Again

Well, I have been comfortable in life, Dad's health has continued to improve after leaving the rehab. Home Care has been coming out to visit him, 2 people, 3 times a week. His coordination has improved and he has returned to moving around the house, getting to the bathroom and kitchen while using his walker and doing self-care tasks like brushing his teeth and shaving. Getting into the shower has proved to be a challenge. Of course a tub-bath is out of the question.

The doctor has been pleased with Dad's improvement. Two months ago the doctor scanned Dad and found the cancer had indeed shrunk and maintained the reduced size. So the doc ceased the chemo, opting instead to allow his strength to return without the drain of life which chemo presents. Dad has been able to return to the front porch and sit in the sun, a great benefit. Neighbors have come by and sat with him, talking about whatever came to mind. All of this activity has proved to be a boost to his mental energy and attitude, in-spite of the pain which continues to plague his body.

One of the rehab personnel who visits each week is Don, a nice guy who proved to be not only interested in his assignment, but sits and talks with Dad too. Don has worked hard, ignoring Dad's attempts to get out of doing his rehab exercises, and actually got him out to the front yard where Dad has hit many golf balls. Not exactly Dad's goal, which was to return to the golf course, but close. Whacking golf balls, while Don holds him from behind with a belt for balance, has proved to be a good thing. But Dad continues to restate his goal of going to a golf course to play at least 18-holes.   In truth his energy and balance will not allow the return but its nice to know he has the chance to swing a club and hit the balls.

All of this 'return to normal life' was due to the cancer being shrunk by the chemo, but guess what?  Yea, the demon is back, the cancer has raised its ugly head. A scan was completed 2 weeks ago and the doctor reported to Mom and Dad that the cancer has returned to its original size before chemo was started. This past Thursday Dad restarted his treatment regiment which will be 3 Thursdays of treatment and one Thursday off; one large monthly treatment dose, like many people receive will be overwhelming for him. Remember the last chemo regiment was to much for his immune system and he developed the infection of his skin, lost his strength and was admitted to the rehab center.

Pray for us, it has returned.

Could Tell A Difference

It's been a couple days since I got home and settled back into the daily routine. I checked in with work Wednesday and things seemed to be ok, I caught some snoozing minutes, washed clothes and made it into work the next morning. I had to take it nice-and-easy while reviewing what seemed to be hundreds of emails and responding to them all. While at work Thursday I called the rehab and checked on Mother and Dad, he was still working through the regular routine, a couple rehab sessions during the day and squirming in the evening and night.

A nurse friend, who is reading my posts wrote me Thursday to tell me that Dad's uncooperative behavior in the evenings sounds like, 'sun-downing' which she said is marked by a change in cognitive and physical behaviors, often with confusion, anger and combativeness; which goes away after sleeping or when the daylight hours return. Knowing this is good, but it doesn't resolve the problem, but it feels good to know he is not losing his mind, or developing some sort of cognitive status.

Thursday it was decided that Dad should go home. He has been standing and walking short steps, but his cognitive skills have not improved. The discussions have centered on the facts that when elderly are out of their regular routine and environment their skills and abilities can decline, the decision was made to return home and bank on the idea this will help clear his cognitive confusion. 

So Friday he returned home after a hospital bed was delivered and setup, along with a bedside commode and wheelchair (remember he already has a walker). He slept the day away one he returned home, and had a small dinner Friday evening. I'm concerned that he will get pushy with my mother and brother, be demanding once he senses he can get away with more at home. I talked with my mother Saturday afternoon and she said that Dad had been asleep a good bit of the day but he woke up several times and she feels his mind is already starting to clear, and return to normal. I found this almost to hard to accept but told her I'd give it some time and hold onto confidence it will work.

I spoke with her a few minutes ago, and she put Dad on the phone toward the end of our conversation. Guess what?  I believe I could tell a difference, but not that much of one; hopefully it will happen and he will return to his 'bright, cheerful self' (ROTFL!!!!), well at least his normal self.  I will check on him Sunday and post something later in the day.

Now the cognitive improvement does not solve his cancer issues, but at least he's home for the July 4th Independence Day holiday!!!!

7/2

Rehab Improvements and Heading Home

Since my last post Dad had 2 days of therapy. During this time he has continued to eat all of the breakfast food, most of the available lunch and some of the dinner. Maybe he is tired in the evening, or just likes food earlier in the day. I tried to pay attention to the textures of the meals to see if that has anything to do with it, but all I was able to tell is that he likes breakfast food. Over all breakfast food has more carbohydrates and fat, dinner items seem to have more protein and fat; heavier types of food to consume…it’s something to think about.

There was no rehab sessions on Sunday (he gets a break from exercising on Sunday), but Dad still got a workout. Brothers and sister visited him, along with several cousins, and other family. It was a busy day and he seemed happy to see them, but got tired in the afternoon and fell asleep, like many other days. He slept so long in the afternoon that a couple people visited but he never woke-up to say “Hello.”

Rehab efforts have continued and he is standing alone, slowly while using the wheelchair as a ‘crutch.’ The rehab folks mentioned that several steps have been taken, slowly - but at least he did take the steps. It was something to celebrate and everyone gave praise and congratulation for the accomplishment. Dad mentioned to me while alone together that he will walk soon, “Get ready.” Cognitively Dad knows he walked in the past and is a little frustrated that it's not happening now, but seems determined to do it again.

But at the same time, in the evenings and during the night he appears to be a different person; like a “Jekyll and Hyde.” Dad practically sits-up in bed, with an angry look in his eyes, firmly grits his teeth, holds out clinched fist, and mumbles orders or thoughts; it is quite scary in a way. When someone asked what he said, or meant cold-heatedly eyes stare back, but he doesn't say a word. It seems as-if he may not know what he is saying, but in either case I don't believe he understands what is being said back to him. If he were able to get out of bed it would be even scarier, but we all know he does not mean what he is doing, and we all know he has never hurt anyone.   

During the evenings Dad argues, squirms around in the bed and tries to pull his clothes off, along with the catheter. This uneasiness might be caused by the catheter, the drugs he’s taking, or maybe it’s just cabin fever from being cooped-up, first in the hospital weeks ago, then going home and then coming to the rehab center. Any case, the nights are long for the rehab staff (family has not been staying with him through the night the last couple nights) and he appears to be quite tired in the mornings. If he could just get on a regular sleep cycle many of us believe things will improve; but with all the constant drug usage Dad falls sleep during the day and is restless during the night.

I have not posted the past couple days; I am driving home now (it's almost midnight now), but wanted to squeeze every moment out of the previous days and spend time with Dad, my mother and family; writing took a backseat. Before leaving I had 2 days of my favorite local, hometown burgers. I ate too much and probably upset my stomach but after growing up on the sandwiches it’s hard to shake the urge to ‘pig-out’ when possible. I told someone in a tweet earlier in the day Tuesday I’d be stopping at Starbuck’s to post something but I got a late start and just lost track of time; starting later than expected I wanted to get out on the road, and get home.  So, here’s my late post from a truck-stop type location using free Wi-Fi; I will post this and get back on the road. I should be home by early morning (after sun-up), dead-tired but I will check-in on work, sleep and then post an update if I can. 

Dad Recap: Dad is still in rehab with no plan as to when he will return home, but hopefully this will happen soon. 

6/28

Pain

Thursday started off like the others, breakfast went well and the first rehab exercises went well too. But as the day wore on Dad started to have a lot of pain, the kind that is bone deep and unavoidable. He seemed to become anxious and continued to complain of pain. Maybe the exercises are taking a toll. His medications were reviewed and more pain medication was administered. This additional medication seemed to have had a negative impact on his behavior and recovery progress.

The second rehab visit for the day did not go as well as been the case. Later when Dad was taken to the community room he did not cooperate and tried to leave the area. This was not allowed by the 'clinicals' and was returned to his room. In a short period of time he was back in the bed, moaning about the pain and complaining that no one was listening to him.

Everyone came to the conclusion it was the pain medication causing the behavior problems. The evening continued with the same issues and my brother came to the rehab site. When Mother and I left for the evening Dad was sleeping and expected to continue through the night.

More to come in the morning.

6/23

Accomplishments

It was another good day in regard to accomplishments. Dad ate a good breakfast and lunch went OK too.  Mother and I got out there around 9am and just beat his breakfast tray arriving to his room.  He insisted on trying to eat the food alone; this went OK but we still helped in the hard-and-eye coordination category. But rehab picked him up and away he went, 30-minutes later he returned with another good report. He is trying and stood on his own and took a couple steps, but after returning he fell asleep and the person who brought him back mentioned that he may sleep several hours due to the exhaustion of his movement. He did sleep and we woke him up when lunch arrived. Afterwards he was taken away for another 30-minutes exercise excursion. 

When he returned a doctor came by to test his strength and it was mentioned that he should not be allowed to stand while alone, and advised that his bed should be lowered to the floor, so that if/when Dad is motivated to move off the bed he will not take part in a fall due ot his accomplishments. It made sense to us and we both nodded.  

Later in the evening the rehab site had an ice cream outing for residents out on the patio. Dad didn't got outside for this, but he enjoyed the ice cream. A consolation from this, he say up for 30-minutes in the wheelchair. Nice!!!  

Mother and I went home for dinner; she went to bed early, I'm still up.

Tomorrow will be another day of accomplishments.  

6/22

Small Steps

Today started off like all the others, with breakfast going well. Dad had a biscuit and some gravy, yogurt, a waffle, milk and juice. Then the 'clinicals' did their morning visits; checking vitals, mental responses, rearranging bedding, and helping him put on his clothes for rehab exercises. This clothing consist of a form of pajamas (house pants), socks with a non-skid bottom and a t-shirt; easy and comfortable. Around 10am he was wheeled away for the first session and 30-minutes later he returned. I rolled him down to the community room and he watched some TV while I enjoyed the break.

But he did not allow this intermission to last long; the next thing I knew he was trying his 'slide-down' tactic. I mentioned that it was not what the 'clinicals' wanted but he continued. They came in once and straightened him up, the second time he was moved out into the hallway, again. We were advised to let him sit there alone, so I did not stay with him and mother sat in the room. In awhile they brought him back in for lunch and then took him away again for more exercise.

I've been thinking about some comments I received since yesterday's post and how people were happy for my dad to be testing the limits of his abilities. I had viewed his behavior as being testy - when he returned from exercising we were told 'he is doing good'. So both mom and I complimented him on his effort and progress. He smiled....and then said he'd like to lay down. :-)

He napped for about half and hour and then sat up the rest of this afternoon/evening. The evening ended like the others, with my brother and family coming out and taking care of the later portion of the day.

It was a good day!

6/21

Opportunities

Well, breakfast was completed this morning with little problem. It seems Dad has come to the conclusion that breakfast food is good.  He ate everything but we still had to help him, guiding the fork and spoon to his mouth. I could feel it in his hand though, confidence seems to be building, he did not seem to be as timid in trying to eat as he was a few days ago.  Afterwards a couple 'clinicals' came in, cleaned him up, helped change his clothes and off to rehab he went. He did not seem to care that he was going but still commented that he was sore and he made sure his meds were taken before he rolled down the hallway.

Thirty minutes later he was back and some of the team helped with his bathroom duties and then lunch arrived. As you can tell, not much happens between breakfast and lunch, at least not in my notes. But during this time meds are brought in, reviews on how he feels take place, and bathroom duties are completed. Since he can not get himself from one place to the other he still depends on a catheter, and bed pans are still being used.

After lunch he tried to lay down but soon afterwards a pair of the staff came by and rolled him away to rehab. The look on his face was not of pleasure and he commented again that he would like to go to bed and sleep. That did not happen and he later returned, but was not brought in the room, but rather rolled down to the community room and was left with me and mother, along with an uncle and his wife. Dad didn't want to stay there and slid down in his seat. The rubber mat was placed under him and he 'sat still.' After an hour or so they took him back down the hall and he sat in his room. But he slid down in the chair and actually made it to the floor this time. When the staff came in and asked what happened Mother told them he managed it himself and would not listen to her. They pulled him up in the wheelchair and told him, "Since you won't behave we'll move you out in the hallway so we can keep an eye on you." The look on his face was like a kid caught with his hand in the cookie jar, but he did not complain. After a short time he was brought back to his room and moved back into the  bed.  The staff mentioned that his behavior is not something to be overly concerned about that this is not uncommon, or things like it with people newly admitted. They also commented that the drugs can sometimes add to this type of behavior, at least for a day or two. Improvement is on the way!!!

He slept a while after returning to his room and then ate dinner with no event, but he still had to be coaxed to eat all the food. My brother and family came out earlier today; Mother and I left earlier than we have to this point (got home 8pm). The adventure and opportunities continue tomorrow.

6/21