Friday, February 25, 2011

If you're looking for an update on yesterday, you might want to prepare yourselves for disappointment. You see, just before bed last night I was tiptoeing in the dark and tripped over my phone charger. This caused my brand new phone to fly directly into the glass of water on my bedside table. The best part is that I didn't notice until about an hour later when my phone was making this really bizarre UFO-like ringing noise for 5 minutes straight. Not only did I lose the majority of my contacts, but I also lost all the notes and pictures to update everyone on what happened yesterday, which was huge by the way. But hey it's cool, luckily I have this really sweet backup "smart" phone that turns off randomly and has a completely shattered screen. Life is good!

First I wanted to point out how awesome Trevor's support system truly is. Who else would have this big of a crowd rooting him on during the little things, such as playing "Connect Four?" Not very many people, that's who. Although it's really unfortunate and heartwrenching to see all the brain and spinal cord injury patients going through intensive rehab with no family or friends there, it makes me realize how lucky we are. Most everyone in my family has been willing to give up everything going on in there lives to be here, and to me, that is huge.

Apparently the earlier sessions of therapy went really well today. Supposedly Trevor counted for 1 to 2o, was able to distinguish between five different objects, said "Gabe," knew he had 3 brothers and 2 sisters and said his birthday. However, by the point I got there, he was overwhelmed and exhausted.

First was speech therapy.

The therapists worked a lot with how how to use pictures in order to express what Trevor is feeling or needing. They held out four pictures: a happy face, a sad face and two other things that have momentarily escaped my memory. They asked Trevor which one meant yes; he pointed to every single before getting it right. Then they drew a bunch of pictures on a sheet of paper for Trevor to use. There were pictures of happy, sad, pain, urinal, toilet, up, down, etc. All of these seem like they would be super helpful for someone like Trevor, who is completely unable to communicate what he needs. Only problem is that I'm not sure whether he gets it or is just guessing all the time...

Next they wanted to see how well Trevor does with following commands. This was absolutely painful to watch. If you need someone to be on your "Simon Says" team, I wouldn't recommend picking Trevor. Wait, are there such things as "Simon Says" teams? Whatever.

The therapist asked Trevor where his shoulder is; he pointed to his cheek. She showed him where it actually is. She then told him to lift his shoulder up; he raised his hand. She asked him again; he raised his whole arm. She asked him again; he rubbed his face. He seems to always rub the scruff on his face when he's either frustrated or confused. It's totally his thinking face. Anyways, after this she helped show him how to lift his shoulder up by doing it for him. She asked him to lift it up again; he lifted his right arm up with the left one. She asked him again; he rubbed his face. She asked him to do it again; he lifted his shoulder. YES! But then she asked him to do it again and he raised his arm.

He got almost every command wrong and didn't even seem to notice. During the last rodeo, I remember therapy being more of a time where he would do or say something completely wrong or off topic, but would realize the error. This time seems totally different. I just wish I could get inside that head of his and know what he's thinking and how much of all this he actually understands.

Next, they wanted to work on his speech. Here is how the conversation between Michelle the therapist (M) and Trevor (T) went:

M: Trevor, say yes
T: Ssssss
M: Say yes
T: Yes (Yes!)

M: Trevor, say no
T: Yes
M: No, I want you to say no
T: [A lot of thought] Shoes

M: Trevor, put your tongue behind your teeth
T: [Raises his hand]

M: Trevor, can you finish my sentences? Let's link these words together. Yes and?
T: Shoes
M: Ok, hot and?
T: Cold (Yay!)

M: Cold and?
T: Shoes

I forget what the medical term for this is but it's pretty common for traumatic brain injury patients to get stuck on certain words or actions if repeated too often. Once this happens, you have to drop what you were talking about or doing, and move on. Clearly, today he got stuck on the word "shoes," which I think is from him saying it in therapy so many times yesterday.

Okay, now back to the conversation:

M: Trevor, can we count from 1 to 20?
T: 1, 2, 3, 4, 5, 6, 7, 9, 9, 10, 20, [Thinks for a while] Shoes

M: Can we do days of the week now?
T: [Points to the "no" sad-face picture]
M: Can we just try?
T: [Points to the "yes" happy-face picture]
M: Okay, Sunday...
T: 1, 2, 3, 5, 6, 6, 6, shoes (666? Yikes.)

The therapists decided to drop conversation and go back to following commands. She put five objects out on the table and told Trevor to hand her the cup; he grabbed the ball and then handed her the comb. She told him to hand her the scrubber; he threw the sock and then handed her the CD.

Is he comprehending what we're saying? Your guess is as good as mine...

As you can see, during recreational rehab they worked on using a computer. We could give Trevor the benefit of the doubt and say that he struggled because he's used to Macs and not PCs, but I'm not so sure that's the case. She pulled up "Google" and told him to search something. It was pretty similar to what the 5-year-old I nanny for types when playing "Office." When she told him to type his name, he entered "Tarav WresaeDS." Although he got a few of the letters right, it was not super reassuring.

According to his "rehabists" (as he called them during the last rodeo), today's therapy was a great example of Trevor's cognitive mental fatigue. What does that mean? Well, I'm no doctor but I think it means that Trevor gets to a certain point where he just points to things or guesses because he's over it and wants therapy to be over with. Cleary I didn't get that out of the Meriam-Webster Medical Dictionary so if it's not a good enough definition for you, look it up yourself!

What else? He's been coughing a ton today. If this doesn't get better, they're going to have to start suctioning again, which nobody is looking forward to. The nurses say it's from drinking fluids down the wrong pipe. Payton argues that it's because of the chocolate shakes here. "They're so good I want them to go down both pipes."

And to end on a more positive note, the staff here at the U's Inpatient Rehab have been impressively awesome. They're all happy and nice, and seem to really love their jobs. Overall, they have definitely made up for the lack of visual essence of this unit. Yup, I love 'em!

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