Our days now included the meal schedules. David was placed on a soft diet such as applesauce, yogurt, thickened water, gelatin, etc. He would gradually be introduced to puree and then solids. I fed him every meal and monitored that he would swallow every bite. One time, his right cheek got swollen and we figured it had been an allergy reaction to possibly pineapple and was relieved when it subsided. He was handling the food so well that was upgraded to puree in no time.
The hardest task was convincing Eddy that David wasn’t ready for a “Malta” and chicken empanada or the ham croquettes which Ana Carolina would bring him from “la cafeteria – The Sandwich King”. The only outside food that got the approval was the “flan” that Jorge insisted he had to have when he was in town. We all hoped that David would continue to improve so that he could enjoy the traditional holiday thanksgiving dinner, which was approaching quickly.
During this time, the Psychiatrist stopped 2 prescriptions including one that is prescribed for Parkinson, which could cause hallucinations. We were moving forward.
During this time, the Psychiatrist stopped 2 prescriptions including one that is prescribed for Parkinson, which could cause hallucinations. We were moving forward.
Family and special friends visited and brought the joy, the stories and special treats. My sister Noemy and brother in law Hector would bring me delicious lunch and coffee and a tray of special treats for the nursing staff when they were visiting. As it was their tradition, they would coordinate and gather all the children, aunts and cousins to have dinner together at favorite spots in the area.
Other special family visits such as Uncle Mayito and Tia Tere, Uncle Ruben, Manny and Aunt Flor would witness the constant progress.
As we celebrated that my sister Gaby would be close to us as she settled in from Orlando to her new place, about 20 minutes away from Miami, it broke our hearts to say goodbye to CNA Norma who was leaving the nursing home. It was a roller-coaster of emotions. We felt so blessed surrounded by so many beautiful people who helped us in our journey.
One afternoon, as I returned from a coffee brake to watch David in the physical therapy room, therapists Julissa and Harold mentioned that David had been fighting with them and explained that confusion and agitation was part of the recovery process from a severe TBI.
Agitation after TBI is an excessive global psychomotor activity, inappropriate to the environment, and may be a manifestation of delirium but frequently exists independently of it. It occurs in up to 70% of TBI patients and it often stems from disorientation and over stimulation. It can be very challenging to manage these agitation episodes. Because it may result in physical harm to the patient, it becomes very stressful for everyone involved. Before medicating an agitated TBI patient, efforts are made to eliminate over stimulation such as limiting visitors, limit lighting and in extreme cases - physically restraining the patient if necessary. After an episode, which can last a few minutes to a few hours, the TBI patient becomes exhausted.
The next morning, as I was feeding breakfast to David, he started yelling. He was having an agitation episode. It became frightening and frustrating. He still had food in his mouth and I quickly removed it hoping he wouldn’t close his mouth and bite me or choke on it. He kept yelling and moving in his bed. I tried to hold him to offer comfort but all of his body was shaking and moving. It was hard to watch him battle this agitation episode on his own. I knew I had to wait it out with him.
Ana Carolina came in a few minutes later and saw my agony. She insisted I leave him with her for the rest of the day so I could get some rest at her place. Nurse Rose came in and insisted on Ana’s proposal and I left. I prayed and cried all the way back to the apartment. There was no room for setbacks. I kept asking myself how long would the agitation phase last and what would be the ramifications? Masses were being offered. People who had not prayed in years were now doing so for David. We were not alone. For the next few weeks, I would just sit next to him and hold his hand - when it was possible - and waited for it to stop. It reminded me of the storming episodes back at the hospital. They finally became less frequent and then one day it ended.
One afternoon, as I returned from a coffee brake to watch David in the physical therapy room, therapists Julissa and Harold mentioned that David had been fighting with them and explained that confusion and agitation was part of the recovery process from a severe TBI.
Agitation after TBI is an excessive global psychomotor activity, inappropriate to the environment, and may be a manifestation of delirium but frequently exists independently of it. It occurs in up to 70% of TBI patients and it often stems from disorientation and over stimulation. It can be very challenging to manage these agitation episodes. Because it may result in physical harm to the patient, it becomes very stressful for everyone involved. Before medicating an agitated TBI patient, efforts are made to eliminate over stimulation such as limiting visitors, limit lighting and in extreme cases - physically restraining the patient if necessary. After an episode, which can last a few minutes to a few hours, the TBI patient becomes exhausted.
The next morning, as I was feeding breakfast to David, he started yelling. He was having an agitation episode. It became frightening and frustrating. He still had food in his mouth and I quickly removed it hoping he wouldn’t close his mouth and bite me or choke on it. He kept yelling and moving in his bed. I tried to hold him to offer comfort but all of his body was shaking and moving. It was hard to watch him battle this agitation episode on his own. I knew I had to wait it out with him.
Ana Carolina came in a few minutes later and saw my agony. She insisted I leave him with her for the rest of the day so I could get some rest at her place. Nurse Rose came in and insisted on Ana’s proposal and I left. I prayed and cried all the way back to the apartment. There was no room for setbacks. I kept asking myself how long would the agitation phase last and what would be the ramifications? Masses were being offered. People who had not prayed in years were now doing so for David. We were not alone. For the next few weeks, I would just sit next to him and hold his hand - when it was possible - and waited for it to stop. It reminded me of the storming episodes back at the hospital. They finally became less frequent and then one day it ended.
A few nights later, as I prayed for God's will to be done, an overpowering emotion of us moving back home soon - got a hold of me. I knew God was in charge and because he makes every - and any plan perfect, I would wait for the signs and not become anxious.
David started moving the right leg more often. The removal of the feeding tube was being considered as he continued to tolerate the food and kept gaining weight.
Now that David was eating, I learned he was able to travel out of the nursing home to the mall, a park or anywhere we wanted with a special permission. I arranged a visit to the transportation office to get the paperwork and David’s ID in order to do so. I was thrilled just imagining how he would react. Our first trip would be to Eddy and Ana’s apartment and then probably to church. He would like that.
The physical therapy sessions became very productive. David could follow all the commands, such as moving his trunk forward and backwards as they requested. Stacy, the speech therapist took David on a date to the vending machine so that he would count the amount of money he needed to buy a chocolate chip cupcake and an orange soda as part of his cognitive therapy and food texture upgrade. He enjoyed every minute of it.
David started moving the right leg more often. The removal of the feeding tube was being considered as he continued to tolerate the food and kept gaining weight.
Now that David was eating, I learned he was able to travel out of the nursing home to the mall, a park or anywhere we wanted with a special permission. I arranged a visit to the transportation office to get the paperwork and David’s ID in order to do so. I was thrilled just imagining how he would react. Our first trip would be to Eddy and Ana’s apartment and then probably to church. He would like that.
The physical therapy sessions became very productive. David could follow all the commands, such as moving his trunk forward and backwards as they requested. Stacy, the speech therapist took David on a date to the vending machine so that he would count the amount of money he needed to buy a chocolate chip cupcake and an orange soda as part of his cognitive therapy and food texture upgrade. He enjoyed every minute of it.
One afternoon, as we waited outside on the sidewalk for the transportation van to pick us up, after a visit to David’s primary physician’s office, a young man named Raul passed in front of us on his bicycle. All of a sudden he turned around and proceeded to tell us that the Holy Spirit had asked him to turn around and pray for David. The prayer was so powerful that it had to have been guided by the Holy Spirit. He then mentioned that David would walk and talk and left. Not even 2 minutes later a gentleman passed us by and as he blessed David he said that David would be OK. The Lord was speaking to us. We were not alone.
John came to watch B-Boy videos with David. Hector Luis and John came to see David and watched B-boy videos with him. Before leaving, Hector Luis placed his watch on David’s arm. David loved watches so we knew this was a positive stimuli. He kept staring at the watch until he fell asleep that night.
The following evening I went to a healing prayer at church. It was powerful. The message was about the Lord’s promise to take care of our children and that He is always with us.
The following evening I went to a healing prayer at church. It was powerful. The message was about the Lord’s promise to take care of our children and that He is always with us.
We all have days full of sorrows and distress. We can choose to allow these moments to twist us into darkness and burden others around us or choose to allow God to give us the fortitude to serve others so that His Love can dwell in us. All we have to do is ask. He will never forsake us.
(Isaiah 41:10; Deuteronomy 31:8; Matthew 28:20)
(Isaiah 41:10; Deuteronomy 31:8; Matthew 28:20)
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