9 weeks

It's now been a little over nine weeks since this nightmare began and I am so ready to go home. I'm not sure where to begin, I suppose where I left off would be a good place to start. We had a roommate for 24 hours then Jerry was put in isolation because he contracted MRSA from Kindred Hospital. The positive side to this is we were moved to our old room of 3 1/2 years ago and we have the room to ourselves. It's been great having therapists, nurses and doctors who know Jerry from his past stay here. Jerry is very well cared for here and I appreciate finally getting the therapies that he needs. For the most part I've been very satisfied with our stay however if I'm being honest I'm not satisfied with the neuro rehab, which is our main purpose for working so hard to get here. The speech therapist has been working on memory exercises which is good but as of yet there has been no neurological assessment. My understanding is the psychologist is the person who is to make an assessment.  Jerry has only seen the psychologist once, in the session she spent the majority of the time focusing on depression and not assessing his neuro status. The psychologist is only planning on seeing Jerry once or twice a week, I can't see that being a sufficient amount of time to rehabilitate Jerry's brain damage. After the session was over I spoke with her out of Jerry's earshot and expressed my concern about Jerry getting a proper assessment. I want a full evaluation to determine exactly the extent of brain damage, and what course of action will be taken to rehabilitate. The psychologist said a full evaluation will be done later, more then likely on an outpatient basis, she explained that he is continuing to heal and make progress and if they do the eval now it will likely not be valid by the time they get the result of the assessment because he will have advanced beyond it. I expressed that logic does not make sense to me, Jerry will likely continue to heal and regain for the next year, you have to assess where he is now so you know what course of treatment is appropriate. The doc said she will do small assessments now but the full eval will be done later. ....so why are we here? This is the best brain injury rehabilitation in CA? I don't get it! It's time to get the trach out, go home and continue treatment on an outpatient basis. 

Jerry continues to improve every day, his voice is almost back to normal and his speech is not far behind, he had TMJ (locked jaw), his teeth could not come together, he had about a 1 inch gap. Jerry's jaw was in pain which is why he wouldn't do his computer and struggled with speech. The TMJ is almost gone so tomorrow he should be upgraded to a normal diet with no limitations. The challenge now with Jerry's speech is having enough air to finish a sentence, he generally runs out of air after 4 to 5 words so the end of the sentence is barely a whisper. When he's tired he doesn't enunciate as well so it gets a little more challenging to understand him, however that's usually later at night.  Jerry was finally able to work his computer yesterday, he fatigued after 30 minutes but I was so thrilled to see that he was capable and now remembers how. Looking back there have been so many improvements, a week ago Jerry could not tell time, and now he can tell time about 50% of the time. Jerry had a calc 2 math equivalent but till today couldn't add, subtract or do basic math, however today he played triominos in skills group and was able to do some simple addition. Jerry suffers from short term memory but seems to remember everything before this incident.

Today I accidentally decannulated  Jerry, I tried to convince the doc to leave it out however he wasn't going for it. While I was changing Jerry's shirt the collar got caught under the trach, when I stretched the collar a bit to get Jer's arm out of the shirt it pulled the trach right out. The actual trach collar that holds the trach in place was way to loose so it didn't take much to pop it right out. The doc inserted a new trach and everything was fine. Jerry also got the stomach tube removed today, I was glad to have that thing gone. So lots of steps in the right direction, progress is being made everyday and we are very close to going home, the projected discharge date is July 2.

Good night,

Katie