Monday, 4 March 2013

A month of two halves

February was a month of two halves. It started well and we felt Dad was on the up...only for things to deteriorate towards the latter half of the month. At the start of February Dad was taking steps wearing his leg brace during his physio sessions and he was eating and sleeping fairly well...but not anymore. So what's happened to change things...? Well these are the events of Dad's stroke recovery during the last month:

On the first day of February Dad went for an eye appointment with the Diabetic Optician. It wasn't a great visit due to the lack of compassion and understanding about Dad's condition from the optician himself. This is obviously what we will be up against when we take Dad out in to the community.  The good news is Dad's eyes are free from any diabetes.

The next appointment in February was to see the Prostate Consultant. Dad certainly made an entrance when we arrived in the quiet, small, crammed waiting area. We pushed his wheelchair in to the room only for Dad to let out a humongous sneeze that resulted in snot shooting three feet through the air, across the room and landing on the carpet in front of everyone! Dad, oblivious to what or where he was, let out another three loud sneezes whilst I moved with lightening speed to wipe the snot off the floor with a tissue...all eyes bearing down on me. The outcome from the appointment was for Dad to attend an ultrasound scan of his prostate in March and to go on yet another course of antibiotics, this time four times a day for two weeks, to try and clear up any infection lying deep in Dads prostate.  

Dad's third appointment in February was to have his internal medicines reviewed by the Stroke Consultant and to have further botox injections administered - his arm is currently very tight due to the high level of muscle tone. We were extremely disappointed to receive a call on the morning from the hospital stating the Consultant was trying to get a flight back from Dubai and we would therefore have to rearrange. That was a week ago and we are still waiting for a new date.

I received a call back from the Mental Health Consultant following a letter I wrote to him asking him to review Dad's medical history. I explained that Dad had taken anti depressants back at NG and that we felt they had had a positive effect on his emotions. Following his review, the Consultant agreed to prescribe Dad anti depressants again and will review Dad in two to three months time. Three weeks on, we have already noticed a positive improvement in Dad's emotions. He laughs more, isn't as tearful and sings once again without becoming upset straight away. Unfortunately they do not stop Dad from shouting, swearing and spitting at staff when they are dealing with him.

The Mental Health Consultant also advised me that with vascular dementia there will be periods of improvement before a sudden dip is taken.  I located a useful fact sheet about vascular dementia on the Stroke Association's website (click on the word vascular dementia and you can download it for further information).

The loss of Dad's eating habits seem to have coincided with him taking the four times a day course of antibiotics and starting the anti depressant medication. At the start of the month Dad weighed 76.9 kgs, he even ate a McDonalds for lunch with Mum and myself whilst we spent a full day at the home with him, following the prostate appointment. He's certainly lost his appetite since, having gone days without eating a thing. The Nutritional Nurse visited with the intention to reduce Dad's nutritional PEG intake during the night - but when she understood Dad wasn't eating and reviewed his weight loss she advised against it.

Dad's physio sessions have not been as successful this month. At the start of February Dad was standing tall when he took steps with the physiotherapist and our hopes were raised for his physical progress. Although he still shouted whilst walking, when asked 'why?' he shouted, Dad said it was because he felt 'vulnerable'. As the month went by, Dad started shouting in pain and wouldn't let anyone touch his foot to put his leg brace on. When the physiotherapist managed to look at Dad's bare foot, she found his big toe to be red and swollen with pressure sores on either side of his foot. The Doctor was asked to review the condition but advised there was nothing fundamentally wrong. We, Dad's family, asked for a second opinion as his foot is almost purple and looks infected. Last week his foot was reviewed again by an alternative Doctor who stated that although there was no ulcer or infection, which was good news, Dad has bad circulation. He has requested a Doppler Test to check the circulation in Dad's leg. 

As Dad has not been able to wear his brace, an appointment has been made with the Orthotist to have his brace amended so it is not so tight and to ease the pain.

A new exercise machine has arrived in the gym - a  MOTOmed. It is a machine used for cycling whilst sitting in a normal chair or wheelchair. The machine is powered electrically but allows the person who is cycling to take over momentum. Dad has been able to use it for seven minutes at a time. This should help Dad's circulation in his left foot.

During the month, a lady from Dudley Stroke Association came to visit Dad for his six month review since leaving hospital. She last saw Dad at NG and was surprised to see him sitting in a comfy chair and answering her questions with a logical response. She advised Mum that it was only down to the love and support from Dad's family as to why he has got to where he is now and that although dementia will be a struggle to cope with, we should never give up.  She took on Mum's feed back about the lack of understanding from the optician and she advised she will write to him offering him training on dealing with stroke survivors suffering from dementia. She laughed with Dad as he told her that her shoes were old fashioned! Dad also sang Sweet Caroline to her assistant named Caroline as she said goodbye.

During February we brought Dad back to Dan and Sue's each Sunday. Before Dad started going downhill, the visits were fairly successful - less so the latter two Sundays. Dad was eating and enjoying watching the football and commented 'This is a nice warm house' when he arrived. We moved on after the first couple of weeks from using the downstairs toilet to using the commode in the front room.  We realised that three adults, a wheelchair and a toilet and basin in a small bathroom was proving too difficult to maneuver in. Having more space definitely helps - although Dad still gets confused and hits out in moments of frustration. During one change with Mum and myself, Dad hit out at Mum almost pushing her over. As you may be able to appreciate, it upset Mum. As soon as Dad saw her upset he apologised saying 'Sorry Wendy, please don't cry. It upsets me to see you cry Wendy'...an emotional experience to say the least...but we got through it.

I was extremely happy to be able to see Dad on my birthday and for him to wish me a 'Happy Birthday' and give me a birthday kiss.  One to treasure - as is the note he wrote to me in my card. The severity of Dad's short term memory was demonstrated when I told him five times within a short space of time that it was both Len's and my birthday...each time he greeted the news as though it was the first time he'd been made aware of it.

Twenty six weeks Dad has been at JC and it is certainly a lot busier than when Dad first arrived there. I won't go in to the detail of the goings on...I'll keep that record of accounts to my private diary of Dads recovery - perhaps to be revealed another day! Needless to say 50 minutes is by far too long a time to wait for Dad to be taken to the toilet, soiled pads should not be left in the middle of Dad's bathroom floor...and if Dad is given one more meal consisting of watery cauliflower cheese or cheese and dry potato mash I think I will scream...

So - February as a whole wasn't  a great month for Dad or Mum for that matter who visits every day. Perhaps now Dad has finished the course of antibiotics he will start to feel less nauseous and rebuild his appetite - we certainly hope so.

I am keeping my hopes on the Orthotist being able to amend Dads brace so it is more comfortable for him to wear so that he will improve again with his walking.

As always...thanks for reading and believing and for never allowing the hope to be taken away from our thoughts.

Stay Strong. Love you Dad x


Dad walking tall at the start of the month


Another physio session in the gym


A birthday kiss from My Dad x