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April
2
2020

From Bob on April 2, 2020

Just to let you know I am well, very well. I have felt so included in our family, by Char, by Steven, by Gabe, and by Al. Somehow, I feel that I excluded myself from my family and didn't know where I was for months. But I'm coming around, thanks to all of you, thanks to everyone. I've been able to walk again. Char and I walked 3 1/2 miles in Tilden Park the other day, up to the ridge, and we walk a couple of miles in Albany almost every day. We start our days at 7am and work out for more than a half-hour, doing qi gong warm ups, physical therapy exercises, stretching, and meditation.  I also have joined the qi gong class at the Albany Senior Center led by Charlene on Monday nights - I've not forgotten the warmups and now Char leads the group at our house on her zoom account which works well. She hosts a group of about 20 people each Monday which I really enjoy.


I don't drive any more, maybe later. Char drives us everywhere. Or we walk. Now since social distancing, when we food shop, I stay in the car and listen to the radio.  Shopping at Monterey Market was a weekly occasion, now maybe every two to three weeks. I make my own breakfast and cleanup in the morning and after dinner. I used to take a nap for a half-hour, more or less, per day. Lately I haven’t needed a nap.


Here is something I wrote the beginning of March when I was starting to write more regularly:


Writing is difficult. Not easy but I can do it. What do I have to say? I don’t know, I’m at a loss, but I can be found, not far away, sitting in my little room, behind the bedroom, and I can hear the chickens, a year gone by. Where have I been?

 

Not far from Charlene, who’s taken a year, now, from her own life to nourish mine.

 

“I’m planning to rejoin my writing group. Will they take me?  I don’t l know. 


Mary will eat here tonight and I will make MaPoTofu. That will make a meal. My first in a year.

 

I’m at a loss. A year ago I slipped, after crossing a ten-foot wooden plank. Charlene saw me tumble and fall into the water below, bouncing rock to rock, rescued by Vincent and Emily lifesaving graduates.

 

I was told I didn’t lose consciousness. I stayed aware, even smiling, Charlene said.

 

I’ve never been a swimmer. My Uncle John rescued me from the bottom of the Big Sur River when I was four years old. I’d done a backwards dive off a tall rock and can still see the colored pebbles through the clear water on the bottom of the Big Sur. Uncle John pulled me to the surface.            .                                                                                                                                  

 

Years later in Vietnam I waded across a river up to my chest, holding an M-16 rifle over my head. How did I survive? On the other side of the river my team and I scrambled up a steep incline. At the top of the bank we took cover and looked back down the slope. We’d made it!

 

The next mile was all swamp and we never dried out. Our jungle boots were soaked and our camouflage fatigues were dense bamboo 5 inches thick in triple canopy jungle, no trail, no path, all swamp.

 

The next day we were exposed, climbing uphill until we reached the top. We stared down the face of the hill. Two male tigers were visible in a clearing, half a mile below. We called in a single round of light artillery on the face of the hill but the round was a dud, landing not more than ten feet away from our position. I never wanted to kill any people or animals.

 

At night-fall, I fished a plastic wrapped, black and white photo from my breast pocket, the snap shot of a high school girlfriend. Was she still my girlfriend? I didn’t know. I had carried her in my breast pocket, soaked or crimped, during every mission, never leaving her behind.

 ________________________________________________________


I am grateful for your good wishes this past year. I have read all of your journal comments and cards and your words continue to encourage and give me hope. 


Thank you so very much for your caring and patience. It’s been a long year.


All my gratitude to my family: my wife, Charlene, my sons, Steven and Gabe, and my daughter in law, Ally.


Love, Bob

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February
12
2020

February 12, 2020 ~ Aloha!

Two months ago at my last Caring Bridge post, I would have never guessed we’d be in Hawaii today.  Yes, we are on the Big Island, awed by the magic of mother earth -- both the catastrophic molten lava flows that do not yield and the beauty of abundant life that returns in due time. Feels like the perfect place for us now approaching a year after Bob’s traumatic fall that uprooted our lives.  


The Saturday after Christmas we hopped in the car for a day long outing.  This was one of the first times we’d gone out without an appointment or goal to reach. We headed toward the coast.  Perhaps we’d make it to Santa Cruz, where we’d met 40 years ago. As we made our various stops throughout the day --  breakfast at a cafe, the vista point at Chrystal Springs Reservoir, my childhood home and the kindergarten I went to --  Bob got in and out of the car with relative ease. He was able to walk (without the walker) short distances on uneven ground, like the hard packed clay and sand between the handicap parking spaces and the picnic tables at San Gregorio Beach.  I was both watchful and in awe. Each moment felt like a slice of eternity as we gazed at beautiful vistas. It was only two weeks since his third and last shunt adjustment. His progress with outpatient physical, speech and occupational therapies had been moving along remarkably well. Bob had recently abandoned his walker in the house and was now attempting to do so outdoors. The possibility of a vacation popped up into my mind. 


Last year I cancelled 4 trips. I had planned to lead or attend several meditation retreats.  There was no way I could have left Bob, our lives were completely upended and what was most important was being together.  Luckily all travel was booked on Southwest where credit for cancelled flights can be used within a year. Since my trips were scheduled throughout the spring and summer, I figured we had plenty of time to think about using the credit for vacation instead. Turns out that year is from when one books, rather than when a flight was scheduled. Suddenly I needed to use or lose almost  $700 in credit all in the month of February.  


I checked with the surgeon’s office and learned, “No travel restrictions.”  Bob’s occupational therapist said, “Vacationing in Hawaii would be great occupational therapy.” Within two days I booked our flights to Hawaii and found 3 different VRBOs (vacation rentals by owner).   4 nights in Kailua Kona (west side), 4 nights in Volcano, and 4 nights north of Hilo (east side). At that point I was uncertain what we’d be able to do, how Bob’s energy would be and what level of mobility he’d have. So even if we just stuck around the places we were staying, I figured at the very least, we could rest, relax and enjoy the surroundings, the Aloha state that Bob was born in.


Being in Hawaii indeed is good therapy.  Bob’s short term memory is markedly improving as he can recall our varied days and activities -- walking on lava paths and beaches, seeing Heiau or temples for traditional Hawaiian ceremony, sampling shave ice, gazing at the Kilauea volcano caldera, its many craters and steam vents, and the steep sharp coast line.  A long time friend of Rona Renner’s lives up here in the town of Volcano. He showed us around and over lunch, Bob talked about his service in Vietnam. "The terrain here reminds me of Vietnam," he shared. Bob continued on about his travels in Europe, and even teaching school. It was the most I’ve heard him speak about his life since his accident.  It wasn’t long ago that Bob couldn't even remember he was in Vietnam, let alone speak so freely about it.


Yesterday, with trekking poles in hand, Bob walked 1.5 miles  on uneven lava terrain to reach a site of ancient petroglyphs. Taking an hour each way, it was a stretch, yet Bob was determined.  I could see his brain working with each step and pole plant. Definitely a major accomplishment. Sequences of events from the past are re-aligning.  Bob has begun journaling here in Hawaii, the first sustained writing he’s done since the accident. 


Today we leave for Hilo, the wet side of the island, where the harsh black lava fields have been reclaimed by lush greenery and spectacular waterfalls.  When we return to the Bay Area, there will be no more physical therapy, as Bob was discharged, rightfully so, just before we left for Hawaii. He will continue with speech and occupational therapy at the VA in Martinez.  I’m sure he’ll have a lot to talk about with his therapists, sharing our adventures. The activities of daily living will continue to help reconnect all the neurons that were damaged from the fall and hydrocephalus. We will return with the Aloha spirit, the imprint of catastrophic change yielding to vibrant life. 

December
11
2019

December 11, 2019

Hard to believe it’s been 4 weeks since Bob’s discharge from Alta Bates Summit Acute Rehab.   His daily improvements are truly amazing. Just the other morning, lying in bed talking about his progress, Bob shared how he feels his writing IS going to come back; he could feel it just under the surface. So many things under the surface are emerging.  Six weeks ago we weren’t actually having verbal conversations yet. At the end of Bob’s hospital stay his speech therapist was pleased that his verbal response time went from 10 seconds down to 5 seconds. Now conversations are back to a normal cadence and his wit is up to speed. Sure, there’s still a ways to go, but seeing how small things, little connections are yielding significant improvements, is sheer delight.  So much is happening so fast. Life is feeling more and more “normal.”

The week before Thanksgiving, Shelly, Bob’s in home PT, considered getting him on the floor for some neuro-muscular exercises.  She aborted the idea though, uncertain Bob would be able to get back up off the floor. I wasn’t surprised by her decision remembering one of the last times Bob fell, I had to call 911 to get him up. The next week, on Black Friday, Shelly returned with another therapist, Thomas, a tall, youthful, buff dude. With a confident and reassuring tone, Thomas instructed Bob to slide off the sofa to the floor, onto his butt.  Without hesitation, Bob gingerly made his way down. 

I immediately flashed on the time he slid out of our bed and onto the floor.  I recalled how once back in bed, Bob was telling himself “try and stay warm.” I figured the visceral experience of sliding must have triggered the memory of landing in the cold pool below the waterfall.  That night we cried together, tenderly holding the trauma safe in our bed. 

Now post shunt procedure, and spotted by Thomas, Bob appeared unruffled by this slide down to the floor. Navigating off his butt, Thomas guided Bob on to his hands and knees, then to a prone position, and finally to turn over on to his back. Two months ago, moving from any one of these positions to the next, was unimaginable. Thomas instructed Bob in a series of exercises and stretches from these various positions. While still on his hands and knees, Bob lifted one arm, then the other. Then after maneuvering down and lying on his back, Bob lifted one leg and the alternating arm simultaneously. This movement was definitely a brain-body challenge.  Getting contra-lateral limbs to move simultaneously requires right-left brain integration which is often damaged in brain injury. Through several of the movements Thomas asked Bob, “Are you ok?” ….Yep!”  "Are you getting tired?….Nope!”  Though I could tell Bob was working hard doing these simple moves, his response to Thomas was cheerful and full of ease. 

After this single PT session I immediately noticed Bob’s more upright posture and improved gait — bigger, more fluid steps. Thomas recommended Bob continue using the walker since his balance is consistently better with the walker.  This will help strengthen the neuro-muscular connections and help him develop better postural habits. Each day Bob looks more sure on his feet. He can hold on to the kitchen counter and stoop down and pick up something that has fallen to the floor.  Another immediate side benefit of the neuro-muscular work on the floor, was that very night, Bob could turn on to his side while laying beside me in bed and give me a kiss!

Bob’s short term memory is returning to. How his memory is returning is interesting…He’s taken several signs down that I posted around our house, Bob had a surgical procedure on October 21. They put in a shunt that drains excess fluid in his brain.  However, he still forgets to use the walker as he independently moves from room to room.  Soon after his return from the hospital, Bob asked if I had talked to his parents Pat and Hugo, insinuating surely I had since so much has happened.  Bob was grief stricken to learn Hugo died 15 years ago. Then the very next day he walked across the room, and picked up a small wooden ox figurine. As he examined it with curiosity, I asked "Remember that?"  To my surprise he replied, "Yes, I bought it! " — which he had almost a year ago.

As Bob re-engages in small things one might have taken for granted, like bringing his plate to the kitchen sink or helping make popcorn, bigger more significant connections are being made.  His increasing observations, noticings, and even what he’s bringing up in conversation, reflect more global awareness.  It’s all starting to become more ordinary rather than revelatory.  I stop and remember there was a time when I had to remind Bob how to grab onto the newly installed handrail to get out of bed or slide forward on the chair in order to stand up. It used to take 30 minutes to cajole Bob into the shower, now it takes seconds for him to hop in!

There is a certain normalcy returning to our life, yet at the same time EVERYTHING is so different. There is still so much to process in the wake of the enormity of what has happened these past 9 months —  the initial accident at the waterfalls, the spinal surgery and rehab, the hydrocephalus and brain surgery, Bob's ongoing healing process, and my new role as a primary caregiver. This may take months, years, perhaps the rest of our lives. Sometimes when he finds himself overly teary from something minor, Bob comments "Maybe I need to “get over it” and move on."  However, I am certain Bob is not trying gloss over “it”.  Throughout our 40 years together we’ve been dedicated to supporting each other go to our depths to find our humanity.  Just last night, lying in bed, it was me crying for no real reason. Held by Bob’s gaze, I felt tenderness, joy and the fragility of life all at once. I am confident we will continue to do our best to meet the many big and little challenges and find "meaning in both the messiness and the sweetness, the magic of their inseparability." 

We are so very grateful for all the little and not so little things our family, extended family, friends, and community have offered. Your prayers, good wishes, meal offerings, grocery shopping, errands, nourish us.  Special thanks to Rona Renner, Kimberly Aumack Yee, Mary Goodell, Lory Poulson, and Nancy Burke who have continued to support the loving “infrastructure” that has sustained us. We especially appreciate our family, Steven, Gabe, and Ally, and Bob’s sister Linda and spouse Curtis, and my siblings and their spouses: Wes & Marguerite, Ernie & Kriss, Jeff & Teri (and Calie their dog!). 

Bob is being discharged from in home therapies Friday, December 13, and will begin outpatient PT at Herrick in Berkeley and OT and ST at VA Martinez the week of December 16.  He will continue with osteopathy, acupuncture, body work, and hyperbaric oxygen treatment. The demanding schedule will be easier now that transfers from house to car take only 10 minutes rather than 30-60 minutes!

As the days get shorter and the darkness grows, may you find inner light that brings nourishment and love to you and yours. 

December
4
2019

Meal Donation Adjustments...December 2, 2019

Hello All, Bob's been home a little over three weeks. He will be discharged from in-home to start outpatient therapies mid-December. 
 
One of Charlene’s creative outlets this week had been making and freezing soups with all the Thanksgiving leftovers. Bob’s OT (occupational therapy) includes helping in the kitchen. They both still love cooking and eating together. 
 
If you would enjoy dropping off or having a meal delivered to them, that would be helpful a couple or a few times per week.  Please sign up on the CaringBridge Ways to Help calendar. There are many doctor appointments and they’ll soon be going out to the Martinez VA hospital for OT and Speech Therapy a couple times per week.  Hyperbaric oxygen treatments will also resume. 
November
21
2019

Update from Charlene, "Good to be Home," November 21, 2019

After 6 weeks in acute rehab, Bob's been home 10 days now.  His balance, gait, and cognition continue to markedly improve each day.  Bob’s verbal cleverness, his play with word puns and sense of humor are back! 


Shortly before his hospital discharge, one evening I called Bob on the phone. We actually had a conversation, more than my usual monologues and Bob’s short yes or no answers.  Coincidentally Gabe called me while we were still on the phone and I added him into our conversation. Not too long after that, Steven called, so we had a 4 way. The boys noted how good Bob sounded.  I commented yes, Bob’s back!  Bob said he felt he had come home to himself.  


Now home,  it’s been good to return to activities of daily living like cooking, washing pots (at least a little bit!), and light exercising.  Check out the gallery for photos. Mind you these don’t happen everyday.


On Tuesday, November 19, Bob had a follow up visit with his surgeon, Dr. Larry Dickinson.  Dr. Larry was delighted to see Bob for the first time dressed and walking. All prior visits, Bob had been in a hospital gown and wheeled in on a gurney!  Dr. Larry thought Bob would benefit from another shunt adjustment, so he dialed him down another notch. The flow of fluid out of Bob’s brain will increase as a result.  The very next day, Bob said he felt even more "back to normal.” Though he feels like he can, Bob hasn’t been cleared to walk without the walker. And sometimes he'll forget to use the walker and suddenly get up out of the chair. We are watchful for possible falls since his sense of balance can falter especially when fatigued.


After the second visit with the physical therapist, she said it won’t be long before in-home PT will no longer challenge Bob.  Within a few weeks he’ll likely be discharged from in-home PT(physical therapy), ST (speech therapy) and OT (occupational therapy).  He’ll return to Herrick in Berkeley for outpatient PT and will utilize the VA for outpatient ST and OT.


Life is good.  With a clear feeling of forward motion, even knowing there is still a ways to go, I I feel energized.  As before, for Bob, his improved cognition brings a sobering sense of challenge as well as a tender heart.

November
9
2019

November 9, 2019 = Meal Update

Hi All, Bob goes home today (maybe he's there now)! Charlene is set for food through the weekend and has some stocks in the freezer. She is hoping to get back to cooking some of the time. For now, meals continue to be welcome as she and Bob settle in again, but it doesn't need to be every day as before. Bob will continue with PT and OT in the house.

November
5
2019

Getting Close to Discharge - Update from Charlene, November 5, 2019

It's hard to keep count, but I believe Bob's had 7 ambulance transports since his most recent stay in the hospital.  The seventh was on October 31, when we returned to the surgeon's office via ambulance, for staple removal and adjustment of the VP (ventriculo-periteneal) shunt system.  Ten days prior when the shunt was installed, it was set at greatest resistance, so only a small amount of excess fluid was being drained.

Bob didn't need a Halloween costume.  With 6 staples in his head, the right front quarter of his head shaved from the surgery, and the remaining three quarters showing a full head of overgrown hair, he looked edgy, even a little scary.

Incisions had healed perfectly. Though a little painful, staple removal was a snap. As expected Bob has experienced remarkable benefit within a very short period of time from the shunt adjustment. His verbal communication continues to increase. Yesterday Bob's speech therapist said he was the most conversational ever.  In describing a photo taken at Gabe and Ally's wedding, Bob proudly said, "I am giving them their vows." It was a touching moment verbalizing about the experience of officiating their vow ceremony two years ago.  Bob created a beautiful space for the vow exchange. We were laughing or crying throughout the ceremony!

Bob's physical therapist has reported major gains in objective physical tests.  The day after the shunt adjustment it took Bob 26 seconds to kick down 10 plastic cones.  Yesterday he was down to 12.5 seconds kicking down the 10 cones as quickly as Mike could replace them.  In a timed test, moving from seated position to standing, walking around a cone, then sitting back down, Bob went from 6 minutes to down to 2.5 minutes! His walking speed (with a walker) improved by 46%.

Bob's progress is so exciting, especially remembering back to September 26 when he was hospitalized.  He could barely stand up, let alone walk.  He was confused and verbally communicating very little.  He life force was low. 

The current discharge goal is for Bob be at "supervisory" level, meaning he will be able to get around with the walker without assistance though with supervision. He'll still need to be watched to guard against falling. This is the same level he was at when he left acute rehab on April 4, after his first stay.  He will receive in-home therapies again, and eventually out patient therapies. 

Bob is taking giant steps forward.  And we are aware of the little steps back, the day to day challenges, the variance in energy level depending on the time of day.  Bob has a great attitude and yet we know it won't be easy. 

We appreciate your love and support.  Keep the well wishes coming.  Bob is always moved when we take turns reading the Caringbridge comments aloud. Check the gallery for more photos.

October
24
2019

Back at Acute Rehab - October 24, 2019

After two nights at Eden Hospital, Bob was transferred back to the acute rehab program at Alta Bates Summit in Oakland. He was greeted with warm welcomes from both staff and fellow patients.  We were pleasantly surprised by how excited Bob’s patient friends were to see him back. 
 
On Bob’s second day after the surgery at Eden Hospital, he was able to sit up unsupported at the bedside.  With assistance he took the initiative to stand up and side then back step to the chair.  He sat down, then stood up again and (with the OT and PT) walked about 8 feet.  You could tell by the look on his face how much focused effort it took.  Gabe, Ally, and I were cheering him on. He excitedly gave both therapists high 5’s once he sat back down.  Steven, in Paris got to witness via video conference! 
 
Bob has been sleeping a lot the past two days after the surgery. When awake, he’s been more expressive verbally, generally responding faster, though still having moments of confusion. He is following commands more readily.  The VP shunt is set at greatest resistance meaning it is currently acting more like a siphon, passively draining excess fluid.  In the coming weeks it will be adjusted to lower resistance levels and we expect to see more benefits.  All and all we are proud of how well Bob has handled the surgery and post op.  (See newest photo in the gallery).
 
In the next few days he will be evaluated for physical, occupational, and speech/cognitive therapy. The team will come up with realistic goals, treatment plan and a new discharge date. 
 
Thanks again for your messages, healing energy and love.