Fatigue and Stroke, aka I'm Hittin' the Wall

(This post is not only for stroke survivors. It is for caregivers, family, friends, health professionals, and others who want to understand fatigue and stroke).

I always pushed myself to the limit. I was like my father, who was shot in his auto parts store by some robbing druggies in 1971 and died on the spot, putting an end to his boundless energy. He worked twelve hours a day, seven days a week, and yet, when he returned home, he ate dinner at 8pm, and sometimes went out again, and always on the weekends, with my mother, who was a stay-at-home mom and had to deal with my boundless energy.

But now that I've had a stroke, my energy has boundaries. All my friends will tell you. I get an entire list of the things I want to do in a day, but I'm always changing the schedule because when it comes to the list, I'm just too damned tired to finish all of it. Why is that? I wanted to know, and I found out a whole lot.

Everybody feels tired at some point. It's the body's way of saying, "Slow down and rest awhile." But the National Stroke Association (NSA) says that post-stroke fatigue (PSF) affects as much as 70 percent of stroke survivors. PSF happens without warning and happens as much as years after the stroke. PSF is not just feeling tired and wanting to take a nap. With PSF, you have to take a nap.





The NSA identified 3 types of fatigue for stroke survivors:

Cognitive (ex: mental fatigue, difficulty focusing, delirium)
 

Physical (ex: function limitations, spasms, pain, muscular weakness, interrupted sleep)

Emotional (ex: motivational deficits, depression, crying and laughing at odd intervals)

I encountered all of them. On the cognitive side, I still have mental fatigue and usually rest once a day; just resting, not necessarily napping. I seldom have difficulty focusing, and deliriums only the first year. I have all of the physical ones randomly, except for function limitations all the time. I have right-sided weakness—a paralyzed arm and I walk with the aid of a quad cane. As for emotional fatigue, I am still, somehow, motivated, but I had depression the first year and off and on since then, and less now. I cried and laughed at the wrong times and places, but that confusion went away after two years.

Aside from different types of fatigue, some medications may point to or worsen fatigue. The medication dosage, the time of day of the medication, or the actual medication itself may need to be adjusted.

Be aware of time and place. Loud stimulation such as music and crowds can be overwhelming for a stroke survivor and bring on fatigue. Some survivors keep a diary of the times a places where fatigue occurred--hand-written or recorded--and if that's so, don't take this diary lightly. Remember, a stroke survivor doesn't want to take a nap; they have to take a nap.

Look for which activities have the greatest impact on stamina, or energy level. (The ones in parentheses are my reactions). Is it watching a sports events? (If the team is winning, go team!) Going shopping? (Absolutely nothing gets in the ways of shopping, especially for clothes). Having a meal? (I didn't fall asleep during a meal. Ever).

The top 10 foods, according to the NSA, that can help ward off fatigue include:

1.   Walnuts
2.   Pumpkin seeds
3.   Quinoa
4.   Yogurt
5.   Whole grains
6.   Wheat bran cereal
7.   Red bell peppers
8.   Tea
9.   Watermelon
10. Dark chocolate

But listen up! Every stroke, just like snowflakes, as the yarn goes, is different. As for me, once I found this list a while ago, I eat them all except pumpkin seeds. They make me cough. And I don't take as many naps every day since.

According to strokeassociation.org, survivors expend more-than-normal energy to do everything.

“You may have less energy than before because of sleeping poorly, not getting enough exercise, poor nutrition or the side effects of medicine. You have as much energy as before, but you’re using it differently because of the effects of your stroke. Things like dressing, talking, or walking take a lot more effort. Changes in thinking and memory take more concentration. You have to stay 'on alert' all the time--and this takes energy,” says the association.

In an article entitled “Post-stroke Rehabilitation: Fatigue After Stroke,” Ed Koeneman says, “The medical conditions of a survivor, such as diabetes, heart disease, anemia, respiratory disease, migraines, or pre-stroke fatigue can contribute to a [stroke] survivor's post stroke fatigue. This is because the stroke itself or the side effects of stroke medication may worsen the survivor's fatigue.

"Sleep apnea is also relatively common among stroke survivors and is reported in high rates among individuals who report fatigue after stroke. However, no solid relationship has been proven," says Koeneman.
 

 And there it is--"no solid relationship has been proven." My belief is that stroke fatigue falls to the back burner, but use the suggestions in this post. They may help. One reader, a stroke survivor, wrote, “Every time I turn the television on and water the plants with one hand simultaneously, I get re-energized.” Good for you, C.L. Whatever works.
------------

In collaboration with http://www.just-health.com.au

The Yin and the Yang of Vaccinations and Strokes

Vaccines have been hurrah-ed as one of medicine's top success stories which have eliminated a host of dastardly diseases in the US. And stroke in childhood is very rare, affecting about 6 in 100,000 per year, according to the National Stroke Association. So what's the connection between vaccinations and strokes? It all comes down to the ying and the yang.

The Yin

In an article entitled “Vaccine-induced strokes on the rise among young people,” published by Natural News, Heidi Stevenson writes that vaccinations are “the elephant in the room” when it comes to a factor for so many younger people getting strokes.

In October 2007, the American Academy of Neurology published a report and found that “between the years of 1993 and 2005, the stroke rate among individuals under the age of 55 increased by more than 44 percent.” Many health professionals said lack of exercise and poor dietary habits might play a factor as well. But vaccines might contribute, too, says Stevenson, with causing seizures and strokes in the young as well.

"A range of neurological disorders [is] associated with vaccines, including macrophagic myofasciitis, encephalopathy, epilepsy, convulsions, Guillain-Barre syndrome, nerve deafness, blindness, paralysis, sudden infant death syndrome, and of course, autism," writes Stevenson. "Now that the earliest recipients of mass vaccination programs are entering middle age, why should we be surprised to find that they're more likely to suffer from another indication of brain damage, stroke?"

A Canadian doctor, Andrew Moulden, who has been in practice for close to 30 years, uncovered the truth before Stevenson. Dr. Moulden discovered that in 2001, vaccines can promote microvascular strokes in some people. Though the news never came to light and was never published in any medical journals, vaccines cause the body's immune system to reject vaccines which prompts a huge release of white blood cells.

And this influx of white blood cells, says Dr Moulden, “are too large to enter the bloodstream, surround capillaries, and actually clog and/or collapse them, leading to what are essentially micro-strokes. As a result, these blockages prevent smaller red blood cells from effectively delivering oxygen to the organs [ie, the brain, for example] near these capillaries.”

Says Stevenson, “What should be clear by now is that vaccines are taking a severe toll on people's brains. The cost both to the individuals, whose lives are affected by strokes, and to society as a whole, which loses productiveness and is burdened with their care, is massive."

The Yang

In an article entitled Vaccines reduce risk of strokes in children, children who received some, few or no vaccines were nearly “seven times more likely to have a stroke than kids who had all or most of their recommended shots,” according to Dr. Heather Fullerton, a professor of neurology and pediatrics at the University of California, San Francisco, and presented the findings of the study at the American Stroke Association's International Stroke Conference in San Diego.

“Pediatric strokes are rare,” says Dr. Fullerton. And to bolster her argument, Fullerton says research has shown that infections greatly increase a child's risk of stroke, partly by causing a temporary increase in the blood clotting. "The exciting thing about this [Fullerton] study is that with vaccination, it might prevent these strokes from happening," neurologist M. Shazam Hussain says, director of the stroke center at the Cleveland Clinic.

Robert Brown, the Mayo Clinic College's chair of neurology, called the study's findings "remarkable. To lower the risk of stroke is noteworthy. And while strokes in children are rare, these are precious young children who are having these strokes, which affect them throughout their long, long lives."

Leaders of the international study, Vascular effects of Infection in Pediatric Stroke, or VIPS, interviewed the parents or guardians of 310 children who had a stroke with 289 children who hadn't. The children, who were around 7 or 8 years old, were from 40 centers on five continents, and is the most renowned study on pediatric stroke funded by the National Institutes of Health. The study concludes that children who received some, few or no routine vaccinations were almost seven times as likely to have a stroke than those receiving all or most vaccines. 

So what do you do as parents? Vaccinate or not? If the National Institutes of Health and other studies are valid, and my guess is they are, with children who received "some, few or no routine vaccinations were almost seven times as likely to have a stroke," how could you  not?

As with everything, there are laws. According to the Yale Journal of Health Policy, Law, and Ethics, the federal government recommends that all children between birth and age eighteen years receive seventy doses of sixteen vaccines.  Of these recommended vaccines, the majority of states require between thirty and forty-five vaccine doses for children to be able to attend school. Forty-seven states require preschool-age children to receive three doses of the hepatitis B vaccine to attend public school. The federal government recommends that infants receive their first dose of the hepatitis B vaccine shortly after birth, while they are in the hospital. 

Every state and its requirements for immunizations are listed at http://www.immunize.org/states.

A nonpartisan, nonprofit website, http://vaccines.procon.org, presents facts, studies, and pro and con statements on questions related to whether or not vaccines should be required for children. In its Did You Know segment, it offers these statements:
 

Did You Know?

All 50 states require vaccinations for children entering public schools even though no mandatory federal vaccination laws exist. All 50 states issue medical exemptions, 48 states (excluding Mississippi and West Virginia) permit religious exemptions, and 20 states allow an exemption for philosophical reasons. Over 5,500 cases alleging a causal relationship between vaccinations and autism have been filed under the National Vaccine Injury Compensation Program in the US Court of Federal Claims between 2001 and 2009. The US Court of Federal Claims Office of Special Masters, between 1988 and 2009, has awarded compensation to 1,322 families whose children suffered brain damage from vaccines. About 30,000 cases of adverse reactions to vaccines have been reported annually to the federal government since 1990, with 13% classified as serious, meaning associated with permanent disability, hospitalization, life-threatening illness, or death. According to a 2003 report by researchers at the Pediatric Academic Society, childhood vaccinations in the US prevent about 10.5 million cases of infectious illness and 33,000 deaths per year.

There's really no choice. How can you not?

Beware, Fat People! A Stroke Might Be A-Comin'!

People are so touchy at times. You have to say things “PC”, aka politically correct. You say the wrong word to describe them--fat, stupid, lazy, even if that description matches, and bingo! They won't talk to you, sometimes maybe never again. But the difference between me and them is, now I don't care. And as a result, some people don't like me. With the stroke, I have no filters—altogether.

A long time ago, when I was little, I did mind if anybody called me chubby, which I was, until about seventh grade when I got self-conscious, right on schedule. 

Clothes used to come in regular and chubby sizes. I took a chubby size all the way through elementary school. I didn't know any different because I had a fat brood—my immediate family, uncles, aunts, cousins, fat people whatever way I turned. The truth is, I loved to eat because I didn't know any better. Eating a lot used to equate to love. 

The fat that I once had doesn't have any bearing on the stroke I now have, or does it? But if you're overweight, morbidly obese, chubby, pleasantly plump—call it what you want—you may be in trouble.

The National Stroke Association says that obesity can put stress on the whole circulatory system. And a recent Harvard University study found that you could cut your stroke risk by
30 percent by eating five daily servings of fruits and vegetables instead of fries, chips, alcohol, and soda. 

Citrus fruits, broccoli, and cauliflower are noted as particularly helpful. It may be their higher concentrations of potassium, folic acid, and fiber are the clues.

The American Heart Association (AHA) “recommends at least 60 minutes of physical activity a day for kids.” The AHA also “recommends that adults get at least 150 minutes of moderate or 75 minutes of vigorous physical activity a week.” If you're fat, you can make time. You just don't want to. You're a creature of the fat habit.

Individuals who are obese have a greater chance of succumbing to sleep disordered breathing, known as sleep apnea. And those with sleep apnea have a greater risk of stroke.

Ok. Need more evidence? A study by researchers at Columbia University say that people with abdominal obesity are at higher risk of ischemic stroke, the most common kind of stroke, caused by blockage of a blood vessel in the brain.

Most of the weight loss articles mention BMI, or body mass index. I'll tell you a simple way to tell if you're overweight if you haven't seen the fat already or you need further proof. The National Institute for Health, aka NIH, has a meter located at http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm. When you give your height in feet and inches and your weight in pounds to the NIH, it gives you guidelines for where you are in the BMI range:

• Underweight = 18 and below
• Normal weight = 18.5–24.9
• Overweight = 25–29.9
• Obesity = BMI of 30 or greater

So I did it. I found out, thinking I was normal weight, that I fall into the normal weight range, just by a smidgeon. I tried another scale, this one from the Centers for Disease Control and Prevention, http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/results_overweight.html. Same result. I was shocked. Just a smidgeon? Seriously?

And one more thing. Being overweight and having a stroke is just too much at times. When I gorge, I watch myself over the next few days. It's like you can tell you've gained weight without a scale to remind you. It's the extra pounds that add to the baggage you have to lug around in the first place.

I could fool those old-time types on the Boardwalk and at county fairs that could guess my weight and give me a prize if they were crazy off the mark. I think that old saying is true, for me at least: "You carry your weight well." And that expression needs to be addressed.

Empathy and Sympathy: There's a Difference

I have a confession to make. I'm nosey, probably because I used to be a reporter. I listen in on everything—a cell phone call, restaurant chatter, a conversation between folks sitting on a bench. Then my imagination takes over and I think I'm a reporter again, creating all sorts of scenarios for why the talk happened in the first place. That process keeps my mind sharp, or as sharp as it can be for someone with a brain injury from my stroke.

One time, I was listening in a restaurant to two college students having coffee in the next booth, discussing the project that they were tasked to accomplish: the difference between empathy and sympathy.

“I need an “A” on this project,” the one girl said, “in order to appease my parents. They said if a get all "A's," they would buy me a car.”

“I should get an 'A,' too, in order to stay in school,” the other one lamented.

I couldn't help it, now that I have no filters of any kind since my stroke. I got the attention of one of the girls and said, “Empathy and sympathy? I could help you with that.”

I, who was having a grilled cheese bagel and tea, and my friend, who was eating a Reuben sandwich--corned beef, swiss cheese, cole slaw, and Russian dressing—and a Coke, slid over to make room for the girls who now came to join us, bringing their coffee in tow.

I thought they were desperate to know because one girl had a car at stake and the other would be in deep doo-doo if she failed the course. And they were just too young to know the difference. I proceeded to tell them, and they had their paper and pens ready to take notes.

“Empathy is comprehending what others are feeling because you were in their shoes yourself or have the ability to put yourself in their shoes. Sympathy is providing comfort when some life-changing event occurs to others.

“Empathy and sympathy are both feelings. You can send somebody a sympathy card and forget it. It's just an act of kindness, often impersonal. But with empathy, you get right to the heart of the matter, with thoughts of experiencing the situation yourself.”

And then, I showed some pictures which I had saved from my lecture long ago.

Empathy:

Sympathy:

Even though they were years younger than me, around 50 years or so my junior, they were smart enough to comprehend.

One of the girls, who was promised a car if she achieved all "A's" asked, "So empathy is harder than sympathy."

"That's right," I replied. "Empathy is harder, and it's more helpful but less common; sympathy is less helpful but more common."

I told them a story of what happened to me in the hospital when I had my stroke.

"Somebody who will remain nameless sent me a sympathy card that said, 'Sorry to hear of your loss.' I felt like I had died. But I didn't. She should have sent a 'get well' or 'thinking of you' card. So sympathy cards should be carefully selected, for mainly death in the family or friendship circle. Sending a sympathy card to a stroke survivor is wrong, mainly because they survived."

I was starting to lose their attention with my story, true though it was. I went on with more detail and their pens were poised once again.

"Empathy can apply to lots more things than death, like getting caught in the rain without an umbrella when you're going to someplace important, losing lots of weight, or changing a tire on a busy highway. If you experienced any of those things, then you know what you're talking about when you say, 'I know how you feel.' And empathy can apply to good things, too."

The girl who had to get an "A" in the project to not bomb out yawned loudly. And then she yawned again. The "car" girl wasn't far behind, but she stifled the yawn out of respect for me. 

We had an appointment coming up and had to leave, and the girls stood to let us by and soon took their new seats once again.

"Thank you," the girls said in unison.

"It was my pleasure," I said. And it was. I was the professor again and I felt great. On the way out, I said, "I'm glad I had the opportunity to teach those girls."

My friend said, "I know how you feel. I'm happy for you." She was practicing empathy. And she was a professor, too.

Different Cultures, Different Mindsets, aka Are They Behind the Times?

I wrote a Facebook post on mammograms that started off humorously, I think and still do, with this picture (http://stroketales.blogspot.com/2012_09_04_archive.html), that said, "Men basically have two things to worry about: erectile dysfunction (yes, ED has an awareness platform, too) and the prospect of prostrate cancer. Big deal. But most men don't know what it takes to be a woman because they've never walked our mile." I then went on to elaborate that "our mile" consists of elusive tampons, bipolar-ish pregnancy hormones, and itchy, non-tested make-up. I thought it was funny, sarcastic humor at its best, at least the best I can do. 

I have pissed off two countries. But seriously, the reality is, both sexes have problems, and often the same, like money issues or additional health problems. That post set off a firestorm of direct hits on Facebook and emails that I got to thinking, it must be a cultural thing.

The overwhelming majority of responses came either from Great Britain or Australia which have a shared language, accent (at least, to the undiscerning, American ear), and legal system based on common law. They also share a monarch--Queen Elizabeth II. It all made sense, now that I thought about it. Here's a thought: If all the English and Australian people were suddenly beamed up, Star Trek style, to America (which isn't possible because America, as far as I know, has no teleportation), the overwhelming majority of them would join the Republican party, or go the Tea Party route. (Again, another piece of American humor. Ha ha?)

Anyway, there's no doubt about it that there are cultural differences between Americans and Brits/Aussies, like mentioning tampons in the post was a no-no, or diaphragms? Good lord! The fact is, tampons and diaphragms are the real deal, but hasn't reality set in yet with most Brits and Aussies?

Those responses to my post got me thinking further. Probably overall, there may be  some questions for more on how we do things here in America, like how we have stupid, reality television shows about the broads (I give them that "title" purposely) in major cities (like The Real Housewives of 'you-fill-in-the-blank-and-who-gives-a-shit-anyway), like why we blame Obama for the government's healthcare website when bugs come with every website launch, why we drink supposedly healthy, bottled water in the billions annually, yet we don't give a damn about what processed, fast foods we consume. And more. Lots more.

So to Brits and Aussies, though I stand by my post, I apologize if it offended you. To all those in the same, aforementioned group who "liked" it (a Facebook term) and got a chuckle out of it, congratulations on your being thick-skinned, enlightened, and reality-based. 

Whoops. I did it again.

Distractions, Disablements, Displeasers, aka Whew! There Are Others!

I have my contact info in my blog. So I was not surprised that I recently received an email from a lady named Grace, and this is what she said:

Hi - I like your blog, but it's hard to read because of the "ink stain" (the wallpaper of your blog). As a stroke survivor, any visual distraction can be hard to deal with.

Thank you, Grace, for that comment. In an effort to satisfy all my readers, I changed the wallpaper.

Here is what my blog looked like before:

                       

Here is my blog now:

I chose the first wallpaper because it made me feel like I was a columnist for the newspaper again. I chose the latter wallpaper because of Grace.

But that email gave me an idea. How many other people didn't read my blog because of the ink stain? As Grace put it, "any visual distraction can be hard to deal with."

I don't have visual distractions in that way, from wallpaper with ink stains, but right after my stroke, my friend took me to "Avatar," the 3-D movie. When we sat down, I put on the 3-D glasses that the theater provided and the movie began, but I immediately had a headache and dizziness, and took off the 3-D glasses. My headache and dizziness stopped. After about 10 minutes, I put the glasses on again, testing myself, and the headache and dizziness resumed.

I sat for over an hour putting the glasses on--and off--at first, thinking it was an anomaly, but I couldn't chalk it up to a mere coincidence. The headache and dizziness always returned when I watched the film with the glasses. Eventually, I closed my eyes for the rest of the lengthy movie and listened, but I missed much in the high-action film. But at least, the headache and dizziness didn't return. The stroke, somehow, was the reason, disabling indeed.

I received another email recently that said: "I have no filters on what I'm saying. I always say something hurtful." The email was signed Anonymous and I won't reveal the address, but it looked ordinary enough,

like joe@yahoo.com. (Sorry, "joe," if you're reading this post). So back to  Anonymous. I have that problem, too. If people brush too close to me in a store, I'll say, "Ex-CUSE ME!" Anyway, it's very displeasing to me, and to the person, if they even heard me.

Are stroke survivors having these problems? The question is rhetorical. Of course they are about 800,000 strokes a year worldwide. They may be not having the exact stroke "side effects" I just mentioned, depending on the extent of brain damage and where the damage occurred, but trust me. Hardly anyone gets a stroke and comes away unscathed. So Grace and Anonymous, and to all the other stroke survivors out there, onward and upward. Like I say in the description to my blog, I have two options: live with the stroke or... well, you know the alternative.

Fractured Bones and a Doctor with an Attitude

I broke my big toe on a cutting board that had fallen from a pile of stuff. Please. Don't ask. Imagine whatever you'd like. 

That was in October 2013 and I quit going to the gym, and naturally, what I had gained gym-wise was depleting rapidly. In November, I went to rehab in Pittsburgh, where I was visiting my son, and the therapist phoned the rehab doctor, known as a physiatrist (I always love to say physiatrist because people always think, as a result of my  stroke,  I'm mispronouncing psychiatrist and they think I'm going to a shrink--sorry to disappoint), who said that 2 or 3 weeks in the rehab in-patient facility (rehab 4 to 5 hours every day of the week) might prove to be not such a bad thing. 

He was serious, and he said to come back Monday for a solution. I mean, I couldn't just check in to a hospital for rehab without his help, but ironically, something happened to make it so.

In December, still visiting Pittsburgh,

my cousin came to visit for a week. Do you know what the Ancients said about visits? Visits are like bad fish. Stay for more than 3 days and they'll both end up stinking. I don't know about that analogy, but her stay was hectic, with her 10 steps ahead wherever we went. I tried to pretend I could keep up with her--it made me feel normal--but it was pointless. She was always in a hurry, like she was having a race with her bucket list.

She left when the week was up, and I was invited to my son's house to chill out and have chicken soup with non-gluten matzah balls. You'd think non-gluten matzoh balls would be a set up for a joke, but it's not.

Nothing is funny here, both before the non-gluten matzah balls or after. By the way, I couldn't tell the difference between non-gluten and gluten. All matzah balls taste the same. The thing that matters is the weight of the matzah balls. My ex-mother-in-law's matzah balls were like tiny bits of mortar, hard and dangerous if they were airborne, but I digress.

I traveled up my son's path with him right behind me. And then I caught my foot on the lip of the step and I fell backward. Fortunately, my son was there to catch me, but not before I skinned my knee and my elbow, and telling my son, once again, that I was incapable of grace. I went into his house, had the soup, and went back to my apartment. 

Here's where the strange part comes in. In summary, I went into his house and an hour and a half later, walked back to the parked car that was across the street. I walked up the outside 4 steps to my apartment, up 4 steps again inside to get to the elevator, and down a long hallway--maybe a hundred feet--to enter the apartment. I went to the bathroom, brushed my teeth, and went to bed. I got up in the morning (here's it is--the mind-boggling part), went to the bathroom, and as I stood up, my stroke-affected leg collapsed like it was made of straw. Fortunately, I didn't hit my head as I careened into the bathtub.

So there I was, on the bathroom floor, but luckily, I had Life Alert. You know, "I've fallen and I can't get up" commercials? So I pressed the Life Alert button and shortly, two paramedics were standing in my bathroom doorway. The maintenance man let them in.

One paramedic said, as he helped me to my feet, "Your choice. You can go to the hospital or not. You're not hurt, as far as I can tell. But you never know."
 
I thought about it. My foot just collapsed. Was I tired from the hectic-cousin visit? Or maybe there was something else wrong. Or maybe it was the combination of both. If I was a betting gal, I'd go with the latter. And I didn't have an option.

So I took a ride in the ambulance and went to the closest hospital. They kept me overnight, what they called "observation mode." When they took an x-ray of my ankle and upwards, the orthopedic surgeon said that nothing was broken, but my foot ballooned to thrice its size, bright red, and swollen, and when the doctor pushed it, his fingerprint impressions remained.

"Maybe I broke my toe again. I mean, there has to be some reason that I walked on it yesterday and this morning, my foot collapsed," I intentionally whined.

The doctor said, "We'll x-ray you toes," in a snarly fashion, like he didn't like me telling him his business. 

"Too bad," I said to myself. Most doctors in the universe are like that, at least in my experience.

The x-ray happened a short while later, but at this point, I couldn't even put any pressure on my foot. The doctor came in with the results in a half hour.

"You fractured the second and third metatarsals." He looked down at the floor. He couldn't get over the fact that I was right. "We're going to transfer you to a different hospital that has more physical therapists than here," the snooty doctor said, who still had an attitude. He was sneering, or maybe that was my imagination.

So I went to a different hospital and just as the physiatrist said, I got rehab 7 days for around 30 hours a week. I stayed there for 3 weeks and then it was time to go back to the apartment. Even though I enjoyed the therapy, I had enough.

My fractures healed to the day the doctor predicted, 4 weeks later. And I was happy that I had instructed the doctor to do what made sense. Sometimes doctors and other health professionals don't listen to the patient, as it was in my case. Hell. I wrote a book about that very thing.
---------
Not to miss an opportunity:
My book, "The Tales of a Stroke Patient," is available online everywhere, like: 

from the publisher, http://bookstore.xlibris.com/Products/SKU-0115053049/The-Tales-of-a-Stroke-Patient.aspx,

or from Amazon,  http://www.amazon.com/The-Tales-Stroke-Patient-ebook/dp/B009J9QC64/ref=sr_1_1?ie=UTF8&qid=1373898600&sr=8-1&keywords=tales+stroke+patient,   

or from Barnes & Noble, http://www.barnesandnoble.com/w/the-tales-of-a-stroke-patient-joyce-hoffman/1113052852?ean=9781479712496.