I figured it was time for an update as it’s been a while since I reported on Chris. He has maintained his status quo: overall healthy, with his routine of therapies and daily one-on-one sessions with amazing Hillary – she is by the way his greatest advocate and works with him daily for an hour.
During last month Chris had family in town (his father spent 1 week with him), and Gabriel also spent an entire Saturday at the hospital with papai and grandpa. I post below the summary email of his stay with Chris.
“In my experience over the past week I have witnessed Chris drinking very well. He seems to enjoy cranberry juice, apple juice and water. there was no hesitation to his drinking, when he was thirsty, he drank. We acquired a new set of razors with enough spares to last several months, hopefully this will reduce the cuts he has sustained on his face. In my opinion, Chris positively responds to commands. He taps his foot on command, he reacts to his name on command and I was able to get him to nob his head for me, albeit not consistent. He also laughs and not always spontaneously. I was repairing his new discman player and he was watching me intently.... he saw that I was getting frustrated and began laughing at me, he knew I was getting angry and that I had little patience. Chris looks very good, I think he gained weight, he eats very well and while he has his up and down days, overall it was a great visit. George”
I also managed to go see him during work hours last week and yesterday, on both occasions for meetings with the Occupational Therapist + team and doctors.
On the OT front, H. is preparing a PCP (Person Centered Plan), which consists of a file written from Chris’ perspective about everything that is important to him, everything that matters to him, how he would like to be cared for, treated, handled, including his morning routine, his afternoons, his bath & hygiene times, etc. It states his values, likes, dislikes as a human being and tries to shed light into the person he was previously and the person he is today. So a small team spent time discussing and reviewing the file and the primary goal is that everyone involved on his care has an opportunity to read it so they understand how he would like to be cared and treated. I think this is a brilliant initiative if the team around him is able to learn more about him and respect his individual needs/ personality, to see the human soul and being underneath the damaged body. The goal ultimately is to improve the rapport and level of care for Chris.
The second meeting (yesterday with the doctors) was prompted in order to discuss options on addressing the continued spasticity and high tone Chris endures and all the problems that arise from this condition (including a lot of pain for Chris – I am convinced of that). It is so disheartening to see him like that – but looking at his arms breaks my heart in ways no one can imagine.
To make a long session short: (i) the doctor will try new medication, (ii) W. will follow up on the phenol injections request we put forth a while ago (Botox does not work for Chris anymore), (iii) the baclofen pump option was again archived.
Doctors in the UK are so adamantly opposed to the Baclofen pump (which they reckon is indeed most commonly used in the USA); nonetheless I was finally convinced of retiring the idea because it was pointed out to me that because this was a procedure not commonly carried out, it would be hard to find a specialist to do the procedure, and hard to monitor, and finally the kiss of death: in case of any complications arising from it, most hospitals would not even be knowledgeable enough to handle it. That plus the 1000 risks associated with it finally convinced me that just sometimes I should listen to what the doctors say.
Last but not least, I got the doctors to agree on starting RMNS (Right Median Nerve Stimulator) for Chris. As soon as I get the necessary equipment, I will post specifically on this new therapy we are going to start for Chris.
My life continues to be hectic. The fact that Gabriel is mostly with a nanny KILLS me. I know many parents also juggle childcare and work. But Gabriel does not have a father, grandparents, siblings, cousins, or aunts nearby. Right now I am actually not 100% settled with babysitting arrangements so there is a bit of mental stress until I sort things out. The fact that I travel for work during the week complicates things so immensely because then I need to figure out a way of finding someone who drops him off at school at 8 AM – while I am gone to an airport or eurostar at 6 AM in the morning. I have two trips coming in the next weeks and I am trying to figure out whom I am going to ask this time around… I am sure I will figure it out but it was so much easier when I had my parents around… So far I have managed to go for day-trips only. If some longer-haul trips pop-up, I have no clue what I am going to do with Gabriel…
Maybe everything would be simply resolved if I just got laid off like the rest of the financial industry – that way I can take care of Gabriel all day long and do not have to worry about my work travel… Sorry, just some twisted humor before logging off and going to bed. Thanks from the bottom of our hearts for checking on us. We are all managing with what we got.
PS – I have my two best friends from Brazil arriving tomorrow in London for a week with us so I am super super excited about that!
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Update on Chris (and us)
Comments
Re: Update on Chris (and us)
by
Kristine Abrams
on Wed 01 Oct 2008 11:47 PM BST | Profile | Permanent Link
How have your parents adjusted without you and their grandson who they were accustomed to being around?
Re: Re: Update on Chris (and us)
by
Koo Cho
on Thu 02 Oct 2008 06:39 AM BST | Profile | Permanent Link
Hi Kristine, my mom and dad are in Korea right now but heading to Brazil shortly to be with my sisters. They were literally sick and in tears for a couple of weeks in the beginning so much they missed Gabriel (not me as much :) it was hard to be away from G as he was the centre and joy of their world - like he is for me... But I think people get used to situations so ...
Koo Re: Update on Chris (and us)
by
SanFranRes1dent
on Sun 05 Oct 2008 12:51 AM BST | Profile | Permanent Link
Hello Koo,
I'm not sure why the facility where your husband is currently at - did not perform damage prevention treatments on his arms. They can apply serial casting and special splinting to keep the arms straight during posturing episodes. Spasticity is very challenging to control, but there are methods to prevent damages as results to the arms, legs, foot, limbs. My son has severe TBI and once a week, the OT (Occupational Therapist) applies serial casting on his legs, just below the knees and down to his feet. The serial cast is soft inside and its weight helps the legs relax. It keeps the legs straight and therefore prevents damage from severe posturing during the neuro storm attacks. The serial cast are removed and replaced every 3-4 days. After 6 weeks of serial casting, my son had the last serial cast "bi-valved." They sliced each cast and smooth the rough edges. It is still a perfect fit. It is secured back in place by a wrapping of special ace bandages. Now the bi-valved serial casts can be taken off twice a day for duration of no longer than 30 minutes to let the skin breath and to apply lotion. It has immensely helped with my son tone and drop-foot. I'm attaching a link to a very good article about Current Understanding of Dysautonomic Syndrome in Severe TBI. In this article, you will find recommendation of various prevention treatments to spasticity such as serial casting, splinting and also the use of certain medications one of which is ITB (Intrathecal Baclofen) Therapy. It has a picture of a patient with serial cast on his wrist, but serial cast can also be applied to arms. It has good information on everything to preserve the quality of life when patient recovers from the initial injury - TBI (some/more or less) http://www.acnr.co.uk/mar_apr_2008/ACNRMA08_current.pdf Also our Neuro-Trauma Surgeon talking about Right Median Nerve Stimulation http://www.legacyhealth.org/body.cfm?id=1052 http://www.dendrites.com/coma.htm I truly admire your dedication to your husband. Take care and God Bless you. Stella Re: Update on Chris (and us)
Dear Koo,
You are an amazing woman and continue to be a mentor to many along this journey of brain injury. We each have our individual path, but the roller coaster of emotions and continued breath of hope is so similar. Thank you for your dedication to journaling and willingness to allow us to breath many prayers and wishes of hope for Chris. My best to you all, Anna |
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