Tuesday, October 16, 2012

Chronicle of a Stroke, Month 2

From Jenny Sue Got Married, originally posted on March 5, 2011. 

My hubby is home!!! He came home on February 17, a full 6 weeks and 1 day after his stroke. Yep, 6 whole weeks in the hospital - 5 of them in inpatient rehab. It's been fabulous to have him home, but a challenge as well. This is some of the equipment that came home with him: a wheelchair (obviously), KAFO: Knee-ankle-foot orthosis,  small-base quad cane, a gait belt, a night splint. 

As you can see, we have a lot of equipment to work with. Al worked hard for the 5 weeks in inpatient rehab, but he still needs some help with the basics. The wheelchair has an obvious purpose, but Al doesn't really use it unless we go any place where he has to take more than about 20 steps. Although his left leg is getting stronger and he is gaining more movement all the time, he requires the KAFO to stand and walk so that his knee doesn't buckle. It's a pretty high-tech device, though, since it has a lock to click it into place as he straightens his leg, but it also has enough "give" to let his knee bend enough to take a step as he learns to walk better. When he stands up, there is a click-click-click, kind of like a Barbie doll leg (or maybe Ken is a better comparison). Along with the KAFO, he is using the quad cane to balance and walk. During inpatient therapy, he was re-taught the painstaking stages of walking, except with 3 steps instead of the original 2. Move the cane forward, take a step with the left leg, and then a step with his right foot, making sure the right leg lands ahead of the left leg, otherwise the process results in the "wedding walk". Oh yeah, and the gait belt. I have to fasten it around his waist so that I have something to hold on to in order to help him keep his balance. So, being an overly-cautious wife, I'm sure that I drove my husband a little bit crazy during the first week, reminding him with every step to be careful and to keep his balance and to remember to try to bend his left knee, and to try to be sure to stand up straight, etc., etc., etc. Now I'm starting to relax a little bit and let him walk alone more often, although the physical therapists haven't officially given us the go-ahead to do that. I try to make sure his path is clear with every step, and I often keep at a close distance so that I can grab his belt if he starts to sway.

At night, he wears the night splint, which keeps his foot from "dropping" - in other words, his foot and ankle have to kept at a 90-degree angle or else it will be extremely difficult for him to stretch back into that position in the morning, which can cause obvious problems with standing and walking. So every night, I have to squeeze his foot and ankle into that uncomfortable thing, and it is fastened VERY tightly so that his foot doesn't move during the night. In the morning, we doff the night splint and don the KAFO, which requires some degree of coordination on both our parts.

This, in addition to the help he still needs with everyday self-care tasks, makes our morning and evening routine longer than it ever was before. But we're getting the hang of it. And this is only what we use for the bottom half! Al will still go to regular physical therapy, as well as speech therapy and occupational therapy, which will focus more on his upper body and hand/arm usage.

As of right now, Al still has very little use of his left arm, with no small motor control at all. He can shrug his shoulders a bit, but the OT's continue to encourage us that the use of his arm will gradually return, and it usually does return with large motor movements first, and then the fine motor skills follow. Speech therapy will have him focus on speaking more clearly as well as using more intonation, which he seems to have lost during the stroke. ST also regularly assesses his cognitive skills, which are still very much intact.

I cannot tell you how grateful I am that my husband is still mentally present, even though he is working hard at getting the rest of his body restored. He does have some trouble with short-term memory loss, but again, that should be recovered with time and practice. I've done a pretty poor job of blogging during this time, although I've stored away many, many details to write about at some later date.

So, this is a very brief update for all that we've been through for the past 2 months. So glad you're still reading!

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