It sort of seems like we've been marking time with Bettie's progress this whole month, her first at home from the hospital. It's not that there has been no progress...there has. But it has been greatly restricted by a recurrence of pain in the gall bladder area which has had her spending a great deal of time lying on the couch. This is time she could have been working on walking, right side movement, and speech. The issue has been that *#@ drain tube.
I had thought that as soon as the tube was removed (one week ago) everything would be wonderful. But as noted in the previous post, the rest of that day (Tuesday) she went straight down hill. However, by Wednesday morning there was vast improvement. Even more the next day and the next and the next. Each day there was some discomfort in the (former) drain area but not much and seemingly diminishing.
Then came yesterday (Sunday). She awoke with considerable abdominal pain and her blood pressure was up by 20 to 30 points (I had been monitoring it closely as Dr. Greenman suggested). I was able to contact Dr. Greenman and he suggested I bring her in to see just what was going on.
At Auburn Medical Center, Dr. Greenman did an ultra-sound scan and lab work. Though it is sort of frustrating to find nothing wrong, it is definitely good news. We came home after a mere 4 hours.
My daughter-in-law, Veronica's theory is, Bettie is healing slower than normal as a result of all her body has gone through. This is evidenced by the bruise that still appears on her forehead from her fall two weeks ago. If that still shows, it should not surprise us that her insides would be bruised too from the drain, and that has only been out a week. I think she's right.
Today (Monday) she is better, though there is still some pain in the affected area.
Everyone who sees her after an absence of a week or more sees improvement.
I'll just have to be more patient.
Monday, August 31, 2009
Thursday, August 27, 2009
On Saying 'Goodbye'
No, no, she didn't die ... so calm down.
As described in Tuesday's post (Maybe We'll Glow in the Dark), Bettie had a gall bladder drain (a small plastic tube) removed after nearly six weeks being in place in her abdomen.
I expected her to immediately feel much better. Instead, by the time we got home from two more appointments that day, she was looking pretty grim. It was literally all she could do to make it up the steps to our bedroom where she collapsed on the bed, barely able to move for the rest of the day. I found it very difficult to determine if the issue was pain or exhaustion. It was probably a fair amount of both.
The doctors had said we would have to watch her closely for the next day or two, and I could see why. For me, it was an evening of hovering. While attending to her that closely, I realized that I could be watching the lights slowly going out. I didn't seriously believe she was dying, but on the other hand watching people die is not something I'm very familiar with.
Just to be sure, I took her vital signs and called for Dr. Stephan, who interrupted his evening to return my call. From what I told him, he reassured me that she should just rest ... "but keep watching." You can bet that I did.
It was during that time, sitting on the edge of the bed, leaning in close, that I began to tell her what a good wife she has been and how well she had treated me these past 50 years. I told her that I wanted her to keep doing that for a long time ... but if she needed to go now, that I -- while it was not an easy thing for me to get out -- I guess I gave her permission to move on ... to eternity.
I can't remember every detail of the conversation, (and it was that: a conversation. She clearly understood and gave me feedback) but I probably should keep that privately between us anyway.
The reason I mention this is because I look back on those moments as very special. Moments that I'll be glad I spent, if she does precede me, no matter how far in the future that may be.
So I'm thinking: "I wonder if this is something every couple should do?" Since we can't know how much time the beloved people in our lives will be, well, in our lives, wouldn't it be a good idea to tell them occasionally, just what they mean to us? I mean the kind of stuff you'd say if you really were saying goodbye for keeps.
Yes, it could be kind of maudlin, but it doesn't necessarily have to be. For me -- and I'm pretty sure for Bettie -- it was a positive time. I'll grant you it might be difficult, but not as difficult as having the same "conversation", in a cold lonely cemetery, on some dreary sad day in the unknown future, hunched over a fresh tombstone.
Note - For the very courageous among the readership of this blog:
Should you find some merit is this suggestion and actually follow through, we would love to have you post a comment on your experience. We know your words will help others. Not on the personal details of what was said, but on your experience with it and how you felt about it. Thanks!
Click here to add your comments and thoughts.
As described in Tuesday's post (Maybe We'll Glow in the Dark), Bettie had a gall bladder drain (a small plastic tube) removed after nearly six weeks being in place in her abdomen.
I expected her to immediately feel much better. Instead, by the time we got home from two more appointments that day, she was looking pretty grim. It was literally all she could do to make it up the steps to our bedroom where she collapsed on the bed, barely able to move for the rest of the day. I found it very difficult to determine if the issue was pain or exhaustion. It was probably a fair amount of both.
The doctors had said we would have to watch her closely for the next day or two, and I could see why. For me, it was an evening of hovering. While attending to her that closely, I realized that I could be watching the lights slowly going out. I didn't seriously believe she was dying, but on the other hand watching people die is not something I'm very familiar with.
Just to be sure, I took her vital signs and called for Dr. Stephan, who interrupted his evening to return my call. From what I told him, he reassured me that she should just rest ... "but keep watching." You can bet that I did.
It was during that time, sitting on the edge of the bed, leaning in close, that I began to tell her what a good wife she has been and how well she had treated me these past 50 years. I told her that I wanted her to keep doing that for a long time ... but if she needed to go now, that I -- while it was not an easy thing for me to get out -- I guess I gave her permission to move on ... to eternity.
I can't remember every detail of the conversation, (and it was that: a conversation. She clearly understood and gave me feedback) but I probably should keep that privately between us anyway.
The reason I mention this is because I look back on those moments as very special. Moments that I'll be glad I spent, if she does precede me, no matter how far in the future that may be.
So I'm thinking: "I wonder if this is something every couple should do?" Since we can't know how much time the beloved people in our lives will be, well, in our lives, wouldn't it be a good idea to tell them occasionally, just what they mean to us? I mean the kind of stuff you'd say if you really were saying goodbye for keeps.
Yes, it could be kind of maudlin, but it doesn't necessarily have to be. For me -- and I'm pretty sure for Bettie -- it was a positive time. I'll grant you it might be difficult, but not as difficult as having the same "conversation", in a cold lonely cemetery, on some dreary sad day in the unknown future, hunched over a fresh tombstone.
Note - For the very courageous among the readership of this blog:
Should you find some merit is this suggestion and actually follow through, we would love to have you post a comment on your experience. We know your words will help others. Not on the personal details of what was said, but on your experience with it and how you felt about it. Thanks!
Click here to add your comments and thoughts.
Tuesday, August 25, 2009
Maybe We'll Glow in the Dark
One can never know what might happen after spending a quarter-hour in a lead suit while X-Ray machines hummed away a few feet from where I sat watching Tuesday morning. Their job was to reveal Bettie's gall bladder on a video screen, just adjacent to where she was lying beneath those probing rays.
And reveal it they did. Well actually they were revealing a dye that had been pumped into the bladder. Bottom line, the bladder is clear and the drain, that has been troubling her for so long, can now be removed.
We were at Auburn Hospital again, two floors below where her home-away-from-home was for the entire month of July. That was a little after 9 O'clock this morning. With the drain issue confirmed, she was moved down the hall where a different imaging device assisted Dr. Gordon Greenman with the actual removal. The internist who we saw last week about having the drain removed (Dr. Donald Stephans) was in attendance too.
The tube out, we had time for just 30 minutes' rest at home before we headed out to Dr. Heide's office for a followup. Both he and his associate confirmed a lot of progress. This is the kind of progress that just sort of sneaks up on those of us here at home, and of which we are largely unaware because we see her every day. Tomorrow we go back to see Dr. Heide's so he can scan the area where she banged her head in last week's fall.
As if all of that were not enough for one day, we next went to the Anti-Coagulation clinic at Valley Hospital where her blood consistency could be checked. It turned out to be still too thick so I am going to have to continue a series of Loxenox injections into her abdomen twice a day, until her Coumadin level improves.
Gee, if it isn't one thing, it's something else.
Well, since she is hopefully headed for brighter days, I won't bore you with the follow up visits and tests she has been through the last few days, but it has been intense. Twelve separate appointments in just the last four business days. Enough already.
And reveal it they did. Well actually they were revealing a dye that had been pumped into the bladder. Bottom line, the bladder is clear and the drain, that has been troubling her for so long, can now be removed.
We were at Auburn Hospital again, two floors below where her home-away-from-home was for the entire month of July. That was a little after 9 O'clock this morning. With the drain issue confirmed, she was moved down the hall where a different imaging device assisted Dr. Gordon Greenman with the actual removal. The internist who we saw last week about having the drain removed (Dr. Donald Stephans) was in attendance too.
Update: A day after yesterday's appointments - on Wednesday morning - within about 30 seconds of each other, both Drs. Greenman and Stephans called me, just to see how Bettie was doing. It sure feels good to be in the hands of such caring professionals.These things always have risks, and complications are not unknown, so we have to watch Bettie closely for the next few days to see that all is well ... but we're very glad to have that darn tube out of her tummy. That's got to feel better. We always take for granted how good feeling nothing can feel.
The tube out, we had time for just 30 minutes' rest at home before we headed out to Dr. Heide's office for a followup. Both he and his associate confirmed a lot of progress. This is the kind of progress that just sort of sneaks up on those of us here at home, and of which we are largely unaware because we see her every day. Tomorrow we go back to see Dr. Heide's so he can scan the area where she banged her head in last week's fall.
As if all of that were not enough for one day, we next went to the Anti-Coagulation clinic at Valley Hospital where her blood consistency could be checked. It turned out to be still too thick so I am going to have to continue a series of Loxenox injections into her abdomen twice a day, until her Coumadin level improves.
Gee, if it isn't one thing, it's something else.
Well, since she is hopefully headed for brighter days, I won't bore you with the follow up visits and tests she has been through the last few days, but it has been intense. Twelve separate appointments in just the last four business days. Enough already.
Thursday, August 20, 2009
Getting Away with Murder
An idiom: "To escape punishment for or detection of an egregiously blameworthy act."
Informal: "To do as one pleases without ever being punished."
One of the most compelling arguments in favor of traditional marriage is the civilizing effect a woman has on a man. Being the product of 50 years of this civilizing, I can say that I am better and everything and everyone I touch is better, because I have had Bettie in my life. It's not that she isn't still in my life, but, at least for now, it is different...and I could revert, I could get away with murder (figuratively, of course).
This realization comes on slowly, creeping into my consciousness like shadows on a summer evening:
Yesterday I was putting something away in an office file drawer. The drawer was pretty full, and I knew very well why: It was half full of folders she had stuffed with travel articles of places we might like to go sometime, or pictures cut from magazines showing attractively appointed rooms...or furniture...or gardens. Just dreams on paper that could be easily duplicated electronically in a few seconds with a web browser and Google.
I had a half-dozen folders emptied, bound for the recycle bin before the guilt hit me: "Getting away with murder I see," I said to myself.
I went into the Family Room, knelt down by the couch where she was lying, and told her what I was doing. We've had this conversation before...it always ended with: "No, I'll go through those things soon." This time she agreed, with a knowing look that said: "Probably not for awhile, huh?"
"Yea," I said, "...that stuff is old anyway."
It got pitched...but because I asked, I got a reduction from felony to misdemeanor. I felt better anyway.
Now I'm telling myself: "Just because you can get away with murder, doesn't mean you should. Go slow here." I don't want to throw away the irreplaceable: Bettie's civilizing influence, just so things can be the way I think they should. That would be a giant step backward.
Informal: "To do as one pleases without ever being punished."
One of the most compelling arguments in favor of traditional marriage is the civilizing effect a woman has on a man. Being the product of 50 years of this civilizing, I can say that I am better and everything and everyone I touch is better, because I have had Bettie in my life. It's not that she isn't still in my life, but, at least for now, it is different...and I could revert, I could get away with murder (figuratively, of course).
This realization comes on slowly, creeping into my consciousness like shadows on a summer evening:
Some of these thoughts are benign and practical: I saved a little on our car insurance by taking her off the policy and promising to deactivate her driver's license; I moved the bedroom phone from her side of the bed to mine; I'll cancel her cell phone service soon. These are just practical little things, right? Should I tell her? Should I ask her permission? I don't know. But other thoughts feel kind of creepy to me."She would probably never know if I..."
"Now is my chance to..."
"I don't think she'll ever miss..."
Yesterday I was putting something away in an office file drawer. The drawer was pretty full, and I knew very well why: It was half full of folders she had stuffed with travel articles of places we might like to go sometime, or pictures cut from magazines showing attractively appointed rooms...or furniture...or gardens. Just dreams on paper that could be easily duplicated electronically in a few seconds with a web browser and Google.
I had a half-dozen folders emptied, bound for the recycle bin before the guilt hit me: "Getting away with murder I see," I said to myself.
I went into the Family Room, knelt down by the couch where she was lying, and told her what I was doing. We've had this conversation before...it always ended with: "No, I'll go through those things soon." This time she agreed, with a knowing look that said: "Probably not for awhile, huh?"
"Yea," I said, "...that stuff is old anyway."
It got pitched...but because I asked, I got a reduction from felony to misdemeanor. I felt better anyway.
Now I'm telling myself: "Just because you can get away with murder, doesn't mean you should. Go slow here." I don't want to throw away the irreplaceable: Bettie's civilizing influence, just so things can be the way I think they should. That would be a giant step backward.
Wednesday, August 19, 2009
She's Got Gall...again
Well, to be more accurate, she's got bile again.
If you read the post from July 14 titled Two Steps Forward, One Step Back you may recall that Bettie had an incident with her gall bladder that required the insertion of a drain. The original prognosis was that the gall bladder was infected and should probably be removed. However, removal in that condition posed a higher risk than the surgeons were willing to take. It was decided that a drain could help clear it up sufficiently to do the surgery later...four to six weeks.
For the past five weeks, since the drain was installed, she has gone without bile. Bile is a digestive juice produced by the liver and stored, when necessary, in the gall bladder. (You don't want to know where or how this is "handled" when a drain is installed...trust me.) The bladder condition, the drain, and the lack of bile to help with digestion, has been somewhat debilitating for Bettie. Today we took what will hopefully be a big step toward solving this issue.
If you read the post from July 14 titled Two Steps Forward, One Step Back you may recall that Bettie had an incident with her gall bladder that required the insertion of a drain. The original prognosis was that the gall bladder was infected and should probably be removed. However, removal in that condition posed a higher risk than the surgeons were willing to take. It was decided that a drain could help clear it up sufficiently to do the surgery later...four to six weeks.
For the past five weeks, since the drain was installed, she has gone without bile. Bile is a digestive juice produced by the liver and stored, when necessary, in the gall bladder. (You don't want to know where or how this is "handled" when a drain is installed...trust me.) The bladder condition, the drain, and the lack of bile to help with digestion, has been somewhat debilitating for Bettie. Today we took what will hopefully be a big step toward solving this issue.
During a visit to the internist, the drain was capped, allowing that nasty collection bag to be removed. The "drain to nowhere" is still in place, but her bile and gall bladder should now function somewhat normally. Next week a couple of tests will confirm that all is well...and if so, the drain comes out and the gall bladder stays in. With that accomplished, we will look for more energy, no more abdominal pain, and an increase in the rate of progress...all good things
Monday, August 17, 2009
A Sickening Thud!
In the post titled Setting Up For Rehab at Home, I mentioned "Standing Guard" while Bettie was in the bathroom. Over the nearly three weeks she has been home from Rehab, this has seemed to be less and less of a requirement. She had been taking care of herself quite well, with minimum "supervision"...until this (Monday) morning.
About 6:45 I awoke as she was getting up to go to the bathroom for the third time since retiring the previous evening. Though I had gotten up with her the previous two times, this time I simply said: "You OK, Honey?". She mumbled: "Uh huh" and proceeded into the bath, clutching her walker. The next thing I know I heard this sickening thud that could only be one thing. I was there in an instant and sure enough, she was in a heap on the floor next to the toilet, holding her head and moaning.
As I lifted her up, her hand came away from her forehead, revealing an inch and a half gash, just below her hairline on the left side. (We later concluded that her head had probably struck the aluminum frame at the bottom of our shower door.) The first time I saw a wound like this was when my son Steve fell off our back-yard slide, many years ago. Because the skull is so close to the skin surface, this type of wound can open easily and look much more serious than it actually is. Having seen Steve's cut years ago, I was not as shocked as I would have been otherwise.
Fortunately, she did not bleed a great deal...I say fortunately because she is on a blood thinner and it could have been quite messy. I got her cleaned up and put on a standard size band-aid. Though she was pretty shaken up by the ordeal and complained that her head hurt, I thought it was a relatively minor mishap. Returning to bed, she was able to go back to sleep for awhile.
Later, however, she did not want to get up for breakfast. I brought it to her in bed and called the Home Care office to cancel the therapists that were scheduled to come later in the day. In that same call, I suggested that it would probably be good for the nurse to come and have a look at Bettie's wound. That was the best thing I did all day.
When Tram, the home health care nurse came, she suggested that it would be better to have the cut stitched rather than try to keep it closed with a bandage. So, to make a long story (2 1/2 hours in the Urgent Care facility in Covington) short, Bettie has four stitches in her forehead (courtesy of Dr. Todd Bouchard) and I have a heavy heart for letting this happen.
She seems fine now...I probably feel worse than she does. I deserve it.
About 6:45 I awoke as she was getting up to go to the bathroom for the third time since retiring the previous evening. Though I had gotten up with her the previous two times, this time I simply said: "You OK, Honey?". She mumbled: "Uh huh" and proceeded into the bath, clutching her walker. The next thing I know I heard this sickening thud that could only be one thing. I was there in an instant and sure enough, she was in a heap on the floor next to the toilet, holding her head and moaning.
As I lifted her up, her hand came away from her forehead, revealing an inch and a half gash, just below her hairline on the left side. (We later concluded that her head had probably struck the aluminum frame at the bottom of our shower door.) The first time I saw a wound like this was when my son Steve fell off our back-yard slide, many years ago. Because the skull is so close to the skin surface, this type of wound can open easily and look much more serious than it actually is. Having seen Steve's cut years ago, I was not as shocked as I would have been otherwise.
Fortunately, she did not bleed a great deal...I say fortunately because she is on a blood thinner and it could have been quite messy. I got her cleaned up and put on a standard size band-aid. Though she was pretty shaken up by the ordeal and complained that her head hurt, I thought it was a relatively minor mishap. Returning to bed, she was able to go back to sleep for awhile.
Later, however, she did not want to get up for breakfast. I brought it to her in bed and called the Home Care office to cancel the therapists that were scheduled to come later in the day. In that same call, I suggested that it would probably be good for the nurse to come and have a look at Bettie's wound. That was the best thing I did all day.
When Tram, the home health care nurse came, she suggested that it would be better to have the cut stitched rather than try to keep it closed with a bandage. So, to make a long story (2 1/2 hours in the Urgent Care facility in Covington) short, Bettie has four stitches in her forehead (courtesy of Dr. Todd Bouchard) and I have a heavy heart for letting this happen.
She seems fine now...I probably feel worse than she does. I deserve it.
Sunday, August 16, 2009
And Now, for Something Completly Different
Yes, I confess, I was a "Monty Python" fan...thus, the title.
When Bettie's stroke occurred on June 23rd, I was about three weeks into a rigorous rehearsal schedule for a series of August performances of Meredith Wilson's wonderful musical "Music Man". I had auditioned for and been awarded a role in the barbershop quartet (known in the play as "The School Board"). Though I sing in Northwest Sound Men's Chorus, I have never performed in real stage drama. When I heard of the opening, I couldn't resist giving it a try.
Rehearsals were Sunday through Thursday evening from 7 to 10, beginning in mid June and going through the first performance on August 7th. Though all cast members were not required at every rehearsal, it was a very big commitment. So you're thinking: "I wonder how much they have to pay people to do that?" The answer: nothing, and that's what I love about it.
The production company that is putting this on is Twelfth Night Productions, founded and directed by Mary Springer. Over the years they have done a variety of productions, usually two to four each year, and this summer, it is Music Man. Though it is all volunteer, it is not amateurish. Read all about them on their web site.
Naturally, I had to resign from my role when the stroke occurred, but I remained on the e-mail list of the company. Thus, I know how hard they all worked to put on this show. I had told Mary that I wanted to bring Bettie, if she was able by the time the performances began. She set aside two tickets for me, from a sold-out house...I couldn't miss it.
Try as I might, I could not convince Bettie to come. She was quite adamant, like she is about going to church, that she would not come. She's just not ready. Veronica attended with me, and thoroughly enjoyed it.
Now I'm not a theater reviewer, so I'll leave that to others. But I am someone who appreciates things "American"...and this is, for my money, as American as it gets. Here you have dozens and dozens of people donating huge amounts of time and talent to give their neighborhood, their society, something good, happy, and entertaining. Not doing it for money, but for the sheer joy of doing it, and doing it the very best they could. Trust me: they succeeded. (Here's a video of the curtain call.)
I said they were not paid...that's not exactly true. I saw the pay on their faces out front after the show. Mary Springer's pay was running down her cheeks as I thanked her for her immeasurable efforts and told her that I would do this blog for the show, in case next weekend is not sold out.
So if you find an opening in your calendar next weekend (Friday and Saturday at 7:30 and Sunday at 3:00 - West Seattle High School Theater) you will see a slice of America at its finest.
When Bettie's stroke occurred on June 23rd, I was about three weeks into a rigorous rehearsal schedule for a series of August performances of Meredith Wilson's wonderful musical "Music Man". I had auditioned for and been awarded a role in the barbershop quartet (known in the play as "The School Board"). Though I sing in Northwest Sound Men's Chorus, I have never performed in real stage drama. When I heard of the opening, I couldn't resist giving it a try.
Rehearsals were Sunday through Thursday evening from 7 to 10, beginning in mid June and going through the first performance on August 7th. Though all cast members were not required at every rehearsal, it was a very big commitment. So you're thinking: "I wonder how much they have to pay people to do that?" The answer: nothing, and that's what I love about it.
The production company that is putting this on is Twelfth Night Productions, founded and directed by Mary Springer. Over the years they have done a variety of productions, usually two to four each year, and this summer, it is Music Man. Though it is all volunteer, it is not amateurish. Read all about them on their web site.
Naturally, I had to resign from my role when the stroke occurred, but I remained on the e-mail list of the company. Thus, I know how hard they all worked to put on this show. I had told Mary that I wanted to bring Bettie, if she was able by the time the performances began. She set aside two tickets for me, from a sold-out house...I couldn't miss it.
Try as I might, I could not convince Bettie to come. She was quite adamant, like she is about going to church, that she would not come. She's just not ready. Veronica attended with me, and thoroughly enjoyed it.
Now I'm not a theater reviewer, so I'll leave that to others. But I am someone who appreciates things "American"...and this is, for my money, as American as it gets. Here you have dozens and dozens of people donating huge amounts of time and talent to give their neighborhood, their society, something good, happy, and entertaining. Not doing it for money, but for the sheer joy of doing it, and doing it the very best they could. Trust me: they succeeded. (Here's a video of the curtain call.)
I said they were not paid...that's not exactly true. I saw the pay on their faces out front after the show. Mary Springer's pay was running down her cheeks as I thanked her for her immeasurable efforts and told her that I would do this blog for the show, in case next weekend is not sold out.
So if you find an opening in your calendar next weekend (Friday and Saturday at 7:30 and Sunday at 3:00 - West Seattle High School Theater) you will see a slice of America at its finest.
A Slow Week
Bettie continues to be troubled by abdominal pain, and it is definitely slowing her progress. We're not sure to what extant the pain is just from her gall bladder drain vs "other issues" she wouldn't want me to mention. Anyway, the net effect is she spends more time than I would like, lying on the family room couch.
When she is up and able, her walking is improving by the day. Many times I walk her to the bathroom, rather that wheeling her, and I can see definite progress. It's frustrating to have her down so much when I can see that with some concentrated work, her walking could improve vastly. Patience is the order here.
When she is down, we work on speech skills, word recognition, and small hand skills as she is able. We see progress there too. During "slow" times like these, it is good to keep in mind that from birth to death, the human body is engaged in a continuous effort to be well. Even while lying down, brain cells are working to restore function, re-make lost connections, etc.
Though the week was slow in terms of progress, she did have visits from all three therapists plus the home nurse. Tram, the nurse, suggested that we try to get the internist doctor visit moved up a week to look into the abdominal issue. We did that and will see that doctor on Wednesday.
Meanwhile, the family continues to refine the routine here at home, adjusting to new duties and requirements. On the three days that I go into my office, I awaken Jordan to come into grandma's bed when I leave. I get home a little before noon to relieve her. When school starts, the schedule will have me, with the blessings of my supervisor at work, working from home most of the time. Two days a week, Veronica will take a long lunch and come home to assist with Bettie while I go into the office for meetings and to maintain a presence with my co-workers. It should work fine.
When she is up and able, her walking is improving by the day. Many times I walk her to the bathroom, rather that wheeling her, and I can see definite progress. It's frustrating to have her down so much when I can see that with some concentrated work, her walking could improve vastly. Patience is the order here.
When she is down, we work on speech skills, word recognition, and small hand skills as she is able. We see progress there too. During "slow" times like these, it is good to keep in mind that from birth to death, the human body is engaged in a continuous effort to be well. Even while lying down, brain cells are working to restore function, re-make lost connections, etc.
Though the week was slow in terms of progress, she did have visits from all three therapists plus the home nurse. Tram, the nurse, suggested that we try to get the internist doctor visit moved up a week to look into the abdominal issue. We did that and will see that doctor on Wednesday.
Meanwhile, the family continues to refine the routine here at home, adjusting to new duties and requirements. On the three days that I go into my office, I awaken Jordan to come into grandma's bed when I leave. I get home a little before noon to relieve her. When school starts, the schedule will have me, with the blessings of my supervisor at work, working from home most of the time. Two days a week, Veronica will take a long lunch and come home to assist with Bettie while I go into the office for meetings and to maintain a presence with my co-workers. It should work fine.
Tuesday, August 11, 2009
A Mystery Doctor - A Failed Scan
For a long time, Bettie has been interested in health and particularly the diet aspect of it. She and I share this wacko idea that what you eat just might have something to do with how you feel, especially over the long haul. I call the idea wacko only because diet has been pretty far down the list of considerations to many "health care" professionals. I think that is changing in recent years and has not been any point of contention with the professionals that have cared for Bettie since June 23.
In the weeks before her stroke, she was actively looking for a doctor (the doctor she had been seeing, died in March) who shared her belief in a more "natural" approach to health and wellness. Just a week or so before the stroke, she found Dr. X. She had one visit with him and one visit with the cardiologist that he referred Bettie to for her atrial fibrillation. (Good doctors know their limits and refer for conditions outside their specialties.)
Yesterday, I spent over an hour talking with Dr. X about Bettie. He carefully took a full page of notes on everything I said. For now, he'll remain a mystery doctor, out of respect for him and his approach. With Bettie mostly in the care of others, he doesn't want to be seen as attempting to counter anything others are doing. In fact, there is not much potential for conflict anyway. (Not to mention the fact that Mystery Doctor makes a catchy post title.)
My mission with Dr. X was to see if, given Bettie's current condition, he would be able to work with her as we had initially discussed early in June. The answer is yes, and she will see him next week.
Following that visit, I hurried home and picked up Bettie for yet another type of brain scan at Dr. Heide's office. In this scan, they inject a dye into a vein in the arm. From there, enough of it winds up in the brain to provide some pretty vivid detail when scanned with one of those machines where the head is placed in the hole of a giant electronic doughnut. I guess this was to be the final proof that Bettie's clot is gone, though I thought that was pretty conclusive with the previous two "scans". (Click the two Scans links in the Information/Links section at the right for more about the various technologies available.)
Well anyway, it was not to be. Bettie's "surface" veins are currently just too weak to take yet another IV. After two painful attempts, the nurse concluded that we would have to go over to Valley Hospital and have them insert a "deep IV". When the nurse asked Dr. Heide, he decided to simply forgo the test. Enough torture for one day.
We came back home. We'll see him next week.
In the weeks before her stroke, she was actively looking for a doctor (the doctor she had been seeing, died in March) who shared her belief in a more "natural" approach to health and wellness. Just a week or so before the stroke, she found Dr. X. She had one visit with him and one visit with the cardiologist that he referred Bettie to for her atrial fibrillation. (Good doctors know their limits and refer for conditions outside their specialties.)
Yesterday, I spent over an hour talking with Dr. X about Bettie. He carefully took a full page of notes on everything I said. For now, he'll remain a mystery doctor, out of respect for him and his approach. With Bettie mostly in the care of others, he doesn't want to be seen as attempting to counter anything others are doing. In fact, there is not much potential for conflict anyway. (Not to mention the fact that Mystery Doctor makes a catchy post title.)
My mission with Dr. X was to see if, given Bettie's current condition, he would be able to work with her as we had initially discussed early in June. The answer is yes, and she will see him next week.
Following that visit, I hurried home and picked up Bettie for yet another type of brain scan at Dr. Heide's office. In this scan, they inject a dye into a vein in the arm. From there, enough of it winds up in the brain to provide some pretty vivid detail when scanned with one of those machines where the head is placed in the hole of a giant electronic doughnut. I guess this was to be the final proof that Bettie's clot is gone, though I thought that was pretty conclusive with the previous two "scans". (Click the two Scans links in the Information/Links section at the right for more about the various technologies available.)
Well anyway, it was not to be. Bettie's "surface" veins are currently just too weak to take yet another IV. After two painful attempts, the nurse concluded that we would have to go over to Valley Hospital and have them insert a "deep IV". When the nurse asked Dr. Heide, he decided to simply forgo the test. Enough torture for one day.
We came back home. We'll see him next week.
Sunday, August 9, 2009
A Diet to Die For
You may remember from the post on Thursday that we spent some time that day at Dr. Heide's Clinic getting briefed on nutrition.
I must confess that when I heard Raven, the pleasant young woman who greeted us, identify herself as a dietitian, I put up my guard. My only experience with "dietitians" has been in a hospital setting ... not exactly a place known for truly healthful eating, at least not in my (and Bettie's) opinion. (The term Jello-dispenser comes to mind.)
It was probably fun for Raven to watch as I morphed from hostile to accepting as she explained her credentials and approach. It turns out she is a graduate of Bastyr University, one of the premier "alternative" medical training schools in the country. (And they are located right here in the Seattle area; Juanita to be precise).
There are a couple of issues for which we needed dietary help:
I must confess that when I heard Raven, the pleasant young woman who greeted us, identify herself as a dietitian, I put up my guard. My only experience with "dietitians" has been in a hospital setting ... not exactly a place known for truly healthful eating, at least not in my (and Bettie's) opinion. (The term Jello-dispenser comes to mind.)
It was probably fun for Raven to watch as I morphed from hostile to accepting as she explained her credentials and approach. It turns out she is a graduate of Bastyr University, one of the premier "alternative" medical training schools in the country. (And they are located right here in the Seattle area; Juanita to be precise).
There are a couple of issues for which we needed dietary help:
- Maintaining a consistent level of foods with sufficient Vitamin K content.
This is so that her diet does not end up counteracting the desirable effect of the blood thinner that Bettie must take. - Stopping further weight loss, and beginning to build back some muscle. (At the time of her stroke, Bettie weighed 122 pounds. She is now down to 102.)
Both these issues are important, and both of them have a feedback method that will tell us how we are doing. For the Vitamin K issue, we go in for a weekly blood check to be sure the consistency is where they want it. The weight loss monitoring is more simple: get her on the scale.
So, what does Raven recommend to arrest the weight loss and begin going the other way? A high calorie diet, of course. Lots of olive oil, nuts and nut butters, cheese, fish, (particularly high-fat salmon). For now, eat the high-starch potatoes before the green vegetables. And how about desert? Oh sure, ice cream, cake, anything dense with lots of calories.
Of course I will be hovering over her at meals, making sure that her plate is clean...secretly hoping that she can't quite finish that last bite (or scoop) of Haagen Dazs Coffee Mocha. Ah, the life of a caregiver. Yes, it's a tough job, but somebody's got to do it.
Friday, August 7, 2009
To the ER...but Home Again
Today we "celebrated" the clot being gone by making a 4-hour visit to the Auburn Medical Center ER, where this whole thing began nearly seven weeks ago.
The gall bladder pain, described in the previous post, got to the point where it hurt her, even when she was lying down. That was the signal that Dr. Spens' nurse said should trigger a trip to the ER. (Of course the issue of pain is complicated by the fact that Bettie cannot accurately relate to us the severity of it.) Better to err on the conservative side, since we can't be sure. That's what we did.
In the ER, Dr. Spens visited us and told us the strategy: "We'll scan the gall bladder and be sure it is OK and the drain is properly in place. If all is OK, we'll assume that the pain is from the drain itself. After all, it is a piece of plastic rubbing on her insides and that is bound to cause some irritation. I'll prescribe a pain killer to help, as the drain needs to stay in for another two weeks."
And that's how it turned out. She's resting comfortably in the family room as I write, looking forward to Friday night pizza. Me too.
The gall bladder pain, described in the previous post, got to the point where it hurt her, even when she was lying down. That was the signal that Dr. Spens' nurse said should trigger a trip to the ER. (Of course the issue of pain is complicated by the fact that Bettie cannot accurately relate to us the severity of it.) Better to err on the conservative side, since we can't be sure. That's what we did.
In the ER, Dr. Spens visited us and told us the strategy: "We'll scan the gall bladder and be sure it is OK and the drain is properly in place. If all is OK, we'll assume that the pain is from the drain itself. After all, it is a piece of plastic rubbing on her insides and that is bound to cause some irritation. I'll prescribe a pain killer to help, as the drain needs to stay in for another two weeks."
And that's how it turned out. She's resting comfortably in the family room as I write, looking forward to Friday night pizza. Me too.
Thursday, August 6, 2009
The Clot is :-) The Gall Bladder is :-(
Big news today: the clot is gone, I saw the evidence today!
We had our second appointment at Dr. Heide's clinic. First we spent nearly an hour with the dietitian, learning how to feed her to get her weight back up and keep her blood consistency stable. After that, we spent the better part of the next hour having her head examined, quite literally.
In a typical clinic exam room, she lay on the table with a crown-like gadget on her head, to which were attached two ultrasound probes, a left and a right. The technician aimed one probe at the vein where the original clot lodged in her left brain hemisphere, and the other at the corresponding vein in the right hemisphere (for comparison).
When he turned it on, we could watch, on a computer monitor, electronic depictions of the sound waves, picking up the blood flow through each vein. A sound amplifier and speaker completed the information flow.
The device ran for just over half an hour, displaying nearly identical pictures of flow through both veins, side by side. The flow sounded the same on each side, and the digital readout of volume was just very slightly better in the right (non-clot) side than the left. I asked the tech if he could tell how long the clot had been gone, but he could only guess that it was probably breaking up fairly soon after it first lodged there. No way to know. Many clots never break up.
Clear flow of blood, means that whatever cells in the clot area survived, should be able to return to good function. It also means good flow to facilitate retraining of adjacent cells. I may not be describing it in good doctor-talk, but any way you say it, it is good news.
On the not-so-good side of things is this: For the last couple of days, by afternoon Bettie has been way more comfortable lying down that any other position. So you're thinking: "Well duh, who isn't?" But this is different.
Her gall bladder area seems to be giving her trouble each time she gets up, at least later in the day. I've talked to the nurse at Dr. Spens' (the doctor who is handling Bettie's gall bladder issue) office both yesterday and today. We decided to move Bettie's follow-up visit up by a week. She'll see Dr. Spens on Monday. Until then, she may be down more than she's up.
Comparing the two issues: No Clot vs (maybe) No Gall Bladder ... well, its a no brainer, isn't it?
We had our second appointment at Dr. Heide's clinic. First we spent nearly an hour with the dietitian, learning how to feed her to get her weight back up and keep her blood consistency stable. After that, we spent the better part of the next hour having her head examined, quite literally.
In a typical clinic exam room, she lay on the table with a crown-like gadget on her head, to which were attached two ultrasound probes, a left and a right. The technician aimed one probe at the vein where the original clot lodged in her left brain hemisphere, and the other at the corresponding vein in the right hemisphere (for comparison).
When he turned it on, we could watch, on a computer monitor, electronic depictions of the sound waves, picking up the blood flow through each vein. A sound amplifier and speaker completed the information flow.
The device ran for just over half an hour, displaying nearly identical pictures of flow through both veins, side by side. The flow sounded the same on each side, and the digital readout of volume was just very slightly better in the right (non-clot) side than the left. I asked the tech if he could tell how long the clot had been gone, but he could only guess that it was probably breaking up fairly soon after it first lodged there. No way to know. Many clots never break up.
Clear flow of blood, means that whatever cells in the clot area survived, should be able to return to good function. It also means good flow to facilitate retraining of adjacent cells. I may not be describing it in good doctor-talk, but any way you say it, it is good news.
-----------------------
On the not-so-good side of things is this: For the last couple of days, by afternoon Bettie has been way more comfortable lying down that any other position. So you're thinking: "Well duh, who isn't?" But this is different.
Her gall bladder area seems to be giving her trouble each time she gets up, at least later in the day. I've talked to the nurse at Dr. Spens' (the doctor who is handling Bettie's gall bladder issue) office both yesterday and today. We decided to move Bettie's follow-up visit up by a week. She'll see Dr. Spens on Monday. Until then, she may be down more than she's up.
Comparing the two issues: No Clot vs (maybe) No Gall Bladder ... well, its a no brainer, isn't it?
Tuesday, August 4, 2009
A New Look for the Blog
A few days ago I mentioned that hereafter I would only be adding a post to this blog every week or so, but would put in daily comments. Fortunately, I had the good sense to ask my co-editor...the one with the brains, what he thought of that idea. Steve's quick response: "No, no, no..." and he listed several reasons why that was not a good idea. His (better) suggestion was to make more and shorter posts and to title each one something related to the content. Well, duh, what a concept.
The meddling little twit even wanted me to go back and rename all those brilliantly titled posts: "Status - Date - Time" with a title that actually means something.
OK, OK...I did it. All the content is as it was, but every post now has a (clever :-o) title that might give you some reason to want to actually read it. You'd better enjoy it...it took me, like forever.
The meddling little twit even wanted me to go back and rename all those brilliantly titled posts: "Status - Date - Time" with a title that actually means something.
OK, OK...I did it. All the content is as it was, but every post now has a (clever :-o) title that might give you some reason to want to actually read it. You'd better enjoy it...it took me, like forever.
"Is there anything I can do to help?"
When this first happened, I couldn't count the number of people who expressed a desire to be of help, as this post is titled. At the time, I had no idea if I needed help and if so, what kind. I needed my wife back, that's what I needed..."Help with that if you can", I thought. Now that I've lived a little over a month with stroke in my life, I have a clearer perspective than at the first.
Our home situation is unique in that we have live-in family. Our son Tim, his wife Veronica, and their two children: Jordan, 17 and Jonny, 14 have been with us since we bought our present home, five years ago. That's a different story, but it has worked out for us quite well...and now it is a godsend.
I often would tell people: "We're like the Waltons (a 70's TV series) and I'm the grandpa." Funny thing: in the TV show, Ellen Corby, the actress who played the Grandma, had a stroke, just like Bettie's: speech impeded somewhat and right side partially paralyzed. She was off the show for a time, then came back, stroke and all. Her role on the show only lasted another couple of years, but she lived 20 more years after the stroke. Will Geer, the actor who played Grandpa, died within a year after her return to the show. (Hope we're not like the Waltons in that regard.)
I mention the home situation only to make the point that what I say here about the need for help and support is being met for me by live-in family.
But if you know of another couple where a spouse has suffered stroke, the unaffected mate needs help immediately. They want to spend every possible minute at the hospital for those first few weeks. This means home meals, lunches for work, house and yard maintenance, car servicing...all the things that take time away from being with the loved one are opportunities to be of service. If you are inclined to be of help, don't ask "Is there anything I can do?". Just pick something and say "I'm going to ...." and then do it.
Once the stroke patient is home, I don't think one person could possibly provide safe and responsible care. If there is no family or other support network, then a live-in facility is probably the only reasonable option.
If you find yourself in that situation (and you should not think "It can't happen to me") your choices for providing that level of care are: be rich or have long term care insurance. Think about it...this is not something you want to try at home...alone.
Our home situation is unique in that we have live-in family. Our son Tim, his wife Veronica, and their two children: Jordan, 17 and Jonny, 14 have been with us since we bought our present home, five years ago. That's a different story, but it has worked out for us quite well...and now it is a godsend.
I often would tell people: "We're like the Waltons (a 70's TV series) and I'm the grandpa." Funny thing: in the TV show, Ellen Corby, the actress who played the Grandma, had a stroke, just like Bettie's: speech impeded somewhat and right side partially paralyzed. She was off the show for a time, then came back, stroke and all. Her role on the show only lasted another couple of years, but she lived 20 more years after the stroke. Will Geer, the actor who played Grandpa, died within a year after her return to the show. (Hope we're not like the Waltons in that regard.)
I mention the home situation only to make the point that what I say here about the need for help and support is being met for me by live-in family.
But if you know of another couple where a spouse has suffered stroke, the unaffected mate needs help immediately. They want to spend every possible minute at the hospital for those first few weeks. This means home meals, lunches for work, house and yard maintenance, car servicing...all the things that take time away from being with the loved one are opportunities to be of service. If you are inclined to be of help, don't ask "Is there anything I can do?". Just pick something and say "I'm going to ...." and then do it.
Once the stroke patient is home, I don't think one person could possibly provide safe and responsible care. If there is no family or other support network, then a live-in facility is probably the only reasonable option.
If you find yourself in that situation (and you should not think "It can't happen to me") your choices for providing that level of care are: be rich or have long term care insurance. Think about it...this is not something you want to try at home...alone.
Monday, August 3, 2009
Settling in at Home
Bettie has now had each of the three therapists (speech, occupational, and physical) visit here at home and a schedule is worked out for regular sessions.
She is making slow but steady progress. We see little signs here and there: Complete sentences that make perfect sense, correct answers to "test" questions, that sort of thing. The scan to confirm the absence of the clot had to be postponed for a week due to insurance issues.
Saturday, August 1, 2009
A Date with "New" Bettie
Several times in the week before coming home I asked Bettie if she would like to go to church next week. Each time she quite adamantly said: "No", with an expression that said: "How could you ask such a thing." I'm not sure just what the issue is, but she clearly is not ready. I went alone again.
Speaking of church, a couple of weeks ago, Art Palecek, the Associate Pastor, announced to the congregation that Bettie's clot had dissolved. I was unsuccessful in getting his attention to correct him...the doctor didn't say that. In fact the doctor said the clot is likely a permanent fixture. Blood is flowing around it, but it is still there. However, if you read the post: A Follow Up With Dr. Heide you know that there is a good chance that Pastor Art was right after all. We'll find out more this week (on Wednesday and Thursday) when more definitive scans are performed. Where do you suppose Pastor Art is getting his information. Hmmm.
When I arrived home, I found Bettie with Veronica and Jordan on the front deck having lunch at the big table under the awning. Later, we took a nap and then, about 4:00 o'clock, I coaxed a "Yes" out of her to have a dinner date with me.
I had received a $50 dinning card for The Cheesecake Factory for Fathers Day, so off we went to cash-in. Though she was a little apprehensive about it at first, she did just fine.
Soon, a couple took the table next to ours. The gentleman was Captain Mike McCoy, with Tukwila Fire Dept. I asked him if he was a 911 responder. He confirmed that he was. I thanked him for his service, and told him that it was people like him that took care of Bettie that fateful morning (June 23rd), and that I have a great respect for people that do what he does. He seemed pleased and, I hope, honored...that's what I intended: "Honor to whom honor is due".
All in all, it was a lovely evening...my first date with the New Bettie.
Speaking of church, a couple of weeks ago, Art Palecek, the Associate Pastor, announced to the congregation that Bettie's clot had dissolved. I was unsuccessful in getting his attention to correct him...the doctor didn't say that. In fact the doctor said the clot is likely a permanent fixture. Blood is flowing around it, but it is still there. However, if you read the post: A Follow Up With Dr. Heide you know that there is a good chance that Pastor Art was right after all. We'll find out more this week (on Wednesday and Thursday) when more definitive scans are performed. Where do you suppose Pastor Art is getting his information. Hmmm.
When I arrived home, I found Bettie with Veronica and Jordan on the front deck having lunch at the big table under the awning. Later, we took a nap and then, about 4:00 o'clock, I coaxed a "Yes" out of her to have a dinner date with me.
I had received a $50 dinning card for The Cheesecake Factory for Fathers Day, so off we went to cash-in. Though she was a little apprehensive about it at first, she did just fine.
Soon, a couple took the table next to ours. The gentleman was Captain Mike McCoy, with Tukwila Fire Dept. I asked him if he was a 911 responder. He confirmed that he was. I thanked him for his service, and told him that it was people like him that took care of Bettie that fateful morning (June 23rd), and that I have a great respect for people that do what he does. He seemed pleased and, I hope, honored...that's what I intended: "Honor to whom honor is due".
All in all, it was a lovely evening...my first date with the New Bettie.
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