Day 53: Scott's Return - May 5, 2012

I am guess you all have noticed there have been a few changes around here... 

- A new blog title

- A new blog header (it rotates through stages of Scott's recovery when you refresh the page)

- No nightly post

Along with all the changes that we are making I requested that Scott's parents, as well as my parents, type up a blog post with their thoughts and feeling so that I might share it with all of you. Now that we have entered this new phase my hope is that Scott and I will be contributing to the blog together on a weekly basis. (Occasionally more or less depending on what is happening)

Over the next few days I will feature the parents' posts on the blog.

Today I will feature Patti's Post:

Patti returned back to Utah yesterday. We love her very much and are so thankful for everything she has done for us. We know she has sacrificed a lot to be here with us during this time of need. We are so appreciative of Todd for all his love and support from Utah!! We miss you both and are so thankful that you are in our lives. 

 

Wow! What an amazing past 2 months! What a miraculous recovery we have been privileged and thrilled to witness! We continue to be amazed at Scott's recovery, and are so very grateful he is defeating some of the odds. Prognosis following DAI is not typically a cheery picture.

The return home has been a positive one for Scott and his "support team". He continues to improve daily. He continues to give us new cause for excitement and encouragement daily. And... the return to his normal life is great therapy for him. He has such a rich and vital "normal life", .... A life that he loves and is anxious to return to.... A life that provides great stimulation and great incentive and drive for him to recover.

1. He has a rich network of friends, who provide great social stimulation for him and good intellectual challenge.... For instance, it helps to have a lot of friends in med school or in the medical world, who can challenge him with questions ...... and..... part of Scashley's regular Sunday routine is "Game night" and dinner with the Pike family. They continued that routine, even in the hospital, bringing dinner and progressively more difficult games as Scott's cognitive abilities improved.  What a fun challenge to look forward to every week!

2. Playing the guitar .... Trying to remember the songs he once played so automatically, providing stimulation to his right hand and arm through picking and strumming, and working to restore his singing abilities..... are also great and fun therapy for him.

3. Sports .... Scott's love of sports has helped us make rehab fun. We do perform the "boring" strengthening and conditioning stuff first, but then... We head into the racquetball court and PLAY. We play catch with large Gymballs and a small/clear/visually difficult "bouncy ball", and we play soccer and perform soccer drills with the small bouncy ball. There are some videos below from our first day.... Of course, he has made daily progress and is more agile and adept currently. I have been able to increase the pace of my passes, and he is now able to respond quickly enough, even with his right leg, to stop the ball. He will even perform a spin move every now and then. His speed, coordination, and control are not what they were, but it simply amazes me that he is able to accept this level of challenge at this point. He does not lose his balance, even when I try to challenge that balance with my full arsenal of "tricks".

4. Faith .... His faith is very integral to his amazing strength and attitude. He truly does not sabotage his recovery with the ifa, coulda, shouldas, or on self-pity. His drive and zest for life remain high.  He focuses on the tasks required to return back to his prior life....

One of his biggest frustrations is his limited ability to be of service to others right now. .... Although, he keeps trying! He routinely lives his life with a strong focus on service to others. This focus on serving others removes him from the destructive weight of self-pity, and provides him with a truly happy spirit. This spirit and attitude have played a huge role in his recovery, and has made the "ride" much more pleasant for those assisting him.  It is certainly expected to see challenges in mood and depression after such an injury... we feel so happy for him that he has been blessed with this amazing spirit that can rise above challenges so automatically .... it is simply inherent to his being.  I am glad for him and I wish for all of us this same strength of spirit.

As a side note, Scott just received an email notifying him that he received the Platinum TOUCH Award for Midwestern University for the year (March 31, 2011 - March 31, 2012). This award is given to the student (from the entire university) who provides the most community service hours for the year.

I think it is safe to say that Scott will instinctively "pay it forward" for the many acts of service from others that he has received over the past 2 months. We truly are soooo very grateful for all of the support and prayers on Scott's behalf.

5. School - Med school definitely challenges and stimulates cognitive abilities. ...and provides goals to strive for during this recovery process.  His brain was well exercised prior to the injury and studying/memorizing in the future will continue to stimulate his return to normal function. The school and his classmates have been very supportive of Scott, and will play an even more vital role as he works to return to being a full-time student.

Word of note.... Scott began taking practice USMLE tests yesterday..... Just to see where he currently stands cognitively ..... He was originally scheduled to take his 3rd year board exams in May. He will reschedule that exam, but has returned to studying for the exam. He took 3 separate practice tests. He scored about 20 percent lower on one of the tests, but he was within 2 points on the other two tests when compared to his score prior to the injury. Heck, I would score lower simply from taking 2 months away from the subject matter without a brain injury! He/we are pleased with his performance on his return to these practice tests. ... And, again, are amazed that he scored as well as he did.  He still needs to study for the exam ,but it appears that he won't have as much catch up to do as we would have expected.  What a relief!

6. Ashley.... Scott is so very fortunate to have such a fabulous wife .... To have the depth of love that they share between each other. ..... Someone who knows and understands him better than anyone, including his mother, at this stage of his life. ... And knows how best to support him and facilitate his continued growth. Someone who is completely dedicated to him and to what is best for him. It was evident, even early on, that Scott's love for Ashley was his primary driving force .....and his strongest emotion. Their's is a true love story! It warms a mother's heart!  And... again... something I wish for all of us!

I could go on..... But I won't.....

We are all extremely grateful for this fabulous and stimulating life. His return will provide so many inherent benefits for his recovery, and it is awesome that it is a life that he loves and is anxious to return to. (Pardon the dangling participle!)

I figure that I should give a status update on Scott before I sign off, since that has traditionally been my role. We have not had some of the follow-up appointments yet. Scott has sooo many MDs due to the multiple areas of trauma, but.... Here is the update as I currently know it.

Right eyeHe is permanently blind in his right eye due to optic nerve damage. His ophthalmologist believes the injury was due to his sphenoid fracture. He does have limited peripheral vision on the right, and ..... he should have depth perception deficits, but we have not noticed them functionally. He does need to wear glasses now with a very mild correction in them. He did not need glasses prior to the accident. The glasses are important mostly to serve as protection for his remaining "unaffected/good" eye. He is still trying to get used to the glasses. They bother him because the frame creates one more visual barrier to his peripheral vision.

We were told that his right eye will begin drifting to the outside.... This drifting results from lack of visual stimulation over time. So Scott may need another surgery later on to correct this "eversion". An interesting thing that we learned from his physician is that the eye "inverts" (goes toward the inside of the eye) if the blindness occurs as a child, but "everts" (goes toward the outside of the eye) if the blindness occurs as an adult.

TBI ( Traumatic Brain Injury)Scott has three brain injuries:
Right epidural temporal hematoma - the craniotomy had great results. We are not seeing any functional residual from this hematoma.

Diffuse Axonal Injury - this is the shearing injury throughout his brain. We do see some limitations on Scott's executive level thinking/processing as a result of this injury, but we are amazed that it is not a bigger problem. He seems to be healing so quickly in this area. Scott will be at risk for seizures for 2 years due to the DAI. He has not had any seizures so far and is no longer on anti-seizure medication. He will need to be mindful of normal seizure precautions, however, to limit the risk. These precautions will delay his return to some of his prior activities, like riding his bike to and from school in 120 degree summer temperatures! Yikes! The summer Phoenix weather will provide some interesting management challenges for Scott, as he is to avoid exhaustion, dehydration, and extreme heat.

Left contra coup subdural hematomas in several locations - these appear to be Scott's primary function-limiting injuries currently. They are responsible for the right hemiplegia (weakness, hypertonus, and numbness in his right leg and arm), his word retrieval difficulties, his memory difficulties, his perseveration and impulsivity, etc. These limitations, too, are improving daily (impulsivity is minimal now, hypertonus is faint now, weakness is lessening, numbness remains, his long-term and short-term memory are improving daily, he can remember up to the Saturday before the accident now and can remember new events for the last 3 weeks,  his appropriateness is much improved but not fully recovered yet), but left hemisphere deficits are primary for Scott right now.

Facial fractures and surgical repairsThe fractures appear to be healing well. Scott has no facial pain. He does have a tiny bit of swelling over the right zygomatic arch (cheek bone) still. He does have significant numbness of his right face, palate, and tongue still, ... which is likely due to local trauma to the nerves from the many fractures. His physician will request his MRIs to further assess the possible cause of the numbness.

Scott's facial muscles continue to improve, but do remain limited on both sides of his face, left limitation greater than right..... This weakness is likely due to cranial nerve damage. We hope to see it continue to improve.   We have not seen much/any improvement in facial numbness yet, but still could.  We are just now able to get an accurate assessment of his numbness.  and.... Nerves regrow very slowly (about an inch a month), so if it does return, it will be down the road.

Rest assured that none of the above problems have inhibited his eating! He does have some right TMJ pain if he opens his mouth wide, but otherwise, he is unlimited with eating and has maintained a healthy appetite.

LungsScott is having zero residual problems with his lungs, or breathing, currently. Wahoo! We hope that remains true from this point forward.

Right AC joint separation (shoulder)

Scott is now allowed to raise his arm forward (flexion), as high as pain allows, but not out to the side (abduction). He is able to raise it to 80 degrees without compensation (cheating). He does have impingement pain at end range elevation, but otherwise is pain free in the shoulder. He is just really really weak in his right arm! .... Due to the hemiparesis combined with the localized injury. We do tape his shoulder to provide some additional stability to the joint, which helps. I expect further precautions to be lifted next week, which will be his 8 week mark.

Right forearm injury/surgeryHis forearm is healing quite nicely. No pain. No swelling. Good circulation and pulse, so the radial artery repair appears successful. His motion is full at his wrist, forearm, and elbow, except for a small decrease in supination (palm up). He does still carry his arm with a bent elbow, but he is able to straighten it fully now. His hand remains numb, but that is from the left hemisphere hematomas. Post-op precautions remain, so he has not been allowed to perform any resistive work with the forearm yet, but..... again I expect some precautions to be freed up at the 8 week mark.

FunctionScott has been fully independent with his return back home. He is able to shower himself. He fixed us breakfast on Sunday morning, being careful to use his numb right hand for cutting, so.... He would know if he was cutting into his normally-feeling left finger! He is safe with ascending and descending the 18 stairs in their home. .....etc..... No limitations at home, other than lifting/resistive tasks with his right arm.

He does get more fatigued than usual, but he is still able to cognitively function when he is tired. He is sleeping well at night now, only awakening when it is time to arise in the am.  He requires more sleep than usual, but is not needing to nap.

His gait pattern is still abnormal, but is not unstable. His balance is good now in all planes. Single leg stance remains mildly limited. His strength, coordination, and reaction times are slower, especially on the right leg, but I see them improve daily during our daily soccer game. Last Thursday at Barrow, I needed Ashley to provide stand by assist when Scott and I began tossing the ball back and forth. Today (this Thursday), Scott is kicking a ball with me...hussling after balls, performing slow spin moves, stretching/reaching for balls while maintaining his balance on the other leg, able to respond quickly to balls passed to him with good pace, etc. It truly amazes me to see that much improvement in one week! I will miss doing rehab with Scott next week when I return home and he begins CTN ( The Center of Transitional Neuro-rehabilitation). It has been fun to have this time with him and to witness his progress.

Well, I apologize for the lengthy post... Had some catching up and finalizing to do.... This is my last post. Scott and Ashley will be updating from here on out.... as they have been for the last 2 weeks. Now... onto Scott's return!

Love to all, and thank you so very much for your support! It has made all the difference!  There are not words adequate to describe the extent of gratitude I have in my heart for the love and support shown to Scott and our family!

- Patti