Tuesday, January 8, 2013 - A Change of Scenery

I sat in on Marc’s physio this afternoon and his control over his left leg is better than yesterday.  They have him standing with a walker and stepping forward on a phone book and back, slowly.  He is definitely placing his foot with more precision. 

He still has trouble remembering where his wheelchair is supposed to be in order to transfer safely to the right onto a bed and off again.  That positioning is just not yet making sense in his head because the wheelchair’s position has to change, depending on whether he is getting into or out of the wheelchair.  I’m going to try and help him come up with a way that works to remind him.  I worry about it because later this afternoon he transferred the wrong way into bed with the help of a nurse.  The physiotherapist was right.  Not all the nurses know about proper transferring techniques. 

Marc also learned today how left neglect works, in relation to his left arm and hand.  When he is driving his wheelchair, he is supposed to use his left hand as well.  What happens is that he will push the left wheel for a few strokes and then his hand just rests on the wheel as it turns, letting his right hand and arm do all the work.  He got annoyed when I kept reminding him to use his left hand.  He insisted that he was using it.  We both figured out that because his hand can feel the wheel under his palm, he thinks he is using the hand.  It’s like his brain, due to the injury caused by the bleed, has decided that the left arm and hand don’t really exist and therefore it forgets to tell it to keep working.  I can only imagine how confusing that must be for Marc.  He is positive that his left hand is turning that wheel and yet here I am bugging him about it every few seconds. 

Speaking of left neglect, Marc’s bed was originally the first bed when you entered his room and the way it was positioned, the space to sit and visit was on his right.  Not helpful to a patient with left neglect.  His roommate was transferring out today so I made sure that they would move Marc to his spot, which allows for visitors to sit on his left.  His physiotherapist and occupational therapists both mentioned the improper bed placement his first day in that room, so they were able to back up my request. 

What I hadn’t anticipated was the anxiety this small move would cause Marc.  He was very concerned about the logistics of the move and was worried about his belongings all getting moved properly.  I’m so glad he was just moving to the bed beside him and not across the country.  I’m not sure we would have survived that. 

I stayed with him until the move was complete and made sure that each item was in place before I left.  He was feeling much better and more settled by the time I was ready to leave.  In fact, he decided that he likes it in that spot even better. 

The added bonus is that now he has a view of the parking lot and the highway beyond.  I’m hoping that having to look to the left to see that view will also help the left neglect. 

It seems like a win-win situation now that the anxiety of the big move is over.