Stroke of Determination, part 1

Late last week, occasional reader and contributor (and longtime chum) Spartacus caught my recent posting here on my mother's stroke, and the first steps of her recovery. He kindly emailed me his best wishes; I responded:

-----Original Message-----
From: Aging Child [mailto: AGeneChilde@YouWho.com]
Sent: Thursday, July 24, 2008 1:07 PM
To: "Spark" le Klaus
Subject: Re: Stroke of Determination

Thanks for the thoughts, Chief. Yes, Mother's strokes (there was a second one in the hospital, and these two may have been part of a possible series of little ones this month) were mild – in that all that seems to be affected are her coordination and motor skills (i.e., damage restricted to her cerebellum). Her humor is indeed firmly in place, and we've all been buoying her morale (and sapping her strength) with frequent visits.

Longer-term prognosis… who knows? She's getting some interesting rehabilitative therapy (and so gets to play with cool/intriguing toys), and her motor skills and speech are improving. It broke my heart to see her cry when (early on) one of her doctors told her she'd probably never drive her car again. Yet… a few days after her first stroke (before my sisters and Mother's doctor corralled her), Mother did indeed drive twice, with no trouble beyond bumping the hubcap on a curb… something I do on a weekly basis myself. (And more recently Mother said dismissively to one of my sisters, "I've driven enough.")

Further stroke(s) since admission have left her nearly unable to walk – though she gamely tries, with walker and nurse and firm resolve, and is getting better at it, too. Yesterday she was playing solitaire (no cheats, either) with her rehab coordinator, and afterward gathered the cards together (flipping them over where needed) to get them back into deck-shape. Sure, she was clumsy… but she did it.

She tries to write… but it looks like Arabic. Strike that; I can read bits of Arabic/Farsi/Urdu… and her scrawl is still just about illegible. Except: when she came back into the Transitional Care Unit late last week (or early this week), she signed her treatment plan and initialed here and here and here and don't forget up here, too, ma'am. This was all legible, and recognizably her own handwriting.

The issue for her is that all her life her mind's known what she wants her body to do, and the body cooperates. Now… it's kind of like when your foot's grown numb while sitting on the toilet with an especially good magazine: you try to walk on it, and the blasted thing just flops around. (Exception: she's not numb in her extremities; I've tested this by tickling her feet; she jerks them back and makes an annoyed look at me. Heh-heh.)

She doesn't give up… and that's never been her way anyway. More than once I've said to her, "You know this isn't a permanent condition, right? That you're getting better?" She usually responds with a simple "Yes." And she does. She also doesn't limit her speech to one- or two-word phrases, but still sticks with full sentences… which often are still very garbled, so we get her to back up and repeat particular words, even the whole sentence, just more slowly, e-nun-ci-ate, and that helps. E.g., about rehab yesterday, she said with impressive clarity, "They worked me harder than ever!" I pointed out (and so did sister Mew) that this is exactly what the rehab folks are supposed to do; she understands that, and embraces it. Doesn't like it… but you can't blame her.

And speaking of magazines: I dropped off the last of your impressive science-magazine stash, plus a couple years' worth of "Consumer Reports" (and a few others) all around the hospital last week: notice a table and chair in waiting-areas, deposit another magazine. There are a lot of waiting-areas… and I had a lot of magazines to work with. [note for readers: Sparks got hold of my mailing address a while back, and this Spring sent me a nice boxload of science-based magazines… I got some good reads, and he solved his recycling-overflow problems.] And they were quite the improvement over "The Watchtower", local real-estate rags, "Dog-Polishers' Monthly", "Feeled and Scream", and so on. And as I walked through the waiting-areas over successive days… folks were reading them, too.

You just may have helped boost (even if just temporarily) the average IQ of the average Hometownian here; on their behalf, I thank you from the heart of my bottom.

Regards,

Hugh Jass

Spartacus sent back:

-----Original Message-----
From: "Spark" le Klaus [mailto:SpartaCuss@Yabbadoo.com]
Sent: Thursday, July 24, 2008 3:18 PM
To: Aging Child
Subject: Re: Stroke of Determination

Thanks much for the fuller report on your mom's condition. Sounds like she is well on the road to recovery. Most importantly, her attitude is in the right place, and that has to make all the difference in the world. You had better start training, man--with the PT she's getting, she could very well be challenging you and your bro to a 5k race one of these days!

I could really relate to your analogy about sitting on the toilet and having a leg go numb; when I worked in construction, I would wake up in the middle of the night with my arm completely numb and unresponsive, like a piece of dead meat attached to my body. Scary stuff.

Glad to hear too that my old mags have found new homes; mental stimulation is a part of the recovery process, and anything's better than "Dog Polisher's Monthly"!

Yawl take care!

--
Some of us have been sleeping for these eight long years, while our nation's values have been traduced, our liberties reduced, and our moral authority around the world trampled and shattered by a nightmare of ideological incompetence.
Ted Sorensen, former advisor to JFK, commenting on the George W. Bush administration

More updates coming, folks. 

 

Stroke of Misfortune

It's obvious – if you're one of my two or three readers – that postings here have been getting sporadic. Well, they will continue to do so for a while. Rather than detail what's been going on, I'll fill in this posting with some recent email traffic, including select responses.

First, though:

To paraphrase Erich Segal: after years of threatening to do so, this month my mother actually turned [muffled] years old. So the weekend before – Saturday, July 5 – the family celebrated the fourteenth anniversary of her third twenty-second birthday… you can do the math.

All five of her grown children were there (this was at my sister Mew's lovely, sprawling house), plus spouses (including older-brother Sarge's new bride, Hyong-Su Nim, formerly known here as Choggun-Nunim), grandchildren (all but one; younger-brother Doc's older daughter, Auriga, is in Australia), Mother's older brother and his wife, and some guests, hangers-on, and passers-by… most of a couple dozen loud, delightful folks.

Mother loved it. And it wearied her a bit, of course. And most recently, her health had been seriously concerning us…

-----Original Message-----
From: A. Gene Childe [mailto:AGeneChilde@YouWho.com]
Sent: Monday, July 07, 2008 10:26 PM
To: 'Shellie, Home'; 'Portia'
Cc: 'Pauli'; 'Azey'; 'Chuckles'
Subject: Update on (Grand)Mother

Good evening, lovely young ladies; here's the latest:

Since we've all been troubled at Grandmother's recent symptoms – the slurred speech, dizziness, tiredness – Mew and Alicia took her to her doctor's early this afternoon for a closer looking-at. On examination, the doctor had her admitted to the hospital (room 4038); her neurologist gave her more detailed tests (MRI, etc.), and determined that she had indeed had a small stroke at the base of her brain, affecting both sides of her body.

(This dovetails closely with what Levi had suggested to me on Saturday as a likely cause of these symptoms – he had described something called vertebrobasilar insufficiency.)

This neurologist wants to have a cardiologist look at her (this'll be tomorrow), since he suspects this might have been brought on / provoked by atrial fibrillation (this, too, Levi had suggested we look for), which could have caused small clots to pass through her bloodstream and lodge in plaque-narrowed veins in the base of her brain – i.e., the cerebellum – which helps with motor control, coordination, and so on.

If these conjectures are on target, the treatment will likely include putting her on a blood-thinner (e.g., Coumadin/Warfarin), which she'll take for the rest of her life – hopefully many more years. Shorter-term will likely involve some rehabilitative therapy so she can manage stairs and so on (and they haven't been a real problem for her anyway… but there's still the risk of slipping and falling), plus she may also have a nice extended stay at Mew's or Sarge's, where nearly everything's on the same floor anyway. Even here, I could put a mini-fridge in the basement, for example… but she really does like being upstairs and doing stuff, and shouldn't be confined in moving around.

I just got back from visiting her (Sarge and Hyong-Su Nim are there right now) with Alicia and Mew; her spirits were fine (she flirted with her male nurse) – the worst that could be said was that she did seem a bit tired and slightly slurred, and at times looked at me with a Popeye-like gaze (i.e., one eye squeezed shut), plus kept sliding down in her bed. I asked her if she feels differently mentally, and she said, no, she still feels the same. I tested her subtly by mentioning and asking about some things recent and further back that would require her to dig around mentally, and she did fine.

And she was very much alert, and – as we saw on Saturday – does like having family around her.

Mew and Alicia have the details; you probably have their email addresses and/or cell numbers. Plus she has her own cell phone with her (and she's allowed to!), as well as her room-phone, and would be delighted to hear from you… although it is just a bit hard to make out what she's saying sometimes – she says it's from the alcohol.

And I'll keep you updated.

Love,

Dad/Gene



...and Garfield made it!

-----Original Message-----
From: chuckles [mailto:chucknyuk@youwho.com]
Sent: Tuesday, July 08, 2008 7:56 AM
To: A. Gene Childe
Subject: Re: Update on (Grand)Mother

Hey there,

My mom had the same thing and said she was fine when you asked, but in reality we could tell she wasn't. She would yell at us when her brain functions got bad., had slurred speech, and ended up using a walker. Maybe you should tell her you'll send Tiger after her if she doesn't behave. I'll call her today. I've got a con meeting at 8 pm tonight.

chuckles

-----Original Message-----
From: A. Gene Childe [mailto:AGeneChilde@YouWho.com]
Sent: Tuesday, July 08, 2008 2:51 PM
To: 'Chuckles'
Subject: RE: Update on (Grand)Mother

Your mom was a great woman… and no grey in her hair until you came along, I bet! She also had a great chuckle to her… thanks to you too, no doubt.

I breezed through briefly this morning to get Mother's paper to her: she still looked at me Popeye-style, but her speech and manner were very clear. On her own, she listed for me all my former employers since 1977 (quite a long list), so she does still seem mentally unaffected, ditto her moods and emotions. She was grumbling about the possibility of being put (even if for a short time) in a nursing home, which is where she might receive some rehab.

It's likely your mother had a somewhat different kind of stroke; this kind seems to have been confined to Mother's motor control, coordination, etc. – in other words, it's finally brought her down to the level of the rest of the family, right?

The main thing is to find out about the source of these clots, if that's what's caused this, and get her on blood-thinner. If this were Shellie, she'd simply thin out her blood with alcohol. And if it were Tiger… well, there's no chance of him getting thinner, unlike your Mr. Smugface.

Gene

-----Original Message-----
From: Pauli [mailto:pauligürl@klatschen.de]
Sent: Friday, July 11, 2008 5:54 PM
To: agenechilde@youwho.com
Subject: Re: Update on (Grand)Mother

Hi A. Gene,

I am glad to hear that your mother got checked out and properly evaluated. Hopefully the new medication will alleviate some of the symptoms she had been struggling with recently. Has she been released from the hospital yet? Please do keep us informed.

Thank you so much for the update. I had wondered how she was doing.

Thanks,
Pauli

-----Original Message-----
From: A. Gene Childe [mailto:AGeneChilde@YouWho.com]
Sent: Saturday, July 12, 2008 12:32 AM
To: 'Pauli'; 'Portia'
Cc: 'Chuckles'; 'Azey'
Subject: RE: Update on (Grand)Mother

Good evening, gals!

The very latest: I went to visit (Grand)Mother a few hours ago; Licia, Mew, Shellie, and baby Dannay-Lee (riding in front of cousin-Shellie like papoose-meets-kangaroo) were already there, and we wore her out – and one of the nurses shut the door because we were getting loud! Well, you've seen this family in action; there should be no surprise in either regard.

(Grand)Mother's been moved to the Transitional Care Unit, room 409, and rehab will start Monday (I think). The cardiologist said that the clot/stroke had not been triggered by atrial-fibrillation -generated blood clots, so I think we don't know what the cause of the cause was, if you follow me. This means, though, on the plus side, she won't be taking Coumadin (also used as a rat poison – really! I'd grimly pictured a large pill-bottle labeled "Zyklon"… yigg! And whew.)

I don't know precisely what medications are currently being administered; I assume she's still on her high- blood-pressure medication, daily aspirin, and a couple other thingies that Mew, Alicia, and Levi would know loads more about. I also don't know how long it'll be before she's back home – again, she may stay a couple days/weeks first with Sarge or/and Mew.

One thing Portia might appreciate: her grandmother's now sporting a black eyepatch to rest her overly-sensitive left eye. (I'd kidded her about that all week, not thinking the doctors would actually give her one!) So as soon as I saw that this evening, I greeted her with an "Arr, matey!"

If anyone has a spare parrot, please let me know.

Her spirits are great, her mind is sharp and keen – and she's been given a two-page list of words to pronounce in order to retrain her tongue (and larynx?), to which I've already added the word "neglected"… not because she is (she's not), but because she was having trouble, uh, getting the "L" out of there. Really! Licia was just finishing getting Mother to pronounce the words when I got there, and Mother was doing great with them… having fun, in fact, by deepening and raising her voice, or altering the word to a synonym (that's another word for the list, come to think of it).

That list put me in mind of a very similar one in my joke vault – I've appended it down below – one that is in fact very useful for quite similar reasons; I'll have to print it up and bring it in to her.

Thursday being her birthday, I brought her a little stuffed Garfield (with sunglasses, gold chain, and big smirk) – Tiger insisted; I though it wasn't something she'd like… but who am I to argue with a cat? Sure enough, Mother's delighted to have him there sitting close to her, grinning away. She and I each had a slice of the cake Sarge and Hyong-Su had dropped off the night before (I got some photos, too – will send later); we set aside a couple slices for Mew and Alicia, and I distributed the rest of them among the hard-working medical staff.

Room 409 is a private room; visiting hours (and I think a few of the visitors, too) are rather loose, and Mother also has her cell phone, and would welcome a call from any one of you (at reasonable hours, of course): 233-243-601-499. She's wearing her own clothes – great for her morale, and so much more dignified than those silly backwards shirts the hospitals issue. (At one point, Mother even started singing "My shirt has not buttons; no buttons has my shirt…"!) She's required to summon a nurse when she needs to get up (e.g., to the bathroom), since there remains the risk of her falling. She also has a walker, but her right wrist is bothering her, and so the walker was not seeing as much use this evening.

Back on her home front: Levi did a couple very skilled walkthroughs of the house, from sidewalk, through the main floor, and down the stairs to Mother's bed, and made recommendations about where to install added railings, and so on. We rearranged (i.e., deranged) the living-room – after Alicia and I finished painting it – for increased mobility-space. Mew and Licia also did similar mobility-considerate things with Mother's bedroom, and also steam-cleaned her carpet. Levi (with needless advice from me) reinstalled a wall cabinet in Mother's bathroom (and patched holes our first attempts had created!).

In sum, all is well (considering), and looking very good. Please don't hesitate to drop by to see her if you're anywhere close (unannounced is okay… though she might be snoozing – Tiger's been teaching her some of his tricks); she loves flowers, so we brought her a couple large blooms from her garden the other day, and I'll bring some replacements tomorrow.

Have a great weekend, everybody; I know Mother will!

Love,

Gene/Dad

P.S.: Here's that alternate list:

Things That Are Difficult to Say When You're Drunk:

Indubitably

Innovative

Preliminary

Proliferation

Cinnamon

Things That Are VERY Difficult to Say When You're Drunk:

Specificity

Judicial system

British constitution

Passive-aggressive disorder

Loquacious transubstantiate

Things That Are Downright IMPOSSIBLE to Say When You're Drunk:

Thanks, but I don't want to have 5ex.

Nope, no more booze for me.

Sorry, but you're not really my type.

Good evening officer; isn't it lovely out tonight?

Oh, I just couldn't. No one wants to hear me sing.

-----Original Message-----
From: A. Gene Childe [mailto:AGeneChilde@YouWho.com]
Sent: Sunday, July 13, 2008 11:46 PM
To: 'Mrs. Dawn Bosco'
Subject: Update on Mother
Importance: High

Good afternoon, Ms. B:

(And I hope I got your email address correct.)

This past Monday (7/7/08), Alicia and Mew took Mother to her doctor's, since she'd been exhibiting dizziness, wobbliness, and – particularly indicative – slurred speech. Her doctor had her admitted immediately to the hospital for further exams to confirm the likeliness she'd suffered a mild stroke.

Confirmed.

To our best determination, Mother's mind is untouched, but her coordination and motor skills have been affected – both sides, but her left a bit more so; her left eye in particular has been weakened, giving her double vision… and necessitating an eyepatch. Since she's been assessed a fall-risk, she has to summon a nurse/caretaker when she needs to get up for the rest room, etc. She also has a walker, but there's some kind of problem with her right wrist (particularly troubling swelling), which Radiology was to look at earlier this afternoon; so use of the walker is a bit of a problem at the moment.

I must stress: her spirits are great, her mind is sharp, and her outlook is a bit feisty… though she's always been a bit sensitive to very mild depression and loneliness. We haven't given her much opportunity to feel lonely, though – all her family stops in to see her at least once to several times a day where possible (even at ridiculously late hours), including "Doc" Rich and Sarge popping up once or twice thus far this week (Doc with a daughter in tow, Sarge with new wife Hyong-Su Nim). Plus Alicia, Levi, and baby Dannay-Lee are still down here (staying at Mew's), so she's getting as much attention as she can stand, and then some!

She's in Transitional Care Unit room #409, is wearing her own clothing (i.e., none of those peekaboo backwards shirts), and can use her cell phone with no danger of futzing up anyone's monitors: 233-243-601-499. I think rehab will start on Monday; I don't know how soon she'll be back home – she may even further transition for a week or two at Mew's or Sarge's, since everything she needs would be on one floor, eliminating the hazard of stairs. In any case, Levi gave me an excellent walk-through of our house, pointing out where rails, etc., could/should be added to make Mother's goings-about much easier and safer; we also rearranged the living-room and Mother's bedroom/office to make them even more mobility-friendly.

Mrs. Bosco, please feel free to stop by and visit her at the hospital – she'd love it, and you needn't call ahead. In any case, you can certainly call her anyway, of course; I know she'd love to hear from you, and to see you. And I think the family could use some inputs/suggestions from you on helping take care of Mother, based on your own experiences, personal and professional (including speech-rehabilitation).

I'll bring her the Eucharist tomorrow, by the way. And she did have an Extraordinary Minister visit during the week… though from what I heard, that person may have missed a class on sensitivity: when told Mother had had a stroke, the woman gasped, and blurted out, "Oh! I'm so sorry!"… this within earshot of Mother, of course. Again, her mind really seems unaffected; only her motor control has been marred. So a comment like that, even out of hearfelt reflex, might have served better silent.

Mew, Levi, and Alicia have more precise details, and longer-term outlooks, and can fill you in even better. But just stop on by there and say hello, and pass word among mutual friends at church (I'll be doing the same tomorrow).

See you there!

Gene

----Original Message-----
From: Mrs. Dawn Bosco [mailto:DBosco@AllSaints.com]
Sent: Monday, July 14, 2008 11:15 PM
To: agenechilde@youwho.com
Subject: Re: Update on Mother

Gene,
Some observations of mine. Certainly your mother's mind remains sharp but her inappropriate responses to some questions and directions leaves me to speculate that there may be some mild receptive language issues. As a result of the stroke she has lost some fine motor and articulator mobility the latter effecting the clarity of her speech. I suggested some mouth exercises to help restore some of that movement, namely going from smile to kiss position of her lips, both of which should be exaggerated. I suggested she pretend she is kissing Cal Ripken but she told me to kiss him myself as he is not one of her favorites. HER HUMOR REMAINS INTACT. I will stop by later in the week to harrass her a little more and will bring her Eucharist on Sunday. I have contacted members of our lenten group and they will pray for her recovery and probably visit her. Take care.

-----Original Message-----
From: A. Gene Childe [mailto:AGeneChilde@YouWho.com]
Sent: Monday, July 14, 2008 11:50 AM
To: BKanntin@EPost.de
Subject: Mutti

Tag, Bea!

Hoffentlich ist alles bei Euch gut, und der Komputer kooperiert gleich.

Letztes Wochenende feierten wir (ein Wenig früh) bei meiner Schwester Muttis 80en Geburtstag (der war eigentlich letzten Donnerstag). Sie hatte etwa 20 Gäste (die meisten waren natürlich Familie und Verwandten), und da war sie sozusagen das fröhliche Auge des Orkans.

Aber da machten wir uns um sie Sorgen, weil sie mehrtägig etwas benommen/schwindlig gewesen war, hatte nur schwäche Ausgeglichenheit, konnte die Wörter nicht klar aussprechen, usw. Daher den nächsten Montag (d.h. letzten Montag) gingen meine Schwestern mit ihr an die Ärztin, und sofort wegen der Diagnose in das Krankenhaus: irgendwann vor ein paar Wochen hatte sie einen kleinen Hirnschlag/Insult.

Weitere Diagnosen nachher zeigten ihn auf: die Schädigung ist nur auf dem Kleinhirn beschränkt: reduzierte Motorik; aber der Verstand (d.h., Erkenntnis, Humor, usw.) ist total unbeeinflusst davon… Gott sei dankbar!

Sie besuchen wir sehr oft, und täglich hat sie auch schon wiederherstellende Behandlung. Wir glauben, sie bleibt nicht länger da drüben, und geht zurückzuhause vielleicht nach einigen Wochen. Da bereiten wir das Haus vor, z.B. Handläufer im Treppenschacht (und in der Dusche) einbauen, Vorleger / kleinen Teppich festmachen, usw.

Ich schreibe mehr später, muss nun den Neffen von der Fahrschule abholen. Bis dann!

Eugen