One morning he reached for Jorge's hand and then reached for mine. He squeezed them and brought each hand over his shoulder. We watched in amazement and cried of joy. He listened attentively to Jorge conversing or singing to him, he focused watching TV or grabbed his grandmother Mama Aby’s hands and smiled. The way he looked at me was different. I could see him. We wondered if he recognized who we were. We asked him to blink his eyes once for yes and twice for no. At times it felt we were really communicating with David and this breakthrough encouraged us to continue playing music, showing him pictures of family and friends; we talked about his business, his job and of places he had been. Having learned that memory almost always is impaired by a brain injury we incorporated activities to build up his memory.
By the fourth week, David was able to stay awake a total of 10 hours. Several events were quickly being introduced such as a feeding tube, which was surgically placed into his stomach through the abdominal wall. “Brain injury frequently affects the skilled coordination of the nerves and 26 different muscles in the neck and esophagus that are used during the normal swallowing process” (www.calder.med.miami.edu). We were becoming more and more aware of so many aspects of our lives we took for granted – lifting a finger, blinking our eyes, swallowing, breathing, coughing and how much our brain controls just about everything we do.
Marla, the speech therapist, ordered to change the tracheotomy tube to a smaller one appropriate for a patient being considered as a candidate to eat and speak which meant a step up for David. Up to this point he had only been given lemon flavored glycerin swab sticks to increase his mouth sensory awareness and moisten his lips. He became a big fan of these lemon swabs to the point that we had to watch him of not biting them out of the sticks to try to swallow them as he did one time to a CNA intern who almost had a heart attack struggling to get the swab out of David’s mouth.
It is also common for traumatic brain injury survivors to have one or more of their senses altered after the injury. Appetite can be affected as well. David had lost over 40 pounds in 4 weeks. We were certain he missed eating. David always enjoyed a good meal. He had his favorite spots for fried calamari, a good piece of steak, empanada or a typical Miami coffee “colada”.
On Tuesday, June 7th our daughter Ana Carolina came to the hospital with fun news. As roommates, David and her would visit “The Sandwich King” cafeteria for their breakfast and coffee colada before they each would go to work or school and on Saturdays for their famous “parrillada” or cookout grills. David would order a sandwich he invented and would encourage other patrons to try it, which always obtained so many praises on how delicious it was. The owners and the attendants had developed a real camaraderie with David throughout the years and the sandwich became their special connection. After learning of David’s accident, the cafeteria owners, Lily and Gustavo decided to add a new item to their menu and the “David Arroyo Sandwich” was born. It became a favorite of family and friends and word has it that it also turn out to be a best seller.