AUGUST UPDATES

 

Tue. 8/31

 

Kathleen vomited this morningaround 9am after a bolus of about 240cc blueberry

juice.This feeding will also be changed to a 30 minute feeding session.

 

Kathleen was visited by her friends from Valley Medical (a speech therapist, occupational

therapist, and physical therapist) who will continue to monitor her progress, adjust her

goals, and work with her. The session was fruitful as Kathleen responded well again to eating

ice after a long hiatus, began e-stimulation of her muscles, and along with Dr. Chin consulted

about a potential use of botox.A decision will be made within the week.

 

Kathleen seemed uncomfortable all evening and had great difficulty for the first time, in sometime,

sleeping.Almaden's nurses and CNAs were very attentive and sweet as Kathleen appeared to be

in some pain and generally unhappy.Her wrists were very tight and during one range of motion

exercise everyone thought Kathleen said "Ow."In the early morning,1 AM, two CNAs and a nurse

fussed over her positioning and then talked to her about her two sweet daughters. They joined hands

with Mike and said a prayer for Kathleen's recovery and Samie and Rachie's well being.

Kathleen fell right to sleep.

 

Mon. 8/30

 

Kathleen's tone in her arms has continued to be a problem.Her left hand and

wrist in particular have become very tight and threatens to become contractures.

 

 

Kathleen was able to get up in the chair just once, but also got in the standing frame

for about 20 minutes.

 

Kathleen's feeding which had been in bolus fashion (about 4 minutes a serving) and then

switched to a drip over two hours was adjusted to about 30 minutes on Monday without

any difficulty.

 

 

Sun. 8/29

 

Kathleen was a great sport through her adventure with Mike and Sheila.After

exercising with her on the side of the bed, Mike and Sheila decided to move her

to her wheelchair.Only after she got to the chair did they realize her seat was

on wrong and they had to move her back.Quickly returning her to the bed,

which was too high...Kathleen was slipping off the bed when she was laid back

against the bed.Finally the two stooges were able to get her comfortably to her

chair where she remained for 3 hours.

 

Kathleen's feeding issues were beginning to be addressed (as feeding times were

about one hour long)

 

 

Sat. 8/28

 

Kathleen spent the morning on the patio and enjoyed a little sun.

Kathleen was unable to get up in the standing frame today due to the feeding

schedule.  Kathleen's eating period has been extended from about 7 minutes to about
2 hours to avoid vomiting, but this is affecting the staff's ability to perform physical

therapy.  The first week is always an adjustment process so we hope to reach
a middle ground now that Kathleen has had time to adjust to her new surroundings.

 

Please note: Here is the new Care Schedule Matrix.

 

Here is a letter from Sam Kendall.

 

Fri. 8/27

 

Kathleen got up in the chair twice and in the standing frame once and a schedule was decided upon
starting Monday for Kathleen's wheelchair and therapy by the Almaden staff.  The family is also

developing a schedule for volunteers to help with her rehabilitation.

She had a wonderful day today and was cheered by a friendly staff at Almaden 

 

Thu. 8/26

 

Kathleen had a great day until late in the evening again.In the morning she

was in the wheelchair for a record 3 hours.†† When Rachel came for an extended

visit, she over and over again turned toward her.It was Rachel's first day of

Kindergarten...perhaps Kathleen knew her baby is growing up.Until this year

she has always cried on the first day of school for the kids.

 

Kathleen stood in the standing frame for twenty minutes followed by another

2 hours in the wheelchair in the evening

 

Many of Bean's visitors reported her alert and having a good day, and she was

much more relaxed (less tone) until the late evening when she once again threw up

(although much less than last night)

 

****PLEASE NOTE****

The Davey family is having a garage sale this Sunday 8/29 from 7 a.m. to 2 p.m. to clear space

for the work that needs to be done to the house for when Kathleen comes home. Here is a map to the house.

 

Wed. 8/25

 

Kathleen was probably the most alert she has been since the accident

in the early afternoon(as per Sue). She was moving her head, following

objects a bit, and seeming to concentrate.Sue claims that Bob Marley

soothes Beaner, but Cece and Mike find the evidence flimsy :)

 

Kathleen had a tough night.She has found it difficult to sleep since the

move and threw up tonight around midnight.She definitely lets her care

givers know when she is upset now by noises she makes and was

making it frequently tonight until she finally nodded off to sleep

around 1:15AM.

 

 

Tue. 8/24

 

Bean is in Room 19.There is no phone in room but cell phones are okay.

If you have one, please leave it on so Mike, etc can call if needed.

 

Temperature in the room is not controlled real well.It was noted that

Bean becomes more alert when comfortable. Please do what you can to ensure

a moderate temperature control.

 

There was some confusion from transfer from Valley Med. The medicines & juice supplement

instructions were not complete.Who is responsible for providing medicines was

at question last night.The nurse on duty was able to 'acquire' most medicines and

administered all of them but Keppra at evening meal.Keppra was due to arrive later at

night.Going forward, Almaden is responsible for all medicine related issues.

This should be further cleared up today.

 

Some therapy was attempted but Bean was not able to be moved to the chair as the

back headrest is MIA from the transfer from Valley Med.

 

Dr. Englander stated that keeping Bean's physical condition at current level during stay

at any SNF would be a daunting and unlikely task.All Caregivers should take this as a

challenge!Not only will it not deterioratebut it will improve!Here is therapy

plan as outlined from Michelle.

 

THERAPY PLAN

 

Here is the new care schedule for Kathleen to be used at the Almaden Health and Rehab facility.

 

 

Mon. 8/23

 

Kathleen said more tearful goodbyes today.Thanks to some wonderful CNAs..Josie, Josephine, and Virginia.

 

Kathleen stood up on the standing-frame again this morning for 20 minutes and enjoyed looking

at herself in the mirror (something she normally hates to do). She did very well and could have stayed

up for longer but threw upand had to be cleaned up.

 

Kathleen got a Nerve Block in both arms and went well (this procedure deadens the nerves so they

can work on the flexibility of her joints and muscles.

 

Kathleen arrived in room #19 at Almaden Health and Rehab around 5pm. She settled down and then promptly went to sleep in the bed next to a patio

door leading to a courtyard.Kathleen left about 10 minutes after Tara departed Valley.We wish her, and her very nice dad (John) all the best.

 

A big thanks to all who have helped with the meals the past few months. The meal deliveries are ending this month.

Thanks to Julie for keeping it organized and running it!

 

 

Sun. 8/22

 

Kathleen spent two hours in the wheelchair today, and briefly worked out sitting on the side of the bed for

15 minutes with draftees Eric S and Michelle R.

 

Kathleen heard a tearful farewell from her favorite CNA who also said prayers with Bean

 

Kathleen is scheduled to have a nerve block, workouts, and more good-byes at Valley and then move to Almaden

Health and Rehab. It is located on 2065 Los Gatos-Almaden Blvd.

 

 

Sat. 8/21

 

Kathleen stood today for about 15 minutes and didgreat job once again.

Kathleen enjoyed long visits from her sister Sheila and sister in law Kim and discussions about Kim's
upcoming marriage. If safe, the Davey's would love for Kathleen to attend.

Kathleen's left arm is very tight and has a tremendous amount of tone, but her right arm has softened its
tone significantly

 

**The Garage Sale has been postponed to next Sunday as the Davey's are having to make preparations

for Kathleen's move and having difficulty covering the hospital this weekend**

 

Fri. 8/20

 

Kathleen went on the standing frame for the first time today and was very successful.

 

Kathleen's nerve block was not given today.  It was scheduled, but nobody arrived.

Kathleen's braces appear to be almost complete (except right wrist) and ready for her to move on Monday.
They donít appear to be making any marks and are working well.

 

**The Garage Sale has been postponed to next Sunday as the Davey's are having to make preparations

for Kathleen's move and having difficulty covering the hospital this weekend**

 

Thu. 8/19

 

Kathleen got her permanent leg braces (AFOs), which will be on and off every 2 hrs back yesterday

which will facilitate her standing.

 

Kathleen is scheduled to get a nerve block on both her left and right arms tomorrow to help maintain

her wrist and arm flexibility (that she regained after casting).

 

Kathleenís tone was very high today after she had 2 UNCOMFORTABLE procedures.

 

Wed. 8/18

 

Kathleen is getting prepared to leave SCVMC, practicing standing and getting her braces perfected

before she leaves.She stood for about 30 minutes today

 

Kathleen has continued to seem more responsive since she began taking an anti-depressant and

re-started the right median nerve stimulator.

 

The Davey family traded in the first car Mike and Kathleen purchased together in order to purchase a

wheelchair accessible vehicle. (The kids are sad...and so is Mike)

 

For those visiting/caring for Kathleen, here is a detailed care schedule you should follow

 

 

Tue. 8/17

 

Kathleen has been verbalizing much more over the past few days and said ďmumumĒ yesterday.

Kathleen's tone was about the same today. 

Kathleen was in the tilt table for about 45 minutes today (new record..Go Bean!)  Therapists are going to
try the standing frame again tomorrow

 

Mon. 8/16

 

Kathleenís tone went down somewhat today, but remains higher than a few weeks ago.

 

Kathleen spent over 2 hours twice in the wheelchair today (a new record) and enjoyed Elizabeth's rendition

of Out of Africa on the piano.

 

It was agreed by Dr. Englander and the family that the recent upsurge in tone should be dealt with, and

Kathleen should be more comfortable in a standing frame (more difficult than the tilt table) before she

leaves the JTR program

 

††††††††††††††††††††††††††††††††††††††††††††††††††

The Davey family is having a garage sale this Sunday 8/22 to clear space for the work that needs to be done to

to the house for when Kathleen comes home.

 

Sun. 8/15

 

Kathleen was very sleepy today, less reactive and her eyes were dilated more than normal.

Kathleen has a small mark on her left ankle from her AFO Cast which will be adjusted

Kathleen had a shower and looked beautiful today on her anniversary.

Kathleen gave Mike a great present when a chiropractic neurologist, Dr. Shad Groves, evaluated

her favorably and made a series of recommendations to help rebuild connections in her brain.

 

Kathleenís left arm very stiff and hard to put into cast.

 

Her trach hole has closed up well

 

Itís Mike and Kathleenís Anniversary! Here is Mikeís letter.

 

 

Sat. 8/14

 

Kathleen's tone has been going up and down during the day as has her swelling in her left hand..

Nurses and guests have noticed a definite increase in her awareness, eye movements, and following of
commands

Kathleen had dinner with her family on the patio and sat in the chair for over 90 minutes before beginning
to tire

The Davey's again visited Almaden Rehabilitation Center today and feel it best suits Kathleen's needs for the
short term after she leaves SCVMC Journey to Recovery Program.  Kathleen's therapist's are putting a list of
goals together to make sure she continues to improve after she leaves the program.

 


Fri. 8/13

 

The swelling in Kathleen's right hand went down significantly (her wrist braces now fit better -
clever changes made by Michelle the OT)

Big news is that she got her trach out!  Breathing sounds a lot less congested.  Her tummy seemed a
little upset, though and she threw up twice.

She continued to be quite alert.  Eyes were more focused.  The tone of her muscles is still tight.

Kathleen had a tearful goodbye with Brenda, her physical therapist.  Thanks to Brenda for all you've

done for Kathleen.  Your encouragement and support have been much appreciated by both the family

and Kathleen.  We all hope to see you in the future.

 

Thu. 8/12

 

Kathleen again seemed to have a high level of tone today.  She was again very sweaty,

grinding her teeth and her limbs were stiff (Kathleenís right hand is still a little swollen

and her fingers on both appear tight.).  Theories for the recent increased tone include

her urinary tract infection , be the sequel to her event.  It has been shown that often
patients with anoxia increase their tone later on, vs. initially like TBI.  The final thought

is that it has coincided with the absence of the median nerve stimulator.

Resumption of the MNS has been sporadic over the past few days as the Davey's are fumbling with

the settings for the new device.  Apparently it has shut off several times and not gone the full time

the past few days.  The device does give strong force however, much like its predecessor.

 

Kathleen had a workout in the wheel outside with Joe. While outside, Joe described sounds of the traffic

as noisy vehicles caught her attention.

 

Kathleen seemed attentive and focused when talk regarding Mikeís return was discussed.

 

Nurses did not give Sinamet last night and the nurse said it was discontinued along with another med.

 

Wed. 8/11

 

Kathleenhad a pretty good dayreceiving OT and PT today.

 

She was on the tilt table for about 20 minutes and held her head up most of the time. 

 

Her muscle tone was much better after going back to bed. 

 

 

Tue. 8/10

 

Kathleenís bed sore is still being treated.

 

Kathleen had PT/OT according to schedule.

 

During the late afternoon through evening Kathleen was alert.

 

She was perspiring quite a bit but enjoyed an hour on the patio during dinner. Some thought that the MNS

was causing the perspiration.

 

Tuesday appeared to be a quiet day.

 

Mon. 8/9

 

Kathleen stood and lifted her head for 20 minutes.

 

Valley Med agreed to use try anti-depressants with Kathleen. Anti-depressants have

had positive effects on stroke patients and have neurogenic aspects.

 

Kathleenís bed sore is being treated.

 

Mike was trained on wheel chair usage and can now be considered the ďexpertĒ.

 

Sun. 8/8

 

Kathleen had a nice shower today and spent much of the day dozing

At 4pm a flotilla of family members finally woke her up and did the work of two

therapist between the lot.Kathleen sat on the side of the bed, showed good trunk
control and some head control for over 30 minutes and then sat in the wheelchair.

 

Bean has a urinary tract infection.

 

After much research and several visits, the Davey family has found only three South

Bay skilled nursing facilities that in their view would provide Kathleen a safe, comforting,

and therapeutic environment.  The most fitting for Kathleen is Care Meridian (in San Martin Ė

5 miles toward San Jose out of Gilroy) which Kaiser has said they will not accept (even though

it is #1 in the state in some key statistics).  The other two include Almaden Health and Rehab

Center(in San Jose) and the Terraces (in Los Gatos)

 

An article with someinteresting findings that may save lives.

 

Another article on cord blood.

 

Sat. 8/7

 

The family will be purchasing a Median Nerve Stimulator ASAP.

 

Kathleen has a serious bedsore from last night due to the SEDs (leg squeezers) being put on incorrectly.

 

 

The Davey Family had a meeting today to discuss various important issues.

Though on paper Kathleenís chances of a meaningful recovery are between 1-4% there

have been recoveries from her exact condition so the family will continue on as if though she

will recover.The long-term plan is to bring her home. The short-term plan is for Kathleen to

leave Valley Medicalsometime around August 19th and go to a skilled nursing facility (which

the family has been evaluating.) until the house is ready.Here is a list of issues and decisions

discussed and made at the meeting: ††††† FAMILY MEETINGHTM FILE

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† FAMILY MEETING EXCEL SPREADSHEET

 

Here is Chadís new website

 

 

Fri. 8/6

 

Kathleen sat on the patio in the chair for about 70 minutes and then right to the tilt table to

stand for 30 more minutes.

She was then poked and prodded for some time to take every test under the sun to see if she

might have an infection

In the evening Kathleen went outside on the patio and had dinner with much of her family who is

town for tomorrow's family meeting

 

 

Thu. 8/5

 

Kathleen got her left wrist cast off and adjusted to become a permanent brace. The right cast will

come off tomorrow.

 

Wed. 8/4

 

Kathleen, who is now closely resembling the mummy (but with a beautiful face and spirit) had

a cast put on her left hand.  For quite awhile today she had 3 casts and a splint.  Both of her final

casts are scheduled to come off tomorrow.  Her range of motion for these joints and safety going

from bed to wheelchair have greatly improved since the casting.  Thanks to her PT Brenda and her

OT Michelle the casting experts.

Kathleen had a disappointment during her swallow test today when much of what she swallowed

went down the wrong tube.  She coughed it out, but the test was close to meaningless and she had

her worst day feeding (most other days have shown no problems with swallowing down the right

passageway).  For the short term Kathleen will return to ice chips which she has shown to bite and

swallow with little difficulty.

Preparations are underway for this weekends family meeting to decide short term and long term care

plans for Kathleen.  Family members have been scouting out care locations and Mike has been looking into
transportation.  The average van conversion is about $20,000 and takes up to 4 weeks.

 

Tue. 8/3

 

Kathleen sat in a wheelchair twice for 90 minutes today.  She was also fitted for another wheelchair
(sleek turbo design). 

Kathleen received another cast on her right hand and will be casted one final time on her left hand
tomorrow.

The replacement MNS did not work again today.  Other options are being considered.

 

Kathleen's Barium Swallow Test will be Wednesday at 1pm

Kathleen's story was mentioned on another local website today.  Tara also had a recent tragedy when

10 days after her wedding she and her husband were struck by another car in a tragic head-on car collision

while returning home from their honeymoon.  Tara has been making a remarkable recovery as of late and

her father John, a very nice man, has been a frequent guest of Kathleen.

The Davey family has also met another young man, Chad, and his heroic mother, Jeanne, who experienced a
stunningly similar to tragedy 20 days before Kathleen. Chad suffered anoxic brain injury went to Valley Med
ICU, and then over to Santa Clara Kaiser.  Both families have provided strong support for each other
on this long journey.  Chad's site is just starting up.

 

Mon. 8/2

 

Kathleen got her right wrist brace off today and will take a day off before casting again tomorrow.

Kathleen stood for 35 minutes today and held her head up for much of it.  Later while in her commode chair
she held her head up for the entire ten minutes without difficulty.

 

Here is this weekís PT/OT/ST Schedule:

 

M 8:15-9 right wrist cast off
    11-12
    TBA ST

T: 8:15-9 OT
    12-1 Wheelchair evaluation
    TBA Barium Swallow Test ST

W: 8:15-9  OT
    10-10:30 OT
    1:30-2:30 PT
    TBA ST

TH: 8:15-9 OT
      1-2 OT
     TBA ST

F: 8:15-9 OT
   11-12  PT
   1:30-2:30 OT/PT
   TBA ST

 

Sun. 8/1

 

Kathleen had a quiet day today, she showered and relaxed in the morning with

sisters, spent some time out on the patio in the sun, exercised on the side of the bed

for just fifteen minutes and prepared for the week ahead.

In the evening, even after she slept her heart rate climbed somewhat higher than normal