We went back to UCSF Orthotics Dept. for a new brace, and it makes a world of difference. Much more comfortable, fits better, keeps Marina even straighter, and it has stars and comets embedded in the fiberglass. Lucy the Dog (see lower left) remains quite confused by this "new" person in her life, and is awfully good about not jumping up.

Goodbye walker, hello cane.
On Monday, the physical therapist did her evangelical number: "Throw away your walker!" So Marina now has a cane, which she finds quite liberating, in terms of where she can go, and how fast she can get there. But it is also a reminder of how weak she often is, so she moves with great care -- although I was not watching closely enough, and she managed to change the sheets on the bed, and was sweeping the floor when I caught her.

Her sodium level on the a bit more liquids regimen went in the wrong direction by two points, as of Tuesday, from 133 to 131, but Dr. Misakian was not alarmed; indeed, she had the feeling that things were stabilizing, and so she said that Marina should try one week with near-normal liquids -- 8 cups a day -- and if the sodium is still in the 130s as of next Tuesday, she can go to once-a-month monitoring.

With liquid returning, Marina's main complaint (besides the left leg) was her now ill-fitting brace. So yesterday afternoon, we returned to the UCSF Prosthetics and Orthotics department, where the very friendly people insisted that she must have stolen someone else's brace, since the current one hardly fit at all.

Her shape has changed so much in three weeks -- no more distended stomach, standing up straighter -- so there was no way to adjust this brace, and an entirely new one is being made. Marina vigorously hopes that the new one will feel better, not press down on the incision where some rib was removed, nor press into her throat when sitting. And besides she had her choice of embedded materials in the fiberglass: butterflies, flowers, the NFL logos, and the one she chose, stars and comets.

Thanks for checking in.

133!
The very happy news is that in five days, Marina's sodium count has risen from 128 to 133. The doctor (and the patient) are extremely pleased, and the reward is an increase in liquid from 3 cups a day to 5, until the next blood test and doctor visit, a week from today. 135 is the low end of the normal range, and that is the goal.

Marina still tires easily, but in between, she is doing the exercises prescribed by the physical therapist who visited the house, eating well in her six small meals every four hours (I've pretty much learned to prepare the 4 a.m. meal without waking up), and she even managed to take her brace off by herself, which I think is anatomically impossible, but Houdini would disagree.

Before, After
I may have figured out (thank you, Brad) how to post pictures here reliably. The picture on the left is what really got this whole adventure started: Marina saw this photo of her at a dance workshop last year, and was inspired to see her doctor, who sent her to a surgeon (who said, "It is more than I can do," and sent her to Dr. Hu). The picture on the right was taken in the hospital on January 3rd. (She is wearing her body brace under the shawl.)

The Energizer Bunny
Marina has been motoring all over the house with her walker, not unlike a post-op Energizer Bunny. She is gaining more and more use of her body: putting on clothes, taking a shower (seated on a shower chair), etc.. While the pain is still significant (and will be for several months), she is living well with it, and the doctor has begun weaning her off the more powerful Norco to a less strong Vicoprofen. She is taking a meal or two a day at the dining table, and has a good appetite, despite the drastic liquid restrictions (half a cup with each pill-taking, six times a day, and that's it).

The sodium factor, while serious, is an intellectual construct at this point, since it causes no discomfort. The next significant event is the Wednesday sodium test followed by meeting with the doctor to discuss the results. Visualize 129 or higher!

128!
On this Friday morning, the sodium level was up a point, which is much better than the alternatives. It keeps Marina out of the hospital, and we go back again next Wednesday for the next blood test and doctor meeting. Her liquid restrictions are now even tougher, with most fruits eliminated as well. Essentially it is now six 1/2 cups of water or milk a day (corresponding with the six pain-pill-taking sessions, every 4 hours. Tough, but much better than the alternatives.

One day at a time.
We're driving to UCSF hospital for lab tests every morning. Today's sodium count was slightly up: 125 to 127, the first improvement in a while. We stop worrying when it reaches 135.

Everything else measurable is OK. Marina is walking more and more, using a walker; handles stairs very slowly but she gets there. Appetite growing (albeit difficult with 3-cup-a-day liquid requirement). Dressing herself (with help of an amazing sock-putting-on device given us by the hospital).

But having said all that, it is also necessary to say that she really isn't ready for visits yet. She is in pretty much constant and severe pain, and those necessary walks and stairs take their toll in utter exhaustion and much bed rest. So having pleasant chats with people just isn't in the cards yet. Thanks for your understanding.

Woods. Not quite out of them.
This Wednesday morning, Marina's sodium level is still troublesome. Visit with Dr. Mikasian, who says she is borderline for a level that would send her back to the hospital. Plan is to do blood samples on Thursday and Friday morning, and report back to Dr. Mikasian later on Friday for a decision.

Liquid intake cut from 4 cups a day to 3, which is tough. Otherwise, things are great. Marina walked half a block from car to lab this morning -- but then was extremely tired by the time we got home. Her staples were removed at Dr. Hu's office, and both incisions look just right. The blood pressure is within normal range; the neural pain in the leg is a bit less, and itches greatly which may (according to the old wives) be a good sign

Home at last (but it's a little like house arrest)
Discussions among the neurosurgeons and the medicine men went on all day Monday, and a compromise was reached. Marina could go home . . . but she must come back tomorrow (Tuesday) morning, and Wednesday morning, to have her sodium (still too low) and her blood pressure (still too high) checked. They reserve the right to recapture her, but the chance is small, we think. She is so incredibly pleased to be home and in her own bed, and eating real (and delicious) food (thank you, Sally S).

And we made a mark on the wall as we left for the hospital on December 14th, and another on homecoming today. It is hard to believe, but Marina is more than 5 inches taller. What fun it will be when she rejoins the dance circle.

Going home today! (Or maybe not.)
It is noon on Monday, and we still don't know if Marina is going home today. Physical Therapy has signed off on her. And apparently the Medicine Men have -- as long as she comes back to the hospital tomorrow and the next day for tests and sees her primary care physician Wednesday. But Neuro has ordered a new set of Xrays, which we are sitting here waiting for. This is either a 'normal' set of exit Xrays or a wish to have another look before signing her out.

We learned an hour ago, from a nutritionist, that the nurses were misinterpreting her fluid order, which has caused huge discomfort and distress -- ostensibly being limited to one liter a day. Marina has eaten very little for three days, because of what she was told she could have. Now it seems that the restriction was on 'free water' only and she can be eating fruit, gravy, milkshakes, prune juice, and other important things. Annoying, but anyway we may be home in a few hours. Or not.