Donna, this is not uncommon. I have hear a similar story from others in the nursing home Ray was in. A stroke, some kind of fall, a series of TIAs can all lead to a persistent weakness that seems not to go away. On the other hand some do recover and go home so I hope Lauren is one of those few.

Keep emphasising to him that it is "move it or lose it" that he needs to increase exercise and movemnt and get stronger so he can go home. I am heart sick when I think of how my Ray lost so much movment with the 2011 stroke that he never returned home. I hope it is not so for Lauren. Keep courage, get your support group praying and you will both come through this.

Sue.

Boy do I still remember those transfer days to/from a WC to the commode, bed, shower, car seat and back again!

I came home from the hospital unable to walk and my wife had to attend mandatory classes in my rehab room before she was allowed to take me home with her first transfer out front at the hospital from the WC to the car seat!

They even gave her the transfer board to insure she had one and that belt they put around the waist to hold on to while on your feet! I think I weighed about 205 at that time too and she was about 130 at most!!

I don't know a lot about this, but I am wondering what people who have not had a stroke do in this same situation. I mean, he can't expect to move around normally and do therapy if a person without a UTI and without a fracture do not do it. Have you did research on the internet to find out what the normal course for the average person is with this same problem. Well, the UTI is not going to be part of the research, as your reg people won't have it..... hey, maybe that's why he got it, he was 'off' from the UTI and so it caused him to not be as balanced. Stroke people with just the UTI are thrown for a loop, and he has a fracture on top of it. I don't know... I'm just not convinced that if a regular person had these problems, they'd be forced into rehab, or be taking another route. Again, I know nothing, just trying to wonder what a non-stroke person's path would be in this same situation, and not expecting a stroke person to accomplish more than they would.

Sandy, compression fractures are different from other types of fractures. The bone is not broken. Two of his vertebra in his spine are compressed together and it causes the material between the two bones to bulge out. It causes pain for anyone but the key to anyone's recovery is to continue movement while it heals. Sometimes the back needs to be supported and they would definitely not want heavy lifting during recovery for anyone. That's not an issue for Lauren. He just needs to continue to bend forward and stand.

You are certainly right that these kind of things in stroke survivors adds an extra level of difficulty. Most people without a stroke or other disability would not likely require rehab to recover but they might need outpatient PT. The goal of rehab for Lauren is to keep that back limber enough to enable him to stand and transfer. If he stops using it for 3 months he will likely not be able to get out of bed on his own power again. I don't think they are expecting more of Lauren than they should. I think everyone is fighting hard to keep him active enough to maintain an adequate level of movement so he won't lose any more ground than is necessary. The most negative impact of the stroke in all this for Lauren is his inability to power through discomfort. He lives very much in the moment and, if it hurts now, he can't look down the road and see that the gain is worth the pain. He wants to go home but can't make himself do the things that will get him there. Discouraging--but it is what it is.

Donna,

Some of us can't think anymore in linear terms. I understand the concepts of linear time and effort/reward continuum, but for the life of me, since stroke I have to fight myself to apply those concepts. I can absolutely tell you that tomorrow, next week or next year will come and that what I do today will impact what the future is like but in my mind when I'm happy, I really can't fully understand that I won't always be happy or what not being happy feels like. If I'm sad, I can't remember ever feeling good or that I will ever feel good again. It drives me nuts but literally all that exists in my emotions and motivation is right here, right now.

Keep in mind that Lauren may not be hiding from discomfort. He may be handling all he can and any new thing is the straw that breaks the camel's back. Add that to the linear issues and he's probably having difficulty finding it worth it to push through the discomfort. He may need reminding why this is so important and it might (might!) help to start a little notebook documenting his recoveries no matter how small, and the things he did (but didnt want to or see the point in) to make those achievements.

You will both be in my prayers.

Donna: I took a long time to review your blog and the responses. I do get a good number of compression fractures in Sub-Acute Rehab for short term recovery-PT, OT; especially if there was infection involved or strengthening is needed for safety at home. But as to Lauren, boy, this is a tough one.

I was considering how you could take him home with help, but if it takes two to transfer him safely, this is not an option at this point, even if you had aggressive in-home therapist. You could possibly hoyer lift him - I did it with Bruce for about a month, but he was working so hard at transferring and I had private duty CNAs seven days a week, well trained, to help me get him out of that hoyer soonest. Even some of my PTs from work came to help out.

But a compression fracture on top of stroke - just trying to think about how that would work. At best you are probably looking at a good two months for that to resolve enough that he can stand the pain. Bruce has severe spinal stenosis and moving for him is very painful. There are corsets and he should be fitted for one. It will give him support.

One thing I would look into is to keeping him in the Sub-Acute Rehab so he gets the therapy. Maybe you will have to challenge the discharge from the Insurance company, but you need his therapists all on board.

As to Lauren. I loved Jaime's advice. Gave me so much insight into what may be happening to Bruce. Donna, it may take a few weeks in the SNF to make him realize that he must be proactive. But if what Jaime advises may be the issue, he will not go forward, no matter how much therapy he receives because he will not remember or consider the fact that he wants to go home the next day. That is why he needs daily pushing and reminders as to what he is working for. Donna, I still give Bruce the same cues 3+ years in, reason being he is comfortable with routine and responds better. He is just more comfortable with the routine because he now knows what the proper response is. So that is not necessarily non-progress. You may have to consider a personal trainer if the SNF allows it, or pay them for PT and OT. What I do know, is that you probably can not bring him home safely - for you and for him - unless you are willing the hire private duty help - every day and consider a lift.

Let me think some more on this and maybe check with the pros at work. Will let you know. In the meantime, I am so sorry. I can't imagine what you must be going through, emotionally. I have no doubt you will make the best decision for you and your family, but I know you do not feel that way. Lauren is yours and you want to make the best decisions for him. You have a responsibility to him and your family. That I understand, but it is not ever black and white - even tho we sure would like it to be. Seems like we are always compromising and then second guessing ourselves. Just please try to sort things out, try to remove emotion as best you can and you can always make changes. Go easy honey, best you can and know I am thinking and praying for all of you. Debbie

I don't know... maybe this is one of those times that you don't try to read into the future and just try to deal with the present and the day at hand. It is so hard for us to know where something might leave us, and it may just be too soon to try to guess it. I would try to live for today, and not second guess what it means in the future, because that will become more clear as time develops. I think we've all been there, when our loved one had a stroke and we looked at the and wondering, 'oh my God, how will he come out of this'. But in the end, it was doing one day at a time, and waiting to see where the chips fell, that saved my sanity. Focus on the immediate, and know we are praying for you both.