I Can't Sleep

It could be because of this awful headache I have. But it could be for other reasons, as well. I don't know for what reason though.

Let's keep going with my awesome adventure, shall we?

We are about a week into my care at Sheltering Arms, I'm thinking we should move forward with their abbreviation of SAI. They did a routine follow up with the wound on the back of my head. Still unsure how that came to be or why it's still there, but they are following up to it! I know I developed the wound at UVA. The lovely wound is all pink with a white-ish border that is raised up. They have been using wipes on it and putting on a wonderful ointment and then dressing it. Did you all know that I have a scar there now on the back of my head? Hair doesn't grow there! I am glad my hair is getting a little longer so that it doesn't show anymore.

Today they capped my tracheotomy!!!! Oh, my goodness this is amazing news! OT took my straight after they capped me, and I have had no issues! This has certainly been a long time coming. No more machines to be hooked up to!!! I have had no machines or oxygen hook ups while in therapy either. I think that's what made up their minds with this decision.

Since my capping, I did mention that OT took me, right? They have me now! I have been able to be put through some problem-solving tests along with my regular ADL tasks. I have completed an 18-piece puzzle; go me. I have been able to reach anteriorly and retrieve cones from various heights. All the while working on my balance and becoming more independent with ADLs. I have also worked on shifting my weight laterally and work on leans to, once again, work on becoming more independent with ADLs. This helps with upper extremity strength, trunk control, and balance!

When my OT came to get me, I was standing at the sink and performing basic hygiene functions with my husband helping me and him helping me get dressed. When it was time for me to get my shoes on, I needed his maximum help. I was apparently a lot more vocal this go around and did not need oxygen assistance. Which they were all please with!

When PT entered my room after my OT session, I let banana know that I was experiencing some pain on my head. My face rating scale of said pain was a number 7, so she notified nursing, and they administered some Tylenol. Today we worked on gait training and distance walking to increase my endurance. When standing it was noted that I had poor postural control. When kneeling I "stood" tall and was able to maintain my posture better. She stated that I would continue to improve with further high intensity training.

SLP came to see me and brought me my meal. I was so ecstatic and thrilled to be able to eat again. Even if it was thin liquids! You have to start somewhere, am I right? After my meal, I was able to tolerate the tongue depressor and the myofascial massage. I mean, a massage does sound great right about now. But I will say, that during my "meal" there was some definite spillage and she noted only one coughing spell. I say "only" because that is great for a first timer! I can eat again!! Hooray! My dad was at my bedside during this session, and he educated him on my use of the medicine cups to take in my thin liquids. Later on, that afternoon my husband was at my side, so she updated him on the use of the medicine cups as well. When she came in the afternoon, she gave me a tongue depressor that was upgraded to a little thicker sponge to keep working on expanding my mouth so I could begin to take in utensils. My husband definitely understood this and agreed to it. I have severe facial paresis, which means one side of my face is paralyzed. But we are still continuing to work on it!

My diet overall has been going well. I mean, it has JUST started. But I am to request more medicine cups as needed to successfully intake my thin liquid meals. We started Ensure to keep up my protein and nutrients. It was noted that I asked my family to bring me a vanilla milkshake. Of course, I do that as soon as I am able to take in liquids! I agree that my daily intake of food by mouth should at least be 50% for now. They are still going to PEG me with some ProSource so I can be sure to continue receiving nutrients!

On this date the team all met up to have their weekly conference on my progress. They stated that I was making good progress daily. That my trach has been capped and I am on an oral diet now. They also stated, and I quote:

"Team Discussion of Patient's Desired Outcome: Patient is doing better every day and is making good functional gains. Her trach has been decannulated and she is on an oral diet now. Plans remain for patient to return home with her husband upon d/c."

See guys! It is MY desire to return home with my husband! MY DESIRE! They wrote it in their notes!

Now with grooming and upper body dressing, I need minimal assistance. With lower body dressing and toilet usage, I need maximum assistance. With bathing/showering, I need TOTAL assistance. In today's world I don't need assistance with the dressing, but I still use the rails for toilet and shower! I mean, if you all need to know that.

Aww, look guys!

"Patient, Caregiver Goals: to return home."

It's in their notes! Even my husband wants me to return home!

My Rehab Psychology Doctor told the team of his visit with me:

"Overall, she appears nearly or recently emerged from posttraumatic amnesia and confusion; her presentation today was most consistent with Rancho VI-VII behavior and cognition, further complicated by effects of brain stem infarctions."

I'm getting there!!! When my psychologist came in to see me, he was there for an hour and a half and said all of the following:

"Observations: Mrs. Damico was sitting in bed visiting her father upon arrival. Her father was in the process of leaving and this author met with Mrs. Damico for alone until her husband arrived toward the last 5-10 minutes of the session. She was alert and fully oriented and engaged in conversation demonstrating good attention. Her speech was clearly articulated though soft in volume and her thoughts were logical and goal directed. She denied experiencing anxious or depressed mood though, when her husband arrived, she seemed to become more dysphoric and reached out to hold his hand in an apparent attempt to seek comfort. Her affect was restricted though she used facial expression (rolling her eyes) to good effect. Her husband was engaged in the session upon his arrival and provided words of support and praise for improvement in her cognitive functioning of late."

"Status and Progress: Mrs. Damico presented with report that she is participating in rehab therapies and maintains motivation for the same. While she denied experiencing adjustment related emotional distress, this was belied by her response when her husband arrived as she likely became more vulnerable in his presence and sought comfort which he reciprocated. Mrs. Damico had questions about her injury, which were answered and additional education regarding TBI, and recovery was provided. Efforts to normalize emotional reaction after injury and trauma were also provided as well as reinforcement of Mrs. Damico's efforts to date in rehab."

Basically, when my husband was there, I sought him out for comfort which he provided. My husband was also thoroughly proud to see my progression! I did have some questions this time about my injury, which is the first time it has been noted!

All in all, we are seeing some definite progression!