Tuesday, Feburary 28

Today was a rough day for Shar.  It seems like the carbon dioxide build up is not dropping as quickly as we had hoped.  She sad she was very tired and slept a lot today.  She did a really good job with reading today and comprehending.  She still struggles to find the words she wants, but that will take time.  Shar doesn't like needing help or not being at her best, so she lacks patience with herself.  We continue to tell her how far she has come already.  8 days ago she was considered non-verbal, and now she can engage in conversation and laughs and jokes.  

Jerry spent a lot of time at the hospital with Shar today.  They held hands and watched Hallmark Channel movies (although they probably already saw them).  It was sweet to witness them together in this way, although they have always been loving with each other throughout their marriage.  Jerry did get frstrated that there is no quick fix for Shar, but he has been great about supporting her.  

Tomorrow (Wednesday) Shar will get an EEG to check her brain waves and make sure she doesn't have any microscopic brain bleeds.  We also expect that she was be transferred out of the critical care unit at some point and hope to get her to the Rehab as soon as possible.  We think she will benefit from the focus on therapy - both physical and speech.  

Thanks to everyone for all your thoughts and prayers!  We tell Shar all the time how many people are praying for her and care about her, and there is not doubt that makes a difference for her!

Monday, February 27

Yesterday was definitely a struggle for Shar.  We knew that this would be a marathon and not a sprint and that there would be set-backs.  Shar was fortunate that her nurse Kelly was great with her over the weekend and strongly advocated for testing to get to the bottom of the issue.  It appears that her issues yesterday were related to a build up of carbon dioxide in her system - something that happened back in November when she was hospitalized.  She was put on a bipap breathing machine last night and seemed much improved this morning.  She was better with her verbal communication and her understanding.  

She had a long visit from Jerry today and they had lunch togerher.  She also had a good OT and PT session where they had her getting up from the bed and taking a few steps.  They also worked on her hand fuction.  

This afternoon, Shar started to feel shortness of breath and was also having trouble with her communication.  She actually asked to go back on the bipap (which she normally hates) and we were able to get respiratory therapy to hook her back up.  She is sleeping peacfully on the bipap right now and the plan is to keep it on until dinner comes.  Then she will go back on regular oxygen until bed time.

We are hoping she becomes medically stable at some point so she can be transferred to the Rehab.  While there, she will get more intensive therapy both physical as well as speech.  In the meantime, we are contiuning to work on strengthening her right hand and fingers, asking her to grip a stress ball shaped like a football.  And yes - we say fumble when she drops it.  We also bought her a finger exerciser to help get some strngth and control back in the fingers of her right hand to prevent them from staying closed.  She has been enthusiastic about using this and the football and has stayed motivated to get her range of motion back.  We are so proud of the progress that she has already made and look forward to seeing her continue making strides each day!

Sunday, February 26

Today has been a bit of a setback day for Shar.  She was been lethargic, working harder to breath and not able to answer questions.  Today her name has been January 25, but she did know Mindy and Steph's names.  There was a discussion about sending her to the Reading Rehab, but those plans have been put on hold until they figure out what's going on today.  They have ordered an EKG, chest x-ray and CT scan of her brain to see if anything comes up.  Her blood gas level was a 76 which is considered critically high which means she is retaining too much carbon dioxide.  This could be the cause of the confusion and lethargy - although when she was awake earlier she did some straight leg raises and heel pumps.  Her friend Kim the PT would have been proud!

We continue to be thankful for all the prayers and will update tonight if/when we get more information.  

Saturday, February 25

Today Mindy took charge of things (like she normally does) and ran Shar through a gambit of neuro tests.  She worked with Shar on letters and colors, and had her reading a little bit.  She also discussed a long term plan which involves her going to the Tower Health Rehab in the next few days.  While there she will get more intensive OT, PT and speech therapy.  She spent some time in the rehab when she was hospitalized back in late November when she had sepsis and we were happy with her care there.  One nice aspect about this facility is that Mindy can continue stalking her chart each day, because the rehab is part of the Tower Health system.  It is also geographically close so that family can visit her regularly.  

This afternoon she is getting an iron transfusion because her hemoglobin levels are low.   We also expect her to have OT and PT at some point.  They are going to check her blood gas levels becase she's been abnormally sleepy today - which, to be fair, might be a by-product of Mindy not leaving her alone to rest.

Friday, February 24

Friday was a good day for Shar.  She ate breakfast, lunch and dinner and even worked on using her left hand to feed herself.  She had OT and PT and they got her out of bed and into a chair using a lift.  She sat in the chair for a good amount of time before the nursing staff moved her back to bed.  She was able to shuffle her feet a little bit.  The ongoing issue with her getting around is that she can't lift more than 5 lbs on her left side because the pacemaker needs time to heal.  And since her right side is what was impacted by the stroke, she doesn't have control or strength in her right hand.  This makes her using a walker a very big challenge.  

Mindy came down for the weekend after moving some of her patients off Friday afternoon.  Mindy took care of the dinner feeding and was grilling mom with neuro questions.  Shar has surprinsgly good comprehension and is able to read.  Her real struggle is that she can think of the words in her head but can't verbalize them.  At times, completely random words come out and she gets frustrated with herself.  She sometime says "no, no, no" when the wrong word comes out.  But we are thankful that she continues to make progress each day.  

 

Thursday, February 23

Good Afternoon.  Shar had a very busy day today.  In the morning, Jerry came in and spent time with her.  She continues to eat pureed foods and her appetite is coming back.  Following her Thanksgiving lunch of turkey, mashed potatoes and mac and cheese (all pureed) she had Occupational Therapy and Physical Therapy.  She was able to sit up on the side of the bed and worked on moved her arms and following instructions.  Both therpaists commented that she made improvments from yestreday to today.  Following that shw was seen by the Speech Pathologists who did a swallow study with her.  This one consisted of a camera being inserted in her nose and down her throat while she was fed various food - all dyed green so they would show up on the camera.  In addition, the speech team did an assessment of her speech, comprehension and reading ability.  Almost right after the speech team left, the cardiologist came in and said that Shar was in afib.  They gave her medicine and thankfully her heart returned to normal rhythm.

Although she lacks patience with herself right now, Shar continues to make progress each day.  The longterm plan is that once she is considered medically stable she will go to the Reading Rehab adjacent to Target.  While there she will get OT, PT and Speech Therapy each day.    

Wednesday, February 22

Update is a little late today with all the individuals coming in and out of the room (and a budget meeting at school).  In positive news, Shar was moved from the ICU to a critical care unit this morning.  She was assessed by a team of neurologists and did ok with the testing.  She struggles identifying some words and gets a little frustrated when she can't think of a word or phrase.  However, the improvement since this weeknd when she was virtually non-verbal has been amazing.  She also had physical therapy today for the first time.  She did very well with that, even sitting up on her own for a little while.  With having to lay flat for the past 6 days, she did get a little dizzy sitting on the side of the bed after a little bit.  But the PT said that was normal.  She also had a little food for breakfast and lunch (if you can help it, don't ever look at pureed french toast.  It might ruin your love of french toast).  Her food has to be pureed for some time to make sure that her tongue and swalling are all back to normal to prevent choking.  She also met with the cardiologists as well as the surgeon with put in her pacemaker.  They all seemed happy with her progress.  Finally, she met with a nurse who explained how the pacemaker works.  There is a receiver that will plug into an electrical outlet at home and transmit all the data about her heart activity to the cardiology team.  They will be able to review how the pacemaker is working and how her heart is doing as well.  The incredible amount of medical technology that Shar has experieinced is astounding.  

Thank you to everyone for all your prayers and support!  It has been overwhelming.  

Tuesday, February 21 Night

Praise Jesus!   We just heard from the cardiologist that Shar made it through surgery okay.  Prior to surgery, there was a lengthy discussion between Mindy and the anesthesiology team about the safest way for her to be sedated.  Mindy was a great advocate for her mom and absolutely made the right call.  Shar handled the sedation that Mindy recommended well and the surgery was a success!  When she wakes up a little she will now be able to sit up and start moving her arms and legs a little.  She will have another swallow study done at some point to see if she can start eating and drinking.  

Tuesday, February 21 Morning

Good Morning.  The good news is that Shar is still holding her own; however, overnight she went into heart block which means that her electrical signals in her heart didn't fire.  This means that she she will need the internal pacemaker inplanted sometime today.  We don't have any timeline for that at this point, but it should be sometime this afternoon. The good news is that once she has the internal pacemaker in, she will be able to sit up and move around.  This means she will be able to start PT, OT and speech therapy.  She is starting to put words together and even some sentences, but she still sturggles with processing issues,  From Sunday to today she has made a lot of improvement already.

Last night Shar was given some food for the first time.  She is on a soft diet so she had a few spoonfuls of mashed potatoes with gravy and some ground up meatloaf.  She didn't eat much, but at least it was some food for the first time in several days.  

She had a visitor this morning.  Jerry came to visit walking to the room unassisted.  Shar's face absolutely lit up when he arrived.  

Monday, February 20 - Afternoon Update

Shar was celebrity this afternoon with 5 caerdiologists coming to visit.  They gave her midicine to speed up her heart rate to see if her heart could handle it on it's own.  During the test he heart sped up on it's own and they cardio team made the decision not to implant an internal pacemaker.  They wll keep the external one in overnight so she still can't move around in the bed, but if all goes well overnight they will take out the external one tomorow.  

We also requested a swallow study which is done by the speech pathology team.  They should be coming in shortly to perform that test.  This will see if she has full use of her tongue and throat which would allow her to start getting some liquids in.  She hasn't had anything to eat or drink since Wednesday night at 6:00 pm so not having nutrients probably adds to her leathargy.  That's a non-medical assessment from Steph and not Mindy.  Hopefully she will pass that test and be able to get something.  If not, they would put in a feeding tube to get her some nutrition.  

UPDATE - the speech and swallow person came really quickly.  They started by giving her an ice chip to make sure she had control of her tongue and throat.  They then moved on to water from a spoon which she also tolerated.  Then she got some applesauces and tolerated that too.  Finally they tried water from a straw and she coughed that up a little bit.  Stephane, the Speech and Swallow Specialist, said that is normal because liquids from a straw come out quicker.  So tonight they are going to give her some liquids from a teaspoon and then reasses tomorrow. Its another little win for her!

Monday, February 20

 Today has been the best day so far.  Shar's face lit up when I (Steph) came in this morning.  She even commented that my coffee mug was cute.  When asked where she was, she aswered the Reading Hospital.  She also asked "what's the story" so we told about her stroke and how lucky she was to be here.   She seemed to understand that Jesus isn't ready for her just yet.  He orobably needs more time to get prepared for all her jokes

The pulmonary team came in and decided to take her off the bipap machine, so she is only regular oxygen with a face mask.  The oxygen flow is about double her normal flow, but that is to be expected with the anestesia she had and everything her body has been through.

The cardiology team also visited her repeatedly and are trying to determine whether she needs an internal pacemaker.  If so, they would do surgery sometime this afternoon to implant the pacemaker.  This would be a backup in case the electrical impulses in her heart don't fire.  A pacemaker is needed in about 5% of heart valve replacement surgeries since the new heart valve somtimes complresses on the area of the heart that controls the electrical inpulses.  

She wanted the television on this morning and watched Let's Make a Deal and the Price is Right.  She is still sleeping off and on, but she is much more awake and alert.  She is still having processing issues and struggles to find words, but that's to be expected with the stroke.  We are all just thankful that she's still here with us.  

Sunday, February 19

Sunday Shar seemed to be awake a little more than the day before.  She responded to requests a little better and was still able to move her arms and legs.  She listened to Lauren's boyfriend, Jaden, compete in his first collegiate baseball game for Holy Cross University.  She also smiled at one point and seemed to laugh at a video that Mindy showed her of two clowns falling off their stilts during a parade.  If you know her at all, you know that she laughs at everything - especially when people fall.  One of her favorite stories is the one where her two friends fell in the bushes at separate times.  She can barely get through telling the story without laughing hysterically.  

Around 3:30pm, her heart went into sinus rhythm on its own without the help of the external pacemaker, which was a very positive development.  However, overnight she needed the pacemaker on and off.  

One positive update was that the nurse asked her to move some body parts and she was able to bend both legs and lift both arms.  Mindy and Steph also played a trick on her and got her to put up her middle finger - as a Sunday School teacher for almost 50 years, it was undoubtedly the first time she every game anyone the finger :).  

Saturday, February 18

Saturday was more of the same.  Shar was alseep for almost the entire day waking up for a few seconds here and there.  In positive news, she had movement in both legs and was able to move both arms.  This was really positive since the stroke affected the part of the brain that controls speech and the right side of her body.  She had no noticeable droop in her face which was also positive.  She remained on the bipap breathing machine to help control her carbon dioxide levels.  

Jerry came in for a few hours on Saturday to sit with her.  Her granddaugher, Lauren, facechatted with her from the University of Kentucky where she is a freshman student.  Shar's face lit up when she saw Lauren on the phone.  

Shar responded to simple commands and answered yes to everything, which is not surprising because she always says yes to things.   She has always been the most compliant patient you could find - always defending the nurses and doctors.  During the day she seemed to mimics what was being asked of her.  When she was asked to give a thumbs up, she couldn't process it, but when the nurse put her thumb up, Shar did the same.  She was blessed with an amazing nurse on Saturday that took great care of her.  

Friday, February 17

Mindy cancelled all her patients on Friday and came down from CT late Thursday night.  She was at the hospital with Shar first thing Friday morning.  That day Shar was having trouble with her heart so there was an external pacemaker put it to help stimulate her heart and help with the eletrical workings of her heat.  She spent almost the entire day asleep and didn't wake up for more than a few seconds at a time.  She was considered non-verball all day.  Mindy and Steph spent the day with her with Mindy translating medical terms for Steph and overseeing her care.

Thursday, February 16

As you may have heard, Shar had heart valve replacement surgery on Thursday, February 16.  The procedure is called a TAVR.  When she was woken up in the recovery room, she was slurring her words and the right side of her face was dropping.  They took her for a CT scan of her brain which showed that she had a stroke.  They immediately took her to the OR for emergency surgery to try and remove the block, but by the time they did surgery the bloackage had calcified and the surgery was unsuccessful.  At that point they weren't were sure that she would make it through surgery and they had no idea if she would recover.  After two surgeries and lots of testing, she got to the ICU on Thursday night around 9:00 pm.

First Update on Shar

The purpose of this blog is to provide information about Shar’s health condition so that everyone who is praying for her knows what is going on.