Update from David

Aloha to our Ohana,

The past week has seen new challenges and rewards on our healing journey, all for which we are thankful to our Lord.  Since our health insurer continues to deny coverage for Theresa's final few weeks at Craig Hospital, it has become necessary for us to move into one of the patient/family apartments.  Over here, I care for Theresa on a 24-hr basis and bring her to the hospital for out-patient rehab therapies during the weekdays.  While the first few nights were a learning experience (as it usually takes 2 aides to assist with some duties), Theresa has made me proud by helping me to help her as much as she can.  Working together, we're successfully caring for each other and as a bonus, Theresa now gets a shower every morning as opposed to the once every 48 hours evening shower at the hospital.  As alluded to previously, the luxury of sharing a bed is wonderful and just having Theresa beside me and listening to her talk and breathe is a gift from God.

In anticipation of leaving the hospital, the past week's OT and PT sessions concentrated on teaching us skills we would need to live apart from their support system.  Theresa did everyone proud by pushing herself hard to master toilet, bed and car transfer techniques.  She is especially adept at using the slider board and just loves the downslope glide from bed or car seat to the wheelchair.  I'm almost afraid she'll slide right off the board but she always catches herself in time.  We took full advantage of these skills on the weekend when Theresa and I took a road trip to Colorado Springs and the top of Pike's Peak at 14,110 feet, just slightly higher than Mauna Kea volcano back home.  Seeing that the conditions were below freezing and extremely windy with very thin air, I can't blame Theresa for not wanting to get out and have her photo taken beside the landmark sign.  On the way down, we were both concerned as the Chevy Suburban ahead of us was riding their brakes to the point of smoking them.  Being flatlanders from Missouri, they probably weren't used to gearing down so we said a prayer for their safety.  Fortunately for all of us, they pulled off at the 11,000 feet brake checkstop but we could smell their overcooked pads for another mile.

In addition to the daily living skills taught by the therapists last week, Theresa also underwent some repeat speech and cognitive testing.  The results show improvement in memory, logic and problem solving, and in the pictogram test, Theresa scored 90% correct as compared to 60% in February.  Observing the complexity of these tests, I would be hard pressed to do much better.  Also, more diagnostic imaging was ordered for Theresa's neck, ankle and major arteries and the good news is she is now cleared of most weight bearing restrictions.  Dr. Courtney Brown, one of the top orthopedic spine surgeons in the country personally delivered the good news to Theresa about her neck.  ASIA testing to measure the level of feeling loss throughout her body due to the spinal cord injury showed some impairment but that should improve as Theresa becomes familiar with interpreting the new sensations.  Right now, Theresa describes it as pins and needles in her extremities however we are grateful that she has regained some feeling in those parts.  Even in the therapeutic recreation sessions, Theresa continues to impress by beating both the therapist and me at Uno and Super Scrabble (winning with a 92-pt word!)  Finally, Theresa kept the best surprise for last Friday during the PT session.  The goal was to get her standing with support from the parallel bars and perhaps try to take a first step if she felt confident.  Well, Theresa amazed all of us by slowly walking a total of 10 feet -- really a miraculous achievement for her first time on her feet moving forward in over four months.  We continue to praise our Lord for His gift of grace and healing for Theresa.

There were also visits from medical staff from two of the three transitional rehab facilities we are considering for the next path on our healing journey.  We are most grateful and humbled that these specialists took the time to fly out to meet Theresa and me, and after long and careful consideration, we have decided on the Center for Neuro Skills in Bakersfield, California.  The move will take place later this week and once we're settled in, I'll provide the new mailing address.  This rehab facility is much more of a residential setting (with nursing care as needed) and the patients will continue their therapies while also learning how to master the skills of daily living to reintegrate into their lives back home.  Among the goals is for Theresa to be walking, if not dancing the hula, by the time she is ready to return home and that should take another 2-3 months.

This morning, we attended our final chapel service at the hospital, listening intently to the pastor speak of thanksgiving during this 3rd week of Lent.  Theresa gave a heartfelt testimony and even played "How Great Thou Art" on the piano.  Later on we drove to the Mexican/Vietnamese part of Denver for some good and inexpensive dim sum.  Theresa's eyes were bigger than her appetite as it looked like she wanted to order just about everything that passed by.  We settled on a few of her favorites and as I watched her enjoy the dishes, marveled at her healing progress.  Back in the apartment, I was beginning to take a nap when Theresa asked about the people in the car that hit hers and how they had fared.  I directed her to the web links for the numerous news articles and TV coverage which Theresa reviewed with rapt attention.  Not long after, she asked if we could return to the chapel as she had this irresistable need to write down a prayer request, a copy of which I am grateful to share with our ohana.  After going through all that she has, it truly is a blessing and a miracle that Theresa retains the Love of God inside of her and continues to do His Work as she heals through His Gift of Grace.

Mahalo,

David

Update from David

Aloha to our Ohana,

By all accounts, Theresa and her sister, Wanda, had a wonderful week with
the two of them enjoying their all-too-short time together.  Without mom
along, Wanda took a different tack and let Theresa attend her rehab
therapies undisturbed.  Between, before and after these sessions, Wanda
worked with Theresa to organize her daily planner and personal belongings,
and made sure that Theresa wore her Dynasplint (renamed battle-splint by
Theresa due to the pain it inflicts) for the prescribed four hours per day.
I'm pretty sure that if Wanda stayed a little longer, Theresa would have
given her an affectionate nickname too, as she has done for some of the
Craig Hospital staff including:  Sarge - a no-nonsense nurse, Jolly Holly -
the always upbeat occupational therapist, and Matey Katie - the only
speech pathologist that could keep her composure through Theresa's
sometimes silly ravings.  Wanda also encouraged Theresa to push her
own wheelchair most of the time and from what I heard, the ice packs
needed to soothe Theresa's sore arms and legs contributed to the ice
machine breaking down regularly.  We are so grateful to our Lord for
Wanda's visit and that she was able to make such an impact on
Theresa's healing.  After a busy week, Wanda's reward was a direct
flight home, unlike the trip out where she became intimately acquainted
with the Seattle and Las Vegas airports en route.

If you notice above that the word "legs" is used in the plural form, it's
because for the first time in over four months of recovering from multiple
surgeries that Theresa's right leg is finally able to bear some weight.  And
with this newfound ability comes the freedom to stand with assistance and
do transfers that formerly required an overhead lift or at least two nursing
aides to accomplish.  The standing exercises started this week with three
sets of five 1-minute reps daily.  The first few sets were a struggle as
Theresa's quadriceps must have hurt like he-- after so long without use.
But by the end of the week, Theresa was standing without requiring
constant encouragement and only needed a light assist from the aide to
get up.  And in a few instances, Theresa didn't even warn anyone that
she was attempting to stand; she just leaned forward into the aide for
support and stood on her own.  All of this culminated in today's PT
session where Theresa leaned into me and stood up for five minutes
nonstop, a huge milestone on our healing journey and one that will
surely be surpassed in the days to come.  This gift of grace from our
Lord is received with utmost humility and gratitude.

When I flew to Denver last Friday, the original purpose was more to prepare
for the upcoming move to a transitional rehab facility but it morphed into
trying to figure out how to deal with the latest snag, the denial of our
health insurer to continue coverage as originally outlined in the treatment
plan.  But I've expended enough bandwidth detailing these travails last time
so I will leave it in our Lord's hands.  Hopefully, the bureaucrats at the
HMO will review our appeal justly and show more compassion towards
their subscribers' needs instead of boasting of their $5 million profit this
past year.  In any case, I am here to share in Theresa's continued healing
steps and am looking forward to the day that she actually takes her first
step.  Until then, Theresa is wheeling herself around the hospital hallways
just fine and now that her spiffy new ride in metallic burnt orange has
arrived, she's doing her joy rounds in style.  Even more inspirational is
that Theresa has incorporated her Hula Teddy in the joy rounds.
Sometimes, it takes more than a friendly face to get a new patient or
their family to look past the anger, blame, denial, etc. and that is where
the hula bear steps in.  Watching Theresa make the bear dance the hula
brings a smile to everyone, no matter the direness of their situation.
That Theresa can see beyond her own limitations and strive to heal
others while being healed herself is another of the Lord's gifts that
are not wasted.

Later this week, there will be visits from evaluators representing some of
the transitional rehab facilities being considered.  While each assisted
living center will have its plus & minus, rest assured that we will review
them carefully before making this all-important choice.  I would like
nothing more than to bring Theresa home right now but we have discussed
it and agreed that the effects of her brain injury can best be managed at one
of these intensive rehab facilities rather than on an outpatient basis in
Hawai'i.  I ask you to join us in prayer for our Lord to guide us to the
next path along Theresa's healing journey of grace.

Mahalo,

David

P.S.  Included in this week's update is an article about Theresa as printed
in her former clinic's newsletter.  Our thanks to everyone at West Hawaii
Community Health Center for the tireless support they have shown us.

Update from David

Aloha to our Ohana,

 

The good news continues to emanate from Craig Hospital and wonder of wonders, Theresa herself has become the chief messenger.  She phoned earlier in the week to let me know she had a revelation of some kind and the result is she now has gained a newfound resolve to get better so she can get home quicker.  Since then, Theresa has worked diligently on her rehab therapies showing good progress, and I even received a call from the family counselor confirming that was the case.  It's as if there was a divine intervention that gave Theresa some added incentive to try harder, and for this I am truly thankful to our Lord for His gift of grace.

 

In addition to doubling her efforts in the therapy sessions, Theresa was confronted with having to learn a majorly difficult skill this week.  As part of the ongoing rehab program, it was time to replace her electric Hill-Rom hospital bed with a regular queen size mattress and boxspring.  Without the safety rails and electrical adjustments of the Hill-Rom, Theresa would have to exert more effort to transfer from the bed to her wheelchair using the slider board.  So if the number of phone calls that day was any indicator, then Theresa's frustration level must have been at orange or above.  After numerous unsuccessful attempts to transfer from the wheelchair to the higher elevated bed,  Theresa called to announce that she was going on a hunger strike until her favorite Hill-Rom bed was returned.  As I pondered this ultimatum, I tried to figure out some way to tell her it's a useful skill to learn because we don't have a Hill-Rom at home either.  Not ten minutes later the phone rang and Theresa was triumphantly describing how she used her left leg as a pivot to swing into bed.  That's our girl!

 

The other big news this week is of course the earthquake off the coast of Japan and the tsunami generated by it.  While we had six hours warning in Hawaii, that was barely sufficient time to evacuate thousands of people from the low-lying areas.  The tsunami waves did cause damage to homes and businesses along the west side of the Big Island but nothing like what happened to Japan's northeast coastline.  Miraculously, there were no human casualties here despite some Darwin nominees attempts at filming their own demise.  After all of the excitement was over, Theresa phoned me that morning to see if everything was okay.  After I assured her that all was well, she made mention again of her travails in the new bed and how she didn't sleep well because of a fear of falling off.

 

For me, the unspoken benefit of the bed change is that there is now room for two.  I'm not sure how Craig Hospital feels about conjugal visits but the next time I'm there and if Theresa is willing, I fully intend to cover the surveillance cameras so we can enjoy our first night together in over four months.  And I'm not even looking for anything more than some warm and loving snuggling although at this point, I won't turn down any gifts either.  Consider it an unorthodox form of recreational or occupational therapy, not unlike Theresa's favorite Hula therapy.

 

Theresa's sister Wanda arrives for a week's visit tomorrow so that should cheer both of them up.  It will be seven weeks since her last visit and I'm sure Theresa and Wanda will have lots to share.  Mom Rosa wont be joining them this round but she is planning another trip down south next month.  By that time, it is highly likely that Theresa will be headed to the next path along her healing journey -- a transitional rehab facility with assisted living care.  While several such care centers in locales ranging from California to Nebraska have been brought to my attention, one deciding factor will likely be if our health insurer is willing to provide coverage and for how long.  While I am grateful that our health insurer has covered Theresa's stay at Craig Hospital thus far, it is mind boggling that they only approve her inpatient rehab program two weeks at a time.  Moreso, that their medical director who is over 3500 miles away can make the decision to deny coverage based on progress notes even though Dr. Weintraub who is at Theresa's side daily and knows what's best for her has to plead her case regularly.  Such is the state of the private health insurance industry and it's no wonder that HMO is sometimes derisively referred to as "Health Moneymaking Organization."  Here is a link to a recent article that discusses the subject in greater detail, along with a fact sheet from the Brain Injury Association.  I'll get off my soapbox now.

http://yourlife.usatoday.com/health/medical/treatments/story/2011/03/For-brain-injuries-a-treatment-gap/44361116/1

http://www.biausa.org/_literature_81098/Access_to_Care_Fact_Sheet_2011

 

Whatever happens in the next few weeks and wherever our healing journey leads us, we know it is by the Grace of God that we have come so far as we continue to praise and put our faith in Him.  Coming to Colorado was certainly not something I would have considered beforehand but Craig Hospital has been a Godsend for Theresa's healing and we have made many new friends here.  That the Good Shepard watches over us is not in doubt.  As long as we follow in His path, we will not lose our way.

 

Mahalo,

 

David

Update from David

Aloha to our Ohana,

The past week has been a quiet one with limited contact from Theresa
herself. There was a phone call or two from her nurses earlier in the week
to update me with basic information from Theresa's daily progress chart,
i.e. she ate 70% of her meals, attended four hours of therapy, used the
commode 3X, required Oxycodone twice, brushed her teeth and hair,
dressedher upper body, and performed other activities of daily living.
Aside fromthis clinical checklist, I haven't learned too much about
Theresa's progressin her rehab therapies after the sutures were removed
from her right ankle/heel or about the x-rays that were taken last week.
That is, until this past weekend when Theresa phoned me with some
good news.

Her right foot is still not weight-bearing however she is doing leg lifts
and light exercises on it in addition to wearing the Dyna-splint up to four
hours per day. In collaboration with the OT/PT staff, Theresa continues to
stand on her left leg for extended periods and the pain in the left shoulder
is subsiding as she slowly regains flexibility and motion in that arm. Even
more exciting for Theresa is that her new wheelchair arrived and it's
properly sized so now she can use her left leg to propel the chair forward
along with both arms. This means Theresa is able to wheel herself pretty
much in a straight line and that allows her more freedom to roam the unit
and beyond.

Theresa told me it feels good to get around and she's used her newfound
mobility to enhance her joy rounds. She recounted some recent
admissions where the patients were either injured in ATV rollovers,
skiing crashes or even waterpark related accidents and how she consoled
the parents to help relieve their guilt over allowing their children to
participate in these activities. Compassion is not often displayed by
patients with brain and spinal cord injuries during their in-hospital stay
so it is a testament to our Lord's healing powers that Theresa can pass
along His grace to those that need it the most.

On a separate note, Theresa surprised me with a call today because she
heard on the news that Kilauea Volcano was erupting and spewing lava
fountains over the weekend. She warned me to leave if the lava flows
towards our home and I promised her I would keep an eye on it.
Fortunately for us, the lava flows are 80 miles away and headed in the
opposite direction. Still, it's a wonderful sign that Theresa now remembers
where we live and for her memory to have come so far in so short a time
is another of God's miracles.

As Theresa's medical condition continues to improve, the goal over the next
few weeks will be to prepare her for a possible move to a transitional rehab
facility. This will allow Theresa to continue with her daily rehab
therapies while staying in a more home-like environment that provides
assisted living care. Depending on whether our health insurance will cover
it, this may be at the patient housing at Craig Hospital or a dedicated
facility elsewhere on the mainland. In either case, this next path along
our healing journey leads Theresa that much closer to coming home. She
has mentioned more than once how she is longing for Hawaii however
for now, the best rehab therapy for her injuries is still far away from home.
Theresa's sister Wanda is planning to visit next week and I plan to return
for the move to the transitional living facility. Until then, please join me in
prayer for the healing and wellbeing of Theresa and everyone else in need
of our Lord's Grace.

Mahalo,

David

Update from David

Aloha to our Ohana,

United 59 from Denver to San Francisco to Kona was not nearly as bumpy as
the outbound leg, however the flight was uncomfortable in its own way as
this 767 was completely full. In fact, 14 passengers on the standby list
didn't make it on board and wound up cooling their heels for eight hours
until the next flight -- not the best of ways to begin a Hawaii vacation,
and it brought back old memories of Theresa and me on our first trip to the
islands in 1997. Back then, we were caught up in Calgary morning rush hour
traffic and when we finally made it to the airport, it seemed it was too
late. As we waited in the snow covered parking lot for the shuttle to take
us to the departures level, I still remember looking up at the pre-dawn sky
and saying a silent prayer. That prayer was answered as we learned upon
checking in that the flight was delayed for an hour due to mechanical
reasons. Looking back, that was certainly not the first time I recall our
Lord answering my prayers but it was one of the most memorable. Fast
forward 14 years and for the first-timers on this flight, there was a sense
of excitement in the cabin as the attendants did their best to get everyone
involved in the festivities. Once again, I did not win the Halfway to
Hawaii contest, missing it this time by a whole 10 minutes. Blame it on the
0300h wake-up call and miscalculating for a tailwind when it should have
been a headwind.

While it was difficult to leave Theresa again, we did have a wonderful and
miraculous week together as documented in the last update. Theresa was
even up and out of bed to send me off that morning and for that I am most
grateful. It was hard for her to understand that I was returning to our
home in Hawaii to do some work, since for her, home is Craig Hospital for
now. Theresa kept asking if I would be joining her for dinner or any other
meals this week. Finally, I took the tack of asking if she remembered how
her Dad used to go away on business trips. That jogged an old memory and
it seemed Theresa finally understood why I was going away for a while.
While it is sad for us to be apart, I leave with a warmth in my heart
knowing that the progress Theresa has made in the past month is truly
remarkable and I dare say it is mostly due to her strength, determination
and faith in receiving God's grace and healing powers.

For the past few weeks, Theresa has had limited range of motion in her left
shoulder and arm, complaining of pain whenever her arm is lifted above the
head, out to the side, or extended too far forward. Despite negative
imaging results for sprains, tears, fractures, etc., she continues to feel
pain on that side. So with no other proof of disability, the highly
technical diagnosis the specialists have come up with is that Theresa has a
"frozen" shoulder due to lack of usage in the past three months. Both OT &
PT are concentrating their work on freeing up Theresa's left shoulder by
various stretching and lifting exercises but the most success seems to come
from the use of overhead pulleys. When attached to her wrists, this series
of ropes and pulleys allows Theresa to use her right arm to control how much
stretch and motion the left arm can tolerate, similar to how a puppeteer
controls their dolls. In the course of a week, there has been measurable
improvement in Theresa's left arm motion and flexibility and she is
encouraged to use that side more. Otherwise, she will continue to go in
circles when wheeling herself down the hallway.

The other significant development this week is that the sutures were removed
from Theresa's right ankle/calcaneus (heel) surgery that was performed a
little over a month ago. Recall that this was a repeat surgery to set the
ankle properly above the heel, as the original surgery would have created in
an unstable ankle/heel connection resulting in pain while walking, dancing,
etc. Over the next few days, additional imaging will be taken of the foot
to determine if it can be partially weight bearing, thus allowing Theresa to
finally try standing on both feet. Being able to stand is a major step on
her healing journey because it means Theresa will not need to rely on the
Guldmann lift to get her from the bed to the wheelchair to the commode or
the physiotherapy mat, although she is also learning to transfer using the
slider board.

In fact, Theresa was so excited by this development that she phoned to tell
me the good news herself. It was wonderful to hear her voice for the first
time since I left and we could have talked for hours except that Theresa's
arm was getting sore from holding the phone too long. Also, I don't think
she realizes there is a 3-hour (soon to be 4-hour) time difference between
us so it's somewhat amusing for me to answer the phone at 0500h and try to
shake off the cobwebs while Theresa recaps what she just had for breakfast.
I don't mind trading sleep for conversation with my wife and I'm sure it's
God's way of preparing me for the sleep interruptions to follow when Theresa
does return home. In the meantime, I will build up my energy reserves in
anticipation of the next visit, hoping and praying that Theresa will be far
enough along her healing journey to begin the move to the transitional
living unit upon my return.

For these blessings and miracles above all else that has taken place in our
lives, I continue to give praise to our Lord for His gifts of grace and
healing.

Mahalo,

David