Stroke Scale

NIH Stroke Scale Response Value
Level of Consciousness----Alert?
LOC Questions-------------Answer 2
LOC Commands-----------Obey 2
Best Gaze--------------------Normal?
Visual------------------------Any visual loss?
Facial palsy------------------Normal?
Left Motor Arm Drift------Any drift?
Right Motor Arm Drift------Any?
Left Motor Leg Drift-------Any?
Right Motor Leg Drift------Any?
Limb Ataxia------------------------Absent?
Sensory----------------------Normal?
Best Language-------------Normal?
Dysarthria------------------Any Aphasia?
     (Motor Speech Disorder)
Extinction-/ Inattention-----------------
    If score is 0      no stroke
                    1-4    minor stroke
                    5-15  moderate stroke
                   15-20  moderate / severe stroke
                   21-42   severe stroke
    For score greater than 4, tPA is usually administered:  Tissue Plasminogen Activator

For Dorothy

"He shook it and it rang like silver.
  He shook it and it shined like gold."

Stealing Dream

    My sister and I were trying to take something from a house that we sneaked  into.  She needed some papers that were in there and I was helping her.  I drove her to the place near where she lived in the city.  It was daylight and the back porch was unlocked and nobody was home, so we went in and she was looking for a specific folder  she wanted to get. Everything around seemed to be white though not new:  the walls, the furniture, the entire back porch where she was searching. She seemed fairly calm but I was nervous, afraid of our getting caught. I had gone inside the main part of the house, left my pocketbook in there, retrieved it, and told her I thought we might get caught, as I had seen a  couple of neighbor ladies drive by  and they seemed to look in our direction.  My concerns were affecting her and we left, in my car, the same one I drive now.  The fear of being found out was so strong that every single thing seemed ominous.  When we stopped at a traffic light, I told her that it probably had a camera that snapped a picture of our license plate.  She thought so too and we tried to come up with a valid excuse as to why we might have been in that neighborhood. We could say we were going to her house, but it was not in line with her address.  We could say we were lost, but we were too close to her house.  We could say we were shopping , but the neighborhood was residential.  If we said we were just driving around, we would seem guilty. We drove away, nervous and afraid, of exactly the same mind, as if we were one person, totally united in our distress.

Ask the dog, Dammit.

   I read this week that an elderly, emaciated, tumor-afflicted dog  that had been abandoned in South Carolina has been transported all the way up here to receive medical treatment and surgery in hopes that the poor thing can eventually be adopted into the home of a loving family who will care for him in the time he has left.  The dog's age is estimated at 10 -13 years, and the surgery to remove and treat his tumor, and the procedures to treat his skeleton-like frame will be intensive and certain to provide only a brief increase in his life span at an enormous financial cost.
      One of the first questions hospital patients are asked, at least those patients of a certain age, is whether they have a DNR.  A valid option, it would seem, as long as it's not misinterpreted.
    But why should it be deemed acceptable that the elderly be questioned about end of life choices with the implication being that there is a right time to die when all-out efforts are made to save an ailing old dog .  The dog was abandoned, we read, so public outrage is directed at whoever allowed that to happen, and the cry is for someone to pay for this atrocity.   Maybe a hard-hearted owner cast the dog out after 10 years or so.  Or it could be that the dog, sick and unable to eat, went away to die: its own decision  that it had suffered enough and knew the time had come  to let go.
  Dogs, not being human, do not have access to a DNR.  It may be that they are smart enough to do the right thing without the need to consult an outside source.

Rescue Me

  But not without cost.  Just received our Health Statement which contains the use of the Hoosic Valley Rescue Squad conveyance on June 17.  They, the Provider, submitted 2 charges, one for $1,050 and the other $272, totaling $1, 322.  One trip but billing for separate services, evidently.  Medicare approved the entire amount, but paid only $401.29.  Our other insurance, BC/BS paid $102.37.  Since we had already met our Deductibles and Out-of-Pocket Maximum for the year, we paid 0.
    That expense has to be a real hardship for those without adequate insurance.  Some must refuse ambulance services if they know the cost. A few days after our emergency service, we received a call asking, on behalf of the Hoosic Valley Rescue Squad, if we were planning to sue the business where the incident had occurred.  I learned the call did not originate from the Squad, but from a central volunteer emergency services billing agency.  The caller seemed surprised when she heard we had no plans to file a lawsuit.  She said she'd bill our insurance then.
 

Not Really Naked, But Afraid

    I was in this place, and I needed to get something to eat, for myself and others, those who were with me, and depending on me to do so.  I went to all the different areas that were selling food, but no one paid any attention.  I tried to flag down the staff members, servers who were delivering food to others, but couldn't be heard.
  I tried to assess the situation, coming up with this theory:   "Maybe," I said to those who were waiting, "it's because I've got this comforter wrapped around me and I'm mistaken for a patient,"
   So I went to get something to wear.  I had a store of clothing, new and unworn.  I selected what looked like a dress, but it was a gown with a princess embellishment on the front.  I knew it was too youthful, so thought of giving it to a grandchild.  I looked at the tag and it was Size 14, so I knew that wouldn't work---I'd be gone before she got to that age.
    I pulled on one sweater, and then another.  They were too small.  I couldn't even comfortably fit my arm in the sleeve.
    I woke up hungry.
**The next night was different.  I was in much the same type of place, with many people around, and, for some now unknown reason, I changed the radio to another station.  After I found out, or failed to find out, what I needed to know, I left.  The man in charge switched the dial back, glowering as he did so.  Later Danny told me it was because he was listening to the latest sensation in broadcasting, Ed Cenci, the podiatrist with the white Afro.  I felt embarrassed: I hadn't known. (I later saw him boating with my daughter, but I remained out of view, beneath a stairwell.)