Wednesday, August 26, 2009

8/26/09

Howdy all. Once again it has been a while since my last update, and I have a feeling that this one will be my last. Over the course of the past couple months I feel like Jon and Allison's story is no longer mine to tell -- it has become their own as they move on with their life.

I don't mean to get all sappy and wax nostaligc, but it is pretty amazing to look back on what has happened since the accident. Six months ago Jon was recovering from major surgery and Allison was fighting for her life. Today, Jon and Allison are on a well-deserved vacation to Banff, Canada, and the wheelchair ramp was just removed. Here's some of the other stuff that has been happening.

Jon got approval to go back to work, starting next week. He has physical limitations to what they are allowing him to do, but I know he can't wait. He helped plan and build a large deck in the backyard for himself as well. Thanks to the Zav's, Jon V, Kyle, Dad, and anyone else that helped. Jon was so happy to be working again that we had to pull him off the job at the end of the day once we were all done - he was ready to outwork all of us. The extra weeks he was in his boot after the most recent surgery were pretty miserable, but he's happy to be out again and walking unassisted. He continues to have therapy on both his elbow and his foot and who knows how much he'll be getting back with those in the end, but I think he tries to not let it bother him. He'll have probably at least one more surgery to remove a plate in his elbow later on.

Allison is back to the hospital once a week for her continuing education classes. She's also driving short distances to and from the hospital and the store. She's back running and competed in the Danish Festival 4mi race in her hometown in Greenville last weekend. She said she wasn't trying to compete, but still managed to get 5th out of her age group - I think her being able to finish at all is just amazing. She's working on her balance and vision right now and getting all of her brain function back to where it needs to be. I know she's chomping at the bit to get back to being a full working doctor and hopefully that transition continues forward smoothly.

Obviously things are looking good compared to six months ago, and even good compared to two months ago or two weeks ago. I want to thank once again all of the friends and family, and even those of you I don't know that were such a great support. The endless thoughts and prayers, the nurses, doctors, and professional staff we enountered -- the State Farm staff, therapists, neighbors, and everyone that was involved in any way. I know that Jon and Allison will probably have to deal with the physical and emotional stresses of this accident for the rest of their lives, but I know that they are happy to try to get some of their own life back together and couldn't have done it without the support they have been given.

Ok, that's enough!


Dave

Friday, June 26, 2009

6/26/09

Well, it has been a while since my last update. I've been pretty busy and was focused on surviving a crazy bachelor trip party there for a while.

Jon did have his surgery two days ago, on June 24th. It was an outpatient surgery that took about an hour and a half. His orthopedic surgeon, Dr. Jones, wasn't too sure what he would need to do to fix his troublesome tendon until he had his ankle opened up. It turned out that the tendon is actually in pretty good shape, nice and healthy, but that it was quite a bit out of place. From what I gathered, he had to remove the sheath around the tendon, split Jon's bone just above his ankle and carve out a groove for the tendon, move the tendon back over into that groove, and then re-wrap the tendon in its sheath. This will eventually make the tendon heal into that grooved bone and solve the problem of the tendon flopping back and forth over his ankle bone. Its pretty amazing, but after about 6 weeks I guess that the sheath will heal in place, forming scar tissue and attaching itself to the notched out bone. Also during the surgery Jon had his achilles lengthened. Dr. Jones made another incision higher up on his calf for this, and while he didn't go into it too much, from what I gathered I think what is done is some small holes are cut into the tendon and then stretched out. Once the holes heal, the tendon will be longer. I may be wrong on the actual procedure, but whatever the case, he said that Jon will have another 5-8 degrees of motion in his ankle with his upward flexion. This doesn't sound like a whole lot to me, but I guess it will help reduce some of the stress on his ankle, hopefully reducing some pain and helping his stride.

Jon's recovery this time seems to be going well. Obviously he is in pain with such an invasive surgery, but it is nothing like right after the accident. He is back in his wheelchair and back to sleeping on our main floor, but being able to use his arm and not having the pain in so many areas like last time definitely helps. He is in pain at the two areas of surgery in his leg when he points out where it hurts, which makes sense. He has accidentally flexed his calf muscle a couple times in the cast which causes him a ton of pain as well. However, he is not on nearly as many pain meds as last time and seems to be doing pretty well. Despite a bit of nausea right after surgery, he had his appetite back that night, and in my opinion has looked and felt better than he did for at least the first 6 or more weeks after the accident. We have both said that things seem to be going pretty well after this surgery and we both thought he'd be down longer and feeling worse than he does. He still wants to continue therapy on his elbow, and I'm planning on taking him later today to do so. Its good that he's feeling well enough to get out a bit and allow the therapist to cause him more pain hah.

For recovery, he is in a hard cast for two weeks, then back into his soft boot for 4 more. It sounds like keeping his ankle immobile so the tendon can heal in the correct place is the important thing, more important than keeping weight off of it like last time. He can put his foot down a little bit now while in the cast, and will be full weight bearing (depending on the pain) while he's in the boot. It sounds like he'll only be back in the wheelchair for the two weeks and after will at least be able to walk around short distances with his walker or cane. He's not excited to be in the hot sweaty boot for the whole month of July, but I'm sure he can tough it out.

Prior to this surgery, Jon had been doing quite well. He was walking without a cane and almost no visible limp. His range of motion on his elbow is improving, but slowly. He is able to cross his arms casually and comfortably, which is a big improvement over a couple of months ago. On the bachelor party he was a trooper, able to climb rocky hills, jump off the top of the houseboat, go down the water slide, and even climb up the rocks and go cliff jumping with us. Since he was back he has been swimming for some exercise (it is hard to pull underwater with his right arm so he always swims towards that one side which I find funny), has gone rock climbing, and has even played racquetball (which he regretted for a couple days). He has tried biking but putting the weight into his handlebars hurts his arm too much, so he tried out some recumbent bikes. A recumbent bike is one where you're sitting upright in almost a chair with your feet out in front of you, and your handlebars up higher so you're not leaning on them. Here's a picture for an example - http://img.alibaba.com/photo/10798856/Recumbent_Bike.jpg . He loved the bikes and is excited to get his own but obviously needs to get past this recovery for now. Its pretty cool because I wasn't sure if he'd ever be able to do some of those things again after the accident, and I'm sure he'll be back into it all again after this recovery.

I'm sure most if not all of you know, but Allison is back living at home, which is great. She came home about a week ago and really enjoyed being able to sleep in until noon or later for a few days, but is now back into therapy mode. She has outpatient therapies at Sojourners almost every day. She is seeing her physical therapist and speech therapist 3 times a week, recreational therapist 1-2 times a week, and her psychologist for keeping track of her mental progress about once a week. She has surgery to remove a cyst on her vocal cords towards the end of July that was formed due to the intubation tube. Once removed, it should fix her scratchy voice after 5 days of no talking at all. The cyst on her vocal cords is around the size of a blueberry, which apparently is quite big and is displacing her vocal cords completely. Her therapist was surprised she could talk at all right now, but its not causing her any pain or anything. In fact, I think Allison is not really in pain at all right now. She is up to running on a treadmill for 15 minutes, with warm up and cool down totaling around 2 miles. She is studying some of her medical board material with her speech therapist as part of her therapy and is thrilled to be doing so again (I don't know what's wrong with her, excited to study?!). At her release on Thursday, her psychologist said she is testing average or above on every measure of her brain right now, but that it still needs to improve before thinking about work again. Some of the measures, while average for her age group, need to be well above average to succeed in a high stress medical environment. The good news is that her mental recovery is still on the upward trend and they expect that to continue. The game plan now is to keep with her current therapy schedule and let her recover from her surgery in a few weeks, then take the full day-long battery of neurological tests again to get a clear picture where she's at and what is next.

Oh I almost forgot, but on Wednesday while Jon was in surgery Allison and I went up to the 4th floor where both Jon and she stayed in Spectrum. I pointed out Jon's room and then we moved on to the ICU. Allison has no memory of Spectrum at all, but she brought some thank you cards for the people who cared for her there. She had worked in the surgical ICU for a while so she had some contacts there already, and she spent time talking to different nurses and doctors. We had a visit from Dr. Hogeboom (sp?) who was her primary doctor, and from several nurses which either worked with her as a doctor or worked on her as a patient. Everyone was amazed at how well she was doing and how good she looked, especially when she told them that she got out of residential care just last week and that she was non weight bearing for 14 weeks. It was good for Allison to visit with some old friends and coworkers, and for them to see their patient up and walking and in good spirits.

Well, that's it for now, thanks for reading.

Tuesday, May 19, 2009

5/19/09

I'm still on vacation, just passing on some secondhand news by way of my Mom who talked to Jon yesterday.

The tendon that is loose and flopping over his ankle does need to have surgery, and pretty soon. He is scheduled for an outpatient surgery on June 24 but is on a cancellation list to get him in sooner if possible. He can keep walking and doing what he's doing for now, but after the surgery will be in a cast again and non weight bearing for 2 weeks. My mom said he didn't seem too sad about it, but I'll bet he's glad that it is after our bachelor party houseboat trip next month.

Thursday, May 14, 2009

5/14/09

Today was Allison's family meeting at Sojourner's.

Things went quite well, once again everyone is happy with her hard work and determination. Jon is now approved to transport her by himself. They also are allowing overnight passes (one night per weekend). Jon will be picking Allison up after her therapies tomorrow and is taking her home to spend the night together for the first time in 11 weeks. They are both thrilled to get some real time together, and Jon is trying to plan a date night with different activities.

All of her therapists are happy with her progress. She is always pushing herself to get better, taking on new challenges and telling them to make things harder if she thinks they are too easy. They still have things they will be working on with her and will be giving her a list of what she needs work on yet. Her Psychologist went over her neruo-psych test results from 2 weeks ago that I mentioned in a previous entry. He said that even that testing from 2 weeks ago has since been outdated, since she is doing so well and improving rapidly. He said she has shown 'remarkable improvement given her injury', but cautions that she is not there yet. There still needs to be more healing for her to return to her regular life. She has some deficiencies in certain areas, including divided attention, alternating attention, memory, and some hands-on tasks like hand-eye coordination. In all areas, however, she is still showing great improvements. Everyone is real encouraged. Some areas where she is testing really well at are her verbal skills, like her use of vocabulary and her comprehension and judgement.

One thing we and especially Jon has noticed is her somewhat flat affect. Jon described it best once when he said that before the accident that if he were to paint Allison it would be an active painting with jagged edges and bright colors. Now, he would be using more neutral and gray tones - almost subdued. Her Psychologist said that this is due to her brain injury and that it will fade with time as she continues to improve. Granted, Allison is definitely herself and generally happy and determined, just not as vibrant as before at times. I'm talking about this as if Allie is a zombie or something and she definitely is not. Its hard to describe, but its great to see her in a setting with family and friends where she can laugh and tell stories and truly be herself. One example Jon gave to illustrate what I mean is when they took her swimsuit shopping last week for her pool therapy. Before the accident, she would have wanted to try on every suit her size and in every possible color before she made her choice. This time, she tried on two and then asked Jon to choose. Jon joked that he could deal with that -- it sure would make shopping for jeans easier.

Given all this, they want Allison to stay at Sojourner's for another 30 day block. They will continue to work on improving what needs improvements. They want to push her stimulation and try to get her in more high activity and high stress situations. She has a meeting with her Orthopedic surgeon that worked on her pelvis, foot, and arm, Dr. Endres, on May 27 and expect more of her weight restrictions lifted so they can start more physical therapy as well. We have a family meeting on June 18 to discuss again how she is doing. Allison didn't really like the decision to stay another full 30 day block, but her being able to spend more time at home will help, and if she can get through these hardships now for the better chance at having a full recovery, I think she will be able to look back and know it was the right decision.

Jon is still doing well, getting more and more independent. He's in a lot of pain in his foot and it swells up pretty big when he's walking on it, but the therapists say that he should keep pushing it so it will strengthen and heal. He's got one tendon that flops back and forth over his ankle bone when he bends his foot which isn't good and will need to be looked at - I think that's primarily what gives him pain. He says that it feels like he's walking on a bad sprain, but he's getting through it ok. He's practially given up on the wheelchair and is only using his cane -- so much for being on crutches for 6 months.

His elbow is healing as well, although he's describing a new pain in it that feels hot, like its burning. When he bends it now its making some really funky and loud grinding/popping noises. However, he was able to have his elbow bent the farthest it has been yesterday, all the way to 135 degrees which is almost full range on the bending. This was done with his therapist putting all her weight into it and him nearly passing out from the pain so its not there yet, but it is improving. His regular everyday range of motion is not nearly that far and I know they are working on his extension as well.


I'm going to be out of town for a week and a half so I won't be having any updates in that time. Take care all.

Thursday, May 7, 2009

5/7/09

Jon is doing really well.

He got approved to walk without his boot on. Its surprising how fast things get approved without him being tested on it, but they said it was fine to not wear the boot. He still wears it around while walking any major distance because it keeps the pain down not bending it so much, but I think he especially likes not wearing the boot while he sleeps.

Jon was mostly asleep when I came home late tonight, but he had his foot propped way with pillows up while asleep which was the first time he has had to elevate that foot since about week 2. I think its hurting with all this action and movement and weight on it. He needs to not overdo things and I think he's realizing that.

The new anti-inflammatory medication seems to be working well for his elbow. Either that, or he's just turned a corner and it happens to coincide with with medication change. He was able to go to 131 degrees passive range (someone cranking on it), and 122 degrees active (him moving it under his own muscle power). For reference, I think his good arm can go up to 145 degrees. He was only able to make it to around 120 last week with the hardest of pushes from a therapist to the limit of his pain. Being able to bend to his old ultimate limit on his own after a week or two is great. He's still working on his extension.

Night!

Tuesday, May 5, 2009

5/5/09

Jon was able to stand up in the shower today for the whole duration for the first time today. It looks like we may be able to get rid of the shower chair and put the bathroom doors back on their hinges soon (they were off so he could get his wheelchair in). Pretty cool.

Monday, May 4, 2009

5/4/09, PM

Jon walks like a champ.

He went in and his physical therapist had a student trainer in with him. Jon started off real slow, bracing himself with some parallel bars, and taking some hesitant steps. By the time he got to the end of the bars, he was taking full strides. The therapist said to his student, with a smile on his face, "See, I told you he'd just take off on his own". Once again, holding him back will be the only problem.

He's got a cane now, as well as his old walker. For anything more than getting around the house he still has his wheelchair. When walking he still has to wear his boot, although in therapy they are working on walking with an air cast which allows for more movement.

Great day.


Oh yeah, and he bent his elbow today more than he ever has been able to before, both with someone cranking on it and with him moving it on his own. With his new anti-inflamitory meds he's in more pain, but able to get more range so he's happy.

Sleep tight.