The Living Cage (translated from Norwegian by Stephen Collett)

By Per Lovhaug

A cerebral stroke strikes the patient directly, but those who are nearest, particularly a spouse, also have their lives changed. And around the nearest circle are the helpers – the health professionals. So there is always the three P ́s: patient, persons near, and personnel. Each of these needs to find his/her place on a scale of emotions, from despair at one end to hope at the other. It is not uncommon for emotions to swing between these outer points.
The remedy is treatment, in the acute phase, and it is vitally important that it begins as soon as possible and that it is effective. There follows the intermediate period of care and gradual mobilization, and then the extended phase of therapy and rehabilitation. This final phase continues without end, in part because one can always improve, and in part to assure that achievements are not lost. The goal is the mastering of the disability and of life itself. Mastering is not the perfect “as I was before”. Mastering is in persevering, in continued training and in keeping hope alive: We will not ever give up, and not even then.
It is critical that the three-P ́s understand what has happened, and they need to understand it with both reason and feelings. To achieve this we need to hear the stories of those affected, namely the patients and persons near them. Per Løvhaug is a journalist and writer. He manages to put words to his experience and emotions, so we can learn from him. He explains how it feels in a manner that we grasp and are ourselves gripped by the telling. He shows us how emotions swing throughout the scale, but still lead towards hope for a livable life. He shows us what love means when catastrophe strikes.
I hope that many will read this little book and be gripped by it as I was. There is hope in the midst of despair, and we must grasp that hope. Gallows humor is often good help: Seize the day, or you can call it a night!

Peter F. Hjort
Professor Emeritus, University of Tromsø

• Language: English
• Publisher: Per Lovhaug
• Release date: Oct 9, 2018
• ISBN: 9780463444009

Book preview

Preface

A cerebral stroke strikes the patient directly, but those who are nearest, particularly a spouse, also have their lives changed. And around the nearest circle are the helpers – the health professionals. So there is always the three P´s: patient, persons near, and personnel. Each of these needs to find his/her place on a scale of emotions, from despair at one end to hope at the other. It is not uncommon for emotions to swing between these outer points.

The remedy is treatment, in the acute phase, and it is vitally important that it begin as soon as possible and that it is effective. There follows the intermediate period of care and gradual mobilization, and then the extended phase of therapy and rehabilitation. This final phase continues without end, in part because one can always improve, and in part to assure that achievements are not lost. The goal is the mastering of the disability and of life itself. Mastering is not the perfect as I was before. Mastering is in persevering, in continued training and in keeping hope alive: We will not ever give up, and not even then.

It is critical that the three-P´s understand what has happened, and they need to understand it with both reason and feelings. To achieve this we need to hear the stories of those affected, namely the patients and persons near them. Per Løvhaug is a journalist and writer. He manages to put words to his experience and emotions, so we can learn from him. He explains how it feels in a manner that we grasp and are ourselves gripped by the telling. He shows us how emotions swing throughout the scale, but still lead towards hope for a livable life. He shows us what love means when catastrophe strikes.

I hope that many will read this little book and be gripped by it as I was. There is hope in the midst of despair, and we must grasp that hope. Gallows humor is often good help: Seize the day, or you can call it a night!

Peter F. Hjort

Professor Emeritus, University of Tromsø

A Nightmare

Imagine that you awaken in your bed, unable to move any part of your body. Your arms lie slack and heavy by your sides, your legs won´t budge. You have lost speech, and your hearing is reduced to a deep rumbling. Through blurry eyes, you look out into a foreign world where everything is double.

You realize that you have lost control of your bodily functions, and you lie there a wreck, robbed of all dignity. You want to close your eyes and glide back into a compassionate sleep, only to discover that nightmares await you there that are worse even than those in what we call reality.

Not even unconsciousness can appease your painful awareness.

The cage was made of finger-thick, smooth bars, woven in an intricate pattern. The bars were rust-red and could have been of iron, but they glided in and out between themselves with the greatest suppleness. They were warm, but they gave no sound.

The cage was alive.

The naked man´s body inside the cage twisted in pain. Sweat ran from it, but no sound escaped his distorted mouth. The bars enveloped his body as he strained to get loose. The more he struggled, the harder the grip was tightened. Not before he resigned himself and relaxed did the cage´s grasp soften.

Slowly and watchfully the bars slid from each other, only to tighten at the least movement. Only when his body had completely submitted did the cage ease its hold.

This was one of many nightmares, as I lay unconscious in the intensive care ward of Flekkefjord Hospital. I had been admitted with cerebral stroke and though my nightmares varied they each reflected my condition: a naked, vulnerable man-person abandoned to forces outside his control, unable to move. The feeling of powerlessness was unbounded, and despair over my paralysis was bottomless.

In one form or another this theme revisited me repeatedly through the three weeks I lay unconscious. But I was not completely senseless. I had a rich dream life that also incorporated parts of what was going on around me. As I began to return to myself the dreams became more nuanced and colored by my surroundings.

It was the third of March, 2007 at eight o´clock in the evening that the stroke hit me, ruthlessly and painlessly. We were to eat dinner at the home of friends in Spind, and were about to have an aperitif of white wine before going to the table. Then it happened. I perceived two blood red stripes that ran parallel down a grey-white glass wall and disappeared into my body. For a moment I tried to follow the stripes with my fingers, without real success.

Berit, our hostess, asked me whether I was frightened, and I said yes. That was the last thing I said for many weeks. In truth, I was more amazed than afraid and observed almost amused the way my left leg began to kick uncontrollably in all directions. I tried to steady it with my left hand, but the hand wouldn´t listen. You have had a stroke, I remember thinking.

In the distance, I heard our host, Stephen, say decisively that we needed to call an ambulance. The next I knew two red-clothed men carried me on a stretcher and put me into the ambulance. I heard my wife Astrid say, distantly, I am coming with you.

Six weeks would pass before I found out where I had been taken.

Astrid told later how the ambulance driver asked whether they should drive to Kristiansand or to Flekkefjord, as Spind, where Berit and Stephen lived, lay fairly equidistant from these two hospitals. She inquired as to what would be best for me, and the driver responded that if it was a blood clot in the brain, seconds could matter.

So drive to Flekkefjord, said Astrid.

In Flekkefjord everything was laid ready when the ambulance arrived. Within twenty minutes it was clear that the problem was a cerebral hemorrhage. It had occurred in the lower brain stem at the juncture with the spine, where the nerve bands are so dense that operating was not an option. I could either die or be paralyzed from the neck down by the least collateral damage.

The new everyman disease

Cerebral stroke is often called the new everyman disease. 16,000 Norwegians are given that diagnosis each year, and the number is expected to rise to 25,000 in the next twelve to fourteen years. Four out of five of us experience a blood clot to the brain, and the patients are increasingly younger. It is crucial that treatment begin immediately, and that rehabilitation begin as early as possible. This is decisive if the patient is to be brought back into employment, or in the least to a worthwhile life. There are examples of people coming back to their jobs and working through to retirement age. Some have perhaps had to work on partial leave, but have nevertheless saved society huge expenses for their care.

The rise in the number of strokes corresponds also with the