Here is an update on Marks condition. He is making progress but it is slow and steady. Keep him in your thoughts and prayers as he continues to get stronger. Happy Thanksgiving everyone! This has been a long and busy week, anticipating Marks return and getting him settled in the Halifax Infirmary. Things happened really quickly in Thailand leading up to his release, and his recovery continues to be remarkable. Ill pick up where we left off last week and bring you up to date on his current condition - this is the long-winded version. Marks Flight: We had made preparations to repatriate Mark through contacts in NS (MSI has a nurse liaison that will help coordinate this for out-of-province residents), but in the end it was the Thai hospital that made the arrangements. Because it is an international hospital and they deal with a lot of these situations they have a staff member who will travel with patients to ensure they arrive home safely. Dr. Melcher, a German physician now working in Phuket, was Marks escort, along with a nurse from the hospital who was also familiar with his condition. These two incredibly compassionate men ensured Marks return was comfortable and uneventful. The flight was a long and tiring trip for Mark, but he completed the 36 hours without incident. The happy coincidence about his early release was that his flight was scheduled to arrive in Halifax within 2 hours of the original return trip that my parents had tentatively scheduled. Due to a delay in Toronto he was about 5 hours behind my parents, and because of their fatigue from their flight I encouraged them to drive home with James. Mark finally did land in Nova Scotia close to 11pm on Wednesday night. He was escorted through the Arrivals gate, attached to the EMS stretcher, and to my great surprise and relief I saw recognition in his face. He was able to speak my name clearly, recalling it without any prompting. He could talk quite well, despite having the trach in place, and even asked how I was doing and where I was going. He was glad to hear I was following him to the hospital, and the nice thing for both of us was that he was soundly asleep in his room by the time I arrived. Physical recovery: Early Thursday morning Mark was examined by Neurology, Orthopedics, and Plastics to assess his physical and mental deficits. He had consults with physiotherapy and OT that morning as well and x-rays and swallowing tests were performed early afternoon. - Speech - as mentioned, I was surprised how well Mark was able to speak with the open trach in place, albeit laboured and slow. Ill mention more about the trach itself below, but once it was changed and corked he was having no trouble communicating. - Tracheotomy - a new trach was placed Thursday morning. The doctors were quite surprised Mark was able to talk as well as he could with the open trach that he travelled with. Once the new one was in place it was corked. This means he now breathes and talks normally (despite the tube sticking out of his neck). As long as he continues to have good oxygen saturation (normal O2 concentration in his blood) they will take the tracheotomy out today - there were no problems when I left. - Eating - a swallowing test was done Thursday morning. The one drawback was that Mark had some liquid and solid foods slip back into his larynx (breathing tube) instead of it all going straight into his stomach. Despite eating everything in Thailand he is restricted to a puree only diet to avoid the risk of aspirating food into his lungs. If his tracheotomy is able to come out, this will give Mark more feedback (cough if something goes down the wrong tube), and he should return to a normal diet soon afterward. - Left Eye - Dad had mentioned just before they left Thailand that Mark indicated he was only able to see the general outline of objects with this eye, however, by the time he was assessed in Halifax he was able to read the name on the Doctors hospital card, and tell time from the clock across the room. The eye itself is still quite bloodshot and there is reduced muscle tone in his eyelids and orbital muscles, but that is quite common when there is a serious eye socket fracture (still incredible recovery of his vision) - Left arm - Mark often complains of pain in this arm (hand and knuckles specifically), but still has no feeling or movement from the left shoulder down. We are still not sure if the nerves were stretched or compressed, but they were not severed. There is still some hope that the sensation will come back on its own (can take up to 6-12 weeks), but if not there are surgical options that we will pursue. Mark currently wears one of two slings at all times to support his dislocated shoulder (walking or resting sling) - these were custom made by the OT and have made his arm much more comfortable. - Right arm - the radial bone was fractured but approximated well with a plate. He has good movement in this hand and is not wearing a cast. - Walking - Mark would walk most of the day if he could. He is steady on his feet and walks without support. The frustrating part for him is he is not allowed off the unit so it is easy to get bored after about ten laps of the small oval ward - we still do 50-60 laps each day. Cognitive recovery: this is still the most concerning. I was encouraged and heartened that Mark recognized me at our initial contact. His long term and short term memory are still limited at this time. He can quite easily follow a conversation, answer a series of questions, comprehend instructions and follow statements about his current condition. Sometimes his recall is ok (addresses you appropriately, can remember names of family members, and other details) but he often cannot reply accurately. You can tell that he is trying to formulate memories, or create his own stories, from the few details he does recall or specifics from recent conversations. I was teasing him about his new chicken legs and how I would run circles around him on the soccer pitch right now, which he had to concede. Ten minutes later he was asking me about when the pitch run was taking place and if he could enter the race. Other memories seem ingrained. I did ask if he knew which soccer team was his favorite; he couldnt remember so I cleverly tried to convince him it was Liverpool and that Steven Gerrard is his favorite player (and still world class). He immediately knew this wasnt the case and replied he was a Man Utd fan, but did admit he couldnt actually remember if that was true or not. He also seems to have no major deficits with reading and writing. Last night Julia had him reading from a newspaper verbatim, and he could also clearly write a message to her: Hi guys, Love from Mark These are some positive signs in his early recovery, but we still have no idea how he will improve. The physicians are reluctant to give specifics, but indications are that he will get close to normal, but likely not 100% - we can only pray that this rehabilitation continues as well as his physical recovery. Visitation: Mark currently has specific infection controls in place on his unit - we must gown and glove to enter the room with him. He tends to do very well with one person in the room with him, and when one or two health professionals are present (engaged in conversation, fairly easy to keep calm, polite and appreciative). When there are a number of people in the room he gets easily confused, finds it more difficult to follow a conversation and can get agitated over time. The nurses tell us this is quite common for serious head injuries. Our family is taking shifts over the weekend, and the hospital provides a sitter from 8pm to 8am. Unfortunately, however, Mark is unable to receive other visitation at this time - we will certainly let you know when this situation changes There is a lot our family has to be thankful for this fall. We continue to pray for further improvement in Marks condition. Happy holiday to all! Scott - See more at: youcaring/medical-fundraiser/-medical-relief-for-mark-/86980#sthash.bulv9Ffk.dpuf
Posted on: Mon, 14 Oct 2013 00:32:31 +0000
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