Archive for the ‘Parkinson’s Disease & My Chinese Father’ Category

Blog Post 3 of 3 “Papa Makes Decision While In Nursing Home Again” by Teresa Jade LeYung

As writing coach and theme consultant Teresa Jade LeYung, I ask my clients: “What does your main character want?”

Sometimes, the client’s response is: “I’m  not sure.”  Other times, the reply is: “Nothing.”

If the protagonist in a story wants nothing, then, what is the story?

There is always something!  Could it be that your Hero cannot accept what is happening to her/him?  Does he/she want life the way it was, not the way it is?

That is my father’s dilemma. He has lost control over his day-to-day activities. Ever since the hospitalization for Aspiration Pneumonia and urinary tract infection in July 2018. Ever since he could no longer live by himself.

No more going to the hallway or balcony with his walker to exercise or taking the elevator to go to the mailroom whenever he wants to. No more watching his Cantonese television programs with his girlfriend who lives in the building. No more telling his caregiver to stop by the grocery store and bring him a particular fruit or a Chinese pastry he is craving.  No more quarterly appointments with his UCSF neurologist or UCSF hi-tech physical therapy for movement-disorder.  What irony – the appointments he had labeled “unnecessary” and “there’s nothing wrong with me” are now out of reach and “Why can’t I go?”

When nursing home staff members ask him “Do you want anything? Do you need anything?” he raises his left hand to gesture “No” and smiles.

When I am with him, occasionally he will tell me in Cantonese: “I don’t want to stay here.” (I think to myself Oh, Papa, of course. You were independent, in spite of Parkinson’s Disease, in your studio apartment.  Aspiration Pneumonia and urinary tract infection created your decline and now you are in a nursing home, in a room with 2 other residents, no furniture of your own. I am sad for you. But, I know that you are safe and well cared for by dedicated staff.  You are a lucky guy.)

I do not lie to him. I say: “This is your home now. Nurses and CNAs take excellent care of you. You are safe here. You have friends here. If you exercise and get strong to the point that you can live on your own again, then, I will help you find another one.”  I reinforce my words by taking out a green exercise band from the top drawer of the nightstand.

I had bought the green band when I was getting physical therapy for my plantar fasciitis. Last month, I found the band, and used a thick permanent marker to write my father’s name on it.  [ If you don't put your name, room and bed number on an item, that item is likely to disappear.  Even if everything were labeled, staff and residents would still experience "missing items."]

Papa is in good hands with the nursing home staff. And, since November, he’s been receiving visits from a nurse, a chaplain and a social worker from Hospice By The Bay.  Also, he gets visits from former caregivers (with help from my sister, I can afford to pay them to visit), his daughter-in-law, his grandson, his girlfriend, a few other people, and me (his representative and advocate).

Who else feels loss of control?  Me.  When I see Papa not practicing safe eating behavior.

What is safe?

- Papa sits upright and is fully awake (should not be putting food or drink into his mouth if he is slouching or sleepy).

- Eat slowly.  He uses a teaspoon to put food or thickened liquid into mouth.  Chew.  Swallow. Swallow again.  Say “AAH” twice.  If you don’t hear a clear AAH, that means food/drink has not cleared past the throat.

-  Do NOT tilt head backward when swallowing (head-tilting increases risk of choking and aspiration)

Oh, how I get exasperated when I find out that someone gave him food that hasn’t been pureed by dietician or liquid that hasn’t been properly thickened by his nurse.  Last month, two other residents gave him something to chew (Chinese chew); the nurses explained to the two nice people that my father cannot just chew, that he has a swallowing problem, that he could accidentally swallow the food. The residents don’t understand that another episode of aspiration-pneumonia could be fatal. They can’t empathize.

That’s another question I ask my writing-clients – “Which characters are sympathized and which ones are empathized by your narrator?

I am indeed grateful that my father likes the staff at the nursing home, and the meals served to him, and that he gets to walk with his walker about 5 times a week with the CNAs who are especially trained.  I am indeed grateful to everyone in his life and mine.

HAPPY LUNAR NEW YEAR 2019!

I wish everyone safety, abundant joy, and excellent health.

Sincerely,

Teresa Jade LeYung

 Teresa Jade LeYung – founder of Love Made of Heart (aka Teresa LeYung-Ryan) says: “When I’m in Paris, I know I have come home.”  Teresa speaks openly through her writing and advocacy, her immigrant experience, and her knowing beauty.  As author, publisher, theme consultant, and a found-object artist, she empowers women to transform dreams into lifestyle. http://lovemadeofheart.com/blog

The following blog post (number 2 of 3 in this series) was written during the latter half of September 2018 and I am just now publishing it today January 7, 2019.

In my August 7, 2018 Blog Post entitled: Papa Makes Decision “Where Do I Go Now?”  After Hospitalization. While In Skilled Nursing Rehab … I had  declared that I (Teresa Jade LeYung) was writing to you not as a novelist, theme consultant or found-object artist but as a memoirist, older daughter of Mr. Leung. Well, I was wrong.  All my note-taking, reporting and advocacy skills are fueled by all my roles, including being a story/theme consultant, writing coach, and lover of cohesive scripts.

Story Question:   Will my father lose his Medi-Cal Bed in the nursing home?

Setting of this scene:

First floor of this establishment is mainly reserved for “patients” who have been referred by physicians to receive post-acute care after hospitalization. The first floor is where you’ll find the Skilled Nursing Facility staff (short-term care covered by Medicare); first floor is also where you’ll find the Rehab staff, the friendly faces at the reception area/front desk, and the offices of Director of Nursing and the Administrator.

The second and third floors are strictly for “residents” (receiving long-term care – some are private pay, others through Medi-Cal) and other administrative offices including Social Services.

Basement floor you’ll find Business Office, Maintenance, Food Service, Laundry Service, and staff lounge.

So, what happened after August 7, 2018?

Papa had difficulty living as a “resident” in one room with 2 roommates. His space included the hospital bed, a  20-inch by 24-inch bulletin board on the wall, an aisle wide enough for wheelchair, a nightstand  (for grooming and bathing paraphernalia), and a closet the size of a school locker.

On September  7, 2018, Nurse D. had called me that morning, telling me that my father had a fever of 105 degrees, that staff brought it down to 101.5, that they were sending him back to UCSF Hospital.

UCSF ER team reported to me that my father had another urinary tract infection – that explained the fever.  And, they saw a pressure ulcer in my father’s inner thigh, near the groin.  But why couldn’t he raise his right arm?  The team had a difficult time communicating with him because …  1) Parkinson’s Disease had impaired his speech  2) English is not his primary language  3) Later, they would find out that he had a stroke in the Pons part of his brain.

One long week in the 5-star Adult Acute Care Unit at UCSF.  Already burdened with Parkinson’s (swallowing difficulty) and now with a new stroke, my father was getting his medicine and nutrients through a tube that was inserted into his right nostril and lowered into his stomach.

A nurse checked on him every hour (including the hours between midnight and seven in the morning); every two hours the nurse and a PCA (patient care assistant) would “reposition” him so that he would not develop more pressure ulcers and bed sores.

I slept on the bed (big chair pulls out into a single-sized mattress) on two occasions.

* the first night after he was admitted, and

* the night he looked at me with moist eyes and whispered in Cantonese: “Don’t leave me.”

The attending physician (who was young, wise and gentle) called a family meeting.  In Papa’s room were my father, the doctor, a Cantonese-speaking interpreter, my husband and me.  The doctor reiterated what Papa was being treated for. Then the doctor said: “Mr. Leung. There is another matter. Do you want me to tell you?” Mr. father nodded yes.

“In the CT-Scan for the urinary tract infection, we saw masses in your kidney. In order to know if it is cancer, we would need to operate.  Based on your age, your current health . . . ” Papa had already closed his eyes (he does that whenever he doesn’t want to hear what is being said).  The doctor asked: “What do you want, Mr. Leung?” Papa did respond in slurred speech, repeatedly: “I do not want to return to the hospital ever again.”

Then the doctor explained to him that the tube could not be a permanent solution, that it would be used for an additional 4 weeks only (to deliver medicine), and, that he would be given food (pureed) by someone hand-feeding him.  The day before discharge, nurse-on-duty taught me how to safely feed someone who has Dysphagia.

Two major concerns -  Aspiration Pneumonia Risk and Fall Risk

1.  Dysphagia is a swallowing disorder.  Dysphagia can lead to malnutrition, aspiration, and pneumonia. For swallowing-safety . . .

- Papa sits upright and is fully awake (do not put food or drink into his mouth if he is slouching or sleepy).

- Eat slowly.  Use teaspoon to put food or thickened liquid into mouth.  Chew.  Swallow. Swallow again.  Say “AAH” twice.  If you don’t hear a clear AAH, that means food/drink has not cleared past the throat.

2. Because he is a fall-risk patient and prone to get pressure ulcers, transferring from bed to chair and vice versa requires the presence of two PCAs (Patient Care Assistants); so does repositioning him in bed.

September 13, 2018 when UCSF doctor informed me that they would discharge Papa the following day (Sept 14) , I requested that they discharge him on September 15.  I pointed out: “My father had not eaten any food by mouth.  You tell me that tonight is when a nurse will hand-feed him. Please let him have at least one full day experiencing being fed by another person.”

Here we go again!  Facts: Skilled Nursing IS post-acute care (short-term care) and IS covered by Medicare.  After Skilled Nursing discharges Papa, he would be returned to long-term care; long-term care is NOT covered  by Medicare.

Medi-Cal can hold a bed for a resident up to 7 days only. What should I do?

I talked to the case manager at the hospital; I talked to the director of social services at the facilities where Papa came from right before they sent him to the hospital; I talked to friends who had resources for me.

Then I asked myself this question:

What does Papa need right now?  Not next week, not next month . . . what does he need today and the next few weeks?

Answer:  Papa needs transition – a bed where he would receive get post-acute care – where he would receive rehabilitation.  Give up his long-term bed for now?  YES! 

If Papa is sent back to the third floor (where he was as a “resident”), even though, according to hospital discharge papers, he is supposed to receive post-acute care, how would that be possible at the facility where post-acute care is on the first floor? How would they be able to send 3 shifts of nurse and .CNA to the third floor for just one patient (my father)?

September 16, 2018 Where is Papa now? 

On the first floor of the nursing home – the Skilled Nursing Facility floor, receiving excellent care from saintly nurses and angelic CNAs and wondrous rehabilitation from the super team of physical therapists, occupational atherapists, and speech/swallowing therapist as well as Activities team. The folks who are in all the other departments also make this facility remarkable. After Papa completes rehab, he will be bounced back to resident-status.

And, I give thanks to the building, standing 3-story tall (4 stories when counting the basement level). Oh, if this building could talk! How many patients, residents, and employees has she housed over the decades?

I will publish blog post #3 of 3 of this series soon.

I wish everyone safety, excellent health and abundant joy.

Sincerely,

Teresa Jade LeYung

Teresa Jade LeYung – founder of Love Made of Heart (aka Teresa LeYung-Ryan) speaks openly through her writing and advocacy, her immigrant experience, and her knowing beauty.  As an author, a story consultant, and a found-object artist, she empowers women to transform their own stories and is often quoted as saying: “You think beauty,  You are beauty.”

August 7, 2018

Dear Readers,

I (Teresa Jade LeYung) write to you not as a novelist, theme consultant or found-object artist but as a memoirist, daughter of Mr. Leung, and a witness to joy and despair and a whole lot of kindness.

Papa was doing fine, as fine as a 84-year-old fellow with Parkinson’s Disease (and Diabetes and hypertension) could do. Just four months ago, he was using his walker several times a day … to go from his apartment to the balcony on his floor and to the courtyard in the senior building he lived in.  To show off in the hallway, whenever a caregiver was nearby (and I have photos to prove this), he would abandon the walker and use the handrail to traverse the seventeen feet to the door of his apartment.

On July 19, around 5:00pm while I was away on a writing retreat with two dear friends/colleagues, my sister (who was here for the summer) called me to say that paramedics were taking our father to an E.R.

A few days prior to this one, his caregivers had been reporting (in Cantonese) that our papa  was “looking sad”.  That morning of July 19, caregiver Mrs. G. had reported to my sister that Papa was feeling dizzy.  When my sister called me, my advice to her was to ask questions: “Had Papa eaten breakfast?  Had he been drinking water everyday? What was he doing before feeling dizzy?” He would be seeing his primary care physician that afternoon at 4:00pm … Well, our papa was in no condition to go to the appointment.  His primary care physician instructed my sister to call 9-1-1.

In E.R. and the hospital, our papa was being treated for pneumonia and urinary tract infection.

Pneumonia. When two friends heard the word “pneumonia” they gently prepared me for the worst case scenario. Well, Papa has beat the odds before.

He had aspiration pneumonia (probably caused by food or water going down the windpipe which led to bacteria infection).

And, he was fighting a urinary tract infection.

July 22 (the day that my sister flies home), Papa is transferred to a skilled nursing facility.  He had bounced back before, twice last year – dehydration and falls.  This time is different.

My papa is not Mr. John Pepper (the hero in Chapter 2 “The Man Who Walks Off His Parkinsonian Symptoms” in the book The Brain’s Way of Healing by Norman Doidge, M.D.).  Papa is his own hero, winning smile, flaws and all.

Papa Makes Decision “Where Do I Go Now?”  After Hospitalization.  While In Skilled Nursing Rehabilitation.

August 7, I asked the Director of Social Services at the skilled nursing facility where Papa was at…

“Could we please have a meeting, with a Cantonese-speaking interpreter, so that my father can hear in his native language…what his choices are when he is discharged? I want him to make his own decision. He’s been asking me to help him go home. He needs to understand what is happening.”

Miracles involving my father also involves the ticking of a clock.

The meeting would take place that afternoon. I asked dear friend Sasa to go with me (I needed someone to witness my role).  The meeting would take place after Papa has his lunch and before my friend would need to leave at 2pm.

Staff members at this institution are pulled in various directions during a work day. The Director of Social Services was most accommodating.  Sasa and I arrived at 12:30, patients were waiting for lunch which was served later than usual today.  1:00pm  Papa’s puree and “controlled carbs” meal arrived (looks delicious, really).

At 1:40pm all the characters for the scene were in place – Papa; director of social services; interpreter who is also activities director; my friend Sasa; Papa’s caregiver Mrs. G who was visiting; and me.

What are the 3 options when skilled nursing facility discharges Papa?

• Go home? He was receiving 5 hours/day of care through IHSS. He now needs 24-hour care.  Who will pay for the 19 hours each day? His monthly income from Social Security is approximately $1,000; $300 of that goes to paying rent of a studio apartment in a senior housing; the balance pays for food, hygiene products, telephone, TV, SF Paratransit. My sister and I can contribute up to $700/month. Care-giving costs $35-$40/hour; most agencies want a 4-hour minimum each day; our $700/month would buy approximately 18 hours.
• **

• Go to an assisted living home or a board-and-care home (fewer residents in these types of homes) – in San Francisco Bay Area, minimum cost is over $3,000/month. According to https://www.senioradvisor.com/san-francisco-ca/how-much-does-san-francisco-assisted-living-cost  on average, a senior can expect to pay approximately $54,000 per year on these services.
• **

• Accept a Medi-Cal bed in a nursing home for long-term care. (If Papa were to private pay, the cost of nursing home care would be more than $300/day.)  Because he has Medi-Cal (thank God), he would authorize Social Security to transfer his monthly income to the nursing home. http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_overview.htm Medi-Cal is a combined federal and California State program designed to help pay for medical care for public assistance recipients and other low-income persons. There are 3 of these beds (vacancies) in the facility right now, on the nursing home floors.
• **

**

The Michael J. Fox Foundation  www.michaeljfox.org

https://www.michaeljfox.org/foundation/news-detail.php?swallowing-and-parkinson-disease  In addition to the classic motor symptoms of Parkinson’s (tremor, slowness, stiffness, walking and/or balance problems), a person may develop changes in speech and/or swallowing.  Speech and swallowing therapy exercises, combined with Parkinson’s medication adjustment and, if necessary, dietary and/or behavioral modifications are the mainstays of management.

… to improve swallowing and lessen the risk of aspirating. These could include dietary modifications — such as thickening liquids — and/or behavioral strategies, such as avoiding drinking through straws, tucking the chin to the chest when swallowing or taking smaller bites at slower intervals.

To hear a webinar presented by Michael J. Fox Foundation on urinary problems and Parkinson’s… click here or look up any webinar by visiting at www.michaeljfox.org/webinars.

http://canhr.org

**

http://canhr.org/factsheets/rcfe_fs/html/rcfe_evalchecklist_fs.htm

Since 1983, California Advocates for Nursing Home Reform (CANHR), a statewide nonprofit 501(c)(3) advocacy organization, has been dedicated to improving the choices, care and quality of life for California’s long term care consumers. Through direct advocacy, community education, legislation and litigation it has been CANHR’s goal to educate and support long term care consumers and advocates regarding the rights and remedies under the law, and to create a united voice for long term care reform and humane alternatives to institutionalization.

**

Sincerely,

Teresa Jade LeYung

http://lovemadeofheart.com/blog/papa-wins-parkinsons-disease-loses-papa-wins/

***

Beautiful brain produces DOPAMINE

Dopamine helps us move with ease.

Parkinson’s Disease depletes Dopamine levels.

WALKING promotes production of DOPAMINE

Chapter 2 “The Man Who Walked Off His Parkinsonian Symptoms” in Dr. Norman Doidge’s book The Brain’s Way of Healing

Walking With Intention/For Safety:  [Cantonese]  Man Dee Ho Dee (Slower is Better), [Cantonese] Gurk Go Dee Ho Dee  (Pick Up Foot, Higher is Better)

and

Youtube “Sit and Be Fit” series by Mary Ann Wilson RN (recommended by our papa’s primary care physician)

Papa wins. Parkinson’s loses. Papa wins.

Sincerely,

Teresa Jade LeYung

aka Teresa LeYung-Ryan, Story Theme Consultant

http://lovemadeofheart.com/blog

Teresa LeYung-Ryan’s Blog Post 3 of 3

How Dr. Norman Doidge’s Books Help Me and My Chinese Papa Who Has Parkinson’s

I am not fluent in Cantonese.

When I was a new immigrant from Hong Kong in the 1960s, San Francisco public schools did not have ESL (English as a Second Language) classes.  Classmate’s snickering compelled me to learn my new language with urgency. By fourth grade, you couldn’t shut me up.  Then our parents (actually, probably just our father) insisted that my siblings and I go to Chinese School (classes in Chinatown everyday after regular school was let out).  One year of misery. Thank goodness our mother spoke up to our father (in Cantonese) – “Let our children succeed in English school first.”

Fast forward to 2017. Parkinson’s Disease has caused what Papa would say with his Cantonese accent “a lot of problem.”

[ According to http://www.parkinson.org/understanding-parkinsons/what-is-parkinsons/ Parkinson’s disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people … a person’s brain slowly stops producing a neurotransmitter called dopamine. With less and less dopamine, a person has less and less ability to regulate their movements, body and emotions.]

Papa and Teresa chuckle at the last part of speech exercises taught by Terri Snyder from Self Help for the Elderly - photo by Wen Hsu, translator extraordinaire

While I lack the vocabulary to tell my father that I sympathize, I do know how to encourage and praise with sincerity.  When he frowns at my prompting to do the exercises (taught by the dear professionals from Self Help for the Elderly) or Sit and Be Fit™  (recommended by NP Heloise Lim), or to pick up his feet when those darn rubber mats at grocery stores and restaurants seem to ambush him and his walker… I say to him: “You win! Do NOT let Parkinson’s win. You win!”

**********************************************

Through the engaging stories in this book – The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity by Norman Doidge, M.D. – I have learned that our wonderful brains are forever changing, growing and healing. That knowledge gives me the vocabulary to ask the right questions as an advocate for my father. Dear friend Wen Hsu ordered the traditional Chinese edition of Dr. Doidge’s book through a bookseller in Taiwan. Papa has the book near his dining table; next to the Chinese edition is the English edition; both books are there for Papa’s helpers and friends to read.

As for my being an advocate/daughter who is not fluent in her parent’s native tongue, I know how to find people who excel in their work. In the past three weeks, Wen Hsu (translator extraordinaire) has translated my multiple letters (written in English) into Chinese for Papa’s Caregivers/Helpers.

I salute Papa’s caregivers/helpers, his caring friends, my caring friends, wise mentors, supportive spouse, dear sister, MaMah, Papa’s spunk, the doctors, nurses, administration staffs, physical therapists, occupational therapists, speech therapists, interpreters, dear folks at Self Help for the Elderly, South Market Senior Health Clinic, UCSF Movement Disorder and Neuromodulation Center, E.R. staffs, staffs at U.C. Medical Center and St. Mary’s Hospital, SFGH Orthotics and Prosthetic Center, the dear staff members at the building where my papa lives, and Dr. Norman Doidge for writing his book The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity.

Mr. Leung with traditional Chinese edition, Teresa LeYung-Ryan with English edition of the book THE BRAIN'S WAY OF HEALING: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity by Norman Doidge, M.D. - photo by Wen Hsu, translator extraordinaire

Special thanks to the dear folks at Self Help for the Elderly – Nurse Valerie Chan, Nurse Chiu Li, Physical Therapist Jenny Chiu, Occupational Therapist Tom Wong, Speech Therapist Terri Snyder, Translator Albie Wong, and of course the administrative staff, and all the nurses and therapists who have helped my father in the past and shall in the future.

Knowledge that leads to health and wellness – this is my wish for everyone.

Sincerely,

Teresa, advocate/daughter to my Chinese papa

P.S.  I am rereading Dr. Norman Doidge’s books

Teresa LeYung-Ryan, photo by Britt

Teresa LeYung-Ryan is

author of:

• Build Your Writer’s Platform & Fanbase In 22 Days: Attract Agents, Editors, Publishers, Readers, and Media Attention NOW (workbook);
• Love Made of Heart: a Daughter Finds Herself through Witnessing Her Mother’s Mental Illness (novel used in college classes, recommended by the California School Library Association and the California Reading Association, and archived at the San Francisco History Center);
• “Talking to My Dead Mom” Monologues (the first monologue received an award from Redwood 10-Minute Play Contest and was staged at the 6th Street Playhouse in Santa Rosa, CA);
• Coach Teresa’s Blog  http://lovemadeofheart.com/blog (which attracts thousands of writers) helps writers build their platforms before and after publication
• “For Themes’ Sake” and “Heroes, Tricksters and Villains” and “Where Are You On Your Writer’s Journey?” and other workshop material

creator of “Immigrant Experience Writing Contest” and

owner of trademark

 and proponent of public libraries, public schools, and excellent public healthcare for ALL!

The link to this blog post #3 of 3 in this series:

http://lovemadeofheart.com/blog/teresa-leyung-ryans-blog-post-3-of-3-how-dr-norman-doidges-books-help-me-and-my-chinese-papa-who-has-parkinsons/

Blog post #2 of 3 in this series:

http://lovemadeofheart.com/blog/teresa-leyung-ryans-blog-post-2-of-3-how-dr-norman-doidges-books-help-me-help-my-papa/

Blog post #1 of 3 in this series:

http://lovemadeofheart.com/blog/theme-consultant-teresa-leyung-ryans-blog-post-1-of-3-what-i-learned-about-the-brain-from-dr-norman-doidges-2-books/

Dear Folks who have been, are, or will be advocates and/or caregivers to a family member who has Parkinson’s,

I salute YOU!  If I didn’t have caring friends, wise mentors, supportive spouse, dear sister, MaMah, and the information from Dr. Norman Doidge‘s book The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity, I would be in need of advocates and caregivers myself.

Last month, Papa fell again.  No broken bones. No kidney damage. He sure is a lucky fellow.  After his first fall earlier this year, the doctors and nurses explained to him (in Cantonese) and to me that when someone falls and cannot get up and is on the floor for hours, the muscles release a material into the bloodstream that could cause kidney damage. So, what did the doctor and interpreter at the hospital say this time?  “Your father was dehydrated and weak. He needs to eat well, eat more. Encourage him. To eat more. To drink plenty of water.”

Aah, the word “encourage” contains the word “courage”.

Parkinson’s Disease has discouraged Papa – the disease has made Papa’s movement “smaller” – small steps, small voice, small hand-writing.

Encourage my father to do this, to do that? Sounds simple enough.  Then why do I feel discouraged myself?  Whatever happens, I must take good care of my own brain.

I am not fluent in Cantonese, Papa is not fluent in English -

At least twice in the past month, he got upset when I said something about myself (he thought I was talking about him). “Teresa, keep your cool,” I tell myself. (Thank you, mentor Lynn!)

 I do not understand why Papa seems to be evasive when answering questions -

“Papa, when did you last eat?” I’d ask.

“I ate a lot,” he replies.

“What time?” I ask.

“A little while ago,” he says.

“What time?  Six o’clock? Ten o’clock? Two?  It’s two-thirty now. What time did you eat?”

“Eight.”

“Eight o’clock! That’s not a little while ago.” I can hear the irritation in my voice.

“Teresa, encourage him, not grill him.”  (Thank you, NP Lim!)

I cringe just thinking about entering his apartment and getting blasted by the television volume set at 84 or the thermostat set at 80 degrees -

What can I do?  I supposed . . . instead of asking (accusing) him “Is your hearing going?” and “Are you cold because you’re ill?” I could just turn down the two dials and engage him in conversation. (Thank you, dear Sasa!)

I, Teresa LeYung-Ryan, daughter of a father who has Parkinson’s, thank everyone who has helped my papa and Dr. Norman Doidge for writing his wonder-full book The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity.

Thank you to all the doctors, nurses, administration staffs, physical therapists, occupational therapists, speech therapists, interpreters, everyone at Self Help for the Elderly, folks in UCSF Movement Disorder and Neuromodulation Center,  E.R. staffs, folks at St. Mary’s Hospital, SFGH Orthotics and Prosthetic Center, and the dear staff at the building where my papa lives.

Knowledge that leads to health and wellness – this is my wish for everyone.

Sincerely,

Teresa LeYung-Ryan

Teresa LeYung-Ryan, advocate for my Chinese papa

Please visit http://LoveMadeOfHeart.com/blog and http://WritingCoachTeresa.com  for resources.

If you’d like to read Blog Post 1 of 3 in this series: http://lovemadeofheart.com/blog/theme-consultant-teresa-leyung-ryans-blog-post-1-of-3-what-i-learned-about-the-brain-from-dr-norman-doidges-2-books/

Teresa’s trademark:

Theme Consultant Teresa LeYung-Ryan’s Blog Post 1 of 3

“What I Learned About the Brain from Dr. Norman Doidge’s 2 Books”

I thank Norman Doidge, M.D. and everyone who contributed to his two books.  http://www.normandoidge.com/

• * The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science  (March 2007 hardcover; December 2007 paperback)

• * The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity (January 2015 hardcover; January 2016 paperback)

On October 21, 2015, I had published my blog post entitled “The Brain’s Way of Healing – Chapter Titles and Index in Book Spark Hope and Motivation to Ask Physicians the Right Questions  As my family members and friends know, what I had learned from Dr. Doidge’s books helped me help my papa.

While loved ones who are ill or have diseases and do not have the energy to read and process the valuable information, WE do, and WE can help them and ourselves.

Knowledge that leads to health and wellness – this is my wish for everyone.

Dr. Doidge’s books are most engaging- I learned from the stories – I did NOT have to look up medical terms; the footnotes were equally engaging.

You have friends who have had . . . Strokes?  Chronic pain?  Suffering from symptoms of MS?  Cerebral Palsy?  Muscular Dystrophy?  Alzheimer’s?  Parkinson’s?  Head injury? Balance problems? Vision problems? Depression?

Dear friend and colleague Elisa Sasa Southard was the one who taught me about hooking attention with no more than 3 talking points in a speech.  Here are mine for this post. I (Teresa LeYung-Ryan) learned that the awesome brain refreshes itself which leads to healing… with a little help from us:

* LIGHT – sit in direct natural light (approximately 20 minutes a day).  Florence Nightingale who established the first professional training school for nurses, Sister J. Ward  who was in charge of preemies in a hospital in Essex, England, Soranus of Ephesus (physician in imperial Rome) – they knew about the healing power of natural light. The Romans had a law “right to light” which guaranteed people’s access to the sun in their homes.

* SELF IMAGE – look at a photograph of yourself (a photo reminiscent of a time when you felt vital) OR create that picture in your mind’s eyes – athletes and musicians know the benefits of visualization as a way of training

* SOUND – sing the songs from your past (a time when you felt vital)  Sara Davidson’s April 23, 2009 article “The Songs They Can’t Forget” for The New York Times – The New Old Age – Caring and Coping Blog inspired me to publish my blog post of July 2 (with a P.S. on July 18), 2017  Dementia. Alzheimer’s. Losing Memory. Losing Joy. Songs from the Past. Experience Joy Again.

Our amazing brains! Help our brains “rewire” (I say “refresh”) to enjoy life. Help the people we care about.

I am Theme Consultant/Platform-Building Coach Teresa LeYung-Ryan who teaches my clients (writers and artists) how to reach out, not stress out, before and after publication –

* identify themes in your manuscripts so that you can rewrite with ease;

* identify themes in your intellectual properties and create scripts for your websites/blogs, pitches, query letters, press releases, talking-points, one-minute videos, photo slideshows, and the all-mighty blog posts.

Please visit http://LoveMadeOfHeart.com/blog and http://WritingCoachTeresa.com  for resources.

Coach Teresa’s motto:  “Reach out, not stress out. Help your fans find you BEFORE & AFTER publication”

Teresa’s workbook:
Build Your Writer’s Platform & Fanbase In 22 Days: Attract Agents, Editors, Publishers, Readers, and Media Attention NOW – print edition available at http://www.laurelbookstore.com in Oakland, CA  and on Amazon – print edition and Kindle edition!

Teresa’s novel:

Love Made of Heart: a daughter–mother love story (used in colleges; recommended by the California School Library Association and the California Reading Association)

 Writing Coach Teresa LeYung-Ryan a Big Fan of Volunteers at EBRPD and Regional Parks Botanic Garden

 In March 2017, I (Teresa LeYung-Ryan) retired from East Bay Regional Park District (EBRPD). My last post with the District was at the Regional Parks Botanic Garden  (aka “a living museum” ) as half-time Senior Office Assistant.  Another title would be “Email Pusher” (in my early career, that was called “paper pusher”). Honestly, so much of my work was communicating online, and creating and distributing documents electronically. Interacting with coworkers (at the Garden and District-wide), assisting visitors and callers, and working with volunteers had brought me joy to last a lifetime. I thank each person who has been kind to me.

Today August 5, 2017 at “the living museum” Volunteers will be recognized for their dedication helping Regional Parks Botanic Garden staff accomplish their annual goals and commitments. The Superstar Volunteers during the last 10 years of my career at the Botanic Garden include Ron Clendenen, Rosemary Clendenen, Sue Rosenthal, John Rusk – these folks had received special recognition from East Bay Regional Park District. I had the privilege of working with these four and many other superstar volunteers.  The beloved volunteers who are now angels watching over the Garden include Jenny Fleming, Es Anderson, Jock Anderson, Pat Eckhardt, Carrie Sprague, Miriam Pollock, Wayne Roderick (as you might know, Wayne was Steve Edwards’s predecessor as Botanic Garden Director). By the way, Steve has happily retired too; his successor is Bart O’Brien.

Volunteers, I celebrate you all!

I advise everyone to get a copy of this book – the book that has helped me help my father and my friends and their friends and families. I am NOT a medical student.; this book is for everyday people. Through the stories in Dr. Doidge’s books, I am able to implement changes and find more resources for my parent and friends.

The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity -  the second book by Norman Doidge, M.D.

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I am Theme Consultant/Platform-Building Coach Teresa LeYung-Ryan who teaches my clients (writers and artists) how to reach out, not stress out, before and after publication –

* identify themes in your manuscripts so that you can rewrite with ease;

* identify themes in your intellectual properties and create scripts for your websites/blogs, pitches, query letters, press releases, talking-points, one-minute videos, photo slideshows, and the all-mighty blog posts.

Please visit http://LoveMadeOfHeart.com/blog and http://WritingCoachTeresa.com  for resources.

Coach Teresa’s motto:  “Reach out, not stress out. Help your fans find you BEFORE & AFTER publication”

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P.S. July 18, 2017 Angels everywhere!

Theme Consultant/Writers’ Platform-Building Coach Teresa LeYung-Ryan here to say: “Angels everywhere!  I found a source for songs to gift to my friends who have dementia or Alzheimer’s.  Five days ago, I opened an email from Patrick von Wiegandt announcing his new CD SWANKY AT ABBEY ROAD.  Seeing Patrick’s name brought back delightful memories of when Elisa Sasa Southard and I were morning presenters (teaching writers how to attract attention from agents, acquisition editors, and anyone who could be a fan) at the San Francisco Writers Conference (founded by Michael Larsen and Elizabeth Pomada).  Over the 3-day conference, Patrick and his team would orchestrate the recordings of 100+ sessions.  Friday and Saturday evenings at the conference, Patrick’s band entertained hundreds of writers.

“What joy to know that his music is for sale.  On his website, Patrick von Wiegandt says: ‘Swanky is a fresh take on some of the most elegant, engaging and absolutely wonderful songs ever composed. This is my loving musical tour of the Jazz Age – 1920′s to 1940′s. My pal, mentor and Legendary Producer/Engineer/Mixer Al Schmitt supervised the recording at Capitol Studios, Hollywood. I want to thank all of the terrific musicians, engineers and all of the creative and hard working folks who helped make this dream come true. I could not  - would not have done this without you.’

“So, I ordered 6 CDs.  And, I asked Patrick if his press releases and other PR material talks about how his CDs (songs from 1920′s to 1940‘s) help folks who are battling memory loss. He replied with heartwarming news. I cheer for Patrick and encourage him to add his news (see below) and photos to his website/blog/social media. Patrick, please help more fans find you. Please blog at least once a month, and add a photo or a 30-second video (of your audience, could be backs of their heads) each time you publish a blog post. You do good work in the community and that ought to be broadcast.  I teach my clients the importance of understanding what fans can do.  Well, I am your fan and I applaud you and I tag your name, your CD titles, and the words “songs from 1920′s to 1940‘s” in this blog post and shouting out . . . 

Patrick von Wiegandt says: “We have been playing in retirement homes and Alzheimer’s facilities in L.A  and Hawaii  – and it’s been an amazing experience.  A real joy  to see people light up when we play these songs from 1920′s to 1940‘s.”   http://www.patrickvon.com/

Sincerely,

Coach Teresa LeYung-Ryan

July 2, 2017

Dementia. Alzheimer’s. Losing Memory. Losing Joy. Songs from the Past. Experience Joy Again.

How can family members, friends, neighbors, caregivers help the person suffering from affliction?

Recently I visited one of my dear mentors – author Lynn Scott who had brought joy to her clients (suffering from Alzheimer’s disease) by singing songs from  her clients’ past.  So, when I was talking to another dear mentor (she and her husband had just moved into an apartment in an assisted living community and now her husband is moved to the “memory care unit” which is in another part of the building), I told this mentor about Lynn Scott; also I asked if their son could get CDs of songs that she and her husband listened to when they were a young couple. This morning, I was awakened by memories of conversations with both mentors. I Googled the words [ Dementia, Alzheimer's, songs from the past ] and found the insightful article written by Sara Davidson:

“The Songs They Can’t Forget” by Sara Davidson April 23, 2009

Lynn Scott’s memoir is  A Joyful Encounter: My Mother, My Alzheimer Clients, and Me

Lynn Scott’s blog https://lynnscott.wordpress.com/

Sincerely,

I am Coach Teresa LeYung-Ryan who teaches my clients (writers, artists) how to reach out, not stress out, before and after publication — identify themes in your manuscripts so that you can rewrite with ease; identify themes in your intellectual properties and create scripts for pitches, query letters, press releases, talking-points, one-minute videos, photo slideshows, and the all-mighty blog. Please visit http://WritingCoachTeresa.com  and http://LoveMadeOfHeart.com/blog for resources.

We’ll always have Paris, my darling friends. And themes.

Blog post by Teresa LeYung-Ryan

The date that Elisa Sasa Southard had written on the first page of the notebook (with drawing of Eiffel Tower on the cover) that she had given me is 20 April 2015. The words she penned in purple ink included pieces from my mental wish list:

“Must See – Notre Dame, Eiffel Tower, Rodin’s, Sainte-Chapelle, Shakespeare and Company

Must Do – Museum pass, Walking tour

Movies to Watch – Midnight In Paris, French Kiss, Irma La Douce, Populaire, The Closet ”

Aah I had seen Woody Allen’s movie Midnight In Paris in a theater, and, later, rented it several times just to see the first four minutes (shots of arrondissements “neighborhoods”) with 3 minutes and 20 seconds of composer Sidney Bechet’s saxophone magic  “Si Tu Vois Ma Mere”

Then Margie Yee Webb gifted me 3 books – The Most Beautiful Walk in the World: A Pedestrian in Paris by John Baxter; Forever Paris: 25 Walks in the Footsteps of Chanel, Hemingway, Picasso, and More by Christina Henry de Tessan; The Sweet Life in Paris: Delicious Adventures in the World’s Most Glorious – and Perplexing – City by David Lebovitz

Even if I cannot go...reading David Lebovitz's most beautifully written book THE SWEET LIFE IN PARIS made me smile happy tears.

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The plan was to go to gay Paris (pronounced “Paree”) in 2016.  In May 2015, my papa received a diagnosis of Parkinson’s Disease – that explains his leg weakness, tremors, and freezing, as well as the “shuffling”. As my darling friends were talking dates and flights, I heard myself saying “I can’t go…What if I am in Paris…and Papa falls…” My friends were sympathetic. Trip planning was terminated.

I created a blog series “Parkinson’s Disease, My Chinese Papa, and My practicing The Four Agreements” (you know, the book The Four Agreements: A Practical Guide to Personal Freedom by Don Miguel Ruiz)

One day, after Papa had assembled a pedal-exerciser (I was so happy for him), he got up too fast…plop.  He fell, right in front of me. His recliner broke his fall. What a lucky fellow! I was in shock for two whole seconds. Gosh, a lot of worrisome thoughts raced through my brain as he popped up to standing position, with a look that said “That did not happen, you did not see that.”

Later that week, I had my epiphany – I could hear my mom telling me “You cannot worry about what might or might not happen.”  She’s been my muse every since she showed up in a mighty healing dream – a dream that inspired my “Talking to My Mom Monologues”.

Here she was again, being the muse.  I started a new monologue “Papa Fell Down, I’m Going to Paris”

I called my darling friends. “Let’s look at calendars. How’s September 2016?”

Teresa LeYung-Ryan here, inspired by the arrondissments we walked in and everyone who have made my 8-day trip to Paris a most remarkable experience. The “everyone” includes my papa, sister, friends (including Margie, Sasa et Will, Linda, Vicki, Lynn, Luisa, Martha, Olga, Kristiane, Cousin Howard, JB, my darling mom of course), colleagues, vendors, and strangers who have given me their well wishes or assistance or greetings of “bonjour” or all the above. Traveling with Elisa “Sasa” Southard (certified tour director and travel writer) who speaks Français and is such a fun and  thoughtful leader and Margie Yee Webb (author, photographer, documentary film producer) who pays attention to details and is also so thoughtful =  joy and delight for me (whose knowledge of magical Paris had been from watching Hollywood, English and French movies…until now).

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Aah, we (Elisa Sasa Southard, yours truly Teresa LeYung-Ryan, Margie Yee Webb) did go. Thank you, lovely AirFrance flight attendant, for taking photo minutes before landing at Charles de Gaulle airport.

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Oui! La Tour Eiffel ("tour" is French word for "tower") is really that beautiful - by day, by night, in sun, in rain! Oui! that is Sasa with Chronicle Books bag (that Margie gifted us) over her right shoulder.

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Parisian architecture, sandstone buildings, trees trees trees, Eiffel Tower!

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The most yummy-looking and truly delicious quiche we enjoyed in Paris was at Café de Flore

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The themes that I got from being in “The City of Light” are:

* sandstone buildings, why maximum height is eight-stories

* what to eat at a boulangerie, pâtisserie, bistrot, traiteur, brasserie, or a restaurant

* art is beauty for all the senses

Forthcoming:

Part 2 What I learned about the Eiffel Tower and the architect

Part 3 Musee d’Orsay, the Louvre, Musée Rodin, museum passes

Part 4 Croissants in Paris and my being wheat gluten intolerant

Part 5 Walked, Walking, Will Walk

Part 6 Airplane, Batobus (ferries), Metro (subway), buses, train, elevators

Part 7 I want to look at everything at the U Express supermarket s’il vous plaît

Part 8 “Make Your Name Stand for Something,” says Writers’ Platform-Building Coach Teresa LeYung-Ryan

Part 9 “I’ll always cherish my time in Paris,” says Teresa LeYung-Ryan

For the slideshow  “We’ll always have Paris, my darling friends,” says author Teresa LeYung-Ryan on Teresa’s Youtube channel, please click on https://youtu.be/LbX50ojbc84

à bientôt!

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Teresa LeYung-Ryan uses her fiction and nonfiction to advocate speaking openly about the stigmas associated with mental illness and the repercussions from family violence.

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She is the author of:

• the mother-daughter novel Love Made of Heart (used as required reading in colleges)
• the workbook Build Your Writer’s Platform & Fanbase In 22 Days
• Coach Teresa’s Blog at http://lovemadeofheart.com/blog/
• her monologue series “Talking to My Dead Mom” (her monologue “Answer Me Now” received an award from CWC Redwood Writers)

Creator of:

• the “Immigrant Experience” Writing Contest
• workshops including:
  • “For Theme’s Sake: Edit Your Own Manuscript Before Pitching to Agents or Self-Publishing”
  • “Heroes, Tricksters, Villains – Know Your Archetypes”
  • “Where Are You on Your Writer’s Journey?”
  • Build/Retrofit Your Writer’s Platform
  • her trademark Love Made of Heart

Affiliated with:

• Women’s National Book Association-San Francisco Chapter (member and past board member and officer)
• California Lawyers for the Arts (member)
• California Writers Club (member, San Francisco Peninsula Branch and Redwood Branch; a past president of the San Francisco Peninsula Branch); a recipient of the Jack London Award for outstanding service to California Writers Club

Advocate for:

• public schools and public libraries!