The Good, The Bad, and The Ugly

The good news is Mom’s stroke, while not small, didn’t leave behind the amount of damage it could have. Dr. S was pleased that she is still mobile albeit with supervision for the time being.  The stroke was in the basal ganglia region on the left side of her brain. That’s a mouthful of unintelligibility isn’t it? I looked up basal ganglia but Uncle Google wasn’t very helpful this time.  More on that later.

The bad news is sometime between the first blood draw in the ER Saturday afternoon, and Monday night, Mom had a heart attack. Women don’t usually exhibit the typical clutch the chest type symptoms and it was missed by everyone until the telltale marker appeared in her blood.  By itself this isn’t better or worse than the stroke.  In conjunction it makes finding the appropriate treatment protocol a bit tricky.

Dr. S recommended keeping Mom’s blood pressure slightly elevated in order to be certain blood was getting to the stroke area, where the blood vessels are extremely narrow from the arterial blockages.  Now that they know her heart is unhappy with that level of BP they have to figure out another, heart-friendlier treatment going forward.

The Ugly:  My dread that this is just the beginning of the end. It has brought back sad memories of my grandmother’s lengthy battle with stroke and her gradual decline.  I keep reminding myself that was over 30 years ago and the medical field has advanced by leaps and bounds since then.  In fact, I really like Mom’s neurologist, which brings us back to the basal ganglia mystery.

Monday in a coincidence of timing, I managed to slide into Mom’s room in the midst of the doctor’s explanations to our daughter and son in law.  I use “slide” because as we were searching for parking daughter A texted that the doctor was there.  JD dropped daughter K and I at the skybridge and we very nearly ran from there to the other side of the hospital where we took the elevator to the neuro floor, then speedwalked through the unit and slid to a (in my mind) screeching stop at the foot of Mom’s bed.

Dr. S was so patient (unintended pun!) and when JD arrived a few minutes later after finding parking he even went over the information (abbreviated a bit this time) again for him.  Here’s where my confusion was – I looked up basal ganglia and found the definition below.

ba·sal gan·gli·a

noun

ANATOMY

1. a group of structures linked to the thalamus in the base of the brain and involved in coordination of movement.

Granted I didn’t have a lot of time to look at other hits for more detailed information so it was more my failure than Uncle Google’s.  As a result, I jumped to the conclusion that this meant she wouldn’t be able to walk or move her arms.  Dr. S explained what I was missing in the definition I read:  coordination of movement.  It isn’t that she can’t move but that she needs to think about it.  When we reach for a spoon we just reach for it without having to consciously think about it right?  Well Mom now has to decide she wants the spoon and then make up her mind to reach for it.  Then there’s the actual reaching.  She does everything very, very slowly now.  But the good news (yes, more good news!) is she is doing things!  She gets up with help and attends to personal needs; she eats and drinks and smiles with recognition when we arrive to visit.

Other good news according to Dr. S is that she understands us (and the doctors and nurses).  That makes things a lot easier because she responds to simple instructions and can answer simple questions correctly (Where are you? What day is it?).  If she was having trouble understanding us it would make her recovery more complicated.  However, she is also experiencing what the doctor referred to as a “word salad”.  All her words might still be there but they’re mixed up together and she has difficulty finding the ones she wants to use.  You can imagine her frustration.

I don’t know how to sum this up or sign off or bring it to a close.  There is a good possibility she can recover and have a few more years of a full life.  For the family’s sake I’d like to see that happen.  On the other hand, how many more of these incidents will she have to endure before she goes to be with Dad?  And how much worse will they get?  The doctor said very clearly that they cannot stop a recurrence, only try to slow down the arterial blockage and find ways to get blood flow to the damaged areas.  I dread watching her fail bit by bit.  More, I dread watching JD watch that.  I wish there was some way to spare the family that experience.