by Constance Daley
American Reporter Correspondent
St. Simons Island, Ga.
November 6, 2007
ST. SIMONS ISLAND, Ga. -- After the first bright and obligatory "Hi, How are you?" and expecting an equally bright "fine," it came as a shock to hear, "My husband had a stroke."
Oh, my. This is my best friend telling me about her husband of 40 years and as strong as my shock is at the words, it pales compared to what she was going through.
There was no warning. One might expect a bang and just doesn't notice the whimper. He was watching television and she said, "C'mon, let's go to bed," offering a hand to stir him awake. He cooperated by half raising himself as she lifted and then he fell right to the floor.
They had a houseguest that weekend, and after determining that he had not broken an ankle, leg or hip, they got him into bed and he slept peacefully all night.
The next morning, his speech was the first sign: He couldn't say her name. "Do you know who I am?" she asked, the fright rising in her voice. There was no response, but thankfully, she saw a look of recognition. He was able to use the bathroom with help getting there, and he could reach for a spoon with his left hand and pass it to his right to feed himself.
The doctor said to take him to the emergency room. I met her there during the hours the ER doctors were evaluating the situation, CAT (computed axial topography) scans, blood tests, X-rays, and all the necessary exams to determine the severity of the situation. He was admitted.
He did not like it. He refused bedpans, and wouldn't eat unless his wife, whose name he could not recall, fed him. His speech was confused. The second day there, his right side was worse. He could not hold a spoon or direct the use of his hand. Although he pointed to the bathroom and knew when he had to use it, the medical personal put him in diapers. He could say "No!" and knew exactly when to say it.
He was trying very hard, you could tell that. Further CAT scans and an MRI (magnetic resonance imaging) were done and the neurologists determined the stroke had not ended, as originally thought, but was ongoing at the time he was admitted. Therapists said there would be a long rehabilitation period; his determination during the daily exercise program sessions would be one of the deciding factors as to how long it would be.
It became necessary for him to be moved to Savannah, Ga., 72 miles away, for a rehabilitation program available 24hours a day, seven days a week.
I've learned a lot just watching how my friend ministers to her husband's needs - even if it's against hospital routine. Policy is one thing; some routines that are not in the best interest of her husband, frustrating him all the more, are not acceptable.
"Why are these blinds closed? He is used to daylight in a bright house," she says, opening the blinds forcefully. "He can't tell if it's night or day when he wakes up." She wonders why they are feeding him gruel when he is capable of having some taste or texture in his diet.
"Yesterday," she told me, "he put two words together." They brought him some food and he said, "Absolutely no!" So, my friend went out into the streets of Savannah to find a store selling cans of Vienna sausages, those small, baby-tender hot dogs that have flavor, if not much texture. She helped him to eat four of those and he was satisfied - as was she.
Luckily, they both turned 65 recently, so Medicare is available. At his job, he has extended-stay coverage that will continue with a partial salary for three months. Their future, so well-planned, is now on hold.
The reports on stroke I read were in a language I don't understand, at least until I came across one that treated stroke rehabilitation with a clever literary device called the McDonald's Analogy.
First, I read that stroke rehabilitation has two phases: first, to "maximize the number of neurons that can be recruited to take over the function of dead neurons." The second phase is "aimed at training these recruited neurons to do the job more efficiently."
Recovery is never 100 percent because the recruited neurons still have to do their old jobs too. Only after reading a">http://www.disaboom.com/Health/Stroke.aspx">a report by Vu Nguyen, M.D., did I finally see what was happening.*
Using the McDonald's Analogy (and economists have been using it for years), Dr. Nguyen suggests we just picture being the best Big Mac maker in McDonald's, the boss loves you and when he had to fire the cashier, he decided his best employee should handle the register 'way up in the front of the store.
Well, the best Big Mac maker was hard-pressed to handle both jobs with top efficiency but he never complained - he just did his best. With enough practice in a comfortable and supportive environment, he could master getting from the front of the store for the register that he had to learn to operate and still turn out the best Big Macs in the back of the store.
But, it took time. He knew he'd never be as good a cashier as someone hired for just that job, or the guy doing only Big Macs, but "this is because I am still responsible for both jobs and have a geographical problem with both jobs being in different locations."
Everybody has two jobs now: I will double up my efforts as their friend, she will double up her efforts as a wife, and he will double up his determination to find his way back. Of course, all this goes without saying.