Tuesday, December 30, 2008

Sensory inventory III




The skin is collectively considered the largest organ of the human body. Human skin reaches the extremes of sensitivity at locations such as the fingertips, and sensitivity to certain hairs of the skin can be exquisitely fine, unto detecting the most delicate whisper of breath passing over.

One of the early effects of first stroke that I did not recognize was a loss of feeling in certain areas where I was formerly accustomed to some sensory input. Particularly in my lower legs.

At the time we were cutting heavy pieces of firewood, I was dropping the occasional piece and barking my shins and lower legs. It didn't hurt at all, so I ignored the incidents. Gradually, my legs became a mass of bloody abrasions and blackened bruises that even I could no longer shrug off.

On reflection, I realize now that I felt no pain because my nerves are no longer signalling properly to my brain. I used to hear the saying, "No brain, no pain". Now I get a first-hand lesson every day.

Or perhaps should I say, first leg?

Monday, December 29, 2008

Snow fun



Patricia's comments remind me that I can still have some fun in the snow, amidst all the serious and somber business.

I am busy getting the little snow plow stuck in the snow drifts and windrows at various locations throughout the valley. Although I cannot safely range too far, I can venture out a ways. Plunging through deep snow is always a thrill -- even from the back of this mechanical camel.

Preparation for being comfortable in colder weather is as much a frame of mind as it is a set of clothing. I have been with scout kids that had a terrific time in spite of their poor dress -- just because they were so thrilled by the incredible environment that they forgot to get cold. Make no mistake. There is no substitute for proper garments, when dressing for the cold. But I have seen energy and enthusiasm make up for a lot.

Winter acclimation also helps one adapt. The sense of discomfort diminishes gradually. Greater comfort with a certain level of exposure can gradually be tolerated, until the body adapts to a relative comfort level.

It is always surprising to realize this, up close and personal, when visiting someplace like San Diego during the winter. The residents are shivering in their down jackets, while the snow people are sweating in tee shirts.

Friday, December 26, 2008

Ever More!


Lots more snow in Snail Hollow over the Christmas holiday. Almost a foot fell in the last storm, but most of it blew away in gusty winds. It was very windy overnight.

We are stuck with big piles of snow all around the driveway. Running out of places to push it where it will be out of the way.

Then there is the path to the kennel.

The dog, Copper, is consigned to lockup after he was caught proudly dragging home the neighbor's dead chicken. We need to maintain the path to access his kennel now, to bring food and water. The snow is very deep. It is a problem that I am not quite ready to deal with, because I am too clumsy to slog through the deep snow without falling. And it is far too difficult for my old mother to handle. Oh well. We'll figure out something.

I missed my PT session Wednesday because we got stuck in Christmas traffic in Provo. The place is a madhouse -- I'm glad we don't go there too often. The clinic is closed today for the holiday. Will resume workouts next week.

Darkness


It gets very dark here when the electricity goes off. Everyone was searching in their kitchen drawers for candles and matches.

I can't stand up very well in the darkness. I keep a flashlight handy at all times. My frequent night trips to the bathroom are made a bit more of an adventure by the dark and the cold, not to mention the fact that water becomes a limited commodity when there is no electricity to power the jet pump in the deep well. So, we make do with what we have.

My bedroom is heated with electricity, so I moved into the house this morning, where there is a wood burning stove. We kept warm, and listened to Handel's Messiah while the batteries lasted on my notebook. The electric service was restored at about 10 this morning, after around twelve hours of blackness.

Tuesday, December 23, 2008

White Christmas!


Lots of new snow falling in this locale.

Mammoth-Cottonwood is the nearest official measuring station, near the top of Fairview Canyon. It reflects about how much snow is on the ground now at Snail Hollow, although I believe our drifted accumulation is a bit more.

I have had plenty of work clearing off driveways and walkways. The new ATV mounted plow has had a pretty good trial, and passed with flying colors.

I can manage most of the functions of operating the ATV pretty well. I have trouble with the transmission shifter at times, but can manhandle it with both hands, when needed. Sometimes the plow blade is difficult to swivel, but I have managed to minimize that operation, after encountering some bit of trouble with it. All in all, a very satisfying operation that went quite smoothly. I was even able to help extricate a stuck vehicle, after some bit of work.

Let it snow!

Saturday, December 20, 2008

Sensory inventory II

I am still in the process of discovery with this curious roadmap that is the somewhat impaired sensory input from different parts of my body.

I noted earlier that regions of my belly seemed rather insensitive to the injections they were giving me at the hospital. I am sure it spoiled the fun for some of the nurses. In any case, I was noticing odd lack of feeling there this morning in the shower too. I had opportunity to explore my new tactile sense, or lack thereof. I note that my stomach has the sensation of a leather jacket. I can feel pressure when I touch the skin with some object, such as my bar of soap. But it feels insular, detached in some strange way. I have determined that my skin is no longer sensitive to direct touch, but still has some deeper nerves that are functioning. So It is very much like wearing a leather shirt. I can still feel pressure, but rather indirectly.

This is a curious effect.

I have noted in this cold weather that many parts of my body which used to grow increasingly uncomfortable with prolonged exposure are not sensitive to very cold temperature any more. I suppose this might be an advantage or disadvantage. On the one hand, I count on the comfort level to sense whether exposure is leaving my body with lower reserves. With less of a sense, I think the cold may present more of an unperceived hazard. On the other hand, I don't need to fret as much about discomfort from the cold weather.

Now all I need is to get myself fit enough to get out in the snow and enjoy it!

Thursday, December 18, 2008

Migraine weirdness



I have been having a weird migraine day

All day, feeling strange. Bright colored spots dart across my field of vision, then quickly disappear. Tonight most of my vision is obscured by a blind spot, but am typing around the edges.

It is outlined with sparkling colors rotating in a wheel, sorta like the picture above. It is blocking off most of my central field of vision, but I can still see around the sides of it.

I don't seem to have a headache with this 'aura' anymore, but my stomach feels queasy, and I feel very uneasy. I don't like noise or lights. Best thing has been to go to sleep, if I can. It usually passes while I am asleep.

Wednesday, December 17, 2008

Rehab progress 30

Physical therapy turns out to be just plain hard work.

I don't know that I expect anything different. I have been through it all once before. But I guess the reality of it all is always a bit discouraging, especially to know that I am covering the same ground again.

Today I pedalled the bike for more than two miles in ten minutes, and I was able to run the treadmill for more than a half-mile. This is about halfway toward the mark I was setting for myself before the last stroke.

If I can sustain a pace of constant and consistent improvement in performance, I may be up to par again before the winter is over. I'm not sure I can build up enough stamina in time to get out on the snowshoes while there is still some deep snow on the skyline, but it is something to work for.

Tomorrow is another day.

Bell's palsy


I had an episode with Bell's palsy a number of years ago, but I do not believe it has any connection with stroke. I just mention it to illustrate what weird afflictions i have suffered in the past.

Bell's palsy is a partial paralysis of one side of the face, characterized by loss of motor control of one side of the mouth, and one eye lid. Swelling and inflammation of the seventh cranial nerve, where it passes through a small aperture in the face of the skull, is thought to cause this paralysis. The restriction due to swelling where the nerve passes through the small opening results in impaired circulation, which causes paralysis of the nerves which connect these facial muscles. The overall effect is a face that is droopy and flaccid on one side. The most serious and painful consequence for me was loss of control over my left eye. I could not move the eye lid, except by manually opening or closing it with my fingers. Lack of ability to blink also left the eyeball dry and irritated much of the time. I resorted to wearing a sinister-looking eye patch.

Fortunately, Bell's palsy proved to be a short-lived temporary condition. After a frenzied trip to the emergency room with complaints about the paralysis, the doctor laughed at my rueful expression and diagnosed "droopy face". He gave a prescription for anti-inflammatory steroids, and sent me home. The paralysis cleared up and symptoms gradually disappeared over a few weeks.

I only wish the current affliction was so ephemeral.

Tuesday, December 16, 2008

Sensory inventory



I have related something about compromised sensing of balance and equilibrium. I wobble when I walk.

Other body senses also seem less active than only a short time ago. I have noticed, in this colder weather, that my sense of temperatures at the skin is somewhat diminished for certain parts of my body. My legs, especially. I can stand out in the cold wind, freezing my hands and ears and my face, but my legs fell no chill. In the shower, I sense the heat deeper within my body apparently, but have less sense of the heat directly on my skin. This is a curious effect, with consequences unforeseen, as yet.

Yesterday, at the neurologist, my dad asked him about this sensory deficit, and if I am likely to regain some of this functionality, or if it is gone forever, like his peripheral neuropathy effects. The neurologist shrugged and replied, he did not know.

That seems to be the nature of so much about this little adventure. I am charting a lot of unmapped and unknown territory. Who can say what there is to discover? Who knows what is possible, and what is not?

I will find out for myself.

Saturday, December 13, 2008

Rehab progress 29


It is with the greatest relief that I note the passage of two headache-free days, for the first time since July. Finally, something that seems to work at stopping the awful pain.

After my doctors told me I was risking potential adverse side-effects from other pain relievers, I declined to use NSAIDs any longer. I was taking dangerously large overdoses seeking to get rid of headaches, and it wasn't working anyway. The neurologist finally prescribed a drug that was developed for migraine relief. It seems to do the job. I am very pleased. The medical community finally comes through with something that actually works for me!

Friday, December 12, 2008

Walking notes



Just the simple act of standing up and walking has assumed a somewhat tentative, dubious nature for me. After the most recent stroke, I notice a deficit of natural balance, standing and walking.

Walking doesn't quite seem so spontaneous. I am noting that the beginning motion basically consists of falling, just slightly forward or back. This shifts the center of gravity, and starts a natural rhythm of alternating the feet in sequence to keep on balance.

Well, I am not performing this little dance quite as spontaneously as I would like it to be, these days. The biggest problem I encounter seems to result from a diminished sense of orientation. I cannot tell when my body is inclined to start falling forward, or back, until I actually start moving. It doesn't feel like anything. But I can see when things start to move. (With my eyes shut, I am helplessly lost, and I fall almost immediately, even trying to stay stationary.)

So, often my first step moves my feet, but my upper body is not leaning the right way in anticipation, and I start to fall. Most often, I tip over backwards.

I have usually been able to recover quickly. I guess I have had enough practice, by now. But it is with an uneasy lack of confidence that I navigate, now, carefully. And with excruciating slow pace.

My associates with the Forest Service were often impatient with me because they thought I hiked too slow. They ought to see me now!

Thursday, December 11, 2008

Rehab progress 28


Back to the treadmill today. Nothing remarkable, except that I tire so quickly, and can only go half the distance I was making easily a few weeks ago.

More slow progress ahead.

Wednesday, December 10, 2008

Frustration

I cannot communicate with doctors. The frustration is driving me nuts. No, wait -- I was already nuts.

Oh, yeah, I remember now. Maybe my history with pshrinks hurts my credibility a bit.

Oh, ya think?

Anyway, after a very nice visit, the doctor suggested that I need to be doped up with drugs, to help me cope. He wrote me a band-aid prescription for anti-depressants. Oh, joy. How absolutely pleasant.

Tuesday, December 09, 2008

Never Give Up


I have always laughed at this silly poster. I have been seeing it for years. Isn't it great?

I don't want to give a wrong impression, to any readers. I will never give up, when there is any hope, or anything left.

Never give up.

Rethinking Unhappiness



I was wrong.

I stated something that was wrong, and I'm sorry.

I can see that others share some of my unhappiness. That makes me feel worse about it all.

I wish there was some way I could stop it from happening. But it looks almost like a natural consequence now, like a storm, or the changing tide, or something like that.

If I could say, don't worry, and mean it, I would. But it probably doesn't matter much any more. The course is set. What will come. will come. If that makes people unhappy, I apologize, but that changes nothing.

I don't know any more answers to all the troubling questions. Seems like I just get more confused.

Finding the way, best I can...

Sunday, December 07, 2008

Failure


There must be easier ways to fail.

Keep trying...

Friday, December 05, 2008

Visiting my Doctor

Isn't that just a marvelous logo? It seems to promise such wonderful, blessed relief, from all that ails us. Just imagine -- "Healing for life".

Now I apologize in advance. Both for the laboriousness and length of this missive, as well as the quality of the content. Cannot be helped.

Of all recent events memorable, the one thing I seem to find to be exclusively a deplorable experience is the doctor visits. I cannot put my finger on exactly the explanation for these bad experiences -- I am certain that it is my own sad deficiency, and no fault of the doctor. In any case, it has been years since I had an active confrontation with any doctors. The men I have dealt with lately are of mild temperament and pleasant personality. My only specific gripe has been over several personal clashes with members of the attending nursing staff, but that is another long tale, one that I have detailed in other posts.

I have in mind to inventory some specific details about what currently is bothering, from my own perspective. Doctors seldom take the time to get this story, and they always seem in a rush for the next appointment. As a result, when I finish a visit, I often find myself standing there with another half-finished thought on my tongue while I am watching the back of the doctor walking away. This is particularly frustrating to me right now, as I struggle to speak at anything like a normal pace, trying to articulate something that I understand so poorly in the first place.

The first event I would like to describe in detail is my initial stroke experience. I was swinging a heavy wood maul at the moment, in spite of getting up from bed feeling ill. I remember thinking at the time that I might feel better if I just did some kind of work. Then, within a moment's time, I felt something that seemed like mounting tremendous pressure inside my head, accompanied by a loud rushing noise, like waves crashing on the seashore, sounding in my ears. The pain and pressure I might have found comparable to instances where I incurred a very solid blow on the head from an overhanging tree branch, but it was obviously coming from inside my head. The noise in my ears was obviously not a sound coming from the environment around me, but to me, sounded as loud as the nearby roar of jet engine exhaust, or some other loud blasting noise, resounding in my ears. The sensation and the noise reached a crescendo together, then diminished suddenly, but left a loud ringing in my ears. At that moment I was struck by sudden weakness and instability, and felt that I was fainting. I had gray spots beginning to obscure my peripheral vision. Although I was no longer thinking very clearly, it came to me that I wanted to sit down in the shade, and rest. As I dropped the implement I was holding, I tried to make my way across the driveway to the house, where my dad was sitting on the porch. I wobbled precariously like a drunk, and as I sat down on the porch, tried to explain to my dad that I "felt like my legs came all unhinged", but I don't think my mumblings were very coherent. After resting in the shade for several minutes, I felt somewhat recovered, and noticed no severe persisting ill effects. We went to dinner in Mount Pleasant a short time thereafter, and though I continued with a generally unsettled feeling, I noted no pronounced weakness or other physical impairments at the time.

The following morning, I woke up to discover partial paralysis on my right side, both in my arm, and leg. A stroke was immediately the suspicion. My leg was still sufficiently mobile that I could move myself, albeit with some difficulty, and my dad and mom ushered me into the car and drove me to the hospital.

In the second incident, I was injured falling down in my bathroom, getting out of the shower. Suffice it to mention that I suffered a broken coccyx, which continues to provide an uncomfortable and sometimes painful reminder of my precarious lack of balance and equilibrium.

In the third incident, I was again injured in a falling accident, this time resulting in some strained ligaments in my rib cage. The occasional discomfort from this injury has eased somewhat.

Fourth, I have experienced almost continuously since the July stroke, a low-grade headache, with some accompanying migraine-like phenomena. I have experienced occasional migraines throughout my life, since earliest memory. At about the age of thirty-five or forty, I quit experiencing the shatteringly severe headaches, but still had irregular bouts with characteristic migraine aura -- scintillating scotoma, paresthesia in mouth, lips, hands, arms, legs, and feet. And other weirdness I associated with the migraine experience. I grew somewhat accustomed to these experiences, enough so that I seldom mentioned them or complained about them, but worked out my own methods for coping.

Anyway, I have suffered from something very similar to this migraine experience, continually, since July. It is not the same thing as migraine, since that always seemed to be a fairly short-term experience, but this condition seems to be chronic. The aura-like experience comes and goes. The headache with accompanying nausea vary greatly in intensity, but never quite go away completely. Ringing ears of varying degrees of volume also accompany the headaches.

I complained to everyone who asked about how I was feeling since last July, but doctors and therapists generally offered no specific response, or recommended over-the-counter NSAIDs like Tylenol for managing the pain. Nothing has been effective at all for diminishing the headaches. Though the Tylenol was sometimes a relief from the other discomforts.

I also resorted to my mom's Tramadol prescription, from time to time. Although I could not discern that it did anything to diminish the intensity of severe headache pain, it did put me to sleep. I would generally note that the headache pain persisted on awakening.

The doctors at the rehab center seemed absolutely horrified when I told them I had been routinely self-medicating with huge quantities of extra-strength Tylenol. I said it mattered little to me, only to escape from the immediate pain, but admitted that the drugs were not providing any significant relief anyway. In concession to his concern about the drugs I was taking, I told Dr. Fyans to forget about administering any pain relievers, and concentrate exclusively on blood pressure control. I already had arrangements to visit a neurologist, so I supposed this was reasonable.

Anyway, the migraine-like symptoms continue, getting better or worse from day to day, but never completely disappearing. This in spite of the drug prescribed by the neurologist. He said the stuff takes some time to take effect. We'll see.

Let's see, a couple of other things to explain. The next is TIA. Transient Ischemic Attack. In the vernacular, a mini-stroke.

I have experienced many episodes similar to that which I first detailed, but varying in intensity and seemingly in severity.

These episodes do not seem typical for most stroke victims. Some of the nursing staff that I described these experiences to characterized them as "freaky". I only know what I experienced.

In one event while I was in the rehab center, my blood pressure was monitored while I experienced a series of what I interpreted as TIAs. Blood pressure readings of well over the 200/180 mark, for some time. A series of repeated episodes where the pounding pressure mounted to seemingly explosive levels. Unbelievable headache pain, well beyond anything I ever experienced before. Accompanied by the loud rushing noise sounding in my ears. During this series of events, I complained of feeling very nauseous, and felt like I was going to faint. The nurse attending was apparently somewhat alarmed, because he kept yelling at me to tell him if I remembered where I was, and what my name was, and such. I think this went on for several minutes with me in semi-lucid state. I remember thinking that there seemed to be a lot of people running around me, making a big fuss, but I was viewing it all from such a haze of pain that I didn't feel much concern -- I just wanted my head to stop hurting, and knew these guys had nothing to help that.

Anyway, that particular event subsided. I remember starting to weep and cry, it hurt so bad, and I told them I just wanted to stop hurting. Eventally I regained some relative lucidity, and my blood pressure dropped and stabilized. The headache pain gradually relented, but not as quickly as the blood pressure event.

I have become sensitized to these TIA events, and have been noting when they occur now. Periodically, I will experience a whole series of them in fairly close sequence, something on the order of one every five to fifteen manutes. This can go on for a number of hours throughout the day. The duration and severity vary widely, as does the frequency.

I cannot think of anything else to say in describing these events, except that nobody else seemed to have ever heard of such a thing. Perhaps I am just hallucinating. But this is what I am experiencing.

One other matter. I need medical attention for the skin growth on the center of my back. It is beyond my ability to see easily, but I know it feels irritated when I turn in the bed now, so it appears not to be healing properly.

Next installment:  My Hospital Experience

Deer in the Headlights





















An apt phrase comes to mind, "Deer in the Headlights". Suggested by musing reflection on Patricia, commenting in passing about the hazards of traveling to Cortez.

The deer abiding peacefully along roadsides give evidence that they have little respect for highway traffic, or any awareness of the potential mayhem it portends, for any unfortunate beast that blunders into the flow of traffic. Of course. we may not ever see those creatures who have been properly schooled, and keep their distance. Those who failed to learn are often enough seen at the roadside, searching for that most dangerous bit of browse -- or whatever it is that motivates them to gravitate toward roadside areas and crossings.

I pause to consider this phrase, and how aptly it characterizes one who suddenly realizes, too late, how very short the future may be. As the headlight beam so suddenly casts its shockingly bright light on the moment of looming crises, the unsuspecting creature raises his head in alarm. In that harsh glare of the moment, no time to react. Not enough warning. Yet, all indications of the impending doom were there beforehand, clearly evidenced, and in plain sight. All that was needed was some wisdom in just exercising a bit of foresight to avert certain disaster and destruction. Just a simple bit of action, at the proper moment, and all would have been well. Instead, all warning signs were overlooked or ignored. And we probably will get another messy roadkill. Yuck!

I was reflecting on my own circumstances the other day, in conversation with one who was discussing the implications of the church's official and practical stance toward same-sex marriage, and the perceived degree of antipathy toward that erstwhile practice. My thoughts were that I felt rather like the disposition that the Mormon prophet-warrior described in his troops, when he discerned that they realized that they were facing inevitable defeat and destruction. Mormon described the fighting men as being filled with remorse that they were defeated, sorrowful for their loss, but not repenting of the mistakes that brought them down. In other words, there was nothing productive or particularly of any benefit about such angst -- it came too late to do anything about it, except grit teeth and prepare for a very rude shock.

So it seems, in my case. I am only holding on to a dim hope that I might survive this lesson long enough to get a bit of practical use from it, before the speeding car slams me down.

Wednesday, December 03, 2008

Credit Union hijinks








Yesterday, pursuant to my recent resolution to change financial institutions that I do business with, I went to the small branch of the credit union, in the Springville Walmart store, to make a very large cash withdrawal. To my embarrassment, they indicated that all my funds are "on hold" for two weeks. The clerk gave me permission to withdraw up to $100. I was requesting many times that amount, covered by cash deposits that I had assumed were immediately available for my access. Somewhat chagrined, I walked away, shaking my head. Apparently, the credit union has free use of these funds, to do with as they see fit, for up to two weeks. In the mean time, I am locked out from using the money.

I do not understand why I keep running into problems such as this. It makes me feel like giving up any relations with financial institutions altogether.

Note that a bit later, the teller phoned me at my home to inform me that she had negotiated clearing the hold on my funds. It was too late for me to do anything about it -- I have to depend on others to provide transportation for me now, at their convenience, and I had already departed from that locale, to my home more than 30 miles away. In her defense, the teller knew nothing about this -- she was just doing her job.

I do appreciate the effort. It just turns out to be a useless gesture. If the credit union administration could have worked this glitch out with a bit more alacrity, it would have spared me substantial angst and mental anguish.

Oh, well. I guess that's what life's all about. *SIGH*

Tuesday, December 02, 2008

Rehab progress 27


I visited the rehab center in Mount Pleasant again today.

Starting over.

It was rather a bleak experience.

With the physical therapist, I reviewed the program and planned out our rehab efforts for the future. While we were discussing it, Ben, the therapist, mentioned that he'd heard on the news about the passing of Elder Wirthlin the night before. He suggested that Elder Wirthlin's recent conference address would make a good theme for my efforts, "Come What May, and Love It".

In spite of some serious misgivings, I went through the therapy workout. I can't say I have as good an attitude as Elder Wirthlin had about life, but I am trying.

I proved that I have some new challenges to work on. Ben said his evaluation indicates I could benefit from more upper-body development, so that dimension is added to the workout regimen. In addition, I renewed my general complaint about mileage on the treadmill, but I can't walk across the room without the threat of falling down. More true than ever.

All in all, lots of work faces me. Easier to give in to the brain damage and depression. I'm determined to get out of the bed, and do the work. As Elder Wirthlin counseled, I will keep trying to look forward to "Come What May, and Love It".