Great News!

Kevin had another CT scan on Friday morning. The previous one was 2 weeks ago and the subdural hematoma had dissolved completely back then - this was the area on the opposite side of the head from the impact that had not bled very much but was most concerning because subdural means between the brain and the leather casing that surrrounds it. So that was good news. The epidural hematoma was still there but looked like it was dissolving. This is on the right side of the head where the impact was and epidural means between the leather casing and the skull. After reviewing the latest images, the neurosurgeons office called to say that it has completely dissolved! So they are finished with Kevin - don't need to see him back. Kevin now needs to proceed with the rehab doctor and therapists (which we are doing). Great news!

It’s been a busy week and there was no new information until now, so I have not updated this blog in a while. Now I have a slew of info so this is going to be long. Kevin has been doing pretty well – but his activities are certainly curtailed compared to what he was up to before his accident. He has not felt like he can return to work yet. He does see friends every day. He either gets rides from them or us or he takes the bus; however, he tends to come home early and he is sleeping pretty late each morning.

I finally connected with the Mapleton Rehab center at the end of last week and they set up a series of 12 appointments over the course of June. In each of 3 categories, occupational therapy, physical therapy and cognitive therapy, they set up one appt for evaluation and then 3 appts for treatment. They do this just to get us in the schedule for now and then after each evaluation the therapist will determine what and how many treatments Kevin needs and then we’ll adjust the schedule. The first evaluation will be physical therapy this Thursday which is good because he continues to have a lot of pain and discomfort around his shoulders and broken clavicle.

Kevin had his first visit to Dr. Julie Stapleton on Monday. She has practiced “Physical Medicine” and “Neurotrauma Rehabilitation” for many years and works closely with the Mapleton rehab center where he will be going. We both liked her very much – she spent a good 45 minutes with Kevin and was mostly assessing where he is 3+ weeks after the accident. She asked him a whole bunch of questions and performed a few cognitive and physical evaluations and really looked at and talked to him about his shoulder/upper chest area where he is having a lot of pain. She works closely with Brandi, the PT that he will be seeing and will wait for Brandi’s evaluation. I took a lot of notes. I will type these below for those of you who really want to know all of these details, but the bottom line is that he should not return to his dishwashing job until the broken clavicle heals – 6 to 8 weeks. She said that it is a hidden blessing when a brain injury is accompanied by a broken bone because the broken bone dictates that a person curtail their activities for that time period and really that is when the brain is JUST becoming ready to resume normal activities. She is very pleased with Kevin’s progress and says that the trajectory of his recovery is very steep, he’s made great progress just being 3 weeks out. This is where I get a little confused – but I think she said that based on where he’s at right now she would label it more mild concussive. He definitely has a brain injury, but it is more moderate than traumatic. He has a head injury (which describes the blow to the head) and he has a brain injury; however, she thinks that he will experience mild/short consequences of the brain injury IF he takes care of himself the best that he can. She sympathized with my frustrations in getting in the rehab center, but said that it is actually good that rehab is delayed this long. The first few weeks out of the hospital should be minimal activity and lots of rest and it isn’t until now that rehab will provide the most benefit – so we’re on a perfect schedule. When Kevin left the appointment, he said that he was so glad that the doctor validated the feelings and symptoms that he HAS been experiencing and also helped him understand what he needs to do to take care of himself (now we’ll see if he really follows through…)

Here are the notes I took on the questions she asked:

What residual symptoms are you experiencing since the accident? Kevin told her that he gets dizzy if he puts his head back and brings it forward or gets up too fast from laying down. He sometimes can’t handle loud, noisy, social events like the graduation party he went to last weekend. He says he can’t describe it, but his brain just shuts down and he has to get out of there. In this case he left the party, went up to his friend’s room and took a nap. The doc said this is exactly what he needs to do. This happened Monday night at a restaurant where he, Steve and I had gone to eat. As the restaurant filled, it got incredibly loud and we could tell Kevin was getting very irritated and then before the entrees arrived, he snapped. Got up and left – had to go to the car and read his book.

Are you having headaches? Hardly at all – maybe one or two in the last week. Doc says this is EXCELLENT – sometimes brain injuries can result in lifelong headaches that are hard to treat.

Change in vision? None

Reading? Yes. Back to normal amount? Yes. For as long as you want? Yes. At your normal comprehension level? Yes. So you’re reading for pleasure? Yes – a lot. Can you come back to the book the next day and pick up where you left off, know the characters, the plot? Yes. EXCELLENT

Change in sense of smell or taste? No. Food tastes the same, like you expect it to? Yes.

Difficulty swallowing? No.

Neck pain? Yes – associated with messed up shoulders, etc. and a lot of bed rest. PT will address.

Trouble finding words when speaking? No more than I used to.

Trouble following directions? No more than I used to.

Sleeping okay? He’s restless late at night and can’t go to sleep very early, comes home knowing he should rest and then can’t – then sleeps all morning. Doc says that’s okay – sometimes brain injuries mess with your sleep cycle. Just SLEEP, SLEEP, SLEEP when you can. Later on they will work with Kevin in therapy to readjust his schedule, but for now – don’t interrupt his sleep if you don’t have to. Are you napping? Not so much anymore, although it does feel good to lay down in the middle of the afternoon.

Moods? Kevin says that he has been pretty irritable lately – says things to friends that he wouldn’t normally say out loud. He’s always been a pretty laid back guy and now he finds that things people do bug him a lot more. Doc says this is classic head injury behavior, should diminish over time.

Do you remember the fall? He has this tunnel vision like memory of going down the hill and skateboard starting to wobble, but can’t remember anything after that.

What’s the first thing you remember in the hospital? Doesn’t remember much about the hospital, kind of remembers ICU but not really. Bad memories? Not really.

Are you having flashbacks of the accident? Are you having any weird dreams of being in danger? Are you experiencing anxiety on any level about anything? (She was probing for post-traumatic syndrome). Kevin said he’s not really experiencing any of this. She asked if he’s anxious while driving. He has driven his friend’s car a few times and wasn’t at all anxious or fearful. She’s glad that he doesn’t seem to have PTS.

She then checked out some physical stuff – balance, etc. and that was fine.

She gave him a few cognitive test:

1. She tapped with her pen on the desk and he had to respond. If she tapped once, he had to tap twice and vice versa. He did this with no problems.

2. She drew a big circle on a piece of paper and told him to draw the face of the clock and put the hands at 11:10. He had done this the last day of the hospital and didn’t do a very good job. This day he drew it just fine and put the hands at 11:05 – but realized his mistake. She said that he was a little slow to do all of this – cognitive therapy will address this.

3. She had him recite the alphabet and count at the same time: A1, B2, C3… He skipped E so said F5, then got mixed up went back tried to correct it, got to G and said he was finished with that activity. Again, some cognitive issues that will be worked on in therapy.

Then she gave him some suggestions of what he can do for himself:

1. SLEEP – the #1 thing you can do for brain injuries

2. While healing (3-6 months) NO activity that would bump his head, even with a helmet. No bike riding, no rough housing with friends, no mosh pits, no contact sports, NOTHING. Another bump would not be good.

3. Instead of 3 big meals, eat lots of little meals high in protein and healthy in nature. This will help healing process and will also help even out moods and fatigue.

4. Take fish oil capsules, Vitamin E and a multi-vitamin every day to aid in the healing process.