Tuesday, September 30, 2008

From the home front

Greetings from Gorham, where Dad and I are keeping house. Wanted to share an encouraging development here today! Cathy, a friend of Mom's from the Historical Society, stopped by this morning. She lives one street over, and wants to help! She offered to check on Dad regularly for us, at no charge--as often as twice a day, if we wanted. She said that because she does not work a regular job, she could give him rides or do errands for him also. She enjoys this type of volunteer work, and has helped in similar ways with several other friends.

We have been praying, and asking you to pray, that God would show us what to do for Dad--he wants to stay home, and we feel he will do best here, at least for now. So this offer touched me deeply and I told Cathy that we had been praying for just such a thing. Besides regular visits, she is someone he could call if a problem arose that he could not handle, and she is close by.

So we are encouraged that the Lord seems to be providing help for Dad! Cathy plans to leave in December for the rest of the winter, but her offer of help buys us a couple of months anyway.

We will continue to trust and wait on the Lord, step by step, down this road He is walking us along. We know His way is best.

September 30

There is not too much change today from yesterday; the doctors had warned us to expect changes in terms of weeks and months as opposed to days. However, her face is looking more and more like "Mom." Her sweet personality shines forth through her trademark smile regularly, and she even accepts the nurses' poking and prodding without a whimper, even when it causes her discomfort.

This morning when I walked into her room I noticed that they had changed her trache tube somewhat. They took her off the old apparatus and now they have just the stub of the tube attached to her throat. They have replaced the breathing tube with one which connects to a bubble-like "mask" which covers the stub and is easily removable. This is in preparation for her removal to the neuro special care unit, which is a step down from the ICU. Rob, Mom's nurse today, told me that she would not be moved today, but possibly it would happen tomorrow or Thursday.

Rob said that Mom's lung secretions have diminished drastically, and now are almost nil. Praise the Lord! He is answering your prayers.

Mom does still have the "brain drain" in (I guess that's as good a term as any), and the amount of fluid draining has not diminished any that I know of. So there is still swelling in her head that does not allow proper circulation of the spinal/cerebral fluid. They have told me that as long as she has that drain in she cannot be moved to a regular room but will have to stay in the special care units. Please continue to pray that God would make the swelling go away.

They have determined that she has not had problems with vasospasms recently, and so are allowing her blood pressure to return down to its normal level. This means that the arteries in her head are done with their protest of the coiling procedure and have decided that they will now stay open as they are supposed to do, and not spasm shut to slow down blood flow to the brain. This is a good thing--it is very bad when the cerebral arteries decide to go on strike!

Mom often nods her head in seeming understanding of what I say to her. She seems to comprehend information given her, but when what is said to her requires some interaction or response on her part, it seems like we are not quite connecting. Ali mentioned this in her blog yesterday. Mom has the sweetest smile on her face, and she nods in agreement to what you say to her, but does not do the action that you request of her. And it is not because she is physically incapable, because we have seen her do what we are asking her to do--but somehow the connection is not being made yet. The resident neurologist on Mom's case told us yesterday that she expects this to improve as the blood pooled in her head is reabsorbed into the tissue surrounding it.

Mom has received numerous get-well cards made and signed with love from lots of people, and I know they are all special to her. Thank you so much for your care and concern! You are a huge part of her recovery, and your prayers are moving God's hand on her behalf. Keep on keeping on!

Monday, September 29, 2008

September 29

Dad & I (Alice) drove 2 1/2 hrs. down to see Mom this afternoon, then waited for 1 1/2 hours before we got in. First she was having a test done, then physical therapy. Poor Dad got a bit frustrated.

However, when we were finally standing beside her bed, it was exciting to see her positioned much more upright. And we were told that the physical therapists previously had her sitting up on the edge of the bed!!

She was also very alert today! She smiles, and nods her head to indicate understanding of what you are saying to her. But there is still some disconnect. The rehab doctor asked her to squeeze with her left hand, which has the most movement. She smiled and nodded--but no squeeze. She did wiggle her toes though, and her right arm large muscles are working now.

Also encouraging is that the secretions in her lungs seem to be clearing out. Thanks for praying!

We continue to seek wisdom for choosing the right rehab facility, and the right means of supporting Dad Ames through this time. There is no clear solution for him yet.

We appreciate your prayers so much!!

Sunday, September 28, 2008

September 28

This is Alice back again for today. Mom continues to be alert off and on, looking at people and smiling some, then quickly closing her eyes to rest. Jack's sister Cindy and her family visited this afternoon, and Marshall & Marion Santy.

The nurses are concerned about fluid that is building up in Mom's lungs, a common problem when someone is lying still for so long. She does cough occasionally, but it is weak.

An encouraging step today--she is moving her right arm!! She had been moving the left one, but until today the right one was lying limp.

I'm staying at Mom & Dad's house in Gorham with Dad this week. He and I will probably drive down to see her tomorrow. I doubt we'll go every day though, maybe every two days or so, as it is a five-hour round trip. I would like to do some housecleaning for them. The house really needs it.

Lois is still staying at the Upper Valley Hostel, close to Mom. She will probably do most of the blog posts this week.

We continue to ask you to please pray for wisdom to choose the right rehab facility when Mom is ready, and to see clearly whether or not Dad can live safely alone. (and if he can't . . . that we would know the right alternative!)

We praise the Lord for his blessings: the good care Mom is receiving, the progress she has made already, the ability for Lois & I to be here, the love and help of our church family, the use of a good (and fuel-efficient!) car, and that Dad is wearing his new Medical Alert button without complaint. God is good, and as John Holliday says, He has yet to make His first mistake! So we trust His plan to unfold in His time, and that He will be glorified in it all.

Saturday, September 27, 2008

September 27 PM

Mom is a lot more alert this afternoon. This morning (actually it was almost 12:00) when Ali and I finally were allowed to see Mom, she was still somewhat sedated from her CAT scan, so we didn't get to see her lovely smile. But it was sure there this afternoon when we went in! It was like night and day compared with how she was a couple of days ago. Her eyes stay open for 10-20 seconds at a time, and her facial expressions look like "Mom." You can tell she WANTS to talk, but she hasn't tried to yet. In all honesty I am not sure whether it is possible for one to talk with a trache tube in place or not. She is able to signal "yes" with a slow blinking of her eyelids--that's how she responded to Debbie Page this afternoon when she walked into Mom's room and asked if she knew who she was. She is also able to nod her head slightly.

Mom's drain is still in place and functioning normally. I quizzed the nurse about it, asking her about the fluid we could see draining from it. The nurse said that everything looks as it should, that every person's brain produces a certain amount of fluid all the time. Because of the swelling in Mom's head, her cerebral fluid is not able to circulate normally, and therefore would build up in the cranium causing a lot of pressure if it were not drained out. As the swelling goes down, the amount of fluid that drains out will decrease. I guess it's not a very lovely subject to talk about, but I found it fascinating. I am glad the nurses here are so approachable and willing to tell you what they know so as to combat uncertainty.

Alice has gone up to Gorham to stay with Dad for now. She will enjoy getting to see friends at Community Bible Church! Mom and I will stay here at the hospital and have our own private service tomorrow morning. I will probably let Charles Spurgeon preach for us, since I have my Morning and Evening devotional book. I am still staying at the Upper Valley Hostel, which provides very affordable accomodations for patients and their families. There are two sisters also staying there, who have offered me transportation to and from the hospital while they are there. Please pray that I can be a blessing and a testimony.

Thank you so much for your continued prayers...it is exciting to see God answering.

September 27, 2008

We are changing things around a bit--this blog has a new author now. I (Lois) am taking over the updates, for a while at least. Details to follow:

Ali had a message from the Lord last night. :-) In the wee hours of the morning she realized that to better understand our Dad's needs and abilities, one of us needs to spend more time with him. So she plans to go up there this afternoon and spend next week with him, to get a better feel of what needs to be our course of action concerning his care.

So I will stay here with Mom, at least for the present. We haven't seen her this morning yet, because when we arrived at the hospital she had gone for a CAT scan. They thought it would be another half hour, so we came to the computer lab while we wait.

I would like to ask prayer for God's leading for me. My husband Chris and our four children--Elisabeth 8, James 6, Grace 4, and Christina 2--for those of you who aren't familiar with our family--are up in Hudson, ME this weekend for a missions conference. We were planning to spend next week driving out to Michigan where our next missions conference is, scheduled to start Sun. Oct. 5th. We thought of taking the kids by to see Niagara Falls on our way out. But if Ali is going to be spending the week up with Dad, driving down to the hospital every other day or so, then that would mean that most of the time Mom would be here alone unless I stay here and send my family on alone again. Chris has graciously told me that if I want to stay here that is fine with him, although I know it is hard being a single parent to four young children and especially travelling where routines are almost impossible to establish or keep. I feel so torn, because I am a wife and mother as much as I am a daughter; I just need to know the Lord's will on this one. Thanks for praying with me on this.

We made Mom smile last night as we were saying good-night. Ali asked Mom if she could give her a kiss on the cheek, and Mom seemed to purse her lips a bit in response, so she proceeded to lean over and kiss her good-night. I was on the other side of the bed, and since I am a bit vertically challenged, I was having a tough time getting close enough. Ali said, "Uh-oh, Lois is too short!" I finally managed to work my way close enough and gave Mom a kiss, and gave a cry of victory as I did so. I think our antics were amusing to Mom because she smiled quite a bit. It is good to know that although Mom's abilities have changed quite a bit for the present, her personality is the same.

Thanks so much for your prayers and notes of encouragement. We are so grateful for you.

Friday, September 26, 2008

Mom is Awake!!!!

This morning, Mom is looking at us and smiling at us. She is not speaking, but she is here!!!!

Julie McLean came by to visit, and Aunt Becky, our cousin Faye, and Dad are here to enjoy this wonderful day also. Mom is resting now, and they are waiting for me to join them for lunch, so will close for now.

Praise God for His mercy and love.

Thursday, September 25, 2008

September 25

After the excitement of Mom's opening her eyes briefly last night, she did not do it at all today. However--drum roll please--she did scratch her nose! :-) It is good that she can control her movements enough to do that. Her left hand is the only one moving though; her right arm lies motionless. The doctors did say that her right side, and her speech, are likely to be affected.

She is still wearing her compression sleeve on her right arm, and her right hand is quite swollen around it. Lois and I have notified the nurses about her lymphedema and they are keeping an eye on it. We are hoping Charlene, her longtime therapist here at DHMC, may be able to do some therapy on it soon.

This afternoon, an angiogram revealed she is still experiencing some "vasospasm" - narrowing of the blood vessels in the brain, caused by irritation from the catheter during the coil insertion procedure last Thursday. So they are keeping her blood pressure slightly high to prevent the vessels from narrowing too much.

Chris and the children are in town tonight so Lois is staying with them at a motel. The hostel moved me to a different room, much more spacious than the tiny room where Lois and I were last night . . . and I have it all to myself! :-)

Evenings at the hostel there is soup or stew available, along with bread and fruit. Tonight the soup was cream of mushroom. :-)

Thank you so much for the comments! It is encouraging to read them and know you are praying. Please continue praying for healing for Mom, comfort and strength for Dad, and wisdom & strength for Lois & I as we seek to make the best decisions about both Mom & Dad's care. And also for our husbands and children. The situation is starting to wear on all of us.

We want God to be glorified through us. So we trust Him to do what is best.

Wednesday, September 24, 2008

Great News

News Flash -- Mom has opened her eyes, briefly, twice tonight!! Once for the nurse, and once for Lois. I haven't seen it yet but am excited about the possibility of seeing it tomorrow!! Praise God.

September 24

A positive step forward today is that Mom is breathing, through her trach tube, without a ventilator! She has not suffered any respiratory distress either, which is a big plus.

She is not responding to us yet, but a couple of times today I thought I might have seen an eyelid flicker, and she seems to be displaying more facial expressions. She still grabs at her tubes if given the chance, which is a good sign also. A nurse practitioner, who is helping us think about rehab options, suggested that as long as we are by her side, we can remove her wrist restraints. That will allow her a bit more comfort and freedom; we just have to stand ready to catch her so she can't pull anything out.

As long as Mom continues stable, they are talking about moving her to a step-down unit, Neurological Surgical Care, in the next couple of days.

We have ordered a Medical Alert button for Dad Ames to wear that will enable to him to call for help if he falls, which he agreed was a good idea. (Thank you Lord!) He very much wants to continue living in his home. While we are concerned for his physical safety, we know that his well-being also includes his mental and emotional health, and we desire to balance all three. We are concerned that forcing him from his home, on top of the great loss he has already suffered, may trigger a rapid decline in his mental state. We are thankful for the help of our church family, and, fervently praying for God's wisdom, we are researching options for ongoing support for him.

Lois and I are feeling God's strength. We have taken time each day to go for a walk outside in the crisp, clear air, seeing the trees starting to turn colors. Our times of prayer together have been precious as well. We have both been emotional, but so far not at the same time. :-) It is such a blessing that we can be together here. We do miss our families though, and knowing they are missing us is difficult. Yesterday Regan (5) asked me, "Are you on the plane to come back?"

We know our God, Who cares about the sparrow, cares about His servants even more. He will not abandon us, and we trust Him to lead and direct our steps.

Tuesday, September 23, 2008

September 23

This morning Mom received a tracheostomy, and a percutaneous endoscopic gastrostomy. (Pretty good huh?) Her breathing tube now enters below her throat, and her feeding tube enters through her side.

This afternoon she does seem more relaxed and comfortable than yesterday. Aunt Betty, Uncle Ted, cousin Debbie, and my Dad all came down to visit today also. It was very emotional for him and for us, but it was a blessing.

We have talked today with numerous doctors, therapists and a social worker, trying to sketch long-term plans. There is hope that she will improve as the blood in the brain is re-absorbed by the body, but the doctors have no way of knowing what damage has been done. They have told us bluntly that her recovery will probably take months, and that she is likely to have impairments when she does wake up.

So we continue to beg you to pray for God's clear guidance. I reminded God today that Mom had willingly sacrificed her daughters to be missionaries, taking them and her precious grandchildren far away from her. So now He needs to help us know how to care for her.

Our Dad is doing fairly well, thanks to the wonderful care of our church family. But whether he can continue to live alone is a big question mark. He is sort of "on the brink" in our opinion. He wants to stay at home and get another car to drive. He just got his license renewed in July. But we worry about his memory loss causing problems, and also the possibility of his falling. He is very unsteady on his feet at times.

We feel kind of like King Jehoshaphat, who said , ". . . we have no might against this great company that cometh against us; neither know we what to do: but our eyes are upon thee." (2 Chronicles 20:12)

Monday, September 22, 2008

September 22, Part B

More news to report: Today's CAT scan showed the areas of fluid in Mom's brain have not gotten any larger. However, they have re-inserted a drain, primarily to be able to monitor the pressure in her head better.

Tomorrow they plan to perform a tracheostomy so that her breathing tube can be inserted below her vocal chords, which helps prevent damage to the vocal chords and will also be more comfortable for her. In addition, they plan to insert her feeding tube directly through her side into her stomach. Amazingly, both these procedures can be done in the ICU, not in the operating room, and I believe are scheduled for 11 am.

Aunt Betty and Uncle Ted are planning to pick Dad up about 9 am and bring him down for a visit. We will have lunch together and hope Mom's procedures will be finished so that we can see her after that.

When she might wake up is still known only by God. One nurse said that many times she had seen patients like Mom wake up and be just fine. Another told us it is often a long, gradual process, measured in months rather than weeks, as the brain slowly heals. A discharge planner came in to intoduce herself, asking if we had any plans for long-term care. We have some preliminary ideas, that need to be discussed with Dad. Please pray that all three of us would be in agreement on what would be best.

September 22

Mom has spent all day today, as far as I know, without any sedation. Lois and I have stayed on opposite sides of her bed, and when one of us is talking, we noticed that she seems to turn her head toward the person speaking! That is exciting.

Another encouraging sign, although not pleasant, is that she has been gagging on the breathing tube this afternoon. That indicates her reflexes are improving. The breathing tube cannot be removed, however, until she responds to commands. If she does not cough on command, they are concerned about secretions entering her lungs, possibly causing pneumonia.

Her eyes have remained closed, although they fluttered once when the LNA was swabbing out her mouth. And she does squeeze our hands occasionally, although not always when we ask her to.

The nurses found a CD player and classical music, which Mom loves, to play softly in her room. In addition to creating a peaceful atmosphere, music has also been shown to be effective therapy to rebuild neural pathways in the brain. I can't cite a specific study, but that's what I've heard. We figured it couldn't hurt. :-) I brought some family pictures also, for her to see when she wakes up.

We are still working on getting Dad down here. Aunt Betty, Mom's sister, may be coming down from Maine tomorrow and stopping to pick him up. If that does not work out, either Lois or I(probably me, I'm the restless one) will go get him.

Thanks so much for your prayers for Mom and all the rest of us as we walk through this valley. We are encouraged that God is with us and He remains faithful.

Sunday, September 21, 2008

September 21

I (Alice) am at Dartmouth-Hitchcock Medical Ctr. with Mom and Lois now. thanking God for a good trip, and for the use of Jack's parents' car. There are 10 computers available for public use, which is a blessing so I can post this update!!

Mom's neurological condition remains stable. Several times today, they tried stopping the sedative to see if she might become more responsive. Unfortunately that did not happen. She did become more agitated, so they have resumed the sedative for now.

Lois and I are discussing the possibility of at least one of us driving up to Gorham tomorrow to bring Dad down for a visit. When I mentioned it to him, he said "That would be nice!" We've told him she probably won't be awake, but he still wants to come.

Mom's sister, our Aunt Rebecca, and our cousins Faye and Lisa came for a visit today. Lois got to see them, but they left before I arrived about 8 pm.

Thank you so much for your prayers. Please pray that the Lord won't let mom continue long in this coma state, that she would either wake up here (which seems preferable to us :-) or in Heaven. We are still hopeful, and praying that as the swelling in the brain goes down, and the blood there is re-absorbed into the body, that her condition will improve in the next several days.

I was thinking today that although Mom is not with us consciously right now, the love that she has poured into my life so richly has helped to give me strength. And her faithfulness to teach me about the Lord has helped to give me faith. So she is very much with me and will always be.

"Now unto Him Who is able to do exceedingly abundantly above all that we ask or think, according to the power that works in us, To Him be glory in the church by Christ Jesus to all generations, forever and ever. Amen." (Eph. 3:20-21)

Saturday, September 20, 2008

September 20, 3 pm

Today Mom has been running a slight temperature and perspiring, so they have given her a tepid bath and Tylenol. They also sent some cultures for testing to check for infection.

Her neurological condition remains "stable." They removed the shunt from her brain, as it was no longer draining. They don't plan to replace it unless her neurological function takes a turn for the worse.

Her nurse said that her arm movements seem more purposeful today, which is encouraging! We are so thankful for the good care she is receiving. Also for all of your prayers, and the many offers of help!!

As far as we know, they are still planning to allow her to come out of sedation and remove the breathing tube on Monday. Our prayer is that the Lord will allow her to wake up and regain full use of her faculties.

The plan for next week is that Lois and I will be rooming together at the Upper Valley Hostel in Hanover, two miles from the hospital. We will have the use of Jack's parents' car, which is a blessing. We will probably go up to spend some time with Dad also, and maybe bring him down to visit Mom if she is awake and he is feeling up to that. Chris is planning to take their children to the missions conference in Hermon, ME where they were scheduled.

In all of this we trust the Lord's care and direction for our family, and we pray He will use us for His glory.

September 19

Today we found out that it will be several more days before the doctors allow Mom to come out of sedation. So we won't know until early next week what loss of function she may experience. The doctors warned us that it could be significant.

Her neurological function is better than it was yesterday, and has remained stable today.She is moving her arms and legs a lot, which is encouraging. And she is breathing mostly on her own, although the ventilator tube remains in place to ensure her airway remains clear.

Jack and I have decided that I should come up to NH. I'll be flying into Manchester Sunday evening. Not sure how long I'll be up there. Jack has been great, urging me to go and stay until the situation becomes more definite and we can make needed arrangements.Thanks so much to all of you for praying. We have told the nurses that many people are praying for her! Thank you also for all your offers of help. We feel blessed and cared for by the Lord and by all of you, and it is a privilege.

September 18

Just want to ask you to please pray for my Mom & Dad in New Hampshire. My mom, Mary Jane, had a brain aneurysm burst this morning while driving, causing her to have a car accident. She was flown to Dartmouth-Hitchcock Medical Center with bleeding on the brain.

An Interventional Radiologist (quite the job title!) inserted a coil in the aneurysm to prevent future bleeding. But he warned us that there was significant bleeding and pressure that built up before they could get a drain inserted. She may experience some dysfunction in speech, and strength on her right side. Lord willing, if this is the case it should be temporary, as the blood will eventually be re-absorbed into the body.

He said we should expect her to remain hospitalized at DHMC for two weeks, with the possibility of a rehab center after that. One miracle for which we praise God is that my sister Lois, a missionary in Ecuador, and her family "happen" to be on furlough and in the area, and could be with her today. My dad, John, at 78 is quite frail and has early-stage Alzheimer's. He is at home, and quite calm, which is an answer to prayer!! Pastor Jon and our church family are being wonderful about making sure he will be OK while she is hospitalized.