Day 114

Early on in this process we were told that Burt’s progress would move two steps forward and one step back.  This has unfortunately been proven true in the last week.

Early last week Burt was sick for a few days.  The nurses at the residence thought it was a gastrointestinal bug, but last Wednesday he was sent to the emergency room.  It turns out that it was actually a kidney stone lodged in his urinary tract.  Burt had a 104 temperature and was very sick, so they had an emergency operation in the middle of the night to install a stent to drain the kidney.  

The back up of the kidney function caused Burt to have a Staph infection in his urine and his blood.  He was treated with high doses of antibiotics, which he will be on for the next month.  The antibiotics irritated his vein so they installed a PICC line, which is like a hard-wired IV. 

It looked like Burt was recovering well, but then on Monday Burt became very lethargic.  He quickly lost the ability to speak and seemed one step above a coma.  All he could do was nod his head now and then and sporadically open his eyes halfway.  The doctors classified it as delirium.  His kidneys began to fail and he kept dry heaving from the build up of urea in his system.

As he was essentially helpless, the Stern family became residents of the hospital.  Connie won the prize, spending 90 hours straight on the hospital, sleeping on a fold out bed next to him.  We had him moved up to a more intensive unit so we could actually go home at night. 

In the last two days Burt has begun dialysis and has regained awareness.  He is still very week and does not have the strength to speak audibly, but if you lean in close and work at it, you can decipher what he’s saying.

We are hoping that he will only be on dialysis temporarily while his kidneys rebound.  We are not sure what caused this, we just want them to heal and for the staph infection to die out so Burt can regain his strength and get back to rehab.  Our old friends Paddy and Randy from Burt’s first rehab already have dibs to kick his ass once he gets back on his feet.

Day 103

Hello everyone,

So this was a big weekend for Burt.  It was the first time he has had his whole family back together in nearly three months.  Gregory flew back from LA and was amazed at how much Burt has changed since he last saw him.  While Connie and David have been there for every step of incremental progress, Gregory was able to see a drastic shift.

When Gregory last saw him Burt was completely bed ridden.  He was just learning to be able to sit up and would have sold either of his sons for a glass of water.  Now Burt can drink by the mouthful.  The applesauce he dreamed of not too long ago is now given to him daily with his pills to help them go down.

Burt can now stand up by himself as long as someone is there to brace him once he does.  He spends most of the day in a wheelchair and has just recently started wheeling himself down the hall with one hand and his right foot for assistance.  He did not tell anyone he could do this, he just started sneaking up behind them and scaring the hell out of them.

He has a lovely private room, which is a far cry from his hospital duds a few months ago.  David set up a bird feeder outside Burt’s window and put the antenna for his XM radio on it so he can listen to opera all day. Rounding out his tech devices, Burt also has an iPad and a Kindle.  While this makes him the envy of most people in their twenties, he has yet to take full advantage of them.  Hopefully he will be inspired to soon, especially since his sons are considering adding a Wii to the collection for Christmas.

Burt is in the rehab section of the residence, separated from Gen Pop, which is full of the catatonic and the crazy.  When Gregory suggested that they watch a Zombie movie, it was pointed out to him that they are already surrounded by zombies.

With all of his tremendous strides, new challenges have become apparent.  While Burt is mostly there, he has certain deficiencies.  His awareness, his attention and his determination are slightly diminished. These are not massively obvious, but they can be seen over time. We are not sure how much he is aware of these, but are confident that with work and focus these should increase over time.

The next step is to start phasing in mental exercises like puzzles, board games and chess.  If anyone feels like dropping by for a game of chess, please do.  Beyond that we want Burt to start setting a schedule for himself.  He has to start owning his day and deciding what he wants in it.  While it is nice at times to have a more complacent version of Burt, he needs to own his recovery a bit more.  He works very hard when it is time for his rehab and enjoys company, but the issue arises when he is alone.  He needs to spend more time doing certain physical, mental and breath exercises when no one is watching to speed up his recovery.

As for this week’s news, Burt was taken for a special triple bone scan the other day to figure out what is going on with his shoulder.  Burt’s shoulder is still a source of pain and aggravation.  He wears a special brace, which is somewhere between football padding and gladiator armor to keep it supported. For the scan, Burt had to drink radioactive liquid that would seep into his bones and make them glow.  He then had to drink copious amounts of water to try and wash it out, which was good practice for the swallow.

Coincidentally this could help prove the case to finally get rid of his feeding tube.  He can now eat enough to sustain himself and takes all of his medication orally.  The last question is whether or not he can stay hydrated.  Once he proves this, they can remove the tube, which would be a great step.

Anyway, that’s it for this week.  If any of you feel like dropping by, Burt would love to see you.  If you can’t but want to do something else, send DVDs.  Burt is currently catching up on a lifetime of lackluster TV viewing.  Classic comedy routines, shows and movies new and very old, operas, all are welcome.

As many of you have no doubt noticed (and some have commented on) the blogging has grown a bit lax of late. No more apologies, from now on the blog will be updated once a week, on Sundays, without fail. For those of you looking to keep up with the goings on for Burt, we will no longer disappoint. Though there may be the occasional mid-week update (Wednesday), the posts will be posted on Sunday — but they will be posted. No more 2 weeks breaks. No more other stuff getting in the way. And now, on to the important stuff.

A bit of email and football with the dogs

It has been a big week for Burt. Yesterday, Burt had yet another in his line of swallow tests (the next one’s free for a valued customer) and passed, provisionally of course. They don’t seem to give away that “good job here’s a lollipop thanks for playing” pass so easily. It’s all about the suspense. However, this means that Burt can transition back to all his favorite foods. He is already eating his three squares a day of soft-mechanical goodness. While soft-mechanical may sound somewhat off-putting, it is a damn sight better than pureed. It is also comforting the number of things that fit into that category. No matter though, he’s racing right through it. Tomorrow, he has his first lunch of regular food that someone hasn’t ground, diced or smashed and he is suitably excited. He is now cleared to take his pills by mouth, which is the last step before we jettison the feed tube. Hopefully in the next week or so Burt will pay a brief visit to his crack surgical team for a little plumbing removal.

First cold beer...

This past Saturday, Burt went to the MET HD broadcast of Don Pasquale for his first foray back into the outside world. Though he had to attend in a wheelchair, Burt loved every minute of it. Afterwards, he went to dinner with friends and had his first non-hospital food in quite a while — fish and chips, if you’re wondering. Washing it down with a Stella Artois and finishing the meal off with a cup of coffee, it was an evening of new firsts for Burt and probably had as much recuperative effect as any of the therapies.

...and coffee

In therapy news, Burt is getting stronger everyday. His walking is much improved. He can now get up and sit back in his wheelchair under his own power with assistance mainly for balance. On Monday of next week, he will be getting a special custom brace that will help give Burt the needed support so that he can continue his therapy and walk with greater confidence and autonomy.

Burt is also finally getting back online and will be beginning to read the blog and email. Feel free to comment here or write him an email, he’d love to hear from all of you. For those who want his phone number, drop David an email.

Until Sunday.

Day 69

A minor update but exciting for Burt. Last night, at some point his feeding tube disconnected but did not stop running for the entire night. It soaked his bed, his clothes and the floor surrounding his bed. Don't worry this isn't the exciting part. While he described that part of the experience as vile, it did lead to the first shower in almost ten weeks. The shower was the best he'd ever had, regardless of the bench.

Sorry, no pictures.

In other news, Burt is eating more and should be moving off his feeding tube completely pretty soon. Keep on chewing Burt! In sports, Burt is keeping up with his walking, getting stronger everyday and is going to start working on a recumbent bike in the next few days.

Day 63

Once again, sorry to all for the lapse, we are trying to regularize the posting again. At the moment both Stern brothers are out in LA, leaving Connie to hold down the fort for a bit. So, today we have a special word from the man himself.

Burt has been at the nursing facility for about two weeks and is adjusting well., Though the first couple of days were a little grisly, as Burt was initially put in one of the regular nursing wings rather than the rehab one. The halls are full of the aged and infirm with an emphasis on senility, dementia, psychologically impaired. The staff do their best but ut is not a place you want to be if you still know the difference. As Burt said, "As long as they stay out there and I stay in here, I'll be all right." He was only partially kidding. Thanks to the facilities extraordinary director of social work and the championing of his PT and OT people Burt made the move to the rehab wing a day and half later.

Burt and the nursing and PT/OT staff work out his care

watching baseball in the new room

Now, he is as comfortable as one can be when not able to go home. He has TV, DVD, internet, books, music, furry friends, winged friends, and exhausted family. All told, it ain't so bad.

Assisted standing and weight bearing

working with Becki on his 'guns'

e-stim with Peter

He is still working hard everyday in rehab. The new people are great and Burt's determination, humor as well as Connie's cookies win everyone over. He has been getting e-stim on his shoulder to pull in the subluxation, as well as on the different muscles of the legs.

One of the physical therapists has been using a method on Burt where she twists and bends the foot until the muscles of the leg engages to yank it out of her grip. At that point, she can use that muscle movement to engage other muscles in compound movements. he results have been striking at times. The only drawback is that the initial wrenching of the foot causes Burt a lot of pain and it is this pain impulse that causes his brain to activate the muscles and pull the leg away. It is literally a case of no pain, no gain. Burt was fitted for a new brace the other day which will provide him with some much needed support to improve his walking. Everyday he is making strides.

In other news, Burt has finally passed his swallow test and is eating more, trying to build up his swallow and chewing muscles to be able to get all his sustenance from food rather than the g-tube. He is beginning to transition to a soft-mechanical diet from pureed. This is the first time real food starts getting integrated into his diet and it feels like eating. It is a slow process and not as satisfying as a cheese burger, but it is another step on the road.

Day 47

Today was Burt’s final day in the acute rehab unit and it had a somewhat subdued air. He has had a lot of triumphs and done a lot of hard work in this unit. When he came in he could barely sit up and now he is on his to walking again. The place has taken on a feeling of home for Burt and the staff has become family. It is never easy to leave home, especially when it is not by choice. But, as uncomfortable as change is, it has its positives. As his friend Lonnie said to him, “Change is your friend. You have come through the worst and now with every week you will be stronger than the last. Staying in the same place will do you no good now. Don’t even think about it, just move forward.”

The day was filled with the discharge evaluations as his physical and occupational therapy teams measured his progress between intake and release. In the morning, Mike took Burt through his occupational therapy evaluation. His left arm is still not responding as much as we hope. It is slow progress. His shoulder is still very tender and the muscles pretty slack. After his OT eval, Burt took his last walk with Pati and beat his own record again — a new personal best of 54 feet. Then, it was back for a bit of rest before Bonnie took him for his PT evaluation.

Burt’s left leg is a lot better than it was. His balance is much improved. His sensation seems fully intact and his positional awareness is quite good on the affected leg— when his left leg his positioned in a certain way, Burt can copy it with the right. These are often faculties that stroke hit quiet harshly. First, Bonnie tested Burt’s range of motion as he lay in his bed; Burt is probably more limber now than he ever was before. Afterward, Bonnie took him to the gym to test his muscle strength. She positioned him on the mat, with his leg on a board, so that she could isolate the muscles and have them work with minimal interference from friction and gravity. The two videos below show the really amazing results Burt has achieved in the weeks in rehab and give us all a lot of hope for what he will achieve in the next rehab.

After his tests were finished, Burt had a bit of applesauce and some water before getting back in bed. At about five-thirty, Lonnie came by to work with him and by six he was back in bed ready for the live cast of Boris Godunov from the Met on Sirius set to begin at seven. Connie and David packed some Burt’s stuff out to the car. Burt lay back amidst his pillows and drift off listening to Mussorsky.

Tomorrow, the Sterns venture to the new facility, leaving their new family behind. But they were all new as well just a few short weeks ago. Burt is sure to win over the new staff with his hard work and attitude just as he did the old ones. His advocates and therapy dogs want all to know that they will be there every day, they will be watching every move, and they will be bringing cookies. Let the healing journey continue as we step with the right and schlep the left.

Day 46

The furry fiends return

Again, we apologize for the lack of entries this week and promise to get back on track. This week was a busy one on all fronts for the Sterns. As Burt continued to work hard in rehab, Connie and David went about the uncertain task of determining Burt’s next stop. They visited a bunch of short-term rehab facilities on the area trying to find the best one. What they came to realize was that they are all, unfortunately, embedded in nursing homes—these are not easy halls to walk. Burt, though he is battling his body at the moment and clawing his way back, is still of vibrant mind and vigorous spirit and doesn’t seem to belong in these places. Silvia, the unfortunate catatonic wheelchair troll stuck in the hallway of one establishment, almost had Connie and David ready to pack Burt up, bring him home and deal with it from there. However, they persevered throughout the week and ended up with two quiet viable choices.

Tuesday, Burt will move from the Acute Rehab unit to the sub-acute rehab facility where he will continue to work for the next 100 days. The facility has a short-term rehab wing with private rooms with a crowd around Burt’s age. While Burt may not qualify for this the day he moves in, the prognosis is that it won’t be long. It is not an easy move, Burt has gone through a lot with his dedicated and intrepid team, they don’t want him leave either, but go tell that to Medicare. So, his chin up Burt marches forward to the next stop, step with the right foot… schlep the left.

Don't hate the playah, hate the game

Burt was cleared to move from prime rib flavored yogurt (it turned out to be false advertising) to homemade soups… pureed to death. Within twenty-four hours there was black bean soup and homemade applesauce. Another twenty-four brought split pea soup (note to all: pureed split pea soup while still tasty takes on a rather disquieting effluent color). The rehab unit fridge has begun to fill up with small containers with Burt’s name on them, literally. You can’t keep a Jewish mother down and restraint has no meaning where a loved one and a fridge are concerned. There is a new black bean stew waiting in the wings, and butternut squash soup is on deck. A slow cooker has been purchased, so let the soups begin.

soup in all sorts of noxious colors

Priceless moment overheard in the rehab gym this week:

Cast:

(the names have been changed to protect the gainfully employed and the demented)

Rachel - sweet 20-something physical therapist.

Gladys – less sweet senile patient with a really bad wig bought in 1982.

Rachel: Do you know where you are?

Gladys: Rehab.

Rachel: But do you know where you are?

Gladys: Rehab.

Rachel: Do you know how old you are?

Gladys: 44.

Rachel: No… do you know how old you are?

Gladys: 64.

Rachel: No, dear, you’re 87.

Pause

Gladys: 87? Oh my god.

Black

This week Burt began the initial work of learning to walk with a cane. He still needs a lot of help but he is steadily trying to relearn the rhythm of walking. The rolling table was removed, his left arm was put safely in a sling (only for the duration of the exercise), and his right hand moved the cane. With his extraordinary therapy team moving around him Burt walked, first using the wall as a guide and then out into the room. It is hard work for all involved, most of all for Burt who has to rethink every step, but it is amazing to watch.

working up to a silver handled walking stick

Burt continued to work with Randy and Mike on his affected arm. He has been put on a new medication called Dantrium. It is intended to relax his muscles and decrease the tone that tightens up his affected muscles and makes them painful and hard to work with. It seems to be helping.

OT with randy and Mike

Burt had an uneasy moment this week as his INR (the blood thinner quotient) spiked one day to 3.3, which is the upper range of the safe zone. He was given a very low dose of his blood thinners for 24 hours until the numbers came back into the normal ranges and was then put on a mid-range dose to keep it steady. He was given a higher dose when he should not have been. All is well, but Burt and his advocates are extremely careful with his INR as that is what put him here in the first place.

On pins and needles.

On Thursday, Lonnie came by again and worked with Burt, putting a few nails in all the right places. They are still concentrating on Burt’s shoulder, leg, general health, and, of course, the swallow. Burt relaxed as the needles worked their subtle magic and visited with Lonnie for a bit. On Friday night, Cousin Robert drove up from Westchester and he, Burt and David visited for a couple of hours. Cousin Rob, like his father before him, has always been a favorite of Burt’s. With a wry sense of humor and a no nonsense optimism, he had Burt joking and laughing as if nothing at all was amiss. Earlier in the week, Connie’s cousins, Lynn and Fern, drove up to see Burt. They had a great visit with Burt and Connie. While Burt will not be making the traditional family Thanksgiving this year in Rhinebeck due to his rehab, he was assured delivery of his favorite nut cookies as soon as it is deemed medically safe that he can eat them.

Burt works his shoulder range with Sarah

Today was a day of relative rest for Burt, a spate of new admits tot he rehab unit meant that Burt was bumped from the rehab list. However, Sarah, one of the physical therapists came by to work Burt’s shoulder at the end of the day just to make sure it didn’t get too tight.

Shave and a haircut

Afterward Burt had a visitor he had been anticipating all week. Scotty from Sim’s Barbershop came by to give Burt a long overdue haircut and shave. Burt felt he was starting to look a bit like the Wolfman and wasn’t enjoying the personal comparison. Scotty and his case of clippers, trimmers and weed wackers had Burt looking like himself again in short order. After his haircut, Burt went back for a bit of a nap before watching the Yankees beat the Twins and drifting off to sleep.

If anyone doubts that Burt is coming back...

Day 40

Burt gets a visit from his favorite furry friends

Apologies to all for the lackluster performance of the blog of late, but as we have gone from two Brothers Stern to one, the schedule has been a bit grueling. West coast Stern will be assisting East coast Stern with more regularity as soon as East coast finds the time to brief him. West coast has found an apartment, started school and his better half begins her new job tomorrow. Knock ‘em dead Lisha.

Meanwhile, back in the Berkshires, Connie and David think they have determined the next step on the rehab train. Unfortunately, Medicare (and other insurance carriers) no longer allow the lengths of stay in acute rehab that they used to and so, on October 12^th Burt will have to move to a skilled nursing and rehab facility for the next part of the process. He will most likely be there for the next hundred days as he continues to work to relearn all of things we all take for granted. The US healthcare apparatus needs some work…what a shocker.

Burt has had an eventful week and his chroniclers have been remiss in posting but tonight there we have a deluge of new video and photos from the Burt-ville. Burt’s first sips of water went reasonably well. While Burt was less than thrilled with the prospect of water and yoghurt, he was hoping to be cleared for a turkey sandwich — he grudgingly accepted that you have to (re)start somewhere. His first sip resulted in a bit of coughing, but he recovered and was able to take a few more sips before declaring that he had had enough. He then moved on to the yoghurt (the prime rib flavor he had requested). After a few spoonfuls of that, he declared himself done for the day. While it was a major accomplishment, it wasn’t quite the triumphant return to solid food that he had hoped.

Apple juice

The next day, under the watchful eye of Carolyn his speech therapist, Burt tried again. His chin tucked, he took a sip and swallowed twice as he had been taught. The first sip again caused him a bit of trouble and a bit of coughing. After that he was able to drink a bit more and move on to some apple juice. With the yoghurt, this time regular peach flavor, he was told to imagine he was swallowing a golf ball — just the kind of sustenance a guy who hasn’t eaten six weeks dreams about. The Titleist 2 is best lightly sautéed on a bed of field greens and garnished with lemon.

Smile

Later that night, Burt and David snuck in another few sips of practice juice before Burt got into bed and they watched a bit of the Hangover. Burt and David discover the problem with movies in the hospital is that you only ever have a half hour between a feed tube changes, medications, or a vitals check. Keeping a sense of continuity in a movie is near impossible. After trying to watch the Hangover in two sittings, Burt gave up on it and instead decided on an episode of Cosmos. He will try the Hangover again another time.

Friday was a busy social day for Burt. Two of his oldest friends from childhood, Don and Fred drove down from Boston to spend the day with him. They stayed for the second set of Burt’s PT and OT and got to see him walk. Burt friend Ron also stopped by and the three of them watched Burt and lent their support as Pati put him through his paces. Both Don and Ron (forgive the alliteration), who had been to visit several weeks before were amazed by the progress Burt has made. Even though Burt can’t always see it, everyone else can.

Taking a break from therapy with Don, Ron and Fred (left to right)

They looked the same in junior high

After Burt’s session had ended, he spent some more time catching up with Don and Fred. Fred, joking with Burt about his progress said, “Pretty soon you’ll be able to bend over and kiss your ass goodbye.” Burt looked over at him and replied dryly, “I’m not that advanced yet. You’re far more mobile than I am, you can bend over and kiss my ass.” About an hour later, after enough old war stories, good memories and embarrassing anecdotes for an afternoon, Don and Fred had to leave for the drive back to Boston. Burt was about to settle in for a bit of a nap when his friends Doug and Rhia stopped by to visit with him. Burt has known Doug since architecture school. They each have far too many opinions regarding the other. Though Burt would have like to spend another hour with them, he was totally exhausted and in desperate need of sleep. Doug, Rhia, he sends his apologies.

Burt and his dedicated team

Saturday saw Burt working with Pati and Randy again. After a visit with his friends Christian and Liz in the morning, Burt was rolled to the gym and worked on strength and balance building exercises. Afterward, he spent the afternoon catching up on a bit of sleep and then getting disgusted by the Yankees. David and Burt finished off the evening with a bit of the Odd Couple.

In other news, it was finally determined why Burt never seemed to call Connie. With David standing by, Burt tried to call Connie’s cell and the woman who picked up told him to stop calling or she’d call the police. Poor guy. Burt discovered that the number programmed into his phone by West coast was one crucial digit off. The problem was corrected and the two are back in contact, except now Connie is also contemplating calling the police.

Being on digit off seemed a theme for the week. Burt’s friends the Bob and Ann sent him a lovely email except they, like others before them, forgot the crucial digit on Burt’s email. When you leave off the 1, instead of getting Burt, you get Brett. A foul-mouthed ranting putz who seems to have nothing better to do it than write long scatological replies to any poor unsuspecting sap who unwittingly makes the error. If anyone feels like spamming the hell out this galactic schmuck you have our full support.

And so begins another week.

Addendum: How to post

We have gotten a number of phone calls from friend eager to post on the blog but unsure as to how to go about it. Here is a quick primer, sorry to all that it took so long to think of this. It is easy once you know what you're looking for. You do not need to be a 'follower' or subscriber of the blog to post a comment, that just let's you know via email when a new post has been put up.

To post:

At the bottom of every blog post there is a 'comment' link that will most likely be blue and will have the number of comments attached to the post (i.e. 1, 2, 0 or 6 if Nancy's been there - keep it up Nancy, we love ya).

Click the link and it will take you to the page for that specific post. At the bottom of that page you will find a white box where you can type your comment. Beneath that, there is a 'Post Comment' button. Click that button and you're comment will be posted to the blog, Simple as that.

So post away.

Day 35

Today was a big day. At 11:30 in the morning Burt was taken for his second video swallow test and he partially passed. First reaction is, of course, what the hell does that mean? It means that while Burt has not been cleared for a cheeseburger, fries and a beer or even a glass of water on his own, he has been cleared to a have a drink under supervision. Tomorrow, as his speech therapist looks on and coaches him, he will have his first sips of water in five weeks. Drinking supervision will initially be in the hands of the speech therapist and then transfer to the nursing staff, as Burt gets more practiced and stronger. While a supervised drink sounds pretty odd, it’s better than no drink at all. Burt almost can’t comprehend it. Hopefully, apple juice will follow soon after with applesauce on its heels. For the moment, the feeding tube will remain in place. It will take some time for Burt to be able to take in enough nutrition by mouth to sustain himself. Everyone lift a glass to our friend the swallow function, you’re a little late to the party but we’re glad you’re here, so hang up your coat and stay awhile.

Later in the day, during his second set of therapy sessions, Burt broke his walking record twice, back to back. He and his team walked across the therapy gym and most of the length. The video of Burt standing shows how much stronger he is getting. After the walking, Randy took Burt to the bathroom to begin to show him how to navigate it safely and independently. Randy had him standing at the sink and was happily surprised by how well it went. As he said, “I didn’t think we’d do half that well.”

Afterward, Burt went back to his room to discuss plans for some changes to his bathroom with Randy and David. Burt wrote a list of the materials he will need from home to begin his preliminary designs. His distinctive block architectural handwriting in is unchanged, a welcome sight.

Then, it was back to Pati for some more standing and walking excercises before Burt was finally done for the afternoon. Burt reflected, “Here I am, at sixty-seven, learning to walk again, who would have thunk it.” As Pati tucked him back into bed, she said to him, “you’re the kind of patient we all get into this to work with.”

Burt was asked and agreed to let his physical therapists Annie and Kelly present him as a case in a symposium on physical therapy with stroke survivors because he has made such strides. The only downside for him is that they don’t need him in attendance, he was hoping for the field trip.

By the time Burt was back in bed and getting ready for his well-earned nap (lousy weather kept him from a roll outside) it was time for Leslie hit the open road. As she gave Burt a hug and kiss goodbye, Burt made sure she knew where she was going and how fast she needed to go to get there unhindered. After she left, Burt made a few phone calls to his brother Harry and his son Gregory, then took a nap for a couple of hours.

The day finished off with a little more Big Lebowski and some range of motion exercises before Burt slipped off to sleep and David headed home.

Day 34

looking smashing in Connie's sunnies

Today was a slow energy day for Burt. He didn’t get a great night’s sleep last night. Hours after being given some milk of magnesia, his stomach decided that the middle of the night was an optimal time to announce itself. He found it a little hard to get back to sleep after that. Though tired, Burt gave it his all in his therapy sessions as always, walking, stretching, and balancing. Afterwards, he crashed for a few hours.

At 5:30, Lonny came by to work with Burt. As Lonny checked his pulses and put needles in the relevant spots, he said he could feel Burt responding. Again, Lonny concentrated on general flow, the left arm and, of course, the all-important swallow. Burt had asked that his swallow test be put off for a few days so that he might have a bit more time to practice. Cross your fingers out there.

After Lonny left, Burt napped for a few hours and the Sterns decided to go get some dinner. They returned to find Burt breathing from his nebulizer and listening to Nero Wolfe. After a brief visit, Connie and Leslie headed back to home to feed the dogs while David and Burt watched a bit of the Big Lebowski in Burt’s room on his new DVD player. Burt made it through about thirty minutes before his sleeping aid was administered and he slipped off to Dreamland.

At Lonny’s suggestion, Burt is going to start a steady diet of comedy, as laughter is still often the best medicine, so suggestions are welcome. He will also be adding in favs from other genres along the way. He will be starting Arrested Development in the next few days, a bit of brilliance that he has never seen. He has also requested Dirty Harry - he calls it a comedy that didn’t intend to be.

After seeing a trailer for the new Fincher/Sorkin film The Social Network about the founding of Facebook, Burt expressed a wish to through his hat into the world of social networking with Assbook – “the place for all the assholes you don’t want to be friends with on Facebook.” Watch out Mark Zuckerberg.

As a closing note, some may have noticed that we have missed a day or two between posts in the last few days. Hopefully, this has not alarmed anyone. The reason is twofold; Burt’s bloggers want to keep the posts informative, entertaining and new. Sometimes, the days can seem a bit redundant. As Burt says, “it’s like Ground Hog Day [the movie] around here.” We don’t want to lose anyone’s interest. Also, in an effort to keep up to date with other responsibilities, the faithful bloggers have also found the need to occasionally take a night off. That being said, dear friends and readers, we will always report the best of Burt, his wisdom, bravery, determination and wit as he marches bravely down this very difficult path. So, stay with us and keep the comments and messages of love and encouragement coming.

Day 32

Burt’s bloggers apologize to all for going dark last night but exhaustion hit a peak. We’re back up and running and with a new feature… Video!

Yesterday started for Burt with his early PT and OT sessions. He had his initial class at Commode University and made sure the family knew they didn’t need to show up too early for a front row seat. Afterward Burt had his session with Mike and his magic e-stim machine. The electronic stimulator fires the muscles in Burt’s forearm in hopes of reconnecting it to his brain.

Cousin Leslie, who had flown in from San Francisco, was heading up from New York in a rental car. Like her sister Wendy, Leslie received another shitty GPS system. The Stern girls don’t have good luck with them apparently. Ms. GPS was firm in her wish for Leslie to take I-90 up to the Berkshires. Leslie, who had spent some formative years in New Jersey, was not ready to go back yet, even to pick up the interstate.  She insisted on continuing up the West Side Highway towards the Taconic. Leslie’s GPS finally got its revenge by directly her on a tour of Harlem. Connie and David received a call mid-morning from Leslie, new speeding ticket in hand (no points), letting them know that she would get there at some point but was going to be a little more assiduous about following those pesky little signs.

But everyone was in attendance later in the day for the showstopper. Burt was up on his feet and, with help from his extraordinary PT team, was taking his first steps. That’s right folks… walking. He isn’t doing it on his own and it is an exhausting process for him, but it is an incredible beginning. As Burt said, “I take a step with my right, then they schlep the left.” With each step, he was getting better. His PT team supported him from the back and front while also facilitating movement of the left foot.

First, he circumambulated a table; his hip and right hand leaned against it for support. The Sterns cheered him on. He looked over and asked, “you want to see my clog dance?” Next, Burt walked along a wall in the rehab gym, his hip against a railing, his team moving with him every step of the way. As Burt stepped along the wall, an extraordinary thing happened, Burt’s left knee kicked in and he straightened it himself. His PT Pati said, “that's it!” And his other PT Bonny responded, "he did it didn't he?" This is a vital part of the return of the walking function. Unfortunately, right after this Pati lost her contact lens and the moment was overshadowed as attention shifted to locate it. Burt, ever the gentlemen, was careful not to take another step until it had been found, he was also glad for the rest. Afterward Burt and his team ventured off the walls and walked out into the middle of the room before Burt finally took his well-earned rest. As Burt rolled back to his room, he remarked, “I’ve had my head in enough middle-aged boobs to last a lifetime.”

Later in the afternoon, Burt’s friend Lonny came by to visit. Lonny is also a world-renowned acupuncturist who had been treating Burt for a while. The Stern’s had asked around within the hospital and none of the doctors had a problem with it but weren’t sure about the liability. Lonny told David that what he done in other cases was come in as a friend and just close the door for a private visit. Burt was understandably a little wary of any alternative technique not cleared by his doctors. But Connie got it cleared by Burt’s physiatrist. Everyone still kept it quiet, just in case. Lonny spent 45 minutes with Burt and focused on general flow points as well as the left arm and his neck (for the swallow). Connie, David and Leslie waited down the hall. Lonny said that Burt was very responsive which is a great sign and shows that acupuncture might help.

Later on, as Burt rested after the long day, he reflected, “I was worried that when you guys were down the hall, and Lonny was down the hall, that some nurse would come in and find me lying here with all these nails sticking out of me and all I’d be able to do is shrug like ‘I don’t know how this happened.’”

Day 30

As rehab continues, Burt’s energy seems to increase everyday. He is more focused, concentrated, stronger, and less fatigued. Even after the day’s therapy sessions had ended, Burt didn’t seem to need the post-therapy nap and instead went for a roll outside.

Burt had heard through the grapevine about another garden option on the hospital grounds, this one supposedly had a fountain. It was decided that this would be the destination for the afternoon. Nobody seemed to know exactly where this Shangri-La was located except that it was in the general vicinity of oncology – tread lightly in those parts.

Down a hallway and up a ramp, a left at radiology (which has the nicest waiting room in the whole place), the Sterns succeeded in finding the garden of a thousand stents. It turned out to be an offshoot of a parking lot, but you can’t be too picky.

The “fountain” was a rock with water flowing over it. It was quiet idyllic save the air-conditioning unit humming away right next to it and the roundabout drop-off zone right behind - a little slice of Zen. Burt looked around and said, “It’s lovely.” Even in his diminished condition, the sarcasm in his voice was audible.

To top it off, after their sojourn in parking lot B the Sterns found themselves locked out and had to roll to new entrance. Burt said he was learning firsthand why building codes stipulated no more then a half-inch lip on any wheelchair accessible ramp or threshold.

The Stern family made it back to the rehab unit and Burt was glad to get back in bed after a long day. He was looking forward to the Yankee game but unfortunately the broadcast schedule in western Massachusetts was not on his side, high school football instead. So, Burt settled in for a bit of a Nero Wolfe audiobook, some stretching and vocal exercises  before bed. For fans of Rex Stout’s famous fat man, Burt has just begun Black Orchids. 

Day 29

One night early on in this saga, back in the ICU days, Gregory asked Burt how he was sleeping.  Burt replied, “I would do better if I had my furry little friends.”  Well today, Burt got his wish and after weeks of Brownies and Apple Cider Doughnuts for the staff, Burt’s treats finally arrived.  That’s right… Macallan and Renny, the fifth and six members of the Stern Clan invaded the ward. 

Fresh from a full trim and clean, their newly white exterior matched their adorable Westie personalities and they charmed all of the nurses and therapists in the Rehab unit.  More importantly, they gave Burt a well-earned taste of home.  While he could not roll around and play with them as he would have liked, he did get a few choice pets in and even went outside with them for a bit of fun in the sun.

The visit was also meaningful to the dogs… or so we think.  They have not seen Burt since the beginning of this event and had no idea whether they would ever see him again.  When they saw him there wagging tails could not be contained and they scurried down the hallway to him.  They were not allowed to fully jump all over him for fear of messing with his G-Tube (the thing in his stomach), but David held them up so they could get a few key licks in.

The rest of the day was filled with electrical stimulation for the left hand and more pre-walking, but for Burt, today was all about the dogs.

Day 28

What Lao-tzu neglected to mention in his pithy proverb is that the second step in the journey of a thousand miles looks much the same as the first, and by the third the resonant footfall has regained the squeak of a rubber sneaker on well-worn linoleum.

Burt was back at it today, going hard. He had his early session of physical therapy this morning followed by work with the speech therapist, who is teaching Burt to project and has given him several exercises that will help him regain control of facial muscles as well as his swallow. He is still waiting for it to return from Capistrano.

By 11:30 he returned to bed for a little rest before it all started again. In the interim, his occupational therapist, Mike, hooked him up to an electronic stimulating device the sends electric impulses through his left hand to fire the muscles. Mike left it on for about twenty minutes as Burt tried to concentrate on opening and closing his hand as the machine fired. It is always about new pathways.

By 1:00, it was time for round 2. Randy, Burt’s benevolent drill instructor came to collect him for his second time through the obstacle course. It is a pretty indescribable thing to watch an eighty year-old grandmother with a hip replacement climb a twenty-foot wall by rope under live fire.

Randy had Burt working on arm exercises and showing him how to stretch it himself. Randy referred to Burt’s arm as it, Burt said “it’s my arm.” Randy asked, “are you from New York? Are you a Yankee fan? It’s an it.” They berated each other good-naturedly for a while and had everyone around in stitches. They have made plans for a trip to the city for proper pastrami as soon as Burt’s up to it.

Next came Pati, Burt’s physical therapist, who had him up standing again, stepping again, stretching again. Even though Burt can’t see the improvements, they can. He was standing straighter, stronger, and more balanced. Bonnie, his therapist from the day before, watched for a bit, remarking that he wasn’t wavering, as he had the day before. Sometimes, you just have to trust the pros.

After the therapy was finished and a brief trip into the sunshine, Burt returned to bed and was asleep before his g-tube hit the pillow. He woke up three hours later unsure if it was morning or night and ready for a few more hours. He said a sleepy farewell to Connie and David and snored back off to ready himself for another big day tomorrow.

Day 27

The journey of a thousand miles begins with a single step.

Lao-tsu

With the last of his belongings shipped to Los Angeles, Gregory’s packed his bags in the car for his flight to LA tomorrow. He had to make a 4:45 train to New York and wanted to spend as much time as he could with Burt before he left. The Stern family arrived at the hospital at about noon to find Burt waiting for his next physical and occupational therapy sessions.

The sessions are always amazing to watch. As terrifying as it is to see how quickly we can be stripped of our physical power and trapped within our own body as if it were a completely foreign entity, it is equally inspiring to see the individual spirit fight to regain control and to witness the endless skirmishes on multiple fronts that must be fought at every step of the process.

Today, Burt took his first tentative steps. He stood, hands on a table for support, bucked up by his physical therapist Bonnie. He used his left leg to carry his weight as he placed his right out in front of him and then to the side. The professionals call the exercise pre-walking, however to the newly initiated each hesitant footfall has an undeniable sound, like the resonant peal of some massive bell rippling outward. With each small movement forward and back, as confidence grows and the uncertain shuffle becomes the decisive step, hope becomes conviction in a moment of instant spiritual alchemy.

Though completely exhausted, Burt pressed on through an hour and a half of therapy that is more grueling than most us can really comprehend. When your equilibrium has deserted you and half the muscles in your body struggle to receive the messages of your brain, the simplest action becomes Herculean effort. Burt never wavered once, his voice small with fatigue, he was always ready for one more try. His eyes clear with determination, he watched himself in a full-length mirror trying to find his center since his innate sense of it has to be re-learned. He watched his left arm and his left leg being manipulated and moved, concentrating hard, trying to think the connections from the brain back into existence. For Burt, the brain we all take for granted has become a quixotic and mercurial entity, in some ways dependable, in others uncooperative or totally absent. But, always, he is looking to forge ahead, mentally hacking his way through the impenetrable grey matter undergrowth in search of new pathways.

To watch him is to be in awe of his quiet and simple determination. There is nothing brash or showy in it, but there is not an ounce of defeat either. He takes it as it comes and looks at each day and obstacle unflinchingly, ready to fight for every inch. As he said today, “this is only the beginning.” We have never been prouder of him.

Day 26

Sunday was a day of rest for Burt and so it is for his bloggers.  Burt is well and enjoyed the day chatting with his family, free from rehab or illness.  He asked us to read any blog responses he may have missed.  The more aware he is getting, the more he appreciates them.  So if you have a bit of time, please post a quick note to him.

Just to add one amusing moment before signing off — Burt had been dressed in his new, appropriately sized sweat pants when the Stern family arrived.  A few hours later, after they returned back from lunch they found him in his hospital garb again and asked why.  He replied, “They got me all dressed up for dancing … but it’s Sunday and there’s no dance today.”

Tomorrow the dance begins again.

Day 25

In keeping with the post from Day 23, this post has been guest written.  Today Burt was joined by one of his favorite adopted sons, Benjamin Posner. Ben greeted Burt with song in their classic in-joke greeting. Burt sung across the room in kind. In case any of you are worried, rest assured that Burt remembers and can recite every nickname, in-joke and old story that are cherished parts of your friendship... even the ones you wish he would have forgotten.

As you may or may not know today is Yom Kippur but instead of fasting and atoning for our sins the Sterns decided to celebrate life. They spent the afternoon with Burt and accompanied him to his physically therapy session where he repeatedly stood (with assistance) and sat down again, much like you would if you spent the day in synagogue. He was tremendous and it was very encouraging to see his progress.

After therapy the Stern gang et al took Burt outside to the courtyard for a breath of fresh air. This is the first time Burt has been outside since the stretcher wheeled him into the Berkshire Medical Center three and a half weeks ago. The day welcomed Burt with warm weather, a blue sky, and plenty of much needed sunlight. Burt quickly complained about the abundant sun and the gang moved to the shade where they could sit and chat comfortably with considerably less squinting. They talked, they laughed and there were even some family photos.

When the Sterns had their fill of the picturesque hospital courtyard and when his tailbone had enough punishment, Burt ventured back to his room. With some help from the staff Burt returned to bed for some well deserved rest. He seemed to fall into a very deep sleep and as everyone agreed, in hushed tones, how well he was doing, Burt piped in "I'm still here." More laughter, then Burt announced that he was now going to shut his eyes and rest, for real this time. Translation, "stop talking behind my back." With that, the next hour or so was spent pinning up some pictures and prints around the room so that our man would have something beautiful to see when he woke. The pictures were pasted to his left so that he could continue to focus on engaging that side of his body.

The Sterns left Burt sound asleep and immediately wished he was riding home with them.

Tomorrow the Sterns will join him again for some more therapy and laughter. They will also be bringing him better fitting sweatpants. The ones he has are "too big" and even in a hospital Burt likes to look his best.

That's all for now. Goodnight and good yontif.

Day 24

David and Gregory walked into the gym today in the early afternoon to find Burt sitting up straight with very little assistance from his drill instructor Randy. He has lost a lot of weight and wears the ordeal that his body has just experienced, but seeing him sitting straight and proud he was a portrait of perseverance and dignity. As a short man, Burt has always had perfect posture so that he could steal every last inch. In the meantime, as he works to regain his lost inches, he is making a few up, adding one or two every time someone asks his height.

While he was sitting, Burt's hand was also scotch taped to a board to keep it flat. He suggested to Randy that they look into better tape that did not tear off all of the hair on his hand. He then took a look at his son's hands and said, "don't ever go to the hospital, you won't have any fur left."

The rehab team has put a lot of energy into trying to keep his hand and arm in good condition and with as little tone as possible. The amount of tone in Burt's arm forces it into a bent position, so the more they can loosen it up, the straighter it will hang. As the rehab progresses, one of the trickiest aspects is Burt's shoulder. Because he does not have control of his left shoulder muscles, his arm hangs away from his body. This is causing sublmexation, which is a separation between his shoulder socket and muscle, which gives him some pain.

Burt said to Randy that his 'bad' shoulder hurt. Randy corrected him and said, "it's not your 'bad' side, it did not do anything to you. It is your affected side." This semantic difference seemed to resonate and for the first time Burt started to freely move his left arm with his right. It showed the glimmer of a man who will one day be able to function on his own.

Overall, Burt is learning to think about his condition and the road ahead in a very positive and realistic manner. He is taking stock of where he is and making new plans for the future. He even asked a friend to get him a 'sissy knob' which will enable him to drive a car with only one hand. It is a ways away, but at least he is thinking about it.

For those of you who are wondering, Burt debated for many hours and eventually decided to fast this Yom Kippur.

Day 23

Burt’s progress is being reported to you by a guest writer of Team Stern. He had a good day today – being evaluated by OT, PT and speech therapy. He has now been moved to a private room in the rehab unit as his visitors are not known for their ability to whisper.

Burt is speaking more clearly than he has in the past few days. The highlight of his day was learning a few exercises that will help him in his next swallow evaluation – which he is practicing diligently. The exercises produce a slow repetitive “GAH” sound that Team Stern will get used to in no time.

While he is still fairly tired, his spirits are high, and his sense of humor is more honed than ever. He was given a gift of a NY Yankees blanket that was going to be placed in his room, but being in Red Sox country, his response was, “don’t bring it… they’ll kill me.”

He is ever the gentle, kind patient, remembering every nurse’s/therapist’s name and always saying thank you after every swab and pillow fluff. He had a nice visit with an old friend, reminiscing about his 7th grade days as a trumpeter, and talking about the opera. If you have the time, drop by for a visit. Even though he usually asks everyone not to come, he is always happy when they do.

But now the strenuous work begins as he will be scheduled for physical therapy daily, and once again getting to work with his old pal Randy. His niece Wendy continued to patrol his room, raising an eyebrow to all who dared to enter, in the hopes that he could get more than 10 continuous minutes of sleep. He was especially concerned about being woken up by the “vampires” for blood draws, but said, “even vampires need a hobby.”