(La Jolla, CA-- March 2016)

It’s been about a year, so an update is definitely due!

It’s been another year of continued hard work and gains for Geoff, with some unexpected surprises as well.  As Geoff often reminds me, “It’s a long, long journey,” but when you have some solid gains it makes the journey feel a little easier.  

It has been six years, but it feels like two.  Time kind of stopped six years ago for us;  things move on around us, our children are growing up, but we are still in this unworldly zone of stroke recovery.

About 10 months ago, Geoff said he finally felt the fog lift.  It was a heavy fog that just sat there in his mind, kind of like he was viewing life from behind a curtain.  Once the fog lifted, he suddenly felt a clarity he hadn’t known since pre-stroke.  He felt ready to begin cautiously re-entering life again.

And so he did.  He began working on expanding the bike trail in our area again, something that had been a big part of his life pre-stroke.  With some help of family and good friends (for the communication aspect), he began brainstorming over trail ideas and re-igniting community support as well as support from local government officials.

He was also part of a fascinating speech study at the University of South Carolina Medical Center in Charleston, South Carolina.  It involved mild electrical stimulation on the head adjacent to the damaged area of the brain at the same time as doing a unique speech therapy.  Geoff did this nearly every day for a month.  It was a double blind study, so we don’t know if Geoff actually had the electric stimulation or not (either way, the machine vibrates and makes a noise, so you can’t tell), but he feels that the difference he began experiencing during the second half of the study was remarkable.  He felt much more able to concentrate in the moment on the words he was trying to produce and using the proper syntax.  There are always so many things to think about in the moment, that it can be overwhelming for Geoff — (What should the subject be? Is the verb past or present or future?  Do I need a helping verb? What subject pronoun should I use? and on and on).  All of this still requires very conscious, intentional thinking, but during the study, Geoff felt all of this come with less effort.  Maybe it was just a coincidence, or maybe not.

Since then, we continue to plug away at all aspects of language.  When a different area other than the typical language area of the brain is trying to learn language, it is a slow and tedious process.  My understanding is that there is no pre-set language neural network in other areas of the brain, so he is not just learning a new language, but he has to first create the networks that will enable him to learn and then permanently hold the language.  As someone has described this, it’s like creating a track on a hard dirt road with a bike.  After going over the road a few times, you probably will see barely any marks left at all.  You have to go over it and over it and over it, probably thousands of times, before it is an actual permanent trail.

So, when Geoff is learning some aspect of language, he may understand just a bit of it, and then maybe we’ll move on to something else.  When we come back around to it again, he may “get” a little more of it this time.  Six months later he gets a little more of it still.  It is baffling to Geoff that this process is so slow and stubborn.  At the same time, it was very exciting last month when after working with diagraming sentences, Geoff suddenly had a clearer understanding of it all in a way he hadn’t earlier, even though of course we have been working on it all along.  “This is fascinating,” he said, shaking his head at the wonder of English grammar.

Janet

Happy Spring!

Hello, friends!

My dad wanted to update everyone with a video on what he's been up to lately. Something he's been working on a lot in speech therapy is the structure of sentences, and creating full paragraphs-- so we thought this would be a cool way to continue that therapy, as well as share with you all the progress and healing he's been making!

Thanks for all continued support, and happy spring!

Geoff Hathaway: Christmas greeting

Hello one and all,

Hope you're all doing well and enjoying the happy bustle and excitement of the holiday season.

We wanted to share this brief video update Geoff put together sharing the challenges of living with aphasia and what the recovery process has been like.  He thought this would be a neat way to give some unique insight into the communicative challenges he faces as well as keep you all updated on his continued healing.

Happy holidays to everyone!

Here's an update from my mother:

It's been awhile since I've updated our blog!

It seems like for a long time, we have simply been working very hard, making good but s-l-o-w progress. So, not a lot of new news to talk about. Recently, however, I feel like we have turned some kind of a corner.

Geoff's speech has progressed to a level where instead of us completely directing his therapy, his brain is starting to "get it" enough to ask questions himself. Like, what do you use in place of "a" when you're talking about two or more things? And, why would you say "This is Geoff Hathaway" when talking on the phone, instead of "I am Geoff Hathaway."

His mind is searching for logic and rules as he re-learns the English language, but we are learning that English doesn't always abide by its rules. This is actually exciting to see though, because it means his brain is starting to take charge, trying to figure things out on its own.

And in the midst of all this, the real Geoff Hathaway (not just a part of his brain), will often laugh at how ridiculous this all seems, that he has to ask questions such as this, and learn everything again.

He spends time everyday doing things like re-memorizing irregular past tense verbs. And learning sounds again.

As it turns out, he was not hearing sounds. He could hear the whole word, but not the sounds within it. If I asked him if the "m" sound was in the word "immune," he couldn't tell you. He couldn't decipher the sounds.

So, we are backing up a bit and working on individual sounds and how to move his mouth to make them. And, how to hear them. This is something his wonderful therapist worked with him on a long time ago, but he could not connect with this exercise at all back then. Now, he can. So every day, we drill through the sounds, how to move his mouth, how to hear them, how to say a word slowly so that he can pull the sounds out of it. It's coming along. Pretty amazing.

The other day, he had a lesson in fruit. How some have "pits" and some have "seeds." And how within the category of apples, there are many types: Golden Delicious, McIntosh, etc. I'm not sure why this all made such an impression on him, but it did. He said it was like opening a distant, fuzzy memory. It was clicking.

As Geoff's language improves and he can better attach his complex thoughts onto something tangible like words, I have the unique and spectacular advantage of seeing Geoff's amazing mind reveal itself, again.


"I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well." Psalm 139:14



-Janet

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...

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

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!

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.

Mom and Dad over Thanksgiving weekend.

<--- Dad doing his "mirror therapy"

It's been a long time since I updated my Dad's blog! Now that we're back home,
things just seem busier!

Dad is doing great back in Monte. He goes to speech 4 days/week, and PT and OT
2 days/week. He was first set for just two-months' worth of PT and OT, but has been doing so well that it has been extended- hopefully for another two months.

In OT, he is slowly working his way down his arm: beginning with his shoulder, then
his upper arm, and now concentrating on his lower arm. Progress seems to keep
happening, and he works real hard on this at home too- doing "rowing" exercises (a rowing movement mid-air), weight-bearing, e-stim on his wrist and fingers. It's cool because for a long time he was able to do the arm movements only in the pool therapy when supported by water. Now, he is able to do a lot of
them in the air, unsupported!

In PT, his therapist is really concentrating hard on his ham string and hip-flexor. It's still difficult for him to lift his leg. His therapist is great and very imaginative, and is trying all sorts of things to get that movement to kick-in. The therapist is also working with Dad on swinging his arm while walking. Even though he is getting a lot of movement with his arm, it doesn't swing freely while he walks.

Tonight for one of the first times, he was able to go up on his toes. That was exciting! He is also doing "mirror therapy" now. This is done by doing movements into the mirror with your good leg and arm, and trying to trick your brain into thinking that the reflection is the affected limb. Sometimes, this can actually initiate new paths in the brain to really move those limbs. My dad tries to do this for an hour each day. Dad's therapist did warn us,however, that since he is so smart, it may be hard to trick his brain.

In speech, his therapist is working mainly on apraxia drills. Dad has learned a
"key word" for almost every sound now (Maggie for the "mm" sound, key for "k," cheese for "ch", etc.), and is slowly able to sound out words. He is working at reading two-syllable words and short sentences out loud. He picked out one of our children's books the other day, and for the first time was able to read part of it out loud. His brain gets real tired doing this, but he has been able to read 12 pages at a sitting. At night, he is slowly making his way through Hemingway's "Farewell to Arms" before he goes to sleep. My brother thought this was one he could tackle, since the sentences are quite short. He reads this silently, not out loud. He is about halfway done!

Many people have commented on how much improvement my dad has made with his speech. Sometimes it's harder for us to tell, since we are with him every day. But other people notice a lot of changes. It's so wonderful, and we are encouraged by every little improvement he makes!

Happy Thanksgiving!

My dad with his siblings and mother in October.