WARNING: Three Things You Need to Know About Your AFO (Ankle/Foot Orthotic), aka People Fuck Up

A long time ago, in a land far, far away (I'm kidding--it was New Jersey), a man, called an orthotist, came to Absecon Manor, a nursing home where I was a patient, and huddled with the physical therapists with no input from me. I wanted to know about the options for materials for the brace, the cost, the right to come back for fittings. But they huddled without me. 

He fitted me for a brace, wrapping plaster on  my socked leg that acted as the mold. He produced what is known universally as an AFO (pictured right).

I hated the AFO. It was cumbersome, and the man told me, in no uncertain and threatening terms, that I could go nowhere without it. I had to wear a high sock, even in the blazing heat of summer, to cover the plastic of the brace which would irritate my skin if it got stuck to it. At night, I'd take it off, where many times the AFO would go with me for an urgent bathroom trip. 

Brace on when I awoke, brace off when I wanted to read stretched out on the sofa, brace on when I wanted a drink from the kitchen, brace off when I wanted to take an hour nap, brace on when I wanted lunch, brace off when I wanted to do my sitting-down exercises, brace on when it was night to close the blinds, brace off.... You do have the pattern, don't you?

Medicare will pay for an AFO every 5 years, and I had the brace for 6 years, so when I moved to Pennsylvania, I found out the AFO was made incorrectly. But I'm getting ahead of myself. Here's my story: 

There are 3 places where I could have the brace made in Pittsburgh. I went to the first, but the orthotist contradicted himself twice. So I lost confidence in him for what I thought was unadulterated bullshit. 

I went to the second place, but the orthotist didn't remember that she took pictures of the old brace twice to remind herself where the strap had to go, she didn't remember an appointment I made with her, and she said there would be a charge when there wasn't any. The same deal. No confidence. 

There was only one place left. I met the orthotist--I'll call him Bill--and he didn't like all the questions I asked, and he would rather that I be stupid, just barely tolerating the questions. And I just barely saved the best place for last.

Bill socked my foot and put the plaster over to create a mold. I came back in a week to receive the finished AFO.

"It hurts in my ankle and there's pain around the calf," I said.

"Try it and call us back if there's any problems," Bill replied.

"Um, I already told you. There's pain in my ankle and calf."

So he adjusted my AFO with some kind of melting-plastic thing and tried it again.

"That's all I can do," Bill said, preferring the people who went in there were uncomplaining and settled on whatever they dished out. 

I left because I had 90 days to complain. I read the fine print.

I called the next morning to request another appointment, and the receptionist said there was nothing available until next week. 

"Look again. My old brace has fractures, and it's only a matter of time when I will be bedridden without the brace," I whined. The old brace did have fractures, but bedridden? I may have exaggerated a teensy bit, but as my father once said, "The squeaky wheel gets the oil." So the receptionist found a spot that afternoon.

But this time, the manager--I'll refer to him as Dave who is an orthotist as well--was there, filled with so much more knowledge than Bill and offering to recast my leg for yet another brace.

I have been there 4 times so far and here's what Dave said, 3 things about the AFO that I think you should know:

1. The AFO must come 1" to 1-1/2" below the head of the fibula. You probably won't know what I'm talking about, but the orthotist will. Dave said the 6-year-old brace was too tall and Bill's brace was too short. Maybe that's why Bill's brace caused me pain, impinging on a nerve. I was impressed with Dave's honesty. He had my interests, instead of the company's, at heart. 

2. Dave also told me that the best material for the AFO is co-polymer, rather than the polypropylene which is a generic name for thousands of compounds used by thousands of vendors. The co-polymer is more rigid and 1/16 of an inch thicker, but it isn't subject to the fractures around the joints--the places where nut and screws go on the AFO--like the polypropylene.

3. The AFO, like the original, 6-year-old one, was free of charge. That news only cheered me up because I needed it. It wasn't a "hurrah" moment and I already knew that Medicare covers the AFO every 5 years.

But there was a chink in the armor, if you will. I'm going back, one more time--at least. My physical therapist saw my new brace and told me to tell Dave that my foot is externally rotated. The brace is supposed to re-mediate that problem, she said. Dave told me that my foot is internally rotated, coming from my hip. There's nothing more he could do.

So they're going to have a conversation in a few days--two experts who both know what they're talking about. Hoo-boy. I'd love to be a fly on the wall for that exchange. I'll let you know in a future post who won. 

Bottom line: I have to wear this brace 18 hours a day and it can't be a C+ situation. The AFO needs an A+. I won't settle for anything less. You shouldn't either. 

The Chances of Getting a Second Stroke, aka Who Me? Worry?

Everybody worries about getting a second stroke after the agony of the first one. So read on.

You probably don't know James Wilson, but the folks at Lighthouse Baptist Church do. In 2000, the Pastor wrote a sermon called "Who Me? Worry?" that has absolutely no connection to the gap-toothed poster boy of MAD Magazine, Alfred E. Neuman, who said sort of the same thing. Alfred substituted "what" for "who." But I digress. 


Anyway, in the sermon, Pastor Wilson took Matthew's words in the New Testament (chapter 6, verse 34) and brought them up to date: 

Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own. 

His sermon was about how much we worry about real things, like children worrying about death, and adults worrying about leaving their children too early when death knocks on their door.

In my world, a second stroke was the real thing. After almost six years since my stroke which happened April 8, 2009, my top worry was about getting a second stroke. Of course, I Googled it, and I found the following article reported by HealthDay in 2005:

"People who have had a minor stroke have a 43 percent risk of another, potentially fatal stroke within 10 years, Dutch researchers report."

There were 2 things wrong with that report. First, it was only said about one country, and second, the report was 10 years old. So I continued to look and found this one from Deborah Davis, DNP (Doctor of Nursing Practices), written 10 years later, aka 2015:

"The American Heart Association and  American Stroke Association estimates nearly a third of the strokes which occur every year in the United States are second strokes.  Also, physicians contend there is a 40% chance of having a second stroke within five years of the first."

If that were true, that means I passed the 5-year milestone. And this from Dr. Oz, a cardiologist, television star, and heart throb with the 45-and-older set, written in our current year as well:

"Certainly, many strokes are caused by high blood pressure. For those people, there's a 20 percent recurrence rate within two years if they control their blood pressure, compared to a 50-percent rate if they don't. You can lower that 20 percent even more (by about 70 percent more) by avoiding smoke (even second-hand), eating healthy fats (like 2 grams of distilled fish oil or an ounce of walnuts a day, controlling stress, and meditating daily."  

Last year, Dr. Bernd Kallmunzer of the Department of Neurology at Universitätsklinikum Erlangen in Germany, after conducting a study on second strokes, told Reuters Health, "Taking a pulse reading can detect atrial fibrillation, a leading source of blood clots that travel to the brain and cause stroke. Detecting atrial fibrillation is important because the patient can be treated with anti-clotting medications to reduce the risk of another stroke or death.

"The risk of a second stroke is highest during the months after the first one [now it's months--better yet--and a neck pulse is ideal for somebody who has use of only one hand], but currently researchers do not know exactly how long this kind of pulse monitoring should go on," he said.

I have low blood pressure, low cholesterol, don't smoke and I'm not around smokers, not overweight, and got over my stress through therapy. No, I shouldn't have another stroke, but I shouldn't have had the first one either. (http://stroketales.blogspot.com/2014/07/how-two-legal-drugs-caused-my-stroke.html)

I always say, because it's true, you never know what's around the corner. You just never know.

Ten Things NOT to Say or Do to a Stroke Patient

This post is different. It comes directly from my book, "The Tales of a Stroke Patient." One of these situations just happened--again. I think it needs a re-print in my blog.
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People are funny, and I don’t mean in a ha-ha sort of way. They could be neurotic, bipolar, obsessive-compulsive, anxious, or agoraphobic, just to name a few types. Some of the ones who came to visit me had their own type: dysfunctional-when-meeting-a-stroke-patient.

Even though they had good intentions, in all fairness to me, some of them said and did things that were downright insulting, if I took the comments and body language personally. But I didn’t, for those people who took the time and came to visit me.

In all fairness to them, how could they know the right responses from the wrong. What it really comes down to is this: How do you speak to a stroke patient who’s had her life turned around in a 180-degree spin?

I made a list of the top ten things you should never say or do to a stroke patient, and I, too, have been guilty of most of them before having my stroke when I visited stroke patients. 
So having set the record straight, here goes.

1. Saying ‘good girl’, ‘good boy’, ‘good job’

Those are phrases you should say to your pets when they are being rewarded with a “Pup-Peroni” or Doritos’ chips. If you say them to me, I am not really being a good “anything.” I’m just sayin’. IT’S SORT OF CONDESCENDING.

 

2. Talking loudly

People have a habit of speaking loudly to foreigners and the sick. Just because they are from somewhere else, speaking loudly to a foreigner will not help get your point across. There is no hearing problem involved. The same thing applies to me. HOW DOES SHOUTING HELP?

 

3. Talking slowly

Talking slowly to a foreigner might be an asset. But talking slowly to me makes me feel mentally disabled. How would YOU like it if someone said, “How — are — you — feeling — today?” If I could, (and I wasn’t able to then), I would have talked quickly in response, possibly making them change their way of speaking. I REPEAT–HOW WOULD YOU LIKE IT?

 

4. Making faces at me

Stroke patients are difficult to understand at times, but please don’t squint, or turn your mouth to one side, or wrinkle your nose at me. Just ask me to repeat my statement, and if you still can’t understand, ask the question in a different way. After all, you’re the one with a full brain! SO USE IT!

 

5. Talking over me

I mostly listen, but when I get up the courage to speak, let me do it. Don’t interrupt me in the middle. In other words, LET ME FINISH!

 

6. Completing my sentence

Some people find the right word choice instantly, but it takes me a few seconds more. So please stop trying to fill in the blanks. WAIT! I’LL GET IT!

 

7. Giving me lists of things to do

If you give me a list of five or more things to do, I’ll may miss one. My brain is going, but the parts that are dead…well, simple died and there’s no hope of getting them back. Did you ever hear that heavy drinkers lose brain cells and the cells won’t be replaced? Same thing. YOU HEAR THAT, HEAVY DRINKERS?

 

8. Ignoring me as if I’m invisible

Once in awhile, at Rehab Y, I would see doctors on the outside. If I’m waiting at a new doctor’s office, for example, staring right at some person who’s in charge, the person invariably stares at my friend to find out what my friend wants, forcing me to shout and look like an idiot–which I am not. I shouted several times in person but even more on the phone. Some of the people just don’t listen and say their “shpiel” regardless if I object. “FOR CHRIST SAKE, I HAD A F***ING STROKE. GIMME A BREAK!” 

 

9. Saying I’m not moving fast enough
Once in awhile, people will say something to the effect, “Could I get by you?” and start moving before they even hear the answer. Their rhetorical question, because that’s what it really is, a few times cost me my balance. WHY ARE VISITORS IN SUCH A HURRY IN THE NURSING HOME?

 

10. Hanging up on me

A lot of operators hang up on me. They are nameless and they take advantage of that fact. But it doesn’t help me. WHY WON’T THEY WAIT?

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Currently, all these situations are still going on with me. Yes, I tell it all from my point of view, hoping that healthcare professionals will take advantage of my thoughts, learning why stroke patients are still frustrated. I am tenacious in my mission to educate the world about stroke survivors. Why do I use "patients" and "survivors" interchangeably? Because sometimes, people make me feel like a patient, even now, 6 years later.

Psychotherapy: It's Been My Life Changer

When one thinks about therapy for stroke survivors,
physical, occupational, and speech therapies are the obvious choices. All the rehabs provide the same, old thing. But what's the missing piece? Psychotherapy, of course! None offer that as routine.

My partner suggested mental therapy almost six years ago. But I didn't do it, not because I didn't think that I needed it after the stroke that caused maximum heartache to both of us and almost ultimate death to one of us; I didn't do it because I wasn't ready. That's the way it was then, and nobody, not even my partner, could change it.

Even if you think you're perfectly all right (which actually no one is) and especially if you think you're not, everyone should experience mental therapy sessions at least once in a lifetime. Most, if not all, insurance plans cover it. You can choose a licensed social worker, a psychologist, a psychiatrist, the latter being able to write prescriptions. But all of them give support with something, maybe a chain of somethings, you just can't figure out.


I've gone to a licensed social worker who is also a psychotherapist for about a year now, twice a week (after the year, once a week), 50 minutes per session, for disappointments and depression from failed relationships among family and friends, some having to do with the stroke, some not. The therapist will read this post and know that I am talking about her. To afford her anonymity, I will call her Sue.

Sue and I talk about a variety of things, like self-esteem, self-worth, and dignity, about life choices, responsibility, and values, about betrayal, rejection, and revenge. I am not nearly done, but looking back, I have made progress. When I first came to her, I was an open, walking wound, but she taught me how to give myself more value, to be a good person. But it turns out, according to Sue and me in collaboration, I was questioning my behavior before the stroke, like choosing the wrong men--angry like my father, narcissistic like my mother, bullying like my brother, or feeling revengeful thoughts against people I once cared about.

Though her office is upstairs, she meets me downstairs to accommodate me. The downstairs space has no comfy couch, no budding plants, no inspiring pictures. Just talk. It's enough for me. With a notebook on her lap, she writes occasionally and listens intently, speaking at random intervals.

Sue is my rudder for making most of my nonsensical thoughts sensical. But she's not a magician. Some of my thoughts get short shrift, dismissed, like the rubbish they are. "Seriously?" she often inquires. And every situation prompts more thoughts. She challenges me and I embrace the challenges. We are a good team--the tough psychotherapist who doesn't let me get away with bullshit comments and the willing patient, eventually choosing what I will become. But not tomorrow. I am a patient patient. I am willing to wait.

The Geek Squad and a Stroke Survivor: It's Like Apples Communicating with an Orange

I was desperate. The whole building had a wi-fi outage, meaning that FIOS knocked out my triple play: the television, the Internet, and the phone. And when it came back on, the television, the Internet, and the phone all worked, but the printer was off the network, aka offline. I knew because the blue light was blinking. I had a speech to give in 3 days at a local hospital and I had to key-in my notes and, consequently, print them. So I, in the current vernacular, was fucked.

I texted my son in Boston who works for Google as a network admin.

"How do I get printer back online," I whined.

"Um, who is this?" my son inquired. I thought he was joking. He was not.

"It's your mother, damn it. How could I get my printer to work? It went offline in the wi-fi outage." Frustration comes to me so easily, now that I'm a stroke survivor. 

"Nothing I can do. Call your Internet provider. Or Google it." Google it. He always ends the conversation that way.

So I texted my other son who works for IBM, here in my city, as a programmer with the same question.

"Everybody thinks [and by everybody he meant me] that I'm supposed to know everything about computers," he lamented.

"I just thought--." I couldn't even finish the sentence.

"I'll take a look when I come over on Sunday," he said because he knew that I really, really needed that printout for my speech.

One son in Google. One son at IBM. All 3 of us in IT, and nobody knew how to fix the wireless printer. Huh.

So Sunday rolled around and he took a look at the printer,  sitting himself down on the rocking chair placed strategically, for my benefit, in front of the printer that was 30 feet away from the laptop. He got the password from the router, yet no luck. He left and I called the Geek Squad.

The Geek Squad, originally independently-owned, was bought by Best Buy in 2008, and fixes your technical what-have-you--computers, printers, home theaters, for example--starting at $250 if you're interested in a one-time home repair and in a bind, emergently speaking, less if you could wait longer. They also have phone support which you could pay an initial fee of pennies short of $100 and $10.95 a month. You could cancel the monthly service fee at any time, but the $100 is theirs. They call themselves agents, like the CIA or FBI.

So I elected for the phone support. I mean, how hard would it be to get the printer online, you know? I called, and just so I wouldn't get anyone in trouble who's probably making close to minimum wage, the names I'm using have no connection to reality. Having said that, Richard was my agent.

"Hello. My name is Agent Richard. I know that problems with technology can be frustrating. [C'mon. He was reading off the script]. What kind of problems are you having?" the agent said in a monotonous tone, as if one problem a day was all that he could handle. I told him the story.

He didn't have to tell me that he was a member of the Geek Squad. I could just picture him. You know the kind, where if his house is on fire and flames are shooting through the roof, he might ask you to wait a minute because he has to finish the algorithm. And that ho-hum, flat voice slayed me.

"I'll have to charge you a fee first." [Of course].

After he accepted my card and the initial subscription fee, he took over my computer, after I approved, by his moving the cursor around. I carefully watched, but these guys were good. After he opened ten windows quickly, including 2 with code, I was lost. 

"You need to get a secret code," he said, adding a little intrigue to the mix, "and I'll type it in for you." A bunch more windows opened, and by now, we were thirty minutes in. "I'll transfer you to an engineer who knows about printers."

"Wait  a minute! I thought you were going to fix my printer," I implored, ready to explode from the passive voice. 

"You'll have to wait for the engineer," he said. So besides agents, they now had engineers, too. "You really shouldn't wait more than 40 minutes."

"Forty minutes," I screamed and I was exploding. "Do I have to be on the phone or can he call me back? Do I sit at the printer or the computer?" I was running out of power, on my cell phone, I mean. Two bars. But he had already gone and left me asking the questions to myself and listening to promos for the Geek Squad, over and over, that were playing in the background.

Richard returned 15 minutes later. "It should take a little longer."

"How much is a little?" I asked.

"Well, you don't need to be on the phone. He'll call you back."

I gritted my teeth and hung up. Three hours passed and I needed to get my mail in the lobby. So I stood up, left, and in the distance as I was halfway down the hall, my phone rang in my apartment. When I returned, I got the message the engineer left.

"Hello. This is Myron. I heard you wanted your printer fixed. I won't be here any longer today, but I'll pass the message on." I never got a return call. So the next day, I decided to write to the Geek Squad about the blue, blinking light. Here is the response I got from Phil:

"Sorry to hear that.  The blinking light indicates that the printer is no longer connected to the network – this can be due to a change in the network (a new router or Wi-Fi password), or increased network traffic causing a conflict with the printer’s IP.   Generally, the easiest way of getting a printer back on the network is through a temporary USB connection.  If you don’t have a USB cable, there should be other options for getting the printer online if the printer has a screen with menu options.  If you are available, please let me know so we can create a new session to get your printer back on the network and working with your computer."

I understood the message, but I just couldn't do a new session. Now, I was out of power, but I agreed to the session anyway because I am tenacious. My speech is tomorrow, but I haven't heard from Phil yet. I sent the text of the speech to my son and he's going to print it for me. 

The Geek Squad didn't come through, but geeks are like everybody else. It doesn't take much to just fuck up. And my printer? Don't ask.

Why I Still Have a Flip Phone, aka How I Missed the Smart Phone Era

"I want to put a ding in the universe." ~ Steve Jobs

And ding it was, partly because of the I-Phone which Jobs helped create, which led to more Smart phones manufactured by a slew of companies. I'll give you a visual history of cell phones leading to the Smart phone, beginning with the first cell by AT&T in 1946:

(that's the kind I have)

 




And finally....the Smart phone pictured with the genius, the  smug Jobs.

I don't have an I-Phone or any other kind of Smart phone and here's the reason why: When the Smart phones became really hot in 2007, I changed jobs and ended up at Cozen O'Connor international law firm in Philadelphia with a Blackberry which is a kind of Smart phone, but it belonged to the firm and I didn't mess around with it by learning how to install apps. It simply wasn't mine and I didn't want to rock the boat.

Then I had the stroke in April, 2009, and I had to return the Blackberry by mail in exchange for my shoes and make-up that were in my cubicle. I got a flip phone that served as my lifeline in case anything happened--a fall, a slip, a seizure. But post-stroke, after the first year, I didn't bother to change it. The flip phone was good enough.

But now, 6 years later, I want more. Here's a rundown of the highlights:
--By the 2nd year,  I started to write a book and this blog, both named "The Tales of a Stroke Patient."
--By the 3rd year, I started to go shopping in my wheelchair or walking with my quad cane, depending on my mood which wasn't great. 
--By the 4th year, I wanted braces because the medics, at the time of my stroke, shoved an endotracheal intubation tube  down my throat so I could breath, and in the process, knocked some teeth out. 
--By the 5th year, I was searching for support groups to invite me to their meetings as a public speaker about strokes.
--And now, I desperately want a Smart phone.

So I got in touch with four manufacturers of devices that could help stroke survivors use a Smart phone with only one, operable hand or anybody who drops or loses or uses the phone constantly. For survivors, the phone or case with device could go on your bad hand which leaves your good hand to do all the work. Or the phone with device could go on your good hand leaving your thumb to do all the work. You'll  just have to judge for yourself.  

The ratings of the devices were done on the following: ease of use, comfort, durability, and cost, with 5 being the highest. I refer to the devices as they are known: the FLYGRIP, the goStrap, the LAZY-HANDS Phone Grip, and the Universal ring, all available on Amazon. The search term I used on Amazon was "cell phone [name of device]".

They all come with very strong adhesive backing to stick directly on your Smart phone or the case that encloses it. And you can buy extra adhesive in case the adhesive wears out. Clean your cell phone or case with a dry eraser like Mr. Clean before applying the adhesive backing. Or you can use an antiseptic towelette like Lysol, but leave it dry before applying the device. If your case is the glossy kind, the adhesive stick is "iffy." If you decide you don't want the device, use a credit card to break the seal. 

I had four used cases that were donated by providers and affixed them each with magnetic weights to equal an average 6 ounces for each phone. I used each device for 2 weeks, 2 hours each a day. Now, I was ready to evaluate.

The FLYGRIP:
Ease of use--5
Comfort--5
Durability--5
Cost--$29.95
The FLYGRIP was the best rated in every category. After 5 minutes, I couldn't even detect it on my fingers. It comes in 3 sizes and the only one of the 4 devices that comes with a 60-day, money-back guarantee! It's the most costly, but the guarantee makes it worth it. 

The goStrap:
Ease of use--5
Comfort--4
Durability--5
Cost--$10.20
I found the goStrap the second best. It accommodates everybody because you fit only two fingers through the strap. During 2 hours each day, I was aware of the strap the whole time. It's do-able, but again, I was aware.

The LAZY-HANDS Phone Grip:
Ease of use--5
Comfort--3
Durability--5
Cost--$11.99
The finger grips were easy to put on, but I was aware of them the whole time. My fingers are slender and they just about fit. So if you have exceptionally fat fingers, this product may not be for you.

The Universal Ring:
Ease of use--2
Comfort--2
Durability--5
Cost--$3.92 reduced from $21.99
This ring doesn't have the stability of the other 3. It's awkward in only having one finger through the ring. And if it's really cold weather, the ring would be equally cold because it's the only one I reviewed made of metal. The ring serves as a stand for your Smart phone. But seriously. Is that necessary? It's no wonder it was reduced in price!

So there you have it. At last, I'm going to get a Smart phone with the FLYGRIP! And I'll enter the Smart phone generation quietly, as if I didn't miss anything. Shhh.
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Postnote: I obtained an iPhone after this post was written. I use the FLYGRIP, too. The only thing I'm wondering is, how did I manage without the iPhone for so long!?! Aah. At last, I join the millions of people sitting round-shouldered over the  iPhone, texting, calling, weathering, cnn'ing, and shopping online!

It's Time for New Year's Resolutions...Again

Last year, at the very same time, I wrote 10 New Year's resolutions for 2014. I referenced the top-10 list that David Letterman, a talk show host for all my foreign readers, uses occasionally, like "The Top Ten Things That Almost Rhyme With Peas"or "The Top Ten Things That You Wouldn't Want to Hear on Christmas Morning." Always creative. Sometimes funny.

So inspired by Letterman, here I go again, "The Top Ten New Year's Resolutions for 2015, Not All Having to Do with Stroke Survivorship": 


10. I'll attempt to find out, from the before and after pics, why I see Marie Osmond's 50-pound weight loss via NutriSystem not seem like 50 pounds. Photoshopped, maybe?

9.  I'll do research on GEICO, the insurance company, and figure out why the ads make no sense whatsoever to me. Maybe it has something to do with the strok.... Nah.

8.  I promise to smile at everyone who insults me, just like Don Keefer in The Newsroom, to throw 'em off the track, like I have something "up my sleeve."

7.  I'll try to not become frustrated when somebody looks at my caregiver, instead of speaking directly to me in my wheelchair, and says, "Does she want to give us her height and weight?" as if I'm invisible. I used to want to knock them the fuck into next month. I still want to smack them.

 

6.  I'll read the dictionary. My son has done it twice. Remembering is the trick.

5.  I'll figure out an invention for the brain injured, and that includes stroke survivors. Eventually, we fall and lie there, sometimes for a long time, until someone comes to rescue us.

4.  I'm going to stand and walk around once an hour (except when I'm sleeping, but you knew that already). http://stroketales.blogspot.com/2013/07/the-5-ws-and-h-of-getting-up-and-moving.html

 3.  I'll donate more. I have a lot of "stuff" that I just don't need, like watches and books. The time is on my cell phone and I have a Kindle. And do I need 20 pairs of shoes?

2.  I'll find out whether Sony just invented the hack as a publicity stunt for The Interview.

1. And finally, I'll continue saying that it was my right frontal lobe damage to my brain that accounts for my having no filters. So all of you who were offended, get over it.

 Happy New Year, goddammit. See? No filters.

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.