Saturday, June 6, 2009
Great News!
Wednesday, June 3, 2009
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
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
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.
Tuesday, May 26, 2009
Busy Weekend!
Kevin continues to improve every day. He sleeps late into the morning, but then seems to stay awake most of the day. Might go lay down for an hour or 2 in the afternoon - and some days doesn't even do that. Went out with friends to do low key things (movies at their apartment) several of these nights and did just fine. Did get a little worn out by the time they brought him home, but no major problems. I still have not noticed any short-term or long-term memory problems nor any cognitive problems. Can still get a little irritated or out of sorts at times, but not very badly. I haven't asked him about his hearing in a few days, if that has completely cleared up or if it's still bothering him a little. He's still having a lot of pain around his shoulders - I don't know if it's the small break in the tip of the clavicle or if it's just because the whole area is tweaked. I'm still waiting for the rehab place to call, maybe he can do some physical therapy for that. He had hurt his right shoulder last year at school in Durango and had never completely felt back to normal from that, so I think this injury compounded the old one. Otherwise, my dad and sister were amazed at how well he is doing - they were expecting a lot worse. He see a doctor next week that specializes in TBI (traumatic brain injury) so we will get a lot greater insight into what he can do to heal completely and what we can expect in the coming year. She'll be the one to guide him through evaluations and rehab if he nees it.
Thursday, May 21, 2009
Tues & Wed
Tuesday, May 19, 2009
Monday
Sunday, May 17, 2009
Saturday and Sunday
Saturday, May 16, 2009
Friday Doc Appt
Meanwhile, it's been the worst trying to sort out his out-patient rehab. I guess I'm fortunate that I'm not well versed in the post-accient red-tape nightmare, but you can waste days before finding out that you need a prescription from a doctor before they can start K's rehab. The hosp did all these evals, a doc from rehab checked him out and wrote a report the last day - I thought the rehab center would know all about him. And - I have tried to call them for the last 2 days, left messages, etc with no call back. It took Steve driving over there and walking in to find out we need a script from a doc. Now when I call the doc's office Friday afternoon, she doesn't have an opening until June 1. What! I will be working on this Monday as well, I thought he would begin this out-patient therapy a little sooner than middle of June.
The rest of his day was just okay - had a visitor for a while - watched a low-key movie. He's so frustrated because he just can't do much, is still hurting a lot, head hurts most of the time, needs to sleep - can't even sleep on his side, head won't let him, so tired of being on his back. Is bored out of his mind but any stimulation (reading, tv, music, visitors) hurts his head pretty soon. He talks about his job so often - he was really loving it and wants so badly just to get back to it and he's not sure when he'll be able to. He really cares about the restaurant and the owners and feels he's part of their team and is letting them down, wanted to go visit Pi yesterday but then knew he wasn't up to it. It's hard to see your child knocked backwards when his life was moving in such a positive direction, but we'll just do all we can to help him make a full and speedy recovery.
Friday, May 15, 2009
Thurday Doc Appts
The ENT doc looked at Kevin's right ear which he had been complaining about, but has actually gotten steadily better. I brought the packet of written reports from the hosp, with descriptions of the findings from the CT scans so he looked at those (Kevin's skull fracture is right above that ear). He cleaned out a little wax to get a good look at the ear drum and Kevin could hear a little better already. The ear drum looks just fine. There's a little bit of dried blood and debris on the ear drum which he said would be painful if he tried to clean, so he wants us to put drops of hydrogen peroxide in it twice a day for a week. Then he sent Kevin off with an audiologist to test his inner ear. She put him in a sound proof room and tested both ears. We then spoke with the doc who said that those came out great! Both ears are hearing at the same level which is in the normal range for a 20 year old male. When she spoke words for Kevin to repeat he heard her at 0 decibles and with 100% accuracy which is excellent. So doc expects Kevin to fully recover - NO DAMAGE TO INNER OR OUTER RIGHT EAR!
The Orthopedic doc looked at his clavicle in the afternoon. He had all of the CT scan images on his computer right there in the office and scanned the written reports that I had brought in. We were looking at the area on Kevin's upper left chest, right under his chin. It had been very painful the night he came home from the hosp, but was feeling better by Thurs. The doc showed us that there is only a separation of where clavicle meets breast bone - the ligaments are stretched, but it will just heal like that. Kevin will have a little bump or rise, no big deal - it won't bother him at all in the future and there's nothing to worry about there. The doc then noticed on the CT images another area on his right clavicle that wasn't mentioned in the reports. The tip where it attaches out near the shoulder socket was chipped a little and it, too, has a separation. Kevin doesn't feel any pain there at all, couldn't tell that it's also damaged. The doc sent him off for x-rays - 2 standing up, one with a weight in that hand gently pulling downward and one without the weight. He wanted to know if the separation gets worse with the weight - but it doesn't at all! So he said that's good. Kevin doesn't need to do anything with that except not lift anything over 10 pounds (25 with both hands) for 6 weeks till bone heals.
LEFT AND RIGHT CLAVICLES SLIGHTLY INJURED
Thursday, May 14, 2009
Thursday morning
He has 2 appointments today, Ear/Nose/Throat in the morning and Orthopedic in the afternoon which will tax him quite a bit to go out and come back, so I'm keeping visitors at bay. Will post what we learn about his right ear and cracked clavicle.
Wednesday, May 13, 2009
Thank You
- Thanks to the Aaron Wildman family. Aaron is a much younger Boy Scout from Kevin's troop. Aaron made a chocolate cake for us and walked it over on Sunday night.
- Thanks to Nick Dotter and family for making us a casserole. It is amazing how fast you run out of food when there is just no time to make it to the grocery store. Nick is Kevin's friend from birth.
- Thanks to the Elephant Hut Thai restaurant where Kevin works. They sent flowers and later a nice card from the whole crew (Pi, Chris, D, Rachel, Nate, Tim, Max, Ana, Pick, and Alex) to Kevin while he was in the hospital. Pi, who is the owner and head chef, also called to the hospital. I will shamelessly put in a plug for them. Great restaurant. Recently opened. Try them out. On 30th next to Joe's Espresso shop. Thanks Pi,
- Thanks to Kevin's friends Maya, Scott, Rose, Rosie, Osha, I know, others, for your homemade cards and gifts and for keeping your visits short.
wed morning
All that said...
He had a very restful night in his own bed - so much more comfortable than a hosp bed, and his room is very dark and quiet. He woke and took only one pain pill right before 4am when I looked in on him - asked for the classical radio station turned on low (which he has always listened to - not odd behavior) and I put an icy washrag over his face. He's still asleep at 6 am.
Steve and I will alternate being home with him. Steve can work from home and I have flexibility with my job. More later.
Tuesday, May 12, 2009
Kevin going home
When I arrived at 8 am he said he had just been through hell and back. I guess he woke at 6am with splitting headache and the bright lights of the room full of sunny windows doesn't help. I think he slept long enough that previous pain pill had really worn off, but a new pain med was kicking in as I arrived and he ate a little and slept 2 hours. Slept most of day with a few quick visitors and a walk down the hall with the PT. All for now.
Monday, May 11, 2009
Day 4
I was with Kevin all day - he was out of sorts when I showed up this morning, says he's very restless at night - isn't sleeping. It hurts in a lot of places - his head the major one! I think he's really feeling it today now that the shock has worn off of his body. He's acknowledging often that he really messed himself up. He's restless at night and then tired during the day after doing just a few simple things (like shower). Sleep is the best thing for him - I sat all day with him and kept quiet and a washrag over his eyes so he could rest. He walked the hallways several times this afternoon. He gets up by himself and walks around - loaded a VHS tape to watch - then heads back to bed. He feels like crap! He doesn't want to be there tonight, but knows he's feeling the worst that he ever has.
Like Corey said, we're not trying to take your fun away--just enhance the experience by hoping you will do it safely. I would really prefer to keep you in a bubble, but knowing that isn't realistic, can only hope that the lesson was learned and you will act to protect yourself with safety gear. As the big sister, I couldn't bear to hear the tremble in your Dad's voice! Instead of driving down to Laredo for Poppa's birthday, I wanted to get on the next flight to Boulder. We all love you very much and are SO HAPPY to know that you aren't just some statistic!
Not a Rock Star
Kevin's recovery
KEVIN IS ONE BLESSED PERSON - Thanks for so many thoughts and prayers
HOWEVER - we can't forget he has sustained a very serious head injury. His skull is cracked and his brain is badly bruised and it needs lots of sleep and low doses of stimulation right now. Steve and I heard that over and over from the staff. We'll be trying to help him help himself (okay - we'll be nagging him) to stay near home and keep visits by friends low-key for a while. Apparently there can be side effects from this for up to a year. Brain injuries are serious things and we'll be educating ourselves about them so that we can help Kevin in the best possible way.
Sunday, May 10, 2009
Kevin was allowed his first non-family visitor today - Maya. Maya arrived just as he was moving into his new room. She brought a flower and some books. Sitting here typing in the waiting area. Just saw Kevin, Maya, and a physical therapist out for a walk down the hallway. Must admit it startled me.
Kevin has been visited by several therapists -- physical, occupational, and speech.
OT evaluates the jumpy vision problems that he is having. He is having trouble with vision convergence. The jumpy stuff is due to problems with his inner ear. (His skull fracture runs along that path.) The OT would like for us to get Kevin's glasses repaired. Need to be full frames to give his eyes a good frame of reference.
The speech therapist analyzes his cognitive state. Her name is Janelle. She gave him a screening test. He scored about 50% -- half pass, half failed. Stuff like recalling number sequences, paragraph comprehension, series of words, naming as many animals as you can in a fixed time, other things. All of this can be overcame with therapy which will continue after he leaves the hospital. We are told that the Mapleton center hospital is great with this sort of therapy. Janelle says that Kevin is really in a good disposition to receive therapy.
We got here at the usual time around 6:30 am. We met Kevin's new daytime nurse. His name is Curtis. Goodbye to Diana. She's on her way back to the ranch in Juhlsberg.
Dr Mason came by and is very please with Kevin's progress. He orders that Kevin can be released to a regular room today. He can leave ICU. And he could come home either Monday or Tuesday. He will need to stay on Dilantin for one more week. Then schedule doctor's visits for one week and one month from now.
Kevin had a really good day overall. He ate well. And no longer has any trouble keeping down his meals. He is able to take his vicodin in tablet form with no issues. Diana spent some time earlier in the day cleaning his road rash wounds.
This evening he got a treat - a real shower. Deb was able to arrange for us to use a real shower up in rehab on the upper floors. Off we went with wheelchair, towels, pajamas, soap, phone, etc. It was the perfect setup with a bench. I was in there in bare feet to hand him wash cloths, towels, and help him get back into pajamas.
Success! Back to bed feeling fresh and good night.
Kevin has asked me to bring him some of his music. It is a concern because the nurses continue to caution on the harmful effects of over stimulation on his brain. Still Kevin wanted me to bring him some of his quieter music. He actually sat down in his chair and wrote out a music list. We were thrilled to see him recalling and writing down all of these albums. I went home and transferred the music from his laptop to my ipod - about 150 songs. Brought the iHome player back with me to the hospital and set it up in his room. Very nice soothing music.
Kevin has somewhat of an eclectic music taste. Here's his list of music:
William Basinski, Soundtrack Clockwork Orange, soundtrack Eternal Sunshine of the Spotless Mind, soundtrack to Waking Life (that cool live/animation technique movie), Beethoven moonlight sonata, Duck Yas Yas, PrimitiveWorldMusic, Delia Derbyshire, Animal Collective / Sung Tongsla, Octopus Project / Avalanche.
Kevin has been bothered by the need to wear a neck brace. Since the vertabrae of the neck are uninjured in the CAT scans, we are hopeful that it can be removed.
One of the neurosurgeons, Dr Mason, came by this morning. He orders that the neck brace needs to stay on for 2 weeks. The reason is that the muscles that support the neck vertebrae have been severly strained.
We say goodbye to Diana the day nurse and hello again to Deb the night nurse. Both are great, highly skilled nurses. Kevin's fourth CAT scan is scheduled for Saturday morning.
We head home around 10 pm. The online artical has triggered a lot of messages on the home phone with expressions of concern and support.
We stepped out for dinner and ended up at KT's. As luck would have it, the doctor came by while we were gone. He is the neurosurgeon,. Dr Villavicencio. Very nice man. He called back once he got home.
Just got off of the phone with him.
He said that Kevin is going to be fine. He won't really be needing the services of a neurosurgeon now. He will probably be going to a regular room tomorrow. The various therapists will be seeing him. So, I am thinking he might be heading home Sunday? We'll see.
People have called us to tell us it is in the paper. Here are the links. We were touched by the Reader's expressions of concern too.
http://www.dailycamera.com/
Officer Richart, the police officer who handled the case, called me. He wanted to check in on Kevin's condition. I learned more details of the accident from the witness accounts. Kevin was speeding down a hill and lost control of his long-board close to 20 mph. He rolled on the street and hit his head on the street curb. A woman held him in her arms until the ambulance could get there. We need to meet her and thank her. We also just heard that one of Darcie's co-workers, Andrea, was at the scene while people waited for the ambulance. Darcie just spoke to Andrea about it.
Kevin showed improvement in his neurological tests all night and throughout this day. He is sleeping except when the nurse comes in for testing once an hour. He has walked around the room once. They give him morphine for his head pain now and then.
Tomorrow morning, he gets another CAT scan. They will send him home when he is able to walk and eat and take care of himself. Probably the earliest that would be is Saturday afternoon.
I think we are past the scary stuff like surgery. He is very much himself when it is time to talk to him. He is answering questions well. The unpredictable part will be the longer term effects of the head injury and concussion, which we are hearing can last up to a year or more.
Darcie and I are told to go to the ICU waiting room.
Eventually we are called back to be with him.
We meet his nurse Deb.
Deb says that BCH has an excellent Neuro unit.
Deb has a son who also suffered a closed head injury.
Kevin is responsive but not clear.
Deb is giving him gross neurological exams by the hour.
Stuff like... what day is it, what month, what year, where are you, who's president, hold your arms out, check you pupils, etc.
He is still throwing up. Mostly blood by now.
He is receiving Dilantin to control any potential seizures.
And still receiving morphine for pain. I think zofran for nausea.
We head home around 10 pm.
His third CAT scan is planned for 5 am.
Nurses change shifts a 7 am.
Once home, we let some relatives know for the first time.
I send out a quick email and head to bed.
When I got to ER he was being treated for a nasty laceration on his head. Kevin is in a neck brace. Multiple road rash cuts. He has had a CAT scan. He is awake, active, and very agitated.
Dr Lunde, the ER doc, informs me that he has a skull fracture, plus epidural and subdural bleeding in two spots. The police officer, Ross Richart, is filling me in on the accident including detailed accounts from two witnesses. An anestheologist shows up and an OR nurse. They are preparing for surgery. Dr Villavicencio is the neurosurgeon on call.
They cart Kevin away for a second CAT scan. He returns. The CAT scan results are quick and yield good news. There is no increase in bleeding. The OR staff is called off. We can relax one small bit.
Some of this will be a repeat of what you all have received in emails.
Thursday, 5pm
Looking back a bit to Thursday about 5 pm.
Darcie received the call from the police that Kevin was in the hospital. That he had had an accident with his skateboard. Darcie called me at work.