In Training

July 21, 2011

It’s been a little while since I’ve done an update.  There are a few things to report.  The first is that the hole in Meg’s neck left from the trach still has not completely healed.  The doctor who performed the tracheotomy said normally it takes from one day to one week to heal after the trach is removed.  Unfortunately, it’s been a number of weeks since her trach was removed and she now has an appointment in early August to see a plastic surgeon as it might require another operation in order to close it.  On the other hand, Meg’s new Physical Therapist told us that in children (and I assume that includes young adults) the healing process can take much longer.

Another problem we are having is getting Meg outpatient therapy.  We received a call from CHKD (Children’s Hospital of the Kings Daughters) but they said it will take a few weeks to get her in (the case manager from our insurance company thinks it might even be longer than that).  In the meantime Tracy has arranged for home care so Meg doesn’t lose any of the ground she’s gained since being in rehab.

In addition, I’ve been working with her after work having her hit wiffle balls and playing catch.  Other than her balance being a little off and her movements somewhat tentative and a little unnatural, she doesn’t seem to have any problem with her hand/eye coordination and has been cracking the ball over the house. And I’m not lobbing the ball to her either. I’m pitching overhand and I’m not going particularly easy on her either (OK, I’m holding off on curves and sliders . . .  for now).

To help her regain her balance her Physical Therapists in Charlottesville gave Tracy a number of exercises we can do with Meg that include walking heal and toe along a masking tape line while holding a soccer ball to her left and right side and over her head.  She’s also been doing a lot of stretching exercises and walking on the treadmill. So everyday after work I tell her she’s got to go to “Gerety’s PT Bar and Grill” for her daily workout.  Tracy is also getting her puzzles, games like Catch Phrase, and even workbooks to help Meg regain her mental agility.

Meg did decorate her helmet with stickers.  Prior to the stickers and after taking her friend Keila and her for a bite to eat the other day, she said to Keila that she should get one of those tee-shirts with the big arrow that says, “I’m with stupid.”  That was sad.  Hopefully the new and improved sticker covered helmet will remove at least some of the stigma and embarrassment of having to wear it in public.  On the other hand her new OT guy said she just needs to “suck it up” for a few months as it could be devastating if anything were ever to hit her “soft spot.”

One of the things Meg wanted for her birthday (which was on June 27th while she was still in the NICU and starting to come out of her coma) was her nose pierced.  Prior to the accident I was adamantly opposed to it.  Since the accident I have admittedly weakened (you try to say “no” to her).  However, before letting her get it I made her sign a contract that included a number of stipulations including:

I will not ask nor get another part of my body pierced at any time until after my 18th birthday and even then will not get any piercings that would make a grandparent wince or is just plain gross.

There were a number of other contractual agreements that she happily agreed to at the penalty of permanently losing her cell phone along with not being able to drive until she’s 18.   However, there was one clause that I stole from my brother which she refused to put her name to:

I will wear pillows around my head until I’m 30.

Well, I tried.

I’ve included a few more pictures that illustrate Meg’s progress.  Admittedly, pictures can be a little deceiving as she does have a way to go until she’s back to normal.  The attending physician when she was in rehab in Charlottesville said that even when she appears to be back to herself, which may be in a few months (or sooner God willing), there could be latent issues with things like reading comprehension or emotional issues that may take considerably more time to resolve themselves.

Things to pray for: 1) That an opening opens at CHKD for outpatient rehab quickly. 2) That the hole in Meg’s neck completely closes and heals on its own without the need for any additional surgery.  3) That her skull completely regenerates so the anticipated reconstructive surgery may also be avoided.  4) That Meg quickly and completely regains all of her mental and physical agility.

Then Jesus said to them, “Most assuredly, I say to you, Moses did not give you the bread from heaven, but My Father gives you the true bread from heaven. For the bread of God is He who comes down from heaven and gives life to the world.”

Then they said to Him, “Lord, give us this bread always.”

And Jesus said to them, “I am the bread of life. He who comes to Me shall never hunger, and he who believes in Me shall never thirst. But I said to you that you have seen Me and yet do not believe. All that the Father gives Me will come to Me, and the one who comes to Me I will by no means cast out. For I have come down from heaven, not to do My own will, but the will of Him who sent Me. This is the will of the Father who sent Me, that of all He has given Me I should lose nothing, but should raise it up at the last day.  And this is the will of Him who sent Me, that everyone who sees the Son and believes in Him may have everlasting life; and I will raise him up at the last day.”

The Jews then complained about Him, because He said, “I am the bread which came down from heaven.” And they said, “Is not this Jesus, the son of Joseph, whose father and mother we know? How is it then that He says, ‘I have come down from heaven’?”

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Coming Home

July 13, 2011

This is just a very quick update to let folks know Meg and Tracy came home last night from Charlottesville.  Only 12 days for in-patient rehab.  I think I freaked her out a bit last night because I kept going in her room every five minutes or so just to look at her.  Their last order of business before leaving was having Meg’s right eye checked by a neurological ophthalmologist.  Everything checked out fine.

A handful of Meg’s girlfriends are over right now for pizza a movie.  I couldn’t be more thankful.

It looks like she’ll be getting set up for outpatient rehab at one of the local CHKD locations.  I praise God for bringing Meaghan home to me and Tracy and I are extremely grateful for everyone for their continued prayers.  Meg has a long road ahead, but if her progress to date is any indication that road may not too long at all.  But, whatever God wills.

In this is love, not that we loved God, but that He loved us and sent His Son to be the propitiation for our sins.

Had a great visit with Meg this past weekend and it does look like she’ll be coming home sometime on Wednesday.  When Conor and I arrived shortly after noon, Meg was sitting in her bed texting away and watching MTV.  She looked great.  That morning she had a full course of OT, PT, speech and even high school. Before we arrived, and as part of her PT, Tracy took Meg for a walk around the grounds that included a walk down and back up a pretty steep and sizable hill.  Meg does need to hold onto someone’s arm or have a spotter when walking, but at least she’s walking.  She also needs to wear her helmet any time she gets up even to go to the bathroom.  Besides loosing her hair I suppose the helmet in her mind just adds insult to injury.  I explained that in her case she should think of it as an exoskeleton, admittedly not a particularly fashionable one, but it’s only for a few months until either her skull regenerates on its own or she has reconstructive surgery (her neurosurgeon thinks it will be the latter, but we’re praying for the former).  Meg did say she wants us to take her to Hotline (a local surf shop) when she gets home so she can decorate her helmet with surf and skate stickers.

I guess the biggest downside about having her hair cropped is that some of the staff at the center thought Meg was a boy.  She said when they were in the cafeteria waiting for food one of the employees turned to her and said; “How’s it going little fella.”  Tracy said politely “She’s a girl,” but Meg said she wanted to punch him.

There is no therapy scheduled Saturday afternoons or on Sunday so it was pretty much hanging around visiting and watching TV.  Meg was really pretty tired and didn’t want to do much of anything. When we arrived Meg had seen a strawberry parfait in a McDonalds’ commercial and was bugging Tracy to run out and get her one.  Not surprisingly tracking down a very unimpressive strawberry parfait from McDonalds was my first order of business.

On Saturday Meg’s friend Victoria showed up with her mother and sister for a visit.  On Sunday it was Caitlin and her mother with Tropical Smoothies and sandwich wraps.  On the way out to some picnic tables to eat I got a kick out of Meg laughing and telling Caitlin; “Did you know that when I was in the hospital I flipped one of the nurses off?”  Of course Caitlin already knew the story, but Meg just thought it was the funniest thing.

I did get a chance to talk to the attending physician who stopped by to check on Meg.  I asked him about her scheduled release on Wednesday and wanted to make sure it wasn’t something insurance driven.  I told him I was concerned that perhaps she was being released prematurely.  He assured me that the decision was completely a medical one, although he understood my concern as there are cases where they’ve had to battle the insurance companies in order to extend a patient’s care.  He said everyone has simply been very impressed by Meg’s progress and that no one thought she’d be where she is right now given the extent of her injuries.  He did say that it could take as long as a year or even two for Meg to fully recover, well after the point where she starts looking and acting like everything is back to normal.  He said there could be some latent problems that might not be easy to identify, like problems with reading comprehension or other learning or emotional difficulties.  He said that generally TBI patients are often given a complete neurological and psychological workup in about nine months in order to determine if there are any “weak spots” that still need to be addressed.  Admittedly reading was already a weak spot for Meaghan before the accident, so perhaps that is something Tracy and I can work on with her beyond any outside therapy.

Meg’s trach opening is still not completely closed.  They said it generally takes from a day to five days to heal.  It’s been over a week.  The doctor said he wasn’t concerned and it will heal when it heals.  Meg also still talks in a very quiet, raspy, and monotone voice.  He assured me that her voice will come back.  She also still has a little bells palsy on the left side of her face, which too should resolve itself.

Needless to say I am considerably more optimistic after the visit that Meg will, by God’s grace, make a complete recovery, even if that’s still a long way down the road.  I think in the immediate future the hard part will be trying to convince Meg that she needs to relax and convalesce and that her recovery will take time.  She seems to think she’ll be coming home and going right to the beach with her friends.  As I mentioned to a woman who posted in one of the comment boxes on this blog (and whose son had a virtually identical TBI and even had Dr. Gurtner as his neurosurgeon), that’s not going to happen for a while unless her mother or I are in tow, which for some reason makes even going to the beach considerably less attractive.

Please continue to pray that Meg does make a complete and full recovery.  Pray also that the Lord will give her patience and that she might learn to appreciate even the boredom knowing that even in those moments God is continuing to rewire and heal all the damage that was done.  Pray that we can find excellent outpatient therapy that will be relatively close to home and that Meaghan will continue to make impressive progress.  Pray too that she will even be able to go back to school in the Fall (why pray small, right?).  Finally, pray that Meg’s skull regenerates on its own and that any further surgeries will not be necessary.

For if Abraham was justified by works, he has something to boast about, but not before God.  For what does the Scripture say? “Abraham believed God, and it was accounted to him for righteousness.” Now to him who works, the wages are not counted as grace but as debt.

But to him who does not work but believes on Him who justifies the ungodly, his faith is accounted for righteousness, just as David also describes the blessedness of the man to whom God imputes righteousness apart from works:

“Blessed are those whose lawless deeds are forgiven, And whose sins are covered;  Blessed is the man to whom the Lord shall not impute sin.”

14 Days in the NICU

July 8, 2011

Below are pictures I took on my cellphone from the earliest days of Meaghan’s 14 days in the NICU at Norfolk General until shortly before she was leaving for rehab.  I think the pictures, at least for me, put things in perspective.  It’s hard to believe how much progress Meg has made in just over 3 weeks (yesterday was the 3 week anniversary of the accident).  It’s also hard to believe that prior to the accident Meg would routinely complain that her mother and I were “too protective.”  Now I have the pictures to prove we weren’t.  Besides, someday, God willing, when Meg is older and has her own kids and they complain that she is being overprotective, she can point to these pictures and say, “See, look at these and then tell me I’m being overprotective.”  That should shut them up.

I also included a grainy picture of the accident that I captured from a screen scrape from one of the television reports.  As I understand it the picture was snapped later that same morning by a neighbor.  You’ll notice the impact was on the rear door on the drivers side.  I was told by an investigating officer that the tree was driven roughly two feet into the car behind the drivers seat.  A couple of inches more toward the front and the boy who was driving, Carter, would have surely died. While I was there on the scene only moments after the accident, I’m not entirely sure if the car had been moved by the time the picture was taken.  (According to police reports the accident occurred at 3:45am and one of Meg’s friends called me at roughly 3:55am and I was on the scene minutes later while Meg was still in the passenger seat of the car and as the paramedics were trying to secure her for transport to Beach General).  Assuming the picture is accurate and the car had not been moved, you can see that the car ended up a couple of feet away from the point of impact.  The car must have literally bounced off the tree.  Even if that’s not the case, the recoil from the impact must have been tremendous.

I suppose these pictures will be disturbing to some, but while I don’t normally agree with the old adage that a picture is worth a thousand words, this time I’ll make an exception.  If these pictures bother you, my apologies.  I do think they illustrate the level to which Meaghan was reduced and how, even as the slides progress, the Lord was at work restoring her to us. The pictures are in order, more or less, of when they were taken.  You can see right from the start where Meg is pictured with an earbud in one ear how we would try and stimulate her back to consciousness with familiar sounds, scents, textures, and smells.  I think in that first picture Meg was listening to one of her favorite groups, Sublime, and, most likely, their rendition of the Grateful Dead tune, Scarlet Begonias.  What can’t be photographed is the nasty smelling body wash Meg loves that we had sprayed on her blanket.  You’ll also notice the groovy blue Addias high-tops Meg’s aunt Gwen and uncle John bought her at the request of the trauma nurses in order to prevent her foot from dropping (I guess they were afraid her feet would get stuck pointing down and Meg would end up walking tippy-toe).

And Jesus said to them, “I am the bread of life. He who comes to Me shall never hunger, and he who believes in Me shall never thirst.  But I said to you that you have seen Me and yet do not believe. All that the Father gives Me will come to Me, and the one who comes to Me I will by no means cast out. For I have come down from heaven, not to do My own will, but the will of Him who sent Me.  This is the will of the Father who sent Me, that of all He has given Me I should lose nothing, but should raise it up at the last day.  And this is the will of Him who sent Me, that everyone who sees the Son and believes in Him may have everlasting life; and I will raise him up at the last day.”

. . . When Jesus knew in Himself that His disciples complained about this, He said to them, “Does this offend you?  What then if you should see the Son of Man ascend where He was before?  It is the Spirit who gives life; the flesh profits nothing. The words that I speak to you are spirit, and they are life.  But there are some of you who do not believe.” For Jesus knew from the beginning who they were who did not believe, and who would betray Him.  And He said, “Therefore I have said to you that no one can come to Me unless it has been granted to him by My Father.”

From that time many of His disciples went back and walked with Him no more.

Then Jesus said to the twelve, “Do you also want to go away?”  But Simon Peter answered Him, “Lord, to whom shall we go? You have the words of eternal life.  Also we have come to believe and know that You are the Christ, the Son of the living God.”

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Wednesday

July 6, 2011

Not to complain, but not being in Charlottesville with Tracy and Meg stinks.  For example, on Monday morning, July 4, I got a call from Tracy telling me they were concerned about what appeared to be excessive swelling around the right side of Meg’s head that appeared to be causing her to continually close her right eye.  She was also complaining about a bad headache.  Plus, earlier in the day while on a treadmill she had to get off and sit down because she was feeling dizzy. Tracy was told that they were concerned that there might be some sort of blockage in the blood supply to her brain and wanted to send her for an MRI that afternoon.  Naturally I started to immediately worry and sent out a prayer request on Facebook and to our church community group.

During the day Tracy would text me wondering if Conor and I were doing anything fun like going to the beach.  She kept texting me telling me to not hang around waiting for the MRI results.  Yeah, right.  About 3:30 Tracy called to tell me that the MRI would not happen until later that evening.  At that point I did take Conor to the neighborhood pool and we went over to some friends for some outstanding Fourth of July BBQ pork ribs.  As it turned out, the MRI was done and everything checked out fine and there was no blockage.  They said the swelling was normal and at some point they’ll have an neurological ophthalmologist examine her right eye to make sure there is nothing else going on.

Admittedly, had they initially said something like: “The swelling, headache and closing of her right eye are probably all normal.  However, we would like to do an MRI just to rule out the possibility that anything else might be going on,” I don’t think I would have spent the day in knots thinking Meg might have a blockage that might require medical intervention or even another surgery.

Thankfully, Meg continues to make amazing progress. Her regiment of OT, PT, Speech and even school has her very busy throughout the day. Tracy said yesterday that Meg’s personality is slowing starting to reemerge.  On a sad note, Tracy said that Meg when was finally able to look at herself in the mirror and she saw that her hair was all gone, all she could do was pout her lips and lower her head in the realization that her beautiful mane was gone.

As the wound from the trach continues to heal Meg is able to speak more clearly.  Admittedly, she still doesn’t sound like herself as her voice is extremely weak and monotone.  It breaks my heart to hear her sound so, well, pitiful (on the other hand this is probably a good time for Meg to hit me up for anything she might want as I don’t think I can say “no” right now).

Meg continues to be confused about a number of things and tends to be impulsive and even obsessive about certain things like her cell phone (we have progressed from Slurpee, Sprite and Dasani).  Thankfully while we were still at Norfolk General Terry 1 told us that this was normal in TBI patients and that it too will resolve itself in time. Tonight Meg had a chicken quesadilla with salsa, sour cream and ranch dressing.  Meg’s four main food groups.  Meg does continue to periodically check her Facebook and yesterday posted her status:  “I want to come home.”

The most important thing to report is that Tracy had a meeting with the rehab team this afternoon and they’re looking at releasing Meg from this phase of her rehab possibly as early as next Wednesday.  It looks like Meg’s Facebook prayer will be answered sooner rather than later.  Praise be to God.

Blessed is he whose transgression is forgiven, Whose sin is covered.

Blessed is the man to whom the Lord does not impute iniquity, And in whose spirit there is no deceit.

When I kept silent, my bones grew old Through my groaning all the day long.

For day and night Your hand was heavy upon me; My vitality was turned into the drought of summer.  

I acknowledged my sin to You, And my iniquity I have not hidden. I said, “I will confess my transgressions to the Lord,” And You forgave the iniquity of my sin.  

Sunday

July 3, 2011

Tracy is settling in with Meg.   She does have a laptop and can get email.  It seems there is no WiFi in her room, but there is in Meg’s room.  Yesterday, Conor and I went out and bought a webcam for our PC and we “web chatted” for the first time this afternoon.  Meg was getting ready to take a nap but I was able to talk with her briefly (she said she wanted to come home) and captured the picture below.  Tracy emailed me the other pictures this morning.

Tracy said they have been working with the OT, PT and Speech Therapist and while tomorrow they’ll only have one session in the morning, they’ll be going full bore starting Tuesday.  Evidently, aside from one boy roughly Meg’s age there are three infants and that’s pretty much the entire Kluge patient population at the moment.  I suppose that’s a good thing as Meg will probably be getting a lot of attention from the staff.  Meg did post her Facebook status today; “in rehab bored.”  My guess is starting Tuesday neither Tracy or Meg will have any time to be bored.  She also posted; “going outside for my first breath of fresh mountain air.”

Tracy was able to leave for a while yesterday and found a Whole Foods and a Walmart close by so she was able to stock up on some supplies.  Also yesterday friends of ours, Albert Lee and three of his four his children, stopped by for a visit.  Albert son’s Jacob is up at UVA and is doing a summer internship.  Today some other friends of ours, Adam and Sarah Shultz, are supposed to be stopping by.  That’s all for now.

Then little children were brought to Him that He might put His hands on them and pray, but the disciples rebuked them. But Jesus said, “Let the little children come to Me, and do not forbid them; for of such is the kingdom of heaven.”

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Saturday

July 2, 2011

Yesterday morning Meg went off with Tracy to the Kluge Children’s Rehabilitation Center in Charlottesville, VA.  Caitlin, Keila and Vic were there to see her off.  We told her that they would be taking her in an ambulance.  She said she wanted to ride “shotgun.”  She also asked repeatedly via hand signals that she wanted her cell phone (she would have to wait until later in the day before getting it).  Meg is still very confused about things, so if anyone gets a text from her that makes no sense please understand.  She’s probably rushing the texting thing a bit, but we’ll see what the folks at rehab think.

Dr. Gurtner stopped by to say goodbye.  She told us to expect great things in rehab and over the next three months Meg should make amazing progress.  She did tell us after that she will plateau, but that she will continue to improve if only at a different (i.e., slower) pace.

At around 9:30 a young, athletic and handsome EMT showed up with a stretcher to transport Meg to Charottesville.  I have to think that made her three hour drive go by quickly.  I could just imagine under different circumstances Meg telling Caitlin, Keila and Vic how “SAAXXY” he was (if you have ever heard Meg say the word sexy when speaking of a boy, which seems to be about every boy, you’ll know exactly what I’m talking about).

The last image I had of Meg was when they were preparing to move her and had to lift the stretcher up in order to wheel her.  I could see her crack a huge, even if a somewhat cockeyed, smile.

That evening Tracy called.  She was totally exhausted.  Besides being barraged upon arrival by rehab staff and administrators, she said they immediately started working with Meg.  They even had her up and walking briefly between parallel bars.  According to the speech therapist Meg doesn’t have use or feeling on the left side of her face so when she smiles or grimaces it’s all on the right side, sort of like after getting Novocain at the dentist.  They said as they work with her that she will be able to get that back.

Today they removed the trach entirely.  It will probably take a day or so to completely heal.  In the meantime the speech therapist showed Meg how to put pressure over the wound so she can speak.  I spoke with her briefly on the phone and she still sounds like she did with the trach valve which is like a very sleepy Miles Davis.*  I did get a “hello,” a few “yeahs” and one “I love you too” before being passed back to Tracy.  I suspect her vocal chords may have been damaged as a result of being on the ventilator, so I guess like everything else it will just take time.

It is amazing already how far Meaghan has come.  A little over 2 weeks ago Tracy and I were preparing ourselves for the news that Meg had died.  In fact, we were told that the only reason they went ahead and performed emergency surgery when she arrived at Norfolk General was because they could see a slight flicker in her pupils.  She was hanging on to this world by a thread.  It is hard to describe how far she has come in a short period of time, but even harder to translate into words how far she still has to go.  But by God’s grace He will continue to restore everything that was taken from her.

In the weeks to come we hope to post pictures of Meg’s progress.  Tracy and I are so thankful for the staff at Norfolk General particularly Dr. Gurtner, Meg’s trauma doctors Novosel and Weireter (who Tracy called “House”), Terry 1, Terry 2, Deborah, Robin, Jennifer, Connie, Christian, Renee, Sharon, and the rest of the NICU nursing staff.  You guys are the best and we look forward to the day when we can bring Meg back to meet you all again for the first time.

* In his autobiography, Miles claims to have damaged his vocal chords following throat surgery and as a result of yelling at his wife at the time, Cicely Tyson, for trying to pull out his hair-weave.  So for the rest of his life he spoke in a whisper, which is really cool for a jazz musician, not so much for a 16 year old girl.

And you He made alive, who were dead in trespasses and sins, in which you once walked according to the course of this world, according to the prince of the power of the air, the spirit who now works in the sons of disobedience,  among whom also we all once conducted ourselves in the lusts of our flesh, fulfilling the desires of the flesh and of the mind, and were by nature children of wrath, just as the others.

But God, who is rich in mercy, because of His great love with which He loved us,  even when we were dead in trespasses, made us alive together with Christ (by grace you have been saved),  and raised us up together, and made us sit together in the heavenly places in Christ Jesus,  that in the ages to come He might show the exceeding riches of His grace in His kindness toward us in Christ Jesus.  For by grace you have been saved through faith, and that not of yourselves; it is the gift of God, not of works, lest anyone should boast.  For we are His workmanship, created in Christ Jesus for good works, which God prepared beforehand that we should walk in them.