Courtney laughed again today just at the reminder of her conversation with Catherine. After breakfast I asked Courtney "is there anything I can get you?" She said "Emma." I told Courtney Emma was home but later in the morning Emma came to visit. Courtney was very happy! Courtney ate french fries today thanks to Auntie Debbie. She's eating grapes and canteloupe for breakfast but not enough food throughout the day.
As Courtney continues to get better she is staying awake for longer and longer. She's also doing alot of walking - lots and lots of walking! Today Courtney wanted me to bring her on the stairs but I said "oh no!" that's a job for the therapists AND Mom! The only stairs I'm walking on alone with Courtney are the carpeted stairs at home!
As Courtney's speech gets better she is making her wants and needs known more and more. Today she asked to take a bath tub instead of shower. That's something that will have to wait until you get home Courtney. We love all the progress that's being made and will start the countdown to coming home tomorrow - February 1st.
Saturday, January 31, 2009
Courtney's Laughing
Courtney had a great visit with her friend Catherine today and laughed for the first time since the accident. It was a wonderful sound to hear. Catherine was telling stories from their overnight trips to Alton Jones Camp and how they tortured the poor boys on the trip! With each reminder of teasing Courtney laughed and smiled broader and brighter.
This was at the end of a great day of therapy and being awake most of the day. We showed pictures of our house to Courtney as her memory is of living in Cranston. She wanted to know why she didn't recognize our house and I explained it was because we just moved there in June. We will show Courtney pictures of our home every day so that she will feel comfortable when she comes home. As we were discussing coming home I told Courtney "you'll be coming home in 3 weeks" and she said "or maybe 2?" Maybe! We'll see but more likely 3 - around the 20th. We are still working on getting Courtney to eat. She only had about 200 calories yesterday. We are trying to offer and give her anything and everything!
This was at the end of a great day of therapy and being awake most of the day. We showed pictures of our house to Courtney as her memory is of living in Cranston. She wanted to know why she didn't recognize our house and I explained it was because we just moved there in June. We will show Courtney pictures of our home every day so that she will feel comfortable when she comes home. As we were discussing coming home I told Courtney "you'll be coming home in 3 weeks" and she said "or maybe 2?" Maybe! We'll see but more likely 3 - around the 20th. We are still working on getting Courtney to eat. She only had about 200 calories yesterday. We are trying to offer and give her anything and everything!
Thursday, January 29, 2009
Mom's Update
Courtney's morning was once again packed with activity. Courtney went from task to task in the shower this morning with very little prompting. She is even bending over to pull on socks and shoes (something she's not really supposed to do because of the baclofin pump).
She did a lot of reading today and is working on orientation to place, date and time. Some days are better than others. Because Courtney's oldest memories will return first she often says that she lives in Cranston rather than in South Kingstown where we moved in June. We are going to bring pictures of the new house and the rooms, especially her bedroom, so that she can recall those memories.
Today Courtney asked me "do you still have meetings?" I said "are you asking me if I am going to work?" she nodded yes. I explained that I have not been to work and am staying with Courtney until she gets better. Then Courtney said "it's a good thing I didn't get hurt worse."
HA! The therapist and I couldn't believe it. At this point Courtney can't begin to imagine how hurt she was but I did tell her that she was very very sick and asleep for a long time that is why we get so excited about her walking and eating, etc.
Because Courtney's morning was filled with therapy she was somewhat overwhelmed and at one point crying she said "it's all to much." It certainly is to much for anyone of us to comprehend what our little Courtney has fought her way back from but we are so proud of her.
While she didn't eat alot today she is trying food a little bit at a time. After trying several things this afternoon Courtney threw up her hands and shook her head showing frustration at not enjoying anything. This is a good sign that she is at least willing to try so we will keep praying that every day she will be more interested in eating and food will start to taste good.
She did a lot of reading today and is working on orientation to place, date and time. Some days are better than others. Because Courtney's oldest memories will return first she often says that she lives in Cranston rather than in South Kingstown where we moved in June. We are going to bring pictures of the new house and the rooms, especially her bedroom, so that she can recall those memories.
Today Courtney asked me "do you still have meetings?" I said "are you asking me if I am going to work?" she nodded yes. I explained that I have not been to work and am staying with Courtney until she gets better. Then Courtney said "it's a good thing I didn't get hurt worse."
HA! The therapist and I couldn't believe it. At this point Courtney can't begin to imagine how hurt she was but I did tell her that she was very very sick and asleep for a long time that is why we get so excited about her walking and eating, etc.
Because Courtney's morning was filled with therapy she was somewhat overwhelmed and at one point crying she said "it's all to much." It certainly is to much for anyone of us to comprehend what our little Courtney has fought her way back from but we are so proud of her.
While she didn't eat alot today she is trying food a little bit at a time. After trying several things this afternoon Courtney threw up her hands and shook her head showing frustration at not enjoying anything. This is a good sign that she is at least willing to try so we will keep praying that every day she will be more interested in eating and food will start to taste good.
Wednesday, January 28, 2009
Tuesday and Wednesday update
Yesterday Courtney worked very hard all morning walking, talking and reading. She walked with the LiteGait which is a machine that rolls along while Courtney is strapped in by a harness. It helps with weight bearing so that Courtney can walk further. It is not comfortable and walking can be painful because of muscles that were tight for so long and 8 weeks in bed. During Courtney's walk on the LiteGait she was crying and saying "it's not fair" and "why?" We all agreed with Courtney that it's not fair but unfortunately I don't have an answer as to why.
I do know that Courtney's miraculous recovery is due to the prayers of many faithful and God's mercy.
Today Courtney told me "I don't deserve this" - she's right no one deserves this. But I told Courtney that she is a fighter and that she has come a long long way and will get better. This afternoon I said "Courtney, you're amazing, do you know that?" She nodded yes! Courtney walked further today than ever and did the stairs with great skill. She is showering and dressing with almost no help at all. Courtney is also reading which will, in the long run, help her speech. After showering we visited the "kitchen" in the rehab gym which is used to help retrain patients in day to day tasks. Courtney put utensils away in the proper compartment with no instruction. She then went on to put cans of coke, milk cartons and juice cups away with like items in the fridge. She did both these tasks with only one instruction "put them away." That shows remarkeable organization and sequencing skills this early in recovery.
Later Courtney and I were making Valentines hearts. Courtney took different colored hearts and layered them without any prompting from me. That shows creativity. Another part of the brain working properly.
The last big hurdle before leaving Braintree is still eating. I have been praying that she will start eating. Please pray with us that Courtney will begin eating and wanting to eat regularly so that she can have her feeding tube removed. Thank you!
I do know that Courtney's miraculous recovery is due to the prayers of many faithful and God's mercy.
Today Courtney told me "I don't deserve this" - she's right no one deserves this. But I told Courtney that she is a fighter and that she has come a long long way and will get better. This afternoon I said "Courtney, you're amazing, do you know that?" She nodded yes! Courtney walked further today than ever and did the stairs with great skill. She is showering and dressing with almost no help at all. Courtney is also reading which will, in the long run, help her speech. After showering we visited the "kitchen" in the rehab gym which is used to help retrain patients in day to day tasks. Courtney put utensils away in the proper compartment with no instruction. She then went on to put cans of coke, milk cartons and juice cups away with like items in the fridge. She did both these tasks with only one instruction "put them away." That shows remarkeable organization and sequencing skills this early in recovery.
Later Courtney and I were making Valentines hearts. Courtney took different colored hearts and layered them without any prompting from me. That shows creativity. Another part of the brain working properly.
The last big hurdle before leaving Braintree is still eating. I have been praying that she will start eating. Please pray with us that Courtney will begin eating and wanting to eat regularly so that she can have her feeding tube removed. Thank you!
Monday, January 26, 2009
"It really is miraculous"
"It really is miraculous." Those were the exact words the Neurology Physician's Assistant used today to describe Courtney's progress. Of course I had to agree with her. She made this observation as she watched Courtney walk back from the shower, unassisted. She's quickly turning into a hall roamer. This afternoon Courtney got out of bed and headed for the door. I asked her "where are you going?" she answered "next door." The nurses in the hallway let her know she wasn't allowed in other patients' rooms and so we walked up and down the hall.
Later Dr. Williams (internal med) came by to check on Courtney. "How's your walking?" he asked. She responded by getting up and walking out the door - actions speak louder than words! He was quite impressed. Tomorrow Courtney's team will meet again to re-write her goals and establish a plan leading up to discharge.
We still face hurdles, not the least of which is eating, and Courtney is being quite stubborn about this. Her team and I talk more now about behavoir problems and working through Courtney's stubborn streak. That same stubborn determination is what has helped her recovery and since there's no playing games with Courtney I have started to tell her there are certain things about which she can not be stubborn.
Courtney did a little reading today. She read from the scrapbook Nora made about Courtney Bears and she read the title of the book "I love you more." Tomorrow she'll read the book to Maureen, a speech therapist. Courtney also answered many of the same annoying questions she answers every day such as 'what month is it?' 'where are you now?', etc. These are reality orienting questions but they drive Courtney crazy because she takes them as an insult to her intelligence. Speech therapists are constantly forced to apologize for the silly questions but insist they must ask them anyway!
Later Dr. Williams (internal med) came by to check on Courtney. "How's your walking?" he asked. She responded by getting up and walking out the door - actions speak louder than words! He was quite impressed. Tomorrow Courtney's team will meet again to re-write her goals and establish a plan leading up to discharge.
We still face hurdles, not the least of which is eating, and Courtney is being quite stubborn about this. Her team and I talk more now about behavoir problems and working through Courtney's stubborn streak. That same stubborn determination is what has helped her recovery and since there's no playing games with Courtney I have started to tell her there are certain things about which she can not be stubborn.
Courtney did a little reading today. She read from the scrapbook Nora made about Courtney Bears and she read the title of the book "I love you more." Tomorrow she'll read the book to Maureen, a speech therapist. Courtney also answered many of the same annoying questions she answers every day such as 'what month is it?' 'where are you now?', etc. These are reality orienting questions but they drive Courtney crazy because she takes them as an insult to her intelligence. Speech therapists are constantly forced to apologize for the silly questions but insist they must ask them anyway!
Sunday, January 25, 2009
from UB
It's so great to see and to learn of Courtney's amazing progress. She keeps going and going and going,,,. It might be unseemly to make money off this terrible situation but I'd like to buy some Courtney stock! Tons of it. In fact, this could be the answer to our economic troubles. My advice would be BUY, BUY, BUY!!!!
Not to be negative but Courtney won't pass my test till she can dodge hockey pucks fired at her by Uncle Bill from 20' feet away! That's how I learned evasive manuevers at a young age. We all played dodgeball in grammar school but that was nothing! Of course, Courtney would need full pads and an opportunity to return the favor.
If you've seen the movie "Dodgeball" you know what I mean. "If you can dodge a wrench, you can dodge a ball." And so, if you can dodge a hard, black, rubber, half frozen hockey puck traveling at 95 miles per hour, in limited lighting conditions, in the middle of winter, then you can dodge a ball and just about anything else coming your way save for a federal search warrant but that's another story.
We all long for the day when Courtney can go home to rest and continue to heal in familiar surrroundings. I also look forward to making my famous thai/mex/italo/chinese/rushkie/greek/franco/japanese seafood, spaghetti, pad thai, crepes, taco, sushi, feta cheese, pupu platter, vodka casserole for Courtney!
Believe me when I tell you, this dish is a real killer! (stomach pumps available)
All my love to Courtney and her family! Semper Fi
Not to be negative but Courtney won't pass my test till she can dodge hockey pucks fired at her by Uncle Bill from 20' feet away! That's how I learned evasive manuevers at a young age. We all played dodgeball in grammar school but that was nothing! Of course, Courtney would need full pads and an opportunity to return the favor.
If you've seen the movie "Dodgeball" you know what I mean. "If you can dodge a wrench, you can dodge a ball." And so, if you can dodge a hard, black, rubber, half frozen hockey puck traveling at 95 miles per hour, in limited lighting conditions, in the middle of winter, then you can dodge a ball and just about anything else coming your way save for a federal search warrant but that's another story.
We all long for the day when Courtney can go home to rest and continue to heal in familiar surrroundings. I also look forward to making my famous thai/mex/italo/chinese/rushkie/greek/franco/japanese seafood, spaghetti, pad thai, crepes, taco, sushi, feta cheese, pupu platter, vodka casserole for Courtney!
Believe me when I tell you, this dish is a real killer! (stomach pumps available)
All my love to Courtney and her family! Semper Fi
Moving along
Courtney's day was highlighted by a walk without any help - completely unassisted! Then Courtney wandered over to the stairwell door and and Meline and Alex asked her if she'd like to do the stairs. Courtney answered yes and rather than doing the practice steps like all the other patients she did a full fight of steps up and down! Next Courtney wanted to get on the elevator - okay up 1 floor - then back on the stairs and down 2 flights of stairs. The energizer Courtney!!!
For Mom the best part of the day was seeing Courtney eat real food. She had a couple of bites of Mrs. Lawson's pancakes and then nothing at lunch. Finally at dinner she ate a quarter piece of wheat bread and a few bites of elbow macaroni. Yahoo!!!! I can not tell Courtney enough times - you must eat so that the doctor can remove your feeding tube.
Everything we talk about with Courtney now is about going home. Eat so you can go home. Walk alone so you can go home. Do your best in each therapy so you can go home. We know she understands and we pray every day all day for her continued remarkeable recovery so that we can bring her home.
For Mom the best part of the day was seeing Courtney eat real food. She had a couple of bites of Mrs. Lawson's pancakes and then nothing at lunch. Finally at dinner she ate a quarter piece of wheat bread and a few bites of elbow macaroni. Yahoo!!!! I can not tell Courtney enough times - you must eat so that the doctor can remove your feeding tube.
Everything we talk about with Courtney now is about going home. Eat so you can go home. Walk alone so you can go home. Do your best in each therapy so you can go home. We know she understands and we pray every day all day for her continued remarkeable recovery so that we can bring her home.
Saturday, January 24, 2009
Mom's Update
Courtney had a painful day today as her left arm was very sore and she had general aches and pains magnified by a hyperalert nervous system as she continues to wake up. Courtney also had emotional pain today as she was definitely struck with the magnitude of her current deficits. It was clear to Courtney today that she is walking, talking, writing and doing everything different and always needing help. She shed many tears today over this and we comforted her as best we could. Despite all her own pain Courtney managed to make us laugh - on purpose - with funny Courtney faces. At one point Craig said "is Daddy silly sometimes?" and Courtney made a funny face and shook her head no - everyone broke out in hysterics.
Today was a big eating day for Courtney as she passed the test to move on to ground and soft foods like pancakes and pasta. It was not an easy test and Courtney challenged Kathleen, the speech therapist by saying "you don't have the right to tell a person what to eat." We were all shocked and impressed by this obvious sign of personal independence, dignity and high level thought. Kathleen respectfully explained to Courtney why she has to make sure that Courtney can safely eat certain foods. Courtney was satisfied with the answer and continued on to pass the test!
Other than some walking today was a day of well deserved rest for Courtney. Imagine in the past two weeks she started and has greatly improved: walking, talking, eating, and independent personal care. These milestones and her diligence in improving at each have the entire staff amazed and delighted. We are so grateful for this progress. When Courtney made her sisters, friends and Mom and Dad laugh only one thought entered my mind: 'thank you God' and I repeated it over and over and over in my head while happy tears ran down my face.
Today was a big eating day for Courtney as she passed the test to move on to ground and soft foods like pancakes and pasta. It was not an easy test and Courtney challenged Kathleen, the speech therapist by saying "you don't have the right to tell a person what to eat." We were all shocked and impressed by this obvious sign of personal independence, dignity and high level thought. Kathleen respectfully explained to Courtney why she has to make sure that Courtney can safely eat certain foods. Courtney was satisfied with the answer and continued on to pass the test!
Other than some walking today was a day of well deserved rest for Courtney. Imagine in the past two weeks she started and has greatly improved: walking, talking, eating, and independent personal care. These milestones and her diligence in improving at each have the entire staff amazed and delighted. We are so grateful for this progress. When Courtney made her sisters, friends and Mom and Dad laugh only one thought entered my mind: 'thank you God' and I repeated it over and over and over in my head while happy tears ran down my face.
Friday, January 23, 2009
Mom's Update
Today was a ride on the Courtney coaster. The day started on a funny note with Courtney making typical funny Courtney faces and showing typical Courtney impatience with certain adults. It was so true Courtney it made me laugh until she smiled along.
Courtney is starting to remember important things like the day, date, year, etc. Therapists use a box of commonly used items and ask Courtney to name them. For a 19 year old girl, a pipe and hammer are not exactly commonly used items. I suggested that we try things Courtney is more familiar with. I pulled out my makeup bag and Courtney went on to name :
makeup case; lipgloss; mascara (not an easy word to say). Then I showed Courtney my phone and asked what it was. Courtney said "work phone" - 100% correct not just any cell phone but my work cell phone. I asked Courtney to tell the speech therapist what kind of cell phone she has -"blackberry"she said - right again!
Courtney's voice is getting stronger and louder. Unfortunately we are not skipping the agitated phase when people use inappropriate language and physical aggression. I can't write what Courtney said but rest assured that she said it with much conviction and sent along the universal sign for a have a nice day!
While I make jokes about this it is truly upsetting to see Courtney act so out of character. While Jillian and Cary were visiting today Courtney had one of those upsetting moments. Her friends acted admirably in staying as calm as possible in a very emotional moment. Courtney would be very proud of them. The rest of the visit was calm and quiet. We are hopeful that this unpleasant phase of waking up ends quickly!
We ended the day on a high note with many warm and gentle hugs and Courtney enjoying 2 rocketpop popsicles. After having the 1st popsicle I told Courtney to use her voice so I could make sure that none of it went into her lungs. She said "like, I want another one?" Okay I said, but just 1 more. Courtney said "or 2?" No I said "1 more and that's it." She savored both popsicles. After 9 weeks of tubes and scopes and more tubes and trach tubes in her throat drinking cold water, cold apple juice and finally frozen pops is a truly enjoyable experience for Courtney. It's wonderful to see her enjoy something and as she does -she nods her head 'yes', 'yes', 'yes' ...that's sooo gooood!!!! We love you Courtney - it's good to see you coming back to us!
Courtney is starting to remember important things like the day, date, year, etc. Therapists use a box of commonly used items and ask Courtney to name them. For a 19 year old girl, a pipe and hammer are not exactly commonly used items. I suggested that we try things Courtney is more familiar with. I pulled out my makeup bag and Courtney went on to name :
makeup case; lipgloss; mascara (not an easy word to say). Then I showed Courtney my phone and asked what it was. Courtney said "work phone" - 100% correct not just any cell phone but my work cell phone. I asked Courtney to tell the speech therapist what kind of cell phone she has -"blackberry"she said - right again!
Courtney's voice is getting stronger and louder. Unfortunately we are not skipping the agitated phase when people use inappropriate language and physical aggression. I can't write what Courtney said but rest assured that she said it with much conviction and sent along the universal sign for a have a nice day!
While I make jokes about this it is truly upsetting to see Courtney act so out of character. While Jillian and Cary were visiting today Courtney had one of those upsetting moments. Her friends acted admirably in staying as calm as possible in a very emotional moment. Courtney would be very proud of them. The rest of the visit was calm and quiet. We are hopeful that this unpleasant phase of waking up ends quickly!
We ended the day on a high note with many warm and gentle hugs and Courtney enjoying 2 rocketpop popsicles. After having the 1st popsicle I told Courtney to use her voice so I could make sure that none of it went into her lungs. She said "like, I want another one?" Okay I said, but just 1 more. Courtney said "or 2?" No I said "1 more and that's it." She savored both popsicles. After 9 weeks of tubes and scopes and more tubes and trach tubes in her throat drinking cold water, cold apple juice and finally frozen pops is a truly enjoyable experience for Courtney. It's wonderful to see her enjoy something and as she does -she nods her head 'yes', 'yes', 'yes' ...that's sooo gooood!!!! We love you Courtney - it's good to see you coming back to us!
from UB
I saw Courtney Sunday and was very impressed with her progess. She continues to live up to the nickname I assigned her, "The Energizer Courtney". It was so encouraging to witness the speed and ease in which Courtney can now sit up in bed and how much more aware she is of her surroundings.
Since Courtney "woke", even in the limited sense that we see, as I have left her at the end of every visit, I have told her, "Bye Courtney, I'll see you soon." So far, Courtney has not responded to me in any discernable manner other than to look at me. That's good enough for me given her condition and the fact that I only see her once a week now and she may have trouble remembering me.
As a step-parent, I have learned that one the most difficult challenges of parenthood is achieving balance. The readers who are parents are more familiar with this issue than I. A child misbehaves and we may struggle with the penalty for such behavior. Is it too much or not enough? As they grow older - when should we press for info and when should we back off ? How much rope should we give them and when do we let go of the rope? I've found that this struggle can also be painful.
This point has been driven home to me while visiting Courtney over the course of these past few months. Day after day, Diane and Craig deal with this formidable challenge made all the more difficult and painful as Courtney's condition continues to change on a weekly basis. At times they may struggle with when they should back off and when they should intervene in Courtney's care, or when they should give Courtney room as they support and coax her back to her old self. Given the intensity of their love for their daughter, this must be extremely difficult and extremely painful.
God continue to bless them and hold them during this monumental struggle.
Since Courtney "woke", even in the limited sense that we see, as I have left her at the end of every visit, I have told her, "Bye Courtney, I'll see you soon." So far, Courtney has not responded to me in any discernable manner other than to look at me. That's good enough for me given her condition and the fact that I only see her once a week now and she may have trouble remembering me.
As a step-parent, I have learned that one the most difficult challenges of parenthood is achieving balance. The readers who are parents are more familiar with this issue than I. A child misbehaves and we may struggle with the penalty for such behavior. Is it too much or not enough? As they grow older - when should we press for info and when should we back off ? How much rope should we give them and when do we let go of the rope? I've found that this struggle can also be painful.
This point has been driven home to me while visiting Courtney over the course of these past few months. Day after day, Diane and Craig deal with this formidable challenge made all the more difficult and painful as Courtney's condition continues to change on a weekly basis. At times they may struggle with when they should back off and when they should intervene in Courtney's care, or when they should give Courtney room as they support and coax her back to her old self. Given the intensity of their love for their daughter, this must be extremely difficult and extremely painful.
God continue to bless them and hold them during this monumental struggle.
Thursday, January 22, 2009
Mom's Update
Courtney's trip to BMC and back was quick and mostly uneventful. The only point of interest was the traffic and misguided driver who thought he could 'cut' through the city and instead gave us the grand tour of Beantown!
The trip was very tiring for Courtney and so between the traveling and exhaustion it cut her therapy time down. She did very well with speech today and was talking to her OT and PT. We saw the stubborn Courtney we know and love today. Maureen, from speech, came in this morning. Courtney wrote on the dry erase board "leave me alone". Maureen asked "why do you want me to leave you alone?" Courtney wrote 'because I want to be left alone" (da da duh)! I asked Courtney if she remembered why she is at Braintree -she wrote "because of Mom." So I explained again about the accident and head injury and said that Maureen was there to help her get better. She nodded and looked at Maureen and said "I'm sorry." Maureen said 'you don't have to be sorry, but what are you sorry about?" Courtney answered "for being bossy."
Tomorrow or the next day Courtney will be walking the practice stairs in the gym. Her walking is very good now and Alissa has been practicing with me so that Courtney and I can walk alone. This weekend she will practice with Craig so he'll know how to walk along with Courtney too.
The trip was very tiring for Courtney and so between the traveling and exhaustion it cut her therapy time down. She did very well with speech today and was talking to her OT and PT. We saw the stubborn Courtney we know and love today. Maureen, from speech, came in this morning. Courtney wrote on the dry erase board "leave me alone". Maureen asked "why do you want me to leave you alone?" Courtney wrote 'because I want to be left alone" (da da duh)! I asked Courtney if she remembered why she is at Braintree -she wrote "because of Mom." So I explained again about the accident and head injury and said that Maureen was there to help her get better. She nodded and looked at Maureen and said "I'm sorry." Maureen said 'you don't have to be sorry, but what are you sorry about?" Courtney answered "for being bossy."
Tomorrow or the next day Courtney will be walking the practice stairs in the gym. Her walking is very good now and Alissa has been practicing with me so that Courtney and I can walk alone. This weekend she will practice with Craig so he'll know how to walk along with Courtney too.
Wednesday, January 21, 2009
Mom's Update
Today was a slow day for Courtney as she started the morning off with an upset stomach. It seems to be due to the fact that they were trying to feed her to much. Courtney was getting 'food' -glucerna through her tube every 3 hours from 6am - 12 midnight. Along with us trying to get her to eat regular food it was all to much. Courtney didn't eat much at all today as a result but did drink juice and more water.
We all know how gross hospital food smells. Courtney is sniffing everything before she eats it. As soon as she smells it she pushes it aside and won't eat it. Then the smell of the hospital food was in the air and she wouldn't even eat yogurt or ice cream. This along with her finnicky (?) appetite is going to make eating a challenge.
I have let Courtney know how important it is for her to eat regular food so she can get better and come home. Tomorrow I will bring homemade scrambled eggs, Quaker oatmeal and yogurt smoothies. Wish me luck!
Courtney was speaking alot today and said "Daddy" for the first time. It made Craig soooo happy. I asked her "what's Daddy's first name?" she said "honey" (that's what I call him)!
When I asked her what his friends call him she said "Craig". Courtney wrote on the dry erase board again today. In clear letters she wrote "Courtney Eva Hollingworth" - "Courtney wants to know what else" (...she was doing before the accident i.e., school & work). She also wrote "obama" "the yogurt" "URI" "Emma".
Courtney played tic tac toe and answered alot of questions accurately today. Speech therapy is going to be mainly focused on repeating much basic information so that Courtney can retrain her brain to remember and reality orientation. Day, time, place, etc.
Courtney is now walking with assistance from only one person and we did some walking -just the 2 of us. Despite not feeling well Courtney once again showed her strong work ethic and determination by participating in almost all therapy sessions. Tomorrow we will travel to BMC for a follow up with Dr. Brown's office but so far the pump looks great.
We all know how gross hospital food smells. Courtney is sniffing everything before she eats it. As soon as she smells it she pushes it aside and won't eat it. Then the smell of the hospital food was in the air and she wouldn't even eat yogurt or ice cream. This along with her finnicky (?) appetite is going to make eating a challenge.
I have let Courtney know how important it is for her to eat regular food so she can get better and come home. Tomorrow I will bring homemade scrambled eggs, Quaker oatmeal and yogurt smoothies. Wish me luck!
Courtney was speaking alot today and said "Daddy" for the first time. It made Craig soooo happy. I asked her "what's Daddy's first name?" she said "honey" (that's what I call him)!
When I asked her what his friends call him she said "Craig". Courtney wrote on the dry erase board again today. In clear letters she wrote "Courtney Eva Hollingworth" - "Courtney wants to know what else" (...she was doing before the accident i.e., school & work). She also wrote "obama" "the yogurt" "URI" "Emma".
Courtney played tic tac toe and answered alot of questions accurately today. Speech therapy is going to be mainly focused on repeating much basic information so that Courtney can retrain her brain to remember and reality orientation. Day, time, place, etc.
Courtney is now walking with assistance from only one person and we did some walking -just the 2 of us. Despite not feeling well Courtney once again showed her strong work ethic and determination by participating in almost all therapy sessions. Tomorrow we will travel to BMC for a follow up with Dr. Brown's office but so far the pump looks great.
Tuesday, January 20, 2009
Mom's Update
Courtney did alot more walking today and practically walking on her own! She used the auto ambulator today - a special treadmill with a harness that helps people maintain proper posture while assisting with weight bearing. Courtney tends to walk with better posture without the harness machines as she quickly realizes she can sit down and yet walk at the same time!
Courtney also talked alot more today and the motivation for this was water -just plain old water. Because it is a thin liquid and staff here has been concerned that Courtney would aspirate she hasn't been allowed to drink water although she'll frequently grab the cup of ice chips and tip the cup back to get whatever water she can!
Kathleen brought a lunch tray in with mashed potatos, carrots, chicken parm all pureed. All that Courtney wanted was the water. Kathleen asked to hear Courtney's voice before she would give her the water and Courtney asked 'like yes?'. Kathleen said "yes like the word yes". After that Courtney gave the answer to everyone question ever asked at Braintree before it was even asked! She said "Courtney - Hollingworth - URI - 19 yrs old - Katy - Claudia -yes - no"
It was quite funny to hear her talk so much and be so motivated by a simple pleasure like ice cold water.
It's hard to describe how hard Courtney is working to do the multitude of things she's doing. The processing required to eat, walk, wash, dress, answer questions, count and generally stay awake through therapy is all exhausting. Courtney will often hold up her index finger and then point to her mouth - her non verbal way of saying 'give me a minute to get the words out.'
The JFK was conducted again today and Courtney scored a 19. We know that she can get a score of 23 and be done with JFK it's just a matter of hitting all the right buttons at the right time! Regardless everyone here continues to be amazed at her progress and we pray to God that it keeps on going.
Courtney also talked alot more today and the motivation for this was water -just plain old water. Because it is a thin liquid and staff here has been concerned that Courtney would aspirate she hasn't been allowed to drink water although she'll frequently grab the cup of ice chips and tip the cup back to get whatever water she can!
Kathleen brought a lunch tray in with mashed potatos, carrots, chicken parm all pureed. All that Courtney wanted was the water. Kathleen asked to hear Courtney's voice before she would give her the water and Courtney asked 'like yes?'. Kathleen said "yes like the word yes". After that Courtney gave the answer to everyone question ever asked at Braintree before it was even asked! She said "Courtney - Hollingworth - URI - 19 yrs old - Katy - Claudia -yes - no"
It was quite funny to hear her talk so much and be so motivated by a simple pleasure like ice cold water.
It's hard to describe how hard Courtney is working to do the multitude of things she's doing. The processing required to eat, walk, wash, dress, answer questions, count and generally stay awake through therapy is all exhausting. Courtney will often hold up her index finger and then point to her mouth - her non verbal way of saying 'give me a minute to get the words out.'
The JFK was conducted again today and Courtney scored a 19. We know that she can get a score of 23 and be done with JFK it's just a matter of hitting all the right buttons at the right time! Regardless everyone here continues to be amazed at her progress and we pray to God that it keeps on going.
Monday's update late
Lots of talking and walking yesterday.
Courtney was eating vanilla ice cream in the morning and we were talking about other foods Courtney might want to eat. She said 'maybe next time you could just order ***(unclear word). I asked 'pizza?' headshake no. 'chinese food?' headshake no. Then she began frantically looking around so I asked 'do you want to write it down?' Headshake yes. Courtney then wrote something that looked like the word 'chocolate' so I asked 'do you mean next time I could just bring chocolate ice cream?' - vigorous headshake yes!
Later when she was walking and she looked a bit pale Alissa asked her if she was feeling dizzy. Courtney shook her head yes. We brought Courtney into a therapy room so that Alissa could take her blood pressure. As Alissa was taking Courtney's blood pressure she looked up at us and said 'not now before when I was in the shower'.
Courtney communicated this morning that she would be watching the innauguration at noon.
There's still alot of work to be done on speech, cognition and eating. Although Courtney is speaking in sentences she's not always verbalizing. These are the things she'll be working on in the coming days and weeks.
Courtney was eating vanilla ice cream in the morning and we were talking about other foods Courtney might want to eat. She said 'maybe next time you could just order ***(unclear word). I asked 'pizza?' headshake no. 'chinese food?' headshake no. Then she began frantically looking around so I asked 'do you want to write it down?' Headshake yes. Courtney then wrote something that looked like the word 'chocolate' so I asked 'do you mean next time I could just bring chocolate ice cream?' - vigorous headshake yes!
Later when she was walking and she looked a bit pale Alissa asked her if she was feeling dizzy. Courtney shook her head yes. We brought Courtney into a therapy room so that Alissa could take her blood pressure. As Alissa was taking Courtney's blood pressure she looked up at us and said 'not now before when I was in the shower'.
Courtney communicated this morning that she would be watching the innauguration at noon.
There's still alot of work to be done on speech, cognition and eating. Although Courtney is speaking in sentences she's not always verbalizing. These are the things she'll be working on in the coming days and weeks.
Sunday, January 18, 2009
Funny Faces
Those who know Courtney knows that she loves to make people laugh. Her personality began showing through yesterday with her working hard to smile - using every facial muscle she could make work.
Today as I wheeled her chair to a mirror I said "look at beautiful you" she did this funny smile with her eye brows raised. Several other times during the day she made funny faces that made us laugh and then repeated them.
It's a gift to know that her personality remains basically the same and we can't wait to hear her laughing.
Today as I wheeled her chair to a mirror I said "look at beautiful you" she did this funny smile with her eye brows raised. Several other times during the day she made funny faces that made us laugh and then repeated them.
It's a gift to know that her personality remains basically the same and we can't wait to hear her laughing.
Mom's Update
Courtney did some great walking today and went even longer than yesterday. Her posture gets stronger every day and her steps get faster too!
The challenge now is keeping Courtney down. She is constantly sitting up at the edge of the bed and wanting to stand and walk. In her state of confusion she doesn't realize that she can't walk alone yet. This afternoon she directed nurse Dottie to stand on one side of her and me on the other - positioning us like the therapists who walk with Courtney!
Courtney's also trying to speak more but still in a whisper - I reminded her today that I'm 'half deaf' and so now when she speaks to me she grabs my ear and pulls me in closer.
She seems to have gotten over the haircut thing and her appetite was back today. Just before noon Courtney told me she was hungry! What a great thing to hear - I ran and got some yogurt to give her. She also had vanilla ice cream today - not the best 2 things for a lactose intollerant kid but the choices are limited for soft foods.
Courtney will start eating more regular meals this week to see how much of her caloric needs she can get through regular eating.
Courtney's progress is so amazing that every day I tell her how amazing she is. The staff here are all sooooo excited about how well Courtney is doing. To think that it was one week ago that she started walking and now she is walking with very little assistance, becoming independent with dressing, eating and talking. We are so tremendously grateful for Courtney's amazing progress, her strong will to recover and her hard work each day to make that happen.
The challenge now is keeping Courtney down. She is constantly sitting up at the edge of the bed and wanting to stand and walk. In her state of confusion she doesn't realize that she can't walk alone yet. This afternoon she directed nurse Dottie to stand on one side of her and me on the other - positioning us like the therapists who walk with Courtney!
Courtney's also trying to speak more but still in a whisper - I reminded her today that I'm 'half deaf' and so now when she speaks to me she grabs my ear and pulls me in closer.
She seems to have gotten over the haircut thing and her appetite was back today. Just before noon Courtney told me she was hungry! What a great thing to hear - I ran and got some yogurt to give her. She also had vanilla ice cream today - not the best 2 things for a lactose intollerant kid but the choices are limited for soft foods.
Courtney will start eating more regular meals this week to see how much of her caloric needs she can get through regular eating.
Courtney's progress is so amazing that every day I tell her how amazing she is. The staff here are all sooooo excited about how well Courtney is doing. To think that it was one week ago that she started walking and now she is walking with very little assistance, becoming independent with dressing, eating and talking. We are so tremendously grateful for Courtney's amazing progress, her strong will to recover and her hard work each day to make that happen.
Saturday, January 17, 2009
Mom's Update
After many people over the last several days have been commenting on Courtney's haircut and now that she has found her voice she managed to ask me if I had her hair cut? I told her yes and she pushed me! I asked her if she was mad at me for having her hair cut and she nodded her head. I explained the circumstance (tangles, matted mess, blah blah blah) but she was undeterred. Courtney then said something to her sisters - they asked her if she was upset about it - she nodded yes. Then while sitting with Uncle Kevin she spoke some incoherent words among which was one clear word 'haircut'. He asked, "are you upset about the haircut?" She nodded yes. Again, later in the day she brought it up to me again, finally after I showed her the mirror a couple of times and promised never to have her haircut again she dropped the subject. So much for attention span issues!
Courtney had a relaxing day with many visitors all of which she handled well. During her one therapy session Courtney walked up the hallway 200 feet and then back down another 200 feet. She was quite energetic without a full schedule of therapy and so we spent the day with her pulling herself along the handrails up and down the hallway. Early this evening she decided it was a good time to get out of bed herself. Courtney doesn't have any difficulties sitting on the edge of the bed - straight up - without assistance! Walking is another issue but she's not quite aware that she can't just get up and go. The coming days will certainly bring new and exciting challenges.
I've no doubt that no one is going to keep Courtney down and by next weekend she will be walking the halls unassisted and letting everyone have a piece of her mind! Look out Braintree!
Courtney had a relaxing day with many visitors all of which she handled well. During her one therapy session Courtney walked up the hallway 200 feet and then back down another 200 feet. She was quite energetic without a full schedule of therapy and so we spent the day with her pulling herself along the handrails up and down the hallway. Early this evening she decided it was a good time to get out of bed herself. Courtney doesn't have any difficulties sitting on the edge of the bed - straight up - without assistance! Walking is another issue but she's not quite aware that she can't just get up and go. The coming days will certainly bring new and exciting challenges.
I've no doubt that no one is going to keep Courtney down and by next weekend she will be walking the halls unassisted and letting everyone have a piece of her mind! Look out Braintree!
Friday, January 16, 2009
from Uncle Brian
Uncle Brian has been on Hiatus. I don't really know what hiatus means but I like saying it. (go ahead, give it a try). It also makes me feel smart when I use it. I asked my neighbor if a hiatus was a vacation to Haiti. For a brief moment I thought he was going to strike me. He told me to stay away from his kids.
Just this morning I was telling my parole officer (just kidding!) what a remarkable story this is. From the moment of impact on that terrible day to this wonderful day, there has been a tremendous human effort aimed at willing and praying Courtney back to full health while also supporting her family. More proof of that,,,,
I went to Walmart today to pick up a tea kettle ($8.78 if you need one and it's the CUTEST little thing!). Of course, I was driving one of the "Please Pray for Courtney" mobiles with the big sign on the back window. As I returned to my truck, I noticed a small card pinned under the wiper blade. The card was approximately 1 1/2" x 2 1/2" inches and there was an image of the Virgin Mary on one side. As I flipped the card over, I could see someone had written a note. It reads as follows, "We prayed for you, Courtney. God bless."
One last thing. I'm not convinced that Courtney's first words were what her mom reported. Not that I don't trust Diane it's just she could have misheard. I'm quite sure Courtney's first words would have been, "Where's Uncle Brian?"
But that's just me.
Love you all, UB
Just this morning I was telling my parole officer (just kidding!) what a remarkable story this is. From the moment of impact on that terrible day to this wonderful day, there has been a tremendous human effort aimed at willing and praying Courtney back to full health while also supporting her family. More proof of that,,,,
I went to Walmart today to pick up a tea kettle ($8.78 if you need one and it's the CUTEST little thing!). Of course, I was driving one of the "Please Pray for Courtney" mobiles with the big sign on the back window. As I returned to my truck, I noticed a small card pinned under the wiper blade. The card was approximately 1 1/2" x 2 1/2" inches and there was an image of the Virgin Mary on one side. As I flipped the card over, I could see someone had written a note. It reads as follows, "We prayed for you, Courtney. God bless."
One last thing. I'm not convinced that Courtney's first words were what her mom reported. Not that I don't trust Diane it's just she could have misheard. I'm quite sure Courtney's first words would have been, "Where's Uncle Brian?"
But that's just me.
Love you all, UB
Courtney's first words
"I have to go to the bathroom" - yup. Never in a million years could any of us have guessed that her first words would be an entire sentence. I'm not surprised that her first words had such meaning and purpose!
Courtney's voice is a whisper and so Melane, her OT and I were leaning in close trying to understand what she was saying and we realized it at the same time. We looked at each other and said "I have to go to the bathroom!" You can imagine the rest of the story and yes it was a success. Two amazing milestones in a 3 minute span!!!!
Next Courtney was in bed and I asked her if she wanted me to snuggle with her -she shook her head 'yes'. As I laid next to her she said "I love you" - I asked her if that's what she said and she shook her head yes.
Katy came in and then left the room. Courtney said some words I couldn't understand among which was "Katy". I explained that Katy left the room to eat her lunch. Then I asked Courtney if she was worried about Katy. She again shook her head 'yes'. I told her not to worry that Katy was doing just fine. She stared right into my eyes as I spoke these words.
Then she said "Claudia" and I told her that Claudia was at school but would see her tonight.
After that Courtney drifted off to sleep.
Amen! Alleluia!!! Thanks be to God - one of the happiest days of our lives!!!!!!!!!!
Courtney's voice is a whisper and so Melane, her OT and I were leaning in close trying to understand what she was saying and we realized it at the same time. We looked at each other and said "I have to go to the bathroom!" You can imagine the rest of the story and yes it was a success. Two amazing milestones in a 3 minute span!!!!
Next Courtney was in bed and I asked her if she wanted me to snuggle with her -she shook her head 'yes'. As I laid next to her she said "I love you" - I asked her if that's what she said and she shook her head yes.
Katy came in and then left the room. Courtney said some words I couldn't understand among which was "Katy". I explained that Katy left the room to eat her lunch. Then I asked Courtney if she was worried about Katy. She again shook her head 'yes'. I told her not to worry that Katy was doing just fine. She stared right into my eyes as I spoke these words.
Then she said "Claudia" and I told her that Claudia was at school but would see her tonight.
After that Courtney drifted off to sleep.
Amen! Alleluia!!! Thanks be to God - one of the happiest days of our lives!!!!!!!!!!
Courtney's communicating
When I arrived this morning I asked Courtney if she wanted to wear a particular sweater. She shook her head no. She hasn't really been shaking yes or no consistently up until today.
But each answer she's giving is deliberate and her response is clear.
Courtney is also trying to speak! It is coming out in incoherent whispers but this is a huge step.
One concern about brain injury recovery is the length of time a patient can attend to a task. This afternoon Courtney played with velcro tennis balls for 15 minutes - throwing them at a velcro target and hitting dozens of bull eyes! She did this sitting up but did take 2 breaks to lie down while continue to extend her hand for the ball!
But each answer she's giving is deliberate and her response is clear.
Courtney is also trying to speak! It is coming out in incoherent whispers but this is a huge step.
One concern about brain injury recovery is the length of time a patient can attend to a task. This afternoon Courtney played with velcro tennis balls for 15 minutes - throwing them at a velcro target and hitting dozens of bull eyes! She did this sitting up but did take 2 breaks to lie down while continue to extend her hand for the ball!
Thursday, January 15, 2009
Mom's Update
Courtney had Botox treatment today in her left arm. As with many other break through treatments in TBI Braintree and Dr. Katz studied the effects of Botox on muscle spasticity some years ago. It has been found to greatly improve spasticity when used in targeted areas.
While the baclofin pump has made a tremendous difference most of the benefits are realized in the lower body. Courtney has significant spasticity in her left wrist, elbow and bicep that could have caused long term damage. The benefits of Botox will last about 3-4 months.
Although we haven't heard Courtney speak a word today I did hear her voice loud and clear when the first injection went into her arm and she cried out in pain. She made several other attempts during the day to vocalize and/or mouth words and began (once again) shaking her head - mostly no.
As I was helping Courtney off with her vest today her arm got stuck. She took her right hand pulled the vest off her left arm worked it around her back and pulled it off her right arm in a flash! I think she's tiring of having her spastic mother help her get dressed! She's also pulling on shirts and pants doing most of the work herself.
We finished out the day with courtney watching one of her favorite shows King of Queens.
While the baclofin pump has made a tremendous difference most of the benefits are realized in the lower body. Courtney has significant spasticity in her left wrist, elbow and bicep that could have caused long term damage. The benefits of Botox will last about 3-4 months.
Although we haven't heard Courtney speak a word today I did hear her voice loud and clear when the first injection went into her arm and she cried out in pain. She made several other attempts during the day to vocalize and/or mouth words and began (once again) shaking her head - mostly no.
As I was helping Courtney off with her vest today her arm got stuck. She took her right hand pulled the vest off her left arm worked it around her back and pulled it off her right arm in a flash! I think she's tiring of having her spastic mother help her get dressed! She's also pulling on shirts and pants doing most of the work herself.
We finished out the day with courtney watching one of her favorite shows King of Queens.
A day at Braintree
Alot of people have asked me what my day is like so I thought I'd share a typical day with Courtney at Braintree.
I usually arrive between 7:30 and 8 depending on traffic. Along with the one to one nurses's aid I help Courtney with her morning bath. Every other day we wash her hair. I help Courtney get dressed -lately she is helping more and more.
Courtney has at least 6 1/2 hour sessions of therapy each day. There 2 - 1/2 hour sessions of pt, ot and speech each. PT sessions are for stretching, standing and/or walking, bed mobility and assessing the tone of Courtney's muscles which have improved greatly since the baclofin pump was implanted just one week ago.
OT sessions are almost always joint PT sessions so that Courtney's entire body is worked. For instance, while in the standing lift the other day therapists played with a balloon with Courtney to get her using her left arm more. They work on getting Courtney to follow commands as well.
Speech therapy sessions focus on cognition as well trying to get Courtney to follow those simple commands I've written about - picking out yes or no from paper cards. These are the exercises that Courtney seems to hate the most. She will often grab the card, crumble it and throw it on the floor! The speech sessions that are her favorite are the ones where she gets to eat!
While 3 hours may not seem like much it is a great deal of activity for Courtney. In between sessions nurses administer medications, check Courtney's incisions or assess her skin integrity and make sure that all of her vital signs are good.
During therapy I sometimes just sit in the corner and watch. Other times I will stand next to or in front of Courtney and speak softly to her to calm her down. Sometimes I'm just a 2nd or 3rd pair of hands to move equipment more quickly so as not to tire or frustrate Courtney.
Of course I'm always encouraging Courtney, telling her she's doing a great job.
I'm very pleased to say that Courtney is developing trust in her regular therapists - Alissa, Melane and Kathleen. It's comforting to see her trust them knowing how vulnerable she must feel.
In between therapy if Courtney is in the wheel chair we walk around the hospital upstairs, downstairs, in the lobby. When it's not to cold we'll go outside for a few minutes. She'll feed herself ice chips (the only thing she's allowed to eat without speech - although that's changing soon). When Courtney's in bed between therapy I encourage her to sleep. Sometimes I'll lay down with her to calm her and other times I sit in a comfy chair in the corner and the two of us nap.
By 4pm Courtney is exhausted and usually takes a cat nap until Craig arrives. Then she'll stay awake for about an 1 1/2 hours playing catch with him or just sitting quietly. By 6pm she's pretty much done for the day and ready for a long night's sleep. I help her get ready for bed and usually leave around 7pm.
Each day brings amazing new things that Courtney does. Each day is a true gift. It's a gift from God that we have Courtney with us and a gift from Paychex that they are supporting me through this leave of absence. We are truly truly blessed to have so much support from employers, friends, family and all the wonderful people here at Braintree.
By the time I arrive at "Uncle Kevin's" house in West Roxbury I'm exhausted! We've also been blessed with wonderful caring family and Kevin almost always cooks dinner for us. I'm sure we'd be eating crackers and peanut butter otherwise! Thank you Uncle Kevin!
I usually arrive between 7:30 and 8 depending on traffic. Along with the one to one nurses's aid I help Courtney with her morning bath. Every other day we wash her hair. I help Courtney get dressed -lately she is helping more and more.
Courtney has at least 6 1/2 hour sessions of therapy each day. There 2 - 1/2 hour sessions of pt, ot and speech each. PT sessions are for stretching, standing and/or walking, bed mobility and assessing the tone of Courtney's muscles which have improved greatly since the baclofin pump was implanted just one week ago.
OT sessions are almost always joint PT sessions so that Courtney's entire body is worked. For instance, while in the standing lift the other day therapists played with a balloon with Courtney to get her using her left arm more. They work on getting Courtney to follow commands as well.
Speech therapy sessions focus on cognition as well trying to get Courtney to follow those simple commands I've written about - picking out yes or no from paper cards. These are the exercises that Courtney seems to hate the most. She will often grab the card, crumble it and throw it on the floor! The speech sessions that are her favorite are the ones where she gets to eat!
While 3 hours may not seem like much it is a great deal of activity for Courtney. In between sessions nurses administer medications, check Courtney's incisions or assess her skin integrity and make sure that all of her vital signs are good.
During therapy I sometimes just sit in the corner and watch. Other times I will stand next to or in front of Courtney and speak softly to her to calm her down. Sometimes I'm just a 2nd or 3rd pair of hands to move equipment more quickly so as not to tire or frustrate Courtney.
Of course I'm always encouraging Courtney, telling her she's doing a great job.
I'm very pleased to say that Courtney is developing trust in her regular therapists - Alissa, Melane and Kathleen. It's comforting to see her trust them knowing how vulnerable she must feel.
In between therapy if Courtney is in the wheel chair we walk around the hospital upstairs, downstairs, in the lobby. When it's not to cold we'll go outside for a few minutes. She'll feed herself ice chips (the only thing she's allowed to eat without speech - although that's changing soon). When Courtney's in bed between therapy I encourage her to sleep. Sometimes I'll lay down with her to calm her and other times I sit in a comfy chair in the corner and the two of us nap.
By 4pm Courtney is exhausted and usually takes a cat nap until Craig arrives. Then she'll stay awake for about an 1 1/2 hours playing catch with him or just sitting quietly. By 6pm she's pretty much done for the day and ready for a long night's sleep. I help her get ready for bed and usually leave around 7pm.
Each day brings amazing new things that Courtney does. Each day is a true gift. It's a gift from God that we have Courtney with us and a gift from Paychex that they are supporting me through this leave of absence. We are truly truly blessed to have so much support from employers, friends, family and all the wonderful people here at Braintree.
By the time I arrive at "Uncle Kevin's" house in West Roxbury I'm exhausted! We've also been blessed with wonderful caring family and Kevin almost always cooks dinner for us. I'm sure we'd be eating crackers and peanut butter otherwise! Thank you Uncle Kevin!
Wednesday, January 14, 2009
Mom's Update
We had trouble maintaining our internet connection. Here is yesterday's post:
Part of the recovery process and moving out of the minimally conscious stage is when patients can use objects in the proper way. Such as a brush. Courtney has been brushing her hair for a while but today when she put the back side of the brush to her head she turned it over to use the 'teeth'. This was excellent.
She also used a toothbrush the right way. Courtney picked her name off a magnetic letter board 3 times today. We put the words yes, no and Courtney. Each time we moved Courtney into a new position and each time she found her name on the board.
She has not cooperated with a simple yes no exercise - often crumbling the papers and throwing them to the floor. Some of the therapists felt it was to simple and though she could follow the commands she was frustrated. We are going to try more complex words to help Courtney express herself and see if she can follow other commands. Courtney will respond to commands like 'scooch up in the chair' or 'put your leg in the pants' or pull your shirt sleeve off. This is why we think she could, if she wanted to, respond to much more simple commands like 'make a fist'.
Tonight when Craig came in to visit he had his gloves in his hand. Courtney took the gloves from him and put them on her hands. Imagine that they are very bulky on her small hands and yet she was able to put the second glove on and pull it tight around her wrist
Part of the recovery process and moving out of the minimally conscious stage is when patients can use objects in the proper way. Such as a brush. Courtney has been brushing her hair for a while but today when she put the back side of the brush to her head she turned it over to use the 'teeth'. This was excellent.
She also used a toothbrush the right way. Courtney picked her name off a magnetic letter board 3 times today. We put the words yes, no and Courtney. Each time we moved Courtney into a new position and each time she found her name on the board.
She has not cooperated with a simple yes no exercise - often crumbling the papers and throwing them to the floor. Some of the therapists felt it was to simple and though she could follow the commands she was frustrated. We are going to try more complex words to help Courtney express herself and see if she can follow other commands. Courtney will respond to commands like 'scooch up in the chair' or 'put your leg in the pants' or pull your shirt sleeve off. This is why we think she could, if she wanted to, respond to much more simple commands like 'make a fist'.
Tonight when Craig came in to visit he had his gloves in his hand. Courtney took the gloves from him and put them on her hands. Imagine that they are very bulky on her small hands and yet she was able to put the second glove on and pull it tight around her wrist
Tuesday, January 13, 2009
Mom's Update
Courtney had the trachea removed today - this is a big deal!
After months of watching her tug on it afraid that she would yank it out herself Dr. Hill came in and removed it. Just the feeding tube to go and Courtney will be 'tube free'!
Courtney will eat more each day but skipped this afternoon's food to give a chance for the trach opening to heal. We've been told that it heals in no time and will already be better tomorrow.
Courtney also had her hair cut last night. This too was a big deal since as the mother of a 19 year old I normally would not make hair style decisions for my daughter. In fact Courtney would most likely ask her friends for an opinion than her mother!
But after weeks of trying to detangle the back of Courtney's head and her own frustration with trying to keep it off her neck while in bed I made the decision to let the hairdresser at Braintree do the deed. It was a very over stimulating experience for Courtney and yet miraculously the cut is beautiful. I can't believe she was able to get it even and look as nice as it does with all the squirming Courtney was doing.
The previous 2 days of standing and walking, eating, hair cut, etc finally caught up with Courtney and she was very tired all day - quite exhausted. At one point while sitting in the chair eating apple sauce Courtney put her head down on the tray table! She kept leaning her head to the side during therapy and looking at everyone with a 'can't you see I'm exhausted' face.
The therapists pressed on as best they could pushing Courtney but not to the point of exhaustion or complete frustration.
Now that the trach has been removed we are very much looking forward to and anticipating hearing Courtney's voice.
After months of watching her tug on it afraid that she would yank it out herself Dr. Hill came in and removed it. Just the feeding tube to go and Courtney will be 'tube free'!
Courtney will eat more each day but skipped this afternoon's food to give a chance for the trach opening to heal. We've been told that it heals in no time and will already be better tomorrow.
Courtney also had her hair cut last night. This too was a big deal since as the mother of a 19 year old I normally would not make hair style decisions for my daughter. In fact Courtney would most likely ask her friends for an opinion than her mother!
But after weeks of trying to detangle the back of Courtney's head and her own frustration with trying to keep it off her neck while in bed I made the decision to let the hairdresser at Braintree do the deed. It was a very over stimulating experience for Courtney and yet miraculously the cut is beautiful. I can't believe she was able to get it even and look as nice as it does with all the squirming Courtney was doing.
The previous 2 days of standing and walking, eating, hair cut, etc finally caught up with Courtney and she was very tired all day - quite exhausted. At one point while sitting in the chair eating apple sauce Courtney put her head down on the tray table! She kept leaning her head to the side during therapy and looking at everyone with a 'can't you see I'm exhausted' face.
The therapists pressed on as best they could pushing Courtney but not to the point of exhaustion or complete frustration.
Now that the trach has been removed we are very much looking forward to and anticipating hearing Courtney's voice.
Monday, January 12, 2009
Amazing Courtney
Yes Courtney is truly amazing and she continues to amaze the staff here at Braintree.
Today Courtney did much more walking and lots of standing. She sat in the wheelchair in front of a bar and pulled herself to a standing position over and over. Melane told Courtney that she would stand 10 times. Like the driven determined person we've always known her to be Courtney kept standing past the count to 10. Courtney had 3 separate therapy sessions today during which she practiced standing and walking.
Tomorrow Courtney will use a machine called Lite Gait. There is a harness that goes around Courtney's body and allows her to weight bear as much as she can but holds her body straighter than she can currently do so. She can walk alot more with this support without having 2 people holding her.
Courtney had apple sauce and ice cream and her trachea was capped (meaning that she was only breathing through her nose and mouth) most of the day. We talked about a plan to remove the trachea maybe by the end of the week or early next week but we are going to be aggressive about it because she is ready. When the therapist turned the spoon upside down so Courtney could lick the ice cream off the spoon Courtney immediately imitated her and did the same thing when feeding herself!
Courtney is also doing alot more to help dress herself. She raises her legs, reaches down to pull the pants, moves her upper body off the bed to pull the shirt on and puts her arms through sleeves almost independently. She spreads the blanket out herself, fixes her pillow the way she likes it was working to try to pull her socks on!
So much happens and changes every day that the staff is amazed and excited. She played catch with a ball with Melane today and then kicked the ball back and forth. Craig throws her stuffed pig in the air and she grabs it out of the air with one hand. Her eye and coordination is so impressive.
Interestingly she won't follow simple commands like close your eyes, open your mouth, thumbs up. It's hard to tell if she's being stubborn or just hasn't woken that part of her brain.
In answer to a question asked earlier, Courtney is just emerging INTO the confusional state. I know it seems odd that she could be counted as minimally conscious and yet doing so much but that is mostly due to her not speaking and very often not following commands. We are not concerned because her progress is so much more than anyone here expected when she arrived 3 weeks ago.
Tomorrow Courtney will eat different ground and pureed foods and do alot more PT/OT.
As a Mom I'm of course beside myself with happiness when Courtney stands and walks and shows her determination but the best part of today was that she was smiling while standing and being encouraged by Alissa and Melane. Your prayers are being heard and answered as Courtney makes her way to a full recovery and back to the life that God has planned for her.
Thank you!
Today Courtney did much more walking and lots of standing. She sat in the wheelchair in front of a bar and pulled herself to a standing position over and over. Melane told Courtney that she would stand 10 times. Like the driven determined person we've always known her to be Courtney kept standing past the count to 10. Courtney had 3 separate therapy sessions today during which she practiced standing and walking.
Tomorrow Courtney will use a machine called Lite Gait. There is a harness that goes around Courtney's body and allows her to weight bear as much as she can but holds her body straighter than she can currently do so. She can walk alot more with this support without having 2 people holding her.
Courtney had apple sauce and ice cream and her trachea was capped (meaning that she was only breathing through her nose and mouth) most of the day. We talked about a plan to remove the trachea maybe by the end of the week or early next week but we are going to be aggressive about it because she is ready. When the therapist turned the spoon upside down so Courtney could lick the ice cream off the spoon Courtney immediately imitated her and did the same thing when feeding herself!
Courtney is also doing alot more to help dress herself. She raises her legs, reaches down to pull the pants, moves her upper body off the bed to pull the shirt on and puts her arms through sleeves almost independently. She spreads the blanket out herself, fixes her pillow the way she likes it was working to try to pull her socks on!
So much happens and changes every day that the staff is amazed and excited. She played catch with a ball with Melane today and then kicked the ball back and forth. Craig throws her stuffed pig in the air and she grabs it out of the air with one hand. Her eye and coordination is so impressive.
Interestingly she won't follow simple commands like close your eyes, open your mouth, thumbs up. It's hard to tell if she's being stubborn or just hasn't woken that part of her brain.
In answer to a question asked earlier, Courtney is just emerging INTO the confusional state. I know it seems odd that she could be counted as minimally conscious and yet doing so much but that is mostly due to her not speaking and very often not following commands. We are not concerned because her progress is so much more than anyone here expected when she arrived 3 weeks ago.
Tomorrow Courtney will eat different ground and pureed foods and do alot more PT/OT.
As a Mom I'm of course beside myself with happiness when Courtney stands and walks and shows her determination but the best part of today was that she was smiling while standing and being encouraged by Alissa and Melane. Your prayers are being heard and answered as Courtney makes her way to a full recovery and back to the life that God has planned for her.
Thank you!
Sunday, January 11, 2009
Courtney Walks!
Yes! Today, January 11th is a great day. Courtney walked 3 separate times today.
Alex and Maura, pts, came in to work with Courtney today. As soon as they had Courtney sitting at the edge of the bed Alex said, "it looks like she wants to take some steps - let's see if she'll do it." So they got Courtney to her feet and she walked 10 feet to the door. Then she sat down, Claudia ran to get Craig and she did it all over again - this time about 12 feet out the door and around the corner. Finally, Courtney sat back in the wheelchair, took a break and then walked out of the room and down the hallway past the nurses station. That's a distance of about 30 feet!!!
It was an amazing moment for all of us. All the staff came out to the hall to watch Courtney walking - other patients' visitors watched knowing that they were seeing a big event. Of course we were crying happy tears!
Every day is an amazing miracle but Sunday January 11th will forever be a day of celebration in the Hollingworth family!!!
Alex and Maura, pts, came in to work with Courtney today. As soon as they had Courtney sitting at the edge of the bed Alex said, "it looks like she wants to take some steps - let's see if she'll do it." So they got Courtney to her feet and she walked 10 feet to the door. Then she sat down, Claudia ran to get Craig and she did it all over again - this time about 12 feet out the door and around the corner. Finally, Courtney sat back in the wheelchair, took a break and then walked out of the room and down the hallway past the nurses station. That's a distance of about 30 feet!!!
It was an amazing moment for all of us. All the staff came out to the hall to watch Courtney walking - other patients' visitors watched knowing that they were seeing a big event. Of course we were crying happy tears!
Every day is an amazing miracle but Sunday January 11th will forever be a day of celebration in the Hollingworth family!!!
Saturday, January 10, 2009
Mom's Update
Courtney had 2 sessions of PT today during which she worked on standing. Each time she stood for 10 seconds - it may not sound like long but when you haven't stood for 8 weeks it's a long time and alot of hard work!
Courtney is sitting forward using her core muscles very well and can reach for things on the tray table in front of her. She was watching Annie earlier tonight and was clearly getting tired. She reached out toward the portable DVD so I pulled her hand back. She reach out again and shut the DVD cover and looked at me as if to say "I'm done!" I got the point.
Courtney is becoming better at using the spoon to feed herself each day. She's doing more of the daily care and has a greater awareness of what she wants and what needs to be done.
Most exciting for me today was when Courtney rolled on her stomach, lifted herself onto her elbows and got herself almost all the way to a sitting position! Amazing but apparently not the proper way to sit in bed so PT is working on showing Courtney the safe way to do things.
As a Mom who gets excited I sometimes forget that it's not a good thing for her to be kneeling up in bed, grabbing a full cup of ice or cleverly pulling the seatbelt off in the wheelchair and leaning forward to make a quick escape! I'm always so impressed and excited by these things I don't think of safety - this is when I let the experts do their thing and become the cheerleader. I'll often yell "yes Courtney that's terrific."
Courtney's visitors today kept her busy as well. Among them was Sarah (SJ) a friend from LaSalle. Courtney quickly started checking out Sarah's pocketbook - very cute yellow bag. Then Craig said "oooh and look at Sarah's shoes." Courtney leaned forward in the wheel chair and looked right down at the shoes then back up at Sarah's face as if to say 'nice shoes'! It never fails to amaze us that she has such great object recognition.
Another impressive recent development is that Courtney is doing what's called 'sequencing'. She understands that things need to happen in certain order. For instance, when working with Melane and Kathleen, Courtney tired of following their commands. She held the brush brought her arm up in the air and threw it straight at Kathleen's head! Normally an employee would be upset about something like this - but this is the strange world of rehab - and so Kathleen and Melane were so excited that Courtney was 'sequencing'!
Courtney has also learned that while in the wheel chair she can grab at the hand railings and move herself! She is now spreading her blanket out to cover herself using both hands and will move items from one hand to the next to get the best grip.
All of this is amazing progress since the pump was put in just 3 days ago. Many of us have noticed that Courtney is attempting to say 'yes' and 'no'. The staff has noticed this a number of times and encourages Courtney to try to speak. I believe that once the trach is out she will make many more attempts.
Today is 8 weeks from the date of the accident and Courtney's progress has been miraculous. We are so grateful for all the support and prayers we have been given and of course mostly for God's grace in saving Courtney and giving us these miracles.
Each day in the hospital we are reminded that there are many people suffering. Craig's co-worker has 2 sons who were involved in a serious accident years ago. One of the sons lives with a life long disability, the other has recovered. Just the other day their third son, only 27 years old died following an asthma attack.
After these past 8 weeks we have some understanding of the immense pain these parents are feeling but will never truly understand their loss. We pray that they are surrounded by loving family and friends and that God will give them the strength to bear this pain. Each day we pray for Courtney's caregivers and also for the many others who sit by the bed of a loved one waiting in hope for a miracle or watching in faith for their loved one's passing to eternal life. May God give all of us strength to continue on our journeys.
Courtney is sitting forward using her core muscles very well and can reach for things on the tray table in front of her. She was watching Annie earlier tonight and was clearly getting tired. She reached out toward the portable DVD so I pulled her hand back. She reach out again and shut the DVD cover and looked at me as if to say "I'm done!" I got the point.
Courtney is becoming better at using the spoon to feed herself each day. She's doing more of the daily care and has a greater awareness of what she wants and what needs to be done.
Most exciting for me today was when Courtney rolled on her stomach, lifted herself onto her elbows and got herself almost all the way to a sitting position! Amazing but apparently not the proper way to sit in bed so PT is working on showing Courtney the safe way to do things.
As a Mom who gets excited I sometimes forget that it's not a good thing for her to be kneeling up in bed, grabbing a full cup of ice or cleverly pulling the seatbelt off in the wheelchair and leaning forward to make a quick escape! I'm always so impressed and excited by these things I don't think of safety - this is when I let the experts do their thing and become the cheerleader. I'll often yell "yes Courtney that's terrific."
Courtney's visitors today kept her busy as well. Among them was Sarah (SJ) a friend from LaSalle. Courtney quickly started checking out Sarah's pocketbook - very cute yellow bag. Then Craig said "oooh and look at Sarah's shoes." Courtney leaned forward in the wheel chair and looked right down at the shoes then back up at Sarah's face as if to say 'nice shoes'! It never fails to amaze us that she has such great object recognition.
Another impressive recent development is that Courtney is doing what's called 'sequencing'. She understands that things need to happen in certain order. For instance, when working with Melane and Kathleen, Courtney tired of following their commands. She held the brush brought her arm up in the air and threw it straight at Kathleen's head! Normally an employee would be upset about something like this - but this is the strange world of rehab - and so Kathleen and Melane were so excited that Courtney was 'sequencing'!
Courtney has also learned that while in the wheel chair she can grab at the hand railings and move herself! She is now spreading her blanket out to cover herself using both hands and will move items from one hand to the next to get the best grip.
All of this is amazing progress since the pump was put in just 3 days ago. Many of us have noticed that Courtney is attempting to say 'yes' and 'no'. The staff has noticed this a number of times and encourages Courtney to try to speak. I believe that once the trach is out she will make many more attempts.
Today is 8 weeks from the date of the accident and Courtney's progress has been miraculous. We are so grateful for all the support and prayers we have been given and of course mostly for God's grace in saving Courtney and giving us these miracles.
Each day in the hospital we are reminded that there are many people suffering. Craig's co-worker has 2 sons who were involved in a serious accident years ago. One of the sons lives with a life long disability, the other has recovered. Just the other day their third son, only 27 years old died following an asthma attack.
After these past 8 weeks we have some understanding of the immense pain these parents are feeling but will never truly understand their loss. We pray that they are surrounded by loving family and friends and that God will give them the strength to bear this pain. Each day we pray for Courtney's caregivers and also for the many others who sit by the bed of a loved one waiting in hope for a miracle or watching in faith for their loved one's passing to eternal life. May God give all of us strength to continue on our journeys.
Friday, January 9, 2009
Mom's Update
Courtney had her first try in the 'standing lift' - this is a unique device that starts in the seated position with support in the front of the knees and a harness around the chest. Her feet are placed inside metal foot plates that hold them in place. Slowly the machine brings Courtney to a full standing position. This was an exciting and exhausting moment for the therapists, Courtney and I as she is quite active all the time.
Courtney also stood with help holding onto a bar that looks like something you find in a dance studio. There's no doubt that Courtney wants to stand - the only thing keeping her from standing is the wobbly legs and stiffness in her left ankle. Most other areas that had severe spasticity have improved. She still has problems with her left wrist, elbow and left ankle.
The rest should continue to improve with the pump and physical therapy. For the more difficult areas Courtney will have botox injections and if necessary casting.
Courtney had orange juice, yogurt, chocolate ice cream today. She looked through a very special book that Courtney made on shutterfly about she and her friend Emma. Courtney turned the pages and looked at the pictures.
Courtney's restlessness and increased agitation and aggression are keeping everyone on their toes. She is active regardless of whether she's in bed or in the wheelchair - throwing teddy bears out of bed, pulling at the trachea, grabbing hands, hair and anything else she can get her hands on! Although Courtney's not speaking yet she makes it very clear what she needs and what is bothering her. Each day she's making vocal chord sounds and we all encourage her to speak.
The weekend will be very busy for Courtney with lots of therapy and visits planned by friends and family. Thank you for being understanding when Courtney is receiving therapy and for remembering that she is easily overstimulated by to many people or loud voices. We look forward to seeing visitors and appreciate the cards and packages that arrive daily for Courtney. We change the cards, pictures and other items around her room so that she gets to see it all.
Courtney also stood with help holding onto a bar that looks like something you find in a dance studio. There's no doubt that Courtney wants to stand - the only thing keeping her from standing is the wobbly legs and stiffness in her left ankle. Most other areas that had severe spasticity have improved. She still has problems with her left wrist, elbow and left ankle.
The rest should continue to improve with the pump and physical therapy. For the more difficult areas Courtney will have botox injections and if necessary casting.
Courtney had orange juice, yogurt, chocolate ice cream today. She looked through a very special book that Courtney made on shutterfly about she and her friend Emma. Courtney turned the pages and looked at the pictures.
Courtney's restlessness and increased agitation and aggression are keeping everyone on their toes. She is active regardless of whether she's in bed or in the wheelchair - throwing teddy bears out of bed, pulling at the trachea, grabbing hands, hair and anything else she can get her hands on! Although Courtney's not speaking yet she makes it very clear what she needs and what is bothering her. Each day she's making vocal chord sounds and we all encourage her to speak.
The weekend will be very busy for Courtney with lots of therapy and visits planned by friends and family. Thank you for being understanding when Courtney is receiving therapy and for remembering that she is easily overstimulated by to many people or loud voices. We look forward to seeing visitors and appreciate the cards and packages that arrive daily for Courtney. We change the cards, pictures and other items around her room so that she gets to see it all.
Thursday, January 8, 2009
Mom's Update
Courtney was out of bed for a long time today and had a very busy therapy day.
She ate oatmeal, fruit and applesauce. She also drank water (although not for the first time). Courtney holds the cup with ice - once she finds the water in the cup she spits out the ice until she gets more water. The oatmeal really cracked me up since Courtney would not have eaten oatmeal before the accident. I am determined to have them feed her all the foods that wouldn't have eaten before in hopes that her finnicky eating habits will change!
Therapists conducted the JFK test today and Courtney scored a 17 - that's a 5 point jump since the last time they did the test. The JFK maxes out at 23 so she's almost on to another test.
Courtney used the brush a couple of times to brush her hair and is now demonstrating the strength of her 'throwing' arm when she gets tired of cooperating with therapy.
She grabbed Dr. Katz arm today and squeezed it very hard - smacked his hand away and tried to grab his flashlight. So in some respects everyone is meeting Courtney for the first time!!!!
Already Courtney's limbs are looser than before the pump and that's a hugely promising sign.
The trachea will be capped - meaning that no air is flowing into or out of it - for longer periods of time starting tomorrow in an attempt to move to removing it. Courtney will also be eating every day (although not 3 meals because it's exhausting) from this point forward.
All the progress we hoped for and a great first day back at Braintree. As we continue to pray for her full recovery let's add special prayers that we will soon hear her voice as we all miss it soooo much!!!! I long to hear her say "mommy". She is starting to sigh and make more noise so we believe she is very close to using her voice.
I'll finish today by saying we love everyone here at Braintree and all agree we can't decide whose our favorite since everyone is so amazing, caring and loving with Courtney.
Thank God for all these wonderful people!
She ate oatmeal, fruit and applesauce. She also drank water (although not for the first time). Courtney holds the cup with ice - once she finds the water in the cup she spits out the ice until she gets more water. The oatmeal really cracked me up since Courtney would not have eaten oatmeal before the accident. I am determined to have them feed her all the foods that wouldn't have eaten before in hopes that her finnicky eating habits will change!
Therapists conducted the JFK test today and Courtney scored a 17 - that's a 5 point jump since the last time they did the test. The JFK maxes out at 23 so she's almost on to another test.
Courtney used the brush a couple of times to brush her hair and is now demonstrating the strength of her 'throwing' arm when she gets tired of cooperating with therapy.
She grabbed Dr. Katz arm today and squeezed it very hard - smacked his hand away and tried to grab his flashlight. So in some respects everyone is meeting Courtney for the first time!!!!
Already Courtney's limbs are looser than before the pump and that's a hugely promising sign.
The trachea will be capped - meaning that no air is flowing into or out of it - for longer periods of time starting tomorrow in an attempt to move to removing it. Courtney will also be eating every day (although not 3 meals because it's exhausting) from this point forward.
All the progress we hoped for and a great first day back at Braintree. As we continue to pray for her full recovery let's add special prayers that we will soon hear her voice as we all miss it soooo much!!!! I long to hear her say "mommy". She is starting to sigh and make more noise so we believe she is very close to using her voice.
I'll finish today by saying we love everyone here at Braintree and all agree we can't decide whose our favorite since everyone is so amazing, caring and loving with Courtney.
Thank God for all these wonderful people!
Mom's Update
Yesterday was a terribly long and not very good day. I know that you were all checking the blog to see about Courtney's transfer. It did not occur until 4pm. While Dr. Brown, his team, the OR team and many of the nurses and aids were great at BMC we did not have a good experience with some nurses and the medicine residents.
So many times over the years we've said that you absolutey need to advocate for yourself or have a good advocate in your family in the medical system today. It is not worth going into the multiple errors, lies and problems we had with some people. The most important thing is that Courtney was returned to Braintree last night and they immediately began taking wonderful care of her including treating skin wounds she got while at BMC.
Courtney managed the pain after surgery very well - she slept most of yesterday which allowed for good healing.
This morning she had a shower and as Mary her nurse said 'she was like a slippery fish'. Courtney was sliding up and down the stretcher that goes right into the shower - it was funny but exhausting. Mary and I took a shower also!
Today's plan is very busy for Courtney with lots of therapy. She'll eat again (yeah!!) and get out of bed. We'll go for a walk and get her back into a normal routine. Very soon Courtney will standing using a special table which will be the first step in her learning to walk again.
When Melane, her OT, told Courtney this Courtney stood right up on her feet! She is very very determined.
Other exciting things have happened over the past 2 days that are signs of progressive recovery. Courtney is becoming more aggressive - she pinched me hard in the face and reaches out to push people away and pinch them. She is pulling her arm through her sleeves while dressing and undressing. This morning when I handed Courtney the brush she brushed her hair a bit - that's a huge change from before when she would simply stare at the brush or try to put it in her mouth!
Last night Courtney was throwing one of her stuffed animals at Craig and I over and over. Then we put one teddy near her foot and she was kicking her leg out to kick it to us over and over. She had a smile on her face as we laughed and were very excited about this movement.
I will try and give another update today about Courtney's activities.
So many times over the years we've said that you absolutey need to advocate for yourself or have a good advocate in your family in the medical system today. It is not worth going into the multiple errors, lies and problems we had with some people. The most important thing is that Courtney was returned to Braintree last night and they immediately began taking wonderful care of her including treating skin wounds she got while at BMC.
Courtney managed the pain after surgery very well - she slept most of yesterday which allowed for good healing.
This morning she had a shower and as Mary her nurse said 'she was like a slippery fish'. Courtney was sliding up and down the stretcher that goes right into the shower - it was funny but exhausting. Mary and I took a shower also!
Today's plan is very busy for Courtney with lots of therapy. She'll eat again (yeah!!) and get out of bed. We'll go for a walk and get her back into a normal routine. Very soon Courtney will standing using a special table which will be the first step in her learning to walk again.
When Melane, her OT, told Courtney this Courtney stood right up on her feet! She is very very determined.
Other exciting things have happened over the past 2 days that are signs of progressive recovery. Courtney is becoming more aggressive - she pinched me hard in the face and reaches out to push people away and pinch them. She is pulling her arm through her sleeves while dressing and undressing. This morning when I handed Courtney the brush she brushed her hair a bit - that's a huge change from before when she would simply stare at the brush or try to put it in her mouth!
Last night Courtney was throwing one of her stuffed animals at Craig and I over and over. Then we put one teddy near her foot and she was kicking her leg out to kick it to us over and over. She had a smile on her face as we laughed and were very excited about this movement.
I will try and give another update today about Courtney's activities.
Tuesday, January 6, 2009
Mom's Update
Courtney's surgery was a success today. It did not begin until 12:30 due to an emergency surgery at the original timeslot.
Courtney did well throughout the surgery and recovering from anesthesia. She is relatively comfortable tonight with her pain being well managed.
She is restless despite the surgery but that's still a good sign. One of the signs of the confusional state is aggressive behavoir and Courtney started to exhibit that today - squeezing our faces and reaching out to push people away. It's funny until she gets a hold of a good chunk of hair like she did with Craig and yanks it out!!!
The plan is for Courtney to be transferred back to Braintree tomorrow which will be a huge relief for all of us as they have a full understanding of the needs of someone with a brain injury like Courtney's.
We don't often write about being thankful to God - not as often as we should - but we all pray every day thanking God for Courtney's recovery so far. Particularly remarkeable since Christmas day. Today is a day that I would like for the heavens to hear our prayers of thanks for this successful surgery and all God's blessings on Courtney thus far just as loudly as the heavens have heard all of our requests!!!
Thank you so much.
Courtney did well throughout the surgery and recovering from anesthesia. She is relatively comfortable tonight with her pain being well managed.
She is restless despite the surgery but that's still a good sign. One of the signs of the confusional state is aggressive behavoir and Courtney started to exhibit that today - squeezing our faces and reaching out to push people away. It's funny until she gets a hold of a good chunk of hair like she did with Craig and yanks it out!!!
The plan is for Courtney to be transferred back to Braintree tomorrow which will be a huge relief for all of us as they have a full understanding of the needs of someone with a brain injury like Courtney's.
We don't often write about being thankful to God - not as often as we should - but we all pray every day thanking God for Courtney's recovery so far. Particularly remarkeable since Christmas day. Today is a day that I would like for the heavens to hear our prayers of thanks for this successful surgery and all God's blessings on Courtney thus far just as loudly as the heavens have heard all of our requests!!!
Thank you so much.
Courtney's Surgery -Mom
Courtney will be heading to the OR in just a little while (it's 8am). Her surgery will start between 9 and 9:30 and will last about 1 1/2 hours.
We had a very rough start here at BMC with misinformation, missing information and less than the quality of nursing care we've been blessed with thus far. I stayed the night with Courtney to ensure that she was cared for in a way that would keep her recovery moving. Thanks to "Auntie Bean" for always being there to listen and provide sage advice.
Hopefully today will be a better day and we get the heck out of Dodge early tomorrow morning!
Please pray for the skillful hands of Dr. Esmond Brown and his team today.
Courtney's progress continues even though she's not been out of bed since Sunday. She had fruit and yogurt yesterday before leaving Braintree. She is now using both hands to accomplish some tasks. While eating ice chips with a spoon (and help) she put the spoon back into the cup to get more!
She's still pulling at her trach but now she uses her right hand to pull the mask away then the left to grab the trach - and she does this with lightning speed!
Courtney is pushing people away, touching our faces and last night she started playing with my hair. She takes some in her hand and twists it around her finger. This morning when Craig was teasing her making snorting noises she reached up and grabbed his nose!
The complicated thought processes that are taking place to facilitate all of these movements are very exciting and show further healing.
There are stories that other families of TBI survivors have shared with us about the power of prayer. I will try to get a few of those posted over the next 2 days as they are very inspiring.
We had a very rough start here at BMC with misinformation, missing information and less than the quality of nursing care we've been blessed with thus far. I stayed the night with Courtney to ensure that she was cared for in a way that would keep her recovery moving. Thanks to "Auntie Bean" for always being there to listen and provide sage advice.
Hopefully today will be a better day and we get the heck out of Dodge early tomorrow morning!
Please pray for the skillful hands of Dr. Esmond Brown and his team today.
Courtney's progress continues even though she's not been out of bed since Sunday. She had fruit and yogurt yesterday before leaving Braintree. She is now using both hands to accomplish some tasks. While eating ice chips with a spoon (and help) she put the spoon back into the cup to get more!
She's still pulling at her trach but now she uses her right hand to pull the mask away then the left to grab the trach - and she does this with lightning speed!
Courtney is pushing people away, touching our faces and last night she started playing with my hair. She takes some in her hand and twists it around her finger. This morning when Craig was teasing her making snorting noises she reached up and grabbed his nose!
The complicated thought processes that are taking place to facilitate all of these movements are very exciting and show further healing.
There are stories that other families of TBI survivors have shared with us about the power of prayer. I will try to get a few of those posted over the next 2 days as they are very inspiring.
Sunday, January 4, 2009
Mom's Update
Courtney had a good day today without alot of restlessness.
She is taking the cup in her right hand and drinking from it. She even knows enough to tilt the cup and her head back all the way at the bottom!
Courtney is also using a spoon lifting it to her mouth and feeding herself ice chips.
She's definitely ready to eat real food and that will happen after her surgery this week.
Courtney is actively moving everything - she sat up today without any help and held herself in that position for quite sometime. She is also rolling all the way onto her stomach which makes her very happy since she's normally a stomach sleeper!
Courtney was also following commands today - reaching for teddy bears and giving them to the nurse Marie. All in all it was a very good day before what will be 3 demanding and exhausting days for Courtney.
Tomorrow morning Courtney will travel by ambulance to the Boston Medical for all the pre-op workup during the day tomorrow. Surgery will be Tuesday and she will return here to Braintree on Wednesday.
We hope and pray that the surgery will be a success, that the baclofin pump will ease Courtney's muscle spasticity and that she will bounce back easily and quickly get back to her remarkeable recovery.
As always we'll keep you up to date with how things progress and thank you for your prayers.
She is taking the cup in her right hand and drinking from it. She even knows enough to tilt the cup and her head back all the way at the bottom!
Courtney is also using a spoon lifting it to her mouth and feeding herself ice chips.
She's definitely ready to eat real food and that will happen after her surgery this week.
Courtney is actively moving everything - she sat up today without any help and held herself in that position for quite sometime. She is also rolling all the way onto her stomach which makes her very happy since she's normally a stomach sleeper!
Courtney was also following commands today - reaching for teddy bears and giving them to the nurse Marie. All in all it was a very good day before what will be 3 demanding and exhausting days for Courtney.
Tomorrow morning Courtney will travel by ambulance to the Boston Medical for all the pre-op workup during the day tomorrow. Surgery will be Tuesday and she will return here to Braintree on Wednesday.
We hope and pray that the surgery will be a success, that the baclofin pump will ease Courtney's muscle spasticity and that she will bounce back easily and quickly get back to her remarkeable recovery.
As always we'll keep you up to date with how things progress and thank you for your prayers.
Saturday, January 3, 2009
Mom's Update
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.'
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.'
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
Friday, December 26, 2008
Mom's Update
Courtney had an impressive day today. It started out with a bath that required help only from Mom because she was rolling from side to side herself and holding on to the railings.
Following that Courtney had ice cream for breakfast! She proved that her swallowing skills are strong and continued to make sounds with her vocal cords.
Courtney showed the strength of her abs and all those workouts in the gym paid off - as she was leaning back against Lisa, a PT with Alyssa, her regular PT was standing in front of her she leaned forward from a 45 degree angle to sitting practically straight up - on her own - with no assistance.
Courtney then moved her head and followed sounds as her Aunties, who were sitting in the room, said hello to her one at a time and she turned her head toward each of them. I called her several times from across the room and each time she picked her head up to look at me.
Later in the afternoon she was in her wheel chair and Craig was sitting in the corner behind her. I told her "Daddy sitting behind you" - Courtney leaned forward and turned her head to see her Dad!
I had just told the nurse 'we're going to take Courtney for a walk' - then Craig asked "is it okay if we take Courtney for a walk?" - If Courtney could have decked him she would have! She pulled her head forward and looked at him as if to say "what the heck are you doing? I'm out the door!"
The day continued with a wonderful visit from her bff Jillian. She looked at Jill as though she were an angel from heaven. Jillian has visited many times while Courtney was in the hospital but today was definitely Courtney's most alert visit with Jilly. The two shared tears and kisses and hugs and a wonderful visit. The best part of the visit was the 2 armed hug Courtney gave Jill. For many weeks therapists and we have been trying to get Courtney to move her right arm. The power of love was all that was needed for motivation for Courtney to raise that arm and wrap it around her friend!
A beautiful day for Courtney and we look forward to many more to come!
Following that Courtney had ice cream for breakfast! She proved that her swallowing skills are strong and continued to make sounds with her vocal cords.
Courtney showed the strength of her abs and all those workouts in the gym paid off - as she was leaning back against Lisa, a PT with Alyssa, her regular PT was standing in front of her she leaned forward from a 45 degree angle to sitting practically straight up - on her own - with no assistance.
Courtney then moved her head and followed sounds as her Aunties, who were sitting in the room, said hello to her one at a time and she turned her head toward each of them. I called her several times from across the room and each time she picked her head up to look at me.
Later in the afternoon she was in her wheel chair and Craig was sitting in the corner behind her. I told her "Daddy sitting behind you" - Courtney leaned forward and turned her head to see her Dad!
I had just told the nurse 'we're going to take Courtney for a walk' - then Craig asked "is it okay if we take Courtney for a walk?" - If Courtney could have decked him she would have! She pulled her head forward and looked at him as if to say "what the heck are you doing? I'm out the door!"
The day continued with a wonderful visit from her bff Jillian. She looked at Jill as though she were an angel from heaven. Jillian has visited many times while Courtney was in the hospital but today was definitely Courtney's most alert visit with Jilly. The two shared tears and kisses and hugs and a wonderful visit. The best part of the visit was the 2 armed hug Courtney gave Jill. For many weeks therapists and we have been trying to get Courtney to move her right arm. The power of love was all that was needed for motivation for Courtney to raise that arm and wrap it around her friend!
A beautiful day for Courtney and we look forward to many more to come!
Christmas Day happiness
Christmas morning started out very emotional for Craig and I. We were quite sad at Courtney having to be here on Christmas day and yet grateful that she is still with us when others have lost their children.
But God blessed us with several happy moments:
Courtney made her first venture outside in the wheel chair. With her favorite winter hat, sunglasses and blankets we walked around in the sun for about 5 minutes.
We cruised the hallways and sat in our favorite large room overlooking the parking lot.
Her Uncles and Aunts and friends came to visit Courtney and she did well through it all.
The end of the day was the highlight - since Courtney first opened her eyes after the accident I will often kiss her head and then ask 'do you want to give me a kiss?' - then I'll place my cheek against her lips. Although she's never actually kissed me she does always have a look of happiness on her face. Last night she did pick her head up off the bed and kiss ne several times. Then she kissed her Dad!
But God blessed us with several happy moments:
Courtney made her first venture outside in the wheel chair. With her favorite winter hat, sunglasses and blankets we walked around in the sun for about 5 minutes.
We cruised the hallways and sat in our favorite large room overlooking the parking lot.
Her Uncles and Aunts and friends came to visit Courtney and she did well through it all.
The end of the day was the highlight - since Courtney first opened her eyes after the accident I will often kiss her head and then ask 'do you want to give me a kiss?' - then I'll place my cheek against her lips. Although she's never actually kissed me she does always have a look of happiness on her face. Last night she did pick her head up off the bed and kiss ne several times. Then she kissed her Dad!
Wednesday, December 24, 2008
Mom's Update
Many people with TBI have problems with muscle spasticity. Courtney has had this problem for about 3 weeks. In these situations muscles in the body tighten and stiffen - the muscles develop 'tone' to the point where they are difficult to stretch out. The results can lead to serious problems that need to be corrected surgically and in some cases they lead to permanent disability.
Dr. Koelbel is a pysiatrist specializing in rehabilitation with a focus on managing and ultimately eliminating spasticity and its debilitating effects. Dr. Koelbel evaluated Courtney this morning and believes the best course of treatment is the most aggressive since her spasticity is wide spread and severe. Therefore on Friday Jan. 2nd Courtney will have a trial of baclofen injected into her spine. If this trial yields positive results then Courtney will have a pump implanted in her stomach with a wire feeding the drug into his spine. This will allow the baclofen to be disbursed to the muscles quickly without the sedating effect of an oral dose of baclofen.
The surgery will take place at Boston Medical Center and it should be about a 24 hour stay.
Success rates with administering baclofen via the pump are about 85%.
We can not overstate the importance of eliminating muscle spasticity and how profoundly this effects her ability to participate in rehab. Imagine for a moment that you've just had a serious muscle pull - your hamstring - you can't walk - you're in pain. Now imagine someone telling you to lift your leg, wiggle your toes, or push your foot down. The pain and stiffness would make those tasks virtually impossible. That has been one of Courtney's challenges for nearly 3 weeks.
Although Courtney could have the trachea removed before the surgery we thought it best that they leave it in so that she would not have to be intubated during the surgery or in the event of an emergency.
We are hopeful that alot will happen after the surgery - trachea removed - by which time she'll be swallowing better and then she can get moving for real! We are very hopeful that this will facilitate progress for Courtney.
We'll let you all know about the test dose on the 2nd and the date of surgery. She will only be away from Braintree for one night - God willing!
Dr. Koelbel is a pysiatrist specializing in rehabilitation with a focus on managing and ultimately eliminating spasticity and its debilitating effects. Dr. Koelbel evaluated Courtney this morning and believes the best course of treatment is the most aggressive since her spasticity is wide spread and severe. Therefore on Friday Jan. 2nd Courtney will have a trial of baclofen injected into her spine. If this trial yields positive results then Courtney will have a pump implanted in her stomach with a wire feeding the drug into his spine. This will allow the baclofen to be disbursed to the muscles quickly without the sedating effect of an oral dose of baclofen.
The surgery will take place at Boston Medical Center and it should be about a 24 hour stay.
Success rates with administering baclofen via the pump are about 85%.
We can not overstate the importance of eliminating muscle spasticity and how profoundly this effects her ability to participate in rehab. Imagine for a moment that you've just had a serious muscle pull - your hamstring - you can't walk - you're in pain. Now imagine someone telling you to lift your leg, wiggle your toes, or push your foot down. The pain and stiffness would make those tasks virtually impossible. That has been one of Courtney's challenges for nearly 3 weeks.
Although Courtney could have the trachea removed before the surgery we thought it best that they leave it in so that she would not have to be intubated during the surgery or in the event of an emergency.
We are hopeful that alot will happen after the surgery - trachea removed - by which time she'll be swallowing better and then she can get moving for real! We are very hopeful that this will facilitate progress for Courtney.
We'll let you all know about the test dose on the 2nd and the date of surgery. She will only be away from Braintree for one night - God willing!
Tuesday, December 23, 2008
from UB
Diane and Katy's posts from Tuesday are below.
Christmas is a special time for all of us, for different reasons. The confluence this year of Courtney's accident and Christmas causes us all mixed emotions. We're thankful we have Courtney, we're sad she has so far to go but we're also hopeful for her recovery. In these difficult times, we lean on each other for support and strength. In that spirit, I have "leaned" on another writer to help express my feelings.
This is an adaptation of Francis P. Church’s famous 1897 editorial, “Yes Virginia, There is a Santa Claus”.
Dearest Courtney,
It occurred to me that during this most difficult and trying time, you, or others around you, might be tempted to question your faith. Certainly, there are people in the world who would gladly tell you that there is no God and that you and your family are alone in your suffering. Courtney, those people are wrong. They have been affected by the skepticism of a skeptical age. They do not believe except they see. They think that nothing can be which is not comprehensible by their little minds. All minds, Courtney, whether they be men’s or children’s, are little. In this great universe of ours, man is a mere insect, an ant, in his intellect as compared with the boundless world about him, as measured by the intelligence capable of grasping the whole of truth and knowledge.
Yes, Courtney, there is a God. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy. Alas! how dreary would be the world if there were no God!? It would be as dreary as if there were no Courtneys – a more dreadful thought does not exist! There would be no faith then, no love, no hope, to make tolerable this existence. We should have no enjoyment, except in sense and sight. The eternal light with which love fills the world would be extinguished.
Not believe in God!? You might as well not believe in the love of your parents. What folly! You might get your Dad to hire men to search the world and the heavens over in the hopes that one may actually see God, but even if they did not see God, what would that prove? Nobody sees God as we see the stars, the sun and the moon, but that is no sign that there is no God. Be comforted in the truth that most real things in the world, precious Courtney, are those that neither children nor men can see. Nobody can conceive or imagine all the wonders there are unseen and unseeable in this world.
You tear apart the baby’s rattle and see what makes the noise inside, but there is a veil covering the unseen world which not the strongest man, nor even the united strength of all the strongest men that ever lived could tear apart. Only faith and love can push aside that heavy curtain to view and picture the heavenly beauty and glory beyond. Is it all real? Ah, Courtney, in all this world there is nothing else real and abiding.
No God? He lives and lives forever! A hundred thousand years from now, Courtney, nay, a 1000 times 100,000 years from now, he will continue to make glad the heart of Men who accept his love.
Even now, Court, only you and God fully know your pain and suffering. He alone hears your voice and knows your most intimate thoughts. So from time to time as you struggle and fight your way through all the challenges that await you on your difficult road to recovery, take time for yourself and try to relax. Try to be quiet and still in mind and body and in that silence - in that calm in the midst of the raging storm, know that God is with you.
With love,
Uncle Brian
Christmas is a special time for all of us, for different reasons. The confluence this year of Courtney's accident and Christmas causes us all mixed emotions. We're thankful we have Courtney, we're sad she has so far to go but we're also hopeful for her recovery. In these difficult times, we lean on each other for support and strength. In that spirit, I have "leaned" on another writer to help express my feelings.
This is an adaptation of Francis P. Church’s famous 1897 editorial, “Yes Virginia, There is a Santa Claus”.
Dearest Courtney,
It occurred to me that during this most difficult and trying time, you, or others around you, might be tempted to question your faith. Certainly, there are people in the world who would gladly tell you that there is no God and that you and your family are alone in your suffering. Courtney, those people are wrong. They have been affected by the skepticism of a skeptical age. They do not believe except they see. They think that nothing can be which is not comprehensible by their little minds. All minds, Courtney, whether they be men’s or children’s, are little. In this great universe of ours, man is a mere insect, an ant, in his intellect as compared with the boundless world about him, as measured by the intelligence capable of grasping the whole of truth and knowledge.
Yes, Courtney, there is a God. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy. Alas! how dreary would be the world if there were no God!? It would be as dreary as if there were no Courtneys – a more dreadful thought does not exist! There would be no faith then, no love, no hope, to make tolerable this existence. We should have no enjoyment, except in sense and sight. The eternal light with which love fills the world would be extinguished.
Not believe in God!? You might as well not believe in the love of your parents. What folly! You might get your Dad to hire men to search the world and the heavens over in the hopes that one may actually see God, but even if they did not see God, what would that prove? Nobody sees God as we see the stars, the sun and the moon, but that is no sign that there is no God. Be comforted in the truth that most real things in the world, precious Courtney, are those that neither children nor men can see. Nobody can conceive or imagine all the wonders there are unseen and unseeable in this world.
You tear apart the baby’s rattle and see what makes the noise inside, but there is a veil covering the unseen world which not the strongest man, nor even the united strength of all the strongest men that ever lived could tear apart. Only faith and love can push aside that heavy curtain to view and picture the heavenly beauty and glory beyond. Is it all real? Ah, Courtney, in all this world there is nothing else real and abiding.
No God? He lives and lives forever! A hundred thousand years from now, Courtney, nay, a 1000 times 100,000 years from now, he will continue to make glad the heart of Men who accept his love.
Even now, Court, only you and God fully know your pain and suffering. He alone hears your voice and knows your most intimate thoughts. So from time to time as you struggle and fight your way through all the challenges that await you on your difficult road to recovery, take time for yourself and try to relax. Try to be quiet and still in mind and body and in that silence - in that calm in the midst of the raging storm, know that God is with you.
With love,
Uncle Brian
Information From Katy
Hi Everyone,
I thought this information might be helpful - and allow everyone to better understand what is going on with Courtney on a day-to-day basis. I'll post it on the blog too.
Courtney's Brain Injury:
Courtney has suffered a Traumatic Brain Injury. This kind of injury results from an outside force hitting the head. There are two categories of TBI that cause trauma to the brain - Courtney has Diffuse Injury. Also referred to as Difuse Anoxal Injury, this results from the shearing and tensile forces associated with significant acceleration/deceleration trauma (like a car accident). The connecting elements of neurons (called axons) are torn and interrupted, causing widespread loss of connectivity. Immediate unconsciousness is a hallmark clinical feature of Diffuse Axonal Injury. Courtney injured the temporal and parietal lobes of her brain. The temporal lobe is located just above the ears, under the frontal lobe. It is responsible for memory, perception, and ability to understand language. The parietal lobe is located just behind the frontal lobe which is at the front of the head. Its responsibilities include the ability to feel (touch sensation), and the ability to integrate sensation for pain, temperature, and movement.
Courtney's Stages of Recovery:
Recovery from a brain injury is a complex process that depends on numerous variables including site, type, severity of injury, and age, among others. The recovery process can plateau at any stage of the recovery process. if the recovery process is prolonged at one stage, each stage after that will also be prolonged. Courtney is in Braintree Rehab Hospital, which uses its own scale to measure the recovery process. I've marked Courtney's current state with "***"
Unconsciousness
Coma
Wakeful Consciousness (Vegetative State)
Confusional
Minimally Conscious State
Confusional State
Post-Confusional
Evolving Independence
Social Competence / Community Re-entry
Coma: When a person is in a coma, it resembles a deep sleep. Their eyes are closed and they have no recognition of or response to internal or external stimuli. They have no apparent sleep/wake cycles.
Wakeful Unconsciousness: This stage is also called a vegetative state. A patient has emerged into this stage when sleep/wake cycles resume and they begin to show reflexive behaviors such as limb posturing, non-purposeful restless movements, startle to loud sounds, or blinking to visual threat. Patients at this stage are still persistently unresponsive and all movements are reflexive.
***Minimally Conscious State***: When patients begin to show higher brain function they have emerged into MCS. This stage is marked by inconsistency. A person may begin to fixate and track people across the room, or turn their head if they name is called. They may begin to follow simple commands or start using objects in a functional way (like combing their hair). These activities are inconsistent - for example, a person may give a high-five if asked one time, but then be unable to replicate this command.
Confusional State: When patients are able to consistently follow commands and use objects consistently and functionally, they have emerged into a confusional state. The hallmark on the confusional state is memory dysfunction, or post traumatic amnesia. Patients are unable to form new memories and are significantly confused as to month, date, year, where they are, and what happened to them. They will be unable to recall recent events and will be unable to recall information from hour to hour or even minute to minute. These patients also demonstrate very poor attention and concentration, varying to very sedate top highly agitated. In this stage, frustration is common and patients will react accordingly. This is common when patients are confused and unable to make sense of their world. Given these behaviors, it is important to maintain a quiet environment, frequent rest breaks, and develop consistent routines.
Evolving Independence: Patients emerge from the confusional state when PTA resolves and new memories can be formed. Patients in this stage are no longer confused and are able to recall elements of their day. Despite this improvement, patients continue to demonstrate significant memory impairment. Deficits in higher level cognitive function become apparent at this stage with continued difficulties in reasoning, abstract thinking, problem solving, and attention. Patients are often discharged at this stage, but continue to need intensive outpatient therapy.
Social Competence / Community Re-entry: Once patients are able to resume community activities such as returning to work or school, they have entered this stage. Even though patients have returned to their normal lives substantial modifications in their homes, work, and school environment are necessary to help compensate for lingering deficits.
Types of Therapy Courtney Receives:
Physical Therapy: Focuses on strengthening, coordination, balance increasing leg flexibility, transferring in and our of bed/chair, and walking.
Occupational Therapy: Focuses on improving strength, coordination, and function of the hands and arms. They also help patients re-learn daily activities, such as bathing, dressing, self-feeding, meal preparation, household tasks, and community activities. They work on the cognitive and perceptual components needed to perform functional activities, including attention, memory, problem solving, insight into impairments, safety awareness, and compensatory strategies.
Speech-Language Pathologist: Focuses on problems with speaking, listening, comprehending, reading, and writing. They also work on improving cognitive skills.
I hope this helps!
Love,
Katy
PS - for everyone with Facebook, I'm updating the group "Get Well Soon Courtney" regularly again :)
I thought this information might be helpful - and allow everyone to better understand what is going on with Courtney on a day-to-day basis. I'll post it on the blog too.
Courtney's Brain Injury:
Courtney has suffered a Traumatic Brain Injury. This kind of injury results from an outside force hitting the head. There are two categories of TBI that cause trauma to the brain - Courtney has Diffuse Injury. Also referred to as Difuse Anoxal Injury, this results from the shearing and tensile forces associated with significant acceleration/deceleration trauma (like a car accident). The connecting elements of neurons (called axons) are torn and interrupted, causing widespread loss of connectivity. Immediate unconsciousness is a hallmark clinical feature of Diffuse Axonal Injury. Courtney injured the temporal and parietal lobes of her brain. The temporal lobe is located just above the ears, under the frontal lobe. It is responsible for memory, perception, and ability to understand language. The parietal lobe is located just behind the frontal lobe which is at the front of the head. Its responsibilities include the ability to feel (touch sensation), and the ability to integrate sensation for pain, temperature, and movement.
Courtney's Stages of Recovery:
Recovery from a brain injury is a complex process that depends on numerous variables including site, type, severity of injury, and age, among others. The recovery process can plateau at any stage of the recovery process. if the recovery process is prolonged at one stage, each stage after that will also be prolonged. Courtney is in Braintree Rehab Hospital, which uses its own scale to measure the recovery process. I've marked Courtney's current state with "***"
Unconsciousness
Coma
Wakeful Consciousness (Vegetative State)
Confusional
Minimally Conscious State
Confusional State
Post-Confusional
Evolving Independence
Social Competence / Community Re-entry
Coma: When a person is in a coma, it resembles a deep sleep. Their eyes are closed and they have no recognition of or response to internal or external stimuli. They have no apparent sleep/wake cycles.
Wakeful Unconsciousness: This stage is also called a vegetative state. A patient has emerged into this stage when sleep/wake cycles resume and they begin to show reflexive behaviors such as limb posturing, non-purposeful restless movements, startle to loud sounds, or blinking to visual threat. Patients at this stage are still persistently unresponsive and all movements are reflexive.
***Minimally Conscious State***: When patients begin to show higher brain function they have emerged into MCS. This stage is marked by inconsistency. A person may begin to fixate and track people across the room, or turn their head if they name is called. They may begin to follow simple commands or start using objects in a functional way (like combing their hair). These activities are inconsistent - for example, a person may give a high-five if asked one time, but then be unable to replicate this command.
Confusional State: When patients are able to consistently follow commands and use objects consistently and functionally, they have emerged into a confusional state. The hallmark on the confusional state is memory dysfunction, or post traumatic amnesia. Patients are unable to form new memories and are significantly confused as to month, date, year, where they are, and what happened to them. They will be unable to recall recent events and will be unable to recall information from hour to hour or even minute to minute. These patients also demonstrate very poor attention and concentration, varying to very sedate top highly agitated. In this stage, frustration is common and patients will react accordingly. This is common when patients are confused and unable to make sense of their world. Given these behaviors, it is important to maintain a quiet environment, frequent rest breaks, and develop consistent routines.
Evolving Independence: Patients emerge from the confusional state when PTA resolves and new memories can be formed. Patients in this stage are no longer confused and are able to recall elements of their day. Despite this improvement, patients continue to demonstrate significant memory impairment. Deficits in higher level cognitive function become apparent at this stage with continued difficulties in reasoning, abstract thinking, problem solving, and attention. Patients are often discharged at this stage, but continue to need intensive outpatient therapy.
Social Competence / Community Re-entry: Once patients are able to resume community activities such as returning to work or school, they have entered this stage. Even though patients have returned to their normal lives substantial modifications in their homes, work, and school environment are necessary to help compensate for lingering deficits.
Types of Therapy Courtney Receives:
Physical Therapy: Focuses on strengthening, coordination, balance increasing leg flexibility, transferring in and our of bed/chair, and walking.
Occupational Therapy: Focuses on improving strength, coordination, and function of the hands and arms. They also help patients re-learn daily activities, such as bathing, dressing, self-feeding, meal preparation, household tasks, and community activities. They work on the cognitive and perceptual components needed to perform functional activities, including attention, memory, problem solving, insight into impairments, safety awareness, and compensatory strategies.
Speech-Language Pathologist: Focuses on problems with speaking, listening, comprehending, reading, and writing. They also work on improving cognitive skills.
I hope this helps!
Love,
Katy
PS - for everyone with Facebook, I'm updating the group "Get Well Soon Courtney" regularly again :)
Mom's Update
It's been written frequently that recovering from brain injury is a bit like starting out at birth.
Like an infant, Courtney can not tell us what hurts, what's bothering her, etc. We never know if something's sticking in her, is she scared, is she in pain. We guess, sometimes we're right, sometimes we're not but this is one of the most painful parts of our experience. It certainly is most painful for Courtney.
Courtney understands everything that is said to her. Today the PT, Dan showed her 2 new ornaments sent by friends at SK Town Rec Dept - one is a globe with her name on it, the other the Grinch. He repeatedly had her 'look at the Grinch', then 'look at the globe' - each time she looked at the correct ornament regardless of how many times he switched positions.
Courtney had OT twice and speech/swallow twice today. She had more ice cream vanilla this time and was in the wheel chair twice. Each time we roamed the hallways to change up the view.
Courtney spent a fair amount of time looking out the window at the cars - her eyes moving back and forth across the parking lot taking it all in.
Dr. Hill came in today to change Courtney's trachea - it is a smaller trachea and will allow her more air which makes it easier for her to speak when she is capped. He also looked at her vocal cords and said they are functioning fine. They are hopeful that Courtney will have the trachea removed within the next 2 weeks - that will be a wonderful day for which we can all pray!
I'd like to share a prayer with you that I pieced together from several prayers. As you gather with your families over these next 2 days I hope you will have a moment to think of Courtney and say a prayer for her.
To Jesus Christ, the light of the world, we pray:
To you o Lord, I lift up my soul.
I trust you, let me not be disappointed.
Those who hope in you shall not be disappointed.
In you I hope all day long
because of your goodness, O Lord.
Remember your mercy, Lord
and the love you have shown from of old.
Come and reward your people's hope!
You come as the dawn of the everlasting day;
sustain in courage those who keep vigil through the
long night of suffering.
You come as the sun of justice to drive away the darkness
of death;
sustain in hope and faith the seriously ill and those who watch beside them.
You come as the light of the world;
sustain in joy all those who are called to follow you.
Amen.
and in the words of Tiny Tim: "God Bless us, everyone!"
Like an infant, Courtney can not tell us what hurts, what's bothering her, etc. We never know if something's sticking in her, is she scared, is she in pain. We guess, sometimes we're right, sometimes we're not but this is one of the most painful parts of our experience. It certainly is most painful for Courtney.
Courtney understands everything that is said to her. Today the PT, Dan showed her 2 new ornaments sent by friends at SK Town Rec Dept - one is a globe with her name on it, the other the Grinch. He repeatedly had her 'look at the Grinch', then 'look at the globe' - each time she looked at the correct ornament regardless of how many times he switched positions.
Courtney had OT twice and speech/swallow twice today. She had more ice cream vanilla this time and was in the wheel chair twice. Each time we roamed the hallways to change up the view.
Courtney spent a fair amount of time looking out the window at the cars - her eyes moving back and forth across the parking lot taking it all in.
Dr. Hill came in today to change Courtney's trachea - it is a smaller trachea and will allow her more air which makes it easier for her to speak when she is capped. He also looked at her vocal cords and said they are functioning fine. They are hopeful that Courtney will have the trachea removed within the next 2 weeks - that will be a wonderful day for which we can all pray!
I'd like to share a prayer with you that I pieced together from several prayers. As you gather with your families over these next 2 days I hope you will have a moment to think of Courtney and say a prayer for her.
To Jesus Christ, the light of the world, we pray:
To you o Lord, I lift up my soul.
I trust you, let me not be disappointed.
Those who hope in you shall not be disappointed.
In you I hope all day long
because of your goodness, O Lord.
Remember your mercy, Lord
and the love you have shown from of old.
Come and reward your people's hope!
You come as the dawn of the everlasting day;
sustain in courage those who keep vigil through the
long night of suffering.
You come as the sun of justice to drive away the darkness
of death;
sustain in hope and faith the seriously ill and those who watch beside them.
You come as the light of the world;
sustain in joy all those who are called to follow you.
Amen.
and in the words of Tiny Tim: "God Bless us, everyone!"
Monday, December 22, 2008
Mom's Update
Courtney had a very busy day today and has hardly slept a wink! She is quite exhausted from all the activity.
The morning started with Anu the Occupational Therapist and a bath where Courtney began, with great assistance, doing things for herself.
Next Anu and Kathleen, Courtney's speech therapist worked on stretching - swallowing and following commands. Courtney has 'yes' and 'no' cards so that she can start to communicate what she needs.
Courtney's swallowing is very strong and her coughing is better and better each day.
Today Courtney had blue ice chips - like a snow cone. Kathleen can watch to make sure Courtney isn't ingesting any of the water into her lungs and then coughing up blue.
The highlight of the day was the chocolate ice cream called 'magic'. The ice cream can be used as a meal replacement and has all the nutrients of a healthy meal! Kathleen said patients love it so much they have to take it away so they'll eat regular food!
Courtney had her first 2 very small tastes of chocolate ice cream today. I told Kathleen that Courtney prefers vanilla - so tomorrow she will get vanilla.
Later in the day Courtney was stretched out by PT and then we took her for a ride in her wheel chair. We toured the floor and showed her the atrium with the Christmas tree.
Most important, as her Dad pointed out, we showed her the door that she would some day walk out. He told her to take a good look at the door because that would be the door she would walk out of some day on her way home!
Hopefully Courtney will sleep well tonight after all this activity. She is getting to know her team - those who are not on Christmas vacation - and all the nurses that take very good care of her.
For those of you who know us personally there was a time many years ago when we had a really difficult time. Craig was out of work for almost 2 years to the week, then both of our mothers passed away around Christmas time within a 3 week period. We used to discuss how we got through those difficult days and always believed that God carried us through. We believe that God again is showing his presence in our lives and we are grateful for his mercy.
Craig and I pray that NO family will ever have to go through the Hell that we are now going through. At least with a nightmare you wake up and the moment is gone. Words cannot adequately describe the horror that we live every minute. We are sustained by our Faith in God and our strong daughters and family. For all of you who are parents who read this. please take a moment and hug your children and let them know what you feel in your heart. Let there never be a day when you go to sleep at night angry over something trivial and not express your love to your children.
Life is fleeting, however love is enduring.
Thank you for praying for us.
The morning started with Anu the Occupational Therapist and a bath where Courtney began, with great assistance, doing things for herself.
Next Anu and Kathleen, Courtney's speech therapist worked on stretching - swallowing and following commands. Courtney has 'yes' and 'no' cards so that she can start to communicate what she needs.
Courtney's swallowing is very strong and her coughing is better and better each day.
Today Courtney had blue ice chips - like a snow cone. Kathleen can watch to make sure Courtney isn't ingesting any of the water into her lungs and then coughing up blue.
The highlight of the day was the chocolate ice cream called 'magic'. The ice cream can be used as a meal replacement and has all the nutrients of a healthy meal! Kathleen said patients love it so much they have to take it away so they'll eat regular food!
Courtney had her first 2 very small tastes of chocolate ice cream today. I told Kathleen that Courtney prefers vanilla - so tomorrow she will get vanilla.
Later in the day Courtney was stretched out by PT and then we took her for a ride in her wheel chair. We toured the floor and showed her the atrium with the Christmas tree.
Most important, as her Dad pointed out, we showed her the door that she would some day walk out. He told her to take a good look at the door because that would be the door she would walk out of some day on her way home!
Hopefully Courtney will sleep well tonight after all this activity. She is getting to know her team - those who are not on Christmas vacation - and all the nurses that take very good care of her.
For those of you who know us personally there was a time many years ago when we had a really difficult time. Craig was out of work for almost 2 years to the week, then both of our mothers passed away around Christmas time within a 3 week period. We used to discuss how we got through those difficult days and always believed that God carried us through. We believe that God again is showing his presence in our lives and we are grateful for his mercy.
Craig and I pray that NO family will ever have to go through the Hell that we are now going through. At least with a nightmare you wake up and the moment is gone. Words cannot adequately describe the horror that we live every minute. We are sustained by our Faith in God and our strong daughters and family. For all of you who are parents who read this. please take a moment and hug your children and let them know what you feel in your heart. Let there never be a day when you go to sleep at night angry over something trivial and not express your love to your children.
Life is fleeting, however love is enduring.
Thank you for praying for us.
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