Tuesday August 25

My apologies for allowing so much time to pass between blog entries. My job has taken me far and wide lately and it looks like September will be a crazy month too but I will try to do better.

We have been told so many things about those who have, "Brain injuries". We have been given parameters and time frames and medication ideas and treatment ideas. Every professional in this field has a hypothesis about what will work, might work or what has worked in the past. There are also ideas about treatments and ways that a family should interact or not interact with a person who is receiving treatment for this "condition". There is the likelihood that some putting into a category, or placing a name on a particular injury, puts a person on the path to a treatment plan which may or may not fit them individually but may describe their chart-labeled affliction. It is the same as a robot trying to perform gall bladder surgery the same way on every patient. We need humans to do this because everyone's body is different and everyone's personality is different and everyone's gall bladder is different.

I digress a bit for effect but it is obvious to me that much in the way that John defied any category when he wasn't at TIRR, he has done the same while he has been there. He is amazing to be around and there have been some interesting and promising changes over the past few days. One of these changes seems bad on the surface in that John has started experiencing a wide range of emotions. He does cry, get angry and frustrated at this point sometimes without warning. But when you ask him or find out where his feelings stem from, they are valid. At one point recently he seemed angry to Holly and she asked him why and he said, "I've been through a lot". To me, he hit the nail on the head with that one!

I will tell you that this path has had obstacles and they do not cease. We recently started to notice that John was extremely fatigued during the day. After some tests were done to rule out any problems with his heart as the root cause, we started to notice that the level of activity and noise in his room was high. I was there one evening and there were 3 televisions and 4 or 5 family members in the room and I could hardly hear him speak! At the beginning of this week, we asked for him to be moved from this four person room to a two person room and they obliged. There was some comfort in John being in the more crowded room in that we knew there was more traffic and therefore the chance for people to check on John was higher but it just seemed like the opportunity to get him into a more peaceful environment might allow him to rest better.

Friday August 21

I have had a fantastic Friday night. I got to sit with a good friend in a comfortable chair and watch an exciting sports event, banter about each play and criticize the calls of the referees. The above pictures are of John and me sitting in his room and watching the little league world series and we were both entranced during all six innings of the Iowa vs. Georgia ballgame. The first few innings, it was a close game, then a home run lead to a few more runs and by the sixth inning, Georgia took a huge lead and the eventual win by sizable margin but of course we continued to root for the underdogs through the end of the game. It was awesome to sit with John and hear him call the pitches as if he were umping the game himself. He also was very complimentary when the kids would make good plays or hit home runs. We could have been watching any game but I am a new fan of little league baseball after tonight.

He ate a great supper as usual...John cleans his plate at every meal even as those around him complain about the taste of the food. He seems to enjoy each bite and never complains about anything as is characteristic of how he normally lives each day. His pleasure comes from a place within that few of us channel for even minutes, and yet he seems to be deeply and constantly connected to. We all have things which soothe us when we hurt, and sports is clearly John's remedy. It helps him to find that level of normalcy in his now chaotic life and his confusion seems lessened when we talk about football, baseball or basketball.
As I was leaving, his roommate's friend had brought up the sweetest little chihuahua mix named Chaca (maybe after Chaka Kahn?) and I asked if I could take her to see John and she mentioned that John had met her before, and of course it was okay. His face lit up as soon as I walked in with her and placed her in bed with him. Although the picture clearly shows Chaca kissing John, he reciprocated and was so happy just to pet her and let her lay on his chest. Animals give him such happiness and I'm quite sure allow him to focus on his home with his three loving pups and wife and his life which awaits him when he is healed and ready to return to them.

Tuesday August 18

Recently, John received a card signed by his co-workers and this is the action photo of him reading it! We make sure that he sees every card sent to him and try to keep him up-to-date on all emails as well. John loves to read portions of the newspaper or look at magazines too. He has a stack of them to catch up on and the paper provides information which might help with his short-term memory.

One of the things we have realized about hospitals in general is that we really have to stay diligent about making sure John is well-cared for. While we believe that throughout this process, John has received some great care, there have also been times when we are left scratching our heads and wondering what people do who don't have family or loved ones to help look after them. As with most industries, treatment centers are understaffed and nurses are overworked. We were exceptionally lucky in the beginning because John was in Intensive Care for so long and had almost constant attention from nurses and physicians. The transition to less intensive care is difficult but very necessary to help patients become more independent but it can also be hard because we still want someone checking on John constantly when we cannot. Obviously, we can't be with him 24 hours a day and this is good because he needs to rest and he also needs to interact with staff without us around so that they may appropriately evaluate him but it is hard to leave. It does make me sad to see some patients who don't seem to get visits from family and friends and I simply cannot imagine making such a journey alone. We have been lucky to establish allies in this process amongst other family members and we have sort of a neighborhood watch program going on so that if one of the patients need something we can be their voice and it is also wonderful to be able to talk with other family members who are in situations similar to ours.

John continues to progress and gets more alert as each day passes. Sometimes the change is small and sometimes it is big but there is change and we are grateful.

Saturday August 15

The past 10 and 1/2 weeks have been a whirlwind to say the least. There have been times of stress, worry, excitement and our emotions have truly run the gamut in terms of the spectrum of feelings you have when you love someone who has been through what John has. There are times when we are in awe and so excited about the progress John is making and then there are times when we simply miss the way things were and feel desperate to get back to how things used to be. We are forging the future with John and it seems a bit uncertain about what it might look like but whatever it looks like, we know it will be full of love and joy and we remain consistently grateful that John is doing as well as he is.

I believe that a lot of the feelings we have are somewhat selfish. It is a lot about what we miss and although it is certainly tempered with gratitude, we all miss the little things about John and darn it; we miss being able to do things with him. The above photo is of John and Hudd at Holly and John's house at Christmas. I wish I could provide the accompanying smells of turkey in the oven or the taste of Paulette's green bean casserole or Holly's mac and cheese (which is the best I have ever had!).

Recently, Holly drove past Spring Branch Elementary School (where John teaches) and started crying. She told me that the thing that upset her the most was that she knows that the kids will miss him. There have been times when a student came to school in need of shoes and John bought them for them and other times when a student who doesn't have a father figure at home looked toward John to fill that void. I'm quite sure that his co-workers are missing him right now too. School is starting soon and I'm thinking that those long in-service days just aren't as enjoyable without the class clown in the room!

The most amazing thing about this is that those of us who see John on a regular basis believe that John will make a full recovery and he will be back in his old classroom soon but in the meantime he continues to teach. He teaches that resiliency comes from a place deep in the soul and that the will to survive and thrive is personal. He teaches that being spiritual and talking the talk is one thing but actually living each day (even after such a traumatic event) is really about being kind to those around you and exuding the love and positive attitude which enables him and us to heal. Although you are never certain who feels this love, when the chips are down, it is a pretty fantastic thing to see just how many folks John has touched, and continues to touch everyone who comes into contact with him. Granted, his students have changed a bit since June 2, but we have learned so much throughout this process and recognize that although we may not understand or be able to fathom why this would happen to such a great guy, in some ways it seems apparent that the fact that it happened to him allows him to continue to impart knowledge to everyone around him. We simply need to take the time to listen and provide him the podium to speak in whatever way he deems necessary.

I recently asked John if he would like for me to put anything on the blog from him and his immediate response was, "Tell everyone thank you and that I couldn't have done it without you".

Thursday August 13

Some of the greatest gifts we receive in being close to John are some of the hardest to recognize. I would say (and I'm quite sure most of us would agree) that patience has been the hardest thing to have but it has now become drilled into our psyche and we are more patient than we were prior to June 2, 2009. There are many sayings about this including the whole, "Take time to smell the roses", or my recent favorite..."Slow and steady wins the race", but the thing is that this is a daily learning experience for everyone involved and every aspect of our spirituality, sustenance and simple life activities are challenged and then exonerated by John's level of progress. While we try hard not to take any of his progress for granted, when he reaches plateaus after making progress for extended periods of time, it can be frustrating. We simply continue to wait and give John the time and love he needs to progress and heal at whatever rate his body and mind are capable of and we continue to be amazed at the support and love we receive from those around us.

I will tell you that you that Holly notices everything about John's progress and she has never for even a second thought that John won't be back to where he was before his heart attack. She is capable of seeing things in her husband that would be impossible for others to see and she would tell you that there has not been a day when John has not progressed. There is a level of heart ache attached to those close to people who have heart attacks which must be similar to men supporting their wives during pregnancy. While they aren't actually experiencing the baby growing inside of them they are solely reliant upon the level of communication derived from their relationships and must wait for that final product and Holly does the same.

Tuesday August 12

Over the weekend John received a visitor of the 4 legged variety. Diesel is Hudd and Tanya's new Boxer puppy and he pretty much wowed the staff and especially John. John loved holding him and snuggling with him and Diesel just seemed content to have a comfy place to lay and get lots of petting.

John is back on his usual rigorous therapeutic schedule. There will be some adjustments made to his medications to hopefully allow him to be less tired and also enable him to sleep better at night and also be a bit more comfortable in the interim. This is a tweaking of sorts with prescription medications and metabolic rates which is so specific to each patient. Evenn as he begins to gain weight and participate in more physical activities, John's meds have to be reevaluated often and changed to suit him individually. The eventual hope is that his medications will be limited even more or become unnecessary.

John now knows exactly where he is and why he is there. If you ask him the reason he is in the hospital he knows he had a heart attack and he also aware that he is at TIRR now. There are a few gaps in his recent memory as is to be expected and his physicians assure us that John is right on track, if not far ahead of most patients who have been through similar circumstances. His progress at this point happens in a different way. A couple of months ago, we were waiting for that first word or for him to open his eyes and then we were hopeful he would walk. His accomplishments so far have been incredible and really visible but at this point his progress is more subtle. He will still at times retreat to his "safe place" when he becomes overwhelmed but it is for much shorter periods of time. At this point it is all of the little channels of communication in his brain need to build bridges and walkways and once again become whole. We know this is happening and see slight changes in John's speech, memory and even reasoning abilities. His awareness also improves daily and it is obvious that he is fitting each of the puzzle pieces back together...one at a time. If you think about the way most of us complete a puzzle we start with the edges and most vibrant sections and then fill in the rest and it is apparent that this is exactly what John is doing.

Monday August 10

Over the weekend, John's activities were kept to a minimum. He had been getting tired easily and coughing some so his physicians were trying to isolate whether physical activity was playing a part in his lethargy or if it is medication driven. In order to be extremely conservative and safe with John's treatment, he underwent another echo-cardiogram, which is his third since June 2. This is essentially a 3 dimensional view of the heart and takes video and gives sound of the heart working. It is painless and John seemed really interested in seeing his heart on the screen for at least the first portion and he seemed equally enthusiastic to sleep through the remainder! This is precautionary and showed the cardiologist that John's heart is functioning normally and continues to show no residual damage from his heart attack and ensuing resuscitation activities. The overall thought at this point is that John seems to think he should be able to do everything he was doing prior to this myocardial infarction and he gets frustrated with his own progress which makes him feel tired. It is a great relief to know that aside from some tweaking of his medications, his upcoming treatment might include helping him deal a little bit better with where he has been and just how far he has come and help him with becoming more patient with himself.

John goes to a class with a group of folks called memorex which helps him with everything from everyday life skills like congenial terms (which, he is great at) and even more short-term recollection activities such as date, time, etc. They also work with him on things like geography and do some fun stuff like play wheel of fortune and other games which help with cognition. John has a backpack which goes with him everywhere. At the moment, it stays with his wheelchair and when he begins walking constantly, he will carry it. Inside this backpack is a red binder notebook which has notes from each of his sessions and allows family to write in it about things that happen on his days off or over the weekend or express concerns which they feel might need to be addressed. This provides a valuable line of communication and enables each of the therapists to communicate in addition to his other charts.

In front of TIRR is a granite and bronze placard (and some copies throughout the hospital) which reads:

"...The realization of potential usefulness remaining to any man appears to be entirely apart from muscular weakness...it is an adjustment that repeatedly demonstrates to all of us that success in living is not success in bodily movement...Creativity, responsiveness, fraternity, responsibility, and equality are not measured by muscle strength...It is as if the man within the shell of mortal clay unleashes himself from the bonds of muscular might and uses the tiniest strengths for the greatest purposes."
By: William A. Spencer, M.D., Founder and First President, TIRR

Every time I read this I see something different in it but it affects me each time I read it. TIRR was first established in 1958 to help people who had polio and required iron lungs to survive. There are photographs in the lobby showing them transporting patients by rail car and ambulance at that time and I look at those photos and marvel at just how far medicine has come. It is absolutely possible and even probable that if we were living at that time, this situation would have had an entirely different outcome and we remain grateful daily but how wonderful it is that even at that time, Dr. Spencer and his colleagues recognized a need and have continued to be on the cutting edge of new treatment modalities.

Saturday August 8 and Sunday August 9

John had a relaxing weekend and I will have some photos taken by Hudd and Tanya of his activities in the next day or so. He is doing well and I will update his status tomorrow. Thanks for your patience!

Friday August 7

Sometimes when I think back over the past 66 days I am so grateful and yet at times I also feel perplexed. While, it is amazing that John has accomplished what he has in slightly over two months, it also confuses me as to how such a virile and wonderful person ended up in such a predicament.

His life has changed and our lives have changed. Those of us close to him miss the usual being around him, going out to eat or seeing him at the gym or school and Holly misses him at home. We remain in this holding pattern waiting to see his progress and hoping that he will surpass all expectations, and so far he has reached the moon and back. We also remain constantly on edge as to what might happen next in terms of his overall achievements and what the future holds. We have some idea as to what is possible but the truth is that it is such an individual task, that no one, and I do mean no human, can tell what the next few days, weeks, months, and even years hold for John. What I can tell you is that the photographs you have seen aren't apparitions or some desert mirage. John does stand and move and talk and walk and dance and his cognitive levels improve daily. I think the hardest thing for each of us is to realize that this is a process and it is a lengthy journey.

We have realizations daily about where we were and where we are but the fact remains that John continues to heal. His body is healing from being sedentary for a bit, his brain is healing from periods without oxygen and his soul is healing from being in a strange place for an extended period of time. Sometimes people want to know more about, "What is really happening with John", but I can tell you that what I write here is what I see. Granted, I am not objective...I love John as if he is my brother and he and I have a connection but I also feel deeply obligated to give the information to the blog readers and all who love him most, in a succinct and honest way without any sort of fluff.

I occasionally glance back to the earliest parts of his journey in my mind and through blog form and am constantly reminded that each day is a blessing beyond each of our wildest thoughts. To see him at North Cypress Hospital, then Triumph Hospital then TIRR has given me a perspective about his recovery which continues to confirm that his spirit and level of fight is extremely high. John never ceases to amaze me and although I'm not usually a tearful person, he can say something that will make me laugh so hard that I feel fulfilled and as though I might burst open with happiness and sadness all at the same time. I'm pretty sure the above photographs are an accurate depiction of this! I should mention that John is his usual self when it comes to taking photographs and he will rarely allow pictures to be taken without making funny faces or trying to strangle those near him!

Wednesday August 5

As promised, some photos of John and Holly dancing. While I was taking pictures, I asked who was leading and Holly said, "Me, I always lead", and I have to say; John followed nicely! I also received a couple more photos from John's friend Ed Raine of John in action on the football field.

John has had a bit of a cough so at the moment he is a restricted in terms of vigorous activity. His physicians want to make sure that no infection is present and that things are going well with his body so as a precaution, they are limiting his activities until Monday. John has a really hard time sitting still so it will be a challenge to keep him relaxed and even slightly stationary in the next few days. Holly brought him his IPOD and is on her way up to TIRR with some chicken. She figures that even though John cleans his plate, he might want some variety. Plus, most of the food at TIRR is a bit under-seasoned for patients with dietary needs so she is taking John some jalepenos to enjoy with his meal and wake up those taste buds. She and Paulette are going to bring John down to the dining room for a change of pace. There are lots of windows and lots of people so plenty for him to see and stimulate him.

Tuesday August 4

We have received numerous, much appreciated, ideas about ways to inspire and interact with John and even used his cues to come up with some of our own. Recently, we have begun to try to help John along with his shorter term memory so Holly came up with the idea that since one of John's passions is being a coach and referee it would be great to bring his referee uniform shirt, whistle and lanyard, and shoes. You must understand that John took as much pride in his uniform as an Army Green Beret might and his shirt maintains a stiff crease along the arms and his shoes are so polished that they gleam and probably blind any sports attendees who might think briefly about arguing with his calls! I did not know that tennis shoes could be shined to that point but I shouldn't be too surprised because I bought a truck from John several years back and that paint job didn't have even one flaw. Interestingly enough, my father bought the truck from me and it sits in his driveway with the most perfectly shiny paint job as any new car on their street straight out of the showroom would have.

So, the above pictures were taken tonight. Holly began to ask him to give calls like she would say, "Foul number 17", and he would make the appropriate signal. John became EXTREMELY animated and was perfect in every call (or at least so I'm told!). The above are when I asked him to show me field goal and touchdown. I hope it's obvious in the photos that John is standing fully upright to give the calls. He still sometimes gets a bit tired but he can stand with almost no assistance and walks with just some balance assistance. It is fantastic to see and he was so incredibly excited to be making calls! His favorite call of the night was when he gave me a technical (and yes he got the sign right!) for mouthing the ref! That one cracked us all up.
He and Holly also had a moment of hugging and then dancing. I got the hugging and will post the dancing ones tomorrow. I love this photo as it seems to show what is going on with John and Holly directly. There is a level of support and appreciation and a sense of reciprocity in this photo that blew my mind when I looked at it larger.

John also read the first few days of the blog (Holly printed it off and brought it to him) to us out loud. He seems to be in the first stages of understanding what happened to him and him reading the blog as if he were a third party is powerful beyond description.

Monday August 3

Holly snapped this picture of her and John after playing some football yesterday. He also walked some during the day and continued his physical therapy even though there was no rigid schedule for it.

I feel the need to point out that while photographs are an amazing way to express what words cannot, there are still some hurdles which John will face very over the next few weeks and months. Although his brain is beginning to process information, he is still trying to re-learn so many things that it is a lot for his mind to comprehend on a daily basis. I liken this to the way that as each of us goes through our day, we don't necessarily answer questions or have to reiterate our life story to each person we come in contact with but John does!

We are amazed beyond words with what has happened so far but at the same time, we equalize our thoughts with what is yet to come. Holly is now back to work full time and has been for a couple of weeks and this is a great thing for her and John. It allows her peace of mind that John is in a great setting which challenges him daily and keeps him safe while giving her the ability to provide for their household. Her co-workers and bosses at Upchurch Kimbrough have been thoughtful and understanding in that they have provided her with the huge gift of time with John when she has needed to be there most. Holly is abundantly appreciative of this gift and feels this gratitude daily.

Saturday August 1 and Sunday August 2

Weekends at TIRR move at a whole different pace than the loud, sometimes frenetic action that occurs during the week. Few patients receive intensive therapy on the weekends however there are still some therapists who do group activities with patients on both Saturdays and Sundays. In the common areas, patients play dominoes, cards, and other games which help with mental acuity and provide interaction. Last weekend, John played Wii bowling and he almost won first. I'm pretty sure the winner was a Wii shark but my understanding is that John had a blast so I guess it's not that important who won. The week before that, John participated in Bingo and he won first place.

Today, Holly and John played some catch in the hallway with another patient named Jason. Jason is a senior in high school and has really been interested in getting to know John and visa-versa. There is a true connection between these patients and their shared circumstances and sometimes they can just look into each others eyes and you see as an observer what so many words cannot say. Some of the patients can speak and others have difficulty but John is friendly to everyone and will frequently reach out his hand to shake that of another or thank his therapists throughout the day with a handshake or verbally. John has always had impeccable manners and is as friendly as ever which shouldn't surprise anyone.

Over this weekend, Paulette went home for some much needed respite and to check on things at her house and take care of household chores, etc. Holly spent most of the weekend with John and they even napped together. Holly provides a much needed normalcy to this whole situation for John and it seems as though he is becoming more aware each day of what has happened to him and why he is where he is. He is now walking from his room to the common area to enjoy meals and Holly took him to the main cafeteria twice over the weekend to enjoy something from the buffet line. The food at TIRR is really good and John has not found a dish there he doesn't like! The main cafeteria is just like a restaurant and he enjoyed selecting items from the menu and loved the breakfast tacos yesterday and pancakes today.

This week will continue John's intensive therapeutic sessions and I hope to get back to TIRR soon to get some more photographs. As always, thanks so much for keeping up with the blog and your continued support of John, and us.

Friday July 31

I was able to be with John during part of his speech therapy session and all of his physical therapy session today. I haven't actually seen John walk or climb stairs and I was in awe and complete amazement. The above photos were taken in the big TIRR gym. The photos of him waving are so great because the whole gym was waving back at him and it sort of reminded me of a person of nobility waving to his minions! His therapists shown in the photos are Desiree and Charles. John practices voice volume when he is on the second floor, his speech is good but he needs to get a bit louder (most of you won't believe that he needs to get louder but it's true!). You will see that John still requires a bit of stabilization and some help to make sure he doesn't fall but it gets better each day and he requires less help as the days pass.

If you can't read the quote on the wall, it says, "Man uses the tiniest strengths for the greatest purpose". That quote seems so appropriate in John's case and also the other patients receiving treatment at TIRR. This place is as spiritual as any I have been and it is absolutely a place of worship in many ways and miracles occur here. You can just feel the fact that a higher power is at work in this gym and there is strength returning, minds healing and lives changing.

The best part about being involved in this process is that everyone seems to know John and all of the therapists speak to him by name which is exceptional in that this facility currently houses around 200 patients. You almost feel like a band groupie or as if you are in a parade walking around with John! The gym area is a theatrical production of patients moving with their therapists through a myriad of equipment, noises and distractions. I constantly feel clumsy and in someone's way but they move through the area as if they are performing that all-cast number of any of your favorite musicals or the ballet.

Today was also great because while John was receiving physical therapy, he participated in music therapy. It looked like John had assembled a mariachi band as we moved down the hall but there is actually a very useful purpose to this music therapy combined with physical therapy. The guitarist (Kate) and another music therapist (Amy) play chords and help each other to give feedback about what needs to happen with the tempo and this gives John a cadence for walking or climbing stairs or whatever he happens to be doing. Heck, I think she even had a tomato picking song! They have to be able to walk backwards, to tempo, playing guitar and at times guiding John verbally. It sort of reminds me of Ginger Rogers and Fred Astaire because she had to do everything Fred did backwards and in high heels! I would be hard-pressed to chew gum and walk so again, I just tried to stay the heck out of the way and snap pictures as they went along.


As we made our way down the corridor, we were headed outside and realized that it was pouring down rain. We haven't had much rain in these parts lately, so it was a bit surprising to see and of course as quickly as it started it stopped so after John took a quick break and we all enjoyed some music, we headed outside. There is a back courtyard which has a garden area with some herbs, vegetables and flowers. John pulled some weeds and was really drawn to the tomato plants. We also got to feel some raindrops on our faces and arms and since John has a clean-shaven head, he got to feel it a lot!XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
I wanted to close with the above picture. This is the first photo of John I have taken of him standing by himself without any assistance and the first time I have seen him do so. He is able to do this for about ten seconds but that is hard to show in photos. None of us could have possibly conceived of this level of progress even 30 days ago and although the photo isn't great, for any of us who saw him within the first few hours or days following June 2, 2009, it is astounding on all levels.