Day 87 (Nov 17)

Tobias was in better form today.  He had two periods where he was mouthing words with regularity and he passed his next swallowing test.  The speaking periods only lasted for a few minutes and he fell back into a staring stupor, but today was a better day than yesterday.

Tobias had most of his therapy sessions in the morning and so the afternoon was free.  The therapies exhaust for him so I let him sleep for an hour when he returned.  He didn't eat much for breakfast or for lunch.  I wasn't around to see why he didn't eat breakfast, but I think he was too tired to eat much at lunch.

Two speech therapists participated in Tobias' therapy today.  They administered the swallowing test where they drop a camera down his nose to watch his ability to swallow as they feed him foods with different textures and consistencies.  They were visibly surprised at how well Tobias swallowed.  The lady running the camera kept calling me over to point out how nothing was left in his oral cavity and throat when he swallowed.  During his last test he wasn't able to clear everything and he even aspirated some liquid and food into his lungs without coughing.  Tobias did so well that he was given the all-clear to drink normal liquids.  His prior beverage clearance was restricted to thickened juices, now he can have pretty much anything.

Today was sunny but cold with a gentle winter wind that left a taste of freshly fallen snow in my mouth.  I took Tobias for a walk outside and it felt like I was walking from the car to the ski slopes.  The cold air felt good in my lungs and reminded me of skiing down snowy slopes with Tobias and the rest of our family.  Tobias' condition has made me grateful and more cognizant for the good memories we share.  We were both bundled up warmly and the hospital keeps blankets in a heated cabinet for patients.  I took two of the warm, folded blankets and set one still folded on Tobias' lap and spread the other over his legs and waist.  I checked him after 20 minutes and the folded underblanket was still warm.  I was a little jealous.  There is a 50 yard stretch between the rehab hospital and the next building where the sun shines on the sidewalk.  Tobias and I wandered this section of the sidewalk for an hour like animals caged by the cold in the sun.  It was distinctly colder and less comfortable when walking on the sidewalk where the buildings blocked the sun.  I was glad for this passage of sidewalk, but I wish the hospital would arrange for a better walking trail for patients.  There are precious few options and getting patients out in the fresh air can only be beneficial.

Tobias was wide awake again for the episodes of Psych that I put on for him.  He fell asleep at some points, but for the most part he was both eyes open.  His evening meal came at 5pm and I fed him as soon as it came.  He was awake and started eating like he was hungry.  I was surprised at how well he ate.  I started with pudding, jello and mixed berries.  He swallowed everything with no coughing and very little hesitation.  After his swallowing improvement he has been cleared for "level 5" foods, which means that the food is no longer pureed.  It is now either chopped up or is soft enough to be easily chewed.  The peach cobbler is real peach cobbler and he had some vegetarian lasagna that was chopped up.  I fed him some peach cobbler and lasagna and these seemed to stop his eating momentum in its tracks.  I had to suction his mouth out and start again.  About this time I noticed that he had soiled his brief so I stopped feeding him and called the nurses aides to get him transferred from the wheelchair to the bed for a fresh brief.  Once he was settled again I went to feed him again, but found that one of the aides had cleaned away his food.  The nurse was kind enough to bring me some apple sauce, pudding and cranberry juice, which Tobias did well with, but he did the best with the regular cranberry juice.  It was a lot easier getting him to intake and swallow the normal juice instead of the thickened version.  It still took some coaxing and waiting, but he ate the "easy" stuff better than he has in the past.  He may have had some help eating the pudding.

Tobias seemed to be in good spirits after eating and watching Psych and he started answering all my questions with only a short delay.  He was even vocalizing on most of his words.  Katja stayed home today to finish her thesis for the degree that she has been working on for several years.  Today is the day that she submitted her final requirements towards her degree.  I called Katja on Facetime and she and Tobias spent time together virtually.  He was staring intently at the phone and answered her questions.  He lost the ability to vocalize, but was mouthing the words clearly.  Then it was all gone and he just stared off at the wall.

Today was definitely a good day.  In reality his abilities today are close to what they were yesterday, but the slight differences get exaggerated in my estimation and make days like today special and memorable.  Today is "Regular Beverage and Chopped Food Day"

Hope over fear.