Day 47 - Monday January 30, 2012

Well, from time to time it happens, that Bridgett has a day where nothing new happens in terms of her progress. That was today.  Therapy went well.  She was VERY tired today, which I'm sure made a difference.  Mark and Tyler gave her a blessing this evening.  When Mark said Bridgett Noland she said yes?  It was cute. Throughout the blessing she would say okay, uh-huh, etc.  Very sweet.  She is so very sweet.  I'm my mind I picture her spending time with angels (including her grandpa) during her coma and I think that she is awakening with that sweet spirit of the angels, overflowing with love.  By the way, Bridgett started receiving cards from people.  Thanks everyone, she was so excited! 

Day 46 - Sunday January 29, 2012I

I'm pretty sure I didn't mention this yet--so, when the doctor removed the trach Steph wanted to get a picture for Bridgett so she could see what it looked like (later on of course) but they put the dressing on so quickly she didn't get one.  I said, it's OK we'll get one tomorrow when they do trach care.  So, the NEXT DAY when they cleaned the site, Steph and I had gone home for the night.  We asked Mark to get a picture and guess what--the hole already closed in one day!  CRAZY!  I mentioned that to several of the therapists, and the CNA's and they all said that sometimes it takes weeks for the site to heal and they've never seen one heal that fast.  So, Bridgett's body is trying to mend quickly! The hole is closed and it should just take a few days to heal up completely.  Today we went to church again, only this time Arrianne and Stephany joined us.  It was really nice.  I told the branch president before the meeting that hopefully Bridgett would remember to whisper and not disrupt the meeting. He said, she's doing so great.  None of us will mind at all.  I think there were over 40 people there today.  Bridgett sang along with the prelude music and all the hymns, by memory.  She whispered although her whisper is now louder.  Hopefully we didn't disturb anyone.  It was a nice day.  We had a few family visitors.  By evening Bridgett was very tired.  One more Sunday in rehab and only nine total days left if everything goes according to plan!  By the way, they are putting topical antibiotic on the peg and it is looking better.  Oh, Penny told me that Bridgett will learn everything again, but it will be days not months to learn compared to when she was a baby.  So, yesterday's new experience--learning how to blow her nose.  Remember trying to teach your little ones about that!  But, by today she was making feeble attempts at it.  When we played on the therapists ipad today, she got over half of the answers right compared to none last weekend.  Yeah!

Day 45 - Saturday January 28, 2012

It's funny how big of a deal remembering the date is.  I mean, that's always a focus here at rehab.  Do you know where you are, why you are here, and what is the date.  So far, Bridgett can't remember any of this on a regular basis.  From time to time she will get the year or the month correct, but never consistently.  After doing some reminding, she might remember where she is for a matter of minutes.  But, then the memory is gone.  From time to time it seems like a switch has been switched on and she seems to remember things.  But these are short in length.  The hope is that these snippets get bigger and bigger and more frequent.  For the past few days Bridgett's peg has been bothering her.  It has been red.  We have stopped using the ab binder during the day in hopes that it will hurt less and be less irritated.  Every day she says it hurts.  Today when we looked at it, there was a greenish, white-ish discharge.  We called the nurse, who called the doctor to look at it.  He said to clean it and watch it and said it could get much worse.  He wasn't overly concerned.  Hopefully it will start looking better soon.  There is no hope to get it out sooner.  He will contact the surgeons that placed it if it continues to worsen.  Today was a short rehab day, with the weekend staff.  Rehab started late and Bridgett was able to sleep in until 9:00.  She has been tired lately, so that was good.  It was another afternoon with all of Bridgett's sisters and lots of laughing.  Jenn brought up a bunch of pictures of Bridgett that we all looked through.  It is very good for Bridgett to see these pictures of herself and try to remember events and people.  By evening, she told everyone she loved them and they could go because she was going to sleep.  You could tell that all the laughing and visiting was getting to be a little too much for her.  Arrianne, Stephany and I left and Jenn and Mark stayed to visit quietly. 

Day 44 - Friday January 27, 2012

I am really glad that I attend the rehab sessions.  It is great to see Bridgett's progress daily.  Also, sometimes I am able to advocate for her.  Every once in a while we will have a new therapist, who doesn't usually see Bridgett (like on the weekend, if someone is sick, etc).  The new therapist sometimes assumes something about Bridgett, without knowing her.  Like a couple of times I have heard them say they think she is not trying.  Then I can tell them she is trying very hard, just having difficulties with reading etc.  Like today, the occupational therapist was trying to get her to read the labels on food cans.  I usually give it a chance before saying something, on the outside chance that things have changed for her.  I had to make a phone call and when I came back he had decided that standing at the cupboard looking at all the cans was too stimulating for Bridgett and she couldn't concentrate.  He had narrowed it down to five cans which he had placed on the table and wanted her to read the labels.  I let her try for a bit and then I said (as she held the mustard) what does this spell Bridgett--MUSTARD and she said mustard.  I did it again for olives.  By then he caught on and spelled things for her and she did great.  Then he wanted her to alphabetize the cans.  He wrote down the alphabet is small letters with a blue pen.  She needs big letters and good contrast.  She tried for a bit and then I reminded him about her vision problems.  We had discussed it in a rehab session last weekend, and I had commented on it already.  He realized then his mistake and anyway it was time for the session to be done.  So, it worked out.  Another time he said to her in another session, I think you are not trying very hard.  She said I always try and she does.  She works hard at rehab and always tries her best.  It is sometimes good when we have a different therapist.  Sometimes a different therapist will try something different that the other therapist hasn't tried.  I do know that her vision problem is a BIG roadblock to recovery right now.  Seeing double interferes with reading, and makes it hard to balance as she walks as well.  She will be getting her eyes tested by the neuro opthamologist on Wednesday.  Everyone pray that she will be able to communicate effectively with him so that he can figure out what the problems are.  She really needs to have help now and not in a month from now when she will be able to answer questions better.  At least during that test I am praying that her mind will be clear and she will be able to answer correctly and get the help she needs.  It is critical to her rehab!

Day 44 - Friday January 27, 2012

You can tell I'm tired!  I published a blank post!  I wanted to post this morning and ask everyone a favor.  Can you please take a minute and send Bridgett a short card.  Yesterday she made the comment that she doesn't have any friends, I'm sure because we can't allow friends to visit at this point. Penny told me that the same thing happened to Courtney.  So, Penny asked everyone to write to Courtney.  I know many of you have wanted to visit, but with Bridgett's rigorous therapy schedule it is not possible.  Also, it is also probably confusing at this point with her amnesia.  But, she needs to feel your support!  Can you please send her a little note and we'll put them on her wall.  Thank you to the Bigfork young women for sending a card already.  Also, I received a card from the K-3 Relief Society (my old ward).  Additionally, several people have sent flowers and dropped off presents--thank you Brother and Sister DeGraff and Alicia!  Of course, family members--thank you!  She will be here for about 10 more days, so you will have to act fast!  When we leave, I will put all of the cards in a scrapbook for her to look at!You can mail the cards to :

Bridgett Noland
c/o Rehabilitation Center
University of Utah Hospitals & Clinics
50 North Medical Drive
Salt Lake City, Utah  84132

Day 43 - Thursday January 26, 2012 - Coma questions

Coma update--I am posting this seperately so everyone notices it.  This whole question about when did Bridgett come out of a coma, how long was she in a coma etc. is very complicated.  She is emerging from a coma is properly what I should be saying--not that she's out of a coma. Actually that makes me feel lots better, because if this is out of a coma-scarey!  She still doesn't really even know who SHE is let alone everyone else!  As the family, we are still trying to understand this whole process, so if you are confused, join the club!  For background--I asked Bridgett's doctor to sign something saying she was in a coma (to use to get her out of her apartment lease) and he said he couldn't do that but he could say that she had a traumatic brain injury.  So, then I asked the patient care coordinator about it and she said she wasn't in a coma. But, I said to the patient care coordinator, she was in a coma when we left Provo, so when did she get out of a coma.  She said--well she's emerging from a coma.  So, properly that's what her state is I guess.  So, I posted she was out of the coma and I really shouldn't have. I have been worried about saying things incorrectly for all the medical people reading this. So, I jumped the gun saying she was out of the coma because Dr Speed said he couldn't say she was in a coma.  That day I was really shaken, not really understanding what was happening and intimidated by all the medical jargon from everyone.  I do want to state the facts correctly and have tried to be really careful about this.  Talking to Penny yesterday, we both agreed that it's all in semantics and hard to define.  Emerging from a coma is a good way to define it at this point.  She said she considers that Courtney is still emerging from the coma, even though she talks, reads, cooks and does lots of things but that she was comatose for a period of time.  So, we should say that Bridgett is still emerging from a coma, but she was comatose for a period of time.  I'll have to look that up exactly how long that was.  I think I was also upset right before she left Provo because I read a definition about coma and vegetative state and coma is when the eyes are closed and vegetative state is when they are open but still not responsive. That's how Bridgett was.  It was hard to think of her in a vegetative state.  I did ask one of the doctors if they considered her in a vegetative state and he said well, she is like in a very deep sleep that she is trying to wake up from and can't yet.  Maybe she was considered vegetative and he felt bad and was trying to break it nicely, I don't know.  It's all so hard to understand and very emotional being the family and trying to hear the news and understand it.  So, anyway, thankfully we are past that point.  Apparently that's why they started on the provigil etc, to try to wake her up out of that vegetative state.  So, anyway, at this point she is emerging from a coma.  She has post traumatic anmesia.  She still does not remember things, even long term memory things.  She still confuses people, although she is now getting immediate family members' names correctly (which happened only a few days ago).  She is still completely off on the year, often thinking it is 2000.  She is still very disoriented and doesn't remember where she is or why.  But we're working on it all the time.  There will come a point (soon I hope) where she will begin to remember these things.  Her brain injury is called Traumatic Brain Injury TBI.  She had a severe TBI.  Her post traumatic amnesia PTA would be considered severe.  At some point I will discuss her brain injury in more detail.  I hope this all makes sense.  It's all very complicated!  And yes, we still have the faith that she will recover from this injury.  We know that Heavenly Father is watching out over her and her progress is a miracle at this point and will continue to be a miracle.

Day 43 - Thursday January 26, 2012

Another great day.  Bridgett is talking all the time now.  This morning when she woke up, she whispered once and I reminded her to talk so she did.  Otherwise, she talked all day.  And boy is she talking!  It's so great to hear!  When she gets tired she starts speaking some nonsense stuff.  But most of the time she is pretty clear.  She does forget words she wants to use.  That is something that will improve as she does speech therapy, and really any therapy.  All of the therapists work on speech, naming, etc. in addition to their specialty.  In fact, two days ago Bridgett was still forgetting that she could actually speak and reverting to whispers.  When she went to physical therapy with Randy, every time she whispered he insisted she speak instead.  By the end of the session she was speaking all the time.  Today he said I think I really helped with her speech, and very likely he did!   All of her therapy went well today.  I asked Randy, so unofficially speaking, by the time she gets released do you think that she will have her balance and be walking fine.  (she does really awesome, but still has to be spotted and still leans, etc.)  He said, I can't guarantee it, but given her rate of progress I think that she will be walking great and having good balance in familiar surroundings.  Of course, safety is always an issue and you don't want her hitting her head again.  That made me really happy!  Speech went well.  Both of Bridgett's usual therapists were gone today, so we met with a gal she's only seen once.  But it was good.  I don't think I've talked about this yet.  Speech therapist are the ones that are in charge of the orders about which diet the patient is on, and who gets to upgrade etc.  So, Monday when Rebecca came in to help Bridgett with breakfast I was talking about how she bites the straw so much and it's hard to get her drink finished.  I said that one of the nurses started having her take a drink without a straw to get her pills down and Rebecca said talk to speech and asked to have her upgraded.  So, I went to speech therapy and talked to them about it.  Of course, they said who was the nurse.  They aren't supposed to do that.  Also, they told me it is really typical for brain injured patients to bite on straws and cups.  Good to know!  Jessica said we will check it out.  She got fake pills and a cup of water, had Bridgett take a sip and swallow the pill and she did it the first time.  The second time, she swished the water in her mouth and the pill moved and she didn't get it down.  So, they changed the orders to say, sip of water, pill in back of mouth, remind her not to swish and down with the pill.  Bridgett is doing so much better this way.  When they gave the pills to her in applesauce, she'd either chew the pills (yuck) or swallow the applesauce and the pill still was left in her mouth.  Oh, this afternoon Courtney and her mom Penny came to visit.  Courtney is doing even better since we saw her last.  It is very inspiring to see her.  Penny brought me a couple of books, one of them was a beautiful Greg Olson book that Courtney liked to look at during rehab.  Another was a book written by a former BYU student that had a traumatic brain injury about 10 years ago.  It apparently addresses how she felt during this whole process.  Great reading I'm sure.  I'm excited to start it!  I missed occupational therapy while I was visiting withe them, but Stephany said that Bridgett put together a puzzle and did sorting of shapes correctly.

Day 42 - Wednesday January 25, 2012

Sorry to everyone that I am so slow to post this week.  It's been a little crazy!  So, today when we saw the doctors they said they were going to try to get the x-ray in the morning and then remove the trach in the afternoon!  Very exciting!  They wanted the x-ray first because they don't want to disturb the trach site after removing it.  So, we went to therapy in the morning, then straight to x-ray before lunch.  After Bridgett's afternoon therapy sessions, the doctor came by and removed the trach.  It was a quick process.  He removed the c-collar she was wearing, removed the trach tie collar that hold the trach in place, asked Bridgett to take a big breath and cough (which she did) and the trach popped out!  The hole looked nice and clean and quite small.  They put on a dressing which they said would be changed daily.  I said, so about two days to heal.  They said it can take up to five, but because hers was nice and small and clean, it would be quicker.  Stephany wanted to get a quick picture, because she knew that Bridgett would want to see it.  However, they covered it so quickly and didn't really listen to her asking.  I said, you can get a picture tomorrow.  They really taped it all up and said to watch for drainage.  Now, they said, you can wear the soft collar and they were going to order one.  But, I still had one from the other hospital.  So, Bridgett reached out and took it from me and put it on herself.  Of course, it wasn't quite tight enough and had to be adjusted but it was cute.  She said, oh, this is SO soft.  Oh, I really like this one!  It will be great having the trach gone and the c-collar as well!  So, now the only annoyance is the peg.  That will not come out for three weeks approximately.  So, we will be release from here with it in and have to return to have it removed.  But, its under the ab binder and out of sight and mostly Bridgett pays no attention to it, so all good.  Oh, I forgot the most exciting thing.  Immediately after removing the trach they told me that she might have trouble talking again because it different again.  They said she might have to put her fingers over the dressing to be able to speak.  They asked her a question then and she talked just as loud as ever! Oh, they said, apparently she won't have any trouble!

Day 41 - Tuesday January 24, 2012

Well, Steph is starting to count the days until Bridgett gets released from rehab! We are all pretty excited about it.  This morning Bridgett had her appointment at the dental clinic.  So, she was actually in a dental chair with actual instruments (not lying in an ICU bed with no equipment) and they found that she had another exposed nerve.  So, at this point I think she will need three root canals and four caps.  The dentist was really nice.  Everything went well as he sealed the tooth and added composite to it.  The other teeth that had been sealed looked good.  He gave me the name of a dentist in Ogden that would do the dental work in a surgical center.  We don't want the trauma of having this done in the dentists office.  I don't really think that her rehab doctors would approve of the dentists office either as they are trying to minimize any further trauma that she has to experience.  Bridgett's oxygen levels with the trach capped have been 98-100% so they will hopefully take the trach out tomorrow.  Apparently they only want her to have one thing happen a day.  So, dentist today, trach tomorrow and neck x-ray the next day (we think that is the order).  On a sad note--Bridgett appears to be slowly remembering her accident.  We were hopeful that she would not remember it, for her sake--apparently most people do not.  Over the past few days she has been making random comments to Arrianne, Stephany and me.  She has said things like...that guy should have stopped and not hit me.....I was so scared and thought I was going to die.....I almost died but I was surrounded by "eyebrow" (this seems to be a word she uses when she doesn't remember the right word)....I was so scared and didn't know what was going to happen.  Perhaps for her this is part of remembering who she is...part of her long term memory coming back.  I asked the doctors about my worries that she doesn't yet have a clear idea of who she is and who we are (although she knows I'm "mom" she doesn't always remember my name, etc) and they said she is still getting oriented and everything is OK, that is not abnormal, etc.  They said she will slowly remember things as she is more oriented.  She is still prone to think she is younger than she really is.  However, sometimes her memory is very clear about something she heard earlier in the day, hours before.  The brain really is a complicated and complex thing!  I talked to one of the therapists today about her vision.  I said, will the brain eventually adjust to double vision and they said yes.  If people can tolerate it, it's better not to patch the eye and let the brain adjust.  It will be interesting to see what the doctors at the Moran eye clinic have to say next week.  Bridgett continues to improve in balance, both while sitting and walking.  She's doing awesome.  Today she walked up and down five flights of stairs, while Randy just held onto the back of her "gate belt", the safety belt they put on everyone so that there is a secure place to hold or grab as the case may be!  Randy said it was 80 stairs.  Whew! She is speaking more all the time.  Jessica at speech therapy said that she would consider that she spoke 75% of the time during therapy today.  When Jessica wrote words on the white board for Bridgett to read she could read some of them.  Others that she couldn't read--if Jessica spelled them, Bridgett would say the word.  Again, many things are complicated because of the whole vision issue.  Bridgett did a comprehension test with Rebecca today; I think that's what they called it.  One of the questions was really hard  I thought.  She gave a list of words for Bridgett to repeat and Bridgett did.  Then she asked about five more questions or so and at the end of the test asked Bridgett to rename the list she had previously given her.  I couldn't even remember it!  Then she gave her clues, like the first word was a fabric--was it velvet, satin or cotton.  Bridgett remembered three of the words like this.  Anyway, she did not do that well on anything that involved vision to answer, but did good on audio things like repeat these numbers and then repeat a second set of numbers in reverse order.  Like I said, its a complicated issue. 

Day 40 - Monday January 23, 2012

This was a day of getting appointments etc.  I have been trying to get a dentist scheduled to come see Bridgett's teeth.  They are hurting her and we need to see exactly what's up at this point.  It appears that the exposed nerve is still covered, but one of the other teeth doesn't look so good.  Also, I have been trying to figure out about getting Bridgett's eye checked.  There appears to be damage to a couple of nerves in the left eye.  So--this is the outcome of these questions--Bridgett has an appointment with the dental clinic in the hospital tomorrow morning.  Also, she has an appointment at the Moran Eye Clinic (next door) on Feb. 1st, with a neuro ophthalmologist.  The button they got to close the trach WAS the correct one, but over the weekend there was another speech therapist there and she just didn't know how to put it on.  Apparently after she couldn't get it on, it is missing and so we didn't have it to try today.  Kristen is awesome and ordered another one STAT, got it in time for speech therapy (it has to be put on by the speech therapists) and got it on for Bridgett.  So, if her oxygen is good today and tonight, they supposedly will remove the trach tomorrow, or at the latest the next day.  Once the trach is out, we can change Bridgett to the soft collar.  We are assuming that the trach site can be covered sufficiently to be OK under the collar.  I guess we will find out!  Then once she has the soft collar on her neck can start getting stronger.  The physical therapist said that her neck will be weak and it will be a process getting it stronger.  So, the sooner we get started on that the better!  Bridgett talked a little more today.  It is a real process getting her to learn to not whisper, apparently!  But, its a little better every day.  Each day she is a little better at every thing she's doing. 

Day 39 - Sunday January 22, 2012

It's nice when Sunday rolls around and we can enjoy a day of rest--even when we are in a rehab hospital!  Every other day of the week there are therapy sessions.  Sunday Bridgett gets to just relax.  When we first got to the rehab hospital we got to meet a cute girl who is 26 years old and was in a very bad car wreck in Provo canyon.  She had a traumatic brain injury (like Bridgett) and was in a coma.  She was just getting ready to be released from the rehab hospital here.  Her name is Courtney.  Mark and I were able to talk to her parents and get some very good insight about the probable experience we would have here.  It was very enlightening.  One of the things that Courtney's mother, Penny, explained to us was that the rehab sessions will help Bridgett, but a necessary thing is REST for the brain to repair and heal.  She suggested that every day Bridgett get a nap.  Actually, Bridgett rarely gets a nap and if she does it's only for about 20 minutes.  I do tuck her into bed and turn out the lights, but she usually just rests.  Also she has not been sleeping well at night either.  But, just the past three or so nights she has slept through the night.  She does move around a lot at night, including doing sign language in her sleep!  But, at least she's been sleeping. When she does actually get a nap I am happy!   By the way, Bridgett's level of consciousness is really good.  She is no longer in a coma.  She is still not really oriented (she doesn't remember where she is, often forgets how old she is, doesn't remember why she is here, doesn't remember the month or year etc.) but she is doing great.  She will become more oriented as time goes by. Oh, for those wondering why they have to leave the peg in for six weeks--once they put in the peg, it takes six weeks for the tract to heal and for complete fusion of the stomach to the abdominal wall. I have heard some doctors say it could be removed as early as four weeks and some say it's best to wait as long as eight weeks. The surgeon who placed Bridgett's peg said it had to be in for at least six weeks. In any case, we will confirm all of this before they remove the peg. Bridgett and I went to the chapel in the hospital for church today. The service only lasted for 30 minutes. It was probably good that Bridgett could only whisper, as she wasn't oriented enough to understand when not to talk. It was good to be in church. I've been able to get the sacrament every week, but it was nice to sing and be with other people. There were quite a few people there. When I counted before the meeting there were 35, and more people showed up after that. The two couples that I had met on other Sundays (when they brought the sacrament to the room) stopped by to chat and say that they were so impressed with how well Bridgett looked when they saw her at church. We have met so many really great people through this experience! One thing that was so touching during the service--when I sang I held up the book and pointed at each word. During the first song she just watched me, during the sacrament song she began to sing the words and on the closing song she sang many of the words. It was neat!

Day 38 - Saturday January 21, 2012

First I wanted to say that Bridgett has been so sweet and loving all the time. The nurses and CNA's always comment on it.  She is so appreciative and always says thank you.  Also, it is cute, every time she eats she says this is SO good.  Or she will say you are SO nice to the CNA's and nurses and therapists.  Or when asked how she is doing she will say SO good.  She emphasizes the so.  Hopefully this is a trend that will continue.  Apparently at this level of Rancho its common to be angry, abusive, curse, etc.  But, so far none of these problems.  Oh, one of the CNA's told me yesterday that it is so good that Bridgett is not having problems since they removed the catheter.  She said that two other people had theirs removed the same afternoon and they are not doing well at all. Bridgett did well at physical therapy and occupational therapy today.  Also, she did well at speech therapy and spoke more words.  During the day if I asked her to hum and then speak, so she did a little bit.  Sometimes she said she was trying to hum, but no sound came out.  For recreational therapy, the therapist, Bridgett and I played Uno.  It went pretty good actually.  We had to remind her about some of the cards not matching that she tried to play, but all in all she did pretty well.  When the doctors came by I talked to them about her peg tube.  She's only had it for 2-1/2 weeks, and it needs to be in for six weeks.  They are not feeding her anymore using the peg (hopefully I posted about that--it was about three night ago they stopped) and they stopped giving her medication through the peg yesterday, so it's purpose is done.  Since they can't remove it for 3-1/2 more weeks, I asked if they can cap it off, more or less, and remove some of the tubing.  There is about a foot of tubing attached to it.  She has actually been telling us that it hurts for several days.  Tonight they put lidocaine on it.  We keep an ab binder around her, to cover the peg so that she doesn't pull on it. Once they shorten it, it will be much more comfortable under the ab binder.  They said they will do this on Monday.  We still have not been able to get the dental clinic (right there at the hospital) to come and reseal some of Bridgett's teeth.  There is one that looks like it needs help and she can't tolerate eating anything cold.  The doctors have been trying to get someone to come up and seal it.  I don't even dare ask Dr. Peacock to come up from Orem, but I think I will call and see if he knows in the Salt Lake area that might come to the hospital and help out.  Oh, Bridgett got to talk to Scott today on the phone.  It was cute! 

Day 37 - Friday January 20, 2012

The big news of the day is that Bridgett actually spoke words today!  She went to speech therapy and I told them the cough thing worked for one word at a time, but she said it hurt her throat.  So, they said we will go back to humming (which she couldn't do yesterday).  They tried humming and today she could do it.  So, she would hum and say one word.  She was able to count and answer yes and no to questions (correctly!). And they had her practice saying hi dad so that she could surprise Mark.  After therapy I called Mark and when he answered she said (hum) hi dad!  He was so surprised!  He said how are you and she said (hum) good.  Every time she says something, she has to say hum first or there is only a whisper.  After that I called Stephany and told her to put the phone on speaker.  Bridgett said (hum) hi this is Bridgett.  (hum) do you want to hum with me!  I thought that was go funny!  They said a few things.  Then I called Tyler and she left a message for him.  I bet that surprised him.  Then I called Jenn.  She told Jenn (hum) you should come and see me.  It was cute.  Jenn started to choke up.  I wanted to call Scott next, but by that time Bridgett said her throat was hurting and she couldn't talk anymore today.  And she actually didn't make another sound.  But, every day should be better!  When we went to physical therapy later I saw the speech therapists and told them and I choked up and so did they!  Everyone was SO HAPPY! 

Day 36 - Thursday January 19, 2012

Today Bridgett got a button on her trach--a speaking valve.  Somehow we all thought that she would just be speaking immediately--mostly because many of the people here said that they would put on the speaking valve and she'd start talking (they didn't explain that she might not remember how to make a sound with her voice rather than whisper).  She is definitely trying to speak all the time!! However, she is only whispering and needs to remember how to make that vibration that makes sound when we speak.  When she went to speech therapy they gave her the button, and she tried to speak.  Kristen worked with her and did a great job trying to help her get out a sound.  First they just tried talking, then humming, then la la la-ing.  Then she had Bridgett cough and get a sound and then say a word.  She alternated a cough with counting--cough, one, cough, two, cough, three etc.  She could make a sound with the cough then a whisper with the counting.  Usually she had sound with the cough, occasionally with a word.  They said that she will be doing better tomorrow--it's a process.  She really "talks" a lot and is trying to communicate all the time. We are all excited and can't wait to actually hear her talking.  She is now at Rancho four level.  Sometimes her thinking is a little mixed up, other times her thoughts are clear.  The funniest thing happened yesterday.  Rebecca was asking Bridgett to write down the names of the people in her family, while looking at a picture of them.  She pointed to Tyler and asked his name.  Rebecca hasn't met Tyler yet and she said I don't think this brother is here.  I said, yes, but he's got a beard right now (he hasn't shaved since we got here).  A few minutes later Rebecca again asked for Tyler's name and Bridgett wrote--beard guy!  It was so funny!  It was one of those times as a parent when you try not to let your child see you laugh at them.  Thankfully I was behind Bridgett and I laughed silently until tears ran down my eyes!  Sometimes she seems very positive about things that are not correct--like that my name is Beth (one of her grandmothers names).  Other times she is very positive about correct facts--like that she is 21 years old.  She often repeats whatever we say.  Sometimes she has the right idea but can't find the right word--I am at a place with doctors and nurses and lots of people--I am here because something happened and I need them to help me right now.  (She wrote this down yesterday in response to where are you and why).  Or when asked are you in a hospital or a school--she said both.  A hospital where I learn.  This is all normal they tell us.  One thing unusual but not abnormal (apparently) is that she first started saying that she was 6 years old, then 8 years old, then 12 years old, then 14 or 15 years old, then 17 years old.  Yesterday is the first time she has said that she is 21 years old.  Now, the doctors said that they are ok with this as long as she doesn't start thinking that she's older than she is.  Physical therapy went great--her walking and balance are getting better every day.  They worked some on core strength.  They had her on her back with her legs bent and asked her to lift her hips.  They wanted her to do it 10 times.  She lifted her hips and held them up for the count of 30 (she was counting so that you could read her lips).  They told her she could go down, but she insisted on doing it.  I told them it is an exercise that is part of her routine so, they just let her do it.  She did 10 of the 30 count holds.  She did a couple of other exercises from her routine.  Randy said it is great working with her because she knows the exercises to do already.  She even did one thing and Randy said I don't know that one.  Occupational therapy went great.  Everyday she does better on the things they are asking her to do.  She is still challenged by the sight on the left side.  The doctors looked at her today and watched her eyes.  They are thinking that it's very probable that there is a problem with the nerves in the left eye--number six and possible number three (if that means anything to you!).  Rebecca had Bridgett use a big electrical screen (like a big screen TV) today.  I can't remember what it's called.  It's run off a computer program.  Different "buttons" on the screen light up one at a time and you have to find the lighted button and push it to turn it off.  Bridgett had to practice starting at the top of the screen and scanning down to find the lighted button--very much harder on the left side.  Also, because of the double vision I guess, she would try to hit the button and miss--just on the left side.  For recreational therapy today, the dog named DIVA came back and did tricks.  Bridgett enjoyed that.  Arrianne came up because she could get $3.00 tickets to the dress rehearsal of Rigoletto performed by the Utah Opera Company. She asked me to go with her.  Mark stayed at the hospital with Bridgett and we went.  It was actually very good and it was nice to have a little break from the hospital.  Arrianne brought up some of Bridgett's rings because she has been very focused on rings lately.  She gave them to Bridgett and Bridgett said oh thank you.  These are the most beautiful rings I've ever seen.  I will wear them forever.  She then said to Arrianne (who was dressed for the opera) you look so pretty.  I think your shirt is ugly though (it wasn't, but apparently Bridgett didn't like it)!  It reminds me of when the kids were young and didn't know what was appropriate to say.  All of this is normal for her level of rancho apparently.  It's an interesting journey!  It doesn't upset me--I just have to smile and realize that things will improve every day.

Day 35 - Wednesday January 18, 2012

Yesterday we were given Bridgett's expected release date--February 7.  We are very happy and excited to hear that date.  The date is only a projection and not set in stone.  In any case, that would put her here since Jan. 5th, just a little over a month.  Originally they were telling us that our insurance would pay for 90 days inpatient rehab and that in order to maximize our benefits, we should consider going to the LTAC for four weeks first.  That would have been a total of about four months!  The Provo rehab said that the average stay for people with a brain injury is two weeks, but they pointed out that Bridgett's brain injury wasn't average.  She was given a blessing that said that the doctors would see a miracle--and they are.  Today was a good day.  This morning they downsized Bridgett's trach to a size four and they will put a button on it tomorrow I believe so that she can talk.  At speech therapy today she had a different therapist and she tried to get her to talk and Bridgett could whisper. So, when Kristen is back tomorrow hopefully they will get a button on it.  During physical therapy today she walked on the treadmill.  They put her in a harness that held her up while she walked.  It was neat and she was definitely smiling to be on the treadmill.  She also did walking around the hall and down the parallel bars.  Occupational therapy worked on eating herself and she did better today.  Also, dressing herself, which is going good as well.  Marks' sister Debbi came up this afternoon and stayed with Bridgett while I went and got some laundry some--which I desperately needed to do!  I was also able to get a one hour nap which I also really needed.  Thanks Debbi for being a life saver!  Debbi went to physical therapy (#2 for the day) and recreational therapy with Bridgett.  During physical therapy they did all new stuff, including balancing on a ball.  During recreational therapy she got to hold the therapy dog--the small one which I believe is a cocker spaniel.  They also had music therapy and went to a room where there were other patients as well and listened to someone play the Irish harp and sing.  Bridgett said it was beautiful!  All in all it was a good day!  Oh, I think I forgot to say this--the other night, I think Monday, a man came around to patients rooms and played the guitar and sing. He asked me what kind of music Bridgett likes and I said she likes lots of different music, but since he was playing the guitar maybe she'd like some country music.  He said he'd sing Honey Bee.  He sang the first verse and chorus.  When he sang the chorus the next three times she sang along with him (of course, mouthing only). It was cute.  I don't know if she knows the song or just listened to the chorus and sang along.  She didn't know the verses, so I think she just sang along on the chorus. 

Day 34 - Tuesday January 17, 2012

Today Bridgett got the catheter removed!  She's doing good right away with the ability to empty her bladder completely.  After so long on a catheter they let her void and then do an ultrasound to see if she completely emptied her bladder.  Sometimes they have to put in a straight catheter to empty the bladder if the person is unable to empty themselves.  They do this test the first three times (if successful each time).  Bridgett has passed the test twice, and will hopefully again this evening.  This is all good news.  Because of the three day weekend, the doctors were very busy and didn't have the time to downsize the trach today so they will do it tomorrow.  Bridgett fed herself breakfast today.  I forgot to mention that yesterday I tried giving her the spoon with food on it already and she fed herself.  The doctor walked in while she was taking a bite and asked how long she had been doing that.  I said this is her third bite!  Well, she's doing great he said.  So, this morning Rebecca asked if she could have her feed herself.  It was a bit messy but she did good.  Her only problem was that her hand was shaking so she'd lose some of the food before she got it to her mouth.  But, she got better as the meal went on. Today she did a great job of eating almost all of her food, so they are discussing cutting back on the peg tube feed and then eliminating it all together.  Of course, as I mentioned before, she has to keep the peg in for six weeks, so we've got four weeks to go.  Bummer!  It sure would have been nice if she could have avoided getting it put in.  But, I asked if they could get rid of most of the tubing when they are done feeding her, so that it's not such a big mass of tubes to deal with.  Right now, we have an ab binder over the tubes, to keep them out of sight, out of mind--to protect the peg from being pulled out.  As times goes by we are either getting rid of tubes, or like I said hopefully soon she will be less focused on pulling things out.  Once she becomes more fully aware, that will improve.  PT went great.  Bridgett did a lot of walking, supported on just one side.  The second person just walked behind and held onto the gate belt just in case.  She played ball standing up and walked the parallel bars really well by herself.  Speech therapy went really well.  Today Bridgett got to use an ipad. There are lots of great aps for speech therapy.  Somehow we need to get one for her I think--it will be a great way to pass the time when she is bored in the late afternoons and evenings.  Last night was the first time she has slept through the night (mostly) until she woke up when they stopped the tube feed.  I know that Tyler appreciated that since he has night shift for the whole night while Mark is out of town in Montana.  Usually he and Mark split the night.  Mark will be back tomorrow night, just in time for Tyler to head to drill.  Congrats on making Sargent, Tyler! 

Day 33 - Monday January 16, 2012

It's just so fun that every day there is something new to report.  Today the speech therapist came in early and told us that she had a funeral that she had to attend, so she was hoping that she could just drop in. I said Bridgett hadn't eaten breakfast yet and she said she could watch Bridgett eat and then upgrade her a level on food.  She asked Bridgett if she wanted bread or something else (I can't remember) and Bridgett mouthed bread.  Kristen went and got bread and crackers, and Bridgett chewed them both and ate them.  So, her food plan has been upgraded one.  Now everything is small, but not pureed.  She can have pasta and bread, etc.  Then I asked Kristen if she could get a white board and she went and got one.  Bridgett was rubbing her legs and Kristen asked her if they hurt.  Bridgett wrote "my legs hurt and I need a heating pad and some Advil!"  Then she said she needed to use the bathroom and she did.  She is getting around really well which has its drawbacks too.  Tonight while I was helping her eat she suddenly sat up and started getting out of bed.  I called to Steph to grab the plate from me and I grabbed Bridgett.  The CNA's were coming in the door just then because they had her on camera and came to help.  Good thing!  So, we then took a stroll around the hallways in the wheelchair.  Since it was a holiday, she did not have a full therapy schedule today. 

Day 32 - Sunday January 15, 2012

Yesterday Jenn came up to visit and Arrianne and Stephany were here too.  I stood Bridgett up to put her in bed and she gave me a great big hug.  Then Jenn said I want one too.  Bridgett gave her a great big hug and a tear ran down her eye.  She misses Jenn!  She gave Arri and Steph a great big hug too.  She was so happy and smiling all day to have her sisters with her.  They primped and pampered her and they all had lots of fun.  Today was another very good day.  A young couple met us in Bridgett's room to bless and pass the sacrament.  I told them that Bridgett can't eat anything that isn't pureed yet.  They said that she can just touch the bread to her lips and it's the same thing (they have been instructed).  Arri and Steph painted Bridgett's fingernails and toenails.  Bridgett has been mouthing lots of words, which will make the speech therapist very happy.  She also wants to write things, but I left the white board at the hotel.  Since it's Sunday, there are no therapists here so I couldn't get one from them.  Bridgett is singing lots of songs.  Also, she and Arrianne and Stephany have been doing hand games--Say Say Oh Playmate, I Went To A Chinese Restaurant and Zing Zing Zing.  Bridgett remembered all the hand gestures and it was so cute and touching to see them "playing" together.  We showed one of the nurses and she said it made her almost cry.  She was very touched to see how close the girls are.  I took Bridgett in the wheelchair for a ride in the hallways before breakfast.  Later on I got her in the wheelchair and met Arrianne and Stephany downstairs.  It was nice for her to get out and ride around a little.  Part of the time she was pushing the wheels herself and deciding where to go.  All in all it has been a day of lots of girl time, lots of laughing and lots of fun. 

Day 31 - Saturday January 14, 2012

One month since the wreck.  It's been a long month and a lot has happened.  We feel so blessed that Bridgett is alive and doing so well!  We have faith that Heavenly Father will continue to bless and strengthen her.  We put our hope and trust in Him.  Again, we are so thankful for all of your prayers and the many kind gestures from family and friends.  Thanks to all of the people who have so lovingly cared for Bridgett over this past month.  It truly is wonderful when people treat their patients like real people and treat us like real people--not just a job.  We've seen people take a personal interest in Bridgett and that makes us very happy! 

Day 30 - Friday January 13, 2012

Bridgett did several new things today.  First of all, she walked up and down a set of therapy stairs, that had four steps.  She did awesome the first time.  They had her do it twice and then she was done.  She walked with the parallel bars again.  They she stood on her own for a short time.  They were spotting her of course.  She sits on her own now too although they spot her.  She seems to be able to regain her balance.  She stood in front of a mirror and they gave her a marker to write on the mirror because she keep trying to write things in the air.  She kept on making hearts.  She is very affectionate these days.  She wants to hug or kiss us a lot.  At her second therapy session they had her walk with a walker and she did fine, spotted.  After therapy I wheeled her to the room.  One of the PT people was with me.  I was going to show her that I could transfer Bridgett to the bed by myself.  Trish stopped the wheelchair by the bottom of the bed. I was laying the bed back and I said just a minute and I'll stand you up and help you to the bed.  Bridgett stood up then and started walking over to the bed.  I guided her and helped her sit down.  As she gets better about moving, transferring etc.  we will be glad that they have bed alarms that go off when a patient gets out of bed by themselves. Right now they are not using that for her, but I can see that its not far off!    Arrianne came up for the weekend.  Her last class on Friday is over by noon, so she has time to come up and visit.  Actually there is no school on Monday, so she can stay for a bit. Bridgett was so glad to see Arrianne.  She just hugged her and hugged her.  She actually hugs all of us for a long time and over and over.  Arrianne told her funny stories about people they both know and Bridgett smiled at first and then actually made a laughing face (no sound because of the trach).  That was really fun for all of us to see.  Arrianne brought up Bridgett's rugby ball and she was glad to have that!  She has lots of fun throwing balls and watching us run around and retrieve them!  I'm so glad that my kids are close friends and that they are all rallying around Bridgett and helping support her so much.  Bridgett we love you!!

Day 29 - Thursday January 12, 2012

Bridgett's really been doing a lot of sign language.  Today when the nurse came in I asked her to sign his name, Ryan, and she did.  Then I asked her to sign the CNA's name, Clayton and I told her the letters as she signed them.  Then I said sign Michael the new CNA and I didn't spell with her and she signed it correctly. I had her sing Popcorn Popping with me--I sang and she did the actions.  She walked a lot and then rode the new step machine at its highest setting for 10 minutes.  She then went to occupational therapy and she signed Rebecca's name.  Rebecca showed her cards with numbers on them and she signed what the number was.  She also wanted to write and took the marker and wrote her name twice. She went to speech therapy and wrote hello, mom, dad, Jessica (one of the therapists name) and then they put a finger over her trach and practiced speaking.  She can whisper and she did the alphabet, counting to 50, the days of the week, and the months of the year.  She repeated nursery rhymes they asked for and sang a song.  The double vision interferes with doing some of the things they want her to do.  The doctors want to give her until next week sometime and if vision still seems to be a problem they will send her to a neuro optomologist.  We are still amazed about the pureed food they give her!  This morning she had french toast--pureed and then molded to look like french toast.  She ate about 1/2 piece.  She only had 3-4 small bites of her lunch, but ate 1/2 of her dinner.  She is not choking at all.  As time goes by they will upgrade her to the next level of food, which includes stuff like macaroni and cheese.  The doctor OK'd removing her pic line today so that got done.  Now only three things to pull out--the trach, the peg and the catheter--none of them a good thing to pull out--and the collar to pull off.  The peg HAS to be in for six weeks, whether they need to use it or not.  The collar needs to be worn for 8 weeks or so, so halfway through.  We are hoping to downsize the trach next week, in preparation for getting rid of it.  Also, they are hoping to get rid of the catheter next week.

Day 28 - Wednesday January 11, 2012

It's been four weeks since the accident.  So much has happened!  It seems like ages ago!  We got moved to a different hotel.  We don't know how long Bridgett will be here at inpatient rehab.  They have a meeting every Monday and asses the projected release date, but this past Monday she was so new here they didn't have enough data for assessment.  So, on Monday we should have some kind of ball park date for release.  Then she will have outpatient therapy for some time.  Today she walked a lot, rode the bike for about 20 minutes, put snap beads together, play toss the ball, played in a bin of little beans and searched for items like checkers, etc.  Bridgett started laughing and smiling at funny things.  Her personality is really starting to show through to the staff here.  It was a very busy day as she had four 45 minute therapy sessions back to back.  Today was her first day of eating.  She is at level dysphagia I--soft foods.  This includes applesauce and pudding and other things of that same texture.  So, what she got for lunch was pureed meatloaf, mashed potatoes and gravy, and carrots.  She ate about 1/2 of those items and skipped berries and soup.  She did great with no choking at all.  When dinner came, she wouldn't even open her mouth.  Apparently her stomach has shrunk so she didn't feel remotely hungry.  Even though she gets the liquid tube feed, it doesn't fill up the stomach, so actually eating really made her full.  Mark did convince her to take a bite of pineapple and she shuttered!  She had a little apple juice and choked and we called it quits.  Mark tasted the food--salmon, mashed potatoes and gravy, green beans and pineapple.  He said the pineapple made him shutter too!  The green beans were terrible, but the salmon and mashed potatoes with gravy were fine.  It was his birthday dinner--today is Mark's birthday!  Not exactly the birthday dinner he might have hoped for!  All in all it was a good day.

Day 27 - Tuesday January 10, 2012

Another great day!  I'm so glad that Bridgett is in rehab!  The people here are amazing!  Another great thing is that they work as a great team.  She has two doctors and a patient care manager.  Then she has her different therapists.  They meet weekly to discuss progress. Also, each see a different part of her progress and addresses that.  For example, the speech therapist ask the doctor to order the swallow test--she took that today and she passed for liquids!  Yes!  The occupational therapist asked the doctor about an eye patch to try to address the double vision--which he ordered and she got today.   It came while she was in bed and she wore it for a while, but got annoyed and took it off several times.  I finally just left it off and thought we'd try it during therapy tomorrow.  Each day she had two sessions of physical therapy, two sessions of occupational therapy and one session of speech therapy.   Today in physical therapy she walked down to the gym (supported by two people), part way she pushed the elevator button (with help) and then walked quite a bit down hallways, and then returned to her room via the elevator.  She also rode the exercise bike for about 20 minutes.  I will have to explain that not only is she supported walking, she still is not awake enough to hold her head upright all the time and so she walks kind of like a drunk person.  Her pupils are often dilated still--they say like she is on drugs.  All of this relates to the state of coma she is presently in.  Occupational therapy--she helped dress herself again, and did other therapy with balls and cones.  Speech therapy--the swallow test which she passed for liquids.  They gave her a cracker but she couldn't figure out how to chew it up.  She had a shower today--in a shower chair and she washed the trunk of her body.  So, all things are getting better and moving along.  Everyday at least one new thing!  Oh, when they came for her second PT, I put her shoes by her and went to walk around the bed to put them on--she picked them up and put them on herself!  Awesome!

Day 26 - Monday January 9, 2012

Bridgett had another great day!  First of all occupational therapy came in and helped her get dressed.  She did even better than the first time.  She is following commands better and her eyes are focusing better.  I think I mentioned that she is having double vision.  She closes one eye in order to try to focus better.  She also has left side neglect, so she doesn't pay any attention to what is happening on the left side.  They are working with her to start to recognize the left.  Physical therapy came in and took her walking again in the morning.  For some reason she was dizzy.  She still walked more than on Saturday, but then they decided to put her on the exercise bike.  She pedaled away for about 12-15 minutes and didn't want to stop, but it was time.  She had a second session of occupational therapy.  This time Rebecca took her into a quiet room and had her throw a beach ball to her and then catch it.  Stephany was with us and so then Rebecca had Stephany throw and catch with Bridgett.  Rebecca worked on stretching out her shoulders and helping her sit straight.  After this she had a break and a good thing as she was exhausted!  She took a nice hour long nap.  Speech therapy came in next.  Wow what a great session we had!  They talked to her and asked what new things she did over the weekend.  I told them about how she is mouthing the words to songs.  No way they said.  Then I said show them how you sign from 1-10 and she did.  They got really excited when they heard she knew sign language.  They asked her to spell Bridgett as well as mom, dad, cat, her sisters name--that's how they asked-- (Arrianne), her brother (Ty), the sister who was in the room (Stephany), ball, and a couple of other words.  They were amazed!  Then they said we need to check this out.  They asked her to do a bunch of facial things, which she did: smile, nod (slightly), pucker, put your tongue in your cheek, stick out your tongue, wrinkle up your nose (she tried), raise your eyebrows (slightly), maybe some other things, I can't remember!  Anyway they were tickled!  They wanted to do a scope test for swallowing tomorrow, but I said that her brain injury doctor, Dr Speed, should approve it.  I had asked him about downsizing the trach and he said it is a little traumatic as they don't use anesthesia and he didn't want her to do anything traumatic right now.  They said they could do a barium test instead.  I said approve it with him.  Physical therapy came for a second time and when they took her to the hall they said maybe her oxygen is low.  They checked it and it was only 85.  So, back to bed and some oxygen.  Perhaps that was the problem this morning as well.  Off and on throughout the afternoon her oxygen was low and finally stabilized in the evening.  Weird!  It must be a brain injury thing because her lungs are great.  Recreational therapy came in and talked to us about her hobbies and things she enjoys (sports!).  Also they told us about extra classes she can take and outings she will be able to go on as she progresses.  All in all it was a great day! 

Day 25 - Sunday January 8, 2012

They are trying to get Bridgett's meds right so that she sleeps at night.  She had LOTS of very restless nights since they started the provigil.  (BTW this rehab doctor has changed her from provigil to ritalin).  Last night she went to sleep about 9:30 and then woke up at 1:00 and was very restless.  The nurses noticed on their video that she was awake and came in and asked how long she'd been awake for.  She has been up for about an hour.  They gave her more meds and she slept until 9:00 a.m.  It was very good to have her get some sleep.  Today was a day of rest for Bridgett, as they had no rehab activities.  She spent lots of time resting which is just exactly what they want her to do when she doesn't have rehab activities.  She was so rested that she actually interacted with the doctor when he came in on rounds.  He was very happy about that.  She stuck out her tongue when he asked, shook his hand and when he asked if she had pain she gave him sign language OK sign.  I asked her to count to 10 in sign for him, which she did.  He said we will keep her meds how they are, things are going good.  Speaking of restful time for Bridgett--the rehab people explained to us that she needs to do her scheduled activities which will stimulate her brain and then rest so that the brain can repair and recover during that time.  In that light--they have asked us not to let anyone visit her for a couple of weeks.  Even the immediate family is a lot of stimulation since there have been five of us there all the time.  Now Arrianne will start back to college tomorrow, so there will be four of us on a regular basis.  As soon as she is able to have visitors, we will let you know.  For now, we are just so thankful that she is in rehab and amazed at the progress she's had in just a few days.  I told you that she was mouthing words to a song last night.  We have been letting her listen to her ipod for several days now.  Late last night she was mouthing the words to the Winnie the Pooh song.  By this morning she was mouthing many phrases and by tonight she was mouthing the words to about 1/2 of each song she listened to.  She is still mouthing things to us, but we cannot understand lots of it.  We catch an occasional word--love, mom, etc.  We are excited for rehab tomorrow and for what exciting things Bridgett will do then!

Day 24 - Saturday January 7, 2012

So, I forgot to report Bridgett's second PT session yesterday:  she walked about 120 feet!  Today was a weekend day and the schedule was a little messed up.  They were late getting her morning meds and helping her get dressed.  Because of that they started her scheduled PT 30 minutes late and she only got 15 minutes.  She walked about 200 feet!  She was really moving along with a good rhythm but they couldn't go any further as they ran out of time.  She didn't want to quit--you could tell because she didn't want to sit down. The physical therapist said--this is atypical of a person at this level of consciousness--to walk so much.  Right now the actions that we see Bridgett are doing are from "muscle memory", things that she has done over and over and her muscles remember.  I think that since Bridgett runs so much, her legs have that really strong muscle memory, and additionally such strength!  Occupational therapy was next.  They worked on sitting up straight--helping her relax her shoulders.  Also, they held out plastic cones and asked her to take them and put them down (one at a time).  They are working on getting her to acknowledge the left side as there is neglect--the brain is not recognizing sight on the left side.  The speech therapist was 20 minutes late getting to Bridgett's room and Bridgett was just nodding off and wouldn't wake up.  Yes-even though she is not out of the coma yet, she still has sleep/wake cycles.  They told me today that she is at level three of the Rancho levels.  I think it will be good to have her move to a point where she either has the trach out or is not compelled to try to pull it out.  They put a "binder" over her mid-section to cover the peg so that she can't pull it out.  The pic line--she mostly doesn't pay too much attention to this.  However, it would be a bad one to pull out. It's just not normal to have all these tubes and she wants them out!  Regarding the trach--she is doing awesome and getting closer to having that removed.  She has the cuff pressure all the way down now.  She is only on 25%  and our air is 21% oxygen.  She goes without oxygen during rehab and does just fine.  Bridgett knows sign language as I said in another post. She is constantly "signing" with her left hand although she does lots of random letters and only some of signs that make sense--although people have told us that many times people babble first and then start to make sense later.  We have been playing Bridgett's familiar music on her ipod.  Tonight I was playing Josh Groban--You Raise Me Up--and she started mouthing the words!  That was special!  Also, this was funny--Jenn reminded us how great Bridgett is at texting.  She can text without looking--she can even text in her sleep.  Jenn said to give Bridgett her phone and see what she does.  Arrianne got her phone and got it ready to send a text to herself and then handed the phone to Bridgett.  Bridgett texted hi and sent it to Arrianne (you have to push send twice), closed the phone and set it down!  Arrianne answered the text back, saying I love you.  Bridgett took her phone and texted glodi (?).  Maybe she was saying good--who knows.  Anyway, very fun!  Also, today she was sitting up in the wheelchair and she looked so cute, crossing her legs.  I took her picture.  Then I said smile for the picture Bridgett and she gave me a big, wide mouth smile!  When Tyler came in the room and kissed her, she kissed him on the cheek.  Then she kissed him in the air several times!  She loves rubbing his beard and his bald head!  Thanks Jenn for the leg rubs for Bridgett today.  She really liked it! 

Day 24 - Saturday January 7, 2012

Short lesson on comas:

Coma is a prolonged period of unconsciousness. Unconsciousness is the lack of appreciation of (or reaction to) a stimulus. Coma differs from sleep in that one cannot be aroused from a coma.
Coma involves two different concepts:

1.) Reactivity: Reactivity refers to the innate (or inborn) functions of the brain, i.e., the telereceptors (eyes and ears), the nociceptors (responses to pain), the arousal reaction (wakefulness) and the orienting response (turning one's head toward the source of sound or movement). We could also refer to these as reflexive movements.
2.) Perceptivity: Perceptivity refers to the responses of the nervous system to stimuli, which have been learned or acquired, i.e., language, communication skills, individual methods of movement such as gestures, etc. Perceptivity also refers to less complex learned or acquired reactions such as flinching when threatened. We can also think of these as conscious movements.

A person in a coma does not exhibit reactivity or perceptivity. He/she can not be aroused by calling his/her name or in response to pain.
As a person begins to emerge from a coma, they may begin to react to certain stimuli. To regain "consciousness" however, reactivity and perceptivity must both be present. These two elements are necessary for a state of awareness. Often, many of the elements of perceptivity must be relearned, such as speech, self-care, etc.
Many people are surprised that all stages of coma do not resemble what we have been taught to expect; a deep sleep. The person in the coma may exhibit movement, make sounds, and experience agitation. It is important to keep in mind that the coma patient may exhibit reflex activities which mimic conscious activities. Coma patients may be restrained to keep them from removing tubes or dislodging IVs. The progress of coma is measured by the patient's increasing awareness of external stimuli. There are many levels of coma which the patient will pass through as functionality increases.

Day 23 - Friday January 6, 2012

Wow!  What a busy day here at rehab.  I'm so very glad we got her right into rehab.  Already so many things have happened.  They came first from from occupational therapy and boy is Rebecca awesome!  She said we want Bridgett to be getting back to regular life, so we want her in regular clothes.  Luckily we brought clothes, although at the time we wondered how she would be able to wear them.  Anyway, the gal came in and had a helper.  She told Bridgett that she wanted her to get dressed.  She got the shirt over her head (difficult with the collar) and then told Bridgett to put her arms in.  She directed Bridgett's arms into the holes and Bridgett pushed her arms through.  Then after both arms were in Bridgett started pulling the shirt down by herself without being asked.  Next she told Bridgett to lift her legs.  Bridgett did not do that so she lifted her legs and put her legs into her shorts.  She told Bridgett to pull her shorts on and put her hands at the waistband.  Bridgett started pulling her shorts on.  She needed help to get them over her hips, as she was sitting, but it was exciting!  It looks so good having her wearing clothes, instead of a hospital gown.  PT came in next and tried to get her walking.  She was very tired from moving to a different place so she only walked to the door of her room.  They put her in a wheelchair.  She wasn't too comfortable because she is very tall and the back was too short.  They took her to the therapy gym and transferred her to a platform.  Then they got a different back for her wheelchair and got it all adjusted just for her.  They keep it just outside her door now and it has her name on it, so it's always ready for her.  Down in the gym they worked out her legs and arms.  Then occupational therapy worked on her posture sitting and stretching out her shoulders. Rebecca brought her back to the room and wheeled her up to the sink.  She told Bridgett that she was going to wash her face.  Take this washcloth and get it wet.  She helped Bridgett do this and squeezed it out.  Take this washcloth and wash your face--and Bridgett did it!  Good!  Now get this washcloth and wash your hands.  Bridgett did that as well.  Now give me the washcloth.  Bridgett did not want to hand it over, but Rebecca nicely convinced her!  Then speech therapy came in and said we are going to work on seeing if she can swallow.  They put blue dye on some ice chips.  They had her put the chips in her mouth and felt for her swallowing.  She did.  They did this three times and then they monitored to see if  there was any blue dye in the trach tube--no all clear.  They said we will watch the trach pad for the rest of the day to see if there is any blue dye and there wasn't.  After that they tried holding a finger over the trach tube to see if she could make any sound and she did!  They asked her to count with them and she tried and we actually heard her say six!  Then they tried to get her to sing a song--you are my sunshine and when the got to the right words she said love.  She made other sounds as well, just hard to know for sure what she was saying.  By the end of the day she was tired out and so were we!

Day 22 - Thursday January 5, 2012 p.m.

Last night during the night I got this idea to bring in a white board for Bridgett to try writing on.  With the neck brace it is very hard for her to even look at the board, but we held it up in the air, she grasped the marker and began to write. She drew a squiggly line with a circle around it.  I was going to take a picture of it, but someone erased it before I did.  Today we tried again and she didn't even hold the marker, just let it slip out of her hand.  Like many things that she does, she's not consistent at this point. It's hard for us to understand the whole coma thing.  It seems weird that she is walking and interacting with us, but not awake yet.  Of course, she is good about doing things in her sleep, including texting! This morning when Brandon came in to do PT with her, he and his assistant did arm and leg exercises first.  Then they got her up to walk.  This time they headed out of the room and down the hall.  She walked clear to the end of the hallway, turned around and walked back.  Of course, she is supported on both sides as she walks.  They walked her back to her bed, but she still wanted to walk and wouldn't sit down.  They walked her again into the hallway, to the nurses station and back to her bed.  She still didn't want to sit, so they let her stand for about 5 more minutes, then convinced her to sit.  It was awesome to see her walk so far.  Everyone at the nurses station was cheering for her.  We feel great about the decision to get her straight into rehab!  Mark and I left about 10 to go the Salt Lake to check out the rehab at the University of Utah hospital.  We had a great tour. When we were sitting outside the office I said it's too bad we couldn't meet the doctor in charge, as that would help me decide easier.  About 1 minute after I said that the office door opened and the gal giving us the tour, Janal (who has been awesome through this whole process) came out to talk to us and at that moment the doctor in charge was walking down the hallway and she introduced him to us.  He was awesome!  He helped us make a decision right away, we called to Provo, we told Janal it was a go and she said hurry back to Provo, I'll have an ambulance ready in 2 hours!  Mark rode to the hospital in the ambulance with Bridgett while I gathered up the kids, removed all our stuff from the hospital waiting room in Provo and from the Guest House, we gased up the cars and headed up to Salt Lake.  Unfortunately we were right at rush hour, which was an interesting experience for Arrianne since it was her first time driving on the freeway.  She did great!  We found the Guest House here in Salt Lake and got checked in with only a few snags (couldn't find it at first, they had the wrong room with a king bed, etc).  They we took the free shuttle to the hospital.  By the time we got to her room (I got lost in the big hospital, but only a little lost) we were all exhausted.  We took turns going to the cafeteria for dinner, and then spent time visiting Bridgett.  The shuttle is a handy thing to use.  We only had to wait like 5 minutes to get picked up.

Day 22 - Thursday January 5, 2012 a.m.

Yesterday when physical therapy came to work with Bridgett she did really well.  She had yet another person and but he also had a great attitude.  He came and worked with his assistant and first they worked out the arms.  They started with passive movements, but she started working with them and did great.  They had her punch towards the sky and then grab their hand and pull down.  She did awesome.  Then they did bicycles with her legs and of course she did awesome at that.  They had her stand and walk again about 8 feet.  Then they had to stop because of the coughing, sit her down and do suction.  They stood her up again and they wanted her to walk the same amount, but the coughing was just too much so they had to stop.  We just need that cough to clear up--that infection to go away.  I finally cornered someone last night and really asked a bunch of questions and found out that they would probably classify her infection as bronchitis not pneumonia.  GOOD!  Since everything got crazy with that operation to remove the vena cava filter, she did not get a second PT session.  Hopefully things will be on schedule for today.  Right now they have taken her down for another CT scan.  They were always taking her at midnight, but they are trying to get her back to a more regular schedule.  Oh, I wanted to say this about the balls--one of the doctors said good idea on the balls, but it would be even better if she could throw them.  So, yesterday I practiced having her drop the ball and pick it up.  This morning I showed her how to throw the ball and kept encouraging her--and she started throwing the ball!  At first just on the bed, then towards the end of the bed, then off the bed!  I may have started something that will really keep us busy!  Of course, if the ball hits the floor I am sanitizing it, so its a little more complicated then if we were in the living room!  Mark and I will be heading up to check out the rehab at the U of U.  Hopefully everything is great there and we were be on our way later today or tomorrow! 

Day 21 - Wednesday January 4, 2012

Oh, I almost forgot!  Yesterday morning Bridgett seemed to be trying to mouth something to me.  Then yesterday evening she mouthed something to Jenn.  This morning she clearly was mouthing something to me over and over and the nurse saw her do it too!  I can't tell what she is saying, but she appears to be asking me a question. 

Day 21- Wednesday January 4, 2012

They were waiting to start feeding Bridgett again until the vena cava filter was removed today.  That was supposed to happen at 10:00.  They never actually took her in until like 3:15.  So, it was all the way until 4:00 before they started the feeding up again.  They will have to increase the feeding gradually until they reach goal.  Frustrating.  At 4:00 the speech therapist came in to check how Bridgett was doing regarding swallowing.  Apparently the speech therapist is the one that works on that.  Anyway, he tried having her swallow cold water, but put it really far back in her mouth and she kind of choked.  The nurse mentioned that the sealant had come off her sensitive tooth and maybe the cold water was bothering it but he said cold works best.  He tried once more and she choked again.  Then they brought back the pressure at the trach cuff and tried a piece of ice.  She chewed it and presumably swallowed.  He thinks she has some swallowing ability intact.  He recommends that they give her ice chips from time to time in order to work on the swallow reflex.  If she gets some water in the lungs, it won't hurt anything.  He said he'd want to wait before trying anything more than water.  The vena cava filter did finally get removed successfully.  They said usually they can retrieve 90% of the filters without problems, and luckily she had no problems.  There was a clot in the filter, but they got it out OK.  At 5:30 the dentist came out again.  As I said, the sealant had come off the tooth with the exposed nerve. I thought that she was sensitive yesterday, and by today you could see the exposed nerve again.  I called Dr. Peacock and he came after work.  He was concerned that it would be much harder than it was last time since she is moving so much.  The nurse was very concerned that it would be difficult.  Right before he started Arrianne said we should explain what is happening.  So, when it was explained to Bridgett they asked her to open her mouth and she did (she's been doing that lately) and she held it open for a quite a while so that he could do a really good job of getting that exposed nerve covered as well as re-doing the tooth next to it.  Now we just have to find someone who will take care of the root canals and caps at an out patient surgical center, as it will be a while until she can actually go to the dentist's office.  I talked to the brain injury people from the rehab and asked if there was something I could get for Bridgett to hold to keep her occupied and keep her hands away from the tubes.  They suggested stress balls, which is what I was thinking.  I had Arrianne and Stephany go to the store and they got an assortment of fun to squeeze balls.  That was such a great idea.  Most of the time she is busy and doesn't bother any of the tubes or wires. 

Day 20 - Tuesday January 3, 2012

Well it turns out that the Provo Rehab is NOT going to be in network, so we will be going to the University of Utah Rehab.  They came down today and evaluated Bridgett and they also said they will accept her straight from the ICU without going to LTAC.  We are so happy about that!  This way she can be progressing right away.  Today they put in the peg for feeding.  It is placed directly in the stomach and replaces the feeding tube in her nose.  That procedure went great with no problems.  Tomorrow they will remove the vena cava filter (for blood clots).  They said that now that she is on blood thinners and up and moving, she will be OK. They started the blood thinner and then did a CT 24 hours later to make sure that it wasn't causing any bleeding in the brain or the neck. The latest CT shows that the swelling in the brain is continuing to go down and the brain is continuing to heal.  Also, looking at Bridgett, she is continuing to heal.  Her bruising on her face is getting so much better and almost faded.  The scrapes are healing up.  The small mark from the surgery to repair the zygomatic arch is so very small that I think there won't be any scarring at all.  The bruises on her legs and arms are fading.  The staples have been removed from her head and her scalp is looking so much better. Once her pneumonia is better they will be able to wean her off the trach tube.  Getting the infection put her back about a week in the weaning process. The peg has to remain in place for at least six weeks.  It is very nice to see Bridgett without that feeding tube in her nose.  Also, they will be better able to manage her calories.  She has been losing some weight so hopefully now she will be able to maintain her weight.

Day 19 - Monday January 2, 2012

I'm late posting for Monday--oops!  Yesterday there was so much going on!  We have been trying to get the whole insurance thing worked out and work on getting her accepted into rehab instead of LTAC.  We went to visit the Provo rehab.  It was very informative.  However, we don't know if this rehab will be in network.  They aren't right now, but are supposedly going to be in network as of yesterday.  So, it's kind of frustrating for us to now really understand what comes next, not be able to really know what choice we have and all of the other unknowns.  My mom came down to visit at the rehab and it was good to just sit with her.  We still have lots of family around and it's been nice to see some of our friends as well.  We are very busy when we are back with Bridgett, as she is active with her hands.  She is sometimes trying to pull the tubes out, but a lot of the time she is just feeling the tubes, rubbing things, trying to scratch or trying to wipe her mouth, etc.  So, once we are standing at the bedside, and constantly holding her hands or playing with her hands, or watching what her hands are doing etc.  It's a good thing we can rotate around.  We are continuing to read to her a lot.  Also, playing some of her familiar music on her ipod.  Bridgett continues to amaze us with the new things she is doing.  Today she walked about 8 feet.  Today one of the doctors that admitted her came in to see us.  She said that when Bridgett first came in she was very fearful that she wouldn't make it.  She said it was so great to see her now and how well she is doing.  One of the respiratory therapists said the same thing to me today.  He was on shift when she came in and he said he was terrified for her.  He said it is so great and amazing to see how good she is doing. 

Day 18 continued January 1, 2012

So many little things happened that I sometimes forget.  I just had to put this down though.  While Justin was here (my youngest brother) they were interacting and then the nurse came in.  She asked Bridgett if she could hold up two fingers.  Bridgett shut her eyes and acted like she was asleep.  The nurse said she must be tired now.  As soon as she left, Bridgett opened up her eyes and did exactly what Justin asked her.  Justin said I think she's tricky pretending to be asleep for some people.  He said Bridgett are you tricky?  Bridgett if you are tricky, squeeze my hand.  Bridgett squeeze his hand!  It is fun seeing her interact and have some personality with us!  Tonight Mark was talking with Jenn and telling the nurse stories about Bridgett and she smiled.  They said something about her beautiful smile and she kept smiling.  The nurse said something about her beautiful fingers and Bridgett held out her fingers.  Also, a story from Thursday--the rehab guy is Carleton.  His helper is Brandon.  Brandon just recently got married to a gal named Bridgett.  So, Carleton was working with Bridgett and said how long have you and Bridgett been married and Bridgett's eyes flew open like she was surprised.  Deb said she assured Bridgett that she was not married!

Day 18 - Sunday January 1, 2012

So, yesterday I told Bridgett that she should remember sign language so that she can communicate with us. Later on Arrianne said Bridgett I love you and Bridgett put her hands up like I love you, but a little sloppy so Arrianne helped her along. When Amy her cousin came Bridgett smiled and Amy said that Bridgett did I love you for her.  Today Jenn asked her if she could do the sign for I love you and Bridgett did it again!  Also, when uncle Justin came over to visit he was clasping her hand and snapped his fingers and Bridgett snapped back.  For quite a while she did that.  It's exciting to have her interact with us!  I love how she will hold my hands, even clasping them interlocking.  She will rub or squeeze my hand too.  When rehab came today and stood her up she started coughing (as usual) but really coughed so much more because she now has an infection in her lungs.  Stuff started coming out of her mouth and she groped around and grabbed Carleton's (rehab guy) sleeve and wiped her mouth!  He's such a nice guy and good sport and said way to go Bridgett. They handed her a paper towel she used that instead.  It was really amazing.  The second time they had her up she walked like 7 steps, maybe more.  She does really well with her left foot and has to concentrate to use the right foot.  It's hard to understand what Bridgett's awareness is at this point.  The doctor said she is like in a deep sleep and trying to wake up.  The nurse said she is in a dream like state.  They have been talking to us about putting Bridgett in an LTAC (Long Term Acute Care).  I haven't discussed it much because it seems upsetting, like we are putting her in a nursing home (even though it's not).  However, in the past few days she has progressed so much that they are now thinking that she can probably go straight to inpatient rehab.  We will know by Tuesday I think. We have also been discussing moving from the feeding tube situation to a peg.  Today the doctor said let's just wait a bit.  She might be able to swallow soon.  Once they do a peg, they have to leave it in for 6 weeks, even if you don't need it anymore. He said let's just see over the next couple of day.  We had been having problems with the feeding tube. Friday was a feeding tube nightmare.  The tube was originally in the stomach.  Then the stomach wasn't working correctly and they had to advance it to the bowel.  When she got the trach tube the doctor removed it from her mouth and put it in her nose, but only advanced it to stomach, but this time she has tolerated it ok.  However, it had come up a little and they were worried it was coming out of the stomach, so they asked the nurse to advance to the bowel again.  The nurse removed the tube (I don't know why they couldn't just advance it) and tried to get it down.  They don't use any sedation and she choked and gagged and turned red and it was awful.  After getting it down, it was in the wrong place and she pulled it out and tried again.  Again with the choking and gagging and it was in the wrong place a second time.  After a third try the nurse said we'll give her a little break and left.  Bridgett had been choking and gagging for like 30 min.  I went and asked the charge nurse to help.  She came in and helped out.  All together it took like an hour and it was awful.  Then Saturday the tube got plugged up. They had to put the guide wire back down to try to unkink it.  That night it plugged up again.  That nurse said that using the guide wire could possibly poke through the tube and perforate something, so she used warm water flushes.  That was worrisome as well, as they are keeping Bridgett in a dehydrated state (to control swelling in the brain) and the extra fluid concerned me.  Today it clogged again!  This nurse is 23 years old and she tried the warm water flushes, then decided to try coke in the tube.  That seems to have done the trick for now.  Hopefully we can ride it through and not that be the deciding factor regarding the tube or peg.  Bridgett had her eyes open most of the day and did very little resting.  Hopefully she is will still and restful tonight.  When she is awake we are holding her hands or keeping them busy so she won't pull out the tubes or wires.  Otherwise, they would have to restrain her and we don't want that.