Bill is always in his wheelchair but he sits straight or leans back for a nap. Yesterday I noticed he was leaning to the left and today I noticed it even more. I even put a pillow next to him so he would sit up straight.

Could this be a sign of a mild stroke? He did have a TIA three years ago; nothing since then. Maybe it's just the progression of the disease.
I didn't call hospice to ask because I figure if it was a stroke, there wouldn't be anything to do now. I'll see the nurse tomorrow and ask her about it, but until then thought I'd get some input from the pros.

Hi, Joyce,

My mom did the same thing. Her mouth also drooped on the side she was leaning. But only when she was asleep. When she was awake she seemed "normal" (I always use that term loosely... )

I, too, thought she might have had another stroke (the first was in 2000) but thef leaning and drooping always seemed to clear up when she was awake so I discounted that theory. I really think it's just a progression of the disease. Don't know if that's good news or bad.............

I don't think it makes much difference at this point Karen. Bill seems to lean awake or asleep.
Thanks for your reply, I didn't notice if his mouth drooped or not. I'll have to pay attention tomorrow.
He is sure doing a lot of wheezing tonight.
I'll just have to wait and see what tomorrow brings.

I have absolutely no medical knowledge but from the following, it sounds like it may be part of the disease


Level 7
Very severe cognitive decline (Late Dementia or Severe AD). All verbal abilities are lost. Frequently there is no speech at all - only grunting. Incontinent of urine, requires assistance toileting and feeding. Lose basic psychomotor skills, e.g., ability to walk, sitting and head control.
The brain appears to no longer be able to tell the body what to do. Generalized and cortical neurologic signs and symptoms are frequently
present.

7a - Speech ability limited to about a half-dozen intelligible words
7b - Intelligible vocabulary limited to a single word
7c - Ambulatory ability lost
7d - Ability to sit up lost
7e - Ability to smile lost
7f - Ability to hold up head lost

Joyce,

I'm not quite sure either. Mom isn't in as late of stages as Bill, and she seems to do the same thing when asleep in her recliner. But one thing to know, there is something you can do from what I have read if someone does have an obvious stroke. There is a pill, don't know the name of it, that given within 3 hours of a stroke, supposedly can get them out of the stroke. I'm sure there is more to what I'm saying, but maybe Aitan can give some background on that.

I don't think it holds true for TIA's, as there a little harder to identify than a full blown stroke. But I would ask the nurse tomorrow for sure.

Jackie

Joyce,

From my experience with Mother, it sounds like the disease. She began leaning toward the left side, mainly head and upper body, when sitting up or in the recliner. I would place a pillow or two on the side for support and that seemed to work.

I know it can be so frustrating. Seems like something comes up almost daily and then it's a real guessing game, even for the professionals.

My thoughts and prayers to you,

Joyce

The medication is tPA (it is spelled that way) and needs to be administered within 3 hours of the stroke via IV.

http://en.wikipedia.org/wiki/Tissue_pla ... _activator

And here is a good website about strokes:

http://www.americanheart.org/presenter. ... ifier=4742


Joyce, my mom leaned a lot as well. We would try to get her to sit up straight or lean a bit to the other side but she seemed to favor a certain side most of the time. From what you are describing, it doesn't sound like a stroke but do look for facial drooping or weakness. Ask Bill if he can smile for you, for instance, and check for the drooping. You can check the grip in both his hands and see if they are both equal too. These are simple tests we do on the ambulance.

Let us know how things are going. I will say a prayer for you both.

Snick,
Asking Bill to smile or do anything would be like asking a newborn to talk.
He has no idea what I'm asking him to do or how to do it.

I figure it is just the progression, but then I started wondering, how do I know if it's a stroke or not. He can't sit up straight, can't talk so he doesn't slur his words. Weakness on one side, he is so weak he can't stand already. Grip my hand, he doesn't know what grip means. He has a slight droop on one side of his mouth and a weakness on his right side from his previous stroke.

He already has all the symptoms of a stroke, so how would I be able to tell is he was having one? Just wondering right now.

Thanks everyone.

What would I look for that he doesn't already have.

Hi Joyce,

Sorry for coming in late on this one. Bill may just have weakness and leaning towards one side is a normal response to that. On the other hand he may have had a stroke. It's always better in these situations to call 911 to check him out as soon as you suspect something is wrong. The reason being that if it were a stroke it may be reversible if it's from a clot, usually within 3 hours they can administer clot busting drugs like tPA. Here's somethings you can do to check in addition to those already mentioned above. Ask him to open his mouth, and if he doesn't understand open yours and maybe he'll imitate it, and then look for tongue shift to the left of the right. Check his pupils and see if one is bigger than the other under normal light. If he's not squeezing your fingers when you ask him to, then you can lie him on his back and hold both arms above his face and then let them drop. If he has had a stroke that has caused partial paralysis of one side of his body then the arm that is affected will fall towards his face and he won't be able to move it to the side. Make sure you're ready to catch his arm so that he doesn't injure himself. There's other tests that can be done, but they are a little more complicated to explain online. It's really best if you just get him seen as soon as possible. Obviously this is well past 3 hours now, but if it was a stroke it could get even worse and the clot could travel farther affecting more areas of the brain and his sensory and motor system. Plus we don't know what kind of stroke it may have been if he had one, it could be hemorrhagic and that could be life threatening.
Lastly, this issue with the wheezing is not something to be taken lightly if this is not common for him. If he is audibly wheezing and you can hear this without a stethoscope that means he has constriction and congestion of his bronchioles and his alveoli in his lungs for some reason. This needs to be corrected with oxygen supplementation and medication to open his airway like albuterol or atrovent. Does he take this medications on a daily basis? This is concerning to me, and I would suggest you take him to the local ER to get checked out right now if this is still going on. If you're still unsure and hesitant call his doctor and ask him/her what you should do.

Hi Joyce, any updates on the possible stroke?

Praying for you and Bill Joyce.

~Kelly~

Bill seems fine now Aitan, thanks for asking. He is in respite this week and I went to see him today. The doctor checked him out and I guess it's just the progression.

The one thing I noticed today and I don't know if it means anything. Both of his feet were very red and they felt warm to the touch. I've never noticed that before so I don't know what that means. The hospice aide was there when I was and she made a point in telling the nurse about it. His hospice nurse will be there tomorrow. I don't know if I'll get to see her because I also have a doctor's appointment to have thyroid levels checked. The aide did make a note of his feet in her report so I'm sure the nurse will check on it, too.

He was scooting all over the place in his wheelchair while I was there. They put a seat belt on him that fastens with velcro and and alarm on the belt in case he takes it off. I guess the velcro covers the no restraint law since he could undo it, if he knew what he was doing. They have orders to use the hoyer lift for transfers. The nurse said they used a stand assist when they got him dressed today, I may have to check on that, it may work for changing him when he comes home. I'll ask his hospice nurse when I see her.