Thursday, February 21, 2013

Feb 20-21: Daddy Coming Home?!

Well, today is day 4 of our new routine...

This part of the post isn't so much about James' recovery- although you'll get some new exciting information in a minute- but about us back at the home front trying to make things smooth for his (imminent!) return!

This past Monday morning was the dawning of a new program for change in our household. With James coming home soon enough, I wanted the house to run more efficiently and with less hounding from me for things to get done. Of course, I also don't want crap laying around the floor for James to trip over.

I laminated some charts, got some money in dimes, and divided it up between four jars.  I gave the kids a weekly responsibility and two monthly chores. Then they would rotate to a new responsibility or chore, so they could all learn all the stuff for the household. Plus they are all making their beds now I had to teach them.

This is just adding to their normal jobs like brushing their teeth, cleaning their rooms, putting away laundry, putting away school stuff, cleaning up toys. etc. So the way it works is this:

The money is in the jar. If you do your jobs
  1. without complaining
  2. all the way- not half way or shoddy
  3. right away
then your dime stays in the jar. If not, then it goes in my jar. If you forget to do it, you have to do it anyway but no dime. If you say stupid or hate, you forfeit a dime. If you help a sibling or do above and beyond, you could get rewarded with a dime from mom's jar.

It has been fabulous. Right this minute, my coffee table and kitchen table and carpet and end table and kitchen counters are all clear and clean. All the animals are tended to, and everyone just jumped on board with a willingness to get it done and keep their dimes. Woo hoo!!

Wednesday, February 20, 2013

Today James was scheduled to have a meeting, called an IDT, which stands for Interdisciplinary Team. It consisted of about12 people who looked after James in different ways. The pharmacist, the OT lady, the PT lady, the dietitian, the social worker, the RN assigned to James, the "umbrella" DR who is over James, the recreational director, and at least 4 other people were in a conference room. Every 90 days a veteran goes in and they go over the Care Plan for the patient.

I was joking with James that it was going to be like the scene from Shawshank Redemption, where Morgan Freeman's character goes before the parole board to try to get approved. Well, it might have been that way for the veteran before or after us, but not James.

We went in. Everyone was glad to meet me- I have only been going up at nights, in Temple, so I hadn't met anyone really. Then I flopped my big three-ring binder open on the table. If they were less glad to see me, it didn't show. (And as a side note, why is everyone I meet stunned to see I am not a wizened unattractive hag?! And feel they have to say so? It's getting old.)

They went around the table one by one talking about James' progress and then next steps. I was most interested in what PT had to say- that in 2-3 weeks, James would get a weekend pass to COME HOME! for a few days and see what was up with the house, what was difficult to do and what was hard to manage- the shower, the steps, the porch, whatever. Then they would give him tools and send a contractor to fix the stuff so he could maneuver better. Then a week or so later, he WOULD BE DISCHARGED to the status of an outpatient!!

I told the PT woman that I trusted her but that I wanted her to tell me that James' request to do PT twice a day wasn't going to damage him or actually slow his recovery. She said it certainly wouldn't. It's 20-30 minutes a day.

The attitude, the electricity of the room was nearly tangible. The team was loving the fact that James was a strong, motivated young man- healing, pushing boundaries, doing his assignments (like exercises in his room during the day). I have said before that every other veteran there is older than James by about 30 years. They actually said 'stay, so we don't get a grumpy difficult patient after your bed is empty,' but we told them NO!

We got all our questions answered and all our concerns addressed. So that was an exciting day.


Thursday, February 21, 2013

Then, today! James called this morning and told me that PT said for him to bring socks and sneakers in... he needed better traction for walking. What!!! Cornell took Jackson and Lily up for the day- with socks, sneakers, enchiladas, tetrazinni, an Odwalla protein drink, and some veggie juice I made that morning. James and the kids played Uno and chess and hung out. Then James was scheduled to go to PT. They all got to go, to watch.

Tonight James calls me. He sounds exhausted. He has just called his nurse for morphine, the first shot in about 5 days. He says, "I walked today."

I shriek and ask a hundred questions. "Did the kids see? What did they do? How far? With what? Like, limping walk? Did it hurt? How did your wrists feel?"

He said the kids were there, and they were jumping up and down and cheering him on. He said he was totally crying. I asked if their cheering made it hard or easier to walk. He said he was so encouraged that the PT instructor told him to slow down.

I just about fell over when he said how far. I was expecting it to be maybe 6 feet or so, or 6 feet and then turn around and go back, but he said HE WALKED NEARLY 60 FEET!! This man, his determination- is unbelievable.

I've always said that he always gets what he wants. If he decides he wants it, nothing is going to get in his way to get it- it's exciting to see him want GOOD things and GOOD activities!!

He also told me he used a regular walker, not the arm support one I showed you previously. He was wearing his wrist brace on his right arm though. Cornell told me, with her eyes bugging out, that she just couldn't believe how he was progressing.

It was exactly a month ago today that the nurse let us sneak the kids in for their first visit. It was a month ago today that James first remembered the day before. And here he is, walking.

Praise the Lord.


Monday, February 18, 2013

Feb 8-18- General Update

Well, where has the time gone- over two weeks without an update?!

I guess that shows two things- how stable James is, and that this really is the ONGOING recovery.

I'm not even going to attempt to cover each day since I posted last. Prayer requests are at the bottom of the post. Here are points of activity that I remember:

PT is every weekday.They ask James to do 3 leg lifts, or whatever, and he does 6. I assume they will stop him or dampen his enthusiasm if it would hurt his recovery? He wants to get out of there as quick as he can. On the one hand, I want him to work hard when he has serious meds available and a quiet place to recuperate after a workout. On the other hand, I want to make sure he won't injure himself or slow his recovery by pressing too hard.

OT seems to be every few days. They issued him a hip replacement kit- see above. It has all sorts of tools to help him get stuff done himself- reach things, put on socks, etc. They gave him a finger strengthener tool (it's also in guitar magazines), and two foam cubes for squeezing. One is harder (less porous?) than the other. She said the average hand strength for a man his age is 120. His left hand is a 20 and his right hand is a 50.

If initially James was upset/disappointed at his VA assignment, he has decided that he thinks it's a good setup. The things we were concerned about- medicine timeliness- has turned out to be ok. He is able to get up in bed, put his legs off the bed, and transfer safely to the wheelchair himself. He can eat and pee himself. He even rolled himself out into the rec room and got his groceries and made himself food! Here's a wrap he made with muffaletta (olive tapenade) on all sorts of crazy meats I had to wait in line at the deli for.


He was initially keeping to his room all the time. The curiosity of the other vets was nearly palpable. They were trying to figure him out based on watching me and Jenni and Cornell come and go. He couldn't sit in the wheelchair for long, and is sometimes anti-social, and was stressed. I'm sure it was a downer that he was the youngest man on the wing by at least 30 years too. I didn't want to push it, but every other one of those men ate every meal at the table with each other except James. Now he is still in his room 80% of the time, but he is out in the rec room sometimes and knows all the men's names now.

Then of course, Jenni went back to Louisiana for two weeks or so. Gotta bring home the bacon, and check in with her peeps (Is peeps plural? I am so old/uncool). So we have had to adjust the "visit James" schedule a lot. Instead of the three of us switching up, it's Cornell and I. The kids need me more in the day, so I stay home with them and we do school and run the house. Then every few days I go up to Temple in the early evening and James and I eat together and have a sleepover. We listen to stand-up on Pandora and watch Walking Dead every Sunday night. Cornell goes up every few days. It's been up and down for James having so much more time alone, but even with the low points he thinks it's good for him.


Here is a picture of Jenni and James when she was getting ready to leave for the day, and fly home the next day. You can see his eye seems swollen underneath- he describes his new look as "Wrong end of a broken bottle fight" or "Russian prisoner." He can't wait to stand in line at HEB, get no questions, and scare little kids. He says.

He is just getting a look at his scars this past week or so. I was shaving his head and his face in his bathroom. We were up in front of the mirror so I could reach the electric outlet, so he was staring in the mirrow. He thought his scar from his clavicle repair was a shadow. He wanted me to take a picture of where the brain drain was inserted. When I showed it to him, he finally saw his scalp- his scars from the facial surgery. He called it "knarly."
Here's his scar on 1/16/13
Here's his scar from 2/16/13

He has been pretty adamant about getting home as soon as possible- so he starts PT twice a day tomorrow.Yikes! I hope they know what they are doing, but you can be sure I will ask. He is really amazing- he can bend his left arm a little beyond 90 degrees! He is working on increasing the twisting action of his wrist, which is really tight.  He can lift his left leg up really well.

Prayer requests:
  1. His left knee gives him a lot of his pain. When he had his femur set, they moved his broken patella aside to  jam  insert the long rod in his femur.
  2. His face is numb on one side. He can only flare one nostril! He can't feel above or below his left eye. He can't feel his upper left lip or his forehead on that side.
  3. He can't smell anything, and it interferes with his appetite and enjoying food.
  4. The top of his right leg is tingly and sometimes numb.
  5. He really misses the kids, but since our visits don't overlap anymore, it's more of a chore to bring them up for just a few hours. And the gas prices!! 30 cents higher since we left Brack!!
  6. He gets fatigued sitting in the wheelchair for very long. His TV sound is broken and we watched Walking Dead in the rec room this Sunday, and he barely made it through.
  7. He is doing really well not using the morphine. He doesn't want to become dependent on the other pain meds either- but he can't imagine not taking those at this point, especially with PT. 
  8. His pain is frequently a 6 or 8, on the scale 1-10.
He isn't on the mechanical soft diet any more, but he isn't eating off his tray very much either. He is drinking vegetable juice I make him, or Odwalla protein smoothies, or frozen fruit smoothies in the little blender his mom brought with her. He's still requesting food from home- could you expect less from a chef like him?

He has had a couple of visitors in Temple. His landscaping partner has come to visit a lot, and a few others. It's about 45 minutes north of Round Rock. He has been really grateful to have his phone replaced and service turned on. He can call people and get company when no one is able to come up to see him. Many people have sent him cool texted photos of their life and surroundings- weird or beautiful things they see when they are out and about. You can do it too, his number is (512) 797-8105. Be sure to tell him who you are if he doesn't already have you in his phone!

If you go see him, it's north on I-35 to exit 299. Get on 190 until you see the exit for 1st-5th street. It'll take you off to the right for a hairpin turn over the highway. Turn right at Avenue R and then you'll see the  VA on your left. Turn in, stay to the left of the flags, and park in the left lot over there. Walk in under the overhang- where they have valet parking- and go through the carpeted foyer, past the piano, to the elevators. Go up to the sixth floor and then go to the left down to the wing called Chisolm Trail. He's past the nurse's station and both rec rooms, on the left wing, in room 06. Of course, if you want to mapquest it or whatever, put in Teague Tower, VA hospital, Temple, Texas. South First Street and Veterans Memorial Parkway are the same road.


Thursday, February 14, 2013

Valentine's Day

Here's a quick poem from James which he wrote around Thanksgiving 2012.

Mere words defy your love.
Core to my foundation
You are the roots to my leaves.

When you catch me staring
I'm pondering the Grace of God
and its endless bounds.

I only hope that when I meet Him
I have something to show for
his blessing of you to me.

Proof of his mercy lies in my unworthiness.

The wonderful thing about fruit
is that we may be blessed
with another season to improve
our
harvest.

Thursday, February 7, 2013

Feb 5-7 -A Quick Update

Tuesday, February 5 
Today was James' first day at the VA in Temple. It was a mixed bag. There are pros and cons. I spent the night last night and I also spent much of today with him to get the feel for the place.

The nurses report that they don't bother the patients pretty much at all during the night. They give you meds but they don't take your vitals every five minutes. So he will get rest. The meals are still "mechanical soft" so that means tasteless and pre-chewed. He's been demanding requesting certain foods from home: it's a good thing his sister and his mom can cook. So far, egg salad and fettucine alfredo.

He was weighed and has lost another 17 lbs, putting the total for 5 weeks at 42 lbs.

The dietician came by and said since he can't have whey-based protein supplements she would try a clear drink and yogurt.

The nurses are less engaging and have more patients so they never come with pain meds on time. It's been a huge problem.

There is a fridge where we can put James' food and if we keep relabeling the date they won't throw it out. And James thought of bringing in his Camelbak and hanging it from his bed so he can get a drink whenever he needs more easily than a cup. How's that for traumatic brain injury?!

He has locking drawers and cabinets in his room so I put anything of value in them. Then, of course, I have to find the key. He sleeps really well when I am there and the kids need me so I have been spending the day with them and sleeping at the VA with James. There isn't paid parking at the VA but the drive is further. Thank you, THANK YOU for anyone who has given us a gas card!!


Wednesday, February 6 
Jenni and Cornell took Lily and Jackson up for the afternoon. James helped Jackson with math on his bed and wiggled Lily's first loose tooth.

James had a great idea to send him pictures over the course of the day of what we're doing or seeing so he can "get out and about" vicariously through us. So I sent him text pictures over the course of the day. If you want to encourage James this way, send him a picture or give him a call at (512) 797-8105.

James' physical therapist came by and did some assessments and gave him some elastic bands to exercise his arms with. He said James will be able to put full weight on his left leg in April, until then it is only a quick toe touch to shift weight to his good leg.

 Thursday, February 7

Because James broke both his wrists, he can't lean on a conventional walker. He needs what is called a platform walker, and the difference between it and the other are these forearm supports pictured above. This way he gets support to stand (and eventually, walk) without further damaging his healing wrists.

Here is James in his first "real" PT session- he's standing bedside with the support of the platform walker, doing leg lifts (from the knee) with his left (bad) leg. Then he sat in the wheelchair and went to the PT room. (you can see the line of hair on his scalp over the stitches from his facial surgery. I shaved his head and had to leave the hair over and next to the stitches so it left an interesting... "look." Doesn't the back of his arm look unremarkable at this distance?!)
 It has all sorts of gear and equipment. He sat in his wheelchair and they put weights on his ankles- about 5 pounds maybe. He did alternating leg lifts- 20 each leg. Then he did kicks- 20 each leg. By then, he had broken a sweat.

To me, this would be expected. But the therapist jumped up, got a wet washcloth, and took his BP. She used an arm cuff on his lowest right calf. (Because his right arm has a PICC line and his left arm is so injured, they take his BP on his right calf.) She was using the wrong size (not a leg cuff) and he was in a sitting position with his leg, obviously, below him. His BP was something like 168/124, I forget- pretty high. She raced him back to bed and took his BP on his leg with the right cuff, laying down, and it was 124/76. We had both explained he just sweats a lot, but I guess she was better safe than sorry. So he got about 30 minutes in today. Every day his PT is at 2:30 so you could pray for him then, and after, when he's exhausted/recovering.

Early this morning they took a blood sample to analyze his pre albumin? albumin? levels. Any number over an 18 is what they want to see. It's a measure of ?available protein? for repair and rebuilding. Anywho what matters is James' level was a 24! So he's getting enough protein. Trauma patients need a lot of protein to heal. James can't digest whey so many protein drinks make him sick. We've been bringing him food from home so we've worried wondered if he's getting enough. And he is!!

Mon Feb 4- VA for Rehab

Well James was given about half an hour notice and then was put in an ambulance and brought to Temple's VA hospital, Teague Tower, for his rehabilitation.

He was very discouraged at first. They put him in a semi-private room with an old guy and then moved him to a private room. I guess there is at least one advantage to having a large loud young family!

His mom was with him when the transfer happened, so I didn't get up to Temple until  the first night. He's on the sixth floor. His wing is called "Chisolm Trail." It smells... the halls smell... like... old hospital, I guess. When he was wheeled in, he surely saw the labels "Nursing Wing." Like, nursing home. Average age patient is 65 or so. Mostly amputees. All Army vets at the moment. Two rec rooms, with large square tables, with some sort of clear polycarbonite covering assembled puzzles as decoration. Your last name and the emblem from your branch of service is in a slidey-plaquard thing on the wall outside your door.
His room is an interesting shape. It has a little lobby made by a curtain. Then there is his room, a rectangle, where the bed is, jutting out into the center. Then there is an alcove corner behind that with a dresser and a rocker. He has a window overlooking  a couple dozen American flags and some of the fine sprawling town of Temple. Did you know that "Temple is home to more physicians per capita than any other community in the nation?" I certainly didn't! His bathroom is FABulous- he has a wheelchair that goes right into the shower. Did you notice the heavens break open before you and the sound of angels come down yesterday? Cause they did over Temple when James had his first hot water shower in 36 days. Aaah!

There were a few reasons the transfer was hard on James.
  1. the social worker that day at Brackenridge had no social skills when she told James about the move.
  2. remember how tired he was after a 10-min foray to the 1st floor garden last week? Multiply that by 12 or 15 and that's how long the transfer to Temple took. 
  3. when he arrived at Teague Tower he had 3 physical assessments in a row by different people. Exhausting.
  4. he wasn't in their computer so his meds were put off. His pain got to an 8, usually it's at a 4. It's much harder to get back down from a high number.
James was at first quite dejected and unhappy with the whole situation. But soon enough he began to react in his new mindset- looking for God's will in the situation and wondering who he was there to influence with his story.


Monday, February 4, 2013

Helping Healing Naturally

This is half of the bruise January 2. It extends under and to the inside of the left thigh. They said he lost 4L of blood,
but none of his broken bones broke through his tough young skin so the blood just puddled under the breaks.

My first secret weapon is ARNICA (see flowers on left).  It is arnica flower extract held in a white petrolatum/paraffin base. On the package it says that it is for dry skin and abrasions.... but it has a magical effect on bruises and bumps. This stuff makes a goose-egg lump flatten really quick. It makes new bruises dissapate within a week. It makes old bruises break up more quickly. Put it on any kind of swelling and it really helps...I've been putting it on his thigh and left arm (where there is intact skin only) to reduce swelling and it is remarkable how well it is doing. The nurses couldn't believe how quickly the bruise on his thigh was healing.

After he started PT/OT every day I amped up the arnica use. I got another gel that included comfrey, boneset, and other plant extracts like calendula. I also got homeopathic pellets that dissolve under the tongue. In addition, I looked for liquid arnica for him to ingest but could only find a distillation in 76% alcohol. I'm still looking locally.

Kids Visiting Dad

James' new dimple.
All the kids at once!
Each day, a fight about who gets to push the buttons.
Angie Hatla ordered these to remind people: PRAY!
Keeping quiet... night view of Austin.

Sunday, February 3, 2013

Jenni and Cornell

I just wanted to post an official Fan Club post for my MIL and SIL.

They are awesome. We've been pretty much splitting James 3 ways- each taking a turn with him. That means they are with the kids a lot too. (Our house is a form of birth control for poor Jenni, who is 21.) They do school work with the kids. They keep the kitchen and the house under control. They do laundry. They feed the dogs. They are positive and encouraging and upbeat and funny. They rub James' feet waaay longer than I do, and are actually good cooks and make him the stuff he requests to make his calorie count.

In short, THEY ARE AMAZING!!

Cornell was in a terrible wreck a few years ago- T-boned by the Excursion I want (dude, it was a drunk illegal alien going about 50 with his lights off, could it have been worse?!) She broke her pelvis in 6 places and a bunch of other bones. She had PT/OT and had to go to rehab at a nursing home. James went to visit her in her recovery and he was amazed at her spirit. She constantly amazes me with her persistent optimism. Anyway, she has first-hand knowledge of what James is going through.

Jenni is James' little sister- by 13 years. She was there for her mom's entire recovery and has a lot of experience from that side of the bed. She is really mature and has been great with the kids. Because our house is so big, she has her own room and bathroom, which she has personalized and arranged just the way she likes. She is going home for two weeks on the 11th. She is a big breadwinner in their house and needs to touch base with her friends, job, house, and cats. Don't worry- it's a round trip ticket. (whew!)

James is blessed to have such women on his side!


REHAB LOCATIONS

So the VA was giving us the runaround.

The VA called Brackenridge Thursday January 17th. Then nothing. The case worker on our floor- first when we were in step-down ICU, then on the OT/PT 8th floor (where we are now), they were calling everyday to get James a spot at the VA rehab facility in Temple. We officially applied via fax on January 25.

Evidently the VA doesn't say "NO" they just say "Uh, we're looking!" forever, until you give up. PT/OT started talking about training Cornell, Jenni and I on James' rehab so we could do it at home, ourselves. They said, "Install a ramp or two and call in that offer of a wheelchair, walker and shower bench that someone offered you." This was terrifying. They certainly didn't say we were left to our own devices, but they kept saying "Two weeks."

This is also the same day that James has a visitor who was in a motorcycle wreck over a year ago. He said he couldn't afford rehab so he went home and did it himself, incorrectly, and now his legs healed wrong and he has chronic back pain from healing crooked. Greeat.

On Tuesday January 29th, the case workers gave James a form letter to his congressman to sign with a Sharpie. They said "we don't give up and we'll continue to call the VA, but start thinking about applying for Medicaid and going to a  crappy, dangerous  other facility. And get that ramp installed." ((shudder)) "Also, " they add, "If you know anyone who can get things done, call them. Call your primary care physician and get a referral to Temple if you can." I begin to play phone tag with James' PCP's nurse.

Within the hour, the congressman's secretary called to get more information. I manage, in about 5 sentences, to give her an update on his wreck and recovery. Also, in another 3 sentences, I explain that he's a disabled veteran who served his country at the NSA and stayed at his post on September 11th even though they thought it could be the next target. She's duly impressed and hangs up.

Then Friday the first of February comes. I'm at a surprise birthday party (it's for me- I'm 34) at the kids' park day with our homeschool friends. Earlier, when I was at the mall getting James a new phone, I had gotten a voicemail from James' PCP's nurse with the names and phone numbers to THREE REHAB FACILITIES IN ROUND ROCK THAT SHE IS AUTHORIZED TO SEND JAMES TO. SHE SAYS PICK ONE. Back at the playground, at my birthday party:

Michelle, my handler, comes up to me.

"Where's your phone?" she asks.
"Uhh," I say
"Your sister in law is trying to reach you." she smirks.

I call my SIL and she shrieks "They want to move James to Temple Monday!" It seems the letter to Congressman Carter has gotten us a space at the VA Temple.

I tell her about the voicemail. I call the case worker for James' floor and tell her the names of the Round Rock facilities. She says she will call each of them and apply for James and then we can chose one.

at Hester's Crossing behind La Frontera in RR
ROUND ROCK RELIANT REHAB!!

Please pray that we will get this facility. It's brand new, less than 3 miles from our house, has a pool for recovery, and is the one that James can get the best PT/OT at. The other facilities are prettymuch for old folks with a broken hip. We already discussed that the other ones are rated 5 stars, and that he could be a ray of sunshine for some old person, but I, we, really want him at the best facility for his recovery.

Please stand with us before the Father Physician God who hears us and has James' best in mind.