Friday, December 9, 2011

The patience of Job

I trained to Wauchope last Sunday afternoon, and returned to Sydney last Tuesday night. My younger brother, Ross, and his wife, Robyn, drove there from Newcastle this afternoon and return tomorrow afternoon. I go up there again this coming Thursday and Friday. Each trip costs me about$150. I want to continue to go up there each fortnight for a while longer yet.

When we were shown the results of the CT Scan on Baz in at Port Macquarie Base Hospital, the geriatrician said that many/most people who have a stroke of this severity will usually have another stroke within three months, unless the underlying problem can be treated. Barry's underlying problem is that he has an atrial flutter which is flinging clots around his body. This needs to be treated with Warfarin or, at the very least, aspirin. However, there are complications. Not only did Baz have a subacute infarct in his left temporal and occipital lobe, and a smaller subacute infarct in the cortex of his posterior right occiptal lobe, but he also had an acute haemorrhage in the inferior posterior left temporal lobe. The infact measures 11cm from back to front, and the haemorrhage is 5x4x3 cms. There has now been a followup scan, and the haemorrhage has receded minutely. Unless this haemorrhage goes, there can be no treatment with warfarin. Therefore, he is likely to have another stroke.

I have not told Barry this. However, he complained to me that the back of his head hurt and his brow. There was a sizeable indentation in his head - above the haemorrhage. And across his brow appeared to have 'bubbled'. I asked the attending physician at WDH who said this was all the swelling due to the haemorrhage and it was something Barry simply had to cope with. It is when the pain becomes suddenly sharp that they know Barry is in real strife. This cannot be masked.

Barry cannot read, and he cannot do Sodoku. He cannot watch television. However, he was playing Bingo when Ross arrived this afternoon. He calls Ross 'his brother' and he calls me 'his sister'. He can tell the time because he was anxious when I arrived on Tuesday at 10:03am. The rehab unit said that some of these smaller skills may flow in and out. I tried to browbeat him into getting into his pyjamas to go to bed each evening, and to put on casual clothing for the daylight hours. I will ask the nursing staff how this is going. I am sure they have to remind him. He is now going to the toilet approrpriately, rather than using drawers or waste paper bins.

I am very pleased with the nursing home up there. Bundaleer. It appears to be very well staffed, with an adequate number of RNs to aides and cleaners. They were very kind to me, like family in many respects. I need to check just who the visiting GP is - Dr G or Dr K. I have also spoken with the private speech pathologist who will include Baz in her weekly rounds. Now to get on with the application ot the Guardianship Tribunal for the powers to oversee the financial and medical decisions that I am making. I asked Barry for permission to do this. Not sure whether I got it or not. But at least I tried to tell him, which is my legal obligation.

Ross and Robyn are doing massive amounts of work on Barry's stock of leather belts which were all around his house. Probably with a market value of close to $10,000. They have three markets lined up to try to sell them all in the lead-up to Christmas.

I have paid a young lad, who also lives on the cooperative farm, to slash the jungle around Barry's house, and to bash down the bamboo. However, with all the rain this week, the paddocks are sodden and the creeks are flooded. I need to get out there to see the condition of the house and immediate paddock. With noone living there, the situation will deteriorate rapidly. I hope his dog, Free, has stayed with his 'new owner' and not done a homing-pigeon. I have not mentioned the farm, or the dog, or the truck to Barry. And, tellingly, he has not asked. It was only this afternoon that he asked Ross where he was and how long he was going to be there.


brattcat said...

i'd been wondering how barry was faring. thank you for this update. and these beautiful images.

diane b said...

A sad story. It is such a rotten task having to watch a loved one deteriorate and sort out their affairs. I feel for you.
It is sad that he wasn't treated with warfarin before the stroke. Bill was on it for 8 years because he has Atrial Fibrillation however now he takes a new drug out called Pradaxa which is a much safer drug. Maybe Baz could take that except it is expensive. Luckily Bill is on a special introductory program and he gets the drug free. GP's can organise that. It is still an anticoagulant and may not be suitable for his condition.

Julie said...

Thanks for that, Dianne. I will ask the GP when I see him next. Ross is on Warfarin and has been for a couple of years. One of the problems with Barry, is that he can not be trusted to go through the INR testing process, or even to take the tablets religiously. When he was hospitalised post-stroke, his Webster pak was all over the place, some taken, others not.

Joan Elizabeth said...

You are doing a great job of the story as it unfolds. You're a great sister.

Kay L. Davies said...

Oh, Julie, this sounded all too familiar while you were discussing the nursing home, remembering Mom and Dad, and then I almost cried about Free.
Not counting my husband, I'm the eldest in my immediate family since my parents died, and I hate the thought of something similar happening to me. I've named my youngest brother and my eldest niece in my will, but I really don't want to be a burden to them.
I'm also concerned about your health in all this running back and forth every two weeks. You've been through so much this year. Please take good care of yourself as well as of Barry.

freefalling said...

He's lucky to have a brother and sister to look out for him.
Does it distress you?
Or are you more pragmatic?
I remember you telling me once about your own "thing" - it just is.
(Something I'm just starting to grasp now at this middle stage of my life.)

"I tried to browbeat him into getting into his pyjamas to go to bed each evening" - made me laugh - it's such a sibling thing to say!
No one can brow beat us as well as our brothers and sisters.

Julie said...

You are both very sweet. However, without us, he has noone ...

Does it distress me? In some ways yes. We are putting in train a range of things based on Barry not recovering. What if he does recover? I am pragmatic, in that I have seen the scan and I have listened to the doctors and I have made a judgement based on that. Ross has made the exact opposite judgment based on the same input. How can that be? Rhetorical question ... I do TRY not to bash my head against the brick wall, ie to be pragmatic, to look at evidence. This time I think the issue I am having is that it is not just ME who is making the decisions and the assessments. I have to take others into account, who think differently. I am a bit of an autocrat I am afraid.

I wonder what the expression 'brow-beat' means ... well, where it came from ...