More physical therapy for Vickie today. Each session, the level of activity increases a little.
Vickie's do-it-herself writing therapy shows she is thinking more about her situation now. Her written words are getting larger and more legible. It's good she has the ability to comprehend what's going on, it's bad in that she refers to some of the negative issues she has to deal with.

Vickie resumed therapy today, all went well.
Not speaking to us yet, we'll be patient.

Another good day for Vickie.She hardly seems to notice that she's all on her own as far as swallowing and breathing goes. The therapist gave her about 1/3 of a cup of ice cream and she did great with it. Not to enthused with physical therapy today but she said she knew she needed to work hard at it which of course she will!! Keep up the good work Vickie!!! (Pam)

Around noon today the house Dr. visited Vickie. The troublesome but crucial trach tube was removed, hopefully it's permanent. Now it should be possible for Vickie to learn to speak again. She appears to have taken this significant change in stride. An important side effect of the trach is it could be the cause of some of the respiratory problems that have plagued Vickie all these months.

Vickie stayed bedridden today. She's very sleepy due to medication for the nausea episodes that started recurring this morning. The theory for the cause is a new antibiotic started Friday.
Despite new problems, the trach remained plugged. Vickie is tolerating the breathing issue better now.

The experiment with the plugged trach continued today. It was kept closed most of the day. Vickie is still unable to completely relax while trying to breathe in a normal fashion. When she has a bout with congestion she seems to panic a little.
Occasionally she will whisper words, she's still not able to control her breathing enough to speak.
Things are going so well now we've nearly forgotten how dismal the situation appeared just a week ago.

Vickie spent a considerable amount of time with her trach plugged today, although she doesn't seem to be overly thrilled with the concept yet. Baring any setbacks, the time span will be increased to 24 hours this weekend. This could lead to a major advancement in her recovery process, the final removal of the trach next week. This would end the last physical impairment to Vickie's ability to speak.

Another good day for Vickie. The trach plugging procedure is up to an hour, twice a day. She is a little anxious, but learning to relax and breathe normally. If she continues with the progress it's possible the trach could be removed sometime next week.

Vickie had a full day of physical and speech therapy,which went quite well. She had a low fever in the evening and was quite tired. Trach was plugged again for 30 min. morning and night, seems to get easier for her each day.Lots of family and friends visited today which is great! (Pam)

Vickie had her trach plugged to breathe on her own,in the morning and evening for 15 minutes each time and did great!! Her oxygen level stayed perfect! She seems to be thinking a lot about her situation and needs extra encouragement and to be reassured that with hard work she WILL GET MUCH BETTER!!I know she really appreciates all of her family and friends love and devotion..you can see it in her big beautiful brown eyes! We love you Vickie....(Pam )

Vickie writing sept. 19th 

Vickie is holding on again today. No setbacks for three days.
The impromptu writing therapy is ongoing and improving. While her penmanship is suspect,it clearly shows her thinking ability and wit are still there.
The nurses have resumed the process of shutting the trach, which forces Vickie to breathe normal for a few minutes, gradually increasing the time span until it's permanent.

Sunday was basically a repeat of Saturday's activity. Vickie was alert and trying to write before noon. She tires after a couple of hours and needs to return to her bed.
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Vickie had her Saturday morning shower and then spent several hours in the sunroom, in her wheel chair. After resting for a while she began writing, without prompting. She filled a page with two or three word questions and statements. Some of it was legible despite being tiny and very unorganized. On a second page she wrote the names of relatives and friends followed by "home phone #" or "cell phone #". I said the numbers and she wrote them out very clearly. She couldn't remember the numbers including her own. We'll overlook that for now.
She still has a fever, but not as severe as it's been the last week. She was more alert and responsive than we've seen in over a week. The contrast from Friday is amazing.

No improvement in Vickie's condition today.
We are coming to the conclusion that Vickie's medical needs might be better met at Emanuel. Of course this position may put us at odds with the current care provider and their phantom physician, since they have a vested interest in maintaining the status quo.

Vickie is still battling the infections that are keeping her down. She was quiet again today, not able to respond very much. She still has a fever and is receiving medication.
Today is the beginning of the fourth month of Vickie's recovery.

It was another quiet day for Vickie. She seemed more alert and responsive. She had several nonfamily visitors during the day and that perked her up. Her youngest grandson came to visit this evening and she responded to him. It looks like we might get back on track now.

Vickie is still trying to fight off her infection.Is more alert then this weekend but still not to much energy.She will stay on the antibiotic until next Tuesday and then they will attempt to see what other infection she may have and see what type of medicine can be used for that infection.Once that is under control Vickie can continue to progress with rehabilitation. (Pam)

Vickie is still struggling with the infections and spent the day resting.

Vickie spent most of the day resting. Her alertness and response were minimal today.
Besides everything else, she is now experiencing some sort of severe stomach distress that isn't helping.
There continues to be some confusion identifying the different infections and what to use to treat them.

It was a rather quiet day for Vickie today.She seemed quite tired out,but rested comfortably. No fever today which is good..maybe the infection is calming down a bit.We all are looking foward to getting back to weaning her off the trach and more physical therapy. (Pam)

Vickie continues to make progress responding and staying alert despite struggling with several infections. The process of closing the trach and allowing her to breath normal has been halted until the lung infection is cleared up.
Each day she seems more aware of her circumstance and what's going on around her.

Vickie was quiet today.
She had a very high fever during the day. It was down some this evening. Not sure what's causing it. More tests and guessing. We're back on the roller coaster.

Vickie had a full schedule today with the different therapies she's doing now. The progress is small but significant. Each day seems to build on the previous one.
Her nurse for the day did the procedure of closing the trach which forces Vickie to breath thru her mouth and nose. While this may seem simple to us, Vickie has not done this in almost three months, so it's somewhat stressful for her. They only do this for a few minutes each day, gradually increasing the time she must breathe normally until she is able to do it all the time. The nurse reported that Vickie said "Yeah" faintly, in response to a question. This would be the first word she has spoken since June 16th.
Tonight we were prompting Vickie to write on her pad. Most of her handwriting is tiny and illegible. One sentence we could read, "when do I get to go home?" Today wouldn't be soon enough.

Back to PT for Vickie today.She stood up(with much support) for 18 min today,she did great. They plugged her trach for 15 min and the nurse said she did much better today,the nurse said tonight another 15 but as of 10:15 that hadn't happened yet.The infection is still present(we were told yesterday it wasn't in error).She will be treated with the antibiotic until trach is out and healed.Fever of 100.8 tonight and had lots of stuff to be suctioned,but was in very good spirits and entertained herself by changing tv channels and turning tv off/on w remote. She did great with her speech doctor and even wrote on paper "Goodbye Robyn" when she left,even spelling her name correctly.Keep up the good work Vickie!!! We know it's hard work but your doing wonderful!!(Pam)

Vickie's trac was plugged for about 5 min today(the nurse supervised the entire time) to see how she could manage breathing through her mouth and nose on her own..she panicked some, but was able to make it through it ok.The goal is to increase the time each day,twice a day until it can be removed all together. We all will be ready to celebrate the day that bothersome (but very necessary) device is removed. Her female speech doctor said she can see some improvement since the last time she saw her,two weeks ago, as well as all of us can.(Pam=Vic's sister)

Vickie was alert today and sat in her chair for around three hours,mostly awake and aware. She had a surprise visitor,her cousin Dolores from Washington came to see her,I'm sure Vickie appreciated her visit very much. She was also happy to see Becky's son from Phoenix..she seems to remember everyone,even those she doesn't see very often..which is great to see!! She was pretty tired tonight and seemed to be comfortable and needed some rest.The results from the culture for her infection will be probably be back on Tuesday,hopefully they will be negative so she can continue to get stronger...(Pam-Vickie's sister)

We met with the speech therapist this morning. He believes Vickie has a ways to go before she can have the trach removed. We will need to be more aggressive in helping her relearn to communicate.
Tonight, when handed her toothbrush, Vickie put it in her mouth and made an attempt to brush her teeth. It's still the little things.

Therapy for Vickie was stepped up this morning. She was placed on a table that can be raised to a vertical position. She was able to be in a standing position, well supported of course, for some time. She seemed to like this new experience and didn't show any signs of distress that sometimes occur when this is attempted for the first time with people in Vickie's condition.
She continues to be very responsive at times.
Saturday morning the speech therapy Dr. will give an update on Vickie's progress and pass on the latest instructions for dealing with her.

Lots of visitors today. Vickie probably wondered what was happening this morning when half the family showed up in her room, waiting for the afore mentioned meeting to start.
One item discussed during the meeting concerned the trach and how soon it might be removed. The infection must be cleared up first and Vickie needs to have control of her ability to swallow. We are close but not quite there yet. She's a long ways from transferring to rehab at the hospital.
Some issues about staff attitudes and procedures were also debated and noted by the supervisors.
The financial aspects of the situation are becoming more important since the insurance coverage will end next week and Vickie's stay at Rest Harbor becomes self paid. The therapy will continue to be covered, so that's some consolation for us.

Vickie was more alert and talkative today than we've seen before.
On several occasions she was scribbling words and partial sentences, some of them we could decipher.
Tomorrow morning there will be a family/professionals meeting. Hopefully we can discuss Vickie's treatment and more importantly what is in store in the near future and for her long term care and recovery.