Friday, December 12, 2014

Stroke survivors and rehab

I was on the news this week about strokes and rehab. Though I am a private guy, I was asked to share my strokes story because my goal is to help other stroke survivors and their love ones and give them hope. 

Here's the segment:

Thursday, December 11, 2014

Great article about aphasia

Why Some Stroke Survivors Struggle With Communication
From Health Day April 15, 2013
MONDAY, April 15 (HealthDay News)  

A shift of language function to the right side of the brain hampers some stroke survivors from recovering their ability to read, write and to say what they mean, a new study indicates.

The inability to do these things is called aphasia, and is caused by damage to the parts of the brain that control language.

The study included 27 right-handed adults who survived a stroke in the left side of their brain. Those who recovered from aphasia showed a return to normal patterns of having language function on the left side of the brain, according to the findings in the current issue of the journal Restorative Neurology and Neuroscience.

“Overall, approximately 30 percent of patients with stroke suffer from various types of aphasia, with this deficit most common in stroke with left middle cerebral artery territory damage,” lead investigator Dr. Jerzy Szaflarski, of the departments of neurology at the University of Alabama and University of Cincinnati Academic Health Center, said in a journal news release.

“Some of the affected patients recover to a certain degree in the months and years following the stroke. The recovery process is [affected] by several known factors, but the degree of the contribution of brain areas unaffected by stroke to the recovery process is less clear,” Szaflarski explained.

The findings provide new insight and may help lead to improved language rehabilitation methods for stroke survivors, according to the researchers.
The study authors noted that a shift of language function to the right side of the brain can help aphasia recovery in children who have suffered a left-hemisphere injury or stroke. But this type of shift in adults may hamper recovery, because they rely on the left side of brain for maintaining and recovering language ability.

Friday, December 5, 2014

Talking Heads, "Blame Canada," and time is an asterisk

The lyrics from the song “Once In A Lifetime” includes the refrain “Same As It Ever Was” by the Talking Heads. I think of the song often when I realize that our son is getting older. He is almost 10 year’s old but he thinks he is older than his actual age. He wants to do so many “adult” things like driving fast expensive cars, have a great career just to buy “stuff,” and to buy a huge mansion. He talks about "his kids" as well. No mention of a spouse yet! 

He is planning his life without a clue about what life entails.

I let him wander in his hopes and dreams though we try to make sure that he is grounded in reality. I do not want to shatter his dreams but he need to be realistic about life, expectations, and limits. We caution him to know that money and success are not what life really should be about. Being a good kid when you are 10 years old will make you successful throughout your life: spiritually, financially, physically, and emotionally.

But he still eagerly dreams about life which is a good thing. Like the song says,

And you may find yourself in another part of the world
And you may find yourself behind the wheel of a large automobile
And you may find yourself in a beautiful house, with a beautiful wife
And you may ask yourself-Well...How did I get here?

On the other hand, I hope the subsequent lyrics will not hold through in his life:

And you may ask yourself
What is that beautiful house?
And you may ask yourself
Where does that highway go?
And you may ask yourself
Am I right?...Am I wrong?
And you may tell yourself
MY GOD!...WHAT HAVE I DONE?

For now, I treasure our son and his numerous quirks, sayings, and funny outbursts like these:  

Listening to my son and his friend Hayden, they were discussing college. When they room together in a dorm, Hayden wants to have the top bunk. Ethan said, "Dang it! It will smell too bad when you are above me.”

He also thinks they will live in the “domes” rather than the “dorms.” His standard answer when we correct him: “Whatever dude.” And then he giggles.

The good news, Ethan believes he will spend six years in college including graduate school. "You have to have a Master’s degree to get a Lamborghini Gallardo! Or a Hummer. Maybe both. But Dad, if you gave me a smart car for my first car I would have to blow it up. Just saying.”

Chanting during a swimming lesson, Ethan told me “Dad. When you are diving, the trick is to be one with the water. Hmmmm.”

On one of the rare occasions when the whole family goes to the movie theater, Ethan whispered to me saying, “We need to take tape when Mom's goes to the show. She never stops talking! She does not get 'silence your cell phone.' Sheesh!”

Last fall, he was excited that a meteor shower might be visible. However, he said, “Dad. I hope the meteor shower will miss our backyard, won’t destroy the house, my room and my Xbox.”

Ethan likes to listen to hip-hop music. I like some of it also. However, I am trying to broaden his musical horizons making him listen to classic rock songs sometimes when we drive. The other day, we were listening to “Why Can't We Be Friends” by the band War. He said to me, “Dad! That is a catchy tune. I really like it. Oh NO! What is wrong with me?”

On another drive, he repeated something, and I said, “You already told me about that.” He laughed, and said, “Dad. I have the Saxton gene! I repeat myself, a talk very loud, and talk a lot!” “The Saxton Gene” refers to his mom whose maiden name is “Saxton.”

I usually say very irreverent – sarcastic is a harsh word – just to rile up Ethan. His new tactic when I do this is sighing and saying “Dad. You are so sad in so many different ways.”

Our son likes his Xbox. We monitor his on-line activities a lot.  We make sure that his on-line friends are the same age, we have a lot restrictions about privacy, etc. Recently, he told me that he “unfriended" a boy. I said, “I thought you like that kid.” He said, “Dad. That kid is very annoying. He is Canadian. He has a weird accent. And he yodels. A lot. I cannot concentrate on my game because he his a Canadian yodeler.”

Ethan wants a husky dog. I said,  “That will never happen. They are too big and they shed too much. Our lifestyle will not allow that kind of dog."   He said, but, the blue eyes are so adorable.” I said that I have blue eyes too. Ethan responded, "Really Dad.  You’re eyes are ugly NOT adorable like mine.”

At a restaurant, background music was a disco song called “Good Times.” Ethan asked if the singer was Michael Jackson. I said, “No, the singer was a woman and Michael Jackson was a man and he died several years ago.”  Ethan said, “Well, she sounds like a dead Michael Jackson.”

Trying to get our son ready for a basketball practice, he would not hurry. Irritated, I said, “Why do you challenge me all of the time!” He laughed and said, “In Mom’s belly, I was warm and comfortable. I did not want to be disturbed. So, I was born difficult!”  

The Catholic Church owns a house across the street from us. The Bishop retired, and a new Idaho Catholic Bishop will be installed in December.  We have no kids in our neighborhood, and our son is often lonely as a result.  Whenever a house goes up for sale in our neighborhood, he hopes to find a boy the same age as him. When I told him that the Bishop will be leaving the neighborhood, he excitedly said, “I hope the new Bishop will have a boy or two!” I said, “Hmmm…Well….a new Catholic Bishop is a priest. No kids. Understand?” “Oh,” he said, “I got it now. Oops. Nevermind. I keep trying!"
 
At the dinner table, our family was laughing. I said something cynical, and my wife said, “You are grounded!”  Ethan retorted, “Mom! You cannot ground Dad because he's old. Really old!”

Out of the blue, Ethan said, “Dad. I am a gun nut. Guns and ammo. Deal with it.”

At a family dinner with relatives, we were discussing different foods. I said, “I really like split pea soup.” Ethan said, “Dad. You are disgusting. You are officially on my unfriend list now.”

Getting ready for bed, Ethan said, “Dad, I am multi-tasking: brushing my teeth and petting my dog. I am very talented.”

Yes he is. I hope he will continue to have such a life force. I will miss him when he grows up. I just want to enjoy this precious moments.  He will be gone before we know it.

Same as it ever was...
Same as it ever was...
Same as it ever was...
Look where my hand was 
Time isn't holding up 
Time is an asterisk 
Same as it ever was...

Monday, November 17, 2014

The Sounds of my Blog Being Silenced and "What's Up Doc?"


I am a very private person. However, a blog is very public especially when you write things about yourself that might uncomfortable. Talking about depression should not be uncomfortable but it usually is. 

In my mind, "Depression" is a dirty secret that people do not talk about. Especially, me. 

However, I have been trying to use my blog to educate people about stroke. Warts and all. "Stroke" is not pretty. Depression is not pretty. 

I try to do my blog every week; however, I have not done it for many weeks because I have been very depressed.  "Depression" is common when you have strokes.

About 6 weeks ago, I was startled when I realized “this is basically it for my life.” Sure, I get better every day, but I will NEVER be back to what I was before. That is a shattering realization for me. Despite brain scans and doctors, I just assumed I would “back.” There is no going back for me. This is it.

Even though I have never really liked Simon & Garfunkel, their sad song -- Sounds of Silence -- is apropos for me right now in many ways.

“Hello darkness, my old friend,
I've come to talk with you again, Because a vision softly creeping, Left its seeds while I was sleeping, And the vision that was planted in my brain Still remains Within the sound of silence.”

My blog has been silenced.

Even though I know depression is common after strokes, I did not think I needed any help. “Anti-depressants” are for weak people. I remember my parents saying that people you need anti-depressants were crazy and pathetic.

Intellectually, I am smarter than this. I do realize that people need help. But, I just assumed that, even after my having strokes and seizures, I was strong to need any help. “Buck up” was one of my motto's.

One of my favorite movies is “What's Up, Doc?” is a 1972 screwball comedy  starring Barbra StreisandRyan O'Neal, and Madeline Kahn. In the movie, Streisand’s father is a judge who is exasperated and tired. In a funny scene, the judge talks to his bailiff:  

Judge Maxwell: You see this yellow pill?




Bailiff: Yes sir.

Judge Maxwell: You know what it's for?

Bailiff: What, Judge?

Judge Maxwell: To remind me to take this BLUE pill!

Bailiff: What's the blue one for, Judge?

Judge Maxwell: I don't know. They're afraid to tell me."

Even though this is comical scene, is resonates for me. I do not like to take pills. On the other hand, I have no choice. Because of strokes and seizures, I have no other option: Take pills or die.

That should be an easy decision, but it not really when you are so depressed that you do not think there is any hope or relief.

I talked with my neurologist about my depression. My wife encouraged me to talk to her. I realize I need “something.” My family needs something to combat “me” and my depression.

My neurologist was somewhat surprised that I have not sought help sooner. She said, “When a devastating brain incident happens, depression is expected.  You are not weak. You are human and need help.”

She prescribed Zoloft.

Another pill I have to take…..

There is the definition:
“Zoloft (sertraline) is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Sertraline affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms. Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, and post-traumatic stress disorder (PTSD).”
When I try to research medications, I get concerned about the side effects.
I was amazed that a side effect for Zoloft is to have “slightly improved verbal fluency but did not affect word learning, short-term memoryvigilanceflicker fusion time, choice reaction timememory span, or psychomotor coordination.  Memory, attention and alertness stayed unchanged. Divided attention was improved and verbal memory under interference conditions decreased marginally. Because of the large number of measures taken, it is possible that these changes were still due to chance. The unique effect of sertraline on dopaminergicneurotransmission may be related to these effects on cognition and vigilance.”
Since I started taking Zoloft, I have noticed that my speech is more fluid. When I do my vision therapy two times a week, my verbal memory and divided attention is getting noticeably better.  My therapist has noticed also. Who knew that the side effects would help me!
The stigma of taking anti-depressants pills for me is still a concern. However, I need to take them. My realistic and wonderful wife said this to me: "Anti-depressants will not make you happy. They will make me not be sad."

Hope so.

Monday, October 13, 2014

"Jesus Christ Superstar" and strokes

Last week I attended the Permanent Building Fund Advisory Council in behalf of the College of Western Idaho where I am a trustee. I came early to listen to several higher education intuitions present their building needs and wishes.

I know 4 of the 5 council members and many of their staffers. Before the meeting, many people shook my hand saying “It is great to see you!”

One person said, “You are completely normal. You are back! Good for you!”

I laughed and said, “I was ‘never’ normal, but, seriously, I will never be the same again.  20% of my brain is dead, and I have residual issues that will never get better. It is what it is. It could be worse.”

My statement was met with stunned silence and then a uncomfortable “Wow! But you seem so normal today.”

I said, “This is my new normal. I have issues that people do not even know about, but that is OK. I just try to live my life every day like it would be my last day.”

Today at my latest therapy session, I recounted that story. I said, “I feel that I am a broken record. People believe my recovery is complete because I look "fine." I am not.” My therapist said, “I should canned story like ‘I am getting consistently better and I am still working on some problems so I do therapy.'”

I feel almost ungrateful for my recovery. 

However, it has been almost three years since those strokes. I have no physical pain like some stroke survivors’, but the emotional toll resonates everyday.

One of my favorite movie musical is “Jesus Christ Superstar.” Perhaps my favorite song is Gethsemane (I Only Want To Say)” where Jesus pleads with his father (“God”) not make him be crucified.  It is a tragic song about loss, devastation, and exhaustion.

After my stroke, I listened to that song over and over. Though the context is different, this lyric echos in my mind because of what I have been through:

“Then I was inspired, now I'm sad and tired
Listen, surely I've exceeded expectations
Tried for three years, seems like thirty
Could you ask as much from any other man?”

Amost “three years” of living, tears, therapy, and, yes, thankfulness for my life. I am happy but sad. Grateful but disheartened. Joyful for my family but trying to disguise depression.

If I had to describe one word about “me” today, it would be “family.” When I get depressed, feel lost, and despondent, I look at my son. I look at my wife. I think of my family.   It makes everything worthwhile. 

Tuesday, September 30, 2014

Two hospital in one day all because of my strokes....



On Wednesday afternoon, September 24, 2014, I attended the Saint Alphonsus Rehabilitation Center rededication.   The hospital remodeled the rehabilitation spaces, and it was about a $1,000,000 project. At the dedication, it was announced that it is now called a “Center” rather than just a part of the hospital located on the hospital's 3-West and 4-West floors.

It was odd for me to go to the celebration. Throughout my career, I have gone to hundreds of ceremonies like this dedication. I saw people at the dedication who I have known for years. It seemed like I was “there” just because I support so many causes. “Great! Mark Dunham is at the dedication! Of course, he is there because that is what he does to support the community.”

I chatted with many people, I ate wonderful hors d'oeuvres, talked with political junkie’s about the upcoming elections, and took a tour of the new remoldeled facilities like the therapy room, the nurses stations, the rooms, and the “Easy Street” where brain injury patients practice for everyday tasks. 

It was bizarre for me. I almost forgot that I was “here” as a patient not too long ago. I almost imagined I was “here” supporting the hospital in a official capacity like my role as a Board member at the College of Western Idaho or the American Heart and Stroke Association. Many people at the celebration knew I had strokes. However, many people did not. They assumed I was there to support the program as a public figure.

However, reality galvanizes my memory when I see my old room, Room 3447, where I thought my life was over. I could not even walk the hallway alone without a nurse beside me just in case I would fall.

On Easy Street, I could not recognize an apple or a orange. "Orange" was the worst: A color and a fruit! 

Saint Alphonsus has a wonderful Stroke Rehabilitation program. From their website:

Welcome to the Inpatient Stroke Rehabilitation Program at Saint Alphonsus Regional Medical Center (SARMC). We are located on the hospital's 3-West floor. The Stroke Program at SARMC has a highly experienced, skilled team of therapists specializing in assisting people recover from cerebrovascular accidents, also known as strokes.

The consequences of a stroke may cross the entire spectrum of medical, physical, cognitive, behavioral, emotional and psychological problems. Because of this, SARMC provides a team of rehabilitation professionals who have specialized training in the treatment of individuals who have survived a stroke.

The Stroke Program at SARMC places a high priority on helping the patient and family deal with the effects of a cerebrovascular accident. Both the patient and the family are key members of the rehabilitation team and assist in goal setting and discharge planning. The team works together in a collaborative manner to meet the needs of each patient and family.

At the celebration, I talked to several therapists who helped me through those dark days. I talked to the doctor who oversaw my overall care. He patted me on my back saying “Wow! You look great!” I chitchatted with the nurse who I saw that first awful day with I was rushed to the hospital in an ambulance.

We laughed. It has been less than three years. 

Even now, “this” is horrifying to me: “I had two strokes less than three years ago.”

It is ironic that the same morning, September 24, 2014, I attended a Aphasia Support Group at St. Lukes. I met two new participants who had strokes and have the obligatory aphasia, apraxia, and dysarthria. 

I asked one woman if she could communicate via email. She said, “No because I cannot read. However, my husband helps. Here is his email.”

The problem, because of my strokes and aphasia, I still cannot hand-write at all!

We all laughed, and one stroke survivor said something like “It takes six stroke survivors to hand-write and copy a simple email address.”

In one day, two meetings, and two different hospitals, the truth of my life was so stark. I celebrate my recovery but I cannot do a simple task like writing a note.

The mockery of my life. 

Saturday, September 20, 2014

Strokes and our son

Mark and Ethan Dunham, January 21, 2012
The other day, I talked to my son about my strokes two and a half years ago. Now that he is 9 (going on 20 it seems), I asked him about his reaction when I had my strokes.

He was 6 when it happened.

I did remember falling in the family room, and he and his mom woke up startled. He said he was half asleep but he does remember yelling “call 911!”

After that, it was “kinda of a blur.” He said he was not scared though he hated the hospital.  “The smells were weird.”

Mark and Ethan Dunham, January 21, 2012
I asked him if my speech issues (I really could not talk at all) made him feel uncomfortable. “Not really,” he said. However, in realty, he did not talk to me much for a year.  He avoided me. When I would try to watch cartoons with him (a favorite pastime before the strokes), he stiffened.

One night in the hospital, my wife told me on a lonely Saturday night, “Get up, get dressed, and do NOT wear sweats. Our son needs to see you normal. Have the room very bright, and be standing up when we get into your room.”

I did all of that. I rehearsed my “speech” over and over. “Hey Buddy! How’s it going.” Over and over.  The fact that I, in my head, I could say “Ethan and Heather” was OK. However, I simply could not pronounce names and words at all. I really could not "feel" my right arm...my phantom arm. 

Mark and  Heather Dunham, January 21, 2012
That night was surreal. It was like an out of body experience. We took pictures to document that evening. 

What will happen to my family? I did not really care about what would happen to me. Just them.

When my family left, I wept.

The day a got out of the hospital was on our son’s 7th birthday. At the restaurant to celebrate his birthday and my release, I was so scared. When my son helped me to the restroom, I was even more sad. I assumed I was just a mental cripple.

From a CEO to a man who’s 7 year old son had to help me to tie my shoes.

Now, he does not remember those specific evenings. Perhaps that is his way of NOT remembering an awful time in our lives.

Now that he is 9 years old and in the Fourth Grade, sometimes he seems so melancholy. He has had to grow up too soon. 

Because of me.