GET READY TO UNLOAD

Now that I escape, sleepwalker awake 
 Those who could relate know the world ain’t cake 
 Jail bars ain’t golden gates 
 Those who fake, they break, 
 When they meet their 400 pound mate 
 If I could rule the world 
 Everyone would have a gun in the ghetto of course 
 When giddyupin’ on their horse 
 I Kick a rhyme drinkin’ moonshine 
 I pour a sip on the concrete, for the deceased 
 But no don’t weep, Wyclef’s in a state of sleep 
 Thinkin’ ‘bout the robbery that I did last week. 
 Money in the bag, banker looked like a drag 
 I want to play with pelicans from here to Baghdad 
 Gun blast, think fast, I think I’m hit 
 My girl pinched my hips to see if I still exist. 
 I think not, I’ll send a letter to my friends, 
 A born again hooligan only to be king again.

Recently in this blog, I’ve started out with some song lyrics that may or may not reflect what is in the actual blog posting. Most of my life, I walk around with a soundtrack in my head, I found it to be mentally balancing and get me through the day. Sometimes the songs are just jingles, sometimes a little more complex.

These songs get me through good days and bad days, sometimes something simple such as “here comes Nyal, he’s one tough customer” which I stole from Randall in Clerks, sometimes it will be the entire discography of Minor Threat or the entire album of the Clash, Sandinista. I think it helps me when I write at work and helps to increase my vocabulary beyond acronyms, jargon and hackneyed business conversation. I wonder sometimes if other people do this, and want to go up to them and say “what’s the last song you were thinking of”.

This will be one of the last two or three blogs that is written in the past tense, after this very therapeutic blast in the first week of posting, I will likely slow down to maybe once a week. The change in my physical abilities has become somewhat incremental, I mean it’s getting better, but I’m not sure enough to write about. But we’ll see because I don’t return to work part time until November 14 so this is a good cognitive exercise as well as being inspirational to me to tell a story that hopefully others will be able to use as a foundation for recovery or to help others recover.

108 in framingham

This entry concerns the days leading up to my discharge from rehab. I will cover the exit itself in another blog. When we lived in Framingham for a time in an awesome but somewhat messy and crazy house we had a street sign that Tim mor someone had acquired that said “ready to unload” in our downstairs bathroom. For some reason as I was getting ready to leave, perhaps because of my continuing difficulty using the restroom without assistance, I kept thinking about the sign and just really how ridiculous it was.(As is much of my life in general) Along with music flashbacks the funny things in the past constantly flow through my head, I have to also say I tend to also relive all the fuck ups that I’ve had in my life as well and unfortunately regret them and wish I could’ve done better. Getting to Spaulding was a huge victory, just starting that is,the prospect of leaving Spaulding was even better.

There’s no place like home, particularly for me, I don’t really enjoy vacations that I have to travel to. We’ve designed our home to fit pretty much all of our daily needs, why the hell would I want to go anywhere else. So I was anxious to get there despite my continuing lack of mobility and how easy physically it was actually to be in Spaulding. People bring you food, whisk you off to appointments, in general your life is managed either by your family or the staff there.

In preparation to leave, there are many things that had to be done. That being said, I never was really officially told what my release day was. The general aspect of rehab is that your insurance really controls the length of your stay. I was pretty happy to have really good insurance, that didn’t seem to be an issue. My speech pathologist leaked to me one day that my release date was October 4. I don’t remember really officially hearing that from anyone in any specific declaration but it became to be known to myself, my family and all the staff. As I got to my last week, I actually started get a little nervous, how would I be climbing the stairs, getting around the kids’ toys, getting around the kids, using the two bathrooms and avoiding my cats below on the floor. This anxiety was of course tempered with the excitement of going home.

a different graduation

To get ready, they essentially would “graduate” me from physical and occupational therapy. I mentioned the earlier the exercises of the community outing and cooking in the kitchen, they also started to make sure I could transfer from toilet up and down and get into the shower safely with a shower chair using grab bars. My wife dutifully bought all the necessary home equipment. This is an important part of your recovery. A week or so before you return home, have a detailed conversation with your therapist (they probably will initiate it anyway) about how your house is set up, if necessary have someone take pictures of everywhere there is a possible physical transition such as stairs and other potential obstacles. You may need to have a friend or contractor help with grab bars in the shower and a railing like we did. We were lucky to have our friend Nick take care of all these issues, you will also probably want to have someone help clean the house. Many of my chores at home included cleaning and organizing, unfortunately those that love you will have to step up for a while. More on that in the next entry. At this point I was fairly strong other people are gonna be in different places and some of you will move on to skilled nursing before heading home.

work

At this point I’m pretty anxious to get back to work, for many of you you’ll have to fill out yet another form along with your FMLA forms called a fitness to work. Most of my work is knowledge work, it involves intellectual stamina, communication, data analysis and sometimes dealing with difficult people. As part of my exit I was in a neuropsych exam. This exam helps to quantify your cognitive readiness to return to life and work. There are no Rorschach tests or laying on a couch talking about your mother. It’s more about how your brain is working around memory and other cognition. It’s very similar to what you are working on in speech pathology. In fact, some of the exercises are identical and some you may have memorized. It’s a long exam, it can take up to three hours or more with a psychologist asking you a series of questions. Initially there are some questions about your attitude and general psychological well-being. They’ll ask you questions about yourself that are quite personal, around drug use, family life and things of those nature but at this point you’re likely to haveput that shit out there to everyone and you’re pretty comfortable talking about it even if you’re somewhat private person. I don’t want to call the test grueling but there was a certain amount of stamina needed to complete the tests and in fact that is part of the test,; can you keep thinking, remembering and completing all the exercises. Some are very difficult and inmy case and probably many of yours they see what level you’re on. If you dropped out of elementary school and got no further education the test will be structured somewhat differently than those with advanced degrees. I did pretty well on these tests and got to the point that I was joking around the psychologist and one of the stories identified State Street as being in South Boston, I said the test was actually wrong, he laughed and indicated just go with the story and memorizing it. I told him, well it goes beyond my best instincts but I’ll do it just so I can pass this test. After the test was over he indicated to me that I did well but that a much longer report would be developed and he later came back and went over the results. This part is important if you plan to return to work in a fairly rapid manner. You don’t have to release all the results, for example there is no reason for HR to know how much I smoked pot as a teenager and young man, but there is an executive summary that is very helpful

I was pretty excited to leave despite my anxiety of being safe when I returned home which I will cover in the next entry. They also take time to review your meds. I was taking no medication at all before my stroke although I probably should have but that’s another story. Getting used to taking these medications and my old own blood pressure twice a day would take some effort. During your entire stay, the nurses drill you on their medications, some of them are very difficult to pronounce but you get the point that you got them down, those in the morning and those at night. For the rest of my life I will probably take high blood pressure medication and anti-cholesterol medication even though my cholesterol was not even that high.

Some of the stuff they do may seem ludicrous and very obvious but there are specific protocols they do to prepare you whether you are Goofus or Gallant. How to separate your pills and put them in the pillbox, they will go over every movement that you do to do your daily activities, ask you if you feel physically safe at home, i.e. will Becky beat me and remind you to stay hydrated and back to their favorite functions, urinating and bowel movements. There were remind you that if you do something like pee blood our fall down the stairs it is probably a good idea to call your primary care physician. Most importantly though and very seriously they will help you to schedule all your next appointments for the next few weeks or even months. As much as I joke around some of the sometimes childlike treatment, I really did understand and appreciate it.

At Spaulding on Monday afternoons all the therapists meet with the doctor who is treating you. They discuss your progress or lack thereof and determine what they are leaving, once again I wasn’t really privy to those meetings in my case manager didn’t really communicate the results very well albeit she was a very nice lady. It is important for you are whoever is managing your care for your family to always show the initiative of asking lots of questions. I’m a strong believer that in fact there are stupid questions, I hear the most of my working day, but here, it’s better to be safe than sorry and they really don’t mind.

Getting ready to leave felt like the same anxiety I felt when I was laying on Clubba’s couch on the morning of my wedding. It was the irrational anxiety that you get even when you know everything is going to be just fine and it will be. This preparation to go home is as essential as going home itself.

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