Thursday, April 14, 2011
Update from David
Aloha to our Ohana,
Week two at the Center for Neuro Skills (CNS) in Bakersfield, California started with a bang. Monday morning, I went to see Theresa at the apartment unit she shares with two roommates before the shuttle takes them to the clinic for a full day of rehab therapy. The rehab aide answered the door and said I could wait in the living room as Theresa was currently in the bathroom. Up until now, the usual routine is for the aide to help Theresa with her transfer to the toilet and then give her some privacy. When Theresa is finished, she calls the aide back for the return transfer to the wheelchair however this time, I noticed the bathroom door opening and there was Theresa wheeling herself into the hallway with a cat that ate the canary grin on her face. Both the aide and I were surprised to see her so the aide asked why Theresa hadn't called for transfer assistance. Her reply was priceless: My butt was getting sore sitting on the toilet so I got up and slid over to the wheelchair by myself. What more proof could anyone need that the Theresa we know and love is coming back! Thank you to our Lord for yet another sign of Your healing powers and gift of grace.
The morning preparations continued with Theresa assisting in making her own breakfast by getting eggs from the fridge and scrambling and seasoning them in a bowl. The aide then cooked the mixture as it would be dangerous for Theresa to do so; reaching up to the stove from her lower wheelchair height could create a burn hazard. After gathering the lunch, snacks, daily planner and other items that Theresa would need during her day at the CNS rehab clinic, she also pulled out an odd assortment of groceries and placed them in a bag. I was about to ask if she was planning a meal that included pancake syrup, Smuckers jam, fruit cocktail, etc. when she caught my eye and told me to give this bag to the food bank. In anticipation of our arrival the previous week, the CNS staff had prestocked the pantry with some staples and now Theresa was cleaning them out to make room for the Trader Joe purchases from Saturday's outing. Sure enough, almost everything in the bag contained a mix of high sodium, high fructose corn syrup, empty carbs or just plain wasn't on Theresa's list of healthy foods. Looks like she could teach the aides a thing or two about scanning ingredient lists for proper nutrition.
Intake testing resumed this week at the CNS clinic and Theresa's progress continues to surprise the therapists, physicians and other staff. In PT, Theresa did 10 sit & stands without any therapist or mechanical assistance and she walked 30' using the elevated EVO walker for support. Even more impressive, Theresa stood for 10 minutes, only leaning on an elevated tray while completing a 50-state map puzzle of the USA (getting Delaware and Rhode Island mixed up but honestly, who among us hasn't made that mistake?) In OT, Theresa's optical acuity tested as good however one eye does not converge, something to note for the neuro-optometrist checkup. She also had some difficulty distinguishing between hot and cold, sharp and dull, and hard and soft sensations in her extremities, all of which are symptoms of the spinal cord injury. As with her other injuries, we continue to pray and give thanks to God and know that Theresa will regain proper feeling when He so chooses.
Despite the less than stellar news on the OT side, Theresa more than made up for it in the cognitive testing. One memory/sequencing test begins with the speech pathologist reading a series of four numbers from 0-9 and then having Theresa repeat them but in numerical order. She completed the series of four, five, six and finally seven numbers with only a couple of errors, amazing considering that the average non-brain injured person has some difficulty with remembering and ordering as few as five numbers. Even more impressive, later in the week while working through a timed reading comprehension test, Theresa suddenly stopped writing and said a sequence of seven numbers out loud. I asked her why she did that and she said it was the answer to the question the therapist was asking the patient in the next room. Sure enough, she was correct and the patient next door (who happened to be another brain-injured M.D.) had gotten it wrong. And in spite of the distraction, Theresa still answered 39 of 40 questions correctly in five minutes.
The remainder of the week was spent conducting more testing along with a thorough check-up by the staff neurologist, a kindly country physician reminiscent of Dr. McCoy (aka Bones.) His findings indicate Theresa has good strength in her legs so it will not be a hindrance to her standing and walking. Confirming the OT testing, there is some lack of sensation in her extremities as she cannot distinguish between one or two needle pricks. Bones also noted Theresa's right arm is stronger than her left, but her right leg is weaker than the left; some kind of cosmic balance is in order here which I'm confident will work out in due time. The left arm weakness could also be due to Theresa's reduced range of motion in her left shoulder which was diagnosed at Craig Hospital in Denver. Here at CNS, they call the condition adhesive capsulitis but I think frozen shoulder has a nice ring to it. Back at Craig, the PT was considering the use of dry needle insertion to loosen the tight shoulder muscles but it turns out that this technique cannot be performed by PTs in California or Hawaii due to differing state laws. So the PT here uses manual pressure manipulation and massage, and so far the results are promising with Theresa now able to lift her left arm almost to shoulder height.
One other rehab therapy at CNS that we've not encountered before is ED or education development. Upon first entering the department, Theresa had a rather large smile and was giggling to herself. Thus when greeted by the therapist, Theresa announced rather loudly, I'm ready for my erectile dysfunction class! I'm not sure if they laughed or winced but I am sure they did not expect this from Theresa. In the ED class, one of their ways to retrain the brain is teaching the cognition module method of learning. The basis of this is to describe an object in eight ways using terms like color, shape, construction, size, weight, texture, function and detail. Theresa had some difficulty remembering these so she made up an anagram that started with "comme si" and ended with "what the f---, David?" That Theresa has regained her sense of humor, albeit a bit naughty, is another sign of her healing progress and one for which we continue to give praise.
Saturday would be our last day together as I was returning to Hawai'i early on Sunday. We spent the morning grocery shopping but went to Albertsons instead of Trader Joes in a failed attempt to stay within the prescribed weekly grocery budget. In the U.S., it costs more to buy healthier foods because they are not subsidized by the government; so a frozen pizza can cost less than the price of an organic apple. That really is a sad commentary but outside of the scope of this update. The afternoon went by quickly as we took a stroll through a nearby park, actually much quicker than expected because the temperature had plunged 30F since the last weekend and it was now starting to rain. There was a planned outing to the Olive Garden that evening for which Theresa was signed up but because the organizer decided to drive a shuttle van rather than the handicap bus with the lift, Theresa could not board it without great difficulty and pain (her torn knee ligaments are still healing so she is unable to climb steps.) As a result, we decided to skip that and I took Theresa and her rehab aide to a local family-run Italian restaurant named Frazettis. It turned out to be the right choice as their food was delicious and it reminded us of our favorite Italian eatery, R Place in the Wisconsin Dells. And as we later learned after returning to Theresa's apartment, the Olive Garden crowd was disappointed due to their 45 minute wait to be seated and then being told they were sold out of some choices.
Although it was getting late, Theresa tried to stay awake because she knew that if she went to bed, I would not be there the next morning. We spent some quality time together watching "My Big Fat Greek Wedding" but I could tell she was getting exhausted and so I put her to bed, kissed her good night, and promised that I would return in a few weeks for the upcoming treatment conference and more importantly, to celebrate Theresa's birthday on April 22. I continue to marvel at Theresa's healing progress and to thank our Lord for all He has done for us and everyone else. Please join us in offering praise and gratitude for everyone's continued well being.
P.S. The new mailing address at CNS for Theresa is:
CNS - Theresa Wang
2500 Gosford Rd., #112
Bakersfield, CA 93309