It did not take long before Elizabeth was having time off the ventilator. The machine was highly intelligent. It was able to detect when Elizabeth was breathing, and just added a bit of breath to start with, and then finished the breath. In this way Elizabeth's body was not let off. Most muscles are quite happy for others to do the work and are quite willing to just wither away. Elizabeth moved onto longer and longer periods of breathing through the traccy hole in her windpipe. On a number of occasions she sneezed violently, sending the breathing valve on the traccy flying across the room. When she could breath by herself, she was ready to move on to the Brian Injury Unit (BIU). This happened about one month after the haemorrhage occurred. Liz was still being PEG fed through a tube into her stomach. It was amazing to read the leaflet we were given about PEG feeds. We learned that the hole through the stomach wall is not affected by caustic erosion from stomach acids. When the tube is removed the hole takes just a few hours to heal. I asked the doctor why stomach ulcers were such a problem when these tubes seemed so unaffected by the acid. I was told that ulcers cover a wide area of the stomach wall, like a graze, and the small hole is quite different. In Brain Injury Liz had her own room. We were able to have large parties of visitors, and sang a lot of songs together. It was here that Liz was able to have her traccy removed by S the physio. Again the hole in her neck healed very quickly over. She had wonderful nurse including E, and S both of whom gave Elizabeth beautiful 'french plaits'.
BIU had some interesting challenges. M, the father of the ex-husband of one of Margaret's colleagues, had been hit by a car. He had terrible traumatic reactions to this and called out incessantly. He was also at risk of falling out of bed. Later we saw him in BRU, and he was a calm, gentle man. In his terrors he would call out 'Louisa, Louisa".
Elizabeth was able to use a highly supported chair in which she sat in at a recumbent angle. As her core body strength improved, she was able to sit more and more upright. Eventually the head rest was removed. Strength was increasing gradually across her body, though the left side remained weak.
After just two weeks in BIU, and during a visit by James, Liz moved to the Neuro Rehab Unit, right at the front of the building. This was from a 8 beded unit to a 16 beded unit. Patients in NRU have a lot of therapy, and Elizabeth developed a close bond with her therapist, who all worked hard to help her succeed. In BRU we had two multi-disciplinary meetings. These felt quite formal. Elizabeth maintained a positive attitude and a consistent friendly humorous rapport with all the staff. She met D, who had experienced a stroke while participating in a park run. They worked out that they had both been struck down on the same day. D was a lovely person. is daughter had just gone to university. D left the ward before Elizabeth and was able to walk out, though this took extreme concentration.
Bit by bit we watched Elizabeth being able to do more. Every evening Liz did exercises on the cycling machine, and did sit ups. The weakness in her left side has been a challenge, and Elizabeth felt that when she was discharged, she preferred to continue her rehabilitation in a rehab centre rather than at home.
When the news of a place at Barclay House came through, the speed of discharge from hospital was rather sudden. The transition also enabled Elizabeth, and consequently the rest of us, to release a lot of pent up emotion.
Barclay house is well run and staffed by wonderful people who are offering a great service. The level of need of the residents is very high, with most people suffering significant cognitive impairment.
I also notice the change from the NHS culture I am so familiar with. No uniforms, no bare below the elbows, no alcohol gel. Far more freedom to talk optimistically about the future.
No comments:
Post a Comment