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

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!