Dear Friends and Family of Joy:
Saturday, September 1st: Joy has come through her reconstructive surgery in fine form. Doctor Sanchez was pleased with the result. In the early morning before the surgery, he told me that he had been viewing 3D models of Joy's cranium the previous day and noticed that the clip that had been installed to isolate one of her aneurysms was dangerously close to the inside surface of her skin that covered the void at her temple. He was concerned that when he peeled back her skin in that area in order to install the Titanium mesh, that he might disturb the deformed artery that had been clipped. That did not happen as it turned out, thanks to his careful efforts and expertise as a neurosurgeon.
The surgery lasted only two hours and fifteen minutes although Dr. Sanchez had reserved four hours in the event he encountered problems. It went well and Joy was placed in Intensive Care for the rest of the day and night. She was mostly unresponsive during the rest of the day, but this morning she was awake and alert although she seemed annoyed at having gone through surgery once more. Here's a picture of her this morning in the ICU, twenty-four hours after coming out of surgery:
For me this morning she didn't smile at all, but this afternoon after coming home, I got a call from our friend Dr. Chuck Smith, who had stopped by after work to see Joy. She'd been moved out of the ICU and was in the secondary neuro-unit. He said she was smiling broadly and that she looked great. We are hoping to bring her home tomorrow.
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Update, Tuesday September 4th: "Tomorrow" was Sunday and she did not make it home. Speech therapists were concerned that she was not eating and that she pocketed some apple sauce they gave her. She failed what is called a "swallow test." This was not an unusual occurrence for those of us who have been caring for Joy at home for the last 16 months, but it alarmed the specialists at Scripps Green sufficiently for them to advise against her release. The neurosurgeon on duty, Dr Uchiyama, considered their opinion and decided to keep her one more night. The following day, the same thing happened with the speech therapist, Joy didn't eat and pocketed some liquid, but after a long consultation with Dr. Uchiyama, who asked all the right questions (Dr. Sanchez was off-duty all weekend), she was allowed to come home on Labor Day.
I was somewhat concerned myself about bringing her home because she appeared to have weakened overnight, but once home she responded as we thought she might and started eating and drinking as we hoped she would. My sense is that the constant attention she got in the hospital-- the turning and changing of position every two hours, the regular checking of vital signs-- combined with the noise of the equipment and its seemingly endless variety of beeps and buzzers, had deprived her of sleep and sapped her energy. Once home, she seemed to return to normal within a couple of hours, although she is understandably still weak.
Here's a picture of Joy just before she was released on Monday afternoon:
She's managing a little smile, probably because she knew she was going home. She looks a little flushed because she had a slight fever, which stayed with her throughout the day, but now, on Tuesday morning, is nearly gone.
And here's a photo taken just before noon today. Nurse Sue Thomas had cleaned Joy up and fixed her hair so that it covered her incision pretty well. The incision is far longer and higher up on her head than I thought it would be. I thought Dr. Sanchez might use the original incision line but I was in error. I'm not sure why, but he cut an entirely new line that ran up near the center line of her head and then down to her ear. I'm sure he had his reasons. She's tired and cranky, but who wouldn't be under the circumstances?
Joy's 60th birthday party on August 12th was a happy occasion and Joy thoroughly enjoyed herself. We had upwards of 15 guests and Joy received too many presents and cards to list here. Special thanks from Joy and me to all those who contributed to the celebration, including sister Susan, who did much of the cooking. I could tell she didn't quite get the concept of blowing out the candles on the birthday pie so I blew them out for her with the hope she will receive the blessing of the deeply-held wish of everyone in attendance that she will continue to recover and improve in the years to come. We are in this for the long haul.
Below a special gift given to Joy by our neighbors and dear friends Donna and David Wilbur. It's metal sculpture cut out of sheet steel and we love it, since it evokes a scene those of us who live in Rancho Heights see on a daily basis: coveys of California quail running across our meadows, hillsides and roads:
Thank you, David and Donna, and thanks to you all who continue to pray for Joy and keep her in your thoughts.
Love,
Doug and Joy
