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Wednesday, February 27, 2013

Finally, A Diagnosis That Makes Sense

Bob's neck/head still stuck in this position....
When Bob was hospitalized, I met Dr. K., a neurologist, who had been sent to see Bob by the vascular surgeon. Dr. K. is  new in town and I had never met him before. We talked about the stroke and he asked me about Bob's neck problem.

Those of you who follow this blog know that Bob's neck suddenly tilted and became sort of "stuck" on his shoulder last spring. Immediately, I had taken him see his neurologist who told us that, unfortunately, the CIDP (chronic inflammatory demyelinating polyneuropathy) had become active again and there was nothing we could do about it except get a neck brace and do PT, i.e. neck stretching exercises.

I never did fully accept this doctor's diagnosis. As it didn't sense to me. It is true that when Bob had full blown CIDP, he could not hold his head up. Back then, his neck muscles were weak and his head dropped forward. He often wore a neck brace. But this is different. This is like his neck is "stuck" on his shoulder...  His muscles are tight and his head is tilted to the side. And wearing a neck brace is now too painful. Also, since the CIDP disappeared post-stroke, I have not seen any other evidence of this dread disease. There has been no "nerve tingling" pain or weak muscles on his unaffected side, which he had pre-stroke. In fact, his left arm is now very strong. Stronger than it ever was. And then there's this problem with Bob's toes on his unaffected side. Which have been curling inward and making it horribly difficult to practice walking. And the neurologist said that, too, was from CIDP. But Bob certainly didn't have a problem with his toes pre-stroke.
Bob's toes 

This is not the first time I've disagreed with Bob's neurologist. After the CIDP vanished, post-stroke, I did some reading about this phenomena and found that CIDP does often go into remission, and does sometimes completely disappear. No one knows why this happens but it does happen. Bob's neurologist and I argued about this. He told me that, in so many words, I was nuts. That CIDP will only become "quiet" but never totally go into remission and certainly it does not ever completely disappear. And Bob will have CIDP for the "rest of his life".

Since then, Bob has gotten a variety of different diagnoses on his neck problem. Everything from it's all my fault for keeping the head of his bed elevated too high at night to a brachial plexus injury. To the onset of scoliosis to a side effect from Lyrica. None of these, however, explained what's happening with Bob's toes. Also, nothing I have done, from neck stretching exercises to lowering the bed and repositioning him at night to taking him off Lyrica has seemed to help.

Then in walks a new neurologist, Dr. K. Who tells me that this neck/toe problem is most definitely not from CIDP.  That CIDP would cause the neck muscles to weaken, and Bob's muscles are not weak, but tight. He also says the magic words: CIDP does sometimes just go away and not come back.

At the hospital, Dr. K. gave me his business card. He told me that he'd like to look into Bob's case, do some tests and consult with another neurologist on his team.

We went to see Dr. K. on Monday. We met with both Dr. K. and another doctor on his team. The consensus of both neuro doctors is that Bob's neck and toe problem are both the result of "dystonia".  Dystonia happens when a certain portion of the brain is damaged from a stroke or other brain injury. Afterwards, that area of the brain attempts to heal itself and somehow, in the healing process, the "wires get crossed" and that's when muscles spasm and contract and "get stuck".

And that explains why these symptoms didn't show up until a year or more post-stroke.

Bad news is there is no known cure for dystonia.

Good news is there is treatment.

The best and usual treatment for dystonia is botox injections in the affected muscles followed by physical therapy. Botox is said to paralyze the tightened muscles, thus loosening them up. The problem with botox injections in the neck is that they have been known to also paralyze the larnyx. Doctors said there was about a 20% chance of this happening in the "average" population and of course Bob is nowhere near "average".  If this happened, it would exacerbate Bob's swallowing problems and make him even higher risk of aspiration. He may, in fact, choke on his own saliva. It would also make it even harder for him to speak. Then, because of the warfarin issue, a "hematoma" could form at the injection site.  Both doctors told me to "think about it", weigh the pro's and con's, risks vs. benefits, as Botox is the best treatment available and usually works and any bad side effects would disappear in 3 months or so. But I don't know, all of this sounds risky and scary to me.... so I'm not sure if this is the way to go.

Bob's regular neurologist had previously told me that botox to the neck could be "fatal" to someone on warfarin and so I asked these new doctors what they thought, but they said it would not be "fatal" but might cause a hematoma which would "uncomfortable" and the biggest issue is the swallowing concerns....

So I am really not sure what to do. Lord, I hate making decisions like this.

There was also talk about two different medications we could try. One a very slow acting oral medication that "might" help. The other being some kind of "intrathecal" medicine--which the doctors want to do some more research on, i.e. see if it would be safe in Bob's case.

Right now, the thought was not to do anything drastic until Bob completely recovers from lung pleurisy.

We did leave with a prescription for Zanaflex, a stronger muscle relaxant than the Baclofen that Bob has been taking.  I am supposed to start him on a very low dose and see how he responds before increasing it.

We see Dr. K. again in a month.

Oh, and I asked Dr. K., before we left, "How would we know if the CIDP had returned?" And he said, the first sign would be overall muscle weakness and pain.

I tell you, my Bob has one darn strong left arm and hand. So I really doubt the CIDP has returned. And I am thinking that we finally found a doctor who actually knows what he's talking about....

Friday, February 22, 2013

Mastering The Condom Catheter (Well, sort of...)

Earlier this month, I took Bob to see the urologist because his overactive/neurogenic bladder symptoms had worsened. Suddenly, Bob is peeing every 15 minutes or so. And this is problematic, to say the least, especially if we are not at home. This problem was also keeping poor Bob up all night long.

So I tell the urologist all of this plus the fact that he's only peeing about a "thimble full" at a time. The urologist gets out the big scope that they use to look inside a bladder. The minute he inserts the scope, Bob starts to pee. I mean, really pee. Pee is shooting up, around that scope, like a fountain.

And this is not a "thimble full" but seems to be the entire contents of Bob's bladder. And there's nothing protecting Bob, his clothes or the wheelchair except a little blue "chuck" that the nurse had laid over Bob's lap.  Now, the chuck is getting soaked, Bob is getting soaked, his pants and wheelchair cushions all soaked.... in fact, the urologist himself is getting a bit soaked.

The urologist doesn't seem to even mind, he just says, "Hey, look! He's peeing!" He says this as if he's absolutely delighted about this shower of pee. Then he adds, "And it smells really, really good!"

Okey dokey. Though this does make me wonder just what kind of doctor would want to devote his entire career to working with pee....

The urologist tells us that Bob's bladder "looks good", there's no obstructions though the prostate is a bit enlarged, but not so much as to cause a worry, and the only thing he can see is that Bob's bladder has a "decreased capacity" from the last exam, meaning it's shrunk....

We leave the urologist's office soaked with pee and armed with a new medication and a prescription for condom catheters and a referral for a home health nurse to "teach me" how to use them.

Now, I have long resisted such a thing as condom catheters. Mainly, because I've always thought that if Bob's brain is ever going to rewire and control his bladder, he needs to actually try to control his bladder. But after more than two years dealing with this, I finally gave in. I mean, I am really tired of spending all our time in the men's room whenever we go out. And it's not only that, but every time he has to urinate it's a BIG emergency. It becomes a mad, frantic dash to the nearest bathroom with Bob practically in tears and me, pretty much killing myself trying to get him there in time. So my idea was to get some external condom catheters to use when we go out, and maybe we could actually go out a little more. You know, do something fun? And also for at night, so Bob can get some sleep. But not to use them 24/7 at home. That way, Bob's brain can still have a chance to "rewire".

Anyway, the home health nurse arrives but she's under the impression that she's here to set up a feeding tube pump. I tell her that we already have a feeding tube pump and it's all set up and I've been using it for over two years, and that she's supposed to be here to "teach me" how to put on a condom catheter.  And that's when she tells she has no clue how to do that. She's never applied a condom catheter to a patient in her entire nursing life.

Then she says, "In fact, I've never even put a regular condom on a guy. Have you?"

When I tell her that it's been long time and in another life since I've done anything like that, she asks Bob, "Do you know how to put condom on?"

Bob says, " Huh?"

"Well," the nurse says, "I did put on condom on a banana once. In school. Can't be that hard." So she opens the "free sample" packet we got from the urologist and finds the directions. She reads these out loud. They are:

1. Open package.
2. Unroll sheath over penis.
3. Connect connector to drainage tubing.

"Sounds simple enough," she says, then opens the package containing the drainage bag and shows me how to connect the tubing of the bag to the tube on the condom catheter, which she knows how to do because this, she says, works just like a Foley catheter. Then she says, "You want to practice putting the condom on me?" And she holds up two fingers.

I kid you not. She actually wants me to put a condom catheter on her fingers.

Which I decline. By now, I am thinking, this whole darn thing is rather ridiculous, because, you know, I can read directions too. And I certainly do not need to practice putting a condom on her fingers.

The nurse packs up her stuff and leaves but not before telling me that if I have any trouble with this procedure, just google it. She's sure there's probably some good how-to videos on You Tube.

All righty. So now, I'm on my own.

I don't know if you've ever seen a condom catheter, but it pretty much looks like a regular condom with a spout at the tip. You unroll it, as the directions say, just like a regular condom, i.e. "unroll sheath over penis". The spout attaches to the tubing of the drainage bag, so that when the person pees, it goes straight down the spout and into the tube and into the bag.... Which is a great idea, in theory.

The problem is getting the darn thing on to begin with.

The big difference between putting on a regular condom and a condom catheter is that when a regular condom is used, the recipient, um, rather rises to the occasion. Not so with a condom catheter. In fact, the effect is quite the opposite. So instead of being like putting a condom on, say, a banana, it's more like trying to put a condom on a blob of jello.

You can imagine the problems this causes.

So, I've been tearing my hair out trying to get this condom catheter on. It's rather like wrestling with a large fat worm. A very flaccid, wiggling, large fat worm, at that. And just when you think you've got the thing on the tip, sort of perched there like a little stocking hat, and you start to "unroll the sheath", the condom will spring back at you, like shooting a rubber band. I tell you, it sometimes takes me twenty minutes to get the darn thing on him.

And yes, I've googled it. Unfortunately, all those You Tube videos show a nurse applying a condom catheter on a plastic manikin.  Easy that. When you're working with hard plastic.

After three days of this struggle, I woke up one morning with my legs aching like you would not believe. And I thought, what the heck did I do? Because I couldn't remember, you know, falling or running into anything. Then, I noticed two large bruises on my upper thighs. But still, I could not remember how I sustained this particular injury. Later, when I was leaning over the hospital bed, wrestling once again with the fat wiggling worm, I realized that, not only was my back killing me, but my thighs were pressing hard against the bed rail in that exact spot those bruises appeared. Who knew this would be such dangerous work?

Then, the other day, while again wrestling with the fat wiggling worm, Bob looked at me and said the magic words: "pump it up". And I about slapped myself on the forehead, because why didn't I think of that? You see, Bob has a penile implant, this device was put in years ago after radiation treatment for cancer caused a myriad of problems. But, personally, I only know the basics of its operation and Bob, being now one-handed, can't do it himself--it's two handed job. So back to google and praise the lord, there are directions. And I manage to pump him up, get that condom catheter on, and pump him back down. Still no easy feat, as you are sort of feeling around in the dark for certain implanted buttons and gizmos---but better than wrestling the worm.

Yesterday, we went to see Bob's primary care doctor. I was glad to see that Bob handled wearing the condom catheter just fine. I was worried it might be uncomfortable. And it was nice to just sit in the waiting room without running to the men's room every 15 minutes.

Oh, and I did give that primary care doc a piece of my mind about the Foley catheter incident. He said, "Well, let's take it out right now." That's when I told him that wouldn't be necessary, as the thing was already gone -- and the guy actually laughed. He was so shocked, he actually laughed right out loud. I tell you, he now knows better than to mess with me.

Monday, February 18, 2013

Home Again, Home Again, Jiggety Jig! (If only it were that easy...)

On Wednesday afternoon, Bob was discharged from the hospital. That was the first time that I saw his primary care doctor at the hospital (except once, I recognized his back, going down the hall). The first words out of the doctor's mouth were, "Let's get him home, before he catches something."

Nice to know, even the doctors think hospitals are nothing but a bed of germs....

So, the primary care doctor leaves to fill out the discharge paperwork. And the nurse comes in to take out Bob's IV's. Then she leaves. Then she comes back with the paperwork. And I say, "Um, you still need to take out the Foley catheter."

She tells me that they do not have an order to discontinue the Foley catheter. That Bob is being discharged home with that tube stuck up his penis! 

I'm thinking, What the f--?!

I say, well, this must be a mistake. So the nurse goes to get the doctor, but the doctor, like Elvis, has already left the building. So, she calls him on the phone.

When she returns to Bob's room, she says that the doctor told her that Bob was, in fact, being discharged with a Foley catheter. This, because, he has bladder retention. The doctor also says that I should take Bob to see a urologist ASAP. That Bob needs to have tests run for bladder retention and also, the urologist should scope the bladder to make sure there isn't an obstruction.

I tell you, I nearly hit the roof.

I mean, this is not some doctor/stranger----this is Bob's primary care doctor who should know better. Bob already has had neurogenic bladder testing and the urologist already knows that Bob has bladder retention and prescribed intermittent catheterization (which I already do) and on top of that, we were just at the urologist's office last week and Bob's bladder was "scoped" for obstructions at that time.

I tell the nurse all of this, but she refuses to call the doctor back. She insists that Bob has "serious bladder retention" and it would be "dangerous" to take the thing out. And the only one authorized to remove the Foley catheter, she says, is a urologist and I must take Bob to see one.

Lord almighty. I was ready to strangle that primary care doctor. And that nurse.

For one thing, I can't believe a doctor would leave an order like this, without speaking to me and Bob first.  I mean, really, would any doctor discharge a patient with a indwelling catheter and not explain/tell them about it and discuss it before discharge? What about personal choice in this matter?This is just another example of people, especially so called medical professionals, treating Bob as if he was less than human. That honestly just pisses me off. Bob has aphasia, but he is not an idiot.

And another thing. Does this doctor realize how much this is going to cost us? A completely unnecessary doctor's appointment with a $40.00 co-pay and the cost of wheelchair transport. And for what? Just to have the urologist yank the thing out. Because we were just there last week. And Bob had a full bladder exam and the urologist changed Bob's overactive bladder med and gave me a script for external condom catheters. We left that doctor's office with poor Bob soaked with urine, his wheelchair soaked with urine, because they couldn't get Bob up on the table and did the "scope" exam in his wheelchair. I had a mess on my hands when we got home. And I certainly wasn't looking forward to going through that again... I mean, give me a break.

To say the least, I was pretty livid when we left the hospital. The first thing I did when we arrived home, after I got Bob situated and comfortable, was get on the computer and google "how to remove a Foley catheter". Because, I tell you, this is one caregiver who is not afraid to take matters into her own hands.

It didn't look too hard. Except you need a special syringe to draw the fluid out of the balloon in his bladder. So, I called a friend, who is a nurse. And she said that she could stop by on Friday and yank the thing out for us.

She also said that I may want to think twice about taking it out. Because it's convenient. Especially for the caregiver.

On Thursday, I took Bob to see his Pain Management doctor. We went with that Foley catheter connected to a leg bag. And it was convenient. First time, ever, we went out and didn't spend half the time in the men's room.... but that's why I asked for the external "condom catheter" prescription from the urologist.

We had gone to see the urologist the week before because Bob's overactive bladder symptoms have changed. Used to be, he had "urge incontinence" meaning he felt like he had to pee and couldn't. Now, it seems, he's peeing every freaking 15 minutes. I kid you not. And that is driving me nuts. Especially when we go out.

After that appointment, the urologist sent a script for condom catheters to a home health agency. Who sent a nurse to our house to "teach" me how to use them. More on that, later....

Anyhow, my friend, who is a nurse, arrived on Friday and took the blasted Foley catheter out. And Bob peed just fine, 15 minutes later. And he continues to pee, every 15 minutes....

But I am glad to have him home. First time, I got a good night's sleep in a week.

A couple of people had told me to take "advantage" of Bob's time in the hospital and get myself some well deserved "respite" from 24/7 caregiving. But I tell you, I really missed him when he wasn't here. Weird that.

We see the primary care doctor this week for a follow-up. And you can bet, he's going to get a piece of my mind.

Wednesday, February 13, 2013

And Then...

Yesterday, I got up at 4:00 a.m. I say "got up" as that's when I physically got out of bed. I had been awake since 3:00 a.m. I had gone to bed at midnight. So that's how little sleep I had gotten. Mostly, I laid in the bed thinking...

On Monday, I had a long discussion with the vascular surgeon, who told me that he had never seen a polyp the size of the polyp on Bob's gallbladder. The thing, he said, was nearly 2 inches long. Shaped like a walnut. There was a big chance that such an enormous polyp would be cancerous, and even if it wasn't now cancerous, it certainly had the potential become malignant and needed to be taken out. He did tell me that gallbladder cancer was "extremely rare", however, when it occurred it was "usually fatal". We also discussed the warfarin situation, and he told me he would switch Bob over to a heparin drip which would keep Bob's blood thin until the surgery and be restarted after surgery. This way, there would only be a 4 hour window that Bob would be unprotected. We talked too about the difference between doing the surgery with a scope or opening Bob up. The scope would be easier, but might not be impossible because of old scar tissue on Bob's stomach. Opening him up would take longer and have more risk factors. Before commencing with the surgery, he would be running some tests.

Monday night, I had left the hospital at 9:30 p.m. when they began preparing to take Bob down for a CAT scan. I left right after a discussion with a curly blonde haired doctor with a heavy foreign accent and an unpronounceable name. The vascular surgeon had ordered the CAT plus a bunch of blood work plus another test called something or other, which sounded like "hyper-supersonic-scan" and this scan, the nurse had explained to me, was a sort of hi-tech super-ultrasound and would look at all of Bob's internal organs. The doctor, the nurse said, were searching for anything that might complicate the surgery. They were looking to see if any bile ducts or arteries near the gallbladder were occluded. They were looking for other "masses" on any nearby organs. They were also reading for "chemical levels" coming from each of Bob's organs. In order to do this test, they had to discontinue all Bob's narcotic pain medications for eight hours.

And this is why I was talking to the unpronounceable named doctor with a heavy foreign accent and curly blonde hair. Because I did not want them to take Bob off his pain medication. Especially cold turkey. Especially for eight hours. I mean, Bob has some heavy duty pain meds, i.e.: Fentynal and oxycodone. And knocking those off, just like that, were going to cause some serious drug withdrawal.

Dr. Curly Blonde Hair,  however, assured me that they could give Bob morphine, on a drip, and that would keep his pain in check plus stop any withdrawal from happening. That's when I left the hospital, went home and laid in bed--my mind churning about things like masses on nearby organs (cancer!) and occluded arteries (stroke!). These thoughts interrupted with feverent prayers for Bob's healing. Funny how I revert back to my Catholic upbringing in times of crisis.

So back to yesterday, which was Tuesday, I arrived around 6:00 a.m. to find Bob, drenched in sweat, screaming in pain and trying like heck to pee. When Bob saw me enter the room, he glared at me and pointed an accusing finger as if I were the cause of all this distress. I immediately asked the nurse, "where's the morphine drip?" And was told that another doctor nixed the morphine and Bob had been stripped of his Fentynal patches and oxycodone at 2:00 a.m. He was scheduled for the hyper-sonic-thingy test at 7:30 a.m. and she assured me, she had Fentynal patches on standby and would put them on immediately when he arrived back in the room.

It was a long wait for 7:30 a.m. With Bob screaming and trying to pee. When Bob returned, he was in even worse shape. His whole hospital gown was soaked with sweat, as was his hair. He was red-faced and trembling and shaking. His legs kicking out, arms flopping. And still trying like heck to pee. I grabbed the nurse but the Fentynal patches were nowhere to be found. She checked the computer and found the order was not due to be filled until noon. I asked if they could cath Bob so he could pee, but she needed a "doctor's order" for that. So that sent me on a mad and fruitless dash in search of a doctor. Who finally arrived around 10:30 and finally ordered patches and morphine, which arrived around 11:00 a.m. And, at my request, the doctor put in an order for a foley catheter, which was inserted into Bob around noon. And he immediately peed 1400 mls of urine. No kidding.

With pain meds and peeing, Bob fell asleep. Nothing much happened, except Bob got moved to a different room on the surgery wing. Then, I got, first, word that the CAT scan showed Bob's lower lung lobes were collasped and an antibiotic was being ordered. Later, word came down that the hyper-sonic-thingy test results were normal. Then, word that the vascular surgeon was ordering another ultrasound.

At around 6:30 p.m., the vascular doctor arrived with test results in hand. He showed me the results of the new ultrasound that he had run on Bob's gallbladder. The results read, in part, :

one unremarkable 3 mm polyp... no sign of abnormality... no inflammation... 
plus several tiny barely visible polyps, the type normally seen in a patient of this age....


And he said, Well. Either the first ultrasound was read by a complete idiot who maybe mistook a shadow for a gigantic polyp. Or the thing magically disappeared within 5 days.

Bottom line: No need for surgery. No more cancer scare. Bob does has lung pleurisy. This, I'm told, will easily clear up with an antibiotic.

Big sigh of relief here. Jeepers. What they put us through.

And a big thank you to all of you for your comments, support, prayers, white healing light, and good intentions and karma.  That doctor did say, the giant polyp may have magically disappeared.... hmmm...

Of course, it could just have been an idiot misreading an ultrasound.

I am off to the hospital. Not sure when they will discharge Bob. Right now, he is getting an IV antibiotic.

Monday, February 11, 2013

Update: Bob in the Hospital

Took Bob to the ER today. He was in great pain. They admitted him for testing and possible gallbladder surgery tomorrow. The "polyp" on his gallbladder is the size of a "walnut", which is huge for such things. Big cancer scare, there. Met with the surgeon, who seems cool and knowledgeable and realizes the risks of another stroke.

It's been a long darn day.... just got home. Me? I'm a nervous wreck.

Prayers, everyone.


Sunday, February 10, 2013

Something new to worry about....

For the past couple of weeks, Bob has been complaining of pain in his right side, under his rib cage. On a few occasions, the pain seemed so great that I nearly rushed him to ER--but he refused to go. Finally, I got him to see his neurologist who determined the location of the pain was Bob's liver and ordered an ultrasound, blood work, and an x-ray. Which we did on Wednesday.

On Thursday, there was a message from the primary care doctor's office stating that they were referring Bob to a vascular surgeon. That's all the message said, and it was after 5:00 p.m. when we got home that day. Why do doctor's offices do this? Leave a spooky message with no explanation.

So I spent a night worrying.... thinking all sorts of dread thoughts. Another clogged artery? One going to the heart? and, oh god, what if he has a heart attack? I tell you, by morning, I had Bob dead and cremated in my mind.... so I was actually relieved when I called the doctor's office in the a.m. and was told that Bob had "gallbladder polyps".

Which didn't sound bad at all.

Until I googled that term.

And I found out there's a chance these things could be cancerous.

And the normal treatment is removal of the gallbladder. Which would mean another surgery. The prospect of which scares the living crap out of me. Because surgery requires going off the warfarin and going off the warfarin puts him at high risk of another stroke.

I couldn't get an appointment with the vascular surgeon until the end of the month. So I get to worry for a few more weeks until we consult with the doctor.

Tuesday, February 5, 2013

Connecting The Dots

Last week, we went to see Dr. P., Bob's endocrinologist. The appointment went like this:

Dr. P. (enters the room):  Well, hello Robert! How are you, today?

Bob:  I'm mighty fine. How are you?

Dr. P:  Not so good, these hemroids are killing me. You won't mind if I stand up while I talk to you?

Bob:  No.

Dr. P:  So who are you routing for? The east coast or west coast?

Me: thinking: huh?

Bob:  East coast.

Dr. P:  So, you're a Raven's fan.

Me: thinking: Ravens? (Sorry, Bob and I don't watch TV, don't follow sports at all.)

Bob: (long pause).... Oh! Football!..... um, um,.....Green Bay!

Dr. P. (looks at me):  Green Bay?

Me:  He's thinking of the Green Bay Packers. We're from Wisconsin, originally.

Dr. P.:  Wisconsin, eh? Boy, that's way up north. Cold up there, I bet.

Bob:  Freezing!

Dr. P.:  So, you're a big football fan?

Bob:  No way!

Dr. P.:  (laughs) I don't like football that much either. (opens the chart) Well, let's see here. Last time you were in, your arm was really bothering you. How's that arm doing today?

Bob:  Better.

Dr. P.:  Good! Anything new you wanted to discuss with me?

Bob:  No.

Dr. P. (sits down then stands back up):  Oh damn these hemroids! I can't even sit down today. And don't even ask about going to the bathroom. God, a person doesn't appreciate how good it is to be healthy, until you're not.

Bob:  Exactly.

Dr. P.:  Well, all the blood work looks good. (closes the chart) So I'll see you again in six months, OK?

Bob:  Okey dokey.

Dr. P.:  Good to see you, Robert. (shakes Bob's hand)

Bob:  Good to see you, too.

I tell you, I was completely floored. Because that was the first time we've gone to a doctor's office and Bob did all the talking! And he was able to follow the conversation even when the doctor jumped from subject to subject.  Wow.

I do believe his brain is finally connecting the dots.

Sunday, February 3, 2013

Legal Update

So, the good news last week from our attorney's office was that they believe (and believe here is the key word) that our case is "indefensible".

This because our attorney has had an initial consult with the hospital's attorney and that's the impression he was left with after talking with her. He believes this so strongly, that he has his staff in a mad scramble to collect all the data and calculate all the numbers we will need to proceed directly to settlement hearings.

This past week, I have spent two afternoons filling out questionnaires sent by the rehabilitation consultant hired by our attorney. The first one was a six page "Upper Extremity Assessment" on Bob's ability to move his upper extremities both pre- and post-stroke. The second, "A Client Information Report", dealt how our lives and our relationship have changed post-stroke. I tell you, this second questionnaire left me in tears.

In addition to that, I spent over 2 hours on the phone being interviewed by the "client assessment coordinator" who is working up the numbers for Bob's "Life Plan", i.e. how much his care will cost for the rest of his life...

Plus, I spent time figuring out my "daily caregiver duties" and copying and e-mailing things like our utility bills.  Believe me, I've been a busy gal.

"Indefensible."  That was our attorney's term.

Meaning, he thinks that the hospital doesn't have a defense and is going admit they screwed up.

Good news, indeed. If he's right.

Of course, they still have their 90 days to officially respond.