Interesting half way meeting with full MDT. They had been considering looking at early discharge as Monty is progressing physically and medically so well. However all the therapy disciplines (speech, physio and OT) described Monty as the model patient – consistency hitting his goals (frequently hitting them early) by working hard in sessions and with extra practice. They have therefore decided that he deserves the full time, so they have left his discharge date at 26th June. Monty is happy (ish) to stay until then (now he has his own room) as he knows he is making good progress.
This will also give the medical team time to complete their tests – currently looking like damage to arteries in neck potentially caused by radiation – but more tests being arranged to confirm.
I asked about currently medication, and if they would recommend Monty remains on the very high does statin, and Orlando said research has shown that remaining on 80mg reduces the risk of a further stroke, so he would recommend remaining on this forever.
In terms of goals for next 6 weeks, we have agreed to shift attention in physio to the arm / shoulder / hand as much as possible, as Monty’s walking has already improved so much. OT will look to incorporate using right arm as much as possible in cooking (which will remain their primary focus, as they currently deem it unsafe for Monty to use the kitchen unsupervised).
The social worker (who I haven’t met before) was in the meeting, and she was talking around a care package for when Monty comes home – I didn’t think we would need anything, but they are keen to explore what options Herts Council offer for first few weeks while we get Monty settled home. They also need to know what Monty is able to call for help if required to determine if he can be left for long periods safely in the home, or if he needs a pendant alarm.
Alice (speech therapist) immediately started working with Monty to practicing calling 999, as she doesn’t think Monty needs this level of support – but it gives us some clear ideas about what we should focus on for safety in the home.
Monty had a really full day of therapy, so was actually shattered, and it was a lesson for me in remembering that although I see moments of Monty speaking really well, and being amazingly engaged, his fatigue levels are still very high. Also multi tasking is really difficult – so for example Monty can listen while walking, but he can’t talk and walk at the same time – he is fully focusing on walking, so hasn’t got any spare brain capacity to talk at the same time.
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