I had to go to the hospital for a meeting with R. (Chris’ Speech and Language Therapist). I found Chris asleep on his wheelchair in the hall; head down with his torso twist and bent to the right. Not a pretty picture. The staff had not been able to wake him up for lunch so his food was waiting… Coincidentally Chris woke up for me and I fed him… Although he ate a good amount, Chris was just swallowing the food without chewing - which is not safe at all.
Similar to the weekend, Chris was spaced out, unfocused and in his own world. It is hard to describe him precisely but obviously and clearly something is not right with Chris. Before, Chris was so attentive and alert and aware of his surroundings that if he was sitting among a group of people, no one could tell much about his disability because he would make eye contact appropriately with whoever was talking, turn his head to voices coming from different directions, etc. Since the weekend, he is just not making much eyes contact and his gaze wanders around and into the space.
His PT also noticed Chris is very “drowsy”, he is sleeping a lot and slept through his physio this morning. Chris fell asleep again after his lunch. Chris has not slept this much in ages. I raised this with the nurse – who will speak with the doctor – and I have asked everyone to please keep an eye. Is he having seizures? Is this hydrocephalus? Clinically Chris is very stable and there are no indications of anything wrong with him. But I know something is wrong with him for sure – I just do not know what is causing this. There has been no change in his medication. Chris has a very weird indescribable episode during lunch: he looked like he was making tons of “effort” not shaking but trembling a bit (like Hulk would do before becoming Hulk). Is this seizure? I would not know how to recognize one and no one was around when it happened.
Chris has been having PT in the sensory room so they can isolate other stimuli. He goes on the water bed – which is warm – and the idea is to soothe and relax him. Usually he does not enjoy the stretching etc as it hurts him a lot.
Regarding my conversation with his SALT, her primary goal is to work with Chris’ hyper-sensitivity. I told her Chris has improved a lot already on the hyper-sensitivity front, but still she feels this needs to be addressed before further work with communication. By hypersensitivity I mean Chris jumps when touched, especially on his arms. He used to not tolerate any touch on his face but this has improved in the last months. So her short term goal is de-sensitization by working with various sensory stimuli, and then will work with his ability to interact.
She has confirmed what I feel… that Chris does not have cognition to understand language, but he clearly responds emotionally to the tone of people’s voice (jokes or loving tone). She explained that babies/ young children do not understand language but know when someone is speaking softly and respond by smiling and laughing. This is what I always thought about his smiling etc.
The SALT does not want to use guards for Chris teeth grinding because she finds it too invasive and Chris will continue to tighten and grind his teeth. She prefers to work with his jaw and face to relax the muscles around his mouth. I totally agree this is a better approach as it resolves the problem for good, as opposed to minimizing the damage from the teeth grinding.
My parents due to visit tomorrow so will see how they find Chris.
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Something not right with Chris...
Comments
Re: Something not right with Chris...
by
Tschmans
on Tue 12 Dec 2006 10:16 PM GMT | Profile | Permanent Link
Hi Koo,
Your description of Chris's lunch episode certainly is a seizure imho. Tori has them as well when we try and move her arm in a particular fashion or when we startle her when she is sleeping. I believe she is in the initial stages of a full blown seizure but most of the time she can regain composure and "snap out of it". But there have been times where she couldn't and a full blown seizure erupts complete with severe body trembling, eyes rolling inside the head and jaw grinding... Very, very unpleasant to witness and they can last up to a minute or two... Chris has had no medication changes right? Perhaps he has been having these all along but they have went undetected? Is Chris on any anti seizure medications like Keppra? That is what Tori is on and she gets 2000mg per day. I'm not sure what advice to give you. If you can catch Chris doing it again during an EEG test they would surely know if it is a seizure or not. Please let me know if I can help any further. -Tim Re: Something not right with Chris...
by
Sue
on Wed 13 Dec 2006 03:40 PM GMT | Profile | Permanent Link
I am so sorry to hear about this development. Double check the medication thing, either changed or not given. That would be my first suspicion. Earl ground his teeth horribly in the beginning but next to never now. We never had a guard because of the possibility of him swallowing it. Thinking of you both. Sue and Earl
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