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~ Acquired Brain Injury (ABI): from the acute hospital to early rehabilitation – more on: www.CaringforPadraig.org and www.ansaol.ie

Hospi-Tales

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Virus

17 Wednesday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 4 Comments

Pádraig started to work his magic this week. It might be hard to believe if you haven’t experienced it yourself first hand.

His therapists are as excited as I am discovering every day, together with Pádraig, new things he’s able to do. It’s contagious. Like a virus. But a good one.

Think about it: here is the first person to be discharged home with this level of brain injury. It’s taking four months to make this happen because so many people are so afraid about so many things that might go so wrong that they check, like Santa, everything twice. No-one else has ever been discharged from the NRH with this level of care, apparently. There are so many “Firsts” here you could fill a book.

Once discharged, this person is turning out to be the miracle man.

He smiles when the therapists come in to work with him. He is so happy to see him. He cycles by himself, he moves limbs he never moved before. Yesterday, I forgot to mention this, he followed instructions to “deeply breath in….. and breathe out…..” and then “breathe in…, hold your breath…, and slowly breathe out…” – essential for generating sounds, for using his voice. He hadn’t done this before. But then, nobody had asked him to do this before either!

You’ll remember that two days ago he started to cycle by himself using the viva the MOTOMed, for a minute or two, and very slow 8-9 rpm. Yesterday, he cycled for nearly 30 minutes, at around 10-11 rpm. Today, he obviously had figured out how this works and cycled the half and hour with an incredible  – not 20, not 30, but 38 rpm! This is a speed faster than ever before in assisted cycling mode where we never went above 25-30 rpm.

Finally, I got a phone call today from Beaumont Hospital. Pádraig has an appointment not with one, but with two eye specialists who believe they can do something about his closed eyelids.

Can’t wait for the next miracle. What’s going on here is truly breath-taking. Go Pádraig! Go Dreamboaters!

 

Aura

16 Tuesday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 4 Comments

There are some people with huge levels of energy who in their own amazing way manage to share this with others. They create this aura around them that makes you ‘go’ with them. They give you the encouragement and the motivation and the drive to do stuff you didn’t either bother to do or, if you did, weren’t able to do.

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Today, Pádraig had a visit from a therapist who managed to make him lift one foot and put it down. Then to lift the other foot and put it down. Then to do the same with one leg. Then the other. And then both legs together.

Try it out yourself: sit on a chair and lift both legs up high in the air. See?

It ain’t easy. I have no idea how Pádraig managed to do this today.

You know, I don’t believe in this (Germans are very rational people) but there must be some energy, some power, something that even German engineers (and you know how brilliant they are about explaining things) could not explain.

It didn’t stop there but got even better later in the day.

Pádraig got really fed up with the alphabet table and the stupid spelling exercises being stuck with those three or four letter words that have no meaning by themselves – other than consisting of letters coming up relatively early in the frequency alphabet. Ja isses denn ein Wunder? would Nina Hagen say. And, to be honest, I would agree. Since we don’t want to give up on the switch, however, Pat has started some new exercises. With his hands. Not complex, but really really difficult for someone who so far had extremely little coordination and control of his limbs.

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Ion’t that incredible?

BlastFromThePast

15 Monday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 2 Comments

Pledge

Over the last two days, and thanks to the efforts of one of An Saol’s strongest supporters, two candidates for the upcoming elections signed up for our Pledge: Catherine Murphy (Social Democrats) and Roderick O’Gorman (Green Party).

PLEASE make absolutely sure that candidates in your constituency sign An Saol’s pledge.

  • Cover letter, click here;
  • Small poster to keep beside your door, click here
  • See who has already signed, click here
  • Sign pledge the pledge here (http://bit.ly/2016Pledge).

First things first

Pádraig is taking on this cycle-thing as his own. He makes me think we should return the MOTOMed gadget to the HSE and get himself a normal exercise bike instead! Well, maybe not quite yet, but we’ve been left absolutely amazed. In all honesty, I’d never had thought that he would take this over, ignore the motor and get cycling himself. (I’m just showing my ‘innocence’, I guess, with someone who doesn’t know, never knew, what boundaries are.) We used to look at other injured wondering how they were doing it! And here is the man himself doing half an hour almost exclusively himself, at his own pace, achieving a new PB every day.

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Shortage of beds for brain injury patients criticised

UnknownLabour’s Minister of State for Primary Care, Mental Health and Disability in the current Irish Government,  Kathleen Lynch, said there was a chronic shortage of beds for patients with acquired brain injuries and a complete lack of such beds in some regions. “With a serious head injury, immediate intervention is essential to ensure the person returns to normality, if normality can be achieved.

“It is conservatively estimated that there are 10,000 new brain injuries every year in this country, but there are just 110 beds in the Republic to deal with these people. That doesn’t make sense at any level,” she said.

“Even if we look at the Bucharest model, Romania, with a population of 22 million has 32 specialists per million of population.”

Ms Lynch said anything beyond a two-week delay was totally unacceptable, “but the tragic certainty that a sick person has to wait two years for an initial assessment is nothing short of abandonment of its obligation to the public by the HSE”.

The HSE, “which has a national annual budget in excess of €13 billion, a sum that would float some of the newer economies in the EU, should be giving us a much better service”.

She didn’t say this recently, but in 2008, when she was speaking during a Labour private members’ motion on neurological services.

The then Minister, Mary Harney, said a final draft report of a national review by the HSE of neurological services had been completed and “has been submitted to the Director of the National Hospitals Office for consideration”.

She said a new hospital with a completion target date of 2012, would provide additional treatment and diagnostic capacity. The design for the hospital is to be submitted for planning by mid-2008.

She added that “the HSE has also informed me that plans have also been prepared to develop a satellite unit of the National Rehabilitation Hospital attached to Beaumont Hospital, linking the rehabilitation expertise of NRH with the neurological services in Beaumont.

“This new proposed unit will provide acute medical rehabilitation services and early rehabilitation for those suffering from brain injury who access the National Neurosciences Unit at Beaumont Hospital and who currently have to access services at the National Rehabilitation Hospital.” She said the Government “is also committed in our programme to increasing rehabilitation bed capacity”.

Then Labour health spokeswoman Jan O’Sullivan, now the Minister of State for Primary Care, Mental Health and Disability in the current Irish Government, was “particularly concerned that we are hearing long-needed development of service being abandoned in order just to simply keep the service going without any changes in the way the service is run”.

Quotes above from an article by Marie O’Halloran in The Irish Times of 23 April 2008. Here is what I would add…

Reality check

None of Labour’s proposals tabled, none of the very grave concerns raised by them in their private motion eight (!) years ago have been tackled during their time in Government over the past five years when they had a chance to do so, which included —

  • A chronic shortage of beds for patients with acquired brain injuries and a complete lack of such beds in some regions;
  • An increase in the number of beds to treat ABI victims adequately (O’Sullivan mentioned that Ireland should aim to match Romania);
  • To do something about getting immediate intervention for ABI victims which is essential to ensure the person returns to normality, if normality can be achieved.

None of the promises made by Mary Harney actually materialised: that includes —

  • A new hospital with a completion target date of 2012, with additional treatment and diagnostic capacity;
  • A satellite unit of the National Rehabilitation Hospital attached to Beaumont Hospital, linking the rehabilitation expertise of NRH with the neurological services in Beaumont;
  • The provision of acute medical rehabilitation services and early rehabilitation for those suffering from brain injury who access the National Neurosciences Unit at Beaumont Hospital;
  • An increase in rehabilitation bed capacity”.

In the meantime…

  • Injured ABI patients spent months or years in acute hospitals, with insufficiently trained staff, acquiring new, additional, and completely avoidable injuries such as dropped feet, dislocated shoulders, or bed sores — occupying badly needed, very expensive beds unnecessarily;
  • The National Rehabilitation Hospital (NRH) does not have one (!) neurologist; not one ophthalmologist; and an insufficient number of therapists.
  • When leaving the NRH, they go back to an acute hospital, or a nursing home, or (in very few cases) home — where there is insufficient support to help the injured and their families to deal with their highly complex needs.
  • The Neurological Alliance of Ireland, together with the National Clinical Programme for Neurology, today published a report stating, among other facts —
    • Ratios for the recommended number of neurologists per head of population (1:70,0000) are exceeded within each hospital group with the Mid West hospital group coming out worst with a ratio of 1:200,000.
    • Waiting times for routine MRI scanning exceed twelve months in seven of the eleven centres.
    • Ten of the eleven neurology centres reported very limited or no access to community neurorehabilitation services which are crucial for recovery and prevention of disability for people with neurological conditions.
    • The lack of neurorehabilitation services places an unsustainable burden on neurology services (RSch: never mind patients!!!) which are unable to discharge patients, or are forced to readmit patients for therapy services that should be available in the community.

Facit

  • Everybody agrees that the services for ABI in Ireland are inadequate – to say it politely.
  • Political parties don’t keep their promises in relation to ABI.
  • Established service providers don’t (cannot?) deliver what is required, including Beaumont Hospital and the National Rehabilitation Hospital.
  • The HSE does not (cannot?) invest in neurological rehabilitation as is required.
  • The situation is worse for survivors of severe acquired brain injury (sABI)
  • We need to set up a pilot project involving all those who really want to change the situation to demonstrate how to help survivors of sABI, based on best international practice and most recent international research.

As there doesn’t seem to be anyone else to do it, let’s work together under the umbrella of An Saol.

We need all sorts of expertise, from health policy to finance to legal to nursing to therapy to medical to regulatory to research to social media to design to marketing to fundraising.

I know I asked you a few times before. Finally: here is the form to sign up!

Now.

Here.

 

Bike

14 Sunday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ Leave a comment

Today was all about bikes and cycling.

Pádraig led the way.

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He cycled, HIMSELF, almost 5 minutes. Isn’t that incredible? Something we would never have thought possible even yesterday. It’s slow and very low impact. But this message never came up, never mind with these figures!

Three of his friends called in this afternoon to help with the planning of the first of two cycles. It’ll be from Boston to Brewster, to leave Boston on Sunday, 26 June, with an overnight in Hyannis, and arriving in Brewster on Monday, 27 June, at 10am. In parallel, we’ll organise a cycle getting into Dublin, possibly from Ráth Chairn (Rathcarran) via the Phoenix Park, arriving on Sunday afternoon, 26 June. We’ll make sure that there will be a close link up between the two cycles.

Another friend called in later and left for town for an undisclosed St Valentine’s meet up. Tonight, love is in the air!

StartUp

13 Saturday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 2 Comments

So now, Pádraig is at home, home. (Most of) his PAs have started. The extension is (almost) finished. (Some of) the equipment he needs has arrived. We’re (about) to organise therapy sessions with An Saol. We’re (almost) there.

Sounds like the end of something. Almost time to relax and sit back. After all the ‘excitement’ and drama and ups and downs and frustrations and uncertainties and sleepless nights and incredibly hard days. We got somewhere.

To the beginning. Of a new life. With all the uncertainties and excitement and opportunities.

Unknown

One of Pádraig’s friends called in last night and was telling Pádraig a great story about how one of his friends greeted a few other friends from the middle of a big stage when they arrived (we know who you all are::) in the same familiar friendly way he would have done had they just appeared at the doorstep of his house. It brought a huge smile to Pádraig’s face and we knew he could not just imagine the scene exactly as it had happened, he could feel the friendship, the implied camaraderie, the meta-story with all the unspoken, unexpressed, but nonetheless present familiarity of the personalities of those involved.

It was brilliant.

Because he knew each of the people involved. He had spent the happiest years of his life with them. Those years no one wants to leave behind, years that should never end, years he looked back on when he sat on one of the Greens in Trinity College after his last exams and realised that they’d be coming to an end. Friends, a spirit of support and community, a togetherness, purpose, fun, music, energy, long nights, early morning sunrises, listening to the same songs again and again and again until the lyrics had been lodged forever into his memory, being together with the most amazing intelligent bright strange and wonderful people – what would happen to all of this?

Pádraig’s friends are the most wonderful people I’ve met in my (long!) life. They had the most wonderful time together and they will always watch out for each other. Over time, their life will evolve, change, and move in different directions. In the way that Pádraig imagined that day sitting in the sun on one of the Greens in Trinity College. Their relationship has changed and will continue to change.

There are new roles and responsibilities that will evolve.

And millions of new ways of having fun together, of enjoying quiet moments, of listening to new music, of watching new films, of reading new (and old) books, of sharing stories, of going out to see plays, see bands, sit in the sun, sit in the rain.

Experience life.

Share it with Pádraig in his new life.

Oh – almost forgot the cakes:)

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Nachfeiern

12 Friday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 7 Comments

It’s a concept our kids really enjoyed when they were small. Neighbours in Tating introduced it to them because we always arrived slightly late for their birthdays in the summer. So they told us, not to worry, you could always “nachfeiern”. I don’t think there is a straight translation for this, but it means something like celebrating the event a bit later, with presents and all:) — And yes, you can also “vorfeiern”:)

I got loads of presents yesterday: among them a cake for my birthday. AND a cake to get better. I won’t show either (because the birthday cake shows my age and it wouldn’t be fair to just show one cake).

Even Pádraig got a present: a leg trainer MOTOMed arrived. On loan for the next four months… We’re hoping to change to an arm and leg trainer over the coming weeks and will keep at it…

But the best present came today. This was truly in the spirit of “Nachfeiern”!

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Okay, it was a really low gear, but you have to start somewhere. And Pádraig started. The FIRST time ever, he cycled himself, just a bit, without much ‘resistance’, but that’s where you start.

Finally, please print the sheet below and keep it beside your door.

Print copies for your neighbours and friends.

Use it when candidates for the upcoming elections call to your door.

Ask them whether they have signed it online (they all got it in their email).

If they didn’t ask them to do so

http://bit.ly/2016Pledge

Pledge Sheet

Remember: Movie night — Fitzcarraldo — on Friday, 19 February 2016, 19:00h. Find out where and let us know whether you’ll be joining us here. Let me know here which other movies we should get for the next movie nights (even if you shouldn’t be able to make it yourself).

About Fizcarraldo:
If you have a dream, the only way to accomplish it is to face it head on. If your dream requires you to drag a massive boat up a mountainside, do it. So says director Werner Herzog in the bizarre but captivating Fitzcarraldo.
http://www.rottentomatoes.com/m/fitzcarraldo/

Disgrace

11 Thursday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ Leave a comment

You might have seen last night’s comment:

It’s an absolute disgrace how few have signed this! It’s an indication of the lack of interest in helping people with sABIs in this country. We all need to get behind this pledge and ‘badger’ our candidates. Everyone needs to email their own ‘wannabes’ and demand a reply.

Martin referred to the number of politicians who have responded to my mail asking them to sign An Saol’s Pledge. (You can see who has already signed up here.)

I’ll leave it with this tonight.

Jewellery

10 Wednesday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 7 Comments

I spent most of the afternoon in bed, just got up in the evening to get something to eat. I found it amazing how long I slept or dozed without really noticing time passing by. Having something stitched up inside me, without having much external evidence of it, also feels really strange. It hurts but without the visible evidence. – Good thing is, it’ll be ok and back to normal in a week or two, fingers crossed.

Talking about fingers: here’s a really imaginative solution of a staff nurse for wearing ‘jewellery’ when you’re having an operation, and you don’t want to take it off (because it’s your wedding ring:). Ignore the wrinkles on the hand, it’s the angle the picture was taken from!

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In the meantime, and as always, the world keeps spinning ’round. Some carers arrive, some are sick, some have been sick since Pádraig arrived home and haven’t met him yet. They are having ads on the radio asking people to get their flu vaccines.

The community team, various therapists and a dietitian, have been here a couple of times and are really making an effort to help as much as they can. Tomorrow, we’ll have a rep in here for the n-th time to measure the height of the room for Pádraig’s soon to be ordered standing bed. We’re not giving up hope, though patience is really required here.

In the meantime, Pádraig has not been standing. Not in the NRH (he has been discharged and put on a waiting list for outpatient therapy); not in the community physio facilities (no physios available to supervise him standing); not at home (no standing bed). We rang around various suppliers in Ireland to see whether we could get a more difficult to handle, but more economical, tilt table, and were told they are not available second hand; getting them would take between 3 and 6 weeks (depending on supplier); they might not be long enough for Pádraig (were going to check but didn’t get back to us).

What do you do when stuff like this drives you around the bend? – Correct: you do it yourself. So we found a supplier of tilt tables in another European Country. They responded to all our queries within minutes. They will, wait for it: manufacture an extra long table for Pádraig; supply it with special supports for the lower limbs, hips, and head; have it ready to be shipped within two days; ship it to Ireland where it should arrive within a week; and all for less than half the cost of the cheapest tilt table available here. I am not sure whether they work the way they do because they care or because they want to do business. But to me it seems that someone who takes weeks to move or doesn’t get back to you at all, does neither care nor is he interested in doing business – maybe it’s because they think they have it all stitched up in a monopoly?

Finally – no positive news yet on premises for the An Saol Sarah Walsh Therapy Centre.

But – Planning of the charity cycles in the US is making progress. Please click here to sign up if you want to join us in Boston in June.

 

Pancakes

09 Tuesday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 4 Comments

Didn’t eat much more than a couple of pancakes today. The morphine did wear off and I felt miserable. Even the pancakes (it’s ‘Pancake Tuesday’!) didn’t do the trick. This keyhole surgery stuff is pretty disappointing. At least with a big cut across your body you have something to show for and people feel with you. With a couple of small holes covered by a simple plaster, nobody really believes that you just had an operation… Bit of a disappointment.

Anyhow, back to normal.

Loads of visitors and therapists today, with some ‘presents’ for Pádraig. Among them this really brilliant cup.

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It shows that details really matter: its opening is oval, it is transparent, it has a detachable large footprint, and a really large handle. Whoever designed this simple mug earned themselves a design award. The first cup that will allow Pádraig to hold a cup and be guided using it.

The other picture tonight is one I took on the way to the hospital yesterday. When I found the envelope with the writing in my pocket I stopped and took a picture of it on the street because I was afraid I might loose it in the hospital. Pat wrote her name on the envelope and it was the first word Pádraig read and recognised, as far as we know.

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My second night upstairs in a row. Won’t have to get up to turn Pádraig. I’m not really that far away, but I miss him. Thanks to everyone for all their good wishes. I was told it would take a few days, maybe a week and I should be ok again. – Can’t wait.

Aside

Hospi-tell

08 Monday Feb 2016

Posted by ReinhardSchaler in Uncategorized

≈ 8 Comments

Today is Shrove Monday, or Karneval: a bit like St Patrick’s Day in Germany (if that makes sense). Today, you’d stick out like a sore thumb if you venture out onto the street in just your ordinary dress. Even police(wo)men and train conductors put on a funny red nose, huge eyebrows, or a funny hat in order to celebrate the last few days before lent starts this coming Wednesday.

I had to think about that today, when I saw myself in a hospital gown. It didn’t feel real. Having spent the best part of the past few years in several different hospitals, there was I in a hospital gown, with ECG contacts on my chest and the O2/heartbeat monitor on my finger, getting ready for my very first ever in my life full anaesthetic and surgery. Virtually risk-less, every-day, routine laparoscopic surgery, the surgeon explained to me (what did that remind me of?) before he painted a few arrows and his initials onto my skin – just so they wouldn’t mix up the side on which they were going to operate. (They also asked me my name and date of birth a dozen times, so that they were sure that I was what it said on the label who I was and they wouldn’t operate the wrong guy. To be honest: my confidence was slowly oozing away.) (Another of the many questions they asked was if I drank alcohol and I said ‘yes’, and when he asked added ‘about seven units’ — what I meant was: a week, but with the best efforts in the world cannot remember whether the nice doctor also meant ‘a week’, or ‘a day’; I can’t get rid of the funny feeling that I’m listed in the hospi-tell files now as a candidate for AA.)

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The most incredible thing is that I am now lying in my own bed, at home. Having had a full anaesthetic and surgery (routine, every-day and all — but surgery) for which a few years ago I would have spent days in hops-tell. I had walked there this morning (sorting out a few messages on the way Pat had asked me for) and getting a lift back with one of our daughters. Ok, I’m slightly confused – but what’s new about that?

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Operate THIS side – NOT the other.

Of course, what was on my mind the whole time, and is tonight, is that this was my First. A tiny little bit of surgery, a few hours being a patient, a couple of hours on an incubator with a tube down my throat. And I felt so incredibly helpless. I have phlegm in my throat I can’t get rid off. Talking and using my voice feels distinctly uncomfortable. I have a feeling of constant heart burn. And all this with the morphine still in my system.

What was on my mind the whole day and still is, of course, is that this, my own First, was just a teeny-tiny taste of what Pádraig has been going through since the day of his accident. And without a voice. Without being able to ask what was going on. What was being done to him. How much time had passed. Is passing. Why he was where he was and for how long he’d be there with whom looking after him when we had to leave. Being deprived of so many things that I can’t even begin to grasp. With a tube down his throat for a year and a half, not just a couple of hours, producing so much phlegm that they stuck another tube down his throat to suck it out so that he could breathe.

Today I felt as calm and collected as I have felt in a long time, as balanced and relaxed as maybe never before. It was like having (re-)discovered what life is all about. Everything became so clear:

We love each other so much, that this love will carry us wherever we want to go. It gives me the inner strength, self-esteem, and security that allows me to break free from imposed and artificial restrictions, to go beyond the limited tunnel vision of dysfunctional systems, and to live a life that allows me to be kind and understanding to others, to treat everybody with respect and dignity, to be honest and fair; while being extremely clear, in a very calm but very determined way, about what is right and what is wrong, what is acceptable and what is not, what I do and what I won’t do.

Ok — I hear you. No, this is not who I am. I am not a saint.

But — dare I say (before the morphine wears off completely:) that this is my prayer for tonight. My positive action plan for the upcoming cuaresma.

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