Monday August 10

Over the weekend, John's activities were kept to a minimum. He had been getting tired easily and coughing some so his physicians were trying to isolate whether physical activity was playing a part in his lethargy or if it is medication driven. In order to be extremely conservative and safe with John's treatment, he underwent another echo-cardiogram, which is his third since June 2. This is essentially a 3 dimensional view of the heart and takes video and gives sound of the heart working. It is painless and John seemed really interested in seeing his heart on the screen for at least the first portion and he seemed equally enthusiastic to sleep through the remainder! This is precautionary and showed the cardiologist that John's heart is functioning normally and continues to show no residual damage from his heart attack and ensuing resuscitation activities. The overall thought at this point is that John seems to think he should be able to do everything he was doing prior to this myocardial infarction and he gets frustrated with his own progress which makes him feel tired. It is a great relief to know that aside from some tweaking of his medications, his upcoming treatment might include helping him deal a little bit better with where he has been and just how far he has come and help him with becoming more patient with himself.

John goes to a class with a group of folks called memorex which helps him with everything from everyday life skills like congenial terms (which, he is great at) and even more short-term recollection activities such as date, time, etc. They also work with him on things like geography and do some fun stuff like play wheel of fortune and other games which help with cognition. John has a backpack which goes with him everywhere. At the moment, it stays with his wheelchair and when he begins walking constantly, he will carry it. Inside this backpack is a red binder notebook which has notes from each of his sessions and allows family to write in it about things that happen on his days off or over the weekend or express concerns which they feel might need to be addressed. This provides a valuable line of communication and enables each of the therapists to communicate in addition to his other charts.

In front of TIRR is a granite and bronze placard (and some copies throughout the hospital) which reads:

"...The realization of potential usefulness remaining to any man appears to be entirely apart from muscular weakness...it is an adjustment that repeatedly demonstrates to all of us that success in living is not success in bodily movement...Creativity, responsiveness, fraternity, responsibility, and equality are not measured by muscle strength...It is as if the man within the shell of mortal clay unleashes himself from the bonds of muscular might and uses the tiniest strengths for the greatest purposes."
By: William A. Spencer, M.D., Founder and First President, TIRR

Every time I read this I see something different in it but it affects me each time I read it. TIRR was first established in 1958 to help people who had polio and required iron lungs to survive. There are photographs in the lobby showing them transporting patients by rail car and ambulance at that time and I look at those photos and marvel at just how far medicine has come. It is absolutely possible and even probable that if we were living at that time, this situation would have had an entirely different outcome and we remain grateful daily but how wonderful it is that even at that time, Dr. Spencer and his colleagues recognized a need and have continued to be on the cutting edge of new treatment modalities.