#YRfanfiction #Niktor #Newmans Now&Forever: Love&War Pt. 6

Published May 28, 2012 by tdaddetta16

Chapter Sixteen
Just as she was about to check in on Nikki again, Casey met up with Dr. Cornwell and Dr. Thorton. “How’s Nikki doing? Any news on Victor’s condition?”
“As you know, we did what we could to treat him, but we couldn’t do much. The damage to his heart was too extensive. We can’t do anything more in terms of repairing it, so at this point, all we can do is put him on a transplant list and hope everything works out. We reviewed the tests we’ve done so far and we’re confident that some kind of argument or other stressful event brought on the attack.” Dr. Thorton spoke first.
Casey listened intently, hoping to pick up on something, some small sign of hope they hadn’t found yet.

“As for what brought on the stroke, we’re not exactly certain yet. We’re still running tests, all we know is that it was caused by a haemorrhaging, but we don’t have an origin or origins or any other details. The results will tell us a lot.”
“Nikki’s handling this as well as can be expected; far better actually. But, she is blaming herself.” Dr. Cornwell said regretfully.
“She always does, she always does when something happens to someone she cares about and she somehow thinks she could have, should have prevented it.” Casey told them quietly, sombrely.
“I don’t have to tell you what’s at stake here. If we don’t find a donor soon, we’ll lose him. I’m sorry, Casey.” Dr. Cornwell put a hand on the younger woman’s shoulder and gave her what she hoped was a comforting smile before she and Dr. Thorton left.

Slowly, as she tried to figure out what to do, what she could possibly say to Nikki at a time like this, Casey walked into the waiting room.
“Casey, what are you doing here?” Nikki asked, surprised to see her.
“I thought I should stay in case you needed me, but I’ll leave if you want me to.”
“No.” Running her fingers through her hair and trying her best to stop the tears that flowed freely from her eyes, Nikki whispered, “How do I tell the children? How do I tell them, Casey?”
“I don’t know, just be honest with them, I guess. Do you want me to stay with you when you tell them?” Casey said honestly, tenderly.
“You’d do that? After what happened the last time we talked, after what I said to you? You’d stay with me?” Nikki asked surprised.
“Of course, we’re family. Besides, how many times have you and I argued worse than that? In spite of all the times you’ve driven me crazy-and you have-I can’t turn my back on you. Face it, little sister, you’re stuck with me.”
“Thanks, I’d better go make some calls.” Nikki replied before giving her sister a quick hug and heading off to make the necessary calls.

Sitting down and wiping her sweaty palms on her pants, Casey looked at the binders beside her and thought to herself, ‘The best thing I can do for Nikki is to read her all the information I can and explain it to her. It’s the best thing, the only thing I can do at this point. She’s never liked it when I hovered, even when it was for her own good.’
‘Besides,’ she reasoned, ‘It’ll be good for me to read up a little too, just in case one of my patients asks. If I push Nikki too hard, if I try and get her to take longer breaks or more of them, it’ll just make things worse. ’

Stretching, she got as comfortable as possible on the couch and began to read. “Stroke Treatment: Rehabilitation and your stroke care team What is rehabilitation therapy?–For survivors, rehabilitation is an integral part of recovery. The aim of any rehabilitation program is to aid survivors in regaining as much of their independence as possible. But, this doesn’t mean they’ll get back to exactly the way they were prior to the stroke. Rehabilitation can’t cure damage to the brain. It can help survivors to relearn the best possible use of their bodies.”

“It’s a good thing Nikki’s taking a break, I don’t think she could’ve taken reading much more of this research.”Casey whispered to herself before continuing. “When should rehabilitation begin–It should start as soon as possible following a stroke. Frequent turning, proper positioning, and gentle exercise of paralysed muscles can aid in preventing stiffness and soreness. This will help prepare muscles for more complex tasks. At first, a nurse or therapist will give this care. Afterwards, caregivers will be taught how to help. Caregivers and family play an important role in rehabilitation. A good way to learn rehabilitation exercises is to practice them while the survivor is in the hospital where the nurse or therapist can give support. Caregivers may also find it useful to spend time with the survivor before discharge to become more familiar with new routines or special equipment like braces or wheelchairs.” Casey tried to imagine what life would be like for victor in a wheelchair and felt chills slip along her skin. ‘He’d hate that so let’s hope it doesn’t come to that.’

“More on Stroke Effects&Treatment: Swallowing and feeding challenges–Strokes can effect the muscles of the mouth, tongue and throat. Because of this, individuals may have difficulty swallowing. This is referred to as dysphagia (dis-fa-je-ah). Dysphagia can be temporary or permanent. More assessment by healthcare professional may be needed. Some ideas to help if individuals have difficulty: take small bites; chew on the stronger side of your mouth; clear your throat and mouth of food after each bit; remove food trapped in the cheek with a finger, using a small mirror to see where food is trapped; don’t talk while chewing; brush your teeth and rinse after each meal. A speech language pathologist can suggest other tips.

How a change in diet can help–Some textures of food may be easier to eat than others. For example, soft, solid foods like applesauce or porridge are easier than liquids. Patients might also try: making liquids thicker (i.e. with a commercial thickener or cornstarch); making foods softer or smoother (such as mashed potatoes); chopping food or making it smaller , like potato salad; grinding foods in a blender. As patients recover, they may be able to gradually get back to a normal diet.”
“Some individuals have difficulty cutting food, holding a glass or opening containers following a stroke. The patient should try not to get discouraged if this happens with him/her. It can take time and practice to learn or adapt new ways to carry out these tasks.”
“Having somebody cut up his food for him would drive Victor crazy, he’d feel like a child.” Casey murmured to herself prying it wouldn’t happen.

“Testing: Neurological Exam–Different portions of the brain control different functions. With a neurological exam, the doctor can obtain important information regarding if and how a patient’s brain has been affected by stroke.
What to expect– A full neurological exam involves testing the patient’s language and memory skills, behaviour, alertness, vision and eye movements, muscle control, ability to walk and sense of touch. The doctor will observe how the patient answers questions and carries out simple tasks and will be looking at the patient’s ability to: Respond to the examination –If the patient seems unusually drowsy or not alert, the doctor may suspect a haemorrhage or an injury to the brainstem. Move your hands, arms, feet and legs– Among other things, the doctor will compare strength, sensation and coordination on both sides of the patient’s body. For example, dragging the left leg when walking or having a left arm which is significantly weaker than the right may show that the right side of the brain has been damaged. See–Changes in eyesight, like loss of vision on one side, double vision or not being able to control eye movement all suggest strokes in different parts of the brain have occurred. Speak, read, write, do math and understand speech–When testing language and memory, doctors or speech specialists will use simple oral and written tests to check for aphasia (difficulty speaking, reading, writing, doing mathematics or understanding speech). If a patient is being tested, he or she may be asked to repeat words and phrases, count, name objects, remember words, follow simple commands, read and write, and show understanding of what he or she has read and heard, think, remember and problem-solve. The patient’s ability to remember things (like the date or his or her age and birth date) will be checked, as will his or her ability to think or problem-solve. The doctor may also attempt to determine whether there’s been any major change in his/her personality following the stroke. Any change is a clue to the location and extent of the stroke in the brain. For example, individuals who’ve had a right hemisphere stroke may speak very flatly, with not emotional tone and voice inflection, or they may seem unconcerned about their sudden disabilities.”

“Warning Signs for Stroke and TIA: Warning signs for stroke include: Weakness–Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary. Trouble speaking–Sudden difficulty speaking, understanding or sudden confusion, even if temporary. Vision problems–Sudden trouble with vision, even if temporary. Headache–Sudden severe and unusual headache Dizziness–Sudden loss of balance, especially with any of the above signs.”

Meanwhile, in the hall, Nikki stood in front of the payphone and thought to herself aloud, “What do I say to them? How do I tell them their father might not make it? How do I find the words to do that?”
“Victoria will be devastated and Nicholas will be heartbroken. One thing’s for sure I can’t do it over the phone. God, how do I do this?”
Running her fingers through her hair as she let out a tired sigh, she said to herself “I need to find some way. They need to know what’s going on. They have a right to know.”
After wiping her sweaty palm on her pants, she sent a shaky hand to pick up the phone.

*

At the ranch, Vicki paced the livingroom, her hands balled into fists, as her imagination conjured up possibility after horrifying possibility about what could be going on with her parents. “Mom, what’s going on? Where are you? You said you were going to look for Dad, why aren’t you home? You should have been here hours ago! What happened? Why haven’t you been answering your phone? I left you at least a dozen messages!” Vicki asked almost frantically after she’d picked up the phone on the second ring.

“Victoria, I’m at Memorial. I haven’t had time to check, my messages and it died on me. We’ve got more important things going on! I need to talk to you–now! Get here as soon as you can!” Nikki replied tiredly yet firmly.
“Memorial? What are you doing at Memorial?” Victoria asked almost frantically.
“Victoria, just calm down, okay. I found your father, he’s here.” Nikki answered, trying to keep both herself and her daughter calm.
“What? What’s he doing at Memorial? Mom, what’s going on? Mom, tell me what’s going on! Is it bad? Mom, is it bad? Mom?”
“Victoria, I don’t want to get into it over the phone. Just get here as soon as you can and bring Nicholas with you. Everything will be fine, just get here as soon as you can.”

With that done, Nikki called Nick next.
“Mom? Where are you? Why aren’t you home?”
“I’m at Memorial. Your father’s been admitted. You and Victoria need to get here as soon as you can.”
“We’ll be right there.” With that Nick hung up and rushed out the door.
He drove quickly to the main house to find Victoria had already gone and decided to meet her at the hospital. Wasting no time, he raced out the door and to the hospital.

Numb, Nikki tried to ignore her stomach lurching and forced her wobbly legs to carry her forward, back to the waiting room.

Back in the waiting room unaware of just how much pain Nikki was in, just what it took for her to tell her children even a little bit about what had happened, Casey stood in front of the window, staring out it blankly at the night sky.
Exhausted, Nikki shuffled in and towards the couch without a word.

“Nikki.” Casey called her name softly, unable to keep the concern from her voice. “Nikki.” She tried again.
Still, Nikki gave no indication she’d heard her as she walked to the couch and slumped onto it.
“Nikki, talk to me, what’s wrong?” Casey asked, her concern growing.
“What’s wrong? What’s wrong? I have to tell my children their father may die! How do I do that? How do I do that Casey? Everybody just walks around like it’s business as usual while my world’s crumbling down around me and there’s not a damn thing I can do about it!” Nikki shot out furious, indignant at her sister’s seemingly nonchalant and aloof attitude where Victor’s situation was concerned!
“Nikki, you can’t do this! You can’t get all worked up like this. It’s no good for you, or the twins. And it’s not going to do Victor any good!” Casey countered, finding it increasingly difficult to be patient with her sister.
“Then by all means, tell me what I’m supposed to do! Tell me, since you’ve got all the answers! What am I supposed to do; sit here and put on a show for everybody! Sorry, Casey show’s over!” Nikki bit out, still seething, completely uninterested in keeping the bitter fury out of her voice.
“Damn it Nikki! I’m on your side! I’m not trying to tell you what to do! I’m trying to keep you from selfdestructing! You’re not going to do anybody any good if you end up in here for exhaustion! Think about your family! Your kids need you! I thought you understood that!” Casey exclaimed, finally starting to lose her patience.
“What I understand is that you’re just like everybody else! You expect me to just sit here and wait, grin and bear it! Newsflash, Casey, I can’t do that! I can’t just shut my feelings on and off like some light switch! I’m not you!”
“Fine, have it your way!” With that, Casey stormed out and headed to her office.

Chapter Seventeen
Just as she was about to check in on Nikki again, Casey met up with Dr. Cornwell and Dr. Thorton. “How’s Nikki doing? Any news on Victor’s condition?”
“As you know, we did what we could to treat him, but we couldn’t do much. The damage to his heart was too extensive. We can’t do anything more in terms of repairing it, so at this point, all we can do is put him on a transplant list and hope everything works out. We reviewed the tests we’ve done so far and we’re confident that some kind of argument or other stressful event brought on the attack.” Dr. Thorton spoke first.
Casey listened intently, hoping to pick up on something, some small sign of hope they hadn’t found yet.

“As for what brought on the stroke, we’re not exactly certain yet. We’re still running tests, all we know is that it was caused by a haemorrhaging, but we don’t have an origin or origins or any other details. The results will tell us a lot.”
“Nikki’s handling this as well as can be expected; far better actually. But, she is blaming herself.” Dr. Cornwell said regretfully.
“She always does, she always does when something happens to someone she cares about and she somehow thinks she could have, should have prevented it.” Casey told them quietly, sombrely.
“I don’t have to tell you what’s at stake here. If we don’t find a donor soon, we’ll lose him. I’m sorry, Casey.” Dr. Cornwell put a hand on the younger woman’s shoulder and gave her what she hoped was a comforting smile before she and Dr. Thorton left.

Slowly, as she tried to figure out what to do, what she could possibly say to Nikki at a time like this, Casey walked into the waiting room.
“Casey, what are you doing here?” Nikki asked, surprised to see her.
“I thought I should stay in case you needed me, but I’ll leave if you want me to.”
“No.” Running her fingers through her hair and trying her best to stop the tears that flowed freely from her eyes, Nikki whispered, “How do I tell the children? How do I tell them, Casey?”
“I don’t know, just be honest with them, I guess. Do you want me to stay with you when you tell them?” Casey said honestly, tenderly.
“You’d do that? After what happened the last time we talked, after what I said to you? You’d stay with me?” Nikki asked surprised.
“Of course, we’re family. Besides, how many times have you and I argued worse than that? In spite of all the times you’ve driven me crazy-and you have-I can’t turn my back on you. Face it, little sister, you’re stuck with me.”
“Thanks, I’d better go make some calls.” Nikki replied before giving her sister a quick hug and heading off to make the necessary calls.
Sitting down and wiping her sweaty palms on her pants, Casey looked at the binders beside her and thought to herself, ‘The best thing I can do for Nikki is to read her all the information I can and explain it to her. It’s the best thing, the only thing I can do at this point. She’s never liked it when I hovered, even when it was for her own good.’
‘Besides,’ she reasoned, ‘It’ll be good for me to read up a little too, just in case one of my patients asks. If I push Nikki too hard, if I try and get her to take longer breaks or more of them, it’ll just make things worse. ’

Stretching, she got as comfortable as possible on the couch and began to read. “Stroke Treatment: Rehabilitation and your stroke care team What is rehabilitation therapy?–For survivors, rehabilitation is an integral part of recovery. The aim of any rehabilitation program is to aid survivors in regaining as much of their independence as possible. But, this doesn’t mean they’ll get back to exactly the way they were prior to the stroke. Rehabilitation can’t cure damage to the brain. It can help survivors to relearn the best possible use of their bodies.”

“It’s a good thing Nikki’s taking a break, I don’t think she could’ve taken reading much more of this research.”Casey whispered to herself before continuing. “When should rehabilitation begin–It should start as soon as possible following a stroke. Frequent turning, proper positioning, and gentle exercise of paralysed muscles can aid in preventing stiffness and soreness. This will help prepare muscles for more complex tasks. At first, a nurse or therapist will give this care. Afterwards, caregivers will be taught how to help. Caregivers and family play an important role in rehabilitation. A good way to learn rehabilitation exercises is to practice them while the survivor is in the hospital where the nurse or therapist can give support. Caregivers may also find it useful to spend time with the survivor before discharge to become more familiar with new routines or special equipment like braces or wheelchairs.” Casey tried to imagine what life would be like for victor in a wheelchair and felt chills slip along her skin. ‘He’d hate that so let’s hope it doesn’t come to that.’

“More on Stroke Effects&Treatment: Swallowing and feeding challenges–Strokes can effect the muscles of the mouth, tongue and throat. Because of this, individuals may have difficulty swallowing. This is referred to as dysphagia (dis-fa-je-ah). Dysphagia can be temporary or permanent. More assessment by healthcare professional may be needed. Some ideas to help if individuals have difficulty: take small bites; chew on the stronger side of your mouth; clear your throat and mouth of food after each bit; remove food trapped in the cheek with a finger, using a small mirror to see where food is trapped; don’t talk while chewing; brush your teeth and rinse after each meal. A speech language pathologist can suggest other tips.

How a change in diet can help–Some textures of food may be easier to eat than others. For example, soft, solid foods like applesauce or porridge are easier than liquids. Patients might also try: making liquids thicker (i.e. with a commercial thickener or cornstarch); making foods softer or smoother (such as mashed potatoes); chopping food or making it smaller , like potato salad; grinding foods in a blender. As patients recover, they may be able to gradually get back to a normal diet.”
“Some individuals have difficulty cutting food, holding a glass or opening containers following a stroke. The patient should try not to get discouraged if this happens with him/her. It can take time and practice to learn or adapt new ways to carry out these tasks.” “Having somebody cut up his food for him would drive Victor crazy, he’d feel like a child.” Casey murmured to herself prying it wouldn’t happen.

“Testing: Neurological Exam–Different portions of the brain control different functions. With a neurological exam, the doctor can obtain important information regarding if and how a patient’s brain has been affected by stroke.
What to expect– A full neurological exam involves testing the patient’s language and memory skills, behaviour, alertness, vision and eye movements, muscle control, ability to walk and sense of touch. The doctor will observe how the patient answers questions and carries out simple tasks and will be looking at the patient’s ability to: Respond to the examination –If the patient seems unusually drowsy or not alert, the doctor may suspect a haemorrhage or an injury to the brainstem. Move your hands, arms, feet and legs– Among other things, the doctor will compare strength, sensation and coordination on both sides of the patient’s body. For example, dragging the left leg when walking or having a left arm which is significantly weaker than the right may show that the right side of the brain has been damaged. See–Changes in eyesight, like loss of vision on one side, double vision or not being able to control eye movement all suggest strokes in different parts of the brain have occurred. Speak, read, write, do math and understand speech–When testing language and memory, doctors or speech specialists will use simple oral and written tests to check for aphasia (difficulty speaking, reading, writing, doing mathematics or understanding speech). If a patient is being tested, he or she may be asked to repeat words and phrases, count, name objects, remember words, follow simple commands, read and write, and show understanding of what he or she has read and heard, think, remember and problem-solve. The patient’s ability to remember things (like the date or his or her age and birth date) will be checked, as will his or her ability to think or problem-solve. The doctor may also attempt to determine whether there’s been any major change in his/her personality following the stroke. Any change is a clue to the location and extent of the stroke in the brain. For example, individuals who’ve had a right hemisphere stroke may speak very flatly, with not emotional tone and voice inflection, or they may seem unconcerned about their sudden disabilities.”

“Warning Signs for Stroke and TIA: Warning signs for stroke include: Weakness–Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary. Trouble speaking–Sudden difficulty speaking, understanding or sudden confusion, even if temporary. Vision problems–Sudden trouble with vision, even if temporary. Headache–Sudden severe and unusual headache Dizziness–Sudden loss of balance, especially with any of the above signs.”

Meanwhile, in the hall, Nikki stood in front of the payphone and thought to herself aloud, “What do I say to them? How do I tell them their father might not make it? How do I find the words to do that?”
“Victoria will be devastated and Nicholas will be heartbroken. One thing’s for sure I can’t do it over the phone. God, how do I do this?”
Running her fingers through her hair as she let out a tired sigh, she said to herself “I need to find some way. They need to know what’s going on. They have a right to know.”
After wiping her sweaty palm on her pants, she sent a shaky hand to pick up the phone.

*

At the ranch, Vicki paced the livingroom, her hands balled into fists, as her imagination conjured up possibility after horrifying possibility about what could be going on with her parents. “Mom, what’s going on? Where are you? You said you were going to look for Dad, why aren’t you home? You should have been here hours ago! What happened? Why haven’t you been answering your phone? I left you at least a dozen messages!” Vicki asked almost frantically after she’d picked up the phone on the second ring.

“Victoria, I’m at Memorial. I haven’t had time to check, my messages and it died on me. We’ve got more important things going on! I need to talk to you–now! Get here as soon as you can!” Nikki replied tiredly yet firmly.
“Memorial? What are you doing at Memorial?” Victoria asked almost frantically.
“Victoria, just calm down, okay. I found your father, he’s here.” Nikki answered, trying to keep both herself and her daughter calm.
“What? What’s he doing at Memorial? Mom, what’s going on? Mom, tell me what’s going on! Is it bad? Mom, is it bad? Mom?”
“Victoria, I don’t want to get into it over the phone. Just get here as soon as you can and bring Nicholas with you. Everything will be fine, just get here as soon as you can.”

With that done, Nikki called Nick next.
“Mom? Where are you? Why aren’t you home?”
“I’m at Memorial. Your father’s been admitted. You and Victoria need to get here as soon as you can.”
“We’ll be right there.” With that Nick hung up and rushed out the door.
He drove quickly to the main house to find Victoria had already gone and decided to meet her at the hospital. Wasting no time, he raced out the door and to the hospital.

Numb, Nikki tried to ignore her stomach lurching and forced her wobbly legs to carry her forward, back to the waiting room.

Back in the waiting room unaware of just how much pain Nikki was in, just what it took for her to tell her children even a little bit about what had happened, Casey stood in front of the window, staring out it blankly at the night sky.
Exhausted, Nikki shuffled in and towards the couch without a word.

“Nikki.” Casey called her name softly, unable to keep the concern from her voice. “Nikki.” She tried again.
Still, Nikki gave no indication she’d heard her as she walked to the couch and slumped onto it.
“Nikki, talk to me, what’s wrong?” Casey asked, her concern growing.
“What’s wrong? What’s wrong? I have to tell my children their father may die! How do I do that? How do I do that Casey? Everybody just walks around like it’s business as usual while my world’s crumbling down around me and there’s not a damn thing I can do about it!” Nikki shot out furious, indignant at her sister’s seemingly nonchalant and aloof attitude where Victor’s situation was concerned!
“Nikki, you can’t do this! You can’t get all worked up like this. It’s no good for you, or the twins. And it’s not going to do Victor any good!” Casey countered, finding it increasingly difficult to be patient with her sister.
“Then by all means, tell me what I’m supposed to do! Tell me, since you’ve got all the answers! What am I supposed to do; sit here and put on a show for everybody! Sorry, Casey show’s over!” Nikki bit out, still seething, completely uninterested in keeping the bitter fury out of her voice.

“Damn it Nikki! I’m on your side! I’m not trying to tell you what to do! I’m trying to keep you from selfdestructing! You’re not going to do anybody any good if you end up in here for exhaustion! Think about your family! Your kids need you! I thought you understood that!” Casey exclaimed, finally starting to lose her patience.
“What I understand is that you’re just like everybody else! You expect me to just sit here and wait, grin and bear it! Newsflash, Casey, I can’t do that! I can’t just shut my feelings on and off like some light switch! I’m not you!”
“Fine, have it your way!” With that, Casey stormed out and headed to her office.

Chapter Eighteen
“Damn it!” Nikki snapped as she slammed her purse down on the table. “Why did I do that? Why did I go of on her like that?!”
Still silently scolding herself sternly, Nikki went back to her research. “Right now, this is the best thing I can do-for everybody.”
“Stroke Risk Factors: “Risk factors you can do something about include: high blood pressure(hypertension), high blood cholesterol, smoking, diabetes, being overweight, physical inactivity, excessive alcohol consumption and stress.”

“What is High Blood pressure–Also known as hypertension, high blood pressure happens when the force of blood pushing against artery walls as blood gets pumped out of the heart, is extremely high. High blood pressure is the number one risk factor for stroke and a major risk factor for heat disease, so it’s extremely important that it’s properly controlled. Over time, high blood pressure can narrow and eventually block arteries. It also strains the heart and eventually makes it weaker. Extremely high blood pressure can also make blood vessels in the brain burst.
Hypertension affects one out of every five Canadians. It’s the number one risk factor stroke and a major risk factor for heart disease, so it’s extremely important that it’s properly controlled. But, forty-two percent of Canadians with high blood pressure don’t even know they have it. You can’t see it, or feel it. But the good news is it can be controlled.

How it causes heart disease and stroke–Over time high blood pressure can damage blood vessel walls resulting in scaring which promotes the build-up of fatty plaque, which can narrow and eventually block arteries. It also puts a strain on the heart and eventually weakens it. Extremely high blood pressure can cause blood vessels in the brain to rupture–causing a stroke.”

As her fists clenched tight on top of the binder, Nikki rasped, “Damn it, Victor! Why didn’t you just stay put? Why couldn’t you do that, for once? Now, who knows how much damage your stubborn pride has done!”

Trying to ignore the rage building within her, Nikki shook her head and continued on. “Reduce your pressure. Reduce your Risk–With proper diagnosis and treatment of high blood pressure, people can cut their risk of stroke by up to forty percent and heart attack by up to twenty-five percent.
Tips to get your blood pressure in check include: Because high blood pressure has no symptoms, individuals should have their blood pressure checked at least once every two years by a healthcare professional. If patients have been told they have high-normal blood pressure, Canadian guidelines recommend they have their blood pressure checked at least once a year. Lead a healthy lifestyle. Eat a balanced diet, be physically active and smoke free, and reduce salt and alcohol intake to help lower blood pressure. Achieve and maintain a healthy weight. Even a modest weight reduction–as little as ten percent– can dramatically lower an individual’s chances of having a heart attack or stroke. Set aside some time daily to relax. Stress can make blood pressure rise–in short term, at least. If a patient’s blood pressure is high, he or she should talk to his or her doctor regarding drinking alcohol. Discuss blood pressure monitoring with your doctor.”
“This explains a lot! Between the stress at work, his diet and exercise, this was bound to happen! Damn it, Victor, how could you be so careless!”

Nikki felt the familiar rage bubbling up inside her once again but bludgeoned it and read on. “Cholesterol, heart disease and stroke–High blood cholesterol is a major risk factor for heart disease and stroke. By lowering your cholesterol, you can dramatically reduce your risk of heart disease and stroke.
High cholesterol may lead to a buildup of plaque in the artery walls and narrow arteries –called atherosclerosis– which can make it more difficult for blood to flow through the heart and body, putting patients at higher risk of circulatory problems, heart disease and stroke.”

“Victor had to have known this, he had to at least known some of this! Why didn’t he listen? If he had-” Nikki stopped herself short and reminded herself sternly, “That isn’t going to do anybody any good!”

Taking a deep breath and trying to relax, Nikki continued. “Ten ways to get your cholesterol in check– Test your cholesterol. Ask your doctor to check it if: You’re male and over forty, you are female and over fifty or post-menopausal. Check it if You have heart disease, stroke, diabetes or high blood pressure, of your waist measures more than one-hundred-two centimetres or forty inches for men or eighty-eight centimetres or forty inches for women, or if you have a family history of heart disease or stroke. Avoid trans fats which are often found in foods made with shortening or partially hydrogenated vegetable oil, hard margarines, fast foods and lots of pre-made foods. These raise bad cholesterol and lower good cholesterol. Cut down your fat intake to twenty to thirty-five percent of your daily calories.”

Slumping back onto the couch, her head resting on the top edge, Nikki whispered bitterly, angrily, “All those nights we had ice cream for a midnight snack sure didn’t help matters! Why did I eat that stuff, why? If I hadn’t, maybe this wouldn’t be happening!” But, as much as she tried to ignore it, a little voice inside her whispered, “Because you didn’t know. You didn’t know anything because, as usual, Victor didn’t tell you anything! As usual, you husband kept it from you because he didn’t think it was important, or he was trying to protect you! Either way, it wasn’t your fault!”

Shaking her head, she bludgeoned the voice and read on. “Choose healthy fats such as polyunsaturated and monounsaturated, found mainly in vegetable oils, nuts and fish. Limit your intake of saturated fat; found mostly in red meat and high-fat dairy products. Eat more whole grains, cereals, vegetables and fruit. Snack wisely. Choose low-salt pretzels, plain popcorn or fruit, rather than higher-fat or ‘junk food’ types of snacks. Use lower-fat cooking methods like baking, broiling or steaming and try to keep away from fried food. Be smoke-free. Smoking increases LDL ‘bad cholesterol.’ Get physically Active. Being physically active most days of the week can improve “good” cholesterol levels.”
“I can just see his face if I gave him plain popcorn or low-salt pretzels, let alone anything low fat!” Nikki thought to herself aloud with a hint of a smile.

Meanwhile, on the quiet roads of the outskirts of town, Vicki was barrelling towards the hospital. ‘Damn it, Dad! What happened? What in God’s name could’ve happened? What’s going on and why won’t Mom tell me anything? Why didn’t she come home and why didn’t she call before now? Why didn’t you just come home? Why?’ Vicki thought to herself furious as she held the steering wheel in a death grip.

Nick stayed close behind her, careful not to lose sight of her as he tried to keep his speed reasonable. “Vicki, what’s wrong with you? You’re driving like a maniac! What’s going on with you? Are you trying to get yourself killed?” He mumbled as he kept a close eye on her as she swerved right and left, taking corners and turns entirely too quickly.

Back at Memorial, Nikki sat exactly where she had been for the past few hours, intensely absorbed in her research. “Heart disease (Arterial Fibrillation)–Heart disease is a major risk factor for stroke. Individuals with heart disease are twice as likely to have a stroke as those without it. Arterial fibrillation is a kind of heart problem called arrhythmia. This is when the heart’s electrical system which controls the heartbeat doesn’t function correctly–making the heart beat at fast, irregular intervals. This can cause blood clots to form, which may lead to stroke. Arterial fibrillation affects about two-hundred-thousand to two-hundred-fifty-thousand Canadians and approximately six percent of individuals sixty-five and over have arterial fibrillation. It’s estimated that as much as fifteen percent of all strokes are caused by arterial fibrillation. Arterial fribrilation may be caused by high blood pressure, a family history of arterial fibrillation, heart disease, a congenital abnormality, can happen after heart surgery, or can be caused by another disease like a thyroid condition.

Warning Signs: Symptoms–Treating arterial fibrillation aids in stroke prevention. That’s why it’s critical to recognize the symptoms so you can get treatment if you need it. Although some individuals don’t have any symptoms, others feel an irregularity right away. If you experience these symptoms, see your doctor to find out the cause and whether or not treatment is needed: racing, uncomfortable heartbeat, ‘flopping’ feeling in your chest, dizziness, sweating and chest pain or pressure, difficulty catching your breath, feeling weak.”
“He must’ve been terrified when he realised what was going on,” Nikki thought to herself aloud as she thought about Victor having had a heart attack before she finally found him and tried to suppress a shudder.

Stoically, she continued. “Risk Factors Continued: Being overweight–If you’ve been struggling with your weight, you aren’t alone. Almost sixty percent of Canadian adults are either overweight or obese; which is a growing concern since it’s a significant risk factor for heart disease and stroke. By achieving and maintaining a healthy weight you can significantly reduce your risk of heart disease and stroke and control other conditions like high blood pressure, high blood cholesterol and diabetes. However, with our busy lives, it’s not always easy to find the time to eat right and be active. To help you get started, here’s an easy plan.

Assess yourself–Waist circumference- Measuring your waist is the fastest and easiest way to see if your shape is putting your health at risk. Individuals who carry extra weight around the middle(apple shape) versus around the hips (pear shaped) are at higher risk of health problems including high blood pressure, high blood cholesterol, diabetes and heart disease. Generally, men with a waist circumference of thirty-five inches or eighty eight centimetres or more are at higher risk and women with a waist circumference of thirty-five inches or eighty-eight centimetres or more are at greater risk.”
“I need to get checked out just to make sure I’m okay.” Nikki told herself, making a mental note to talk to her doctor.

Trying her best to clear her head, she went on. “BMI–Another way of finding out if your weight falls within a healthy range is to consult something called the Body Mass index (BMI). This is a ratio of height and weight, which allows for a range of weights to be associated with good health versus only one ideal weight. Find out whether weight is putting you at risk for obesity related diseases such as high blood pressure, high cholesterol, diabetes and heart disease and stroke.

Eat right–When it comes to diet, variety is crucial. Try a variety of nutritious foods, ones that can help prevent disease and taste great.”

Fighting exhaustion, she continued. “Get active– There are many important reasons for making physical activity part of daily life. It’s a great way to keep a healthy diet going, to reduce high blood pressure, lower blood cholesterol levels, manage stress and decrease your risk of heart disease and stroke. Tips to maintain a healthy weight–Eat a healthy diet and be physically active. Lose weight slowly. Achieving a healthy weight is a long-term commitment. Avoid fad diets. Eat a diet that’s lower in saturated and trans fats and includes fresh vegetables and fruit, complex carbohydrates and foods higher in fibre. Use less fats in cooking. Bake, broil. steam, boil, microwave or barbeque food. Manage portion size. Divide the plate into for sections, fill three quarters with grains and vegetables and fill the last quarter with meat or meat alternatives. If overeating is you means of coping with stress, identify where your stress is coming from and learn new ways to cope.”

“Excessive alcohol consumption–Although alcohol–particularly red wine–is good for your heart, drinking too much of any kind of alcohol can increase blood pressure and contribute to the development of heart disease and stroke. While there is some evidence that individuals who drink moderately have a somewhat lower risk of heart disease and stroke than those who don’t drink or drink excessively, if you really want to have an impact on your heart health you’re better off eating a healthy diet, being physically active most days of the week and becoming smoke-free. If you drink alcohol, limit yourself to one or two standard drinks per day, to weekly maximum of nine for women and fourteen for men. One drink is equal to: three-hundred-forty-one milliletres or twelve ounces (one bottle) of regular strength beer; one-hundred-forty-two milliletres or five ounces of wine; forty-three milliletres or one-and-one-half ounces of spirits.
Moderate your alcohol intake– Discuss the risks of drinking alcohol with your doctor. If you have high blood pressure, limit your alcohol use and/or talk to your doctor regarding alcohol. If you don’t drink, don’t start. If you do drink, wait a minimum of an hour between drinks and alternate alcoholic drinks with water or juice. Avoid excessive drinking or getting drunk. Guidelines don’t apply if you have liver disease, mental illness; are taking certain medications, have a personal or family history of drinking problems or cancer, are pregnant, attempting to get pregnant or breastfeeding, or are told not to drink for legal, medical or other reasons. If you have concerns regarding how drinking may affect your health, consult your doctor.”
“Drinking as much tequila and brandy or whiskey as he has been the last few days and weeks can’t have helped!” Nikki muttered to herself frustrated before refocusing on her research.

“Physical inactivity–Individuals who aren’t physically active have twice the risk for heart disease and stroke. Active living is critical to maintaining good heart health throughout your life. Whether it’s gardening, walking or running, being active means something different to everybody-but everything counts.
Make it part of your life–There are many important reasons to make physical activity part of your life. It’s a great way to maintain a healthy weight, reduce high blood pressure, lower cholesterol levels, manage stress and cut your risk of heart disease and stroke. It can also help prevent or control diabetes. It’s not even necessary to have an intense workout to get the healthy benefits. As little as thirty minutes most days of the week is all it takes to start–and everything counts, even gardening, housework or dancing with your kids.”
Nikki smiled as she thought of her twins. “Maybe you can help me keep Daddy healthy? What do you think?” She asked with a small smile. After a moment or two, she felt a swift, strong kick and smiled once again. “We’ve got a deal then.”
Feeling somewhat better knowing there were some things she could do to help Victor get back to normal, she finished. “Then, slowly work your way up to sixty minutes.”

On the third floor, Casey sat in her office, still fuming over the argument she’d had with her sister. “Why doesn’t she get it? I’m only trying to help her! She’s driving herself crazy with all that stuff. Why does she insist on doing everything on her own? She’s got to realize she’s not some superwoman! She needs to take help when it’s offered!”
Reconsidering, she continued thoughtfully, “She is under a lot of stress and she definitely brings new meaning to the phrase stress does strange things to people, but she can’t go around biting everybody’s head off, including mine! She needs to realize she can’t do everything on her own all the time! She can’t do that if she wants to have a smooth pregnancy, which I’m getting the feeling she’s not!”
Heaving a tired sigh, Casey decided, “I’ll finish up signing off on these charts and go back downstairs to talk to her. If she’s calm enough to have a mature, calm, adult conversation, I’ll talk to her, I might even stay with her–otherwise I’m out of here!”

*

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