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 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.   

Funeral program

Last night after a BSU banquet, when I took off my suit, I found this in my pocket: Mom's funeral program. I haven't worn that suit since my mom's funeral almost 2 years ago. Sad

Monday, September 15, 2014

Stroke, possibilities and friendship!

Great article about two women who had strokes! It reaffirms that friendship and possibilities are endless!

Sunday, September 7, 2014

Strokes: Is my recovery resignation or acceptance?

I went to a stroke support group this week and it was enlightening.

I have been going to that support group often on since my stroke 2 3/4 years ago. There are the "regulars." They are wonderful stroke survivors, and I have gotten to know them pretty well.

This week was different. The “regulars” (as I call them) shared their stories. However several new stroke survivors and their caregivers shared their compelling stories.

A woman in her mid-40s seems very normal. For the outside world, she seems "just fine" because of her outward appearance.

But after the meeting we talked about recovery possibilities and limitations. We both know how people treat us differently since our strokes. Because we look fine, people assume our recovery is complete. We are NOT complete. Until you have a stroke (or two like me!), people just cannot understand the emotions we go through in our daily lives.

Another new stroke survivor shared his emotional story. He is very successful and an alpha male. Like me, he was “in charge,” a leader and accomplished in every way.

However, since his stroke, the emotional toll he is experiencing is similar to mine.   He is just getting used to his “new normal.” He needs help just to do basic life skills. You feel like you are less of a man in many ways. You never needed any help at all, and, out of the blue, you cannot do anything alone.

Two other recent stroke survivors, talked about their limitations and their depression.

The roads they are going on are difficult. Their journey is just starting and they had no idea their life would take this awful difficult turn. I'm grateful that my strokes are behind me even though I know I will never be the same. 

But I've had almost 3 years to deal with the aftermath. The most recent stroke survivors are still dealing with the question of “why me?" Their anger is raw, palpable and understandable.

I'm not sure when I turned the corner realizing that I had to accept my strokes and get on with life.  Is my emotional recovery after my strokes resignation or acceptance?   Is there a difference?   

I am hopeful that I can help with these recent stroke survivors. They are “survivors,” but they just don't know it yet.