The Road to Recovery - week 6

The flower that blooms in adversity is the rarest
and most beautiful of all.  (Walt Disney)

Alysha update Sept 3/12
A relaxed day.
     Lisa and Rich spent the day with Alysha today.  She rested for most of the day. When she was awake she was relaxed, smiled and gave kisses.  They were unable to get Alysha up in her chair to sit because the lift that helps to transfer her body from her bed to the chair was broken.

Alysha update Sept 2/12
Corking the Trach Tube
     Two big items of news today.  The first is that Alysha communicated with her eyes today.  The Doctor asked Alysha a series of questions; could she open her eyes, could she close her eyes, could she keep her eyes closed for a period of time?  She responded to these 3 questions with the requested actions.  The Doctor then asked Alysha to close her eyes and keep them closed if she was in any pain. She kept her eyes open.  The Doctor said, I see from the fact that you kept your eyes open that you are not in any pain.  Alysha continued to keep her eyes open.
      The next big news is that they corked Alysha's trach tube today for half an hour so that she could practice breathing through her nose and mouth.  A cork is a plastic cap that they fit over the end of the trach tube.  With the trach tube corked, Alysha had the ability to make sound as air could travel through her vocal cords.  She made some moaning noises, but didn't say any words.  She also made coughing noises and had a cry with usual crying noises.  These are the first sounds we have heard Alysha make in almost 7 weeks.  Lisa reports that the sounds seemed to startle Alysha, as she is not used to making any noise.

Tracheostomy Cork

      Visitors today included Paul, Denise, Michelle, Nana King, Lisa and Rich.  Michelle thought Alysha looked very restless today.  Alysha's arms remained flexed at the elbows with her hands resting at the level of her neck.  Her wrists were contracted down or flexed and her fingers were flexed (curled under). Her flexed pointer finger stood up a bit more than the other fingers. Michelle said that she was only able to coax Alysha's arms down to her sides one time for less than a minute.  Alysha rests in the bed with her knees flexed and out to the side and ankles together up near her bottom (froggy position).  She then flexes and extends her legs continuously when she is restless. Sometimes her upper body will make jerky movements when she shifts her focus from one side to the other.



Alysha update Sept 1/12
A day with Dad.
      Ron stayed with Alysha for the day today. He reports that she was a bit restless in the morning.  The staff gave her medication and after that she slept most of the day. Alysha's vital signs were good for the day and her lungs are improving.   She only required airway-suctioning one time during the day. They are giving Alysha a new medication that decreases her agitation/ restlessness.  They told Ron  that until they figure out the proper dosage it may make her drowsy.  The nurse said that it could take up to a week to figure out the proper amount of medication to give Alysha, because everyone  processes medications differently. 
     Alysha smiled for her dad today and gave him a kiss good-night.  She got a little sad when he left but she settled after he explained that he would be back to see her soon.

Alysha, Dad-Ron and Memere-Yvette

Alysha update August 31/12
Alysha becomes responsive in the afternoon.
      For most of the day Alysha remained unresponsive. At around 3:00 pm that changed.  She began to open her eyes and track people again. She gave kisses to her family and smiled.  She cried at the end of the day when it was time for Lisa and Rich to leave for the night.  She is moving her legs a fair bit, but she isn't moving her arms as much.  Her hands remain contracted with fingers flexed and she can't hold or squeeze anyone's hand today.
      Yesterday we were told that Alysha's non-responsive condition was not related to any medications. Today we were told that she was given medications yesterday that could have caused the apparent decline in her condition.  We are left weaving the rare and often conflicting pieces of valuable information together into a confused understanding of Alysha's condition and care by the staff at St. Michael's hospital.

Alysha update August 30/12
Back into the ICU after a day.
      Alysha returned to the ICU this afternoon.  She continues to choke on plugs of mucus and require suctioning and one to one nursing which can't be provided outside of the ICU.  For the entire day Alysha has been completely non-responsive. If you pick up her hand it hangs limply in your grasp and flops down when you let go.  She didn't respond to any painful or annoying stimuli by the doctors or nurses today.  Occasionally she opened her eyes but didn't focus on anything or anyone.  Lisa said it is as though she is back in a coma with the exception of her eyes opening occasionally.  The staff are frequently having to suction her airway today.  Lisa is unclear about the sequence of events last night that lead to Alysha's present condition.  As usual, the practice of partial debriefing of the family regarding relevant events relating to Alysha's recovery was repeated for this latest setback.  In fact, the family continues to wait for the meeting with the doctor about the last code blue on August 22nd.

Alysha Update August 29/12
Alysha moves out of the ICU for the second time.
      Alysha moved out of the ICU today and into a private room.  The patient to nurse ratio is usually 5 to 1 during the day and 6 to 1 at night.  Lisa was assured that there would be an exception made for Alysha to receive 1 to 1 nursing for the remainder of her first 24 hours out of the ICU.
      Guests today were able to see Alysha in her new room.  There are no time restrictions or number of people restrictions for Alysha's visitors.  It is nice for the family to be able to see Alysha without having to stand outside locked doors and ask for permission as we did in the ICU.  Alysha's guests still need to dawn yellow infection control gowns and gloves because of Alysha's susceptibility to infections.  So today there were a number of yellow clad family members visiting with Alysha and each other in Alysha's new room.  Zoe and I joined Nana King, Lisa, Rich and Justin as the welcoming committee for Alysha's new room.  Zoe and I picked up a few gifts for Alysha including 2 pairs of bright knee socks, flavoured chap-stick and scented moisturizing cream.
      Justin reported that Alysha looked more restless and less responsive and energetic than on Monday. Alysha's activity and energy today is similar to yesterday.

Alysha Update August 28/12
Tired, but responsive. 
      Alysha seemed to have less strength than yesterday.  She was tired and slept most of the late afternoon and evening.  This morning the staff reported that she only had 2 hours of sleep last night because she was very restless. Regardless of her fatigue she continued to smile and make hearts and hold hands with her visitors today, it just seemed like each movement took more effort.  Earlier in the day the physiotherapist had her working at sitting up on the side of the bed with her legs dangling down.  Her right side seems to be stronger than her left because when she attempts to sit, she tips over to the left.

      It is likely that Alysha will be moved out of the ICU tomorrow and into a private room again.  The staff tell Lisa that the transition out of the ICU will be better organized this time.  A registered nurse will be with Alysha for the first 24 hours and they will be assigning a sitter that can touch Alysha and do tasks like clear out her breathing tube.  There will also be a respiratory therapist who will follow Alysha to her new floor.
      Visitors today included Chrissy, Jason, Lisa, Rich, Justin and Aashish.