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.  :)

I thought you might like to see how much my Dad's writing has improved.  A week after his stroke, he tried to write something. But all he could write were a bunch of W's and E's which of course, didn't make sense.

This is how he is writing today.  He was describing the fruit bowl.

Hi everyone! This is Rose, now taking over the blog. My dad has been making
such progress, and I thought we should share.

My dad has been working out at Snap Fitness 2-4 times a week. He works on his
right arm and especially on his leg. He goes on the elliptical, pulls weights with both
arms and now he is able to go on the bike machine without the use of his brace, which is GREAT! Recently he proved to my mom that his ankle was getting stronger by taking of
his brace and turning in circles. Today he even started to tap his foot! He also has been working on mirror therapy with his hand, specifically trying to move a single finger at a time. This week, for the first time, he managed to twitch one finger a tiny bit! He also works his arm by punching a punching bag that now stands in the middle of our living room. The movement in his shoulder keeps getting stronger (as
does his punches!).

My dad continues working on reading out loud; now he is reading Cowboy Sam and the Rodeo. Speaking full sentences is still very tough, but more often now he is able to speak short sentences. At speech therapy he is beginning to work on question words like who, what, where, etc. It’s hard for him to keep them straight, but he is slowly getting better at it.

We had a busy Christmas, flying down to Costa Rica on Christmas morning for my sister’s wedding. My sister was married a few days later in a little outdoor ceremony. My dad walked her down the aisle. Of course it made every one teary. So did his speech, which he gave at her reception. My mom wrote it for him, based on his general ideas, and he had been practicing it for three months. It was about 30 seconds long, and he read it perfectly- not one mistake! My mom had lots of little diagrams and pictures above the different words, such as the position his mouth needed to be in for certain sounds, or other words that began with the same sound.

We enjoyed the sunshine and beautiful flowers and a tram ride through a rain forest while we were there.

Now Dad is back in therapy again, working harder than ever. His energy level has really picked up these last few months, and he can work a lot harder for longer periods now. He finished reading his first whole book out loud. He chose an old children’s book we have: Cowboy Sam. It is 63 pages long, and it took him several weeks to read it (out loud). He would read an average of 5 pages/day, a few days a week. It was really hard work for him, but it got easier as it went. Next read aloud projects: Cowboy Sam and Freddy.

At speech therapy, Dad is spending a lot of time working on blended consonants (sk, st, etc.) and small words (it, is, in, his, her, etc). Small words seem to be the most difficult because they are more abstract. When he can visualize a picture in his mind to go with the word, he can say it much more easily.

We pull out lots of worksheets for him to do at home. He is working on 6th grade reading comprehension skills (with quizzes; he almost always gets 6 or 7 out of 8 correct.).

He is also working more at writing. Writing single words is often quite easy, but putting those words into sentences is very difficult. His words get mixed up and often words that don’t really belong in the sentence sneak in there, throwing off the entire meaning. We challenge him by emailing him questions, such as: “List two adjectives that describe President Lincoln” or harder ones such as “Do you think NATO was right to intervene in Libya?” (We like to challenge his thinking, too!) Even friends of Dad’s are getting into this form of therapy with him. This is hard work for my Dad, and he usually waits a few days before trying to answer.

Not all writing is difficult, however. He did a good job writing up a list of chores for Rose and I to do, organizing them into daily, weekly, and monthly.

Dad is finally at a point where he can work at picking up a plastic cone with his right hand from a pile, lifting it up, and putting it into a new pile about a foot away. He can do about 10 cones now, but two weeks ago, he could do only 5.