Endings

We said good-bye to the occupational therapist on Monday.  We said good-bye to the speech therapist today.  Bill is done with both, so other than his blood tests that will provide the INR number that the doctor needs to monitor his coumadin dosage, he is done as an outpatient.  I have to say that although I had gotten used to sitting there in the waiting area with my yarn as he went to these various appointments, I think I will not miss them too much! 

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Another Couple of Steps in the Right Direction

Bill went back to work this morning. After the occupational therapist told him on Monday that she thought he was OK to drive, we went for a test run yesterday to the library, where I ended up with 6 of my 8 hold requests being in--of course they all come in at once (I am not complaining!!!)!  He felt fine driving, so this morning it was back into the routine as he went off to work.  He left work an hour early to go see the speech therapist and I met him there.  We had been told that she saw no reason to see him as an outpatient, but then he got a call yesterday saying there was an order for an appointment there, so since he had to see the physical therapist this afternoon anyway, he decided to do the speech thing just before that.  I spoke to her after the appointment and she was quite enthusiastic in saying that he was doing great and she would only see him once or twice more.  I had been wondering what she would do because there has been a huge improvement since she last saw him over two weeks ago.

After the speech therapist he went to physical therapy where they did some evaluation.  He scored 56 out of a possible 56 and the therapist said, "I really don't think there is anything I can do for you."  She said that if he wanted to come in, he could, but she thought he did not need to have any more appointments.  He cancelled the appointments that had been made for him for the next month.  So he is done with physical therapy even before it started--this was his first appointment.  He has another one or two with the occupational therapist and the same with the speech therapist.  Hopefully they will get his coumadin dose regulated over the next few weeks and we will not be going there as much.  Not that the people are not wonderful.  They are so nice and I found myself sitting there in the waiting area tatting and smiling.  I caught myself smiling and thought how odd it was that I should feel so comfortable in a hospital.  I have to say that they do a remarkable job there.

So he has had a long day--he left for work before 8 this morning and we got home at 3:15.  He has not taken a nap and he is doing well--his stamina is improving a little each day.  Here's to normal life!!

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Almost Usual!

Today we went back to the hospital so Bill could have his blood test and see the occupational therapist.  I walked both ways, he took the bus in and walked home.  His stamina was much better today.  The OT said she thinks she will probably only see him once more.  She came out to talk to me as I was sitting there tatting and waiting--she wanted to ask me how I thought he was doing.  She said she thought he was doing really well and I said I agreed with that.  She seemed particularly impressed with the progress in his hand.  She asked me if I thought things were getting back to normal and I had to say that I did think that.  He goes back to work Wednesday.

We had a lovely quiet weekend and went nowhere.  I am by nature a homebody.  I can spend days happily doing things at home.  It was nice to do that again.  I did not take off my mohair slippers and alpaca socks :-)
I also watched all 6 hours worth of lectures I had from the library called Understanding the Brain.  It is one of those "Great Courses" DVD sets--I used to get ads for them in the mail all the time.  It was the first set of 3 and I put set 2 on hold this morning.  I started watching on Saturday night and I was just fascinated, so watched 3 hours then and 3 hours last night.  The prof was from the Vanderbilt University School of Medicine, so I had my doubts about how useful it would be for someone with very little science background--I am not a hard scientist at all--give me social science any day--and the extent of my brain background is my study of human evolution, since pysical anthropology is a subfield I had to have some background in to get my degrees.  I needn't have worried--she did a great job of explaining things clearly.  I learned quite a bit.  Somewhere in set two is a lecture about the brain and language, which I am also quite looking forward to, being so interested in sociolinguistics and communication.  Of course, since I am me, I had to look up "Great Courses" in the keyword section of the catalog search on the library website.  I resisted the urge to request several of them, altough I probably will sometime in the future.  But I could not resist a couple of them, so besides the brain one, I will soon be getting one on the archaeology of prehistorical spirituality/religion and one on Emerson, Thoreau, and the Transcendentalists.  These are subjects I know something about, but I think they will still be interesting and contain information and ideas that are new to me.

So we are walking back toward normal.  I think that the almost daily walks we have been taking have helped Bill's progress along and certainly he feels better when he gets out to walk.  He left the hospital 2 weeks ago tomorrow--feels like a lifetime ago that all this started!

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Today, the Cardiologist

So today we went back to the hospital for a blood test and a visit with the cardiologist.  Happily, the cardiologist he saw in the hospital was on vacation, so he saw the other guy today.  This guy is better--he answers questions clearly, patiently, and adequately.  When he told Bill to make another appointment for a month from now, he said it could be with him or the other guy.  Bill chose him.  I'm glad. 

Things seem to be going well.  The lab is amazing.  We took the bus there and Bill went off for the blood test.  he was done by 1:15.  When we got to Dr Lawrence's office at 2, Nurse Joan already had the results.  Bill's INR was high this time--4.  Needs to be between 2 and 3, so doc wanted him to take half a dose of coumadin today, a full dose tomorrow, and to alternate like that until he says otherwise.  Bill will go for another blood test on Monday and then the office will call and let him know how to proceed with the coumadin and when the next blood test should be--we've been consistently told that things will be sort of irregular like this at first.  He has to go in for another occupational therapy appointment on Monday anyway.

Bill had another EKG because his heartbeat was still irregular.  We were told at the beginning of this process that it is likely to remain that way, since it has probably been like that for years, so is unlikely to reverse itself now.  We were also told that people live without problems with this condition.  Since his heart rate and blood pressure were good, we were happy.  So we had another good report from the docs.  Yay!

We walked home again today and Bill felt much less tired than he did yesterday.  We actually walked farther than we did yesterday because we had to stop at the pharmacy to get a pill cutter. 

Tomorrow, we do not have to go anywhere.  Thank goodness!!!

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Making Progress and Human Brains

This morning Bill had an appointment with the occupational therapist.  He got a ride from our wonderful neighbor and I left early on foot to run some errands.  I stopped at the library, where I returned books and a DVD about the human brain and I picked up a book that Bill had on hold and another DVD about the brain.  I raced out of there and decided that since I was going right by the grocery store, I might as well stop there and grab some whole wheat pasta to have with supper--and I grabbed some Parmesan and Romano cheese and a can of tomato paste as well.  Paid for my food and stuffed it into my backpack.  I zipped outside and started walking across the parking lot when I spotted a lonely $5 bill folded up on the asphalt.  After putting that in my pocket, I headed to Maine St and started my power walk to the hospital.  There were a few icy patches on the sidewalk that I had to skirt, but I made good time and got there a couple of minutes before Bill.  I sat, drank coffee, and read while he filled out paperwork and had his appointment.

After that we went to the office of the doctor that we thought was going to be his primary care physician.  This guy was suggested to us by the two hospitalists and one of them even talked to him to set it up.  In his discharge paperwork, this was listed along with the guy's phone number.  Since we were there, we decided that we would just speak to someone in person rather than play phone tag with yet another office.  The woman there said that this guy could not be Bill's doctor because he'd reached his quota of MaineCare patients.  When I explained that the doc had already been consulted about this and had agreed, she said, "Doctors never talk about insurance." and she told us we should go upstairs to some other office.  I told her that we needed someone to take his lab results and monitor his coumadin dosage and asked if they do that.  She said they do.  It was lunch time and we decided that it would be pointless to try and make any headway today, so we left it for tomorrow, since we'll be back there for another blood test and a meeting with the cardiologist.  We ate the lunches we'd brought with us and headed home.  It was a one and a half mile walk and Bill did get tired, coming as it did right after the occupational therapy stuff, but he made it. 

I didn't get the details of how the appointment went and Bill is napping as I type, so I am sure I'll get filled in later.  But she did say that he's improved over last week and that she does not think he will need to see her many more times.  She told him to do word search puzzles (helps with scanning) and gave him some balls to move around in his hand (strength and coordination, I guess).  She had him lay on the floor and asked if he could get up.  He laughed and told her that we sleep in a futon on the floor, so he's had practice getting up!  It sounds like things went well.

We watched the DVD about the brain last night and it was fascinating.  Some of the stuff I already knew and some I did not.  One of the things I got excited about was when the brain scientist started talking about the brain and culture.  He and his colleagues have come to many of the same conclusions I have about certain things from a purely physical scientific standpoint.  I always think that the more people can support an argument from as many different angles as possible, the better, so I was thrilled that the brain scientist got to the same place as I did through sociocultural anthropology.  I cannot tell you how many times I have gotten blank looks and silence when I suggest to people that a certain viewpoint or aspect of their worldview isn't actually inherently "real" in any concrete sense--it's the story they are telling themselves about what is happening.  They can tell a different story.  We can't experience anything without interpreting it and to do that, we tell a story.  If enough people tell the same story, it's culture, and it seems real enough--and in a sense it is--but when enough people start to tell a different story, culture changes.  Clearly, the human brain has evolved to tell stories in groups, so we need each other, and one thing the brain scientist talked about was finding ways to have people get a sense of that group cohesion without doing the whole "othering" thing, which leads to discrimination and war.  I was also pretty excited to hear him talk about certain social institutions as essentially brainwashing people--really that is what enculturation is--because that's how I see it, too.  We're all brainwashed to a certain degree.  Anyway, what he was essentially saying was that in the great nature vs nurture debate, you need to study both, because you can't understand how the brain works without knowing how it functions as it's being socialized.  It was a good overview kind of DVD and I liked it a lot.  The next one I have is a series of 36 lectures put out by some school of medicine somewhere, so I will see how that goes.  I have the first 12 lectures and there is a second and a third set, but I will watch part of this one before requesting the next one.  Each set is 6 hours and I only get them for a week, since they are DVDs from a different library.  I don't want to have too much at once!

UPDATE:  Bill just got off the phone with the woman we spoke to earlier from Dr Boyd's office.  He was the one who was supposed to be Bill's primary care physician until we were told he had reached his MaineCare quota.  Turns out that when she looked at stuff on her other desk, she found a list of people the doc was expecting to hear from and Bill's name was on the list.  So she apologized, took his info and made an appointment for him.  Now that we don't have to go in search of these other people tomorrow, that's one less thing we have to do.  Yay!

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Day 10 Post-Stroke

Here we are 10 days later.  Bill has been home from the hospital for 5 days.  We continue to be grateful that things were not more serious.  Things steadily improve each day.  Bill gets tired easily and when that happens, he has a moment where it seems like it is hard for him to get the words out--not that they aren't understandable and not that he cannot find the words, just that the act of speech seems tiring.  He then rests for a few minutes and is fine.  We have been going out for walks each day.  The library is a great destination because if he gets tired by the time we get there, we can go in and sit.  Bill reads a newspaper and I look at a magazine.  The other day I left him there and went grocery shopping.  I shoved about 25 pounds of food in my large backpack, went back to the library to tell him I was done, and off we went home.  Happily, the library and post office are right across the street from one another and the grocery store is a block away.  All of these things are close to home.  On Friday morning, Heather and I set out on foot with the dirty laundry--once again I had my large backpack stuffed and Heather had her things in a tote bag.  We put them in the washing machine and I crocheted for the half hour it took for the wash to be completed.  Then wet clothes got stuffed back into the backpack and hauled home to be hung on our drying rack.  I thought I was missing an alpaca sock, but discovered that it had never made it to the laundromat at all--it fell under the chair as I was moving the dirty clothes from the laundry back to the backpack.  I will either handwash it or put it in the next load. 

One of the interesting things about this whole experience now is that it requires both Bill and I to work on things that are hard for us.  For him, learning when to stop and rest is important.  He has a tendency to just keep going, even when he is tired.  He can't do that now.  I tend to want to jump in and fix things for people and I have to step back from that impulse now.  Bill does not need me to do everything for him--he needs to do it himself.  If I do everything it will actually hinder his progress.  So I have to learn to stand back and let him proceed.  Once in a while, things get annoying or too many things happen at once and he gets tired.  So I am getting practice with observing, understanding when I do need to help, and only then offering assistance. 
We each have an opportunity to work on improving skills!

Both of us are so grateful for the support we have received from people.  Our neighbor has been great--giving rides to and from the hopsital and offering other assistance.  A friend and her husband brought over supper the first day he was home.  People have gathered information, shared expertise, and offered words of encouragement and support.  It has all been so helpful and appreciated! 

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You Never Know

On Friday, Bill came home from work in the midst of a stroke.  I called 911, we hopped in the ambulance and went to the hospital.  He was admitted, spent a night in ICU for observation, 3 nights in a regular room, and came home yesterday.  His stroke was small and the effects relatively minimal.  Nonetheless, he will now be on medication for the rest of his life--blood thinners and a heart medicine that treats his atrial fibrillation.  Not the way we'd planned to spend the weekend, but since things could have been astonishingly worse, we choose to be grateful that things are as mild as they are.

As we began this journey into the medical system, I sort of shut out all extraneous stuff and put all my attention on understanding what was happening, listening and asking questions of medical personnel, and trying to maintain my composure so I could make good decisions.  Once it was clear that this was not a life threatening event, the focus changed to more information gathering so that we would know what to do as we proceeded.

Now that he is home and the crisis is past, I have started to analyze more.  This is typically me and I felt that I had entered a new phase of this experience the other day in the hospital when I began doing an analysis of the communication that was going on from the perspective of gender.  For me, that is a normal thing to do.  In more general terms, though, I am thinking about people who find themselves in the hospital and may not have someone who can be there all the time with them when they talk to all of the medical personnel who come in and out of their room.  Monday was a particularly tiring day.  There was the usual stuff that the nurses and CNAs did every day.  Then the hospitalist came in--a different one because it was a new week.  He was interpreting things differently than the previous one, so the information he was giving us was different.  Then there was the occupational therapist, someone from patient services, a different physical therapist, and a speech therapist.  Later in the day, a neurologist and a cardiologist came in separately and then together.  These people were not finished until after 6 p.m.  Bill had been awakened at 5:30 a.m. for a blood test.  That is a long day for anyone, let alone someone who is sick in some way.  Both of us are smart, well-educated people (and several of these medical people asked about education level).  But one of us had had a brain trauma and was exhausted.  If there had been no one else there, how on earth would he have been able to understand what they were telling him?  How could he evaluate it?  I realized at some point that I was witnessing the intangible benefits of my education and life history.  I have always had really excellent verbal/reading skills and that helped me a great deal in terms of understanding what was being said and interpreting it.  I have taught many different kinds of students and interviewed many different kinds of people, so I know how to keep asking the same question in a different way if I have to until I get the information I need--and to ask someone else, if necessary. My anthropological research has sharpened my natural skills of observation and analysis and my ability to engage in cross cultural communication (and this was a kind of cross-cultural communication).  Because I have always been interested in social institutions, I knew how to quickly and pretty unconsciously evaluate the system that is in place and the information that was coming from the institution.  I have a good memory, so I could retain most of the important information that I was digesting.  In other words, a great many things came together to allow me to effectively understand what was being said, when people were contradicting each other and themselves, and to generally get a clear picture of what was going on.  But what about people who have a different skill set, or not as much education, or no one there to take over when they get tired?  It must be incredibly difficult.  I cannot imagine being ill and trying to make sense of everything that is swirling around you.  I was noticing an incredible amount of repitition, both in terms of the same person saying the same thing and different people saying the same thing.  I guess part of that is so that the patient will hear it many times at many different times of the day and it will be more likely to stick! 

It's funny, this life thing.  You never know what's going to happen.  You never know what skills you have that will come in handy in a completely unexpected way.  You never know how your strengths will rise up and maintain you in a crisis.  You never know what's gonna come in handy.  You just never know.

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