busy busy

Cosima told Sam that it was a very busy day. She had quite a few visitors today so she enjoyed getting to catch up with them.

She is having physical therapy each day during the work week and it is going well. For the last 1 1/2 days she has been off her pain medications. She is having a bit of pain but it isn't unbearable. Cosima is hoping being off the pain medication will help reduce her stomach pain and make it easier for her to digest her food as well.

In addition to all the other activity the nursing center has had Halloween trick or treaters coming in to get candy and visit the residents. I think this is great especially as most of the residents are older and am sure it is a treat for them to have children visit and see them in their costumes. I love Halloween and would be delighted to have trick or treaters come by for 2 days before the holiday - maybe I will have to figure this one out.

cards and more cards


All of the cards and letters Cosima has received have filled a drawer. She is so grateful for all of the support and correspondance she has received - in fact she is actually in a bit of awe at how many people have reached out. These mean so much to her and those who have been there have been reading them to her. Please keep them coming as they play a role in her recovery.

Sam told me several times on the phone about just how many there were as he couldn't quite believe it either.

Cosima has touched so many lives and we appreciate that some of this is coming back to her during this difficult time.

Our deepest thanks to everyone who has taken the time to write - it isn't a lost art yet even with the internet!

schedule


Before Sam leaves he is trying to put together a schedule. So many people have helping out, been visiting, and offereed to assist we wanted to put together a more structured schedule over the next month or two. We want Cosima to know someone will be with her on most days for support and companionship.

So far the schedule consists of the following:
Monday - Angele
Tuesday - Jan
Weds - Angele
Thursday - Gracia
Friday - Gracia
Saturday - open
Sunday - Jan

Sam and Zach are going to try have one of them come down most weekends - it would be a Friday through Monday timeframe though every weekend may not always be possible. Once they have plane tickets and have coordinated through work we will post those dates.

Thelma will also be around quite a bit as well but we don't want to wear her out and also allow her to go home for some days so she can get things taken care of at home and rest. Not to mention sleep in her own bed - we all can relate to how much better we all sleep in our own bed.

If you are able to come down for the day to help out please email me at kaylaschober@gmail.com and we will put you on the schedule. This way it will help us spread out her visitors and also ensure she will have someone with her most of the time during visiting hours. Seeing her friends and family is very important to her and a critical piece to her recovery.

Today has been a very difficult day. Emotionally it has been very hard as she is starting to process even more what has happened to her and what it means for her. I cannot even imagine having to come to grips with the extent of her injuries and the long journey to recovery and have been so impressed with her strength. Even though she has been very strong there are obviously times it will overwhelm her and today was one of those days. She is still having significant pain as well and we aren't sure yet of exactly the source.

This makes it even harder for Sam to have to leave this evening as she keeps asking him how many more hours he will be there for today. Knowing that he has started the process to put a schedule in place makes it just a little bit easier.
We would love to have the gift of time from anyone who is able so please let us know if you would like to be on the schedule. This is not to discourage visitors or anyone who is just able to stop by since we definitely want that to continue. We are just trying to space it out a bit and ensure someone is with her as having a friend with you can make a world of difference, especially if you can know in advance who will be there.

Thanks again for all the thoughts, prayers, visits, and cards it certainly makes her family feel so much better when we aren't able to be there ourselves that there are so many people watching out for her.

Sorry for the long post - I have always said I wanted to write a novel but honestly wasn't trying to do that today.

payback

After all the years that his mom took care of him while growing up Sam is paying a bit of that back. While he is in Arizona he has been able to help take care a bit the last few days. He has helped brush her teeth and put on her lip salve. When she wants a favorite yogurt he is able to go get it for her. Knowing he can be there for her and spend time with her just holding her hand, keeping her company, and chatting is healing for both of them.

Today Cosima had a good morning. After eating later though she did have some stomach pain and we are unsure if this is related to the food she ate or is from something else.

Sundays seem to be pretty slow days since the staff levels are lower and most of the appts, check-ups, and therapy come during Monday through Friday.

Tomorrow she has several visitors expected along with her appts and therapy so it will be a busy day - seems like it may consist of the same busyness many of us experience on Mondays.

broccoli and chocolate

Broccoli and chocolate - 2 items Cosima has been craving and she has had both of them now. Last evening she had broccoli and chicken and today she was able to eat a piece of Belgium chocolate.

Today she is a bit more tired but then it was a pretty busy day yesterday. She is currently taking a nap. The therapists aren't there on the weekends so she has a bit of a break.

The therapists at Rio Rancho just started with the assessments so she hasn't gotten through many of the exercises but when she gets those she will be able to practice those on the weekends.

a big change


Sam is amazed at how far his mom has come since he last saw her. Cosima is in excellent spirits.

Today the therapists got her in the wheelchair to do some tests. Afterwards Sam took her outside in the wheelchair so she could get some fresh air and enjoy the sunshine. She was even able to get off road a bit onto the grass and hug a tree which she has done ever since Sam can remember.

Cosima is able to move her arms and legs quite a bit and can even lift her leg off the bed.

The dietitian met with them today and go over her diet and they are working with her on her special dietary needs. Everyone seems to be very conscientious and nice. The facility is a nursing and rehabilitative center so there are quite a few older people who are there.

It seems like the new facility is a good fit and that they will provide the support and therapy Cosima needs right now.

Nancy's comments

Nancy sent the following email to my sisters and I this evening that I thought was worth sharing.

"Pat is doing incredibly well when you think of her having broken bones from top to bottom or bottom to top! So good about all of it with a fantastic attitude. She made the remark that she felt her body had really needed a rest and a vacation - I did suggest she try a different mode the next time that the need arises. She was singing in the shower the night before I left - a slightly different experience than most showers - it takes place on a plastic bed with holes in it! And she is so appreciative of everything done for her. She was moved today to the facility where she can have more rehab and therapy. Hopefully that will go well - has the advantage of being about 45 minutes closer to her Mom and friends.

You would all love Sam's grandmother - what a dynamo and just a kick! 83 years old -very petite - uses a walker like Grandma Schober had - says she just takes it along so she has a place to put her purse. And when she takes it along you need to be prepared to RUN to keep up with her! She married her husband's brother after her husband died - but says she is not getting married again as she is all out of O'Neals.

So I did have a good time even tho' under different circumstances than would have been chosen by any of us"

Thanks again Mom for helping out - we are very lucky to have you!

new digs

Cosima has been moved to the Rio Rancho Nursing and Rehabilitation Center.

Rio Ranching Nursing and Rehabilitative Center
4210 Sabana Grande NE
Rio Rancho, NM
505-892-6603

This is the place where the focus will be on rehabilitation and therapy. Both Nancy and Jan were very impressed with this facility and met some of the therapists they feel will work well with Cosima. Her physical therapy will increase from what she has been receiving at Kindred.

has food ever tasted so good?

Cosima is continuing to do well eating since the feeding tube was removed. Even though it is mechanically processed being able to eat and taste has to be huge after not eating for over a month on her own. She has been doing very well with her diet so far.

Last evening she was able to get a bath which was something she was eagerly looking forward to. The small things in life like eating and having a bath become big deals when you can't do them. I will have to remind myself at dinner tonight to really enjoy my food and not just shovel it in.

Her spirits remain high and it will be good for her to be a bit closer to her home and many friends. It looks like the move will happen tomorrow morning now but we will update as we get any information.

Nancy left today to head back home to Friday Harbor and Thelma is currently with Cosima right now. Sam will be coming to New Mexico on Friday morning to spend some time with his mom. She is definitely looking forward to their time together and Sam is anxious to get back as well and am sure we will be amazed at how far she has come.

a move is in the works

It looks like Cosima will be moving in the next day or so to a new facility. She will be discharged from the hospital and will be going to a nursing/rehab facility. We are hoping they will be able to provide both the nursing and rehabilitative care so she won't have to move again but this could change.

Jan and Nancy were able to go look at the 2 options today and were able to choose the one they felt was a better choice for her. It is in Rio Rancho so it may be a bit closer for some of you which will be good. I am very glad the timing worked out so my Mom was able to help look with her nursing background and ask the right questions.

Right now it looks like Cosima will have the semi-private room as none of the private rooms are available currently. They were able to place her on a list for a private room but these are in short supply.

Passing the swallow test was a big step in her moving to the next level of care so this is the next progression in her recovery.

Please check this website before visiting her as we will update it with the address once we have been told she has been moved by the hospital. I will update it as soon as we have confirmation so this will be the first place to get the information after the family has been told.

she passed!

Cosima passed her swallow test this morning with flying colors! She is currently drinking a glass of water. At noon she will have food - it will be mechanical soft (fancy name for the already been chewed kind of food) but it is food and she will be eating it on her own. This means the feeding tube is gone - so one more tube down.

As we can imagine Cosima is ecstatic to have passed. Cosima and Nancy met with the dietitian and she was very helpful and recognizes and understands her dietary needs. The hospital will be very accommodating to the dietary requests.

Angele, Cosima's friend, showed up shortly after the test and she is off to the coop to pick up some special items for her that aren't available at the hospital. There is a small fridge they can store these items for her use.

Thelma will be back down to the hospital tomorrow and Jan will be coming down tomorrow as well.

weekend wheels

This weekend has gone very well. Nancy was able to do the therapy with Cosima that she learned from the therapists. This is good as it means she didn't have time off and could keep progressing.

Cosima was able to spend quite a bit of time in the wheelchair though there still is some pain from her broken pelvis when she sits in it. She has also gotten in plenty of outside time as well. Her spirits are good and Nancy reports she is doing marvelously well considering all that she has been through.

Tomorrow is the swallow test which is a big one since that could mean solid food for the first time if she passes. There is obviously a bit of stress involved looking forward to this since it such a big step and Cosima wants to make sure she passes. The big focus over the last few days has been practicing the swallow test.

Several visitors stopped by so she enjoyed seeing her friends. Thelma had to go back home today since her furnace went out but they found the part so they should be able to get it fixed for her tomorrow.

Sleep has been much easier the last few evenings as well. Cosima feels she has been resting much better lately.

We all have our fingers crossed for the big test tomorrow and will update the blog when we have any news.

therapy and more therapy

Cosima once again got quite a bit of therapy today. She seems in good spirts and said that today (Friday) is going well for her.

Nancy (my mom) is there with her today along with Thelma and Jan. During the therapy this morning Nancy spoke with the therapists and learned what they were doing so she can help Cosima with some of the exercises over the weekend. The therapists aren't at the hospital during the weekends and they thought this would be great is she could help Cosima continue it when they aren't there.

Another swallow test is scheduled for Monday so Cosima is getting ice chips frequently in preparation and the speech therapy helps get her ready as well. Nancy told her that she would see if there was any way to get chocolate flavored ice chips since Cosima was wanting some chocolate earlier.

She has been up and about for most of the day and was able to get outside for quite a bit. The weather was beautiful outside today so she was able to take advantage of it.

another change of the guard

Zach left New Mexico Tuesday evening to head back home to Virginia Beach Having him there for all this time was a great help and know that Cosima was grateful to have him there with her.

My mom, Nancy, is going to travel to New Mexico on Thursday to be with Cosima for 5 days beginning on Friday. She is a nurse so she will be able to help manage her care and ask the medical questions we might not know to ask. She has been the one I call about questions and double-check my information with though I still get it wrong sometimes in spite of her assistance.

Thelma will be there as well during this time. She was able to go home for a couple of days to get things caught up there but is heading back to Kindred to be with her daughter.

Jan and Gracia will be with Cosima on Thursday.

UNMH check up

Tuesday Cosima saw the Orthopaedic doctor at the University of New Mexico Hospital to check in on how she is healing with her broken bones and her wounds. Things are progressing and her wounds are healing. As part of the procedure they give a weight bearing test as well. Right now she isn't weight bearing yet which is not a surprise. This was part of the test they give as an overall check.

She is still functioning well without any additional oxygen so it looks like she is off it permanently right now.

Therapy has been continuing as well this week.

sunday shower

Sunday was a pretty low key day. The big news is that Cosima got the shower she wanted. They put her in a shower chair and then wheeled her into the shower room. Zach was able to help her shampoo her hair at the same time. She really enjoyed this but sitting in the chair is still a bit painful on her tailbone though I think taking the shower was definitely worth it.

Last night she didn't have any restraints so that made it easier for her to sleep.

The respiratory therapist decided to remove her oxygen completely so she is no longer on oxygen right now. They monitored the oxygen levels in her blood throughout the day and if she drops below 87 they will restart it. So far she was able to stay off the oxygen even through the night.

Several visitors came by as well - sorry we haven't been able to keep track of everyone to mention them by name but having the company and seeing her friends is good. The best time for visits are late morning and early afternoon. She is most awake then and her pain levels are most controlled at this point. Other times are usually when she will have therapy and have hospital staff checking on her. She may have appointments during the late morning and early afternoon but for the most part this is the best part of day to get in some quality time with her.

Cosima is still doing well with the ice chips - having these about once an hour. It seems she is aspirating very little of the ice chips so this is good progress and hopefully will eventually lead to her being able to have solid foods.

Monday is a busy day as physical, occupation, and speech therapy are all scheduled to happen. We got a bit off track at the end of last week with these because of everything else that was going on so it will be good to be back on schedule.

ready for a day off

Cosima told Sam today that she is ready for a day off from the hospital. I am sure she would like a break but it seems like a day off may be a bit premature at this point. Sam told her it was like a job where you don't get time off but fortunately she didn't ask about a paycheck from this job other than getting better.

She was able to go outside again for a short while and this time seems to be a welcome respite for her.

Therapy will resume on Monday and the speech therapy should help her get ready to pass her swallow test so she can eventually move to solid food.

ice chips

Cosima is able to have 1/4 cup of ice chips every 2 hours. So far it seems she is handling these much better with minimal coughing. She hasn't had speech therapy for a few days now but it should resume again on Monday. This may slow down her ability to take the swallow study but Zach was told we shouldn't try and rush it.

She had a test to determine if she possibly has gallstones but so far the results aren't back yet. This would no be uncommon for her to have these at this point and is standard procedure to test for gallstones.

Cosima has tried to get out of bed now during the night when she was by herself so they are concerned she might try again. She does seem to have a reaction to the morphine so this may have contributed to her trying to get up and her confusion. She hasn't tried for a bit now so hopefully we are past this point though while she is by herself during the night she is restrained to make sure she won't hurt herself if she tries again.

On Saturday Jan was able to take her outside again in the wheelchair and she enjoyed getting outside of her room again.

better spirits

Cosima was in much better spirits on Saturday. It helps if you don't have any major procedures and are left alone a bit more.

She was able to go outside again today and am sure that lifted her spirits. Being able to get a bit of fresh air and venture outside of her room provided a boost.

We should have more information later but wanted to let people know it has been a much better day for her.

feeding tube

Thursday was a challenging day. They needed to reinsert her feeding tube through her nose but Cosima didn't want to have it done as she was wants to have solid foods. Her swallow test showed she wasn't ready so she had to have a feeding tube put back in so she could get nourishment. They might put a feeding tube in through her stomach but this would need to be done at UNMH and it can't be done until next week.

They aren't able to give her the swallow test again for another week as she needs to strengthen her upper esophageal sphincter (UES) muscle before it can be done again.
During the test on Wednesday it showed she was still aspirating the food she was given and the concern is that it could end up in her lungs which would be dangerous.

It took several attempts but they were finally able to get it back in. They did sedate her some for the procedure but it is still very uncomfortable. The rest of they day she was sleeping from the effects of the sedatives.

Also on her Weds trip to UNMH they removed the sutures from her skin graft and took off the cast on her right arm. She was given a removable wrist brace for support.

Getting the feeding tube back in was a major hurdle and we are hoping for a much easier day Friday.

visiting UNMH

Cosima went to the University of New Mexico Hospital (UNMH) today. She rode in the ambulance back to UNMH and met with the spine clinic in the afternoon. Her neck brace is off now which should make it a bit more comfortable for her. This should be a good improvement as the neck brace put her in a position where she was facing upwards and didn't have much mobility from the neck up.

Unfortunately she is still on the feeding tube which she isn't thrilled about. She didn't pass the xray test today as she isn't quite ready for it to be removed. They will see where she is at in about a week. It was a bit difficult putting the tube back in as she was really wanting to have solid foods at this point.

So far we have still been impressed by how she has progressed in spite of her injuries. She will still have challenging days ahead as she realizes the challenges in front of her but know her strong spirit and determination will help pull her through.

new bed

Cosima seemed to be a bit uncomfortable today and the hospital determined that there might be something wrong with her bed so the gave her a different model which was the newest one they had. So far it seems to be a bit more comfortable and she is pleased with it.

She again had physical therapy in the morning and was able to get in the wheelchair again and venture outside. Her spirits did start to improve in the afternoon again - am sure going outside helped quite a bit.

Tomorrow she has an appt with the speech therapist and they will see if she can be taken to xray for the the swallow study. If all goes well she could have her feeding tube removed and be on solid foods. Not sure if ice cream and chocolate will be first on the agenda but know she will be making requests.

Also on the schedule for tomorrow is her visit to University New Mexico Hospital to the spine clinic. She might be able to have her neck brace removed - at least our fingers are crossed for this one as this will be so much more comfortable not to have it on.

Several visitors have stopped by in the last few days. She has enjoyed the companionship. I know several others are scheduled to visit including her friend Dr Dan. If you are planning on coming from out of town please check with one of us to make sure she will be around as there are several appointments scheduled now at UNMH and we wouldn't want you to miss her.

Cosima has been very thankful for the flowers she has received. She has made a request though that due to the smell that anyone wanting to send any other flowers hold off for now. The smell is a bit overwhelming for her right now and she is in a smaller room that she shares with another patient. The flowers are beautiful and all the thoughtfulness people have shown is very appreciated. Please continue to send cards and your thoughts her way.

on wheels outside


Cosima was able to be in a wheelchair for a bit today and was able to go outside with Zach to get some fresh air. I am sure getting out of the bed helped along with actually being outside of a hospital room for the first time in over 3 weeks (I don't count the ambulance ride to Kindred a week ago).

They did the ice chip test today but her respiration was still a little low so the trach will need to stay in for at least a few more days. Once she passes the ice chip test x-rays are needed to make sure it is ready to come out.

Today she asked Sam if she would be able to leave soon and go to Wal-Mart and then on home. This might be just a bit ambitious right now but we are encouraged that she is so eager to be on her way to recovery. Sam told her once the doctors and nurses said ok he would sign off on it but it would have to wait until then.

She is very ready to leave but we still have quite a ways to go in her recovery process. I think she is still processing all of this in her mind and it might still take a bit for her to wrap her mind around just how long it might take. Remember Cosima is just now being able to process all that has happened while the rest of us have had several weeks to do so.

The central line was taken out of her shoulder yesterday so it was a bit sore especially during physical therapy. During physical therapy they did some range of motion and did give her some pain medication before so it would help with her pain levels. Being on her side is still pretty painful for her at this time.

It seems Cosima is also ready to some of her own hygiene items and was wondering if Zach could go get her some things for her shower. They have a large shower room at Kindred where they can wheel someone in on their bed and the shower heads are in the ceiling. It seems like a pretty slick set-up and am sure a shower would even beat chocolate and ice-cream right about now.

first chocolate now its ice cream


Cosima had quite a few visitors today and it is great she can finally talk and share with those who visit her. Today she seemed in very good spirits and was very alert and interactive. She was even able to get around to watching a movie as well.

Her request now is for some ice cream. First chocolate and now ice cream - Sam was sure her first request would be for broccoli. Guess when you haven't eaten solid foods for several weeks veggies aren't at the top of the list for anyone not even Cosima.

She was given some pain medication last evening and it helps her get some rest during the night. During the days now Cosima is very alert and awake. So far she doesn't seem to remember the accident or her helicopter ride to the hospital but does remember the days on the bike tour before the accident.

Sam was able to speak with her briefly on the phone again today though with the trach he says if he didn't know it was her he wouldn't recognize her voice. We have been getting daily reports from Zach on her progress and current status. Having him there with her right now lets us know she is in very good hands. It seems like each day has been more positive than the last one for several days now which I know is the news we have all been looking forward to.

talking!

I feel like this is the best news I have had to report - Cosima is talking! Her spirits are much higher as well. Just a few minutes Sam was able to speak with her on the phone so that is very exciting. She just started being able to talk this morning. I feel like we are really on the road to recovery with her ability to talk to us now and am sure this will give her a huge lift as well since she can finally let everyone know what she thinks and wants.

She says it does hurt on her side when she moves. The doctors and nurses are going to let her have say in her pain medication as long as her vitals remain stable.

She told Zach she wants some chocolate so I would say we are on the mend. I am sure after all this time she definitely deserves some very good chocolate when she is able to eat. Yesterday she indicated she wanted a drink of something when she saw Zach having something to drink.

Hopefully in the next day or 2 she can be able to start eating. They will first take some pictures of her throat to make sure she is ready.

slow news day

Not much to report on Cosima for the day. She hasn't had pain medication for 24 hours now and seems to be comfortable. When being asked if she wants any she has been turning it down. There is most likely still some pain medication in her system from previously so that may be helping a bit.

Her vital signs are all looking good, normally we have been able to tell by increased pulse and blood pressure when she is in pain, so this looks to be very good right now.

Zach is trying to figure out a way for her to write since she still isn't able to speak. Because her neck brace puts her neck in such a way that her eyes are more on the ceiling he hasn't figured out a solution yet. There are rumors of some type of a foam pen where those with casts can still write so he is looking into this.

Would love to have her be able to communicate more than just via a yes or no nod. She is mouthing words but so far no success in understanding what she is trying to say. After all this time she should have quite a bit to say when she is able to. Am sure if I hadn't spoken in almost 3 weeks everyone would be in dread of when I started to speak and it was all stored up. Everyone would be making a mad dash for the exit to escape. We will see how much she has to share when she can finally talk.

glasses are on


Sorry for the late post today.

Cosima is becoming more awake now. She is lucid and is starting to refuse her pain medication so I would definitely say she is more aware and starting to assert herself. She is also wearing her glasses now throughout the day.

The nursing staff at Kindred has a 6 to 1 patient ratio versus nurse compared to the 2 to 1 we had at New Mexico University Hospital. We were initially concerned about the big difference but so far the level of attention seems to be very sufficient.

Physical Therapy has started - right now it is just basic range of motion. Having very little movement the last few weeks we are pleased that this is starting to help prevent any further muscle atrophy.

The staff also did an ice test in her mouth, not sure what all this entails but it has to do with being able to remove the trach. The optimistic goal is to have her off the trach by the end of the weekend but more realistically it could be another week.

a temporary new home

Cosima has been moved to a different hospital in Albuquerque. Her new home for the next few weeks is Kindred Hospital. This is a LTAC (long term acute care) facility and is step 2 of her recovery plan. We were given 2 choices of LTAC facilities and Kindred is the one we chose.

They were able to move her since her pneumonia seems to be gone and she is no longer running a fever.

Yesterday Cosima seemed to be much more alert and her pain seemed to be under control. She is not talking yet as they will have to teach her how with the trach.

Visiting hours at Kindred are from 10-9 daily. This hospital is a 57 bed facility just 1 exit south of New Mexico University Hospital.

Kindred Hospital - Albuquerque
700 High Street NE
Albuquerque, NM 87102
Phone: (505) 242-4444
Room # 108-2 though this may change

If you would like to send cards please do so to Cosima's attention at the above address.