Thursday, March 19

We are Finally on a Roll

It seems like it has been so long since Dad has his stroke and so many uphill battles that it seems impossible we have had almost a week without a major medical crisis. But it is true. Today marks the one week anniversary of Dad being transferred to Sheltering Arms and so far so good.

Matt's report today was very positive. Dad walked around the gym (not sure what size the gym is) at Sheltering Arms twice today. He only had to sit down once. He did wonderfully in OT and in a BIGGIE he got to eat a little bit of oatmeal. If it had been me eating the oatmeal it would have been on the negative side of things because I HATE oatmeal but Dad loves it and it was the first solid food he's had to eat since February 8 ---Go Dad!!!!

Dad had visits from a deacon, a pastor, and a chaplain today. While I am sure he loved the visits Mom says he started talking and telling one of his stories right in the middle of the deacon praying. Sounds like his mouth is going as fast as his legs are. Oh well, Rome wasn't build in a day.

It is great for Dad to finally have a chance to get out of bed and begin to heal. They anticipate he will be at the Rehab about three weeks. I can't wait to see how much progress he can make.

Thank you all for your continued prayers and thank you Matt for taking such good care of Dad and Mom.

Tuesday, March 17

3/17/09 -- Live from New York


I've been in Boston (family) and New York (business) for the last ten days, so I haven't had a chance to see Dad since he was discharged from the hospital and transferred to Sheltering Arms.  This short update is therefore based mostly on reports I received today from Matt, who has seen Dad at least twice a day since he was moved.  (Thanks, Matt.)

Dad had a fairly good day of rehab today.  He appeared to be starting to regain some of the strength he lost during his recovery from surgery.  Additionally, and importantly, he appeared to be somewhat more focused, and less easily distracted.  The staff has come up with a plan that may help his sharpen attention and focus through medication.   Everyone keep your fingers crossed on that one.

As I've noted on several occasions in this blog, rehab is truly a roller-coaster ride.  While we all wish that Dad's recovery would consist of a series of steady, predictable, daily improvements, that's not the way these things seem to work.  All the more reason, then, to appreciate the good days, like today.
   

The Unseen Effects of Stroke


When my father had his stroke his official diagnosis was a massive right middle cerebral artery stroke. This meant little to us at the time. We all wondered at Dad's ability to remember stories from his childhood, early adult years and his retired life with my Mom and growing family of grandchildren. We were then thrown into the world of superbacteria, the devastating effects of c diff, and our father's emergency surgery. As Dad has gotten stronger we are beginning to see the effects of his stroke and I have learned much more about the temporal lobe, parietal lobe, and insular cortex than I ever wanted to know.

We are all getting to know a Dad who is very familiar to us and at the same time a stranger. Dad has always been a quiet reflective man, but now he talks up a storm. The torrent comes whether he is in one of his therapy sessions or talking with us. Dad has always been a dutiful man. He served in two wars, rarely took a day off from work, is devoted to my mother, and takes care of himself following whatever orders his doctor might give. He now shows disinterest in his therapies preferring to sleep or talk about his family. While Dad can verbalize his desire to be home and his feelings about having to stay in a hospital, when it comes to recognizing the emotions in others he draws a blank. He has difficulty maintaining his attention and concentration is a struggle. This lack of concentration affects everything he does, even interfering with swallowing. As I am sitting here I realize he talks freely about his touch and go c diff hospitalization but has not mentioned his stroke or it's effects and ignores us when we discuss it.

The doctors talk about aprosodia, anosognosia, and neglect. They discuss auditory comprehension, lability, and post-stroke fatigue. I am beginning to learn what the doctors are saying when they speak this "foreign language." In many ways I am grateful for the research that has been done so they can actually name stroke symptoms, tells us specifically what part of brain they come from, and develop a treatment plan to help either remediate or cope with the damage. On the other hand with these symptoms unnamed it is easier to just look at my father, listen to the stories, and pretend he is my Daddy once again.

Sunday, March 15

After a Month Long Delay Dad Can Begin to Pick Oranges


Dad has a dear friend, Wharton Gaul. Dr. Gaul and my father went to Virginia Episcopal School together, went into the military together, and even contracted scarlet fever together while in the military. Dad has often talked about how, if Dr. Gaul had not gotten out of his own sick bed to care for my Dad, Dad probably would not have lived through the illness.

Ever since Dad's stroke Dr. Gaul has called me every Wednesday between 3 and 4 p.m. to ask how Dad is doing. This past week he told me an interesting story. According to Dr. Gaul, after Dad and Dr. Gaul got out of the "make shift" hospital in California for scarlet fever, they were sent to a rehab facility. What was unique about this facility was the fact that it was not a rehab facility at all, it was an orange grove, donated to the military by Bing Crosby. Dad and Dr. Gaul would get up every day, walk around the grove, pick oranges and recuperate. Despite Dad's many tales from his past this is one we had never heard. We asked Dad about it. He remembered it well. Dad said they told him he could have whatever he wanted to eat. Dad ate peach pie every day.

As I sat yesterday in Dad's new rehab I was reminded a little of this story--there is a big picture window in Dad's room and he has a wonderful view of the many pear trees blooming outside. There are courtyards for Dad to go out and get fresh air and the room--despite having the trapping of a hospital room--had wallpaper and a wonderful ledge at the window for plants and cards. You could hear talking throughout the rehab but there were no bells going off, announcements over the intercom or harsh lights. This may not be the orange grove of Dad and Dr. Gaul's memory but it seems to be a place of relative peace where he can begin to heal.

Dad is already looking better. He was up in a wheelchair when Mom and I arrived and was getting ready to have speech therapy. The speech therapist was asking Dad questions to assess his cognitive losses. I don't think the therapist quite knew what she was getting herself into. 

She started off with a very simple question--I can't remember the question but Dad got it wrong. She looked somewhat concerned and then asked Dad again. This time he got it right. After that he was off and running, "Do you put salt in your milk?" "NOOOOOOOO! of course not," Dad replied. "Are the sun and the moon in the sky at the same time?" "Yes," Dad replied, The therapist looked concerned. "Well I guess they can when there is an eclipse," she said. No Dad said, "it happens twice a month." "Which can go faster, a motorless car or a bicycle." "A motorless car," Dad replied. She again looked concerned. I did too--maybe there were more cognitive issues than we thought. "It's simple," Dad replied. "You put the car at the top of a hill and it rolls down the hill like a go-cart." I think that was pretty creative. They may have to rewrite this test after Dad's done with it. Meeting with the therapist after seeing Dad she indicated she did not see any cognitive issues--more issues of attention and concentration as well as Dad continuing to talk a LOT!!!!!!

I sometimes wonder how Dad feels after giving people psychological testing for so many years he is now having the testing done on him. I think he is actually having a little bit of fun with it.

Dad says his children are BOSSY. He still wants very much to go home and Matt had a talk with him about not going home until he completes rehab. He may not be happy with it but I think he is accepting of the fact--especially since Matt is so close he can see him several times a day.

Since Dad is finally feeling good, even though he is very weak, we now have a chance to see what progress he can make to recover from the stroke. This may not be Bing Crosby's orange grove but I have a very good feeling the results will be the same.