Monday July 13

Today, John began his intensive therapy sessions. They start fairly early in the morning and do not finish until around 4pm. Although there are some breaks throughout the day for meals and to give therapists the chance to complete paperwork they work with him for the entire assigned sessions. In between times when they are working with him directly, John is sitting up in a wheelchair so it makes for some long days for him. He is a very physical guy and has not been sleeping all that well at night so the hope is to get his sleep/wake cycles back on track. Taking cat naps throughout the day when he did not have these challenging therapeutic sessions worked before but at this point it is essential to get him on a regular schedule. He can hopefully begin to get excited and anticipate the next session each day.

John has began reaching for the utensils when we try to feed him. It is almost as if he is ready for us to stop taking the easy route to get that food into him and simply wait and be patient while he works on using the fork for himself. So far, he can raise his arms and touch his head if you ask him but it takes time and it's not the same way you would expect. It seems that knowing where his mouth is with his hands will take a bit more time. He can see it and respond but if you try to see a fork when it is close to your mouth (I tried it earlier!) it is darn near impossible. It is hard to tell if his fingertips have all of their sensation back and gripping small items is difficult for him. So, as expected, the small motor skills will need to redevelop. He can now grip our hands or larger objects but getting those fingertips working will be the focus of some of his physical therapy over the next few weeks.

Another facet of his treatment will be psychiatric care. This will help him come to terms with everything that is going on and the traumatic recent events. I actually believe that these professionals are on staff to help family members as much as patients and they have informative groups weekly. Last week was, "Anatomy of the brain", and this week is going to be, "Coping mechanisms for relatives of a person with a brain injury". I should note here that John is considered to have a brain injury because throughout the trauma of his heart attack and subsequent days, his brain did not receive the normal amount of oxygen and therefore his brain is "injured". I believe that injury is a great word and lets us know that it is treatable much like you would treat any other injury. It's just that when the brain is injured, there are many more aspects involved including memory, motor skills, and some physical activities. TIRR sees the gaps between the physical and mental aspects of what the brain does as requiring a specific course of treatment. Essentially, the portions of the brain which control movement and the other portions which control thought, emotion and memory must once again be merged. It's a sort of invisible bridge building process. The architects are the physicians and other hospital staff along with family and social support are the contractors. That might not be the best analogy however it's what I have derived in being near John and from what I've noticed along his journey.