Tribute and Update

Two (and a half) posts in one – a big collective tribute and an update on Mike for those who are worried that no news is bad news. (Really the no news is because Mike is closing down the blog, because he is on email again.)

The tribute

Lee and I have been meaning for some time to express our gratitude for the uncounted ways we have been helped since Michael's accident. Happily, it is unusual to be on the receiving end of a torrent of support. It is a humbling but rewarding experience. We have learnt how important that support is and how multi-faceted it can be.

We all find ourselves in situations where we want to help but find it hard to know what we can do. This is certainly true of the trauma of having someone in a coma in intensive care; really it is a waiting game. With severe brain injury it is a much longer waiting game.

Yet look at the following, inevitably incomplete, list of the ways people have helped us all since Mike's accident.

· very generous offers of accommodation in Auckland, for as long as we needed it;
· people who provided meals to save us from having to think about organising ourselves;
· help with transport; including what was virtually a taxi service to and from the airport;
· off-street parking near the hospital in the driveway of someone's boss's house;
· a continual supply of all sorts of provisions for the mass of supporters in the waiting room;
· family who ditched everything to be there for us, especially Tracy and Andrew who quit their OE in England and moved back to NZ to help us;
· the overwhelming support and kindness of all the visitors to the hospitals – Mike's business colleagues, Ironman colleagues, all our friends and family;
· the idea of starting a daily diary by Mike's bedside for making notes on his condition and progress for the benefit of (1) the professional staff, (2) our own morale as we recorded his progress, and (3) so that he could read it in later months to 'fill in the blanks";
· the idea of starting a collage of photographs on his hospital ward wall to help jog his long-term memory – when (if) that became an issue;
· those who added to it with Ironman race numbers, medals, postcards, posters and even a Japanese flag, marking completion of a Japanese marathon;
· the nurses who explained and explained, gave us a lecture about the need to pace ourselves rather than indulge in 'all night vigils' and even gave us hugs!;
· knowledgeable friends and contacts who helped us navigate the hospital system, intensive care and the eerie world of brain injury;
· people who provided an amazing range of ideas and gadgets to stimulate Mike's brain;
· ideas about IT input that enabled us to set up this blog page and later get Mike's computer 'on-line' at Cavit at a low cost;
· the great comfort and strength provided by quiet empathy – those who have the gift of "just being there' and resist the impulse to fuss to help;.
· the zest of youth, Mike's friends could evoke a response from him and lift everyone's morale, including that of the young nurses;
· morale-boosting stories about, and contacts with, people who had pulled through similar experiences successfully;
· motivational stories about great achievers;
· friends and colleagues in Wellington who kept our businesses and family affairs going; and
· the strength and positivity from everyone, always backing the positive option, even at the worst news. Its the only attitude to take, but its easier said than done. (One point of comfort here is the realisation after a day or two of observing an intensive care ward ,that death is not necessarily the worst option.)

Lee tells me that I will bore any reader with a longer list, so please forgive me for not mentioning a thousand and one kindnesses, flowers, gifts, and heartfelt thoughts and offers of assistance pored into emails, letters, cards and voicemails. Thank you all.

Tribute to people more than institutions

Some people who are aware of my views about our hospitals being 'on the wrong side of the Berlin wall' and about the problems with our monopoly ACC system have asked me what my thoughts are now in the light of this experience. Here are some brief observations:

· the medical care Mike received saved his life several times over. This is humbling and we will neve forget it;
· the quality of the nursing in intensive care was awesome, as was the level of responsibility. It was great how they dealt with traumatised relatives too;
· the rehab care Mike has received at Cavit has fully justified its high reputation and the hopes of its founder, It really is a fine example of interdisciplinary cooperation. On arrival Mike was soon in a life and death situation and we will also never forget the professionalism and commitment that assessed the situation and rectified it;
· ACC has performed in our case every bit as well as Woodhouse and his supporters dreamed it would. It is currently focused on rehabilitation and return to work and this aligns with Michael's objectives and priorities 100 percent. From our perspective the interface between ACC (the insurer) and Cavit (the provider) is seamless;
· the inequitable gap between state cover for accident and sickness is a matter of every day experience in these situations; it is caused by the utopian approach to accident compensation;
· hospitals are indeed dangerous places (I think Ivan Illich once reported that they are as dangerous as a construction site) and we had a small number of unnerving experiences. Transitions are particularly dangerous, be it a change in shift or a transfer from one unit to another;
· fundamentally incoherent politicised, monopoly systems perform as well as they do because good people have limited options and enough of them hang in and make them perform despite the problems of pay, working conditions, bureaucracy, lack of control and intractable 'quality differences'. (For example, don't bother asking Cavit when construction will start on their new building.)

In a sentence I am very grateful to a lot of people, but I wish the system was better for them.

Brief update on Mike

Michael is making good progress, albeit not fast enough for his taste.

Three days a week a typical day is (1) healthy breakfast, (2) travel to Cavit for physio, (3) lunch (4) rest, visits from friends, hours on the computer, and perhaps a walk or Sudoku (5) dinner, chat, more computer, bed.

The other two weekdays there will be more walks and likely a swim at the Freyburg pool (currently 60 metres x 5) plus aqua jogging. He is cooking family dinners too.

In the weekends more friends, more coffee, overnight at the beach house, some TV, walk on the beach – and last Sunday a big PB – Mike's first bike ride along the beach for about 300 metres x 2, with Lee and I glued to each side of the bike. The great thing here is that his balance looks like its going to be OK for cycling again.

Walking, Mike is walking indoors now without his walking stick and looking steadier all the time. Carrying a full mug of coffee is still a bit too dicey, but he is getting there. Out of doors he still takes a walking stick. He is still a bit wobbly for jogging. I tried him on jogging on the spot (thought he was less likely to trip over himself and fall), but he did not seem to have neutral gear, only slow forward.

Swimming, Mike's arm action looks as professional as before, but his legs are a bit wonky. Overall he is back down to his Dad's speed, or slower. It won't be long.

Fatigue management is the problem we anticipated. He has been red-carded twice by Cavit's physio in recent weeks for being too exhausted on arrival. The first occasion was caused by too much physical exercise the day before. The second was caused by his attending a seminar at his work for 4-5 hours. So it is frustrating for him. One message here is the trade-off between getting physically fit again and returning to work. Both are needed, but each creates fatigue that can set him back for days. Fatigue measurement is the problem, no doubt someone will solve it one day.

Discharged!

Yesterday (Friday 9th September), a bit under seven months since the accident, I was discharged from Cavit. Although I will still have to go in for physiotherapy as an outpatient, my discharge was a nice milestone to achieve.

I will probably go out with my family over the next few days to celebrate the discharge. The change of scene will be nice but the battle won’t end, though. I’ll still have to do my best in my recovery from here on in.

The next step in my recovery is the process of getting back to work and contributing to the economy again rather than being so lazy. First though, I get to live off the fatted calf at Mum and Dad's and do nothing while I work out what deficits I have and what strategies I can use for them for about six weeks.

It's a bit hard for me to remember, though it is probably easier for others and I have received reminders from people, what I was like and how much help I needed and how far I’ve come. The days when I couldn’t talk or get around like I can now seem like ages ago, though. Like another lifetime.

My recovery is possibly a bit weird for permanent residents at Cavit. They see a guy come in who is initially worse than them, slowly improves and then is eventually discharged while they’re still there. They’re good guys, though, and I’ll do my best to stay in touch.

This will be my last post on the blog although my parents might well put a final post on. The blog has been a fantastic way of letting people know how things are going. Before the accident I think I knew what a blog was, but not how useful they could be. I offer my thanks to my sister whose idea it was. Without it my family and I would have had to repeat ourselves a hell of a lot more.

My final post seems like a good time to start another round of more complete thanks yous. My thanks go to my immediate and extended families. This journey would have been a lot harder without your support. My thanks also go to all the medical staff involved with my recovery. The guidance that you were able to provide was awesome. Thanks for keeping me alive even though I did my best to check out there a couple of times. It’s fortunate that I can say I think that checking out was something I could have been better at it. My thanks also go to my co-accidentee, Ben Schurr. That must have been a very tough call to make to my Dad telling my parents about the accident. It is a credit to you that you coped with everything and still completed a very good Ironman two weeks later.

I have heard about people who face some sort of ostracisation after accidents similar to mine. My post card covered wall at Cavit would have attested to the fact that that hasn’t been a problem for me. The support from everyone, including from people all over the world, has been amazing.

I understand quite a few people read this blog who haven’t even met me. If you’re one of those people I hope you didn’t find my musings too weird. I also hope to meet you all at some stage. To everyone else I hope to meet you again sometime in the not too distant future.

Cheers for keeping track of me,
Mike

Talk the Talk, Walk the Walk

Since the last two posts were very philosophical, I thought we had better talk about something more normal in this post. The last 7 days involved the passing of a few walking milestones. Over last weekend, I had a go at walking down and up the path behind Parliament, using my stick, that I will use to get to work. I got a bit puffed going up it, but what was physiologically more difficult was getting down it. I had trouble regulating my speed and had to come to a complete stop pretty regularly to make sure I didn't go too fast. Apparently, that is due to difficulties for the quads in paying out properly.

On Tuesday, I walked, with my stick, to the Epuni shops, which are a bit under a km from the hospital, with my physio, Sue. I got about 200m back when my core muscles gave up and my hips started moving in odd directions. It is a bit of a strange thing when your core muscles get tired. It's like you know how your muscles should move to allow you to stay balanced, but even concentrating on making them move that way doesn't fix your difficulties. Fortunately, Sue was pushing my wheelchair so I was able to use that.

On Thurday, I walked, again using the stick, down to Janus Café, the local café and the reason that David Haines lost his bet about cafes in the Hutt not having couches. Finally, on Friday, I walked to within about 100m of the main hospital café, which also has couches, without using my stick. Again, my core muscles gave up with that short distance left and I had to use my stick, which my speech and language therapist was carrying. I might be able to talk the talk ok, but I can only walk the walk for so long.

My muscle fatigue underlines the fact that there will not be a day when I suddenly can walk and run normally. Everything will have to be fought for and earnt. It is only comparatively recently, say over the last few months, that this has become apparent to me, even though it is probably exceedingly obvious to most people. We'd like to recover immediately, but good things take time, I guess.

Cheers,
Mike

Am I Going Bonkers?

This post like last week's post is about my thinking rather than any particular event, but some news first. A friend sent me a quote after last week's post that I liked so much I decided to put it on the blog. It is from former Israeli prime minister, Golda Meir, who said "Don't be humble. You're not that great."

My second bit of news is that during the week my physio said it was ok for me to get around places with predictable terrain like Cavit without my stick. She had a good look at my walk before she said that. One of my problems that will, hopefully, pass with time is that, occasionally, I try and transfer my weight on to the foot in the air before it is on the ground. That causes the foot to come down too early. My physio thinks that I should stop doing that in time, but, in the mean time, the stick should make me think about it more and be more useful when the terrain isn't flat or predictable.

The main reason for this post and the reason for the strange title is to tell you about what I am thinking what life will be like post-discharge. I have managed to avoid the common head injury patient desire to get back home earlier than is sensible. However, I don't seem to have avoided the common head injury patient belief that help won't be needed after discharge. I do accept that I will need some physiotherapy after I'm discharged, but it's sort of hard to ignore the issue when you have trouble walking. I don't, however, believe that I will need much more therapy like occupational therapy.

The issue has arisen recently in a meeting between me, my Mum, the clinical leader and the occupational therapist who is most likely to give me help (if I need it :-) after discharge. It has also been an issue in thinking about going away for a trip post-discharge.

This belief creates an interesting situation for me because I am aware that it is so common for head injury patients to believe what they believe despite the common need for help post-discharge. I spend a bit of time wondering if my thinking actually is irrational and if maybe I'm going bonkers.

Still, I might be right (hopefully) and my physio says the difference with me is that I'm willing to listen to what people have to say, but this doesn't stop me wondering if I might be thinking irrationally. How do you ever know if you're going crazy, I guess?

Cheers,
Mike

My 'Miraculous' Recovery

This post is more about my thinking rather than any particular event. I mentioned what I thought about my 'miraculous' recovery and how it didn't feel miraculous a few posts ago in regard to writing a book about my experiences but I have been doing some more thinking about it this week so you have to put up with a more complete post about it.

Nearly everyone I meet, if I know them, wants to tell me how amazing or miraculous (or some other similar superlative) my recovery is. It doesn't really matter but I don't like talking about it because generally I can think of better things to talk about. The main thing, however, is that I don't like talking about it because it feels immodest because it implies that my efforts are amazing or miraculous when it's probably all a matter of luck or something else outside of my control.

This probably seems like a funny thing to think about, but people bring it up so often that if you are at all uncomfortable about it you are forced to deal with it.

My parents point out that I can't remember how bad I was when I was in hospital and that it probably seems amazing or miraculous to those who can. While this might be true (I have remembered some more pre-accident stuff but early April is still my earliest memory post-accident) it doesn't change the fact that I feel slightly uncomfortable about it.

My Dad was telling a close family friend and a former chemistry buddy of his about things shortly after my accident and they hoped that the "variance would be my friend." By that, they mean that my recovery would, hopefully, be above average. Indeed, it seems the variance has been my friend and there is lots to remind me of how easily things could have been so much worse. Again though, I feel uncomfortable that my recovery could be attributed to much more than good luck or some other outside force.

My thinking this week was based around what to say when people start talking about it. I discussed the issue with family, Cavit staff and a few unfortunate close friends. The best idea came from my physio, Sue, who said that if people try and tell me my recovery is miraculous I should change the subject by saying that miracles are for French peasants.

It seems inevitable that people are going to say whatever comes to mind though, so I thought the problem is probably with my definition of immodesty rather than with other people. Perhaps, it's not immodest to accept but not endorse such comments. So, now I'm going to accept such comments but offer none of my own views on them.

This probably seems like an awfully long thought process to arrive at a simple conclusion, but that's the price of doing my best to keep my modesty, I guess.

Cheers,
Mike

Painting the Town Red

On Tuesday (9th August) night, I went to the Business Roundtable's 2005 Sir Ron Trotter lecture. The event, held at Te Papa, was very flash and it was the first time I had worn a suit since the accident. I was using my walking stick to get around and, apparently, if I twirled it and put on a top hat I would have looked something like Fred Astaire.

The evening passed pretty much ok except near the start I had a drink of orange juice in my hand when someone lightly bumped in to me. Before the accident it wouldn't have mattered, but this time I managed to spill quite a bit of orange juice. Not the safest pair of hands now, I guess.

The lecture itself was good. It was given by a US academic economist, Tyler Cowen, and was on globalisation and culture. I found I needed to make more of a conscious effort to concentrate during some parts of the speech. For instance, I found that I couldn't remember what the question was that was asked as Prof. Cowen answered it.

My concentration also cropped up as an issue at other times. At one stage, a man on one side of me was talking to a man seated two away on the other side of me. While the man seated two away from me was speaking I thought there was no way the other bloke could have heard, given he was further away than me. I must have been concentrating less, though, than the other bloke, because he answered straight away without clarification.

All in all, I enjoyed the lecture, though, and my fatigue allowed me to stay on a bit afterwards. Who would have thought an economics lecture could be so exciting?

Cheers,
Mike

Computer Geek

This is one of those posts where one subject on its own isn't enough to write a post about but collectively the subjects can turn into something substantial enough.

Firstly, some slightly bad news. I had another chat with my physio during the week about a leaving date and when, previously, she had said that they could think about discharging me sometime in August I realised I should have interpreted her literally and that this didn't mean they would be likely to discharge me until September,

On the face of it, getting discharged a month later than I thought might be a bit of a bad step, but I didn't think I would have been ready to be discharged by the end of August. A discharge sometime in September gives me more time to exceed expectations.

To be well enough to be discharged I have to be able to walk without it mattering if I get distracted (by people talking, for instance) and do things like look over my shoulder while walking. I'm getting closer but I'm not there yet. My latest milestone is that I am now able to walk without an aid between my physio gym and the dining room which is a distance of about 50m thee times. My hips start moving in the wrong way towards the end of the third go, which is apparently a result of muscle fatigue, but it's not enough to stop me finishing off the walk.

My Mum has also put me on to a website that offers programmes for people to practice using their brain power. If you click on the link (My Brain Trainer) or type www.mybraintrainer.com into your address line you will be taken to the site. It is actually designed for normal people (those without brain injuries) and if you click on Take the Challenge you can try an exercise for free. The score to beat is about 127-128, which was set by my brother on his first go.

As predicted by the medical staff, my reaction speed is significantly below average but improving. It seems a bit geeky to rely on my computer for some of my recovery, but what can you do? Before you have a go at the challenge could you pass me my pocket protector?

Cheers,
Mike

Training Day(s)

I thought I'd talk about something I'd already mentioned like I did for the walking in this post so you have to put up with me talking about my training. Back on 4th July I had my first session on an exercycle. I think I wrote on the blog at the time that the exercycle was the idea of a friend's sister who was seriously injured in a car versus pedestrian accident a few year ago but now is extremely fit.

I have been on the exercycle a few times since and it's great to be active again. If, in the future, I appear to be taking the ability to get fit for granted I am giving permission to people to tell me off. I haven't been too often because my physio feels responsible for me and wants to come too, but it still feels great. My physio wanting to come too creates quite a big problem for me because I would rather do balance exercises with her than train. Hopefully, I will get discharged soon and I can get an exercycle to use at home. The quality of the exercycles at the hospital makes me a bit fussy. I will probably get my old pedals from Paraparaumu and buy some new clips and shoes (my old ones were never returned). I am a bit of an exercise snob after all.

The exercycle has a number of advantages over other forms of exercise. I can’t run or swim normally yet and I am meant to stay off the road while riding for a bit. Also, the more observant of you might have noticed that the article written about me recently mentioned I had some double vision. In certain directions I find I have two images, which is the result of my eyes pointing very slightly in different directions. Apparently, this will have been caused by fragile nerves between my eyes and brain getting shaken up in the accident and will come right either in time or by operation. The double vision would also prevent me from riding on the road.

The exercycling will be more helpful if I am able to ride again in the future. This is not guaranteed, because my balance while riding may be a bit of a problem. I haven't done anything to make me think it will be a problem yet, but I guess we won't find out for sure until I get enough truck strength to try riding again.

If I can't ride I will probably just take up running or something. Even if I devote myself to running full time I still don't think I'll be as quick as my ironman training mate and co-accidentee, Ben 'The Hammer' Schurr. There are plenty of sports to try, though, even if we can't be good at all of them.

Cheers,
Mike

Where To From Here?

So, where to from here? Well, the next major step is getting discharged from Cavit. There are a few stepping stones towards that, the principle of which is getting walking independently full time again.

My physio, Sue, has a new piece of equipment to help with my truck strength and therefore my balance, ominously called the Reformer, that she says arrived at an ideal time for me. The Reformer is designed principally for pilates exercises and she can get me to do exercises and see what exactly is going wrong. Normally, I do exercises on the Reformer once a day. Sue, who teaches pilates herself, thinks that pilates is the one form of exercise that brings all other forms of exercises together. Assuming my diet of pilates goes OK, the Cavit staff think they'll be able to discharge me sometime in August.

After I get discharged I will probably come and live with Mum and Dad in Thorndon and after a bit of time at home make the slow transition back to work from there. The main limiting factor is likely to be my fatigue. It is normal to only start back at work for a few hours a day and build up from there.

There is a similar slow transition back to living without help. After living easy at Mum and Dad's for a while, and assuming that everything is OK, I'll move in to a flat or something.

The head injury apparently is likely to have affected my reaction speed so I'm not likely to be licensed to drive for about a year from the date of my accident. I'm also meant to stay away from road biking for about a similar length of time so there'll be no quick return to triathlon.

A friend jokingly asked me if I had started writing book about my miraculous recovery. My current defence is that I wasn't a good writer before the accident and don't expect to be one now. Also I've heard plenty of people describe my recovery as miraculous but it doesn't feel miraculous. Some of it, like not being killed outright or put in to a vegetative state, was out of my hands. In regard to the other stuff, I just living how I normally live. That is, I figure out what I could be better at and then set about doing my best to improve at it.

So there is the road map. It involves quite a few factors, and depends on quite a few things, but I'll do my best (same as always) to exceed expectations.

Cheers,
Mike

Steak Out

Hi again. Lee here after quite a silence. I thought it was time I clocked in and added the parental perspective.

We now collect Mike on a Friday night and keep him till Monday morning. Last Friday night, brother-in-law Andrew decided he should check out Mike's computer game skills. He and Mike had a happy evening racing cars on the screen. While the noise and movement was far too exhausting for the middle aged brains present, Mike didn't seem to turn a hair. His stamina is better now and when he does have to rest, it doesn't seem to take as long to recharge his batteries.

Mike decided this weekend that it was time he practiced his new found eating technique ona good steak. Who better than little bro and Chef Extraordinaire - Phil as the inaugural chef. What a superb steak and Mike coped with it just fine, so thats another PB ( or SB - Steak Best)

The rest of the weekend, Bryce and I navigate our way through a wonderful range of old and young friends, all coming to visit Mike. It means so much to Mike to have this on-going support. Some push him in the wheelchair to seek out a coffee at a local cafe. We've decided that the proximity of our apartment to town is going to work well when Mike comes home full time. Although we don't have a vast amount of space, people can visit so easily and he will be able to get out to the city and its events easily. We'd thought we might havc to rent out in the suburbs for a few months, but have decided staying here will work really well.

Our kitchen turns out to be quite well set up for someone who can't walk well. It has benches on all sides, so Mike can be put to work on various tasks, propping himself up on the benches and edging his way around like a spider. Pity to waste accessible labour.

The walking is progressing but still has a way to go. As well as balance, Mike's having to develop a sense of direction. At the moment the hapless support person keeps getting driven into the wall. The physio uses Pilates a lot for Mike's exercise regime and I find it very interesting watching how it relates to yoga. She has a wonderful machine that goes by the ominous name of THE REFORMER. It does all sorts of great exercises that can relate to very specific weaknesses in the brain-body message system. At the same time it can provide the specific support Mike needs to be able to actually do each exercise.

So enough from me. Bye.

Lee

P.S. Mike here. Sorry, we haven't done a good job of coordinating our posts this week. If you haven't looked at the blog for a few days don't miss the post below.

Read All About It!

Why come up with my own writings for this blog when I can free ride off someone else’s? Either click on the link on the right of the screen or you can type or copy the address in the brackets into your address line (http://www.stuff.co.nz/stuff/sundaystartimes/auckland/0,2106,3345414a6016,00.html) and it will take you to a newspaper article about my recovery along with a sexy photo. The article appeared on the front page of the Eastern Bays Couiers last week.

Live Man Walking

I thought that walking unassisted required more than just a bare mention in my last blog so I'll write a bit more this time. On Monday (4th July, rather fittingly, as my physio, Sue, pointed out, Independence Day) I took my first walk unassisted with Sue watching. I didn't walk very far, but it was an important milestone.

Like eating early on, walking requires quite a lot of concentration and things go to hell (with legs going in the wrong place) anytime something distracts me (like talking to someone). No doubt things will become more automatic, though, as time wears on.

To give you an idea of what it feels like, it as if you are walking on a tightrope. You know that at any moment you could fall and you have to use your concentration to reduce the chance of that happening.

Stopping or changing direction does increase the risk of me falling. As does reaching for a hand hold. Although having a hand hold is more comforting focusing on it distracts me and stopping or changing directions places more demands on my balance.

It was over four months since the accident and so much of my physiotherapy has been focussed on walking again that it was a nice milestone to reach. Still, the physiotherapy doesn't end there because I'm still a bit shaky and Sue has to chose where to stand carefully in case things go wrong and I start to fall. There is still more work to be done on increasing my strength in my trunk and therefore my balance.

Hopefully, that gives you an idea on what it feels like.

Cheers,
Mike

Beach Boy

Late on Friday (1st July) afternoon, my Mum picked me up and we went up the coast to Mum and Dad’s place in Paraparaumu. As usual, it was nice to be out of Cavit even for just the weekend, but the trip was different for three reasons.

Mum and Dad have a lot more room out there than in town so most of my stuff is out there. I had a look at my bike for the first time. Its frame was broken in two places and both wheels were buckled. I was quite surprised that I had collided with enough force to brake the frame but, as my sister said, the more energy my bike absorbed the less my head absorbed.

Saturday was quite calm (unusual, given how close Paraparaumu is to Wellington) and clear so my Mum and I went for a walk on the beach. I walked with my Zimmer frame and did my best not to look too old. I was a bit slower than I was before but we did close to a kilometre all up. I got tired with about 100m to go so we had to stop and sit on a log for a few minutes. That just gave us time to pick holes in the posture of other people walking by.

On Saturday we watched the All Blacks’ game with my Great Uncle Jack. For those of you who don’t know my Uncle Jack, he likes supporting the team he thinks will most upset the people there. He also doesn’t like supporting New Zealand. The Lions were an obvious team to support for him but it was good fun as he went quieter and quieter as the game wore on. The game was so enjoyable that I couldn’t leave and managed to last the whole thing without a rest.

Two more things happened before I wrote this that are worth writing about. I biked on an exer-cycle for the first time. The exer-cycle was the suggestion of a friend’s sister who came away with serious injuries in a car vs pedestrian accident a few years ago but is now extremely fit. I only did 10 minutes because I had to save energy to walk back and it was a far cry from my situation before the accident (I’ve lost all the fitness I ever had) but it was the start of the road back to fitness.

After I got back from the gym, I had my first unassisted walk with my physio, Sue, watching. It wasn’t very far but it was an important milestone. As my brother wrote in a text to me afterwards, bring on the next Ironman.

Cheers,
Mike

Home Again

Hi everyone,

Lee again after quite a silence. Mike reckoned there were no new PBs. I felt it is all one great PB, so here's my interpretation of last week's progress:

Each event was small in itself but each builds into a lot more independence and interaction. I think the major difference is that Mike has so much more energy now. He can last longer in activity and it doesn't seem to take so long to rebuild his energy. That enables him to work at things a bit longer. Also, as he does manage a new challenge, it seems to build his confidence that he can cope with the next one.

One bit of progress was that Mike got a new wheelchair - one that he can wheel himself and that is easier for us to manage too. He doesn't have enough energy to wheel very far, but it is a great feeling of independence. With it, the walking frame and the trolley he can organise his day to suit himself without having to wait for anyone else.

Now that Mike is up for longer, he needs more clothes so Bryce and I wheeled him into Lambton Quay. We bought some more clothes and even met some friends of Mike's in the shop. Of course Bryce so loves shopping it was a real thrill for him!

Yesterday Mike and I wheeled our way into the World Press Photo exhibition. It was very crowded but we discovered that everyone makes way for us to be able to see the photos. The only time I've parted the crowds before was when I was with a nun friend who wears the full nun regalia. We'd recommend the exhibition,if it comes your way - the photos I mean, not the nuns.

All the domestic activity has a good effect on Mike's skills. Its like second time around of training up your kids! I've been putting him to work washing dishes and peeling vegetables. Tracy started a new job last week. She and Andrew moved out of our apartment and into a place within walking distance. Phil, Bryce and I were helping them move into their flat and Mike got caught up in that too. It all requires a lot of work from Mike, to prop himself up against things, manoeuvre around furniture, and to develop small scale movements such as usng a vegetable peeler.

Plus of course last weekend required the crucial cultural skills connected with watching the All Black Lions Test. Mike lasted the whole game with just a half time rest.

Plus Bryce has even got Mike working on that blasted addictive Sudoku maths puzzle stuff.

On a smaller scale, Mike can now eat unsupervised, so we're expecting further weight gains. He can also shower when he wants to. Sounds trivial but it means he doesn't need to wait until the nurses are free to keep an eye on him. His swimming is progressing. Mostly the hydrotherapy focuses on trunk flexibility and walking action, but in his short attempts at freestyle, his legs are sinking less. Plus on Sunday night he discovered that he can still do press ups! He did two easily. I had a go and struggled with one. The walking is going okay and Mike is now walking with one crutch with someone to help. The physio expects that in another three weeks he will be able to walk entirely on his own. Mike's non-physical project this week is to carry out a bit of work/economics analysis and he is really looking forward to getting into that.

Cavit are now talking about Mike coming home to live within the next couple of months, so things are falling into place. Now Tracy and Andrew have moved out we will be able to set up the spare bedroom for Mike to be there for a while. I presume he will continue to go out to Cavit for therapy some days and gradually start to integrate into ordinary life.

You can see that Mike's life each day makes further progress towards normal living. The amazing thing is how normal it is becoming when we were facing disaster such a short time ago.

Back to Mike again next time.

Lee

Home Is Where The Head Injured Patient Is

Wednesday’s run of good luck continued and on Friday (17th June) one of the Cavit staff came and asked me if I would like to spend a night at home that weekend. It was much to my family’s and my surprise because none of us expected that opportunity to arise until I could get around better.

The next morning my Mum and Dad came and picked me up and we started the quick journey home to Mum and Dad’s place in Thorndon. It was nearly 4 months since the accident occurred and around 6 months since I’d last been home but it was fine. A few issues presented themselves like sloping access, but once I was aware of them they weren’t a problem.

The main issue of moving around inside was a flight of stairs to the living area on the second level. But these didn’t slow me down too much and apparently I got better with them as time went on.

Quite a few relatives turned up on Sunday for a visit, but that was fine. Whenever I got tired I just popped downstairs to a bedroom for a rest.

Later on I went down to the Wellington waterfront with Mum, Dad and a family friend. It was the first time I’d been in a wheelchair in a crowded place. People’s reactions to me were quite different to what they would have been normally. It was as if they wanted to look but thought that they shouldn’t. I myself would probably have reacted that way before the accident, but will force myself to react normally now.

Then it was back to Cavit on Sunday night for another week’s therapy. May there be many more visits home.

Mike

Fat Bastard

(For those of you are unsure about the title Fat Bastard was a heavily overweight yet amusing character played by a presumably padded Mike Myers in a couple of recent movies.)

Wednesday (15 June) represented a particularly good day for me. Firstly, I had enough weight to be taken off drinking a protein drink called Fortisip. I was somewhere around 65 kg before the accident and at my lightest measurement I came in at 52 kg. That represents a weight loss of around 20%. If I figured out some way of converting this head injury into something that could be taken I could make a lot of money.

On Tuesday I weighed in at 62 kg. While this represents a big weight gain I tried on a pair of my old trousers over the weekend. The trousers used to fit comfortably. Now, I wouldn’t say they were falling off me, but there is substantially more room than there was before.

I am close enough to my previous weight and my ideal weight that they decided to take me off Fortisip. While I didn’t think Fortisip tasted bad, depending on which flavour you had, the high protein content disrupted my skin and gave me more red rashes and more pimples than normal.

Secondly, and in keeping with the weight thing, I got a trolley on Wednesday. While this represents a minor step in the scheme of things it allows me to cook breakfast for myself and is the first time I’ve been independent in this.

Right. Happy eating.

Kind regards,
Mike

15th June: Mike and the success factors

Hi again. Lee again.
Those of you who were there at the beginning of Mike's long saga will remember the factors we were told that would give Mike a better chance of comingn out of the accident ok. The factors were high intelligence; good interpersonal skills; strong family support; good physical fitness and a previous optimistic attitude to life. This week I have clearly been seeing two in action -previous physical fitness and interpersonal skills.

I was watching Mike's progress at Physio today and talking with his physio. Mike accident has affected him greatly physically, but he is making such good progress. I can see that he understands muscle groups and what muscles are where. The physio can explain what she needs him to do and Mike knows what is involved, even if the muscle messages are weak. He also really concentrates on what is required. I am sure it is because this physical focus is familiar territory to him.

On Monday Mike started having breakfast in the day room and attending the half hour current events session afterwards. For various reasons this time of day brings much more interaction. Up till now Mike has related a lot to people visiting and not much to other patients. In that three days I have seen him really increase his involvement in the group and show much more awareness of the other patients needs and difficulties. Presumably this is like an old behviour that is warming up too. Some of it must be due to increased exposure to the other patients, some due to his improved energy and some the old Mike reappearing.

It is very interesting to see some of those factors mentioned right near the start actually coming into play in microcosm.

Regards

Lee

June14: He's big, he's bad and he's still an economist

Hi there Everyone
It was a real progress today. Mike was asked to talk briefly about the write-off of Third World Debt to the morning orientation session at the Rehab Unit. what a request. Little did they know the threat of being subjected to hours of economics. Little did they know all the literature Bryce immediately down-loaded as a contribution. I was amazed. BUT that old economics brain was still there chugging away. Sometimes there was a bit of a wait for the next idea, but the interconnections, the mindset, the familiar old increasing complexity ..still all there. I would have burst into tears, except that people might have thought it was in sorrow at still being stuck with an economist after all that shaking around of the grey matter. Those of you who saw Mike comatose in Auckland Hospital will understand how exciting the progress is, even if it does all lead to more economics.

Other progress. Mike is now having breakfast out in the day room and is able to sit in a chair. This brings him into more social interaction with the other people at Cavitt. He and I think his energy levels are improving. He can last longer in activities and it does not take as long for him to recharge his batteries.

We got a general report today on Mike's Occupational Therapy testing and he had done better than either of us had expected. It looks like most of his abilities are still there, just the time taken to do thing is a bit slow at present. Some of the exercises we think he would have done about the same level pre-accident. One was the sort of skill required to rummage around in a handbag and find things like a mobile phone or a comb. Just as well it's not a blokey activity.

9th June: Inching towards independence

Hi. Lee here again. Bryce and Andrew are tacking their way ever closer to setting Mike up with a computer and then there will be no holding him back. At the moment, Mike is off line and in the meantime there's just me.

Mike has shifted rooms, in with two other guys. This means that there's someone sicker than him, which I guess is progress. For those of you who visit, he's now in a room on the other side of the unit, down the end nearest Pilmuir Street. He's decided to sack me as his personal secretary and take over running his social life. Which is great.

Mike's new room is closer to the toilet, so he is able to walk there with a walking frame and just a nurse to watch his walking. And this morning he ate his breakfast sitting up on the side of his bed, which makes eating a lot easier. Each of these developments seem small but involve a lot of work on muscle control and strength.

The latest O2Max magazine has an inspirational article in it about a young woman who was badly hurt in a road accident and has trained her way back into being one of NZ's top surf lifesavers. This was great reading for MIke, especially when he realised she'd had a brain injury as well as extensive other injuries. I guess we all are inspired by such stories but we just never think that life will make sucha demand on someone close to us. The day in day out requiremnent for determination, patience and courage is very difficult to communicate.

On that profound note,good night!

Lee

Can't beat Wellington on a cold day

Hi Everyone,

Yesterday Bryce and I took Mike for another car ride. A bit further afield this time and he coped really well. We came into Wellington, bought an icecream and a coffee and sat looking at the new beach at Oriental Bay,feeling that all things considered Life was pretty good. There's a great icecream place on the Bay there called soemthing like Cafe Eis. We also did a smal tour around Phil's new place of work and the location of his new flat - all those changes had happened while Mike was out to it. After that, Mike was pretty tired, so we went home. The apartment was tantalisingly visible, but until he can walk a visit home is not really feasible.

Mike's cycling friend Nicky was down from Auckland and it was great for us all to see her. Nicky's visit reminded Mike of his great circle of friends back there and I think her visit gave him new determination about races etc. When I tentatively suggested aiming for a 10km walk as a starting goal (thinking, hey I could do that too!) I got scorn poured upon it.

Meanwhile it's back to walking practice for Mike and a torso that does not yet obey mental commands yet. But there's definitely progress everyday.

Lee

Mike's

Back to my element

Hi guys,

Friday (3rd June) ended two difficult yet successful days of Physiotherapy. On both days my Physio, Sue, was pleased with how things went.

On Thursday, I successfully negotiated some stairs. Going down stairs can ordinarily make recovering patients dizzy. They made my Dad dizzy during his recovery after he decided to throw himself off a bridge during a mountain biking trip when I was 13 resulting in a broken pelvis amongst other injuries. Fortunately, there was no dizziness for me and I managed to get 16 in before I tired.

On Friday, much to Haydn's (my former swimming coach) presumed pleasure I had my first swim. The swim can make patients throw up, but that wasn't an issue for me. It was good to be in the water again. After a number of seasons of water polo in secondary school and swimming training prior to my decision to get into triathlon (plus the fact my brother and I were known as water babies growing up) made swimming easily my best triathlon discipline. The only problem this time was that due to a lack of trunk strength my bottom half wouldn't float like it used to so I had trouble kicking when I tried a few strokes. Still the tiredness didn't kick in as much as it could have and the walking (the real reason we came swimming) went well.

All in all, it was a rewarding couple of days.

Kind regards,
Mike

P.S. David Haines, I don't mean to talk up the Hutt but you owe me a flat white [check what he promised]. Janus café has two couches.

1st June: Bryce and the search for OBJECTIVE MEASURES

Greetings everyone

For a change tonight there is a different aspect of PBs to report. Bryce has been beavering away trying to work out an objective measure for Mike to use to assess his fatigue. Those of you who know Bryce well will understand the importance of such measures to him. Despite heaps of scorn poured on by me, his ever-admiring wife, I have to admit that he has come up with quite a neat idea, at least for someone like Mike.

The system relates to mental arithmetic that Bryce and his class mates did at Primary School. Yes I know you have to wonder about someone who remembers anything from that long ago, let alone specific mental arithmetic, but we're talking Wilkinsons here and it was Christchurch where there'd be stuff all else to do. The system involves giving Mike a number between 1-100, then two numbers to add and subtract. (The adding number is higher than the subtracting number, just to make it easier.) Then Mike adds and subtracts the same numbers for a minute - how many can he do in a minute. Then he keeps track of how he performs during different degrees of tiredness and can track fastest performance and slowest. So tonight I arrive, I think Mike seems fatigued but he says he isn't bad. He volunteers to do THE TEST and lo, he was very tired. Lowest score so far. Interestingly, I could see half way through the minute that suddenly the fatigue kicked in and his rate dropped fast. (You will notice that there is no mention of Yours Truly subjecting herself to the test!) In essence the message from that test meant: 'Go home Mum'

Progress with the walking today. Mike got so that he can bring his leg right through the stride, rather than just bring it up to the other leg. When you think about it that advance takes nerve and, if successful, quite a lot of balance. Mike had both.

Regards and happy mental arithmetic

Lee

May 30th: Back to the olds

Great to get all your positive comments for Mike. I can see that the Hutt Valley has a bit of an image crisis! It sure felt a wonderful place to us as we drove Mike around for the first time. The small things in life take on such a new meaning. We were armed with clean up gear because brain injured people often get car sick, but not Mike.

Each day Mike gets a little bit better co-ordinated and a tiny bit stronger. It is hard to describe unless you see it close up and notice the micro changes. Where even a week ago he was so shaky I had to get help to transfer him from the wheelchair to his bed, now he is good enough to manage with only me. But they think it will still be six weeks till he is really freely walking on his own.

The fatigue is an on-going issue and we're all still learning about it. Even just Mike lying in bed listening to music or reading tires him. Even having us read to him is not restful enough - he doesn't lose energy, but he doesn't gain it either. So its quite a challenge, particularly for a guy who all his life has been either full on or sound asleep! Any suggestions for ways to rest are welcome! I've been teaching him yoga breathing. I plan to seek out someone to teach him meditation when he has more stamina, but it would have to be someone really willing to adapt their technique to brain injury.

One good thing from his goals though - by July apparently Mike will be doing his own washing and they will have taught him to cook. At that point, we will all move into Cavit with him and he can look after us.

Mike is really enjoying his visitors. Thank you so much to the regulars and the casuals. Just call me if you're planning to visit so I can keep things co-ordinated.

Lee

3rd Post - 1st Drive

Hi guys,

Saturday 28th May was a milestone day or, in my Dad's words, a PB. I had my first car ride with Mum and Dad. The ride through the Hutt (from the hospital) was (fortunately) uneventful.

There was some nervousness as it is common for head injury patients to get nausea. Fortunately, I was not inflicted with that problem. All I had was some dizziness and it was gone by the time we got home. Unfortunately, the ride wore me out and I was stuffed afterwards.

For those of you who know the Hutt, we went up to the Wainui hill lookout and the Petone foreshore for a coke (I had to get some caffeine in there somewhere). We also checked out two houses that I grew up in (neither had changed much).

The ride, along with my first weight measurement over 60 kilos the day before, felt like more of a return to normality,

Kind regards,
Mike

A Day In My Life At CAVIT

Firstly, I have some news. On Tuesday, I had my first walk with a cane. Admittedly I was supported by my Physio Sue, but it was (literally) a step in the right direction. We had another family meeting with the Cavit staff. It was weird to sit there while everyone talked about you. As I said before though, things are headed in the right direction, so the meeting went well.
A day in my life at CAVIT centres around therapy. I get up around 7.30 and generally have a shower first. Mum normally makes me breakfast after that.
Then we move into therapy for the day. Given my circumstances, I spend more time in Physiotherapy than Speech or Occupational Therapy. Normally, I have two sessions of Physiotherapy and one of either Speech or Occupational Therapy. Usually, one of the Physiotherapy sessions is on Sue's machine and the other is practicing walking somewhere. The name of the game is to get my muscles to listen to commands from the brain. While there are only a few main muscles for walking there are a lot of muscles through our trunks involved in balance. These represent the central focus of my Physiotherapy.
Stuck in there somewhere are lunch and dinner. After dinner I have a bit more control over my time and can wear myself down reading or working on my next blog post.

2nd Family Consultation

Cavit's experts reported to Mike and his family today on his progress in the last 8 weeks, and on what lies ahead. The bottom line is that they expect him to be able to live again in due course as an independent adult and to hold down paid employment. I think the literature on brain injuries describes such outcomes as a 'good recovery'. This is amazing in the light of the severity of his injury -- eg 54 days in a state of post-trauma amnesia when 6 hours is regarded as serious. The cognitive testing shows up a few things that need working on, but it would be a miracle if it were otherwise and none of them can be expected to be intractable. Perhaps the best news of all is that they report that he has a high level of awareness of things that need to be worked on. Apparently it is common for people with these injuries to fail to perceive areas where things are not yet what they were. Obviously it is much harder to put something right when you do not know that it is wrong.
The immediate target is to see him walking solo in the next 6 weeks. He gets into the swimming pool for the first time this Friday, now that the site of his P.E.G is sufficiently healed. That should increase his range of therapeutic activities. There is no doubt that Mike is keen to see what he is capable of in the water, given his difficulties with walking.
In the light of all this, fatigue management appears to be the biggest issue Mike faces for the foreseeable future. The physio reports that whereas a few weeks ago he could handle a few minutes physio max, now he can handle 20 minutes. Then he must rest.
One conclusion to come out of this is the desirability of scheduling visits to Mike so that he has rest periods between visits. To achieve this he almost needs an appointment book so that he knows the time at which you will be visiting so that he can rest up before you arrive. So please contact his social secretary (Lee) and book in a time for visiting, and try to arrive on that time if you can so that Mike can plan his energy levels accordingly. This is not the normal casual Kiwi way, we know, but this fatigue problem is not normal either.
Finally, Mike was naturally chuffed by all the responses to his blog.
The positive energy you are all giving him undoubtedly boosts his impressively positive spirit.
Yours appreciatively
Bryce

23rd May: Back to me

Hi Everyone,
Lee here again. It was just great to see the buzz Mike got from your comments on his posting. (I hope I got the terminology right because I get told off if I use the wrong word for it all.) Many thanks.

We took MIke out for breakfast on Sunday morning - PEB Personal Eating Best? He got himself through a big breakfast with remarkable speed and it all felt so wonderfully normal.

The therapists have taken pity on Mike's one finger typing and did some work on getting back his touch typing today, so he may be able to up the speed soon. His walking is coming along well. If he can just get stable enoujgh to practise on his own I am sure he'll go ahead really rapidly. Mike's now got his sights aimed at getting in the swimming pool. We suspect he has a bit of a shock coming in terms of what he can manage, but it will be another step along the way.

I mentioned a day or two ago that our next family meeting is on Wednesday. It is a good feeling to think back to where Mike was at for the last one - only recently back from the medical ward, still in post traumatic amnesia and simply not well enough to take part in the meeting. This time he will be able to be his own voice, with us just there ar back up.

22nd May: A posting direct from the man himself

Hi guys,

Well it's nice to be something like a happy ending to this story. My recovery is headed in the right direction yet I'm conscious of the fact that things could have easily been so much worse. If I've learnt one thing from this whole experience it's that no matter what happens things could always be worse and you should always keep on pushing (my apologies for the triathlon-speak in that last bit).

To let you know what it feels like (and to use my physio Sue's analogy) it as if an army has run through my head with a scorched earth policy burning all the crops and killing all the locals. There's quite a lot to get used to. The most major thing is the fatigue given I wasn't a guy who ever let lack of sleep get in the way of anything important to me. Most things that use muscles require relearning (for example for accuracy reasons I'm having to one finger type the keys for this document even though I knew how to touch type before the accident). The relearning includes walking and eating. For example, try swallowing your saliva three times. I'm told that the third time was what it was like for me eating originally. On top of this I have a number of problems I'm told are common to head injuries the most annoying of which is a cloudiness over the brain. My memory is ok but as events move closer to 20th Feb they get harder to remember without prompting. I have no memory from before the accident itself until early April (for better or worse). This all said, I've been told by friends who knew me well before the accident that I still have the same sense of humour and the same smile.

I've tried to say thank you to a number of people and been told either that the accident wasn't my fault or I would have done the same for them. While both of these may be true neither reduces my need to say thank you to a few people. Firstly, my thanks go out to my parents, Lee and Bryce, (who could ask for anything more?), my sister and brother-in-law, Tracy and Andrew, (thanks for cutting short your OE for me) and my brother, Phillip, (thanks for your attitude and for still coming to visit me despite getting told off by the Cavit staff at least twice). My thanks also go to my extended family, to all the medical staff involved in my recovery (including the unknown doctor who stopped and helped me immediately following the accident) and to my co-accidentee, Ben Schurr. Lastly, I would like to thank everyone who has come to visit me, sent something to me or posted something on this blog site.

I don't have an internet connection yet but hope to get one very shortly. I will take over putting posts on this blog but I'm sorry to say the frequency will drop. I will put something on this site when I have some major news about my recovery.

Kind regards and best wishes,
Mike

20th May: Three months since Mike's accident

It is hard to believe that the three month mark is here. I look back to our lives pre 20th February and it all looks so far away, like a vaguely familiar movie.. It is also amazing to realise how far Mike has come since that dreadful day. the support of friends, family, friends of friends and total strangers has been so vital to Mike and all of us.

We had a celebratory meal of takeaways around Mike's bed tonight, and the anniversary made me think about progress to date:

His walking is coming along okay. Today Sue the physio got Mike walking with his arms stretched out and resting on her shoulders. This seemed to keep him more stabel than on the walking frame. The two of them looked like a couple of rather slow and stiff tango dancers. He will get there with the walking.

He is eating pretty well now and we're doing just fine on the weight gain. Apparently Mike's gained 2.8kg in a week, which is pretty impressive. It makes me realise how eating too much puts on weight! Duhhhh. For skinny Mike it means he is able to take in plenty enough food despite coming off the drip.

Mike has got a lot better at monitoring his tiredness. He's not good at judging when he is tired, but he does have his head around having to store up energy for the therapy activity or visitors and then resting to recover. We think we're not far off him being able to come out for a car ride and that would be a wonderful step forward.

His talking is fine as long as he is not tired. His voice is still hoarse, but that will improve apparently. The therapists are testing his cognitive ability and so on and I guess we will get an up-date at the family meeting next week.

Mike is having a few problems with double vision, but once again this is common and should disappear as he recovers. At the moment it affects his reading and anything else that requires his eyes to focus.

So thanks to everyone

Lee

May 18th: Quiet day for Mike

A bit quieter couple of days for Mike. Probably the main event was Bryce getting back from ten days in the US. There is a scurry of testing happening, so we presume this is to meet the deadline of our next family meeting on Wednesday next week. I look at some of the tests and wonder how us non-brain injured people would score. Some tests are cognitive and earlier this week there was one called Behavioural Recall which seemed to relate more to practical recall relevant to aspects of every day life - so skills such as remembering names, remembering to ask a question during an appointment, remembering where you put something and so on.

Mike's walking is gradually getting more stable. I presume once he is more steady he will be able to practise on his own and make more rapid progress. I gather that at the moment there are quite a range of skills the therapists would like to work on, but they have to just focus Mike's small amounts of energy on the highest priorities.

Regards to all

Lee

May 16th: Onward and outward

Mike is rather like Hansel in the witches house in Hansel and Gretel. Each day he pokes a skinny finger out and we all try to fatten him up. Must have been a record today: Three regular meals, about five high fat and protein drinks, I took a muffin out, Tracy took a baked kumara to heat up and Cousin David really hit the spot with Burger King!

Mike's walking continues to strengthen. He walked from his room to the day room with no walking frame, just some stabilising hands from the physios and me trotting along behind with a chair for him to rest on half way. So we were really pleased with that. The balance takes a great effort and at the end of that walk he was exhausted.

Regards

Lee

14th May: PSB

Hi everyone

PSB? Personal Social Best. I took Mike on a wheel chair ride around the block to buy a coffee, because it was A GORGEOUS WELLINGTON DAY AS USUAL.
Quite a collection of his uncles(2), aunts (2 sort of), cousins (1), sister (1) and brother-in-law (1) were at the cafe because another cousin had rugby nearby. Mike coped well with this collection of rellies all talking at once, plus the crowded cafe plus the cafe music. I thought it would confuse and tire him, but he coped well and was not too bad by the time we got back. How the pleasure of the simple kicks in - just being able to be out in the sun, with family, choosing his own food etc. So another set of high fives.

It is easier to manage this sort of trip on the weekend because there is no therapy to tire him out.

Regards to everyone

Lee

10th May: Bye Bye P.E.G.

Another good step along the way today. A nurse came from Endoscopy (sp?) and pulled out the P.E.G.feeding tube into Mike's stomach, so now it's All by mouth. A fine change from 'Nil by mouth'. When I write 'pulled', I mean literally that. Amazing really. So now we have what many of us would regard as a nice challenge: How to whack heaps of calories into Mike, so he doesn't lose weight. The food still has to be of fairly uniform texture because he can't manage eating hard stuff, or chewy stuff, or too much variation in texture. We celebrated with a latte and a muffin in the hospital cafe.

The physio is going fine. Each time I watch I can see that Mike is getting his muscles a bit more stabilised and under control. In some ways it is very like gradually building up the weights in the gym. He starts out okay and then as he tires his muscles get wobbly. Because Mike is having to concentrate on each aspect of muscle movement, it is amazing to realise some of the complexity of even a small movement - stabilising other muscles, focusing on the one you want to move, controlling it, positioning the rest of your body to manage, bringing in to play the associated muscles etc.

Yours muscularly

Lee

9th May: More Milestones

I arrived at the rehab ward this morning to find a tired, beaming Mike emerging fromthe shower. He had managed his whole shower and shave himself and was most pleased. We'd had a conversation just the day before about the frustration of not being in control of things, so this was a good step.

Next the Team Leader came and said to us that they think Mike can cope with sometimes having two visitors at once now and to schedule visits between 4 and 8pm, so that makes life a bit easier. They also think he can cope with e-mailing too, so once we have him set up with a computer of some sort, expect lift off.

Finally this afternoon the Physio shifted Mike on to a walking frame. He still needs someone supporting him, but this is really good progress even just since last week.

One pleased Mike.

Lee

May 8th:Peaceful progress

We've been a bit quiet on the blog lately, but Mike has continued to make really good progress. Each day his walking is getting a bit stronger and his general posture is better. He can now sit in a regular chair to eat his meals, without needing the side and head support of a wheel chair. So with support he can walk out to the dining area at Cavit then just sit and eat. The sheer move to normality of this is a great joy to us all.

The cognitive testing proceeds when he is not too tired. He is doing pretty well, but as each level gets more complex he has to concentrate really hard. The therapists keep saying it is not pass/fail; that it is an indicator of where they need to focus the therapy interventions. However, I can see that as far as Mike is concerned every single question is definitely pass/fail. The difference in his mental reasoning between alert and fatigued is very marked and the switch is really sudden, but they say his stamina will increase.

We are gradually increasing Mike's visitors,now that the OE exodus seems to have stopped and we have a better idea of the rehab schedule each day. We don't have many slots because the day time during the week is taken up with rehab and resting most days. If you can find time to go out and see Mike, could you make sure you phone me (Lee) first and we'll arrange when to fit it in. As we've said before, the fatigue thing is so crucial we just have to be really careful about how we manage it. Generally, the evening or weekends will work the best. Mike can only cope with one person at a time and he needs to rest after each visitor, so it needs a bit of organising.

Regards

Lee

A request for help with books

Tracy here, and asking for a favour: We'd like some book recommendations.

Mike has a CD/tape/radio machine. He can operate the CD and radio by remote control, but not the tape deck. So we are looking at borrowing talking CDs for him to listen to when his eyes get too tired for reading.

Wellington Library has the following lists available of books on CD (plus a few others that wind up in the list for some mysterious reason):

• Fiction CDs: http://whekenui.wcl.govt.nz/cgi-bin/cw_cgi?10030+REDIRX+usedatabase_2540_w_fiction%20cd
  
• Non-Fiction CDs:
  http://whekenui.wcl.govt.nz/cgi-bin/cw_cgi?10030+REDIRX+usedatabase_2540_c_CD1
  

We need CDs where:

• the language is reasonably simple (no complex imagery)
  
• the story is upbeat (otherwise he gets depressed)
  
• and is overall something that Mike would like (so romantic fiction is out).
  

We've tried Asimov (a bit depressing apparently) and Dave Barry (a hit), and I recently took out a Bernard Cornwall CD (Sharpe's Honour), but I don't know enough about all the authors available. So, if you have some time, happen to know that one of the books available on CD meets these criteria and you'd recommend it for Mike, could you please say so in the comments?

Cheers

Update
Just a couple of notes. Firstly according to the librarian the non-fiction list starts off with a lot of self-help books and then moves onto other subjects. So if you find the first few screens like being at an American motivational conference, it's not all like that.

Secondly, it might take a while to get your recommendation to Mike. He's happily listening to music CDs at the moment and then there's the issue of when the library next gets the CD in. So, if Mike doesn't provide a review of every single rec by tomorrow, please forgive me. :)

4 May - End of night feeds

Mike had a good day today. The dietician has said that he's gained enough weight that he doesn't need any more night feeds. Mike is very happy about it - the night feeding machine wasn't uncomfortable but it did make annoying beeping sounds all night.

He started some cognitive testing today. Apparently the whole test takes an hour, and Mike tires too easily to do it all at once so he only did the first part of it today. However, he seems to have done reasonably well so far. The therapist kept reminding Mike that it wasn't a pass/fail test, but rather was designed to give them information on where to focus the therapy. However, Mike was doing his focusing breathing between sets and clearly he saw it as pass/fail and fail wasn't going to be it.

We showed Mike the photos of various people visiting him at Auckland Hospital while he was in intensive care. He was very happy to see all the people who had come to see him and a bit sad that he can't remember the visits.

In other news, Mike had some more workouts on the parallel bars. So just keep yesterday's photo in your mind.

May 3rd:More walking

So today we went back to the gym and Mike had another go at walking along between the parallel bars. This time he did three forays of back and forth. On the first trip Mike's feet were like an inebriated duck trying to goose step. A little advice from the physio, a determined gleam in Mike's eye and on his second go the feet were much more under control. Slow but miles better placed. His torso is still really floppy and twisty, but I guess it will join the programme at some stage. By the third go Mike was absolutely exhausted, but on a high.

A good brain injury fatigue metaphor today from the nursing team leader, Deb. She said to Mike that if he did not rest after learning something, the learning would not get written to his hard drive and his injured brain would just delete it. So in between each trip down the parallel bars, Mike had to rest up to manage the next one.

Lee passing over to Tracy now.

Tracy here. Mike managed another PB today - he took off his jersey without any assistance. According to Mike this is the first time he's managed that. This burst of activity may have been caused by some extra caffine. The weather is miserably wet today, so no walk outside. Instead I took Mike for a trip down to the coffee shop in the hospital buildings. A flat white seemed to hit the spot perfectly. Interesting that two months of deprivation haven't altered Mike's caffine addiction one iota.

2nd May:Onward and outward

Another great milestone today. It was a very mild still day (Yes, they do occur in Wellington!), so Mike's physio and I wheeled Mike around the block. At first we went through a nice quiet garden area, but then we continued down busy High Street with the traffic whizzing by. Mike coped really well, so once back inside Sue, the physio took us on a tour of the rehab gym and the hydrotherapy pool. I could see the determined glint in his eye at the sight of all the fitness machinery. Sue must have noticed too because in the gym she got Mike to walk about 5 metres one way, supporting himself on two parallel bars. After a rest he walked back again. So that was his first walk without other people supporting him. Once we were back in his room he was really exhausted but feeling very pleased with his progress.

29th April:Yet another PB

The PBs are coming thick and fast at present, but apparently slow down after a while. With the support of the physio and me, Mike walked from his room to the day room for lunch. He said his feet feel less heavy and more in control. He also managed to conduct an economics education session on opportunity cost, for the physio and speech language therapist, so all is not lost! He managed to walk back again after lunch, but then fell asleep really fast.

I had a chat with the physio about the difference in rehab between brain damage through stroke and through injury. She said a stroke is usually clearly in one part of the brain, so the medics can fairly accurately predict the deficits and what rehab will be required. With Mike's diffuse brain injury, they can't see where the particular severe injury is located, thus they have no idea what the deficits will be and how they will combine. So the rehab has to be very individual and they have to constantly adjust to the deficits they find. She also said that while stroke patients experience fatigue, it is not as severe as in a brain injury it doesn't hit as fast and the worst fatigue disappears relatively quickly. Thus the rehab can be lengthier and more energetic.

There endeth my lesson for the day!

Lee

28 April:A PCB: Personal Coke Best

They installed a Coke dispensing machine in Cavit today, and Mike got to drink the first bottle. Now that is a milestone for Mike, his first Coke since 20 February.

The nurses are pleased, even amazed, by his progress. They are telling him now that they thought he was likely to die when he had the lung infection. I took the chance to ask how much weight he had lost at his worst. A nurse checked the records and declared that his lowest recorded weight was 52 kg. He is now heading in the right direction, being back up to 54 kg. So that is about a 20 percent loss from his pre-accident 'Ironman' weight. I gather that a 20 percent weight loss is not unusual for this injury.

He is feeding himself very well now. Coke is one of the hardest things to manage, for reasons I don't really understand. It looks like they might be able to remove the tube from his stomach in a week or two.

As he improves they are stepping up the rehab programme. A mini target is presumably to get him to be able to take a step or two on his own. The extra physio tires him out, of course. So he needs lots of rest and if he misses out on rest he does not sleep well at night, which sets him back, and they have to cut back on the physio. So there seems to be no end in sight to the need to limit his visitors where possible. Currently available slots are being filled by friends passing through or heading off to do their OE. We are amazed by the number of you who are heading off overseas. So, Wellingtonians, please continue to be patient.

Bryce

26th April: On with the rehab

Today Mike started in on more intensive rehab. First stop was speech language therapy. Mike's right side weakness affects the right side of his face, mouth muscles and even his tongue, so there is a lot of hard basic work to be done to get more clarity of speech. Next stop was physio and the realisation of the difficulty of really basic exercises, such as very light lat pulldowns. One problem is that after about three reps of these really light exercises, Mike is utterly exhausted. However, Mike being Mike, he was thrilled to be exercising again and more challenged than perturbed about the long journey to fitness.

We had a chat about all the resting Mike's having to do, or what Mike calls 'waiting'. One of the nurses is from Chile, so Mike's getting him to teach him some Spanish. I think learning even a little of another language should help forge those new neural pathways he needs. Plus presumably it will cheer him up about everyone else heading overseas.

We're still having to really carefully manage Mike's visitors. Partly it's because of basic eternal tiredness and also to conserve his energy for the rehab work.

Regards

Lee

25th April: Things chugging along well

Our apologies for a gap of a couple of days. It just shows that we are a lot more relaxed about Mike. He's still progressing well. The rehab side has been quiet over the break, but Mike has a series of exercises he is working on. They look so unbelieveably basic when I think about him pre-accident, but they represent unbelieveable progress compared to post-accident. His right side is still a bit shaky but a whole lot better.

The main challenge at present is still the one of managing his fatigue. Mike doesn't generally realise that he is tired, but he's working on it. He really wants to be working more on his walking, but it can only be in very short bursts followed by lengthy rests.

He's busy trying to remember events in February, but most of the month before the acccident is a blank at this stage. We think he will get a lot of it back, but he seems to need to piece the whole time together. If any of you can add some pieces of his 6 weeks prior to the accident, Mike would be really pleased. I thought he'd been to an Ironman camp a few weeks before, but he has no recollection of that particular camp.

Mike's close friends, Kim and Paul, came down from Tauranga for the weekend to see him. He really enjoyed that and it was good for us to see through there eyes how much progress he has made since they last saw him in Auckland. Kim and Paul are soon off overseas and I think Mike feels he might be the last young person left in New Zealand.

Regards

Lee

April 22nd: Mike rejoins the cafe society

A really great milestone today. I got to wheel Mike in his wheelchair down to the Zoom Cafe in the Hutt Hospital and we bought a great coffee. A superb feeling. On the way we met one of the physios from the medical ward who was amazed to see us out and about. It wasn't till later that I realised that the Post Traumatic Amnesia meant that Mike couldn't remember any of the time in the medical ward, or any of the people - physios or otherwise. He had been awake, laughing, semi-communicating etc, but couldn't actually remember any of it.


Now Mike can eat, he is starting to put on weight and is now back up in the 40kg class having added nearly two kilos. Still quite a way to go.

21 April - Cards & more cards

Just realised that no one had put up a post last night.

Mike is still working on memorising all the cards in his room, including the ones we've put up behind his head. He wants us to bring in all the cards he has received - I'm not sure if he realises how many those are. He can now read the messages in the cards himself and he is very good at recognising the postcards sent in daily by Mary and John from Japan.

He's eating pasta for lunch now, a big step towards a civilised diet. We're getting closer to a steak and chips, or what I think is Mike's most important goal: a Coke.

April 20th:Family birthday

Today was TJ's birthday. After quite a lot of figuring out, we held a small birthday celebration around Mike's bedside so he wouldn't feel left out of family events. It was a challenge getting a birthday cake Mike could handle, plus a few birthday people, all without tiring him too much. So the cake was a rather runny panna cotta with candles leaning at alarming angles. The people were Gran and Uncle Jack who got shunted in and out in about 15 minutes, including the time it took to unwrap presents, light candles and sing happy birthday. TJ and I decided it was quite a memorable birthday in its own way.

Today I discovered that one of Mike's efforts at occupying himself involves memorising who has sent each cards that we have displayed on the walls. It's a bit like a remote form of that old kids card game, Memory. I don't think he has taken on board that we're rotating about 150 cards through his wall display!

Lee

19th April:Quiet day

Mike seems in good spirits at present. His friend Kylie visited to say goodbye as she is off to the UK shortly. We keep expecting Mike to find it difficult seeing so many friends heading off on their OEs, but he seems okay about it. I presume sadness at what he has lost and is missing out on will kick in some time, but not yet, it seems.

His main achievement today was to eat a small pottle of yoghurt managing the spoon and the pottle. It was great to have independent eating. You never think what a complicated process that is. Mike needs to really concentrate and can't manage if any distractions occur, even just someone talking. The art of slow eating. The yoghurt took about half an hour. Makes me realise how much we shove food down, usually while yacking away. Mike did a little bit of walking today. Whilst his feet don't work well at all yet, he's getting better control over his torso and head. He has to really concentrate on each element to manage it though.

Regards

Lee

18th April:Where are we at now Mike's out of PTA

Today Mike is officially out of Post Traumatic Amnesia. While this is good news, this PTA stage has taken a long time (over 7 weeks). The length fits the pattern of a serious brain injury and means that Mike is very unlikely to make a 100% recovery. On the other hand, his progress so far has been considerably better expected, so there is a lot of reason to think that he will do far better than the average.

This all means that there is a really long way to go - we don't know how long, or where the journey is leading us. Because Mike has been so fragile, he has not been able to manage any active rehab, but this can start now. Such are his fatigue levels, that rehab will start with 5 minutes in the morning and 5 minutes in the afternoon and initially even that small amount will exhaust him.

Still, onward and upward. Mike had a PBB today - Personal Banana Best. His banana eating speed has increased! Those of you who know Mike's banana eating prowess will be relieved by his progress in this area.

Regards

Lee

17th April: Quiet normality

A quiet weekend, but very satisfying for Mike. Tracy went to visit him this afternoon and there he was on his own (no longer needing someone constantly with him during the day), sitting in bed, CD player on (under his control by a remote), and reading a book. It must feel great for Mike to get a sense of his own space back and some control over what he is doing. I must ask him that tomorrow.

The next major steps I presume will be on the action side. They have stayed away from that waiting for the trachy wound to heal. Apparently any major movement puts the stitches under too much pressure. Mike, meanwhile is eying his speedos!

Regards

Lee

Mike's Fortitude & Resilience

I was reading Michael the lead story on the business page this morning. It was about the issue of a single banking regulator for Australasia. Mike said, out of the blue, and with equanimity: "It doesn't really matter if I don't recover enough to be able to work as an economist again. If that happens, I will find something else to do." Knowing how much Mike has invested in economics, how much he likes it, how much he was enjoying CRA, and how seriously he was exploring (and saving for) the option of a US PhD in economics, I was enormously impressed by his insight, positive approach, fortitude and resilience. What a lesson in confronting a worst fear, and defanging it!

I was so stunned that I forgot to make the joke I had prepared for this contingency. It was "Don't worry if you find you can't think straight as an economist any more Mike, that is an essential requirement for a central planner in government."

So while Mike is working hard at overcoming real immediate problems, like learning how to swallow food again, he is also working out how to get control of his future -- and I don't think he's going to become a central planner!

I also get the impression that Mike has got his head around the issue Lee raised -- of the need to build a generous amount of time for rest into the optimal recovery plan. Now he happily reports on both his latest "PBs" and his degree of rest when asked how he is doing. He is also quick to say that he is tired, when asked.

Kent and Amanda, Mike sends his thanks for your 3rd minidisk. He was listening to your disks again early this morning, well before normal breakfast time.

Bryce

15th April:Still more food

Mike's food range is ever widening. Today he added to his eating range, soft thin toast and honey and later hash browns and tomato sauce (Of course it must be Watties, Uncle Gerald). Mike's grin when he saw the sauce would've been a good advert. The concentration required for these less liquid foods is really challenging and exhausting, but of course the rewards are great. The Speech Language Therapists think in two weeks Mike will be consuming all his food by mouth.

If you want a comparison, do a big swallow of your saliva three times in quick succession. The difficulty of that third swallow is kind of remotely like the concentration Mike needs for every swallow.

On that strange note - Good night!

Lee

14th April:Food, glorious food

More progress on the eating front today. Mike ate mushy weetbix in the morning and scrambled egg in the afternoon. Clearly both tasted like ambrosia but the concentration required is amazing. No surprise to all Mike's SP'TH friends (Speech Language Therapy),but astounding to us uninitiated mortals. After a one-egg scrambled egg, he was exhausted and needed a lengthy sleep.

The challenge for Mike currently is laying off the goal-oriented stuff and just focusing on the resting process. I've decided that our society places a huge emphasis generally on goal setting and persistence and Mike has focused on it much more than the average person would. This brain injury stuff needs the opposite behaviour. At this stage persistence and determination gets in the way of recovery. It's a balance because obviously he's needing to work hard to re-learn these skills. However, if he does slightly too much, the exhaustion really sets him back, he even forgets what he just learnt. For example in one session Mike will seem to have made good progress with learning to walk, in the next session if he's tired his walking will have greatly regressed.

You can see that it's an upside down process for all of us and we're having to learn different ways of helping him through the challenges.

Regards to you all

Lee

13th April:A taste of the real world

A red letter day for Mike. Firstly he finally managed some caffeine intake - in the morning some Cyclops Coffee Yoghurt and in the afternoon 6 sips of flat white coffee (cooled) whilst hovered over by anxious nurses monitoring swallowing. So he's a big step closer to that goal of going to the Zoom cafe in the hospital and having a coffee.

Secondly Mike's boss visited and Mike was clearly really pleased to be in touch with the work team. He had lots of questions about what was happening in the firm. Each day his voice is getting closer to his old voice. I think once the trachy wound is healed over, it will be pretty much his old voice.

One on-going challenge for Mike at present is keeping still, so he can rest as much as possible. All his life Mike has always been either asleep or in full action. He doesn't seem bored, but those legs just keep fidgeting around. Apparently it's part of the brain recovery process to have to build awareness of what those extremities are doing.

So a good day in terms of progress and a good day for Mike's sense of well-being.

Regards

Lee

Addendum
It took two Cavit staff about 15 minutes to make it possible for Mike to have his coffee. I watched closely to see if he would remember to thank them, like the Mike of old. No worries. He gave them his full trademark smile and thanked them handsomely and graciously for the delicious coffee. Mike still seems to be the gentleman we all knew and loved, and the world somehow seems to be a better place.
Bryce

13 April Visitor Update - No Visitors Please Until Further Notice

Michael is still very easily tired. It will be great if his cousins, friends and colleagues can visit when he is feeling stronger.

12th April: One step forward, one backwards

Yesterday we were so pleased that Mike had his trachy out. Onward and upward we thought, but really it's all such a fragile process. Last night Mike was very restless and agitated and the nurses think this was caused by fatigue resulting from the trachy removal. (Four injections in your neck aren't exactly nice!) Today as a result he was very tired and drawn. Mike was very pleased to start on food through his mouth. They started very carefully using pureed food, but this afternoon his temperature went up, so there was a possibility that he was aspirating some of the food risking another chest infection.

So it is just not even progress. However, Mike in good Ironman style is collecting PBs. One was that he talked to us via Tracy's cell phone - it's a sign of modern life for that to seem such a major step forward! The other PB was that he fed himself the pureed fruit. This would seem a tiny step, but the small motor skills involved are difficult. Yesterday he had a go at wiping his face with a flannel and found that required a huge input of energy and co-ordination.

Here's hoping he's settled down by tomorrow.

Lee

12 April Visitor Update - Still no visitors

Michael is tired after physiotherapy this morning, and Cavit advise that it would be best if he had no visitors today other than immediate family.

Mike's 3rd Blog - 11 April

I've had a good day; its great to have the trachy out.

11 April Visiting Notice -- Still no visiting please

Excellent news. Michael had the "trachy" - the breathing tube inserted directly into his windpipe - removed this morning. Assuming he does not have any problems now in keeping his windpipe clear by himself, the next steps will presumably be for him to take food and then drink progressively through his mouth, rather than directly into the stomach through the peg. Mike is getting closer to his goal of coffee and coke. He also has his eye on a steak (further out) at Phillip's new restaurant -- Lonestar.
Still no visitors please, as Michael is still having to take things quietly.

10th April: Continuing peaceful progress

Mike felt he had a good day today. He walked about 4 metres taking all his own weight, just needing the nurses for support. That’s a big improvement from just a couple of days ago.

His voice is getting stronger too and if the trachy comes out tomorrow as planned, he should gradually sound a lot clearer. His right side that was so slow to get going is improving daily. Each day he can do increasing amounts of things for himself. With his improved sleep we’re hoping he’ll be strong enough soon for some more intensive rehabilitation.

The contrast with the over-hyped Mike of a week ago is quite marked. It’s a peaceful life at this stage. We’re visiting him just one person at a time, to simplify things for him and we read to him for long periods. All those cards and messages you sent are getting double value – each day I take in three or four from the pile to read to him. So many arrived while he was unconscious that they’re all new to him. We always talk for a bit about each person and I’m surprised at the detail he remembers about all of you.

When he can receive visitors, take care you’re feeling fit. He’s already persuaded his big sister and his Chilean nurse, Juan, that they should do a half marathon with him. It’s hard to imagine at this stage, but what a superb goal.

Thanks for all your messages, they are sustaining to us as well as Mike.

Lee

9 April - More and more talking

Mike's doing very well with the blocked-off trachie and is talking more and more and more loudly. He still gets tired easily and sleeps a lot - being read to seems to send him to sleep, even when Frodo and the others are trapped in the Barrow by the Barrow-wright, which I thought would have been exciting enough to keep anyone awake. He is a lot more peaceful now that he is getting more sleep.

When I (Tracy) arrived this morning Mike was in his wheelchair, so I took him for a tour around the rehab centre. When I wheeled him into the day-room, another of the clients was there. On seeing Mike, his whole face lit up and though he can't talk, all his attention was focussed on Mike, and Mike gave him a grin and a hand-wave and asked him how he was doing. Also, another of the clients gave Mike his Charlie Brown doll last night, and according to the staff he does not give presents to just anyone. Looks like Mike's friendship skills are still intact.

Mike really enjoys Kent & Amanda's mini-discs, and wants to compete in another Ironman. Which is fair enough, I would be deeply frustrated by doing all that training and getting two weeks from the start line, and then not competing. But right now he's still got to learn to walk.

At least he does have a shorter-term goal, which also shows how much of a JAFA he still is - he wants to go out to a cafe and have a coffee.

9 & 10 April Visiting Notice -- Still no visitors please

Cavit's experts are in the process of cutting back on his reliance on the tracheotomy to keep fluid out of his lungs. If all goes well, it could be removed entirely on Monday. Meanwhile, the expert view seems to be that it is best if Mike continues to rest without visitors.

Sleeping Beauty

Mike is sleeping lots now. When he is awake he is talking lots. His voice is deep and getting clearer, although it is still not easy to follow. He is consistently concerned about others and wanting to get news of how friends and family are faring. Yesterday, he wanted to know everything Ben had told us about his accident. Then he wanted to know if Ben was running the Ironman in 2006. So we 'text' (as our kids say) Ben, who affirmed that he was, perhaps with a deep breath. The nurse then told Mike to think again. She said, not unkindly, that the last bloke who was in Cavit with Mike's degree of injury was there for 18 months. Mike looked a bit shocked. So was I, truth to tell. The nurse added that while Cavit would do everything it could to help Mike recover, Cavit could not effect a recovery, that had to come from Mike. I think that was what Mike wanted to hear. As Ben 'text' back, the 18 months benchmark is one target Mike will be keen to blow away. Mike was sleepier today, and perhaps a bit less lucid with it. For example, he asked that I take care of the hotel bill for now. A nurse put his mind at rest by explaining that this was a hospital. (We did not need to explain that it was not a US hospital, or that he was insured.) It is good to see him more relaxed -- indicating that the nurses were right about his being over-stimulated earlier in the week .
Bryce

8 April Visitor Update -- Still no visitors please

Mike had a good night's sleep, but is still tired

April 7th: Good progress day

The experts seem to be right. Cutting Mike back to a low stimulus existence is improving his sleep patterns and though he is tiring easily, we are really thrilled by his progress. Mike was started on the process towards trachy removal yesterday. The first step is blocking off the trachy for a few hours and closely monitoring his oxygen levels and how he manages his swallowing. He did so well that today they have left the blocked off trachy on all day. It means that he can whisper a bit and by today the whisper was getting reasonably audible. The speech language therapist tested him and found he could make all the necessary sounds for English, including ones very similar such as 'k' and 'b'. It's so wonderful to be whispering away with him. It feels like we're talking to the old Mike, though we're still having to be really careful that he rests a lot. One aspect that makes this easier is that Mike seems to realise for himself how tired he gets and so far doesn't seem to be getting bored. That will come apparently and will be a sign that he is getting better.

At present he is hanging out for a cup of coffee! Of course he has had 'nil by mouth' since 20 Feb, and even when this changes it is a long process and liquid is the last food added because it is so hard to keep out of the windpipe.

Those of you who know Mike will not be surprised to know that his mind is working away on missing the Ironman. He's already had Bryce text Ben Schurr (who was training with Mike when he had the accident) asking if he is planning to do next years' one. He's asking after so many of his friends and his memory for past events connected with you all seems on the whole to be fine.