Since You Asked...

Here are some of the details that people have been asking about.

Bettie's Condition:

• She is still able to get up, and, with assistance (and her walker), make her way to the bathroom and back.
• Her communication is pretty much unchanged, that is, she seems to understand most or all of what is said to her and can usually make appropriate simple responses. She almost never expresses her desires or comments with the right words, so it is often a guessing game to determine her intent.
• She is in her own bed, other than bathroom visits, all the time. We can get a hospital bed from the hospice care people, but have not found the need to, so far. At this point, it seems doubtful she will be going anywhere else, even downstairs to the family room.
• Her pain is managed by a 3-day patch of Fentanyl, plus Oxycodone when needed. All her pain seems to be abdominal, in the area where the biopsy was performed two weeks ago.
• She has a diminishing appetite, but is able to eat something at each meal time. We try to give her what ever she might enjoy, often breaking her natural-and-organic-only rules, from before this happened. Her weight a week ago was 96.6 lbs, up slightly from a couple of weeks before. (Before the stroke, June 23rd, she was 123 lbs.)
• She sleeps well...maybe too well. Pain medication make one sleepy, so this it to be expected.
• She does pretty well with visitors. With hospice care people in several times a week, family, and friends, she has had a fair number of callers. She is able to engage everyone with at least a weak "Hi", though she may fall asleep at some point in a visit.
• Occasionally she will sit up a little so as to view a recent addition to our bedroom, a large plasma television. She can enjoy a movie or favorite show, sometimes even staying awake to the end. Most of the time it displays a continuous aquarium scene that is quite soothing, with soft background music.
• And, yes, she can still make funny faces...on occasion. I love that.

How am I doing:

• As mentioned earlier, this is a shocking change in my life. In the months after the stroke but before the diagnosis, there was time to seriously consider the things that could come next, but it was still traumatic to actually experience it. Nevertheless, this is not new ground I'm breaking here. This kind of thing happens to people all the time. I imagine all of you blog readers have had to deal with equally sad situations. I don't know...we just do it, don't we? All in all, I'm doing OK.
• Health wise, I just today finished all the followup visits after my two days in the hospital scare a month ago (see Oh No, Back in the Hospital). Apparently most of the stroke-like symptoms I exhibited came from some slight interference in my neck where a little arthritis has narrowed the clearance for the spinal cord. Heart is in great shape, and nothing much to be concerned with otherwise. Just don't play tackle football or run with scissors...that kind of stuff.

Am I still working, and singing:

• My employer, iShip Inc., as been particularily wonderful during this time. I am able to spend all the time I need and want with Bettie. I do still go into the office as I'm able and I can work from home for most of the things I do too. There is more detail about my work in the post from June 30th, titled And Now, a Word From Our Sponsor.
• Last Wednesday was the day we saw the oncologist. It did not seem appropriate to go singing that evening, though it was regular chorus rehersal night. Donny, our director, made a brief announcement to the chorus about my situation. This week, I'll return. Singing helps...so does the brotherly fellowship and support I get there.

Do I have enough help:

• I was telling the hospice nurse yesterday: "We're probably less in need of help that your average clients". Beside the live in family (My son Tim, Veronica, his wife, and Jordan and Jonny their teenage children) I now have my son Rick (a former CNA) as a full-time helper. Just last night, my son (and co-editor) Steve flew in from San Francisco for some time with "Mom". So we have a house full.
• And speaking of hospice home care, they really provide an amazing amount of help. Besides equipment of all kinds, they have nurses, massage therapists, bathing assistance, housekeeping help, spiritual counseling, and more. Next time they are here, I'll ask about leaf raking. (I call this place "Five Oaks" for a reason.) Oh, never mind, that's Jonny's job.

Can you visit:

• Yes, you can. At a minimum, call a hour or so ahead of time...a day before might be even better. (253 854-5725). Even with that, it is possible you may have to wait downstairs for a hospice care person to finish a visit.

If it Isn't One Thing...

Right... it's something else. And the something else turns out to be arthritis.

A couple of weeks ago Bettie had a follow-up visit with Dr. Sultana, the director of the Acute Rehab Center at Auburn Regional Medical Center. While going through the standard stuff: "What is your name...show me two fingers...point to your nose" etc., he asked her to take a few steps. He noted that she had a slight limp, which the rest of us just thought was stroke related. "I want that right hip x-rayed" he said, "There's something going on there".

He was correct. The subsequent x-ray shows that she has moderate to severe degradation in the right hip joint and is a prime candidate for a hip replacement...but not in her present condition. She needs to be stronger and just generally more stable, medically speaking.

So it appears that the pain in the right side resulting from the gall bladder drain tube has indeed been subsiding, but the pain from bone-on-bone contact in her hip has been increasing. Because of her inability to be very specific about just what hurts, it was easy for those of us close to her to assume the right side pain was a continuation of the drain issue. In fact, it now appears to be mostly, or maybe even entirely, hip pain. It always hurts when she walks, and always stops when she lies down. In hindsight, it is not so hard to diagnose.

So, what to do? Here's the plan: Monday she will have an imaging-directed shot of Cortizone (or something like it) injected directly where it will (hopefully) do the most good. This should give her two weeks to a month of freedom from pain. The shot can be repeated a limited number of times. This buys time for her to gain strength and weight so that we can seriously consider hip replacement.

Though there is still pain in her life, and it is still limiting how much progress she can make with some of the physical things like walking, it is a relief that the issue isn't some mysterious internal problem with the gall bladder, gizzard, or whatever, in her insides.

Since she can't get on the treadmill just yet, I asked my son Tim to move the weight bench into our master bedroom so she can start working on strength training. She realizes the need for "getting in shape" and is taking to it very well. She can do leg lifts without hip pain. She's up to thirty pounds, and climbing. And that's not all.

Bettie is driving again!

Yesterday, for the second time in the last week or so, we made a trip to the Fred Meyer store in Covington. For the convenience of handicapped customers, they have drivable electric grocery carts. She got one one, and off she went. The only thing she found difficult was getting off when it was time to leave. When we finished at Fred Meyer, we went (practically next door) to Costco. There she quickly mastered the Costco cart, which naturally had a much bigger basket.

Having these electric carts for free use by customers is a great boon to caregivers like me. It is a big help in my new role as the primary grocery shopper, because she knows where everything is, what brands, and sizes we use, etc. It is good for her to get out and do something meaningful and fun. It also gives her an informal opportunity to get comfortable interacting with people.

And to prove this last point, in both stores we ran into people we knew. Ah, let me change that...we bumped into...no, no,...we saw, people we knew. That's better. Anyway, in Fred Meyer, it was Dora Darby, the woman I sat next to in church last week. In Costco, it was Bobbie and Chuck Stocton, old friends from the church we attended previously. Both interactions were warm and supportive...just what she needs.

Daily Life in Auburn Acute Rehab

Bettie was in bed the entire visit, having finished her dinner before I arrived. So now, going forward, I'll start reporting on the things that are not getting better, as most everything is. For example, she shook Dr. Heide's hand with her right hand today. It's like, 'No big deal'.

Now that she is close to home -- it is about 15 minutes to drive there and another five minutes to park and get up to her room -- it's much better for everyone. (At Highline, it was about 35 for the entire trip, one way.)

This makes a huge difference to family from two perspectives: One is simply the logistics. It is not hard to just run down there when the mood strikes, as opposed to planning a "trip".

The other is how much less a burden it is to leave her. To family it just seems like: "I'll be right back, just going to run home for a little bit." It is just, I don't know, lighter somehow. We no longer feel like we're leaving her way over in some other city. (This is no reflection on the care she was given at Highline. I've already praised that. Just the distance and perception in our minds.)

Now, about visiting. As I told Bettie, "You are in school". The good news about visiting is that you can come any time between around 8:00 in the morning to 8:00 in the evening. The bad news is that three or more of those hours she will have a "teacher" (therapist) with her, so you will do more watching than visiting.

Therapy sessions are usually 45 minutes to an hour and have a little free time on either side between them. More often than not they are midway between meals.

But, watching her therapy is a good thing, because it shows you things you can be helping her with during your visits (please). Bottom line: come anytime ... please. Every time you come, you will see more of the "new" Bettie. Speaking of the new Bettie, she looked totally fetching in her new jammies Deana. So thank you very much.

I think that from now on, I'll report her status at the end of each day, rather than twice a day. I totally enjoy writing up these reports, but it is time consuming and I've got banisters to put up and other stuff to do. After all, she will be home before we know it and I've got to be ready.

Before I close for the day, I'd like to report on a gift I received today from a bunch of very special guys that I hang out with every Wednesday evening, pretty much year around. They are the Northwest Sound Men's Chorus.

As I write, they are in Anaheim, Calif., preparing to compete for the title of International Chorus Champion of the Barbershop Harmony Society, which takes place tomorrow evening. I would have been with them, had the stroke not happened.

What they gave me brought to mind the Mastercard commercial: "Priceless". The entire chorus called me on the phone and sang me a song, then they all shouted "Hi Dick".

It was wonderful. I thanked them and then said: "A loving God would not let you win without me on the risers with you. But second place is not bad." :)

I'll be watching on the internet tomorrow, and singing along.