Day 2: MRI update March 15, 2012

“Wait and See”. That is our new buzz phrase. Brain injuries are so variable and different and unpredictable, and...well.... just impossible to be concrete about. We will be “waiting to see” when he wakes up, what symptoms he presents with when he wakes up, how long each symptom will take to recover, and even what extent his recovery will be. We know we need to be more patient with the “waking up” piece due to the diffuse axonal injury (DAI). Ashley's sister just found a study (found here) that stated the patients with grade II DAI recovered consciousness within 2 weeks. The MD stated that he would be unable to guess when Scott would wake up, but that he expected that he would wake up at some point. FYI... Grade II DAI is defined by small diffuse injuries in the white matter of the upper hemispheres of the brain (Scott has this) and swelling /shearing injury of the corpus collosum (Scott has this.) The corpus collosum is in the lower part of the brain and connects the right and left sides of the brain. The largest swelling noted on Scott's MRI was in the corpus collosum. Grade III includes injury to the brainstem, which Scott does not have thankfully.

Currently Scott is sedated again. They will try to wean him off of the sedation, giving him only enough to prevent him from fidgeting too much, from pulling out the intubation tubing, etc. But the sedation can slow his return to consciousness, so they want to begin minimizing it. The main focus will shift, though, to getting all of his surgeries done, so they can finally get him off the ventilator. They say that , but they won' take him off the ventilator until he regains consciousness because he needs to be able to manage his secretions, clearing his airway when needed, etc. to be safe. So... it all really does revolve around him waking up. If he is not off of the ventilator before they wire his jaw shut, they will likely put a trach and a feeding tube in. They can't wire his jaw shut with the ventilator tubing in his mouth. They could move the tubing to his nose, but then they lose his avenue to receive nutrition, so.... they will be forced to go the trach and feeding tube route.

The MRI did clear his neck, so the cervical collar is now off. The wound vac is off of his arm now. The surgery today was successful. They were able to close his arm wound., and are allowing me to begin some gentle passive motion to his elbow. His swelling is much less in his face/eye.

Oh... the “eye guy” came in today and evaluated him. He said the CT scan looked good for the optic nerve. His physical exam showed no hemorrhaging, no detachments, nothing really concerning. He does have a bulging eye (proptsosis) due to the swelling, but the MD is not concerned about that saying it will reabsorb and the orbital fracture actually allow the socket to decompress/move with the pressure of the edema. The only thing he wants to watch is “possibly, maybe, a tiny bit, hard to really tell” (his words) of swelling of the optic nerve on physical examination. He said that the optic nerve turns pale when it is swollen, but it only does so after 2 weeks. And... 2 weeks have not passed yet, so... he wants to recheck it.

So... I am hoping to read up a little bit on DAI tomorrow and will link some information with what I find. Basic summary of what we are being told is that they think it likely he will regain full or close to full function, but it will take a long time.... maybe up to a year....but.... it is so very hard to tell and to predict, so we need to “wait and see”...be patient....But they are being much more positive and encouraging about his recovery prognosis.

Once they get the surgeries completed, and have a venitlator solution and have him stable, they will transfer him to either a Skilled Nursing Facility or to a Neurological Rehab facility, and we will progress from there. That's when more will be able to be done to help Scott and Ashley.

Oh... FYI.... We have loved the goodies, fresh fruit, etc that we have received in ICU, but... it became problematic for the nurses trying to do their job and they were concerned about food bringing in bugs they didn't want in ICU, so we had to remove them and take them to the room that Michael and Carol are staying in (Scott's dad and step mom). So... head's up, we won't be allowed to receive any more. We were bummed but completely understand and are wanting to do anything and everything we can to enhance Scott's recovery, keep him and others in ICU safe from bugs, etc....

Once Scott wakes up and is out of the ICU, he will be able to have more visitors. We will need to coordinate visits, though, and spread things out so he doesn't get too overstimulated and exhausted, but I'm sure it will buoy him up to feel the love and support that has been sent his way this week.

We truly are appreciative for all of the love, prayers, offers of help, etc. We feel comforted and strengthened. We are seeing the results from the fervent prayers, and are so very grateful for them. I wish I could call each of you personally and let you know how very much your love and support has meant to us.

Love you all,

Patti