This is little Cous Cous
...about 2 months after I got her..she is much healthier and a real trickster...but looks a right regal Queen cat here..its her carpet and I should respect that ifn I know my place
Friday, January 30, 2009
Wednesday, January 28, 2009
A new post on my other blog "Quick Whipped Up Faeries"...
http://quickwhippedupfaeries.blogspot.com/
finally...been a bit of a drought there of late for those who follow
http://quickwhippedupfaeries.blogspot.com/
finally...been a bit of a drought there of late for those who follow
Friday, January 23, 2009
In Dreams.
When I was down in Melbourne at my daughter's place, she played a song she had been singing for me. Don always loved this song. She got about two words in and I burst into tears, but asked to hear it all...tears are okay I know this now. So I asked her to send tit to me. between us we put it together with a selection of photos...I had no idea how hard it was to synchronise the photos with the music... She said its a tribute...but having over 50 photo albums it was hard choosing.
I always get emotional when I listen to my daughter sing, no matter what she sings but this for me was just beautiful. It has to be played in "High Quality" (right hand side under the pictures) because in uploading the photo quality deteriorated...
Unfortunately, I noticed that as some of the photos come up somehow there are dark spots on some of them...we didn't bash each other up okay... we might have felt like it once or twice, and in fact little Alice as she was called did thump Melissa on the nose, when the straw finally broke, but she had to wait till Melissa was sitting down to reach...
When I was down in Melbourne at my daughter's place, she played a song she had been singing for me. Don always loved this song. She got about two words in and I burst into tears, but asked to hear it all...tears are okay I know this now. So I asked her to send tit to me. between us we put it together with a selection of photos...I had no idea how hard it was to synchronise the photos with the music... She said its a tribute...but having over 50 photo albums it was hard choosing.
I always get emotional when I listen to my daughter sing, no matter what she sings but this for me was just beautiful. It has to be played in "High Quality" (right hand side under the pictures) because in uploading the photo quality deteriorated...
Unfortunately, I noticed that as some of the photos come up somehow there are dark spots on some of them...we didn't bash each other up okay... we might have felt like it once or twice, and in fact little Alice as she was called did thump Melissa on the nose, when the straw finally broke, but she had to wait till Melissa was sitting down to reach...
Sunday, January 18, 2009
Last week I stayed with my youngest daughter Alison in Melbourne (Australia)
This lovely girl has suffered illnesses that I am not sure I would withstand. Not long after her dad (my Don) died, she seemed t turn the corner but will have t have injections of Vitamin B 12 every three days for the rest of her life, amongst other things she takes just to be able to be okay....
She was sick, very sick all through her 20's which were basically lost to her, We spoke about this while I was there and a few tears were shed. She is an amazing person, and has a lot of her dad in her...which she happily admits.
She is kind, wise and true. She also does not take any prisoners of people who are unworthy of her trust and I like this about her.
This last week she was so good to me. I had two appointments with a varicose vein specialist who did sessions needling the most bulbous and dangerous of my varicose veins.
She drove me there and looked after me as I painfully and slowly hauled myself where I needed to be with many curses.
I was given cups of tea... cooked dinner and basically taken care of. I burst out crying more than once and explained to Alison that it was the kindness that made me cry. I am not used to anyone doing this sort of stuff for me.
Kindness brings me undone. I still think of my kids as my kids...but they are adults now in their thirties...and they are kind in an adult way...this is hard to comprehend... but also it is nice to consider.
This lovely girl has suffered illnesses that I am not sure I would withstand. Not long after her dad (my Don) died, she seemed t turn the corner but will have t have injections of Vitamin B 12 every three days for the rest of her life, amongst other things she takes just to be able to be okay....
She was sick, very sick all through her 20's which were basically lost to her, We spoke about this while I was there and a few tears were shed. She is an amazing person, and has a lot of her dad in her...which she happily admits.
She is kind, wise and true. She also does not take any prisoners of people who are unworthy of her trust and I like this about her.
This last week she was so good to me. I had two appointments with a varicose vein specialist who did sessions needling the most bulbous and dangerous of my varicose veins.
She drove me there and looked after me as I painfully and slowly hauled myself where I needed to be with many curses.
I was given cups of tea... cooked dinner and basically taken care of. I burst out crying more than once and explained to Alison that it was the kindness that made me cry. I am not used to anyone doing this sort of stuff for me.
Kindness brings me undone. I still think of my kids as my kids...but they are adults now in their thirties...and they are kind in an adult way...this is hard to comprehend... but also it is nice to consider.
Sunday, January 11, 2009
I just had to post this. This is Don and his second sister Judy..his first sister was killed in the late '60's...Judy was doing a "bewdy course" and Don being who he was easily volunteered to be her guinea pig...he loved this stuff
Judy sadly died from cancer in 1998 and Don and I spent the last 3 months of her life beside her as she died..I used to hear them talking softly on the long afternoons as she laid resting in bed. He would park his wheelchair beside her and rest alongside her. He loved her much and I learnt to love her the same. Many of his family had "charm" which those of us loving them feel privileged to have known..if this makes sense.
and as mentioned Don loved nothing as much as being in the hands of women...makeup, conversation, company. He was a relatively macho man at one time but had a soft side.... I believe that these two would be somewhere abouts each other right now.
Todays a better day
...and as long as I don't play any old music I'll be okay I think. Sometimes I download an old song or two but I seldom listen to music these days. Music is like the smell of wood fire in winter for me, or a pair of eyes in the crowd. Its like real food for my soul and it opens up the heart to whatever is foremost inside. If its good stuff thats great, but when you are fragile, sometimes is just better to leave talkback on the radio, which is just about all I have on these days. I remember how my mum used to play the piano and listen to Elvis...but the neighbours would tell me they knew when she was down, because the piano was silent and they heard no music at all from her house.
Sometimes I just don't want to hear the news or pronouncements by Prime Ministers or Presidents. Sometimes I like to hear someone ring in and tell us all about his six brothers and how he loved his mother's Gramma Pie, and what it was like to come home from school and have it with cream straight from the dairy. I have to consider that there is as much importance as this one person's memories and there is in anything, any celebrity can declare on the front pages of every newspaper in the world.
(Don and I in the mid 1980's. He loved having his photo taken, especially if it was a good lookin woman taking it... and this was taken by a women...thats why the "charmer-smile")
Alison said to me today, in a kind way "mum, we maybe will just have to accept that our family will never be the same again, how could it be? Which was just the right thing to say.
I think that when someone dies that you love, you think there is grief in the first few months, and it is devastating, but as time passes and reality really sets in, and you find yourself in total disbelief that you will not ever once see that person in this life again...the tears begin in reality. (thats okay)
Luckily I have not been called upon to lose my children...thats yet another sort of grief...every parent's dread...no matter how old the child... but with a husband and wife, a pair that have been lucky enough to find each other in the whole mix up of people on planet earth...the loss really is like that of the half of your heart you felt would always be with you...somewhere in our lives together we found the place of total trust and oneness...not in some droopy new age crapola, but as it has been since man and woman first loved.
Everywhere I go there are couples and families and people together. I never noticed this before. Its this which drives me home most days lately in tears. The loss is now becoming reality. There is an emptiness never knew in all my life before Don and I met. I was on my own then and happy to be independent and so called 'free". I realise plenty of people are just 'one" and now I see them and they see me. Thats okay, its all part of being alive.
I wonder how long it will be till I feel I can actually laugh and smile as I always did. I know that I was lucky as was Don in each other. Not easy in the years we were together as we fought like cats and dogs at times...but then we would touch and it would all be gone.
The hardest part is that my mind too often relives the brutalisation he was subjected to by some Royal North Shore Doctors and nurses. He was so fragile when he went there.
What I feel is different because of this. There is a dreadful guilt because I could not protect him. I couldn't save him, stop it. At that time I feel I would like to have fucking thwacked them in the face to wake them up...but I didn't, mores the pity. It wasn't till I got the notes that I knew the whole horror of what they had done and the fucking lies they told us...over and over. But this is okay by the authorities. I know exactly how the families of those murdered feel, until there is a publoc justice and acknowledgement of that crime.
This is what stinks the most. Such a frail man as Don can be murdered basically...call it what you will but I know he was killed, and did not just die - this is acceptable. Acceptable.
For many years Don and I used to get involved in fighting for social justice in our small town, we spent thousands fighting things that were wrong...I have folders of our many letters to the editor and authorities... hundreds of them...i, writing was easy for me but in his case each letter was painstalingly tapped out with a piece of wooden dowel strapped to a bit of velcor around his hand.
But when he is treated like a piece of garbage, and killed, no one body, no disability group, not one person who he had helped over the years put their hands up and said, "I'll help". Thats "society".
So as said, maybe the small stories on talkback, the individuals and their lives and hopes are more important than the big picture we are always being slammed and terrorised with.
This is my "bitter" day. I have just got the shits with it all.
Tomorrow I hope I feel differently. I am off to Melbourne to get my varicose veins fixed...I live in another state but I got in here quicker than the year I would have had to wait in Port Macquarie... I get to spend some time with my youngest, and I know this will help.
But... but...
But... but...
I may have some good news soon...unsure...There is a chance I may be able to have a doggie in early February...to go with my cat Cous Cous. This dog is 6years old and a female half Kelpie/Blue Heeler. her name is Harley and her owner had to move into a unit. The funny thing is she really is a harlequin as a whole half of her face is Kelpie, (brown and tan) and the other half is Blue Heeler (Blue Heelers were bred in Aberdeen NSW -my home town - no matter what those in Muswellbrook say). She has Blue Heeler colouring on the rest of her body and the legs to match... She is not as showingly handsome as the old dog Thorn, but looks don't matter, she has a nice look in her eyes.
I need a dog. The cat has helped but we aways had both.
Friday, January 09, 2009
Tonight I admit...I am not dealing with losing my Don. Today I accepted as fact that I can't go out and deal with the world as "normal". Just seeing couples together... not youngsters but any couples brings me to tears....
how am I meant to know how and in what time frame I can deal with my grief. I thought it would get easier s the year past but it gets worse... I see everything in the eyes of both of us...which is how I lived for all my adult life...
sorry folks... I am not dealing well... and it gets worse as time passes
we all have our own problems.... I know this, but I recall every pore of Don's skin, evrey hair on his arms. His smell, his eyes... his incredible love...I know its just grief...and I will deal with it in time...
how am I meant to know how and in what time frame I can deal with my grief. I thought it would get easier s the year past but it gets worse... I see everything in the eyes of both of us...which is how I lived for all my adult life...
sorry folks... I am not dealing well... and it gets worse as time passes
we all have our own problems.... I know this, but I recall every pore of Don's skin, evrey hair on his arms. His smell, his eyes... his incredible love...I know its just grief...and I will deal with it in time...
A most interesting day
... today I drove to the divide between the road to Port Macquarie and the road to Wauchope. it was unusually cool...has been stinking hot...so today I turned towards Wauchope...when I arrived I went to the park just to sit...and there was a country and western band setup. The weekend coming up is a celebration of Aussie and C&W music...
I sat down and the very first song they belted out was Slim Dusty's "Gday G'day". Don and Alison used to sing this song to each other when they were on the phone and it near broke my heart because I could hear them singing against each other...like it was yesterday.
... today I drove to the divide between the road to Port Macquarie and the road to Wauchope. it was unusually cool...has been stinking hot...so today I turned towards Wauchope...when I arrived I went to the park just to sit...and there was a country and western band setup. The weekend coming up is a celebration of Aussie and C&W music...
I sat down and the very first song they belted out was Slim Dusty's "Gday G'day". Don and Alison used to sing this song to each other when they were on the phone and it near broke my heart because I could hear them singing against each other...like it was yesterday.
There is lot of city/urban prejudice about country and western music... and a couple of years back I was the same... but realised I was wrong...its all music, all a part of the human experience...and now I like it as much as I like the good and bad of all other forms..it was freaky to just turn up somewhere and fond that they were singing the very same song Don used to belt out over the phone...
A Pack of ratbags.
I just rediscovered this old photo amongst some I was scanning in. The three girls in this are our eldest Melissa pouring a bucket of water over the other one who shall remain nameless. Alison is on the right in the stripey swimmers throwing two half eaten green apples ...
What happened here made me so proud of my kids, the way they stuck together. The one getting the bucket of water had been making Alison's life at school a real misery. She was a bully - emotionally. Many times Alison would beg me not to make her go to school...till finally I went to the principal and was informed that many of the other girls parent's had complained about her as well. The fact that the parents were "IN" with the school may have explained why they took so long to act. Good training for adult life. This kid would decide one week that you were "out" and the whole class of girls would isolate you. The next week it was another and on and on. She had the kids so confused that they were doing everything they could to avoid being the one picked out.
So it came time for Alison's birthday in October (still cold enough in Australia) and of course this kid had to be invited. Melissa knew what she had done to Alison and she was ready for her. We were all in on it...( i had the camera ready on cue, and waited on the verandah where I couldn't be seen) Melissa devised a game... apple bobbing...but never told the kids what the prize was...so the bully won of course..then the prize was announced by Melissa...it was a bucket of cold water, and to have the apples thrown at her. She couldn't say anything because she'd won the prize and came first, but for days we snickered about it,...nothing like a bit of sibling support to put things right. Not long after this this kids parents were called in...they had no idea. Things settled after this, but when I found this photo, even though the girls are 34 and 31, and a generation almost has past...they are tight this way. Alison even said in her speech at the wedding reception when Chris and Melissa married, all five foot one of her..."And you'd better look after my sister or else"
Others may have got their revenge in a more violent way, but the pleasure that this gave us stayed with us and even today I can hear them snickering when they talk about that birthday. Sadly the apples didn't connect, which may be a good thing. Her parents would be likely to raise Cain against a pair of ratbags like Don and I.
I use the word "ratbags" because I found out just after Don was killed, that some of the parents (those important in the school hierarchy), spoke about us and said that we were a pair of ratbags. One of them broke ranks and thought I should know...Why...after all these years when our kids are now the age we were then. In Australia there are different ways of using ratbag. It can be done with affection or as a big putdown...but knowing what we did and achieved, by being vocal and fighting for what we believed in...I consider being called a ratbag by that lot a compliment. Now that time has passed and some of those parents have also had "things" happen to them, in the street they come up to me and are so friendly, telling me to keep fighting for justice etc etc blah blah... and I cop It sweet, but sometimes its all I can do not to spit in their eyes.
The image of our girls taking matters into their own hands, planning it and letting us in on it knowing we'd be on their side...is all that really matters to me. Maybe we were a family of ratbags... but God it was fun. The kids only had to flick an eyebrow sometimes at others and it was all we could do to not burst out laughing. We would be all walking behind Don in town sometimes and just by the set of his shoulders you knew something was coming. I know what became of the bully, and she turned out okay, who knows maybe our little lesson helped a bit...
I just rediscovered this old photo amongst some I was scanning in. The three girls in this are our eldest Melissa pouring a bucket of water over the other one who shall remain nameless. Alison is on the right in the stripey swimmers throwing two half eaten green apples ...
What happened here made me so proud of my kids, the way they stuck together. The one getting the bucket of water had been making Alison's life at school a real misery. She was a bully - emotionally. Many times Alison would beg me not to make her go to school...till finally I went to the principal and was informed that many of the other girls parent's had complained about her as well. The fact that the parents were "IN" with the school may have explained why they took so long to act. Good training for adult life. This kid would decide one week that you were "out" and the whole class of girls would isolate you. The next week it was another and on and on. She had the kids so confused that they were doing everything they could to avoid being the one picked out.
So it came time for Alison's birthday in October (still cold enough in Australia) and of course this kid had to be invited. Melissa knew what she had done to Alison and she was ready for her. We were all in on it...( i had the camera ready on cue, and waited on the verandah where I couldn't be seen) Melissa devised a game... apple bobbing...but never told the kids what the prize was...so the bully won of course..then the prize was announced by Melissa...it was a bucket of cold water, and to have the apples thrown at her. She couldn't say anything because she'd won the prize and came first, but for days we snickered about it,...nothing like a bit of sibling support to put things right. Not long after this this kids parents were called in...they had no idea. Things settled after this, but when I found this photo, even though the girls are 34 and 31, and a generation almost has past...they are tight this way. Alison even said in her speech at the wedding reception when Chris and Melissa married, all five foot one of her..."And you'd better look after my sister or else"
Others may have got their revenge in a more violent way, but the pleasure that this gave us stayed with us and even today I can hear them snickering when they talk about that birthday. Sadly the apples didn't connect, which may be a good thing. Her parents would be likely to raise Cain against a pair of ratbags like Don and I.
I use the word "ratbags" because I found out just after Don was killed, that some of the parents (those important in the school hierarchy), spoke about us and said that we were a pair of ratbags. One of them broke ranks and thought I should know...Why...after all these years when our kids are now the age we were then. In Australia there are different ways of using ratbag. It can be done with affection or as a big putdown...but knowing what we did and achieved, by being vocal and fighting for what we believed in...I consider being called a ratbag by that lot a compliment. Now that time has passed and some of those parents have also had "things" happen to them, in the street they come up to me and are so friendly, telling me to keep fighting for justice etc etc blah blah... and I cop It sweet, but sometimes its all I can do not to spit in their eyes.
The image of our girls taking matters into their own hands, planning it and letting us in on it knowing we'd be on their side...is all that really matters to me. Maybe we were a family of ratbags... but God it was fun. The kids only had to flick an eyebrow sometimes at others and it was all we could do to not burst out laughing. We would be all walking behind Don in town sometimes and just by the set of his shoulders you knew something was coming. I know what became of the bully, and she turned out okay, who knows maybe our little lesson helped a bit...
Saturday, January 03, 2009
I now have a professional editor for my book "First Do no harm"
It took some figuring out and a disastrous and time wasting false start, followed by help from a friend who helped me to edit...but I realised a professional was going to be needed to do this properly...I had no idea of the complexity of the job when I started,,,thought I was finished when i put the last full stop. My friend pointed out some areas i hadn't covered which was a chapter basically telling people what Quadriplegia meant to us, and a chapter explaining the sort of person Don was. I am reprinting that first one here as I don't think I can be sued for this part. I think a better understanding of this condition could be helpful should any of you have close contact with someone whith this condition. The next step after editing is to sit down with a lawyer who specialises in defamation and go through the book...this is a must unless I want to be out on the streets.
" Chapter Three – Understanding Don’s Quadriplegia
Before I go any further, the reader needs to understand how quadriplegia compromises a person's health in the beginning and especially the complications that occur with long standing quadriplegia. Some people have the impression that Quadriplegics and Paraplegics are almost the same thing. Nothing could be further from the truth. They imagine that because a person spends all day in a wheelchair that they have no body needs such as toileting, showering and the rest. Seriously. We had people sometimes say to us “And what do you do all day long?” Or they’d go into long winded descriptions about an ache in their arm or a bit of Bursitis in their knee.
This leads to another misconception which is that all Quadriplegics experience no feeling below the break, hence no pain. This was for Don, sadly not true. Don endured internal organ pain which he described as feeling as if it was burning hot to ice cold as mentioned in a previous chapter. He was hypersensitive to this pain. So for any understanding of what happened to Don, I will take a short space here and try to convey the normal life of most quadriplegics. Then there will be a better understanding of how ill and debilitated Don had become, before arriving at RNSH on April the 11th 2007.
Don became a Quadriplegic in 1982, aged thirty two, as the result of a work accident. The correct term for his Quadriplegia is C5/C6 complete. His Spinal cord was completely severed between the 5th and 6th cervical or neck vertebrae. At the time of this accident, he was a healthy, active man, and this helped him survive the initial trauma. All Quadriplegics suffer differently, depending on the level and site of the injury occurs; the severity of the spinal cord damage and a myriad of other things which affect the quality of life and also on the speed and quality of medical treatment and rehabilitation. For Don it meant complete paralysis below the break with some weakened and unpredictable arm movement, but no hand movement or feeling.
Don explained his almost total lack of balance. He said, "I feel as if my head and shoulders are balancing on a large blob of jelly.” It was often a struggle to hold his position, something it took people and even doctors and nurses time to fully comprehend. If, when you were dressing Don you let him lean in the chair to get his shirt on, for example he would keep falling forward and onto the floor. He had to be supported from the front or side or back depending on what the action was. Don had some small arm ability when he sat up in the wheelchair, and learned how to make the best use of what he had with a few aids. But once lying flat in bed he was helpless and his arms were almost useless. I always worried when others were looking after him when he was in hospital.
For Don his Quadriplegia meant that he was permanently catheterised which caused many problems such as an almost constant state of Urinary tract infection which we only treated when Don felt ill. You couldn’t treat infections every time as the antibiotics would become useless against the many infections. He had a suprapubic catheter, and a bladder the size of a walnut which did not stretch any more. This caused major problems, and many Quads develop Bladder cancer. Don was being yearly monitored for this.
Don had severe osteoporosis due to no weight being exerted through his bones. His hips were the worst but hip replacements were impossible because there was no good bone to drill into to stabilise the joint. So Don sat for years bone to bone in hip joints and that pain was unbelievable. He certainly could feel pain, despite his quadriplegia. It used to horrify me to imagine him being turned over in bed by anyone who didn’t understand the fragility. I would always turn him so that there was a pillow between his knees hoping that this time the hip joint or a long bone didn’t snap or shear away. Too often nurses would be quite rough with him and responded to our admonishments as though we were being fussy. Some treated his serious problems too casually, like playing Russian Roulette with someone else’s body. His pain was managed but never totally alleviated with Physeptone (methadone) which enabled him to get out of bed at least but never really covered the pain. The bones in his feet were as fragile as like eggshells, and the fifth, sixth and seventh cervical vertebrae were fused together into one block, not separate bones. Cervical three and four were badly degenerated. He had constant pain in his shoulders and arms and head.
He had neuropathic or nerve pain which was present constantly for many years and I would sometimes hear him softly gasping when it got too bad. Poor Don.
I will mention this in more detail later when it's relevant but what most people don’t understand about Quadriplegics is that many Quads are hypersensitive to internal organ and tissue pain, but may not feel surface pain. For example, many times Don had blisters on his hand from resting it on things he was unaware were hot but yet often he would say that his kidneys felt like they were on fire..
Circulation was not good so we were careful not to let any infection take hold anywhere but mostly on hands and feet. Don lost all his teeth in the last two years of his life, caused by medication. Because of this, Don had a constantly dry mouth, which causes tooth decay. He had a Colostomy because of bowel problems caused by Quadriplegia. Most Quads have no peristalsis [the waves of involuntary muscle contractions that transport food, waste matter, or other contents through a tube-shaped organ such as the intestine] in the bowel. Without this bowel problems are common and uncomfortable. He was often in pain from this.
All Quadriplegics and Paraplegics have to be extremely careful not to sit up in the wheelchair if there is even a slight blemish on the bottom, because by the end of the day, after sitting on this, it can develop into a pressure area and become a pressure sore. These pressure sores can take months to heal and entail time spent in bed lying on the side to heal. Don never had a broken area on his skin in all the years at home but spent many weeks and at one time six months bedridden because of skin trauma. We figured, prevention is better than cure. The time spent like this was worth it for all the good time sitting up and able to get on with life, it bought Don. Also, when sitting, no folds of clothing could be allowed to dig into the skin, so extreme care had to be taken in dressing.
In common with all Quadriplegics, Don had a poor temperature control mechanism. This is to do with where the injury is and what body systems get damaged or knocked out. Once he got too cold he would shiver like a motor for hours loaded up with blankets till we could get his temperature back to somewhere near normal. It was the same with heat, he would get hotter and hotter unable to regain control. Don suffered extremes of blood pressure. Sometimes his pressure would be so low he would just become unconscious right before my eyes. I’d grab his legs and hold them up, while lowering the head of the wheelchair so his feet were higher. He came close to death on many occasions like this.
Then he would swing from extremely low to dangerously high blood pressure – all within minutes at times. This condition which Don had almost daily since 1994 was called Autonomic Dysreflexia. Don and I managed this daily and many is the day we thought he would not survive but he did. Most Quads don’t get it this often and some never have it at all.
A more detailed explanation of this unusual condition may be necessary here. Autonomic Dysreflexia (AD) is a complicated condition and only happens to Quadriplegics. Most have it rarely, some more often. Don unfortunately was plagued by daily bouts of this life threatening condition. The technical explanation is a bit too complicated so I’ll try and explain it in layman’s terms. Most Quads have a very low Blood pressure [BP] when lying down 90/60 or slightly lower and even lower than this when seated.
Because of the damage done to the spine, if there is pain from a blocked catheter, an ingrown toenail, bowel compaction, any pain whatsoever, the Blood Pressure will shoot up dramatically and within ten minutes or so can reach dangerously high levels. For a Quad 140/80 is a dangerously high BP and if symptoms [pain or pressure] are not relieved immediately a stroke, seizures or a cardiac arrhythmia is likely to occur.
It is considered a medical emergency and should be treated as such. In Don’s case there were many causes of pain and these could not really be relieved. We would check to see that nothing was wrong but then it was a matter of piercing a capsule of Adalat and getting it under his tongue. All other methods were too slow for us and we imported our medication from the US, because it was difficult to get in Australia once Federal Health Minister Michael Wooldridge took it off the Pharmaceutical benefits Scheme [PBS]. That capsule and Don’s and my quick action saved Don’s life every single day, for the last thirteen years of his Quadriplegia. We carried an emergency card in case Don was hospitalised. When he was in other’s care we both worried because the lack of understanding in the general medical community of this condition is breathtaking. Too many assumed that Don was being fussy or hysterical, and they thought that if he calmed down his BP would decrease. Often they were too slow to administer the Adalat, again endangering Don’s life.
He had very limited breathing, something I call Quad breathing for want of a simpler term. Quadriplegics breathe in a totally different way. Don’s laboured breathing was always much worse whilst sitting up because of his breathing mechanism. If there is fluid on the lungs, most of us can breathe more easily, by sitting up, but for Don it was the opposite. This is important to understand and it will be realised later on why. Any spinal specialist knows that the breathing mechanism of a C5/C6 Quad is different to the breathing most people experience. Quads breathe using the diaphragm. They have much less respiratory reserves than the rest of us. Because of this, they also have ineffectual coughing and vomiting. The dangers this presents are that any cold or infection can quickly become life threatening because of the inability to cough up phlegm or mucus from infection. The same goes for vomiting, where ineffectual vomiting can lead to vomit entering lungs, as it can too easily be inspired into the lungs because it is unable to be expelled as effectively as it is for the rest of us. Don had been unable to fully expand his lungs since 1982 and his breathing was always shallow.
All of the above, Don had to deal with daily. But life was so good and we lived in the moment, laughing often and getting out and about when it was possible. Don was such a man. He was so brave and solid. With all the above to deal with he was the first to help others who were ill or in trouble.
Hopefully the above explanation of just some of his complex medical conditions will allow understanding that such a person should have been treated very carefully by Cardiothoracic Specialists in RNSH, not the exact opposite as was the case."
Before I go any further, the reader needs to understand how quadriplegia compromises a person's health in the beginning and especially the complications that occur with long standing quadriplegia. Some people have the impression that Quadriplegics and Paraplegics are almost the same thing. Nothing could be further from the truth. They imagine that because a person spends all day in a wheelchair that they have no body needs such as toileting, showering and the rest. Seriously. We had people sometimes say to us “And what do you do all day long?” Or they’d go into long winded descriptions about an ache in their arm or a bit of Bursitis in their knee.
This leads to another misconception which is that all Quadriplegics experience no feeling below the break, hence no pain. This was for Don, sadly not true. Don endured internal organ pain which he described as feeling as if it was burning hot to ice cold as mentioned in a previous chapter. He was hypersensitive to this pain. So for any understanding of what happened to Don, I will take a short space here and try to convey the normal life of most quadriplegics. Then there will be a better understanding of how ill and debilitated Don had become, before arriving at RNSH on April the 11th 2007.
Don became a Quadriplegic in 1982, aged thirty two, as the result of a work accident. The correct term for his Quadriplegia is C5/C6 complete. His Spinal cord was completely severed between the 5th and 6th cervical or neck vertebrae. At the time of this accident, he was a healthy, active man, and this helped him survive the initial trauma. All Quadriplegics suffer differently, depending on the level and site of the injury occurs; the severity of the spinal cord damage and a myriad of other things which affect the quality of life and also on the speed and quality of medical treatment and rehabilitation. For Don it meant complete paralysis below the break with some weakened and unpredictable arm movement, but no hand movement or feeling.
Don explained his almost total lack of balance. He said, "I feel as if my head and shoulders are balancing on a large blob of jelly.” It was often a struggle to hold his position, something it took people and even doctors and nurses time to fully comprehend. If, when you were dressing Don you let him lean in the chair to get his shirt on, for example he would keep falling forward and onto the floor. He had to be supported from the front or side or back depending on what the action was. Don had some small arm ability when he sat up in the wheelchair, and learned how to make the best use of what he had with a few aids. But once lying flat in bed he was helpless and his arms were almost useless. I always worried when others were looking after him when he was in hospital.
For Don his Quadriplegia meant that he was permanently catheterised which caused many problems such as an almost constant state of Urinary tract infection which we only treated when Don felt ill. You couldn’t treat infections every time as the antibiotics would become useless against the many infections. He had a suprapubic catheter, and a bladder the size of a walnut which did not stretch any more. This caused major problems, and many Quads develop Bladder cancer. Don was being yearly monitored for this.
Don had severe osteoporosis due to no weight being exerted through his bones. His hips were the worst but hip replacements were impossible because there was no good bone to drill into to stabilise the joint. So Don sat for years bone to bone in hip joints and that pain was unbelievable. He certainly could feel pain, despite his quadriplegia. It used to horrify me to imagine him being turned over in bed by anyone who didn’t understand the fragility. I would always turn him so that there was a pillow between his knees hoping that this time the hip joint or a long bone didn’t snap or shear away. Too often nurses would be quite rough with him and responded to our admonishments as though we were being fussy. Some treated his serious problems too casually, like playing Russian Roulette with someone else’s body. His pain was managed but never totally alleviated with Physeptone (methadone) which enabled him to get out of bed at least but never really covered the pain. The bones in his feet were as fragile as like eggshells, and the fifth, sixth and seventh cervical vertebrae were fused together into one block, not separate bones. Cervical three and four were badly degenerated. He had constant pain in his shoulders and arms and head.
He had neuropathic or nerve pain which was present constantly for many years and I would sometimes hear him softly gasping when it got too bad. Poor Don.
I will mention this in more detail later when it's relevant but what most people don’t understand about Quadriplegics is that many Quads are hypersensitive to internal organ and tissue pain, but may not feel surface pain. For example, many times Don had blisters on his hand from resting it on things he was unaware were hot but yet often he would say that his kidneys felt like they were on fire..
Circulation was not good so we were careful not to let any infection take hold anywhere but mostly on hands and feet. Don lost all his teeth in the last two years of his life, caused by medication. Because of this, Don had a constantly dry mouth, which causes tooth decay. He had a Colostomy because of bowel problems caused by Quadriplegia. Most Quads have no peristalsis [the waves of involuntary muscle contractions that transport food, waste matter, or other contents through a tube-shaped organ such as the intestine] in the bowel. Without this bowel problems are common and uncomfortable. He was often in pain from this.
All Quadriplegics and Paraplegics have to be extremely careful not to sit up in the wheelchair if there is even a slight blemish on the bottom, because by the end of the day, after sitting on this, it can develop into a pressure area and become a pressure sore. These pressure sores can take months to heal and entail time spent in bed lying on the side to heal. Don never had a broken area on his skin in all the years at home but spent many weeks and at one time six months bedridden because of skin trauma. We figured, prevention is better than cure. The time spent like this was worth it for all the good time sitting up and able to get on with life, it bought Don. Also, when sitting, no folds of clothing could be allowed to dig into the skin, so extreme care had to be taken in dressing.
In common with all Quadriplegics, Don had a poor temperature control mechanism. This is to do with where the injury is and what body systems get damaged or knocked out. Once he got too cold he would shiver like a motor for hours loaded up with blankets till we could get his temperature back to somewhere near normal. It was the same with heat, he would get hotter and hotter unable to regain control. Don suffered extremes of blood pressure. Sometimes his pressure would be so low he would just become unconscious right before my eyes. I’d grab his legs and hold them up, while lowering the head of the wheelchair so his feet were higher. He came close to death on many occasions like this.
Then he would swing from extremely low to dangerously high blood pressure – all within minutes at times. This condition which Don had almost daily since 1994 was called Autonomic Dysreflexia. Don and I managed this daily and many is the day we thought he would not survive but he did. Most Quads don’t get it this often and some never have it at all.
A more detailed explanation of this unusual condition may be necessary here. Autonomic Dysreflexia (AD) is a complicated condition and only happens to Quadriplegics. Most have it rarely, some more often. Don unfortunately was plagued by daily bouts of this life threatening condition. The technical explanation is a bit too complicated so I’ll try and explain it in layman’s terms. Most Quads have a very low Blood pressure [BP] when lying down 90/60 or slightly lower and even lower than this when seated.
Because of the damage done to the spine, if there is pain from a blocked catheter, an ingrown toenail, bowel compaction, any pain whatsoever, the Blood Pressure will shoot up dramatically and within ten minutes or so can reach dangerously high levels. For a Quad 140/80 is a dangerously high BP and if symptoms [pain or pressure] are not relieved immediately a stroke, seizures or a cardiac arrhythmia is likely to occur.
It is considered a medical emergency and should be treated as such. In Don’s case there were many causes of pain and these could not really be relieved. We would check to see that nothing was wrong but then it was a matter of piercing a capsule of Adalat and getting it under his tongue. All other methods were too slow for us and we imported our medication from the US, because it was difficult to get in Australia once Federal Health Minister Michael Wooldridge took it off the Pharmaceutical benefits Scheme [PBS]. That capsule and Don’s and my quick action saved Don’s life every single day, for the last thirteen years of his Quadriplegia. We carried an emergency card in case Don was hospitalised. When he was in other’s care we both worried because the lack of understanding in the general medical community of this condition is breathtaking. Too many assumed that Don was being fussy or hysterical, and they thought that if he calmed down his BP would decrease. Often they were too slow to administer the Adalat, again endangering Don’s life.
He had very limited breathing, something I call Quad breathing for want of a simpler term. Quadriplegics breathe in a totally different way. Don’s laboured breathing was always much worse whilst sitting up because of his breathing mechanism. If there is fluid on the lungs, most of us can breathe more easily, by sitting up, but for Don it was the opposite. This is important to understand and it will be realised later on why. Any spinal specialist knows that the breathing mechanism of a C5/C6 Quad is different to the breathing most people experience. Quads breathe using the diaphragm. They have much less respiratory reserves than the rest of us. Because of this, they also have ineffectual coughing and vomiting. The dangers this presents are that any cold or infection can quickly become life threatening because of the inability to cough up phlegm or mucus from infection. The same goes for vomiting, where ineffectual vomiting can lead to vomit entering lungs, as it can too easily be inspired into the lungs because it is unable to be expelled as effectively as it is for the rest of us. Don had been unable to fully expand his lungs since 1982 and his breathing was always shallow.
All of the above, Don had to deal with daily. But life was so good and we lived in the moment, laughing often and getting out and about when it was possible. Don was such a man. He was so brave and solid. With all the above to deal with he was the first to help others who were ill or in trouble.
Hopefully the above explanation of just some of his complex medical conditions will allow understanding that such a person should have been treated very carefully by Cardiothoracic Specialists in RNSH, not the exact opposite as was the case."
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