Wednesday, November 21, 2007

Stroke of Genius: 'Miracle' Recovery After Wife Pulls Plug

What would you do if doctors told you a loved one would certainly die? Would you silently agree, or fight against all odds? Despite what the doctors told her, one local woman facing this dilemma refused to let her husband die.

On June 3, 2003, Dan Mountain's wife discovered him unconscious on the floor.

"I knew right away what had happened. Dan was on the ground and I could tell he was paralyzed," said Dorothy Mountain.

At UCLA Medical Center, doctors explained a blood vessel burst, creating a huge blood clot in Dan's brain.

The staff called in the neurosurgery specialist.

"This is 11:30 p.m. at night in the deep, dark dungeons of our hospital, trying to relay to her I thought there was really no hope," said Dr. John Frazee. "But she was very insistent, so that night we went to surgery."

"They didn't even know if he'd survive the surgery," said Dorothy.

Dan survived, but three weeks later it appeared he would never wake.

"They wanted me to make this decision: 'You need to take him off life support.' And I had family fly in, people were begging me, begging me. And I just couldn't," said Dorothy

Finally, Dan's wife decided to end the life support. Then amazingly, he woke

Race aids healing for ex-wife of dementia patient

HONOLULU -- It was "The Pit," the bottom of the humid and desolate dark road leading to the Natural Energy Lab on the Big Island's Kona Coast, and Katherine Nichols had to dig deep to finish the Ironman Triathlon.

The physical and emotional pain of her successful run to the finish line was part of her journey of healing from the physical and emotional strain of being a caregiver for a dementia patient.

"Doing the Ironman this year was very symbolic for me," said the 41-year-old Nichols. "It was gaining the physical, mental and emotional strength to get through this journey. It has been part of my recovery from losing my husband."

Nichols is the former wife of Dr. Edwin Cadman, former dean of the University of Hawaii medical school, who went public with his illness when he resigned the prestigious post shortly after being diagnosed with primary progressive aphasia, a type of frontotemporal dementia, in March 2005. next....

St. John’s Speech Professor Linda Carozza to be Featured in Advance For Speech-Language Pathologists & Audiologists

Linda Carozza, Ph.D., CCC-SLP, Assistant Professor of Speech at St. John’s University’s Staten Island campus, will be featured in Advance for Speech-Language Pathologists and Audiologists, along with her colleagues, Tricia Olea-Santos, MS, CCC-SLP, and Therese Marie Abesamis, BS, SLP, in the November 19 issue.

Dr. Carozza and her associates designed a subjective screening tool called the Communicative Effectiveness and Stress Rating Scale (CEASRS), designed to identify the possible role of psychological stress in communication of patients with aphasia, an acquired communication disorder that impairs a person's ability to process language.

Patients suffering with this neurological impairment experience difficulty in speaking, reading and writing, and often suffer from stress related to the condition. Though still in its early stages, Dr. Carozza, Santos and Abesamis hope the CEASRS can provide health care professionals with an appreciation of psychological factors that may affect the communication skills of those with aphasia. Next....

Losing the ability to communicate can be devastating

Rehabilitation is an essential part of recovering from a stroke and one Tyneside unit is celebrating 10 years dedicated to helping patients rebuild their lives. Health reporter Jane Picken found out more.

TUCKED away and nestled in the middle of Newcastle General Hospital’s sprawling site lies a little haven for people recuperating from the devastating results of a stroke.

A stroke’s impact can change a sufferer’s life for good, but at the Cherryburn Stroke Rehabilitation Unit, expert nurses, doctors, physiotherapists, nutritionists and speech therapists are all on hand to help ease severe physical difficulties and restore confidence.


Sunday, November 18, 2007

Don’t Call Him a Filmmaker, at Least Not First

THE paintings on broken plates that made
Julian Schnabel an art-world star in the early 1980s seemed to announce their importance not just by their retrograde swagger but also by their sheer weight. Hanging one on a wall was like suspending a cabinet full of Buffalo china.The other day in a former smelting factory near the Gowanus Canal in Brooklyn a bunch of new paintings that he had hanging on the walls seemed by contrast to be almost weightless, looking as if skeins of smoke had settled on the canvas. But they were actually digitally printed blow-ups of antique French hospital X-rays that he had come across last year in northern Normandy. And as such they were pieces not simply of art but of argument, Mr. Schnabel’s pointed way of saying that while his life as a filmmaker may be threatening to eclipse his life as a painter, he still has his palette firmly in hand.

He found the X-rays in a building near the naval hospital at Berck-sur-Mer on the Normandy coast, where he had just finished directing “The Diving Bell and the Butterfly,” his movie based on the best-selling memoir by Jean-Dominique Bauby, the former editor in chief of Elle magazine in France. In 1995 Mr. Bauby suffered a stroke that left him with a condition called locked-in syndrome, conscious but paralyzed, with only his left eye remaining functional, and he composed the memoir painstakingly by blinking that eye to select letters on a chart.

The movie, which will open Nov. 30 in New York and Los Angeles, has proved to be a kind of hat trick for Mr. Schnabel, whose first film, “Basquiat” in 1996, got a respectable reception considering his inexperience and his share of detractors in the art world, where it was set. His second movie, “Before Night Falls” in 2000, about the gay Cuban writer Reinaldo Arenas, established him solidly as a filmmaker, earning an Oscar nomination for its star, Javier Bardem. And “The Diving Bell” has been even more widely praised in the early going, winning Mr. Schnabel the best director award at the Cannes Film Festival and fueling Oscar dreams on the part of Miramax, its American distributor.

The only problem with this track record, of course, is that it has a lot of people describing Mr. Schnabel as a director who paints, and not the other way around. This development does not always sit well with a man who has made thousands of paintings — and millions of dollars from them — over the last 30 years and who once declared that he was the “closest you’ll get to Picasso in this life.” Next....

The Kessler Medical Rehabilitation Research

W e l c o m e !

Do you know someone who has had a stroke or some type of cognitive or mental processing problem, speech or language disorder, visual-spatial disorder, or memory loss?

Do you know:

We at the Kessler Medical Rehabilitation Research and Education Corporation’s (KMRREC) Stroke Lab invite you to find out more about the current research done at the KMRREC Stroke Laboratory by clicking on any of the following areas: space, speech and language, strategies for memory, skilled movement, staff, success, faq


Friday, October 26, 2007

Stroke patients left without speech therapy

Six out of ten local authorities in Sweden do not employ speech therapists for stroke patients, according to figures from the Swedish National Stroke Register.

"This is serious, as there is plenty of evidence that early and intensive speech training pays off," said Ann-Charlotte Laska, consultant at the stroke unit of Stockholm's Danderyd Hospital to Svenska...Next...

On the long road to recovery by Jim Totten

A tall, lean muscular man, Doug Gillis appears to be the example of perfect health.

He's a talented athlete and pitcher who throws an 80 mph softball. He's played on five Team USA softball teams — the U.S. national team — and still plays fast-pitch softball with the Midland Explorers.

Gillis also owns Gillis Softball Academy, a successful business in Wixom where he's comfortable talking before large groups of youth and giving them pointers about the sport he loves.

Besides an irregular heartbeat, the 42-year-old Brighton Township man never gave much thought to health issues, and didn't think he ever would until June 24, 2006.

On that day, Gillis, 41 at the time, suffered a stroke that left his right side paralyzed and took away his ability to talk.Next.........

Aphasia - The Cruelest Language Barrier

Imagine the following scenario: You wake up one morning and instead of speaking English, everyone around you–including your family and friends–is speaking Hungarian. This is a problem because you don’t speak Hungarian and you don’t have a clue what they’re saying. You become frustrated. The people around you become frustrated, too, but instead of switching back to English, they speak Hungarian more loudly. Next...

Thursday, October 25, 2007

Diving Bell and the Butterfly

aphasia brain New York speech

Friday, October 19, 2007

Strangers are reaping the benefit of a tragedy that hit Orewa Rotarian Rod Dennis

SPEECHLESS: Recovery success after being struck dumb by aphasia has prompted, from left, Murray Higgins, Bill Reece, Keith Barnard and Rod Dennis to help others similarly afflicted.

In February 2003, aged 72, he was having success as district chairman of Rotary's biggest project - raising millions to combat malaria - when he had a stroke.

It severely damaged his brain's language centre and he says it made him feel such a 'freak' he stayed home for three months.

Into thin air: Altitude's toll on the brain


by David Dobbs

Editor, Mind Matters

"The mountains," wrote climbing enthusiast Sir Francis Younghusband, "reserve their choice gifts for those who stand upon their summits." Yet those who earn these gifts pay a unique price. As neuroscientist and weekend climber R. Douglas Fields relates below, a recent study used brain scans to examine both the effects that both one-time and cumulative high-altitude climbing have on the human brain. The findings are not elevating for those of us who love to climb.


Brain Cells into Thin Air


R. Douglas Fields

National Institutes of Mental Health

Washington, D.C.

"Mount Everest is very easy to climb, only just a little too high." - The Observer, Jan 25, 1953.

Three attributes of a good mountaineer are high pain threshold, bad memory, and ... I forget the third. - R. Douglas Fields

Climbing Mount Everest is not so difficult; the hard part is getting down intact. According to a recent brain imaging study, almost no one does. Of thirteen climbers in the study who attempted Mount Everest, none returned without brain damage. The study also scanned the brains of climbers who attempted less extreme summits. For those Next............

Finding a Voice in the Face of Aphasia: Using Personal Storytelling to Reconstruct Self

FAYETTEVILLE, Ark. - Lessons learned in a communication group at the University of Arkansas offer people with serious communication problems a way to redefine who they are on their own terms.

When stroke or disease damages the ability to understand or use language - a condition known as aphasia - more is lost than words and sentences. Since people express who they are through conversation and other communication, aphasia can mean a loss of self, what University of Arkansas researcher Barbara B. Shadden has called "identity theft."

Shadden and sociologist Patricia R. Koski have applied sociological theory to illuminate the process of a communication group for people with aphasia. An article about the results of the group, "Social Construction of Self for Persons with Aphasia: When Language as a Cultural Tool is Impaired," appears in a recent issue of the Journal of Medical Speech Language Pathology.

Theorists in a number of disciplines agree that "language, talk and communication are critical elements of the ongoing construction of self," the researchers wrote. When people with aphasia are involved with the medical system, their role as patients reshapes their life stories. Often they begin to see themselves as powerless, incompetent and socially marginal.

"The way you create yourself is that you tell a story," Koski said. "Think of how you present yourself to other people. You tell a story. It's not just a presentation of self - it's a creation of self."

"But if something happens to that communication tool that lets you tell that story," Shadden said, "then how do you do it? How do you create yourself? What do you do if your tool has failed you and others don't know who you are?"

In 2004, a communication group was created at the University of Arkansas Speech and Hearing Clinic as a way of "transforming communication strategies learned in individual therapy into a broader social context." While communications professionals in the group facilitated discussion, everyone participated on an equal footing, which created very different relationships than are typically seen with the medical model.

"The medical model is a very comfortable model," Koski said. "There's you the professional, and there's that other person the client. You treat the client. You have power, you are separate, and you don't have to take a risk. This support group was based on the assumption that there was fundamentally no power difference."

Shadden had always taught her clinical students that they were dealing with a person first and a disorder second. With the communication group, she said, "We were trying to put some teeth into that."

The group was a place for people with aphasia to use the cultural tools available to tell the story of who they had been and were becoming. A cultural tool is more than the act of speaking and using language. Cultural tools include, among other things, beliefs, assumptions, values, posture, gestures, facial expressions - and assistive devices. For people who have lost their ability to use language, assistive devices may involve computer programs or other people.

"Being articulate is a really important tool in our society. Being able to express things well with a voice is an incredibly important tool," Koski said.

"That idea of voice, not in just the literal sense, but the idea of 'having a voice,' is really about having a self. You can't separate the two," Shadden said.

The logistics of the communication group were simple. People were seated in a way to maximize social support and communication. For example, a woman who could write but not speak was seated next to a man who could read and share her writings with the group. Group members selected personal biographical discussion topics ranging from the first kiss and first car to vacations of the past and future. Topics were selected well in advance to give everyone time to prepare. Facilitators were active and equal participants in the discussion, presenting their own personal story along with everyone else.

Shadden and Koski use the example of Jack to show the impact of the group process. A stroke had left him able to say little more than "uh huh" and "no" while also communicating through facial expressions, various vocalizations and drawing. Eight years after the stroke, Jack and his wife both expressed anger and frustration and seemed to be focused on what he was unable to do. He had an assistive tool that he avoided using.

"In my discipline people think if you get the right computerized device into someone's hands that will solve the problem. That's the easy part," Shadden said. "Figuring out what they can and can't do is easy. Figuring out what they will or won't do is hard. What matters about a tool is what you do with it."

Over the course of a year and a half, Jack responded to the group story-telling exercises and the good-humored support by engaging in more complex explanations of his feelings. He was transformed "as he found his voice and was able to share his life story." Subsequently, when faced with the life-threatening result of a medical test, he was able to discuss it with the group and later with his wife.

"For the first time, they began to communicate about how they wanted to live their lives in the face of this threat. During the course of this transformation, his wife appeared to be picking up her life story as well, as anger abated and her life story expanded beyond being married to an angry man who had had a stroke."

Shadden, Koski and colleague Fran Hagstrom will be publishing a book to be released in spring 2008 about the importance of sharing one's story in the process of maintaining and reconstructing a sense of self. Aimed at both practitioners and researchers, the book includes theoretical discussion and individual life stories from persons whose communication has been disrupted by a number of neurological conditions, including aphasia, ALS, Parkinson's disease, and dementia.

Shadden is a professor and director of the Speech and Hearing Clinic in the College of Education and Health Professions. Koski is an associate professor in the department of sociology and criminal justice and associate dean of the University of Arkansas Graduate School. Hagstrom is an assistant professor of communication disorders, also in the College of Education and Health Professions.


Sunday, October 14, 2007

Oliver Sacks

Oliver Wolf Sacks (born July 9, 1933, London), is a United States-based British neurologist, who has written popular books about his patients; the most famous of which is Awakenings, which was adapted into a film starring Robin Williams and Robert De Niro.

Sacks considers that his literary style follows the tradition of 19th-century "clinical anecdotes", a literary-style that included informal case histories, following the writings of Alexander Luria.[1] Sacks is a childhood friend of Jonathan Miller[2] and a cousin of Robert Aumann and the late Abba Eban.[3]

In 2007,[4] Columbia University appointed Sacks as "its first Columbia artist, a newly created designation." next....

Thursday, September 27, 2007

Tedy Bruschi

aphasia brain New York speech

Lynn Johnston Honored by American Speech-Language-Hearing Association

Lynn Johnston, creator of For Better or For Worse, will be presented a 2007 Media Award by the American Speech-Language-Hearing Association bringing attention to “Aphasia” a disorder often brought out as a result of a stroke or brain injury. In her comic feature, the grandfather character struggles to regain his speech after a stroke. The plot-line demonstrates the difficulties not only for the individual, but also the family and caregiver.

Language and the brain

Today I will explain the function of specific areas in the brain for language functions. The brain has two hemispheres, the right and the left, and Corpus Collosum, that connects the two hemispheres. The right hemisphere is about non-verbal sounds (among other things) and the left hemisphere is about language.

This localization view should be taken cautiously since there are a lot of intrincate connections in the brain, and damage to one area can have repercussions in another. There are some difficulties in language for production or processing:

It is an interesting field in linguistics so I must try to deal with this issue. To conclude this entry I will include an image of the brain and its differents parts.

Wednesday, August 29, 2007

Sen. Tim Johnson second chance at life and work

Sen. Tim Johnson's Second Chance at Life and Work
Bob Woodruff Follows the Remarkable Recovery and Return of the South Dakota Senator
Senator Tim Johnson, who returned to South Dakota today for the first time since suffering a brain hemorrhage last December, says he plans to run for re-election in 2008. "I expect to run and to win," he said. (Office of Senator Tim Johnson)
From Nightline

Sen. Tim Johnson, D-S.D., addressed a crowd today in Sioux Falls, S.D., "Wow. You guys are a sight for sore eyes. It's good to be home."
It's been a long road home for the senator in the eight months since the brain hemorrhage that nearly killed him in December. In that time he's had to learn to walk again and to cope with speech slowed by aphasia.
Related Stories

"I am back and I promise you all that I will work harder than ever for you and for our state," Johnson said.
One thing Johnson, who will return to the Senate on Sept. 5, hasn't lost is his sense of humor.
"I will promise you that when my speech is back to normal, I will not act like a typical politician and overuse the gift."
"Of course, I believe I have an unfair edge over most of my colleagues right now — my mind works faster than my mouth does," he said. "I'm hoping that folks will focus more on my work than how quickly I walk these days."
Johnson has always been a straightforward, moderate Democrat from a mostly Republican state. He is a man so respected by his colleagues that they made him chairman of the Senate Ethics Committee. He is also the only senator with a son who has served in Afghanistan and Iraq.
When Johnson fell ill with what appeared to be a stroke, the outpouring of concern from both sides of the aisle was heartfelt and genuine.
White House Press Secretary Tony Snow told reporters, "This is a time to pray for Tim Johnson's health, and I'll leave it to others to start doing political calculations."
Dec. 13, 2006
Shortly before noon on Dec. 13, 2006, Johnson was conducting a telephone news conference when his words began to falter.
"I looked at him and kind of gave him a sign like wrap it up. And he said, 'Frustrating.' He said frustrating, I think two times," Johnson's communications director Julianne Fisher said. "And I turned and looked at his scheduler and pulled her aside and said, 'I think he's having a stroke.' … By 12:15 he was probably in the ambulance and gone."
Johnson only recalls part of that day.
"I remember that time, and all the way to the emergency room— ambulance ride, the emergency room. And then I become vaguer. I don't remember anymore," he said.
Johnson was unaware that the scene outside George Washington Hospital quickly became a media circus, much to the dismay of his worried family and staff inside.

Monday, August 27, 2007

Joseph Chaikin

Joseph Chaikin (September 16, 1935June 22, 2003) was an American theatre director, teacher and playwright. He suffered from heart complications as a child, and was sent to a children's hospital in Florida the age of five. It was during this period of isolation that he began to experiment in the theatre.

He briefly attended Drake University in Iowa, and then went on to work with The Living Theatre before founding The Open Theater an experimental theatre co-operative that progressed from being a closed laboratory to performing devised work to an audience. In 1970 they performed Endgame by Samuel Beckett, with Chaikin playing the role of Hamm, at the Grasslands Penitentiary, a fulfillment of his desire to experiment with audiences who would be fundamentally different to the ones they were playing for. In 1970- 71 they performed Terminal by Susan Yankovitz in many maximum and minimum security prisons on the East Coast of the USA and Canada. The Open Theater ran for about ten years. Chaikin wound the company up to avoid its institutionalising, since it achieved critical success, something which he spurned saying, "I have rarely known a case where a critic's response to actors, directors or writers has expanded or encouraged their talent- I have known cases where by panning or praising, the critic has crushed or discouraged creative inspiration".

He then formed a company called The Winter Project, whose members included Ronnie Gilbert and Will Patton. Chaikin had a close working relationship with Sam Shepard and together they wrote the plays Tongues and Savage/Love, both of which premiered at San Francisco's Magic Theatre. They were commissioned to write When The World Was Green for the 1996 Olympics in Atlanta, Georgia. Beyond performing in his plays, Chaikin was an expert on Samuel Beckett, directing a number of his plays including Endgame at the Manhattan Theatre Club. Beckett wrote a poem for Chaikin entitled What Is the Word?. He received six Obie Awards, including one for Lifetime Achievement, and two Guggenheim Fellowships.

In 1984, a stroke suffered during open-heart surgery left Chaikin with partial aphasia. Despite this barrier to communication, Chaikin continued to direct and to create plays collaboratively with other writers, including John Belluso, whose disability-themed plays were produced at the Mark Taper Forum, Trinity Rep, Pacific Repertory Theatre and the New York Shakespeare Festival. Chaikin was also a lifelong teacher of acting and directing, and lived in New York's West Village until his death.

In 1972 his book, "The Presence of The Actor" was first published with a second edition in 1991 published by Theatre Communications Group. It includes exemplar notes, photographs and exercises from several Open Theatre productions as well as presenting Chaikin's philosophy on how theatre can bring about social transformation.

Chaikin was born and died in New York City. His son, Mauricio, now resides in Deer Park, New York.

Tuesday, August 21, 2007

Language Evolution’s Slippery Tropes

This view now faces many rivals. The big-bang theory has been countered by linguists who believe that just as the eye evolved to meet a need for vision, language evolved to meet the need for communication. Ms. Kenneally ushers onto the stage researchers who have discovered that many animal species possess languagelike skills previously unimagined and, without benefit of syntax or words, have a complicated inner life. They believe that the study of animal language and gestures could shed light on a possible protolanguage stage in human development.

The idea that language is restricted to a specific area of the brain has been more or less discarded. Brain researchers now believe that language tasks are assigned throughout the brain. Moreover, some linguists now believe that language is a two-way street. It’s not something emanating from the brain of a communicating human. It actually changes the processes of the brain. Stroke victims suffering from aphasia, a condition involving language loss, do not simply find it difficult to communicate, they also find it more difficult to categorize, remember and organize information.


Dr. Ronald Cohn/Gorilla Foundation/PBS

Koko, a gorilla with a vocabulary.

Assessment Aphasia

Book Description:
Spreen and Risser present a comprehensive, critical review of available methods for the assessment of aphasia and related disorders in adults and children. The authors explore test instruments and approaches that have been used traditionally for the diagnosis of aphasia, ranging from bedside screening and ratings, to tests of specific aspects of language, and to comprehensive and psychometrically standardized aphasia batteries. Coverage of other methods reflects newer trends, including the areas of functional communication, testing of bilingual patients, psycholinguistic approaches, and pragmatic and discourse-related aspects of language in everyday life. The authors also examine the expansion of language assessment to individuals with non-aphasic neurological disorders, such as patients with traumatic brain injury, lesions of the right hemisphere, the healthy elderly, and invidulas with dimentia. Taking a flexible and empirical approach to the assessment process in their own clinical practice, Spreen and Risser review numerous test instruments and their source for professionals and students-in-training to choose from in their own use. The introductory chapters cover the history of aphasia assessment, a basic outline of subtypes of aphasia- both neuro-anatomically and psycholinguistically-, and the basic psychometric requirements for assessment instruments. The final part discusses issues in general clinical pracitce, specifically questions of test selection and interpretation.L The book is a thorough and practical resource for speech and language pathologists, neuropsychologists, and their students and trainees.

A Novelist in Shadowland

I knew that the left hemisphere processes positive feelings, the right negative ones; unopposed, the remaining right hemisphere could spark dark angry emotions for the rest of his life.

"Mem, Mem, Mem.

" After a stroke, a prolific novelist struggles to say how the mental world of aphasia looks and feels. [Via ectoplasmosis.]

Exactly the same thing happened to me. Apart from the bit about being a famous writer & poet.

This is a great link, and very sad. My great-grandmother had aphasia after several strokes and it was so hard to see her frustration when she struggled to say something and could only produce random syllables.

velvetrabbit's link about Edwyn Collins from earlier this week is interesting in this context.

Great link and inspiring story.

He sounds like someone interesting to talk to, and the process of his writing while coping with aphasia is compelling, but I just couldn't get into his new writing.

All of his writing can be fairly opaque.

What an absolutely riveting read!

I'm also reminded of my grandmother - she was in and out of it at the end. In one of her lucid moments she found out that my no-good cousin was in jail and insisted on dictating a letter to him. It read much like West's aphasic memoir.

« Older It's the weekend, whattya want? | YouTube has a new (old)

Aphasic memoirs

'Mem, Mem, Mem' -- After a stroke, a prolific novelist struggles to say how the mental world of aphasia looks and feels, by Paul West; introduced by Diane Ackerman. American Scholar, Summer 2007.

from the introduction: "'You know, dear,' I said to him one day, about two months after the stroke, when he was feeling mighty low, 'maybe you want to write the first aphasic memoir.' He smiled broadly, said, 'Good idea! Mem, mem, mem.' And so he began dictating, sometimes with mountain-moving effort, and at others sailing along at a good clip, an account of what he’d just gone through, what the mental world of aphasia felt and looked like. Writing the book was the best speech therapy anyone could have prescribed. For three exhausting hours each day, he forced his brain to recruit cells, build new connections, find the right sounds to go with words, and piece together whole sentences. Going over the text the next day helped refine his thoughts and showed him some of aphasia’s fingerprints in the prose." [More] (via Arts & Letters Daily)

(Post a new comment)

2007-08-18 03:09 pm UTC (link)
That's a fascinating piece, and I find it ultimately very encouraging. I hope one doesn't have to be a novelist to work through aphasia! I think there may be hope for those of us who talk and blog almost incessantly (like me!).

(Reply to this)

Wednesday, August 1, 2007

ravel and the third stream cont.

We know now that Ravel first began to show signs of neurological problems in 1927, and over the next several years, he experienced progressive muscle problems and aphasia, or the inability to speak. Neuroscientist Daniel J. Levitin has written that Ravel suffered brain damage that impaired his ability to hear pitch*. He began to show signs of dementia, worsened by a car crash he suffered in 1932. Over the next few years, he became unable to understand the written word, and he lost all ability to communicate through speech or writing. Finally, after an unsuccessful brain operation, he died in Paris on December 28, 1937, one week prior to my six-month birthday.

*Interested in the neurological and psychological aspects of music and composers? Check out This is your Brain on Music: The Science of a Human Obsession by Daniel J. Levitin.

thoughts about tiantan puhua

alright, now that i have a good internet connection outside the hospital, i can give you all my thoughts on my stay at the hospital.

first of all, it was difficult communicating with the nurses because many of them do not speak english. it was difficult talking with them at first. some of the nurses in the south ward speak a bit of english (like ally who’s no longer working there and jingjing who replaced her) but MOST of them do not. unfortunately my chinese isn’t good enough to really talk with them, so oftentimes, no communication went on…but i do miss seeing the nurses. many of them were very attentive and i can tell you that there were a few gifted in searching out my small, non-existent veins for my IVs. irene and shirley were very good! i miss them dropping off my 9am, 12, 4, and 8pm medicines, telling me, “9-clock…12-clock, 4-clock, 8-clock.” i miss them. hahah
second, i was lucky considering that many other patients had all sorts of problems. for example, some people had diarrhea and others had bacteria infection in their brains due to their brain surgeries. it’s funny that as soon as i check out of tiantan puhua, i get sick. i had a fever of 37.8 C and it lasted for 3 days. i got home on saturday and i started feeling sick the next wednesday. luckily by friday, my fever had lowered and by saturday, i was fine! whew!
third, let me tell you, don’t have high expectations for therapy at this hospital. for me, the most important therapies were speech and physiotherapy. i did NOT have a real speech therapist until basically a month after i checked in! i had lily for a little while who was such a great speech therapist! but turns out that her boss zhou comes into my room during our therapy session, starts yelling at her in chinese for a while, and then leaves. poor lily was crying and i asked her what was wrong. it basically was about how she spent too much time on this one patient during february and march because they did not have a lot of patients then. i’ve heard different stories since, but nonetheless, zhou is a poor manager which is why she is no longer the therapy manager. mark became the manager a few days before i checked out of the hospital.
granted, they understand they do need to work hard at improving the therapies, but i was disappointed because the most important part of getting stem cells is also working them so they know what their new role’s/job’s supposed to be! dr. wang and dr. wu, the” directors” of my case constantly stated this: stem cells plus therapy produces the best results!! well, obviously i got 4 stem cell injections as i’ve said on this blog, but therapy? quite lacking. so you know what? i was in the hospital for a total of 66 days and i had 19 days of speech therapy sessions. yes, that’s right. ONLY 19. that’s all. so yes, the hospital knows their therapy is lacking and they told hubby and me that they are working hard to improve them.

also i wrote many patients who had been treated at tiantan puhua and nanshan stem cells therapy hospitals to get an overall view of the treatments/therapies. i found that at nanshan, they have the vocastim collar which actually would’ve been EXCELLENT in my healing process, especially because it helps people with ataxia, dysphasia, and dysarthia problems. i have all 3 of those!!! it’s basically Electric Current Therapy of larynx paresis, aphasia, dysphasia, dysarthria and dysphagia.
i put a picture of christine with the vocastim collar on in a previous blog so you can check it if you want to see it.

you can read about vocastim here:

you can see more here:


not sure you could read that so i copied it here:

Electric Current Therapy of larynx paresis, aphasia, dysphasia, dysarthria and dysphagia
(as published by Johannes Pahn, Martin Ptok, Hans-Joachim Radü, Gabriele Witt in: “Interdisziplinär Jg. 11, August 3, 2003, p. 176 – 178)
electrotherapy, larynx pareses, aphasia, dysphasia, dysarthria, dysphagia
In Germany, about 100.000 goiter surgeries are carried out annually. It is assumed that 1,000 - 3,000 patients are suffering from larynx paresis as a consequence, with unreported numbers probably ranging much higher. As registration is not compulsory, an additional number of larynx pareses caused by surgeries of head, cervical spine and throat with different indication can be assumed. Additionally, it is estimated that cerebral damage triggers another 10,000 – 20,000 cases of vocal and speech deficiency or loss. This is caused by cerebral insults or infarcts, aneurysms, tumors, meningitis, encephalitis, neuritis and generalized affections of the nervous system. In Germany, it is estimated that about 100 people suffer severe skull-brain-trauma caused by accidents in a day. Reporting such cases is also not obligatory. The total number of patients suffering from respiratory and phonatory damage triggered by pareses of cerebral nerves is thus an estimated 20,000, at the least, with a large portion suffering from dysphagy as well. This figure, however, comprises only the newly affected patients per year.
The medical and neurological acute care and subsequent attendance of a rehabilitation clinic is followed by so-called practicing exercises. This is what ambulant therapy of vocal, phonatory and swallowing dysfunctions concentrates on. A sensible selection of exercises is promoted by diverse tests as well as diagnostic measures.
The combination of practicing exercises and electric current, however, is used to a very small degree, although electrotherapy is extensively applied in the fields of orthopaedy and physiotherapy in the context of motoric damages with identical etiology (Edel, 1983). Such treatment has proven to be extremely successful in these fields.
What are the reasons for neglecting electrotherapeutical treatment of vocal and phonatory irritations including swallowing dysfunctions triggered by pareses of cerebral nerves?
First, we may assume that patients without proper experience are somewhat reluctant to handle a stimulation current unit. This obstacle however, could be eliminated by special education in the course of the training. This is hardly advisable for physiotherapists, as training for vocal and phonatory treatment would be much more of an effort than for the vocal and speech therapist to read the user instructions of the stimulation current unit.
Other reasons for reluctance have to be considered:
Several expert fields cover the diagnosis and therapy of diseases of the cerebral nerves V, VII, IX, X and XI. Both interdisciplinary contact and knowledge are presumably not sufficient to cross the border to close cooperation. Due to this, problems in competence, terminology, the interpretation of diagnostic procedures and different therapy conceptions are likely to occur.
Obviously, distinctions of the pareses of the cerebral nerves have to become more sophisticated. In most cases, the knowledge on nervus vagus impairments is very much restricted on the recurrent nerve paresis. The diagnosis for any damage to all nerves connected with swallowing and articulation is most frequently sensoric and motoric aphasia and dysarthria. The subtle motoric movements are full of antagonisms however, which can
only be avoided by synchronizing the electric current impulse with one single and separate performance intended by the patient in each case. Simultaneous stimulation of both agonist and antagonist will block any form of regeneration. This principle also applies for the skeleton muscles. The size of the individual muscles, however, already facilitates the isolated stimulation of the agonist. When dealing with phonatory, articulatory, resonance forming and swallowing subfunctions of a muscular system commonly used, you fall into the trap of antagonism quite easily. The success of muscle training depends on the small border between too much and too little demand. Crossing this border is dangerous in both directions. Sports trainers create fine-tuned individual training schedules to avoid making mistakes. This principle has an even higher significance for pareses and the effects on muscles as well as possibly the impaired regulation of the function.
This concerns:
1. The frequency of the stimulation. It must be applied several times a day.
2. Pauses for the affected system to recover between each phonation or articulation as well as between the daily applications.
3. Adaptation of the requirements to the performance to the state of regeneration
4. Adaptation of the stimulation current properties to the reacting capabilities of the neuromuscular units. They continually change in the course of the regeneration. The actual state can be determined by electrical measurement of the accommodation and a subtle vocal status. In case of pareses with difficulties in breathing, spirometry with differentiation of the expiratory and inspiratory dyspnea must also be included.
Conditional reflexes only function in case of undamaged reflex arcs. This includes sensor afference, center, efference and motor. Speech requires a multitude of conditional reflexes, which form automatisms, combined to dynamic stereotypes. No damage to a peripheral neuron only concerns efferent nerve fibers. It always also affects the afferent fibers morphologically positioned in the same nerve with the efferent fibers. The lack of a sensorial information of the center in the medulla oblongata and in the cerebrum blocks any motorial reaction. This means that the motors are not regenerated without regeneration of the sensors, which gives the stimulation of the sensors the same significance as that of the motors. A normal regulation depends on deep and superficial sensitivity. The sensors of the surface are positioned in the mucous membrane. Every acute or chronic inflammation of the mucous membrane not only damages its power of resistance, but also its embedded sensors. However, it is required that the sensors function to make electrostimulation successful. An acute inflammation is found to be painful. A slowly developing chronic inflammation, in contrast, is hardly recognized, or only as globus sensation. The causes for chronic inflammations are nicotine, alcohol, allergies and, above all, reflux. In most cases of chronic pharyngo-laryngo-tracheo-bronchitis caused by reflux, symptoms such as heartburn or pain are missing. Consequently the reason for starting a therapy is missing.
Every patient with dysphagia, bilateral laryngeal paresis and frequently only unilateral paresis suffers from chronic inflammation of the mucous membrane through reflux. The inflammation is significantly more serious as the one frequently found among all people. The reason, for central etyology via the cerebral nerves IX and X, is believed to be damage of the plexus pharyngicus, which innervates the sphincter pharyngis inferior in the esophagus entrance in addition to its function for articulation, resonance formation and swallowing. In case of central and peripheral lesions, impairments of ventilation, arytenoid movement to open the lower hypopharynx and sensor failure must also be taken into account. The success of an electrostimulation therefore strongly depends on a successful reflux therapy, among other things.
Very frequently, any therapy is postponed in expectation of a spontaneous remission. However, it cannot be predicted. At least, it is frequently expected after goiter surgery.
This problem lies in the interval between damage and remission. If it takes commences too late, fibrosis of the joint capsule of the arytenoid has already started. This means ankylosis, which in case of a bilateral paresis can lead to tracheotomy and lateral fixation of a vocal chord.
But even a unilateral paresis with a milder dyspnea frequently impairs physical stress and the vocal functions. Exercises don’t help much in these cases. Electrostimulation is not taken into consideration, because it is known not to be very helpful with the modalities of the application used until now. Prerequisite to an effective stimulation of the stiffened arytenoids is a manipulative relaxation of the capsular fibrosis in combination with several applications of stimulation a day. A suitable manipulator is manufactured by Storz. The goal of every therapeutical measure is facilitated by exact knowledge of the pattern of paresis. Neither central nor peripheral pareses affect the nerves in question in the same way with respect to distribution and seriousness of the damage. Even a recurrent paresis may have a quite diverse pattern. Precise information connects electromyography with speech and vocal status. The muscles used for articulation can be easily measured electromyographically using superficial electrodes. The muscles of the larynx, however, can only be measured adequately using puncturing electrodes and exercise. The procedure depends on the availability of equipment and required expertise. The problem is situated within the competence of three fields, phoniatry, neurology and logopedics. But it could be solved by special training for interested specialists.
Therapy results
The diagnosis and therapy for pareses of the voice and the articulation performed at the university clinic for otorhinolaryngology currently has experience with more than 1,000 patients. In most cases, these are referred patients with long intervals with damage of up to six years. Even in cases of bilateral recurrent pareses that have existed for several years, decannulation can be achieved in approx. 50% of all cases. Between 1992 and 1998, the tracheal cannula could be removed in six out of eleven cases. This number is limited by neurological and medical diseases, threat of relapses and old age. In cases of a short interval after the damage has taken place, we estimate that regeneration is reached in 80% of all cases. Remission takes places sooner and faster than we would expect without stimulation current. In total, partial or complete regeneration in cases of delayed treatment can be achieved in 62% of all cases.
Dysphagia existing for several years respond astonishingly well to stimulation current. The remission of every aphasia, dysphasia and dysarthria is accelerated considerably in combination with standard therapeutic measures, which do not lose their significance at all. The results are confirmed in Bochum (Radü), Hannover (Ptok) and Brügge (van Gompel).
Based on the results and practical experience, the stimulation current device VOCASTIM was developed by Physiomed. In combination with 4 CDs, it features an extremely safe standardized procedure of electrophonatory and articulatory stimulation (NMEPS/NMEAS Pahn, 2002).
The device is manufactured in two versions. The master version for therapists features excitability measurement, programming a chipcard with the respective stimulation current properties and control of the therapy time already used. The more basic version was developed for the execises carried out by the patient at home. The chipcard prevents from any wrong operation.
Still, it is required that the patients see their phoniatrist/speech therapist regularly to check the progress and adapt the stimulation current properties as well as the vocal/speech performances to the state of the regeneration. Exercises besides electrostimulation are also necessary.
Even if the number of laryngeal pareses after goiter surgery slowly decreases through neuromonitoring recently applied (Neumann, 200), the total number of all pareses with a
vocal/speech background is not likely to change in the near future. Traffic accidents alone cause a large number. It should be rewarding to do away with prejudices against electrotherapy and again start using this therapeutic method almost forgotten since Gutzmann in phoniatry and speech therapy. (Kruse, 1989). The results when expertly applied speak for themselves.

ok i could go on and on about how much that vocastim collar could’ve helped me improve. unfortunately i didn’t push them enough to get it. i bugged them about 3 weeks before i checked out of the hospital which was plenty of time to get it but the higher-ups didn’t want to spend the money to get it since it is very expensive. sigh, so that’s very disappointing for me.

luckily hubby told kotan before i checked out of the hospital that they should’ve charged the first few people who need to use it a bit more for their therapy so then actually, the collar would’ve been paid for in absolutely no time! i think he said why not charge the first 5 people an extra $500 so after 5 people use it, it’s all paid for!!! sigh. it’s just disappointing that the one thing that would’ve added so much benefit to my therapy sessions wasn’t bought when i was there.
but the good news for me is that my tongue has fattened out and it actually can move a bit to the right, the first time that has happened since i was misdiagnosed in tokyo, japan in june 2003!!! that was 4 years ago and from the stem cells and therapy i’m doing on my own, my tongue now is looking more normal and actually moving to the right!! YEA!!!

Old brains, new ideas

Category: History of neuroscienceNeuroscience

Posted on: July 16, 2007 9:22 PM, by Mo

The French anatomist, anthropologist, and surgeon Pierre Paul Broca (1824-1880, left) is best remembered for his descriptions of two patients who had lost the ability to speak after sustaining damage to the left frontal lobe of the brain. Broca's observations of these patients, and the conclusions he reached after his post-mortem examinations, would lead to major advances in the understanding of the brain, and laid the foundations for modern neuropsychology.

In 1859, Broca founded the Societe d'Anthropologie de Paris. Two years later, several heated debates had arisen there: one was about the relationship between brain size, race and intelligence, and the other about the localization of cerebral function. In the latter, one of the main proponents of the localization theory was Franz Joseph Gall (1758-1828), the founder of phrenology. Gall and others believed that the faculty of articulate speech resided in the anterior lobes of the brain, but most members of the scientific community were cautious; some argued that Phineas Gage provided strong evidence against the theory that speech was localized to the anterior lobes. Gage, a railroad worker, had suffered severe frontal lobe damage in 1848 when a tamping iron was propelled through his skull, but had retained his ability to speak after the injury.

Sunday, July 15, 2007

Radiology Picture

This 59 year-old female patient presented with acute right hemiplegia, aphasia and confusion. She had a known cerebral melanoma metastasis in the left frontal lobe. This axial T2-weighted MR (click image for arrows) shows a large haematoma with a fluid-fluid level (green arrows). There is a smaller low signal area anteriorly (red arrows) which corresponded to the known metastasis. This smaller area enhanced after gadolinium, as did the overlying dura.

Melanoma metastases may be hyperintense on T1W images and demonstrate signal loss on T2 or T2* sequences. This is due to the presence of both melanin and blood products. Melanoma metastases are 5 times more likely to show signal loss on T2* images than lung metastases, and 4.5 times more likely to be T1 hyperintense. T1 hyperintensity correlates with melanin content better than does T2* signal loss. T2* imaging (or susceptibility-weighted imaging) may be useful in screening for melanoma metastases as lesions are more conspicuous.

Reference: Gaviani P, et al. Improved Detection of Metastatic Melanoma by T2*-Weighted Imaging. American Journal of Neuroradiology 27:605-608, March 2006

Credit: Dr Laughlin Dawes

Aphasia Progress in the last quarter of a century

Argye E. Hillis, MD

From the Departments of Neurology and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, and Department of Cognitive Science, Johns Hopkins University, Baltimore, MD.

Address correspondence and reprint requests to Dr. Argye E. Hillis, Department of Neurology, Phipps 126, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287

In the last 25 years, characterization of aphasia has shifted from descriptions of the language tasks that are impaired by brain damage to identification of the disrupted cognitive processes underlying language. At the same time advances in technology, including functional imaging, electrophysiologic studies, perfusion imaging, diffusion tensor imaging, and transcranial magnetic stimulation, have led to new insights regarding the relationships between language and the brain. These insights, together with computational models of language processes, converge on the view that a given language task relies on a complex set of cognitive processes and representations carried out by an intricate network of neural regions working together. Recovery from aphasia depends on restoration of tissue function or reorganization of the cognitive/neural network underlying language, which can be facilitated by a number of diverse interventions. The original research by the author reported in this article was supported by NIH R01 DC05375.

Aphasia group a finalist in fund competition

Good Things Happening


At age 52, Johan de Roos was a picture of health last year: no high blood pressure, no signs of heart disease and a comfortable cholesterol level.

Then came a stroke and what followed was a diagnosis of aphasia, a disease neither he nor his wife, Susan, knew much about.

Aphasia, they learned, is caused by a stroke or traumatic brain injury. It damages the ability to speak and understand others, and causes difficulty with reading, writing and numbers.

The Evendale couple started an Aphasia Support Center project that has been selected as one of three from Cincinnati to make the top 50 list of the American Express Members Project, putting it in line for several million dollars.

Other local projects in the top 50 list: 50,000 Families up From Poverty and Children's Safe Drinking Water.

Susan de Roos said for years people with aphasia were given little hope for improvement beyond the first three months.

"Now we know that with continued therapy, improvement is possible," said Susan de Roos, a retired manager at General Electric, Evendale.

She said the Aphasia Support Center would provide group therapy, group activities, computer aided therapy, caregiver support and community outreach.

The 50,000 Families up From Poverty group aims to provide water to communities in India, Africa and other impoverished areas worldwide by drilling tube wells wherever needed.

The Children's Safe Drinking Water project aims to address this issue through an innovative and low-cost technology that effectively purifies and cleans water while removing bacteria, viruses and parasites.

American Express sponsors the program. Card members and the Members Project Advisory panel selected the final 50 projects from 7,000 ideas submitted.

Ideas included community-based projects throughout the United States and international aid projects in Africa and Asia.

In the next phase, cardholders will register and vote for a favorite project.

"We are encouraging all card members to make their voices heard by voting for the idea they want American Express to make a reality," said Jud Linville, president and chief executive officer of U.S. Consumer Business at American Express. "The power is in their hands."

To vote, log on to Card members can register to vote through Aug. 5.


Two local couples have joined 12 other couples, individuals and organizations in the United Way of Greater Cincinnati's Million Dollar Roundtable.

They are Stanley M. Chesley and his wife, Susan J. Dlott; and Jack Gluckman and his wife, Victoria Buyniski Gluckman.

Chesley, an attorney, is president of Waite, Schneider, Bayless and Chesley. His wife, Susan, is a U.S. District Court judge for the Southern District of Ohio.

Jack Gluckman is professor of otolaryngology, head and neck surgery, at the University of Cincinnati.

Victoria Gluckman is founder and CEO of United Medical Resources Inc.


FORMER Prime Minister Tony Blair has no doubt left a lasting legacy during a decade in the hot seat.

Mr Blair has made tough decisions during his three terms in office and chaired challenging Cabinet meetings.

His work included the controversial decision to go to war in Iraq, constitutional reforms for Scotland and Wales, and a raft of domestic policies.

Now a Furness charity worker has had a glimpse of what it’s like being in Mr Blair’s shoes.

Retired Ulverston shopkeeper Christine Adams felt like she was PM for a day when she sat in the hot seat occupied by Mr Blair.

Mrs Adams, from Birkett Drive, also got the chance to meet Cherie Blair, wife of the Prime Minister, two weeks before her husband handed over the reins of power to Gordon Brown.

The 67-year-old grandmother is a member of a local branch of Speakability, a self help charity group which covers South Lakes, and is based in Kendal.

Speakability is involved with helping the quarter of a million people in the UK who suffer from “aphasia”, a condition which affects victims of strokes, head injuries or other neurological conditions.

And Mrs Adams was one of two members of the group lucky enough to go No 10 and raise the profile of Speakability with Cherie Blair.

Mrs Adams said: “Although we meet in Kendal we have members from all over the South Lakes. In fact our chairman, Fred Hammond, lives in Flass Lane, Barrow, and I live on Birkett Drive, in Ulverston.

“It was my speech therapist who put me in touch with them, when I had a brain aneurism and it was such a help to me I have stayed with them.

“Speakability relies on donations and we had collections in Booths’ supermarket in Windermere and Morrisons’ store in Kendal where we raised over a thousand pounds.

“Janet Rockliffe, the branch secretary, and I were lucky enough to be chosen to visit No 10 Downing Street. Names were drawn out of a hat and 45 people, including myself, were chosen.

“We were first taken through the main gate, where we had to go through security and were allowed to take photographs outside No 10. We went in three at a time to meet Cherie Blair and Lady Wilson, Harold Wilson’s widow, Mary. Cherie spoke to each of us and she was very nice. She was especially interested in Speakability as Tony’s father has aphasia and Tony is a vice-president of the charity. Cherie then came in and addressed everyone.

“We were able to look around the rooms, the dining room and the Cabinet Office where I sat in Tony Blair’s chair, and for a couple of minutes thought I was the Prime Minister!”

* Cherie Blair is featured on The Real Cherie Blair, on BBC One at 9pm tonight.
FORMER Prime Minister Tony Blair has no doubt left a lasting legacy during a decade in the hot seat.

Mr Blair has made tough decisions during his three terms in office and chaired challenging Cabinet meetings.

His work included the controversial decision to go to war in Iraq, constitutional reforms for Scotland and Wales, and a raft of domestic policies.

Now a Furness charity worker has had a glimpse of what it’s like being in Mr Blair’s shoes.

Retired Ulverston shopkeeper Christine Adams felt like she was PM for a day when she sat in the hot seat occupied by Mr Blair.

Mrs Adams, from Birkett Drive, also got the chance to meet Cherie Blair, wife of the Prime Minister, two weeks before her husband handed over the reins of power to Gordon Brown.

The 67-year-old grandmother is a member of a local branch of Speakability, a self help charity group which covers South Lakes, and is based in Kendal.

Speakability is involved with helping the quarter of a million people in the UK who suffer from “aphasia”, a condition which affects victims of strokes, head injuries or other neurological conditions.

And Mrs Adams was one of two members of the group lucky enough to go No 10 and raise the profile of Speakability with Cherie Blair.

Mrs Adams said: “Although we meet in Kendal we have members from all over the South Lakes. In fact our chairman, Fred Hammond, lives in Flass Lane, Barrow, and I live on Birkett Drive, in Ulverston.

“It was my speech therapist who put me in touch with them, when I had a brain aneurism and it was such a help to me I have stayed with them.

“Speakability relies on donations and we had collections in Booths’ supermarket in Windermere and Morrisons’ store in Kendal where we raised over a thousand pounds.

“Janet Rockliffe, the branch secretary, and I were lucky enough to be chosen to visit No 10 Downing Street. Names were drawn out of a hat and 45 people, including myself, were chosen.

“We were first taken through the main gate, where we had to go through security and were allowed to take photographs outside No 10. We went in three at a time to meet Cherie Blair and Lady Wilson, Harold Wilson’s widow, Mary. Cherie spoke to each of us and she was very nice. She was especially interested in Speakability as Tony’s father has aphasia and Tony is a vice-president of the charity. Cherie then came in and addressed everyone.

“We were able to look around the rooms, the dining room and the Cabinet Office where I sat in Tony Blair’s chair, and for a couple of minutes thought I was the Prime Minister!”

* Cherie Blair is featured on The Real Cherie Blair, on BBC One at 9pm tonight.

Sunday, July 1, 2007

Aphasia Sufferer's Book Club

The website of the National Aphasia Association defines the condition as: "Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to injury to the brain-most commonly from a stroke, particularly in older individuals.But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections." Victims of the disorder often lose their ability to enjoy various forms of reading that they may have once enjoyed. Book clubs for victims of the disease have been formed in several areas throughout the country.

One such book club has been founded at the Gesinger South Rehabilitation Center in Central Pennsylvania. Several types of the disorder exists and not everyone who gains the condition through a stroke will have difficulty reading.

According to Robin Petrus, the facilitator of the book club, the person with the condition retains the same personality, but difficulties expressing themselves result in ostracism. A patient suffering from the condition may hear a word and know what the word means but will not be able to make the same conclusion if it appears on the printed page.

The goal of the program is to restore the ability of the participants to read and understand a complete sentences and then to string them together into complete stroy. Petrus conceived the idea after hearing of a similar program that obtained good results in California. "I've had several patients who really enjoyed reading before their stroke and missed it a loft. So I felt it would be a good oppopurtunity for people with similar interestest to come together. The purpose of the group," Petrus stated, "Is to help people who have enjoyed reading before having aphasia to enjoy a good book again. It's therapeutic by nature."

Participants in the program not only receive a prepare guide to help them study the material and if the book on tape to help them along. According to Barbara Pizzoli, a resident of Atlas, the book club produced immediate results for her. Another participant had her ability to read and enjoy suspenseful mysteries restored. Debra Horn found it difficult to pay attention to what she read after suffering from a stroke in 1998.

In addition to restoring the ability to read and enjoy books, the program also brings together people who suffer from a similar condition. For many of them, who have difficulty getting around, it is one of the few opportunities they get to meet and interact with other people. Petrus said, "That's the key. I want this book club to help people do something they always enjoyed doing. We don't emphasize the disability. We emphasize their ability."