Friday, August 25, 2006

Progress

Hail,
And thanks for all the well-wishes, too.

Sarah says it's okay to talk about this here, so here goes.

What happened is her dad (tall, grey-haired, Nordic-eyed, one of the three or four smartest people I know) and mother (dark-haired, walks with a frame, one of the other smartest people I know) were on an aeroplane to England when Stewart lost consciousness and slumped over in his seat. Anne raised the alarm (after first smacking him in the chest in case he was having a heart attack, the famed 'precordial thump' you see on some tv shows).

Said alarm was raised and there was a doctor and two nurses on board and those in charge turned the plane around. Apparently Qantas was wonderful. Unfortunately they were over ninety minutes away from the nearest city, so by the time everything had happened (landed in the dead of night, ambulance waiting, whisked off to that city's version of the Royal, called, surprisingly, the Royal, scanned) he was just outside the three hour time limit for safe maximal therapy*.

At this stage I don't know if he was lucid or not, but he could not move or feel his left side at all. When he woke (possibly that night) he was able to understand and be understood

And over the next few days he has gradually improved. All eight hundred IQ points seem be intact, which is good. He can speak, he can understand and be understood. He can feel strange, slight, odd sensations on his left side, and can now feel when someone is touching him, and discriminate between a single touch and two simultaneous touches. He can make a fist and yesterday he could move his left leg a little.

He can see no reason why he should not recover sufficiently to be able to drive his wife around again. And as far as I can tell, this is not one of the artificial good moods, not that belle indifference that psychiatric patients get but whatever the neurological correlate is. I saw a guy with this once, this doesn't sound like that. He sounds exactly like himself.

Soon they will try to sit him in a chair.

It seems odd to sound so cheerful about this, but there are a number of things that could have got worse, and none of them have. This three thousand miles away medicine is so frustrating.

Stewart is startlingly chirpy about this, I have heard him laughing in the background when I have called. I suppose there are a number of possible reasons for this. He is of the generation and the stock that do not complain when things are bad. I suspect foremost in his mind are thoughts of gratitude that he is still able to communicate, that his mind has not been affected, and that he has not, to his reckoning, been reduced to something that needs caring for. His dignity is intact.

And I suspect that the way he sees it, he is still the principle carer for his crippled wife, and it is therefore unthinkable that he should be unwell and more unthinkable that he should display any sign of being so.

Meanwhile, the family have gathered from the corners of the globe to be with him, filling the house. Sarah is translating from the medical whenever the neurologist descends from on high (although, she says, with some difficulty). If, like law and science, medicine is another language, then neurology is a particularly obscure dialect, High Old Eastern Basque or something, a tongue scattered with bizzare diacritical marks and inverted asterisks, with seventeen genders for furniture alone.

Anyway - when we first heard about it (close to one in the morning, three thousand miles away) all we knew was loss of consciousness and one-sided paralysis. We guessed (wrongly) where the stroke was, and worried he'd never be able to speak again, or would lose the ability to read. For someone like Stewart, that would be a grave loss. And when we found out where the stroke was (the brainstem, the bit where your spinal cord sticks onto your brain) we realised again how horribly bad things could have been.

Blindness. Incontinence. Inability to swallow or to taste. A life-long burning pain over the half of the body on the opposite side of the stroke. At worst, locked in syndrome, awake and aware but only able to blink. Eternal coma or death.

And there's still a sizeable chance that any of those things could manifest, that things could worsen in the next few days, but I think that chance gets less as every day passes.

And he doesn't have pain, or mutism, or intractable, life-long vomiting. He can see, he can swallow, he can speak.

He is talking about playing soccer in the hallways when he gets out. Things could have been so much worse.

Anyway, I am due on at Florey in an hour. I must shave, shower and somehow fill my head with all the stuff that has left it in the last few months. Further information as it comes to hand.

Thanks for listening,
John

* they inject some clot-busting stuff into the affected area, like with the heart after a heart attack. This is a relatively simple decision with the heart, because hearts are simple, but brains are less so. Anyway, after three hours, the risks of injecting the clotbusting stuff outweigh the benefits, so they don't do it.

Interesting news in this weeks New Scientist, too, on very early stage research that may lead to treatments for Alzheimers and for type two diabetes. One of the future posts will be about the Spike.

3 Comments:

Blogger Niamh Sage said...

Thank the gods. I am SO relieved. I hope that he continues to improve and is safely back at home soon.

Thanks for the update, much appreciated.

*millions of hogs*

Camilla

6:03 PM  
Blogger lauritajuanitasanchez said...

Wow! He IS lucky! Brainstem strokes heal relatively quickly, from what I remember (I'm a speech therapist, but it's been a while since I've worked in a hospital setting). By "heal", I mean, any loss of skill seems to re-gain function (maybe with continued limitations) more quickly than had it happened in the cortex.

It did sound like a right brain stroke...I wonder if there will be any other characteristics of right brain injury? I'd check with the hospital team about things like visual integration and left neglect before putting him behind the wheel of a car!

Well...I'm glad to hear he's OK. Thanks for posting.

9:01 PM  
Blogger Juanita J. Sanchez said...

What a relief. Hooray for good news!

3:10 AM  

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