Friday, December 30

Terry arrived today and will be the new contact for Margaret's friends.  My phone number is 763-432-9090.
Margaret was happy to visit with Jeremy and Amelia and their friends and watched a movie with them while snuggling with her daughter in bed.  Friends came a bit later in the day bearing gifts of strawberries and cream and chocolates.  First day of real food that didn't look like baby food - lasagna for dinner!  Since Barb was the food police I now need to take that role and make sure she eats carefully and eats well with good veggie and fruit drinks.  One of her favorites today was blueberry kefir.
 It is again a holiday weekend at the rehab center so there won't be as much therapy.  It will rev back up on Tuesday with a full day's schedule.

Happy New Year from Margaret and her family!

Thursday, December 29

We are settling into rehab life. Margaret's schedule has been shuffled around a bit to allow her naps in between therapy sessions, but already in 1 day I have seen her stamina increase.  I guess what I am learning is that every day can be very different from the last.  Margaret's head and eye movement to the left is increasing and she gains a bit more independence with each day as she learns to balance and control her body.  She received a pleasant manicure and pedicure from 4 wonderful friends last night and there was quite a bit of giggling and laughter going on as I kept furtive watch for any staff in uniform who might take an inkling to stop such women fun!  Actually the staff is great, very respectful and caring.  The women closed the evening with the rosary and prayers for Margaret and her recovery.  Thank you for such an uplifting gift you gave both of us.
  Terry, Margaret's brother will be arriving in Atlanta Friday as he takes over from Barb. I am sure he will give you his contact information so you can keep in touch.
 

Tuesday, December 27

"Amazing Grace" resounded through the family room as Margaret played the piano today.  Half asleep, since Recreational therapy came right on the heels of OT and PT and ADL (adult daily living) therapy, she could still play perfectly with her right hand.  We were on next to play poker, but one can't do that in your sleep! (Darn, I was ready to bet her on that beautiful shawl she received).  After a nap, lunch arrived and in the afternoon more PT and speech therapy.
  The flowers, balloon, Santa toy and cards are all used by the therapists to turn that head to the left, so thank  you again for making the room so bright and cheerful!
  We have a few needs if anyone cares to bring something.  Shoelaces that are elastic - the curly kind - would be appreciated.  A pedicure and manicure would be a welcome gift at this time if the curist (new word) would be able to come to the rehab center.  My phone number is 952-356-2841 (Barb - Margaret's sister).  Just a note after seeing how today went:  I'm guessing a visit late afternnoon or evening will be better than earlier as Margaret needs the naps after therapy right now.  
 

Monday, December 26

 Margaret spent Christmas with her children, sister and friends.  Although it was a holiday she still had OT and PT therapy.  There was a Christmas service which she attended and a special brownie treat whipped up into puree.  We are told that tomorrow, once the holidays are now past and regular staff is on hand, the program gets stepped up quite a bit. So, I am letting her take a little doze this morning after OT, but we will attack bedside exercises at intervals throughout the day.
  If you come to visit, ask the woman who is in her room if that is her mother.  It will bring a really big grin to Margaret's face!  Although I'm only 4 years older, 2 nurses have asked that question already!  OK, Margaret does look quite young in her boyishly cute crew cut and I do have grey hair; maybe time for a dye job?
 We are reading together the book, Infidel which the book club will be discussing in January.  There is a bookmark in it, so feel free to pick it up and read for awhile with her if you so prefer.  We have a CD player in her room and if you would like to bring some CD's to play, that would be great. If you leave them for awhile, just label them with your last name.
 Margaret is doing wonderful and does work hard on learning new skills.

Saturday, December 24, Christmas Eve

Thanks for all the visits.  I am continuing with speech, occupational and physical therapy. The staff is encouraging and upbeat. My goal is to be back at home within a few weeks. Thank you Pam, for decorating the wall with ribbon and cards.

Dictated by Margaret to her sister, Barb

#2 Friday December 23

Emory Rehabilitation Center Phone Number is:  404-712-5512

Friday December 23

Margaret is snoozing away after 3 hours of therapy this morning.  She is practicing standing, sitting, moving her head and eyes to the left (extremely hard right now) and balancing.  She was driving her wheelchair yesterday but almost mowed down a doctor and decided to get even with her sister by pinning her against the wall.  Please check the wiki post "margaretinatlanta" for info on visiting, what to bring, parking, etc when visiting.  Margaret is still on a pureed diet but is looking around for salmon and octopus.  A thick juice such as Naked vegetable and fruit juices she likes and it is a change from the hospital fare. Santa Claus gave her a call last night so he knows where to find her!  Her family will most likely start working on her house to make it more wheelchair accessible as soon as we know a bit more next week.  If anyone has references for good home care  please pass that along.  For those who asked about sending cards and gifts her address is:
Margaret Pumper
Room Number 444
C/O Center for Rehabilitation Medicine
1441 Clifton Road, NE
Atlanta, GA 30322/

Thursday, Dec. 22nd

Margaret has moved to Emory Rehab which is right across the street from the hospital.  She is in Room 444.

#2 Wednesday December 21

Just in- Margaret will be moving to Emory Rehabilitation Center tomorrow which is just across the street from Emory Hospital on Clifton Road.  Visitors are still welcomed - we just don't know the schedule yet.  Margaret is improving each day and her sense of humor keeps the therapy on a light note.  Roach, your Santa light up toy has proven invaluable to the therapists!  And Kathleen the quilt looks homey and beautiful on her bed tonight.  Joanne the pudding was gobbled up before anything else and not a drop of lunch was left. Manay the poinsettia adds to the cheeriness of the room with it's bright red petals.  Thank you from Margaret for all the support that is given.

Wednesday, December 21

 Thanks to my Atlanta friends who visited today, including Joanne and Barb.  Barb (my sister) is helping me research rehab facitlities.  I expect to choose a place by Wednesday. The nurses are taking good care of me and I get a warm bath every morning.

Wednesday, Dec. 21 (specific question from Mary)

Hi Atlanta friends,
Barb had posted that Margaret will be going to a rehab facility soon.  As of now, we're looking at Emory and Shepherd Center.  Do you know of anyone who works at either one of these facilities or is in the medical field and has a recommendation?  From what we currently know, either one of these places would be an excellent choice.  This question was also posted on the wiki website.  If you don't know what I'm talking about, look at the comment from Dec. 19.  Thanks.

Tuesday, December 20

Margaret is working at her rehabilitation as the Physical and Occupational therapists visit her and help her gain strength and mobility. After a few medical tests are finished she will be moving to a rehabilitation facility which we will keep you updated on so you will know where to find her!  From what I understand it will be an intensive time of work and classes. She has had visitors and greatly appreciates them.  Thank you for the flowers, cards and prayers you offer.

Monday, December 19

So much has happened since arriving at Emory hospital in Atlanta.  Physical, occupational and speech therapy have been initiated, visitors are starting to arrive, more tests are being taken.  Margaret was given a swallow test and finally was able to eat a hearty lunch today which she will need as the therapists have her doing many physical tasks. Rehab is all important right now.
  We would love to have you come visit Margaret as this is an important part of her recovery.  She is suggesting smoothie flavors to bring her and as of now your presence and encouragement is vital.  Thank you to those who consistently offer their help!

Saturday, Dec. 17th

A VERY BIG day today!  Margaret arrived safely at Emory Hospital in Atlanta.  We're just waiting here now for the doctor.  Upon arriving at the hospital, Margaret really perked up  - I mean, all of these people talking English and we could understand everything they were saying!!  Her room is so spacious and comfy compared to what we had in Spain - it really makes you appreciate everything we have here in the US that we so often take for granted.  I think Margaret and I are both going to sleep like logs tonight.  I'll be heading back to MN tomorrow and our sister Barb will be taking over.  She arrived in Atlanta earlier today and met us at the hospital. I had hoped Margaret could write the blog tonight but she's already sleeping peacefully so maybe tomorrow.  Since this is my last blog entry, I just want to tell you how much it has meant to me to read your comments and know that there were so many people praying and thinking of Margaret while we were so far away. 

Mary

Friday, Dec. 16th

We are scheduled to depart Madrid Saturday morning via Delta commercial carrier and upon arriving, being transported to Emory University Hospital.  Please pray that if for any reason this should not happen at this time, that God will intervene.  Pray for a safe and uneventful flight and easy traveling for Margaret.  She is excited to come home.  Although I know that we'll have to hand out numbers outside of Margaret's room (!), please no visitors until we let you know that she is ready. Saturday will be a very long day and with the time change, remember that 6 PM Atlanta time is midnight Madrid time.  It will take a few days of adjustment to get back to the Eastern time zone. Tonight, will you please pray with me, "Dear Jesus, we ask that Your Will be made known.  We pray for your hand of healing and protection upon Margaret as we take this long flight home.  May your angels surround her and may Margaret feel Your peace.  Give the nurse who is accompanying us the wisdom to take the best possible care of Margaret. We ask this in Your holy name. Amen."

Wednesday, Dec. 14th

Starting to talk specifics about coming home now. Discussing commercial airliner vs. air ambulance - travel insurance company believes commercial airliner will work but have to have clearance from the airline for them to accept the passenger.  She will be traveling with medical personnel. Should know tomorrow about which hospital will be the receiving hospital.  She will be transported to the airplane via ambulance and in Atlanta, will also be transported to hospital via ambulance. Started rehab today and she ate very well tonight!  Also had some right hip pain so could be due to the activity or just being in bed for 3 weeks straight.    I turned music on tonight from Margaret's i-phone - I believe it was very relaxing for her.  Also started reading a book to her - a good way to end the evening. Big meeting among many specialists at the hospital tomorrow where they'll be discussing Margaret's timing of her departure.  Things change by the hour - it's been quite the roller coaster ride.

Tuesday, Dec. 13th

It's been 3 weeks today since Margaret had her stroke - hard to believe all that has happened in these past 21 days. Today, the pile of cards started arriving - wow!  Very fun to get mail and read all the wonderful messages!  Margaret has an amazing group of friends from all different arenas - tennis, book club, movie club, Fulbright group, Down's Syndrome group, work,  and I'm sure I'm forgetting something besides.  She's been a busy woman!  We're getting ever closer to having a date to come home - we hope to have something definite by the end of this week. Margaret did not get to go to the gym today unfortunately.  She needed an ultrasound today and the rehab people didn't know when the ultrasound was going to be done so they didn't want to have her gone from her room.  Kind of the way it is here.............. We had more smiles from Margaret today and we continue to see her left arm move so that's very encouraging.  I thank God for each and every one of you in Margaret's life - you will all play an important part in her recovery as she returns home.

Monday, Dec. 12th

First of all, I am so happy to share with you that we have been assigned the most amazing nurse case manager at UHC who is going to turn the world upside down to get Margaret home.

Secondly, in response to Shauna's comment, my e-mail address is mary.l.johnson01@gmail.com - we're looking forward to viewing the video!

When we came in to see Margaret this morning, she was very talkative and smiled a lot - so good to see that!  After morning nap, the rest of the day was more subdued.  Margaret was moving her left arm some today which is definitely encouraging.  They promised me Margaret would get a trip to the "gym" tomorrow so we're really looking forward to that.  The head neurologist wasn't there today so no official report but we'll be meeting with him and his team tomorrow and hopefully having a conversation with the UHC medical team and the Spanish medical team to come to some decisions on when Margaret can travel home.  Pray for that conversation - that the Spanish doctors will be receptive to information that the UHC team will be presenting to them as it may differ from their standard practice. 

Goodnight everyone - until tomorrow.

Saturday, Dec. 10th

We've been telling Margaret about the blog and she said she wanted to write her own blog message tonight so here it is:  "I'm eating a lot, getting stronger and trying to find a cerveza (beer)!!"

Thursday, Dec. 8th

Margaret surprises me.  I got several “yes” and “no” answers today with quite a bit of hesitation between my question and her answer and then a news show came on TV this evening and I asked Margaret if she knew who the person was, and she responded, “that’s the newly elected conservative prime minister of Spain” !!!!!!!!!!!!!!!   That's our Margaret!  Her left hand squeezed my hand today once.  Wow - don't know if it was voluntary or involuntary but it still moved!  One of Margaret's good friends from Georgetown sent this huge treasure box filled wih things and we've been bringing in something new every day. Today it was a battery operated toothbrush which Margaret really liked.  Another good day. 

Wednesday, Dec. 7th

Margaret continues to get stronger. She's eating well.  She's in a room with a shared TV with her roommate and although it's Spanish TV, Margaret is keeping her eyes open to watch the screen - it is entertaining to try and figure out what is going on!  To the movie group, Margaret's request for a movie is Toy Story 3 - we hear that Buzz Lightyear has a Spanish button and that's how Margaret is going to be when she returns - she's picking up Spanish by osmosis!  Forrest, thanks for the card.  We received it today. It's good to get real mail so I would encourage anyone to send a card to the APO address in one of these first blogs.  Mrs. Magnus, we heard about you from Jeremy and he must have showed us the picture of his classmates holding up their signs saying "We miss you Jeremy" at least 10 times.  He obviously loves going to school and loves his teachers and classmates. I imagine you'll be seeing his new article of clothing today but I won't spoil the surprise here. When we spoke with the neurologist today about how Margaret is doing, he indicated that she is doing very well medically - that if she was a Spaniard, she would shortly be moving to a rehab facility or to home with visits to a rehab clinic.  He didn't have the information he needed to determine when she could fly.  But later in the day, Dr. P., the embassy doctor came by and gave the neurologist some information from the New England Journal of Medicine and he feels she can come home in 7-10 days.  We hope the neurologist agrees when we see him again on Friday. Thursday again is a holiday so it's like things semi-stop at the hospital - no rehab exercises today, duty doctor on instead of neurologist - can be frustrating because I want things just to keep moving.  Patience, patience.....  Please pray for decisions to be made quickly and we have good communication with the travel insurance company so the details of Margaret's transfer back to the US proceed well.  Thank you.

Monday, Dec. 5th

Happy St. Nicholas Day!

Margaret moved from ICU to the stroke unit today.  Hallelujah!!!!!  Jeremy and Amelia got a chance to say hello and talk to her.  She has more alert times and more tired times.  It was a big day for her too.  She had a lot to say with Kim and I this evening and smiled several times. She ate pureed carrots, pureed fish stew and flan without any difficulty.  The neurologist needs to investigate the facts surrounding flying home and whether or not the change in airplane cabin pressure might present any issues.  He hopes to have more information about that by the end of this week. So I was able to be with Margaret from about 11:30 until 9:00 tonight.   I also want to tell you that I may not be able to keep up the blog every day since the hospital doesn't have wi-fi and I won't be getting home until late.  Thank you again many times over for all the well-wishes that keep pouring in and all the prayers lifted up to heaven on her behalf.

Sunday, Dec. 4th

A great day!  Margaret's eyes were open, she was alert during our entire visits today and we had good conversation.  She asked us a lot of questions about her health status today. She gave us our first smile today too!  She's having a little difficulty with swallowing still and will be evaluated by a specialist tomorrow. Her children are here but have not been able to see her as she's still in the ICU.  She's well enough to see them but they have strict rules here and although the ICU has private rooms, it is very open with glass walls so you can see the other critically ill patients and so they don't want children there. We're hoping they'll be able to move her tomorrow or Tuesday.  We're looking forward to talking to her primary doctors tomorrow to hopefully get a better sense of when Margaret may be able to travel home.

Saturday, Dec. 3rd

Dear friends,
Margaret continues to make progress. She's able to swallow pills now with a little water.  She wanted to make another phone call tonight.  She's following our conversations and continues to contribute to them.  She hasn't asked us for a notepad to write as she's able to speak what she wants to tell us.  Please pray that she'll be able to move to a regular room on Monday.  I think the more that we're able to be in the room with her, the faster she'll recover. 

Friday, Dec. 2nd

Dear friends,
More good news to share with you today. Margaret is talking more and opening her eyes more.  Kim and I do most of the talking and carry on a conversation about lots of things and Margaret will chime in every once in a while so she's following everything we're saying. She had her first taste of food since last Tuesday and she's swallowing well. The doctors are very encouraged by the progress she is making.  Tomorrow she wants us to bring in a movie!  It's midnight here now so making this short and sweet.  Thanks for the comments that you're sending - it warms my heart to know how many caring friends Margaret has. 

Thursday, Dec. 1st

Today was an amazing day. 

When we came at 11:00, Margaret opened her eyes a little for a few seconds and said "hi" or something like that - I think we were so surprised we weren't prepared to listen!  That was the only thing she said during our visit.  Then the nurses came in and moved her from the bed to a chair so she could sit up better.  She wanted to text her children so she wrote what she wanted to say on a notepad.  Mind you, this is with her eyes closed so we just keep trying to move the paper as she's writing. She also wrote several more things she wanted to tell us.

When we came tonight at 6 PM, she was back in the chair again and she was talking to us!  There was no need for the notepad. 

She's getting stronger minute by minute, hour by hour. 

Thank you Jesus and thank you for all your prayers!

Wednesday, Nov. 30th

Friends, you have a new writer for the blogspot.  This is Mary, Margaret's sister.  We visited with Margaret during the 2 daily timeperiods when we're allowed to see her.  She's holding her own.  The neurosurgeon spoke with us today and said she's made remarkable progress during this short time period. As you can imagine, that was very good news for us to hear.  Will you join with me in prayer for her?  Dear Jesus, We thank you for Margaret.  She is a wonderful, loving mom and friend.  We have seen how you have provided for her - we have so many things to thank you for; for Margaret being in a public place when she had her stroke where she could receive immediate help, for the excellent care she's receiving, for her dear friends Kim and Juan in Madrid and their family, for workplaces that are so willing to allow her siblings to drop everything to come to Madrid and be with her.  Tonight, may you fill Margaret with your peace which exceeds anything we can understand.  Amen.

Tuesday Nov 29 update

Tonight will be again a single update for the day because we picked up Margaret's sister from the airport between visiting times.

Today we were one of the first people called for the information updates.  Her doctor is one of the directors of the ICU and has his own office so we had our consult in his office with I think was a student doctor.  Basically everything is going well was what the student doctor said.  They spoke Spanish so we got the translation from Kim and Juan (Margaret's friends that live in Madrid).  They said they were going to keep her in the ICU for a few more days.  They have also been unable to adequately evaluate her condition for a variety of reasons.  The first and obvious is the language barrier.  Margaret has not opened her eyes so they are unable to know if she is unresponsive to them because she is asleep or not.  She also has not talked so this makes it impossible for them to make an accurate assessment of her condition.  The doctors do not want to move her from the ICU without an accurate assessment of her condition and being sure that her recovery will continue to progress when she is moved to a regular room.  We were given instructions to try to get her to talk and open her eyes.  No new bad news, and that was good.

Margaret was as awake and as responsive as she has been for us. We did ask several questions and were able to get responses from her by asking yes and no questions.  The doctors like that we were stimulating her and let us stay longer.  Actually insisted that we stay longer.  We were able to keep her thinking and stimulated in a way that the hospital staff has not been able to do because of the language barrier.  We told her about everyone that obviously cares about her and about the comments that you have left.  I should mention that she did say 2 words, quietly but she said them.  She did not open her eyes but we did see her eyelids move as she was trying to open them.  We did see her move her left arm and legs a little.

We picked up Margaret's sister at the airport and headed back for the evening visiting hour.  Margaret was quite calm and not very responsive.  It seemed that she was sleeping or resting.  I guess we tired her out earlier.  She would squeeze our hand but not much else.  She had the pressure monitor removed that was monitoring the pressure in the left side of her brain removed.  The pressure has been normal and decreasing and apparently they felt it was no longer needed.  After about 30 minutes another patient in the ICU was having problems as evidenced by the steady alarm tone.  There was a lot of commotion and we were told to leave.  We were hoping that we might be able to go back and see Margaret but after a half an hour they said that we could not.

Basically it was a good day.  Progress will be slow at times. 

I want to tell you a little bit about the hospital she is in.  Spain has socialized medicine.  Yesterday was the first time that any mention of insurance or repayment was mentioned.  The hospital is different that what we are used to in the states.  They spend their money on treatment and not so much on the facility.  The ICU is nice and we like her there.  The regular patient rooms have 2 beds, 2 chairs, and a dividing curtain.  Nothing else and there really isn't room for anything else.  There is no television or phone or dresser.  The waiting rooms are sparse with only chairs.  The care is very good and Margaret is in one of the best hospitals in Madrid.  We have heard even the King goes there.  We have had requests for the hospital address for cards and such.  The hospital I don't think is set up for that.  The best way is to send cards to her friend at the embassy (a US address so normal postage):

Kim DeBlauw
PSC 61, Box 2503
APO AE 09642

Basically it was a good day

Monday Nov 28 Update

Today will be one long post because we were not by a computer to make an update after the morning visit and update.

This morning we were one of the first people called to have an update from the doctor.  As you know if you have to wait it cuts into visiting time.  The doctor spoke very good English which is good so we heard everything without translation.  Basically he said everything was going well.  She is making good progress and she was off sedation and while in theory it should be out of her system in 10 minutes it realistically takes 5-6 hours.  He told us she was off of the respirator but they are waiting for 24 hours of her off of the respirator before taking out the breathing tube.  They want to make sure she has the strength to breath on her own and be able to cough and do everything we don't even think we are doing while breathing.  She was responding to commands for them. 
We then went to see her and she was "awake" meaning she was aware we were there but she did not open her eyes.  She squeezed her right hand when we asked her questions.  Then she tried to write words on our palm.  We finally figured out that she was spelling "pain" and she pointed to her throat.  We knew what was causing the pain, it was the breathing tube.  They were already giving her pain medication but it was good to know that she was able to have this new form of communication.  We explained the situation that they would take it out as soon as they could but it wouldn't be until tomorrow.  Frustration was felt by all including Margaret.  Before we knew it they came by and said visitation time was over.  Amazing how fast an hour can go.  We walked out of the hospital feeling pretty good.

After seeing sights of old Madrid, eating some lunch, and some time at the "Catedral de la Almudena" we went back to the hospital for the evening visiting hour.  They call you in by patient name and make sure there are only 2 people heading to the ICU.  There are 2 ICU wards with 11 "rooms" each.  Margaret is in room 3 so we were called pretty early.  "Room" is a bed with a partial glass divider open to where the nurses are.  It is pretty open so the nurses can see all of the patients in the ward.  The first surprise we saw when walking into the ward was that she only had an oxygen mask and no breathing tube.  We were not prepared for that.  The next surprise was when she was able to hold a pen and do some writing.  After a little trial and error on how to hold and move the paper plus some deciphering we were able to get what she was trying to say.  "Yes Margaret we have your iPhone" was one answer to what she wrote.  After a couple of minutes she was getting tired.  We spent the next hour or so just talking to her.  Fortunately, they gave us some extra time, maybe because we don't speak Spanish or because we were so elated with how she was responding and the medical staff was happy with Margaret's positive interaction with us.  She was able to move her right leg and arm and it made it look like she was uncomfortable.  She did not move her left leg and and only a slight twitch of her left arm.  We left after an hour and a half visit.

After 5 days of so little to have so much even though it seems like not much otherwise made this a GREAT day. We hope and expect to see continued improvement.  This is around the time of maximum swelling of her brain. It seems that she is making very good progress compared to what we are told to expect. 
It is amazing the number of requests for help that we are getting.  I think we have things covered and will certainly let any of you know if there is anything you can do.  What you are doing now, praying and hoping for Margaret I think is helping.  Trust me we are letting her know during the 2 hours we are able to see her 2 at a time of everyone that is hoping for a speedy recovery.

Sunday Night, Nov 27 Update

Tonight we received an update from the same doctor that was in her room during the morning visiting half hour.  We were the first to be called in so that also gave us a full hour or more to be with Margaret.  Basically the update from the doctor was that they did work with her some while she was awake.  She is able to respond to commands and while she cannot talk because of the breathing tube in her throat, she can squeeze your hand.  The doctor said she was very responsive.  She is able to move her right side very well (that is controlled by the left hemisphere and was not affected by the stroke).  She is able to move her left leg some but no really her left arm if at all.  That right hemisphere is the side she had the stroke so the left side of her body is affected.  It is still very early and her brain may still be swelling still though it should be close to being done swelling.  It usually swells for 5-7 days after the stroke and we are only on day 5.  There should be improvement as the swelling decreases which could take several weeks to months.  Everything else is going well.  There are no sign of infections or other problems, though she is a bit anemic.

The doctor said that she was being sedated so that she could rest from her earlier awake time.  She was quiet and seemed asleep for most of the hour we were with her.  She started to stir after Liz quietly hummed a tune.  Her blood pressure increased and so did her heart rate (we have become "experts" at reading all of the monitors attached to her).  Margaret moved and responded with hand squeezes to questions.  She knew who was with her and could respond to other questions.  It may seem small and not very encouraging but it made our day.  Then visiting time was over and we had to leave.

We will be back tomorrow morning at 11am when the information session will be before visiting time.  Only 1 hour and only 2 people at a time.

Sunday Morning Nov 27 Visit

This morning's visiting hours were from 11:30 to Noon.  We were lucky in that a doctor was in her room to talk to us because this was just visiting hours and the information session is during tonights visiting hours.  Margaret was sedated and on the respirator.  The doctor said that this was normal as they are trying to wean her off of the sedation and respirator but it is a long process.  They take her off for a few hours and then back on.  She was sedated so she could get some rest.  She was quite active last night and they want her to rest.  This is going to be a long process and in today's instant gratification society we are impatient and expect fast results and all the answers now.  We are not going to get that instant gratification with Margaret.  Progress is normal and she is doing well even though at times nothing seems to change or even seems to be going backwards.  The good news is nothing out of the normal (ie bad) has happened.  The doctor today explained as the other doctors had that the medication they give to ischemic stroke victims (blockage as opposed to hemorrhage stroke) was not effective with Margaret.  The medication is given immediately after the stroke and needs to be administered within 3 hours to be effective.  We believe she received immediate medical attention but she was alone visiting a museum that day and was on her way to meet her friend Kim.  The medication given was supposed to dissolve the blockage and reduce damage to the brain.  Unfortunately, the extent of damage caused to her brain will not be known for weeks.  They are saying that it was a big stroke so there will most likely be permanent impairment affecting her left side mobility, strength and coordination.  On the positive side her left hemisphere pressure is normal and seems to have no damage and that is the side that controls speech. 

We will be going again tonight for the information session and visitation.  We will post another update tonight.  Please remember that this will be a long recovery time and progress will seem incredibly slow.  But there is progress. 

Saturday Nov 25 Update

Today's visiting hours were from 1130-1200 and 6-7pm. This morning there was not much change.  Margaret did squeeze our hand a couple of times but for the most part she was sedate.  The positive side is that there was no problems over night and the pressure in her brain remained normal.  She has a pressure monitor installed on the left side and the readings were and have been normal since the surgery (when they installed the monitor).

The evening we had to wait until about 6:45pm to get an update from the doctor.  This doctor was very nice and recapped what had happened.  We liked her manner as she seemed more compassionate and understanding.  She had a nice way of recapping what had happened and what they had done.  She explained again to us that a large part of the right side of her skull was removed to allow room for her brain to swell.  The swelling should stop in a couple of days.  They have said it usually continues to swell for 5-7 days after the stroke.  And it will take weeks or more for the her brain to recover from the swelling.  They are still trying to determine a cause for the stroke and want to find the cause to prevent any future problems.  There is not an apparent and obvious cause.

We then visited with her.  She was not responsive at first until the doctor came in and woke her up.  Then she did respond by squeezing her right hand in response to specific questions.  It was reassuring.  They allowed us extra time after 7pm since we had to wait so long to see the doctor.  Just before we left she did get quite agitated and moved quite a bit.  She still has the breathing tube in but the ventilator is disconnected so she is breathing on her own.  The doctors just need to make sure she can cough and has the proper respiratory responses before they remove the tube.  Hopefully they will remove the tube tomorrow.  She was able to move her body (the right side) and did lift up both her right and left knees.  She was agitated and probably frustrated because her blood pressure did increase and the doctor said she was crying.  The lifting of the left knee was encouraging because they were saying she may not have movement on the left side for a while and likely may not return to normal ever.  While her condition still is not good it has not worsened.  We see little signs of improvement and that is giving us hope and helping to keep us positive.

Friday November 25

We are just trying to get caught up with daily updates so this is what happened yesterday.   We are allowed to visit her twice a day at 11am and 6pm.  Updates from the doctors are only once a day at 11am during the week and 6pm on weekends.  We will try to make updates after each visit.  Madrid is 6 hours later than Eastern time zone.

Margaret was still under sedation in the morning visit. Her color had returned and she was looking better.  She was on a ventilator and did seem to move her head once and face while we were talking to her.  During the day the sedation was stopped.  She responded to requests to squeeze her hands.  She was able to squeeze her right hand but not her left.  That is to be expected with the stroke she experienced.  She also moved and lifted her right leg.  It was comforting to have her respond to us.  She is not able to open her eyes, though it a result of the stroke and brain swelling.  

It is frustrating that while she is in the ICU we are only allowed to visit at those specific times.  They are quite strict with the visitation rules.  Once she is moved out of the ICU, visitation will be much more liberal. 

We have learned that brain injuries have no defined time lines as each person is different and recovers at a different rate.  The positive side is that she is young and otherwise healthy, and it was the right hemisphere of the brain.  All of the doctors say it will take time for her to heal.

Margaret's Stroke

Margaret suffered a pretty bad stroke on Tuesday, November 22nd while on vacation in Madrid, Spain. She was taken to a very good teaching hospital in Madrid.  The stroke was a blockage of the vessels as opposed to the rupture of a blood vessel type.  The stroke occurred in the right hemisphere which is the better side as her speech was not affected.  She was awake and could talk though she weakness to paralysis on her left side.  She received immediate medical treatment but the drugs used to treat this type of stroke were not effective.  The brain tends to swell after a stroke for several days.  On Thursday the doctors determined that the swelling in her brain was starting to affect the left hemisphere and brain stem.  There is no extra room in the skull for the brain to expand so surgery was performed to remove part of her skull to allow the brain room to expand.  The skull is being well kept by her in her abdomen for replacement after her brain in no longer swollen.  The surgery has been successful in it has reduced the pressure on the left hemisphere and brain stem to normal levels.