Wednesday, October 30, 2013

The Addams Family and Ideational Apraxia

I have blogged about apraxia before.  The clinical definition is: Ideational apraxia (IA) is a neurological disorder which explains the loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects in everyday life. Ideational apraxia is a condition in which an individual is unable to plan movement related to an object because he has lost the perception of the object's purpose. Characteristics of this disorder include a disturbance in the idea of sequential organization of voluntary actions.”

When my strokes happened in January, 2012, I was paralyzed in my right arm. My right arm was useless. It came back quickly, but in the hospital, I would look at my right arm and it seemed that it was NOT my arm.  Over and over, I would move that phantom arm because, it did not seem like it was attached to my body.

It was like “Thing” from “The Addams Family.”  A hand with a life of its own.

When I got out of the hospital, right away, I got acupuncture and massage for my right arm. I firmly believe that those unorthodox therapies made a huge difference in my recovery. Sometimes, I need more acupuncture and massage because sometimes my  right arm seems weak. 

Most people do not know that I had paralysis because I look “normal” but, in the night, when I lay wrong – “my arm is asleep” – I jump out of bed because I think that stroke will happen again. Then I settle down, and realize it nothing.  

However, there are still residual issues. Months ago, I could not put on my right sock in the right way. I put the heel upside down. It took my son to help me overcome that issue.  

But I still have a semblance of Ideational apraxia:  

When I drive, I cannot park correctly!

A parking stall is should be perpendicular:  An angle formed by the perpendicular intersection of two straight lines; an angle of 90°.”  But when I park, the angle more like 85°!

I try and try and try. I over compensate, but my angle is always off.

Oh well. It could be worse. I can parallel park very well!

Monday, October 7, 2013

Dynavision, stroke, and a church parking lot

When my strokes happened, I was not thinking about my vision.  When you dodged a bullet and you thought you would die, the last thing I thought about was my eyesight.

During that awful 18 days in the hospital, I had so many tests. To say that I was poked and prodded is an understatement. There is no shame and no privacy in a hospital. 

When my strokes happened, I was a zombie.

Test my blood pressure. Sure! “What is blood pressure?” Of course, I could not even say “blood pressure” because I could not speak!

“How is your vision” the doctors asked? How would I know! I had double vision and I was very groggy. 

Afterall, I almost died!

It became very clear that I had some vision issues.  One of my therapists put me in a small room, and hurriedly told me that I needed to do this test called “Dynavision.” 

I have always been a skeptic. I need to be shown rather than follow blindly without an explanation. That was a major problem for me at the outset because the just basically told me to “do it.”

Do what?  Tell me first! Then I will try it. But, I could not explain what I was thinking and meaning.

After several tests on the Dynavision, one therapist told me bluntly “Mark, you should know that you probably will never drive again.”  The news just got better and better....

I was just trying to grasp the strokes, and this was a body blow.

Fast forward when I got home on those cold January days, I was so scared even riding in a car. I would gasp and close my eyes. 

In February, my wife drove our son to school and I rode along. Heather said, “Do you want to even try driving?”  The therapist words hung in the air, and I said, “I cannot even legally drive."

There is a church parking lot by our house, and Heather said “Just try.”

I drove halting around the parking lot. I was scared and devastated. What is “park and drive?” No way!

The fact that I would never drive again was such a hard reality, but I have so many new realities.

I got out of the hospital on January 27, 2012, a Friday. On Monday morning, I entered Saint Alphonsus Rehabilitation Services (STARS) where I went for at least 200 therapy sessions. Their website says “Care often begins immediately after your injury and continues through each step of your recovery. Our multidisciplinary teams create and manage your individual therapy program, involving your family as an integral part of the team and linking you to community resources.”

Over several months, I worked so hard and my wife was so wonderful. She drove me everywhere and never complained. She was so supportive.
In about June, I started vision therapy. And the dreaded Dynavision was again my nemesis. Over and over and over I did it. Over and over and over.  But, it got better. My results got must better and more impressive. 

Finally, in October, my therapist said “I think you can drive again.” I almost cried.

And I did!

It has been a year. The church parking lot is a constant reminder of what I have gained -- and lost in some respects.

20 months. Wow!