Saturday, January 1, 2011

January: Looking Backwards and Forwards

On the first day of the year, Janus, the Roman God of transitions,  looks backwards and forwards.  The namesake for the month of January, Janus reminds us of bridges and door entrys.  His temple had two entrances: one towards the rising sun and one towards the setting sun. We look for change and recapitulation.

As janus rostrum okretu ciachImage via Wikipedia
I think of Janus a bit musically as modulations.  Most of the time, changes in our lives don't occur with a thunderclap but as a gentle flow from one theme to another.  The key changes from major to minor.   Our intonation flutters.  Our rhythms syncopate and then resolve into a steady beat.  Our pitch rises and falls.

And so has it been this year for me.  I had my thunderclap the year before last  with the diagnosis of non-verbal learning disorder.  I have taken this theme and expanded on it and recapitulated.  There are passages in the music of my life last year when I am sure that diagnosis was a mistake and there are times when I wonder if I am fooling myself and I really am on the autistic spectrum.   This past year, I have been thinking that I will resolve physical ailments and then I'll tackle higher order function.  However, it has been pointed out to me that attentional problems can get in the way of the focus needed for sustained fine motor skills.  So maybe I will start transitioning into looking at executive function sooner than I have expected. 

So, looking backwards, what's happened?

My vision is almost there.  I have overcome problems with focusing, visual memory, and spatial orientation.  I can actually play visually oriented games and have fun with them.  I am whipping through tangrams and now can look at a small diagram and figure out how to make a larger tangram from scattered shapes (i.e. scale and transformation).  I can draw a bit although it is still very hard because my fine motor skills are not good.  My binocular vision is coming along and I do see more dimensionality in this world.   I use a GPS and I get to where I am going with much less ado.

Getting better vision means I can see a lot of the wonderful architectural detail and natural beauty in the very special corner of the world that I live in.  I live amongst Pennsylvania farmhouses, Federalist buildings and homes, and Victorian gingerbread as well as the  odd, modern architectural statement.  A Five minute walk from my development leads me into a historically preserved town.  A ten minute drive leads me into rural farmland. Ecologically, I live between  river, streams, lakes, watersheds and rolling hills with lots of farmland in between.   When I walk in the woods, I can see more of the many animals that live here: deer, foxes, turkeys, pheasants, raccoons, skunks, opossums, squirrels, and rabbits. We are on the migration path for many birds and have a lovely sanctuary which day by day is a pleasure to ramble. I am starting to learn how to identify birds and can simply see a lot more birds in the wild as they are not obscured by the foliage.  We have a wonderful assortment of feathered friends:  robins, gold finches, egrets, herons, Canadian geese, tufted titmouse, cardinals, grackles, woodpeckers, and the occasional wild turkey, turkey vulture and hawk.    The migration of the birds are a lovely way to mark the passage of time as they leave in the fall and return in spring.  

Time is also marked by the ebb and flow of the blooming of flowers.  When I walk by the canal, I can see the lovely jewelroot, hawkweed, devil's paintbrush, and wild sweet william. The many gardeners around me mark the season as snowdrop, daffodils, tulips, irises, roses, and mums.  Somehow I feel more naturally tuned and grounded watching these friends cycle through my year.  

In some ways, my hearing has improved a lot.  I can hear more lyrics of old songs and more background vocals and instruments. I am rediscovering music from my youth -- all the pop songs from the 60s, 70s and 80 have lyrics that I can now understand.  I am not asking people to repeat as much. Lately, I am not lip reading one-on-one in a quiet environment.    In other ways, I still have not made much progress on the ringing in my ears from tinnitus.  I am not sure whether I have really lost hearing function in the parts of high pitched soft sound.  My hearing has just fluctuated a lot from gains made with the interactive metronome and sinus surgery helping out and the tinnitus decreasing hearings.  

I am able to sing on key.  This is a wonderful thing.

Sinus surgery has helped smell a little bit and breathing a lot.  I can smell a little bit better.   With the right amount of lidocaine and afrin I can smell the Penn Med School.  

Breathing is now a wonderful thing.  A good deep breath is akin to a cocktail.  Nice deep calming and sensually delightful.  When I want to make myself feel good, I take a good deep breath and enjoy.

Balance has improved a lot.  My posture has improved a lot and I am standing and sitting up right. I am a lot more steady and can play sports a lot better.  I am mastering certain WII fit modules including Snowball Fighting,   I am doing really well at WII Boxing so you better not meet me in a dark alley!  I am no longer afraid of heights or tipping out the passenger side of a car while driving. I'm not feeling unsteady when I walk on ice.   I feel a lot more confident and calm. 

Tummy is a lot calmer and less upset.  Taking probiotics and VSL has really helped.  Not putting milk/cheese and bread/wheat down the hatch keeps tummy nice and quiet. 

Perception is changing.  I am stopping to notice a lot more things than what I used to.  At the beginning it was kind of cool.  But now the novelty is wearing off.  Sometimes it is disruptive as I really would like to be focused on something else.  Other times, it is kind of sad that what is mundane for most people is a sudden novelty for me.  

I feel smarter and I feel like I am thinking a lot more clearer and being a lot less forgetful.  Little by little, my life is getting more orderly.  My kitchen counters are staying neater.  My paper work is more organized.  More stuff is getting done on time.  

Looking Forward to Next Year

Finishing up the tummy.  Why do I have malabsorption?  In January, I have an appointment to see a gastroenterologist down at Hospital of the University of Pennsylvania.  I am not sure he is the right person as he is more of a surgeon but the IBS specialist is not accepting new patients.  However, I find that getting a good doctor often opens up access to his network and he probably knows who is God's gift to malabsorption.  

Finishing up balance.  I will be ordering orthotics on the first week of January and should get them at the beginning of February.  I will also see an orthopedic doctor in February to find out why one foot is shorter than the other, why my pelvis is tilted and get a recommendation on some therapy to fix my gait.  Sometime in January I expect that I will be a WII master and will be moving on to Dance Dance Revolution.

Finishing up the eyes.  I still have to work on binocular vision.  I'd also like my peripheral vision checked and we'll see if I can do some of the automaticity drills that we were trying to do with the metronome.  I will see Dr. Herzberg in January and find out what the next steps are.  If I can get these issues resolved, my eyesight will be normalized.

Finishing up Rhythm.  I am still pondering this one.   Other than Dance Revolution, I am not sure where to go on this one.

Starting up Smell.   I have an appointment in January with the Penn Smell Clinic to find out why I have a diminished sense of smell.

Starting up Hearing.  I have an appointment in January with Maxine Young and we will tackle amplification, tinnitus, and APD.  

Starting up Fine Motor Skills.  I have an appointment with Dr. Osterman who is supposed to be the be-all and end all of hands.  He is the editor of the Journal, "Hand" and a surgeon.  I don't think I need surgery but I think Dr. Osterman will know who and where to go for fine motor skills.  

Executive Function.  I will start slowly working on that.  There are some problems with response time and response timing that impact attention.  I am not sure how much of the design fluency and gestalt problems noted during my assessment at Columbia Presbyterian are real problems in and of themselves and how much of them are vision and fine motor skill problems.  Concept formation problems -- I have no idea how to tackle this one.  Although I suspect that some of this may go away as visual motor skills come more fully on line.  Perseveration?  I don't know yet. 

Needless to say, I won't be doing all these therapies at once.  But by the end of January, I should have the game plan for the rest of the year.  

Consciousness.  I am starting to ponder what all of this means in terms of coming into the world.   In Buddhism, there is a concept called viññāṇa (consciousness).  It is the third link between mind body formations and name and form.  There are six types of Consciousness:  eye-consciousness, ear-consciousness, nose-consciousness, tongue-consciousness, body-consciousness, and intellect-consciousness.  My question is what does this all mean when I have been functioning in a world where my sense perceptions are really quite fuzzed.  I have nervous system that functions as if it were on Novocaine and takes a lot more stimulation to be aroused (ie SIPT Low Registration for Sensory Processing).  For a long time, I have not been really able to count on receiving a correct input so I can be sure of what I a actually conscious of.  Much of my life, this has not been an issue.  How can you worry about something that doesn't exist?

At any rate, this is the game plan for this year.   Will keep you posted.

I am starting to tackle executive function and we shall
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