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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