Sunday, April 24, 2016

Letting Papa Go

Today a friend came by the house and told me his grandfather was going to a nursing home. He said the thought of it is tearing him up but he knows it is in Papa's best interest. The old guy has quit taking his meds, won't bathe, and won't eat. I think the last straw was when Papa parked his scooter in the middle of the highway and wouldn't move. The sheriff had to come out and move him (Papa in the road on a scooter....that's the kind of stuff you see in the movies only this was for real and not so funny).

After all this, the friend said "I can't fight the ___. They're going to put him in a nursing home."
Several things went through my mind like can anyone convince him to change his behavior so he can stay home? Who reported the incidents? How did they know he wasn't taking his meds? (blood tests). I thought how much stress must be on my friend and his family trying to keep "Papa" safe and "they" putting Papa in a nursing home wasn't a bad guy stepping in but someone coming in and saying this situation isn't safe and we need to step in.

The big question is when you make a promise to keep an elder home when do you say 'Enough, I can't do it anymore' without feeling like you are betraying him or her? How do you finally say 'I need help' without feeling like a failure?

In my friend's case I am on the outside and I can see how some intervention is called for; however the view for my friend is not so clear.

I am a devil's advocate. I can't help myself. I try to look at both sides of an argument and recognize the other person's side of the story. I see the pain and helplessness on the friend's face. I also know how hard it is to care for someone. As a nurse 12 hours caring for a person can be exhausting especially when the person has some form of dementia but I get to go home. How hard it must be to do it all day and night and with no escape. ....and how difficult it must be when there is no one else to come in and take over, no night shift, no one to give you a coffee break.

Well, I guess I will keep them all in my prayers; my friend for the helpless feeling, Papa for wanting to be independent and not doing a good job at it, and the folks where he is going where he will be treated with care and respect...and keep him out of the road.

Post by Eileen

Monday, April 18, 2016

My Dog Had a Stroke The Salty Dog Blues Part 2 Recovery

I promised an update of Salty's recovery. I originally journaled it on Facebook so please pardon the format. Here it is:

March 19, 2016
Salty Dog update: A long, tiring day with Dad. Walked 10-15 feet four times today and drank water. Even had time for a short 4-wheeler ride. Still no appetite but rice gruel and chicken is on the menu for tomorrow. Hopefully he will be able to lap some up. He's not giving up so we won't either.

Salty in the hubby's hands. 
March 20, 2016 Salty Dog update: He's eating, really eating on his own....and pork chop, not rice gruel. He walked earlier today and not interested in walking with me tonight but tomorrow is another day. Another step on the road to recovery.
Dan started Salty on rice gruel (over-cooked rice in too much water until it becomes mush) mixed with a can of Mighty Dog dog food. He started eating one morsel at a time.

March 21, 2016  Salty Dog update. He is eating a bit better, in fact we need to cook more rice for him. He only walks and eats for Dan, though. Lots of massages to keep his legs from stiffening up. And there's Sammie checking on him. Maybe she's a little jealous. Just a little.

March 22, 2016 Salty Dog update: Fall precautions.
Today Salty spent the day with Dan. He ate breakfast, walked, drank, watched Dan work on the bedroom wall and work in the garage. Dan sat him up in a chair and it was there Salty decided to get up and jump from the chair. Dan wasn't fast enough and Salty fell. He doesn't look worse for wear but Dan is. Shook him up a bit. All I could think of is putting his bed on the floor and little yellow socks for his four little poodle feet. Four little yellow socks. And a "Fall Precautions" sign.

March 23, 2016 Salty Dog update
Salty got a bit of therapy in the form of petting and hugs from the grandkids. He was barely moving this morning until he saw them and heard them call his name. When he heard "Bud Bud" his tail started wagging more than it has since the stroke. The little guy who would hide under the table stayed alongside the girls just taking in every bit of love he could. He even joined us for supper eating some of Dan's then walking to the water bowl on his own.
A slow recovery but a recovery none the less. I am amazed at the difference love can make and awed by the magic that exists in a child's voice.
Salty riding the four wheeler with Dan. He loves the wind blowing his ears back.

March 25, 2016 Salty Dog update
Today is the 9th day since Salty had his stroke and the first time since then that he got to ride the four wheeler. A milestone but it is overshadowed by him climbing the porch steps by himself.


We celebrated by dressing up with a bow tie and having a picture taken. It's a little hard to see the red bow tie but he knows it's on. Sam was a little jealous and had to have a ribbon, too.
Thanks to all the get well wishes from everyone.

April 1, 2016
Salty Dog update....He got his bark back!
After suffering a big stroke Salty suffered a cardiac arrest. After resuscitation he was unable to move his left side. Recovery has been slow but he can move. He's running again. His bark was still missing until today. His tongue still hangs out, though. Scruffy little fellow. #‎SaltyDogBlues #‎ToughLittleDog

I tried looking on the internet about the loss of bark from a stroke and found nothing. The symptoms of strokes in dogs weren't like Salty's and involved walking in circles. I spoke to a neurologist from UF about Salty's loss of bark after his stroke and if it was equivalent to human aphasia  and he believes it is. The vocal cords in humans are much more developed than in dogs but the loss of bark is like the loss of speech. I am glad I followed my intuition and didn't give him water before he was ready. Not barking could have meant the inability to swallow as well which meant he had a high risk of aspiration.

If a patient,  a human patient, suffers a stroke, one of the first things done is a speech and swallow evaluation to avoid aspiration. The food provided is soft, sometime ground or pureed until a person is able to swallow safely. In extreme cases the person may have to have a tube placed into his stomach for nutrition. Each case is treated on an individual basis.

April 18, 2016
Salty is still recovering and doing well. He is a little slower than he was prior to the stroke but his recovery is remarkable none the less. He eats outside in the morning with everyone else and lets us know when he has to go out. He's still not steady enough to climb and watch for cars. He likes to stay on the porch and wait for the hubby to come in the yard. Once he's in the yard Salty doesn't leave his side. He tires out faster and sleeps more than he used to. He still loves to go to the garage and hang with the guys. The hubby is his favorite person and he's happy just being next to him. He lets me brush him, something he never did least not without a battle.

We don't keep Salty on any special food or do anything special.  He is no longer on the aspirin. The aspirin was for 10 days, no longer, to avoid risk of stomach upset. The recovery is no longer as dramatic as earlier. We see improvement but it is much slower.

We are grateful for everyday we have with him. We love him and he loves us. It's all about quality of life and the little guy is happy just being with us.

Post by Eileen Patterson whose dog, Salty Dog, had a stroke and recovered. A four legged miracle that has his bark back.

The Medical Mission to Haiti

Back in January I went on a  medical mission to Haiti.  Our group joined with Medical Missions Work, to establish a free-standing medical clinic in the remote mountain village of Fond Jean-Noel and provide healthcare to the children and staff of three orphanages in the city of Leogane.

The mission consisted of three distinct parts: our arrival to Leogane and visits to the orphanages, the medical clinic in Fond Jean Noel, and the return to a Leogane orphanage then on to a Port au Prince school, then home to the USA. 
Haiti is very mountainous. The people get around on motorbikes, 4-wheel drive trucks, tap-tap buses, and on foot. The people carry just about everything on their heads. I tried to get pictures but I was usually too awed to get the shots. 
While at the medical clinic over 350 people received care and medications. The people walked 3-4 hours to attend the clinic and were very appreciative of our efforts. The most common problems were headaches, neck and back pain (carrying all that stuff on their heads), high blood pressure (the yummy food), stomach problems (the spicy, yummy food), and stuffy noses (lots of lush, green woods in the country, auto exhaust in the city). We ran out of stomach meds quick. 
In the mountains I didn't see any obese people probably because of all the walking they do. No smokers, either.  I didn't see too many old people either, though. Most of the people in the mountains died before they got old, however I did have a 90 year old patient. Her complaint was her knees hurt when she walked up the mountains. She was grateful for ibuprofen and blessed me countless times. 

The experience was humbling; the memories of which I will hold close and keep in my heart forever. I am forever grateful for the love of family and friends who helped make the mission a success. 

Here's a few of the pictures I took while there. 

Lots  of motorcycles in Haiti. The whole family will get on one bike. I saw as many as five on one bike at the same time. Most of the motorbikes are small by American standards, under 200 cc's. 
Our group consisted of hospital workers from Portland, Maine and two nurses from Gainesville, Florida. I'm in the front, third from the right.
Security at the Residence in Leogane. 

Dinner at the Residence 

The surrounding area from the orphanage. Very lush and green
One of the girls from the first orphanage

One of the older girls at the orphanage taking care of one of the little ones. 

New dresses are special

Handmade dresses for the girls donated by a local church. 
The second orphanage on our agenda.
Denise with one of the children at the orphanage. 

A day off and we still go to the hospital. 

Surgery at the Leogane Hosptial. The hospital is well known for its treatment of filariasis (elephantitis). Here the surgeons take time from their practices in the US to treat the patients. The nurse in the picture is a member of the hospital staff.

We heard about this orphanage in town. They were out of food and had beds for 6 of the 30+ children there. 
We brought groceries,  lots of beans, rice, oil, and other supplies to help them out. The next day some of our people went back to build beds and deliver mattresses. 
The Tap-Tap buses intrigued me. Each one was brightly painted. You tap the side when you want to get on or off.  Unfortunately, they are not known keeping a strict schedule.
Another tap-tap bus.

We had to cross the river to get to Fond Jean Noel
Going through a market town on the way to Fond Jean Noel

Vegetables for sale at the market

A shop owner's son. His smile is infectious

Emily instructing women at the clinic in the use of the Days for Girls bags. 

Haitian Alarm Clock
The day we arrived back in Port au Prince the locals were upset about the upcoming elections. Yes, that is a very serious weapon the officer is holding. 

A group of students at the school. Our interpreters run the school. The men grew up in an orphanage and finished high school whenever they could. One of the gents finished at 29 years old, not because he didn't have the smarts but because he didn't have the money, and never gave up. He is a remarkable guy, very knowledgeable in history and writes the curriculum for the school. 

Denise and one of the students. The students learn to paint and raise money for the school through their artwork.
I learned several things on the mission. Here's a few things:
1) People respond to a gentle touch and voice regardless of the language.
2) Children laugh at jokes and silly stuff. I am known as “Grann Feu” or Crazy Grandma. I hope to learn magic tricks before I go back....and bring my clown wig and nose.
3) Education is a treasure and should never be taken for granted. Finish when you can and never stop learning. 

4) You can carry a lot of stuff on your head if it is positioned well...and you have a cushion for your head.

Post by Eileen who took a few days from GoofingOff Sewing to do nursing care in Haiti. 

Sunday, April 10, 2016

Salty Dog Blues: My Dog Had a Stroke Days 1-3


Three weeks ago my littlest guy, Salty Dog, suffered a cardiac arrest. At first we didn't know what happened but after resuscitation (doggie CPR) and through his recovery, we were able to piece together that he suffered a cerebral vascular accident, CVA, more commonly known as a stroke. I posted updates on Facebook with pictures of his recovery but my friends said I should blog his story so others might learn from it. I broke the story into parts so it wouldn't be overwhelming. Throughout his recovery I found little on the web about dogs recovering from stroke or what to do so everything we did was by the seat of our pants. I hope it helps someone. 
By the way, we love our vet. We get lots of good advice and care but sometimes things happen after hours or on the weekend....and we live in the country, a bit of a distance from the big city so not everything is easily accessible.

Sorry I have been away for a while but the last month has been a bit crazy. Between Salty having a stroke the day before having surgery for cancer removal (not a big cancer but the C word scares me) sort of had me a bit preoccupied. 

Day One:
The morning before the surgery I was a little on edge so I thought I would walk my least 2 of them. Sammie, the boxer, and Fred, my bigger male poodle (he's not that big, 15 pounds but he thinks he is big) walk while Salty, the little toy poodle of the pack..7 pounds after he eats, runs to the garage to hang with the hubby in the man cave. That day was no different, Salty ran out of the yard as fast as he could to be with the hubby while I circled the drive with the other two. 
When I got back to the house my hubby called me sounding a bit off. "Babe, could you come here a minute?" he said. 
"What's up?" I said really thinking now what. "Salty's dead. He just died." 
I thought of the little guy running so happily from the yard. "What happened? Did something fall on him?" 
He just fell over dead. He's not breathing," was my hubby's response.
My husband was carrying Salty, cradling him in his arms. He had tears in his eyes and he sat on the ground next to a big oak. "Come on little guy. Come on Bud Bud. Don't leave me," he said. 
The next thing I knew I saw my husband start mouth to snout CPR, resuscitation, on Salty. I assisted with compressions. 
I wondered what could have caused a sudden cardiac arrest and thought it could have been one of two things, a heart attack with a fatal arrhythmia or a CVA, stroke. In Salty's case I didn't know what it could be. He had no signs or symptoms of major health problems that I was aware of. He'd been to the vet and had a clean bill of health. 

After a few breaths and compressions Salty started to open his eyes. He didn't focus and his head flopped back. He couldn't move the left side of his body. His left legs stiffened and he couldn't control his head movement.  It looked like he had a massive stroke.

While supporting his head I carried him into the house. I gently bathed him at the kitchen sink talking to him and singing soft to him while supporting his head. I didn't know if those were his last moments and, if they were, I wanted him to hear a loving voice. I thought about taking him to the vet but thought there wasn't a whole lot they would offer a little old dog other than watch him. I also examined him while I bathed him. I noticed his pupils were equal, not blown, so I didn't think he had a hemorrhage. I also noticed it didn't seem like he could see if someone was on his left side, left-sided neglect. I noticed he couldn't bark or wag his tail and his tongue hung out of the left side of his mouth, like facial droop. 

My husband and I talked about taking him to the vet. He was afraid he would need to be put down and he said he couldn't do it. To tell the truth, I couldn't either. 

"I'm not taking him to the vet," I told my husband. "What will they tell us? Put him down? Leave him with us and we'll watch him? I'm not leaving him in a strange kennel with strangers. He won't know what's going on and he'll be scared. We can watch him here. If this is his last day on earth he's going to spend it with family." There was no way I would leave my little dog with strangers during his last hours on earth. Thankfully my husband agreed. 

My husband and I held Salty for hours moving his legs and supporting his head while talking to him. We made sure to stand on his right side so he could see us...and we supported his head. 
 I made a place for him on the pillow on the floor with a towel on it. He couldn't control his bladder. He just laid there and went to sleep. 

I remembered from stroke care that the sooner physical therapy is started on the affected limbs the better the recovery. It was then I started moving his legs, range of motion. My husband watched me and took turns doing it, too.

I don't know how many times the hubby got up during the night to check Salty but I know I got up at least four times, each time expecting to find him gone. He amazed me, though. Even more, Sammie, the boxer, stood guard at his side watching him during the night. She laid down next to him and slept. 

Day 2
Salty was still there. He was able to lift his head but nothing else yet. I went for my skin cancer removal and straight home when it was through. When we arrived home Salty was still there and seemed to lift his head a little. 
Salty recognized us, me particularly, and would turn his head to my voice. He still couldn't drink or eat anything which worried my husband. I explained to him it was pretty dangerous to give him water by eye dropper especially since he couldn't bark yet. I was afraid of aspiration, water getting into the lungs, and thought we still had time to address it. 
The rest of the day was filled with holding, range of motion, and worry. 

The hubby holding Salty so his head wouldn't flop around.

Day 3

Day 3 brought me a big surprise. Salty tried to get up for breakfast. I thought I should take him out like I usually do and he walked under his own power to pee. He walked in the yard about 10 feet then rested. He was pretty wobbly but he did it himself. A while later I made him walk again and he walked to the water bowl for a drink. It seemed like he was making up for all the water he couldn't drink over the last few days. Still not ready to eat, though. He wasn't ready to quit so we wouldn't, either. Hourly physical therapy that included walking, massages, lots of hugging, holding...and doggie dose aspirin.

 I thought about how to treat Salty. In the hospital setting we use clot busters, like TPA, to restore blood flow after a CT scan to make sure there is no hemorrhage but we were home and I was treating by instinct.  Since we didn't have a CT scan or TPA I thought about what other blood thinners could be used and remembered dogs can take aspirin. Aspirin is used commonly treat cardiac patients to decrease platelet aggregation, or clumping.  I thought why not try it for Salty. I looked up "doggy dose aspirin" and found 5 mg per pound of body weight. Salty weighed 7 pounds. I split an enteric coated baby aspirin (81 mg)  in half and gave him a half tablet. I started him on a half tablet twice a day, or every twelve hours. 

The hubby holding Salty and Sammie, Salty's nurse, sitting close by.
To learn more about Doggie CPR there are several YouTube videos that demonstrate the technique. Here's one:

Dog Dose Aspirin:
"Most veterinarians recommend from 5 mg to 10 mg per pound of the dog's weight during a 12 hour period. (That is about 10-20 mg per kg weight). Going on the safe side, a recommended dosage of aspirin of about 5 mg/lb (10 mg/kg) seems to work well for most dogs." Giving Your Dog Aspirin by Ron Kurtus, November 11, 2008.

Remember, do not use ibuprofen (Motrin) or acetaminophen (Tylenol) on dogs. Ever. And never use aspirin on cats. Never. 

Post by Eileen from GoofingOff Sewing
Nursing people and dogs. 

Merle Haggard

The other day the world lost a music legend, Merle Haggard. I loved his music but one of my favorites is a song he did with Janie Fricke, "Natural High."

Natural High was released in 1985 on the album "It's All in the Game."

A beautiful love song written by Freddie Powers, it was Number 66 in the Top 100 Country Love Songs.

Merle's version made it to number 1 for 1 week. It is overshadowed by his many hits like "Mama Tried" and "Okie from Muskogee" but it is one that touched my heart.
I hope you enjoy it.

Post by Eileen