Fw: Daniel update
Topic: Daniel
SeNT: Thursday, April 07, 2005 3:22 AM
SubjeCT: Daniel update


Hello friends, family and supporters of the Miracle Man!

It's been 5 weeks since our last update and Daniel's progress has been measured but steady -- and remarkable. The giant steps made in the first few weeks have given way to "baby steps". But that's not a slowdown in his progress, it's just a measure of how far he's come!

We visited the Neurologist about a month ago and he instructed Daniel to begin reducing his anti-seizure medications by one pill each week. As of Monday (April 4th) Daniel is off all of his medications! He still takes Advil as needed for his shoulder and knee injuries, but the rest is history.

He has been going to therapy (PT, OT, & ST) -- three times a week/three hour sessions -- since he was discharged from the Acute Recovery Unit. The staff has been so pleased with his progress that they've set a date for his "graduation". Next Friday (April 15th) will mark the end of his therapy! He's been a cooperative patient and worked so hard that they are now releasing him to work on his own.

He is still susceptible to brain fatigue and must limit his activity/stimulation, but he's able to do so much more. His therapists have encouraged him to engage in "remote monitored" activities such as walks in the neighborhood. The other evening he took his cell phone and went out by himself. An hour and a half later it was dark and I was just about ready to call him when he came in the door. He'd walked all the way up to the highest point in the city (the base of the water tower). He was physically tired, but the sense of independence that he gained was a real boost.
Last weekend he went to his brother's house in the next city. It was his second overnight foray in as many weeks. He spent several hours gardening -- pruning, watering, sweeping, etc. -- at a nice meditative pace. Another good thing for this young man who so much enjoys nature and the outdoors. Being one who is acutely aware of what he currently can't do (mountain biking, snowboarding, rock climbing, mountain hiking, skateboarding...), it's good for him to take encouragement in what he can do. And that's a tall order for someone who has been "extreme" by most measures.

Daniel had no medical insurance. It doesn't take a rocket scientist to calculate that his medical care was expensive, to put it mildly. He applied for coverage under MSI and we learned just recently that he was approved and will be covered, effective January 1, 2005!

The hospital where he received his life-saving care and rehabilitation, Mission Hospital and Regional Trauma Center, is recognized as one of the best of it's kind in the country. We couldn't agree more! In addition to their unbelievable medical care they were completely supportive of our family in every way imaginable. They allowed us to take photos and video of Daniel during his stay and have requested permission to use Daniel's material in training programs! If you could see the forty minutes of video, taken over a 30 day period, you'd understand why. It's like a Documentary of a Miracle.

Daniel is a very intelligent, sensitive and hard-working young man who has always been very active. He 'knows' that he is a miracle, and is grateful for all of the support that he has received -- especially from so many friends whom he has never even met. Together with his family, you all have made the difference in his survival and continuing recovery. Please continue your thoughts and prayers for him. There is a big gap at times between what he 'knows' and how he 'feels'. His progress at this point is slow, and it will be 1-3 years before his brain and body can be said to be healed. He's come so far, so fast. When he's depressed it's difficult for him to remember that his life isn't over, it's just begun!

As always, thanks to all of you for your kindnesses and support for Daniel.

Fw: Daniel Update
Topic: Daniel

SeNT: Sunday, February 27, 2005 7:46 PM
SubjeCT: Daniel Update


Here we are, six weeks after Daniel's accident, and things could not be better! He's been home for 1 1/2 weeks and is adjusting to life and cooperating with the rules of his therapy and recovery routine.
He attends out-patient therapy sessions three days per week, three hours per day. His progress is just astounding! Though he's dealing with short-term memory issues and tends to repeat himself (hmmm, sounds like me!), his speech and mobility are doing well and his pre-trauma memory is completely fine. Earlier in the week Daniel and I were chatting after dinner. Somehow the conversation got around to Ayn Rand and I sat there in amazement, realizing that a TBI patient was discussing The Fountainhead and Atlas Shrugged the way most folks talk about a TV show! Just astounding.

His therapists have noted his improvement physically and have expanded his activities to include walks around the neighborhood on the days that he doesn't have therapy sessions; helping with light household chores; taking showers while standing on his own; and even a short trip to the grocery store. Today he went to his brother's house for a visit.

The main issues of concern continue to be short-term memory and multi-tasking. We're seeing small, steady improvements in these areas and appreciate his positive attitude and cooperative spirit.

Oh, one more thing. On Thursday he baked cookies (supervised) and took them to the staff at the Trauma Unit on Friday! They continue to be as amazed and encouraged by his progress as we are.

Again, thanks to all of you who have been so supportive during these last months. He truly is a Miracle Man.

Fw: Daniel's farwell
Topic: Daniel


SeNT: Wednesday, February 16, 2005 1:29 PM
SubjeCT: Daniel's farwell


Before we left the hospital today, we took Daniel up to the Trauma Unit on the fourth floor to say thanks to all of the fine folks up there.

In the photo are Nurses Gil, Lori, and Allison.
And Daniel.

Fw: Daniel's coming home
Topic: Daniel
SeNT: Wednesday, February 16, 2005 8:52 AM
SubjeCT: Daniel's coming home


It has been another week of progress that defies the 'norm'.
Daniel will be discharged from the Acute Rehab Unit today! We'll be bringing him home around noon.

Yesterday was the big teST: One of the therapists accompanied us on his first "outing" from the hospital.
We picked him up at about 10:30 and drove a couple miles to a Food Court at a local shopping center. The time of day was chosen so that the crowds would be at a minimum and not overstimulate his battered brain.
Daniel decided that Chinese food sounded good.
As we walked from the van to the restaurant I was nearly overcome with emotion as I watched my son moving under his own power. (A couple of days earlier he was given permission to walk to the restroom and dining hall without assistance, which were HUGE steps in his progress -- and great confidence builders for a very independent and self-reliant young man.) His slight unsteadiness is probably not even noticeable to the casual observER: it's similar to most folks after a couple drinks at happy hour. = )

Daniel walked up to the cashier and ordered from the take-out/dine-in menu. After all five of us had ordered and taken our seats, the therapist tested hIM:
*Do you remember how much your lunch cost? (yes, $7.48)
*If your dad hadn't paid, how much would you have given the cashier? (I have two $5s, I'd have given her both of them.)
*And how much change would you have received? ($2.52. I'd have put the two dollars in my pocket and the 52 cents in the tip jar on the counter.) Short-term memory and problem-solving skills are improved when he's not tired. Silly overachiever....

When the meal arrived, the therapist asked the server if we could have chopsticks. "How many?" Daniel added his request to the total.
Do you have any idea how it feels to sit and watch what followED: A young man who, two weeks ago could hardly use the right side of his body, eating lunch with chopsticks!?

The stress of the outing was fatiguing for Daniel but he did quite well. It was the longest period of activity that he'd had so far -- and his first ride in a vehicle. The therapists have been playing with his schedule during the past week, sometimes doing back-to-back sessions (OT and/or PT & ST) to simulate the increasing stresses of life 'on the outside'. The goal was not to exhaust or push him, but to measure his progress. They always end a session early if he shows signs of Brain Fatigue. REST is the best remedy and TIME is the healer.

Last week it was planned that he'd have home-therapy for the first few weeks or months and then graduate to three-hour outpatient sessions at the hospital. That has changed. He'll go in for an evaluation at the rehab tomorrow morning and they'll set up his schedule for M/W/F beginning next week as an outpatient!

All of us, including the medical staff from Trauma and Rehab, are amazed at his incredible progress. Our 'favorite' trauma nurse came down to visit him twice last week. She mentioned that it's so rare to see an outcome this good, this fast, and the entire Trauma Team is taking great encouragement from his case. (And she's a cutie, too. Bright, articulate, caring... but enough with the matchmaker stuff!) = )

I'll post some photos a bit later. They'll give a time-compressed view of the past month.

Again, our thanks to everyone for your prayers, emails, cards, phone calls....

Time to shower and go bring home our Miracle Man.

Fw: Daniel update -- Great news!!
Topic: Daniel

SeNT: Tuesday, February 01, 2005 4:53 AM
SubjeCT: Daniel update -- Great news!!


I got a great night's sleep last night. (We kept telling Daniel to wake up so that we could have a turn!)
For those of you who only have time for the highlights, I've used boldface type so that you can scan quickly and skip the details.

Saturday and Sunday were rough days. Daniel was somewhat awake and could communicate by facial expression. With the tubes from the ventilator going down his throat he was uncomfortable, but didn't fight them too much.
Saturday's biggest battle was coughing and gagging. As the morphine & other drugs wore off he needed to adjust and had a difficult time. He's on Methadone to ease him over the withdrawal from morphine & Ativan.
Then Saturday night he began having episodes of muscle contractions. They came in waves and reminded me of the labor of childbirth, except all of his body was involved. His pulse would jump from 65 to 130. It was necessary to put his arms in restraints so that he couldn't accidentally pull out any of his lines. Barb & I and his mother & sister took turns working shifts at his bedside. We'd gently massage his feet and hold his legs so that he didn't kick himself right out of bed.
On Sunday the staff began talking about removing his ventilator tube. The Methadone protocol was adjusted so as not to suppress his breathing and they tested him to see if he could breathe sufficiently on his own. The first tests indicated just a bit too little volume and pressure when he wasn't assisted, so they were going to wait until Monday morning and re-test.
During her shift in the 'wee hours' on Monday a.m., Barb noticed that the severity and duration of his contractions seemed to be lessening. As daylight broke, he was almost through and was able to manage himself with only minimal help. Wahoo!
At the shift change (7 a.m.) on Monday they tested his breathing and decided to remove his ventilator! What incredible progress he's made in only a few short hours. I left work and arrived at the hospital at noon. I found Daniel smiling weakly with only a nasal cannula and one IV line; his bed turned so that he could see the two large posters with photos of Daniel's life; the noontime sun was streaming into his room -- now nearly devoid of the forest of medical machines!
The doctor in charge of rehabilitation came in to assess Daniel at 1 pm. Having not met Daniel before he wasn't prepared for the surprise of such an alert young man. Although it was difficult for Daniel to speak because of the recently removed tubes, he did a good job with the assessment questions that the doctor asked him. He's a little slow in responding and has to think out his answers, but did really well. Even got a little creative for the doctOR:

DOC: Daniel, I'd like for you to recite the alphabet, but skip every other letter. Like "A, C,..." Can you do that for me?
DaniEL: (pause) "Automobile, Camaro,..."
Yeah, that's my boy. = )

He's doing so well that they are going to assess him later in the week and might transfer him directly to Advanced rehab and skip the transition to the Medical Floor.

After 18 days of darkness, the dawn has arrived. We're exhausted! But Barb & I have to admit that we couldn't have made it this far without the support and prayers of so many friends (and strangers). And then there's Daniel. I feel like he's been re-born.
Maybe we'll send out birth announcements....

Fw: Daniel after two weeks
Topic: Daniel

SeNT: Friday, January 28, 2005 2:32 PM
SubjeCT: Daniel after two weeks


The past couple of days have brought some changes for Daniel -- some subtle, some more obvious.

When you walk into his room there is more spaCE: fewer machines! He's still on the ventilator and will continue to be as he's weaned off of the heavy doses of morphine. But several of the other monitors have been removed as his condition has stabilized. (Later I'll post a couple of photo for those who would like to see the difference that three days can make.)

He is finally tolerating his liquid nutrition. There had been problems placing the catheter that went down his throat, through his stomach and into his intestine. Yesterday they finally felt that he was stable enough to endure the procedure to get it placed properly. He has lost considerable weight (and he was *very* lean to begin with!) and they are giving him I.V. as well as G.I. calories.

The two I.V. lines (one in his chest and one in his lower arm) have been replaced by a single line in his upper arm that threads into his chest. Last night they adjusted the ventilator to begin weaning him off of it -- he needs to begin breathing on his own.

The fluid in his sinuses and lungs continues to be a concern, but he's on two antibiotics to address that issue.
The sterile blue surgical wraps that were on his head have been replaced by a 'stocking cap' which covers the rows and rows of surgical staples in his scalp. We had the opportunity to view the CAT scans again yesterday and to see the extent of his skull fractures as they appeared when he arrived at the hospital. I can't comprehend how he survived. What a miracle! The CAT scan taken before his surgery shows that the bleeding in his head was so severe that the centerline of his brain was pushed over to the right. What a mess.

He continues his sluggish attempts at semi-consciousness, opening his eyes when his name is called. The medical staff is now encouraging us to keep talking to him and touching him, encouraging him to wake up. We're happy to do that!

Again, our thanks for all of your prayers, emails, phone calls and kind thoughts.

Fw: Daniel opens his eyes
Topic: Daniel

SeNT: Tuesday, January 25, 2005 6:51 PM
SubjeCT: Daniel opens his eyes


Yes, you read that correctly.
Yesterday the medical staff decided to lower the medication that was keeping Daniel in a deep coma (and allowing his brain to rest and control the swelling). The pressure had been much more stable over the past three days and they felt that this was a good sign that his swelling was not increasing. (They had been monitoring it closely and draining the cerebrospinal fluid frequently.)
This morning his nurse had a surpriSE: He opened his eyes. He's still on heavy doses of morphine and Ativan so he's anything but responsive. His eyes aren't focusing or moving, but he opens them when sounds in the room disturb him. The neurosurgeon came in a while later and removed the ICP sensor/drain from his head!
This afternoon while the nurse was changing the dressing on his head he actually moved his head slightly. And later he was moving his legs a bit and then one arm slightly. He even squeezed his mom's hand, though it was probably more reflexive than conscious.
We are ecstatic!!
Tomorrow they'll begin lowering the dosage of morphine. They'll do it slowly, adding Methadone to help avoid painful withdrawal symptoms.
This has been a huge day of changes for Daniel's condition. It reminds me of the excitement of his first steps as a toddlER: a great beginning on a long road.
We can hardly wait to see what tomorrow will bring....

Fw: Daniel's best day
Topic: Daniel

SeNT: Saturday, January 22, 2005 4:31 AM
SubjeCT: Daniel's best day


Thanks to all of you for your prayers and kind words regarding Daniel.
Although he remains on life support and in a coma a week after his accident, yesterday he had his first 'stable' day. The swelling of his brain appears to be under control and the infection in his lungs is responding.
Our family is truly touch by the support of so many friends. May God bless you as he has us.

Fw: Daniel, day 5
Topic: Daniel

SeNT: Tuesday, January 18, 2005 7:32 PM
SubjeCT: Daniel, day 5


Where to begin....
He's still with us, but not doing well. Still critical, still in a coma.
Yesterday was a pretty uneventful day, which was a good thing -- no hiccups. He had a CAT scan (scheduled) and it showed no significant changes from his last one.
During the night he began having more brain swelling. By morning they ordered another CAT scan; induced a deeper coma to minimize brain activity and metabolism and rest it; administered mannitol to help reduce swelling. He seemed to respond to these measures as indicated by the pressure monitor implanted in his brain.
By late this afternoon the pressure was again rising in his head and his temperature was rising. They are concerned about the crud that they are suctioning from his lungs and sent it for lab tests. Aspiration pneumonia/infection may be an issue.
If they can't get the swelling in the brain under control they may have to remove part of the skull (temporarily). Tonight will be crucial.
They are also leaning towards a tracheotomy to replace the vent tube through his mouth and down his throat. And they want to insert a feeding tube through his abdominal wall. Neither of these two procedures are a matter of emergency, just better care/comfort for the weeks ahead.

Thanks to everyone for all of your prayers, notes, & kind words of support. It means so much to us to have so many friends carrying the load with us.

Daniel 3
Topic: Daniel
FrOM: Jill Kessler
TO: GSRC@yahoogroups.com
SeNT: Sunday, January 16, 2005 10:30 AM
SubjeCT: [GSRC] Daniel


Bret, while that is still all so overwhelmng it's all good news. It sounds like he's receiving the best care possible, and time and God will tell us how he will fare. But still, you're heart must feel like it's in a vise every moment of the day.
That pretty well describes it. Just moment-by moment.

How's Barb holding up? Is he still on the ventilator? Is he out of the critical zone yet?
Barb's hanging in there -- we're sharing that vise.
Yes, he's still on the vent. And still critical. But we made it through the third day which is often the most difficult in terms of post-trauma brain swelling. It'll be day-by-day for a while.

Tell Daniel, even though he's not awake, "To keep fighting the good fight" for me. Make sure you tell him that he will NOT leave this physical world at this time, that you forbid it! Or perhaps some empty promises such as "I'll buy you the new Lamborghini Diablo when you wake up." Some dumb jokes are always good, or stories of Onyx and Barb (which amuse me and Bev endlessly).

I took a couple of books to read to him. But that will come later. Right now they want minumum stimulation of the brain. Any electrical activity in the head requires oxygen, and they want to save any O2 for just living at this point. So we whisper when we're in the room.
He's less interested in fancy cars than most guys. He might respond to a promise to climb Half Dome or hike the Olympic Rain forest. Or share a week camping in the redwoods. He loves working in the yard, planting and growing things. Damn, he reminds me of me.
Ah, Barb & O-man. She's concerned that he gets enough "quality time" during our burnout-at-the-hospital. So she locked me in the bedroom (sleeping) with Havoc & Kaj and brought Onyx upstairs to hang in the livingroom with her and Majik. After her sniffed around the kitchen and dining room he just laid down next to her chair.
They are really doing well together. (I don't think she's anywhere ready to slip the choke chain around his neck and take him for a walk!)
Your family is constantly in my thoughts. I can give you Jack if you need a little boy to run around the house and demand Mac and Cheese.

Thanks.
Barb made Mac & Cheese last week. She's a wonderful cook and it's always a hit -- so tell Jack he'll have to stay home.
+ )
Off to work....