Ms. Purvis (speech-language pathologist) gradually increased the exercises over time: arrange numbers according to descending order, repeat a sentence reverse. She increased noise levels and distraction. to approximate Ms. Lewis’s busy work environment. She kept the door open and turned on television news, eventually holding sessions in the bustling gym for physical therapy.
Amid the hum of treadmills, exercise bikes and other patients’ conversations, Ms. Lewis worked earnestly to arrange playing cards by suit in ascending order and flip numbers spelled with a “T,”Like “two.” Simultaneously, Ms. Purvis recited words, and Ms. Lewis tried her best to raise her hand whenever someone started with them. “B.”
“You missed 12, which is a lot more than you normally miss,” Ms. Purvis said.
“Ay,”Ms. Lewis sighed, her fingers fidgeting.
Ms. Lewis asked her to continue at 1 and add 9 and subtract 4, until she reached 130. She was slow and halting.
“Oh my God,”She exclaimed after she was done. “That one was harder.”
Later, she was able to recall four statements that she had recited in the session’s early stages. “Rubber bands last longer when refrigerated.”
“It’s been challenging,”She told Ms. Purvis. “I don’t feel super-disheartened, though.”
Dr. Roth explained that some patients may experience worsening symptoms due to cognitive or physical exertion. He suggested that patients use the AbilityLab. “push themselves as much as they can, but not beyond.”