Saturday, June 30, 2012

Vestibular Disorders: explanation, coping tips and more


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VESTIBULAR   DISORDERS:  description of outcomes and coping issue

(please excuse spelling and grammer errors - author is visually impaired)                                                
It is said that one simply cannot go through an
 experience without being changed by it.  As an
 individual living with the experiences a
 vestibular disorder presents, I am indeed a
 changed person.

 First, I will take liberty tor explain that the
 vestibular system is the part of the inner ear
 concerned with balance and body orientation
 (a sense of knowing where one's body is in
 relation to the vertical and horizontal planes).
  When this inner ear portion is damaged by
 disease or by injury, a vestibular disorder can
 result.  Since the vestibular system interacts with other parts of the nervous system, symptoms of a vestibular disorder are experienced as problems elsewhere in the body and brain (i.e. symptoms are not  limited to balance and  body orientation).   The ramificationa of the wide range of physical and cognitive (basic mental function) disturbances associated with many vestibular disorders are extensive and life-changing. orientation).  The ramifications of the widerange of physical and cognitive (basic mental function) disturbances associated with many vestibular disorders are extensive and life-changing.
 The most commonly diagnosed vestibular disorders include positional vertigo (also called Benign Paroxysmal Positional Vertigo (BPPV) or (BPV);  Meniere's Disease; infections of the inner ear (called labyrinthitis or vestibular neuronitis);  injury caused by trauma to the head (called inner ear concussion syndrome);  endolympathic hydrops; and perilymph fistula.  Other, and more rare disorders, include acoustic neuromas (tumors  on the vestibular nerve) and a variety of other conditions associated with auto-immune disorders.

Symptoms of vestibular disoders mimic other disorders such as multiple sclerosis and clinical depression because  imbalance and vertigo (sensation of spinning) can affect not only the ability to stand and walk, but vision, hearing, and mental function.

Traumatic head injury and whiplash are the most frequent causes of vestibular disorders in people under age 50 . Chronic bacterial ear infections, exposure to toxic chemicals and high doses or long term use of certain antibiotics are also causative factours.  Additonally, if the flow of blood to the inner ear or the brain is reduced or blocked (as in the case of a stroke), damage to the vestibular system can result.

Physical limitatons of a vestibular system disorder can include some of or all of the following:
- changes in vision, visual perception and visual control;
- changes in hearing, reduced hearing ability, distortion of sound;
- reduced proprioception (reduced sensation in muscle and other tissues)
- imbalance or loss of equilibrium (in advanced cases this results in an inability to maintain body
   postures;
- vertigo, a violent spinning sensation;
- dizziness, nausea, vomiting intolerance to motion and movement;
- coordination difficulties, clumsiness, alteration in gait; and
- hypersensitivity to hot and cold temperatures; and general fatigue

To date little is known about the cognitive (basic mental functions) aspects of vestibular disorders, however, studies recognize a number of associated cognitive difficulties.  Researchers conclude that the reason cognitive problems are experienced by "vestibular persons" is because the brainstem is involved.  The brain stem is a stalk-like structure connfected to the spinal cord.  There are nuculei located in the brain system and to other reslated structures; they are also highly important for keeping one's cortex or think areas alert, aroused and attentive.  Some of the cognitive disturbances include, but not restricted to, the following:
- attention and memory deficits; difficulty and concentration;
- diminished sequencing ability;
- lack of confeptual validation (a sense of internal certainty, seeing the big picture)
- trouble in perceiving accurate spatial relationships;
- visual, auditory and/or time agnosia (an inability to recognize familiar objects, sounds and/or the
   loss of comphrhension of succession and durantion of events);
- difficulty in comprehending or expressing language (including tracking, conversation, word-finding,
   etc);
- diminished menta stamina.
- a tendency of "facial blindness" and  XXXXX
- an inability to  judge speed - for brain injury suvivors in particular, the sense of "speed" is not
   recognized or determined.

What do these disturbances translate to in one's everyday living?  To begin with, these disturbances wreak havoc with one's ability to function in any setting in the home, at work, in the community, in social interactions and in the family envirnment.  The contrast with one's ability to perform any task before the onset of a vestibular disorder to that after the onset is a picture of confusion

What do these disturbances translate to in one's everyday living?  To begin with, these disturbances wreak havoc with one's ability to function in any setting in the home, at work, in the community, in social interations and in the family environment.  The contrast with one's ability to perform any task before the onset of a vestibular disorder to that after the onset is a picture of  near total confusion.

Certainly, the various physical symptoms and cognitive distrubances that accompany the vesitular disorder affect all aspects of one's daily living.

With respect to imposed physical difficulties, balance problems pose a very difficutl but manangeable challenge.  Cognitive struggles, howevr, hav dictated fthe need to find a balance t life itself.  The task of rebuilding a world is an enduring exercise of self-examination, personal development and acceptance.

How does a "vestibular person" cope with what would seem to be an imposition of overwhelming change?  For the average person, this process evolves over a number of years and provides extraordinary personal growth opporutnities.  Don't allow my messsge  to lead you to belive this process being that of  a picnic as the road will be bumpy.  In the course of managing acute episodes, always reflect back to the blessing of what you have achieved to this point is worthy of the biggest hug you have every experiencied.  Validition and acceptance follows in its natural course.

With respect to imposed physical difficulties, balance problems pose a very difficult but manageable challenge.  Cognitive struggles, however, have dicated the need to find a balance to life itself. 

Many believe this one missing link of the immediate path blocks validation.  It  is the outocme of a lack of internal certainity or the inability to get the big picture that becomes the osbacle.  At the conslusion of each day it is important for the vestibular compromized individual to acknowledge that she has done the best she can and be very satisfied -- enough for her to herself a hug and a pat on the back.  Trying to recapature a day becomes an impossibility as there is always that sense of fragmentation and uncertainity present.  There is  never a true feeling of completion and closure.  No amount of note-taking, detailed journal entries or graphic displays have been recognized  to alleviate this haunting delimma. 

An inability to understand and have a sense of time is another rather unque limitation.  Some "vestibular persons" consider this a great disturbance while others prefer to remain "ageless". 

On a personal scale a few of my strongest personality traits have also served me well through years of rehabilitation.  I think my obsessive nature has sustained me, and my creative side has allowed me to find and developing coping strategies.

I am also fourtunate to be one of a long line of optimists in my family.  When I have been at my absolutel worse, that optimism has provided me with the spirit needed to regroup and carry on.

The key to my ability to manage the more difficult physical symptoms is my use of self-hypnosis and meditation.  Before becoming skilled in this activities, the effects of motion sickness left me confied to home and in bed much of the time.  Now, through the benefits of these skills my world has become much larger, full and satisfying.

Partipating in a therapeutic program of an equestrian focus, provided great advantages and gain.  I now translate the sense of motion on a bumpy sidewalk to the motion I once enjoyed as a skier and equestrian enthusiast.   

When encountering a difficult path, I transfer the unpleasant effect of motion as a pleasant expereince and expectation to what which I enjoyed while riding.   After becoming disabled, and with many limitations, I returned to the horse stable and through riding challenged vestibular function.

What advice do I have for other "vestibular persons"?  This is a question that is not easily answered.  First, it is essential to find coping strategies to address memory deficits, mobility issues and fatigue.  The services of a physical medicine specialist, neuropsychologist, physiotherapy, occupational therapist and a speech pathologist can be of great assistance with respecct to these matters.

When considering the mammoth alterations that take place on one's basic thought processes, it would be only reeasonable to conclude that anxiety and depression,  as well as self-doubt, could become part of the picture. 
   
I would also encourage "vestibular persons" to continue to seek out alternative medicines until they find options that work for them.  I would caution that there is no "quick fix" approach to most of the symptoms of a vestibular disorder and that the support of loving family and friends is imperative.

Some additional words of wisdom that I ewill pass on are:
- accept change but don't surrender to it,
- keep personal goals realistic,
- be passionate abgourt achieving goals,
- be good to yourself,
- celebrate even the smallest gain, and
- ABOVE ALL - keep a sense of humor.

Networking with persons who also experience similar problems can be of help as they are most often willing to share coping strategies. 

Nightingale - July 2012










Friday, June 29, 2012

Separation Anxiety - The Inevitable for Twins




(the author of this blog is visually impaired - please excuse typing and grammar)



The above photos (circa 2004) of Melanie Elliott (at the top) and her twin, Melodie Elliott-Clark (lower photo) were images created at the same time, at different enviroments and participating in an activity each shared.  Their locations were thousands of miles apart and each was not aware of her sister's activities at that given moment.  Their experienes as twins sharing similarities and participating in life on the same level and at time were quite often discovered and explain it by a coincidential occasion.  Melanie and Melodie have a different spin to these events and lable them as auspicious occasions and in a more casual manner - "a Twin Thing experience".  The Elliott twins consider this as a gift and truly believe that only identical twins are privileged to this phenomen.  They  encourage identical twins to embrace each unique twin event they are aware of and if a twin has lost her birth partner Melodie and Melanie hope their story will provide some comfort for each to realize she is not alone. 
In the above images each twin is participating in her personal passion of gardening. After Melanie had finished,  she had a sense of "need" to connect with Melodie.   This same sense of need to connect with her twin was shared by Melodie as she attended to garden matters --- had  a notion  that her twin would phone and waited with a sense of anxiety while waiting for the phone to ring.  Time seemed to come to a stop as Melodie anxiously waited to hear frm Melanie.

Melodie's anxiety was secondary to the fact that although she knew Melanie would call she was did not have a sense as to why.   Like Melanie, Melodie's need to connect with Melanie was a "sense" born out of need not want.  Anxiety prevailed until the phone rang....and a true sampling of an anxiety separation event.  

In this story, friends on each coast, by auspicious coincidence, had taken *photos of the twins and from these,  Melodie and Melanie realized that a "twin-thing experience" had once again surfaced.
Melanie, first born,  is a strong believer that the event of their actual birth was the foundation of their first separation anxiety.   A second event was immediately in tow when they were quickly removed from the birthing area, wrapped up and placed in separate sophisticated incubators. The environment of each twin instantly became a world that lacked all what they experienced in-ureto....that which they refered to throughtout their growth.   Once born,  the constant sounds, touch, warmth of their sister and much more were lacking.   The fact that they were **"mirror images" added to the sense of loss and only out of natural instinct for survival did they develop without the immediate presence of one another.

There is a belief of some that the separation anxiety does not arise until approximately one year of age.  Others, such as Melodie and Melanie are of a different but unscientific opinion and have observed other identical infants at a much earlier agree. 

Melanie is also of the opinion that the early newborn development of twins is somewhat delayed and such is  due to the fact twins "mourn" for the presence of their birth partner and,  in doing so, much energy for development is jeopardized. Hearing is enhightened, physical motions become more intense,etc. all in an effort to locate what was in each child's "space" while in-utero. Non-twin newborns are not subjected to this energy resource difference - incubator or not. Identical twins show excessive distress. 

There is not a solution for this sense of loss, grief, mourning --- the absence "just becomes more familiar" and in due course their personal development which is offered and observed to be borderline catches up and demonstrates acceptable development level.  In some speciality health centers, twins receive treatment for their separation anxiety distress.

Melodie and Melanie did not take their first steps until almost two months after their 1st birthday however by age 6 years of age, they were able to master all physical and  cognitive skills testing suited for their age.  In their early beginnings of "language", they often communicate in their own language and often without words.  The Mother of Melodie and Melanie was aware of this when they were toddlers and was not concerned as she felt they would "join the rest of the world when exposed to social interaction, school and cultural event"s.

 Memory of  "their" language use was never forgotten.
In Melodie's words "I didn't realize the strength of our bond until we were aware of being separated for the first time".  The separation anxiety had been present however it was not recognized by primary care-providers and it was Melodie's experience that brought the subject to light.  

Melodie continued to explain that "when Melanie, at the age of 7 years, was scheduled to have her tonsils out,  I dressed up in my world of fantasy to cover up the fear. The feeling was suppressed until the following day when I saw my father carrying her into the house having left the hospital  wrapped in blankets. It didn't look like her.  The spitting and bleeding from the mouth was too much".

"As I lay on my parent's bed, I couldn't believe what I was seeing. I returned to my collection of costumes that Melanie liked and told her stories that she normally would have laughed at. She didn't seem to care, or really even hear me.  I fled in tears and my world of make-believe but nothing could console me. This first lesson, in facing reality, is one I'll never forget" . When looking back in years ahead she recalls the feeling of being "detached".

Melanie's first memory of experiencing separation anxiety came about the age of 10 years young.  She describes a summer event when they were introduced to their first summer camp experience.  Melodie became ill with a rather severe throat infection. Camp officials contacted our parents who and suggested they leave the comfort of the family home and attend to their daughter's health crisis. Our  parents wasted no time and drove to the camp site about 1:00 am. They bundled Melodie up and took her home where our Godfather, a physician, was able to treat her and ensure she was comfortable.

Melanie was expected to remain at camp and it was suggested she play a part in a play that Melodie had been rehearsing for with several other campers.  Encouragement came from all who were aware of the situation. In later years Melanie recalls the learning curve to be a roller coaster and in retrospect cannot imagine how and where she found the confidence to move forward with this activity. The goal of the performers was to perform in the presence of parents at the last day of the camp.

Meanwhile, back at the family home, Melodie's recovery was achieved in record time. However, her parents recognized she was not herself and suspected she might be experiencing a feeling of loss and worry as Melanie was still at camp.

Melodie's parents asked if she would like to return to camp knowing that I had accomplished the role Melodie was initially assigned to in a camp stage play.  Melodie was quick to gather up her belongings and without knowing, she would be present for the stage performance that Melanie had been working hard to perfect.

Melanie did not realize Melodie was going to be present and when she arrived with her Mum and Dad,  it was a reunion of an incredible touching and joyful moment.

Melodie was very excited to see her new friends again however her seeing Melanie in a stage play was an empowering moment for both of girls. Melanie was exceptionally shy and was about to leave her cocoon for the first time --- She was about to "fly" on her own.

It would be neglectful not to mention that Melodie's presence enhanced Melanie's personal growth experience that was in the making.  After the performance Melanie expressed the feeling of worry and anxiety when she started to enter the stage however she describes it as being a magical experience.  This was quite unusual and almost foreign to Melanie.
A public performance was a milestone-----it was hard to recognise and accept that Melanie's behaviour of being shyand with little self-confidence were no longer her trademarks - her new role not only in the performance but in the performance in life itself.

Once they returned home, friends and family were heard to speak of Melanie's new level of self-esteem, spirit and a good dose of humor.

The camp occasion added to the realization that Melanie and Melodie were no longer two little girls with similar names but two little girls with their own unique personalities with varying characteristics.

One of the more extreem separation anxiety events occured when the twin's parents realized teachers had not successfully managed to respect their twin daughters as individuals. No longer would they accept a teacher's inability to address each twin with a sense of a separate identity. The school had two classes at each level and this was thought to be a sensitive solution to separate the twins -- keeping their comforts and individual preferences and needs in mind. Melodie was much more extroverted and when comparing the reactions of the girls being separated at school particiption, the transition was much more difficult for Melanie.
 Levels of stress and worry were of concern by her parents however she was quick to find some comfort with being among peers of similar capacity, interests, and passions. In record time they settled into their own and new territories and were excited to participate in their studies and careers in separate locations.
The summers were often a new challenge for both girls -- they had a passion to swim and attended swimming classes when every they had an opportunity.  This activity was a challange to teachers who did not know them prior to their enrollment in a swimming program.  With identical swim suites it was a nightmare for instructors and instructional swimming teachers.  In one particular swimming program in the little heritage town of Lunenburg and in the cold waters of the Atlantic an instructor, out of desperation to identify who was who, gave each a nickname.  He was clever to recognize that near one-half of the confusion of identifying each twin was the fact that their names were so, so much alike.  Once he was able to sort out names by using two foreign names that were of no similarity was his way to conquering the challange.  Melodie as assigned the name Sam, and Melanie was Mich --- to this day it is a puzzle what those particular names were chosen.
Another dear friend in their last years at home also had tagged them with nicknames -- names that they took to heart and were received as being very special.  The family and neighbourhood would, to this day, remember the names Hector and Rosco and once again no one had any idea from where these names came.   There was a special bond and territory between both twins and their nick-naming friend,- Lloyd, who was a neighbourhood home owner.  I would be neglectful not to mention this dear man who, on the twins 16th birthday, presented them with an incredible bouquet of salmon pink long stem roses.  Both girls shed a few tears out of the joy and respect that he had provided them ---- a respect that they had reached a young adult landmark.

In the summer prior to Melodie's graduation from high school she found work at Acadia University's summer play production in the town of Wolfville, Nova Scotia.  She was assigned dance roles as well as participation in group singing numbers.
Upon the completion of high school Melodie entered a Nursing School in Windsor, Nova Scotia and Melanie was privileged to a scholarship to attend a Health Professional Program for Health Record Administrators in Kingston, Ontario.   Melanie applied to Nursing School however her medical history did was not condusive to her wish.  Feeling somewhat isolated she applied for a scholarship offered by the New Brunswick health community - her career in that field would provide her with extraordinary career advancements.

When both girls were ready to graduate in their respective careers, the idea of sharing an apartment in Kingston, Ontario was their dream.  Finally they were together and both had a sense that life was their oyster.  Upon Melodie's arrival in Kingston she stated that "only if we cold bottle up the moment of our joy, heart and energy".

From the words of Melodie, "Melanie met her twin at the train station and they both found it was hard to contain their excitement. They had planned to rent an apartment together and really live by desire and comfort -- no more curfews and no studing for either of us.

As the taxi driver moved on, Melanie [subtley tired to tel her twin that their apartment was small, but we could do marvelous things with "our" place.  Can you imagne being so close to the hospital (our workplace) and the rent only $100.00 a month?   Then the mathematical genious looked at me straight in the eye an offered  "that's only $50.00 per month for each of us".  I felt some how that's she was saving me form the aweful truth].

The girls arrived at a large old brick house with an air of an old British family home. Melodie could not help think that their apartment was somewhere near the top.  When Melanie opened the door she warned that they could not be opened at the two doors at same time. Melodie's first impression was that they were entering their sardine can.    Melanie's enthusiasm was contagious and Melodie was not about to break her twin's bubble. Melodie remarked that the two of them could not fit these two peas in this pod. They would put their heads together and decide that this was going to be home and it would just need a little imagination.

Melodie and Melanie appreciated that this was their transition from the status of students to that of young professional adults. Despite age and various activities their names continued to be a source of twin mix-ups. Out of frustration of a new acquaintance, in her inability to make some sense of these two rather exceptional young women remarked not far enough under her breath--- "they even walk alike!""

Melodie and Melanie spent two wonderful years in their cozy apartment. Life was great ---jobs enabled them to use personal gifts and talents. Culture, social experiences, heart, enthusiasm and employment were the food from which they grew.

Meeting young men was always a story to be told. The girls would spend considerable time trying on each others new clothes....wardrobes were a frequent focus as their lives were full with a wide range of activities...everything from dance and a long list of activities that a 22 year old could possibly want. I had began dating a final-year medical student and Melodie a final-year RCMP Cadet who would become the love of her life.

After the university year, Melodie, her gentle friend, Geoff and Melanie and boyfriend, John,  headed to British Columbia on an extended camping trip.  Melanie and John did not consider the opportunity of moving to BC as they had unfinished educational experiences in Kingston, Ontario.

Geoff B. Clark, Melodie's partner, would participate in this road trip as his first military posting was in a small community of Comox on Vancouver Island. Melodie, in the meantime, found an exceptional work experience at the University of British Columbia Health Sciences Hospital....her expertise was that of psychiatric nursing.

He and Melodie spent their weekends together and over several months they began to tire from weekend trips between Vancouver and Comox. They therefore found an apartment in the village of Comox and Melodie began a new job in a local small acute-care hospital in the village. In order for Melodie to join Geoff in Comox she left behind a job she would never forget -- it called upon her psychiatric training in its true form --- the hospital was an active teaching medical facility within the complex of the University of British Columbia. She experienced a great deal opportunity to apply her skills and at the same time was able to maintain an aura of incredible energy in her workspace.

The beginning of September came all too soon for Melanie -- her leave of absence from her worksite in Kingston called her back to Ontario. Shortly after getting settled in the routine at work she developed a recurring severe episode of Meniere's Disease and told I could not return to work for several weeks. To make a long story short she was advised to travel to Los Angeles for the purpose of undergoing a neurological surgery procedure in an attempt to remove damaged tissue in her inner ear - near the brainstem. The disease had destroyed the function of the inner ear leaving her deaf on that side and balance was compromised. The support she received from a Ear, Nose Throat specialist, Dr. Arthur Shane in Halifax gave Melanie the courage to undergo a newly developed surgical procedure to treat this disease. Surgery was well tolerated and Melodie's presence and support were great motivators to tolerate the post surgical discomforts and compensation for balance issues. When able, Melanie flew to Comox, British Columbia to be with Melodie and Geoff for an exceptional visit.

Friends of Melodie and Geoff spoiled Melanie --every new day she was given a scenic tour of the the exceptional nooks and cranny's of the Comox Valley. The tour guide was usually a pilot as they worked twelve-hour day or night shifts.

Melanie vowed to someday return to that area in her retirement and "grow roses".  She  became very fond of one of Geoff's friends, Phil and married him in a matter of a 1 1/2 months from the time she met him.

Melanie's daily ventures ended when the surgical site began to drain and after a storm of seizures, Melanie was on the road to the nearest medical facility where I she was treated by a surgeon who, after talking with her surgeon in Los Angles, confirmed a diagnosis and the less intrusive surgical treatment was immediately organized.

Phil, Melanie's friend drove Melanie,  Melodie and Geoff to the hospital. The procedure was classified as an emergency and therefore a team of nurses and operating room technicians who were back-ups for the weekend shifts, were contacted to be present for the procedure. Melodie was called upon to assist in the operating room however minutes after an incision was made,  Melodie was overcome by the surgical invasion of her twin. Melodie fainted and assisted out of the surgical area.

Later Melodie was told that the expectation of her assistance was unrealistic and apologized for the expectation that she assist in what would be intrusive to Melanie.....not only was Melanie a sibling - she was Melanie's twin.  To observe her twin being a subject of surgery would subconsciously translate to the fact that her twin was subjected to harm.
Throughout the procedure Melanie was semi-conscious and with surgical drapes around her head.   She feared the unknown and had a sense that something was not going as planned. She was in the dark - not only visually but in the auditory realm as the ear from which she did hear was against the surgery table as she laid on her side.  Melanie waited to receive a cue from Melodie that she was safe.  Melanie became fearful and in a state of great anxiety as she was not connecting with her twin..... again - the phenomena of separation anxiety of twins reared its ugly head. The surgeon realizing Melanie's anxiety asked the anesthetist to provide a general anaesthetic.

Surgery was successful and over a period of time her balance was well compensated for ....to a level in which she could ski the coastal mountains with the best of my friends.
A few days following the surgery in which Melodie had a syncope (fainting) spell, Melanie was able to return to living a normal life.  Melodie took leave from work so that they could find some time to paint, treat themselves for lunch and go for a walk along a farmer's field. 

During that stroll along a farmer's fence, there was a sea of beautiful red Virgina Creeper, further on the beautiful wild grasses presented an amazing picture with the dew still present. They took a moment out to sit on the grasses, enjoyed the scents of the country landscape and for moments just sat without words in a fashion of meditation. Indeed, it was a moment that called for reflection and calm -- a tremendous energy was present -- and both remarking on the beauty of a spiritual moment. The twins both expressed their appreciation to be in each others space and share the exceptional energy.  It was a moment of awakening.  Later they would refer to that experience as a "Buddhist Moment".  That experience with a flood of peace and calm had occured in our past however on this occasion they were both mindfully aware of the energy and calm that surrounded them.
In actuality the "Buddhist Moments" were not only experienced in Melodie's presence. We had on several occasions addressed the fact that our connection was oh so real, true and like non other.
Several years later we once again shared another outstanding and meaningful "Buddhist Moment"....it occurred just months before Melodie's life unexpectedly ended. We sat in the warmth of the sun, together in our wheelchairs on an incredible warm Indian Summer Day and, Thanksgiving Day. Our favourite musical peace playing softly in the background and in this setting we once again recognized an energy shift -- without actually speaking,  We communicated our comforts and peace -- no words were required. We were sharing, with an awareness of shared energy.
Melanie extended her stay in Comox and in that time came to know and appreciate her new partner, Phil.  Melanie left British Columbia in late November so she could be with Melodie as she put the last minute plans together for her wedding...her marriage to Geoff..

A tragedy of an unimaginable magnitude occurred just days before the wedding --- Melodie and Geoff were in a car accident which left Melodie a quadriplegic due to the effects of a broken neck. Geoff received some laceration and remained in a small town hospital for 24 hours to ensure there were no unseen injuries or concussion. Their wedding day was scheduled for 23 December 1971 and both were determined to marry regardless of their tragic circumstances.  Melanie was present at the wedding - a short ceremony at Melodie's bedside as she lay there not being able to move anything than her eyelids.
When Melanie's new friend, Phil, and three others  heard of the news in their Comox location, they flew east to be with both Geoff and Melodie and the Elliott Family. They were able to offer Geoff some support and the presence of Melanie's future husband she was able to manage and function in circumstances unknown to few was certainly a gift of strength to Melanie. Just days after Phil's arrival, he asked Melanie if she would marry him.  It was a confusing time as Melanie had a sense of guilt -- after all, this was Melodie's time...it was to be all about her. With the experience of Melodie and Geoff Melanie and Phil had an appreciation that life's preciuos time is to be embraced as it could end in an instant.
Melodie was hospitalized for three months in a major teaching hospital in Halifax....she would  remained in traction for a three month period.  Melanie felt so incredibly helpless and said  "I could do nothing to enhance her life in any manner."  Phil was on his way to the UK for a flight training session and Melanie remained in Halifax to be with her Melodie.  Melanie was able to find work in the hospital where Melodie laid motionless in her hospital bed. 
Melanie flew back to British Columbia a few days after Melodie was scheduled to be discharged and flown to Comox British Columbia. She began her journey from an air base in Dartmouth, Nova Scotia and Melanie  so well recalles her twin lying on a  stretcher moving along the tarmac.  A medic pulled a sheet over her face to keep her from becoming wet from snowflakes. Melodie would have no part of that - she stated that it was the first time she has felt alive since the accident. ...the snow was a true marking that she indeed was to begin her new journey. Seeing the complexity of  Melodie being positioned in the airplane was difficult to watch -- Melodie had asked Melanie to remain close by.  Melanie, on a couple of occasions turned around and sobbed from many mixed emotions and especially that of the separation anxiety. Melanie's  fear that she would not survive the flight and was overwhelmed by thoughts of Melodie and Geoff struggling to maintain any type of life quality.....all this, in additon to the awareness that Melodie's hopes and dreams were truly shattered.   Melodie's last words before the plane's doors were "Melanie, keep your spirit, as I have a feeling I can going to be in need of it on occasion".
Melanie re-united with my new husband, Phil. a few days after Melodie had been aerovacked to Comox, British Columbia.
Melanie was most fortunate to find work in a local hospital in Comox - she was told of the incredible reception Melodie  received when the plane landed on the airfield as well as at the entrance of the hospital.   Once the plane landed at the military base Melodie was flown by helicopter to the hospital grounds just a few miles away - it was at the hospital in which Melanie was an employee on leave.  Friends related that  to see that helicopter land was a true celebration of the spirit.  Melodie was astounded at the reception she was recieving from staff at the hospital -- the same location where she last worked prior to leaving for Nova Scotia for her wedding.
The years ahead were at times very confusing and Melanie's marriage ended in its eighth year. Just prior to it becoming a done deal, her husband's behaviour with respect to the relationship Melanie and Melodie had became an unacceptable issue.  Phil was of the opinon that Melanie was spending too much time with Melodie and not enough with him.

 On one occasion, Melodie wanted to demonstrate to Geoff that she was able to go about her life with him and continue their fascination and devoted love.   Melodie, in her last days of an 18 month stay in the Physical Rehabilitation center in Vancouver wanted to make a surprise visit to Comox for a weekend with Geoff.   Melodie  called her twin to ask if she would meet her at the airport and enable her to call Geoff from the location of Melanie and Phil's home. Phil met the twins at the front door to announce that he would not permit Melodie to stay due to the fact he did not want any reasonsibility or be at risk of a law suit should Melodie have a need that he or Melanie could not attend to. That one event continues to be emotionally painful for Melanie to the day.

As the seasons pass, it became evident that military life was not compatible with Melodie and Geoff's needs. Geoff's solution was that of asking for an alternate posting -- a job at the military base in Chilliwack, British Columbia (a location in the Upper Fraser Valley) and this location became his new workplace and their residence. Once settled in Chilliwack,  Melodie was working hard with an occupational therapist trying to find adaptive ways from which she could manage to express her talents in painting. Her progress astonished all - Geoff and Melodie were encouraged by the fact that the art gallery was becoming inceasingly popular and from this they were confident that their art gallery was a viable business.....thus Elliott-Clark Arts was created.
Just as life was becoming somewhat organized and personal goals on track, Melanie experienced a direct exposure of an aerial sprayed pesticide which caused a toxic effect to brain tissue . This event has increased seizure activity and balance was such that she became wheelchair dependent. The effects of this was caused by the toxic pesticide (insecticide), Furadan.  The importer of this toxin has been Bayer Corp.(yes this the same corporation that stacks the grocery shelves with baby food and Bayer Asprin and has been around for decades) -- Melanie found it so, so hard to unravel and understand the responsibility of this pharmaceutical.

Melanie was in and out of a coma for the major part of a month. As she slowly retuned to function,  it was not obvious or comprehensible that her experience would translate to years of managing many linitations.  There was a great range of  cognitive and physical limitations.   For different reasons and locations Melanie, too, left hospital as a wheelchair dependent individual.  When she left hospital, physicians with sophisticated technology were able to put a label to the fact that the brain had been damaged however the toxic agent had not been identified.
 Seveal months later, Melanie received a call from Melodie who explained that there had been community meetings addressing the toxic effects of Furadan (a toxic pesticide) which provided tradegies to unsuspecting victims.  With new testings beyond the Canadian boarder, Melanie was diagnosed with the same diagnosis of nearly 300 individuals in the Lower Mainland (Upper Fraser Valley) Area of British Columbia. 
With each sign of progress to attain a ban of Furadan, Melanie's dedication grew to a devoted Canadian Scientist, Pierre Mineau who has worked for over 18 years in an attempt to take this chemical off the shelves. Over many years of "studies", supports of a ban did begin to make an impact.  We all have a reason to be grateful to this very devoted supporter of a safe living environment...... Doctor Pierre Mineau....a hero to those who were fortunate to have met him.

When Melanie was medically stable, she was discharged from the hospital unit under the care of Melodie and Geoff. Melanie's diagnosis at time of discharge was that of toxic encephalopathy (a brain that was not fully functioning due to toxic effects of foregin subsances).  The life-lasting limitations from this poisoning was such that Melanie was not able to preceive the total picture.  Within this picture and accompanying dignoses,  the label of epilepsy of an uncontrolled  nature,  would no longer provide her with the the privledge to drive and with many additional obstacles..

As a freelance writer,  Melanie took liberty to relay the outcome of what others had experienced secondary to exposure to the same chemical.  She posted an article, om am American Internet site -- such was accomplished and welcomed by an American webmaster's  invitation for a contribution of his site and magazine.  Several months after it's publication,  Melanie had reason to return to it only to find the major substance of the article was no longer present. Upon further investigation she was informed that the American Federal Bureau of Investigation (FBI) in collerabation with the Environmental Protection Agency had approached this webmaster and provided orders to remove portions of Melanie's article as they (various gov. agencies) had concerns this  chemical/pesiticde as a potential  "Weapon of Distruction".

When Melanie found herself in a "dark space", memories of her shared "Buddhist Moments" with her twin continued to be heart felt and a powerful means to much needed inner peace. Melodie shared the fact that their "Buddhisst moments" were  a strong source of strength and addressed  mental, physical and spirtitual elements in their lives.  They shared the appreciation that these events became the most profound moments of  Meoldie and Melanie's lifetime.  The phenomen became a life-sustaining component for both girls.

 After one-year of intense physiotherapy, occupational therapy and speech therapy, Melanie attributed esceptional progress to a neuropsychologist who helped her re-establish portions of memory, concepts,  balance improvement and a focus on what she experiences as a "left-sided neglect".  Melanie did not lose hope and unlike many brain injury survivors she refused to be as those who find comfort within the walls of their homes. She faced these obstacles as a warrior and by doing so she was accessing life.

. Knowledge that Melodie and Geoff had settled into their new neighbourhood in Chilliwack was of great relief to Melanie. From the moment of the tragic accident she was totally confused as to what direction she would best travel.  She felt there was absolutely nothing she could do for Melodie other than put her make-up on before visitors arrived.  Melanie felt she  had no means of protecting her and sensed she (Melanie) had let her twin down.  Melanie hid her emotions out of a need to demonstrate that she was strong and able to provide protection in Melodie's new journey. Without Geoff's supports, Melanie honestly did  not know how  Melodie would manage her own life.   As the twins discussed the issues at hand,  it became obvious that Melanie's capacity to know herself was very much in need of addressing.  Melanie had no energy or way to consol her sister from an open heart.

With mutual love and determination,  Geoff and Melodie's efforts in the art world became a successful investment.  With Geoff's financial strength together with Melodie's talent, Elliott-Clark Arts was a key to a successful art gallery. 
During this period they became very involved with their community.  Geoff was appointed as Mayor for a two-year term, he participated in a variation of sports and for that matter, Melodie was known  to give her husband an extended ski holiday as a gift.  It was obvious to Melanie that in late fall Geoff would become bogged down with the responsibilities of the gallery, his position as Mayor and participation with the progression of a first class community center for the arts.  All this turned around when, each winter, the mountains were his....a skiers dream.

 When Easter Sunday  arrived Melanie recalls a lovely Easter meal.  Geoff was up to his "tricks" and placed small Easter Eggs throughout Melanie's residence.  Eventually when I moved from that specific residence in West Vancouver she came across some of the easter Eggs Geoff left behind -- she embraced the event and  laughed so hard and such would remain as a great memory.

      Melanie recalls going to Chilliwack to join her twin and husband and with respect to  Melodie and Melanie's usual traditions, they were presented wtih a lovely bag full of great little gifts -- all from the heart of Geoff.  He went about his daily routine and if he saw something he felt would be appropriate in an Easter gift bag, he purchased two of everthing---and all for Melodie and Melanie.

     The twins were known to give each other the same gift and on one of many Easter's giving traditions the they were not only offered Easter eggs but gave one another with the same blue summer shoes and a great t-shirt.  When it came to a birthday of the twins -- Melanie captures the scene by using the words "come one, come all".  Relatives and friend made a point of being with the twins as they opened a birthday gift to each other.....we were never let down and the joy of sharing even the same birthday card was a conveniencing observation as some individuals present, "needed to see this to believe it". Relatives would come as far as a four-hour car ride.

In 2000 Melodie and Geoff left their business in British Columbia and took a year off to visit Australia.   Melodie had spoken of this dream on many occasions and Melanie suspected her physician was aware that her body would shut down in a not-so-modest time.  The couple, then seriously looked at their options and participated in a one-year tour of Australia. The ventue was tremendous and experiences became a view beyond that which Melanie could  dream about.

Melodie had Elliott Island on her "to visit list"  and did make a visit which they described  as a wonderous place. The next morning, it was their time to try suba diving (in tandum). Melodie was living a life time dream as she swam with dolphins. After the event she expressed a life-long need to participate in this activity one more time.

During that underwater experience, Geoff was able to take photos of Melodie and captured the magnificant colors surrounding them as they scanned the underwater activity. .  Small schools of fish would come out of no-where and the colour of  larger fish were such she had never seen before. She felt it was an experience that she would once again participate in and this was provided to her while vacationing in the region of Martinique two years later would be privileged to yet another day of exception and another item about to be crossed off her bucket list. Her greatest joy in Martinique waters was that of the presence of dolphins and Melodie took advantage of the opportunity to be in the water with them.

Unfortunately, their day of exception ended in disaster.  In the late evening Melodie had finally been able to unwind from the events of the day. The evening was a quiet time as Melodie was tired but remained very excited and with lots of energy from the day's activity.  The activity of the day caught up to her and off to bed she went.   Indeed they had a busy day en route to the Island and I fully expect the trip as well as the excitement of her swimming experience imposed great stress on her physical being.  Her heart failed that night as she laid calm and unaware of the end of her journey.
Now, several years after her twin's death,  Melanie feels  blessed in knowing that her personal sense of a "presence of Melodie" gave her every reason to believe  Melodie was and has been with her from the moment she passed.   Melanie was able to prove her point while receiving craniosacral  massage. The therapist, John, stood at the top of the massage table as Melanie laid face down. Melanie was so, so much enjoying state of relaxation - a level of calm that she had never previously experienced.

After the massage and acupuncture treatment, John asked if  Melanie experienced anything different during the massage treatment.  Melanie described the level of relaxation that she had never before been achieved.

The therapist, John, a deeply spiritual man, slowly expressed his experience while during the craniosacral massage procedure. He shared the fact that he saw a white soft aura surrounding Melanie's body.  For a split second John thought it was a reflection of Melanie's energy field  however was quick to realize that it was not Melanie but an energy field of her twin.  Melodie asked if he, John (acupuncturist), would be a messenger for her and pass on messages she wanted to share..   Messages were passed on to Melanie and many words John repeated were words only Melodie would use in communication with Melanie (the history of these words,  which are not in the English language, but words recalled from a very young age when these twins had their own language).
It  was obvious that John had no knowledge of some of the "language" that Melodie spoke however they were significant to Melanie. The entire experience was share the same joy and remaining in  absolute awe.   
Melodie's message to Melanie was acknowldgement that she was pleased how she has recognized that anxiety has returned to Melanie's world.  Melodie was adament that Melanie know, understand and believe  that when it is Melanie's time to leave life, she will be with her twin..  Melodie reinforced this a few times during her conversation with the acupuncturist.  Melodie was wanting Melanie to know she (Melanie) will never be alone before and after her life on earth. She added the fact that she was proud as to how Melanie is living her life.

As the acupuncturist left Melanie's resident, she collapsed with absolute and splended joy and felt compelled to acknowledge the moment in prayer.

Five years after Melodie passed away, Melanie had taken refuge in Buddhism.  In keeping with this a rather unique interpretation of death was Melanie's salvation. 

Melanie states "Although Melodie is no longer with us and in this world as we know it, I thought the separation anxiety would be intolerable --- such was not the case."  Melanie became stronger by the day as her Buddhist connnections helped her to adjust to this occurance and celebrate the fact that she has unconditional access and love from Melodie.

Melodie emphased that Melanie's passing will be an incredible experience for the both of them. Not a day goes buy when Melodie fails to make her presence known and in her humor characteristics has been very clever in her messages. Just the other day Melanie was looking for images on the Internet for inspiration and as she scanned the first page for an image, the monitor hiccuped and when Melanie looked closer, Melodie's image (seen in this blog) had arrived on Melanie's screen and Melodie's imagine from that experience remains at the same site every day.  The experience was so typically Melodie -- Melanie was overcome with joy and emotions ranged from giggles at her creative and sensitivity when connecting with Melanie.
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Melanie encourages Melodie to come more often and asks that her little David be with her whenever possible.  It was at that moment when Melanie retired for the night and was so, so comforted that Melodie was happy, secure and lived in comfort and peace.

At each visitation both girls are wearing their hair in the sampe style.  Both are with long blond hair .David loves to play with his Mother's hair in his very gentle way.  Melanie loves to see her twin singing to him and after she finishes a tune, David continies to produce sound in his own self-gradification and out of happiness.

David often indicates that he wants to play in the sand.  Melodie prepares an area for him and he remains content in one spot.  When it was time to leave, Melodie joined David at sand level and in simple words explains tthat they have to return the sand  to the the manner which it was before he had begun to play in it.  She takes his little hand, speaks of Mother Earth's kindness and together they pat down the sand so that it is not disrupting nature's gift.
Upon Melanie's recognition and awareneess that Melodie is with her and unconditionally so, Melanie had no longer felt this to all be judged as an illusion/delusion or an outcome of a mental meltdown.

Melanie  took the matter of psyhic energy one-step further and was in contact with a physic who informed Melanie that her twin has a busy life and that she should consider her sister's personal and private time. He strongly supported that she embrace all communications and be open hearted as she (Melodie) has a need for the "light" side of life and celebrates her contrabutions.  Melanie was advised not call upon Melodie when she is in distress and wishing to have a listening ear when experiencing negative outomes in mundane daily issues and frustrations. Melanie knew oh so well that this would be difficult to maintain the self-discipline to approach communications with a calm, rather less-than-gentle manner. If Melanie was not able to accommodate the psychic warned that Melodie may find a need to visit less frequently.  Although commmunication has to remain without the blemishes of daily living it was suggested that Melanie personally vow  to embrace the fact that, this love, time and purpose will remain understood, protected and that both would remain with meaningful tools, they had been given.  To this day Melanie remains without any knowldge of "tools" and looks forward to this topic as a child would wait for Christmas..

 The sharing of the twin's experiences with a psychic provided Melanie with a gain in wisdom, and a gentle calm that she feared to be incapable of.  Such goodness would be their rewards and that there were benefits of connecting in  the proper manner.

The psychic continued to say that our communication is a powerful gift and will serve to provide the energy needed to meeting life's end...the stronger the bond the greater the passing experience. It will have an affect to the quality of Melanie's journey when leaving life and a special achievement on Melodie's part.
In order to establish a "calm" Melanie repeats a mantra each evening and does not call Melodie to join her when she is poorly managing stress or with anxiety, Melodie stated that with a calmness, issues of anxiety and anger will become more tolerable as time advances.

On occasion when Melanie as a very strong need to paint, she works on what is named a "wet on wet" technique painting techniques. (water on paper and "color" dropped into it creating interesting images. with a wish the outcomes become of interest and pleasure).   Melanie established this type of painting as a therapy -- grand surprises each time a color is applied and when color is dropped in a  "paper puddles" and in doing so creates an amazing, uncontrolled appreciation of color, texture and above all - joy and recreation.

Melodie's spirit and energy when Melanie is lacking self-confidence or about to have a meltdown is much less a struggle since hearing the acupuncturist,  John's message from Melodie.  Melanie is now comfortable with no expectations placed on her as just knowing her twin is present is in it's self  all that Melanie needs and is working hard on being able to pick up on Melodie's presence and participation.  Now, when Melanie feels she can no longer participate in life she reflects on the situation and does not give credit to anxieties, depression, anger and disappointment...she explains that communication glitches and perceptions are just "thoughts" of the moment. The word "perception" and its awareness is the key that emotional thoughts do not require Melanie's time being soaked up like a sponge.  She has discovered that the  easiest method to prevent energy loss unecessarily is to take a deep breath and allow as little time possible to participate in a less-than-positve events as it is more important that embracing the positive situation will provide a much higher and quality of energy in an effort to move on.

Melanie so often is dragged into what she describes as "a dark place" ... indeed a negative behaviour. Quite often Melodie will remind her twin that there is good in everything....a thought of comfort when going into her "dark space" serves no one and only adds to the lack of self-confidence Melanie is well known for.

Today, Melanie has stayed in bed and with not enough energy to even water her plants.  In the past she would be incredibly disappointed, irritable and without any humor.  She can now use the past tense "was" as by taking Melodie's advice, She shows incredible joy in knowing she was able to meet a deadlne to finish and mail an application for what she preceves as a new beginning in her participation in life and has joy in becoming a proud, self-confident, compassionate and wise  Senior. In this vein, Melanie found strength to complete an application for the purpose of retirement. (1 September 2012]

As Melanie fell asleep today she did so with great joy and pride that despite the attitude of medical health professionals and service providers....she has done it her way and such was pointed out to Melodie during a spiritual visit.  Melodie was obviously touched by Melanie's "not accepting an answer that reflected "no".....she described it as "the twins way"
Perhaps the most dramatic episode in our life of exception took place on Christmas Eve approximaely 1984. . Melodie and Geoff had been working at the gallery at a feverish pitch for weeks and once again they got through another Christmas Day count down and after a short break after the 25th December,  it was the tradition to unwind and indulge in the comforts of their indoor spa and dine with scrumptious treats on a floating tray in front of them.

The evening agenda was to enjoy a platter of seafood, delicacies in the light of a candles and sitting in a lovely warm hottub.  Melodie had arranged for music to be played in the background.   Her choice of music was that which both twins prefer...this was a continued source of great joy.  Another gesture and reminder from Melodie is the fact that she is with me to share more music selections and at times return to the old.

All three in the party (Melodie, Melanie and Geoff) had a mutual understanding that we would all attend the candle light service at the church...a midnight service.

 There was a rule of the household on Christmas Eve. namely,   those in the house would have access to one and only one Christmas gift.  Geoff, in his humor and sensitivity added to the evening with an unprecidented gift for Melodie.  The time he put into her gift was always thought to be repesentative of his love for her. 

One unforgetable event occured when in it was time to get dressed for church, Melodie was obviously exhausted and agreed to lie down while Geoff ad I went to the midnight serivice together.

Melanie was proud to join Geoff and had no, absolutely no idea of what she would met up with at the service.   Melodie and Geoff were regular attendees and Melanieit was planned that Melanie would take her place which Melodie  Geoff escorted Melanie to an adapted seating area (for wheelchairs) and Melanie promptly found herself in her twins church-going designated location and with Geoff beside her.. this met with a haunting silence in the congregation.  Melanie looked at  Geoff for some explanations of what had occured to cause such an overwhelming change. Geoff rolled his eyes and spoke a phrase (one which was a fad at the time) "go with it".   I had no idea what was brewing and my separation from Melodie as I sat in her church position was disturbing and anxiety provoking.
  
The congretation was obviously confused by the fact that Melanie had taken Melodie's seat.  Melanie became uncomfortable until Geoff leaned over and came to Melanie's rescue ...his words were "it is a twin thing" - indeed ! and of a major proportion. That very phrase was all Melanie needed to realize why the congregration were in total confuson. Some were quick to realize Melanie was the twin of Melodie and those present in the church were touch and saddend by what should have been Melodie sitting in front of them.  The reality of Melodie's lack of physical freedoms were for the first time acknowledged.    Melodie's past  and, in the image of Melanie, truths prevailed.  With reality in front of them, emotions were very mixed and present.

There  were participants with tears in that church service.  Others were nodding out of respect of my presence and their gratitude for my efforts to ensure Geoff was not alone on Christmas Eve.

The experince and sensitivity of the night left behind a range of emotions for Melanie .  The reactions of the congregation were certainly statements of the love and empathy they had for Geoff.

The Minister was in a position of feeling compelled to address the situation and so kindly introduced me to the congregation. The energy in the room qjickly became that of incredible compassionate-filled, appreciation and provide Melanie a Christmas I will never forget.
After the service Geoff and Melanie spoke with several of Melodie's and his friends,  Melanie was quite surprised as they too had not been mindful of the scope of Melodie's limitations.  Several apologized for their lack of compassion, empathy, and social expectations of her. Some spoke of their remorse.....as they had not been sensitive to Melodie's disabilities. It would seem that  Melanie's was sent to present the message.  Clarity to Melodie's spirit and shelflessness had been celebrated.

Back to the Present: Each visual visit the twins are wearing very similair clothing.  Melodie appears to have put together a nice stylish wardrobe and wearing casual clothing in most visitations - lots of color and with striking jewelry....like Melanie, she continues to wear pearl ear rings despite the occasion or location.
"Their Meeting Place" has become one which Melanie intends to paint...she feels she knows it will provide her the an awareness and permanent landscape, and with an emphasis of "calm".
Now that Melanie is aware of Melodie's presence she no longer feels she has had a melt down to all of this.  The twins connection is very real and Melanie has no intent to argue the topic which she holds as private and so  precious.


Melanie  longs to see Melodie's child, David,  who blends so well in the prescence of his proud mother.  Melanie is of the opinon that this child has an abundance of calm, inner peace, love.  At a gathering of any kind, little David, gets passed around to all who value the unconditional love of this oh so innocent open-hearted angel.
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Prior to Melanie's communications with Melodie grieved so deeply .... her world was upside down.  She tried so,so hard to justify and accept the inevitable event when in the passing of one twin, the second twin would would leaving life and such would translate to the second twin  physically behind and  alone.

The twins had discussed this fact at great length and although there was no solution or resolution they each promised their twin to carry on in life and embrace it. She is to continue to make a difference in the lives of others.   Melanie, intellectually,  knew this outcome would occur however she was not prepared for the extreme agony that came with it.  Initually, Melanie could not imagine how she would begin to participate in life again without her twin, her heart has not been open since Melodie's death --- the separation anxiety that accompanied Melanie's grief presented a picture she was not prepared for.  After Melodie's visit with the acupuncturist present, the affirmation of Melodie's energy being present valided that her twin, Melodie remains by her side.  It was a statement of a truth  that Melanie unequivocally knew and drew strength from the knowledge that she and Melodie "would Never be Alone".


.......Nightingale
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