Rollercoasters

This summer my wife and I took our 10 and 13 year old daughters to Six Flags over Texas. I took along a healthy supply of Dramamine "just in case." I more than made use of the medicine in an attempt to overcome the drops, spins, loops that modern day thrill rides seem to supply in an abundance.

This last week with Dad has left me feeling in need of Dramamine again.

I'm happy to report that the most recent trip left me feeling more optimistic. Dad opened an eye and tried to communicate with my sister. We talked to him and he responded. Laughing where appropriate, a half-smile and several well timed grunts. Certainly promising.

On the flip-side, he only opened his left eye. The right side of his face is noticeably relaxed, and that side of his mouth is not responding. We know that there will always be some paralysis on that side of his body, just from the first stroke. We know that when he's tired, he has more trouble with that side of his body. But this is certainly pronounced, and reminiscent of February/March.

They have also put him back into restraints. For his own protection, but also a source of irritation for him, I'm sure. The idea of him removing his feeding tube is enough to encourage this response, but it's the fear of him reaching for the drain that solidifies the need to protect him from himself.

They believe that he's still bleeding. I think it ties back to the color of the fluid leaving his head. It's closer to red now that it was initially. They called in a "blood doc" to consult, and have postulated that it may have to do with one of his medications. Apparently, he was on an anti-seizure medication that may have interfered with his platelets. What little I remember from biology reminds me that they are key to clotting. So, they've stopped that medication and reviewed all the others for anything that might be contributing to the problem.

As to the future, it's all still up in the air. We need the bleeding to stop. We need the pressure inside his head to stabilize. We need him to adjust to that new pressure. Then we begin the rehabilitation phase again. Precisely what and how much he will need can't be assessed until he is stabilized. If things go well, they expect him to remain in the ICU for another 7-9 days.

Guess I better refill that Dramamine.

An Ill Wind

In the last 24 hours things have taken a noticeable change for the worse.

It's difficult to pinpoint precisely when this happened or what triggered it. Over the weekend, he was confused and certainly slept most of the time. But he was communicative and responsive. Sometime Sunday he became more confused and resistant to the treatment he was receiving in the ICU. He was given medications to help him relax. And he did.

We weren't concerned, honestly we were glad to see him get some rest. This rest continued through Monday, and again, nobody was overly concerned. At least, not until Monday night.

I received a call from Mom this morning, explaining the activities of the previous evening. When the RN came online for the night shift, he was troubled that Dad wouldn't respond to my brother and sister. They were visiting, and he wouldn't open his eyes. He contacted one of the various doctors that are involved in Dad's care, and a scan was ordered.

The scan was shipped off to Australia for review (some sort of night scanning service) and they flagged it for alert. I don't know precisely what they saw, but it led them to the conclusion that the pressure was too high inside his skull.

Several other steps fell into place here, involving more scans, and more consultations with doctors. It was at this point that they surgically installed a complicated system of tubes and bags to release some of the fluid that was building up, increasing the pressure inside his head. I'm told that he was noticeably improved the second that the system was put into place.

All of this is second-hand really. By the time I saw him today, the tube was in place, and he was calm and sleeping. He wouldn't or couldn't open his eyes or talk, but I did manage to hold hands with him briefly. He's largely unresponsive to stimulation, but does occasionally make some sort of movement in an apparent attempt to become more comfortable.

I don't know what to say, except that I feel a little bit like I've been blind-sided by this. While nobody expected the second (or first) stroke, he was still himself most of Friday. Even Saturday and Sunday I was confident that he'd be home soon, and would be able to resume therapy where he left off. The hospital staff seem confident, if not pleased with themselves, that they caught this recent situation and acted accordingly. I'm sure they have, it's just a little bit shocking to see him deteriorate so quickly in the last 24-36 hours.