Geoff, On Camera!

Geoff wanted to update his blog himself this time.  This is a short video we took, unrehearsed.

As you may know, Geoff’s language is what was affected the most, and is what he is working hardest on.  Immediately after his stroke, his brain remembered only one word:  you.  Doctors believe that most of his word storage area was wiped away, along with all understanding of how you use words together in order to express an idea (such as in sentences).  Writing, complex reading...also lost.

Since then, he has had approximately 750 hours of structured speech therapy (that includes Music Intonation Therapy, too), plus at least as many hours working on language at home (that includes Rosetta Stone).

He continues to meet with an outstanding speech therapist in our local hospital four days/week -- someone who knew Geoff pre-stroke.  He also meets with someone else in town twice/week who works with him on Music Intonation Therapy.   (Another person who knew Geoff pre-stroke;  one of the advantages of living in a small town!)

At home, we often sing our words so that he continues to build up fluency through music and rhythm.  He does language exercises on his iPad, and we work on Rosetta Stone 5 days/week.  He practices reading columns of difficult words out loud:  words with blended consonants, or that involve complex motor movements.  (Motor planning exercises.)  He reads news sites on his iPad every day (NY Times, BBC News), and interesting books (often children’s abridged versions, which are a little easier to follow).

He has come a long way!!

Janet

February update

There’s much to update on, but I’ll stick with what’s going on right now, here in Costa Rica (where I’m writing this and where we’re visiting family).

It’s great to be able to walk outside again, even on crumbly, uneven sidewalks.  (It beats the ice and snow!)  We went hiking in one of the national forests yesterday, and Geoff was determined to walk the rocky and somewhat steep half-hour trail to the beautiful beach.  It was tough work, especially when it got steep, but he did it (with a shoulder to lean on, just in case).  He also walked the short, maybe half-mile trail out of the park, in soft sand, later in the day.  Soft sand is really difficult to walk on, but he did that too.  And that was all with his somewhat new brace that doesn’t offer quite as much support.

Later in the day, to get out of the heat (over 100 degrees), Geoff decided to cool off in the motel pool.  The last time he was in a pool was over a year ago, and he was very cautious, always leaving one foot on the ground.  This time, without even thinking about it, he swam across the pool.  He said it felt great.  (Granted, it was one-armed, but he seemed to do it quite easily!)

Other things to note:  we attended a church service with Maggie and Victor, which was in Spanish, and Geoff said he was generally able to follow along.  When people ask him a yes or no question in Spanish (as long as it’s not too fast), he can usually answer (with a yes or no).  It’s all interesting given that he had been fluent in Spanish prior to the stroke, and clearly some of that has been retained.

He is currently reading two books on the life of Abe Lincoln (young adult versions, mostly -- where the sentences are a little clearer and shorter), in preparation for the Lincoln movie which we missed in Minnesota but is still playing in Costa Rica.  :)

Lastly, Geoff has been working on more leg exercises lately.  He has not been able to lift his right leg up at all (at a 90 degree angle), except just enough to walk.  He is now able to do that movement when lying on his back.  That is, he can lift his knee almost up to his chest.  He tries to do a multitude of these exercises about every other day, with the hope that some day he’ll be able to do it while standing up.

HAPPY NEW YEAR!

a HAPPY NEW YEAR to all, we're here to ring in 2013 with news of my dad's continued progress.

the music therapy study through Harvard University has recently ended; my mom and Etty accompanied my dad to Boston in mid-December for one last session of testing, study evaluation, and a final MRI scan.  it was an amazing study that truly facilitated my dad's speech and communication progress, he benefited from a GREAT team of doctors and therapists, and although his time with the program is over, he hopes to continue to periodically get in touch with the Harvard team to check continued progress.  although the official study period has ended, my dad continues to use music therapy in daily conversation (with all of us!) in order to work on continued improvement in speech skills and to keep the strategies learned in the program (sentence structure, word pronunciation, etc.) a constant part of his communication.  he will also begin some one-on-one music therapy practice with an instructor in town to continue working on speech skills.

we also have a new arm exerciser in the house!  my dad has decided to put more work into his arm, hand, and finer finger movements.  the machine works on bilateral movement in which both arms move for a certain number of repetitions, eventually increasing the limited movement of his right arm.  he's also able to lift 10-pound weights with his right arm, and he also does various boxing exercises to continue upper-arm strength.

the cold weather has limited my dad's desire to go out for long walks, so he's renewed his gym membership and will continue to work on cardio exercises and leg movement and strengthening with gym equipment.

my dad just finished with an audio listening program that he would listen to approximately 15 minutes a day in order to help strengthen the listening pathways in the brain through various music and nature sound recordings.

in his down time, he enjoys keeping up on global news, both online and by reading TIME Magazine.

X-Mas Photo 2012!

Fall Update

Hello friends, it's been awhile since we last shared my dad's progress with you, and this blog is due for another update.

My dad's days revolve around his continued participation in the music therapy program through Harvard; he spends his morning skyping with his speech therapist in Boston, working on communicating through musical speech intonation, and continues to engage in conversation with us focusing on the speech strategies he has learned.  In a sense, he is re-teaching his brain to form and verbally express ideas, and music therapy is part of the training process, teaching the brain to first come up with ideas, sing them internally, and then repeat full words and sentences externally with specific musical intonation.  It's been a challenging study, but there have been great improvements in his ability to structure full sentences and more accurately express lengthy ideas and thoughts, even delving into more complex words and verb tenses.  Oftentimes, if he is unable to pronounce a given word, quietly humming out the syllables or intonation will allow him to then state the word without a problem.  He is over half-way done with the study.

More and more, he is allowing himself time for hobbies and personal interests.  He enjoys word games such as Words With Friends and Scrabble (and is quite a formidable opponent).  It's interesting to track his brain's healing process; in the months following his stroke, he could only manage two-letter Scrabble words, whereas now he can compete with any one of us.  At nighttime, he reads Huckleberry Finn.  He usually takes up to a month to complete any one book, and he'll usually read the book through twice.

Walking continues to be a great way he can get out and challenge himself, as well as relax; he tries to walk about a mile daily, but can easily walk more, sometimes spending a couple of hours outdoors on walks.  He recently designed a new brace for himself similar to his most recent one, but with extra support under his foot to keep his toes from curling up.  The new brace allows for more ankle movement and flexibility, encouraging him to strengthen and work his leg and foot muscles.  Victor (Maggie's husband) has also begun to work on leg therapy with my dad, strengthening his quadriceps and hip flexors.  He has just recently starting showing huge improvements in leg movement while lying down; our goal is to get the strength training to carry over to when he is standing up.

My dad's thinking and thought processing continues to improve as he works his way through aphasia, and he tells us that he experiences more mental clarity as his healing improves.

We also have a lovely new addition to the family, an Australian Shepherd named Mowgli!  He's an absolute sweetheart, and so far has managed to stay on my dad's good side.

Also, a little peek at my dad's newfound creativity; I'm attaching a photo of Ned, a character he drew with his left-hand the other night at the dinner table.

This summer has been pretty busy for my dad. We have just recently
returned from 2 1/2 weeks in Boston where my Dad was part of a MIT (music
intonation therapy) study with Harvard.

The first half of his time there was spent testing and taking MRI images.  From
looking at the MRI images, they said it looks like my dad's word storage area
had been destroyed, although somehow he still comes up with new words on his own
every day now. 

After the testing, he jumped into learning the MIT technique.  He started learning to
sing his words.  He is supposed to be singing his words as much as possible now
(while tapping his left hand), and apparently it is helpful if we do, too. 

The MIT method will trigger the music part of the brain to help take
over some of the language-related jobs.  It is also supposed to help my dad's
speech flow more smoothly, especially as his vocabulary grows.  

In these last few weeks, my dad would sometimes answer a question with a word in
Spanish instead of English.  Also, when he was Skyping with some of our relatives in Mexico,
he said that he could understand the Spanish, as long as it
was spoken slowly.  (My dad used to be fluent in Spanish, proficient in Arabic and
French, and knew a bit of German, too!)

While in Boston, we did find time to sightsee a little.  My dad really enjoyed touring the State House, where the House and Senate were in session.
We also saw the Museum of Fine Arts, the Duck Tour, and the new Batman
movie.  :)

We're back in Montevideo for awhile, and my dad remains busy.  Part of the MIT
study through Harvard involves Skyping everyday for an hour or more with
someone from the research team at Harvard. 

For Father's Day we got my Dad an Xbox Kinect.  It has sport games on it, but
his favorite is boxing.  He tries to work at it every day now, moving his right
arm.

Since the weather has finally cooled off a little, it makes walking more pleasant for my dad.
 These days he usually walks at least a mile a day, often
two.

My dad has just finished doing a three-week intensive speech program through North Memorial
Hospital.  He went every morning from 9:00 to 12:30.  When he got home, he wasn't
as tired as he used to be, so he usually still had energy to take a walk, go to a
movie, and...do more speech exercises!  The program even gave him homework, which took him
about an hour/day.  The homework involved taking a mix of words and
turning them into sentences, or he was given a category such as 'grocery store'
and then he had to think of five other words that are associated with a grocery store.
Or, he read an article with two missing words per sentence, and then he
had to come up with words that make sense.

He is getting a lot better at doing exercises like the ones he is doing now.  One year ago, he
probably wouldn't have been able to do any of this.

His silent reading is also getting a lot better.  He reads more and more literature
and newspapers, and says it's getting easier.  Currently he is reading the book 'Chitty Chitty Bang Bang' as well as a National Geographic history book that he received on Father's Day.
 He also spends time going to khanacademy.com on his iPad and listening to various lectures.  His
favorites are the ones on astronomy.

Ever since his stroke, he has said he feels so foggy in his head, this makes it difficult for him to concentrate and think clearly.  A few months ago my mother
made a chart so he can rate his fogginess every day.  (His cousin's idea.  :D ) 
Over the last few months (especially this past one) he says that his fogginess has greatly improved.
There isn't really an explanation for this except that he is getting better, as my dad says, "Slowly, but surely!"

Some additional exciting news: My dad has been working on strengthening his leg and ankle, and today he made the change from his big plastic knee-high brace (that he got when he was in the hospital) to a little black ankle brace.  It's worn by volleyball players to prevent  ankle sprains. This is a HUGE difference, because the large brace restricted the use of many muscles, and now since they've been getting stronger, he is able to wear the smaller one which only restricts his ankle. He's not quite used to it and is still figuring out how much he is able to do with it but he wears it in the house and on flat surfaces now. Another plus is now my dad can wear some of his old shoes again.  :)