In this section you will find my blog posts relating to Ladan. For the story of what befell Ladan in 2004/2005 
I have wanted to write an update about Ladan, but it has been hard to decide what to write with a varied audience. Currently Ladan is in a stable condition not disimilar to that which she has previously been in when she has been stable before. In December Ladan was subjected to a hospital stay following an asthma attack with the possible complication of a chest infection, hospital stays are always fairly traumatic, this time Ladan was admitted following a day of notable improvement but her improvement was slowed by the stopping of all food and medicine while the hospital doctors assessed the situation, on each of the three admissions to hospital that Ladan has had for potential infections over the years there has been a deteroraton in this early stage, which is very worrying when Ladan is admitted while she has been improving, retrospectively it is generally agreed that the last two hospital stays might have been avoided by simply continuing with the prescribed course of action in the nursing home. It did not help that I had popped out when a doctor visited last time and so family observations and formal information relating to improvement in her chest were not communicated to the GP effectively. When Ladan is not well we try to be with her all the time, and when Ladan is in hospital where they do not know her at all this becoes even more important. Even after nearly 3 years in the nursing home most of the staff would be unable to distinguish between the different reactions that Ladan has to various forms of distress, and so for hospital staff who have never even seen Ladan in a relaxed and stable state the task of recognizing her needs is virtually impossible, at least in the nursing home most of the nurses will recognize if Ladan is particularly distressed and can then try to take an educated guess as to why. I never feel particularly comfortable being sat on a female ward all night long, even with the curtains pulled around. We spent the last part of our stay on a very friendly and efficient ward at the Freeman Hospital where, after a few days they managed to find Ladan a cubicle which made life more comfortable.
Although Ladan has remained healthy and stable it took a couple of months for her to return to her best. Meanwhile I am still looking for a flat or bungalow to take Ladan back to (which, although there are plenty of suitable places for sale in todays market, will have to be one already belonging to the council or a housing association for now), when we do that Ladan will be able to have a much better, personalised, environment and level of care, and things will hopefully also be much easier for the rest of the family for the most part too.
During the aforementioned hospital stay I was not able to get Internet access to update the blog (Facebook worked in a simple form), I am now set up to write articles from my phone (this is the first one I am doing this way) so that I will be able to update the blog under such circumstances.
The Zolpidem Question
October 12, 2007 in Comment, Ladan | 1 comment
I have previously mentioned that there were no dramatic results from using the medication with Ladan, but that there may have been some small changes. A full update should follow in the next week or two, but this entry is to explain the delay in reporting how I feel the trial went, and to give some indication of what happened during the trial. In this blog entry I am not going to differentiate between what was observed by staff and what was observed by family members.
Zolpidem is a short acting drug, it usually starts acting within 15 to 30 minutes and stops working after a few hours. About 15 minutes after the drug was administered Ladan would typically go through a period of increased rapid eye movements for a period of around 10 – 30 seconds, with her eyes closed, and then seem generally sleepy. She remained arousable by movement or speech, but was not generally as agitated when aroused. Ladan often has quite normal reflexes which are superseded by extensive behaviour (stretching out her arms and legs) if she remains disturbed or uncomfortable for a “prolonged” period. That “prolonged” period may be a matter of seconds, but can often be avoided if you react to the non-extensive reaction and remove the stimulation, or otherwise relax Ladan, soon enough. During the course of the medication Ladan was found to be generally less extensive and her reflexes appeared to be slightly better refined. Ladan’s individual fingers were, for example, felt to react better as individual fingers when touched rather than as a collection of fingers reacting together. There were also times when people felt Ladan was more alert or aware than usual, and that her reactions to speech were more natural. Most of the the possible differences that were observed were not new, but were either more frequent or, as in the case of being more relaxed and less extensive, more prolonged.
One of the more notable facts about most of the observations referred to above is that these “differences” were being observed throughout the whole time period of the trial, that is to say they were not limited to the few hours during which the drug would typically have an impact, the “difference” was still being noticed at least 21 hours after the drug had been given. I have three possible explanations for this, firstly it is possible that some of the “differences” were seen because they were being looked for, secondly I theorize that some part of the mind was put to rest by the tablet and that this enabled better reactions when the resting effect wore off (this would require a medical opinion, which I hope to get soon), my third explanation is that I was personally present more of the time. I have previously mentioned in blog entries that there appears to be a direct link between how settled Ladan is and how much time I spend with her. Many previous times where Ladan has seemed to be more aware have also followed on from an increased presence from myself. As I was arriving to be with Ladan from an hour to an hour and a half earlier each day and not popping out as often it is likely that at least some of the improvement would be down to this, rather than the medication.
So, following the two week trial Ladan had a week of how things were previously, and now I am trying to spend extra time with Ladan for a week to see what effect that has. It has so far proved difficult to spend the extra time with Ladan, so to get a farier comparative picture this might stretch on a little beyond one week. Once I have a better idea of the difference between “Ladan with more James” and “Ladan with Zolpidem and more James” I will be writing up a report on the differences for the relevant medical staff to look at. There is a small possibility that they will feel the medication may be worth trying for a longer time period, but otherwise there are other things that have had significant results on people in conditions similar to Ladan’s which I hope to research further and, if appropriate, discuss with Ladan’s doctor.