Monday, November 26, 2012

Stroke recovery: From where I lie





My view of cloudy weather from second-floor

I started today’s therapy session in a prone position with my left shoulder encased in a heating pad wrapped in towels.  Recent cooler temperatures have increased the stroke-induced tone that tightens my shoulder to a painful degree.

To combat that tightness a 15-minute appointment with the heating pad has preceded my working with occupational therapist Amy to improve the strength and control of my left arm muscles. Today I pulled out my camera during my date with the heating pad and shot what I could see.

The challenge was my position on a mat in a far corner at the back of the gym, the need to avoid having other patients in my snaps and unsteadiness. To my right were windows with a view of the sky. To my left Amy was working with another patient.

For me and for her other patients Amy devises creative exercises to fit the specific deficiences her patients experience.

If it helps a patient, Amy doesn’t hesitate to take to the floor.

Amy works with another patient.

My photo session wasn’t stellar. But my therapy session with Amy was more positive. The workout she gave my left shoulder and arm also gave the right side of my brain a vigorous retraining experience.

She held my arm up and away with a red theraband. As I lay on my back, my job was to bring my arm back to my side with my elbow straight. I could do it if I could look at my arm. But that was a no no. Amy doesn’t want me to develop the habit of looking down in order to move my arm. She rounded up a bell, positioned it where my hand should wind up. Then she talked me through the movement.

As I had a few successes ringing the bell I could tell my control was improving with fewer verbal cues. I still have little sensory input other than sight and sound about what is happening on my left side. I hope that, as with earlier movements I have relearned, I will begin to recognize other cues about where my arm is and what it is doing as I become more successful in accomplishing specific movements.

From where I lie, that possibility looks pretty good to me.


Sunday, November 25, 2012

My favorite Christmas decorators


It’s time to decorate Baboo and Nana’s tree!

The decorating that our grands, ages 2, 4, 6, and 10 accomplished the day after Thanksgiving was a joyful and laughter-filled experience for this grandmother, even as I struggled to keep my laughter diplomatically contained.

Of course, our sons and daughters-in-law kept things moving by fitting ornaments with hangers as needed and parceling out the tree decorations in an orderly procession. I was surprised at the intense concentration common to each of the grands, regardless of age. They solemnly considered positioning options, then carefully hung each ornament. The youngest all headed for the same branches within their reach.  
Charlie, top, leads the girl squad.

Walker, 2, gets the job done.

Stella

Nate was recovering from a bug, but gamely decorated with style.

Louisiana grands Molly Kate and Walker

This year the decorating exercise also included the transfer of a bit of family history as offspring questioned their elders about specific ornaments.
Charlie is happy with the Garfield Santa her dad Walt received as a youngster.

Molly Kate proudly displays the Rudolph the Red-Nosed Reindeer that her dad Jeremy made from his thumb-print in elementary school a couple of decades ago.
Molly Kate

Luke likes the Coke keychain that poses as a tree ornament. Maybe our oldest grand will join Nana in her rabid appreciation of Coke.
Luke

The bug Nate had picked up Thursday migrated to his sisters. Its effect on Stella warranted a trip to one of the local urgent care clinics before the family attempted the return to Georgia Saturday. The clinic staff provided medication and banished the specter of dehydration.

Both families headed home. We were thankful for the call that evening letting us know that the Georgia Skupiens made it home safely and without any further cookie-tossing incidents.

Our girls, ready for the extended family Christmas get-together Friday evening: From the left, Sarah and daughters Charlie and Stella; Molly Kate and her mom Katie.

With the exception of Thanksgiving night, the Georgia crew bunked with us for the week and divided their visiting time between the home of Sarah’s parents and our home. Thursday night she and the boys stayed at her childhood home and the girls and Dad stayed with us. Then the next day youngest son Jeremy and his crew arrived.

After the busy times with our family all together, Husband Walter and I spent a quiet Saturday at home. But I haven’t had a chance to miss our young families. Every time I walk by the Christmas tree and see all those ornaments bunched together on the lower branches, I break out in a big grin. 

And for a moment those loved ones, big, little and in between, are right here with me.

Saturday, November 24, 2012

The season begins


At right is the Christmas Bunny, AKA Grandaughter Molly Kate, with her cousin Stella, our other four-year old grand, sporting evidence of the banana-split ice cream Baboo dished out.

Our little part of the Skupien clan usually celebrates Thanksgiving on the Friday after Thanksgiving Day. This year, however, the holidays merged a bit. Instead of a Thanksgiving meal, we shared a light, casual lunch, anticipating the annual Christmas gathering of our extended family of Skupien relatives Friday evening.

Scheduling was a bit sudden, which helped increase my enjoyment as I had little time to dither about what to get for the adults’ Dirty Santa gift exchange or what to bring for the communal feast. In fact, the younger generation had taken over all the organizing and we adults and the not-yet-adult cousins had a wonderful time last night.

Thank you to all the adult Skupien kids!

We still had time early Friday afternoon for our grands to play together and to decorate the Christmas tree, a day-after Thanksgiving tradition now in its third year. More photos to come on that.

Our blogging daughter-in-law Katie and I shared a collective moan about how behind we both are on our respective blogs. Katie does a better job of keeping posts in the chronological order of special events and every-day moments in her children’s lives.

But we both blog so that we don’t forget things. She records memories of what her family is experiencing in these early days of Molly Kate and Walker’s childhoods. I blog to record memories of my thoughts and experiences in this retirement stage of life.

I will eventually finish posting about our recent travels and at-home observations, hopefully before we take off on another jaunt planned for early December.

Oh, about that Christmas bunny in the photo: Donning bunny masks at nearly every visit is a tradition started and carried forward by our youngest grands. My mother-in-law, Grandma Sugar, a veteran bargain shopper, gifted the little ones with packs of the masks several Easters ago. The masks reside with the toys at our house until grands visit. I am always amazed that the masks have endured so long.

Thank you, Grandma Sugar for sparking fun and helping your great grandchildren make happy memories.

Wednesday, November 21, 2012

Anniversary celebration: Late or early?


A ducky greeting

When Husband Walter was making reservations for a night at The Tides Inn,  Shelter Cove, California, what he thought was a casual conversation followed a query about recent special occasions on our calendar. He had mentioned that our 45th wedding anniversary had come and gone.

Evidently the conversation was more purposeful than he realized. The result was the little bride and groom welcoming committee above that we saw as we entered our suite at The Tides Inn.

It was worth the drive on a winding, narrow road to reach our night’s lodging perched high above the rocks and waves at the edge of the Pacific. It was the slow season, and we were the only guests.
Sunset view from our third-floor balcony

The weather was beautiful and our cozy suite included a balcony that overlooked the Pacific with a front-row seat for experiencing the changing hues of sky and sea, the calls of seals, the sounds of waves breaking on rocks and shore, and the clean salt-water scent and sensations that accompanied our air supply. It was a picture-perfect end to Day Three and to the start of Day Four of our nine-day West Coast trip.
The first flush of dawn

I still haven’t figured out if we should label our impromptu anniversary celebration a late 45th or an early start on our 46th anniversary. I am leaning toward that early start idea with maybe a once-a-month quiet but planned “something.”

Perhaps my procrastination has already cast the die for 45th, though. The opportunity for a November anniversary something is almost gone. One thing for sure, whenever and wherever we celebrate future anniversaries, the setting will not match the dramatic environment of Shelter Cove, California.

Friday, November 16, 2012

My stroke recovery: A visit to the neurologist


I received my third botox treatment for muscle spasticity this week. My visit to my neurologist also included a comprehensive discussion of my April 22, 2011, hemorrhagic stroke. Although more than 18 months seems a long wait for details, I think the information arrived right on time and in language I could absorb--mostly. The inevitable inaccuracies are all my own.

I have been seeing a neurologist for about nine months. In response to my request in a previous office visit, he went into teaching mode during this appointment. We examined two cat scans: one made soon after the stroke and the second near the end of my 27-day stint in an in-patient rehab center. My neuro doc also gave me guided tours of the MRI I had several weeks ago plus dozens of images pulled up through Google, of other stroke-affected brains.

The basics I came away with were twofold: first, most strokes like mine occur in one of three areas. Of those three, the general area mine occurred in is usually the least severe. But secondly, and this is a big “but,” my stroke was in the worst place in that region of the brain, right on the “internal capsule.”

That internal capsule is a structure where a large number of motor and sensory fibers are bundled together and lead to the spinal cord. I borrowed the image below from Stanford School of Medicine’s “Stanford 25” Website.


If my stroke had been even a little bit to one side or the other, the internal capsule would have escaped the degree of damage I experienced. Likely in that case I would already have recovered more range of movement in my shoulder and arm, at least some function in my elbow, wrist, fingers and thumb and maybe even some sensory input on my left side.

The speculations about what might have been are all from my own inference from what my doctor said and from what I gleaned via Google. Although I have a long way to go before my left hand and arm are contributing substantially to tasks of daily living, the fact that they are contributing at all is improvement.

Rather than despair at learning the specifics of the damage to my brain, I find it interesting. This knowledge is part of my journey. And I am buoyed up by the improvement that has occurred in my condition. I know that function can be regained because I am regaining function, slowly and in minute increments, but it is happening.

I am not sure what my reaction would have been if I had learned all the details earlier in my recovery. Looking back on those early days of inpatient rehab, I realize that sometimes what I heard from therapists and physicians was not what they were actually saying. A long-haul recovery wasn’t on my horizon. I think I just assumed everything would be back to normal shortly and processed everything to fit that assumption.

Now I am in the long haul, and I am thankful for all the folks who are hanging in there with me.

A Google note: Googling “internal capsule” launched me into a brief exploration of the Stanford 25. That has been an adventure in itself. I appreciated evidence of the Stanford School of Medicine’s common-sense emphasis on mastery of hands-on, bedside examination as a crucial element of accurate diagnosis.

And I appreciate even more my neurologist. He did a year’s fellowship with the reigning leader in the use of botox to treat muscle spasticity like mine. The field is so new that techniques are not readily available in books or papers. At this stage, my neurologist explained, the treatment is a combination of art and science.

With completion of my third set of botox injections, I have observed that combination in action in his treatments. And I am alsoconvinced that he could probably make it in stand-up comedy. His stories are hilarious. But it was no laughing matter when I walked out of that office and could immediately see that my elbow was straighter. And that was without the usual monumental effort from me to force it straight.

Monday, November 12, 2012

Veterans Day: Thank you to our dads


Both Husband Walter’s dad and mine were veterans of World War II. They are gone now, but I pause today to thank them and all the other veterans who have served.

Our niece Lauren took this photo of my father-in-law’s marker in the National Cemetery in Biloxi, Mississippi.


My dad Cecil L. Carpenter

This time two years ago I had joined my mother and friends at her assisted living home for their Veterans Day event. This Veterans Day she is no longer with us.

But her stories of World War II remind me that, on this day as I honor those past and present who accepted the responsibilities and sacrifices of service, I also want to remember their spouses and families. Military families’ lives are marked by those same responsibilities and sacrifices as they work, pray and hope.

Thank you, all.

Friday, November 9, 2012

West Coast posies


Eye-catching lily

Wherever we travel, flora both wild and domesticated attract my attention. I found much to enjoy during our recent West Coast travel, but I remain in the dark about the identities of the plants posted here. Even without knowing the names of my new plant friends, they supplied an additional layer of pleasure for me on our trip.

Lilies create swaths of pink
Pink lilies graced yards and roadsides on our drive south from Oregon. Husband Walter took the photos above for me in an old rural cemetery. Their color, shape and abundance charmed me, and I wondered if they are native or are escapees from gardens. 

Lavender blossom at a coastal California coffee shop
There is more to my interest in blossoms, though, than color, scent, shape and natural history. My nearsightedness and other assorted vision conditions make me appreciate the fact that flowers don’t run away or fly off.

Tiny, white and unidentified
Since my April 2011 stroke I have balance and mobility challenges that I am still working on, and I find flowers offer abundant subjects that are often easy to get to for closeup photos.

I suppose the pleasure derived from attempting close-up photos of flowers and other objects also stems from my nearsightedness. The old adage of “How the twig is bent . . .” applies. My twig was definitely bent to observe close-up details. After 10 years of seeing clearly only what was within inches of my nose, a new screening program at my elementary school revealed my myopia. Now I enjoy capturing macro images, even though with the glasses I now wear, I can also savor panoramic views.

Oregon coast

Hubby was wheeling me around in a lightweight transporter over the paved walkways along the coastline captured in the photo above. I was able to shoot several coast views that are a dramatic contrast to our near sea-level coastline on the Gulf of Mexico. On our “stroll” I spotted purple aster-like flowers that were attracting bees.

Of course I wanted to snap, snap, snap with my camera. But the wind was whipping. And even with the sunshine and my heavy jacket I became chilled and started shivering. I knew I would have difficulty balancing and keeping my camera still for taking in-focus closeups. Hubby graciously took my camera and captured the photo below.
Bee and bloom by Husband Walter.

A landscaped bed in the Shelter Cove, California, community sported this small evergreen with red fruit.
Bright and weird

Wednesday, November 7, 2012

B&B history and comfort


At the end of Day One -- Coos Bay Manor

When we had planned the first full day of our West Coast travel, we were at our home in mostly flat coastal Mississippi. There is a huge difference in the number of miles that constitute a leisurely day’s drive in Mississippi in contrast with a day of driving and sightseeing in the mountainous terrain we were encountering in northern California and Oregon.

Husband Walter and I always seem to underestimate both drive time and the time we like to spend in spontaneous stops along the way in western states. Even though we enjoyed our long day and the new sights and experiences, we arrived at 10 p.m. at our bed and breakfast for the night – exhausted. Hubby just informed me we arrived at 8 p.m. It felt like 10 p.m. or later to me.

The home’s lived-in history offered welcoming comfort, and our brief stay at Coos Bay Manor in the coastal town of Coos Bay, Oregon, proved to be restorative. Friendly innkeepers-owners Dave and Madge greeted us Sunday night with a warm welcome.
David and Madge Osborn

The luxurious bed in our spacious second-floor room was not only picturesque, it also enveloped us in comfort. We awoke the next morning refreshed and reinvigorated.

Sweet dreams
Hubby straightened the bed linens for the morning photo above. But I am sure if Madge should see the photo she would be itching to return the pillows to her original artful order.

A comfortable spot for enjoying early morning tea
We started our day with pots of hot tea and coffee left conveniently outside our door with perfect timing. I felt like a queen in the comfy antique chair. I pulled up the upholstered footstool that Madge had placed by my side of the bed the night before to help me negotiate the climb into bed. It was also perfect for propping my feet as I enjoyed my wake-up cups of a delicious brew.

It was our first stay in a B and B, and our experience was off to a superlative start. Thanks to the tea and coffee, we were ready for pre-breakfast exploration. Hubby and I were the only guests on this low-season, weekday morning, and with our cameras in hand, we ambled around the historic home. It was built in the late 19th century, and retains many of the original fixtures and architectural details intact.

A view of the entry
The second floor open hallway overlooked the entry and gave a grand sense of spaciousness. The owners and their son and his wife make the third floor of the manor their home. They all have a hand in running Coos Bay Manor, as well as pursuing other professional and creative interests.

Radiators ornate and functional
There was no slick, cookie cutter décor. Age and evidence of real life and use created an inviting sense of home. The radiators, for example, were ornate in the public areas and less decorated in the behind-the-scenes rooms. They are original to the house and continue to provide the home’s heat through circulation of heated water. The only modern difference is the fuel source for heating the water.

A piano in the parlor appears ready for a musical evening.


The front porch invites lingering for fresh air and conversation.

The dining room was flooded with natural light through tall windows. The tables, table settings and serving items fit the period with elegance and efficiency. Breakfast was delicious and spiced by conversation with Madge about her home’s history and her family’s experiences as newly minted innkeepers.

Thank you, Hubby, for this surprise treat. And thank you, Dave and Madge Osborn, for your gracious hospitality.   

The photos of Coos Bay Manor and Dave and Madge are borrowed from the Coos Bay Manor Website.

Husband Walter posted photos and a synopsis here of our eight nights of lodging experiences.

Tuesday, November 6, 2012

Stroke survivor travel: More Day One pleasures and a bit of terror


 Siskiyou Mountain summit, highest elevation on I-5

By mid-morning on Day One of our West Coast jaunt, we were enjoying scenic mountains and entering Oregon. We passed Siskiyou summit where Interstate 5 passes through the Siskiyou Mountains at 4310 feet elevation.

We left the interstate for Oregon's Rogue-Umpqua Scenic Byway and picnicked beside the Rogue River.

Husband Walter prepares lunch by the Rogue.
Sun sparkling off the rippling water, mountains, forest and quiet created the relaxing décor of our outdoor eatery. A bonus was an apple tree that provided a small, tart apple for dessert. Hubby prefers sweet. I like tart, so he left the apple eating up to me.

Mt. Thielsen
The glacier-sculpted peaks of Mt. Thielsen soared before us and added drama to our drive in mid-afternoon.

We arrived at the trail to Tokekee Falls as shadows lengthened in the late afternoon.

Tokekee Falls, Photo by Walter Skupien
Hubby has a passion for capturing images of water in motion. Since my slow pace would diminish his chance of catching light at the falls, I stayed behind while he headed to the falls. I love the image he captured. My plan was to go as far as I could on the trail and meet him on his way back.

Wooden 12-foot diameter pipeline
But first I wanted to find out about the huge, strange-looking tube that crawled through the landscape near the parking area. Interpretive signage at the trail entrance held answers. The wooden pipeline diverts flow from the North Umpqua River to a hydroelectric plant downstream. It was completed in 1949 and carries water from a 102-acre reservoir located less than a mile upstream of the falls.

An inviting scene
After snapping a few shots of the pipeline and the interpretive sign as background notes, I considered the trail to Tokekee Falls. Before me was a serene scene of level ground and stately trees with afternoon sunlight slanting through the evergreens. The combination created a ghostly but benign-looking atmosphere.

A few steps on the trail and I was thoroughly engrossed in my first independent hiking experience. I had discussed attempting this trail with my physical therapist, and she and techs had been creative about helping me improve my balance on uneven terrain.

Weeks before our trip west, therapist Ashley had arranged firm foam planks, ovals and squares plus sturdy wooden boxes of four to six inches high in a hallway to create my Tokekee Falls trail obstacle course in the Ocean Springs Neuro Rehab Center.

What couldn’t be mimicked were abrupt changes in the pitch of inclines. At one point I misjudged the steepness of an incline and found my gait increasing and my body beginning to pitch forward. In a moment of terror I managed to stop, straighten up, recover and consider options.

Backtracking wasn’t an option. I didn’t have any confidence that I could keep my balance to go back up the steep incline. My first attempt downward made me certain that, even using my usual slaloming zigzag strategy for elevation changes, going down wasn’t a safe option.

Cautious experimentation led me to ease across the trail, off the slippery stone surface and on to the crumbly soil at the trail’s edge. I have never before been so appreciative of good old dirt. The rich, black, cushiony soil was a blessing. Not many steps later the sharp incline eased and I moved back on to the trail, once again safely on my way.

A bit farther, I ran into a combination of exposed roots and jagged rock. I appreciated my therapist and the exercises that she had put me through to prepare me for the trail. Two women returning from the falls appeared and waited patiently for me to pick my way through the obstacles.

“You don’t have far to go to the falls,” one said. “ You shouldn’t have trouble making it the rest of the way.”

Beautiful but treacherous
Right. Obviously she had no previous acquaintance with a stroke survivor. The path soon narrowed. There was a deep gorge and rushing water on my left. The sound of the river accompanied my steps, a musical reminder that I needed to pay attention or I could wind up an unintentional part of the scenery in the gorge.

A few turns later, a flight of stone stairs faced me. Hmmmm. Water and steep drop-off were nearby and no railings graced the stairway. It was time for me to look for a boulder or stump, sit down, rest and wait for Hubby.

I turned from the stairs, took a few steps toward a potential perch and Hubby appeared. He was less than pleased that I had not stopped at earlier challenges on the trail. He was right. But turning back had not been a safe solution. Rehab continues with lessons learned about navigating safely!

Friday, November 2, 2012

Belated birthdays, Halloween and more


An ice cream cake marks our October celebration of grandson Nate’s August birthday.

Birthdays, Halloween and glimpses of youngsters’ lives filled a weekend visit with Georgia kids and grandkids.

Friday, Oct. 26. Day One—We walked to the school bus stop with daughter-in-law Sarah to meet granddaughter Charlie returning from her day at kindergarten, or is it first grade? How quickly those milestones pass these days! Later I rode with daughter-in-law Sarah to pick up grands Luke and Nate from their elementary school where they had stayed for after-school karate lessons.

Back at the Skupien homestead, Baboo put into action his plan for
a casual, impromptu, abbreviated and belated birthday celebration. The belated birthday was his solution for overcoming a number of factors that limit our opportunities to celebrate birthdays with our kids and grands in person.

Part of the event is that Hubby, aka Baboo, takes the birthday grand to a grocery, usually Walmart, for the birthday honoree to choose a birthday cake and ice cream.

We light a candle, sing happy birthday, cut the cake and dish out ice cream. Nate chose a cookies-and-cream ice cream cake. In July we celebrated oldest grandson Luke’s June birthday with his choice of a pizza-sized birthday cookie. Both were tasty choices.

We had missed Sarah’s September birthday so Baboo brought her a tiny square of red velvet cake. We laughed and teased and ate until all of the ice cream cake disappeared. Sarah and I demolished the red velvet cake the next day.

Saturday, Oct. 27. Day 2.
Sisters ham it up after a morning of ballet classes.

Halloween was on everyone’s mind, and Baboo was eager to introduce the Georgia tribe to the Six Flags amusement park’s annual October Fright Fest. I think the Fab Four’s first experience was fun, even though our visit was the event’s final weekend before Halloween and the park was packed.

The siblings, from the left, Charlie, Stella, Nate and Luke, kept themselves entertained while waiting in long lines for rides.

Stella, sporting Halloween “blood” on her face, seems lost in her own world of movement and fantasy.

Ballooning at Six Flags Over Georgia

Our son Walt videos his youngsters’ thrills and squeals.

This Fright Fest apparition visits the Monster Mansion queue.

Ack! Too close!

Sunday, Oct. 28. Day 3—Walt left at 5 a.m. to join Georgia Power work crews. The crews were preparing for a trip to a yet-to-be determined East Coast destination to restore power once Sandy moved out of the area.

The evaluations of Luke and Nate’s sprinting, passing, ball catching and flag capturing skills later in the day was a first for me. The adults shepherding the flag football program would use the evaluations to make sure that all teams have a balance of skilled and not-as-skilled players.

The Arctic front had arrived, and I spent the evaluation sessions cozy inside the family vehicle with the grandgirls, immersed in their homemade knock knock jokes and made-up Halloween tales.

Late afternoon church service, dinner and ghosting of neighbors closed our day. Ghosting was another first for me.

(Halloween Ghost by Shari Weinsheimer)
In the darkened neighborhood, each of our grands, accompanied by a sibling, followed the ghosting routine of hopping out of the vehicle at a selected neighbor’s residence, darting up the driveway, depositing at the front door a “ghost” stapled to a small bag of candy, ringing the doorbell, running back down the driveway and climbing back into the minivan, the official “getaway car.”

Any idea of avoiding detection was probably a false hope with the raucous laughter coming from the getaway car. And I wasn’t the only noisemaker succumbing to hilarity at the mad scramble.

Monday morning it was back to the school bus stop with the three oldest. As our DIL and the youngest prepared to leave for Stella’s preschool, Baboo loaded our van. Then we headed for home, tired but taking good memories with us.