The Diagnosis

A month ago we went to the VA hospital in Madison for a Neuro-psychology exam. This is a brain function test of executive functions, thinking, making decisions, planning, understanding, language, perception, and ...well, you get the idea.

It was a two hour test that we did on the 14th of last month. I should say, a two hour test that Rich did last month.
I learned in Physical Therapy-Speech last year that issues a person has pre stroke generally become worse post stroke or as the PT gal said, the issues would be greater in general.

We sat down in the room and I mentally thought I was prepared for hearing the two doctors conclusions.
I wasn't.

Cognitive Disorder, specifically Vascular Dementia -- the doctors were quick to say that Dementia means Brain Changes-- the stigma of hearing "You have Dementia" is about as horrid as hearing the word "Cancer".  Perhaps even much worse. Dementia is like saying: You are going to lose your mind.

We have gone down the Cancer Road already so I didn't think anything would actually shock me.

Rich has not just had one stroke. Last year's stroke was just a big bang compared to all the others he has had over the years. In other words, he has had a lot of insidious brain damage over the years.

I had thought perhaps that Rich had Vascular Dementia, but until the words were clearly spoken to me in that room, there was a chance that it wouldn't be that.

I looked over at my husband and wondered how he was taking the news. Hard to tell as he was just listening and watching. The doctors were very good to look us both directly in the eye.

Then they asked a few direct questions. "Val, you are not working correct?" I smiled and said that was correct, I had to quit last year to stay home and take care of Rich.
"We have a treatment plan and some things we believe will be helpful but it is a big commitment."

The question behind the question. 'Will you go running from this room screaming your head off and ditch your husband? Or are you willing to put in time and extreme effort for his therapy and care?'

I replied to them that I was there for the long haul. After all, I'd driven to the UW 5 days a week for over 6 weeks to take Rich to radiation treatments and tried to work on the weekends.

They went over the details of getting appointments with PT, OT, and seeing a Medical Psychologist too. I inquired if that would be that same as the gent we saw during cancer treatments. He was quite helpful. They thought they'd try to schedule us back with him since we had a history already of seeing him during the cancer treatments.

Social workers, OT coming to the house for inspection, testing Rich for safety, OT doing driving tests with Rich...arranging Respite Care.

Discussions of driving, not driving.

And then the bombshell.

"Do you have your POA set up?" the one doctor asks of us.
"Yes," I answer, "we did that quite a while ago."
"Financial and Medical?"
I nodded.
Rich nodded.

They turned and looked at Rich. "We may ask your wife to be your Medical Agent as we are not sure you can make your own health decisions. We will consider Financial POA also."

I could see that Rich was a bit shocked. So I piped up.
"Honey, if they do that, nothing really changes. Right now we are doing all of this together anyway. We sit and do the bills together, we go to appointments together right?"
He nodded. "I could do the checkbook," he said, "but my tremors are so bad. I can't write so Val does it."

There it was, the same thing we went through with his mother. Losing your independence officially. It didn't matter that I've already been doing most of what a Guardian or an Agent for Health/Finances would be doing already. But the 'threat' of having that taken away was downright frightening for him.

The discussion went on to talk about how Speech Therapy would help, meeting with the Med/Psych doctor would help, PT, OT, Social Workers, setting things up.

The goal was to maintain Rich on a plateau provided there wasn't another brain incident or other health incidents.

In one year they would test him again to see if he was able to maintain or...
Well.
Let's just say it out loud. This sort of brain damage doesn't reverse itself.

I'm not asking for sympathy or writing this for shock value.
I may continue writing about this on my other blog called The Long Road.
The Long Road is where I addressed our travels through Cancer.

I hope that I am prepared to travel down this new fork in the road.

90 plus days later...

On May 6th Rich had a stroke. The professionals all said, "The first 3 months are the most important. You will see the biggest improvements during that time."

Speech is still an issue. Rich gets frustrated when he talks sometimes. Fatigue is his biggest enemy. Fatigue seems to short-circuit his ability to find words and express ideas.
Physically he is doing pretty good. We had a follow up with oncology last week and learned that his throat cancer had been a stage IV. When the doctor told us that I was rather surprised. I don't recall learning the stage. Perhaps it was mentioned but I guess we focused on treatment and not the diagnosis.
So far, 2 years after treatment and still no return of cancer which is another sigh of relief.

My plan for the summer was this. Keep Rich engaged. I saw how he reacted right after the stroke when people were around. I had to stay home now to help him.
My farm and home became something of a revolving door.

Grace and Evelyn for a week, Ariel for a week, Dennis and Ariel for a week. Visitors who came and stayed the weekend. Mule riding. Fishing.
But always time for speech therapy and rest too.

I posted this photo already once but feel it sums up so many things accomplished in 3 short months.

96 days ago he could speak only one word. He ate with his utensils upside down. He needed a nurse at his side to leave the bed.

We are still working with Speech Therapy to try to improve the effects of aphasia and are going to address the possibility of driving again with limitations.

I was asked if I missed my work place. Not really. I don't miss the hours at all. I don't miss getting up at 2am to work a 12 hour shift.
The garden has been productive. I have frozen, dried, and canned food for this winter. I have been able to dedicate some rather long days to 'putting up food' for the winter.

Rich helps with chores now. I let him take care of the cattle. We will be shipping several to auction before the winter and keeping a few prospects for 'processing' later.

Things are coming together. I am looking forward to the possibility of part time work as a teacher's aide at one of our local schools. We'll see how things keep progressing.

Winter is looming on the horizon and it will be a challenge to keep Rich engaged with activities through that time.

For now... things are peaceful. I still can't leave him on his own, but I don't mind being here for him either.
Through good and bad we keep chugging along.

Here is to the next 90 plus days...

Life can change

A person's life can change in a flash of a second.
One moment I was getting ready for work, the next moment threw me into a bizarre life turning event.

In 2015 during Rich's cancer treatments, he had a TIA. The Neurologists from University of WI said that if you have a TIA, your risk for future stroke is higher.

Well, he had a CVA or cerebral vascular accident on Saturday in the predawn hours. The ambulance transported him locally and the trauma center was notified by local ER.
By the time I caught up with him at the Trauma Center in LaCrosse at Gunderson Lutheran Hospital, they had prepped him for surgery and were whisking him out of the room.
A kindly white haired man took me to the side and we talked about what was happening.
Turns out this kindly white haired fellow was a Neurologist. He explained that they were going to 'go in and remove the blockage' and they had enough brain to save.
He also let me know that the brain was a mysterious thing in a way and only time would tell as to my husband's recovery and progress.

I'm going to spare you the details of the past four days. And say this.

I am married to the most amazing person. He impressed Physical Therapy so much by his physical gains and strengths, that he was released and allowed to come home with constant supervision.

The area of the brain that had an 'injury' relates to speech and some thought process.
When words evade him, we have been finding another way to communicate.
Too much going on at once can be a bit confusing.

We have some real work to do together.

And some serious fishing to get done this summer.

Rockin' It.

Well there we go.  Another day on the farm.

Rich was in a big hurry after the contractors got to the house.  He decided to run his errands in town and I was to stay at home for the plumbers and the construction crew.

Well I did.  I found two more beat up buckets for my marigolds and petunias.  I figured this summer that I'd make my flowers movable so when the construction was done, I could move the planters around the porch.

The porch is now the place to hang out. It is quieter than inside the house during the day.
Just ask Morris.

Morning views from the porch are exceptional.  I can see that we will be spending a ton of time on said porch.

Morning View from the Porch

 Our relaxing spot

Yesterday he finished re-stringing the gelding mule pasture in the woods and let them out.  Today he was going to finish re-stringing fence and let the Dexter cattle out on their summer pasture.

I'd offered to do this a few weeks ago but he'd told me that he needed to do it.
I'd reminded him that last year I made electric fence all by myself and moved all of our animals onto our summer pastures too.

He told me no, that he'd do it. He sort of indicated that I wasn't capable. 
Well that kind of steamed me so I decided to sit back and let him do it in his own good time. 
[Which of course is different than my own good time...]


When he returned he backed his pickup as close to the shed as he could get.  The plumbers and the contractor's truck were parked close in as they had supplies in their trucks.

So Mr. I am In a Hurry, came out of the shed and made tried to hustle over to his truck across the gravel. In that section of our 'dooryard' there are large breaker run gravel that still poke up out of the driveway.

And Mr. I am In a Hurry, stepped on one and went down in a heap.
I believe that I am married to the man with the worst ankles on the face of the earth.

He sat a long while.
"You okay?" I asked.
He grunted.
Well I took that to mean 'Not really.'

I waited, he sighed and then finally got up.  In our 20 years of marriage, I think he has been on crutches for a twisted, broken, or sprained ankle at least once every two years.

He gimped over to the truck and limped back with dog food. I offered to help but he got Grumpy. When he is Grumpy Gus, I simply let him be.

I went back to my buckets and my dirt. 

I found a cool old crate in the little red shed and cleaned it up.  While it dried I took out some scraps of lumber and sanded them.
I thought I'd try something I'd looked up on a DIY site. I'd put some numbers on the kids' blocks for Elena and Sterling.

They didn't turn out too badly.  I choose the blocks at random, but after setting them on the spool table together I thought they might fit together like a puzzle.

I still have to put a finish on them, but that was fun. I guess I have to make numbers including 0 and 4 through 9 now.

Meanwhile ol' Grumpy supervised the workers putting up drywall and the plumbers who finished installing the shower/tub.

Of course his ankle was getting more sore by the minute. I suggested he take a load off and ice it.

NOPE. 
I shook my head.  Men.

When the guys left at 4:30, ol' Grumpy had me wrap his ankle and he went to lay down.
By the time he got up, he was really gimping and limping.

He sat on the porch where I showed him my blocks and the crate.  Then he spoke up. 

He needed to get back to the Dexter's summer pasture and put those lines back up right now.  

Since he was so bullheaded about his ankle and my abilities... I shrugged and said, "Okay, go ahead."

I didn't offer to move off the porch.  He sat there.

By golly he wasn't going to pull the wool over my eyes. And since he was Mr. Stubborn, I wasn't going to offer him help. When the other men were around, he was Tough Guy.
Now? Not so much it seemed.

I waited. I arranged some flowers inside the old crate and snapped a shot of them.

I intended to take several more shot while I waited.

I knew he needed help. But he was going to be too stubborn to ask for it. 

He looked out at the winter pasture and sighed. "I really need to get out there, maybe I'll take the 4 wheeler."

"Good idea," I replied.

After another long pause in conversation I gave up. 
"Why don't you take me back there and I can help you, then it will be done in a jiffy."

I sort of hated myself for giving him an out. 
Mr. Stubborn looked pleased and got up out of his chair, he limped across the new porch and I reluctantly followed.

Wasn't that mean of me? 
Before we went to bed he thanked me for my help. I shrugged.

Isn't it an interesting way we interact with our spouses sometimes? 

I'm sure ol' Grumpy Gus knew that if he waited me out long enough that I'd help. I'm sure he really knows that I am very capable of the work but likes things done his way.

And so it goes.
I'm going to keep an eye out for those ankle busting rocks.