The Road to Recovery - week 19

I walk slowly, but I never walk backward. 

(Abraham Lincoln)

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.")

December 3/12
The feeding tube remains out.
     After an eventful weekend at home, Alysha returned to the Rehab Center in time to start her daily therapy sessions.  Lisa, Justin and Nana joined her on her return trip and stayed the day with her.  Justin bugged Alysha all day long like brothers do.  Alysha responded by telling him off like sisters do.
     Late in the afternoon the doctor came in to talk about the feeding tube.  At this time they are going to leave it out.  They will monitor what Alysha is eating, count calories, increase her oral intake of water and fluid and they ordered 1 serving of the liquid meal Ensure for each day (to replace the 4 cans of food she used to receive through her feeding tube.) They will also run blood tests every week to make sure it is fine for Alysha to proceed without the feeding tube.
     This is a side note.  On the weekend, Alysha watched some movies on her large screen TV at home.   She had some snacks to go with her TV watching.  One of the snacks that she really enjoyed was Cheesies.   Cheesies tend to melt in your mouth making them a fairly easy snack to eat.  Doreeto's on the other hand are a more difficult snack to consume.  Justin shared some Cool Ranch Doreeto's with Alysha.  She enjoyed these.

Nana King and Alysha back at Rehab.

December 2/12
The feeding tube falls out.
     There was a small glitch last night.  After a busy day and a wonderful homecoming complete with her favourite meal (spaghetti), Lisa tucked Alysha into her own bed, put a movie on the television and set up, connected and started Alysha's feeding pump.  Shortly after her gastric tube feed had been initiated, the tube that was surgically placed to deliver liquid nutrition, water and medication, directly into her bowel came out!!
     Lisa was alerted to this by Alysha calling for her. "Mom," "Mom!" Lisa headed into the room to see what Alysha wanted.  Alysha was smiling and pointing at her belly.  It took a few seconds for Lisa to realize what she was seeing.  There was Alysha's belly freed from the last remaining tube, with the feeding tube lying on the ground at the foot of the pump + pole.  Alysha didn't seem to have found the extubation process painful.  In fact she spent the next half hour giggling as Lisa and Rich organized medical follow up.
     A quick google search and a phone conversation with a friend who has knowledge of these things helped Lisa to decide to bring Alysha to Emerge at the Barrie Hospital (RVH).  The aim is to replace the tube as soon as possible to avoid the hole closing up.  Well, add the wait-time in Emerge onto the 40 minute drive to Barrie and you can guess what happened next.  They were unable to replace the feeding tube.  They did make sure the site was cleaned and bandaged.  They told Lisa to come back and have it placed on Monday.  Lisa's plan is to head back down to the Rehab centre on Monday and speak to the doctors there.
     Without the feeding tube Alysha worked hard at drinking more water to replace the water flushes she normally receives each day.  Lisa went out and purchased some Ensure (liquid meal replacement) and Alysha drank a can of that in addition to eating the meals that Lisa prepared for her.  Alysha usually receives her vitamin and muscle relaxant pills dissolved in water through her tube.  Instead, Lisa ground them up and mixed them in with her meals.  Alysha had no problem taking her medication like this.  Alysha has told her mother she doesn't want the tube to be replaced. In fact she readily adopted the necessary changes in her eating and drinking habits to compensate for the tube remaining discontinued.
   

December 1/12
Alysha goes home for the weekend.
     What an exciting day.  As a reward for working so hard in her therapy sessions, Alysha spent time with the therapy dog today at the rehab institute.  I was surprised to see that Alysha's supported walking now only requires the support of 2 staff members.  When I saw her walk 2 weeks ago it took the support of 3 staff.  Below you will find a video of Alysha walking.  After a full morning of physio and occupational therapy.  Alysha, Lisa and the staff were all abuzz with the excitement of Alysha going home to spend Saturday and Sunday night at home. Alysha hasn't slept at her home since July 23/12.  Marcia and Abby were down in Toronto to participate in Alysha's send off.

November 29/12
Initiation of an Incentive program.
Alysha ate half her oatmeal this morning and half her carrot spice pudding.  At 11 am she did her physiotherapy starting with a new stair climbing exercise.  For this exercise Alysha holds onto 2 railings, one in each hand and alternates lifting her left and right feet up, placing them on a stair and then placing them back down again.  She did this 4 times with each foot.  She doesn't put weight on her raised foot or lift herself up onto the stair yet. Alysha went on to practice standing for 5 minutes supported by holding onto a railing with her left arm for balance.  She concluded the session by walking back to her bedroom.  She cried a bit on the walk back. Frustration?, effort?, pain? hard work?
     At noon Alysha had lunch Alysha consumed an entire serving of minced chicken and mashed potatoes. She also ate half a serving of of mashed peas.  At 1:30 the occupational therapist brought Alysha to the gym for more range of motion and conditioning exercises.  They asked Alysha what she wanted to do first and she chose the hardest task.  This exercise involved leaning forward and reaching up for an object 4 times and reaching down for an object 4 times then repeating the other exercise with her other hand and arm for a total of 16 stretches.  The therapist remarked to Ron that on Tuesday, Alysha could only manage this exercise 1 time on the left side.  She is showing fantastic progress.  The next exercises involved stretching out her arms, and again Ron commented that there has been a noticeable improvement in her ability to straighten her arms.  Ron told Alysha that he is amazed by her display of heart and determination.
  For dinner Alysha had 1 serving of minced oriental ground beef and 1 serving of mashed potatoes and half a serving of mixed vegetables.
     Alysha struggles with her therapy sessions.  She often breaks down and cries.  If Lisa or Ron aren't right there to reassure her Alysha can sometimes become unconsolable for the therapists.  After consulting with Lisa the previous day, the therapists implemented an incentive program with Alysha that capitalized on her love of animals.  Together, Alysha and the therapists come up with therapy goals.  When she achieves each goal, she gets rewarded with a sticker and when she has accumulated 5 stickers she gets a visit with a therapy dog.  Once she gets 10 stickers she gets a visit with Chocolate her horse.  Unlike the mascot for the Calgary Stampeders that made an appearance in the Royal York Hotel, Alysha's visit with her horse will be at home on the farm, not in the lobby or halls of the Rehab Institute.   Alysha seems to be responding well to the incentive program and completed her exercises today with minimal crying.

   

The Road to Recovery - week 18

"Recovery itself is a very un-glamorous daily process of being willing to fall down again, to break again, to cry again, to get up and try yet again until 'success' manifests as ever-greater sustained healing." - Shannon Cutts

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.")

November 26/12
Range of motion exercises.
     Alysha had a great physiotherapy session and at the end of it she walked back to her bedroom, sat on the side of the bed and lay down.  She went on to have a gruelling occupational therapy session where they worked on range of motion in her arms.  She has good range of motion in her right arm but her left arm is more contracted.  The therapists therefore have a plan to focus on her left arm.  Lisa reports that Alysha isn't enthusiastic about working on her left arm as evidenced by her crying and vocalizing but with some persistent encouragement from staff and family she will manage.  
     Alysha wasn't a fan of the hospital food today.  Instead, Lisa used a frozen (stirfry) meal that she had prepared at home, brought to the hospital and left in the freezer for occasions such as this.  Alysha had no problem eating all of her mother's home cooking. 
     
November 25/12
A visit over coffee.
     Alysha spent the day with her dad with visits from Aunt Michelle and Memere. Everyone bundled up and went for a walk down the street to Tim Hortons where they drank some coffee and enjoyed a visit.
     Alysha ate half a serving of apple cinnamon oatmeal in the morning and all of her hamburger and mashed potatos and pees at lunch.  Below you will see a picture of Alysha's dinner which consisted of minced chicken, mashed potatoes, minced peas, gravy and broth.  For desert she had chocolate pudding.  She ate almost everything.

November 24/12
Weekend therapy session
     The rehab center sometimes offers Saturday therapy sessions and Alysha took advantage of that this weekend.  Again, she walked from the therapy room to her bed.  She worked also with the speech therapist on family names.  Later, Ron worked with her on her french vocabulary like, bonjour, mon ami, je t'aime. 
     Today she enjoyed the hospital's cuisine. They presented Alysha with normal adult size portions of food.  For lunch she ate 1/4 of her quiche, all of her mashed potatoes, carrots and cranberry juice and for dinner she consumed half a hamburger patty, and all of her mashed potatoes and gravy.  The therapist observed Alysha eating and suggested that she shouldn't use a straw when drinking because it is harder for her to control.  The rehab center has a large bright common room with lots of windows and tables and a TV.  Alysha ate her dinner in this room. 
     During dinner, Pepere (Alysha's grandfather) called and spoke with her on the phone.  Alysha used her words yes and no to answer his questions and to agree or disagree with him. She used other words in their phone conversation, some were discernible others were not. Alysha continues to practice her verbal communication.
     

November 23/12
Alysha completes her quest.
     Today, Alysha walked (supported by staff) from the physiotherapy room into her sleeping quarters and then she sat on the side of the bed. The distance she travelled was about 30 meters.
     Now that the antibiotics have been discontinued Alysha enjoyed a day free from vomit and gagging.  This put her in good spirits for her therapy sessions.
     The speech therapist's focus today was swallowing.  Once again Alysha participated in a swallow test.  This time the staff were evaluating Alysha's ability to eat chopped food.  Lisa has been making Alysha's favourite meals (spaghetti, chicken stir fry and sweet and sour meatballs) at home and coarsely blending them so that they have small chunks. Alysha hasn't eaten pureed meals for over a week now, so this test was merely a formality.  It was no surprise to Lisa and Ron who have been feeding Alysha her meals that she passed the swallow test. 

November 22/12
Alysha can spell
     Today Alysha walked 25 meters.  She made it from the physiotherapy room to the doorway of her bedroom.  Alysha is on track to complete her week's quest tomorrow and walk from her physiotherapy room into her bedroom.  Lisa will suggest that the walk happen at the end of the therapy session because when Alysha sees her bed she'll be all about climbing into it and ending the session.
     A new speech therapist worked with Alysha today.  She asked Alysha to inform her of the names of people in her family.  Alysha told her that she has a brother and a step brother and then proceeded to verbally spell their names. J-u-s-t-i-n and K-e-i-r-a-n.  Lisa was thrilled with the knowledge that Alysha can spell.
     Lisa also told me that Alysha has become a regular chatter box.  She is using words a lot.  Some of them Lisa understands, others she doesn't. Today Lisa was bugging Alysha and kissing her neck and she heard Alysha say, "get lost." 
     A pattern of vomiting is associated with the administration of Alysha's antibiotics, so after 3 days of treatment and vomit they are discontinuing this medication.  They will test Alysha in the next week to make sure the brief treatment regime worked.

November 21/12
Alysha walks 20 meters.
     Today Alysha hung out with her dad.  She walked 20 meters during her physiotherapy session and she stood up for a full 2 minutes and 25 seconds.  Her strength and endurance in improving day by day.   It used to be that Alysha could only stand for 5 - 10 seconds at a time.  

November 20/12
Alysha reads words.

    
     In therapy today, Alysha walked 15 meters supported by 3 staff members.  The goal is for Alysha to be able to walk (with assistance) from the therapy room back to her own room by the end of the week.  Alysha is on track to meet this milestone.
     Yesterday the speech therapist wrote the words that Alysha was practicing on a piece of paper; Mom, Dad, Aunty Marcy, Justin, Nana, Cierra and Aunty Shell.  She wrote these words with a pen and made the letters around 1.5 - 2 inches tall.  She asked Alysha if she could read the letters and Alysha responded no.  Alysha didn't have her glasses on at the time.  Today the therapist traced over the words with a black marker and Alysha was able to read them and say the words when the therapist pointed to them.  This indicates to us that Alysha can read.  We are looking forward to some more exercises such as these to confirm Alysha's  knowledge of written and spoken language. 
     Alysha also participated in an exercise that tested her vision.  They held two cards with related images side by side and Alysha couldn't make out the pictures.  The therapist then held both cards up together but separated them a small distance and Alysha recognized and responded appropriately about the images. The therapist explained to Lisa and Jeanne (Nana was down visiting today) that Alysha's eye muscles are a bit weak.  As they strengthen Alysha should be able to see images closer together like in the exercise she completed today.
     Alysha also made some progress with the amount of food she can take in orally.  Today she ate 1.5 cups (12 ounces) of a chicken stir fry and rice meal that Lisa had prepared for her.  For comparison, previously Alysha was eating 4.5 ounces of food for a meal.  In this meal, the vegetables and chicken were chopped into small pieces in a food processor but the rice remained unprocessed.  
      Yesterday we were told by the doctor that they had discontinued many of Alysha's medications such as blood thinners, antipsychotics (Loxapine and Clonazepam) and the evening chill-pill (ativan).  The only medications she takes regularly now are multivitamins,  a heavy-duty ant-acid, and baclofen (a muscle relaxant).  Lisa was happy that they had discontinued these medications as she had been advocating for this throughout Alysha's hospital experience.  Lisa was unhappy with the fact that changes had been made a week ago without her knowledge.  Lisa has asked the staff to please keep her informed her of any recommended changes to Alysha's medications and care.  Today they started Alysha on antibiotics for another urinary tract infection.  
     At Lisa's request they are working at giving Alysha's medications orally instead of through her feeding tube.  Today they started giving Alysha her multivitamin mashed up in some food.  This was consumed without any problems.  They will continue to give Alysha her vitamins orally and eventually will add the other medications into an oral regime as well.  Later in the morning, a nurse and student came in to give Alysha some medications by her feeding tube.  This is a process Lisa has witnessed hundreds of times.  The student did a nice job working with Alysha but the process ended up involving more water than usual to dissolve the medication.  After they finished giving Alysha her medication through her tube, they planned to give her additional water through her tube, "a water flush." Lisa spoke up and said, "you have given her a lot of water already, she doesn't seem to tolerate too much water at one time and she will throw up."  Despite Lisa's objections, the nurse and student went ahead and gave the extra water. Within the hour Alysha vomited.  Another "mother knows best," story.

The Road to Recovery- Week 17

"Though no one can go back and make a new start, anyone can start from now and make a brand new end." (Carl Bard)

November 19/12
Alysha walks 13 meters.
     Every time I go to visit Alysha I can see the progress she has made.  This has been particularly true since Thanksgiving weekend. Today when I arrived Alysha was finishing the last 2 meters of a 13 meter supported walk in the corridor of the rehab center.  Alysha completed this walk without the assistance of a walker.  Instead she was supported by 3 staff members.  They found that Alysha adopts a more upright posture without the walker.  
     Alysha is practicing speaking quite frequently now.  In addition to the 40 minute speech therapy sessions, Lisa encourages Alysha to use words whenever possible.  I was pleasantly surprised with how clearly she can say the words yes and no.  Unfortunately for Lisa and the staff, Alysha's "no," is more clear than her, "yes." The other words I heard her say today were Justin, younger, water, pop, mom, dad, nana, etc. 
     The speech therapist was asking Alysha questions about her life.  Alysha used words like Georgian (for Georgian College) to explain.  The therapist frequently gives Alysha 2 options when she asks a question and assigns one answer to each of the therapists hands.  For example, is your brother younger (and she would put up her right hand) or older (and she would put up her left hand).  Both of the therapist's hands remained elevated and ready for selection, Alysha would point to the hand that signified the correct answer.  Below you will find an audio clip of Alysha practicing some words.

November 18/12
Alysha watches the Toronto Santa Claus Parade.
     Born and raised a country girl Alysha enjoyed one benefit of living down-town Toronto today.  The annually televised Santa Claus parade route passes right in front of the Rehab center.  Accompanied by her Aunt Chrissy, Uncle Jason, Noah, Jacob, Lisa and Rich, Alysha dawned her winter coat, headed outside and watched most of the parade.

Rich, Alysha and Uncle Jason at the Santa Claus Parade

Alysha and Aunty Chrissy at the Parade

November 15/12

Another productive day at Rehab.

     Today they combined Alysha's occupational therapy and physiotherapy sessions into one long work-out that lasted over an hour.  They worked on Alysha's walking supported by the modified walker.  Alysha is able to make it the entire length of the therapy room.  She was working so hard she was sweating by then end of it all.

     The speech therapist worked with Alysha in the afternoon. They worked on vowel sounds a,e,i,o and u.  They worked on words Hi and By and Hey.

     Alysha was presented with a daily itinerary that applies to her Monday to Friday activities. She has physiotherapy at 11:00, occupational therapy at 1:00 and speech therapy at 2:00. Each session is given a one hour block of time but the actual duration of the therapy depends on Alysha's endurance that day. 

November 14/12
     Lisa called and spoke to the night nurse at 5:00 am which has been her routine for the past 15 weeks.  She was pleasantly surprised by how forthcomming the nurse was with information.  The nurse reassured Lisa that Alysha had "slept like a princess."  Without being asked she offered that she had been in to see Alysha every half hour, that her vital signs had been assessed and were normal, that she helped Alysha change positions in the bed etc. etc. Lisa was made to feel welcome to call any day, any time.  What an appreciated change from the response she received most times she called St. Mikes to check in on Alysha.
     Alysha was awake when Ron arrived at 8:00 am. She ate a small bowl of oatmeal cereal, had 1 % milk and and carrot cake yogurt.  Ron noticed that Alysha's appetite is getting bigger.  The nurse asked Alysha if she wanted a shower this morning.  No one other than Lisa ever asked Alysha if she wanted a shower at St. Mikes.  At 11:00 Alysha had a 30 minute physiotherapy session in the gym where they tested the mobility in her arms and legs.  At 1:00 pm the occupational therapist came in and also assessed her mobility and facilitated some exercises with her right arm. She encouraged Alysha to brush her own teeth and hair.  When the therapist tried to help Alysha brush her teeth, Alysha pulled her arm away and wanted to do it by herself. Ron noted, "she is so determined." She also encouraged Alysha to push herself around in the wheelchair with her leg.  At 2:00 pm Alysha had a speech therapy session where they practiced the sounds m, a, o, and e.  The therapist put these letters on a board in Alysha's room for Alysha to practice.
     Wow, what a difference in time spent in therapy between this facility and St. Mikes.  At St. Mikes, Alysha had one 15 minute therapy session with a staff member every week-day.  Here, Alysha receives three 30 - 45 minute sessions Monday to Friday.  I expect we will see some amazing progress with this amount of time dedicated to Rehab therapy combined with Alysha's determination.

November 13/12

Alysha moves into the Toronto Rehab Institute.

      
     This morning Alysha, Lisa and Rich said goodbye to the staff and headed out of the hospital affectionally marketed as "the urban angel."  These are not the words our family uses when referring to this health care facility.     
      16 weeks after Alysha entered St. Michael's hospital as a healthy, vibrant, and chatty college student, she left the hospital unable to eat, stand, walk or talk without assistance.  Lisa and Rich drove Alysha to the Toronto Rehab Institute where they will continue to support Alysha's efforts to heal and rehabilitate herself. Alysha is enrolled in a residential long course rehabilitation program.  We expect that she will be at this institute for the next four months.
     It was a very busy day for Alysha, moving into a new room and meeting a number of new people.  By late afternoon, Alysha seemed to have adjusted to her new surroundings. Lisa reports that Alysha fell asleep the moment her head hit the pillow tonight.  She is going to need a good night's sleep because tomorrow the rehabilitation begins in earnest.

Link to: Toronto Rehab Institute
Link to : Long-Course Rehab information
      

The Road to Recovery - Week 16 (St. Michael's Hospital Toronto)

"It's kind of fun to do the impossible."

(Walt Disney)

November 12/12
Alysha's last day at St. Michael's hospital
     The application that was sent last week for the residential rehab program was accepted today.  Lisa was informed that by 10:00 am tomorrow morning Alysha will no longer be a patient at St. Michael's hospital.  She is expected to be at the Toronto Rehabilitation Institute in the morning where she will begin a new phase of her recovery.   
      Lisa, Rich and Alysha took advantage of another nice warm day and stROLLed over to the Eaton's Center where they bought Alysha some new rehab - wear. 
     The dietician was in this morning and she has reduced Alysha's enteral feeds by 2 cans because of the nutrition Alysha is able to obtain orally with her improved chewing and swallowing skills. Instead of receiving 6 cans a day through her stomach tube, Alysha now receives 4.   

November 11/12
     Unlike yesterday, today lacked the thrill of a trip home.  Alysha remained in Toronto, in and close by St. Michael's hospital. 
     Alysha has quickly graduated from completely pureed food to food with little soft solid chunks in it. Alysha is a fan of the chunky food and handles it very well.  She presently eats about 4 oz each meal.
     Last night, for reasons not explained to Lisa, the nurses delayed initiating Alysha's enteral (stomach tube) feed.  The unfortunate delay meant that Alysha was attached to the feeding pump for the entire morning and unable to go outside and enjoy this unseasonably warm day until later in the afternoon. 
     With an entourage of Lisa, Rich and Lisa's friend Debbie, Alysha eventually made her way outside. They meandered about on the streets close to the hospital, and purchased a fruit smoothy for Alysha from a nearby store.  She really enjoyed this frozen beverage (see picture.)  Lisa is looking forward to a meeting with the dietician early in the week to review the feeding plan as it relates to removing the feeding tube that goes though Alysha's skin into her stomach.
     

Fruit Smoothy

Alysha and Debbie

November 10/12
Out of the hospital on a DAY PASS
     After the administration of her morning medications and a quick breakfast of pureed peaches Alysha left the hospital for the day!  With Rich driving and Lisa planning the day's itinerary, they made a quick stop at our house and then headed home to Elmvale.  There was a reception crew waiting for Alysha at her house. Aunt Michelle, Uncle Chris, Aarren, Brycen and Jayden, Uncle Paul, Denise and Kahlan and Nana King.  
     A highlight of Alysha's day was her reunion with her dog.  Later in the afternoon Alysha lay down on the couch but she was so happy to be home with her family that she couldn't close her eyes and sleep.  Lisa prepared a roast beef dinner for everyone.  Aunty Michelle helped Alysha with her pureed version of the meal. 
     It seemed like all too soon it was time to go back to the hospital.  Lisa, Rich and Alysha headed back down to Toronto and returned Alysha to St. Michael's hospital about 1 hour later than her hospital imposed curfew.

Aunty Michelle and Alysha

Zoe, Alysha and Abby.

Aunt Marcia, Uncle John, Abby, Zoe and Alysha

Abby and Alysha

Uncle Paul, Denise, Kahlan, Lisa & Alysha

Alysha is reunited with her dog Cierra

A rest at home

Alysha and Uncle Chris

November 9/12
Lisa straighten's Alysha's hair.
     Alysha had some pureed fruit for breakfast and chicken and rice puree (baby food) for lunch.  Alysha doesn't like us to call it baby food.  With a little bit of added salt, Lisa said that the chicken and rice tasted pretty good.
     Lisa facilitated Alysha's physiotherapy session in her bed.  The physiotherapist, like many of the staff was off today for the hospital recognized November 11/12 holiday.  Lisa also helped Alysha have a shower and then straightened her hair. A few days ago Lisa shaped Alysha's eyebrows.  Alysha really appreciates these little personal care touches reminiscent of her hygiene habits prior to July 25/12  (the day that everything changed.)
     Stay tuned for Tomorrow's report.  There is something really exciting in the works for Alysha and her family.

November 8/12
An application is sent to the Rehab Program.
     Alysha ate an entire yogurt and half an apple juice for breakfast.  She then went on to have a fantastic physiotherapy session.  Today she walked across the room and out the door.  Alysha's room is situated in close proximity to the nurses station.  When Alysha crossed the threshold of her room and out into the hall it caught the attention of all the nurses who proceeded to cheer for her.    
     With all the wonderful progress Alysha has been making, she now qualifies for a residential rehab program.  The doctors and staff have been preparing Alysha's application for rehab all week and today they sent it.  The family is looking forward to this new phase of Alysha's recovery.
   

November 7/12
Alysha passes a modified barium swallow test
      Today Alysha passed a modified barium swallow test.  This test is a special xray that is taken to check swallowing skills.  Alysha was asked to swallow small amounts of food and liquid mixed with barium.  The barium allowed images of her mouth throat and esophagus to be seen on x-ray.  The x-ray catches moving images of the food Alysha was swallowing as it traveled from her mouth through her throat and into her esophagus. This test helped to confirm that food and liquid are not entering Alysha's lungs (aspiration) through her eating process.  
      Alysha was told she could go ahead and eat mushy foods like mashed potatoes or apple sauce.  Three times a day, the hospital will send up some food and a drink for Alysha.
      Lisa reports that Alysha walked the entire length of her room today.  Below you will find a video of Alysha transferring from her wheel chair to her bed. Alysha provides most of the muscle and Lisa supports her balance. Alysha and Lisa posed for a picture mid-transfer.

November 6/12
Alysha Walks!
     Alysha got dressed up in her comfy pants, sweatshirt and gloves and surprised me as I was coming off the subway.  The vision of Alysha out of the hospital and out of her hospital gown was so marvelous. Alysha was also wearing her glasses today.  Lisa put the glasses on Alysha and she indicated that they improved her vision.  Something else that I noticed right away is that Alysha no longer has a dressing over her tracheostomy site.  This wound is healing nicely, you can see it as a dark brown spot in the middle of Alysha's neck.
     The speech therapist was in today and Alysha showed off her eating abilities.  She ate an entire petit danone yogurt.  When Lisa was distracted talking to the staff, Alysha got impatient and leaned forward in her chair with her mouth open to signal that she was ready for more.  Not only did she swallow the yogurt but she also chewed a few small pieces of canned peaches.  We all watched as she moved the pieces of peach around with her tongue to get them in line with her teeth so that she could chew them up.
     The speech therapist also practiced some vowel sounds with Alysha.  Alysha has mastered the "soft a" sound. Her E, I and O sounds are marginally different from the "soft a," and I have no doubt that with more practice Alysha will be able to produce these vowel sounds more clearly.
     The most exciting news of the day is that Alysha walked about 2 meters supported by the modified walker (see photo of the assistive device November 5/12).  WOW!!!

Alysha Meets Aunty Marcia coming off the subway.