So we were chatting and all of a sudden he transitioned from his normal speech with occasional word-finding troubles to pure word salad.
“What did you say, Dad?”
“Flurrinasal better bell-bottom sinny sinny biggle.”
I held up a pen. “What’s this?”
“That’s digerrigar blombat.”
I pointed at his watch. “What’s this?”
I hollered for Beloved, who was just draining the pasta for dinner. And in five minutes, we were on the way to the hospital in a driving rainstorm. We hit the ER at the 29-minute mark. We decided that the hospital I used to work at was the place to go, even if administration didn’t like me. (I gave them plenty of reason to do so, but in my defense, they gave me more reason to give them reason. Or something.) They had the stroke program I knew was as it should be. Of course they did. I’d set it up 12 years ago.
The security guard recognized me and had him back in a bed in moments. The stroke protocol system rolled smoothly along just as it ought to, and my old partner showed up less than an hour after his symptoms had started, the Pharmacist had the tPA dose waiting for her and he got the bolus 50 minutes after we hit the door. Not bad at all.
And we waited for his speech to clear. It didn’t.
Then he started to bleed. The venipuncture site just gushed. Pressure dressing. A skin tear from five days ago opened up like it was brand new. Another pressure dressing. And then his cheek started to swell right over the cheekbone. What the hell?
Then I remembered that he’d fallen two weeks ago and wound up lying on that side of his face. But he never developed a bruise or anything at the time. Apparently, he should have. Later we would figure out that another large hematoma had popped up on his right hip, where he’d fallen. His cheek continued to swell and darken and we looked at each other in consternation. Not a place to get a pressure dressing. Hard place to put an ice pack, which he didn’t tolerate anyway. We talked about getting Plastic Surgery to come in in the morning.
We got him to the ICU and got him settled. I left at 10:00 PM. At 10:45 they called. He’d started sundowning and was basically uncontrollable, repeatedly trying to crawl out of bed and hitting at people who tried to keep him from hurting himself. A patient has to keep quiet after tPA, there’s too much bleeding risk and if he falls, there’s hell to pay. And there was hell keeping him quiet.
Beloved talked me out of going to him, insisting that he go himself. I had to work at 5:00 AM, and he insisted I needed to sleep. God, he’s wonderful.
They had a rough night, but of course, once the sun came up, Dad calmed down and was back to his usual cheerful self. His speech is much clearer today and he did well with Therapies and the doctors. The hematoma on his face has shrunk some, but now he has a beautiful black eye. He leaves the ICU for the floor tomorrow. Beloved has gone to get some sleep and then he’ll come back and stay the night again.
The nurses were full of praise for how good Beloved was. “I’m no dummy,” I said. “I married a Neuro Nurse.” And he’s wonderful.
The sun is setting and so far, Dad’s calm, although he’s started with some increased confusion. Pray for a better night.
We went through something similar with my Abuela. (Severe hypoglycemia, not neuro. Her glucose level was a 7 when they got her into the ambulance.) After having to watch them vanish by inches, it can almost feel like twisting the knife in the wound. I don't actually have any good words for how to handle it. I just muddled through and carved space out for myself to cry when necessary. But I can offer hugs, and you'll muddle through too.