HOW DO I GET THERE/WHERE DO I PARK?

Mikey has moved to The Greenery, a long-term care facility in North Andover.

Directions from 93: Take 93 North to Exit 41 (Route 125). Follow 125 towards Wilmington/Andover; it's a pretty straight shot, though the road does curve around Merrimack College. Stay on 125 through an intersection where it also becomes 133 (follow signs to the Police Station). Take a right at Park Street (one way; V.F.W. hall on corner), Greenery is on your right. Park in the Visitor's lot. Mikey is up one level, take the elevator or stairs. There is a reception desk as you enter the floor. Mikey's room is just past the desk.

If you'd like to arrange a ride to Andover, write M.A. Ricciardi for more information.

WHAT SHOULD I DO WHILE I’M VISITING?

Despite obvious physical limitations, Mikey is still Mikey. He still enjoys scene gossip, movie and entertainment news, trivia, jokes and music. Ask him what he wants to do, how he's feeling. Play a cd (instructions on using the "robo-dj" are on the wall by the stereo), pop in a video, or just sit with him. He’s glad you’re there.

Please take a look at the big purple binder --The Mikey Book. The Mikey Book is a good way to see what’s been going on with him from way back in the beginning to earlier in the day or week. If you find Mikey tired and inattentive it's possible he's already had lot of visitors or therapy that day. Please record your own visit: what you did, how Mikey seemed, and any messages for Mikey or team members in The Mikey Book (or at least just a quick note that you were there). There are also breathing/speech exercises for Mikey to do in the book. You may want to ask him if he’d like to work and then go through some or all of the exercises.

If you'd like to help out with his therapy, try the mirror with Mikey. It helps him see what he looks like and helps him work on his articulation and expressiveness. Bubble blowing and the penny whistle are other fun therapy toys (there's a whole box of toys near the stereo). If he's up to it, Mikey can play word-games like Boggle (use the sticky letters) or hangman, and he can also play tic-tac-toe, trivia games. Anything that can be played with yes/no confirmation.

Please do not give Mikey any lollipops or anything else to eat until further notice.

CAN MIKEY HAVE A CONVERSATION? IS HE REALLY "WITH ME"?

Yes! Mikey is cognitively intact, he’s "all there,” he has no amnesia, his personality and ability to think has not been compromised by the stroke. The stroke damaged his brainstem the "automatic" part of the brain which controls movement, not his cerebral cortext (where the thinking happens). If he knows you (and has his glasses on), he will recognize you. You can also announce yourself as you enter, just in case. Sometimes Mikey may seem distracted or "out of it" He tires easily and, naturally, has moments of melancholy. Please don't be put off by a bored expression or by his occasional sighing. The sighing is simply his body's way of getting more air, it doesn't usually mean anything else.

While real speech is still out of his grasp he is very emotive non-verbally. His eyes and mannerisms can tell you a lot about his mood, how he’s feeling physically, etc. Form your converstion with inquiries or questions. He will answer yes or no with either a nod/shake or (if he's having bad muscle spasms) eyes up=yes, eyes down=no. A shrug generally means "maybe," "i don't know," "i don't care," or "sometimes" -- depending on the context. Sometimes he'll prefer a thumbs up for yes, no thumb movement for no. Establish what's working for him that day. It is essential though, that you give Mikey time to process your question: often, his head will move in a shake (no) --or he will mouth "no" -- before he begins nodding (yes). If his answer is unclear, tell him you didn’t get it, and ask it again. Be patient; his response time can sometimes seem slow.

There is also a letterboard and whiteboard with stick-on letters which Mikey can use to spell more elaborate responses but he generally prefers yes/no communication (If you want instructions on other communication systems email Eleanor Ramsay at eleanor@rockopera.com).

WHAT CAN I BRING?

A little of your time to spend with the Dee. But also band stickers (for his wheelchair), CDs, videotapes (you can find out what he needs from Mary or Tina), posters, cards, magazines. Mikey's vision is not good enough to read small print right now but he likes to look at the pictures and can read large print and headlines. Read the text to him.

WHAT IF HE STARTS COUGHING/CRYING/SPASMING/SPITTING?

Something you'll notice is that Mikey’s emotions are very "labile" -- they swing back and forth. This is a common occurence in many stroke survivors. The emotional regulatory system that we all take for granted has been affected somehow. For instance, something that would make you smile might make Mikey roar with laughter. Likewise, something mildly touching might make him bawl. Don’t be alarmed if this happens. If he cries, just comfort him; he will stop.

His swallowing mechanism is also controlled by the brainstem and is being relearned. This is one of the main reasons he cannot speak or eat yet. This also makes him kinda drooly. Just wipe his chin nonchalantly every so often (you’d probably want someone to do it for you). Occasionally he'll swallow a bit down the wrong pipe and, just as you would, may start coughing. Just help him to sit forward gently, and it’ll stop.

When Mikey is tired, or when he is concentrating hard on something, he gets muscle spasms. These can be anything from thumb wriggling to head shaking. You can try to help him stop the spasms by focusing his attention on deep breathing or something else: squeezing your hand, telling jokes, singing a song. If the spasms get too severe, he may tune out -- ask him if he’d like to get into bed and find a nurse or assistant to get him there.

WHAT IF I GET THERE AND THE CURTAIN IS PULLED/DOOR IS CLOSED?

It may be that Mikey (or his roommate) is being put in bed/gotten out of bed etc. Just wait outside the room and/or ask at the desk how long they think he’ll be.

WHAT IF I LEAVE WITH MORE QUESTIONS, OR AM SAD/WORRIED/UPSET?

Please email Mary Riccairdi at parkdale@mindspring.com. She checks that mail every day or two and will respond as promptly as possible. If you have a real concern speak to someone at the reception desk before you leave.

CAN I POST MY VISIT UPDATE AT MIKEY'S SITE?

If you want to post your thoughts at the website send it as an email to mikeyvisit@rockopera.com. It will not be added automatically but we'll post it for you.