The Road to Recovery - week 12 (St. Michael's Hospital Toronto)

He who would learn to fly one day must first learn to stand and walk and run and climb and dance;  one cannot fly into flying. (Friedrich Nietzsche)

Our sweet cherished Alysha Rose Smith is recovering from a post surgical complication that put her into cardiac arrest and into a coma for 7 days.  She emerged from the coma with severe brain damage.  This website was created to update friends and family of Alysha's progress along the road to recovery.  Please join us as we support Alysha on her journey.  (For earlier details, like the history behind this medical nightmare scroll to the bottom of the blog and click "older posts.")

Alysha update October 15/12
Smiles and Giggles and Responsive communication.
     I headed down to Toronto today to see for myself all the amazing progress I was hearing about.  I wasn't disappointed with what I saw.  Alysha was responding to communication around her with actions and smiles and frowns and giggles.  Alysha knows her right side from her left side.  If you ask Alysha to raise her right or left foot or right or left hand without gesturing or prompting, she can pick up the appropriate sided limb. She can nod yes and shake her head no.  On a few different occasions she raised her hand to her cheek to wipe away a tear or scratch her nose. 
      A lot of Alysha's vocalizations sound like a soft a.... aaaaahhhhhh, aaaaahhhhh. Alysha's cousin Abigail called and we put the phone up to Alysha's ear.  We heard her say Aaaaaaaaaaaaaab. Then Abby asked her to say, "hi," and heard the airy "Hhhhhhhhh" sound without the "i".  The family is looking forward to a visit from the speech therapist to help us facilitate Alysha's speech rehab.
      The day was filled with laughter.  It started with a laughing outburst when I told her a funny story about her cousin Abigail.  It continued each time she sneezed or drooled mucus that someone would have to catch or clean up.  In fact we had a 3 minute game of catch the mucus while Alysha was sitting in her chair.  She purposely drooled out of her mouth so that her mom would jump and catch it.  (See the video clip below)
      Doctors came to assess Alysha to figure out the source of pain that she has been having in the late afternoon for the past 2 weeks.  In the morning when Alysha was pain-free, the doctor stood at the foot of Alysha's bed and was asking Lisa what Alysha looks like when she is in pain.  While he was waiting for Lisa's answer, Alysha provided a demonstration by pulling her legs up to her abdomen and wriggling back and forth in the bed.  Lisa pointed to Alysha and responded, "like that."  Lisa then said, "Oh my goodness Alysha are you giving the Doctor an example of your pain?"Alysha confirmed the charade with a smile and a giggle.  She looked pretty proud of herself. Later in the day I saw Alysha overcome with this abdominal pain and it looked exactly as her demonstration did with some crying sounds added in.  The doctors came back when she was having a pain episode in the afternoon and after some quick assessments determined that the pain was not due to muscle spasm as previously thought but was abdominal in origin.  Further investigations into this pain will take place this week.
      Nana King visited today and got a long awaited hug from Alysha when she was on the tilt table. For the most part, the tilt table session didn't go well because of the abdominal pain Alysha was having.  The therapist recognized that Alysha was in pain and cut the session short. 
      

     


Alysha update October 14/12
Alysha extends her arms to hug her uncle Paul.
      Today Alysha was sleepy.  She did wake up to spend a few hours with Uncle Paul and Denise.  She amazed them by how well she was doing.  She showed off raising her arms and legs, winking at them, nodding yes and no and trying to speak.  When Ron asked her to give a kiss to her uncle Paul she extended both her arms for a hug as well.  Shortly after Paul and Denise left Alysha returned to her bed after spending 3 hours in her chair.
      They took stomach x-rays today to try to pinpoint the cause of Alysha's discomfort as it has appeared lately that she has some abdominal or pelvic pain.  The staff wonder if she has been having some muscle spasms in her back.  They suspect her vomiting last night was because of acid in her stomach so they gave her gravol, Zantac and may look into muscle relaxers on Monday.  These medications will make Alysha drowsy, but hopefully she will be alert and awake enough to continue to build on the wonderful progress she has made over the past four days. 

Alysha update October 13/12
Speech therapy is initiated by the family.
      Alysha was sick in the morning.  The staff aren't sure of the cause.   Ron initiated some speech therapy today where he was getting Alysha to say "ah" and "hi."  Alysha and Ron did the usual arm stretch exercises, walked and rolled around the unit and watched a movie together (The Incredible Hulk).
       Alysha had visits from Dawn and Beth who brought her a special healing blanket blessed by the church. Carolyn came in the evening for a visit and.  Auntie Shell and Alysha had a cyber visit through face-time on their iphones.  In the picture below Alysha is in a wheel chair that reclines.  Behind her you can see the feeding pump with a bag of beige coloured formula hanging above it.  To the right at the back is the grey and orange hoist they use to move Alysha from bed to chair.

Dawn, Alysha and Beth have a visit.

Alysha update October 12/12
Alysha tries to talk on the phone.
      Alysha was on the tilt table today raising her arms, moving her head left and right, and looking up and down. Ron asked that she shake his hand and she did this. 
      Freed from all breathing tubes and extra oxygen, Ron took Alysha for a roll around the unit in her chair to the window.  While she was gazing out the window, Lisa called Alysha and Ron on the phone.  Ron put the phone up to Alysha's ear so that Lisa could talk to her.  Lisa asked Alysha to say hi to her and she tried to. It came out as a nondescript sound, but she produced it again when Lisa asked her to repeat it.  She made more vocalizations as greetings to the nurses on the roll back to her room.  Ron plans to practice speaking with Alysha through the weekend.  There is a plan for a speech therapist to consult with the family regarding speech rehabilitation in the next week.
      Pepere and Pierrette had a final visit with Alysha before they head back home.  They had been surprised with Alysha's improvement so far.  They gave her big kisses and wished her continued success with her recovery.

Alysha update October 11/12 - A BIG DAY
Alysha stands & tracheostomy is removed.
      Today was such a wonderful day of progress for Alysha.  Staff from the 9th floor of the hospital that specialize in brain injuries came up and consulted on Alysha's case.  They inquired about whether or not Alysha had tried to stand.  They suggested a trial of standing when they heard it hadn't been done before.  They started by having Alysha sit (supported) on the side of the bed.  They asked Alysha if she would like to try standing up.  Alysha responded with a big smile.  Taking this as an affirmative answer they supported Alysha to a standing position beside the bed.  After some time standing, Alysha sat back down on the side of the bed.  They asked her if she would like to try standing again and received another smile as an answer.  Up she went again into a supported standing position.  Lisa and Rich were ecstatic.   This was not the end of the good news today.
      Alysha has had her tracheostomy cannula corked for more than 48 hours today without any concerns.  Over the past week they have gradually decreased the size of the inside cannula until today when they removed it all together.  There is no longer a plastic airway protruding from Alysha's neck.  They taped a piece of fabric over the hole in her neck and expect it to fully heal on it's own over the next couple of weeks.
  

The tracheostomy tube is removed

Alysha update October 9th and 10th /12
The tilt table goes missing; The day-sitter is retired.
      Lisa had returned to the hospital to find that the tilt table was missing from the corner of Alysha's room where it was stored in between therapy sessions.  A bit of reconnaissance and the table found it's way back to Alysha's room for a fantastic therapy session.  Alysha's tracheostomy was corked on October 9th at 9:30 am and remained corked through the 10th and on-going.  Alysha has been more responsive and smiling in the past few days.  The family is hopeful that this is a sign of good things to come.
      Staffing has been cut back for Alysha because her health has improved and the acuity of her needs is much less than when she was first admitted to this floor.  The hospital no longer has a day-time "sitter" (someone who is paid to watch Alysha and alert a nurse if Alysha needs something).  With a family member there every single day during the day it was felt by the hospital that the sitter was no longer needed during the day.  Presently they still have a sitter providing one to one observation of Alysha at night.