll continue to keep you posted through this blog. Katie will probably do so as well. Please feel free to pass on the link to anyone interested in Karen's progress.

Love, Bill

Nothing New

As she had a free day today... nothing new to report therapy wise. She was a little crabby throughout the day but as she really only gets cat naps that is perfectly understandable. She's just tired... hopefully she'll sleep a little better tonight.

Free Day

Today is a free day for mom -- no PT today. She's pretty happy about that! She's doing ok today. They are continuing the heparin along with the cumadin. Once the cumadin level gets to the right point they will stop the heparin which will be good. She may even be ready for short visits with visitors. Dad will let you know.
Dad got some rest the last two days... and we were able to get him to the movies and out to dinner. The other kids will appreciate this -- we cleaned out the freezer and found food from 2005!
We head back to Tucson today after the TV repair man comes out.

Week's End

As promised... PT really started pushing her to do more. She was sound asleep by 8pm tonight -- they really wore her out. But that's good news for the long run. She's going to have a rough couple of weeks as her legs are so sore... and she still has some dizziness but she needs to push through it during PT so we can get her home.

Better Morning

The assessment of her headache and dizziness is inner ear damage by the anti-biotics. The good news is it's treatable... the bad news is the way they treat it is by getting her up and moving her around. Basically her brain needs to re-learn to function and the dizziness will go away.
The doctors all met and have decided to keep her on the acute PT floor. Medicare is giving her until the 9th to show some improvement or they will force her to move to another nursing home type facility. So the PT staff is really going to start pushing her beyond her comfort level to try to get some improvement.
She remains on heparin and cumadin -- and will most likely be on it now the rest of her life. They are watching the levels very carefully.
She is actually doing better today than yesterday. The headache and dizziness is a little less, she got some sleep and ate all of her breakfast. She also a little less altered... so all in all a pretty good morning.
Dad really appreciates the support he's received from all of you and is grateful you are reading this blog. It is helping him to not get calls -- as it's allowing him to rest when he's home.

CT Scan results

Mom had a CT to see if anything in her brain was causing the head pain and dizziness. Good news -- all clear. Still no definitive answer on why the pain... checking meds. They are doing a test in the morning for a type of vertigo.
Bill

New Problem

Just saw mom as we came to Surprise for a couple of days. She is now experiencing dizziness and head pain. The doctors believe it to be a side effect of some medication but they are not sure. So they are trying to figure it out. It's a bummer because with the severe head pain she is taking major pain medication which in turn means little to no therapy. With us here... we'll give Dad a little break from the hospital and make him stay home and play with Caitlyn! :) Mom got to see Caitlyn too as we brought her up there when we arrived in town... hopefully some motivation to get moving although she's still pretty altered. Hopefully we'll get the head pain figured out and back on the PT track. Some minor good news is her kidneys have once again started functioning normally.

Doctors Confab

The doctors will meet Friday morning with the Social Worker to discuss whether mom can remain in the hospital or is moved to a nursing home for the remainder of her recovery. We hope she stays there as they work with her 3 times a day... and it's closer for dad. Obviously Medicare wants an update as she has now been in the hospital for 4 and a half weeks. We'll keep you posted.

Therapy Continues

Not much new this morning... The Physical Therapy continued today... but still minimal. Mom is motivated because she wants to go home but her legs are still very painful. She is still taking serious pain medication so she remains a little altered -- just so you understand what that means I'll give you an example. Mom said, "The FBI took my cellphone for 12 hours yesterday -- I want it back." Obviously the FBI was not in her room. It's funnier now that we understand what's causing it (the pain medication) which is why if you do get to talk to her take everything with a grain of salt and get the real updates from us.

Background Information

For some new folks, following is Karen's update from the start of her medical difficulties. On Monday, 4-27, she was admitted to the hospital with abdominal pain and breathing difficulties. She was diagnosed with blood clots in both of her lungs. Blood thinners were prescribed, but resulted in hemorhaging 48 hours later from her mouth and nose. She was immediately moved to the Intensive Care Unit. She had great difficulty breathing and had significant blood loss. She was intubated and surgery was done to stop the bleeding in both her lungs and sinuses. The doctors told me it would be a good idea to have all the family here as her condition was so fragile. The kids came in, and two days later the vent was removed. The doctors said she was stable, but remained on the critical list. The kids went as she was then in no imminent danger. Given all the sedation during her time on the ventilator, she came out with severe mobility, speech, confusion and infection concerns. Her speech, mobility, and blood oxygen were monitored for three weeks in the ICU; she remained critical for the entire three weeks. She needed many blood units and plasma to help coagulate her blood. Unfortunately, but not surprisingly, she picked up two infections which have been cleared up with antibiotics. On 5-22, after 21 days in the ICU, she was moved to the acute rehab unit to get speech, occupational, breathing, and physical therapy. After two days, the pain in her legs was so acute that a doppler was prescribed to check for blood clots in her legs. It was confirmed that both legs have blood clots from above her knees to her ankles. Needless to say, care is being exercised to use thinners to treat the blood clots given her experience three weeks ago-there is a concern that she might hemorhage again. Therapy is now being given with her legs being gingerly treated. Don't know how long she will require therapy; all they say is "we take it one day at a time". The physical therapy people speak in terms of several weeks or two to three months before she has the use of her legs. It's possible she may have continued therapy in a semi-acute facility(nursing home) depending on her progress. Her speech has come around nicely and the upper parts of her frame are in good condition.

Having the support of so many friends and neighbors means a lot to both Karen and I. Your cards, letters, thoughts and prayers are helping carry us through this difficult time.
Bill

Still Struggling

While Mom's pain is a little less it seems the blood thinners haven't done much yet to break up the clots in her legs. She's still on pain medication but she was able to do a little PT today which is good as she's so weak. The Doctors will give us no time table on how long it will take but they are being very conservative with the blood thinners due to the major bleeding she had a few weeks ago. Dad is doing ok -- pretty stressed but hangin' in there.

Noon Update

Doctor changed one of Karen's meds as it seems to cause an altered state. Her pain has eased a little bit. Now monitoring to see if the blood thinner works.

Bill

No Calls Please

Dad is holidng up ok... but asks friends to refrain from calling him at home or on his cell unless it's urgent. He is trying to nap at weird hours when he's not at the hospital. One of us will try to update the blog regularly. Or you can call my cell if needed 520-488-8279. Katie

A Setback

After working in PT for 2 days, she complained of severe pain in her legs. A doppler imaging test revealed the return of blood clots throughout both legs. This is not great news. She is now back on blood thinners although at a much lower dose. We are hoping this will break up the clots. She remains on the PT wing but on pain killers -- so no visitors.

Memorial Day Updates

As you all know -- these 4 weeks have been rough. Mom was hospitalized 4 weeks ago today with blood clots in her lungs. Too much blood thinner -- and two days later she nearly died. After 2 days on a ventilator, she began the long slow recovery process. 1 week later she contracted pneumonia. She recovered from that but was still altered and extremely weak. Another week goes by and she's moved out of ICU into telemetry. On 5/20/2009, she was moved into physical therapy and seems to be going in the right direction.