Therapy

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Next morning
I woke up to Nat checking on me
Gabby- morning
Nat- good morning!
She took me off bi-pap since I was awake and kept checking everything. She gave me all the morning meds and hooked me back up my feed.
Nat- what do you think of the new formula so far?
Gabby- better
Nat- I'm going to increase your feed rate then but just let someone know if you need it lowered again.
Gabby- ok
Nat- ok, time for braces then your chair, you have speech soon.
Right, I start speech today, no clue what's going to happen with that. Nat gets my braces on, it's been a lot easier since the Botox. Then a nurse came in to help get me in my chair.
Nat- ok, I think you're good. Suction, oxygen and vent are all on the back of your chair
Gabby- I don't need vent or oxygen.
Nat- it's your first time doing speech, you're bringing all the stuff
Gabby- fine
Nat- and I'm being paged, someone will bring you to speech in a few minutes.
She ran out and a few minutes later a nurse came in. I don't know any of the nurses here since I just moved last night.
Nurse- hi I'm Jen
Gabby- hi Gabby
Jen- right, you just got here
Gabby- yesterday from ICU
Jen- ok, sorry I haven't had time to read all the charts this morning.
Gabby- it's fine, paperwork sucks
Jen- what do you do that involves annoying paperwork?
Gabby- I was PIC on ambo 61, then firefighter then working in Puerto Rico
Jen- wow, what brought you back to Chicago?
Gabby- brain injury
Jen- oh sorry, you came to Med from Puerto Rico?
Gabby- yes. 10 weeks ago
Jen- wow, you've been her for a long time.
She starts bringing me to speech.
Gabby- ya. 3 weeks coma lots of complications finally out of ICU
Jen- ok now I have to read your chart!
Gabby- it's very long
We get to the speech room
Lisa- hi Gabby
Gabby- hi
Jen- I'll see you later
Gabby- bye.

Lisa- ready to get started?
Gabby- what are we doing
Lisa- you're going to try a passy-muir valve, a speech valve. First we're just going to see how you do breathing with it on, then maybe see if you can make any noise.
Gabby- ok
She puts this little purple thing on my trach. It feels weird
Lisa- how is it
Gabby- weird
Lisa- breathing ok?
Gabby- I think so
Lisa- ok, just take a few minutes to adjust to it. How's the eye gaze
Gabby- good, I learned where things are it's faster.
Lisa- good, anything you want to change about it?
Gabby- it's fine, just hard. I could speak 3 languages before, now just one.
Lisa- I know. There are AAC systems in different languages, we could look into that.
Gabby- no. I just want to sign for Shay.
Lisa- I know. Are you ready to try some stuff?
Gabby- yes
Lisa- ok, just try to make a sound.
I tried for a while, after a few minutes I made a bit of a sound.
Lisa- good, can you do more?
I tried again and my head fell because I was focused on making noise. Lisa picked my head up.
Lisa- how about we use the head supports so you can focus on making sounds
Gabby- ok
She flipped the head supports down, I haven't used them in weeks. After a few minutes I managed to make a sound again. Lisa was giving me tips on what to do and I made noise a few times but it was really quiet and I couldn't control what sound I made. Then I started choking.
Lisa- ok, just breathe, I'll get the suction
She suctioned my mouth and I stopped choking.
Lisa- can you be any louder?
Gabby- don't think so
Lisa- ok, we'll keep working on it. We'll also do some activities to work on relearning how to chew and swallow and once dr Rhodes says it's ok for your stomach you'll do a swallow study and if you pass you can start eating.
Gabby- wow ok
Lisa- it will be slow, even if you pass the swallow study it will take a long time before you can eat enough by mouth to not need the tube and liquids are really hard. Honestly, and it's still early so I'm not sure, but you might always need the g-tube at least for liquids.
Gabby- ok
I was not expecting that. She was talking about getting me talking and eating and all these good things then just suddenly you might never be able to drink again. Obviously I know that I might not get back to where I was before, it's always in the back of my mind but people don't usually just state it like that.
Lisa- sorry, I just don't want you to get your hopes up. Aspiration is a big risk.
Gabby- I know. I just don't like thinking about it.
Lisa- you don't need to worry about the long term effects right now. There's no way of knowing yet.

I finished speech and went back to my room until I had PT. I got to keep the speech valve on since I was doing fine breathing with it. Kidd and Brett came to visit for a while which was nice. At PT they got me on the treadmill again with them moving my legs.
Kate- now I want you to try to move your legs to take a step.
I tried and it just made them even tighter.
Kate- it's ok, that's normal. Just doing this where we're moving your legs is going to help retrain your brain on how to do this movement.

After the treadmill they moved me back to the table and tried more sitting which still didn't go very well. Then they laid me on my stomach over a peanut ball, that's what they called it, it's a weird shaped exercise ball. On the ball they had me in a crawling position trying to get me to hold that position and also lift my head up off the ball. I got my head up briefly a few times when someone held my hands against the ground. Then I went back in the stander, which I could now stand straight in, for half an hour. Back in my room I fell asleep.

A/N
Sorry I haven't been posting as much, I've been really busy with school and work. I have a lot written I just need to remember to post!

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