Thursday, December 27, 2007

Vision

Hello. My vision has been off since the accident, I am seeing double and my left eye also rotates one of the images. Seeing the eye doc who is placing the blame on my 3rd and 4th cranial nerve - and he will make me a left eyeglass prism that may help my extraocular muscle retrain to not rotate. I have also been somewhat self critical and my shrink told me that is quite common for brain injured patients to get self-critical so he advised me to "TEFLON-IZE" MYSELF - to get tougher during the challenging recovery. Those reading who know me well know what a self critic I am so this is a challenging time for me and my therapists are finding out the hard way! Take care and happy 2008! Marilyn

Tuesday, December 25, 2007

Wisdom

Merry Xmas! Just watched Bob Marley documentary -(thanks Sarah!) it was very good and I am inspired to read his biography again. Dealing with the moods that go with brain injury : cranky, frustrated; also trying to come up with a good plan for when I am discharged which is in 2 weeks.
"You give your more
To receive your less." Bob Marley




Marilyn

Monday, December 24, 2007

Impatient Inpatient Twilight

We are nearing the end of Marilyn's inpatient stay at Craig. The latest date we have heard pushes her discharge back a bit and is now January 8. There are dozens of goals for the next 2 weeks, with the obvious and biggest goal being to leave the wheelchair behind. Today Marilyn spent most of the day doing just that - walking to all her classes and therapy sessions. Our vision of her being back in Dolores soon is fading as we are beginning to realize that her outpatient therapy needs (at least in the short term) would be best served by doing them right here at Craig. So - we have much to figure out in the days and weeks to come. As always the doctors, therapists and staff here are extremely helpful and we feel whatever the decision reached, it will be a sound one.

Tuesday, December 18, 2007

Recommended Reading and Folding Clothes

I just finished 'Over My Head' by Dr. Claudia L. Osborn, recommended to me by Marilyn's friend, Melissa. (Easy to find on Amazon.com) It tells the story of a Physicians struggles following a traumatic brain injury resulting from a bike accident. While her recovery journey was much different than Marilyn's appears to be, this book does an extraordinary job of describing what is going on from the point of view of the brain injured person. The perspective on being a medical professional with TBI is especially poignant. Reading it was often excruciating for me in the midst of Marilyn's early recovery and because it describes so many challenges on the cognitive front - many of which Marilyn thankfully seems to be bypassing and many of which she has yet to confront. This book has helped me come to terms with the fact that this accident will net a changed, but not lesser Marilyn. (No more waiting for the "old" Marilyn to come back.) That change may be less evident externally as time goes by but that change will be very evident for her. To be clear - when I say change, I mean change as in all we experience in life produces change. Profound experiences or events produce profound change. So, I urge you to read this book (or about TBI in general), particularly those of you who will be around her when she returns to Dolores.

On another note - Marilyn insisted on and successfully folded her clothes Sunday night before I left for the week.

“The determination to win is the better part of winning.”~Daisaku Ikeda

Saturday, December 15, 2007

Pictures from Ecuador

As many of you know, Marlyn has had no recollection of our short trip to Ecuador. In fact, she has had no recollection of ever planning the trip, let alone going there. The closest memory preceding her accident that we could trace was putting gear in our newly built shed two nights before we left.

Yesterday, I finally got around to showing Marilyn the few pictures we took in Ecuador. At first they were nothing but pictures to her. Then suddenly, a trigger. There was a picture of a vary modern glass building in a park we had visited above the city of Quito. She remembered the building and then, more memories came flooding back.
As we looked at the pictures from Vilcabamba, where she was hurt, she recalled the place we stayed there - even the layout of the hotel grounds.

Of course, this is scary and encouraging, all in one. I hope she never remembers the accident but I am glad that she is piecing more and more things together leading up to it.

Friday, December 14, 2007

Psychologically Challenged

I'm still here and living through the psychological challenges of having a brain injury: my left side not working and my brain being somewhat different in terms of its cognitive functioning lately. We have moved into a new room on the East side which gives us more freedom and responsibility and I am still working on relearning to walk and it is coming along still according to schedule. I did get upset earlier in the week because I was trying to fold my clean laundry and since my left side is so weak, I was not able to fold. That was really hard for me to get through and incredibly frustrating about this injury. We did have a team meeting and I was told these frustrations are part of recovery from my injury - my prognosis is that full recovery may be up to 2 years. we'll see. bye everyone!

Tuesday, December 11, 2007

Alison's Post

I thought Alison's comment from the last post was so good that I have copied it over as a new post.

Gareth

Hi Mar and everyone, I just talked with Mar tonight who sounds great!! Mar, your voice is really sounding like yourself again. It's so cool! Mar was busy packing to move to Craig's East Wing tomorrow, which will give her a lot more privacy and freedom, and has a kitchenette. And Mar's new discharge date is Jan 4--this is moved up, so obviously the doctors see how fast Mar is improving--very exciting!! Mar was writing with her left hand, slowly but legibly, and walking and tackling stairs, with a little assistance. She and Gareth visited Gareth's parents, and with Gareth's help, Mar left her wheelchair in the car. They also went to a Broncos game, complete with Vandy quarterback Jay Cutler. As it turns out, one of Mar's doctors works with the Broncos, and will see if Jay can come visit Mar.

There's still a journey before us, but as the Beatles say, "It's getting better all the time"

Love, Alison

Wednesday, December 5, 2007

Counting..

We've now reached 3 months since Marilyn's accident and are in week 5 at Craig hospital, with another 5 to go. Once we get back home there will be 3-4 months of outpatient therapy. We are both beginning to realize the subtleties of "full recovery". No doubt Marilyn will get back to work and be fully active again. But I know that I (and to a degree she) had the idea in the back of our heads that recovery meant it would be like this all never happened. Recovery means readjustment on all fronts - a new and very different life is unfolding before us. Marilyn has approached each day with an incredibly positive attitude and many smiles, rarely expressing frustration. She exists with calm and focus in the moment. Perhaps that is a blessed side effect of the injury. Regardless, it is what grounded me when I become flooded with too many 'what if's and how are 'we going to's. We press forward with happiness and determination. Each day is a better day.
Gareth

Monday, December 3, 2007

My Weekend

Hello again! Since I last wrote I got a good and long night's sleep (and some much deserved and needed rest) only to wake up and start Physical Therapy where I walked up and down a staircase with my therapist and Gareth helping in preparation for the holidays when I hope to be doing that with only Gareth helping. I hope you are all getting prepared for the upcoming holidays as well as we are!
We`had a great weekend going to the museum on Saturday with Eric, Alison, Eddie (a 1 year old baby who I am trying to beat in our walking contest), Chris and Alex, then stopping on Sunday morning for breakfast at the IHop with Bill Hatcher, Chris and Alex before Gareth and I went to his parent's home in Golden for the Broncos game and to see the doggies!
I hope you can tell I am silly but not stupid. My brain may have been traumatized but it came out unaffected in terms of its intelligence!

I hope to see everyone soon! Bye y'all!
Marilyn

Saturday, December 1, 2007

One month at Craig

Wednesday night we went to an Italian restaurant near the hospital. It was really good and we went even though I'm still in a wheelchair. The night was cold. As it turned out it was kind of the night that started the weekend because on Thursday night, my friend from college Alison arrived with her husband Eric and their son Eddie who is only one year old. Eddie is one of the coolest babies we've hung out with. In a way he reminded me of myself because like Eddie, I am learning how to walk and use my left hand and left leg. In fact, I am relearning everything that I learned as a child. It was good to see Chuck and MB who visited on Friday. It was good hearing about Dolores happenings. Chuck and MB joked with us about how all their friends are younger. Chris and Alex were here today. We all went to the Denver Museum of Nature and Science because Eric wanted to see the exhibit on Colorado rocks and minerals. We learned that aquamarine is found on Mount Antero. Alison, Eric and Eddie had to leave and it was hard to say goodbye but we stayed with Chris and Alex and had dinner at a local Thai restaurant. They told us all about their vacation. Tomorrow we are going to Golden and see our dogs and Gareth's parents and Jay Cutler. Next weekend we might go to a Bronco game with the hospital bus. Don't get stuck in the snow Dolores folks. Think of me when you ski! Take care,
Marilyn

Tuesday, November 27, 2007

Marilyn's update - 11/27/07

Lately I've been learning the ins and outs of the therapy professions, including physical, speech and occupational. My schedule stays booked everyday with these therapies leaving me tired in the evening. I am still having trouble with the left side of my body but it is getting better. I am working on walking and that is rewarding. I hope in the next couple weeks I'll be thinking more clearly. The speech therapists are constantly testing my critical thinking skills. Gareth is here helping me with everything. Hopefully it will all pay off soon so we can make it back to Dolores and see everybody. I went to Gareth's parents house on Sunday and got to spend a day away from the hospital which was a good experience. It's been good to read about everybody's support and I appreciate that.

Love to you all,
Marilyn

Monday, November 26, 2007

A Day at Craig

Every weekday at Craig offers a full schedule of therapies geared towards each patient's challenges and current abilities. Marilyn's head continues to "clear" and she is getting better and better at dealing with day to day routine. Additonally, her left side gets stronger every day. Here's an example of Marilyn's schedule this week.

7:30am - Wake up, order breakfast and eat.
8:30am - Occupational therapist arrives - pick clothes for the day (without forgetting every item you are supposed to wear and change into them despite a weak left side).
Wash face, comb hair, brush teeth.
9:00am - Propel wheel chair with feet to Orientation class. Review what day it is, read daily news articles, practice memory assignments.
9:30am - Go to Physical Therapy. Extensive mat exercises, balance ball workout, practice walking and left leg stability.
10:30 - Go to Occupational therapy - work on left arm and left hand strength, fine motor coordination.
11:00 - Wheel down to Speech Therapy office, practice visual recall, mental organization, memory retention.
11:30 - Lunch, practice eating with left hand.
1:00 - Pedal stationary bike.
1:30 - Work on jigsaw puzzle.
2:00- Mat class, yoga and stretches geared towards individuals current physical ability.
3:00 - Speech therapy, round 2.
3:30 - Meet with neuropsychologist.

When not in class or in therapy, Marilyn and I practice a lot. Today she sucessfully tried writing with her left (dominant) hand for the first time. We practiced eye exercises to help bring her left eye in line with the right. (She currently has double vision but glasses with tape over part of the lens of the left side alleviate this.) At dinner, we practice eating with her left hand. She constantly works out her left arm and today broke all records by lifting it and extending it fully above her head. Our conversations consistently integrate the skills we have both learned to help her organize her thinking and improve her short term memory.

As Marilyn continues to improve, the days will become more full and challenging and the therapy will continue to be adjusted to her increasing abilities. All toward the goal of bringing back the Marilyn that was before the accident.

Friday, November 16, 2007


To EVERYONE that is a part of the big benefit music festival for Marilyn:

Hi! I hope you all have fun. Thanks for thinking of me. I'm trying to recover so I can dance with all of you next time.

Love,
Marilyn
(as transcribed by Gareth)

Wednesday, November 14, 2007

The BIG update

Today we had our first conference with Marilyn's nurses, therapists and doctors. I wanted to give you all an overdue and a very thorough update on everything. First, Marilyn's current condition. Keep in mind this changes almost daily.

On the physical front she is regaining strength in her left leg. Her PT is rigorous in this area - building her core and walking mechanisms. Yesterday, she walked the parallel bars. With help but nevertheless she walked them - twice. She is particularly focused, diligent and driven on the PT front. The OT therapist is focusing on her left arm and left hand. Currently she can lift and move the arm slowly, open and close her hand, grab and drop objects and initiate finer motor function like touching her thumb to each finger. OT also is helping with her left eye nerve damage. Her vision is getting clearer, tracking is much stronger and the dilation is beginning to subside. Depending on how this heals she may have some double vision along the way. Speech Therapy focuses on her mental function. She speaks clearly and with great insight. Her challenges are short term memory and recall and her attention span. These are all improving and she will be moving into reasoning and problem solving soon. To get an idea of where her head is, imagine being given a step by step puzzle. The steps are initially easy to follow, but halfway through you forget the goal of the puzzle. Towards the end things get fuzzy and you become fatigued - so much so that you struggle to complete the puzzle. Further, she often is unable to locate the correct word to describe or identify something. Her range of emotion and expressiveness exists and a great deal of Marilyn's personality is there, but she is "flatter" than that of a person without a brain injury. She constantly struggles with extreme fatigue adding to the challenge of all her therapies. This is the fog of a brain injury - periods of blissful, unworried happiness, bouts of frustration and confusion, and overwhelming tiredness.

Here is a summary of her injuries and medical prognosis. The fall she took basically shook and twisted her brain inside her skull. The front of her brain which stores all her knowledge sustained little damage. The mid portion or relay portion of her brain did sustain significant damage. The "long wire" connections challenge her speech and memory pathways. The relay connections challenge her left side. The left eye is a symptom of nerve damage. It will resolve in three phases: the eyelid will stop being droopy, the eye will track correctly, and finally the dilation will subside. The other major thing that happened in the fall were fractures of the C2 and C7. These caused dissections or kinks of the right vertebral artery. This area had the potential to be a devastating injury and in her doctor's words it is somewhat of a miracle that it wasn't. I couldn't agree more. To treat this injury she has been on a course of various blood thinners to avoid clots and seizures. This has been an apparently tricky area for her doctors but they appear to have things resolved. Long term treatment will be to cut out the blood thinning drugs, switch to a baby aspirin per day and then even drop that. She will need to wear a C-collar until early January.

Finally, speaking of dates. Marilyn's discharge date will be January 18. This is by no means set in stone and I suspect Marilyn will trump this date, but there is also no reason to short her the OUTSTANDING therapy offered here at Craig. Their goal is to have her WALK out of the hospital physically and mentally prepared for a return to life in the real world. Following her return home, she will need 3-4 months of outpatient therapy to further her healing. It will likely be even longer until she can work again but, I fully expect the Marilyn we all knew back 110%. That eclipses the headache of any medical bill. It's all just a matter of time.

Sunday, November 11, 2007

Starting to Remember

Beginning with our visit from Steve, Alicia, Melissa and Sarah, Marilyn is remembering the recent past. This is a very good sign, because it means the fog is beginning to clear. We both wish things would go faster, but we also know we have to be patient and work hard together. We both just had big smiles reading your comments following Marilyn's post. Today we'll spend some time outside and watching the Bronco game. Hopefully they can win one.

Cutler - 27 Chiefs - 11

Thursday, November 8, 2007

Marilyn's First Post

Hi all -

I am about to dictate Marilyn's first blog post.

Gareth

Hi everyone! Thank you for checking on me. My brain isn't quite working yet. I'll keep you posted. Gotta go. I'm tired.

Love,
Marilyn

Friday, November 2, 2007

In a week's time..

An extraordinary week has gone by. Last Friday, the 26th of October Marilyn was finally well enough to begin eating pureed food with assistance. Today we sat at a table and she ate regular food next to me on her own, no assistance. Last Friday she would generally only speak if someone called on the phone or if a nurse or therapist made her angry. Verbalization in itself, was clearly a struggle for her. Today she spoke most of the day asking questions about her injury and weakness on the left, telling us about her confusion, answering questions for each therapist. In short, coming back to life. We are excited to be at Craig Hospital- and not a day too late, given her progress this week. It is a very special place with a strong aura that immediately lets you know that good things happen here. She will excel here.

Tuesday, October 30, 2007

Tuesday October 30

Things are continuing to progress well. The main thing that strikes me, is how many steps that I didn't even think about being there, that are there. All the basic things we take for granted in our daily life are huge challenges for Marilyn to overcome. When we break a bone we stabilize it and wait for it to heal, but a traumatic head injury requires healing and so much work on the part of the individual. All this makes the road home seem very long but each day I see Marilyn getting better is one day closer.

Thursday, October 25, 2007

Thursday October 25


Marilyn is in the first stages of gaining some speech and some movement on her left side. These are great signs as we continue down the long road ahead. Thanks to everyone for everything that has given us the STRENGTH to move through these first 3 weeks.

Monday, October 22, 2007

Monday 10/22 - Turning a Corner

Over the weekend Marilyn has woken up. She is now awake at least 80% of the day and very aware of her surroundings and the people around her. So - I think I can officially say we have turned a corner! That makes this week especially big with lots of evaluation by rehab and neuro docs to figure out what is going on with speech and especially with her left side. She and I will be working hard. Keep sending the energy, we are on the way...

Friday, October 19, 2007

Friday 10/19 update



Our first week at Kindred is drawing to an end. I've gained a good perspective on what we face in weeks and months to come. First, there really isn't a dramatic "wake-up" from an injury like this. Progress is incremental, often subtle and slow. Challenges are maintaining Marilyn's health while getting her plenty of rehab therapy. I am comfortable that is happening here, although I am sure I've been a bit of a pain in the neck to the caregivers.

Overall - she is trying to break through. Good signs include: chewing and swallowing ice, yawning, holding a brush and taking it to her hair, holding a toothbrush and taking it to her mouth, tossing a ball at me, snapping her fingers, spending part of each day in a special chair and even going outside, trying to speak on the phone, opening her mouth and sticking out her tongue so I could brush her teeth, turning on the TV with the remote and changing channels and more. I hope for more wake up time, speaking and revival of her left side in time.

I've found some good sources for understanding what is going on with Marilyn that I will share with you. First the Rancho Los Amigos scale lines out the general stages of brain injury recovery: http://www.rancho.org/patient_education/bi_cognition.pdf. Also the Craig Hospital website (Marilyn's next stop) provides many educational resources here. http://www.craighospital.org/TBI/HealthandWellness.asp

Monday, October 15, 2007

Slowly but surely

Just a quick note to let everyone know that Marilyn is showing sign after sign of her strength. Her waking periods are more and more lucid and active and I am confident that she absolutely knows who is around her and where she is. She has begun regular therapy too. Our goal this week is to establish a routine, both for her and myself. It is easy to get impatient and wish that she would fully wake up and start speaking - but it is a slow process. She is trying so hard to break through and I believe that she is going to blow us all away..

Also - I want everyone to know that Marilyn and I hear your collective voices. For different reasons, we can't always respond, but your energy is felt. Thank you, it means so much.

Gareth

Sunday, October 14, 2007

Looking back and moving forward


words and photos by Bill Hatcher
Hi All, When I went to visit Marilyn and Gareth last week at University hospital I made some photos. These photos are from the first days in the ICU. Marilyn's room was decorated with many photos including her high school graduating class and her adventures with Gareth as well as her life and travels with her adorable dogs from Vanderbilt to Colorado.



When Marilyn first opened her eyes Gareth was at her side and she was surrounded by family and friends. But there was much work to be done to help Marilyn and to deal with the myriad of details of Marilyn and Gareths new world.
A communications post was set up just outside the ICU to field calls, meet with visitors as well as to begin this blog.

We kept busy contacting Marilyn's friends, Marilyn's Mom and Dad, who were at Marilyn's side through all of this, were a great help in contacting friends from Marilyn's high school and college days. We also received many calls from friends and family. Gareth, when he was not at Marilyns side, was on the phone. In the first few days there were hundreds of calls made and received. Gareth often had to make calls from the hallway since reception inside the ICU was poor.

The first few days in the ICU were so stressful as Marilyn's condition was being assessed. Each hour in the ICU would bring new news from the excellent team of doctors and nurses working with Marilyn. I watched as friends and family talked to Marilyn. When she had the strength she seemed to try and comfort them with a smile or hand movement. My three days in the ICU went by so fast it seems a blur.

Marilyn is now out of the ICU and in rehab. Her injuries are healing and her progress is positive. She is taking strong steps toward fully waking up. Her recovery will require time and plenty of love and care from her friends. Thank you all who have visited Marilyn and have reached out to help Marilyn. That kind of love has no measure in the degree it helps Marilyn in her recovery.





Bill

Saturday, October 13, 2007

About Marilyn

I thought I'd add a post that tells all about Marilyn - the extraordinary person that we all want back with us. So this is a little story of who Marilyn is - please add your own on this post.

I met Marilyn about 7 years ago when she moved to Dolores. She moved there to work for Indian Health Services at the Shiprock Hospital as a Nurse Practitioner. Marilyn has a passion for cardiology and she eventually spent two years in Chinle, AZ working on a cardiology study on the Navajo. She graduated from Vanderbilt - a fact that she is very proud of, a truly academic background. In the realm of family practice she worked for Valley Wide Health in Durango and Mancos and now works at our own Dolores Medical Center. The thing that has always struck me about her is her diligence in really taking great care of people. She analyzes and thinks through every diagnosis - never making assumptions. She uses her knowledge and seeks additional knowledge to do her very best for people every day.

A Nurse Practitioner is an advanced care giver. Marilyn has the knowledge and legal authority to make referalls, prescribe medication - in short make most of the decisions a doctor would with the advantage of being able to spend time with each patient. So that's the work skill side of Marilyn.

I won't wax poetic here about our nearly 4 years together, how wonderful she is (she is) etc. Suffice it to say that Marilyn has stood by me strongly and consistently. We're going to bring her back 100%. I'm excited to read your stories and impressions of Marilyn. I'll keep reading all the posts on this blog to her too.

Friday, October 12, 2007

Signs


This afternoon and early evening Marilyn woke up a few times. This evening, she gave us two big signs. First, the nurse asked if she was in pain. Marilyn shook her head , no. Then we gave her a pen and a pad (right hand, Marilyn is left handed) and asked her to write her name. She scribbled for a moment and then clearly wrote an "M".

We've moved..

Today we moved to Kindred Hospital..note address at right. Marilyn is comfortable, well cared for and okay. She has not woken up but when she opens her eye (left eye doesn't open well right now) she tracks, looks at what we show her and seems to understand. More later...

Thursday, October 11, 2007

Left Side

One area of recovery that I am getting some conflicting info on is how much Marilyn's left side will recover. Currently she can feel on that side but her ability to move is very minimal. This is all associated with the brain stem bruising. OT and PT will tell more in weeks to come, but please send your energy to her LEFT SIDE.

Wednesday, October 10, 2007

Wednesday October 10th

Marilyn has been moved from ICU to a regular room in the neurology wing of the hospital - note the address update at right. She is still not awake, but her track is generally upward. She also has been accepted at Craig Rehabilitation Hospital, which happens to be one, if not the best hospital of this type in the country. As the waiting list is long, we will likely be moving in the interim to a rehab hospital called Kindred Hospital which shares doctors with Craig...Much more on this to come as lots is still up in the air..

Tuesday, October 9, 2007

Tuesday October 9 update


On the right I have added our family and friends who have been by our side and visiting since our arrival in Denver. Thanks to them, Marilyn has not been on her own at anytime - always someone by her side. The list is ever growing, bringing Marilyn strength and healing each day.



Marilyn has not woken up but she remains responsive to the various stimuli around her. The hospital already has OT's , PT's, and Speech Pathologists working with her and she has done quite well, although she seems very tired at times. We hope to be moved to a main room and out of the Neuro ICU tomorrow, which will be great. I am here every day and every night with her - her parents, my parents and our friends have helped me so much in being able to step out for fresh air, make phone calls - just deal with all the stuff this situation has presented.

Our focus now needs to be on her waking up. Please send her the thought.. Wake up, Marilyn, wake up.

Gareth

Monday, October 8, 2007

Marilyn Update From Sunday 10/7


Hello all -


Thanks so much for your thoughts and prayers. Here is an update on Marilyn. Her condition remains stable. Today she was able to keep her right eye open and tracking us as we talked to her. She even smiles a couple of times. She still remains unconcious though and has yet to approach anything that one would consider "awake". Today the doctor told us that for the most part, her injuries will heal. The most significant injury is that of the brainstem which has caused her left eye to dilate and not respond and her left side to not be very active. She will need a lot of rehab and this is the most questionable area - we can only hope that it comes back. Further injuries were found - two skull fractures and another minor fracture on her C7. Important that the C2 and C7 fracutres are non-displaced - no spinal injury. This is also the first time that we were given any type of time frame as to what we are facing - 6 months to 1 year for recovery. So - we're going to be here in Denver for a while - my best guess is a month or two, just really hard to say until she wakes up. But we will come home. We will come home. For those of you that are coming up this way - Marilyn and I can't wait to see you. Thank you we love you,

Gareth and Marilyn

Hi friends,

We have established this blog to keep you up-dated on Marilyn's recovery. This will make it easier for Gareth to keep you informed and still give Marilyn his full attention. THIS BLOG WILL BE UPDATED DAILY TO LET YOU KNOW HOW MARILYN IS PROGRESSING.

BACKGROUND INFORMATION: This email was sent out by Gareth on Saturday, October 6:

By now you have heard the terrible news about Marilyn. On Wednesday, October 3rd we were riding beater bikes down into the village of Vlicabamba, Ecuador when the brakes on Marilyn’s bike gave way on a downhill. She was unable to slow down the bike hit a dirt burm and was ejected nearly 30 feet into the air. It was a horrific and unexpected accident. We were expecting to have a quiet, relaxed day. With significant difficulty we were able to evac via air ambulance and she is now a patient at the Neuro Intensive care Unit at the University of Colorado hospital, Denver.

Her injuries and condition are as follows. She remains unconscious but responsive to touch and voice. She suffered a closed head injury – difuse axonal injury – small injuries on different parts of her brain. In addition she has bruising on the left upper portion of her brain and in the brain stem which has caused her left eye to be dilated and unresponsive. She has good motion on the right side of her body and poor motion on the left. Her prognosis at this time is unknown – the recovery will be very slow. We do not know if she will be able to return to her work as a nurse practitioner.

The experience has been mentally draining and has left us on precarious financial footing. The air evac ($60,000) was not coverd by insurance and has placed a significant financial burden on us. While Marilyn is in recovery I will need to take over her financial obligations. We will be establishing a charitable account in Marilyn's name to help defray these expenses. For now, I want to let you all know how much I appreciate your thoughts and love – please keep sending them. I will talk to each of you in days to come – for now reliving the experience with one person at a time is just too much. Please forward this to anyone who loves Marilyn that I probably have missed – not thinking fully clearly at the moment.