Monday, March 3, 2014

Here's an update from my mom:

Because our Minnesota winter is lasting far too long, Geoff and I decided to leave. We
are now in Costa Rica with our daughter Maggie and son-in-law Victor for three months.
We picked a great winter to leave, it sounds like!

Our first week here, Geoff began every day by announcing: “Eighty degrees and sunny,
AGAIN!” It really is wonderful to be here, and the change in environment and weather
help keep Geoff motivated to work hard.

When Maggie and Victor were out running one day, they passed a little heated therapy
pool just eight blocks away. It was almost too good to be true! There are actually about 6
big pools within a mile of our apartment, but this one is small and warm and private.
Victor has learned Geoff’s pool exercises and has even thought of new ones. He and
Geoff go nearly every day and work for an hour at a time. Geoff feels that his
movements in the water pay off on land. Especially, he feels it in his knee control.

But that’s not all--
Several months ago -- as we mentioned in our last blog entry, Geoff’s wonderful speech
therapist back home suggested they try and keep up their speech sessions over Skype
(or similar program) while we are gone. Apparently our health insurance company had
never done this before and initially said no. We appealed it, which required a lot of
hurdles and paperwork and meetings (for our therapist, that is). One of the hurdles
even required her to be listed as a registered speech therapist in Costa Rica! In the
end, amazingly, it was all approved, and Geoff is once again the trail blazer.
This has been a HUGE plus for us. Geoff is on a good recovery path with his speech,
and even though it feels painstakingly slow, it is continuing steadily and really, he has
never had a lull with it. We didn’t want to have to stop therapy while we were here, and
now we don’t have to. Geoff continues to meet with his ST four days/week, just like he
did in Monte.

One thing (among so many) that we have learned about stroke recovery, is that you
have to fight for every improvement. There is not much that is re-learned “passively,”
which is I guess what I was hoping for at first. It seems that if you do not actively work
at it, probably it won’t happen. So, being able to continue with therapy down here is a
very important aspect of our being here.

Geoff is continuing to read I Am Malala, just completed Matilda (a less challenging read
but easier to follow), and spends a lot of time browsing various newspapers on his iPad.
(I remember at one year after his stroke, he first began reading newspaper headlines --
just the headlines -- although I don’t really know how much of them he understood.) He
also spends time on a website that allows him to read AND listen to stories at the same
time. It’s helpful to get this double input, and to work on his listening skills. Listening
and following conversations -- catching all of the sounds and words -- is a lot of work but
is also slowly improving.

We take lots of walks, and have found our favorite coffee shop two blocks away that
roasts its own coffee beans. We also go on lots of picnics, and next week we’ll be
driving to the beach for the weekend and staying at a motel surrounded by monkeys.
We’ve seen several movies since being here, all of them with Spanish subtitles.
Interestingly, Geoff can usually follow the Spanish when he sees it on the screen, or at
least get the gist of it. (He used to be fluent in Spanish.)

Many family members either have or will be visiting us while here -- we feel really
fortunate!

I’m adding some photos: one of the therapy pool, another of Geoff doing his daily
speech therapy over the internet, and another of our apartment for those wondering
where we are...




Tuesday, January 7, 2014

2014 update!






Happy new year, everyone.  

It's refreshing to step forward into the new year with the anticipation of new goals and challenges that lie ahead, but I believe it's just as valuable to stop and evaluate the accomplishments and achievements from the past year.  My dad has come to realize, more than ever, that goals involve time, commitment, and patience.  Oftentimes they are not concrete or immediate; they're a process.  

And here are some of the most recent, significant advances and accomplishments in his healing process.

He continues to work diligently on his speech, attending speech therapy 3-4 times a week and music therapy 2 days a week.  My dad is focusing primarily on forming complete sentences, really sharpening his grammar skills, and successfully piecing together words and ideas.  He's focusing on active and passive sentences and verb conjugations.  Besides structured therapy every week, he is also plugging away at speech-based learning programs and grammar exercises.  And we like to have conversations together that force him to really think about full sentences and grammar structure.  Speech continues to be his greatest challenge and primary focus.

He's been reading a couple of literary pieces, he just got I Am Malala for his birthday, which should be a difficult but rewarding read, as well as D-Day, a World-War II era book that he's working on for a while now.  This not only helps his information-processing skills but his critical reading and general concentration as well.

My parents will be flying to Chicago this weekend for a second evaluation with Northwestern University, where he is involved in a research study on syntax.  He recently finished up a summer of occupational and physical therapy at the Courage Center in the Twin Cities.  Both he (and the rest of the family) were very impressed and pleased both with the incredible staff as well as the results of the therapy program.

On the side, he continues to work on recuperating finer muscle movement in his arm, hands, and fingers; he uses the Tailwind arm exercising machine, exercise stretch bands, cowbells, and the occasional Wii workout in the living room.

The exciting news is that both my mom and dad will be flying down to Costa Rica at the end of the month for an extended vacation in Central America!  They're excited to swap the snow and cold for some sunshine and palm trees; the warm weather will make physical exercise, like the long walks my dad likes to take, easier and much more enjoyable.  The change of scenery will be a refreshing and a much needed respite but will also give my dad a new chance to really dig into therapy in a new environment.  My dad's absolutely fantastic speech therapist here in Montevideo has also figured out how to continue her speech therapy sessions with my dad via skype during his time abroad, which will allow my dad to continue to really plug away at speech despite his absence.  My husband, Victor, and I are more than excited to have them in Costa Rica with us so that we can drag them along on lots of wild adventures.

Coming home and spending time with my dad really gives me a chance to see the improvements and accomplishments that have taking place during my absence.  These 3-4 month periods of not seeing him give a clearer picture of what he's been focusing on and the areas where he's been improving the most.  It frustrating for my dad because the simple act of responding to a question or making a general statement, something we normally do so effortlessly, is a difficult, conscience action on my dad's part that requires thought and deliberation.  It is so impressive to see his deliberate effort to find the words and form a perfect sentence.  Despite it being much easier to just continue to use words or short phrases to convey his ideas, he's disciplining himself, slowing down and taking the time to challenge himself to form a full statement through complex sentences.  But it's not just the fact that he forces himself to do this, it's his ability to make the sentences come out RIGHT, an incredible feat!

The process continues; his invaluable discipline, patience, and determination show through with every new day of healing.

-- Maggie

Friday, September 27, 2013

September Update.


An update from my mom:

It’s been a long time since we’ve posted on here!

 Last spring, we decided it had been a long time since Geoff had gone to formal physical and occupational therapy sessions. (Although of course he exercises on his own.) We thought it would be helpful to meet with therapists again, so we looked into Courage Center in Minneapolis. It turned out to be a perfect fit! He started going every Thursday and Friday in June, and will probably continue until the snow comes. (It’s a 3-hour drive for us.) Geoff’s therapists there are fantastic, and they love working with him because he works so hard and is able to put into practice a lot of what they are working on.

His PT is enjoying breaking apart his gait and tackling one muscle group at a time. She is trying to get him to lift his hip higher when he walks and work at controlling his knee so it doesn’t snap back so much. He can do these things when he really concentrates now, which is great, but when he’s doing his normal walking there are so many other things for his brain to think about, that it’s hard to incorporate everything. His OT is working at quieting his larger and far stronger shoulder muscle group on his right side so that his smaller, very weak muscles further down his arm have a chance to figure things out and learn to work again. She is designing exercises that help him with this. All of this requires building up new paths in the brain, not just reviving old ones. Building new paths takes a lot of time: not just months, but years.

Probably the most exciting new event is that Geoff has been accepted into a pretty amazing new speech study through Northwestern University in Chicago. They want participants who have regained a lot of vocabulary words, but who still struggle to put them into sentences. He will be doing this about 4 hours/week. It involves massive amounts of testing every three months -- testing his speech, brain activity through MRI’s, and eye-tracking (which is quite fascinating). We just spent a week in Chicago getting to know the research team and undergoing the preliminary tests, and hope to get started with the therapy next week.

 We are nearly done with Rosetta Stone 1, but will probably put off starting 2 until after this research study is complete, in about six months. 

Other speech items that Geoff is hitting hard these days: numbers, prepositions, question words (Who? What? How? etc.), and verb tenses. Again, it’s not a simple matter of “waking up” those language memories, or a quick language lesson. It’s learning them again hundreds and even thousands of times, before the new paths in the brain finally “set.”

 Rebuilding the brain is slow, hard work, but we are finding that it does happen.

"But let endurance have its perfect work, that you may be perfect and complete, lacking in nothing. " --James 1:4

Wednesday, April 10, 2013


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

Sunday, February 24, 2013

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.

Wednesday, January 9, 2013

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!





Wednesday, November 7, 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.