Dear D.,

Greetings! I do hope all is well with you. I am writing to give you an update on Chris and request funding for an additional ₤328.20/ week. I will outline below the rationale and reasons behind this request as I am not sure how often you follow Chris’ blog. As you know, I always write everything with the utmost integrity and honesty as many other brain injured families and carers follow the blog, so I do not sugar coat anything.

Following the three months of therapy in China, I am very happy to report that Chris has returned with various improvements. They are not yet major functional improvements but they are marked enough for all staff and therapists at the Jacob Centre to notice, celebrate and congratulate us all on the effort.

I had a meeting with the MTD at the Jacob Centre last week and I have requested increased therapy and stimulation for Chris in order to ensure his continued progress. So much was achieved regarding his range in all four limbs (more accentuated in the left side), his sensitivity to touch, less resistance, more emotional response… all this while decreasing major drugs (tizanidine, sertraline, clonazepan, among others). Since his return, Chris has been able to go on the tilt table – which was something impossible to do prior to the stem cell treatment. Chris’ spasticity, which has been our main battle since his injury, got better. He offers less resistance. This is a major victory because nothing so far seemed to have reversed the tone and spasticity problem. Therefore, nurses and therapists at the Jacob are thrilled to work with him.

The Chinese doctors emphasized how important is for Chris to continue to receive daily therapy and stimulation for the next 6 months in order to ensure that the stem cells continue to pick up neural function. Without therapy and stimulation, the stem cells will not do much. The momentum right now is very good. I am sure that you appreciate that generally speaking therapists who deal with severe brain injuries like the one Chris’ suffered do not enthusiastically undertake to do more therapy for the sake of it. The fact that Chris’ therapist team is fully on board with a plan for daily therapy AND a one on one carer to continue to provide more stimulation is for me the greatest demonstration of how enthusiastic they are about the progress Chris has made so far. More importantly I think they endorse the belief that Chris will continue to improve. We all want to provide the most in the next 6 months when the stem cells will be most active.

I believe Wendy Stuttle mailed you a copy of the additional weekly cost for providing what Chris needs at this time: ₤ 328.20 per week. I’d like to kindly request your approval to fund this weekly amount. This would NOT be a permanent increase. I have told the Jacob Centre team that all these increased efforts would be until year end, and we would reassess everything from thereon. I’d not waste funds (specially public funds) if Chris was not progressing. I hope you know me well enough by now to know that I’d not put unreasonable requests forward. (i.e. I would never ask the PCT to fund stem cell treatment in China).

I do believe Chris’ recent improvements grants basis for the additional therapy/ stimulation as requested herein. I have decided that the changes on Chris are significant enough to grant another treatment course during the first quarter of 2008 in China.

I believe a carer (that will liase with the current PT, SALT and nursing teams) is the most cost effective way to provide the appropriate amount of therapeutic input to ensure Chris’ continued progress.

I know this is not a valid argument, but somehow the lower funding costs during the three months Chris was away would offset the increased cost in the next 6 months?

Apologies for the long email. I am sending a copy via post and I will follow up with a phone call very shortly to get your views on this.

Many thanks for your consideration to this matter and the continued support on all of Chris’ health needs.

Sincerely,



Koo Cho