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.