saturday evening

it is so nice to know that people care enough to read about gen here, and to pray for her and her progress. i am amazed and humbled by the comments from friends new and old, by the dedication to prayer i see in church groups all over, by the kindness extended to us through this blog. thank you everyone for keeping us in your hearts and trusting us to God's care. that's where i want to be. gen had a slow day since it is saturday, but she did work on the arm bicycle in ot (she pedalled it frontward and backward with her arms today...backward was a first) and she practised driving the wheelchair in pt. david was her therapist today, and he had her work on driving around cones outside where the weather was beautiful. tomorrow is supposed to be in the 90s, and gen is looking forward to that. she gets to go out tomorrow afternoon again. today she also had company, and she would like to say thanks to dick and eillen for the flowers and the cookies and for the nice visit. she's sorry pt cut short the goodbyes with you. gen says thanks to forest for the stuffed animal and for bringing leighton and randi for a visit. and thanks to leighton and randi for bringing the top layer of the wedding cake for josh and gen's first anniversary celebration tomorrow.

susan

friday evening

gen worked on her cursive with and without e-stim during ot. in pt, she worked on more of the standing. for speech, she played more pitch and volume video games. she had her feet recasted today, which made her miss out on an hour of therapy. oh, well.

-joshua


message from gen to jenny- carnies. circus folk. small hands.

thursday evening

we started off the day with an early breakfast and then swimming therapy. gen stood longer today in the pool than she had before. she also pushed down into the water with her arms. in ot we had a training session for relaxing gen's shoulder muscles so her arms can move more freely. we did this in the half hour before pt so she would be ready for kneeling. she balanced on an exercise ball, which required her shoulders to be raised higher than is comfortable. she did well. at the end of the session, we (amy and courtney and josh and i) all helped gen stand up without the standing frame. she went from the mat to the wheelchair without our using a slideboard to transfer her. this was a first. in speech gen was talking loudly and longer than the speech therapist had ever heard. in her second speech session, we used a computer program that showed the pitch and volume of gen's speech on a graph. we used another program that required her to change pitch to make hummingbirds move up to flowers on the screen. she scored higher than our goal for the day was, which means she had more range of pitch than katie expected. that's great; it means she is getting away from a monotone. it requires a lot of muscle control to change pitch. yesterday one of the speech pathologists had gen make a video demonstrating four different eye/computer screen systems. the video will be used for teaching other speech therapists how to use these programs. gen made it all look easy. they said she is the fastest learner they have had using these systems. we thank God for answering prayers for gen's recovery. every day we get something new. we thank all those who care enough to read about gen's progress.

susan

wednesday evening

we got another week! all the therapies went well today. gen worked on typing with her mobile arm support in ot. during pt, she had e-stim. she told us that, for the first time, she could feel muscles in her legs kicking in. tonight she started isolating her leg muscles by kicking out her legs alternately.
keep those comments and cards coming. we love to hear from home.

-joshua

tuesday evening

gen had a tough day today. breakfast at 8, pool therapy at 9, ot from 10-11, pt at 11:30, lunch at 12:30, ot at 1, pt at 2:30 and speech from 3:30-4;30. josh and i had to work with gen in a transitional apartment here, practicing things you would do at home, like getting into and out of the shower, getting around furniture, etc. we did this after therapy and before dinner. by the time we did all gen's exercises and stretches with her, everyone was ready for a break. it is tough for gen to keep going all day like that. every action she does requires effort. she has to focus all her thoughts on what she is doing, whether it is moving her legs, writing her name or working on speaking and breath control. i have to remind myself every day that nothing is easy for her right now, and it is amazing to me that gen keeps her patience with me as i bumble my way around trying to help. i thank God for gen's christian spirit. God is greatly to be praised for reminding us of His love every day, whether it is through an especially beautiful sky or a brilliant rainbow, a bunny rabbit on the lawn or a cheerful birdsong, gen's ability to move and speak or her progress in the pool and in the gym. every good and perfect gift comes from above from the Father. the best gifts of all are His own Son from whom we have peace and His Spirit in whom we have comfort. what more do we need?

susan

monday evening

today, we had another outing. we went to the sunken garden. gen worked on driving her wheelchair with her hand. the paths were all cobblestone, so it was hard terrain for her to drive on. the sunken garden looked like any other garden but bigger and with more bees. during pt, gen got stretched out on her back and on her stomach. tonight, gen was able, for the first time, to sustain her voice for a long period. she's been working on this since we were at ku.
jenny- gen was going to say the same thing. is that a titleist?

-joshua

sunday evening

gen didn't have any therapy today, but she put herself through her paces anyway. she had josh and me do all her arm exercises with her. she practiced her talking too. at noon we had company arrive. leighton and randi and kyle and meghan drove up to see gen and to bring birthday presents for josh. we all went to the house we are staying in...gen drove her chair all the way from the hospital across the parking lot to the street. josh drove her on around the corner to the house. the weather was perfect and we sat out on the patio for lunch. we had such a good visit and such a good time. mid-afternoon we came back and took everyone on a tour of the hospital, including a side trip to the gym where gen showed everyone what she can do. we were sorry to see them leave, but we were so happy to see them and to spend a whole afternoon with friends and family from home. after they left, gen kept working on her speaking, and managed to get her voice to go from a low tone to a high tone and back again...like playing trombone with her voice. she has been working on this in speech but hadn't gotten it perfected till tonight. she wanted me to say to jenny, "they're chocolate; they're mint; they're delicious!"

susan

saturday evening

in ot, gen worked on the arm bike for the entire session. in pt, she did sitting excercises. gen practiced driving her wheelchair. we are looking forward to tomorrow because gen will be able to leave the hospital with us and visit the house where we're staying.

-joshua

friday evening

we had another festive day today. gen's therapists ordered in an italian feast from valentino's and we all had lunch together (even the case workers and the doctor were there). gen ate pizza, lasagna, mostaccioli, and even a piece of a breadstick. her speech therapist was so impressed that she asked the doctor right then and there to okay gen for the soft food diet (level 3) and he said yes. this lunch was a birthday party for josh, but we ran out of time before we got to the cake and ice cream. we did have time however for gen to sing "happy birthday" to josh. there might have been some dry eyes in the room, but not on my face. she is talking so much better, and working on inflection and intonation now. in st she worked on loud/soft, low/high and then worked on some of the harder consonants like "g" and "k". she got the "g" at least two times and thrilled the speech therapist. in pt she worked on hamstrings and she did a kneeling exercise which really stretched her. in ot she worked on shoulders and on writing. she tried writing with the paper flat on the table today, and it was great for her. (she had been using the draftsman-like table before.) in afternoon st we had cake and ice cream (all chocolate) and laughed a lot. she practiced driving the chair herself and got so much more control over her hand movements that everyone was impressed. tonight after she got into bed, she practiced moving her right hand left-right-forward-backward. the strength in her arm is noticeably better. we plan to do more practice with the driving tomorrow, and she should have one session of each type of therapy too. she doesn't want to slack off on her exercises at all, because she can see progress, and that is important. thank you all for your prayers on her behalf. i know people are praying for her recovery and for her to keep her spirits up. most of all i know that all of you are praying for God's will to be done in her life and ours. it means so much to us to know people care enough to entrust us to God's care, knowing He knows best what we need. thank you.

susan

thursday evening

pool therapy was great today. gen got to stand up in the pool. she still required assistance, but told me she was doing 50% of the standing work. she also got to roll over and over and over and over in the pool. in ot, gen did some shoulder and upper arm stretches. she got to stand in the standing frame for pt. we went to the movies this afternoon. we saw idlewild, the outkast musical. it was awesomely awful and terribly terrific. thank you for all the b-day wishes. i guess they worked, because i did have a happy b-day.

-joshua

wednesday evening

gen had a pretty good day today. she had e-stim again in ot, and practiced writing. she got to sign her birthday card for josh when he was out of the room. she was so happy she has a surprise for him. the last part of ot was devoted to finding a satisfactory joystick for gen's wheelchair. we finally had success! she steered herself around the gym, and then in pt she drove down the hall to the cafeteria and back. everyone was so happy she can use it now. in speech she practiced again talking louder, and also practiced singing "happy birthday to you" getting ready for the birthday party. she gets to help bake a cake tomorrow using some gadgets they have here that will let her do some of the work. early this evening, when all the therapy was over, gen had a little sick spell (felt nauseated, sweats and then chills, blurry vision, a tingling in her forehead and eventually a headache and dizziness.) we called the nurses as soon as she said she wasn't feeling well. they checked for low blood sugar and several other things, but found nothing wrong. she felt bad enough that her stroke doctor recommended she go by ambulance to a nearby hospital's er (but as a non-emergency trip) to get a cat scan as a precaution. we were at the other hospital a couple of hours while they did blood tests and the cat scan. everything turned out fine, and they don't really know why she had the spell. she felt a lot better by the time the ambulance brought her back to madonna. it was a relief to have them react so quickly and rule out another stroke, which was something gen feared. all's well that ends well. we hope to jump back into the therapy schedule first thing tomorrow morning with the pool therapy at 9 am. gen wanted me to say "thanks" to aunt judy and to say to jenny "bop she-bop."

susan

tuesday evening

st- today, we learned that gen is not officially on level 3 foods. she had a trial with bread and cookies. the bread got stuck, the cookies were no problem. during the co-treat with pt, gen worked on breathing, yelling and phrases like "help me" and "right now."

ot- for the first hour, gen worked on cursive writing and ice cream eating with her arm supports and e-stim. for the last half-hour, she had some new and intense pec and shoulder stretches.

pt- the first session was devoted to adapting gen's wheelchair. in the afternoon, gen did some sitting excercises. she did very well.

gen also had pool therapy this morning.

-joshua

monday evening

boy, it got cold up here this weekend. the low tonight is supposed to be in the 30's, if you can believe that! since we are indoors most of the time, it doesn't really bother us. gen started off the day with a good speech session. her regular therapist was back from vacation, and she was pleasantly surprised at gen's improvement since last week. her tongue is stronger and her voice is more understandable. we haven't had any problem with level 2 food (chopped meat, pasta, canned vegetables and fruits) so katie decided to move gen to level 3. i don't know esactly what that is, but she can try to eat whatever she wants to try. this includes bread, which was not allowed on level 2. well, she had french toast and cinnamon rolls, but they were slurried. if you don't know what that is, i can't explain it. the end result is an item that sits on a plate and looks like a cinnamon roll, but it is mush. so we are excited about the prospect of better food. in ot she worked with the controls on the wheelchair (still not adjusted totally right.) in pt she worked with her legs...hamstrings in the morning and quadriceps in the afternoon. gen loves getting cards in the mail, and we thank everyone for continuing to remember her in this way. she has gotten a couple of musical cards, and she really likes them. she has started keeping time with her head when she listens to them. we really appreciate everyone's comments, cards, prayers, thoughts and gifts. we know we are not alone, because Jesus said he would never leave us or forsake us. but it is nice to know that there are people all over the place who also are with us in spirit. we are blessed.

susan

saturday evening

we had a regular saturday today, with only one half-hour of each therapy. the weekend therapists are always people we don't know very well, but they try to use the notes from the regular therapists to direct the sessions. in speech, gen worked on breathing and vocalizing as usual. every day she is able to speak louder and more clearly. (note to john: "e" is hardest for her because it requires more of the mouth to move, involving the smiling muscles that she is just getting back. "a" and "i" are just kind of open mouthed; "o" and "u" use the lips in a forward position; "e" needs the lips and tongue flattened out and pulled to both sides. hope that explains it more clearly). in ot gen worked on writing, and did better than last time. she is tracing cursive letters on paper propped on a draftsman-like table. in pt she worked on sitting balance, and for the first time she sat up straight with no support from anyone else. she practiced leaning forward and backward and to each side, and straightening herself back out. the substitute therapist was very good with her. the rest of the day was free...we watched tv, played cards (texas hold 'em poker) and looked out the window. the weather is stormy (tornado warning last night and storm warnings today.) i like to watch the clouds and remember that the Lord will come with clouds. i like to feel the wind and remember that the Lord walks on the wings of the wind. He reminds us every day that He is with us and will never leave us or forsake us. we also remember that there are many people who remember us every day and who will be there for us no matter what. we are grateful.

susan

thursday evening

today was probably the busiest we have had so far. we got gen up and dressed early, and she had time to eat about half her breakfast before we had to leave for the pool. she spent about 40 minutes iin the therapy pool, moving her arms and legs and her whole torso in 92 degree water. the therapist was a very nice lady who will be working with gen two days a week from now on while she is here. we got back to the room with about 15 minutes to dry and dress gen before speech therapy. right after that she had ot for an hour and then pt for a half hour. her first break was at noon. the morning ot was spent working on fine-tuning the joystick for her wheelchair. the spilled over into pt. her regular speech therapist is on a vacation, so she had to work with someone else who was just getting to know gen. ot worked with her during lunch, letting her feed herself part of her food. in afternoon pt gen stood again, and did new stretches twisting from right to left. this used some muscles she has not been using. in afternoon speech she worked with the new lady again, and they worked on vowel sounds mostly. "e" is still the hardest to speak clearly. all in all, a busy and rewarding day. we're pretty happy about the pool therapy. gen was very pleased to be in the water again. thank you for checking the blog and keeping gen in your thoughts and prayers.

susan

wednesday evening

in st, gen worked on making "sss" and "shhh" sounds. she's working a lot on breaking up her voice. during ot, gen drove her chair, used the arm bike, and practiced writing cursive. for pt, gen laid on her stomach and back for some stretches and had e-stim. tomorrow will be her first day in pool therapy.

-joshua

this is susan and it is tuesday evening. sorry the title is below the paragraph. gen had another busy day today. she worked on vowel sounds in speech, she drove herself in her chair to ot, she had e-stim on her wrist in ot which made her better able to use a spoon or pen or the controls on her chair. in pt she worked on standing in the morning and did work on sitting and leg extension in the afternoon. she can lift her legs from the knee nearly straight out from a sittinig position now. that is so great. this evening, she showed us that she can tighten her right hand and then open it. she keeps practicing what she has been able to do, and keeps trying things she hasn't yet mastered. we are so pleased at her progress, and we thank God for keeping her safe and well.

susan

tuesday evening

monday evening

during speech, gen clucked her tongue. her st and pt were pleasantly surprised with her breathing. she is breathing more from her stomach and less from her chest. in ot, gen worked on using her wheelchair, eating, and writing. she's started using cursive, per susan's suggestion, and it is working better than print. during pt, gen had e-stim on her legs. it went well.

-joshua

sunday evening

today was even more relaxed than saturday was. there were no scheduled therapy sessions, so we worked on breathing, talking, sitting, kicking, etc on our own in gen's room. gen's sitting strength is stronger than ever. she can lean forward and pull herself back to a sitting position with no help. she can put her shoulders back and sit very straight and tall. she can lean to the right and left and pull herself back up straight every time. this strength in her torso is crucial for standing and walking. we are so happy to see the progress she has made. as always, we know that God is in control and He always hears, always sees, always knows what is best for us. we are thankful for that.

susan

sunday evening

today was even more relaxed than saturday was. there were no scheduled therapy sessions, so we worked on breathing, talking, sitting, kicking, etc on our own in gen's room. gen's sitting strength is stronger than ever. she can lean forward and pull herself back to a sitting position with no help. she can put her shoulders back and sit very straight and tall. she can lean to the right and left and pull herself back up straight every time. this strength in her torso is crucial for standing and walking. we are so happy to see the progress she has made. as always, we know that God is in control and He always hears, always sees, always knows what is best for us. we are thankful for that.

susan

saturday evening

we had a pretty easy day. gen only had two half hour sessions. in ot, we went to the gym and worked with the arm-bike. the pt came to gen's room and did some stretches. we started a movie, but didn't get to finish it... maybe tomorrow. gen worked on her hand-controlled wheelchair for half an hour. she is getting better at it.

-joshua

friday evening

another week gone, with much to show for it. gen has started moving her wrists, up and down and right to left. she can straighten her shoulders and hold herself up straight. she can kick each of her feet from the knee almost straight. she can smile when she wants to, not just when she is amused. these are all huge moves forward. just today she was okayed to move to level 2 for meals. this means no more pureed hotdogs or pureed lasagna with gravy. she will have cooked pastas, canned vegetables and fruits, and ground meats. she is already on thin liquids, meaning just like the rest of us drink. also today she was okayed to use the therapy pool. this will take a few days to get the schedule worked out, but hopefully by the middle of next week she will be doing that as another important therapy. the water is a great medium to work out in, and on top of that gen is a real swim-oriented person. she was thrilled to hear she was considered ready for this. Our God is great, and He is merciful. He knows how much we can bear, and does not press us beyond our capacity to endure. He gives peace and joy even when the world around is anything but peaceful or joyous. we thank God for all the blessings, and we thank Him for giving us caring friends and family who support us so faithfully with prayers and cards and thoughts and encouragement. we appreciate all of you very much.

susan

wednesday evening

even gen's therapists comment that she does something new every day. today in speech she worked with the laser screen. in ot she practiced some of the everyday things she will do when she goes home. this place has rooms just off the gym fixed up like kitchen, bedroom, bathroom, etc and each are furnished with everything you might need in them. they really work on getting people to be independent no matter where they are in their recovery. then courtney, the ot, surprised gen by having her try a joystick-controlled wheelchair. this is a step up from the head-controlled one she is using now. if she can do well enough driving with her hand and arm, she will not have to use the head array. she really would rather be walking, but if she is in a chair, she would rather use a joystick than a head array. there was talk all over the hospital about gen's advancement. in pt she had electrodes used on her legs, and she kicked and moved both legs well. after a few uses of the electrodes, her legs should move better on their own if they do like her arms did. the electodes stimulate the muscles to work, but her brain gets the picture and picks up where it should by telling the muscles to work when the brain tells them to. she did more vocalizing in speech/pt in the afternoon. she was able to say four and five syllables in a breath. her therapists were well-pleased with her work today.

susan

wednesday evening

tuesday evening

gen's breath control is getting better each day. she has started getting longer vocalizations. in pt today, she pinched her shoulder blades together for the first time. this is something we have been working on for quite some time, and is a big step in holding herself up and keeping her back straight. gen got to eat a popsicle in ot using the mobile arm supports and e-stim. she also did a little writing. she has started helping susan and i with her arm and leg excercises that we do every night.

-joshua

monday evening

gen got a new attachment for her wheelchair today. it allows her to change the mode of the chair (from forward to reverse or to tilt) by moving her head. there are still some kinks that we are working out. but when it works right, it will give her more independence for as long as she is still using a chair. in speech she worked on multi-syllable words. the therapist was only using two-syllables, but as soon as she left, gen turned to me and said she wanted to watch the law and order marathon, saying the word "marathon" as clear as a bell. three syllables with no effort. in pt we worked with the chair most of the time, but amy also did some new stretches for gen's back that will help her flexibility for standing and walking later. in ot we used the electrodes again and gen applied lip gloss and fed herself. the big news, though, is that gen can do chipmunk cheeks, pursing her lips and filling her cheeks with air. this is a big step forward. it means that the muscles in her mouth are stronger and her breathing is good enough to get a mouthful of air. we are blessed indeed. thank you for your prayers and comments. God has been very good to us.

susan

saturday evening

gen had a good time at the zoo yesterday. that outing counted as physical therapy and recreational therapy, and both those therapists went along. in ot gen worked with her arms, feeding herself using the mobile arm support. in speech therapy katie switched gen to regular liquids instead of nectar. this means she can have coffee or juice or water without our having to thicken it. it tastes much better in its real form than thickened. she had a good night's sleep, and today was a slower pace in therapy. she worked on sitting and leaning in pt, feeding herself in ot and working on strengthening her tongue in speech therapy. she is eating three full meals a day, and has fruit or yogurt with her medications (pills are powdered and mixed in). she had lots of visitors in the last two days. gen says to jenny, richie, connie, carey and momo, "thanks for coming to see me, and i hope you had a safe trip home." it was very good to see gen talking by way of her laser computer screen and laughing with her company. god has blessed her with something new every day, and that is a wonderful answer to the prayers of many people. thank you for caring.

susan