SATURDAY — Hi, I’m at home …

… in my recliner using my laptop — having checked out of the Kittitas Valley Rehabilitation Center yesterday right before noon, after my physical therapy.   John drove me to CWU campus where we participated in a scholarship luncheon with my normal Friday group.   Then home – first time since I left at 3:00 A.M. with chest pains, the day after Thanksgiving.

I was hopeful John would continue the blog because my writing nowhere touches his, but he insisted I needed to pick up now that I’m home with access to my computer (wow.. have not touched it so almost forgot how to start a Word document).  John says he will do a couple more general things before he quits but the day-to-day ones I can do.  We have an appointment with the heart surgeon on March 9th.  We will report on that and likely stop then.

Back to my first day home.  The 4 Brittanys were so happy to see me.   Meghan was the most responsive and sensitive first as I sat on the potty, my first stop in the house.  Then I walked to my recliner and got to pet Annie (youngest) and her dad, Dan.  Oh, Shay also came to say hi before I got back to the recliner.

It was a busy afternoon and I finally got to nap from about 4:00 to 5:20, and shortly after John and I went to a  home where our music group was having a potluck and play time.  We had to practice Irish music for an appearance the Saturday before St. Patrick’s day.  After bringing in the Mexican enchilada dish to share, John went on to the pharmacy to pick up the many meds I will have to take – no more nurses to hand them out.

My first night was longer than any recently because it was quiet and comfortable.  My only challenge is now I need John’s assistance to stand from the low & soft recliner.  All the chairs I have learned to get out of at Physical Therapy are higher and have a  sturdier push-up from seat.  It’s okay – I’ll get there soon.  I’m continuing out-patient therapy at the facility in town 3 days a week.

I’m so happy to be able to report I survived and am home again and regaining strength each day.   I could not have done it without the obvious help of doctors, surgeons, nurses, assistants, care providers, all the thoughts and prayers and contact from all of you, my friends and relatives.   Thank you all so much.  My most intensive support, love and concern, came from John, my sweetie.  It was rough on him to take care of the animals (3 horses & 4 dogs), and still make one or two trips to be with me in Yakima for all those many weeks.  I wasn’t transferred to the Rehab center here until Jan 20th, and I could not get out of bed on my own for many weeks.   Then once there he visited for two meals each day.  At least the drive was closer.  He also has honchoed all the paperwork with CWU for retirement and cleaned out my office of the many boxes with materials back over all my teaching years (starting 1966 at Georgia State University in Atlanta).

So, I have written more than you will likely be willing to read, and there are many thank you messages to be done (I’ll get to some of those later) but, for now, I want to express a general Thank You! to those who got the word out to others, sent cards, presents, visited and so on.

I had contacts from all over the world.  It was very special.


WEDNESDAY — 43 and counting

That’s hours!

About Noon on Friday Nancy will sign out of her guest lodgings.  As I write, that is just over 43.5 hours.  Saturday will be her first full-day home since Thanksgiving – 3 months.

Home, however is a mess.  The office she occupied at the university is empty.  Its contents, not counting what I have thrown out or given away, are now in our previously cluttered living space.  For a few days Nancy and her 3-wheeled walker will be severely restricted as to where they can go together.  The “un-approved” method of travel – what the physical therapist calls “furniture-walking” may take her a bit farther.

The way I see it, the more throwing away we do, the more her living space will expand.  Is that an incentive, or what?

TUESDAY — the reporter checks back in

Sunday was a non-event day.  There were a couple of visitors and me for lunch and supper.  By non-event I mean there was no therapy.  Nancy got a lot of rest.

Monday the therapy folks made her work hard.  Then as lunch was about over a tall thin fellow with a guitar and a fiddle, two young ladies, one with a guitar and one with a fiddle and a 2 year old – came to play for the patients.  The man came to Nancy’s building but the other three missed the fact that there are two facilities side-by-side, and they entered the other one.

For a short time the man was alone with assembled patients, a guitar and a fiddle.  He asked if anyone could play with him but no one was able so I got Nancy – she is in the adjacent room – and just as the two of them got started the other ladies showed up.  The man was from the upper mid-west and the ladies seemed to be local.  They all knew the tunes, though, and Nancy didn’t.  They would start a tune and she would have to pick it up and add what she could.  Some were story-songs the fellow had written.  It all worked quite well.  For the last song they powwowed with Nancy and agreed on a tune she knew.  She was most pleased.

When I got home I had a message on the recorder from a person in Yakima that wanted to tell Nancy about the latest blood test and what amounts of medication to take.

Tuesday morning I gave the number to Nancy and she called the person.  The conversation was a bit off-kilter because the lady felt she was responsible for reviewing tests and changing medications and, somehow, she didn’t know that Nancy was not at home and didn’t quite grasp that Nancy knew only that her blood had been taken – and nothing more until a rehab nurse brought the pills.  The nurse then talked to the lady in Yakima.  The source of confusion was never uncovered.  We don’t know who handled the med-change on either end.  However, when the nurse explained the change and the reason for it to Nancy and me we both understood what was being done and why.  We have never known the chain of data once the blood is drawn.  Were we supposed to?

I expect Nancy to leave rehab on Friday.  I think the decision is still to be made on Wednesday afternoon.


The distance traveled today was 0.48 mile, one way.  Double that and we still didn’t make a full mile in the car.  I should have zagged or zigged on the way to or from.  I wasn’t sure whether to zig or zag so I didn’t.

Nancy got in and out of the car just fine.  The 4-wheeled walker ‘just’ fit in the back.  These things do fold but are still large and odd shaped.  The place we visited is a series of apartments with mostly senior folk and from the gender of those that showed up, about 94% female.   A few came with walkers much like the one Nancy is using.  There were a couple of wheel chairs and maybe a cane or two.  There were snacks afterward but of the dry cookie type or small sandwich variety.  I could have made a meal of the stuff but Nancy is into moist and softer things and we didn’t stay.

Also, we needed to return to her room for a potty stop and then she needed a nap. She very much wants to participate but from getting going to getting back was about 2 hours and that, currently, is a lot for her.

Changing direction a little, we’ve noticed that on her lower legs her skin is peeling much as it would if sunburned and there is some general redness there also.  This is the location of the worst of the edema and visible swelling during her ICU stay.  I suspect a connection and have briefly searched on the ‘web’ with little success.  The search results I’m getting are all over the spectrum and not what I want.  I guess my search terms need improvement.  If you have any ideas on this issue you can let me – John –  know here:

FRIDAY — PT outside

On Thursday we wheelchaired across the parking lot between the facility where Nancy is and another with assisted-living characteristics.  Nancy and other “fiddlers and friends” played music for a few folks in the dinning room.

Friday A.M. they have also taken the wheelchair away.  She is able to get out of bed and use the walker.  When it is not within reach she still is supposed to have someone move it into position and lock the wheels.  She can take herself to the potty, now fitted with a raised platform with arm rests.  This is making everyone’s day more pleasant.

If she is in a chair with a low seat she may still need a little tug to get vertical but less so each day.

Today I took my car to the back of the building.  Nancy trundled outside using the 4-wheeled walker and the physical therapist explained a safe way for her to approach, back up to, and seat herself in the passenger seat.  She did this more easily than we expected – even after a rather strenuous workout during the morning (inside) exercises.

The immediate need for the correct manner of getting in and out of the car is so we can go to another music session on Saturday.  The place is not far away but enough so that she is not ready to go that far with just the walker and I don’t want to push a wheelchair that far.  I think this little trip is on the level of Ivory Soap®-sure* but check back.


* 99.44 % :  See 3rd paragraph in History, here:

WEDNESDAY — progress assessment

The assembled members of the nursing and therapy council pronounced a stellar performance by Nancy at this point in her rehabilitation.

I think the thing that confounds just about all of us is that no one is quite sure of what Nancy is being rehabilitated from.  People tend to view situations a little differently based on their own previous experiences.  The views of the people we talked with today are influenced by the many patients they have cared for with injuries or strokes.  Nancy has a combination of factors that have incapacitated her but injury (a shattered hip from a fall, say) and stroke are not among her problems.

I wish I knew more about the damage done to organs and cells in the few days in late November and early December but it seems to me that the body’s natural repair of these things was a slow process.  During much of December this process was underway but complicated by the faulty heart.  This resulted in many days of “down time” for Nancy during which her muscles went unused.

In the midst of all this was open heart surgery.

Nancy can extract herself from bed, stand and move into either a walker or a wheel chair, and move about.  The seat of the wheel chair is lower to the floor than the bed so (today) it still required a helpful tug for her to achieve vertical status from the chair.  Still all this seems to be progressing well and a little faster than some thought it would.

One issue all would like complete recover for is the inability to maintain bladder control.  This function was compromised by the extended lack of use of the muscles and the use of a catheter.  In recent weeks Nancy has not been able to get out of bed on her own nor to get on to or off of the potty.  Help has not been timely, creating frequent unpleasantries for Nancy and the staff.

Following from Nancy’s increased mobility and ability to sit and stand from taller items, today a raised platform with arms was fitted over the low commode.  This and an introduction to “Kegel exercises” should soon resolve the problem and everyone, especially Nancy, will soon give a shout of joy.


If you care:

TUESDAY — shura

Same ‘ol, same ‘ol today – nothing new or different.  But tomorrow is big!  There’s to be a council of care givers.  Someone (Who?) set up a meeting (Where?) to discuss –I don’t know (What?).  I do know that the time of this meeting/council/shura is 2 P.M. Pacific Standard Time because Nancy told me that much.  Why?  I don’t know?  She told me today so I could be there tomorrow – I guess.  Without a time clock to worry about, I don’t care what time it will be.  I’ll just wait.

I will, seriously, report on the meeting after it happens.  Meanwhile, if you need a good chuckle, try this video:

MONDAY — swans

A swan seems to take off with difficulty, some even say clumsily.  Once airborne the legs tuck in and the neck stretches out – and the clumsy becomes graceful in flight.

Nancy is close, but not yet able, to get started on her own.  Wheelchair, potties, and most beds are low and she just can’t quite get up from them.  In the PT room they have a bed that is higher off the floor.  From it Nancy can get her feet on the floor and with the high handles of her ‘walker’ she can establish vertical posture.  Then she is ready and able to travel.

The grace of a swan in flight?  Maybe not.

But grace, nonetheless.


Friday evening, with Nancy doing well, I decided I would stay home on Saturday morning.  So I did.  I stayed home this morning to do a few things and failed – not in staying home but in getting anything done.  Dogs and horses needed attention. Nancy called several times.

Her roommate’s daughter had stopped at a well know food place and bought a milkshake – “one of the best shakes in town.”  Nancy thought she might like one.  To kill two of us birds with one stone I decided to order my meal as well.  $10 later I was on my way.  Why does a small milkshake cost $3.00 when I can buy a half-gallon of ice cream (on sale) for the same price?

Next “milkshake day” I’ll make it at home and carry it in.  And don’t get me started on how little things cost when I was young!

It is late afternoon and I’ll soon be headed back to town.  We have 100% cloud cover and it is sprinkling and I have to go out and feed horses.  And the dogs want to go out and run in the muck – not a chance!

I’ve looked all over for a phone number she wants.  Can’t find it.

Ran her soiled shirts (blouses) through the laundry.  Then ran the dish washer just to claim I’d done something useful.

In December Nancy was in the hospital and I bought a cell phone.  It has a camera.  It isn’t of much use unless I can get the images from it to my computer.  It has “Bluetooth” and a USB port.  I haven’t figured out the Bluetooth thingy yet so I went (today) and bought the appropriate cable for the USB connector.  I just spent an hour trying to figure that out.  No luck.  So I will make another trek to the AT&T store to see if they have any idea.  If that doesn’t work I’ll have to go find an 8 year-old.

Rant over.

FRIDAY — what’s a whack?

Nancy was carted over to the hospital this afternoon and seated between the open ends of a horseshoe-shaped thingy that lit up a monitor with an image (in shades of white, gray, and black) of her mouth and jaw, and points south.  Lowest on the screen were the top two metal sutures used to tightly re-close her split sternum.  If you lower your chin to your chest you will come close to where the top one of these appears.

Nancy was given food items containing a small amount of Barium sulfate that acts as a contrast agent with respect to the body tissue and bones.  That is, whereever this stuff goes can be seen on the screen as near black globs.  Because Barium is of relatively high atomic number (Z = 56), its compounds absorb X-rays more strongly than compounds derived from lighter nuclei.  Although barium is a heavy metal, and its water-soluble compounds are often highly toxic, the extremely low solubility of barium sulfate protects the patient from absorbing harmful amounts of the metal. Barium sulfate is also readily removed from the body.

The compound is administered as a suspension of fine particles mixed with foods of different texture.  Nancy had grape juice, applesauce, a fruit mixture, mashed banana, and mashed chicken.  Following her time in the ICU with tubes down her gullet Nancy existed primarily on non-solid foods, especially fortified drinks.  As more-solid textures were introduced she became accustomed to small bites and tentative swallowing.  Frequently she would chew something for awhile and then spit out the solid parts.

The passageway from lips to stomach experienced little real action for many weeks.  The muscles along the way degraded, lost their tone, or underwent “disuse atrophy.”  I think this is what we suspected and confirmed today.

As Nancy ingested the barium sulfate laced food all parts worked as they should except at the very lower limit of the image there was a just noticeable slowing of the material (the dark glob on the screen) and then it dropped out of range for the set-up being used.  Thus, while her real food intake is improving she instinctively remains cautious and rightly takes small amounts and swallows carefully.

In the room today for the exam we had Nancy, the imaging specialist, two swallowing specialists, and me.  Not that my opinion was needed, but we all agreed on what we saw, and what we thought it meant.

During Nancy’s time in the hospital (except when sedated) she continued to use her hands and arms – right more than left.  Since January 20th she has had therapy on a regular basis.  Yesterday she was able to play her violin for the hour jam session with her friends, and it is now six weeks since open heart surgery.

However, Nancy is not yet able to get herself out of bed nor into a standing position from a sitting position.  Noticeable progress is apparent as regards these very visible muscular activities.  The tone of these less used muscles is returning more slowly than those in her hands and arms.  It seems reasonable that the equally atrophied muscles used for eating that we cannot see at work will likewise take longer to regain their capabilities.

So, having found nothing really out-of-whack, we expect continued improvement.

[whack?  See: ]