To reduce the noise, I moved all of the to-do and notes items to another blog page.
- She started acute therapy on Fri, Oct 3. It's the sixth floor of Grand Strand Hospital.
- Plan is to move to a sub-acute facility on Oct 24, but the only place (NHC) that will accept Mom doesn't have a bed until Tue, Oct 28.
- She can drink thin liquids now.
- Can't move right arm. Can very slightly move right foot.
- The right side of her mouth is droopy.
- She can understand when you talk to her at a normal pace.
- If she speaks slowly, she can have a conversation.
- She wakes up, is fully coherent, and we just talk to her.
- Overall, there is continuous progress, which is important and good.
- Her smile is still beautiful.
Tue, Nov 4
20:04
Minor improvements each day. Nothing major. She was able to say four sentences in a row to Barb, which is progress. She's just living at NHC in Garden City, SC for now. Possible discharge is Nov 14.
Barb is preparing to have Mom live with her. Getting a hospital bed, a stedy lift to help transfer her to/from the bed, ramps, home nursing help, etc.
We're also investigating what Medicare, Medicaid, and Medicaid LTC (long term care) will help cover after the discharge.
Wed, Oct 29
09:48
OT and PT are here right now doing an evaluation. They sat Mom up on the side of the bed and she actually kicked her right leg out like 12 inches.
They don’t have a schedule for OT and PT, but they try to keep somewhat consistent times. We need to ask the nurses to help her brush her hair and teeth in the morning so she’s not waiting all day.
They didn’t bring breakfast until 9:00, so we need to keep some snacks here for her. But the good news is that the food here is good. She had a french toast casserole with sausage and oatmeal.
I just stepped out of the room because Mom told the OT and PT she had to go to the bathroom. They’re going to try a bedpan for the first time. That’s happening right now…
Mom has a nice roommate, and we're now actually glad she doesn't have a private room. Helen is nice and she and Mom talk.
Mon, Oct 27
15:48
This is probably Mom's last day at Grand Strand. She has been in good spirits today and had all three therapy sessions today. While she didn't move as well in her wheelchair today, one significant thing happened... she was able to stand! We helped her get up, then the therapist helped hold her right leg while Mom stood.
Also...
This is the plan I just shared with our group:
I just spoke with Brooke, and I want to share with the group here because it will help with our plans.
Mom is supposed to go to NHC tomorrow, and as of now, that's on track. Barb and I will pay Brooke to be with Meema at NHC during the day (something like 8:30 - 4:00). There may be a day or two here and there where she can't do it because of the new job, but she'll be able to do most days. And when visitors come to see Meema, she can take more of a break. Barb can cover much of the weekends.
The thought is that Meema may only be at NHC for 14 days. But we're hoping it actually goes for a month. After that, we're working on plans to have Meema move in with Barb. There are a lot of details to work through, but that's the gist.
Brooke: Please let me know if anything is incorrect. The only minor issues I see are:
1. What happens when Brooke can't be there for a day?
2. Leaving at 4:00 is hopefully ok. Maybe she'll be alone for a bit until Barb gets there.
Oh, and I’m still here until Saturday morning, so I can be with Meema all day during her first four days at NHC.
Sat, Oct 25
09:38
Mom is in good spirits this morning. She had her PT session before I even got here at 8:15. She has nothing scheduled for the rest of the day and she's happy about that. Just going to relax.
I've been asking her about 20 questions each day, like her kids' names, her family members' names, what states we live in, count backward from 20, etc. She get almost everything right. However, yesterday, she couldn't remember Grandpa Bow's first name, and she couldn't remember what state I live in. It was the same thing today. Even after I told her Ohio, and asked again a minute later, she still didn't know. Then I started asking more questions and she struggled a bit. When I asked Mom for Donna’s kids’ names, she said: “Donna and Scott.” I said: “Good, and who is Scott’s sister?” She didn’t know. She couldn't name Dale's kids without my help. I asked the nurse if this is because of the stroke and will this come back. She's going to check some things and get back with me.
10:28
The nurse said she spoke with the speech therapist about Mom not remembering some things. She said that could be due to the stress and things coming back to her. She said what we need to do is see if she starts remembering those things as time goes on. Hopefully it comes back.
Thu, Oct 23
10:14
She’s having a better day than the last two. She did better with occupational and was sitting in the regular wheelchair when I walked in this morning. Speech is here now.
In other news, every post-acute facility said no except NHC. That was in our top 3, but it’s also the farthest away. And they can’t take her until Tuesday. So the care worker is working on getting insurance to cover here until Tuesday.
Speech therapist: "Say fish are swimming in the sea."
Mom: "Fish are first..."
That happened over and over. She struggled to say it because she kept wanting to say "first" for some reason.
Wed, Oct 22
10:46
This morning was tough. Occupational therapy didn’t go well — when they sat Mom up to transfer her to the wheelchair, she got dizzy and couldn’t stay upright without a lot of help. Her vitals were fine, but she still felt light-headed, so they kept her in bed and just did small things like brushing her teeth and hair.
Dr. Wilkins said our appeal to keep her in acute rehab will likely be denied since they only approve it if the next facility would be unsafe. He said Mom has plateaued a bit and still needs a stedy, so it could be weeks or months before going home is even possible.
Dr. Santiago recommended NHC or Brightwater for sub-acute care, though someone else here told us "absolutely not" about Brightwater. Staff keep emphasizing that family presence makes a big difference there, which is discouraging to hear because that means the facility doesn't do what they should without us pushing it.
Mom has seemed confused and scared this morning, and it’s heartbreaking to see her like that.
14:22
Mom was cleared for thin liquids, so that’s good. We decided not to appeal, which means we’re in the process of going to a sub-acute therapy facility. We’re applying for three that take Medicaid: NHC, Pruitt, Angel Oak. The reason we’re not fighting it is because I can be here for her first week at the facility. Mom is going back and forth between being tired and sad, and being alert and ok. Physical Therapy decided to let her sleep right now and they will try again in just over an hour.
Tue, Oct 21
11:56
We had a care team meeting today, and while Mom is continuing to make progress, the hospital determined that she isn’t ready to go home yet. She’ll be moving to a sub-acute rehab facility, likely for about six weeks. It’s a step down in care — fewer nurses and less daily attention — so family visits will be important to help advocate for her. She was heartbroken to learn she couldn’t go home yet, and it was an emotional moment for both of us. We’ll be getting a list of facilities soon and will need to choose three options, with her transfer expected around Friday.
Oh, and the x-ray on her wrist was fine. The doctor said it was arthritis. They are going to heat the wrist to see if it helps.
Mon, Oct 20
17:34
Mom had another encouraging day in physical therapy — she was able to sit up without any support for over two minutes and even move her right foot forward and backward. Later, she joined a group activity at the hospital while they took an x-ray of her wrist to check what might be causing her pain.
Sun, Oct 19
16:28
I (Bob) am back at the hospital for another two weeks. I got here around lunchtime today. My plan is to work from the hospital room for the next two weeks so Barb can get some much-needed breaks.
The difference between now and when I went home two weeks ago is like night and day. She seems alert and aware of what's happening. We can actually have conversations again. I think she cleanly says what she wants to say about 65% of the time. And when she says things that she knows we can't understand, she'll sometimes just laugh it off, which is good. She still slips a bit, like when we FaceTimed with Nate. She called Nate Joe, and when I told her it was Nate, she said: "That's not Joe?" So there is still some work to do.
Barb and I took Mom outside in a wheelchair today. I think this is only the second time she has been outside in the last four weeks.
She's in good spirits and we're just relaxing in the hospital room. She can very slightly move her right foot, but still can't move her right arm/hand. She's working hard by doing three different therapies (occupational, physical, and speech) each day.
Some outside time!
Fri, Oct 17
10:54
Last night brought some encouraging progress — Mom got to enjoy some crab-stuffed mushrooms (a favorite!) and has officially moved from thickened liquids to nectar consistency. The next step is regular liquids, which is huge! Even more exciting, she showed slight movement in her right leg for the first time. It’s small, but it’s movement — a big step forward.
Emotionally, she’s struggling a bit after hearing she’ll likely need to stay another week, but she’s still fighting.
This morning took a scary turn — her heart rate spiked up to 170, so doctors and nurses rushed in. She now has an IV for medication, and her heart rate is back down around 100. The vascular team is working to get a better IV line in place. She’s tired but alert, talking, and in good spirits again.
Tue, Oct 14
Update on Mom – October 14
We had a team meeting today to review Mom’s progress and recovery plans.
Overall outlook:
Her care team feels she’s making steady progress, though recovery will still take time. They’re aiming for about 90% recovery around week 6, but emphasized that improvements in walking and talking can continue well beyond that — there’s no set limit on progress.
Current abilities:
- Team said she's starting to be able to move her right leg, but we haven't seen it. No movement in her right arm.
- She can eat on her own.
- She still needs help with bathing (about 50% assistance) and full help with footwear.
- Getting in and out of bed is difficult; therapists are encouraging her to do more of it without equipment.
- She still needs some help using the bathroom, though they expect that to lessen next week.
Speech and cognition:
We can understand about 50-60% of what she says right now. Speech, cognition, and swallowing therapy continue daily, and another swallow study (an x-ray of her swallowing ability) is scheduled for later this week.
Next steps:
Case management is in a “holding pattern” for now — they’ll discuss discharge plans next week. The doctor emphasized that she won’t be discharged until it’s safe, with the primary goal still being to return home once she’s ready.
Family note:
I (Bob) will be observing her physical therapy next week to get a better sense of her progress.
Mon, Oct 13
From Barb:
Mom had speech therapy today. Then she had physical therapy. She sat up and ate her lunch and she didn’t eat much of it but she ate it all on her own. We FaceTime aunt Carol and uncle Dale. And then occupational therapy came in at 1:30. Occupational therapy said that she’s gonna be added to the list for group luncheons meaning they put 2 to 3 people together at a table down in some lunchroom so they can all sit together and interact while they eat. So that’s a good new step she’s taking. I asked if there were any hot men. Meema rolled her eyes. Lol.
Wed, Oct 9
Continuing PT and making strides every day.
Mon, Oct 7
Entire medical team was in Mom's room today to discuss overall status. While they are still going to keep reevaluating as we go, they actually mentioned releasing Mom to go home on Fri, Sep 24. We're now trying to figure out long-term care because she'll need some help.
She is talking even better today. Improvements are being made every day.
Mon, Oct 6
Barb's reply to "how are things:"
Good. Occupational therapy arrived 7:30 am. New better wheelchair. Got her in it to feed her. Back into bed for speech therapy. She can stay in bed for that.
PT in at 10:30. All back to back. She’ll be exhausted after.
Sun, Oct 5
Bob and Holly drove home yesterday. Barb is sending a lot of updates. Here is the summary:
She is on her second day of acute therapy: speech, occupational, and physical. She is able to sit in a wheelchair without someone holding her in place. She is even going to the cafeteria now and having real food: muffins, mac and cheese, chicken alfredo, etc.
David is getting back to the hospital today to help be with her. Bob will go back to SC in maybe 2-3 weeks, depending on the progress.
She is making progress every day, which is all we can ask.
Fri, Oct 3
09:20
She woke up in a lot of pain around 1:00, but it appeared to be from a bed sore. We shifted her and it was much better. She had breakfast and medication recently, and now she’s sleeping/watching TV.
** BIG MILESTONE **
A lady just came in and said mom gets to go upstairs (acute therapy) today! She said probably early this afternoon.
10:02
Shannon, the speech therapist came in. She had Mom say:
- Numbers (1-10)
- Days of Week (got them all)
- Months (got them all)
- Alphabet (didn't do this one, but it's good to do)
- Singing (she sang the entire happy birthday song)
Good exercises:
- Puff her cheeks
- Pucker
- Smile
Good to do:
Put on country music station and hum along.
Shannon: favorite country artist?
Mom: Roy Orbison (what? really?)
Thu, Oct 2
09:56: Had a decent night. This morning she ate quite a bit (all pureed): peaches, pudding, magic cup ice cream, and some thick coffee. She even said: "Would you put my bed down, please?" She also looked at the analog clock and told me it was "quarter to nine," which was correct. She had a couple of her laughing attacks, too. When I woke up at 4:30 and looked at her, she was just lying there with her eyes open. I asked if she needed anything. She took my hand and said: "sleep." She wanted to make sure I was getting enough sleep. The only negative was that she didn't always recognize people in pictures, including me. But overall it's good progress.
10:56: She has had a few more laughing attacks. I also held up her phone, a book, and a chapstick. She was mostly able to pick the one I said. And when I showed her only the book, and asked what it was, she said: “picture book.” Then I help up the phone and she said: “picture phone.” So she’s close.
Also, Dr. Chastain just came in. He said they’re trying to get approval from Medicare or Medicaid today to cover the therapy. Mom has to be able to do three hours of therapy to get the kind she needs. Otherwise, they said nursing facility where it’s more just taking care of her. I told him we definitely want the more aggressive therapy. I explained she was able to do PT and speech therapy back to back.
15:36: From Holly:
- Caseworker said the doctor approved her therapy.
- Now they’re waiting on paperwork from the insurance company.
- It usually just takes a day to get all the paperwork back.
- They’re hoping tomorrow she can be move if there’s bed available.
- The caseworker will call Barb if there are any changes or when they know more info.
21:46: The doctor approved Mom for acute therapy, which is a significant milestone. That means the doctor thinks she has the potential to get better. She can't move her right side yet, but she can now feel when touched on her right side. And her words, and short sentences, are getting better each day. She's watching TV and we'll both be sleeping for the night soon.
Wed, Oct 1
8:54: Mom had ice cream and peanut butter last night and loved it. She had a good night. Drawing blood causes her pain because it's hard to find a vein. Other than that, she's fairly comfortable. She's saying words more loudly this morning. Hopefully we'll find out the results of yesterday's CT scan this morning, and we're pushing to get her to rehab before the weekend so we don't have to wait all weekend. We've asked her if she knows what year it is (multiple times), and she says no. She just had breakfast and now she's watching Andy Griffith, falling asleep, and snoring loudly. :)
9:52: PT was just here. Mom sat up, looked at herself in the mirror, and used her left arm to reach for things in various places. They had to hold her in place so she could stay sitting upright, but they did it for at least 15 minutes, which was good for her. Doctor also came in. CT scan was good. No new blood issues or anything else. She said moving her to longer-term therapy is up to the case worker, and the order has been put in. Just waiting for an opening.
11:04:
Shannon, from speech therapy, was just here. She said while Mom can’t have ice cream, they have a special kind here called Magic Cup. The orange tastes like orange sherbet. Mom lit up. Shannon will make sure we get some. I think she said we can also get it outside the hospital.
Speech therapy had mixed results. First, she answered a lot of questions correctly. She saw three pictures and had to point to the one she heard the app say. Then there were individual pictures and she had to say what they were.
While she answered most (~75%) correctly, she missed these:
- Does march come before june?
- Do you eat a banana before you peel it?
- Are the lights on in this room? (They were on and very bright.)
- Couldn't identify a horse.
- Point to the ceiling and blink twice. (She blinked, but didn't point to the ceiling.)
- Point to the window. (Just didn't do it.)
- Say "x" (I forgot what word was used). She said: "I'm tired."
- Is your hobby watching tv or fishing? She said fishing. The therapist asked: "Do you like to fish," and she said yes. This was a surprise to me, and I think just wrong.
Get Lingraphica for the iPhone. Do these with her:
- oral motor exercises
- conversation
- activities of daily living
The Lingraphica apps: SmallTalk (oral motor, phonemes, conversation, ADLs, etc.).
Put three objects on a table and have her pick the one we say.
Also say, "this is a straw. what is this?"
After rehab: Medical Univ SC, stroke research center
We should contact them.
Will put her name in DB. When they do a research project for that area of the brain, they can include her. They can pick her up, and sometimes pay you to participate. (If we reach a plateau, this can help.)
Getting to acute rehab is important. It's what she needs.
- Encompass in Little River
- Tidelands
- Grand Strand
Defintitely go to one of these three.
ACUTE REHAB only. That's what she needs.
If aphasia persists, there are four rehabs (dedicated aphasia programs) in the country: FL, CA, MI, IL, CO
Hopefully she doesn't need it.
Swallowing exercises (sheet of paper): start with 6 and 8
20:44: When Mom was moved, she had pain in her right leg today, which is GREAT. She felt it! I guess that pain can happen when feeling starts coming back. And she felt us tickle her right foot and even pulled her foot away. I hope this means she's going to get some function back on her right side. She's resting comfortably now.
Tue, Sep 30
Not much to report overnight, but she's tired this morning. Sleeping now.
10:08
Mom just asked me to sing. So this happened:
Me: “Rudolph the red-nosed reindeer, had a very shiny nose, and if you ever saw it…”
Mom: “You would even say it glows.”
11:30
She passed the swallow test this morning! Now she can drink thick liquids and eat pureed food. And now the tube in her nose is finally out!
21:30
We had a bit of a scare today. Mom didn't want to be awake. She would wake up for a few seconds, then be out again. It got to the point where the nurse was concerned and so they took her for a CT scan. We're still waiting for those results (from about two hours ago). However, she has been awake and alert for a good hour now. She even had a cup of ice cream and a tiny cup of peanut butter. She's now resting and watching Everybody Loves Raymond.
Sep 29
Resting somewhat comfortably. Waiting for swallow test tomorrow. Can say a few words in a row.
Devastating news. My Mom had a massive stroke yesterday.
I got a gibberish text from her early in the morning (she texts me every morning and night).
I raced to her. She obviously needed an ambulance. They got her to the hosiptial and confirmed the stroke and performed a thrombectomy.
She is currently unable to speak or move her right side (face, arm, leg).
We are PRAYING that she regains speech and movement of her right side.
She can hear us and responds by lifting her brows for “yes” and closing her eyes or blinking for “no”.
Anyone that believes in prayer…. We would appreciate any and all prayers for Doris Appelt Horn, my Mother Dearest and best friend!
🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼
Such a difficult time. She is surrounded by many loved ones as we pray and do whatever we can to help her heal.
😢🙏🏼😢
Meema (Mom) update. Sunday morning stroke:
She has complete paralysis of her right side (face, arm, leg). She is completely “there”. Understands everything we say. For 2 days she couldn’t even move her mouth to talk. She was so frustrated to not be able to talk or even move her lips to express her thoughts and feelings — just stared with sad and devastated eyes over her condition.
The right side of her face is still drooped. Tuesday night my brother Bob asked her a yes or no question that was “yes” with raised eyebrows or a “no” w a blink. Instead of that SHE SAID “NO”!!!!!!! Slurry no, but a no nonetheless.
Wednesday a “yes” came out. Slurry. She also said my name. Slurry.
If I say “I” she SAYS “love you” slurred but for sure that.
Thursday/today…. Doctor asked her where she is. She doesn’t know which hospital she is in so she spoke THREE words in a row “Horry County Hospital”!!!!!!!!!!!! No pause. Had to know what she was saying to know she answered correctly. But she did!!!! No pause. Couldn’t say the year it is
She still can’t swallow so has a feeding tube in her nose. She hates it. Pulled it out once on Monday night so they have STRAPPED HER DOWN. She hates that.
When I’m alone w her I release her and hold her hand. Have gotten in trouble more than once but please tell me how an 80 year old woman half paralyzed with only 2 fingers on her only functioning hand could arm wrestle me to get to her feeding tube.
I’m about to be banned from the hospital but I think it is absolute cruelty to give her not even one single inch of wiggle room. She needs to move her arm at least bit.
They turned her to her right/paralyzed side yesterday and kept her left hand strapped so tightly to the bed like a person in the back of a police car with cuffs behind her back. Evil!
When staff comes in she throws her hand down and I snap her back in. She knows if we get kicked out she is alone. She’s accepted the strap when someone isn’t holding her hand.
She still can’t swallow so needs the tube or one surgically in her stomach/abdomen. Doctors keep giving us mixed info as to doing that or not so she can move on to the upper floor for therapy. We will decide tomorrow.
We’ve printed emojis and words for her to point to in order to communicate. Sometimes works.
There is improvement every day w getting some words out.
I’m so glad that she is surrounded by family every single second she is there. I pass by rooms for 4 days now with not one visitor and seeing them strapped. No help w providing the sponge of minimal water to wet their lips or clean their mouth, or have interaction. It’s so sad!
Mom hasn’t been alone for one second (unless staff make us leave for her sponge bath).
She’s still sassy and loving. Struggling but has improvement in some words. It’s amazing!!!! Likely will never walk again, may need a feeding tube forever, but at least she is starting to communicate! She likes us jumping up and down with each new word! Her half smile is beautiful!
🙏🏼🙏🏼🙏🏼
