Chaplain/ Psychologist

After having attended the dysarthria group, I was escorted back into my room by Ellie the nurse. As I approached my room, I noticed that the door was open and as I looked in, I saw a man standing near my bed. It appears he was waiting for me while I was away in the group. But who this man was is still a mystery, so I entered my room and asked Ellie to roll me a bit closer on my chair to inquire him on who he was and what he wants. Having asked him a couple of questions, I discovered that he was the hospital chaplain that was on duty within my ward. Though he was a chaplain and his main duty was to provide spiritual guidance, particularly to those of the Christian faith. He assured me that he had no intent in preaching me about the bible, rather he offered himself as a counselor that I could approach anytime If I ever have any problems, in other words, he was being my personal psychologist. I asked him for his name and he responded, "Dennis" We became good friends immediately and would often bump into each other in the hallways.

After my encounter with the chaplain, I realized that there were many ways to stay socially engaged in hospitals without always having to go to certain therapy groups. I could remain socially active by chatting with just anybody. Dennis the chaplain was a good example of a person that I could rely on if I have any problems. So I advise any current inpatient that are reading this to get in touch with their chaplain/ psychologist on duty in the hospital to talk away all your concerns. Another benefit of being in touch with the chaplain or psychologist is that they also serve as an occupational therapist. A lot of times when you meet them, they would give you tests to evaluate your cognitive function just like in occupational therapy. I remembered one of our meetings where Dennis offered me for lunch outside of the hospital but I have to be the one who plans the transportation to get to the restaurant and make an estimation on how much money will be needed to eat at a particular place. He also asked me to remember what we do on that day and be able to report it to my occupational therapist, Jescinta the next day during my OT session with her.

Another good reason to get in touch with the hospital chaplain is that you have someone to play games with when no one else is available. I've done this many times with father Dennis as we casually meet up at the guest lounge of the hospital with other nurses or patients and play a game of Uno or chess or blackjack. Not only is it fun but it also provides a sense of escape from the dull and yet sad reality of being stuck in the hospital. Another thing that we can learn from being engaged with the chaplain, psychologist or any other members of the hospital staff is that they can give you insight on how to better recover yourself and excel yourself in all your therapies to accomplish your discharge criteria much faster. Since they have dealt with multiple patients n the past, they are more likely to know better the right kind of habit or attitude that will lead to a better recovery.

Father Denis told me that the best discharge criteria for a brain injury patient are always independence, being able to do things on your own and taking care of yourself. Once you're able to do all this, they'll let you out of the ward since the main goal of rehab is to return you to a normal life without any assistance just like when you were healthy. If you must, you should take all your medication by yourself without asking to show the doctors and nurses that you know your routine a be able to do things independently. The same goes for hygiene, patients should at least be able to carry themselves into the bathroom and shower themselves. This task may be easy for patents without any motoric disabilities but for those who have such problems, it's best to use a showering chair that you can sit on while you're showering.

Another advice that father Dennis has given me is to take frequent excursions on your own and come back. If you're able to able to achieve this then it shows you are capable of navigating the outside world unassisted. This also proves you are able to find your direction, something that most brain injury patients find difficult especially when they have a lack of spatial awareness. It's also best that patients engage in other daily activities such as shopping, paying taxes, planning an event or meeting and etc. These are all activities that require the brain to plan and process information. Engaging on these activities more often will speed up the brain towards homeostasis, the new state of normal for the brain.                                                                             

Dysarthria group

From reading the title of this post, I'm pretty sure that many of you have no idea on what dysarthria is. To put it simply, it is the inability to normally articulate clear speech. In other words, people having difficulty explaining things due to them always slurring what they explain. This is very common amongst patients that have brain injuries as they often end up with facial paralysis that weakens muscles used for communicating. This leaves some patients frustrated as they aren't able to talk like they used to. However such effects after a stroke especially dysarthria tend to get better with time and practice as long as patents keep on improving their speech.

One of the ways that patients can practice their speech is through dysarthria groups, which are essentially where patients with the same speech problems meet up to talk about something they like or to practice learning to talk together using programmed speech exercises. An example of these exercises includes breathing techniques to train our diaphragms to expand and contract to synthesize speech. Patients are asked to both inhale and exhale their breath during this exercise and take notice of how their diaphragms move when they are breathing. When we inhale the lung expands and the diaphragms push downwards t allow the lungs t increase its size to hold the air in. When we exhale, our lungs will contract and the diaphragms would contract as well pushing the lungs upwards to push out all the air. it's at this moment of exhalation that we use the escaping air from the lungs to form our voice and create speech. In most breathing exercises, patients are often asked to mirror each other to see if they have followed the right breathing steps needed to talk and to correct one another if they made a mistake.

In some cases, patients are asked to make an "aaaaa" sound when they exhale to strengthen their vocal cords so that they can amplify their voice volume much better when they talk or that they are asked to take a deep breath before reading a small text on a piece of paper or book. These exercises help improve not only speech but also reading comprehension, which is essential for someone experiencing aphasia. So to anyone out there who have slurred speech and difficulty reading or articulating a coherent conversation then this group is for you. If you've never been to a dysarthria group before then it's best that you prepare yourself by having a topic prepared that you could talk to your mates during the meetup. Some topic suggestions would be on your favorite hobbies, food, vacation destinations, and even movies or TV shows. As previously discussed in my last post, I went into the city to watch Doctor Strange with my mum. This excursion can be used as a topic of discussion that you can ask your friends at the group about. therefore it would be beneficial if you prepare yourself with some topic before coming in.

Besides improving speech, these groups also build a support community for those facing depression after an injury. most of the time you re free to express your problems and worries to anyone at the group, one of the best way to get your problems or feelings of anxiety of your chest. This helps build bonds between you and your friends at the group and you won't feel alone afterward. The group also prepares you for the real world when you are fully discharged from the hospital and back to society. Your new friends in this group can role play as your relatives so you can practice what you'd like to say to them when you actually see them. If you're a business orientated person, the group gives you the chance for networking and you can add new people in your business contacts that you can use to further expand your business activities once you're out. Some of the greatest friendships or business partnerships happen in the most unlikely places, so why not give it a go?

Dysarthria group is also a great way for entertainment if you're always stuck in your room with no one to talk to or play games with then the group offers you the chance to do so. Most of the time, patients are allowed to bring board games or cards that they could play with the other patients, an example would be Blackjack, UNO, and cards against humanity. Chess is also another great game for patients as it trains them to think ahead of what will happen and to devise a strategy to defeat the opponent. You could say that chess is the perfect brain game for those willing to improve their cognitive planning skills, something that not a lot of patients could do after a brain injury so chess can help train these skills.                                                                     

Patron hero of disability

On an early Saturday in the month of November, I woke up inside my room with a lot of joy and eagerness as it was on this day that the hospital had finally given me a chance for a day leave with my mother to go outside of the hospital grounds and into the city to do whatever we wanted to do. By this time I had already changed roommates for the fifth time and the fifth one wasn't as social as the first one so it was good timing to leave the room and explore the city. My mother and I opted to go to Fremantle to visit the Hoyts cinema to watch a movie that I had long waited for, "Dr. Srange", A Marvel superhero that tells the story of an arrogant Neurosurgeon by the name of Stephen strange who became master of the mystic arts and a powerful member of the Avengers after an accident that left his hands crippled rendering him useless with his job as a neurosurgeon and soon loses his career. One day a man told him that his cure lies at a place in the Himalayas called Kamar TaJ, a place where travelers go to to to find both healing and spiritual enlightenment. 

Desperate for a full recovery, Strange heads off to the Himalayas in search of this place. Sure enough, he finds it and embarks on a spiritual journey of both self-discovery and enlightenment. Upon arriving he was greeted by Mordo, A member of the Society who was living in Kamar Taj and a disciple of The ancient one, The spiritual guru who promises Strange that he could get his hands back if he follows the teachings of the ancient one. To Strange's surprise, the ancient one was a bald woman in robes of white. She approached him and gave Strange a brief summary of the program that he is going to do with her. The teachings are somewhat contradictory to what he had learned n medical school as the teachings of the ancient one is mostly about the mind, the power of belief, suggestions, chakras, energy healing, the soul, and manipulation of reality. To a surgeon like Strange, this all sounds like superstitious pseudoscience mumbo jumbo. He quickly rejects the teachings and walked away from the ancient one. Before he could do so the ancient one hit strange with her fist and Strange's Astral body was thrown out of his physical body and he traveled across the multiverse seeing a plethora of different form of beings and places that exists in other dimensions.

After the experience, he was convinced that her teachings are true and had the potential to fix his disabilities. Over the next few weeks, and months Strange was taught how to manipulate energy from around him to move objects, create weapons out of thin air and teleport to places through opening extradimensional gateways to access other multiverses. All of these feats have been accomplished by  Strange, which made him powerful at the end of the movie and was able to defeat the antagonist, Kaecilius and Dormammu, dark entity living in the dark dimension. Despite his victory over the villains he was still paralyzed in both of his hands. Nearing the end of the Movie the ancient one told Strange that his healing lies in his choice on how he wants to heal himself, either through the standard medical treatment or using his mind to channel his beliefs into his hands and recover them by faith.

Strange eventually chose the second option and uses his mind to slowly recover the severed nerves in his hands. The movie teaches us that the mind is very powerful and has the capacity to shape who we are and the realities we perceive on a daily basis. At some point, it can even affect our physical bodies and the environment around us, surprisingly there is even a metaphysical term or this phenomenon, it's called the law of attraction, meaning we become what we believe and receive what we desire most in both our thoughts and emotions. As the great French philosopher, Renee de carte once said, "I think, therefore I am" This lesson is even taught in the Bible with Jesus's parable of words turning to flesh meaning being mindful of what we say or think as it might just happen.

Both the metaphysical and moral lesson of this superhero movie can be applied in real life for most patients with disabilities especially those with brain injuries. The movie is a reminder to all of us that the mind goes beyond the limits of the physical a that our brains are nothing more but vessels that houses our very thoughts. If we are mindful of this lesson and fully tune in into our recovery with not only positive thinking but a strong belief of recovery, then complete healing can indeed take place. Just remember the advice that I've mentioned i "Tips on stroke recovery" What we imagine or believe shapes the neurons in our brains as if we are doing what we imagine.

Another great lesson that we can derive from this movie is the transformative power of tragedy and the beauty of failure. It's not only after the accident which severed Strange's nerves that he could find the drive to search for a cure and ultimately gain something else as an addition which made him more than the average new yorker or humans like you and I. The movie is also a reminder of the importance of time and how to use it wisely. During the fight scenes, the ancient one finally dies from a falling injury. Before she died, she told Strange that she had always believed in him and that he was capable of accomplishing great things not because he was a qualified and experienced surgeon but because he believed in himself. we are also reminded in this movie that time is short it goes by fast when you least expect it, especially with a brain injury from a stroke, all those precious seconds are stolen from you and it will never be retrieved again so you have to appreciate the little things in life and make use of our time wisely as not to waste it.                                                                                   

Books to read and videos to watch

As previously discussed in my last post. I spend the majority o my free time at the hospital reading informative nonfiction books regarding neuroscience and applied neuropsychology as means of not only occupying my time to escape the boredom in my room but also to engage my brain with processing information. I would recommend all patients in the hospital to do the same and be proactive in using the grey matter in their brain. This post will be dedicated to discussing the list of books, videos, and websites for those with brain injuries.

List of neuroscience books to read:

• The brain's way of healing:  Written by Norman Doidge, a Canadian Neuropsychiatrist. This book is a collection of real-life cases of people that have overcome some of their mental and physical disabilities through a rigorous form of self-training and therapies that are both conventional and non-conventional. The chapter starts off with a man by the name of John pepper who regained his lost movements from Parkinson's disease with a form of conscious movement that he developed by always being conscious of where limbs are in space. Other cases include the application of the Feldenkrais method that was developed by an Israeli engineer and physicist, Moshe Feldenkrais which promotes reconnection between the brain and body to improve movement and overall mental wellbeing. 
• The brain that changes itself: Written by Norman Doidge as well, this book is similar to the one mentioned above but focusing more on the biological mechanism of how certain therapies work and how certain neurological illnesses affect the body. This book may be a little it more complicated to understand as a lot of scientific jargons will be used to describe the cases that are mentioned in this book. Best to read this book slowly and take down some notes on scientific terms and concepts that are hard to comprehend, so you can research them later to better understand
• The body keeps the score: A comprehensive guide written by Bessel Van der Kolk on how trauma is stored in both the brain and body and how one can make use of their biology to turn off its negative effects and to maintain and develop a healthy mental state afterward. Some cases that are mentioned in this book also describes the treatments that are applied to resolve the issues. Some treatments that are mentioned include the following: Neurofeedback, EMDR therapy, Yoga and acting.

List TED talks on Neuroscience to watch:

• You can grow new brain cells, here's how: An informative TED talk delivered by neuroscientist Sandrine Thurette on the biological mechanism of Neurogenesis, the brain's natural ability to grow new cells. The talks also discuss the importance of maintaining a healthy lifestyle and diet which all play a contributive role in fostering cell growth. Link: 
• The brain changing benefits of exercise: This talk discusses the healing capabilities and benefits of physical exercise on the brain as well as how exercise plays a role in determining the quality of recovery after a brain injury.
• One more reason to get a good night's sleep: A talk that discusses the important role of sleep in memory consolidation and recovery.
• Power foods for the brain: Discussing the role of diet in shaping our brains ad how they function with a comparative example of how bad diet leads to the development of certain brain diseases such as Alzheimer's.
• The brain may be able to repair itself: A Swiss neurosurgeon delivers a talk on some methods to improve a patient's well being and overall function after surgery or trauma to the brain. The methods mentioned include deep brain stimulation and implantation of cultured stem cell.  

Lst of brain training sites:

• Jetpunk: A quiz website on general knowledge and logical reasoning
• Lumosity: A brain training website that is specially designed to test the brain's neuroplastic capability in terms of memory, planning, and reaction.
• Sudoku: A number games website that tests your reasoning with arranging numbers.                                                  

     

Day four

The fourth day at the hospital follows the same routine schedule that was already designed by my group of therapists. The only difference with this particular day was that I woke up without my roommate on the other side of the room. Turns out, Roy had been transferred to a different section of the ward as he was making significant improvements and was already prepared to be discharged. Without a roommate to chat, my time inside my room would most definitely be mundane, thankfully my new roommate came in a few minutes later and took the place where Roy was sleeping. Reese was a typical Aussie millennial, still looking young in his early twenties. I assume he had been admitted to the hospital for some ridiculous cause as most Aussie blokes within their twenties are prone to doing dangerous acts of stupidity that ends up giving them self injury. My predictions were true, Reese had a brain injury from bashing his head against a rock after somersaulting drunk on a fence.

Though his case of being admitted to the hospice was undoubtfully stupid. Such cases don't surprise me as there are plenty of young millennials with substantially low grey matter in their brains to even think with common sense to decide on things which they should or should not be doing within the confines of reality. Reese wasn't that much of a talker as he would spend the majority of his time gazing the television. Because of this lack of a social presence, I diverted my attention into looking at educational youtube videos particularly TED videos concerning Neuroscience and Neuropsychology. I would open one of these videos and try to focus in to obtain the key points of all the presentations. Surprisingly they were all very informative regarding the brain and how an injury affects it both mentally and physically and metally. If any of you are stroke patients of a ruptured AVM that is still an inpatient in the hospital then I highly recommend looking at TED videos as a productive way of enjoying your free time when you're not doing therapies or engaging in a meaningful conversation with your roommate.

Another highly productive activity as an alternative to watching TED videos is reading books whether they are fiction or non-fiction. I will list some of my favorite TED videos and books to read in my next entry to make things easier for you to choose the book you would like to read or the videos on TED you would like to watch. If you do end up watching or reading some of the things that I will suggest in my next post, be sure to take down notes to make things easier for you to understand.

Now going back to the current situation in my room. Without a very social roommate to talk to, I rarely spend much time in my room. I spend most of it on my therapies. uring this day in my speech therapy, I asked my speech pathologist Alicia if there was some sort of social group Where I could talk with other patients and improve my speech at the same time. Turns out there was something called Dysarthria group every Wednesday. Patients who would like to join and chat with other stroke affected individuals are free to come and join them. n this group patients are able to talk just about anything as long as it's not controversial such as political or religious discussions.

After having registered for this group with Alicia, I went to the kitchen to get some alone time for myself. This room has the only large screen telivision, where visitors can relax while they are visiting their sick relatives. I turned on the Television and there it was a Promo for the new upcoming Marvel movie, Dr. Strange. I had to see this film as I am a devout Marvel fan and an admirer of Stan Lee, the creator of Marvel comics. After watching this trailer, I walked to the main reception of the nurse's station and asked if I could get a day leave from the hospital to watch the movie at the cinema. They gladly approve my request and gave me the time to leave the hospital the next day to watch it. however, I have to take my meds with me and I had to be accompanied by my mother while I'm outside as part of the conditions for da leave and I had to be back before six or the doors will close shut for me.                                                                                 

Eating after brain injury

Food is the nourishment that the body needs to sustain its biological function, primarily keeping us alive. However, all of the body's function comes to a near stop after a stroke or any other form of brain injury. Patients are to be reminded that both brain and body are inherently interconnected. One does not work without the other. If you are suffering from a hemorrhage in the brain or a clot, it's most likely that you will end up with damage in one of your brain's hemispheres. These damages will have a profound impact on certain functions such as our cognition, mobility, spatial awareness and so on. The damage will also likely to affect how we eat and drink, especially if the subcortical cortex suffers damage as well. Therefore the first steps of recovery should solely focus on relearning how to eat and drink.

Actions such as eating drinking may look simple on the outside but its biological mechanism often fails or slows down after a brain injury. The esophagus will contract slower causing food or liquid to get stuck or move too fast, which could result in choking or asphyxiation. Most hospitals would attach a feeding tube through the nostrils, directly connected to the stomach to feed us without the need of putting it in our mouths to chew. Other methods include a PEG (Percutaneous Endoscopic Gastronomy)  tube directly attached to the stomach via an external incision, this the most common form of eating for most patients. It's safe and direct, however despite having a tube attached to you to help you eat. Patients should not be dependent on them, it is recommended that brain injury survivors take the chance of trying to consume normal food. In doing so they are readjusting their bodies natural function of eating and swallowing food after the injury.

Another important reminder for patients is that readjusting to normal food may take a long time as the body after the initial injury to the brain may reduce the contraction movements of the esophagus, making swallowing difficult. Thus patients should at least try to eat something a bit solid for a start but not too hard on the texture. Most speech pathologists would use a sponge cake to retrain a patient to eat since they have a soft texture and easy to swallow. Once you've accomplished eating something with a soft texture, you can proceed with eating something harder that may take a bit more chewing before swallowing. These can be crackers or cereal grains. When chewing these things, patients should try to chew on the side with weakness or paralysis to strengthen their jaw muscles. This will also help improve pronunciation and prevent slurring during talking.

Patients must always remember to stay upright as possible when eating or drinking a this prevents choking or food going down the wrong way and would help digestion become easier. straight posture is also needed when taking as it helps air travel easily into the larynx and voicebox that we need to produce our voices. Being aware of posture most of the time is essentially the key to regaining a normal gastrointestinal system for a speedy recovery. Besides being mindful on how to eat or drink, we should be mindful a well by what we put in our mouths. Most hospitals would assign nutritionist to oversee the type and amount of food we consume during our stay in hospitals but it's very rare that the nutritionist plays a role in maintaining our diet. A lot of times hospitals end up serving us with unhealthy stuff such as fries or sizzled sausages. At times these things will be substituted by liquid supplements in the form of antibiotics probiotics which cause constipation. If possible they should be substituted with something healthier for the digestive system such as fruit and vegetable juice that will easily be absorbed by the intestines and easily disposed of as excrements once it has gone out of our rectums. Another reason for changing to such diet instead o following the catered meals in hospitals that are randomly prepared by the catering crew is simply because of certain food containing BDNF ( Brain Derived Neurotropic Factor), these are naturally occurring chemicals in the brain that helps speed up neurogenesis to produce new neurons.     

When being fed alternative supplements like antibiotics, doctor and nurses will most likely feed it through the peg tube as a means of easy access. Using the tube fo feeding should be done with good maintenance. Once food has gone down the tube, nurse or doctors should flush it with water to prevent any leftovers from getting stuck. Failure to do so would cause the leftovers to clog up the peg tub and it would become unusable for further use. the stuck leftovers may even become breeding grounds for bacteria that could cause infection when this happens it is necessary to get the peg tub removed and replaced with a new one. When replacing the tube, it should be conducted with an endoscope to firstly remove the inner seal that will release the outer tube with ease.                                               

Day three

The third day of my stay at Fiona Stanley starts off like the last two days I was there. Breakfast always starts off first at around 7:30 sharp and the catering crew never comes late, always punctual. As usual, the catering crew would always ask me for my details; name, date of birth and patient ID on my wrist band. Without these details, i would not be able to receive any of my meals and it's already hospital protocol that these questions are asked to prevent the wrong food from being given especially when the patients have allergies. After providing the patient details, my breakfast was then placed on the bed side table, i reached over the tray and lifted it to see what the menu was. To my surprise it was the same kind of menu as yesterdays breakfast but with an additional baked beans and toast. This was an upgrade but the drinks are still thickened and horrid to taste. I started with the eggs first before taking on the beans. I aded a bit of salt and pepper on the eggs as they were quite tasteless to begin with. After having aded some flavor on the eggs, I hurry up as i could to finish up my food to start the day a bit earlier than usual.

The last to be eaten on my tray was the toast. I aded a bit of jam on it for flavor before putting them in my mouth. After having eaten all the food on my tray, i grabbed the patient buzzer to call for the nurses to help me transfer myself on the toilet. I pressed the button and one of the nurses came into the room. Strangely enough, it wasn't the usual morning nurses that came into the room. It was a trainee nurse from ECU, so it was clear that she was still a greenhorn, still learning basic nursing. I don't know how she will help me transfer on the toilet but i'm willing to give her a chance. Once i got on the wheelchair, she rolled me into the bathroom and brought me close to the toilet, I then held on to the disability bars on the side of the toilet to make my transfer easier. A i shifted my bottom from the chair onto the toilet, I slipped and fell on the floor. Thankfully i landed on my posterior and not my head otherwise, the impact would be fatal. As i lay on the floor in pain from the fall, the student nurse panicked and pressed the emergency button. The entire hospital staff came rushing into the bathroom to inspect my condition. They asked me if i hurt my head to which i responded," not my head but my ass hurts" Hearing my response, they all chuckled with laughter and were relieved that it was my bottom that was the victim and not my brain. However i did tell them with sarcasm that some people do have their brains in their asses, especially the senior nurse for not supervising a novice on handling patients but it was also my fault for not telling the student nurse to pull up my pressure stockings before i transferred myself on the toilet. Thus it is therefore important that all stroke patients should be aware of either removing or pulling up their pressure stockings before moving around to prevent any slipping from happening.

The doctors and other nurses then drew their attention on the student nurse and began interogating her on how my fall took place.  I told them to go easy on her since it's only her first day of actual practical in the hospital, she was then relieved of her duties and was transferred to different ward with less difficult patients to deal with. The doctors and nurses then assisted me in getting myself back on the wheelchair. After the fall I decided to go to the bathroom a bit later in the evening when i have more free time to do whatever i want. Looking at the clock on my phone, it was already 8:45, i had to rush myself to occupational therapy and see Jescinta to do my daily exercises. I asked Ellie, the nurse to push me all the way to the OT room, she did and i arrived there only a few seconds late. I was relieved that she wasn't furious about me being a few seconds late. She then handed me a crossword puzzle to complete, the questions asked on it were pretty simple. I managed to complete it within five minutes. She then proceeded to asking me some logical questions. They were mostly logical such as safety questions on what should be done when there is a grease fire at home, what would be the appropriate thing to do to resolve the problem or how to plan a vacation. the questions are pretty straightforward and logical.

At the end of the test, Jescinta concluded that i did well on my probing and reasoning questions but when it comes to planning, i was labeled as slightly impaired as my planning sometimes weren't coherent or in line with the intended sequence of how things should be done. But this didn't prove anything as i was mostly a person who never plan anything in real life even prior to my accident. I just do things as i see fit or necessary just like the joker from the batman trilogy of Christopher Nolan. With the OT test completed, I went straight to my speech therapy appointment with my speech pathologist, Jan. I visited her inside her office, inside she was waiting for me in front of her computer and on her desk were three snacks; a sponge cake, an Oreo and some cheese crackers. I approached her and she told me that we were going to do some food test. She wanted me to eat each and every one of them to see if i was able to properly chew my food and swallow it without choking. To me this seems like a fun test since i get to eat something that's way better than your average hospital food. Without further a due, i approached the snacks and tore the packages open before gobbling them down my throat. I finished them all with lightning speed as i was hungry and had not tasted real food for a long time. By the end of the session, jan concluded that i had passed the test and i could now go back to eating normal things. She turned towards her computer and began writing down the results with an additional note sent to the hospital catering team that said," normal diet" This indicated that i was finally off the standard thickened food for stroke patients and i could immediately consume anything i want. The moment i left the speech therapy room, i headed to the hospital food court and bought myself a subway sandwich for appetizer before my main lunch back in my room. I asked one of the nurses to escort me to the food court to purchase my sandwich, they did so and i managed to buy the sandwich before my meal arrived in my room.

On my way back to the ward. I ate my sandwich as fast as i could so i could save some room for my lunch. Having tasted a subway sandwich after months of being in hospital was truly a blessing. The suffering that i have endured has made me realized the importance of gratitude for the little things in life such as good food, being able to drink water, being able to sleep in your own comfy bed and taking a shower in your own bathroom. I realized how lucky i was to have experienced all these things while i was healthy and wished i could return to that state of joy of being whole and healthy again. As i arrived in my room, my room mate Roy had already finished his lunch and had already dozed off to his nap. the nurse rolled me over to the bedside table where my lunch awaits me and i ate it silently as best i could so i wouldn't disturb roy from his midday slumber.