Joanie visits the ENT

We had our appointment with Dan to check on the broken bones in her face. We were nervous because it seemed likely that surgery was going to be required. Dan saw no evidence of a break below her eye and the nose, which was broken in two places, has healed nicely. There is a slight bump in her nose, but if you can see it, you are getting too close! If after six months, Joanie wishes to, he can do surgery on it. At this point we're thinking that isn't likely to happen. It was great to look at the CT scan of her face on Dan's computer screen and view all the different layers and views they took. I'd sent them three CD's from Memorial Hospital. When we left, I took the CD's and dropped them off at Steve's office so he can see what her shoulder and arm break look like.

Joanie enjoys home

Joanie has been home four days now. The first day three different people came in and spent 2-3 hours with her to make sure she was making the adjustment from hospital to home life. She enjoyed visiting with her friends and was ready for bed that night. She slept for over 11 1/2 hours! Both Thursday & Friday I went into school late so I could get her day started right. She did fine by herself on Friday. Earlene dropped by about noon to check on her and the visiting nurses came by to talk with her and draw blood. Her INR was 2.9--a little high so they had me cut back on her Coumadin. Sabbath was a restful day for both of us. Teri came by in the afternoon and Joanie really enjoyed talking with her. Teri has taken Joanie's place at school, teaching 1st & 2nd grade. They found enough to talk about, so I went on a bike ride. Just before I reached home, I was followed by one of those huge four wheeled drive diesel pickups that our county is famous for. I thought they were being nice and waiting for a safe place to pass me (difficult to find on our hilly, twisty roads with NO shoulders) but instead it was just Bob & Earlene and grand kids! They stopped over for a few minutes so the girls (3+ & 1+) could play with the cat's toys.

Today we took a short walk on our street with Joanie using her cane. I've had her stop using it in the house since it seems to get in the way, she's always leaving it behind, and she can't carry anything if she has her cane. Her left arm remains multi colored from the bruising and break. She faithfully wears her brace and generally behaves herself. Another visiting nurse stopped by and checked up on her.

Monday we are off to the ENT to see what he says about the breaks in her face. I sent all the XRays over to him from the Modesto hospital several days ago. When we leave Dan's office, I'll probably drop the X Rays off at Steve's orthopedic office for him to look at the break in the arm.

Joanie's home!

I brought Joanie home this afternoon. She had a tough night and day today because her new roommate had a bad smoker's cough, was confused, and talked loudly and often. She is delighted to be home & I've promised to not talk to her...well, maybe a little. We had two kinds of soup thanks to Bonnie & Wendy. Joanie called her relatives to bring them up to date, and was delighted to go to bed at 8:30. The cat was delighted she went to bed then also. I unloaded and put away a lot of things, did a load of wash, and washed dishes. I'm also looking forward to crashing soon.

I'm going to go in late to school in the morning so I can get Joanie up, help her get dressed, (a challenge with one arm strapped to your body because of a break), and get her breakfast. Three wonderful friends are going to take turns staying with her Thursday (thanks Earlene, Bonnie, & Nancy) while we assess her ability to be home alone.

She continues to look better and feel better except for the great pain in her left arm/shoulder. Thanks for your prayers.

Joanie comes home!

Wednesday afternoon, Joanie is scheduled to be released from her inpatient therapy center. She is feeling better and looking better as she continues to make progress every day. Since arriving here in Sonora last Tuesday, Joanie has made many positive steps towards returning home. In spite of her great care, she is anticipating looking out her own windows at home where several trees are have beautiful leaves to view. She seems to think that she needs her cat to sit on her lap (the cat agrees!) and watch a little Home & Garden TV. By the time she gets home, she will have been gone almost four weeks.

This photo was taken Sabbath afternoon sitting on the patio at TCU. It was one of those perfect Fall afternoons with temperatures in the mid 70's.

Joanie likes art

Joanie continues to improve. I spent some time with her Wednesday afternoon. When Bonnie arrived to visit, I returned to school to grade papers. In the early evening I returned to find her sitting in a chair eating supper. That of course is a huge change from one week ago when she was in ICU. She had prepared another list of things I needed to bring from home to make her stay more comfortable or to allow her to dress for therapy. Since her left arm is strapped to her body, many common tasks remain challenging.

Thursday morning I again dropped some things off in her room and watched her sleep for a few moments before I left on a field trip to San Francisco and the King Tut exhibit. The students did well and may have enjoyed viewing objects made about 3500 years ago! By the time I got to her room at about 6:45 PM, she was sitting in a lounge talking with four of her good friends about art. This group gets together monthly to encourage each other to work on art. Joanie had verbalized on Wednesday that she regretted having missed their last gathering. I told her that Earlene had called and that they were planning on bringing the meeting to her. She was jazzed and enjoyed thinking about that for the next day. I stopped by for a minute to see her before I drove home, knowing that she was more interested in her art meeting that seeing me at the moment.

Joanie takes Sonora by storm...sorry, bad weather today!

Joanie arrived by ambulance in Sonora about noon today! I'm so excited to almost have her home again. We were dreading her ride up here since she can get car sick just thinking about it. Turns out our concerns were in vain. Apparently the crew doesn't relish cleaning up their unit and so she arrived in good shape. Joanie's settled into the in patient rehab unit. She really likes the staff there and remembers them from her stay there for several weeks following her stroke in May 2008. Her only complaint is that it was used as the birthing center before the new hospital was built about five years ago and they've never updated it. The paint scheme is blues & pinks and very dated. Her roommate is sweet, quite deaf, and likes to turn her TV on before promptly falling asleep.

Joanie is now getting out of bed, with assistance, and walking to the bathroom. She sits on the edge of her bed and feeds herself with a good appetite. These are all remarkable changes from just a couple of days ago! She is in good spirits and is delighted that I am now only a couple of blocks away. I was able to see her during lunch, right after school and then again after I left school before I came home. This beats a one hour plus drive down to Modesto and back.

Monday--Coming home, almost!

As I was driving Troy to the Bay Area to catch a morning flight home, I received a call from one of Joanie's numerous doctors. Enough of them were able to communicate and agree that Joanie can be discharged. They expect to discharge her "early" Tuesday morning. She is to be transported by ambulance to Sonora Regional Medical Center's in-patient rehab unit. I can't wait!

She was finally placed back on Coumadin this afternoon. It is their policy to wait one week after a bleed to restart the blood thinner. Even though they have been monitoring her heart, her not being on Coumadin has made me very nervous. We don't need another stroke!! She sat up for quite a while today, ate on her own, (even though I bribed her with her favorite See's chocolates if she ate enough) and started taking oral meds. She doesn't yet get up and around by herself.

After dropping Troy off at the Pleasantan BART station, I drove home. Since there is nothing I can do to help Joanie tomorrow, I plan to go back to school.

Sunday evening

Troy & I went home to Twain Harte last night. This morning, I went down to school and worked on lesson plans for next week. It is nice to have an excellent substitute (thanks Julie) who has taught with me for 17 years. She knows the school and has been forced to figure out how I operate (pardon the pun). We took care of several tasks at home before returning to Modesto.

Joanie has had a migraine today and so has spent much of the day sleeping. This evening she is in pretty good spirits and talkative. She always makes sure that Troy has his chair positioned so that she can see him from her bed.

Joanie's hemoglobin has climbed to 9.5 which we consider a good sign. Her day nurse has left a note for her hospitalist to see if they will consider starting her on anti coagulants again since her INR is down to 0.9. Her night nurse and the charge nurse have both been in to check on her.

We are enjoying some beautiful flower arrangements sent & brought by good friends.

Friday, Noon--written by Troy

Mom is doing better. This morning they moved her out of ICU to a regular room. Dr. Lance Carle asked for her to still be hooked up to "telemetry" monitors. He might have a promising future in the medical field from both his own experience and working with Mom.

Dad drove down early this morning from Stockton where we are staying and I came down later with Grandma Elaine.

When we got here she was pretty groggy. She had another CAT scan of her face and the movement made her sick. She's on nausea medicine and pain killers.

We saw her bone doctor. He walked in in street clothes (looking much like a construction worker) and both Dad and I thought he was just in the wrong room. He told us that she likely wouldn't need surgery for her shoulder. It would just take 3 months or so to heal.

We also met the "discharge planner." She and Dad are expecting that she'll be here at least through the weekend and then she might be able to move to a care facility in Sonora for a while for her to regain her strength.

Lunch just arrived.

The "hospitalist" is here now. He is saying that she's in good shape. Her hemoglobin has dropped some so they are watching that.

Mom looks better today. Her face is less swollen and her eyes and nose are looking better. She's a little groggy right now, but she's still my Mom. She was joking around with her nurse last night and made us all laugh. She's happy Dad and I are here.

Thursday 4:00 PM

I was pretty exhausted yesterday since Joanie prevented me from getting a good night's sleep. Tuesday night I drove back to Twain Harte and got to bed about 1:30 AM. Wednesday I had every intention to get back down to Modesto in a timely manner. It turns out that I was so distracted and disjointed that it took forever to get away. I decided to wash her clothes that I'd brought home from the hospital to get the blood out of them. I threw away her shirt & bra that had been cut off her, but happily washed her fleece jacket. When I took it out of the washer, I realized that it had also been cut to shreds! Her jeans have a mysterious one inch cut in the bottom of one cuff. I'm guessing they started to cut them off but then decided to just remove them. They were her best fitting pair of jeans. Maybe I can fray and cut up the cuffs and she can be more stylish.

When I arrived this morning I learned that the neurosurgeon had finally been able to look in on her last night about 11:00 PM. He canceled all orders for an MRI of her head and lower back. He must be satisfied with her progress. I talked to her hospitalist this afternoon and he is pleased with her progress but is deferring to the neurosurgeon about when to move her out of ICU. Joanie's INR is down to 1.0 with the addition of another unit of plasma yesterday. The anti coag clinic in Sonora has been doing an excellent job of keeping her between 2-3 to avoid the possibility of her throwing a clot if she goes into atrial fibrillation again. When she arrived at ER Tuesday evening her INR was 2.3. When the internist talked about moving her soon, I requested that she be kept on a heart monitor as long as possible.

Physical Therapy has been in twice today to get her out of bed. The second time they had her take a few steps out into the hall using a hemi walker since she cannot put any weight on her left arm/hand. Wouldn't you know it, 3-4 weeks ago I donated her hemi walker to a group that gives them out to needy people. After her stroke in May 2008, I had purchased her a new one when I could not find a used one. She used it in the house only two or three times before going without. C'est la vie!

Joanie is looking better but is not so much fun some of the time. She is still on morphine for pain and enjoys sleeping. Apparently I'm not that much company. She is still very puffy in the face but they are slowly working at washing away all the dried blood from her face. Some places have scabbed over so of course they are leaving those alone.

We are amazed at the responses we are getting from this blog and FaceBook. I've been on FB for six to eight months and have made 3-4 posts and 4-5 comments. Mostly I just glance at it every day or two. Within about thirty minutes of my post yesterday morning mentioning Joanie's condition and linking to this blog, I had three responses and I continue to hear from people. I read all of them to Joanie and we marvel at the outpouring of love for her. That and your prayers are keeping her going.

We have heard nothing about a timeline for Joanie's release from the hospital. Since we are getting such good care, I'm in no rush.

Joanie is in good spirits and is doing as well as can be expected. She really likes her nurse and we are glad to hear she will be back again tomorrow on another 12 hour shift. The ENT doc wants to wait about a week before thinking about surgery because of the swelling. The ortho PA says that the break in the left arm is in the humerous and will not require surgery. They have ordered some kind of a brace that will hold it still so she'll have less pain when moving. The left side is the most painful but she hurts all over! The blood in her brain seems to be shifting a little, perhaps because she's lying on her back all the time. Consequently she has a terrific headache. Her face is swollen and black & blue but typical Joanie, she feels badly when she calls out in pain. We feel that she is being very well treated her in Memorial Med Ctr in Modesto.

We are waiting to see the neuro surgeon but he's in surgery right now. They expect him to order an MRI and they also want to do an MRI of the lumbar region to see if the compressions they see are new or old. They'd like to do both at the same time since the movement is so painful.

Troy landed in SF at 4:00 after flying down on Virgin America. They offered him an upgrade to First Class for an additional $20. It was probably a mistake because he loved it!! His Aunt Cathy, who lives and works in SF, picked him up at the airport and is bringing him over. Joanie is excited to see Troy. He did tell her that she didn't need to go to such lengths to get him to come down from Seattle. He will be able to stay in Calif. till Monday evening. I'm not sure how he'll manage without his girlfriend and her new puppy. We can't match that.

Not much new to report. Joanie has been seen by a Trauma specialist and the ENT. They are going to wait for some swelling to go down before the ENT decides what to do. She is in some pain because she just got more morphine and is sleeping. Her nurse last night said she spent much time talking about her good times down in La Sierra/Loma Linda and remembered the train ride north. She has no memory of her fall.

Troy is flying in to San Francisco this afternoon and will be here for several days. How nice that his school has home leave beginning at noon today. I'm looking forward to having him around!!!

Joanie spent a wonderful 10 days down in Southern California visiting with her sister and mother. She was also able to see a number of close "old" friends. She had ridden the train/bus down there and returned yesterday afternoon to Modesto, our closest train stop which is about 1 1/2 hours from the house. I was 3-4 minutes late getting there yesterday. The train was still in the station but I couldn't find Joanie anywhere. Her suitcase was in the station but she wasn't. I had a good idea she was on the train because I'd talked to her 30 minutes earlier. Finally the station master received word that someone had fallen and pointed to the open door. I knew that it had to be Joanie. I ran over to the train and climbed aboard to a scene from CSI. Joanie was lying at the bottom of the stairs in a pool of blood but conscious! The conductor was on his cell phone just calling for an ambulance. (As I sit here typing, I can't help but cry as I recall the scene.) What I know is that she fell down the stairs in the train car. Each car is a double decker with fairly steep stairs going between the two levels. What I believe happened is that she was riding on the top for the better view and went down stairs to use the bathroom prior to her arrival in Modesto. I think she was returning upstairs as the train slowed and stopped. An eye witness says he thinks she was going up the stairs. I think she lost her balance, fell forward and hit her nose and head (hence the copious amount of blood) and then fell back down 6-8 steps to the floor.

The EMT's put a collar on her and placed her on a backboard before loading her unto the stretcher. She was taken to Memorial Medical Center in Modesto, about 3-4 miles away. They treated her very well in ER and she was seen immediately. After X-Rays & CT scans I was told by a neurosurgeon she had a hematoma in her brain between the the two hemispheres. He expects it to dissolve and that she won't need surgery. They took her off Coumadin and gave her two units of plasma to thicken her blood. There is a risk there, but no other option to get the bleed to stop. I had been told she had broken bones in her shoulder, but the neurosurgeon saw no breaks, only some spurs. She also has some broken bones in her left shoulder, the one that has been painful since her stroke. That has been the only pain she has complained of so far. They also did a CT of her face and discovered that she has broken bones in her nose. She was in ER from 5:30 till 1:00 AM before being admitted to ICU. The night nurse says that she talked much of the night about her adventures in Southern Calif. but has no memory of her fall.

Today she will be seen by an ENT for her nose and face and by an ortho for her shoulder and perhaps neck. I came home last night, arriving about 1:00 AM. When I called, they were just taking her to the room.