Alice Needs Speech Therapy

It's a fine madness, all right!
It’s a fine madness, all right!

Alice needs help recovering her ability to speak, and earlier today I began blaming myself.

I thought, “With all the plaudits that relatives and well-meaning friends send my way, what good am I until Alice connects her brain energy to those vocal cords?  There has to be some measure of personal accountability here, and it’s time to look in the mirror for help.”

There’s credence for my self-criticism.  Before Alice was released from RIO, speech therapist Jennifer Bonas provided a rehabilitation notebook filled with exercises designed to link key words with their sounds.  “Try to fit in three 15-30 minute sessions of Speech Therapy work daily,” the manual advises.

Yet, I speculated, “How have I frittered away the time?”

Watching March Madness – the NCAA basketball tournament.  What’s worse, our DVR can record four channels at once, so I’ve been able to watch all games that are competitive.

Tomorrow, March 30, Alice and I are scheduled to meet with speech therapist Jordan Johnson at Kaiser Permanente’s Central Interstate Medical Office.  If we’re honest and heed Johnson’s instructions, we can turn this whole thing around.

But what sacrifices must be made?  Before you answer, here’s the kicker: Alice loves the tournament, too!

Inevitably, we’re stuck with an operative dilemma: How to avoid the empty wide-eyed stares associated with becoming basketball brain junkies.

Alice won’t let me take the blame alone for the slow pace of our speech recovery.  Like everything else in life, we’re in this together!

So the upshot of this whole exercise in beating oneself up has become: Do you know how frustrating it is when the one you love refuses to allow you to be a martyr?

The Best Birthday of All

lovenox needle-lr

The photo above is slightly out of focus, and that’s all right.  Because that’s the way I remember the syringe.

It begs a penultimate question:  What would you do for the one you love?

As a child, I abhorred needles.  Whenever I waited to receive a vaccination, I would cringe.  At our family dentist’s office, the moment the kindly, spectacled doctor reached for a hypodermic to numb part of my mouth with Novocain, I grasped the handles of the patient chair so tightly my knuckles turned white.  And that was minutes before the threatening needle was removed from a drawer and positioned near a tooth that ached.

Watching excess Novocain squirt from the tip of the needle caused my pulse to race.  I knew then I could never opine for a career in the medical profession.  How could interns sit in a surgical theater to watch a real-life operation without throwing up?  Good luck, Charlie.  See you in scrubs, Maryjane.

So after Alice was released from rehabilitation to come home with me, I never imagined what horrible task I would be expected to perform.  Give my wife twice-daily injections of enoxaparin, commonly known as Lovenox – in the stomach an inch from the navel, no less.

What torture, what anguish.  Could I walk through a pit of fire for my lady love?  Would I lay down my life for her?

The first injection was the worst.  “What if I hit a blood vessel?” I wondered.  Could the needle do physical harm or cause unbearable pain?  Nine hours after being released, now lying on our bed, she exposed her belly and looked down at me.

I removed a plastic cap unleashing the profane needle and stared at Alice’s abdomen where previous injections caused black-and-blue bruises.  Would I be responsible for more horrendous scarring from previous body blows?

I called to mind the 45-degree angle at which I was instructed to inflict unfathomable distress.  I flicked the top of the syringe with my forefinger to position the air bubble atop the fluid.  Finally, I stared at the area I was going to attack, moving the needle back and forth uncertainly.

I cursed my timidity.  “I can’t wait forever,” I admonished myself silently.

In one fell swoop, I pierced her skin and pushed the needle deep as Alice gasped, slowly pushing the lever until the 30 milligrams of enoxaparin was emptied.  Pressing hard against the top of the hypodermic device, I caused the needle to withdraw automatically into its plastic housing, bringing to an end our mutual ordeal.

For the moment, that was.  I repeated the dastardly deed five more times at 12-hour intervals.

On Monday, March 23, as I turned 72, I escorted Alice as instructed to Kaiser Permanente’s Westside Medical Center where a skilled technician drew a vial of blood.  If all went well, I was told, we might be granted a reprieve.

Alice showed him compassion and honesty.  She complimented the tech on how little pain his experienced hands caused.  And she spoke perfectly.

As the rest of the day unfolded, she and I waited for the results, jumping each time the phone rang.  Alice had prepared four birthday cards earlier, but neither of us was ready to open any of them on this day of traditional celebration.  We hoped for good news to free us from an ungodly routine, plus medically empower Alice to imbibe wine anew.

When we heard nothing by 5 pm, nervousness set in.  Alice prompted me to leap into action.

I tried every phone number that seemed plausible for an informed interpretation and set us free from our emotional pain and suffering.  Ahhhh, Alice was fine, I was the nervous Norris.  What a wuss I am!

Each query ran into a roadblock, though, and sure enough I began to consider the worst.  Hope for the best, but prepare for the worst is my motto.

Suddenly, the phone rang.  It was Kaiser Permanente’s anticoagulation nurse, April!

For what seemed like an eternity, April offered a litany of warnings and made us aware of potential threatening side effects from various medications that could require immediate transport to KP’s emergency room.  Then she broke the happy news.

No more injections were necessary!  And Alice could have a glass of wine, too!

Half an hour later, we feasted on a sumptuous dinner of pork chops, thick and juicy.  And Alice lovingly presented me with my birthday cards, each of them meaningful.

By 8 pm, we drove out to Tanasbourne’s Bugatti Restaurant, where Alice feasted on a slice of tiramisu and a glass of wine, and I exalted over the culinary-splendid spumoni.

Before we left, as we were the last patrons to leave (Bugatti’s closes at 9 pm on Mondays), we sang happy birthday to yours truly.  And we rejoiced over the best birthday present I ever was given: not having to give my partner any more injections.  Such relief was unimaginable.

What a night, and I rejoiced over the best birthday present I could ever have.

Thinking of Rio

Legacy Good Samaritan Medical Center houses RIO's good work on its sixth floor.  Since Portland is not blemished by an overabundance of skyscrapers, the sixth-floor skywalk offers a panoramic view.
Legacy Good Samaritan Medical Center houses RIO on its sixth floor. Portland is not blemished by an overabundance of skyscrapers, so the sixth-floor skywalk offers a panoramic view.

While Alice recuperated from her stroke at Legacy Rehabilitative Institute of Oregon (RIO), I observed a cooperative medical team in action.  I do not use the word “team” lightly, like many in the corporate world do.  I use “team” in the highest sense; they’re restoring lives.

Speech therapist Jennifer Solac was diligent in showing Alice how to relearn the skill of speaking.
Speech therapist Jennifer Bonas was diligent in showing Alice how to relearn the art of speech.

While staying with Alice at the highly regarded facility in central Portland, I observed a medical team put its collective conscience to work on stroke sufferers, and witnessed members of patients’ families glean unexpected insights.  Each member of RIO’s team works in tandem (kind of funny, since Alice and I live on “Tandem Way”), keeping each patient so busy that former dwellers there term the experience “boot camp.”

Food service specialist Leticia M's first language used to be Filipino.  Today, it's the speech of stroke patients.
Food service specialist Leticia M’s first language used to be Filipino. Today, it’s the speech of stroke patients.

I want this post to pay tribute to the women and men who look after patients there.  Alice and I spoke with one particular neuropsychologist, Dr. Diane Pierce, who found Alice’s decision to go public with her stroke laudable.  And she agreed heartily when the idea of writing about Alice’s new life was floated.

What do you think?  Should the subject of strokes become de-mystified?

Every writer needs a mission.  Making a difference has always tugged at my heart.

How could I refuse such a challenge?

A glorious meditation chapel is situated on the center's third floor.
A glorious meditation chapel is situated on the center’s third floor.

The Road to Recovery

Alice enjoyed her first cup of coffee at our breakfast table this morning.
Alice enjoyed her first cup of coffee at our breakfast table this morning.  And her hospital bracelet is gone!

There’s good news on the home front.

Alice was released from Legacy Rehabilitative Institute of Oregon (RIO) Friday noontime, March 20.  A team of 11 doctors, nurses and therapists met beforehand with Alice and me to give their candid assessment of aftereffects from the stroke suffered eight days earlier.  Then they gave the green light.

Except for a speech difficulty known as aphasia, Alice appears 90 percent recovered.  As I drove her home yesterday, her mood was giddy relief.  We were in such a hurry to depart her cellphone charger was left behind, but RIO’s eagle-eyed staff found the device and left it at a nursing station.  We picked it up earlier this afternoon.

On our first full day together again, Alice makes fun of her inability to string together a coherent sentence, laughing aloud whenever an unexpected word pops out from of her mouth.

As usual, I do her bidding (well, most of it), and she thanks everyone for the thoughtful comments left on this website.  If you haven’t seen the good wishes from friends and family, check them out on my previous post.  More comments keep coming in!

Alice is a wonder.  After her release yesterday, we stopped by KinderCare where she works to show their staff how well she is doing.  They seemed mightily impressed.

So am I, especially because I woke up this morning to an intelligent creature who declared her love in our Sept. 24, 2011 commitment ceremony.

For all who read my posts, this is the place to join together on Alice’s road to recovery.  There are more photos coming.  We love you all, and thank you.

Alice Endures a Stroke

Alice's day nurse took this photo on March 15.  A hospital bracelet adorns her left arm.
Alice’s day nurse took this photo on March 15. A hospital bracelet adorns her left arm.

When I left my apartment on March 11 for Mt. Tabor, on the east side of Portland, Oregon, I didn’t realize the destination of my writers’ conference sat on top of a dormant volcanic vent.  But that’s old news.  Little did I know a different kind of eruption was going on at home.

Three hours and twenty minutes later, I returned home to see the aftermath.  Alice was staring at the kitchen counter while all the silverware from the dishwasher was strewn about.

Alice explained everything was fine, and so was she.  No, that wasn’t right, everything was not fine.  Her ramblings didn’t seem logical.

Ten minutes later, I stammered, “I think we should go to the emergency room,” but Alice again tried to make sense of nonsense.  Five minutes of slurred speech later, I insisted she get dressed and go with me to seek help at Kaiser Permanente Westside Medical Center’s emergency room.  She consented, resignedly.

Attentive doctors and nurses surrounded us from the moment we walked in, and hurriedly we were escorted to Triage Room #12.  Within 36 hours, after being admitted into the hospital, we learned the bitter truth: Alice suffered a full-blown stroke.

The dark forces attacking Alice’s wellbeing caused me distress, and tears readily revealed my love.  And on Friday, March 13th, after the alert, caring staff throughout Kaiser Permanente had stabilized Alice, she was admitted to downtown Portland’s renowned Legacy Rehabilitation Institute of Oregon, known fondly as RIO.

Alice is in RIO, because her stroke resulted in aphasia, the same affliction that former Arizona’s representative to the U.S. Congress Gabrielle Giffords suffered after a failed assassination attempt.  Aphasia is characterized by an inability to speak because of damage to the language pathways in the brain’s left hemisphere.

Giffords got better as her rehabilitation became markedly effective, although those who suffer the injury have little hope of full recovery.  On March 15, CBS-TV’s Sunday Morning show created a video essay about the Congresswoman and retired astronaut husband Mark Kelly, documenting how much she’s improved.

Here in Portland, though, Alice has just been diagnosed.  She keeps her cellphone turned off, because she can’t finish sentences.  She can’t text competently either.

But over the uncertain days I’ve watched her, a pattern has become clear.  Alice worries more about me than herself.  Her entire focus is my own wellbeing.  And she hardly ever complains.

When Alice said it was okay for me to write about her stroke, she displayed courage that transcends the violation of privacy.  Alice isn’t bothered about what others might think; she wants me to channel my anguish into a positive creative outlet.

I don’t know what good deeds I’ve done over the years to have such a woman at my side.  All I know is my heart is filled with admiration and unyielding affection when I think of her.

Before I left her bedside, she made me promise to do two things: first, to exercise at the fitness area in our apartment complex; second, to write something new, so this blog doesn’t grow stale.

In my mind, Alice McCormick represents the essence of love.  And whatever mischief the fates had in mind can only fan the flames of love that burn inside me.

So goodnight, my love.  I’ve done all that you asked of me.

A White-Knuckle Drive

Oregon has plenty of surprises.  This sign was one of them.  Photo by Alice McCormick.
Oregon has plenty of surprises. This sign was one of them. Photo by Alice McCormick.

“Hey Alice, did you see that sign?” I asked my partner.

Alice and I had finished our first visit of the town of Astoria in late January, and were driving back at night to our apartment complex when a cautionary roadside sign advised us to watch out for – were my eyes deceiving me? – ELK?!!!

“ELK,” Alice said.

No, we weren’t imagining things.  My GPS offered a shortcut back home to Hillsboro.  Instead of driving due south toward Seaside where we would pick up US 26, the cellphone app advised that using Oregon highways 202 and 103 until reaching US 26 would save 2½ miles.

Oh, a different way to go, I thought, which would avoid highway fatigue.  So instead of taking the long US 101 bridge across Youngs Bay, I turned onto Oregon Highway 202 and began climbing along the west side of the Bay.  And what a surprise.  The highways of our “shorter route” twist and turn through Oregon’s Coastal Range of mountains for 38 miles.  And the first sign we had left civilization behind was an ELK sign.

No wonder we didn’t encounter traffic!  But this little adventure should not take too much out of us, I thought, and our trusted GPS was watching over us all the way.

Within a few minutes, my confidence was shaken.  We had become enveloped in fog.

Every sharp curve around imagined drop-offs were shrouded in the battleground between moist Pacific Ocean air and the mountains of the Clatsop State Forest.  My hands gripped the steering wheel tightly, and the Ford Escape lovingly called “Betsy” responded well to my alternating use of the brake and accelerator pedals.

Then we came across another sign: ELK VIEWING POINT!

Bull elk standing guard over his herd.  Photograph by Rick Swart.
Bull elk standing guard over his herd. Photograph by Rick Swart.

WTF???!!!  Little did we realize that this highway crosses the heart of Jewell Meadows Wildlife Area.  And January was the heart of Roosevelt elk viewing season, a popular pastime for visitors to the Coast.  My eyes darted across the road from one side to the other, looking for any sign of a rogue bull elk charging across the highway.  But how could we see such a creature while shrouded in fog?

I drove on, while Alice chided me for being openly nervous.  But what did she expect?  The sign had said: ELK!

While grasping the wheel, I imagined what fun we might have encountering a tree fallen across the highway.  If such an obstacle was encountered, we would have to detour back to Astoria, because there no other highways were around.  Oh what fun I had anticipating the worst.

When I finally encountered the turnoff to Route 103, my dread began to disappear.  We made it this far.  Only nine miles left to go before the main highway!  Even the fog seemed to lift slightly from my elation, but only slightly.

Finally, we arrived at Highway 103’s junction with US 26, and we enthusiastically joined a line of traffic headed east toward Portland.  Sure, there still was fog, but the cars ahead of me would lead the way to Hillsboro’s city lights and its 95,000 residents.

When we got home, I breathed a sigh of relief and silently thanked our good luck and any divine guidance that might have been looking over us.  And over the next month, I tried not to drive at night.

Why?  Because I feared some wayward animal might find its way in front of our car.  Out here, one can anticipate an occasional brush with unexpected adventure.

After all, we had somehow wound our way through an imagined herd of ELK!

Portlanders Don’t Know Pizza

The quality of Fat Dog Pizza in Tillamook compensates what's lacking in Portland.
The quality of Fat Dog Pizza in Tillamook compensates what’s lacking in Portland.  Photographs by Alice McCormick.

Portland, Oregon has many perks, mainly the climate.  During the first two months of 2015, this city’s wintertime high temperatures peaked 10 times at 60 degrees and beyond.

By comparison, Doylestown, PA’s low temperatures dropped below-zero three times this winter, although its snowpack is modest compared with Boston.  Western Oregon’s climate is behaving like a fresh, cool breeze, and we shudder to think what our utility bills would be like if we had stayed back East.

One handicap, though: Portland doesn’t know pizza.  Every single pizza joint here appears to be franchised (think Godfather’s, Domino’s, or, God forbid, Pizza Hut).  Even large bar/restaurants prepare bland dough in advance or have it prepared for them factory style.

One popular pizza chain called Mod funnels patrons through a long line – alarmingly cafeteria style – where enthusiastic but unskilled servers place a plethora of toppings on thin-crust pies.  Novice gourmets using restaurant apps like Yelp rate this chain four stars or higher, seemingly unfazed how Mod’s pizza dough, cheese and tomato sauce taste more like ingredients prepared in an assembly line.

After five months of having our palates unrewarded, we inadvertently discovered a pizza place on the Coast that shames its Portland cousins.  Fat Dog Pizza, in the heart of downtown Tillamook on Main Avenue (US 101) at 2nd Street, makes its dough from scratch each morning – creating a pie worth shouting about.

Roadside views from State Highway 6 in the Tillamook State Forest are special.
Roadside views from State Highway 6 in the Tillamook State Forest are special.

The 70-minute, 60-mile drive to Tillamook on State Highway 6 is palatable, as the road cuts through the heart of the Tillamook Forest Center.  Here is where the fun actually begins, because the Tillamook Forest represents Oregonians’ dedication to sustainable green living.

A wayside hut exhibits Tillamook State Forest's history.
A wayside hut exhibits Tillamook State Forest’s history.

What one sees of Tillamook’s forest today is largely reclamation by Oregon’s Department of Forestry after a devastating wildfire.  On Aug. 14, 1933 while winding down work in Gales Creek Canyon, a logging crew dragged a log across a dry fallen tree.  One single spark from that inadvertent friction ignited one of the largest forest fires to strike the West.

Fire quickly spread to the dry slash, and soon green trees were engulfed in the flames.  Although thousands of volunteers tried to contain the blaze, after 10 days more than 40,000 acres were destroyed.

Then strong winds swept through the area, and the fire exploded across a 15-mile front, sending a mushroom cloud 40,000 feet into the air.  Amid dark clouds of ash, entire trees were uprooted by hurricane-force winds.  Damage was phenomenal; another 200,000 acres were devastated in just 30 hours, amounting to 13 billion board feet of timber.  That’s enough lumber to build a million homes.

Afterward, Oregonians demanded Tillamook’s forest reclamation, and the area now has been turned into a living museum illustrating how the public good can be served through man-managed forests.  Located in the heart of the Tillamook State Forest, an interpretative and educational center showcases the Tillamook Burn reforestation project, shaping a legacy for sustainable forest management.

The Wilson River runs along State Highway 6.
The Wilson River runs along State Highway 6 in Tillamook State Forest.

With a 40-foot-high replica of a climbable fire lookout tower and a 250-foot-long pedestrian suspension bridge across the Wilson River, the Tillamook Forest Center is the outgrowth of a major public-private partnership.  Located 50 miles west of Portland, the learning center provides a breath of fresh air to monumental environmental calamities plaguing the rest of the world.

That’s why a drive for great pizza can be rewarding for the entire family.  After all, Fat Dog Pizza in Tillamook is only 22 miles east from the Forest Center.  And if you want something else to enjoy, the Tillamook Cheese Factory, two miles north of Tillamook on US 101, is a rewarding extra attraction.  Visitors flock there to see how Tillamook’s popular cheeses, milk and ice cream are manufactured.

An enormous hangar three miles south of Tillamook housed Navy blimps during World War II that scouted the Coast for Japanese subs. It's now the home of an aircraft museum, and impossible to miss from US 101.
An enormous hangar three miles south of Tillamook housed Navy blimps during World War II that scouted the Coast for Japanese subs. It’s now the home of an aircraft museum, and impossible to miss from US 101.

But that’s for visitors, and it’s all indoors.  The sensory highlight for a pleasurable drive to the Coast is the Tillamook Forest Center, and it just opened for the spring-summer-fall season.  Its website invites visitors to enjoy “camping, hiking, picnicking, off-highway vehicle riding, horseback riding, fishing, hunting, swimming, bird watching, geocaching, berry picking, mushroom hunting and firewood cutting.”

What better excuse can one find to feast on a top-notch, family-pleasing pizza pie than basking in one of Oregon’s prime forest recreation areas along the way?  And why else are we so willing to forgive Portlanders for not knowing pizza?

Eight miles south of Tillamook is a combination paved/gravel road leading to 266-foot-high Munson Creek Falls.  When we visited, the top of the trail was closed off due to a landslide.
Eight miles south of Tillamook is a combination paved/gravel road leading to 266-foot-high Munson Creek Falls. When we visited, the top of the trail was closed off due to a landslide.
The quarter-mile trail to the falls is dotted with moss-covered rocks and trees, a testament to the rainy conditions often encountered at the Coast.
The quarter-mile trail to the falls is dotted with moss-covered rocks and trees, a testament to rainy conditions often encountered at the Coast.


For the price of a cup of coffee, the owner of Tillamook's Second Street Coffeehouse (next to Fat Dog Pizza) will let you peruse his memorabilia and bric-a-brac.
For the price of a cup of coffee, the owner of Tillamook’s Second Street Coffeehouse (next to Fat Dog Pizza) will let you peruse his memorabilia and bric-a-brac.