Update on Matthew - Week 3 through Week 13

Monday, April 28th
Today is the beginning of week 3. To make it a little easier to get the latest, I started this new post. If you would like to review the day by day account of the first 2 weeks or read previous comments, you may view the original post by scrolling down.

Matthew had another really good night with his ICP levels staying low and his temperature remaining close to normal. He had some respiration issues yesterday evening and through the night, but it appears the adjustments made to his respirator have helped and this morning he is breathing normal and his O2 levels are good.

They have cut the sedative dosage in half again, which means he is down to just 12.5% of what he was on a couple of days ago. They should be able to stop it completely later today, although it may still take another day or two to get all of it out of his system.


Tuesday, April 29th
Another good night for Matthew. They have backed him down to 40% Oxygen again and his respiration is still good. We're waiting to see if they take him off the sedatives today. 1PM They've started doing some physical therapy with Matthew today, moving his arms and legs and rotating his shoulders. He's handling it very well, no increase in ICP level. They also did a scan of his legs to make sure there were no blood clots, everything looked fine. They will be taking him off the sedatives within the next hour, so he will only be on pain medication and antibiotics. He's progressing really well as we all expected he would.


Wednesday, April 30th
Matthew's still doing pretty well. He does have a touch of pneumonia and is running a little fever, but nothing too serious. He no longer has the drain tube and his pressure has remained good. He's gradually showing more and more signs of movement and response to external stimulus. We hope today they will perform a tracheostomy (insert a trach tube into an opening in the neck) and remove the breathing tube from his mouth. This would be safer for his larnyx and vocal cords, not to mention it will be much more comfortable when he wakes. However, to do this would require Matthew to lay flat for about an hour, something the doctors have not felt he could withstand up to this point. Since he is doing so much better, he should be getting close to the point of being able to handle this without any problem. Thursday, May 1st Not much has changed with Matthew's condition, he's still doing well. Last night they removed the ICP monitoring device from his head. They plan to put in the trach tomorrow. 3PM The doctors told us they are going to do the trach tube and move the feeding tube to his abdomen tomorrow afternoon. 5PM Matthew's fever came up this afternoon and he started having some respiration problems. They are doing another bronchoscopy to clear out his lungs and airways. At this point they still plan to do the trach and feeding tube procedures tomorrow.


Friday, May 2nd
They have just completed the surgery to insert the trach tube and the feeding tube in Matthew's abdomen. Everything is fine and the family should be able to go see him soon. This should make it much easier on Matthew to breathe and will be much more comfortable for him as he recovers.


Sunday, May 4th
Matthew has continued to improve each day, he looks so much better now that the breathing tube and feeding tube are out of his mouth. He's breathing almost entirely on his own now with little help from the respirator. It could be a while before he wakes up, or he could wake up tonight. If anything changes, I'll post again.


Wednesday, May 7th
Not much has changed since Sunday. Matthew continues to do well and responds a little more every day. He's had some issues with congestion and respiration, but nothing major. As of this evening he's breathing fine again and his oxygen levels are good.


Thursday, May 8th
They are doing an MRI today of Matthew's brain. We are still waiting for results and will post an update as soon as we have them. Matthew is breathing on his own although is still on the respirator just in case he needs assistance. They plan to wean him off the respirator completely in the next few days.

6PM According to the preliminary analysis of the MRI by the Neuro-sugeon, it showed that the blood clots were resolving and there was no additional bleeding. There is some scarring where the blood clots were, which could cause some seizures but is not a major concern at this time. They could not determine the extent of the damage to Matthew's brain from the MRI. They will not be able to fully assess the effects of the damage until Matthew's brain completes the healing process, which could be a very long and slow process. The radiologist will read the MRI tomorrow and give their analysis.


Saturday, May 10th
Today the neurologist explained that based on their analysis of the MRI, and all of Matthew's case, they feel the severity of his brain injury is such that he will not recover much beyond his present state. They mentioned to Kimberly that there were signs of damage in the brain stem area, which was their biggest fear. However this was not mentioned in their official report, only that the injuries were severe and there was nothing more they could do for him. Therefore, the neurologists have signed off on his case and he is now completely under the care of the Trauma Unit. We expect to have several more meetings this week to determine the next steps for Matthew, as well as the possibility of moving him to a long term care center where he can begin therapy.

While this is obviously not the news any of us wanted to hear, the family is standing firm in our faith and still believe that God can fully restore Matthew. We were told the day of his accident, almost 4 weeks ago, that it wasn't likely Matthew would make it at all - yet he's still with us today and is showing signs every day that he is fighting and making progress. We'll continue to pray and seek the best medical advice possible and we ask that all of you continue to pray for Matthew on a daily basis.



Tuesday, May 13th
Matthew continues to show positive signs each day and is able to respond to some verbal commands. Today they have taken him off the respirator for the first time. He's been on Oxygen only for over 2 hours and is doing just fine with his breathing. If he struggles with his breathing, they'll put him back on it for a while to let him rest and continue this process until he no longer requires the resipirator. They are currently doing a spinal tap to check for meningitis. It will be 24 to 48 hours before we know the results.



Thursday, May 15th
The spinal tap did not grow anything but did suggest there was an infection. Since the antibiotics they have him on are working, they are going to leave him on it.

Yesterday, they left Matthew off of the respirator all day until about 10PM when they put him back on to make sure he got a good nights rest. They took him back off today around 12:30PM and will likely leave him off until sometime tonight. He's doing well with his breathing.


This morning, Kimberly and Shawna visited a facility here in Oklahoma City called Select Specialty Hospital (see http://www.selectmedicalcorp.com/hospitals/oklahomacity.htm for more details). This facility was highly recommended by OU Medical Center, as they specialize in rehab for patients with Traumatic Brain Injuries. It will likely be early next week before he is transferred.


Monday, May 19th
Matthew has been completely off the respirator since Friday. They've reduced the trach hole down to a size 6 and will eventually close it completely, perhaps with an oxygen mask if needed. He will be transferred tomorrow afternoon from OU Medical to Select Specialty Hospital.


Tuesday, May 20th
Matthew was transferred today to Select Specialty Hospital here in OKC. The move went fine. Matthew has been struggling a bit with his breathing and fighting a fever, so late in the evening they put him back on the respirator.


Monday, May 26th
Not a lot of changes, Matthew continues to fight an infection and some respiratory issues. All in all though, he's doing well and is being well cared for.


Tuesday, June 3rd
I know its been a while since I've updated, but there hasn't been a lot of changes. Matthew has continued to battle a series of issues with blood pressure, heart rate, and fever. Nothing life threatening but enough to keep the doctors busy trying to keep things under control and isolate any possible infections. He's still on the respirator but the doctors have indicated they hope to wean him off of it soon. They plan to do a CT Scan tomorrow and try to determine if injury to brain might be the cause for the unstable body temperate, rather than an infection. Until they can get these things under control, he will remain in ICU and their focus will remain on stabilization rather than rehabilitation.


Tuesday, June 17th
Today is Matthew's 22nd Birthday!! He's had a really good week - they've taken him off the respirator completely and have started sitting him up in bed. He's doing really well and making little progressions each day. He can open his eyes all the way and will follow movement in the room, even turn his head. He's had some issues with his blood pressure but has responded well to medication. Kimberly just texted and informed me that they are moving him out of ICU to his own room!!


Thursday, June 26th
Matthew was moved today to Valir Rehabilitation Hospital in Oklahoma City. The move went fine and he will begin rehab sessions in the next couple of days after he settles in.


Saturday, June 28th
Matthew has been battling fever, so they did not start him on therapy sessions. He's also fighting an infection. Once they get him cleared up they can begin working with him more in therapy.


Wednesday, July 9th
Matthew has been doing really well the last couple of weeks. He has 3 therapy sessions a day during the week and 1 a day on weekends. He is trying to vocalize, following movement with his eyes, and making good progress each day. This week they have him sitting up in a chair some, which is a big step, and are using speaking valve to help him try to talk. They are giving him Baclofen to help relax his muscles and it,s made a big improvement. This afternoon they are going to lie him on a mat so they can really work on rotating his arms and legs.





Friday, July 11th
They got Matthew up in the wheelchair again today and took him downstairs to the gym, where they layed him on an exercise mat with his legs hanging down to help with the bending of his legs from the knee down. Matthew's tone (the stiffness in his legs) has relaxed so much in the two weeks we have been here.

Here are some pictures that were taken today of Matthew's first day on the mat.

Matthew lying on the mat stretching knees/legs.

Gale stretching neck muscles, Katy holding legs.

Gale stretching shoulders, Katy holding legs.

Gale stretching his arm and shoulder.

Katy and Gale stretching him every which way.

Totally relaxed after a hard workout

Aaahhh! That sun feels good and relaxing.

As you can see, it is very exhausting for him, but he handles it well.


Saturday, July 12th
This is Kimberly. I will be updating the blog now and starting Monday, July 14th, There will be a new post starting Matthew's Rehabilitation Journey Week 14 on.

Here is a little of what's been going on since we have arrived at Valir Rehabilitation Hospital. After arriving here, the doctor diagnosed Matthew with "Sympathetic Storming". All the problems Matthew was having with high blood pressure, high respiratory rate, pupils dilating, high heart rate, posturing, increase in muscle tone, extreme sweating and temperature (besides the times he had infection) were due to this exaggerated stress response, known as Sympathetic Storming. This occurs in 15-33% of patients with severe traumatic brain injury who are comatose. It is thought to be a stage of recovery from severe traumatic brain injury. The Baclofen (which was started to help with the spasticity of his muscles), is also a treatment for this, so Matthew has had a much better time since we've been at Valir. Sympathetic Storming is a condition that usually occurs after backing the patient off of the sedatives and narcotics in the ICU. The good news, we finally had a name for what he was experiencing and it is thought to be a stage of recovery. Thank God.

Matthew has been having 2 sessions a day of speech therapy, occupational therapy and physical therapy. Starting on Monday, his 2 a day occupational and physical therapy (which for now are combined) will involve the mat. They put him on the mat so that they can get more stretch, of more muscles, it is also easier for them to maneuver him into those positions, rather than in a bed.

Matthew has a speaking valve now. The speaking valve fits over his trach cannula and prevents any air from going in or out of the trach, so that he can move the air through his mouth and nose only. The first time he had it put on, he did awesome. They say it can cause distress and some people can only handle it for a short while and have to adjust. Matthew had no problems at all and had it on for 30 minutes his first time. He has said Mom a few times with a raspy voice. He usually only calls my name when Katy and Gale have walked away from him and I really think he wants me to make them quit. LOL! He is finding his voice box, but they say it will take time to learn to push it out. He has to learn how to talk again, and how to voice the words he wants to say. He does move his mouth mouthing words and some that he has mouthed are stop, no, and what.

Ok, I will continue from here on, with daily or as close as I can get to daily posts to keep everyone updated.

Again, I thank everyone for all your thoughts and prayers, without them this journey would have been much harder.


Sunday, July 13th
Today was a light day, as Matthew had only 1 therapy session today. He did get up in the wheelchair and we went outside a couple of times. He said Mom a few times today. He still sounds like "Froggy" but it is a wonderful sound.

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