The Good, The Bad, The Ugly

I used to trust reviews on the internet–100%.  I was easily swayed by comments and  perfectly photoshopped photos of pretty people in white coats with stethoscopes.

 

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After reading reviews for this one neurologist, I convinced my sister to schedule an appointment for our mother, Alberta.

 

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“This doctor must be really good,” I said. “Five stars and she’s interested in natural medicine,” I said.   I was wrong.  Those reviews were wrong.  It was a bad experience. But at least we got forms filled out to get a temporary handicap placard for the car. And at least I learned a lesson.

 

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My twin sister later told our mom’s acupuncturist all about  the horrible experience at the neurologist’s office. He then said, “My dad’s a doctor.  You should call him.  He’s not traditional at all.  You’ll like him.”

 

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Dr. Robert Bookman, a.k.a. Dr. Bob (https://www.a2hi.com)  is not your typical doctor.  We did not even have to leave the house for the appointment with him.  He called us on the phone. He then ordered extensive lab tests to figure out how to best proceed with our mother.

  • “I want to understand everything that is out of balance with my patients in order to return them to optimum health. I provide the support and guidance for you to achieve and maintain a healthy existence.”

Robert H. Brookman, D.O.
FCCP, FACOI, ABAARM

 

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When the testing was completed– Dr. Brookman  analyzed the results and called us again–this time  with a plan of action.

 

 

Dr. Bob’s 10 steps to achieve optimum health are:

  • Nutrition, Nutrition, Nutrition
  • Exercise is Medicine
  • Stress Reduction
  • Gastrointestinal Health
  • Detoxification
  • Balance Vitamins, Minerals, Fatty Acids and Amino Acids
  • Hormone Balance
  • Immune Modulation
  • Enhance Mitochondrial Health
  • Longevity Enhancement

The Company of Dogs

According to https://www.medicalnewstoday.com  — looking at “puppy dog eyes” triggers a 300% increase in a person’s oxytocin levels – the “love hormone” involved in maternal bonding.

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According to https://www.Helpguide.org :

  • Dogs in particular can reduce stress, anxiety, and depression, ease loneliness, encourage exercise and playfulness, and even improve your cardiovascular health. 

 

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  • One study even found that when people with borderline hypertension adopted dogs from a shelter, their blood pressure declined significantly within five months.

 

  • People with dogs have lower blood pressure in stressful situations than those without pets. 

 

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  • More than any other animal, dogs have evolved to become acutely attuned to humans and our behavior and emotions.

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  • While dogs are able to understand many of the words we use, they’re even better at interpreting our tone of voice, body language, and gestures.

 

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  • And like any good human friend, a loyal dog will look into your eyes to gauge your emotional state and try to understand what you’re thinking and feeling.

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  • Stroking, hugging, or otherwise touching a loving animal can rapidly calm and soothe us when we’re stressed or anxious.

 

 

  • Playing with a dog or cat can elevate levels of serotonin and dopamine, which calm and relax.

 

 

  • One of the reasons for these therapeutic effects is that dogs (and cats) fulfill the basic human need to touch.

 

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  • Taking a dog for a walk, hike, or run are fun and rewarding ways to fit healthy daily exercise into your schedule.

 

 

  • Studies have shown that dog owners are far more likely to meet their daily exercise requirements

 

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  • And exercising every day is great for the animal as well. It will deepen the connection between you, eradicate most behavior problems in dogs, and keep your pet fit and healthy.

 

 

 

Feldenkrais for Fitness

 

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Last January (just before my mom’s stroke) I bought Bruce Holmes’ cd called The Feldenkrais Lessons: Awareness Through Movement.  I was looking for something different from my regular exercise routine. Back then, I had no idea how crucial Feldenkrais would become– not only for me and my own well being–but also for my mother, Alberta, and her stroke recovery.

 

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The Feldenkrais Method of Somatic Education (from https://www.feldenkrais.com):

  • The Feldenkrais Method® is a form of somatic education that uses gentle movement and directed attention to improve movement and enhance human functioning. Through this Method, you can increase your ease and range of motion, improve your flexibility and coordination, and rediscover your innate capacity for graceful, efficient movement. These improvements will often generalize to enhance functioning in other aspects of your life.
  • The Feldenkrais Method is based on principles of physics, biomechanics and an empirical understanding of learning and human development. By expanding the self-image through movement sequences that bring attention to the parts of the self that are out of awareness, the Method enables you to include more of yourself in your functioning movements. 

 

 

Take a moment to participate in this short lesson to try Feldenkrais for yourself.

 

 

After I read Dr. Moshe Feldenkrais’ book, Body Awareness as Healing Therapy: The Case of Nora, I knew for sure that my mom could also benefit from Feldenkrais.  In the book, Dr. Feldenkrais describes his work with Nora– a woman who suffered a massive stroke and lost her neuromuscular coordination, including the ability to read and write.

 

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Thanks to the internet, I found a Feldenkrais practitioner, Chrish Kresge (https://www.chrishkresge.com) to help my mom.

 

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Chrish teaches my mother crucial strategies for improved awareness.

 

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With Feldenkrais my mother is also learning how to overcome obstacles more effectively  with less strain on her body.

 

 

Chrish has been fundamental in helping my mother regain her balance and independence.

 

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Working Again (Repurposed)

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According to http://www.takingcharge.csh.umn.edu/enhance-your-wellbeing/purpose/life-purpose/why-life-purpose-important:

  • One of the common features among people who live with a purpose is that they are able to find meaning in the things that happen to them. Andrew Zolli, author of Resilience, describes these people as being able to “cog­ni­tively reap­praise sit­u­a­tions and reg­u­late emo­tions, turn­ing life’s prover­bial lemons into lemon­ade.”

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Back when my mother, Alberta, was in rehab, I arranged for her to have a phone consultation with Dr. Steven D. Farmer (http://www.earthmagic.net).  Dr. Farmer is a spiritual healer, psychotherapist (retired) and shaman.  My mother has no interest in anything esoteric, woo-woo or  otherworldly.  But as a former psychotherapist, I knew Dr. Farmer would know how to speak to my mother in a way that would be both  encouraging and therapeutic. I also knew that his shamanic abilities could reach those esoteric parts of my mother that needed healing and support.

Dr. Farmer talked to my mother about  her purpose– her role with her patients and her family.  It was a very helpful and much needed conversation.

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  Dr. Victor J. Stretcher, author of the book “On Purpose” states

  • When you see the data about the elderly who have little or no purpose in life, and how quickly they get sick and die, you realize how important it is for an elderly person to repurpose their life toward something bigger than themselves.

Although, I had referred most of my mom’s patients to other child psychiatrists or pediatricians–a handful of parents kept calling, sending cards –asking when they could  make an appointment.

I don’t think my mother anticipated how  going back to work would affect her.  Her patients have given her a huge gift.  Because of them–she has not only repurposed herself but she has also reclaimed her self esteem.

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Getting to Know You

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My dad was mischievous.  Even when he was seriously ill and in treatment for non-Hodgkin’s lymphoma–he was mischievous.  My twin sister and I used to take him to chemo and radiation therapy–daily.  It was a difficult time, but in hindsight it was also a great time because we got a chance to get to know each other–differently.

 

 

I remember once driving my dad home from the grocery store– I had the radio on and was listening to Bon Jovi.  My dad turned to me and said, “I didn’t know you liked this kind of music.  There’s so much I don’t know about you.”

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Later, when we got back the house, my dad started to make an elaborate  lunch.  My dad loved to cook.  He then set the table for 4 instead of 3.  “Someone  else joining us?” I asked. “Oh.  Just a friend I met… who speaks Italian.”  At that time, I was obsessed with everything Italian. I had even learned to speak Italian  in college.  So, of course, I was excited.  I started thinking about the fabulous possibilities of this mystery guest.  “I’m gonna be the next Mrs. Ferragamo or  Mrs. Gucci,” I thought to myself as I planned an elegant, yet simple wedding.

 

 

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Then the doorbell rang.  It was my dad’s new friend–an elderly,  Ethiopian man.  My dad introduced him as Mr. Wollo.  “This is odd,” I mumbled.  My twin sister, Akwelle, giggled. We all sat down for lunch.  My dad then told this old, odd man, Mr. Wollo, all about me and my interests.  “She looooves speaking Italian.  She loves to cook.  She loves to paint. She loves photography. Why don’t you say something in Italian, Koko?” my dad said to me  as he opened his eyes up super  wide.  I growled something incomprehensible, even to me.  Then I stormed from the table and ran up to my room and devoured a party size bag of plain M&M’s.

 

 

By the time I went back downstairs, lunch was over.  Mr. Wollo was long gone. Then I yelled at my father, “What was your plan here with this crazy lunch!? Have you lost your mind?  Mr. Wollo is even older than you … and… he’s… hideous!”

 

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My dad was laughing loudly by this point.  Coughing even. “You take things too seriously. Your temper tantrum was priceless, though. It was all a joke. No big deal. But if you change your mind, I am sure Mr. Wollo is free tomorrow,” my dad said as he continued laughing his biggest laugh.  I was too upset to appreciate the humor.

 

 

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Late last night, when I was helping my mother get to the bathroom (for the 4th time), she suddenly started laughing.  She was walking very, very slowly and said, “I’m a comin’.  I’m a comin’.  I might be a little slow and the coffee might be cold when I get there, but I’m a comin’.”  Then she really started laughing, coughing even–with tears in her eyes.   By this point, she was pretending to hold up a cup of coffee as she moseyed along in her fuzzy, pink, skid-proof socks.  We were both laughing!

 

 

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I mention all of this really as a reminder to myself that even in difficult times–there’s still always something to laugh about.  I am able to appreciate that now.  Ultimately, this whole experience– with my mom’s stroke and recovery– is a chance for us to get to know each other–differently, and to keep laughing.

 

 

Marching Orders

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My mother, Alberta,  likes having a schedule. Before her stroke, her life was highly routinized. She was always up by 5:30 a.m.–at the office by 7:30–home by 3:30–dinner was by  4:00– and at 4:30 she was always watching  Judge Judy.  Her nightly  bath was at 6:00  and she was in bed by 7:00 p.m.

 

 

Once our mom left the inpatient rehab facility, she soon started outpatient rehab 3-4 times a week.  This routine of physical therapy, occupational therapy and speech therapy was grueling– but our mother needed something to do.

 

 

 

 

I appreciated speech therapy the most. The speech pathologist  was the first (and only) person who explained the nature of our mom’s stroke to us.

 

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Frontal Lobe – Front part of the brain; involved in planning, organizing, problem solving, selective attention, personality and a variety of “higher cognitive functions” including behavior and emotions. 

The speech pathologist informed us that the area of the brain where our mom had her stroke (frontal lobe) governs sequence, organization and memory. She explained that speech is more than just verbal ability. It is all about how we see ourselves in space. It was the first time anyone mentioned how the brain damage from the stroke affected how our mom perceives and misperceives herself and others in the world around her. As a result of the stroke, our mom is much more impulsive and restless.  And she has no filter for her thoughts. If she thinks the food you made is bad, she will not sugar coat it. She tells it like (she thinks) it is.

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The speech pathologist, however, gave us tools and cognitive exercises to kick-start our mom’s brain back into appropriate action. We were also encouraged  to get a (paper) calendar so that our mother could anticipate her daily schedule and routine.

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The speech pathologist explained that we all need awareness (a sense of ourselves in time and space) to effectively function in the world.

 

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When our mom first started outpatient rehab she was in a wheelchair and was using a right sided hemi-walker to stand up, sit down and shuffle from place to place.  Midway through rehab, our mom started using a 4 pronged cane to walk.  We were also told to “ditch the wheelchair.”

 

When outpatient rehab (4 months) was over, the discharge advice was:  Keep walking. Walking boosts brain function.

 

In Search of an Acupuncturist

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David Crow’s “In Search of the Medicine Buddha” is one of my favorite books.  It’s about an acupuncturist, David Crow, who leaves his acupuncture practice in San Francisco to study Tibetan healing practices in Nepal.

 

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When my mom first had her stroke, I knew acupuncture could help her.  The problem was finding an acupuncturist who made house calls.  When I found one who did–the next problem was convincing the nursing home/ rehab facility of the value of such a service. Long story short, they were not convinced.  The medical staff would not even allow our mother to leave the facility for acupuncture treatment. My sisters and I had to wait (3 months) until our mom was home before she could be treated by the acupuncturist.

 

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When the acupuncturist, Matt Brookman (http://www.brookmanacupuncture.com), first came to our house, he asked our mom about her concerns.  Our mom said she was “miserable” and wanted to feel better.  She was in a lot of physical pain and was mentally drained. The main concerns my sisters and I had centered around our mother’s emotional state–plus her insomnia, excessive night time urination and anxiety. The acupuncturist  evaluated our mom by looking at her tongue and checking her various pulses.  The acupuncturist then explained that the meridians of the body he would be working on for stroke recovery are the same meridian points  that affect emotional balance.  A win-win for us!

 

 

According to The Academy of Classical Oriental Sciences (www.acos.org):

  • A meridian is an ‘energy highway’ in the human body. Qi (chee) energy flows through this meridian or energy highway, accessing all party of the body. Meridians can be mapped throughout the body; they flow within the body and not on the surface, meridians exist in corresponding pairs and each meridian has many acupuncture points along its path.
  • The term ‘meridian’ describes the overall energy distribution system of Chinese Medicine and helps us to understand how basic substances of the body (Qi, blood and body fluids) permeate the whole body. The individual meridians themselves are often described as ‘channels’ or even ‘vessels’ which reflects the notion of carrying, holding, or transporting qi, blood and body fluids around the body.
  • Practitioners of Chinese Medicine must be as knowledgeable about these meridian channels as the Western Doctor is about anatomy and physiology of the physical body. Without this thorough understanding, successful acupuncture treatments would be difficult. A practitioner of Chinese Medicine must know how and where to access the qi energy of the body to facilitate the healing process.

 

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Matt, the acupuncturist, also prescribed  Chinese Herbal Medicine for our mother. Matt ordered the herbs for us.

 

 

Our job was to cook the herbs in water and give them to our mother in the form of a tea twice a day.

 

 

Matt’s acupuncture treatments along with his prescribed medicinal tea have proven to be crucial components in our mother’s recovery.   And Kookaburra is happy because she finally has a new boyfriend!

 

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First Night Jitters

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Once we got home, my sisters and I had to figure out how to get our mom out of the car, down a few steps, onto the walkway  and into the house– in a wheelchair.  At this point our mom was unable to maneuver steps well.  The therapists at the rehab facility told us to remember, “right foot up, left foot down.”

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But the rain made walking more complicated.  We had to figure out another way. For some reason we thought carrying our mom in the wheelchair was the easiest option to get from A to B.  It was a clumsy mess.  But– finally we got her to the front door and eventually into the house.

 

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Once inside, our mother was in a state of total disbelief.  It was like she was returning from war or prison.  We were  prepared for the little things like getting rid of the floor rugs and making sure we had plenty of pull-up diapers and wipes and even a bath lift and shower chair. But we were miserably ill prepared for the emotional aspect of our mother’s return. We were each experiencing a sort of PTSD.

 

 

I kept waiting for my own emotional meltdown.  I busied myself by spending time with Kookaburra.

 

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The therapists warned us against installing a stair lift to get our mom from the first floor to the second floor.  They said stair lifts promote laziness. Instead they suggested bumping up the stairs.  That first night–it took us two hours to bump our mom up those fourteen steps. We were all exhausted.

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My sisters and I divided our time with our mother– giving each other breaks to avoid burnout.  I chose the night shift.  I crazily thought this would be easy.  That first night was easy.  Our mom slept like a baby.

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A Change of Plans (Leaving Rehab)

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My mother was hospitalized for the second time in rehab due to extreme stomach pains. She had stopped eating and lost a lot of weight.

 

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By this point, she was no longer taking Lisinopril (high blood pressure medication). Her blood pressure had actually  normalized thanks to an Ayurvedic home remedy–a cup of hot water with a teaspoon of honey and 5-10 drops of apple cider vinegar each morning before breakfast.  But she was still taking Aggrenox (a blood thinner) and Lipitor (for cholesterol-even though she did not have a cholesterol problem).

 

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Initially, the Emergency Room doctors thought our mom’s stomach pain was due to gallstones. The scans, however, showed no gallstones. Nevertheless, they still wanted to do  exploratory surgery to make sure. The surgeon in charge said she did not feel comfortable operating on someone who was already compromised by stroke.  She said her gut instinct was that our mom was having a poor reaction to the Lipitor.  The surgeon was very concerned about our mom’s elevated liver enzymes.  She immediately discontinued the Lipitor believing this medication was causing  the problem.  The surgeon explained that  Aggrenox is often paired with Lipitor because (for some stroke patients) these drugs work synergistically– even if there are no cholesterol issues. However, she said, “Not all drugs are effective for all people. Some can do more harm than good.”

 

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One day after the Lipitor was discontinued, our mother started eating again.  She was then able to go back to the rehab/nursing home.

 

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Although our mom was eating– by this point she had completely given  up on her physical therapy.  She even resorted to falling asleep in the PT gym.   She was becoming increasingly more despondent and depressed– repeating over and over that she would never get better. The therapists kindly explained to her that recovery takes time.  My mom’s Occupational Therapist even gave her a pep talk for encouragement. She responded by telling him that we (her daughters) had abandoned her.

 

 

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After 3 months in the nursing home, our mother was an emotional wreck.  She could be laughing  one moment, then suddenly  crying the next. She was confused and disoriented. She even said she wanted to die.  She also spent hours perseverating on nonsensical themes.

 

 

 

I was afraid our mother would not survive another week  in inpatient care.  Her initial plan was to stay in rehab “until I can walk,” she said.  But we needed to change plans.

 

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It was time to bring her home. The social worker at the facility then started the 3 day discharge process.  The social worker  arranged for continued outpatient speech therapy, occupational therapy and physical therapy at a different facility.

 

 

 

On a rainy day in late April, my sisters and I  nervously brought our mother home.

 

 

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A Sort of Déjà vu

 

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My mother, Alberta, arrived at her new inpatient rehab/ nursing home by ambulance. She  had only one bag carrying three medications (Aggrenox, Lipitor and Lisinopril) from the hospital with her.  She was wearing a hospital gown, socks and pull-up style diapers.  My mother had grown so weak and frail during her  hospital stay that she had completely given up on any attempt at  using a toilet. This is when her nearly 9 month dependency on diapers started.

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My mother was hospitalized twice while in the nursing home.  Once was for a Urinary Tract Infection.  I later learned that “most of the residents get UTIs because they wear diapers.” The time when my mom got a UTI was when she was left in her urine soaked and waste laden diaper until morning.  The night staff  was mostly interested in sleeping, not working.  Although my mom called for help with the call button, no one came. Unfortunately, the night staff was also not well educated about the different needs of the different residents.   A more effective approach would be to train the staff about what it means to have stroke.  Or what it means to have Parkinson’s. Or what is means to have Dementia.  Regardless of the condition of the residents, the true missing component of the night staff was compassion.

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The daytime nursing staff at the facility was great.  They were always busy–but for the most part–they were kind, caring and attentive. My sisters and I practically lived there.  The daytime nursing staff even knew our schedules.  My older sister Aellyn was there from the early morning hours until about 9:45 am when my twin sister and I would arrive.  At around noon,  my twin sister and I would leave the facility, go to the office (and mostly refer patients to other psychiatrists).  Then we’d go home for lunch, walk Kookaburra and then return to the nursing home and stay until dinner when our older sister would come back and stay until it was time for our mother to go to sleep at around 8:00 p.m.

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My mother had daily Physical Therapy, Occupational Therapy and Speech Therapy.   My mother appreciated all of her therapists.   But she particularly adored her Speech Therapist and her Occupational Therapist.

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From the moment I saw my mom’s Occupational Therapist I had a strong feeling that I knew him.  It was  an unusual experience– but not an unfamiliar one for me.  I had a feeling like this once before when I got extended eye contact with Ricky Martin.  Yep, that Ricky Martin! It may sound odd, but I think different realities/past lives must sometimes overlap and something like a bleed through happens.  Did I seem familiar to my mom’s Occupational Therapist?  We’ll never know for sure.  But one time, it kind of seemed like maybe, perhaps he did remember our romance in 4th century China.  He was assisting me and my twin sister in the bathroom with our mother when suddenly our mom was about to fall over on me.  I stabilized my mom. Then I noticed hands around my waist and a thumb gently caressing and stroking my back.  It was the Occupational Therapist!  I turned around– he  was intensely blushing and his beard was all fluffy.  When I later told my twin sister, she said, the Occupational Therapist was just acting and reacting from “plain animal instinct.  Nothing more.”