Wednesday, December 29, 2010

Looking For That Independence

She made it.  Lara is out of the hospital.  Friday was such an exciting day.  We got her home and settled in.  The next morning, being Christmas, was an early one.  Lara still has to be checked on every two hours through out the night to either help her move, or make sure she isn't laying funny on her left arm or leg.  Lara's current room is downstairs on the main floor of our house (Ben and Lacy's house, her sister).  So our 5 and 3 year old were up bright and early to check and see what Santa brought, which of course woke Lara .  Santa even had a stocking for Aunt Lara with her beloved sonicare and a few other things, but that sonicare is all that mattered to Lara.  It was a good morning.  We did our little family morning Christmas and then our big breakfast.  Lara loved being able to see her nieces and their reactions and share in those special moments.  Later that day we had the whole family over for food, more presents, games, and more food.  I thought the day may overwhelm her.  But she did great.

The next day we did our at home therapies of speech, OT and PT.  Then she went to her brothers place for his birthday.  She even had to go up a few stairs to get in.  She had her first appointment on Monday for her shunt.  Everything looks good.  Only has to go back for certain patterns of headaches for an adjustment.

Yesterday was out patient therapy evaluation day.  Lara will still be having all three therapies multiple times during the week.  Because of the therapists work schedules Lara will have to go in 5 days a week.

Today was my first day of gathering the posse by myself for some errands.  We made it!  Lara is doing great with her transfers and communication.  Still not 100% reliable.  She still will be impulsive without evaluating the full situation which could lead to some accidents.  She still has that left side neglect.  So working on seeing the whole picture to gather all of the information is still a work in progress.  Over all, physically, Lara is leaps and bounds better than she was even just a week ago.  It is her memory, emotional lability, just overall more of her mental game, that seems to still be moving slowly.  But hey...it's moving!

Looking for that independence is what these next few months are about.  We are starting small.  Well for you it would probably be ridiculously small.  Things like if you don't put the lid back onto the toothpaste tube, it gets hard and you can't squeeze your toothpaste.  (Which she has learned by experience) But instead of saying, "Lara put the lid back on the toothpaste" it is phrased, "Ok, is there anything else you need to do before we leave the bathroom?"  Or watching her fling her shirt around for five minutes before she asks for help and rather than giving her physical help, telling her a way that would be easier to get it on by herself.  Then watch her fling it some more (her attention span is the size of my 3 year olds pinkie finger) then she asks again for help and asking her if my instructions before were helpful.  Sometimes she gets it that she didn't try the suggestion, sometimes she still doesn't listen, sometimes she gets mad and frustrated...all depends on the moment.  That is more of the mental game I was talking about that seems to be moving along slower than the physical.  But again, moving!

Thursday, December 23, 2010

Ready or not here she comes!

Well, tonight is Lara's LAST night in the hospital.  I know my posts have gotten farther apart.  This past week I have been a little more hands on with her for her therapies and with the chaos of getting ready for her to come home plus the holiday season it has given little for extra time.

This past week Lara has done some amazing things.  She is going up and down stairs.  Of course this is with a four prong cane, a belt, and at least one other person.  She is walking farther and her form is getting better.  Again with the cane, belt, and another person.  They still want her primary mode of transportation to be by wheel chair and only the walking for therapy until she gets more stable and focused.  But she is moving her left leg on her own.  Lara got casted a couple days ago for a leg brace for that left side.  We have to ease her into wearing it literally minutes at a time so she doesn't get sores.

Her left arm is also improving.  From her fingers to her wrist there are some major improvements.  Her left shoulder is still not really working.  Supposedly, as the leg gets stronger and more stable, the arm is soon to follow.

She still hallucinates, and her memory isn't always great.  She has gotten more impulsive.  She tried to get out of bed on her own on Sunday night and fell.  It really crushed her ego she said.  It's pretty frustrating for her.  She wants that independence and can see it in sight, yet still needs help for now.  But soon, very soon.

It's been kind of sad the past few days saying good bye to her therapists and nurses.  Lara has built such a repertoire with all of them.  She even has some patient friends.  Their conversations are so cute.  One lady a couple days ago in the dinning hall asked Lara, "I'm a new patient.  I'm in room 312, what room are you in?" (as though they were going to visit each other or hang out).  Another lady who also has had a stroke and is struggling with her memory was in therapy across from Lara one day.  She was actually playing a memory game with her therapist (but not doing very well), when she saw Lara she said, "That's Lara.  She likes bacon.  She has bacon on her hamburgers."  We all were so proud of her!  There are definitely some great people at St Joe's that we will forever love!

Now we are entering a new phase of her recovery.  She will be having PT, OT, and speech, but now all out patient.  There will be more responsibility at home for her to do her exercises and progress on her own.  Thank you to each of you who have prayed, hugged, visited, and supported not just Lara, but her family too.  Don't get me wrong, this is by no means over.  I will still be updating.  (Hopefully more consistently than I have these past two weeks).  Lara still has a lot for you all to keep up on!

Tuesday, December 14, 2010

Wanted you to SEE it too!

What a great day Lara had today!  Talking with her physical therapist today she was saying that sometimes throughout the therapy there are some peaks and plateaus.  Last week Lara seemed to be on a plateau in terms of some of her physical progress.  Well this week looks like we are climbing a peak.  (Did you hear me tellin' that mountain to move yesterday?)  Today Lara went up and down stairs!  She learned how to use her strong right side and a rail to get herself up and then down.  Of course it took a long time, and with lots of rests (or distractions is what we would call them :) )and the help of two therapists, but she did it.  Lara also walked longer than she had been with her cane and with NO railing.  Holy guacamole!  All in one day.  And I'm not done there folks.  As though that wasn't enough, she made cookies in OT today.  Cracked the egg herself, one handed like the Incredible Hulk (and the therapist picked out some of the shells).  Read the directions and followed them.  Even got to share them.

We found out that Lara is slotted for another day pass for Sunday.  We had a tentative discharge date for next week that has been requested to be extended for two more days.  Not because she needs more care, but because these past two days she has made such good progress, they want to extend that growth as long as they can.  We will find out later this week the actual date.  She has a special wheelchair ordered for her and her brace for her left leg.  We have been prepping at home getting ready for her.  Bars, transfer seats, and a ramp.

Just wanted to let you all in on a quick update.  So you too could SEE "that mountain is moving from here to there."

Monday, December 13, 2010

Move Mountain Move

Oh my, has it really been a week since I last gave you an update?  Umm time flies when you're having fun? :)

Physically we are making some good progress.  Lara has used a cane to walk a few feet.  The therapist has to still help on that left side.  But even that left side is getting better.  We are looking for more strength and stability in that leg.  Her knee still wants to collapse and balance overall is still a big issue, but there is no doubt that there is a big improvement.  Lara can also transfer (move) herself from her bed to her wheelchair.  A little unnerving if you are not prepared for her to do it, and yes there have been a few over or under estimation of where the seat actually is.  She has gotten what the nurses call "impulsive".  She has done something once or over estimates her ability and then well...like two days ago she slid out of her bed.  So we are now kind of "on watch".

She has gotten better at doing somethings one handed like putting her shirt on and off.  Of course the goal is still to get more mobility out of that arm.  Her squeeze is stronger, but still not much extension in those fingers.

We are still trying to balance her medications.  Trying to help decrease some of these hallucinations.  Sometimes she is aware of her hallucinations, sometimes she's not.  When she is fully awake and alert she is pretty good mentally and emotionally.  She still has bouts of melt downs mixed with laughter and irritation.  Her speech therapist said sometimes that happens with brain injuries.  It's like a leaky faucet.  You or I can turn our faucet of emotion on or off, but Lara's has a leak.  Whether or not over time if there is more healing  of her faucet or not we will have to wait and see.  Some of her cognitive abilities have improved as well.  She has read a few sentences.  She has to be reminded to look ALL the way left.  Her left vision is still impaired.  She is also better at things like telling time.  Not perfect on these things, but better.

We are now allowed to take her down to some of the other floors with the cafe and little store, or down to the cafeteria.  One day she went down to lunch with Mom during peak lunch time.  She had ordered a sandwich and by the time Mom had wheeled her to a table she was crying.  "I need two hands to eat this sandwich."  Mom tried to reassure her she could cut it smaller for her.  But to no avail.  Lara was full on overwhelmed.  She didn't want people looking at her, still crying, but now hysterically.  So Mom took her upstairs and they ate their lunch in her room.  Since then we have gone down a few more times when it is not quite as busy, but still has people there just to start easing her in to more social situations.  She did good.  Even ate a little down there.

And the moment you have all been waiting for...Lara got a day pass!  (insert stadium crowd cheer here) Yesterday Lara was allowed to come home for a few hours.  We brought her home and hung out for the day with just the family.  It was good to see her in a home environment.  It also gave us a slight taste (ok more of just a flavor) of what it might be like when she does come home.  There will obviously be some big adjustments.

It's funny how small that last sentence is because the details between those words are so many and so BIG.  They seem to all run through my mind at one time and I look back that sentence and it is so small.  (It doesn't really carry the weight I guess).  "...if you had faith even as small as a mustard seed, you could say to this mountain, 'Move from here to there,' and it would move.  Nothing would be impossible."  I am faithful in God and His healing of Lara.  I am also faithful that God is not only healing Lara, but those of us around her.  Like I've said before, sometimes God is more concerned about our hearts than our physical body.  So..MOVE MOUNTAIN, MOVE!

Monday, December 6, 2010

A Day of Firsts (and one second)

Yesterday Lara had a lot of firsts.  She got to go outside for the first time in 35 days (yay).  We rolled her out and literally about 3 minutes later she said, "Ok, I'm ready to go back in."  I had to make her wait a minute so I could get a picture.  She also got to go down to the cafeteria for the first time.  She was craving a chocolate chip cookie.  She also went to the computer room to try and get on the computer.  But we couldn't figure out the login and password.

She spent some time playing go-fish with her nieces.  Lara doesn't really like to play games, never really has.  But she does things she doesn't want to for her nieces, and it is also some great therapy for Lara (though she might not realize that part).  Lara still has to conscientiously "scan" to the left because she can't see on her left side as well.  The therapist has showed her how to use her right hand to find the edge on the left of things, plates, books, cards, her tray so she can see things in their entirety and not starting in the middle and going to the right.

This past week she has also had her second shower.  What a special treat.  She said it makes her feel like a "real person".  Still no washing the hair, have to wait on those top stitches that seem to be taking longer than the back of her head or her stomach stitches.  She is also taking a few less pills.  I think we are down to only 10 at a time.  Not including her occasional vicodin, but that is less frequent as well.  Which is good because she gets so sleepy and starts to hallucinate with those.  Makes therapy kind of difficult.

Physically she is getting stronger.  She can squeeze her left hand, but still needs a little help on fully extending her fingers (like for a high five her fingers are curled).  She practiced walking with a cane some on Sunday.  She still needs help with that left side.  Her knee buckles and sometimes the therapist has to slide her left side forward.  They are trying to teach her how to align herself with the cane (or bar that is along the wall) so that she is balanced.  It is hard with her right side being so strong and her left so weak.  They call it pushers syndrome.  Basically her right side "over" pushes, but the left side is so weak, there is nothing to push back...so she falls.  Well they don't let her fall of course, but basically a lot of work on balance.  She is getting there.  It was nice to hear the therapist on Sunday also ask her how she was doing mentally, emotionally, and spiritually.

This current week is a big week.  Every Tuesday all of the doctors and therapists that work with Lara have a conference specifically about her, how she is doing and they reassess her goals.  They will also be contemplating a "day pass".  A day pass (usually on Sundays because there is no therapy on Sundays so she wouldn't miss any work), means she would get to be released from 10:30am to 7pm unless she was tired and needed to come back sooner.  Then we will learn how to transfer her in and out of the cars, her medication schedule, basically anything she might need for the day.  Her therapy would be more suited to getting her ready for out in the real world.  We are hoping she is well enough to get to do that this Sunday the 12th. 

Keep your prayers coming.  I have complete faith that God will heal Lara.  It may be a rough road physically, mentally, and emotionally for us all, but sometimes God is more about the hearts than He is about the body.