Having recently had to deal with Pop's anosognosia / storyteller without an anomaly detector, I felt that I didn't have the distance required to respond coherently! I went back into my notes, seeking advice and council. Will admit also had to sleep on it !
Last May I was able to ask Dr Amador a question during a live call in where he was speaking to family and caregivers of people that were dealing with Anosognosia.
I asked if he had any general recommendations for us. Then later on went back and made some notes from his book :
"Have to stop talking about them being ill."
"There are lots of things that we CAN do to help: Respect , Listening."
"They are alone in their experience. "
"Reflective Listening. If they have an alliance with someone they will stay in treatment."
"Let's agree to disagree !"
"Convey your respect for their point of view. "
"Start conversations where you can learn something and you reflect back what they are feeling."
So again for those that haven't looked at Dr Amadors site : The Leap Institute, I highly recommend a visit.
It's been the only thing out there that I have found, offering a bit of solace, for those of us on the front lines.
"Listen. Empathise. Agree. Partner. LEAP!"
Wednesday, December 18, 2013
Saturday, November 16, 2013
Anosognosia
Such a big word! So hard to say and remember. Used to describe to forms of delusional expression in someone like Pop, with his injury to his right parietal, to someone suffering full blown schizophrenia. Anosognosia certainly has serious implications for someone with schizophrenia as in denying their illness means they won't take medication. I won't go into a further description of this aspect of Anosognosia as it is the better documented. You can "google" it ! Pop's version is probably very common too, considering just how any people have strokes. But as there is no cure as it were, there isn't much out there in how to deal with it.
The main thing that I'd like to talk about in this post are the various things that we use in helping someone in my Pops situation.
Because the one piece of help that we didn't get from any neurologist or doctor was just how to work with and not against someone with this condition. We needed to learn not only how to understand what was going on with Pop's thought processes post stroke but also how to relieve his anxiety about what he saw as inconsistencies in our response to something he considered fact. By "we" , i include not just my mother and I, but all of those helping him, his caregivers, his friends and wider family.
So back to anosognosia. That big long word translates to "denial of illness".
While you might think it describes a psychological response (denial) to two conflicting views of the same sensory information, It's a little more complicated than that. It doesn't really have anything to do with denial as a psychological mechanism. Anosognosia arises after an injury (or perhaps a mistake to the genetic code) to the brain in the parietal and frontal lobes.
There is no talking therapy, no medicine, no retraining another part of the brain, that heals or transforms this injury into something positive. It just is. You go on from there.
Wild harebrained ideas zing through our brains all the time, don't they? Sometimes they seem like an inspired and creative answer to a question that we are researching. Or perhaps it is some otherwise totally incongruous and outrageous inner response to say a push on a crowded train? What is driving this process? The left hand side of the brain. An incredible mixture of language, memory and reason. The left overflows with information. Coming in, going out, stored in those places that it has dedicated to short term memory, long term memory, all that.
For the vast majority of us, our right parietal takes in this information and comes back with its judgement of the situation. It's the part of our brain that fits that piece of information arriving in our complex sensory system and says: Yes ! That fits in there. No! That looks that looks like it might fit in there but it really goes into that spot. The right parietal is basically the part of your brain that is building your reality with all of this sensory information: sight, hearing, touch, taste, running that through a check with the various areas that store memory and updating the general picture. Building our reality instant by instant with the information that it has on hand, constantly fine tuning "reality" as new information comes on board. Amazing!
Pop's right parietal, his "anomaly detector" simply can no longer counterbalance his left hemisphere's workings. This can't be fixed/regrown nor its function taken over by another part in the surrounding area. It doesn't get "better".
Just think how many variations the left can come up with as to how to fit in this or that piece of information into a general picture? Without a "general" picture we can't function. So what does it look like when only your left hand hemisphere holds sway over building that very important general picture of reality? Well the answer is that sometimes it can put together a pretty decent picture. And sometimes it can't.
He says it's all about building trust between yourself and someone dealing with anosognosia.
The first thing is to offer an ear. We listen. We sit there next to him, take the time and just listen.
The second thing: No challenges to his version of reality. We do not say "That's not true, Tal!"
Pretty garden variety suggestions so far aren't they? Now comes the hard part.
Third thing : We agree. Simply that. Even the most spectacular and unbelievable of the realities he is describing, we agree to their possibility.
Fourth thing: We offer partnership in looking into the situation further. Helping check the facts. Being his legs, arms, eyes for a moment. Questioning like a journalist. Pop helps ! Pointing out if you have tried a leading question. He's not amenable to those ! His story emerges. Not your story. His.
When I use the word "story" that already sounds like i'm talking about something fictional, doesn't it?
And that's one of the difficulties. Because you don't want to just give lip service to someone like Pop. He can read that kind of response a mile away. No, you put preconceptions aside and enter into his world, his reality of the moment. This happens at his pace. He is the guide. You are simply the visitor, the cartographer of a new city, looking around, making a map with names of streets and avenues and metrolines. Putting in the landmarks and centers of interest. Showing curiosity for even the littlest side street and noting even the mundane of daily life. It's not all museums, libraries and the Eiffel tower!
The reward is mutual trust. In dealing with someone with Anosognosia, that's all you should be looking for. It's an quite a positive outcome for something that appears so dire at the outset.
Lissa, in a cold wet and grey November in Paris. Missing her Pop. And her Mom!
The main thing that I'd like to talk about in this post are the various things that we use in helping someone in my Pops situation.
Because the one piece of help that we didn't get from any neurologist or doctor was just how to work with and not against someone with this condition. We needed to learn not only how to understand what was going on with Pop's thought processes post stroke but also how to relieve his anxiety about what he saw as inconsistencies in our response to something he considered fact. By "we" , i include not just my mother and I, but all of those helping him, his caregivers, his friends and wider family.
So back to anosognosia. That big long word translates to "denial of illness".
While you might think it describes a psychological response (denial) to two conflicting views of the same sensory information, It's a little more complicated than that. It doesn't really have anything to do with denial as a psychological mechanism. Anosognosia arises after an injury (or perhaps a mistake to the genetic code) to the brain in the parietal and frontal lobes.
There is no talking therapy, no medicine, no retraining another part of the brain, that heals or transforms this injury into something positive. It just is. You go on from there.
Wild harebrained ideas zing through our brains all the time, don't they? Sometimes they seem like an inspired and creative answer to a question that we are researching. Or perhaps it is some otherwise totally incongruous and outrageous inner response to say a push on a crowded train? What is driving this process? The left hand side of the brain. An incredible mixture of language, memory and reason. The left overflows with information. Coming in, going out, stored in those places that it has dedicated to short term memory, long term memory, all that.
For the vast majority of us, our right parietal takes in this information and comes back with its judgement of the situation. It's the part of our brain that fits that piece of information arriving in our complex sensory system and says: Yes ! That fits in there. No! That looks that looks like it might fit in there but it really goes into that spot. The right parietal is basically the part of your brain that is building your reality with all of this sensory information: sight, hearing, touch, taste, running that through a check with the various areas that store memory and updating the general picture. Building our reality instant by instant with the information that it has on hand, constantly fine tuning "reality" as new information comes on board. Amazing!
Pop's right parietal, his "anomaly detector" simply can no longer counterbalance his left hemisphere's workings. This can't be fixed/regrown nor its function taken over by another part in the surrounding area. It doesn't get "better".
Just think how many variations the left can come up with as to how to fit in this or that piece of information into a general picture? Without a "general" picture we can't function. So what does it look like when only your left hand hemisphere holds sway over building that very important general picture of reality? Well the answer is that sometimes it can put together a pretty decent picture. And sometimes it can't.
We see that Pop's version of his present reality is best, when he's been up awhile. Is physically sufficiently stimulated to feel "awake" but not so over-stimulated as to feel overwhelmed and therefore tired.
That golden time is usually around meal times, before and after. Perhaps at the very beginning of a trip outside. Where he feels the air, a breeze, sees the sky! Or having started some basic conversation with a visitor, allows it to develop. This can take an hour or so. Its akin to "priming the tank".
When is the left furthest from the mark ? When Pop is just waking from either deep sleep or a nap. When his left hand brain has been using his dreamscape to construct his reality.
How do we recognize the anosognosia in Pop? Simple stuff really. Pop might say that he is just going to get up and wants to take a walk, stretch his legs. That he wants to go use the bathroom. That no, he doesn't need a new wheelchair because he will be out of bed soon and won't be needing a wheelchair!
It makes things like his ability to participate in any kind of physical therapy, impossible. I mean why do 100 leg lifts if you didn't think there was anything wrong with you in the first place? Why try to stand up when you can stand up if you want to? You just don't want to at the moment.
One of Pop's best explanations of why he doesn't try and walk is that his doctor(s) told him he was to stay in bed and rest. That was what he was doing. Staying in bed and resting. Following doctors orders, he said.
101 reasons why whatever reality he has built at that moment is definitely the right one. He fits all the facts in from his point of view with great, great creativity and makes it all sound very, very plausible!
But what do those of us around him do when one of his versions of reality is really way way off ? And is causing him great distress ? This can happen and it's really heartwrenching.
At this point, I'd like to introduce the writing and practice of Dr Xavier Amador
Dr Amador is a psychologist best known for his help for the families, caregivers and "responders" (police and emergency medical teams) that work or have to deal with schizophrenics. Schizophrenia. Another Big Word. From my reading, schizophrenia seems to be something that comes from an injury, a tumor or malformation of the frontal and parietal lobes. Where have we come across that before ?!
Dr Amador's suggestions in "I'm Not Sick! I Don't Need Help!" offers the only working therapy model for someone with anosognosia. From the start, it looks pretty simple:
Listen, Empathize, Agree, Partner. "LEAP! "
That golden time is usually around meal times, before and after. Perhaps at the very beginning of a trip outside. Where he feels the air, a breeze, sees the sky! Or having started some basic conversation with a visitor, allows it to develop. This can take an hour or so. Its akin to "priming the tank".
When is the left furthest from the mark ? When Pop is just waking from either deep sleep or a nap. When his left hand brain has been using his dreamscape to construct his reality.
How do we recognize the anosognosia in Pop? Simple stuff really. Pop might say that he is just going to get up and wants to take a walk, stretch his legs. That he wants to go use the bathroom. That no, he doesn't need a new wheelchair because he will be out of bed soon and won't be needing a wheelchair!
It makes things like his ability to participate in any kind of physical therapy, impossible. I mean why do 100 leg lifts if you didn't think there was anything wrong with you in the first place? Why try to stand up when you can stand up if you want to? You just don't want to at the moment.
One of Pop's best explanations of why he doesn't try and walk is that his doctor(s) told him he was to stay in bed and rest. That was what he was doing. Staying in bed and resting. Following doctors orders, he said.
101 reasons why whatever reality he has built at that moment is definitely the right one. He fits all the facts in from his point of view with great, great creativity and makes it all sound very, very plausible!
But what do those of us around him do when one of his versions of reality is really way way off ? And is causing him great distress ? This can happen and it's really heartwrenching.
At this point, I'd like to introduce the writing and practice of Dr Xavier Amador
Dr Amador is a psychologist best known for his help for the families, caregivers and "responders" (police and emergency medical teams) that work or have to deal with schizophrenics. Schizophrenia. Another Big Word. From my reading, schizophrenia seems to be something that comes from an injury, a tumor or malformation of the frontal and parietal lobes. Where have we come across that before ?!
Dr Amador's suggestions in "I'm Not Sick! I Don't Need Help!" offers the only working therapy model for someone with anosognosia. From the start, it looks pretty simple:
Listen, Empathize, Agree, Partner. "LEAP! "
He says it's all about building trust between yourself and someone dealing with anosognosia.
The first thing is to offer an ear. We listen. We sit there next to him, take the time and just listen.
The second thing: No challenges to his version of reality. We do not say "That's not true, Tal!"
Pretty garden variety suggestions so far aren't they? Now comes the hard part.
Third thing : We agree. Simply that. Even the most spectacular and unbelievable of the realities he is describing, we agree to their possibility.
Fourth thing: We offer partnership in looking into the situation further. Helping check the facts. Being his legs, arms, eyes for a moment. Questioning like a journalist. Pop helps ! Pointing out if you have tried a leading question. He's not amenable to those ! His story emerges. Not your story. His.
When I use the word "story" that already sounds like i'm talking about something fictional, doesn't it?
And that's one of the difficulties. Because you don't want to just give lip service to someone like Pop. He can read that kind of response a mile away. No, you put preconceptions aside and enter into his world, his reality of the moment. This happens at his pace. He is the guide. You are simply the visitor, the cartographer of a new city, looking around, making a map with names of streets and avenues and metrolines. Putting in the landmarks and centers of interest. Showing curiosity for even the littlest side street and noting even the mundane of daily life. It's not all museums, libraries and the Eiffel tower!
The reward is mutual trust. In dealing with someone with Anosognosia, that's all you should be looking for. It's an quite a positive outcome for something that appears so dire at the outset.
Lissa, in a cold wet and grey November in Paris. Missing her Pop. And her Mom!
 |
| from "The Atlas of Experience" by Louise van Swaaji, therapist, Jean Klare, graphic designer and cartographer and David Winner, writer. |
Sunday, October 13, 2013
The Arrival of the Amanuensis - Tal Writing : Tal on Television, - Sept 2013
Looking over Pop's writing this past summer and found this :
Tal on the subject of Television :
"Television is "High Anxiety"! Hour after hour, making the world a place to be fearful of. Have you seen something called Saturday Night Seduction ? Every step leads to terror and death. I think older people are more sensitive to this and after awhile they accept it as normal. (not just older people, everyone! )
They have the beginning of that thought/feeling that the world out there is really such a frightening place. You wonder where the beauty went ?
You want to say: "Wait a Moment! I need something that leads you to beautiful thoughts! Not that lead you to your fears! "
If you have a TV, I'd be more careful."
You might be wondering how Tal "writes" with the damage sustained to his right parietal ?
Well his ever resourceful left hemisphere has come up with a solution of sorts. Use of Pop's terrific long term memory. We often see him writing with his right finger on shoulder or knee. I'm guessing this is some type of memory enhancement. We need a decent neurologist to describe what is truly happening here but it seems to be something like memorization. It's certainly one of Tal's primary activities, this finger writing.
So it isn't surprising when you hear him able to start telling you a new Dragon Tale or speaking to a recent interest in perfect sentences. I quickly grab the ipad or a sheet of paper and start taking his words down down as fast as i can. When he pauses, I read him back what I have written and on he goes, correcting grammer, changing a word here or there.
Sometimes like this piece on Television with a capitol T , it comes out exactly like he's said it. Quite different than having a conversation with him ! It's as if he had been working on what he wanted to say, honing his words before sharing them with me. Pretty surprising isn't it?
We are trying to encourage him in this direction and have asked a young therapist to try combining "talk therapy" with that of being an amamuensis. At first Pop was quite wary. He would gladly "write" with me, his daughter, but with Craig, he said he thought C was going to use these words in "his book on Tal" !
"No, that isn't the case. Craig is going to be your amanuensis as well as your talking therapist. Like Eric Fenby was to Frederick Delius. We wouldn't have "Song of Summer"* if it weren't for Eric Fenby !" I told him.
And this he was able to take on board. Evidence ? He's been doing some pretty interesting writing with Craig these past few months. Hopefully the trust between these two men will only grow stronger as they practice this new way of working together. It requires great sensitivity on both sides, I think. Craig to Pop's physical condition of the day and Pop's sensitivity to Craig's searching for the way into his maze of a brain. They will certainly have fits and starts and back steps. But Mom and I are optimistic !
-L
*Song of Summer is both the title of an incredibly beautiful piece of music composed by Fredrick Delius near the end of his life in 1931 and a film of the same name made for the BBC by the enfant terrible of English cinema, Ken Russell, in 1968.
Before you dismiss the film entirely on reading that, you should know this is pre "Sons and Lovers","The Boyfriend"; "Tommy" et all. Certainly one of Russell's greatest films.
Shot in black and white, impeccable editing and with wonderful performances from Max Adrian as Delius, Maureen Pryor as Delius's long suffering wife Jelka and Christopher Gable as Delius' amanuensis : Eric Fenby. And there is the beautiful Delius music throughout. One of Pops all time favorite films.
Tal on the subject of Television :
"Television is "High Anxiety"! Hour after hour, making the world a place to be fearful of. Have you seen something called Saturday Night Seduction ? Every step leads to terror and death. I think older people are more sensitive to this and after awhile they accept it as normal. (not just older people, everyone! )
They have the beginning of that thought/feeling that the world out there is really such a frightening place. You wonder where the beauty went ?
You want to say: "Wait a Moment! I need something that leads you to beautiful thoughts! Not that lead you to your fears! "
If you have a TV, I'd be more careful."
You might be wondering how Tal "writes" with the damage sustained to his right parietal ?
Well his ever resourceful left hemisphere has come up with a solution of sorts. Use of Pop's terrific long term memory. We often see him writing with his right finger on shoulder or knee. I'm guessing this is some type of memory enhancement. We need a decent neurologist to describe what is truly happening here but it seems to be something like memorization. It's certainly one of Tal's primary activities, this finger writing.
So it isn't surprising when you hear him able to start telling you a new Dragon Tale or speaking to a recent interest in perfect sentences. I quickly grab the ipad or a sheet of paper and start taking his words down down as fast as i can. When he pauses, I read him back what I have written and on he goes, correcting grammer, changing a word here or there.
Sometimes like this piece on Television with a capitol T , it comes out exactly like he's said it. Quite different than having a conversation with him ! It's as if he had been working on what he wanted to say, honing his words before sharing them with me. Pretty surprising isn't it?
We are trying to encourage him in this direction and have asked a young therapist to try combining "talk therapy" with that of being an amamuensis. At first Pop was quite wary. He would gladly "write" with me, his daughter, but with Craig, he said he thought C was going to use these words in "his book on Tal" !
"No, that isn't the case. Craig is going to be your amanuensis as well as your talking therapist. Like Eric Fenby was to Frederick Delius. We wouldn't have "Song of Summer"* if it weren't for Eric Fenby !" I told him.
And this he was able to take on board. Evidence ? He's been doing some pretty interesting writing with Craig these past few months. Hopefully the trust between these two men will only grow stronger as they practice this new way of working together. It requires great sensitivity on both sides, I think. Craig to Pop's physical condition of the day and Pop's sensitivity to Craig's searching for the way into his maze of a brain. They will certainly have fits and starts and back steps. But Mom and I are optimistic !
-L
*Song of Summer is both the title of an incredibly beautiful piece of music composed by Fredrick Delius near the end of his life in 1931 and a film of the same name made for the BBC by the enfant terrible of English cinema, Ken Russell, in 1968.
Before you dismiss the film entirely on reading that, you should know this is pre "Sons and Lovers","The Boyfriend"; "Tommy" et all. Certainly one of Russell's greatest films.
Shot in black and white, impeccable editing and with wonderful performances from Max Adrian as Delius, Maureen Pryor as Delius's long suffering wife Jelka and Christopher Gable as Delius' amanuensis : Eric Fenby. And there is the beautiful Delius music throughout. One of Pops all time favorite films.
Sunday, September 29, 2013
Tal's World Today : Fall 2013
Yes, you ask yourself if you would be able to survive the day in - day out life Pop has been living these past few years ? I think its a little bit more complex than you might imagine. As his brain processes information differently these days, we think that this is probably the best we can offer him. A life where things move at a pretty even pace. Changes are not abrupt. Yes, stimulation ( visual, talk, visits, outings) but we always make sure Pop has time to recuperate and adapt both physically and mentally.
What does his world, his view from the bed look like ? A bit chaotic, but he seems to prefer it like that. I proposed changing out the postcards for instance, he said no he wanted everything left just as it was...so we just add a new area as new things come in.
What does his world, his view from the bed look like ? A bit chaotic, but he seems to prefer it like that. I proposed changing out the postcards for instance, he said no he wanted everything left just as it was...so we just add a new area as new things come in.
Two bright blue socks hang with the message : " See Tal ? The sky really does begin at your feet! "
That's a famous Tal Streeter quote by the way: "The Sky Begins At Your Feet !" Oh those boys from Kansas!
At Pops window, two Ken Conrad kites (Great Winds Kite Co. Seattle, WA) . Tal: "You see that kite over there? I am almost embarrassed to admit how much pleasure I have got out of watching that kite fly all day today. It is so beautiful how the tails come down and twirl around each other. All I have done all day is lay in this bed and watch that kite."
At the far end of his bed, Bruce George has made a small model of a sculpture that Tal wants to put up at the Dream of Flight , Museum and Library.
Pop has a television. He doesn't watch it. Mom has covered it up with a cloth so I'd guess he has forgotten that he has one. We sometimes watch YouTube video on his iPad in bed. Most subjects are flight related. Hummingbirds, bird, butterfly and all types of insect flight as well as the Virgin Galactic animations for future spaceflight.
L.S, September 28, 2013
Santa Fe, New Mexico
Tuesday, September 3, 2013
Tal's Butterfly Blog : Here we are and Here we will be ! August 2013
Welcome all! Friends and family of Tal Streeter. As some of you may know, I've stopped updating the Care Pages Blogspot of the same name, quite some time ago. Out of sheer exhaustion, more than anything else!
As things seem to have stabilized somewhat in my family's life, I've moved all the old posts over here from that earlier care pages blog. I'll be doing two monthly updates here about my Pop, Tal Streeter, the Dream of Flight Museum and Library (soon opening here in Santa Fe, New Mexico) and any subject that Tal wants to write about : sky, clouds, night sky, rocks, kites, Domina Jalbert, butterflies, hummingbirds, Manhattan, Kansas, Spaceport America in Las Cruces, NM, The Art Of The Japanese Kite, Kite Journey Through India last but not least : Tal's up and coming projects!
For those of you just joining us, "Dream Of Flight, Museum and Library" is something that Tal has been working on for many many years. His first efforts went towards Newcastle in the U.K., then somewhat nearer to home in Verbank New York. Finally in 2012 here in Santa Fe, New Mexico, the Wong-Wagner family generously donated land, funds, and their enormous energy. They established "Friends of the Sky Foundation", surpervised the design and put in the hard work and construction of this amazing structure.
Dream of Flight will house Tal's library and personal collection of six to seven thousand kites from the world over, sky related material as well as his sculpture, drawings and archives. It's going to be a marvelous place where all things flight intersect with the poetic and the inspirational quality of the sky.
In this blog, l'll also be talking about the peculiar consequences of Pop's ischemic stroke in February of 2011. He incurred serious injury to his right hemisphere in his parietal and temporal lobes. We think it is important to share what we have learned with the wider world as well as asking for help and advice in dealing with this right brain parietal injury. We will be updating in here about various aspects and experience with Tal's long term care as and when we can : bed, wheelchair, talk therapy, dealing with anosognosia, Modern Hospice Care, Hoyer Lift's, Relexology, Massage Therapy et all !
For those of you that haven't seen Pop in the flesh, rest assured he looks great! He is very dapper, has good humour, memory and is still the fascinating fellow that we all know and love! Bit different, tires easily...but underneath it all, he is there.
I want to thank George Peters for inspiring me to start this blog . Both he and his wife Melanie Walker offer stunning blogs and set a wonderful example. George said he thought Tal deserved a blog that was worthy of him! I couldn't do that at the time but am going to attempt one now! Thanks also go out to Jerry Hickey, the night owl (retired) to whom I promised to restart/revamp Tal's Butterfly Blog and post regularly! Jerry, keep after me will you ?
And that beautiful picture of an Albers Dream Kite ? David Wagner, made the original from one of Pop's drawings, flew it with him, and offered this photo of that moment together.
Lissa Streeter
Santa Fe, New Mexico
August 2013
Tal Streeter in Santa Fe, New Mexico : January 2012
Six months since leaving word here on this carepages blog. partly because all of us are feeling overwhelmed with these events, partly because the complexity of our situation and the difficulty of finding immediate solutions for Pops care, left us all with little energy for anything else to be honest!
Pop is now living in Santa Fe New Mexico at a wonderful spot: El Castillo. He is still paralyzed on his left side, still unable to read as he has no vision in his left eye. (Or should say he has no problem with his eyes but the connection from left eye to right hemisphere, right parietal lobe is absent)
He is quite frail as he has lost most of his muscle. Arms, legs are thin thin and boney. This for several reasons. One is Pop needs feeding at each meal and until recently that was something that they weren't consistent about at El Castillo. He counts on food that he can eat rather than on tube feedings. He still gets a few of those to keep his food tube open and functioning. The food is excellent, varied and if someone takes the time to help him eat it, he really likes it!
He no longer has "pain" of any kind except when he does a big day of exercise.
Jason, having moved down with Tal from Kansas, was working with him almost daily on stretching and helping keep whatever muscle he has. Joel has taken over most of that work of recent as Jason has started back to nursing school!
Pops thinking. I suggest anyone interested, have a look at a youtube video of the Gifford Lectures in Edinburgh where the great neuroscientist, Michael Gazzaniga describes what we understand 'bout the left and right hemispheres these days.
Here is the link: http://www.youtube.com/watch?v=mJKloz2vwlc
The 3rd part of the lectures, entitled "the Interpreter", best describes what is going on with Pops brain and specifically how the injuries he sustained to his right parietal and temporal lobes, affect his thinking.
Pops left hemishphere is in perfect working order. It weaves rather complex stories with whatever sensory input/ memories it has on hand. Some of these stories can become quite exaggerated and I think until recently we all took this as a sign of madness of some sort!
This "interpreter", weaving stories, is indeed what we ALL do! What you and I have, the right parietal lobe, Pop no longer has. The right parietal lobe is a counterbalance of sorts to our story weaving "Interpreter" in the lefts parietal lobe. : Both of Pops right parietal and temporal lobes sustained massive damage during the stroke.They will not miraculously come back. This is a reality.
So...what we have kind of come up with as a way to help Pop, is for his interlocuters to fill the role of his right parietal lobe in daily conversation. His left hemishphere totally welcomes this intervention on the part of the person that he converses with! Basically, it continues weaving the story but now incorporates the correct information!
This might sound kind like it makes for an odd conversation but really it doesn't. POp takes in what you offer him very quickly. Indeed he doesn't resist what you offer. It might go something like this:
Tal: "Romig went off to China yesterday"
Lissa: "No Pop. Mom is staying home for a few days because she has a cold. She will come in as soon as she feels better and won't pass on her cold."
Tal:"I knew that."
(And this effectivly eliminates China from the conversation!) ( China entered the conversation because one of his aides who looks slightly Asian, had just been in. She is Hispanic but Dad thought she was Asian till we finally asked : reality check!Reality checks are totally welcome!)
It's kind of like he inserts all kinds of information into his thinking: dreams, sensory, overheard conversations, all kind of things! Once you know how his left side is weaving the story, you can gently bring him back on topic.
It's kind of like he inserts all kinds of information into his thinking: dreams, sensory, overheard conversations, all kind of things! Once you know how his left side is weaving the story, you can gently bring him back on topic.
It's quite fascinating and keeps you on your toes.
For me it was really important to explain this left hemisphere functioning to him. His thinking "feels" different to him and i think he wondered himself if he was crazy! I kept repeating to him that he wasn't crazy ! Just missing that right parietal lobe. His "intellect", if you can describe it as such, is totally intact! And that was quite a relief for him!
So the good news is that he has been working. Coming up with new ideas for sculpture, working with David on their foundation in Santa Fe, Friends Of the Sky as well as Marie on the wall relief for the foundation of all things sky and flight!
I should offer another example of how this all works for Pop.
While I was there visiting, Dad was working with David's drawings for a logo for their foundation. Dads left hemisphere needs extra time to "think" about a project so I was showing him the choices that he and David had made the day before. I said I was going to lay them out so that he could get them into his mind again, then gather them up and put them away. Which I did.
I rolled his wheelchair around to look outside at the snow falling outside his window.
He said excitedly: "I have another idea! I see a group of pink horses running, you know, all four feet off the ground, and they are blurred and just one is black. That one is me."
Stay with us here. To Pops far left was a pink carousel horse music box that Raana had given him for Christmas. I brought it over closer to him saying "Like this one Pop?"
His reply floored me. He was as surprised as I to see that he had incorporated something so far from the subject of flight, the sky etc into his "logo" and he replied: "We must get back to the essential. The logo must be red."
Gone was any talk of the horses. He had re-centered himself to the task at hand which was designing a logo.
This all sounds a bit loopy and it does take some practice to get used to but it feels like such a breakthrough to me!
The trick is to help him when he starts to fly off subject. Help him recognize where the "thought" came from. He then goes on "weaving" but this time grounded in reality. I really think this will get easier and easier for him as everyone: family, aides, nurses, visitors understand what is happening and don't just think to themselves "Poor Tal is loosing it" but help him re-center his train of thought. He takes over from there I can assure you! It is very exciting when you see that he really can hold onto it!
Several days after I left, Pop described to Jason, in great detail, a new sculpture that he wanted to make. You can tell from reading the description that it is totally him. He CAN be totally on track and that wonderful artist that we all admire.
So this is the Tal that are we hearing from. This is the Tal that is gaining confidence and assurance. Hopefully he will continue to have better and better moments as those around him understand his situation/manner of thinking. And aren't scared by it!
Lissa writing from Paris
January 2012
postscript August 2013 : reading back over this and I see just how far we have come! We have a totally different way of helping Pop in our daily conversation/interaction. And physical therapy is very different. But more on that in our future posting!
Taking Things for Granted : Aug 12, 2011
August 12 :Tal's message to you all!
Posted Aug 12, 2011 3:26pm
Presently the things that we take for granted : putting on a t shirt, pulling it on with one functioning arm, sitting and standing ; all monumental tasks! I am making progress with these tasks! Pulling on ones socks with one hand is yet another level!
Love to you all, Tal
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