Alex Adventures

Since mid-August, adventures with Alex have been mixed – some bad adventures (sad news and two hospital visits), but also some good adventures (Oakland Zoo and a Halloween party). Let's get the bad stuff out of the way first.

The Bad News:
On August 15 Alex's bunny died. Alex called him Raah, short for rabbit (sounds like the oft pronounced name for Egyptian sun god Ra) which is somewhat appropriate since Alex sort of worshipped his bunny like a god.

The rabbit was older and frail and there was a heat wave that may have contributed to his demise. Alex was aware that the bunny was not responding and would be gone for good; he was subdued but did not seem to be despondent at the loss. The bunny, originally thought to be female, was named Alexandra by the staff, but shortly thereafter changed to Alexander when the true gender was discerned. It did not matter. To Alex he was Raah. Fortunately the manager at Alex's residence had another bunny belonging to her two adult sons that was also being cared for at Alex's residence. The fact that BunBun was still there and Alex was able to feed him carrots softened the blow.

Alex may have been quiet due to two other reasons. One reason is that one of the other residents of the home passed away in her sleep about a week previous. She was one of the more vocal and ambulatory residents and interacted with Alex a fair amount. She was in her sixties with multiple disabilities but nevertheless, her sudden death was unexpected.  We do not believe that Alex grasps the concept of death (do any of us?) but her presence is missed and the household was askew.

A second reason for Alex's quietness was that he was intermittently running a fever for several days. Again, the weather had been unusually hot that week so the fever was monitored and treated with Tylenol. When a speckled rash appeared on his arms and face, Alex was taken to urgent care, which sent him on to the emergency room of the hospital with a suspected diagnosis of spinal meningitis. After sedation and anesthesia for a spinal tap on Monday August 19th, which was negative for meningitis, he was discharged. There was no diagnosis or prescribed medication, only a presumption of a viral infection that would run its course. After nearly a week of continued intermittent fever and lethargy, Alex once again, on Friday August 23rd, saw a different doctor, who found Alex had a huge internal anal abscess that required lancing. (The urgent care doctor on August 19th had missed it, dismissing a bump as a harmless hemorrhoid, postulating instead the wrong diagnosis of potential meningitis.) After an oral antibiotic and anesthesia for the second time to lance and insert insert a drainage tube that remained for ~10 days, Alex seemed to be on the mend. Shortly after Labor Day his tube was removed and he returned to his regular routine. He had missed three weeks of his day program.

September was relatively quiet. Then on our anniversary, September 27th, Alex was taken again to the emergency room (this time we avoided urgent care) because of a rash on his arms and because another client at the home had the mumps and there was a false alarm that he might also. He endured an 11 day hospital stay, September 27th - October 7th, with multiple traumatic blood draws for petri dish growths, trying to determine which antibiotic would best treat his particular systemic bacterial infection.

During his hospital stay, Frank and I tag-teamed each other to be with him morning/afternoon and afternoon/evening, with a hospital sitter at night. Videos and puzzles helped Alex pass the time, though he did repeatedly request to go bowling.

The optimal antibiotic was not available in oral form and so he was put on an intravenous antibiotic which had to be continued for fourteen days. A visit by a therapy dog brightened one of his days. 

Alex was tolerant for a week and then he had had it. A staff member from Alex's residence came on his day off bringing Pringles and giving Alex a shave and a haircut. Alex beamed up at him as they walked the halls together, singing. Still, Alex fought crossing the threshold back into his hospital room after being out in the hallways.

Fortunately 11 of those 14 days of antibiotic were used up in the hospital. He was discharged with the caveat that we take him daily to an infusion clinic, one used for chemotherapy treatment of cancer patients, for his remaining four doses, 30 minutes duration each, October 8-11.  Prior to release he was subjected to a third sedation/anesthesia bout to install a mid-line catheter for his infusions. A midline catheter is an 8-12 cm flexible tube inserted in the upper arm with the tip located just below the armpit. It is heavily taped in place and a knit sleeve from wrist to armpit is worn over the arm to protect against its dislodging. Alex was a champ wearing that invasive tube and during those four half-hour treatments. I settled him in with a movie on my iPad and with M&Ms or Hershey Kisses and he was content and cooperative. We were a bit bummed that the mid-line catheter could not be removed on that final Friday October 11th because there was no doctor's order to do so. It would need to remain in yet another weekend. Alex's beloved bowling would need to be postponed yet again for fear of dislodging the mid-line.

In making lemonade out of lemons however, we noticed that the succulent landscaping outside the infusion clinic was in bloom. It was beautiful. I never knew those purple "cabbages" could be so pretty.

The Good News:

So on Sunday October 13th, in lieu of bowling, Frank and I took Alex to the Oakland Zoo. The weather was positively gorgeous and we had a great time. The zoo had a newly added upper viewing area that we had never seen. The tan somewhat circular trail is a wooden  and concrete pathway that overlooks free roaming animal areas beneath. The black silhouetted figures alert to the presence of the Gray Wolf, Jaguar, Bald Eagle, California Condor, Grizzly Bear, Mountain Lion, and Black Bear.

We took a gondola ride to the upper level. It's path up the hillside is marked by the central vertical red line on the previous map. The cars swing by in a U-turn path at the lower terminal and upper terminal. The gondola had the height and views of a ski-lift experience but with all-enclosed cars that held six passengers each. During the ride the hillsides above and below were visible as were the other cars as they passed in the opposing direction. Alex smiled the whole way.

Once at the top we had an ice cream snack outside the landing cafe. Alex was content to cling onto his map, periodically crumpling it and tearing off bits to throw religiously and diligently in the trash.

Then we went on into a building called the California Conservation Habitarium that was nestled into a hillside. It had large windows that looked out on the grizzly bear roaming region. Ground level at the rear was at window height so visitors could be up close and personal with the grizzly bears.

There were five sorting canisters so visitors could contribute to collecting data on what the bears were doing at the moment. 

• At rest
• On the move
• Interacting with another grizzly
• Interacting with something in exhibit
• Eating

Choices were moot since we never saw a bear on which to collect data.

Alex enjoyed the setup immensely and spent an inordinate amount of time sliding CDs into slots at the top of each canister. It was a grand bank system to him. I sure hope the data was not sacred since I am positive Alex skewed it beyond all measure. But he was having a blast; Frank and I just smiled, watching and allowing him persist for probably close to 20-30 minutes time. After being cooped up in the hospital, we felt he deserved to do whatever he wanted for as long as he wanted. We just pulled up a seat on a nearby bench or on the carpeted floor and chilled. Oh, and yes, he went back again later to do it some more. His knit sleeve is visible on his right arm and his zoo entry stamp of a gorilla on his left arm.

Close by within the building was another area with a rope bridge over it. Alex had fun walking (actually running) back and forth across the swaying contraption.

We wound our way counterclockwise around the pathway catching at least a glimpse of the following animals in this order: Black Bear, Mountain Lion, Jaguar, Gray Wolf.

The bears were being feed. A keeper would place a tennis ball on a stick against the fence at certain positions and then feed the bear at those points.

Signage at the zoo was amusing, advising people to guard their voices. There was a coyote sign with a finger shadow puppet image behind it.  The wolf sign made me wonder just how many people had acted in a way that made the sign necessary.

At the upper platform terminal we posed for a few photos while waiting our turn for the gondola ride down the hillside.

Alex never sopped smiling and is still clutching his mangled map, dropping torn-off bits of it at each trash can, like a trail of bread crumbs.

On the ride down we looked at the map for the lower level of the zoo. (Frank and I had preserved ours so we would know the lay of the land.) Alex is still smiling!

It was nearing the end of the day and we'd decided to finish up with a train ride around the lower level. The rail path is designated at the green line on the following map. There is a loop around Adventure Landing where the carnival type rides are, a mildly curved way past the Main Entrance, and a loop around Wild Australia at the bottom of the map.

The "straightaway" still had gentle curves, ideal for photographing a sense of the scale of the train while in motion. Note the yellow diamond road signs for the Emu, Wallaby, and Wallaroo when entering Wild Australia. Size of these marsupials range from smallest to largest: wallaby, wallaroo, then kangaroo.

End of the line and time to head home! Note a bit of that map still remains in Alex's left hand.

On Monday October 14th, Alex had a post-hospital office visit with his primary care physician. She called a midline certified nurse into her office to remove Alex's midline catheter right then and there, instead of needing to return to the infusion clinic. It was a struggled to remove all the taping and Alex protested a large amount with the discomfort of tugging against at the adhesive. But once it was off, the catheter line slid out like a dream and Alex was out of that doctor's office like a shot. Frank had to run after him as Alex wanted outdoors, now! I hastily threw my sweater over his shoulders and that knit sleeve is still slid down to his wrist. But, as far as he was concerned, he was, "Free at last!" He and Frank waited outdoors for me to finish speaking with the doctor and to gather our belongings.

Here Alex is holding his get well card sent by his sister-in-law Carrie.

Midline removed, Alex could return to his day program on Tuesday October 15th. The next event would be Halloween and a party both at his day program and a local recreation program. Alex was thrilled and proud to go as Woody from Toy Story. He even was willing to forgo his Green Bay Packers cap (in his hand in the next photo)  to wear a cowboy hat like Woody. Now that is a momentous occasion.