Wednesday, August 20, 2008

Friends 2

It is good to see my friends again. They cheer me up, they bring flowers and chocolate, they offer me help of any kind: bringing food, doing chores even coming to clean the house… So nice of them to do that. But I have something else in mind for them to help with: my Speech.
With great deliberation I write down a schedule, later I will ask my mom to connect each one of my friends on the schedule and confirm. They are: Naciye, Zeyno, Nicole, Hilda and Zeynep. Nicole and Zeyno are working from home and they have flexible hours, Naciye and Hilda are full time moms like me, and Zeynep is a student.

We will give the schedule a try next week. They don’t know what they will help with, I don’t know either, but we will see…

Monday, August 18, 2008


In June of this year, I contacted my first speech therapist Sandy and requested an interview. Sandy, who is quite a character, had read my blog. She corrected my last entry. She said that it wasn’t until the 20’th day or so that she would give me a list of full words. Instead, the first weeks went by, by trying to produce some sounds, I had luck with.
She said that her strategy as a speech therapist was: she would take a sound, any sound I could utter, then do variations on it, see whether I could pronounce them. Depending on which ones I could pronounce, she would add them to my vocabulary or to my working list.
Let’s take the sound “P”. It is somewhat easy to say because you can watch how the therapist’s lips are closing, you can feel that there is no vibration of the throat. The “P” sound is produced by bringing the lips together followed by an explosion of air, blowing the lips apart.
Seeing I could utter “P”, she would work on variations that would be familiar to me. Like: “Pooh” (as in Winnie the Pooh), like “Pee”, or “Pa” (as in Papa) etc.
In other words, she said, she would build on success and go from there!
In her presence, I was always on my toes. In an encouraging sort of way.
During that one hour of speech therapy, I spend so much energy, I cannot believe. I sweat profusely, my toes are clenched, my knees are locked. By the end of the hour, I’m so tired, I’m ready to sleep in the car.
By the end of the week my friends pay me a visit. Here, I have to open a bracket and tell you about my friends a bit.
I have moved to Metro Washington DC area in 2003, right before my son was born, two months before. My son was born in May. With that birth I developed post partum depression. I had no history of depression before, I am quite a “no worries” person, quite determined in my attitude…
But moving to a foreign city, leaving all my support system behind was, I guess, the last straw on the proverbial camel’s back. It did me in. I spent an entire year crying, torn between the feeling of guilt –for I couldn’t show any affection for my son – and my own survival instinct… Then we moved to a Condominium complex and so I met Ursula. Ursula was a German lady with two very cute children, one my son’s age. Through Ursula I met a wonderful friends: International Women’s Group (IWG). A group located in Bethesda MD, about 100 – 150 woman of all nationalities. All new to DC area, all in the same boat of raising their young children and needing friends. So we all leaned on each other for support, for laughter… Slowly with the help of medication, lots of sleep and a better social environment my depression cleared. I started to think about volunteering within the group because I wanted to give back to this community who had helped me in my darkest days. So in 2004/2006 season I volunteered for the Presidency of the group and I made even more friends this way. Within those two years, I also befriended wonderful Turkish women through IWG, we became each other’s family in the absence of our own families.
It was in the middle of all this when my stroke happened. Everyone in my friend’s group was shocked. Utterly shocked. Stroke is something for elderly people, we all thought, not for somebody in their 30’s, raising young children… Suddenly the reality of vulnerability set in.
It is a tradition in our group, when a friend needs help, we all line up to help her any which way we can. In my case, my friends didn’t fully know how to help. My mother had come from Turkey to help with my son and the house, my husband was a physician at NIH. What kind of help could be needed?
They started with the most logical thing: Informing themselves. They invited a neurologist to talk to them about aphasia, to understand what it is about.
It is quite common that after a brain injury or a stroke one has paralysis. In that horrible case, there is something visible. People can understand the case of a limb not working. But in the case of loss of a hard to explain brain function, people classify that as a mental health problem and put you the same category as “all those crazy people”. It is a kneejerk reaction of facing the unknown. For almost anybody losing mental functions is unthinkable. We understand we get the flu, chickenpox, lower back pain even cancer… But losing our mind? That is a no no, as we imagine ourselves bravely facing all atrocities, enduring pain and thus modeling courage for our children… Having a part of our brain not functioning has no role in this scenario. Although, of course brain is an organ just like any other, it has a remarkable capacity for healing, but nevertheless it is an organ, it can malfunction.
So, after my friends informed themselves about what to expect, they came to visit.

Tuesday, August 12, 2008

My other therapist

My other therapist:

Sometime towards the end of the second week I ask Mehmet to get an appointment from my psychiatrist Wendy Hookman. I want to consult with her about my medications, now that I take many of them, I want to ask whether there are any drug interactions I should worry about, whether the current dosage is right.
Why do I see a psychiatrist? Because when I gave birth at the age of 36 I have developed post partum depression. I never thought that I would fall victim to mental illness; having lived a very stable, robust, straight forward life… But when I gave birth I fell into a deep deep hole. It started with 2 miscarriages followed by a high risk pregnancy. At the 7th month of my pregnancy we moved to Washington DC, a strange city, no friends, no family… I was diagnosed two weeks after giving birth. I didn’t want to take any medication because I was breast feeding until the baby was 6 months old. After that I couldn’t take it anymore and started medication. Thank goodness the first medicine worked and I started to recover after two months. Unfortunately after that incidence my brain wasn’t able to produce serotonin at the old levels again. To this day I take my medication religiously albeit at a much lower dose. It is much like with any other deficiency. For example, a significant number of women develop diabetes while pregnant, after birth usually this goes away, but for some, their pancreas seizes to produce sufficient insulin. Mine was like this, my brain seized to produce sufficient serotonin.
Now, we know that for some people SSRIs (depression drugs) may have a blood pressure raising effect. In my case this was the fact, of course we found this out after the fact.
Mehmet and I sit at the waiting room, well… waiting. He is going to do the talking for me this time. In any case I bring my magna doodle with me. Wendy finally invites us in, asking me how I am doing, I cannot answer of course. She laughingly asks me whether the “The cat got your tongue?” When she finds out what happened, she is utterly shocked.
She questions me and establishes that I am happy, that I should continue at the same level of drugs, that there are no adverse affects with the new drugs which include a blood pressure drug. Well, in fact, in many ways I feel better than I ever felt in the last 4 or 5 years. Why is that? I feel almost euphoric. She explains that when someone experiences a stroke, most of the time, this acts like a electrical shock to the brain, increasing the serotonin levels. But she says that the good feeling usually lasts for about six months or so, then it returns to normal, whatever they were before. I am so lucky to be given this opportunity by my injured brain, so that I can deal with its aftermath. I explain to her that when I compare the periods when I was experiencing depression v.s. now, now is much better, depression was much worse. What is the difference? Depression is a lonely experience, very lonely. Nobody understands the deep hole you are in, you feel there is no escape, things will only get worse. Whereas everybody around you thinks that only if you would get your act together! Slip out of it! But of course you cannot. Your brain cannot suddenly begin to produce serotonin any more than a diabetic person’s pancreas can begin to produce insulin.
Whereas with the stroke, it is obvious what happened to you, you are making progress, it can be only better from now on. It is a shared experience. People understand and help you.