My Little Darlin, PT day 58 by David

Day 22 at Shepherd.  Jan woke up very early this morning not feeling well at all.  As I have talked about, her primary limiting factor has been what she describes as dizziness.  We have had difficulty trying to determine what is causing this with possible causes being orthostatic hypotension, drug related or related to her injury.  It was bothering her worse than it had been since she has been aware enough to tell us what she was feeling.  She would not get out of bed for fear of worsening the sensation. There some associated nausea.  I was concerned not only for how poorly she felt but that she was going to miss a day of valuable therapy and of course why was she feeling this way.  I did a tilt test on her first thing and there was nothing to suggest this was orthostatic hypotension (related to blood pressure drop).  Her attending physician came in and thought it could be vestibular related to the trauma and had planned to have the therapist help her with this.  I talked to an ENT friend of mine about this.  He said it could be central (brain) or peripheral and the therapy was the best next step.  Thanks Walter, your input is much appreciated.   She also had the nurse give Jan something for the nausea and about 30 minutes later Jan seemed to feel better than she had since she got here.  She subsequently had a great day of therapy.  Her physician also had the pharmacy review her meds to see if their were any combinations that may be contributing to the problem and one possibility was found and that med has been discontinued.  If we can get this "dizziness" under control then I think physically she will continue to rapidly improve.  More specifically improve her mobility.  She is very sharp mentally considering what has happened to her.  She has some short term memory/orientation problems such as what she did earlier the same day but with questioning she will recall this.  She can also confuse what she did today thinking she did it yesterday.  On one of the deduction test I talked about yesterday  she picked up a subtle error that I had not noticed.  By a series of written questions she had to determine which country went with which clue.  She could not get the last country.  When I gave her a suggestion she informed me that Africa is not a country but a continent, I would not have noticed that and would have placed Africa in the slot without question.  She tells me she walked down stairs with her therapist today.  She walked with me after dinner.  She still is very unsteady but continues to improve.  It was interesting watching her occupational therapist do some mental exercises with her today.  She gave her images that had 4 identical objects except one was the mirror image of the other three and all were in different orientations.  Jan had to pick out the mirror image.  Some were difficult and as she says making her think is hard.  While she was doing these she started physically getting hot from the mental work she was doing.   For her I suspect she will recover most of what she lost but it will take time.  Given where she was less than two weeks ago though if it were a race she would win.

SHARE THE ROAD, IT'S A LIFE
PUT THE !%@$# CELL PHONE DOWN BEFORE YOU KILL SOMEBODY
GET OFF THE COUCH,  LIFE IS FOR DOING STUFF
SUPPORT BIKE WALK MISSISSIPPI,  THEY WILL HELP MAKE CHANGES HAPPEN
BE BRIGHT AND BE SEEN

I Love My Little Darlin, 
David