Speech Therapy Is Done, aka I Graduated from Talking School

I still have the remnants of dysarthria, the speech condition that makes talking tough after the stroke and affects the muscles in the face, particularly the mouth, and respiratory system. But I went to a speech therapist to get help and who I didn't like at first. She was all grim and business-y. Like when she corrected me when I called her a speech therapist instead of the more la-de-da-sounding speech and language pathologist. Drama queen, I said to myself.

Slowly, after two months, she got around to cracking a smile. When she and I were done a month later, she told me that her husband was an egomaniac, that her partying son flunked out of Harvard, and that her stressed-out daughter couldn't get pregnant. I sat there calmly, but I had my own problems.  

Anyway, there were four things I had to remember from the speech wizard: "HOSE." Permit me to explain.  


I started to develop that habit in 11th grade to be sure I could remember all the chemical symbols. When I was in college, and then when I started to work as a professional--a professor, a columnist, a technical trainer--I made lists of words to remind me what should be on the final or what was up for the day. The words didn't have to be in the dictionary. My only job was remembering what they were.  

For example, on the final exam in Sociology, "BIDS" meant sociology was the study of Behavior,  Interaction, Development, and Structure of organized groups of human beings. Or if I were going to teach a beginner class in Microsoft Word, I'd remember "NOPS" which stands for how to open a New file, Open an old file, Print, and Save a current one.  

It was the same way in speech therapy. Thus, "HOSE."

The H stands for Hydration. Make sure your water consumption has been sufficient after you sleep. Your tissues are dehydrated after sleep, naps as well, so it is important to sustain the water in our system. Aside from flushing out waste and and keeping other body parts lubricated, you'll need more water to hydrate your voice if you sleep with your mouth open, if you're sleeping with air conditioner or heating, or if you are allergic to dust particles.

The Institute of Medicine (IOM) recommends about 91 ounces of water per day for women and 120 ounces for men. You may need more if you're exercising, so if you are, Gatorade is good for replenishing the electrolytes in your body, but if you have none available, good ol' water is fine, too, in the meantime. Most people struggle to even come close to IOM's recommendations, so you have to focus on drinking, even if you're not thirsty.

The O stands for Overarticulation and the S stands for Speak Slower. They're a package deal. Mostly all dysarthria patients will need both overarticulation and a  general slow down for best quality of speech because the mission of the dysarthria patients is to be understood. 

Let's give it a test. If you really, really do both--overarticulate and slow your speech down, see how many people don't ask to say your request again. If I was to lay odds, I bet you don't have to repeat yourself at least 50% of the time. 

When I was horrible in the beginning after I had my stroke, and I just started to speak after 5 weeks of having not, I was speaking so fast, not overarticulating at all. But 5 years later, when I learned from the speech therapist, it actually made a difference. Some people are bad listeners and they ask me to repeat myself, but I know it's not from articulation or fast speech.

And finally, the E stands for speak on the Exhale. From creativespeechcentre.com (CPC), comes this: "[The students] have difficulty coordinating their breathing with their speaking; they exhale first and then speak. As a result, they speak in a low volume and they constrict their stomach, chest and throat muscles to create speech, resulting in tense sounding speech.

"What surprises them is that when we speak, we actually exhale, and that coordinating these two actions automatically results in louder, clearer speech. They learn to breathe deeply, then speak until much of their breath is exhaled and repeat the process."

The best explanation yet is our voice, not to get to the mumbo-jumbo, technical jargon used by speech therapists everywhere, is like a wind instrument, says CPC. When we exhale, our  vocal cords vibrate our voice box and allow us to produced sounds, plain and simple.

Here's a simple test: try saying the word "well" on the inhale and again on the exhale. When you say it on the inhale, the word sounds strained, as if you are running out of air, which you are. When you say "well" while expelling your breath, it come out relaxed. The same applies to everything you say. Speaking on the exhale takes practice. But I think you'll find it easier once you get your breathing coordinated.

H-O-S-E. That's one that I'll remember always. And the speech therapist said the same 4 things. Share my method if you like. It's free, and free is almost always good. 

My PT and the Marathon, aka I Want to Be a Contender

I was watching On the Waterfront the other day when Marlon Brando laments and, dare I say, whines, "You don't understand. I coulda had class. I coulda been a contender." 

Coulda been a contender. Huh. Brando's lines were about boxing, but my brain works funny now. I started to think about marathons (I was a runner, but never ran in any races) and that started me thinking, why not? My brain was going into hyper speed with the thought of being in a marathon and I missed the rest of the movie.

Anyway, I had a new physical therapist who used to be a fitness trainer and wasn't used to my weird questions, so I asked: "I want to be a contender," borrowing that line from Brando, "so could you train me to run in a marathon?" 

And surprisingly, she said, "Yes."

I made it clear. "Without a wheelchair, I mean." It could be my imagination, but I think she was sorry she replied so quickly.

The marathon is a running event with a distance of 26 miles and change. The Greeks had the first one back in the day when there were Olympics but no TV. 

Some runners do not participate in a marathon to be victors. Their personal time to finish the race is key, and some runners just want to finish the godforsaken race. Ten years ago, for example, the average marathon time in the U.S. for men was 4 hours, 32 minutes, 8 seconds, for women, 5 hours, 6 minutes, 8 seconds. I might do it in around 3 days, give or take. 

The PT still looked uneasy.  "I'll have to train you for a year," hoping, I think, that I would change my mind.

Of course, after her physical therapy session, I researched and found out that two weeks before the race, I'd have to load up on carbohydrates without increasing caloric intake to enable my body to store glycogen, an energy source, aided by carbohydrates, like potatoes and rice.

After the marathon, the recommendation is to eat carbohydrates for glycogen restoration and lots of protein to prevent muscle failure. So basically, fish and steak, potatoes and rice. I could live with that.

 And after the race, it is also advisable to soak your legs in cold water to get the blood flowing again.

Cold water. That was how Alfred Hitchcock got Janet Leigh to shriek in Psycho. Unbeknownst to her, he directed his assistant to turn off the hot water while she was positioned in the shower, and Janet let out a blood-curdling scream. Cold water does that. I'd do the same thing.

Staying hydrated during marathons is advisable, but over-consumption of water during marathons is not. 

"Drinking excessive amounts of fluid," one article in the New York Times said, "during a race can lead to dilution of sodium in the blood, a condition called exercise-associated hyponatremia, which may result in vomiting, seizures, coma, and even death." 

I barely survived the hemorrhagic stroke, which is not a small achievement in itself, but a year of training, frigid water, and possibly death. Nah. I didn't hear enough yet to change my mind. And I didn't finish my physical therapy sessions yet. So I'll let you know.

The big question is, why would I take the time, and a risk of cold-water shock and death, to run a marathon. The hip and flip answer is, it's on my bucket list. Flying in a hot air balloon over the Loire Valley, going tandem skydiving, or riding a mechanical bull are not. They were but not now.

But when I think more deeply about it, I want to spread stroke awareness so other people affected by stroke in the world could run the race, too, and I'd collect money for every mile I ran, preferably all 26 and change miles, and donate all the proceeds to stroke research. Running a marathon would do that.

Interlude: My Book, "The Tales of a Stroke Patient"

My book about strokes--"The Tales of a Stroke Patient"--was published September 26, 2012, and is not only for survivors but for caregivers, family, friends, health professionals, and anybody who loves to read. The facts are still the same because when you come down to it, strokes suck!

If I could get a stroke, anybody could get a stroke. I had low cholesterol, low blood pressure, no diabetes, a non-smoker, not obese. So WHY? My book offers theories. But more than that, it shows how stroke survivors could re-gain their dignity, self-esteem, and empowerment that somehow was lost in the process. 

Here's my promotion:
“The Tales of a Stroke Patient” making lemonade from lemons….

I just wrote a book about my stroke, all from the patient's—that is, my—perspective. How about taking time to read it!

from the publisher, http://bookstore.xlibris.com/Products/SKU-0115053049/The-Tales-of-a-Stroke-Patient.aspx, 

or from Amazon, http://www.amazon.com/The-Tales-Stroke-Patient-ebook/dp/B009J9QC64/ref=sr_1_1?ie=UTF8&qid=1373898600&sr=8-1&keywords=tales+stroke+patient, 

or from Barnes & Noble, http://www.barnesandnoble.com/w/the-tales-of-a-stroke-patient-joyce-hoffman/1113052852?ean=9781479712496. 


Don’t want to use a credit card? Message me at hcwriter@gmail.com or Facebook to see how you can get a copy!

Here's the press release from the publisher:

New Book Recounts the Arduous Ordeals of a Stroke Survivor

Author Joyce Hoffman discusses the long and difficult road to rehabilitation 

According to the Center for Disease Control, cardiovascular accidents, commonly known as strokes, account for at least 128,842 deaths annually in the United States. They are not only the third leading cause of death in the nation, they are also the leading cause of serious, long-term disability. Joyce Hoffman recalls her own experience as a stroke survivor, and her struggle to recover from disability, in The Tales of a Stroke Patient.

Hoffman begins with the symptoms that preceded the sudden and unexpected cardiovascular accident that left her paralyzed and unable to speak. She then recollects her time in the hospital, the hopelessness, fear and frustration she felt, and the slow journey towards recovery she had to undertake. Hoffman recounts her difficulties and misunderstandings with the overworked staff of her rehabilitation center, the long hours of therapy she had to endure, and the progress she made despite her disabilities. In her book, Hoffman also shares important medical advice, as well as a variety of other stories from her life.

With The Tales of a Stroke Patient, Hoffman hopes to help other stroke survivors re-gain the dignity, self esteem, and empowerment that was taken from them. Her work is a sincere depiction of the disabilities and difficulties countless Americans have to live with on a daily basis, and serves to raise awareness on one of the nation’s most important health issues today.   

I Triple Dare You to Take The Cleveland Clinic Stroke Risk Calculator, aka When Is Health Ignorance OK?

This situation is purely hypothetical. So here goes. You don't have a crystal ball that will predict the future, and if you knew, really knew, that you had a 50/50 chance of having a serious condition, like a stroke, for example, would you live your life differently?

Think about it while I'll  have you meet Katrina Walker, a woman with a 50 percent chance of having Huntington's, a disease that could cause her death in the next 20 or 30 years. 

She's 28--active, healthy, content, working as an activity assistant at a senior center.

But Walker's mother has Huntington's disease, a degenerative disease that gives Walker a 50 percent chance of having the Huntington’s gene. Jon Fortenbury covers the story of Walker in The Atlantic when he writes, "Huntington’s causes nerve cells in the brain to break down, and typically hits between the ages of 30 and 50, starting with mood changes and depression. In its latest stage it can cause an inability to speak or make voluntary movements. Most people diagnosed with Huntington’s die from complications of the disease, such as choking and pneumonia." 

There's a test for Huntington's, but Walker won't take it, at least not at 28 years old.

"Knowing isn’t going to prevent me from having it. At this point in life, I don’t need to know," says Walker
who agrees that "knowing" would make her anxiety go through the roof. So she prefers to be, according to the myth, an ostrich, putting her head in the proverbial sand and not hearing the outcome of the test.

Fortenbury cites one study in which 15 percent of college students paid to avoid a free herpes test. 

“Unnecessary stress or anxiety” was the #1 reason many college students gave for not wanting to be tested.

There were other studies, too, that Fortenbury offers, like the 2011 study that says "knowing" is more likely to lead to divorce, early retirement, and carefree spending. 

He says, "Knowing your life expectancy is cut by 20 to 30 years is bound to cause some urgency."

For Walker, she doesn’t plan on having kids so she’s not worried about passing on the Huntington gene.

“Right now, I feel like my future is wide open and if I got tested and found out I have Huntington’s, I’d feel like, ‘Well, there’s my future, there’s my fate,’” Walker said. “Right now I have more time and freedom.”

That argument got me to thinking, as I said in the beginning on this post, if you had a test and knew for certain that you had a 50/50 chance of having a serious condition, like a stroke, would you live your life differently?

The Cleveland Clinic has developed a Stroke Risk Calculator with the caveat: "The stroke risk calculator below can be used to assess your risk of having a stroke within the next 10 years. Please note that this calculation is an estimate only - please see your doctor for an accurate diagnosis as there may be other contributing risk factors." 

To try it, if you dare, go to this link: http://my.clevelandclinic.org/health/tools-quizzes/stroke-risk-calculator.aspx

I achieved a total of 6 out of 27 points with a 10-Year Stroke Probability of 3%. The average 10-year stroke probability is 7.2% for women in my age group. (I am 66). 

But then again, I got a stroke because of medications: http://stroketales.blogspot.com/2014_07_03_archive.html

My bottom line? With only one go-round at life, if my 10-Year Stroke Probability was 50 percent or higher, would I want to know?

It's like the country song by Tim McGraw, "Live Like You Were Dying":

------------

"I was in my early forties with a lot of life before me
When a moment came that stopped me on a dime.
I spent most of the next days, looking at the x-rays
Talking 'bout the options and talking 'bout sweet times.
 
"I asked him when it sank in
That this might really be the real end.

"How's it hit 'cha when you get that kind of news?
Man, what'd ya do?" He said,
 

"I went skydiving, I went Rocky Mountain climbing
I went two point seven seconds on a bull named Fu Man Chu
And I loved deeper, and I spoke sweeter
And I gave forgiveness I'd been denyin'.
 
"And he said, "Someday I hope you get the chance
To live like you were dyin'.
 
He said, "I was finally the husband that most the time I wasn't
And I became a friend, a friend would like to have,
And all of a sudden goin' fishin' wasn't such an imposition
And I went three times that year I lost my dad.
 
"Well I, I finally read the good book
And I took a good, long hard look
At what I'd do if I could do it all again.
And then

"I went skydiving, I went Rocky Mountain climbing
I went two point seven seconds on a bull named Fu Man Chu
And I loved deeper, and I spoke sweeter
And I gave forgiveness I'd been denyin'.
 
And he said, "Someday I hope you get the chance
To live like you were dyin'."

------------

I would want to know.

Enough about Ebola. Get a Flu Shot!

The CDC and the Dallas Hospital are in deep doo-doo. Unlike Vegas, what happened in Dallas didn't stay in Dallas.

In an article by Christina Coleman called "5 Mistakes The CDC and Texas Health Presbyterian (THP) Hospital Made While Handling Ebola," she wrote just a few days ago that 1) Thomas Duncan, the man from Liberia who had Ebola, was sent home from THP the first time despite his fever and his telling the nurse he came from West Africa, 2) improper protective gear, like for Nina Pham, the first person and a nurse in the US to contract Ebola, who attended to Duncan, 3) inappropriate disposal of waste, 4) lack of response by the CDC in regard to the training for nursing staff, and 5) the CDC's endorsement for Amber Vinson, the second person and a nurse who contracted Ebola and who also attended to Duncan, to board a jet packed with132 other people, all contributed to the possible exponential spread of Ebola.

Figure it like this, taking one of many examples: Vinson traveled from Dallas to Cleveland on a plane while she may have been showing early symptoms with Ebola. While in Cleveland, attending to her bridesmaids and their gowns, she may have been sweating or coughing or sneezing and she touched the gowns. 

The bridal shop closed after it was revealed that Vinson had been there and it was confirmed that she had Ebola upon Vinson's return to Dallas. The owner said that no bridal shop workers would go to her store for fear they would catch Ebola and their families would be at risk. In addition, the TSA agent in Cleveland who patted down Vinson was put on administrative leave as an Ebola "suspect." And there it is--the exponential part, or if you don't know what exponential means, think of it as the virus multiplying out of control. Remember, that's just one example. What about the people on the plane and other people in the airport who may have had bodily contact with Vinson?

"The only way that a person can contract Ebola is by coming into direct contact with the bodily fluids of somebody who is showing symptoms. In other words, if they don't have symptoms, they're not contagious," said President Obama, quoting the CDC.

But could Obama's words change? Maybe, like the government could decide it is airborne. Stuff like that always happens. Remember Saccharine and cancer? 

But take a simple thing like a flu shot. The CDC says, "While there are many different flu viruses, the seasonal flu vaccine is designed to protect against the main flu viruses that research suggests will cause the most illness during the upcoming flu season."

You may ask, why am I quoting the CDC? That is a fair question given that they f---ed up with Ebola in Dallas. I'm giving them kudos because despite what happened in Dallas, the CDC has done wonderful things over time, like this sampling since the CDC's inception in 1946:
 
1949: The US was declared free of malaria as a significant public health problem.
 
1957: National guidelines for influenza vaccine were developed.
 
1964: The first Surgeon General’s report linking smoking to lung cancer was released. It stated that “cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.
 
1978: Alcorn County, Mississippi, reported cases of the first outbreak of tuberculosis resistance to formerly effective drugs.
 
1982: CDC advised of the possible risk of Reye syndrome associated with the use of aspirin by children with chickenpox and flu-like symptoms.
 
1994: Polio elimination was certified in the Americas.
 
And these more recent ones:
 
2005: Rubella was eliminated in the United States.
 
2009: CDC identifies the novel H1N1 influenza virus. The H1N1 flu pandemic dominated CDC activity for the year, and demonstrated CDC's unique ability to assess and explain the risk.
 
2010: In the aftermath of the 7.0 magnitude earthquake in Haiti, CDC response efforts helped prevent 7,000 deaths from cholera.
 
So if you have had a stroke or any condition where your immunity is compromised, you need to take steps to fight the flu. First and foremost, get a flu vaccine. Even if you don’t have a regular doctor or nurse, you can get a flu vaccine. Look around. In case you've been in hibernation, they're offered at pharmacies, health centers, and many local colleges, too.
 
In case you did get a shot and still contracted the flu, the antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious health problems that can result from the flu. You might consider getting a pneumococcal vaccine to protect against pneumonia. Pneumonia is an example of a flu-related complication that can cause death. Pneumococcal vaccines may be given at the same time as flu vaccines.
 
The height of the flu season is from November til March. November is two weeks away. There's still time.

Selfie Helped Woman Who Was Having a Stroke: She Captured the Whole Thing

One of the many dictionary-type websites defines selfie as, "a photograph that one takes of oneself with a digital camera or a front-facing smartphone, tablet, or webcam, especially for posting on a social-networking or photo-sharing website." 

I have done so myself in a moment when I wanted to capture myself with a new hairstyle or a new outfit, albeit without posting it anywhere. Selfies are pure vanity moments, but so what? Everyone is allowed. And hardly no one takes one selfie. It has to be right. The least I took was three--I won't tell you the most--and I was on break and had nothing to do but photograph myself. 

Thanks to one woman's stroke selfie, she has put a "face" on the symptoms. Back in April, 2014, Stacey Yepes, from Ontario, Canada, started experiencing stroke-like symptoms. Her docs from the ER told her that her symptoms were just stress and sent her home. Later, it happened again on the way out of the hospital's parking lot.
 

During that second attack, Yepes recorded a selfie on her Smart phone. When she arrived at the ER again, doctors saw the picture and knew for sure she was having a stroke. (I believe the correct interjection here is "duh").

One vascular neurologist, Elizabeth Carroll, D.O., serves as South Austin Medical Center Stroke Medical Director who saw Yepes stroke selfie. Dr. Carroll says when Yepes initially experienced stroke-like symptoms that went away, she probably had a transient ischemic attack (TIA).

"They come and they go," says Dr. Carroll. "People are visual a lot of the time. When they actually see something happening it's much more effective potentially than if they read about or if they had a friend who had it. But that actual visual seeing it I think is very potent for a lot of people."

Yepes had it all: face numbness, slurred speech, difficulty walking. And yet the doctors dismissed her as being stress-related. That proves my point, shared by many: Doctors don't know everything, especially about strokes.

“It’s hard to say why there was an incorrect diagnosis initially, but things like that can happen,” Dr. Markku Kaste, of the World Stroke Organization, said. “Still, the quicker you go to the hospital, the higher the likelihood of a good outcome.”

Dr. Kaste is right, but Yepes had to go to the hospital twice, to give the doctors a chance to issue the correct diagnosis as a do-over. Couldn't they tell from her classic symptoms? The doctors probably missed the lecture on strokes in medical school. Good grief. There's no excuse.

A Nursing Home Mini-Series: The Final Chapter

Ebola Virus

I planned on writing more in the nursing home mini-series, but I've been sick with some virus. I gave the nurse a stool sample so the people in some laboratory nearby will play around with it to decide which virus. I don't care really because I'm getting out of here this weekend, as long as it isn't life threatening like Ebola. My luck. Ebola.

Anyway, I'll give you a microwave version of what went on. I was going to write a whole post about the time Beatrice answered the cell phone in the dining room in the middle of dinner. Beatrice is hard of hearing. The person to whom she was speaking was evidently hard of hearing, too.

"I have diarrhea," Beatrice said to the caller. The caller obviously didn't discern the word. "Diarrhea! DIARRHEA! DIARRHEA!" Beatrice screamed. 

A few people sitting nearby didn't blink because they were hard of hearing, too. The others went right on eating their dinner. I walked away from the table, and I was sorry about that, because we were up to dessert and the scrumptious pies usually served there are terrific. But I had no appetite. Diarrhea indeed.

 
And there was the time that two aides got in a verbal fight over whether they should serve chicken soup broth to a vegetarian. It was the height of the argument.

"You can't see the chicken because it's fuckin' broth!" screamed the one aide.

"Chicken is meat and vegetarians don't eat no meat!" screamed the other.

I didn't get involved, but I had my opinion, too. Chicken is meat. I'm just sayin'.

A few other posts were in construction, but I am calling this post the final chapter in the mini-series because it is. I'm feeling depleted of energy from the virus. I have rashes on my extremities, the "d" word (Beatrice would love this post), vomiting, stomach pains, fever, and nausea. If I were to take a guess, I'd say it was the norovirus. Same symptoms, same misery.
http://stroketales.blogspot.com/2013_03_05_archive.html

A Nursing Home Mini-Series: Praying Is Praying, aka Right Pew, Wrong Church

Beatrice drank water and wasn't dehydrated anymore, and improved to the point where she could participate in the nursing home activities.

Though Beatrice didn't know my ethnicity, she said, "Do you want to go to a worship service with me?" 

The nursing home had a hall where any event could be held. Last week, a Polka tribute. This week, a worship service.

The worship service was at 7pm and I knew it wasn't the Jewish kind. We, as Jews, don't say worship service. Every Saturday morning, we say "Shabbat" service, and on the many holidays throughout the year, we have a service to commemorate that holiday, or Holy Days, as with the case of Rosh Ha'Shanah and Yom Kippur. 

But we share a Bible--the Old Testament--and when it comes right down to the heart of it, we're all praying to the same God, so I said, "Sure. I'll go with you." 

I figured, with a stroke and following my drop-foot surgery, a bunch of prayers couldn't hurt. In other words, I needed all the prayers I could get.

Beatrice was in worse shape than I was, so I followed the aide who was pushing Beatrice's wheelchair in my wheelchair through the narrow curves in the hallway, negotiating and steering with one left hand and foot. I didn't take the cane because it was too darn far.

At last, we arrived at the massive hall, and I thought of the chairs as pews because it was a worship service. There were hushed and whispered sounds all around. Beatrice and I sat in our own wheelchairs outside the "pews." 

A few people handed out booklets from Baptist Homes Society Sunday Chapel Service which contained the notes and lyrics to the service, and minutes later, the tall pastor entered and a pretty pianist, who was already seated at the piano, started to play "Call to Worship and Lord's Prayer."

Glory be to the Father and to Son and to the Holy Ghost....

I could have hummed the melody because I could read the notes from my extensive music background. But that didn't sit right with me. I was on auto-pilot. My brain didn't want to do it, to sing those words I didn't believe in. 

I mouthed the words slowly so that I would reach of end of the "Shmah" when all the gentiles would reach the end of "Call to Worship and Lord's Prayer." Translation: "Hear, O Israel: the Lord our God, the LORD is one," found in Deuteronomy 6:4.

The next song  was "Jesus, Lover of My Soul." I didn't ever sing to Jesus. I automatically sang, under my breath, "Ein keloheinu." Translation:
There is none like our God, There is none like our Lord, There is none like our King, There is none like our Savior. Who is like our God?, Who is like our Lord?, Who is like our King?, Who is like our Savior?
Let us thank our God, Let us thank our Lord, Let us thank our King, Let us thank our Savior.
Blessed be our God, Blessed be our Lord, Blessed be our King, Blessed be our Savior.
You are our God, You are our Lord, You are our King, You are our Savior.

There were 3 songs left, and I sang silently the "Ma'Nishtana" for Passover and the blessing over the candles and the Dreidel song for Hanukah. It was a mish-mash of songs, in the wrong order and/or holiday, that I remembered from going to Hebrew school for 10 years and services for almost 60 years.

Then the pastor told a little tale that had to with, when I was listening, a man, some fish, and a river. I was distracted by the auto-nicity of my brain to sing the Hebrew songs rather than the gentile ones.

The service came to a close 45 minutes later and the pastor, with two hands, grabbed both Beatrice's and my wheelchairs and took us back to our rooms, Beatrice in front and me in back, confident in the knowledge that we both prayed. 

Deep in my heart, I knew that God would understand. 

A Nursing Home Mini-Series: Seeing Things That Aren't There, aka Hallucinations

Maggy was a fall risk, never knowing when she would pass out, and Beatrice, who fell in her kitchen, had an IV bag attached to her arm because she was dehydrated. They were relegated to their rooms for all activities, including therapy. And Cassey was, at last, home. So I had to find a new "eating" table, the most popular activity in the nursing home.

I chose to sit with Tillie because no one else wanted to. Tillie was always seeing things. She was 92 years old and she talked about the cats she saw so clearly on her feet, in the garden, through the plants. But there were no cats to be seen. She had a stroke 12 years ago, had macular degeneration, had a recent fall, and she was hallucinating. She was healthy otherwise, knowing that people rejected her but not knowing why.

During breakfast, she said, "Of course, the mother cat looked after her offspring. She was tawny in color and searching for food the kittens could eat." And she described the kittens, one being all white and one being striped. And she had a vision of dogs playing in the courtyard of our nursing home--one a blonde cocker spaniel, the other a tan and black beagle. 

So I decided to do some research on seeing things that weren't there. 

Oliver Sacks -- Hallucinations

The hallucination [that's what most neurologists call them] is convincingly apparent, produced by the same neural pathways as real-as-life perceptions. 

Oliver Sacks, a professor of neurology at the N.Y.U. School of Medicine and the author of a book called “Hallucinations," wrote this excerpt in The New York Times in 2012: "People with impaired sight, similarly, may start to have strange, visual hallucinations....Perhaps 20 percent of those losing their vision or hearing may have such hallucinations." Remember Tillie had macular degeneration?

Sacks added that Charles Bonnet Syndrome (CBS) is a condition where people with vision problems begin to experience visual hallucinations. This condition -- CBS -- usually belongs to the elderly. They may see active cats or flying birds, for example. Remember Tillie saw cats and dogs?

New medications or a faulty mix, or a quick change in environment, may cause hallucinations as well. I remember when my grandfather suddenly moved to a nursing home and he "saw," though nobody else did, a variety of animals soon after. Tillie went into the nursing home suddenly, too.

Given the imperfection of the human body, aka nobody is perfect, it is more than likely that something in the brain
is at fault. After all, the brain controls everything, as individuals, that make us who we are, like strokes, for instance. Any of those factors -- macular degeneration, Charles Bonnet Syndrome, sudden change in environment -- could have contributed to Tillie's hallucinations.

However, it didn't matter. Tillie, at 92, is who she is and lucky to be alive, and seeing things that aren't there is a part of her. I'd always sit with her because hearing odd shit is who I am.

A Nursing Home Mini-Series: Life with Old People

Some of you missed my last post -- http://stroketales.blogspot.com/2014/07/wake-up-stroke-survivors-before-its-too.html -- in which I told the outcome of my stroke-related surgery. The surgeon said the operation was successful. I say the surgeon did the best he could with what he had to work with. 

Anyway, I'm in a nursing home now, which is divided between residents (I say "lifers") or, as with me, people who go here to recuperate. I had surgery so I fall into the second batch.

The nursing home serves three complete meals a day -- breakfast at 8, lunch at 12, and dinner at 5, plus snacks, if anybody wants them, in between and after dinner. So you could spend around six hours just eating.

The nursing home is understaffed, so the aides start bringing  people down to the dining room thirty minutes before the meal started in order for all of the people to be there when the meal officially began.

The aides are responsible, too, for bringing the platters of all people who don't want to socialize. One aide said to me, "The people eat in their rooms, if they are sick or don't want to socialize with 'old' people." I took offense at that remark because I am one of them, the old people, I mean. I don't know when it happened and I don't feel old. But numbers never lie. I am 66.

I got to the nursing home just before dinner. In the wheelchair, I saw an open spot in the table for four. One of was the little, old lady named Gert. I don't know the reason for her going to the nursing home. She died three days later and Cassey took her spot. Cassey, who was a year younger than I was, was a geriatric/psychiatric nurse who had a hip replacement. She was quiet and liked observing the other two. 

Maggy was an 91-year-old, bust-ass, no-holds-barred, obese lady who actually was comfortable and secure being obese. Maggy was a diabetic who passed out until somebody in her family had the sense to gain her admittance to the hospital. Then the doctors figured out what it was, but I never knew. And I didn't ask. She came her to rest.

And the fourth was Beatrice, 89, who said platitudes all day like "Where there's a will, there's a way" or "If it's meant to be, it will happen." Beatrice had a fall and she exhibited black-and-blue marks on every inch or two of her body. She was also a sentence finisher, like if you paused and were trying to finish the sentence, she would finish the sentence for you. Most times, she was wrong in the word that she selected. And that got the hairs on Maggy's neck to stand up at full attention.

"I don't like when you fill in the blanks," Maggy screamed.

"Well, the right word fits the shoe," Beatrice said, mixing up platitudes. Sometimes, when Beatrice got tired, she said them that way.

So that was the table. I sat with them for three weeks until Cassey's hip allowed her to be discharged. Cassey sent me an email when she arrived home, happy to be with her boys (aka cats) and her comfy, overly high bed which, as her email said, she accessed with a step stool she borrowed from her sister.  

Maggy passed out again, and Beatrice was still hooked to an IV bag for dehydration. So tomorrow, I was on my own to find new people at a different table.

That's the thing about nursing homes. I didn't think I'd have time for making really good friends because there's a fast turnover rate, akin to a revolving door. But I had enough sense that I wouldn't die trying either.