Dear Friends and Family of Joy:
Joy's surgery appears to have been a success. The procedure was a little more problematic than I understood it to be. There was a chance that they would have had to remove a portion of her skull if it showed signs of osteomyelitis. Although tests are being performed in the lab on the plate and screws that were removed, Doctor Sanchez was in general pleased at what he found.
Joy will spend at least tonight and probably tomorrow night in the hospital. She is responsive, but needs to rest and recover. She does not appear to be in pain.
We had one of those small and subtle instances of progress on the way down to the hospital. I was driving and Joy was sitting in the front passenger seat. At one point, she reached over to the air conditioning vent in the center of the dashboard and deftly turned the knurled dial to divert the air away from blowing on her. This suggested to me that she may be recovering some of her memory and her motor skills. It was all very natural.
Thank you for your kind thoughts and prayers. I'll post another update in a few days.
Love,
Doug
[UPDATE, Tuesday, 10/25]: Joy is home and doing well. She's had a low grade fever off and on, but is lively, energetic and glad to be home. Tylenol should take care of the fever. We will spend the next couple of days replenishing her with the nourishment that she didn't get for nearly 24 hours. Dr. Sanchez also adjusted her shunt so that it was pumping less and will want to see her again next Tuesday to see how that is working. Joy will likely have her angioplasty procedure sometime in the next two to four weeks. We will keep you posted. .......... Doug
Monday, October 24, 2011
Sunday, October 23, 2011
Change In Schedule
Friends and family of Joy:
We have had an abrupt change in plans for Joy's procedures. The angioplasty scheduled for Tuesday Oct. 25th, has been postponed. Doctor Sanchez-Mejia and Dr. Redfield, an expert in infectious diseases, determined that the metal plate that is exposed on Joy's incision line along the edge of her scalp should be removed before any more procedures are performed. That will occur tomorrow, Monday. It had been contaminated with a MRSA infection but we have been treating it for several weeks with doxycycline and the more the infection went away, the more the plate installed to fasten her skull flap has become exposed. Dr. Sanchez commented that the skin appeared to be growing back under the plate which is approximately a half inch wide and an inch long and attached by surgical screws. This has been a problem since at least March, although we didn't really know what it was until a month or two ago. Why it was not diagnosed correctly by the doctors at Carmel Mountain Rehab when we first began to notice in March, I don't know.
We saw Drs. Sanchez and Redfield and Dr. Sanchez's assistant Brenda on Thursday, the 20th. Here's a picture of Brenda checking Joy's vital signs:
Dr. Sanchez believes we can schedule the angioplasty procedure sometime in the next month. We will keep you posted on that. He told me that there have been advancements in coiling and stenting procedures since Joy had her first angioplasty procedure back in early January and that he will be able to do things for her that could not have been done then. Then there is the matter of the repair of the voids in Joy's skull. I believe it will be several months before we attempt that, but we will continue to consult with Dr. Sanchez on when the best time would be.
We missed some physical therapy dates because Joy had a low grade fever for a couple of days and Nurse Sue's new dog suffered some bite wounds from her two other dogs, which led to surgery and made Sue unavailable. But we went Friday the 21st and had a good session with Rachel. Here are two pictures from that day:
Joy looks lovely and healthy these days. She seems happy and contented, although occasionally she asserts her will at what seem like inopportune times for us. For example she sometimes balks at getting into the car before and/or after an appointment or outing. This can turn into a test of wills, which I think is good for her. Although she is improving, she has a long way to go in terms of recovery. In the parlance of stroke terminology, she has "deficits." Her deficits are described medically as "aphasia," "apraxia" and to a lesser extent "dysphagia." She cannot speak except in occasional phrases, she can't do most simple tasks, and while she can swallow and will eat heartily, she tends to "pocket" her food at certain times, which means she doesn't always swallow things immediately and will hold food or liquid in her mouth for half an hour or more. Her deficits are abating slowly, but it is going to be a long process. There is much she will have to re-learn. That said, her progress is frequently noticeable in small and subtle ways.
One day last week, Sue saw that a great blue heron had landed on the wall of our spa, perhaps 25 feet from our back door. (It often feeds on the small fish in our neighbor's large koi fish pond next door.) She brought Joy over to the glass door to see the creature, which is nearly four feet tall when standing perched. Joy looked at it and said slowly, "Oh my!"
I bought Joy an Ipad this week and also one for her sister Susan. The money for this came from the generosity of Joy's co-workers who way back in January donated $1650 in gift credit cards to show their appreciation and help in her recovery. I will never forget the day that Cyndy Smith, Joy's friend and associate at Pitney Bowes, first came to visit Joy at Loma Linda UMC and brought the gift with her. It came at a very difficult time and it moved me to tears. (Cyndy and I went through quite a few tissues that day.) I'm hoping the Ipads can help in Joy's recovery. There are apparently a number of applications at the Apple Store for disabled people to help in their recovery. Susan and I will be looking into them. I am very grateful to Joy's co-workers and thank them from the bottom of my heart for their generosity.
Yesterday, Joy, Susan and Sue went shopping for shoes for Joy, since the ones she usually wears are getting old. Joy loves shoes and was a fearsome and legendary shopper for them before her ordeal. Think Imelda Marcos with coupons. Yesterday, she clearly favored a pair of stitched and studded red shoes with straps. Susan swore that she could tell that Joy fell in love with the shoes and was looking at them from all angles in the mirror. So they bought them for her, even though they cost $300. If Joy--who had a rule to never buy something that wasn't on sale--had known what the shoes cost, she would have had a heart attack. The good news is that we finally got our tax refund this week after filing late this year. Here are the (quite handsome) shoes:
I will try and post a quick update after Joy's procedure on Monday.
Love to you all,
Doug
We have had an abrupt change in plans for Joy's procedures. The angioplasty scheduled for Tuesday Oct. 25th, has been postponed. Doctor Sanchez-Mejia and Dr. Redfield, an expert in infectious diseases, determined that the metal plate that is exposed on Joy's incision line along the edge of her scalp should be removed before any more procedures are performed. That will occur tomorrow, Monday. It had been contaminated with a MRSA infection but we have been treating it for several weeks with doxycycline and the more the infection went away, the more the plate installed to fasten her skull flap has become exposed. Dr. Sanchez commented that the skin appeared to be growing back under the plate which is approximately a half inch wide and an inch long and attached by surgical screws. This has been a problem since at least March, although we didn't really know what it was until a month or two ago. Why it was not diagnosed correctly by the doctors at Carmel Mountain Rehab when we first began to notice in March, I don't know.
We saw Drs. Sanchez and Redfield and Dr. Sanchez's assistant Brenda on Thursday, the 20th. Here's a picture of Brenda checking Joy's vital signs:
 |
| Brenda and Joy |
Brenda is a capable and caring medical professional and we feel lucky to have her working with Joy.
Dr. Sanchez believes we can schedule the angioplasty procedure sometime in the next month. We will keep you posted on that. He told me that there have been advancements in coiling and stenting procedures since Joy had her first angioplasty procedure back in early January and that he will be able to do things for her that could not have been done then. Then there is the matter of the repair of the voids in Joy's skull. I believe it will be several months before we attempt that, but we will continue to consult with Dr. Sanchez on when the best time would be.
We missed some physical therapy dates because Joy had a low grade fever for a couple of days and Nurse Sue's new dog suffered some bite wounds from her two other dogs, which led to surgery and made Sue unavailable. But we went Friday the 21st and had a good session with Rachel. Here are two pictures from that day:
 |
| as photogenic as ever |
 |
| learning to rake again |
Joy looks lovely and healthy these days. She seems happy and contented, although occasionally she asserts her will at what seem like inopportune times for us. For example she sometimes balks at getting into the car before and/or after an appointment or outing. This can turn into a test of wills, which I think is good for her. Although she is improving, she has a long way to go in terms of recovery. In the parlance of stroke terminology, she has "deficits." Her deficits are described medically as "aphasia," "apraxia" and to a lesser extent "dysphagia." She cannot speak except in occasional phrases, she can't do most simple tasks, and while she can swallow and will eat heartily, she tends to "pocket" her food at certain times, which means she doesn't always swallow things immediately and will hold food or liquid in her mouth for half an hour or more. Her deficits are abating slowly, but it is going to be a long process. There is much she will have to re-learn. That said, her progress is frequently noticeable in small and subtle ways.
One day last week, Sue saw that a great blue heron had landed on the wall of our spa, perhaps 25 feet from our back door. (It often feeds on the small fish in our neighbor's large koi fish pond next door.) She brought Joy over to the glass door to see the creature, which is nearly four feet tall when standing perched. Joy looked at it and said slowly, "Oh my!"
I bought Joy an Ipad this week and also one for her sister Susan. The money for this came from the generosity of Joy's co-workers who way back in January donated $1650 in gift credit cards to show their appreciation and help in her recovery. I will never forget the day that Cyndy Smith, Joy's friend and associate at Pitney Bowes, first came to visit Joy at Loma Linda UMC and brought the gift with her. It came at a very difficult time and it moved me to tears. (Cyndy and I went through quite a few tissues that day.) I'm hoping the Ipads can help in Joy's recovery. There are apparently a number of applications at the Apple Store for disabled people to help in their recovery. Susan and I will be looking into them. I am very grateful to Joy's co-workers and thank them from the bottom of my heart for their generosity.
Yesterday, Joy, Susan and Sue went shopping for shoes for Joy, since the ones she usually wears are getting old. Joy loves shoes and was a fearsome and legendary shopper for them before her ordeal. Think Imelda Marcos with coupons. Yesterday, she clearly favored a pair of stitched and studded red shoes with straps. Susan swore that she could tell that Joy fell in love with the shoes and was looking at them from all angles in the mirror. So they bought them for her, even though they cost $300. If Joy--who had a rule to never buy something that wasn't on sale--had known what the shoes cost, she would have had a heart attack. The good news is that we finally got our tax refund this week after filing late this year. Here are the (quite handsome) shoes:
I will try and post a quick update after Joy's procedure on Monday.
Love to you all,
Doug
Sunday, October 2, 2011
October 2nd, 2011
Just a quick post to update everyone and to post some pictures. Joy is moving ahead with her therapy at Scripps Encinitas Rehab Center. She's had four one-hour sessions of physical therapy and two one-hour sessions of occupational therapy. She's showing some dexterity. For example, she can unscrew and screw back on the cap on a tube of toothpaste. She's walking longer distances with better balance every day. Below a photo of her with her therapist Rachel putting a case on a pillow.
Rachel has been teaching Joy how to get in and out of bed more easily (and safely). She also walks Joy and they look at a series of paintings on a wall that are to Joy's right in order to expand her field of vision on that side.
Joy's angioplasty procedure to coil her slowly-growing aneurysm is scheduled for early in the morning on Tuesday, Oct. 25. The hope is that she will be able to return home that afternoon once she comes out from under anesthesia and recovers sufficiently. Then we hope she will quickly be able to resume her therapy sessions. We are in this for the long haul.
We went for a walk this morning out to the street. Here are a couple of pictures:
Rachel has been teaching Joy how to get in and out of bed more easily (and safely). She also walks Joy and they look at a series of paintings on a wall that are to Joy's right in order to expand her field of vision on that side.
Joy's angioplasty procedure to coil her slowly-growing aneurysm is scheduled for early in the morning on Tuesday, Oct. 25. The hope is that she will be able to return home that afternoon once she comes out from under anesthesia and recovers sufficiently. Then we hope she will quickly be able to resume her therapy sessions. We are in this for the long haul.
We went for a walk this morning out to the street. Here are a couple of pictures:
 |
| Our brother-in-law Paul recently asked, "Did Heidi come with that ball installed?" |
 |
| left to right: Beauty and the Beast |
As you can see (or at least those of you who've seen me in the past two years), I've added some facial hair and some pounds. Time for that diet again. Joy's healthy cooking is sorely missed.
Now here's a treat: a couple of pictures of one of our more regal neighbors in Pala. We see him twice a week on the way to rehab in Encinitas. He's over five feet tall, at least seven feet long and probably weighs between 1500 and 1800 pounds:
 | ||
| Glad he's not a carnivore |
Thanks to everyone for your prayers, calls and cards. I'll try and post a few new pictures every week.
Doug
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