ain't that a kick in the head

this afternoon, during physical therapy, gen picked and held up her head all on her own. since gen favors her right side, the physical therapist asked her to turn her head to the left. gen was able to turn her head from right to center on her own, needing assistance from center to left. she is working on focusing her eyes to the left too (again she favors the right side). the speech therapist is thrilled with her facial movements, lip muscles, ability to swallow if she concentrates and her cognitive ability. the way it has been explained to us is that when something like a stroke occurs, if the patient survives, the first things that begin working are the first tier priority things: heartbeat, blood pressure, breathing, coughing, digestion, etc. then the face and head begin responding: expressions, eye movement, swallowing, opening the mouth, communicating. at some point, if the brain stem damage is not too great and if messages can be reestablished by the brain with other parts of the body, the left side usually begins to work, and last of all, the right side. of course this is not set in stone, only a general progression in stroke patients. we have already seen the internal workings functioning on their own, and her face and throat are beginning to work on command, when she wants them to. time will tell how far she progresses, and we will work with her to make sure she has the therapy and assistance she needs to recover what she can. she asked a lot of questions today about what happened, how she is, what caused it, etc. she and I (susan) had a good cry together and promised each other we would not give up or get discouraged, because we know God is in control and He loves us.

-joshua and susan

who can turn the world on with her smile

gen smiled and laughed today! there was still no sound because of the trach tube. it was positively amazing. she did it several times after the initial one. her facial muscles are improving. gen is being weaned off heparin, it being replaced with coumadin. she worked out with the speech therapist and sat in the cardiac chair for her physical workout.

we received a message from olivia woolsey, which reads as follows:

[For everyone who loves the Cordell/Moore families I have good news! An account will be finalized at SMB Bank tomorrow, June 30, 2006 thanks to the efforts of ForAll Bible (where Susan Cordell works). God always provides for His children, and he can use all of us to be the heart and hands of His love and provision during this journey. If you are interested in sharing at this time, just contact SMB and tell them you want to contribute to the Genevieve Moore fund.]

we are humbled and grateful for this gesture,
joshua and susan

let's get physical (and speech-ical)

the speech therapist has been by twice today. she told us that gen has been swallowing on her own and has a very strong cough. gen swallowed on command today. she will also be given daily jaw and facial massages by the speech therapist. we have a new conversation board from speech therapy. it has pictures and ideas as well as letters. they were terribly impressed at the system we had already set up. (here's how it works: we have two sheets of paper. the first sheet has two rows of letters, a-g and h-m. the second sheet has two rows of letters, n-t and u-z. we have her pick sheet, row, letter. it narrows down the choices and things go much quicker. she picks by tightly closing her eyes.) they thought the alphabet papers we had were such a great idea and they were sorry they hadn't done it themselves. the occupational and physical therapist were here today. they held gen up in a sitting position on the edge of the bed. gen still can not hold her head up on her own.

-joshua and susan

a room with a view

gen has a new room! they have moved her to the neuro unit. all the nurses there specialize in neuro patients. she spelled a bit for us this morning, and has been sleeping on and off since.

a funny thing happened on the way to recovery

i talked to a social worker this morning. she told me she would begin the application process for gen to be sent to the mount vernon rehab center for long-term acute care. the mount vernon hospital is run by MU and has a great reputation. a physical therapist visited gen and worked with her for a while. she will be back tomorrow with others to give gen a good workout. so far, gen has had no voluntary movement anywhere but her eyes. she has reflexive movement everywhere.

gen spelled a little for us today. we think it tires her out, so we try not to push too hard right now. we are using letters written on a page(thank you, randi). this morning, susan and i worked with her for about thirty minutes. she spelled "my head is..." we were then interrupted by the nurse, who finished washing gen's hair, dried it, combed it, rearranged her head and pillows, and cleaned out her mouth. when the nurse was done and gone, we asked gen if the nurse had taken care of what "my head is..." she blinked yes. about ten hours later, gen spelled "my head is unc..," and i guessed the rest.

-joshua and susan

sunday evening

It's 10:50 p.m. and visiting hours are almost up. There haven't been many changes today, Genevieve rested most of the day. Randi read a story by a 30-year-old lady who had suffered a stroke had recovered. The lady said that she had communicated by blinking first, and then her family brought a board with letters on it so she could pick letters and spell words.
Randi wrote big letters on paper and Josh took the paper in and tried it. He told Gen it was a trial run and that she should pick an easy word. Josh went through all the letters and told Gen to close her eyes tight when he reached the right letters. Gen spelled "eye." This is good, and with some practice it might become helpful.
Apart from that, Gen watched TV for a while and slept for a lot of the day.
We appreciate your prayers and thoughts.
thanks, Leighton

Saturday evening

Genevieve has been doing well today. There have not been many changes to her state, but she appears to be able now to move her eyes moreso to the left than she had previously. Not entirely to the left, but left of the center, and so we are happy with this development. She has coughed several times today, which is good for her (although it seems fairly unpleasant for her.) All of these things are fairly small, but are nonetheless improvements. And so we are glad. Good night, and thanks for your prayers. - Leighton

slide show presentation

http://www.flickr.com/photos/miepcadex/sets/72157594174974416/show/
I apologize for the url mess. But if you copy and paste you'll be able to enjoy a little slideshow of random photographs we had around.

saturday morning

gen was in a cardiac chair watching tv when we came in this morning. they have since moved her back to the bed. she answered a few simple questions(blinking), but not too many, as we didn't want to push her too hard. her coughing is back to normal. the nurse thinks its a good sign.

-joshua

respirate her no more!

gen is off the respirator! she has been breathing on her own perfectly since 5 this evening. the staff did an ultrasound and an x-ray on her right arm, since it was so swollen. they found three blood clots between her elbow and her shoulder. this is something they expected to see, as it happens often around iv lines. this is nothing to be worried about because, unlike clots in the leg, arm clots will not break off and travel through her veins. the heperin(blood thinner) will dissolve them and they will be reabsorbed. they have removed all the lines from her right side and put one line on her left arm. as today wore on, gen's ability to focus her eyes on one thing improved dramatically. the nurses washed gen's hair tonight. they used a shampoo cap. it's a shower cap with shampoo built into it. gen watched and listened to tcm all day long.

-joshua and susan

today's progress

genevieve's eyes are wide open this morning. she has eye movement from right to center, and we are working on center to left. dr. terry said it is an improvement, and we feel the same. she is answering "yes" and "no" with very definite blinks. dr. terry has her on a trial in which she initiates her own breaths through the respirator. this is part of the process of taking her off the respirator, which he hopes to do in the next day or two. they are hoping to get her out of icu in the next day or two. the nurses are going to try to get her into a cardiac chair, so she can sit up and watch tv. the swelling in her face, as well as her arms and hands, has gone down considerably. she is off of the blood pressure medicine, and her bp is doing just fine. all the staff(dr, nurses, respiratory people) believe she has shown remarkable improvement in the last two days. dr. terry got gen's blood tests back today. she has a genetic condition which causes low activity of protein s. dr. terry believes this to be the underlying cause for the blood clot.
this morning, gen let us know that she did not want to watch and listen to game shows, that she preferred to watch and listen to the classic movie channel(tcm).

-joshua and susan

goodnight post

gen has been in various stages of awake since 6 this evening. they have taken her off propofol. she has been keeping her eyes open for 2 or 3 minutes at a time. she seems to be wide awake. i turned the tele to tcm(turner classic movies) and put the speaker close to her head. i think she enjoys hearing the sound of old movies.

-joshua

Trach & PEG

the trauma team finished with gen's trach tube and PEG(feeding tube) around 12:30pm today. they did not have any trouble with the surgery. she is currently on propofol(sedative), a paralytic, and pain medication, all things they put her on for the surgery. they stopped heperin(blood-thinner), but will resume it sometime later today. gen's face is a little swollen(mainly lips and eyes), but alexsis(nurse) said it was due to the tape and straps holding her face tubes in place and, now that those are gone, the swelling will go down. she will likely be asleep for most of the day. for the next 24 hours, they will monitor both trach and PEG as a precaution, but that is routine. after the 24 hour period, gen will get food and possibly medication through the PEG. today is the first time we've been able to see her full face in one week, and it looks just as beautiful as ever.

thank you all for your thoughts and prayers.
-joshua

Little bit of information

Okay this is randi and well, I don't do entries with the same to the point savvyness that leighton does but here goes.... This morning an occupational therapist worked a bit with gen having her raise her arms and bend them with her assistance. I don't know how well that really went but there was a bit of movement (not on her own) This afternoon they have done an EEG, we have yet to recieve the results. A resident radiologist had also removed one of the arterial lines (one that was keeping track of her blood presure, they are still monitoring it but using a cuff instead.) Because of this removal she has to remain still for six hours so not to cause difficulties with the clotting of that artery. Due to that the medical staff has increased the propofol so that she will be sedated and still. Apparently she was moving her knees up against the pressure of the doctor setting the clot in the leg. ( he had to apply pressure for 20 straight minutes.) I'd like to think that it wasn't a reflex but rather gen being sassy. I will say that so far all of the staff we have met or dealt with have been so kind and willing to walk us though the jargen.

Wednesday afternoon update

It's Wednesday, approximately 1:10. The resident with the trauma team spoke with Josh and Susan this morning. He said that they are planning on doing the Tracheostomy and feeding PEG on Thursday morning, but it is not definite. They will be able to do the surgery in the room, and will take her off blood thinners 2 hours before the surgery. It is possible that the timeframe will change, because the surgery will be done by the trauma team. They sometimes get emergency calls which take priority.
Josh obtained an address to which cards may be sent, if anyone wants to send a card. The address is:
Genevieve Moore
c/o KU Hospital
3901 Rainbow Blvd.
Kansas City, KS 66160

This is all the information we have received at this point. Genevieve looks about the same as she has for the past few visits. She has good color, and is at a good temperature, and she is matching the breathe-assist machine with 10 of her own breaths per minute. This level varies, but usually is around 20 when she's awake (10 machine, 10 Genevieve). The staff here has been phenomenal. The nurses are all very nice, helpful and informative (especially Alexis) and the doctor speaks plainly and makes good sense. This, we have come to find out, is a rare quality in a doctor.
Thank you all for your prayers and thoughts.

About Visiting - Read Me

This is Leighton, from the hospital on Tuesday evening, June 20th. We have set up this blog for anyone who is concerned about Gen and wishing to know her medical status. We appreciate all of your prayers and thoughts in the matter, and Genevieve is most definitely in need of them. Please feel free to call us if you have our numbers, and leave a message if you don't get us. We keep our phones close, but we have technical difficulties at times (lack of service, dying batteries, etc.)
We would request that you don't visit at the hospital, unless we have asked you to come. Visiting times are fairly limited, and the waiting room is usually crowded with other families who have loved ones in the ICU.
Please check this blog, and we will try to update it regularly as we get information from the doctor.
In closing, I will say thank you for your prayers. Genevieve needs them.

6/20/06 Tuesday evening

For anyone visiting this blog, this is an update on the medical condition of Genevieve Moore, following the stroke she suffered on Thursday morning, June 15.
It's 9:45 on Tuesday evening, June 20 and we have just visited Genevieve. She had her eyes open when we went in, and was able to look at us. Josh had been in earlier and she motioned (by blinking 3 times) that she knew he was there. She has been communicating in this manner since the first time she opened her eyes.
The doctor came in earlier today and gave an update on the results of the MRI taken earlier today. He said that the blood vessels in the back of the brain are open, which is good, but that there appears to be damage on both sides of the brain stem. He said that this means that both sides of the body will likely be affected. However, this damage is "patchy" according to the doctor, which means that some of the areas are not as damaged as others, and this could be good. We won't know what the damage is until she is able to wake up fully and work with therapists and doctors to see what she will be able to do. The doctor said it would be a waiting game. We are talking 6 months to a year to know for sure.
He also told us that the mortality rate for a stroke of this nature is 75 to 80 percent, and that Genevieve had already overcome incredible odds just by surviving.
The plan is to install a trach tube and a feeding peg, probably tomorrow. These are preferable to the tubes down her nose and throat because they won't damage her vocal cords like the tubes will. The tracheotomy is scheduled, but we have not heard an exact time frame for when the operation will take place. The doctor said that he believes after the operation Genevieve will be able to be moved from the ICU and will no longer require respiratory assistance.
That is about all the news we have received.
Thanks for reading, and we appreciate your prayers and thoughts.