Saturday, September 22, 2007

Speech Class Diary, Part 6

This part of the diary covers 9/06 through 12/06.

Sept 20, 06
1st Speech Class, Fall

Yesterday was Don’s evaluations at the college where he goes to speech classes with undergraduate student clinicians. He’ll have two of them again this semester for his individual classes and three for group classes. The two girls for the Tuesday classes seem to have the perfect personalities for working with Don, not too reserved or shy. And he does better with people who have a good sense of humor. A couple of times, one of the girls instinctively was able pick up on what Don was trying to say with his telegraphic speech. (For those who don’t know what the means, he uses mostly nouns and is unable to get most of the other words out without a painful amount of queuing.)

Here’s an actual record of the words Don got out at the breakfast table a few days ago: “Belding, foreman, 20’s, Dodge, Olsen, two---Olsen, Olsen. See. Florida.” It was one of his better ‘conversations’ because I didn’t have to dance around too long to figure out that he was talking about his x-foremen who used to live in Belding but moved to Florida in retirement. He also had one of those highly prized verbs in the mix. What the Dodge and 20’s had to do with the foreman is still a mystery but the “see” part was Don expecting me to pack up the car and go visit the guy. Sure, Don. Aside from the fact that he hasn’t seen the guy in ten years and he’s been dead for five, this little wifee-poo doesn’t do long-distance driving anymore.

During the evaluations, Don got a 100% on the yes/no questions that they use to test cognitive issues. No surprise to me. With visual retrieval of words he didn’t do very well and they stopped the test before getting to the end. Then they have a section where they use what I call trick questions that are meant to test listening ability. Questions like: Will cork sink in water? Is a hammer good for cutting wood? Don got about 25% of them wrong which didn’t surprise me because listening has always been one of his deficiencies that speech therapists have worked on since day one.

Then they gave Don story questions that got increasingly harder as they went along. He didn’t do very well on those at all. This was followed up with the Boston Naming Test that seems to be pretty standard for all speech testing sessions. For the most part, Don did excellent---spitting those nouns out quickly---except he had problems with: volcano, unicorn, tripod, octopus, stereoscope and cactus which took a lot of time and tries and in some cases, he never did get the words out. During this test, Don got stuck on saying the same noun for several pictures in a row and the professor stopped the test, explained why he was doing that and told the girls to watch for that in their clients and give them little breaks when it happens. I love the academic setting for speech classes. I learn, too.

At another point during the hour Don had a series of coughs after sipping coffee and the professor again stopped the testing and gave a mini lesson of swallowing issues. She said when he swallows liquids Don doesn’t realize that he isn’t swallowing it all and it blocks his airway. But with Don, she said, he has a “healthy” cough that brings the liquid up so he can re-swallow it. “Listen for his ‘wet’ speech,” she told the girls and when you hear it, tell Don to cough." I’ve heard this stuff before, of course, but it’s nice to be reminded---especially the part about not panicking when Don turns beet red. “Trust that his ‘healthy’ cough can clear his airway,” she assured us all. This actually happens every couple of months. Without the cough, the professor said she’d recommend another swallowing study but with the cough, she isn’t worried about his swallowing issues.

At the end of class, the professor said to the girls, “Trust me, Don will be the best client you will ever have. You will learn a lot from him.” Don, upon hearing that, did his classic Jack Benny gig saying, “Well” as he raised his eyebrows and slapped the side of his face. I knew what the professor meant by that statement. She’s told me in the past that they keep asking Don back because he teaches the students that even though a client is without much speech they can still have strong personalities and can learn to be completely at easy out in society. The latter is one of a speech pathologist’s goals for people with very severe aphasia and apraxia like Don's.

All and all Don was happy to be back at school and I’m pleased that we got our favorite professor to over-see his student therapists.

Jean Riva ©

A Crying Good Day

Before aphasia and apraxia entered our lives, Don used to love to tell a story about his 1984 hunting trip out west with his life-long friend. Don had taken delivery on a brand new pick up truck a few hours before leaving and on the second day in Wyoming, his friend shot a hole in the hood of the new Chevy. What happened afterwards was a story that Don could spin into an hour long monologue that would have his audience holding their aching bellies from laughing so hard. He’d told the story so many times over the years that it was perfected into something similar to a Mark Twain tale---suspenseful, dramatic, humorous, hear twarming, Don’s story had it all.

The student pathologists, knowing that Don used to be an avid storyteller, asked me to write out one of his favorites so they could use it as part of his speech therapy. I sent them a copy of a blog I wrote long ago about this hunting trip. The girls simplified the story down to 20 sentences and they had each sentence on a separate slip of paper. One by one, they spend the entire hour helping him get out the sentences in sequence to tell story of the year two old friends who went on hunting and bagged a Chevy.

I sat in the observation room watching and about seven sentences into the story I started chocking up and trying to hold back the tears. I never thought I’d ever hear Don tell that tale again. It didn’t matter that each sentence had to be repeat six times with the therapist doing the model-model-together-together-fade-and-alone pattern of queuing the sentences out of him. It didn’t matter that all the rich details were missing from Don's pre-stroke version. Don was storytelling again and he was having fun doing it! A powerful flood of emotions washed over me when that thought hit me. I couldn’t keep the joyful tears from tracking down my face. And for the rest of the hour I alternated between laughing and cried so hard that by the end of the session I felt like I could take a two hour nap. I truly had a crying good day.

School’s out! School’s out!

Free at last! Yesterday was the last day of speech class until the middle of February when the college resumes their speech clinic again. I can’t tell you how happy that makes me. We’ve been on the go since last year’s winter break and I’m tired of being on the run. Hey, I’m just plan tired! Most years, we get the summers off from the craziness but because I filled last summer up with get-control-of-Jean’s-health stuff we were busier than ants at a picnic.

Yesterday was the discharge evaluation and the party that follows afterwards. Don’s evaluation report was good. He showed improvement in auditory comprehension, reading comprehension, verbal expression and cognition. For social pragmatic communication they wrote: “Don has a great sense of humor. While easily distractible he knows when to be focused again.” That’s my guy---easily distractible. The best part, though, is always at the end when they recommend that he come back next semester for group and personal therapy. We sweat this every time. He’s going to be one devastated guy when the time comes when he doesn’t get that recommendation. One of our friends from group class, who is even-steven with Don in both physical and speech disabilities, didn’t get invited back last semester and I thought Don was going to cry for the guy. I was one mad mama that his student clinician ‘flunked’ him when, in fact, it was probably her that didn’t work hard enough.

We always give Don’s two student clinicians and the overseeing professor little gifts at the end of these classes. This year, both girls were BIG TIME fighting back tears when they opened up the boxes with the silver tone wishbone necklaces. Good thing we were still in the treatment room before the party. Not everyone gives their clinicians gifts and most of those who do give things like flowers, homemade baked goods or hand lotions, etc. I like to give something lasting as a keepsake from their very first speech client. We don’t have any other gifts to buy for the coming holiday, so we put thought into these two.

Speaking of gifts, Don wore his new Christmas present (the Pendleton shirt) and he was as proud as a peacock in his sea shadow plaid western cut. I wore one of my Christmas gifts, too. Every since I graduated from college back in 1985 I’ve wanted an alumni sweatshirt and this year I ordered one. It took my twenty-five years, start to finish, to graduate and I thought it was about time I treated myself with something I've wanted for so long. I’m teasing Don with the other gift I ordered off e-Bay, the Amazing Grace set. I’m doing what he did with the shirt---opening the front door every half hour and fake crying that the UPS truck isn’t coming. I haven’t told him what I ordered, either. I told him someone should have a surprise on Christmas.

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