Swan Lake; Broken Hip; Successful Surgery; Room 590 in Sid Richardson Building

Harris Rehab wanted Mom to be more independent. So, she took it upon herself to dance Swan Lake, solo, on the way to the toilet.

Not really. I kid. Mom did fall while walking herself to the toilet. She was supposed to have called a nurse to help her. In her own words:
I did a pirouette, fell, and could tell something was wrong.
The nurses found her sitting on the floor of her room, calling for help, with a broken left hip socket.

This afternoon's surgery, to replace her hip socket, was successful. Mom will be moved to

Room 590

Sid Richardson Building.

She will be able to walk on her new hip socket possibly as soon as tomorrow(Wed). She will go back to Harris Rehab approx. Friday, and will begin a full rehab schedule on Monday. The overall impact of the broken hip will be to move her rehab schedule back by one week.

Unrelated:
There are lots of male ballet dancers who are famous, but almost zero female ballet dancers. Does anyone know if there is a reason for this? Is it just a fluke?

Impressed with Harris Rehab

The Harris therapists: speech, physical, occupational, have been very professional. Am impressed with their plans for Mom. Things will really get cooking beginning Tuesday.

Harris does not want nurses doing every little thing for Mom. They want her to shift herself around her bed, and walk (supervised) around the hospital, and do things for herself. They want her to increase her independence.

Speaking of independence, I got a laugh at her response to a question from her speech therapist:
What would you do if you lost your credit card?
I would call one of my sons....

Continued progress and another move

Bradley here, guest blogging again for Greg's ailing PC:

Mom continues to progress in a slow but steady pace. She had spent the last two weeks at Kindred Hospital, an acute care facility. The doctors are pleased enough with her progress that they are moving her tomorrow to Harris Hospital Rehabilitation Center, near downtown Ft. Worth, to

Room #300 in the Sid Richardson building

(this is now confirmed).

The primary reason for the move is that she can sustain up to 3 hours of physical therapy per day, which is good enough to be over the hurdle of the acute care facility. Anyone planning to visit please redirect your route to Harris.

Other tidbits gleaned from a distance:

She is now walking, aided, up to 250 feet. To continue in the spirit of Greg's sports analogies, she fielded a kickoff at the goal line and burst through the wedge and away from the secondary defenders, only to get tripped up by the kicker at the 16 yard line.

Her voice is louder, although still a far measure away from full volume. The best way to describe it is that in a perfectly quiet room, you can hear her speak from 10 feet away. Greg did relate that the other day everyone was standing outside the room, and Mom wanted something. In a clear, commanding voice, she called "Jake!". It was so startling and exciting that she used a normal voice, everyone rushed in to hear, but she was back to low volume instantly. Apparently Mom needs proper motivation plus a grandchild to get good volume.

They have been doing electric stimulation therapy with her throat to help with her swallowing/aspiration issues. No revolutionary development to report yet.

Snippets

Jenny Robertson's FedEx penguin return was Monday's top story in Baton Rouge's newspaper: The Advocate. Way to go, Jen.

Later on Saturday, Doug Melton and Mark Carter visited Mom, to round out the Saturday visitors. She loves to see those guys.

Sunday, Monday, and Tuesday were days of long distance relatives' visits:

• Sister Pat Caggiola, and husband Larry, from Bossier City.
• Sister Jane Grismer, and husband Jerry, from Little Rock.
• Sister June Post, and son Frank, long distance from Colleyville!
• Grandson Baron, from Denham Springs, LA.
• Also, Tommy from WNH, Connie from WNH, and prolific mother Stephanie Hunsinger(and I'm sure I missed some people - apologies).

Still, this was not enough, as Mom demanded Janet and Bob Dodson's appearance:
Me: "Janet and Bob were just here on Saturday."
Mom: "They are retired now, and they can come visit again."

Austin and Kacy have provided decorative artwork for the walls of Mom's room at Kindred. Toria Post has also contributed her considered art talents to the room. (Nancy Cotharn Update desires emailed pictures of Toria[creating her art] and Preston[in Tae Kwon Do stance])

Mom is demanding her cell phone. She made her first outgoing call on her room phone: a late night call to the nurses' station at WNH. Shape up, whoever is on duty. She might show up in person next time.

My son (Jake) played a DVD of a Jazz Band song performance for Mom. Other visitors were in the room, so he turned off the DVD after one song:
Mom(insistent, pointing at the laptop computer): "Play the rest of the concert!"
Jake: "These people don't want to watch the entire concert."
Mom(matter of factly): "If they don't want to watch, they can leave the room."
You should know that we all watched (most of) the rest of the concert.

Note: Jake's Jazz Concert was expertly filmed by my beautiful and brilliant film school graduate cousin: Brooke Dodson. She is for hire -for weddings and parties. She is accomodating, and pleasant, and is the most talented videographer you could possibly hire, as she already has two years post graduate experience in the business, and has produced and shot two dramatic movies, along with documentary and for-hire projects. Get her now, before her schedule becomes completely overloaded with commercial and movie shoots:

SBDodson Productions

sbdodson [at] gmail.com

She'll be the best contractor you've hired in years.

I am being firsthand reminded of all the nice things Mom does on a consistent basis. She is ordering me to take on her various tasks:

• Go and get Jake's awards framed - in nice frames, so he can be proud of them. Do it before he leaves for California.
• Go and pick up sandwiches for everyone who is coming to visit.
• Go and make sure Baron gets high quality golf shoes, and pay for them(I got partially out of that task, as I do dislike shopping).
• Do x,y, and z around the house. Prepare these beds for these persons. Set up this area for people to do their make-up. Purchase this food to feed them while they are at the house. And this juice. And these desserts.

Come to think of it, I've shirked almost every one of those tasks. For all of you who are unsandwiched, unjuiced, undesserted, and in possession of unframed awards: you clearly cannot count on me.

An old story: Nurses frequently awaken Mom, and ask her the month and the year, to make sure she is thinking clearly, and nothing untoward is happening with her brain. I walked in her room one day, just as she was waking up:
Me: "Hi Mom! Are you awake? Do you know what month it is?"
Mom(gives an exasperated sigh): "Everybody asks me that!"

Jake visited Mom in full graduation gown. She loved that.

Baron purchased Mom a Mark Texiera jersey/t-shirt. She loved that.

Thanks from her for all the flowers and plants! We're desperately trying to keep the plants alive, until Mom can get home and give them some expert care.


Bank officer cousin Kathy Helgason opened an account for Jake. Baron and I sat in:

Kathy(typing info into computer + singsonging):
"I know your Grandmother's maiden name!"

Baron Post Cotharn:
"What is it?"

[...]

Kathy:
"Jake, what is your address?"

Jake(who just moved to a new house):
"Um... I've got to call my Mom!"

Kathy(reassuringly):
"That's okay. Can you tell me your phone number?"

Jake(frantically clicking keys on his cellphone):
"I've got to call my Mom!!"


Kindred Hospital, Room 212:

Aunt Jane:
"My great-grandchild Annika is sooo happy!"

Aunt Patsy:
"I've never seen my great-grandchild Abby shed a tear! She is the happiest baby ever! And she never sees a stranger!"

Aunt Jane:
"Annika is sooo personable. She just glows when she meets new people! And she's under contract, you know - as a professional model!"

Aunt Patsy:
"Abby is just beautiful! Leslie dresses her in the most adorable outfits!"

Aunt Jane:
"You should see Annika in her modeling outfits! She's so adorable in this bikini!"

Aunt Patsy: et al; ad infinitum.

Aunt Jane: et al; ad infinitum.

Vachel(sitting in chair): zzzzz

Larry(sitting in chair): zzzzz

Jerry(sitting in chair): zzzzz

Mom:
"That is so interesting! Tell me more. Wait, let me tell you about Kacy...."

120'

Mom corrected me today. She is no longer walking 1oo', but is now walking 120'.

Mom had nurses' aides helping with her hair and make-up this morning, so she would be ready for her visitors. Apparently, the nurses' aides much enjoyed playing around in Mom's extensive make-up kit. As for me, I enjoy playing around with Mom's hair. It is a wonderland.

I'm slighting everyone who has ever visited her, but Mom has much enjoyed her visitors so far today:

• Her beloved niece Jenny Robertson - who shelters the famous emailing cats: Jenny and Ling, visited all the way from Mud Island, in Memphis, TN. Jenny has coordinated GMA and the Today show to publicize FedEx's transporting of penguins back to the New Orlean's Zoo. Look for that story on Monday.
• Beloved niece Nancy Dodson, who took time off from planning her July 1 wedding to visit Mom again, and to show off her "soon to be a bride" glow.
• Janet and Bob Dodson, who came to make sure I was watering their gift of an ivy topiary.
• Claudine Allbaugh, dietary consultant for WNH, whose son is currently flying C-130's out of Bagram AFB.
• Tommy, of WNH, and his wife: Rochelle(who works at Kindred on the 3rd floor).
• Marshall and Cloe Harris, who drove in from Granbury - the new boom town of north central Texas, to kindly dish about their grandchildren: the cheerleaders, Marshall Harris III, and the not-shy triplets.

The day is still young...

Walking 100'

Which means Mom is ready to sharply single into the left field corner, round first at a not so brisk pace (if the left fielder kicks the ball around in the corner awhile, then the SS drops the relay throw), skid her walker to a stop in the basepath dirt, then do a 180 and return safely to the bag (if the SS has tossed the relay into the first base stands).

Also sitting up for 2 1/2 hours.

Also receiving some therapy. The goal is to become strong enough to receive 3 hours therapy per day.

Swallowing

The Bad News:
This is a problem Mom may not be able to beat. The Speech Therapist says she aspirates even on her own saliva. The Speech Therapist says whether she recovers proper swallowing ability is completely unpredictable. However, the Speech Therapist was not encouraged by Mom's situation at this time.

The Good News:
People who cannot swallow properly can still go back to work, and can still lead full lives. They just do not eat or drink. They receive nutrition and fluids through a stomach tube.

The Problem:
may be either fatigue-based, or neurology-based.

The Treatment:
1. Electronic Stimulation(E-Stim) of the throat muscles. Usually, if the patient is to recover swallowing ability, they will recover it after 7-10 E-Stim treatments. If not, the treatments can continue for some months.
2. Time. Parts of the brain, which are still partially swollen, might spontaneously reduce to normal size. Proper swallowing ability might spontaneously return.

Overview

One month out from the bleeding aneurysm. Where are we?

Chances of Survival = outstanding. Would be a big fluke if anything life-threatening happened at this time.

Physical:

• Sitting up 90 minutes at a time. Can stand, with help, for very short periods.
• Mom is impatient to be allowed more physical activity. Physical therapy and Occupational therapy are beginning to crank up to higher levels.
• Swallowing problem persists (swallows liquid into lungs w/o coughing it back up). Treated by machine which stimulates muscles of throat. I am unclear on the prognosis for recovery, and will ask the Dr. about this tomorrow.
• Speech therapy has begun. Mom's voice volume immediately improved after her Monday therapy session. Her voice is now three times as strong as it was last week, and stronger than it was even Monday morning. If you focus, you can (just) understand her words from across the hospital room.

Neuro:

Mom shows good memory for things which happened before her incident. She shows medium good short-term memory, which is an improvement.

One problem might be termed a problem of focus. She will be talking along, sharp as a tack, then seemingly forget what the ongoing conversation is about, and wander off onto another subject.

Second, when she awakens from sleep, it takes 5 or 10 minutes of awakeness for her to re-orient to her current circumstances. In truth, Mom has always awakened slowly (like her eldest granddaughter: Courtney). This might've been something we could've anticipated :)

The long term neuro outlook is not predictable. She could make a full neuro recovery (per the neuro surgeon) in a few months. She could make a full recovery in a year. She could make a 90% or 95% recovery in a year, and a full recovery in approx. two years. She could make any type of partial recovery inside any of that time frame, yet not quite make it to a full recovery. She could suddenly stop recovering exactly where she is now - which, btw, is not any type of terrible place. Mom is healthy, and she has recovered her typical personality. She is entertaining. She has a good and happy sense of humor. There is plenty of her to love. And she has plenty of love to dole out - especially if you are one of her grandchildren.

Incremental Progress

Mom's orientation to her surroundings has improved. Her short term memory is still spotty, but it has also improved. Her voice is still weak, but it is twice as strong as it was early in the week.

Overview:

Mom is physically in a strong place - compared to where she has been. She is sitting up for some of each day. She is moving arms and legs more and more, and showing more and more strength.

Mom is mentally still in a difficult place. However, she continues to get incrementally better, and incrementally better some more, at her own pace. She is right there in some conversations, and is very sharp. She drifts sometimes, and begins speaking of things which are totally unrelated to the conversation happening in the room. I absolutely feel her awareness has gotten better this week. She still has a distance to go, if she is to return to where she was before her incident.

Moved to Kindred Hospital

Directions to Kindred:

West on I-20 past Hulen Mall (stay left when the highway splits at Hulen Mall)

South on Bryant Irvin for 1.1 miles (this exit is immediately after the highway split)

Turn right on Oakbend Tr.(there's a stop light), then continue almost to end of street (approx. 1/4 mi). Kindred is on the left.

Room 212.

Bring chit chatty news. Mom loves that.

Kittens!

Computer is fixed! Hoorah!

These pics are from Mom's grandniece: Lindsey. Lindsey is Aunt Lindsey to Abby, and is a famous Hollywood "Background Actress" to the rest of us, having appeared in more shows than it is possible to TIVO. Lindsey can soon be seen on the big screen, making it within 15 feet of safety, before being crushed by a falling World Trade Center Tower, in Oliver Stone's upcoming movie. This is one more reason the Nancy Cotharn Update is not a fan of Osama Bin Laden.

Lindsey's email:

I volunteer through LA Animal Services as a foster mom for un-weaned kittens or bottle babies. Every year they call me during "kitten season" and ask if I can foster a litter of kittens that don't have a mom, I usually get them when they are a day or two old with their eyes still closed. I bottle feed them until they are old enough to be taught to eat on their own then I teach them to eat and use the litter box and all the things a kitten should know. When they are between 8 and 10 weeks old I have them spayed or neutered and then I find them great homes. The two kittens I have now are from different litters, they didn't have any brothers or sisters. The white one (female) is older by about a week and a half and the gray one is a male and he's about 4 weeks old. So if anyone in the Texas/Louisiana area would like a kitten let me know, I can get them to you! They have such great personalities when they are hand raised.

Lindsey

Step Forward, Step Sideways

Wed, Mom sat up for approx 90 minutes. It seems, to me, that she is more oriented and more focused than she was a couple of days ago.

Mom listens closely to any medical talk by doctors or nurses. When doctors or nurses are talking outside her room, she wants everyone to be quiet so she can listen to their chatter. She is trying, by listening to them, to glean details about her condition.

Wed, the hospital wing paged a social worker thusly: "Nancy, call _____." Mom immediately interrupted a conversation, and called me over to see if the hospital was paging her in her hospital bed.

Mom is still unable to distinguish if she is swallowing fluids into her stomach, or accidentally down the wrong place, and into her lungs. She does not reflexively cough when she swallows into her lungs, as you or I would do. The remedy is to place a newly invented exerciser on either side of her throat, to massage her throat muscles. In the interim, she cannot take oral fluids or food.

Because her "NG" (feeding) tube has been in her nose so long, there is a risk of sinus infection. Today, Mom had a feeding tube placed into her stomach. When she is able to take food and liquid orally, the tube will be removed.

For now, it looks as if Mom will be moved to Kindred either Friday or Saturday afternoon.

Harris Tower, Room 603

Yea! Harris Tower is the building containing the hospital cafeteria.

Yesterday, the PT sat Mom up on the side of the bed for the first time. One small step after another...

Coming soon: kittens!

Short Term Future

Mom may leave the ICU as soon as tomorrow. She may leave the hospital within a week, and move to Kindred, which is an acute care facility with an excellent reputation. Kindred has a doctor who is well regarded for his rehabbing of brain injuries. Mom would work puzzles and games which are designed to help her memory, spatial relationships, and other cognitive abilities. She would also receive occupational therapy, and physical therapy. Kindred is located near Harris Hospital Southwest, which is south of I-20, off of Bryant Irvin Road. She would likely stay at Kindred for at least 30 days.

Short Term Memory Showing Hopeful Signs

Mom is starting to remember some short term things. Friday night, I went to Ronda's wedding, then came back to the hospital. She said: "Back from the wedding so soon?" She is remembering her nurses' names some of the time. She is remembering other misc. short term details. I think these are hopeful signs.

Mom still talks very quietly. This could result from being intubated for so many days. It is frustrating. I am ready for her to speak loudly.

Boring Children

None of Nancy's friends and family have any interesting stories to tell about their children. The children's strong suits must be their good looks...

Thanks to Bruce and Bradley for pinch hitting the blog while my computer is down. I hope to have the computer fixed very soon.

Musical hospital rooms....

It seems as though the nurses in the Sid Richardson building at Harris Hospital, who normally take care of 5 - 7 rooms at a time, have been concerned about giving Mom the proper personal care needed to monitor her breathing.

Back to Neuro ICU she goes...room# 3304.

Harris Hospital's version of musical chairs, or the ICU nurses playing;

• Red rover, red rover let Nancy come over........
• duck, duck, goose, and off to Neuro ICU if you can catch me........
• hide and seek, if you can find her, Nancy's it......

When the music stops, look for Mom's room on the third floor!!

Moving from ICU to regular room

This is Bradley, guest blogging from the Arctic North for Greg today. I must note that Greg is unavailable at the moment because he is getting ready for Ronda Pippen's wedding. Ronda is marrying Bryan Crum at 7:30p this evening at Richland Hills United Methodist Church. The Nancy Cotharn Update would like to extend its warmest wishes and hopes for a lifetime of happiness to the young couple. I know that Nancy, Bradley, Kris, Austin, and Kacy wish they could be in attendance tonight, and our thoughts and prayers are in Richland Hills.

On to the official business. Mom is being moved this evening from ICU into a regular hospital room. She will be in Room 576, for those of you who are planning to visit, phone, or send cards.

I asked Greg about the trigger point that made the doctors comfortable moving Mom from ICU. In his view, it was two primary things:

1. Mom is now able to breathe on her own without assistance from the CPAP.
2. The Neurologist believes that the risk of stroke is now minimal.

Mom continues to make slow but steady progress toward recovery. Today is another good step.

Long Term Memory is Good

Mom is barely on the CPAP anymore. Lungs are stronger.

Mom switched from Room 3314 to Room 3319. The new room has a nice and large window, the better to let sunlight stream in, and to normalize her day and night routine. She is re-orienting pretty well, and is already displaying less disorientation. The ICU nurses wake her every hour, around the clock, to ask her questions, and to be certain her neurology is solid. Between that, and machines beeping, and people streaming in and out of her room, for over 16 days now, anyone would be a bit disoriented. If Marines did this same routine to Guantanamo prisoners - waking them once an hour for days and weeks - Senator Durbin(D-IL) would compare the Marines to Nazi torturers. Oh, wait - Senator Durbin already compared Marines to Nazi torturers - even without the waking once an hour thing. Never mind. Lord knows what Sen. Durbin would think of these nurses.

When reading Mom her get well cards, she knows everyone at the nursing home, and what their job is. She corrects me if I mispronounce someone's name. Her short-term memory is not as good, but there are good signs on that front. If you focus on having her clearly understand a short term thing - such as her nurse's name, or why she is in the hospital(aneurysm) - she will probably remember those things 5 or 10 minutes later. A good sign, I think. And the nurse thinks so also.

Having computer (operator) problems. I do not anticipate an update on Friday. I'll get something posted on Saturday, one way or another.

Disoriented

When Mom was extubated last week, she was mentally sharp, as you can see by the questions she asked at that time:

• Where is your father?
• How is he doing?
• Cancel my beauty shop appointment at Plaza Beauty Shop. Me: Rosie already cancelled the appointment at Plaza Beauty School. She: No, it's not a beauty school!
• Am I in ICU?
• How long have I been here?
• What did they do? (Arteriogram to solve the bleeding aneurysm problem - but no actual surgery)
• That's amazing!
• What are my dosages?

Since Mom's second extubation, on Sunday, she has been disoriented. She is not as attuned to her circumstances. They did a CT scan today. An initial read reveals no additional swelling in her brain, and no additional blood seepage into her subarachnoid cavity. There could be myriad reasons for her disorientation - ranging from drug reaction, on through a range of reasons, including simply being disoriented by the artificial atmosphere of ICU.

The disorientation is likely nothing serious, or lasting. They hope to figure out what's causing it in the interim. If it is disorientation from being in ICU, it should be cured when Mom leaves the ICU a few days hence, and moves into the more normalized environment of a hospital room.

Kacy Story

Nancy Cotharn Update has used up all our pics. Our new policy will be to include either pics or stories, about either children or pets. We'll start with this one, from Bradley (appropriately pasted in University of Wisconsin red):

Yesterday Kris picked up Austin and Kacy from daycare. On the way out of her room, Kacy (mischievous provocateur that she is) was walking on a pile of blocks she should not have been on. She fell and hurt her stomach, and cried and whimpered her way outside to the truck.

Austin was playing the protective big brother role, with his arm around Kacy, asking if she was ok. When they got outside, he grabbed a dandelion and told her that you could make a wish and blow the seeds off. Austin said "I wish Kacy's stomach would stop hurting," and blew the dandelion. Kacy was delighted with the attention, and her tears turned to giggles. Score one for big brother.

Kacy grabbed a dandelion and carried it into the truck. On the way home, she asked if she could make a wish with her dandelion. Kris rolled down Kacy's window, and told her she could make a wish and blow the dandelion seeds outside it. Kacy said
"I wish Grandmother would get better so she could leave the hospital and go home."

Progress: Breathing All Through the Night

On her own - and all through the morning!
and even after lunch!
whereupon Mom tired, and went back on the CPAP to rest.
Good progress.

Overview:

Mom is now two weeks out from the incident, and two weeks out is a nice marker to pass. Her outlook brightens.

The neurosurgeon says her risk of stroke is very small. That is nice to hear.

Her lung capacity looks like it is returning.

The main hurdle remaining is the return of full mental acuity. Brains are unpredictable, and this process could take a frustratingly long time. Nothing is guaranteed. We can only wait, be very patient, and let the brain heal itself.

Prayers are welcomed.

Austin, Max, and Kacy

This is my nephew - Austin, and my niece- Kacy, posing with the redoubtable Max. They brighten the days of my brother - Bradley, and his wife - Kris. Austin is in first grade, and one of his favorite subjects is math. He is especially talented at kicking balls hard and far, and at catching football passes. Austin is a good soccer player. Kacy is a girlie girl. She loves to set up play scenarios, such as: "You are the father, and I am the mother, and we are taking the baby to the park." Part of Kacy's charm is that she is an instigator, and a mischievous provocateur. We uncles love that kind of stuff. Kacy's favorite color is "rainbow."

Austin and Kacy are wishing their Grandmother well. They know they are her favorites, and will score lots of fun stuff when Mom gets out of the hospital, and back into Walmart. The older grandchildren have been unceremoniously usurped.

Good News: Breathing 4 1/2 Hours

with perfect respiratory numbers! A 50% increase over her previous best time of 3 hours. A good sign. Mom could've gone longer, but they decided not to tire her out too much. Time to break out the happy dance: //^\\~*~//^\\
That's right ... I got rhythm ...

Bumpy Road, cont.

Mom doesn't have the strength to breathe on her for 24 hours a day. She has to build up her strength. Her doctors and nurses seem optimistic that she can do so. So far, Mom can breathe about 3 hours before her respiratory numbers start to decline, and they put the CPAP back on her. She had two periods of breathing on her own today, and may have another period of breathing on her own tonight. The nurses had her on the CPAP during visiting hours, so she wouldn't be asking strings of questions, and we visitors would not tire her out too much. She still tried to ask questions through her mask. She is a hard-headed patient.

Jenny and Ling: Redux

I buried Jenny and Ling under a pile of posts. Such beautiful cats merit a bump to the top. Their email, from their home in Memphis:

We, the cats of Jenny and Rob Robertson, would like to lodge a complaint about the lack of diversity on your Web site. You have shared pictures of mongrels and humans, yet there has been no representation from the decidedly-superior feline species.

Attached is a picture of us. I, Jenny (the white cat),belonged to Rob before he met that annoying girl who now lives with us, and I remind her daily that I am the original Jenny in Rob's life. I, Ling (the black cat), like to play fetch and otherwise pretend I am a dog. While we both appreciate being rescued by our owners from the city pound, we generally do not dignify their presence in our lives and tend to act independent of their wishes.

We trust you will stop the discrimination against cats on your site and promptly post our picture. We also wish for a speedy recovery of Aunt Nancy, even if she is more of a dog person.

Sincerely,
Jenny (the original) and Ling