First Full Day Home

Kathy's first full day home was very busy. The house needed some attention with laundry and putting away some of the items that had accumulated over the past 2 months. We also had multiple stretching sessions and had to return to Kessler at 1:00pm to begin an outpatient therapy. Kathy will again have both OT and PT. She met with both therapists who do their own initial assessment and start her on a newly customized therapy plan. Other than the travel, the outpatient therapy room at Kessler seems to be much more active than the inpatient therapy room. It seems likely that the inpatient therapy had reached a point where it no longer was challenging her to the extent that she needs to be work.

One of the benefits of being home is that there are no longer any restrictions on how Kathy moves around. Now the wheelchair just stays in the doorway and is pretty much only for the times when we leave the house. Inside the house Kathy walks using the walker and sits normally on the couch or at the kitchen table. This new amount of walking and moving around will be great for her strength gains. We will still be monitoring her blood pressure and heart rate as she is still on medications for both.

Kathy's appetite is still very small and getting good food in meaningful amounts is difficult. Kathy's first night home she was able to do her first grocery shopping in 2 months using the PeaPod service. PeaPod allowed us to select all of the groceries that we want online then schedule the delivery - for just six dollars extra! This was great and allowed Kathy to really select what she wants to eat. This should be good for getting appetite back. The weekend is going to be filled with relaxing, yard work and hopefully some walks outside.

The official going home picture!!

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New Developments

Everyday brings something new! Yesterday Kathy called me very excited that she had walked without the walker! The only support was holding the therapists hand. At my visit today, I spent sometime in therapy with Kathy and was able to walk with her holding just her hand. This was awesome and everyone in the therapy gym was checking her out!

The next steps on Kathy's agenda are figuring out outpatient therapy times and a support structure for her time at home. Kathy is still in a phase called "contact guard" which requires her to have someone present with a supporting hand on her when she transfers, walks, or moves in anyway out of or into a chair / bed / walker. While she is in this phase and at home someone will need to be with her at all times. Even though she could likely do most things on her own the risk of additional injury is still high without the support.

We have a good idea how we are going to staff the house to support Kathy and will firm this up next week. We also decided what times will be best for her to travel back to West Orange for therapy. Hopefully these times will also work for Kessler. Last on the list is adapting the house to Kathy's needs. There will be a ramp for the front door and front porch. Also, additional railings in the stairwell and well placed chairs in the house. The throw rugs will be taken up for easy wheeling / walker use and we will likely move the kitchen table to create a bit more space to move around.

Six more days then into the next phase!

Kessler last day finally determined

Kathy's stay at Kessler has been extended by one week. Her final day will be next Wednesday 5/26. Over the past few days Kathy and I have gotten into the idea of her coming home, so an extension of her stay at Kessler is nothing monumental at this point. However, it will give us additional time to make arrangements for care, plan her outpatient therapy, and most importantly give Kathy extra days to make strength advancements prior to coming home.

Kathy's original goal was to be home by the end of May with the ability to walk and function fairly easily within our home. She will certainly make the time goal that she set for herself, however Kathy feels that she is behind on the functionality side. I think she can make the functionality goal as well since she can easily walk 75+ feet and our house requires no more than half that from end to end. I believe that once Kathy is home, she will discover that moving around the house and functioning independently is achievable. This may include some strategically placed items ie. drinks, snacks, computer, and chairs for resting.

We are almost certain that Kathy will travel back to West Orange to do the outpatient portion of her rehab. This will be three days a week for two hour sessions. Additionally, there will be home stretching and strength exercises (we practiced some of these today). In preparation for coming home, tomorrow afternoon Kathy and I will be doing additional training for transfer and support scenarios that could come up in real world situations.

Good Week

This has been a very good week but definitely had its stressful moments. Kathy has made many improvements in strength and stamina. Her walking distance has improved to about 75 feet with the walker and she told me today that her legs feel similar to how they felt the day she walked into the hospital on March 27th. She is also doing some of her transfers totally under her own power, in fact getting out of the car today I did not even need to spot her. Earlier in the week (Tuesday) her catheter was removed and apparently this can present problems where people have trouble regaining the same level of control that they had prior to the catheter. Of course, for Kathy this was not the case and once it was removed it was as if the catheter had never been there.

Friday, Kathy and I learned that she will likely be discharged from Kessler either Wednesday this coming week or potentially a couple days later in the week. This will be determined sometime on Tuesday. This did come as a surprise and initially both Kathy and I were very apprehensive and even a bit shocked about this as we felt that she needs more time. However, the determination is made based on whether or not Kathy needs medical support ie. a doctors care 24/7. Both Kathy and I have a substantially more holistic idea of what medical means but it seems that in the doctors and insurance companies eyes medical has to do with medicine. How a body functions and an individuals ability to be independent is not a medical issue but a social issue.

Since Kathy truly no longer needs the support of a medical doctor and medicine (as defined), we both understand that coming home is probably for the best. In fact, the idea of Kathy coming home has grown on me over the weekend and I am now feeling that this is the best thing. She is ready to be back in her space and with her family and friends. This will allow her the fastest progression through the next few months of strength building. Outpatient rehab will be the next step along with strength building and stretching at home on a daily basis.

I will be very excited to have Kathy home!!

Day Pass

Yesterday was Kathy's first day outside of the hospital since March 27th. We started with a plan to go for a drive and then a walk in the local park. We drove north a ways passing the park we hoped to return to and then west towards the Caldwells on Bloomfield Ave. The drive quickly became goal oriented and we never made it to the park. About 45 minutes into our ride Kathy suddenly wanted to go home and see her house, street, and take a nap in her own bed. I was more than excited to oblige this request. I have found over the past few weeks that it takes almost exactly one hour to get from the Oranges back down to our house. Yesterday there was a bit of traffic so an hour and ten minutes later we were in the driveway.

Kathy was a bit nervous the entire way down. She wasn't exactly sure what she was nervous about, maybe seeing the house or her wheelchair not fitting properly in the house. However, all of this worked out and soon Kathy was napping in her own bed and had "Bravo" on the TV instantly. Being home for a even a short amount of time was wonderful for Kathy and myself. It created a brief sense of normalcy at an otherwise very strange time in our lives. I can't wait for her to come home again.

Friday / Saturday Day Pass

Yesterday started very well for Kathy. She told me that in morning PT she increased her walking distance and was able to do this with no assistance from the therapists, they stay very, very close though just in case. Kathy did some visualization work on Thursday evening for her walking. She visualized her leg lifting then landing heal, toe, push and all over again on the other side. Since Kathy had a tough time walking earlier in the week, she felt this would help prepare her for Friday's work. In this case it did and her walking was good, even on both sides of her body, with her heals hitting first.

Kathy reported that the last of the pins and needles feelings are finally leaving her feet and toes. This has been gradually improving over the past two weeks from the knees down through the feet. Additionally, her doctor plans to do a full re-assessment of her capabilities next week. This should be interesting as now there is a base line to compare against (the day she arrived).

A test was run on Thursday to determine if Kathy has any urinary tract issues or infections. Based on the results of this test it is very likely that her catheter will be removed on Monday. This is the last tube to be removed! However, this presents a new set of challenges and fears. Once the catheter is out Kathy is on her own for urinary control and this is not likely to be a problem but sometimes finding assistance to transfer to the toilet is a problem. At times the nursing staff and aid staff at Kessler is a bit overwhelmed and not always able to respond in a meaningful amount of time, not consistently, but occasionally. Of course, even occasionally will not be acceptable once the catheter is out. Based on this fact, before it is removed Kathy plans to ask a few questions to her doctor.

At times, there are reminders of Kathy's home life, school life, and yoga world that bring on emotional moments. Yesterday Kathy received a card from one of the students that she teaches at McGinn Elementary. The card was very sweat and heartfelt and probably not as much the card itself but the personality of the young person who created it. Opening this card became a very emotional reminder for Kathy of everything she gave up in her life to go back to college and become a teacher. She expressed her frustration that just as she began this wonderful new chapter in her life (teaching), she now has to fight to save it after fighting to get it. Yesterday, Kathy wanted nothing more than to return to her school and see all of the young faces that make each of her days teaching so special.

Feel Better Mrs. Fritz

Today (Saturday) will be a cool day. Kathy received a day pass to leave the Kessler facility. Since we had practiced car transfers and also stair and curb obstacles with the wheelchair, we are now allowed to leave using the day pass. I can't wait to get Kathy out and about again. We may start with just a drive but will see where it goes after that.

Car Transfers

Today Kathy and I learned how to do a car transfer. This is wheelchair to passenger seat of the car. We practiced this in the therapy gym using an actual mock up of a car! I was a bit intimidated by this at first, but quickly found that it is very easy. In fact Kathy does almost all of the work. I face Kathy with the door behind me and guide her from the chair to the passenger seat by grabbing her pants around the belt loop area. Kathy places one hand where she is going (car seat) and one where she was (wheelchair) and just slides over. Hopefully we will get the chance to go out very soon (maybe Sunday). Leaving Kessler does require prior written authorization from Kathy's doctor. I am assuming that means a certain time to leave and a certain time to return.

Before we practiced car transfers, we practiced wheelchair to bed transfers. I had been watching the nurses do this and basically followed their lead, apparently I had been doing this incorrectly. The big difference between what the nurses do and what the therapists do, is the amount of work Kathy needs to do to accommodate the transfer. The nurses move the patients in the quickest manner, which seems to be just pick them up and move them. Kathy's therapists want me to lightly support her and make her stand up and do the transfer using as much of her own strength as possible. Kathy told me she liked the way I was doing the transfers because there was no work on her end, now that I know better that is all over!!

Once all transfer training was complete it was on to the walker again. This time no walking, just standing. The goal was for Kathy to stand up into the walker and be able to stand for a longer period of time that her last therapy session (about 45 seconds). Today Kathy was consistently standing for a full minute and even briefly took both hands off the walker and stood under her own power. This was totally awesome to see, and it surprised Kathy as well.

I am looking forward to what tomorrow will bring.

Weekend Update

Kathy continues to make progress with her recovery. The major muscles of her upper body are working well but the primary issue for her continues to be a lack of strength and fatigue. Kathy's core muscles are strong and she was able to sit up on her own yesterday as she moved to the side of the bed for a transfer to the wheelchair.

Kathy is no longer using the lift to move from the bed to the wheelchair. This is now done via a bed to chair transfer. The person helping Kathy with the transfer gives her a decent amount of support in moving directly from the bed to the chair. Kathy is also able to use her core and her arms to move herself back in the chair to the most comfortable position. This was not possible a week ago, as she still required assistance to move back in the chair to a comfortable position.

Now that both the feeding tube and trachea tube are out, all that remains is the catheter. This will likely go away very soon as well. I think this would be a good thing, even if it is an inconvenience. It would get Kathy accustomed to having to go to the bathroom on a regular basis again and reinforce her transferring skills.

Over the weekend there were plenty of visitors to keep Kathy company. Additionally, she did a full day of therapy on Saturday to make up for her missed therapy sessions earlier in the week. I learned that there is a strict therapy documentation rule in order to adhere to insurance guidelines. Insurance mandates that a patient in acute therapy must do three hours of therapy five days a week. Missed therapy sessions must be made up on Saturday or Sunday, but it has to be three total hours in each day of therapy.

Tomorrow will be an exciting day! I have been invited back into therapy to learn how to do a car transfer. Once Kathy and I are proficient at this (hopefully tomorrow) I will be able to take her off campus. This could mean a dinner out, movie, the mall, the park, (Z's birthday party!). I can't wait!!

I will update tomorrow after we have learned this new valuable skill!