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
Monday, November 30, 2015
Sunday, November 29, 2015
Thursday, November 26, 2015
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.
Wednesday, November 25, 2015
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.
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.
Saturday, November 14, 2015
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.
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.
Saturday, November 7, 2015
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.)
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.)
Friday, October 30, 2015
Journal Entries----Elementary, My Dear
Evidently mandated: Journal Entry Assignment: Things I Never Knew Until Now
Sept. 22, 1980---Today I was warned not to get my white pants dirty, but someone in this class pushed me, namely S.
Sept. 25, 1980--Today I signed up for trumpet.
Sept. 26, 1980--Today was boring. Nothing really happened,except that I played kickball.
Sept. 29, 1980--Nothing happened today so I'm going to write about Saturday and Sunday. I went to the Red Coach that made me sick. Oh! Today I was goalie.
Sept. 30, 1980--Today I woke up at 7:00 a.m. and watched "Dr. Who." Besides that nothing really happened.
Wed., Oct. 1, 1980--Well, today I decided to go grasshopper hunting for Mr. Scerbo, but played soccer after I found out you had to squish their heads. But I played a good game of soccer. I was goalie, they scored one and we scored two.
Thurs. Oct.2, 1980--I really don't believe it. Tomorrow is my birthday. Well, gotta go.
Fri. Oct.3, 1980--Today at 5:00 a.m. I WAS ten. Out on the playground I played soccer and I got massacred. Not in soccer, though. Anthony saw my journal and man did I get it.
Mon. Oct.6, 1980--Today, nothing happened, so I'm writing about Saturday and Sunday. I got a lot of presents. One of them is Empire Strikes Back figures. And a bike, a digital radio, shirts, and a huge silver coin collection.
Tues., Oct.7, 1980--Well, nothing really happened. Oh, I forgot today we had silent lunch, but I didn't really care. I sort of liked it.
Wed. Oct. 8, 1980--Today was boring. Nothing really happened except Mr. Jones came in and said, "There is to be no talking for fifteen minutes."
Thurs, Oct.9, 1980--Today nothing really happened.
Fri., Oct.10, 1980--Today I found out that there will be no contact activities. I don't know about soccer, But I hate Mr. Jones's rule anyway.
Wed. Oct. 16, 1980--Today in lunch Mr. Jones came in and said that there will be no talking until five of. And made Michele B. stay in his office for a week. But it was a serious crime, coming back from the lunchline.
Oct. 20, 1980--Today nothing really only that we fought out on the playground. Oh, today I'm going to run a mile. You see I've been running a half mile, now I'm going a mile.
Thur., Oct. 23, 1980----Today in lunch (well., I'll just use a couple of names) someone crumpled a "Scooter Pie" and passed it down and somewhere along the line it was thrown. It was thrown about 15 minutes until as I hear Greg threw it on my food, and I was so mad I threw it on the table as hard as I could. Oh, and before that Sheeran threw the Scooter Pie away. But Gary took one of his and threw his. After that Mrs. Simpson came over and made me stand up on stage after the whole class was throwing it. Most everyone stuck up for me but it didn't help.
Thurs. Oct. 27, 1980--Today nothing happened except we had silent lunch.
Wed. Oct. 29, 1980--Today was a normal day nothing very exciting happened just the same old thing.
Fri. Oct. 31, 1980--Today is Halloween and I'm going to be an electronic game, and out on the playground Scott and Gordon were fighting with their fists. I wasn't.
11/3/80--Today there was a "big" fight scheduled with Gordon and Strope but Gordon didn't come out.
11/5/80--Today was a normal day except I missed the bus and my father drove me to school. Oh, I almost forgot yesterday was the election and Reagan won but I wished Carter was elected for president.
11/7/80--Today while we were fooling around I saw Gordon smoking and Greg told.
11/10/80--Today, man it was cold. I was just wearing a jacket and my hands were freezing about ready to fall off. In lunch the mustard was spilled all over the table.
11/2/80--Today was normal. Dickie got whopped in the head by Mike.
11/17/80--Today was normal. Nothing really happened, just that we were supposed to have silent lunch but we didn't.
11/20/80--Today Mr. Scerbo took us out in the snow. We made snowballs about 100 pounds. I got soaking wet because of the snow. I kept on sliding into the little snowballs so they wouldn't be competing with ours.
11/12/80---Today was normal only that we went out in the snow.
12/1/80--A lot of things happened during Thanksgiving vacation. I had a wonderful time. I just don't know where to start.
12/2/80--Today we played smear the ***. Nothing else really happened. You could say it was a normal one. Oh, today Mr. Estramonte was in.
12/3/80--Today I got another point in SS, so that means I'm tied with Mark S. And also two work periods. Oh, today we didn't have recess. We had a work period.
12/4/80---Thank God it's Friday. This week was really long. Lots of homework and a cold. But today wasn't that bad. I played checkers and Bermuda Triangle.
Mon. 12/8/80--Today we didn't go out but we had a play period. It wasn't much fun but it was a time to play.
Tues.12/9/80--Today we went out and Anthony and Mark got hurt.
1/13/81--This is my first entry in 1981. Can you believe we haven't written in over a month. We didn't write about Christmas or even New Year's.
1/16/81--Today nothing much really happened, just that it's 1981. Now I gotta go.
1/29/81--Today we saw a movie on TV in school.
I think it was called the Great Train Robbery. It was by Walt Disney.
3/6/81--Today we went outside. It was
3/31/81--Yesterday President Reagan was shot. The man who shot him was John Warnock Hinckley. He also shot 8 other persons. One was James Brady, the Press Secretary, a D.C. officer and a Secret Service man. Luckily a rib stopped a bullet that saved President Reagan.
4/1/81--This is a new month besides that it was usual.
4/3/81--Today was o.k. except we went out.
4/9/81--Today we went out. Man, were kids hurt. I think Sheeren broke his nose and I got my thumb jammed.
5/5/81--Today I got about 30 sec. of play because I had to do homework.
6/12/81--This is the last day before there's only 1 week left.
Sept. 22, 1980---Today I was warned not to get my white pants dirty, but someone in this class pushed me, namely S.
Sept. 25, 1980--Today I signed up for trumpet.
Sept. 26, 1980--Today was boring. Nothing really happened,except that I played kickball.
Sept. 29, 1980--Nothing happened today so I'm going to write about Saturday and Sunday. I went to the Red Coach that made me sick. Oh! Today I was goalie.
Sept. 30, 1980--Today I woke up at 7:00 a.m. and watched "Dr. Who." Besides that nothing really happened.
Wed., Oct. 1, 1980--Well, today I decided to go grasshopper hunting for Mr. Scerbo, but played soccer after I found out you had to squish their heads. But I played a good game of soccer. I was goalie, they scored one and we scored two.
Thurs. Oct.2, 1980--I really don't believe it. Tomorrow is my birthday. Well, gotta go.
Fri. Oct.3, 1980--Today at 5:00 a.m. I WAS ten. Out on the playground I played soccer and I got massacred. Not in soccer, though. Anthony saw my journal and man did I get it.
Mon. Oct.6, 1980--Today, nothing happened, so I'm writing about Saturday and Sunday. I got a lot of presents. One of them is Empire Strikes Back figures. And a bike, a digital radio, shirts, and a huge silver coin collection.
Tues., Oct.7, 1980--Well, nothing really happened. Oh, I forgot today we had silent lunch, but I didn't really care. I sort of liked it.
Wed. Oct. 8, 1980--Today was boring. Nothing really happened except Mr. Jones came in and said, "There is to be no talking for fifteen minutes."
Thurs, Oct.9, 1980--Today nothing really happened.
Fri., Oct.10, 1980--Today I found out that there will be no contact activities. I don't know about soccer, But I hate Mr. Jones's rule anyway.
Wed. Oct. 16, 1980--Today in lunch Mr. Jones came in and said that there will be no talking until five of. And made Michele B. stay in his office for a week. But it was a serious crime, coming back from the lunchline.
Oct. 20, 1980--Today nothing really only that we fought out on the playground. Oh, today I'm going to run a mile. You see I've been running a half mile, now I'm going a mile.
Thur., Oct. 23, 1980----Today in lunch (well., I'll just use a couple of names) someone crumpled a "Scooter Pie" and passed it down and somewhere along the line it was thrown. It was thrown about 15 minutes until as I hear Greg threw it on my food, and I was so mad I threw it on the table as hard as I could. Oh, and before that Sheeran threw the Scooter Pie away. But Gary took one of his and threw his. After that Mrs. Simpson came over and made me stand up on stage after the whole class was throwing it. Most everyone stuck up for me but it didn't help.
Thurs. Oct. 27, 1980--Today nothing happened except we had silent lunch.
Wed. Oct. 29, 1980--Today was a normal day nothing very exciting happened just the same old thing.
Fri. Oct. 31, 1980--Today is Halloween and I'm going to be an electronic game, and out on the playground Scott and Gordon were fighting with their fists. I wasn't.
11/3/80--Today there was a "big" fight scheduled with Gordon and Strope but Gordon didn't come out.
11/5/80--Today was a normal day except I missed the bus and my father drove me to school. Oh, I almost forgot yesterday was the election and Reagan won but I wished Carter was elected for president.
11/7/80--Today while we were fooling around I saw Gordon smoking and Greg told.
11/10/80--Today, man it was cold. I was just wearing a jacket and my hands were freezing about ready to fall off. In lunch the mustard was spilled all over the table.
11/2/80--Today was normal. Dickie got whopped in the head by Mike.
11/17/80--Today was normal. Nothing really happened, just that we were supposed to have silent lunch but we didn't.
11/20/80--Today Mr. Scerbo took us out in the snow. We made snowballs about 100 pounds. I got soaking wet because of the snow. I kept on sliding into the little snowballs so they wouldn't be competing with ours.
11/12/80---Today was normal only that we went out in the snow.
12/1/80--A lot of things happened during Thanksgiving vacation. I had a wonderful time. I just don't know where to start.
12/2/80--Today we played smear the ***. Nothing else really happened. You could say it was a normal one. Oh, today Mr. Estramonte was in.
12/3/80--Today I got another point in SS, so that means I'm tied with Mark S. And also two work periods. Oh, today we didn't have recess. We had a work period.
12/4/80---Thank God it's Friday. This week was really long. Lots of homework and a cold. But today wasn't that bad. I played checkers and Bermuda Triangle.
Mon. 12/8/80--Today we didn't go out but we had a play period. It wasn't much fun but it was a time to play.
Tues.12/9/80--Today we went out and Anthony and Mark got hurt.
1/13/81--This is my first entry in 1981. Can you believe we haven't written in over a month. We didn't write about Christmas or even New Year's.
1/16/81--Today nothing much really happened, just that it's 1981. Now I gotta go.
1/29/81--Today we saw a movie on TV in school.
I think it was called the Great Train Robbery. It was by Walt Disney.
3/6/81--Today we went outside. It was
3/31/81--Yesterday President Reagan was shot. The man who shot him was John Warnock Hinckley. He also shot 8 other persons. One was James Brady, the Press Secretary, a D.C. officer and a Secret Service man. Luckily a rib stopped a bullet that saved President Reagan.
4/1/81--This is a new month besides that it was usual.
4/3/81--Today was o.k. except we went out.
4/9/81--Today we went out. Man, were kids hurt. I think Sheeren broke his nose and I got my thumb jammed.
5/5/81--Today I got about 30 sec. of play because I had to do homework.
6/12/81--This is the last day before there's only 1 week left.
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