Tashie's HIP re-"pear"

George writes from Toronto: "Monitoring Tashie's recovery via the blog.  Here's a little message via pears, eggs, blueberries and strawberries."

Hip Pears...

Hip Eggs...

Hooray Blueberries & Strawberries!

Square House

Since we have this rapt audience, this might be the perfect forum to spread the word that the Square House has been readied for rental. Photos tell the story.

Welcome Mat is Out!

Tashie is doing so very well that she is restless for diversion. Although she is working hard for a good part of the day, with brief rests in between, her work day ends at around four o'clock, at which time she will be receiving. Call her during the day to arrange an approximate time, so that the riches of visitors can be spread out a bit. She is in room 440 at St. Charles Hospital, and her telephone number is 541-382-4321.
The plan is that Tashie will be coming home to Camp Sherman on Wednesday, with Bruce managing the homecoming. Bob will be spending a couple of days with her as well, and then Fred and Wanda arrive on Friday night.

Note from Bruce

If Tashie comes home Saturday, Eliza readies the house, picks Tash up at St. Charles, and settles her in at home. I'll relieve Eliza on Sunday night or Monday morning.

If Tashie comes home Tuesday or Wednesday, I'll plan to be at her house the day before to make sure it's relatively hazard-free, and then will pick her up from the hospital.

Bob Levitt has agreed to come up next week, probable arrival on Tuesday. He and I will tag team until Fred and Wanda arrive in Camp Sherman, tentatively on Sunday August 8th (or Saturday the 7th; flight expense is a determinant here).

Tashie's contact information

Katherine S. Livingston
Room 440
St. Charles Bend

2500 N.E. Neff Road

Bend, Oregon 97701

(541) 382-4321

Vashti & Micah Return

Oooh, that feels so good!

Reunited

Tashie had her last feline visitation for a spell - Vashti and Micah travelled back to Portland with Eliza Sunday afternoon, and will return to Camp Sherman next weekend for more pet therapy. It is amazing to see Tashie greeting them, and they her. Micah sat on her bed quietly for some time, tending to his own needs, and Vashti settled down long enough for a cuddle.

Micah is taking it easy today

Tashie is moving ahead with Physical Therapy and Occupational Therapy, working hard and getting stronger and stronger all the time. She now gets up out of bed and into her wheelchair herself, needing only the observing eye of a staff member as witness. She is also doing a good job of weaning herself from the trapeze and the multi-positional functions of the hospital bed.

Tashie has just gotten out of bed, dressed herself, and into the wheelchair! Brava!!

Philip arrived after the departure of Eliza and the felines and, at Tashie's request, brought the fixings for a root beer float. Yum yum! What a way to stoke the fires for a second round of workouts with the therapists! Philip takes off for Oakland on Wednesday, to return sometime in September.
Tashie's discharge day is yet to be determined: the earliest will be Saturday next, but it could also be moved to Monday or Tuesday.

Franceschi / Rowland / Livingston Visitations

Sunny Rebecca with Tashie

Grandchildren et al. in rapt attention

Yesterday evening, Tashie had multiple family visits: first Bruce and Bethany arrived, en route to Portland. Rebecca, Monique, and Dom and Roz came later, soaking in their Tashie stories before continuing on to Portland. And Dom is not stopping in Portland - he takes off next week to start his academic and craftsmen adventures at the American College of the Building Arts in for Charleston, South Carolina.

Monday's Schedule

Generic Google calendar

9:00 Occupational therapy
10:30 Physiotherapy
12:00 Lunch
3:00 Physiotherapy
3:30 Occupational therapy
5:45 Dinner
She generally needs to rest for 1/2 hour to 1 hour after therapy, so this should help you figure out when she might be up to taking a telephone call.

A Second Feline Visitation

Tashie with Micah

Vashti smelling the roses

Eliza brought Vashti and Micah in for another visit, and this time Micah was attentive to Tashie. Yesterday they were too curious investigating the room, and had little time for socializing. Today, Vashti continued to explore, giving Tashie only a glance or two before jumping off the bed to check out the intriguing flowers that came from the Lumbers. Holly, the occupational therapy lady, came by after about half an hour, so we packed up and left so that Tashie could focus on therapy. We have admonished her that therapy comes first - no telephone calls, no visitors when therapy is happening. Which brings to mind . . .her physiotherapist is getting concerned that Tashie is wearing herself out with telephone chin wags, so we are suggesting that you hold calls until late afternoon, any time after five o'clock. At that point, therapy will have been completed, and she will have had time for a little rest. Lunch time is a good time for face to face visits.

Sunday Family Pow Wow

Rebecca (feeling sunstruck) with minutes of pow wow

Family meeting on the Ashram deck to think about and plan Tashie's post-discharge care, with Rebecca as scribe (Her surprising expression is not typical, but her beauty shines through anyway).
Laurie will be coming in every morning M-F to help Tashie get up and dressed, prepare breakfast, clean up, and prep for lunch. A home health worker will be coming twice a week to do showers. Physical therapy and Occupational therapy people will be there a couple of times a week, but we don't yet know the exact schedule.She needs someone with her, or in the near environs, 24/7.
For all of you who have been eager to be involved in her care, there are several options available.
We need volunteers to help on a number of fronts:
1) Cover 24-hour shift
2) Prepare and bring supper for three or four people
3) Come in on days that OT / PT are not here, go through exercises with her
4) Grocery shopping
Odd jobs to do during 24 hr shift:
1) Fill bird feeder, etc.
2) Laundry, changing sheets, etc.
3) Turn on the tape recorder and record her stories as she tells them

Clarke and Rebecca listening . . . 

To the right is a hyperlink to a google calendar, which we will fill in as we hear from you, so that you'll know where the vacancies lie.

A Feline Visitation

"Where am I?" Micah wonders.

Tashie's pals, Vashti and Micah, visited today, after Eliza filled out a form that they would behave well. Pet Therapy! Tashie was thrilled - they have seemed a bit flummoxed not to have been able to find her at her house, in her bed, so they were quite glad to see her, and extremely curious about the new environment in which they found her.
Tashie worked hard learning how to get in and out of bed without the crutch or the trapeze, or the side rails. She also practiced walking, and is getting better and better, more and more steady. Although she did not have pain during her therapy session, she had quite a bit afterward, but a mighty Percoset took care of that.

Working Hard

Learning how to get to bed

Always more walking!

KD and Cameron visited.
The rehab staff fax'd their evaluation of Tashie early this morning - this is the piece that HealthNet has to see in order to make an evaluation regarding another week in rehab. Bethany just got word now that the insurance has approved Tashie's care until Saturday next! Yippee!! Why do they make this so difficult? And what happens to poor souls who don't have families with terrier-like grips? We don't know, but we're awfully glad that she got these extra days....mostly thanks to Bruce's tenacity.

Sorry about no photos recently - the photographers have been working in portland these past few days, and are now back.

Rehab Redux

Micah blissed out by KD and Cameron

Ellen Wood, another Hipster Tash Team Member, spent last night with Tashie, the last night she'll have a personal family attendant. She doesn't need us anymore 24/7, and she'll probably get a lot more rest if she has some times without one of us asking: are you sleepy? does it hurt? where? do you need another pillow? want some juice? shall I read to you?
Another item: Visitors Welcome! Both via the telephone, and face-to-face. Try to schedule your visit so that it doesn't interfere with PT or OT. IN the morning, a physiotherapy schedule is posted,
Tashie was approved for 3 days on the acute rehab unit, day one starting with her transfer from Orthopedics at 4 p.m. on Wednesday. Bruce met with Tashie's Case Manager today, trying to get approval for another week.  Meantime, we are exploring various scenarios for her return home to Spring Creek. And also meantime, life goes on at Spring Creek, and we look forward to Tashie being back here. Above are KD and Cameron fussing over the kitties that made the trek from Portland.

Milestones Met

Lift your head up!

Captain Joe training her for transfer

Tashie is really doing her part to get the go ahead to rehab - she is working hard, walking farther and farther each time, and beginning to learn about getting in and out of bed with less and less assistance.

The view from Tashie's room 440

Good news is that she met her milestones, the insurance finally acknowledged it, and Bruce moved her today to "a sweet suite with a mountain view" on the rehab unit . . . a huge accomplishment.She and Bruce and a physiotherapist met this afternoon to discuss goals, plans, etc.

Hooray!!

Is this the goal?

Tashie's insurance has just approved her move to the acute rehab unit, and she'll be moved down there today, probably this afternoon. Not sure her room number, but the unit is within St. Charles.
She is very eager to get going, down to rehab for some intense work, and then, in the next week or so, over the high desert roads to Camp Sherman.

A Great Night

Tashie and Bruce in St Charles' Garden

Tashie slept like a baby last night, in the care of Mabsie, and after having been guided through bedtime rituals and ablutions with Anne. Although her view of Pilot Butte is "nice," she is eager to get back to the ponderosas and peaks of home, so we'll be putting together a plan. Whether she comes directly home, or home via a few days in rehab, is still not decided. The insurance company has to respond to the appeals within 72 hours, so that means we should get a response tomorrow.
Fred wings back to Oakland today, and will probably return once she is home and settled. He has been a trooper, patiently waiting for the time to visit, and then having a chin wag when she was up to it, and just being there when she wasn't.
I expect Tashie will work really hard at PT today. She is getting better and better at maneuvering her body with less and less assistance, and the nurses have been stellar at pushing her diligently to do a little better each time.

Who's Who

People have asked about the identities of a few of the people mentioned, so I'll try to clarify:
Fred is Tashie's high school sweetheart they reconnected last year - another story altogether!
Rebecca is Tashie's grand-daughter via Bruce and Bethany
KD is Tashie's grand-daughter via Bruce

Nicholas relaxing in Portland

Anne and Dan Ankram are dear family friends from Portland/Camp Sherman/Bend, both RNs
Gail is a dear friend who helps Tashie stay on track, and who also happens to be a first responder/EMT.
And also, here's Nicholas, having arrived back in Portland after 5+ weeks in the Yukon, sporting a magnificent tan and 2 sprained ankles!

A Bad Night

Tashie with KD

Last night was a wasteland of bad leg cramps and no sleep...and definitely no fun. Yesterday Tashie worked really hard at physiotherapy, walking farther than she had walked before, getting herself in and out of bed with minimal help, and faithfully doing the muscle building exercises as instructed. After all that work, she had a long sleep, and then we went out to the garden with Fred and KD, and Tashie launched into story-telling mode.

Fred and Tashie

All was going swimmingly. Until we settled down to sleep at around midnight. Then the leg spasms began, and she was unable to get comfortable in any position. Pain meds didn't seem to help, nor did muscle relaxants. I think it was about seven am before she was able to drift off a bit, and then later in the afternoon she had a long sleep. It was really tough - she had earned a good night's sleep, and it just didn't happen.

A Better Day

Bruce encouraging Tashie

These photos tell the story, at least some of it. Anne and Dan continue to come three times a day to push/help/support the therapy goals, and Tashie is working hard. Bruce has been getting her up and active whenever she feels remotely like it, and alternates the activity with well-earned rest. Changing of the guard on Monday, when Bruce retires to get some rest himself, and Eliza takes over. Monday is sure to be a fireworks type of day, with jousts with the insurance sharks.

An Outdoor Interlude

Tashie's first outing to the garden

Tashie is having a pretty good day. She is a bit worried about what's next, given the insurance debacle. But the OT people got her going, and Bethany pushed her out into the sunshine for a change of scene. Nothing like blue sky and sunshine to wash away the funks.
Matthew arrived from Seattle midday, and will be with Tashie for tonight and tomorrow. Anne and Dan continue to work their magic; we have written to Pope Benedict to see about canonization.

A Glitch

The hospitalist, the rehab doctor, the case manager, the nursing staff, and the patient herself are all agreed that Tashie's next move must be to the rehab unit. Her insurance company, HealthNet, is denying coverage, claiming that this care is not necessary. This is an unfortunate example of business number-crunchers making medical decisions. The hospital plans to appeal this decision, and should they be unsuccessful, we are getting our armaments in order.
The good news is that Tashie continues to work hard with the physiotherapist (Tom) and Dan and Anne, and continues to make progress. Every move she makes is a challenge, but she is rising to the occasion, and not giving up.

Fabulous News!

Bruce went exploring to check out the possibilities of rehab options outside St. Charles this afternoon, and was discouraged generally. And in his words:
"BUT, when I returned to the hospital with a chocolate milkshake, I learned that Dr. Fitzsimmons had been in, and told Tash that she has a good attitude, has worked hard, and is just the kind of person they want... "You worked very, very hard, and I know you were in a lot of pain, but you kept working." So cutting to the chase, Tash will be in room 310 until Monday, when she will be moved to the rehab unit here in the hospital. HOORAY!!
I have to tell you again how absolutely critical the intelligence/generosity/love of Dan and Anne has been in getting Tash to this place. They knew the right questions to ask, the right medical issues, and have the expertise essential to bringing it all together. We tag-teamed Tashie about kinds of pain and fear and apprehension... She did the hard work, and D and A provided the framework of support for the staff here to insure that we didn't just talk about it, we did it. They're coming back tonight so we can complete round 3 of today's exercise regimen (round 2 happened while I was off; it involved sitting on the bed's edge, standing straight, taking a few steps, turning by steps 90°, sitting on a chair for a few minutes, getting up and transferring to the commode, then back up and returning to bed).
For those of you who do not know the Anne and Dan who have been so essential to the direction Tashie is going: Anne and Dan Ankram are old and dear family friends, who also happen to be crackerjack RNs, and who also live short minutes away from the hospital. They have been truly amazing.

Notes from Room 310

Bruce: It's been a busy day. Tashie had a good night from midnight until 5:30 when the blood draw man showed up. Then, having lost track of time, she called Les and Gail to chat, not realizing that it was several hours before their normal waking time.
Lots of nursing activity with Brooke and Jenn, a great pair through the night and morning.
Tom, Dan and Anne had a very successful exercise session with her about noon today. Got her sitting on the edge of the bed, standing up for a couple of minutes, and then rotating 90° to approach the chair, then backing up to it and taking a seat. This was a huge deal, and a major step beyond last night's attempts. She has to repeat this process two more times today in order to be on a strong track to go directly to the rehab place downstairs.
Tash is still asleep (exhausted from her exercise), but woke up about 15 minutes ago.
Dan and Anne are highly skilled saints. They've advocated for her vigorously, and asked lots of questions that I wouldn't have known to ask. I'm thrilled that they're coming back tonight.

Onward and Upward into a Chair

Onward and Upward into a Chair
Reports from Tash's bedside:The morning was spent in deep slumber - well-deserved - and gathering energy to mend the wounded places and heal the tiredness. She was even too tired to have Fred sit by her bedside - plum tuckered out she is. The physiotherapy team arrived, and Tashie had more energy today. She sat in the chair for more than an hour, and in general, was able to move a little more easily than yesterday. Dan gave her a pep talk about pushing herself to meet the milestones that will land her in rehab . . . as opposed to not meeting those milestones and going to a nursing facility :( The milestones to be met in order to go to rehab: she has to be able to work at least 3 hours a day at physio. That's a good motivator to work hard! Bruce is with her tonight and tomorrow, and he'll cheer her on when she lags.

In Pursuit of Quiet

It became clear, today, how profoundly exhausted Tashie is: a traumatic fall, 6 hours in excruciating pain with no relief; a 2+ hour surgery. She barely has the energy to respond to simple questions from the nice nurses; even smiling seems an effort. The incentive spirometer, which she understands is really really important, presents a physical challenge that seems to nearly overwhelm her. With lots of coaching and coaxing, she gives it one blast up to 1200 or 1500, and then she is spent, too exhausted to try once more.

At midday, the physiotherapist plus an RN plus a CNA got her up and sitting (in a slanted fashion) on the edge of the bed. She teetered unsteadily, and winced with the pain. She felt dizzy, and after fewer than 5 minutes, lay back on the bed.

She was disappointed that she hadn't been able to stay up and sit for a while in a chair as planned, but also too tired to try again.

It makes us realize how much serious work she has ahead of her, and how her success will depend upon her efforts and determination and her body's cooperation. But to mobilize those forces, she needs rest rest rest and more rest. Tonight Philip is with her, and when I inquired as to her status, he texted: "Enjoying a hard-earned slumber. And some quiet." A hospital is a challenging place to get that quiet!

Calendar

There is a Google calendar available called "Tashie's Mending." We are hoping that you can check it out, and plan your visits/help accordingly. We are thinking it best to defer visits (except for fred of course) until she gets onto the rehab unit here at St. Charles, probably Thursday. And once she does start to receive, one visitor in the morning and one in the afternoon will probably be all she can handle for a while. This event has really exhausted her, and she is sleeping a lot, which is good. Her energy is very low, understandably. Speaking on the phone is not yet easy for her, and she is not on email. We are reading your emails, or parts of them, to her; cards or notes would be fine.

Tashie is dozing again, and we are leaving her undisturbed so that she can be ready and energetic for physio when they come in with their cheery demands. They plan to get her up and standing, and sitting in a chair today. It will be good for her to see the world from an upright position for a change. I read her a half chapter of Moby Dick before I noticed that she had fallen asleep.

Buona Notte

Tashie had a whisper of mangoes and sticky rice tonight, and a smaller whisper of chicken, She seemed to quite enjoy it. She slept and dozed most of the day, and this evening successfully instructed her nurses how to change her position: slowly and mindfully. She is snoozing now, after reporting her level of pain to be zero!

Monday Afternoon

Tashie is still making up for lost sleep last night, so physiotherapy crew decided to wait until tomorrow morning to get her up again. Blake and Cameron made a surprise visit, bringing with them a Rolls Royce of walkers. . . with a jaunty mylar "Get Well" balloon tied to the handle with a pale blue ribbon. The nurses suggested we spirit it away before someone else does, so it awaits Tashie's return home, at the moment in the back of my car, but eventually to Camp Sherman. Clarke drove Fred in to spend time with Tashie, mostly just sitting here quietly with her while she dozed. His California caretaker, Wanda, flies up tonight to help out with Fred's needs while we're all preoccupied with Tashie's needs. Clarke will meet her at the airport and drive her up to Camp Sherman later tonight.

Up and Out!

Fred arrives for a visit

This morning physiotherapy came by, and got Tashie sitting up on the side of her bed, and then standing up! Her nurse is very pleased, and says they'll be back this afternoon to get her up again. She is dozing now after a rough night of pain and bad leg cramps. Bruce is on a coffee run, and will bring her back a frozen mocha . . .and a latte for me.

The real story re. the ambulance ride

This note just arrived from Gail:

A little clarification: When I heard the dispatcher instruct the ambulance to go in on Tract C road per the patient, I assumed that was just her instructions to assist them in finding her house, as opposed to a specific request. I redirected them because I knew it would take

less time to reach her. Only after I got there did I learn that she was attempting to avoid the "Camp Sherman news system". She was still concerned when we left her house and went back through "downtown"

but I explained to her that riding in the back of an ambulance (which is a bit rough even on the highway) on Tract C Rd with a broken hip could be uncomfortable, even with the morphine she'd had. Maybe some day she'll forgive me....