During this time, the Psychiatrist stopped 2 prescriptions including one that is prescribed for Parkinson, which could cause hallucinations. We were moving forward.
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.
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.
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.
(Isaiah 41:10; Deuteronomy 31:8; Matthew 28:20)