Day 77 & counting.

Dear friends,

Today is Day 77 since the accident, and I keep hearing a word pop up:

• “What’s the damage to his brain look like now?”
• “Is damage going to inhibit him from talking?”
• “His brain was damaged from the accident.”

Damage means a change in something for the worse. It doesn’t convey the time warp G’s in right now. His forward progress defies its very meaning. What we’re talking about here is injury. At the scene of the accident, Gabe was completely unconscious and on death’s doorstep. At Day 3, he was intibated, on life support, and in a full-scale, unresponsive coma. Day 14 he auto-regulated his inter-cranial pressure and the invasive head monitors were removed. Seven days later he localized pain and was no longer considered in a coma, but a vegetative state. By Day 28 he was breathing on his own, moved out of the ICU, and weaning off painkillers. By Day 34 he began passive rehab therapies (occupational, physical, speech). And on Day 47, he awoke. In the past 10 days he’s been distinguishing letters, shapes, colors, and use of household objects. So stop thinking damage because he’s far from hitting his ceiling yet, and we’re looking at years before he does.

Now, what’s Gabe been up to? Is he bored? Does he talk? Is he standing up yet?

Monday through Friday Gabe has 3 active hours of rehab treatment—OT, PT, and speech. As of Day 67, Gabe is now fully weight-bearing and his pelvis fractures have healed 100%.  You can bet his physical therapist got him up right quick to assisted standing, kneeling, and sitting cross-legged. He does this three times a week for 10-15 minutes to relearn balance, establish equilibrium, and rebuild the 30 pounds of muscle he’s lost. PT is also developing his neck muscles and he’s holding his chin up pretty close to what you and I do every day. He’s doing this more often for longer periods of time. A reminder, his left side, from hand to foot, is still considerably weak. He can recover, he’s just going to have to work twice as hard on the left as he does on the right.

In terms of cognizance, he is more alert to his surroundings. He has greater focus and his attention shifts quickly. He is also responding commands consistently, which include:

• “Gabe, look at your calendar/letters/bike jersey on the wall.”
• Touch your nose/ears/left hand/knee/thigh/shoulder/chin/etc/etc/etc
• Cognitive awareness of objects (i.e. knows what to do with a comb, toothbrush, chapstick, electric shaver, moose)
• Cognitive choice between two objects (i.e. queens vs. brooklyn t-shirt or mishka t-shirt; book of animal stories or book on cycling

Speech therapy has the goals of establishing communication through speech and aggressively weaning him off the trach. Something really cool: Gabe is mouthing words. On Day 65, his doc asked him if his last name was Allen, and for the first time, he mouthed something in return! We were all surprised by that one, I think even Gabe was because his eyebrows popped up and his eyes widened. We explain to him that even though there isn’t sound and won’t be until the trach comes out, it’s totally cool to still move his mouth. Last Wednesday, Day 71, he mouthed “Hi, mom,” to Donna. Yesterday, he was asked to finish about seven sentences, like so:

• We can drive east or ____
• The elevator goes up or ____
• That invitation was sent to me and ____
• The door swings in and ____

He mouthed all but one of them! Today, objects were held up and he named each one, and showed how to use each (whistle, sunglasses, watch, butter knife, hammer, etc).  He moved to put his sunglasses on, and picked up the mirror to check himself out. When he realized the watch wouldn’t fit over his left hand, he slid it over mine and then helped to take it off.

Something else mighty cool are the foam letters Donna bought for him on Day 66. She had the bright idea of using Y for yes, and N for no. When a question is asked, he’ll respond by touching it or handing directly to whoever is asking. Keep in mind that his movements are still not fluid and graceful as yours and mine are; he’s still learning dexterity of his fingers. Gripping an object and letting go of it are difficult, operating on a 0-15 second delay. But it’s improved as he used to have a 10-20 second delay. You can imagine the patience one builds when working with him. On Day 71, I busted out the letters and laid out a blue E and red R and explained that we’d practice picking up and letting go of the letters, which would build to popsicles, cupcakes, and coffee cups. “Gabe, can you hand me the blue E?”

BOOM! He reached out for it, took it, and placed it in my hand. And this was the letter further from his grasp. I replaced the E and R with a yellow 6 and green 7. “What about the 6? Can you hand it to me?”

Sure thing, no problem. He hands me the 6. What was fascinating was that he not only distinguished the shapes of the numbers and letters, he did so despite whether or not I said the color.  I pulled the letters, D-O-G, mixed them up, and placed them in front of him. I spelled the word DOG, and he handed me the letters. After we spelt GABE. He did both with ease and his ability to release his grip is better. Donna and I do this with him every day, and every day we see a difference. We see control.

One last good story about Gabe’s awesomeness: last week on a reconnaissance trip to check out acute rehab hospitals, I raced in Prospect Park; despite coming in last out of the five women, I was still awarded a yellow Tour de France cap. When I returned I placed the cap in his left hand and he took it by the bill in his right and moved it up to his head. He got the front on, and I pulled it down in the back. He took the mirror offered up, but closed his eyes without looking. I turned to rummage through one of his drawers, and when I turned back he was checking himself out in the mirror. There’s a picture of that, and sometime soon I hope to share it with you all.

That’s a quick fell-swoop of what Gabe is up to. A good friend of Gabe’s recently wrote me after receiving an update:

I am amazed at the progress Gabe keeps making, then at the same time I am not b/c it seems so in line with the way he is.  I see it very much like I see him when he is racing at the track or during an alley cat.  He takes a smooth approach, never looks like he is exhausted, but keeps making steady progress.

It’s true. And the man is just revving the engine.

-Kierie