Simon was sitting out in his chair today, and looked much better for it. It takes a big effort to get him out of bed (three nurses plus a hoist), and I think it is quite scary for the patient the first time. He seemed pleased with himself, and it gave me a chance to rub his back. I didn't get chance to feed him my home-made lasagne because he had already scoffed a sandwich and a banana. However, he did have some strawberries and cream that I had taken in. Shirley and I will have the lasagne for tea.
After about three hours in the chair, Simon said he was tired and wanted to go back to bed. It is quite an effort sitting up because he tends to fall over to the right side and has to keep dragging his body upright.
Once back in bed the breathing mask was replaced, making it difficult to communicate. He asked for a small radio, I have one somewhere. Once again, Simon wanted details of his 'accident', so I told him all over again. Also he asked how long he might be in the hospital. I confess that I lied a little, and said it would not be for long.
He noticed that Shirley was wearing unusual shoes, pointed at them and smiled - she is wearing granny lace-ups these days. Later he passed Shirley her walking stick. This man is not stage two! By the way, the stages refer to the Brunnstrom Recovery Scale if anyone wants to look that up. His preferred reading matter today was a catalogue of mobile phones!
Love Marian x
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Wow, he sounds so much stronger. Tell him he got the best Layzee boy in the hospital from me will ya?
ReplyDeleteI am away at a festival and will only have limited access to the internet, but you are all in my thoughts
xx
Well, a shallow internet search was less than helpful and even Wikipedia failed to come up with the goods and so here is a fast and dirty overview of Brunnstrom's Seven Stages (of stroke recovery) culled from a number of sources. Thus, if it is in any way lacking or inaccurate I would be very happy for someone to improve or replace it.
ReplyDeleteStage 1:
A patient has no intentional control of the affected side of the body and muscles are usually flaccid.
Stage 2:
The muscles are no longer flaccid and a patient may be able to initiate a few voluntary movements. However, muscles will also tend to tighten both independently and excessively in response to initiation or stimuli (spasticity or muscular hyper - tonicity). This typically gives rise to 'synergy patterns' in which an excessive number of muscles and muscle groups can become involved in movements that should only involve a few muscles and muscle groups. As a result, while movement can be initiated,there is very little control and intended goals are not achieved. (This must be horribly frustrating.)
Stage 3:
While muscular hyper-tonicity tends to increase, a patient has far more control over ongoing synergy patterns and thus, while deliberate movements can be massively exaggerated, they can achieve some limited goals.
Stage 4:
While the vast majority of intentional movement is still dogged with synergies, there will be some evidence of finer motor control. Muscular hyper-tonicity will begin to decrease.
Stage 5:
Muscular hyper-tonicity continues to decline, There are less synergies and increasingly complex and fine motor coordination becomes possible with practice.
Stage 6:
Muscular hyper-tonicity should no longer be apparent; joints will be able to move with almost complete independence and little or no synergy.
Stage 7:
Normal function is resumed.
So, that's the roadmap to Simon's recovery over the next few months.
I hope it is helpful.
Matt
Find Simon a magazine with the new HTC Hero in it, it's exactly the sort of HCI geekfest he loves!
Actually, after writing all that I found this excellent paper which is both informative and also opens a search right up:
ReplyDeletehttp://www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed=google&rid=physmedrehab.section.726
Far more useful!
Matt, thank you for this research. In truth, they are right he is at Stage Two because the right side is not doing anything apart from movement from the shoulder. I have assessed him on the Barttel Index at 15%. A long way to go.
ReplyDeleteMarian x
Hi Marian & Simon
ReplyDeleteHave been away in sunny Yorkshire where as yet electricity is hard to find never mind the internet. Glad to hear Simon is making what sound like good progress on his recovery but bet he's impatient to be at Stage 7. I know it seems a long way to go at the moment but with someone as tenacious as you by his side then he'll get there.
Thinking of you both lots. Love for now Jean xx