Swallow Test follow up - A happy result and happy reunions

Wednesday July 29, 2009: It was on Tuesday, July 7th (see my previous post dated Wednesday, July 8th), almost four weeks since entering the hospital and since he last ingested food through his mouth, that Tesfaye received a conditional pass on the swallow test allowing him to eat soft textured foods and drink thickened liquids, with the further restriction that he turn his head to the right as he swallows; unfortunately, it appeared that some damage (likely temporary) to his vocal chords from the second time insertion of the breathing tube had affected Tesfaye's swallowing ability. Notwithstanding these restrictions, this was certainly fantastic news for Tesfaye (you can imagine receiving your nutrition for four weeks solely by way of liquids administered through a feeding tube inserted into your stomach through your nose). Nevertheless, after faithfully following these restrictions for over three weeks, we were hoping that he would now be able to fully pass the swallow test and have all restrictions removed. What gave us hope that he was ready was the fact that his voice had steadily progressed over the last couple of weeks, to the point it was very strong and seemingly back to normal.
At 8:30 Tesfaye and I arrived at the hospital and received a lovely welcome from a number of staff members, who all remarked how great Tesfaye was looking. While waiting for John the OT, we were with Lise and then saw Brian, the spine surgeon from Ireland here on a Fellowship, who was part of Tesfaye's spine surgery team during the June 12th operation. Brian was pleased to see how good Tesfaye looked, and answered a few questions that Tesfaye had; Brian is on his way back to Ireland on August 5th. We then met up with John and made our way over to the Swallow Test X ray room that we had previously attended on July 7th, whereupon the team of John, Catherine the Speech Therapist, Dr.Salat, Ramen, and Vanessa conducted the repeat swallow test on a wide range of foods and liquids, with the result that: Tesfaye received a 100% pass! Tesfaye was now free to eat or drink anything he pleases and without needing to turn his head to the right as he swallows; he was most looking forward to drinking normal, unthickened water, and I no longer would always be thinking he was looking at me for some reason as he ate.

Successful Swallow Test Video
So all in all it was a happy return visit to the hospital, as much for the nice reunion as the successful swallow test. While it was nice to see so many familiar faces of the truly wonderful Spinal Unit staff, many of whom I have mentioned in previous postings throughout Tesfaye's hospital stay, before leaving Lise said that there were two operating room nurses, Patsy and Fiona, that heard that Tesfaye was going to be at VGH this morning and were very keen to see him; they both had been with Tesfaye throughout the marathon 14 hour back surgery on June 12th but had not seen him since then. Because they were also occupied in the Operating Room this morning we had to wait some time for them to be able to make it up to the Spine Unit for the visit, but Tesfaye and I were very happy to wait for them. When they arrived they really appreciated the opportunity to see the marvellous outcome that the surgery had for Tesfaye, because not only was this a unique case, but they also remarked how they never before had the chance to see their patients after they leave the operating room; by the same token, Tesfaye and I appreciated the opportunity to thank them for their role in the outcome. I certainly remember that moment when I first met Patsy, bright and early the morning of June 12th, as she wheeled Tesfaye away to the OR for the surgery - we have been through so much since that moment, it now seems so long ago.

Before leaving the Hospital there was one more visit that I really wanted to make with Tesfaye if possible. Without advance notice I took a shot at seeing if Anne Sutherland Boal, Chief Operating Officer of Vancouver Coastal Health, might be available to Tesfaye, since as far as I knew she had not yet had the opportunity to see Tesfaye up and walking and looking as strong and upright as he was today. Anne was a critical part of the approval process for Tesfaye's surgery at VGH; as it was a unique undertaking for Vancouver Coastal Health, not to mention a very complicated surgical procedure requiring a certain medical expertise, it required both a skilled and willing surgical champion (Dr. Marcel Dvorak and his team) and an open and innovative mindset at the top administration executive level. Without Anne's support and desire to have VGH undertake this life changing surgery for Tesfaye it could not have happened. I was so pleased to hear that indeed Anne would take a few minutes to step out of a meeting she was in to say hello to Tesfaye and me. It was my first opportunity to get a picture of the two of them, and with that we were on our way home to spread the good news about the swallow test.

[Thursday July 30, 2009: Tesfaye flies up to Kelowna through Monday August 3rd for the long weekend, away from Vancouver for the first time since arriving from Ethiopia.

Friday July 31, 2009: Tesfaye is anxiously awaiting his midnight appointment to talk to his mother for the first time since the surgery.

Details and pictures about these events and Tesfaye's Kelowna experience will be posted over the next couple of days as time permits, so please revisit]

Update from Ho Chi Minh City Vietnam - Motorbike madness

July 20 to July 25, 2009: It's Saturday here in Ho Chi Minh City Vietnam. If Detroit is Motor City, then this is Motorbike City. Little motorbikes, mostly cheaper Chinese made ones, outnumber cars by at least 10 to 1. With the way they weave in and out of cars and each other in seeming chaos, I am amazed that I did not witness any accidents. That's a good thing, as you often see these little bikes with 3 or 4 family members, including little children on them. Anyway, it has been a whirlwind week of travel and factory visits - something like 7 cities in 6 days in 2 countries. I won't go into many details about my trip here, except to say it has been extremely hot and humid everywhere (record heat in Shanghai), I got to see part of the solar eclipse, I have visited many factories that we are either dealing with already or about to deal with, I haven't slept much, and I have had some very good Chinese food on this trip but I am ready to take a break from it.

Tesfaye this week - These are are few of the highlight that I have heard of regarding Tesfaye's week:
- Generally I have many reports that he has had a great appetite and is eating well. It seems he has discovered and developed a fondness for Nando's.
- He has been feeling so good there are some days that he doesn't take any of his medication.
- The night of the fireworks he went for Ethiopian food to Fassil restaurant with Brandon and Stephanie, and then to my parents' house for a safe view of the fireworks. He was very excited to see fireworks, as he had never seen them before.
- He has been practicing some newly learned computer skills and regularly works on his English grammar books.
- Erica Leyland very kindly took Tesfaye on an outing to the Aquarium and he emailed me that it was amazing.

Well, I am now catching a 6 am flight from Vietnam to Vancouver via Hong Kong and I am very much looking forward to seeing the whole extended family. Cheers!
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Shanghai - mission accomplished

Monday July 20 (China)/Sunday July 19 (Vancouver), 2009: It was nice when I landed to be greeted by my first email message, which was from Tesfaye, asking me how is China and telling me that he misses me. The next nice thing was that it did work out in the end that I could see Justin. We were able to coordinate meeting for seven or eight minutes after he checked in and we exited the baggae area. It was great to see him after 6 weeks or so, and he looked terrific. Unfortunately I will have to wait another week to hear some of his crazy and humorous stories told in his own inimitable style. After checking into our hotel we were driven to the Stylecraft Factory where we had some initial meetings with our partners and then went for a very nice "modern" Chinese cuisine dinner. My associates and I were fading rapidly by the end of dinner and couldn't wait to get to bed.

In the meantime, I did receive some regular updates from Nanci. On Sunday Erica came over for a 2 hour visit and met Tesfaye. I understand she will take him on an outing this week. The other unfortunate news that I heard was that Adam was badly bitten on the nose by our bird Mango; I just don't understand the "love/ hate" relationship they seem to have. Anyway, he went for a stitch, but is fine.

I am off to our Shanghai factory now. Later.

This week - Gary's Journey

Sunday July 19, 2009: I left Sunday morning for a week long business trip to China and Vietnam. Any updates this week regarding Tesfaye will have to be long distance and indirect reports. Well, I guess that's not totally true, as Nanci has set up a Gmail account for Tesfaye and he has learned how to send emails.

So I was sad to be leaving Tesfaye's smiling face for a week and, of course, the rest of my family. I said my goodbyes to Tesfaye Saturday night even though he did want to get up and say goodbye. Nanci drove me to the airport and I got there reasonably early (for me). It was a very comfortable flight. Justin is going to be flying back to Vancouver a couple of hours after we land, so I was really hoping to somehow be able to coordinate seeing him at the airport for even a few minutes so that I don't have to wait an extra week to see him. We'll see.

Getting word to Tesfaye's mother at last

Friday, July 17, 2009: After lunch I had a nice surprise visit from Nanci and Tesfaye at my office, which was his first return visit since the surgery. As everyone in the office had certainly been getting updates from me on Tesfaye's progress, they appreciated the opportunity to see him in person. The highlight later in the day was successfully connecting through to Meheret in Gojjam Ethiopia at midnight our time. Meheret owns a shop in the town near the village where Tesfaye's mother Yeshi lives. It is about a 2 hour walk from her village, the village where Tesfaye was born and grew up until making his way to Addis to find help; as they do not have any telephone service ( nor electricity or running water), the method whereby Tesfaye can reach his family is to reach Meheret and have him relay a message to his mother and/or set up a time for her to walk to his shop to receive a telephone call from Tesfaye. The last time he did this was a week or so before his surgery, and unfortunately Melaku and I unsuccessfully tried to provide an update in this manner after the surgery. Amazingly, on our first or second try we got through and Tesfaye was so happy to be able to tell him that the surgery was a success and that he is doing very well now. They in fact had been anxiously awaiting to hear how the operation went. Meheret will communicate the good news to Yeshi, and Tesfaye told him that he will call back to speak to his mother at the same time in two weeks from now.

Suture removal - a reminder of how far we've come

Thursday July 16, 2009: We were all looking forward to the 3:00 pm appointment at VGH to have the remainder of Tesfaye's sutures removed. Tesfaye was also looking forward to his noon haircut with Karen at Sweet Pea. Tesfaye came on May 20 with very close cropped hair, but it was now around two months since he last had his hair cut (not counting the snipping Stephi did one day in the hospital to get some glue out of his hair where the electrodes were attached).

So at 3:00 pm I met Tesfaye, Haley and Nanci at the hospital for our suture removal appointment with Lise. This was Tesfaye's first return visit to VGH since coming home last Friday, and it would be interesting to see everybody's reaction. Well, everybody thought Tesfaye looked terrific and that his face appeared to have filled out a lot over the last six days; his voice was also noticeably stronger; by the way, it was also a great haircut. We first bumped into pain specialist Doctor Mike Negreaff and discussed Tesfaye's pill regime and told him that Tesfaye had stopped taking the strong pain killer hydramorphone. Doctor Mike told him what other pills he could also start modifying accordingly.

Lise then found a room she could use to remove Tesfaye's sutures. After having Tesfaye sit on a raised bed with his back to her, Lise then began the somewhat time-consuming process. She removed around 25 of the blue sutures, and then found another couple of them that eluded her the first go around. There were also another 25 or so sutures that had been removed two weeks earlier from the upper portion of his incision. The incision, which probably measures 18 inches or so and extends down virtually the whole length of his back, has healed very well. I took pictures of it so that Tesfaye could see how it looked. Looking at him both sitting and standing there with his shirt off and remembering what his back looked like before the surgery, it really was truly amazing to behold and hard to believe just how straight his back is now. With the stitches now out, even though it was probably unnecessary, Tesfaye wanted the area to be re-bandaged with some small strips and Lise did a precision job of doing so. In the process of saying our good byes on the way out we bumped into John the OT, and he also was duly impressed with Tesfayes marked improvement since coming home. As his voice was also significantly stronger we talked about moving up the time when the swallow restrictions may be abandoned, to maybe 10 days from now. The other things still to be scheduled are a follow up xray and pulmonary function test. As we exited the hospital we had an opportunity for Jim O'Hara from the VGH foundation office to get his first look at Tesfaye upright and walking post surgery.

Later in the evening when I got home from the office and my workout, Lis was over visiting for a while but could not stay for dinner, but Jim and Haley were staying. Tesfaye's appetite has been growing so nicely we bought him his own special fork and spoon set ; ). We all enjoyed the warm Vancouver summer evening by having a light BBQ chicken meal seated outdoors on the patio. Ever since Tesfaye's arrival on May 20 our weather has been unbelievable; he certainly has brought sunshine into our lives.