XRe Posted April 10, 2007 Author Share Posted April 10, 2007 Thanks again, everyone... Your support is very appreciated. I got to speak w/ the neurologist today - its an intra-cranial hemorrhagic stroke, which means she had some bleeding into the central part of the brain (as opposed to a surface bleed). There's thankfully no aneurysm, which would definitely be a more serious issue. There's obviously a lot of swelling in the brain, right now, due to the blood collected there, but its apparently not causing a lot of excess cranial pressure. The docs have a positive outlook, at this point - many people with this sort of stroke regain quite a bit of their previous ability. With my mom being a paraplegic, though, the primary concern is will she be able to take care of herself without assistance. She's groggy - basically hasn't slept in 36 or more hours (hard to sleep in an ICU), but she knows folks are there, and can carry on lucid conversations and such. Its hard to know when she's awake and paying any attention, though, right now. She's not allowed any thin liquids, due to difficulty swallowing, but we might be able to get some more solid stuff in her tomorrow. She's still got a little bit of sense of humor, which is a plus. Tomorrow will be spent figuring out the insurance situation, and what kind of arrangements we can make for her, etc. Not a whole lot else to know, at this point - those of you who have gone through this know that its a waiting game for a while... waiting is the worst If someone just had some damn answers But... it is what it is... and the answers will become apparent when they are meant to be known. Anyhow... again, thank you all so much. I'm glad you guys are here Link to comment Share on other sites More sharing options...
nm3gnr Posted April 10, 2007 Share Posted April 10, 2007 Dave, Our thoughts and prayers are with your family! Link to comment Share on other sites More sharing options...
lmccrock Posted April 10, 2007 Share Posted April 10, 2007 (edited) I'm glad you guys are here to distract me when I need it Good place to stop: http://www.brianenos.com/forums/index.php?showforum=24 I have been spending more time than usual visiting my mom. She just finished round 2 of chemo, and while her prognosis is ok, the path is tough. Dave, best wishes. Lee Edited April 10, 2007 by lmccrock Link to comment Share on other sites More sharing options...
Gameplayer Posted April 10, 2007 Share Posted April 10, 2007 Prayers sent for your Mother and family. Link to comment Share on other sites More sharing options...
Hey QuicksDraw! Posted April 10, 2007 Share Posted April 10, 2007 My thoughts and prayers are with you and your family. My father had a severe stroke last year so I can relate. PM me as much as you like and need. Stew Link to comment Share on other sites More sharing options...
XRe Posted April 12, 2007 Author Share Posted April 12, 2007 Thanks again for all your support. Yesterday was a bit harder, as the swelling was increasing, and her behavior became a little bit erratic. Today was a little better. She's still pretty dissociated, but she's talking better, and starting to be more cohesive. We'll see what tomorrow holds... Dave Link to comment Share on other sites More sharing options...
Bryan W Posted April 12, 2007 Share Posted April 12, 2007 Hang in there buddy Link to comment Share on other sites More sharing options...
DougCarden Posted April 12, 2007 Share Posted April 12, 2007 Dave, Hang in there. My son has had 4 surgeries since the first of the year. When you overload get out of the hospital. It WILL happen and when it does get away for an hour or two. If you are fried and difficult to be around you do no good and make life hard on your family and the hospital staff. Go to a sporting goods store and walk around, something to escape to or just find a restaurant that you really like and get your mind off of it for just a few moments. Things like this help me to keep my sanity, I cant tell you how many times I have read my Sierra Load Manual in the hospital...... Prayers sent, DougC Link to comment Share on other sites More sharing options...
Calamity Jane Posted April 13, 2007 Share Posted April 13, 2007 Thanks again for all your support.Yesterday was a bit harder, as the swelling was increasing, and her behavior became a little bit erratic. Today was a little better. She's still pretty dissociated, but she's talking better, and starting to be more cohesive. We'll see what tomorrow holds... Dave I was expecting this. This is not abnormal for her condition. Hang in there. Link to comment Share on other sites More sharing options...
carinab Posted April 13, 2007 Share Posted April 13, 2007 Hang tough Dave and be her strength but as Doug said, don't forget to recharge. Prayers on the way for a speedy recovery. Link to comment Share on other sites More sharing options...
edwin garcia Posted April 13, 2007 Share Posted April 13, 2007 My prayers go to you and your mom. Hang in there buddy. Link to comment Share on other sites More sharing options...
XRe Posted April 14, 2007 Author Share Posted April 14, 2007 Past two days have shown some improvement, as expected. She's generally pretty aware, and much less dissociated. Sleeping a lot, but that's fine. She is, of course, still in some denial about her condition - this is totally a result of the stroke, of course. She's moving to the rehab floor tomorrow, and part of the treatment there will be putting her in front of a mirror so that she can see for herself that her left arm doesn't move when she thinks its moving. This is all normal stroke stuff - but she might take a morale hit tomorrow... I'm coming back to TX on Tuesday, and will return back up here at some point, though I haven't made those plans, yet. At least it looks like I'll get some shooting in in between, and still get to shoot the SCC. If I come back up before the Open Nats, I'll bring my heater along and try to get a match or some practice in up here with the Ohio folks - anything to keep my sanity As the danger period appears to be over, the prayers and thoughts we need now are for as complete a recovery as possible, positive attitudes, and luck in knowing the right path to follow with her ongoing treatment... Those of you who have been here know what I'm getting at, I'm sure... Link to comment Share on other sites More sharing options...
Calamity Jane Posted April 14, 2007 Share Posted April 14, 2007 Past two days have shown some improvement, as expected. Glad to hear she is doing better. Rehab is another journey. Hoping and praying the best for you and your mother. Link to comment Share on other sites More sharing options...
XRe Posted April 16, 2007 Author Share Posted April 16, 2007 Setbacks yesterday and today... She'd had a headache since she got to the hospital last Sunday. They gave her Tylenol in the neuro ICU, which she said took the edge off, but didn't kill it all the way. She was doing well yesterday morning, though, again incremental improvement over Friday... My brother and I hung out until they moved her to rehab (at 2:30) and then left to get some lunch. When we got back, she'd been given two Vicodin for the headache... hmmm.... I'm not going to judge the action taken, and I certainly don't know what kind of pain she was really in. But... she was totally out of it, as if she'd regressed back to the first day. She was given two more this morning, and stayed in the same state all day long today - even though she was only given the two pills this morning. Obviously, its impossible to say how a certain drug will affect someone, especially after their brain has been changed in this fashion. But... it was disheartening to see what would appear to be a pretty major backslide. While I was discussing it w/ her nurse today, she mentioned that she had not administered more because she felt like it was doing too much, and my mom wouldn't be able to do much of the rehab stuff if she was that out of it (like, really??? You don't say.... ) I'm baffled as to why they started with two Vicodin, right off the bat... Again, its not my profession, of course.... Seems, though, that perhaps one might've been a better starting point?? Or maybe a Darvocet or something else a little less strong??? Is headache a normal side effect of stroke? I was under the impression that the brain doesn't really feel pain?? But perhaps the surrounding stuff?? I'm wondering if it doesn't have anything to do with the funky head positions I keep finding her in and stuff.... hmmmm.... Anyhow... the best ride I could get to Columbus to fly out will get me there at 2pm tomorrow, so I'm actually flying out tomorrow, instead of Tuesday... I get home around 9pm... I'm so thankful to be getting home...!!! At least for a little while Link to comment Share on other sites More sharing options...
AikiDale Posted April 16, 2007 Share Posted April 16, 2007 I've had kids and parents in the hospital and couldn't do a damn thing to make it better. Hang in there Dave. Link to comment Share on other sites More sharing options...
Sharyn Posted April 16, 2007 Share Posted April 16, 2007 (edited) First, I'm sorry to hear of your mother's condition and hope the best for you and your family. Setbacks yesterday and today... She'd had a headache since she got to the hospital last Sunday. They gave her Tylenol in the neuro ICU, which she said took the edge off, but didn't kill it all the way. I'll try to help address some of your concerns/questions. Although I don't currently work neuro (or adult) ICU, I'd imagine that they somewhat restricted your mom to Tylenol in order to most accurately assess her neurological status while in the neuro ICU. As you've seen, narcotics can distort "normal" behavior. When we got back, she'd been given two Vicodin for the headache... hmmm.... I'm not going to judge the action taken, and I certainly don't know what kind of pain she was really in. But... she was totally out of it, as if she'd regressed back to the first day. She was given two more this morning, and stayed in the same state all day long today - even though she was only given the two pills this morning.Obviously, its impossible to say how a certain drug will affect someone, especially after their brain has been changed in this fashion. But... it was disheartening to see what would appear to be a pretty major backslide. Not being there and not knowing the complete situation, I can only speculate. However, I wouldn't think of it as a backslide or regression. She will have good days and bad days, but you simply can't determine a bad day while she was under the influence of narcotics. How was her headache? Did she feel better? Maybe you can take solace in her comfort...? I'm baffled as to why they started with two Vicodin, right off the bat... Again, its not my profession, of course.... Seems, though, that perhaps one might've been a better starting point?? Or maybe a Darvocet or something else a little less strong??? Darvocet or Fiorocet might have been an alternative, but I'm not up on current post-CVA literature (nor do I dare get into insurance coverage or hospital formularies). Again, I can only speculate on the dosage, but Vicodin is extremely common for moderate to severe pain and one to two tabs is standard dosing. If she was in a lot of pain, I assessed her to be in a lot of pain, and she requested two tabs, I'd have given them to her. It really depends on the nurse and the patient. If I ask a patient what their pain is on a scale of 1-10, 10 being the worst, and they reply 11... they're likely to receive the two Vicodin that have been prescribed. I'm not the type of nurse to give them one and "see if it works" if they're really suffering. That will just prolong the time it takes for relief. I'll certainly educate the patient about the medication and its effects, but they have every right to request (and receive) the maximum dosage. What were her clinical signs? Elevated blood pressure and heart rate? Tense? Tearful? She would not have been able to perform her rehabilitation activities if she was suffering from a severe headache either. It's really difficult for a bystander to determine sufficient pain relief. Pain and pain relief are subjective with 'some' objective measurability. Is headache a normal side effect of stroke? I was under the impression that the brain doesn't really feel pain?? But perhaps the surrounding stuff?? I'm wondering if it doesn't have anything to do with the funky head positions I keep finding her in and stuff.... hmmmm.... Yes, headaches can be experienced post-stroke. Her doctor would not have prescribed Vicodin if they didn't anticipate her experiencing pain. And you may also be correct in thinking her headaches may be associated with "funky head positions". Headaches can be caused by a number of things (inflammation - increased intracranial pressure, muscle tension, high blood pressure, stress, etc.)... just being in the hospital can certainly be one. Again, I am not an adult ICU nurse, but I work day in and day out assessing patients for pain that have very, very limited means of communicating. Best wishes to you and yours. edited for grammar Edited April 16, 2007 by Sharyn Link to comment Share on other sites More sharing options...
Calamity Jane Posted April 16, 2007 Share Posted April 16, 2007 (edited) +1 to Sharyn's post. I'm so sorry that you have to wait and watch your loved one go through this tremendous physical trial and not have a lot of control of what happens. It's the nature of the beast. Glad you're going home for a little while. Hang in there. Edited April 16, 2007 by Calamity Jane Link to comment Share on other sites More sharing options...
XRe Posted April 16, 2007 Author Share Posted April 16, 2007 Ladies, thank you both for your responses... I can fill in a couple of details - I don't want to give the impression that I feel the nurses involved necessarily did the wrong thing, or that I'm upset with them - its just frustrating and disconcerting (as I'm sure you can imagine)... Part of it, I'm sure, is that she suddenly seemed much like her father, who died from complications due to PSP. Her facial expressions, lack of ability to respond to slow response, frequent periods of eyes closed but not necessarily sleeping, etc - all seem way too familiar. I wouldn't wish PSP on anyone.... I'd imagine that they somewhat restricted your mom to Tylenol in order to most accurately assess her neurological status while in the neuro ICU. Totally with you there... How was her headache? Did she feel better? Maybe you can take solace in her comfort...? It was definitely gone. I'm definitely glad she was not in pain. Vicodin is extremely common for moderate to severe pain and one to two tabs is standard dosing. Yeah, I'm with you there, too. What were her clinical signs? Elevated blood pressure and heart rate? Tense? Tearful? She came in w/ elevated BP last Sunday. She apparently hasn't been under treatment for high BP, but the MRA showed damage to the small blood vessels due to hypertension, and it was at least one contributor to the stroke, according to the doc. So.... I don't know what a normal baseline would look like for. Hard to judge tension, too, due to her condition. She wasn't tearful or anything like that... It's really difficult for a bystander to determine sufficient pain relief. Pain and pain relief are subjective with 'some' objective measurability. I'm with you there, too... just being in the hospital can certainly be one. God knows I have one... I think I'll stick to Tylenol, though... Thanks again.... I'm headed down one more time, and see how she's doing. Then its out to Colombus - I'm actually being able to head home tonight, due to the timing of my ride to the airport area, so... Link to comment Share on other sites More sharing options...
zhunter Posted April 16, 2007 Share Posted April 16, 2007 Dave I will continue to send my prayers. Jay Link to comment Share on other sites More sharing options...
Sharyn Posted April 16, 2007 Share Posted April 16, 2007 Ladies, thank you both for your responses... I can fill in a couple of details - I don't want to give the impression that I feel the nurses involved necessarily did the wrong thing, or that I'm upset with them - its just frustrating and disconcerting (as I'm sure you can imagine)... Part of it, I'm sure, is that she suddenly seemed much like her father, who died from complications due to PSP. Her facial expressions, lack of ability to respond to slow response, frequent periods of eyes closed but not necessarily sleeping, etc - all seem way too familiar. I wouldn't wish PSP on anyone.... As difficult as it may be... try to stay in the moment and deal with what's at hand. It's terribly difficult to do that let alone handling the past and future. We're here to support you. She came in w/ elevated BP last Sunday. She apparently hasn't been under treatment for high BP, but the MRA showed damage to the small blood vessels due to hypertension, and it was at least one contributor to the stroke, according to the doc. So.... I don't know what a normal baseline would look like for. Hard to judge tension, too, due to her condition. She wasn't tearful or anything like that... Just to clarify, hypertension is a contributor to pain as well and an indicator of pain. I was essentially referring to her post-stroke condition. The medical staff would have had a baseline to work from. In many of my patients, all I can assess for signs of pain are blood pressure and heart rate. God knows I have one... I think I'll stick to Tylenol, though... Well, stick to Tylenol... A glass of wine (or hot cup of tea for non-drinkers), warm bath, long walk, day at the range or any other relaxing activity will help. One thing many people forget to do when they're concerned about another is to take care of themselves. Please, don't forget your own well-being. Hang in there! Link to comment Share on other sites More sharing options...
SiG Lady Posted April 16, 2007 Share Posted April 16, 2007 Vicodin is extremely disorienting. I refuse to take it unless I'm dying from pain. You can't recall things from one minute to the next and lose track of time, and things like that. The side effects (at least for me) were MUCH worse than the pain. I'm not sure I would've given Vicodin to a patient with her symptoms and conditions. But I'm not a doctor OR a nurse. But my eyes bugged out when you said "two Vicodin..." God, that's enough to disorient a healthy horse! Link to comment Share on other sites More sharing options...
XRe Posted April 16, 2007 Author Share Posted April 16, 2007 One thing many people forget to do when they're concerned about another is to take care of themselves. Please, don't forget your own well-being. Doing my best with that... I might force some time to hit the range tomorrow, and that'll help a bunch... I can tell you this, though - if anything, I've learned a couple of things.... the various legal documents I've been putting off doing are getting done, now... (living will, will, springing powers of attorney, et al).... Its been hell trying to get stuff done for her w/o any of that. I'm going to have to do it all remotely, now.... And... I'm sure as hell glad I don't smoke... Charlene - funnily, two Vicodin hardly do much to me at all... but my system is weird that way. Also, I know what it takes to totally disorient a horse... Two Vicodin ain't enough... Link to comment Share on other sites More sharing options...
SiG Lady Posted April 16, 2007 Share Posted April 16, 2007 Well, probably not, but I don't know of ANYONE at the moment who's had positive reactions to that medication... including me. Even with significant pain, I would likely never take it again. There are many alternatives. Link to comment Share on other sites More sharing options...
Guest Posted April 16, 2007 Share Posted April 16, 2007 Sound like you are doing all the right things. I am no expert in either the legal or medical aspects, but I learned a lot after my Mom had a stroke in Feb 2006. Here are some of the things I did which, in hindsight, worked out well. I live 3000 miles from where my Mom lives and had to take over (and reconstruct) her finances, too. 1. I got hooked up with the best elder care family lawyer I could find/afford. She (the lawyer) reviewed my Mom's trust, revised her will, obtained P.O.A for my brother an myself, advised us on the laws regarding Medi-care and Medi-Cal (California's version of Medic-Aid), advised us on how to legally protect our family's assets, advised us on the tax issues, helped us on several occasions to cash in annuities, vanguard accounts, mutual funds, etc. required to pay for my Mom's care (It's amazing how difficult this can be even though you have POA, all the right documents, etc....a quick call/letter from a good lawyer can instantly solve problems that would have taken us weeks to work through ourselves). All in all, the lawyer was well worth the expense (which wasn't all that much, actually). She was also a very caring person who visited my Mom several times (at no charge!) just to make sure she understood what we were doing and why (no small task considering my Mom's condition). Made me take back all those evil things I've said about lawyers over the years. 2. It took me about 2-3 months to collect all of the financial data on my Mom. Once I had that I went to a local CPA to determine what the best way to pay for the care for My Mom (she needs custodial and medical care). Under the CPA's advice we developed a spend down plan to pay for the care of my Mom with the understanding that her assets would not last for ever and we would have to get into the Medi-Cal program at some point. The cost of assisted living or nursing home care can be pretty steep (if you want to know the expenses we pay, PM me). We also found out about things like what can be written off, what accounts needed to be closed and/or consolidated (we closed all of her credit card accounts except for one to prevent fraud), and how to handle her taxes. After getting things organized, I started using Quicken to keep track of the type of expenses, accounts, etc. Make reporting to the other family members what the current status is very easy, and doing the taxes a lot easier. 3. Sought out support and help from her health provider's (Kaiser) Social Worker. She was a huge asset in helping us to decide how we could best care for her and get the level of care she needs. In addition, she recommend several facilities and even went with me to the first few I toured so I could get an idea of what to look for. 4. Got everybody's (family & friends) email and send pics and a report on how Mom is doing after I get back from every visit (about every 4-8 weeks). This took a huge load off me since I didn't have to call everybody individually. Ok, I've rattled on long enough..Hang in there - there are good days, and bad days, and a lot of learning on everybody's part everyday. You and your Mom are in my prayers. Bob Link to comment Share on other sites More sharing options...
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