Forgot to mention that yesterday the doctor had reviewed Karen’s medication and had moved Karen’s sleeping tablet to the “as and when required” category instead of the daily category. The same goes for the anti-sickness injection in the morning. She didn’t take the sleeping tablet last night, but still had a good night’s sleep which is great. She missed the anti-sickness injection and felt a little nauseous after brushing her teeth but no sickness came so another bit of medication out of the way.

kp enjoyed her bath as usual. It is one of the highlights of her day along with physio. She said she wouldn’t know what to do with herself if it wasn’t for the bath and physio.

Lunch followed snooze followed bath.

Physio today involved them working on Karen’s arm. She mentioned it had been giving her jip. Karen was hoisted from the wheelchair to the bench and she looked really hunched up on her left side. They laid her down on her right side and the main physio moved her left arm in all sorts of directions. He did loads with her shoulder as well. After about 30-40 minutes of these movements (with the odd “ow!”), kp’s movement (without pain) had increased quite a bit.

Towards the end, he was getting Karen to move her left arm in different directions herself. He held her hand so she didn’t have the weight of her hand to move. She did very well. I was uncertain how much the physio was doing and how much kp was doing. I will have to ask kp tomorrow.
We had a conversation today about what the physio had said about her left arm and how it may not get back to full health. She wasn’t overly concerned about it and basically had the opinion on the long lines of “as long as I can still do all the things I used to do”. She thought about it for a few seconds and then said “If I can’t walk the dogs on my own, I will be annoyed.” This made me a little bit sad, because she definately will need 2 arms to walk the dogs, possibly even 3 !

I think, in time, she will realise how much she needs 2 arms and this may get her down, but she is ok for now, and you never know, she could regain enough movement in her left arm to do the things she likes to do, although I personally can’t see this happening, but what do I know : she keeps amazing me with something every week !

I phoned Karen just before I had my tea (7.30pm) just to check all was ok.

It wasn’t. She was very upset and “just want(ed) to go home”. It appears she had got really upset whilst Marie was still there and poor Marie had to leave her at 6.30pm (to get her bus) with Karen assuring her she would be ok and just needed to be alone.

When I phoned she couldn’t get the sentence “I want to come home” out without interrupting it with real anguish and tears.

dp:- Do you want me to come in ?
kp:- No, there’s (sobbing) nothing (sobbing) you can do
dp:- I am coming in.

When I got there and this will sound corny, I could feel kp’s mood lift. I could see how much she had been crying, her face was beetroot red, but she was pleased to see me. We had lots of tears and lots of talking. A couple of things had triggered it :-

• The realisation that her left arm may not get to be as capable as her right arm (and the implications)
• A discussion she had had with another patient where she had found out the other patient (very similar age to Karen) was going home on Friday

We talked these things through. There are no easy answers or quick fixes that can be applied. It will be hard, but I think Karen took solace in the fact that we would get through them together.

We discussed at length home visits and whether she would want them or not. The pros for them are being home, seeing the dogs, a bit of normality and lots more. The cons are leaving the home and more importantly the dogs.

She doesn’t want to leave the dogs. We decided on the fact that she would come home for visits when she can stand up from the bed to get into the wheelchair, and stand up from the wheelchair to a chair that is at any height. In other words, when she comes home, she could get on to the settee, back to the wheelchair, get to the loo etc….

She seemed happy with that for now.

I left her at 10pm tired and more settled than she was. She was very grateful that I had come in, I think especially because she had said to me “you don’t have to come in”. I am starting to understand the female language better the older I get. I now understand that “you don’t have to come in” means “be here within 30 minutes”

Hope you feel better tomorrow love

dp
xxxxx