20241030 - Hot water....

When I had my stroke early in 2019 I was in the hospital's ICU for a little over a month. I don't remember if they gave me a bath in the ICU. It didn't matter to me anyway as I was unconscious there mostly and hallucinating all the time. 

Later they shifted me to their HDU ward (high dependency unit). It was at the end of a long corridor of atleast another 20-24 wards/ rooms. 

That made it miserable! 

Why you say?

They have very skeletal staff for the night shift (nurses, attenders, doctors, everything). It is the duty/ responsibility of the night shift staff to give a bath to the patients and handover to the day staff. 

Usually 1 nurse + 1 attender (ward boy) had the responsibility of giving bath to all the patients of one side of the long corridor. 

They did a quick namesake job (ಕಾಟಾಚಾರ ಕೆಲಸ). Even then, it would take 15-20 minutes per patient - disrobe, bath, enrobe, teeth cleaning, etc). 

They had to finish this for all the patients before 7:30AM (which was when they had to handover). So, if you conservatively assume 15 min and 10 patients, that's 2½ hr  - meaning they had to start at ~ 5:00AM atleast. Here they typically started at 4:30AM.

Apart from being generally pissed off with this approach towards patients in general (imagine waking up a patient in a hospital and insisting on giving a bath that early!), I was also particularly pissed off because I was at the far end of the long corridor and so the first one to get this mistreatment (abuse if you ask me!)

Don't imagine a bathroom for bath for bedridden patients... It is "sponge bath" (I have not seen a single sponge all the 5½ months I stayed in the hospital).

Sponge bath means wiping the patient with wet wipes - yes, the alcohol treated wet wipes which are cool on the skin because of the quick evaporation property of alcohols.

Before wiping the body, they would dip the wipes in wide steel basin of water (which they got from the bathroom)

It used to be a miserable routine every morning! I was pretty much unable to commute this misery as I was a vegetable for a while but once I was able to somehow convey my misery , I think I used to let my displeasure known through a combination of expression, left hand actions, etc. i think on 1-2 occasions i have made my night family attender tell them it is too early and too cold and the water they used was not hot enough etc. 

Anyway, after I got home and the nurses at home started giving me a proper "spong bath" using a bucket full of hot water, and towels/ cloth and soap. (still no Sponge though🙂)

The nurses would bring a bucket full of  water , having been heated by 2.5 kW geyser for an hour. It used to be scalding hot visibly with intense steam rising from it. The nurses sometimes wore 2 layers of rubber gloves as the water was way too hot and they would dip a towel, wring it and very gingerly touch it against my skin and ask if was bearable.

Nada! Nothing! It used to feel like plain room temperature water to me..

That's when I realised what the problem was...

The thermometer in my brain was broken! 

I just couldn't feel heat against my skin. 

The water in the hospital basin presumably was hot as well!

I'd like to make a distinction between the body feeling the heat, the brain feeling the heat and finally the mind perceiving the heat. 

After my stroke, in March - April that year everyone around me was always complaining how hot the summer was. My body was feeling that heat as well. I would have beads of sweat on my arms, i would feel it trickle down my armpit etc. so visibly, I knew it was hot. But my brain (the thermometer) was broken! Hence my mind was not able to perceive the sensation at all. I don't feel hot for years even in peak hot summers.

The reverse had happened with cold things. Everything cold was super amplified. Eg., in the early days in the hospital, they would plonk me on a wheelchair to move me around. They would keep my legs on the wheelchair foot support. This support was metal and felt like keeping my feet on a slab of ice. Since I couldn't move or convey to anyone else, I could just sit and hope it gets over soon (or sometimes they would keep a pillow underneath the feet). There are many such examples but I will leave it at that.

This temperature imbalance has started at the extreme ends and very very slowly inching to the centre over the past 5+ years. 

It is not a visible improvement like hand or feet movement but even harder for the brain to do I am sure. 

Imagine having our built-in thermometer broken overnight, having to build a new one and then calibrate it to the proper scale all by itself. 

Atleast for visible things, there is physiotherapy, occupational therapy, speech therapy, swallow therapy, etc. etc . 

There is absolutely no therapy for such things. Just have to allow time and trust the brain that it knows what it is doing. 

So. Why am I sharing this long story from a long time ago? 

Because, today evening, during my "sponge bath", after almost 6 years, I had to tell my nurse to mix some cold water because the water was a little too hot! 

So, in case you are a stroke survivor and not seeing visible changes, don't worry, you are just not seeing changes on top of the iceberg but you brain is doing a lot more work underneath the surface. Give it time...

And if you are not a stroke survivor - you don't have a broken brain. It can do miracles for you. Invest it wisely and don't squander it on petty things...