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
Saturday, April 16, 2005
Friday, April 15, 2005
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
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
Thursday, April 14, 2005
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
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
Wednesday, April 13, 2005
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
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.
Tuesday, April 12, 2005
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
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.
Monday, April 11, 2005
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.
Still no visitors please, as Michael is still having to take things quietly.
Sunday, April 10, 2005
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
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
Saturday, April 09, 2005
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.
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.
Friday, April 08, 2005
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
Bryce
8 April Visitor Update -- Still no visitors please
Mike had a good night's sleep, but is still tired
Thursday, April 07, 2005
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.
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.
Wednesday, April 06, 2005
April 6: Mike's second posting
Thank you for your words of encouragement. Please come and visit when I am well enough.
Mike
PS: The messages are a bit limited, partly because Mike has to either whisper them or spell them out via the alphabet sheet and then we have to work out what he means! As soon as he gets tired, the spelling and whispering become erratic.
Mike
PS: The messages are a bit limited, partly because Mike has to either whisper them or spell them out via the alphabet sheet and then we have to work out what he means! As soon as he gets tired, the spelling and whispering become erratic.
6 April Visiting Notice - No visitors please
This is the first of many notices we expect to post advising of the assessment by Cavit staff of Mike's capacity to take visitors.
As explained in the 6 April family meeting blog, Mike's condition is currently so fragile that it would be best if he has no visitors until his condition materially improves.
Thank you for your restraint. Please post any messages for Mike on the blog, or email them to one of us directly.
Bryce
As explained in the 6 April family meeting blog, Mike's condition is currently so fragile that it would be best if he has no visitors until his condition materially improves.
Thank you for your restraint. Please post any messages for Mike on the blog, or email them to one of us directly.
Bryce
Family Meeting with Cavit staff
We had our first family meeting with the staff at Cavit today.
There was plenty of good news. Given his progress at swallowing and coughing and the encouraging findings from his ENT inspection on Monday, his trachy is likely to be out in a matter of days rather than weeks. Then they would wait to see how he handles that before taking the peg out of his stomach. So that step is weeks away rather than days away (all assuming no setbacks of course). The ENT inspection is also encouraging in respect of his vocal chords, etc, and therefore his ability to speak. But of course his actual ability remains to be revealed. In many other ways his progress (eg listening and understanding) has been"superb".
The bad news is that staff say that his health is very fragile, medically. There is a concern about infection and about his failure to sleep well. Apparently last night was the first night since his readmission to Cavit during which he has slept at all satisfactorily. The staff attribute that in good part to reduced numbers of visitors yesterday, compared to the weekend. They believe that his failure to sleep well is likely due to exhaustion from over-stimulation.
Obviously, making sure that he gets enough rest has to be a high priority right now, at least until he is sleeping better and in a more robust state. The staff think that he needs the (quiet) company of immediate family for reasons of familiarity and reassurance.
After some discussion, we reached the following gameplan in respect of visiting arrangements:
(1) We ask all Mike's friends, cussies and colleagues to (continue to) refrain from visiting Mike until further notice;
(2) Where you need to be an exception -- eg because you are just heading off for your OE and won't be able to visit Mike later -- please call Lee 021 455 326.
(3) Once or twice a day, one of us will call Cavit and ascertain whether Mike is in a condition at that time to take some visitors. If so, we will post a blog telling you this. (Staff say that his condition is so unstable that his capacity for visitors can change almost hourly.)
(4) Please don't visit even then if you might be carrying a bug;
(5) If you do get to visit, please aim to make it between 3pm and 5 pm, and limit it to 10 minutes, and keep it restful.
(6) Make sure in particular that you do not visit between 1 pm and 3 pm. This is when they are trying to keep the area quiet for all patients.
(7) If you do visit, please use the hand-cleaner on the table on the left immediately inside the entrance door.
(8) If all else fails, please call Cavit ABI Rehabilitation directly on 04 570 9284 to check on Mike's ability to take visitors.
We know these are hard restrictions, not just for you but we suspect for Mike as well. However, if it is in Mike's best interests for now, so be it.
Meantime, if you want to send any messages to Mike, please post them on the blog. Lee is doing a daily reading to Mike of your postings. He is keenly interested and it will not surprise you to know that Mike thinks they should all be replied too. However, it seems clear that Mike can't go 'online' until his condition is much more stable.
All in all, we can all be thankful and encouraged by the confirmation of Mike's superb progress, notwithstanding the long, difficult, even hazardous, road ahead.
Mike's Dad
There was plenty of good news. Given his progress at swallowing and coughing and the encouraging findings from his ENT inspection on Monday, his trachy is likely to be out in a matter of days rather than weeks. Then they would wait to see how he handles that before taking the peg out of his stomach. So that step is weeks away rather than days away (all assuming no setbacks of course). The ENT inspection is also encouraging in respect of his vocal chords, etc, and therefore his ability to speak. But of course his actual ability remains to be revealed. In many other ways his progress (eg listening and understanding) has been"superb".
The bad news is that staff say that his health is very fragile, medically. There is a concern about infection and about his failure to sleep well. Apparently last night was the first night since his readmission to Cavit during which he has slept at all satisfactorily. The staff attribute that in good part to reduced numbers of visitors yesterday, compared to the weekend. They believe that his failure to sleep well is likely due to exhaustion from over-stimulation.
Obviously, making sure that he gets enough rest has to be a high priority right now, at least until he is sleeping better and in a more robust state. The staff think that he needs the (quiet) company of immediate family for reasons of familiarity and reassurance.
After some discussion, we reached the following gameplan in respect of visiting arrangements:
(1) We ask all Mike's friends, cussies and colleagues to (continue to) refrain from visiting Mike until further notice;
(2) Where you need to be an exception -- eg because you are just heading off for your OE and won't be able to visit Mike later -- please call Lee 021 455 326.
(3) Once or twice a day, one of us will call Cavit and ascertain whether Mike is in a condition at that time to take some visitors. If so, we will post a blog telling you this. (Staff say that his condition is so unstable that his capacity for visitors can change almost hourly.)
(4) Please don't visit even then if you might be carrying a bug;
(5) If you do get to visit, please aim to make it between 3pm and 5 pm, and limit it to 10 minutes, and keep it restful.
(6) Make sure in particular that you do not visit between 1 pm and 3 pm. This is when they are trying to keep the area quiet for all patients.
(7) If you do visit, please use the hand-cleaner on the table on the left immediately inside the entrance door.
(8) If all else fails, please call Cavit ABI Rehabilitation directly on 04 570 9284 to check on Mike's ability to take visitors.
We know these are hard restrictions, not just for you but we suspect for Mike as well. However, if it is in Mike's best interests for now, so be it.
Meantime, if you want to send any messages to Mike, please post them on the blog. Lee is doing a daily reading to Mike of your postings. He is keenly interested and it will not surprise you to know that Mike thinks they should all be replied too. However, it seems clear that Mike can't go 'online' until his condition is much more stable.
All in all, we can all be thankful and encouraged by the confirmation of Mike's superb progress, notwithstanding the long, difficult, even hazardous, road ahead.
Mike's Dad
Tuesday, April 05, 2005
April 5: Not such a good day
Bit of a difficult day today. Mike was very tired,restless and sleepless. He was supposed to have a whole bunch of tests, but some couldn't be done because he was too tired. In the end, his boring fart mother, me, arrived. Only five minutes being read to by soporific me and off he went to sleep - and that happened twice, not once.
Mike is thrilled by the responses to his blog site. He expected updates from each visitor as they arrived, so thank you everyone. Mikes 31 hits have outdone the rest of us!
Interesting with one lot of tests - checking for Post Trauma Amnesia. The Occupational Therapist asked him how old he was. Now he didn't have a twenty-fifth birthday because of being unconscious, so he said he is twenty four. Fair enough I thought, no cake, no presents, no birthday, one year younger.
Tomorrow is the family conference and our first opportunity to discuss where we are going.
Lee
Mike is thrilled by the responses to his blog site. He expected updates from each visitor as they arrived, so thank you everyone. Mikes 31 hits have outdone the rest of us!
Interesting with one lot of tests - checking for Post Trauma Amnesia. The Occupational Therapist asked him how old he was. Now he didn't have a twenty-fifth birthday because of being unconscious, so he said he is twenty four. Fair enough I thought, no cake, no presents, no birthday, one year younger.
Tomorrow is the family conference and our first opportunity to discuss where we are going.
Lee
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