Lists

Toroweap Overlook at the Grand Canyon

Toroweap Overlook at the Grand Canyon

Probably the worst injury I have from my brain injury is memory loss. I can still remember things about my childhood and most of the years after that, but I cannot remember much about the five or ten years before the accident. I cannot remember anything about the work that I did in my five years at Callier Center. I cannot remember names, places, US states, cities, TV or movie actors, countries, and lots of things like that.

Through my rehab I have been learning many ways to help me remember. For instance to remember the state of Illinois, where I lived when I worked at State Farm Insurance, I can remember the city of Chicago, a city I have visited several times in my life, both from work and from family vacations (see photo above – not Chicago, but from a vacation.). And when I think of Chicago I can easily remember its state, Illinois. So when I want to remember that state I just think of Chicago. Another tool I have been using are lists. Fortunately I have been doing that most of my life.

As a child I made lists of what teachers I had for each class each year, especially after I got to junior high and high school, where I had multiple teachers each day. Like most boys – and probably girls, too – I kept lists of the people I dated or wanted to date, including when we went out, where we went and of course a rating system for each girl. At first I did this in a printed calender, but eventually bought a “little black book” to keep records of that. I don’t have that list any longer because just before Jean and I were married, I destroyed my black book.

But I kept making lists. About our vacations and the places I traveled for work, all the cars I have owned, all the places I worked, my salaries, the places I have lived, the cell phones I have owned, my bank and credit card accounts, recipes, musical instruments and stereo equipment I have owned, hurricanes I have lived through – eight, many of the people I worked with, went to school with, and from my college fraternity. And for some of these lists I kept pretty good details. For instance my list of cars also has the make, model, year manufactured, dates purchased and sold, whether they were new or used, purchased or leased, paint colors, engine size, cylinders, horse power, even the EPA estimated rating when available, where I bought it and how I disposed of it – sold, traded in, or handed down to my son Evan or my brother-in-law Bill.

Early on I used paper and pencil to make these lists, but in the 1970’s when I started working with computers, I used those to keep my lists. In the 80’s I started using personal computers and in 2003 I got my first smartphone, which I have been using ever since.

All of that was long before my brain injury, so it was easy for me to continue doing that. While I was at the Centre for Neuro Skills (CNS), even though it took me six months before I could remember enough to use my phone, I kept lists of my therapists, neuro rehab specialists, roommates, even the meds I was taking. I also made lists of thing I needed to remember like US states, countries around the world that were in the news, all my bills, my medical accounts – Blue Cross, COBRA, Medicare, Social Security, Fidelity (the holder of my five retirement funds – Oncor, John Hancock, Sabre, Nielsen, Hewlett-Packard), unemployment, and of course the ACA Marketplace (obamacare)!

So as you can see I was prepared for brain damage long before it ever happened. There area still may things I have trouble remembering, but now I have plenty of resources I created throughout my life to aid in my recovery.

Brian White

Follow my blog with Bloglovin
Brian White & wife

Brian was my counselor at the Centre for Neuro Skills and he helped me immensely. Like all the other therapists and teachers at CNS, he spent a lot of time when I first arrived there testing me to determine how much I had suffered from my brain damage. He gave me a raft of tests to measure my thinking abilities, but like others at that time he soon discovered that I could not read. I also could not remember very much and so soon realized that I could not answer many of the questions he had for me. That was okay because he was not measuring what I knew, as they do when you are in school, but rather how much I had forgotten.

Brian was a wise and gentle man who, like me, was a computer geek, a libertarian who understood that drugs should be legalized, and that there probably was no god. What we found out through his testing was that I could not remember any of the companies for whom I had worked, the states where I had lived, almost nothing about the countries of the world, and not even any of the streets or towns around Dallas where I lived. Geographically and historically my mind was a blank slate.

We would meet each day in his office and talk about whatever he and I wanted to discuss. We spent many hours trying to recreate my work history over the past forty years. I could only remember two of the six US states in which I have lived. We also spent a lot of time working on my insurance needs and my plans for Jean’s and my retirement. He helped me complete the forms we needed to submit in order to apply for my Social Security Disability Income, which always takes a lot of time – in fact, it was more than a year from the time Brian and I started working on those forms that my SSDI was approved and I began receiving income. We also worked on the forms necessary for my Long Term Disability income, which was what paid our bills (but only 60% of my former salary) after the University of Texas at Dallas had fired me nine months after my injury. That was to have been expected, because even now, more than two years later, I still cannot remember anything about the software I was working on at Callier Center. It can take years for someone to recover from TBI, and I knew the university could not wait that long.

Brian also researched the new Affordable Care Act and even filled out the online forms in the Marketplace web site, so together we suffered through the agonizing problems through the early days of that process. After leaving UTD, I had signed up for COBRA – the Consolidated Omnibus Budget Reconciliation Act of 1985, which increased our medical insurance from about $200 each month to over $1,000. With Brian doing most of the Obamacare application, our health insurance was less than half of what we were paying through COBRA (see this post for complete financial history).

Brian also got me hooked on TED, which began in 1984 as a conference where Technology, Entertainment and Design converged, and today covers almost all topics — from science to business to global issues — in more than 100 languages. Even now I spend several hours each week watching fascinating contributions through TED talks and events.

Thanks for reading my blogs. Please feel free to leave a comment here or use my CONTACT ME page to send me email.

My first attempt at writing

Kimberly, my reading therapist , is now pregnant with their first child!

Kimberly, my reading therapist , is now pregnant with her first child!

First things first: Evan and Mirjam found out last Monday that they will be having a GIRL next May!

When I woke up at Zale Lipshy, one of the first things I discovered about my condition was that I could not read. I could not even recognize the written alphabet. Even now, more than two years later, reading is difficult for me. I confuse many letters, like (P, Q and R), which slows my reading down to a crawl. About seven or eight months after my brain injury, Brian White, my CNS Counselor, asked if I had tried to write anything. He then sat me down at his computer and we found that I could write almost as well as before the accident. He told me that two different areas of the brain control our abilities to read and write, and that it appeared that the part that handled my writing must not have been damaged – even after writing something, I still could not read it! Soon after we discovered that I could still write, Alyce in Occupational Therapy had me sit at one of their computers and write about my injury and recover to that point. This is what I wrote, about a year and a half ago (nothing has been corrected):

“November 1, 2012 – Heading to work as I had for nearly five years, I arrived via DART bus at 8:00am. I walked across Inwood Road toward my office at Callier Center, a part of the University of Texas at Dallas.

“As I crossed the street I was struck by a car turning left from Arlington Park Drive onto Inwood Road. Apparently the sun, rising on my left, blinded her such that she struck me on the hood and front window of her car. She immediately stopped, called for an ambulance, and perceiving that I was not breathing, began performing CPR on me.

“I remember nothing of this accident, or the first month after that. I am told that my brain was damaged and that swelling had begun. Dr Rickart at Parkland Hospital performed several hours of surgery on me to relieve the swelling occurring to my head. I was in a coma for a couple of weeks after that surgery. I did not come to until nearly a month after the accident, and even then I was in-and-out of consciousness for the next month (I had been moved nearby to Zale Lipshy University Hospital). While I have very little memory of that time, I do remember over a dozen memories that I had. Some of those memories reflected some of what was happening to me in the “real world,” which I can remember little or none of. For example, I am told that I had had a tracheotomy tube inserted into my throat, which I continued to pull out regularly so that they strapped me to my bed to prevent that. I remember none of that process but I did have a dream where I was strapped to a bed and no one would help me get loose. Similarly, I had other dreams that could later be traced to actual occurrences that I could later identify from things I know or found out about.

“Needing another place to get rehabilitated, my dear wife Jean researched and selected for me a quality rehab center called Centre for Neuro Skills in Irving to continue my recovery. So after two months at Parkland Hospital, and the adjacent Zale Lipshy University Hospital, I was transferred on Wednesday January 2, 2013 to CNS, living in their apartments and attending rehabilitation therapy at their nearby clinic.

“At first I decided I would rather just go home. I had no understanding that my brain damages were severe and quite debilitating; I could not walk (I was in a wheelchair for several months), unable to read, unable to swallow any food without choking (I had a g-tube for feeding), nor could I remember very much (especially names, numbers, history, places and countries). Then during the first few weeks at CNS, I could not get food down – I regurgitated everything that I ate.

“That ended about a week later, and I had a couple of successes in my recovery. The first advance was getting away from my dependence on the wheelchair. After I got over the digestive problems, Sunil told me to get out of my wheelchair and walk. I told him that I could not do that. I could not stand up without it. He would have none of that crap, and insisted that I leave my chair. It took me about another three weeks, but I finally got to the point where I could get into the van that took me back to the apartments without having to use the wheelchair lift at the back of the van. This was a major accomplishment for me. I had been in that wheelchair for nearly four months since I was taken to the hospital.

“How I learned to love the apartments. The first week I was in the apartments, an NRS (probably Kim) wanted to find out what kinds of activities and programs in which I might be interested. Every time she described something like “sports,” “movies,” or “games” I replied “not interested.” All I wanted to do when I returned to that apartment after class was to go to bed and sleep.

“Only after I started to get my brain working a little better, was I able to know some of the people at the apartments. NRS employees, supervisors, transportation drivers, and other patients – I came to realize that this CNS place might be useful.

“I must especially mention the people in PT who provided instruction and support for an anti-exercise master like me. When I first came to CNS, I detested doing any exercise at all. They helped me to understand that (combined with the medical staff) they represented the equals of any fitness resource in the nation.

“I must mention a few of the people at the apartments whom I got to know, an who helped me survive the experience of brain damage. I got to know people like Tiffany, Bernadette, and especially Nicole (and dozens more). By keeping me company and sharing their lives with me, I came to again find that life was very much worth living. Today, I can now read and eat and know that I have survived from traumatic brain damage. I became so excited about learning to be around these people and how they could be people that I loved and be loved by, I now had a reason to get better.

“I must also mention the other people at CNS who helped me beyond belief – educators Sunil, Vanessa, Whitney (PT), Alyce, Carla, Matt (OT), Debbie, Michelle, Veronica (Speech), Kimberly, Amy, Maribel (Education), Brian (Counseling), Brandy (Case Management), Dr Johnson, Selam, Ashley (nursing), April, Bella, Carl, Eduardo and Vanessa (transportation drivers), and many others I don’t have room to list. I was at CNS just under twelve months, and by then I was able to walk up to two miles during Physical Therapy, read fairly well (it can take years for the brain to recover from such injuries), and even eat many types of food. I would not have gotten this far without the assistance of all the friends I made at CNS. I now plan to retire to helping others with such brain injuries and work to get more people aware of the lack of notoriety drawn by such highly debilitating injuries.”

30 Days hath September

480px-Roman-calendar

Brain damage typically results in severe memory loss. As a result of mine I had – and still have to some degree – an inability to read, count, remember words and names, towns, countries, states and many other things. One loss I felt most deeply was time and dates, especially the months. At CNS we had a van driver named April. Since I could never remember anyone’s name, I had to develop ways in which I could remember those things. April was easy because it is a month, so all I needed to do was think, “January, February, March, APRIL!” There, that’s her name!

I got my first job in the computer business at Computer Language Research (aka Fast-Tax) on May 27, 1975. I interviewed a couple of weeks before that and learned that they developed their applications in PL/I, a programming language developed by IBM about ten years earlier. After I accepted that position, while I was perusing the local Barnes & Nobel, I found a book on PL/I at a reasonable price and took it home to read. That book used the function of printing a 12-month calendar as its way to teach the language, so my first education in writing computer software was to understand how calendars worked and how to design and print them.

One of my first software programs was developing a way to take a year, and develop how to organize and print that calender. First I had to determine on what day of the week January 1st fell, and for each subsequent month whether I needed to print four, five or six rows in a given month. For instance, for next year 2015, February only needs four rows, May and August need six, and all the rest need five. By the time I left Fast-Tax and went to work for Lone Star Gas, I had learned how to determine the start of any year going back to 1752, when Britain and her colonies adopted the Gregorian calendar, and developed a method to print the calendar as 12 months on a page or larger versions with each month filling a single page and leaving room on each day to write notes.  I had even begun adding the ability to include most holidays – even Easter, which requires being able to determine the paschal lunar year and its full moon, and then the Sunday after the paschal lunar month’s 14th day.

Another problem working with calendars was that, having been designed by Julius Caesar and introduced in 46 BC, for the next 1600 years it only used Roman numerals. And that was very different from how we figure dates today using Arabic numerals. For example to the Romans January 8, the date of my birth, would have been written as a.d. V Id. Jan. = ante diem = on the fifth day before the Ides of January. January 4, Jean’s birthday, would have been a.d. I Non. Jan. = ante diem = on the first day before the Nones of January. What I have shown is so complicated that both of these examples are probably wrong!

Anyway, with the introduction of the Arabic numerals and the use of zero, using dates became so much simpler that most of us can do most of what we need calendars for without the aid of a computer. Except for me. I still have to count the months to figure out what month this is, the same way I have to do with the letters of the alphabet.

Nicole

Words I needed to remember

Words I needed to remember

After I had been attending rehab at the Centre for Neuro Skills for a few months, my counselor Brain asked me this question: “Patrick, thinking about your entire life, what was your best day?” Without skipping a beat I replied, “Today. Today is my best day.”

That beautifully captured my heightened awareness, my excitement and anticipation, that comes with working for a great purpose, the way that such reformation brings spice, meaning and joy to life. Through my recovery process, I have met so many wonderful people and made so many lifelong friends, each new day is always my best day.

On Wednesday January 2, 2013, I was loaded into a van on my wheelchair, and moved to CNS. The first person I met at the apartments was Nicole Douglas-Barclay. She was my neuro rehabilitation specialist. It would be many months before I knew what that was, and several months before I could even remember “NRS.” Since my condition kept me from remembering most names I heard, over the next few months I often had to ask my wife Jean what Nicole’s name was. I could not remember that.

Jean soon became aware during my first couple of weeks at the CNS apartments how important Nicole was to my recovery. So much so that when CNS decided to move me into a different apartment there, Jean asked the powers-that-be at CNS if Nicole could also be moved to be my NRS. That change of location and getting to take Nicole with me at each move continued twice again, allowing me to continue with the excellent care and development that Nicole provided me.

No matter to which apartment they moved me, Nicole and I were together. Life was good for both of us. It is good to be in rehabilitation — when learning again how to read and how to remember names and places, recovering from brain damage nothing is better. Food tastes better. Water is more brilliant. Girls are more beautiful. The sky is bluer. For the brain damaged in recovery. My life was the best. I was the happiest man alive.

What did she do for me? Everything. From the first day she would ask me a series of orientation questions, to help rebuild my memory:

What is your name?
What day of the week is it?
What is today’s date?
What month is it?
What year is it?
What is the name of the rehab building you are in?
What is my name?
What type of injury caused you to be here?
What city are you in?
What state are you in?
What country are you in?
What city are you from?
What state are you from?
What season of the year is it?
What is the weather like today?
Who is the president of the U.S.?
How old are you?
Where were you before you came to see me?
What do you do when we have a fire alarm?
What is the address for the apartment and clinic?

At first I knew the answers to none of these questions. By reviewing them each and every day over the months, my brain began to be restored, one answer at a time.

Nicole also spent time helping me to walk. After just a month I was out of my wheelchair and able to walk on my own. Each evening she would have me walk with her around the apartment complex. It was not far, about two-tenths of a mile, but before long I could walk around it twice, then three and eventually five times – a full mile each evening.

She helped me with my reading. Kimberly, my English teacher, gave me a set of flash-cards of short, basic words to read in order to heal my memory and reading ability (see the photo at the top). Nicole spent hours with me each evening showing me all these words so I could remember how to read.

Nicole, standing behind me at the wedding

Nicole, standing behind me at the wedding

Nicole went with me to Evan and Mirjam’s wedding. CNS provided a car and driver (Nicole, who had grown up in Jamaica, had no Texas drivers license) to take us to Garland for the wedding and back. CNS also had various events for the patients, such as going to movies, shopping and local parks. Along with some other patients, Nicole would accompany me on these outings. We went to several movies – the only one that I can remember was 42, about Jackie Robinson, although there were several other movies. We would go to local parks in Irving just to walk around and get to know the other patients and NRS’s. I was strong enough that I could help push the other patient’s wheelchairs around the parks. My shopping trips were limited to Target – because I could only eat through my gastrostomy tube (G-tube) Nicole never got to take me to do any grocery shopping.

What is probably Jean’s favorite task that Nicole taught me was to do my own laundry!

Sadly, CNS has a regulation against NRS’s providing patients any of their contact information, so I have not been able to communicate with her in over a year. Please check out my page about her, and contact me if you know how I can reach her,

Two years of therapy later

RAN (Rapid Automatic Naming) Module

RAN (Rapid Automatic Naming) Module

Yesterday was the second-year milestone of the day when I was taken to Parkland with a brain injury. I want to let you know about the status of my recovery and what I expect for my future.

Two years ago I spent two months at Dallas’s Parkland and Zale Lipshy, followed by eleven months at Irving’s Centre for Neuro Skills, seven months as an inpatient and four outpatient while living at home. I then spent a couple of months in the Baylor Institute for Rehabilitation (BIR) Outpatient Services clinic in Garland, and for the past year I have been at the University of Texas at Dallas (UTD) Callier Center, Richardson, where I plan to continue my rehab into next year.

When I first began my recovery I could not read at all. In fact, I could not say or read any letters on the alphabet. I spent many months reading the list of letters (see the RAN page above). One of the last letters I had problems remembering was “K” which really caused grief for my reading teacher Kimberly!  The situation was pretty much the same for numbers – I could not count to ten or do any arithmetic. I could not remember where I had worked or what I had done at work. I could not remember where I had lived – even six months later I could only name four of the seven US states in which I have lived. I remember a time when I would try to talk about Oklahoma, where I had lived for ten years from 1997 through 2007, by asking Jean, “What’s that state just north of Texas?” Even now, two years later, when I hear a mention of “democrats” or “republicans,” I have to think a second before I can remember which party is which. And remember, at the time I was in a coma in Parkland, we had the 2012 election for which I had been a CANDIDATE!

While my ability to read is still at about a 4th grade level, I never lost my ability to write. About six months into my rehab at CNS, my counselor Brian wanted to see what my writing skill was – since I had such trouble even reading at all, no one had bothered to check my writing yet. He asked me to sit down at his computer and type something, so I did and quickly typed, “Now is the time for all good men to come to the aid of their country.” I could type that completely in less than one minute! But I still had difficulty reading it, even after I had written it! Apparently two different  parts of the brain control reading and writing. Similarly with math, after struggling with that for two or three months, I simply awoke one morning able to easily do basic addition exercises like 6 x 8 = 48 and 9 x 7 = 63. Just a few of weeks earlier Kimberly had given me a page of 100 arithmetic problems to do and after struggling through seven or eight problems, I put down my pencil and said that I could not do it. She looked at what I had done and I’d only got one or two correct. So after I told her about suddenly remembering arithmetic, Kimberly gave me that test again and I completed the rest of the page in less than twenty minutes and got all the rest – about 92 problems – completely correct!

I am also still working on my memory. Originally I could not remember the names of states, countries, people or anything else. My favorite person at CNS was Nicole, my Neuro Rehabilitation Specialist. It took me six months to be able to remember her name, and even today, it escapes me more then I’d like to admit. Some names I have no problem with: Jean, Evan and even Mirjam, but most names I still have trouble remembering.

There were a couple of injuries resulting from being hit by that car that were never identified during my time at Parkland. At CNS they knew that I had some vision problems and they suggested that I go see a brain injury specialist about it but because of the costs involved I never did that until last month. Dr Poonam Nathu found that I needed some exercises to strengthen my vision and also wanted me to switch to bifocals to improve my reading. She called Diane, my therapist at Callier to work out a program of exercises I needed. About the same time I had some x-rays done which found that the accident also caused a fracture in my coccyx which was mostly healed. I think that may have been why I had so much trouble on my wheelchair at Zale Lipshy and kept wanting to go back to bed in my hospital room all the time. Anyway, since the fracture has pretty much healed over the past two years, and the pain is mostly manageable, I will probably get by with just using a coccyx orthopedic comfort seat cushion – also known as a donut pillow.

But even when I do struggle with some parts of my rehab, so much else is coming nicely. Two years later I am happier, stronger and healthier than I have ever been in my life. I have gotten into the habit of daily exercise, learned to eat everything (even all the things I used to hate), lost over a hundred pounds and retired from working. And I am now signed up for Medicare, which starts January 1. I love it!

 

More from when I awoke from the coma

ZaleLipshy_12-16-2012

It has been almost two years since I had a fist-sized chunk of my skull removed and stored in a freezer for nearly three weeks, and about another month before I began to awake from all that. By then I had been moved to Zale Lipshy University Hospital, located on Harry Hines Boulevard next to Parkland Memorial Hospital.

Right away I figured out that I was in a hospital somewhere, and that something very wrong had happened to me. I did not know where I was – at first I thought I was in Oklahoma City, most likely because I had dreamed about being there. I had no memory of why I was there or what had happened or how long I had been there. I did not know what day it was and whenever I was told, I quickly forgot. In my mind I thought maybe I had been there for about a year. I knew that my father had died, but I could not remember how long ago that had been (it was actually October 2, 2012, almost a month before I was taken to the hospital). Eventually my family would explain all of this, but it took days and weeks for it to all sink in.

I had been losing weight since shortly after I started working at UTD Callier in November, 2007, and had dropped from 325 to 290 about the time I went into the hospital. After more than two months in Parkland and Zale Lipshy and the brain surgery and the coma, I had lost more than another twenty pounds. I can’t blame that on the quality of the food at Zale Lipshy. In fact they tried very intently to feed me and it was all good stuff – from burgers and pizza to soups, salads, steaks, pasta, baked potatoes, and much more. I could call and order practically anything I wanted. I just was not hungry. They would send me menus of what was available each day with a phone number I could call and place my order, but unfortunately, I could not remember how to use a telephone. My family would offer to call in my order, but I just never felt like eating. The dietitians at Zale Lipshy even began coming to my room to take my order, but I would order nothing or would order just a small amount and then leave it on the table uneaten. I really don’t know why I was never hungry. It might have been the dysphagia, or something else related to the brain damage.

While I was in a coma from the brain surgery, my son Evan flew to the Philippines to fetch Mirjam, his fiance and bring her back to the United States. Evan had gone to the Philippines for over a month just a year earlier and had communicated with her via Skype for over three years. They planned to marry about two months after he brought her to Texas. Meeting and seeing Mirjam for the first time was a thrill for me. She is a very gentle and beautiful woman who has found a new home in our hearts. Instead of “daughter in law,” Jean calls her our “daughter in love.” Mirjam is really special in our lives.

It’s hard for me to imagine that I was only at Zale Lipshy for less than three weeks. Because that is where I began my recovery from the brain surgery, after being unconscious for seven weeks, many of my most powerful memories are from that period. One thing I remember vividly is feeling like the rooms were all tilted 90 degrees to the left! I have no idea why I felt that way. Maybe it was the brain surgery, or being restricted to the wheelchair. I really do not know and cannot explain it, but I kept wondering why the people who worked there didn’t experience it. I kept wondering why they did not topple over while trying to walk around! That awkward sensation vanished only after I moved to the Centre for Neuro Skills in Irving.

I had only two classes that I remember at Zale Lipshy, one for reading and the other for physical therapy. After each class the therapist would roll me into the hall across from the 8th floor reception area to wait for the next therapy class. Those waits were interminable. Sometimes it could be as much as half an hour before some one came to help me. And I was only 30 feet from my room and my bed. I got so tired of sitting in that wheelchair and leaning over 90 degrees, that I would wait until the receptionist wasn’t paying attention and wheel myself back to my room and try to get into bed. So they started locking my wheelchair, but the lock was at the front of the wheels where I could easily release them. So then they started to use something to fasten them on the back or lower down to make it more difficult, so I would holler and complain about the way they kept torturing me, to little or no avail. I only survived by leaving to go to CNS.

If you have any question or comments, please leave me a message on WordPress at spreng.wordpress.com.

 

Number games

Numbers

Learning numbers

I learned yesterday that a new brain is in the process of development. This is special to me because it will be our first grandchild. Evan and Mirjam are expecting a child due in seven months, about Cinco de Mayo!

My own father Ted spent a great deal of his time helping to focus his son towards success in life. I learned to swim when I was two years old, I learned to read before I was five, and, like him, he wanted me to gain a mastery of numbers. Whenever we were together he would have me count, add, subtract, multiply and divide in my head. When I was ten the Federal Reserve Bank, where he worked, acquired its first IBM 1401 Data Processing System (computer), and he was sent to Endicott, NY, to learn how to program it. After he returned home, he started working with me to learn how to count in binary arithmetic: 1, 2, 4, 8, 16, 32, 64, etc, and later to program in Autocoder. In high school my nickname was “IBM.”

So after suffering brain damage, not only could I not read or even remember the alphabet, I did not know numbers or how to count. When I first arrived at CNS, two months after the injury, whenever the therapists needed me to answer questions to determine the levels and types of memory losses I had suffered, they had to test me orally. So, like Julie Andrews sang in The Sound of Music, I had to “start at the very beginning. . .  with A, B, C.” And mathematically, with 1,2, 3.

A different area of the brain is used for math than for language, so those two kinds of trauma recover at different rates. While I was still having trouble remembering which letter of the alphabet was which (and still do to some extent), I was more quickly able to recognize and remember numbers. That was partly because there are only ten digits – versus 26 letters – but also because of the early training I had received from my father. Thus after only two or three months at CNS, one morning I awoke to discover that a large portion of my numeric skills had suddenly come back. I could do basic arithmetic like counting, addition, subtraction, multiplication and division. What I could not do (and still can’t) was doing that in my head – mental arithmetic. But that wasn’t really much of problem. Even in class I could write the problem down, make notes, and still find the answers. Outside of class I use my phone or a computer to easily handle anything dealing with math.

I was so excited about recovering that part of my memory, and so determined to get my reading ability back, that I announced to Kimberly, my reading/math teacher, that I no longer needed help with the math and we could focus on my reading. Of course, she did not believe me and proceeded to give me a math test. She gave me a page of one hundred arithmetic problems that I had tried and failed just a couple of weeks earlier – I had completely given up after struggling trough just five or six problems – and I quickly finished it and answered all of the remaining ninety some-odd problems correctly!

The math was BACK!

Roommates at CNS Apartments

cns_apartments

On January 2, 2013 I was loaded into a van in my wheelchair and moved from Zale Lipshy at Parkland Memorial Hospital to the Centre for Neuro Skills in Irving. CNS owns and operates a residential care living facility – an apartment complex – in Irving, nearly four miles from their therapy clinic. That is where I lived for the next seven months while I was going to rehab classes at CNS.

There are about nine buildings, each having four apartments, each apartment housing two patients. For each pair of patients there are six Neuro Rehabilitation Specialists taking care of us – mornings from 7:30 am until we leave for class in one of several vans sometime between 8:30 am and 10:30 am, depending on when we start classes for the day. The patients then return to the apartments either at 3:30 pm or 4:30 pm, depending on our schedules, where we have NRS’s who are with us from then until their shifts end at 11:30 pm. There are then additional NRS’s in each apartment from 11:30 pm until 7:30 am the next morning. I was rarely awake and active overnight, except when I went to the bathroom, so I rarely saw the ones who worked that shift.

During those months in the apartments, I lived in four different apartments with five roommates: Charles “Bo” Lewis, Ashton Cerka, Bo again, Charlie Thums, William “Bill” Donaldson, and John Sims. Like all the other patients at CNS, my roommates had brain injuries, but each had unique symptoms from which they were recovering. Before I suffered my brain injury, I did not know anything about that condition, except when I would see a car park in a handicapped spot and appear to be perfectly healthy when they walked from their car. Then I would jokingly say, “It must be brain damage.” I have now learned quite a lot about brain injuries because I lived and learned with people who suffered from many different types of neural damage, caused from both physical trauma – car and motorcycle accidents, strokes, aneurysms, seizures, surgery, etc. – and poisons, like mercury and lead.

My first roommate, in my first apartment, was Bo. He was a fireman from Mineral Wells, in his fifty’s, maybe ten years younger than me, who was married and had two or three grown children. I think his injury was from an accident suffered on-the-job. He had severe memory problems, especially difficulty remember words, places and events. In fact, shortly after I shared an apartment with him, he left for about a month for surgery. And since I had my own mental problems at that time, I don’t remember much about him then, except that he did not talk much at all.

My second roommate was Ashton, and I really don’t know why he was there, except that he had problems using his arms. What I do remember is that, whenever he showered each morning, he would always have music playing. I don’t know if it was a radio or records or his cell phone, but I loved the music pouring out of the washroom. In fact, I did not like the way, whenever anyone entered the apartment – my roommates, the NRS, or anyone else – the first thing they did was turn on the television, whether they intended to actually watch it or not. They just wanted some noise. I did not. From Ashton I learned that having good music was much more pleasant than mindless noise from the television.

I hadn’t relearned to use my cell phone at that time, but I did have a lot of recordings at home on my desktop computer. So I had my son Evan copy all my songs – over a thousand of them – to my HP/Palm tablet, which I had purchased about a year before I was hospitalized, and asked him to teach me how to use it. I did not know how to find a specific song, so I just set the app to play them all, randomly. From then on, if no one was watching the television, I would turn it off and start my music on my tablet from wherever it had stopped when I last turned if off. In August 2013, about the time I moved out of the CNS apartments, I got a new cell phone onto which I had Evan load all my songs from the tablet, and which I have sense learned to use much more extensively. I still play it every day, and still set it to randomly play everything, mainly because all of the songs I play are my personal favorites!

After I’d been in the apartments for about a month, Ashton and I were moved to different apartments, him to live by himself and me next door to my first apartment. I do not know why these changes occurred, or maybe I did but cannot remember, but I was in an apartment alone for a couple of weeks, and then Bo released from the hospital and moved in with me again. He was talking a little bit now, but it was mostly just “God dammit” and “oh, shit” and very little else. They told me this was a function of his brain injury and to just ignore it. But it was funny.

One thing that occurred with Bo was related to the fact that I was getting all my nutrition from a feeding tube, because of my dysphagia (swallowing difficulty). One evening after Bo had finished his supper – he was not on a feeding tube – he had a small cup of chocolate pudding. Since he was still in a wheelchair and I was not, when I saw him trying to find a place to throw away the empty cup, I go up and threw the cup away for him. However, before I placed it in the garbage can, I took my finger, wiped off a little bit of pudding that was at the bottom of the container, and ate it. Nicole, our NRS, as she was required to do, wrote about what I had done in the record book she was required to maintain about everything that Bo and I did in the apartment. Apparently we all got in trouble when the people at CNS found out that I had eaten something besides the meals I received through the g-tube.

After two or three weeks with Bo, he was moved to another apartment and so was I, but not to the same place. I was moved in with Charlie, a patient with a very different set of problems. He was about 25 and had received damage to his skull from a motorcycle accident. His parents, Sue and Roger, who were divorced and lived in Wisconsin where Charlie had grown up, took turns living in Dallas in an apartment they had rented just to take turns staying near Charlie during his TBI recovery. Charlie did not have any physical problems, but suffered from severe loss of memory. In fact, he did not know that he even had any memory damage. He thought he still lived with his mother in her Wisconsin apartment, and would often try to find his room upstairs, not understanding that he was not in Wisconsin and that this apartment had only one floor. He also could not remember when he had eaten and would look for food over and over again. During the month I lived with him, Charlie gained 15 or 20 pounds. When I last saw him, about six months later, he had put on at least another 20 pounds. He would also want to look for the stuff he needed to take to school, things like his wallet, cell phone, keys and notebooks, all of which he neither needed nor had. Every morning and afternoon, when it was time to go to class or return home, he would delay the vans wanting to find one or more of these items.

One thing I remember from my time at those apartments was that about once each week we would have a fire drill. Everyone had to get out of their apartment and stand outside the fence until the NRS supervisors had checked each room to insure that everyone had left the buildings. After one “all clear” signal, when we all headed back to our apartments, Charlie went into the wrong one. They pretty much all looked alike, but when he got inside, he insisted that was his apartment and refused to leave. After that incident, I made a point after each fire drill to escort him back to our room so that would not happen again.

Because Charlie would often come into my room and take some of my things, I asked to be moved to another apartment. My next roommate was Bill, who was almost well enough to move back home. He would spend hours asking Nicole what he had to do at the apartments to “graduate” and move home. He was my roommate for only two or three weeks before he was able to go home, but one evening, as we were getting to know each other, I told him that I was 93 years old – I was only 63, but had difficulty with numbers and memory because of my injury. He was astonished, of course, and repeatedly insisted that I could not be that old, but I kept insisting, until I mentioned this to someone else, who know how old I was, and who set me straight. I was so embarrassed and I had to tell Bill that I was not really lying, I was just confused.

My last roommate, after Bill moved out, was John Sims, an engineer at Bell Helicopters. He was severely restricted to a wheelchair and had to be bodily moved from that to his bed or anywhere else. He also had limited speech, so we were not able to get to know each other much. He did have frequent visitors – his mother and children – with whom I was able to learn a bit about him, and I often saw him at the clinic as they work on his mental and physical difficulties.

In late July I was happy that I could move back home, but I will never forget the roommates I had there and all of the NRS’s, drivers and other friends I made at CNS, all of whom helped me in my TBI recovery.

I still go to therapy class

Lisa, graduate student at Callier Richardson

Lisa, graduate student at Callier Richardson

It has been over 22 months since I suffered a traumatic brain injury, being hit by a car as I walked across the street to work, November 1, 2012. After a couple of days in Parkland Memorial Hospital the doctors determined that my brain was swelling too much and needed immediate attention. During surgery a chunk of my scull, about the size of my hand, was sliced off and placed into a refrigerator for a couple of weeks to allow my brain to complete its swelling and return to normal size. During that time I was in an induced coma so I have no memory from the time I was walking across Inwood Road until I slowly started waking up seven weeks later in a hospital bed at Zale Lipshy, UT Southwestern Medical Center’s neurological diagnostic and treatment centers, adjacent to Parkland.

I was only at Zale Lipshy for a couple of weeks, where I started doing physical therapy (which was very similar to what I had been through nine years earlier, when I was learning to walk again while recovering from Guillain–Barré syndrome). At the same time I received rehab classes with a speech therapist because I could not read – at all. I could not even remember the alphabet.

On the 2nd of January, 2013, I was moved to the Centre for Neuro Skills in Irving, Texas, for more intensive rehabilitation. CNS provides postacute therapeutic rehabilitation and disease management services for those of us recovering from acquired brain injury. I spent eleven months at CNS undergoing daily classes for educational therapy (speech, language, memory and reading), physical therapy, occupational therapy, social counseling and other problems resulting from traumatic brain injury (TBI). Much of my time and therapy was done at CNS’s apartments where I lived full-time for seven months before reaching a level of recovery where I could stay at home and ride their van each day to rehab.

At the apartments there were CNS employees – neuro rehabilitation specialists – who lived and worked around the clock seven days a week. In addition to helping us through our day-to-day activities – going to the bathroom, getting around on the wheelchairs, getting to the clinic and back each day for therapy – they helped prepare us for the essential knowledge of how to live on our own in the outside world – the world beyond rehab. That training included how to do my own laundry, make my bed, prepare meals, learn to make grocery lists for meal plans, and even how to do simple things like take a shower or use the toilet – not easy to do when you are in a wheelchair.

After I left CNS, I really needed to continue my rehab – I still have severe memory loss and can barely read – so I enrolled in classes at Baylor Garland, the nearest TBI therapy clinic to my home. I started there December 10, 2013, less than three weeks after leaving CNS. At CNS I was in the therapy clinic six hours a day, five days a week. At Baylor I was with a therapist two or three days a week for just an hour each visit. Quite a difference, but then I was recovering each say, little by little so that was sufficient.

Unfortunately I only got to stay at Baylor Garland for less than a month because my health plan – ObamaCare – started January 1st and I had to pay the full cost for my therapy until my deductible was fully payed. Fortunately, my therapist, Carey Hammond told me about a TBI therapy program at Callier Center – where I worked at the time I received my brain injury – that was not tied to insurance plans. As a university they only charged a small flat fee per semester because the program was designed to teach UTD graduate students to become therapists. In fact several of the therapists I’d had at CNS had graduated from this program at UTD Callier.

I started at Callier about a week after my last session at Baylor and have been attended their classes ever since. In fact the new fall semester started a couple of days ago. Last spring and this fall semester I am attending one day a week, on Fridays. Over the summer semester I went Mondays, Wednesdays and Fridays, just to see if I really needed that much therapy.

The rehab classes at each facility are quite different. At CNS there were six hour-long classes each day, similar to classes at high school or college, except for the group counseling sessions which consisted of a coundelor and three to six patients. We also had an hour at noon for lunch and we each brought our lunch from the apartments or from home. Most of the time while I was in the apartments I was not able to eat meals at all – I was restricted to a feeding tube because of my dysphagia (difficulty swallowing). I got off the g-tube about two weeks before I moved home, so that was the only time I had anything at the apartments with which to make lunches. After I moved home I made lunch before the van picked me up each morning.

During my brief time in rehab at Baylor Garland I had therapy sessions for one hour a day two or three times each week. Like at CNS, these were one hour sessions one-on-one with a therapist, either Carey or Theresa Welch. At Callier I had Friday therapy class from 9am until 11:30am. The first hour was a group class with half a dozen patients and as many graduate students discussing current events gathered by the students during the week for which they collected news photos to show the class. After this segment we watch a brief portion (ten or fifteen minutes) of a movie or television documentary selected by the instructor – during the spring semester we watched the movie Remember the Titans with Denzel Washington, during the summer we watched Long Way Round, a documentary about two guys riding motorcycles from the UK across Asia and North America to New York City, starring Ewan McGregor and Charlie Boorman.

Finally we would spend 45 minutes one-on-one with one of the students. This would be things like having me read out-loud from a book or read a story and answer question. They would also give me some exercises to strengthen my memory and recall. But the parts I enjoyed the most were just talking about things like their educational goals or my writing of this blog. To me this is the best part of my therapy sessions.

Currently my memory is getting a little better every day, but my reading is not improving as much, if at all. I do not know how much longer I will need to continue therapy, but I will see what happens this semester and won’t have to decide until December.