Matthew's Rehabilitation Journey Week 14

Monday, July 14th
Today marks 14 weeks and 3 months since the accident. I decided to create a new post for the rehabilitation journey.

We are at Valir Rehabilitation Hospital, address 700 NW 7th St., Oklahoma City, Oklahoma 73102 If you search for directions, enter the address 721 NW 6th Street. Parking is on the 6th St. side of the building.

Directions from Clayton are: Follow I-40 West to Classen Blvd. Take Classen to NW 6th St. Turn Right on NW 6th St. Go through the next light ich is Shartel) and turn (almost immediately) left at Valir Rehabilitation Hospital.

We are on the second floor, Room 226. We would love anyone to visit. Visiting hours are 8:00 a.m. to 8:30 p.m., but the best time to visit is after 4:00 p.m., due to his therapy sessions. Visitors are not allowed at the therapy sessions. At this hospital, children under 12 are NOT allowed on the wing that Matthew is on. If you have children, you can have someone at the fsecond floor desk let me know you are here or call me and I can arrange to have Matthew in his wheelchair and bring him downstairs to the patio or the dining room.

9:30 a.m.

Speech therapy had a great morning with Matthew. He used his humming voice to let her know he wanted to stop messing with his face two times. She told him she would quit putting the wet washcloth on his face if he would make that sound and he did it. Also, in front of her, he said Mom really good in his voice and a few whispers while I was cleaning (picking his nose) with a washcloth. LOL. But finally, I have a witness that he is saying Mom. So today has started off as a great day.

11:30 a.m.
It seems so fitting that I started a new post of the rehabilitation journey today, because Matthew has made a turning point. In physical therapy, he gave a thumbs up, raised his arm to grab my hand, squeezed my hand, then squeezed tighter, then let go, all on command. He also said Mom again and whispered stop (while I was popping pimples again, LOL). Ok, I know it sounds mean, but anything to make him talk. Besides, I won't be able to do it when he gets those arms to moving up further. After the physical therapy session, we met with the speech therapist again, he did all these things again for her. She took him upstairs while I was texting the good news and when I got back in the room, she told me that he was very vocal, not words but sounds, that he did not like what she was doing with the wet washcloth on his face. All the therapists, are WOW!, I don't know what you said or did to him this weekend but something happened. I actually told him yesterday that if he didn't start doing stuff for other people, we'd never get to go home. Maybe he listened. LOL!

Seriously though, I know that it was nothing I did or said, it is our Lord and Saviour at work on the miracle that I know is and will be. It was in God's time for Matthew to do these things and that time came today. When and what else he does is still in God's time, but this has been a glorious day for me. Thank you Lord for everything you have done for Matthew and are continuing to do each and everyday.

The speech therapist told me this morning, that they had talked to Dr. Washburn and they will be changing the trach to a cuffless trach (the one he has now has a cuff in it, that can inflate and deflate to let air through or not. It has been deflated since the ventilator came off, but this means that they don't expect any more chance of having the vent again.). Yet another step to getting the trach out.

4:40 p.m

Praise God, what a wonderful day! We had another great and productive PT/OT session this afternoon. Matthew sat with a ball behind his back with his arms on the wheelchair arm rests, head and shoulders up for about 30 minutes. When the PT was stretching his hamstring, she told him if he would grab her hand she would quit. He moved his left arm over, grabbed her finger and pulled it toward him. She quit. He also told the therapists NO while they were working with him. He mouthed yes once also but no sound. He tries many times to voice the words they or I tell him to, but he doesn't always get the voice box to go with it. This will take time. He is having to take deep breaths, and push the air through to his voice box while also using his tongue to pronunciate the sounds. He is learning to talk all over again, just as a baby does. After he was totally exhausted, he was asked by Marissa (his speech therapist, who had dropped in) if he wanted to keep working with Gale (his occupational therapist). He said NO. He's learning. LOL!

July 15th, 2008

Today has been a good day! Matthew was either still very tired from everything he did yesterday or just being stubborn, but he did not say anything today. He did make progress on his physical therapy though. This morning's session, he moved his left arm up in the air, while trying to grab the therapist to get her to quit stretching his arm. They were also able to get one knee/leg bent at 90 degrees for the first time. He sat up at 90 degrees today and bent better at the waist/hips. In this afternoon's therapy session, he made a fist and moved his right arm more than he ever has, Gale told me to be ready in case he got it up to hit her. LOL!

They have removed the cuffed trach and replaced it with a smaller cuffless trach. He is on the smallest cannula there is for trachs, so the next step is to cap it and as well as he is doing with the speaking valve (which caps the trach off), I look for it to not be very long before we get to capping it off. Then the only step left will be to remove the trach completely and let him heal.

I want to thank everyone for the posts. Now that I have computer access, I check it several times during the day. I look forward to the posts and hearing from people and I love to be able to share what Matthew has been doing during the day. Thanks again for all the prayers and support.

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July 17, 2008

9:20 p.m.

Sorry, I didn't get to update yesterday. Not much happened new and I was trying to get my questions ready for my family meeting with the case managers and insurance. The meeting went well, all the therapists gave their updates on Matthew's progress to the worker's comp case manager and adjuster, and they were all good. His stay is a week to week decision, but as long as he progresses he will be here. I did learn today that our apartment will not work for when I bring Matthew home, so if anyone knows of a place to rent let me know so I can check it out to see if it will work.

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Today was a day of firsts again. Matthew got his first ice chips today. The first one took him 30 seconds to swallow, but by the time she had given him ice a few times he had it down to an 8 second swallow reflex, which is still not normal or safe, but so much better than the first one. They are going to do a therma (something like that) treatment, where they freeze lemon swabs and rub them on the part of the throat that controls the swallowing reflex. This will exercise his swallowing instincts and help. His Dr. is on vacation this week but next week we will be talking about the Barium Swallow tests, which will show if what he is swallowing is going to the right place. No water came out of his trach today, so that shows it was going at least down and not out of the trach.

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Now about the trach. Another first, his trach was capped today for the first time. The speaking valve caps it off but air is still able to flow through the trach. The cap today allows no air to go through. He tolerated it well and they will continue to do capping trials for the next few days. If he continues to tolerate it, then it will be capped permanently and the trach will be removed.

Matthew's right leg had swollen up yesterday and they did x-rays to check for fracture. No fracture so they sent him for a Doppler Ultrasound over at St. Anthony's Hospital to rule out DVT (blood clot). Preliminary reports showed no DVT. Good news. We ruled out the two bad things, so it is either the muscle is inflamed or some scar tissue has broken up due to the bending and therapy of the leg.

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Well, it's been a long day and I'm going to hit the sack. Thanks again for all the support and keep posting. I'll try to post earlier tomorrow, since it won't be near as hectic. Meetings and appointments just kept me running today.

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July 18, 2008

Today was pretty uneventful, except they are still trying to figure out what is going on with Matthew' s knee. They took more x-rays of the hip, thigh and knee. They think that it may be something called heterotopic ossification (HO) which is the abnormal formation of true bone within extraskeletal soft tissues. It is usually seen in spinal cord injuries and traumatic brain injuries due to to immobility and mixed signals in the body. HO can form anywhere in the body but the most common location is the hips, then knees, shoulders etc... This is why they retook x-rays of the hip, thigh and knee to see if they could see any bone formation. If the x-rays don't show any bone formation then the next step should be a bone scan (according to my research). HO's only treatment from what I can tell is vigourous physical therapy to keep as much range of motion as possible and a drug called Didronel that will not treat what is already there but can aid in prevention of more bony formation. If the HO is bad enough, then surgery is the treatment.

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The good news is that it will not stop his physical therapy. We are continuing his knee splints and physical therapy exercises. His leg does not seem to cause pain except for touch of the swollen area, movement does not seem to hurt him and will be the best thing for him. The only other thing they have mentioned it could be is a possible old ligament injury inflamed.

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Speech therapy worked on his swallowing responses today and he was more in the 6-8 second range of delay, which is not too bad.

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Respiratory therapy, speech therapy and physical therapy capped his trach today while they had their sessions. He did well. The respiratory therapist says that he is ready, so when we can talk to the doctors again, they may issue the order to cap for good. The next step after that will be removing the trach, but that will come probably quite a bit later. They will want him to be cognitively more alert and responsive and probably eating before they remove it. Better safe than sorry.

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He did say no, no, no or mom, mom, mom today when the PT was stretching his arm and I was doing the sternal rub (which is your knuckle in your sternum and is painful). Anything to get him to talk, LOL. He is making more sounds now, so speaking more consistently is probably not too far ahead, hopefully anyway.

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Well, the weekends around here are pretty quite, with less therapy sessions and not his regular therapists, but if anything happens I will post.

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July 19, 2008

They have capped the trach around the clock as of this morning. He is tolerating it well. This is the last step before having it removed permanently, which should be some time after 48 hours if he continues to tolerate it. I'll update later if something new happens.

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NOTE: The red text in the paragraph above is a correction from last night's posting. I originally stated that it would be awhile before they removed the trach permanently.

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July 20, 2008

Matthew continues to tolerate the trach being cuffed. He did have some break through pain last night, but his pain patch was due to be changed today and he's been fine today.

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Tomorrow, they should start the Ritalin and hopefully we will find out more about his knee.

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I have changed the blog format a little, hope everyone likes it. From now on I will be posting through the week and each week will be archived. You will notice to the right of the screen where it says Blog Archives. If you want to read older posts, just click on the Blog Archives and the week you want to view or you can go to the end of the current posting and click on older blogs. Hope you enjoy the new look. Later...