In our last blog I talked about us driving back to Washington so we could work on our house. My buddy, Tim, got the necessary parts and made up a 50 amp hookup for us. When we are plugged in, we are also able to get water but unfortunately, no sewer hookup on that side of the house. But we wanted to be at the house instead of staying at 1000 Trails in Birch Bay, about a 45 minute drive one way.
We moved the coach over on Saturday, finally got it leveled and set up. Our friend, Richard, happened to be driving by and stopped to visit. He was driving his pickup truck and also agreed to make a dump run, I have been removing stuff from the house. We had a very good visit then went to Lorraine’s sister’s house for dinner with her and her husband.
Once again we had a good visit with John, Thelma and their son Carl. We headed out about the time it was getting dusk and sure enough, we saw a number of deer either alongside or crossing the road. Maybe they are used to cars because we didn’t have any close encounters, that’s a good thing.
Sunday morning I woke up earlier than usual and after my shower and taking Misty out for her walk, I decided to go into the house and start working on my to-do project list. I managed to get a couple of items marked off the list and was heading to the shop to get a large garbage can to put some flooring material in when I saw Lorraine coming out of the coach. She had recently got up and said she had a good nights sleep. I talked with her for a minute or so then walked on to the shop and got the garbage can.
When I came around the corner about two minutes later, I saw Lorraine standing in the driveway, moving her right foot but not going anywhere. As I got closer I could see she was having some sort of issue. I ran over to her to see what was happening and noticed she was showing signs of a stroke, her left side wasn’t cooperating, it seemed.
Background here, Lorraine has had two previous strokes and during her recovery process from the second one, the doctors found and repaired two brain aneurysm. When we saw the surgeon the last time, he said he didn’t think she would ever have another stroke caused by the two aneurysm as they were now plugged. So based on that information, I was extremely surprised to see her in full stroke symptoms. But the aneurysms were on the left side of her brain which controls the right side of her body and these symptoms were on the left side, indicating to me that the problem was on the right side of her brain.
I got to where she was standing and grabbed her just as she was falling, her left side was failing her. I was able to get her to the car, about 20’ away and into the passenger seat. I closed up and locked the house and motorhome then headed out to the hospital in Bellingham.
Bellingham has a very good hospital, especially well known for their heart department. But it isn’t one of the 60 plus stroke certified care facilities in the nation. We got to the hospital and they almost met us at the door to get her into the emergency room. I first noticed the stroke symptoms about 9:03 and we were at the hospital about 9:45.
They got her set up for a CT scan and called in the on-call neurologist. By the time I was allowed back in her room, she was hooked up to IVs and monitors and ready for the CT scan.
More background here. Strokes can be caused by either uncontrolled bleeding into the brain or by blood clots in the arteries to the brain. Both of Lorraine’s previous strokes are believed to have been caused from blood clots and she is on blood thinning medicine to help prevent blood from clotting as easily.
The CT scan showed that Lorraine had indeed had another stroke, this time on the right side of her brain, caused by a blood clot. There is a medicine they can give stroke patients who have had a blood clot caused stroke if they can administer it within 3 hours of onset of symptoms. We were well within that window but I’m not a fan of this medicine, called TPA. It is a powerful blood thinner and although it can help, when it has side effects they can be devastating. We know of at least three people who were given the TPA and it made the stroke MUCH worse. I have not allowed them to give Lorraine this medicine for her prior strokes and both times the doctors said it was a good decision, looking back at it anyway. I did, however, ask her neurologist in San Jose about it and he said he is a big believer in it and would recommend its use if the symptoms were severe. I never expected I would be considering this medicine but just wanted his input just in case.
Lorraine’s symptoms were pretty bad, she couldn’t move her left arm or leg, her face was drooping on the left side, when she stuck her tongue out, it drooped to the left and she could only smile on the right side of her face. She was pretty unresponsive to orders from the doctors and when she tried to talk it was very slow, quiet and slurred. I talked to the doctors about the TPA, of course they wanted to administer it but I told them I had to be convinced first. We talked about her recent aneurysm repairs and the doctor decided to call the specialist in Seattle to get their opinion.
The neurologist in Seattle recommended against TPA therapy because of the recent aneurysm repairs just about the time I agreed to let them give it to Lorraine so that option didn’t happen. They also reviewed her CT results with the Bellingham neurologist. There is one more option they have to remove the blood clot and that is to go inside the vein in her leg with a camera and coil-spring looking deally thingy (a proper medical term for a layman). They get to the blood clot, insert the spring thingy into the clot and mechanically remove the clot, allowing blood to flow normally through the arteries.
The problem with this procedure is it had to be done within 6 hours of the symptom onset. Also the clot has to be accessible from the inside and in a big enough artery for them to get their “tools” through. The hospital in Bellingham doesn’t have a doctor trained in interventional vascular surgery so the local doctor called and talked to the one in Seattle. They agreed that there wasn’t a good chance to gain access to the clot for removal so that option was taken off the table too. I asked the doctor in Bellingham if the doctor in Seattle had seen the actual images or just taken his word about the blood clot and he said it had been just verbally so far but he would send the images to Seattle for their eyes on review.
About 20 minutes late the doctor came back to Lorraine’s emergency room and said after reviewing the images, the doctor in Seattle said he thought he could get to and remove the clot. By now it was close to 4 hours so things started moving rapidly, they needed to get her out of the emergency room, into an ambulance and over to the helicopter. The trip down was about 45 minutes, giving them plenty of time to prep her for the procedure. Unfortunately I couldn’t ride down in the helicopter plus I needed to go back to our coach to get some clothes for our stay in Seattle.
I hung around just long enough to see the copter lift off then headed to our place. I called my good friend Tim to see if he could/would go by and get Misty and keep her until we got back to town. Our friend Richard also called and said he would meet me at the house where he hoped to talk me into letting him drive me down but that would have left me without a car. He even said he could call his wife, Sandy, to see if she would be able to drive down and pick him up after he drove my car down. I refused to allow him to go to that much trouble but he was still trying to talk me into that when I got into the car, ha. Thanks to both of you two for jumping in to help, much appreciated for sure.
I started driving and it wasn’t long before I got a call from the hospital in Seattle that Lorraine had safely arrived and they were sending her out for a new CT scan. The doctor had a few questions about her care so far and needed to get more info and would call me back soon. About 30 minutes later he called and said the new CT scan showed more brain damage than the one from Bellingham and they would not be doing the procedure to pull out the clot, shoot.
They said they would keep her in the emergency room until I got there then we would talk about further care. The doctor said she would be kept there for at least a couple more days. I asked about sending her back to Bellingham, in fact, I asked about her riding with me. I must say, he did a fairly good job of hiding his laughter when he said “NO”.
I got here to Harborview just after 4 pm, the traffic was horrible. I found a place to park and headed for the entry. The security guy wouldn’t let me enter there, said I had to walk all the way around the hospital and enter through the emergency room door. Well, OK then.
I got to emergency room entry and had to go through a metal detector screening, which I failed. The buzzer was going off as I walked through the gate and I was prepared to go around and do it again but the security guard asked if I had any knives or guns and when I said no, he let me go through. Surprised me, guess I don’t fit the profile of a terrorist.
I checked in at the desk and they escorted me back to Lorraine’s bed. She was happy to see me, the nurse said she had been asked for me the whole time. I did a quick check of what I could see and it appeared that Lorraine’s condition had worsen since I last saw her, three hours ago.
I couldn’t get a doctor to come over and talk with me but I told the nurse about my observations and she said she would let the doctors know. I sat with Lorraine for about 4 hours before they could get her a room in the acute care area of the hospital.
Lorraine was having a tough time communicating with them but I could understand her better so I acted as her representative. She had pain in her right shoulder/neck and a bad headache on the right side of her head where the stroke had happened. I told the nurse about this and asked what pain medications she had been given. She said no one had given her any pain meds. That’s when I asked (demanded) to see a doctor.
It didn’t take too long before a doctor came by, listened to me and left to order some pain meds for Lorraine. That has been my only complaint about this hospital so far but I know they couldn’t understand Lorraine when she tried to tell them.
The emergency room was a busy/noisy place and I was glad when they finally moved her to her regular, shared room. We got her settled and I had a talk with the night nurses, three very nice nurses who took excellent care of Lorraine all night long. They even found me a recliner chair that folds down into a semi-bed, not very comfortable but at least I was at Lorraine’s side all night. I must say that I had almost forgotten that you don’t get much uninterrupted sleep in a hospital, they were in/out at least once an hour.
So far, I could tell this stroke episode was very different from her two previous ones. Previous symptoms were she couldn’t find her parts of her body, they would say touch your forehead and she would touch her nose or elbow. She have speech problems but it seemed to be hard to come up with the correct words she wanted but her physical issues cleared up within a day or two.
This time her speech difficulty seems to be more a function that she just couldn’t form the words with her mouth/tongue/lips, not that she doesn’t know the word she wants. This time the physical problems are bigger and more severe although she has been moving her left arm and leg just a bit this afternoon.
The speech therapist came by this afternoon and ran a couple of tests. They have not allowed Lorraine to have anything to drink or eat because they are worried about her ability to swallow. Lots of times stroke patients have problems swallowing and the liquid/food gets into their lungs. This can cause pneumonia and become a lift threating problem. Lorraine does have difficulty swallowing so they still won’t let her eat or drink anything. They said a doctor would come by later and talk to us about the next step, I assume a feeding tube.
The occupational therapist came by too. She worked with Lorraine for awhile and found that some of her joints on the left side are already becoming hard to move/stiff. Also, her left foot is drooping. My job is to help Lorraine exercise these her arm and leg periodically throughout the day. She also gave Lorraine a boot to keep her foot in a more upright/natural position. She is to wear the boot for two hours, off for two hours throughout the day. And this is only after two days, wow. She also was able to get Lorraine to sit up on the side of her bed, the first time she hasn’t been laying flat for two days. Lorraine said it felt good to sit up.
They are, naturally, running lots of test on Lorraine, CT scans, x-rays, an upcoming MRI, blood test, neurological test and such. So far, they can’t tell me why Lorraine had a blood clot caused stroke when she on Plavix/Aspirin therapy since her last stroke in March. These two are supposed to thin her blood so she doesn’t form clots as easily but yet here we are. Tough trying to make sense of this one for sure.
Lorraine seems to be taking this one in stride pretty well, she knows what’s happened, where she is and what her symptoms are. She is sleeping quite a bit but that’s a good thing, her body needs to repair itself and sleep is a good help in that.
The neurologist in Bellingham told me that Lorraine’s symptoms were not uncommon, in fact, he said sometimes patients don’t recognize their effected side, they call it “called neglected side syndrome. He suggested that Lorraine may be in that category. He told me of a guy who would only shave the left side of his face, he didn’t recognize the right side as belonging to him. He said sometimes they won’t even turn to the effected side, for example, when asked to turn to their left, they would turn to their right 270 degrees vs turning to the left only 90. Sure hope that isn’t something Lorraine has trouble with as I almost always walk on her left side. We have seen that Lorraine doesn’t want to look to her left as readily as to the right.
Not sure of how long she will be here but the doctors don’t want to transfer care to Bellingham until she can swallow on her own and her blood pressure and other signs are normal. Then she will probably be in a rehab center for some time period, who knows how long. I’ve told them I want her back in Bellingham for that, whenever it happens and they said they know of good centers there too.
I’m thinking we are in for a long haul on this recovery and once we get our house sold, we will make the decision to stay in the Bellingham area or head back to the good doctors she had in the Bay area. But that’s down the road, right now its almost one hour/thing at a time.
Lorraine is out for an x-ray right now so I will check this over and try to get it posted.
Well that didn’t happen, she got back before I finished. We’ve had the nurses do a change over, night shift is back. Two of the neurologist stopped by and we talked about probable causes for her stroke and they are still working on that. But I did get them to increase her pain meds so hopefully that will help.
The day shift nurse just left, he gave Lorraine a feeding tube so she can get some nutrition, she hasn’t had anything for two whole days. The tube will stay in place until she is able to swallow and they are hoping that will only be two days but no promises.
Once again I find myself asking for your good thoughts and especially prayers for Lorraine. She certainly has gone through a lot in the past few months and it appears this episode could last for awhile too. Here’s hoping she gets back to 100% and as soon as possible!
Thanks Chuck
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