Birthday Party

Enjoying dinner!

Last night we went to a Chinese buffet in Rockingham for a birthday dinner. Boo thoroughly enjoyed himself. He had hot and sour soup, two kinds of shrimp, steamed crab, spare ribs, lots of stir fried vegetables, part of my piece of chocolate cake and a fortune cookie. He slept on the way home and then went to bed early---about 8:30pm. He woke only to take medication and eat a snack. This morning he informed me that he likes eating out, but it’s too tiring. Oh well…


This morning after Mary brought Boo Communion, we found a Latin Mass on TV. Boo remembered the responses and what they meant. He has talked nonstop about praying the Mass in Latin growing up. I wish I’d had the foresight to record it for him. Maybe we can do that next time.

Boo seems to be adjusting well to the changes in his medications. He is far less unsteady and dizzy. However, his stamina is poor. We are working to improve that---slowly and steadily. Most days he tolerates three twelve-minute standing exercise periods and at least one walk outside. His walk varies from 1.5 blocks to 2.5 blocks depending on weather, his steadiness and his BP.

One of the things we will begin to change this week is the timing of his walks. Because he doesn’t tolerate the heat in the summer, we walk in the early morning and late evening. Boo has been less open to changing his exercise routine and his schedule recently. So, I have begun to discuss the upcoming week with him and remind him of things that are going to be different for him. Those changes that are inevitable, I try to make SLOWLY and with as much explanation as possible.

Doctor's Visit

He SAYS he's watching westerns!

I think he's sleeping.

Boo has had a very busy day.  First thing this morning, he had a physical therapy session.  Then, we got dressed to go to the doctor, had lunch and went to the doctor's office.  We're back home now and Boo is exhausted---not that he will admit that. He is watching westerns with his eyes closed and snoring.

Boo's primary care physician has altered the ammounts of two of his medications.  Hopefully that will help decrease his vertigo episodes.  If not, we'll try somethihng else.  At the doctor's office, Boo's left foot was fine.  PT had not yet faxed his doctor their evaluation.  So, we'll have to wait on that.

Lazy Day---for one of us!

23 February 2011

Boo has managed to sleep until 11:00 this morning. He woke to take his 7:00am medication and eat a light breakfast. Then he decided to go back to bed while I caught up on a few chores. I neglected to set an alarm to remind myself to awaken him. Here it is 11:00 and I am definitely having trouble convincing him to GET UP. He wants to sleep a little longer. When lunch is almost ready, he must tear himself out of bed. He’s due a second round of meds at noon and needs to eat before taking them.


Yesterday Boo began rolling his left foot towards the inside when he stands or walks. His left side is the most affected by his last two strokes. Until now, his left-sided weakness only manifested itself when he was tired or sick. At those times he is prone to drag his left foot when walking, have difficulty lifting his left foot to dress himself and, once in a while, bumps into things---as though he is less aware of his left side. Neither his physical therapy assistant nor I can determine what is causing this new issue. All the usual culprits---elevated or abnormally low BP or glucose levels, overexertion, illness---don’t seem to apply. Tomorrow Boo has an appointment with his primary care doctor. I guess she’ll evaluate this then. His physical therapist will visit either tomorrow or Friday to see what she thinks can be done to correct his foot turning.

Boo, Grumpy and Grumpy's long suffering wife

We had a wonderful visit from some friends that have known Boo for years and years.  It's always a joy to spend time with Grumpy and his wife.  Boo was rather quiet and seemed to need to search for words when he did talk.  Now that they've gone home, he can think of things to say.  Oh well...

Reevaluation and Improvement

Boo walking with physical therapist

Yesterday was assessment and evaluation day for Boo with Home Health. He was discharged from occupational therapy. Even with his recent vertigo problems, he met his goals for self-care. Besides his usual morning and evening routines which include dressing, bathing or washing off and mouth care, he is helping with some meal preparation and housecleaning. OT had not set any goals for Boo beyond dressing and basic hygiene because neither they nor his doctors thought he’d be capable of anything else. Yesterday he demonstrated to his occupational therapist his sandwich and snack making skills. He also showed her how he sweeps the house (with a carpet sweeper) and cleans the bathroom sinks and mirrors.


Boo has not yet met his physical therapy goals---although he has made a lot of progress since his last hospitalization. PT will continue to work with him to improve his balance and stamina. Intermittent vertigo has been a real issue. On the positive side, Boo has not lost muscle tone even though he hasn’t been able to walk or do his standing exercises as much as we’d hoped. His persistence in doing his seated and lying exercises twice a day when he couldn’t walk definitely made a difference.

Yesterday Boo had few vertigo episodes. He walked a total of five blocks all day (total from three separate walks.) Last night he was tired and went to bed early, but he’s fine today.

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Ok, maybe he’s not quite fine. Boo walked two blocks this morning, ate lunch and took a nap. He’s a little confused now---not remembering that my mother is at the beach, not remembering that his father died. He is alert and remembers the day to day things that most concern him---where the coffee carafe is, where his snacks are, how to find westerns on TV.

Necessary Medical Information

Alright Patty, this is for you. Here is all the basic information you need when you call an ambulance, go to the ER or a new doctor. When you’re dealing with a sick child (or spouse) and you’re upset too, it is so much easier to have all the important information right in front of you. I use a Home Health notebook for day to day information, a Medical Information notebook for emergency and new medical providers and several flash drives with medical information (easier to stash in a purse than a notebook.)




Home Health Notebook

Daily Log sheets

Current Medication List

Medical Provider Phone List

Calendar pages to record appointments



Boo’s Home Health Notebook is my brain. All the information I need when talking to Boo’s doctors or his home health nurse is at hand. On his Daily Log sheets, I record his BP and glucose readings, the exact times he takes his medications, physical and occupational therapy exercises completed and anything else I think needs to be recorded. The absolute minimum that must be recorded daily for Boo is 3 BP readings, 1 glucose reading, the exact times medication is given and exercises completed. I also record any behavior that is abnormal for him. From time to time, I have recorded his intake and output---if he is confused for more than a day, runs a fever, etc. If he has nausea or diarrhea, I’ll take several glucose readings during the day to ensure that his blood sugar remains as constant as possible.

Medical Information Notebook



Medical History

Current Medication List

Medication Changes within the last 6 months

Medical Provider List with complete contact information

Family Medical History

Medical Power of Attorney form, notarized copy

Living Will or Right to Life form, notarized copy

Copy of insurance cards, front and back

Copies of medical tests for last 6 months

Medical Information Flash Drive

Same information that is in the notebook

At the hospital or a new doctor’s office, all the basic information that is generally needed is right in the notebook or flash drive. Of course, copies of medical tests need to be obtained from the original source. The copies in the notebook provide immediate information---that has been very useful for Boo when it took longer than expected to get records during a past hospitalization. About the NC Medical Power of Attorney, Living Will and Right to Life forms: (1) They must be notarized. (2) There is a website for filing these forms with the state. Filing them is not required, but would provide medical providers immediate access.


I also have all the information in his Medical Info notebook saved on a flash drive as jpeg or Word documents that I keep in my purse. If we are away from home and Boo needs medical care, most hospitals can download information from your flash drive.



Emergency Backpack


Medical Information Notebook

Complete change of clothes for Boo

Comb, toothpaste, toothbrush, denture cleanser and adhesive

Rosary

CD/Walkman (not sure what it’s called)

Batteries

2 or 3 CDs

Spare phone charger

Extra pair of socks for me

Sunflower seeds

A few dollars (Our local hospital doesn’t accept ATM cards.)

1 Junk food book (You know one of those books you can pick up and read with no concentration required.)



I keep Boo’s Medical Information Notebook in his ER backpack so that I always know exactly where it is. We store his backpack in the sunroom closet, filled and ready. I do try to remember Boo’s Home Health Notebook on the way out the door because that gives his daily information.



A word to the wise about calling 911:


Be sure to have not only your physical address written down, but also the closest intersection. It’s amazing what you can’t remember when you’re upset! I’d post an emergency info card by each phone so you’re always prepared.

I’ll try to post forms and links as soon as I can.  Hope this helps!

Vertigo

15 February 2011




We just came home from our second visit to Boo’s family doctor in two weeks and he’ll see her again next week. Vertigo is no fun---and I’ve never had it. Boo is definitely less stable now than he was two weeks ago. I appreciate his doctor’s attentiveness and the time she takes electing information from him. It’s possible that the combination of his nightly stuffy nose, brain damage from his three strokes and his medications are all contributing to his intermittent vertigo. She has prescribed a mild nasal spray to help alleviate one possible problem. We’ll see…

This past week has been very difficult. Boo absolutely doesn’t like feeling like he is going backwards, but this dizziness has shaken him. He is so unstable first thing in the morning and just before bed, that he needs both a gait belt and a walker. There have been several days when Boo was unable to do his standing exercises because of his balance. He still does his seated exercises. With his physical therapist, Boo has worked out a series of exercises he can do in bed. Thank you Jamie! He is so much more content when he is able to exercise. It also helps strengthen muscles that he isn’t using as much right now.

Boudreaux to the Rescue!!!

11 February 2011




Once again Boudreaux saved the day! This morning, while I was changing our bed linens and Boo was watching the news in the den, Boudreaux started howling. I ran to the den to find Boo trying to walk without assistance (no cane, no walker). Boudreaux was standing in front of him howling at the top of his lungs. With Boo’s intermittent vertigo and general instability, he MUST use a cane or walker. I’d rather he let me know when he’s getting up---and he usually does. Who knows what he was thinking this time? Thank goodness for Boudreaux!

Inner Ear Problems

10 February 2011






This has been a difficult week. Beginning late Friday night, Boo has had major issues with balance. Saturday and Sunday were the worst days he’s had so far---walking just a few feet in the house required a gait belt and a walker. He complained of being dizzy and “weak in the knees.” After talking to the on-call nurse for his home health and determining that his BP, temperature and blood sugar were normal, we decided to wait until Monday morning to visit his family doctor.

His family doctor ran a few tests and spent an hour, on and off, with Boo. She took the time to ask him questions, wait for his response and then ask for clarification. I was properly impressed. Questioning Boo like that and allowing time for him to recoup between questions, she elicited more information from him than I had. She determined that he probably had benign vertigo.

Boo is better than he was over the weekend. Balance is still a problem, but he is using his cane instead of the walker inside while he is awake. When he gets up after going to bed, he needs his walker. His wonderful physical therapy aid and occupational therapist have really worked with balance and safety this week. Boo seems to respond well to them. When they suggest---strongly---that he use a walker at night and first thing in the morning, he willing does so.

Until his balance is resolved, Boo requires more vigilant care and more help than usual. I need to stay very close so that I lend a hand every time he stands or walks. Boo does ask for help when he realizes that he needs it. He just doesn’t always realize he needs help quickly enough for me to respond unless I'm close by. I guess ALMOST falling a few times has made him more cautious.


On a very positive note, Boo’s A1C level is 5.8. Last August it was 6.1. In December of 2007, after his first stroke, his A1C was 8.1. Following an appropriate diet, taking his medication as prescribed and exercising has made a difference. Yeah Boo!

Cold, Wet and Rainy

4 February 2011




All this lovely, needed rain is definitely putting a damper on Boo’s outdoor walks. Were wet, slippery surfaces not a major safety risk, we’d bundle up and walk anyway. We did attempt to walk on our large, covered front porch earlier. While the porch floor is wet, there is good traction. Unfortunately, Boo kept trying to maneuver off the porch. When that man is determined to take a walk, he is DETERMINED!!! He has repeatedly told me this morning, “I’m got to keep getting better. I’m going to take a walk for endurance.” I admire his determination and his attitude. Just now I wish he could grasp the wisdom of waiting. Even in dry weather, Boo’s balance is precarious on uneven surfaces. With rain added to the equation, I’m not willing to risk it.

Boo will repeat his physical therapy exercises later today to attempt to make up for missing his morning walk. Right now, he’s sweeping the floors with a carpet sweeper---and he is happy. I had started vacuuming and Boo tried to take over. The vacuum is unwieldy and he couldn’t manage it, which was very frustrating for him---just one more thing he can’t do. However, the carpet sweeper is lightweight and perfect for him. He can even use his cane and still maneuver it. Why didn’t I think of this before now? It provides a way for Boo to be genuinely helpful and eliminates one of my chores. Now I must remember to keep the sweeper charged…

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Boy, oh boy, am I in trouble---and this time I’m innocent! It’s been raining all day. Both Boo and Boudreaux are upset with me. One keeps hopefully presenting good reasons to take a walk. The other looks out the window, looks at me and fusses. According the news, we’ve gotten 2 inches of rain today. That’s two inches that we really need. So, my two fussy young men are just going to have to deal with it.

Progress!!!

Boo has made major progress with stamina and far more quickly than any of us had anticipated. Yesterday, after walking no more than three quarters of a block daily since his last hospitalization, Boo walked a total of four and a half blocks! He wanted to go with me to check on my sister’s pets, two and a quarter blocks each way. I thought it was probably too much too soon, but arranged with a cousin to be ready to pick us up when he’d gone as far as he could. One of the things I’ve learned is to allow Boo to try as much as he wants---with appropriate safeguards. If he doesn’t succeed, he has at least tried and we can usually figure out how to better enable him to reach his goals. I am SO proud of him.


Boo’s occupational therapist updated his upper body exercises today. In about a week he’ll have them memorized and will do them himself. He does his seated physical therapy exercises daily without reminders. Boo is determined to all that he can on his own and has an awesome attitude. I did make 5x7 cards with his new exercises on them---though their main purpose is to remind him to remind me to work with him until he memorizes them. His vision usually prohibits him from reading anything.

After all Boo’s walking yesterday, I was prepared for a rough night. Usually he is confused at night when he’s over worked himself and I was ready. We had an extremely calm, quiet evening following our night time routine and I had medication ready for anxiety (which he didn’t need.) We need days like today to bolster our spirits sometimes.