Thursday, May 22, 2014

Phantom Blindness and Taking a Break after Strokes

I met with my eye doctor last week about taking some time off from my vision therapy. I have been doing therapy since my stroke almost two and a half years ago. I am tired, and a need a break.

My doctor said, “This is completely understandable. Take some time off.”
At the appointment, my doctor tested my vision. Because of the strokes, my vision was affected, and I have a problem in my field of vision on the right side. I have a deficit with my right side peripheral vision. However, it is getting better.

During the test, I told him that I “sense things on the right side of my peripheral vision.” It seems that I know that something is there, but I cannot really distinguish what it is.

He told me that there is a body of thought describing phantom vision or phantom blindness.

A Polish researcher, L. Bieganowski, described this phantom blindness this way:   “The subject of the paper is the phenomenon of phantom vision. It occurs among the blind (or almost blind) and is characterized by perceiving various visual sensations, for example: light, geometrical shapes, buildings, people, flowers etc. The paper presents views explaining the generation of phantom vision. According to Melzack's theory, the occurrence of these sensations is explained in relation to the phenomenon of transforming the neuro-activity of the brain in a specific--for each organ--neuronal network called neuromatrix. Even if some organs do exist but have ceased to function completely (or to a significant degree) and consequently the brain does not receive any sensory stimuli from them, the neuromatrix in brain can generate visual sensations constituting the phantom vision phenomenon.”

I said, “This is really interesting. However, is this good or bad considering my vision issues?” He stressed “This is great news!”

So, I am going to take a month or two off from therapy. However, I will continue doing home vision therapy.

I will continuing doing the “Hart Chart” to improve ability to organize and visually track while maintaining peripheral awareness.

What you do is this:

1. The patient stands in a relaxed an balanced posture. One eye is patched.

2. The Hart Chart is placed at eye level. The patient should be a comfortable distance (2-3 feet) from the chart. Set the metronome at sixty beats per minute.

3. The patient is asked to read the letters out loud in a rhythmic fashion without moving their head – one letter per beat of the metronome. The patient reads the entire chart proceeding from left to right, top to bottom. The patient should be encouraged to maintain peripheral awareness of the whole chart and of other objects in the room.

4. Repeat for the other eye. As this becomes easier, take several steps back from the chart.

5. If there are significant differences between the eyes, practice the poorer eye more frequently.

Level II – Outside In

1. Have the patient start with the first line of letters and read in the following order: first letter, last letter, second letter, second from last letter, and so on.

2. The patient should read each line from the ends to the middle in this fashion.

Level III – Columns 1. The patient reads the first and last letter of each line. When they get to the bottom of the chart, they should proceed to the second and second-to-last letter of each row. When these two columns are completed, the patient should move to the next two columns in and so on. 

Level IV – Obliques

1. When the above activities have been mastered, the patient begins reading the first letter of the first column, last letter of the last column, second letter in the first column and next to last letter in the last column. (He reads the first column top to bottom alternating with the last column bottom to top.)

2. When this has been achieved, the patient should progress to the second and second to last column. Repeat with the remaining columns.

Here is a YouTube video about the Hart Chart:

Also, “Slap Tap” which is described this way:

This activity is a sheet that hangs on the wall in front of the patient. There are a series of symbols which represent left arm, left leg, right arm, and right leg. During this activity the patient will read each symbol and call out the direction while moving the corresponding body part. Once this has become automatic for the patient, they will move to the second series which adds both arms and both legs. This activity will help patients gain a better sense of their own body and directions. By making directionality automatic for patients, visualization will become easier. For many patients activities such as slap tap help if there is difficulty reversing letters or numbers. 

Here is a YouTube video about this:

It is amazing that I have been doing therapy for two plus years. I have done about 300#  therapy sessions since my strokes. I will continue doing therapy plus I will continue working on the Boards that I am on including the College of Western Idaho, the Idaho Housing and Finance Board, and the Idaho Chapter of the American Heart and Stroke Association.

But, years ago when I completed my first round of therapy after the strokes, my doctor and my therapists at St. Al’s Rehab told me that part of my therapy was "just to live" and be with my family.

I will take that advice. For now. Like Arnold Schwarzenegger, "I will be back!"

Sunday, May 18, 2014

Strokes, Mountain Dew and Beef Stew

Early this morning I drove to the grocery store to get Downy. At the store, I bought bacon,  stew meat, eggs, bacon and English muffins. 

This morning, I'll be making breakfast and preparing beef stew for dinner.

On the way to the grocery store, I drove to to get my Mountain Dew, which is my last vice since the strokes. Returning from the store, I drove to Dutch Brothers coffee to surprise my wife with a skinny mocha.

Basically, it seems like a typical Sunday morning. 

The severity of my strokes two and a half years ago makes this typical Sunday morning a miracle.

This typical Sunday morning belies the fact that when my strokes happened, most people -- including my doctors and therapists -- believed I would never have that typical Sunday morning again. 

Consider this morning:

I got dressed. Alone.

I made sure that I had my wallet, my car keys, and my phone.

I drove to Jackson's, Fred Meyer and Dutch brothers.

I conversed with several clerks at the stores. We joked and laughed and they have no idea that I couldn't talk two years ago.

On the fly at the store, I decided to make beef stew for dinner and for breakfast, I will make a quasi Eggs Benedict dish. 

Wandering about the store, I was thinking about the ingredients I need and will use for my recipes.

The goal for the morning is to get Downy fabric softener to finish our laundry. I checked the Downy fragrances, and I made sure the that I chose was on sale. The stew meat was also on sale.

When I checked out, I did self check out and processed my debit card. 

This 45 minute process from garage to store and home again seems so simple. This trip was liberating for me but it was not simple.

The process of going to stores is not simple when you have strokes. Everything I have to do is deliberate and carefully thought out.

When you see my brain scan realized that 20% of my brain is dead, driving to the store alone, ordering coffee and a Mountain Dew, and planning a complicated meal almost makes me emotional because I'm so happy.

However, what is not normal now, I did not buy a newspaper which was my normal Sunday morning ritual. When you cannot read very well because of my strokes, you realize that physically, people think I am "just fine." I am not. Yet....

I still have a long way to go, but I relish a typical Sunday morning that most people take for granted. When you have a stroke, nothing is "typical."

Thursday, May 15, 2014

Teachers and "Nixon is the One!"

Sacred Heart Catholic School, 3rd Grade, at the Idaho Capitol May 14, 2014
On May 14, 2014, I accompanied my son’s third grade class on a tour of the Idaho capitol building. Our son goes to Sacred Heart Catholic School, and I helped his wonderful teacher with some logistics. 

When I was in the third grade myself, I visited the Idaho Capitol building. I have always been interested in politics. In 2nd grade, I supported Nixon in the 1968 election! I still have my old “Nixon Is the One” button! I was eight years old. Our son asked, "Were you always a geek Dad!"

Mark Dunham at the Capitol 1969
Mark Dunham at the Capitol 2014
Because of the Capitol tour, our son has been asking a lot of questions about presidents, Idaho history, and government. Our son’s teacher is a great educator who keeps the kids interested. Keeping third graders interested is a challenge.

But, “Mrs. G” has a way of making learning fun.

I thought a lot about my own teachers from Kindergarten through college. I have a handful of “teachers” who I admire even now. They were not “just teachers,” they embodied the best attributes of teachers. I found a list of teacher attributes from Maria Orlando, EdD in Philosophy of Teaching:

A great teacher respects students. In a great teacher’s classroom, each person’s ideas and opinions are valued. Students feel safe to express their feelings and learn to respect and listen to others. This teacher creates a welcoming learning environment for all students.

A great teacher creates a sense of community and belonging in the classroom. The mutual respect in this teacher’s classroom provides a supportive, collaborative environment. In this small community, there are rules to follow and jobs to be done and each student is aware that he or she is an important, integral part of the group. A great teacher lets students know that they can depend not only on her, but also on the entire class.

A great teacher is warm, accessible, enthusiastic and caring. This person is approachable, not only to students, but to everyone on campus or the school. This is the teacher to whom students know they can go with any problems or concerns or even to share a funny story. Great teachers possess good listening skills and take time out of their way-too-busy schedules for anyone who needs them. If this teacher is having a bad day, no one ever knows—the teacher leaves personal baggage outside the school doors.

A great teacher sets high expectations for all students. This teacher realizes that the expectations she has for her students greatly affect their achievement; she knows that students generally give to teachers as much or as little as is expected of them.

A great teacher has his own love of learning and inspires students with his passion for education and for the course material. He constantly renews himself as a professional on his quest to provide students with the highest quality of education possible. This teacher has no fear of learning new teaching strategies or incorporating new technologies into lessons, and always seems to be the one who is willing to share what he’s learned with colleagues.

A great teacher is a skilled leader. Different from administrative leaders, effective teachers focus on shared decision-making and teamwork, as well as on community building. This great teacher conveys this sense of leadership to students by providing opportunities for each of them to assume leadership roles.

A great teacher can “shift-gears” and is flexible when a lesson isn’t working. This teacher assesses his teaching throughout the lessons and finds new ways to present material to make sure that every student understands the key concepts.

A great teacher collaborates with colleagues on an ongoing basis. Rather than thinking of herself as weak because she asks for suggestions or help, this teacher views collaboration as a way to learn from a fellow professional. A great teacher uses constructive criticism and advice as an opportunity to grow as an educator.

A great teacher maintains professionalism in all areas—from personal appearance to organizational skills and preparedness for each day. Her communication skills are exemplary, whether she is speaking with an administrator, one of her students or a colleague. The respect that the great teacher receives because of her professional manner is obvious to those around her.

For me, these specific teachers made learning fun, interesting and thought provoking:
Twin Falls High School
  • Dorothy Guest, my 4th Grade teacher at Morningside Elementary School in Twin Falls, Idaho.
  • Mary Lu Barry, Twin Falls High School.
  • Susan LaBeau Pliler, Twin Falls High School.
  • Ed Chupa, Twin Falls High School.
  • Dr. Laurel Traynowicz, Ph.D. Boise State University.
  • Dr. Phoebe Lundy, Ph.D. Boise State University.
  • Dr. Barry Asmus, Ph.D. Boise State University.
  • Mark Dunham, BSU Distinguished Alumni, 2012
  • Dr. John Mitchell, Ph.D. Boise State University.
Each of those teachers had an amazing influence on my life. They challenged me so much. They made me think about my biases and my beliefs. Those 7 incredible teachers made me the man that I am today. I am grateful for their mentorship and patience.

I wonder when our son looks back on his teachers, who will be the ones that he will remember? 

Tuesday, May 13, 2014

Google Plus, Google and Blogger are jokes.

I have a blog through “Blogger” which is a Google service. I have had my blog for many years.

Recently, I decided to try Google Plus. That was a massive mistake. However, now my blog supported by Blogger (and even my YouTube) account will NOT let me sign on at all.

If I use my IPhone, my Blogger and my YouTube accounts work. I can edit my blog. However, if I use a desk top computer, it will not work.
I been trying to call Google for several days. Several. I have been on hold for hours and hours.

My internet service is Cable One. Cable One tech support has tried over and over again to rectify this issue.
I have a Cable One account and also a Gmail account. It does not matter which account I use, I get the same result.

If I try to sign into my Blogger account, I get these messages:

“Google Plus is not available for your organization (cable one) Please contact your administrator to enable this service for at least one user in the organization. If you're an administrator, learn more here, about enabling Google Plus and learn more here about applying policies to different users.”

 “Google accounts: We are sorry, but you do not have access to this service. Please contact your domain administrator for access.”

Again, this is NOT a Cable One issue. It is a Google issue. I can see my blog. On my phone, I have access to edit the blog and to do a new post. However, with a desk top computer it will not work at all.  I have two computers, and I get the same results.

So I'm doing this post on my phone. Google and Google Plus is a joke. They have no customer service. 

Friday, May 9, 2014

The Imposture Syndrome & and strokes

20 years ago, a friend and I had a conversation about the "impostor syndrome." We laughed when we admitted that we have that condition.

Throughout my career I have thought about the impostor syndrome a lot. I have been honored and have accolades heaped on me. 

But often I don't believe my "Press" has been deserved. From high school when I was honored to be the "Most Likely to Succeed" and through the years I have received honors like "BSU Alumni of the Year," elected twice to be on the board of the College of Western Idaho, etc. I have plaques galore. 

Since the strokes, I was elected again to be on the board of the College of Western Idaho. The governor appointed me to be on the Board of the Idaho Housing and Finance Association. And I was chosen to be on the board of the American Heart and Stroke Association, the Idaho Chapter.

I'm trying to reconcile my life and being a victim of the impostor syndrome.

From Wikipedia, here is the definition:

"The impostor syndrome, sometimes called impostor phenomenon or fraud syndrome, is a psychological phenomenon in which people are unable to internalize their accomplishments. Despite external evidence of their competence, those with the syndrome remain convinced that they are frauds and do not deserve the success they have achieved. Proof of success is dismissed as luck, timing, or as a result of deceiving others into thinking they are more intelligent and competent than they believe themselves to be."

My strokes have compounded my impostor syndrome for several reasons.

Even now, 27 months later I'm so humbled that hundreds of people donated funds to help with my therapy. Therapy that is ongoing even now. There are so many people more deserving. 
Why me?

Early in my career, I became CEO of a large trade association. Throughout my career people consider me to be a leader. I don't know why.

Many people have told me that I am their mentor. I like to help people but not for the accolades. Why do they think I am their mentor? 

Throughout my life people have asked me to be involved in so many ways. But why me?

My strokes 27 months ago, changed everything. But what did not change is my imposter syndrome. Actually, the stroke heightened my awareness of my limitations.

During a trip to Disney World, a friend of mine on Facebook commented that I look "so healthy, happy and relaxed. I am

In reality, though I'm grateful for my recovery, the impostor syndrome has exacerbated my lack of confidence. When you cannot read, write, and speak very well at all, it heightens your sense that you are an impostor in your life.  

Monday, May 5, 2014

Disney World, Stroke and Recovery

Four years ago my family and I to Disney World. At that point my son was five years old, and I did all the rides with him. Of course, there were height limits and my son was too short to go on some rides.

At Epcot, we did go to test track and we rode that ride over and over!

For four years, our son has been waiting to return to Disney World so he could experience the big kid rides. 

Four years ago, he did all of the five-year-old boy things: pirate face painting, Jedi training, digging for fossils, etc.

He has a good memory and he often tells me about that Disney World trip.  He will say, "Daddy, do you remember the haunted mansion! You remember splash Mountain!"

I remember. I'm glad I have those memories.

This week we are returning to Disney World. Because of my strokes and health issues, I'm very wary about rides and elevated blood pressure. My doctors and my neurologist cautioned us about making this trip. We are being very careful.

My wife always looks on the bright side of life.  She says, "Four years ago I did all the rides with her son. It is my turn now."

We're in the same hotel,  Port Orleans Riverside. The just the food is the same. The crowds are the same. Short tempers are flaring and kids and adults are hot and sticky. Lines of strollers. 

The much is the same has four years ago. But I sit outside waiting ffor my family because signs warn about health risks. 

But I'm okay about that! I'm just grateful to experience Disney World with my family again. Amost two and a half years ago, the prospect of going to Disney World was a faded dream.

Thursday, May 1, 2014

My life is Silent Lucidity

I had a vivid dream last night. A friend and a former coworker asked me to help him present information for new Idaho lobbyists. We were going to present together in a tag team format. That was a common occurrence in the “old days.”

However, when I woke up, it was back to reality.

I do not make presentations like that anymore. Because of my strokes and my aphasia, it is simply not possible for me to do what I loved doing before.

There is a song called “Silent Lucidity” from Queensryche. That song is haunting, and sometimes when I have dreams for some reason, I wake up and think of that song:

“Hush now don't you cry
Wipe away the teardrop from your eye You're lying safe in bed It was all a bad dream Spinning in your head”
“Wide awake you face the day
Your dream is over or has it just begun?”

When I woke up from that lobbying dream, I was lying safe in bed. However, it was NOT a “bad dream.” It was wonderful because I was my “old normal self.” I miss that.

I was on the top of my game professionally. Testifying at the legislature was fun for me. I relished hostile legislators peppering me with hard questions. I would make speeches around the nation. Writing and speaking were second nature to me.

In the blink of an eye, January 10, 2012 at 5:00 am, it was gone with the strokes. Hopes and dreams were dashed -- with my courage to face life sometimes. 

So, when I dream, I am back to "normal." Safe dreams.

However, I am still eternally grateful for my life and my recovery. My motto is “it could be worse.” I do have a second – maybe third – chance in life. I love my family. But still, I miss my old dreams.

“Wide awake you face the day

Your dream is over or has it just begun?”