Thursday, December 24, 2009

At Last! Adele is home.



ADELE IS HOME!
Yesterday Adele was driven home by Fred from the NE Sinai Hospital after a full 6 weeks of being in various hospitals. What a relief! She was very pleased to just be able to take a nap without any beeps, alarms, nurses, therapists, housekeeping, or aids waking her up. She will have services from a visiting nurse, a home therapist and a home health aid for a while. She has a shiny new blue walker with a seat and a basket that she will be modeling around town. She is pleased to be home and looking forward to again seeing her favorite trees decorated for the season- Dollar Tree and Christmas Tree Shops of course!
Please join us in celebrating the end of a long difficult journey away from home for Adele and in supporting the start of the next phase of her recovery.

Monday, December 21, 2009

Damn. Almost there.

Today Adele got disappointing news that because her Coumadin level had gotten too high in the past couple of days she could not go home on Tuesday as planned. Her doctor said she had to have two good consecutive daily readings for her to be released safely. This was an unwelcome shock. Adele went through all the phases of coping with a loss- denial, anger, bargaining, depression, and finally acceptance- in the span of one day. She is now resigned to staying until Wednesday in the hopes that she will have "good" Coumadin levels on both Tuesday morning and Wednesday morning so she can leave. Meanwhile the team is setting up services for her at home after she is discharged. The Brockton VNA will provide her with nursing and therapies at home for a while. She can then be referred by her new outpatient cardiologist to a cardiac rehab program. We are also looking into where she wants to see a dietician/ nutritionist for help setting up a new plan for eating in line with both a heart-healthy and diabetic diet. PLEASE help support this difficult change by not bringing her any food or candy that is not sugar-free and low in sodium and low in saturated or trans fat. She has a chance to come through this healthier than she has been in a while. She was very fortunate to have little to no damage from her initial, mild heart attack and it is our hope that she will be able to avoid any repeat problems in the future.

Sunday, December 20, 2009

A Holiday Gift

Good News! Adele's doctor said she should be going home on Tuesday. That will be a day shy of 6 weeks since she first left home. It will be a welcome homecoming indeed- the best gift we could hope for just between the Channukah and Christmas holidays. What progress she has made! On Friday she was totally off of oxygen and was able to handle 20 steps with the PT. She is more independent with all of her self care after working with the occupational therapist to learn how to handle tasks without putting pressure on her healing sternum. Her Coumadin level has been in the therapeutic range for several days. This morning it was a little high, but her dose will again be adjusted to keep it where it needs to be.
So in honor of the snow and the holiday season we are giving a little something back to all of you who have been so generous to Adele with your calls, visits, cards, prayers and love. This is a small gift that is in keeping with Adele's sensibility. We are including a link at the right to an excerpt of "The Santaland Diaries" read by the author David Sedaris. It is a dark and funny account of the author's brief stint as an elf in Macy's Santaland display. It will give you something to remember if you take family to the new Enchanted Village display at Jordan's Furniture, just down the road from the NE Sinai. A copy of the book, "The Santaland Diaries" was given to Adele to read during a prior holiday season that she had to spend in the hospital and she really enjoyed it. We hope you will too.

NOTE: From the link you can play the excerpt in NPR's online media player by clicking on the "Listen" icon under the title, download an audio file of the excerpt to play on your computer's media player, or click on the link to read a transcript of the excerpt. Listening to the author, if possible, is more fun than reading transcript.

Wednesday, December 16, 2009

To Sinai from Beth Israel

Tonight we kindle the lights of for the 5th day of Hannuka. This reminds us of the miracle in ancient Israel and it is appropriate to reflect on Adele's journey today from (Beth) Israel to the Sinai. Yes her extended vacation continues on what is expected to be the last leg of her journey. In classic Adele style she did not take a camel but was personally chauffeured in a climate controlled vehicle with an individual attendant- and even flashing lights. Some suspect she may have made the journey just so she wouldn't be outdone by her friends in who recently traveled with the Judy Group along a similar route through Israel, Jordan, and Egypt. But that is really just conjecture and I digress.
Adele settled in comfortably at Sinai this evening. She remains on anticoagulants and her levels are being adjusted until they are therapeutic. Her oxygen level is better and they were still deciding on whether she would get some oxygen overnight when the last of us left. Her spirits are better as she is closer to home and has successfully navigated through one more difficult challenge. It has now been over 5 weeks that she has been away from home and while the accommodations have been top notch she is really feeling ready to be home again. Hopefully by the end of this Hannuka see will be well on her way to a miraculous recovery and be just about ready to return home from her long journey.

Sunday, December 13, 2009

Almost ready to leave

Adele has been doing very well on the cardiac unit at the Beth Israel over the past few days. She was up and walking a couple of time today and yesterday. Her balance and strength seem to be coming back. She is just about ready to return to New England Sinai to finish her rehab. She is first waiting for the level of her Coumadin (anticoagulant pills that prevents clotting) to get to a therapeutic level before she is taken off of the intravenous anticoagulant (Heperin) medication. It is not yet clear whether she will go to the rehab with the IV medication or wait a couple of days until she no longer needs it. News of her move will be posted here when the decision gets made.

Thursday, December 10, 2009

Good Signs

Today Adele was moved out of the ICU and onto a cardiac floor at the Beth Israel. She no longer needs the intensive monitoring and treatment options the ICU provides. She is stable and the blood tests of the heparin (anticoagulant) have been where the doctors wanted them. She is also needing less oxygen than she did her last evening at N.E. Sinai. So all the news has been positive so far. It is not yet clear how long she may stay at the B.I. but she will likely return to N.E. Sinai at some point to finish her rehab. There is a link to an article on pulmonary embolisms that you can click on to the right of this post. We continue to learn a lot of important medical information through this journey and we hope that sharing it will help others.

Wednesday, December 9, 2009

A Setback for Adele

Today Adele was diagnoses with a pulmonary embolism- a blot clot in her lung- that is responsible for her decreased blood oxygen level. Because this is a serious condition she was transfered to the Beth Israel Deaconess Medical Center in Boston . She was admitted to the Intensive Care Unit this evening. There she will be receiving blood thinning agent(s) to prevent further clotting. Many times this is enough to allow her body to take care of the clot on its own without further intervention. The ICU is necessary so that staff can keep a close eye on her oxygen levels and constantly monitor her vital signs in addition to overseeing her medication regimen and administering the supplemental oxygen based on her evolving needs. Fortunately her heart function and blood pressure remain good and she is not in any serious discomfort. Immediate family will be with her tomorrow and will keep folks in the loop as things develop.

Tuesday, December 8, 2009

A Bump in the Road

First of all it's important to say that things have been generally going along quite well at NE Sinai. Adele has gotten stronger in physical therapy and has been able to climb 10 steps. She has learned a great deal in occupational therapy about how to safely do things at home without putting pressure on her sternum or carrying or supporting more than 10 lbs. of weight with her arms. Her surgical wounds have been healing nicely and her hair has looked fabulous thanks to the regular visits from the hairdresser.
Now the one area that has been problematic has been her breathing. Adele has been on oxygen since the surgery in Worcester. She had been weaning off of it slowly but seemed to always need some to keep her blood oxygen level above  90% where it belongs. She has needed more when she is in PT exerting herself. A few days ago her level dropped during PT and she took the rest of the day off feeling very fatigued. Today her oxygen level went even lower during PT and the amount of oxygen she receives through her nose had to be significantly increased.. That seemed like a setback and it is not yet clear what caused it. She will have some additional tests tomorrow as well as a pulmonology consult. One thing we know is that she has some fluid build up in the area around one of her lungs. It looks like the amount of fluid hasn't changed since she got to Sinai but it hasn't been reabsorbed and decreased on its own as often happens after a surgery. How much that plays a role in her need for oxygen supplementation is not clear. When we know more it will be shared across the blogosphere with all of her adoring fans.
On a brighter note, her daily get-well card count has surpassed 110! She still loves opening and reading them so don't worry about having to stop sending them any time soon!

Tuesday, December 1, 2009

Giving Thanks

Now that Thanksgiving has past we wanted to take the time to share some of the things for which Adele and the family have been thankful this season.

  • For the love and support of family and friends first and foremost
  • For the excellent care Adele has received at both UMass Medical Center and New England Sinai Rehab Hospital
  • For having such a mild heart attack that she escaped any serious damage to her heart
  • For the fine skill and personable nature of Adele's heart surgeon, Dr. Tam
  • For Orbit Bubblemint sugar-free gum
  • For Sinai being so close to home so that Fred, Marc and others don't have to drive to Worcester everyday.
  • For the hairdresser and manicurist that see patients at Sinai
  • For the frogs that Herbie and Lois have given her to keep her company when the rest of us cannot.
  • For there being a gift shop at Sinai Adele can be wheeled to so she doesn't go through full scale withdrawal from her shopping "hobby" 
  • For Rachel, Mikala, Jacob, Adah, Zayna, and Adam whose young smiling faces are postered to her wall.
  • For passing the halfway mark to her quota for get well cards
It has been a stressful time but such times often bring into focus the things that are most important to us in life. The people we love and care about top this list. Adele and family thank you for the wonderful support and kindness you have shown to our family recently and over the years- sometimes decades.

It is worth adding a brief update about Adele's recovery. She is still weaning off the oxygen support but getting noticeably stronger almost every day. She is now getting both physical therapy and occupational therapy twice each day. She has been walking further and further with her PT. She can climb several stairs. She has learned how to do basic self care in ways that do not require her to use her arm strength which would strain the healing wounds from her surgery. Today the occupational therapist began to work with her on cooking and cleaning. Unfortunately in these specific areas she found that Adele's level of disability much greater than she had anticipated!

Tuesday, November 24, 2009

A good day in Sanai

Well therapy has started in earnest today and Adele is doing well. She is walking and has done a couple of steps. However she still needs oxygen, which limits what she can do. While Fred was there her Occupational Therapist said she would be showing Adele how to cook- to which Fred replied, "I'd be happy if she could boil water!" Adele herself is getting her spunk and her humor back, thanks to the recognition she has gotten from her many devoted friends and family in the form of calls, a few visits, and lots and lots of cards. Today's count was up to 56 since we know everyone has been wondering. If that wasn't enough to overnourish her ego she was visited by some of the most important, influential and powerful people at Sinai, thanks to her friend Tom O'Connor who is on the Sinai Board and head of the Men's Association. At different times she had the president and CEO of Sinai, the president of Sinai's Foundation, and the Patient Care Coordinator visiting her. They came bearing gifts like the magi to the manger: pens, paper and a Sinai paperweight (okay, not quite gold, frankincense and myrrh but pretty good for an older woman with no messianic claims in such a bad economy, no?)