Sunday papers

Jo's right eye is open more and speech is almost normal. She asked for the Mail On Sunday, a big change from last weekend when she did not care about the Sunday papers. Mum came visiting with me and was amazed at her progress.

A little ray of sunshine

Only a brief visit this morning as I am taking Mum to The Boatyard for lunch for her birthday. Jo is improving daily, her speech is less slurred today. At The Boatyard a ray of sunshine shone on Jo's place throughout lunch.

First signs of neglect

Jo looks better today although still tired. The physiotherapists got Jo standing in a machine which helped her. They helped her support her head in her hands. She couldn't feel her face with her left hand when both hands were supporting her head, which I learned later is a sign of "neglect".

Fatigue sets in

Just saw Jo briefly in the morning as I had to go to Gatwick. Jo was tired and I wasn't surprised, although disappointed, to find she had refused physiotherapy, when I rang her in the evening.

Second physiotherapy session

Jo had her second physiotherapy session today, sitting on the edge of the bed and trying to maintain her balance. Right eye beginning to open.

Geographically challenged

A Doctor told us today we have a choice of two hospitals, the Homerton (NHS) and the Wellington (Private). Have these people no grasp of geography? Both hospitals are in central London, miles from our home.

Jo continues to make good progress generally, speech still slurred but improving although she refused physiotherapy today.

August Bank Holiday

Bank Holiday weekend so no physiotherapy for 3 days. Jo continues to make good progress generally.

A small scare

Jo was very tired this morning and speech was hard. She has been working on the physiotherapy stroking her left arm to stimulate it so maybe she has worn herself out. She is also probably more than a little despondent.

There was a small scare when her temperature was elevated, with a fear of infection in the lungs due to not swallowing properly but all blood and urine tests came back negative and her temperature was back to normal by the evening.

She slept for a couple of hours and I observed her drawing her left leg up six times.

First physiotherapy

Jo had her first physiotherapy session today, designed to reawaken the memory in her brain of the fact it has a left arm and leg to look after. There was some success, with small movement being encouraged in both arm and leg. I saw the neurosurgeon, who said there was no brain damage, which he described as remarkable, and that physiotherapy would see her recover the movement in the left arm and leg.

Early days

Jo was a little less bright today although still lucid and there are small signs of recovery. The scar, which runs from th middle of her forehead to just below th right ear, is healing well and the right eye, which has become closed with the bruising of the nerves around the eye, is beginning to reopen.

Going for gold.

They moved Jo onto the ward today. She was asking for her TV as she had heard that Britain was third in the Gold Medals league. I am elated

Jo awakes

Jo was quite awake! Her speech is slurred but she asked where Mum was so had obviously seen her and registered that yesterday.

A startling incident

On the way to see Jo this morning a pigeon flew straight in our path and hit the wind shield with such force he must have died instantly.

When we entered HDU Jo opened one eye and she definitely saw us. She looked bewildered and frightened and I just wanted to take all this pain and suffering away from her.

From Neurological Critical Care to High Dependency Unit

They moved Jo from NCCU to HDU today, a good sign. She is a little more awake and trying to respond.

Looking upwards

They have begun to wake Jo up, her eyes try to open when I speak but the pupils are looking upward. She is obviously very sedated.

Still under sedation

More improvement today, Jo is moving spontaneously and opening her eyes when I talk to her. She is still showing the effects of sedation though and her pupils are barely visible. They have taken her off the last sedative and there are only nutrient and sodium level feeds. She is still on the respirator. They tried twice to take her off it but she is only breathing 5 times a minute instead of 12. She is moving her right arm and leg spontaneously and chomping on her oxygen tube. I thought I detected some slight movement in her left leg a couple of times.

Still in a coma but there are signs of life

Jo has some colour in her cheeks after a blood transfusion and is responding to commands, barely opening her eyes but able to move her right side in response to commands. They stopped the dopamine this morning so are weaning her off the sedative. The brain swelling is under control and shows no sign of recurring. The main focus is on her heart rate, which is erratic, and blood pressure, which is high.

A miracle

Jo is a little more stable today. Her heart rate is a more normal 90-100 and she shows some signs of responding. Jo is still under sedation. It seems the right part of the brain has suffered a mild stroke, affecting the left arm and there is hope that the left side of her body, specifically the leg, will only suffer from the brain being asleep for so long and will be able to be treated with physiotherapy. For now the main focus is on making sure the brain swelling does not reappear and on maintaining her vital functions. I saw the neurosurgeon who said things were looking a lot better and described it as a miracle.

Jo is in the neurological critical care unit

A visit to the hospital this morning saw Jo still under sedation but with the swelling reduced. The intern explained that the bypass had not been successful, the blood vessel collapsing and hence that part of the brain would almost certainly have suffered a stroke.

Her heart rate is cause for some concern, being between 125 and 156, and they were keeping her blood pressure up with drugs as that had become dangerously low. She is still sedated and there is little or no response from her.

The worst phone call I have ever received.

I visited the hospital again this morning and another scan showed that the blood flow was further reduced. There was no sign of a stroke at this stage and I was advised a further operation was necessary to put a bypass in place to circumvent the occluded blood vessel.

They began preparing Jo for surgery at 14:00

At 21:30 the neurosurgeon phoned me to say that as they began to implement the bypass Jo's brain began to swell. He was concerned this was life threatening and doubted she would last the night.

No change

There was little change in the morning, Jo having been stable overnight. It was decided to keep her under sedation for 24 hours to allow the situation to resolve itself.

The 8th of August 2008 – an auspicious date?

Jo was booked in for a clipping or possible bypass of the aneurysm that had haemorrhaged in 2000, as the coiling had failed to occlude it and it was still filling.

Jo checked into the hospital in Cambridge on the Thursday as the operation was scheduled for 8:30 the following morning. Jo phoned me from the hospital and was in good spirits as she regarded the date of 08/08/08 as particularly auspicious, being her goddaughter’s eigth birthday and eight being regarded as very luckyby the Chinese.

At 14:58 the Neurosurgeon, phoned me to say the operation had gone well as far as the aneurysm was concerned but that damage had been done to the blood vessel when they tried to clean it out as the coils had gone through the back of the aneurysm, the part they couldn't see, and “cut through the blood vessel like a cheese grater.” This had meant the operation lasted one and a half hours longer than expected and he was concerned at the possible damage to the brain by having those blood vessels clipped off for so long. As he described it, the right half of her brain had been asleep for longer than they hd anticipated and would have forgotten it had a left half of the body to operate. The best case scenario is that the brain would remember, the worst case scenario is that it would have to relearn these functions.

The repaired blood vessel had only a 50% flow through it. Jo was therefore kept under sedation with drugs to lower the brain's need for oxygen and hopefully give the flow time to establish itself.