Athena

The care team had their weekly meeting and the initial assessment is that Athena is going to need 4 to 6 weeks of therapy to obtain basic skills. Athena went to the Colby campus this morning to have a new PEG (feeding tube assembly) put in.

I’m pleased that her doctor switched her back to morphine (liquid and faster acting than Opana crushed up pills) and may be easier to find her current baseline with the increase in activity.

Athena was on the mats this afternoon working out with PT/OT. Speech also worked with her today. Athena is talking more and working towards sentences. I asked Athena’s nurse how she is doing on the endurance side and he said that she isn’t showing any signs of being tired.

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Athena’s transfer went fine and the remainder of the day was getting her meds ordered and feeding tube hooked up. Dr. Lee spent some time with Athena today doing assessments. The staff here is friendly and professional. I took a few pictures of the Providence Everett campus to share with everyone.

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Athena stood up with the help of her PT/OT therapists. Amee came to visit today and I haven’t seen Athena laugh this much in ages,

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This is a picture I took today of Athena after telling her that she will be transferring to Providence (ranked in the top 10 percent of all inpatient rehabilitation facilities in the nation) as early as Thursday and no later then Monday. Athena took a trip to Harborview today to have the followup look at her stoma by the attending doctor that did the surgery. It still isn’t closed yet and Regional was hoping to hear something more than it will take time. I think a phone call would have worked just as well rather than the cost and resources to get Athena there for a quick peek and a five minute chat.

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Days at Island ICU: 10
Days at Harborview ICU: 109
Days at Regional: 163

For those that have known Athena before she got sick, I thought I would share one of the rare moments of seeing Athena without being in a withdrawal state and looking like herself. This picture was taken at Harborview after her surgery in the recovery room. (50 µgrams Fentanyl IV) The only other time I was able to cherish the moment is when Dr. Ann Lipkey used Fentanyl which began the first round of weaning Athena off the medical narcotics. I can’t begin to imagine the suffering Athena has gone through over the last 9 months. Try to put yourself in Athena’s position and ask yourself how long could you tolerate what she has been put through? A month, week, day or even an hour of this torture.

I was upset to see Athena’s legs strapped to her bed when she has been having muscle spasms and moving her legs is the only way she can try to relieve the pain. My request for muscle relaxers for Athena has been ignored so far. Her nurse freed her when we said we would be in the room to watch her. Athena was trying to get out of her bed again and there wasn’t enough staff to keep a close eye on her. I wonder what happened to the sitters she had assigned to her previously so they didn’t have to strap her down.

I thought Dr. Clark was using Propranolol to address Athena’s trauma related symptoms. Propranolol is primarily used to control heart rate. The battle the care team had was keeping her heart rate from jumping to 160+ and oscillating in the 130 range after giving Athena her meds. The solution, wean without the scream using Propranolol to mask the life threatening withdrawl effects. (tachycardia, coma, seizures, ...)

I brought Athena’s mom to visit today and we took Athena outside for some fresh air and scenery. There was a picnic going on in the employee parking lot so we stopped by and let Athena enjoy the good times folks were having. (music, cookout, laughing)

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I was able to chat with Providence admittance and they are waiting for a complete assessment and goals from Athena’s caseworker. I have requested that the Regional PT/OT lead for Athena’s care plan contact Providence directly so they can get a clear picture of where Athena stands with her rehab process at Regional. Athena seems to have regained most of her strength in her legs and is standing with assisted support. She is sitting at the edge of her bed and performing occupation skills. (washing face, using a spoon, ...) I have not heard of any reports that Athena was unable to complete any of the requests asked of her. Athena continues to saturate in the high 90s since she was decannulated.

Athena has indicated that she is ready to move on to the final phase of her acute rehab knowing that she only gets one shot at this. I don’t think the Providence rehab team will be disappointed with what Athena has to give. My hope is that paperwork and funding will be completed by Wed. and she will be at Providence before weeks end.

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I visited Athena today and she seems to be doing better with her new baseline. Nursing is being flexible with her dosing if she is showing signs of withdrawals and it’s within the hour of when she is due her meds. Athena told me she got to stand up today with a new harness Regional is using with the overhead lift system that is used to put Athena in her chair. Athena got to go outside twice today. Once before I got there and at 4:30 when it wasn’t so hot outside. Athena wanted to go out the main entrance and watch cars going by. I told her she will be driving again soon if she keeps working hard to get on her feet. Once that happens the bed will no longer be a central point of her life.

I asked Athena if she is ready for an intensive physical therapy program that is the last phase of her acute care before going home. I told her this is a one time deal and if she isn’t ready she needs to tell me. Athena told me she is ready and is up to the challenge. I told her the pain level is going to increase as her body comes back on line and she can’t count on pain meds as they are being eliminated from her care plan. She said there is nothing more painful then being without Madison and she wants to come home.

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I would like to thank Athena’s Guardian ad Litem for getting the ball rolling again by asking why Athena is still at Regional Hospital and hasn’t moved on to Providence physical therapy rehab yet. Providence has reserved a bed for Athena for a next week arrival. Athena’s case worker is sending Providence an updated assessment based on the outstanding progress the PT/OT/Speech care team has been able to achieve in a relatively short time frame. Dr. Clark has signed off indicating that she no longer needs the care being provided by Regional hospital. Providence is a 2-4 week program and Athena would be able to come home from there and continue with out-patient rehab in a facility near her home.

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Athena made it to Harborview and I’m with her in her OR prep/recovery room. Athena should be going into surgery around 1pm and is scheduled for an hour and a half. I understand Athena will spend the night at Harborview. I will try to update Athena’s progress during the day if I have access to the internet.

Athena is back at Regional and everything went well. Her stoma should be fully closed in 7 to 10 days with a slight scar.

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