Sunday, March 17, 2013

Intercranial Pressure SYMPTOMS

This is an excerpt from my book.

Intercranial Pressure: Symptoms February 11, 2007

The CCS research has told me that one result of the brain tumour is intercranial pressure (ICP). These are the symptoms of this. I know that Dad had shown these symptoms over the course of the past eleven months, since his tumour was rediagnosed. 

1. headache – often occurring early in the morning and made worse by coughing, bending or straining 2. nausea
3. vomiting
4. dizziness
5. vision problems
6. difficulty speaking
7. confusion
8. restlessness
9. drowsiness and decreased consciousness
10. trouble with coordination
11. loss of muscle strength
12. loss of the ability to move a body part (paralysis)
13. seizure
14. coma

I went in to see dad before choir practice in Orillia. A PSW had just changed dad’s sheets. I had seen her from the parking lot as I looked up at dad’s window. His Valentine decorations were a bright spot in an otherwise bland institutional building.

Snow has piled up and was quite a chill in the minus 15-degree brisk winter air. Once I made it up to his room I found him in his chair, with his head lolling over to one side. I mentally kicked myself since I had washed his Obus form cover and had forgotten it at home. I had forgotten to send Brian in with it, too. It would have helped him greatly. He won’t lean back and put his head on the headrest.

Occasionally his head would shake with tremours. It pained me to look at him. He was trying to form words but could not speak clearly. He spoke as if he had marbles in his mouth. I thought I heard, “Yie down.” meaning he wanted to lie down. He spoke this phrase several times, too ill to gesture any more. He just cannot relax. I heard him say, 'aaggghh.' I knew that there were two staff members on breaks after the meal they had just served at five. I could hear staff calling for help with ‘lifts’, putting residents into bed. I decided to sit and wait until staff came, as I knew they would eventually.

 The PSW came into the room. The PSW mentioned that she had just changed his bed, as it was quite messy and smelly with bowel movements. I thanked her for doing so and showing such concern. We spoke of his ear problem. There were crusted bits in it. I told her he had big wax problems and she thought that he had an ear infection. I told her that I though he was in more pain than the medications could help.

When they began to change his adult brief there was a big problem. Nursing staff had given him a laxative, since he had been constipated. He hadn’t eaten anything in ages, but I am just the daughter.

The ladies began to lift him; he groaned as they did so. He could be having any number of symptoms, but I am sure he was in pain. He had been nauseous for months. I could see the bones in his back sticking out. He was as gaunt as a holocaust survivor. He had pressure sores from his bones digging through his thin buttock skin into where he sat on the cushioned wheelchair. They wiped and washed and changed him several times, as he was still evacuating his bowels. The kept their sense of humour and smiled. He grunted and moaned. I know the man is in pain. After this difficult scene I got into the car and drove to choir.

I was shaking after the 35 minutes drive. It felt good to have something else to do, sing and read the music. I couldn’t get the smell of dad’s feces out of my nose. I wondered if I smelled this bad or if I was just remembering and worrying. M sits beside me at choir and she listened while I vented. I explained that we are having trouble advocating for dad. She is married to a pharmacist. She said to keep advocating. We know Dad best and know what we want done for him. I came home determined. I spoke to this pharmacist, with experience in such matters, and he strongly suggested that Dad could go on morphine at this point. I will always be grateful to Wayne Cox for helping me! On the way home I popped in to see if dad was asleep in the care home. It was ten o’clock, very cold and dark. The place was deathly quiet. He was sleeping and I was relieved. Off I went home.

I sat down with Brian. He listened to my story and agreed and suggested I either call the doctor or call the Charge Nurse. I did all of the above the next day. The Charge nurse was unable to get hold of the doctor. They told me to do so.

It took three days for the doctor to prescribe morphine. He was unreachable at his office, or his clinic. I reported him to the College of Physicians after Dad died a day later.

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