Much Overdue Update

It's been far too long since my last post. Life has become more complicated for me in the last several weeks; Matt H. and I are both fully immersed in new jobs and finding our way around our new home in Rhode Island. But of course, lots has been happening with Dad.

A few weeks ago, he rejoined the choir at Pine Ridge Baptist. They've already started working on their Christmas music, and Dad greatly enjoys his biweekly sessions with his choir friends. Apparently stroke survivors dealing with aphasia frequently benefit from being involved with music, and so Mom and Dad are thinking of his time with the choir as not just a source of pleasure, but also a form of therapy.

He continues to go to the outpatient rehab center three days a week for speech and occupational therapy, and just this week, he has started seeing a physical therapist in Nashville. While he ended his outpatient physical therapy several weeks ago -- he regained his balance and basic mobility very quickly -- he still needs a little work in the areas of stretching, toning, and enhanced range of joint motion. Anyone who knows Dad will also know that he's not exactly the most flexible person around! His joints, especially his knees, have given him trouble for years -- basically as long as I can remember, he's said he has "bad knees." Meanwhile, he continues to have some weakness in his right index finger. His therapists, though, have said they expect it to return to 99% of its original strength over time.

Whenever Dad thinks about returning to life as usual, and doing things he loves like turning bowls, he's faced with the present reality of a puny right pointer. But at the same time, his attitude throughout this entire experience has been amazing and, without fail, upbeat. And so he seems a bit philosophical about it all -- turning and other sorts of fine motor work will come back eventually. And in the meantime, he'll mow grass. (There's been lots of grass, what with all the rain.) And watch Law and Order.

Last weekend Mom and Dad attended one of their favorite annual church events at Pine Ridge, Homecoming. I was not surprised to hear that Dad indulged in a large wedge of his very favorite Homecoming dessert, Maple Nut Chiffon Cake.

Just today he's had an opportunity to give back a little in the caregiver department and minister to Mom, who had a routine colonoscopy in Raleigh. Thanks to Dominee for shuttling Mom and Dad to and from the hospital!

I'm heading home for a long weekend on Saturday morning; I can't wait to see how things are in Pine Ridge.

Aphasia Day

Yesterday I had an opportunity to attend Dad's weekly group therapy session for aphasia patients. I confess that when I first heard that part of dad's outpatient rehab would involve these weekly gatherings, I was seriously dubious. Dad's just not a group therapy sort of person! I couldn't imagine him participating in a break out session, or a small group exercise, or anything of the sort.

But fortunately, my doubts have turned out to be altogether incorrect. Dad really seems to enjoy spending time with the patients in the group, and has developed an excellent rapport with the group leader, a very dynamic and charasmatic speech therapist named Maura Silverman. Most of the patients deal with much more serious impediments than Dad faces. Most -- but not all -- of the patients have suffered strokes, but all have had some sort of brain injury. Some of them struggle with apraxia (another speech function disorder) in addition to aphasia, others have significant physical challenges, and still others are working to recover everyday functions such as recognizing numbers and letters. And yet despite their many differences, they all seem to genuinely enjoy being in a community of shared goals. I witnessed much laughter, many smiles, and a great deal of mutual affection.

Spending a little time with the group helped me understand just how well Dad is doing, and how amazing it is that he's progressed so far in such a short period of time. Likewise, Dad also seems to have gained an important sense of perspective. About midway through the group session yesterday, he came over to where I was sitting and took a little break. He was more reflective than I once would have imagined possible, and I was so pleased and encouraged to hear his comments about this experience. "These are all good people," he said, "and being with them makes me so thankful to be in the condition I'm in." We talked about the different ways the group members had sustained their injuries -- one young member was invovled in a terrible cycling accident, another member has just recently had a portion of her skull replaced after surviving numerous complications that required her to wear a helmet for several months. And Dad also made an important point: lots of people who suffer brain damage don't make it at all. He seems to be truly grateful to be alive, and that perspective seems to have made a tremendous difference to his outlook.

Next week Mom and Dad are flying back to Rhode Island with me to visit for a few days. Who would have thought 10 weeks ago that he'd be able to make such a long trip? I'm constantly amazed by the speed of his recovery; he's such a strong, resilient person.

And on the 31st of this month, Mom and Dad will celebrate their 45th anniversary. What a wonderful gift to have had all these years together -- and to be able to look ahead to many more to come.

Belated Update

Lots has happened since the last time I posted. Dad's recovery continues at a rapid pace. He has completed the physical therapy portion of rehab, which consists primarily of working to build balance and mobility functions. This is not to say, however, that Dad's completely back to his pre-stroke condition. A bit of weakness in his right leg remains, and he still has a ways to go with recovering his full right hand fine-motor skills. Of course, these are minor impediments that will likely be corrected with time, and it's amazing that he's come so far in just over 10 weeks.

Dad's physical recovery has been so swift, in fact, that he's returned to working in the garden and around the farm, especially on Saturday morning--always the big chore time--when he has help from Lee. Of course, Dad's undaunted approach to work has been essential for returning to this sort of demanding physical activity. Even when faced with a challenge, he just charges ahead and works through it.

Earlier this week he decided it was time to get back to additional everyday activities, namely using his computer. It seems that some of his computing skills disappeared with the stroke, and so he and Mom have arranged to begin weekly private instructional sessions at the Apple store in Raleigh. Apparently the in-store training staff has training in working with stroke survivors, and so Dad and Mom are both very excited to get going with this new adventure.

Another everyday skill he hopes to recover soon is driving. His therapists at the rehab center will begin working towards this goal soon; they have a battery of tests, as well as in-the-center driving exercises, to determine when he's road-ready. Any of you who know Dad will surely appreciate how difficult it's been for him to be only a passenger for this long!

Meanwhile, Mom and Dad have just enjoyed a very long visit from Matt, Elizabeth, Lucy, and Simon, who were able to spend two weeks in Pine Ridge. Matt and Elizabeth provided much help and support around the house and farm, and Mom tells me that Lucy and Simon kept Dad company and made him smile. What better therapy can a grandfather get?

Mom is doing really well. Of course, she has gained tremendous strength and support from all the family members who live close by, and from the wonderful community at Pine Ridge Baptist, and from all her dear friends from Rocky Mount and elsewhere. She's also done some reading that has been very helpful, both in terms of encouraging her through difficult moments, and by helping her understand the nuts and bolts -- medical, physiological, psychological, etc. -- of what happens during a stroke. Two books in particular are Jill Bolte Taylor's My Stroke of Insight and Norman Doidge's The Brain that Changes Itself.

Thanks to all of you who have visited Dad recently. He really seems to thrive on this sort of contact, and any opportunity he can have to engage in conversation, initiate discussion, and just make chit-chat with friends is incredibly helpful.

Progress Report

Yesterday Dad, Mom, and I met with all of Dad's therapists -- speech, physical, and two occupational -- plus the social worker who is coordinating his rehabilitation.  He had just completed his third week in rehab and was due for a progress report.  We were thrilled with the news we got.  

Not surprisingly, his physical recovery is almost perfect:  he tested at 4.5 out of 5 for mobility and balance.  Bette, his PT, is continuing to work on his flexibility as well as fine motor skills in his right hand.  

The area that continues to challenge Dad the most is definitely speech; we are learning, more and more, that "speech therapy" encompasses a tremendously broad area of cognition.  In fact, it's kind of hard to figure out where Occupational Therapy leaves off and Speech Therapy picks up.  For example, sequencing -- or completing the steps for a task in the proper order -- is a speech-based challenge.  Anyway, lately Dad's speech therapist, Kelly, has also started to work more on his reading activities, especially the various levels of comprehension and recall.  

We were especially excited, though, when Kelly told us how much he has improved in the last 3 weeks.  During his first visit, Dad tested about 20% on the battery of tests she administered.  This week, he tested at 75%.  Still some room for improvement, to be sure, but how exciting!

Anecdotally, I've noticed a tremendous improvement in Dad's conversational skills since I last saw him just under 2 weeks ago.  His vocabulary is strong -- yesterday he referred to something as "assinine."  Good one, Jackie.

The folks at the rehab center predict that Dad's outpatient therapy will last 16 weeks altogether -- 13 weeks longer -- at which point they expect that he will be able to function with close to full independence.  This is not to say, of course, that his recovery will cease at that point.  Most stroke patients report change, growth, and improvement one, two, even three years or longer after their strokes.  For now, we're hoping for a continued upward path and steady, regular progress.

Adventures with the Aunts

Yesterday afternoon my Aunt Jean and Uncle George arrived from Tampa; they'll be staying in Pine Ridge for about 10 days. How wonderful of them to come to NC!

Dad had today off from therapy, so this morning, Mom and Dad went to Raleigh with Aunt Jean and Aunt Joyce to see an exhibit of the Dead Sea Scrolls at the North Carolina Museum of Natural Sciences. Afterwards they got takeout from P.F. Changs -- everyone's favorite.

I'm so pleased that Dad's able to make these outings now. He really seems to benefit from being out and about. In fact, he got a little cranky on his day off last week when Mom didn't have anything planned!

Farm and Other Activities

I returned to Pine Ridge on Friday to find Dad in good spirits.  He and Mom had a very busy week, with therapy each day Monday through Thursday.  On Wednesday, they attended their first weekly meeting of TAP (Triangle Aphasia Project), a group that helps patients with aphasia re-engage.  It also offers support to families of the patients.

During the week Dad revisited a couple of his favorite activities:  gardening and puttering around the farm on the Ranger, their all-wheel farm vehicle.  Yesterday the usual Saturday yard chores took up most of the morning, and Dad was able to help me remember how to pilot his crazy Husqvarna zero-turn mower without careening around like a drunk driver.  He also rode herd on everyone, including Lee and Andre, walking around and pointing out spots of grass we might have missed.

Visits from friends and family continue to sustain us all, and of course we are so grateful for the help that everyone is providing.  Mom's cousins Doris and Betty have done an amazing job keeping the garden watered and weeded.  On Thursday night Dad's office staff brought dinner, and Mom reports that everyone had a grand time.

Aunt Jean and Uncle George are arriving from Tampa on Monday afternoon and will stay for two weeks.  Everyone's looking forward to their visit.

This morning Mom is conducting a biscuit-making tutorial for me; it's one of those essential Southern skills I've never have gotten the hang of.  And later on we're going to head out to the Raleigh Farmers Market to buy provisions for our summer veg dinner.  Matt, who had to stay in Princeton working on the last- minute details of his book manuscript this weekend, will no doubt be jealous; the veg dinner with cornbread is one of his favorite Pine Ridge summer rituals.

Big Ed's

Dad is settling in nicely to his routine at home.  He seems very pleased to be able to spend time in his armchair watching his big TV, and TNT has obliged with plenty Law and Order episodes for his viewing pleasure!

On Tuesday of this week Dad began his out-patient therapy schedule in Raleigh with 4 hours of sessions with his OT, PT, and speech therapist.  He had more sessions on Wednesday, and is taking a break today.  Sessions resume tomorrow, and from now on, he'll go for 3 weekly sessions of 3 hours apiece.  He'll also attend one weekly group session for patients dealing with aphasia.

Matt H. and I arrived in Pine Ridge last night to find Mom, Dad, and Eli waiting for us on the front porch.  Dad is in very good spirits and continuing his road to recovery.  We'll be here for the long holiday weekend and are looking forward to spending lots of quality time with both Mom and Dad. Oh--and Eli too, of course.

This morning we piled in the car and drove to Raleigh for breakfast at Big Ed's in City Market, one of Dad's favorite places.  Matt's midwestern culinary sensibilities were piqued by menu items including brains and eggs, roe and eggs, fatback, red eye gravy, and blackstrap molasses for your biscuits.  He elected for the more predictable choice of french toast.