Brain Dump

I am a stream of consciousness kind of guy, full of random thoughts that spill out in no particular order.  Marty was pretty much the same way, though a much more focused thinker.  As I have not been able to write a coherent sentence for a few days I thought I would simply write down a few of these incredibly insightful and intelligent thoughts:

• ·         We went to see Marty’s neurologist this week and I updated him on Marty’s recent health.  I hadn’t realized it but she hasn’t taken an antibiotic since the middle of May.  I do count, that’s four months, that’s fantastic.
• ·         My son who is a loyal young man and a faithful reader is convinced I never had sexual relations with his mother.  He just couldn’t get past the first two paragraphs of my last post.  Sorry big guy, I was there at your conception, your sister too.
• ·         I’ve been thinking about my fears lately.  My fears range from messing up something that hurts Marty to dentists to snakes.  A new fear – President Rick Perry.  He makes George Bush look measured, reasoned and intelligent.  You have to wonder why we have to replay the Scopes Monkey trial all over again.
• ·         In the last five years I have had two minor bouts of cellulitis, a virginal introduction to poison ivy, two stomach viruses and one minor episode of food poisoning.  Now I have the shingles.  I have learned two things from all of this, the shingles really, really hurt, I am allergic to poison ivy and I clearly need to wash my hands more. 
• ·         I have had some of the kindest and most understanding notes and comments about my blog post on sex.  It is so meaningful for people to say, in so many ways, they understand the loss of this most basic part of our life.  It really is touching.
• ·         We celebrated my father and mother’s 83^rd birthdays in August and September.  We celebrated Marty’s birthday in August and we are going to Dallas to celebrate my son’s birthday to be followed by my grandson’s birthday, the birth of our third grandchild (the baby to be named later) and my daughter’s birthday in November.  Clearly my family tends to procreate in the winter months.
• ·         Unless he commits some heinous crime I will still vote for Barack Obama.  Given the circumstances (a $1.5 trillion deficit he inherited, the economy contracting by 5% and shedding 200k jobs per month) I think he has done more right than wrong.  Though I tell you, if the rumors that he really is a Muslim, Buddhist, Wiccan, Marxist trying to establish a USA caliphate and he has used his secret Muslim scientists to cause the drought in Texas then he can count me out.
• ·         I wish a very quick recovery to my children’s other Mom, Sue.  Surgery sucks, two surgeries double suck, three times in the hospital, well it’s just a major drag.  So sorry for you and aren’t you proud of your children and your husband.
• ·         I worry that my Texas Tech Red Raiders are going to be a team without a country when the Big 12 implodes.  All of this blowing off of tradition kind of makes me sad and that makes me feel like an old fogey.
• ·         I skim the obituaries for people I might know.  Does that make me old?  When I read them and talk about them to my friends and then talk about having the shingles that makes me old.  Having a 32 year old son, a 29 year old daughter, a 2 year old grandson doesn’t make me old, it makes me happy.
• ·         I sometimes worry I don’t try enough new things for and with Marty.  I’m not sure I am doing enough to really keep her stimulated.  It takes a lot of energy for both of us to do things and go places and step out of our routine.  I hope when I look back on these days I see that I kept the right balance for her and for me. 
• ·         Flu shots get your flu shots, it’s easy and they don’t hurt, much.  HPV, get your HPV vaccine if you are young enough and your parents will let you, preventing cancer is a good thing.  I like it when I can find a reason to agree with my Governor.
• ·         Last, from the what I learn from Marty file, cut people some slack.  No matter what I do to Marty, no matter how many times I bang her foot into the wall when I’m pushing her wheelchair, or how many times I simply hold her wrong, her action is always very simple.  She forgives and completely moves past the bump, every day she cuts me slack.  It makes me want to do better.

I told you they come out in fits and spurts, it’s just random.  That’s why sometimes I have to let the ideas flow and spill out or my brain just gets too crowded.  My brain feels better now.

Lookin' for Wood

I’m not a superstitious guy.  But, just to hedge my bets; I never walk under a ladder, which seems pretty prudent regardless of superstition.  I also will occasionally spit when a black cat crosses my path and I immediately seek some wood to knock on when talking about good things happening in my life.

With that being said you will understand why I’m knocking because I want to report that in the grand scheme of things Marty has really been “healthy” lately; hear the knocking on wood? 

She has not been in the hospital for almost 18 months.  We haven’t seen the inside of an emergency room in almost a year and we only went to see Great and Wise a couple of weeks ago so I could brag in person about beating him in scrabble.  Rap, rap, rap on real wood.

Over the last six years we have seen more of doctor’s offices and various hospitals than many see in a life time.  There are a lot of people in this world who have never been hospitalized.  For us, the nurses on 3^rd floor south at Providence Hospital knew Marty by name.  For a while we had personal relationships with most of the ER doctors at our favorite emergency room and the nurses would come in and ask about our kids.  I liked them all but would have preferred to have met and known them from the Cryin’ Shame bar down the street.

Marty has survived so much.  She has lived through so many things so many times it’s a bit mind numbing.  From seizures to pneumonia to urinary tract infections to broken limbs, she has done it all, multiple times.  At one point in time, at least in my mind, I just knew she would ultimately lose her battle for life to some rare infection with an obscure Latin name.

As days have moved to weeks, months and years things have gradually changed, we have learned, we have grown, we have gotten better at dealing with illness and the illnesses have become more sporadic. We have not conquered the most difficult part of stroke recovery, chronic and constant illness,  but we have fought it to a draw. 

The disability part of the strokes is hard but it’s never been the hardest part, the wheelchair has never been the most frightening part of the strokes.  The frailty, the constant illnesses and need to be on constant guard for a new sickness has been the most difficult, stressful part of our new normal.  It has been the only prayer I have prayed, to give us some relief from the constant infections, the repeated trips to the hospital.  I’ve not prayed for a cure, I’ve not petitioned for Marty to walk or talk, I have simply prayed for Marty to feel better longer.

For the last months instead of sitting in Great and Wise’s waiting room, instead of taking antibiotics, instead of getting Marty stuck in the arm to get blood we have been enjoying the peace and comfort of being infection free.  I’m not watching her blood pressure or her oxygen levels like an old maid, I’m not trying to shoe horn a doctor’s appointment into our day, I’m not waking up in the morning with a surge of adrenalin wondering what bug has crept into Marty’s bloodstream threatening her life.

Marty clearly feels better.  Antibiotics have saved her life, but she simply doesn’t feel as good, as sharp when taking the medicine.  The length of time between bouts of upper respiratory infections or pneumonia have allowed her lungs to heal, to get stronger, to better support her in every way.  The very simple blessing of being well feels good and has a cumulative effect on her demeanor and her quality of life.

It is such a relief to not have to constantly be watching Marty for the next sign, it is freeing to be able to leave the house and not worry about what is happening at home.   It feels great to not sweat out a medical report.  I know Marty feels a sense of relief that I am not constantly watching her every breath, cough or wobble.  It is so much better to go see Great and Wise and not worry about test results but to talk about the scrabble words he uses that I don’t recognize, he’s a good scrabble player.

There are times in our lives where we want to celebrate but we are afraid because the celebration might somehow jinx the cause of the celebration.  That kind of thinking tends to limit celebrating the bright spots in a sometimes dark life.  Not being the superstitious kind of guy I’m thinking I’m going to do the happy dance to celebrate the past few weeks, while knocking on some real wood just to be safe.

Small Gifts

I once wrote that we gauged how good or bad our weeks were by the number of times we visited the offices of Great and Wise. By this measure, and by almost any other measure that makes sense for a chronically ill woman, we are doing great. I hesitate to trumpet this too much lest I be guilty of moving past the living day-to-day thing, but all-in-all, Marty is doing well, consequently Marty’s husband is doing well.

Since May Marty has been medically ill enough for antibiotics just once and I suspect that illness was a virus because she gave it to me, bless her heart. I, who have the good health and constitution of wonderful ancestors, have been on antibiotics more than Marty over the last few weeks due to my little tookus issue last month. Given Marty’s history of infections this is wonderful territory for us.

This is not to say we haven’t had some issues which led to a couple of fascinating doctor visits. A swelling face due to blocked salivary ducts and shooting blood out of your eye like a horned toad will lead to some teachable moments. Neither of these issues was serious, in retrospect, they were both a bit titillating to the uninitiated.

As the months of favorable health have moved on (yes, its six months and I’m counting) we have been able to do more things, see more people and experience more life in general. As the months of feeling good pile up its clear Marty feels better and is somehow just a little bit stronger, a little more attentive to her surroundings and a lot more communicative.

Yesterday as I read her our last post, about me trying to understand what she is thinking and feeling, she listened intently as I read. The last line of the post read, “Just once though I would like to really be able to see behind those clear blue eyes and know and really understand what it really feels like for Marty.”

I looked at Marty and asked the obvious, “What do you think? Is that okay?”

She looked at me for second and said, “No you don’t.”

“No I don’t what?” I asked.

“Want to know what it’s like inside my head.”

“Why not?”

“Because the inside of my head is awful, it sucks, and it just doesn’t work right” she replied, looking straight at me.

There wasn’t much for me to say as we looked at each other. Aside from the birth of our two children Marty was always most proud of her intelligence, her communication skill and her ability to understand her surroundings. The strokes took what she thought was the best part of her.

I think the strokes have proven that her perseverance and spirit are and have always been the best part of her.

It was time for lunch and I asked her if she wanted to go supervise me as I made her world famous, minimalist tuna salad. Equal parts of Miracle Whip, sweet pickle relish and solid white tuna is all that’s required (I know, way too sweet for most of you). She wanted to go oversee my cooking.

I got up, turned her around and pushed her into our kitchen and started making the tuna salad while making small talk and asking her if I was using the right proportions. She was pretty comfortable with my technique but threw in an occasional hint.

I picked up the bowl, moved over to the other counter, set the bowl down and looked at Marty to ask if she wanted me to toast her bread. Before I could ask her she looked at me and said very simply, “I love you.”

I like it when she feels good even though the improved cognition can sometimes magnify her losses. I like it because she sometimes surprises me with small gifts.

Here's Blood in Your Eye

Blood, just a small drop, barely noticeable welled up in the left corner of her right eye. She coughed hard several times as just a tiny bit of blood began in the right corner of her right eye and slowly started to trail down her cheek as she continued to cough. I carefully pulled the long thin catheter from her nose as the blood from her eye moved further down her right cheek.

Erica quickly took a soft tissue and dabbed the tiny bit of blood from Marty’s cheek and said, “That’s new.”

“Yeah”, I said, thinking, “I hate new.”

We sat Marty up from her supine position in her bed as she gasped for the air I had just suctioned from her lungs along with the sticky phlegm. I looked at her right eye and didn’t see any more blood pooling in the eye. I didn’t see any sign of broken blood vessels or any redness in her eye, only the tiniest remnants of blood and tears.

Marty struggled to catch her breath and to breathe normally as I looked at her and as calmly as I could I got her attention on me and said, “Everything’s okay, take slow deep breaths.” Erica gently placed the nasal cannula under her nose and turned on the oxygen. Marty’s breathing slowly began to return to normal as the trauma from the suctioning abated.

I looked at her eye again and could not see any sign of blood and I internally decided to ignore this new event. I was an experienced caregiver, I had seen “new” before and in most cases it was nothing more than an anomaly, a one-off, I could be cool for a change and not obsess about this little event.

It was late. Marty had settled into her bed comfortably, Erica was with her, I went to get ready for bed. I sat in the living room and ruminated on what had just happened. It was bound to be something simple. She had coughed, she had coughed really hard as I had suctioned, it must have been just a small capillary that had burst and leaked a little bit of blood. That was the simplest, most straight forward explanation. I checked on Marty and Erica one more time, they were resting, I went to sleep.

By the next morning I was patting myself on the back for my practical coolness in the face of “new”. I really wasn’t all that cool. Virtually every thought I was having focused on why Marty had blood in her eye. I was beginning to obsess and coming up with all kinds of very unlikely scenarios. It was time to call Great and Wise and see if he could see her today and make sure she wasn’t going blind in her right eye or having a hemorrhagic stroke or some other exotic ailment. I called and one of our friends at the office, Angie, figured out how to squeeze us in to see the good doctor.

When we got into the office I told Great and Wise about our rather harrowing experience and he began to examine Marty, looking at her eye, looking in her ears and last taking his little light and looking in her nose. He kissed Marty on the cheek and looked at me asking, “You ever seen the guy on David Letterman that can suck milk in his nose and shoot it out his eyes?”

He walked over to the ubiquitous chart on the wall diagramming the face, the nose, and the sinuses and pointed to where the tear duct runs down into the nose. He explained, “She has just a small cut in her nose where it bled just a little last night. I imagine when you put the catheter in her nose you nicked it just bit. When she was coughing so hard it probably pushed the blood up the tear duct into her eye pushing a bit of blood out the tear ducts. Just like the guy with the milk only with blood.” The man is a genius.

We left with me thinking better thoughts while talking to Marty about how weird and interesting this whole event was. My initial intuition was right in that it was an anomaly, but it was a really strange anomaly I could not over look. I guess that sort of defines anomaly.

I later relayed this story to Jerry and Luann, Marty’s brother and his wife. Jerry immediately identified with the story in that Jean, Marty and Jerry’s mom, used to literally shot smoke out of her eyes. She would inhale the smoke from her cigarette in her nose and push it through the tear ducts out of her eyes. Jerry said she didn’t do it often because it hurt. I bet it did.

Clearly the body will do some amazing things if you can shoot milk, smoke or blood out of your eyes. I have to tell you it’s really freaky to see it and I’m about tired of learning of new and fascinating body facts. I have become a veritable font of useless anatomical information. If I’m ever on a game show or if you need a phone-a-friend just let me know it may have happened to Marty.

The 2nd One -- Part I -- Back Again

Marty and I had developed a really bad habit of eating supper in the living room while watching the somewhat inane but funny television show "Everybody Loves Raymond". It was our 30th wedding anniversary and we were celebrating in the emotionally and physically fatigued manner befitting the end of the holidays. We were just getting over a long trip to Dalhart, Texas and Angel Fire, New Mexico.

We had celebrated Christmas, Marty's mother's 80th birthday and snow skied in the Sangre de Cristo Mountains. It was an epic voyage and an appropriate celebration of Marty's survival from her ruptured aneurysm. It had not been a particularly relaxing return trip out of the mountains and to Waco so celebrating wasn't on anyone’s priority list. Rest and relaxation with mind numbing comedy seemed to be the best way to celebrate this anniversary.

We had been to the doctor that day to see Great and Wise because Marty just didn't feel well and I was worried and anxious, a condition which had become all too familiar. Marty had been having vague symptoms of something, I just didn't know what, it is really hard to explain, I just felt like things weren't right. The good doctor checked Marty over and said she seemed okay but her blood pressure was a bit elevated. We settled in for our fabulous supper of grilled chicken and I felt a bit better just being relaxed in our home.

We finished eating in peace, silently. Marty was to my right in a large recliner, I glanced at her, then I looked again as I saw her slumping to her left. Marty's face was slack, contorted, drooping in a way that could only be one thing. She was drooling just a bit from the left side of her mouth and she tried to talk but couldn't. She had a look of confusion, but confusion mixed with terror. She intuitively knew what was happening, but didn't, all at the same time. On a scale of worst moments in our life, it was at the top, we both knew it was another stroke.

I took the empty plate from her lap, the food gone. I called 911 and tried to tell the person on the other end of the phone what was happening as calmly as I could. I simply could not believe I was standing there, asking for emergency help while the beautiful brain of my wife was starved for blood. Police arrived first; they do that in our community, quickly followed by an ambulance.

Marty began to revive a little as the EMT's did their thing, taking blood pressure, checking oxygen saturation levels, asking Marty questions, asking me questions, looking at her eyes, listening to her heart, all while she sat slumped in her chair. The slack in her face began to slowly recede and Marty began to recover a bit. I was afraid, confused, angry, anxious and probably on the verge of exploding. It's what I wanted to do, just blow up, blood, guts, and soft tissue everywhere, paint the walls of our house.

There was no question we were headed back to the emergency room at Providence Hospital. I just wanted them to hurry. They gently loaded Marty onto the gurney and rolled her out of the house. I had seen this before, I hated seeing it again. I had lived 50 years without seeing anyone I loved being put into an ambulance. Now it was happening again. I watched as they loaded Marty into the back and closed the doors. I stood outside of the ambulance watching through the windows in the doors as they hooked Marty up to IVs and locked her gurney into place. For a brief moment I thought I would just open the doors, push the EMT’s aside, unhook my wife and leave. I wanted, I needed control, I had none.

The upside of going to the ER in an ambulance with stroke symptoms is you get seen quickly. There really aren’t any down sides. They had Marty in an exam room with a doctor by the time I got there. It's a short trip from our house, less than 10 minutes, and in that time I called both of our children and Sue, one of our Persons (see earlier post).

The ER doc immediately ordered a series of tests, most importantly a CAT scan. Marty could no lover have MRI's because of the metal clip in her brain, so a CAT scan would be the most definite test to identify a stroke. Because Marty had previously experienced a cerebral hemorrhage the docs really did not want to give her blood thinners or clot busters. We were really kind of caught between a rock and a hard place; the best treatments for strokes were not really available to us.

Marty symptoms kind of waxed and waned while she was in the exam room. One minute she could still move her left arm and left leg and she was completely lucid. In some ways, at some moments, I could hear and see shadows of Marty before the first stroke. She was funny, she was sarcastic, she was cracking wise and she was trying to entertain. At other moments you could see the classic stroke effects, her face drooped, she was confused, her left side was limp, and her speech was slurred. The doctors, including Great and Wise who made a dash to the hospital, were fairly certain it was a stroke, but the CAT scan did not show bleeding (good), but it also did not show any signs of a stroke, yet.

Marty was stable, it was clear we were dealing with another catastrophic event, but she was stable. After several hours we were joined by Matt, Erin and Sarah, all making mad dashes from their parts of Texas to be with their Mom. It was another case where we just didn’t know, we just really didn’t know what was going to happen next.

They moved Marty to the Intensive Care Unit at Providence. We went to ICU as a precaution and because there were no other rooms available. Just so you know, the first of the year is a particularly sucky time to year to go into the hospital, it's much too crowded.

I went with Marty to the ICU and the nurse there promised me, swore to me she would personally care for Marty and watch over her all night. By this time it was about 3 in the morning. My children and I once again left Marty, once again we went home to try and sleep, once again I looked at my wife and hoped and prayed I would see her again. It’s hard leaving.

Healing by Chocolate

I've never seen a grade A Bennie Hinn type miracle healing. Count me a skeptic and as one who thinks Pastor Hinn is a fake and a charlatan who preys on people in their most vulnerable state. I'm not saying miracles don't happen, I'm just saying I haven't seen one, felt one, or touched one; at least until last Saturday when one came really kind of close.

Marty broke her right arm about a month ago when she had an infection induced seizure. It was the first seizure she experienced in about three years but it was bad. Because of inactivity due to her strokes and long term steroid use Marty's bones are much more brittle than normal. When she had the seizure she was in bed at the hospital and the sheer force of the muscles in her arm contracting and releasing caused the compound fracture of the upper part of her right humerus. It was a horrible fracture of her good right arm, the left arm being paralyzed by stroke number two.

Saying the arm hurt then and still hurts is stating the obvious. We are letting the arm heal, but even now, a month later, it is still very painful. Marty never complains about pain, she never complains about anything, but if you move her arm you get, "oh, oh, oh." This means it really hurts. Pain meds help but they dull everything else so much she often chooses to not take the heavier pain medication. She is a better person than I Gunga Din.

Over the last month she has started to try and use the arm a little bit at a time, and I mean a real little bit. It hurts to move it at all and it appears to be pretty weak. She played the piano for about five minutes the other day, she is starting to hold on to the support rail for her bath chair and has started holding a drink with a straw; all awesome and incredibly helpful improvements. She still requires someone to feed her which she doesn’t much like but tolerates as long as you do it the way she wants.

The other night as we were sitting watching TV, one of our caregivers, Erica came in with a Heath chocolate bar, one of Marty's favorites. Marty has a bit of a chocolate problem, she has a sweets issue, and she likes candy. I can identify, even bad chocolate can be a spiritual experience.

Erica broke the bar into three small pieces and gave Marty a small piece in her right hand. Marty's hand was lying on her stomach as she sat in her chair. Marty took the piece looked at it, looked at Erica and then moving her broken right arm up she put the piece to her mouth. Erica and I both sat a bit stunned; we laughed and clapped celebrating one of life's little victories.

The next day Marty and I were sitting outside enjoying the spring with another of our caregivers, Nikkie, and I told her the story of the Heath bar. She laughed and said Marty had been "touched" and I said "Amen it was a miracle; Marty had been touched by the power of chocolate." We all laughed, it's always, always good to laugh.

I'm not saying what happened was a huge big-ass deal miracle. It wasn't. I didn't see Bennie Hinn in his Nehru jacket popping people in the forehead anywhere. Really we didn’t need Bennie, we had Heath and frankly Heath is a lot more credible in my faith journey.

That Little Therapeutic Piano

Marty has been a musician for as long as I have known her. At one time or another she developed a reasonable level of proficiency playing the baritone, the French horn, the guitar, banjo and piano. She loved playing the piano, took lessons in her youth and became quite accomplished. She also enjoyed singing. Over the years she sang with several choirs and she particularly relished singing alto with her small group chorus, The Common Souls, from our church.

One of our first major furniture purchases was a piano, a dark cherry Wurlitzer up-right that still has a place of honor in our living room. I remember Marty’s Father helping us with the down payment and negotiating with the salesman. He got him to throw in the sales tax. Marty played the piano for hours on end and I would often sit with her and sing while she played. I can't really carry a tune in a bucket but I can sing loud. Loud can be good, right?

After Marty’s first stroke she didn’t play much, she found it very hard to concentrate on the music and her right hand was still weak from the left sided stroke. After she had the 2nd stroke, music seemed like something that would be lost forever.

There are places where you go after a stroke, after the hospital, called sub acute care units. These are kind of half way houses after you no longer need a hospital but still need skilled nursing and therapy. We went to St. Catherine’s. Physical, occupational and speech therapy become the daily regimen for any recovering stroke patient. It’s an incredibly important part of a very long recovery process.

Marty would go to therapy three times a day. She was weak, confused and had very little stamina, but she went and she tried and we learned. It was incredibly hard to watch as she struggled with the simplest things, as she often struggled just to keep her head up and stay awake and aware.

Therapists are a wonderful lot and they see and work with people that are completely broken and trying to heal. Theirs is a very difficult job trying to get people to move beyond their current circumstances and make daily progress. Sometimes, I think, I saw, after about two weeks and no significant progress everyone gets a bit discouraged and everyone is a bit inclined to lose a certain amount of hope. We got there; I saw that, I know the therapists got there.

Then one Saturday afternoon we found some hope. Our daughter Erin and our son Matt were so faithful and good to come see their Mom virtually every weekend and we needed help on the weekends. The days without therapy were incredibly long and both Marty and I needed the diversion.

That Saturday afternoon Erin took her Mom out of her room and to the central lounge. In the lounge were the requisite couches, overstuffed chairs, a large aquarium, a couple of tables and most importantly a very old upright piano someone had donated. Erin pushed her Mom in her wheelchair and sat her in front of the piano and opened up an old, generic hymnbook.

Marty’s left hand, left leg and parts of her left brain had been essentially rendered useless by this most recent stroke. But, somewhere in the recesses of that broken brain she recognized the notes on the page of the old hymnal, raised her good right arm, put her good right foot on the pedal and slowly, haltingly started to play. It was slow, broken with missed sharps and flats at first, but slowly, surely the music began to smooth out and the right notes and chords started to kind of lift out of that old piano.

I watched Marty and Erin sitting at that piano and started to let myself feel just a little bit of hope as Erin turned the page and Marty began another hymn. A couple of the nurses saw Marty playing and came over to see if it was really her playing and not her daughter. Each one touched her back and mouthed the words, “Amazing”, as Marty continued to process the notes from the page to the keys on the piano, as Marty started her own process of healing.

It was one of those moments I keep in my heart and my mind. When the therapists heard our story of the piano, we all attacked therapy with a renewed sense of effort and hope.

Marty's Latest Trip

What started as something relatively simple, and I say relatively because the hospital is never simple, became complicated Sunday night. We checked into the hospital, Sunday, for a fairly routine treatment of IV antibiotics. The bacteria in her bladder, causing a new urinary tract infection was not sensitive to our normal arsenal of medicine, we did this same thing about a 1 1/2 years ago with success.

That night, right as they were starting the IV, right after Marty had her usual night time meds, after I had gone home for the night, Marty had a major seizure. Marty's has had seizures, but the last was in April of 2007 and were directly related to an asthma medicine Marty was taking and quit taking back then. She has had no apparent seizure activity since then and taking her off the seizure meds really helped her overall recovery as these meds tend to have some debilitating cognitive effects on her.

Nikki was here with Marty when she had the seizure and immediately called the nurse and they immediately responded with their rapid response team and made sure Marty was not in danger. The staff, Nikkie, all did a great job. When I got there Marty was just starting to recover from the seizure, these electronic assaults on your brain require recovery time. As Marty began to regain her bearings she knew Nikki, she knew me and was oriented at least to place, she did complain about her arm burning. She kept saying, "My arm, my arm, my arm", and could not really move her arm. We figured the IV was burning, the medicine was burning, and the seizure was limiting her ability to move it. I left the hospital for a little sleep when it was clear Marty was stable and safe.

When I came back in Monday a.m. Marty had not slept well and was complaining about her arm. Keep in mind Marty does not complain, if she says it hurts, it hurts; and she said it hurt. I looked at the arm and the shoulder was starting to swell and I called the nurse, who called Great and Wise (who has been very great and wise throughout all of this), who ordered an x-ray.

This is the only complaint I have of the hospital stay. The x-ray was ordered at 10 a.m... It was finally done at 5:15 p.m... ; Much too long. They came up twice to get Marty in a wheel chair but she was in pain and medicated with both pain meds and Ativan to ward off any more seizures and was not wheel chair capable. We sent them back twice for a gurney and twice they never returned. Our nurse kept calling, I kept harping and began to get very frustrated as Marty's shoulder continued to swell and bruise. It was clear something was wrong.

Great and Wise came in right after the x-ray was finally done, in Marty's room. We talked about the UTI, blood test results and then he went to check on the shoulder x-ray. I knew when he came back the news wasn't good. I had thought the shoulder was separated, it was a compound fracture, the ball on the top part of the humerus, the large arm bone, had broken off Marty's arm. Apparently, during Marty's seizure she had broken her strong arm, the arm she uses to eat, to play the piano, to drink, to take her meds, to support herself in her wheelchair, to help us help her stand. I know the color must have drained from my face when I heard his words. It sure felt like it.

"What does this mean", I kind of stammered. "Surgery", G & W replied. I went pale again.

Marty and I have often talked about what we needed to do for her in the event new problems arose. She has been very clear, no surgery, she did not want the anesthesia, she did not want another tube in her throat, she did not want to face another recovery. All I saw was she could not move her arm without a lot of pain. It was devastating news and I was immediately taken back to five years ago and all of the false choices we had to face then, do you want it to suck big or bigger?

Marty seemed to get sicker Monday and Tuesday. Great and Wise had already requested another culture on the urine and sure enough we found another bug, not sensitive to the Azactam we were using, but another antibiotic we had used before, he called at 10 p.m. Tuesday night to add the new antibiotic. Wednesday, yesterday, Marty started getting better.

We have talked to an orthopedic surgeon several times over the last couple of days. He said Marty's bones are really older than her age because of the medications she has taken and just the general assault on her body; which explains why the bone broke under the tremendous pressure from the seizure. Her bone density, or lack thereof, really complicated any potential repair and in all likelihood the only surgical option would be to completely replace the shoulder. The other option, do nothing.

The short summary, (I know, I already went past short) we have decided, after talking with our kids, after talking with Marty, after visiting with friends, after visiting with doctors, the surgery is just not worth the risk. Marty is a very high risk surgical candidate and the potential gains from surgery are just not worth the risk; it's just too much to ask of her. We are going to let the arm heal. We are going to work really hard, after it has healed to get Marty back to the point she can fully participate in her care the same way she does today. It's an unknown, but we can handle it, until then Dilaudid is her friend.

As of this writing we are still in the hospital but we have made good strides in dealing with the infection that brought us to the hospital. Marty's white count is much improved as is her sodium, both very positive signs. She needs a little more antibiotic and we are awaiting the results from the EEG to discover next steps regarding seizures. I guess we are starting another new normal.

Good thoughts and prayers are always appreciated.

We're Back, Again

We're there, again. Providence Hospital, Waco, Texas, 5th floor this time. We came in the Presbyterian way, decently and in order. It turns out ol Larry wasn't just being his usual hyper vigilant self but obviously has been gifted with the power of super diagnosis; we have a urinary tract infection.

In point of fact it's not a really bad one; it's just one that we can't treat with oral antibiotics. We are once again fighting the same bacterial nemesis we did this past summer, only this time it's in the bladder not the lungs, but it's still pseudomonas aeruginosa. It's good we were able to identify the bug, identify it early and identify the appropriate antibiotic to kill it.

Great and Wise checked Marty's culture yesterday, yes on Saturday and called to give us the news. We decided to wait until today, Sunday, after church to come to the hospital. He called today to make sure there was a room at the inn, there was and here we are on the 5th floor, home of women's care and maternity. I like it up here, women are cleaner I think.

We came up and met the good Doctor and he checked us in and wrote all of the appropriate orders and we now are the owners of a brand new IV through which they will pour the bug fighting antibacterial and other goodies as needed. I told Great and Wise I needed to send Mrs. Great and Wise some flowers; she puts up with a lot. I'm sure she knows she is married to an amazing man but she needs to know how he makes people’s lives better.

Hopefully we can blow this joint by Wednesday, but that all depends on the bug. We can take comfort in knowing Nikki, Erica and Renae will be on the job and we have wonderful health care providers, providing health care. We shall see how it goes, so far, so smooth.

Stroke Facts

Marty's first stroke occurred in April of 2005. She had a ruptured aneurysm, a broken blood vessel in her brain which caused a subarachnoid hemorrhage also known in the medical world as really bad stuff. Marty was one of about 800,000 who had strokes that year, but only one of 3% that had a subarachnoid hemorrhage. Marty was lucky because most who have her type of stroke do not survive beyond six months. We're working on almost five years from the first stroke.

Her second stroke, January 3, 2006, was a more typical stroke, an ischemic stroke which comprises about 85% of all strokes. Again, Marty survived, though the 2nd stroke was the more physically and cognitively impairing of the two strokes. Stroke is the third leading killer in the United States killing approximately 140,000 people a year and the leading cause of incapacitation.

I never really thought about or understood the disabling aspect of strokes or how many people under 65 are affected by strokes. About 200,000 people under 65 are hit by strokes every year. It's not something we think of as a young person's disease, but it can be. Strokes change lives, not just for the person who has the stroke but for all of the families and friends of the stroke victim.

When Marty was training as a Speech Pathologist in Lubbock in the 70’s she worked with elderly stroke patients who had aphasia. We talked about it at the time and Marty often talked about how devastating this disease was for the patient and for the family. It never really registered with me. I never thought stroke would be a part of my life then.

I never really understood all of the underlying difficulties strokes cause. I never thought about the swallowing issues, I never thought about the talking issues, I never thought about the respiratory issues or the urinary tract infections. I never thought about the issues with dressing and bathing, I never thought about the transportation issues or the sleeping issues or any of the myriad difficulties people who have been affected by strokes must deal with every day. It just wasn't part of my plan so I didn't think about it. I'm just thankful I'm young enough, strong enough and we have the financial resources to care for Marty. She gets much better care than most.

The biggest risk factor for strokes -- high blood pressure, it's a big deal. Heart problems, diabetes, and genetics are all risk factors for stroke. Obesity, smoking, inactivity all contribute to strokes. Have your blood pressure checked, take your blood pressure medications, control your diabetes if you have it, don't smoke and exercise. I know all of these are easy to say and in some ways hard to do, but you don't want to have a stroke, you really, really don't.

Recovery from stroke is life long, it doesn’t end when you leave the rehabilitation facility, you are really just starting. Marty’s road to recovery has been long but I believe there are still miles ahead of us. She has continued to improve, her cognition, her ability to think and communicate is still getting better and I think will continue to get better. It will never be the same – our job now is simply to continue to adjust to our new normal. This is a never ending quest.

I Know -- TMI

More news from the colon front, or shoud we say colon back.  Bet you didn't think this would be something you would ever be reading.  Frankly, I didn't ever think I would be sharing colon news.

Actually, it's just a brief story.  I did have a colonoscopy.  If you are over 50, it's a rite of passage and you too should know the joys of the "prep". 

The only thing I can really remember is the doctor saying let's try a test dose of this versed.  The next thing I know daughter Erin and some really nice nurse are trying to get me to stay awake so I can go home.  I don't remember anything, which is great because this kind of experience is high on my list of things unremembered.  Also unremembered that day, how did I get dressed and get home.  Oh well, not to worry.

I got the results back yesterday and everything is just dandy.  I passed this tidbit on to my bride and grumbled slightly because they said I needed to come back in three years, not five.  My wonderful loving wife, who I have supported and cared for said, "Don't worry, you might not even be alive in three years."

Gee thanks darling  what a nice way to end a pleasant discourse on the health of the lower bowel.  But, she's right, I just hope she's not a prophet.