Week 4

End of Halucinations. Lots of visits. Melissa 6.1 (w/De-Fib Pacemaker). Move to rehab.

ℹ️ Info

Created: 2023-03-13

2023-03-11 to 03-17 - End of Halucinations, Lots of visits. Melissa 6.1 (w/De-Fib Pacemaker).

The fourth week was visits, getting her Pacemaker upgrade (w/De-Fib), and getting her into Rehab.

Lots of friends visiting (or calling) which keeps Melissa engaged, talking, and happy. She loves people.

She got her new Pacemaker (Melissa 6.1) w/De-Fibrillator functionality. That set back rehab a couple days

They did some tests before releasing her to rehab... but she got there Thurs night, and started work on Friday.

Friday was tough; she's declared legally blind for Rehab and that didn't go over well. But she worked hard, sat/stood, got a shower, is eating better, and is rated high on cognitive abilities. So the work begins.

Day 22[edit source]

Main article: 2023 Heart Attack/Day 22

2023-03-11 (Saturday) - Hard night (bored, long, halucinations). Then she had a good day, until we need to leave

Hard day's night

Melissa has hard nights. She's got Hospital Dementia, along with CBS (Halucinations due to optical processing damage) that kicks in more when she gets tired. And she's bored (can't watch TV when she's tired). This messes with her reality. She was getting the sheets off the bed, and makes her truly scared at night or when people are leaving.

She loves people, wears herself out when people visit, and then starts getting halucinations.

The other day we got her to nap (because we were there), and she had a great second wind. But that messes with her Circadian Rhythms / (day/night mode). Then had the same terrors when Mandy had to leave.

When she just wakes up, and you close the blinds (get rid of distracting light) you can turn on the TV, and she can focus on it. But she needs the light (blinds open) to get her back in rhythm. Then as she gets tired, she can't see the TV through the fatigue. Thus the TV is useless when she needs it to entertain her or lull her into sleep. And then her halucinations take over. (The space she's in becomes huge, and scary).

She gets pain and cramped up, or ties herself up in things at night (drops her leg off the side of the bed, then claims she can't get it back). But she can move it during the day. And when I give her foot massages and leg work-outs, she's happy and it relieves all her pain.

She remembers that the Cell Phone or Tablet are great entertainment. But they're too small for her to see well and interact with for now. So you give them to her, and she quickly gets frustrated at not being able to control them (her bodies betrayal).

Night is tough for her. And you just can't be there all the time.

Accomplishments That being said, she keeps getting better.

She can talk more clearly and longer day-by-day.

Today's PT was better than yesterday -- she sat upright on her own for 7 minutes. Stands (but it wears her out).

We propped up her bed in a more siting position for rounds (w/Doctors) and was asking good questions, and we explained everything that's coming and why. (She's very cogent and there). She helped talk through property management tasks, and who was in which unit, and what to do with various things.

We were talking about Gina and her elementary school friends that had a get-together, so we called Gina, and Melissa had a great call with her. And Gina could tell the differences from just a few days ago.

Melissa doesn't recognize how fast she's progressing -- so we keep re-inforcing it. It gives her a light at the end of the tunnel.

My Fault?

We had a conversation where she asked what caused it. I mentioned that we don't know. We know it wasn't plumbing (her bypasses were good). But it was either (a) her electrolytes (potassium) was so far off that it caused the flutter (b) her electronics that fire the heart were off, and that screwed with her electrolytes. She asked if that means this was her fault, or she could have avoided it? I answered we (they) don't know. But (1) she's wearing the harness to get hints (2) we can do some blood tests to check to see that her potassium doesn't fall off in the future (3) she'll have the new De-Fib pacemaker to fix it, if it happens again.

I wasn't liking the self-blame aspects of that -- of course even if it could have been avoided, she didn't know she was causing it (with some dietary or supplimental failure, or just being dehydrated), or she would have obviously avoided it. Just like if I knew it was a risk, I would have pressured her. She and Dr. V had talked about adding a 3rd lead to do de-fib, because they'd seen possible V-tach events on the pacemaker log (I think back around Nov 2021 discussion). She seemed to want to make that her fault, or his fault, "If he'd just replaced it, this wouldn't have happened?" I really didn't like the "fault" aspects, especially on something we don't know. Heck, I could have demanded she get it when I remembered hearing something about that (so was it my fault?). Everyone wanted to monitor before over-reacting and causing an unnecessarily invasive procedure. So I was trying to divert her back to future ways to prevent it, rather than rear-ward looking towards whose to blame - because we each could have done more. And we probably will in the future. But of course, we didn't expect or want the heart-attack/stroke as the outcome.

Day 23[edit source]

Main article: 2023 Heart Attack/Day 23

2023-03-12 (Sunday) - good night, but headache crisis, then good day (and a new haircut)

Melissa slept better, no night terrors

Even though leaving her was a little rough yesteday, she slept pretty well, doesn't remember any night crisis.

She woke and had a little bit of a headache, and reduced vision, was causing a little bit of a crisis for her. (She is afraid of another stroke just as she's getting her life back a little). But reassurances and tylonol quickly got past that.

Her vision was less strong (and blurrier). But the CBS (Hallucinations) have reduced substantially. When we brought that to her attention, she was happy. And she seemed better able to make out things close, even if she couldn't recognize objects as far away as before. Assuming this is just part of the process. There's still some frustration that an iPad Mini is too small for her to use yet. But she is able to use the Nurse Call button by herself, even if the TV remote is too small/complex.

Accomplishments

Dry eggs for breakfast (she ate those). I got them to add cheese on top tommorrow.
She likes Dave's foot rubs (daily, more than once). (Helps with the cramping). "I'm the best foot massager, ever".
She had a good chat with Debi (while Mary and I grabbed lunch). Melissa felt bad about the depression she's been having -- but that's a natural reaction to pain and a lack of control. And she knew Paul (Debi's Dad) became an invalid after his stroke, and Debi reminded Melissa that she is not an 80 year old man at the end of her life (and is already on a better baseline+trajectory).
Melissa wanted to try writing when I said we were going to get her some books to work on that later (got that idea from Greg/Neighbor whose father or father-in-law had strokes). M was able to sign her name and print it -- both poorly and shakily. But better than you might expect for someone who lost a lot of fine-motor skills and who can't see the paper.
She didn't have any Lidocaine Patch, or the Chalky stuff (Zinc Oxide) they put on her feet, and was doing good without it. (Her pain is getting better, and her ability to not just focus on it, also reduced).

We were talking about writing, and she wanted to try. So a ballpoint pen, on slick paper, on a tablet, and not being able to focus/see that close/detailed yet. This isn't bad for a first attempt under those conditions. (Signature + printing her first name).

Mandy Visit

Mandy came by after lunch, and took over, and acted as underpaid Hospital staff:

She brought scissors, and hacked at the giant dredlock in the back, until Melissa got an assymetric bob. Inverse mullet: Party in the front, business in the back. (Looks cute -- and perfect tactics to combat bed-head!)
Mandy also played OT (Occupational Therapist) and got Melissa to (a) Brush her own hair (b) brush her own teeth. It's wonderful to show Melissa she's going to get her life back, one independence assisting step at a time.
They also figured out when Melissa starts to fade and go slurry, it's a blood-sugar/calorie thing. Mandy got her to drink some high-calorie shake stuff, and Melissa got a second wind with a lot more mental acuity/energy.

Fixed the big dreadlock From the front Hairdresser and Hairdressed

Day 24[edit source]

Main article: 2023 Heart Attack/Day 24

2023-03-13 (Monday) - Melissa 6.1; now with de-fib mode Hospital called, they want to move the de-fib install to today I was OK with that, we drove in... and waited, and waited. As usual, they wouldn't let her drink anything ("for her safety"). Since they forgot to got me to sign some things, they asked me to come back there. And Melissa and I chatted for a couple hours while waiting for them to bring her to the slice-and-dice room. (Cute tinfoil had they put on them). She said Melissa 2.0... I explained that was her first bypass, the second was 3.0... the titanium leg replacement was 4.0. I'm counting 5 conversions (heart restarts), 2 ablations, and a Watchman device as 5.0. And her first pacemaker was 6.0. This is just a modest 6.1 upgrade that comes with a new Pacemaker with De-Fibrillator. She was a little surprised at my versioning, and how many things we've gone through together. (Her the filet, me the supporting cast). And I wasn't even counting the stroke, or the dozen or so angiograms. But I pointed out it was 30 years since we got married and she got her last bypass, which was the last MAJOR-major issue, the others before this, were just tune-ups. So if we get another 30 years, that's not too bad. She tolerated the procedure well, has the new integrated de-fib functionality. She bled a little (she's on enough blood thinners to be a vampire delicacy). They put the new pacemaker in the same place as the old one (under the pectoral muscle), and it's a little thicker -- and she's getting a pressure bandage to control the bleeding (she hates those). So she's gonna be sore. If no problems overnight, she gets to be released tomorrow to Rehab.

Day 25[edit source]

Main article: 2023 Heart Attack/Day 25

2023-03-14 (Tuesday) - Mom doing servant duties. On pain meds. Called Julie. Summary After the procedure last night we visited briefly, and I went back to the room. Melissa asked her Mom to stay with her. So her mom slept on a bed/couch in the room, and got to do Nurse duties. Both were happy with that. Because of the procedure (Pacemaker), Melissa is on pain meds and an ice-pack today, thus she goes from talking to snoring pretty quickly. They also moved out rehab to Thursday. We had some good visiting today, usual foot massage, some snoring. There was a brief Mandy call. Then she talked to her cousin Julie a little (Head of Nursing in Phoenix, though the chatter was more familial than Nursing related), with some future catching up scheduled. And older friend (Angela) was scheduled to drive in from Austin tomorrow -- but Melissa's so foggy she asked to kick it out. Did want to waste her time on that drive, unless they were going to get some good 1 on 1 time (they've got some catchin' up to do). They rolled Melissa off in early evening and did a CT scan to make sure that the Pacemaker is placed correctly, and no blood clots are forming. But I couldn't find the test results, and they didn't inform them of the results. (Maybe tomorrow). They're also informing Melissa on her issues and signing off that they did it -- but that included a signoff that she has an altered consciousness. I kinda feel they should be letting her Husband know on all this.

Day 26[edit source]

Main article: 2023 Heart Attack/Day 26

2023-03-15 (Wednesday) - PT, Jennifer and Rebecca visited, CT in prep for release (to Rehab) Summary Good PT - sat upright for 45 minutes. (She skipped yesterday; resting after Pacemaker). Jen and Rebecca S (Heart-Rebecca) visited. Jen was impressed with how much better she was talking -- and her stamina at talking. Another CT (and EEG)- prepping for release (I assume). Evening call from M, and I was with Vick and Rich, so Melissa got a good chat/catchup with them. Melissa sat upright (on her own) for 30 minutes This is with her favorite PT (OT) Person; Judy. Jen and Rebecca S selfie Top lines -- (1) I smell smoke. (2) Some suction cups and wires is all it takes to make her stay silent/still for 30 minutes? (3) Are they trying to jump start it?

Day 27[edit source]

Main article: 2023 Heart Attack/Day 27

2023-03-16 (Thursday) - Glaucoma, Rehab, Foley, Visit, Brother. Summary Melissa called this morning (via Mary) and asked about her Glaucoma medicines. M has a mild form of Glaucoma, and I'd let the hospital know. And they had a Opthamologist check her out. But she hadn't been taking her drops, and was concerned about that. Maybe that's impacting her vision? I doubt it, but I had forgotten about that, and am impressed that she is out-thinking us all. So I brought it up to the docs. They don't care (or think it's the cause), so M can start using her perscription. And her Opthamologist will see her (pun intended), after she's out of Rehab. There's a little bit of progress or things that keep me from getting too concerned. At one point she could see the TV about 15' away. I tried again, and could track my face from 3' back to about 15' and recognize that the TV was on, and knew it was a talk-show type thing. So she can't find things at distance yet, but she can see things out there (even if everything is blurry). It also gets better and worse through the day (which hints that it can heal?). She also has better visibility in right eye than her left. So I have some hope/faith that it will get better, or we might be able to get glasses to help. Jess from Kingwood Fit (Melissa's running group) visited, and they had a great talk today They sat her up in a fitness chair for 45 minutes and forgot about her for 2 hours. By the end she was sore, but not her core, her butt (that lost all it's tone and padding). She wanted to see if she could write her name any better, and she did. She can't see enough detail to know where she's printing, but her fine motor skills were a lot better. She moved to West Pavillion (Rehab: 10-26) -- so that's progress. Not as nice/new a room, but great people so far. And that's what's important. A friend (Pam) sent vegan mini-cupcakes "by Melissa" for Melissa, for her birthday. The hospital was annoyingly reluctant to get her off the Foley Cath. They tried a couple times, but she wasn't fully pee'ing (emptying) so they put it back in, and gave her some pills. Finally with her going to Rehab, they took it out again, and told her just to pee. The first time, she didn't empty fully, they said they'd be back in a few hours. Then they asked her to, and she pee'ed enough to soak the pad/daiper, her clothes, the bedding. She really got into water sports, and convince to them that she was good to go. (Pun intended). I don't know why the little vacuum/sponge thing they have for girls didn't work. My Brother (Devon) flew into town for a visit for M's birthday on Saturday. Getting better at writing her name (even if she can't see the paper) She was happy in the chair At least at first. By hour 2, she was getting a bit tired.

Day 28[edit source]

Main article: 2023 Heart Attack/Day 28

2023-03-17 (Friday) - Rehab Day-1; fear, hard work, shower, and only a little vomit Summary Mary called this morning and Melissa was having a VERY bad day. For purposes of Rehab, they listed her as legally blind -- and Melissa kinda of lost it. TBI (traumatic brain injury) still takes down one's defenses and leaves you a little more hyper-focused on a single thing. Not a happy wife. I was able to talk her down, as she knows I'll tell her the truth. And I explained we don't know... but reminded her how much her vision had already progressed; a week ago she was having halucinations, and she has had brief times when she can see better/further than others. She was able to recognize me, what I was wearing, her Mom, the same with my brother from further away. So there's still some hope. She sat up for long periods in a wheelchair, stood up for a bit, took a couple steps, only threw up a few times (don't know what that's about), then got to take a shower, more Physical Therapy. She works HARD, and through the pain (like a torn up shoulder/pectoral, thanks to her pacemaker). She had occupational therapy, and cognitive tests that are showing her memory and cognitive awareness is really good. Getting Blood Pressure Taken (in regular clothes) Melissa in her standing chair It goes fast, it comes back hard. But she's a worker. Melissa and Devon (Bro)