Thursday, August 6, 2009

Appointments,Appointments....

Has it already been almost a week since I blogged? I didn't think that much time had gone by already.

We have been fairly busy this last week and a half,so today I get to play catch up.

Rick has had alot of appts during this last month,and we added three more to that list.
We were hoping when he saw the orthopedic surgeon for his knees that we might get a surgery date. Well, much to our disappointment,that didn't happen. His dislocated kneecap will probably go unfixed. The problem is he had bad arthritis in both knees and he is almost 47. Apparently,they usually do this kind of surgery on younger people before the arthritis gets bad. The success rate goes down when the age and arthritis level goes up. OK. The arthritis is causing the terrible swelling in his knees-a couple month ago they drained 50cc's of fluid out of his left one. The MRI also showed a tear in his left ligament. However,because he had meniscus removed from both his knees ( one in the late 80's,the other in early 90's-stemming from his Airborne days),they cannot be sure if it is actually a tear,or if that is just what it now looks like from having some meniscus removed. They also saw some dark spots on his bone,that could be areas of dead bone,so he ordered a Rosenberg xray of both his knees (which we have done)and a bone scan (which we will do Aug 17). From there they will make a determination as to what they can do,it there is indeed anything they can do.

Rick says he just wants a firm diagnosis,and if he has to live with the pain he is in,then he can deal with it. He just doesn't want to hold out hope for some relief if there is none forthcoming. We have applied for a handicap placard for the rearview mirror of the car. Some days it will come in very handy so he doesn't have to walk so far to the store. Once he's in,he uses the cart to take as much weight as possible off his legs,and it helps. It took awhile to get him to want to get the placard,and he is adamant that he does not want to use the little scooters that people with walking disabilities have.We will only use the placard on his bad days.

Rick has also started speech pathology. The goal is to get him to use techniques to help his memory. He has had one appointment, so it was spent working on word memorization. She would say several pairs of words. Some of them were associated with each other,and others weren't. He did OK,but missed a few. Then she read him a paragraph,and he had to tell her what it was about. It had specific details in it. He got the jist of the story right,but omitted most of the major details. He also had to tell her all the words he could think of that began with a certain letter in the span of a minute,etc. Part of the problem is that he spent a good part of the time trying remembering what he already said so he wouldn't repeat it,that he only was able to come up 4 or 5 words.

His goal for his next appt is that he has to come up with a method of keeping a daily list,whether it be pen and paper,PDA,or a small recorder. It has to be something that he will keep with him at all times,however. He has to make a daily list,and he had to try not to rely on me to remember his goals for the day. We have all three techniques,the problem is getting him to remember to use them. And unfortunately,I don't always remember to remind him,either.
This month our appt load isn't' quite so heavy:

August 4- EEG in Jamaica Plain,MA. He had to stay up past midnight so he would be really tired and start to fall asleep.His neuro TBI doctor wanted this set up. We don't have results on this yet.
August 11 ( Happy Birthday,Rick!)- Neuro TBI appt. The dr is determining what physical problems were cause by his brain injury. So far they determined he has lost some taste and smell,but only a small amount.He also has a speech pathology session.
August 17-Speech pathology and the bone scan.
August 19-Sleep study. His neuro TBI dr ordered this because ever since he came home he snores like there is no tomorrow,and they are concerned that he might have sleep apnea.
August 21-Neuro Opthamology in Jamaica Plain,MA. When Rick got back home, he noticed his distance vision was a bit off,somewhat doubled. We chalked it up to getting older,and needing glasses,and glasses did help out. He also had some sensitivity to light.Once he had his stroke ( a year ago Aug 4) his double vision worsened,and now he sees things in a 3D effect all the time. He claims he is getting used to it. He also has to wear sunglasses outside,in stores, etc. They have tried glasses,drops,etc,and so far nothing has worked. He had a test that determined that his has "cracks" in his eye lenses,which they feel is accounting for the problem with the vision. There is a theory that this might have been caused by the head injury,so this Dr is going to work with Rick to see if there is something they can do to fix this problem,and,we hope,get a definite diagnosis as to how this occurred. If they can't work it out with another kind of eye drop,then they might remove his lenses and replace them with plastic ones. However, it might not work.
August 24-Cornea clinic at Jamaica Plain,MA. His other eye doctor makes a follow up.

Of course, some of these appts could spur on others, but so far that is our agenda for the month.

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