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.