Tonight we asked Ang if there was anything that she wanted us to post for her on the caring bridge site.  She asked that we add the following:

• My neighbor is very loud and annoying. (She screams constantly)
• Please pray for the pain to go away in my elbow and back because I hurt a lot.
• Please pray for the “pins and needles” to go away in my face.
• I miss my kitties and church
• I WANT MORE JESUS IN MY LIFE. (Atta’ Girl!)

My wife is amazing!

I think that I am going to be asking her to do this more.  After all, this site belongs to her, not us.

Ang had a very restful night.  She slept at least 8 hours, which I believe might be a record.  We gave her some Lidoderm patches for her back and arm (Like what the dentist would give you when you get a filling.)  They seemed to do the trick.  Hope they work again tonight.  She woke up many times but fell back to sleep quickly.  She was also extremely calm during her acupuncture session today.  She had a couple of times where she wanted to stop, but like OT the day before she realized it was for her benefit and told our friend to keep going.

She is getting more in tune with social norms or what is generally acceptable in a social environment.  She has become quick to apologize when she realizes that she might be doing something that isn’t quite acceptable.  She even asked about a couple of things and listened when I told her that most people probably wouldn’t do that.

Ang asked for a cup of tea today.  Might seem small, but this is a huge step forward.  Until now she has been given choices based on things that are available.  Today she wanted tea and she asked for it.  AWESOME!

Her speech therapy session this morning went extremely well.  I think she really surprised the guy.  She went through about 4 pages of cognitive evaluation questions and got the vast majority of them correct.  I don’t think that the ST thought she would be able to focus for 30 minutes plus, let alone ace the questions that he had for her.  She gave the most beautiful definition of the word “gracious”.  She has about 10 more pages to go through but I am sure she will do great.  The sleep really pays off!

Ang has her follow-up appointment tomorrow at Harborview for her hip and arm.  Please be in prayer that all goes well and that Ang does not get over-stimulated.  It is going to be a big day.

Ang and I do something that we call a “finger hug”.  It is simply touching the tips of your index fingers together.  We do it when we sit across from each other out at dinner or in the car, etc.  Tonight when I was leaving she gave me one out of the blue!  

She is finding herself again, but it is SO hard to be patient!

Love you, Meow.

Much love to all-

Josh

A restful night was not in the plan but a rest filled day was....  Angela's wrist hurts greatly.   She is asking almost any visitor including the therapists to take the pins out of her arm.   She accused me of not loving her because I would not just pull them out....and then, decidedly announced she would do it herself.   Knowing the tenacity of my child, I spent a near sleepless night refastening velcro on the splint and distracting the little one from her intended mission.

Pins review is scheduled for early afternoon on Thursday so please pray for continued success at distraction and for the pins to remain intact until the appointment and then for the doctors to see the wisdom of an alternate plan that more associates with Angela's needs.   

We did have quite a bout with terrible accusations coming from my child designed deliberately to press every vulnerable button I own.   Many prayers and some unexpected, well-timed affirmations from people with more perspective than I got me through the night and reinforced me.   Thank you Holy Spirit!   My faith is intact.  My ability to verbalize and share my faith is growing exponentially.

Ang requested and received some stronger pain medications early this morning and as a result slept ALL DAY with tiny little breaks for a shower, some physical and occupational therapy.   It was quite quiet and we shall see if it carries over for Josh tonight.

In PT Angela got to stand with a one armed walker.   This is designed to help people who can only bear weight on one side get the exercise of standing.   We were able to accomplish it three times and with the last one, Angela actually stood on her own for several seconds not holding on at all.   Such an amazing beginning.

In OT we did the usual stretching and elongating tendons with one HUGE difference.  Today, although it hurt, she asked the OT guy to please continue since "I know this is something that has to be done."    WOW!

Josh and I have noticed that with some of you, Angela will initiate a "thanks for coming" or "see you soon".   Since this is "normal" talk you may not realize you are making our day as we observe this monumental step forward in cognitive development.   YAHOOO! ! ! !

Opey visited today and visiting dogs are so therapeutic.   Buster was in recently too and pictures of Hal and Blue triggered some fun babysitting memories.   It is so fun to see Ang with the dog and then to hear her talk about the visit later.   Thanks for making this happen.

Josh and I were also blessed with a visit from a man who has experienced a similar type accident.  He came in and shared his story - what worked and what didn't work so well on his journey to recovery - answered our questions and was so genuinely affirming that Angela's journey is a unique and personal experience while also guiding us with some practical and loving suggestions.   We thank you ever so much for spending some time with us and we look forward to connecting again soon.

Well, the laundry just got finished so I am off to get some sleep.

Love,

Teresa 

Lots to do tonight, so I apologize for the short post.

Ang cried for the first time last night.  She asked me to kiss her tears..  Her nerves are really starting to wake up and she is feeling much more pain throughout her little body.  This is good, but it makes things much harder on her.  She even gave ME a call on the phone!

She is having a tough time with not feeling “pretty”.  We are trying to come up with ideas on how we can help her get through this.  I continue to remind her of Psalm 139, telling her that she is “fearfully and wonderfully made”; that I will always see her in white.  Please be in prayer for this.

Ang “passed” her swallow test today so she is now authorized for thin liquids. Lattes here we come!

Ang did great with her cognitive exercises today.  She did extremely well with her orientation questions. (Who are you?  What day is it?  Where are you? Etc.)  I gave her two words to remember at the start of the day and she had retained them through the evening.  She has a lot of trouble with short-term memory so this is a big step!

Ang also walked utilizing the parallel bars this afternoon with PT.  One therapist held her left foot while she hopped with her right.  She did great, but we found out that she gets dizzy when she stands for prolonged periods of time. Her body just isn’t used to it after being seated or in bed for a month and a half. We will have to work with her on standing for longer periods to help get past this.

Acupuncture was tough tonight.  Ang had a lot going on with visits and therapy this afternoon and I think that she got over-stimulated.  She started to display some of the old aggressive behavior that had not been present for the past couple of days.  She was doing so well that I think we forgot how much of an impact lots of activity can have on her.  

Please pray for a restful night tonight and that she will not be aggressive with her mother.  Pray for protection against Satan and his works and affects.  Now is an opportune time for attack and we must be vigilant with prayers of protection.

Josh

What can I do?   I have been thinking about this for awhile now and I have an idea to share with you....

Come and be part of therapy!   

How can I do this you might ask, well here are some ideas:

1.  Ask Angela to play catch.   We have small toys to throw.  This builds strong eye/hand coordination especially if you take small steps backwards between throws so as to require her to recalculate the distance and hit her mark.   This can be done while she is in the bed or out in the yard.  Many times Josh starts at the foot of the bed and gets all the way back to the closet before she tires.   This can also be done in a triangle if you come with a friend.   Angela puts up her hand so you know where to throw it to her.   You might have to remind her to open both eyes and you might have to retrieve her missed catch on the rare occasion that she drops it.

2.  Bring a category and ask Ang to name a certain number of things in that category.  Examples:  fish, birds, colors, States, ... you get the idea.  Five is a minimum and we are curious how far she can go.

3.  Be more adventurous and play round robin with the category...let's name birds, I'll go first - robin.   Your turn... and count how many times you go back and forth or go around if you are in a group and report in to Josh or me so we can record in the speech therapy journal.

4.  Bring math puzzles in your head or on a piece of paper or with flashcards.   Things like:  Add these two numbers and divide by this number.   Add these two numbers, divide by this number and then subtract this number.   See how many steps she can keep in her head and if you have to repeat the steps to get her to solve.   Remember to only ask items you already know the answer to so as to be able to provide that stabilizing base for her brain.    If you are like me, you have to write these puzzles down in order to remember them....   so bring a "worksheet".

5.  Ask for our pocket dictionary and randomly pick a word.  Ask Angela to spell it, define it, use it in a sentence, tell you its opposite, tell you something it reminds her of, 

We are recording attention span - how long will she stay engaged.  We are recording if she can follow directions.  We are recording her ability to calm herself if she gets stressed (going slowly and being calm yourself help facilitate her ability to remain calm).   We are also recording how well she plays with others.   SO...report your successes, failures, observations, questions....  it all gets reported in the ST journal for the "experts".  It all gets used to show progress!   REMEMBER:  We started with a 20 second attention span.

A.  If you are the hugging kind, ask her for a hug.   A stand-up hug.   This will require Josh or me to show you how to get her up out of bed safely but this is great exercise:  getting up, having balance, getting back down... and HUGS are therapeutic all by themselves.

Last night my sister stayed with Angela.   I was obsessing about the chair transfer sequence as there are so many parts and so many chances to hurt her.   I was talking through it with my sister and having her check my written instructions but I was not calm.   Angela calmly announces she has to go to the bathroom.   My sister jumps in and processes the sequence with small tips, suggestions, clarifications, reminders, etc. from me.   When Ang gets back to the bed and my sister moves over to wash her hands, Ang looks at me and says "Feel better now, Mom?".   She NEVER fails to astonish me.

If you come and we are are in Physical or Occupational therapy - come cheer! ! !   WOW!, You can do it, Way to go, High Five may all be appropriate and help encourage the little trooper.   You know your husband and mother think you are amazing but when your friends and family members do too....well, maybe it is true.

Josh pointed out several stage VII behaviors and the stage IV behaviors are subsiding unless she is provoked.   Happy Days for that !!!

Thanks to all of you who remind me to pray and then make prayer happen before you leave.   It calms the room and brings the grace and Holy Spirit right in where they are welcome and where they belong.   

We are so grateful and appreciative of your assistance in getting our girl back to "normal" (stage X).    

Hugs,

Teresa

Hi All-

Tough night for Ang last night.  She slept from about 8 to 11 and was up for the remainder of the night.  It seemed as though she was asleep off and on, but she was very restless.  I am hoping that the big day that she had today will facilitate her ability to get some much needed rest tonight.

The morning started off slow and then Ang had her acupuncture session.  She took it like a champ for the most part.  The OT commented on how “soft” her arm was today and I would like to attribute it to the additional therapy that she is getting outside of the general regimen.

It was a gorgeous day in West Seattle today so Teresa and I decided to sign Ang out of the SNF for the first time and went for a nice walk with her.  She wore her sunglasses and was wearing her trademark tank-top for the landmark excursion (Everything she had on today from head to tow was from her closet so we hope it helps her feel more like herself).  We headed South down California Ave. towards the Admiral Theatre, one of the places that we frequent quite often in the hood.  She was in good spirits and we even stopped so she could pet a little grey pitbull dog along the way.  She was ready for a nap when we got back.  It takes a lot out of her to process all of the things going on outside but she continues to amaze me.  With TBI much of the reference material available indicates that a quiet calm environment is needed to promote healing. Conversely, much of the material available on neuroplacticity indicates that it is good to stimulate the brain as much as tolerable to mitigate brain atrophy and promote the “re-wiring” process.  I think that if Ang had to sit in a room and not do anything for months she would go crazy!

As Teresa mentioned, Ang continues to improve her ability to focus on specific activities for longer periods of time.  She recalls more information than she could just days before on a regular basis.  We will continue to work with her on her cognitive exercises as much as time allows, considering the resident ST is primarily focused on her ability to swallow.  It is frustrating because it appears that her ability to progress is contingent upon the resident ST’s schedule.  We were approved by one of the subs to give her water under certain conditions and she does just fine.  So- as far as we are concerned she is past the thickened liquids stage and the resident ST can write whatever he wants in his report.  We aren’t going to hinder her progress simply to accommodate someone’s schedule.

PT went well.  Ang had more E-therapy on her leg.  She can now straighten her left leg on her own without any stimulation.  This is a blessing and a bit scary. The gained mobility means that she is more able to move herself around in her bed and we have to keep a close eye on her during the night to ensure that she doesn’t push herself onto the floor accidentally.  She also did 7.5 minutes on the seated cross-trainer.  She said that she will shoot for 8.5 on Monday! 

OT went well also.  A bit less intense today.  They like to give the patients a little slack on the weekend.  Ang stays more calm when I am working with her so the OT has involved me more and more in her therapy.  Today I worked with her on her range of motion exercises and massaging her tendons.  In general these activities really agitate her, but today she was much more calm.  The OT is great at promoting family involvement and he trains Teresa and I so that we can work with Ang on our own.

Auntie Marian is filling in for Teresa and I again tonight.  Praying that things go smoothly and that she gets some rest.  Tomorrow should be low-key and we are looking forward to visits from friends and family.

Josh

Sleep was blessed, restful, and in fairly contiguous bouts last night.  Thank you Jesus!   We have been in a fairly relaxed mode in the mornings, working hard in therapies in the afternoons, visiting with people in the early evening and trying for lights out by 9:00pm.   I see Angela's stamina growing daily.   She is really able to frequently "use her words (or gestures)" to let us know what is up with her instead of just whining.

We had a funny conversation about the importance of facial expressions....and how they convey a lot of information without using any words.   She can mimic "surprise" and "angry" and can sometimes make up her own rendition of "funny".   

Our OT (Occupational Therapist), the guy who works on waist up activities (dressing, personal care, arms, balance, and some cognitive) reminded us to be extra patient regarding the use of her left arm.   He shared with us that when the fingers map on the brain, many parts of the brain have to connect and fire together to make the fingers do all they are capable of doing.   More research on the this subject is fascinating.  I admit I took a lot of the daily movements for granted but when you break it down, each finger moving independently and then together in all their multiple motions is quite extensive.   As Josh noted, we see daily improvement.   We do get to the have exposed pins in her wrist looked at on October 1st so maybe we will hear good news and have them out.   I know Angela's pain will subside when that one event occurs.

One of the ST (Speech Therapy) tasks is concentration, focus, and reducing the impulsive actions (good luck) to a controllable level.   When we first started working with Angela on Sept. 14, she could sort about 10 cards from a deck of cards into black/red piles.   Tonight (just 10 days later) she did the entire 52 cards.   This demonstrates an amazing enhancement to her level of concentration, ability to remain focused on a task without distraction, and willingness to engage in a "mindless" task because she was asked to.   

We were asked to create a notebook for Angela for therapy purposes so when you come, ask to sign the guest book.   Know you can also read it as we continue to fill it out.   I know some of you see her today and wonder WOW she has a long way to go... we see her and wonder WOW, look how far she has come.   Thanks for being on this journey with us so we can share our perspectives with each other.

Angela's PT session (waist down - strong focus on legs and standing) took place on the seated stairmaster machine....I am certain all you gym nuts know what this means... but for seven minutes she pushed with alternate feet and used her right arm on the arm lever to build those leg muscles while controlling the tension and speed to help reinforce keeping the impulsiveness under control.

Standing is becoming an ongoing practice item during the day as a trip to the bathroom involves bed to chair, chair to toilet, toilet to chair, chair to bed....  whew....   There is a routine and a number of steps we are to sequence with her each and every time she is involved in this process so please know we aren't keeping you away from the "fun", we are just following the therapy process....ask for training if you want to participate in moving her.   It will reduce my anxiety and increase both Angela's and your safety.   Thanks so much.

Reading is going well.   Angela appears to drift off but can talk about some of the things that were read to her in those quiet nighttime moments.   It is also a fantastic time for Josh and me to catch a snooze so don't be offended if we relax and drift off.   We are still on alert if a bathroom cry goes out from Ang.

You are all amazing!

Teresa