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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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Stay Away

17 Sunday Nov 2013

Posted by ReinhardSchaler in Uncategorized

≈ 6 Comments

As every morning, we were listening to the RTE News this morning and heard that Beaumont Hospital asked all visitors to ‘stay away’ to prevent the spread of the vomiting bug Norovirus, against the” backdrop of an increased incidence of the winter vomiting bug in the community”. Restrictions had started last weekend when Pádraig was getting ready to leave for Germany – and his friends and family wanted to say ‘good-bye’. Many of his friends cancelled their visits, his GP was stopped on the corridor on her way to see Pádraig and was told to leave. While everybody agrees that patients need to be protected from dangerous bugs, you wonder who poses the greater threat: visitors, who are just seeing their one family member or friend, or staff, who are moving from patient to patient, and from ward to ward – at times, as we have heard, without observing even basic hygiene procedures like cleaning their hands.

Anyway – today Pádraig was as relaxed as he had not been for a very long time. We were used to heard rates of 120 and fast breathing – when we came in to see him this afternoon, Pádraig was the incarnation of relaxation: heart rate down to just above 70, breathing not much more than 10 breaths/min. We asked his second favorite nurse (!) whether something was wrong, or whether he had been given medication. Nothing was wrong, and no drugs had been administered – we were told. A doctor had seen him and they had checked him out, but all was well. The nurse told us that she had been feeling Pádraig’s presence and that she thought he was communicating with her. We think he might be in the process of finding back to himself through rest and relaxation. We can’t wait to see him tomorrow.

For us – we are still learning how to find our way around. Working on getting a decent internet connection in the middle of the German countryside is as challenging as getting it in Leitrim. There is an endless number of forms to be filled in for the hospital, the insurance, the city council, social welfare, … . And, we are trying to find the optimum speed for the close to 300km return drive to Hamburg – not too slow (saving time), but not too fast either (saving petrol).

One thing is for sure: we will not stay away from Pádraig – and we are hearing with delight that there are family and friends from Ireland planning to visit him over the coming weeks. Hopefully, he will be out of the isolation room by then and it’ll be easier to visit him.

PS1: Today’s German Music tip: Reinhard Mey, Über den Wolken… (1974). Unfortunately, I couldn’t find the slightly psychedelic original version, but here is one from 1998:  http://www.youtube.com/watch?v=Cu57mDP75Jo
(Watch or: listen out for the “Luftaufsichtsbaracke’:)
PS2: Just missed the 12 o’clock deadline for the second time in a row – so, despite showing Sunday’s date, this is Saturday’s blog!

On the Road – Now we’re movin’!

16 Saturday Nov 2013

Posted by ReinhardSchaler in Uncategorized

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Having lived more than half of my life in Ireland, taxi drivers still ask me whether I like living here (I stopped thinking about this a long time ago) and colleagues at work wonder why on earth I still haven’t figured out how things are done: put pressure on your TD, have a chat over coffee – but never refer to any kind of written agreement, regulation or procedure, unless you really want to get yourself into trouble. They think, I am German. Here in Germany, I am Irish: I don’t believe in timetables (works of fiction – but: it’ll be grand), I try to connect with people (rather than procedures), and I can’t believe that the former president of Germany has just been put on trial, having resigned over the affair some time ago, of course: he had allowed someone to pay a 700 euro bill for him at the Oktoberfest (I would have expected a tribunal of investigation).

Why is this relevant? Here is one reason: I am on a bus this morning to go from Hamburg via Bremen to Münster to collect a car our German relatives have organized for us. At 08h28, the driver stepped onto the bus, took off his jacket, sat down, and pulled out at 08h30. Within minutes we were on the motorway because the rush hour, of course, was long over. I was so proud that I had discovered this bargain when I bought the €25 ticket for the 330km long journey – until an elderly lady told me that she had just paid €37 for her 800km return trip to Düsseldorf (there was a bit of ‘Schadenfreude’ on her face when she did:). So, if you want to visit Pádraig and cannot find a cheap flight to Hamburg, check out the flights to Berlin, Köln, Düsseldorf, Bremen (Ryanair), Amsterdam – they all have good-value and regular bus connections to Hamburg. No matter where you will arrive in Hamburg, central train station (or Hauptbahnhof), bus station (right beside the train station), or airport, just take a 10-15 minute ride on the Hamburg equivalent of the DART (S-Bahn) for less than 2 euro: it’s the S1 and you get off in Friedrichsberg – kind of in the middle between the airport on one and the central train station on the other side. From there, it’s just ‘um die Ecke’, a 5 minute walk to the hospital.

But there is another reason why this is relevant: people are held responsible and accountable for what they are doing here. ‘Herr Schäler’s’ favorite nurse comes in every 15 minutes or so to check on Pádraig apologizing, of course, for the interruption when she comes in. She tells Pádraig who she is and explains to him what she is doing. When it’s going to be uncomfortable, she tells him in advance and apologizes. But there are also limits to her kindness – when I went out to the corridor in my blue gown and mouth protector to look for a second chair yesterday, I was told quite firmly to get back in, and quickly: can’t leave the room in this gear! In fairness, she then organized a second chair for us, ‘kein Problem’. Turns out she also checked out the bed sore on Pádraig’s right heal and took pictures of it to document that this injury hadn’t happened under her watch. (She removed the bandage from the heel, and it’s healing well.)

She also removed the Beaumont ID arm band, and another strange looking ‘ID tag’: his Oireachtas arm band / ticket that his friends had brought in for Pádraig as he couldn’t make it in person to Killarney this year. When a colleague told her that this was not just another auld hospital ID tag, but a very valuable concert ticket she went through the bins, found the armband she had cut off, then taped it back together, left it in his drawer – and told us all about it (we didn’t even have to ask).

I am still on the bus, listening to the regular announcements of the driver’s ‘navi’ (“Fester Blitzer in 400…300…200…100 Meter”) warning him of the ever-present and, no doubt, well-functioning stationary speed cameras. It’s all under control, now we’re movin’.

(Note: I wrote this blog on Friday morning. By the time I got back, visited Pádraig,  collected Pat and Maria, drove our new car up to Tating, and managed to publish the blog, it was just after midnight, Saturday morning.)

Caring is Sharing

14 Thursday Nov 2013

Posted by ReinhardSchaler in Uncategorized

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German Chancellor

Today, I had to think about the media storm that broke loose and the solid intervention by Minister Dermot Ahern in 2007 when the then German Ambassador to Ireland, Christian Pauls, told a group of visiting German business men that Junior ministers here earned more than the German Chancellor; that our “chaotic” hospital waiting lists would not be tolerated anywhere else; and that doctors had rejected €200,000 a year posts on the basis that this sum was “Mickey Mouse” money. (He had compared that to the salary of just over 30,000 euro earned by his daughter, also a doctor and second in charge of a children’s hospital in the North of Germany, I believe.) The Department of Foreign Affairs felt his remarks could discourage investment here. At the time, it seemed to me that we had a sharing problem – but nobody cared, really.

The care Pádraig is getting here is really remarkable. The nurses and staff couldn’t be nicer to him and to us. The cleaner knocks on the door before she comes in to clean his room, his nurse (with a couple of big, beautiful tattoos on her arms:) tells him how sorry she is for having to introduce this tube into his throat to suction him, and today we were brought extra chairs, as well as coffee and tea to his bedside. The physios and doctors are working with him, but it’s clear that the journey from Ireland to Germany, as well as this new infection, are taking a lot out of him – which is why he has been on supported breathing a few times since we arrived.

Despite of these small temporary setbacks, I have not seen Pádraig as alert and ‘aufmerksam’ since the accident. His favourite nurse told us that she herself, the night nurses, and the physios had definitely noticed that Pádraig was, in his own small way for the time being, cooperating with them – moving his legs when being turned in the bed, opening his mouth for oral hygiene, and so on.

There is a real caring attitude here where staff on Pádraig’s ward share things around. This is only possible because there is a larger system that supports their work, a system supported right from the top, a system anchored in German society where caring means sharing, where, according to the German ‘Grundgesetz’ (or constitution), ‘Eigentum verpflichtet’ (with ownership comes responsibility) and ‘Sein Gebrauch soll zugleich dem Wohle der Allgemeinheit dienen’ (its uses should at the same time serve the common good).

So tonight, when we asked, we were very politely told that, of course, they would  pad the side railings of his bed, in case he would cough, bend up and then fall to one side against the railings.

Tomorrow, Maria will join us for a few days. We will also get a German car on loan that will allow us to be a bit more mobile and to move out of our current ho(s)tel accommodation (which we had found using the excellent German portal http://www.hrs.de – in case you are planning to come over for a visit).

Small Details can make a Big Difference

13 Wednesday Nov 2013

Posted by ReinhardSchaler in Uncategorized

≈ 8 Comments

Sometimes, it’s the small things that matter – because they are an indicator of what a place is all about. Making sure that Pádraig is comfortable, that he is positioned correctly,  that his arms are supported, and that his head is straight – these are all small things that add up to making a big difference.

Pádraig still has a slight fever and is getting the antibiotic he was started on the day before we left Beaumont. The microbiologists will tell doctors here tomorrow whether they should adjust them or whether it is ok to continue the current course. The physios started to work with Pádraig today and are beginning to develop a feel for his condition and his personality. Some staff are still addressing him as ‘Herr Schäler’ and ‘Sie’ but this happens less every day.

Staff close the door to give us privacy, they apologize for the interruption when they come in, they introduce themselves to us, and they explain to Pádraig everything they do so that he is fully kept in the picture and understands what is going on.

Last night, Pádraig clearly responded to me a number of times when I asked him to blink once for ‘yes’, and twice for ‘no’. Today, before Pat arrived, I spent a few hours with Pádraig and when I asked him three or four times to squeeze my hand, and to let go of my hand – he did it. No doubt. – Of course, these are all only small steps (and not entirely new to some of you), but for us they are amazing because they demonstrate that Pádraig understands what we are saying to him and that he is able to react to what we are saying to him.

Pat and I feel really privileged that we could bring Pádraig to Germany, into a hospital where we feel people really care for him and have access to the necessary resources and manpower to do the best job possible – although one nurse today showed us that good care does not necessarily require expensive high-tech sophisticated equipment. She had noticed that Pádraig’s hands were very cold. So she put warm water into two of these surgical gloves, knotted them up, put one of them under each of Pádraig’s hand, and secured them with a towel around each of his hands.

A small detail – but one of many that make a big difference Pádraig feel he is in safe hands, that he will receive the best care and therapy there is to help him wake up again. And he is responding.

At First Glance

12 Tuesday Nov 2013

Posted by ReinhardSchaler in Uncategorized

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So, what is different here compared to Beaumont? The short answer is that we don’t know yet – apart from what we can see at first glance. It’s definitely quieter here than in Beaumont, and not just because Pádraig is the only patient in a two-bed room, but also because there are hardly any visitors, measured by Irish standards. Another difference is that none of the staff wears a casual dress on the ward, and that includes doctors and consultants. In fact, it would be impossible to tell nurses and doctors apart based on their dress: they all wear the same ‘proper’ hospital gear; and they wear name badges with their job title, instead of the 24-No-More buttons we became so familiar with in Dublin. There is an obvious resource advantage here in comparison to the ward we got to know in Ireland – everything looks new, and you get the feeling that patients get what they need.

One thing that is not different to Dublin is that they were not prepared for Pádraig’s height. While the bed itself could be extended, they are still looking for an extension to the standard mattress.

Finally, I  explained that he would never react if addressed as ‘Herr Schäler’ and with the formal ‘Sie’, as Doctors did yesterday when we arrived. It will need some time not just to get over this exhausting trip but also to get to know each other on the ward. We will need to get beyond of what we can see at first glance – although what we have seen so far is  promising.

We have arrived

11 Monday Nov 2013

Posted by ReinhardSchaler in Uncategorized

≈ 8 Comments

Tags

germany, hospital, ireland, neuro, neurological rehabilitation, rehab

Pádraig and I have arrived in Hamburg, Germany. The staff at Beaumont Hospital had got up in the middle of the night today to prepare Pádraig for his second big trip in four months. An ambulance picked us up at the hospital and we arrived safely at Dublin Airport a few minutes later. We had to wait 45 minutes for airport police to complete some paperwork, and then they escorted us to the air ambulance waiting for us on the tarmac. The flight was relatively uneventful and took less than two hours. Out of the plane, into the German ambulance, and off to Hamburg-Eilbek’s Schön-Klinik (no paperwork this time).
Pádraig was brought to the neuro ICU, located in a 2-year old building. Upon arrival, there were about eight hospital staff who checked him in and made him comfortable. I had a 30-minute ‘welcome-talk’ with an ‘Oberarzt’ (senior doctor). She explained to me that they will test Pádraig for multi-resistant bacteria and that his room will an ‘isolation’ room until the swabs will come back. This means, you can only get into this room with a special disposable apron and a face mask for the next three days or so. Once Pádraig has settled in, she is planning to run a number of tests and scans to get a better picture of Pádraig’s condition.
Following a very long day for both of us, I had to leave Pádraig to look for a hostel. It took a while, but with the help of hospital staff who let me use their computer and internet, I found one.
So here we are, Pádraig in his new bed in the Schön-Klinik, me in a hostel not too far away from Hamburg’s main train station – both of us absolutely exhausted. I am writing the first entry into our hospi-tales, something I intend to do every day from now on. I hope these tales from the hospital will help us to stay connected with Ireland, and the town Pádraig and I loved so well. This is a new beginning, with new hope. It’s a new beginning but with a heavy heart.

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