In case you haven't already heard Natalie has tested out of the coma stim program meaning that she is no longer considered to be in a coma! She does not act any differently because of this and her progress is still slow but gradual. It mainly means that she scored a 20 (out of 23) or higher on her coma emergence test two weeks in a row - she actually scored a perfect 23 both weeks!
Natalie has been good and talkative for most of the week except today. She was very nauseous and quiet today and as a result missed most of her therapies for the day. Doctors suspect her c-diff is coming back and causing the vomitting. As of now they are unsure but I will post an update once her condition is resolved.
Monday, November 27, 2006
Sunday, November 26, 2006
A further request
A further request:
As requested before: Please do not just show up at sunnyview. Natalie needs to concentrate on her therapies and rest. It makes it difficult on the family to have to turn people away, but this will have to be done on Natalie's behalf.
Thanks for the continued support.
Gratefully yours
Tina
(concerned Mum)
Please respect the wishes of the family as they are trying to do what is best for a speedy recovery.
Thank you.
As requested before: Please do not just show up at sunnyview. Natalie needs to concentrate on her therapies and rest. It makes it difficult on the family to have to turn people away, but this will have to be done on Natalie's behalf.
Thanks for the continued support.
Gratefully yours
Tina
(concerned Mum)
Please respect the wishes of the family as they are trying to do what is best for a speedy recovery.
Thank you.
Monday, November 20, 2006
Great week!
Natalie has made some excellent progress in the past week. These improvements include eating better portions of food - she will now request food (Wendy's frosty, cinnamon buns, etc.) that she can eat with assistance. She has also been talking a lot more. Recently Natalie has been able to compose more complex sentences, for instance she is now able to say a name (or direct her voice) and then ask a question or tell a joke. Natalie seems more comfortable this week than any previous week. She is able to tell us when she is hurting and what is bothering her and sometimes can remedy the problem herself. She will even ask us to be quiet or stop talking when she needs some time to herself!
Natalie has spent most of her days this week in her wheelchair instead of in bed. When she is in her wheelchair the family includes her in games or tells stories with her. Her speech is becoming increasingly coherent as she speaks louder and is more consistent with her thoughts.
She has been doing very well with her therapies and is making excellent progress from the last time I saw her, two weeks ago.
Natalie still needs to focus her energy on her therapies as she is always exhausted at night. Because of this the family still asks that visitors are strictly limited to close family friends and relatives. Please do not show up without calling the family first. I will let you all know once Natalie is able to have more visitors! Otherwise keep the prayers coming and thank you all for reading the blog!
On a sidenote - The format of the blog will be a bit different. Because Natalie's stay at Sunnyview is somewhat of a 'rollercoaster' I will be doing weekly updates on her status. If something extremely important happens, I will surely break the format. Otherwise, join us next week for more miracles!
Natalie has spent most of her days this week in her wheelchair instead of in bed. When she is in her wheelchair the family includes her in games or tells stories with her. Her speech is becoming increasingly coherent as she speaks louder and is more consistent with her thoughts.
She has been doing very well with her therapies and is making excellent progress from the last time I saw her, two weeks ago.
Natalie still needs to focus her energy on her therapies as she is always exhausted at night. Because of this the family still asks that visitors are strictly limited to close family friends and relatives. Please do not show up without calling the family first. I will let you all know once Natalie is able to have more visitors! Otherwise keep the prayers coming and thank you all for reading the blog!
On a sidenote - The format of the blog will be a bit different. Because Natalie's stay at Sunnyview is somewhat of a 'rollercoaster' I will be doing weekly updates on her status. If something extremely important happens, I will surely break the format. Otherwise, join us next week for more miracles!
Thursday, November 09, 2006
Brief update
Therapists began trying to feed Natalie three times a day. This includes very small portions of food (cheerios, orange juice, yogurt, etc.) but will help to get Natalie back into the habit of eating three meals daily. She is not yet able to eat enough on her own to completely nourish herself so they are continuing the tube feeding to remedy that.
Natalie's nausea continued today but she was more alert today than she had been in the past few days (talking more and participating more in her therapies). She continued working on improvements in therapies - including beginning to learn how to use a regular wheelchair (natalies current wheelchair is able to angle her back so she sits back more comfortably and also has a headrest).
I was also told that Marc was able to show Natalie the website for the first time and he read a few comments to her. I look forward to the near future when she will be able and alert enough to read the comments herself - I believe that day is not so far away!
Keep praying!
Natalie's nausea continued today but she was more alert today than she had been in the past few days (talking more and participating more in her therapies). She continued working on improvements in therapies - including beginning to learn how to use a regular wheelchair (natalies current wheelchair is able to angle her back so she sits back more comfortably and also has a headrest).
I was also told that Marc was able to show Natalie the website for the first time and he read a few comments to her. I look forward to the near future when she will be able and alert enough to read the comments herself - I believe that day is not so far away!
Keep praying!
Monday, November 06, 2006
Update and Goals
Thanks to Marc for today's wonderful post!
Natalie had another minor setback this week when her feeding tube got blocked on Thursday evening. The tube had clogged up before, but this time the nurses could not get it unblocked. Nat missed all her meds that day and the tube feeding as well. On Friday she was taken over to Ellis hospital, a general hospital right next door to Sunnyview. There they x-rayed the tube with dye in it and found that it had pulled out of her jejunum, and had kinked. They straightened out the kink but could not re-insert it into the jejunum because her intestines were in spasms. However the x-rays showed that the blockage between her stomach and her jejunum seemed to have resolved in the last few weeks. It was decided to convert the tube back to a G-tube, in her stomach instead of in the jejunum, and see if she could tolerate that over the weekend. So far so good!
When Natalie is feeling unwell or tired she stops talking, or talks much less. Between her C-diff infection last week and the tube problems and procedure this week she has been very tired, and has not talked as much as before, but when she does talk her voice is now louder and clearer.
The therapists recently gave Natalie a new set of goals for the next 3-4 weeks. The most important of the goals are:
1) Orientation to “people, place and time”: People emerging from a coma have very little short term memory, and can typically remember some information from several years ago much better than they can remember information from a few hours ago. For this reason they have trouble recognizing people, understanding what time, date or year it is, or remembering where they are. Natalie is fairly well oriented to people, she knows each of us and generally remembers her therapists. She is somewhat oriented to place, she usually remembers that she is in hospital, and can pick the right hospital name if given a couple of options. She has more trouble with time, even though we go through the calendar several times a day.
2) Following commands consistently: Natalie can follow simple commands, but is not yet 100% consistent in doing so.
3) Discontinue the feeding tube: Natalie is beginning to eat a few small spoonfuls of soft foods by mouth in the morning, and drinking a little with a straw. Gradually she will be encouraged to eat and drink more with the goal of establishing 3 meals a day and phasing out the feeding tube.
4) Switch to a regular wheelchair and learn to wheel it around herself: One of the goals of her physical therapy is to strengthen and tone her back and stomach muscles so that she can sit without full support. She can then switch from her special wheelchair, which has wrap around support and a neck brace, to a regular wheelchair.
5) Family training for bed to wheelchair transfers: We have a goal too! We are learning how to safely transfer her to a wheelchair, and will learn how to transfer her from a wheelchair to a car, so that we will be ready when the time comes for her to make short trips out of the hospital. Natalie will also be taught to help with the transfers by taking some weight on one leg.
There has been some confusion over the posting about Nat walking. To be clear, she was held upright for a few minutes, without taking any of her own weight on her feet, and was encouraged and helped to move her legs in a walking motion. It took 4 people to do this and by no means was she actually walking. She was practicing movements only. We do hope that she will walk again eventually, but that will not happen until she can straighten her right leg and regain more strength and feeling in her left side.
Natalie had another minor setback this week when her feeding tube got blocked on Thursday evening. The tube had clogged up before, but this time the nurses could not get it unblocked. Nat missed all her meds that day and the tube feeding as well. On Friday she was taken over to Ellis hospital, a general hospital right next door to Sunnyview. There they x-rayed the tube with dye in it and found that it had pulled out of her jejunum, and had kinked. They straightened out the kink but could not re-insert it into the jejunum because her intestines were in spasms. However the x-rays showed that the blockage between her stomach and her jejunum seemed to have resolved in the last few weeks. It was decided to convert the tube back to a G-tube, in her stomach instead of in the jejunum, and see if she could tolerate that over the weekend. So far so good!
When Natalie is feeling unwell or tired she stops talking, or talks much less. Between her C-diff infection last week and the tube problems and procedure this week she has been very tired, and has not talked as much as before, but when she does talk her voice is now louder and clearer.
The therapists recently gave Natalie a new set of goals for the next 3-4 weeks. The most important of the goals are:
1) Orientation to “people, place and time”: People emerging from a coma have very little short term memory, and can typically remember some information from several years ago much better than they can remember information from a few hours ago. For this reason they have trouble recognizing people, understanding what time, date or year it is, or remembering where they are. Natalie is fairly well oriented to people, she knows each of us and generally remembers her therapists. She is somewhat oriented to place, she usually remembers that she is in hospital, and can pick the right hospital name if given a couple of options. She has more trouble with time, even though we go through the calendar several times a day.
2) Following commands consistently: Natalie can follow simple commands, but is not yet 100% consistent in doing so.
3) Discontinue the feeding tube: Natalie is beginning to eat a few small spoonfuls of soft foods by mouth in the morning, and drinking a little with a straw. Gradually she will be encouraged to eat and drink more with the goal of establishing 3 meals a day and phasing out the feeding tube.
4) Switch to a regular wheelchair and learn to wheel it around herself: One of the goals of her physical therapy is to strengthen and tone her back and stomach muscles so that she can sit without full support. She can then switch from her special wheelchair, which has wrap around support and a neck brace, to a regular wheelchair.
5) Family training for bed to wheelchair transfers: We have a goal too! We are learning how to safely transfer her to a wheelchair, and will learn how to transfer her from a wheelchair to a car, so that we will be ready when the time comes for her to make short trips out of the hospital. Natalie will also be taught to help with the transfers by taking some weight on one leg.
There has been some confusion over the posting about Nat walking. To be clear, she was held upright for a few minutes, without taking any of her own weight on her feet, and was encouraged and helped to move her legs in a walking motion. It took 4 people to do this and by no means was she actually walking. She was practicing movements only. We do hope that she will walk again eventually, but that will not happen until she can straighten her right leg and regain more strength and feeling in her left side.
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