Week 7 ~ Mike's Visit

My brother Mike was with my dad this last weekend and called me with an update.

Dad is making slow and steady progress. He is able to wheel himself around in his wheelchair all over the hospital. He can also stand up for a bit and move around. He still gets tired easy and only does a little walking everyday. Dad officially does not have a one on one anymore, which means his impulsivity is lessening. He is out of the posey bed and is gaining more independence in his daily routine. 

For the most part dad's attitude is positive. As you can imagine being stuck in a hospital is not an ideal situation. He wants to come home and sometimes he has a hard time understanding why he needs to stay at Craig. Dad being who he is did take apart his seat belt on his wheelchair. The staff had to be a little more creative after that and had to explain that the belt was only there for his safety. The last thing we need is dad falling again. 

Dad doesn't care a whole lot for his speech therapist but even he admits that is because she pushes him and makes him work. The ST has asked us to put together a timeline for dad and his work. While dad knows who everybody is he sometimes has a hard time putting dates together for where he works. The good news is he making progress and seems to becoming more aware everyday. His speech has improved greatly and he is able to have longer conversations than before.

Dad is being able to participate in more activities through the hospital. He was able to go to the Camp Hobie BBQ with my mom and sister, Liz, during their visit last week. He also has been enjoying movie nights. One of his favorite things to do during the weekend is play games and read his books. He loves cribbage and he was very happy to get his kindle from Mike. His OT said card games are a great way for him to work his mind over the weekends. I keep reminding him of that one time I beat him at words with friends but he says he conveniently forgot about that ;)

Mike was able to get his off campus pass and was able to take mom and dad to dinner while in Denver. This was a big deal. I have to admit I am really looking forward to returning to Denver just to be able to take dad out on the town. Mike also accompanied dad on the fishing day trip the hospital organized. It was catch and release and both dad and Mike each caught 2 fish.

I will be returning to Denver at the end of August over Labor Day weekend. The care team has schedule another care meeting for the end of the month. This meeting will mark the halfway point at Craig Hospital. It is really important to remember that dad's injury is very serious and he is still healing from his fall. It is difficult to have him so far away but with an injury as serious as his it will take a lot of time to get him back to where he was.

A big thank you to my Grandma Rolfe for taking the time to come visit and help out with my dad. I know it meant so much to him and us kids are so grateful to her for her continued love and support. We know it isn't easy being away from home for a whole week. Also thank you to those who have sent cards, letters and packages. It makes his day to hear from family and friends ♥

My sister, Liz, my dad in his favorite shirt and my brother, Mike, with his daughter Samiya
~ Aug 16, 2013

Dad fishing with my brother Mike. He was able to catch 2 fish :)
~ Aug 17, 2013

Out to dinner for the 1st time since the accident.
With my brother, Mike, my mom, Liz and Dad.

My Aunt Stephanie (my dad's sister) sent dad a package that made his day.
This shirt was one of the things she sent ♥

Letters

Dad is in for a long recovery and will be at the hospital for awhile. We are looking at a discharge date of October 4th. Dad loves getting mail! It would be great if he could get a continuos flow of mail while he is at the hospital :) I have provided the mailing address for the hospital if you would like to send him a letter, card or pictures to keep dad in touch. Thank You

Craig Hospital TBI unit

c/o Tim Rolfe 

3425 south Clarkson Street

Englewood, CO 80113

Week 6 ~ Routine, Routine, ROUTINE!

We flew into Denver to meet with dad's care team earlier this week. Below is a break down of the report from each area of dad's care team including nursing, PT, OT, ST, psychology as well as a report from his dr and the social worker.

Dr Weintraub
Dr Weintraub is dad's neurologist and primary dr. He spoke to us about dad's injury and what that means for dad. The dr commented that dad's injury damaged the frontal and temporal lobes. An injury in this area affects several things for dad such as his problem solving, judgement, self-monitoring, emotions, attention/memory, speaking as well as hearing and organization of his thoughts. The dr kept stressing that this is a very serious brain injury but with time dad can make a great recovery.
The dr and his team have been great about dad's care from the moment he rolled thru the door. When dad got to Craig he was a mess. McKay Dee was keeping him sedated and heavily medicated, they had placed the wrong sized g tube and he had major infection. In the last 10 days since he arrived at Craig the dr has changed his meds which have lead to a less agitated and much clearer dad :) They have also been able to clear up the nasty infection around his g tube and have gotten him moving towards independence.
The dr stressed how important a 24/7 routine is for dad. It will become a re-occurring theme throughout dad's recovery.

Nursing
The goal is to keep dad on a 24/7 routine. When he is done with his care he should be able to care for his own needs. The nurse also reported that his G tube will be coming out in 30 days.

Physical Therapy
The therapist will work with dad to regain his independence and mobility. She will work on building strength thru daily PT, walking/standing and other activities. At this time the PT feels like he won't have his wheelchair for much longer however he will still need it for long distances.

Speech Therapy
Dad has 5 goals for speech therapy.

1. Swallowing - Dad has been cleared to eat solid foods however he is not allowed to have liquids just yet for fear of aspiration. Unfortunately this means no coke :( The therapist believes he will meet this goal soon.
2. Speech - Dad's voice was affected by the ventilator when he was in the ICU so the therapist has written a goal for dad to Speak Loudly and Slow Down in speech.
3. Verbal Initiation - Anybody who knows dad knows he is not a big talker. With that being said the therapist has written a goal for him to initiate conversation. At this point he has only been answering questions and not starting conversation. Her hope is that he will be better about initiating conversation. 
4. Cognition/Memory - This is a big one and will be a slow and steady process thru continued therapy.
5. Intention - This is a goal for being able to focus for longer times. Again this one will take time.

Occupational Therapy
The overall goal here will be to work on dad's daily living skills. The therapist has 2 working goals:

1. To take of his own needs - Dad is making good progress but he still needs a lot of verbal cues. The goal is to eliminate these so he can take care of himself.
2. Create a day to day routine - This is vital to dad's recovery. It is important to create a routine to be able to gain the skills to complete daily tasks. The therapist will incorporate his interests and will focus on making a plan before he starts a task.

Dr Barry- Psychologist
Dr Barry is dad's psychologist. He will be working with dad to deal with the frustrations of recovery. He will do this by helping dad build strategies to recognize how he is feeling and how to handle it. The dr will also be working on emotions and how to organize dad's thinking for himself.
The dr is also available to family members. This is not an easy process and there will be changes in dad along with differences in how things will go after therapy. Dr Barry will help us thru this process.

Social Worker
The social worker has been working with the family throughout this whole process. She will be helping teach the family on what needs to happen for dad to go home. Some of the goals will be:

1. Dad will need extreme structure. He is learning this thru therapy at the hospital but it is vital that this is continued at home.
2. Dad will need to master his own independent living. 

Right now dad has a discharge date set for October 4th. However the care team is talking about a post acute program that would help with all of his goals. It was explained to us that a post acute hospital would allow dad to gain his independence better that a home program. The post acute setting is more structured and will help him with rehabilitation and get him back to work. If this does happen dad will not be home until Christmas :( This took us by surprise. The dr commented that our family situation is being taken into consideration. We have a unique situation in the fact that mom has her own disability with her brain aneurism. Dad was mom's caregiver now that he has been severely injured at work it changes things dramatically. The dr also mentioned that a post acute program is important to get dad back to where he was physically/cognitively and back to work.
There will be another care meeting next month to discuss dad's progress and confirm what the next step in recovery will be.

Isaac left for Denver yesterday and will be there until Sunday.  I have not gotten an update but I plan on updating the blog when I do. My grandma Rolfe (dad's mom) along with my mom and lil sis will be staying the week in Denver with dad. My brother Mike will then go to Denver on Friday and spend the next weekend visiting with dad. Mike is hoping to have an off campus pass for dad by this time so he can take dad to a football game. Dad loves his football. He is a HUGE Minnesota Vikings fan and commented that he would like to go see the Denver Broncos lose :p

Thank You for your continued support and love. This is not an easy process. It will take time for dad to recover but with the strong support from our family and friends dad can and will make a great recovery <3

Week 5 ~ Emily's visit

Update from my sister who is with my dad this week. Tomorrow Mike and I fly into Denver for dad's meeting with his care team.

Day 34 ~ August 1st

Dad had a great day today. He likes his new bed and slept peacefully through the night. He was able to eat his first real food since the accident. The speech therapist brought in fried chicken and mashed potatoes. He was so excited he kept trying to tear into that poor chicken like a starved animal. The ST kept having to remind him to go slow and only take small bites. They would ask him to talk in between bites which he found annoying. He just wanted to eat that chicken. He said it was very good and tomorrow he wants Olive Garden. The ST passed him for soft foods and thicken liquids for meals and expects by the end of the week he will be able to eat even more. Mom and I helped him fill out his menu request for the rest of the weeks. He will be eating lots of oatmeal and eggs for breakfast and ground meat with gravy for lunch and dinner. This is food he can eat unsupervised by the ST. Non-thickened liquids like regular water and juice are the hardest to swallow and will be some of the last foods he will be cleared for. 

Dad had an eye exam today and did really well. Great vision far away but he needs stronger reading glasses. Dad out walked mom in PT today :) He walked out of the hall, over the bridge, around the halls of the other wing of the hospital and back. He was so exhausted by the time he made it back that they had to finish PT 20minutes early. 

We signed dad up  for activities while he is here at Craig. He will be able to go to movie night in the entertainment room, Root beer floats in the rec room and a fishing activity later in the month.

Day 35 ~ August 2nd 

ST

Dad's first therapy of the day was speech where he did amazing! He scored a 29 vs 20 on his orientation quiz. ST told me that anything over 25 is considered amazing. The only question he missed was what city he was in. He knew he was in Colorado but couldn't remember the city. He then was asked to play solitaire on the computer to test his ability to attend to task. The first session he was given quiet and left alone to play. The second game, mom and I were talking to him and asking him questions to try and get him to do minimal multitasking. He struggled with that. He started complaining about his eyes after awhile. He has also been complaining about his ears. He will be seeing audiologist some time early next week. When the ST asked him about his eyes and ears he showed good insight when he told us "I feel like my brain is only half connected... its hard for me to concentrate on one thing." Which shows how he can easily become overstimulated and has a hard time multitasking. Over all the ST says he is progressing much faster then they expected. Concentration is improving fast. Speech and memory are also improving. The ST gave him three rules to speaking she calls them SOS. 1. SLOW DOWN 2. OPEN MOUTH 3. SPEAK UP (talk louder). We still have a ways to go but we are moving at a nice steady pace. That being said tomorrow he may not do as well as today. It is not uncommon for them to go up and down slightly day to day.

PT

Dad started PT with a long walk. He walked across the bridge to the other side and went down the elevator to take his first walk outside. He crossed the street where they let him rest for a few minutes. Then he took his first crack at the stairs first down then up. Then he walked back to his room. He did so well we didn't even bring his wheelchair with him. After a ten minute rest he was able to keep going. The PT repeated some balance testing with him. Tuesday they did the same tests and he did really bad during the balance tests. Today was the complete opposite. He did AMAZING! He started to sway a little during the last little bit but was able to pull himself together and finish really strong. 

OT

This was probably the most fun therapy for dad. The OT filling in asked dad what he did for a living and decided that they could do some work more up his ally. First they had him re-creating pictures with pipes. Then following simple directions to build completed circuits that turned things on like lights, fans and speakers. He loved that. Finally they gave him some tools and a metal structure and his only task was to take it apart. They got him to do it with minimal distraction. The OT and mom were telling him jokes to offer some outside distraction ;) and he had a good time with it. 

By the time this was all done he was pooped but he was scheduled for his end of week appointment with the Nero psychologist. He was asked at the start what he thought of the hospital so far and he said he liked it but if he could change one thing it would be "that you would bring more of his family in" He is remembering so much more about his past. Still a little confused about his work he knows he works for Loft House but he still thinks he works for Salt Creek at the same time. The things he remembers the clearest has to do with Mom or his kids and grand kids. He is remembering more and more what is happening. Recalling most of what happened today yesterday and earlier today in  his own words (aka no one is giving him prompts to help) Also able to express more of the way he is feeling. Today he told the psychologist that he feels like "its silly the more he does the more people want to see him do" He joked he would be better off acting like he couldn't do much.

He does get headaches towards the end of the day that make it hurt when he tries to think to hard. (for this reason we left early today and let his brain have a rest) He also starts to get less coherent and "with it" as he tires out both mentally and physically.

REAL FOOD! :)

Rocking the eye patch

Eye Test

Working hard in ST

1st walk outside :)

Walking the stairs

Mom & Dad <3

Balance Test in PT

Dad in OT ~ working mechanics

Dad has always loved fixing things :)

Week 5 ~ Slow and Steady

They sure do keep dad busy here! Everyday dad has physical therapy and occupational therapy along with speech therapy twice a day. The 1st day of therapy dad was only able to take a few steps. By the time I left Wednesday he was not only walking up and down the PT room but also around the unit and to his own room. Dad also is able to spin on the stationary bike during therapy. I told him before he knew it he would be riding a 100 miles with me, he smiled and commented, "Yea . . . all downhill!" I laughed my butt off, feels good to see his sense of humor coming back :)
Dad does a swallowing test everyday. He has had problems aspirating when he eats. He is making progress, when I left on Wednesday he was allowed to have ice chips. His therapist believes he will be on solid foods by next week which we are all excited about. They have a soda machine in the therapy room and every time we pass it dad wants his coke!
We are working towards getting dad an off campus pass. This requires the family to be trained in several areas including how to use the wheelchair, seizure and emergency training. As soon as the dr clears him we will be able to take dad to the outdoor patios, garden and rec room without a one on one assistant. The rec room here is fun. They have ping pong, a pool and a garden. Dad is able to participate in several rec classes including fishing. Anybody who knows dad knows how much he loves his fishing ;)
Dad is making progress everyday, I see him become more clear and aware of his surroundings. With that being said he still shows some delays in his cognition and thinking. It takes him a minute to answer questions and remember things. His memory is slowly coming back, the last time I spoke to him he wanted to call his work at Salt Creek to let them know where he was. He hasn't worked there for 10+ years. The dr says this is normal for a brain injury and things will return slowly but surely. He will probably never remember falling or being at McKay Dee Hospital. The 1st day of speech therapy dad scored a 7 on his cognitive test the very next day he scored a 23. His therapist said she has never seen improvement like this in her career. This is an encouraging sign towards his recovery. The first 10 days at the hospital are used for assessment. There has been a Care Team meeting scheduled for Monday, Aug 5th to discuss his care plan, progress as well as a discharge date. Mike and I will be flying into Denver for this meeting. 
My sister, Emily, arrived in Denver on Wednesday to be with my dad. Victoria, Brayden and Landen came with Emily and they were able to visit with papa for the 1st time since the accident. This was a beautiful moment for the family, dad's face lit up when he saw his grandchildren. After giving Emily the tour and updating her on dad's progress I returned to Utah to be with my family. The plan is to alternate weeks to enable us to return to work and be with our own families. She will be taking pictures and communicating dad's progress with me and I will give an update on the blog every few days.

July 30th ~ 1st day of PT

Performing a strength test

Speech Therapy

July 30th ~ 2nd day of PT ~ he walked the length of the therapy room twice this day!

July 30th ~ Becky, Eva and Dad. He is looking better everyday :)

Dad on the bike ~ July 30th

Brayden and Dad ~ July 31st
 This was the 1st time dad had seen Brayden since the accident. It was a short visit but one we will always remember.

Tori and Papa ~ July 31st

Dad's new set of wheels ~ July 31st

Bed Upgrade ~ July 31st

Brayden and Becky visiting Papa ~ July 31st

Day 31 ~ July 29th Dad's 1st PT assessment

This was the 1st time dad has walked since the accident. This video was taken on Monday, by the time I left Wednesday he was not only walking up and down the PT room but also around the unit and to his own room. He is making great improvement everyday :)