Gene had another debriding procedure today.
His pressure wound is large and now involves some muscle tissue and is very close to bone. The caregivers at Kindred still seem to say that pressure sores of this nature heal. Dr. Brice explained to Emily today that Gene's body is using all it's abilities to heal other things, and that a pressure wound is not a high priority for the body resources of someone who is as sick as Gene has been.
Gene had visits today from Elizabeth and Elijah as well as his son Russ. He was somewhat subdued because of the debriding procedure, but he is always very uplifted to have visitors - especially his children and grandchildren. It is so sweet to see Emily telling him good night and saying "I love you"; he mouths back, "I love you too."
Prayer requests:
Please pray for Gene's to continue to grow stronger in his respiration and for the debriding procedure to help make the healing of his pressure wound possible. Pray that his body will grow strong enough to allow his body resources to be used for the healing of this wound. Pray for Emily to draw strength from her family this weekend and to have the courage to continue caring for Gene and keeping her own needs in mind.
Friday, July 31, 2009
Thursday, July 30, 2009
July 30, 2009
Gene is back at the hard work of ventilator weaning; his pressure has been lowered to a 7. This is good. He is scheduled for another debriding tomorrow sometime. It will be done bedside with a local anesthesia. The doctor has assured us that it will not affect his ability to enjoy visits from family.
Steve and Russ were both here today and had an opportunity to visit with him. Gene remains very patient and a wonderful example for how to deal with the most difficult times that life can hand to us.
The family is looking forward to Gene getting to visit with grandchildren and great grandchildren and believe that will be a really positive experience. There is still figuring out the logistics of him getting to see the grandchildren since they won't be able to go into the hospital.
Prayer requests:
Please pray for Gene's to continue to grow stronger in his respiration and for the debriding procedure to be successful and begin to make healing possible. Pray for Emily to have the comfort of good sleep and strength to deal with the days and weeks ahead.
Steve and Russ were both here today and had an opportunity to visit with him. Gene remains very patient and a wonderful example for how to deal with the most difficult times that life can hand to us.
The family is looking forward to Gene getting to visit with grandchildren and great grandchildren and believe that will be a really positive experience. There is still figuring out the logistics of him getting to see the grandchildren since they won't be able to go into the hospital.
Prayer requests:
Please pray for Gene's to continue to grow stronger in his respiration and for the debriding procedure to be successful and begin to make healing possible. Pray for Emily to have the comfort of good sleep and strength to deal with the days and weeks ahead.
Wednesday, July 29, 2009
July 29, 2009
Today was a "team meeting" for Gene at Kindred.
This is a weekly meeting of all the care providers who work at Kindred on Gene's case. They get together to discuss what is going on with him and family members are invited to attend. Not all of the doctors are in this meeting because they are not all actually Kindred staff, but have privileges to practice at Kindred just like many of our family physicians practice at a hospital but have a private practice as well. But all of the caregivers who have day to day responsibility for him are represented in the meeting to discuss his progress and future plans. This is a great practice!
Emily, Joyce, and Lynn attended this meeting. The wound care nurse addressed the pressure sore and the steps that will be taken to heal it. Dr. Brice who is the wound care doctor had been in earlier in the day and wanted to debride the wound again. This time it will be able to be done at bedside with a local anesthesia. Once a wound has dead tissue, that prevents healthy tissue from generating, so it must be kept clean. It is a really nasty wound, but they assured us that it can heal. That debriding procedure has been scheduled for Friday morning or early afternoon. One of the care givers also explained to us that when a person is really sick the body uses all its resources to take care of the heart, the lungs, and other vital processes, and that in the "body's priorities" a skin wound is a very low priority. The nutritionist reported that they will continue to increase the amount of his feeding. They have added a nutritional supplement called Juven which is specifically for wound healing. In addition, he is on a bed which inflates and turns him automatically; has heel boots to protect that portion of his skin; and is being watched very carefully by the nurses, but even more importantly by Emily.
Gene's vent pressure has been increased from the CPAP setting which is him breathing all on his own with just the support of pressure and oxygen to a setting that measures his breaths per minute and gives him additional breaths if he does not meet the standard. The respiratory nurse indicated that it is to be expected to have some variation in his breathing. In addition they will continue to work with him on swallowing. He will have ice, which produces a very small and slow stream of water to swallow, then later sips of water, then he can graduate to something with texture such as applesauce or pudding. He is quite eager to graduate to a cup of coffee in the mornings!
The pharmacist reported on the medications Gene is receiving. He is back on a daily Levaquin IV for infection and is on the anticoagulant Heparin. The family reminded them of his hemorrhagic stroke 6 years ago and they assured that they are watching his clotting factors very closely.
The director of infectious disease control is a Master Gardener and knows Gene from the Master Gardeners of Hamilton County where he has been active since the move to Chattanooga. It's nice to think that he has touched so many lives in such a positive way here in Chattanooga even though he has not been here very long.
This is a weekly meeting of all the care providers who work at Kindred on Gene's case. They get together to discuss what is going on with him and family members are invited to attend. Not all of the doctors are in this meeting because they are not all actually Kindred staff, but have privileges to practice at Kindred just like many of our family physicians practice at a hospital but have a private practice as well. But all of the caregivers who have day to day responsibility for him are represented in the meeting to discuss his progress and future plans. This is a great practice!
Emily, Joyce, and Lynn attended this meeting. The wound care nurse addressed the pressure sore and the steps that will be taken to heal it. Dr. Brice who is the wound care doctor had been in earlier in the day and wanted to debride the wound again. This time it will be able to be done at bedside with a local anesthesia. Once a wound has dead tissue, that prevents healthy tissue from generating, so it must be kept clean. It is a really nasty wound, but they assured us that it can heal. That debriding procedure has been scheduled for Friday morning or early afternoon. One of the care givers also explained to us that when a person is really sick the body uses all its resources to take care of the heart, the lungs, and other vital processes, and that in the "body's priorities" a skin wound is a very low priority. The nutritionist reported that they will continue to increase the amount of his feeding. They have added a nutritional supplement called Juven which is specifically for wound healing. In addition, he is on a bed which inflates and turns him automatically; has heel boots to protect that portion of his skin; and is being watched very carefully by the nurses, but even more importantly by Emily.
Gene's vent pressure has been increased from the CPAP setting which is him breathing all on his own with just the support of pressure and oxygen to a setting that measures his breaths per minute and gives him additional breaths if he does not meet the standard. The respiratory nurse indicated that it is to be expected to have some variation in his breathing. In addition they will continue to work with him on swallowing. He will have ice, which produces a very small and slow stream of water to swallow, then later sips of water, then he can graduate to something with texture such as applesauce or pudding. He is quite eager to graduate to a cup of coffee in the mornings!
The pharmacist reported on the medications Gene is receiving. He is back on a daily Levaquin IV for infection and is on the anticoagulant Heparin. The family reminded them of his hemorrhagic stroke 6 years ago and they assured that they are watching his clotting factors very closely.
The director of infectious disease control is a Master Gardener and knows Gene from the Master Gardeners of Hamilton County where he has been active since the move to Chattanooga. It's nice to think that he has touched so many lives in such a positive way here in Chattanooga even though he has not been here very long.
Tuesday, July 28, 2009
July 28, 2009
Gene had his first full day back at Kindred.
His respiration is not where he had hoped it would be and he has experienced some difficulty breathing today. He told Emily that he thought one of his lungs had stopped working. Dr. DeVersa ordered a CT scan to make sure that everything was OK.
Late this afternoon the report was in. They checked for pneumonia - he doesn't have it. They checked for blood clots - he doesn't have any. He does have one little area where the lung is not properly inflating. Apparently this is not uncommon and not necessarily of concern.
It's good that Kindred is so pro-active about his treatment. When he gets his strength back they will begin the hard work of vent weaning again. And the physical therapists and all the other staff who work so hard with him, were already checking in today to see when to get back to work on his therapies.
Emily and Joyce visited late this evening and found Gene was feeling much better. His color was better and he was in better spirits. His pressure sore is still not where it needs to be. The wound care doctor will look at it perhaps tomorrow.
Prayer requests:
Please pray for Gene's respiration to grow stronger and for his pressure sore to respond to the treatments and begin to heal. Pray for Emily to have the comfort of good sleep and strength to deal with the days and weeks ahead.
His respiration is not where he had hoped it would be and he has experienced some difficulty breathing today. He told Emily that he thought one of his lungs had stopped working. Dr. DeVersa ordered a CT scan to make sure that everything was OK.
Late this afternoon the report was in. They checked for pneumonia - he doesn't have it. They checked for blood clots - he doesn't have any. He does have one little area where the lung is not properly inflating. Apparently this is not uncommon and not necessarily of concern.
It's good that Kindred is so pro-active about his treatment. When he gets his strength back they will begin the hard work of vent weaning again. And the physical therapists and all the other staff who work so hard with him, were already checking in today to see when to get back to work on his therapies.
Emily and Joyce visited late this evening and found Gene was feeling much better. His color was better and he was in better spirits. His pressure sore is still not where it needs to be. The wound care doctor will look at it perhaps tomorrow.
Prayer requests:
Please pray for Gene's respiration to grow stronger and for his pressure sore to respond to the treatments and begin to heal. Pray for Emily to have the comfort of good sleep and strength to deal with the days and weeks ahead.
Monday, July 27, 2009
July 27, 20009
This afternoon the Erlanger medical team decided that Gene was doing well enough to return to Kindred. Emily was notified early afternoon. By 5:30 he was in a room at Kindred, settling in, and feeling really good about being back there.
He is in a different room which is somewhat smaller. It looks like it's too small to accommodate a cot, making it much more difficult for Emily to spend the night there. The hospital sits on a hillside with the entrance of the 2nd floor at ground level and sloping so that the end of the 2nd floor is two floors off the ground. When Gene was at Kindred before, he was all the way at the end. All this explanation to say that there's a silver lining to all this. Emily has been trying to figure out how Gene can see the great-grandchildren this weekend. The babies are too small to be in the hospital environment, and Gene has a great longing to see them. He's said on several occasions that he wishes he could see them. Well, Emily has it figured out. The window in the room is close enough to the sidewalk that we'll be able to figure out how he can see them outside! He will be so uplifted to see them.
Gene said tonight that he's really glad to be back at Kindred. He knows that it is really hard work and he wants to do it. It's amazing to realize that swallowing and breathing and coughing and all the things that go into proper respiration can be so difficult to relearn. If it is a matter of working hard at it that will measure the success, then Gene will be successful at being weaned from the ventilator.
Visitors are welcome to see Gene at Kindred in room 206. If you choose to visit remember that ALL visitors are required to wear gown, gloves, and face mask.
Prayer requests:
Please pray that Gene's return to Kindred bodes well for him to become weaned from the ventilator. Pray that his pressure sore begins to heal and that he continues to grow stronger. Pray for Emily to have the strength that she needs to negotiate the days and weeks ahead.
He is in a different room which is somewhat smaller. It looks like it's too small to accommodate a cot, making it much more difficult for Emily to spend the night there. The hospital sits on a hillside with the entrance of the 2nd floor at ground level and sloping so that the end of the 2nd floor is two floors off the ground. When Gene was at Kindred before, he was all the way at the end. All this explanation to say that there's a silver lining to all this. Emily has been trying to figure out how Gene can see the great-grandchildren this weekend. The babies are too small to be in the hospital environment, and Gene has a great longing to see them. He's said on several occasions that he wishes he could see them. Well, Emily has it figured out. The window in the room is close enough to the sidewalk that we'll be able to figure out how he can see them outside! He will be so uplifted to see them.
Gene said tonight that he's really glad to be back at Kindred. He knows that it is really hard work and he wants to do it. It's amazing to realize that swallowing and breathing and coughing and all the things that go into proper respiration can be so difficult to relearn. If it is a matter of working hard at it that will measure the success, then Gene will be successful at being weaned from the ventilator.
Visitors are welcome to see Gene at Kindred in room 206. If you choose to visit remember that ALL visitors are required to wear gown, gloves, and face mask.
Prayer requests:
Please pray that Gene's return to Kindred bodes well for him to become weaned from the ventilator. Pray that his pressure sore begins to heal and that he continues to grow stronger. Pray for Emily to have the strength that she needs to negotiate the days and weeks ahead.
Sunday, July 26, 2009
July 26, 2009
Gene was tired today and said that he slept most of the afternoon. He also said that he thought he'd probably be up all night since he had such a long nap.
Steve and Pat were here this morning and Steve mowed the lawn, while Pat finished up helping Mom with some things around the house. Then they went to the hospital and had a great visit with Gene before heading back to Atlanta. They'll be back up for the gathering this weekend. I think the family is beginning to get excited about getting together. Gene is disappointed that he won't be able to gather with everyone, but it will be so good for him to have visits from so many people.
Gene is still at Erlanger and is able to have visitors. He is on the 6th floor in the Intermediate Care Unit, room 13. Visitors must wear a robe and gloves which are available at the door of his room. He can't speak because of the ventilator, but he can mouth words and enjoys hearing the news of the day or being brought up to date - especially those who can give him news about the various groups he has been a part of.
Gene's grip is getting stronger, he is able to move his feet some and is growing stronger.
Prayer requests:
Please pray for Gene to continue to recover surgical procedure. Pray his pressure sore to heal, and for him to continue to grow stronger. Pray for Emily.
Steve and Pat were here this morning and Steve mowed the lawn, while Pat finished up helping Mom with some things around the house. Then they went to the hospital and had a great visit with Gene before heading back to Atlanta. They'll be back up for the gathering this weekend. I think the family is beginning to get excited about getting together. Gene is disappointed that he won't be able to gather with everyone, but it will be so good for him to have visits from so many people.
Gene is still at Erlanger and is able to have visitors. He is on the 6th floor in the Intermediate Care Unit, room 13. Visitors must wear a robe and gloves which are available at the door of his room. He can't speak because of the ventilator, but he can mouth words and enjoys hearing the news of the day or being brought up to date - especially those who can give him news about the various groups he has been a part of.
Gene's grip is getting stronger, he is able to move his feet some and is growing stronger.
Prayer requests:
Please pray for Gene to continue to recover surgical procedure. Pray his pressure sore to heal, and for him to continue to grow stronger. Pray for Emily.
Saturday, July 25, 2009
Molly Blue
Sometime in the fall of 1993 Emily and Gene were looking to add a dog to their household. Emilyhad always wanted a Border Collie and they began to ask around to see if anyone knew of a litter.
One weekend in December, they found a litter of pups at Mt. Victory, Kentucky. The folks who were renting the property which had belonged to Emily's parents pointed to this cute little girl and said that her sire was a Border Collie. Just a look can let you know why they fell in love with her!
By early 1994 Molly was weaned and ready to come home to Middlesboro, Kentucky to live with Emily and Gene. She quickly became a real pet. When Emily and Gene's children were growing up, it was very clear that the house was for people and that animals lived outside. They had nicely constructed places to get out of the wet and the cold, and might get to come in if the temperature dipped really low (or if Lynn sneaked one into her bedroom). Imagine everyone's surprise to see that Molly sometimes got to come in the house! She learned very early on to go lie down on her bed when she was in the house.
It also became apparent to some of us that maybe Molly really didn't have much Border Collie heritage. Dad told the story about a store owner back in a little town in the back country of Kentucky. When a customer came in and told him he needed to buy a blue suit, the owner yelled to the back of the store, " T.J., turn on the blue light". So Molly became Molly Blue.When Molly Blue was about a year old, she was run over by a truck and her hips were shattered. Molly made the trip to the small animal hospital at the University of Tennessee Vet School for a double hip replacement. Emily faithfully did physical therapy with her in a kid's swimming pool on the deck in Middlesboro, and got her back in shape. Of course, every chance she got, Molly would take a walk up Cumberland Avenue to see if she could find any leftovers in the McDonald's parking lot.
Molly was a fixture on her little bed in the family room at Emily and Gene's house in Chattanooga. Gene sat in his recliner or at the table and watched TV or worked on his latest revision of A Name In the Sand, or another one of his remarkable memoirs, and Molly Blue lay on her bed across the room from him.
Family Memories of Molly Blue
Mom and Dad always said they wanted to have a Border Collie and Molly Blue was their Border Collie; she was no bigger than a cat. Dad would say "if you turn the lights down low, she really looks like a Border Collie".
We remember the time Molly was run over. She had steel pins put in her hips and came back home to become more of a house dog than earlier. Molly had house privileges in the winter months and would be invited inside from time to time all through the year. Mom told me one time, "Dad is really fond of that little dog. She has shown a lot of courage." Molly Blue will be remembered by our family as a good dog.
Russ
July 19, 2009
Molly must have been pretty special because all of the regular pet rules didn't apply to her, basically meaning she was allowed in the house. I remember that she was a great travel companion and she was a loved and dear member of the Howard household.
Elizabeth
July 19, 2009
Molly got to visit with us in Chattanooga quite a bit. When Emily and Gene traveled, Molly often stayed with us. She and and our beautiful dog, Hank, bonded and became quite good friends. Who could have known that in a few years she would be living just around the corner from her friend Hank. When Emily and Gene moved to Chattanooga, Molly made the transition with them and settled in quite nicely - as a matter of fact, once in awhile she would escape from the fenced in back yard and make her way up the street and around the corner to end up visiting with whoever happened to be at home at our house.
Lynn
July 19, 2009
When Gene and Emily went out of town, we kept Molly. She never forgot her way HOME!
Alan
July 20,2009
We would see Molly Blue limping around from having her hind quarters crushed by a delivery truck at the Middlesboro Hospital ....until she saw a ground squirrel, and then she could chase it just as if nothing was wrong.
I also remember that she had her special place in the den that she always stayed. And in her older years, the cats had to be put outside when she ate so that they wouldn't get her food.
I remember Mom thinking of doing Physical Therapy (putting Molly in an inflatable kiddy pool, which made her swim and exercise her hind quarters) that I'm sure helped nurse Molly Blue back to health after the accident.
Steve
July 20, 2009
Molly was one special doggie, and so many people fell in love with her over the years. What a loyal companion, and a very smart one too. We will all miss her.
Joyce
July 20, 2009
July 25, 2009
Gene said he felt stronger today.
Gene came through his surgical procedures just fine and is doing very well. He told his visitors today that he felt stronger. He has gained movement in his feet and ankles and proudly showed that off. The family is all eager to have him regain his strength so that he can return to the work at Kindred of being weaned from the ventilator and regaining more of his physical strength.
Steve came to Chattanooga today and he and Pat have been helping Emily with some projects around the house. They've also had a couple of really good visits with Gene. We are so fortunate to have family close by. It is so good for Emily to have visits from her children and others.
Emily and Pat are still hard at work on those beet pickles. There are several jars already canned and sitting on the table; tonight there's a pot of beets on the stove ready for the pickling and there's another pot with I think about 6 cans doing the hot bath thing. It seems they are having a good time with the beet pickle project.
Steve is going to help Emily with some yard word while he's here. In the meantime they are all working really hard to get the house ready for next weekend when the children, grandchildren, great-grandchildren and a few other relatives who live nearby will be here to visit. Gene will be glad to see everyone who is able to visit.
Prayer requests:
Please pray for Gene to have full recovery from his surgical procedures, and for his pressure sore to heal. Pray for him to continue to grow stronger. Pray for Emily.
Gene came through his surgical procedures just fine and is doing very well. He told his visitors today that he felt stronger. He has gained movement in his feet and ankles and proudly showed that off. The family is all eager to have him regain his strength so that he can return to the work at Kindred of being weaned from the ventilator and regaining more of his physical strength.
Steve came to Chattanooga today and he and Pat have been helping Emily with some projects around the house. They've also had a couple of really good visits with Gene. We are so fortunate to have family close by. It is so good for Emily to have visits from her children and others.
Emily and Pat are still hard at work on those beet pickles. There are several jars already canned and sitting on the table; tonight there's a pot of beets on the stove ready for the pickling and there's another pot with I think about 6 cans doing the hot bath thing. It seems they are having a good time with the beet pickle project.
Steve is going to help Emily with some yard word while he's here. In the meantime they are all working really hard to get the house ready for next weekend when the children, grandchildren, great-grandchildren and a few other relatives who live nearby will be here to visit. Gene will be glad to see everyone who is able to visit.
Prayer requests:
Please pray for Gene to have full recovery from his surgical procedures, and for his pressure sore to heal. Pray for him to continue to grow stronger. Pray for Emily.
Friday, July 24, 2009
July 24, 2009
Gene is doing well after more surgical procedures.
The skin around his pressure sore continued to break down, and the surgeon went back in today and did some more work to clean it. Gene has very sensitive skin and it may be that some of the bandaging is contributing to the difficulty with the healing.
He went into surgery about 3 this afternoon, and by 7 Emily had a report from the doctor. He tolerated the surgery very well and was able to return to his room in the intermediate care unit. Emily and Pat were able to see him and reported that he was doing very well even though he was still groggy from the anesthesia.
Emily and Pat are still working on those beet pickles. At one point in the afternoon, Pat took a minute and went back to the house to get the beets out of the water they were in. We should take bets on how many jars of beet pickles they'll get out of that bushel of beets!
Pat has been such a support for Mom this week! She has done several things for Emily around the house, been at the hospital to provide support for all the medical decisions that have needed to be made, has lifted Gene's spirits, and allowed Alan and Lynn to know that everything was under control! Thanks a million Pat.
Prayer requests:
Please pray for Gene to have full recovery from his surgical procedure, and for his pressure sore to begin healing. Pray for him to be at peace and have the strength to continue the hard work necessary for healing. Pray for Emily.
The skin around his pressure sore continued to break down, and the surgeon went back in today and did some more work to clean it. Gene has very sensitive skin and it may be that some of the bandaging is contributing to the difficulty with the healing.
He went into surgery about 3 this afternoon, and by 7 Emily had a report from the doctor. He tolerated the surgery very well and was able to return to his room in the intermediate care unit. Emily and Pat were able to see him and reported that he was doing very well even though he was still groggy from the anesthesia.
Emily and Pat are still working on those beet pickles. At one point in the afternoon, Pat took a minute and went back to the house to get the beets out of the water they were in. We should take bets on how many jars of beet pickles they'll get out of that bushel of beets!
Pat has been such a support for Mom this week! She has done several things for Emily around the house, been at the hospital to provide support for all the medical decisions that have needed to be made, has lifted Gene's spirits, and allowed Alan and Lynn to know that everything was under control! Thanks a million Pat.
Prayer requests:
Please pray for Gene to have full recovery from his surgical procedure, and for his pressure sore to begin healing. Pray for him to be at peace and have the strength to continue the hard work necessary for healing. Pray for Emily.
Thursday, July 23, 2009
July 23, 2009
Gene had another strong day today.
Emily, Steve, and Pat went down early this morning and visited until mid-morning. It seems that he will need to have some additional debridement on the pressure sore. That will happen sometime tomorrow, probably tomorrow afternoon.
Pat is staying with Emily for a couple of days, and they have been down this evening to see how he's doing. He was watching the weather channel. This is one of the first times since his surgery that he's wanted to watch TV! Yesterday's nurse, David, also ordered a unit that lets Gene call for the nurse by moving his head and pushing a button. When Emily and Pat went back to visit this evening that unit had been brought in and set up.
It's looking like Gene will be at Erlanger for a few more days before he will be ready to transfer back to Kindred.
Prayer requests:
Please pray for Gene's surgical procedure to go well, and for his pressure sore to begin healing.
Emily, Steve, and Pat went down early this morning and visited until mid-morning. It seems that he will need to have some additional debridement on the pressure sore. That will happen sometime tomorrow, probably tomorrow afternoon.
Pat is staying with Emily for a couple of days, and they have been down this evening to see how he's doing. He was watching the weather channel. This is one of the first times since his surgery that he's wanted to watch TV! Yesterday's nurse, David, also ordered a unit that lets Gene call for the nurse by moving his head and pushing a button. When Emily and Pat went back to visit this evening that unit had been brought in and set up.
It's looking like Gene will be at Erlanger for a few more days before he will be ready to transfer back to Kindred.
Prayer requests:
Please pray for Gene's surgical procedure to go well, and for his pressure sore to begin healing.
Wednesday, July 22, 2009
July 22, 2009
Gene had a really good day today.
Emily and Joyce visited this morning and found him to be more alert than he has been since his surgery. He also had visits from Dr. Carver, their minister, and Steve and Pat, as well as Alan.
Pat is here for a few days to help Emily with some things around the house as well as to make some "beet pickles". There's a story behind the beet pickles, so here it is.
The Howard children grew up savoring Grandma VanSant's beet pickles. They were especially good with a dinner of pinto beans, cornbread, and other fixins. Gene always grew beets in his garden, and Emily made beet pickles from her mother's recipe. In 1971, Grandma VanSant hand wrote the recipe in a letter to Emily. In the letter that contains that recipe, she elaborated on the way she made them - how she cooked the beets, how she made the pickling juice, what kind of pan to use, and so on.
Fast forward a few years - Emily and Gene are living in Middlesboro with that huge garden in the back; Steve and Pat are married. Edith and Clarence, Pat's parents, live nearby in Harrogate, TN. A partnership developed from Steve and Pat's love for beet pickles and the proximity of their parents. Emily and Gene grew beets, and Edith and Clarence made beet pickles and Pat and Steve always had plenty! It's such a great story.
Edith passed away this last year, and Pat has decided to take over as the beet pickle maker! She came to Chattanooga with a bushel of beets and a copy of the 1971 letter from Grandma VanSant as well as her mother's recipe card taken from that letter, all with the intention of making the beet pickles with Emily and learning the tricks so she can keep her family in beet pickles and be ready to hand the knowledge down to the next generation when one of them is ready!
Emily and Joyce visited this morning and found him to be more alert than he has been since his surgery. He also had visits from Dr. Carver, their minister, and Steve and Pat, as well as Alan.
Pat is here for a few days to help Emily with some things around the house as well as to make some "beet pickles". There's a story behind the beet pickles, so here it is.
The Howard children grew up savoring Grandma VanSant's beet pickles. They were especially good with a dinner of pinto beans, cornbread, and other fixins. Gene always grew beets in his garden, and Emily made beet pickles from her mother's recipe. In 1971, Grandma VanSant hand wrote the recipe in a letter to Emily. In the letter that contains that recipe, she elaborated on the way she made them - how she cooked the beets, how she made the pickling juice, what kind of pan to use, and so on.
Fast forward a few years - Emily and Gene are living in Middlesboro with that huge garden in the back; Steve and Pat are married. Edith and Clarence, Pat's parents, live nearby in Harrogate, TN. A partnership developed from Steve and Pat's love for beet pickles and the proximity of their parents. Emily and Gene grew beets, and Edith and Clarence made beet pickles and Pat and Steve always had plenty! It's such a great story.
Edith passed away this last year, and Pat has decided to take over as the beet pickle maker! She came to Chattanooga with a bushel of beets and a copy of the 1971 letter from Grandma VanSant as well as her mother's recipe card taken from that letter, all with the intention of making the beet pickles with Emily and learning the tricks so she can keep her family in beet pickles and be ready to hand the knowledge down to the next generation when one of them is ready!
Tuesday, July 21, 2009
July 21, 2009
Gene had minor surgery for the pressure sore on his lower back early this afternoon at Erlanger. He came through the surgery very well and went back to the ICU for a few hours, but by late this afternoon, he had been deemed well enough to leave ICU and is now back on the 6th floor where visitation hours are much more flexible. Emily stayed with him until late afternoon and was very pleased with the care and attention the staff was giving him.
Emily's sister Joyce came down from Knoxville and the two of them went back this evening for a visit with Gene. They found him in great spirits and had a wonderful visit with him.
Joyce told him that he was going to have to write another story about his adventure in the hospital. He smiled really big and told her "No, I'm going to write another book. It's going to be called There Is No Such Thing as Time in a Hospital". They all got a great kick out of that. Emily told him that now she knew what he'd been doing all that time when he has his eyes closed - he's writing his new book in his head!
Gene is once more displaying his remarkable character as he takes this setback in stride and makes us all marvel at his spirit.
Emily's sister Joyce came down from Knoxville and the two of them went back this evening for a visit with Gene. They found him in great spirits and had a wonderful visit with him.
Joyce told him that he was going to have to write another story about his adventure in the hospital. He smiled really big and told her "No, I'm going to write another book. It's going to be called There Is No Such Thing as Time in a Hospital". They all got a great kick out of that. Emily told him that now she knew what he'd been doing all that time when he has his eyes closed - he's writing his new book in his head!
Gene is once more displaying his remarkable character as he takes this setback in stride and makes us all marvel at his spirit.
Monday, July 20, 2009
July 20, 2009
Gene had to return to Erlanger tonight in order to have a minor surgical procedure on that pressure sore on his lower back. It has grown and become a concern. The surgeon who has privileges at Kindred is on vacation, and his doctor felt like he needed to have a procedure called debridement. So while this is not an emergency, it seems that it might not have been wise for it to wait until the doctor returned.
Because Gene is still on a ventilator he has to go to an ICU unit for evaluation before anything else can happen. He is in the surgical ICU and has gotten settled in very nicely. Alan and Emily went down to see him at the 8:30 visitation and he seems to be doing OK. Right now they are not sure how soon the surgery will take place. We will post an update as soon as we know.
Dr. Bolt was on duty and remembered Dad very well. Dad moved his feet for him, and Dr. Bolt said, "we need to tell Shepherd about this!" Someone from the neurosurgeon's office will see him while he is there at Erlanger.
Alan's comment after seeing Gene was "He is an incredible fellow. He has such a great spirit."
Prayer requests:
Please pray for Gene's surgical procedure to go well and for him to return to Kindred much stronger and in a better place to begin again the hard, hard work of vent weaning and physical therapy. Pray for Emily to have peace about Gene's return to Erlanger and for her to have strength for this next stretch.
Because Gene is still on a ventilator he has to go to an ICU unit for evaluation before anything else can happen. He is in the surgical ICU and has gotten settled in very nicely. Alan and Emily went down to see him at the 8:30 visitation and he seems to be doing OK. Right now they are not sure how soon the surgery will take place. We will post an update as soon as we know.
Dr. Bolt was on duty and remembered Dad very well. Dad moved his feet for him, and Dr. Bolt said, "we need to tell Shepherd about this!" Someone from the neurosurgeon's office will see him while he is there at Erlanger.
Alan's comment after seeing Gene was "He is an incredible fellow. He has such a great spirit."
Prayer requests:
Please pray for Gene's surgical procedure to go well and for him to return to Kindred much stronger and in a better place to begin again the hard, hard work of vent weaning and physical therapy. Pray for Emily to have peace about Gene's return to Erlanger and for her to have strength for this next stretch.
Sunday, July 19, 2009
July 19, 2009
Emily spent last night at the hospital with Gene, came home for awhile this morning and then went back after lunch, went to Lynn and Alan's for an early dinner, then stopped by home for a few minutes, and then back to Kindred to spend the night with Gene again.
His respiration pressure was turned down a notch to 11 today. His nighttime pressure is 12, and so he is once again beginning the weaning process. He was down to 7 last week when he had the setback and had to have his pressure moved back up to the sleep setting for a few days.
Gene continues to seem tired. Emily has speculated that his level of inactivity for so long, and his general weakness is contributing to his tiredness. But it also seemed that his increase in activity last week may have contributed to his respiration difficulties.
Prayer Requests
Please continue to pray for Gene's respiration to grow stronger and for the pressure sore on his lower back to begin to heal. Pray for him to continue to have increased strength and movement in his body. Pray for Emily to have an the strength and courage to find the balance she needs.
His respiration pressure was turned down a notch to 11 today. His nighttime pressure is 12, and so he is once again beginning the weaning process. He was down to 7 last week when he had the setback and had to have his pressure moved back up to the sleep setting for a few days.
Gene continues to seem tired. Emily has speculated that his level of inactivity for so long, and his general weakness is contributing to his tiredness. But it also seemed that his increase in activity last week may have contributed to his respiration difficulties.
Prayer Requests
Please continue to pray for Gene's respiration to grow stronger and for the pressure sore on his lower back to begin to heal. Pray for him to continue to have increased strength and movement in his body. Pray for Emily to have an the strength and courage to find the balance she needs.
Saturday, July 18, 2009
July 18, 2009
Gene had a pretty good day today.
When Emily arrived at the hospital to spend the evening and night with him, he seemed comfortable although tired. He is still on the C-Pap sleep setting with the ventilator, although he did come back down one notch for a little while during the day. He is also still set up a bit on his supplementary oxygen.
Emily shared some very encouraging news about his movement this evening. She told him that she was going to rub some lotion on his feet, and then took off his massage boots, he started moving his foot from side to side! That is the first voluntary movement of his feet in that way since the infarction at Erlanger. What a hopeful sign.
Prayer Requests
Please continue to pray for Gene's respiration to stabilize so that he can begin working on the weaning progress again and for the pressure sore on his lower back to begin to heal. Pray for him to continue to have increased strength and movement in his body! Pray for Emily. She is an amazing woman who is a great example for those of us who watch her in this time. Pray for her to have strength and courage as Dad's advocate over these next days and weeks, and the wisdom to know when she has to take time for herself.
When Emily arrived at the hospital to spend the evening and night with him, he seemed comfortable although tired. He is still on the C-Pap sleep setting with the ventilator, although he did come back down one notch for a little while during the day. He is also still set up a bit on his supplementary oxygen.
Emily shared some very encouraging news about his movement this evening. She told him that she was going to rub some lotion on his feet, and then took off his massage boots, he started moving his foot from side to side! That is the first voluntary movement of his feet in that way since the infarction at Erlanger. What a hopeful sign.
Prayer Requests
Please continue to pray for Gene's respiration to stabilize so that he can begin working on the weaning progress again and for the pressure sore on his lower back to begin to heal. Pray for him to continue to have increased strength and movement in his body! Pray for Emily. She is an amazing woman who is a great example for those of us who watch her in this time. Pray for her to have strength and courage as Dad's advocate over these next days and weeks, and the wisdom to know when she has to take time for herself.
Friday, July 17, 2009
July 17, 2009
Gene had another difficult day with his respiration today.
He had made some amazing progress, so it's disappointing that he has suffered this setback, but the family holds on to the caution of one of his doctors who said to expect to have some setbacks along the way.
Emily was at the hospital earlier today and thought that he seemed very tired and weak, and he is still on a higher setting for his C-Pap. She thought it would be best if she spent the night with him tonight, something she hasn't done for the last several nights.
Mollie Blue, Emily and Gene's wonderful little companion dog of 16 years died today. She was buried in a grave that Patrick, their grandson, had prepared for her. Emily has chosen not to tell Gene today, but will let him know as soon as he grows a bit stronger. I know they will miss her, as will all of the family who remember her.
Prayer requests:
Please pray for Gene's respiration to stabilize so that he can begin working on weaning progress again and for the pressure sore on his lower back to begin to heal. Pray for Emily to have the strength she needs over these next days and weeks.
He had made some amazing progress, so it's disappointing that he has suffered this setback, but the family holds on to the caution of one of his doctors who said to expect to have some setbacks along the way.
Emily was at the hospital earlier today and thought that he seemed very tired and weak, and he is still on a higher setting for his C-Pap. She thought it would be best if she spent the night with him tonight, something she hasn't done for the last several nights.
Mollie Blue, Emily and Gene's wonderful little companion dog of 16 years died today. She was buried in a grave that Patrick, their grandson, had prepared for her. Emily has chosen not to tell Gene today, but will let him know as soon as he grows a bit stronger. I know they will miss her, as will all of the family who remember her.
Prayer requests:
Please pray for Gene's respiration to stabilize so that he can begin working on weaning progress again and for the pressure sore on his lower back to begin to heal. Pray for Emily to have the strength she needs over these next days and weeks.
Thursday, July 16, 2009
July 16, 2009
Gene had a restful night last night.
Today his C-Pap pressure was set down another number to 7, but he was struggling with it by a little before noon. The respiratory therapist set his pressure back up to his night time setting and upped his oxygen to allow him to rest. All of us are reminding ourselves that we've been told to expect some days like this, and that the progress graph on the whole is on an upward trend. His other therapists did not do much work with him today as the efforts centered on getting him back on track with his respiration.
I'm sad to report that Emily and Gene's little dog Mollie is not doing well at all. She has been very sick and frail for the last few days, and has not wanted to eat anything at all. Emily took her to the vet today and has left her overnight.
Grandson Patrick came up to stay a couple of days with MaMa and has helped her with some chores around the house that she wants to get done and visiting with PaPa. It's a wonderful gift for him to come spend his time this way. Emily's sister Joyce also came down for a couple of nights and helped Mom get a couple of pressing chores underway. We are so grateful!
Prayer requests:
Please pray for the setback in Gene's tolerance of decreased breathing pressure to be just temporary, for the pressure sore on his lower back to begin to heal. Pray for Emily and Gene's little dog Mollie and for the next steps the family must negotiate.
Today his C-Pap pressure was set down another number to 7, but he was struggling with it by a little before noon. The respiratory therapist set his pressure back up to his night time setting and upped his oxygen to allow him to rest. All of us are reminding ourselves that we've been told to expect some days like this, and that the progress graph on the whole is on an upward trend. His other therapists did not do much work with him today as the efforts centered on getting him back on track with his respiration.
I'm sad to report that Emily and Gene's little dog Mollie is not doing well at all. She has been very sick and frail for the last few days, and has not wanted to eat anything at all. Emily took her to the vet today and has left her overnight.
Grandson Patrick came up to stay a couple of days with MaMa and has helped her with some chores around the house that she wants to get done and visiting with PaPa. It's a wonderful gift for him to come spend his time this way. Emily's sister Joyce also came down for a couple of nights and helped Mom get a couple of pressing chores underway. We are so grateful!
Prayer requests:
Please pray for the setback in Gene's tolerance of decreased breathing pressure to be just temporary, for the pressure sore on his lower back to begin to heal. Pray for Emily and Gene's little dog Mollie and for the next steps the family must negotiate.
Wednesday, July 15, 2009
July 15, 2009
Gene continues to make good progress.
His C-PAP pressure was lowered again today to a 7. Once again it will be increased to a 12 for night time restfulness. He also is getting some supplemental oxygen through the C-PAP. The respiratory team says that he is making very good progress and is ahead of where they thought he would be at this time.
Today was a busy day. He increased his sitting up time by 3 minutes for a total of 13 minutes. They lowered the bed and had him sit on the side of it with his feet on the floor. Gene indicated that he could feel his feet on the floor. He also had visits from the physical therapist, occupational therapist, speech therapist, and wound specialist.
The family is very concerned about the pressure sore on his lower back. The wound care specialist indicates that it has not gotten any worse, but that his body is not really strong enough to give the resources to its healing. Of course it was there when he arrived at Kindred. Emily is extremely concerned and is making sure to let the care givers know how important the family thinks it is to give it the attention it needs.
Emily and Joyce and Alan attended a team care meeting today that involved someone from each aspect of his care and overall felt very positive about the reports.
Prayer requests:
Please pray for the pressure sore on Gene's lower back to begin to heal, for him to continue to tolerate the decrease of respiratory pressure support, and for his swallowing reflex to continue growing stronger. Pray for strength and movement to return to his body especially in his arms, hands, and fingers. Pray for both Emily and Gene to have the patience, courage, and strength to negotiate these next days and weeks. Pray for Emily and Gene's little dog Mollie, as she is becoming very weak and her health seems to be rapidly failing.
His C-PAP pressure was lowered again today to a 7. Once again it will be increased to a 12 for night time restfulness. He also is getting some supplemental oxygen through the C-PAP. The respiratory team says that he is making very good progress and is ahead of where they thought he would be at this time.
Today was a busy day. He increased his sitting up time by 3 minutes for a total of 13 minutes. They lowered the bed and had him sit on the side of it with his feet on the floor. Gene indicated that he could feel his feet on the floor. He also had visits from the physical therapist, occupational therapist, speech therapist, and wound specialist.
The family is very concerned about the pressure sore on his lower back. The wound care specialist indicates that it has not gotten any worse, but that his body is not really strong enough to give the resources to its healing. Of course it was there when he arrived at Kindred. Emily is extremely concerned and is making sure to let the care givers know how important the family thinks it is to give it the attention it needs.
Emily and Joyce and Alan attended a team care meeting today that involved someone from each aspect of his care and overall felt very positive about the reports.
Prayer requests:
Please pray for the pressure sore on Gene's lower back to begin to heal, for him to continue to tolerate the decrease of respiratory pressure support, and for his swallowing reflex to continue growing stronger. Pray for strength and movement to return to his body especially in his arms, hands, and fingers. Pray for both Emily and Gene to have the patience, courage, and strength to negotiate these next days and weeks. Pray for Emily and Gene's little dog Mollie, as she is becoming very weak and her health seems to be rapidly failing.
Tuesday, July 14, 2009
July 14, 2009
Gene continues to make progress.
Today his ventilator pressure was lowered to 8 for much of the day. It is increased for night time when he is sleeping much like someone who has a C-Pap machine for sleep apnea.
He also sat on the edge of the bed for 10 minutes with some support from the nursing staff. This was the first time he has actually sat upright by himself. Previously, at the hospital, he sat up; but it was always in a stretcher chair which gave him full support, and didn't really have him upright altogether. The nursing staff also reestablished his PIC line today.
Gene still has the pressure sore on his lower back. It does not seem to be getting any worse, nor does it seem to be getting better. The wound nurse explained to Emily that they would keep it stabilized and that it would not get better until he begins to regain some of his strength.
Prayer requests:
Please pray for Gene to continue to tolerate the decrease of respiratory pressure support, for his swallowing reflex to grow stronger with every trial. He has said that he misses his morning cup of coffee! Pray for the pressure sore on his back to begin to heal, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him continue to have patience, courage, and strength. Pray also for Emily, as she continues to keep the home fires burning, while devoting much of each day to being with Gene at the hospital.
Today his ventilator pressure was lowered to 8 for much of the day. It is increased for night time when he is sleeping much like someone who has a C-Pap machine for sleep apnea.
He also sat on the edge of the bed for 10 minutes with some support from the nursing staff. This was the first time he has actually sat upright by himself. Previously, at the hospital, he sat up; but it was always in a stretcher chair which gave him full support, and didn't really have him upright altogether. The nursing staff also reestablished his PIC line today.
Gene still has the pressure sore on his lower back. It does not seem to be getting any worse, nor does it seem to be getting better. The wound nurse explained to Emily that they would keep it stabilized and that it would not get better until he begins to regain some of his strength.
Prayer requests:
Please pray for Gene to continue to tolerate the decrease of respiratory pressure support, for his swallowing reflex to grow stronger with every trial. He has said that he misses his morning cup of coffee! Pray for the pressure sore on his back to begin to heal, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him continue to have patience, courage, and strength. Pray also for Emily, as she continues to keep the home fires burning, while devoting much of each day to being with Gene at the hospital.
Sunday, July 12, 2009
July 12. 2009
Gene was doing well today. His C-Pap pressure was lowered to 10 today - that is good progress. The speech therapist gave Dad ice and about 5 sips of water today which he successfully got down!
More good progress.
The next step will be to have him take a semi-solid food such as pudding or applesauce. Brandy has promised to remember that he is really missing his morning cup of coffee.
Emily spent much of the day with him again today and tomorrow is going to take a much needed break to go on an outing to Rome with her PEO sisters. She has arranged for him to have lots of visitors, and she will see him in the evening when she returns.
Gene seems to be gaining strength in his arms.
Prayer requests:
Please pray for Gene to continue to tolerate the decrease of respiratory pressure support, for his swallowing reflex to grow stronger with every trial so that he can enjoy that cup of coffee, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him to have the courage and strength to do the work that the Kindred staff gives him to accomplish. Pray also for Emily.
More good progress.
The next step will be to have him take a semi-solid food such as pudding or applesauce. Brandy has promised to remember that he is really missing his morning cup of coffee.
Emily spent much of the day with him again today and tomorrow is going to take a much needed break to go on an outing to Rome with her PEO sisters. She has arranged for him to have lots of visitors, and she will see him in the evening when she returns.
Gene seems to be gaining strength in his arms.
Prayer requests:
Please pray for Gene to continue to tolerate the decrease of respiratory pressure support, for his swallowing reflex to grow stronger with every trial so that he can enjoy that cup of coffee, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him to have the courage and strength to do the work that the Kindred staff gives him to accomplish. Pray also for Emily.
Saturday, July 11, 2009
July 11, 2009
Gene continues to show improvement. Emily spent a good portion of the day with him, and had a good meeting with his case manager at Kindred.
Emily reports that Gene has had another good day. His C-PAP pressure on the Ventilator was set down one point today - another good step in the right direction. He also initiated a wave at a visitor - that's another real positive.
Gene continues to grow stronger. He is working hard at the tasks that he's given by all his care givers, and continues to make progress.
Emily is spending a large portion of each day with Gene. She has been spending the nights with him as well. It is sometimes apparent that she is quite weary. But, she is showing with each day the tower of strength that she has always been.
Prayer requests:
Please pray for Gene to tolerate well the lessening of respiratory pressure support, for his swallowing reflex to grow stronger with every trial, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him to have the courage and strength to do the work that the Kindred staff gives him to accomplish. Pray also for Emily to have the focus and strength to do those things that need to be done in these next few weeks.
Emily reports that Gene has had another good day. His C-PAP pressure on the Ventilator was set down one point today - another good step in the right direction. He also initiated a wave at a visitor - that's another real positive.
Gene continues to grow stronger. He is working hard at the tasks that he's given by all his care givers, and continues to make progress.
Emily is spending a large portion of each day with Gene. She has been spending the nights with him as well. It is sometimes apparent that she is quite weary. But, she is showing with each day the tower of strength that she has always been.
Prayer requests:
Please pray for Gene to tolerate well the lessening of respiratory pressure support, for his swallowing reflex to grow stronger with every trial, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him to have the courage and strength to do the work that the Kindred staff gives him to accomplish. Pray also for Emily to have the focus and strength to do those things that need to be done in these next few weeks.
Friday, July 10, 2009
July 10, 2009
Gene had a good day today. Emily found him more alert today than he has been before now. She had some pictures of Madison that Aunt Frances had taken with an old fashioned disposable flash camera. So I think they were in a more familiar form than all the pictures I've been showing him on the iphone. Mom asked him if he wanted his glasses to look at it and he said yes. Then he kept his glasses on for a little while today.
It is so great to know that he's getting very aggressive treatment for vent weaning, physical therapy, occupational therapy, wound treatment, and speech therapy! All of his care givers are commenting on his progress. He is currently on the C-Pap setting on the ventilator, which means that he only gets pressure to help him breathe and some oxygen support. He is actually initiating all the breaths on his own. When the family sees him day in and day out it is sometimes harder to see the progress. It's also clear that the caregivers have a very clear notion of the task analysis that will take him to the long term goals. They know each little step that must be accomplished to give him the foundation for the next level of accomplishment. So the family greets their progress reports with maybe not an entire level of understanding, but with enthusiasm.
Gene has developed a pressure sore on his lower back which is giving Emily some concern. The wound nurse is working actively on it. Wound care is one of the specialized services offered at Kindred, so it seems that we can expect good results for that.
Emily is still spending the nights with Gene, sleeping on a cot in his room - she reports that she is sleeping well. Emily has always had such a strong nature. We are certainly seeing it in the way she is moving through this situation.
Prayer requests:
Please pray for Gene to be comfortable with the lessening of respiratory pressure support, for his swallowing reflex to grow stronger every trial, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him to have the courage and strength to do the work that the Kindred staff gives him to accomplish.
It is so great to know that he's getting very aggressive treatment for vent weaning, physical therapy, occupational therapy, wound treatment, and speech therapy! All of his care givers are commenting on his progress. He is currently on the C-Pap setting on the ventilator, which means that he only gets pressure to help him breathe and some oxygen support. He is actually initiating all the breaths on his own. When the family sees him day in and day out it is sometimes harder to see the progress. It's also clear that the caregivers have a very clear notion of the task analysis that will take him to the long term goals. They know each little step that must be accomplished to give him the foundation for the next level of accomplishment. So the family greets their progress reports with maybe not an entire level of understanding, but with enthusiasm.
Gene has developed a pressure sore on his lower back which is giving Emily some concern. The wound nurse is working actively on it. Wound care is one of the specialized services offered at Kindred, so it seems that we can expect good results for that.
Emily is still spending the nights with Gene, sleeping on a cot in his room - she reports that she is sleeping well. Emily has always had such a strong nature. We are certainly seeing it in the way she is moving through this situation.
Prayer requests:
Please pray for Gene to be comfortable with the lessening of respiratory pressure support, for his swallowing reflex to grow stronger every trial, for him to continue to have increased strength and movement in his arms, hands, and especially his fingers, and for him to have the courage and strength to do the work that the Kindred staff gives him to accomplish.
Thursday, July 9, 2009
July 9, 2009
Gene has settled nicely into Kindred Hospital, and they have begun the serious business of rehabilitation. The staff is absolutely attentive and wonderful to him.
This morning Dr. Deversa saw Gene and spoke with some of the family. He indicated that many patients take as long as a month to get off a ventilator, and that if that is what Gene needs, that will be fine, but that he is really much further along than that. This was very encouraging news.
An example of the level of care was explained today. At Erlanger, where he was in an acute care facility, he would be one patient of a respiratory therapist who would have responsibility for patients on 3 floors. At Kindred, there are 3 respiratory therapists on duty for 37 ventilator patients in a much smaller space. It seems that he is seen much more frequently by someone involved with his care. Whether it is a nurse, a CNA, a respiratory therapist, a speech therapist, a physical therapist, or an occupational therapist, it seems that there are lots of people who are working with him. He actually was very tired this evening!
Today Brandy, the speech therapist, worked with Gene's swallowing reflex - she was feeding him small pieces of ice. She explained that her short term goal would be to have him consuming a significant amount of ice. From there she will move to sips of water. She will also begin to give him something of the texture of pudding or applesauce. The long term goal will be to have him able to handle both liquid and solid textures. Brandy explained to us that swallowing is very complex. A person has to suspend their breathing for about a second and a half to swallow and then resume breathing again. She says he will have to relearn this response. Her initial efforts at giving him ice, allows him to have the liquid in very small amounts (the ice melts slowly in his mouth and he only swallows a tiny bit at a time). She says that he has made significant progress since he arrived on Monday. She also told Gene that she and her fiance had signed up for the Master Gardener class in January, and that she was looking forward to him being well enough to teach her. He said "I hope so".
Gene also had physical therapy and occupational therapy visits today. The occupational therapist worked with Gene's arms and shoulders. He also left some yellow therapy putty for Gene to grip, and encouraged Emily to work with him as often as possible. The physical therapist used electrical stimulation on his legs, and Gene was able to feel the stimulation on the highest setting. She was very encouraged and said that she expected for him to continue to have gains using this therapy.
Emily has been spending the nights at Kindred. Today her sisters convinced her to take some time off (while they stayed with Gene) and go to her P.E.O. meeting. Her P.E.O. sisters were so glad to see her, and she seemed to enjoy the opportunity to attend the meeting. Two of her P.E.O. sisters volunteered to take over her responsibility to host the next two times she is scheduled. That will be so much help for her!
This morning Dr. Deversa saw Gene and spoke with some of the family. He indicated that many patients take as long as a month to get off a ventilator, and that if that is what Gene needs, that will be fine, but that he is really much further along than that. This was very encouraging news.
An example of the level of care was explained today. At Erlanger, where he was in an acute care facility, he would be one patient of a respiratory therapist who would have responsibility for patients on 3 floors. At Kindred, there are 3 respiratory therapists on duty for 37 ventilator patients in a much smaller space. It seems that he is seen much more frequently by someone involved with his care. Whether it is a nurse, a CNA, a respiratory therapist, a speech therapist, a physical therapist, or an occupational therapist, it seems that there are lots of people who are working with him. He actually was very tired this evening!
Today Brandy, the speech therapist, worked with Gene's swallowing reflex - she was feeding him small pieces of ice. She explained that her short term goal would be to have him consuming a significant amount of ice. From there she will move to sips of water. She will also begin to give him something of the texture of pudding or applesauce. The long term goal will be to have him able to handle both liquid and solid textures. Brandy explained to us that swallowing is very complex. A person has to suspend their breathing for about a second and a half to swallow and then resume breathing again. She says he will have to relearn this response. Her initial efforts at giving him ice, allows him to have the liquid in very small amounts (the ice melts slowly in his mouth and he only swallows a tiny bit at a time). She says that he has made significant progress since he arrived on Monday. She also told Gene that she and her fiance had signed up for the Master Gardener class in January, and that she was looking forward to him being well enough to teach her. He said "I hope so".
Gene also had physical therapy and occupational therapy visits today. The occupational therapist worked with Gene's arms and shoulders. He also left some yellow therapy putty for Gene to grip, and encouraged Emily to work with him as often as possible. The physical therapist used electrical stimulation on his legs, and Gene was able to feel the stimulation on the highest setting. She was very encouraged and said that she expected for him to continue to have gains using this therapy.
Emily has been spending the nights at Kindred. Today her sisters convinced her to take some time off (while they stayed with Gene) and go to her P.E.O. meeting. Her P.E.O. sisters were so glad to see her, and she seemed to enjoy the opportunity to attend the meeting. Two of her P.E.O. sisters volunteered to take over her responsibility to host the next two times she is scheduled. That will be so much help for her!
Wednesday, July 8, 2009
July 8, 2009
This is Gene's third day at Kindred Hospital. He seems comfortable and glad to be there.
He has not been on ventilator support since he arrived at Kindred. He is still getting air pressure support and supplemental oxygen through his tracheotomy. Today the respiratory therapist said that they had already begun to wean him from the support. Each 12 hours his air pressure will be turned down by 1 point as long as he is doing well. Today when the therapist asked how he was doing he responded "perfect breathing". It did take a couple of repetitions before we could make out what he was saying, but everyone felt good.
Emily has been spending the nights in his room with him since he moved to Kindred. She says she is sleeping well even though she is in the hospital. Perhaps it's reassuring for them both to be sleeping in the same room.
The staff at Kindred is wonderful. They seem to be very interested and attentive.
Gene is regaining some little movement in his fingers and can move his arms and his wrists. He has lost about 25 pounds, and at this time he is very weak. He will be able to have much more access to therapy to increase his strength at the Kindred location than in the acute care setting at Erlanger, so we are eager to begin to see some results of that.
Gene is allowed to have visitors at Kindred. It is located at 709 Walnut Street in Chattanooga. This is in the next block from the Court House. (423) 266-7721 If you visit, make sure to sign in at the front desk. ALL visitors are required to wear a robe, gloves, and mask. These are available on the door to Gene's room. He is very tired and is sleeping or lying with his eyes closed lots of times. However, visitors do seem to cheer him up. Today in addition to his regular visitors, his baby sister Mary, and her oldest daughter Lynda, as well as grandson Valdis, and his sister-in-law Frances visited with him. While Frances visited with him, she read to him from his memoirs - the Atlantic Ocean crossing, the short stay in Scotland (including his escape from the hospital), and the train ride to Land's End. If you visit, there is a journal in his room, and the family would like to ask that you write something in it.
Prayer Requests:
Please pray for Gene's respiratory strength to continue to improve, and for him to continue to have increased strength and movement in his arms, hands, and fingers, and for him to have the courage and strength to tackle the next step in his rehabilitation process.
Monday, July 6, 2009
July 6, 2009
Gene moved from the Erlanger Intermediate Care Unit to Kindred Hospital.
This morning Emily and Frances visited him. Jim West from Gideons, and Dr. Carver, their minister, visited him as well. He sat up in his chair from 10 this morning until noon. His visitors spoke with him and reminisced with him. Gene clearly enjoyed their company and their prayers.
Dr. Claxton reviewed his chart and confirmed that his team of physicians were in accord that he was strong enough to move. Russ, Steve, and Emily have all spoken with Gene about Kindred and he was eager to go. By noon, it was clear that the move was going to happen in a short time. Emily was able to ride in the ambulance with him for the move. After they arrived at Kindred, and Gene was in his room, Emily was asked to go to a waiting area while they did the intake procedures. It was about an hour before she was able to go back to the room with him. The move wore him out! He was very tired, but expressed that he was glad to be moved.
His room is large and well lit. They have already set up a cot for Emily, and she plans to spend several nights there at the beginning of his stay. The respiratory therapist spoke with Emily and indicated that the work toward weaning him from the ventilator would be the first order of business. This of course will include therapy to help him regain overall body strength.
Prayer requests:
Please pray for Gene to have an easy transition to the new facility, for his respiratory strength to continue to improve, and for him to continue to have increased strength and movement in his hands and fingers as well as his whole body.
This morning Emily and Frances visited him. Jim West from Gideons, and Dr. Carver, their minister, visited him as well. He sat up in his chair from 10 this morning until noon. His visitors spoke with him and reminisced with him. Gene clearly enjoyed their company and their prayers.
Dr. Claxton reviewed his chart and confirmed that his team of physicians were in accord that he was strong enough to move. Russ, Steve, and Emily have all spoken with Gene about Kindred and he was eager to go. By noon, it was clear that the move was going to happen in a short time. Emily was able to ride in the ambulance with him for the move. After they arrived at Kindred, and Gene was in his room, Emily was asked to go to a waiting area while they did the intake procedures. It was about an hour before she was able to go back to the room with him. The move wore him out! He was very tired, but expressed that he was glad to be moved.
His room is large and well lit. They have already set up a cot for Emily, and she plans to spend several nights there at the beginning of his stay. The respiratory therapist spoke with Emily and indicated that the work toward weaning him from the ventilator would be the first order of business. This of course will include therapy to help him regain overall body strength.
Prayer requests:
Please pray for Gene to have an easy transition to the new facility, for his respiratory strength to continue to improve, and for him to continue to have increased strength and movement in his hands and fingers as well as his whole body.
Sunday, July 5, 2009
July 5, 2009
Gene had a good day today. He had a visit from his granddaughter Lauren and her husband Ryan McSwain. They were traveling home from Florida where they worked with the Lighthouse a church project which serves families who are coping with cancer. They came via Atlanta where their daughter Madison had spent a few days with her grandparents, MaMa Pat and Poppa Steve. Lauren and Ryan took along their laptop and showed Gene a video of Madison kicking around in a swimming pool in Florida. He smiled and told them that she is a "cutie pie".
Emily and her sister Frances also visited the hospital twice today. We continue to have an expectation that he will be moved to Kindred Hospital, a facility which has expertise in ventilator weaning, sometime next week. The pulmonologist on duty over the weekend told Emily that his tracheotomy needed to be changed. We didn't have any indication about when that would happen.
Prayer requests:
Please continue to pray that Gene's respiration will improve, he will regain movement and strength in his hands and fingers, and he will have the strength and patience for the work he has to do for his recovery.
Emily and her sister Frances also visited the hospital twice today. We continue to have an expectation that he will be moved to Kindred Hospital, a facility which has expertise in ventilator weaning, sometime next week. The pulmonologist on duty over the weekend told Emily that his tracheotomy needed to be changed. We didn't have any indication about when that would happen.
Prayer requests:
Please continue to pray that Gene's respiration will improve, he will regain movement and strength in his hands and fingers, and he will have the strength and patience for the work he has to do for his recovery.
Saturday, July 4, 2009
July 4, 2009
Gene had a good day today. He wasn't able to sit up in the chair because all the members of the lift team were not working this holiday weekend.
Dr. Bolt, one of the hospital pulmonologists spoke with Emily while she was visiting early this evening. He indicated that it was time for Dad to have his tracheotomy changed. We aren't clear exactly what that means, but it seems that may need to happen before he can be moved to Kindred.
Gene's color is good and he is spending some time each day breathing on his own with only pressure to help with his breathing. We are very hopeful that the expertise at Kindred will be able to help wean him from the ventilator. We all seem to see some movement returning to the fingers on his left hand. He is always so pleased to have visitors.
Prayer requests include continued respiratory strength, continued return of movement in his hands and fingers, and the strength to fight this battle!
Dr. Bolt, one of the hospital pulmonologists spoke with Emily while she was visiting early this evening. He indicated that it was time for Dad to have his tracheotomy changed. We aren't clear exactly what that means, but it seems that may need to happen before he can be moved to Kindred.
Gene's color is good and he is spending some time each day breathing on his own with only pressure to help with his breathing. We are very hopeful that the expertise at Kindred will be able to help wean him from the ventilator. We all seem to see some movement returning to the fingers on his left hand. He is always so pleased to have visitors.
Prayer requests include continued respiratory strength, continued return of movement in his hands and fingers, and the strength to fight this battle!
Friday, July 3, 2009
July 3, 2009
Gene continues to be at Erlanger in the Intermediate Care Unit for the time being. He has battled pneumonia, diarrhea, weight loss, and muscle mass loss. He is an inspiration for all of those who encounter him. He is patient, and sweet, and is working hard on the tasks that he is given.
Thank you for your continued prayers. His respiration continues to improve, with a set-back here and there. He spends a part of every day sitting in a special chair with the ventilator turned off. The objective is to wean him from his dependence on the ventilator. Some days he is able to go for long periods of time - four and a half hours or so, other days he doesn't go as long. He also works with the physical therapist.
Gene will be transferred to Kindred Hospital in Chattanooga as soon as the doctors at Erlanger deem it safe for him to go. There was a possibility for that happening early last week, but he had an incident with low blood pressure that made the doctors want to keep him for a bit longer. We are eagerly anticipating his move to Kindred, where there will be a focus on physical therapy and ventilator weaning.
Continue to pray for Gene's respiration to improve, his movement to continue to recover - particularly in his hands and fingers, and for him to have the courage and strength to face the challenges that lie ahead of him.
Thank you for your continued prayers. His respiration continues to improve, with a set-back here and there. He spends a part of every day sitting in a special chair with the ventilator turned off. The objective is to wean him from his dependence on the ventilator. Some days he is able to go for long periods of time - four and a half hours or so, other days he doesn't go as long. He also works with the physical therapist.
Gene will be transferred to Kindred Hospital in Chattanooga as soon as the doctors at Erlanger deem it safe for him to go. There was a possibility for that happening early last week, but he had an incident with low blood pressure that made the doctors want to keep him for a bit longer. We are eagerly anticipating his move to Kindred, where there will be a focus on physical therapy and ventilator weaning.
Continue to pray for Gene's respiration to improve, his movement to continue to recover - particularly in his hands and fingers, and for him to have the courage and strength to face the challenges that lie ahead of him.
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