Greetings everyone from Bryant Park in NYC,
Here is Merwin again and it appears that I have been successful in getting started on Bernice's blog from the exotic location of our little studio apartment that overlooks the verdant lawn and trees of Bryant park. I have been sleeping over here since Tuesday the day after Bernice was admitted to Mt Sinai hospital. I know that everyone is anxious to hear the latest on Bernice's condition. Harvey has been posting a daily email to immediate family and I excerpt the following from today:
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Bernice/Baba/Mom has pulled up out of the valley she has been in for the last few days. She has more energy today, can breathe more effectively, her foot and leg swelling is down and most importantly she stated: "I'm looking forward to getting back to my Shakespeare work!" I take this last comment as an important indicator of a significantly improved state of mind and attitude.
On the more concrete level her white blood cell count (WBC) continues to drop, her kidneys continue to remove her excess water, and her pain is being managed. The challenge now is to coordinate all the caregivers so we end up with a discharge strategy and plan once she gets back home. That is starting to gel, but has not been fully implemented yet.
As many of you may know, doctors tend to work in their spheres and it takes a conductor to bring them all together. We shall see how the music plays out.
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I can add a couple of additional medical observation. To reduce her WBC she was given a strong shot of her regular and this drove the value down from almost 190 to 185 but also reduced her hemoglobin to a low enough level to make her anemic. This is all a delicate balancing act and will take some medical artistry to align and balance things. To bring her hemoglobin back up she was getting a transfusion as I left her tonight. Teams of doctors consult with each other and coordinate their efforts under Bernice's hematologist Dr. Mascarenhas (a superb doctor and a favorite of ours). There is a pain management team, a pulmonary team, and the physical therapy people. Having Harvey around is a big help in many ways. he doesn't at all push the fact but his being an MD/PhD from Yale is noticed and (I feel) probably is improving the attention and care.
Harvey has been staying with long-time friends who have an apartment within a 20 minute walk to the hospital who have a spare bedroom with its own bath. They are both doctors working in some other NY hospital. Interestingly, Harvey ran into two of his former residents now on staff at Mt Sinai.
It takes me about 30-40 minutes to travel by subway from our 40th street apartment to the 100th street location of the hospital. One indication of how Bernice's spirits have been lifted in the last three days is that she asked me if I had brought her metrocard to the city with me. Why? She wants to get to the apartment when she is released. I told her that I would treat her to a cab ride. I have been making two trips a day to the hospital with welcome little nap after a lunch at the apartment.
That is it folks!
love to all,
Merwin
Wednesday, August 18, 2010
Tuesday, August 17, 2010
A hasty blog
Hi All,
A limited communication today. Harvey and Sandy did come in on the weekend and it was a great help. We got in touch with Dr Mascarenhas, Bernice's hematologist at Mt Sinai, by email on the weekend and he agreed to see her on Monday. Ordinarily he sees patients only on Tuesday and Thursday and does rounds and research on other days. Harvey drove us all in and many tests were performed. It was felt that the best option would be to admit Bernice to Mt Sinai hospital where there are droves of experts who will consult and look at her. We have enormous confidence in Dr. M who will be in the loop. I intend to spend some nights in our city studio apartments so will have only email there. No blogs for awhile.
love to all,
Merwin
A limited communication today. Harvey and Sandy did come in on the weekend and it was a great help. We got in touch with Dr Mascarenhas, Bernice's hematologist at Mt Sinai, by email on the weekend and he agreed to see her on Monday. Ordinarily he sees patients only on Tuesday and Thursday and does rounds and research on other days. Harvey drove us all in and many tests were performed. It was felt that the best option would be to admit Bernice to Mt Sinai hospital where there are droves of experts who will consult and look at her. We have enormous confidence in Dr. M who will be in the loop. I intend to spend some nights in our city studio apartments so will have only email there. No blogs for awhile.
love to all,
Merwin
Saturday, August 14, 2010
Never Ending Adventures?
Hello All,
Merwin still at the keyboard. As I reported earlier, Bernice returned home from Rehab last Wednesday and home life has been far from peaceful since then. I wish that I could write about non-medical issues like the lovely day it is today but such choices are not always ours. On the last two days of her Rehab I felt that not only was Bernice’s mobility, getting into and out of bed and making the trip to the bathroom, not improving, but I felt it was getting worse. With the PT schedule at the hospital allowing me to visit only after 4:00 I thought that I was seeing her after a long day of effort and this explained things. At her discharge I mentioned this to the discharge doctor and he said that the PT reported she was fine and his examination showed nothing amiss. So off to home we went and I now could see that Bernice was weaker than I had ever seen her. She applied herself to the exercises she had been given and we hoped these would soon improve things. In keeping with getting into shape Bernice insisted on at least trying to do things as much as possible on her own.
On Friday in the course of moving from bed to her wheelie on the way to the bathroom, she tilted slightly to right. Ordinarily, a quick movement of her right foot to the right would have kept her upright but she continued to list and sunk to the floor. Fortunately, her only injury was a bruise to her cheek where she hit the bedside cabinet. I had been standing by but it all transpired too quickly for me to catch her but I also saw it all in a slow-motion blur. She now sat with her back to the bedside. I positioned myself behind her and soon found that, try as I might, I was unable to right her again. My injured back of a couple weeks ago probably blunted my effort. Bernice could not help. After a fruitless search for a neighbor (the young were at work and only seniors were at home) I finally called our fire rescue unit and they dispatched a policeman. A hearty young buck soon had Bernice on her feet.
I now made a number of phone calls. Our local hematologist is on vacation until next Thursday and we were not happy about trying to visit a backup. Our primary care doctor, Dr. Goldberg, a cardiologist and internist, asked us to come in at 7:30 after his last scheduled patient. Our son Dave helped in the transport and in many house tasks. Dr. Goldberg's examination showed nothing abnormal but he was concerned about her blood values and wants her to be seen by a hematologist as soon as feasible. Again, at the time of her fall on July 23 Bernice had been on a trial drug from about five weeks. Looking at what has happened to her blood values since, it seems that this drug had many benefits. For example, her white blood cell count was at 102 days before her fall and other values were in reasonable balance. Normal WBC is in a range 4 to 11. Since the fall, with no trial drug, her WBC has soared to 264 as of August 9. We will try to get into Mount Sinai and her hematologist there as soon as we can. Not being a doctor, I can only speculate as to causes for her weakness.
Our son Harvey and his wife Sandy are due to arrive here soon. They originally were going to visit our son Arthur and wife Debby in New Hampshire but changed their plans. We are looking into having an aid to help out here.
Hoping things calm down here and Bernice mends soon.
Love to all,
Merwin
Merwin still at the keyboard. As I reported earlier, Bernice returned home from Rehab last Wednesday and home life has been far from peaceful since then. I wish that I could write about non-medical issues like the lovely day it is today but such choices are not always ours. On the last two days of her Rehab I felt that not only was Bernice’s mobility, getting into and out of bed and making the trip to the bathroom, not improving, but I felt it was getting worse. With the PT schedule at the hospital allowing me to visit only after 4:00 I thought that I was seeing her after a long day of effort and this explained things. At her discharge I mentioned this to the discharge doctor and he said that the PT reported she was fine and his examination showed nothing amiss. So off to home we went and I now could see that Bernice was weaker than I had ever seen her. She applied herself to the exercises she had been given and we hoped these would soon improve things. In keeping with getting into shape Bernice insisted on at least trying to do things as much as possible on her own.
On Friday in the course of moving from bed to her wheelie on the way to the bathroom, she tilted slightly to right. Ordinarily, a quick movement of her right foot to the right would have kept her upright but she continued to list and sunk to the floor. Fortunately, her only injury was a bruise to her cheek where she hit the bedside cabinet. I had been standing by but it all transpired too quickly for me to catch her but I also saw it all in a slow-motion blur. She now sat with her back to the bedside. I positioned myself behind her and soon found that, try as I might, I was unable to right her again. My injured back of a couple weeks ago probably blunted my effort. Bernice could not help. After a fruitless search for a neighbor (the young were at work and only seniors were at home) I finally called our fire rescue unit and they dispatched a policeman. A hearty young buck soon had Bernice on her feet.
I now made a number of phone calls. Our local hematologist is on vacation until next Thursday and we were not happy about trying to visit a backup. Our primary care doctor, Dr. Goldberg, a cardiologist and internist, asked us to come in at 7:30 after his last scheduled patient. Our son Dave helped in the transport and in many house tasks. Dr. Goldberg's examination showed nothing abnormal but he was concerned about her blood values and wants her to be seen by a hematologist as soon as feasible. Again, at the time of her fall on July 23 Bernice had been on a trial drug from about five weeks. Looking at what has happened to her blood values since, it seems that this drug had many benefits. For example, her white blood cell count was at 102 days before her fall and other values were in reasonable balance. Normal WBC is in a range 4 to 11. Since the fall, with no trial drug, her WBC has soared to 264 as of August 9. We will try to get into Mount Sinai and her hematologist there as soon as we can. Not being a doctor, I can only speculate as to causes for her weakness.
Our son Harvey and his wife Sandy are due to arrive here soon. They originally were going to visit our son Arthur and wife Debby in New Hampshire but changed their plans. We are looking into having an aid to help out here.
Hoping things calm down here and Bernice mends soon.
Love to all,
Merwin
Wednesday, August 11, 2010
Homecoming
Hello All,
Pictured are the Lavin Girls. From the oldest: Grace, Kate, and Sarah. They each made colorful get-well cards for Bernice and this may have helped the healing. Their celebration was some other occasion but their joy is appropriate for Bernice's homecoming. Their mom, Sophie, supplied a number of portions of really spectacular spinach pie.
Bernice returned home today at midday and is resting comfortably in her own room now. Her two wheelies are deployed: one on the bedroom level and another on the main level. One helped her negotiate the front path to our front steps. Steps are an effort — she practiced on steps at Rehab — but her schedule of exercises should soon strengthen her. Dave helped transport things home including a toilet seat with arm rests which makes that operation safer. The intention is to have her get PT (physical therapy) at a facility in Glen Cove only about 7 miles away. After her pelvic fall last March I installed grab bars and stair railings and these are all coming in handily (if I may) now. There are new grab bars in the shower and a new shower seat also. This painful back fracture makes movement difficult and all these aids are welcome.
Bernice has not yet ventured to her computer but I sense that my blogging days may be limited. I know that she will be happy to get directly to her email instead of having me read to her in spite of her telling me that that mode is also enjoyable.
More news on her progress soon. Love to all,
Merwin
Sunday, August 8, 2010
Another weekend
Merwin still on the job.
My darling is showing signs of improvement and is looking forward to the possibility of a homecoming by midweek. As do we all. Pain remains an unwelcome companion. Bernice tried to reduce the pain meds to avoid their downside but relented on that approach and now welcomes the relief. She is catching up on her New Yorkers. Among the things I do during my visits is to read chosen NY Times pieces.
Our son Arthur, visiting for a few days from New Hampshire, left for home at 6:30 this morning. His visit was good medicine for both Bernice and myself. On Friday evening another son, Lincoln, joined Arthur and myself in an extended visit with Bernice punctuated with stories and many laughs. Afterward that night us boys continued with a dinner out. Arthur was great help in many ways. Yesterday we went shopping together and he made sure I was adequately provisioned for the coming days and he told me he would prepare dinner for us after our return from the rehab center.
Our visit with Bernice was very pleasant which included Arthur explaining many interesting details of his work which otherwise there would be little time to explore. When Arthur and I arrived home he dove into our dinner preparation. As a starter he steamed artichokes and served these with a delicious garlic butter sauce for dipping. The main course was a flounder fillet. He had to improvise for bread crumbs could not be found and he used corn meal instead. As a total loss as a cook I can attest to the tasty final product but can only describe in outline form what Arthur did to create his culinary offering. He dredged the fish in some kind of egg mixture and I learned this for there appeared on the plate beside the fish a little pancake of cheese and egg. After the egg served it purpose in cooking the fish he added cheese and created little omelets. So, I was the beneficiary of cooking skills learned early on by all our sons under their mother's firm tutelage. Bernice strongly felt that our boys should be dependent on no one and should be thoroughly knowledgeable with how to cook, do their wash, and generally take care of themselves in the home. Harvey, while in med school was asked to cater the wedding dinner for two of his classmates. At age six Bernice started a "Lincoln Cookbook" for our son Lincoln which grew as he learned how to prepare new dishes. All our boys remain skilled cooks.
In addition to cooking, Arthur also used his inventive skills in our home. The shower handle in the master bedroom had been broken and I had not yet come up with a feasible way to repair the door since no replacement parts could be found. Arthur came up with a brilliant yet simple solution and the repair is now done.
I am off for a visit to dear Bernice.
best to all,
Merwin
My darling is showing signs of improvement and is looking forward to the possibility of a homecoming by midweek. As do we all. Pain remains an unwelcome companion. Bernice tried to reduce the pain meds to avoid their downside but relented on that approach and now welcomes the relief. She is catching up on her New Yorkers. Among the things I do during my visits is to read chosen NY Times pieces.
Our son Arthur, visiting for a few days from New Hampshire, left for home at 6:30 this morning. His visit was good medicine for both Bernice and myself. On Friday evening another son, Lincoln, joined Arthur and myself in an extended visit with Bernice punctuated with stories and many laughs. Afterward that night us boys continued with a dinner out. Arthur was great help in many ways. Yesterday we went shopping together and he made sure I was adequately provisioned for the coming days and he told me he would prepare dinner for us after our return from the rehab center.
Our visit with Bernice was very pleasant which included Arthur explaining many interesting details of his work which otherwise there would be little time to explore. When Arthur and I arrived home he dove into our dinner preparation. As a starter he steamed artichokes and served these with a delicious garlic butter sauce for dipping. The main course was a flounder fillet. He had to improvise for bread crumbs could not be found and he used corn meal instead. As a total loss as a cook I can attest to the tasty final product but can only describe in outline form what Arthur did to create his culinary offering. He dredged the fish in some kind of egg mixture and I learned this for there appeared on the plate beside the fish a little pancake of cheese and egg. After the egg served it purpose in cooking the fish he added cheese and created little omelets. So, I was the beneficiary of cooking skills learned early on by all our sons under their mother's firm tutelage. Bernice strongly felt that our boys should be dependent on no one and should be thoroughly knowledgeable with how to cook, do their wash, and generally take care of themselves in the home. Harvey, while in med school was asked to cater the wedding dinner for two of his classmates. At age six Bernice started a "Lincoln Cookbook" for our son Lincoln which grew as he learned how to prepare new dishes. All our boys remain skilled cooks.
In addition to cooking, Arthur also used his inventive skills in our home. The shower handle in the master bedroom had been broken and I had not yet come up with a feasible way to repair the door since no replacement parts could be found. Arthur came up with a brilliant yet simple solution and the repair is now done.
I am off for a visit to dear Bernice.
best to all,
Merwin
Friday, August 6, 2010
A Bumpy Road
Hi All,
Merwin here at the helm again.
Bernice continues her adventure in Rehab. She has graduated to wearing an orange bracelet which permits her to enter and leave the bed on her own and to visit the bathroom with no aid. The stitches have been removed from her head wound but it is that broken T9 vertebra which gives her the most pain, both during the day or night when some movement is required. Mention has been made of a return home next Wednesday but that will be qualified by her condition next week. Since entering the hospital she has been off the drug trial which she entered in mid-June and some of the annoying and distressing symptoms which may have been suppressed have now returned. The medical situation with her underlying blood condition and this new injury is complicated for everyone including her doctors. The hospital staff has been very good and caring. Dr. M (and his staff), her hematologist at Mount Sinai, has been very attentive. I have been sending her blood reports every day. He wants to see her as soon as she is mobile enough to make it to the city. He emails and is also a blog reader.
Our sons are also very attentive with almost daily phone calls. Arthur who lives in New Hampshire arrived on Wednesday night and will stay through the weekend. He is helping me do some things around the house when he is not working or visiting his mom. Luckily, his company has an office on the island so he has been working there this week.
I have already retrieved the "wheelie" from the synagogue where we sent it after she recovered sufficiently from her broken pelvis. I am going this afternoon to get another one which we borrowed and returned to Bernice's generous friend Elaine.
I continue to collect all her emails and take them to her. Thanks for all the good wishes. In closing I can state again that not all sailing is smooth and I note that engineers are permitted great leeway concerning mixed metaphors.
love to all,
Merwin
Merwin here at the helm again.
Bernice continues her adventure in Rehab. She has graduated to wearing an orange bracelet which permits her to enter and leave the bed on her own and to visit the bathroom with no aid. The stitches have been removed from her head wound but it is that broken T9 vertebra which gives her the most pain, both during the day or night when some movement is required. Mention has been made of a return home next Wednesday but that will be qualified by her condition next week. Since entering the hospital she has been off the drug trial which she entered in mid-June and some of the annoying and distressing symptoms which may have been suppressed have now returned. The medical situation with her underlying blood condition and this new injury is complicated for everyone including her doctors. The hospital staff has been very good and caring. Dr. M (and his staff), her hematologist at Mount Sinai, has been very attentive. I have been sending her blood reports every day. He wants to see her as soon as she is mobile enough to make it to the city. He emails and is also a blog reader.
Our sons are also very attentive with almost daily phone calls. Arthur who lives in New Hampshire arrived on Wednesday night and will stay through the weekend. He is helping me do some things around the house when he is not working or visiting his mom. Luckily, his company has an office on the island so he has been working there this week.
I have already retrieved the "wheelie" from the synagogue where we sent it after she recovered sufficiently from her broken pelvis. I am going this afternoon to get another one which we borrowed and returned to Bernice's generous friend Elaine.
I continue to collect all her emails and take them to her. Thanks for all the good wishes. In closing I can state again that not all sailing is smooth and I note that engineers are permitted great leeway concerning mixed metaphors.
love to all,
Merwin
Tuesday, August 3, 2010
Regular Workouts Now
Merwin still reporting.
On Monday Bernice was a full participant in the rehabilitation program. They are awoken at about 6:30 but Bernice was already awake. She is in a good-sized room with three other women so they take turns in the single bathroom, have their breakfast, get dressed, see their doctors if scheduled. Something like a childhood summer camp experience. At 10:00 she started an hour long session in Occupational Therapy. Its aim is to prepare for doing all the necessary tasks of home life such as dealing with stairs, getting into and out of bed, dressing with special attention to getting on socks, shoes, and other attire that may now be somewhat out of reach. When Bernice fell in March and broke her pelvis our dear friend Betty sent her a set of very useful tools to help in such pursuits. Now Bernice is practicing with these same tools and finds them very useful. It is ironic that in May or so when Bernice no longer needed these aids, we sent them off to our synagogue so they could be used by others with a similar need. I now intend to retrieve the tools along with a "wheelie" we also sent off. At 11:00 the hour-long Physical Therapy session commenced where the aim is to strengthen all the muscles so needed for walking, lifting, and doing all the ordinary things that the able understandably take for granted. There is a break for lunch and a bit of a rest. Bernice enthusiastically embraces the routines and it is amazing to me just how much she needs to build herself up again to the level she was at last March when she did Spin three days a week and took other exercise classes the other three days. At 3:00 there is another hour of Physical Therapy.
I came for my first visit at about 5:00 bearing a raft of her emails, two more New Yorkers, and the NY Times. I wheel-chaired her out to a lovely patio lined with trees and flowering shrubs and there, after verbally catching up on our day's news and exchanging modest kisses, I read to her. The classes had pooped her and this interlude catching up on news with my reading was clearly a relaxing coda to the day.
I may not report daily for I anticipate that Bernice's routine will now be one of repetitive but hopefully very healing rehab sessions.
love to all,
Merwin
On Monday Bernice was a full participant in the rehabilitation program. They are awoken at about 6:30 but Bernice was already awake. She is in a good-sized room with three other women so they take turns in the single bathroom, have their breakfast, get dressed, see their doctors if scheduled. Something like a childhood summer camp experience. At 10:00 she started an hour long session in Occupational Therapy. Its aim is to prepare for doing all the necessary tasks of home life such as dealing with stairs, getting into and out of bed, dressing with special attention to getting on socks, shoes, and other attire that may now be somewhat out of reach. When Bernice fell in March and broke her pelvis our dear friend Betty sent her a set of very useful tools to help in such pursuits. Now Bernice is practicing with these same tools and finds them very useful. It is ironic that in May or so when Bernice no longer needed these aids, we sent them off to our synagogue so they could be used by others with a similar need. I now intend to retrieve the tools along with a "wheelie" we also sent off. At 11:00 the hour-long Physical Therapy session commenced where the aim is to strengthen all the muscles so needed for walking, lifting, and doing all the ordinary things that the able understandably take for granted. There is a break for lunch and a bit of a rest. Bernice enthusiastically embraces the routines and it is amazing to me just how much she needs to build herself up again to the level she was at last March when she did Spin three days a week and took other exercise classes the other three days. At 3:00 there is another hour of Physical Therapy.
I came for my first visit at about 5:00 bearing a raft of her emails, two more New Yorkers, and the NY Times. I wheel-chaired her out to a lovely patio lined with trees and flowering shrubs and there, after verbally catching up on our day's news and exchanging modest kisses, I read to her. The classes had pooped her and this interlude catching up on news with my reading was clearly a relaxing coda to the day.
I may not report daily for I anticipate that Bernice's routine will now be one of repetitive but hopefully very healing rehab sessions.
love to all,
Merwin
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