Sunday, May 6, 2012

I passed!

I can't sleep, and it might help me sleep if I write a little post.  But I can't sleep for a positive reason.  I passed the HI Bar Exam!  The Board of Bar Examiners kindly tempered my notice of passing the exam by reminding me that I can't be an attorney yet because my character and fitness evaluation is not yet complete and that I still have to take the MPRE (ethics exam) within a year.  BUT I PASSED!

The funny thing to me about my excitement to this news is that I while I take credit for the effort I put into studying for the exam, I really think this was an act of God - a miracle!  I find it amusing that none of the other huge milestones after my stroke have gotten me quite this worked up:  me  surviving my stroke; my being as healthy and strong as I am now; my ability to forge on with my life independently; etc.  But to me passing this exam ... totally divine intervention! 

I guess I say this because, while I studied hard and felt like I would have passed if everything went well, everything did not go well.  The first day was the state specific day and that day actually did go well.   I slept well the night before,  the questions and subject areas that appeared were manageable and while i suffered a swollen thumb from writing too much that day.  I felt like I performed passably.  BUT for day 2, the MBE (a 200Q multiple choice exam: 100Q in the am and 100Q in the pm).  Things didn't go qute so smoothly.  I didn't sleep a wink the night before; I literally lay awake all night, and I still don't know why.  I was scared that my lack of sleep would affect my performance, especially after my stroke when my brain is running on less than 100% capacity due to the damage.  But I had to take the test.  So I tried my best,  but the morning session was awful.  I left 10 questions unanswered! In a test where you aren't penalized for wrong answers, one of the first test taking pearls of wisdom given to you is, "don't leave any questions unanswered".  So naturally, when the proctor called time and I had 10 questions unanswered I was devastated.  During the lunch break, I had my mom pick me up so I could at least lie in silence at home for 20-30 mins like I used to do to recover from fatigue.   The afternoon session was much better.  I actually answered every question.  But overall I thought the MBE was extremely difficult and I was very discouraged after the exam.  the 10 unanswered questions lingered on my mind.  I thought for sure that I wouldn't be able to overcome the deficits to obtain a passing score.   I had only been getting about 50-60% correct on the practice tests (when I answered all the questions! so I was freaked out)

Of course, I got over this and kept telling myself that it was possible that I did extremely well on the ones that I answered and that my performance on the first day would compensate for whatever miserable score I got on the second day since the two day's scores are averaged for the final result.  But I was still scared.  I prayed to God that I had passed.  I really didn't want to have to take the exam again, and the more I thought about my future career plans, I realized that I may want to practice law for a few more years.

I came home tonight from a night hike up Olomana to checkout the"supermoon" and I'm exhausted and sore.  I was already quite pleased with myself for taking on the challenge, of course with the help of friends who made sure I was safe, the hike was not easy and involved scaling some steep faces with the help of rope and navigating narrow ridges.  After I showered, I noticed a manila envelope on the kitchen table from the HI Board of Bar Examiners.  I was so nervous, and curious.  I said a final silent prayer and opened the envelope.  And to my surprise, I passed!  Tonight's unexpected news about my Bar Exam results in conjunction with the rush from hiking has really gotten my adrenaline pumping or something making it impossible to sleep.  But hopefully writing this out has helped my mind scale down the excited thoughts about  the bar exam a bit so I can sleep

I really feel like this is a miracle! There were so many things that had gone wrong during my exam that suggested a possible failure. The Bar Exam like most standardized exams is NOT about intelligence.  A lot has to do with how well you can perform under test conditions.  As a stroke survivor, I was nervous, not about my ability to learn the information, but about my ability to perform under the time constraints and stress.  And when I actually buckled under the pressure while taking the test, I felt like I had failed.  But wow, God worked a miracle for me!

But really, it's funny to me that of all the things to get excited about since my stroke, passing this bar exam is really a highlight!

Saturday, March 31, 2012

Always try to use both hands

The other day I was chided by my therapist for only using my right hand.  I was trying to roll up my capri pants which is a task that I would probably use two hands to do if both were functioning well.  However, after my stroke, many two handed activities have become right hand only activities because trying to incorporate both hand makes the task more time consuming and cumbersome.  The pant rolling is a perfect example.  It's a task that is very doable with one hand, it would probably be better with two able hands, but one hand will suffice in a pinch. There are actually a lot of things that I should use both hands for but have not been very good at remembering to do.  One is typing, I can type with only my right hand on the keyboard and allow my left hand to just sit in my lap, but I know the better way is to put both hands on the desk and use the left to press the Shift key at least.  Incorporating my left, is supposed to aid recovery, even if it seems like the left is doing nothing. 

It reminds me of the OT Breakfast Group I would try to attend when I was inpatient.  I found it annoying that the therapists kept putting my hand on my breakfast tray, even if it meant that it was in the way because they wanted to encourage me to keep my left side "engaged" even if it was just to sit on the tray, so I wouldn't forget about it.  So we'd haul the darn thing up onto my unsteady food tray and  try to get me to use it in my eating (which generally meant it sat on my tray like a dinner roll).  Between trying to watch my left hand and watching out for dribbles out the left side of my mouth (due to my facial weakness & numbness), breakfast was a busy event.  But at least I was eating with my dominant hand, so I was probably the neatest eater in the group.

I understood the premise, but I hate inefficiency, and it felt like my limp hand was just getting in the way of eating.  So now that no one is observing me,  I often don't think to use both hands if both will be less efficient, or if the left really wouldn't help much.  But now that my therapist pointed it out, I'm trying to be more conscious of including the left, even if it does very little. 

For example, I've  been trying to use both hands together to shampoo my hair the way "normal" people do it.  I have to admit that I've been guilty of letting my left arm lie at my side as I only used my right hand used to shampoo my whole head, but I'm trying to change that now, even though the left hand scrubs my head very ineffectively.  I just reach over a few times with the right to get the left side of my head - but I try to keep both elbows up now! Another one I'm trying is to keep my left hand at the keyboard, although I'm much faster if I use my right only.  Another drawback to keeping my left hand at the keyboard  is that the effort is exhausting for my left shoulder! That's something I didn't expect! But I'm going to keep trying, wish me luck! 
 

Sunday, March 25, 2012

Two Year Anniversary

It's been two years now.  Time flies and a lot has happened.  Next year I think I'll have a party.  This one kinda snuck up on me, I didn't get to plan anything.

Instead, I helped wash cars at my church car wash to raise money to assist with the financial challenge of adopting a child on behalf of a church member.  Used a lot of my right arm, but got some good left wrist work because I was wringing out drying cloths.  Then when I got home and tried to do some laundry, the washing machine overflowed and made a mess, so I was sopping up water and wringing out more rags to clean up that mess, both of my hands are pretty unhappy right now.

I just read my entry from my one year anniversary.

It's interesting that 2 years is not that emotional for me.   I think one year was hard because I was dealing with the belief that after year one, the door to recovery closes so there was a bit of frustration that I had not progressed as far as hoped and some self hate for not making bigger progress. And let's not forget all the other crazy emotions I was dealing with at the time.

Going forward, I know that I will just continue to have small improvements; I will probably not see the kind of dramatic changes that I saw in the first few months after my stroke. The first time that I extended a finger was amazing, the hand that had been non responsive (except for the elusive claims that I could extend my fingers while sleeping) finally followed a command, it seemed like a miracle.  I don't recall if my fingers were fisted or just limp and kinda closed, I think they were probably limp and kinda closed but pretty motionless. 

It happened just before I was discharged and it was an emotional moment.  After that first finger, I got two, then I was practicing picking up plastic cones and water bottles in the next couple of weeks!  within a month I was working on picking things up using a two or three finger pinch.  Discovering movement again is a pretty amazing journey, and I wish I could see the rapid improvements again.  But these days, it's really slow.  These are a few of the things I've noticed in the past year. 

-Middle finger extension, but it's not consistent, and feels almost impossible when my fingers are flat;

-I can pick up a large marble with my ring finger and thumb. 

-I'm doing push ups on my knees, but I think I could do that last year too, but a week ago I challenged myself to do the push up while stabilizing myself on a bosu ball.  pretty tough, but mostly because the pressure to my hands is painful,  the large muscle groups don't seem to be too challenged.

-I can open my entire hand pretty decently to wave hi (it looks a bit awkward) but it's not that bad.  I'll keep practicing that one.

Next year I hope to be able to say more things.  I'd love to be able to point my index finger; make finger guns (for double guns!) extend my fingers while the fingers all touch, so I can ask people to put something in my hand without worrying about it falling through my fingers that are all spread apart.

These sound so simple and maybe I'm thinking too small, but these are pretty complicated hand movements if you think about all the different ways the muscles in your hand have to move simultaneously.  So I think it's a good pace to start and anything additional will be bonus!
Maybe I'll be typing with two hands! :)

 

Wednesday, March 7, 2012

Street Cred

 The other day, my friend told me that, a colleague who had seen a recent CT scan of my brain had commented that my level of functioning is pretty amazing considering how much of my brain was injured as a result of my stroke.  I took great pride in this statement. (I don't know what that says about me) But one of my struggles is trying to accept the fact that yes, I went through a pretty traumatic event, and I HAVE come a long way! It's hard for me to acknowledge that in light of my remarkable recovery.   So to hear that a third party objectively made the observation made me appreciate that maybe I should give myself some credit.

I don't know why it should matter, but when people meet me and interact with me, they often assume I had a minor brain injury, and I get a bit indignant.  I realize it's contradictory because I actively try to downplay my injury, yet when someone accepts my representation, I'm indignant. Perhaps I'm seeking the acknowledgement that I can't give myself from others.  Hence, this observation from the third party doctor made me feel like I had some "street cred" with respect to my brain injury.   

My neurologist in NY had told me that I had a sizeable injury and had recovered very well, but for some reason, although I believed him, it didn't effect me in the same way as this other doctor's comment.  Part of the problem is that I really can't imagine how big a brain is and when I see my CT images with a lot of black space, I don't know what I'm looking at, it just looks like a cool abstract art video installment with green, red, blue, black color splotches weaving in and out. 

In the first few months of my recovery,  I tried to quantify the degree of damage my stroke had caused, but lost interest when I realized that the damage is irrelevant because what is important is what I'm doing now to get better.  Plus, my friends mocked me for trying to relate the size of my injury to my fist, i think the jokes came from the belief I thought that my brain was that big as well as the gesture I would make (a menacing fist) to ask about my injury.  :)

I'm not going to use this observation to get complacent about my recovery, I still expect myself to get much better than where I'm at now.  But I think the observation is testament to the magic of neuroplasticity, while I don't understand it completely, I agree that the brain is constantly generating new connections based on our experiences, in the case of brain injury, the brain tries to establish new connections to take over the functions that the injured brain cannot do anymore.  It's pretty amazing, I guess I had a lot of unused brain that stepped up to the plate when the other part of my brain died.  We all have a lot of unused brain tho, imagine if we could access all of it?  I'm suddenly thinking about that movie with Bradley Cooper where he takes those pills that make you really really aware (Limitless) interesting movie and Bradley Cooper is so cute!

As an end note, I just want to comment that brain injury is very unique to each person, and regardless of how large or small the actual injury is, the effects can be great depending on where the injury is located and the degree of damage that was inflicted.  i don't think I'll ever fully understand why some people can have a stroke with no visible deficits, some people can recover fully in a matter of years, and others seem to plateau for a long time.  So please don't compare (tho it's understandably hard not to) and let's try to see the experience of others as instructive and inspirational.    

Saturday, February 4, 2012

This is me, typing with my right hand as fast as possible with no edits... i'm just trying to keep up with the words that are coming into my brain, in as real time as possible.   I'm typing my response to flashcards I made for bar review purposes:
---

Presis commander is cheof and he can semd troops anywhere for any reason
But congress mainyains the power to declare war and rsise, support and maintain trop
Hirarcht f laws
Comnsttution
Treateties and statrtutes
Executve agreements
State law
Regulating speech in venue
Public – sidewalks and parkd must be content neutral subject matter and viewpoint and tpm restricyionms may be puy on for an importsand purpose
Designated pub forum ids a normally non poubkic forum but one ghat govt oopens uo to speech, same standat as public
---
I'm clearly going over constitutional law right? My handwriting is pretty messy, but I'm glad that I'm not typing my bar exam!  without auto correct functionality (which I had to fight from using once I pasted the above into this window), it would probably take twice as long for me to edit my essays.  
still on the fence about pursuing the one handed touch typing thing, i think the woman who created the training book can do about 60-70 wpm at her fastest.  i used to probably do about double that with my two hands and be pretty accurate, my current state is pretty annoying.  I decided not to stress myself out with learning it cuz i figured i could get fast with my own one handed style, but it's kinda frustrating to look at my hand while typing and still make so many typos.  I guess the other reason I didn't want to learn it was her book preface said that one should learn the touch type only if you were certain not to regain use of the other hand. And I still want to believe.   

Thursday, January 19, 2012

Right Brain v. Left Brain

I'm currently studying for the Bar Exam (why am I posting? because I felt like it), and I noticed an interesting potentially fatigue related phenomenon - tho I'm denial that I have any fatigue symptoms remaining, this is something my brother actually pointed out to me and I wanted to bring it up.  I've noticed that I can sit down and study for four hours straight no problem, but when I'm in a meeting, or an interview or some sort of socially engaging work type thing, and even some purely social things, I notice that I start to feel quite fatigued after a few hours, granted this might be nothing out of the ordinary since I think many people would be exhausted after a three hour interview or a really intense two hour business development meeting, but the other day, I noticed the fatigue kicking in after a two hour social lunch where I was mostly just listening. What I call "fatigue" at this point is totally bearable, I notice it and I might get a bit irritable, but I can bear it and plow through.


My brother suggested that maybe since my brain injury is located in my right brain and since the right brain is said to control emotions, feelings creativity, etc, that maybe I'm getting more tired in the social settings because my brain has to work  harder at being engaged than it used to when there was no injury to my right brain.  I dunno, I guess it's a good thing for all the logical stuff that is said to be housed in the left brain, but I don't know how much I really believe that stuff.  Any thoughts?

Though in the beginning, fatigue hit me regardless of whether I was doing something solitary or social.  I remember I spent an afternoon sorting through my medical bills sometime in May/June of 2010 (2-3 months post stroke) and I was out of commission for the night.  I remember barely being able to eat my dinner from being so exhausted.  But on another occassion probably in July, I read through a guidebook, planning out a vacation for most of the afternoon, I think I spent  was atleast 3-4 hours pouring through the book and taking notes and I remember thinking that it was cool that I didn't feel fatigued. 

I guess I'm also lucky that I always felt like I was more left-brain oriented than right-brain, so my stroke didn't affect my usual way of thinking all that much, just made it even harder for me to fully access my emotional right-brain?

Tuesday, November 8, 2011

Learned disuse

I'm guilty of this phenomenon, and I get criticism about it, I need to learn how to accept the criticism as constructive and not get so defensive.

Learned disuse, from what I understand, is when a person doesn't use a part of the body that is affected/injured and compensates for those movements by finding other ways to do things.  Specific to me, I don't use my left (weak) hand as much as I used to because now I find it cumbersome, slow and generally difficult to move. For example, when I want to open a ketchup packet or a candy bar, I will utilize my teeth in performing the function because I can't get a good grip on the darn thing with my left hand.  So as a result, when I eat a snickers, my left arm lies limp at my side while my right hand and teeth try to take the wrapper off.  To my credit, I will try to open it with both hands at first, but if it feels impossible, i will resort to my adaptation. 

This type of behavior is mere survival to me, but in the eyes of doctors and therapists, I'm doing myself a huge disservice because I'm encouraging my brain to learn how to live without full use of both hands. As a result my brain is not building the neded neural pathways to rehab my left hand.  The fewer signals i send to my brain to use my left hand the more and more my brain forgets about my left hand and how to move it! The muscles in my left arm and hand will atrophy which will make it even harder for movement to return. 

I know I need to use my left hand more, and I think I make an effort to.  I open doors with my left hand, turn on lights with my left hand, and press buttons with my left hand if time permits.  But I don't do the reccommended 5 hours a day of sitting at home with a sock on my right hand to constrain it to force myself to use my left.

I know it would be good therapy, but I'm a right hand dominant person, so having my dominant hand in a sock, and relying solely on my non dominant hand which is even weaker due to the stroke makes me uncomfortable because I feel like I will basically be rendered a person without any hands,  I recognize that such people exist and those courageous people have found ways to adapt, but I don't know if I'm strong enough.

I don't know what stands in the way.  I think that it's the risk and reward, if I was told that if put myself through this therapy for 5 hours a day for 6 weeks and at the end of that 6 weeks I was guaranteed a perfectly functioning left hand, I may be able to stomach the challenge.  But since there is no such measure of reward it makes it difficult for me to give up my present freedom. I guess it's economics?