Day 44 (Oct 8)

 

Tobias has stormed during large portions of the preceding several days, but last night he had a very quiet night.  His heartrate was in the 70s for over an hour.  This morning when we arrived he was back in the 120s and he was storming, but his sweating was mild and his musculature was looser than it has been.  

The therapists has a good early session with him before visiting hours and we participated in a good session in the afternoon.  Tobias was falling asleep so the occupational therapist rubbed his knuckles hard on Tobias' sternum to keep his awake.  Tobias reached over with his left arm and pushed against the therapist's hand.  Tobias reversed his arm slightly and pushed again on the therapist's hand.  This is significant for several reasons.  First, Tobias has never purposefully moved to remove an irritant.  Second, Tobias withdrew the arm slightly before advancing it again, which means that it wasn't reflex driving the arm movement, but Tobias was controlling the movement.  Third, Tobias used his left arm, which should be the weaker arm since the brain injury is on the right side of his brain.  His left arm has more "tone", which is a PT way of saying that his muscles are usually rigid and not flexible, so it was interesting that Tobias used the left arm to remove the irritant.

Afternoon therapy was outside and today was chilly.  Tobias has been very heat sensitive so he must have felt great to have his whole body cooled down.  The PT placed a soccer ball in front of the wheel chair and told Tobias to kick the ball.  I don't know if I've seen Tobias move his leg intentionally since the injury, but he unbent his leg slightly on the command.  It wasn't much, but it is a start and another first.

Katja and I asked to be trained in the use of the "Hoyer", which is the lift used to get Tobias out and back into bed.  We were able to safely move Tobias from the bed to the wheelchair with the OT and both PTs looking on and giving us coaching advice from the peanut gallery.  We left Tobias in the wheelchair after therapy because we figured it would be better for his body to split time between the chair and the bed.  His heartrate slowly increased, but the OT put Tobias in a fully reclined position right before he left and Tobias' heartrate fell into the 80s for the next 30 minutes.  When his heartrate started to increase again, I moved the wheelchair to a slightly-more-upright-but-still-very-reclined position and his heartrate dropped again.  After over an hour, Tobias gave the thumbs up (we think, it wasn't very convincing) to getting back into bed and he was lifted up and over with the nurse at the helm and Katja as first mate.  I was busy doing some work and played spectator.

Plot twist!  Tobias does NOT have pneumonia.  A nurse spoke with Katja out-of-turn last night and we got bad information.  The pneumonia tests were ordered and pneumonia was suspected, but the tests came back negative.  Today the doctor removed the supplemental oxygen feed to his nose and Tobias has done well on room oxygen today.

Today was a good day only because the last two days were rough.  We're like the farmer in Aesop's fable who wanted a bigger house for his wife and was told to bring all the farm animals inside one-by-one.  Once the farm animals were taken back outside after several days, the farmer and his wife felt like their house was much larger.  We’re not ahead of where we were a few days ago, but today felt "much larger".

Hope over fear.