Sunday Stroke Survival ~ Rewiring the Brain with Games

Cognitive ability loss is often hard to determine in a hospital setting mainly because it is a away from your home environment. The patient isn't in their daily home routine. Sure you can count to ten or recite the alphabet, but getting back to your old, normal routine is that is the true measure of what was lost. The effects of the stroke come home to roost and are glaringly obvious and tragic.

Me for example when I arrived home, I sat in front of my computer. I had a month's worth of story ideas stockpiled in my head. I'm a writer and that's what I do. After switching everything around so that it was left hand accessible, I opened up my MS Word program to type. The first challenge I faced was how to type one handed. I typed 120 WPM with two hands and capitalizing letters, or numbers, or symbols was a no brainer before. Now I had to figure out how to do it all with one hand. There are still somethings I haven't figured out how to do even with a smaller, compact keyboard. It's almost a feat of magic holding two keys down by pressing a third.

What I see or pretty close. IT IS GETTING BETTER!

I started to type and everything got jumbled in my brain. Letters, spelling, and not to mention grammar was gone. I jokingly call it my Dyslexic/ADD (letters are backwards and twisted in order), but that's the way it seems when I try to put thoughts from my brain to the keyboard. Luckily Windows 7 has a spell checker for everything otherwise my posts in here would be jibberish. One of these days I'll show you a uncorrected posts even now and May will be two year since my first stroke.

In one of my outpatient rehab sessions I found out why. In reciting my alphabet verbally, I lost letters. What I thought was so easy and a no brainer when asked to do it was gappy like I was in grade school first learning my alphabet instead of using it for over fifty years. Numbers had the same difficulty once I was past ten and got into double digits. Forget simple math like addition and subtraction.

But yet I can read for the most part. It's very tiring to do and mentally taxing. That's because of my skim and context reading ability. I'm thankful every day that I didn't lose that. But editing written text requires being able to read each and every word and analyze the sentence structure. That, at this point, is beyond me in critiquing and editing. That's the baby step I'm working on by blogging.

I have talked at length ( here, here, and here)of how I use computer games to rebuild my cognitive gaps. I'll play word games and number games trying to rewire my brain back to normal. It has been a challenge, but I persist. Now imagine being an author with these kind of issues.

Don't take me wrong. Every stroke survivor has their own issues in resolving their past with their present situation. I'm just an author. It was my livelihood and will be again. I just have to work harder to achieve it. Just like we all do. We each have our own goals fraught with reality of impairments.

For me, regressing backwards one morning in my game playing ability gave me the lightning bolt that I'd had another stroke. Games that had become easy and repetitious to the point of dull were hard again. It was more than stress and my body's reaction to it. It wasn't a momentary thing but over days and weeks. Granted, I've got some serious stress factors going on now, but when I pushed them aside and analyzed the results, there was little doubt even without a MRI. A follow-up MRI proved it. A small new dead area close to the previous one. Just enough to set me back some but incurring only minor new damage.

The thing about rewiring the brain is that it has to be enjoyable to you even if it's a workout. We are and always have been a game playing family from a game playing family. Bingo was how I reinforced number recognition in my TBI daughter so it was natural for me to do the same for myself. While I may never play twelve cards at once online and thirty in real life again, I use it to rewire my brain to recognize numbers,  simple addition, and the concept of higher and lower. Addition, huh? In POGO one one of the types of bingo players will post how many they needed for bingo in chat. Three cards-three numbers. So I took to adding my three numbers together and comparing it to other players. There are all sorts of "tricks" you can do with games if you have an imagination.

Now for how far I've come playing online games daily. I can play Tri-peaks Solitare, that's numbers forwards and backwards without a cheat sheet. If you haven't read my previous post on this, my cheat sheet was a slip of paper that I put over my function keys that was numbered forwards and backwards A-K or 1-13.

I've progressed from Bingo Luau (three cards with medium speed of spoken numbers and the numbers light up when I pass them) to Fortune Bingo (three cards, medium speed spoken numbers, and the numbers don't light up when I pass them, plus no pattern help is given other than the diagram at the top of the screen) just like regular Bingo  cards. Yes, I'm still making mistakes with this new game. Numbers get reversed in my head as I'm searching for them and I'm still having to repeat the double digit numbers in my head or verbally while I search to keep them straight like 1-2 for twelve.

I also no longer look for the same number throughout the card. Somewhere in my mind I knew the number called would only appear once, but in playing I would search in multiple rows and even the same rows for the number repeating itself. Insanity was calmed in my method of searching for the number by only looking in the assigned row and realizing that they'd only appear once. Now I can place my cursor at the bottom of a row and read the whole row. This was a major breakthrough.

The point is the games have measurable progress. I can see myself making positive progress. As far as my writing goes... It's not going anywhere. I don't have the uninterrupted time I need to focus on getting my writing ability back. AND, the key to getting any cognitive skill back is repetition and doing it.

It would take all my concentration to write sentences in a cohesive manner. Right now, there are too many interruptions and an ear constantly listening for my husband. It's too distracting to focus with all of this going on. I have to respond at a moments notice and when I come back to my screen the thought is gone. By the time it comes back there is another thing which has me leaving the screen again. Too frustrating and maddening to even attempt writing other than my blog.

I have a humongously growing list of people waiting to read this book and that should spur me on to write, but it's too hard to do right now. I must keep calm and unflustered to handle my daily growing list of have-to-dos. Although part of my mind balks at the lack of forward progress of the book and I chastise myself for laziness, I also realize I'm a damaged human being that her wants won't kill her. All my efforts are focused on getting through this day and what it brings instead of want-to-dos. This is as it should be.

So as for my cognitive skills recovery, I'll stick to game playing. It's a measurable step forward in recovery each and every time I play. I'll continue to set mini goals for each game and try to achieve them. No effort is wasted. When my brain tires, I stop and do something else because it is mentally taxing to rewire the brain. That's the thing about recovery after a stroke, you start off with a clean slate and everything you do is a goal and achievement. Whether it is making a sandwich, doing rehab exercises, or playing games over and over again. I'm trying to get back to taking things for granted instead of looking for goals and achievement beyond the normal. Right now I'm striving for the new Abby Normal in my life. As should we all.

Nothing is impossible with determination.

Monday Mailbox ~ Games People Can Play After a Stroke

All I can say is wow. My mailbox was on fire after I posted about the games I played and why. By a large margin one of the highest email responses for a single post with 78 emails in one week. This is a long answer so be warned.

That has to be a record of some kind. The general gist of most of the emails follow two basic trains of thoughts: 1) I never thought of that! and 2) How clever or smart. How do I find out more?

Thank you, thank you. Since I pay for membership every year for Pogo, why not use what I have at my disposal? Made sense to me. They do have free games on Pogo, but I've been a member for five years and don't know which games are free.

Lord knows, the what the average stroke recovery patient pays for in braces, splints, assorted orthotics and other adaptive equipment are big bucks. All of it is not covered by insurance. Not to mention the cost of physical, speech, and occupational therapies.

I'm all about squeezing pennies into a dime. I'm still in some financial bind without me bring home the extra bacon we need to live comfortably. I'm not working and still unknown when I'll be able to return to work. Social Security Disability is in the hands of the lawyers, but God knows when that will kick in...if ever.

I often say that of all the things I lost with the stroke, I miss my mind the most and it's true. I can learn to type one-handed (obviously), to use a calculator for math instead of doing it all in my head, cook one-handed, and a lot of other things eventually as the need arises. But what do you do when your brain cells cannot remember to spell or which punctuation is used when, or you cannot plan a day without backtracking all over the place, or sequence numbers in order or recognize them? I play games. I used to do it for the challenge and fun, but now I do it to relearn and challenge myself.

My family has always been into games. They teach children counting, addition, subtraction, and logic. So why wouldn't it work to help rebuild my mind? It does.

I first started with Tri Peaks Pyramid because it was forwards and backwards sequencing. Almost everyone knows playing cards, right? I played nothing else but this game for two months until I could play it without having to think of the order or have a cheat sheet of the order in front of me. My husband wrote it out on a 3x5 card. Is it really cheating, if you honestly cannot remember? Nope this isn't a test. It's relearning something you already knew.

My life revolves around words as a public speaker, as an author, as an editor, as a minister, and as a wife of a hearing impaired husband...spoken and written So I added QWERTY, a word game like Scrabble, to my list of games. My spelling ability increased over time. To reinforce my spelling and grammar I started to do what I always did, I blogged and started a book. As time, now nine months worth, passed I increased this blog from once a week to five to seven times a week and my other one to twice a month. It helped my writing go more smoothly. Does this mean I don't misspell words or use anything but simple grammar? No, I still have brain fart moments but it is getting better. You will have to figure out what works best for you.

I added other games as I noticed other areas which needed work. Now I've moved on to Bingo. More precisely Bingo Luau. The number recognition is now up to seventy-five numbers. I still get confused by my "dyslexic ADD" with multiple combinations such as 57 & 75 and the like. There is a handy chart up at the top for any number I might have missed plus they light up if they've been called when you put your cursor on them. I'm not playing to call Bingo, but I wouldn't mind if I did. Humans are such a competitive race. My main focus is to find the right numbers. As I said in my previous post, I have worked my way up to a medium speed caller and three cards.

That's basically how it works. Now for matching skills, it's Mahjong, I gave up trying to play Mahjong with regular tiles because my brain spent too much time trying to translate the tile faces. My brain would tell me, "Come on. You know this!"

It became very frustrating, but Pogo had a solution, Mahjong Safari. It uses animals instead of Chinese characters.

Yes, I'm writing a new book and eventually it will be finished, but it isn't bringing in income. The argument-But you have other books, I hear you asking. Yes, and since my stroke I haven't been marketing them as hard as I used to. I'm not doing public appearances or spending the time I should be to promote them. The royalties per quarter are less  than my house payment for a month. NO, I'm not on the pity pot again. My finances are my finances. They will work out over time.

Getting back to games. I realized my cognitive difficulties after I tried to resume my life after my stroke. I've always believed that nothing is impossible with hard work. I'm also too stubborn for my own good. Why should I spend dwindling funds on speech therapy when I could do most of it myself.

My aphasia was not as bad as some others. It was holey like Swiss cheese, but recovery from a stroke was creating new pathways past the damaged parts. I speak aloud and I am helped and corrected. Patience is always in the forefront with others I am talking to. I am not shushed or talked for. I'm luckier than most. I can see that now after time has gone by. The cognitive issues are slowly resolving, but faster than my physical ones.

One of the first issues I had was I was DOMINANTLY right handed. My left hand did not have much in the way of fine motor skills and was weaker than my right hand usually was. Now everything that needed doing had to be done left handed.

Eating and drinking was no problem because I've never had a problem stuffing my face. My weight problem proves it. Brushing my teeth and bathing, I'd rather use my right hand but my left works just fine. Writing was another story as was using the computer mouse and typing. These were new skills I had to learn.

Just like in business, it's location, location, location; after a stroke it's repeat, repeat, repeat to create new pathways for functioning. Just like for anything new you are learning its practice, practice, practice. Is my repeating things three times annoying you? I'll stop now.

I could have played solitaire with real cards but then I'd have to shuffle the deck. The computer was easier with a click of the mouse button. It also served to build the strength and dexterity in my left hand. Sometimes we forget just how weak our nondominant hand really is until we need it, but that's all changing now.

Most computers these days have a couple of solitaire games installed with Windows. Try these first. Nothing beats free or included with the price of the computer. For me, I'll keep trying to connect the pathways. Of all the things I've lost, I miss my mind the most.

Keep writing and loving the Lord.