A Remarkable Experience

Beauty-GardenI love this time of year and the message Easter brings. One of my favorite articles I’ve written was posted on Easter Sunday 2014, He Lives. I decided to repost parts of it today, because it’s a marvelous, comforting experience worth retelling.

The spring season is the transition from winter to summer. It’s a time of growth and renewal of life, when plants and trees which have been dormant for a season regain life and begin to bud into a lush, green, beautiful plant. The timing is perfect for the event of our Savior’s resurrection. Springtime is usually my favorite, however, in 1991 it was a lost season because Mark literally slept through it in a coma after our horrific car accident.

I was grateful Mark appeared to be in a safe and sheltered place, unaware of the hospital surroundings, while I struggled to hold myself together. Helpless to make Mark better, I sat next to his bedside in the Intensive Care Unit at MacKay Dee Hospital in Ogden, Utah. My right arm was in a sling and I wore a brace for my broken collarbone, but I hardly noticed the pain—it was nothing compared to my broken heart and worry. Mark, lying perfectly still and quiet, wasn’t bothered by the loud noises from the monitors or the shunt inserted at the top of his head, draining excessive fluid from his brain.

During the long three months Mark was comatose I wondered, where is he? I could see his body, but often his spirit felt absent. Peace radiated from him and I felt a glimpse of heaven in his presence. What will he be able to tell me when he’s conscious? I was certain it would be something special. I longed to hear his voice. There were some days when I felt his company for a short time and on a few better days our spirits were able to communicate through thoughts. I would talk to him and hear his reply in my mind or feel his comfort. It was an impressive, angelic form of communication and I cherished those moments, but I had no control over when or how it would happen.

Mark’s ability to regain consciousness was a slow and gradual process which took several more weeks. At first he would occasionally answer yes or no questions by blinking his eyes once for no and twice for yes. We tested him often with obvious questions. As he improved he would whisper a word or two. One day I showed Mark a picture of Christ and asked him if he’d seen Him. He quietly said, “Yes.” Months later when he could talk in sentences he told of his experience, which he has now written down.

“Just before waking from my coma, I thought I was walking the length of a long white hallway. Standing at the far end of the hall was another man about my same height. I say this because neither of us had to look noticeably up or down to look directly into the other’s eyes. He had a full head of pure white hair longer than shoulder length, and a pure white beard that was chest length. I presumed that man to be Jesus Christ. Thinking I had died and would be in His proximity for eternity, I walked up to within a few feet of Him and stopped. I asked for the location of Heavenly Father. He then pointed up and over His shoulder with His thumb toward the door behind Him and said, ‘In the next room.’ I reached around Him and opened the door. Before seeing anything in the next room, I awakened from my coma. I wish I’d known then how short that meeting would be; I would’ve liked to have spent more time with Him.”

As Mark related this experience to me, I knew it was true. During his months of unconsciousness, I knew he was in a special place feeling peace and contentment. I believe there’s more to his experience than he remembers and appreciate the comfort this memory brings to him. It brings comfort to me also; not only does it reassure me that Christ is real and knows each one of us, but I believe that the doors were Mark’s choice and the door he chose brought him back to me. He loves to relate this experience to whoever will listen. Remarkably, he tells it using the same words. Since his TBI, Mark has short term memory loss, meaning he can’t remember who he’s told or the words he used. Nevertheless, he uses nearly the same words each time. This confirms to me that Mark’s experience was real and he was given the memory of it and the words to share it, not only to bring comfort to himself, but to touch the lives of others.

By this experience and others, we know Christ lives! He is resurrected. We will return to His presence, where joy, peace and comfort will be found. We were blessed to survive the shocking car accident and we were blessed again by this marvelous experience. We share it along with a beautiful rendition of our favorite hymn in celebration of His resurrection. Happy Easter!

<p><a href=”http://vimeo.com/29685920″>I Know That My Redeemer Lives</a> from <a href=”http://vimeo.com/user8691070″>INTO THE LIGHT Journal</a> on <a href=”https://vimeo.com”>Vimeo</a&gt;.</p>

 

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Understanding a Complicated System

Have you ever studied so hard your brain hurts or feels tired? How delicate is our brain? Why does a person with a traumatic brain injury drift in and out of consciousness? I’ve researched some sites on the brain and meshed information together from two of my favorite sources, which are listed at the end of my article.

Our brains weigh about 3.4 pounds of extremely delicate soft tissue, being the consistency of jelly or soft butter. So delicate it can’t even support its own weight. Fortunately, it’s well protected in the hard bones of our skulls, durable tissue and surrounded in a bath of cerebral spinal fluid. Because the brain is immersed in a liquid, its weight is reduced to a point at which it can support itself. The cerebral spinal fluid provides further protection to the brain by its presence within a series of hollow, interconnected chambers, called ventricles. Aside from contributing to the structural support of the brain, this bath of fluid also provides a water cushion that protects your brain in a collision or if you just bump your head.

The brain has no ability to maintain long term energy reserves; it must be constantly supplied with blood. This occurs through the vertebral arteries and the internal carotid arteries. Within the brain itself, these arteries are interconnected, allowing for a continuous supply of blood to all portions of the brain when one or more arteries become blocked.

Brain scans show that thinking uses up a lot of energy, which is revealed by increased blood flow. It uses as much as a fifth of all the energy we get from food. Since our brains can’t store much energy and because they’re tightly enclosed inside our skulls, there is a limit to how much blood and therefore energy can be supplied to the active areas. Consequently, thinking hard tires your brain.

Image credit: File:Neuron.svg

Image credit: File:Neuron.svg

Specialized cells called neurons perform the information processing that occurs within the brain. This processing occurs as a result of the transmitting and receiving of electrochemical signals by these cells.

Many of our brain’s nerve fibers are wrapped in a fatty sheath, which makes 10% of our brain fat. This fatty sheath, called myelin, is vital as it insulates the nerves. This allows electrical impulses to travel quickly around your brain.

Image credit: Imgarcade.com

Image credit: Imgarcade.com

If you hit your head hard and the skull is broken, the pieces of the broken bone may dig into the brain and tear the delicate tissue. Even if your skull isn’t broken, it’s possible to sustain serious brain damage if the brain impacts onto the inside of the skull or twists against its rough surface. When there is sudden speeding up and slowing down, such as in a car crash or fall, the brain can move around violently inside the skull, resulting in injury causing bruising or bleeding. Bleeding is particularly dangerous, causing further damage. A person with this type of injury may seem fine initially as the effects take several hours to reveal themselves.

The severity of injury refers to the degree or extent of brain tissue damage. The degree of damage is estimated by measuring the duration of unconsciousness, the depth of coma and level of amnesia or memory loss. MRIs or CT scans are also used to project the injury.

Research shows that just like with muscles the more you use a part of your brain, the larger it will get. Also like muscles, as you use a particular part of your brain, more blood is pumped to that area to provide energy. Finally, as with muscles, the more you use your brain, the better it works, subsequently it can improve.

The human brain is a complicated system comprised of over 1 billion specialized cells called neurons. These neurons get damaged in a collision and take time to heal. Amongst these neurons there are countless connections. “To comprehend this fully, one needs not look further than the Amazon rainforest, where there are some 1 billion trees. If one counted every leaf on every tree, the sum would closely parallel the number of connections in the human brain.”-unknown author.

Your brain is constantly monitoring and fine tuning what is going on in your body – 24 hours a day, year after year – without you even being aware of it. What do you do to ensure its health and safety?

Resources:

http://www.brocku.ca/stutter/frpgs/brain.html

http://www.youramazingbrain.org.uk/insidebrain/yourbrain.htm

 

 

Looking for Inspiration

Mark’s pneumonia seemed to be improving, but the fever persisted and the white cell count was too high. Dr. Wright felt changing his feeding tube would improve his condition.

“The nasogastric (NG) tube is not meant for long term and can be a source of infection. Since we don’t know how long it will take for Mark to be capable of chewing and swallowing, I recommend it be replaced with a gastrostomy tube which allows feeding directly into the stomach,” Dr. Wright said.

“It would be his third surgery in nearly three months. I would hate for him to go through it, especially when he’s showing signs of improvement.”

“The percutaneous endoscopic gastrostomy (PEG) procedure is relatively common under these circumstances. It’s a simple surgery, which only takes 30-45 minutes,” the doctor said.

I despised making decisions for Mark. The responsibility was a heavy load that I was unprepared to carry. What would he want? I tried to connect with his spirit. Tell me Mark, what do you want me to say? Do you need the feeding tube? Should I agree to it? I knew I had to be his voice, but I wanted him to give me the answers. I felt and heard nothing.

“I believe the PEG will improve Mark’s condition and lower the frequency of aspiration. He’ll tolerate it better,” the doctor encouraged.

“Okay,” I agreed reluctantly.

Within a few days, Dr. Wright arranged for the surgery at a nearby hospital and ordered a specialized van which could transport Mark in a reclined wheelchair. I rode in the van with Mark. He was unconscious and seemingly unaware of the drive on this beautiful, hot summer day in July. When we arrived at Cottonwood Hospital, two male aides lifted Mark’s stiff body onto a stretcher and wheeled him into an operating waiting room. I meet the surgeon for the first time just minutes before the surgery was scheduled. With a nurse at his side, the doctor explained to me the procedure details. The nurse handed me a thin, wooden clipboard with forms for me to sign, not only giving approval for the surgery, but declaring my understanding of the risks involved. The complications listed included: aspiration, oversedation, wound infection and/or bleeding. These complications I could comprehend, but an injury to the liver, bowel or spleen took me by surprise. When I read hemorrhaging and perforation, or unwanted hole in the bowel wall, which could be fatal, a big red flag shot up in my mind.

Risks—wait a minute. I was only told about how common and simple this procedure was. Now I’m reading about all the unfortunate possibilities and just minutes before the surgery was scheduled. I felt trapped and wasn’t convinced Mark needed the PEG in the first place. I believed with every fiber of my being that life would get back on the normal track—the one we were familiar with.  I couldn’t imagine any other way of life, but these foreign road blocks kept getting in our way.

I looked at Mark, who was unaware of my turmoil. I resented being in this position. I was hoping and praying for inspiration to know what his desires were, but I felt nothing.

“I can’t sign these forms,” I said to the surgeon, handing back the clipboard and forms to the nurse. “I wasn’t made aware of these complications.”

“Oh, the chances of any of them happening are one in a thousand,” he said in a reassuring voice.

“Before our car accident, I could think Mark would never be that ‘one in a thousand’. The statistics mean nothing to me now. How many car accidents happen and result in a traumatic brain injury, causing a coma for three months? If you happen to be that ‘one in a thousand’, that’s all that counts.”

“He’s had the NG tube twice as long as recommended. They are not meant to be used more than six weeks. Dr. Wright has recommended this procedure in order to maintain adequate nutrition for Mark.”

“I understand, but I just don’t know how much longer he will need any feeding tube and I wasn’t told about the risks until now. I need a few minutes to process this information. I don’t want to sign the consent forms under pressure. I need to think about it, I’ll be back soon,” I said as I walked out of the room, leaving the nurse and surgeon with Mark.

I hurried down the hall wanting to vanish from this situation, but not knowing where to go. I can’t believe I just walked out. I don’t want to make one more decision about Mark’s healthcare, but I’m expected to. I wasn’t getting an answer from Mark on what I should do, so I knew my best option was to find a secluded place to pray. I spotted a women’s bathroom, went inside and locked the stall door. Lord, I’m under pressure to sign for this procedure. I believe you know all from the beginning to the end. Please tell me—should I sign for Mark to have the surgery? Does he really need it?

Feeling awkward and anxious about this strange place for such an important prayer and my desperate need for inspiration, I was quickly overcome with a calming sensation. Yes, he needs the surgery. Fear not, everything will be alright., I am with thee.

Thank you for your insight and reassurance.

I walked back to the room with confidence in my decision and the surgeon and nurse were relieved when I told them I was ready to sign the forms. The nurse handed me the clipboard and after my signatures, they rushed off to the operating room.

Ninety minutes later the surgeon finally came to the waiting room where I was told to wait. “The surgery was a success. The reason it took longer than usual was because of Mark’s strong stomach muscles.”

“He’ll be proud to hear that,” I said with a smile. “Mark did a hundred sit-ups nightly to stay fit and trim. He never wanted a pot belly.”

“Well, he definitely doesn’t have one. It’s more like abs of steel,” the doctor said as he shook my hand good-bye.

Mark and I spent a few more hours at Cottonwood Hospital in a recovery room and by early evening the van came and drove us back to Western Rehab. The dreaded G-tube was in place and all went well. Mark survived his third operation and I looked forward to telling him that the surgeon confirmed his abs were made of steel.

 

Understanding Traumatic Brain Injury, Part 2

While Mark was at McKay Dee Hospital, I was introduced to the Glasgow Coma Scale (GCS), which is used to measure the depth of a coma. When Mark moved to Western Rehab they used the Rancho Los Amigos Scale, also known as the Level of Cognitive Functioning Scale (LCFS). The treatment team used this scale as a guide for his therapy plan. Their strategy changed as Mark progressed from one level to the next. They believed Mark would have to go through each level, without skipping one to progress. Consequently, the team was always encouraging and working to get Mark to the next level. I don’t believe Mark ever went through the dreaded Level IV. I did see other patients go through this level and it was upsetting, not only for the patient and family, but for all who witnessed the confusion and agitation.

Each person with a brain injury moves through the cognitive levels at various speeds. Some patients will be discharged from the hospital prior to progressing through all ten levels. I brought Mark home at cognitive level VI.

Level I – No Response: Patient needs total assistance and appears to be in a deep sleep or coma and does not respond to any external stimuli.

Level II – Generalized Response: Patient needs total assistance, but moves around. Movement doesn’t seem to have a purpose or consistency. This reaction may be due to deep pain. Patient may open their eyes, but does not seem to be focused on anything in particular.

Level III – Localized Response: Patient needs total assistance, but begins to move their eyes and look at specific people and objects. They turn toward or away from loud voices or noise. The patient may follow a simple command such as, “squeeze my hand.”  Responses are inconsistent and directly related to the type of stimulus.

Level IV – Confused and Agitated: Patient needs maximal assistance. They are very confused and agitated about where he or she is and what is happening in the surroundings. At the slightest provocation, the patient may become very restless, aggressive or abusive, verbally and/or physically. The patient may enter in incoherent conversation in reaction to inner confusion, fear or disorientation. Safety and deficit awareness are important issues.

Level V – Confused, Inappropriate, Nonagitated: Patient needs maximal assistance. They are confused and do not make sense in conversations. They may be able to follow simple directions. Stressful situations may provoke some upset, but agitation is no longer a major problem. Patients may experience some frustration as elements of memory return. Follows tasks for 2-3 minutes, but is easily distracted by environment.

Level VI – Confused, Appropriate: Patient needs moderate assistance. Speech makes sense and they are able to do simple things such as dressing, eating and brushing teeth. Although patients know how to perform a specific activity, they need help discerning when to start and stop. Learning new things may also be difficult. The patient’s memory and attention are increasing and they are able to attend to a task for 30 minutes.

Level VII – Automatic, Appropriate: Patient needs minimal assistance and can perform self-care activities and is usually coherent. Behavior is appropriately in familiar settings and shows carry-over for new learning at a lower than normal rate. They may have difficulty remembering recent events and discussions. If physically able, patient can carry out routine activities, but has difficulty with rational judgments, calculations and solving multi-step problems. Patient may not realize this and needs supervision for safety.  Patient initiates social interactions, but judgment remains impaired.

Level VIII – Purposeful, Appropriate: Patient needs stand-by assistance, but is independent for familiar tasks in a distracting environment for a short period of time. He or she acknowledges impairments, but has difficulty self-monitoring. Emotional issues such as depression, irritability and low frustration tolerance may be observed.

Level IX – Purposeful, Appropriate: Patient needs stand-by assistance on request, but is able to shift between tasks for two hours. They require some assistance to adjust to life demands. Emotional and behavioral issues may be of concern.

Level X – Purposeful, Appropriate: Patient is modified independent and is goal directed, handling multiple tasks and independently using assistive strategies. Prone to breaks in attention and may require additional time to complete tasks.

Resources: http://www.tbims.org/combi/lcfs/lcfs.pdf , https://www.jhsmh.org/LinkClick.aspx?fileticket=8hAd-OqTIQ0%3D&tabid=298

I hope this information is helpful in understanding the recovery process from traumatic brain injury. Did you or your loved one go through each level? At what level were they released from the hospital?

Understanding Traumatic Brain Injury, Part 1

Shortly after the car accident, the hospital informed me of an ongoing weekly class they held in the evening to help family members understand Traumatic Brain Injury (TBI). It was informative, helpful and overwhelming. I attended the classes every week only because it was information I needed, but it was definitely not wanted information. To be honest, I hated the class. It was frightening and discouraging. I wanted Mark’s recovery to be like the ones portrayed in the movies, where a person in a coma just one day wakes. I didn’t realize there was a measurement to the depth of a coma and there would be a process for waking up. After all, we do it every morning with little thought. It was difficult to throw out the mentality that you’re either comatose or not and realize there are levels or stages.

At first I was introduced to the Glasgow Coma Scale (GCS), which is used to measure the depth of a coma. “The GCS rates three aspects of functioning: eye opening, motor response and verbal response. Individuals in deep coma score very low on all these aspects of functioning, while those less severely injured or recovering from coma score higher. A GCS score of 3 indicates the deepest level of coma, describing a person who is totally unresponsive. A score of 9 or more indicates that the person is no longer in coma, but is not fully alert. The highest score (15) refers to a person who is fully conscious.” http://www.msktc.org/tbi/factsheets/Understanding-TBI/What-Happens-During-Injury-And-In-Early-Stages-Of-Recovery

I. Eye Opening
1 = No eye opening
2 = Eyes open to pain
3 = Eyes open to speech
4 = Spontaneous eye opening
II. Verbal Response
1 = No sounds
2 = Incomprehensible sounds
3 = Inappropriate words and jumbled phrases consisting of words
4 = Confused, yet coherent, speech
5 = Alert and oriented
III. Motor Response
1 = No response
2 = Extensor response, abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backwards. The muscles are tightened and held rigidly. This type of posturing usually means there has been severe damage to the brain.
3 = Abnormal flexion, posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest.
4 = Withdraws from unpleasant or painful stimuli
5 = Localizes to unpleasant or painful stimuli
6 = Obeys commands fully

The final score is determined by adding the values of I+II+III. This number helps medical practitioners categorize the four possible levels for survival, a lower number indicating a more severe injury and a poorer prognosis.

Mark’s highest score for the first seven weeks was 4: Eye Opening 2 + Verbal Response 1+ Motor Response 1 = 4.

Mild TBI Symptoms – score 13-15

Moderate Disability score 9-12:

  • Loss of consciousness greater than 30 minutes
  • Physical or cognitive impairments which may or may not resolve
  • Benefit from rehabilitation

Severe Disability score 3-8:

  • Coma: unconscious state. No meaningful response, no voluntary activities

 Vegetative State score less than 3:

  • Sleep wake cycles
  • Arousal, but no interaction with environment
  • No localized response to pain

 Persistent Vegetative State:

  • Vegetative state lasting longer than one month

 Brain Death:

  • No brain function
  • Specific criteria needed for making this diagnosis

Resource: http://www.traumaticbraininjury.com/symptoms-of-tbi/glasgow-coma-scale/

When he moved to Western Rehab, they used a Rancho Los Amigos Scale or Level of Cognitive Functioning Scale (LCFS) which I’ll save for part 2.

Did you find this information helpful? What has been your experience or understanding of TBI?

Closer to Home

by Katie, May 1991. One month after her 7th birthday. A picture of Katie and Christopher. Our cat, Spook in a picture on the wall. She expressed her biggest fear, “I hope you will remember us.”

Mark’s neurologist explained that it’s difficult for any physician to predict the outcome of traumatic brain injury. Along with family members, they have to “wait and see” how the patient progresses. They encouraged me to bring Mark’s favorite music and surround him with familiar people and things.  After meeting each one of the therapists assigned to work with Mark, Mom drove me home.  What a huge difference it made having him only 2.3 miles away. What used to be an hour drive to see Mark now took five minutes. This relieved the pressure of feeling like someone needed to be at the hospital at all times. Knowing I could get there quickly in an emergency lightened the stress. My dad, brothers and brother-in-law would no longer need to take turns spending the night at the hospital. I will be forever grateful for the weeks they did so.

May 1991, Christopher’s drawing of the swing set Mark built for the kids

I picked up the kids from the neighbor’s house and they gathered pictures they had drawn and colored for their Dad over the past seven weeks with get well notes to him. They were excited to decorate his room with them. Christopher put his prized pinewood derby car in a bag, along with the first place trophy he had won the week before. I packed up some family pictures, clothes and dinner for us to eat in Mark’s new hospital room. We were all anxious to be together again as a family and we went there with the intention of making Mark’s hospital room feel like a second home. Our excitement made the memory of their fearful first visit disappear.

Scan0015At the hospital, the kids helped me tape their pictures on the salmon colored walls and closet door right in front of Mark’s bed. I put framed school pictures of the kids and some family pictures on the shelves above the drawers. We hoped these pictures would be the first thing Mark would see when he opened his eyes. While I placed underwear and socks in the drawers, I encouraged the kids to read to their Dad, which was the nightly routine before the accident. I hung a few pullover shirts and sweat pants in the closet before taking a seat in the room. There was a small, round table with only two chairs in the room. I asked  the nurse if I could bring in one more chair from the recreation room so we could each have one. The three of us sat around the table and we ate our first meal by Mark’s bedside. It felt so good to all be together again and the kids seemed to be happy to see their dad. Christopher pulled the pinewood derby car and trophy from the bag and set it on the night stand next to his dad’s hospital bed. A touch of home was now in the room. We knelt by his bed and said our prayers with him before leaving the hospital. This became our nightly routine which enabled me to sleep better than I had in the previous seven weeks. Having Mark so close to home was indeed a big blessing.

Scan0013Struggling to understand this complicated condition, I made sure I was at the hospital every morning for Mark’s therapies. On my way, I would drop the kids off at the neighbor’s home or my parents would take them to their home or their cousin’s home to play for the day. Before dinner, I would pick up the kids from wherever they spent the day and we’d take dinner up to the hospital. After our meal together, the kids would play with the other children in the hospital playroom; some of them were patients while a few were visitors. They enjoyed playing and helping the children. The nurses and aides were friendly and caring in helping our children adjust to our new situation. They helped the kids become comfortable in the hospital setting, encouraging them to sit in the wheelchairs and learn to maneuver them.

Scan0019The uncertainty of Mark’s health condition was frightening. Each family member and friend dealt with this crisis in his or her own way. Being responsible for Mark’s well-being,  I felt an urgency to learn everything about his condition so I could make wise choices in his behalf. All the stress and worry made it difficult for me to concentrate and remember explanations given to me. Keeping a journal of events, feelings, concerns, and questions became my way of coping. Overwhelmed, I felt the need to write down my questions and the answers I received from therapists, doctors and nurses. Some of the staff were fine seeing me doing this, while it made others feel guarded and suspicious of my motives. I was constantly taking notes because I didn’t want to forget what I was told and it helped me understand and stay focused on what I felt was most urgent at the time. I was aware of each staff member’s concern, but I just focused on the most critical ones at a time. I believed Mark would come out of his coma once his other injuries and infections healed, but for his therapists, the coma was the most concerning.

Scan0018After three weeks of the powerful intravenous medication, Amphotericin B, Mark’s red and white cell counts were in the normal range and it was another victory to complete this treatment. The next focus for improvement was weaning Mark off the ventilator. The respiratory therapist came three times daily. I asked and kept record of his respiratory rate and the breaths Mark initiated on his own. I was encouraged every time the preset pressure value was turned down. After one week of weaning him off of the ventilator, the tracheotomy tube was downsized and a smaller tube was inserted. The smaller size allowed for the stoma site to shrink. The next step towards removing the tracheotomy was to plug it. The purpose of this cork was to insure that he was able to clear his own airway effectively without the need for suctioning. After a couple of days without any complications, the doctor ordered the trach tube to be removed. Glorious news, but I was taken by surprise when they pulled the tube out right there in his hospital room and then covered it with dressing and taped it in Respiratory Therapistsplace. I was unprepared for the gasping, high-pitched sound he made and I panicked. It was hard to watch him struggle. The respiratory therapist kept a close eye on him and tried to reassure me the hole would close up on its own quickly. Since I had no previous experience with this, I doubted him. It was the first night since Mark had been at Western Rehab that I didn’t dare take the kids to see him nor did I want to leave him. Thankfully, Mom and Dad were able to keep the kids overnight and within twenty-four hours, Mark was breathing more easily all on his own.

Welcome to Western Rehab

The sixty mile ride in the ambulance seemed so strange and unlike the ride I had the day of the accident. I was grateful to be in the passenger seat and not on the stretcher in the back. Both technicians were very friendly and asked lots of questions about the accident and our experience over the past seven weeks. It felt unreal as I talked to them about it. How could all of this have happened to me? Events like this happen to someone else, not me, somebody who is better prepared for it. When would I wake up from this bad dream? A sense of being stuck in it hit me hard.

Picture from http://www.healthsouthutah.com.       Formerly Western Rehab Hospital

Before I knew it we were pulling up to the entrance of Western Rehab. My excitement to finally be there turned to fear, like the first day of elementary school. You can hardly wait to go, but when you get there you realize you don’t know what it’s going to be like. My eagerness turned to worry as the EMT’s unstrapped the stretcher from the ambulance and wheeled it into the hospital. I hadn’t given much thought about what would be expected or how hard and painful it would be until we walked through the doors. Yes, I had taken a tour of the hospital and had met some of the staff before, but all that was discussed on that visit was the details of the facility and their therapy program. My confidence turned to insecurity as we approached the front desk to check in with Mark lying on the stretcher in a coma.

Picture from http://www.healthsouthutah.com. Formerly Western Rehab Hospital

The receptionist welcomed us and said Mark’s room was going to be in the special care unit right in front of the nurse’s station.  She directed us to go straight down the hallway. One EMT pushed the stretcher from the head of the bed while the other guided from the foot. My mother had followed the ambulance in her car and met up with us at the receptionist desk. As we walked by Mark’s side, I noticed a man in a wheelchair with his head bolted to a halo. The sparkling clean, wide tile hallway seemed filled with pain and suffering. I was overwhelmed by what some of the patients were enduring. Sights of treatments for injuries I had never seen before. Would I get used to seeing discomfort, agony and grief? Mark was in a peaceful coma; what would his recovery be like? Am I strong enough to handle it?

As we approached the nurse’s station we were greeted by Rita, a cheerful, friendly nurse who escorted us to Mark’s room. While the EMT’s were getting Mark transferred from the stretcher to the hospital bed, Rita opened the closet door and said, “Bring some clothes for Mark because we plan to dress him every day. He will need loose fitting pull over shirts and pull on pants with high top shoes. Socks and underwear can go in these drawers, along with any other personal belongings you want to bring,” she said as she pulled out one of the drawers on the left side of the closet.  She pointed to the white board on the right side of the closet. “This will be Mark’s daily schedule.” Written on the board was:

Therapy

9:00 am OT – Cheryl

10:00 am Respiratory

11:00 am PT – Leslie

Noon – 1pm – Rest

1:30 pm  Speech – Chris

2:00 pm OT – Cheryl

3:00 pm PT – Leslie

4:00 pm  Respiratory

4:30 pm Speech – Chris

10:00pm Respiratory

Sitting Up

Up – 11:00 am                   Down – 12:00 pm

Up – 2:00 pm                     Down – 4:00 pm

Up – 8:00 pm                     Down – 9:30 pm

Wow, what a busy schedule. How can Mark do all that? At McKay-Dee Hospital Mark didn’t have a set schedule, so I was thrilled they thought he could do it, yet flabbergasted at what seemed unrealistic.  In my mind I could see the doctor at Mackay-Dee Hospital, saying “I tried to tell you it’s too soon.” I pushed the thought out of my head as I remembered my first day of school and the overwhelming feelings of schedules and expectations. However, from the past I’d learned I could adapt, so I silently committed to help Mark in every way adjust to this new schedule and meet their expectations.

I was familiar with the range of motion routine the Physical Therapist (PT) would do with Mark at McKay-Dee Hospital, but I couldn’t imagine why he needed a Speech Therapist (ST) or an Occupational Therapist (OT).

“What will Mark do in speech therapy while he’s in a coma and has a trachea tube?” I asked the nurse as she detached the tube from the portable ventilator to the stationary hospital ventilator and hung his IV to the post on his bed.

“The therapist will come by and explain what they will do in their therapy sessions and the doctor should be in any minute now. Make yourself at home and let me know if I can get you anything.”

I sat in the chair next to Mark’s bed and Mom took one on the other side. I looked at Mark and was relieved that the move appeared to go unnoticed by him. He slept peacefully through the ambulance ride and transferring from the stretcher to the bed. He seemed unaware of his new surroundings. I was grateful to be in our home town of Sandy, UT.

A young, handsome man walked into our room and introduced himself as Mark’s new neurologist, Dr. Wright. He reviewed the reports he’d read  from McKay-Dee Hospital with us and we discussed the  treatment plan. His mannerism was gentle and compassionate. Immediately I felt at ease with him and confident Mark’s recovery was in good hands. He explained Mark would be completing the powerful intravenous anti-biotic in five days and he ordered all therapies to be done in his room until then.

“What will they be doing in respiratory therapy?” I asked, pointing to the schedule.

“The therapist will keep the tracheotomy cleaned and gradually turn down the ventilator, weaning him off of it. The respiratory therapist will help Mark learn to breathe on his own again.”

“What about speech therapy?” I asked.

“They use objects like bells and whistles to try to get Mark to respond to them.”

“Cool,” I said, hopeful and excited. This staff is planning for him to come out of his coma!