Thursday, June 17, 2010

Update On Mr. AOW

(Click directly on the image to enlarge it)

I often have to remind myself that Mr. AOW has greatly improved since his right-side thalamic hemorrhage (size 3.5 cm x 3.9 cm, the size of a small plum) resulting from high blood pressure. The hemorrhage was so large that the intensive-care doctors sent me home the afternoon of the stroke to get the advance medical directives to file with them.

Please see this post of February 1, 2010, to understand just how difficult the situation for months on end.

Of course, early on, the situation was unmanageable here at home: Mr. AOW couldn't swallow solid food and couldn't sit up at all; he was also incontinent. As a result of all his deficits, he spent a total of ten weeks in various medical-care facilities. Getting him out of that nursing home required the threat of litigation!

Continue reading below the fold.

Once Mr. AOW returned home on November 25, there were five months of assisting a 190-pound man with every potty-chair transfer! Until one blessed day, when I returned home from giving a tutoring session, I found Mr. AOW sitting up on the side of the bed and grinning at his success in making the transfer to and fro all by himself.

These potty-chair transfers on his own haven’t always been successful, however. On one occasion not so long ago, Mr. AOW slipped and banged himself up pretty good in attempting to get back to the bed – not to mention overturning the potty chair. Fortunately, Mr. AOW wasn’t significantly injured and the homeschool ladies arrived just a few minutes later: with their assistance and the assistance of Mr. AOW’s stepfather, getting safely up off the floor was accomplished. Since that nasty event, Mr. AOW is wary of potty-chair transfers on his own, as well he should be. We have found that wearing a non-slip footie or a shoe on the affected foot minimizes the precariousness of transfers.

I do still get up at least once during the night to empty Mr. AOW's bedside urinals and, sometimes, for a bed change. Not getting an uninterrupted night's sleep every single night takes its toll on me. I do try to make up for lost sleep by hitting the sack earlier than I did before Mr. AOW had a stroke.

More on Mr. AOW's situation now, some nine months post-stroke:

Mr. AOW still cannot walk and spends his days and nights at home in a hospital bed in the living room. But he is starting to be able to stand! Standing balance is essential to his relearning the neurologically-complex skill of walking.

After nearly five months of home therapy and maxing out that particular benefit provided by the health-insurance plan, we now venture out of the house to a particular hospital which offers neuro-therapy. The sessions are two hours in length and grueling. The therapists remain certain that Mr. AOW will improve even more, particularly because his left side (leg and arm) show no signs of atrophy, meaning that the signals from the brain are getting through to the muscles even if Mr. AOW cannot yet use those muscles consistently. On the negative side, Mr. AOW's left hand does suffer from contracture. The stroke began in the hand, so the hand may be the spot of permanent dysfunction. As Mr. AOW is left-handed, this lack of function of the left hand causes him significant distress.

Because Mr. AOW's left hand and arm don't function, his managing the hand-held urinals present problems with spillage. The episodes of spillage are less frequent now, though. Therefore, I actually have the occasional day of doing no laundry. Woohoo!

Mr. AOW's attitude is beyond excellent! He remains committed to trying to get better. Also, he continues to practice the exercises assigned by the therapists, and his appetite is good – too good, in fact. I have to watch his caloric intake so as to prevent any more weight gain.

Mr. AOW continues to require maximum assistance with showers. In fact, this task requires another person besides myself to get him to and from the bathroom, several rooms away and safely in and out of the shower. A loyal friend and I wheel him into the bathroom in the transport chair; next, with assistance from me, he transfers onto the commode (lid down), then onto the shower chair, at which point I have to lift his left leg into the bathtub so that I can turn on the shower head and scrub him down.

I use this same chair, much lighter in weight than a standard wheelchair, to take Mr. AOW down the ramp and to the car. Occasionally, we do hire the expensive handicapped taxi to take Mr. AOW to a place where he wants to get around by himself, such as the shopping mall or the local VFW. Because he has left neglect, Mr. AOW cannot travel unsupervised – even up and down our residential street. For example, on one little trip down the street on his own, Mr. AOW forgot to look to his left side and ended up in the muddy ditch.

This left neglect also means that Mr. AOW will likely never drive again. Fortunately, this possibility doesn't weigh on his mind too much as those with right-side strokes tend to have a rosy outlook on life in general. Still, Mr. AOW does miss driving the Mustang convertible (pictured left in better days). In fact, the car is presently sidelined; shortly, we'll have it flatbedded out and get an estimate to see if it's repairable. Looking back, Mr. AOW and I now realize that some of the damage incurred to the Mustang last summer was the result of his having mini-hemorrhages as he cannot clearly recall the episodes that resulted in damage to the vehicle.

Getting Mr. AOW ready to go out anywhere is a Herculean task! In addition to tending to bathrooming, he cannot yet completely dress himself. The occupational therapist is working on the skill of getting dressed despite hemiplegia. Because Mr. AOW cannot travel from room to room inside the house, everything has to be brought to him: food, drink, toiletries, clothing, toothbrush and toothpaste, etc. I must walk miles every day inside this house!

Psychologically, the biggest problem for Mr. AOW is the lack of friends coming to visit. We have a lot of used-to-be friends. Conversely, we have discovered who our real friends are; see THIS about what a family of my former clients did for us and THIS about The Merry Widow, for example. We have also discovered just how loyal our friends at the VFW are; in addition to our local VFW's building the wheelchair ramp here at our house so that I could bring Mr. AOW home, once or twice a month, one of the VFW members will stop by to take Mr. AOW out for the evening. I stay home and nap while Mr. AOW goes out on his male-bonding outings.

A year ago, when Mr. AOW and I celebrated our thirty-seventh anniversary in our usual carefree manner, we had no idea how much life could change in one short year. At the age of fifty-nine, just an hour after finishing a shift at work, he was catapulted into an unforeseen lifestyle. As I draft this posting, the man who led a full and active life on September 14 is sitting on the front porch in his transport chair and tossing bits of bread to the birds.

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posted by Always On Watch @ 6/17/2010 04:35:00 AM