Where has my Independence Gone?

“That's me in the corner
That's me in the spotlight
Losing my religion…” ~ R.E.M.

What if the song became an anthem for elderly and we swapped out religion for independence?  Especially when we begin to lose some of our abilities due to illness, the lines from the song,

“I thought that I heard you laughing
I thought that I heard you sing
I think I thought I saw you try
But that was just a dream
That was just a dream”

…takes on new meaning, when the “I” begins to lose eyesight and hearing…

One day we feel young and vital, making our own decisions, taking on the challenges of the world and living every day to its fullest in the manner we dictate (all about choices).  Then, one day, all of that changes.  We find ourselves stripped of making our own decisions, our challenges become making it through the day, where others tell us what to do.  Sometimes this process is a slow transition, while sometimes, it happens in a matter of moments.  No one asks to become dependent.  No one asks to lose his or her abilities / functions.  No one cognitively expects age to overtake us.  Using my family as an example, four years ago, I equated people with walkers to be elderly and infirmed.  Today, three immediate members of my family have walkers and a fourth just received one.     

As a child (since my Dad and Mother-in-Law are still here), it is weird to see parents age, and ultimately become less independent.  For cryin’ out loud, these were the people that raised us, provided examples from which to draw out our own conclusion and tended to us when we were small.  I now stand idly by, watching, as some people seem to not want to accept losing pieces of their independence, some begin to come to terms that they are less independent and some recognize this change and accept it. 

Rebellion has taken on an interesting life cycle.  As a teen / young adult, we rebel against the rules that our parents dictate to us, as we stretch for our independence.  We start to drink alcoholic beverages, some start to smoke, others dabble in drugs (I am not going to be naïve here), behavior unbecoming to the previous generation appears and the desire to be an individual begins.  The ensuing decades most people follow a “standard” life - they become busy with marriage, raising a family, having a career, owning a business, volunteering our time and, ultimately, developing a life.  All of a sudden, the twilight of our years comes upon us, where the actual time spent on earth varies greatly.  I watch the twilight rebels begin to emerge, as they start to drink Ensure, some quit smoking due to oxygen, others dabble in maintenance drugs (morning and evening rationing), behavior unbecoming to the next generation appears and the desire to be remembered as an individual begins.  The ability to drive, cook our own meals, pay our bills and schedule our time slips away from us like trying to hold water with an open hand.

The important thing to remember is to live each day to its fullest.  As they say, treat today as if it is your last.  Do the things that you want to while you are able, for one day, our revised R.E.M. song might apply to you.

Witnessing a Stroke

We sat there around the table at a local Italian restaurant, Gab, Debbie, her mother and myself.  Gab had come home from school on her break, making it a good reason to go out for dinner.  My mother-in-law, the day before heard that she was well enough to graduate from rehab and go home.  Hungrily, we ordered our food and then talked over appetizers; everything was going well and everyone was happy.  Then, like a scene out of the Twilight Zone, time seemed to slow and focus became narrow, as we / I looked across the table and noticed my mother-in-law twisted and leaning to her left, away from Debbie whom she was talking to moments before.  “Barbara,” I yelled.  Her eyes had become unresponsive and, though she tried, could not talk.  “Grandma, are you OK?” Gab asked.  I stood up and called her again, she looked over then went back to the same position.  Gab was immediately up and tending to her.  I asked a passing waiter to call an ambulance – she was having a stroke.

A stroke, this would be her second one.  As with the first stroke that she had, they labeled this a mini-stroke, or a TIA (Transient ischemic attack), that should not have any lingering effects.  My grandfather, 30 years ago, suffered a massive, debilitating stroke, which left him wheel chair bound and needing 24 hour nursing care.  He lived that way until he died of unrelated causes about 9 years later.  My father, almost three years ago, had a stroke while recovering from neck surgery that left him mobile, but needing a cane and sometimes a walker to get around.  The Centers for Disease Control and Prevention (CDC) lists three main types of stroke:

• Ischemic stroke (caused by blood clots) – This is what my grandfather had
• Hemorrhagic stroke (caused by ruptured blood vessels that cause brain bleeding) – This is what my father had
• Transient ischemic attack (TIA) (a “mini-stroke,” caused by a temporary blood clot) – This is what my mother-in-law had

After my father had his stroke, someone recommended that I read the book, “My Stroke of Insight: A Brain Scientist’s Personal Journey,” written by Jill Bolte Taylor.  In the book, Taylor describes, in detail, her experience in being home alone, having a massive stroke and the years of recovery that followed.  While the human mind is great at protecting us from remembering trauma, as a brain scientist (neuroanatomist), she was able to observe and remember her own experience.  In my mother-in-law’s case, once the episode passes, within a day, there was no lasting impact (except fear of re-occurrence).  In reading the book, it helped me with my dad in that I was able to ask questions based on some understanding of what happened to him in the weeks that followed.

Unfortunately, when a stroke happens, it is unexpected, can leave the “victim” confused and potentially unable to communicate.  Time is of the essence to get treatment to the patient.  On the Stroke Foundation’s website, they state that “…Recognising the signs of a stroke and getting to hospital quickly for early treatment after a stroke is important to minimise the effects of a stroke.”  In addition, posted on the American Stroke Association’s site, “If you’re having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long-term effects of a stroke and even prevent death. Thanks to recent medical advances, stroke treatments and survival rates have improved greatly over the last decade.”

A police officer showed up quickly, followed by the ambulance.  They asked us a few short questions to help evaluate the situation while the EMT quickly went to work.  After about 30 seconds, they had brought a gurney into the tight quarters and moved my mother-in-law out and into the ambulance.  Debbie told them the hospital that provides her mother’s care, at which the person in charge said they are taking her to the hospital across the street.  Time was important and to not move further than necessary.  As it ends up, the hospital we went to was one of two New Jersey state-certified Stroke Centers in the area.  A few hours later, her functions were returning to normal.  She had dodged a bullet and the hospital stay would be short.

It is sometimes hard to maintain a level head when trauma of this nature occurs in front of us.  It is important to know how to properly react in a given situation and, in this case, know the signs to look for.  We were lucky this time, in being together to spot the situation, in reacting quickly and in taking action instead of waiting to see what happens.