Friday, April 10, 2009
Bed time
Just put Dad to bed. I reminded him that he would be visiting Ken and family this weekend. He responded..."It's always nice to see Kenny".
Thursday, April 09, 2009
Up Day
Dad had more of an "up" day today. I got him to bed relatively early last night, and this morning when I asked him how he was doing he said "Very Good!". He also showed more energy in his outside walks (We had "dueling walkers" with me and Dylan in his walker, and Dad with Lois in his walker and we crossed paths a few times. It was a nice day here today (high 60's, clear.)
Lois does have Dad read daily...today outside he was reading articles in the newspaper (she points to what he should read and he reads it...so he's not trying to process it, but clearly can still read). It's true that I haven't noticed him lately watching much television, but it was something I've noticed him doing before since he's been here in California.
I purchased a couple of puzzles at TJ Maxx today to add to Dad's repertoire...Lois utilizes these most days. They are the juvenile type that involve matching...one has about 75 pieces, and it takes 3 or 4 pieces to make one complete rectangle which has a picture and a name on it (e.g. "frog" or "sun"). The other has numerous pieces also, and you have to find the matches (e.g., horse hoof with picture of horse). Other suggestions are welcome.
Chip, Jennie...It would also be great to get the Navy discussion video and/or the paper that Faye wrote. Lois still goes through the U.S.S. New Jersey War book we have and if there was more accurate info that would be great.
Lois does have Dad read daily...today outside he was reading articles in the newspaper (she points to what he should read and he reads it...so he's not trying to process it, but clearly can still read). It's true that I haven't noticed him lately watching much television, but it was something I've noticed him doing before since he's been here in California.
I purchased a couple of puzzles at TJ Maxx today to add to Dad's repertoire...Lois utilizes these most days. They are the juvenile type that involve matching...one has about 75 pieces, and it takes 3 or 4 pieces to make one complete rectangle which has a picture and a name on it (e.g. "frog" or "sun"). The other has numerous pieces also, and you have to find the matches (e.g., horse hoof with picture of horse). Other suggestions are welcome.
Chip, Jennie...It would also be great to get the Navy discussion video and/or the paper that Faye wrote. Lois still goes through the U.S.S. New Jersey War book we have and if there was more accurate info that would be great.
General observations with Dad
I really enjoyed the opportunity to spend some time with Dad and see how he is doing. He is getting really good care and in general seems to continue to enjoy relatively good health. He mostly eats well and gets exercise every day.
I do think he seems a bit weaker overall since I saw him last, though he still gets around. I didn't observe any times when he wanted to walk without his walker though (which I had seen before on 'good' days). He is not quite as quick to recognize people, and does appear to be confused most of the times I talked with him. He did easily recognize Mom's picture, and us as well. I was showing him older photographs for the most part (when we were kids up to the early 70s). I tried to get him to talk about Navy experiences without too much luck. He mixed up the stories with references to me or other things in the room. He doesn't seem to respond to the television much at all any more - certainly doesn't talk about anything. We watched the Final Four basketball and he wasn't interested. I tried to work with him with a card game based on dominoes (but using pictures), but he said it was too hard to try and match the pictures, so I stopped. I didn't get a chance to try scrabble. He still reads well, so perhaps making words or reading words from the letters would be a good activity.
Barb and I started talking about arrangements for getting Dad to the beach this summer. I'm wondering if it might be his last opportunity to be together with a larger group. I think he could still have years left, I'm not sure such a big trip will be possible much longer.
I do think he seems a bit weaker overall since I saw him last, though he still gets around. I didn't observe any times when he wanted to walk without his walker though (which I had seen before on 'good' days). He is not quite as quick to recognize people, and does appear to be confused most of the times I talked with him. He did easily recognize Mom's picture, and us as well. I was showing him older photographs for the most part (when we were kids up to the early 70s). I tried to get him to talk about Navy experiences without too much luck. He mixed up the stories with references to me or other things in the room. He doesn't seem to respond to the television much at all any more - certainly doesn't talk about anything. We watched the Final Four basketball and he wasn't interested. I tried to work with him with a card game based on dominoes (but using pictures), but he said it was too hard to try and match the pictures, so I stopped. I didn't get a chance to try scrabble. He still reads well, so perhaps making words or reading words from the letters would be a good activity.
Barb and I started talking about arrangements for getting Dad to the beach this summer. I'm wondering if it might be his last opportunity to be together with a larger group. I think he could still have years left, I'm not sure such a big trip will be possible much longer.
Dermatologist - update
Barb and I accompanied Dad to the dermatologist (Dr. Iwasaki) on Tuesday, and we discussed in more detail the diagnoses and recommended treatments.
The squaemous cell cancer is on Dad's forehead. It is relatively large, and the doctor explained that surgery would require even larger excision. She recommended doing MOHS surgery (referred to another doctor for this), which provides the opportunity to test during the surgery to determine the depth required to remove all cancerous cells, as well as doing any required skin grafts or skin flaps to repair the surgical excision and minimize scarring.
The basal cell cancer is in a crease between the nose and mouth. Dr. Iwasaki said she would be able to do this surgery in her office, but that we should do the others first.
The melanoma (the most serious), is on Dad's right cheek. Dr. Iwasaki recommends MOHS surgery for this as well. She ordered one more test to be done on the biopsy sample (called a 'stain'), which will verify whether the cancer is superficial (extending only into the first layer of skin) or if some cells have extended further. If the cancer has extended further, it may be necessary to do a lymph node test to see if it has actually penetrated to a lymph node. Results should be received soon. The MOHS surgery has been scheduled for next Wednesday, April 15th.
Only one MOHS surgery can be handled at once, so a second appointment will be required for the squaemous cell cancer, once the first is done.
Once all of these surgeries are complete, Dr. Iwasaki suggests doing a full body inventory of Dad's skin marks to identify any other potential problems. She visually noted at least one on Dad's face (near his eye), but wants to wait until all the current surgeries are done before completing the inventory and determining a treatment plan according to priority.
The squaemous cell cancer is on Dad's forehead. It is relatively large, and the doctor explained that surgery would require even larger excision. She recommended doing MOHS surgery (referred to another doctor for this), which provides the opportunity to test during the surgery to determine the depth required to remove all cancerous cells, as well as doing any required skin grafts or skin flaps to repair the surgical excision and minimize scarring.
The basal cell cancer is in a crease between the nose and mouth. Dr. Iwasaki said she would be able to do this surgery in her office, but that we should do the others first.
The melanoma (the most serious), is on Dad's right cheek. Dr. Iwasaki recommends MOHS surgery for this as well. She ordered one more test to be done on the biopsy sample (called a 'stain'), which will verify whether the cancer is superficial (extending only into the first layer of skin) or if some cells have extended further. If the cancer has extended further, it may be necessary to do a lymph node test to see if it has actually penetrated to a lymph node. Results should be received soon. The MOHS surgery has been scheduled for next Wednesday, April 15th.
Only one MOHS surgery can be handled at once, so a second appointment will be required for the squaemous cell cancer, once the first is done.
Once all of these surgeries are complete, Dr. Iwasaki suggests doing a full body inventory of Dad's skin marks to identify any other potential problems. She visually noted at least one on Dad's face (near his eye), but wants to wait until all the current surgeries are done before completing the inventory and determining a treatment plan according to priority.