April 30, 2006
St. Joseph Medical Center
Specialty Care Hospital
Phoenix, AZ
I would like to put a face of so
me folks I been talking about ever since Lisa was admitted to the Specialty Acute-Care Hospital in Phoenix. With the able assistance of photographer Richard Wintory Meet face to face Connie, Marty and Maureen. Richard describes Connie as the “Upper-Body-Brace Queen” and one who says to Lisa, “No more blinks from you little lady, I want to see you reply by nodding.” Marty the physical therapist has Lisa sitting, standing with assistance, working on her gross motor skills, regaining balance and protecting her gate. Maureen is the quoted as saying, “… if she can squeak—she can speak” or words to that effect. As a speech therapist Maureen is working hard to enable Lisa to vocally communicate. I’m not sure if “enable” is the appropriate word here, so if it isn’t pick one that works for you.
This weekend for and with Lisa has been fun and exciting. It started off with a visit from my sister Cora and her husband Austin who live in Denver. Austin was on business in Scottsdale and they took the opportunity to drive to meet with Richard and see Lisa. The four of them went outside to relax and enjoy the fresh air, sunshine and gardens at St. Joseph’s. Lisa had a special visitor. Maggie her Sheltie drove in from Tucson and this was a happy reunion for them both. (More about Maggie’s visit later) The four visitors (Austin, Cora, Richard and Maggie) had lunch on the hospital patio, and Maggie assumed it her duty to keep the marauding pigeons at bay while coffee was enjoyed. Cora surprised Richard with a gift for Michael’s college fund, and with hugs and tears the Klahn’s departed for the airport.
It would be fair to
say, “Lisa loves her dog Maggie” they have been together for a very long time, and Maggie is, among other things, a traveler. She visited us once in Galesburg, but I digress. Maggie took a day trip to Phoenix and it couldn’t have turned out better. Upon her arrival, she walk in the front door of St. Joseph’s through the heavy foot traffic, and the commotion on the ground floor; then proceeded to the elevator as if it was part of her daily routine and boarded for a quick trip to the 3rd floor. She then, head high tail wagging and with a regal gate proceeded to Lisa’s room amid the warm applause and cry’s of happiness from the hospital staff, visitors and those patients who could see her. It was her finest hour. She entered Lisa’s room as if she did it everyday walked up to Lisa’s face—licked it a couple of time, and proceed to turn around stick her butt into Lisa’s face and laid down. Maggie hung out on Lisa’s bed until it was time for therapy. She sat in Lisa’s lap while Maureen worked with Lisa, and she calmly waited while Lisa was prepared to go outside and happily as noted earlier remained beside Lisa throughout lunch. Year ago, the Sisters of Mercy would never have dreamed of letting a dog enter a hospital, but well documented research has shown that dogs ease anxiety, improve health status of hospitalized heart failure patients. A Sister suggested to Richard that Maggie visit the other patients on the floor, and she was a big boost to everyone’s morale. So Maggie earned the smiles she got!
Doctor Christine Kwasnika and Richard were in a 40-minute meeting about Lisa’s condition. She reviewed the MRI scans taken in Oro Valley and said they were encouraging in that her front brain condition was preserved. She also noted there was no organic damage that would prevent Lisa from making a significant recovery. Dr. Kwasnika then clarified whe
n she said, “I mean nothing is keeping Lisa from making her goal.” The immediate goal is for her interact and provide clear yes/no responses to stimuli. You may be wondering, about medicine, wouldn’t one or more of them help? Yes, there are dozens of medicines that are used in these kinds of situations, that Dr. K. can not use them because of Lisa’s heart condition and her experience with Stevens-Johnson syndrome. Dr. K. is treading very lightly, and very conservatively, bit is pleased and encouraged by Lisa’s steady progress without drugs being in the arsenal. The doctor’s approach is made difficult by the fight to get more awake time with Lisa without drugs and the fight against her body when it is affected by spasticity. Spasticity is a physical condition that occurs when certain nerve signals do not reach muscles because of injury or disease that affects certain parts of the brain or spinal cord. Common conditions associated with spasticity include cerebral palsy, brain injury, stroke, multiple sclerosis, or spinal injury. Spasticity is characterized by tight, stiff muscles that make movement, especially of the arms or legs, difficult or uncontrollable. This is why the therapy is so aggressive with splints, casts, range of motion therapy, standing her erect, seating her in a chair, having her support herself into a seated position. This past Thursday, a fiberglass cast was applied to Lisa’s feet and ankles, wrists and arms. Instead of the cast’s color being Oklahoma crimson it was in fact the weenie red of Nebraska, and much to the delight of Connie a Husker. The purpose of the serial cast’s adjustment of her feet and ankles are to help resist the spasticity. As time has progressed, ranging Lisa is requiring more force and she has been moved from splints to dynamic ranging with a new device which enables more aggressive treatment, but is also more comfortable and adjustable.
To recap, Dr. K. said that if one followed the book one would not be this aggressive, but the medicine used to fight spasticity would make Lisa drowsy and could have adverse side effects on her heart and/or could reignite the Stevens-Johnson syndrome. Therefore the splints and casting because they lower the risk, and preserve her alertness. The race here is between Lisa’s ability to command her body and communicate with us given the injury to her brain. Speaking of race it’s not a sprint, but a marathon.
Lisa has had all of the tubes removed save the feeding tube. That means the three towers with 18 bags dripping into her body is now reduced to 1 tower and 1 bag. The PICC is out. The catheter is out. The trac is out, and the hole from the incision is healing nicely.
Forecast is 2 more weeks at Specialty Care Hospital then on to Barrow Institute. and Barrow something like 8 to 10 weeks, and afterward outpatient rehab 6-months to a year or possibly more. At the moment Tucson isn’t ready for a patient like Lisa and as this likely a 2-year marathon it seems Phoenix is the very best place to “hold” it. When one looks at a life time, 2-years of inconvenience to give Lisa the best possible opportunity available is more than well worth the sacrifice by Richard for him to get 40-good years together as a family.
Two days ago, Maureen said, I know Lisa vocalized and last night Jay, CAN who works with Lisa heard her vocalize twice. Lisa ended the day with a “leg” up on tomorrow.
Michael
mlwintory@msn.com
Galesburg, IL
P.S. This is my last report from Galesburg, unless we get some late breaking news about Lisa, until next weekend when we’re back in Arizona.
Photo credits: Connie, Marty and Maureen taken by Richard at Specialty Care Hospital. The picture of Lisa and Maggie and Lisa were taken on her and Richard's wedding day.
me folks I been talking about ever since Lisa was admitted to the 
say, “Lisa loves her dog Maggie” they have been together for a very long time, and Maggie is, among other things, a traveler. She visited us once in 
n she said, “I mean nothing is keeping Lisa from making her goal.” The immediate goal is for her interact and provide clear yes/no responses to stimuli. You may be wondering, about medicine, wouldn’t one or more of them help? Yes, there are dozens of medicines that are used in these kinds of situations, that Dr. K. can not use them because of Lisa’s heart condition and her experience with Stevens-Johnson syndrome. Dr. K. is treading very lightly, and very conservatively, bit is pleased and encouraged by Lisa’s steady progress without drugs being in the arsenal. The doctor’s approach is made difficult by the fight to get more awake time with Lisa without drugs and the fight against her body when it is affected by spasticity. Spasticity is a physical condition that occurs when certain nerve signals do not reach muscles because of injury or disease that affects certain parts of the brain or spinal cord. Common conditions associated with spasticity include cerebral palsy, brain injury, stroke, multiple sclerosis, or spinal injury. Spasticity is characterized by tight, stiff muscles that make movement, especially of the arms or legs, difficult or uncontrollable. This is why the therapy is so aggressive with splints, casts, range of motion therapy, standing her erect, seating her in a chair, having her support herself into a seated position. This past Thursday, a fiberglass cast was applied to Lisa’s feet and ankles, wrists and arms. Instead of the cast’s color being 
