A few weeks ago we were offered a couple of sessions with a neuropsychologist who would be able to properly identify which cognitive functions have been affected by Amanda’s stroke.

After completing an initial visit followed by a written questionnaire (which had a version for me and a version for Amanda), the second visit was a full 40 minute test.

The first questions were grammar and language – based. The Psych read aloud a list of 30 words three times and Amanda had to remember as many as possible. She remembered the first 5 but struggled to get any further.

Next were a series of questions like ‘What is water?’, ‘Why do we explore outer space?’ This time she managed a sensible answer each time.

Next, the number questions.

Amanda was able to remember a spoken sequence of up to 5 numbers. Then she was asked to verbally put up to 5 numbers into the correct sequence from lowest to highest.

Success again.

Finally, 3 questions along the lines of ‘if John has 4 children and 20 apples, how many apples does each child get?’ –  Versions of this got progressively harder, and this is where Amanda struggled.

The neuropsychologist concluded Amanda has lost her ‘working memory’; the whiteboard or scratchpad we all carry in our brain which allows us to formulate the first part of a puzzle and hold it while we work out the next part before putting the two bits together to give the answer. By the time Amanda has worked out the second bit, she has already forgotten the first!

This was clearly demonstrated this morning when Amanda was practicing reading aloud from the list below. She has an alphabet to hand to assist in identifying letters and can easily spot an upper case letter in the alphabet even though the actual word is in lower case. But, for example with a word like ‘fox’ by the time she gets to the ‘x’ she has forgotten what the other 2 letters were!

 

Bizarrely if I ask her to point to any one of the words on the list, she can do so straight away. So I could say “point to bridge” – and she points to bridge immediately. But if I point to bridge and ask her what the word is…she doesn’t  know.

I asked her if she realises how strange that seems , when she has been reading for the previous 50 years? Her response was that she could not remember being able to read and each time she looks at the letters it’s like trying to decipher hieroglyphics all over again.

But…

Amanda’s support worker has noted her multitasking has improved to the extent that she can now easily make lunch and a hot drink simultaneously. Also, during her 2 hours at work on Friday morning her occupational therapist noticed how well she can carry out tasks when they are in a work context rather than just exercises.

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Amanda was desperate to remember my birthday this week and had carefully noted the first day of October.  On the other hand, I had no expectation

So on Thursday morning as she showered, I answered the phone.

“Who was that?” She asked. So I had to say it was my parents to wish me happy birthday. She looked at me in horror and I had to tell her not to worry about it.

But on Thursday evening I came home from work to a chocolate cake. In the morning she had remembered to ask her support worker to help her bake it, and then when she returned at lunch time, Amanda iced it. Amanda then insisted I take the cake to work on Monday morning.

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Physio Jason continues to challenge Amanda with new tasks. The latest videos, which he records on Amanda’s Ipad so anyone else can see what he wants her to (re)learn, shows why learning to grip the clothes peg was so important a few weeks ago. This has now progressed to practicing holding a plastic cup (see below).