Day 92 (Nov 22)

Today was a big day.  It was Tobias' sister's birthday and it was the day that his mom flew back to Germany to be there when he arrives.

Katja flew at 2:45 in the afternoon, but we went to the airport first thing in the morning to drop off her luggage.  She wasn't able to check in online since her flight is international and we didn't want to get stressed in the afternoon.  She checked in and turned in her luggage.  The medical transport flight can only take a small carryon for Tobias and we still don't know if I will be allowed on his medical flight so Katja had to take three suitcases for Tobias in addition to her suitcase.  The first extra bag costs $100 and any bag thereafter costs $285.  We explained the reason for the bags and pointed out that Tobias won't be able to use his return flight.  The airline generously comped us for two of Tobias' bags so we only had to pay the $100 extra fee.  I should also mention that the line at the airport was the shortest line I can remember waiting in for an international flight.  In Berlin our check in took over two hours and we almost missed the flight.  Lucky us this time.

After the airport we drove to the hospital so that Katja could see Tobias before she left.  She spent 90 minutes with him and he was in good form.  He was able to communicate several times and even told her that he will miss her.  The injury and his loneliness must be having an impact on him.  It's hard to envision him saying that to her before the injury.  It was a lovely moment, but it makes me think that Tobias is suffering emotionally through his isolation.  He is more aware of his surroundings than he can communicate.

We left the hospital at noon to bring Katja to the airport and everything went smoothly.  I was back at the hospital in less than an hour.  Tobias was at therapy so I swung by to see the case manager.  I caught him at his desk, but he was in the middle of lunch so he promised to come see me when he was finished.  I grabbed some lunch of my own and the case manager dropped by just as I was finishing up.  Luckily the rehab doctor also joined us after a few minutes and we were able to check several things off the "to do" list.  The four things that I wanted to address are 1) settle a return date for Tobias 2) get a request from the rehab doctor to the insurance company to allow me to accompany Tobias 3) get the written reports of the CT scans for the Germany doctors 4) arrange for the rehab doctor to discuss Tobias' situation with the hospital doctors in Germany so that they can reserve a bed for him in the proper area.

1) return date: the doctor confirmed that the neuro team wanted a week's notice so that they can perform a final angiogram on Tobias.  The angiogram is the procedure that maps the flow of blood in Tobias' brain.  It can identify if there is a blockage or areas of weakness that could be risky, especially for a patient about to fly.  We have heard different accounts of the request including one that said that the return date had be to at least a week after the angiogram.  The real request is that the neuro team wanted at least a week's notice before Tobias flew back to Germany so that they have time to perform the angiogram.  The rehab doctor will get in touch with the neuro unit and let them know they can perform the angiogram any time.  Once the angiogram is performed the process of returning Tobias to Germany will begin in earnest.  We agreed that I should hold the passport until the angiogram is completed.  Since this week is Thanksgiving, I don't know what impact that will have on the angiogram scheduling.  At most I think that the angiogram will be done in seven to eight days, but it could be done before Thanksgiving.

2) Travel with Tobias: The rehab doctor agreed that it would be better for Tobias to have me along for the flight.  He'll send the insurance company a letter asking them to allow me to accompany Tobias.

3) CT scan reports: The case manager is going to get the reports for us.  We'll get them to the German doctors.  Job done.

4) Determine the proper ward in the German hospital for Tobias: The case manager will organize a meeting for the German doctor to speak with our rehab doctor.  I need to send the case manager the doctor's contact information.

The bottom line is that we think Tobias will return to Germany within a week or two, but we'll be here for Thanksgiving.  Katja will be in Germany to liaise with the hospital and rehab facility in case we need any boots on the ground to make his transition seamless.

Over the course of the next several days we'll learn more.

Hope over fear.

P.S.  Happy Birthday Emily!  I love you.