Wednesday, August 19, 2015

We’re in Bellingham, Washington


Once again I’ve had some folks asking for an update on Lorraine’s condition so here goes.  I just checked and it’s hard to realize its been almost a week since the last blog update and 12 days since her stroke.

Last blog Lorraine was still in Settle at Harborview Medical Center, one of the 60 or so Certified Stroke Centers in the nation.  Lorraine was airlifted from Bellingham down there to have a medical procedure but when she got there it was deemed to be too much of a risk to attempt it so it wasn’t done.  

Lorraine did get excellent care while in that  hospital, the doctors and especially the nurses were very professional and treated her with respect as a person, not just another patient.  I would recommend Harborview to anyone if Lorraine’s treatment was normal, everyday treatment for everyone. 

Lorraine had been making good progress with her swallowing, the speech therapist had even upgraded her to a thinner drink.  This was a biggie as that meant her feeding tube could be removed soon.  She was eating so well that they decided to not even feed her via the the feeding tube on Thursday night but left in place just in case as it isn’t a pleasant experience putting it back in if needed.  The doctors were also wanting her blood pressure under control before she could be released too and had just started her normal blood pressure meds. 

I was trying to get a treatment plan from the doctors at the hospital and basically it was “When she is ready, we will transfer her to an appropriate facility”.  They weren’t sure if it would be to a skilled nursing place or a rehab center, it depended on how much she had recovered.  As I understand the level of care it goes from hospital, skilled nursing, rehab, long term care and assisted living.  In her case we are hoping to go from hospital – skilled nursing – rehab – home. 

I was told they have an excellent skilled nursing facility on the 5th floor at Harborview so that is where they really wanted her to go.  But I had been pushing for her to be transferred back to Bellingham so she would be able to see friends and family and I might be able to get away and work at our house some. 

Lorraine was having her headache pain mostly under control, she was receiving three pain pills every 3 hours on Wednesday.  In fact, I asked if we could reduce it to two pills if she wasn’t in pain as I wanted her more alert if possible.  They agreed to let the nurses, Lorraine and me make that decision, up to three pain pills as needed. 

I believe it was on Thursday that they changed her pain meds to three pills every 4 hours, as needed.  That seemed to be enough to keep her pain under control but she did start telling us that she had a pain on the right side of her abdomen.  They said they would keep an eye on this newly developed symptom. 

Friday they once again changed her pain meds,this time to two pills every 4 hours.  I thought this was just at the edge of not keeping her pain under control but she was more alert.  The doctors and I talked about this dosage and agreed to try it for a day or so and she how it worked although the pain in her side seemed to be getting a bit worse. 

But they did remove the feeding tube from her Friday morning YEA.  They were just coming by with the equipment to do this when Lorraine happened to snag the tube as she was moving about and pulled it out about 5”.  The nurse didn’t hesitate and pulled it out the rest of the way.  Boy was that a good improvement for both of us.  To this day Lorraine explains that it felt like they were using a ball peen hammer to insert the feeding tube into her nostril, it hurt her that bad.  

Our friends, Richard and Sandy, drove down from Bellingham to see Lorraine on Friday also.  His sister had been her for over 2 months last year when she had a brain aneurysm rupture.  She was in critical condition and was also airlifted from Bellingham for treatment so he had spent some time there and know his way around very well.  Lorraine was really happy to see them but was tired so they only stayed for a short visit.  Thanks Richard and Sandy.   

Our son, Rich, flew down from Alaska to see his mom on Friday.  He caught the red eye flight from Anchorage and had a screaming kid in the seat right behind his so he didn’t get any sleep.  He did get into Seattle early but couldn’t get to the hospital to see her right away, he had to have some rest first as he knew it would be tough.  But he did get there early in the afternoon. 

Lorraine’s room was directly across from the nurse’s station and when Rich got there, he just walked into her room.  Lorraine saw him and started crying, of course.  But within 10 seconds or so, the nurse came rushing into the room, I thought there might have been a check in procedure or something that I was unaware of.  But no, the nurse asked if everything was ok with Lorraine.  I told her she was fine, our son had walked in the room just moments before.  She said that explained the different action on her heart monitor, I guess the alarms started going off at the nurse’s station when Lorraine saw Rich, funny.  But everything was fine and seeing him definitely helped her.

The nurses were still putting Lorraine into a chair every afternoon for a couple hours or so.  The did this by lifting her onto a gurney type bed that could be folded into a chair.  She said she liked sitting up vs laying in bed all the time, I believe she actually had her lunch while sitting in the chair and Rich helped feed her. 

Susy was also on her way up, driving up from the Bay area.  She left early on Friday morning and had one overnight stop scheduled.  Every time we talked with her, she was making good time and everything was going good. 

I had been talking with the Social Worker at the hospital about Lorraine’s transfer and she warned me that most facilities in Bellingham might be hard to contact over the weekend due to the administration folks not working.  So it was somewhat of a surprise when I got a call from her on Saturday morning that she had found a skilled nursing facility in Bellingham and we could transfer to it that day.  I hadn’t completed my research on what was available or how they were rated but the one that she told me about wasn’t on my short list. 

In our last blog I had asked for information from anyone in the Bellingham area that might have personal experience about the nursing homes up there.  I had a number of folks reply to that request, some telling me which one was good or bad in their minds.  A special thanks to everyone who replied to that request, it’s nice to have friends who can and will help when asked!!

I got an email from  a good friend up there who was a very valuable source of information as she had worked with some of these facility with her job, before she retired.  She said the one they wanted to send Lorraine to wasn’t very high on her list and suggested that they would attempt to send her to the first one that would accept her, not necessarily the best one.  Based on that suggestion and some info I found online, I called the social worker gal and turned down that offer.  She was fine with that decision but once again told me it would hard to find another one on the weekend.  I said I understood and gave her my list and asked if she could attempt to get her into St. Joe’s Rehab Center.

I had earlier called St. Joe’s based on suggestions/recommendations from others and was highly impressed with my conversation with the gal I talked too.  She told me their goal is to get someone who needs rehab through an intense therapy treatment course and get them back HOME as soon as possible.  She said most folks are out and back HOME in 3 or 4 weeks, wow. 

She also said, based on my assessment of Lorraine’s condition, that they had an open bed and would accept her based on her medical record and information from the doctors at the hospital.  She did say that Lorraine would have to be able to do 3 hours of intense therapy per day, 6 days per week, not necessary three hours in a row but throughout the day.  I told her I didn’t think Lorraine was up to that but she said, don’t sell her short as they have had some show up that were in pretty bad shape and they went HOME within a few weeks.

So anyway, the social worker said she would send Lorraine’s medical records to three places in Bellingham.  I once again told her my ratings of these places and hoped to have something at St. Joe’s. 

As I was working on this, Susy got to the hospital once again Lorraine’s heart monitor took off.  But I had warned the nurse so they didn’t respond like when Rich showed up, forewarning is a good thing.  Susy quickly assessed what was happening and got “up to speed” with everything.  With both Rich and Susy there, I could see that Lorraine had settled down a lot. 

Rich has a friend in the area that wanted him to stay at his place as long as needed and Susy had made a reservation at a hotel so they both headed out that evening.  Once again, I stayed by Lorraine’s side, sleeping in a recliner chair at her bedside.  I sure appreciate the hospital allowing family to stay overnight but the other patient in Lorraine’s room sort of took advantage of that and had three folks stay overnight one night (and the guy snored like a chainsaw). 

That evening I got another call from the social worker and she told me that St. Joe’s had reviewed Lorraine’s record and decided she would be better served if she spent some time in a skilled nursing facility, until she could do the 3 hours of therapy.  They had contacted Shuksan Healthcare Center to have them accept Lorraine, work with her until she regained enough strength, keep them informed of her progress and transfer when she was ready.  Wow, great service and they would also be keeping up with her progress. 

So that’s what happened.  They said Lorraine would have to be transported via ambulance and would be leaving the hospital at 10 am on Sunday morning.  It would be about three hours from bed to bed so I worked with the nurses to get Lorraine’s meds set up on a schedule that would give her max pain meds between 9:30 and 10, hoping it made her trip better. 

Next morning everything went as planned, Lorraine had her breakfast, the nurses cleaned her up, gave her the pain meds then the ambulance guys called and said they had mechanical issues with their rig and would have to get a different one.  They estimated it would take about 1/2 hour and they would try to shorten the time as possible. 

It was about 11 when they actually got to Lorraine’s room to transport her to the ambulance.  They moved her over to a gurney and wheeled her out.  Susy was going to ride with Lorraine in the ambulance, Rick had to stay in Seattle for a short while, Mike and I would drive our cars and follow the ambulance.  Wow, another big step for Lorraine, discharged from the hospital one week after her stroke. 

Although the traffic was heavy, it wasn’t too bad and the ambulance and us arrived at here at Shuksan.  The entry door was closed and locked so I walked around to the normal entrance and got a nurse to walk down and open the door for us.  By the time she found the key and got the door opened, the ambulance guys had already wheeled Lorraine up to the same door I had walked in and got her into her room and in her bed. 

My first impression of this place was pretty good, it looked clean, I didn’t see anyone sitting in chairs in the hallway with no one watching them and Lorraine was put into a private room.  She had a couple nurses show up to check her out, they even called in a off duty therapist to check her too.

Everyone seemed very nice, explained lots of things and answered my many questions.  They said they are used to having folks who haven’t been around care facilities before and pretty much knew what I would ask, funny.  Lorraine was pretty tired although Susy said she did appear to sleep a lot on the drive. 

They asked Lorraine what she would like for dinner and even offered us to have a meal too, nice.  After dinner I had a discussion with the nurse and he told me that Harborview doctors had once again lowered Lorraine’s pain meds, down to one pill every 4 hours.  I asked for the on call doctor to review this with us but was informed that we would have to have Lorraine’s primary doctor here in the area write the change for her.  I called her doctor and, of course it being a Sunday evening, got their answering service.  The gal who answered the phone said I could do one of two things, leave a message for the doctor and they would get it on Monday morning or declare an emergency and she would transfer me to 911.  All I wanted was a prescription, not 911, really disappointed in this service for sure. 

Anyway, the nurse here worked some magic and got an extra pain pill for her which made her feel better.  She had a good meal even though it was once again back to the pureed food but at least it wasn’t formed into some dry patty.  Lorraine was able to eat probably about half of her meal that evening. 

I figured Lorraine would sleep deeply that night but she kept waking up about every 15 minutes or so with a question for me.  Mostly she was worried about her sister’s upcoming 50th wedding anniversary and wanted to make sure I knew how to make the salad she wanted, wanted me to get our clothes out of the closet so she could iron them and couldn’t remember if she had wrapped their presents or not.  She has always been a planner and was really worried that the party wouldn’t be a success if she wasn’t able to do her normal activities for this type party. 

Monday morning I continued to ask lots of questions about this place, wanting to know procedures, policies and whatnot.  I found every one willing to answer any questions I had as best they could.  I have not been exposed to a skilled nursing place before and wanted to know about doctor care (our family doctor is in charge and they have doctors come by on Wednesday and Friday), how many LPN/RN on site (no less than 4 at night and up to 7 during the daytime), how they handle prescriptions (they have a deal with a large pharmacy in town and they will make up and deliver meds any hour of the day/night) and other such questions. 

Once again, they ordered up a meal for Lorraine and offered a meal to us if we wanted.  They said they haven’t heard of another place that does this for family members but they wanted to make it as easy for us as they could. 

I called our family doctor as soon as they were open and explained the issue with Lorraine’s pain meds and they quickly sent new orders her to allow Lorraine up to three pills every 4 hours or reduced as needed.  Just what we wanted to hear.  The doctor had also ordered up a urine test to see if Lorraine may have a urinary track infection.  The preliminary results are that she does in fact have an infection and they’ve started her on an antibiotic series of pills for seven days to knock it out.   

Lorraine really likes this doctor, when we first changed to having him as her primary doctor, on the first visit he set down eye to eye with her and explained that he had spent 4 hours going over her medical file so he know her medical issues but didn’t know her.  He asked her to tell him what she wanted and everything she wanted him to know.  He spent about 45 minutes with her and really made her (and me) feel good about having him as her new doctor.  And they way he handled this situation is just about what I would expect from him, a good doctor.  He also wants Lorraine to see him in his office next Monday so that gives her a goal, being able to get into a wheelchair for at least 3 hours. 

This place has two dining rooms, one for folks who can feed themselves with no problem and one for those who need assistance.  Seeing as how Lorraine has someone with her basically around the clock, they have been bringing her meals to her room and we can assist her.  They also taught us how to make the thick water or juice that she can have, pretty simple once you know how. 

I made a few calls about our on going house repairs on Monday and had the contractor doing the fire repairs and our real estate agent meeting with me at our house on Tuesday morning.  The contractor was first and we sort of agreed on the amount of work completed and they will be paid for that, guess you can say he’s fired.  The remaining work will be completed by the guy I had already hired to do lots of damage repair and upgrades around the house. 

Plus I had to have a glass company come out to replace three broken skylight fixtures and two broken windows.  I still don’t understand how the skylight mechanisms got so badly broken that they can’t even be closed but whatever, they have to be completely replaced.  In fact, on one of them there is a 3/4 x 4” board that was broken width wise, I couldn’t do that if I wanted.  Sure glad the owner of the glass company is a personal friend of ours, I’m sure he will make sure the work is done right. 

While I was at the house, I also removed some more of the flooring that is going to be replaced along with a few other items I needed to do.  I also took a shower while I was there. 

I drove over to the Water and Sewer service folks and got everything changed back to our names and paid a couple months in advance.  They asked me if I had contacted the Tribes Housing folks to see if they had someone on their list that would qualify to buy our home.  Wow, a possible lead to selling the house.  I told them it would be donuts for the whole office staff if something worked out from their lead, ha. 

Rich had been with Lorraine while I was gone, from about 8:30 till 2.  As I was driving back to here, he called and said Lorraine wanted to talk with me.  When she heard my voice she started crying and wanted to know where I was and when I would be back.  Rich said that was the first time she had cried about it but she had wanted to talk with me for awhile before he actually called.  When I got back, she said she was afraid I had left her, really made me sad. 

When I got back, Lorraine had a couple visitors and for the next couple of hours had about 10 folks show up and visit for a short while.  She was really tired and didn’t participate in the discussions too much but did manage to thank everyone who came by. 

While I was out, the therapists had shown up and worked with Lorraine.  They had her sitting up on the side of the bed for awhile and it really tired her out.  Plus she had a good lunch except she couldn’t eat the hot dog even though it was cut up into small pieces reason.  Not sure if she just didn’t like it or what but Rich said she couldn’t/wouldn’t eat it. 

Anyway, once I got back and told here where I was and what I had done, she was fine once again.  I told her I had to run some errands once again on Wednesday morning and would be at our house for awhile too.  I wanted to make sure she knew when and where I was going to be and hoped she wouldn’t become upset again.  I know it’s going to be tough for her when Susy and Rich leave and I have to leave her side, especially overnight.  I plan on making small moves in that directions over the next few days to see how she handles it, don’t want her to get upset and have a major problem with me being gone when I have to be. 

I had asked for the speech therapist to come by and re-evaluate Lorraine with a new swallow test.  I thought she wasn’t having any issues with food/water going down the wrong pipe and wanted them to upgrade her food from pureed to finely chopped.  But after checking her out that evening, the therapist suggested leaving it as is for a few more days, better to error on the side of caution.  She did say that she understood she was seeing Lorraine at the end of the day when she was most tired but that would be when she would be most likely to have problems.  The speech therapist is also the one that works at St. Joe’s, our next medical center once we leave here.  She wants to check on Lorraine at least two or three times a week. 

Wednesday morning I met with the guy doing the repair work at our house at Home Depot.  We wanted to purchase all the material he needed to work on the house for the next two weeks.  We picked up new flooring material for three bedrooms, three baths and a hallway.  We also had to pick up enough wood trim for all these rooms too plus get a new door for the bedroom where the fire was.  And his wife is going to paint inside the garage for me so we had to get enough paint for that.  I was surprised that all this could fit inside his van but he said he does this all the time.  We then drove over to the house and unloaded all this material. 

By now I had been gone for about 4 hours and I was anxious to see how Lorraine was taking my being gone for this amount of time.  When I got back, I just explained what happened and she seemed fine, although once again, Rich was here with her the whole time I was gone. 

And while I was gone, the therapists had shown up again and this time they got her into a wheelchair.  Rich pushed her around and even took her outside to the patio garden area.  I asked him to take some pictures and Lorraine looked to be happy in all of them, even giving the peace sign.  Rich said she was flashing thumbs up to other residents as she passed them.  Too bad I missed that, she had just been returned to her bed just before I got back.  I think she had a couple of folks come by to visit today too. 

Ok, Lorraine’s condition report.  She knows what happened, where she is and what she has to do to get better.  I tell her everyday that she has to do three things, eat well, sleep well and do her therapy.  She can now repeat that phrase very well.  She has shown many small signs of recovery and that gives us all hope.  Of course, we can’t predict how much she will recover but if she doesn’t get back to 100%, it won’t be from lack of trying. 

She is mentally alert and sharp and still in good spirits considering what she’s going through.   She is usually in good spirits, especially if her pain is under control.  She hasn’t lost her sense of humor or her mothering instinct.  She still gets a bit confused at times, asks to go home to our rig often and a couple of times she has asked me why I’m being mean to her and won’t let her get up out of bed.  But her mental state is mostly good and I don’t think she is depressed. 

She is still unable to move her left arm or hand and very little movement on her left leg although we all have seen slight movement on command in her leg and toes every once in a while.  She does curl her left arm to her chest by herself but doesn’t move it on  command.  We can feel the muscles attempt to work in her leg on command when we are doing range of motion exercises with her.  The therapists are pleased to see that and say it is a good sign to see/feel that at this stage. 

Lorraine was suffering from what is called Left Side Neglect, at least she was suffering from it.  This is when someone doesn’t know anything exists on their left side, not just their body but no awareness of anything on their left side.  I mentioned in an earlier blog that some men only shave one side of their face.  Also, when asked to turn to their left, some people turn to their right all the way around.  But anyway, Lorraine is getting better in this regard too.  She now moves her eyes and head to her left, will point to her left arm and when asked to move her left leg, she looks at it and attempts to move.  Another good recovery sign for her. 

Her last two strokes were on the left side of her brain and affected her speech and vision but she didn’t have any lasting physical issues from either of them.  This time, however, the stroke was on the right side of her brain and appears to mostly have affected her physically. 

She is regaining her ability to swallow although like I said, she isn’t back to normal just yet.  Her speaking voice is very soft, I have to get real close in order to hear her.  She doesn’t appear to be grasping for what word she wants to say, she just has trouble saying it.  I think that is because the muscles in her mouth, tongue and lips don’t work right on her left side.  The left side of her face is still drooping and when she smiles its only on the right side.  She has talked on the phone but with the quiet voice and somewhat slurred speech, she is hard to understand. 

She really seems to enjoy getting up out of bed and can’t wait until she gets a full shower vs a sponge bath.  Susy is trying to talk to her about getting her hair cut to make it easier to take care of and she isn’t totally against that idea.  I know that will be a traumatic event for her if that happens and I would like both Rich and Susy to be here if/when that happens for support. 

She does have an appetite, even though the food is like baby food consistency, guess that doesn’t change the taste too much.  We are letting her sleep as much as she wants, that’s a good thing to do to help with the healing.  One of the nurses told me that her brain is now using as much nutrition as the rest of her body as it tries to heal itself and make new pathways for the neurons to flow.  He said he expects to see lots of recovery within the next 10 days, based on what he’s seen for the past three.  Sure hope he’s right!!

Now for my normal closing here.  I ask for everyone to keep her in your prayers and send all the good thoughts you can her way.  She is able to accept visitors here and because she is in a private room, there is no visiting hours to worry about.  The speech therapist told me today that we need to restrict visitors to no more than two at once in the room and try to keep the visits short and upbeat.  She was impressed with Lorraine’s attitude and says that will really be a good asset to her as we continue going down this recovery road.

So with God’s help, your prayers. good thoughts and visits, we will do our best to get her moving towards recovery as best we can.  I do tell her every facebook, email or phone call she gets wishing her well and she appreciates every one.  So please keep them coming!

Well, once again I didn’t finish the blog until late so I waited until this morning to post it, I was too tired to do a good proof read.  Of course, that doesn’t mean you can’t find any mistakes here if you look, so just overlook any you may find. 

Thanks   Chuck


1 comment:

Beth & Eric said...

Hi Chuck and Lorraine,
Sad news to hear that Lorraine has had another stroke but so glad to hear that she is improving. She still has a way to go but tell her we're cheering her on in this and praying for the best recovery she can attain. And we appreciate your blog, too. Safe travels to your kids when they return home. And I look forward to again seeing Lorraine's great smile.
Beth & Eric Rasmussen