I attended a seminar a few years ago presented by Marilyn Spivack. She is the ‘godmother of brain injury’, creating the Brain Injury Association of America. She opened the lesson with a question. “Resilience; Is it a trait or a process”?
Tomorrow will be two months since Corey’s fall. Her concussion added to her existing brain injury has been a new education in TBI for us. She has been receiving Speech, OT and PT twice a week for 5 weeks. In that time, she has made some progress.
Speech not only works on talking, the therapist also works on the mechanics of eating and cognitive skills including reading, memory, reasoning skills etc. The concussion affected Corey’s swallowing and speech. Prior to the fall we saw some signs, ‘sparks’, of short term memory, which quickly dimmed after the fall. Corey has been practicing tongue exercises to strengthen the muscle not only to move the food to the back of her throat but to control her swallow as well. A daily ritual we all take for granted until we choke. This week she was safely cleared after eating a full menu of varied foods in size and texture including liquids. The exercises have also led to better articulation almost returning her to her baseline speech. We created a new calendar that has been working very well. Corey has been confused about the time lapse in her day and week. The calendar not only reflects the current day but can also show her the previous day, upcoming days and has a journal-like section she titled “Memory Notes for Today”. Our version of a day timer helps Corey write what she accomplished but also gives her the answer to her constant question of what are we doing today/tomorrow? The calendar is also easing her separation anxiety (Nervous Nelly has returned…at least she didn’t bring Corrine with her).
Anne, OT, gave us several home exercises to strengthen Corey’s left arm and hand. We named her favorite “Jackie’s toss across”. JohnPaul’s wife, Jackie was a tennis player in college; team captain. We picked up a case of tennis balls at Costco, filled an umbrella stand and Corey keeps them at her left side. She reaches in with her left hand, can now grasp the ball and uses her right hand to assist her left arm up to the height of the table, across her body to release her grip and drops the ball on a tray to her right. Then she reverses the process. She’s gone from 3-4 reps to just over 30. She hopes to stand and hold a racket by spring to have a ‘kitchen’ volley with Jackie.
Anne has also begun to use Electric Stim on Corey’s left arm, shoulder and back muscles. Corey’s responding well, which is a good sign there’s no nerve damage. They will begin exercises using the stim during their sessions to help her range of motion.
Natalie, PT, has had the greatest challenge. Corey’s walking is inconsistent. Her knees are still buckling and her left foot still swings to hit the left heel on the right foot as she takes a step. We have not exercised on her bike or in her home harness for this reason and because she hasn’t been able to stand or balance long enough to ‘workout’ at home. It’s taken Natalie 5 weeks to work on this puzzling inconsistent pattern. One walk Corey’s knee collapses with every step. The ladies sit to rest and next walk Corey nails it then loses it. Natalie tries one technique; it works, then the next trial it fails…this is brain injury. This is also why an individual needs an extended length of stay. Keep in mind Natalie’s 5 weeks has been 10 one hour sessions…insurance continues to misunderstand the process required for the therapist to assist in the survivors healing and recovery. Natalie is now looking at Corey’s left hip. This creates a new question. You can put a brace on other parts of the body, what do you do with the hip? It takes exercise and healing. We have one more ‘approved’ week…will insurance let that happen in rehab or will we be asked to ‘wait’ at home until she’s “ready”? I think you all know what MY answer will be….yes, the stressful battle continues…
So, what is the answer to defining Resilience? Is it a trait or a process? Is it a trait that drives the process or does the process create the trait? Is it something learned or inherent? There are many factors that go into its definition. I will be using the pronoun WE because challenges (any challenge we face) affect the individual, family and their friends. Yes, we’ve had a set back but not as far back as where we were. It has affected our physical, mental, emotional and behavioral responses. We have cried, screamed, cursed, fought and talked about our frustrations and fears. We’ve been slowly regrouping, creating new strategies and rebuilding stamina (both physical and emotional) We remind each other goals change as we change but it doesn’t have to change our ability to Hope and Dream. Resilience is a great word for 2017. It will be defined differently each day but I think that’s part of its true meaning, xoxo