http://www.don.smith.net/Gerald_Smith_update.htm 2006
Gerald Smith update – July 15
Dad has been enjoying living at home instead of the LTC facility. But, it does take its toll on the care giver
– mom. The warmer weather has
helped. Dad really enjoys getting
outside. His walking has really
progressed. He gets around pretty well
with a walker. We continue to walk
behind him when he is walking as sometimes his balance is not so great. He is eating solid food very well. We have to cut it up for him and things like
steak are pretty heard, but cooked meats go down pretty well. He still has a
PEG tube in his stomach as water continues to be problem for him to
swallow. A doctor suggested we try
slushy ice type drinks. We are
considering Vitastem therapy for his speech as well
as his improving his swallowing. During
the month of June they were in
Gerald Smith update – March 18
They have stopped the physical therapy with dad. They say he has learned as much as he needs
to know, right now. They did offer if
there are skills later that we want help with they could restart the therapy. The last thing they taught him was getting in
and out of a car. He does pretty well at
that. We did get him a new rental
hospital bed as the old / borrowed one we were using was having some
problems. Mom has a woman help her three
days out of the week, but she still sound tired to me. Being a full time care giver and taking care
of a house is putting a strain on her.
Gerald Smith update – February 26
Dad has made some more progress. His is now able to get up
from a chair and is able to walk with his walker mostly by himself. He is
stronger. We made the decision to bring dad home from the nursing
home. So two weeks ago we brought him home where he now stays. My
two sisters stayed with mom the first week to make sure things were going okay,
which everything went fine. Dad is happier now that he gets to sleep at
home. We are watching mom now to make sure this is not too much of a load
for her. She said she was tired when I talked to her yesterday. I
think we might try to have the woman who is helping her two days of the week to
maybe try to help more days. We don't want mom to get to tired and run
down.
He has been working with a speech therapist since Jan 25. We are seeing some small progress, but not
much.
______________________________________________________________
2005
Gerald Smith update – December 29
Dad very much
enjoyed seeing everyone at Christmas. We had him home during the day for
the last two weeks. He enjoyed the time with his family. Dad
continues to eat more food. The food still has to be puréed, but he is
enjoying tasting food again. They have reduced his feeding into his
stomach tube from 3 cans a night to 2 cans a night, with the expectation that
if his weight holds up, they will reduce it to 1 can and then hopefully no cans
in the next couple of weeks. He is still fed water and his medications
through this stomach tube as he can not really drink water. The
water goes down his throat to fast and he will choke on it. While I
was home we worked on his walking every day. He is getting pretty strong
and can walk 75 meters using a walker. But, he has some control problems
yet and sometimes looses his balance so someone has to hang onto him while he
is walking. We are also working on helping him get standing up and
setting down. He is slowly developing some muscle control it takes to do
- the simple things we take for granted.
We are having some
struggles with his digestive track. It is taking some time to get it used
to real food again. We are fighting constipation and bleeding in his
digestive track. We hope with a bit of time it will settle down.
We continue to make
small steps forward. It has been 4 months since I had last seen
him. I was over joyed to see the progress he
has made. The physical therapist commented that he did not think dad
would ever walk - and he is happy that dad has proved him wrong.
Gerald Smith update – November 21
Hello all,
Dad continues to
make progress. The physical therapist is
making headway with him, along with the family working with him. Dad is now walking short distances, with a
walker and some help for balance. Dad is
also eating some soft, blended up foods.
All good things. His speech continues to slowly improve. We are continuing to move forward, slowly but
surely. Thanks for your continued
prayers!
Gerald Smith update – October 23
Hello all,
Dad continues to
make slow but steady progress. We have
taken him on the reglan. We had some diarrhea for a couple of week,
but we not think that was due to a flu. He is better now that he is off the reglan. The rocking in
the wheel chair and the “out of it” have both
improved. He is saying some short
phrases now and then. Plus, we have got
a physical therapist working with him.
He has dad doing some assisted standing.
He also has been working on taking a couple of steps (very much
assisted). It is all good progress. Dad told me he loved me on the phone the
other day. That really brought joy to my
heart. Today he asked me what I was
doing. His speech is still pretty hard
to understand, but you can understand him. Every step forward is a blessing.
Gerald Smith update – July 4
Hello all,
I want to thank all
of you for your prayers and support during this journey with my father. On Friday we moved dad to a nursing home that
is close to home (in Leoti). Dad took the move pretty well and seems to be
accepting this new phase of his life.
Mom is having a hard time being home now without dad. But, she is physically and mentally exhausted
so it is good that she will at least be in her own bed now. We have also bought a used wheel chair
minivan. We are going to try to bring
dad home a few times during the week. My
brothers and sisters brought dad home on Sunday. It was the first time he had been in the
house since the stroke. He cried a bit,
but overall I think it helped his spirits.
Some cousins had a hospital bed that they have loaned us to use as dad
has limited tolerance in a wheel chair and needs a rest when we bring him
home. Dad is still pretty high care so
we are concerned that the nursing home will not be able to provide the care he
needs, but we are where we need to be right now. So the family enters the next phase of life.
Thanks again to all
who have helped and prayed for us.
Don and the Gerald
Smith Family
Gerald Smith update – May 26
Hello all,
We got dad moved to Colby. It is a nice facility. The staff works more as a team – the benefit of a smaller facility. We have been here for almost two weeks now. We have a very compassionate and caring doctor that we really like. She sees dad twice a day. The therapists are working well with dad. We have OT, PT and speech.
We continue to fight keeping the pneumonia from coming
back. They are giving him breathing
treatments and getting him up
All this is taking its toll on him. Dad lost another 10 pounds over the last 3 weeks. He is pretty thin.
I got back to
Thank you all for your continued prayers and support,
Don and the Gerald Smith Family
Hello all,
Hopefully this is the last email and last weekend from
He seems to have gone backwards on his swallowing capability and is not managing his saliva well now. They think it is related to the pneumonia. This may be a long term problem for us, but only time will tell.
I am going to head back to
Dad will be at:
Gerald Smith update – May 8
We are still in
But, dad was taken to the emergency room of the local
hospital on Sunday, May 1st.
He had been having diarrhea since the Wednesday and he developed a cough
on that Sunday morning. He has been
diagnosed with pneumonia as well as CDiff. After avoiding CDiff
in
I have extended my leave of absence by 2 weeks to get dad to Colby. I’ll go back to work on May 31.
We are in
We did get ear tubes put in last Friday before we left
Dad is at:
Medica Lodge Post Acute Care
Room 506-1
Mom and I are staying with my sister Ruth for now. I looked at hotels today so we will be moving to a hotel this weekend.
Gerald Smith update – April 21
It took the doctors two days after cat scans of his head, chest and abdomen to find out that dad did have pneumonia. It was pretty low in the lungs so it did not show up on the chest xrays. They antibiotic they started him on did not work, so they switched him to two antibiotics, vencoxycin and zosyn. The venco is the strongest antibiotic on the market. But it worked and pretty quickly took care of the pneumonia. He was feeling stronger on Sunday and has been making lot’s of sounds lately. Occasionally he says no, yes, mom, okay. We are encouraged.
We continue to fight the diarrhea. They switched dad to a new tube feeding formula that we are hopeful will work better. It is more expensive than the others, but his bottom has bleeding sores on it now so we really need to try to get something that will work for him.
We are headed to
I will send out new addresses once we settle in some where in KC.
Gerald Smith update – April 13
As expected, this week the doctor told us to plan on a
discharge by the end of the week. He has
been fighting the diarrhea all week.
They were going to discharge him once that was cleared up. So, we made plans to take dad to
The week was going pretty well. The therapy was continuing and he was starting to eat a bit. But, this will set us back a week or two. Dad continues to have to fight for every step on this journey. Please keep him in your prayers. It continues to amaze me that his heart and body continues the fight so well, as well as keeping his spirits up.
Every day is a challenge for us and dad.
The doctor came in today and told us that he believes that dad has reached a plateau and will probably not recover any more. He told us in 8 to 10 days we will have to make a decision on what we want to do with dad as he does not think he will be able to go from skilled nursing to rehab. We are disappointed and struggling with the next step for dad. The path looks to be putting him in an old folks home as he is not self sufficient enough to take home. We are in low spirits right now. Dad never wanted to live life in a home. We are looking seriously at Hyperbaric Oxygen Therapy. The put dad in a oxygen rich pressure chamber and force oxygen into his system. It would be multiple treatments over about 20 days. There have been good results on stroke patients. It’s not covered by insurance and would require us caring for dad in a hotel room as the treatment is outpatient. We are praying for guidance and direction now.
Dad came down with a sinus infection on Monday. They did xrays and a catscan. It’s not a real bad one, but we are back on antibiotics. He also had some bleeding from his urinary track on Sunday night and Monday that no-one could explain. It has stopped but we are keeping an eye on it. They did a urine analysis and so far it has been negative for infection.
I have put the updates on my web site, in chronological order, fyi:
http://www.don.smith.net/Gerald_Smith_update.htm
Mom and I enjoyed a couple of days back home at the house. We spent a good part of a day getting mom’s flower gardens in order, mowing the lawn, etc. The weather was nice, 75 degrees both days.
The big news is that dad was able to receive communion on Friday. The speech therapist was working with dad in the room when the eucharistic minister came in the room and asked if he could receive. The speech therapist has been working on his swallowing and she thought it would be okay. We did a 1/3 of a host and had to give him a bit of water to help him swallow. Dad was so joyous. He cried tears of joy. Having the speech therapist in the room (who is also catholic) that could make the decision to allow dad at the same time the minister came in was designed by our Lord. It really lifted dad’s spirits on Friday.
Therapy has been going pretty well. He does an hour and a half in the morning and
another hour and half in the after
On Monday (tomorrow) they are going to do a swallowing study on dad. They will give him a barium fluid to swallow then take xrays to see if all the fluid goes down into the tummy and not into the lungs. If this goes well, we will start working on feeding him some things. He seems to swallow okay but the stroke affected his mouth so the challenge for him is getting the food to the back of the mouth to swallow it.
Thank you all for the continued prayers and support,
Gerald Smith update - March 29
It has been a good week. Dad’s breathing has started to settle down. He still has problems breathing lying on his back, but is better on his side. We are still coaching him on using his nose and mouth. The panic / anxiety breathing is very in frequent now. He is learning how to breathe again.
He has been make great progress with therapy this week. PT has been working on his legs and trunk building strength. OT has been working on his arms. PT has been working every day on getting his blood pressure to self-regulate. They have a big table that they are slowly moving from horizontal to being vertical, ie standing. They strap dad to the table and slowly increase the angle to get him standing. Each day he gets closer to vertical before his blood pressure plummets and they have to move him back to horizontal. He has been able to set up in a wheel chair longer and longer each day. We are up to 2 hours now. His right leg and arm are returning more and more each day. He was able to move his right hand today – fingers!
Dad started making sounds on Sunday during a crying period. It was joy to our hearts despite the anguish that was in his voice. His vocal cords work. His mouth and tongue control have a ways to go before he will be able to talk, but it’s a start. He has an automatic swallowing reflex that we hope will grow into him being able to control. Then, we can get rid of the last tube, his stomach tube. He still has frequent stools but they say that is part of the tube feeding. We are still fighting the bladder infection. Dad is allergic to sulfa which is in the antibiotics that would take care of this. So, still some challenges.
Mom and I are going to go back to Marienthal for the weekend this coming weekend. We need a break away from the hospitals. Dad is stable enough now that it’s time for us to take a break. It will be 9 weeks for her and 8 weeks for me coming this weekend.
I wanted to share something that I forgot to mention in my
last email. As many of you know, some
how the song “Amazing Grace” has shown up on the points of high stress. On the last Friday when the doctor capped
dad’s trach at
Dad update - March 26
Sorry I have not written in a while, it has been a busy time for us.
Dad was doing really well the last week in
Western Plains Medical Complex
3001 Avenue A
Room 105
We will probably be spending 20 days here to build dad up enough that he can get into a rehab unit (at this same hospital). If we cannot get him up to the required entry levels to go into rehab, then we will have to move him to a nursing home. But, we keep praying and working with him so that we can make the next step of getting into rehab. The doctor taking care of him is very aggressive in his treatment. Thursday we did some testing and let him recover from his trip. On Friday morning the doctor capped the trach to force him to breath out of his nose and mouth. He did well in the morning so at lunch time the doctor pulled the trach out and has a dressing covering it so it will heal up. Unfortunately into the evening, overnight and into today dad has been having problems breathing. It is a combination of anxiety and not knowing how to always use his mouth and nose. He did not sleep much last night. I was with him most of the night trying to keep him calm. He was exhausted today and has not been very cooperative with the therapy people. We hope to get over this last big hurdle then we can focus on building his strength up. Breathing will be the last “life critical” thing for us to tackle, hopefully.
This doctor has also been pulling out tubes. Today they removed the pick lines (semi-permanent IV’s). We have the diet working, though we are still changing him every couple of hours. The bladder infection is proving resistant so we changed to another course of antibiotics and are hoping it will work. I know the bladder infection really hurts him sometimes. We started him on some anti-anxiety drugs today to try to help him relax.
Mom and I moved into a hotel:
Nedel’s Inn & Suites
Room 206
It is not as good as were we are, but the rooms are okay. We don’t spend much time here anyway :-)
Gerald Smith - march 19th update
Dad was off tube feeding for most of the week and on IV
feeding. The IV feed (TPN) really helped
strengthen him this week. We finally got
the diarrhea to stop on Wednesday so they restarted the tube feeding on
Thursday. His diarrhea returned today
(Saturday) so we are still not winning this battle. They had been talking about transferring dad
to
Every week brings another challenge. Dad has a bladder infection now. They removed the catheter in his bladder and replaced it with a condom type catheter and started him on a course of antibiotics. This may be contributing to the restart of the diarrhea.
Dad was pretty depressed this week. We went through two days where he did not sleep and would not rest nor cooperate on anything. We started him on an antidepressant on Thursday that has settled him down and has him sleeping again.
The sore on his bottom is better but we are being vigilant on keeping it covered as we don’t want him to get a septic infection from the diarrhea.
Gerald Smith update - March 13
Thank you for your continued prayers for dad and this family. I thank God for you all.
As with every update, 2 steps forward, 1 step backward.Dad has been off the ventilator for over a week now. They took the ventilator out of the room this week as he does not need it. We are still on blowby. They will not try to progress capping his trach and getting him to breath out of his mouth until he is more coherent and has more control over his mouth.
Dad was up and down this week. We had agitated days were he just thrashed around the bed all day followed by him sleeping and unresponsive the next day. They said the roller coaster ride is expected.
We are still fighting the diarrhea. We had hoped to be able to start him on a feed plan by now but his colon is still not good. They started him on TPN last night (Total Parameter Nutrition). He gets all his meal through the IV. There a dangers and downsides with this but he was getting so weak we needed to do something. Tomorrow (Monday) we will have a Gastro Intestine doctor come in and consult on dad’s case. See if he has any suggestions.
We had a nurse assistant last night that left dad set on his back all night. He was lying on a fold in the linen. As his bottom was already sore it turned into an open bed sore. So, that’s bad and so we will be trying to help that heal.
The hospital told us at
Dad is able to push his right leg now. He can’t pull it to him yet, but we are half way. AND, he moved his right arm today, ever so slightly, and he did it three times for me so it was not just reflex. I’ll pass it on to the therapist tomorrow. God is smiling on us.
Gerald Smith update - march 8
Thank you for the continued prayers for my dad. As always, it’s been a progress on some things, setbacks on others.
Dad continues to battle diarrhea pretty badly. The feeding tube food was passing right through him. Then, his bum has got very, very sore. We were almost to an open wound on Monday. We really struggled with keeping his linen changed over the weekend (we were changing him every hour). We asked the doctor for a rectal tube on Sunday but he refused and then got mean to the nurse. On Monday we went to the case manager and got a new doctor. One of the other partners came in and apologized for her partner and talked to another group and convinced them to take dad on. Today (Tuesday) she came by and evaluated dad – wow, what a difference. She agreed with what we have been saying for 2 weeks. His digestive system is wiped out. She stopped the tube feeding and is going to work on a new feeding regiment after his system has time to get going. His bottom has also improved with the rectal tube in place.
An Xray showed fluid in his lungs yesterday. They thought he may have had pneumonia. They put a tube through his ribs today and drew out the fluid. It looked clearish so the doctor thought he probably was okay. They are running lab tests on the fluid.
Physical Therapy told us today that they have been seeing some muscle control on his right leg. It is small yet, but a start. So, we are hopeful on him getting his leg working again.
Dad also has been off the vent since Friday morning. He is on “blowby”. It’s a tube that carries an oxygen / moist environment to his trach for him to breath. They have also been reducing his oxygen percentage. We are down to 28% 02. Normal air is 21. They also tried a valve on his trach that let air in, but forced air out of his mouth. He did not have any control over his mouth so we are concerned about the paralysis of his face. But, it may also take some time to get it going after not working for a while. But, we are looking good to wean him off totally soon. Halleluiah.
Dad is getting weaker by the day. He has lost a great deal of weight. We are really hoping they get the diarrhea and diet figured out soon as we are concerned he may get so weak that his body won’t be able to fight. Therapy has cut back on what they were doing with him each day as he is so weak and did not have the energy to do much. So, please pray for strength to return to him soon.
Gerald Smith update - march 1
just an update on dad tonight (Gerald Smith).
We had an exciting weekend. Our doctor did not come in on Saturday. He showed up Sunday afternoon and finally decided that dad's stomach had stretched out enough to be of concern to call another doctor to consult (after we have been telling him for a week!). They took an xray of dad's lower abdomen. The new doctor got excited. They took dad down to xray and gave him a barium (sp?) enema and then took more xrays. His colon was 14 centimeters in diameter, anything over 9 is in danger of rupturing. The doctor was concerned that dad's colon may be twisted and blocked as the enema only made it half way through. He called in some more people on Sunday night and said he would start with a colonoscopy and hope that it was a blockage he could clear without surgery. It turned out to be hard stool blocking his colon. They suctioned out a bunch of hard stool and did not need to operate - what a relief. Dad's stomach is significantly smaller, and continues to decrease as his colon shrinks (normally it is about 4 cm). His breathing has also improved as the pressure on his lower diaphragm is gone.
The downside is his digestive track is a wreck. He has a very liquid stool that runs all day long. They put in a rectal tube last night as we could not keep his bed clean. His bottom is very sore and blistered. They are running tests on his stool to see if he has a bad bug in his system (something called CDiff, amongst others). They did re-start his feeding tube today. They stopped it on Friday. The feeding tube is a on very low rate.
This week’s respitory doctor is
still working on keeping dad off the ventilator from
We also are going to have the wound specialist look at his stomach tube tomorrow as it is still red and oozing some. But, it is better than it was 2 weeks ago.
Dad is more alert and also more communicative. No response from his right side yet. We are working on keeping some strength in his left side and keeping the swelling from fluid build up on his right side down.
That's about all tonight. Mom and I did not go back to the hospital tonight. Dad had an uneventful day plus we had a good night nurse so we needed a break.
Thank you all for your continued prayers and support,
Gerald Smith update – feb 23
Hi all,
today is Wednesday. I made it safely to
Hi bowels were impacted so they gave him an enima (sp?) last night. It was a messy night and day. But, the nurses have been pretty good about cleaning him up. I know this has been a humbling experiance for dad, but he seems to be resolved to putting up with it.
Still no movement on his right side, but we keep massaging him. They did some tests on his eyes and the stroke affected both of them. His right eye can move left - right only. His left eye can move up - down only. I'm sure he is seeing blurry / multi - images. But, he keeps looking at us and making facial expressions. We have also started working with his mouth trying to teach him how to open and close his mouth. His left side is coming along well. He has good control over his leg and arm. We are still working on his fingers and hand now.
Keep praying for mom please. The strain is starting to show on her. Once we get dad off the vent we are going to have someone take her home for a few days for a break. She gets wound very tight about things now and it takes some effort to try to keep her calm and from jumping on the hospital staff.
Gerald Smith update feb
19
Hi all,
Dad continues to progress, slowly but surely on getting off the ventilator.
They are taking him off the vent for 2 periods of 4 hours now. He is progressing slower than average, but is progressing. He also is getting therapy to try to keep his muscles and joints moving. They have also been working on pain management for dad. He has been improving faster when they have been helping keep the pain down. Dad was visited by his two sisters and brother this week. I think it helped lift his spirits.
I am headed back to
Gerald Smith update feb
7
Hi everyone. Enough energy in me tonight to send out an email. Hopefully it will not have to many typos. Every day is 2 steps forward and 1 step back. Dad had a full (and rough) day. PT / OT moved his legs and arms around then sat him up for a minute. He coughed up a great deal of junk. Then they took the stiches out of his Trachea (sp?) and gave it a good cleaning. More coughing. The bed guy came in and agreed that the bed was not functioning right and so he organized another bed. Meanwhile they wanted to weigh dad. So we got them to do it in series. Sounded like a good idea. They lifted dad up in this body sling, wheeled the bed out and wheeled in the new one and lowered him. My younger brother and I were both in room thank God. They nearly let him fall out of bed, did not support his head when the lifted him up, got his IV line caught. wow. I really felt sorry for dad. He did not look comfortable this evening so they gave him tylenol. We are trying to stay away from the morphine as the goal is to wake his brain up.
probably the hardest thing every day is trying to understand if he is in pain or uncomfortable and not being able to communicate. His mind is there. We read get well cards to him and he started crying this morning. We have been playing his polka tapes to him to help him relax. But, he has not much of any way to communicate. We are working on that as we would like to know what is going on in his head.
I ask for your continued prayers for him - primarily to get off his vent. We are making some headway on reducing his O2 input. I also ask for your prayers to keep his spirits up. He was never one to set still of give up. He is just kind of there these days. I don't know how much fight is in him, it is hard undertaking at 74 years of age. I also ask for prayers for my mom. She is still dealing with what has happened to her husband of 52 years. She breaks down and crys a couple of times a day. We are providing what ever comfort we can.
Gerald Smith update Feb 3
Once again there is a mixed bag of news regarding Don’s father. Today (Thursday), he is less responsive than he was the first few days. However on the more positive side his vent was reduced from 20% to 15% and he doesn’t seem to be struggling with this.
His blood Oxygen is lower today at 94% but that’s still an
acceptable range. They are taking him
out of ICU because he’s not considered critical care at this point. But they have to move Gerald to another
hospital because the only place in the current hospital that they can do a
ventilator is in the ICU. So tomorrow
(Friday) they are going to transfer him to a different Hospital in
They started feeding Gerald through the feeding tube a few hours ago, so hopefully that will help strengthen him. He is sleeping a lot, and he does sometimes respond, but not nearly as vigorous as in the past few days. Also, they are trying to get his blood pressure down a little more for the transport to the new hospital so they put him back on some blood pressure medication.
Don and mom and sister will need to move into different accommodations and they are trying to figure that out right now. They will probably stay in a nearby hotel.
If he gets off the ventilator they plan to move him to a hospital
in Hayes which from what I remember is a few hours drive from
Keep the prayers coming. If your church has a local prayer chain, please think about adding Gerald and family to the list. Don sends his love and thanks.
Gerald Smith update
Feb 1
Don's father is in desperate need of prayers. Don's father Gerald had a series of strokes
this past Saturday and was air cared to St. Joeseph
Hospital in
There is much to say about the events that have occurred over the past few days, but not enough time to give the full update. Currently Gerald is struggling very badly and Don hopes that he has not given up. He is not breathing very well and has a sinus infection on top of this. He is now not responding very well now.
They tried to feed him through a feeding tube down his throat but didn't have any luck with this. They had trouble getting the feeding tube in the right position and actually damaged the trachea trying to do this.
He is supposed to have emergency surgery today to put a feeding tube into his stomache and to give him a tracheotomy. But they can't do this until he becomes stabil. His heart rate and blood pressure are too high. His heart rate is around 120 and the blood pressure is something like 240 over 140.
Don says his dad doesn't look well at all and is asking for prayers, especially that his blood pressure comes down since it was up about this high before he had a series of strokes. I ask you all to lift Don up in prayer as well. As can be expected, this has been really difficult for him. Thank you all for you love and support.