The plans they are a' changin'

Yesterday, Dad's therapy team decided, based on the progress he's been making in his current setting, to extend his stay until May 11 (one week). I was a little surprised by the extension, as they've been angling towards in-patient rehab starting May 4 for a couple of weeks now, but I'm comfortable with the decision. He does seem to have made noticeable progress in the last 7-10 days; extending in that environment makes sense to me. Apparently they'll take stock at their weekly meeting each Tuesday, and as long as he's still progressing, they'll probably keep extending.

Something sounds different

The title of this post is somewhat misleading. When I spoke with Dad this morning, he sounded different from what we've been hearing since the beginning of March, but much more like himself pre-stroke. His voice was less croaky, and he was able to get out a lot more words. He said that it was still hard work talking, but it seems like LS's suspicion (mentioned back on 7 April) was correct: his vocal cords were spasming shut. It's clearly taking some deliberate effort for Dad to relax the cords, as the croaky, halting speech went and came while we talked, and he allowed as he needed a break after 15 minutes, but still, it was a wonderful conversation. The whole family here got to hear a lot from him.

Standing

I received a video call from the physical therapy gym yesterday and saw Dad standing up. It was with some support, mind; he was holding on to something like a walker bolted to the floor. Nonetheless, it was much more than I had seen since the stroke. His therapist said that he had been standing for about five minutes. Speaking to Dad's longer-term progress on this front, as the left side strengthens, he is listing less in that direction, and can right himself - no pun intended - as he does. Transfers are getting easier as he can assist more. His control over his left arm is improving, as well. I think I mentioned previously that he had used both his hands together to open some mail; the therapist also reported that Dad is better able to release things once he gets hold of them with Lefty. (Aside: I had always thought of a stroke as damaging the ability to do certain things. But one thing I've learned is that, at least for Dad, the damage often manifests as the inability to stop doing certain things, even things we think of as voluntary. This has applied in both the physical and cognitive realms.)

The plan is still to write an order next Monday for him to go to in-patient rehab on May 4. The rehab facility will need to review his case, to see that he is making progress, to accept him. Given what I've seen over the last seven weeks and within the last ten days, I am optimistic that he'll be accepted.

Update

For whatever reason, I woke up this morning and realized that I hadn't shared any updates for a week. There are indeed updates to share.

Most of Dad's sutures came out a few days after his fall. Everything seems to be healing fine. Beyond the wound itself, he had some bruising on the forehead and around the eye.

His care team wasn't happy about him spending another two weeks confined to his room, so they tested him for SARS-CoV-2. It came back negative, so now he's got a little more freedom within the facility.

We're still on the outside, of course, but the staff arranged a time for us to meet at a distance. A great distance, in fact, as he's on the 8th floor. But nonetheless, last Saturday morning, Kerry, Owen, Katherine, and I were standing in the median of the road outside his building, waving up to him. He sat at the window, and with assistance, stood twice, waving. Of course this being this modern life, we were also Facetiming, so there were moments when we were standing in the median of the road outside his building, huddled around my phone to talk with him less than 100 yards away.

I think these sorts of connection mean a lot to Dad. I know they do to me. In that vein, thank you very much to those who have sent Dad cards and emails via me. Please send them as often as you like.

Dad's care team thinks that he would benefit from another round of in-patient rehab. He would receive at least 3 hours of therapy per day, as he did in Tulsa. This makes sense to me, given what I've heard about most stroke recovery happening in the initial months after the event. If all goes to plan, he would move to a new facility for in-patient rehab on May 4.

After the fall

I Facetimed with Dad today. It was another good conversation, not quite as good as the one last Friday, but pretty good for a guy who has a fresh bandage on his head. His therapist, LS, also shared that he has been intentionally using his left hand (eg, to open an envelope).

But, as every silver lining has a cloud, my fear was confirmed: Dad's little jaunt to the ER caused his 14-day covid quarantine to reset. Yesterday had been day 14, but it became day 1. In truth, this is a relatively small limitation, as all group activities (eg, dining) are suspended. Nonetheless, once he gets past 14 days (again), he'll be able to go to the gym for physical therapy and use the full suite of equipment there.

Never a dull moment

This morning, Dad took a tumble out of his wheelchair, reaching for his shoes. He landed on his noggin and needed to go to the hospital to get some stitches. That sounds bad, but apparently it wasn't so bad that he didn't finish his breakfast before going to the hospital. They also did a CT scan there to confirm that there was nothing more serious going on inside. There wasn't.

One week update

Dad has been in Dallas for a week. My updates have come from his speech therapist, LS, who has helped Dad to call/Facetime me, but also to talk with me, to learn about Dad and to let me know what she's seeing. In short, there is not much change in his condition. He did eat his breakfast entirely on his own this morning, without any prompting. LS speculates that he may have spasms in his vocal cords, slamming them shut when he tries to speak. This would account for his croaky voice, as well as the extreme effort it seems to require at times for him to start speaking.

I don't know about physical and occupational therapy. I should learn more during a call this Thursday.

All of the staff are wearing face masks all the time, so patients can only see their eyes. This is an extra challenge, with mouths entirely hidden and facial expressions limited to eyes and eyebrows. LS was asking me about Dad's interests, so that she would have more things to talk about with him. I really appreciate her reaching out.

Speaking of reaching out, while there are no visitors, and phone calls/Facetime are touch and go, Dad can definitely receive mail. It's probably best if you send things to me, and I'll bring them over; I don't know when his location in the facility might change, or how good their mail forwarding is. If you'd prefer to do it electronically, you can email me, and I'll print out and take things to him. For content or questions, I'm at rtdunbar-at-gmail-dot-com. Thanks in advance.