Thursday, September 30, 2010

Home & Reunited with Dogs

Today has been full
Thanks to the support of the hospital and the skills of Toren's dedicated Service Coordinator -
The County visited and increased his personal support hours today (this is incredible and amazing - when the system is worked by caring people the results are impressive). And visiting nurses came in and set up his case for in home PT, OT and Speech Therapy. The Speech Therapist was oh so smart - Toren will not be able to trick her, and fake her out. She had a great way with him, and with me too
Melinda visited this morning, so I got to shower, and organize the whole visits thing, Toren so enjoyed just hugging her and spending breakfast in her company. Marvin was great, having installed shower safety bars yesterday, he chipped in again today and collected the dogs from the wonderful Melissa... they are happy and healthy and clearly well cared for - and also thrilled to be home!!
The wonderful Tara had left delicious food in the fridge - what a treat, and later this evening she will hang here while Toren rests, and I take the dogs for a serious walk... important for both them and me!
The pharmacy was in shock yesterday as they filled all his scripts... making phone calls to confirm the dosages... that are over recommended limited. Still it was all handled inside three trips... which was fine because Helaini stayed until it was all handled. She even did the last trip to pick up the final medication.
Mummy had made Toren his favorite soup - which he loved at lunch time today. She had stocked the fridge with Helaini and even gotten flowers for me.
Then when we got home last night, there were balloons on the beds, and chocolate and dog toys too... as well as a Welcome Home balloon on the front steps.... Tara sure knows how to touch our hearts. Toren and Gracie (Tara's dog) were reunited last night.... it was so lovely... they just cuddled each other.
Today also brought, phone calls, and messages, of support and welcome... as well as a lovely arrangement of fall flowers from our North Carolina family. We are so blessed, and feel truly loved and supported. You should know I am keeping the phone on vibrate so it doesn't disturb Toren (so yes that makes me tougher to reach... but I will listen to voicemails, read texts and return calls within a day or so) ... and we are trying to schedule visits so he doesn't get too overwhelmed and exhausted. He is very gregarious as you all know, and short visits, timed wisely is truly a treat and so healing, however, too much and he is wasted for hours.



Wednesday, September 29, 2010

HOME SWEET HOME

We are all simply thrilled to be home.
I have already done battle with CVS to issue all his meds.... the kitchen table is quite loaded with little brown containers with white lids ....
Cocktails are numerous times a day...
Toren has already snuggled with Gracie and can't wait to see ours tomorrow.
We have ordered Gluten Free pizza and then Helaini will head home and we will hit the sack... Tonight I get to sleep in Toren's room...
Friday night Helaini is sleeping here - so I get to sleep in my own bed!!
Horray:)
love you all - more news tomorrow

Wednesday- Day 30 - Prepping to go HOME!!

Wow - what a full few days.
Toren got to walk further and stronger yesterday than any day before.
I got trained in all sorts of new skills - including driving the wheelchair over curbs, bump, etc. Not as easy as it sounds!
I am now checked on on supervising Toren doing the vestibular exercises that make him feel so very queasy - isn't that grand!! Still it makes the world of difference.

Toren is having a shower, and then planning to wear street clothes - what a treat.
Helaini is parking the car, and then it is simply the gathering of the last pieces of paperwork and filling prescriptions before hitting the road for home.

We have said many of our goodbyes, and it is strangely bittersweet. The caring, the support and the true investment in Toren's recovery has been amazing. We have been so blessed.

The last two evenings have been spent with Fiona visiting us, it has been so wonderful to see his face light up when he sees her. We are blessed with family, with friends and community... it holds us up, pulls us forward, and gives us strength and hope when ours falters.

Going home is full of its own challenges, but I am confident that will the support we have we will go from strength to strength. As we speak Marvin is hopefully installing shower bars for Toren. His wheelchair is being delivered to Saratoga... my mother is making favorite treats for Toren to eat... And already we have tentative plans for a special visitor on Shabbat, and dinner with dear friends at our house on Friday night .... the balance of the next few days is dog play and settling in - and of course the key element in recovery - SLEEP - that is for both of us!!


Monday, September 27, 2010

More progress. Monday day 28

Today Toren was chirpy and bright and worked outrageously hard in therapies. He walked several 100 feet without his walker. Which is amazing. Right now he is happy to resting in bed. He is very excited about going home and also about seeing those he knows with two and four legs. More news to follow

Saturday, September 25, 2010

Saturday Night - Almost home...

Toren had another good day today... last night ended with a trip to the succah, blessings and the eating of challah... Toren looked at it and said "I can't wait to bake with Rabbi Jonathan again" It took a lot of effort for him to get that full sentence out, but it was so very heartfelt. Toren is so determined, every day he makes progress.
Today he had OT, and stood up by himself for 10 solid minutes while throwing balls into a basket... he even picked up some of the ones he dropped - a seriously exhausting challenge given the state of his balance systems!
His jaw was so set during the activity that later in the afternoon he had increased muscle pain in the jaw...
He had a whole hour of speech therapy today and he really is making daily progress... he has so many skills that he has gathered along this 2 year (and then some) journey - and they help him face the struggle to find words, to deal with the frustration, and the asking for support. He inspires us, hugs us, and thanks us - daily.
At PT today he managed to walk a whole flight of stairs taking reciprocal steps going down - this is incredible - he is so aware of the journey ahead, and the distance he wants to travel... but he is very humble about the effort he is making, or the progress he has gained. It is touching... and makes us want to cheer even more as he conquers the mountains that which we take for granted.
I am writing this from my own bed in Saratoga... it was so hard to leave the kids in the city - but I know that Helaini will give Toren her utmost support and attention, she is amazing. Toren's continues to be seizure free on his exotic cocktail of anticonvulsants.... and this is a blessing. For dinner tonight he had a salad from a great salad bar by the hospital... it was the first time he has been able to chew something that crunchy... he was delighted... his eyes were shining and he said it tasted soooo good. He is looking forward to returning to home cooked foods.

Friday, September 24, 2010

Friday afternoon - almost Shabbat

Today has been another full day of wonderful, hard won progress. Toren's determination is inspiring and his challenges are complex. He has earned the respect of everyone who has worked with him. The staff have been a true blessing... he is well cared for and treated with dignity and kindness, and just enough compassion to soothe.... and enough pushing to encourage him to move forward. Today he took no midday nap, just rested while socializing with Lindsey and Terri before they headed home to Western New York.
Helaini is back here and that is wonderful. I am going to be in Saratoga to teach Sunday school and then head back here, so I doubt I will do much connecting with folk... but then we will be home on Wednesday late in the day. We have been advised to keep Toren's life as structured and simple as possible, he is very fragile and vulnerable, and stimulus is very overwhelming... so we will see how easily he adjusts to home, with his wheelchair and walker to make getting around a possibility.
These last few days have consisted of meetings and trainings for me, planning for getting home. I am so excited as is Toren... he crosses off each day and counts down with a two thumbs up when he gets to the end of it.
It was hard to say goodbye to Lindsey, Terri and their friend Peggy - but Lindsey is planning to visit for a weekend once in a while come October - which is great news!!
Toren is so looking forward to seeing friends and playing with his gang of dogs!
We will figure it all out one day at a time.
We even went to the Succah here last night... and we will again before shabbos so he can wave Lulav.
Shabbat Shalom

Thursday, September 23, 2010

Thursday morning - day 24 - on a roll

Toren continues to make progress. He is so determined to get home asap. We have a calendar up by his bed and each morning he crosses off the prior day... so he can see it getting closer and closer.
Today I got here by 7:30 he was already, up dressed and showered, and in a good mood. The access aide from last night was great with him. He walked with some support to the sink... a good 15 ft and stood to clean his teeth and walked back. This is incredible, all that balance and energy. We hardly ever consider how complex the systems are that keep us upright and moving. One of his wounds is looking good, the other one is slower to heal... Toren's need to scratch it might indeed be a contributing factor!!
In PT today he was really pushing himself, and his progress is profound... he was able to stand with his feet touching for a few seconds - a serious leap..
When doctors ask how he is doing - he answers with that classic Toren candor - the right eyebrow lifts, and he say "I do not feel great" When they look concerned he lifts his hands and says "I feel better, but I do not feel great" The smiles follow!!

The care here in Rusk has been wonderful too... we have been so very blessed. Toren has really enjoyed getting visitors... he is truly tired of hospital life so visits with Eve yesterday and Terri and Lindsey over the past two days and Emma before that - have been a boost to his spirits. I have been fighting a bit of a cold... but holding my own. I moved into the very sweet and snug apartment on 39th Street... it was a nice walk this morning before all the UN hoopla starts.
Last night Lindsey treated us to theatre - we went to Mary Poppins - I just smiled from start to finish - it was simply delightful and a lovely diversion. What a wonderful gift the Frasers have been in our lives.

Toren appreciates messages and cards, even when he can't always place names or faces, it helps him feel loved and supported.

His memory is getting clearer, and this morning he asked how I liked the show, and how the new apartment was - this is so wonderful.
The MRI still shows swelling and we will know more as the weeks progress - and the brain settles down from the trauma of the past month. Today Toren worked on taking apart a telephone - right up his alley - and suddenly a lot of work!
He recognizes the gaps and it hurts him - but he cuddles me tight and talks about getting home and playing with the dogs, and being among friends.

Tuesday, September 21, 2010

Tuesday - two really good days in a row

It is Tuesday night, the end of day 22... what a ride we have had, but today was also a really good day... Toren is working so very hard to make progress. On my arrival each day after a hug and a good morning kiss - he asks The Question - When can we go home to Saratoga... Today we addressed that question with his team... and we have a target date... Sept 29 - Next Wednesday - it is tentative, but everyone is confident that if he keeps making progress at this rate. He will truly be ready to go home and do all the rest of this journey from home. He is so excited.

Today he walked a whole flight of stairs... it was exhausting for him, but he was so determined to do it. He also took on his vestibular exercises with grim focus... and it was better than yesterday. He worked hard at everything... his nap at lunch time was so sound, he slept through lunch - drinking an Ensure to get him through his afternoon therapies.

For added delight today his dear friend Emma came in for a visit... he couldn't stop beaming. He also really enjoyed reconnecting with our friends Lindsey and Terri from our May trip here. It was so good to have all this distraction. He was so ready to sleep and hear the Shema tonight. Tonight he has his room to himself again... so he is very relaxed.

In keeping with that flow of positive progress today I got in touch with a connection from my friend Inbal in Israel and I have an apartment to stay in very close to the hospital for what I believe will be the balance of our stay here in NYU. We are so blessed... in too many ways to count... and today it is gloriously obvious - I can feel it without the energy of seeking the blessings.

I enjoy so much hearing news from friends, even when I don't respond directly.
Thank you for your notes, your wishes, directly and through my mum and other connections. We really do all feel held up. The caring community sent a lovely gift, it lifted our spirits - and Toren didn't even want to share the chocolate - all the more for me!! - My medicine of choice.
Tomorrow I am planning on lunch out with my dear friend Eve... and more time in the evening with Lindsey and Terri... but it will be a busy morning of packing and cleaning this apartment for the next folk. I am off now to buy clothes for another patient whose family is overseas... it is wonderful to be able to do something for someone else.

Have a good night.
With love
Martina

Monday, September 20, 2010

Monday - An all round good day

Hi Dear Ones,
We have had an all around good day today.
Toren seems clearer headed, and his speech is more focused more often... it does a heart good. Helaini was with him first thing, so I had a lazy morning, laundry, puttering. Then while Toren was being worked hard by OT and PT his girls went out for breakfast at the Moonstuck Diner. It was nice just to sit and shmooze. Toren ate well today enjoyed chatting with me during his two hour break between therapies... He chatted about Lindsey and Terri - friends from our visit in May. He was so excited to know they would be visiting with us for a few days. He is cuddling right now with Helaini, it is so good for us all to just hang here together.

Toren worked so hard today in PT and OT - he was able to stand unassisted for 1 whole minute - this is huge progress. He also did managed to walk a little without support... amazing. I am so very impressed by his determination - Every morning he asked to go home to Saratoga. Each day we talk about how working hard and resting well is the pathway to us getting home. Sometimes the very same thing makes me want to cry with both joy and sorrow. He has been through so much, and the journey is far from over, but he is so patient with us, grateful for all the help we try to give, always thanking Doctors, Nursing, Therapists and general staff - so much so that it warms our hearts. He has a serious challenge with his balance right now - so he needs to do exercises that stimulate the vestibular system... the result of the exercises is to make him very dizzy and queasy - at least in the short term. Such a tough gig - the exercise to get well makes the symptoms worse in order to help.
He was so disoriented.
But was willing to do it again when it was required... he is so courageous.
On Wednesday I have to give up the apartment for the next family that needs it... I am in the process of deciding what is the best choice for me. I imagine that we are going to be here for several weeks yet.
I send you love and appreciation.
Martina

Sunday, September 19, 2010

Sunday Night - Day 20 draws to a close

Good evening dear friends
So today was a therapy free day for Toren.
He got to have a real lie in - he didn't really get up until gone 10am... and then only for breakfast... He went back to bed for a stretch to let the headache medicine work its magic... Then it was time for a shower and for Helaini and I to encourage him to go for a tour around the building... he held up for a short while and then more rest... before and after lunch.
But after dinner we played games, went for a walk along the corridor and toured the lobby. He was much clearer today and thoroughly enjoyed his mid day foot massage... He scars are less itchy without the staples and they are looking less angry with each day - even with Toren's fingers working on them.
He is clearer headed today and a little less dizzy - reducing one of his meds. is helping. It is nearly 8pm, and he is snuggled down for the night... therapy starts at 8am tomorrow morning.... so we will be getting an early start to the day.
Shavuah Tov
Martina

Friday, September 17, 2010

Erev Yom Tov - G'mar Hatimah Tova

Good afternoon all,
Toren has had a very good and tiring day.
The stitches are OUT - great
The scars are a little inflamed so he is on precautionary doses of antibiotics.
As of tomorrow we will start to wean him off Dylantine (one of 5 anti-seizure meds in his cocktail!!)
If it goes well, he could be off it within 2 more weeks - that would be good... it might be contributing to his virtigo and confusion.
He worked hard today - 2 hours to PT
2 hours of OT and a therapy appointment.
Right now he is cuddling his sister and resting...
Soon a shower - and that first head/hair wash - soooo exciting... a real shower!!
Then he is going to attend services to help make minyan... such a mensch!
Bless you all
M

Thursday, September 16, 2010

Progress & smiles

Good Evening dear ones
It has been such a full 28 hours, it is hard to know where to start - so this is a very quick over view... maybe more later... but I am a little tired in a good way.
Toren moved to Rusk at about 4pm... on Wednesday
Room was small, no rooming in (for me) - a sitter/personal access aide was on board for Toren...
He was anxious to be in a new setting, roommate was not a good match...
Toren was sad I was leaving, and didnt really grasp the whole idea of rehab.
He had a rough night (I actually slept really well... a rarity)
By the time I arrive at 7:45am today (I left after 10:30pm) Toren was very sad and rather shut down... transitions are hard for him.
Toren, felt queasie, sad and frustrated.
During the night, even with an aide he was able to sufficiently mess with his PIC line so that by 4am - the doctor on call had to remove it - this has several ramifications - A) Toren was relieved of an irritant Good - B) He knows he can do that Bad C) There is no easy access for blood draws or emergency medication if he seizes... (Bad) D) We have to make another set of decisions - semi-permanent port - new PIC - nothing - Central Line (hard to know if this is good or bad - but it adds another dimension - hooray!!)
We had lots of therapist evaluations today, meetings with rehab docs, and learning the ropes...
We had a wonderful - absolutely perfect access aide for Toren today... (Thank God)
Melinda visited - wonderful - I now have clean laundry again - Toren has new clothes - we went to MACYS (very big - lots of people - not so good)
I feel more like me... walked on the streets, sat in the garden for lunch... Toren is bright and perky - he WALK UP # STAIRS TODAY AND BACK DOWN - THIS IS AWESOME PROGRESS,,,
He has loved visiting with Melinda, and his access aide...
He got to wear street clothes and crocs.
He is making progress each day - we are blessed, blessed, and blessed again.
The nurse today was incredible and responsive... the therapists and bright and young and pretty - very motivating... they are kind and very thorough...
We are in good - no excellent - hands.
Prayers are answered every day - I happen to like to answers we are getting these days!!!
Thanks for being there - for writing for cards, for emails, for blog comments - you are a pillar of strength - I can feel you holding me up as I hold Toren.
With love
Martina

Wednesday, September 15, 2010

Continuing the journey - Rehab today!!

Just a quick note
Toren had a better night. He is feeling off color today, head and stomach aches. This morning he was resting and feeling sad, and confused. I am sure that moving rooms was disorienting to him... as will today's change. However, once we are at Rusk Rehab later today and he adjusts I am confident he will make his usual leaps, he is both determined and willing. By 10:15 he felt a little brighter and so we went for our longest walk yet. He seems much stronger and steadier. He is speaking more clearly and able to focus more each day. Praise God.
Thanks for your reaching out to us, with words and prayers and visits. It makes the world of difference.
with love
Martina

Tuesday, September 14, 2010

Day 15 Draws to a close - more progress

Today was a very good day - with some bumps along the way.
Toren has a really rough night last night - I stayed with him, he was either wonderful and resting or trying to leap out of bed, or trying to remove his own incision staples !!! What fun - I got very little sleep... but he didn't get sedatives - which is progress in a warped sort of way.
Today he walked many more times, and further, and stronger. He is talking up a storm, and more of what he says is clear and on topic... and obviously quite a bit is still disjointed and confused. He has no understanding as to why we are in the hospital, why he had brain surgery, or any recall right now of having Epilepsy - sounds good to me!!
It was painful to explain it all to him, and watch him try to grasp what I am talking about. He was delighted to see Rabbis Linda and Jonathan, as was I - it was tough to see them leave. We had a lovely Middle Eastern picnic for lunch - Toren enjoyed it too. A nice change from hospital food.
Toren has PT and OT again today, and he is starting to read more and write a little. This is wonderful progress.
He is very willing to do the work... and even when he is tired can be coaxed to do just a little more. He has spent more of the day in the chair than in bed. Right now as I write he is in the shower, and then we are moving out of ICU onto the floor.
The other highlights of the day, include several falls - one hard enough to warrant a trip to CAT scan!! He seems fine enough. The falls come from his enthusiasm to get up without assistance or any warning, but he is still rather unsteady on his feet - to put it mildly.
The other progress is that we are in line to move into Rehab, we met with their intake MD today and hopefully tomorrow that will happen.
Lots of action... well off I go to pack up our stuff.
Blessings
Martina

Monday, September 13, 2010

Monday afternoon.... Day 14 - More Progress

Toren is now seizure free for over 48 hours - a big step in the right direction. He is tolerating the very high doses of meds with relative ease... meaning his liver is handling it all. Right now I am watching him and Helaini cuddling/resting in his ICU bed. He is happy to be free of the EEG - and is being very responsive to instructions not to remove the staples in his scars. The staples will come out on Friday... thank God. Today Toren managed to feed himself most of his own lunch -this is wonderful progress. It did require a fair bit of clean up - but honestly so what!! He managed to walk the length of the ward with his Physical Therapists... also amazing progress. He has very limited stamina - but given what his body has been through it is to be expected. Today before lunch - his girls gave him a shave, he looks so fresh, and was thrilled to be able to dress in his own PJs. Before dinner Helaini and I are planning to walk him around the ward again. Either tomorrow or Wednesday we hope he will be stable and strong enough to move to Rehab here at NYU. Almost all his meds are now in pill form. We still have a journey ahead of us, but for now we are able to dwell in this quiet place of appreciation. The hospital staff as a whole has been wonderfully supportive. The apartment from FACES has been an incredibly generous blessing.
Our family is so fortunate to be held in the prayers and hearts of so many. Today and yesterday Toren asked when we would be going home to Saratoga Springs and our dogs. It too is a wonderful sign of recovery.
I look forward to getting home, to sharing Shabbat with friends, to walking the dogs, and to seeing the faces of our own community. May the days between now and Yom Kippur allow you to make whatever peace you need between you and yours. And for any misdeeds, intentional or accidental in this past year... please forgive me.
May you be written in the Book of Life for health and contentment, peace and success in all your endeavors.
And may you remember to pray with sincerity.
With love
Martina

Monday morning - day 14 - holding steady

So this is the last day of week two.
What a ride.
Right now at 8:30am Toren is resting the breakfast tray is waiting.
He had a really rough night - Helaini and I slept at the apartment, we were so weary.
It was most probably not the best choice
Toren is driven crazy by the itchiness of the EEG and the incision staples. He was so restless and agitated during the night that the nurse ended up administering a sedative twice. Obviously we will not be leaving him alone at night again at this stage.
He had such a solid day yesterday, he was so very co-operative and really making good strides. It is another stage of the journey, and sometimes I miss call his needs. I feel like I let him down last night. But still I have had a couple of nights in a bed, so that should hold me for a spell. We are going to be considering removing the EEG monitor today.
Linda and Jonathan will be visiting tomorrow morning - which will be lovely I am sure. Fiona is coming over tomorrow evening. And Melinda is coming on Thursday, so we have lots of support and breaks. Helaini leaves for Albany tonight, it has been so wonderful to spend the last 4 days with her, Toren lights up when he sees her.
With love and gratitude for your prayers and concern.
M

Sunday, September 12, 2010

Day 13 - More Progress

Hi Friends,
Sorry for the delayed writing - we are so very tired.
Toren did a great job today, he ate well, gave hugs and kisses, enjoyed a visit with his cousins Sarah and Hannah. He walked around the bed to the loo(with assistance)... twice today, sat in a regular chair for over half an hour - several times. He is speaking more clearly and more frequently and yet again I am thrilled. He is very loving to Helaini and I. Tonight he has a fever again - so his cooling blanket is back on.. hard to know why - he might just be exhausted. He is able to follow many more directions during the Neuro checks. Hopefully we will leave ICU soon and then we might make it to rehab later this week, if all goes well
Your prayers and notes, touch our heart, hold us up when we feel too weary. We are truly a very blessed and fortunate family.
More details tomorrow.
With much love to all
Martina (and children)

Saturday, September 11, 2010

Shabbos - Day 12

Toren had a very good day yesterday that tired him out quite a bit though. Friday included PT, and by the late afternoon the task of standing that seemed so imposable in the morning was accomplished with great pride. Toren was able to eat, with the help of mummy and his wonderful nurses. He had some applesauce, pudding, jello and even had pasta for dinner! He is now taking more of his meds orally and following directions much better. Toren had a restless night last night. He managed to throw himself out of bed but not to worry he did not incur any extra injuries, internal or otherwise, from the event. Our dear friend Cynthia came for Shabbos and offered to stay the night here at the hospital which was truly a blessing, giving both mum and I a full nights sleep and some time together just the two of us. Toren had a breakthrough seizure this morning that manifested in his legs and is now back on the external EEG and has been resting all day due to the Ativan they gave him to resolve the seizure. Toren had a fever today and is on a cooling blanket now which seems to be doing the trick and we are keeping in mind that with every two steps forward it is only fair to take one step back. We know you are all behind us and can feel your love and support, it makes the world of difference given our emotionally exhausted state of being. We are happy to be together though for the start of the new year.

All my love

Laini, and mum sends her best

Wednesday, September 8, 2010

Erev Rosh Hashana

So as day 9 winds to a close Toren is resting comfortably - considering. He is very very exhausted, it is a struggle for him to speak, clearly his mouth and throat are sore. He has only one IV attached to his PIC line... Toren has had PT and OT today, tasted a spoonful of Jello (the feeding tube has been removed). He also said ouch in response to the question "are you in pain?". When I held the phone to his ear so he could listen to Rabbis J & L voices - his face brightened. I think he is tired of listening to my voice - How can that be??!! - No need to respond to that question.
I will not blog or be on the phone during the first day of the Chag... I send you my love, and my deepest gratitude for keeping us in your hearts and prayers. We might have a long journey still yet ahead - but this day has been full of progress. With help Toren will go from strength to strength.
My mother and I are siting here quietly simply enjoying looking at our boy!
L'Shana Tova.
M

CELEBRATION TOREN IS OFF THE VENT

This is a quick note
About one hour ago he came off the vent and off the anesthesia - he is breathing fine - trying to talk
Praise God
Thanks for your prayers
More news soon
M

Good morning dear ones,

Today is erev Rosh HaShanah - it takes conscious focus to relate to that here in the timelessness of Neuro ICU - I imagine many of you getting ready, making food for those you love. Such simple pleasures. And yes I know some of you are rushing and feeling pressured.


I want you to know that I am with you in spirit, I sense that this year will be full of many things, ups and downs, challenges and triumphs - I have also come to truly appreciate that peace is not an external thing, no matter how much we acquire or accomplish - peace comes from a rare mix of action and acceptance. I wish you all peace of soul and the power of wisdom. May your days be full of blessings that you have the ability to notice, and be nourished by.


Toren appears to have been seizure free since midnight (ish) on Monday night.../ wee hours Tuesday morning - this is wonderful news - Praise God. Toren is so strong he has spent many moments - trying to sit up - and/ or remove the various throat/nose tubes, this is my retribution for having pushed him to workout!! (Krit & Helaini I hope you can truly appreciate the humor in that). He appears to have developed quite the tolerance for Propofol - the anesthesia!! - and is way more active on it that the nurses expect. (So very Toren) Right this moment he has been resting comfortably for an hour and a half... having tossed and turned for several hours.

Eventually I left here last night to sleep in the beloved FACES apartment bed!! What a gift... so now I have the quietude to be present to todays challenges.


Last night they started tube feeds, which quite honestly make him restless - but are necessary at this point. Hopefully today the Epilepsy team will start the wean from that and his brain will stay quiet and he can be taken off the vent... it may take several days. Everyone on the team wants to go slowly to protect him. The doctors are wonderful and very informative. Each staff member brings something unique and important to his care, to our view of how to best support Toren in healing. The nursing staff are an inspiration - it makes me even more respectful of the choice of career that Helaini is following - these women are truly angels of mercy. This hospital is so family friendly - I never feel like I am unwelcome, or intruding - it is a wonderful culture - they allow us to help and is soothes my mothering soul to be able to keep caring for my beloved son.


Our friends Rabbis Eve and Elliot came down last evening and gave me a break - I showered and changed (everyone was in favor of that!!) Elliot brought me a Makzor in case I don't get out to join the several communities that have generously offered to welcome us. I am self medicating with Cadbury's Dairy Milk - and yoga in the cracks(okay more chocolate than yoga)... both serve a unique purpose. There is a wonderful salad bar across the street, and I have a fridge full of goodies thanks to Fiona. I even made myself a little veggie meal last night - So yes I am taking care of myself, which is as many of you know tricky for me!! Thanks for the encouragement!(read nagging) Marvin is very kindly driving my mum down today - he is too under the weather to visit Toren himself. They will stay overnight and then head home tomorrow late afternoon. Helaini will be back early on Friday for four days. It is easier when we are together, our little trio.


Thank you all for reaching out - I read every e-mail and comment several times, it helps - I share what you write with Toren... Please send me emails about your lives, or the world at large... to distract me from this world, and to help me feel part of your lives. I send you love and wishes for a joyous and healthy new year.

Martina

Tuesday, September 7, 2010

Today is the beginning of Week 2!

Toren is resting quietly. It is 7am... he had two wonderful nurses with him last night. The care here is amazing. While he had his morning bed bath, etc. they wisely sent me packing... It is very hard to leave him. I did a little bit of yoga - which settled me, and then I got to walk around the block, and see the sunrise - the sky was full of pinks and purples, I even got to pet a very cute 5 month old puppy - so here we are waiting.
Toren only had one clinical seizure yesterday night at around 9pm. This is better than the night before, baby steps. His blood pressure has become a bit of an issue - it is too high - hard to know why given how many medications he needs right now to stay stable. They are treating it as needed. Even though Toren is still on the ventilator he is breathing over it much of the time... which is good, it means his lungs are working well and he is strong. Today the doctors hope to reduce his anesthesia slowly today.
Yesterday, Toren was much more active, in fact he has a restraint loosely on his left arm, because he started to remove one of his tubes!! He has moved his right arm and leg more in the past 24 hours, which is wonderful news. Also, he has opened both his eyes. While none of this is on command, it is a good start. So while the progress is slow - it is enough to keep us positive. I remind myself every day - that Toren has pulled through before, that he is strong of spirit and body, and that the prayers of many friends and family around the globe are holding us up.

It is strangely peaceful to sit here with just Toren,
Helaini left on the evening train, and will be back on Friday, it was very hard to encourage her to go... but she is holding a stake into the future, and that is so important for us all. It is hard to imagine that tomorrow is erev chag - hospital stays distort time. Friends have called, and sometimes I even pick up - but it is all about timing... nothing personal, email and blog comments are shared with Toren I am sure he can hear me on some deep level this support pulls him forward.
With love to you all - thank you for gracing our lives with your presence - we are very blessed.
We are very blessed to be here, to be so well loved.

Monday, September 6, 2010

Monday morning, bumps in the road

Good morning my friends,
Just before our Indian food arrived, Toren had another clinical seizure, it was mild. The doctors boosted some more phenobarb and increased the anesthesia a little higher (this is the propofol we are trying to wean him off). He had a peaceful night until around 3am and then started to have a couple of mild clinical seizures, raising the Propofol again settled him for several hours and then at about 7am he had another mild seizure. Right now, he is resting quietly. The doctors feel we are making solid progress... with these clinical seizures and only 2 subclinical seizures overnight. Today the plan is to do nothing more - or less and see if he can be stable on these doses. Then start the weaning process again. The good news is that he is withdrawing to pain on the lower doses. This a positive for checking 'normal' brain function. He is moving his right leg a little more... so that too is progress. Helaini will go home tonight. She has classes on Tuesday and Thursdays. She will be back for the weekend. I will miss her. My mother and Marvin will come down and give me some support over the next few days. I am trying to sleep a few hours each day/night in the bed at the apartment - which helps my body. I need to start spending a little bit of time outside each day. But it is hard to leave Toren.

The weather outside is beautiful again, so I am hoping everyone can be enjoying a glorious last weekend of summer.
Helaini stayed with Toren until 4am - I got back here after 5 wonderful hours in a bed... and took up the holding of his hand, and chatting with our beloved boy.
Thanks for the well wishes.
Martina

Sunday, September 5, 2010

Sunday evening - more progress

Today has been a really good day. Only good news.
Toren is often breathing over the vent - which indicates his lungs are strong and that he is coming steadily out of the sedation. He is on about half the dose of anesthesia that he needed to be stable yesterday at midnight.... this is wonderful - we have both felt tiny squeezes of his left hand when we are holding it - this is so heart soothing for us both. Being with him we can feel his strong spirit and his determination to pull through.
The plan is to keep slowly decreasing the propofol (anesthesia) during the night, while increasing the doses of his anti-seizure cocktail! Strange Toren get's cocktails in hospital - but we are surprisingly sober. Today Fiona stopped by with more liquids - and bless her - clean laundry!!
Eve and Elliot visited and that was lovely - they brought more books to read. Our friends from Shul the Silverman's were also here - being a very generous gift from the Sisters Ami. We feel so very supported.
Yesterday's visit from my friend Jonathan was very healing for me... if gave me that chance to cry just enough to take deeper breathes. Lisa and Fiona were amazing. We must be one of the most blessed families. My mother will most probably come down for a visit early this week... and Marvin think's he might be able to come down and let me get a chance to sleep while Helaini is in Albany, at classes.
Each day one of us takes a long nap... we juggle our way through the night - last night I slept/dozed in the room. Helaini went to the apt at 4am and returned well rested and clean before noon... I then went for my nap and had a lovely long hot shower.
Toren radiates such a strong energy - he seems peaceful most of the time. His ability and determination to pull through fills the room. This hospital has the most caring culture. Even the maintenance staff ask how he is doing.
To all of you - please comment, send emails, it helps us to no end to be upbeat and hopeful and feel held and loved.
Bless you all.
with love
M & H

9:45am Day 6 - Good News

Good morning...
Toren has an easier night, no clinical seizures, and only 4 sub-clinicals. For the balance of the night he was stable. He is s strong, and his chest is clear and his vital signs are solid. There was some concern about the bladder/kidneys - but in the end it was just the Foley that needed to be replaced.
This morning the Epilepsy Doctors decided to start to very slowly reduce his anesthesia. He appears to be tolerating the changes... this is wonderful progress and we are so relieved and grateful. We know there is still quiet a journey ahead of us, but this is the first step... and one we were not completely certain we could get to.
The two nurses in the last 24 hours have been amazing, attentive, proactive and wonderfully compassionate as well as intuitive. It is exciting to see the powerful impact of a cohesive and dedicated team. They are so very good at including the family.
The lead doctors on the case gave us cell phone numbers to reach them directly for when things got rough, and we not only used them, but were thanked for doing so!!
We are in the right place, with Toren's angels in overdrive.
For your, prayers - messages - emails and blog comments - which we share with Toren - thank you all... it makes such a difference - it is easier for us to respond to writing communications than phone calls - after all this is ICU - and we have been engaging with a significant number of talented medical professionals!!
lots of love
M & H -

Saturday, September 4, 2010

11pm Saturday Night... its been a rough day.

All day today we have cycled from relief to anxiety and back again. The medical team have been trying to managed the seizures and with each change(increase) in anesthesia and anti-seizure medicine they make progress for several hours as many as four - and then the tide turns and the dragon rears its head again, and Toren's seizures break through the medical barrier... and the team consults and explains and makes significant increases in dosage and Toren's brain and body get some respite before the fight begins again. Helaini and I are both sleeping here in the room tonight. The doctors have already put a plan in place for the next onslaught if it comes. We feel your prayers. We had visitors today, lots of powerful and positive messages and support... I will share more about the day next time we write. Wishing you all a peaceful start to your week.
All our love,
Helaini and Martina

Shabbos - Day 5

Dear Friends,
It is shabbos morning. Marvin stayed with Toren until 3 or 4 am - all seemed quiet. He stopped by before he left. His being here allowed Helaini and I get to a decent enough night's sleep. And for that we are very grateful. I got here a little after 8:15 and Toren has been having clinical seizures even on the propofol and fentanyl - these are anesthesias. He has had 12 clinical seizures since then... 9 in half an hour and then the doctors increased the propofol and he has improved. Now he has had 3 in the past hour. The team is consulting and studying the data to decide how to proceed.
We are understandably anxious
Prayers are welcome

Friday, September 3, 2010

Friday 4:30pm - News from the OR

Toren went into the OR today deeply sedated and still seizing. The hope was that a short time on anesthesia would break the seizure cycle. After quite a few hours of trying the dedicated team was not able to keep him seizure free. So as I write the wonderful Dr. Doyle is completing the removal of the electrodes, and doing the bone work to close up the openings in the skull.
The experiment gave us more information, however, it was not the information that we had hoped to receive. While Toren had the resection on Tuesday, it was not sufficient to stop seizures, and the remaining seizures are defuse scattered around the whole left side of the brain. Far too many important valuable areas of the brain to allow for further resection to be considered.
What does this mean... well it is early days yet.
First we get him stable and recovered from these challenging days... we take stock, we change the medicinal cocktail.
We are so disappointed, and sad... and yet we remind ourselves... that a change has happened in the brain, and Toren has a brain that is highly reactive to change... it is dramatically reorganized differently than the 'standard' brain... maybe with time, another reorganization will take place and Toren will heal with the same miraculous gift that has graced our lives until this point.
Toren has gone through so very much, and the loving supportive community around us has held us up.
Thank you for all you have given us.
Shabbat Shalom
with love
Martina & Helaini

Still in the OR - NO SEIZURES

The waiting game continues...
Now having stopped the seizures with high and fast doses of Anesthesia the team wants to try and wean him off very slowly and see if Toren's brain remains quiet. If that works they will keep the electrodes in place... Otherwise they will need to remove the electrodes. Your prayers for the highest and best for Toren - and continued skill and wisdom for his medical team would be greatly appreciated.
With love
~Martina and Helaini

Friday morning - back in the OR

Dear Ones,
We are waiting in the recovery room. They decided to take Toren back to the OR to try and stop the seizures with General Anesthetic. If it works they will keep him under and on a vent for 24 hours and then start to lift the sedation and assess the state of his brain/seizure function. If they can't stop the seizures then they have to remove the electrodes and close the brain - we remain confident that this team is exactly who should be working with us. Please keep Dr. Doyle, Alison and all the team in your prayers and hearts. We are grateful to have you behind us, sending love and light.
Fiona and Lisa where on point to support me yesterday, plying us with food and companionship. Helaini is back in NYC having jumped on the bus last night... she is full of positive energy even on very very little sleep.
Jonathan was willing to be a sounding board for me very early this morning.
Marvin is going to come down for a visit today, which will give Helaini and I a chance to breathe some fresh air before he goes back home to be at work early tomorrow morning.
I will post again soon.



Thursday, September 2, 2010

48 hours after surgery

Toren is resting, in a deeply drugged sleep. It is almost 11pm on Thursday night... we are back on the Epilepsy floor - in the same 4 bed nurse monitored unit as last time. We are in the other window corner. The doctors are working diligently to stop the endless seizures... to quieten the brain and in essence let is reset - much like rebooting a computer. This team of doctors and nurses are amazing, the open interactions, the questioning of the situation, the willingness to explore all the options, the humility is awe inspiring. Even while the doctors remain very concerned, I feel this sense that we are walking the right path... he looks to healthy and strong... all his vital signs are perfect, and yes it is alarming that the seizures remain so out of control. So fear or faith, it is a choice, I choose faith.
We have come so far,

Day 3 - Thursday Sept 2nd -More Info

The plan as of now...
Somehow stop the seizures - more medications... let Toren's tired brain and body rest for 24 hours and then slowly peel back the medications so that he can seize again, hopefully with a clearer pattern, similar to his prior seizure pattern and then the doctors can come up with a plan of action. Mapping, further resection/s, vassal dilator, etc. etc.. Because of the Tonic seizure activity we are staying up on the 12th floor - Neuro ICU - at least for the time being.
Your prayers and messages make a significant difference. I am in awe of the staff here. We are so very blessed to be in this place, supported by all of you, seen and unseen... and in so many different ways.
I find myself in a place of strange peace, the knowledge that we are doing what we can, and that God will handle the rest is soothing. The unseen - ness of this path we travel is its own strange blessing. The candor and inclusive style of Dr. Carlson and Dr. Doyle and his NP Alison is truly inspiring. However, this journey plays out. I know without doubt that angels are walking the path with us, and that we are held up by the love and kindnesses of so many.

Day 3 - Thursday Sept 2nd

It is Thursday morning I started writing this at 8:30 - but have been fortunate enough to have various meetings with doctors and nurses. Right now at nearly noon, Toren is sleeping quietly even though he is have a lot of sub-clinical seizures - which means we can see the seizures on the EEG but not in his body. He fairly well drugged up with sedatives, anti-seizure medication and pain killers, topped off with some antibiotics and medicine to lower his blood pressure. He has been so kind and brave, but is obviously periodically very uncomfortable physically and emotionally.
It was another long night. Toren has been having increasingly longer and more frequent mild seizures.. so the doctors can collect lots of data and that will help them figure out how to address the 2nd and maybe 3rd focal point/s. Toren had a restless night, but still managed to get some real sleep. He is still unable to move his right side in any significant way.
We remain confident that this is not the result of a stroke... they did all the MRI/CAT scan's yesterday and right after surgery. We have seen this before after seizures... how much rehab it will require remains to be seen... but we know that Toren is determined and strong.
He is still unable to really talk, but lets us know he has needs (and we are often able to understand what to do for him).

Toren gives waves to all who enter, and hugs to many of his favorite nurses. He enjoys holding hands and giving us hugs. He is often aware of the onset of the seizures, and lets us know with sounds, or hand waves.

Helaini and Mummy left yesterday early evening and Fiona spent most of the evening with me, plying me with liquids, foods and much needed distractions. I am so lucky to have friends who have been email, commenting, texting, phoning and visiting. It helps.

While I am rather tired (Fiona will come in this afternoon to give me a chance to go back to the apartment to sleep.

Toren's drains are out - which is a good thing - I got to help by holding his good arm - it was my work out for the day. His doctors and nurses have been so wonderful and supportive and clearly remain determined to keep me involved in the conversation about what to do next.
It is strange to say - but brain surgery and post operative experiences are not as horrific as I had imagined. In my world I feared it would look a lot like our crisis in the ER and ICU after an uncontrolled episode... He is far less uncomfortable, and less vulnerable. more later

Wednesday, September 1, 2010

The Morning After the Surgery

Is it 11:30am... I have finally made it back to the apartment to take a break, and get a little sleep. Helaini and Mummy are with Toren, bless them.
Toren had a rough night... he didnt get to recovery until around midnight. The surgery went well. All the grids, stripe and probes are appropriately in place. The left front temporal resection was also completed successfully. The was some complications upon waking him. He was hard to rouse... very hard, enough that the did an emergency CT scan before bringing him to recovery. He is post seizure... that was the problem. He has what we hope is only temporary loss of mobility in his right leg and hand, he is struggling to speak, but has said, YES, NO, STOP, MOVE and OK - and clearly recognizes his family and reaches for us, and hugs us with his good arm. He is in a lot of pain, which the doctors are trying to manage. He is clearly confused, and exhausted, Thank God however, he is stable... now we wait for more seizures, to get more data about the 2nd focal point. He is still in Neuro ICU and we might move to Epilepsy floor later today, or tomorrow... For added excitement he lost his IV access at about daybreak... and it was impossible to find another vein.... okay they found one, but it only lasted 5 minutes. So then we went down with Alison, Dr. Doyle's very wonderful and capable NP and got a PIC line put in... and then to MRI just to check how things look today.... Now that he has a line in, he can get his medications.....
The left side of his face is swelling slightly....but his color is good and he often reaches for us, to give us a hug to his chest.
Thank you for all your well wishes and prayers... we will keep you posted

Toren's surgery was successful. He is stable, although he has had a rough night, and is in the Neuro ICU. As soon as Martina gets a chance, she will blog more details.
- Fiona