Monday August 27

Today was a great day of progress and insight.

Donna started a new memory related group session that she will go to every day.  One of the impacts of a traumatic brain injury (TBI) is that after coma the patient goes through a period called Post Trauma Amnesia (PTA).  During this period, the injured may remember everything from their life pre-injury but has great difficulty remembering the short term issues since and has difficulty placing themselves in space and time.  This is because during this phase the brain is still healing but confused and not able to process the new information.  

Donna has seen these PTA impacts but her neuropsychologist this morning indicated that she is close to exiting this phase.  This is great news for several reasons.  First, she is improving at a quick pace, second, it means that her brain is getting its act together, third, we're told that the 3 months after exiting PTA are the most rapid months of recovery.  Well this was just music to my ears because Donna is improving quickly now and the thought of a more rapid 3 month recovery period sounds like heaven.  He also said that while the post-PTA 3 months are the most rapid, the post-PTA 12 months will continue to be significant for improvement.  He also indicated that Donna’s progress is great and she is well on track.

I've been asked to clarify just what is Donna's condition.  Physically Donna still has a few limitations.  The physical limits are mostly muscular or neurological and many involve her right side.  It has just been the slower side to wake up due to the brain trauma.  The slow wake up impacts muscular strength due to limited activity.  She has a few muscles that are too tight, but she'll get some injections within the next day or so that should rectify them.  From a motor controls perspective, her brain is sending more signals to the right side every day.  This excites us all, and has the therapists strengthening the muscles to keep up and accelerate it.   Currently these right side issues set the pace of her physical development.

Regarding speech and cognitive functions, Donna is able to speak and express herself well.  The slower right side has her still slurring a bit but it is improving continuously.  Her mind is all there; it is clear from the things she says. She does still have trouble remembering short-term things and making certain types of connections but, as I mentioned earlier, this is normal and expected to improve materially.

What is amazing is that she improves everyday and having gotten more of her medications removed, she is Donna in smile, word and action.  She wants it all and wants it now.  That determination will get us there.

One of the other recovery issues is Donna’s swallow. I have talked about this in the past.  Swallowing is a complicated process that gets out of synch after a coma.  It is expected to come back fine (and Donna’s is coming back steadily) but we need to be patient Ugh…..  As we wait she needs to stay away from thin liquids (like water) but it doesn’t keep her from eating real food.  This swallow issue is a prerequisite for taking medications by mouth and therefore a limit on removing her peg line to her stomach.  She is motivated and is eating and practicing that swallow hard.  I expect it wont take long to line out this issue (crossed fingers).

Well there is your latest Donna run down.  Hopefully that explains where she is but she is changing daily and in a positive direction.

On a much lighter note, to get Donna’s right Achilles fully stretched, Laura, Donna’s physical therapist asked me today if 5 times a day I could stand with her and shift her weight between her feet. She asked me this because I have become a pretty accomplished person transferor in many methods.  In response I told Laura, “let me get this straight, my homework is to stand with my arms around my wife shifting weight in a way that looks a lot like slow dancing and I need to do this 5 times a day for 10 minutes each?”  You should see Donna beam when we stand with our arms around each other swaying side to side.  We had to demonstrate for a lot of the TIRR staff today.  Best homework I have ever done.  I have to believe if 5 times is good, 10 have to be much better.

Thank you for all the support.  2.5 months is a long time to keep the support going but we feel it and thank you all.

Sarah is arriving tomorrow and Donna and I are very glad to see her.

Thanks to all

Bob