Thursday August 25, 2005

Thursday August 25, 2005 Zack was up early this morning and had breakfast before I arrived. Dr. Miller came by and looked at his head wound, which is healing nicely. He also discussed waiting until next week before we move him out of his tent bed and into a lowboy (which can be set only 6” off the floor). We are very afraid that he will get out of bed in the middle of the night and fall without his helmet on. It was almost 9:00 so I had to drag Zack out of bed so he would be ready for speech. When he got up and walked towards the closet to pick out clothes he had another “attack”. He stopped and I had to support him. He had a blank look in his eyes like he wasn’t there for about 3 seconds. Dr. Mook came in and said he would order an EEG to rule out seizures (It still may be difficult to tell unless he has a seizure during the test). It was 5 after 9:00 and we were ready for Kathy when our schedule arrived with changes. Apparently we weren’t going to speech until 11:30 and Zack was not happy about it. He got very upset and we walked the halls because “we have to find somewhere to go”. He keeps trying to go down the elevator to go to therapy and when I stop him he yells, “You’re pissing me off”! He does not like his schedule being changed. He was mad but expressing himself very well. When we got back to his room he told me “get on the bench and call somebody”. He wants me to fix it if I am going to stay on his team, otherwise I can get off the bench. In P.T./O.T. Amy and Mary Beth had him working out doing sit ups, crunches and exercising his right arm by pushing a weight up a small platform while receiving E-stem (electric stimulation). Donna found our missing camera in the back of someone else’s wheelchair. We have been looking for it since last week so now we can get those pictures developed. 11:30 In speech I think Zack was still mad at the time being changed because Kathy asked him basic questions, day, date why you are here, who am I and he couldn’t answer any of them. She showed him a piece of paper with random numbers and letters and asked him to find a particular one. He got 90% of them right. When she switched to words, showing him 3 at a time, he only got about 60% of them.
Mary Beth (O.T.) came to have lunch with us again today to work with Zack on personal skills. We love having her for lunch because she is so good with Zack. She also told us how serious re-injury would be and how common it is, particularly in teenage boys. She explained that when Zack comes home his friends are going to want to take him out but it can’t happen. For some time either Scott or I will have to be with him when he goes out because he does not have the filter to stop him from saying something that could get him in trouble. He may be standing in line with his friend to get ice cream and some big guy is ordering a banana split. Everyone may be thinking “this guy doesn’t need to be eating” but they would never say it to his face. Unfortunately Zack might and then the guy could punch him. Re-injury! His friends could want to take him bowling but there are people smoking there and 2nd hand smoke causes seizures in people with traumatic brain injuries. Zack may wear his friends down and convince them it would be O.K. Re-injury! Once you have had one brain injury a 2nd one can be devastating so we can’t take chances. We can’t let his friends have that responsibility. We have to be careful where he goes and protect him from potentially dangerous situations because he will not make good decisions for a while. 1:30 Speech with Kathy and Zack is asked to finish the end of a sentence (Put the pie in the _____________). She would also give him 2 tasks to do at the same time (touch your nose and pat your head). Two days ago he got 50% but today he accomplished all of them. The afternoon P.T. session with Amy was difficult. He had to get on his knees on a mat and touch targets in Amy’s hands that she moved around. He got very frustrated and hit a pillow with his fist. She had him lie on a large skateboard and pull himself around with his arms. It was hard work and he was very tired. In O.T. Mary Beth had him walk like a spider on his hands and feet belly down and then turn around and do it belly up. Very difficult and I’m not sure how well I could have done it. Zack got tired and he complained but he would stop. He is so determined and strong. I think he really understands that we are here for therapy and that’s what makes him better. Back in his room he was resting in his recliner. He decided to get up and again had another “attack”. I thought we had these figured out and giving him plenty of fluids would solve the problem but here they are again. Several of his friends came to visit and when it was time for them to leave he wanted to go with them. We told them they had to go do homework to make it not so appealing. I need to remind his friends when it’s time to leave not to discuss where they might be going since Zack is very aware of what he cannot do now. He is progressing at such a rapid pace that the rules change all the time. Some of the rules I have not enforced but now I will have to. We need to keep it to 2 or 3 visitors at a time. He can get over stimulated, which could aggravate his depression. If you come as a group please be aware that some of you may have to wait in the conference room (there is a wide screen TV there). Please be sensitive that when you have been visiting for a while and others come that you should end your visit. He loves to see his friends and it is good therapy as long as we don’t overwhelm him. 10:00 PM Zack has been sleeping for about an hour so when he wakes up Kelly (night nurse) wants to weigh him and he needs to go to the bathroom. As we walk that way he has another attack but this time I have Kelly and Erin (aide) to witness it. Kelly says it looks like he was having a focal seizure. We sit him down and he says something about his vision. He says he sees 2 of me. I hold up 1 finger he says he sees 2. He closes one eye and I hold up 1 finger and he sees only 1. He is seeing double at times, just as Mary Beth has suspected since the first week here (I told you I liked her). Kelly wrote it in the report and we will be sure to talk to Dr Mook about it in the morning. Please pray for wisdom that the doctors can figure out what is causing these “attacks”. Pray that discussions about the accident will be productive (he is starting to ask questions and making comments...”how bad was it?”). Pray that he will understand and embrace God’s promise in Romans 8:28- “And we know that in all things God works for the good of those who love him, who have been called according to his purpose.” And always pray for complete recovery in order to glorify God!