Thursday October 27, 2005

Thursday October 27, 2005 Zack was up at 7:00 and wanted cereal for breakfast. On the way to Frasier East I told him I would be there at 2:30 for the Team Meeting and his therapist would tell me how well he was doing. I also told him that we were going to meet the firemen that rescued him the night of the accident. I explained how the guardrail came through the windshield and cut his head and how they had to cut the top of the car off to get him out. I told him they thought he was dead and he said, “That’s good that I’m not dead”. I agree. I met with his therapy team at 2:30: Sandy Clark RN, Dr. Perri (psychologist), Leslie and Megan (speech) Suzanne and Scott (occupational).
There was not a physical therapist present but all they need to work on physically is endurance and strength. Speech and Occupational therapy at this point kind of overlap. They both work with him on attention to detail, awareness, impulsivity, perception and reading. His main deficits at this point are still language (aphasia) and visual perception (agnosia) but the aphasia has gotten much better. He is starting to recognize that many tasks are harder than they use to be therefore he will become more aware of his deficits. The more aware he becomes of his deficits (particularly if those deficits become permanent) the more likely he is to experience depression. He is at the beginning of the awareness stage. Cognitively and physically he works well (75% accurate) for 20 to 25 minutes before fatigue sets in. The more tired he becomes, the more impulsive he gets and the less attention or focus he maintains. Fatigue could be a deficit that remains for a long time. His reading has improved a lot this week but is hampered by the aphasia. They suggested that we label things around the house so that he will see written words and associate them with the object. Kyle will really enjoy making index labels and putting them throughout the house. This week they confirmed that he has visual perception problems and they suspect he has a “field cut”. This is when a section of his visual field is absent. It could be a pathway that is severed or actually a damaged nerve (which could not be repaired) or a combination of both. With a field cut a portion of his visual field is missing but he does not see it as a blank spot. His brain fills in the missing part which is not a problem if he is looking at a landscape or sky because the brain just fills in more sky at the missing section. However it becomes a real problem when you try to read because the brain doesn’t always know what letter to fill in. They have referred him to Dr. Weinberg for a Neuro Optometry Evaluation to determine exactly where the field cut is and how large it is. Then they can develop therapies to teach him to work around his deficit (much the same as you work with dyslexia). I have scheduled an appointment for Tuesday Nov 8th and hope that they discover only a small area that can easily be treated. They feel that we will find it on the right side because he still does not scan all the way around on that side. Scott took him to Kroger again today on a scavenger hunt. He asked him questions, like show me where the frozen foods are and has him scan visually from left to right. He stops at about 2:00 so this reminds me very much of “right side neglect” that we dealt with in the first month at Frasier Rehab. Scott also pointed out that Zack really needs to focus more on awareness to his surroundings especially when it comes to safety issues. He is likely to walk right into the traffic lane but Scott did say that he is listening and learning. On the way back from Kroger Zack remembered that he was supposed to do something because he asked Scott, “Am I supposed to stop and look here?” Dr. Perri said that Zack seems to do much better in group sessions and is impressed with his social skills. We can thank his friends for that because they have been socializing him since the first day of his accident. I told his therapist how his friends came to see him every day, played ball and cards with him, even when all he could play was “Go Fish”. I told them they still come everyday and play pool and he gets out to soccer and football games and his youth group as Southeast Christian Church. This is the reason that Zack does so well in group settings…thank you! In general they all agree that Zack is cooperative, he tries very hard, he is a pleasure to work with and is improving every day. They expect him to do very well and return to school but they are not prepared to say when that could happen. They want him to be at a point that he will be successful when he returns to school and right now it is too early to say when that could be. I pray that after we have our appointment with Dr. Weinberg they can develop an aggressive therapy that will help him recovery his reading skills. Zack had interrupted our meeting one time when he was done with his therapy. I told him he had a Seek–n-Find book in his binder and he needed to go work on it. When we were finished I found him in the therapy gym at a table working on a page in the book. He showed me how he had almost found every word but was ready to go home. He said he was very tired but I reminded him we were going to Middletown Fire Station. We got stuck on Gene Snyder Freeway behind an accident and were late arriving at the station. One of the firefighters was already gone but we got to meet Fireman Michael Williams. He was one of the first on the scene and had cut the roof off the car to get Zack out. He described how the airbag and dashboard were on his chest and they thought he was dead until they felt his pulse. He described how Zack started to fight when they intibated him and tried to pull the tube out of his mouth. It was a good sign that he was moving. They really didn’t expect him to live and Michael was very glad we came to see him. Unfortunately, the team working that night has been split up among 3 stations but we intend to visit the Lyndon Lane and the LaGrange Road station and meet the other firefighters that God used to save Zack that night. They invited us to come back and have dinner with them one day and we took pictures with the fire truck (Zack got in the drivers seat). I am looking forward to meeting the other firefighters and hearing their rendition of that night. I admire them greatly and now we are forever grateful for their skill that night. Zack wanted to meet them but now was ready for a nap. He was able to sleep for about 90 minutes before dinner and then I had to attend a middle school parent meeting. When I arrived back home there were several friends visiting with Zack. He has had so many people play a part in his recovery…the firefighters, surgeons, ICU nurses, therapist, doctors and Frazier nurses…but his friends have never failed him. They have been constant, faithful therapist by simply providing support, encouragement, acceptance and love. How blessed we are that God has placed them in his life. They may make bad choices sometimes but to us they show a Christ-like character as Peter described in 1 Peter 1:22 “Love one another fervently with a pure heart”. Praise God for your children. Pray that they will be caught in their disobedience so you can correct bad behavior. Pray that God gives you the courage to be a diligent parent and that your child will recognize it as love. Never give up teaching them how to make wise decisions. Cherish them because, even in their defiance, they need you. Please continue to pray for Zack’s complete recovery for Gods glory.