There are so many factors involved in the recovery and prognosis for a stroke victim that one just has to trust in the process and follow the course. My belief and faith was that my efforts and actions would help the recovery process.
I turned all of my energy and attention to helping Jon heal from his stroke. The doctors had ultimately decided he had suffered one of the most serious, debilitating types of stroke, one most people never come back from, a brain stem stroke. The saving factor, they determined, that through the whole incident, his heart had continued to beat circulating his blood and the life necessary oxygen to his brain cells. If his heart had stopped, this stroke would have caused irreparable brain damage. This type of stroke shuts down all of the body systems causing most victims to die. Apparently, he had received medical intervention quickly enough to give him the gift of possibilities.
Once on life support, respirator, IV’s, monitors, catheters, dialysis, oxygen and blood pressure monitors, he was stabilized. Then my job began, even as he was comatose I saw that my job was now monumental. My faith was that my love and care for him would make the difference in his survival and recovery. I committed myself totally to being at his side as much as I possibly could. This is when I first began to develop The Process. Communication with a comatose patient, I believe is critical.
The importance of having a strong advocate is critical for the recovery of the comatose patient who has any chance of revival. A friend of mine had lent me a book. I found the book boring and nearly impossible to finish. I like to finish all of my goals, so I remembered the book. Since I had rapidly run out of things to talk to Jon about, I began to read the book. Jon would hear my voice and I could accomplish a difficult goal…so, I began to read the book out loud to Jon. My belief was that it didn’t matter what I said, just that there was a voice of someone important to Jon for him to have something to hook onto to help them pull back from the other side… to know that there is someone there who really and truly cares about you and your recovery helps the patient fight back. I had hoped that my actions would provide the difference for him to make it back.
So, the first step was communication and connection with the comatose patient.
The next problem was the respirator. I continued to read, but periodically during the day, I would talk to Jon about the respirator and his breathing. The first and most important step would be to get off the respirator. Over the first week, he was absolutely comatose, but during the second week he appeared to have some periods of consciousness. If he were waking up, he would need to be able to talk and verbally communicate. That was impossible with a breathing tube and respirator installed in his mouth. So, I told him, at least once per hour, “Jon, don’t think about any thing else but your breathing. Focus all of your healing strength on stabilizing your breathing. In slowly and count to 10, out slowly, count to ten, slow deep breaths. Work to control your breathing. If you can do this, we can remove the breathing tube.”
Thus began The Process. Daily discussions with the attending physicians gave me the insight to select the next item for Jon to concentrate on. We did this step by step over the course of his thirty-day interment in the hospital and continued when he was discharged. Jon had much to relearn, talking, his vocabulary, how to write, how to use his computer, how to take care of himself. He was so very weak when he was discharged that he had also to learn how to relax. And concentrate on getting well.
Part of The Process, Jon quickly learned when he arrived home, was to let go of some of the things he loved. He was so excited to see his garden again, that the first day he was home, he put on his garden jeans, shirt and shoes and picked up his favorite trowel to tend his neglected garden. Within ten minutes he returned to his resting spot, he did not have the strength to hold the trowel and work in his beloved garden for even ten minutes.
The Process is important and includes sacrifices for the end result. To optimize his recovery, Jon learned to focus on one step at a time, one goal at a time. Achieve that goal, pass that test and start on the next step and the rewards will reveal themselves. Jon did it one step at a time with full support and love of his family. This to me is the most important factor in the success or failure for the optimum recovery of a stroke patient, or any patient, or even a recipe for living. Identify the most important thing to do and do it.
For the stroke patient, communication with them is critical and helping them to be able to handle the frustration of not being able to do what their mind tells them they can do, but their body cannot do. The second part of The Process is helping the patient handle the frustration. Identify the most important frustration and tell them to get to do what they want to do, they have to pass a test. We all can identify with that one. All of us have and continue to have to pass tests. If we pass a test, we go on to the next level. If we fail the test, we keep trying or accept where we are as our limit. So, when the patient wants to get up and walk, they first have to pass a series of tests. I have noticed that this simple information helps relieve the frustration and helps the patient refocus on the step that is most important at the time. So, The Process becomes a series of activities and tests, pass the test and find the next step.
"The Process is a simple, but very effective approach to recovery and living life on a daily basis.
Find the step, pass the test, accept the results and go on, one step at a time."
________ Barbara Hall
Whenever I talked to Jon, he seemed to relax and be more at peace. I could see the tension ease out of his body and his mind change focus from his arms and legs to breathing. I was ecstatic, he was responding to my communications. Ten days into the breathing exercises, Jon became more aware. I was sure he was frustrated. Anyone who knows my family, knows we are talkers…love to talk. Jon could not talk with that tube in his mouth. In discussions with the doctors, they began to feel that he may be strong enough to remove the breathing tube. We agreed it would be removed the next morning, Tuesday morning. I was so excited. Jon would be able to talk.
I hurried through my breakfast and drove to the hospital. There was much excitement and agitation in the ICU that morning. Jon had become impatient and had ripped the respirator tubes out of his throat. Maybe we had forgotten to tell him it was coming out that day or maybe he forgot. This caused the next problem. During the process of ripping the respirator tube out, Jon had damaged his swallowing mechanism. That became the next process for focus. The doctors ordered a therapist to retrain his swallowing. I continued to read to him and told him now to concentrate on his swallowing.
