April 7, 2006 (Part II)
47 Days into the ordeal…
Specialty Care Unit
St. Joseph’s Medical Care Center
Phoenix, AZ
To paraphrase Winston Churchill, “It is not the end of Lisa’s ordeal, and it is not the beginning, but it is
the end of the beginning!” Today Lisa, for the first time, made cognitive and volitional responses to questions and requests. Lisa went into therapy today bathed, groomed and rested. She was dressed in a racy, hot pink tea shirt (Richard’s description) and coordinated workout pants. The therapy began by Lisa being placed at the edge of a low-cushioned table. There, a large exercise ball was positioned so that it tucked under her chin, and then her arms were placed around the ball. The great thing about the ball is it balances weight and properly positions her head on her shoulders. Lisa has a tendency to clasp her arms to her chest; therefore the ball functions as an isometric exercise as she clasps the, and then…the therapists pull Lisa’s head back off of the ball and Lisa returns her head to the ball.
47 Days into the ordeal…
Specialty Care Unit
St. Joseph’s Medical Care Center
Phoenix, AZ
To paraphrase Winston Churchill, “It is not the end of Lisa’s ordeal, and it is not the beginning, but it is
the end of the beginning!” Today Lisa, for the first time, made cognitive and volitional responses to questions and requests. Lisa went into therapy today bathed, groomed and rested. She was dressed in a racy, hot pink tea shirt (Richard’s description) and coordinated workout pants. The therapy began by Lisa being placed at the edge of a low-cushioned table. There, a large exercise ball was positioned so that it tucked under her chin, and then her arms were placed around the ball. The great thing about the ball is it balances weight and properly positions her head on her shoulders. Lisa has a tendency to clasp her arms to her chest; therefore the ball functions as an isometric exercise as she clasps the, and then…the therapists pull Lisa’s head back off of the ball and Lisa returns her head to the ball. Today it was Connie, an Occupational Therapist and Maurine a Speech Therapist working with Lisa. Richard describes them as “seasoned and salty professionals” who both might have come to Arizona from Missouri. (In case you don’t get my weak attempt at humor, the Show Me State.) It starts like this. Connie says to Lisa, “Okay Lisa, today we want to establish your ability to communicate with us. So, when you want to tell us NO, move your head from the left to the right. Lisa show us you understand by telling us NO.” LISA slowly and deliberately began to move her head to the left; she then deliberately rotated her head to the right. “Lisa,” Connie instructed, “now, when you want to tell us YES, move your head down and then up.” Lisa slowly and deliberately moved her head down, way, way down. So far down, in fact, she needed boost to assist her effort in raising her head, but she did it. Richard meanwhile continually encouraged her and gave verbal support. I don’t know, but he may have still been under the influence of the pink tea shirt. (Just kidding)
Then, then Maurine asked, “Is Richard in the room?” Lisa said, “YES,” by moving first down (but not so 
far down this time) and then raised her head up.” LISA OBVIOUSLY LEARNED NOT TO GO TOO FAR from her previous response. Now, Maurine asked, “Is your mother in the room?” Lisa said “NO,” by deliberately moving her head to the left, and then the right. Richard then questioned, “Do you want Michael to come and see you?” Answer, with head movement, “YES.” Richard then asked Lisa, “do you know how much I love you?” and Lisa nodded YES. It was then, Richard said, “that Maurine and Connie lost it.” (their professionalism that is, by cheering.) Connie continued, “Lisa, remove your right arm from the ball.” Lisa responded by slowly pulling away from the ball, but there was a problem. Lisa, you will remember, was in the hot pink tea shirt so her arms were bare, so after Connie “unstuck” her from the ball, Lisa resumed her progress of slowly removing her arm from the ball. When asked to do the same with her left arm, her response was quicker, but not more decisive than with the right arm. Let me say it, “Yes, Lisa was decisive with both arms!” Connie asked Lisa to push back against her and to rock forward. Lisa ever so slowly, without-a-doubt, complied. There was no delay in her initiating a response. Lisa clearly was processing the information and responding appropriately. Whew, I’m exhausted, but there is more, much more. Remember the table? With the table she was slowly rotated to an upright-standing on her feet position! Now, get this, Lisa while upright was still able to move her head left and right with direct responses to questions. And she continued to be stimulated in this manner until Dr. Kwuazika arrived. What Dr. Kwuazika told Richard was that Lisa is in stable condition and showing “terrific progress. “such good progress,” she said that it warrants the administration to a new medication, PROVIGIL. (PROVIGIL is a medication to treat excessive sle
epiness caused by certain sleep disorders.) PROVIGIL will help Lisa focus on stimulation, and has the least side effects risk. The doctor said that the kind of response that she exhibits is progress one usually does not observe this early, and is a positive predictor of a good outcome. Richard got a little excited at this point, as you can imagine. So he flipped into his prosecutor mode (no surprise, huh?) and sought clarification from Dr. Kwuazika. She, the doctor, said, “… absolutely is a positive predictor of a good outcome.” But wait, there’s more.
Lisa is
now breathing through her mouth and nose as a small plug was placed into her trach, and also she is vocalizing more. As aside, she receives her meds by IV and through the PICC line. The trach facilitates suction and is used to keep her lungs clear. I mention this detail because it indicates Lisa is well on the way to having the trach removed. Dr. K followed by adding, “… this is what we need to be seeing to get her into Barrows. (Hospital, which according to U.S. News and World Report, is one of America's finest neurological... ) Remember? Barrows Hospital is the next beginning in her rehabilitation.
St. Joseph’s has a beautifully landscaped courtyard, and Richard and Lisa finished the day with a walk in the park, so to speak. Lisa deserved the aroma from the flowers in bloom and the splashing water as it played in the fountain.
Michael
mlwintory@msn.com
Pictures of Lisa, Lisa & Richard taken by Linda Thompson, Norman, Oklahoma January 2nd, 2006. Richard and Michael’s pictures were taken while Richard was slaughtering a carrot in his kitchen… earlier this week.
far down this time) and then raised her head up.” LISA OBVIOUSLY LEARNED NOT TO GO TOO FAR from her previous response. Now, Maurine asked, “Is your mother in the room?” Lisa said “NO,” by deliberately moving her head to the left, and then the right. Richard then questioned, “Do you want Michael to come and see you?” Answer, with head movement, “YES.” Richard then asked Lisa, “do you know how much I love you?” and Lisa nodded YES. It was then, Richard said, “that Maurine and Connie lost it.” (their professionalism that is, by cheering.) Connie continued, “Lisa, remove your right arm from the ball.” Lisa responded by slowly pulling away from the ball, but there was a problem. Lisa, you will remember, was in the hot pink tea shirt so her arms were bare, so after Connie “unstuck” her from the ball, Lisa resumed her progress of slowly removing her arm from the ball. When asked to do the same with her left arm, her response was quicker, but not more decisive than with the right arm. Let me say it, “Yes, Lisa was decisive with both arms!” Connie asked Lisa to push back against her and to rock forward. Lisa ever so slowly, without-a-doubt, complied. There was no delay in her initiating a response. Lisa clearly was processing the information and responding appropriately. Whew, I’m exhausted, but there is more, much more. Remember the table? With the table she was slowly rotated to an upright-standing on her feet position! Now, get this, Lisa while upright was still able to move her head left and right with direct responses to questions. And she continued to be stimulated in this manner until Dr. Kwuazika arrived. What Dr. Kwuazika told Richard was that Lisa is in stable condition and showing “terrific progress. “such good progress,” she said that it warrants the administration to a new medication, PROVIGIL. (PROVIGIL is a medication to treat excessive sle
epiness caused by certain sleep disorders.) PROVIGIL will help Lisa focus on stimulation, and has the least side effects risk. The doctor said that the kind of response that she exhibits is progress one usually does not observe this early, and is a positive predictor of a good outcome. Richard got a little excited at this point, as you can imagine. So he flipped into his prosecutor mode (no surprise, huh?) and sought clarification from Dr. Kwuazika. She, the doctor, said, “… absolutely is a positive predictor of a good outcome.” But wait, there’s more.Lisa is
now breathing through her mouth and nose as a small plug was placed into her trach, and also she is vocalizing more. As aside, she receives her meds by IV and through the PICC line. The trach facilitates suction and is used to keep her lungs clear. I mention this detail because it indicates Lisa is well on the way to having the trach removed. Dr. K followed by adding, “… this is what we need to be seeing to get her into Barrows. (Hospital, which according to U.S. News and World Report, is one of America's finest neurological... ) Remember? Barrows Hospital is the next beginning in her rehabilitation.St. Joseph’s has a beautifully landscaped courtyard, and Richard and Lisa finished the day with a walk in the park, so to speak. Lisa deserved the aroma from the flowers in bloom and the splashing water as it played in the fountain.
Michael
mlwintory@msn.com
Pictures of Lisa, Lisa & Richard taken by Linda Thompson, Norman, Oklahoma January 2nd, 2006. Richard and Michael’s pictures were taken while Richard was slaughtering a carrot in his kitchen… earlier this week.
