Showing posts with label stroke. Show all posts
Showing posts with label stroke. Show all posts

Saturday, July 14, 2012

Day Twenty-Three - Strokes

I visited an old friend today. Ed was one of the first patients I worked with when I had started a new rehab position five years ago. He had just been admitted from the hospital after his stroke, was paralyzed on his right side, and was unable to speak. You could see the fear in his eyes when I met him; none of his words were coming out of his mouth and he was unable to move. Our rehab team (physical, occupational and speech therapy) swooped in to help Ed start his recovery.

Ed's stroke occurred in the motor area in the left hemisphere of his brain, resulting in Broca's aphasia. Usually, people with Broca's have good comprehension, but struggle to express themselves verbally. Ed and I started with yes/no questions, picture-pointing tasks, and Melodic Intonation Therapy. His progress was slow, but steady; he was able to request items with single words like "drink", "bathroom", and "cold".  His wife Eleanor was an interesting lady. She was very intense, asked many questions, and frequently screamed at the nurses if they did not get her what she wanted. She liked me, fortunately. I think it was just the fact that I listened to her and empathized with how hard Ed's recovery was going to be for both of them.

I was fortunate, given the limited rehab time that is often given to patients post stroke, to work with Ed for almost six months. He continued to make measurable progress. We had progressed to short conversations. He shared some of the details of his life. I found out he had been a mechanical engineer. He had three sons and four grandchildren. Ironically, two of his grandchildren attended my middle school. He is a recovering alcoholic. He told me his marriage was challenging, and that he had considered divorce. His wife had thrown the telephone at him, hitting him in the head; it was at that moment that he had the stroke.

Ed could be challenging himself; he would become frustrated with his inability to express himself quickly and would swear at the staff - his words came out so clearly then! Even after his health care plan stopped paying for therapy, I would stop in to see him before or after my shift at work to have a conversation, or to set up his TV to watch a baseball game. He became like a second father.

I worked at the facility part-time after school. The facility decided after I had been there a year that they wanted to hire a full-time SLP. Since I was not available to take the job, they hired someone else. I was sad, because I really loved working at this place. I filled in here and there when the new SLP was on vacation or unavailable, and continued visiting with Ed. One day, when I stopped by to see him, a nurse on the floor told me that the family had moved him. The administrator would not tell me where he went. It would have been blurring the margins of my jobs to talk about this with his grandchildren; I knew eventually, I would see his son to ask Ed's whereabouts.

Ed's only granddaughter was graduating this year, and I ran into her dad, Nate after the ceremony. He gave me a big hug, and told me where his dad was living now. His mom was in an assisted living facility as well. Today, I stopped by to visit my old friend. His speech continues to come out in short bursts - he uses three to four words phrases, but they are clearly articulated. He told me about his wife, his grandchildren, and how much he missed the old facility. He kissed my hand and told me how glad he was to see me again.

I know I say it all the time, but I am so blessed to do the work I do. I meet the most wonderful people, and get to have a positive impact on their lives. I know that they have an even bigger impact on mine. I plan to see Ed again next week.

Saturday, July 9, 2011

Day Sixteen - Response

Sisters-in-law are falling apart. Dearly Beloved is a pillar of strength. Insurance company wants to move her to another facility, even though that would be grossly inhumane. DB lobbed some major responses back at them. By the end of Friday, Mother was still in her room in the hospital. Tonight she spoke to my DB, and asked him where she was. She knows we are around! He was there to reassure her, and make her comfortable. He is a wonderful man, and my hero!

Thursday, July 7, 2011

Day Fifteen - Receive

It has been another long day. In respect for her wishes, extreme measures will not be provided. She is receiving pain medication, and Dearly Beloved and SIL2 take turns being with her, so she is not afraid or alone. Her breathing has become more labored as the evening progressed. She will go when she is ready.

Day Fourteen - Rough

Rough day. Summer school in the morning. Afternoon and evening at the hospital. Mother has taken a downward turn. I don't think she will be with us much longer.

Wednesday, July 6, 2011

Day Thirteen - Report

Doctor, Doctor, gimme the news...

It was a Doctorpalooza day. Mother was not doing well. She failed her swallowing test; she has no swallow reflex at this time. I talked to the SLP who was evaluating her; she will try again tomorrow to see if she has improved. Nursing reported she is not doing well; the doctor has called for a family meeting to discuss Mother's final wishes. Dearly Beloved and I planned to attend, and fill in his west-coast siblings later on.

When we arrived at the hospital, Mother was like a different person! She was telling slightly confused stories, but there was no facial droop, and her speech was not slurred! The doctor was blown away, and decided he had to change his meeting plan. Instead of planning for her imminent demise, we discussed rehab, and the possibility of a short-term feeding tube if her swallowing problems continued. Things are looking brighter!

The other doctor event...remember that bloodwork I had done? The doctor's office called to discuss it, which in my book is never a good sign. They told me that I have an abnormally underactive thyroid, and that I had to start taking medication for it, which I will take for the rest of my life. Rather mind-blowing! I am happy it is not heart disease, or diabetes, any other horrid thing, but this is the first long-term medicine I have had to take. Bummer.

Maybe this will lead to magical, permanent weight loss!  Surrender....!

Tuesday, July 5, 2011

Day Twelve - Ride

Dearly Beloved arrived at the cottage yesterday afternoon. We spent a nice afternoon and evening together, and today we drove home. Mother is fair at best. She is seeing a neurologist today, and will have a speech/swallow evaluation tomorrow. She is in good spirits, but cannot swallow. Most definitely had a stroke...some drooping in her right side, some slurring in her speech. We will see what tomorrow brings.

Happy Independence Day, America the Beautiful!

Sunday, July 3, 2011

Day Eleven - Retreat

Dearly Beloved planned to be here yesterday evening. Alas, plans often go awry! His fiesty, determined mother (age 89) was suddenly unable to stand up or keep her balance Friday evening at around midnight. Ambulance was called. Mother was lugged off to the hospital. After many hours, CT scans, blood work, etc., hospital said, "Good news! It wasn't a stroke. We think it is an inner ear thing, and we will give her some medicine. You can take her home now!"  DB replied, "Great! Let's see her get up and walk with just my help." A walker was brought in. Mother fell out of the bed that she thinks is leaning at a 90 degree angle, and was caught by hospital staff. Three people helping could not help her walk. She stayed in the hospital overnight, and was transferred to a rehab yesterday. At the rehab, they discover that she cannot swallow. ANYTHING. This is new; this lady eats like a lumberjack, as long as you make it for her. So Mother has been shipped back to the hospital for a Modified Barium Swallow, where a speech-language pathologist and radiologist ask you to swallow barium-laced  foods and liquids of different consistencies, while taking an X-ray/video to see what you can safely eat. My speech-language pathology brain is in high gear now - if she did not have a stroke, why the sudden inability to swallow? I will patiently wait for the results, and then ask all my questions.

Poor Dearly Beloved - he is exhausted. I hope to see him soon.