Friday, February 20, 2009

Today was Christy's most exciting day yet!  When I came to see Christy this morning, she was sitting in the regular chair with her left leg in the knee immobilizer, propped up on another chair.  That morning, Christy had been TALKING ON THE PHONE to Mom, Kaeo, Keli'i, Alan, friends (I'm not sure who exactly, it was before I got there).  Christy has been talking today- Alot more!! Not just one word or two but actually saying small sentences!! We've been waiting so long for her to actually be talking to us, it seems surreal.  Christy gets tired and nods instead of using words.  She takes naps and rests throughout the day.  She had a couple big spurts of active times, and it was just pure excitement to be there and see her talking!  I was jumping up and down, unable to control our pure joy and gratefulness!!  

After being in the chair for a while, Christy told us that she wanted to get back to bed.  Donald has been carrying her back and forth, and allowing her to stand from the seated position when she wanted.  So today Christy tried getting back to bed with Donald -- Lorene and I supporting on standby on both sides of her.   We moved her chair (with her seated in it) next to the bed, so she would be right near the mattress once she stood.  Donald got in front of Christy on the chair and counted to three and they stood together.  I supported her lower back some, but Christy stood with Don supporting her for a few minutes.  Donald put Lorene on the spot and asked her to sing the song that she sang at their wedding-- so they could dance while they were standing together! :)  Lorene has a beautiful voice, and she sang their song, and Christy and Donald had a little swaying dancing moment! It was sweet.  Then it was time to get back to work.  We tried to guide Christy's legs to instruct her how to move them to step.  Christy was bearing almost all of her weight on her own feet.  Once Christy started to try and step toward the bed, she wasn't very happy.  Was she hurting from standing? stepping?  Were we pressing on her feeding tube holding her up?? We weren't sure, and Christy didn't tell us.  Chris was right next to the bed, and we sat her on the bed right away.  Christy calmed down almost instantly.

Christy laid in her bed, and we stretched her legs.  It causes her a lot of discomfort to stretch her legs completely strait, but she has to do it to continue rehab and to walk again.  We placed the knee immobilizers on both legs to keep them outstretched.  At this time the healing touch volunteer came to do Healing Touch.  She played soothing soft music and gave Christy a treatment!  Christy feel asleep afterward, and was just resting.  Christy got a little nap in before Physical Therapy came in to see her.  Christy was talking as soon as she got up from her nap.  It's still hard to understand her sometimes, and despite Christy repeating her phrase, it can't quite be deciphered. 

 At this point, the PTs (2 of them came) were removing the knee immobilizers and started to get her up at the edge of the bed (pictured).  Here, Christy is dangling at the edge of the bed.  She is practicing "sitting strength".  The goal is to get her to sit up by herself without any help.  Christy's body tends to move left and right and forward, and backward. Her legs want to lift up to her body, too.  That is why there is a therapist in front and one in back.  They teach Christy how to place her hands and arms, and coax her legs down so they don't come up to her chest.  The PT described Christy's desire to pull up her legs to her chest as a muscle spasm.  It's kinda uncontrolled.  She also called it "tone".  Short for muscle tone- the state of tension or responsiveness of the tissues of the body.  Sitting up allows strengthening of her arms & back & abs, which hold her upright and centered, strengthening of her neck which brings her head upright and holds it there.  She stretches her legs and hip-flexors to lessen the tension in her muscles.

While Christy was in this dangling position, the speech therapist Kim came to see her!!  Kim likes to see Christy while she is in the chair or is sitting up completely.  Christy was really alert at this time, much more alert than when Kim was there yesterday to see her.  Kim went to grab some Chocolate pudding and Apple Sauce becuase she thought Christy was alert enough to do a "P.O. trial"  That just means to test out if Christy can take anything by mouth.   I was sitting next to Chris on the bed, and asked her if she wanted something to eat and her eyes completely lit up wide and she nodded her head yes!!!! The PTs held Christy in the sitting position-- Christy needed a lot of help because she was concentrating on talking and using her mouth.  Kim, the speech therapist asked Christy which one she would like to eat... pudding or apple sauce.  No answer.  Kim asked "Pudding?", Christy shook her head "no".  "Applesauce?", Kim asked, and Christy shook her head "No".  "What would you like to have?" And Christy responded slow and clear... "Diet Coke!"   We all cracked up laughing.  Of course Christy would ask for a diet coke, that's her favorite!!!! HA!!! And Christy laughed too.  It was hilarious.  So Christy finally chose pudding.  Before she ate the pudding, Kim had her open her mouth, stik out her tongue, and try to move it side to side (the moving it part was too hard, but the other part she did immediately!) Kim also asked to hear her voice & to say "Ahhhh" nice and loud and Christy did!!  Then we were ready for pudding.  The reason Kim brought pudding is that Christy needs to have something with a thicker consistency-- not liquid, because thicker consistency is easier to swallow.  She can choke easier on liquid.... so no diet coke for a while till it is safe for her to drink.  Christy had about 5 bites of pudding.  She had to take cues from Kim on opening her mouth and closing her mouth,  "pumping her tongue", moving her cheeks to move the food back and swallow it.  Christy has a delayed swallow and it takes her more than one time to swallow the bite of pudding.  She will need more coaching and practice before she starts to eat meals of food.  Christy was amazing with following directions and talking.  She was answering questions well.  Tina asked her what Kelelina meant (i forget why we were talking about it), but Christy said "Geraldine"!!  We were all so excited and so loud, i guess, that the other nurses working and the nurses aids came in to see what was happening!!  Christy has been on their floor for a while now, and they too, have watched her progress.  It's amazing us all!!  

Christy got back to bed after all the excitement, and my mom was there to do more healing touch on her!  Chrsity tried to relax for a while during that.  

Christy had to use the bathroom later, and Donald put her on the throne.  He holds her and whoever is there assists.  Christy was having some pain and wanted to tell us something.  Donald and I couldn't understand what she was trying to tell us.  We adjusted her tubes and tried to help her sit up more.... We couldn't understand what she needed right away.  Then I was repeating words she was saying that I could understand in the phrase.  And "doo doo" was at the end & I repeated it. Then we were all talking over each other, and she was saying "What?" and I repeated "What?" and she said "What?" Then she started totally cracking up and we all started busting out laughing because we're desperately trying to understand every word and help her, and it turned out to be a "Who's on first" kinda situation. I'm still laughing out loud.  But seeing her expressions and laughing at what crazys we sounded like, warmed my heart!  We've waited so long to hear her voice again... I almost can't believe it is real. Thank you God for giving us Christy back....    And by the way we figured out that she was saying "all pau doo doo".  She was telling us she was done.  I hope Christy doesn't kill me for sharing her doo doo stories....

Edna, the case manager gave us a little update on the Craig status.  I guess Craig said they were going to have some beds open up next week, and that's why I heard the week of the 23rd through the grapevine.  So it wasn't a set date for Chris to go.  HMSA still has to approve Craig (meaning they have to agree to pay for Craig as a benefit of her insurance plan).  HMSA denied paying for Christy's travel with a nurse due to the fact that she can not complete 3 hours of rehab.  It's an accepted community standard & with Medicare,  for a patient to be able tolerate 3 hours of Physical rehab before they are accepted to an Inpatient Acute Rehab Hospital.  This sounds like someone who is very able to participate and concentrate the entire time & they are just overcoming physical difficulties.  Christy has to relearn many things, sitting up, getting out of bed, walking.  She needs to do those things first before the intense 3 hours of physical rehab to get her to run.  It seems unfair that they are wanting her to run before she can walk. They have not made a decision if they are going to approve Craig  as a benefit yet.  Edna gave them a deadline of this coming week (week of the 23rd).  If they deny Chris to go to Craig by using the same excuse as not approving the Medical travel & RN, we need to ask them what kind of plan they have for helping Christy.  We don't know what they will decide, so please pray for HMSA and for Christy--- she needs to go to Craig, she needs the specialty of those doctors and therapist.  The insurance has to spend more money for Christy to go to a place like Craig than for a "medical-surgical" floor in the hospital or a floor like Christy is on.  All of the specialist Christy needs to see, and the equipment and knowledge they have specifically for brain injury patients at Craig is very expensive.  Please let them see that Christy is young, with  a whole life ahead of her and three children who need her.  She needs this help now to regain her independence.  HMSA owes it to her as their subscriber, who paid the premiums, to give her the care she needs now.  They need to think of taking care of Christy.

Christy also talked to the kids on the phone tonight, it was so sweet... Christy made us all cry today, all day at different times.  

Today Christy totally blew us away... can't wait for tomorrow!

The last thing is that we are asking is for visitation to be limited to family right now. Christy gets overwhelmed and tired out by too many visitors.  It takes so much energy to do her therapy and her sleep and rest time are precious to her healing brain.  We want Don and the Kids to be able to enjoy Christy, and for her to be able to give 100% to her therapies which are very challenging every day.  Thank you so much for loving her so much and for coming to see her and bring her things that make her feel loved.  We appreciate the understanding.  I will keep you posted on everything I can on the blogs to keep you close to Christy at this time!!! big hugs and kisses to you all!!!