We’ve had a pretty good day here in Mercy CR inpatient therapy. To be honest, Mackenzie has been asleep for about the last hour because they have worn both of us out.

Her day started with occupational therapy and doing the things we all take for granted like brushing your teeth and eating breakfast. All of that went exceptionally well. Next up was speech therapy and that went well, but clearly it’s the biggest obstacle that she still has to overcome. It’s clear that she understands what she hears and even what she reads, but she has trouble verbally communicating some things back to us. We’re finding that she can write and draw even better than she can speak at this point.

The clinical terms for her condition are aphasia, which she has a little of, but it’s more likely that most of her condition is aproxia. She knows what she wants to say, but sometimes what comes out of her mouth isn’t the same thing. Essentially the muscles in her mouth and her speech-making don’t coordinate with her thoughts, so she says things differently than what she’s thinking at times.

The speech therapist asked us to continue working with her and giving her exercises with lots of repetition and sometimes giving multiple choices in writing if she can’t get the words out.

One interesting example today was her pointing to her nose and telling us that it was irritated, and that she had been given something to help with that but she couldn’t tell us what that was. She also said it was not Christa, her regular doctor, who treated her for that, but was someone named Erica. I looked up her doctors office information and found there is a practitioner named Erica there so I started to write to the clinic and ask what she might be using for the irritation in her nose. Before I got a response from the clinic I asked her to draw a picture of what she was trying to name, and she drew a picture of an elongated jar with a blue lid. She said the container was kind of white and yellow, and Morgan realized she was describing a jar of Vaseline. As soon as I said that name she said YES and we got her some petroleum jelly to help moisturize her nose. It is very, very dry in here so that was helpful.

Next up was another hour of occupational therapy and she did very well with that too. In this session she practiced holding objects with her eyes closed and feeling them to describe what they were. She got most of them right with both hands and passed with flying colors. Then the therapist brought in some squishy toys to work on strengthening her right hand, but he was very impressed that she was drawing very detailed sketches even before he returned with some additional items. He also cut one of the squishy sponge-like objects up into numerous small cubes and asked her to stack them as high as she could. They were not cut very well and are oddly shaped but she tried her best to stack them up and actually did very very well. I promised that if she got all 12 stacked I would take her picture but before she could do that the physical therapist finally arrived. To be honest I’m not sure anyone could stack those things and keep them from falling over but she will keep trying.

Her final therapy today was a visit from the physical therapist, and that also went very, very well. The clinic here had been demanding that she always use a walker and always call for a nurse before getting up. She did not always do that and when she was given a walker, she would usually pick it up and carry it so the therapist had her working out and walking around the ward with a belt on to assist, but she never needed it. So the therapist pulled the walker and said she would not need that any longer, but they still want her to have a grab belt in case she loses her balance, which hasn’t been an issue thus far.

The usual length of stay here is between 7 to 10 days, but the PT advised that the decision to move to outpatient care would fall to her and the occupational therapist, not the speech therapist. She suggested that after tomorrow morning they might cancel physical therapy and allocate those hours to speech and occupational therapy. She also predicted that we might move to outpatient care sooner than that 7 to 10 day average. I’ve made calls to the therapy providers in Grinnell as well as to her family doctor for a referral there.

She’s getting lots of rest just now and I think maybe I need to do the same. I hope to write more and share more progress tomorrow. Take care.

– Mark M