Friday August 5, 2005

Friday August 5, 2005 I ended up spending the night last night because I felt too sleepy to safely drive home. Dr. Skolnick (pulmonary) came in to check his Trach hole and said it should be closed up completely in a few days. Dr. Miller (physiatrist resident) checked out his head wound and said just to be safe they would probably wait until Monday to remove the stitches. The CAT Scan looked good, no real changes. 8:00 AM Zack is sitting up in bed and keeps putting his foot on the floor like he is going to get out of bed. We get him dressed, in his chair and down to the gym for physical and occupational therapy at 10:00. They have him stand while holding onto as walker and he does it very well except for holding his head up. When they sit him down he starts to throw up again. Mary Beth (O.T.) and Amy (P.T.) discuss that he may be dizzy and it would not be uncommon for him to have some vision problems. All of us are anxious to get him over this because it interferes with his therapy and that is why we are here. We return to his room and put him back in bed to rest. At 11:15 he is throwing up in bed. We contact Dr Miller and he orders Raglan (a motility agent that helps move food through the digestive system) with the hope that it will stop the vomiting. We have been holding off on the Raglan because one of the potential side effects is confusion, the last thing a person with a brain injury needs. He also decreased the amount Bolus food during the day and increased his tube feeds at night. We are looking for the perfect balance to give him the proper amount of calories in a manor that his digestive system can handle. He gets his first dose of Raglan at 1:00 and we head to speech therapy. He does very little in speech except to rub his head. He gives us signs like he has a headache (not surprising) but will not answer when questioned. I head to the gym for his afternoon O.T./P.T. session and I am rather depressed. I was so hoping for a good therapy day since yesterday he was sick and now he is sick again. Mary Beth approaches me and asks if I would mind sitting out this session so they could work with him in a private room with some sensory therapy. Another blessing from God, because I was just sitting there thinking that I couldn’t handle watching another therapy session where he did nothing. I return to his room and sit down to wait. I have Dr Miller paged to ask him if Zack can have any Tylenol for his headache. When Mary Beth returns with Zack she tells me that he did very well. They used a 12” kick ball and he made several baskets. He also caught the ball at least 10 times and used his right hand (which he has been neglecting). They introduced several different smells and he responded to lemon (he tried to bring it to his mouth), which probably reminded him of his favorite dessert, Key Lime Pie. We get another visit from Dr. Kraft, Director of the Brain Injury and Spinal Cord Injury Program at Frazier. I tell him I have a few questions and he asks me to take a walk. He takes me to a conference room at the end of the hall and we talk for nearly an hour. He is a brilliant man and appreciates my desire to know as much as I can about brain injury. He explains to me how the neurons in the brain send messages, past from one neuron to the next using chemicals. When an injury occurs the brain experiences “excitoxic”, which means the neurons get excited and all start sending out messages at once, releasing so many chemicals at once that they become toxic to the brain. When an injury to the brain occurs some of these neurons are damaged, some recover and some do not. The human brain has 100 billion neurons, some are specialized (designed to control a specific part of the body like the leg) and some can do many different things. As you recover from a brain injury the neurons that aren’t specialized take over functions for neurons that are damaged. Initial recovery takes about 6 months but continues for years to get better.
The frontal lobe of the brain, which is responsible for reasoning, is the last part of the brain to develop (which is complete at about age 23). That is why teenagers with an underdeveloped frontal lobe don’t always make good decisions. That is why parents need to set boundaries for teenagers to help them make good decisions (emphasis added). I have way over simplified it but you can see that the brain is very complex and we have many neurons that can be trained to take over new tasks. There are 5.3 million Americans with brain injuries and research continues to find ways to enhance recovery. Dr. Kraft explains that brain injury is an inconvenience but it doesn’t have to be devastating. We will never have the son back that we knew before the accident. He will have depth as a teenager that you don’t see in people much older. There will be no limits on what he can do but it may be harder for him than most other people. This will make him stronger with a deeper appreciation of life. We can be proud of the person he will become. There are people with spinal cord injuries that never get out of a wheel chair but they go on to college, write books, fly planes, get married, laugh with friends and have a wonderful, productive life. Then there are people with no injuries that drop out of school, have a meaningless job and live each day for their 6 pack of beer. Who has a more rewarding, fulfilling life? Dr Kraft also gave us advise for the phase Zack is currently going through. He told us that he needs a quieter environment, less visitors at a time and not several conversations going on that would over stimulate him. They should talk directly to Zack about normal stuff, what is going on at school, who is dating who, that annoying dog down the street…gossip. We should talk to him like we always would, be honest, tell him the good and the bad. He doesn’t need to be told that he is “going to be fine” because he doesn’t think anything is “not fine”. To him a minute is like a day is like an hour. He doesn’t need a cheerleader. He needs someone to hold his hand and talk with him about normal, every day stuff. His friends are great at this (although we get too many at one time). When I leave Dr. Kraft I am energized. I am no longer down about Zack throwing up and not doing well in therapy today. I am again, blessed by God for sending just the right person to talk with me. I am eager to share what I have learned with Scott and the rest of our friends and family. Many of Zack’s friends come and visit him tonight. He is more alert than at any other time today. He is looking to the right with no tone in his right arm. He seems very relaxed, content, with a grin just beneath the surface. He winks at Brittney Garr. He is a teenager with a cell phone. He is a person that happens to have a brain injury that one day soon will amaze us all. He will face challenges but eventually he will overcome them, stronger than before. He will come through the fire with the knowledge that he was never alone. When his friends are gone and I leave for home there is one who never leaves him. The one who is called up along side…the Holy Spirit. Keep praying. The healing continues.

For those that would like to learn more about brain injury go to the following websites:
www.biausa.org or search for Centre for Neuro Skills