I continued to keep a journal of every development in David’s daily routine. The withdrawal of medications can be challenging so; I knew documenting reactions and changes would be valuable.
David was on 13 different medications to attend his respiratory and digestive system, for Parkinson and blood pressure, stimulants, depressants, muscle relaxants, anticoagulant, antibiotics, antacids and eye drops. All these were administered through the feeding tube. The concern of side effects and problems with the metabolism was always present. Some of the effects included hallucinations, agitation, confusion, nausea, seizures and restlessness. One of the medications with sedative properties was Baclofen to treat muscle spasms or spasticity. Spasticity is a muscle control disorder that is characterized by tight or stiff muscles and an inability to control those muscles (http://www.webmd.com/pain-management/pain-management-spasticity). A few possible side effects of Baclofen were drowsiness, dizziness and muscle weakness. I wondered how I would discern if David would be experiencing any of these effects because of the medications he was taking or because of the brain injury. I questioned if these medications would delay his mental alertness and cognitive improvement.
David would take long naps during the day. We also learned that after a Traumatic brain injury, many injured sleep an unusually long amount of time as the brain is trying to heal from the injury. Sleep is important because it helps in the rehabilitation process. (http://www.traumaticbraininjury.net/sleep-disturbances-and-tbi/) During sleep, muscles and soft tissues heal, scar tissue develops and the brain and body recharge.
Proper sleep follows regular and predictable rhythm cycles. When we sleep, our brain sets down memories and refreshes various connections that allow it to work. Quality sleep helps us think more clearly, be more alert, and function at our best in all areas: mental, physical, and emotional. It is also possible, especially after a serious injury, that the brain’s electrical rhythms be disrupted. As the brain and body heal from injuries, sleep patterns may become more normal. (https://healthonline.washington.edu/document/health_online/pdf/Sleep_Problems_Brain_Injury_11_08.pdf)
Proper sleep follows regular and predictable rhythm cycles. When we sleep, our brain sets down memories and refreshes various connections that allow it to work. Quality sleep helps us think more clearly, be more alert, and function at our best in all areas: mental, physical, and emotional. It is also possible, especially after a serious injury, that the brain’s electrical rhythms be disrupted. As the brain and body heal from injuries, sleep patterns may become more normal. (https://healthonline.washington.edu/document/health_online/pdf/Sleep_Problems_Brain_Injury_11_08.pdf)
When breakfast, lunch or dinner was delivered to the room, David would be wide-awake. We knew he had not lost his sense of smell. Because of his injury, David received his nutrition through a feeding tube because it was considered unsafe for him to consume anything orally. 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.
Therapy is necessary to rebuild the patients’ swallowing ability. (http://calder.med.miami.edu/pointis/tbifam/swal2.html).
Once in a while we would hold a piece of ice so he could practice swallowing. I would roll the curtains so that he wouldn’t have to watch his roommates eat.
Great and new happenings occurred during the following week. David moved his right hand and foot, which had not been active at all. His Physical Therapist, Julissa took him to stand up for the first time. He became more vocal with the Aaaaaah. He worked on puzzles with Gaby and mimicked her by shaping his mouth to try and vocal the O. Sue and Alex came to visit and Tio Mayito and Tia Tere came from Puerto Rico to spend time with us.
Therapy is necessary to rebuild the patients’ swallowing ability. (http://calder.med.miami.edu/pointis/tbifam/swal2.html).
Once in a while we would hold a piece of ice so he could practice swallowing. I would roll the curtains so that he wouldn’t have to watch his roommates eat.
Great and new happenings occurred during the following week. David moved his right hand and foot, which had not been active at all. His Physical Therapist, Julissa took him to stand up for the first time. He became more vocal with the Aaaaaah. He worked on puzzles with Gaby and mimicked her by shaping his mouth to try and vocal the O. Sue and Alex came to visit and Tio Mayito and Tia Tere came from Puerto Rico to spend time with us.
Tio Mayito visited from Puerto Rico.
We taught and prayed the Divine Mercy chaplet with his roommates Don Carlos and Stucky. He moved his tongue from side to side, which meant a step towards speech therapy and swallowing training. We were to expect a call regarding the removal of the tracheotomy tubes, which was the other important step on the way to eating real food. He had his first shower.
An important highlight that week was the visit of his barber Ziad who David always visited every two weeks. Zi gave him his first official haircut and spent time showing David some pictures of them together. It was great having him over.
An important highlight that week was the visit of his barber Ziad who David always visited every two weeks. Zi gave him his first official haircut and spent time showing David some pictures of them together. It was great having him over.
Zi came to give him a haircut.
One afternoon Eddie & Jorge spent the day with David and Ana Carolina kidnapped me for the day. We went grocery shopping and went to her apartment. She had me watching TV enjoying some sushi as an appetizer, while she cooked sirloin, mash, mac/cheese & asparagus. It was great.
As we worked through the introduction of new experiences and the visit of loved ones, we looked forward to important events that would happen during the following weeks; especially the possibility of the tracheotomy removal, which was being seriously considered.
At the end of that week, I had a dream about the trach tube falling off. The next morning I found him with a new trach tube. It was as if we were especially connected. I prayed that removing the tube would be the next doctor’s orders. We would wait and see.
| Waiting with patience and embracing the love of family and friends made our days joyful and peaceful. We knew we were moving in the right direction. |  |
RSS Feed