Clinical neuropsychology

[Nancy]

Could I ask you to take a BRIEF (lol lol) Look at the dozens and dozens and dozens of wood carvings on http://community.webshots.com/user/nancymo44 ?

I carved only Santas -- the lowest part of caricature carving - the lowest part of any carving ~sigh~ And I didn't mind a bit. I was making more money than I could as a clerk at the local Wal-Mart and it made me feel good.

Losing that ability to carve is what's really bothering me.

Many thanks for talking to me.

[RobinN]

They are wonderful Nancy. I can tell that you enjoyed it by the expression you gave each of them. Is it your hands that don't work the same anymore? Perhaps you can create in another method.

[Zoe]

Could I ask you to take a BRIEF (lol lol) Look at the dozens and dozens and dozens of wood carvings on http://community.webshots.com/user/nancymo44 ?

I carved only Santas -- the lowest part of caricature carving - the lowest part of any carving ~sigh~ And I didn't mind a bit. I was making more money than I could as a clerk at the local Wal-Mart and it made me feel good.

Losing that ability to carve is what's really bothering me.

Many thanks for talking to me.

Nancy,
Those are great carvings! Don't assume you will never be able to do them again. Give yourself time to heal and create ways to do the work and\or find other ways to express yourself in the process.
So maybe now you will have to take a convoluted route to do the things you want to do or learn other things to do instead.
You can look at what is a problem for you now with carving and pick on one aspect to deal with at a time. Are you having trouble with coordination, vision? Can you manage the tools safely? What about working with clay using just your hands to refamiliarize yourself with the process of making shapes? Is that an option? If you try this and it gets really frustrating, you can always toss the clay onto the floor or against a wall and make throw pots. I've made a few of those!
Your brain has been traumatized-it needs care and nurturing to overcome the stress it has endured. Just because you can't do the carving now, doesn't mean you never will again.
We need our time to grieve our losses, for sure, and to clearly identify what we've lost. But the loss need not be permanent. Brain injury\trauma isn't irreversible. If you identify and state the problems as you are experiencing them, you are in a position to work on them one by one. This is getting too long so am posting some stuff on vision therapy in the next post. I had some of this and wore special glasses for a long time to retrain my eyes to focus in unision.

[Zoe]

This is from Aetna Insurance. Looks like they don't cover much, but it is good information on what opthamologists are doing in this area.

Clinical Policy Bulletins:
Vision Therapy


Number: 0489


Policy


Note: Some Aetna plans specifically exclude benefits for vision therapy (orthoptic training). Under these plans, charges for orthoptic and/or pleoptic training (eye exercises) and training aids or vision therapy for any diagnosis should be denied based on this contractual exclusion.

Under plans with no such exclusion, Aetna considers up to 32 vision therapy visits or sessions medically necessary for treatment of the following conditions:

Amblyopia

Strabismic amblyopia
Suppression amblyopia
Deprivation amblyopia
Refractive amblyopia

Strabismus (concomitant)

Monocular esotropia
Alternating esotropia
Monocular exotropia
Alternating exotropia
Intermittent esotropia, monocular
Intermittent esotropia, alternating
Intermittent exotropia, monocular
Intermittent exotropia, alternating
Accommodative component in esotropia

Non-strabismic disorder of binocular eye movements

Convergence insufficiency
Convergence excess
Anomalies of divergence

Non-presbyopic accommodative inability for members over twelve years old.

Requests for vision therapy exceeding 32 visits for these indications are subject to medical review.

Note: Under Aetna plans that cover vision therapy, orthoptic or pleoptic training aids are covered as durable medical equipment.

Vision therapy for the following diagnoses may be considered medically necessary upon medical review:

Heterophoria

Esophoria
Exophoria

Note: Heterophoria that requires treatment should be causing asthenopia or fusion with defective stereopsis.

Myopia
Nystagmus.

Aetna considers vision therapy experimental and investigational for any of the following:

Eccentric fixation
Anomalous retinal correspondence
Traumatic brain injury (TBI)
Dyslexia and learning disabilities (see CPB 078 - Learning Disabilities, Dyslexia, and Vision )
Any diagnoses not listed above.

Eccentric fixation and anomalous retinal correspondence are adaptations to either amblyopia or strabismus and do not exist in their absence. Vision therapy in TBI, dyslexia and learning disabilities has not been shown to be effective treatment. Note: In addition, most Aetna benefit plans exclude coverage of services, treatment, education testing or training related to learning disabilities, or developmental delays. Please check benefit plan descriptions.



Background
Vision therapy encompasses a wide variety of non-surgical methods to correct or improve specific visual dysfunctions. It may include the use of eye patches, penlights, mirrors, lenses, prisms, and patches, as well as eye exercises. Other modalities in use by vision therapy proponents that are considered unproven include sensory, motor, and perceptual activities. Orthoptics and pleoptics are common forms of vision therapy. Orthoptics are exercises designed to improve the function of the eye muscles. These exercises are considered particularly useful in the treatment of strabismus (cross-eyes). Pleoptics are exercises designed to improve impaired vision when there is no evidence of organic eye diseases.

There is a broad range of vision therapy techniques and methods among practitioners who perform vision therapy making the practice of vision therapy difficult to standardize and evaluate. The National Eye Institute (NEI) of the National Institutes of Health (NIH) acknowledges the need for clinical trials of noninvasive treatments (such as orthoptics and vision training) to determine the presence of improvement in eye alignment and visual function in patients with early vision abnormalities such as amblyopia and impaired stereoscopic vision. The American Academy of Ophthalmology (AAO) accepts eye exercises and other non-surgical treatments, usually provided by an orthoptist (a professional eye specialist who works under the supervision of an ophthalmologist), as beneficial for individuals who have eye muscle problems. However, the AAO believes that these treatments should not be confused with vision therapy. The American Academy of Pediatrics (AAP), American Association for Pediatric Ophthalmology (AAPOS), and the AAO issued a joint statement in July 1992 stating that there is no scientific evidence to support the claim “that the academic abilities of dyslexic or learning-disabled children can be improved with treatment based on (a) visual training, including muscle exercises, ocular pursuit, tracking exercises, or ‘training’ glasses (with or without bifocals or prisms); (b) neurological organizational training (laterality training, crawling, balance board, perceptual training): or (c) tinted or colored lenses. It is the opinion of these organizations that any claims of improved reading and learning with the use of these methods usually are based on poorly controlled studies. Thus, there are no eye or visual causes for dyslexia and learning disabilities, and there is no effective treatment.

The American Academy of Optometry and American Optometric Association issued a joint policy statement in 1997 on vision, learning, and dyslexia, maintaining that vision therapy does not treat learning disabilities or dyslexia directly, but is a treatment to improve visual efficiency and visual processing to allow an individual to be more responsive to educational instruction. However, there is little data available on the efficacy of vision therapy for treating learning disabilities or dyslexia. In addition, Aetna does not cover services, treatment, education testing or training related to learning disabilities, or developmental delays.

http://www.aetna.com/cpb/medical/data/400_499/0489.html
Here is more info on vision therapy to check out.

Vision Rehabilitation after Stroke or Brain Injury - Vision ...Common types of vision loss after a stroke or traumatic brain injury include: ... patients improve their vision. Therapy modules are individualized for each ...
www.helpforvisionloss.com/vrt/ - 19k - Cached - Similar pages - Note this

Neuroplasticity - the Science of Stroke or Traumatic Brain Injury ...Neuroplasticity – the Key to Stroke and Traumatic Brain Injury Vision ... The vision therapy program is analyzed and updated periodically as the patient ...
www.helpforvisionloss.com/vrt/neuroplasticity/ - 21k - Cached - Similar pages - Note this
[ More results from www.helpforvisionloss.com ]

Vision Disorders in Acquired Brain InjuryOptometrists who specialize in vision therapy can provide needed treatment that allows patients with acquired brain injury to more easily and adequately ...
www.visionhelp.com/brain.htm

[brain]

Nancy - those are lovely carvings!
I hadn't had brain surgery but I lost
the ability to draw, paint, sketch, etc.
Even my handwriting is affected. And I
can almost relate to your frustration of
your passion, love, devotion, and desire!

[Birdbomb]

Nancy those carvings are WONDERFUL!

I can relate to your fustrations. In 2000 I decieded to go back to college and earn my Business Degree. During this time, my left knee was deteriating from arthritis, so I took the summer semister off in 2001 to have a total replacement done. About 6 weeks after the knee was done, I had my first and only grand mal.

It was a whopper! I ended up in the hospital longer for that seizure than I did for the knee surgery! But when I got out of the hospital I began to learn the extent of damage that seizure caused.

For the first 3-4 months, I could not read. The combination of letters just didn't make any sense. After the reading skills began to return, I could not retain what I had read. I also discovered all my math skills vanished. There was only one more math credit I needed, but every algebraic formula was gone. In fact, I coun't even balance the checkbook. Piano was my passion and I had always wanted to learn to play. I aced the first semister, but then lost evey scrap of knowlege I had learnd about music. I used to know my way around Vegas like the back of my hand. Now I have trouble, reading maps, and following directions.

Using new computer programs takes me forever to learn, My brain just dodn't want to keep it. Lost most of my German gone, too.

Brain injuries are horrible and frustrating beyond belief! I found out later on, I had tried to go back to college TOO soon. It takes the body about 18 months to heal from major trauma but the brain takes at least 2 years or more! Even with special ed and tutors, I just couldn't do it.

I used to do lots of different crafts. Sewing was my passion. Lost most of those skills too, although I was nowhere as good as you and RobiN, I'd win 1st and 2nd prize ribbons on the stuff I'd enter into the State and County Fairs.

Those days are long gone now.

(sigh)

[Nancy]

Many thanks for all your kind words and many thanks for listening and responding.

Zoe - I'm reasonably confident about my vision and have annual check-ups there. It didn't change before or after the surgeries. I wish yours were doing as well and as easily.

Whatever is wrong with my carving ability happened BEFORE the surgery.... I don't know why. The people involved keep telling me to keep trying. Bless their hearts - they know it's important to me.

Because of the surgery, my major loss has been language and memory. The most difficult thing to deal with has been TALKING.

[Zoe]

Many thanks for all your kind words and many thanks for listening and responding.

Zoe - I'm reasonably confident about my vision and have annual check-ups there. It didn't change before or after the surgeries. I wish yours were doing as well and as easily.

Whatever is wrong with my carving ability happened BEFORE the surgery.... I don't know why. The people involved keep telling me to keep trying. Bless their hearts - they know it's important to me.

Because of the surgery, my major loss has been language and memory. The most difficult thing to deal with has been TALKING.

Nancy,
There may be a rough analogy with writing here; If I'm stuck on a piece, not getting anywhere with it, I need to just walk away from it, let it go. After a while reading and re-reading it, I get numbed to it and can't do any revising. Leaving it and doing something else for a while allows me to come back to it with a fresh mind [what's left of it ] and then I can often get past my stuck points. Maybe just put all the carving down for a while and during that time do other things creative and not even think about carving. When you come back to it, maybe then you can get past whatever block you are encountering with it now.

What are the difficulties you find now with talking? What are your thoughts about it? Any ideas on how you might get from where you are now to where you want to be with the talking problem?
It seems paradoxical, but expressing a difficulty outside of myself, in writing, had the effect of allowing me to see the problem in a way I could not do talking to myself. Being able to "see it" this way made it easier to figure out strategies for changing things. After the strokes, I just couldn't hold as much stuff in my memory and juggle it around mentally.

[Zoe]

Nancy those carvings are WONDERFUL!

Brain injuries are horrible and frustrating beyond belief! I found out later on, I had tried to go back to college TOO soon. It takes the body about 18 months to heal from major trauma but the brain takes at least 2 years or more! Even with special ed and tutors, I just couldn't do it.

I used to do lots of different crafts. Sewing was my passion. Lost most of those skills too, although I was nowhere as good as you and RobiN, I'd win 1st and 2nd prize ribbons on the stuff I'd enter into the State and County Fairs.

Those days are long gone now.

(sigh)

Birdy,

I'm with you on not going too fast on recovery. I had to drop out of school several times because I just wasn't able learn in a normal classroom setting. I finally just went to distance learning on internet courses, but was sorry to miss out on the social stuff with college.
I could REALLY empathize with a lot of what you wrote. I put myself through high school and some of my college on my sewing and original crochet work. I sang, played guitar, and did some painting, drawing, and other crafts. Lost almost all my skills to the strokes and brain surgeries but have regained a lot of them too. If I try really hard sometimes I can hit a C flat when I sing.
After the first brain surgery, my ability to orient geographically was completely gone, along with most of the memory of my adult life. Whenever I moved in Seattle, the police and fire department had to be notified that I would be unable to find my way out of the building in an emergency and they would have to come looking for me. I lived in one building for five years and could never consistently recognize it. That went on for fifteen years, untill 1998, when I got my seizures under control.

Totally unexpected, when I began using taurine for my seizures, not only did it put an end to my complex partials, but my sense of direction and ability to reognize my surroundings also returned. Go figure! I had read studies on rats and how destroying part of their temporal lobes would leave them unable to work mazes, to find their way around geographically. Since my right temporal lobe, part of my prefrontal lobe were removed and all of my brain damaged by the meningitis, I thought I'd never recover.
Well taurine's role in seizures is only getting recognized in humans these past ten years, though many earlier studies were done on animals. It is often low in those who have seizures and I think seizures themselves may lower the taurine level, thus keep the seizure threshold down.
I have no idea why the taurine also led to my regaining a sense of direction after fifteen years. But with this also came the ability again to do some of my crafts, even sewing, to mentally be able to "see' what I was doing or wanted to do. I used the taurine for about four years and feel it had much to do not only with keeping me seizure free, but in some way allowing my brain to regain the ability to do a lot of my craft work.

[Birdbomb]

You have had an unusual amount of brain injuries! I am intrigued with the results you have had from taurine. I moderate an ECT board with many members who have been damaged from ECT. They describe their brain injuries much like mine but then they also have great loss of memories.

It seems the memories are still there for some but the pathway to the memory is destroyed.

Do you think taurine would help these folks?

I would have to check with my Rheumatologist before I am allowed to take any OTC or suppliments. That stuff does not play well with the drugs I take.

I can't say how much of my creative skills have returned because the past 6 years have been so hetic and I am raising my grandaughters. Doesn't leave much time for fun and games. Only time I sew is when the mending basket is full and the RA allows me freedom of movement.

[RobinN]

I give Rebecca taurine. It is 1000mg which I give her in the morning. She still is forgetful

[Birdbomb]

Memory loss from brain injury is different. There is also the loss of emotional attachment associated with memories and objects.

Being forgetful as a teen is not the same thing. She's most likely to be focused on other stuff or her medication is causing it. Her memories can be triggered whereas with these types of brain injuries, there is no trigger. Faces of loved ones are forgotten, memories of weddings, child birth all gone. Some NEVER to return because of the damage.

The brain can re-learn much, but the injury has to recognized. This is where these people are trapped. The doctors who prescribe ECT refuse to acknowlege the injuries ECT causes but they know that most who have ECT will have to go on disability afterwards!

Oh this is a topic I really don't want to get into right now. It makes my head hurt just thinking about it!

[RobinN]

I am sorry that i didn't clarify that I was hinting at sarcasm. Teen forgetfulness is very different. Sorry to have made you hurt your head.

However with that said, Rebecca did lose her memory for two months last year. She could not remember family members, time and places. It was a very emotional time. She also loses her memory each and every time she has a seizure. Some days it is a longer period than others. This week she has no recollection of about seven hours of time. So I do understand the frustrations and trauma surrounding the subject. We have to play catch up with what has happened during the day. She rarely knows what let up to the seizure.

Non of it is fun.

[Nancy]

Yesterday at exactly 1 PM - as scheduled - the neuropsychologist who was in charge of that test last Monday telephoned me as scheduled to discuss the test results.

As I expected she said I aced -lol- the test except for word finding and memory. I blew those quite horribly......
She said I'd managed those quite well in the tests before and AFTER the first surgery but they had expected that the second surgery would be very hard on me. If I keep working and trying those ......(words???) abilities (??) should slowly return.

She talked a long, long and gentle time.

I was told ahead of all this that at university hospital I would be treated like a number. I've felt like #1 for 2 years.

[RobinN]

That is really wonderful to hear. Our university hospital made me feel quite the opposite. So it goes to show it matters who see not where you are.

[Zoe]

You have had an unusual amount of brain injuries! I am intrigued with the results you have had from taurine. I moderate an ECT board with many members who have been damaged from ECT. They describe their brain injuries much like mine but then they also have great loss of memories.

It seems the memories are still there for some but the pathway to the memory is destroyed.

Do you think taurine would help these folks?

I would have to check with my Rheumatologist before I am allowed to take any OTC or suppliments. That stuff does not play well with the drugs I take.

Not only your rheumatologist, but maybe your pharmacist as well. They often have more knowledge and immediate access to information than my docs have handy.

I think you are on the bull's eye about the "pathway" to memories being lost. But they can be restored or redeveloped too. I can't say if taurine would help folks injured by ECT but am checking into it. It does get depleted by seizure activity, so I think it would be likely true for ECT victims as well, but t isn't showing up in my brief google search. What also helped tremendously is lecithin which I take in the form of capsules as the granules upset my stomach. IMO, ECT effects are like PTSD and would look at all that can be done to heal the trauma, on many levels. I've known some victims of it too.

When my amnesia was severe, it was difficult. I found myself very upset about issues related to racism, but didn't then recall that I'd been involved in civil rights activities in my native Virginia. Something would make me feel a strong emotion, negative or positive, but with no recall why I felt and reacted, as I did, damaged pathways.

With ECT, I'd look really closely at the nutrients that play an important role in maintaining good cognitive function, especially the b vitamins. It would likely be useful to look at things such as the homocysteine levels as this is raised by low levels of folic acid and B12, which in turn may be side effects of taking drugs and can result in the symptoms diagnosed as various mental illnesses.

I can't be truly objective on this issue as I consider ECT a crime against humanity. Here's a few of the links that turned up in my search.

Using thiamine to reduce post-ECT confusionB vitamins is a recognized treatment of the confusion. that occurs in these conditions. ... effects of electroconvulsive therapy and depression on ...
doi.wiley.com/10.1002/gps.498


DepressionElectroconvulsive therapy is the use of an electric stimulus to produce a ... Research suggests that diets high in tryptophan, certain B vitamins, ...
http://www.upmc.com/HealthManagement...chunkiid=11908

[Birdbomb]

Thank you Zoe. I have taken the liberty of posting a link to this thread at Zaprap.org I know several members are the benifits of B12.

I wish more people would realize how IMPORTANT nutrition is to their emotional well-being. Learning about it is the easy part, it's moving to action that's the struggle for most.

[Roncentaur]

Hi Randy,

I was a little disturbed by your statement that your long time exposure to anti-epileptic drugs has made you incapable of learning new tasks. Believe me, for me to say that I am not a fan of anti-epileptic drugs is an understatement of considerable magnitude, but for them to cause as much damage as you say they have caused you is fightening to say the least. Is it possible that it is the anti-epileptic drugs themselves, with their associated side effects which include impaired cognitive function, are the culprit and not some sort of irreparable brain damage. I wonder if an adjustment in your meds might reverse your problem. Also, have you looked into alternative treatments that might allow you to perhaps lower your present dosages. There are also exercises you can do to improve your cognitive skills. Anyway, I think it is important to remember that if we believe we are limited then we are limited.
I don't know you, but I can't help feeling that your test results prove nothing and your situation has a great potential for improvement. Anyway, best of luck to you.


Ron

[Zoe]

Thank you Zoe. I have taken the liberty of posting a link to this thread at Zaprap.org I know several members are the benifits of B12.

I wish more people would realize how IMPORTANT nutrition is to their emotional well-being. Learning about it is the easy part, it's moving to action that's the struggle for most.

Right Birdy,
But it isn't nutrition in the usual sense, but needing to know and understand more of what is affecting the nutritional status of our bodies and brains and how to keep ourselves on an even keel. Even when we do understand, it is so very difficult to act when we feel lousy. That's been a challenge for me much of my life in coping with brain damage, etc. We just have to nurture ourselves along bit by bit as we are able to do so and not get too discouraged when we can't meet our hopes and expectations in the process.
There is a lot of information to be found on google searches on nutrition and mental states too.

[RobinN]

it isn't nutrition in the usual sense, but needing to know and understand more of what is affecting the nutritional status of our bodies and brains

So true Zoe. Perhaps made a little easier when you take control of your personal nutrition. I am finding it a challenge with knowing how a particular supplement/vitamin/mineral is affecting or helping my loved one. The experience isn't there with a child and observation isn't always good enough.