After two days in the Neuro ICU, I know more about brain aneurysms and subsequent stroke care than I had ever hoped I would, and I still feel like I’m a neophyte navigating through limbo. That is despite the teams of experts that from my naïve opinion are offering the latest breakthroughs in care and 24-hour monitoring. Two days ago, my mother-in-law had a ruptured cerebral aneurysm. The statistics are grim. A rupture of an aneurysm in the brain is fatal in at least 40% of the cases. Of those who make it to the hospital, at least two-thirds will have some sort of permanent disability. In my mother-in-law’s case, it is suspected that the rupture happened at least two to three days prior to being admitted into the hospital. By the time she made it to ICU, she was already on shaky ground. She was scheduled for an angiogram to determine the size and extent of the rupture, and hopefully determine next best steps.
I can now tell you the difference between “clipping” and “coiling” a rupture as well as recite the various complications. Being the daughter-in-law, I can ask the questions that no one else wants to ask as fear and denial, common forms of processing and coping, paralyze her immediate family. She has always been the submissive one in a family of dominant personalities and strong opinions. Wishful thinking was dashed the moment I entered the room and the doctor that had performed the angiogram pulled me aside, looking for someone willing to listen and willing to disseminate the information. My father-in-law refused to put in his hearing aid, and could you blame him? None of us wanted to hear what the doctor had to say. I listened as he told me that the procedure had gone flawlessly, indicated the location of the aneurysm and described the coiling procedure they used to stop the bleeding . He explained the need for using the least invasive techniques based on the situation. The current complication was more serious. As they finished, a blood clot or even, a miniscule piece of plaque from an artery, dislodged causing a subsequent stroke. Her prognosis at the moment was that only 20% of patients in her situation fully recovered. Currently she was presenting weakness on her left side, although her speech functions seemed to be intact. It was just like her to quip “you’re welcome” as a technician thanked her for letting him poke and prod her as they tested her responsiveness. She has always been the well-mannered one in the family.
All I could think about after the delivery of the news and complications was: how could we make sure she gained admission to the twenty-percent club? I thought about how in her everyday life, she would not be the person that would come to mind that would fight to be the achiever. She is always the enabler. As I looked around at her husband and children, this would be a role-reversal that would challenge them to their core. We needed to become the enablers, and find a way for her to beat the odds. I relayed the stark statistics as honestly and as gently as I could.
Today, before I left for the hospital, I went out to my flower bed, prepared but unplanted. My mother-in-law is an avid gardener. Spectacular flowers abound at their main house and an enviable vegetable and fruit garden flourishes at their Eastern Washington get-away. I looked at the barren soil. In all the ways my mother-in-law is passive and submissive, I’m not. But as I looked at my pitiful excuse for a garden, I had a thought. I’ve seen my mother in-law in the garden and she is ruthless. I am always tentative when tending the landscape or planting any living thing. I’m held back by the thought that I might hurt something, or in many cases inflict neglect and subsequent death. Watching my mother-in-law in the garden is like watching a warrior. She attacks the weeds with almost machete-like efficiency, honing them down at sight. She will cut into stubborn roots with the sharp edge of a shovel, digging out any unwelcome guest. She uses the strongest of chemicals to combat any pest that may attack her prized roses, where I mix soap and water and hope that the mere slipperiness of the leaves will deter the aphids and fungi. To look at her bountiful bouquets, her technique has definitely won out. It donned on me that right now she needs to fight like she fights in her garden.
I went into the garage and pulled out every flower seed packet I had ever bought and never planted. I took them to my garden bed, destined to remain barren due to the reluctance of the gardener and the ineptitude of the gardener. One by one, I opened a seed packet and sprinkled them throughout the bed. I took the unopened canister of “Flowers for Hummingbirds” and broke it open and sprinkled the contents vigorously. Don’t be tentative, I reminded myself. Flowers don’t grow in the dark, in the garage, sealed in unopened packages. I continued my process, until every packet was empty. I pulled over the hose and watered generously. Even if only 20% of the seeds germinate, and only 20% of those produce a bloom, my garden will be much more bountiful than it was yesterday. And I promised to be ruthless in my attention and protection, just as I will be in ICU, everyday with every good intention.
I don’t know if we will be so fortunate to witness this lovely lady’s admission into the twenty-percent club. But I do know, that as we sit down to make a family plan, we will tend to her care as diligently as she tends her garden, throwing aside the weeds, removing the pests, and giving her all the nurturing possible so at least she has a fighting chance.
© Kelly Tweeddale 2012