Fourth Day Post-op

…and still in the hospital.  Today, Monday, was the day to achieve the therapy evaluations.  Physical Therapy, Speech Therapy and Occupational Therapy paraded through Richard’s room performing evaluations and reporting back to the doctor.

Richard is speaking more, but also frustrated more over getting his ideas formed and expressed.  In short, he was nervous over the idea of going home.  He couldn’t express what exactly was unnerving him, and that block in communication seemed to compound the frustration.  To stop that cycle and to empower him to feel full control over his situation, John and I left when he suddenly asked us too.  Richard was concerned for our safe travel in making the miles back to Rolla in the threat of a major winter storm warning. 

According to various reports tomorrow is supposed to be the day of a massive avalanche of ice and snow in south-central Missouri and the St. Louis area.  John and I made it safely home, and I will need to evaluate the conditions when they are in place tomorrow.  Here we are on the road to Wait-and-See.  

Third Day Post-op

Richard is out of Intensive Care and into a standard room on the neurological post-operative unit. The great move came at 1 PM today, Sunday.  He is stable on his feet.  His main challenge is in regaining his capacity of speech.  He did utter one very long sentence saying, "I'm not a dazzling conversationalist."  Those 11 syllables took work but he sounded so good and triumphant in delivery.

Given his steady solid progression and given the threat of the a huge winter storm on the horizon, I think he will probably be discharged to come home tomorrow.  Speech therapy and physical therapy should be able to be arranged to visit him at home and should prove to be a bargain for the insurance company. I have my hopes up to bring  him home.

Second Day Post-op

Richard made great strides of progress today. Well, maybe it was a series of baby-steps, but it was progress none the less.  He started the day with the new CT scan and a clear liquid breakfast – I’d never seen such a face oozing euphoria over hospital coffee or sighing that Jello was so delightful. He could answer questions with a simple yes or no which made me euphoric.

About noon Dr. Matz came in and things started to move. Doctor said that the scan was clear so he removed the drain from the top of Richard’s head.  With that tether gone, Richard could gradually increase his mobility and progress to getting rid of some other tubes.  Like a jack-in-the-box he sprang into the recliner in the room – well, almost.  The physical therapist helped him get up and validated his stability.  After sitting in the chair for about 2 hours and after eating real food of pork roast and mashed potatoes with cheese cake, he settled back in bed. 

As I was leaving for the day the nurses removed his catheter.  He was delighted to have lost the tube on top and the tube down under.  Richard was starting to look more himself. 

I have returned to Rolla for the night.  After church in the morning, John and I will be going to St. Louis to see Richard’s progress. The doctor had said that Richard can move to the standard neurological unit to begin concentrating on rehabilitation – physical therapy and speech therapy.  By the time we get to the hospital tomorrow (about 1 PM) he may well be in a new room.  More tomorrow…

The early morning CT scan is done, so we are waiting for the results and the doctor's visit. Richard is savoring clear liquids - he just recieved his first meal - broth, jello and coffee. He moves all 4 limbs fine. The only lag is with speech. I get to do a monologue for now with his smiles, frowns and nods as reply. I'm heading home tonight to replenish my laundry and then probably commuting for a couple days or until threatening weather crops up that way different kids can come with me.

First Day Post-op

Richard looked much better when we arrived at his room this morning. He was alert but not talking, drinking but not eating yet. He was plagued by a headache and the nurse was trying to get just the right combination of medications for him without knocking him out. By late afternoon she had succeeded.  He was alert, pain-free and even smiling at times as Laura and I conversed to tell him our day's adventure.  One adventure was in finding a bra shop that had a drive-thru window.

The word from the doctor is that Richard is doing okay.  Richard is experiencing a delay in getting his speech back but that is called "supplementary motor syndrome." It is a normal post-op effect when the surgical incision is through the dominant side of the brain.  Dr. Matz said Richard is a stong candidate for rehab especailly in light of the fact that he has episodes of speech - such as telling the doctor his name this morning, naming the doctor's coat color and the type of writing instrument the doctor was carrying. 

Richard's brain pressure readings have been low all day indicating he is re-establishing the flow of fluid around his brain without apparent obstruction.  His drain was clamped off all day with no problems.  Tomorrow morning he will have a CT scan to verify everything is fine and then they can assess if the drain should come out.  Once the drain is out he can start moving more, even getting out of bed with help. Doctor feels that stimulation and movement will help him regain his speech and move his recovery forward faster.

The game plan right now is:
+ get moving and
+ wait for time to heal.

Oh Lord, grant us persistence and patience.

Anticipation and suspense continue

As I ponder what to write here I feel like I am drafting an article for some tabloid about a soap opera.  My mind is flooded with the twists and turns of possiblities that may lay ahead. 

About an hour and a half after the doctor was in to see us no one had called us from the Neuro Intensive Care Unit.  I decided to be bold and just walk on up.  Taking the just-walk-like-you-know-what-you-are-doing approach, I waltzed through the automatic doors and stopped at the unit secretary's desk.  Of course, she wasn't there so my bluster was busted.  I gently turned to the only nurse I saw writing notes on a computer outside a patient room that obviously did not contain Richard.  She was kind and pointed me to the next room. (This ICU is huge with 19 spacious rooms.)  The room was in a quiet corner of the unit. 

Richard opened his eyes when I called his name, but did not appear to really be tracking.  His color was good.  His vitals on the monitor were ideal.  He is just neurologically out-to-lunch right now.  John, Emory, Laura, Peter and Richard's mother Cathy all were able to enter his room to also speak to him. The doctor dropped in again and said Richard just needs some time to get past the anaesthesia and the brain manipulation.  That made sense to me.  We all decided to leave for the night so that we can return rested in the morning.  Now comes the part that will require the most patience - waiting for his mind to clear to see if he has memory and mobility issues. 

Bring the organ vibrato up and let me sign off with a cliff hanger... to be continued tomorrow.

Richard out of surgery...

Richard came out of surgery at 2:30 PM. The surgeon said all went well, but the cyst was not a typical colloid cyst as expected. It contained staining as if it had collected some blood at some point. We will be in suspense until the pathology report comes back in a few days. They are getting him settled in to a bed in the Neuro ICU and then will let us in to see him. He will have a fluid drain from his incision for a couple days (we had originally anticipated that would be in place less than 24 hours). He will stay in ICU until the drain is out. He can not come home until a couple days after the drain is out. Therefore, it will be mid-week next week before he gets released to home. For now we are waiting to see just how his brain will react to having been manipulated - short-term and long-term challenges. Suspense seems to be the rule of life.