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Archive for the 'Stroke' Category

Recovered from a Stroke: Part IV

Tuesday, January 3rd, 2012

I suppose I have had enough time to collect my thoughts about my stroke. Although my motto has been, “Never look back,” I think this might be an exception to the rule. I have had an experience that I am trying not to have affect my life, but I did bring a few articles out of the experience.

I experienced aphasia. After teaching about it for 30 years or so, I finally now know first hand the frustration that accompanies it.

Surgery left me suffering from echolalia, the inability to originate speech but only repeat what I heard. Broca’s and Wernicke’s areas are located in the left hemisphere, the hemisphere affected by my stroke. They control what I call ‘morphemes’ and ‘lexemes’, respectively in my morphological theory, Lexeme-Morpheme Base Morphology. Morphemes are what others call ‘functioin words’ plus affixes; lexemes are the stems of words.

The test for area of the brain is whether I recalled the grammatical morpheme (or just ‘morphemes’ in my lexeme-morpheme based theory). I tried to say the personal pronouns—they were there. I next tried using the verbal suffixes, -s, -ing, and -ed and, if I tried, I could find them and express them. The stroke was a first-hand, up-close test of my theory. I was out of the theoretical realm and in the clinical.

I could still use idioms, ‘climbing the wall’, ‘left holding the bag’, ‘fly off the handle’ for they are stored in the right hemisphere, which was unaffected either by my bleed or by surgery. But I couldn’t construct sentences from their parts, lexemes and morphemes. Slowly but surely this ability returned to me. I was lucky.

Second, it seemed that many more people cared for me than I had imagined. I’m a recluse, sitting behind my computer monitor seven days a week. I know more people around the world than in Lewisburg. My lovely wife of 50 years, Faye, was there throughout each and every day with me and some nights. But I was impressed by the visits from friends, neighbors, and employees. Sometimes five or six at the time. It was wonderful.

Finally, it struck me how much a human being knows and how much we lose each time one dies. Although I was never near death (that I know of), I gave it a lot of thought. I try to write out much of what I know and publish it at alphadictionary.com. But I carry so much more in my head. Some are trivial, passwords, accounts, how to pay bills, when the house needs painting, the gutters need cleaning, and so on and so forth. But others are insights that I have accumulated, examined, sorted, and stored over the course of my life. I shudder to think how many that might be.

But other things are not written down: my knowledge of politics, philosophy, economics, literature, art, and music. I taught a course on these subjects as pertain to the old USSR. I actually workied my way through high school and college playing jazz piano, right when jazz was turning into rock and roll. My wife keeps urging me to write the editor of the local newpaper about my views of US politics and economics. I’m writing at a desk that I built after coming up from a kitchen I designed (twice) and built.

I guess I could sum up the experience by saying that it heightened my appreciation of myself, my body and mind, and those of others.

Recovered from a Stroke, Part III

Monday, November 7th, 2011

Sorry to have waited so long for Part III. There will be one more part about what I took away from the experience. I hope I can get around to it more quickly than this.

My physical, occupational, and speech therapy took place at HealthSouth on the Geisinger campus. The physical therapy applied to my right leg while the occupational therapy, to my right arm. The physical and occupational therapy didn’t frighten me; the speech therapy worried me. I had little knowledge of transcortical aphasia, and really had less knowledge of what the therapy did.

I only knew of cases where there had been severe in irreparable damage to the left hemisphere. I was banking on the fact that there had been no damage done to my left hemisphere, but who knows?

Speech therapy turned out to be conceptual, semantic therapy.  There were math problems, such as toting up my checkbook register. I was also presented with puzzles such as we see in newspapers: what is missing from this picture, can you show me the X in that picure, what is out of place in this picture.

I could not write at the beginning, could not sign my name. We had to carry out the payroll through PayPal. Jeffrey attended to that. But after a month with Lisa and Cathy my writing began to improve materially.

I also began walking, though not without the help of a piece of duct tape on my right shoe toe. My right foot was still dragging, so the tape helped me slide it along.

Then a funny thing happened. A blood clot was discovered in my leg and I was sent back to Geisinger Medical Center. There they discovered several small clots in my lungs and put me on a blood thinner. It took five days to get the blood thinner up to acceptable levels.

The strange thing was, while I could not walk unassisted before I left HealthSouth, the second day back at Geisinger, I could–without further physical therapy.  (The use of a couple of my fingers also returned.)

This was comforting news, for it confirmed the idea that there had been no damage to my left hemisphere and, after the swelling caused by the surgery subsided, I would return to my normal state. The next question was:  how much of my normal state would I recover?

Well, to make a long story short, I am now fully recovered. I tried a little outpatient therapy but saw no reason to continue it so long as it was a matter of my brain healing. I forgot a few words that I knew, but then I remember a few I had had difficulty recalling before my surgery. My ability to touch type is back to normal and I’m playing the piano again. Though I forgot a few passages, I don’t know if that was caused by my “bleed” or simply by not practicing for three months.

Apparently, Dr. Darren Jacobs had done an excellent job. Everyone at HealthSouth were wonderful, especially Faith Mummey, who woke me every morning with her laughter. This is not to derogate from the entire staff who attended me cheerfully and efficiently. I only knew their first names and as the memories of my 73 years comes flooding back, I’m afraid they have washed them all away.

Recovered from a Stroke, Part II

Thursday, October 20th, 2011

I woke up–I don’t know when–to discover that my entire right side was paralyzed. This was much worse than I thought it would be. I was encouraged by the surgeon’s Physician’s Assistant attempts to calm me by saying that most of the paralysis would desist when the natural swelling of the brain, caused by the operation, went down.

I then discovered myself to be suffering from transcortical aphasia, a speech disorder whose main symptom is echolalia, the limitation of speech to repeating what others said to me.  I was really worried by this but kept telling myself at least I was alive and could only get better.

After about 5 days I was transferred to HealthSouth rehabilitation facility on the campus of Geisinger Medical Center. I could not move even my thumb on my right arm nor any part of my right leg.

When my occupational therapist, Bobbi, told me that she wanted to see me give her the thumbs up when she left in the middle of the following week, it seemed to me an impossibility. (But by then, I could do it, though I had little other mobility in my right arm.)

My physical therapist immediately made me walk by holding a hand rail that ran along the wall and dragging my right foot along with my left. I couldn’t see recovery beyond being able to walk with some kind of support.

I had little success originally with my speech therapists, Lisa and Kathy, for I could only repeat what they said. I had checked my grammar, located in Broca’s area, by rehearsing in memory grammatical function words like of, is, was, the. So I knew they were there and the possibility of speaking normally again was there. I could also recall quite a few words, just not utter them.

My wife started planning ahead: talking about getting a walker, a wheel chair and my younger son, Owen, the architect and contractor, planned to visit from Denver once I came home, so that he could build banisters for the steps and make the house more amenable to a c ripple.

My older son Jeff came early in my rehabilitation and bought me a portable DVD player so that I wouldn’t have to watch commercial TV. That was a boon. I watched 2-3 movies a day (we have about 100 of my favorites) from that point to my release. Jeffrey also took control of Lexiteria, answering the important e-mail, while Andrew Shaffer (Lexiteria) reran a series of only past Good Words and kept the website up and running.

My lovely wife, Faye, was there every day. She even slept over the first night, since there was no one in the other bed.  She drove 25 miles to Geisinger in the mornings and 25 miles back in the evening.

Dawn Shawley (office and translation manager) and Brian Hilkert (accounts manager) ran the translations. Dawn kept up the work with our major customers, Volvo CE, John Wiley,  and Geisinger Research Center, working with Brian to get out the POs, invoices, and payments.

I also had a plethora of friends visiting me. They were a reservoir of hope and strength. Two or three at least visited me every day, most were from Lexiteria and Congregation Beth El (of which we are “honorary” members), but also by neighbors, volunteers from the Union County Democratic Committee (on which my wife serves), and casual friends, one of whom visited wearing a leg cast. A very, very deep reservoir of hope and strength.

Recovered from a Stroke, Part I

Monday, October 17th, 2011

I am now feeling like my old self (as I best remember me–my memory still has not fully recovered) and feel I should first write about my experience.

Sunday I noticed a weakening in my pinky and ring finger on my right hand. I paid little attention to it because I could adjust for it by hitting the keys a little harder. Monday morning I noticed my right foot was dragging as I did my morning walk. I quickly put two and two together and my wife, Faye, drove me immediately to the emergency room at Evangelical Hospital in Lewisburg.

Now, I knew from teaching neurolinguistcs that hemispheres of the brain control the opposite sides of the body. Since I was having trouble with my right side, I knew that the problem lay in the left hemisphere. Now, here is the rub: the left hemisphere also controls language, both syntax and vocabulary. I was alarmed that I might lose control of my language skills (well, if you want to call them skills).

The CT scan at Evangelical Hospital showed a large “bleed” in the left hemisphere. It was stable, in fact, this one had been preceded by a more ancient one. I was placed in an ambulance and taken to Geisinger Medical Center, about 25 miles away, where there were neurosurgeons.

The subdural hematoma was confirmed there and surgery was scheduled for the next morning: the bleed seemed to be stable.  Early the next morning I was wheeled into the operating room and quickly went to sleep.