When Therapy Runs Out

We have almost exhausted my father’s allotment of therapy for his stroke. Will supplemental insurance make a difference? For now he is seeing an acpuncturist twice a week.

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Sometimes it feels like we are going in circles.

In order to get better after his most recent stroke, my father needed therapy. He could only tolerate so much therapy when we started. And then when he could tolerate more, and was starting to make progress, we had to decide how much therapy and which therapy to keep.

As you may have guessed, Medicare will only provide a certain amount of money for therapy. To complicate matters, speech and physical therapy funds come from the same bucket. And speech and physical therapy are what he needed the most.

We have already seen a difference in how easily he is able to sit up once he is moved from a wheelchair to a bed at therapy. When he was attending weekly, not surprisingly, it was easier for him.

If he needs therapy to get better, goes to therapy, then tolerates more therapy and makes progress, but then has to stop, how will he get better?

If he needs therapy to get better, goes to therapy, then tolerates more therapy and makes progress, but then has to stop, how will he get better?

I have looked into supplemental Medicare plans, but that will not help his current situation and get him addditional therapy.

A family member might be able to add him to his insurance, but that might not happen until next year. Which means my father, who is still making an effort to get better, will go half a year without therapy.

I asked what it costs to pay out of pocket for therapy, and it is not cheap.

The good news is he makes progress with mental stimulation exercises, particularly math and multiplication tables. He is now up to the “6” times tables and one of the activities persons at the skilled nursing facilty is supposed to review them with him (in addition to being mentally sitmulating, it is something he enjoys). For some reason his mind remembers addition and subtraction easily, but multiplication has become a challenge.

He continues to move his left arm slightly during occupational therapy exercises. The left side of his body was paralyzed whe he had his stroke last March.

And he recenlty moved his left thumb.

While these are all minor improvements, they are still cause for celebrating. I remind him that each small improvement will lead to more, and the more he is able to move, the easier it will become.

Acupuncture is going well, and his traditional Chinese acpuncturist immediately recommended herbs that have helped with his circulation. His skin color looks healthier, he is more alert and he is holding his head up better.

He is now tolerating twice-a-week appointments.

It is slightly easier for him to close his mouth, which is important for swallowing. Swallowing is still difficult, but when he closes his mouth and then “chews”, it is a little easier for him to swallow. But oftentimes he must be prompted verbally to do so, and sometimes verbally as well as physically (tactile sensation on his chin and tongue are usually the triggers to get him to swallow).

It is slightly easier for him to close his mouth, which is important for swallowing. Swallowing is still difficult, but when he closes his mouth and then “chews”, it is a little easier for him to swallow. But he must be prompted verbally to do so, and sometimes physically and verbally (tactile sensation on his chin and tongue are usually the triggers to get him to swallow).

We have our light moments.

My significant other, who is fluent in Mandarin, taught me to say, “I speak a little Chinese.”

Like an eager tourist, I tried out my Mandarin on a native speaker. My father listened, and then he started to laugh. I asked if my Chinese was OK — I wasn’t sure if he knew it was Chinese — and he nodded. Then I asked him to tell me if it was good (thumbs up), so-so (rotating hand side to side), or bad (thumbs down).

He graciously said it was so-so.

It reminded me of the time I called him several years ago to tell him I was taking a Mandarin class. He said to tell him something in Mandarin. I did. But he had trouble understanding me, so I repeated it a few times.  Then he said to just tell him in English.

His acupuncturist helps me translate and speaks a few words of Spanish to me sometimes because she knows I am part Mexican. A few times she has teased him, in Mandarin, for not teaching me to speak his language.

 

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My father, at acupuncture last week. Electric pulses course through some of his nerves when small clips at the end of the different colored cables attach to some of the needles in his face and body. Acupuncture has helped his paralyzed side move a little, improved his flexibility, and given him more energy and strength to participate in physical and occupational therapy. By being better able to participate in therapy, he has gotten stronger, and able to sit with little or no assistance at times.

 

And at a recent acupuncture visit he moved his left arm. He lifted it when I asked. It was a very natural movement, immediate and deliberate. For a second or two I forgot the left arm has not moved since the stroke last year. Then the realization hit me.

“Hun hao (very good),” I exclaimed. “You raised your arm, that’s great!”

And at a recent acupuncture visit he moved his left arm. He lifted it when I asked. It was a very natural movement, immediate and deliberate. For a second or two I forgot the left arm has not moved since the stroke last year. Then the realization hit me.

He could only do it once, and knows whether he can or cannot move it. It fascinates me to hear his occupational therapist ask him in Mandarin if he can move his arm or if he can move it again after an exercise. He answers honestly, and immediately.

Our trips to USC Keck Medical Center for outpatient rehab have become less frequent for the moment, which is why I increased his acupuncture treatments. It seems to me it is a little easier for him to close his mouth, and I wanted to get his feedback. So I asked.

Google translated for me and when I played the question for him in Mandarin, he listened. Then he nodded.

 

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Google translated my question to my father into Mandarin, and then I played the translation for him to hear. My father has shared with me that my Mandarin is so-so (which is generous of him) and I translate and play back questions or phrases whenever possible.

 

This might sound like a simple question. Or an odd question. But for a person recovering from a massive stroke — who cannot eat and has difficulty swallowing, closing his mouth and being able to keep it closed, and command the muscles to obey and move and swallow — the ability to answer that question affirmatively is quite a feat.

Practice makes it easier. And having someone help him practice when he is not at USC for therapy, or with his acupuncturist or with me, is a challenge. We will soon see if with some additional training the staff at the skilled nursing facillity will be up to the challenge of helping him perform some basic exercises to trigger a swallow.

 

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I recently provided this list of common words the staff at the skilled nursing facility can use with my dad. At least one nurse expressed interested in learning Mandarin when I mentioned during a training session I translate words to Mandarin to make it easier for him to understand what I am asking. 

 

He is scheduled for a visit with my acupuncturist later in July. Some readers of this blog may recall I had a complicated ankle injury that involved damaged nerves, a sprain and a minor fracture. I had difficulty moving my toes, could not move my foot to the left and was on crutches for half the year.

My official diagnosis was Chronic Regional Pain Syndrome (CRPS) which in severe cases make life extremely painful and dibilitating. Not to say that my time on crutches was a pleasure. I rarely take medication, I prefer the natural route. But the pain was so severe at times I had to take pain meds, and then suffered the side effects.

The CRPS was causing false pain messages to be sent to my brain and with physical therapy and acupuncture, I was eventually able to walk and run again. My acupuncturist essentially “rewired” me so that messages would no longer travel on the paths that were sending the pain message to my brain.

I am curious how this will help my father after a stroke. I know that it will, that has already been made clear. But with her particular bag of tricks, things will get very interesting.

 

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My father, after an acupuncture treatment. 

Father’s Day Is Sometimes Complicated

The holiday has caused such confusion and questioning that for a long time it was easier to ignore it and its significance.

I never knew how to feel about Father’s Day. 

As a little girl, I probably was obligated to make a card for my father in school. As I grew older and sparred with him verbally, I chose not to celebrate Father’s Day. My father was not the “World’s Best Dad” or “No.1 Dad” — I knew this at a young age. Then as adult, I eventually understood that he knew he had made mistakes as a parent and father, and I had started to meet him for lunch or dinner and share my life with him.

My father was not the “World’s Best Dad” or “No.1 Dad” — I knew this at a young age.

Last year he had another stroke, and I became his caretaker.

And then Sunday was Father’s Day.

It had occurred to me to get him a card, or enlarge a photo that he indicated he liked, or do something to mark the occasion. After all, he is still alive, aware of his surroundings and continues to make progress during therapy.

But making the journey from Orange County to L.A. for his appointments (three or four a week, depending on his therapists’ and acupuncturist’s schedules) is not easy, and the physical and emotional strain is high.

I accompanied him to acupuncture Saturday, and the coward in me thought it might be best to not acknowledge the holiday. If I did, I knew I would start crying, and then I would surely upset him. While I have told him that we both made mistakes and that I would prefer to have him in my life, there are so many little things we have not said.

As it turned out, I was in the area after all on Sunday.

My compromise with myself was to stop in on him at the skilled nursing facility, say hello, ask him how he was doing and let him know I’d be back in two days to accompany him to speech therapy. I told him my visit would be brief because I was on my scooter and wanted to get home before traffic became too heavy and the day became night.

He raised his arm and moved his hand in a way to indicate he felt so-so on this day, and after a few more questions I said goodbye.

The stroke has changed him, especially physically, but even before that, he had been humbled by other strokes and age. He was no longer the commanding and frightening authority figure. He became a man who waned to communicate with his children, although he lacked the tools to do so.  

The stroke has changed him, especially physically, but even before that, he had been humbled by other strokes and age. He was no longer the commanding and frightening authority figure. He became a man who wanted to communicate with his children, although he lacked the tools to do so.

I am certain I am not the only one who feels ambivalence or confusion on this holiday. Even the president of the United States has complicated feelings towards a father he hardly knew. It brought me some comfort to read the article about the trove of letters written by Barack Obama, Sr., preserved, sitting in a box, awaiting the day his son is ready to read them.

The Road to USC (and Speech Therapy) After a Stroke

For almost a week, I called different departments at USC Keck School of Medicine, wanting to speak to someone about how to get speech therapy with vital stimulation for my father.

I kept getting an answering service and had left a few messages, but was not getting a call back. 

My father has been a resident of a nursing facility since his stroke in March, and it is not possible for doctors or therapists from other organizations to come on site and treat him, with the exception of his primary care doctor.

After my father was hospitalized in October for a fever and what turned out to be a less severe form of pneumonia, he had the opportunity to get NMES, or neuro muscular electrical stimulation, also called vital stimulation, on his throat during speech therapy there.

It helped him to swallow, something he still cannot do regularly on his own. He eats through a G-tube and because he cannot swallow well, his saliva went the wrong way and caused him to aspirate. He was coughing and eventually became ill.

To avoid this, and provide him with every opportunity to get better, especially for something as important as swallowing and eating, I began calling USC as their speech therapists are trained in vital stim. The speech therapist at the nursing facility is not.

For some reason, each time I called the number for outpatient therapy at USC given to me by the operator, I would get an answering service.

Then I decided to have USC call me through a feature on the speech therapy page of their website.

The heavens opened, and a live person came on the line.

I explained the situation and the woman said it sounded like her supervisor would need to speak with me, but unfortunately, her supervisor was out of the office. The receptionist took down my information and said she would have her supervisor call me.

In the meantime…

I asked the administrator at the nursing facility about how I could get my father to USC for speech therapy and vital stim, since they did not offer it, and I was told he did not know because they do not normally send their patients off site. They employ therapists at the facility, and usually residents are seen by their on-site therapists.

If an outside therapist is not allowed on site, then how do I get my father to a place where speech therapy with vital stim is offered?

The administrator at the nursing facility said he wanted to help, and I said that was great, because I was trying to reach USC, but had no idea what I needed to get the process started.

I was referred to the nursing facility’s social worker who seemed very confused about what I wanted to do.

“We haven’t done this before,” she said.

“OK, well neither have I,” I said.

She suggested I call USC and ask what they needed, and that I call his insurance for information about whether it would be covered if he was being seen in an outpatient setting.

I was referred to the nursing facility’s social worker who seemed very confused about what I wanted to do. 

“We haven’t done this before,” she said.

“OK, well neither have I,” I said.

“Shouldn’t you call his insurance and USC Keck’s speech therapy to inquire about costs and insurance?” I asked. “After all, he is a resident at your facility. Why do I feel like I am the one doing all the research?”

Probably because I was.

To the credit of the insurance customer service rep, she did explain the process for the paperwork that was needed. She could tell me speech, occupational and physical therapy were covered. But she could not see his Medicare information, and in terms of whether my father could have just one therapy, such as speech, off site, was a question for the nursing facility.

As to what was needed to make off site therapy happen, and the cost, the facility knows, the customer service rep informed me. They should be the ones contacting the provider, she said.

Funny, I was thinking the same thing.

“Shouldn’t you call his insurance and USC Keck’s speech therapy to inquire about costs and insurance?” I asked.

“Why do I feel like I am the one doing all the research?”

Probably because I was.

I put my writing skills to use, and drafted a detailed email to the administrator of the nursing facility. I laid out all my questions, and shared that both USC and the insurance company said the nursing facility (as in he and his staff) needed to answer several questions and provide the paperwork needed to begin the process of outpatient therapy.

At least two weeks had gone by before the staff at the nursing facility offered to sit down and discuss this to see how we could make it happen.

The green light, after so many reds…

I drafted my email to the nursing facility’s administrator after I spoke with the USC rehab supervisor. She was sympathetic and helpful, and is the second wonderful person I have spoken to over the phone at USC Keck. (The first person was extremely kind and helpful when I was looking for nursing facilities shortly after my father’s stroke.)

She asked me many of the questions I ended up asking the administrator. She made it clear that she was there to help, adding she could hear the frustration in my voice and that I should not stop advocating for my father.

It was evident I had come across a series of road blocks, she said, and she would be a green light.

I was so thrilled someone seemed to understand the language I was speaking that I thought I was going to cry.

The staff at the nursing facility seemed miffed I had put them to work. And defensive at the thought that I would seek therapy elsewhere. Some of them, anyway. The speech therapist would later tell me she was glad my father would be getting vital stim and continuing with acupuncture.

Which brings me to some good news: acupuncture helped my father swallow.

The Monday after his acupuncture treatment, in which fine needles were inserted mostly on his head and in his ears, he was a much more willing participant during speech therapy at the nursing facility. The speech therapist informed me that she tallied 14 swallows, and that he ate most of the gooey substance in the small cup.

By the end of the week, when I visited with him, it was difficult for him to manage a handful of swallows.

I’m impressed and overjoyed. I knew acupuncture would help him in some way, but I was not sure how. I had hoped it would help with his ability to swallow, but I did not expect this.

More acupuncture appointments are on the calendar, and I just received confirmation from the nursing facility that his transportation is scheduled.

Now, I just need to make sure all the paperwork is in and that we — because I will be going as well — are ready for evaluations at USC for speech, occupational and physical therapy. Each evaluation will be about an hour, and once I know where on the USC Keck campus each evaluation will take place, we can schedule transportation.

Progress. Finally.

Dad_little My father, when he was much younger. Taken in or near Shanghai, in the early 1940s.

The people in the top photo are my parents, circa 1970.

My father goes to acupuncture

A family member graciously allows me to crash on his couch when I plan to visit my father.

It is an extremely convenient arrangement, given that his apartment is a block or so from a train stop, and perhaps more importantly, only a 15-minute walk (or quick Lyft ride) to the nursing facility where my dad is currently a resident.

After an initial stay at a skilled nursing facility in Rosemead, which is ridiculously far from Los Angeles — officially 18 miles from my former Koreatown apartment and about 30 minutes without traffic — we found a better and closer place in Highland Park, northeast of downtown L.A.

My father has made progress after a stroke in March, but it seems he has hit a wall after so many initial gains. His mobility on the right side has increased, but he cannot move the left side of his body without assistance. He has difficulty swallowing, and does not speak.

He was refusing to participate with the speech therapist, perhaps because it is still very difficult for him to swallow, but I’m not sure. After the electro stimulation on his throat during speech therapy at the hospital, he was a more willing participant, but he coughed a lot after trying different substances.

When he refused to participate in some aspects of physical therapy, that therapist could talk him into it.

Something is clearly going on inside that head of his, but since he cannot talk, we have no way of knowing what it is.

Acupuncture after a stroke seemed like a good idea, but because he was dealing with so many complications, we waited to make arrangements for scheduling an appointment.

We are hoping acupuncture will help stimulate his nerves and remind his brain and body what they should be doing. If it helps with movement, swallowing, and/or his mood, those are all pluses. I have wondered if he is depressed, given he is now confined to a room, his movement determined by others, and limited to answering yes or no questions.

Full disclosure: I have used acupuncture regularly, most recently for a complicated ankle sprain involving stretched nerves and loss of control of my toes, and the subsequent pain. I turned to it when migraines were dictating my life. My father turned to it for his maladies and introduced our family to it. He took me to an acpuncturist in downtown L.A.’s Chinatown when I tweaked my thumb while playing volleyball in high school.

Now it appears I am returning the favor.

I arrived at the nursing facility about 15 minutes before our scheduled departure.

He was dressed and ready to be moved to a wheelchair when I arrived.

The driver arrived a few minutes later, and I walked with him as he wheeled my father to the back parking lot where a small, white van was waiting.

I watched the driver open the van doors, unfold and pull out the ramp. Seatbelts attached to the wheelchair and acted as pulleys to get my father up the ramp and into the back of the van.

The wheelchair was secured, and then a seatbelt was pulled across my father’s chest. He seemed at ease and nodded to indicate he was aware we were going to acupuncture.

Once we got on the road, my father took in the scenery, looking mostly to his right, at a world he had not visited in seven months.

He seemed to enjoy the view, and being away from the nursing facility.

From the front seat, I asked if he was OK. He turned away from the window and looked at me briefly, then nodded. It was almost like I had interrupted him, and he went back to looking out the window.

He was alert the entire ride over and watched the nurse practitioner intently as she took his blood pressure and jotted the information down in his file. He responded to the acupuncturist, who is also his primary care physician.

The doctor, who I met for the first time that day, asked him to hold his left hand with his right. It apparently helps the brain remember and acknowledge the other side of the body. (This reminded me of my physical therapy treatments for my ankle.) She asked him, in Mandarin, to raise both arms up to his face. He complied as much as he could.

Before she began to insert needles, she massaged his face, shoulders and head. She was a bit rough for my taste, but he didn’t seem to mind. He looked calm, and comfortable.

She and I chatted, and she looked me over before saying she thought I looked like him.

Once the needles were in for a bit, my father began to snore. He slept almost the entire way back. I plan to see him again this week, and will schedule another visit. I want to get a better idea of how often he can make the trip. He did better than I anticipated — I thought he might have difficulties with traveling, but it was quite the opposite.

download_20151023_133548 My father, in the back of the van, on our way to his first acupuncture treatment.

A Stroke, and Both Our Worlds Are Changed

My father still has difficulty holding his head up, among a laundry list of other ailments. While he has made progress, it is his continued inability to swallow, and speak, that has me worried. But I also wonder if seven months after the stroke, he has tired of fighting.

In March, my father had another stroke.

Stubborn by nature, he had not checked in with his primary care doctor for almost a year leading up to the stroke and had not been taking his heart and high blood pressure medication regularly. He had some difficulty walking, and a fall from late 2013 still affected him. But he lived independently.

I remember the day, it was last year, when he told me his ex-wife passed away. I later learned it was around the time he stopped taking his medication. Apparently, he knew her when they were young, in Shanghai, and I think she was the love of his life.

He was calm and clear about how it happened, he showed no emotion, but talked in a soft tone. I almost cried, and wanted to embrace him, but hugging is not something my father and I did regularly. That may sound harsh and cold. And he was.

For most of my life, until I graduated from college and began working my way into a jounalism career, I did not speak with my father often. It was easier not to. Eventually, the rage and disappointment gave way to acceptance and forgiveness. There were occasional lunches and dinners before the stroke. But ours is still a complicated relationship.

Since March, I have debated if I should share what has been happening with him, and by extension, with me, and my past. And my family’s past. There is much we have not said to each other about a difficult upbringing that included frequent fights between my parents and a divorce after he left our home to live with another woman.

I know we wasted an enormous amount of time blaming and ignoring him. Of course, I understand I cannot change the past, but I am keenly aware of the hurt that lingers. I feel as if I have been keeping a secret, and now, I am letting some of you in on it.

Since March, I have debated if I should share what has been happening with him, and by extension, with me, and my past. And my family’s past. There is much we have not said to each other about a difficult upbringing that included frequent fights between my parents and a divorce after he left our home to live with another woman.

Writing is usually therapeutic, but it also means experiencing the hurt all over again. I have started and stopped various drafts about my experience with hospital and nursing facility staff; about researching different types of strokes, nursing homes and about recovery from a stroke; and possible places for him to receive electrical stimulation on his throat to help him swallow and possibly, speak again.

He has not uttered a word since March. It is ironic, given how much he yelled and enforced his will verbally when we were growing up.

My father is Chinese, hence my last name, which means “heart” and has a silent “H”; my mother is Mexican. They came to the U.S. in the late 60s, if I’m not mistaken, met in Los Angeles and married in the early 70s.

It was made clear to me by both parents that my gender meant there were certain things I could and could not do, despite having really good grades and being a pretty responsible kid. My father was stern and demanding, and he was the undisputed head of the household. Unlike many of my Latino friends’ fathers growing up, he cooked, often.

He also constantly tinkered with the old cars that sat in our driveway. I like driving through the city and enjoy road trips, probably because of the many Sundays we spent travelling to what seemed like distant cities in his 1963, banged up, white Chevy Impala.

I enjoy shopping for groceries in downtown L.A.’s Chinatown because we spent so much time dining and buying the proper ingredients for dinner there. I am independent and stubborn, like him. But he did not teach us his language, and I will likely forever be an outsider in that world. I do speak Spanish, quite well, and can still have a simple conversation in French.

All of this played in my head as there was a point after the stroke when the doctors did not think my father would make it. I decided to traverse the city to see him, and thought about the countless times we drove down Wilshire Boulevard.

I now lived walking distance from this major street. It was my route to the subway, and the first part of my journey to his bedside. I hopped on the subway from my Koreatown apartment and transferred to a bus that would take me from downtown L.A. to the hospital in Alhambra.

Driving there, without traffic, would take about 30 minutes.

But that was not a drive I wanted to make on my scooter.

I now lived walking distance from this major street. It was my route to the subway, and the first part of my journey to his bedside. I hopped on the subway from my Koreatown apartment and transferred to a bus that would take me from downtown L.A. to the hospital in Alhambra.

I felt I needed to tell him that I forgave him, and that I would help him if he wanted me to. I started writing a story on the bus, on my phone, and I remember passing one of his favorite restaurants at Garvey Avenue and Atlantic Boulevard in Monterey Park.

By the time I got to the hospital, my nose was puffy and my eyes were red. My father opened his eyes when I called to him, and once the nurse left the room, I began to say what I wanted to say. He began to shake, and his face contorted, but I don’t think he made any noise. Tears began to stream down his face. He was crying.

I was relieved he could understand, but then I felt badly for upsetting him. I took him by the hand and told him it was OK, that there was still time, including time for him to teach me Mandarin. (I studied Mandarin for a semester and I barely passed. My pronunciation is apparently horrible. When I called my dad one day to tell him I was taking the class, I said something to him in Mandarin and he asked me to repeat it. After a few more attempts and he still couldn’t understand what I was saying, he said I should just tell him in English.) I also told him that it was up to him, and how much effort he was willing to put into his recovery.

The last week has been pretty difficult, for me and for him, as he had just returned from an 11-day hospital stay due to pneumonia. It’s likely his own saliva went down the wrong pipe and into his lungs. He was receiving great care at Glendale Adventist Hospital, and the speech therapist there was using electrical stimulation on his throat.

After some initial frustration, and a visit by me during a session with his therapist, my father began to swallow various types of liquids and gooey substances. He would need several months of this before we would see real progress, but because his pneumonia was on the mend and his lungs were clear, he was discharged back to the nursing facility.

I don’t have any real complaints about the care at the nursing facility, but unfortunately, they do not offer vital stimulation for his throat during speech therapy.

I’ve spent almost a week looking into how to make this happen for him off site. Insurance is never easy, but I was able to speak with a live person after several messages and being routed to various departments, and she will let me know how and if therapy away from the nursing facility will happen. (If you’re curious, this is the link for what I’m looking into).

My emotional state was already shaky, and I was looking forward to attending the first-ever Laguna Film Festival in Orange County. The first short documentary, called “Alzheimer’s: A Love Story,” broke my heart into even more pieces. The film opens with two men, one sitting in a wheelchair with a homemade birthday cake in his lap that the other man is holding. The man’s head droops forward as he sits in the wheelchair. The other man is trying to get him to sing or blow out the candle. We later learn the man in the wheelchair is in a special treatment facility for Alzheimer’s Disease and the other man is his partner of more than 40 years.

The man in the wheelchair immediately reminded me of my father.

My father still has difficulty holding his head up, among a laundry list of other ailments. A tube connects to his stomach from a machine that feeds him liquid nutrients. I was told early on that one of the most important things in recovery is a person’s ability to eat solid food again.

While he has made progress, it is his continued inability to swallow, and speak, that has me worried. He remains at a high risk for pneumonia because he still cannot swallow. I also wonder if seven months after the stroke, he has tired of fighting.

While he has made progress, it is his continued inability to swallow, and speak, that has me worried. He remains at a high risk for pneumonia because he still cannot swallow. I also wonder if seven months after the stroke, he has tired of fighting.

I can only wonder what thoughts are locked inside his head. While he can nod or blink his eyes for “yes,” and shake his head for “no,” he often refuses to answer. He will simply stare back when you ask him a question or look away. I have attempted to have him spell out words to me, but most of the time he has refused.

At the hospital, he did hold a pen and attempt to spell “yes,” but he lacks control. I was going to see if he could touch the screen on my tablet to spell during my last visit, but he was too tired to wake from his sleep. Apparently, he had been rather active the day before, and it was the same week he returned from the hospital.

Tomorrow my father has an acupuncture appointment, and electrical stimulation is now part of his physical therapy. That therapist will be using electrical stimulation on his shoulders and neck, to help him with head control, and by extension, possibly with swallowing. Cross your fingers.

The couple on the left in the photo are my godparents. My parents stand next to them, and my father is on the right.

The little things in life: wearing two shoes

2shoes

Hello everyone! I am so excited that I was not functioning correctly at the office this morning. I couldn’t get numbers straight – well, that happens often – but more so than usual today.

Great news: I am wearing TWO shoes!

Before you think I’m smoking something I need a doctor’s note for or popping one too many pain pills, please allow me to explain.

For someone who has been on crutches since April because of an ankle sprain (and minor fracture and partial tear and nerve damage), this is HUGE. My right ankle has been in a brace or wrapped up, and finding a sock to go over the wrap or thick enough to go under the brace has been an interesting experience. Those socks have a special place in my wardrobe as they have a special purpose. And now, I am able to wear two matching socks and, yes, two shoes.

If you’ve ever had surgery on a knee or ankle, or been on crutches for a prolonged period of time, you know that simple things are not so simple anymore. You may recall my previous posts about attempting to go grocery shopping at Whole Foods and almost falling over while reaching for Pirate’s Booty, and my first time driving left footed.

But I digress.

I am wearing two shoes because my physical therapist says it’s time to start flexing my ankle and reminding my foot how it needs to move so I can walk. That means that while on crutches, I put my right ankle down (the injured one), and let my foot pretend it is walking – without bearing any weight on it. Apparently my foot and ankle seem to be remembering this well, as I am able to take some steps without my crutches. And I am able to stand up straight, on my two feet, like a normal human.

I never thought I’d say this, but receiving electric shocks during the neurology exam for my ankle proved helpful. 

Thank you PT. And thank you acupuncture for that first round of electric stimulation.

And Aetna, my offer still stands. I’d like to follow up with the orthopedic surgeon that correctly diagnosed my problem. You know, that condition that was making my foot blue and causing poor circulation. 

The Crutches Chronicles – Chapter 10, or is it 20?

splint

The latest chapter in the Crutches Chronicles has our protagonist waiting oh-so-impatiently for her appointment at an orthopedic hospital. It seems it has taken ages to get to this point: she might just be getting an MRI done on her ankle next Monday.

OK, not ages.

Just two months.

After waiting for my employer’s health insurance plan to kick in (which should have happened in February, but what’s a few months?); explaining the situation to my newly appointed primary care physician (PCP for short); two trips to the urgent care facility for a CD of the X-rays of my foot over two days, and two calls to the urgent care facility to ensure my records were indeed sent to my PCP; a week’s wait for authorization for a referral to the orthopedic hospital; and a two-week wait for an appointment with a Physician’s Assistant, or PA, at the orthopedic hospital, I will finally see a specialist about the ankle.

And, and, it is possible I could have an MRI done the SAME DAY, according to the paperwork I received. Wow. Not have to go back to the insurance company for authorization and then wait for another appointment? Oh my God, Becky!

The ankle is not broken and not fractured, but still, I cannot walk or put pressure on it. A bruise is still visible where my toes connect to my foot. It is an effort, still, to wiggle my toes. The calluses on my hands have healed thanks to the wristbands I put on the crutches, which I may need to pad with another set, but I still have rough spots on each palm. As I mentioned, my left arm is still hurting a bit, and my left wrist hurts, especially when I type. Which is never, right?

A trip to Good Samaritan Hospital’s ER was needed last Wednesday due to the pain associated with the fall days before. The pain was mostly in the left arm, but the good doctor decided a splint would be needed for a few days to hold the ankle in place, and perhaps start the healing process.

It felt better having a splint on the ankle than just the beige ankle wrap, which unfortunately I cannot locate at this moment. I am now without a splint and while my foot is lighter, it feels more vulnerable.

Physical therapy is likely part of the plan going forward. But that will not be known until next Monday.

Hopefully I will have an answer for people who ask, “How much longer are you going to be on crutches?” Some people don’t see the humor in the answer, “What crutches?”

A tale of two “foots”

It was bound to happen. I had to leave the house. And not just to go to work. I was low on toilet paper and also needed to eat something. 

I feel I mastered the getting to and from work part — driving left footed is now just a part of my routine. I just need to make sure I am sitting at the right angle. And that I adjusted my mirrors. And that I don’t take any calls. Most days I reach the pedals just fine, although sometimes, I give The Tank a little too much gas and my head whips back. 

After three weeks together, I think it’s safe to say my crutches and I won’t be friends. We can work together, we’re civil. But there won’t be any lunch dates in our near future, that’s for sure. 

The latest news on this severe ankle sprain of mine is that I will likely be scheduling an MRI to see what exactly I tore when I crashed into the tree that is my older brother during a volleyball game. I lost my balance after bumping or running into him at an alumni volleyball tournament at my former elementary school on April 6. I then fell awkwardly on my ankle.

It is a challenge to move my toes, but there is more movement than before. And I’m a little more mobile. I don’t have to rely solely on my crutches to get around the house or the office. I can use my right leg as a kickstand to get me short distances.

My latest adventure was at Whole Foods. I figured late morning on a weekday wouldn’t be as busy as a Sunday evening — which was the first time I ventured out for non-work related driving. For some reason, I was able to balance on the crutches with the grocery bag on my shoulder just fine on Sunday.

But when I tried it today, I felt the weight of the bag was throwing off my balance, and thrusting me forward after I had stopped.

I didn’t want to fall in front of a crowd (I’ve already done that, thank you very much). I could just hear someone relaying the incident to a friend later: “The funniest thing happened at Whole Foods in the snack and cookie aisle. This girl on crutches suddenly just fell forward, after trying to grab three bags of Pirate’s Booty.”

Have you had the Pirate’s Booty white cheddar popcorn? No? Then don’t judge me.  

I decided to use my crutches as a walking cane and put the bag on my shoulder. The right hand supported the crutches and the left shoulder had the bag on it.

Balance, Danielson, as Mr. Miyagi, the karate master, might have said. 

But my foot gets tired of me using its heel to quasi-walk. And after a while the ankle starts to complain as well. Holding my foot at that ankle is painful after a while. But I managed to pick up what I needed for another week and an employee with a wrist injury helped me to my car. She apparently hurt her wrist after so much repetitive motion at work and was wearing a black brace. We exchanged horror stories about the difficulty of small, everyday things — like putting make up on, going to the bathroom, showering, getting in and out of the car, etc. 

I had another acupuncture session this week and I am pleased to report that my foot looks a lot closer to normal. I took some photos this time. The swelling continues to recede and the bruising is less. My brother said the photos show it could be a high ankle sprain, whatever that means.

Cupping therapy may be in store for the ankle next week. The last time I sprained an ankle, my acupuncturist performed cupping on the ankle and made it bleed. It wasn’t exactly painless and I was a bit grossed out at the sight of dark, stagnant blood. But that, coupled with an herbal paste and acupuncture, helped me walk almost immediately. I wore a thick brace, but I did not need crutches. I thought we might do the cupping on the first visit, but my acupuncturist thought the injury was still too raw.

For the uninitiated, cupping therapy helps the blood flow to promote healing and while it can leave bruises that look like hickeys, it was very effective on my ankle. Here’s what WebMD has to say about cupping.

My father is Chinese so this notion of helping your body help itself isn’t new to me. Smelly herbs, acupuncture, cupping, and a smelly fridge with smelly foods from a smelly grocery store were common in my house. When I was younger, I was cynical about why my father would get acupuncture treatments or use herbs. But I’ve seen results.

And call me crazy, but I like my medical care to come without side effects. ImageImage

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A poking and a clean up plan

piles

If you’ve been following along, it won’t surprise you to learn tomorrow will mark the two-week anniversary of my ankle sprain.

Which of course means that I have been on this adventure on crutches for practically two weeks.

While the rest of the world has been (understandably) watching a massive manhunt in and around Boston, an explosion in Texas, and locally, preparing for other marathons, Taco Madness in Downtown L.A.’s Grand Park on Saturday, which also includes alcohol (sounds like a perfect pairing for 4/20), and CicLAvia on Sunday, I’m documenting the progress on my ankle. In my little world, that’s a big deal.

I am happy to report that my right foot looks almost normal after an acupuncture treatment yesterday. I broke the news to my acupuncturist and friend from elementary school that unfortunately, I had cheated on her. She took it like the strong woman she is and chuckled. As long as my condition was improving, that is all that mattered, she said.

Then she wanted details.

Where did this take place?

With whom?

Was it better?

I jest. Sort of. She wanted to know where needles were inserted. I am guessing in not enough places. Although the first treatment helped alleviate the pain, my foot was still quite swollen. It is sometimes hard to sleep because of the pain.

But, no, the other acupuncturist didn’t do it better.

After my treatment at Pure Life Acupuncture (my “regular” spot for poking), the bruising was visibly less (meaning it wasn’t as blue) and my foot looked thinner. Almost the way I remember it pre-tree days. (If you don’t get that reference, shame on you! It means you did not read my first blog about my ankle sprain). My foot still has a yellow and green tint to it, with a touch of blue near my toes.

I’m a little more mobile now. I don’t always have to use the crutches. I can go short distances using my right heel/leg as a kickstand. But I don’t do it too often because even that slight amount of pressure makes my ankle hurt.

I’ll be back at my poker’s Torrance office Monday for round two. I’ll make sure to take some photos. I meant to do that yesterday and then got really excited to see that my foot looked almost normal and I forgot.

I have a plan of what I’d like to get done today, but given that’s it’s almost late afternoon and I’m still in my PJs, I’m not sure how much I will be able to check off my list. I’d also like to eat something.

But here goes.

Three of the four piles of laundry that I separated last week — which took me about 30 minutes — are still patiently waiting to be washed. But I haven’t figured out how to get to the basement for laundering. Doing so involves two sets of stairs, and as you may recall, I’m not graceful on crutches. Adding a basket of laundry makes for a perilous situation.

I guess I could just throw the clothes over the railing of my back porch: they should land at the basement door. Then I could go down the steps, like a little kid, on my backside. There are a lot of steps, though. Plus I’m worried one of you might swing by just to photograph me doing that.

While I am on the couch with my leg propped up, I see the little pieces of lint on the rug; the dust and hair on my usually spotless hardwood floor; and the boxes, mail, clothing and other things in my living room that need to be put away.

Cleaning the hardwood floor and kitchen and bathroom flooring usually involves sweeping, dusting and then wiping the floor down with the wet Swiffer cloths. I’d settle for just dry Swiffer-ing. I’m wondering how the ankle will feel about that. I’m guessing it’s voting “no,” just from the pain I’m starting to feel after doing some hobbling sans crutches earlier.

Any volunteers?

You’d have my undying affection, get to ride in The Tank with me to Whole Foods, and get some cheese and crackers out of it.

My adventures on crutches and driving left footed

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I have been dependent on crutches for a little over a week now.

My exciting Saturday of April 6 consisted of me bumping into my older brother during a volleyball game, losing my balance, and falling awkwardly. On my right ankle.

Fortunately I am only dealing with a sprain. A severe sprain, but there is no fracture and it is not broken. I am unable to walk and hence dealing with the hobbling around that comes with being on crutches.

For the last week, I have tried to become friends with my crutches.

It’s about focus, and finding a rhythm, one person said.

There’s a YouTube video to make sure you have the correct posture and aren’t hunching over, a woman said. Apparently, I may have been guilty of hunching. It may explain why my back was hurting a little.

I find I am often off balance on the crutches. Sometimes I go too fast and almost fall forward. Sometimes, I swing my right leg and the sprained ankle hits the wall or the object I just passed. Sometimes, I forget I need to hold both crutches and let one go while I grab for something else with the same hand. And then a crutch falls on my ankle.

It’s my first time on crutches, can you tell?

I really am trying.

But my body hurts. I am hopping, crawling, bending, and sitting up more than the average person. And having the crutches in that area under my underarms isn’t exactly comfortable.

Showering is an ordeal. Going to the bathroom is an ordeal. Getting dressed is an ordeal. Getting in and out bed is an ordeal. Figuring how and what to make for lunch or dinner is an ordeal. I could write an entire blog post about how I made dinner the other day, but I wouldn’t want you to stop reading my blog.

Look on the bright side, you say.

It’s just a sprain, you say.

You’re building muscle, you say.

And you’re practicing patience, you say.

Oh yeah?

I think I’m developing a callus on my palm, I say.

I think I’m developing a callus on each palm, I say.

It’s likely my left leg will be buffer than my right leg, I say.

And, I get enough practice with patience at my day job, I say.

My amazing neighbor kindly volunteered for taxi duty last week. What a relief. I was still in a good amount of pain and not having to worry about how to get myself to and from the office was a huge relief.

Eventually, I had to drive myself to work.

It was a little daunting just thinking about getting in The Tank — my 1991 Chevy Corsica that doesn’t like to stop — and driving left footed. What if I pressed the wrong pedal? I could picture the headline: “Woman runs over Asian, Mexican and East Indian pedestrians in Koreatown while driving left footed.”

But once I situated myself carefully and propped up the right leg to ensure continued circulation, I was able to get out of the driveway and make it to Downtown L.A. I’m not worried about pressing the wrong pedal. A greater concern is giving the car the right amount of gas and then being able to stop it.

I’m hoping the acupuncture treatments will help me to be less dependent on the crutches — in other words, part ways amicably. But more on that later.

It looks like it is about that time for my new nightly ritual: rubbing the ankle with muscle and joint relief gel and then wrapping it up.

Until next time.