TIA, a glimpse at the next stage

Lynne D

My husband and I walked to the post office today. On the way back he shuffled his feet more than usual, and veered off in a stumble, then I could barely walk him home. He fell on the final stair into the living room. He could not follow one simple direction (not uncommon) and his muscles were simply not working. Thankfully he fell into the memory from dog bed, and after trying to get him up I thought I would just let him rest there. (Writing that part out makes me feel like a bad person. It is a big dog! The bed is clean-ish.) It took about 45 minutes to get him up. He “sat” on the couch, leaning severely to the left, and ate finger food, drooling. After about another hour he was upright and able to stand and walk.

The nurse said it was a TIA, and to just keep mad eye on him and let her know if I needed help.

I have a Google medical degree, so consulted the literature and read that a TIA can mean a full-on stroke within days to a week. It really got my mind whirring about what the next stage will look like.

Strangely, when he was able to regain his limited ability to communicate, he was grateful for me and loving. Go figure.

I am steeling myself for what comes next.

Quilting brings calm

A TIA can be followed by a stroke… or not.  Depends on the cause and the patient of course.  I totally get the dog bed - any port in a storm. It’s better than the floor, and the floor might be all you could  have done otherwise. We can only do what we can do and  trying to wrestle a grown man into a comfortable   chair or bed isn’t always possible. 

Try to rest now  in case the next few weeks do mean more trauma for you. 

Joydean

Lynne so sorry! After just having a few good days. Thank goodness the dog bed was there. As QBC said that was more forgiving than a hard floor. Glad he was eating and getting around a little better. The best part he was grateful and loving to you!  Isn’t that the way it goes, something happens to scare the crap out of you and they are loving and happy you are there. Take care Lynne.

Jo C.

Omigoodness Lynne; I am so sorry.  I am not a physician, but even with a TIA being diagnosed over the phone by a nurse, I probably would have him seen.  Reason is, hate to say this, but Zyprexa is one of those drugs that can increase risk for strokes and strokes can mean many different things depending.

It is understood that your husband is at a point at which no heroics would be done.  However, strokes do not always kill outright.  The person can be left with severe issues such as inabililty to speak or understand speech, inability to use arms or legs or limbs on one side of the body and so much more and yet be awake and alert.

May be best to have him checked out, assess the meds with the doctor, and have the MD advise what if any measures/meds to be taken.   It would be a horror show for both of you for him to have a CVA on top of the dementia, remaining alert and living with a dramatic outcome.  Since you have been dedicated to caring for him at home, that could increase the heavy hands-on care issues.

Since this is an abrupt new occurrence, it appears it would probably be covered by Medicare to have an ambulance transport to the ER where he could be seen and if he is still compromised in some way, he may possibly even be admitted.

Lynne; you are one of the kindest, dearest persons who leaves no stone unturned with your meeting challenges head on and caring for your husband under some severely difficult challenges.  I admire and respect you.  I can imagine that you must be pretty tired and did not need one more thing happening after the relief of the success with Zyprexa which we were all so happy for you and your husband.  Again, I am so very sorry.

It may be your decision to let things go as is and let things play out; that is indeed an option, however; if one could prevent increased disability, especially if he stays alert and requiring increased heavy care, that is another option to consider.   Just something to think about.   There is no right or wrong, just what is best under the circumstances considering the entirety of it all.

Let us know how you and he are doing; I will be thinking of you with warmest of thoughts and hoping for the best for you.

J.

saltom

Over the past few years my DH's legs have given way and he has fallen several times; not hurt himself but just didn't have the strength to get up.  I have had to dial 911 and ask for list assist. I explain DH is not hurt, just can't get up, and the EMTs come and get him on his feet and take him to a chair or bed or where ever he was going in the house. I have noticed on our area "pulse point" reports that lift assists are quite common.

Lynne D

Thanks all for your comments and support.

Jo C., as he is under hospice care I was instructed to not do anything other than call them. 

I choose to let things play out. He is seldom alert and his communication skills are limited. He can barely walk. 

He is completely unmanageable this evening, resistant to changing urine soaked clothes, and attempted elopement. There is a sweet spot after Halidol administration where I may get him cleaned up. I got very little sleep last night as he was up several times. When I woke up I could not find the dog anywhere. I hopped in the car to go look for him and there he was! 

There is zero sense in prolonging this insanity for the sake of a lengthier period of insanity. Sorry in advance for those who may be offended.

Quilting brings calm

Lynne 

I am not offended at all. Your comments are exactly my thoughts about my parents. Those are exactly my mom’s wishes as she told me, my dad, and the doctor.  She  doesn’t want to progress  to the later stages, she wants to go long before she gets there. She’s still at the mild level so  I know she meant what she said.  It will be a long while yet for her as she’s basically healthy other than walking with a walker and neuropathy in her feet. Step-dad has all kinds of serious physical ailments and I do hope one of those takes him before he gets to the later stages of this disease.   

Lynne D

Quilting: thank you from the bottom of my heart for the relief your words bring.

Ed1937

Lynne, I'm so sorry to hear this. It is easy to understand why you wouldn't want to prolong this hell any longer than necessary. You have been through so much with him, you really need relief.

M1

Lynne sounds like you handled it very well. Dog bed sounds good to me! So glad hospice is on board, you may need them more. Totally support your comfort approach. Hang in there.

toolbeltexpert

Lynne I am sorry for the downturn, but I agree with your outlook on this disease, I am not going to prolong it and pray for mercy.. it was good that the dog bed softened him landing as the others have said. My prayers continue for you daily.

Stewart

Joydean

Lynne, I don’t know how anyone could be offended?  Honestly I pray daily for the good Lord to take my dh before he gets to the late stage 6. I love him and don’t want to see him have to go through that.

Cherjer

Oh Lynn, I am so sorry to hear the recent development. Definitely not offended and like so many,  I hope my dh does not go through the last stage. I sometimes wonder how this horrible disease strikes our loved ones...it takes down so many of us...our loved ones, us as caregivers, our families etc. May the good Lord bless you for being there for your husband. You have endured so much and still are by his side. Much love.

CD5

Hi, I’m just sending you support and a hug. Christy

jmlarue

Another bad experience heaped on so many others. I'm so sorry, Lynne. There's just no way to be prepared for these TIAs (or full-blown strokes for that matter). I fully support the decision to utilize Hospice for his comfort and yours. Thinking of you.

Jeff86

One more voice here in support of your decision, Lynne.  It’s your entirely your decision to make, and it may be the more thoughtful and kinder choice to limit medical interventions in late stages of AD.

White Crane

Lynne, I am so sorry to hear this.  Things seemed to be going better for you the last few days.  Know that you and your DH are in my prayers.

Lills

I'm so sorry, Lynne.  I could have written your post two years ago.  DH and I were walking home from a short walk; his legs quivered and he could hardly move forward.  By the time we arrived home,  I was practically carrying him up the 4 steps.  I understand the fear and helplessness you were feeling.  No need to even question yourself whether to prolong this insidious illness with medical interventions.  It's the illness' progression.  

dayn2nite2

When I read your original post, I remembered he was on hospice and I totally agree that this would be the appropriate course to take - to not aggressively pursue diagnosis/treatment only to possibly lengthen a life that is already compromised.

This disease is a piece of XXX and puts everyone through some of the worst things that life can throw at us.

I was relieved when my mom had a cardiac event and likely passed from that after 3 days.  While she was already in stage 7 and was wheelchair and bedbound, anything that ended her being locked into that body was welcome.  I'm not ashamed to say it.  

That's what we all wish for each other, to survive this disease without going down with it and without forcing our LOs to live in these bodies that no longer work because of the degenerative nature of the disease.

Jo C.

Lynne; mea culpa!  I had somehow forgotten that your husband was on Hospice.    The plan for simple supportive care for comfort is absolutely spot on.  Cannot imagine anyone being upset about that and hope that if family and friends are in contact that they are being supportive.

Just so sorry that this happened on top of everything else.  Great happenstance that the big, soft doggie bed was in just the right place for that split second need.

Hope that you are able to find some good rest and sleep tonight.   You have been through so much and have done a herculean job of it all for a very long time with huge, huge problem issues; especially with the over the moon heavy problematic behaviors.  How you managed to keep going, is one of those amazing things about how you continued to move forward.

Please continue to let us know how you are doing when you can; we all care very much and though you cannot see us, we are at your side in spirit.

J.