Sunday, February 18, 2018

Sunday Stroke Survival: How Pets Help Motivate You After a Stroke

A pet in your house after a stroke is a must/must not argument. They have their pluses and minuses. I know people who have given away their pets post stroke, but I kept mine and even added to their number since moving to northeast Georgia. I'm not talking about service animals here, but pets.

Pets are a huge responsibility (as big as children) which is a good and bad thing living post stroke. On one hand they have to be cared for, loved, and are almost constant companions. But on the other hand, it may be more responsibility than you can handle just after a stroke and they pose a fall hazard. As with all things in life, you weigh the good and the bad in the decision making process.

The bad-
The fall hazards of owning a pet is a real concern. If they were in your home before your stroke, after a stroke your movements are not the same as the animal is used to. It will take some time for you both to get used to each other again. In this adjustment period missteps happen.

My older cat, Patches, threw me off balance as I opened the door to let her out. It was in the first month I was home from the hospital after my stroke. The resulting fall caused an AC ligament tear in my shoulder that took months to heal (surgical repair was not an option). I lost valuable rehab time during the golden 6 month period of my recovery due to this injury.

Now, almost 6 years post stroke, Patches will look up at me while I'm moving. She's quick to move away from me if I start to fall. It only took one time of me falling on her to teach her this. When I climb up stairs, she's only one step ahead of me. Most times when she trips me up is a miscalculation on her part between our mobile speeds and distance. But she's gotten pretty good at these calculations.

The good-
This same cat will escort me to and from my van. If I take longer than usual to get out of my van, she'll jump on the running board to check on me. Because of the way my spasticity hurts me worse in colder and damper weather, she will lay her full body length on my spastic arm to keep it warm at night. I don't know how she knows how to do this, but she does. If I'm outside, she's no more than ten steps (her steps) away from me. She'll play in the tall grasses and weeds that I pull for the rabbits. Her antics of tiger in the grass always puts a smile on my face. She is my shadow.

I'm envious of her black eyeliner
Lil Bit waits on me with a go ahead command so we never collide. She doesn't race me to a location but waits for me to get settled so that I can give her undivided attention. Even when she was little, she waited on commands from me. She's very timid when it comes to interactions with her new housemates.

She always makes herself known to me so I know where she is. She hasn't tripped me or made me fall yet. She's always aware of her surroundings and she's as much my comforter as I am hers. She lulls me to sleep each night with her purrs. She awakens me each morning with gentle licks with the tip of her tongue on whatever body part is exposed. If she really is insistent on waking me up, she'll use the rough part of her tongue on my eyelid. At these times there's danger. She used to wake me up when my beloved was alive and in trouble.

My puppies, the German  Shepherds, were sold before I moved to northeast Georgia, but we were assimilated into a new pack of pets with the move.

Nnyus, a pit bull/ridge back mix dog, is as gentle as they come so long as you are not a predator.  Her main danger to me is her rambunctious nature and her whip like tail. She's been great at helping me keep my balance. She's just the right size to help me up too if I've fallen. If I fall, she's right there licking me into submission. Her soft brown eyes full of concern. If I can't get up, she'll bark until Mel comes to see what she is barking at.

She is deathly afraid of snakes even yarn ones, she'll "dog scream" and run away. It's hilarious to watch her do this when I drop a few rows of knitting on the floor.

Strangers are afraid to get out of their cars or trucks at the sight of her. She's got the distinctive pit bull squared head and body, but the long snout of a hound. She's harmless unless you hurt those that she's protecting. To predators like coyotes, raccoons, and wolves she's lethal. She even chases deer off our property to my dismay during hunting season.

Herbie, a border terrier, is  like all terriers. A more loyal as a companion as you could ever wish for. He's constantly at my feet. Ever watchful for any movement. But like most terriers, he's very vocal about everything. His allergies to fleas causes him to bite and chew himself much to his whining aggravation. He's stubborn and argumentative.

Although Mel taught him how to whisper (gruffle rather than bark), He has to agree with the command for him to comply. Several times a night we are awakened by his agitation at the fleas or something else that's popped into his head. 'Hey, it's getting colder in here. Get up and tend to the fire.' 'Hmm, I'm awake and everybody is sleeping. I'm lonely.' It will set him off barking until someone gets up. Usually, it's me. That suits him just fine.

If anything this little dog is too smart for his own good because when we get aggravated at him we make him go outside. Now that I'm sort of laid up with a broken foot, he'll make a bee line to under Mel's bed. He knows I can't balance well enough to chase him outside. But even given that, he has become my dog. If I go outside, he follows me. When I drive off, he sits on the porch until I return. When he sees my van coming down the driveway, he gives a series of happy barks as if saying, "She's home! Jo's back!"

That leads me to Ms. Whirling Dervish. She's Mel's service cat. Derv has been queen of her domain. She and Patches went round and round in a power struggle when I first came here. They have decided on splitting the power for the sake of peace in the realm.

I swear this cat is an alcoholic. She actually has a specific cry for wine.  But it has to be red wine. Mel will give her finger droplets of the beverage. But she'll also drink screwdrivers. Usually cats will turn their noses up at citrus, but not her. If Mel is drinking it, it must be okay and she wants some too. She'll even lift a paw and points to the glass to let Mel know when she when she wants more.  If Mel leaves her glass on the table and goes to the bathroom, the cat will help herself to the drink sticking her whole head in a glass to lap it up.

Needless to say, Mel and this cat have a special relationship. Wherever Mel goes Derv is sure to be within ear shot. Occasionally, she will allow me to pay homage to her.

And last but hardly least is Flynn. She's the baby we found abandoned in our lower acreage this past spring. This baby is definitely Mel's baby. If she isn't playing, eating, or sleeping she is cuddling with Mel. She's already learning how not to streak between my legs.  She hasn't made me fall yet, but close. I rarely see this kitten walk by. It's always a blur of orange and cream. Everything is a toy to her even little scraps of wood. She's just so cute you can't stay mad at her.

 This little kitten started her day like normal by harassing Lil Bit and playing with Patches, and then she went outside to have fun with the chickens. Her idea of fun with the chickens is to hide in the Monkey grass or bushes and jump out at them. She has great fun watching them squawk and jump straight up. Unfortunately, this week, she ran into a snake to play with. It was poisonous and we lost Flynn. We dutifully killed the snake. All the rain we've had are driving them out of the woods.

All these new pets have had to learn that I'm not stable when I'm walking by. They give me a wide berth. We tend to watch out for each other. I'm watching where I step to keep an even foot step and by the same token, they are watching me.

Having household pets takes diligent caution on everyone's part to keep accidents at bay, but the rewards are priceless. In my mind they are well worth the trouble of owning them. I've had animals all my life so it's natural for me. Cleaning up messes on the floor that they make (pee, poop, vomit, shredded paper, etc), changing litter boxes, and feeding and grooming comes as second nature to me although challenging just after my stroke. My dogs enjoyed baths while Mel's don't. So she washes them.

I get genuine companionship from these pets. Each in their own way. They change my focus from me to them. It allows me to care for something other than myself. Having something to care for is motivation to get up and do which is very important after a stroke.  Motivation is hard to maintain in the long race to recovery or even day to day life. Pets will make me smile even when all I feel like doing is cry. My pets, I think I'll keep them.

Nothing is impossible.

Monday, February 12, 2018

Sunday Stroke Survival: Hello,Hello Out There?

Are you new strokee (survivor)? Are you an old strokee that's part of the stroke tribe (members of the now defunct Stroke Tattler)? Are you a new member of one of the other organizations that redistribute my blogs? Did you just surf the web and decided to read my blog? You've been reading (lurking) my blog for a while now but did so anonymously? Did you find this blog via one of my books?

I know you are out there. I get some 1,000 plus views per blog post. I get some 30-50 emails about my blogs any given week. But what about the rest of you? I hear y'all. "And you're complaining?" No, I'm not. Honestly, I'm not. I'm thrilled. I'm just curious to how you found my little blog and who you are. This inquiring mind here wants to know. I know where my old timers are from. I've frequented many of their sites..although I've been lazy about adding my comments for the past year or so. I'm still reading them. The stroke tribe and I have a cemented in concrete relationship starting with the Stroke Tattler. The Tattler was my first organization that redistributed my blog some five years ago. About ten nationally and internationally now have my permission to do so in bits and pieces or in its entirety.

My followers haven't increased numerically. Of course they may be followers from somewhere else  than I keep track of too. I have heard from a few that do not have a Google membership to comment on my blogs via email. Many of whom email me frequently. Everyone else is a mystery. All these views cannot be a click by mistake because they are consistent across the board. But if you clicked on me by mistake and decided to stay a while that's okay too.

I am actually puzzled about this. So hello, hello out there! Welcome to my blog family. If you feel like answering pipe up in comments or by email. Even send me a line via facebook. Although I don't frequent that website as much as I used to. My curiosity is aroused. Let me know who sent you so I might thank them.

Nothing is impossible.

Sunday, February 11, 2018

Sunday Stroke Survival: Killer Inactivity

For someone like me, inactivity is almost a fate worse than death.  It has never been my style. Just after my first stroke in the acute wing of the hospital, I was going nuts and that was only four days!

Now, a couple of weeks has gone by since I broke my foot. I'm definitely going insane. The pain in my foot has not abated. It isn't any better. Even the new x-rays show no healing. Absolutely none. So my forced inactivity continues and I'm bored. There's only so much Netflix, computer time, spinning, and knitting I can do. Coupled by a spell of warmer weather (60s), I wanted to be out in the outside and doing.

Do I sound whinny? I know I am. I should be grateful that more bones didn't and haven't broken. I am but not really. I'm yearning for my old life where I could escape for hours or days writing. That's how I survived the months after I broke my toes last time. I find myself complaining a lot, and that's not me either. But, I'm having a hard time stopping myself from voicing my frustration.

I may not be a diabetic anymore, but the diabetic neuropathy in my legs, and slow healing associated with diabetes continue on as if I was. So does the poor circulation to my lower extremities. It's maddening! You do everything right and it still kicks you in the hinny. It ranks right up there with post stroke spasticity.

Speaking of spasticity, I'm still in a holding pattern with Emory neurosurgery. The first appointment available is not until May! I know you were wondering.

I'm in another Catch-22 with my foot healing. The build up on the heel of my AFO causes more pressure on my lower foot. Thus it causes stress fractures from just walking with it. But I need the build up because of the Achilles tendon contracture. I can't even get therapy or do exercises to stretch my Achilles tendon, like I was doing, because of the fractures. I do alright, most days, with wearing my AFO only inside the house. But Lord help me when I have to wear a shoe. The pressure of the shoe sends me back to the initial pain. Pain levels to 9 or 10 out of 10.

Rethinking the Iwalk crutch. Ease of use with the Iwalk crutch is dependent on a normal gait and balance. It isn't recommended for anyone who has balance issues. Living post stroke, like I am, I do not have a normal gait or balance. I'm constantly stumbling on invisible lint on the floor. The terrain, where I live, is not level so I'm constantly stepping up and down on angles. Considering all that, my balance, though better than it was, is still not great and I'm still prone to fall.

That brings me to another point against the Iwalk crutch. To sit or drive, you have to take it off. That means undoing the three straps to take it off and redoing them and tightening them up again every time I got up. With two working hands and good balance, it might not be so hard, but for impaired me? Can you see me going to the store?  I'll get to my car, sit catty corner on the edge front seat (remember when you sit the crutch part is sticking straight out so the car door is a factor), drive to the store and do the same thing in reverse before even entering the store. I might mention here that on the plus side of this equation, all the buckles and adjustment straps are on the inside the thigh and calf (easier to access). You would repeat the whole process to go home. Even for someone without chronic fatigue this would be taxing. The only good thing is that I wouldn't need a motorized cart to shop with.

So basically, I sit at home. When I do go anywhere, like to therapy or the drug store, I'll painfully put on my shoes. The shoe adds to the pressure on the fractured bones. In the house, I'll just don my AFO only. (I know, I know. You're not supposed to)  I take my rollator to the car. But first I have to manhandle the rollator down three steps. Painful process. I manhandle the rollator into the back seat, pivot with my back to the van into the front seat of my van, and repeat the process when I get to therapy. I'd have to do the same with a knee scooter.Then again, it supposedly takes two hands to operate just like my rollator. But I manage okay so long as there are no drastic inclines or declines.

So that leads me back to killer inactivity. Mel is having to do everything and I feel about useless. I will occasionally cook.I can periodically put my weight on the AFO build up in the heel, but the spasticity on my foot causes my toes to curl under and my big toe to arch up. If I stand for too long the spasticity combined with muscle spasms which twists my foot and  put pressure on the fractures too. The strap on my AFO that prevents this cuts right across the fractures causing pain. I can stand bearing most of my weight on my functioning leg or sitting on the rollator's seat. Keep in mind that none of our cabinets or appliances are the right height. Being short, I'm about nose level to whatever I'm doing in the kitchen. Not exactly safe but it gives Mel a break. It also breaks up my boring day to day existence.

I do try to keep my brain active. I play games like Tripeaks and Scrabble on the computer, but after an hour of playing these, I  quickly get bored with these. I'll watch YouTube, but then I'll be chomping at the bit to do or try something only to be stopped by my foot.

Another three weeks til the next set of x-rays. But, I'm using pain as an indicator for amount of healing taking place. Mel keeps telling me that pain is associated with the bones knitting back together. I hope she's right. But having broken more bones than her, I fear she isn't. Meanwhile, I'm crossing my fingers. I'd cross my toes too if it didn't hurts so much.

Nothing is impossible.

Sunday, February 4, 2018

Sunday Stroke Survival: It's Overwhelming!

How many times have you looked at your to-do list and just felt overwhelmed? It feels like you are drowning and you haven't even started yet.

Before my stroke, I was a master juggler. I could do it all. I'd turn mountains of receipts into concise profits and loss statements and do the tax returns for multiple sole proprietorships, partnerships, and corporate entities. Tune the tune of 250 returns a year. At the same time, I'd write multiple books every year, run my own international consulting firm, and care for a family of four or more depending on how many grandkids were around. I didn't feel overwhelmed at all. I had it made until two life altering thing happened. My elder in-laws moved to town and my husband's illness became worse. I still was a master juggler. I kept track of everyone's medications and doctors appointments including mine. I prepared meals to go around, clean and organized everything. I still wasn't overwhelmed by it all. I was Superwoman, Supermom, and Wonder Woman rolled up in little, old me.

And then, I had my first stroke and my second. A screeching halt to not being overwhelmed was the price I paid with them. Everything went into overload to my healing, damaged brain. Instead of handling everything, it became one job at a time. And, I still felt like I was drowning.  By now, the children were grown and my in-laws had passed. God knew I couldn't cope with the extra burdens.

Family get-togethers of more than three people was overwhelming. A load of dishes to wash (even if it was for two people) was overwhelming. A conversation with more than one person was overwhelming. Trying to organize the chores list like cleaning the bathroom was overwhelming. Taking a phone number was excruciating overwhelming without having the other party repeating the number four or five times. Life was/is too complicated.

After almost six years since my first stroke, I wish I could say it has gotten easier, but it hasn't. This from a person who flew across the country for a movie premiere, has talked to numerous groups about living post stroke, buried her husband, and uprooted herself from her previous life to follow her dreams. I have two definite coping skills I use every single stubbornness and my ability to use math. I may not be able to add, subtract, multiply and divide worth a hoot any more, but stay tuned how I used my math skills to cope.

My stubbornness is basically self explanatory.  I refuse to ask for help as a first option. I raised my children to be problem solvers because I was one. They couldn't ask for help until they tried at least twice before they asked for help. Could I do any less? No, I'll try six or seven times. What can I say, I'm an overachiever still even if it's in my own mind.

To establish macro to micro vision, it's simplifying every task. As all of us learned in every math class we ever took, I hear y'all groaning out there.  Break the problem down to the smallest components, and then work the problem. Small things are easy to accomplish. Do those first.

Take a sink load of dirty dishes.
Example: Not my kitchen!
We don't wash dishes every day. There's only two of us so it takes a few days for this amount of dirty dishes to pile up unless it's a heavy cooking day. But when it does my overwhelmed factor kicks in. I've got only two choices: leave it and it gets bigger, or do it.

You simplify the overwhelm into doable. So I'll break it down to the simplest elements. All the silverware and cooking utensils goes into a mug or dirty pitcher. All the individual plates and bowls get stacked. Dirty pots are stacked on the stove as an extended counter. You get the idea. Now my sinks are empty. I'll clean them first. I'll fill one sink with hot soapy water. The other is left empty. I don't look at the huge piles of dishes, I just focus on the silverware. I'll empty the jug into the sink. Then I'll throw all the plastic containers and glasses into the sink. Grease sticks the worst to these so they get the hottest water and the strongest amount of soap. The silverware and cooking utensils soak while I wash up the plastic and glassware. These are put soapy dishes in the empty sink. Then I'll tackle the silverware and utensils. Once the empty sink is full, I'll rinse them all under hot water. I'll use my dishwasher racks to hold them all to dry. By using hot water only to rinse them, the glasses and flatware dry without spots. Pretty neat, huh?

Next comes the mugs and small stuff, dishes and bowls. By this time, the wash water is pretty dirty so I'll drain it and run a fresh batch of soapy water for the pots and lids. When stacking the dishes in the dishwasher, by doing it this way, I fill the top section first, and as  the dishes get larger, I'll use the bottom section only. This way, I only have one rack at a time open instead of switching back and forth. I also know all these dirty dishes won't fit on a standard drying rack. You might ask why I didn't use the dishwasher to wash the dishes in the first place. It's broken and I haven't gotten around to replacing it yet.

By emptying the sink first of all that mess, I was able to work in smaller, more doable batches. The job wasn't so overwhelming. It's just steady work until it's done. I wish the same could be said for the laundry I do.

With family get-togethers, that's another coping skill. I have a huge family. Three generations of 50 people or more at the moderate get-together. Even a small one of just my kids, their spouses, and my grandchildren is 18! It's more than I can handle at one time. I'll find a spot to sit in that's not in the crowd. This way, I'm not surrounded with five or six conversations going at once. I make people come to me. They come in ones or twos and that doesn't overwhelm me. The old days of having ten at the table playing Canasta are over for me. It's a sad reality of my living post stroke and stopping myself from being overwhelmed.

Now, each task I do is simplified first into its smallest components to keep them from being overwhelming. It works with most problems I tackle. I can look back and see that I had a good time or a big job and got it done. I wasn't stressed or overwhelmed. I took it all in stride. This has gotten easier with time. I don't have to think about it so hard any more. I just take tasks from the macro view to the micro view and back again. Then when finished, I can pat myself on the back for a job well done.I may not be a master juggler any more, but I can still conquer a mountain and if I break it down into molehills. But then again. It's harder to trip over mountains. Molehills, that's another story.

Nothing is impossible.

Sunday, January 28, 2018

Sunday Stroke Survival: Spasticity Update #1

When I saw Dr. Fox. He was my physical therapy doctor at Emory. All I can say positive about the appointment is two things... He never said, "It's the disease process," nor "It's the best it's ever going to be." In due course, I thanked him for this.

He agreed that all the PT in the world wasn't going to fix the spasticity. It would keep the permanent contratures of the tendons and muscles from happening. There is no simple fix for this. I really didn't expect one. Thanks to Dean at Dean's Stroke Musing and a couple other sites, I'm pretty well self educated on this side effect of my strokes. In fact, I've been told as much by several doctors. They simply do not have the time to stay current. I, on the other hand, have nothing but time to spend on research.

He did suggest continuing with the therapy and dry needling. I need the stretching. If it wasn't so awkward, I could do it myself. Alas, as much as I tried over the years, I just can't manipulate my body to get  a good, full extension stretch. These days I can carry about thirty pounds of grocery bags on my affected arm and not have it budge. That's how bad the constant spasticity in my arm has gotten. Even the therapist has got to do dry needling and stripping the muscles down before it will budge. But after all of that, my arm will move like pictured. It only lasts for the extent of the therapy and it's right back into the 45 degree angle. But the pain relief lasts for about 4 or 5 days which is heavenly. The charlie horse spasms which brings me to tears are reduced in frequency also. Should I be happy and grateful with only this?

So what's the next step?

I'm waiting once again for a functional neurosurgeon appointment. I'm back where I was in October. Maddening, isn't it? One step forward and two back. I should be used to this by now, but I'm not. After the appointment, I sat in my car on the verge of tears. It's so frustrating! My appointment time was 4PM in mid town Atlanta so not only did I do battle with the early rush hour traffic getting to my appointment, but now, after an hour with the doctor, it was the mass exodus of workers between their job and home. If you've never driven in a big city at rush hour, picture this. This is interstate driving with a 70mph speed limit. You are in stop and go traffic, and my best speed is 15mph. The sun is setting and all I can see in my rear view mirror is bumper to bumper traffic behind me for miles. In front of me is miles of tail lights. Six to seven lanes of traffic going one-way. It took an hour and a half to go 22 miles! The only good thing about it was I could take my eyes off the road and sip on my diet cola whenever I wanted. My cup holder is down between the front seats of my minivan. My right arm doesn't function to even hold the steering wheel while driving.

But I made it home safely. I guess I should've thanked God for that, but I was too upset to even think about it. The tears of frustration rolled down my cheek as I told Mel about the appointment. I'm back in hurry-up-and-wait mode again. Meanwhile, I still haven't heard a peep from  Shepherd's Center about an open spot for me to get in there. It's hard not to be angry or feeling like I'm being jerked around. It's hard not to feel like I'm being dumped on, or others just don't care. I've met a lot of caring folks along this journey. They all want to truly help, they just can't. They don't have the God given wisdom to help me. I know I'm not the only one faced with this dilemma. So should I be satisfied? Is it just my stubbornness? Lord knows, I've prayed long and hard about this. Should I just give up even though that's not my nature. You know, what the old Serenity prayer says...
I have a problem with the first line. No problem with the second line. The key is the third line that's a 50-50 shot with me. Hey, I'm being honest here. I think most of us fall in the same boat. At times the Wisdom is written in black and white. You've had a stroke and you are paralyzed. You work hard to recover what you can, and make adaptions to your lifestyle. Or, like me now, when I recovered so much only to lose it again to spasticity. So Courage isn't an issue in that respect. I'll try to do something half a dozen times before looking for an easier way or calling for help. In my mind, there's got to be a solution until God gives the notion that there isn't a way to do it. That's the kicker for me with the third line.  The wisdom is not always forth coming in a timely manner. At least to me. Remember me, I gotta have it now to be happy. I've gotten better about patience since my strokes, but I still have a long way to go. That's why I am in the questioning mode. Sometimes, God has to literally knock me in the head, "Hey child, I'm talking to you!" But that isn't always the case.
Everything I've read about spasticity says there is no cure. They also use the quantifiers like this may be helpful, moderately successful treatments, and research is ongoing. So the situation is not exactly hopeless, BUT there is no cure right now. And, I want it right now! I want it now before I regress to no recovery at all like I was just after my stroke. I want it before I'm back in a wheelchair. I want it now so the cycle of pain stops. It's a cruel punishment to give you back use, and then take it away due to a side effects of a stroke.

Do I sound whinny here? I'm in that cycle of grief again, where I'm angry most of the time. As I said before, grief never truly goes away. I realize the cause is just frustration. It will drive me nuts if I let it. Okay, then I have a choice to make. Do I want to drive myself nuts? No, not really. The people in my head know my quirks, but most other real people don't. I really don't want to step off that ledge. Okay then, what can I do about the problem? Well, the first thing is to step away from the ledge and decide to live beyond the frustrating bits. Sure they'll be back in the forefront again, but for right now, step away from the ledge. Whew! That was a close one. 

Now, take one step in the opposite direction. It doesn't have to be a huge one. Baby steps faltering as they may be. I've decided not to live in frustration. I'm going to take another step from the ledge. How do I do that? Distraction works. Firewood needs to come onto the porch. Now, it needs to be stacked. A load of wood needs to come in by the stove carrying two pieces at a time. Wow, two hours has passed since I took that baby step from the ledge. I sure don't want to freeze to death while walking away from the ledge into nutsville. Oh, there's that sweater I started knitting for Mel's birthday. The chickens and rabbits need to be fed. There's a new movie on Netflixs I wanted to see. Before you know it, the day has passed. I've been so busy living my life the frustration wasn't given a second thought. It doesn't mean that a new or continuing frustration point won't hit me square in the face tomorrow. It probably will. Remember, Murphy's Law is always waiting around the corner. But I survived the day and more than that, I was productive. 
Tomorrow will never come because tomorrow will become today when you wake. All's you have to do is survive the day. One day at a time. Each day, you make a conscience choice to step away from the ledge until you don't have to. With all frustration and grief, it begins to resolve with a conscience choice.

Nothing is impossible.