Courtney's day was busy with therapy and many friends and family visiting.
Agitation, over stimulation and frustration are all good signs of the waking up process and show that Courtney is moving into the confusional stage. Fortunately and unfortunately Courtney experienced all those today. It must be terribly frustrating for her to not be able to vocalize her needs.
While Courtney's overall memory seems to be good she is mainly focused on the current moment so that she won't remember what happened earlier that day. While I might tell Courtney who is coming to visit it won't mean anything to her until she actually sees them. This is all a natural part of this phase. Courtney is remembering family and friends well. Dr. Katz explained that the earliest memories return first and gradually Courtney's memory will work it's way up the just before the accident. The vast majority of people have no recollection of the accident and most can't remember up to days or weeks before the injury.
As most of you know there has been some question as to whether Courtney hydroplaned or had an episode of low or high bloood sugar that caused her to drive eractically. There seems to be little doubt at this point that Courtney is diabetic but we will never know the exact cause of the accident. Regardless of the cause, Courtney's determination and persistence will bring her through all her future challenges.
The best moment of the day was Courtney reaching up to stroke her Daddy's face as he kissed her good morning. Sometimes Dads just know the right thing to say and the right way to say it go get their children moving in the right direction. Craig has shown that gift throughout Courtney's recovery. She has listened intently to his words of encouragement with complete love and trust proving that she will always be 'Daddy's little girl.'
Saturday, January 3, 2009
Friday, January 2, 2009
Mom's Update
The baclofin test went very well today and although Courtney was already showing improvement with spasticity the decision was made to go ahead with the surgery since it would most likely provide benefit to Courtney.
It was a very stressful day for Courtney but as with everything else she fought through it like a champion. She is moving around quite a bit and learning more and more to communicate.
Courtney started mouthing words today - she mouthed 'yes' several times. The highlight of the day was definitely the fruit cup. Tomorrow Courtney will have even more real food to eat.
Once the surgery is behind her Courtney can resume her progress including having the trachea removed and once she's eating normal food multiple times a day she can have the feeding tube removed. Hopefully those things will occur early in the 2nd week of January depending on how well she bounces back from surgery. The doctors told us that the surgery may set her back a week. We are are optimistic that she will demonstrate her determination to overcome adversity.
We are so, so thankful for all of the prayers and support that our family has recieved for the last 7 weeks. Words are inadequate to describe the heartfelt thanks that we want to express to everyone.
It seems to our family that having placed our faith in God her recovery been remarkable. When we describe remarkable we use the basis of what we were told to expect with the severity of her brain injury. We believe this is the power of all our collective prayers. Thank you again!
It was a very stressful day for Courtney but as with everything else she fought through it like a champion. She is moving around quite a bit and learning more and more to communicate.
Courtney started mouthing words today - she mouthed 'yes' several times. The highlight of the day was definitely the fruit cup. Tomorrow Courtney will have even more real food to eat.
Once the surgery is behind her Courtney can resume her progress including having the trachea removed and once she's eating normal food multiple times a day she can have the feeding tube removed. Hopefully those things will occur early in the 2nd week of January depending on how well she bounces back from surgery. The doctors told us that the surgery may set her back a week. We are are optimistic that she will demonstrate her determination to overcome adversity.
We are so, so thankful for all of the prayers and support that our family has recieved for the last 7 weeks. Words are inadequate to describe the heartfelt thanks that we want to express to everyone.
It seems to our family that having placed our faith in God her recovery been remarkable. When we describe remarkable we use the basis of what we were told to expect with the severity of her brain injury. We believe this is the power of all our collective prayers. Thank you again!
Mom's Update
Courtney had a traumatic morning today because it took so many people to hold her down for a temporary IV and she has very small veins. It took multiple attempts to get the IV in.
Then the spinal tap was done to insert the baclofin and because she needed to be held very still it took 4 people to hold her down. I had to literally sit on Courtney to hold her down. She's so strong it's amazing to everyone!
We will see throughout the day how she reacts to the baclofin but in the meantime, the doctor was very encouraged that within the past week Courtney's spasticity has improved on its own.
The rest of the day will be spent with normal therapy but evaluations every hour to see how the medication works.
Courtney is really a fighter - it's evident to everyone who cares for her that she is trying her very best to move and do the things she wants to do and those that are asked of her.
Then the spinal tap was done to insert the baclofin and because she needed to be held very still it took 4 people to hold her down. I had to literally sit on Courtney to hold her down. She's so strong it's amazing to everyone!
We will see throughout the day how she reacts to the baclofin but in the meantime, the doctor was very encouraged that within the past week Courtney's spasticity has improved on its own.
The rest of the day will be spent with normal therapy but evaluations every hour to see how the medication works.
Courtney is really a fighter - it's evident to everyone who cares for her that she is trying her very best to move and do the things she wants to do and those that are asked of her.
Thursday, January 1, 2009
Prayer for a Miracle
God of all creation, you who spoke a simple command and brought forth light from the darkness, I call upon you now to send forth your miracle-working power into every aspect of Courtney's being. In the same way that you spoke unto the dust of the ground when you created humakind in your own image, I ask you to send forth your healing power into Courtney's body. Send forth your word and command every cell, every electrical and chemical impulse, tissue, joint, ligament, organ, gland, muscle, bone and every molecule in Courtney's body to come under complete and perfect health, strength, alignment, balance, and harmony.
It is through you that we live and move and have our being. With every breath we take, we live under your life-giving grace. I ask you to touch Courtney now with the same miracle-working power that you used when you fashioned her inside her mother's womb. As surely as you have created Courtney in your image and likeness, you can also recreate her now and restore her to health.
Please fill Courtney with your healing power. Cast out all that should not be inside of her. I ask you to mend all that is broken, root out every sickness and disease, open all blocked arteries and veins, restore Courtney's internal organs, rebuild her damaged tissues, remove all inflammation and cleanse her of all infections, viruses and destructive forms of bacteria.
Let the warmth of your healing love flood Courtney's entire being, so that her body will function the way it was created to be, whole and complete, renewed in your perfect health. I ask this through my Lord, Jesus Christ, your son, who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.
Thank you for continuing to pray with us for Courtney's full recovery.
It is through you that we live and move and have our being. With every breath we take, we live under your life-giving grace. I ask you to touch Courtney now with the same miracle-working power that you used when you fashioned her inside her mother's womb. As surely as you have created Courtney in your image and likeness, you can also recreate her now and restore her to health.
Please fill Courtney with your healing power. Cast out all that should not be inside of her. I ask you to mend all that is broken, root out every sickness and disease, open all blocked arteries and veins, restore Courtney's internal organs, rebuild her damaged tissues, remove all inflammation and cleanse her of all infections, viruses and destructive forms of bacteria.
Let the warmth of your healing love flood Courtney's entire being, so that her body will function the way it was created to be, whole and complete, renewed in your perfect health. I ask this through my Lord, Jesus Christ, your son, who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.
Thank you for continuing to pray with us for Courtney's full recovery.
Update for New Years
Courtney's day was very busy yesterday and so there wasn't any free time for a posting.
She had lots and lots of therapy and also is rolling over in bed - reaching for the railing and pretty much getting out of the bed. It's all good activity that shows she is ready to get up and go!
Courtney had lots of ice cream yesterday and is ready to move on to other types of food. Kathleen her speech therapist told Courtney it won't be long before she'll be eating regular food. These are more great steps toward recovery since eating stimulates so much of the brain, both motor skills and emotions.
Dr. Katz, neurologist, met with Craig and I yesterday and told us that Courtney is progressing better than he thought when she arrived just 2 weeks ago. The rest of the staff agree.
Tomorrow is the baclofin pump test which will take about 6 hours during which she will be closely monitored and evaluated. Courtney will have normal therapy throughout the day.
One of the trickiest new challenges is that Courtney is trying to get out of the wheel chair - after all she's close to standing it makes sense in her mind. We watch her closely and staff is very good at moving swiftly to get her sitting back safely. Courtney has also learned to scoot herself back up into the chair.
One big development of the past two days is Courtney scratching her nose and feeling her hair. This is not only purposeful but is voluntary movement that shows other parts of her brain coming back.
Check back later for a new years prayer for miracles. We certainly are praying that God will bless Courtney many times over again in 2009!
She had lots and lots of therapy and also is rolling over in bed - reaching for the railing and pretty much getting out of the bed. It's all good activity that shows she is ready to get up and go!
Courtney had lots of ice cream yesterday and is ready to move on to other types of food. Kathleen her speech therapist told Courtney it won't be long before she'll be eating regular food. These are more great steps toward recovery since eating stimulates so much of the brain, both motor skills and emotions.
Dr. Katz, neurologist, met with Craig and I yesterday and told us that Courtney is progressing better than he thought when she arrived just 2 weeks ago. The rest of the staff agree.
Tomorrow is the baclofin pump test which will take about 6 hours during which she will be closely monitored and evaluated. Courtney will have normal therapy throughout the day.
One of the trickiest new challenges is that Courtney is trying to get out of the wheel chair - after all she's close to standing it makes sense in her mind. We watch her closely and staff is very good at moving swiftly to get her sitting back safely. Courtney has also learned to scoot herself back up into the chair.
One big development of the past two days is Courtney scratching her nose and feeling her hair. This is not only purposeful but is voluntary movement that shows other parts of her brain coming back.
Check back later for a new years prayer for miracles. We certainly are praying that God will bless Courtney many times over again in 2009!
Tuesday, December 30, 2008
Mom's Update
Courtney had another busy day. The day started with the usual beauty treatment followed by speech therapy. Courtney had more ice cream and her trachea was capped so that she was breathing completely through her nose and mouth. She had lots of stretching, sitting up and other exercises meant to strengthen her trunk, neck and overall posture. Courtney worked very very hard and did great with everything!
Today's capping was the beginning of a trial - tomorrow she will be capped for 4 hours - then next day for longer. Once Courtney has tolerated 3 consecutive days of capping the trachea will be removed.
The baclofin pump trial is scheduled for Friday and surgery is scheduled for Monday providing that the trial goes well.
On another note, we are always living in the world of reality and we need prayers that will help us to be able to keep Courtney here as long as she needs. Blue Cross is only approving 5 days at a time here. It seems as though they're looking for the type of improvements one would see with a hip replacement patient. Unfortunately, TBI progress of this nature is very slow.
The staff here is documenting all of her progress very well to support the need for Courtney to stay. But everything we've asked for through prayer we have received and so I'm asking you all to fervently pray that Courtney stays here where she is meant to be. Please pray.
Thank you for the wonderful cards, emails and visits - they are great lift to our spirits and Courtney's enjoying these more as each day passes.
Today's capping was the beginning of a trial - tomorrow she will be capped for 4 hours - then next day for longer. Once Courtney has tolerated 3 consecutive days of capping the trachea will be removed.
The baclofin pump trial is scheduled for Friday and surgery is scheduled for Monday providing that the trial goes well.
On another note, we are always living in the world of reality and we need prayers that will help us to be able to keep Courtney here as long as she needs. Blue Cross is only approving 5 days at a time here. It seems as though they're looking for the type of improvements one would see with a hip replacement patient. Unfortunately, TBI progress of this nature is very slow.
The staff here is documenting all of her progress very well to support the need for Courtney to stay. But everything we've asked for through prayer we have received and so I'm asking you all to fervently pray that Courtney stays here where she is meant to be. Please pray.
Thank you for the wonderful cards, emails and visits - they are great lift to our spirits and Courtney's enjoying these more as each day passes.
Monday, December 29, 2008
Mom and Dad's Update
Courtney has been very active the past 2 days. While sitting in bed and in her wheel chair she has been throwing her legs over the side. Courtney has also been leaning forward - lifting herself from the waist up off the bed and rolling from side to side.
Because of all that activity, and because Braintree never wants to restrain patients Courtney is now in a 'low' bed. It looks very much like a hospital bed but it sits near the floor similar to a toddler's bed. There are large soft mats on either side so that if Courtney does try to get out of bed she will not hurt herself.
It is obvious that Courtey is very frustrated that she is not walking and talking. We have explained to her that the muscle tone (tightness, spasms, spasticity) has to be addressed before she will be ready to walk - otherwise she would be walking on her toes and hurting her ankles and other joints.
Courtney can speak but the valve that is currently in her trachea doesn't allow for the normal amount of air that passes through our mouths. This feels awkward causing Courtney to force air through her mouth which then comes out in a hoarse tone.
Tomorrow Kathleen, speech therapist, will 'cap' the trachea as it was at RIH thereby allowing all air to pass through Courtney's mouth. When she does make sound it will be her natural voice.
The fact that Courtney is now aware of her deficits is a huge step forward in the process. Her frustration will motivate her to do the hard work she needs to continue her recovery.
Courtney's first week at BRH has been a success considering that she wasn't moving around as much, wasn't eating or swallowing anything (barely opening her mouth) and wasn't communicating just one week ago.
Courtney will nod yes and no to questions and is now making choices about wardrobe. Both yesterday and today I showed her 2 pairs of pants - then 2 shirts - each time she stared at the one she wanted. Then I switched positions and asked her to look at her choice - she made the same choice each time. This morning she added a firm nod leaving no doubt about her choice!
Courtney's genuinely affectionate and loving side is coming through as she is frequently leaning forward to give us kisses. Tonight I kissed her on both cheeks and said 'we'll kiss like Europeans' - this made Courtney laugh - it was a great sound!
We believe that Courtney's memory is very good. Today when I showed her pictured of her holding Jessica and Audrey Laffey in her lap she leaned forward and kissed each face in the picture. She stared lovingly at the picture several times during the day.
Now that Courtney is so much more aware it's a good time to talk about visiting.
Visiting hours during the week are 12-1 and 4-8. Weekends 12-8.
In our experience 3-5:30/6:00 are the best times during the week because by 7pm Courtney is wiped out from all the work she's done all day.
12-1 is okay during the week too.
Weekends from 12-5:30/6:00 work best.
A few things to remember when visiting:
Courtney does have therapy on the weekends and so you may have to wait to see her.
She may be very tired and sleepy - therefore the visit could involve just sitting with Courtney.
Overstimulation is not good - so a crowd of visitors is to much for Courtney to handle. If you come with a group it's best to have 3-4 people in the room at a time.
Avoid using loud voices - she responds best to soft soothing voices.
It's okay to show emotion - sometimes when Courtney sees a good friend she cries -it's okay for you to cry too. We always say 'it stinks that you have to go through this Courtney, but we cry happy tears too because you're doing so well."
Every adult who has visited Courtney has struggled through seeing her less than her energetic self. We all have difficulty reconciling our feelings. If you have young children we strongly discourage you from bringing them to see Courtney. They simply can not reconcile why she is not the bubbly Courtney she usually is. Courtney would be the first person to say "don't upset children by bringing them into a situation they can't handle."
If you ever have any questions about visiting or Courtney's progress feel free to post it on comments or call my cell phone.
Because of all that activity, and because Braintree never wants to restrain patients Courtney is now in a 'low' bed. It looks very much like a hospital bed but it sits near the floor similar to a toddler's bed. There are large soft mats on either side so that if Courtney does try to get out of bed she will not hurt herself.
It is obvious that Courtey is very frustrated that she is not walking and talking. We have explained to her that the muscle tone (tightness, spasms, spasticity) has to be addressed before she will be ready to walk - otherwise she would be walking on her toes and hurting her ankles and other joints.
Courtney can speak but the valve that is currently in her trachea doesn't allow for the normal amount of air that passes through our mouths. This feels awkward causing Courtney to force air through her mouth which then comes out in a hoarse tone.
Tomorrow Kathleen, speech therapist, will 'cap' the trachea as it was at RIH thereby allowing all air to pass through Courtney's mouth. When she does make sound it will be her natural voice.
The fact that Courtney is now aware of her deficits is a huge step forward in the process. Her frustration will motivate her to do the hard work she needs to continue her recovery.
Courtney's first week at BRH has been a success considering that she wasn't moving around as much, wasn't eating or swallowing anything (barely opening her mouth) and wasn't communicating just one week ago.
Courtney will nod yes and no to questions and is now making choices about wardrobe. Both yesterday and today I showed her 2 pairs of pants - then 2 shirts - each time she stared at the one she wanted. Then I switched positions and asked her to look at her choice - she made the same choice each time. This morning she added a firm nod leaving no doubt about her choice!
Courtney's genuinely affectionate and loving side is coming through as she is frequently leaning forward to give us kisses. Tonight I kissed her on both cheeks and said 'we'll kiss like Europeans' - this made Courtney laugh - it was a great sound!
We believe that Courtney's memory is very good. Today when I showed her pictured of her holding Jessica and Audrey Laffey in her lap she leaned forward and kissed each face in the picture. She stared lovingly at the picture several times during the day.
Now that Courtney is so much more aware it's a good time to talk about visiting.
Visiting hours during the week are 12-1 and 4-8. Weekends 12-8.
In our experience 3-5:30/6:00 are the best times during the week because by 7pm Courtney is wiped out from all the work she's done all day.
12-1 is okay during the week too.
Weekends from 12-5:30/6:00 work best.
A few things to remember when visiting:
Courtney does have therapy on the weekends and so you may have to wait to see her.
She may be very tired and sleepy - therefore the visit could involve just sitting with Courtney.
Overstimulation is not good - so a crowd of visitors is to much for Courtney to handle. If you come with a group it's best to have 3-4 people in the room at a time.
Avoid using loud voices - she responds best to soft soothing voices.
It's okay to show emotion - sometimes when Courtney sees a good friend she cries -it's okay for you to cry too. We always say 'it stinks that you have to go through this Courtney, but we cry happy tears too because you're doing so well."
Every adult who has visited Courtney has struggled through seeing her less than her energetic self. We all have difficulty reconciling our feelings. If you have young children we strongly discourage you from bringing them to see Courtney. They simply can not reconcile why she is not the bubbly Courtney she usually is. Courtney would be the first person to say "don't upset children by bringing them into a situation they can't handle."
If you ever have any questions about visiting or Courtney's progress feel free to post it on comments or call my cell phone.
Sunday, December 28, 2008
RIH Trauma Intensive Care Unit(TICU)
When I originally thought about writing of our experience on TICU (trauma intensive care unit) I thought it might be 'TICU in the rearview mirror'. But the emotions of our experience there are to recent and run to deep - they are not behind us but will remain a part of us for a long time.
Imagine for a moment a world where time stands still. A world of constant beeping, alarms, drips, machines humming, voices in the hallway, lights on, lights off, lights on again, more beeping, endless alarms. Those are the aethestics of TICU. A world of intensity where lives are saved and lost nearly every day, often more than once a day.I
remember the first 'night' - it was early morning when we were brought up to the TICU. Lisa was the nurse on duty but many other nurses and doctors were still busy rushing in and out to attend to Courtney's very serious status. As I think back to Lisa asking us questions about Courtney it's odd that I can recall only one emotion during the first hour in TICU - I felt calm.
Perhaps it is the peace in the midst of the storm so often sung about in gospel hymns.
The peace on that day was certainly God's gift but the instrument he used to deliver that gift was the staff on TICU. So often I told them individually "you are giving people a gift."
There were conversations Craig and I had with doctors that cut us in half, I remember being practically carried to a chair more than once, and yet somewhere in the corner of my mind was the thought "how do they have these conversations?" How to you ask a parent about organ donation? How do you ask the unthinkable question of ending life support? The only answer is that they have been gifted by God with an amount of compassion that is beyound reach for for the rest of us.
The doctors who have chosen trauma as their specialty are certainly a breed of their own. The nursing staff dedicated to caring for critically ill patients, with multiple injuries, whose grasp on life is so tentative, have their own amazing capacity to provide compassion , caring and love.
All the staff who work the TICU, xray technicians, housekeeping, see, feel the pain and anguish of patients and families in crisis. They are all a blessing to all of us. These are your neighbors, friends, relatives and the people you pass on the street or in the store without a second glance. Every morning for the entire time that Courtney was in TICU at least 3-5 of the housekeeping staff would stand at the end of her bed and say silent prayers for her. They did this not because they knew Courtney or our family but because they also have a gift of love that runs deep through their hearts.
Not only did they care for Courtney as though she were their own sister, daughter, granddaughter, they cared for us too. We can't count the number of times doctors and nurses alike stopped to ask 'are you okay?', 'do you need anything?', 'is there anything I can do for you?
We found their compassion and willingness to extend that love to us nothing short of amazing.
From the bottom of our hearts we will never forget or be able to thank enough all those who brought Courtney from the brink of death to be medically stable enough to continue her recovery. It was these dedicated professionals, along with close friends and family, who have been by our side during the beginning of this awful journey. A journey where we have been shown Gods presence in this world.
May God bless them all with the strength to continue loving, with compassion for others that only saints have known, and the peace of knowing there are many many grateful hearts who will always and forever pray in thanksgiving for their being.
Diane, Craig, Katy, Claudia and Courtney
Imagine for a moment a world where time stands still. A world of constant beeping, alarms, drips, machines humming, voices in the hallway, lights on, lights off, lights on again, more beeping, endless alarms. Those are the aethestics of TICU. A world of intensity where lives are saved and lost nearly every day, often more than once a day.I
remember the first 'night' - it was early morning when we were brought up to the TICU. Lisa was the nurse on duty but many other nurses and doctors were still busy rushing in and out to attend to Courtney's very serious status. As I think back to Lisa asking us questions about Courtney it's odd that I can recall only one emotion during the first hour in TICU - I felt calm.
Perhaps it is the peace in the midst of the storm so often sung about in gospel hymns.
The peace on that day was certainly God's gift but the instrument he used to deliver that gift was the staff on TICU. So often I told them individually "you are giving people a gift."
There were conversations Craig and I had with doctors that cut us in half, I remember being practically carried to a chair more than once, and yet somewhere in the corner of my mind was the thought "how do they have these conversations?" How to you ask a parent about organ donation? How do you ask the unthinkable question of ending life support? The only answer is that they have been gifted by God with an amount of compassion that is beyound reach for for the rest of us.
The doctors who have chosen trauma as their specialty are certainly a breed of their own. The nursing staff dedicated to caring for critically ill patients, with multiple injuries, whose grasp on life is so tentative, have their own amazing capacity to provide compassion , caring and love.
All the staff who work the TICU, xray technicians, housekeeping, see, feel the pain and anguish of patients and families in crisis. They are all a blessing to all of us. These are your neighbors, friends, relatives and the people you pass on the street or in the store without a second glance. Every morning for the entire time that Courtney was in TICU at least 3-5 of the housekeeping staff would stand at the end of her bed and say silent prayers for her. They did this not because they knew Courtney or our family but because they also have a gift of love that runs deep through their hearts.
Not only did they care for Courtney as though she were their own sister, daughter, granddaughter, they cared for us too. We can't count the number of times doctors and nurses alike stopped to ask 'are you okay?', 'do you need anything?', 'is there anything I can do for you?
We found their compassion and willingness to extend that love to us nothing short of amazing.
From the bottom of our hearts we will never forget or be able to thank enough all those who brought Courtney from the brink of death to be medically stable enough to continue her recovery. It was these dedicated professionals, along with close friends and family, who have been by our side during the beginning of this awful journey. A journey where we have been shown Gods presence in this world.
May God bless them all with the strength to continue loving, with compassion for others that only saints have known, and the peace of knowing there are many many grateful hearts who will always and forever pray in thanksgiving for their being.
Diane, Craig, Katy, Claudia and Courtney
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