Day 75 (Nov 8)

Tobias is still exhausted and couldn't find his words easily today.  His vital signs were good and we think that he just needs a lot of rest.  Given the damage that needs to be repaired in his brain, this makes sense.  Tobias  stared off into the distance many times today and it was difficult to keep his attention in the therapies as well as when Katja and I were working with him.  He seems to have developed a tolerance to the warm towel therapy.  The warm towel was successful in getting him to focus on our faces, but he wasn't often able to form words.  Katja worked with him for 20 minutes asking him the same questions over and over and eventually got Tobias to say the name of his university.  He also said his mom's name on her repeated insistence.  One area where Tobias has improved is vocalizing the words he does say.  In the last two days there were two occasions where Tobias clearly spoke, vocal chords vibrating and all.  Normally his speaking consists only of him moving his lips or mustering an almost indecipherable whisper, but he is more frequently coordinating his speaking to increase the decibels in his voice.  His speech is getting stronger.  But oh so slowly.

Katja tried to feed him in the evening to give him some more practice swallowing, but he was unresponsive.  She had to finally suction out the food that she had wangled passed his inert lips.  She thought he was going to be able to eat better, because earlier he had been coughing and she was able to extract via the suction wand a gooey obstruction the size of my index finger.  He immediately started breathing easier and appeared to be in a better state, but the more comfortable disposition didn't translate to better eating.  It's confusing that he can do something well one day and then it disappears from his arsenal of abilities.  He used to give a pretty convincing thumbs up, but now he can only move his thumb a quarter of what he used to be able to do.  The path to recovery has many ups and downs, however the road is gaining altitude.  But oh so slowly.

Hope over fear.

Addendum:

My apologies to the 12 readers who already read today's post.  I have to add some good news that occurred after I thought the day's events had come to an end.  Katja decided to stay a little longer and write more on her thesis paper so I grabbed a cup and some cranberry juice and decided to give Tobias another go at swallow practice.  I don't remember Tobias being a big fan of cranberry juice and it took three minutes of holding the juice against his lips before he started sipping the first time, but he stuck with it and finished his first 4 oz container (118 ml) of juice.  (November 8th is now Cranberry Juice Day in the Dunn family calendar of holidays)  He flagged for a few minutes in the middle of the marathon cranberry juice-sipping endeavor, but after two minutes of reticence, he rallied his lips and masticators and started nibbling at the juice in the cup again.  He finished strong with quick action.  As soon as the juice spilled against his lips, he swallowed quickly and decisively.  Interestingly, after the last mouthful, he developed the hiccups and it was endearing to see his arms and torso collapse and explode in the minute movements caused by the hiccups.  Rarely do we get to see him coordinating so many body parts together.  I had been asking him the entire session whether he wanted to continue or whether he still needed to clear liquid from his mouth, but he always stared at me or stared ahead in silence.  It looked like he was concentrating to find the right combination of muscle movements to give me an answer, but the solution eluded him.  At the end I asked him if he had the hiccups and with a bit of lucky timing, he attempted to give me an answer just as a hiccup sent a burst of air past his vocal chords.  The result was the loudest and clearest "yep" that we have heard since Day 0.