Thursday, 16 July 2009

PFO is now closed .....

Sorry for the delay in posting an update but things have been rather hectic recently.

Douglas went into the Royal Infirmary on the 8th July for closure of the PFO. As requested he was really zonked out for the whole procedure so remembers little of the whole affair!! Closure was done using the femoral vein to place a couple of wee umbrella like devices, one on each side of the hole.
According to the cardiologist, it was a straight forward op and all went very well with no complications.
Doug was back home by around 9pm the same day.
He will have a follow-up examination at the Western in around 3 weeks just to check that all is still OK.
Needless to say he is a very relieved young man! I think the PFO business was really weighing heavily on his mind and he is mightily relieved that it is all over. As he says ... no more excuses!!

He had an appointment with the eye man on the Friday and it was decided that since his left eye was not really self sustaining, it would be necessary to do a small op to insert a gold weight above the muscle in the upper eye lid. We all expected a lengthy delay but, on the following Monday he got an appointment for the procedure to be done on the Wednesday (15th).
Doug was a bit taken aback at the speed of the whole thing and was somewhat reluctant. However, on the day, it turned out that he knew the eye surgeon from his climbing days at Alien Rock!! Talk about a small world. She explained it all to him and, to our delight Douglas agreed.
He has now been renamed 'Man with the Golden Eye'! As he says it is wonderful to be able to close his left eye for the first time on 15 months.
Hopefully this will stabilise his eye condition and even lead to improvements.

Iain

Wednesday, 24 June 2009

..... Back on a bike again !!!!!!!

Tuesday 23rd was a momentous day .............
Douglas went for his first bike ride since April 2008!!!!!
OK, so it was on a recumbent tricycle and definitely not up to his high standards but, hey, what a step forward :-)
Sheena and I took him out to Dalkeith where he and one of the Physios (Margot) borrowed a recumbent for a couple of hours to try it out and, much to our delight, off he went complete with brand new crash helmet, a birthday present from the guys and gals in the Coop.
They covered a couple of kliks including some short sections on the public highway, the rest being on a beautiful cycle path (part of the original Borders railway).


Needless to say Doug was all fired up about it and is planning for another outing next Tuesday if it can be arranged. The chap who lent the bike is quite willing to let us have short loans provided we can arrange transport from Dalkeith (and safe storage obviously).
Watch this space!!!

Iain

Monday, 22 June 2009

... and as for the PFO ...

Douglas now has a date for closure of his PFO (hole in the heart) of the 8th July.
He will be in the New Royal Infirmary pretty much all day and, hopefully, will not have to stay in overnight.
Seems incredible really that such a procedure is now classed as 'minor' in the great scheme of things.
He appears to be fairly relaxed about it all and I think is secretly relieved that he will have one less thing to worry him.
We are not certain precisely which closure method is to be used although it will be done in the same way as fitting a Stent i.e. going into an artery in the groin and working up to the affected part of the heart.
Hopefully we'll find out more when we eventually get the actual letter from the surgeon (postal strikes etc. permitting).

So things they are a movin'

Iain

Friday, 19 June 2009

Home Sweet Home ....

Well Doug has survived the first full week at home under the tender care of Mom and Pop!!!
It is great to have him home in familiar surroundings and to be able to resume a more normal life style.
Doug was rather concerned that it would be a case of 'out of sight - out of mind' where the rehab programme was concerned but in reality it has been quite the reverse!
We now have a well established schedule for each day that starts at around 7:30 am with breakfast closely followed by a wash and brush up session that can take us through to about 9:45.
He has a short rest period up to 11:00 am when he is taken in hand by the physios and OT's for around an hour of pretty intensive activity.
This is followed by another rest period then lunch.
We are trying to ensure that Doug gets a post prandial nap up to around 3pm and its then all hands on deck for the afternoon and evening of more domestic stuff.

Douglas is really doing very well indeed having acquired a new lease of energy and commitment with his discharge from the Astley. Of course it is still all too slow for him, but none the less he is progressing. Most notable is the improvement in his standing and mobility. He is now able to stand unaided (albeit a bit shaky for now) for periods in excess of a minute - and getting longer by the day too! This really helps his confidence in using the zimmer and and in particular in washing, dressing and using the toilet. As he said to me the other day, try doing all that with one hand, standing on one leg and you'll get an idea of how it feels! Needless to say I haven't taken him up on that - I've got trouble enough already :-)
Physio is also addressing co-ordination (hand and eye) issues and in improving Dougs use of his left hand which still tends to be 'forgotten' much of the time.
Doug is hoping that the OT's may be able to offer solutions to the vision issue when he is trying to read PC size screens and text. There appear to be some solutions available but whether or not they'll suit remains to be seen. In the meantime I'm acting as a somewhat inefficient secretary in this respect.
There does seem to be a very slow improvement in his ability to blink with the left eye although we still need to apply liquid tears as a lubricant four times per day and tape the eyelid shut over night. Not the best of situations but needs must when the devil drives.

Visiting friends have also added a new dimension and he has had several outings without M&P fussing around :-) I cannot express my thanks enough to his circle of friends who are such an important part of the support team and do so much to bolster Dougs spirits and help him back into the great outside world.

Needless to say we are all having to learn new ways of doing things around the house which is not helped by the fact that some of the 'essential' modifications have not yet happened (like a door on the downstairs toilet!!!!) Having said that, the City Council have been great in providing the mechanical bits and bobs like handrails at the front door and bannisters on the staircase. We are so fortunate in this respect.

As regards visiting ........ afternoons and early evenings are the ideal since it gives Doug a rest period after his rehab exercises in the late morning and time to have lunch. So I'd suggest 3pm onwards but if that's not suitable, just give me a ring and we'll see what we can do. We usually have tea at around 6pm.
For those who have tried finding us in Cammo ........ I've just painted up a new house number so you don't have to worry about trying to recognise car number plates or anything else!

Iain

Tuesday, 2 June 2009

Outside is forever (nearly!!)

Well things are really starting to move now!
Doug had his first two nighter at home last week-end and enjoyed it greatly:-) Even better, Nick, Heike, Jules, Malky and Clare took Doug out for the afternoon on Sunday and after perambulations along the foreshore, ended up in the local hostelry!!! Talk about breaking the mould!! Doug REALLY enjoyed the afternoon ......... thank you folks so much.

No sooner had he 'checked back in' than a rather dishy young doctor (female I am assured) came along to take out his PEG feeding tube! (Monday) I think we were all a bit concerned about this, but, according to Doug, it was just a question of grabbing a hold of the tube and giving it a quick heave and ... pop ... out it came. Huummmm Not sure it was really that simple but ......
Apparently the outside hole heals very rapidly (a day or so) and the inside one (in the gut?) seals almost immediately. I'd still be a bit worried about the leaking inner tube thing though they know what the're about.
So - now all food and liquids are taken orally!!!! Liquids still have to be thickened because of the swallow reflex deficiency but fortunately Doug has taken a liking for Lemon and Barley water which he drinks by the litre!! Anyone tried thickening gin and tonic???????

To top it all off we now have a discharge date for Doug. 10th June is the big day!
From that point on he'll be at home, under the care of Mom and Pop, aided and abetted by the Community Rehab Team who, I am told, will really be working him hard.
The 10th will be out for visiting what with the transfer followed by the Rehab Team visit.

So I guess, for those of you who work in and around the town centre, visiting could be a little less easy; however, on the plus side we'll not be constrained by hospital visiting hours and the surroundings are certainly more congenial!! Clearly we'll have to work around the Rehab schedule (whatever that turns out to be). If the weather keeps up remember to bring sun cream so you can all sit out in the sunshine!!

Dougs mood certainly seems much more positive now although he still has trouble with the balance issue and therefore with the business of walking and standing.
He has started the process of applying for 'a place of his own' through Edinburgh City Council although that is likely to be a fairly long drawn out process given both his particular requirements for wheel chair access and the relative shortage of such housing. He tells me he is very apprehensive at the idea of living on his own but hopefully his fears will diminish as he becomes more confident around the house.
He has also applied for a Blue Badge that will make going anywhere just that little bit easier and a Taxi Card that gives discounts on cab fares around the city.

We have still not heard anything further about the PFO business (closure of the hole in the heart) and I hope this is simply due to pressure on available resources. Were it otherwise I'm sure we'd have been advised.

The upcoming week-end (5th; 6th and 7th) Doug will be at home - Friday lunchtime till Sunday evening, so if you want to pop in for a visit in the afternoon, give me a bell first just to make sure allus OK.

Iain

Wednesday, 20 May 2009

Outside is not all that bad ...............

Doug went for his Ear Nose and Throat consult on the 7th May and the results were a bit like the curates egg - good in parts.
The good news was that it now appears that both vocal chords are working (previously only the right one was doing its stuff) and this should make swallowing more certain. Whether or not it is reflected in his speech remains to be seen. :-)
As for hearing ....... the consultant was not very encouraging although he did not rule out slow improvements. He more or less said that, as Doug has found, it is possible to 'tune out' the tinnitus (white noise) with a lot of practice. Huuuummm
In balance - there was some progress.
Needless to say (and quite understandably) this was NOT what Doug may have hoped for so he was a bit down for a while.

None the less there is progress ..............
We have had bannister rails fitted on the house entrance to the front door and on both side of the internal staircase to the first floor.
Doug coped very well with the outside rails (Sat 16th), getting from his chair on the front path to inside the house with the minimum of assistance and then down the hall on his zimmer. However it was all a bit tiring - pretty good for a first attempt I say!!!! Doug did concede that it was somewhat short of perfect :-)
We are waiting for a high backed chair, the seat of which will be more on a level with the cushion on his wheel chair, fitted with rail arm rests that should make transfers to and from wheel chair or zimmer much more practical.

In the mean time Doug is being worked pretty hard by the Physios on stair climbing (and descending) and is doing very well at this so we are told.

All this is aimed at Doug being able to stay at home overnight at week ends in the short term (like this week end?!), with weekday visits to the Astley for physio.
To help with this we have converted the downstairs dining room into a bedroom for him. Sadly he will have to have his showers between Monday and Friday in the hospital.
The ultimate aim is to have him home full time in around 5 to 6 weeks when his physio etc. will be managed by the Community Nursing system although I guess this will depend on his stair climbing ability.
After a period of 'settling down' in the home environment (around 6 weeks) he will be entered into the Out Patients Rehab Programme at the Astley under Dr Todd.
To be honest, a lot of this period is aimed at 'de-institutionalising' (if there is such a word) Doug and getting the idea firmly fixed in his mind that a return to normal life is what it is all about.

However, on that subject, his friends have been absolutely great especially in the last 10 days or so in persuading him that the great 'outside' is not a bad place!!!!! For the first time for over 6 months Doug actually agreed to go for a walk in his wheelchair (whoopeee!!!) with Nick Stephenson. Nick we are forever in your debt!!
Then, much to our delight he went out in the Astley grounds with Veronica yesterday afternoon.
It all sounds a bit naff I guess, but Doug had set his mind on only going outside in a social sense when he could 'take himself walking' so to speak and we just did not seem to be getting out of the rut on this one. I know several others have tried persuading him without success but PLEASE do not take his refusal as any sort of personal comment - so much depends on how he is feeling at any particular time. None the less, having broken the mould I hope casual outings will become the norm.

So what about visiting I hear you say!!!
For the moment Mondays to Fridays at the Astley from 3 till 8 (but not 5.45 to 6.30 - Meal time) are great.
Saturday and Sunday any time between 2:30 pm and 9:00 pm at home.
I will confirm the week end timings once we have agreed things with the Astley (hopefully Friday this week).
EXCEPTION ........ Friday 22nd Doug will be at home being put through his paces with stairs, handrails etc. etc. so really the 22nd is a no go.

Oh, by the way ......... Kay, if you read this Doug did his extra 3 steps!!!! I have no idea what this is all about but I'm sure you'll know :-)

Iain

Monday, 4 May 2009

Maan ... he's all heart ..........

Douglas went for his cardiac investigation with some trepidation - not so much over the likely result but more over the actual examination itself since it involved swallowing a small ultrasound transducer. The swallowing part has always been very uncomfortable in the past.
However the staff at the Western recognised his concern and really zonked him out for the whole event, so much so that he took around 2 hours to fully come around afterwards.

The good news, if you can call it that, is that he definitely has one hole some 3mm in diameter and around 15 mm in length (a tunnel like defect) which appears to be classed as 'large'.
It was deemed a good candidate for sealing although we have not yet heard which sealing method is considered best. I understand that it will either be the umbrella type or the mesh type and definitely NOT the 'stitch it up' type.

We are all just waiting for feedback on this and on the date for an op (estimated at within 5 weeks).

Douglas had bets on the number of holes and suffice to say I won the bet. Mind you its not much of a win, since I have to give him the stake in the first place ........

We are currently getting set up for a 'home evaluation visit' by the physios and OT lassies to establish just how well Doug can manage at home. This will both set targets for the rehab programme and also give us some idea about any changes that may be needed around the house.
Unfortunately Doug feels a bit threatened by all this .......... they just want to get rid of me sort of thing. I can understand his concerns and Sheena and I have been doing our best to convince him that this is only the first step towards a getting home point sometime in the future. Not at all sure how well we have managed that though?

Saturdays at home continue to be a great favourite and Doug really relaxes when he gets through the front door - its so good to see!! Mind you he gets spoiled rotten (we'll not be admitting that to the OT's!!!!).
He continues with the rehab stuff but still has problems with balance that play havoc with his confidence in walking with the zimmer frame. Never the less he is slowly getting more flexibility in movement.

He agreed a wee while ago to be part of a study into Cronic Fatigue Syndrome in stroke victims and although I'm not really sure how it works, its a comfort to know that it is recognised as an adverse factor in rehabilitation. Whether or not it will all result in any palliatives or even a cure remains to be seen. In the meantime he still gets really pissed off at how easily he runs out of energy.

The next thing on the list is a visit to the ENT clinic on the 7th May. Doug has said recently that he occasionally gets bursts of what he describes as white noise in his left ear. Whether or not this indicates any degree of recovery of hearing on that side I'm not sure. Perhaps this appointment may help provide answers.
I'll pop up another update soon.

In the meanwhile, thanks again for all the visits and for the messages through the blog and facebook. Doug really looks forward to hearing them all.
Iain