Colleagues,I want to give you an update on Pam's condition as of Friday 5/24 at 3:00 PM. MIRACLES ARE HAPPENING!
In my last update I said that we had been told that if Pam did not progress significantly by day 5-7 she was unlikely to do so. On Sunday (day 5) her neurologist said he didn't think she was likely to recover much function beyond where she was. On Monday (day 6) we learned that some people believe this sufficient initial progress can occur up to as late as day 12, at which point the ICU protocol calls for replacing the ventilator with a tracheostomy, and the mouth feeding tube with a direct one through the abdomen -- a step up in invasiveness. So with that information, we decided we would wait until day 11 to make a final decision on whether to continue Pam's care. But Monday evening her heart rate suddenly jumped to 290 beats per minute, over three times normal; in a matter of minutes a team of 15 was in her room, applied one electric shock, and her heartbeat returned to normal. Just one shock was a good sign, but it was still unnerving. As I walked to the hospital Tuesday morning (day 7) I was very discouraged, and I was praying for a miracle. During the day there were several small signs of small progress, basically with more small physical movements.
On Wednesday (day 8), I got to the hospital late in the morning to discover that the doctors had decided she had improved enough physically (specifically a lot more large movements of her arms and legs) to replace her ventilator tube with a simple oxygen nose clip. By late afternoon she was off that and was receiving no breathing assistance at all. The neurologist came by and said that based on all her progress "all [previous] bets are off" and that he wished such dramatic changes happened more often. An order was placed for physical therapy, the physical therapists came up, and they soon had Pam sitting on the edge of the bed with limited support. They placed her in a chair, saying they wanted her to tolerate that for at least 10 minutes, but hopefully up to an hour. She was in the chair for at least an hour with no problems. Then a social worker came by to discuss possible rehabilitation facilities that Pam might be transferred to as the next step in her care. She attempted to vocalize but only could manage occasional moans. She had a very thin feeding tube installed through her nose. No feeding started, however, because her cardiologists had decided that she was physically able to have a cardiac catheterization (a diagnostic procedure to see what problems exist in her heart). So Wednesday there was tremendous physical progress. But there was no clear cognitive progress, although some of her facial expressions gave us reason to hope that some was occurring.
Yesterday (Thursday, day 9) there was additional progress. Most notably she began to say simple words like yes, sure, yeah, OK, ow, and ouch. The one multiword phrase that she was saying was "love you too" -- that is unquestionably my favorite response! In addition, her beautiful smile began coming back, and she occasionally even seemed to make a small laugh! The cardio catheterization went well, and found one slight blockage, but nothing to require a stent or any other surgical treatment.
Today (Friday, day 10) I arrived at the hospital to find that my daughter had begun to play music from Pam's Amazon playlist for her, and on "Leader of the Band" Pam had started mouthing some of the words! For over an hour, and then for a shorter time later in the day, she listened to her playlist and often mouthed some of the words. Sometimes she would turn her head a little and close her eyes and purse her lips to add a little performance flourish, just as she used to when singing! While her brother, a retired car dealer was here visiting her, she even vocalized the last two words to "Hot Rod Lincoln." You could tell from the smile on her face and the look in her eyes that she was excited to be remembering the words.
These responses do not occur all the time, so there is clearly a very, very long way to go in reestablishing her cognitive and motor abilities. There are of course so many things that need to improve in order for her to one day have what she would view as a decent quality of life, but my hope continues to grow, and we will see what each day brings. She is going to be transferred out of ICU and into an Intermediate Care unit as soon as they have a bed available, so that is a sign of growing stability. She would be there for at least a week. She is also going to have a defibrillator implanted to prevent any further cardiac incidents. I also received a phone call from the best of the rehabilitation facilities, the Sylvia Brady AbilityLab in Chicago, indicating that Pam may well be a good candidate for admission. They specialize in working with individuals who have suffered brain injuries. Hopefully, she will be accepted there so that she can receive the greatest possible expert treatment in the long arduous process that lies ahead for her.
So please, continue to pray for miracles for Pam! Please specifically ask that her injured brain cells will heal and that new ones will grow, that damaged neural pathways will be reestablished, and that the misfiring and jumbled static that is still occurring inside her brain will further calm and ease and clear. Please pray that she will be comforted and will not feel scared or hopeless, so that she can relax and think clearly. Please pray that her cognitive abilities will be restored, as well as her ability to hear and process, and to formulate and express her thoughts verbally. Pray that she will not be trapped in a damaged brain but may come all the way back to once again be the intelligent, loving and compassionate person that she has been for so many years. In addition, she needs to make progress in controlling her large motions, as well as her fine motor skills and her swallowing and speech abilities. At the moment she has a very bad bottom rash from some leakage that was occurring from her catheter and from loose bowel movements. She is now on a rectal catheter, which should help. So healing from the rash and regaining control over excretory functions are other specific needs she has.
Again, I know that you, and all of those praying for and sending good thoughts out for Pam, are helping make a positive difference in her life! Please continue to do so and ask God to bless her that she can come all the way back in the days and weeks and months ahead!
Finally, thank you to all of you who have taken the time to write any special impressions of Pam and memories of specific experiences with her! They have been such a comfort and inspiration to me. I have read many of them to her and will continue to do so. I truly believe that these will aid in her recovery and be a blessing to her grandchildren and future descendants. If you haven't had time to do so yet, please do so!
And thank you for the beautiful, thoughtful messages that many of you have written to me! I truly appreciate them and have felt lifted and supported throughout this experience. From the bottom of my heart, thank you to all of you for the love and concern you have shown for Pam and for me! God bless you!