A&E Round Three....

How disappointed I am to have to write this blog documenting Dad's stroke recovery after such an excellent start in the new care home.

The photo's I put on the last update lifted everyone's spirits - I know this because we received so many texts, emails and phone calls from family and friends expressing their joy and relief to see Dad standing...such positive news. 

Unfortunately....Dad's progress for the time being ended there, as he has slipped back considerably - almost back to the days when he was in hospital in May/early June.  Gone has all the enthusiasm for singing and the determination to work hard in physio, even trying to lift his head is too much for Dad at the moment and if he does speak the words are slurred and confused. His behaviour has changed too. 

Something must have happened...?

By the start of this week the care home had raised their concerns about Dad too and after speaking with the local Doctor, arranged for some tests to be carried out - blood pressure, breathing, urine - but all were reported as normal.  Dad's routine bloods should also have been checked, but to date no one has yet been.

Dad's frustrations have been let out at the carers, his language blue, voice shouting and tone aggressive - even post stroke this is not the Alan Skett we know and love.  Now we appreciate Dad doesn't always look forward to taking his medication and having his insulin injected (who does) but an extreme came Tuesday evening witnessed by both Mum and Dad's brother. Dad's behaviour really did turn and he hit out at the male Nurse in pure anger, bearing in mind Dad is still very strong on the right side of his body.  Confused and convinced he was being poisoned Dad shouted at Mum to get away from them all and that they will all be going down for 30 years...  As you can imagine, an emotional evening for all.

It was a relief to hear that when the Nurse went back to try to administer the meds again, Dad was calm and polite as usual, and composed as he took the medication.

The local Doctor went out to assess Dad on Wednesday morning.  We had concerns that Dad had experienced another TIA (mini-stroke) or seizure to put his progress back this far and to effect his behaviour and personality  in this way, but it was fed back to us that the Doctor did not share these concerns and had ruled them out. The Nurse at the care home spent over an hour talking with Mum, Len and I as we sat with a calmer but still very tired Dad on Wednesday evening discussing Dad's behaviours and deterioration.  It became apparent towards the end of the conversation just how many times Dad is changed during the night.

The carers check on Dad every hour throughout the night and if he is wet, they have a duty of care to change Dad and make him comfy.  We were told Dad 'messes' with his pads through the night and undoes them, therefore when he urinates, he wets both the bed and his pyjamas - resulting in the carers changing Dad.  This happens on average 4/5 times a night - which means Dad is getting very little sleep at night, making him extremely tired through the day.  It's a big contrast to NG where Dad was left to be wet throughout the night, but ended up getting some sleep.  It's a catch 22.  So maybe the lack of sleep is having a detrimental affect on Dad's personality and behaviour...I know what I'm like if I don't get a good night's sleep...and that's without the addition of damage to my brain from a stroke?  

And so to Thursday - at half past 12 midday, just as Mum was preparing to visit Dad, she received a call from the care home advising her that Dad had fallen out of his wheelchair and gashed his head - an ambulance was on it's way to take him to hospital.  Mum and Dan then spent several long hours, again in a&e, waiting for Dad to have the wound stitched.  Three times in the last five months my poor and exhausted Mum has endured the a&e experience with Dad - this really is a test of her strength, love and devotion for her husband x.

Due to Dad being on walfarin, his blood is thinned and Mum reported that it just wouldn't stop bleeding, trickling down Dad's neck and forming a puddle, even though it was bandaged.  At 9pm - eight hours after being admitted - the wound was finally stitched. Mum and Dan again experienced first hand Dad's frustration - Mum saying if it wasn't for Dan having the strength to hold Dad down, several hospital workers would have been attacked.  Dad's language was foul and the shouting horrific, especially when having the cannula fitted and the stitches put in.  This is just not Dad, even post stroke.  

The Doctors are keeping Dad in for a few days to monitor him as they have concerns regards Dad's blood being so thin and the high risk of a bleed to the brain.  He had a CT scan last night and we are now waiting to go to the hospital to receive the results.  I pray that no further damage has been done.  The Doctor that came to assess Dad Wednesday morning called me  following a request from us to meet to discuss his observations.  I updated him regards the recent events - and he did advise that the CT scan would be able to show if a further TIA had occurred in the last few weeks, but if there is any damage to the brain as a result of the acute head injury - it would be on the outside of the brain.

One piece of information I am clinging to, is that one Doctor did say that Dad could have the start of a chest infection or a water infection due to the strong smell of his urine - although he was tested on Monday and the reading was normal?  If this is the case - the water infection could be accountable for Dad reacting the way that he is with his aggressive behaviour?

What a trying and testing time; just when you think you've turned a corner - boom another hurdle to climb.  But we will get there...slowly...and we must NEVER give up.

We shall know more over the next few days...I shall of course keep you updated on this journey. Thanks for the read and as always, the love and support.  Stay positive for us - and let's hope we get to that next corner soon.

Love you Dad x

Dad Bruised and Stitched 21/9/2012