Thursday, April 30, 2009

Mom is starting to read magazines and asked for a newspaper. She again did better on cognitive testing (thinking) today. She is starting to remember the accident. My sister Kim will be visiting this weekend to both see mom and to help Bob when mom is at home for her one-day pass on Saturday.

Wednesday, April 29, 2009

Mom continues to show improvement. She went up and down 4 stairs with assistance. In addition, she walked farther today than she has since the injury--again with assistance. She is scoring better on her daily mental status exam. She is more alert and aware, but is still confused about certain things.

Tuesday, April 28, 2009

Bob learned today that mom will be allowed to go home on a pass for one night this weekend. The occupational therapist will visit their home before the pass is granted to assess what needs to be done before mom goes home. Her tentative discharge date is still 5/8.

Mom continues to get speech, occupational and physical therapy twice daily from 9-11 AM and from 1-3 PM. She takes a short nap and has lunch between these sessions.

Monday, April 27, 2009

Mom is gradually eating more and taking some medications by mouth. She went up one step then stepped back down. Bob will be meeting with the social worker tomorrow to learn how the care team thinks she is improving and whether they will amend her planned discharge date.

Friday, April 24, 2009

Mom walked so much yesterday that she irritated her knee and did not walk today. However, Bob reports that she is becoming more aware. Two visitors who had not seen mom for a week were surprised by how much she had improved in her mental status.

Thursday, April 23, 2009

Mom did well enough with her swallow evaluation today to start trying to eat thickened liquids and softened solids. She did a little better on her mental status testings today. I spoke with her social worker who will arrange to have an occupational therapist evaluate their home in anticipation of mom's discharge.

Wednesday, April 22, 2009

My sister Kimberly and her husband Michael found a resource on traumatic brain injury which may be helpful not only in understanding what mom is going through but also how it affects her family and friends. The link is http://tbiguide.com/index.html.
Mom did start bolus feedings today as I described yesterday. So instead of receiving a continuous rate of feeding she gets 400 ml of formula 4 times each day. She took two walks today. She seems more alert during the day. However, she continues to struggle with her swallow studies.

Tuesday, April 21, 2009


Each Tuesday mom's care team meets to assess her progress and to revise her care plan. They also try to give a tentative discharge date when they meet. Currently mom's target date for discharge is May 8th. This is subject to change depending on how she improves. It is entirely likely that she could go home earlier or later than this tentative date. The care team will revise this target date if needed. Bob now must get their home ready since it will be quite some time before she will be able to negotiate stairs and accomplish other activities of daily living.


Much happened today. Mom only has one tube now--her PEG feeding tube which is well hidden. Today her PIC line (IV line) and catheter were removed. She walked about 78 feet with a walker and two assistants. In the afternoon she only had one assistant and did not go quite as far. She does about 25 % of the work to dress herself. She is still only allowed to have water and ice chips based on how she is doing with her swallow studies.


One of her big challenges is that her days and nights are mixed up. She stays awake much of the night and is often sleepy during the day. They are making some changes to her medications in an effort to correct this problem.


They are changing her formula to a formula which is higher in protein and fiber. The type of formula that is given through her PEG tube varies in order to meet her nutritional needs. In other words, her nutrition needs vary based on her condition. For example, during the early time in the ICU she needed one type of formula and needs a different one now that she is in rehab. In the next several days, they will likely change her from continuous feeds (getting a certain amount every hour) to bolus feeds (getting larger amounts at a time to mimic a meal schedule).
Lastly, I should mention that mom's current challenges are quite typical of someone who has suffered a traumatic brain injury. However, her MS may cause her to take longer to recover.


Monday, April 20, 2009

Mom's care team will have their weekly meeting tomorrow after which the social worker will give a report to Bob. They will assess her progress and Bob hopes they can give some sort of prediction for how long mom will need to be in rehab. However, it is notoriously difficult to make such predictions. Mom tried a walker twice today taking 15 steps with the first attempt and 22 steps on the second. She continues to struggle with her swallow.

Sunday, April 19, 2009

Mom came off oxygen today and was taken on a walk outside (she was in a wheelchair). She is now off all narcotics (fentanyl and Lortab) and as a result she enjoys being regular again. She was able to take a shower. The nurse feels like mom is easier to transfer from the bed to other activities which indicates that she is getting stronger. I was able to speak to her on the phone while she was in the cafeteria with Bob practicing her swallow with ice chips. I habitually said "How are you?" She replied "fine" and then said "lie, lie, lie, ..." Her voice seems to be returning to normal as the inflammation from the breathing tube slowly resolves. She overall seems to be less confused but still has some issues. However, she did remember to tell me to say hi to Evelyn, my mother-in-law.

Saturday, April 18, 2009

Bob reports that mom is more mentally alert today. She was able to place Uno cards in numerical order while only having trouble with the number 7. She is now allowed to have ice chips without the speech therapist being present. There was some concern among visitors that the staff at UVRMC did not know about all her injuries. I spoke to the bedside nurse yesterday evening. This nurse was aware of both mom's past medical history and all the injuries she sustained in the accident.

Friday, April 17, 2009


Mom in physical therapy today.
Mom had a good day today. She road a stationary bike in therapy and they dress her each morning. She did better with her ice chips but not with crackers during her swallow study. She is no longer on a medication called Zyprexa and will soon be taken off Seroquel. A different medicine was started today to help her brain. Bob asked me to tell people that they can visit anytime on Sundays.

Thursday, April 16, 2009

Bob reports that mom showed some improvement today. First, she did better but not perfect on her mental status exam. Her short term recall was better. She was able to write her name. Lastly, she showed improvement on her swallow study--she only had trouble with one ice chip. The physicians are trying to change her medications and medication schedule so she will be less sleepy during the day when she needs to do her therapies.

Wednesday, April 15, 2009

There were big changes today. Mom was transferred to the Utah Valley Regional Medical Center (UVRMC) Inpatient Rehabilitation Unit today. She is in room 2671 and visiting hours are 5 pm to 9 pm. This unit is on the south side of the UVRMC in Provo. This is a big step forward. She will receive two sessions per day of physical therapy, occupational therapy and speech therapy. This is a significant increase over what she could get at the Utah Valley Specialty Hospital (UVSH). She needed to be at this the UVSH during the time between when she came out of the ICU and when she was well enough to go to rehab.

The pins were taken out of her right hand. She is now off Fentanyl and is being weaning off Lortab. I don't know whether she is being weaned off any other meds. Once she passes a swallow study, she will be taken to a dining room to eat. For now she will continue to get gastrostomy tube feedings. Furthermore, once she is well enough, she can have day and night passes to leave the hospital. That is the great news. The bad news is that she continues to be somewhat confused. Hopefully the combination of weaning the medications and giving her brain time to heal will help her become less confused.

Bob is happier than he has been for quite some time. As stated above, this is a big step for mom. As of tomorrow it will be two months since her accident and she will likely be hospitalized for more weeks or months.

Tuesday, April 14, 2009

Bob reports that mom's short term memory seems to be somewhat better. She is remembering explanations for why she cannot do certain things. She continues to do her physical therapy. Lastly, when Bob showed mom the photos of Shawn's and Julie's new baby, she told Bob to make sure he did not lose them--perhaps this suggests that she in becoming less confused.

Monday, April 13, 2009

Mom and Bob have a new granddaughter who was born yesterday in Denver to Shawn and Julie. She was delivered at 36 weeks and her name is Kennedy Ava. She is healthy and well.

Mom continues to get physical therapy. She has not yet been cleared to eat by mouth. The current plan is for her to be ready for transfer to a rehab facility by the end of the month.



Friday, April 10, 2009

Mom had her first shower since the accident today. She is slowly getting better with sitting and standing. Her progress is slow but it is nevertheless progress.

Thursday, April 9, 2009

Mom's grandson Garrett (the tall one) takes second place in the pinewood derby. He designed his car, painted it and helped to apply the stickers. He also helped to prepare the axels and wheels. His brother Jake (the one without the scout uniform) missed participating by a few days. He is eager for his first derby next year.


Bob reports that mom tolerated 2 1/2 hours of physical therapy today, but this caused her to be very sleepy this afternoon. She has an improving swallow but has not yet passed her swallow study. As a result she continues to get all her nutrition through her gastrostomy tube (tube across her abdomen into her stomach) with occasional IV fluids. Lastly, she is answering questions better.

Wednesday, April 8, 2009

Over past few days mom has been able to use the toilet with assistance. This is a big step forward for mom. She is too prim and proper to use a bed pan. She has been getting a lot of physical therapy which wears her out. Bob reports that mom was more lucid today during a visit from a friend who had been part of the same social group at BYU. We appreciate all those who have visited both mom and Bob. Thank you also for you ongoing prayers.

Sunday, April 5, 2009


I just returned to Boise after spending the weekend with mom and Bob. Bob is doing well. He diligently completes his physical therapy to rehab his shoulder. I was able to get some tickets to the Priesthood Session of General Conference. Bob attended with his sons Michael and Jonathon along with two of Jonathon's brothers in law. I attend with two friends from high school--Ken Carabello and Allen Morris. It was fun to hear about how Allen just won the world Elk Bugling Championship and about Ken's work with the mentally ill in prision. We all had a great time.

Mom has had an eventful few days. When Bob and I arrived yesterday morning mom was back on oxygen and was hypotensive (low blood pressure). By the time I left this afternoon her oxygen requirement had decreased and her blood pressure had increased. The exact cause for each problem is not certain, although the care team has some theories.

The most interesting thing is that she is more alert which is making her confusion more apparent. Her long term memory is okay but her short term memory is not functioning well. For example she thought she was in Chicago yesterday and Spanish Fork today. She repeats herself frequently and does not remember instructions well. She sometimes says inappropriate things. For those of you who visit, please remember that most of these types of comments are the brain injury talking and not mom's true nature. Sometimes she has an irritable mood (yesterday) but at other times she is happy (today).

She received another priesthood blessing today. Bob and I feel confident that although she may not completely return to her baseline, she will continue to improve. Thank you for every one's thoughts and prayers. Thank you also to everyone who visits both Bob and mom.

Friday, April 3, 2009


Much has happened since my last entry. First of all, mom has been transferred to a new room. She is now in room 202. The reason for her transfer is that she is requiring less acute care. This is a sign that she is improving.


A second major development was the consultation from the neurologist. He explained that mom's MS will cause her recovery to be slower than in someone without MS. He changed her medications so she will be less sedated. She has been taken off trazadone, promethazine and clonazepam. She is now on seroquel and zyprexa. Furthermore, she continues to be weaned off her fentanyl.


A plastic surgeon was also consulted. He found that mom's skin graft on her left arm was healing nicely. He also evaluated her right hand fractures. As you may remember, mom pulled one of the pins out of this hand. The bone that was supported by this pin is healing well. The other two bones are not healing as quickly. I believe that they have asked an orthopedic surgeon to evaluate her left arm fractures to see how these are healing. I am not aware about whether this has occurred.

A rehab physician began to assess whether mom is ready to be transferred to a facility where she can receive more therapy. Mom mostly gets therapy once a day on weekdays when she is awake enough. She is not receiving therapy on the weekends or when she is too sedated and sleepy. Her therapy consists of physical therapy and speech therapy (for swallowing). She has not been doing as well with her swallow. Hopefully as she is more awake, she will be able to pass all her swallow studies.


Bob is doing well. He is now using resistance with his physical therapy in order to rehabilitate his shoulder injury. He took the attached photo of mom today as she sat up in a wheel chair in her new room. I am visiting for the weekend and am eager to see mom tomorrow.


Wednesday, April 1, 2009

Curtis and Marina Loosli called today to check up on mom and Bob. Curtis is mom's first cousin and lives in Idaho Falls. They opened their home to all of us while mom was hospitalized at EIRMC. We will forever be grateful for their hospitality and generosity. I particular enjoyed meeting Marina and hearing Curtis tell the stories about the family that Grandma did tell us.

We are thankful for all the friends and family who have been so kind and helpful while mom is recovering. It is impossible for me to keep abreast of everything and everyone. If I don't mention you on the blog it is out of ignorance.

Joyce is helping Bob through the bills. Her experience in this area will be quite helpful. She will likely help Bob review and visit the next facility to which mom will be transferred. We don't have a time table for this, but as mom improves she will likely be transferred to a facility where she can get more aggressive therapy.

Today mom sat up in a wheel chair for 75 minutes which is a great improvement and demonstrates more trunk strength that other sitting maneuvers. She also stood for awhile. She was not given anything by mouth to eat or drink because she coughed a lot with ice chips yesterday. They will continue to evaluate this daily.