As many of you know, Phyllis (Mom) had a "Brain Stem Stroke" (bleeding in the brain stem). We don't know when it actually happened, but knowing what we know now, we suspect it happened the day she fell outside an Ankeny elementary school where she was substitute teaching. (end of April) We didn't know the severity of her condition, or even that it was a stroke until June 8th when we had a follow-up appointment with a neurologist. Here's our attempt to summarize the last few months:
1) The day in late April when she fell, she hit her head on the pavement and broke her glasses. She did not remember tripping or any reason for falling down that day. We suspect the bleeding in her brain caused her to fall down. The school nurse took her to their WC doctor where they examined her, and the main thing they noticed was she had fractured her wrist. They gave her pain medication and a brace for her wrist.
2) Over the next couple of weeks, she began noticing problems with her balance and headaches. The headaches were getting worse and she also started having double vision, more balance issues, dizziness, etc
3) She went to the WC doctor in early May. The doctor said they would order a CT Scan, after getting approval from the insurance company. A few days went by and nothing happened. She followed up but nothing happened.
4) On May 16th, mom went to her own doctor and was sent to the ER at Mercy in the hope of WC would pay for the scan. She finally got a CT scan and MRI. The scans revealed bleeding in her brain stem so she was admitted to the ICU-Neuro so they could monitor her blood pressure and other vitals.
5) She was in ICU for a day, and then in a regular room for a day. At that point, the neurosurgeon/neurologist had called it an "inter-cranial hemorrhage". The doctors also ordered an MRA to ensure it was not an aneurysm or similar issue. They confirmed it was not, and thus were not concerned about this being life-threatening. They sent her home on May 18th and ordered physical therapy and follow up appointments, along with a follow-up MRI to happen about 8 weeks later.
6) Mom was doing okay at home, but she couldn't drive (which has been very hard for her!). Aunt Mary was taking her to therapy twice a week (thanks aunt Mary!). Mom didn't feel the therapy was helping her much. She still had dizziness/vertigo, but the double vision went away and the headaches were a little better.
7) On June 8th, we met with a neurologist and he confirmed she had a stroke. I (Kristy) was at that appointment and the three of us had a discussion about what that meant and prospects for her. He said the fall did not cause the brain stem bleeding. The stroke was caused by her high blood pressure which she had been dealing with for a couple of years. He thought the bleeding had probably been happening for some time, and then she fell, which caused all the events above. He said the stroke caused damage to the brain, which means she would probably be dealing with some version of her physical symptoms for the rest of her life, but the severity remains to be seen. That was a tough day and don't think mom was able to absorb or accept everything that day. His treatment was to continue to keep the blood pressure under control with medication and continue with physical therapy.
8) On June 13th, we met with mom's general doctor, Lorene Mein and discussed the neurologist visit. Lorene was very supportive and advised mom to see how the summer goes and not worry about trying to go back to substitute teaching in the fall (which mom wanted to do, of course). She told her not to do too much...just take it one day at a time and eat healthy, take her meds, try to do more walking (which meant she had to get a walker), and go to therapy.
9) Shortly after that, Aunt Gloria came to visit! She stayed with mom for a few days, took her to therapy, gave helpful advice, and helped her with her daily routine. I know mom enjoyed that a lot. At this point, she was still having dizziness, headaches, and feeling quite tired/sleepy much of the time.
10) On June 27th, mom went back in to her doctor, as the dizziness, balance issues, tiredness, double vision symptoms has been worsening and/or coming back. She was also starting to have more numbness in her face and her speech as a little slurred. She was sent back to the ER at Mercy where they did CT Scan and MRI again. The scans revealed a slightly larger area of bleeding in the brain stem, but actually showed the blood was absorbing into the area, which could be causing the symptoms as well. She was admitted to the ICU-Neuro for a few days and then sent to a regular room. She was getting physical and speech therapy on most days. At this point, she was having a much harder time walking because of the dizziness/vertigo, so they kept her in a "regular" room for another couple of weeks while the next step was determined. Aunt Gloria and Aunt Susie/Tina came to visit mom while she was there. Aunt Mary visited often too. Cousin Michelle was there one evening which also helped lift mom's spirits... we had fun conversations :)
11) On July 12th, she was finally transferred to Parkridge Specialty Care, a skilled nursing and rehabilitation facility in Pleasant Hill (near mom's house). When admitted, she had started having numbness on her left side (leg, arm, hand). The dizziness was worse as well, so she was facing many challenges and was having a very difficult time walking. She needed a lot of assistance.
12) I don't want to end this update on a sad note! Today is July 27th and mom has been improving at the nursing home. She gets 2.5-3 hours of physical/speech/occupational therapy per day. Karla and I take turns visiting her so she has one of us there every day. Aunt Mary also visits often which is so appreciated, and I know helps keep mom in good spirits! She remains positive that she will recover and get to live independently again someday. Cognitively, she is totally fine, and she still cracks jokes and likes to interact with the people there. I observed one of her physical therapy appointments this week. She was having a good day and was able to use the walker and assistance from the therapist to do a good amount of walking/ transfer to sitting/ getting up, etc. Which is an improvement! That being said, she is ready to get out of there :) and will be coming to live with me on August 4th. I know she wants to go home but physically she is not quite ready to live on her own (even with home health aide/therapists coming in daily). We feel this is the best option for her right now so we can see if she recovers enough to live on her own.