The neurosurgeon paid a visit

The neurosurgeon paid a visit to Mike today.  Based on his examination, Mike’s skull flap will be replaced between 9 and 9:30 AM this Friday morning.

Mike’s doctor said that when he walked in the room, saw Mike with both eyes open, able to track his voice and followed his command, Dr. Jebrali almost passed out.  Because of the number of injuries to his brain, he said Mike was doing better and farther along than he anticipated.  He ordered a new CT scan for comparison - we should hear the results by Friday.

Keep in mind, this is the same doctor that told us in the first days after the accident, to expect Mike’s coma to last up to six months and possibly a year before we saw real progress.  I don’t think he and Mike had met before

If there are no surgical complications on Friday, there is every indication that Mike will be moved to the Mt. Vernon Rehab facility in Alexandria on Saturday.

Mike is still very slow to respond and sometimes doesn’t respond at all.  Sometimes his eyes are focused, sometimes they’re not.  All to be expected.

No trach. As the techs were bathing Mike this morning, his trach accidently came out.

11-13-07 @10PM - No trach.  As the techs were bathing Mike this morning, his trach accidently came out.  Because Mike had been breathing so well on his own, his doctor and the respiratory nurse made the decision just to keep it out.  His nurse Sheila, checked his oxygen levels throughout the day and Mike was able to maintain 95-98%.  They were very pleased.

The huge area of swelling in the skull flap area is almost non-apparent.  The stocking cap that Mike wears to cover the now indented area, is very similar to the “skully” he used to wear from Banana Republic.  Mike looks great but with outside evidence of daily brain storming, there is still swelling and bruising on the inside.

There is talk of transferring Mike to the Mt. Vernon Rehabilitation Center in Alexandria as early as this Friday.  We all believe that if Mike were able to make the decision himself, he would approach his rehabilitation aggressively.   4-5 hours of physical therapy, 7 days a week is much better for his recovery than 20 minutes a day, 5 days a week.  Mt. Vernon has a special brain injury unit and normally requires that patients have the ability to respond consistently to commands.  Although Mike is not consistent, he is young and strong.  They have agreed and believe a jump-start is in order.

A better day. No fever, less traffic and lots of rest seemed to make a big difference.

11-11-07@ 9:30 PM - A better day. No fever, less traffic and lots of rest seemed to make a big difference. The only medication given to Mike today was a pain med. A minor procedure to reduce the size of Mike’s trach caused a little pain and an increase in coughing but otherwise a restful day. The further reduction in trach size will encourage Mike to use mouth and nose 100% for breathing. We could already see an increase in mouth breathing. It seemed like he was gasping for air but the nurse explained that his efforts will be less labored as he adjusts to the new size.

Mike’s heart monitor and catheter were removed today

11-8-07 @9:00/PM – Mike’s heart monitor and catheter were removed today as his physical health continues to improve. During his physical therapy session, the Physical Therapist opened Mike’s hand and told Mike to catch the ball that she was about to drop and he did. She then asked him to release it and he did. They sat Mike on the edge of the bed for a few minutes and then stood him straight up to allow his feet and legs to bear the weight of his body. These are all great steps in the right direction.

Mike had a great day yesterday.

11-7-07 @11:30/AM – Mike had a great day yesterday. He continues to smile, opening his eyes, move his hand, arms and legs but without consistent responses to commands. Mike was moved out of the Neuro ICU to the Neuro Observation unit. In combination with this move, they are restricting sedation meds to one nighttime dose and Adderal in the morning to stimulate awakeness. This is another step in the right direction. All of his vital signs have remained stable.

On a second note, Emily, his little sister, was hospitalized at Prince William yesterday afternoon for what appears to be a kidney, bladder and urinary infection. She is doing fine now and we hope to have her home by this afternoon.

First full day in the new unit, a busy day for Mike.

11-7-07 @9:30/PM – First full day in the new unit, a busy day for Mike. His Physical Therapists, Speech Pathologist and Pet Therapists were in to observe and work with him. The speech pathologist requested a smaller trach tube for Mike - that procedure was done midday. If I remember correctly, this helps to promote more breathing from his nose and mouth. We noticed after the change that Mike was able to open his mouth more frequently, rubbing his tongue over his teeth and moving with speech like movements. Mike’s vital signs are stable and he continues to move around and open his eyes but without consistency to commands. Mike is still in a coma but as one of the Therapists described to us, brain healing is like working through a 3-story building. He is currently in the basement healing his way to the third floor. It appears that Mike can hear us, sometimes sees us and is able to make some associations.

Emily was released from the hospital yesterday afternoon and is doing better but she is still very weak.

Pet Therapy

11-5-07 @2:45/PM – Mike is having a responsive day. He has offered several smiles, eye openings, hand, arms and leg movements. The doctors requested animal assisted care for Mike and depending on availability, a dog will be brought in a couple times a week or as often as once a day.  A German Shepard visited today.  She got on the bed & laid on Mike’s legs. The trainer then placed Mike’s hand on the dog and asked Mike to pet her. Mike responded 2 out of 3 times. She was hoping for 3 out of 3 but said with this being Mike’s first time, she said it was actually more than she expected. Mike’s blood pressure, heart rate, fever and breathing on his own remain the same.

Mike is having a quiet day.

11-4-07 @2:50/PM – Mike is having a quiet day. We are seeing very few responses but hold on to those baby steps that we have seen over the last several days. He remains stable with no set backs - his blood pressure is 119/54, heart rate is between 96 and 110, temperature is 98.6 to 101.3 and the Glasgow Coma Scale remains at a 5.

A more active afternoon…

11-4-07 @4:34/PM – A more active afternoon…Mike responds with intention. His Mother was leaning very close to his face so her voice went straight to his ear. She kissed him on the cheek and said she would just keep kissing him until he woke up. Mike moved his head toward her voice and seemed to pucker his lips. His sister Emily ran her nails on the under side of his feet and Mike reacted, twitching his feet and moving his legs. With a new hand sized ball to squeeze, his Father watched as Mike raised his arm while gripping the ball with his fingers. AND…the Redskins won.

No Changes

11-3-07 - No changes - Mike is healing peacefully.