Friday, July 29, 2011

A New Kind of Good Day

One thing that I learned during the time that Dad was sick is that whether a day is a Good Day or a Bad Day depends more on one's perspective than on how the day actually goes.

Dad talked a lot about what he wanted to do after he got out of the hospital and started feeling better; he knew his Bucket List had to be modified but still had Hope that he would get the chance to do some of the things he still really wanted to do, like going to the beach again.

We started thinking that as long as Dad was able to do at least one thing that he needed to do and one thing that he wanted to do each day, that day could be considered to have been a Good Day.

Nine days after Dad was admitted to the hospital and diagnosed with brain cancer, we had the first New Kind of Good Day: we got to take him to rehab, where it seemed like Hope was stored and a promise of Normal awaited. 

It had been a whirlwind of activity since we’d gotten to the hospital.  Dad arrived by ambulance on Oct. 23, had surgery to “debulk” the tumor on October 27, was moved from the Neuro-ICU to a regular hospital room on the Neuro floor on October 29, and was transferred to an inpatient physical rehabilitation facility on November 1. 

When we’d toured the rehab facility before we’d decided that he should go there, we were told that he would receive at least 3 hours daily of PT, OT, and Speech Therapy.  We told the admissions coordinator that we felt he might benefit from a week or so of that type of intensive rehab on an inpatient basis and then we would take him home, after which he could get more therapy on an outpatient basis.  We had High Hopes that a short stay in rehab would give him the boost he needed to be able to walk unaided, get ready for the day safely, and possibly even drive a car.  We wanted as badly as he did for him to be able to get back his independence and even a modified version of his life.

The hospital staff wanted Dad to be transported by ambulance to the rehab facility, which was about 10 miles away.  "I feel confident in my ability to keep him safe," I told the nurse when she told me they were planning to call an ambulance, "and that's what I am going to do."  Maybe that wasn't 100% true, but I'd be damned if I let a decision that I thought was a Big Deal be made by someone who didn't know us and didn't know how determined Dad and the rest of us.  Because I thought that another ambulance ride would further underscore the fact that Dad was sick and how much his life had changed, I insisted that my mom and I take him to rehab on our own, and that we did. 

Dad was so happy to get outside the four walls of the hospital, even if it just meant exiting through the stinky underground parking garage of the hospital and then viewing the world through the windows of the car on the way to entering the front doors of the rehab facility.  He tried to talk us into stopping by a restaurant for lunch in between the hospital and rehab, even offering to "go for fast food" if we didn't think it was a good idea to go to "a sit-down restaurant." 

Looking back, I wish we'd done it ~ I wish we'd said to hell with The Rules; if Dad wants to go to a sit-down restaurant, then we're going!  But we had been told to go straight to rehab, do not pass Go, do not collect $200, and that's what we did. 

We wheeled Dad into his new room at rehab and got him settled in the bed.  He was tired from the transport and from the excitement of the day, so we let him "rest his eyes," as he put it, while Mom and I unpacked and arranged the room. 

Dad in his room at the rehab facility
 We had also been instructed to deliver a copy of Dad's medical records from the hospital to the staff at the rehab facility.  Before I handed them over, I studied the neurosurgeon's notes from during Dad's surgery, even making notes in my notebook of what had been written in the summary.  I didn't have time to process or use for that information at the time but thought I might in the future, and I felt like the more information I could get on Dad's condition, the better armed I would be.

The rehab director came by shortly thereafter and did his assessment on Dad.  He had him do much of the same stuff we'd seen requested of Dad at the hospital: "Touch your finger to your nose," "Follow my light," "Hold your arm up and don't let me push it down," and, of course, then came The Questions.

That time, after so much rehearsal in the hospital and after having heard us talk about going to rehab so much, Dad did well in proving that he was oriented to person, place, time, and reason for admission ("I guess I have a brain tumor," he told the doctor.).

And then came the call for some more challenging cognitive tasks:  "Count backwards from 100 by 7's," "Listen to these three words and after we finish talking in ten minutes I'm going to get you to say those words back to me," and "Name the item that I am using words to describe."

These were tricky.  Dad tried his best; he got part of each of those tests correct and then searched my face for help on the rest.  That was the worst part - when he realized that he didn't know the rest of the answers on something he knew he should have known.

"That's why we're here, Dad," I told him.  "I can help you with getting your balance, strength, and coordination back, but we need to make sure your memory is better and that you are safe."  He trusted us to make the call of what he should do next to get better, and so he agreed to stay.

After all of that activity, Dad said that he was ready for bed before 10:00 that night.  I had to be back at work the next day and then planned to come back the day after that to go with Dad and Mom to the oncologist's office to find out The Plan,  and so I left Mom to watch over him in their new quarters.  As I turned to walk out of the room, Dad looked at me and said, "Thanks, Steph!  It's been a Good Day."

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