Thursday August 4, 2005

Thursday August 4, 2005 There were several people in Zack’s room when I arrived this morning (a little later than usual). Dr. Skolnick had removed his Trach at 7:30 A.M.
Dr. Mook was discussing changing his catheter because there was some blood in his urine. Apparently Zack had been pulling on it through the night and didn’t sleep much after 3:30 A.M. (for those in the medical field, they changed from a Folie catheter to a Texas). Dr. Mook also ordered a CAT Scan because they want to check the hematoma (bruise) underneath his head wound. They want to remove his stitches but they need to be sure everything is O.K. first. Carla Herman (a nurse and friend of the family) had stopped in to see Zack before going to work and was holding his hand while all these discussions were taking place. Zack was watching her intently and suddenly he winked at her. Very deliberately. It was delightful and amusing. Zack did not seem right in our morning O.T./P.T. therapy session. Mary Beth (O.T.) and Amy (P.T.) discussed that Zack was showing signs of “apraxia” which is very common in brain injury. When he is given a command you can see him trying to do it. He knows what you want him to do but his brain just can’t make his body do it. It is just another phase we have to work through in therapy. Zack was sitting on the edge of the mat and they were getting him ready to stand up when he projectile vomited. He was a mess and so were Mary Beth and Amy (I was spared only because I was standing on the mat behind him). We ask him if his stomach hurts and he nods “yes”. He looks ill. Back to the room to figure out what was going on. I talked to Dr. Miller and he ordered that the next Bolus feeding be hung to let gravity put it into his stomach slowly instead of injecting it. Zack has not had his stomach full for so long he just can’t take a lot of food right now. It is a catch 22 because we need his calories to increase (to get his weight and strength up) and the only way to do that is volume. We put Zack to bed for a while until it is time to go to Speech Therapy. Kyle (Zack’s 9 year old little sister) meets us there with a bowl of Key Lime pie. Kathy, our speech therapist, told us we could bring something in that Zack really liked to try swallowing and his favorite dessert is Key Lime pie. Of course he only gets tiny bites of the filling. It took him awhile but after Kathy gave him a hand mirror and he could see it on his lips he finally licked it off. It sounds so simple but the tongue coming out of the mouth is a positive recovery sign. Afternoon O.T./P.T. session was different. Amy and Mary Beth decided to try to see if Zack would use an answer board. They printed a question on a piece of paper and had Yes and No printed on other pieces. They asked, “Is your name Zack”. It took a little while but he finally moved his hand to the “yes” paper. They asked, “is your Dad taller than you” and again he answered “yes”. Scott and Zack were very close to the same size before the accident but Zack is definitely taller now. He tired of that game pretty quickly (he has the attention span of a 2 year old except with the cell phone) and they decided to just stretch out some muscles. They sat him on the mat with his feet straightforward and were stretching out his hamstrings. He had a terrible look on his face and began to cry. He was moaning and I thought he might talk. This was the first true sign that he was in any kind of physical pain during therapy. They asked him if it hurt and he nodded “yes”. They decided to move away from the stretches and into an activity that Zack apparently enjoyed. They stood him up. They squirted foam soap over the mirror that covers one wall in our therapy area. They give Zack a washcloth and he begins to wash off the mirror. He even reaches far above his head. He cleaned every speck off the left side but ignored most of the right (right side neglect). He did this all standing up with support. Back in the room at 5:00 P.M. they start his Bolus on a 2-hour slow feeding. At 6:45 they take him for his CAT Scan. At 7:30 he keeps trying to sit up in bed and seems very agitated. Again he starts to throw up. We have to get this rhythm of feeding at a level that gives him enough calories but not enough to make him throw up. I would like to say I ended the day with a warm smile or a Hi Mom but he is only resting now. We turned away a few of his friends tonight since he needed to rest so he could do well in therapy tomorrow. My night was comforted by a card I received from someone I work with (thanks Pat). The card reminded me that we are part of a perfect plan designed by God who loves us completely. We are in His thoughts every minute and they are filled with a desire to bless us. I am confident that God is working in our lives. I can’t wait for tomorrow to see how he will fulfill the scripture “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” Romans 8:28 How perfect for us at this time. I ask for your prayers that we will get Zack’s feeding plan figured out. I ask you to pray that God will turn his head to face the world straightforward. Never stop praying.