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Showing posts from 2012

K. Vishwanath – Thank You

As a young family living in Andhra Pradesh in 1980s it would’ve been hard to miss movies of K. Vishwanath that are now regarded as classics.   His movies revolve around some theme of classical dance or music.   With no formal knowledge in this classical tradition, but with the ability to enjoy and appreciate art our parents were huge admirers of his movies.   By huge I mean diehard. 
We watched the movie Sagara Sangamam countless time -  as kids we made multiple trips to the theater with barely any comprehension of its mature theme,as young teens at home it seemed entertaining and as adults and equals with parents we spent countless hours appreciating and sometimes explaining certain nuances.   Music from his movies was a constant on our record player.
Now with all the post stroke rehabilitation we show, do and talk thing that we know our father enjoys.   We repeatedly played the scenes and songs from the Sagara Sangamam, Shankarabaranam,  and Swathi Muthyam.   He definitely enjoys  …

Brain Rewires Itself - Always Good News with the Brain

Good information from this The New York Times article.  Here it goes - 

August 6, 2012, 2:08 pm
Really? The Brain Gets Rewired if One of the Senses Is Lost By ANAHAD O'CONNORTHE FACTS
Certain regions of the human brain are dedicated to the various senses. The visual cortex handles vision, for example, while the auditory cortex processes sound.

But what happens if one of the senses is lost? Do the neurons in the auditory cortex of a deaf person atrophy and go to waste, for instance, or are they put to work processing vision and other senses?
In studies, scientists have shown that when one sense is lost, the corresponding brain region can be recruited for other tasks. Researchers learned this primarily by studying the blind. Brain imaging studies have found that blind subjects can locate sounds using both the auditory cortex and the occipital lobe, the brain's visual processing center.

But recently a similar phenomenon was discovered in the deaf. In a study financed by…

Neuroplasticity of Our Nurses’ Brains

Brain is constantly changing by forming and even growing new neural connections.   This inherent malleability is called neuroplasticity.   Training, experience and environmental factors can help rearrange the brain.  So we necessarily don’t die with the brain we are born with.    
‘Practice makes a man perfect’, and similar other sayings were in fact alluding to Neuroplasticity.  We know this when we practice an instrument, a language or any skill for that matter.  
These days since I breathe Neuro plasticity, its conscious application is the obvious next step.  I’ve had the perfect opportunity to practice this when we get poorly trained and poorly trainable nurses.   
Some of these nurses amaze me with their limited knowledge of nursing.   From ignorance about a Trach tube or a PEG feed, they are clueless about basic care giving like changing diaper, giving bath and changing sheets for a person confined to bed.  Makes you wonder why are they then considered nurses?  Well, that call…

Stroke Support Group – 1-2-3 GO!

For the longest of times I have been obsessed with forming a support group for families with stroke patients.    In my conversations with Doctors, Nurses, Physiotherapists, and Social workers one of my predominant questions would be if they know of any families with stroke patients.    If they answer in affirmative, then they would be subjected to a barrage of questions.   What happened? When? Present condition? Who takes care of them? Which Neurologist is consulted?  Which hospital?  And the questions go on.  It usually ends with “May I have their contact number and talk to them myself?”
If I do get the number, the families would be asked these and more questions.   In almost all the cases there has been a ready willingness to talk and share.   So now I have around 10 families or so that I talk to on regular basis.  Getting a call from them is a rarity, its usually me hounding them every now and then to enquire of progress or the lack of.
Hungry for more families I reached out to o…

Tooth Fairy

Our father’s lower teeth dentures were missing since the time of his hemorrhage.   They were removable; he was supposed to get them out every night before hitting the bed. We were on the lookout for them.  Well, to be precise my sister was.   She asked everyone -  at the first hospital he was taken to, to the neighbors who took him there,  to any and every staff who came in contact with our father at the specialty hospital where he was later admitted.  No luck.  Dentures weren't to be found. 
We got home, months passed, urinary infections visited us a ton of times, my sister still didn’t forget the dentures.  I couldn’t understand what the fuss was all about.  Yes, our father could eat orally, but it was more of swallowing than chewing, so I didn’t see the urgency for tracking down the missing dentures.
Bowing to the pressure from his wife and being a dentist himself my brother-in-law took our father to his mentor who is a leading prostodontist in our city.  The Doctor was a goo…


One of the persistent recommendations during our father’s ICU days to stimulate the unconscious brain was to repeatedly play his favorite music or a recording our voices.   Trusting a positive response to the music than to our voices, the choice of which to play was an easy one.  We did it in the ICU, later when in a private room, and also when at home.
A cousin of ours gave us a CD by one of those new age teachers.   The recommended dosage to play was everyday for one hour and continue this for at least a month.  Did we follow it?  Ofcourse we did.  I read somewhere that classical music helps, especially with a varied tempo.  So Hindustani and Carnatic instruments would rock on in his ears when asleep.    
It is beyond doubt for me that music helps and what we did helped.   Although I don’t exactly know how.  This seems to be the conclusion of most of the literature on music therapy  - very effective, uncertain strategy and studies to channel the efforts for maximum results are sti…

The Mystery of Heavy Breathing – I

It first happened around the third or fourth day after our father was shifted to the ward from three weeks in the ICU.   His usual languid right side, would stiffen up, his right arm all clenched would move to his chest, his facial expression would be that of a person in utmost pain and breathing would be heavy, noisy and rapid.   It was scary to say the least, to watch him have this episode all of a sudden when he was asleep peacefully.   This would recur – sometimes every time 10 minutes, sometimes every half hour and on real fun days every 5 minutes. 
The first night it happened, he was moved back to ICU for observation.  Nothing particularly seemed amiss, he was wheeled back to the room next morning. 
In our five month stay at the hospital, this happened every so very often.    Some said our father was getting emotional.   Emotional?  So timed, every 10 minutes emotional?  Nah.   He was given steroids.   Didn’t help.   Was given strong antibiotics.  No real help there either.

Heavy Breathing: Cause Figured II

It was an all nighter of heavy breathing on the first night at home.  A night to remember.  A new fumbling bumbling nurse, father breathing like he was possessed, and me just watched them with exhaustion all night.   And there, it stopped in the morning.  
After a couple of days of just watching him obsessively, figured he breathed so when passing urine.   However did not know if the heavy breathing caused him to pass urine, or passing urine caused him to breath rapidly.   All I knew was they were connected.   Since IMC was usually done first thing in the morning, there was no frequent heavy breathing during the day.   Ha, there, the explanation why the episodes occurred mostly during the night.   It was because there was so much urine retention in the night and he was struggling to pass it and hence the frequency.  But why was the interval between so timed, I still do not know.
So we then started him on IMC three times a day –early morning, evening and post mid night.   Late night IM…

An Amazingly Simple (Temporary) Solution for Heavy Breathing – III

Unable to bear our father’s suffering any longer, we circumvented the experts and tried inserting a catheter anyway.  It was highly uncomfortable for our father, he started to bleed and few blood clots came out.   It scared us sufficiently, pulled out the experimental catheter.   It must’ve been the wounds from the regular IMC that caused the bleed. Not knowing the next steps, we waited for the wounds to heal – just miraculously.

Complications Due to IMC Source:

After maybe like a week or two, my sister was at the temple for a special prayer session and I was rushing out for a meeting.  I would’ve been out of the door in a minute, but our nurse came running to tell me that our father was shivering and had temperature.  Having known the drill of infection, I knew what it was. 
Unable to cancel the meeting at the last minute and not wanting to disturb my sister during her prayer, I told the nurse to give a paracetamol, called the lab to do the neces…


Although our father could swallow food in small quantities, he was mainly fed through the ryles tube.  With repeated episodes of him yanking it out due to discomfort and given his chronic cold, we were advised to have a PEG tube inserted in his stomach.   

Apparently ryles tube is a temporary solution, not recommended for more than couple of months, if even that.   So we decided to have the PEG in place.  It's a fairly simple procedure, does not take more than 20 minutes. There was a gastroenterologist in our hospital, whom I will hence forth refer to as Dr. G.  He seemed friendly and we zeroed on him to perform the procedure.  Dr. G, recommended that we get our father admitted a day before the procedure, then stay for another couple of days to monitor him.   Although the expenses for such a stay at this corporate hospital seemed daunting, we opted for it given it was for the greater good!
Incidentally in July 2010 we were admitted at the hospital for Urinary Tract Infections (UTI). …


This is the second birthday for our father since the stoke.   For the first one we were still at the hospital.  Coincidentally some of his friends showed up the hospital, the staff had arranged for a cake, apart from which I had picked up a cake and some decorations.  So his hospital room was full of nurses, duty doctors, cleaning staff, family, friends and two cakes.   He wasn’t too alert, seemed like he knew something was up, we couldn’t tell for sure if he really understood. 
This January 4th was different.   There was just one cake and the room was decorated by our driver under the supervision of our nurse.  My sister and I put some balloons up and our physiotherapist showed up as we were getting ready to cut the cake.   A dear cousin sent a bouquet of red roses.   Our father looked around the room in amusement, cut the cake with enthusiasm and gave us a piece each.  A Happy birthday indeed.