Thursday, November 26, 2009

Tuesday November 24 – The Neuroplasticity Window

One the way to school, Quinn says he “want the magic potion.” He means the H1N1 vaccine. I have to look into this and see how we are going to fit this into the routine.
You are starting to get to know all the staff in the hospital. You greeted Lily, maintenance lady, like you are best friends. She has captured your heart because she retires next March, after 29 years on the job.

You ask Anne, an LPN, whether she is married or not. “No, I’m still not.” She replies “You ask me that every day that I see you.” “Well, I just want to know if I can relax or not.” “What do you mean – relax?” I ask. “I just want to know if I have to find you a guy.”

You have been taking everyone’s love life very seriously. You offer advice freely. “Love each other”, “Don’t put things off”, “Life’s too short” and “Be happy with yourself.”

Will your next career be matchmaker and marriage counselor?

It’s nice to see you bond with the health care team at the hospital – I’ll be sorry to see that chapter close. But you make friends wherever you go and I think there will be special friends ahead in rehab.

You are still glowing in the light of Rod Carew’s phone call. He certainly hit a home run with you. If there is any future calls – they will probably a grand slam. You are in awe of the conversation – which you have almost committed to memory. I am in awe to the timing. Had Rod called two months ago – you would have had very little voice and you would not have had any memory. If it was a month ago – you would have been only been able to whisper and it might have been one of the first memories you retained.

You idly wonder about Rod’s age, so I got out the book that Dave gave you on Rod’s early career. You want to read it. I hold the book, but you have a lot of difficulty following to lines. When your eyes move to a new line they don’t scan all the way to the left to get the beginning of the line. You start then line in the middle.

I hold a coloured paper above the line to help you track the lines and tap my finger to the left of the page as you switch from line to line. You read about half a page and you were exhausted ... and frustrated.

While you rest, I read the book to you. We make an interesting discovery about a connection that you and Rod have. The MLB organization has a rule about recruiting young players. A player can not be signed up before midnight of the day of his high school graduation. Rod graduated June 24,1964. You were born 25 June, 1964. You were born on the day Rod officially started his professional career. It sounds like an obscure connection that one would find in a W. P. Kinsella book.

We spend the rest of the morning discussing the Christmas present planning. It is an annual event that most parents must do. You must decide what is reasonable and what would WOW your offspring, and yet you still want to teach that giving is the important part of Christmas, not receiving.

You are feeling very generous towards the children. You are thinking an ipod and nintendo DS. I am a little shy of giving gadgets. Especially electronic gadgets. I think there will be plenty of time for those things in their lives and I would prefer that they make acquiring those things their own personal project. If they have to save the money and budget the money to spend the money then they will be more likely to look after the gadget and not loose or break it.

You wear me down with your ‘I want to be generous’ logic. “They are great kids.” You say. I agree and suggest that if we do this then there should be a stipulation from Santa or whoever is giving the gifts, will be that they must share the two different machines. They will be family gadgets. This builds cooperation and sharing. You seem OK with this idea. This will help with the machines being over used.

I point out that generous gifts do not compensate for you being lost to us for a few months. You can’t compensate for that. Being with them and giving them encouraging support like you did last week, that is what they need … and want.

“Yeah but I mean, I’m a parent for the rest of their lives. One pep talk doesn’t make me a parent – it’s an ongoing thing.”

Sarah, a friend from London ON, called. She is Martha’s sister. You relive the phone call from Rod again. You mention that if you can befriend Rod, then you “will have to unload a lot of friends that I have now to make room for Rod.”

Stan and Julie came to visit and Stan shared experiences that he had when he had a brain injury. I think that talking to survivors really helps you to envision what the future might look like. It certainty helps me.

I tried to talk to you Monday while the children are in gymnastics to see what you think about Tara’s demeanor with you and her health concerns. You were tired and weren’t very receptive. I decide to try again today. When Jane, the social worker, came to visit you – I had an opening. I ask her what her read of Tara’s various ailments was. She felt that Tara was feeling ignored. I need to spend time with her.

You seem to understand that I have to somehow find time to do this. You mention that you are not as needy now at night as you were. You are right. Nights are much better, but the children don’t benefit from this much because they are asleep. We try to develop a plan to create time for one on one with both Tara and Quinn.

We start to work on the Christmas letter. You made several attempts and tackled different ideas.

We laid down for a nap, but you don’t sleep. We talk about the future. About our dream life in a little house on the Bras D’Or lakes. Walking on the beach in Cape Breton – just you and me. I mentioned that we would want an area where Tara and Quinn and their families could camp out. We talked about renewing our vows. I said I won’t be so nervous, you said that you would be more nervous then the first time around. “Why” I ask. “Because I know more about what the commitment means now.”

Val, from the animal hospital, visited. She lifts your spirits and is able to banter with you easily. She brought a game of Yahtzee. This was one of the game ideas I had for a Christmas present. She also brought a blanket for when ‘all your women sleep over’. Val’s Dad had a major stroke about four years ago. He still has some significant mobility issues as a legacy. She shared some of the struggles her family has had. “It’s good now.” she says. I want to believe her.

We waited all day for physio – no show – I’m frustrated. I don’t know where we are on the map for rehab. I just want a road map for rehab. And I was hoping that I would have answers today. Tara has been anxious about this too. She wanted me to report to her as soon as I had talked to the physio and OT team.

After talking to stroke victims and their families, I have come to the conclusion that the right therapy at the right time is important. I worried, before, that depression would ambush your recovery. I don’t think that is the case at this time … but that can change.

I can see that the right attitude to the therapy is important. You have to want to work hard at it even when you are frustrated. One survivor said that reading was such a challenge during the recovery that he gave it up. He can read, but only for a short time. His favorite reading, now, is to his grandchildren. He wondered that if he pushed himself more at the time, he would have gained some of the neuroplasticity back for reading.

Without fully understanding how the brain heals, I can not be too critical of your current treatments. But I do understand that for neurons to make new connections and create neuroplasticity, the timing of appropriate therapy is essential. I don’t want your therapy to be poorly timed.

I think the healing and reconstruction phases as windows of opportunity. These windows have a shelf life. And significant changes after the window for neuroplasticity closes won’t happen. I don’t want to lose a minute of opportunity.

Before bed, Tara was secretly working on a letter … a letter to Santa. Once she is asleep I check it out. It’s an impassioned plea to Santa to have you walking and home for Christmas. She signs off and adds a PS: Please Help Me! (in large letters).

I remind myself about her powerful belief in the Magic Blanket almost 13 weeks ago. Maybe she has a special power to wish and get miracles.

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