A Place for Family and Friends
We brought Mike home today. All I can say is WOW!!!! We now start a new chapter in his life. We are blessed to have come this far but we still have far to go. We will have a more complete update soon. “Thank You” to everyone and Happy New Year.
We had our last family meeting yesterday. The Dr’s and Therapies were thrilled with his progress and are excited about his future. Mike continues to fight with initiation and where his body is in space. This appears to be one of the biggest hurdles that he has to over come but as always, Mike is up for the battle with a great attitude and outlook. Mike will have a procedure on Monday afternoon to turn the clot filter. We hope that this will be the last turn of the filter and the next procedure will be to remove the filter. Mike has come very far in his progress but he has a very long way to go.
The plan for the next several weeks is for him to be discharged Friday January 4th and start in-home therapy Saturday January 5th. He will have three hours of therapy three days a week. After completing the in-home therapy, he will be enrolled into an outpatient DayOne program at Mt Vernon that will help him transition back into the community.
Everything is going smooth…no major changes but many observations to share. Our first family meeting is Thursday at 2pm with all of Mike’s therapists, his doctor and hospital case manager. Hopefully there will be lots to share. I apologize for no real updates…it sometimes takes it’s toll. I’ll be back at it tomorrow. Till then…
xxoo
The MRI shows that Michael’s right knee has torn cartilidge. We don’t know the details yet, still waiting to meet with an Orthopedic. Depending on the location and severity of the injury, there are several options for repair…we’ll just have to wait to see what the doctor says. Mike continues to push himself with each therapy session but fatigue sets in so quickly that out of an hour, he probably has only 30 minutes of real work. Endurance, strength and stamina will all come in time. There has been such incredible progress this week, we’re just waiting with baited breath to see what the repaired knee and 5 more weeks of rehabilitation will bring.
The results of the blood and urine cultures were negative for staff and the UTI infection is history. Mike had the remaining staples removed from the bone flap incision and with the help of his occupational therapist, was able to take his first shower in five weeks. Oh, yeah. You know that had to feel gooood.
After physical therapy at 3pm, you could see that Mike was spent. He was visibly agitated and uncomfortable while he sat in his wheelchair for the extra hour after PT. I was able to figure out that Mike’s back is part of the discomfort the longer he sits in the chair. After an hour of physical activity and weight bearing exercises, he’s feeling the burn.
About 5:30pm and right in the middle of dinner, they took Mike for the MRI. Hopefully, the MRI will show the cause of the intense pain associated with movement of his right leg, the knee in particular and will lead to the end of one of the last stumbling blocks for Mike’s physical rehabilitation.
The feeding peg was supposed to be removed today but… He’s human right? He probably forgot.
The Doppler ultrasound revealed yesterday that Michael does have a clot in the right groin area, so the IVC filter could not be removed. At 3pm Michael was taken to the operatory where under local anesthesia, the filter was repositioned. A guide wire was inserted through a blood vessel on the right side of his neck, the cone shaped IVC filter was then pulled up and placed back in position. All they needed to do was move it, not move it to a new location. Michael will be treated with anticoagulants until he is up and fully functioning. Michael communicated in many ways that his neck where the incision was made, was hurting. He was uncomfortable and tired toward early evening and was given medication to ease the pain. The doctor that performed the procedure did not think that the swelling in his knee was related to the blood clot in the groin area.
Michael responded well and excited every visitor that came to call. His speech and memory continue to bring more of “Mike” to the forefront sometimes with a ”hi Emily”, a secret handshake, or an insight of what memory he has of the accident and why he’s in the hospital. The occupational therapist asked him what was injured; Mike answered “my brains.”
A brief update from the hospital case manager, reports that on all levels the doctor and therapists are pleased with Michael’s progress. The feeding peg and remaining staples will be removed Thursday with a well-needed shower to follow. They’ll finally be able to do the “over due” MRI to investigate the pain and swelling in Mike’s right knee. The plan is for five weeks of continued therapy and if everything goes as planned, Michael may be able to begin the new year at home.
Michael had a doppler ultrasound on both legs to determine if blood clots could be a factor in the swelling and pain in his right knee (deep vein thrombosis) and to also see if there were signs of clotting in either leg. If no clotting is found, the vena cava filter that was placed at Fairfax Hospital to prevent deep vein thrombosis and to protect clots from traveling to the heart, will be removed.
Still no word on the blood or urine cultures to verify that the UTI and staff infections are gone. We hope to hear those results and get an answer about removing the feeding peg on Wednesday.
I’m sure Michael will feel good about having all pegs, tubes and any other foreign object removed.
Michael continues to give 110% to his rehabilitation therapists. In turn, they compliment his determination to push his physical limitations to the point of exhaustion. Affecting his progress though, is his very swollen right knee. Along with knee, his pelvis and femur were x-rayed last week with no signs of a fracture or break. Michael feels the pain when pressure is applied toward or leg movement toward the hip. After examination from the Doctor again today, an MRI was ordered. The nurse scheduled the MRI but with staples in his head still intact, no MRI. Dr. Gisofi asked the nurse to remove every other staple and says he’d check the incision tomorrow to see how it looked.
We are seeing more movement with his right hand and he is not tensing it as much as before. He will take his left hand and striaghten out his right. At times, he’ll move and wiggle the toes on his right foot but never his leg. Over the weekend his Father asked him if he could feel his leg “yes”. Can you move it? “I’ve been trying to”
Speech is developing and is articulate but still sparatic. Most movements are purposeful but there are a few movement tics that we see Mike working through. Bicycle type movement of his left leg, crossing his left leg and foot over the right, moving his left foot in a tapping circular motion (which he always did when he was going to sleep), scratching his head where the bone flap incision staples itch and the newest and most pleasant, picking his nose. You can see that he becomes aware of the non-puposeful movements and then tries to settle himself to stop. Michael never liked inappropriate social behavior, so we know he’ll work hard to stop picking his nose in front of people. 
We must have humor people
Blood and urine samples were taken Saturday to check the UTI and staff infections that started at Fairfax Hospital. We’re hoping to hear the results soon. If the infections are gone, out comes the aggravating hand IV.
The feeding peg is still in and Michael continues to receive a nightime feeding. The nutritionist will evaluate his diet this week and with the doctor, make a determination to keep or remove the peg. If he’s getting and maintaining enough calories and nutrients, the peg will be removed.
At mealtime, once the food is on, he can hold the spoon or fork and with guidance take it to his mouth. He chews and swallows perfectly. Mike will pick up a cup on his own, take a drink and place the cup back on the tray. If there is something on his mouth, he takes the napkin from the tray and wipes his mouth clean. He will now let me floss his teeth without trying to chew my fingers.
Six days a week M-Sa, Mike’s therapy sessions are 9 or 10am, (lunch between 11:30-12:30) then therapy again at 1pm and 3pm. So far it’s been Occupational first, Speech second and Physical therapy last. They all wipe him out so it’s vitally important that he rest well in between. Thank you for waiting until after 5 to visit. Thank you for keeping your visits short and thank you for caring enough to understand the importance.
We love you all and cannot thank you enough for your prayers and well wishes. Keep ‘em coming. Without your love and support, none of us including Michael, would be able to make it through. It truly takes a village.
xxoo
Michael has overcome the incredible odds against his survival and continues to amaze everyone with his determination and strength to win. We have personally witnessed miraculous and incredible activity during these last 33 days. From the weeks right after the accident when Michael was still fighting for his life, to overcoming the odds and becoming awake and aware. The day he moved a finger or the first twinge of his mouth to smile, wiggling his toes and the day Nate made him laugh out loud. Michael seems to demonstrate new improvements and behavior each passing day.
Yesterday we were able to watch Michael during his physical therapy session. We watched as he sat on the raised mat in the gym, supporting his weight with arms positioned behind him. One of the therapists asked Michael if he could support himself in the chair and he whispered “maybe, I think so”. At dinner last night, I was honored to see him reach for his drink, grasp it with his left hand and move it to mid-range to show he could do it himself. A piece of the fish he ate got caught between his teeth and he took his finger to try to get it out. Nathan and Sylvette brought in a Yacht magazine and as Nate stood by his side, we watched as Michael reached to hold the left side of the magazine and then took his right hand to try to turn the pages. I am humbled and give thanks to God.
No one can predict the future of Michael’s outcome or just how far he can go with his recovery, but his strength and determination thus far, give us every indication that he will achieve the most optimal recovery and the highest quality of life possible. He will fight to make it so.
Michael’s therapists at Mt. Vernon estimate that he will need at least six weeks of inpatient rehabilitation therapy with outpatient rehab to follow. Requiring a weekly report, the insurance company will only approve 7 days at a time. His case manager will give us a family update every Wednesday to let us know his progress and if the insurance company has granted him another week. The reality of our health care system is that Michael’s continued rehabilitation will be out of pocket at some point. We are commited to do everything humanly possible to ensure and provide Michael every opportunity to continue this journey back to life. Together, we will make it happen.
If it has been a while since you’ve seen Michael and you get a chance to visit him at Mt. Vernon, it will bring tears to your eyes. He charms the nurses with his smile and his strong will inspires even the physical therapists. He will raise him arm and hand to scratch his nose and try to reach his very itchy healing head. He will greet you with that recognizable smile but you may see frustration in his eyes as he tries to speak. The speech therapist explained that Mike has the thought process and the words to speak but is struggling with the ability to initiate. Give him time, he does not give up.
LIVESTRONG Michael.
Day 1 after the bone flap replacement, the therapist offers applesauce and pudding to see if Mike has the ability to swallow successfully. Job well done. A few of spoons ice chips to see if he can chew…another job well done. They will continue the tests through Monday to determine if Mike is ready to have the feeding peg removed and begin a soft, spoon fed diet.
Mike’s overall condition is good. He is awake and is technically out of the coma, but still not responding consistently to verbal commands. He is aware of his surroundings, tracking with his eyes, smiling at appropriate moments, moving both arms and hands, and moving the left leg but still no movement in his right leg. He tires very easily and slips in and out of “being there” during those periods of rest.
A representative from the Mt. Vernon Rehab Center will re-evaluate Michael tomorrow to see if he meets the criteria for rehab. Our hope is that Mike is well rested, alert and strong when he is reviewed tomorrow and will be accepted into the program. The unfortunate alternative to rehab is transferring him to a nursing home.
We ask for your continued prayers for strength and healing.
Matthew 21:22: “And all things, whatsoever ye shall ask in prayer, believing, ye shall receive.”
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