Vickie appeared to be her regular self today, with little leftover effects from the problems she experienced the last couple of days.
Friday morning she has an appointment for an EEG at Mt Hood MC. It's just a check to see if anything unusual has happened. It was scheduled several weeks ago and has no connection to the most recent events.

Vickie recovered from her bout with nausea. Although she was quiet and only whispering today, she managed to eat her meals without any problems.
The evaluation at R.I.O. was cancelled this morning and rescheduled in January.

Today was a setback for Vickie. She spent the day sleeping after episodes of nausea. Medication for the problem acts as a sedative. The timing couldn't be much worse since she has an appointment with one of the R.I.O. drs Wednesday morning for an evaluation to determine if she might be ready for their program.

Vickie's incremental progress continues.
The confusion seems to be the major issue now that some of the other problems are resolving themselves.
There doesn't appear to be much improvement in her left side paralysis.

Vickie got off to a slow start this morning and later in the afternoon due to staffing issues.
She fed herself both lunch and dinner. Just one more example of the progress Vickie's making.
She's starting to ask pointed questions about her condition and future that are difficult to answer honestly. Even in her confused state of mind she knows things aren't right.

Each day Vickie's cognition improves, albeit ever so slightly. Her conversation is more relevant and spontaneous.
These posts are probably starting to seem redundant, but without the constant crisis situations we were accustomed to, there's not much to make note of.

Vickie's diet is gradually going to "normal" food and she seems to like it.
Next week she will go to R.I.O. to be evaluated by one of their Drs. If she keeps improving as she has the last few weeks it could go well.

Today was the same as yesterday for Vickie, only a little better. Sleep some, eat a little more, do some writing [it's a little more legible], watch a little bit of TV and know what's going on and talk with visitors in her own way.

There were no apparent changes in Vickie's situation or condition today.

There were no new issues for Vickie to deal with. That means it was a good day.

Vickie continues to up the ante on food, having a regular sandwich for dinner. The use of the feeding tube should end very soon.
Vickie has started to notice her surroundings more and commenting on what she thinks she sees.
In December Vickie has several appointments she must travel to. It might be time to look for a low cost wheelchair van to buy.

Apparently the staff doesn't believe Vickie is consuming enough food at her meals. The tube feeding has been restarted. We think they aren't seeing the situation as we do. She feeds herself, not quickly or neatly, but she gets the job done. She never has been a big eater. It's institutional food, who wants to eat a lot of that?
Otherwise is was a good day.

Things calmed down today, Vickie ate her meals and kept them down. She talked plenty with her visitors and then was relaxed at bedtime.
The confusion continues and Vickie is aware that she has problems remembering and organizing her thoughts.

Vickie fed herself Thanksgiving dinner today, however for some reason she was unable to keep it down. She was very sleepy all day, either from the anti-nausea medication or possibly a virus.

Vickie seems to have settled into a routine. Three meals a day on schedule, gradually moving to more conventional food.
Her writing is becoming more legible.

For dinner this evening Vickie was fed by her therapist food that wasn't pureed, but chopped very fine. The pace of improvement is increasing.
We've gone several days without any serious problems.

The house Dr. visited Vickie this morning. The daily inhaler treatment and the blood sugar tests are terminated. There will be no more feeding thru the tube as long as she continues to eat regular food. The tube will remain in case of a setback.

Tonight Vickie was more quiet and lucid than usual, less anxiety and more thought out remarks.

Vickie spent the day eating, sitting in her chair writing,napping and talking, at times with visitors sometimes without visitors.
The confusion is constant and there are times of anxiety, possibly the two are related.

Vickie is eating more of her meals. She is attempting to feed her self. She now drinks from a cup that she can pick up on her own. Maybe the feeding tube's days are numbered.

The end of Vickie's fifth month of recovery passed by last week without mention. Sometimes the remarkable progress she is making is lost on those of us who see her daily, as we get caught up in the immediate issues she must constantly deal with.

Vickie is continuing with her eating binge. The amount she eats is gradually increasing. The current schedule is for three meals a day with an aide feeding her.

Vickie has been experiencing some severe anxiety episodes. Not sure what the cause is.

Everything went well today.
Vickie is starting to eat more varieties of food. She can hold her own glass to drink now. It's possible she may not need the feeding tube in a few weeks.
She was alert and talkative again today, however the confusion is still a major problem.
Vickie has a tentative December appointment to be evaluated for the R.I.O. program. Hopefully she will progress enough in the next weeks to qualify for their therapy.

No stress for Vickie today. This evening she was alert and talkative.

Vickie spent half an hour on the stand-up platform this morning. Apparently the effort wore her out, she was very tired the rest of the day.

Vickie had a good day, no crisis or new problems.

Vickie had good interaction with her visitors today.

The speech therapy Dr. was in this evening. Vickie had a bowl of tomato soup with crackers, a sandwich and ice cream to finish it off. Her ability to eat is not in question, however her cognitive awareness is still not where it needs to be for her to eat on her own.

Like many others, Vickie seems to have a head cold, but it's not having a serious effect, at least for now.

Vickie had a good calm day.

Vickie had a quiet day, sleeping more than usual. There were times of increased agitation, probably due to the confusion she is experiencing.

As Vickie's recovery continues, the medical issues are not as critical as they were previously. Now her mental status is more apparent. She is experiencing confusion as to her situation and she's becoming frustrated with her inability to sort things out in her mind. This is probably normal for someone with her condition, but it's still troubling to us.

While the physical therapy has been temporarily discontinued, Vickie is still learning to eat and drink again.
There were no negative events so it was a good day.

Vickie's condition seems to have stabilized. No crisis today.
Therapy has been discontinued for a while until her cognitive ability improves.

Vickie will have an evaluation by a Dr. from R.I.O. in December.

Physical therapy was resumed this morning. Vickie did well.
This evening she was able to eat more food. It may have been too much, too soon, since she wasn't able to keep it down.
Vickie has a fever again, like before, we don't know why.

Vickie was quiet or sleeping much of the day, probably due to the anti-anxiety medication she received last night. This evening she was awake and talking some.

Vickie had a session with her speech therapist. She had some soup and used a straw to drink this evening. The next hurdle is for Vickie to feed herself and be rid of the feeding tube.

While Vickie has moments when she seems completely lucid, at other times she tends to be somewhat confused about her situation. This week she has at times complained of head pain. Given her circumstance this can be an alarming symptom to us. It's difficult to determine the difference between what is really occurring and that which is the product of her mind's disorganized state. The staff wants to react to her complaints, using medication without any further investigation.

The evaluator for R.I.O. determined that Vickie is not ready for their program just yet. The R.I.O. therapy is more intensive, for a longer duration each day and much more expensive than what Vickie is undergoing now. Also a follow up plan for Vickie's care will need to be presented that's appropriate for her when she is discharged.

A strenuous therapy session for Vickie this morning.
No word on the R.I.O. evaluation yet.

Vickie had a visit with the evaluator for R.I.O. today. This is the first step to moving to Good Sam. for full time therapy. We'll get her initial opinion tomorrow to find out how much more Vickie needs to be able to do in order to make the transition.

Vickie was very tired after her triple session of therapies today. She has received authorization for 7 days to see how she responds.

Vickie had another quiet day.
No word on the therapy issue.

Vickie spent the evening sitting in front of her room passing out treats to the goblins visiting the facility for Halloween. She wore her witch hat and kept a running count of the treats she had on hand.

With the absence of infections and fever Vickie is becoming more talkative. While many of her comments and questions aren't in any logical [to us] context, she still comes up with some profound statements and quips. The change in the last two weeks is remarkable.

Vickie had another pleasant day with no setbacks. She interacted with her visitors well. Each day there is a small improvement.
The therapy issue is still in question.

Despite Vickie's speech therapy Dr.'s insistence, the insurance purveyor still insists on withholding payment for therapy.

Vickie did well today. She was awake and in her wheel chair until 9:30 pm. writing.
We have gone more than a week without any serious medical setbacks.

Vickie's speech therapy Dr. pronounced her ready for more therapy. The insurance moguls will reconsider her situation. She's ready if they do. Tonight she was wheeled down to the piano, without prompting she plunked out a one finger rendition of "Mary had a little lamb".

Thursday we have a staff/family meeting to discuss Vickie's care and future. Not sure what they can tell us that we aren't already aware of.

No crisis today. Vickie was in her chair for an extended time during the middle of the day. The subtle but steady progress is encouraging.

The Dr. was in to see Vickie this morning, he's ok with her progress.

This evening Vickie was in her chair taking a tour of the facility. When she was sitting by the piano in the TV room, she started plunking on the keys with her right hand. No concert, but music to our ears.

We now have to begin the aggravating duel with the insurance overseers, trying to persuade them to pay for Vickie's therapy.

Vickie had a quiet Sunday. No crisis today, we needed a break.
This evening Vickie asked the most pertinent question yet. She wanted to know what is wrong with her? Did she have cancer or some other debilitating disease? She was told that she had a stroke. She said she needed to ask her Dr. some questions. What should her diet be and some other relevant questions.

Vickie is becoming more aware every day now. This morning she experienced a minor panic episode while being lifted from her bed to the rolling chair for her shower. She has done this procedure often but this is the first time she has shown a negative reaction.
Later in the day vickie was talking and interacting with visitors as best she could. She has participated in several short telephone conversations in the last few days.

It's official, the financial overlords have determined that Vickie is no longer eligible for Physical therapy since she hasn't kept to their timeline for improvement.
Vickie's speech is improving along with her ability to comprehend. The down side is she is showing some frustration and she seems a little depressed at times.

Vickie participated in physical therapy this morning. She is now allotted P.T. an a one day at a time basis, providing she meets the criteria imposed by the provider. We probably should be thankful for the largesse of the provider.
Vickie is talking more now and making conversation, albeit not always in context.

Vickie was transported to Mt. Hood Medical Center this morning for tests to determine the cause of the pain and bloating she is experiencing. The tests were inconclusive.

Vickie spent a couple of hours in her chair this morning before asking to return to bed because of pain in her abdomen.
This evening she had a high fever, still don't know the cause of the fever or the pain.

After Vickie's sisters demanded more attention to the pain she is experiencing, the staff relented and contacted the house Dr. He appeared this afternoon and agreed to an ultrasound exam. The exam didn't show anything definitive that could be a source of the pain. Now we will wait for any results from the blood tests that were done today.

Vickie is continuing to talk and at times coherently.

The financial gatekeepers have decided that Vickie isn't progressing fast enough to meet their criteria for continued physical therapy and have stopped authorizing it. Just when we appear to be on the verge of a major breakthrough this comes up.

Vickie is still complaining about severe pain in her abdomen. The staff insists on treating the condition with Tylenol type medication. We suspect the problem might require a serious hands on investigation to determine the cause. The phantom Dr. is of little help so far, diagnosing by telephone or osmosis.
At noon, Vickie was whispering her thoughts to us. This evening she was speaking loud enough to hear from her bedside.

Despite bouts of nausea and the persistent fever, Vickie was able to have a good visit with three of her cousins from Washington this morning.
Although she's not speaking regularly, Vickie is still communicating her thoughts with audible whispering.
Today is the beginning of the fifth month in Vickie's recovery.

Vickie celebrated her birthday with a small group of relatives and friends tonight. It might have been a little overwhelming for her.
A new problem has come up now. Vickie says she is experiencing severe pain in her waist area. We don't know what's the cause or what to do about it.
One thing is for sure, she can now tell us what she's feeling, no more guessing and playing charades trying to figure out what's going on with her.

Thursday was pretty much a repeat of yesterday. Vickie is slowly regaining her voice, uttering an occasional word loud enough to be heard across the room. Some of her comments are profound, others are not.

Vickie actively participated in her therapies this morning. With the therapy and the fever that just won't go away, she needs to rest a lot in the afternoon. She was awake and responsive later this evening, but tired quickly.

The fever problem was still with Vickie this morning.
She spent a considerable amount of time in the wheel chair during the morning and then later this evening. Tonight she asked to be put in her chair.
We are trying to teach her to use the call button at her bed to summon the staff. It would be helpful if they would do their part in our little exercise.
Vickie's asking more questions about her circumstance. It's difficult for her to understand why she's where she is.

For some unknown reason Vickie is still having fever problems that come and go. Otherwise she appears to be doing good.
She isn't able to make the step from a quiet whisper to talking out loud yet. She has quite a bit to say even though a lot of it seems to be out of context.

There were lots of visitors today, including an aunt and cousin who traveled from North Dakota. Vickie was a good host, sitting in her chair ,writing and answering questions as best she could.
With Vickie's door closed and no noise in the room, it's now possible to hear and comprehend her whispering. Her comments and questions are another matter. They can be a bit confusing. Of course this is all understandable and acceptable considering what she's been through.

Vickie's fever was a little lower today. She was very alert and trying to whisper louder. She will be speaking soon.

Vickie participated in physical therapy despite a high fever and early morning nausea.
This evening the fever was lower and she seem to feel better.

Vickie spent a large part of the day in her wheel chair. Lots of writing in her tiny and random method. She is able to whisper what she wants to say at times. The trend is definitely up.

The fever Vickie had yesterday left as quickly as it came. No explanation.
Vickie had some potato soup today, slowly starting her on regular food.
This evening she was very "bright", alert and whispering at an almost audible level. We're getting very close now.

It was a down day for Vickie. She has a high fever, it's cause unknown. Maybe tomorrow it can be diagnosed and treated.
Vickie doesn't have much enthusiasm when she has to deal with extra problems.

We seem to have settled into a routine with no profound changes, just a slow and small incremental improvement for Vickie.

Sunday was a repeat of yesterday, only better. Good speech and swallowing therapy. Lots of self-directed writing exercise. Vickie was alert and responsive for extended times. She is now able to communicate some of her basic needs.

Vickie did good in her speech therapy this morning. She had a little ice cream and a small amount of soup to test her ability to swallow.
She managed to do a little larger writing, impressing the therapy Dr. He's predicting she could start talking soon.
She seemed alert and responsive during the day. Vickie is communicating her needs more now. Lots of writing on her pad, still difficult to decipher because it's so tiny and unorganized.

Another good session of physical therapy today for Vickie. With the aid of support equipment, she is able to stand up for a short period of time. Her ability to swallow under control is increasing, demonstrated by her eating a small amount of sherbet. At some point in the near future maybe the feeding tube will go away.

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.
I've added a setting for anyone who wants to e-mail a daily post. Click on the little envelope under the post.

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.