Size Matters…

There’s been a lot of chatter lately on the therapists’ email forum about vectograms; the do’s, the don’t’s, the how’s and why’s.  I’ve written many times of my affection for the activity, and it always gives me an ounce or two of excitement to learn something new from those seeking new paths to success with an activity which I’ve grown rather fond of, in particular when it’s other therapists seeking the knowledge.  Vectograms can be challenging to both patient and therapist alike. The geometry alone, that is understanding the changing dynamics which occur with variable working distances and available background opportunities, can be a fairly steep mountain to climb. If there’s one thing I’ve learned though, mostly through trial and error, its sometimes it’s best to just keep asking questions and things will come to pass – eventually.

One population with whom my spirit has definitely become fond is those who have suffered a brain injury. Having had a mild head injury myself way back when, some of the symptoms patients discuss are similar to challenges once faced through my eyes.  Luckily my recovery was relatively mild, and with the exception of some minor difficulties which may or may not have occurred anyway, my life continued unscathed. All things considered, I definitely consider myself among the lucky. Part of my path in helping these wonderful people are introducing them to, and walking them through vectograms, slowly.  Today marked yet another amazing moment with a patient who continues to clear his thoughts and visually reorganize his world with the help of these silly plastic sliding cards.

My friend “Craig”, who is a self proclaimed “gear head”, made a career out of delivering tools to automotive shops and discussing the latest restoration project to take up his carport near the side of his house.  According to Craig’s wife, his carport is really a shed with a tarp nailed to it, but Craig refers to it as a carport so we’re going with it. Now nearing his mid 60’s, his pride and joy is a 1959 Cadillac which has been driven less than 30,000 Miles, which he inherited from his grandmother in 1985. Together, this man and his toy have been in car shows from coast to coast, Craig via airplane and the Cadillac on the back of a trailer.  Craig also has an affection for Harley Davidson motorcycles.  Old photos he shared of himself and his wife on a Harley back when they were dating are something special.  About 18 months ago, Craig was rear-ended at high speed while riding his motorcycle down a main road here in Austin.  Aside from multiple broken bones, gashes, and abrasions, his head bounced off the pavement many times as his near lifeless body rolled to a stop. His wife, who was riding her motorcycle too, was not far behind when the accident occurred and witnessed the entire thing.  She has a hard time discussing things without becoming emotional, so I don’t push, but she has told me when Craig was airlifted to the emergency room, doctors told her Craig was near death but there were two factors in his favor: he was wearing a helmet and his wife was a nurse. She was by his side almost instantly after the accident and knew the measures needed to save him until help arrived. Take away either one of those factors and Craig would not have survived. Craig has shared photos of himself in the hospital which apparently were taken the next morning. Due to the gore factor I’m not including them in this post, but believe me when I report he was unrecognizable.

Craig’s vision therapy program has been challenging. He has a tough time with balance, walks with a cane, his memory is unreliable, and his problem solving skills are weak, to say the least.  Craig has told me many times of the day after his accident he tried to change a tail light bulb in his beloved Cadillac. In the “old days” it would have taken his 10 minutes.  On his last attempt, he removed 22 screws from the car and the tail light wasn’t even lose. Luckily, his brother lives nearby and shares the affection for old cars, and assisted with completing the project.

In treating his vertical imbalance and propensity for cyclo-rotation, one activity we rely heavily on is the vectograms.  It often makes Craig feel nauseous, but he is determined, nonetheless.  His perspective in single and clear with the activity some days, and other days he reports it looking like “a big mess”. Having been down this path before with other patients who suffered head injuries, my experience tells me the key with Craig is to go slow, and listen to what he’s not saying as much as what he is saying. It’s a tough gig for both of us, but we have learned to appreciate each other’s patience for the process, which makes it fun. As we progressed through the Spirangle today, Craig verbalized, for the first time, an awareness of the changing aspect ratio as the cards move. After giggling through a few locker room style “size matters” quips, Craig went on for several moments reporting how both the size and the depth were changing as the cards slid. He was amazed at his newly discovered awareness, as it seemed to open all sorts of new doors in his visual processing world.

As he was leaving, Craig stopped at our front desk to report to our lovely and well-mannered receptionist he had solved man’s greatest mystery. When she inquired as to what he meant, Craig, in his most profound, jovial, unfiltered, booming, stentorian voice reported…

“Size really does matter. Make sure to go home and tell your husband…”.

Craig’s wife hurried him out of the office.

I almost pee’d my pants.