Sunday, May 22, 2011
Aloha to our Ohana,
After returning from Bakersfield a couple of weeks ago, my plan until the next scheduled visit in June was to remain in Hawai'i and catch up on office work and home duties. Of course, our best-laid plans don't always mesh with those of our Lord and sure enough after about ten days back, a message arrived from the Center for Neuro Skills. They were having issues with renewing the approval for Theresa's continued stay so the possibility of a coverage gap existed. In order to cover all bases, it would be best for me to return to Bakersfield in case Theresa had to be discharged. So for the second time in less than three weeks, I made flight arrangements for yet another Trans-Pacific crossing; again not knowing how long I would need to stay but trusting in God that this was part of His plan.
Thankfully with the passing of Easter, the airfare has dropped back to the $800 range compared to at least $1200 beforehand; plus there are plenty of seats to choose from. Not an hour after the flight was booked, Theresa called to give me her nightly update. In addition to her walking, arm movements and cognition progress, Theresa was fixated on the primary care physician labelling her as diabetic from a single fasting blood glucose test of 119 mg/dl (101 to 140 is considered pre-diabetic) and then putting her on Metformin, a drug to control blood sugar levels. Theresa told the nurse the proper way to diagnose diabetes is with the hemoglobin A1C test and anyone that relied solely on the blood sugar test was practicing medicine from the last millenium. Because Metformin has several uncomfortable side effects including diarrhea, nausea, gas, weakness, indigestion, and headache, Theresa would not consider putting her patients on it without a positive set of tests. That said, because Theresa is playing the role of patient this time, she will reluctantly take the Metformin but has warned the staff to prepare for sudden and urgent bathroom sorties.
Theresa's mood brightened considerably when I let her know of my upcoming trip back. She said it was actually perfect timing because CNS was holding a Lu'au themed picnic that Friday afternoon, partly in honor of the three patients currently there from Hawai'i. So if I could pack her paʻu or hula skirt and also bring a lei, she would be properly dressed for the occasion; and it wouldn't hurt to pick up some local treats to share with the CNS staff and patients. Time was a luxury I didn't have that evening as I rushed home to repack (keeping a packed carry-on bag ready to go has become a habit these past six months.) In anticipation of the next trip, I had started to collect some treats to bring so mac nut kisses and wasabi-flavored tortilla chips would have to suffice this time. Besides, with the bulky paʻu my carry-on was already stuffed beyond its design limits. Again, Pastor Al and Lynda were kind enough to provide the ride and comforting faith on the way to the airport and for that I am truly thankful to our Lord.
The flight to SFO was relatively smooth and for the first time since starting these ocean hops in January, I had the blessing of a row of three seats to myself. The horizontal position is definitely more conducive to sleeping however in times like this, I do envy Theresa's ability to lay across a row of three and not have her feet dangle into the aisle. Still, laying down and curling up has its advantages, not the least of which is to block the glare from the overhead monitor. It may be the fantasy of some but this night, Jennifer Aniston would not be keeping me awake. Getting a couple of hours more rest on the layover before the shuttle flight to Bakersfield, I arrived at the CNS Clinic and ran into Wade, a compatriot from Theresa's time at Craig Hospital. In his unique way, he said there must be a mistake because he saw Theresa roaming the clinic hallways using a 4-prong cane and in search of her wheelchair. Turns out her first session of the morning was PT and the therapist took away her wheelchair and gave her the cane to get around with for the remainder of the day.
When I finally caught up with Theresa in cognitive rehab (CR), we were so happy to see each other that it distracted her from completing her sorting box task accurately. She was working on multitasking by listening to a nature story while answering questions, sorting out objects and then switching tasks every few minutes. Between tasks, Theresa recalled with relish the toppings and sides on her evening outing to Juicy Burger that included chipotle ketchup, assorted veggies and sweet potato fries. As I listened and marveled at Theresa sitting on a regular chair and not her wheelchair, there was something else different about her. She was wearing pajamas and in fact, so were most of the staff and patients. Turns out Thursday was PJ day and thankfully, the attire of choice leaned towards Cotton Ginny rather than Victoria's Secret.
Theresa's next class was occupational therapy(OT) which she stood up and walked to slowly and surely without any struggle. It was a pleasure to watch as she prepared an omelet from scratch, scrambling eggs, chopping up peppers, onions, etc. and even walking to the cupboard and reaching up for spices. For safety from oil splatter, the therapist assisted with the flipping but it came out so poorly that I'm sure Theresa could have done a cleaner job. That afternoon, Theresa walked so well with the cane to the rest of her sessions that the PT assigned the cane as homework. To celebrate this milestone, we went to dinner at a local Chinese restaurant with the rehab aide along just in case. I don't have the words to describe my joy watching Theresa get in and out of the car without needing a sliding board, and then doing the same to sit in the restaurant booth next to me instead of at the end in a wheelchair. All I can do is thank our Lord for his gift of grace and healing powers.
Friday was Lu'au Day at CNS and sure enough, most everyone was decked out in aloha wear, plastic leis and grass skirts and even coconut shell tops. Theresa looked lovely in her paʻu and blue fringe lei and in addition to the Hawaiian wear, she also sported some kinesiology tape on her elbow and knees; too bad I forgot to take a photo of its colorful and intricate pattern. This tape has been used in Asia for decades to relax overused muscles and facilitate underused muscles and for Theresa, it has certainly reduced the soreness from all of the walking, stairclimbing, pedaling and reaching. Kinesiotape was seen most prominently on the shoulder of Kerry Walsh, the U.S. beach volleyball player at the Beijing Olympics. Not to be left out, I also joined in with my standard office attire aloha shirt topped with a kukui nut lei. One of the patients, Gary, seemed fascinated by the style so we switched leis on a whim. Later that morning, he gave me a salmon-motif bracelet he had made from a piece of ceramic found on the beach. It's said a good negotiation is when both sides go away happy and that was certainly the case here.
The good karma continued later that day during the conference call with the health insurer. It seems the reason they were reluctant to extend further coverage for Theresa's stay was because an initial discharge planning report had not yet been prepared. Apparently, it is standard procedure to begin planning for a patient's discharge from the moment of their admission so everyone involved has a timeline to follow. Because CNS had not presented this report yet, the health insurer had no idea how long Theresa might stay here other than the initial estimate of 3-6 months. And with Theresa exceeding most benchmarks of healing after seven weeks, it's becoming more certain that her length of stay will be in the lower range of that timespan. So with an agreement to extend coverage for a few more weeks in place, Theresa can continue with her intensive rehab therapy and look forward to returning to Hawai'i by late June if not sooner.
Following the morning therapy sessions, the staff and patients transferred to the site of the lu'au picnic, the nearby Yokuts Park located alongside the Kern River. Yokuts (also called the Mariposa Indians) is the name of the indigenous population that inhabited the Central Valley and they numbered as high as 70,000 before the arrival of the European settlers. Today, there are fewer than 2000 Yokuts and they mostly live on reservations in the outlying areas. The lu'au festivities were well organized and the catered food was delicious with kalua pork, teriyaki chicken, sweetbread, homemade pineapple ice cream and an orange/cranberry salad (OK, maybe not so much that last one.) Theresa and I enjoyed the meal together although she did miss her favorite lu'au dishes, Poké and poi. One of the afternoon activities was mini golf and despite Theresa's soreness in her taped up legs, she still managed to play three holes before retiring. Given all of the exertion of the past week, Theresa has done so well and made such progress along her healing journey. Despite all we've gone through, she continues to keep a positive attitude as do I and we know in our hearts it would not be possible without the support of our Ohana and our Lord, Jesus Christ.
Saturday, May 14, 2011
Aloha to our Ohana,
The early morning drive to the airport went by quickly as I reminisced over the wonderful birthday and Easter weekend spent with the lovely Theresa, and how I am so thankful to our Lord for that precious time together. My return trip to Kona started on schedule now that I am aware the Bakersfield airport is not located off the Airport Rd exit but rather, Merle Haggard Drive. Turns out this hall-of-fame country singer known for his most famous song "Okie from Muskogee" was actually born in Oildale, a hardscrabble suburb of Bakersfield, and the home to thousands of economic refugees from Oklahoma and surrounding states during the Great Depression. Having resolved that link, I boarded the 0600h puddle jumper flight to San Francisco -- because pond hopper is too grand a descriptor for this propeller plane with chrome engines from the de Havilland era.
All went smoothly until the delayed landing due to low cloud cover in the Bay Area. Recall that on the last trip, it was all I could do to sprint like O.J. to make the 37 minute connection. This time, United Airlines in their infinite wisdom had adjusted the schedule and shortened it to 30 min, meaning there's only 20 min to deplane, rush between terminals, and board the Kona flight before the door closes 10 min before departure. So even with the flight attendant asking all other passengers to remain seated until the three of us with tight connections to Baltimore, Seattle and Kona could get out first, it was not to be. Maybe if I had O.J.'s ability to fly through the terminal as he did in the later Hertz commercials, I could have made it. But then that begs the question, why does one even need to be at the airport if they can fly?
Showing up at the outbound gate five min. after the last call, the agent offered me two options: reroute through LAX and HNL to arrive in Kona at 1700h (compared to the missed flight that would arrive at 1100h) or wait 8 hours and take the next direct flight to Kona, arriving at 1900h. Choosing the more sensible option, I found a spot to settle in and break out the laptop and phone to stay connected with the office 2500 miles away. Besides having to occasionally share the power plug with other travelers, the time went remarkably fast and I got a fair bit of catch-up work done. There were even humorous moments like when I called the Dept. of Water Supply in Hilo and our conversation was interrupted by the overhead warning to report any suspicious person or unattended baggage to the SFO airport authority.
The later flight was uneventful and sadly for Hawai'i tourism, there were 65 empty seats. But even with the reduced numbers on board, I still could not manage to win the Halfway to Hawai'i game -- maybe it's God's way of telling me to stop overcalculating and just take a wild guess! Upon landing, there was a stored message from Theresa describing her day and that she was going out for sushi, sashimi and/or teppanyaki in the evening. That girl is getting out much more with the rehab facility than she ever did back home, not that I'm jealous (or maybe just feeling a little left out.) And text messages later that week confirmed her busy social calendar, with planned outings for meals, movies and even a local theatrical performance.
On the rehab front, Theresa provided updates through the week on her own progress, notably that she's doing leg lifts using the EVO walker to build up strength and relearn stairclimbing, and that she is walking longer distances using only the 4-prong cane to steady herself. All of this exercise is resulting in sore quads, knees, ankles, etc. yet Theresa only takes Tylenol instead of the hard stuff (as she likes to call Oxycodone.) She even keeps a secret stash of Tylenol around because sometimes it takes too long for the rehab aides to order it through the proper channels. Cognitively, Theresa is also progressing as she improves her math, problem solving and reading comprehension skills, all while dealing with outside distractions from the therapist and other patients. The educational testing scale ranges from grade 1-18 and with her prior education, she should have scored near the top pre-injury. Post-injury, Theresa is making good progress and well on her way back. And for those questions she doesn't answer correctly immediately, she's able to talk (maybe BS?) her way to the right answer. For these signs of constant healing, I am in awe and offer praise to our Lord.
Last Sunday, the car wash fundraiser was held by Theresa's clinic associates in conjunction with our friend, Chef Edwin, who supplied and grilled the delicious local ingredients that go into his famous Village Burger recipes. It was a huge success and with everyone's combined efforts, I estimate over 100 vehicles were washed that day. That a couple of "cut" guys wearing board shorts were out front holding signs certainly didn't hurt as there seemed a steady stream of lady and some gentlemen drivers getting their not-so-dirty cars washed. Mauna Lani's own Chef Al supplied the tunes to keep the energy high while a dozen others from work also showed up for our cause. Theresa had intended to phone in and thank everyone during the event however the timing just didn't mesh and she ended up calling while Richard, the clinic director, and I were in his office reviewing some healing music chants. At least Theresa and Richard spoke at length and he was able to pass that message along to the hard working, fun loving group outside. The weather cooperated, everybody had fun, and we are most grateful for having so many friends that have truly adopted us into their ohana.
Earlier this week, Theresa relayed the exciting news that she met a new patient from Hawai'i by the name of Jason, and that upon being introduced, he already knew of Theresa's story from the news updates back home. The only thing that surprised him was Theresa's haircut, as she recently went back to an easy-to-maintain bob, as compared to the update photos that show her with longer hair. Theresa also mentioned that with the guidance of the PT, she's tucking in her butt, straightening her back and the result is she's walking faster and with more confidence. This culminated in yesterday's announcement that she spent the whole day at the clinic using only the 4-prong cane to move around between classes. That is a huge achievement and one which we know is a direct result of our Lord's gift of grace and healing. For this above all others, we give thanks for all He has done.
Friday, May 6, 2011
Aloha to our Ohana,
During the early 1900s, a wave of settlers from the mountains of the French and Spanish Pyrenees came to start a new life in Bakersfield. These immigrants referred to themselves as coming from the Basque country, and with them they brought their farming and sheepherding skills. To say their descendants have thrived in this agricultural paradise is an understatement. The Basque have learned to perpetuate their culture, which is first the people, then their social events, the eating, drinking, laughing, dancing, singing and whatever God may have desired for the Basque and their friends to take pleasure in and enjoy. And it was ensconsed in this spirit of joy that Theresa and I celebrated her birthday with dinner at Chalet Basque, one of close to a dozen such restaurants in the area.
Wheeling into the main dining area was an experience in itself. The rehab aides at the Center for Neuro Skills told us the service was family-style and sure enough, many of the diners were in groups of 10 or more and they most certainly looked related. With just the two of us, the hostess (who coincidentally was from Shanghai) asked us to wait a bit as they opened another section. My suspicion is they usually seat parties of two in the booths but that wouldn't work with Theresa's wheelchair. Once seated, we browsed through the menu and settled on some entrees, the braised lamb for Theresa and pork chops for me. If anyone out there is disgusted by our choices, be reminded that if God didn't want us to eat meat, He wouldn't have made animals so tasty!
The best part of the Basque dining experience is that with the exception of the entree and drinks, everything else is included. Not only is there endless bread, soup and salad, but even the appetizers and sides are generous. The server hinted that some first-time diners are put off by the pickled tongue dish however Theresa delighted in it along with the delicious cabbage soup for which we enjoyed a second helping. Sitting there just watching, listening to and enjoying dinner conversation with Theresa made for a wonderful evening that I will always remember. And for the first time since before the accident, I noticed Theresa was using her knife and fork with both hands rather than just favoring her stronger side. With this abundance of food & drink, it wasn't long before Theresa needed a bathroom break so off we went in search of the facilities.
Being with someone in a wheelchair has given me a new perspective on handicap-accessible bathrooms and how they can differ tremendously. The most convenient are the ones where there is enough room next to the toilet to back in the wheelchair, allowing the occupant to slide over without too much effort. Others are barely wider than public stalls with just enough room to get the wheelchair inside facing the toilet, so the user must stand and do a 180 degree pivot. In Denver, we had some difficulty with this type of stall and sure enough, that was all Chalet Basque offered. Once we were in and the door was closed, I was contemplating how to assist Theresa with her transfer in the tight quarters when she just stood up, grabbed the safety rails and slowly stepped and turned until she was ready to sit down. All she asked of me was to pull down her pants and then she sat and let nature take its course. To the casual observer, these may seem like small steps but to know how far Theresa has come, this really is just one more sign of our Lord blessing us with His healing grace.
The scheduled outing the next morning was the weekly grocery shopping trip and this time, the rehab aide suggested that it would be a good planning exercise for Theresa to see if she could stick to the $75 budget for food only. That pretty much ruled out Trader Joe's for the most part as Theresa spent almost double the budget there the last time I was in town. So we went into Albertson's instead and were doing pretty well with Theresa mostly selecting products on sale and keeping a rough tally on the back of her shopping list. She even managed to squeeze in a strawberry tres-leche birthday cake, something we didn't have room for the night before and now she wanted to share it with her roommates and the rehab aides. At the check-out, I watched the total purchase amount ring up and sure enough, it stopped at $73; that is until the cashier asked if there was anything else, which was Theresa's cue to reach up to the magazine rack and throw in a special wedding publication celebrating Prince William and Kate Middleton, which blew the budget completely. This is an old trick she used to pull pre-aneurysm so in some ways, I am grateful for that side of her coming back too. Still, the look of enjoyment and wonder as she read about the royals and shared cake with everyone made it worthwhile.
Easter Sunday arrived and following a beautiful Spanish mass service, we ventured to the local shopping center in search of stationery and thank-you cards. Theresa has received close to if not more than a hundred get-well cards and her goal is to reply to each sender as her time and energy permits. She chose a box of 24 at Target and then we decided to wheel through the mall for a look-see. That turned out to be a mistake as the sound of muzak competing with loud conversations, music from other stores, echoes and the such conspired to give both of us headaches. Taking refuge from the noise, we detoured into what appeared to be a department store but was Forever 21, a clothing and accessory outlet geared towards younger ladies and those still clinging to youthfulness. We've heard of this store but up to now had never been inside one. At first it was fascinating to see an entire department-size store devoted to the young miss set but soon enough, their music also took its toll and we headed for the nearest exit and returned to the CNS residence, just in time for Easter dinner.
To celebrate Easter, the CNS staff prepared a special meal consisting of beef tri-tip, salad, rice & beans, and assorted desserts for the residents and their visitors. It was a nice surprise and a wonderful way to cap off a beautiful day celebrating our Lord Jesus Christ's resurrection. There also were baskets of easter eggs on each table with chocolates and other goodies inside. Theresa's aide, Darlene, dined with us and I asked her half-jokingly why the eggs weren't hidden for everyone to find. Her completely serious reply was that it was tried in the past however the results were unexpected as some of the residents became obsessed and looked into the wee hours of the night. Sometimes, it's just simpler to hit the EASY button.
With dinner completed, it was fast approaching 8pm and I had a 4am wake-up call for my return flight to Kona on Monday. Theresa and I spent a few more precious moments together as I wheeled her back to her apartment. She thanked me for coming out and said that this weekend together was her best birthday gift ever. I fully agree and continue to praise our Heavenly Father for all He has blessed us with. Kissing Theresa farewell, I drove back towards the hotel but not five minutes later, her distinctive ring tone (the nose twitching sound from Bewitched) alerted me to who was calling. Sure enough, Theresa was checking if I was safely back and that she was already missing me. To heck with the hotel room, I turned around and returned to the apartment where Theresa and I spent more of our last evening together. The simple acts of chatting, folding laundry and applying Maderna gel to some of her fast-disappearing scars brought loving joy to my heart, a feeling that remained long after I said farewell for the second time that night.