BethBlog

A note from Beth:

Today I am going home — Taiwan home — to see my mother and family. I miss my mother very much and, even though she doesn’t know how sick I’ve been, her love has given me great strength.

I am happy to make this trip, and I am very happy because I AM ABLE to make it. I am happy to be alive. I am happy to be with you.

I want to say thanks to you for your prayers, support and help over the past nine months. I couldn’t talk or move or even think when this adventure started, but I felt your love throughout. Our friends in Belgium and Bonnie, Kristen, and Fulton were at my bedside, but I felt all of you there too. Thank you.

My trip to Taiwan is a victory for me — and for you!

A note from Fulton:

Please accept my thanks also.

When I look at pictures of me and Beth visiting castles in France just one week before she fell ill, when I look into her eyes in those snapshots, and when I realize that we had no idea what challenge lurked just days away, I feel pain.

I guess we have to live our lives knowing that very bad things can happen in an instant, but believing that they won’t. The fear could be debilitating, paralyzing.

Like you, I have marveled at Beth’s miraculous recovery. I have also marveled at how your love and support have contributed to that miracle. Family, friends, faith and the love that holds it all together are what get us through that fear of the unknowable and the challenges that confront us. So I, too, say THANKS to you!!

Note that the entries below are in reverse chronological order - with the newest up top.

Since our return to the United States in December, Beth has had many appointments with doctors and therapists, and she’s undergone lots of tests and evaluations. We have been to Arlington Hospital and other medical facilities more than a dozen and a half times.

The news has been consistently good. In fact, we’re hearing that the level of Beth’s recovery puts her in a very small group of aneurysm patients. She’s worked hard and deserves a lot of credit, but great things like this don’t happen without a lot of support from the friends among us and from friends “upstairs.” Your prayers and messages of love and hope have been crucial. The brilliance of her surgeon and doctors back in Belgium is also clear.

Quick updates:

– CT-scans, a CT-Angiogram, and an EEG showed good healing of Beth’s brain and very good brain activity.

– The doctors have taken Beth off her antiseizure medication. She’d never had a significant seizure but took the medication to prevent them. The medicine had some difficult side-effects, however, so she’s delighted to be off it.

– The speech therapist has been giving Beth plenty of homework — and Beth’s speech is improving! Among the assignments: Have someone read a list of four words, and then Beth repeats them back in REVERSE order. (Not easy!)

– The occupational therapist gave Beth exercises to help rebuild strength in her right hand. But when Beth demonstrated her bead-jewelry skills, the therapist said, “You don’t need me!”

The recovery is a multiyear process, but the consensus from all the medical professionals is clear: Beth’s progress in the seven months since her surgery has been truly impressive. Unlucky to have the aneurysm, she’s been supremely lucky in her survival and smooth recovery.

“Thanks” is a word on Beth’s lips a lot. During our last week in Belgium, she wanted to declare her thanks for all to know. The sign in the shopping center parking lot at SHAPE, which you can see by clicking here, was one way. These friends visited her practically every day and provided love and patient support and assistance for which Beth will be eternally grateful. Lila continued to help even after returning to Italy!

One couple whose names wouldn’t fit on the electronic billboard was with us through every phase of Beth’s crisis and recovery. Col. Chip Bridge provided leadership that helped save Beth’s life, and he and Sara supported us in the emergency room, in intensive care, on the neurology floor, and in the four months between Beth’s discharge from the hospital and our departure from Belgium. They cooked; they drove; they played DVDs; they opened their guest-room; they helped us pack out; and they’re still helping us take care of hospital accounts. We wish we could have leased a billboard to thank them up in Waterloo, where they live.

* * * * * * * * * * * * * * *

We are back in our house now. Our furniture has arrived. Things are beginning to look “normal.” Beth greatly misses her friends in Belgium (and friends she made in Belgium who have returned to Italy, the UK, Greece, and Spain), but being home has been therapeutic too.

In a few short months, she’ll fly “home” to Taiwan — to see her mother and family.

When Beth refers to home, she could mean home-in-the-US or home-in-Taiwan. She’s got her eyes on both.

Right now, we’re in the process of preparing for our return to the United States on December 5. All of our furniture, kitchen stuff, books, beading gear, computers, etc., have been packed up and put in crates addressed “Mr/Mrs Armstrong; Arlington, Virginia, USA.” We went through the rigorous “out-inspection” process at the house on Monday — during which a real inspector, the landlord and I went through the house with a fine-toothed comb — and we passed with flying colors.

We’ve moved into a charming hotel in downtown Mons, right off the central square (Grand Place), while I do our “out-processing” and last-minute work at the office. We’re staying in exactly the same room as we did when we arrived here three years ago! The weather — grey, rainy, chilly — is the same too!

Belgium’s been very good, and the medical care’s been great. Beth’s going to miss her friends at SHAPE a lot. Lila, Paula, Rita, Barbara and Floriana have been powerful assistants in Beth’s struggle, often visiting her several times a week. Their patience and love and generosity have been gifts of inestimable value — an example for us all. (They also make the world’s best lasagnes, tiramisu and limoncello!!)

But you can imagine how important this move is for Beth. Going home means being with Bonnie and Kristen, and with Alek and Megan. It means having easier access to familiar foods. (Beth’s first meal upon return is going to be a great big bowl of pho — Vietnamese beef noodle soup.) Going home means moving back into a familiar house we love. Going home means seeing friends we’ve loved for decades. Going home also means continuing medical treatment and therapy.

And then … after a couple months at home-in-the-US … Beth’s going to set her sights on visiting home-in-Taiwan.

Beth returned to Erasmus Hospital on Thursday — 15 weeks after her surgery — to “meet” her surgeon for a checkup. She’d actually met him a number of times while in the hospital, but she had no recollection whatsoever of him.

Doctor and patient hit it off, and the checkup went as well as we could ever have hoped.

The doctor reviewed Beth’s record since the surgery, including an angiogram she got while in the hospital and a CT-scan she underwent two weeks ago. He also looked at the results of her two most recent blood tests. Then he gave her a couple tests to do.  She walked forward and backward with her eyes closed. He also asked her to hold her hands still in front of her with her eyes closed.

He then pronounced that her progress was “spectacular.” And, very importantly, he said that the pace of her progress so far indicated that further progress toward recovery would continue to be strong. In addition, he said:

– The CT-scan was “perfect.” The clip on the aneurysm is holding perfectly, and the aftereffects in the brain of the aneurysm rupture and surgery are within normal parameters.

– One of Beth’s remaining serious concerns — about tremors in both hands that make it very difficult for her to do her artwork — is a side effect of the medication she’s taking, not permanent damage to the brain. (The medication, which prevents vascular spasms in the brain for patients like Beth, is similar to that used for epilepsy.) The trembling will stop when she completes the required six to 12 months on the medication.

– She is cleared to fly. She’s cleared to engage in aerobic exercise. She’s cleared to enjoy life.

When we left the surgeon’s office, we (including the surgeon) saw the chief neurologist who was in charge of Beth’s case after the surgery. Briefing him, the surgeon used the same words to describe Beth’s progress — including “spectacular”– and the neurologist agreed. The neurologist only cautioned that we shouldn’t get frustrated that language returns slowly; he called it a “two-year process.”

This sort of good news, coupled with the care Beth has been receiving from a doctor down here at SHAPE, is a real boost to her morale. At SHAPE, she has received extraordinary support from a doctor who practices more than just medicine; he practices the art of healing. We’ve been so impressed that I wrote a letter to senior officers expressing appreciation for his help. I said he applies his science and training with discipline, but he also applies compassion, confidence, and calm. He cures fears as energetically as he does diseases. On our refrigerator, we’ve stuck a note he wrote to Beth: “Every day better!”

And he’s right. The past 15 weeks have been a true challenge for Beth, and she still has a way to go, but every day has been better.

Imagine this:  You’re the neurologist at Ambroise Paré Hospital (here in Mons) who was the first person to look at Beth’s CAT-scan on June 26, the first person to see her aneurysm.  You’re the person who told me and my friend Chip that Beth’s situation was “very grave,” that she required emergency brain surgery, and that an ambulance would take her immediately to Brussels, into an uncertain future.

And …  you’re that neurologist today, and Beth walks into your office bright and early this morning, sits down, and says, “Hello.”

What do you say?  You say, “I am VERY happy to see you.  You look much better than the last time I saw you.”

And over the course of the conversation you say, “It’s a miracle, you know.  It’s a miracle how well you have recovered in just two months.  Your aneurysm was among the extremely serious kind, from which few come back as well as you have.  To have difficulty with only speech after an aneurysm and surgery like this is wonderful.  Congratulations.  I am happy for you.”

Needless to say, it was a wonderful checkup for Beth.

Three weeks ago, when Beth came home after release from Erasmus Hospital, I said, “You know, this is a miracle.”  She thought I said, “This is America,” so she said, “No, it’s not.  It’s Belgium.”  But when the doctor referred to miracles this morning, she knew exactly what he meant.

I think that we have witnessed a host of miracles … the miracle you all have prayed for; the miracle of advanced medicine and incredibly talented doctors; the miracle of committed, caring nurses and therapists; the miracle of friends and their prayers, cards, visits, gifts, and help to us finding care and therapy; and the miracle of the patient struggling to live and improve.

Yesterday was the two-month “anniversary” of Beth’s surgery, and I think you’d be delighted to see her progress!

She’s still a bit weak and skinny, and the aphasia’s obviously a big challenge, but Beth la combattante is doing very well.

Her first meeting with the speech therapist was excellent. The diagnosis is that Beth has “classic, textbook aphasia,” and the therapist is crafting a package of exercises for her. We’ll leave the professional training to the therapist, but those of us in routine contact with Beth can help her rebuild her vocabulary by pointing to things and saying, “What’s this?” We’re allowed to give her a hint — such as the first sound of the word or a definition — but Beth’s instructions are to “produce the word.”

We’re happy this stage of therapy’s off to a good start.

On the second “anniversary,” Beth was commenting on the impact the aneurysm and surgery have had on her life and outlook. One thing has been the awareness that, yes, big problems can hit you out of the blue; your life can be turned on its head in just one second even while calmly and healthfully sitting in the safety of your home.

The implications of that are huge. If you’ve been hit once, you know that you can be hit again. The laws of statistics don’t give you a pass.

But neither can you live in fear of the unpredictable. You can’t deny yourself the pleasure of the moment because you fear that the happiness may be your last. However hard it is to be optimistic at times, Beth’s guiding thought is that catastrophe may loom around the corner again but we still have to walk down the street … and try to enjoy it.

Being home for these two weeks has been very good for Beth. Every day she says Erasmus was a great hospital but she’s happy to be home.

She’s resting well, and gradually getting her appetite back. Lila has been visiting each day — helping make sure Beth eats well, takes walks, and talks! Paola and Rita have visited her, also raising her spirits.

After sadly having to turn down other invitations, Beth went to a BBQ at Chip and Sara’s house in Waterloo for a while yesterday. Chip had put a sign on his garage door saying, “This space reserved for BETH” in exactly the format required by Belgian law — and Beth laughed hard when she saw it. Beth went to a quiet room for breaks every little while during the BBQ, but it was a great first outing for her! (And she received a huge bouquet!)

Moreover, Beth’s treatment seems to be falling into place. She’s already had to go for two blood tests, and one result has been that she’s been able to reduce one of her medications. She’s going to see a doctor later this coming week, and we’re hoping he will be able to help us think through next steps on the medical side — or at least until Beth returns to Erasmus Hospital for a CAT-scan in September and a checkup with the surgeon in October.

And even more important at this phase, it seems like we’ve found a good English-speaking speech therapist. Beth hasn’t wanted me to help her with language exercises. (I wonder why. I was such a good driving instructor for her 25 years ago!) But she’s eager, in the hands of a good therapist, to learn more about how to overcome her aphasia. She has a language evaluation tomorrow, and then the therapist will propose a plan.

I say it’s important not because Beth can’t talk. She can talk, and her ability is improving every day in both English and Chinese. The progress is most evident in the mornings; she gets tired in the afternoon and has trouble even after a nap. I think the therapy is also hugely important for rebuilding her confidence. What’s happening now is that when she can’t remember a word or a name — which happens to all of us (right, Uncle Bob?) — she worries that it means she’s not progressing fast enough.

One thing is certain: a medical and therapy plan like this wouldn’t be coming together without friends here at SHAPE like Lila and Mauro, and Paola and Rita, and Rita’s husband — who has the best medical Rolodex in Belgium, if not Western Europe.

Another thing that Beth has to look forward to this week: Kristen’s returning for a short vacation next Saturday. Like Bonnie’s recent visit, it’ll be a huge morale boost for Beth.

Beth’s taking over here as if she’d never been away. And she doesn’t seem to think that my housekeeping skills in her absence were totally up to snuff; she’s already pulled out the vacuum-cleaner twice.

Seriously … she’s adapting to life at home with joy. She’s genuinely happy to be home, and she says so repeatedly. She also repeats something she said last week: “I’m happy to be alive; everyone should be happy to be alive.”

I’ve begun working with the clinic at SHAPE (the NATO base where I work) on Beth’s follow-up needs. They’ve arranged for Beth to see a doctor for the blood tests needed to adjust her medications. They’ve started helping me look for an English-speaking speech therapist in this area — so we don’t have to drive up to Brussels several times a week — but so far we haven’t had much luck. This is a holiday week in Belgium (tomorrow is the Catholic feast of Assumption), so many people are on vacation.

Beth’s friend Lila has come over each day and provided Beth saintly support. They’ve taken walks and caught up on seven weeks of news. Today, Annie and Leo joined them. Beth is responding with clearer, more sophisticated language day by day.

The doctors have prescribed formal speech therapy, but I’ve got to think that the only reason they don’t prescribe this sort of engagement with loving friends is that it’s so rare.

Beth was sitting in the chair next to her bed when I arrived at the hospital at eleven o’clock sharp this morning.  She had her jacket on, shoes tied, and possessions neatly packed in a shopping bag at her feet.  She was as ready to go as she ever could be.

We checked out at the nursing station.  They gave us a package of information and medications to get Beth well into next week.  Beth said her good-byes to the chief nurse and his amazing staff, with a merci that they all knew came from her heart.

The nurses reciprocated the affection.  I can’t help but think that, even though they’ve seen it many times, they themselves must marvel at the sight of a patient like Beth walking out on her own power, steady and proud and thankful to be alive.  It’s a miracle that all had a hand in.

Forty-six days ago, Beth and I were riding an ambulance on the northbound side of the E-19.  Today we were headed southbound — yelping our happiness and high-fiving each other.  Chip and Sara called on the cellphone while we were driving, and I’ll bet they sensed a giddiness in Beth’s voice that they didn’t dare think they’d hear again seven weeks ago.

When Beth and I turned into our little lane, I tooted the horn, and Monique and Michel rushed out to welcome her.  When we opened the door of the house, Beth saw the beautiful sunflower — her favorite flower — that Lila brought over.  She looked at the cards and gifts on the diningroom table, and turned to me with the biggest smile I’d seen in 47 days.

In the understatement of the day, Beth said, “I’m home.”

Then she said, “Tell everyone I said Thank you.”

The doctor and therapist’s reports were quite positive.  They’re always uncomfortable making long-term predictions — an incident as severe as an aneurysm almost certainly leaves some permanent deficit (as they say) — but their comments pointed to a very good if not excellent recovery.  Even the word “optimistic” was used once.

The medical team says that she can take a break from physical therapy and ergotherapy (occupational therapy) for a while.  On those fronts, they’re prepared to give her body some time to catch up.  She’s regained a lot of strength and coordination.  They’re recommending some “bead therapy” — working with her friends and former students on beads.

Interestingly, the doctors still have not cleared her to fly; that is not likely, except in an emergency, until the surgeon sees her again in October.

Despite clear progress in language, Beth is still aphasic and needs continued speech therapy, after which she will benefit from the assistance of a neuropsychologist.  One of my tasks next week is to find her a good English-speaking speech therapist here in the Mons area.

But my task today is to celebrate with her … let her take a nice nap … take her for a walk (after days of crummy weather, it’s warm and dry today) … cook her a nice dinner … and let her enjoy a cup of Chunky Monkey.

Beth’s home, and after almost seven weeks of struggle and progress, she deserves some time off.

I’ll continue updates, although probably not daily, here on the blog as Beth enters this new, exciting phase of her recovery.  Your comments are, of course, ALWAYS welcome and appreciated.  The daily printouts I have brought her have been a source of great comfort and inspiration!

Thanks for your cards and notes, for your prayers, and for your support!  You have participated in a miracle too!

I return from the hospital with all good news for you tonight.

Beth is, indeed, coming home tomorrow, définitivement (as they say in French). The doctor and chief therapist gave me a very good report on Beth’s progress — good in its thoroughness, and good in the sense that it confirms that Beth has made very important progress. It’s even good, within the couched terminology of the medical world, in its prognosis for her recovery.

The medical team asked that I pick Beth up at 11:30 tomorrow morning. She has to undergo a blood test, and they want the results before she’s released (so they can adjust her medication if necessary).

When I said good-bye to her and said I’d be back at 11:30, she said, “How about eight o’clock?”

This is, clearly, a woman who’s eager to come home.

I’ll give you more details tomorrow on my conversation with the doctor. Tonight I would like to share with you the hand-written notes that Beth’s two roommates left for her while she was at therapy and I was meeting with the medical team. They both left for home furlough while we were away.

The first note (written in English):

To Beth Armstrong and her good husband: Good luck to you. I really wish you the best! –Anne, the girl with the beer!! [Note: Anne’s referring to the fact that I was VERY impressed that her hospital dinner, delivered by the nurses each evening, included a 10-oz bottle of Jupiler lager.]

The second note (written in French):

I wish you a good return home. I hope that all will go well during your recovery. Hang in there [bon courage], and good luck!!

These notes, on the heels of the doctor’s briefing, have meaning far beyond the words. Beth went into Erasme Hospital near death; she endured an incredible struggle; and her roommates are going to miss her. That’s an amazing achievement, but … you know … Beth, la combattante, is an amazing woman!