it is real

On October 23, 2007 an old friend from high school and a fellow agent in my office posted on the blog ”I have a 19 year old son and I can only imagine the impact that Michael’s accident has had on your family”. Sunday night/early Monday morning I wish it had been her imagination when she was notified that her now 20 year old, her eldest son on his way home after drinking with friends, lost his life in an alcohol related auto accident.  I spoke with Pam yesterday and she said that she talked about Michael’s accident with Trey. They watched the video slideshow, they read the posts and comments from friends and family and talked about the real consequences of getting behind the wheel of a car after drinking.  Pam kept up with Mike’s progress and made a point to share his story with her family.  Trey did not make the decision to get behind the wheel after drinking; he made the decision to ride home with one of the friends he had been drinking with.  Like many, they might have thought about the chance of getting pulled over by the police but most don’t ask  themselves in that moment “what if I die? or what if I have to live the rest of my life a shadow of my former self? Or worse – what if I kill someone?  Who asks those questions?  Each one of us should. Most don’t and the consequence of that one decision is real! Our thoughts and prayers are with the Roseberry family.

The responsibility that comes with drinking is huge and peer pressure for young men in particular is so underestimated.  Pam’s son’s life ended and the life my son knew also ended because of one bad decision. That’s all it takes to change your life and the lives of everyone around you FOREVER. It is real.

I can give you the upbeat version of the progress that Mike has made despite the profound disabilities he will have to live with for the rest of his life. That’s what you want to hear because it’s the happy ending version that let’s everybody off the hook.  It’s the happy ending that let’s you go on about your life and not think about the consequences of alcohol consumption. How being under the influence influences your perception of what is acceptable, what is right or wrong; whether it influences  your own or the behavior and decision making ability of your friends.  I will return to the happy ending updates of Michael’s miraculous and continued recovery but not today. Today I want you to know that because of alcohol’s impact on decision making processes another father is grieving, another brother is alone, another mother is mourning the loss of her son and she is unable to make it better. She cannot make it go away. Her pain is real and it will scream loud inside her but in the silence of his absence it/he will persist. An echo is what persists when the source is gone. 

Did you know that alcohol involvement is the single greatest factor in auto deaths and injuries? Only 4% of all crashes involve the use of alcohol but 41% of fatal crashes do.  Did you know that  binge drinkers are more apt to make the decision to get behind the wheel under the influence? Did you know there have been over 5000 drunk driving deaths so far in 2009? Did you know that your life matters to someone?

John Young Roseberry III “Trey” age 20 a native of Nokesville VA was killed early Monday , May 18 2009.  He was a 2006  graduate of Brentsville High School where he was an outstanding wrestler and football player. He is survived by his father  John Young Roseberry, Jr., his mother Pamela Gill Roseberry and his younger brother  Zachary. It is real.

On this Memorial Day weekend please keep in mind that the effects of alcohol and intoxicated driving are far reaching. The effects reach way beyond the number of those killed or injured.  Take care of each other – friends do not let friends drive drunk.

I am the mother of three children, one of which is an alcohol related auto accident TBI survivor and there by the Grace of God go I.

One Love.

xxoo

from blue ribbons to code blue and back

I want everyone to know and the people who know me perhaps already do know that I had been a Olympic swimmer (that’s right Dad, I can count Junior Olympics).  I would say no doubt that had helped me throughout my recovery.  Thirty day coma, 6 months of rehab, I don’t think that there could have been a previous training that could have helped more to get through everything, so it did and here I am.  I’m a winner and blue and I go very well together.  I have bluish eyes and lots of blue ribbons.  The only blue that didn’t go over very well was code blue.  so I’m thinkin’ there was a guy Ive heard about who did the Ironman Triathalon. He had been in a car accident that almost killed him for good but he had been a champion swimmer also, so I’m thinkin’ being the champion swimmer that I am and who says I can’t do that.

well, one thing would be fatigue issues stemming from a traumatic brain injury that has been very huge for me to hurdle. I’m tired from the moment I wake up. Physically exhausted. But I think this cold weather has also had a lot to do with it. Summer time is around the corner and that’s where I thrive.  Run- I had been very physically active until this past winter walking a couple miles daily.  My knee was one of the first injuries I sustained from the car accident and is still troublesome. Last summer my mother and I would try to mix in a light jog with that walk so that I could gauge how much I could do with this bad knee. troublesome yes but my hope is that with time comes healing and that more healing is what needs to be done for my knee to be at 100%. I started walking the two miles again recently and no knee problems to report. So what, we have run, bike, swim.  Bike- balance. Yeah, not so good still but I would go so far as to say marginally better. I would basically have to learn to ride a bike again but that’s ok. I actually got on Nate’s bike today and aside from my mother running beside me wanting to hold my arm the  whole time and then Nate freaking out because I ran up to the curb, all in all I think it went pretty well. And then we come to swim- now just because I had been a champion swimmer doesn’t mean I could jump in and swim 2 miles, although I would argue with anybody that swimming is easily my greatest  strength.  so, the thing again would be endurance coupled with my, thanks to the brain injury decreased initiation I’ve got a heck of a challenge. But again I’ve never been one to shy away from a challenge. The Ironman Triathlon consists of a 2.4 mile swim, a 112-mile bike ride and a 26.2 mile run the Half Ironman consists of 1.2mile Swim | 56mile Bike | 13.1mile Run. I think with training, I can set my sights toward an “Ironman” Triathlon

Last year when i first started using my planner I set a mission statement and this is what it said “I realize that the mountain I must climb today may seem like a hill to others and I except that”. Now, this mountain may not seem like a hill to anybody and I know it’s a big undertaking but I am willing to work towards it. I’m learning that it’s ok to set my goals high and that it’s also ok as long as I can find motivation in smaller successes. speaking of small successes I use Nintendo DS as an informal cognitive trainer and I set my sights to finish a game I got for Easter. I’d been playing it daily, it’s been my go to game on DS and this week I beat it. So small success comes in a variety of shapes and sizes. I know that a half triathlon is not an immediate goal but neither is a PHD but if I can stay focused for long enough and work hard enough and be patient enough with myself then…

a new look

Jim and Mike are in the process of revamping the website…what do you think? I LOVE it! It is still a work in progress so bear with us while we work out a few of the kinks and continue to add the photos, slideshow and some new stuff to the site.  Mike has wanted to do this for awhile and thanks to Jim and a geek day today, it happened!

Good things are happening…stay tuned

little bit of this, a little bit of that

This last month has had it’s share of ups and downs but along this journey, that’s to be expected. We get stuck when where we are is not a good place and we can’t find or see our way out. Did you see the movie “Silence of the Lambs”?  Remember the scene in the movie where the girl is at the bottom of the dry well? She knows where she is and as she tries to climb her way up this impossible wall, she sees fingernails stuck in the wall where others have gone before her. Knowing that others had seen the darkness, felt the emptiness, the helplessness, the overwhelming silence and the stillness of the bottom of the well gave her strength to keep fighting. That’s where we find ourselves sometimes… at the bottom of a dark well unable to find the way out but somehow we do. No matter how dark, no matter how impossible the challenges seem, we never give up hope but we sometimes lose faith in ourselves.

We’ve had to work pretty hard at it the last couple of weeks but listening to our pastor during the Easter service, I was able to unload a lot of the burden and place it right where it belongs; in the hands of God. After all it was God that saved Michael’s life and although we lose sight of it, it was God that decided this was the road we would travel. Our pastor spoke of doubting Thomas and I related.  Thomas questioned everything and without witnessing himself, could not believe. He did not have blind faith that many of the other disciples had…I have behaved much like Thomas. I lose sight of the very thing we must have to get through this; faith. I lose faith that it will be any better than it is today. I lose faith that I can live up to what others expect of me but if I am being truthful, I lose faith that I can live up to my own expectations. I lose faith that God has a plan and although we have the freedom of choice (and yes, as a woman I thank God for the moral and political freedom of that as well), God is in control. He would not give us more than we could bear and it is within our control to choose how we stand up to the challenges placed before us.   

It is still challenging to motivate Michael to do things that are rehab related. (I should say for me to motivate him) A bit of depression, a bit of “it’s just this stage of recovery” which is good but the brunt of it takes the patience and understanding of Job (pronounced like Joe with a b for you that may not know of him), a bit of being 26 and tired of seeing his mother every day and not a bit, but a lot of anger and frustration that just being a TBI survivor brings. In May it will be a year and a half since Michael’s accident and although short term memory is still a huge barrier for him, he can remember enough to know that over the last year he’s worked harder than he’s ever worked at anything. He is exhausted (comes free with the brain injury) and as he looks ahead, he is told that for the rest of his life he must keep working to overcome the injuries to his brain. He said in one of the neuro pysch sessions that he just wants to retire from rehab. He doesn’t want to do this recovery thing anymore.  He just wants to be “normal” again.  He wants to go about life without this huge ugly reminder of the consequences of that one night, of that one horrible decision.  The mental challenges, the physical challenges, the emotional challenges are taking their toll and he just wants to be done. How does he face this enormous beast day after day and find the strength to persevere? Some days he doesn’t.

There is quite a bit going on for Michael now (although ask him, he never does anything). His involvement with brain injury services has opened doors to what we hope will be exciting things ahead. His case manager from BIS has just completed Michael’s case management plan and has scheduled a meeting for next week to make sure that this plan meets Michael’s needs and expectations. Michael will join an adjustment group for young men who have survived traumatic brain injuries. It is headed by a psychologist and meets in Springfield the first and third Wednesdays of the month. This gives Mike a chance to socialize with other young men he might be able to relate to. The constant in getting back your life after TBI is the feeling that people don’t really understand what it’s like. As a person living with a survivor, I would say he’s probably right. Brain injury is not often understood and the behaviors are often misunderstood.  Mike will also be able to take part in BIS’s Pal Program that offers a social mentoring type environment. This is designed to introduce possible challenges in the workplace and to assist in becoming more comfortable meeting new people after brain injury. It takes the comfortable old you with the uncomfortable new you learning to greet the old world on a new playing field.

In the course of a lifetime how many times do we wish for a do-over? I’ve never heard Mike say that…he accepts the consequences of his actions. He knows why he is where he is and he doesn’t try to hide behind excuses. He blames no one, he doesn’t even question why.  His comments during the down times are pretty consistent - he is sorry and he is tired. During the sermon at church yesterday the preacher said that we shouldn’t expect miracles just because we pray but if we pray, we should believe that all things we ask in prayer will be received. For the most part, my prayers are the same today as they were October 21, 2007.  I pray for strength and acceptance to handle whatever may come.  My prayer for healing is now not only for Michael but I ask for healing for our family (trauma =trauma for all) and I pray for healing for our friends who’s lives we hold very dear.   I pray for guidance … I embrace the strength I have within but I get lost sometimes.  I am working toward accepting that I can not do this all on my own. It is a process.

xxoo

weluvmike.com

World

Wide

Web

The scale of this website hit me the other day. That truly it is the world, and from looking at the cluster map, I feel like now it is my mission to make it the entire world, its funny ’cause already every computer I’m on I make sure (if not already) to set the internet homepage as weluvmike.com.

So in addition to pHd I see it as my mission to set the worlds computers’ homepages to www.weluvmike.com.  I guess I should apologize for my coming if as egotistical…..I’m sorry

Waltraut Giesela Kairies

Val-trout

My grandma Vee (My dads mom) is now further from me than she has been in a long time……..ever,really…..she is closer though to her daughter Dorothy, in Yorktown VA also there is my dad and his wife Mary.  For me it’s bitter sweet that at least she will be closer to her children but the distance for me is almost too great it seems like visits will be few and far between. She was at my celebration of life so I think that means the most.

Grandma if you are reading this or it’s being read to you, I miss you already.  Hopefully soon we will get to come down there. Also please know that of course, I am wearing my jacket.  I do hope your enjoying your new place

awareness

Quick update… we were thrilled to meet Michael’s case manager Chris with Brain Injury Services.  The first visit was an informal “get to know ya” but I think the first impression was shared by all – this is the perfect match for Mike.  He was open to working with Mike’s Neuropsychologist, I would actually say he was delighted to work in partnership with her. Mike’s team will now include two people who specialize in helping brain injury survivors find their way.  YEAH!!!!

March is Brain Injury Awareness Month – to bring attention to the seriousness of brain injury, their focus varies each year. Ironically, 2009 is to raise awareness of sports related brain injury.

I’m sure everyone has heard of the recent untimely death of Natasha Richardson during a skiing lesson on a beginner’s slope.  Her death caused by an injury to her brain.  By all accounts, her injury was a mild head injury much less severe than the injury Michael sustained to his brain. Her death was an accident, a sports related head injury. The doctors said she might have survived if she had received immediate treatment. However, nearly four hours elapsed between her fall and the time she was seen at the hospital. She suffered from an epidural hematoma, which is often caused by a skull fracture. It can quickly produce a blood clot that puts pressure on the brain. That pressure can force the brain downward, pressing on the brain stem that controls breathing and other vital functions that keep us alive. The scary thing is you might feel fine immediately afterward because symptoms from the bleeding may take time to emerge.

For Michael – an auto accident. He suffered blunt head trauma and multiple lacerations to his head while driving home intoxicated on Interstate 66 at exit 66. The vehicle left the road at a speed in excess of 60 miles an hour, hit a guard rail at the exit, the impact propelled the Jeep forward with it’s rear flipping over the front. It landed headlights up on the right rear side, the sudden deceleration threw the Jeep forward again hitting a tree headlights down and one more bounce back to all four tires.

There were many forces that caused traumatic damage to his brain. He had three large lacerations; the temporal areas of both sides and the occipital area of the back of his head. The cerebral cortex was bruised (contused), the deep white matter suffered diffuse axonal injury when his head whip-lashed without necessarily hitting a hard object, the axons stretched so much that they were torn and damaged (sheered). Cerebral contusions at the tips of the frontal and temporal lobes where they banged up against the interior of his skull. Diffuse axonal injury occurred more toward the center of his brain where the axons were subjected to the most stretching. His brain was swelling from bruising and pooling of blood. Michael’s injuries were so severe, he was non-responsive and Code Blue upon arrival in the ER.

The outward injuries to his body were obvious but the injuries to his brain although assumed, were invisible. We were fortunate that a cab driver witnessed the accident and called for help. Blessed that the ambulance responded quickly and Fairfax Hospital was within minutes of Exit 66. Within those first critical hours, he received brain injury specific medical treatment including a craniotomy that allowed his brain to decompress. Swelling of the brain becomes dangerous when the swelling causes a rise in intracranial pressure which prevents blood from entering the skull to deliver oxygen to the brain. Because of immediate medical attention, Michael survived. It could have been so different. Worse yet, it could have been prevented.

Sports injuries however may not be as clear cut, not as easy to identify as Michael’s. Many times head injuries are very treatable if you’re aware of what the problem is and you quickly receive medical attention. Would it be horrible to think the injury to your/his/her brain could have been prevented? If only I/he/she had worn a helmet. If only he hadn’t gotten behind the wheel. I speak from my heart when unequivocally I answer, yes. Yes, it is horrible to know it could have been prevented.

Ya know, I’ve been thinking. Wearing a helmet may be like wearing a condom. Nobody “wants” to wear one but each will save your life. Put helmets on those heads.

xxoo

hear ye, hear ye

The best therapist/mother I’ve had, my own mother, has released a new video. If you will direct your attention toward the video section, you may notice the newest addition.Carry on.

today – the next step

I considered purchasing a tin sign, complete with instructions that I saw in a store the other day. There was a circle in the center and “Bang Head Here” written in bold lettering. Resistance personified.  Resistance? OMG! You don’t even know but we’ll get to that later…

The next step… Michael’s intelligence still fully intact (thank you God) scoring with an above average intelligence, which is awesome but unfortunately also leads to a large measure of his frustration and honestly adds to much confusion with family and friends. Traumatic brain injury is so complicated. When your brain stores so much of the same pre-injury information how could he see the variety of cognitive impairments? How would he acknowledge the impaired memory ability, the compromised executive functioning, and decreased fine motor speed? The brain controls everything – and self assessment or the lack of, is a part of the injury.

But if we’re talking about Michael’s desire to move forward, his primary focus of going back to school, his determination to stop this “busy work” and get back to business then we should probably start at the beginning.  You see Michael is tired of this rehab stuff with me – TI ERD (that’s country for really tired).  He’s impatient, antsy, ready to move on.  He just doesn’t realize how far he’s come, or what a short distance we’ve traveled on this road to recovery. 

Remember the Glascow Coma Scale and the Rancho Los Amigos?
Glascow Coma Scale
Eye opening
4 = Spontaneously
3 = To voice
2 = To pain
1 = None

Verbal response
5 = Oriented
4 = Confused
3 = Inappropriate words
2 = Incomprehensible sounds
1 = None

Motor Response
6 = Follows commands
5 = Localizes pain
4 = Withdrawal to pain
3 = Abnormal flexion
2 = Abnormal extension
1 = None

The scale is also used to determine chances of recovery from head injury:
Mild (GCS 13-15)
Moderate (GCS 9-12)
Severe (GCS 3-8)

The Glasgow Coma Scale is the most widely used method of defining a patient’s level of consciousness and neurological status, or brain health. Michael was Code Blue on arrival with no movement, eye opening or verbal response to pain – his GCS of 3 was the lowest it could be without being dead.  He remained at a GCS of 3 for a month.  We believe that prayer and the grace of God were responsible for the miraculous healing and this second chance to live. 

During the year following his decision to get behind the wheel after drinking with friends, Michael moved his way up the GCS and on to the Rancho Los Amigos measure.  After 17 exhausting months of daily physical and cognitive training, I would love to say to Michael that he doesn’t have to work at this anymore, that I won’t push him to be everything that God intends him to be, but I can’t. A traumatic injury to the brain changes your life forever.  I won’t ever be able to say to my son “you’re healed”, “it’s done, you can relax now”.  BUT what I can say is with persistence and dedication every single day for the rest of his life, his brain can be re-trained, it can and will learn new pathways. But it will NEVER, EVER be the same.
 

Rancho Los Amigos

Today Michael probably sits between and Level VII and Level VIII

Rancho Los Amigos
Level VII
Automatic, Appropriate: Minimal Assistance for Daily Living Skills
* Consistently oriented to person and place, within highly familiar environments.      
* Moderate assistance for orientation to time.
* Able to attend to highly familiar tasks in a non-distraction environment for at least 30 minutes with minimal assist to complete tasks.
* Minimal supervision for new learning.
* Demonstrates carry over of new learning.
* Initiates and carries out steps to complete familiar personal and household routine but has shallow recall of what he/she has been doing.
* Able to monitor accuracy and completeness of each step in routine personal and household ADLs and modify plan with minimal assistance.
* Superficial awareness of his/her condition but unaware of specific impairments and disabilities and the limits they place on his/her ability to safely, accurately and completely carry out his/her household, community, work and leisure ADLs.
* Minimal supervision for safety in routine home and community activities.
* Unrealistic planning for the future.
* Unable to think about consequences of a decision or action.
* Overestimates abilities.
* Unaware of others’ needs and feelings.
* Oppositional/uncooperative.
* Unable to recognize inappropriate social interaction behavior.

Level VIII Purposeful, Appropriate: Stand-By Assistance
* Consistently oriented to person, place and time.
* Independently attends to and completes familiar tasks for 1 hour in distracting environments.
* Able to recall and integrate past and recent events.
* Uses assistive memory devices to recall daily schedule, “to do” lists and record critical information for later use with stand-by assistance.
* Initiates and carries out steps to complete familiar personal, household, community, work and leisure routines with stand-by assistance and can modify the plan when needed with minimal assistance.
* Requires no assistance once new tasks/activities are learned.
* Aware of and acknowledges impairments and disabilities when they interfere with task completion but requires stand-by assistance to take appropriate corrective action.
* Thinks about consequences of a decision or action with minimal assistance.
* Overestimates or underestimates abilities.
* Acknowledges others’ needs and feelings and responds appropriately with minimal assistance.
* Depressed.
* Irritable.
* Low frustration tolerance/easily angered.
* Argumentative.
* Self-centered.
* Uncharacteristically dependent/independent.
* Able to recognize and acknowledge inappropriate social interaction behavior while it is occurring and takes corrective action with minimal assistance.

The next step is to continue training, continue rebuilding, continue setting daily goals that lead to achieving weekly goals that build the new foundation for the future. Michael’s hopes and dreams for his future are not so different than they were pre-accident.  But the road he’ll travel to get there is profoundly different. He wants to be a leader, he wants to have a lifetime of learning which equates to getting back into the class room every now and then, he dreams of having someone by his side for love and companionship, he hopes to have children, he wants a life. He wants to be the driver of that life, not the passenger. 

The only limitation I see for Michael is him getting in the way of himself; concrete rigid thinking and stubborness.  And Michael knows that no matter how difficult it gets, I am there to push him through the concrete. He will not have an easy time of getting in the way of himself.  My prayer is that his and all of our hopes and dreams come true. This is what we’re doing to get there:

Michael is rebuilding with tools for life after and with a brain injury.  He meets with a neuro-pyschologist on a weekly basis and together they are developing plans for Michael to take control of his own recovery.  Does that mean he does it alone?  No, it means ultimately he is in control with the understanding that needing help, doesn’t mean you are helpless. Together they are building a base of strategies for success to compensate for cognitive losses that may or may not return.  A very positive hour that also allows Michael to share and to work through his frustrations and concerns with a professional. Someone outside the family who has the knowledge and experience to light the way when all we see is darkness.

Michael’s application has been accepted and he has been assigned a case manager through Brain Injury Services.  The first official meeting is this coming Tuesday (St. Patty’s Day) when we will learn about social activities, cognitive therapy and perhaps even vocational training.  We are looking forward to opening many more doors with BIS and hopeful that this will assist Michael in his journey forward. We welcome their assistance.

We greatly appreciate the recent order for physical therapy from Michael’s primary care physician.  She will work with him to improve his gait and to strengthen his prior dominant right side so it will take over for his now dominant left side. 

From my perspective, as his mother and TBI caregiver this is more than a bumpy ride. It is emotionally draining, physically exhausting and (remember the tin sign?) often times very frustrating. The bridge connecting my relevance to Michael’s rehabilitation efforts are increasingly lost with him. Each day he is less likely to actively participate in our cognitive exercises and some days refusing to participate altogether. It’s a very tough place to be emotionally even for him, but we’ll get through it.  I do respect the fact that Michael is exerting his independence again and I am thrilled that he has reached this level of recovery.  I understand that I am the constant reminder (the general he jokes) and sometimes he just doesn’t want to be reminded of what needs to be done. Sometimes he just want to be a normal twenty six year old guy, wanting to get on with his “normal” life. 

The next step… one foot in front of the other,  breathing in, breathing out, one step at a time, one day at a time.  We persist. 

LIVESTRONG Michael

xxoo

purpose?

Now being that this is “Mike Rosner’s blog” I figured this question might be better off asked here

ok………now I have always believed things happen for a reason; my accident included, realistically it was the best thing that has happened…….the coma sucked,the therapy sucked, and now the solitude sucks. I really do believe things happen for a reason (that readon?)  Question is what is the reason?  what now?

For me I feel like theres a chance to continue building my life…….school. I’m very ambitious and would like to see MY next steps as an opportunity to further my education. I am unsure as to which schools would be appropriate or even if there is much difference in which school to choose.  I need to get my bachelors in order to finally go for a phd so thats’s where I start.  So Bachelors-any help?