Wednesday, April 25, 2012
4/25
Dad has been released from PT! He went back to the gym this week (I even woke up early to go with him at 5am) and he had a couple awesome workouts. Things are going great!
Monday, April 16, 2012
4/16
This past week of having Dad back at home has been going GREAT. I swear he's doing better now than at any point so far in his recovery. The most recent hospitalization has been a mere bump in the road, his motivation and attitude are so fantastic. He's home and really enjoying life - sitting on the front porch drinking coffee, catching up with filing and reading, weeding my garden, and playing with the kids.
He was prescribed outpatient PT, OT, and speech therapy. But out of all three, he really only needs the OT because it addresses his vision impairment and left hand strength/dexterity. He's only had two sessions so far and already showing nice improvement. They tested his strength in both arms, hands, and feet and he's definitely still a bit weaker on the left. But despite that he still tested above average for his age in all areas. They're working on his left hand dexterity a lot too with complicated stuff that even I would have a hard time doing with my left hand, pretty soon he'll be ambidextrous! And they have special vision-training machines to help strengthen his peripheral visual field, which is awesome. His left peripheral vision has definitely been steadily improving though. At first he had a pretty significant left visual field cut. Now it's mostly just the extreme left side and bottom of his periphery that seems to lag behind. We have an appointment scheduled with Dr. Bytoff next month, a neuro opthamologist to follow up more in-depth with the vision and find out when he's allowed to drive again.
He really doesn't need the PT, but I think he'll end up going a few more times. It's nice for working on balance and equilibrium, but he's plenty strong and agile enough. They gave him clearance to go back to the gym so it's just a matter of time until PT discharges him from their services.
He had speech therapy for the first time today and he's already been discharged from their services. Evan, the same speech therapist from last time, said he got out his absolute hardest tests to use on my dad. He said he was really excited about these tests because he never gets to use ones that are this challenging, they are designed to be taxing for even the most "cognitively-gifted". A.k.a. They're supposed to be really hard even for the smartest of the smarty-pants. And let me tell you - they were HARD. Like, seriously really really hard. It was like the mental olympics or something, I couldn't keep up. Needless to say my dad did excellent and Evan said he didn't need to see him again.
So that's the latest update!
He was prescribed outpatient PT, OT, and speech therapy. But out of all three, he really only needs the OT because it addresses his vision impairment and left hand strength/dexterity. He's only had two sessions so far and already showing nice improvement. They tested his strength in both arms, hands, and feet and he's definitely still a bit weaker on the left. But despite that he still tested above average for his age in all areas. They're working on his left hand dexterity a lot too with complicated stuff that even I would have a hard time doing with my left hand, pretty soon he'll be ambidextrous! And they have special vision-training machines to help strengthen his peripheral visual field, which is awesome. His left peripheral vision has definitely been steadily improving though. At first he had a pretty significant left visual field cut. Now it's mostly just the extreme left side and bottom of his periphery that seems to lag behind. We have an appointment scheduled with Dr. Bytoff next month, a neuro opthamologist to follow up more in-depth with the vision and find out when he's allowed to drive again.
He really doesn't need the PT, but I think he'll end up going a few more times. It's nice for working on balance and equilibrium, but he's plenty strong and agile enough. They gave him clearance to go back to the gym so it's just a matter of time until PT discharges him from their services.
He had speech therapy for the first time today and he's already been discharged from their services. Evan, the same speech therapist from last time, said he got out his absolute hardest tests to use on my dad. He said he was really excited about these tests because he never gets to use ones that are this challenging, they are designed to be taxing for even the most "cognitively-gifted". A.k.a. They're supposed to be really hard even for the smartest of the smarty-pants. And let me tell you - they were HARD. Like, seriously really really hard. It was like the mental olympics or something, I couldn't keep up. Needless to say my dad did excellent and Evan said he didn't need to see him again.
So that's the latest update!
Wednesday, April 11, 2012
4/10
Dad is HOME!!!
He was discharged yesterday afternoon, I've never seen him so happy as when we finally got to blow that clambake. We both practically skipped all the way to the car.
The final verdict is still that this whole thing was inflammation from an autoimmune response, but no one can seem to identify the exact trigger. Just that this again is "extremely rare and unexpected". No matter what the trigger though, the treatment is a course of steroids so I suppose it doesn't matter. It would just be nice to know. They said it could be remnant inflammation from the prior encephalitis, something in the environment, or something related to the thyroid. So we'll just keep close watch and make sure it doesn't happen again.
As for Dad, he's really doing fantastic. The weakness in his left arm/hand is now minor and the visual field deficit is improving. He will be going to outpatient OT and PT and has an appointment in May with an awesome neuro-opthamologist to address the vision.
I have more details, but I'm running late for work so I'll try to get another post in soon this week. Just wanted to pass on the news that he's HOME.
He was discharged yesterday afternoon, I've never seen him so happy as when we finally got to blow that clambake. We both practically skipped all the way to the car.
The final verdict is still that this whole thing was inflammation from an autoimmune response, but no one can seem to identify the exact trigger. Just that this again is "extremely rare and unexpected". No matter what the trigger though, the treatment is a course of steroids so I suppose it doesn't matter. It would just be nice to know. They said it could be remnant inflammation from the prior encephalitis, something in the environment, or something related to the thyroid. So we'll just keep close watch and make sure it doesn't happen again.
As for Dad, he's really doing fantastic. The weakness in his left arm/hand is now minor and the visual field deficit is improving. He will be going to outpatient OT and PT and has an appointment in May with an awesome neuro-opthamologist to address the vision.
I have more details, but I'm running late for work so I'll try to get another post in soon this week. Just wanted to pass on the news that he's HOME.
Monday, April 9, 2012
Happy Easter
We celebrated another holiday in the hospital, but took it in stride and came together as a family to enjoy the day and each other.
The kids really enjoyed opening their Easter baskets in Dad's room, despite some initial confusion when I told Zoey that the Easter Bunny was delivering their baskets to the hospital and Zoey having this horrified look on her face saying "The Easter Bunny is in the hospital?!? Oh nooooo". She's much better now after being reassured that the Easter Bunny is ok.
And just because I like to brag about my awesome kids, here's a couple more Easter photos of them:
As for my Dad, he's incredibly eager to get out of the hospital and we're hoping for a discharge today. More on all of that to come!
Thursday, April 5, 2012
4/5
Apologies for the delay in updating, I realize many of you have likely been checking in here to find out the latest. It has been a hectic week.
Well, we've had a bit of a setback.
I took Dad in to the ER on Sunday 4/1 for stroke symptoms. He had onset of significant left arm and left hand weakness, slight left-sided mouth droop, and significant left peripheral vision loss.
He was seen immediately in the ER where I work and was quickly evaluated by the Neurology service. Initially he was admitted for stroke and the whole stroke work-up was ordered. He remains in the Neurology IMC (Intermediate Care Unit) at Hershey Medical Center.
I'll spare a lot of the details over the past week, but after some tests it no longer appears that he had a stroke (which is good news). His MRI shows that he has superficial tissue damage to the back right part of his brain. That tissue is "angry" but not dead. This is not consistent with strokes, which show deeper brain involvement and usually an actual death of brain tissue.
So then the question arises, what is it?
Initially his neurologist, Dr. Reichwein, had 3 possibilities: 1) inflammation 2) infection 3) seizure. To narrow this down, he had a lot of tests ordered, most notably EEG (to look for seizure activity) and a lumbar puncture (LP) to check his CSF (cerebrospinal fluid) for signs of infection or inflammation.
We're still waiting for the EEG to be done, but he had the LP and the results are consistent with inflammation. The CSF was also sent out to test for recurrence of the viral infection that caused his encephalitis back in December, but those results won't be back for a couple of days.
Right now he is being treated with IV steroids for inflammation and also IV Acyclovir pre-emptively just in case the CSF comes back positive for infection. Dr. Reichwein is fairly certain that there is no infectious process or recurrence of his encephalitis, but we'd rather treat with the Acyclovir as a precaution.
So then the question is, how did he get this brain inflammation?
It is related to his encephalitis, but Dr. Reichwein said it's highly unusual for this to occur. His current thinking is that when my dad originally got sick in December he had the infection (which was treated) and the inflammation (which was expected to resolve after the infection did). The infection went away but the inflammation didn't. Further, (and this is the part which is highly unusual), he thinks that the inflammation may have migrated from the site of his infection (middle of the brain) to the back of the brain. The treatment for this is IV steroids.
Currently he has improved (even before we started the steroids). His left arm is just as strong as his right arm now, although he has still has issues with left hand finger dexterity. The mouth droop is basically gone. He still has a significant left-peripheral vision deficit, but it has gotten slightly better in the lower part of his visual field.
The plan is to keep him in the hospital until at least Monday to get the IV steroids, monitor him, possibly repeat the MRI, and do the EEG. He may also go home on oral steroids, depending on his progression.
What I find interesting is that the site of his current inflammation (and his pain) is the back right of his head - the same place he's had pain all along. Dr. Reichwein agreed that he may have had this inflammation brewing for awhile.
So, that's the current update. He's bummed to be in the hospital, but dealing with it well. Mostly just annoyed to be hooked up to so many cords and wires. We're disappointed that he has to spend another holiday all cooped up. We celebrated Christmas in the hospital, now Easter too. But we plan to have an egg hunt for the kids in his room and we'll open their Easter baskets there Sunday morning. Should be interesting if we don't find all the eggs, the next patient in that room will get a nice surprise!
Well, we've had a bit of a setback.
I took Dad in to the ER on Sunday 4/1 for stroke symptoms. He had onset of significant left arm and left hand weakness, slight left-sided mouth droop, and significant left peripheral vision loss.
He was seen immediately in the ER where I work and was quickly evaluated by the Neurology service. Initially he was admitted for stroke and the whole stroke work-up was ordered. He remains in the Neurology IMC (Intermediate Care Unit) at Hershey Medical Center.
I'll spare a lot of the details over the past week, but after some tests it no longer appears that he had a stroke (which is good news). His MRI shows that he has superficial tissue damage to the back right part of his brain. That tissue is "angry" but not dead. This is not consistent with strokes, which show deeper brain involvement and usually an actual death of brain tissue.
So then the question arises, what is it?
Initially his neurologist, Dr. Reichwein, had 3 possibilities: 1) inflammation 2) infection 3) seizure. To narrow this down, he had a lot of tests ordered, most notably EEG (to look for seizure activity) and a lumbar puncture (LP) to check his CSF (cerebrospinal fluid) for signs of infection or inflammation.
We're still waiting for the EEG to be done, but he had the LP and the results are consistent with inflammation. The CSF was also sent out to test for recurrence of the viral infection that caused his encephalitis back in December, but those results won't be back for a couple of days.
Right now he is being treated with IV steroids for inflammation and also IV Acyclovir pre-emptively just in case the CSF comes back positive for infection. Dr. Reichwein is fairly certain that there is no infectious process or recurrence of his encephalitis, but we'd rather treat with the Acyclovir as a precaution.
So then the question is, how did he get this brain inflammation?
It is related to his encephalitis, but Dr. Reichwein said it's highly unusual for this to occur. His current thinking is that when my dad originally got sick in December he had the infection (which was treated) and the inflammation (which was expected to resolve after the infection did). The infection went away but the inflammation didn't. Further, (and this is the part which is highly unusual), he thinks that the inflammation may have migrated from the site of his infection (middle of the brain) to the back of the brain. The treatment for this is IV steroids.
Currently he has improved (even before we started the steroids). His left arm is just as strong as his right arm now, although he has still has issues with left hand finger dexterity. The mouth droop is basically gone. He still has a significant left-peripheral vision deficit, but it has gotten slightly better in the lower part of his visual field.
The plan is to keep him in the hospital until at least Monday to get the IV steroids, monitor him, possibly repeat the MRI, and do the EEG. He may also go home on oral steroids, depending on his progression.
What I find interesting is that the site of his current inflammation (and his pain) is the back right of his head - the same place he's had pain all along. Dr. Reichwein agreed that he may have had this inflammation brewing for awhile.
So, that's the current update. He's bummed to be in the hospital, but dealing with it well. Mostly just annoyed to be hooked up to so many cords and wires. We're disappointed that he has to spend another holiday all cooped up. We celebrated Christmas in the hospital, now Easter too. But we plan to have an egg hunt for the kids in his room and we'll open their Easter baskets there Sunday morning. Should be interesting if we don't find all the eggs, the next patient in that room will get a nice surprise!
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