Sunday, November 23, 2014

Chapter 16 "Would you tell me, please, which way I ought to go from here?"

Where to start.  My husband's in the hospital on the neuro critical care unit.  He slipped and fell on the ice this morning.  His feet literally flew out from under him and he landed flat on his back, hitting his head in the process.  He lay there, dazed for a bit.  I'm not sure how long.  Probably just a few seconds.  He was very disoriented as we waited for the ambulance.  He didn't understand why I'd called 911 - didn't remember he'd fallen.  He had no physical injuries, and no large lump on the back of his head.  But needed to be repeatedly told to sit still in my car - "who's car is this?"  he asked several times.  By the time I'd followed the ambulance to the emergency room, he'd had a seizure.  Apparently he'd been joking and talking in Spanish to the EMT's and emergency room workers - then seized.  So I was led to a waiting room until they rushed him upstairs for a CT.  After the CT, he seized again. 

I waited in the room for awhile, periodically going to the doorway and looking up and down the hall, hoping someone was looking for me to fill me in.  I am not very good at waiting.

After a while, they came to get me to take me back to his "room" in the ER.  He didn't know who I was.  "A woman with glasses."  He couldn't move his left leg or arm - I was asked if he'd ever had a stroke.  Thoughts were zigging and zagging through my mind.  He'd had two doses of Adavan - one after each seizure - so he was pretty out of it - I knew that - but I still had my life flashing before me - not my past life - what the future might hold.  About a half an hour later, my daughter arrived.  He did recognize her, and by then recognized me.  He was starting to move his left leg and arm.  What a relief.

The nurse working with him in the ER was an angel.  So compassionate and caring.  He held Dave's hand a lot.  Kept saying that Dave had been through a lot, that he was a trooper.  He had seen Dave at his most charming, joking and speaking Spanish to everyone, and now saw him at the lowest point ever.  It was very touching.

Dave was moved up to the ICU.  Kristin and I waited about an hour while they got him settled in his room.  He was very out of it.  Slow and slurred speech.  Dozing off.  Some drooping on the left side of his face.  By late afternoon, he seemed more alert.  Still confused and a little lost.  Kept trying to get out of bed.  Was surprised he had to stay the night.  Every hour a neurological assessment was done.  The strength in his arms and legs was returning.  He could say his social security number, his birthday, his name.  He had the date right, was off on the year - like 1214, or 1914.  Would answer that he was at Deaconess or St. V's hospital in his home town in Montana, before he would get it right.  I was glad to leave the hospital and come home in the evening.  I was spent and couldn't face that reality any more.

Continuing on Sunday - when I got to the hospital at 7, I knew he was doing much better when I saw at some point he'd requested the cable tv listing - yay!  The collar from around his neck had been removed.  He told me he'd been awakened every hour for the neurological assessment, all night long.  His speech seemed normal.  His eyes were bright.  I felt SO relieved.  He read the newspaper - seemed so well compared to the day before.  About nine, I headed down to the cafeteria to get something to drink.  The last thing I did before I left the room was show him the nurse call button, reminded him he could not get out of bed on his own, and that he had a catheter in and didn't have to worry about that - I came back to a little chaos.  He'd gotten out of bed on his own to use the restroom, and got half way across the room before his IV pulled out, his catheter came apart at the bed and started spilling, his monitors pulled off.  The nurse and nurse's aide were in there cleaning everything up, changing the bed, getting him cleaned up.......... I know it is to be expected.  But it still stuns at the core.  He seemed to get it after that that he needed to stay put.  He was so wobbly on his feet, I don't know how he made it as far as he did without falling.  Ugh.

Through out the day, he needed constant reminders to stay in bed.  He did not remember anything about the day before.  He was allowed to eat and drink and did so with gusto.  Doctors came and went.  He won't be able to drive for about six months.  He'll be on anti-seizure medication for awhile.  He seemed to take all that in.  He was moved to the step-down unit for brain and stroke patients.  Got settled in there.  I went home for awhile in the afternoon - Kristin sat with him for awhile - but he continued to try to get out of bed - pulled off monitors, just not being sure what they were.  When I got there about six tonight, the nurse was in the room.  He had been calling the nurse every fifteen minutes to go to the bathroom.  She asked if he usually goes to the bathroom that much, and I told her that was not normal.  When he did it two more times while I was there, I suggested they give him a bottle or something.  He tried that, but again contacted the nurse.  Unfortunately when there is an auditory response from the nurses' desk through a small speaker, Dave can't hear it.  So he wasn't responding to their questioning.  It was disheartening to witness it, to see a little frustration from the nursing team - I don't blame them - they were still very kind and responsive - but I could sense the frustration.  They put an alarm on the bed so they'll know when he tries to get out.  He is trying to squeeze through the little part of the bed that doesn't have a railing - he's persistent!  As the new team came in for their shift, I explained about the FTD, that Dave just couldn't retain the instructions to not get out of bed, etc.  They were all understanding.  But it was difficult for me to witness it happening again and again and again and again.

Before I left, he was talking about not being able to work on Wednesday and that he'd have to call them and say he couldn't do it till the next week.  I reminded him he would not be able to drive for awhile - he seemed quite surprised, despite the fact we'd discussed it several times during the day. 

I have many questions - could this significant short term memory loss be permanent?  Tomorrow, will he remember today?  Does the FTD exacerbate this new brain injury?  I've been assured that this brain injury and seizure is a separate issue from FTD - but I'm wondering what this will add to the picture.  As I'm writing this, I just have no idea what the next days and weeks will bring.  Dave is getting an MRI this evening.  Hopefully we'll have some results tomorrow.  He's still so unsteady on his feet, I'm not sure he'll be able to come home tomorrow.  And how long til he can really be on his own?  Should I take family medical leave?  Just not sure what happens now.  Another reality check - I've had enough of them lately!  Now I'll be researching subdural hematomas, long term effects, etc.  Double ugh.



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