The day of the transfer was a difficult one. I was excited to be moving on. It was a sign of progress. The morning was spent getting ready- Paperwork, getting cleaned up, gathering possessions, waiting and more waiting. One strange event was that the nurse would normally give me one syringe of something (soapy water?) to encourage a bowel movement. Today he chose to give me three. I could not ask why because I couldn’t speak.The ambulance was late, which as the norm instead of the exception. Of course I had a bowel movement just before they arrived, and the nurse had to hurriedly change my diaper. That was a sign of a long day coming. I was eventually loaded on the ambulance, and a Keystone cop-like journey to Hospital B followed. Of course, I had another bowel movement in transit. We arrived at Hospital B, just before shift change, late on a Friday afternoon. This put the nurse in a bad mood. She put some paperwork in the room and left, my mom read it, the nurse returned and snapped at my mom to not read her stuff. Of course, this infuriated my mom. We were off to a great start. My tech, Janet came in to clean me up and change my diaper. My room had a great view overlooking Rice University. Eventually the night shift nurse arrived. She was from a temp agency.
She was a Jamaican with long dreadlocks. When she came in to do her rounds, she didn’t seem to know how to do anything. I feared she was an imposter. Later, when I was in pain and needed medication, she was nowhere to be found. My mother buzzed and checked the desk, but nobody was around. She showed up about an hour later and gave me my meds. My mother and I were pretty ticked off. What if there had been an emergency?
Her technician was a slender African guy. I needed my diaper changed again later that night. It was a comical scene of changing diapers of a big sack of potatoes. Unfortunately, I had soiled the sheets too and needed new sheets. The African dude was unhappy and frustrated. I was too but at least I had a clean diaper and sheets. Eventually I fell into a fitful sleep. I was awoken later that night when the Jamaican nurse came in to draw blood. I was feverish at this point. I drifted off to sleep and had a nightmare. My nurse was part of a Jamaican vampire gang who were harvesting my blood for resale. This was going to go on for eternity. I was paralyzed and doomed to be a blood bank. This seemed real and terrifying. I was so happy when the sun came up. I had survived the night. I slept most of the next day. My mother complained to the hospital and I never saw that Jamaican nurse again. Thank God! Sunday was a day of rest and Mom and Kevin moved in to share my room.
Monday was evaluation day. It was the fourteenth day since the stroke. Every time you change hospitals, you are re-evaluated to assess your status and plan your therapy. First was the mental exam, to determine if you knew who you are, where you are, when it is, etc. Are you Randall, are you in Houston, is it Tuesday, etc. I couldn’t talk so my only communication was eye movement. Up and down for yes; and left and right for no. Then body movement and speech were measured. I could weakly move three fingers and my wrist of my left hand. My doctor was Dr. Ahmed. He explained that hard work was key to my recovery. The harder I worked, the better the chances of my recovery. What I would be doing was similar to a spider building a web. One strand at a time. It was going to take a lot of time and hard work to rebuild my web.
Day Fifteen was the start of my therapy. Armando was my physical therapist and Mary Jo was my speech therapist. They were the first of my many fantastic therapists. There are three types of therapy- Physical, Occupational,and Speech. Physical therapy focuses on the legs and maintaining posture. Occupational therapy focuses on the arms and hands. Speech therapy focuses on speech and swallowing. The first day was pretty basic, more orientation than work.
My standard day started with routines. Watching the sun come up over Houston and ‘greeting’ my mother and brother when they woke up. Eventually the nurse arrived. Blood draw, needle pricks, shots of anti-clotting medicine, having vitals taken (blood pressure, pulse and temperature), diaper maintenance, changing out the IV, and traech maintenance followed. The respiratory technician would run a vacuum tube down the traech to suck out the mucus. The process ended when the lungs were touched and irritated. This would set off a violent coughing fit, which while uncomfortable, would clear my lungs. I had a strong cough. Therapy was started by transferring me from my bed to a gurney. Two strong assistants would slide a board under me and slide me onto the gurney. I would then be rolled to therapy. An example of Physical therapy would be to transfer me to incline table. I was then strapped down and the bed was slowly tilted til I was upright. This was done to increase my endurance and help my body to adjust to the blood pressure changes for blood flow to my brain when upright. If I got light headed, they lowered the angle of the table. Everyday this procedure was repeated to build my strength and stamina. My occupational therapist would move my arms and hands, to stretch them and limber them. At night, my mother and brother would help with my therapy. My brother providing the muscle to help me move my legs and my mother helping me with my hands, where I would try to squeeze a ball and try to get more movement in my fingers. Slowly I was getting stronger. Everyday had a small improvement. I was re-building my web.
Communication was difficult. I couldn’t talk, and I could barely move my fingers and left forearm. My eyes were my only reliable option: up and down for yes, left and right for no. Communication had to be almost telepathic. I could get the attention of my mother or brother, but it was slow and difficult to communicate what I needed. So we built a list of my common requests ( I need my body adjusted (to relieve muscle pain), I need a new cool towel on my forehead, I need pain meds, etc). They would go down the list until I moved my eyes up and down. The issue was when the new problem was not on the list. Then a tragi-comical frustrating game of schrades followed. For example, once I was sweating so much, the stinging sweat was burning my eyes. My mother or brother would ask a question, my eyes replied yes or no. After a frustrating long banter of questions, my need was communicated and added to the list. My mother and brother showed so much patience, more than I ever could have.
While I was at hospital B, they installed a PIC line, which was an IV line that stayed attached to my arm. It was installed by a medical technician while I laid in my bed. The line ran up my vein in my right arm to my heart. It had three ports that could be used to draw blood, inject medicine, IV feeding, etc. I was always worried it would somehow get pulled out and I would bleed out.
On day eighteen, the doctor stopped by and suggested I work extra hard on my right side. That is one thing about strokes, they tend to affect one side more than the other. Even though I was right handed prior to the stroke, my left hand was much better. Apparently the left side of my brain had more damage, being that the left hemisphere controls the right side of the body. Also my right arm had the PIC line, which greatly inhibited therapy. But I continued to toil away, building my web.
Sleeping at night was an ordeal. Laying all night in one position caused the body to tighten up, combined with the general tightening of my muscles from a lack of use. This resulted in pain, which resulted in not being able to sleep. I would be given painkillers to help me fall asleep, but when these wore off and I awoke later in the night, I would be in pain and not be able to sleep. Since I was paralyzed, I could’t adjust my position in bed or even buzz the nurse. I would look over and see my mother and brother asleep, but I couldn’t communicate to them my need to be re-positioned or to get more pain medication. My only option was the oxygen monitor on the index finger of my left hand. It had a blinking red light on it, and I would move my finger to try to get the attention of my mother or brother if they woke up. If I was really hurting, I would work to wiggle the oxygen sensor off my finger, which would set off a beeping alarm because the instrument thought my oxygen level had fallen too low. This would wake up somebody and they could help resolve my problem. Usually by adjusting my body, and rearranging my many pillows. Also, every night the techs would roll me on my side. The great fear was of developing bed sores. So I would be rolled on my side, usually in an uncomfortable position, and have pillows stuffed under me to hold me in place. This happened twice a night. Plus the staff would come in at all hours of the night to take vitals, draw blood, etc. A good night of sleep is a gift that is taken for granted.
On day 19, I was strapped into a chair for a short period in physical therapy. This was to further build my strength and stamina, with the goal of someday sitting upright. It sounds easy but it was very strenuous. Day 20 was the first day I could move three fingers on my left hand. Later,I was taken off the breathing machine at night.
On day 22, Armaundo, my physical therapist, said he thought I could make a full recovery if I worked hard. I took full recovery to mean I could achieve independence rather than regain 100% of my former functions. I decided my minimum goals were I could use a walker, lived on a diet of applesauce and yogurt, and was a mute. I wanted my independence back. On day 24, my traech was downsized to make my lungs work harder. Also my left leg was starting to get better. I could weakly move it side to side.
During this time, friends who were in town would stop by to visit. I wasn’t much good for visiting but I appreciated it and it gave my mother and brother someone to visit with. Robin brought some homemade chocolate chip cookies. They sure looked good but the odd thing was I had no appetite.
On Day 25, they installed a MIRR valve on my traech. This was to enable me to “speak” through my traech. Yes, that was weird. It had a reed in it, like a musical instrument. I tolerated it, but I did not like it. I worked with my speech therapist, Mary Jo. As time went on, my speech got louder and my enunciation better, but it was still low and flawed, but it was a start.
On Day 26, I sat upright in my chair for two and a half hours. And I moved my right wrist sideways. My right side was starting to wake up. Building my web continued everyday. My doctor came by and told me a representative from a renowned Rehabilitation hospital (ranked third in the country) was coming to evaluate me for admission. This was great news. My mother had gotten to be friends with Nazy, whose husband was next door. My mother thought she looked like a young Elizabeth Taylor. She had an inside scoop where the hospital kept extra pillows and wash clothes. After my daily hospital therapy, I would do more therapy with my mother and brother. My right hand was starting to be able to grip and I could straighten my fingers except my pinkie. And I practiced the alphabet every night.
On Day 27, I had the dog and pony show for the next hospital. It was short and it went well. They wanted to see what limbs I could move and to what extent, and make sure I didn’t have any serious medical issues , such as bed sores.
On Day 28, I had an ultra sound test to check for clots on my arms and upper body. I expected the blood flow to sound like my heart (ka-thump, ka-thump) but it sounded like a raging river. It made me wonder if this was why exercise was so beneficial because the fast circulation would scour the circulation system of plaque that would settle in the eddies of the circulation system. Later that day, I was informed that I was accepted to the next hospital. hip-hip-hurray.
On Day 29, My traech was capped for two hours to force me to breathe thru my mouth and nose again. It went well. I will be transported to to the next hospital tomorrow. Thanks to Dr Ahmed, Armaundo, Mary Jo, Janet, Ashe and all the staff at the hospital for working so hard and being gracious. My family and I spent the night packing and planning the next day.