Monday, October 17, 2011

Update from David - Home at Last

Aloha to our Ohana,
 
It's been just over two months since Theresa came home to Hawai'i and I must apologize for not providing an update to our Ohana sooner.  To say our time was occupied over the past 75 days is putting it lightly; Theresa's busy schedule so far has included the commencement of local rehab therapy, introductory and follow-up appointments with all forms of mainstream and alternative medicine practitioners in Kona, Waikoloa and Waimea, and multiple overnight or longer trips to Honolulu for visits with specialists, friends and others.  This is all in addition to becoming refamiliarized with home life after 8 1/2 months away.  This ongoing saga would certainly overwhelm most of us but not our dear Theresa, who continues to thrive from the healing powers of our Lord.
 
The day after our long journey home, Theresa was up bright and early (0500h to be exact) and raring to attend the early morning service at our Waikoloa Community Church.  Given the 3-hr difference from the West Coast, she was definitely ahead of her time so we leisurely enjoyed our first breakfast at home and then shared the West Hawaii Today Sunday Edition before heading out.  Arriving at church, Theresa made it clear that she wanted to walk rather than be wheeled in and so it was.  Holding her cane in one hand and my arm to steady herself in the other, she slowly made her way inside and down the aisle to the amazement and stunned silence of those who knew of our story.  Pastor Al and his wife Lynda were still in California however one of the church elders preparing the service stopped mid-sentence and came down to hug Theresa so tightly it was like she was the return of the prodigal son.  The reunion brought tears to many eyes that morning, not just because Theresa had come home alive and well, but because it was definitive proof that our merciful and loving God answers all prayers.
 
With the commencement of the work week, I prepared to return to my duties at Mauna Lani but not to worry, Theresa would be left in the capable hands of two home care aides (angels sent by our Lord), Nancy & Pam.  The plan was to split the week between them and take Theresa to rehab therapies and medical appointments locally.  They would provide for care, companionship and transportation needs while I was at the office, and it has worked out well these past two months.  Theresa's first week at Hawaiian Rehab Services was like a reunion of sorts, seeing that she had graduated from their therapies during her brain aneurysm recovery just two years before.  This time, it became quickly evident to the therapists that the level and duration of rehab therapy would need to be more intensive and prolonged, given Theresa's multiple fractures, spinal cord and traumatic brain injuries.  Still, the early reports are promising and reflect Theresa's strength of will to regain her independence one day.
 
On the path of this healing journey, we have been blessed to encounter many true healers that have made all of the difference in Theresa's remarkable progress thus far.  As life would have it, there have also been a few false ones along the way.  Perhaps it was only our experience with them that was tainted so I won't name any names, but hopefully those that make their money by taking advantage of the poor and sick know who they are.  We forgive their trespasses and will pray that they change their ways before it is too late.  For the true healers, we are truly thankful to our Lord for their skill and faith.  Some may wonder why I mention faith when it comes to the medical profession so here is my best example to date:
 
On our first trip to Honolulu for follow-up visits with some of the specialists, Theresa met with Dr. Mitsunaga, the orthopod that repaired her leg fractures on the day of the accident, and her arm and neck fractures ten days later.  To say he was elated to see Theresa standing in his office exam room is an understatement.  While I had met Dr. Mitsunaga briefly following six hours of emergency surgery that fateful Nov. 19, and again after the successful repairs to her neck and arms, I never learned the true extent of Theresa's condition until now.  When she arrived at Queen's Trauma Center, Theresa had already gone through 4 liters of blood transfusions on the flight over (our bodies only contain 5 liters) and it was deemed by the trauma team that she was unlikely to survive the night.  But rather than give up, Dr. Mitsunaga went ahead with the leg repairs as the trauma surgeons worked to stabilize Theresa's condition; because in his words "if she doesn't survive, all I've lost is six hours of my time, but if she does survive and I didn't do the surgery, she will still have multiple broken bones to deal with later."  Now nine months later, the smile and expression of happiness on his face only confirmed the rightness of his decision.  This act of faith not only saved Theresa's life but also serves as proof that even when the odds are against us, if we have faith, the Lord will provide.
 
Mahalo,
 
David

Tuesday, August 9, 2011

Update from David

Aloha to our Ohana,

Continuing with Theresa's last week in California, the final few days turned out
to be more hectic than I expected.  On Wednesday, the original therapy schedule
called for more PT, OT, cognitive rehab, education and counseling however this
was replaced by a last-minute appointment with the neuro-optometrist in Santa
Clarita.  At the previous visit, not all of the visual assessments were finished
so this trip would complete the testing.  Theresa also needed to pick up and be
fitted for her new reading glasses with built-in prisms to keep her eyes
tracking on the same line.  Anticipating another two hour crossing of the Tejon
Pass to reach the Greater Los Angeles area, we started out early by fueling up
at Chick-Fil-A, taking advantage of their "chicken for breakfast" promotion.
Properly supplied, we dropped by the hotel to pick up Nancy, one of the home
care providers that was here to train with Theresa.  Traffic was steady but we
took advantage of some openings and the brave little Escape threaded its way
between the big rigs with surprising vigor.  About halfway there, a white Mini
with a black roof zoomed past on one of the downhills so that became our rabbit
for the chase, getting us to Valencia in record time (at least a new record for
me.)

Arriving at the clinic earlier than planned, Theresa sat down in the waiting
room to work on her favorite Sudoku puzzle in the Bakersfield Californian paper.
It's a good thing we did get there quickly because the doctor was just finishing
up with the current patient and could take Theresa in a few minutes.  This final
series of tests measured the eye to brain connection and there is definitely
some noticeable deficit.  For example, when instructed to draw circles on a
whiteboard using both hands at the same time, the left side always lags behind
the right.  Also, it was previously noted that Theresa's left eye does not
converge with the right eye when staring at a pen brought closer and closer to
the nose, so that was another reason for the specialized reading glasses.  Once
fitted properly, Theresa's eyes opened wide as she passed the reading test with
flying colors, able to track sentences without wavering.  An assortment of other
eye/brain coordination exercises were taught to us for home practice and then we
said our farewell to Dr. Garbus and his wife.  They are a dedicated pair and we
are truly thankful to our Lord for placing these healing angels along Theresa's
healing journey.

In addition to the specialist appointment and picking up her glasses, Theresa's
other agenda was to have lunch at Dink's, a Jewish deli with a reputation for
the best matzo ball soup and piled-high pastrami sandwiches in the valley.  Sure
enough, the food was delicious and even the half-soup/sandwich specials were
sufficient to feed most of the lunchtime crowd.  My mistake was to try the BLT
that in no fault of Dink's (with such a name, I had to use it more than once)
was just as it should be, a bacon-lettuce-tomato sandwich.  A take-out pastrami
on rye order quickly rectified the error and kept the Escape smelling of
Schwartz's deli in Montreal (another favorite of Theresa's) for the return run
to Bakersfield.  One more errand to complete before returning to the CNS
residence was pick up a new cane of her own.  The one that Theresa used in PT
has seen better days so we dropped by the home healthcare supply shop to select
one.  Who would believe that there are several styles of walking canes and
they come in a multitude of colors and patterns?  After trying out a few,
Theresa chose a plain black one with an ergonomic palm grip that fit her hand
well.  To think, just a short few months ago in Denver, we were flipping through
a wheelchair catalogue and now Theresa is graduating to a cane, it truly is
another sign of the incredible healing powers of God.

Thursday was Theresa's graduation day from the Center for Neuro Skills, after
being admitted almost four months ago on March 30.  In all of that day's therapy
sessions, Theresa received lots of homework, training tips, hugs and
congratulations.  In some cases, tears flowed freely from Theresa, her
therapists and the other patients -- one CNS staffer even described Theresa's
spirit as angel-like, saying her presence would be sorely missed.  In
place of the final PT session that afternoon, we were shown the results of
Theresa's recent brain MRI and the interpretation of those findings.  The images
clearly showed the damage to certain regions of the brain, including those
responsible for coordination & balance, short term memory, attention, problem
solving, and the sending of visual cues from the eyes to the brain.  In spite of
these tremendous deficits, Theresa's outward appearance is that of someone
perhaps suffering from a mild case of jetlag.  We know that the brain is elastic
and it is constantly repairing and rewiring itself.  In that way, Theresa is
improving daily and with her conscientious efforts to challenge herself, I know
that our prayers are being answered.  Not to miss out due to the MRI
presentation, Sara the PT found Theresa for the final 15 minutes and made her do
one more series of stair step and getting up off the floor maneuvers.  When the
end of the day finally came, we said our farewells to the CNS Clinic and Theresa
walked out to the cheers and applause of the staff and patients.  Our heartfelt
thanks go to Zenobia, Kathy, Sara, Marty, Paul, Katie, Alison, Stephanie, Megan,
Robin, Patricia, Darlene, Lynda, Candy, Maria, Violetta, Drs. Ashley, Helvie,
Newbrough, Edwards and a host of others for their caring efforts to make
Theresa's stay at CNS a success.

While the day was over as far as the CNS Clinic was concerned, we still had to
return to the residence and finish packing before the 3-hr drive to Riverside
County that evening.  Being away from home for over eight months, Theresa has
collected a huge amount of clothing and accessories, not surprising considering
this healing journey took her from Honolulu to -20F Denver in January to +108F
in Bakersfield.  And this doesn't even account for all of the get-well cards,
gifts, household items and other such things accumulated over this timespan.  In
all, it took us almost three hours to whittle it down to four pieces of checked
baggage but that included several breaks for farewell visits from rehab aides,
staff and other patients wishing Theresa their best.  Both Theresa and I found
it touching that these people working through their own challenges (a lifetime's
worth in some cases) could care for and bond with someone that was only here for
four months.  Theresa tells me that she has had dreams of St. Michael, the arch
angel, being there to rescue her at the accident scene, and to watch over her
during this healing journey.  Perhaps Theresa's positive attitude and spirit
have done the same for those whose lives she has touched at CNS.  For this, we
are again in awe and praise of our Lord, Jesus Christ.

With all of Theresa's worldly belongings safely tucked into the Escape, we left
behind a few shopping bags worth of Trader Joe's groceries and clothing that the
rehab aides will no doubt appreciate, although I'm not sure if anyone is brave
enough to try the pesto-encrusted halibut.  The mini ice-cream cones were no
doubt a hit and probably disappeared before we pulled out of the complex one
last time.  Venturing into unfamiliar territory, it was assuring to program the
GPS to prudently avoid the heart of central L.A. on the way to the Holiday Inn
Express in Temecula.  Truck traffic was surpringly heavy on Interstate 5 and
remained that way for the first hour as the GPS regularly updated the estimated
time of arrival, adding minutes to the clock.  Leaving behind the 97F heat of
the Central Valley at 2000h, we climbed once again through the mountain pass but
at this late hour, there were no rabbits to chase so it was a slow and steady
course the GPS charted.  Finally breaking from the I-5 and heading east on the
210, there was room to stretch the Escape's legs, which was rewarded with a
reduced time on arrival.  I don't know what the record is between Bakersfield
and Temecula but it took only 2h40m until we checked in that evening.  With the
late arrival, I asked for but didn't expect a handicap-accessible room and sure
enough, all were occupied.  The apologetic front desk agent tried to explain
that a firefighter convention was in town so they took all of the handicap
rooms -- if someone can see the connection between the two, please let us know?
In any case, our room was well equipped with grab bars in the tub/shower and
suited our needs just fine.  A raised toilet would have been nice but that just
gave Theresa the opportunity to further practice her squat & stands.

The day of the wedding, we awoke early and enjoyed the HIE complimentary
breakfast that included eggs, sausage, make-it-yourself waffles and the regular
continental assortment.  A phone call to Rylie Ai-Lin's family let us know that
Mom along with all six of the daughters were out for hair, make-up and whatever
else girls do to prepare for the wedding day.  So we dropped by their house with
the wedding gift plus a special little one for Rylie Ai-Lin, and spent a couple
of hours visiting with the "men of the household" that comprised of Dad and his
seven sons.  When we arrived, everyone was lounging around in casual clothes and
it was nice to visit and catch up with all of them.  Still I can't help thinking
it's somewhat unfair that guys can prepare for a wedding in under an hour while
it takes the gals much of the day; but then the guys probably pay that back over
the remainder of their lives  -- I plan to offer no further explanation for that
comment.

When we called the nearby Chinese restaurant for take-out, the pause on the
other end of the line was clearly evident.  Who orders dinner for 10 at 1100am?
It was no surprise that they made us pay in advance and true to their word, the
food was mostly ready and packed by the time we got there.  Theresa insisted on
coming into the restaurant to assist and sure enough, with cane in one hand, she
carried out some of the food in the other.  After lunch, Theresa and I returned
to the hotel for a much needed rest before the evening's festivities.  I'd
planned on our napping for a couple of hours but Theresa was so exhausted from
the previous day (if not the past two years) that she fell asleep without even
removing her shoes.  Gently awakening her in time for the ceremony, I watched as
Theresa dolled up and put on the lovely dress she'd picked up on a shopping
outing the previous week.  Her original plan called for me to bring her favorite
Taryn Rose ballet shoes to complement the outfit but her still-healing ankle
couldn't support even the 1" heel without wobbling so we went to the wedding
with her "dress Asics" runners instead, and I don't think anyone even noticed.

There are two Douglas streets near Temecula and the up-until-now trusty GPS
directed us to the wrong one, a new gated community with no way to enter and no
sign of a wedding anywhere.  After fruitlessly trying to figure out a solution
and with the ceremony scheduled to start shortly, Theresa and I said a prayer to
our Lord and within a few minutes, an answer arrived in the form of an online
search.  While the various mapping programs, Yahoo, Google, Mapquest, all
offered the same wrong directions as the GPS, I found an obscure reference to a
second Douglass street with two "s" and sure enough, this led us to the right
location.  Finding parking was another issue but suffice to say, we arrived in
time for the most important part of the ceremony and are thankful to our Lord
for guiding us there safely and on His schedule.

It was a wonderful ceremony and reception and we made some new friends as well
as met old acquaintances.  Occasionally, we would get fleeting glimpses of
Ai-Lin and I sometimes caught her looking at us from a distance.  I knew she
would be initially shy and as the night wore on, might come over to visit.  We
were willing to wait and if it didn't happen, then it was not meant to be.  In
the meantime, one guest sharing our table listened to Theresa intently as she
described her healing journey from the aneurysm to the accident to now.  It
turns out this guest's sister very recently suffered a brain aneurysm and is
currently back home after checking herself out of the hospital.  Theresa
impressed upon this new friend how important it is for her sister to get proper
rehab therapy right now and we will pray that she does.  The friend thanked
Theresa profusely and said it was an act of providence that the Lord allowed
them to share the table and our experiences.

Following dinner, Ai-Lin came to our table accompanied by her Mom.  After
updating us on Ai-Lin's promising progress in the past year, Mom went off to
attend to "Mother of the Bride" duties and Ai-Lin moved onto Theresa's lap.
There was silence for a few moments and then Ai-Lin noticed the surgical scars
on Theresa's legs and commented "you have an ouwee?"  Theresa tried to explain
but it was probably beyond a 5-yr-old's understanding so Ai-Lin's next comment
was "do you want a bandage?"  That simple offer of compassion warmed my heart
and I'm sure it did the same for Theresa.  Thank you, Lord for giving us this
sign that we made the right decision to place Ai-Lin in the family that she was
meant for.  While we love her dearly, she is where she needs to be and for that
we will always be grateful for His guidance and wisdom.  Ai-Lin stayed with us
for the remainder of our time there, transferring over to my lap once Theresa's
legs became too sore to hold her weight.  Ai-Lin didn't say too much and just
held on tightly, wrapping her little legs around my calf to keep from sliding
off.  When Theresa became fatigued and needed to rest, we let Ai-Lin know that
we would be going soon.  She asked if we're returning to Hawai'i, and then if
she could come along too.  I explained that one day when she was older, maybe
she could come visit Hawai'i with her family.  Perhaps that was not the answer
she was looking for so when we finally stood up, she ran off to be held by
another guest.  Ai-Lin has her own healing journey and we continue to pray that
she is guided in the footsteps of our Heavenly Father.  We then offered our
congratulations to the bride & groom and bid farewell to Pastor Al and Lynda
before heading back to the HIE for a few hours rest before the early morning
drive to LAX.

The 0400h wake-up call jarred me to attention while Theresa continued her
blissful rest.  Consolidating our belongings into four checked bags while doing
my best circus weight guesser impression, I hoped none were over the dreaded 50
lb limit.  By the time I was back from loading the Escape, Theresa was up and
getting ready.  I continue to marvel at her improving planning skills and
flexibility, this morning demonstrated by the TED anti-embolism stockings she
was putting on in preparation for the 2-hr drive and 6-hr flight.  The Saturday
morning traffic to the airport was light by L.A. standards until arriving at LAX
itself.  Then it became an uncoordinated dance to cross five lanes of traffic
and get to the curbside check-in location.  Assistance arrived in the form of a
friendly & helpful porter who took our bags, weighed them (one was at 50.7 lbs,
whew!), got our boarding passes, and even offered to keep an eye on Theresa
while I returned the rental car.

Due to my unfamiliarity with the rental car return lot and delays on the
shuttle, it took almost 30 minutes to return to the airport.  Theresa did
amazingly well by herself, even phoning me from inside the terminal when it
became too hectic for her to continue waiting at the curbside.  Upon rejoining
my beautiful bride in her wheelchair, we were directed to the priority access
security line, another blessing compared to the 45-min wait otherwise.  As a
bonus, the TSA's cancer scanner (backscatter radiation imaging -- known to cause
cellular defects with prolonged exposure) was down, not that Theresa needed any
more nuking after the dozens of CT scans and x-rays in the recent past.
Arriving at the gate, I noticed that our seats were no longer together as
originally booked.  It turns out that seats 8D&E are considered exit row even
though that row ends in a window, so Theresa was moved back to 12D.  Because the
flight was almost full, the gate agent couldn't swap me to 12E without the
approval of the current passenger who wasn't in the gate area yet.  But after
preboarding, the nice flight attendant made it her mission to seat me beside
Theresa and she eventually was able to do so with a 4-way seat swap involving 8E
to 8A to 13C to 12E.  Being able to sit next to my wife on her flight home is
yet another miracle and a small prayer of thanks was offered.  The surprises did
not end there for when the food cart came around and Theresa chose the turkey
bagel sandwich, the flight attendant said "Welcome Home, your meal is being
covered by the agent in Kona"

The remainder of the flight went smoothly and Theresa slept through, only waking
when the lap baby in front peeked over his father and made noise.  It still
confounds me that all carry-on baggage needs to be stowed for take-off and
landing in case it becomes a projectile during an emergency, but a 15-30 lb lap
baby is somehow exempt from the laws of physics.  Fortunately, no such emergency
occurred and the landing was safe if rather bumpy.  After everyone else
deplaned, the service person and I strapped Theresa into the narrow aisle
wheelchair and took the lift down to the tarmac.  There, I set up our own
wheelchair and Theresa happily transferred over.  A quick restroom break later,
we went through the exit door to a greeting of cheers and applause from over a
dozen well wishers including family, friends, co-workers, hula sisters, church
members and several print & media reporters.  In spite of the long travel day
that began at 0100h Hawaii time, Theresa felt alive so close to the ocean and had the energy to interview with some of the reporters.
 
Cousin Darien,  her husband Darrin and their three keiki accompanied us home.  Theresa was lively and talkative on the drive to Waikoloa, taking in the broad vistas of sea to summits and talking up a storm with Darien.  Upon arriving home, my first thought was to get the wheelchair set up since Theresa must be exhausted after the combined twelve hours of traveling.  Instead, she got up out of the van holding her cane and proceeded to walk through the garage and into the house all by herself.  Once inside, I followed her all the way to our bedroom where she put her hand on the fresh sheets that Darien had arranged for.  Theresa then turned to me and said "I'm taking a nap!" following which she got into bed and slept for the next four hours.  After almost 8 1/2 months away, Theresa was finally home; thanks to the prayers and support of our Ohana near and far; to the skilled healers in Hawai'i, Colorado and California; and most of all to our Lord and Savior, Jesus Christ.
 
Mahalo,
 
David

P.S.  Here is a sampling of the local news accounts of Theresa's triumphant return to Hawai'i:
 
Dr. Theresa Wang comes home
KHON2
Greeted by friends, family and flower lei, Doctor Theresa Wang was given a ... Police say an SUV with Colt Brennan and his girlfriend Shatki Stream as the ... http://www.khon2.com/news/local/story/Dr-Theresa-Wang-comes-home/J8SMnnLF4EGsKvYu3_VbkA.cspx
 
Theresa Wang Speaks About Nearly Fatal Crash
KITV.com
Theresa Wang says she's still in pain, eight and a half months after the ... the car being driven by Colt Brennan's girlfriend Shakti Stream crossed the ... http://www.youtube.com/watch?v=JXCCMF89OqM

Wang has a happy homecoming
Hawaii 24/7
Theresa Wang greets the friends she hasn't seen in nearly nine months. ... The couple said they don't have bad feelings toward Stream or Brennan. ... http://www.hawaii247.com/2011/07/31/wang-has-a-happy-homecoming/

Kona Dr. Returns Home 8 Months After Auto Crash
KITV Honolulu
HONOLULU -- Dr. Theresa Wang arrived home in Kona Saturday after spending the ... University of Hawaii quarterback Colt Brennan's girlfriend, Shakti Stream. ...  http://www.kitv.com/news/28719251/detail.html 
 
VIDEO: Dr. Theresa Wang returns to Hawaii after car crash
Big Island Video News
Dr. Theresa Wang made her return to Kona on Saturday, 8 months after a ... Brennan was also in the car. Wang – who today seems to be in high spirits ... http://www.bigislandvideonews.com/2011/08/01/video-dr-theresa-wang-returns-to-hawaii-after-car-crash/
Crash victim, husband ready to rest after a long recovery
Honolulu Star-Advertiser
... Dr. Theresa Wang and husband David Chen are embarking on a personal odyssey of ... girlfriend of former University of Hawaii quarterback Colt Brennan, ...  http://www.staradvertiser.com/news/hawaiinews/20110801_Crash_victim_husband_ready_to_rest_after_a_long_recovery.html

Thursday, August 4, 2011

A letter from Darien

Dear friends and neighbors of David and Theresa,


My name is Darien Gee and I am David's second cousin. As many of you know, Theresa came home on Saturday and we're so grateful that she is back on island and at home with David.

Since Theresa's accident last November, many of you have asked how you can help. Because David is working and Theresa is still on the road to recovery, I know the gift of a meal would be a huge help to the Chens. A home-cooked meal or one that is given by a friend is a huge comfort and always much appreciated.

Beginning Monday, August 8, we are asking anyone who is able to leave a meal or contribute towards a meal to please look at the dates below and send me an email. If you prefer not to cook and would like to make a donation, that would also be appreciated. The link for that is here:   http://tinyurl.com/3fe2nuu
 
In order to assist with the meal coordination, we are using mealTrain which will let you schedule your own drop-offs (and change them if necessary), provide directions, send you an email reminder the day before, and so on. Here is the information you need to get started:
 
- Schedule a meal drop off by clicking here:
 
http://www.mealtrain.com/?id=mpbclfhkihkt

- The schedule is open from now until the end of the year

- The meal just needs to be enough for two adults and should be able to be frozen

- You don't need to make anything special; simple is sometimes best and David and Theresa are grateful for however you can help!

- If you have any questions, please feel free to email me at geeohana@yahoo.com or call (808) 938-4466

with thanks,
Darien

Monday, August 1, 2011

Update from David

Aloha to our Ohana,
 
This past week at the Center for Neuro Skills in Bakersfield, CA was devoted to last-minute testing and preparing for Theresa's planned discharge date near the end of the month.  Since our plan was to fly home from Los Angeles rather than Bakersfield, the red-eye from Kona only took me as far as LAX where a rental car was booked for the drive to CNS.  Landing at the uncivilized time of 0450h, I waited for the Avis shuttle in the surprisingly chilly predawn hours and noted how wheelchair unfriendly the LAX airport is for moving between the various bus stop islands.  The support columns at the islands are so wide there isn't enough room for a wheelchair (or even a large suitcase) to pass without one wheel falling off the curb.  To get from the hotel shuttle stop to the rental car stop involves crossing traffic to return to the terminal curbside, wheeling ahead 100 ft (30M) and then crossing traffic again.  Fortunately, Theresa will only be with me for the return trip so this did not pose an issue.  Arriving at the rental desk, the agent perfunctorily offered the full coverage insurance, followed by the damage waiver, followed by the fueling option, and finally an upsell to a larger vehicle, all of which I declined.  Coincidentally, the assigned vehicle was a Ford Escape which is entirely fitting for Theresa's return home.
 
Leaving the rental car lot and merging on the near empty six lane 405 freeway at 0500h on a Saturday was a surreal experience, similar to those end-of-days scenes in future apocalypse films.  As the sun rose, traffic started to pick up and by the time I passed the Magic Mountain parkway, there was sufficient vehicle volume to make the drive through the Tejon Pass at least semi-challenging.  Descending into the Central Valley, the temperature was already in the mid-90s at 0700h, well on the way to the forecasted 103F (39C) for that weekend.  For this final visit, I foregoed staying at the usual Ramada Limited Suites and drove straight to the CNS residence.  There, Theresa greeted me with a kiss and some perfectly seasoned scrambled eggs that I devoured in less time than it likely took to make them.  While this would be our final week here, Theresa still needed to attend to grocery shopping so off we went to the now familiar Trader Joe's.  The big difference compared to last week was that the physical therapist had assigned a no-wheelchair trip as homework so for the first time in over six months, Theresa left behind her wheels.
 
Using the shopping cart as support, Theresa walked through the store picking up old favorites and from the higher vantage point, noticed a few new items that she'd missed before.  Those extra steps and standing meant Theresa was on her feet for over 40 minutes so by the time we reached the checkout counter, her legs were about ready to give out.  Quickly, I found a chair so she could take a break while the cashier rang up the total.  With the near collapse averted, it only took a few minutes for Theresa to recover before standing again and helping to push the full cart to the far end of the lot where we'd parked.  For whatever reason, the handicap parking spots always seem to be taken up in Bakersfield, as if everyone and their dog have a pass.  We've even seen Porsche and Corvette drivers pull into these stalls, hang up their placard and walk or in one case, even run into the shop without difficulty.  Maybe their handicap is invisible or they're having a good day so perhaps I shouldn't judge.  Our Lord tells us to forgive others so we do so giving Him full praise for allowing Theresa to walk so far in so short a time.
 
After dropping off the groceries at the residence, Theresa told me that she needed to pick up a few more supplies for a potluck BBQ she and another patient, Cory, were planning for Sunday.  This being our last weekend at CNS, Theresa's original idea was to buy a Target gift card using a cash gift she'd received from a fellow church member back in Waikoloa.  This gift card would be placed in a drawing for all of the rehab aides, Theresa's way of thanking them for their kindness and support these past four months.  The aides were excited but word got around to CNS management and they let Theresa know it was against their rules to give gifts to the staff so instead, the idea for a potluck BBQ was born.  Theresa intended to use the cash gift to buy food to treat the aides so off we went to Costco.  Rather than doing the predictable and just buying some pizzas, we decided on a tube steakfest and returned with Costco's famous hotdogs & Polish sausages, buns, salad ingredients and pies aplenty.  The BBQ became a sensation and not only did the aides come by on their breaks but some patients had heard about Theresa's potluck (Cory had dropped out due to the heat) and brought their own food to cook.  Unfortunately, most of them weren't cleared to use the grill so yours truly was drafted to the position of grillmaster this day.  Too bad I didn't have my chef uniform handy as it would have saved my shirt from all of the grease splatter and some of the heat.  On the positive side (and there's always a silver lining if you look hard enough) I learned that when it's 108F (42C) in the shade, BBQ meat cooks really fast even when the burners are on low.  After three hours of hotline duty, everyone's food was cooked and there was lots of leftovers to take away.  One of the aides thanked me profusely and said this was the first time she could ever recall a patient hosting an event for the staff.  As Theresa's colleagues from her clinic in Wisconsin will attest, she plans wonderful parties (including her own farewell lu'au) and I am truly thankful to our Heavenly Father that Theresa has not lost this gift.
 
What would be Theresa's last week at the CNS clinic started with the usual therapies of PT where she was challenged with speed-walking, sidestepping, stairs, and getting up off the floor; CR where Theresa read passages from Ivanhoe and then answered questions; and OT where Theresa made a salad and minestrone soup for 30 using a knock-off Olive Garden recipe downloaded from the net.  That she was able to plan and execute that meal in the alotted time, and make it delicious to boot, means she has a bright future on Master Chef if her career in medicine doesn't work out.  The next day, Nancy, one of the homecare providers that our Lord has graced us with, arrived at the clinic for three days of intensive training to learn Theresa's therapy routine at CNS and to support her back home.  The therapists were excited to meet Nancy and devoted a good deal of time showing her how they train and encourage Theresa to succeed.  The PT also noticed that Theresa is rolling her right ankle (the one that was operated on twice) on uneven terrain so a last-minute visit to an orthotics specialist led to a wedge under the heel and a removable ankle splint for improved stability.  With much of these fine tunings and followup appointments out of the way, we could look forward to a relaxing couple of days before heading out.  It continues to amaze and endear us that all has gone so well with Theresa's healing journey and for that we offer praise to our Lord.
 
To be continued next week....
 
Mahalo,
 
David

Monday, July 25, 2011

Update from David

Aloha to our Ohana,

A few weeks have gone by since the last update and we're truly thankful to our
Lord for all of the good news He has blessed us with since then.  Theresa has
called almost daily to chat and provide updates on her progress.  She's started
to walk/jog in the pool recently and finds that to be less tiring than walking
on the treadmill.  Theresa says she would much rather be swimming in the warm
waters off the Kohala Coast, however that will follow in due time.  I do sense a
note of frustration in Theresa's voice on occasion but who among us wouldn't
feel the same after spending over eight months in hospitals and rehab facilities
far away from home.  That she is able to maintain her positive outlook and
encourage others since before she could even remember doing so (because of her
post traumatic amnesia) is a testimony to the healing powers of our Lord.

Bakersfield was in a prolonged heatwave for the last few weeks with temperatures
soaring as high as 109F (43C) so it greatly limited Theresa's outdoor activity
time.  Her therapies at the rehab clinic continue to improve her strength,
endurance, dexterity and cognition, and when she is back at the residence,
Theresa tries to stay cool by reading, writing to friends, and even coming up
with new cooking ideas.  A few days ago, she called to say the recipe for a
Moroccan-style chicken dish turned out so well, she froze some for me to enjoy.
Over the Independence Day weekend, the CNS residence held an afternoon potluck
dinner and one of Theresa's contributions was a tray of cupcakes with
alternating red/white/blue frosting.  For whatever reason, only the blue
cupcakes were taken so Theresa in her own inimitable way, rearranged the red &
white ones to form a stylized flag of Canada.  Since there's no celebrating
Canada Day down here, I think that was Theresa's way to do so; always creative
and a little mischevous at the same time, that's what I love about her.

In early July, my return trip to see Theresa took a different tack as this was
the first time using the Priceline.com service to bid for a ticket.  With the
next treatment conference scheduled for the upcoming week and quoted airfares
stubbornly staying in the $1200 range, I figured what harm could there be since
Priceline guarantees a 1-stop connection and layovers of 3 hours or less.  Well,
after bidding and winning a $580 ticket, the itinerary turned out fine with one
caveat -- the puddle jumper to Bakersfield wasn't scheduled to arrive until
2359h, but the car rental desk closed at 2330h.  While waiting for the late
connection at LAX, I phoned the car rental agency and explained the situation.
The nice lady said not to worry as they're familiar with that late arriving
flight and would wait until 0015h.  Praise the Lord, the flight came in on time
and I made it to the rental counter by 10 after midnight.  In my luggage was a
bag of chocolate macadamia nuts intended for the rehab clinic staff that I
gratefully offered to the rental agent.  With both of us happy, it was off
to the hotel for a few hours rest before the busy day ahead.

Fighting off the jet lag, I arrived at the CNS clinic early the next morning to
find Theresa in the dark, literally.  She was attending occupational therapy in
the darkened Dynavision room, being retested for her peripheral vision and
ability to read numbers flashed for less than 1/4th of a second.  These
results showed some improvement in Theresa's recognition and reaction times
compared to two months ago.  At PT, Theresa walked on the treadmill up to 30
minutes at 1.5mph, almost twice the speed and endurance from a month ago.
However when free walking with a cane, Theresa seems somewhat tentative and takes steps more deliberately and thus slower.  Following the group counseling session (that I
didn't attend), we wheeled over to the nearby shopping center and enjoyed lunch
at El Pollo Loco, a Mexican fast food chain known for their chicken.  Aside from
a street vendor in Tulum, this is the tastiest citrus grilled chicken we've ever
had.  While foodies may deem it the Mexican equivalent of KFC, our motto is if
it tastes good and is semi-healthy, what's not to like?

The afternoon rehab sessions went quickly, which was good because it was plain
to see Theresa was tiring out and about ready to call it a week.  Plus, CNS
planned for Theresa to spend the upcoming weekend with me at the hotel so I
could assess her abilities and let them know which areas to concentrate on over
her remaining time here.  But before our romantic rendezvous could start,
Theresa had previously booked the Friday evening dinner outing to Red Lobster.
Now those of our friends that know us well are aware that I'm seriously allergic
to certain shellfish (and beer & wine) so dining at RL is akin to someone with a
nut allergy taking a tour of Planters.  I judiciously chose tilapia, the safest
seafood item on the menu while Theresa went all out and ordered a dozen raw
oysters for the more daring among us.  Some of the rehab aides have never tried this
delicacy so it was a surprise when several of them indulged, leaving just a
couple to whet Theresa's appetite as she waited for her main course.  When the
whole Maine lobster platter arrived, it was a sight to behold as Theresa dove
in methodically, doing her occupational therapist proud with her improved hand
dexterity.  It brought back the memory of our first road trip together in 1992,
when at the Sooke Harbour House on Vancouver Island, I learned that when it
comes to eating whole lobster, Theresa has few equals.

The next morning, Theresa met me for her weekly grocery outing at Trader Joe's where the improvement from our first outing in April was entirely evident.  This Saturday, Theresa was focused and determined and knew the store intimately well, wheeling herself directly to the aisles and shelves to get what she needed, plus a coffee and food sample as a reward for a shopping experience well-handled.  It's too bad there isn't a TJ's back home but I'm sure the vendors at the Waimea Farmers' Market will welcome Theresa back with their own special Aloha.  Dropping off the groceries at her apartment, Theresa organized and packed a weekend bag by herself before we headed off to my hotel room.  On the way, she wanted to stop at Target for a few toiletries and while there, we checked the registry for an upcoming wedding to which we're invited.  This is the wedding of the oldest child of the family that readopted our daughter Rylie Ai-Lin and because it is being held only three hours from here, we fully intend to be there to celebrate their happiness.  That our Lord has blessed us with this wondrous opportunity on our healing journey is yet another miracle for which we offer our praise and gratitude.
After arriving at the hotel room, I helped Theresa to unpack as she checked out the bathroom.  Women (at least ones I've known) seem to do that often, never really concerned about the bed, the TV or even the view as long as the bathroom suits their needs.  Apparently, it met with her approval because following a light dinner, Theresa announced that she wanted to take a bath.  I didn't think much of it until I fully appreciated what she was asking.  Instead of sitting on a bath chair and using a handheld showerhead, she wanted to soak in the tub up to her neck.  After considering the logistics for a bit, I helped Theresa sit down in the tub and then added foaming soap as the water level rose.  She luxuriated in the warm bubbly bathwater and the look of satisfaction on her face brought tears to my eyes.  It was only then I realized the importance of this day, the first time Theresa has enjoyed a soaking bath in over eight months.  Getting out of the tub took a little more ingenuity on both our parts but in the end, it was worth all we've been through to get to this point.

The remainder of the weekend was also a revelation as Theresa pretty much cared for herself, bathing, dressing, taking her meds on time, getting breakfast in the lobby, and making it through the night uninterrupted.  We also took in the movie Super 8 and Theresa stayed alert and engaged throughout, thoroughly enjoying the show.  This is a big improvement compared to when we viewed X-Men a couple of months ago where she felt the need to leave halfway through due to fatigue & overstimulation.  Returning to the CNS residence on Sunday evening on the heel of this successful trial, we kissed good night and looked ahead to the update conference the next day.
At the treatment conference, Theresa's various rehab therapists presented updates on her progress with no real surprises.  There is marked improvement in some areas with deficits still noted in others and although Theresa has benefited much from the specialized treatment at CNS these past four months, it's time for her rehab to take the next step.  That will mean progressing back home to a truly independent living environment so with this goal in mind, a tentative discharge date was set for the end of July (is that cheering I hear from our Ohana?)  In preparation for her long anticipated return home (where there are far fewer brain injury rehab services), the discharge planning will involve contacting resources in Hawaii as well as seeing a number of neuro specialists in the Los Angeles area over the next two weeks.  CNS highly recommended that I accompany Theresa to these appointments in case there were questions she or her aide couldn't answer, so what was originally a short 4-day kiss & fly trip grew into an extended 2-week whirlwind of further testing & specialist consultations.
Over the next 10 days, we drove to Valencia, Northridge and other points on the compass to see a neuro-optometrist, a neuro-psychiatrist, an orthopedic surgeon, a neurologist, a neuro-psychologist, a neuro-neurologist (just kidding) and even a few imaging facilities for CT angiography, MRI and plain old x-rays.  In cases such as with the neuro-optometrist, the diagnosis was very pertinent to Theresa's complaints.  It was mentioned previously that Theresa walks well on the treadmill but not so freestyle.  After testing her eyes and adding prisms to her glasses, Theresa was able to better converge the views from both eyes, improving her vision and balance.  It really is amazing how the interaction between our eyes and brain are so important to walking and we are truly thankful to our Lord for guiding us towards these healers.

The next day, another two hour slog on the Los Angeles freeway system led to 
a visit with a neuro-psychiatrist who prescribed a change in medication,
schedule, and dosage to combat Theresa's mid-morning fatigue.  Later on at the orthopod,
it was discovered that the ongoing pain in the left knee is due to a previously
undiagnosed meniscal tear, which will require a followup consult and
arthroscopic surgery back home.  This was also Theresa's first opportunity to
see detailed images of the wide assortment of rods, pins, plates and screws in
her neck and other extremities.  Her off-the-cuff comment was "no wonder I ache
all over after PT!"  On a positive note, the orthopod noted that the majority of
the fractures are healing well and perhaps in 6-12 months, we should consider
having some of the supporting hardware removed.  With additional appointments
scheduled following my return to Kona, I pray a solution will be found for
Theresa's continued inability to flex the toes on her right foot along with the
sensation there of constant tingling.  Up until the day I had to leave, Theresa was
still undergoing intensive neuropsychological testing, which will provide a good
baseline measurement when she is reassessed in a year or so.
With all of this going on, I still needed to return home to make arrangements for Theresa's eventual care in Hawaii.  My return ticket was pretty much useless as the change fees and fare differential would have amounted to over $800.  Then inspiration struck and I found a $238 one-way flight from San Jose to Kona on Alaska Airlines.  Bidding Theresa farewell and promising to return during the week of her expected discharge, I began the four hour drive leaving Bakersfield at roughly 0200h.  At that time of night, the roads are mostly quiet except for the occasional convoy of trucks, possibly driven by vampires according to my wandering thoughts (have to stop watching True Blood in the hotel room.)  Being the middle of the night, the temperature had dropped sufficiently that I could drive with the windows open.  This not only kept me more alert but it also let in the varied smell of the counties.  Moving from the petroleum odor of Bakersfield, to the lush greenery of the Central Valley's agriculture and onto the cow manure of the California dairy industry, it was an olfactory delight that kept me going until the harrowing mountain pass between I-5 and Hwy 101.  Descents through fog-shrouded winding roads can be full of dangers but not to fear, even in the wee hours this day my guardian angel kept up and I made it safely and on time to the San Jose airport.  Having never flown Alaska Airlines before, it was a pleasant surprise when they served a Kona coffee cookie upon departure and a mac nut sampler nearing arrival.  I was greeted by our dear friend Betty who Theresa first met over Konaweb.com even before moving here.  She, along with a few others have generously provided me with rides to/from the airport since this began and I am truly grateful to them and to our Lord for sending these angels in our time of need.
Back home for the past week, I was able to confirm the services of not one but two homecare providers to support Theresa.   A month ago, I had no leads and with the help of friends and associates at work, everything is quickly coming together in preparation for Theresa's homecoming.  For this among all of the other miracles and blessings our Lord has graced us with, please join me in giving thanks.

Mahalo,
David
P.S.  With a tentative discharge date now in place, my plan is to bring Theresa home on the United flight from LAX arriving in Kona at noon on Saturday July 30.  It would be a wonderful show of support if some of our Ohana could be there to welcome Theresa home following our 8-month journey of healing grace.

Monday, July 4, 2011

Update from David

Aloha to our Ohana,
 
The last update ended with our becoming lost while looking for Lake Isabella however the Good Shepherd was watching over us as always.  He ensured our safe passage while traversing a narrow, winding mountain pass and when we stopped at a turnaround to do just that, the distant view of the lake was revealed in all its glory.  On the way back through town, Theresa needed a restroom break (and I needed to just plain rest) so we stopped at that ubiquitous Scottish chain restaurant that has a presence in most American towns.  While McDonalds is not usually on our frequented dining list, their restrooms are handicap-accessible and mostly clean, mostly.  So feeling somewhat guilty for having used their facilities, Theresa ordered a frozen strawberry lemonade which she promptly handed to me after only a few slurps.  For our Wisconsin ohana, Culvers has nothing to worry about as this artificially sweetened concoction is hardly a match for their lemon ice cooler.
 
The return drive through the mountains was just as beautiful with the raging river on Theresa's side.  She appeared mesmerized by the sheer force of the water and just stared as it dove and cut its way through the canyon.  I was kept busy concentrating on driving the right line through the twisting road and at one point definitely made use of the rental Kia's entire 102HP arsenal to overtake a slow-moving propane tanker.  Just as we safely completed the pass, I noticed two sheriff cars parked at the bottom of the hill.  If their radar/laser was aimed this way they would have had easy pickings that afternoon.  Instead, both of the deputies were out of their cars just shooting the sh*t and enjoying the late afternoon sunshine.  For that serendipitous moment, both I and my insurance premiums continue to be thankful for our Lord's grace.
 
Returning to Theresa's residence, we shared the remainder of a lovely day together.  As she showered by herself (a seemingly simple task that we take for granted until we no longer can,), I prepared a dinner of wild Alaskan salmon using what was available in her refrigerator.  A chef friend once told me that fine cooking is nothing more than the application of heat and spices to good quality ingredients and that was certainly the case here.  Back home, the TV is usually off and especially during meals however here it's just the opposite -- I suspect its purpose is to keep the rehab aides awake 8^).  We still enjoyed dinner despite having The Simpsons as a distraction and besides, that show has jumped the shark so many times, you'd think the shark would have died of starvation already.  Still, we are grateful to our Lord for providing these precious moments together and know that some day soon, they will be more plentiful.
 
Monday was our final day together on this go-around and it would be dominated by the treatment update conference.  Before that, Theresa had PT in the morning and she bested her previous treadmill record by walking 25 minutes non-stop.  Towards the end, I could tell she was in some pain however she soldiered through anyway.  With a few minutes remaining in the session, the physical therapist wanted Theresa to work on getting up from a prone position but that was not to be as her aching joints cried out for mercy.  Continuing on to the cognitive rehab and education session, Theresa completed the sorting and written comprehension exercises cleanly.  That led to the lunch break where Theresa and I sat with Wade, her alumnus from Craig Hospital and his wife.  Comparing notes, both patients have similar opinions of their stays so far -- the rehab therapy at the clinic is top-notch however the residential followup is lacking.  That was the message we brought to the conference and the management assured us it would be addressed.
 
From the therapists' viewpoint, Theresa has been initiating well at the residential facility, especially since moving to the single apartment unit.  Without roommates, Theresa has to do all of the cleaning and she has it down to a T.  Watching her run the vacuum from a standing or seated position is a sight to behold.  CR reports that Theresa's episodic memory is improving (what she had for lunch; what's on her to-do list?) which is an important step towards rebuilding the executive functions of logic and problem solving.  PT testing shows Theresa is making good improvement in strength and flexibility although stairs are still her nemesis, sometimes leading with the weaker leg which results in unsteady ascents.  Vestibular balancing is also an issue when her feet are lined up heel-to-toe (likely related to her cerebellum and/or brain stem injury) so it's good that Theresa isn't driving yet as she'd be unable to pass a field sobriety test.  From an educational measure, Theresa's reading comprehension is at 87% which is equivalent to a grade 14 level; given her prior accomplishments, she should be at the top level of grade 18 so there is still some work to do.  And from a counseling perspective, Theresa maintains a good attitude, taking bad news in stride, encouraging other patients and having good self-worth and esteem.  For me, it's good to hear of Theresa's progress and also be reminded of her current limitations.  Of utmost importance is her positive attitude and determination which really comes through in the photos and for that I continue to praise our Lord for His Gift of Healing Grace.
 
The first week after I returned home, Theresa phoned to let me know of her continued healing and progress.  She was now walking up to one mph on the treadmill and her endurance was steady at 25 minutes.  There were also stories of the weekend outing to the movies and eateries, one of which really touched me.  This night, the plan was for the group to go to the Noriega Hotel & Restaurant for a Basque family dinner (like the one we went to in the last update) however no one bothered to phone ahead.  Upon arrival, it was discovered that there was a private function so the restaurant was closed to the public.  With a bunch of hungry patients getting restless, Theresa recalled from her list of Basque restaurants that Benji's French Basque eatery was nearby so off they went.  While Benji's had room, a glitch arose with the rehab aides' presence.  At Noriega's, the management would allow the aides to sit with and assist the patients with their dining but at Benji's the rule was that each occupied seat had to place an order.  So with the aides unwilling to order, it seemed like the group would return home hungry until Theresa decided to pay for the all-you-can-eat soup, salad, appetizer, and dessert portion of the meal for the aides.  The restaurant agreed that would be sufficient and dinner was on.  All went well and everyone in the group enjoyed themselves, some sampling Basque cuisine for the first time despite having lived in the area all their lives.  I later asked Theresa how she came up with the money to pay for all of the aides' meals and she said it came out of her pen sales and savings from the unspent grocery and outing money.  Once again, Theresa's generosity and loving attitude come through and even for the non-believers among us, it's hard to argue against this sign of the healing power of God.
 
Mahalo,
 
David

Monday, June 20, 2011

Update from David

Aloha to our Ohana,
 
A swarm of dark eagles was swooping down as I futilely looked around for any kind of shelter.  Just as they flew close enough to reveal their menacing faces clearly, my early morning wake-up call arrived 15 minutes sooner than anticipated.  As I awoke from the slumber and forced myself to focus on the alarm clock, it gradually became evident to my sleep-shrouded mind that 0445h is way too early to get up, especially following a late evening meal that ended not seven hours before.  It was our last night together on this visit and although the clock had struck 1900h, Theresa did not want the evening to end -- and certainly not with a slice of Costco pizza.  Since we had such a good time at our first Basque dining experience a few weeks ago, that was her intention for tonight.  Theresa pulled from her planner a handwritten list of Basque restaurant names with stars beside those that she heard were good (this should no longer amaze me given her improving memory and cognition but it still does and I am ever so thankful to our Lord for these not-so-small signs of healing.)
 
After driving crosstown to reach Old Town Kern, created in 1874 when the Southern Pacific railway bypassed Bakersfield due to a dispute over how much right-of-way to cede, it's where two of the more famous Basque restaurants are located.  Although we didn't have reservations, that shouldn't have been a problem given the half-empty parking lot that greeted us.  Theresa was so looking forward to dinner that upon exiting the car, she told me not to bother with setting up the wheelchair and just hand over her cane.  But upon entering the James Beard award winning Noriega Hotel & Restaurant, the nice hostess told us that dinner had started at 1900h and they were already serving the third course.  With only one seating per evening, you have to be there on time; we didn't know this but will for our next visit.  At Wool Growers Restaurant, the other Basque establishment a couple of blocks away, the story was different but the end result was the same -- they're closed on Sunday.
 
Rather than be upset, all of this driving and walking was building up an appetite so I suggested to Theresa as we headed back towards her residence that she should keep an eye out for any eatery that appeals to her as long as it isn't Mexican food.  I don't have anything against the people but having sampled their style of cooking in Texas, California, New Mexico and even Tijuana, Cancun and Tulum, I must conclude that Mexican cuisine just won't make it onto my list of "last five meals to enjoy before departing this world."  Besides, it's kind of an unwritten rule that when we do have Mexican food, it must be early enough to allow for a few hours to digest before bedtime.  With 2000h fast approaching and our dining options acting like it was triple witching hour, Theresa scanned the restaurant district and dismissed Red Lobster, Marie Callender, In 'N' Out, El Pollo Loco and a few others.  Finally on California Ave., her eyes lit up when we passed a place called Pho Hut.  Now normally, any restaurant that takes the Pizza Hut logo and Photoshops in its own name would be questionable but we were getting desperate.  By now, Theresa was too tired to walk so we reverted to the wheelchair, which always draws stares of sympathy wherever she enters.  Not that we take advantage of the situation (except for the handicap parking pass) but probably in a month or so, I expect the wheelchair will be a remnant of our past and for that we continue to offer praise to God.  Theresa's instincts were right as usual and the food & service were wonderful at Pho Hut, a great first addition to our Bakersfield late night eateries.
 
The return flight to Kona was uneventful although it involved another mad dash between gates, except this time I made it, but just barely.  The reward was that as the last one to board, there was no room for my carry-on so it was gate checked at no additional cost.  The pleasantries continued as my row of three was open, allowing me to stretch out for the six hour flight to follow.  Upon landing and catching the Air Taxi straight to the hotel, I picked up a text from Theresa thanking me for the visit, grateful to our Lord for choosing me as her husband, and wishing that she could have come home with me.  I know in my heart that Theresa will be returning to Hawai'i and with God's Grace, it will be sooner than anyone expects.
 
For the next couple of weeks, Theresa kept in touch with me by phone, voicemail and text.  The good news is that the intensive rehab therapy schedule continues to produce marked improvements both physically and cognitively.  The day after I left, the PT put Theresa on the treadmill but she could not keep up at even the slowest speed of 0.8mph.  By the second week, Theresa reports that she is able to walk on the treadmill for 2 x 10 minute sessions and the next goal is to slowly increase the speed up to 2.5mph which is considered normal walking pace when outside.  OT is working with Theresa to improve her arm reach, strength and dexterity, and the cognitive and educational therapists are challenging her with ever more difficult and distracting puzzles, math and reading assignments.  Theresa said one assignment involves balancing a mock checking account and it took a few tries but she got it right.  Pretty impressive considering she hasn't had to balance a checkbook in real life since about 1999 when I joined her in Wisconsin.  In some ways, this new improved version of Theresa reminds me of the Bionic Woman -- better, stronger, faster.
 
On the residential front, Unit #412, a 1-bedroom apartment became available recently and Theresa gladly participated in the move, personally ensuring her orchids were successfully transplanted and decorating the empty living room wall with the Get Well Aunty Theresa poster made by our church's keiki (children).  Although the relocation was exhausting, the new unit allows more privacy and better rest at night as Theresa is no longer awakened every few hours by a roommate heading outside to smoke.  With the quieter surroundings, Theresa is reading books, magazines and even some medical journals I brought last time.  She's also writing thank-you cards to those that sent greetings so don't be surprised if you receive one soon.  The other week, Theresa told me of a new patient who only speaks Mandarin Chinese.  During clinic hours, there is a translator to assist with the communication but back at the residence, the rehab aides are pretty much left to figure out how to talk to the new patient, or as a last resort to use the telephone translation service.  One of the aides noticed Theresa speaking to the new arrival so now they ask Theresa to translate when they can't get through.  Theresa's comment to me was that she'd be happy to translate and would only charge half of what the AT&T operator does.  I don't know if she's kidding or it's a sign that Theresa's entrepreneurial spirit has returned but I'll praise our Lord either way.
 
At CNS, the daily living therapy includes managing the weekly grocery budget plus a separate fund for outings like movies, salons, restaurants, take-out, etc.  But once that outing budget is spent, the patient has to wait until the next week to receive additional funds.  Theresa's first attempt at increasing her outing budget was to buy a box of cheap pens and sell them at a small profit to the rehab aides, who are always looking for a pen to document the patient activities.  At $0.17 profit per pen, it was taking a long time to save up even the $6 for a movie so Theresa has taken on a new tack.  There are nicer pens equipped with cushion grips at the clinic so when she sees one, she compliments the staff member and asks if it's okay to keep it.  They invariably say yes and by the end of the day, Theresa has accumulated a few of these nicer pens.  She then takes them back to the residence and sells them for up to $1 each.  When I mentioned that this wasn't entirely ethical, her reply was that she does give the occasional pen away for free, probably to increase her sales with more exposure.  Perhaps I just need to remind Theresa about her experience with the Valentine's Day chocolate giveaway since that took place during her post traumatic amnesia phase.  The Lord always provides so whatever you give away, you will be blessed to receive many times over.
 
In early June, I found it necessary to return to Bakersfield as the health insurer was once again balking at extending coverage for Theresa's ongoing rehab at CNS.  This time, their tactic was to imply that she could receive comparable treatment in Honolulu or even on an out-patient basis in Kona.  Having experienced both in & out-patient rehab therapy during Theresa's prior recovery in 2009, we have intimate knowledge of the difference between CNS and what's available in Hawai'i, and both have their purposes.  For now, Theresa can still benefit from CNS (& Craig Hospital's) intensive rehab therapy which is so important in the first few months post-traumatic brain injury and when that phase of healing is completed, she can continue with out-patient rehab back home.  This is not a difficult concept to grasp but it seems to elude the health insurer.  If Theresa were not making the progress that she has, I could understand not wasting valuable resources and just sending her to a nursing home to live out her days, but she is improving steadily day by day and cutting us off at this critical time of healing clearly sends a message of valuing finances over proper healthcare.  Again, it is out of our hands however the health insurer decides but it does not weaken our faith in our Lord Jesus Christ.
 
On a more positive note, this unexpected visit allowed Theresa and me to see each other sooner than planned and we spent another wonderful long weekend together.  This time we did get to dine at Noriega's and the wait was well worth the lifetime experience of sharing a 50' long table with 100 other patrons.  Not only was the endless food and wine beyond our expectations, but we learned a lot from the couple sitting across who've been coming for dinner regularly for the past 20 years.  Other Basque restaurants may have more exposure or better PR but their verdict is that Noriega's has the best food and true family service.  We are in complete agreement and will definitely return as each day of the week has different food & wine pairings.
 
Last Sunday, we took advantage of the first clear day that week and headed out to nearby Lake Isabella.  It was a beautiful drive along the curving canyon road and the raging river with the late spring runoff was a site to behold.  Upon arriving at the town near the lake, we took a wrong turn and ended up climbing a mountain pass rather than going to the lakeside.  So instead of getting a photo by the lake, the view we had was from a narrow winding road atop the nearby mountain.  Beautiful in its own right and another sign that God is indeed Great!
 
Mahalo,
 
David

Monday, June 6, 2011

Update from David

Aloha to our Ohana,
 
It's been a couple of weeks since the last update and I appreciate your patience and dedication in following our healing journey of grace.  There's much to share so it's best to continue from where we left off at the afternoon of Lu'au fun.  Following the round of golf where Theresa amazed us by walking and playing three holes, the next activity was cognitive therapy disguised as a game of memory.  For the eight patients playing, the first would name an item they would bring to a lu'au starting with the letter 'A.'  The next one would repeat the first item, then add their own starting with the next letter in the alphabet.  This would go on until all 26 letters and their corresponding items were used.  By the letter 'N' everyone had made at least one mistake except for Theresa.  In fact, the therapist had to remind her numerous times not to give hints to the others as everyone was being graded on their working memory abilities.  In the end, Theresa won the game by recalling all 26 of the items correctly.  That this part of her cognition is coming back is a wonderful blessing and another sign of our Lord's incredible healing powers.
 
With all of the exertion and activities that afternoon, I expected that Theresa would want to return to the CNS residential facility to rest and relax before calling it a night.  That was not the case as the last thing Theresa wanted to do was spend an evening sitting alongside her roommates or the rehab aide while being tortured by yet another disease of the week movie on the LMN channel.  As an aside, we rarely watch TV at home, having cut the cable TV line over two years ago and replaced it with a $50 Radio Shack antenna.  The loss of  80+ channels wasn't missed and it allowed us more time to talk, take evening walks, and fully enjoy more of each other's company; another of God's little pleasures that I look forward to soon.  And with savings of $1000/yr on the cable bill, if former HGTV junkies like us could do it, so could many of our Ohana!
 
When I arrived at Theresa's apartment, she was just finishing her shower and getting dressed, not for bed but to go out again.  Joining her in the bathroom, I continued to marvel at her progress as she prepared two towels for drying: one draped over the wheelchair and the other on her head and upper body.  Once her hair was wrapped, just using the grab bar on the wall, Theresa stood up from the shower chair and carefully pivoted until she sat down in the wheelchair.  She then proceeded to dry herself and headed over to the vanity to brush her hair.  Watching her do this with both her arms overhead brought joy to my heart as it was not so long ago that she had that frozen shoulder syndrome.  After dressing almost completely by herself (I helped with the socks as her sock-aide was in the wash) Theresa saw the look of puzzlement in my eyes and then stated rather plainly, "Oh, we're going out tonight so choose a movie."  Somewhat stunned into compliance, I wheeled her out the door bidding farewell to the roommates and aide, and off we went to the local megaplex cinema.
 
Bakersfield is so spread out that even the local cinema isn't so close.  Just driving from the airport to the clinic to the residence and then returning to the hotel easily puts 60 miles (100km) on the car.  The Maya Cineplex was a good 15-20 minutes away however traffic was decidedly light for a Friday evening and we arrived in time to choose from the 1900h selections.  Since Theresa has already seen many of the recent releases including Soul Surfer, Thor, Bridesmaids and a few others, I chose "Water for Elephants" not knowing much about it.  The film's story is along the lines of The Notebook or Titanic in that the elderly narrator is describing life changing events from their past.  Other than taking a bathroom break about halfway through (where Theresa showed off her improved standing and walking ability) we became engrossed in the simple yet sweet love story.  What really surprised me was that Theresa stayed alert and engaged and even asked some pertinent questions throughout.  She did mention that the circus ringmaster gave her the creeps but that just means he played his part well.  About the only glitch in that long day and night was when Theresa tried to get out of the theater chair after the show.  It's the type that's low to the ground and the seat bottom slides forward as it reclines.  Despite her efforts, the seat would slide as soon as she tried to get up causing her to fall back into it.  After a couple more attempts that ended  in laughter (she started and then I joined in) I stood in front and just told her to lean forward into me rather than try to stand.  Once she did so and was free of the carnival chair, all I had to do was hold her hips while she stood herself up.  I am so grateful to our Lord for the time spent with Theresa, to be able to witness her progress as His healing powers make her whole again.
 
The next morning was the weekly grocery outing so Theresa called to say she would be on the CNS shuttle and to meet her at Trader Joe's at 1100h.  The hour came and went as I waited until finally Theresa phoned to say that with so many patients and their unique mobility challenges, some delay was inevitable; thus the caravan didn't arrive until after 1200h.  We hurriedly made our purchases although Theresa took her time to leisurely sample some food and coffee and then went back for seconds.  The reason for the rush was that I had received a call from my Aunts Helen & Margaret from San Diego and L.A. and they were already on their way to Bakersfield to meet us for a late lunch.  Along was my mother, Shirley, who just happened to be visiting them that week from Edmonton, Alberta.  After rushing back to Theresa's apartment to unload the groceries, we headed to the Grand View Chinese restaurant where sure enough, my Mom and her sisters were already waiting and had placed an order for various Dim Sum dishes.  As we sat down and caught up, my Mom and her sisters were surprised at Theresa's improving condition and how she was so alert and engaging in conversation.  The food then started to arrive and of all people, Theresa led us in an eloquent and heartfelt prayer of grace and thanksgiving.  The highlight of the meal was when Theresa emptied the steamer basket of shrimp dumplings onto her plate.  I was about to suggest we should share but thought better of it.  Theresa later told me that after being subjected to microwaved Lean Cuisine and Healthy Choices lunches for the past two months, she deserved to enjoy one of her favorite dishes by herself.
 
Following lunch, we bid farewell to my relatives as they prepared for their 3-hr return drive to L.A.  They'd also brought a gift of orchid flowers that Theresa just adored so rather than return to the residence right away, she wanted to shop for a watering pitcher and a pot.  This entailed a multi-stop trip to Target, Home Depot, Albertsons and others to find just the right equipment.  By late afternoon, we finally returned to the apartment where Theresa immediately found a sheltered spot to put the orchids.  Even I was bushed and looking forward to a quiet evening but that was not in the cards.  Not half an hour later, the fire alarm went off and everyone had to evacuate the complex.  I still don't know if it was a false alarm or not but as we were waiting across the street at the designated gathering area, Theresa asked for the second time in two nights which movie I'd like to see -- so much for the relaxing evening together.  This movie outing had been previously scheduled and Theresa had signed herself up, not knowing at the time that I would be there.  In the end, it wasn't as tiring as I thought and we enjoyed each others company while laughing and cringing at the silly gal pal flick, Bridesmaids.
 
Sunday would be our final time together on this visit and the day was already looking to be packed.  Following church tv, there was a planned outing to the Knotty Pine Cafe, located north of town near the airport.  Known for its heaping plates of food (the chicken-fried steak is a two plate affair) the line-up outside the door promised good things to come.  When our turn came, Theresa had the quesadilla omelet and I bravely ordered the CF steak, thinking it could be shared with others in our group.  Her omelet seemed to be missing a key ingredient (tomatoes and/or salsa) and yes, the CF steak was as large as a plate but also about as tasty as one.  This didn't even merit comparison to the famous CF steak at Hickory Hollow in Houston let alone that truck stop restaurant in Nagodoches Texas that served the best CF steak in our memories.  Still, it was nice to sit with some of the other CNS patients and their families and share the sacrifices we have all made for our loved ones.  One devoted daughter swapped her aspiring career in Boston for a Starbucks barista job here just so she could be near and support her brain-injured mother during this critical phase of healing.  In times like these, we must do what we feel is right, and praying for guidance from God is an important step in that process.
 
The afternoon was spent back at the residence, assisting Theresa with her assigned chore of bathroom cleaning.  She did a good job on the vanity, toilet, floors and shower compartment but even while standing, Theresa had trouble reaching high enough to wipe down the counter-to-ceiling mirror.  Partly due to her height and partly because of the limited over the head reach in her arms, I cleaned and polished it but she still received the credit.  Later on, we made a run to Costco for another box of Depends and a few other supplies.  She doesn't even need it most nights but sometimes it's easier to have on just-in-case, or if the aide has moved her wheelchair out of reach.  While leaving, Theresa had a craving for pizza so I was about to get her a slice when she asked if we could order a whole pie.  Having visions of indigestion haunting us in the middle of the night, I asked if she needed that much food and the reply was it's not for us, it's for the rehab aides!  This one is always thinking of others and her actions were certainly appreciated by the hungry staff that night.  In the end, what started out as a trepiditious arrival due to the health insurer's questioning of the need for continuing care, turned out to be a very rewarding visit with my wife.  While it is in the health insurer's nature to choose profit over the patient's needs, their decisions will not derail the faith we have in the healing powers of our Lord, Jesus Christ.
 
Mahalo,
 
David

Sunday, May 22, 2011

Update from David

Aloha to our Ohana,
 
After returning from Bakersfield a couple of weeks ago, my plan until the next scheduled visit in June was to remain in Hawai'i and catch up on office work and home duties.  Of course, our best-laid plans don't always mesh with those of our Lord and sure enough after about ten days back, a message arrived from the Center for Neuro Skills.  They were having issues with renewing the approval for Theresa's continued stay so the possibility of a coverage gap existed.  In order to cover all bases, it would be best for me to return to Bakersfield in case Theresa had to be discharged.  So for the second time in less than three weeks, I made flight arrangements for yet another Trans-Pacific crossing; again not knowing how long I would need to stay but trusting in God that this was part of His plan.
 
Thankfully with the passing of Easter, the airfare has dropped back to the $800 range compared to at least $1200 beforehand; plus there are plenty of seats to choose from.  Not an hour after the flight was booked, Theresa called to give me her nightly update.  In addition to her walking, arm movements and cognition progress, Theresa was fixated on the primary care physician labelling her as diabetic from a single fasting blood glucose test of 119 mg/dl (101 to 140 is considered pre-diabetic) and then putting her on Metformin, a drug to control blood sugar levels.  Theresa told the nurse the proper way to diagnose diabetes is with the hemoglobin A1C test and anyone that relied solely on the blood sugar test was practicing medicine from the last millenium.  Because Metformin has several uncomfortable side effects including diarrhea, nausea, gas, weakness, indigestion, and headache, Theresa would not consider putting her patients on it without a positive set of tests.  That said, because Theresa is playing the role of patient this time, she will reluctantly take the Metformin but has warned the staff to prepare for sudden and urgent bathroom sorties.
 
Theresa's mood brightened considerably when I let her know of my upcoming trip back.  She said it was actually perfect timing because CNS was holding a Lu'au themed picnic that Friday afternoon, partly in honor of the three patients currently there from Hawai'i.  So if I could pack her paʻu or hula skirt and also bring a lei, she would be properly dressed for the occasion; and it wouldn't hurt to pick up some local treats to share with the CNS staff and patients.  Time was a luxury I didn't have that evening as I rushed home to repack (keeping a packed carry-on bag ready to go has become a habit these past six months.)  In anticipation of the next trip, I had started to collect some treats to bring so mac nut kisses and wasabi-flavored tortilla chips would have to suffice this time.  Besides, with the bulky paʻu my carry-on was already stuffed beyond its design limits.  Again, Pastor Al and Lynda were kind enough to provide the ride and comforting faith on the way to the airport and for that I am truly thankful to our Lord.
 
The flight to SFO was relatively smooth and for the first time since starting these ocean hops in January, I had the blessing of a row of three seats to myself.  The horizontal position is definitely more conducive to sleeping however in times like this, I do envy Theresa's ability to lay across a row of three and not have her feet dangle into the aisle.  Still, laying down and curling up has its advantages, not the least of which is to block the glare from the overhead monitor.  It may be the fantasy of some but this night, Jennifer Aniston would not be keeping me awake.  Getting a couple of hours more rest on the layover before the shuttle flight to Bakersfield, I arrived at the CNS Clinic and ran into Wade, a compatriot from Theresa's time at Craig Hospital.  In his unique way, he said there must be a mistake because he saw Theresa roaming the clinic hallways using a 4-prong cane and in search of her wheelchair.  Turns out her first session of the morning was PT and the therapist took away her wheelchair and gave her the cane to get around with for the remainder of the day.
 
When I finally caught up with Theresa in cognitive rehab (CR), we were so happy to see each other that it distracted her from completing her sorting box task accurately.  She was working on multitasking by listening to a nature story while answering questions, sorting out objects and then switching tasks every few minutes.  Between tasks, Theresa recalled with relish the toppings and sides on her evening outing to Juicy Burger that included chipotle ketchup, assorted veggies and sweet potato fries.  As I listened and marveled at Theresa sitting on a regular chair and not her wheelchair, there was something else different about her.  She was wearing pajamas and in fact, so were most of the staff and patients.  Turns out Thursday was PJ day and thankfully, the attire of choice leaned towards Cotton Ginny rather than Victoria's Secret.
 
Theresa's next class was occupational therapy(OT) which she stood up and walked to slowly and surely without any struggle.  It was a pleasure to watch as she prepared an omelet from scratch, scrambling eggs, chopping up peppers, onions, etc. and even walking to the cupboard and reaching up for spices.  For safety from oil splatter, the therapist assisted with the flipping but it came out so poorly that I'm sure Theresa could have done a cleaner job.  That afternoon, Theresa walked so well with the cane to the rest of her sessions that the PT assigned the cane as homework.  To celebrate this milestone, we went to dinner at a local Chinese restaurant with the rehab aide along just in case.  I don't have the words to describe my joy watching Theresa get in and out of the car without needing a sliding board, and then doing the same to sit in the restaurant booth next to me instead of at the end in a wheelchair.  All I can do is thank our Lord for his gift of grace and healing powers.
 
Friday was Lu'au Day at CNS and sure enough, most everyone was decked out in aloha wear, plastic leis and grass skirts and even coconut shell tops.  Theresa looked lovely in her paʻu and blue fringe lei and in addition to the Hawaiian wear, she also sported some kinesiology tape on her elbow and knees; too bad I forgot to take a photo of its colorful and intricate pattern.  This tape has been used in Asia for decades to relax overused muscles and facilitate underused muscles and for Theresa, it has certainly reduced the soreness from all of the walking, stairclimbing, pedaling and reaching.  Kinesiotape was seen most prominently on the shoulder of Kerry Walsh, the U.S. beach volleyball player at the Beijing Olympics.  Not to be left out, I also joined in with my standard office attire aloha shirt topped with a kukui nut lei.  One of the patients, Gary, seemed fascinated by the style so we switched leis on a whim.  Later that morning, he gave me a salmon-motif bracelet he had made from a piece of ceramic found on the beach.  It's said a good negotiation is when both sides go away happy and that was certainly the case here.
 
The good karma continued later that day during the conference call with the health insurer.  It seems the reason they were reluctant to extend further coverage for Theresa's stay was because an initial discharge planning report had not yet been prepared.  Apparently, it is standard procedure to begin planning for a patient's discharge from the moment of their admission so everyone involved has a timeline to follow.  Because CNS had not presented this report yet, the health insurer had no idea how long Theresa might stay here other than the initial estimate of 3-6 months.  And with Theresa exceeding most benchmarks of healing after seven weeks, it's becoming more certain that her length of stay will be in the lower range of that timespan.  So with an agreement to extend coverage for a few more weeks in place, Theresa can continue with her intensive rehab therapy and look forward to returning to Hawai'i by late June if not sooner.
 
Following the morning therapy sessions, the staff and patients transferred to the site of the lu'au picnic, the nearby Yokuts Park located alongside the Kern River.  Yokuts (also called the Mariposa Indians) is the name of the indigenous population that inhabited the Central Valley and they numbered as high as 70,000 before the arrival of the European settlers.  Today, there are fewer than 2000 Yokuts and they mostly live on reservations in the outlying areas.  The lu'au festivities were well organized and the catered food was delicious with kalua pork, teriyaki chicken, sweetbread, homemade pineapple ice cream and an orange/cranberry salad (OK, maybe not so much that last one.)  Theresa and I enjoyed the meal together although she did miss her favorite lu'au dishes, Poké and poi.  One of the afternoon activities was mini golf and despite Theresa's soreness in her taped up legs, she still managed to play three holes before retiring.  Given all of the exertion of the past week, Theresa has done so well and made such progress along her healing journey.  Despite all we've gone through, she continues to keep a positive attitude as do I and we know in our hearts it would not be possible without the support of our Ohana and our Lord, Jesus Christ.
 
Mahalo,
 
David