Grand Central Station

Dear Family and Friends

Isabel did get to vote on Day 2 of eight hours a day OFF the
respirator! Day 2 has now turned into Day 6.

"That's one third of the day! That's one third of Isabel's
marathon!" declared the niece of another West Nile Virus Neurological
Syndrome survivor.

It has been a good week. Although Isabel continues to cope with
constant neurological fatigue, her desire to be socially active
increases weekly.

Friday was such a day. The afternoon began with a visit from two
Abernethy friends who spent 15 minutes telling Mum news from her home
community.

Just before 2:00, two cousins arrived bearing a variety pack of home-
baking "For Isabel's caregivers" and two hand knitted exercise balls
for Mum's hands. As the cousins prepared to come into see her, Mum's
two physiotherapists and social worker arrived to give Isabel and her
family a half hour coaching session of Mum's new physio/occupational
therapy plan. As we have said before, Mum has a dynamo physio team.
Mum was sitting up in bed and her lead physio plopped down on the bed
beside Mum to talk about the plan. The cheers and chatter were
constant as members of Isabel's family were put through the drill.
Mum's letter-board was brought out and she contributed her own
questions about her therapy.

At one point in this session, a respiratory therapist stuck his head
in the door to add his cheers for Mum's progress. A passer-by nurse
inquired if this was the cheerleader practice for the Riders' big
game on Sunday.

In the meantime, ward staff from nurses to respiratory specialists to
housekeepers came by to taste the home-baking. When the cheering
squad left with mouths full of baking, Isabel's cousins came in to
share news of extended family activities.

Amid the huge compromises to Isabel's physical health, we continue
to be so thankful that Mum's cognitive ability, delight in
socializing and hearing news, and warm greetings to people as they
come through her door are in no way diminished! This in itself is a
miracle!

Your messages of good wishes and news continue to be bright spots in
every day.

THANK YOU! THANK YOU! THANK YOU!

GO RIDERS GO!

Catherine, Nancy, and Janet

Exercising One's Civic Duty

Hello Family and Friends

When Mum wants to tell us or ask us something, we frequently need to
present a verbal list of possible topics before we discover the
"general area" of conversation that Mum wishes to have with us.

During time identifying discussion topics on Saturday, Catherine was
perplexed about the keen interest that Mum had in a particular topic
that did not fit the usual categories of health care, communication,
family, friends, community events, and things that Isabel wants her
daughters to do (also known as "orders").

Mum finally rolled her eyes, motioned to the letter-board and rapidly
spelled out "vote". She and Catherine then had a 15 minute
"conversation" about events leading up to the Saskatchewan provincial
election this week. Catherine was not up to speed on all of
Isabel's questions including the names and positions of all the
candidates in the riding where Isabel lives. We might have to count
on a son-in-law for that analysis!

One of Isabel's doctors came during that discussion, and Catherine
suggested that this was a good time for Isabel to teach him the
letter-board. He declined claiming possible political pressure placed
on him by a patient. Perhaps next week he will agree to be one of
Isabel's students! As he left, he reminded Isabel that she did have
the right to vote and she nodded enthusiastically.

Here's a toast to Isabel and her keen interest in civic and community
issues -- and educating others!

Mum has had another steady week of 6 hours off the respirator each
day. Slow but steady goes this marathon.

Nancy, Janet, and Catherine

Isabel's Ride-abouts

Dear Family and Friends

This week has been a good one!

One good day has stretched into two and now to eight.  Mum has been regularly "off the respirator" for up to six hours at a time for five consecutive days.  This means that the respirator is shut off for six hours a day and Mum breathes on her own with only a trach mask of humidity and some oxygen.  For the remaining 18 hours a day, Mum breathes primarily on her own with the respirator providing "some puffs of air" to expand her lungs.  While off the respirator and with some support of oxygen and humidity through the trach mask, Mum has managed physiotherapy which has included range of motion movements in bed, sitting on the side of her bed for up to 10 minutes, standing with help, and sitting in her chair for up to three hours.  For someone who has been in bed and dependent on a respirator to breathe for 2.5 months, this is progress!

This week, Mum's dynamo lead cheerleader physiotherapist returned from holidays, took one session to assess Mum's progress, and declared her breathing to be stable enough to go for a "ride-about" around the ward.  So Mum was able with the support of oxygen to leave "the four walls" of her room and take a wheelchair trip courtesy of the two physios who pushed her around the ward.  Nurses from all over the ward cheered "YEA, ISABEL!!!" as she sailed by.

While on the ride-about, Mum was able to greet the other West Nile Virus Neurological Syndrome patient at her door with a "thumbs-up".  The other woman waved back to cheer on Mum!  It was a moving moment!  Mum has been very interested in the stories of other WNVNS survivors but this was the first in-person "meet and greet".

Although we continue to live with the sobering reality of Mum's debilitating fatigue, inability to speak, and severely compromised muscular and neurological systems, we are grateful for these consistently positive eight days.  Despite the phenomenal fatigue that is common to all WNVNS patients, Mum sleeps little during the day.  Thus your letters and cards and phone calls continue to be essential to her well-being.  Connections with Mum's wide community are so important to sustain us ALL during the long hospital days.

Each week, we receive messages from Mum's broad community of friends from the many different decades of her life.  New people call and write as news continues to spread of her illness and recovery.  We continue to be amazed by Mum's sphere of influence, and she --  and we --  are so grateful that you take time to phone and write.

In gratitude and hope, as ever,

Janet, Nancy, and Catherine

The Warmth of Autumn Colours

Hello Family and Friends

Isabel's Marathon to wean herself from the respirator with support
from a variety of cheerleaders is taking place in a room filled with
colour. Strings of autumn leaves hang on the curtains. A large
orange bristle-board calendar created by Mary and Josh and covered
with 93 stickers is on Grannie's wall marking special days including
birthdays. Photo boards and art creations from all the grand-kids,
Mum's young friends from Abernethy, and grand-nieces and grand-
nephews cover another part of a wall. An Abernethy friend has sent
two large quilted wall hangings -- one with falling leaves; the other
of filled jam jars. Strings of your cards hang in different parts of
the room. A teddy bear peers out from behind a gigantic pink clock.
Mum's CD player plays a collection of spiritual, Scottish (bagpipes,
too!), and easy listening music. Mum has a collection of bright
coloured fleece blankets -- in maroons, corals, and brown-cream-coral
stripes.

In this midst of this created beauty, Isabel's marathon includes time
on and off the respirator, the flexes and stretches of physio, and
time sitting supported in a chair surveying all she can see out her
door. Mum has three neighbours in the nearby rooms. All four rooms
are designed for persons who need respirators to breathe. Each person
including one other West Nile Neurological Syndrome patient is a long
time respirator user.

There are a lot of Marathon checkpoints still to go. Thank you --
week after week -- for hanging in with us and being Mum's cheering
section. Mum wears her running shoes for physio every time she is up
and as the therapists or nurses help her move to her chair. A good
grip and feet solid on the ground are important whether one is
training for one mile -- or twenty-six.

Blessings of Autumn colours from us back to you,
Janet, Nancy & Catherine

Training for the Marathon

Dear Friends and Family

This week Isabel had a consultation with a respiratory specialist who
described her current work as Training for a Marathon. We used that
image before on the blog, and it is appropriate to use it again.

A marathon is 26.2 miles. Consider yourself. Imagine you -- any one
of us -- training to run 26 miles -- and then running it successfully.

On some days of training, you run a comfortable distance -- one with
which your body is comfortable. Some days you push harder -- mind
over matter -- what feels beyond your means. Other days you rest.

That's exactly what Mum is doing. The marathon that Mum is training
for is to wean herself from the respirator so that she can breathe on
her own.

This process will take weeks -- perhaps months. This is Isabel's
marathon. Varied pacing. Comfort; then the push beyond what feels
possible; then rest. One day at a time -- yet with your mind always
focused on a long-term goal -- 26 gruelling miles later.

We - and YOU -- are her cheering section. You send encouragement and
good cheer through your letters and e-mails. You are like spectators
at the marathon checkpoints offering a fitness drink, a power bar,
and a cheer of "You can do it, Isabel!"

Your messages also bring much cheer to us. The days are long in the
hospital and we are always glad of news of the outside world -- and
your encouraging words to us all.

Despite the huge compromises to her physical ability, Mum does not
miss a beat! She reminds us of things we forget to do, and asks
about family and friends through her letter board.

Mum has a steel-trap mind. Nancy told her in early August that she
had a speech to do this coming weekend. Mum has asked Nancy through
her letter-board every day in the last week about the speech.
FINALLY, today, Nancy brought her speech in to practice in front of
Mum! Shades of old 4-H days and practising for speaking contests!

Those of you who know Mum's list-making abilities can imagine how
many questions she has for you.

THANK YOU for breathing deep and training for this marathon with Mum
and with all of us.

Catherine, Nancy, and Janet

Thanksgiving Blessing

HAPPY THANKSGIVING!

 

LOVE ISABEL

The words of Mum's choosing -- letter by letter with her nods -- for all of us.

Cracking the Code!

Dear Family and Friends

We are jubilant that together -- Mum and we  -- have found a way for her to communicate words and phrases.

Inspired by the moving story of Jean-Dominique Baub in THE DIVING BELL AND THE BUTTERFLY, we provided Mum with a verbal and written listing of the alphabet consisting of the letters reordered in accordance with their frequency in the English language.  Here they are: 

etaoin

srhldc

umfpg

wybvkxjqz

Through head nods, Mum spells out the letters of the words and phrases she wants to communicate.

Once we explained how the system worked, Mum's first word came in under a minute.  We quickly graduated to Mum wanting to do phrases, but the only thing in this process that is quick is Mum's ability to scan the letters.  Her helpers need to keep up with her.   Not an easy task!  Mum does amazingly well at keeping two files open at once -- remembering where she is in the word she is spelling while searching for the next letter on the board or through her listening. 

Mum has always been a wizard with words -- in verbal conversation and in the thousands of letters that she has written in her lifetime. That skill coupled with years of teaching children to read and write means that she is a natural with this process.

The nurses and therapists have found ways to understand Mum's basic physical needs, but Mum can now express some of her emotional needs.  This is a different level of communication. It is still tediously slow and it very very tiring for Mum.  HOWEVER, she can provide us with discussion topics of her choice so we can continue with YES and NO questions.

We enter this Thanksgiving time knowing we have entered a new chapter in Mum's ability to communicate.

We continue to search for a Speech and Language Pathologist who can "meet Mum where she is at" -- far beyond the basic communication boards that an acute care hospital provides.  Mum is gifted with words and wit whirling about in her mind and heart,  and waiting to be expressed.

With this posting, comes our recommendation for the fine book (recently made into a movie)  that inspired us to try this method with Mum.  THE DIVING BELL AND THE BUTTERFLY is the memoir of a 43 year old French magazine editor who experienced a massive stroke.  He could move his head a little, and blink his left eyelid. Through the system described above, he dictated an entire book with the flick of his eyelid.

Mum has much more movement than the flick of an eyelid.  Each week her muscles are very very slowly increasing in strength.  She is sitting and standing with help and does her exercises hour after hour in bed.  She can shake her head vigourously (and thus can once again give 'orders' to her daughters which she indicates is very satisfying!).  Mum also communicates some emotions through eye movements.  We see very slow change -- but it is positive, and that gives us all hope. 

May it be so for you --  our loyal readers and Mum's fans!

Nancy, Janet, and Catherine