Family life after traumatic brain injury

Survivors

2009-02-25T09:25:00.014-06:00

Mark's first horse show in years
Top Hands at the Houston Rodeo
2nd in English equitation!

And as soon as we came home, we trimmed and hauled limbs for heavy trash pick up next week. I did the artistic work (the trimming) and Mark did the heavy lifting.
I joked that I'm the ATV (able to get around in the grass easily) and Mark's the Ferrari, very much prefering concrete. Unfortunately, the gearbox is broken and he's stuck in the lowest gear.
He hauled all these limbs.

Here's some more survivors. I have under one crepe myrtle snapdragons and pinks that hung on last summer, after being planted in early 2008. Under another crepe are several native violets.

Dozens of cilantro plants have sprung up all over the yard since the mama plant died last summer.

And the loropetalum (Chinese witch hazel) throbs in full, hot pink glory.

New stuff and some old, too

2009-02-18T08:36:00.006-06:00

New recumbent trike - very cool!

Some of the rest of us....

See below for thirty years ago!

Executive (dys) function revisited

2009-01-30T17:22:00.002-06:00

Getting out of bed, starting the daily routine, making plans for the day, returning to the routine if interrupted or distracted, moving onto the next item, striving to conclusion, and recognizing when a task is complete; these are some of the "executive functions" of the brain. Recognizing when efforts are going well or seeing problems ahead and then problem solving or changing plans on the fly; all are tasks for the brain's frontal lobes (the seat of executive functioning). The frontal lobes enable us to persist in the face of difficulties or discomfort and to tolerate frustration. When we remember to pick up the dry-cleaning on the way home and to make plans for a birthday next week, when we notice a friend's new haircut and then remark on it, when we go on to express empathy for that friend's sick relative then pick up social cues that it's time for the conversation to move on; that's also all executive functioning. Your well-working frontal lobes allow you usually to think before you act and enable you to use self-talk to control behavior and direct future actions. When you've finished the day pleased with what you've done but ruefully vowing to go back and work on the items you put off, thank your frontal lobes for serving so faithfully.

Mark has largely lost all of this. But I know, and researchers agree, that with effort and activity, persons with brain injuries can regain functions. Mark has goals. He wants to improve physically, to be a better husband and father, to cook, and more. He just can't get there from here without God's divine power and grace and, I think, without friends who will share their lives and share his.

New Year brings new accomplishments

2009-01-26T13:08:00.014-06:00

What a difference a year (or more) makes! When Mark first came home, he was unable to figure out why the toaster wasn't working when the unplugged-in cord was laying on the counter. Six months later, he might work on something requiring persistence for five minutes, only if I were in the room, and only if not distracted. Last week, these arm cycles arrived (one for my dad, who's had a stroke, and one for Mark). Without help and without my even being in the house, Mark spent a half-hour assembling his. This morning, he put together the one for my dad.

After the huge blow in nearly losing Mark, losing both our incomes, and truly losing him in his roles as husband and father, this fall brought even more loss. My dad, who used to spend weeks at a time here helping us, suffered a major stroke, leaving him nearly speechless in a wheelchair. Mark's mother, another pillar of support for us, had major surgery requiring months of recovery. And at least four other families and individuals important to me and the kids, providing daily acts of service for us, all moved out of state. Three of the four moved out of the country. I felt the blows raining down while the ground was cut out from under my feet. I've tried to trust God and am truly grateful, but I felt more and more alone.

Resilience and faith wins out, though, helped with a resolve to look forward rather than behind (as much as I can). Mark's mother has recovered to the point that, even at nearly 87, she could entertain Mark for two weeks. With this break and the advent of the new year, I've thought intensely (and should have prayed even more) about my goals for Mark this year. I've decided on three: to help Mark regain self-determination, to help Mark relearn or reimplement how to connect with people in a meaningful way, and to help him develop or maintain his physical status to the point he can do what he wants to do. For me, the most important goal I have is to get help for me and our children.

I've decided, or realized, or have had revealed, that I must move from being taskmaster for Mark to facilitator, companion, and friend.

Here we are working on movement together preparatory to working on all the goals noted above.

So far as motor skills are concerned, Mark has the greatest difficulty with his left side (meaning the right side of the brain). See below and compare to the video right below this one.

Mark finds it easier to move his right side, though his poor balance and spasticity in his hips and thighs affects his use of his entire body.

Control of impulses and attention remain a great challenge for Mark. Here he's distracted by our dog.

Blessings all and have a wonderful 2009!

Tiki's tops!

2008-10-08T09:13:00.003-05:00

Though she's looking relaxed here, Tiki's quite a mover. Mark rode at the trot for the first time in years yesterday! And he'll be riding Tiki on the trail ride, too.

Winning Races

2008-10-03T17:38:00.005-05:00

Yeah! My guy's a winner at many things, but two recent victories stand out. We've been raising money for SIRE's Rideathon. We worked our way, thanks friends, onto the list of top fundraisers, so my guy gets to ride a trail ride at 7IL Trails in Cat Spring, Texas. We celebrated our 10th anniversary with friends and family at a horse show just down the road in Bellville many years ago.

Even better, Dear Husband walked his 6 minute test 30% faster this month than last. And his scores on the Berg balance scale improved by 20%. His reward? Another month of training twice a week using the Loko-mat.

Loco for Lokomat

2008-09-22T15:20:00.003-05:00

My guy's been cleared to have therapy using the Lokomat, a robot-assisted walking system. In the video below, you'll first see a a screen with a simple smiley face. The bigger the smile, the more correctly the client is walking.

Hurricane Ike Has Done Come and Gone

2008-09-17T19:57:00.006-05:00

Last Friday in tromped a loud, obnoxious party crasher who refused to leave and really trashed the place. Every house, street after street, sports several chest-high piles of limbs and leaves. Amazingly enough, few houses right by us had more than minimal structural damage.

We weathered the storm rather well. A privacy fence blew down and the neighbor behind me lost the crown of his pecan, which landed in our yard.

Friends and neighbors helped us prepare, Mark and the kids stayed calm and slept through the night. We lost power for for about 36 hours. Many friends and neighbors still lack electrical service and are not expected to get it until the end of the month, so we have been charging cell phones, providing ice, meals, fridge space, and internet access.

Please pray for all those displaced, those who have lost everything, those whose jobs are gone, and all those who are working 'round the clock to help get everything working again.

New school year

2008-08-17T21:32:00.002-05:00

Schools about to start for the kids and it never ends for M and myself. Thank goodness, I'm still seeing lots of progress. When the children returned home after a trip with relatives, M spoke with our son. Initiation of conversation with more content than a polite social nicety, accurately keeping track of where the kids were, neither would have happened as recently as a week or two ago.

M also consistently follows his morning routine, a list of some seven items. He's much better able to control his reactions to unfortunate events (such as a vase falling off the entertainment center).

one of my favorite passages -

Philippians 4 (NIV)

4Rejoice in the Lord always. I will say it again: Rejoice! 5Let your gentleness be evident to all. The Lord is near. 6Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. 7And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.

8Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things. 9Whatever you have learned or received or heard from me, or seen in me—put it into practice. And the God of peace will be with you.

Working

2008-05-05T10:23:00.004-05:00

Dh's taking on more responsibilities around the house and is more able to keep himself on track in those activities. Now mowing the back yard has been added to his list of things to do.

Before the accident, dh loved to read, but had little opportunity between 70 hour work weeks (he often worked 7 am - 7 pm M-F and another 8 hours on Saturday) and work at home. I'm so tickled that dh now makes our family of readers complete. Today he finished his first book in 15 months: Don Piper's 90 Minutes in Heaven. Here's what's written on the back cover:

On the way home from a conference, Don Piper's car was crushed by a semi that crossed into his lane. Medical personnel said he died instantly. While his body lay lifeless inside the ruins of his car, Piper experienced the glories of heaven, awed by its beaty and music. ... 90 Minutes in Heaven encourages those recovering from serious injuries and those dealing with the loss of a loved one.

Much of the book chronicles Mr. Piper's struggles recovering from his injuries and learning to live life as a person changed inwardly and outwardly. Clearly this would appeal to dh and the story's appeal resonanted even more since much of it is set in places with which dh has a connection. He found, lying in the stacks of books we have around the house, the ideal one to entice him back into the hours of concentration required to read a book.

Signs of progress to praise

2008-03-28T19:55:00.002-05:00

has greater control when frustrated;
exhibits more empathy;
showing more reasoning power;
has better day to day memory;
initiating conversation with content greater than social niceties;
initiating participation with others in household chores;
also initiating some household chores independently, and
an instance of independently returning to computer work after a break.

And I'm just starting to read a series of essays by Floyd Skloot, who suffered marked brain damage from a bout of viral encephalitis. He describes his struggles so simply and profoundly, I'll be reading In the Shadow of Memory to our children.

Cool videos on brain function

2008-03-28T19:46:00.006-05:00

"Neuroanatomist Jill Bolte Taylor had an opportunity few brain scientists would wish for: One morning, she realized she was having a massive stroke. As it happened -- as she felt her brain functions slip away one by one, speech, movement, understanding -- she studied and remembered every moment. This is a powerful story about how our brains define us and connect us to the world and to one another. "

And here's a test for you: follow instructions and try again for a big surprise.

http://view.break.com/470052 - Watch more free videos

More, better Ping Pong

2008-02-25T19:37:00.013-06:00

Thank you, Julio, for your enthusiasm, creativity, and care. Best wishes in your new position.

Below, see more left-handed ping pong, but use of arm is much freer (see post on January 13).

Progress seen through photos

2008-02-23T13:56:00.014-06:00

February 2007, before tracheotomy

April 2007 at TIRR

June 2007 at home

February 2008

Anniversary

2008-02-08T14:12:00.002-06:00

Our saga started exactly one year ago today. I've been stunned, scared, and sad. More often, though, I've been grateful. Thank God for dh's progress and thanks to all who have stood by us and offered support in so many ways.

In the past few days, I've had friends note that dh seems warmer, more "there," and more aware of others. His physical therapist has seen immense improvement in the kind and amount of exercises dh's able to do. He's initiating more and showing more abstract thought.

Blessings!

Therapeutic riding

2008-01-29T12:38:00.001-06:00

Years ago, dh and I lived in the country, where we had horses and rode all the time. Here's a photo of dh from those days.

I had known of riding for the handicapped then and, with the help of a friend who teaches at one such facility, had dh evaluated late in 2007. Though there's a long waiting list, dh was able to start this spring, hooray!

Here are a couple of short videos of dh's first lesson at SIRE, which offers certified therapeutic riding and hippotherapy near us.

The physical and emotional benefits of horseback riding have been known for several hundred years. In particular, the horse’s gait replicates the correct position of the human body in a walk, helping retrain movement in the rider's trunk and retraining a senseof balance. At SIRE, certified instructors serve more than 185 clients weekly through programs which include therapeutic riding, carriage driving, vaulting and hippotherapy. Clients report great improvements in gross and fine motor skills, balance and posture. So much more than just sitting on the back of a horse, for the only time in their lives, these children and adults are able to move through space, with a freedom of movement and sense of accomplishment that changes lives.

More progress

2008-01-27T13:37:00.001-06:00

Recently I asked dh to help find something our son lost. A few months ago, ever agreeable, he would say "yes, I'll help," then he promptly would sit down without making ANY effort to do what he said he would do. He since has progressed to where he would have made a cursory attempt, but not stay focused or on task. Now, though, he agreed and then immediately went to our son and asked him where he last had the notebook. Dh systematically looked in all the likely places, persisting until I told him to not bother anymore. (We still haven't found the notebook!)

And another - one of dh's chores is to unload the dishwasher. Each morning, ten minutes after unloading it, he won't remember. So when I ask about it, dh will go and unload it again, even if the dishes are now the next load waiting to be washed. He's on a single track, "unload the washer," and doesn't catch on to whether unloading makes sense (such as when you're putting a peanut butter encrusted knife back into the silverware drawer).

But yesterday, when dh was unloading the washer, he picked up a bowl, showed it to me and remarked, "This isn't clean, I'll put it back in to be washed again."

Just a few days ago, when he was at his sister's, he observed a disagreement between her and her 18 year old daughter. After the teenager left, dh made appropriate empathetic remarks to his sister and noted we're about to have a teenager in our house, too.

And dh spontaneously remembered, without ANY prompting, that our son had to be at church early this week for his baptism, remembering about 6 days after Mark last heard the schedule.

I'm very grateful for all these signs of progress. Especially grateful since I am making a conscious effort to turn dh's recovery entirely over to God. Dh and I have been working very hard, but I've come to acknowledge that our hard work isn't enough. In some ways, I feel as though I had been getting in God's way, picking up burdens that are not mine to bear. And God has been very good to us.

Another Recovery

2008-01-21T07:05:00.000-06:00

A TBI caregiver's story, from the online support group TBI Together -

She starts her letter:
It's been a very, very, very long 20 months since my husband's fall off his ladder (and subsequent coma for about a month). He was hospitalized for over 5 months. And when I first brought him home in October 2006 ... he couldn't walk. He was in diapers, he needed to be fed most of the time, he couldn't talk very well. He had horrible behavioral problems and my arms and upper trunk were usually covered in black and blue marks.

This caregiver continues,
here we are, all this time later, and I have to tell you all, life DOES get BETTER. Dean is walking with a cane now, he speaks very well and even wrote a long letter to his sister in a birthday card. (He remembered her birthday without any help from me.) .... He's just finished reading his first FULL LENGTH book since the accident!

He rides his tractor to plow out the driveway .... He participated fully in our Christmas celebrations (even getting our son and daughter-in-law to take him shopping for presents for ME!) And his behavior is under control. .... He tells me he loves me often! Truly, my cup runneth over. And life IS getting better, better everyday. And to think he hasn't even reached his 2-year anniversary yet.

And she concluded her email saying,
I keep"talking" with people who have either survived TBI or have cared for loved ones with TBI and the message is ALWAYS the same. Two years is nothing. Improvements continue and continue and continue. ... I wanted to provide our story and to give hope to those just starting. Of course, there are times when life continues to be difficult, but there are so many more times when life is delightful. Who could ask for more?

Let's play a game

2008-01-13T18:52:00.001-06:00

For your viewing pleasure, a video of dh playing ping pong using his affected left side.
This was filmed during a occupational therapy session, January 2007. Occupational therapy focuses on the upper body and skills for daily life.

Christmas presents

2007-12-30T17:07:00.001-06:00

Dh walked the dog with me today using his new tricycle. This season has been nothing short of amazing, with this only one example. Friends have blessed us with good wishes and with many unexpected gifts for me and the children. Dh's sister, brother-in-law and mother gave me the gift of a break. Dh did wonderfully well at his sister's house, while the kids and I spent some restful days out of state with my sister. Dh has come so far and the improvements have even sped up recently. With some of our Christmas money (thanks friends and neighbors!), I bought a Nintendo DS with brain training software, and Mindfit and Brain Fitness for the PC. And dh's doing these with minimal assistance from me (mainly just keeping him on task). I've experienced many things to give me hope: dh's behavior, the amazing stories others have shared, convictions in my prayers and prayers of others, and the stories in a fantastic book, The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science.

Christmas Letter

2007-12-18T09:31:00.001-06:00

Hello! The following is old news to those following our blog. Prayers and good wishes to everyone for a wonderful holiday season and a new year full of blessings.

We started 2007 with dh full of confidence in a new role, partner in his own firm. I had gone back to work for the first time since our first child's birth, eleven years ago then, and was proud to lead an environmental nonprofit.

In early February, though, dh nearly died in a car accident. He was virtually untouched, except for a devastatingly severe brain injury that left him in a coma for weeks and partially paralyzed for months. It still affects his memory, emotions, and thinking as well as his ability to balance and use his left side. Medically, he's expected to improve for years. So we are hopeful he will be better able to connect with his family and become more independent with time, healing, and therapy. And God has answered so many prayers. We continue to pray and ask for prayer.

Dh's holding on to the long-term goals of returning to work and to being a more active parent. In the near term, he's learning how to compensate for the areas where his brain doesn't function as well as it used too.

As I look back over this year, I'm grateful for so many things: dh always has known who we were, can now speak without difficulty, can get around without a wheelchair, and even helps at home with household chores. I've experienced tremendous support from family, friends, our church, and neighbors. Our children's resilience reassures me. I don't know what I would have done had we not had the support and some financial means to enable me to stay at home and assist in dh's recovery. Most of all, I know God has plans for good for us.

And I thank God for all those who have stood by us and held us up. I've made some wonderful new friends, too. I've found a depth and sense of purpose in all of us that we didn't know we could have.

With age and maturity most of us come to understand and experience personally that life entails loss, too. We just experienced it faster and harder than many. As dh improves, it makes it easier for me to be buoyed by hope. I rely on Jesus's reassurance, "Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light." (Matthew 11:29-30, NIV)

This year stunned our household. But we wake up in the light of a new day every day.

Happy Holidays!

2007-12-15T10:30:00.001-06:00

We got to open one Christmas present early today - dh has started a fifteen week post-acute brain injury program. This is his second experience with the program. The first time, we bowed out early. Dh wasn't cognitively ready and his insurance program limited the number of physical therapy hours. This time around the state is paying, one of the few enlightened programs offered by the state to help people get back on their feet. This program consists of physical therapy, group therapy and some counseling.

We're blessed too by dh's continued improvement. He's interacting with us more, seeming more emotionally connected. Mark is getting more physically fit, walking on a treadmill about 5 times a week and walking in a heated pool, too.

God still is giving us the gift of people caring for us. A friend took advantage of our neighborhood holiday party, Lights in the Heights, to set up a table selling hot chocolate to raise Christmas money for us. And we've had the chance to meet more families of brain injury survivors, many with children similar in ages to ours. I'm hopeful our children will benefit from friendships with other children who know what it's like to have a parent with a brain injury.

Miracles and Ambiguous Loss

2007-11-11T09:57:00.001-06:00

Joel 2:24-26 (NIV) The threshing floors will be filled with grain; the vats will overflow with new wine and oil. "I will repay you for the years the locusts have eaten.... You will have plenty to eat, until you are full, and you will praise the name of the LORD your God, who has worked wonders for you; never again will my people be shamed."

The symptoms of unresolved grief from ambiguous loss are similar to post-traumatic stress disorder. Ambiguous loss is also a psychologically distressing event that is outside the realm of ordinary human experience; like the events triggering PTSD, it lacks resolution and traumatizes. But with ambiguous loss, the trauma (the ambiguity) continues to exist in the present. It is not post anything. Ambiguous loss is typically a long-term situation that traumatizes and immobilizes. Ambiguous Loss by Pauline Boss (1999) p. 24

Dh's being here today is a blessing and a gift. I'm certain he is still alive and part of his family for a reason. Briefly, I'll recount the miracles that led us here.

I don't remember being given dh's chances of survival, but now as I type this I remember that maybe I was, "fifty-fifty." After a week or so, I was told he would survive, but be in a coma or coma-like state for possibly months, after which "he will have to learn everything all over again." Later no one would ever tell me if he could walk again and his therapist would caution that even if he could walk with her, it would be a far cry from walking in a community setting with uneven surfaces and distracting surroundings. Early on, a consulting neurologist told us dh was blind. And months later, even after he came home, we were told the left arm very likely would remain unresponsive. As for being independent, I was told that dh would be able to stay at home, but would accomplish activities only if rigorously trained to rely upon lists. Though dh has a far way to go, he has greatly surpassed all of these expectations.

Still, almost everything he does must be planned, organized, directed, and evaluated by another brain - usually mine. Though generally dh has a pleasant demeanor, his emotional life remains very shallow. When I strained a muscle trying to fold the wheelchair he no longer needs, he watched impassively, not asking if I was okay, not empathizing with my pain. The few flashes of emotion expressed are anger. When in bed I reached out to pat dh on the shoulder and accidentally touched his face, dh grabbed my hand and twisted it, letting go only when I repeatedly told him not to hurt me. Not dismayed at his lack of control, he also did not apologize without being told to do so.

So many things are mixed blessings. I think God I have a sound mind and body (such as it is!). Just as a silly but telling example, we've camped once since his accident and I'm planning for us to again this weekend. Of course, I do the planning, all the packing, loading, unloading, tent set-up etc. Then all night long I'll be escorting dh back and forth to the bathroom. A consequence of the brain injury can be an overactive bladder and, Mark insists, trees are not a suitable substitute for the restroom. Dh had been the parent who was more adventurous, who would take the kids mountain climbing, mountain-biking, fishing, kayaking, etc. Once I could walk the dog and children along trails. Now dh's walking speed is so slow and balance precarious enough that his job is to hold down the fort at fireside. Mine is to attend to him.

Dh is not the man he once was. We hold on to realistic hope that things will continue to improve for months and years to come. But our lives, particularly the lives of our 9 and 12 year old children, can't stand still waiting for Daddy to come back. What is it like to watch movies with a man, whom you once looked up to and relied upon as the bedrock of security in your life, who now guffaws at puerile humor that as a nine-year-old you don't think is funny anymore? You have a dad who thinks he still takes you to school and helps with your homework, but really has to be told when to go to bed before your own bedtime. Your dad once spent all Christmas holidays making rockets for you and now doesn't remember it, can't cross the pastures launch the rockets, and doesn't understand how they work anymore?

Of all the losses experienced in personal relationships, ambiguous loss is the most devastating because it remains unclear, indeterminate.... People hunger for certainty. Even sure knowledge of death is more welcome than continuation of doubt. (Ambiguous Loss p. 6)

Ironically, the greatest source of ambiguity is dh's improvement. How will he finally be re-integrated into our family? As a dependent who nevertheless still can help around the house or as a person with his own thoughts, feelings and desires? Even better, as someone who has a concept of the future and who recognizes others' feelings and still cares for them?

How does ambiguous loss make people feel helpless?

The loss is confusing and not amenable to problem-solving. Lack of mastery ... increases not only perceptions of helplessness but real helplessness. (p.79)
Because of the ambiguity, adjusting roles and rules in the family relationships is difficult.
There are no symbolic, supportive rituals (such as funerals) to help the greater community to validate or verify the loss.
The clear evidence of the unfairness of life as well as the ambiguity constrains community and extended family members from lending support.
Ambiguous loss goes on and on, exhausting caregivers in the grip of relentless uncertainty.
In the midst of turmoil, the family must reconstruct itself and manage daily lives in a new way.(paraphrased pp. 7-8, 20)

Recent Blessings

2007-11-10T16:04:00.001-06:00

Psalm 10:17

You hear, O LORD, the desire of the afflicted; you encourage them, and you listen to their cry.

I've met some lovely people lately who fill me with hope. One, a stroke survivor, can explain what things are difficult for her and why. I marvel at her making an independent life for herself as a single mother. I've also recently met a neighbor whose husband had a brain injury ten years ago. In all that time she had not yet met a wife supporting a spouse so devastated in the prime of life and yet so unaware. I'm grateful I have the family and community support and dh is well enough that I can care for him at home. I met a brain injury survivor at the rehab program who similarly is blogging her life, which includes twin pre-schoolers. And one of the first caregivers I met at the program amazes me with her dedication and spirit. Her husband recently was recognized Texas Brain Injury Survivor of the Year.

Today dh returns from a two-day, one-night men's retreat with our church. I'm grateful to the men, dhs friends and mine, who volunteered to take dh and look after him. In return, they gleefully took dh's presence as the excuse necessary to rent a golf cart for the weekend.

Another Miraculous Story

2007-11-09T20:48:00.000-06:00

For some reason, pregnancy seems to give license for people to share their horror stories of labor. My experience regarding brain injury has been the opposite. Rather than stories of despair or deterioration, stories of amazing recoveries abound. I've just seen one such touching story recently in an online chat.

My cousin was a sheriff's deputy who had the misfortune to have a bomb planted underneath his cruiser. It blew and he wrecked. He was in a coma for 4 months. The docs told us that he would never regain consciousness and would remain a vegetable for the rest of his life. They said there was absolutely NO brain activity and that machines were the only thing keeping him alive. They wanted his wife to sign the papers to disconnect all life support. She refused and he is alive to this day, more than 20 years later. He came out of the coma with amazingly few deficits considering. His gait is awkward, his speech is sometimes slurred and he has some memory issues, but he knows who we are and has fewer executive functioning problems than my husband [also a TBI survivor]. He can drive himself, takes an active role in his church, helps coach little league, etc. As I stated before, WE WERE TOLD THAT HE WAS COMPLETELY BRAIN DEAD!!!! He did have to undergo extensive cognitive and physical therapies to learn to walk and talk, etc, but he is by no means brain dead! Do not give up hope!!!!! Until [the] last breath, there is always hope.
Psalm 37:4 Delight yourself in the LORD and he will give you the desires of your heart.

Winter Comes

2007-11-07T20:10:00.001-06:00

But you never know what season M thinks it is. He's been fairly accurate about dates lately, but today he told me it was September. No telling why. I see now I last wrote here in September, so sorry.

M's progress continues, but more slowly. Today, for the first time, M tapped on the car window to let me know that the door was locked. Up until now, he would just stand there until I noticed that I had not yet unlocked the door. And a few weeks ago, he completed a task (stemming grapes and putting the bag of grapes in the freezer) without my direction and while I was out of the house. M does chores much better, with more common sense.

We've been waiting for M's next step in therapy to be approved by the state's Department of Adult Rehabilitative Services. I expect he will return to a rehab program soon. But I have been told the approval process can take months. In the meanwhile, I'm doing therapy for M at home. We're following the exercises his last OT, PT and speech therapist gave him to do. I'm seeing lots of progress is M's being able to stay with a particular exercise once I direct him to start. In addition, almost every weekday M walks on a friend's treadmill (he's up to a blazing 1.7 mph for 15 minutes) and walks in the water for another half hour at the city's pool.

Please continue praying for us. God has been so good to us. Bless you all.

Another crossroads

2007-09-19T18:17:00.002-05:00

Dh will be at a crossroads soon. He’s mostly met his initial goals at TIRR Outpatient Services (TOTS) and they will discharge him by mid-October. His speech therapist believes she's reaching the end of what can or should be done with M one on one. Instead, his growth and development requires working in groups and under more of his own initiative. Among the many things I don't understand is how, if a person is improving all the time, and a payor will pay, therapy ends. M's fastest improvement they say will be in these first two years, so I'm eager for therapy to continue. At the same time, I recognize that the real world, as strange as it is and unlike the one we knew before, has come. Therapy will end at some point and living on our own in this new world begins.

I’m trying to get him back in a community re-entry program. He is not ready for their vocational rehabilitation track. Still others are there to prepare for returning to school (there are some teenagers and early twenty-year-olds there). Though M had been in Challenge in early summer, we left because he was not cognitively ready and he had run into his insurance policy’s limits on PT and OT, 20 combined hours. If Challenge staff thinks he’s still not ready, or if they want him but insurance will not pay, I'm not sure what our alternatives are other than go home. Some other possibilities are the Transition Learning Center in Galveston, a residential program, or return to TOTS.

M continues to amaze and frustrate me. His major physical limitations stem from his brain's inability to recognize the left side as capable of bearing weight. He walks, but excruciating slowly and balance on sloped or uneven ground remains precarious. I'm determined to go on our son's cub scout camping trip this October, so I've had M practice getting in and out of the tent. He can, for the first time, get up off the floor unsupported. He needs coaching to do it, though.

The cognitive limits also are perplexing. M probably could pass the bar again now. But if you ask him today if he had therapy, he'll reply, "No, not much" even though he spends three half-days a week in therapy.

I do leave M alone for about 45 minutes in the morning walking the dog. M has a list of chores (dress, make the bed, shave, that sort of thing). He can do about half independently, but invariably will go off track and will not self-correct. Much of my energy is not spent caretaking (feeding, dressing, and so on), but in coaching. "What are you supposed to do now? Look on the board. What have you done? Use your eyes to verify...." (Often he says he's done things he hasn't and says he hasn't done things he has.)

M made lunch a few times this week. For the first time (not including breakfast peanut butter toast), he made a meal entirely independently, with no one in the room coaching him. He offered grilled cheese, I accepted; and he made grilled cheese sandwiches. A few days later, he offered again to make sandwiches, tuna. I said yes, but not tuna. Mark quickly prepared the bread, then took 45 minutes to find and use lunch meat. I kept trying to understand out what he was having difficulty with. It turns out he could not get past tuna. He knew I said no tuna, but couldn't switch over to a new thought. He knew where the other lunch meat is, but couldn't let go of the other thought to get it.

This week marked a special day for our family, an anniversary of sorts. When I asked M what he might do to help celebrate the occasion, he said make dinner reservations and take me out to dinner, which is what we always used to do. But I had to point out to him that he hasn't picked up a phone to make a call in seven months and that he has been specifically told he can't drive. Given that, I ask, what else can he do? He says again, make reservations and take you out. That's, in other words, inflexibility in thinking as well as a lack of self-awareness.

Another important component to what makes a person is their emotional life. M generally cooperates, has a pleasant demeanor, and has impulse control, mostly. But no empathy, which turns out to be not so much a character trait, but a fairly sophisticated cognitive skill. You must recognize what the other person is feeling, then identify based on your own experiences what that feels like and what might be an appropriate response. Then you have to act on that knowledge to indicate a reflection, recognition, or attempt at amelioration in what the other person is feeling. When others are sad, myself included, M has no empathetic response, no initiative to reach out or comfort. In addition, because he lacks much self-awareness, he doesn't feel or express loss, from missing work for example or doing things with me and the kids. He's oblivious to all I'm doing to keep our own little ship afloat and how his injury has thrown all that on me.

It's been seven months. M lives, talks, walks, even contributes to housework. I know God works all things for good, but the good now for me seems to be the refiner's fire. I know he is with me.

The many ways we are blessed

2007-08-28T20:33:00.001-05:00

The second day of school, we rush out to the car, three people to deliver to three different places all by 8 a.m. The children noticed it first- a flat tire, totally dead flat, not going anywhere fast flat. Grabbing the handy cell phone, I first call one friend to see if her hubby has time to get the spare on for me (he does), call another to see if she can take the children with hers to school (she can), and catch a therapist on her way to work to ask if she could swing by and take dh to her work which also is where dh gets therapy (she can). All this accomplished, I drive to the tire store and ask about the other tire on the same side. I had noticed this morning a new gash on the tread extending up into the sidewall. It turns out the flat can be repaired, but the other tire must be replaced right away. Better still, it's under warranty. I'm so grateful for all those looking out for us. Even more, I feel safe in the cleft of the rock. God is near.

Dh has greatly improved in his abilities to move from one activity to another and do tasks when asked. He can initiate routine tasks, even a routine new since the accident (especially in the morning), but still struggles to initiate new activities. For example, when bored, dh has a hard time finding things to do without being prompted by me. Once prompted, though, he can work on a task for at least a few minutes. He jokes, his conversations are more on point, and he seems less on edge and better able to cope with stressful situations.

Thank goodness, because now demands to get everyone where they need to be, with all the accoutrements, has greatly increased now that the school year has started. A routine helps us all though and gives us all something to concentrate on.

Summer's Over

2007-08-22T16:51:00.001-05:00

But it's still so hot! We've had several firsts this week, three months since M has come home from the hospital. M and the children have been playing "keep away" in our community pool. M's been staying home without me for an hour at a time. He's doing more and more complex activities (such as going into another room to get a friend a glass of water) without coaching. In his month-end evaluations for his therapies, M greatly surpassed many of the therapists' goals. I'm happy to report he's using his left hand more and more voluntarily around the house and in activities of daily living. Finally, his emotions are starting to be more finely nuanced.

Our children have returned from all the visits to relatives and summer camps; school starts the last Monday of August. This is M's third week at TIRR's outpatient facility (TOTS), concentrating on the individual disciplines of OT, PT, and speech therapy. He'll probably continue at TOTS another month or so, then he may go to the Transitional Learning Center, an inpatient facility, in Galveston for further rehab perhaps to the end of the year.

So our days consist of going through normal household activities, albiet much more slowly than in the past, home exercises (about an hour or two a day) recreational activities to lift M's spirits and give his brain a workout, and (three days a week) going to therapy. Now we'll add in taking the kids to school and volunteering there.

Please pray for a smooth start of the school year and COMPLETE recovery.

Cooking with Gas

2007-07-28T09:09:00.001-05:00

Mmmm, omelette stuffed with smoked salmon, the first meal M has cooked on the stove since the accident in February. AND he used his left hand to turn the burner knob. His left arm is really coming along, with almost complete passive range of motion and every single muscle group working in response to M's thinking of movement.

With lots of cuing, M's also cleaning the kitchen counters and sink every morning. He'll unload the dishwasher all on his own, but sometimes needs to be reminded to go back and finish.

Some of the oddest things keep coming up - all frontal lobe, executive function issues. For most of us most of the time, we know if we have done something. For example, if you know you intend to wipe down a counter, you'll get around to it, then know you have completed the task.

For M, there's a strange disconnect between thinking and doing. I'll see him walk out of the kitchen, right past a sign that asks, "Did I complete my tasks?," and ask him, "M, what were you supposed to do? Did you do it?" He now can always say what he was supposed to do, but invariably will answer he did do it, when a cursory glance would reveal that the task hadn't even been attempted. As best I can tell, it's as if thinking about something means he must have done it. There almost no internal checking mechanism or self-monitoring, "Am I doing what I'm supposed to do?"

I say almost none, because he can monitor in some things if given an external reminder. For example, when you ask if his left arm is properly positioned, a month ago, he would have replied yes, without looking, even if his hand was not in the right position. A couple of weeks ago, he would have looked, seen it wasn't correct, and repositioned it. Now, if asked if his hand is palm down, he will reposition it without any more cuing or prompting. He'll even position it on his own occasionally.

He remembers things quite well, considering his injuries. He'll remember even mundane activities from one day to the next. But he still can be a bit unmoored. For example, when his new speech therapist, who spent two sessions evaluating his cognitive functions, asked who she was, M said she was one of his doctors (kinda making sense, since M considered the PhD neuropsychologist in the hospital who evaluated him to be one of his doctors). M also said we were on the fifth floor of the hospital, when we actually were at the same outpatient therapy location he has been going to for a month, a one-story structure.

The only other oddity to come out of the testing was when the therapist asked about holidays. M had difficulty naming a holiday in January, thought long and hard about one in February before coming up with Valentine's Day, then when asked what holiday just passed, said that July 4th was coming up next week even though he had checked his watch and answered, when asked the day at least three times within that hour, July 27th. He didn't recognize the inconsistency until it was pointed out to him. Then the lightbulb went off, "What I'm thinking and said doesn't make sense." Thank goodness most often M does recognize logical inconsistencies now, once they are pointed out to him. Again, though, his own internal automatic self-checking facility is not there for the most part. We can only pray that it will come back or redevelop.

More therapy, more progress

2007-07-23T10:05:00.001-05:00

Those who only see M occasionally always remark how much he has progressed. As for me, it's like not noticing how much your child has grown until you get the winter pants out, then you realize, "Wow, she must be two inches taller than last year!" For M, we can see measurable progress by the week, but because I'm so close, expectations are so high, and my frustrations so close at hand, I see less the miracle in front of my eyes.

This week M will transfer from Challenge to TOTS (TIRR outpatient therapy services) so he can get more therapy, paid for by the state. Our health insurance coverage for therapy has maxed out.

Today for the first time, M walked around the esplanade in front of our house, a fifth of a mile, I think. And last week, when I griped that I always had to warm up our meals (many days we have meals prepared for us), M got up, prepared and served dinner! Great initiation.

Implementing Change

2007-07-03T20:59:00.001-05:00

M could have so easily died in the accident. He could have been left in the limbo of a vegetative state. I don't know why this loss had to happen to us. God grants us all free will and terrible things happen as the result of our decisions or the decisions of others.

Knowing my husband's being here on earth, slowly but surely improving, is a gift from God sustains me. From a purely psychological point of view, I can choose to wallow in pity or see this as a challenge to which we all can rise. I choose the latter and thank God he is with me and daily ask for wisdom and strength.

Today our Challenge social worker and neuropsychologist reviewed the results of M's neuropsychological assessment. As we all knew, M suffered tremendous damage to many areas of the brain, leading to significant cognitive impairments. The brain heals so slowly, there still many months of significant changes to come, merely as a result of healing. In addition, even with severely impaired brains, the brain injured can relearn skills such as problem solving and learn new ways of coping, using aids for memory, for example. Deficits remain, though, even for those with much less severe injuries.

For now M is too impaired cognitively, too foggy, to make use of the Challenge program. In addition, he requires more one-on-one support than offered by Challenge, where all but the PT and OT sessions are group sessions.

I've decided instead, with the agreement of our Challenge case manager, to take advantage of a state-funded program that will provide 120 hours of occupational and physical therapy after the paltry 20 hours his health insurance offers is exhausted. We can do that at the same TIRR facility, with therapists who specialize in treating persons with brain injuries. Concentrating on the physical side will increase M's physical safety and competence, while giving me more time to concentrate on intense one-on-one work with him. I'll guide Mark through problem-solving, coping with perseveration, developing a routine to get through the day, and addressing lack of initiation. The social worker and neuropsychologist seemed to think that within the year Mark would be able to return more profitably to Challenge. In the meanwhile, they and I will try to find a neuropsychologist who will consult with me to carry on a program for M.

Please pray for wisdom and strength for me, understanding and support for the children, and healing, miraculous healing, for M. I pray too that God's love shines through us, that all is to his glory.

6 Praise be to the LORD,
for he has heard my cry for mercy.
7 The LORD is my strength and my shield;
my heart trusts in him, and I am helped.
My heart leaps for joy
and I will give thanks to him in song.
Psalm 28, NIV

TIRR Challenge

2007-06-23T16:23:00.001-05:00

M has come much further than many expected: his language skills are very good; he accomplishes some aspects of self care (eating, dressing, shaving, etc., once everything is set up), and he can walk a fair distance indoors in a quiet area. His memory continues to improve. And he is less self-centered and volatile than many with similar brain injuries. Go outside a routine he learned before the injury, though, and you'll see how profoundly he remains affected. And when he encounters an obstacle (for example, his electric razor doesn't work because it's unplugged), he's unable to problem solve (in this example, he'll just switch the razor off and on, then put it down, not even knowing or able to check the plug). He's supposed to do something; he can't do it, so he's stuck. Quite a difference even from a two-year-old. An incredible entity, the brain; but broken, it breaks down in so many critical ways.

Four and a half months since M's injury and just when I get used to one routine, it changes. Since March 2nd, we had the same therapists and same routine - physical therapy, occupational therapy, speech therapy, and group therapy five days a week. M has been moved to the next step, TIRR Challenge, and this week had four days of mostly group therapy. It will take another week or two for the evaluations to be completed and his treatment plan developed and approved. By then, we'll get used to the new setting and new personnel, who already seem enthusiastic and kind.

We'll have a lot more time at home, so more time for one on one work. And we have an exercise program for the pool that we can do in our neighborhood pool. Having so much time with M at home, though, reminds me of being at home with a toddler, only harder. To keep M engaged and working productively (on worksheets or rudimentary housework) or playing, constant attention is required. Every week, though, something gets easier. I pray for strength and to align myself with God's will. After all, his burden is light.

You have it in you to help

2007-06-12T21:18:00.001-05:00

During morning rush hour a few weeks ago, truck driver Roberto Gauna responded instantly to the horror unfolding in front of him on a Houston highway. A young motorcyclist, Jeff Blessing, had hit another vehicle and was hurtled across the freeway only to lie crumpled in the middle of the lanes. Gauna maneuvered his cement truck to protect Blessing.

I thought you were fighting for your life," a tearful Gauna told Blessing on Wednesday when the two met for the first time since Gauna used his cement truck to stop traffic and keep other drivers from running over and killing Blessing. "I was holding your hand, and I prayed, 'Lord, give this man life,' and he did."

Not many of us have the assurance we would react so bravely and quickly as this wonderful story recounts. We all have it in us, though, to respond lovingly and kindly to the suffering of friends and loved ones.

I've been blessed many times over with the help of friends and neighbors. A few days ago, I read a primer for helping loved ones suffering as M and I have been. It starts with a bit of finger wagging: " Some people are gifted helpers. For the rest of us, no 'gifting' is no excuse. Drop 'let me know if I can do anything' from your vocabulary and make a difference in a hurting friend's life. " The article then continues with a useful list of what you can do to help friends in need. Thank you, all those who have helped and are helping me.

Think basics. When life gets hectic, refocus on the basics of running a life and family: food, clothes, cleanliness and childcare. Many friends did for us, thank you. Specifically,

Offer to run regular errands.
Provide meals.
Do laundry.
Pick up and deliver dry cleaning.
Gather a group of friends willing to clean and rotate teams or pay for a service.
Try the team approach for helping care for the children.
Help provide money, transportation, personal support and treats. A gift of money or restaurant gift cards might help relieve financial strain.
Provide transportation to appointments or take children to school or activities.

Offer your presence. Sit with families. Cry with them. Listen. Offer to go with them wherever they need to go. A presence can comfort in this lonely time. Offer to sit with the injured or ill family member to free others up for personal errands or even a nap. I always felt so torn, wanting a constant presence with Mark, but needing to be elsewhere, too, and needing finally a break before I broke.

Deliver a treat. For the longest time, in ICU, M couldn't have flowers. And he wouldn't have recognized any treats anyway. But thoughtful friends and family delivered treats to the children -- sweets, games, and special meals -- who were hurting and undoubtedly felt abandoned and scared. The gifts were a recognition that others were thinking and caring for them. So too were the gifts of books and personal care items to me, a concrete reminder that others were thinking of us and I had a life outside the four walls of the hospital.

Coordinate. My dear friend AH has been a lifesaver, coordinating meals and the flow of information via email. Other suggestions in this article include making a flowchart, a schedule, a phone log. More suggestions? Follow up; remember event milestones.

Pray. Do it, believe in its power and tell the family you're praying. We believe fervently in the power of prayer. Even had we not, knowing that others around the world have us in their hearts bouys us immensely. Prayer begats more prayer. The one thing I can do in return for others now, in addition to giving heartfelt thanks, is to pray. Our church has been doing a wonderful series, Break Through, on God's kingdom.

Ask. Ask for a specific need then meet it. We've had folks take our children for sleepovers, to movies, even on vacation and offer to pay for summer camps. Our dog, too, was not forgotten. Friends have walked him, let him out daily, even taken him home to play with their dogs.

Texas Legislature comes through

2007-06-06T19:33:00.001-05:00

I'm wincing as I write this
-- the Texas Legislature sat on every air pollution control measure GHASP supported --
but this year the Texas Legislature appropriated more than $4.5 million to address the Comprehensive Rehabilitation Services waiting list.

So tonight I received a call from M's counselor at the Texas Department of Assistive and Rehabilitative Services. Months ago she had cautioned me that M, though eligible for services, would not receive financial assistance until the Fall at the earliest. But now, the money is available and the list is moving. DARS won't pay for services already rendered, but will help in the future as a payor of last resort (above insurance). Our counselor said that they can pick up the copays for the Challenge program and could continue his participation after his insurance runs out.

Below is more info on DARS:

The DARS Division for Rehabilitation Services (DRS) realizes that timely and intensive rehabilitation is crucial for a person with a traumatic spinal cord injury or traumatic brain injury to re-enter the community; and live as independently as possible. For some, it's relearning skills most take for granted, such as walking, talking, eating, or writing. Or, it may require learning to accomplish these tasks in a new way.

Mandated by the state Legislature, a percentage of fines collected for misdemeanors and felonies goes into a special fund to pay for these services. DRS provides payment for the following:

Inpatient Comprehensive Medical Rehabilitation: A team of qualified professionals provides a variety of intensive therapies, medical care and other services to help individuals live as independently as possible. Services are provided on an inpatient basis at an accredited rehabilitation hospital.
Outpatient Services: Rehabilitation Services for occupational therapy, physical therapy, speech therapy and cognitive therapy may be continued on an outpatient basis.
Post-Acute Traumatic Brain Injury Services: These services help an individual deal with injury-related cognitive difficulties such as memory loss and/or inappropriate behaviors.

Because there are more consumers requesting services than there are funds available, the CRS program has an Interest and Waiting List. Consumers are served in the order in which a plan of services is completed and the consumer is ready to participate in those services.

To be eligible for the Comprehensive Rehabilitation Services program, the individual must have a traumatic brain injury and/or spinal cord injury that results in a substantial impediment to functioning independently. There must also be a reasonable expectation that the individual's ability to function within the family and/or community will improve with the provision of services.

Knowing our next step

2007-06-06T14:15:00.001-05:00

Ms team (his rehab doc and therapists) have come to a consensus for his next destination: TIRR's Challenge Program near the medical center. My first thought? Free parking!!! I must have spent more than $700 in parking since M's injury.

M will start Monday after next unless there is a waiting list. If so, he'll stay in the TIRR day program at the hospital until a spot opens up for him. In the Challenge program, he'll continue physical and occupational therapy, but the emphasis on cognitive rehabilitation and daily living skills will intensify.

As in the day program now, I'll be expected to spend the day while M is there, though I can't participate in the groups. Groups generally are closed to family members to protect patient privacy and encourage patient independence and group bonding.

M will be learning skills for independent living. How do you plan your day and week? How do you keep up with the things you need to do? How do you keep on track and keep moving forward through your to do list? Even as simple to us as how do you plan and prepare a meal? How do you stay safe? How do you get around town given that you are not yet able to drive?

Many of these skills are things that you and I do seemingly without thinking. For the brain injured person, each one of these requires tremendous thought, effort, use and practice at coping skills. What do you need to prop up your unreliable memory? What do you need to prompt you through out the day? How do you ensure you'll use your aids? His team must see potential in Mark and agree that he may eventually be free of constant supervision and caregiving.

In my last post I asked for prayer for M to be better at initiating, less impulsive and more empathetic. Last night M thanked me for all that I've been doing and said he realized how much I have to do. And today, for the first time, he called to me from another room to help him get up; very important for his safety, my peace of mind and sanity. He also day by day better controls his impulses.

Also new for M, he's getting into the pool at his sister's house. His left arm continues to grow in responsiveness and walking gets better by the day. The children are looking forward to a day when their dad can play a game like Clue with them (he's close to be able to follow the rules) and better still, shoot off the rockets he made them for Christmas 2006. Keep praying and bless you all.

A birthday today!

2007-06-05T05:31:00.001-05:00

M's strength, ability to do things, and walking continue to improve. Yesterday, he walked with his therapist outside, up and down curbs and ramps and stairs. Insight, impulse control, and emotiveness remain a challenge.

Please be in prayer for his cognitive and emotional qualities to be restored as his physical abilities return. For his safety, M must be under direct supervision round the clock. He can stand and walk on his own, but doesn't understand why he shouldn't. He'll swear he won't get up without calling me, then does as soon as I step out of the room. So I can't step out of the room, the potential consequences are too grave. If he should fall and suffer another head injury, he would have an even worse prognosis.

M has three more weeks scheduled of day therapy (4-5 hours of therapy) at the TIRR hospital. The next step's not yet been decided.

3 Sing to him a new song;
play skillfully, and shout for joy.
4 For the word of the LORD is right and true;
he is faithful in all he does.
5 The LORD loves righteousness and justice;
the earth is full of his unfailing love.
6 By the word of the LORD were the heavens made,
their starry host by the breath of his mouth.
7 He gathers the waters of the sea into jars;
he puts the deep into storehouses.
8 Let all the earth fear the LORD;
let all the people of the world revere him.
9 For he spoke, and it came to be;
he commanded, and it stood firm.
Psalm 33 NIV

Home

2007-05-25T14:18:00.002-05:00

We're enjoying a quiet weekend -- the kids are at Grandma's and M's getting used to being at home. It's a nice respite from the work week in TIRR's day program (9-4 M-F), where M will be through June 22 at least, working on various components of his recovery.

Considering all the dire consequences of severe injury to temporal and frontal lobes, M's recovery proceeds gratifyingly well. At home, M's been making breakfast - peanut butter toast - every now and then. Today, for the first time since February, M dressed himself from head to toe. It took an hour, but he did it all himself, with not a whole lot of prodding and coaching. His difficulty stems from weak motivation, a weak left side, and also a very stiff and out of shape body, too. All the heartening signs, though, show a healing brain and lots of hard work by M, his therapists, and me. The coaching is constant. Plus for various reasons, M and I get up several times a night, making for long, fatiguing days.

M's memory remains poor, though it is improving. His inflexible thinking, poor initiation, and dampened emotional affect remain areas for improvement. As M improves, though, I'll be constantly at hand, not just as a coach, supporter and loving spouse, but also as a security guard. If I'm in another room, M will stand up and walk to take care of things, not out of stubbornness, but because that's how he's always done it. Never mind that his balance and judgment remain unreliable and that everyone tells him NOT to get up without assistance.

We're blessed with lots of support, but the amount of help I need remains daunting. Help in errands, cooking, company for M, and more are all needed. I'm expecting now to work full time (i.e., to be officially unemployed) on M's recovery for at least a year or two. I'm convinced in my heart and from everything I've read and heard that his prognosis is best with strong support and help. I won't be able to shoulder this all on my own, though.

Please continue praying for M's complete physical, emotional, and cognitive recovery. I'll need strength and insight as will the children. Bless you all.

Set for four weeks

2007-05-15T17:55:00.001-05:00

M's coming home! After two sweet home visits, on two successive Sundays, he'll sleep in his own bed this Friday. It's a sign of his improvement that I am eager to have him home and feel I am better able to care for him - after all, it will be a ratio of one to one - than the nursing staff at TIRR.

Having M at home presents its own set of challenges. I'll be getting seven ready for the day (four humans and three animals) and out of the house by 7:15 in the morning. For one week, the last week of school, I'll drop the children off, then take M to TIRR. I've hired a caregiver to attend M in the mornings at TIRR, so I'll meet her then zip off to my work at GHASP for the morning. I'll relieve her at lunch and stay with M until the end of his work day, generally 4:30. I'll gather my chicks and we'll have dinner together, lovingly prepared by friends, for the first time in over three months.

I don't know how well M sleeps through the night. Though I spent the night with him for the first three weeks he was at TIRR, that's been long ago. We used to get up early in the morning to exercise- he would run and I would walk with friends - from 5 to 6 a.m. Who knows how it will be now. And so the day starts again.

Today I was told that M will be served through the TIRR day program (with his same therapists, in the same facility as now) through June 15th. We've been so worried that his insurance had low limits on outpatient therapy (20 visits or less), but apparently Aetna has an internal directive extending care beyond regular policy limits in cases such as M's. According to the case manager at TIRR, his therapy is unlimited and must only have a certification of medical necessity at the 5 week mark.

Please pray for strength, protection, and good humor for me. This comes from the person who fell trying to walk and talk at the same time getting the kids off to school this week. And who spent a half hour trying to persuade M with logic that he was not injured a year and three months ago, that he really hasn't loaded up the wheelchair in the car to drive around the hospital, which really is a school.

Please pray for the signals to get through better and better on Ms left side, that he understands his predicament just enough to be safe and reasonable, but not enough to be overwhelmed with depression, and that his memory be reliable. Please pray that our children grow through this experience and grow more loving and kind not judgmental or avoiding or dramatic (a tall order for intense preteens).

I am so thankful for our little, manageable, wheelchair-friendly house. I thank God for friends and neighbors who have rallied round, with prayers and meals and errands and yardwork and money and more. Bless you all.

I'm still dazed

2007-05-07T21:08:00.001-05:00

A wild weekend we just had. Beginning with a bang, the fundraiser Friday night raised tens of thousands of dollars toward therapy and other health care needs for M. Little did I know this would be the the outcome of my saying yes to BVD. We have been blessed by her heart and hard work and by those of others - many of whom we do not even know. Those of you I do know, I'm sure I'll never know how much of your time and attention have gone to us in these past few months. I'm honored and touched and grateful to you and God above.

I don't know how this all will end, but I am convinced things will be better. What a great adventure we are on, I've told the kids. Others may pay thousands of dollars and leave home, but we are together with all the comforts of home, surrounded by friends and family. We've reached the base camp and shortly will be setting out to ascend our own Mount Everest. Bless you for being our supply chain and for cheering us on.

Yesterday, M got to go home on our first eight-hour day pass. Day passes provide the family a practice run, to see if the house is fully accessible and if the caregiver is adequately trained. We accomplished everything we tried, but I discovered a few more modifications to be the house will be necessary.

Please pray that I will be vigilant enough. Brain injury survivors are at much greater risk than the general population of being brain-injured again - eight times more likely, I am told. And the consequences of the second injury are much more severe. As much as I look forward to having the family under one roof, I'll be needing to tend to the whole family - all at the same time. This was brought home to me last night as I pulled M, in his wheelchair, into our tiny bathroom, so I could keep an eye on him while I showered our son.

Plans now are for M to be discharged May 17th or 18th. He then will continue his therapy at TIRR in the day program. So he will continue to have speech, occupational, physical, recreational, and music therapy, along with his group therapy, all with the same therapists he sees now. I'll transport him back and forth and ensure he has someone sitting with him or waiting for him at TIRR during the day, from about 9-4. This may continue another 2-4 weeks, into mid-June, to be followed by perhaps the Transitional Learning Center, an inpatient program in Galveston, or the Challenge program at another TIRR facility, through the summer.

“Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus.”- 1 Thessalonians 5:16-18

Amazing Stuff

2007-05-02T20:12:00.001-05:00

I'm walking, yes indeed
Ms physical therapist today told me she has recommended that we NOT buy a wheelchair, that she expects M to begin walking, at home at least, in the next few months. God be praised. M will soon go home on an eight-hour day pass, so we can make sure we have modified the house appropriately and that I have enough training as his caregiver. We'll be on our own for those hours.

Going once, twice...
Up next, however, is a fabulous shindig put on by friends to help defray M's expenses. For one, he'll be needing therapy for at least a few more months and the insurance pays for twenty visits max (which will be used up in the first month).

The generosity of everyone confounds me and I am everlastingly grateful. So far, Beth tells me that she's received the following donations for the auction:

1/2 carat diamond necklace;
Fishing trip with a professional salt water guide and overnight stay at the famous Los Cazadores Lodge in Matagorda;
Week in the Casita Chorro, San Miguel, Mexico;
Week in Hacienda Guadalupe, San Miguel, Mexico;
Weekend hunt at the La Escondida Ranch;
Handcarved, hand painted 5 foot tall Wooden Indian sculpted by Gene Delaney (featured on Ray Miller's Texas);
Complete set of Architectural plans;
Photograph taken for a memory book for M; and
new silverware place settings, original artwork, stained glass window, items for the home, chiropractic services, dental services, books, autographed baseballs, Dynamo tickets, Astros tickets, symphony tickets, ballet tickets, Swim Club membership, collectibles, gymnastics, art classes......

Visiting M

Until May 17th or 18th, M will be an in-patient at TIRR. Though it has locations all over town for out-patient therapy, only one location houses the hospital, 1333 Moursund in the medical center. There's abundant, though pricy, parking both in front of the hospital and in the adjacent parking garage. ....

Even though his hair is cut in a very short buzz, you'll recognize M right away. He was virtually untouched in the accident, except for his brain. His verbal skills compare to his abilities before the accident. There's no hesitation or speaking difficulties. His memory is jumbled up, but there, so he will know who you are. Since he can't make new memories very effectively yet, he may forget in a few hours or a day that you were there. Even so, he will very much enjoy your visit. He does think his judgement is better than it is, so call a nurse if he unbuckles his safety belt. He also should not go anywhere by himself and needs help from an aide in the bathroom. He gets so bored at the end of therapy (4-6 weekdays) and all weekend, when there is no therapy, that these are excellent visiting hours. On the weekends, I'm there afternoons, so keep him company when I'm not there or come when I am there if you would feel more comfortable. Do come when and if you can.

Elizabeth Elliot on Prayer

Author: Elisabeth ElliotSource: Love Has A Price Tag

Scripture: Ephesians 6:12 Luke 9:23

Notes on Prayer
People who ski, I suppose, are people who happen to like skiing, who have time for skiing, who can afford to ski, and who are good at skiing. Recently I found that I often treat prayer as though it were a sport like skiing--something you do if you like it, something you do in your spare time, something you do if you can afford the trouble, something you do if you're good at it. Otherwise you do without it most of the time. When you get in a pinch you try it and then you call an expert.

But prayer isn't a sport. It's work. As soon as I've said that I'm in trouble because so many sports have become professional and as such are almost wholly indistinguishable from work. I could say that work is something you have to decide to do, you have to allow time for, you have to go at with energy, skill and concentration. But all those things could be said of the big business which is sports. Competition is deadly, equipment highly technical and expensive, salaries absurdly high.

But prayer is no game. Even if you are part of a "team," as when others join you in prayer, you are not cheered on by spectators or coached by any experts. You won't get any trophies--not on this side of the Jordan, anyway. It's not likely you'll get any credit at all. For some people prayer might fall into the category of "fun," but that's not usually the reason we pray. It's a matter of need and responsibility.

Prayer is work because a Christian simply can't "make a living" without it. He can't live a Christian life at all if he doesn't pray.

Prayer is the opposite of leisure. It's something to be engaged in, not indulged in. It's a job you give first priority to, performing not when you have energy left for nothing else. "Pray when you feel like praying," somebody has said. "Pray when you don't feel like praying. Pray until you do feel like praying." If we pray only "at our leisure"--that is, at our own convenience--can we be true disciples? Jesus said, "Anyone who wants to follow me must put aside his own desires and conveniences" (Luke 9:23 LB).

The apostle Paul did use an analogy from sports to describe prayer. He said we "wrestle." In the wrestling of a Christian in prayer, "our fight is not against any physical enemy: it is against organizations and powers that are spiritual. We are up against the unseen power that controls this dark world, and spiritual agents from the very headquarters of evil" (Eph. 6:12, Phillips). Seldom do we consider the nature of our opponent, and that is to his advantage. When we do recognize him for what he is, however, we have an inkling as to why prayer is never easy. It's the weapon that Unseen Power dreads most, and if he can get us to treat it as casually as we treat a pair of skis or a tennis racquet he can keep his hold.

If we're going to ask, "Is prayer work?" somebody will want to ask, "Does prayer work?" That question assumes that results ought to be measurable. The trouble is they are not by any means always measurable or predictable because the One to whom we address our prayers is infinite and incomprehensible, "and all that is comprehensible about him" (wrote John of Damascus) "is his infinity and incomprehensibility." His thoughts are as much higher than our thoughts as the heavens are higher than the earth.

And he is Love. Infinite Love will never give a stone when bread is asked for, or a scorpion in place of an egg. But what will Infinite Love give if our prayer is for a scorpion?

Prayer is compared in the Bible to incense. "Let my prayer be counted as incense before thee," wrote the Psalmist, and the angel who stood before the altar with the golden censer in Revelation 8 was given incense to mingle with the prayers of the saints. Incense was very expensive, blended by a perfumer according to a strict formula. It appears to serve no particularly useful purpose. Its smoke and fragrance soon dissipate. Couldn't incense be done without?

Prayer is like incense. It costs a great deal. It doesn't seem to accomplish much (as we mortals assess things). It soon dissipates. But God likes the smell. It was God's idea to arrange the work of the tabernacle to include a special altar for incense. We can be pretty sure he included all that was necessary and nothing that was unnecessary.

Christ prayed. He offered thanksgiving, he interceded for others, he made petitions. That the Son--co-equal, co-eternal, consubstantial with the Father--should come to the Father in prayer is a mystery. That we, God's children, should be not only permitted but commanded also to come is a mystery. How can we change things by prayer? How "move" a sovereign and omnipotent God? We do not understand. We simply obey because it is a law of the universe, as we obey other laws of the universe, knowing only that this is how things have been arranged: the book falls to the floor in obedience to the law of gravity if I let go of it. Spiritual power is released through prayer.

I could say, "God can make my hands clean if he wants to," or I could wash them myself. Chances are God won't make my hands clean. That's a job he leaves up to me. His omnipotence is not impaired by his having ordained my participation, whether it be in the washing of hands with soap or the helping of a friend with prayer. Christ redeemed the world by the laying down of his life, a perfect sacrifice, once for all. Yet he is in the business, as David Redding says, of "maintenance and repair." He lets us participate with him in that business by the laying down of our own lives.

One way of laying down our lives is by praying for somebody. In prayer I am saying, in effect, "my life for yours." My time, my energy, my thought, my concern, my concentration, my faith--here they are, for you. So it is that I participate in the work of Christ. So it is that no work of faith, no labor of love, no smallest prayer is ever lost, but, like the smoke of the incense on the golden altar, rises from the hand of the angel before God.

Visiting

2007-04-28T11:57:00.001-05:00

One and all, please come visit M especially between 12-1 and 4:30-6 pm weekdays, and anytime 9-6 Sat and Sunday. Sadly, he's not getting many visitors. Thanks to those who do come, though.

His verbal skills remain excellent and he loves company even more than before. Nothing else suits as well to while away the hours. M can read, but lacks the attention span to find it of value right now. Staring at the walls or watching TV doesn't nearly compare for stimulation to support his brain in healing. As much as I feel compelled to be with M to provide stimulation and company, I do have other things take me away (paying bills for one, taking care of the children is another, though parents of their friends have supplanted me there to a large extent.) Be aware that he is confused, so take much of what he says about his activities with a grain of salt. If something concerns you, check with me (for example, he'll talk about the kids getting physical therapy or other family members in the hospital, they aren't and nobody else is). His memory of things past is jumbled, but intact, so you can reminisce about past events or talk about things today, especially politics or whatever.

HOWEVER, there are some caveats to know. M is buckled into his wheelchair with a safety belt for a reason: he thinks he can get out of the chair and safely move about from place to place. He cannot. This morning, he managed to unbuckle the belt and fell. He didn't hit his head, thank God, but did scrape his back. So, please make sure he doesn't unbuckle the selt belt. Also, it's best that Mark and visitors stay in the day room, rather than in his room. He will talk sometimes about going to lie down. It's a bit of an obsession, so just talk around it. Thanks!

A little "toodle-loo"

2007-04-25T08:29:00.001-05:00

Let me hasten to say we are not bidding all adieu, but I can imagine M brightly chirping in one of his fake Brit accents, "toodle-loo," as he wiggles the fingers of his left hand. Yes, he can move, even if just barely, all the fingers on his weak side and he can flex his left biceps to oh-so-slowly move his right hand up. It was the week of April 2nd that I first noted M could move his left thumb. As slow as this seems, apparently this is rapid progress in the world of injured brains.

Cognitively, M progresses rather rapidly too. He's been reading the blog at a computer in the hospital for a couple of days and even made a comment yesterday. We can get conversations going either through comments or through an email account newly set up for him. Please do write. He enjoys conversation more than anything, I think, and he is touched by expressions of concern. Bless you all.

Another sharp upswing

2007-04-23T20:05:00.001-05:00

What a sweet weekend we had. We celebrated our son's birthday at the hospital with relatives and M joked around and laughed. Later that evening, M on his own started reflecting about the future. He wants to work, to teach others. When he returns to work, he said, he wants to serve others, especially the disabled.

I've mentioned previously the possible consequences of frontal lobe damage: the loss of insight, planning ability, self awareness and awareness of others. Over the past few days, M has been demonstrating a remarkable insight and an ability to empathize. He's projecting himself into the future, showing some of the executive functions so necessary for taking charge of one'e own life.

Later Sunday evening, he transferred himself (with my help) from the wheelchair to a low couch and we sat together for a bible study our church is doing. For twenty minutes, we read the Bible and reflected on answers asked in the study. How sweet to commune with my husband. He reached sometimes in his reflections, was not either as facile or as intense as he could have been three months ago, but he was fully present -- such a gift. A week ago, ten minutes without a non sequiter would have been impossible.

God continues to be so good. We prayed so hard at church Sunday for Ms memory to improve. On a whim, one therapist decided today to test his immediate memory. He amazed all of us by making an almost perfect score. With the immediate memory (remembering things within minutes, such as when you look a phone number up, then turn to dial it), he can use aids to assist his memory. It also shows that healing proceeds.

And today he started reading the blog. A half hour later, he forgot he read the parts he had read, but he was so absorbed while reading, he sat straight up in the wheelchair for half an hour.

Late in the afternoon, we spoke with his doctor. She too is encouraged by his progress, stating she expected his recovery to continue at a rapid pace.

Bless you all. This weekend saw lots of activity at the house, too, with the rooms totally rearranged and most of the boxes of stuff put away. Today dear friends started redoing our entry floor, with stunning results. Soon we'll have a refreshing garden entrance, one that M can negotiate in a wheelchair. It reminds me of an old-fashioned conservatory, just the place for a convalescent to bask in the sun.

Still making progress

2007-04-21T06:04:00.002-05:00

In every session of physical therapy, M walks. He requires assistance, mostly with the left leg, but even the assistance required is lessening. Though progress is achingly slow, M's left arm slowly is regaining strength. The left hand remains mostly unresponsive, but M does have a small amount of control over shoulder and upper arm muscles, which tire easily.

In his cognitive therapies, M's powers of concentration have improved daily. A favorite of the therapists in group therapy, M encourages the other patients, laughs and jokes. Most frustrating, I think, for all of us is how poorly his short term memory operates right now.

Discharge from TIRR is now expected to be May 17th and the recommendation is for M to continue in the day program at TIRR. This means that his schedule would remain the same, but he would stay home nights and we would be responsible for providing personal care during the day while he is at TIRR.

We're making progress at home, too. In a few days, we'll have a new floor in another room and all the boxes will be put away in another week or so.

Bless you all and please pray for progress, strength, and wisdom for us.

Thanks for the works of art

2007-04-15T21:19:00.002-05:00

I have had so much help from so many. Gal pals have piled out of their minivans (and trucks) to freshen up my yard for spring. Barbara has spent two Saturdays in a row moving furniture with me. Ashlyn showed up with fresh fruit and veggie from her co-op, food she and another member, Tina, have pitched in to provide for us.

Still more friends spent all Saturday ripping up the carpet in our bedroom, then sanding and refinishing the hardwood floor. Though the plywood patch (a full sheet of plywood) was an unpleasant surprise that we weren't able to alleviate for now, the concrete patching and other interesting "repairs" were removed nicely. Plus, I can no longer see down to the dirt under the house, thanks!

Thanks especially to Nathan and Darrin, who stayed until 11 p.m. working on the floor. And to Debby, who makes a mean chili cheese dog, times ten or so. And to Kristen, who left at 8:30 only to give our kids a quiet place to sleep, her house.

On Sunday, a bunch a guys we've known from our kids' school showed up to rip and pound the lumber Jim already had delivered earlier, all to make a beautiful ramp. Thanks Jim, Scott, Bill, and Wolfgang. Thanks too to your families who gave up a good part of the weekend with hubby or dad.

I should have jumped up and down at the results of your time and knowledge (and/or brute force). As gorgeous as the ramp is -- fitting perfectly in style with our house and deck -- it hurts to see it out my kitchen window. It's such a present reminder of things having changed. M said it perfectly today when I told him what was going on at the house today (he remembers all you guys). He said he thought you wouldn't mind if he doesn't use the ramp. I agree; I don't think you will.

Any Questions? Any Comments?

2007-04-15T21:11:00.001-05:00

Let me know. Thanks to those who have commented. Otherwise, it's lonely lobbing thoughts into the vastness of the web.....

In turn, I should acknowledge my indebtedness to others who have trod this road before me. M is one of the three M's at church. Margaret's emotional honesty touched me deeply and inspires me. I feel for Rita in her role as mother, wife, and chief cheerleader for her husband Mike. As you check on M, please also pray for Mike and Margaret and their families. ...

Caregiving

2007-04-13T10:25:00.000-05:00

About half the time now, I hang out in Mark's speech sessions. He speaks very well, but the therapist also helps with cognitive issues such as organization and impulse control, all encompassed within the general term of "executive control." Mark almost entirely lacks these critical skills now and is constantly coached, when in therapy.

I'm glad to be able to participate and am grateful the therapist spoke at length with me about the value of my being there, not just as a caregiver, but actually helping with therapy.

The caregiver role has its own burdens and rewards. Tricia, who used to work with Mark, sent me this.

DEAR LORD, I THANK YOU!

By M. Lemmons

Dear LORD, when you chose me to be a caregiver, I doubted YOU had the right person for the job. I have since learned that YOU have bestowed many blessings on me, and I Thank YOU!

YOU blessed me by giving me the strength to face the challenges each new day brings. YOU blessed me by giving me each new day, and I thank YOU!

YOU blessed me by giving me the patience to be a caregiver, and I thank YOU!

YOU blessed me by showing me how to smile when I wanted to cry and didn't have the time, or the time was inappropriate, and I thank YOU!

YOU blessed me by teaching me to be tolerant of others weaknesses, and I thank YOU!

YOU blessed me by giving me a sense of humor to laugh at myself when I get confused, forgetful, or do something really dumb, and I thank YOU!

YOU blessed me by giving me the determination to do my best for the person I am caring for, and I thank YOU!

YOU blessed me by showing me the intensity of the love I have for the person I am caring for, and I thank YOU!

But most of all, YOU have blessed me by allowing the person I am caring for to stay in my life, and I thank YOU!

Quick Update

2007-04-13T04:42:00.000-05:00

Mark continues to progress cognitively and physically, with an edge to the latter. He's been working more on supported walking, using the Robomedica treadmill for the first time yesterday. Because of the specific nature of his injuries (mainly to frontal and temporal lobes), Mark is largely unaware of the severity of his injuries (for example, he does not understand that he cannot walk without assistance and has not for two months). Therefore, he doesn't feel any great need or desire to work on using his left side. Please pray for improvement in his immediate memory and organization skills, areas where his spectacular improvement lags. Please pray also for continued reduction in perseveration.

More good news came in the results of tests this week. His cat scan this week shows all the bleeding and pooled blood in Mark's brain has been resolved. Another vision screening indicated his left neglect has improved greatly.

Today some of his family members and I will tour the Transitional Learning Center in Galveston. The latest recommendation from his doctor at TIRR, though, is for Mark to be discharged in early May, come home, and continue on in the TIRR day program. That means his days will remain the same, except he'll be sleeping at home and I will be responsible for his care, feeding, and transport. I'm eager for continued progress, but wondering how I will juggle work and staying with Mark at TIRR all day. Discharge planning on the institutional end and on mine will come more clear in the next week or so.

It's been explained to me that because Mark has not plateaued in his physical rehab, he would best benefit from continued intensive physical therapy. (This is his doctor's opinion.) When improvement in walking, for example, slows, or if healing leads to accelerated cognitive abilities (and better orientation), a program specializing in cognitive therapy would be most appropriate.

Blessings all.

Author: Elisabeth Elliot
Source: A Lamp For My Feet
Scripture: Exodus 13
Detours

When Pharaoh let the people go, "God did not guide them by the road towards the Philistines, though that way was the shortest.... God made them go round by way of the wilderness towards the Red Sea" (Ex 13: 17, 18 NEB).
The direct route would save time as well as wear and tear on the people, but God had something infinitely more important than economics in mind--He wanted the people to be able to sing the song of praise of chapter 15--"The Lord is my refuge and my defence...my deliverer. He is my God and I will glorify Him; He is my father's God and I will exalt Him" (Ex 15:2 NEB). They sang this song because they had firsthand experience of God's power and deliverance. Pursued by all the chariots and horses, cavalry and infantry of Egypt, they had passed through the Red Sea in safety and seen the enemy drowned. They would have missed this glorious lesson if they had taken the short road.
When we are puzzled by delays and detours, let us think about the great purpose of life: to glorify God. The lessons He wants to teach us "in the wilderness" are priceless means of providing us with a song we could not otherwise have sung: "In Thy constant love Thou hast led the people!" (Ex 15:13).

TWO Thumbs up

2007-04-06T06:56:00.001-05:00

I jumped up and down this week at the news that M was able to lift the thumb of his left hand in therapy. His therapist told me, not M, who had forgotten and/or not held this accomplishment in mind as anything special, one little incident indicating how profound and total brain injury can be. The emotional response most of us feel to events, the ability to reflect on experience and recognize its relevance to our lives, M lacks for the most part for the time being. I can say "for the most part" because M is still making progress in leaps and bounds.

Flashes of self-awareness, that the brain injury has affected the survivor's abilities, indicate a big milestone in the recovery process. And M has started saying things such as his memory isn't working very well and that his body is in terrible shape, showing that he is becoming aware of himself. Even further, he is showing an awareness of others' feelings. He turned to me a few nights ago and asked me if I loved him. When I answered yes, of course, why would he ask, he answered that I deserved to be protected and cared for. I was stunned, but able to answer in all truth that we both are sheltered by God.

M's memory, both of events before the accident and since, is returning. He consistently remembers, for example, that he is in TIRR to recover from a traffic accident and that he is right now working on making a pizza with a couple of his therapists. Some have asked about his recognition of people. From the beginning of his ability to let me know, he has always recognized his family members and always has known he has two children, even in the early days when he thought he was still 24 years old. He also recognizes people he had gotten to know just a few years ago and those he has met since being at TIRR.

Others have wondered about our financial circumstances and what lies ahead. M has health insurance, but his group coverage will end before the end of the year. At that point, though I don't have the details, our only option will be to join the state's high-risk pool. I will try to find individual insurance for the children and myself. My office does not offer health insurance as a benefit.

Two years from now, M may qualify for Medicare, if he qualifies for social security disability. I've started the application process for the latter. Mark will be deemed to qualify he is judged to be unable to work in any capacity for a year or longer. His doctors have advised me that is their prognosis for M. But the ss administration will keep a medical hold on M's file for at least several months as he continues to recover.

At this point, M's lead doctor is recommending that, after TIRR, Mark go on to a residential rehabilitation program in Galveston, the Transitional Learning Center, to learn self-care and cognitive coping skills. As much as I want him home, I am realizing more and more how much M needs to learn, but more positively, how much he can learn. We don't know yet if he would be accepted into the program, if the insurance will pay, and when he might go.

Another resource will be available to us in the fall. M is on the waiting list for comprehensive rehabilitation services through the state's Department of Adult Rehabilitation Services. Knowing the paltry level of social services offered in Texas, I'm surprised that such a program exists, but not surprised to know that it will be six months before the program will have sufficient funds to offer services to M. Of course, any expenditures now will not be reimbursed.

As for expenses, without the bills from the hospitals Memorial Hermann or TIRR (over two months of hospitalization), Aetna's accounting has us owing more than $20,000 to doctors alone. M will have a custom wheelchair that may cost us several thousand dollars out of pocket. And our living expenses, without any medical expenses, exceed my income. I am profoundly grateful for friends and family members who already have given us financial support in so many ways, not just cash, but services and meals and other expenditures. Then there is the Herculean effort BVD is putting into a fundraiser for M. In early days, I thought that would be icing on the cake, but am now realizing how important every dollar will be. Regardless of stories about wild spending sprees at the expense of the poor credit card companies, the majority of U.S. bankrupties are precipitated by an incident of illness or disability. And middle class persons with insurance are more likely than the uninsured to owe more money and go bankrupt in such circumstances. (Maybe it is in all truth because we get more services.) More sad statistics, most persons with severe brain injuries go bankrupt and, if married, have a 75% chance of getting divorced. I resolve that, as much as I have any ability to determine things, we will not add to those statistics.

I'm actually getting excited at the prospect of being the family breadwinner (when I'm not daunted and scared witless). Two books I devoured in the course of two days have helped me immeasureably: Where is the Mango Princess?, by the wife of a brain injury survivor and Over my Head: A Doctor's Own Story. I highly recommend both.

In this season of resurrection and new life, I give thanks for all of you, for your prayers, and the possibility of new life for all of us. I pray for God to be glorified and for the good news to spread far and wide.

And I pray that you, being rooted and established in love, may have power, together with all the saints, to grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge—that you may be filled to the measure of all the fullness of God. Ephesians 3:17-19

Your attitude should be the same as that of Christ Jesus: Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself and became obedient to death— even death on a cross! Therefore God exalted him to the highest place and gave him the name that is above every name, that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father. Philippians 2:5-11

Nice visits, great progress

2007-04-02T20:57:00.001-05:00

We've been blessed with lots of visits this weekend and Monday and M has done much better. Visitors really engage his attention and he'll crack jokes and laugh. Cognitively, M was much better today, including his memory of recent events. With friends, we played Battleship and "Kings in a Corner," a solitaire-type card game.

He’s so much stronger physically that he was able to transfer, with only my help holding on to make sure he kept his balance, from wheelchair to bed and other places a few times today. And he went on a bowling outing with other patients and therapists in the morning. Although his left leg is strong enough to bear his weight, he cannot voluntarily move it yet. He can, for very brief moments and ever so slightly, voluntarily move his left arm. Please pray for peace for me and protection from unecessary pain for M. I qualify it because he needs to feel pain on the left side to protect himself from hurt, but not unremitting pain caused by misfiring of nerve signals.

But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions—it is by grace you have been saved. And God raised us up with Christ and seated us with him in the heavenly realms in Christ Jesus, in order that in the coming ages he might show the incomparable riches of his grace, expressed in his kindness to us in Christ Jesus. For it is by grace you have been saved, through faith—and this not from yourselves, it is the gift of God— not by works, so that no one can boast. For we are God's workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do. Ephesians 2:5-10 (NIV)

"It gets worse before it gets better."

2007-03-31T12:04:00.001-05:00

This stands as one of two oracle-like statements I have heard repeatedly; the other one being, "Prepare yourself for a marathon, not a sprint." But I am one that has to experience these things for myself rather than take things as pronounced. So far, however, both seem to be true. And, even at nearly two months after the accident, these are still very early days. That too is very hard to believe and to take.

M's getting better means that he is frustrated and feels confined (without understanding he is and why). He's angry when I don't take him back to his room (where he will ask 30 times in 30 minutes to go to bed, telling me to get out of the way; no, go over there; now, get me up....) Being in his wheelchair a very long time every day builds his endurance. But, being in a hospital with noises and interruptions and even because of his injury, sleep at night is short and fitful. So he is tired and he is bored. His attention span is very short, so reading or even watching TV fail to entertain (or if you're anti-TV like me, fails to stupify).

I take him 'round the hospital to redirect his attention, but he gets so frustrated, he tells me to get in the chair, so he can get up and push me, and tells me and tells me....

To keep him (and many of the other patients) safely in his chair, the buckles on the seatbelts can only be opened not by a special key, but any thin sharp object such as a pencil. He's smart enough (again evidence of a good thing) that he knows this and he now fashions his own tools to open the buckle. If he should succeed (pray not), he would fall, a very serious but common risk in TBI (traumatic brain injury) patients.

He perserverates about bed less when he is away from his room, so I'll wheel him out to the day room, but he is so strong that he can DRAG the wheelchair, brakes locked, back to his room.

Please pray that these behaviors pass quickly. Please also pray that I not be afraid. I'm very concerned about my ability to cope with these behaviors at home, the children's responses, and my ability to find a caregiver who will cope adequately. I pray to always be reminded that the problems now may soon pass, though the perserveration about bed has lasted for a week now. Pray for wisdom for me and pray that we will emerge with a stronger marriage and stronger family ties.

Psalm 121
A song of ascents.
1 I lift up my eyes to the hills—
where does my help come from?
2 My help comes from the LORD,
the Maker of heaven and earth.
3 He will not let your foot slip—
he who watches over you will not slumber;
4 indeed, he who watches over Israel
will neither slumber nor sleep.
5 The LORD watches over you—
the LORD is your shade at your right hand;
6 the sun will not harm you by day,
nor the moon by night.
7 The LORD will keep you from all harm—
he will watch over your life;
8 the LORD will watch over your coming and going
both now and forevermore.

Last week of March

2007-03-27T21:02:00.003-05:00

The trend continues with me getting good reports from all of his therapists. This week M has graduated to a smaller wheelchair, one that he will be learning to propel. He can move forward and back, but needs help steering, since all the (human) power for now comes from his right side. They will practice that in therapy.

I’m slowly pulling back at the hospital as M improves enough to be testy with me for not doing everything for him (when he needs to do the work to get better). I’m at home with the kids at night, which is good for them too, though I miss not knowing everything that M experiences day and night. I’ll go still further and resume work next week.

M is still on track to come home in early May and I’ll have to get prepared. He’s improving rapidly enough that it’s hard to know exactly what to do, but I’m nearly certain we’ll need a ramp. We are in a tiny 1924 bungalow, with every space already spoken for and then some, so I may have to evict a kiddo from his or her room if M has to have a hospital bed and toileting facilities. I think our bathroom is too small for wheelchair access, but the occupational therapist will evaluate that.

We’ll also probably need at least a part-time caregiver. M will not need skilled nursing care (and so the insurance will not pay toward care), but should not be left unattended for a minute, at least at first while he still recovers. Please let me know any suggestions or referrals you might have.

I am exceedingly grateful that a former paralegal of M’s stepped forward to organize a dinner and auction Friday, May 4th. More details are forthcoming, but I just heard of a beautiful offer, a hunting weekend in the brush country, from a colleague of his that will be available at the auction. Please see the next entry for details.

Even in my darker moments, I know God has us in the palm of his hand and we are lifted up by so many friends.

Time catches us

2007-03-26T05:34:00.002-05:00

Some day we will exist unbound by time and space, but for now, in mortal bodies, we are carried inexorably forward. M slowly is getting used to the rhythm of the week, with the work week contantly busy. On the weekends, he is more restless, with little scheduled work to use up his energy. And he struggles to make sense of time -- day and night, minutes and hours. M can read, so I have written important milestones and facts from his life and posted these on the wall of his room. As I put one sheet on the wall, M says, "We were married in 1946." No actually, I say, we ARE 46, but we married in 1981, as I hasten to add that to the paper.

On April 2nd, he will have spent a month at TIRR, very profitably so. M has progressed wonderfully. But there is so much more to be done (I pray) and M's stay is projected to be halfway over. In early May, he will be coming home. And on the first Friday of May, friends have organized a fundraiser for us. Later in the month, we will celebrate our 26th wedding anniversary and then school will be out for the summer. Before then, I will return to work and we will be establishing a whole new rhythm to our lives. I pray that by then, M will be more moored by time. Blessings all!

Dh's recovery "incredible"

2007-03-22T18:08:00.001-05:00

Today, in discussing M's recovery with his psychologist, I mentioned that M was doing so well that a great day was not good enough, I wanted incredible. The psychologist replied that his recovery is already incredible. He did not think upon admission that M would have improved to the point he is now by discharge in early May.

We have had so many answered prayers. One day, I hope to be able to enumerate them all. For now, let the most recent count suffice. Recently M's eyesight in both eyes has proven to be better than 20/20, he has no more hospital-acquired antibiotic-resistant bacteria, and he can maintain his blood sugar balance, so no longer requires insulin. He has a new roommate who also likes it quiet and dark, with an early bedtime, so no more late night interruptions. M had his best night's sleep yet last night and spent the morning standing up (with help), throwing a ball to a golden retriever named Ginger. He retains his sense of humor, wonderful richness of English usage, and dedication to hard work.

Oh, but the bills are starting to come in, many in the five figures to start. I've devoted all my time to M, so am on leave without pay from work (and feel guilty but grateful for my board's and co-workers' forebearance).

I took photos all around the house and measured all the doors to give to the therapists and soon will hear their recommendations for adaptations. And when M leaves TIRR, he must have round-the-clock supervision and will continue hours of rehab a day, with someone taking him and staying with him.

But -- and -- above all -- what more can I say? God has so blessed me with confidence in him and strength. And he has protected and held up the children. Thank you Jesus. Bless all those reading this and saying prayers or sending good wishes our way. Know that things can happen in an instant to turn your life upside down and treasure every profound or silly moment. This may have been the only way for M and I to understand life is not ours to control and that patience truly is a virtue.

From Paul's great statement of theology, the book of Romans -

18I consider that our present sufferings are not worth comparing with the glory that will be revealed in us. 19The creation waits in eager expectation for the sons of God to be revealed. 20For the creation was subjected to frustration, not by its own choice, but by the will of the one who subjected it, in hope 21that the creation itself will be liberated from its bondage to decay and brought into the glorious freedom of the children of God.

22We know that the whole creation has been groaning as in the pains of childbirth right up to the present time. 23Not only so, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for our adoption as sons, the redemption of our bodies. 24For in this hope we were saved. But hope that is seen is no hope at all. Who hopes for what he already has? 25But if we hope for what we do not yet have, we wait for it patiently.

26In the same way, the Spirit helps us in our weakness. We do not know what we ought to pray for, but the Spirit himself intercedes for us with groans that words cannot express. 27And he who searches our hearts knows the mind of the Spirit, because the Spirit intercedes for the saints in accordance with God's will.

28And we know that in all things God works for the good of those who love him, who have been called according to his purpose. 29For those God foreknew he also predestined to be conformed to the likeness of his Son, that he might be the firstborn among many brothers. 30And those he predestined, he also called; those he called, he also justified; those he justified, he also glorified.
31What, then, shall we say in response to this? If God is for us, who can be against us? 32He who did not spare his own Son, but gave him up for us all—how will he not also, along with him, graciously give us all things? 33Who will bring any charge against those whom God has chosen? It is God who justifies. 34Who is he that condemns? Christ Jesus, who died—more than that, who was raised to life—is at the right hand of God and is also interceding for us. 35Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword? 36As it is written: "For your sake we face death all day long; we are considered as sheep to be slaughtered." 37No, in all these things we are more than conquerors through him who loved us. 38For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, 39neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.

Romans 8: 18-38 NIV

Sleep and wake cycles still disturbed

2007-03-21T04:48:00.001-05:00

As you might imagine, being in an ICU as M was for a month can totally disrupt the normal sleep-wake cycle. Add to that the injury itself and concommitant confusion about what night and day are, and the result is that some days M is less energetic during the day and every day he is wide awake at 3 in the morning.

Yesterday (on Tuesday), M spent time standing with support in both occupational and physical therapy. He's doing well in his group, "Memorex," for memory issues. He was pretty tired during speech, though. Please pray for stamina for all of us and for his left hand to respond as his left leg is.

We are having glorious spring weather and I pray we will be able to return to enjoying the outdoors as a family. God bless you and keep you.

Dh still progressing

2007-03-19T17:49:00.001-05:00

He's shaky in math, not knowing which is greater - three or five, but conversing up a storm. You can really tell he's trying to piece things together and is really trying to figure out things. His strength and stamina also are improving.

M's recovery to date is nothing short of miraculous. Every milestone that is set, he reaches much more quickly than estimated. Even so, it is unequivocal that he will need complete supervision at home and likely quite a bit of equipment, at least for a while. We're told his healing will continue for more than a year.

I must thank God for giving me strength and peace, and a conviction and direction. I also thank him for the work he has done in our lives so far. The children remain remarkably well adjusted and have drawn closer to one another. I thank also all those who have been helping with them and keeping an eye out for them. And most of all, thank you God, for answering so many prayers for M's healing. Please, all, continue to pray. Bless you.

Improvements and setbacks

2007-03-19T04:56:00.000-05:00

Mark's ability to converse astounds at times. His memory remains also amazing, but in its loss. All weekend, too, he was so restless in the wheelchair that he was unable to stay in it the desired six to eight hours. Today I'll be speaking with the doctors and therapists about addressing the restlessness - is it a healing brain, adjusted medication, poor wheelchair fit, or something else. Bless you and thank you for your prayers and support.

Psalm 111
1[a] Praise the LORD. I will extol the LORD with all my heart in the council of the upright and in the assembly.
2 Great are the works of the LORD;
they are pondered by all who delight in them.
3 Glorious and majestic are his deeds,
and his righteousness endures forever.
4 He has caused his wonders to be remembered;
the LORD is gracious and compassionate.

Conversations

2007-03-17T06:52:00.001-05:00

We had a meeting yesterday with the therapy team. All attended except his rehab dr, who leads the team. All note M was progressing rapidly and was expected to continue to improve for a year or more. Right now, he has problems focusing on instructions and following through, though that is improving. His ability to communicate has improved greatly to the point he can hold on to a train of thought long enough to have a brief conversation. He still has a long way to go in controlling his body. He's in a wheelchair that tilts because he has difficulty controlling his trunk, head and neck for very long (last week he couldn't control these at all). Right now he's working on skills for standing, with lots of mechanical and human assistance. Have a wonderful weekend! God is good.

Teaching the therapists

2007-03-16T05:32:00.001-05:00

He remembered yesterday marked the Ides of March, when Julius Caesar was assassinated, something his therapists did not know. M has been reading, speaking ,and writing more. He stood in a standing frame (which helps with a lot of support and alignment). But the left arm remains motionless, not responding either to volitional control or reflexes. And M has very restless nights, making concentration during the day harder. Please be in prayer for all these and for complete healing. Blessings all.

After the rain, a rainbow

2007-03-15T05:28:00.001-05:00

Even with all the concerns of my post yesterday, we have been so richly blessed, there's always hope, and we have the evidence of things seen as well. M can hold his head up, has the stamina to stay in the wheelchair for five hours or more, and began to write yesterday. I can't read all of it, but I can some - it looks like pieces of a draft of a settlement of all things.

His sister and I saw M's occupational therapist and she was very encouraging, as have been all the other members of his team. His estimated discharge date remains early May. And today he starts his pet therapy group.

Some of you have remarked on the time stamp for these posts. Maybe it's Pacific time? Please don't be concerned, I am not writing these at three in the morning, but usually at 5, which is our normal early morning wake-up.

He Will if You Will

Author: Elisabeth Elliot
Source: A Lamp For My Feet
Scripture: 2 Corinthians 1:11-11
All through the Bible we see the interworking of the will of God and the will of man. It was God, Creator and Sovereign, who conceived freedom for man--the glorious likeness to Himself in "the dignity of causality," to use Pascal's phrase. All things are so arranged in God's universe that He may work his will through man's exercising his gift of a free will. It is a gift, and one which, while it confers staggering power on us humans, also limits the Almighty. Here lies the tremendous mystery--that God should be all-powerful, yet refuse to coerce. He summons us to cooperation. We are honored in being given the opportunity to participate in his good deeds. Remember how He asked for help in performing his miracles: Fill the waterpots, stretch out your hand, distribute the loaves.
This little word of Paul's to the Corinthian Christians contains the whole kernel of that truth: "He will deliver us if you will cooperate by praying" (2 Cor 1:11).
Is there something you are hoping for today? Perhaps there is a condition you must fulfill before the Lord can grant it. He will if you will.

Real life begins again

2007-03-14T05:37:00.001-05:00

In a way, the past six weeks have been almost a dream state, a hiatus, a pause while home and work and family life are in abeyance. The children have been cared for by others to a large extent and now they are out of town with relatives for spring break. I've left my work responsibilities to others for a time and even my dog is being cared for by others.

Though I'm not consciously thinking this, I'm sure a part of me is running on adrenaline and denial until real life (our old life) resumes. Fostering this sense of abeyance is being at the hospital while M works and improves every day. But soon he's coming home and nothing will ever be the same. I know it will be better than now and pray that in the end it will be better than before. I keep praying to rely on God; not to be anxious, for he will care for us.

For the children, I will be responsible, as always except lately. I will be responsible for their everyday needs; meals, laundry, chauffer service, homework supervision. At least for a while, I will sorely miss M's participation. He was a full partner in caring for the children and house. You see, I have to use past tense now. For all this time, I have resisted referring to things as if they were not true now. (For example, saying M cooks all the meals on the weekends. I have to say now M used to cook all our weekend meals.)

Soon, for the children I will have the usual responsibilities (which I haven't had for several weeks) and also must help with their new emotional needs coming from living in a family where their Daddy is not the support of the family but needs more care than they do.

On the financial end, most of our adult lives, M's salary supported the family. Indeed, we have been blessed in having the ability for me to stay home with the children for more than ten years. Though I have returned to work, my income cannot cover our basic living expenses, let alone any additional needs. Nor do we have health insurance except through M's work.

And above all (at least in my list today) is M's needs. Right now it's constant care. He cannot feed himself, he cannot turn over in bed, let alone get up and move from one room to another. He will require someone on hand 24 hours a day. How will I work? How will I get the kids back and forth to school? We've always been on the go and he'll have countless appointments and I don't even know how or if I can get him in and out of our van.

Real life can't be held off much longer. Friday TIRR staff will hold a family training session for me, when I will hear their prognosis and what family must be able to do. Please be in prayer for us.

Already God has met so many of our needs through our support system here on earth. Everyone has been so helpful in sharing my burdens. On the financial end, too, friends have stepped forward to organize a benefit to defray our new expenses. ...Bless you all.

25Therefore I say unto you, Take no thought for your life, what ye shall eat, or what ye shall drink; nor yet for your body, what ye shall put on. Is not the life more than meat, and the body than raiment?
26Behold the fowls of the air: for they sow not, neither do they reap, nor gather into barns; yet your heavenly Father feedeth them. Are ye not much better than they?
27Which of you by taking thought can add one cubit unto his stature?
28And why take ye thought for raiment? Consider the lilies of the field, how they grow; they toil not, neither do they spin:
29And yet I say unto you, That even Solomon in all his glory was not arrayed like one of these.
30Wherefore, if God so clothe the grass of the field, which to day is, and to morrow is cast into the oven, shall he not much more clothe you, O ye of little faith?
31Therefore take no thought, saying, What shall we eat? or, What shall we drink? or, Wherewithal shall we be clothed?
32(For after all these things do the Gentiles seek:) for your heavenly Father knoweth that ye have need of all these things.
33But seek ye first the kingdom of God, and his righteousness; and all these things shall be added unto you.
34Take therefore no thought for the morrow: for the morrow shall take thought for the things of itself. Sufficient unto the day is the evil thereof.
Matthew 6:25-34

Never again will they hunger; never again will they thirst. The sun will not beat upon them, nor any scorching heat. For the Lamb at the center of the throne will be their shepherd; he will lead them to springs of living water. And God will wipe away every tear from their eyes."
Revelations 7:16-17

Still improving

2007-03-12T19:40:00.001-05:00

M spoke more today and he did very well in occupational therapy, controlling his body movements more. He can't control his left arm and hand at all, so please pray for that. He has trouble accessing short-term and some long-term memory as well. His brain continues to heal and the training and practice helps too.

Please also be in prayer for my cousin's brother-in-law Lee, who also is recovering from being critically ill, a massive staph infection in his case. Though the doctors had been very negative, Lee too is recovering more than the doctors expected, but has a far, far way to go.

Blessings all.

Love never fails

2007-03-12T05:37:00.000-05:00

I think of these verses from 1st Corinthians (see last paragraph) every day these days. Mark had a good Sunday and so did the rest of the family. As promised, speaking seems gradually to get easier and easier for him. Please continue to pray that he will regain control of his left side. Daily the right side gains strength.

Lenten devotional from Goshen College
The LORD says to Israel… I have loved you with an everlasting love; I have drawn you with loving-kindness and I will build you up again… Jeremiah 31:3-4.

The Lenten season reminds us that Jesus opens his arms with everlasting love and kindness and invites us into God’s welcoming embrace. When we accept this invitation, we join with all God’s people in experiencing the depth and dimensions of what it means to be loved with an everlasting love. As we come to experience the welcome of Jesus, we are more able to open our arms in everlasting love to others as Jesus did, to those we love and to those we are inclined not to love. We can then hold the Christ-light for them and live out God’s welcoming love that they long to feel.

For love is patient, love is kind.It does not envy, it does not boast, it is not proud.It is not rude, it is not self-seeking.It is not easily angered, it keeps no record of wrongs.Love does not delight in evil, but rejoices with the truth.It always protects, always trusts, always hopes, always perseveres.Love never fails. (I Corinthians 13:4-8) Lent reminds us that God loves us with an everlasting love and build us up again. As we experience God’s love for us, we can more fully express God’s welcoming love to others.

Our pup visits

2007-03-11T05:34:00.001-05:00

With a newly minted seal of approval from therapeutic recreation, F had a long visit with M Saturday. I feared F wouldn't recognize his master, but he came right up to M in his wheelchair, tried to push up M's elbow with his nose for a pat, and finally jumped up on M's wheelchair to plant several wet doggie kisses on M's face. M laughed and reached out his hand to pet the dog. Also on Saturday, M spoke more and moved his left leg vigorously in response to stimulus.

At some point during his pilgrimages to various hospitals, M has been colonized by a multiple-drug resistant bacteria. He shows no sign of infection, but as long as he has the bacteria, he can infect others, so lots of extra precautions must be taken. I pray that no one else gets infected and the bacteria can be cleared from his system. In the meanwhile, he has to share a room with another man who has the same bacteria. This man's care requirements are such that all night nurses are in the room for hours at a time, with the lights on, making considerable noise. M is unable to get more than an hour or two of sleep. Please pray for all this to be resolved.

Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light. Matthew 11:28-30, NIV

Elisabeth Elliot devotional

2007-03-10T07:10:00.000-06:00

Elizabeth Elliot has had many wonderful ministries over the years. Some of you may hear her commentary on Christian radio, she has a wonderful voice and thought-provoking and comforting comments. You may also recognize her name from the movie, End of a Spear, about her first husband's death at the hands of South American tribesman and her return, toddler in tow, to evangelize that tribe.

Author: Elisabeth Elliot
Source: A Lamp For My Feet
Scripture: John 12:25

Hour of Glory
The miracle of Lazarus being raised from the grave brought the crowds waving palms to Jesus, proclaiming Him King. Even foreigners (some Greeks) heard of Him and asked his disciple Philip if they might see Him. This, surely, was his hour of glory.

Heaven's definition of glory, however, is a very different thing from earth's. "The hour has come," Jesus said to Philip and Andrew, "for the Son of Man to be glorified" (Jn 12:23 NEB). Then He illustrated his meaning: a grain of wheat is merely a solitary grain until it dies. It is death that brings glory, the glory of the rich harvest. It was not popular acclaim but popular rejection and his own suffering and death that constituted his "hour of glory," and He prayed to be spared that hour.

The one who would serve Him must understand the conditions. He must follow--into death--that is, he must "lose himself." Then, the promise is that he will be "kept safe for eternal life" (Jn 12:25) and honored by the Father. The hour of glory is the hour of suffering--seen from heaven's side.

Lord, be near us in our pain and grant us the clear eye of faith to see it from heaven's perspective. Jesus walked this road. Help us to follow him gladly.

Another favorite passage

2007-03-10T07:04:00.000-06:00

1 Thessalonians 5:17-24 NIV

16Be joyful always; 17pray continually; 18give thanks in all circumstances, for this is God's will for you in Christ Jesus.
19Do not put out the Spirit's fire; 20do not treat prophecies with contempt. 21Test everything. Hold on to the good. 22Avoid every kind of evil.
23May God himself, the God of peace, sanctify you through and through. May your whole spirit, soul and body be kept blameless at the coming of our Lord Jesus Christ. 24The one who calls you is faithful and he will do it.

Prayers the world round

2007-03-10T06:42:00.001-06:00

From the very beginning I have asked that prayers be poured out for M and the response blossomed. We have had prayers in Azerbaijan, Sri Lanka, and all over the U.S. Most sweetly, many are from friends of friends, or relatives of our children's teachers, or M's colleagues in a case he had years ago in Missouri, and so on. One of M's clients had a mass held for him. Another friend had a prayer sent to the western wall (wailing wall) of the Temple in Jerusalem.

At our church now, we have the three M's, I'm told. There's my dh, and also Mike H. who is battling melanoma and is in the midst of an intense chemo round, and Margaret H., who has been tenaciously and graciously battling cancer for a while. Her heartfelt emails helped inspire me to do this. Please pray for us all. And there's also the Nichols family, formerly at Vineyard of Houston, now in Georgia. Diabetes and cystic fibrosis stalks this family. I pray, as was prayed for me years ago,

Zephaniah 3:15-17
15 The LORD has taken away your punishment, he has turned back your enemy. The LORD, the King of Israel, is with you; never again will you fear any harm.
16 On that day they will say to Jerusalem, "Do not fear, O Zion; do not let your hands hang limp.
17 The LORD your God is with you, he is mighty to save. He will take great delight in you, he will quiet you with his love, he will rejoice over you with singing."

Pruning the vine

2007-03-10T06:34:00.001-06:00

I've been praying that God be glorified in all this, so the devotional below meant much to me. I know God is moving powerfully.

Many at TIRR and Hermann are clearly devout. Last night, the nurse changing M sang a spiritual over him. Many tell me to pray. Not all believe, though, and I have to remember not to assume (just as that's true for some of you reading this). All are amazed at M's progress and reassure me, knowing that light speed still doesn't seem fast enough for me.

Yesterday, M's nurse, Jorge said, "I don't know who you're praying to, but he's listening." I just said in return I KNOW who I am praying to. So the ground is being prepared. Please pray that M and I too will bear fruit.

From Goshen College
http://www.goshen.edu/cgi-bin/blosxom/devLent07/2007/Mar/09/March9-Justabitmore
March 9 - Just a bit more
By Malinda Berry, visiting scholar in religion and women’s studies.

Scripture: Luke 13:1-9 (NRSV) Scroll down for complete scripture.
Devotional:When I first read today’s lection, I thought it rather odd — there are lots of pronouns and not much context. In my copy of the NRSV titles to chapter thirteen’s opening section "Repent or Perish" which makes some sense: "Produce fruit or be cut down!" But I find I’m more interested in the gardener’s intercessory pleading with his employer: "Wait, give me a chance to nurture the tree a bit more. If nothing changes, then you can do what you want with it." At face value, it appears as though Abba is the vineyard owner, Jesus is the gardener and humankind is the unproductive fig tree. But parables are never that simple. Commentators point out that Jesus tells this story in response to the talk about town regarding Pilate’s suppression of a recent Jewish uprising in Galilee. The Gailean rebels failed in their attempt to overthrow Pilate, Caesar’s local representative — their actions, like what the vineyard owner proposes, were rash and brought death. But criticizing those who died and the way they died doesn’t make the living virtuous. So where does that leave us? From where I sit, this parable is about more than righteousness, judgment and intercession. I think this story is also about paying attention to when things and people and places need some extra care and attention to thrive lest desperation and rash decisions lead us all down a path of destruction rather than toward that place where "they shall beat their swords into plowshares, and their spears into pruning hooks; nation shall not lift up sword against nation, neither shall they learn war any more; but they shall all sit under their own vines and under their own fig trees, and no one shall make them afraid" (Micah 4:3b–4a, NRSV).

Scripture: Luke 13:1-9 (NRSV)At that very time there were some present who told him about the Galileans whose blood Pilate had mingled with their sacrifices. He asked them, 'Do you think that because these Galileans suffered in this way they were worse sinners than all other Galileans? No, I tell you; but unless you repent, you will all perish as they did. Or those eighteen who were killed when the tower of Siloam fell on them— do you think that they were worse offenders than all the others living in Jerusalem? No, I tell you; but unless you repent, you will all perish just as they did.' Then he told this parable: 'A man had a fig tree planted in his vineyard; and he came looking for fruit on it and found none. So he said to the gardener, "See here! For three years I have come looking for fruit on this fig tree, and still I find none. Cut it down! Why should it be wasting the soil?" He replied, "Sir, let it alone for one more year, until I dig round it and put manure on it. If it bears fruit next year, well and good; but if not, you can cut it down."'

"Smoking the competition"

2007-03-10T06:14:00.001-06:00

Two days ago marked one month since M's accident. This week in particular has been one of many changes. The trach is out and the breathing treatments (albuterol) have been discontinued. He passed his final swallowing test - can he eat a hamburger - with flying colors and so can eat anything anyone else can. He's daily gaining more trunk and head control. Even so, he still needs contant care for everything, not being able to turn himself in bed, attend to bodily functions, get to the wheelchair, etc. Yesterday, though, the nurse said to hold off on any modifications to the house because M is improving so fast. His is the quote in the title for today. And, such sweet sounds, I heard M say my name, his sister's and the children's yesterday. More often than not, he still can't reply to questions, but each day he speaks a little more. And he smiles and laughs. As a lagniappe, our golden retriever has been cleared to visit M in his room at the hospital.

Psalm 111 NIV
1Praise the LORD.
I will extol the LORD with all my heart
in the council of the upright and in the assembly.
2 Great are the works of the LORD;
they are pondered by all who delight in them.
3 Glorious and majestic are his deeds,
and his righteousness endures forever.
4 He has caused his wonders to be remembered;
the LORD is gracious and compassionate.
5 He provides food for those who fear him;
he remembers his covenant forever.
6 He has shown his people the power of his works,
giving them the lands of other nations.
7 The works of his hands are faithful and just;
all his precepts are trustworthy.
8 They are steadfast for ever and ever,
done in faithfulness and uprightness.

Tracheotomy is gone!

2007-03-07T18:51:00.001-06:00

Just like that, the doctor pulled it out and bandaged the area. It should close in a few days. Everyone is pleased with M's progress and thinks he'll go far. Because he is young(ish), fit, and is "oriented" mentally, they think he can improve with a lot of therapy, thus they plan (at this point and pending weekly insurance approvals) to keep M for 8 weeks. He's smiling lots and even laughing at jokes.

Passing another test

2007-03-06T18:33:00.001-06:00

Having passed the swallowing test (an interesting procedure with barium and real-time X-rays), M had solid food for lunch and dinner. I'm feeding him for now, though he can pick things up with his right hand and he himself is taking care of holding a cup and drinking. Speaking is very hard, but he can every great now and again. I'm told it will get easier and easier.

And I had the answer to prayer when he held my hand, brought it to his mouth and kissed it. What bliss! It's like being a teenager again.

God's strength and love is all around; sometimes I feel suffused with it. I pray all reading this will know how much he cares for each one of us.

Rehab begins in earnest

2007-03-05T18:44:00.001-06:00

M had an hour of speech therapy (though he's not speaking, he recognizes words and pictures), sat up supported in physical therapy, and continued his occupational therapy evaluation. He's being weaned off the stomach feeding and trach as well. I'm in the thick of it too, staying at the hospital about 22 of 24 hours/day. Blessings all!

Great progress

2007-03-04T19:45:00.001-06:00

We're at TIRR and have been since Friday night. So many prayers have been answered. Rehab started Sat. I've seen many things that tell me M's ability to understand complex language remains intact. These are v. exciting days.
M's left side still is much weaker and he's not walking yet. "Yet" will be our adverb of choice these days. Blessings all.

2007-03-02T16:27:00.000-06:00

We're off to TIRR! Any minute now, which in hospitalese I've found can mean sometime in the next six hours or more. Mark puckers up for a kiss (for me only I hope) and waved goodbye to me today. His internal medicine dr (great guy BTW) says he thinks Mark will be walking back in Hermann 6 months from now. God willing and God has been so good so far.

A colleague's opinion

2007-03-02T10:57:00.002-06:00

From Jack Lejune, a court reporter M respects highly. Ma took Jack to Paris a few years ago instead of me!

Though I have met and worked with, quite likely, over a thousand attorneys in the past 34 years, M stands out, even in such a large group. He’s always friendly, patient and, most notably, always happy. I’ve seen, on numerous occasions, defense counsel (as many as 8) become upset (seemingly) with M, tell him he’s wrong, sometimes angrily, at times condescendingly and, M to his credit, presses on, unswayed, unintimidated and, again most notably, happily; smiling all the while. Unflappable; that’s M. Perhaps he thrives on controversy. Perhaps he finds humorous the attempts of others to “derail” him. I don’t know, but it’s an admirable quality, one I’ve very much enjoyed observing.
M is a special human being and one of my favorite attorneys to work with. Hopefully he will attain full recovery so that we can all have the pleasure of his company, his presence, for many years to come.

Thank you, Jack. I would love others to send me their stories, too.

Improvement

2007-03-01T18:36:00.001-06:00

But the improvement seems glacial to me, though the docs are impressed with his speed of recovery. He has some purposeful movement, is clearly awake, but has considerable left-side weakness and cannot yet communicate. As soon as a bed opens in TIRR, we're going there.

Please pray for all of us and for everyone, families and workers, at Hermann. Today was such a lovely day here, bright with the promise of spring. I refuse to believe that M won't be fully enjoying the breezes, sights, and smells of spring some day, in the thick of it, being pysically active as he loves to be. Thank you all.

Psalm 107:1
Give thanks to the LORD, for he is good; his love endures forever

Still at Hermann

2007-02-28T20:11:00.001-06:00

I've been spending almost all my time at the hospital while I can. At TIRR, I can't spend overnights except maybe once or twice. M's had more tests, nothing major really. Every day he seems to improve slightly. One of the nurses told me the brain heals about one-ninth the rate of the rest of the body so that it takes nine days to heal what the body could heal in one. And M is expected to be home around the beginning of April. We have our work cut out for us!

Romans 8: 26-35
26In the same way, the Spirit helps us in our weakness. We do not know what we ought to pray for, but the Spirit himself intercedes for us with groans that words cannot express. 27And he who searches our hearts knows the mind of the Spirit, because the Spirit intercedes for the saints in accordance with God's will.
28And we know that in all things God works for the good of those who love him,who have been called according to his purpose. 29For those God foreknew he also predestined to be conformed to the likeness of his Son, that he might be the firstborn among many brothers. 30And those he predestined, he also called; those he called, he also justified; those he justified, he also glorified.
31What, then, shall we say in response to this? If God is for us, who can be against us? 32He who did not spare his own Son, but gave him up for us all—how will he not also, along with him, graciously give us all things? 33Who will bring any charge against those whom God has chosen? It is God who justifies. 34Who is he that condemns? Christ Jesus, who died—more than that, who was raised to life—is at the right hand of God and is also interceding for us. 35Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword?

TIRR evaluation

2007-02-26T22:28:00.001-06:00

Today I had a lovely visit with several friends, but especially from an old dear friend who has experience in neural stimulation. She brought a whole program for M that we began to practice. We also had a visit with a nurse manager from TIRR, who deemed M ready for TIRR. We'll have to check insurance though, and may make a stop at a long-term acute care hospital along the way if we don't have enough benefits to take full advantage of TIRR right away.

M was more tired today, the result undoubtedly of having bueacoup visitors Sunday. We did see the inkling of a half-smile a time or two, though.

Please hold us up in prayer. I feel torn even more ways now and have more paperwork to juggle. Bessings all.

A wonderful old hymn

2007-02-25T11:10:00.000-06:00

We sang this today and I've always loved it.

Today we sang this hymn in church.

I stand amazed in the presence of Jesus the Nazarene,
and wonder how he could love me, a sinner, condemned, unclean.
Refrain:How marvelous! How wonderful!
And my song shall ever be:How marvelous!
How wonderful is my Savior's love for me!

For me it was in the garden he prayed: "Not my will, but thine."
He had no tears for his own griefs, but sweat-drops of blood for mine. (Refrain)

In pity angels beheld him, and came from the world of light
to comfort him in the sorrows he bore for my soul that night. (Refrain)

He took my sins and my sorrows, he made them his very own;
he bore the burden to Calvary, and suffered and died alone. (Refrain)

When with the ransomed in glory his face I at last shall see, '
twill be my joy through the ages to sing of his love for me. (Refrain)
Text: Charles H. Gabriel Music: Charles H. Gabriel

Responding

2007-02-25T11:07:00.001-06:00

Praise God, M is responding to commands.

Another great verse from a friend

2007-02-25T08:59:00.001-06:00

Proverbs 3: 5,6

"Trust in the Lord with all your heart and lean not on your own understanding; In all your ways acknowledge Him, and He shall direct your paths." (NKJV)

Hurrah! a private room

2007-02-24T17:55:00.001-06:00

Today M was moved to a private room, which means we now have chairs we can sit in and the visiting hours are vastly expanded. We've brought in a CD player and have music playing for him and posters and photos right where he can see. All this is to stimulate M's brain to preserve old connections and make new ones. He seemed very interested in watching the children and he seems to respond on occasion to requests for him to open his mouth.

M's sister and I also visited TIRR to learn more about it and the admission process. He'll probably be evaluated Monday by a nurse manager, who, together with a physician at TIRR, will decide if he's ready to benefit from their services. It's an amazing place, so please pray he'll be ready.

I have always loved the verse below. M and I are people of the word. The Word can mean the Bible, the Word of God, and we are devoted Christians. But also we love words. Reading and speaking give us pleasure and we each earn our livings by skillful understanding and use of words. The neurosurgeon said last week that once M said his first word, the pace of improvement would accelerate. Please pray that the word, in all senses, is preserved or will be restored for M.

God bless you all. Thank you for your prayers, concern, and help.

In the beginning was the Word, and the Word was with God, and the Word was God. He was with God in the beginning.
Through him all things were made; without him nothing was made that has been made. In him was life, and that life was the light of men. The light shines in the darkness, but the darkness has not understood it.
There came a man who was sent from God; his name was John. He came as a witness to testify concerning that light, so that through him all men might believe. He himself was not the light; he came only as a witness to the light. The true light that gives light to every man was coming into the world. John 1: 1-9

2007-02-24T06:24:00.000-06:00

Scripture

2007-02-24T05:52:00.000-06:00

All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness, so that the man of God may be thoroughly equipped for every good work. 2 Timothy 3:17-18

A very busy day

2007-02-23T21:44:00.001-06:00

We all had a busy day today. M remains about the same. I would prefer improvement, but same is good for now. This morning, the thinking was M would be transferred to a long-term acute care hospital (LTACH), not being ready for rehab. But then the decision was made to at least order a review by The Institute of Rehabilitation and Research. So that will take place in the next few days. Somewhere in that time frame, M will be moved to a room where we can stay for longer than twenty minutes every two hours (the current visitation schedule). He also had an MRI today which will determine if the cervical collar (hot and uncomfortable) can be removed from around his neck.

A special visitor came today, an uncle of friends of ours, who happens to be a neurologist. He examined M, looked at some of his records, taught me some exercises to do with M and said he thought M would be much more aware in a few days. What happy news to hear. We can't keep this neurologist, though, he's going back home to Taiwan very soon. But we did get recommendations for another neurologist, who may come see M this weekend. And all, have a wonderful weekend!

...those who plan what is good find love and faithfulness.”- Proverbs 14:22

About M's career

2007-02-23T21:37:00.001-06:00

Information as of 2006

CAREER HIGHLIGHTS
Since 1988, M has won numerous personal injury trials before judges and juries in state and federal courts. His practice currently focuses on representing plaintiffs in the areas of products liability, premises liability, and medical negligence. M also has substantial experience representing both plaintiffs and defendants in transportation-related claims (marine, aviation, trucking and railroads), and has developed a specialty in the procedural and jurisdictional issues that arise in trans-national and interstate tort claims.
In M's approach to litigation, early and exhaustive investigation forms the foundation for all strategic planning. With this philosophy, plaintiff's counsel should ideally be ready to try each case before it is filed.
M is Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization, and is also a member of the College of the State Bar of Texas, an honorary law society of the State Bar of Texas. He has been awarded an AV rating by Martindale-Hubbell, which identifies a lawyer with very high to preeminent legal ability, and is a frequent speaker on litigation and trial issues at continuing legal education seminars across Texas.

LEGAL MATTERS
As one of four members appointed to the Claimants' (Plaintiffs') Steering Committee in the limitation of liability litigation arising out of the allision of the M/V/ BROWN WATER V with the Queen Isabella Causeway in south Texas, M was responsible for coordinating the Plaintiffs' discovery and motion practice. M successfully negotiated a seven-figure, policy limits settlement of this difficult admiralty case involving eight deaths and numerous personal injuries.
Negotiated a settlement in excess of $3.8 million for the surviving elderly mother of a construction worker who was mortally injured in a workplace accident. The victim had no spouse or children. The lawsuit, which involved theories of defective product design, premises liability and negligent activity, settled on the eve of trial against multiple defendants.
Negotiated a $325,000 settlement of sexual assault/psychological injury lawsuit against an apartment complex. Allegations included inadequate security and premises liability. The case was controlled by the current Texas law which permits a criminal perpetrator's responsibility to reduce the defendant's responsibility. In this case the jury's allocation of fault against each of four perpetrators (all of whom were convicted of rape) would have reduced the fault of the apartment complex.

Obtained jury verdict, including $550,000 award of future pain and suffering, in medical malpractice case in Liberty County, Texas. The defendants made no offer prior to trial in this case, in which we alleged that they had failed to diagnose and treat a "saddle embolus" in the distal aorta resulting in injury to our client's leg, and an otherwise avoidable, disfiguring surgery. The case ultimately resulted in a confidential settlement in excess of eighty-five percent (85%) of the judgment.

Negotiated multi-million dollar settlement on behalf of child with a spinal injury in Houston, Harris County, Texas. Premises liability, fall through balcony railing. Case was investigated and rejected by several other personal injury law firms, as "no liability."

Negotiated settlement in excess of $650,000 on behalf of chemical plant worker who suffered fractured jaw, unoperated shoulder and unoperated neck injuries in Houston, Harris County, Texas.

Negotiated $300,000 settlement in a products liability case in Houston, Harris County, Texas for a wood worker who suffered a penetrating abdominal injury and resulting neuropathy.

REPRESENTATIVE CASES
Transportes Aereos De Coahuila, S.A., a/k/a TACSA v. Falcon, 5 S.W.3d 712 (Tex. App.-San Antonio, 1999, pet. denied)
Scott v. Huey Cheramie, Inc., 833 S.W.2d 240 (Tex. App.-Houston (14th Dist.) 1992, no writ)

ACTIVITIES AND AFFILIATIONS
Member, Texas, Galveston County and Harris County Bar Associations
Member, Association of Trial Lawyers of America
Member, Texas Trial Lawyers Association
Member, Maritime Law Association of the United States

EDUCATIONAL AND PROFESSIONAL BACKGROUND
Ajamie LLP, Houston (1998-present)
Royston, Rayzor, Vickery and Williams, L.L.P., Galveston and Houston (1988-1998); Partner (1994-1998)
University of Texas (B.S., with honors, 1981; J.D., with honors, 1987)
Staff Member: The Review of Litigation, University of Texas

Verse from a friend

2007-02-23T09:53:00.000-06:00

May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit. Romans 15:13

Soon to be moved

2007-02-22T17:31:00.001-06:00

M had an easier time looking straight ahead today rather than to the right, though he doesn't seem to be able to track to the left very much at all. It has been better still on other days, so I pray the healing process isn't over by a long shot.

The ventric. was removed today from his head, meaning he can be moved to the intermediate unit on the same floor, with much more generous visiting hours, soon, maybe even tomorrow. He's off almost all the meds except for antibiotics, insulin (he's not controlling his blood suger very well), and probably an anti-convulsant medication. No change in his mental status, though, at least according to their neuro tests.

Blessings tonight to all.

28"Come to me, all you who are weary and burdened, and I will give you rest. 29Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. 30For my yoke is easy and my burden is light." Matthew 11

For other verse and translations, see Bible Gateway.

2-22 recap and update

2007-02-22T08:48:00.002-06:00

Two weeks ago today, M was coming home after negotiating a large settlement. I know he was very happy. Things were going well in his work and at home. I had gone back to work for the first time in 11 years in August.

M encouraged me to return to work - this particular position - saying he would do what ever needed to be done and he completely fulfilled that promise. Caring for the children and house, his share was surely at least half all the while working very hard at his law practice.

Along the way from Austin on February 9th, M collided with another car (I've been told both drivers contributed). The other driver also is a middle-aged (how M hates to be characterized as such) professional. The other driver was uninjured; he stopped and called 911. M suffered very serious head injuries, but remarkably little trauma to the rest of his body - bruised lungs, two cracked ribs, and fracture of the transverse process of one or two lumbar vertebrae.

M was first treated in a small hospital, then transported to a trauma unit out of town. There was a possibility he would not survive. Thanks to help from the doctors there, and friends of friends knowledgeable of the workings of the local hospital, M was transported by Lifeflight the next day. He was on a ventilator and a intercranial pressure monitor (see http://www.doereport.com/generateexhibit.php?ID=3449) and drain was used to relieve pressure on his brain from the bruising and swelling.

Though sedated for a while, he was never in a medically induced coma. Over the ensuing days, his intercranial pressure has stayed normal and now preparations are being made to remove the monitor/drain. He has been weaned from the ventilator, but has a tracheotomy because he is at risk for aspirating secretions and getting pneumonia. The trach allows caregivers to suction secretions.

Every hour, round the clock, M's neurological status is tested. He rates a "10," whereas just about anyone reading this will be a 15. We can initiate conversation. M is not responding to commands, though his eyes are open and he responds to his chest being rubbed. (Look up Glascow coma scale for more.) A week ago, the neurosurgeon told me he thought M would wake up, but it would take time. M will be moved to another, less-intensive ward in a few days. By the middle of next week, if he continues to be stable, he will be moved either to a long-term acute care hospital, while we wait for his brain to heal enough for him to be more aware; or he will be moved to TIRR, a top-of-the-line rehabilitation hospital. The neurosurgeon and TIRR will make the decision of which is most appropriate for him for the time being.

I visit every chance I can (visiting hours in this unit are strict) and tell M things about the day and how much I love him. Last week was our 30th Valentine's Day together. But everyone insists M looks 30. Please be in prayer for his complete, swift recovery. Please also pray that we as a family will continue to be drawn together.

Whenever I visit, I'm always upbeat and I talk about when he comes home, when he wakes up, never if and I don't allow caregivers to plant that seed either (to the extent I am there). I've been told that people still hear, and can recall, things told to them while in a coma.

Thank you all for your concern, offers of help, and help. Don't worry, if I haven't asked you for something yet, your turn will come. This will be a months-long or even years-long recovery process.

God bless you and keep you.