Sunday, May 22, 2011

let us run with patience the race that is set before us

                                         May 12th - May 15th 2011

Psalm 146: 2  I will sing to the LORD all my life; I will sing praise to my God as long as I live.


  Apparently Scott's uneventful flights last week left me being the one to have more than my share of airport stories.  Typically while traveling I wear comfortable footwear that is easy to slip in and out of during the security process, however this trip I opted for my running shoes and that choice paid unexpected dividends.   The combination of a cancelled flight, delayed flight and rerouting with another carrier all left me sprinting to the gate to make my connection.  In spite of the delays I was able to arrive at the rehabilitation institute in time to catch Dennis sporting his spiffy new slip on sneakers and hard at work with the physical therapists.  Following his session in the gym those sneakers continued to add mileage as he demonstrated his fancy footwork and maneuvered his wheelchair to the elevator, thru the hallways and to the dining room.  I now found myself equally, if not more thankful for Dennis' tennis shoes and his perseverance.
  Observing Dennis eat his supper I was impressed with all the textures of food he was handling.  From feeding tube to soft diet and now a fairly wide open menu.  Chris brought me up to speed on the schedule, facility, staff and procedures as she fed Dennis. He continued to prove himself a worthy member of the  clean plate club.  Scott had mentioned how much Dennis enjoyed the vanilla milkshake he brought him last weekend, so plans were made for another "Purple Cow" run.
  The weekday schedule is full, getting dressed, breakfast, morning therapy sessions, lunch, nap, afternoon therapy, dinner, a shower tossed in somewhere, and that's just the basics.  Long days for Dennis but they are paying off, much progression from Thursday afternoon to Friday morning and then Friday morning to Friday afternoon.  One of the occupational sessions included the introduction of a universal cuff.  The cuff slips over the fingers and slides down the hand with an elastic portion resting across the top of the hand below the knuckles while a leather portion with a slit lies in the palm of the hand.  The desired utensil is placed in the slit and it enables Dennis to have better control of a spoon or fork and work on the aspects of regaining the ability to feed himself.  Scott texted as the trial run with the cuff was about to occur and asked what he was going to have.  "Chocolate pudding" was the reply, to which Scott responded "but he likes Tapioca best."  Even from Pennsylvania Scott can make things happen in Arkansas, tapioca pudding was added to the shopping list.
  Another therapy session focused on transitions from sitting to standing and standing to sitting.  Something we do all the time and never think twice about.  A little attitude,  and a lot sweat, exhausted-Dennis pressed on with a P.T. that refused to take anything less than his best effort.  He earned rights to his first pizza in two months.

  From the time I arrived at The Baptist Health Rehabilitation Institute (BHRI) it was pure southern hospitality.  The first person I asked regarding the whereabouts of the gym was headed that direction. A short conversation was pleasant and encouraging and I later found out he was the physician Chris had been telling us she was extremely pleased with.  Hence the nickname Dr. Wonderful, to continue the original style of Scott's blogging.  Another nickname that quickly fell into place was Nurse Fantastic, although no cape, a super hero of sorts who can single handedly move Dennis with just his pinky while juggling four stethoscopes and three thermometers and simultaneously operate a bed by foot control.   Seriously, he motivates, encourages, and gets results from Dennis, having him do as much as he is able to do for himself.  He appropriately pushes Dennis to exert more effort yet delicately balances when to cut him slack as he tires.  What thrilled me the entire stay, (minus just one don't even expect me to Smile type nurse) was the respect and dignity that the therapists, nurses and aides offer to Dennis.  Scott would have been beaming and most likely exclaiming-- NOW THAT'S WHAT I'M TALKING ABOUT--as the staff addressed Dennis personally, (no talking over him as if he wasn't there) established eye contact, and found a point of connection.  I was reintroduced to many southern phrases and even learned a few new ones as I listened to all the interactions, thanking God for the precious employees here who realize the importance of proper communication and patient rapport.  Continued kindness and concern weaved its thread throughout each building from security to food services and even in the gift shop.  Point of interest:  the hospital chaplain is the same pastor that performed the marriage ceremony for Dennis and Chris.  When I commented to him about the excellent care at BHRI he shared with me a little card he carries in his wallet that summarized what I had been witnessing;   Our Belief -  Baptist Health is more than a business;  we are a healing ministry.  Our Mission - Provide quality patient services and respond to the changing health needs of Arkansans with Christian compassion.
  Random information:  Coffee lovers, there is a Starbucks on site.  While waiting on drinks one afternoon, I noticed some kids bouncing around with delight with what appeared to be ballon like animals with accordion style legs bopping along on a string.  Further investigating I saw the ladies in the gift shop having a heap of fun as they sorted thru packages.  What does one do with all that happiness surrounding them?    Pick out a puppy for Dennis of course!  They didn't even charge extra for a hospital broken, obedience trained, cream of the litter selection.  Returning with sweet teas, and a mylar golden retriever,  I asked Dennis what he would like to name his new puppy.  He immediately responded Pooch.   Those of you that knew Dennis during his school days may recall Poochie was the name of the family dog middle school thru college years.  Dennis' long  term memory is clear whereas his short term memory remains very fuzzy.
 One of my favorite memories from this visit occurred after Dennis had been listening to some sports coverage and dozed off.  I turned the t.v. off and switched on the radio which was tuned to K-love (contemporary Christian music.)  The song "By His Wounds"  from the group "Glory Revealed" came on.  At the end of this song the group incorporates two lines from a hymn.  Much to my surprise I heard a familiar voice join in "what can wash away my sins, nothing but the blood of Jesus."   Not knowing whether to jump for joy or burst into tears I opted to start the next line of the hymn, "what can make me" and Dennis continued to sing "whole again, nothing but the blood of Jesus.  Oh precious is the flow that makes me white as snow, no other fount I know, nothing but the blood of Jesus.".   Incredible, the man who was slowly piecing words together again was now singing word perfect, in tempo and in tune, a familiar hymn from childhood.  I have heard previous reports of people that struggle talking but can sing, and have witnessed the effects of music therapy, yet at that moment I stood amazed as Dennis initiated his own version of music therapy and...to the glory of God.
(listen to the song here  http://www.youtube.com/watch?v=u3LHI19xxk4)

 A couple new occurrences for Chris as well during my stay.  One, after sleeping in hospital beds since March 20th, and waking up with a fever Friday, she agreed to go to the hotel around the corner and climb into a regular bed and get some real sleep!  And then on Saturday after going to pick up some supplies and a "healthy" pizza for Dennis (chicken, cashews, veggies) Chris ventured home for the remainder of the day/evening to join those having a work day prepping the house and yard in anticipation of their eventual homecoming.
  As I left Baptist on Sunday morning Chris and Dennis were getting ready to go to the hospital church service.  The airport greeted me with another delayed flight. The gate attendant scrambled for one of the last tickets to reroute me and like the passing of a baton in a relay race, she sent me sprinting to a plane that was already loading.  I haven't examined my shoes to see if there is any tread left, but I have examined my heart and it is full of praise!

Post script...grace to Scott for this late entry.  Once again, his guest blogger did not submit prior to acceptable deadlines.  Much has occurred over this past week following my departure and no doubt Scott is already preparing a feast of tasty morsels to serve up on his next posting.

Thursday, May 12, 2011

One small step for man, one giant leap for mankind

Friday was a successful mission in which I have come up with the name: operation surprise for obvious reason. Only a select few were privileged enough to know that I was going to make a surprise visit to the hospital this weekend. No one from Arkansas was aware because I didn’t want to ruin the surprise and now that I’m old enough to rent a car on my own, I figured I should take advantage of my old age and keep it secret by renting a car and driving on my own. I had the weekend off of work, and hearing about dads recent successes, I had the opportunity to come and spend some time with him and wanted to take full advantage of it. Chris and Courtney both thought that my aunt was coming down to help and much to their surprise, it was me! I made it to the hospital around 9:30 at night, and I walk to the unit where Chris was “working” first. As I walk up to the nurses’ station, she looks up with a confused look as if she was thinking, “ look at that strapping young lad, he looks just like Scott (I know it’d be a lucky kid if there were two of us).” The closer she looked and the more she began to process it, she realized it was me, she then blurts out an “o my word, what are you doing here?” Still in shock, we go up stairs to Dads room where Courtney was sitting and dad was sleeping. Courtney looked just as confused, and probably a little irritated that she wasn’t aware I was coming (she thinks she’s knows everything and is nosey of course, but what older sister isn’t?) As I’m talking to her, Dad wakes up (I’m assuming it was my angelic voice) and as he sees me, he starts grinning. I’m not sure if he knew I haven’t been there for awhile, or just sensed the excitement in the room, but he seemed pretty happy I was there, but quickly feel back asleep.

I was trying to think of what I was going to say when I walked in the room for the past couple days. I wish I had a cape so that I could open the door and jump in as if I was superman, but I went with the less drastic option and threw open the door and asked where the bathroom was in this joint. I think it was a successful surprise and definitely put a smile on some faces and most importantly dads. I’ve been warning dad that he needs to get some sleep tonight because boot camp starts tomorrow at 0900 (o nine hundred) and that he’s not going to be able to sleep during the day because he wouldn’t let me sleep at night. I told him we’re going to do jumping jacks, somersaults, handstands, push ups and cart wheels. If he begins to sleep, I’m going to buy a fly swatter and hit him, shake the bed, or make loud annoying noises (to bad I don’t have a recording of quincy talking).

My first thoughts of dad through the night were that overall he looks pretty good. He still has a lot of involuntary/uncontrolled movements which is typically called ataxia or ataxic movements. This can be caused because he was out of it for so long and his brain didn’t really have to think about his movements and coordinating them properly. He is going has to relearn how to move in a smooth pattern. It’s not uncommon to have, but he seems to have a pretty good case of it. He’s definitely talking more and most of the talking is simple responses and repetitive. I’m trying to get him to use his voice more than just little whispers so we can hear him and understand him. He’s forming his own language and he refers to it as “thai.” He has random words he says all the time some of the being pottayyy (which means potty) and ta ta. He tends to say pottayy a lot even when he doesn’t have to go and I’ve reminded him of the boy who cried wolf, because that is all I have heard the entire night was. I also had to tell him what ta ta was and that we aren’t going to talk about that when I’m here.

The therapist came in today and I can say without a doubt I’m fairly disappointed. First of all if you’ve been following at all you know that it irritates me when people do not introduce themselves or explain what they’re going to be doing. I don’t care if you explain it to me, but explain it to the patient. The transfers were just not that good and they lifted improperly because it was “Easier.” He stood up and transferred to the toilet and was able to sit with pretty good balance for awhile, but he fatigued fairly quickly. The therapist was trying to get him to lift his arms up (which he’s been having issues with because he’s so weak). I’m trying to get him to focus on picking his head up but it’s a lot harder than you think. He hasn’t had to hold it up for quite a while and now that he needs to his muscles are really weak.
In the experience I’ve had, you need to focus on the easiest stuff first such as sitting edge of bed, keeping your head up, and safe transfers before you begin to walk appropriately. Although that stuff is still hard and very tiring, I feel that most therapist focus on quantity rather than quality. A lot of people will think that since you’re walking 60 feet you’re doing great when in actuality you should only be walking 10 feet at a time and focus on doing that correct before you go any farther. It’s my fear that there are focusing more on the quantity of it, because they aren’t a true rehab hospital they just aren’t familiar with what to do first.

I can also say that I’ve been disappointed with the nursing staff overall on this unit. Some of them have been very friendly but they don’t seem to be doing much at all. It could be the fact that I’m in the room all the time, but it’s be nice to actually see someone around the start of their shift and not 3 hours into it. I miss most of the ICU nurses I’m familiar with and the care that they were giving. The nurses on this unit don’t know how to work the bed, and aren’t comfortable with helping transferring to the toilet. I’m just ready to get him to a nice rehab facility so we can really focus on the things that we need to.

We worked a little bit more on therapy before I left on Sunday. A retired physical therapist in the family has been gracious enough to spend his time and come and help with dad and his progress. We worked a lot on trying to normalize the movements to decrease the ataxic movement and we also worked on strengthening overall, especially the muscles that help him stand. He’s weak and needs a lot of work and therapy needs to focus on transferring and overall strengthening.

It was a pretty boring flight both there and on the way back. I think I slept most of the time and there really weren’t any interesting stories. I did stop by the ICU waiting room and it looks different. I think I’m just not use to my stuff not being cluttered everywhere around my bed. in there. Since my return dad has moved to little rock and is now at a neuro rehab facility. From what I’ve heard about it so far it seems to be a pretty nice place. I’m excited to journey back down and check it out to see his progress.