One Week Later

It's been a roller coaster of a week. Yesterday Mom was finally discharged from ICU at SRRMC back to the skilled nursing facility she had been in for some 6 weeks until just about a month ago. Though she has been understandably bored the past week, the nurses in ICU were great. Awesome crew. I have to admire and tip my hat to anyone who can do that job and still maintain such a great attitude. Tough job! Mom definitely wasn't as bad off as most anyone else there- no ventilator, no traction.

Monday she had been transferred out of ICU to a regular room, but within a few hours her left side was flacid again, and her speech was seriously affected. I noticed immediately when I came in to see her after work. Apparently, so had her neurologist, who ordered another CT scan when he saw her a few hours earlier. Radiology came in to get her for that minutes later, as it happened. Nothing new showed up from it, so the neurologist ordered an MRI Tues. By Tues morning, she was almost back to where she was Sunday afternoon- she could raise her left arm and leg, and the left side of her face was better. The MRI revealed 2 separate and unrelated issues- an 8mm aneurysm and a stroke- both in the stem area of her brain. We go to a vascular neuro-surgeon the first week of May to see what our options are.

So far, she's been holding since Tues. No new strokes, and her Coumadin INR has been at an acceptable level. Hopefully, the physical therapy dept. will cure her boredom for a while...

I'm really glad I can quit collecting these now-

Set-back

Mom had yet another stroke this morning. I had been at work about an hour when Mike called and said he was taking her to the hospital- she couldn't move her left side and her speech was slurred. They had just returned from a doctor visit for a Coumadin INR check. I told him I would meet them there and left work. It was all I could do to keep it together the 40 minutes drive down there. Seeing fear and disappointment written all over her face when I got there didn't help any.

Again, the CT scan showed no hemorrhaging. But since she'd had a stroke not long ago, and she is on Coumadin, no tPA this time. So, for now she's on a heparin drip. And we wait.

She hasn't responded well when evaluated for swallowing, so to avoid aspiration, no drink or food (or pills for that matter) are allowed. She's hungry, too. Mom has kept her sense of humor up to this point, but she is quite serious about food...

The Irish Half

(I had originally written this on March 1st, 3 weeks after Mom's stroke.)

If there's anything to it, Mom's Irish blood has been living up to what is often called the Luck of the Irish. On Feb 7, at 9:10 AM, I heard two big, loud thunks coming from her room. I called out asking if she was okay- no answer. I ran into her room, where I found her face down on the floor, unable to speak and not moving. Her nose was beginning to bleed. She had landed on her face. I suspected a stroke and yelled for Mike to call 911. In what seemed like a pretty short time- 10 minutes or so- an ambulance was here. The nearest hospital is 10 minutes drive from here. We don't have a lot around here, but we do have a decent hospital. They asked me a few questions before they took her down there, then a few more when we got to the emergency room. Mostly focusing on when I thought she had had the stroke- there is a 3 hour window with the tPA treatment. I could tell she had already been up and gone out for her paper and had her cereal.

The ambulance left first, we followed shortly after. By the time we got there, she was already in getting a (non-contrast) CT scan. Very shortly, she was in the ER and awaiting the results. She was still on a stretcher, with neck brace, too. Her nose was cut and swollen from the fall. I told her they were taking the very best care of her and not to worry. We mothers worry a lot. Often more than necessary.

The ER doc came in and told us the CT scan showed no hemorrhaging, which indicated an ischemic (dry) stroke, which made her a candidate for tPA treatment, aka the clot-buster. I debated for a few minutes, but it really was a no-brainer, if you will. 93% success rate, 7% resulting in worsened symptoms, creating hemorrhaging in the brain. When I gave the okay, they immediately went into action. It was a big room, so Mike and I could sit on the sidelines. The nurse, Rosemarie, or Rosie, was so very good. Mom's left side was affected- left side of her face, left arm and leg. She also couldn't look to the right past center. She couldn't talk- she was still fully awake and observant, but couldn't make more than weak attempt. Once they got the tPA drip going, we waited, though not for long. At 6 minutes: she could move her head to the right again. 15-20 minutes: she could move her left arm and leg. Within an hour she could talk some- she said she was thirsty. Because swallowing is affected, and to avoid a choking hazard, she wasn't allowed anything to drink or eat for 24 hours. She had an IV and that was it. Later that day I learned that this hospital is a certifed Primary Stroke Center. How lucky is that?
She spent 2 days in ICU, 2 more days in the hospital, then she was released to a skilled nursing facility, where she stayed with physical therapy until March 26th. With a nurse visiting a couple of times a week, and continued physical therapy, she's doing quite well, considering how it could have been. She's graduated from wheelchair to a rolling walker with brakes. She may always need one, but who knows? This is the second round of strokes for her- the first was almost 3 years ago, though she wasn't so lucky. No one was around to take her for treatment. She recovered okay, but it took some work.

At the top of everyone's agenda is finding a way to keep Mom busy enough to stay out of trouble... Ha!

So this is my way of sneaking in a PSA. This is serious business, and I'd be willing to bet most of us are at risk here. I know I am. I've decided I must take better care of myself NOW. Regular exercise, eat better, reduce stress and so on.

American Stroke Association.
Interesting article on tPA
End of PSA
Thanks for indulging me.

Nine days after the stroke, with the residual black eyes,
my mother, Mary.


Cheers to Mike- I don't know how I'd manage without his support.