Hi Daniela,
Hope for the best for u and your dad. Just going by your description, I am
infering that your dad has hemianopsia (most likely bi-temporal as he can
only see things right in front of him- I am guessing the bi-nasal
hemispheric fields are intact). You could check if both the upper and lower
quadrants in temporal fields are affected. Depending upon the occipital
lobe/ optic chiasma involvement and recovery it would be advisable to wait
and see, what he recovers. I have seen patients that have had visual field
defects, and have seen recoveries as well. You may compensate by positioning
reading materials right in his field of vision. It is possible that along
with his field, he probably has difficulty with depth/ figure-ground as
well. Seems that his acuity is affected as well (if he needs things right in
front of him). Also, seems that physically he is recovering alright with
movements returning ('numbness' may be because of decreased proprioception/
kinesthesia- weight bearing for proceptive feedback may help/ note tone
complications if any). Ask your neurologist, may be a repeat CT scan could
be compared with the results of the original to see if the bleed/clot in the
occipital region is resolving itself. Remember, god is the best healer. Best
wishes.
Joe
----- Original Message -----
From: "cybs" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Saturday, March 22, 2003 2:03 PM
Subject: Re: Please help my dad
> Hi Daniela!
>
> So sorry to hear about what happened! And yes - it's so
> difficult to be both professionally and privately involved - I
> do understand why you wrote "being his daughter I don't feel
> i should assess him".
>
> I didn't know about fresnel prisms, but have now researced a
> bit - and I'm afraid they're not going to help him with either
> reading or driving. What they are adressing is seeing depth
> and perspective, that is, helping the eyes to work together.
> Driving without having full visual field would still be very
> dangerous IMO (imagine a child running out in the street from
> the side of the road - the narrower your visual field the later
> you'll see him). Also - reading requires only one eye - so if
> he's not able to read now with one of his eyes covered, better
> eye cooperation is not going to help him, I'm afraid.
>
> For help from abroad, though, I do know that there's something
> going on re: cooperation between my country and yours about
> OT and other kind of help for disabled children - maybe also
> adults? I think the place to contact about this is an institution
> for disabled children in Gozo - don't know it's name, but I think
> there's only one of it's kind?
>
> Best wishes for you and your father!
>
> susanne, denmark
>
> ----- Original Message -----
> From: "Daniela S. Apap" <[EMAIL PROTECTED]>
> To: <[EMAIL PROTECTED]>
> Sent: Saturday, March 22, 2003 9:38 AM
> Subject: Please help my dad
>
>
> Dear all,
>
> I'm a 4th year OT student from Malta. In the past two weeks my dad (57
> years old) has had three strokes. The first two have affected his
> occipital lobe and now his visual field is really limited and he can
> only see what is directly in front of him. He has also said that he
> cannot recognise written letters but is able to write. I suspect he
> might have alexia without agraphia but being his daughter I don't feel i
> should assess him as when I started asking him questions he got very
> worried and kept on asking me why I was asking such questions. The
> third stroke, which happened last Thursday, was not yet visible on
> Thursday's CT scan so I don't know what happened exactly. At first the
> right half of his body was numb and very weak but in a matter of hours
> he regained movement in his upper and lower limb and now is complaining
> that half his face his numb and that his fingers are not back to normal
> (but he is able to move them).
>
> On my phys. dysfunction book (Trombly 4th edition) fresnel prisms were
> described as being of use in visual field probs. resulting from stroke,
> however, these prisms or any other kind of prisms having the same
> function are not available in Malta. I've asked OTs, opthalmologists,
> doctors... and no one has ever seen anything of the sort. Yesterday I
> managed to contact a neurologist and she said that last November one of
> her clients with a similar visual field prob. to my dad's went to
> America to get special spectacles with prisms done. She said his life
> has improved drastically since. She told me I should wait at least 6 -
> 18 months before we start thinking about getting something of the sort
> done for dad to see how much he improves. However, I think that he does
> need something (at least something cheaper and provisional) at this
> stage. 18 months is such a long wait.
>
> Do you have any information about these prisms? America is definitely
> too far away (Malta is in the middle of the Mediterranean Sea), is there
> anywhere in Europe where we could get these prisms? Did you have any
> clients who went back to driving or to work with the help of these
> prisms?
>
> My book also mentioned 'stimulation' to improve the visual field,
> however, there is no description of what kind of 'stimulation' is done.
> Do you know what kind of stimulation is required and how it is done?
>
> As regards the fact that he cannot read as he is not able to recognise
> letters what can I do? My dad has been a teacher for almost 30 years, an
> assistant headmaster for about for years and he is an Education Officer
> now. He is in charge of the finances of all primary and secondary
> schools in Malta so the fact that he cannot read has been such a hard
> blow on him. If things don't improve he'll have to leave work, won't be
> able to drive, and give up on his greatest hobbies - reading and
> woodwork.
>
> Please help!!! I'm so worried that I cannot figure out how I can help!
> So many things have happened in the past two weeks.
>
> I can't concentrate on my course work. I was meant to finish my thesis
> and start preparing for my final exams but I can't even start the
> Discussion Chapter because I can't think and I have been practically
> living in hospital for the past two weeks. The same day my dad got his
> first stroke two weeks ago, my tutor (of my thesis) had a terrible
> accident which left her with a spinal cord injury (complete transection
> T12 - L1). She's a great friend and a great OT too - the only one in
> Malta who had an M.Sc. in Neurorehab. Please pray for us.
>
> Thanks for reading this email, I would really appreciate your help,
>
> Daniela Sarah Apap
>
> 39, 'Lyall',
> St. George Street,
> Naxxar NXR 03,
> MALTA
>
> email - [EMAIL PROTECTED]
>
>
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