Tommy Long

Sunday, October 30, 2010

2010-10-31T06:56:00.000-07:00

Just when I thought nobody was reading the blog anymore, four friends over this past week said they had checked it and were eager for an update on the old man. So, here goes, folks.
It's good news: Tommy is still working his way through his nine lives. And we are finally enjoying our "summer"...I say that because the actual summer months proved to be yet another trial for us. Within weeks of Tommy getting home from his two months in rehab following the spring gall-bladder crisis, Tommy had a totally unexpected "heart event" while pedaling on his exerciser. This culminated in another ambulance ride, with me following in my car behind--this time, all the way to Washington Hospital Center in D.C.--to get two stents installed in Tommy's lower anterior descending artery (the artery that is also called "the widowmaker"). (The cardiologists at the major regional hospital in Salisbury, Md., where Tommy was taken first, said it was too dangerous to try to do the procedure there.) We were supposed to be two nights in D.C. and ended up being there five nights. It's a terrific hospital, but the experience was exhausting for both of us. Thank heaven our good friend Amy Smith lives only a mile down the street and welcomed me with a chilled glass of white wine every night around 9 when I stumbled in. While I sat staring at the kitchen wall, she rustled up homemade burritos for me...and listened to me babble. I keep saying it--thank heaven for our friends.
When we got back home, Tommy began another stint of home health care, plus we had weeks of juggling his new drug regimen with the help of the home-health nurse, appropriately named Angel. We got through it all with the help of Gaie (who drove out for a week to help me get back on my feet), Tommy's wonderful Dr. Giddins, my brother Marshall, and Patti and Irv.
Now things are on an even keel once again. I tell Tommy that he's like an old classic car that's being restored; everything is getting replaced and pretty soon he'll be like new. Getting the stents in his artery has definitely made a difference in his awareness or whatever the word would be; we have longer conversations and his episodes of confusion are less frequent.
So, at this point, Tommy is working his way back to where he was in the early spring, before the first of the two unplanned hospital visits. This means that he walks (with walker and me helping) to the dining room every morning, and he pedals daily (although not as vigorously as he did before the stents were put in). We often go out in the afternoon for errands. We have a wonderful woman named Billie who hangs out with him once a week while I go out.
This week, Marty Wolfe visited for the first time since last Thanksgiving, and he told Tommy that he seems much improved since his last visit. Thanks, Marty.
Oh--and on November 4, Tommy turns 75! We'll have an open house for him next Sunday, with the usual suspects stopping by. Give him a call this week--he would love it...302-539-8079, or drop him a card (P.O. Box 1427, Ocean View, DE 19970). And come visit!

May 22, 2010

2010-05-22T06:36:00.000-07:00

Great news: Two days ago, I attended the second care-plan meeting for Tommy at Atlantic Shores rehab. The social worker told me that Tommy has been meeting the goals that were set for his therapy, and that if he continues to progress as expected, he will be discharged on Memorial Day. Just in time for us to enjoy summer. My brother, Marshall, is coming for the weekend, and Patti and Irv will come by to welcome Tommy back home. I picture us all sitting on the back deck, with Penny and Sandy running around looking for handouts. We'll watch the jet-skiers dodge the go-fast boats out on the creek--always exciting viewing, especially on sunny holiday weekends--and we'll take turns lobbing tennis balls for the dogs with the Chuck-it that Diana and Larry gave us (truly the best dog toy ever invented).
Tommy has been working hard in therapy and now is almost able to walk the same distance (with a walker and an assist) that he was able to walk prior to the gall-bladder surgery. He can lift almost all of his own weight during transfers. He has gained back some 12 or 15 pounds--he now weighs 154 lb.--helped along by the high protein "Magic Cups" he wolfs down and the daily power drink that I've been bringing him (low-fat yogurt, ground almonds, fresh fruit and a dash of vanilla). Speaking of wolves, he is now joking with the caregiving aides (some of whom are floored, because they had gotten the idea over the first few weeks that he was unable to talk). The other day he told one of them to "climb in bed with me" as she was helping him lie down. He's baaack.

Friday, April 9, 2010

2010-04-09T04:17:00.000-07:00

Yesterday was kind of hectic--in the morning I went to Harris-Teeter (always a pleasure) to grab ingredients for some edible "puree diet" food for Tommy, since pureed food and "thickened" liquids are basically yucky. Tommy won't even touch the gluey liquids. My approach is just to go with delicious soups, instead--at least they're "intended" to be pureed. I mean, pureed pancakes? Please. I got him lobster bisque and then ran it through the blender at home just in case there were any little chunks of lobster, and he gobbled it up at dinner. For tonight I have made gazpacho.

Just before dinner I met with the nutritionist and, like the head of physical therapy, she is young and extremely bright and nice. Good sign. They had Tommy in the gym when I got there around 4--a Filipino guy named Peter, who seemed very good and was also very warm to Tommy, was working with him at the parallel bars and got him to stand for maybe 20 seconds (with a lot of support), so that was good.

At dinner Tommy was extremely tired. A friend of his, Frank Carr, came to visit right after dinner, and also the facility's doctor arrived at about the same time. The doctor turns out to be Dr. Raj, who was Tommy's primary-care doctor until last summer (at that time, I changed Tommy to Dr. Giddins because Dr. Raj was basically unavailable when Tommy was having a gallstone emergency and was being led around the barn by all kinds of unfocused specialists' assistants...we couldn't even get to the specialists). But we always have loved Dr. Raj, so we are very happy that he is on the case while Tommy is at Atlantic Shores rehab because he knows Tommy very well.

Also, yesterday Tommy's lungs were making a lot of noise so they gave him an X ray and found that there is a small area in his lower right lung that they think is pneumonia, so Dr. Raj has prescribed a stronger antibiotic than what he has been getting.

I asked Tommy at bedtime if he feels comfortable and secure at this new place and he said yes. One day down...more to come.

Thursday, April 8, 2010

2010-04-09T03:43:00.000-07:00

Well, as Diana recently told Janis, Tommy has nine lives. A week ago
Tuesday he was raced into emergency surgery at Atlantic General
Hospital in Berlin, Md. (a very good hospital) for removal of a
disintegrating gall bladder. For two days after that, he was "septic"
and fighting for life in the ICU. He had so many tubes and wires going
into him he looked like a robot. Two days after surgery, his system
finally kicked in as his white blood cell count started to fall and he
was able to begin to keep up his blood pressure without being pumped
full of fluids. His recovery was steady after that. He is now on a
puree diet and his swallowing is improving daily, so he should soon be
able to handle actual "food".

Yesterday afternoon he was moved to the residential rehab place, which
is in Millsboro, a 20-minute drive from the house. The docs can't say
exactly how long he will be there, but that it will probably be a
matter of weeks rather than months. He is still very tired and
sometimes confused, but when he's awake he's often alert and hits me
with the occasional zinger. Example: Yesterday at lunch time, when I told him
I was going to run down to the hospital's cafeteria to grab a bite, he
said, "Check and see if there's any beer in the fridge." (He hasn't
had a beer in more than two years, of course.)

Tommy has a lot of work to do to get back to where he was before the
gall-bladder surgery--he is unable to stand up on his own, so even
transfers are being done with the help of various mechanical lifts--but
he says he wants to come home and that he's ready to buckle down. He
will have therapy sessions in the morning and afternoon. I will be
with him for dinner every evening, so a good time to call him (on my
cell phone--302-344-8652) would be from about 6 to 7 (i.e., right after
dinner).

If you want to send him a card, here is the address:

Atlantic Shores Rehab Center
231 S. Washington St.
Millsboro, De. 19966
Attention: Tom Long, Rm. 703D

Thank you for all the support and good wishes. I know it means a lot
to Tommy to hear from his family and friends. (Me, too '-) ~Connie

Sunday, Dec. 27, 2009

2009-12-27T05:49:00.000-08:00

This has been a busy week, as my family is visiting. Tommy continues to hold his own in the gym and at the dinner table--good walking, good eating, generally good all around. As I have said so many times before, simple peace and "not too much happening" has shot to the top of my list of "good news" in the past year and a half; and therefore, I wish all of you simple peace as a baseline for 2010 and if you care to embellish on that, go for it. And, to all of you, thank you for the calls, cards, e-mails and visits over this year; we are always so happy to be in touch with you.

Saturday, December 12, 2009

2009-12-12T08:25:00.000-08:00

Lest anyone think that Tommy Long has lost his sense of humor or his, shall we say, drive, consider his response to a question this morning. It was when we were doing his morning relaxation exercise. This occurs while Tommy is still lying in bed, and it consists of me telling him to send a message from his mind's eye down to each part of his body; and the message is, "relax". We start with each arm; then the legs; then the bladder; then the intestines (aka what I call his "sh*t mine", which is to say that I ask him if he wants to tell the boys who are in there shoveling the sh*t for him if he has a message for them, to which he usually responds, "Yeah...thanks, boys; take five"); then his stomach; then the guys plucking on his vocal cords; and finally his schwaz. So this morning I asked him, "Do you have a message to send to your schwaz?" "Yeah," he said, lifting his head and looking down there. "Find a woman."

Thanksgiving Day 2009

2009-11-26T17:26:00.000-08:00

We are still enjoying the fall. We've been in touch with lots of family and friends in the past few weeks. The nor'easter earlier this month gave us a scare with its high flood tides, but although the house was totally surrounded by water and we had to move out for two days (thank you, Irv!), the house stayed dry. Tommy is still going to the Tidewater gym two mornings a week, where Bob Cairo, a prince among men, keeps an eye on his progress. We had a lovely day today, with my brother serving as turkey sous chef and a visit from Marty Wolfe, one of Tommy's former boatyard employees. Marty got a huge smile from Tommy when he said, "You look good, Tommy--almost as good as me!" Everything seems to be going our way right now, and for that we are most thankful. Amen.

Friday, November 6, 2009

2009-11-06T12:48:00.000-08:00

It's been a really relaxing and beautiful month since the last entry in this blog. The bright, sunny days are growing steadily more bracing, but that's okay because we have the firewood ready. Tommy still goes to Tidewater "gym" two mornings a week, where he rides the bike for a good half-hour and Bob Cairo walks with him using the walker. We will soon get back to walking on the back porch--as we were doing before the great gall-stone disaster set Tommy back for the summer. So, we are slowly but surely working our way back to where Tommy was in the late spring. Two steps forward, one step back does seem to be the way of it. Tommy turned 74 on Sunday; we had a dinner party for him with everyone bringing a dish to supplement the leg of lamb that I roasted for him. He heard from many family and friends, both with phone calls and cards, and had a wonderful day.

Tuesday, October 6, 2009

2009-10-06T07:06:00.000-07:00

We are enjoying the fall so much--fall as in autumn, that is, not as in down you go. Good news, too, from Bob Cairo, Tommy's primary therapist at Tidewater Physical Therapy right here in town, where Tommy and I have gotten so much help. Bob is going to let Tommy come twice a week on his own dime--a very reasonable charge--now that Tommy's prescription for physical therapy has run out. Patti and I are going to throw a big cook-out later in the month, and I'm thinking Tommy could help out by serving as judge for the pumpkin-carving contest.

Friday, September 25, 2009

2009-09-25T12:04:00.000-07:00

Tommy has continued to get back up to speed, and in a week or so he should be back to about where he was on Memorial Day weekend, when he went to the emergency room as all his looming problems came to a head. He is now again able to take all of his weight when doing transfers, and soon he'll be walking those dozen or so daily "laps" on the porch with the walker and me assisting. Bob Cairo and his staff at Tidewater rehab have done a great job helping Tommy; he may actually have only another week or two at Tidewater before his prescription runs out. Then we'll be on our own again for therapy, but I have learned a lot from the Tidewater folks so we'll be ready.
Yesterday evening we went to the VFW for the post's last crabfest of the season. It was Patti's birthday party, so we had a tableful of pickers with flowers and a cake to top it off. We sat at the far end of the enclosed porch, with a fabulous view of the sunset over Indian River Bay. Patti's neighbor Gordon very kindly picked crabs for Tommy, allowing me to kick back for a while. It was a very pleasant way to end the summer.

Monday, September 21, 2009

2009-09-21T16:41:00.000-07:00

We had a hunky dory weekend. Tommy is getting back to where he was before (aack) Memorial-Day-in-the-Hospital weekend; and we are in the midst of those incredibly bright, breezy early fall days; and, to top it off, we celebrated both Patti's and Irv's September birthdays on Sunday with a feast supplied mostly by Patti, with me throwing in the corn and tomatoes. We spend several hours a day just dozing on the sun-warmed back deck with the dogs. More days like this, please.

Thursday, September 10, 2009

2009-09-10T09:09:00.000-07:00

Tommy is still struggling with the g.i.-tract problem; it has caused him much off-and-on discomfort and also kept him from two of his three physical-therapy sessions this week. Yesterday, Irv and I took him to see Dr. Giddins, who told me to continue with the regimen she recommended last week, plus to give him one packet of MiraLax every morning. She also ordered an X ray; so, when we left her office, I took Tommy down the street to the Beebe Imaging outpost, where the staff were wonderful and fun, too. We will see what the X ray shows and also how Tommy does through the weekend.

September 8, 2009

2009-09-08T00:26:00.000-07:00

Just when things seemed to be looking up, Tommy came down with a really bad case of constipation early last week, and he's been struggling off and on with it since then. His doctor said to add Colace to the efforts I was already making, which has helped a little bit. If Tommy isn't strong enough to go to physical therapy tomorrow (he missed two sessions last week), I am going to ask the doctor to send in the nurse again, and maybe she can come up with a plan. In spite of his slowdown, Tommy was able to join Irv, Patti and me for our "farewell to summer" cookout dinner on the porch last night. Patti brought several wonderful salads made with the last of the summer vegetables (including her own luscious tomatoes), and Irv grilled Italian sausages. What a feast. Needless to say, Tommy's plate was heavy on the veggies (fiber) and light on the meat. His appetite has been flagging the last few days, but not last night, which made us all happy.

Monday, August 31, 2009

2009-08-31T04:51:00.000-07:00

With the Tommy blog, no news is good news. When everything is ok, there's less to say. (Who was that modernist architect who said, "Less is more"?) We have been enjoying lots of phone calls and visits on the back deck with friends. Somebody lobs the tennis balls for the dogs with the Chuck-it that Diana and Larry brought us, and somebody grills something, and we pass around the binoculars and watch the jet-skis dodging the fishing boats dodging the kayakers in the creek. Tommy is working hard in his three-times-a-week therapy sessions. He's still a "moderate assist," but that's fine; he lost a lot of ground during that setback in June and July. Ugh...I'm not even going to try to count up the number of doctor visits and blood-giving sessions for those two months alone. Now, everything is going in the right direction, and Tommy's blood work is "normal", and normal never sounded so good. In other words, we are more than happy with less. Except for family & friends. We are so grateful for all the love you guys out there have sent our way, in so many different forms. We look forward to seeing and/or talking with all of you as we move into fall.

Friday, August 21, 2009

2009-08-21T16:27:00.000-07:00

This week we've been relaxing into our summer--finally. Tommy is now in outpatient physical therapy. The therapy practice, called Tidewater, is close--maybe a half-mile toward the ocean from the Food Lion. Tommy will have three sessions a week for a month, possibly longer. Tommy really likes the folks there, and I do too. Besides working with the therapists, Tommy does about eight minutes a session on a machine that he loves and that is perfectly suited to him. I looked it up on the internet: It's officially called a "recumbent step trainer," and it's top of the line. Of course, it costs a small fortune; on eBay, the closest used one was in Indiana, and it was going for $2,600. Plus, shipping would cost a small fortune. So, no go for adding one to the home gym. However, I'm going to check with the senior center workout places around here and see if any of them have one; if so, maybe we can join after Tommy is finished with outpatient therapy.
We had a visitor from DC for the last couple of days named Onka Dekker. She's a woman about my age who worked for Tommy a long time ago, i.e., she's one of the "boatyard family" and has remained friends with our friend Capt. Steve Doles, who is now in Florida. Onka painted boats for a summer, and says that she loved working at the boatyard because it was such a refuge from the craziness of the city. She has returned to college to get a degree in history and is writing a paper on the closure of the boatyard, so she came to interview Tommy. It was a fun visit.

Monday, August 17, 2009

2009-08-17T14:38:00.000-07:00

All systems are go with Tommy, and he continues to get his strength and his weight back up. Today was the last session with Scott, the physical therapist from PRMC's home health-care network. Now that Tommy is finished with home health care, he will get help at outpatient therapy for a month, and possibly longer. He has almost worked his way back to where he was when his liver problems happened during the spring and early summer. After the last few months, we are both still having trouble believing that we can relax and begin to enjoy summer!

Friday, August 14, 2009

2009-08-14T18:42:00.000-07:00

This week, Tommy again gave blood for the follow-up to the endoscopic gall-stone removal procedure in June, to make sure that his liver enzyme numbers were getting back to normal. Today we got the results, and we were thrilled to see that all of the numbers are now back down in the normal range. For example, the normal range for alkalyne phosphatase is 40-129 units per liter. Prior to the procedure, that number had skyrocketed to 877; it is now 120. To celebrate, Tommy said he wanted to drive down to Ocean City for crabcakes, so that's what we did for dinner.

Tuesday, August 4, 2009

2009-08-04T05:31:00.001-07:00

Today's photo is a shot of Tommy with his occupational therapist, Megan. That green blob in Tommy's hand is basically "silly putty" (it's called Theraputy--no kidding--when it's sold for three times the cost of the kids' version and used to help people improve their hand and finger coordination). Tommy's job is to roll it with both hands, pull it like taffy, roll it into a donut and then stretch it thinner by putting it around his cupped fingers, or flatten it out like a miniature crust for a pizza (which he's doing in the photo). Yesterday was Tommy's last session with Megan, who said that Tommy is doing great and that he and I work very well as a team. Yay. We learned a lot from Megan and will miss her.

Thursday, July 30

2009-07-30T05:29:00.000-07:00

On Tuesday afternoon, Tommy got a beard trim (much-needed...I told him he was too young to look like Gabby Hayes). Kirsten (who will be Tommy's home-health-care aide for a month, maybe more) did a great job. Next Tuesday, Kirsten is going to cut Tommy's hair, and she is teaching me in the process. Her husband trained to be a barber and has taught her; she says he doesn't have a barber shop yet but hopes to eventually open one. Kirsten is also a barrel of fun. What a treat.
Yesterday, Tommy saw Dr. Giddins, his new primary-care doctor. She told Tommy several times how great he looks and that unless something else comes up she wants to see him in the usual three months. Everything turned around for Tommy when he saw Dr. DeMarco in Salisbury on July 13 for that emergency "second opinion" on his inability-to-urinate-at-all problem, and Dr. DeMarco took care of that by irrigating Tommy's bladder. During that same visit, his nurse, Jeanne, told me that there is a doctor named Dr. Giddins who is affiliated with their hospital (Peninsula Regional Medical Center, or PRMC, in Salisbury) who has an office right next to our post office in Ocean View! Dr. Giddins saw Tommy two days later, and she helped Tommy get over the pain hump (including making a call to Dr. DeMarco's office while we were there, which was the kind of communication that had not been happening with so many of the doctors we had previously been seeing). Finally, we could get some sleep. Dr. Giddins also called in the home-health-care troops from PRMC (which will now be our hospital of choice), and so for the past week these folks have been getting Tommy back up to speed: Mariel, the R.N. (who helped me with the fine points of catheter/bladder-irrigation techniques); Scott (physical therapy, who has a garage full of boats so he and Tommy are instant pals); Megan (occupational therapy, who finally solved my longtime problem of how to keep the bathroom floor dry during the shower when the shower bench sticks out into the room); and, of course, Kirsten.
In the spring, Irv, Tommy and I agreed that our big project this summer would be to go surf fishing. So, Irv and I got Irv's pickup truck registered and ready for us to take Tommy surf fishing. Now we can finally start to think about that!

Monday, July 27, 2009

2009-07-27T05:00:00.000-07:00

We can now safely say that Tommy is out of the woods. The last couple of days, his entire food-and-water-processing system has stabilized and he has slept soundly through the nights. Yesterday morning, I asked him how he felt, and he said, "Like a new penny." What a hassle we've had since he went to the hospital on Memorial Day weekend--first the gall stones, then that horrible bladder problem that came out of left field. But now it looks like we can move on. Yay.

Thursday, July 23, 2009

2009-07-23T05:55:00.000-07:00

Yesterday, it looked like Tommy was going to get through the voiding trial without a hitch--after the catheter was removed in the morning, he was able to urinate several times during the day with no pain. However, last night he tossed and turned for several hours; only after I gave him a pain pill was he able to sleep. Fortunately, the visiting nurse is coming today. Two steps forward, one step back.

July 22, 2009

2009-07-20T19:50:00.000-07:00

In two days, Tommy will have a "voiding trial" to see whether his water works come back on line when the catheter is removed. The trial will require two appointments--one in the morning and one in the late afternoon. Dr. DeMarco's urology practice is in Salisbury, but on Wednesdays one of his colleagues comes right here to Millville, to the same suite of offices where Dr. Giddins has her office (these doctors are all affiliated with Peninsula Regional Medical Center in Salisbury, rather than with Beebe Hospital up in Lewes). So, on Wednesday, Tommy will visit the doctor twice--and it's only five minutes away. Yay.

Thursday, July 18, 2009

2009-07-16T07:27:00.000-07:00

Overall, the past week was very difficult--no sleep turns us both into zombies--but gradually things are looking up a little. Tommy's inability to urinate was such an unexpected problem after that endoscopic procedure--and then, even when he had a catheter, he still was unable to urinate a lot of the time because the catheter was getting blocked up. It was difficult on several levels--I ended up getting that second opinion from Dr. DeMarco (very good move), who saw Tommy immediately on Monday; and Dr. DeMarco will now be Tommy's urologist. Then, yesterday, I changed Tommy's primary-care doctor (a huge move, but necessary for a growing list of reasons); and together, the new team is beginning to move us past this impasse. Tommy saw the new doctor, Dr. Giddins, yesterday; and after conferring with Dr. DeMarco's office, she prescribed a pain killer for Tommy so that he can sleep. Dr. Giddins also lined up a visiting nurse, a physical therapist, an occupational therapist and a bathing aide; each of them will come twice a week for a month and possibly longer. The home-health nurse is coming today, sometime between 12 and 1.
This month, I especially thank my lucky stars for Gaie (for her invaluable phone support) and "the three Musketeers" (Irv, for his unflagging help; Steve, for making it possible for me to attend the wedding in Michigan of my godson Jesse; and Marshall, my brother, who came for nine days and helped in myriad ways, including yeoman chef service).

Tuesday, July 14, 2009

2009-07-14T09:45:00.000-07:00

After a very rough Sunday night, due to Tommy's bladder shutting down (it turned out to be a clot/obstruction where the bladder drains out into the catheter tube), the "second opinion" urologist agreed to see Tommy yesterday morning if I could get him over to his urology team's home office in Salisbury, Maryland. Thank goodness for that. The urologist, Dr. DeMarco, who is very good, got up to speed with Tommy's overall medical situation amazingly quickly. Just as Dr. Caruso had done with Tommy's difficult liver-enzyme problem, this doctor immediately laid out a treatment plan that was just what I had hoped for. Then, to allow Tommy's bladder to drain, he and his nurse, Jeanne, irrigated it using something Jeanne compared to a turkey baster, insterting its tip into the outside end of the catheter hose and sending up a stream of distilled water. Out came the bladder's contents, and Tommy didn't float away after all. Then Jeanne showed me how I can do the same procedure at home if his bladder gets stopped up again and handed me a turkey baster to take along. Now to the plan. This Friday, I will take Tommy to Peninsula Regional Medical Center in Salisbury for a renal sonogram and also some blood work. If all looks okay, then next Wednesday, Tommy will see one of Dr. DeMarco's fellow doctors, who comes to Millville once a week to see patients. Tommy will go in the morning. and then again in the late afternoon, for a "voiding trial"; the catheter will be removed in the morning, and then--it is hoped--by the time Tommy comes back in the afternoon, he will demonstrate an ability to send that urine out of his body through his own hose. Dr. DeMarco was careful to warn that sometimes, when a patient, in recovering his functions after anesthesia, loses the ability to control the bladder's functions, it never returns at all. But we have to try. In the meantime, Tommy (and I) had a much-needed good night's sleep last night, and things with the catheter went swimmingly while he slept.

Friday, July 10, 2009

2009-07-10T05:24:00.000-07:00

Yesterday, I took Tommy to Lewes for his appointment with the urologist (actually, the urologist's nurse practitioner), who was recommended by the emergency room doctor who put in Tommy's second catheter last week. I thought this would be a relatively straightforward procedure; i.e., that the nurse practitioner would take out the catheter and give us strategies and exercises to help in getting Tommy back to normal so he can urinate. But, instead, he ordered a total workup of Tommy's urinary system...tests, blood work, CT scan at the hospital of Tommy's one kidney... instead of being removed, he said, the catheter would have to stay in for more than a month longer. That delay is worrisome, because if Tommy's problem is neurological--i.e., if something about the endoscopic procedure such as anesthesia temporarily shut down his brain-to-bladder connection, then it seems possible that the longer the catheter remains in, the more difficult it will be for Tommy to relearn how to control that function. In any case, this morning I found out that there is a urologist right here in Millville, and so I have booked Tommy to see him on July 22 for a second opinion. I've never gotten a second opinion before, and if this doctor agrees that the catheter needs to stay in for another month and that all these other tests must be done, so be it. At least this urologist is only five minutes away rather than almost an hour away (I wish the emergency room in Millville had recommended him in the first place!), so it will be worth the extra effort.

Thursday, July 2, 2009

2009-07-02T15:48:00.000-07:00

Tommy's enzyme numbers (I took him to the blood lab Tuesday and they came back yesterday) look really good. After a steady and alarming rise since at least December, they have dropped significantly since the endoscopic procedure last week, when Dr. Caruso, the gastroenterologist, pushed out a bunch of gall stones from Tommy's bile duct. So, clearly the gall stone obstruction in the common bile duct was a large cause of the problem--maybe the whole cause (my fingers are crossed). So these lowered liver numbers are exciting. Dr. Caruso will talk with us tomorrow or Monday and he will tell us what the numbers mean and what needs to happen next.
There has been a problem this past week and a half, but nothing on the order of the liver problem. It's with the urinary system. Tommy's bladder hasn't gotten up and running since the procedure, so it's been on-again, off-again with catheters. I had to take Tommy back to the emergency clinic last night to get his second catheter since the procedure--he couldn't have gone through the night without floating away. This catheter will be removed late next week at the urologist's office in Lewes.
Thank goodness, during the summer we have an emergency room right here in tiny Millville--it's a tourist-season outpost of Beebe Hospital in Lewes. It's only a five-minute drive that would otherwise be an hour's drive up to Beebe.

Friday, June 26, 2009

2009-06-26T09:29:00.000-07:00

Tommy came through the endoscopic procedure on Tuesday very well, except that he had a reaction to the anesthesia afterward and needed a catheter. That's working out okay and the plan is that it will be removed on Monday. During the procedure, Dr. Caruso got the endoscope down to where the common bile duct meets the intestine; he expected to find a 1-cm. gall stone that had shown up on the tests last week, but that gall stone was no longer there. However, there were numerous smaller gall stones, so Doctor Caruso made a small incision at the junction to allow some of them to pass through. On Tuesday, Tommy will again give blood for a liver panel, to see if the enzymes have come down. If not, Dr. Caruso will look more closely at the liver itself (possibly, a liver biopsy) for the cause of the problem. The good news is that the MRI and the MRCP showed no sign of liver cancer or cirrhosis of the liver. So, at this point, we know there is inflammation, but we don't know why. This weekend, Steve is hanging with Tommy, as I am attending the wedding of my godson Jesse in Michigan. I asked Tommy on the phone this morning if he's having fun with his son, and he said, "Oh yes...he's like an old wife." Steve says that the two of them had a good time watching wrestling on tv last night and that when Steve asked him if he and I ever watched it, Tommy said no. Ugh--that's for sure. So things are looking up for now.

Monday, June 22, 2009

2009-06-22T05:01:00.000-07:00

Tomorrow is G Day--gall stone day--the day for Tommy's outpatient surgery at Milford Hospital. At 1:00 today I must call the hospital to get the official time for the surgery. Dr. Caruso's office said last week that it is scheduled for 3:00, but the hospital won't confirm the time until this afternoon. If all goes well, he should be home before dark tomorrow evening. Although Tommy is really tired this week (he hasn't walked for more than a week and his voice is very weak), he isn't in any pain and his appetite is better than it was last week. He was really happy to hear from his kids on Father's Day, even though he was pretty much whispering into the phone. So he's hanging in there, but it ain't easy.

Thursday, June 18, 2009

2009-06-18T15:31:00.000-07:00

Due to booking issues, the date for Tommy's surgery has been changed from next Monday to next Tuesday. Yesterday, we spent the afternoon at Milford Hospital (an hour's drive north) for Tommy's preadmission appointments--three different meetings--first with the screener, then the o.r. nurse, and then the anesthesiologist, Dr. "Lisa". (Like Tommy's primary-care doctor, Rajshekar Narasimaiah, she has become known by her first name because her last name is hard to remember.) Last night was rough, as Tommy was tired and also had digestive problems; but today he rebounded, with fifty arm pulls on the wall pulley and 450 foot strokes on the pedal exerciser. Because the bile-duct obstruction is affecting his ability to process fat, his diet is heavy on soups and stews, with no meat but lots of seafood and beans.

Monday, June 15, 2009

2009-06-15T07:46:00.000-07:00

Just got a call from Dr. Caruso's office; the surgery is scheduled for the afternoon of Monday, June 22.

Monday, June 15, 2009

2009-06-15T05:41:00.000-07:00

Today, we should learn the plan for Tommy's surgery from Dr. Caruso's office. He is aiming for Friday, and his office is in touch with Tommy's neurologist, Dr. Peet, to make sure it's okay to stop Tommy's daily aspirin beginning this morning (so that his blood will not be so thin during the procedure). The diagnosis for Tommy's condition is Bile-duct obstruction; specifically, a stone about 1 cm. in diameter is blocking the common bile duct, which--among other problems--could result in damage to the pancreas if not taken care of quickly. The technical name for the procedure, which the health-care folks call ERCP for short, is Endoscopic retrograde cholangiopancreatography. After Tommy is anesthetized, Dr. Caruso will thread a flexible tube (an endoscope) into his digestive tract to where the common bile duct enters into the upper portion of the small intestine (the duodenum). There will be a cutting device attached to the tube. Dr. Caruso will insert the tube through the entrance of the bile duct, and enlarge the entrance to permit passage of the obstructing stone.
Tommy is unusually tired these days, and I'm sure it's because of the bile-duct obstruction; I am so eager for this surgery to get done so he can get back in the groove. I just hope that's the only problem in that part of his body and that there are no complications. He also has lost his appetite (very rare for him), which is another symptom of the obstruction, so I am trying all the time to get him to eat. I'll just be glad when all this is behind us!
On a brighter note, Tommy did some pedaling yesterday (he hasn't had enough energy to do any walking for several days now), and then in the evening, which was gorgeous, we sat on the couch on the back porch. I put his feet up on the foot-rest, and I stood at the other end of the porch, and we played catch for at least a half-hour with the big orange ball--Tommy was awake and a pretty good aim the whole time, and the dogs kept trying to horn in on the game which made us laugh. So that was a pleasant rebound on Tommy's part.

Friday, June 12, 2009

2009-06-12T11:02:00.000-07:00

This morning Tommy and I headed out to get the tests done that Dr. Caruso ordered. We left the house at 6:15 for Beebe Hospital up in Lewes. There, in a single session, Tommy was given two separate tests--an MRI, and also an MRCP (similar to an MRI, and also non-contrast, but targeted more closely at the biliary system-and-liver region than the MRI). On the way home, we stopped at the Beebe system's walk-in blood lab for the blood test (to get Tommy's current liver numbers). When we got home, Dr. Caruso had already called and wanted to discuss the results of the MRCP, which had just been phoned to him (he is a really good doc). Dr. Caruso says the MRCP shows a significant gall stone (about 1 cm. in diameter) in the common bile duct, and he would like to remove it at the hospital at Milford Hospital late next week. His office is contacting Dr. Peet (Tommy's neurologist) to see if it will be okay to stop Tommy's daily aspirin tablet starting Monday, to minimize the chance of hemorrhaging during the procedure. Basically, Dr. Caruso will go down Tommy's throat and digestive system with a high-tech fishing rod and find the stone and somehow get rid of it. Tommy should be ok to go home later in the day unless there is a complication (pretty rare). So, by the end of Monday, we should have a plan in place.

Thursday, June 11, 2009

2009-06-11T08:07:00.000-07:00

Yesterday afternoon, Tommy saw the gastroenterologist, Dr. Caruso, who ordered an MRI/MRCP (a pair of non-invasive tests) for first thing tomorrow morning up in Lewes ( we have to leave at 6:15 in the morning...that should be interesting). He also ordered more blood tests, also to be done tomorrow. I am relieved at least because Dr. Caruso is good and it was obvious during the appointment that he is focused on the case and has taken a good look at Tommy's history. Dr. Caruso says that the various indicators of Tommy's problem in the liver/biliary system region are very complex and the pattern is unusual and therefore difficult to diagnose. If the tests tomorrow don't make the problem clear, then he will order a liver biopsy. Dr. Caruso made it clear that he will see it through--all of which was missing for the past few weeks while the various doctors who are involved all saw something different in the tests, and the wheels were spinning.

Friday, June 5, 2009

2009-06-05T08:12:00.000-07:00

Tommy is still not out of the woods; his liver enzyme numbers continue to climb. The doctors have been going around and around about whether the problem is with gall stones or with the liver itself. (If the problem is with the liver, it's probably far more serious.) Dr. Raj (Tommy's primary-care doctor) said for weeks that he thought it was a bile-duct obstruction. Then, Dr. Portz (the Beebe Hospital emergency-department doctor, who saw Tommy on Memorial Day weekend) said that Tommy had acute gall stone disease and that he should see a surgeon immediately. First thing after the holiday, I took Tommy to see the surgeon, Dr. Tatineni; but after reviewing the countless tests that had been done up to that point--numerous blood-work reports, MRI, X ray, ultrasound, diagnosis from Dr. Portz--Dr. Tatineni said no, Tommy may have gall stones but they're "innocent bystanders" and the problem is with the liver. Dr. Raj and the surgeon then talked, after which Dr. Raj called us to say that he now agreed with the surgeon. The surgeon referred Tommy to Dr. Caruso, the gastroenterologist; but when we got to that appointment, it was actually with Dr. Caruso's nurse-practitioner, Kelly. She ordered more tests, but this was clearly a situation where we needed the specialist, and I insisted that Tommy see Dr. Caruso as soon as possible. So, next Wednesday Tommy will finally see Dr. Caruso, and I'm hoping he will come up with a diagnosis and a plan as soon as possible.
Meanwhile, though, Tommy has no symptoms of stress in his liver or biliary system (no jaundice, elevated temperature, nausea, loss of appetite, etc.)--which is heartening. Yesterday and this morning, he has been right on target with his physical and speech therapy (we have been doing 30 minutes a day of speech therapy to help him get his voice stronger). Please, if you are reading this entry, give a call and talk with Tommy on the phone (late afternoon/early evening is best--302-539-8079). Talking on the phone, not to mention hearing from friends and family, is great therapy for him!

Wednesday, May 27, 2009

2009-05-27T05:30:00.000-07:00

Took Tommy to see the surgeon, Ramakrishna Tatineni, yesterday morning. He has put Tommy on a careful diet for now and has directed him to get more blood work (this morning), then to see the gastroenterologist (Friday afternoon, up in Lewes), then back to see him next Tuesday morning. By then, we should have a game plan. Meanwhile, on Monday, we had our first cookout of the season, with Patti bringing the baked beans and butternut cake, Frank bringing snacks and wine, Irv bringing the muffins and grilling the ribs, and me providing the first local asparagus and tomatoes of the summer. It was wonderful to have friends over and now we're catching up with our naps--between medical expeditions and physical-therapy sessions, that is.

Sunday, May 24, 2009

2009-05-24T05:28:00.000-07:00

We had a scare yesterday--Tommy awoke vomiting & with severe constipation, etc.; so, to make a long story short, we spent the whole day at the emergency department at Beebe Hospital up in Lewes. The upshot, after a bunch of tests (and a favorable outcome regarding the constipation) is that I have to call the surgeon on Tuesday morning so that gall-bladder surgery can be scheduled. The official diagnosis is acute cholelithiasis, but the condition is better known to us lay people as gall stones. Tommy's CT scan a month ago indicated gall stones, but Dr. Raj had hoped the condition would clear up; unfortunately, though, it has worsened. At least Tommy was able to come home with me last night. The good news is that Tommy's liver, heart, lungs and intestines all looked basically healthy in the CT scan. Anyone who knows Tommy's history with Budweiser will be as surprised as I was at the fact that "there is no evidence of hepatomegaly or fatty infiltration of the liver." What a day!

Tuesday, May 12, 2009

2009-05-12T15:35:00.000-07:00

I didn't know what I was going to slug this entry. But when the moment came, I typed in "We love spring". Then I turned around and said to Tommy, "Do we love spring?" "Yes," he said. "Why?" I asked.
"We got so much ahead of that."
"Like what?"
"Like warmth and sunshine."
Ah yes, warmth and sunshine. We have enjoyed sunshine all day--and in the spring, the sunshine is just right. Right now, for example, we are finishing dinner at the dining-room table, which faces west; so sunshine is pouring in through the front windows. This morning, we did our physical-therapy session on the back porch, which was also bathed in sunshine because it faces east. In this morning's session, Tommy set a new record with 12 minutes of pedaling. I know why he's doing so well with his pedaling: last week, I told him that I would do my free-weight arm lifts in tandem with his pedaling, so that every time one of his feet goes down, I have to lower the five-pound weight on that side and lift the opposite weight above my head. In effect, this arrangement has given Tommy control over my arm exercises--it has turned the tables and made him my trainer instead of me serving as his trainer. And seeing me sweat bullets lifting weights has motivated him to work harder at his pedaling. This morning, for example, as he kept pedaling instead of stopping at the ten-minute mark (for the first time), and as he watched me struggling to keep up with him for those two additional minutes, he was laughing. Ah, the things we do for love. But hey, it is spring, after all.

Thursday, April 30

2009-04-30T15:39:00.000-07:00

We have added another component to Tommy's daily physical-therapy sessions: A pair of five pound free weights. After Tommy pedals (usually for about six minutes), walks with the walker (eight or ten "laps" across the porch, sometimes more), and pulls the arm exerciser that is mounted on the wall (50 pulls), we do arm lifts together. Ten lifts per arm, each a lift of only several inches, is enough right now; but it's a start. Yesterday we had dinner with our friend Frank at the Crabcake Factory, and this weekend we will share a potluck meal with Mary and Al, our friends from Ren rehab. And with the spring weather, we have been enjoying the back deck with Irv and Patti. These are good days.

Tuesday, April 21

2009-04-21T16:46:00.000-07:00

The news on Tommy's CT scan is fairly good. Dr. Raj says that there appear to be small gall stones obstructing some flow in the bile ducts. Tommy's elevated liver numbers may be caused by these gall stones (which might disintegrate on their own); or the elevated numbers may be caused by one of the medications Tommy was taking, Gemfibrozil, which Dr. Raj discontinued several weeks ago. In six weeks, Tommy's blood will again be tested, and if his liver panel hasn't improved, he will probably need to see a surgeon.

Sunday, April 19, 2009

2009-04-19T05:35:00.000-07:00

"You didn't know you were gettin' hung up with a river rat, did you?" These were Tommy's first words to me this morning when I poked my head into the bedroom to see if his eyes were open. It's still true, after all these years, that Tommy has the most colorful language of anyone I've ever gotten "hung up" with!
It's been a good week and a bad week. On the good side, Tommy is walking up a storm on the back porch--yesterday he set a new record of 12 laps (each lap is a trip from one end of the porch to the other, with walker and Connie). On the bad side, Tommy's second blood test again indicated elevated numbers in his liver panel--in particular, the alkalyne phosphatase and the GGT--and when those numbers are elevated, the most likely cause is some kind of obstruction in the bile ducts (such as gall stones, or a tumor, or scar tissue). Consequently, Dr. Raj ordered a CT scan, and I took Tommy for that on Friday; so we should hear tomorrow from Dr. Raj whether we're any closer to solving that mystery.

Saturday, April 11

2009-04-10T23:37:00.000-07:00

Last week Tommy was discharged from outpatient physical therapy, so now Tommy and I do daily therapy sessions on the back porch. He has the same basic routine that he had in outpatient therapy: arm exercises and eight minutes on the pedal exerciser, followed by "laps" back and forth on the porch using the walker. Twice this week we met friends for lunch at local restaurants, and we get out for errands every afternoon. He has up days and down days, but overall he continues to improve in his "don't want to rush into anything" way.

Wednesday, April 1, 2009

2009-04-01T04:49:00.000-07:00

It's drizzling and cold on this, the first day of April, as spring flirts with winter and Tommy continues to progress slowly but surely. He still goes to physical therapy three times a week, where he rides the stationary bike, walks back and forth along the "kitchen counter" and walks with his walker with Jenna at his side. On sunny days we spend a lot of time on the back porch, where Tommy watches the ugly houses go up across the creek with his binoculars or snoozes on the couch. On Monday, he saw Dr. Raj, who said that Tommy's lab work from last week shows continuing improvement except for a spike in his liver enzymes. This appears to be a result of one of the drugs Tommy has been taking (Gemfibrozil), so Dr. Raj discontinued that drug and Tommy will have some more blood drawn next week to see if there is an improvement. If not, Dr. Raj will send him to a specialist. For the first time, Tommy was able to step up onto the scales, with help from the nurse and myself, and he now weighs 156 (his weight was more than 200 when he had the stroke). Dr. Raj says that is a good weight for him. I knew that Tommy had lost weight, but when I'm getting clothes for him I still have to remind myself that he no longer wears size XXL shirts!

Sunday, March 22

2009-03-22T19:25:00.000-07:00

Overall, Tommy continues to improve, although he was unusually tired this week--why, I don't know. He is still going to physical therapy three times a week, and he didn't do any walking this week, which is a definite slowdown from the progress he has been making in previous weeks. Hopefully, this week he'll be up to speed again. The weather is turning to spring, and several times over the past couple of weeks we have gone to the boardwalk at Bethany Beach, where I usually walk a mile and a half while pushing him ahead of me. But today, Tommy spent most of the day snoozing on the back porch.

Saturday, March 7

2009-03-07T04:30:00.000-08:00

My blog entries are not as frequent, and that's because everything is going well. Last week, Gaie came to visit during spring break at Eastern Michigan University, where she teaches nursing. Her visits are always wonderful; she teaches me so much about how I can help Tommy better (plus the end-of-winter sales at the Rehoboth outlets are under way).
Last week, Tommy "graduated" from Beebe's outpatient occupational therapy with Jennifer, because she says that he has met her goals for him. They include dressing himself (top half), grooming and other basics of everyday living. Jennifer is a terrific therapist and helped Tommy a lot in learning those tasks. Tommy continues to go three times a week to physical therapy, where he spends a lot of time walking with the walker (under the supervision of either Tim or Jenna). He is getting stronger and, two days ago, with me assisting, he walked with the walker from the dining-room table out to a chair on the back porch to sit in the sun. We go out for errands together every afternoon, and we sometimes go up to the Bethany Beach boardwalk for an ocean fix.
A couple of days ago, we called Tommy's daughter, Karen, to wish her a happy birthday, and Tommy had a long conversation with her about boats and engines, an interest they share. Talking on the phone is a really good thing for Tommy, and he enjoys his frequent phone calls with his kids, sisters and friends. If you haven't called him lately, please give a call one of these days around dinner time (302-539-8079). Promise: If you call him, we'll make the next call back to you!
On the last Thursday in February, we attended the first meeting of a newly formed stroke-survivor support group, which was organized by Beebe speech pathologist Holly Sullivan and held at the Tunnell Center, up near the Rehoboth outlets. Mary and Al were there, as were a dozen or so other stroke survivors and their caregivers. It was a good meeting, with everyone getting to know each other. When Holly asked everyone to tell the group what their hobby is, people said things like gardening, reading, taking care of their dogs...until it came around to Tommy, who said "sex." Oh, Mr. Long--behave!

Tuesday, February 17, 2009

2009-02-17T10:31:00.000-08:00

Jack and his friend Danny came for a couple of days to see Tommy, and of course Tommy was delighted to see his old pal. This morning, Jack prepared one of his legendary breakfasts--smoked bacon from the Family Butcher Shop, fried potatoes and onions, eggs over easy, toast--the works. It was a definite departure from the more austere diet that Tommy and I have been following, but what the hey. Jack promised that when he comes back this summer for some fishing, he'll make his pancake and sausage breakfast; if we stay with oatmeal until then, we should be okay for another splurge. Meanwhile, Tommy continues slow and steady progress at outpatient therapy. Yesterday, at the end of his physical-therapy session with Jenna, he walked out to the car for the first time using his walker and with Jenna and aide David at his sides. Big achievement.

Thursday, February 5, 2009

2009-02-05T05:34:00.000-08:00

Yesterday Tommy was feeling a little stronger, thank goodness. I took him to see Dr. Raj, who said that he shows no signs of a significant downturn and that it's normal, after his two-day interlude at the hospital, for him to be tired for a few days afterward. My fingers are crossed that this is the case. Lovely morning here--we're socked in with real snow, a rare treat. I couldn't get the sliding door to the dog run open this morning because it was frozen shut. It's sunny and the fluffy snow is being blown in little whirlwinds, a lovely sight. Tommy will resume his outpatient therapy tomorrow (I'm not sure I would have been able to get him there today anyway), so this will be an at-home day. On the menu: homemade applesauce and lentil soup.

Tuesday, February 3, 2009

2009-02-03T08:01:00.000-08:00

I got Tommy home and to bed late Saturday night. He will see Dr. Raj tomorrow--the doctor wants to see him before allowing him to resume physical and occupational therapy. That's a good thing, because the hospital visit seems to have sapped him of momentum and strength. I am hoping that's all it is--one step back due to all the rigamarole. Yesterday Tommy's longtime friend and boating buddy Frank came over to visit, and Tommy barely said two words. A rough patch.

Saturday, January 31, 2009

2009-01-31T07:11:00.000-08:00

Yesterday was a very difficult day, but it looks like things are working out. It all started when Tommy was at rehab and I was down the street grocery shopping. One of the therapists called me on my cell phone and said they thought Tommy might be having a stroke; he had complained of pain, seemed weak on his left side, and wasn't speaking. The next thing I knew I was following the ambulance up the ocean highway to Beebe hospital in Lewes, talking with my sister on my cell phone for moral support. But although the hospital has kept Tommy overnight, the doctors think he's okay. What a day, sitting with him in a little emergency-room cubicle for nine hours. Thank goodness it was pretty apparent to me within a short time of arriving there that, whatever had happened, he seemed basically okay--he was talking to me and was responding appropriately (although he did tell the neurologist that he's 53 and left-handed...). The results of the CAT scan and MRI that he was given during the afternoon showed no sign of new damage. This morning, he will be given another CAT scan and MRI, and if the results are the same he will come home later in the day.

Wednesday, January 28

2009-01-28T04:26:00.000-08:00

Something weird happened around the time of the tooth-fragment-that-didn't-get-pulled fiasco in December; life at Lazy Lagoon seems to have gone into warp speed. Now it's almost the end of January and somehow I'm still turning the corner into the new year. Tommy continues to go to therapy at Millville rehab--three times a week for two hours. He is improving slowly but surely--more overall strength, better appetite, same salty sense of humor. On Sunday, Tommy's sister Elaine and her hubby Alan visited, and we had a nice, low-key afternoon of reminiscing and comparing notes about Medicare hassles. Although Tommy listened to the conversation, he didn't have a lot to say (my theory is that he clams up when he's confused, which happens fairly often but doesn't last too long).
Meanwhile, there's been a huge change in the way we eat. Since Tommy's stroke, he has been on a low-sodium, low-fat, low-sugar diet, and since he came home in November we have both been eating that way. In order to give him this diet, I began reading the FDA-mandated labels on all packaged or processed food at the grocery store and was floored by how much sodium, fat, and sugar all the "foods" contained. My first question was: What is this "high fructose corn syrup" and why is it the main ingredient in so many foods of other names (answer: it's cheap unhealthy filler, aka junk). As a result, we now eat what I will call "scratch" foods--almost nothing from the cans and boxes that fill those middle aisles of the store--and instead of sugar Tommy gets Splenda and I get Stevia (an herb derivative that Tommy finds bitter). The result is that Tommy's blood sugar has improved so much that he no longer needs to take medication for Type II diabetes (he was diagnosed as "borderline Type II last spring, a couple of months before his stroke). Of course, it surely must also help that he no longer drinks beer. His drink of choice, believe it or not, is now perhaps the healthiest beverage a person can drink: Decaffeinated green tea. Go figure. As for the sodium dilemma, I have discovered that a seasoning called Spike (the non-sodium mix) is great as a substitute for salt. I showed Tommy a photo of the two of us from two years ago, and we both looked like a couple on the road to trouble--fat 'n saggy. So, in many ways, we are healthier now than we were back then.

Sunday, January 18, 2009

2009-01-18T09:46:00.000-08:00

Yesterday, we made our first "social visit." We went to see Mary and Al, up in Harbeson, a forty-minute drive (very long for us). Al had a stroke a month after Tommy did, and we got to be good friends at Ren rehab, where we'd often be a foursome for dinner. At first, Al couldn't talk other than saying "No no no", which he did often and loudly; and--as he got better--he started to make short mumbling sounds that sounded like "Rr rr rr" to Mary and me. What's funny is that Al and Tommy both have great senses of humor, and when Al would say something funny, Al and Tommy would look across the table at each other and laugh out loud--something neither had done since their strokes. I will never forget the evening that Mary, for the first time, understood what Al was saying. She and I had been talking about the presidential race (we were on different sides), and Al looked across at Tommy and, with a big smile, said "Rr rr rr"; and the two laughed. Mary turned to Al and said, "You just said we sure talk a lot, didn't you?!" He nodded yes, with great big nods, and we all had a good laugh.

Thursday, January 8

2009-01-08T06:39:00.000-08:00

Tommy is now officially enrolled in what I'll call Millville rehab. A well-staffed and -equipped storefront gym, it's a branch of Beebe hospital in Lewes, which is about 45 minutes away. (Millville rehab has some sort of proper name, but the names that these health-care facilities have are almost never descriptive and almost always forgettable.) Thankfully, Millville is Sussex County's closest town to us, and Millville rehab is only about five minutes away in the small shopping center next to the Food Lion.
Yesterday morning, Tommy was registered by David, the therapy aide, and then evaluated by Jennifer, the occupational therapist, and Tim, the physical therapist (this is Tommy's second physical therapist named Tim; it was Tim at Ren rehab who got him walking in the hallways). Tommy was responsive but tired. He went through a series of interesting tests with Jennifer that involved squeezing and grasping various precision instruments that looked like something a surveyor would use. Toward the end of the two hours, he walked the length of the compact gym with his walker (he's still a mid-assist, which means he walked with Tim assisting and David following with the wheelchair). Today, he has an OT session, tomorrow a PT session, and then for several weeks we'll go there three times a week.

Wednesday, January 7, 2009

2009-01-07T03:23:00.000-08:00

It's 2009? You're kidding. Where did Christmas go? Yes, Matilda, the second half of 2008 is kind of a blur. Let's review: Tommy had his stroke in June; then he was a week in the hospital; then he spent a month at an acute rehab center an hour's drive north (where I stayed all day every day and often overnight while our friend Irv ran and fed the dogs for us); then he had three months in a rehab place a half-hour drive north of here, where I went every day; and then he came home at the beginning of November and we had home therapists every day for several hours (during which time Steve and Jill took our rambunctious dog Sandy under their wings); and then he had his teeth pulled (except for a fragment that gave him trouble right up until Christmas); and now, today, Tommy begins outpatient therapy at a facility only five minutes away. Whew--what a long haul. We have had a lot of family and friends come to visit, and Tommy continues to receive phone calls and cards, so we've had a lot of support. A "big party" for us these days is what we did the other evening--our friends Patti and Irv came over for dinner and a movie, and the main course was a venison tenderloin that Irv brought back from his autumn hunting trip to West Virginia. We were in bed by 9 p.m. '-)
Yesterday was a typical day for us. Tommy spent eight nonstop minutes (a new record) pedaling the cycle exerciser, and he also did a number of other exercises with his legs and arms that are based on the t'ai chi form that I practice. He walked the length of the living room using the walker, with me assisting. He is still on a "mechanical soft" diet, so anything I cook for him gets a quick run through the mini-Cuisinart that Patti gave me for Christmas (thanks, Patti!). As soon as Tommy's new schedule is set up with the Beebe outpatient folks, I will schedule him for a visit to Dr. James, the dentist who will fit him for new teeth. As for me, my heart is still stuck at Thanksgiving, my new favorite holiday. And the Christmas cards I send every year? Hah! I do believe this is the year that I will send Chinese new year cards.

Monday, December 29

2008-12-29T04:30:00.000-08:00

This week is the official end of the Beebe home health people--Linda, the nurse, has been coming once a week to make sure Tommy is coming along okay; and Reva (sometimes, Gail) has been coming twice a week to give Tommy his showers. Now it's just Tommy and me for the showers; but I have learned a lot from watching Reva, an 18-year veteran, so I feel confident we'll do fine. We'll miss you, Reva!

December 24, Christmas eve

2008-12-24T09:27:00.000-08:00

Oh boy. Sometimes you can tell that there's a problem but it takes a while to figure out what it is. That was the case beginning a week or so after Tommy's remaining lower teeth were pulled. It was supposed to take two weeks to heal, at which time Tommy would revisit his new dentist, Dr. James, to get molds made for his new plates. Not.
The problem was where the teeth had been removed, but it was unclear what it was. Tommy had no infection, no elevated temperature, no sign of any problem other than the fact that chewing was uncomfortable along the far right end of the lower gum. The visiting nurse, Linda, and I agreed that a puree diet was in order, and it did help. But, finally, the day before yesterday, we learned what the problem was--on awakening, Tommy showed me with the tip of his tongue a tooth fragment sticking up like a tiny iceberg. Until then, it had been covered by a thin layer of skin, so we hadn't see it hiding out under there. I touched it very lightly; it was very sharp, and Tommy said, "Ow!" In the afternoon, Linda confirmed that it was a piece of tooth or bone sticking up. I called the oral surgeon's office, and they fit him in the following afternoon. I was relieved that the surgeon was seeing him so quickly, but I was also filled with trepidation that the tooth was only the tip of an iceberg and the surgeon would have to open up Tommy's gums again. Thank goodness, it turned out to be only a fragment of tooth that somehow the surgeon had missed, and within ten minutes we were leaving the office (this time, without a stop at the front desk to pay).
We are now ready for a nice, relaxing Christmas. Tonight, Tommy will supervise Marsh and me as we put the ornaments on the tree (our family tradition is to decorate the tree on Christmas eve, although I jumped the gun with the lights a few weeks ago). If you are reading this blog, Tommy would love to hear your voice on the phone (me, too '-), so give a call at 302-539-8079. We will send out cards, but they will be late. For now, we're here quietly celebrating, with thanks in our hearts for all the wonderful things that family, friends and health-care folks have done for us this year.

Thursday, December 18

2008-12-18T05:33:00.000-08:00

After days of gray skies, wind and rain, we again have bright sun this morning--yay. This means that, while Tommy is doing his cycling this morning, we will be able to sit in the sun and enjoy the scent of our Christmas tree and the many bright orange blooms of the hibiscus plants that my pals Susanna, Nancy and Laura brought me last spring. Tommy is temporarily between official treatment plans--after many visits during November and December by the Beebe home-health folks, all but two of them have "discharged" him (Linda and Reva, the nurse and bathing aide, will continue to come through December 30). Then, with the new year, I will sign Tommy up for his outpatient physical therapy. This means that, two or three times a week, we will ride over to the Beebe storefront rehab facility right here in Millville, next door to the Food Lion. There, Tommy will spend a couple of hours with a physical, occupational and speech therapist.
On Monday, we took a ride down to the Assawoman Wildlife Area south of town, our first purely fun "outing" since Tommy came home from Ren rehab, and the forests, marshes and boat landings were as lovely as ever. We both were thrilled to make that pilgrimage to one of our favorite places (Penny too, but we couldn't let her get out of the car because it's hunting season and visitors have to stay on the roads!).
Yesterday we had visits from Irv and Frank, and tomorrow Steve will arrive with our number two dog, Sandy. I am so grateful that Steve, Jill and the kids took care of Sandy while all those home-health people were coming and going, because Sandy is still rambunctious and it would have been chaotic to have her here for all that excitement. A huge thank-you, guys!

Wednesday, December 10

2008-12-10T06:00:00.000-08:00

We're doing fine here; it's still a steep learning curve for me, but I'm getting the hang of it. Letting a natural routine emerge is the key, I think. That way, things get done naturally. Irv and I got the Christmas tree in from the deck last weekend (Tommy and I had a live tree with a root ball last Christmas, which we bought at the country store south of town, and which spent the better part of this year on the corner of the deck). I already have the lights on it, and Tommy and I enjoy it every evening twinkling out there on the porch. It will be the centerpiece on Christmas eve, when we will have a very casual open house, with the usual suspects coming by as well as a few new friends we've made this year at the thrift shop, library and Ren rehab. And, needless to say, if you are reading this blog, you are invited! Please let me know if you'll be in town and can come (Frank?).
Minor change of December plan: It turned out that, although Tommy's lower gumline healed well, the experience took several days of steam out of Tommy's system. He slept a lot and even now has more trouble than usual getting his right foot to pivot on command, which is a necessary skill during "transfers" from bed to wheelchair, etc. (One of the key problems Tommy has been working on since the stroke is getting commands from his brain to his right leg and arm.) In fact, the whole teeth-pulling project was like, well, pulling teeth. So, Tommy has decided that he wants to wait until after the holidays before doing anything about getting his new set of teeth. He says that he actually likes his ancient and worn upper plate and, not only that, he says that he actually likes using his lower gums to chew (as long as the food is softened, but by now I'm an old hand at that).

NOTE: The best time to call Tommy is now probably between 7 and 8 in the evening. Another good time is between 11 and noon. From around 3 to 5, Tommy usually takes a nap. Of course, any time you want to call, please do (302-539-8079), since you can always leave a message and we'll call back later. We're nearly always home but, if not, leave a message and we'll call back soon.

Thursday, December 4

2008-12-04T06:30:00.000-08:00

Our Thanksgiving was wonderful--my sister, Trudy, was in charge of the turkey and stuffing (fabulous) and my brother, Marsh, provided back-up help. During the course of the holiday weekend, Tommy got to say hi to lots of family and friends, including both his sisters and both his kids. Over the past week, Tommy's home therapists have been discharging him from their care, with the recommendation that, after a week or two of rest, he continue therapy as an outpatient. Meanwhile, Tommy now has a daily exercise regimen--swallowing and tongue-strengthening exercises that were written down by the speech pathologist, arm and hand exercises written down by the occupational therapist, and five minutes each of pedal-exercising and walker practice. The last couple of days we've had fun with Tommy's old Erector set (his mom gave it to him for Christmas), which I dug out of the bedroom closet; right now, we're putting together the traveling jib crane (see photo).

Tuesday, November 25

2008-11-25T20:18:00.000-08:00

What a crazy day yesterday, but everything came out fine. Everything, in this case, being Tommy's four remaining teeth, which were front and center in the bottom half. The day-long saga began at 8 in the morning, when we went to Dr. James, who is my dentist. Tommy hasn't had a dentist in living memory, so it was very fortunate that she would see him on such short notice. (There was an air of immediacy because one of the teeth was wiggling loose, and Dr. Raj was concerned that if it came out while he was lying down in bed, he could choke on it.) After a careful examination and an X ray, Dr. James concluded that Tommy needed to see an oral surgeon for the teeth-pulling, because there was a risk of greater than normal bleeding. While we were still in her office, she arranged for Tommy to see an oral surgeon in Lewes later in the day; so, at three o'clock, with me holding his hand to provide moral support (but not doing such a good job--I was trying not to pass out), Tommy sat in a small operating room where he endured numerous needle-stickings by the surgeon and, ten minutes later, the extraction of his four teeth with the use of a formidable pair of pliers. I was only able to watch at the very end, when the surgeon was sewing up the newly naked gums. Tommy has been eating soft foods while his mouth heals, which will take a couple of weeks. Then, he'll go back to Dr. James, who will make him a new set of choppers, top and bottom. He's pretty excited about it, because, in his words, "Then I can eat steak."

Sunday, November 23

2008-11-23T16:49:00.000-08:00

All is going well. Tommy is getting more showers now than he ever did before his stroke. He loves his new pedal exerciser (officially called a "Restorator" by Sammons-Preston). Tomorrow morning he goes to the dentist, who will pull his two loose bottom teeth and then begin the process of making a new bottom plate for him. I'm sure he'll be happy when that's over. Me, too.

Wednesday, November 19

2008-11-19T07:30:00.000-08:00

Following two weeks of ceaseless rain and wind, sunny fall weather has finally arrived. Tommy and I both enjoy sitting on the sun-bathed back porch in the morning and pitching the ball out into the run for Penny. Tommy also watches the occasional passing fishing boat heading out to the inlet, as well as the construction of the weirdly painted town houses that are going up across the creek (so far, we have pink, powder blue, purple and (for the creekside poolhouse) lime green. The builder seems to have a fixation on Key West.
Tommy continues to progress, although since yesterday he has been dealing with ye olde problem of constipation. He was uncomfortable yesterday, but this morning, with several doses of Milk of Magnesia under his belt, plus lots of prunes, broccoli and warm green tea, he's feeling better. Yesterday, when we realized there was a problem, I got good guidance by phone from a Beebe home health nurse; and today, Tommy's visiting nurse, Linda, is coming around 11, and she will guide me further on the best strategy. This afternoon, Stephanie (occupational therapy) will be here, and I will give Tommy a shower under her watchful eye. I am so glad I have the help of the Beebe home-health people, especially since the visit that Gaie scheduled in late September to help me when Tommy came home ended up happening early because his rehab stay was extended (nevertheless, Gaie gave me invaluable help when she was here, plus we had lots of good Scrabble games). My sister, Trudy, is due tomorrow (flying into Philly & driving down) for a couple of weeks' and my brother, Marshall, will join us for Thanksgiving. Tommy's sister and her husband are also coming to visit pretty soon. Tommy is still getting lots of calls and cards from family and friends, so he is getting a lot of warm attention (me, too '-). Irv is going on his annual hunting trip to West Virginia for a couple of weeks starting this weekend...I always like knowing he's in town, but he has promised to bring venison for us, as he does every year. He and I are going to make up a huge batch of venison stew and freeze a bunch of portions. With apologies to Rachael Ray, I can only say Yum-o.

Sunday, November 16

2008-11-16T20:04:00.000-08:00

It's been two weeks and a day since Tommy came home and everything goes well. But it's been busy--there is always a long list of things to get done, and never enough time. It's been raining nearly nonstop since Tommy's return, but finally today we had ample sunshine and blue skies among the high winds and scudding clouds. Very relaxing. Tomorrow Tommy must buckle down for another week of various therapy sessions.

Wednesday, November 12

2008-11-12T17:08:00.000-08:00

Everything is going along well. The Beebe home health folks are coming in various combinations each day; today Tommy worked with Paul and Stephanie (physical therapy and occupational therapy). He keeps getting stronger and more chipper. Yesterday's visit to Dr. Raj went very well. Tommy was happy to see Dr. Raj coming out of his office to shake his hand and tell him that he was looking good--I think that Tommy realizes that a handshake from Dr. Raj means that things are getting back to normal.

Saturday, November 8

2008-11-08T11:20:00.000-08:00

One week with Tommy home, and what a week it's been. Very steep learning curve for both of us. The team that is taking care of him--from the Beebe Home Health Agency--is outstanding. (This agency is affiliated with Beebe Hospital in Lewes, where Tommy was taken when he had his stroke; and Beebe took such good care of him that I figured the home health agency would be very good, too.) Tommy's physical therapist, Paul, has had him walking across the living room using the walker; Paul is also working with Tommy a lot on transfers, because Tommy still has that bad habit of trying to sit down before he has completely finished pivoting. The rest of the team is Stephanie (occupational therapist), Gail (nurse and sometimes aide), Jill (speech pathologist) and Reva (aide). In one week, there have been a total of twelve visits by these folks. A typical day was yesterday: Gail came first thing in the morning and took Tommy's vital signs (all fine); Paul came at 11; then Stephanie and Reva came together after lunch to give Tommy a shower (he did very well). So, all systems are go. Today is a day of rest for both of us. It's odd not to be hanging out with our friends at Renaissance rehab--we miss so many of the staff, patients and patients' families that we got to know there. There are several with whom we now stay in touch--we all hope we'll be able to get together before too long.
The last couple of days, Tommy and I have finally begun to relax a little. Late yesterday afternoon, Tommy was napping and I was on the porch playing with Penny when I heard him call. I went to the bedroom and said, "You okay?" "Yeah," he mumbled sleepily, "I was having a dream." "Was it a good dream?" I asked. "Mm-hmm," he said. "What were you dreaming about?" I asked. "Eatin' ribs," he finally mumbled, as he dozed back off to continue the feast.

Wednesday, November 5

2008-11-05T16:36:00.000-08:00

It's still crazy around here, with so many different health-care workers coming to work with Tommy, and with Tommy and me figuring out our new routine; but it's all good. It's almost five o'clock, and it's the first chance I've had today to sit down and tap out even these few sentences. More to come when I get caught up.
Yesterday was an exciting day, because it was Tommy's birthday--he turned 73--and he received cards from lots of family and friends and got happy-birthday calls from his kids and his sisters. And cake and ice cream for dessert, of course.

Monday, November 3

2008-11-03T07:41:00.000-08:00

I think Tommy is enormously relieved to be home. Every once in a while at Ren, I got him to talk about his feelings, and deep down he was worried about a lot of things, even though he didn't show it much. Steve, Irv and I got him settled at home around noon on Saturday, and, so far, having him home has been manageable but difficult. A temporary setback is to be expected, because each time Tommy has been moved from one facility to another, it has taken him a couple of days to recover from the huge physical and emotional strain. So I expect he'll be more focused and relaxed in a day or two. I have to keep a very close eye on him, because even though he knows he's not supposed to try to get up by himself, he has those confusion issues and sometimes--especially right after he wakes up from a nap and his briefs are wet--he thinks he has to get in to the john by himself. So far, I have caught him early, i.e., while he's trying to inch his feet over the side of the bed, but it's unnerving.
For Tommy's meds, I bought a giant week-at-a-time pill box at Happy Harry's that looks like a Scrabble board, it has so many compartments. It took Steve and me about an hour to figure out how to organize the pills and get the right ones into the right places, but it'll be a lot easier from now on. Steve also installed the grab bars in the bathroom, with Tommy assisting (he held the box of screws, which he handed to Steve as needed). For Tommy's first evening home, I told him I'd make him a welcome-home dinner of his choice, and of course he asked for steak, mashed potatoes, broccoli and a salad. With his loose bottom teeth (which will have to be pulled soon and replaced by a new plate), he can't chew solid meat; so I got filet mignon, which Steve seasoned, grilled and sliced into very thin, small bites. Tommy was in heaven.
Yesterday morning, Steve headed home, taking Sandy with him for a visit; Sandy is a bit too rambunctious to be underfoot while Tommy regains his walking chops. Later, the visiting nurse, Jennifer, came over to assess Tommy's situation and fill us in on the schedule of nurses, therapists and aides we can expect. There will be someone coming here almost every day. Tommy's Medicare/medigap coverage will cover all of it for two months, at which time the degree of his "progress" will be assessed; if he's still progressing, he'll get coverage for another two months.
Last night, too tired to cook a meal, I gave Tommy homemade fish chowder--one of the many frozen meals Gaie made up for him while she was here. I told him, "Last night was your welcome-home meal from Steve and me, and tonight it's Gaie's welcome-home meal." He said, "This is so good. I wish I could thank Gaie personally." I said, well, maybe you can. So I dialed Gaie and Rich's number and gave Tommy the phone, and Gaie answered, and he said, "I wanted to thank you personally for this seafood chowder." It was a wonderful moment. I am so glad to have him home.

Saturday, November 1

2008-11-01T08:50:00.000-07:00

Great Halloween party at Ren on Thursday evening. At least a hundred little kids and their parents came through to trick or treat, and there was a fabulous "haunted house" at the far end of the facility with mummies moving on guywires overhead and scary witches' cackles (although none of those cackles match therapy-assistant Pearl's cackle). Tommy wore a shark mask, and as I wheeled him through the rehab and long-term wings, he drew lots of laughs with his scary "Rr-rr-rr-rr" shark growl (do sharks growl?--who cares). This morning, he's coming home. Steve and I are getting ready to head up there right now. Yay. Stay tuned.

Wednesday, October 29

2008-10-29T19:52:00.000-07:00

Tommy is counting the days until he comes home. Every evening, I take down the small calendar that hangs next to his get-well cards, and he makes an X with a red wax pencil on the day that is just ending. Then, we count how many more days remain before Saturday morning, November first. On the home front, things have been a little hectic getting everything done, but we're getting there. The only blip in the screen the last couple of days was Tommy being Tommy--yesterday evening, he ended up hugging his wheelchair when he tried to transfer to it unattended. Four of the Ren staffers were around him in a New York minute and quickly got him straightened out, but I was, like, a little shaken up myself. Tommy, what were you thinking?!

Sunday, October 26

2008-10-26T10:30:00.000-07:00

A relaxed Saturday yesterday, as everyone feasted on fabulous cake (low-sugar, low-fat) that Mary and Al's daughter had baked to celebrate their 22nd wedding anniversary. After dinner, Tommy had his second and final whirlpool bath, compliments of Stephania, the same wonderful nurse's aide who gave him his earlier whirlpool bath (as opposed to the more-common shower) a month or so ago. Tommy was in heaven as he lay his head back in the tub--which looks like a big white space capsule--with the soapsuds gurgling and churning around him.

Wednesday, October 22

2008-10-22T23:42:00.000-07:00

This afternoon the discharge-care-plan meeting for Tommy was held in the Ren rehab wing dining room. Seated around the table were Meredith, the social worker; Lorie, the head nurse of the wing; therapists Shannon (PT) and Barb (OT), and Tommy and me. The discharge date was firmed up at Saturday morning, November 1, a week from this Saturday. Preparations are going into high gear on all fronts. Equipment is getting ordered and the primary caregiver (me) will get continued training from the therapists and nursing staff on transfers; on getting Tommy in and out of the car; on setting up and following the medication regimen; and on toileting procedures. Tommy will have several visits a week from a home-health-care person and from a physical therapist. I was told to make an appointment with Dr. Raj for the first week or two after Tommy gets home, and that appointment will be Thursday afternoon, November 6.
On the big day, Steve, Irv and Patti will all help with getting Tommy home and settled, and with helping the caregiver unwind with a glass or two of red wine '-) During the meeting, one of the attendees asked Tommy, "Are you excited about going home?" "I sure am," he answered.

Monday, October 20

2008-10-20T06:21:00.000-07:00

All went well over the weekend. We had a couple of very pleasant dinners with Mary and Al. It felt like we were out at a restaurant; there were fall-color tablecloths and centerpieces, and one of the aides, Peggy, had discovered a channel that plays classical music--not Handel's Water Music, but close. At one dinner, we were joined by Ralph, the speech pathologist who has been working individually with both Tommy and Al. Ralph has taught all of us a lot about how to prevent choking, and he's good fun, too. Al and Tommy sometimes look across the table and laugh over something that Mary and I have no clue about, and they had Ralph laughing, too. A memorable dinner. On Saturday evening, one of Tommy's favorite aides, Lu Ann, gave Tommy a shower (see photo, above right) in the rehab wing's well-equipped "spa". The spa has a few pieces of equipment that I am now researching, including the grab bars (both the placement and the lengths), and also the shower wheelchair, which I think is really well designed. At Milford rehab, Tommy's bathroom had a long Rubbermaid bench with removable arm rests--also a very good design, and probably better suited for our needs since we don't have a "roll-in" shower (we can line up his wheelchair with the bench, and then, using a sliding board, we can get Tommy across to the other seat).
On Wednesday there will be a care-plan-after-discharge meeting. The social worker, Meredith, told me some weeks back that one of the therapists will also visit the house to see what still needs to be done to make it Tommy-friendly. This visit will probably be scheduled on Wednesday, and the therapist will be able to answer my questions with a good idea of how the house is set up.

Friday, October 17

2008-10-17T10:28:00.000-07:00

Several friends have asked lately about the best time to stop in and say hi to Tommy at Renaissance rehab. The best time is on weekends in either the morning or afternoon (say, between 10 to 12 in the morning, and 2 to 5 in the afternoon); or on weekday afternoons between around 3 and 5. Mealtime is not the best visiting time, because Tommy still requires the aid of another person, and the speech therapists want him to concentrate on eating and not much else. Renaissance rehab is about a half-hour north of our house. It's on the north side of Rt. 24, the route that runs between Rt. 113 at Millsboro and the "ocean highway" (Route 1); it's just about exactly midway between Millsboro at the west end and the Rt. 1 at the east end. If you have any questions, give me a call at 302-539-8079. If I'm not home, the phone will ring about a dozen times before voice mail kicks in; that's because it's set on "maximum number of rings" to give Tommy time to get to the phone.

Tuesday, October 14

2008-10-14T20:50:00.000-07:00

I have said "small bites" to Tommy at least a thousand times over the last couple of months, but it finally looks like I can toss out that broken record. This evening, Tommy ate his dinner as dainty as you please--as though the size of his bites had never been a problem. It was a meal that I had brought from home--a garden salad followed by sausage and green peppers over spaghetti--and was better than Ren's fare of hamburger and fries (their food is okay but not great). I don't know whether Tommy was inspired by the food, or if the big-bite ghost just suddenly left his body to find another poor soul to haunt. In any case, it was pleasant to share a meal with Tommy without having to carp incessantly at him.

Sunday, October 12

2008-10-12T10:59:00.000-07:00

Tommy now has a treadmill. It awaits him in the room-formerly-known-as-the-rec-room, which can probably now be called the gym, since it has a growing number of exercise machines: my Nordie elliptical exerciser, the set of pedals that attach to the wheelchair, and now the treadmill. I've been looking for one for several weeks, ever since learning about that Johns Hopkins research study showing that stroke victims who use a treadmill get far healthier than those who don't. I found it last Saturday morning, when Patti and I were hitting a couple of yard sales. Yesterday Irv and I carried it in the house and tried it out, and it's great. It's a Proform, one of the heavier, rehab-grade models. It can be cranked down to a very slow speed, and it has a well-designed safety key that attaches to the walker's belt loop. Once Tommy gets home, he will have three physical-therapy sessions a week for several months. Being able to use the treadmill may not be feasible right away; but maybe, under the supervision of the physical therapist, he can move in that direction. Happy to say, I can cross "get a treadmill" off my to-do list, which is long with a capital L these days.

Wednesday, October 8

2008-10-08T22:05:00.000-07:00

Tonight at dinner, I reminded Tommy that he has only three weeks to go, and then he will come home. He wants to come home, but he trusts what Tim, Shannon and the other therapists and caregivers have told him--that the longer he stays there and improves in therapy, the better his chances of continuing a strong recovery once he gets home. Today, with Shannon, he walked in the hallways, and his gait, balance and strength continue to improve. He still needs to work on transfers and eating issues. The other evening, I asked him if he was up for this final push at Ren rehab. He nodded and said, "Focus factor." I said what? He said, "Focus factor--that's what it's about." Never heard of focus factor before, but it makes sense.

Sunday, October 5

2008-10-05T22:27:00.000-07:00

Things are getting very busy here, now that the countdown is solid: Friday, October 31. The house is ready, except for details such as installing grab bars, and also answering the question, should I get Tommy a hospital bed? Different advice from different people. I am thinking that the solution is to take the two narrower-than-twin beds out of the back bedroom, and put a "hospital-grade" bed in there that doesn't necessarily look like a hospital bed. It has to be able to do the tricks (spine and knees raised into a zig-zag contour, sitting position, and entire bed can be raised and lowered). I also want it to have side rails that can be raised or lowered, and maybe even removable when you just want to use the bed as a regular bed. The bed at Ren rehab has rails on both sides, which Tommy uses to pull himself up from the wheelchair (makes me think that the bed must weigh a ton). If we put such a bed in the back bedroom, we'll have a heavy-duty bed if we need it, but Tommy won't have to sleep in it if he doesn't want to and he can handle the regular bed.

Thursday, October 2

2008-10-02T23:23:00.000-07:00

Over a single day it's difficult to see Tommy's progress, but when viewed week to week it's obvious. This week, Tommy has improved in doing his transfers, although he still has trouble if he has to move in the direction of his still-recovering right leg. That is, when he has to begin the sequence of small steps with his left leg, it's easier because then he's only bringing his right leg along, not leading with it. Shannon has been putting Tommy through these paces and it helps that Tommy's earlier distraction problem is fading; he is paying closer attention all the time. On Tuesday, Shannon asked me to assist Tommy in a transfer (from a wheelchair to an upholstered chair pulled alongside), and Tommy did very well; but again, he did better moving to his left than he did on the return trip. Tommy is also getting stronger at lifting himself out of his wheelchair when using grab bars on the wall, but in general he needs to practice all aspects of these transfers until they become pretty much bombproof.

Tuesday, September 30

2008-09-30T19:22:00.000-07:00

Good progress for Tommy the last couple of days, especially with Shannon in walking and continuing to master transfers. Speech pathologist Ralph has been working more intensively with Tommy during meals in an effort to help him master the pacing of food and drink intake...i.e., a small bite followed by a small sip; not three giant bites followed by four giant gulps. The speech therapists are concerned about aspiration--i.e., a particle of food or drink going down the wrong pipe into the lungs, which can lead to pneumonia.

Sunday, September 28

2008-09-28T23:53:00.000-07:00

Another fun weekend. Tommy got a lot of rest on Saturday; for dinner, he and I joined Rosemary and her daughter, Sue (a veterinary surgical nurse, so you can be sure the table talk was interesting). Afterward, with Rosemary's fluffy pomeranian, Foxy Lady, leading the way, we all hiked down through the long-term-resident wing to the facility's roofed patio. There, we found Bill and Allan, who we often see out there. The patio conversation again revolved around Sue's stories of life in the pet-operating room; Tommy didn't say much but listened as intently as the rest of us. Over the weekend, Tommy talked on the phone with a half-dozen family members and friends, which always perks him up.

Friday, September 26

2008-09-26T23:42:00.000-07:00

Because the blog site, for some reason, wouldn't let me in for several days, I was unable to make entries. I finally got in this evening. I don't know how these sites work, but I wonder if it sometimes gets overloaded with users. So--to the subject of the old man. Tommy has been progressing this week on all fronts except the eating/swallowing function. As far as strength and mobility, he can now pull himself up to a standing position with the help of grab bars, but he still needs work on pivoting, using a walker and walking with an assist. The therapy department folks believe that Tommy can and should master these things before coming home, so they have just moved his discharge date to Oct. 31.

Tuesday, September 23

2008-09-23T22:43:00.000-07:00

The plans are going into place for Tommy's homecoming. His tentative discharge date remains Oct. 4, although the therapy department may extend it a week or two more. But, barring a setback, it will be October. In therapy, Tommy continues to work hard for Shannon, Heather and the others. Last week, Red taught Tommy how to use the sliding board. (Red left Ren rehab at the end of last week. We were really sorry to see her go. She was lively, fun and very good at what she did. She helped Tommy a lot.) Tommy is comfy in the Rehab wing; he's getting great care from the nursing staff and he likes to sit with Rosemary, Willie Mae and Al. Tommy has been eating unusually well this past week, compliments of Gaie, who has made fish chowder, pot roast and quiche for him.
At home, the ramp and new shower are ready, and Gaie and I are figuring out where the sidebars will go. I've ordered a pedaling machine for Tommy to use. I'm in the midst of learning exactly what is required to set up the next stage of Medicare-covered supplies and services once Tommy gets home, including home health care and therapy. Gaie, who teaches nursing at Eastern Michigan University, has been my go-to girl for a lot of that, all the way through.
We heard from Marty Wolfe this week (thanks, Mike, for letting him know about Tommy), and Tommy and Marty are going to talk tonight. Old buddy Frank Carr stopped by twice this weekend, during his recent trip to South Bethany, and Tommy was thrilled to see him walk in the room. "Hi Frank!" he called in a strong voice (the first time I have heard that voice since before the stroke). For those of you who would like to talk with the old man, a good way to do this is for you to call on our home phone (302-539-8079) and let me know. Then, I'll place a call for him to you, just before dinnertime, during the next day or two. Hmmm. Next week would be a great time for Tommy to catch up with his old pals... hint hint.

Sunday, September 21

2008-09-21T23:24:00.000-07:00

Sundays at Ren rehab are pleasant. All the patients who were bushed by the end of the week have taken Saturday to catch up, so by Sunday everybody is pretty mellow. Today was even better because it was a perfect sunny autumn day. Lots of family and friends visited the wing, and by now we all know each other. Amid the hubbub of kids working puzzles and one patient's four-generation family contingent, Rosemary took the cake. She sat in her wheelchair with her five-pound Pomeranian, Foxy, in her lap. Meanwhile, Rosemary's daughter, who was pushing her wheelchair, was walking a miniature dachschund named Noodle, whose leash was attached with a carabiner to the loop of her jeans. It was a sight to behold. Rosemary is one of Tommy's new buddies around the place; two of his old buddies, with whom he always ate breakfast, were discharged last week. For dinner, Tommy got a special meal prepared by Gaie, who is visiting from Michigan--quiche with a spaghetti-squash crust. He savored every bite.

Friday, September 19

2008-09-19T21:20:00.000-07:00

All's well the last couple of days. No setbacks. With help from physical therapist Red, Tommy now knows how to transfer from wheelchair to bed using a wooden sliding board. He continues to walk very well with Shannon. Our friend Gaie, who just arrived for a visit, went with me today to see Tommy, and when he saw her, he said, "You look like a flower." During dinner, we were joined by speech pathologist Ralph, who said Tommy's eating and swallowing have improved over last week. Two good days.

Wednesday, September 17

2008-09-17T11:48:00.000-07:00

Today, Tommy walked very well with Shannon at his side; his balance continues to improve. However, he's still not getting the pivots and transfers down, so Red told me that they are going to bring a "sliding board" into the mix. A sliding board can serve as a backup for those times when standing-and-pivoting transfers are too risky. A strong, thin board (the ones I've seen are heavy plastic), it can be inserted partway under the rump of the person and extend to the target sitting spot--it provides a continuous, sliding surface from point A to point B. So, for example, if the person is sitting in a wheelchair, you can line the wheelchair up next to the bed, remove the wheelchair's armrest, insert the sliding board across to the bed, and then (with help from the sitting person) slide that person across the bridged gap, at a slight diagonal angle, without doing any lifting. At least, I think this is how it works....I'll be learning more about it in rehab.

Tuesday, September 16

2008-09-16T23:42:00.000-07:00

Several of you have asked me questions about yesterday's post--specifically, why has his discharge been delayed if he's advancing so well with walking. Yes, it's true that Tommy's progress with walking has been encouraging; but remember, he has had a lot of sessions, even dating back to his time at Milford Rehab during the month of July, when he was walking along the parallel bars. So, he's been working up to being able to walk for a long time. But there are other skills where he needs a lot more practice. For example, he needs to learn to pivot--that's when he stands up in front of, say, a bed, and he needs
to sit down in a wheelchair that's sitting alongside the bed. Before he can sit down again, he needs to "pivot"; i.e., he needs to move his feet in a simple turning pattern--with assistance from one person--so that his back is no longer facing the bed, but is instead facing the wheelchair. As with other seemingly simple tasks that Tommy has had to relearn, such as swallowing or standing up, it's more complicated than one would think. Think of riding a bike or driving a car; it seems seamless to us now, but when we were first learning, the number of individual things to remember and integrate was daunting. Also, Tommy needs to learn how to reach back behind him to find the armrest of the chair or the side of the bed before he commits himself to sitting down. And, of course, he needs to become more dependable at being able to stand up at all--that is, sometimes he stands up without weight-bearing help from the person assisting, but sometimes he doesn't--and on those occasions when he doesn't stand by himself, it can take a toll on the back of the person assisting him. (I was chatting with one of Tommy's nurses, who told me that the backs of most nursing aides are "shot" by age 40 because of so many years of lifting.) These are all basic necessities before Tommy can come home, where, for much of the time, only one person (that would be me) will be available to assist him.

Monday, September 15

2008-09-15T15:55:00.000-07:00

This morning I learned from the social worker at Ren rehab that Tommy's discharge date has been moved from Sept. 20 to Oct. 4. Tommy has been progressing well in terms of walking and general regaining of strength, but he needs improvement in other areas, including transfers and swallowing. Tommy also needs to voice his wants and needs, a task that is complicated by the fact that he has periods of confusion (I suspect that the reason he clams up at times is because that's what's going on). Occasionally, for example, Tommy says things to me that reveal that at that moment he thinks that he lives in DC, or that he still runs the boatyard, or even that he is working at the car dealership in Georgetown (where he worked before he began to repair boats). It's interesting that, when I realize he's confused in this way, I get him back to "now" by asking him if he has dogs; and when he says yes, by asking what their names are. He always remembers Penny and Sandy.

Saturday, September 13

2008-09-13T22:32:00.000-07:00

Today was Janis' last day here, so we splurged on a crabcake dinner. Tommy's newest buddy at Ren rehab, Rosemary, joined us at the table. She is a blast and we had a great time. During the meal, speech pathologist Ralph also checked in with Tommy from time to time to make sure that he was swallowing okay. He's been having a problem this week with dry food getting caught on its way down, so we need to make sure that he takes a sip of his beverage between every bite or so.

Friday, September 12

2008-09-12T23:30:00.000-07:00

Today Tommy led a parade. Tommy was at the center--walking the entire circular route of Ren center's interior hallway, resting only once. The total distance was roughly halfway around our house. With no walker! Marching with him were therapy-assistant Pearl at his right and therapist Shannon on his left. No marching band, but Janis--bringing up the rear with the wheelchair--sang out steady praise as he stepped along briskly. No majorette, but I walked backwards ahead of the cluster, taking pictures with the camera. Along the route, staffers and patients congratulated him. "Way to go, Tom!" called his pal Bill, who has also progressed from walker to free walking. "Look at you!" said Meredith, Ren's social worker, as she passed by.
In the evening, Janis and I joined Irv at the VFW bar (with its splendid view of the sunset over Indian River) for some perfect comfort food--pork and sauerkraut with a side of mashed potatoes. A great day.

Thursday, September 11

2008-09-11T23:00:00.000-07:00

Today was nonstop therapy for Tommy. He was a little tired because one of his buddies, Craig, was discharged last night to his home, and the nursing staff threw a little party for him. Usually, Tommy is in bed by around 7, but by the time they'd had their cake and milk, it was a good hour later. Speaking of discharges, during the afternoon I met with Pam, the finance person at Ren rehab--now that Tommy's own discharge is approaching, I must get a firm handle on the next chapter of Medicare hell. I could immediately see that this will be another "interesting" challenge when she began a sentence, "We can't skill a person if..." "Excuse me," I interrupted, "Did you say skill a person?" "Yes," she said; "Am I confusing you?" "Uh," I said. "I've never actually heard skill used as a verb..." She was patient with my many questions. I have learned that, among others, there are the Romance languages, the Indo-Tibetan languages, and the Healthcare languages.

Wednesday, September 10

2008-09-11T05:07:00.000-07:00

This morning--for the first time, and with Shannon and Pearl at his sides--Tommy walked a few steps without his walker. It happened in the therapy department's outside courtyard.
We were in the courtyard because, a few minutes earlier when Tommy was walking the hallway with his walker, with Shannon at his side and me following with the wheelchair, he pointed through the window to the courtyard. Shannon asked, "Do you want to go out there?" and Tommy nodded yes. This was a very good moment, because Tommy was asking for something he wanted rather than being passive. The therapists have explained to me that part of Tommy's recovery is making his needs and wishes known, and I have been impressed by the way that Tim and Barb, and now Shannon and Red, have all responded to Tommy, on those rare occasions when he asks for something, by immediately doing all they can to give him what he has asked for. The same is true of the nursing staff. But I digress.
Once we got Tommy wheeled out into the courtyard, Shannon brought a small beach ball outside for Tommy to throw to me. The game was that I would stand like a statue and if the ball hit me, I would give Tommy a kiss. Then, with assists from Shannon and Pearl, Tommy stood up and, with them holding him at his sides, he continued the game, tentatively aiming and dropping the ball in my direction. After a few minutes of this, as Tommy got his sea legs, Shannon said he thought Tommy was ready to take a few steps. Indeed, he was; he walked about ten steps to collect his kiss. We were all excited by it. Later, Janis and I joined Tommy for dinner; we brought him crab cakes from Pizza Palace; but alas, Pizza Palace seasons the crab cakes much as they do their excellent pizzas, which is to say the crab cakes were too spicy. Looks like it's time for another carry-out pilgrimage down to my poker group's favorite beach eatery--the Crabcake Factory in north O.C.

Tuesday, September 9

2008-09-09T21:37:00.000-07:00

A good day all around. Tommy's physical-therapy schedule is now firmed up--he'll have Shannon on Mondays, Wednesdays and Fridays, and Loretta (whose nickname is Red, for her long red hair) on Tuesdays and Thursdays. This morning Red gave Tommy a good workout, and a speech-therapist joined him and Janis for lunch. Tommy is still on a "mechanical soft" diet; i.e., the food is midway between solid and pureed. This weird food category is most noticeable with meat; a "mech-soft" pork chop, for example, looks kind of like a pile of chopped-up rubber bands. But until Tommy can limit the size of his bites, the speech therapist will keep him on this regimen. Today, she also directed that Tommy not be given straws; this is because he continues to sip too much too fast (rather than taking one sip at a time), which leads to coughing fits. Our dinner was quite fine--I brought steamed shrimp and Pat, the wife of Tommy's roommate Mike, brought a big box of Popeye's chicken. After dinner, Tommy had a long phone chat with his son Steve. So things are back on track after yesterday's turmoil.

Monday, September 8

2008-09-08T23:30:00.000-07:00

Just after lunch, we had a scare when the nurses at Ren rehab thought that Tommy might be having a heart attack. His symptoms included pains in his chest and arm, not to mention his "deer-in-the-headlights" look and muteness once he was surrounded by a flurry of staffers hooking him up to an oxygen tank, putting nitroglycerin under his tongue, and other stuff. So off they sent him to Beebe Hospital in an ambulance (with me riding in front and Janis following in her car). Thank goodness, after Tommy had an EKG, heart-enzyme workup, chest X ray and other procedures, the doctor there determined that his heart was fine and that the symptoms may have resulted from Tommy leaning too much on his walker during morning therapy. We were all back at Ren rehab by dark, and after some hot vegetable soup with fresh parmesan-tossed corn I'd brought him from home, he was his old self. It'll be "therapy-lite" for a couple of days, but after that the old man should be as good as new.

Sunday, September 7

2008-09-07T21:00:00.000-07:00

Tommy had a very good weekend, with both Janis and me waiting on him, and with lots of laughs with our friends at the rehab center. In general, Tommy's strength continues to return. I found out on Friday the good news that he will have Shannon as his physical therapist (Shannon was a part-time therapist at Milford Rehab, and Tommy had a couple of good sessions with him there). Also, tomorrow his occupational therapist Barb returns from her vacation. So, all systems are go.

Friday, September 5

2008-09-05T22:00:00.000-07:00

After dinner this evening, Tommy had a speech-therapy session with a nice fellow named Ralph, who hadn't met Tommy before. It was very entertaining to witness. "Ok, Tom," Ralph said; "I'm going to start a phrase, and you finish it. How are...?" "You," said Tommy. "Very good," said Ralph. This went on a while until Ralph said, "Oops, I dropped the ..." "Boat," said Tommy. "Boat?" said Ralph. "Yes, I dropped the boat." "Uh, okay," Ralph said dubiously as he made a checkmark on his worksheet. "Most people would say the phone or the ball, but a boat...okay." Further into the session, Ralph said, "Now Tom, I'll start a sentence and you finish it." After a few of these, Ralph said, "I like to drive a ..." "Travelift," said Tommy. "A what?" said Ralph. "A Travelift," said Tommy. "That's what I was driving when I dropped the boat."

Thursday, September 4

2008-09-04T19:10:00.000-07:00

Today things seem to be getting back on track. Heather, who is filling in for Barb this week for Tommy's OT sessions, reported that this morning Tommy was far more talkative than he's been before, and that he made her laugh. "I asked him if he was growing a beard," she told me when I arrived at Ren rehab; "and he said yes. So I asked, 'Do you want to shave it off?' And he said, 'No--I don't want to ruin my image'"! She did help him to trim his beard, however, which he did quite well. In the afternoon Elaine and Alan arrived, once again bearing a big box of tomatoes and green peppers from their garden, and they joined Tommy at dinner.

Wednesday, September 3

2008-09-03T23:28:00.000-07:00

Today was Tommy's last physical-therapy session with Tim, who appears in several of the photographs above. Tim has been such a great help to Tommy, and we wished him best of luck in his pursuit of a career in real estate in Rehoboth Beach. We gave him a small gift in appreciation, which Tommy handed to him, almost shyly. "You have all the tools to get well," Tim told Tommy; "and you've been working hard. Keep it up and you'll just keep getting better." We'll know in the next couple of days who his new physical therapist will be. Meanwhile, his occupational therapist, Barb, has been on vacation this week; and while the other OT staffers have been working with Tommy, we'll be glad to see Barb back again on Monday--Barb also has been very good with Tommy, and it's that continuity issue again. This whole week, actually, has been difficult for both Tommy and me. The long Labor Day weekend followed by changes with Tim and Barb have set Tommy back a bit with therapy and also with the bladder-control program. It's been a slog for me, too; on the home front, the shower renovation (as with any work on this house) has led to more complications and so is still ongoing; and I also got very worrisome news about one of my beloved cousins. There will be weeks like this, and this has been one of them. We do look forward to a visit tomorrow from Tommy's sister and brother-in-law, Elaine and Alan; and this Saturday our dear friend Janis arrives for a weeklong visit. So things are looking up.

Monday, September 1

2008-09-01T17:26:00.000-07:00

It's Labor Day, so Tommy got a vacation from therapy. Instead, this afternoon, we watched Planet of the Apes with several other patients and their families on the rehab center's large-screen tv. Tommy worked hard all week and earned this day of rest. Yesterday, in his OT session, he propelled his wheelchair (with his arms and one leg) with much improved agility, and for quite a distance.

Sunday, August 31

2008-08-31T17:00:00.000-07:00

Today at Ren rehab I met a woman whose husband just came there a couple of days ago. He had a stroke, she told me, in late July--a month after Tommy had his (Tommy's was in late June, her husband's was in late July). As she told me about his stroke, her eyes began to tear up. Oh Lord, I thought, as I listened to her, I know just where she's at. "He can't talk," she told me; "and his whole right side is paralyzed." I had seen her in the rehab wing the last couple of days, coming and going; very young looking (at least compared with me), with a fresh lovely face and long reddish-brown hair. We talked for a few minutes, and I found out that she's a few years younger than I am, and he's a few years older than Tommy is. "It'll be okay," I said to her; "this is a good place and the rehab people will help him a lot." So, when I got home this evening, Irv was here, taking the dogs out for their evening run. I told him about my encounter in the rehab wing. "It was weird," I told Irv; "I felt like I was so far ahead of her, because....because..." And, Irv finished my sentence...."because, you were a month ahead of her." "Yes," I said. A month. There are times when a month seems like a thousand years, and it seems like you've known an old friend--like Irv--for that long as well.

Friday, August 29

2008-08-29T22:00:00.000-07:00

Where did the summer go? Hard to believe we're moving into fall, and Tommy is moving into the home stretch. This weekend, my visits to Tommy will have to be at odd hours, because the route to and from Ren rehab is along the dreaded "beach route," which means hours-long traffic back-ups if you time it wrong. Today, Tommy got a new roommate, Mike, who is a really nice fellow. In therapy, Tommy walked the hall and also spent 15 minutes on his favorite exercise machine--I don't know what it's called, but he sits in it and pushes his feet forward and backward while he pushes and pulls forward and backward with his arms as well. Actually, it's a lot like my elliptical exerciser. Tommy says that he would love to get this machine for home, so I'm going to search around.
Starting on Tuesday, work on the bathroom shower will be finished. Once that's done, a therapist from Ren rehab will make a home visit. Originally, Tim was scheduled to do it but, alas, he told us this week that he has decided to leave Ren rehab (his last day is next Wednesday) and will try his hand at real estate. He has helped Tommy so much. What a loss for the physical therapy profession.
NOTE: I have noticed that the last two or three of my posts have been delayed by hours and even for a day or two--it seems that the blog site has been undergoing "construction" issues and apparently that's the reason. I'm hoping we'll be back on track soon.

Thursday, August 28

2008-08-28T17:06:00.000-07:00

Today, Tommy's roommate, Pat, is leaving to go home, where he will have in-home cardio therapy sessions three times a week. Pat and his wife Ruth have been good company for Tommy, as well as for me, and we'll miss them. Pat was an airline mechanic and restored his old T-bird, so he and Tommy have a lot in common. They also agreed on the room temperature (71), which I have learned can be a thorny issue in such situations!
We've gotten to know so many people throughout this experience--patients, family members of patients, staff members. I've been staying in touch with a growing number of them, including Pat and Ruth, and we are hoping to get together in the future when everybody is back into their respective homes and routines. In the meantime, several of the guy patients who already are at home return every few days to visit Tommy. Since most of them have boats and like to fish, they have a lot to talk about. Although they do most of the talking, Tommy holds up his end of the conversations with comments and an occasional laugh.

Tuesday, August 26

2008-08-26T23:45:00.000-07:00

Today, Tim reiterated that, although Tommy's tentative discharge date had been set for Sept. 6, it will be moved to Sept. 15 at the earliest, with more possible moves to a later date depending on his continuing progress. Tommy is definitely progressing with walking and transfers, but there are areas that require continuing improvement. He is approaching the point where transfers will be possible with one person assisting, rather than two; and his bathroom issues are also improving. There is also a worrisome sore on one of his legs that must heal before he leaves the nurses' care; because he scratches it during the night, it has continued to be a problem.
Dr. Aurigemma told me several weeks ago that the chance of a stroke victim having another stroke is 30 percent--distressingly high odds. I wondered if that statistic included people who took poor care of themselves following the stroke, such as continuing to smoke or not exercising. Because my old pal Nancy, who writes on health issues for US News and World Report magazine, has been doing research for me along the way on my "stroke questions", I asked her what kind of research there is on this question. Yesterday, she e-mailed me a very encouraging news report about the results of a just-completed study led by Johns Hopkins researchers. It found that stroke victims who use a treadmill show far more significant improvement in their recovery than had been previously thought; the exercising stimulates the brain to lay down new pathways, recruiting parts of the brain that weren't trashed by the stroke. At home, we already have my elliptical exerciser, and with Tim's help I'm buying the same pedaling machine for Tommy that they use at the rehab gym--and now a treadmill sounds like a good addition, too. Maybe we should just turn the living room into a big gym!