Year-end review

We've been spending a lot of time lately talking about where Matt was a year ago. I read through old posts and tell him stories about things he used to do and he is always surprised. As frustrated as we both have been with the day-to-day of healing, it's amazing to look back at his life a year ago and see where we are now. At Christmas last year, we were thankful that he could eat dinner with us - he started eating solid food just 4 days before. This year we had the best Christmas - lots of good food and even a few rounds of dominoes. Here's hoping a year from now we are even more amazed.

I listened to Matt work out a conversation with his OT the other day - and I know that we're all getting better at figuring out what he is trying to say, but they really did have quite the conversation. He asked her how much of his arm & hand she thought would come back and she just said she has no way of knowing. But in over 20 years as a therapist, she's never worked with anyone who's had recovery like him - to have his arm start working almost 10 months out and then continue to make marked progress is pretty unbelievable. She feels that what they're working on at this point (wrist extension and finger movement) is detail work that she wasn't sure he would progress to and that since he has, hopefully things will continue to improve and he'll end up with some functional movement in his hand.

Hope you all have a fantastic New Year and all the best in 2011!

oh christmas trees

We've been crazy busy the last few weeks with Christmas tree sales and it's been really hard for Matt to see everyone running around and not being able to help. He makes an appearance each day and handles his inability to work with amazing grace as always, but it's much easier for him to stay in the house and not be confronted by it all. He keeps saying 'next year, next year' and I know he's motivated enough to get there.

Recently Matt got a new glove that he's using to get muscle control back in his fingers and wrist. He's been able to squeeze his fingers together, but releasing them again is very difficult due to the tone in his arm muscles. The glove has metal stays that fit over each finger and help him straighten the fingers again. He's been working on grasping small objects on one side, moving his arm across his body, and releasing the object on the other side. It's pretty amazing to watch.

He's also still horseback riding since they have an indoor arena and it seems to be the highlight of his week. I don't know if I've written this before, but when he first started, they made reigns for him with a single bar in the middle that he could control with one hand. Now they have the reigns separated with a handle on the right side that he can grip and he's controlling the horse with both arms. All the trainers comment on how great Matt and Norfie are matched - they work really well together.

A better version

2009 - hospital waiting room.

2010 - the parents' house.

We have the most to be thankful for this year.

the anniversary

It all started in the dark, early morning of 11/19/09 - a Thursday last year. A policeman pounded on my door, woke me up and left me with a scrap of paper - an ER number to call 2 1/2 hours away where Matt was fighting for his life. I know that I did not understand the full gravity of the situation at the time. Either his doctor was selective about the information she gave me or I just chose not to believe that it could be that bad. She told me they were sending Matt up to Dartmouth for surgery and that I should meet him there.


By the time I got there, he was already in surgery and I still had no idea what had actually happened, so when his surgeon finally came and talked to me was when my world turned upside down. He said that Matt's accident was really bad and that if he lives, he might never walk or talk again. He had suffered a serious skull fracture above his left ear which had caused a blood clot that they had to remove. Then it became a waiting game - I saw Matt once that afternoon for a few minutes and then later that night when they finally moved him into the ICU. I didn't take any pictures when he was there because I didn't want to remember, but I've found that I will never forget how he looked the first time I saw him - all the monitors, tubes and bandaging. It still seems unreal.

Now fast forward a year (if only that was actually possible) and as you know he's walking and talking and showing no signs of slowing his progress. I know that we would never have come from that low to where we are now without everything everyone has done for us along the way - from the first group of visitors at Dartmouth to the cards, comments, thoughts and prayers we still receive today. Thank you for everything that you do - we are truly blessed to have you all in our lives.

November already

I've been going to Matt's therapies with him a lot lately because it is so great to watch how he's progressing - and he can never really explain to me afterwards how awesome he's doing. (and since the hospital wifi is my only internet connection, I haven't had time to blog, even though I've had a lot to blog about.) So here's a rundown of the last couple weeks:

PT - Matt's really working hard with his hamstrings and they are slowly progressing. One exercise he's been doing is to lay on his stomach and try to lift his heel up by bending his knee. A few weeks ago, it was nearly impossible and we had to help every time. Now he can lift his lower leg by himself and he's using therabands (which add resistance) to strengthen the muscles. He's walking around the house without his cane at all and goes on short walks outside without it, too. He carries it with him, but tries to not use it - unless he's also going without the brace, in which case he still needs the cane.

OT - We all know Matt's wicked strong and it was only a matter of time before things clicked, but now that they have, his arm control is picking up quite rapidly. It's still really hard and requires a lot of concentration, but he's been able to straighten and bend his arm without any assistance. What used to require e-stim to engage, now only requires muscle massage and some of the time his biceps will engage without anything at all. At the end of the last session, even the muscles that make the wrist bend up were working with very little massage.

It's all very amazing and exciting to see - I'll try take another video soon! He's actually just starting another OT session, so I'm going to go watch what he does today.

working on...

Even though his arm just started moving, we're looking for another big step forward, but we have to be content with how the little things are progressing right now. In speech, he's been reading half -page paragraphs out loud! He read through two yesterday and it just about wiped him out, but he made it through all the sentences. Piecing all the little words together is really hard and frustrating - but he's doing so much better than even two weeks ago.

Whenever Matt walks up stairs, he always steps up with his good leg and then swings the right leg up to the same step. It's really slow going, but he hasn't had the muscle strength to bend his right leg enough to lift it up to the next step. He started working on this last week, though, and it's slowly coming along - he's even trying it outside of therapy whenever we come across stairs. He's still working without his brace or cane in therapy and went up and down a pretty steep hill today with almost no trouble. He isn't ready to try that at home, yet, but he is getting there.

Watch this!

Just one week ago, Matt couldn't move his arm at all. Then last Thursday, they called me into his therapy session and we watched him move his arm just a little bit - and it gave him a crazy headache to concentrate that hard. By the end of the weekend, he could do this! He's also gaining strength through his arm and shoulder - he can push against his therapist as she moves his arm around. Now he has to work on control in his wrist and fingers, but he's a lot closer to a functioning arm than it looked like he would be.

Exponentially

This is Norfi - Matt's therapy horse. He's had two sessions now and he loves it.

Matt was explaining to us the other day how he was getting better with just a slight incline and now it's become a steeper incline. It only took him two tries to be able to repeat the word exponentially, so his speech is coming along. We're working on finding him more functional things (like writing checks and IDing traffic signs) to do for speech therapy now and that seems to be making a big difference. I walked in the other day and he was looking at a magazine (which he has not wanted to do yet) and he said he's starting to be able to understand more when he tries to read.

He left OT on Friday telling me that he thought it went really well - which hasn't happened for as long as I can remember. He's always been so frustrated by OT that he doesn't really like to talk about it, so when he came out happy with the session it was a really good sign.

another good week

Things are still rolling along here - Matt continues to have little movements in his hand. His OT today said he could squeeze his fingers together towards a fist and as he did that his wrist moved up. Last week he couldn't really bend his wrist back - it was only forwards.

Matt also started horse riding lessons this week and loved it. He and his horse have some communication issues to work out - Matt has to hold the reigns in one hand and move them across his neck to turn him, which the horse didn't understand at first, but I think they'll get it figured out quickly.

He's still frustrated by what he feels is slow progress. He really wants to be done with his cane, but can only go for short distances without it. I know there is also a lot more he wants to be telling us, but often has to resort to "thinking good but speech is bad."

We're trying to work out ways for him to do things around the house and recently got him a cutting board that can hold vegetables or a mixing bowl so he can prepare meals one handed. He made gumbo last night which was awesome!

what a week

Matt had re-evaluations in all his therapies this week and they all showed a lot of progress. The most exciting was in OT - with all his might and concentration, Matt got his wrist to move ever so slightly! He could also barely squeeze his fingers together and release them again. The movement was almost imperceptible, but definitely there if you watched very carefully. His therapist was so excited that she kept bringing more people over to see him do it again and again and he was completely wiped out but very happy. We looked at one of his old evaluation sheets and every single arm muscle tested then was a 0/5 and this time every muscle at least had a trace of something happening. Only a few muscles show movement with gravity eliminated and none can withstand resistance yet, so he's still at a trace to 2/5, but it's something!

Even his doctor back at Crotched Mountain was cautiously optimistic about his improvement. He said that when there is nothing, it's hard to know if anything will ever come back, but with some movement, it's 'easier' to get more. There is still no guarantee that Matt's arm will completely recover and be as useful as before, but things are looking a little less bleak.

better and better, but bored

Matt keeps telling me that is leg is feeling better and better and he is so ready to be done with either the cane or the brace - or both! He's not there yet and continues to be frustrated by that. He seemed stronger than ever during his pool session the other day and his therapist is finding ways to add resistance to his exercises since they've become easier.

The main thing we're trying to deal with now (besides his arm function) is boredom. Matt's taking the same walk through the woods everyday and spending a lot of time watching TV which is just not him. He's not ready to venture off the road yet to explore other parts of the farm and there is a limited number of places to walk via road.

We're starting to look into other activities and programs available for Matt and finally found something he's excited about - horseback riding! There is a stable near by that offers a therapeutic riding program that we're hoping Matt can participate in once a week for the next few months. The lessons would consist of grooming, tacking and riding and figuring out ways for Matt to accomplish everything on his own. They're excited to work with Matt and he'll hopefully have his first lesson on the 22nd. (If you're curious and want more information on this program it's called hippotherapy.)

so far, so good

I feel like I'm telling you all the same things, but Matt's had a pretty good week. His pool session on Tuesday was great - he's working on strengthening his hamstrings and movements he needed help with 2 weeks ago he could do on his own. He's able to do more repetitions of everything, too, so he's gaining endurance along with strength.

His speech sessions continue to get better and better. Yesterday he did a naming test and had 82% of the pictures on the first try, often too fast for his therapist to keep up with flipping the pages. He's describing pictures in full sentences quite well and really working on the writing now. Spelling is super hard, but his handwriting is about the same as it used to be with his right hand!

Acer saccharum

I went along with Matt on his daily walk today and he was pointing out trees and trying to name things the whole way. He was even up for a little Latin - nothing he was even slightly interested in before. He wanted to show me all the sugar maples that he would add to the sap lines someday. Once we got back we spent a bunch of time with his tree guides looking up more Latin names. He said that names are on the tip of his tongue and after I told him, yes, but they're coming back, he replied, "But I want them now." We were out walking for over an hour and I'm amazed by his strength and stamina - I had no idea that was how far he walks every day.

We're going to see a neuromuscular massage therapist this afternoon to see if a different approach to his arm might start things moving. I'll keep you posted.

Have a good day.

When I used to leave for work before Matt was out of bed he would always mumble 'have a good day' without really waking up. He said it again this morning for the first time-and in a complete sentence! His speech seems to be improving exponentially these days.

This past week has been pretty tough - Matt noticed some changes in his head along the line where they put the skull back and he was sure something was very wrong. We could really see the difference in the pieces above his forehead and it was pretty scary. We went back to Dartmouth for a CT and everything is fine. There are bigger gaps in between the bone pieces than I realized and spinal fluid is moving in and out and as this happens, the appearance of the skull pieces becomes more prominent. It's nothing his surgeon is concerned about - it's really only cosmetic and Matt could opt to have another surgery (not anytime soon) if he wants to have the gaps cemented someday. It sounds like some of the bone will continue to knit together and make it less noticeable, but that he will always have some gaps because of how fractured the original skull was.

Now that Matt is feeling better, he's back to business at therapy. His pool session this week was awesome - his hamstrings are getting stronger and stronger and he's able to pull his leg back pretty well against the force of water. They are going to start e-stim on his hamstrings this week, too, so we'll see how quickly they progress.

We also went to see the guy who made Matt's leg brace and he cut the brace at the ankle so that it flexes now. This allows Matt to bend his ankle like normal while the brace still supports his knee. We were hoping to get rid of his brace completely soon, but when Matt gets tired while walking without it, his knee really snaps back. The last thing he needs is to add a knee problem to the list, so he'll keep the brace for awhile yet.

two weeks already

Time flies by even though things are feeling very slow. All I can really say about the past two weeks is that we're still here and working hard. Matt started pool therapy and has had a few sessions there and I think it's going well. He hates the cold water, but this therapy helps him focus on his muscles in a different way than does therapy on land. I think he'd like it a lot more if he had been into swimming before, but he's tolerating it for now because it seems to be helping.

Thanks for all the birthday wishes - we spent a great afternoon at a lake and had a nice break from everything stressful. Here's hoping that 32 is way better than 31 was!

Weekly update

Overall Matt has had a pretty good week. We finally got the mower fixed with a new belt and he's been busy catching up for 2 days and everything is running fine. In PT, his hamstrings are finally engaging and he's able to control them pretty well. Up to this point, he was mainly using his quads to move his leg and wasn't able to extend just his lower leg. His therapist has been working his leg really hard this week and trying to fine tune his muscle control. She also has started swinging his right arm while he walks so that he can 'feel' it and watch it move. We're hoping to make a connection with his brain that the arm is moving naturally when he walks. (I don't really want to talk much more about his arm right now, but if you need something to think about to help Matt along - that would definitely be it.)

He had speech two days in a row this week, so since he didn't have time to complete much homework in between, she brought a reading test for Matt and it was fascinating. He did several groups of picture/word matching and only had trouble with one word. Then he had to read sentences that told him to point to something specific or answer a question from a picture. It took him awhile to read through everything, but he could actually process the sentences! Then he tried to move on to paragraphs, but after 45 minutes he was exhausted and it was too much to handle. He was pretty thrilled with the results, though, and told her to bring the paragraphs back sometime soon, maybe when he's not so tired.

slow and steady

I know that plateaus are fairly common in brain injury rehab and it's not as if Matt has actually stopped progressing, but it feels a little slower at this point. I think we keep waiting for a major breakthrough while being thankful for the steps he his making. He keeps getting stronger and after each long walk they take in therapy they say he looks better and more natural. I know he's walking more at home, too, and will tell me about what he saw in the woods which is quite a ways from the house.


His speech continues to improve as well and he's getting sick of me pointing out his sentences all the time. He still never believes anyone when they tell him how awesome he's doing - it's always, "oh really?" when they point out his progress. Just yesterday a hospital volunteer who sees him once a week stopped him to say how great he looked. Hopefully one of these days it will sink in...

Mirrors

Last week we went back to Crotched Mountain to see Matt's physiatrist and we talked about the lack of progress with Matt's arm. He suggested that we try mirror therapy again, which Matt tried months ago but hasn't used since. Apparently, studies are now showing that this therapy can 'jump start' an arm like Matt's sometimes. He has to sit with a mirror perpendicular to him with his right (non functioning) hand behind the mirror. Then by looking in the mirror while he moves his left hand, it appears to the mind that both of his arms are working. Try it for yourself - it's a little trippy. He's supposed to do this for at least 20 minutes a day for who knows how long and it might just start something.

In speech he's working as hard as ever and is making progress on sentences and some basic spelling. Right now he has pictures of objects and he tries to put together a sentence for each one like 'Here is one box. Here are two boxes.' The is/are distinction has been really difficult but he seems to be getting it now. Plural forms are also difficult and he'll often change their placements like 'Here ares two box.' This has been especially hard to correct because he doesn't understand how he said it wrong - it seems that he doesn't always hear what he says, he just sees what is on the paper and it looks correct. When he tries to write the sentences, he doesn't always know what letter he's looking for, but he does always know when he writes the wrong one. It's fascinating to watch him process through each word until he has the sentence correct. His therapist is always excited at the end of his sessions - she tells him all this will come back and be easy again, it's just taking time.

We were also talking about the date and Matt knew what today is. He couldn't come up with the word anniversary, but he told his therapist that today is 'you, me - married, 5.' We talked about where we were 5 years ago and how much has happened since then. We are so incredibly lucky and thankful that we get to have today together and for each next day that we get.

Look, no cane!

Here's Matt walking without a cane or his brace! It's blurry because he doesn't want to stop. He's only practicing this in PT right now, but as soon as he's strong enough, he can start walking around the house without the cane. Although I did come home the other day and he was on the couch with a sandwich while the cane was still in the kitchen...

Everything else is progressing as it has been - too slow for Matt. He continues to surprise me with sentences every once in a while and his vocab is still increasing. I am reminding him of less and giving fewer cues when he wants to tell his speech therapist something.

He's struggling with boredom and having rough days as a result - but at least he now realizes it and tells me later "wowee, bad day." I try to come up with ways for him to do things, but it doesn't always help - he knows I'm just trying to keep him busy and that makes him feel worse. As soon as the cane is gone for real, he says, things will be better.

Busy week

I know that I don't post that often any more - we're just so busy, I don't know where the time goes! It also seems that we've settled into our life and it feels 'normal' and somewhat less blog-worthy. It is certainly not because Matt has slowed down or is making less progress at this point. In fact, it is quite the opposite.

He's really working hard on his speech homework and when he doesn't think about it, he can ask complete questions and speak quite clearly. The other day, I was looking in a tree book and asked him if he knew something about witch hazel. He said,"Can you show me a picture? I think I know it, but I don't remember for sure." He didn't even realize he had said all of that - I had to point it out to him. But that's what we're looking for - clear communication without conscious effort.

Matt goes for a good walk everyday and he's getting pretty strong and fast (still with his cane). He was always a 'mosey-er' before and it feels like he's almost back to that pace. Then he gets on his new mower that has a left-hand joystick and he zips around the farm faster than I like to drive it. This mower has helped a lot to make him feel productive again - or at least it will now that it has stopped raining.

step by step

Last week Matt's therapist came out of the gym so excited - Matt moved his right foot all on his own! In order to flex his foot up, he has to engage his anterior tibialis - a muscle that runs along the shin - and when he had his evaluation two weeks ago, she couldn't feel any movement in that muscle. Now he's doing foot flexes whenever he's sitting down. He still has to wear his leg brace at home, but they are starting to practice walking without it in therapy. He says give him six more weeks to get rid of the cane & brace, but we'll see.

Today in speech he told his therapist a complete sentence about what he did this weekend and used the terms today, yesterday, and tomorrow. She said that the homework he's had so far was really concentrating on cognitive recall and that it seems he doesn't need that as much anymore. Now we need to work on sound sequencing and words and how to get his thoughts out. He likes to say thinking is good, speaking is bad. At one point today, he even said his thinking was brilliant. He-he.

[I just realized that it might be difficult to dig through all the posts to find our contact info, so I've updated my profile on the opening page. You'll find our address and my email there.]

Working hard

Matt's had a couple of rough weeks recently - he is working so hard, but he can't see enough progress and is quite frustrated. The last few days, however, have been better and he'll at least listen to me when I say he is progressing. I don't think he really believes me, but at least he is listening.

Last week, he talked on the phone to a few people and actually carried on conversations. He was pretty thrilled. In OT, they work with his arm mostly by having his therapist move his arm while he thinks about moving it. On Thursday, she said that she could feel little muscle twinges in his lower arm right below his elbow as she moved his arm forward. It's not really movement, but that's how his leg started 4 months ago. Then on Friday, I watched him pull his arm back a little bit on his own! His OT reminded him that he hasn't used these muscles in 6 months and anyone who had their arm in a cast that long would have to work to get movement again, but that he is also retraining his brain at the same time. He has to concentrate so hard and gets so tired while trying to move that arm - it's definitely the hardest job he's ever had!

One month home

I can't believe we've been home for a month already - the time has flown by. We went back to Crotched Mountain last week for some outpatient therapy and it seemed like a million years since we'd been there. It was nice to see some of the people Matt had worked with and they all said he's looking great and sounding so much better.

We've been noticing little signs of progress in Matt's speech and he continues to be surprised every time we mention them. He's been remembering names so much better and doesn't just point at me anymore - he knows I'm Keri and he can say the names of people who've visited him without using his book. He also seems to be thinking more complete thoughts and using simple, full sentences to get his point across.

He's working really hard in PT and is walking quite well at this point. He even tried to give me his cane last week after I'd thrown out my back because he thought I needed it more than he did. His ankle isn't really working yet, but he can lift his leg higher and can bend his knee more without using his hand for help. Even people in the waiting room at therapy have noticed his improvement over the last few weeks.

Wednesday morning

Another quick week and things are going well - Matt is working so hard and is super busy with all his homework. He started OT last Friday and he really likes this therapist, too. She said it's good that he has some feeling in his shoulder - it's something to work with and a place to start. He's still struggling with a lot of tone in his hand, which is when the muscles are uncontrollably tense all the time. He has a hard splint that he spends 6-8 hours a day in to stretch out his fingers and his therapist says she can get his hand to relax more than before. Again, a good place to start.

Reading is slowly coming along - it's still really difficult to read full sentences, but he's getting through more of the list each day. Yesterday he asked his ST to give him longer sentences to try and she was thrilled. I've noticed him struggling with the desire to say more lately and the inability to find all the words he wants. Last night he really wanted to ID the birds we heard during dinner and it was driving him crazy not to know the names. We grabbed the field guides and he pointed them all out - if only we had field guides for everything!

I did drive him out to the woods this weekend and we wandered around a bit looking at wildflowers which seemed to make him quite happy. Now as he wanders further from the house he sees more of the work he wants to be doing and it's quite a struggle. Most of the time, he keeps up a pretty good sense of humor and says "add it to your list!" and shakes his cane at me. He's managed to remember the word 'supervisor' and is pretty good at it.

Wednesday night

Matt started speech therapy this week and I think it's going to be really good. We spent almost two hours talking with the new therapist and she got a very clear picture of where Matt is and what is still difficult for him. He'll have sessions with her twice a week and she'll be sending him home with lots of work to do on his own. One of her goals is for more independence for Matt, so he needs to write his name, address, phone and the date every day.

His hardest work so far is a sheet of full sentences to read out loud. Apparently it's very common for people with aphasia to look at or hear a sentence and only be able to repeat the main words. For instance, she said "He picked up the paper from the coffee table." and Matt repeated "picked up paper coffee table". He has a list of 10 sentences to read through like 'He paid his rent.' and so far he's been able to read through 5 with help and it is so hard! But that's what the work is for and it is going to help him get better. Unfortunately, it also makes him feel stupid and get really frustrated with himself, so we have to find the right balance of challenging but completable tasks.

His PT worked with his walking gait this week and we've all noticed a big difference. Before, Matt would lean over a little and throw his straight leg out to the side and around in front of him. Now, he's concentrating very hard on picking up his leg and bringing it out in front by bending his knee. It's slowed him down a bit, but it looks really natural. We've been out walking almost every night and he's now off the cement and out to the garlic field and back! Hopefully we can make it to the woods before all the spring wildflowers are gone.

Cheers!

I cannot believe it's Friday already - our first week at home as flown by and I've only posted once! Matt's going to PT three times a week and we'll add speech and OT therapies next week. With outpatient therapy, they'll be giving him a lot of homework to do, so he's going to be busy!

Matt had a CT scan on Tuesday and we met with his surgeon for what appears to be the last time. He was completely amazed with Matt's progress so far and said that most of the recovery happens within the first year, so Matt still has 7 months to gain back more function. He said it also takes about a year for the bone to grow back together completely so Matt should avoid any blows to the head for at least a year (and hopefully for the rest of his life!). And then as we were getting ready to leave, Matt got the best news - he leaned over to me and stage whispered "beer" - and his surgeon laughed and said don't tie one on, but you can have an occasional beer. So raise your glasses to recovery!

Outpatient therapy

Matt started in outpatient today - it's such a different experience from inpatient, but it's definitely a good step. We only met with his new physical therapist, who I think is going to work really well. She told us that it's impossible to know how much of his arm movement will come back so she's just going to shoot for 100%. Perfect. He'll be meeting with her 3 times a week for now. He has to wait until next week to meet with an OT and we're waiting to hear back from a speech therapist, but he's going to be pretty busy once those are scheduled.

I took Matt out for a drive around the farm yesterday and he is so happy to be here. It's lucky that we have a giant cement pad around our house - the grass is too uneven for him to feel comfortable walking around, so he likes to make loops around the house. I wish that he could have helped plant trees today, but he'll get there. He's made so much progress in 5 months!

Home sweet home!!!

Here's Matt leaving Crotched Mountain and then enjoying his 'new' recliner and relaxing at home. It's so good to be here!

Matt has a lot of work still ahead of him that starts with new therapy appointments on Monday, but I think being at home is going to give him another boost of motivation. Thanks for all the good wishes and powerful good energy!

A long day, but good news!

So after lots of phone tag and tracking down someone new to do a home evaluation, I think we got everything worked out and we are bound for home on Friday! We're supposed to have the evaluation done before Matt's discharged from here, but the people who are available to come to the house won't come until Matt is at home. Such a weird process this all is. But everyone signed off on this concession and we're leaving here late morning and meeting the evaluator at home in the afternoon. This has been a great place, but Matt is so ready for the next step...out the door!

A little snafu

We thought everything was lined up for Friday, but I just got a call that the person who was going to do the home evaluation cancelled and they're scrambling to find someone else. Problem is, no one here is licensed to work in Vermont, nor is anyone at the insurance company. Matt keeps saying "three days - out the door", which we're still hoping for, but we'll see what happens.

His therapies are going well this week. Yesterday he went for a walk outside, including up and down hills and through a small patch of trees. When they came back, his therapist said it wasn't her idea and Matt just smiled. In OT, he moved more of his upper arm than I've ever seen before, but they couldn't work with his arm too long because of all the tone and tightness in his muscles.

Little milestones

We had our meeting today with Matt's case manager - we might get to go home in a week! There are quite a few things to line up before then, but everyone is working to have it done by next Friday. Matt is so excited and ready to be home. He understands it could get postponed for a few days, but at least it's within sight!

He seems to have been getting himself ready for this. He's now been without his wheelchair for 2 full weeks and without any pain medications for one week. On Wednesday, he asked his nurse not to replace his scopalamine patch, which is a medication for dizziness and motion sickness. Last time the patch fell off he was instantly sick, but he's been fine for 2 days now.

He got his new glasses today and after a bit of adjustment, he says they're working fine. We had a long discussion about his double vision vs. the blind spot on his right side. He would talk for a while and then ask us to repeat back what he said to make sure we understood. Basically, I think he says the new glasses fix his double vision and are better than the old pair with scotch tape over one lens. The glasses can't help with the blind spot, but that doesn't matter - he'll just turn his head. If only all of his problems had such simple solutions...

Good PT day

Yesterday we talked to Matt's PT about a few things he wants to work on before we get ready to leave. First, he wants to know how to get down on the ground safely and stand back up again. She started on the mat table to make sure Matt could figure it out before he was actually on the ground. He was pretty quick at working through the process of going from his stomach to his knees and then to standing (all with one arm and a fairly weak leg!). Then she showed him once how to lower himself to the ground and stand back up again and he just copied her with no issues. Goal #1 - check.

Second, she wanted to take him outside to walk up and down a fairly steep hill on his own. He was slightly winded once he got to the top, but otherwise it went fine. Goal #2 - check.

Matt has been getting electric stim on his right leg for several weeks now to make him lift his toes. For a normal person, the machine would be set at 20-30 mAMPs to make the muscle work. Matt started out at 48-55 mAMPs, but today he only required 36! The machine cycles on for 4 seconds and off for 12 seconds for 20 minutes. Afterwards, Matt tries to lift his toes on his own, hoping this process is developing muscle memory - he's up to 10 reps before he can't make it work anymore. The goal is to get the setting below 30 and be able to do 20 reps afterwards, so he's well on his way.

I also snuck into his afternoon session today and watched him work on the parallel bars. Last time I saw him try to walk sideways, he would take very small steps with his right foot by leaning to the left and really swinging his leg out using just his hip muscles. Today he could step to the right almost naturally - he stayed upright and stepped over by picking up his right leg. It wore him out, but he looked great!

Happy Easter!

We got to visit home this weekend! It was so fantastic to have Easter dinner outside at our house and enjoy a little bit of spring at the farm. Matt had a bit of a hard time, so I don't think that we'll be visiting again until we leave here for good, but it was nice for the weekend.

When he's here at rehab, he feels like he's doing better and everyone tells him how much improvement he has made. I think when he was at home, though, he realized how far he has to go and what he's missing right now. Matt, this strong, physical, hard-working person, had to sit there while we went to the barn and brought out the Adirondack chairs. He can't even walk to the barn yet, let alone help carry anything back. Then he had to see the chairs that he had made last fall - I just can't imagine how hard it was for him. We managed to talk him into staying last night and I think that he was happy today - especially once Freddie got there.

At one point today Matt said to me that Crotched Mountain was good and Dummerston was good, but both is bad. He needs to stay in his routine and concentrate on his work here until he gets to be at home for good, which he still hopes is soon. Then he can develop a routine at home, which is comforting, and figure out new ways to get work done. Knowing Matt, this is probably the last weekend he'll just be sitting around the house.

New glasses

We went back to the eye doctor yesterday and this time they were able to figure out which prisms Matt needs to fix his double vision. They gave him trial lenses to try on and he just said "whoa." Apparently he'd gotten used to seeing two images and it's weird to see one again. He should get his new glasses in about a week!


They also figured out that Matt has lost a significant portion of his peripheral vision on the right side. We had no idea because he's been compensating for it just fine and it was only this weekend that he was first able to describe to us what was going on. He said that it's always been this way, but I'm not sure if he means since the accident or since his surgery. It's unclear if his vision therapy will help with this or if he'll just continue to live with it.


Matt has been on a daily dose of heavy duty pain killers since early January, which kept him from getting headaches. It's pretty common to need them until the bone flap is put back, but I hadn't been thinking about when they would take Matt off of them. But yesterday, they discontinued this and so far, he's been fine! One more step towards out the door...

A few new things

We got a new computer program for Matt today that I'm hoping will help him communicate easier. He's been using charts of words, but the book of pages is quickly becoming to large to be useful. Someone came from Assistive Technology today and loaded a program on our laptop that is going to allow him to create so many more lists and pages all connected to each other. He can navigate through the different pages, click on words he wants to add to a sentence and then the computer will help him read the words. It should be interesting to see how well it works.

Matt's been trying to track down the head nurse here to remove the last of the staples and she finally came by today. He strongly implied that he wanted them out today and when she left to get the kit, he got this worried look on his face. He thought he had pressured her into removing them and that the cut wasn't actually healed completely, so he made me check it out. As if I have any idea! He's quite thrilled to have them all out.

Matt also had his second acupuncture treatment today and he said that he felt little tingles in his right hand this time. The feeling didn't really last and he doesn't think it's anything yet, but I'm choosing to be a little excited about it.

No more wheelchair

Today makes 4 days in a row that Matt hasn't used his wheelchair. We're keeping it around in case he gets so tired he needs it, but yesterday he walked all the way to the cafeteria and back (which is in another building) without it, so I think he's going to be just fine. He still needs a good nap everyday and every 2-3 days he takes a 3 hour nap, but he's getting so much stronger and has so much more endurance. I was expecting him to get better right after his surgery, but I think we're just now starting to see more and more improvement.

We had a fantastic weekend - Matt was up for hanging out with friends at a nearby hotel for much longer than I thought he would. I think he surprised himself, too, and was just really happy with how he's feeling.

We're talking more about going home, but it looks like it's going to be later in April than we'd originally hoped. I talked with our case manager from the insurance company last night and she can't get here until next Wednesday for a meeting. She will then do our home evaluation, line up any work we need done to get the house ready for Matt, and get him scheduled with his new team in Brattleboro. Matt's disappointed it's going to take that long, but he's going to end up with everything he needs and really good care in the end, so it will be worth it.

Thursday morning

Matt's care planning meeting went really well yesterday. Basically, all his therapists gave us a summary of what they're seeing and what goals they still have for Matt. Even though I am there everyday, it was nice to hear what they are thinking about his overall recovery. They all said that they felt Matt was ready for discharge in the next couple of weeks, but that any time he spends here is still going to be beneficial.

I think that sometimes people get stuck at a rehab hospital while they wait to figure things out at home. Meanwhile, they don't really need inpatient therapy, so they just sit around waiting. Matt still has plenty of progress to make and will continue with all of his therapies up until the day we leave. His care coordinator will be spending the next few days finding outpatient therapists and scheduling a home evaluation. Our time left here will depend on how all of that goes.

Crotched Mountain has one of the best cognitive therapy programs in the country and usually these are only inpatient programs, so if Matt needed it, he would have to stay longer. His speech therapist told us yesterday that he doesn't need cog help - he's understanding everything fine and has no cognitive shortfalls. Since he's 'only' having expressive difficulties, he can continue in regular outpatient speech therapy.

Matt got most of his staples out yesterday - just 3 left in one spot that hasn't healed completely. The rest of it looks great! Even with his hair shaved, it's pretty inconspicuous, so once his hair grows out, it will be almost impossible to see.

Tuesday morning

Now that Matt's had his surgery and things are progressing along, we're starting to hear talk of discharge. It's going to be a long process, but at least his therapists are talking about it. I think Matt was worried that Crotched Mountain would be his only chance of recovery and that therapy would end once he went home or that he would be stuck here until he recovered what he could. He's pretty thrilled with the idea of living at home and continuing therapy there.

We have a care plan meeting tomorrow and will get a better idea of the next steps. We're going to have to find new therapists and programs to help Matt with his speech and his right arm. Yesterday his speech therapist told Matt that it could be another 6 months before he really recovers his communication skills, but that it seems entirely possible. I think time lines make Matt feel much better - even though it's a long time, he can see the end of the road. His arm is another matter, though. He's convinced that it's never going to work because he doesn't see any progress. We can't really give him an idea of how long it will take or how much will come back either, so it's really frustrating for him. It's also difficult because with his arm, it's all or nothing to him. At least with speech we are able to communicate fine on a functional basis as he's relearning words and fluency.

Nice and relaxed

This is how Matt likes to spend his weekends - he seems to be feeling so much better, but he enjoys taking it easy for a few days. Anytime we ask him if he wants to do something, he just sips his coffee and says "nice and relax." We did make it outside a few times and he got to see Freddie today, which made him very happy.

I counted the staples in Matt's incision tonight and when I told him the number - 39, by the way - he reached for his apple juice and said "ah, scotch." We found out that the staples will come out on Wednesday. It's nice that they have someone here who can do that and we don't have to drive back up to Dartmouth. He'll have a follow-up CT scan and another meeting with his surgeon in late April, but everything seems to be healing quite well.

Playing the TBI card

Today was a good day. This morning Matt cooked in OT and while he and his therapists were discussing hot sauce, he couldn't come up with the name of his favorite kind. His PT mentioned two and said they were the only ones that were any good, but he kept trying to tell her there was a third. When she said it didn't count unless he could say it, he said "Hello - Brain Injury!"

It was a fantastic day outside so we took Matt for a stroll and he played Bocce in recreation therapy. The fresh air and sunshine seems to be doing wonders. Of course, he's still annoyed with his arm and frustrated about being here, but he does seem to be a little more positive about life today.

No surprise

Yesterday Matt was wiped out and took several long naps through therapy appointments. He always wakes up quite upset whenever this happens and thinks it's another step backwards. I tried to explain that it is normal for people recovering from head injuries and is, in fact, expected that he has tired days. He seemed to feel a little better after that, but certainly not happy.

Today, of course, is another story and he's doing great. In speech this morning he practiced making category lists. His therapist says "fruits" and he tries to say as many as he can in a minute. Monday it was 4, with hints, and today it was 8 all on his own. Then he said he wanted to list "meats" and I lost count of how many he said (when have we ever had filet mignon and why would he remember that?). Next was 'vegetables' and he couldn't think of any! :-) Of course he was tired of thinking by then so he took a break for awhile. Then he wanted to continue making lists during down time which he hasn't wanted to do in a long time.

It's still weird to see him walking out of therapy by himself and without a helmet, but he's doing great on his own with just a cane. We've had to figure out where to keep all his stuff near his bed so that he can get up and ready by himself. I've had to learn to back off and let him do things himself, but he's quick to give me 'friendly' reminders when I help to much. :-)

Tuesday afternoon

Matt's getting back into therapy and doing pretty well. He's been out of his room for most meals the past two days and getting lots of comments about how great he looks. I forget that most people weren't used to seeing Matt without a helmet. His PT cleared him today to be independent on the unit with his cane. Not that he spends much time alone, but it's nice to know that she thinks he's safe and strong enough to move around as he pleases.

Speech is still difficult and he's having a hard time communicating which is quite stressful. He's more aware of time and does not like the idea of how long he's been in the hospital. He really wants to know how much longer he's going to be here and it's difficult to explain that we just don't know.

Feeling better

Matt had a bit of a rough morning yesterday - he woke up from a nap very confused, which scared him a lot. He couldn't answer the basic questions about his name, where he's from, and where he is right now without a lot of thinking. He also had something he really wanted to say, but could only repeat "I don't know." when we'd ask him what it was.

Luckily one of the nurses came to check on his incision and had all the right things to say. She told Matt that the medicines he was on during and after the surgery can cause this confusion and take awhile to work through his system. The fact that she was not at all concerned really made him feel better. Plus, she took all the bandages off and said his incision looked great - the staples will come out in two weeks or so. It is quite the scar and it's hard to believe we won't be able to see it once his hair grows out.

This morning has started off much better - he answered all the nurse's questions without any problems and kept repeating things to me as he recalled them again later. He was even coming up with names that we hadn't been talking about. He ate a great breakfast and told me he was happy and feeling good. He wasn't interested in doing any exercising today, though, just feeling good enough for a nice day of rest.

Friday evening

I think I wanted Matt to bounce back quicker, but I must remember he just had surgery on his head. Nobody feels good after having anesthesia and Matt seems to be especially sensitive. He hasn't really eaten much since Tuesday and is just really wiped out.

It's good that they gave him the day off and he has a relaxing weekend ahead. All his therapists scheduled appointments today because they were excited to work with him again, but he knows his limits, and asked to be left alone. He's on a regular course of meds and should start feeling better soon, but it's really hard to see him this uncomfortable and exhausted again.

Settled in

I went in to see Matt this morning and his social worker came in to tell us we could leave whenever he was ready. Matt gave a thumbs up and 20 minutes later we were out the door. The ride back was a little uncomfortable thanks to all the frost heaves, but he's back in bed and sound asleep now. He's happy to be back and everyone was excited to see him here.

A little more rest

This morning they said Matt could go back to the rehab hospital today, but now they've decided to keep him one more night. He hasn't really eaten anything and is still nauseous, so they want to keep a close eye on him for a little longer. It's probably just from the anesthesia, but nausea is something they really want to watch with a head injury. He's taking medicine for it and says he feels fine now, but they want him to feel fine without the medicine before we take him for a car ride. I think it will be good to have one more day of rest here in his quiet room before we head back to Crotched Mountain.

Tuesday night

Matt's doing well this evening. I haven't spent too much time with him because he's mostly sleeping, but everyone seems happy with how things are going. He's having trouble keeping fluids down and his heart rate is a little high, but he's on several IVs and they're not too worried about any of it. We'll find out sometime in the morning if he'll be able to go back to Crotched Mountain tomorrow.

He hasn't been interested in talking much, but he's speaking as well as he did before the surgery. The nurse said his neuro checks are great, his color looks good and his head looks round and even under all the bandages!

All the kings' horses & all the kings' men

Matt is out of surgery and the doctor said everything went really well. We have to wait until he wakes up in recovery before we can see him. He'll stay here tonight and they'll do a follow up CT scan tomorrow morning to make sure everything looks okay and we'll probably go back to the rehab hospital sometime tomorrow. I'll post again once we get to talk to him.

Thanks for all your love and thoughts!

Sunday evening

This weekend has been all about distraction for Matt - lots of movies and naps. He's still really upset about his upcoming surgery, but there is only so much we can say that helps. It's a good thing that he has therapy tomorrow. It will keep him busy and tired enough to nap.

It seems that his appointment will be really early Tuesday morning, but we won't know for sure until they finalize the OR schedule tomorrow. We'll be at Dartmouth at least one night, maybe two.

Thursday

Matt's had a few good days of therapy in a row, but now he is exhausted and sleeping for awhile. In PT, they've had him working on walking without a cane and he says, "Yeah, but yikes." His right leg is getting much stronger and it looks like they might change his brace soon. Right now he has a solid plastic brace that fits under his foot and wraps around the back side of his calf almost up to his knee. Soon they will modify this brace and add a hinge which will allow him to bend his ankle and walk more naturally while still providing stability.

He knows surgery is 5 days away and keeps telling everyone that he's scared and nervous, but seems a little more ready to have it done. I'm trying to stay positive for him (mostly by not thinking about it) and everyone here is doing a great job of explaining how much better he'll be once he's all put back together.

Speech update

On the wall in Matt's room is a marker board on which we write the date every day. It's hard enough for us to stay orientated to what day it is, so it's a good reminder to everyone. Then in speech therapy, they talk about the date a lot, trying to keep Matt cognizant of the world around him. At first, Matt would only be able to repeat what we would tell him and by the end of the session he would have forgotten what the date was again. Little by little, he's gotten to the point where he can say the date with only small sound cues.

Over the past two weeks, they've been working on writing in speech therapy. We made pages for his book of the days of the week and the months of the year which he copies from and is able to write down the date with help only for the number. The first time he tried it, he wrote down 2010 first because he knows that and didn't want to forget it while he worked on the rest of the words. Today he started writing Monday before we even had the pages out and he remembered it was March 1st without any help. He was pretty happy. Plus, his left handed writing is now almost as legible as his old writing was.

Sunday evening

We all had a great weekend. Matt was up for leaving the mountain last night for the first time. We went for a short trip into town and picked up food & a movie. Today we had a big group of visitors (thanks for coming!) and Matt seemed quite content to stay awake and out of his room to spend time with everyone. It's really uplifting to spend 'ordinary' time with Matt.

We're counting down the days until Matt's surgery (next Tuesday), but he is quite worried about it. Today he told us he's anxious which was a completely new word. All of his therapists and nurses keep telling him how great he'll be and how much it will help, but it hasn't really sunk in yet.

Snowed in

Thanks to all the snow, Matt has a much needed day off. He almost fell asleep at the breakfast table and has been sound asleep since then. I think it's so easy for all of us, including Matt himself, to push him too hard now that he's doing better. Yesterday he was exhausted to the point of tears before he would finally stop therapy and take a nap. We just have to work more on finding the right balance of work & rest for him.

Gaining strength

Matt's really working towards getting rid of his wheel chair - he's walking almost everywhere in the unit with his cane. Since speech therapy is upstairs, and always wipes him out, he's taking his wheelchair there, but that's about it. It's a hard balance to figure out how much to push him without completely wiping him out. This weekend he had to sleep quite a bit, but he's definitely getting stronger.

Every time that Matt gets in and out of bed, I've been helping him swing his legs up or down. Then on Friday, his PT made him do it himself, and without a problem, he swung his legs up and then figured out how to get his left leg under his right leg and swing them back down again. So now I pretty much only have to bring him his shoes and cane and stand next to him when he's walking. It's a good place to be.

Challenging the therapists

Matt has a 'new' PT who saw him his very first day here, but had 6 weeks of leave planned starting the next day. She came back yesterday and is amazed with Matt. Today they were trying to come up with things to challenge him and decided to work on his balance.

His OT & PT were working together and first just 'bumped' his shoulders while he was standing on both feet. Since he had no trouble with that, they quickly had to make it more difficult. By the end of a half hour session, they had him standing on a gym mat with foam pieces underneath it to make it an uneven surface. Then they added in a game of catch so that he was concentrating on more than one thing. He never once had trouble keeping his balance.

This afternoon we ditched the quad cane completely - now he'll be using just a regular cane and trying to walk more throughout the day. To finish off his last session today, he walked about 100 feet with no cane at all! I think it was just as difficult mentally as it was a physical challenge, but now he knows its possible.

Tuesday

I've found it harder to write recently as there are fewer milestones for Matt to reach. We know he's getting better and especially building endurance, but he's really struggling with how slow things seem to be going. He's ready to have his surgery and reminded me today that it's 3 weeks away. I wasn't sure he understood the concept of time yet, so it was amazing to hear that.

We've made a book for speech therapy that is really helping with his communication. I wasn't sure how much he would like it, but he seems to understand its usefulness. There are pages of 15 words that cover everything from pain & medicine to foods/drinks to feelings to names of people he wants to recall. He keeps joking that its going to be 3 inches thick before we have everything covered. This week we've added an Olympics page and we spend his therapy time talking about what we watched the night before. He keeps the book in his chair and pulls it out whenever he gets stuck on a word he's trying to tell us. And just like when he used to point at numbers, he'll point at the word he wants even if he's saying a different word.

Looking good

We just went for a walk and one of the weekend LNA's who hadn't seen Matt walk before said, "wow, look at you!" and Matt replied, "Yeah, looking good!" I also overheard him tell someone this week that he was doing "not just good, phenomenal." He's still dealing with a lot of frustration about his progress, but he seems to understand a little about how he's doing.

Wednesday

Yesterday Matt stayed awake almost all day, which is quite the feat. It seemed like he was headed that way today, too, but now he's down for a nap. He was in rare form this morning joking with all his therapists and whenever he was goofing around, his right arm would move slightly! Then he'd try and watch it and he couldn't make it work again, but we definately saw it happen.

Matt's PT always has trouble thinking of ways to challenge him - everything she comes up with he handles after very little explanation. Now it seems that he's going to be working mostly on endurance. Her goal is to ditch the wheelchair in the next couple weeks! This means working more in his free time and on the weekends, which will be good for all of us.

Monday

Last week was the first time Matt made it to all his therapy sessions and we were hoping that would continue. He's been really tired today, though, and slept through speech. He also slept a lot this weekend, but managed to stay awake for the Super Bowl. He laughed at most of the commercials and was excited about the Saints' win.

I got a call this morning from the hospital and Matt's surgery is scheduled for March 9. After all we talked about at his appointment, the surgeon decided that his skull is in good shape and that he would rather use the bone instead of a plastic replacement. At least this means that we don't have to go back for another CT and we have a surgery day.

Therapy update

Here's a general overview of where Matt is in his therapies and how he spends his days.

Physical therapy: He's walking every day with a quad cane and a belt that the therapist can hold onto in case he tips, but this rarely happens. Every once in awhile his right toe will catch on the floor as he's swinging his leg forward, but he can usually tell and corrects his balance. This morning he went up & down the stairs pretty quickly and figured out how to keep his right toes from catching on the lip of the steps. His therapist also got him on an exercise bike for 5 minutes, hoping to do this regularly and increase the time as his strength & endurance increases. In his afternoon session, he walked up and down the hallway, which is quite the obstacle course here with all the wheelchairs and lifts parked in the way. Then she had him stop at a spring-loaded door and figure out how to get in and out of the room with just one functioning arm that needs to hold a cane. His motor planning still amazes everyone he works with.

Occupational therapy: OT covers a lot of different things, so he has one full hour of OT each day. When they were doing 2-30 minute sessions, they would just get going and it would be time to stop, so this is working much better for him. Sometimes he'll work in his room and his therapist will help him with ADLs (activities of daily living) like how to dress himself, brush his teeth, and transfer to and from his wheelchair independently. Today they did some electric stimulation on his right arm which is sometimes paired with mirror therapy. He puts his right arm inside a tube that has a mirror on the outside. Then he moves his left arm and watches the reflection in the mirror which makes his brain think he's moving his right arm. Its crazy to watch and it seems to be making some muscles engage in his right arm, but it is a really hard workout for Matt, so they never do it for very long. He also spends part of every session working on his vision - they're really trying to get his eyes to work together, but his eyes are just not cooperating.

Speech therapy: This is definitely the area in which Matt struggles the most. He really likes his therapist, but he's usually not that excited about going to speech. He has to work so hard and it really wipes him out, so its better when he has 2 short sessions - one in the morning and one in the afternoon, but sometimes he'll have 45 minutes - 1 hour straight and that just ruins him for the rest of the day. Recently, they've started laying out 15 words and then showing Matt the corresponding pictures and he can point out the right word every time, and mostly read the words correctly, too. This has been kind of a breakthrough and something they're going to expand on for use outside of therapy sessions. We might get a program loaded onto our laptop that will have tabs full of common words Matt needs to access and then he can just point to them. If that doesn't work, we'll make boards or a book full of different pages of words. Either way, I think its going to make a huge difference in the amount of frustration he deals with when trying to communicate.

Therapeutic recreation: Once a week, Matt with have TR and so far, we've been going bowling. Basically, this session is a way to incorporate all of his therapies into a hobby or activity that Matt enjoys. He has to figure out how to get to the lanes, how to make everything work, and how to count pins. Hopefully he will be able to stand and bowl soon, without having to work around his wheelchair. He could do other things in TR like bike, cook, or swim, but so far he seems pretty happy with bowling.

results

Our trip to Dartmouth went really well, although we don't have a surgery scheduled yet. His CT scan showed no more swelling and his surgeon is impressed with how he's doing. I probably shouldn't have looked at the picture, but I managed to not pass out and the doctor showed us how everything was doing.

The doctor recommended that we don't use the pieces of Matt's skull that they kept, but have a plastic replacement made instead. There is a high risk of infection using the bone and other difficulties associated with the multiple pieces. Matt will have to have a more detailed CT scan done (hopefully soon) so that they can make the plastic piece to fit his head exactly. This takes 2-3 weeks, so we're most likely looking at March for the surgery.

I was really hoping it would be sooner, but the news we got is good so I just have to remember that everything in this process takes awhile.

Monday morning

Matt had a pretty good weekend - he's fighting headaches again and taking more medication which makes him unhappy. We're trying to stay on top of it before it gets unbearable, but he doesn't show discomfort too easily, and anytime a nurse checks with him he always says he's 'perfect.' I think it is body aches, as well, since he's moving so much more, but he just can't articulate the difference.

His PT left us with the stand up walker this weekend (pictured in last Monday's post) so he could stay in shape. Matt seemed a little nervous about having just me help him use the quad cane, so this walker is much more stable. The cane is helping him more with balance while engaging his leg muscles, but with the walker he can really cruise the hallways. His gate is much more fluid and natural since the wheels allow the walker to move with him.

We've noticed recently that Matt wants to tell us more and he is quite frustrated by his limited ability to communicate. We used to be able to guess what he's trying to tell us because it was pretty basic - something to eat, drink, a blanket, etc. Now he wants to bring up new subjects or discuss things in more detail. In therapy, he's been able to recall more and come up with words easier, but its going to be awhile before he can really communicate as well as he wants.

We're heading up to Dartmouth tomorrow morning for a CT scan and appointment with his surgeon, during which we will hopefully schedule the surgery to have Matt's skull flap put back. Here's hoping that everything is stabilized and he can have surgery soon! We've heard that once they've had that surgery, patients' rehab really takes off, so at the rate Matt's going already, he should be flying out of here soon.

A few good reads

Things are going well today - Matt's still cruising with the quad cane and going further every time. His right hand is starting to bother him in therapy, which is a good sign, I guess. That's how his leg started, too. He's also moving his right shoulder during exercises more than I've seen before.

A few people have asked if we've found any good books to read about brain injury and such and even though I have a hard time concentrating on reading, I have read a few. So if you're interested, I would recommend:

'My stroke of insight' by Dr. Jill Bolte Taylor - Dr. Taylor's stroke was in the left hemisphere of her brain and she discusses some of the same issues Matt has had. Plus, its a good read for inspiration about the spiritual and 'positive' sides of brain injuries.

'In an Instant' by Lee and Bob Woodruff - Bob Woodruff was a reporter imbedded with a unit in Iraq when he suffered a TBI from a roadside bomb. I haven't read this yet, but it is traveling around my family and my sister really recommends it.

'Mindstorms' by Dr. John W. Cassidy - I'm in the middle of this book, but so far its a good informational read about the basics of brain injury and treatments.

'The brain that changes itself' by Dr. Norman Doige - I also haven't read this one, but it comes highly recommended from other families here at rehab. Its about the plasticity of the brain and how much it can relearn after an injury.

Telling time

Matt was completely exhausted this afternoon. He'd been sleeping since 3 and wasn't all that thrilled with us waking him up for dinner. But somehow he always wakes up by 7:30 - time for the Simpsons!

Today we learned how to transfer from the wheelchair to the truck - Matt was pretty excited to ride in his truck again. Then he worked on walking up the stairs in the gym, which was pretty difficult, and probably the reason for him being so tired.

Next steps

Another exciting day - Matt walked about 180 feet with just a four-legged cane! (For those of you who have visited he went from the couch in the lobby out to the hallway and then back almost all the way to the gym.)

His speech therapist was really happy with his progress today, too. Matt followed one-step directions (like point to the window) 100% and named 70% of a group of objects without any cues. Two-step directions are still too much to concentrate on, but it was amazing progress today.

Giant leap

Check it out - Matt is moving his right leg without the therapist's help! You must all have been sending him positive energy today. Thank you thank you thank you!

He's been using this walker for awhile, but the PT always has to stand behind him and help move the right leg through. Today she was helping him stand up and get his right arm secured and he just stepped forward with his right leg. Everyone stopped like that hadn't just happened. Then he did it again. Then he walked down the hall, back up and into the gym.

During his second session, his regular PT (who was bummed that she wasn't helping him when he made his first step!) had him try a cane. So he walked back and forth across the gym with just a cane! Its a cane just like the guy had in 'Up' which we recently watched and that observation made Matt smile. Then he had to come back for a nap.

I started out today excited because Matt remembered to ask for milk which is one of his hard words and then all this happened! What a day.

Fresh air

We made it to the treehouse yesterday and I think Matt really liked being outside. Sometimes I think he does things with us because he thinks it will make us happy, not really because its what he wants. We've been noticing this a lot recently - he is always very concerned about other people around him.

We worked on more math problems yesterday and Matt's still having trouble naming numbers. But then we played the card game war for awhile and he knew the number values without any trouble.

This morning Matt was trying to ask me something about 'position system' again and then sat for awhile really thinking about something. Finally he asked 'you sleep, well?' I think this is the first time we've had a conversation that he initiated.

Saturday morning

I think that there is always going to be a small voice in my head wondering if I chose the right rehab facility regardless of how great Matt is doing here. But the past few days we've realized again why its been the perfect place - Freddie gets to visit here! And Matt is so happy. He had an awesome and very busy day of therapy yesterday and then came back to the room for a nap. Freddie jumped up on the bed with him and they both slept quite contendedly. We're hoping to get Matt outside later this afternoon to take Freddie for a walk, too. Maybe we can make it to the treehouse.

Thursday morning

Matt's appointment with the eye doctor went pretty well yesterday. They took pictures of his retinas and everything is fine - there's no swelling or broken blood vessels from the accident, so he thought Matt's vision would clear up eventually.

The doctor was trying to fit him with prisms over his glasses that would make the two images he sees come together. However, Matt's aphasia was causing too much difficulty in determining when the prisms were actually working and if the images were closer together or further apart. He figured it was worse to have the wrong prisms than nothing at all, so we'll have to go back later once Matt can communicate more clearly.

He did put tape over one lens of Matt's glasses which will block out the extra image for right now while still allowing light into his eye. So no more patch - which Matt isn't sure is so great. I think he was used to it and isn't happy about adjusting to something new. Then this morning I gave him just his glasses and asked him how many of me he sees and he said "one, but you suck." :-)So I think he's just fine.

Tuesday evening

Monday's therapies went really well - Matt stood on his own for about 10 minutes in PT. He started today with more math in speech and it wiped him out for most of the day. His therapist wrote down the numbers 1-10 and gave Matt addition problems to complete in his head. It was fascinating to watch him point to the correct answers, but say the wrong number out loud. He keeps getting caught on certain words and repeats them for everything. For math problems, he always says '10'. For everything else he wants to tell us, its 'global positioning system' or 'too much TV'.


I try to always ask him if he wants me to come along to his therapy sessions, and this week is the first time he's ever said no. He's on his way to becoming more independant - he's learned how to transfer in/out of his wheelchair without any assistance. I stand by just in case, but he pretty much doesn't need help anymore.

This afternoon his OT handed him the brace he wears on his right leg and told Matt to put it on. I was trying to figure out how he was going to pick up his right leg, move the foot rest, hold onto the brace, and put it around his leg all with one hand. Meanwhile, Matt looked at it and figured it all out. Motor planning is not an issue.

Sunday evening

Matt had a great weekend. He napped a lot, but had a great time in between with many visitors. He seemed happier than I've seen him in awhile - maybe because he's getting tired of seeing us all the time and got to see friends yesterday. ;-)

Matt's speech therapist is giving him homework now, so we worked on that for a little while yesterday morning and today. Math is hard! He did 5 addition problems and then had to take a nap. This morning he worked on generating words and got through a good list before he needed a break. I hope he continues to have speech in two 1/2 hour sessions this week, because language is definately the hardest thing for him. I think his ST is proud of making Matt more tired than he is from physical therapy.

Time flies

We came to Crotched Mountain one month ago and I cannot believe where Matt is compared to December 14th. He's walked (still with his PT moving his right leg) all the way from the gym to his room 4 days in a row, which is quite the feat. He's eating most of his meals in the dining room now and doesn't seem so overwhelmed by activity and noise. He's doing better than 50% when he id's pictures in speech therapy. And he seems to recall more and answers questions much more reliably.

He has a few upcoming appointments that are going to be big steps in his recovery. Next Wednesday he's going to see a neuro optomotrist to get his double vision figured out. Hopefully this will allow him to stop wearing an eye patch and help with his headaches. Then in a few weeks we go back to Dartmouth for a CT scan and to visit his surgeon. Think healing thoughts for the next 2 weeks and hopefully the scan will show no more swelling. We don't know how soon he would have surgery after that, but the sooner he gets the skull flap back in the better!

Wednesday morning

What a difference its made for Matt to get his meds figured out! Now he's not taking the blood pressure lowering medicine and he gets a small dose of oxycodone right away in the morning. He's been wide awake and ready for therapies for 3 days in a row - and he mostly stays awake in between, too, which is something completely new. This morning he didn't even want to go back to his room after therapy so we went and sat out in the hallway.

We then had to figure out something to do while he waits for his next session. His OT had given him word searches a few weeks ago, and once we figured out that 'paint book' meant those activity sheets he was very happy. He read through a large list of words searching for 'orange' before he got tired.

There's a whole list of other small steps of progress he's made, but he's ready for therapy, so I'll post that later.

Sunday morning

Matt says he's causing us too much trouble, but really he's just keeping us entertained and busy, which is why I keep forgetting to blog. He was dealing with pretty bad headaches this week that kept him out of therapy and sleeping a lot.

Yesterday they decided to start the day with a small dose of oxy hoping to keep his headaches at bay rather than knocking him out with a large dose once he gets a headache. It seemed to work fairly well and he's been in rare form since then. He's recalling all of his one-liners and jokes better than other vocab so we spend a lot of time laughing.

We're not sure if its due to the injury or the fact that he was working the night shift before the accident, but he comes alive late at night. His speech therapist can hardly believe the stories we tell of what Matt has said because he never sees that side of Matt in the morning when he's sleepy. We've tried to tell him to come and hang out with us at night, but we'll see. It's nice for us because we can go back to the room to sleep feeling pretty good about Matt's condition.

No more tubes!

Matt is finally tube free! This afternoon Carol, his nurse practitioner, removed his g-tube that he had been getting food/meds through. He's been off the tube food for awhile - no surprise that Matt has a healthy appetite and will eat just about everything they put in front of him. They did want to wait awhile to try swallowing pills, but that went just fine on Sunday, so today was the day. It took about 2 seconds, but Carol wanted to make sure that we knew it was a huge step in his recovery. There are many patients who've been here much longer than Matt and still have their tubes.

Other than that, Matt had a slow day of rest - he's fighting headaches again and the medicine knocks him out. First thing this morning, he wanted meds, so I asked if he just wanted Tylenol or needed oxycodon, and he said "oxy - boom." Which is exactly what happens when he gets it- he was out for most of the morning. He had a little bit of therapy this afternoon, but then he had more issues with his blood pressure being too low, so he's back asleep, hoping for a more theraputic day tomorrow.

Tuesday evening

You won't believe what Crotched Mountain has - bowling lanes! Its candlepin bowling which took Matt a little while to get used to, but he figured out rather quickly how to work from his wheelchair and managed to beat me for a few frames. He's pretty excited to have the ability to go back there on the weekends.

Also, it's in the basement of the next building over, so it took a long time for Matt to manuever himself there, then we bowled for awhile, and then he made it almost all the way back. After this he had 1.5 hours of therapy, followed by lunch, and then another hour of therapy. He couldn't quite handle his last session this afternoon, but what a day! He is working harder and harder every day and its pretty amazing to be along for the ride.

Good New Year

Guess who got to visit yesterday! You should have seen Matt's eyes light up when we told him he could go outside and see Freddie. It's pretty cold and we have a lot of snow up here, so we couldn't stay outside for very long, but it made Matt's day. Our friends who are watching Freddie hadn't seen Matt in two weeks and were amazed at how he's progressing. And we were amazed at the differences they talked about, too - we've all forgotten the steps he's been through.

We've talked about writing all these things down, but we're not sure Matt's going to want to know and we're not sure we want to remember either! I figure this blog will be great for him if/when he wants to know what happened and that all the comments will be so helpful when rehab gets tough.