February 27, 2020

Solutions for My Extreme Sleep Deprivation

I have had insomnia all my life, but my stroke brought this problem to a new level.  I had a stroke in the brainstem which puts us to sleep and wakes us up. Since my stroke I have repeatedly had nights where I get only two hours of sleep per night.  When I did not sleep and did not feel sleepy for two days I FREAKED OUT so I got aggressive about addressing this problem.

Daytime routine.  I avoid caffeine after lunch time.  This meant changing to decaffinated iced tea for dinner and drinking water when I eat out at night.

Bedroom environment.  I sleep in a dark bedroom with no TV.  The alarm clock is placed where I cannot see it.  Sometimes I wake up and find I am sweating.  So I lowered the room temperature because a lower body temperature tells the brain to sleep. 

Preparing for bed.  If I am sleepy at 9 p.m. I go to bed.  If I wake up in the middle of the night at least I have slept for 4 or 5 hours because I went to bed early.  If I am still wide awake at 10 p.m.
I go to war.  I turn off the TV, wash my face and brush my teeth, and come back to the living room to listen to a calming CD.  If my body aches I take Tylenol.  The constant burning in my hemiplegic foot keeps me awake so I provide a competing sensation by taking a warm gel pack to bed.

Back up plans.  (1) If I lay in bed and cannot fall asleep, I get up and eat a tiny bowl of cereal with milk.  (2) If I wake up at 3 a.m. to go to the bathroom and cannot fall asleep, I get up and turn on a calming CD or a fan at a low volume for background noise.  These back up strategies work only IF I realize I have been lying awake for an hour or more.  homeafterstroke.blogspot.com

February 17, 2020

Freaked Out = Home Modification

I live alone so when the electricity goes out 2 to 3 times a year I have to handle it.  My stroke took away my ability to know where vertical is unless I can see my surroundings.  So I put flashlights in every room.  My plan worked until last night when the house went completely black while I was watching TV at 10 p.m.  I reached down for the flashlight on the floor next to my couch.  I started to freak out when I could not find it.  The electricity has gone off for hours in the past and sitting on my short couch until sunrise would be awful.  I finally found the flashlight, but after the lights came back on I put the flashlight in a different location.  I moved it to the tray on my couch that holds my remote control devices.  I also moved a second flashlight to a counter directly behind the place I sit at my kitchen table.

A previous outage taught me to put a battery operated lanturn on a cart next to my bed.  I turn the lantern on by rolling on my side and pulling the cart close too me so I can feel the on switch.

Unusual problem solving after a stroke NEVER ENDS.  homeafterstroke.blogspot.com

February 10, 2020

The Medical Profession Has to Pivot

I am the 1st generation of Americans who were not killed by whooping cough or paralyzed by polio.  In my lifetime, cancer and organ failure stopped being a death sentence.  But at the end of my life I am paying for all this great medical care.  Millions of Americans are living until 80 and beyond so we have lots of time to acquire multiple chronic diseases like stroke and dementia.

Doctors are taught to cure people, but clients with chronic diseases need medical care that supports participation in valued activities.  Doctors may not value this goal if they have not had multiple valued activities taken away from them.  Screening for activity participation is a quick way to detect physical, social, and cognitive decline which makes a chronic disease worse.  Doctors have a personal incentive to shift their focus.  The generation who will be free of chronic diseases has yet to be born.  Doctors need decades to learn how to turn off chronic inflammation that attacks the body from the 40s onwards.  https://www.mdlinx.com/internal-medicine/top-medical-news/article/2020/02/07/7606755

Not participating in valued activities speeds up disuse which can end at a long-term care facility.  Some nursing homes have not improved that much since I was a young therapist.  Corporations that own long-term care facilities put lots of artwork on the walls and nice couches in the lounge  which may trick families into believing their loved one will be happy there.  What I learned while visiting nursing homes with friends who have elderly parents was disturbing.  For example, corporations may hire too few aides who have big caseloads so residents are put on a toilet line.  I saw a group of old people sitting in an activity room with their heads hanging down while the TV blares.  Warehousing people with chronic diseases is a tragic and expensive solution.       homeafterstroke.blogspot.com

February 3, 2020

A Happy Accident

For years when people offered to help I said "I can handle it but thanks for offering."  However, there are some people who repeatedly insist that they help me.  Initially I gave up my independence so these people could feel good about helping me.

Recently a friend offered to sit in the back seat of the car so I could sit in the front seat which has more leg room.  I heard myself say "If I baby my knee it will not get better."  My friend honored my wishes.  In the future if stubborn people insist on helping me I will say "If I baby my _____ it will not get better."  If they still insist on helping me I will see how they respond when I say "You do not want my ______ to get better?"  homeafterstroke.blogspot.com