A Second Blow
January 20, 2006 started out like any other day. Since it was a Tuesday, Bill didn’t get his shower from the senior center’s home health care aide. As I got him dressed, he seemed more lethargic than usual, but I wasn’t too concerned since we managed the transfers and breakfast without a hitch. Bill had therapy that morning, and we planned to meet later at the senior center for lunch where we would attend our monthly visually impaired support group meeting. The previous summer, I was elected president of the Wyoming Council of the Blind, and that evening, our board of directors‘ meeting was scheduled via conference call.
The support group was one Bill started after he moved here. He had facilitated such a group in Colorado. After the stroke, it was up to me to publicize and facilitate the meetings and come up with guest speakers and other activities. This was a tough job because most of the participants had no idea what they wanted to do, and at times, I felt like I was pulling teeth. However, they were all supportive of my endeavors to care for Bill at home. At that day’s meeting, a volunteer interested in starting a reading group at the senior center agreed to talk to us about his project. As I got Bill’s coat on him in preparation for the Minibus, our local paratransit service, to pick him up for therapy, I hoped someone would come up with a topic idea for the next month’s meeting.
After Bill left for therapy, I did some work in my office before starting the trek to the senior center. Snow was on the ground, and the sidewalks were icy in places where they hadn’t been shoveled. At one intersection lay a huge snowdrift where I would have crossed, and since I couldn’t see a way around it, and I was wearing boots, I stepped through it, using my cane as a ski pole. Fortunately, anticipating this, I had left in plenty of time so I wouldn’t be late.
At the senior center, I found other support group participants at a table where we usually ate lunch together before the meeting. Bill soon arrived. “Angelique says he’s sleepy,” said the Minibus driver, as she parked him next to me at the table. Angelique was Bill’s occupational therapist.
His head hung down, almost to his chin, and I couldn’t see his face because the hood of his sweatshirt was pulled down over it. Usually, he greeted me with an embrace but not today. “Ken says I need to take a nap,” he said. Ken was his physical therapist. Apparently, he didn’t have enough energy for therapy.
When our food arrived, Bill showed little interest in eating, even when the volunteer who delivered our trays offered to cut his meat for him. I was concerned, but I told myself there was nothing to worry about. He was just tired. Maybe he hadn’t slept well the night before. I had promised to fix goulash for supper, and maybe he was holding out for that since it was one of his favorite meals.
Much to my consternation, Bill slept through the whole support group meeting. Afterward, the Minibus took us home, and when I wheeled him into the bedroom and transferred him to the bed, I discovered he had wet his pants. He was so weak I could hardly get him onto the bed. I took off his soiled pants, covered him with a blanket, and left the room.
Bill had recently started taking a different muscle relaxant, and I wondered if this was causing his weakness, although he’d been fine for the past few days. I called his doctor, and to my surprise and relief, I was able to get through to her immediately. She said she didn’t think the muscle relaxant was causing the problem but said to decrease the dosage and see what happened.
The minute I got off the phone in my office, I heard Bill’s clacker that he used to call me. When I hurried to his side, he said he had to pee but didn’t think he could sit up. I handed him the urinal, but before he could position it, his urine saturated the bedspread. In those days, I didn’t put a pad down to prevent such accidents since most of the time, he peed either while sitting on the side of the bed or on the commode in the bathroom. Because he was so weak, transferring him from the bed to the wheelchair in order to put on clean bedding was impossible. All I could do was cover him with a blanket.
Five minutes later, it happened again, but this time, he was able to get some in the urinal. “I think there’s blood in there,” he said. “Maybe I should go to Sheridan Manor.”
“We’ll see,” I said, stroking his hair. Actually, I thought that wasn’t such a bad idea. I didn’t know if I could take this much longer. I peered in the jug and didn’t see any blood, but to be on the safe side, I called John who had better eyes, and after taking a look, he said he didn’t see any blood, either.
As the afternoon wore on, I made frequent trips to the bedroom to give Bill the urinal. Sometimes, he got it in the jug, and at other times, his urine soaked the bedclothes. He laughed every time he called me. It was probably out of embarrassment or frustration, but that didn’t make it any less nerve-wracking. Finally, he pointed to his penis and said, “I hurt here.”
It was nearly five o’clock, and when I called the doctor’s office a second time, I expected to get the answering service or voicemail. To my relief, the nurse answered the phone. I knew her voice because I’d talked to her many times before about Bill and was almost in tears when I told her what was going on. “You’d better get him to the emergency room,” she said.
Relieved, I called 911, and Bill was soon on his way to the hospital. Grandma had been admitted the day before with pneumonia. I punched in Dad’s number and hoped he hadn’t left for the hospital to visit her. To my relief, he answered, and when I told him what happened, he agreed to drive me. It was then I remembered the Wyoming Council of the Blind’s board meeting. While waiting for Dad to pick me up, I called a friend who was also on the board and asked her to call everyone else on the board and say the meeting was canceled.
At the hospital, when the emergency room physician learned Bill’s symptoms, he thought it was a urinary tract infection. My heart sank. If that was the case, we would be sent home with antibiotics. I didn’t think I could care for Bill in his weak condition.
The doctor took a urine sample, and an hour later when it came up negative, he ordered a CAT scan. While Bill was having that done, Dad took me to the cafeteria for supper. So much for the goulash, I thought, as I bit into a tasteless sandwich. After supper, we returned to the emergency room and found Bill back in his cubicle. Since the results of the CAT scan weren’t yet available, Dad left me to visit Grandma, saying he would be back soon.
All this time, Bill was alert. For the next half hour, I held his hand and talked to him about this and that. I wished the doctor would hurry up and tell us what was wrong, and though I didn’t tell Bill, I also hoped that whatever it was, they would admit him, at least overnight. I needed a break.
When the doctor finally arrived, he said, “Well, it looks like you had another stroke, not as severe, but on the same side of the brain.” I was alarmed a moment later when the nurse took his blood pressure, and the top number was 180. The neurologist had told us it needed to stay below 150. No wonder Bill had suffered another stroke.
To my relief Bill was admitted to the intensive care unit, and Dad soon drove me home. Later, after calling Bill’s sisters in Colorado and California and giving them the bad news, it occurred to me to call Laura, the therapist who had stuck with us while Bill was at Sheridan Manor. We hadn’t talked to her since October when she told us we no longer needed her. I thought back to that last day. Bill cried when she left, and I wanted to cry, too, but instead, I held and comforted him until he quieted down. This was usually what I did when he burst into tears. He was sad to see her go, but for once, I was confident we’d be all right, and we were, until now.
“Oh Abbie, I’m just sick,” she said when I told her.
“I know,” I said. What I didn’t tell her was that I was relieved not to have to care for Bill for a while. I was exhausted, and it was nice knowing I wouldn’t have to put him to bed. Fortunately, the urine outbursts hadn’t spread to my side of the bed. I crawled under the sheets and went right to sleep. Needless to say, the first thing I did the next morning was throw the bedding in the wash and put clean sheets on the bed.
The next few days were a blur. Bill seemed to be getting better, but Grandma was getting worse, and Dad’s brothers from Colorado and California flew in just in case. Although I visited Grandma for a few minutes when I went to see Bill and noticed her deteriorating condition, I couldn’t be too concerned about her. Bill was constantly on my mind.
When the neurologist visited, he said perhaps one of Bill’s arthritis medications caused his blood pressure to skyrocket so he suggested decreasing the dosage and that we monitor his blood pressure regularly which we hadn’t been doing. He also said that since the second stroke hadn’t been as severe, the recovery process wouldn’t take as long. It was not yet known that this stroke probably set him back enough to the point he would never walk again.
The hospital staff was a lot better about helping Bill eat than at the facility in Billings, Montana, where he was airlifted after his first stroke. When I was there at mealtime, they offered to bring me a tray. His appetite was good, and he seemed to be gaining strength. We were given the impression Bill could participate in the hospital’s therapy program. On Thursday morning when he asked me to bring his talking books and portable cassette player with headphones, I started feeling optimistic.
On Thursday evening, Bill was moved out of the intensive care unit and into a room near Grandma which made visiting both of them easier. On Friday morning when I walked into Bill’s room, his doctor was there, and to my surprise, she said that he was ready to go home. My mouth dropped open, as I stared at Bill. “Yeah,” he said.
“The therapy department says he’s at full strength,” the doctor said.
“Okay,” I said, but I had a bad feeling about this.
I went to Grandma’s room and told everyone there the news. My uncles and Dad were more thrilled than I was, but Grandma was barely conscious, and I wasn’t sure she understood what was going on around her. With Bill to think of, I couldn’t be too concerned about her. Dad agreed to drive me home to get clothes and Bill’s wheelchair.
Once I returned to the hospital, I wondered how I would dress Bill. There was no pole for him to hold onto, and although I could get his pants on without it, I didn’t know how I would sit him up in order to put on his shirt and gait belt. Fortunately, an aid offered to dress him. As she struggled to pull on his pants, I said, “Honey, are you sure you can do this?”
“Yes I can,” he said.
In minutes, Bill was discharged. I called the Minibus to pick us up, and we were soon home.
“Put me in the recliner,” he said when we got in the door. That transfer went pretty smoothly, despite my trepidation, and I began to relax. He didn’t want lunch, but said, “I want goulash for supper.” That was also a good sign.
By evening, it was clear I’d used my heart instead of my head when I decided to bring him home. We managed to get through dinner, but he was pretty weak. Afterward, he said he had to go to the bathroom, and it was all I could do to transfer him from the wheelchair to the commode. He couldn’t go, and after an hour, he finally gave up. “Let’s go to bed,” he said.
When I pulled him to his feet and pushed him against the wall, he could barely stand. I found myself bracing him while I pulled up his pants. I aimed his butt at the wheelchair in the nick of time.
The transfer to the bed was just as harrowing, but miracle of miracles, Bill didn’t hit the floor. I took off his clothes, tucked him into bed, and kissed him goodnight, as if it were any other night. Later, I crawled in beside him, physically and emotionally exhausted.
I couldn’t sleep. Bill was restless. His legs kept twitching this way and that. Many times, just as I drifted off to sleep, I was jerked awake. Maybe the dosage on his muscle relaxant needed to be adjusted again. In the meantime, I crawled out of bed and went to the spare room to sleep, as I often did, leaving the clacker within easy reach in case he needed me in the night.
I slept fitfully, and at five in the morning, I woke to the clickety clack that told me I was needed. Bill was laughing when I reached his side. The bed was again saturated with urine. I’d put a pad down, but there seemed to have been a torrent, and I was afraid the mattress was ruined. I climbed in bed next to him and held him, burying my face in his hair that still smelled like the hospital and wished he were still there.
After another three hours of fitful sleep, I got up to take a shower. Bill woke up and said, “Maybe I should go to Sheridan Manor.”
“I’ll call Laura and see what she says.” I hated the idea of him going back there, and Laura agreed with me.
“It would ruin his self esteem,” she told me. “Call the doctor and tell her you want Bill to go back to the hospital’s rehabilitation program.”
When I called the doctor’s office, I got a voice mail and left a message for her to call me as soon as possible. To my amazement, she called me back in a matter of minutes. I explained the situation, and she assured me the arrangements would be made. Laura came and dressed Bill and transferred him to his wheelchair. I called the Minibus, and we were on our way.
At the hospital, they were expecting us, and we got Bill settled in another room. I called Dad and told him what happened and which room we were in. He said he was getting ready to go visit Grandma and that she wasn’t doing any better. “I’m sorry,” I said, but I couldn’t be too worried. Bill was in a different room, and I wasn’t sure I could find Grandma’s room, and I didn’t have the strength to try.
Bill’s room had a recliner, and once he was settled there, he was happy. We had lunch together, and just as I was about to call the Minibus to take me home, my aunt appeared in the doorway. “Grandma passed,” she said.
I was stunned. I knew she was dying, but because I was so preoccupied with Bill, the concept hadn’t sunk in until now. Numb with shock, I said goodbye to Bill, promising to return the next day, and went with my aunt to Grandma’s room.
Grandma lay peacefully in her bed, and everyone was there, including Dad. “I’m sorry,” I said. It was all I could say. Although my aunt was sobbing in her husband’s arms, I felt no tears. I watched, as one of my uncles leaned over the bed and kissed Grandma’s face, but I couldn’t bring myself to do that.
On Monday afternoon, Bill and I met with the hospital social worker. She thought Bill could try the therapy program, but she wasn’t sure how successful that would be. “They’re familiar with him at Sheridan Manor. He might be better off there.”
“That’s where I wanted to go all along,” Bill said.
Feeling sheepish, I asked the social worker to make the arrangements. After one quick phone call, it was done. The nursing home’s van would pick him up at the hospital in the morning.
After the social worker left Bill’s room, the nurse who took care of Grandma came by and told us how sorry she was about her passing. Bill burst into tears, and when I held him, my own cheeks were wet. Grandma was gone, and Bill was almost back to where he was a year ago. It was too much.