Corporate Liberal

Jody recovery report #4

For those who are just joining us, my wife, Dr. Jody Kaufman, was severely injured when she was thrown from her horse at a riding event in Rochester, NH on September 12th. She has significant degradation of sensation and voluntary movement in all extremities. MRI and CT scans showed degeneration and narrowing of the spinal canal, instability of the anterior longitudinal ligament which was displaced around vertebrae C5 and C6, disruption of other ligaments, and fractures of some of the spinous processes in that area. She also had minor facial injuries.

Jody had surgery to repair the fractures and ligament damage, stabilize her spine by fusing vertebrae C4-C6 using pieces of bone from her hip, and relieve the pressure on her spinal cord.

Status

Jody is at HealthSouth Rehabilitation Hospital in Concord, where she is expected to remain for about a month. The idea is that she will then be able to return home and continue her recovery on an outpatient basis.

In the past two days Jody has emerged from what she called the “black hole” of pain, wooziness, and nausea she had been spiraling around in for the previous week. Her appetite has improved considerably. She is markedly stronger physically and is much more engaged with what’s going on around her. Needless to say I am very relieved.

The urinary tract infection Jody developed earlier has resolved and she is no longer symptomatic. She has developed a minor rash which is likely an antibiotic reaction, so the drug therapy has been discontinued. We’ll keep a close eye on this as long as Jody continues to need catheterization. (I had no idea how much harder it is to catheterize a female than a male of the species. Rediscovering her sphincter will be a major milestone in Jody’s recovery!)

The pain in Jody’s left shoulder has improved and she has a bit more strength and voluntary movement in that arm. (Kudos to the staff physician who was sure this was going to happen eventually, and who therefore resisted the more aggressive treatment options that had been advocated with increasing stridency by the patient’s husband.) The pain made it difficult to exercise the arm but now that Jody has seen some improvement there I think progress will be more rapid.

Jody has quite a bit of vertigo when she moves or tries to focus on moving objects. There is some thought that the vertigo may be caused by a little particle in her semi-circular canal that will be easily resolved once she can turn her
head in all directions. Jody figured out that the progressive lenses in her glasses were at least partly to blame — she can’t easily move her head to align the appropriate part of the lens with whatever she’s looking at. Removing her glasses when she’s moving has helped.

Jody still can’t quite swallow normally, but at this point the tight cervical collar she’s wearing probably has as much to do with that as any remaining post-surgical inflammation.

Treatment

Jody is receiving intensive physical and occupational therapy seven days a week. Yesterday she walked about 150 feet in a walking machine. She’s been doing a lot of range of motion exercises to help relax muscles stiff from disuse. She requires less pain medication than previously and has been using a patch to help control her nausea. She’s getting frequent massages from our wonderful friends and these have helped control the intense “pins and needles” sensation in her limbs.

Prognosis

Unchanged. I am increasingly optimistic that Jody will make a complete recovery, but it will take 3-18 months to achieve and will require a tremendous amount of work. Now that Jody’s usual iron determination has begun to reassert itself I have no doubt that she’ll do whatever it takes to get her life back.

Asks

Many, many people have called or emailed asking what they can do to help us and we are very grateful for all of your support.

Jody seems to find fresh foods most palatable. The delicious soups that people have been bringing her have done more to catalyze Jody’s recovery than any amount of drugs or therapy possibly could have. Thank you all so much, and please keep it up. Solid constituents still need to be small so she can swallow them easily. Do remember to check with me first so we don’t get everything at once!

There’s no better example of the wonderful network of friends we have around us than my request to have our road cleaned up a few days ago. Several people have reported that they went over with trash bags shortly after receiving my message but found the road in pristine condition.

Those who want to help but haven’t yet found a way to do so should keep in mind that we are going to need a great deal of help around the house once Jody comes home from rehab in a month or so.

Calls, visits

Thanks to everyone for keeping your calls and visits brief. As much as Jody appreciates them, talking really tires her out. The hospital has installed a speaker phone that answers automatically so Jody can now receive calls even when no one else is there to pick up the phone. The direct line to her room is 603-226-9718.

Thanks

Once again many more people deserve thanks than I will be able to remember. They include Andi Axman, Debbie Bauch, Don Carignan, Jessica Chasney, Melissa Crespy, Margaret Dellacona, Merril Dwyer, Diane Eagle, Susan Fockler, Sen. Maggie Hassan, Carl Hefflefinger, Carol & Lee Hodsdon, Elena Jespersen, Andrea & Mike Lariviere, Ursula Mackey, Polly MacMullen, Sue Mitchell, Sarah Nolan, Dr. Sally Oxnard, John & Alison Parodi, Charlie & Joanie Pratt, Felicia Pratto, Drs. Mark & Leslie Prescott, Nolan Ring, Amy & Brad Robinson, Mary Robison, Martha & Leo Roy, Emily Schmalzer, Andy Silva, Ken Smookler, Meredith Stolper, Molly Supple, Pooh Vanderzanden, Diantha Wade, Joanie Webster, and Ellen Wight.

Several people were curious about the inclusion of Sen. Hillary Rodham Clinton on this list last time. Sen. Clinton called me to ask after Jody and placed her NH campaign staff at our disposal. It was a very gracious gesture that I will remember for a long time.

Forwarding and mailing list

Please feel free to forward this message in appropriate ways. If you received this from a friend and would like to be added to the mailing list for future updates, or to be removed from the list, please email me at roger [-@at@-] rogergoun.org.

Jody recovery report #3

For those who are just joining us, my wife, Dr. Jody Kaufman, was severely injured when she was thrown from her horse at a riding event in Rochester, NH on September 12th. She has significant degradation of sensation and voluntary movement in all extremities. MRI and CT scans showed degeneration and narrowing of the spinal canal, instability of the anterior longitudinal ligament which was displaced around vertebrae C5 and C6, disruption of other ligaments, and fractures of some of the spinous processes in that area. She also had minor facial injuries and may have an entrapped nerve in her left shoulder.

Jody had surgery to repair the fractures and ligament damage, stabilize her spine by fusing vertebrae C4-C6 using pieces of bone from her hip, and relieve the pressure on her spinal cord.

Status

Jody has been at HealthSouth Rehabilitation Hospital in Concord since Friday. She is expected to remain there for about a month. The idea is that she will then be able to return home and continue her recovery on an outpatient basis.

Unfortunately the medications needed to control her pain tend to cause nausea, the anti-nausea and anti-spasmodic drugs cause drowsiness, and the whole cycle has greatly reduced her appetite. As a result she has lost a lot of weight, and if you know Jody you know that she doesn’t have any body fat to lose, so she’s been burning muscle tissue instead. Needless to say this is a Bad Thing.

The pain in Jody’s left shoulder continues unabated and that arm has been slowest to recover sensation and voluntary motion. The local physician plans additional studies to see what might be going on there. She has developed a urinary tract infection, which will be cultured and treated with antibiotics. I’m hoping this won’t turn out to be some hospital-acquired superbug.

Jody continues to have some difficulty swallowing as a result of inflammation following surgery, but this is slowly improving. She is able to drink ordinary thin liquids through a straw and to eat soft foods and fruit with less concern about aspiration than previously.

At the hospital’s suggestion we’ve discontinued having someone stay overnight in the room with Jody. If this doesn’t work out well we’ll reinstate the overnight shifts. Thanks so much to everyone who has volunteered — it’s been an enormous relief to both of us to know that Jody hasn’t been left alone during the initial stages of her recovery.

Treatment

Jody is receiving intensive physical and occupational therapy seven days a week, and has made considerable progress. She spends a few hours a day sitting up in a reclining wheelchair. Four days ago she was sitting on the edge of the bed supported by three therapists; she looked like a rag doll. Today she did it with only a therapist’s hand behind her back for balance.

The clinicians are trying to find the right combination of drugs on the right schedule to control Jody’s pain and nausea. This seems key to continued progress.

Prognosis

Unchanged. I remain cautiously optimistic that Jody will make a complete recovery, but it will take 3-18 months to achieve and will require a tremendous amount of work.

Anecdote

While under the influence of all manner of potent pharmaceuticals, Jody recited her email address and then said, “The horse trailer’s registration is nine months overdue, and if Donnelly [her pony] is going to be arrested I want him to be wearing his green sunglasses.”

Asks

Many, many people have called or emailed asking what they can do to help us and we are very grateful for all of your support.

Jody seems to find fresh foods most palatable. Last night she ate quite a bit of some tomato cream soup that our friend Ellen made for her using tomatoes from our own garden. We would really appreciate it if folks could bring over some tasty fresh soups packaged in small quantities. Solid constituents need to be small so she can swallow them easily. Please check with me first so we don’t get everything at once! We really need to stop this weight loss and help Jody regain her strength and I’m sure we can do that if we can just get her eating semi-normally again.

I haven’t been able to pick up trash along the dirt road leading to our house for a while and it’s starting to show. Would love it if someone from the neighborhood could walk the road now and then and help keep it picked up.

Calls, visits

Thanks to everyone for keeping your calls and visits brief. As much as Jody appreciates them, talking really tires her out. The direct line to her room is 603-226-9718. She can’t pick up the phone yet, so if no one answers on the first few rings please hang up and try again later.

Thanks

So many people have been so kind to us over the past several days that there is no hope that I will remember to thank them all. Prominent on the list are Janet Atkins, Andi Axman, Debbie Bauch, Barbara Binder, Kate Binder, Heather Carley, Jessica Chasney, Sen. Hillary Rodham Clinton, Bruce Coy, Bruce Dawson, Diane Eagle, Brandy Gentry, Bobbi Jameson, Pamela Kaufman, Terrence Kirby, Dr. Kate Lawton, Toni McLellan, Kim Meyer, Carla Nino, Sarah Nolan, Amanda & Marty Northrup, John & Alison Parodi, Charlie & Joanie Pratt, Drs. Mark & Leslie Prescott, Muffy Prescott, Karen Prior, Nolan Ring, Amy & Brad Robinson, Martha & Leo Roy, Rep. Carol Shea-Porter, Carole Soule, Kimberly Stinson, Molly Supple, Sue Sutch, Dick & Katrina Swett, Barry Tannenbaum, Pooh Vanderzanden, Patti Vieira, Ellen Wight, Dr. Mark Windt, Rob Wofchuck, and the anonymous person who has been leaving delicious dinners on my doorstep every evening before I get home.

Forwarding and mailing list

Please feel free to forward this message in appropriate ways. If you received this from a friend and would like to be added to the mailing list for future updates, or to be removed from the list, please email me at roger [-@at@-] rogergoun.org.

Jody recovery report #2

For those who are just joining us, my wife, Dr. Jody Kaufman, was severely injured when she was thrown from her horse at a riding event in Rochester, NH on Wednesday. She is in the intensive care unit at Frisbie Memorial Hospital in Rochester, NH (map). She has significant degradation of sensation and voluntary movement in all extremities. MRI and CT scans showed degeneration and narrowing of the spinal canal, instability of the anterior longitudinal ligament which was displaced around vertebrae C5 and C6, disruption of other ligaments, and fractures of some of the spinous processes in that area. She also had minor facial injuries.

Status

Jody had surgery yesterday to repair the fractures and ligament damage, stabilize her spine by fusing vertebrae C4-C6 using pieces of bone from her hip, and relieve the pressure on her spinal cord. I spoke with the orthopedic surgeon, Dr. Dirksmeier, at length immediately after surgery and again last night. He said the surgery went “beautifully.” Jody had “tremendous” pre-existing arthritis in her spine which contributed to the severity of her injury. Her C5-C6 space was “completely disrupted” and has now been “all cleaned up.” Spinal cord monitoring was stable throughout the procedure. He felt certain that the shoulder pain she was experiencing was referred pain from the spinal injury and not an indication of a shoulder injury.

Immediately after surgery Jody had slightly less sensation and voluntary motion than she had had before surgery, but she was barely conscious and nobody was much worried about this. She had an extremely difficult afternoon and evening but eventually the nurses were able to adjust her position and her meds to make her more comfortable.

Once that happened, Jody’s improvement was amazing. She was able to press hard with her feet (the left still lagging the right), extend her fingers a bit for the first time since her injury, and her shoulder pain abated as predicted. Most striking, all at once her voice became so much stronger that for a moment I didn’t realize it was she who was speaking.

Treatment

Jody will continue to receive large doses of steroids for the next couple of days and then will receive a diminishing dose for a while longer.

Assuming no problems crop up, she will begin a program of intense physical and occupational therapy today. In a few days if her condition is stable she’ll be moved to an acute rehabilitation facility specializing in recovery from spinal cord injury, where she will continue to receive intensive therapy until she’s well enough to come home and continue her recovery on an out-patient basis.

On Wednesday, my sister Debbie, Jody’s sister Carla, and I will tour possible rehab facilities and fill Jody in on what we learn so she can make an informed decision about the next step in her recovery.

Prognosis

I remain cautiously optimistic that Jody will make a complete recovery, but it will take 3-18 months to achieve and will require a tremendous amount of work.

Asks

Many, many people have called or emailed asking what they can do to help us and we are very grateful for all of your support.

We continue to need overnight coverage at the hospital to allow me to get some sleep while ensuring that Jody is never left alone. If you can do an occasional 4-8 hour overnight shift please send an email to let me know. I’m trying to torque my sleep cycle around so I can leave a little earlier in the evening and return to the hospital earlier in the morning, when Jody is less tired. To support that I’d like to try to change shifts earlier than we’ve been doing so far - 6:00-7:00pm, say. But if you’d like to volunteer and can’t get there that early, I’m happy to be flexible on shift start and end times.

Currently we need to fill the overnight shifts on Sunday, 9/23; Friday, 9/28; Sunday, 9/30; and every night thereafter.

I’ve set up a Google Calendar so potential volunteers can easily see which nights are still available. (I know: I’m a geek. Sue me.) Point your Web browser at this address:

http://www.google.com/calendar/embed?src=6986bd9i3g8tmmjq98n6u23a6o%40group.calendar.google.com

You can also view the calendar through a feed reader at this address:

http://www.google.com/calendar/feeds/6986bd9i3g8tmmjq98n6u23a6o%40group.calendar.google.com/public/basic

Or using an iCal-compatible calendaring program at this address:

http://www.google.com/calendar/ical/6986bd9i3g8tmmjq98n6u23a6o%40group.calendar.google.com/public/basic.ics

If you don’t know what any of this means, don’t worry. Just send me an email.

Other requests:

The hand controls in my ancient Volvo are nearly unusable right now. They need (at least) to be disassembled, cleaned, lubricated, and adjusted. I’m looking for someone to take the car to Londonderry (it can be driven normally with the foot pedals) and bring it back, either waiting for it or bringing a friend along to bring you home and then going back for it when it’s ready. (Pickup and return can be done by different people, of course.) If you’d like to do this, let me know which dates in the next few weeks you’re available and I’ll try to make an appointment that works for you.

Here’s where it needs to go:

Ride-Away Handicap Equipment Corporation
54 Wentworth Avenue, Londonderry, NH
(800) 237-7979

Also, a wiring problem in the car’s tailgate is screwing up the high brake light, so it won’t pass inspection. My father suggested that it might be possible to fix the problem easily by running a wire off one of the other rear brake lights. If you or someone you know is familiar with ancient Volvo electrical systems, please let me know.

Calls, visits, gifts

Jody loves getting calls and visits from friends, but I have to caution everyone that some of the calls have gone on too long and have tired her out and sometimes interfered with her medical care. Please be sensitive to this. The phone number in ICU is 603-335-8175.

Flowers are officially banned from ICU. The staff has been letting them in (and they’re lovely!) but there isn’t really a lot of room in Jody’s ICU bay for them. If you really want to send Jody something, yummy treats that encourage her to take on the calories she needs might be a good choice.

Anecdote

One of the ICU nurses told me the following story, which might even be true.

A 12 year-old girl got dizzy on a diving board, fell, and landed on the edge of the pool. She didn’t move a muscle for six months, but one day she twitched a toe. They threw a party. She came back to visit the ICU recently. She’s a nurse now.

Those of you who have not yet had a good cry over all of this may now proceed.

Thanks

Many, many people have been amazingly kind and helpful to us, and I can’t begin to thank them all. Most recently they have included Debbie Bauch, Jessica & Kelly Chasney, Pete Clark, Diane Eagle, Dr. Kate Lawton, Kim Meyer, Sue Mitchell, Dr. Sally Oxnard, John Parodi, Drs. Mark & Leslie Prescott, Dr. Jennifer Raaf, Nolan Ring, Amy Robinson, Martha & Leo Roy, Emily & Victor Schmalzer, Rep. Carol Shea-Porter, Jean Stearns, Molly Supple, Pooh Vanderzanden, Ann Wicander, Ellen Wight, and Dr. Robin Zuckerman. Abject apologies to everyone I’ve inadvertently left out.

Forwarding and mailing list

Please feel free to forward this message in appropriate ways. If you received this from a friend and would like to be added to the mailing list for future updates, or to be removed from the list, please email me at roger [-@at@-] rogergoun.org.