Reality Check

Walter's progress encourages us, and I try to emphasize that in this blog. We continue to pray and hope for a miraculous (by which, in our minds, we often tend to mean "fast" and "complete") healing. Circumstances, though, remind us that we are now in a new reality, one in which we must seek the miraculous in the otherwise seemingly incremental and mundane.

A doctor in the northeast, experienced in neurological issues associated with strokes, follows this blog and very graciously offers her insights from time to time. I share portions of her most recent email here to give you a sense of what this reality may look like in part:

"About the speech:

"It will be frustrating at times to get the words out. Depending on the bleed and size the speech center is most likely involved [note – Walter's doctors tell us that this is not the case with him]. . . . The brain is a funny thing. People can have strokes in their language center which may not affect their 'singing' or 'cursing' center. I will have some of my stroke patients with aphasias sing out what they want. Sounds silly but sometimes it works. You will also notice that when Walt gets extremely frustrated or upset that you will understand all of the profanity that comes out of his mouth crystal-clear.

"He is going to be confused for a while. Electrolyte (ie. sodium) abnormalities and blood in the head can make you lethargic and may take longer than you like to recover. Because of his stroke, I would like to inform you all that in the future that he most likely will take longer to bounce back from even simple things like a cold, flu or an urinary tract infection. His brain is not 100% from here on out. I also have some patients that recover well from their strokes and when they get a cold, flu or UTI their old stroke 'talks' because the cells that were involved with the previous stroke are vulnerable to simple electrolyte changes or infections. It may look like he had another stroke or worsening of his stroke symptoms, but it could be that the brain cells are irritated and once they calm down so will his symptoms.

"He is not used to being down. I know that he is aware of the long road ahead, but you will have to remind him again and again of it and what progress that he has made. There is a high incidence of depression in stroke patients. If he needs chemical help through that, remind him that it is normal.

"Sleep is a restorative process for the body. If he is sleeping a lot, let him. I have to remind my families of this. They are at times too concerned that they are sleeping too much. They want to make sure that they are not too lethargic or getting worse. I have had some families continue to wake up the patient to make sure that they were not rebleeding. ICUs are noisy and sometimes it is not until they get to the regular hospital room where it can be more quiet for quality sleep that they start perking up.

"Reinforce over and over again that blood pressure management is key for the next several years. Emphasize that you do not want to revisit this nightmare again in the future.

"I am glad that he is doing better. Remember a young brain is better than an old brain."

We will learn Walter's specific issues as we go, but these observations give us some idea of what we may expect.

The report from the last couple of days is that Walter seems to be sleeping much better since removal of the NG tube. The doctors continue to monitor the ventricular pressure with the EVD closed off; so far, so good. The various therapies continue and will get more rigourous. Again, the doctors and nurses remind us not to expect dramatic improvement while he is in the hospital. The noticeable improvements should come once he gets into rehab.

Jessica's mother Brenda is here this weekend, allowing some of the others some down time. Jessica is still pretty much at the hospital when she's not working, with some small breaks here and there. Good friends provide food. A day at a time . . . .