Hi Everyone,

We had a very full day at the gym. Corey’s sessions were planned in ½ hour increments which helped the day fly by.

We began with Coach Kate and Coach Laura for Speech. The ladies have been working with Corey on swallowing thins (water, milk, juice). In the past, Corey aspirates with every trial. As a result, she refused any exercise introducing thins. Last week she managed to work past her fear and tried sipping water from a teaspoon. She had 14 successful swallows. Today she refused until I handed her the teaspoon and told her to feed herself. Her new record ~ 31! (I wish our home therapist Diane was there to see her)

The ladies have also been working on letter recognition. Corey is still having difficulty recognizing the individual letters of the alphabet but if she traces the letter on the flash card, she can correctly name it. This weekend she and I played a game. I pulled the first 4-5 letters of the alphabet, scrambled them, laid them on the table and asked Corey to identify each card. After she traced them, I asked her to put them in order. She hesitated until we began to sing the alphabet song. We moved through the alphabet sequentially until all the cards were in order. She only misread 3 throughout the game.

Once the letters were lined up across the table, I pushed Corey further. I asked her to pull the individual cards that spelled her name, my name and each of the pets. If she reached for a letter and hesitated, we sang the alphabet song. She instinctually corrected herself and pulled the appropriate letter.

We shared our new game with Laura and Kate loved it. They both wanted to play with Corey. Kate took the game to a new level. She wanted to play a form of Scrabble. She laid out B. A. C. She asked Corey what we could spell if we scrambled the first and last letter. Corey told her CAB. She smiled and told Kate, “I rode in one in NY”. Kate was very impressed!

Natalie is happy Corey’s upper body control is improving as she walks. She is no longer leaning back with each step. The ladies are working on her left leg bending at the knee prior to her lift, step and kick through. Corey is beginning to get the heel/toe motion with her right foot rather than the “Frankenstein” walk with stiff knees and flat feet.

Coach Elaine, OT, has been playing paddle tennis with Corey. Their paddles have suction darts on them. When Corey throws the ball it sticks to the paddle; as well as when she catches the ball tossed to her. There is a purpose to this unique paddle game. Corey is right handed. She tosses and catches the ball with the paddle in her right hand but must reach and “pop off” the ball with her left hand. Now that she is lifting and extending her left arm as well as opening and closing her left hand to grasp an object, this game is developing strength and dexterity for the muscles on her left side. Just for the record, she has a better arm than Elaine!
We closed our day with Dr. Janet. We discussed the challenges we’ve been working through in regard to Corey’s behavior. She confirmed our self diagnosis of awakening in Rancho Stage 4. Ironically, a family we’ve met via these carepages wrote us this morning. In their note, they recalled working through this stage. Our journal entry brought back the memories and emotions they went through during the same stage but assured us that the “other side” is wonderful and greater recovery will begin to emerge. (Thank you Debbie; your reassurance were words I needed to read today!)

Dr. Janet confirmed that most patients experience this stage as an inpatient. It can last a few weeks or 6-9 months. Frequently they have the support of the inpatient staff and therapy team to help them as they present and move through it. Dr. Janet believes that Corey is just entering this stage at the 2 year mark (which is not uncommon for low level patients that have sustained the severity of her injury).

Dr. Janet believes we may have another year before we can truly assess where Corey will be emotionally and cognitively. She compared her to the stages of an infant. She is certainly going through the separation anxiety as well as stranger anxiety. Think of all the faces she’s seen in the last two years as she tries to gain some sense of control over the current reality and shattered memories she’s trying to reassemble. No wonder she’s irate!

The staff is specialized for Neuro therapy; however, the typical patient is well beyond Stage 4 when they enter the day program. Corey is still considered low level in comparison. We are beginning to formulate a plan for the team to better understand, become better educated and implement their personal behavioral strategies in responding to Corey as she works through this volatile stage. Corey’s cognitive stage coupled with her short term memory loss needs to be understood. OUR behavior and responses need to be modified before Corey’s reactions can become diffused. We have a long rocky road ahead of us but the staffs dedicated to Corey and are willing to join our weekly sessions.

“The purpose of education is to turn mirrors into windows” ~ Sydney Harris

Corey I want to thank you. Every day you challenge me to learn something new, look at my day from a new perspective, practice my patience, compassion, unconditional love and most important; appreciate the present moment and the view! xoxo