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.