Monday, 1 April 2013

Speech Mountain Re-visited

"When we get to heaven you'll be without your eyes and I without my mouth", she once mused about our respective faults. But ever since her stroke I long for her sharp tongue to return, even to say the simplest of things. Speech has got little progress - the latest is her tendency to sigh and exclaim or utter incoherently. Her hearing seems excellent, even accentuated by her lack of communication. But when we speak her eyes seem to show focus and the question is whether she understands but could not answer, or not understand as well as uncommunicative. It is not clear whether her damaged memory has affected her ability to associate words with meaning, or damaged her vocal controls or both. Right now, there is not even a channel for yes-no communication. So probably her hearing vocabulary is non-functional. Anybody's guess, because her non-volitional limbs are also not indicative of her desires nor understanding. Only her eyes blink. Yes, we've tried using it as a Y-N channel, but inconsistent. Hearing vocabulary is non-existent?

Thursday 4 Apr 8pm:  Last few days she appeared sad, so often I've to put on a brave face to cheer her. She's cheer-able.

Monday 8 Apr 10am: By looking at her eyes it seems she still cannot recognize her friends or other family. She will not turn her head to your voice and the only way she focus is when you look straight at her line of vision. Some way to go before she comes out of coma completely.

Thursday 11 Apr 1pm: Fatigue - thats what I'm fighting these days. But she sleeps most of the time.

Monday 15 Apr 11am: Is she coming back ever? I kept asking myself this question. Doctor friends don't think so - unless they are miracle believers. Meanwhile Miranda in her most comfortable state looks like a baby, unaware of whats around her.

Thursday 18 Apr 9pm: A small improvement - shes now looking straight and focus straight. Still making those unintelligible utterance softly.

Wednesday 24 Apr 11am: She looks normal. Especially after a good night's sleep. But her cognition is not coming back. Only for now I hope. There's also a slight infection.

Sunday 28 Apr 8am: Have not been able to make any new entries on this blog on her progress. Only significant new developments will be noted from now.

Sunday 5 May 9am: Could Miranda have been saved from this? That is the question I kept asking myself in the doldrums of her recovery. Could the aneurysm be triggered or associated with her onset of Parkinsons? If only she had an angiogram instead of cat-scan in 2009 review of her motor condition. We could have then seen the bulge and the demon would have been caught in a simple hourly radiography-intervention procedure. Despite the potential life-threatening angiogram, her family being neurologically predisposed (her father's stroke, her advancing dementic mother, etc) and the high pressure job - couldn't it have caught the attention of some luminary medical friend? I hear in Japan angiograms are routine procedures of senior citizens. But here I am watching water rushing under the bridge, holding the can.
Post note: There is a possibility that Miranda does not have Parkinson's at all, as the drug prescribed then (2009) did not have significant improvement on her motor response. Golf improved it. As it turned out the aneurysm dramatically showed itself while playing golf.

Wednesday 8 May 6pm: Surrounded by family and long lost friends last 2 days think I detected a smile. Friday 10 May: Cough and some infection. Visits avoid for now.

 Friday 17 May 10am: Still on antibiotics for her UTI. Mysterious leg rash disappeared.

Wednesday 22 May 8pm: So now the UTI has subsided, but the cough persists for almost 2 weeks now. Hoping the chest irritation is not serious. She has to learn the excise the phlegm and avoid any pneumonia which has grave consequences for bed-bound patients.

Saturday 25 May 4am: "Don't worry - just keep going and I'll meet you on the other side". Miranda used to talk about a father encouraging his young son on his first solo swim for a full lap. It must be daunting to brave the interminable cold water, thrashing all might for the other end of the pool to come into view. But then there was the smiling Father. If she had known that she will not be conscious again before succumbing to the stroke I'm sure she'll exchange those same words with me.

Thursday 30 May 10am: Just when I was giving up ever hearing any word from her she started uttering something. But her cognition is still weak and it is unclear whether she has any vocal memory.

Saturday 1 Jun 8am: She seemed to be able to sense urgency in conversation, like when I mentioned visiting my father. Hoping her awareness of the environment increases.

Friday 7 Jun 4pm: Making a slight progress of vocal utterance - usually a sigh or frustration or discomfort.

Sunday 9 Jun noon: So when I told her that father passed away last week she just looked straight at me unmoved. That is very unlike her, she is a most filial person to family members. At night her vocal cries continued. She's been fighting a chest congestion and fits. Back to Kepra medication.

Wednesday 12 Jun 10am: The anti-fits drug is making her sleepy most of the day. Still struggling with chest congestion. At 2pm there was blood due to trauma from the nasal-gastro feeding tube. It may or may not be the cause of all the phlegm and congestion from the throat and chest.

Friday 14 Jun noon: Her cough was reduced and hence she was able to sleep last night. Must watch for such infection. This morning was able to utter some sound and roll her eyes. Her verbal progress still slow - her neural recovery must precede it.

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