Thursday, June 30, 2011

My Little Darlin, PT day 38 by David

Day #2 at Shepherd.  Ranchos Los Amigos Level IV.  I am told she will move out of this level but not surprisingly can not predict when.  She was kept very busy this morning.  They bathed and dressed her around 4 in the morning.  She was dressed but still in bed when I got here around 7.  She was calm, this was different in a good way from the somewhat agitated state she has been in.  Things move like clockwork around here.  At 7:30 she had her back brace put on and was gotten out of bed and placed in her fitted wheel chair.  I helped.  Shortly after the orthopedist consultant came by.  He gave the okay for weight bearing on her legs and says the neck and back braces can come off this weekend/early next week (6 weeks).  8:30 was breakfast with the speech therapists.   Jan did not care for the eggs or waffles.  She is clearly confused as she usually loves waffles.  She did well with the ham.  When the speech pathologists realized that Jan was not immediately balking at the ham they gave her a goal of five bites which with coaxing she accomplished.  It is like trying to get a 2 year old to focus.  The occupational therapists had her from 9 till 10.  They tried to get Jan to do simple things like comb her hair without much success.  They did put her in a special chair that stood her with support for several minutes.  This was tolerated fairly well.  She did get hypotensive but try lying on your back for more than 5 weeks and it will happen to us all.  This was followed with evaluation by the neuropsychologist and after that more by the speech pathologist until 11.  They gave her some more stimulation one of which was to separate playing cards into red or black piles.  When she finally focused on the task she zipped right through.  She very boisterously voiced her displeasure at what was being asked of her all morning.  She was allowed to sleep until 12.   This afternoon I sat with her trying to get her to eat real food.  We spent about one and onehalf hours on this while in the main therapy room with her in a wheel chair.  Everything I could get her to put in her mouth caused her to make a very bad face saying how bad it tastes with a few expletives.  I would continue to coax her and eventually got her to eat all of her fruit.  It was actually a very good time and started when she spontaneously said "it is only wafer thin" and smiled.  For those of you that are Monte Python fans you will understand the humor in this.  This kind of clear and humorous banter went on for a good 30 minutes with different things she and I like to pick on each other about.  She even laughed about her being dain bramaged, a line that we got from an old comedians skit.  After this she spent an hour standing with help.  She DID NOT LIKE THIS and very expressly let everyone in the room know it.  We just put her back in the bed a short time ago where she promptly fell asleep.

This next part is extremely important for everyone who is a registered voter in Mississippi and cares about what happened to Jan to read and act on.  As i previously wrote the amendment to the three foot law is going to be introduced by  Representative Margaret Ellis-Rogers.  In order for this to have a chance at making it through we ALL must call, send an email or letter to our Senator and Representative urging them to support, coauthor or if anyone knows a State Senator that would author the amendment to the senate then please ask them to do so.   This would get it introduced in both the house and senate.   The note should not be a form letter.   It does not have to be fancy.  The note should include your name and address so that they know you are in their district and your phone number.  You should also ask for them to give you a response to the effect of" I look forward to hearing back from you on this request".  This lets them know it is something important to you and you are willing to talk about it.   !!!!!!!!!!PLEASE DO THIS !!!!!!!!!

If anyone that has better computer skills than I have (and that is likely everyone) can find a link to make it easy for anyone to find not only who their State Senator and Representative is but also their contact info, please post it.

Thank you all for your concern,  I saw my Little Darlin laugh today (TIGT)




Wednesday, June 29, 2011

My Little Darlin, PT day 37 by David

We have been at the Shepherd Center in Atlanta for about 24 hours.  My little darlin is a Ranchos Los Amigos Level IV.  Google Ranchos Los Amigos and you will understand what I have been seeing in Jan for the past few days.  She is confused and does get agitated but she does call me by name if she so desires.  You can not take anything she says personally.   She will have moments of clarity but they are short lived.  She did get to drink milk today and the first thing out of her mouth after was "that sucks".  She has started eating some food but it is not a priority for her and she still needs the tube feeding to receive adequate nutrition.  She has worked with physical therapists, speech therapists and occupational therapists throughout today.  About 3 hours of therapy evaluation have worn her out.  It will only get harder for her and TIGT.  They have had her sitting up on the side of the bed and or in a wheel chair for a large part of the day.  She can not hold her self up.  I am not certain if it is because of her brain injury or weakness from being down for so long or both.   I suspect both.  She has frequently and loudly expressed her displeasure about todays activities.  Sean and I watched through the day as the therapists did what they do.  This will change after a couple of days and we (I) will not be involved for a while.  There will be education however given to me regarding her care and injury.   She did tell me once today she did not want to do another Ironman Triathlon.  I do not know if that was a moment of clarity or confusion.  I guess it depends on your point of view.   The staff here are excellent and all seem to enjoy what they are doing and care for their patients.   I am very happy she is now where she is.  I do not know how long it is going to take and do not think anyone does but I do think she is in the right place to give her the best odds for recovery.

This evening she was brought a tray of food.  It was ground beef with gravy, mushrooms and spinach. She took one bite of the meat and would take no more.  She would not try the mushrooms or spinach (adamantly refused actually).  She would not eat her brownie either, now I really know she has a ways to go.  Remember the Ding Dong diet.  When I left her she was lying on her side and appeared as comfortable as I have seen in over a month.  She had fallen asleep so she was not rambling on in a confused manner as she has been doing.  It was nice to leave her like that.  Maybe that vision will allow me to get some peaceful sleep tonight.

The things that come out of Jan's mouth can make you smile and or laugh but It is truly sad seeing My Little Darlin like this because of a senseless act (two actually).   Seeing her the way she is now can be almost as hard as those first several days when this nightmare started and I was not sure if she was going to survive.  I keep hearing stories of people with similar traumatic histories and good outcomes.  It is a whole different story when you are living it and there is still that lingering uncertainty.  This is a hell of a lot harder than any ironman triathlon, medical school, board exams, etc and I would not wish this on anyone, not even the person that did this to Jan.  I hope that person learned something from this and is passing that lesson on.  Thank everyone for reading and caring about my Little Darlin.  Do not let what happened to Jan be in vain.

Please do not forget why she is here.  Do what you can to educate others about sharing the road.  Support Bike Walk Mississippi it is our organized advocacy group.  if you are not from Mississippi then support your local advocacy group.  There is power in numbers.   Put your cell phone away while you drive.  Even if it is hands free you can be totally distracted.   It takes only an instant to maim or kill someone and you do not want to live with that.  Hopefully the victim can live with it.  Jan and I are not yet sure how our life is going to be.  Get off the couch,  get out there on the road yourself.  Your health will benefit,  more people on the road make more people aware and you will be an example of healthy living that will influence others including your own family.


I love My Little Darlin, It is sad seeing her like this but we are in a good place where good things happen

Tuesday, June 28, 2011

Jan Update 6-28

Hello Friends! David ask that I post that they made it to the Shepherd Center yesterday and TIGT! He will not be able to post anything until wireless available!! Hopefully, he will get connected ASAP and keep us all up to date on Jan's progress!!

Monday, June 27, 2011

My Little Darlin, PT day 36, by David

My step mother Linda stayed with Jan last night and my stepson Derek stayed with her the night before to allow me to catch up on some needed sleep.  Each morning I came in after being away over night I would walk in with the hopeful anticipation that she had had an amazing over night acceleration in her neurological condition and would be sitting up on bed with a big smile on her face carrying on a normal conversation.  It did not happen.  Last night she slept very little, maybe 15 minutes at a time although she had several 30 to 60 min naps during the day yesterday.  She has periods of clarity particularly once yesterday when Parisa asked her how well I could dance and she answers "pitiful".  She was dead on with that response.  I must  admit it is very difficult psychologically for me most of the time to see her like this.  I do a pretty good job of keeping my emotions in check.  I do not show her any negative emotion.  She continues to ramble but one thing for certain she wants some milk.  That has been her primary focus the past two days.  Kevin has also been a focus.  He, Parisa and David spent some time with us yesterday.  She did tell Kevin he was her hero.  She will occasionally focus and respond appropriately naming people and reading things such as tag lines on t shirts.   Again the fear is that how she is now will not improve but I have been reassured by a friend of mine who has quite a bit of professional experience with similar patients that where she is now is not unexpected and may be ahead of the curve.  From day one I have had the fear she would not improve but she has.  I am usually a very patient person but it is hard when it comes to My Little Solemate.

We are on our way to the Shepherd center this morning.  I have high expectations and have heard nothing but good things about them.  I just want my Jan back and I want her back now.

Please do not forget why Jan is in here.  I perceive there is momentum that is producing changes for the good.  I would not want this to have been done to her in vain.

I will continue my posts on Jan's hopefully rapid rehabilitation at the Shepherd Center starting tomorrow.  It will be an education for me as well.

Thank you for reading, thank you for not letting this be in vain.


I Love My Little Darlin , I miss doing stuff (or nothing) with her

My Little Darlin, PT day 35, by David

It has been 5 weeks.
Not a whole lot of change this morning.  She continues to talk a lot most of it being nonsensical rambling.  Her voice and words are clear.  She will focus on any individual when addressed directly.  She may or may (usually will not) not give an appropriate response.  She does pick up on things that would surprise you.  Such as yesterday afternoon the television was on the movie playing was Paul Blart Mall Cop (I think this was the title).  I had not noticed it but she kept repeating the title.  I walked in and she read the name on my shirt without being prompted.  She spontaneously brings up subjects from out of nowhere such as dogs we have had,  mentioned one of my old partners from when I was in Jackson and frequently asks for  milk.   She is being given ice chips only for now.  As soon as her diet is advanced further I will definitely get her some milk.  This morning she is constantly chattering in a somewhat agitated way for unknowns reasons.  She did fall asleep after being given a bath.  There are times when I see her doing and saying some of the things she does that make me smile because they come out cute and funny but the longer it goes on the more disheartened I get.  I know she will get better and still believe she can come back as my former Little Darlin but it is still very hard to see her like this.  Do not get me wrong, this is so much better than she was five weeks ago and even one week ago.  I keep having to remind my self be patient.  There will be improvement just it will be slow.  Physical therapy has had her sitting on the side of the bed for short periods.  She "does not like it".  Her right arm and both legs are very active, not much left arm movement.  Still hoping that will improve.  The only tubular device that she still has penetrating her skin is her PEG tube and is still being fed through this.  Do not want to advance giving her food by mouth too fast for risk of aspiration which would be a major setback.  I suspect though she is not far from normal eating.

With prompting Mr Allgood is looking further into the details of what happened with the crash.  I have talked to a very close friend of mine who tells me Mr Allgood takes very seriously what he does and truly wants to do the right thing.  He is bound by Mississippi law.   I trust what my friend tells me as much as I trust my own brother.  I will be patient and await his reevaluation of the situation.

After Jan's health and well being the next most important things which I will continue to harp on are for all who follow this to never forget what, why, and how this happened so that we can all do what we can to limit this from happening to any one else.  Not only should this not happen to someone as a victim but for most normal people doing this to someone would be psychologically devastating.  Continue to practice and preaching  "Share the road" giving anyone exposed plenty of room.  It should never have to be about the law, it is a life.  It is someone's wife, husband, son, daughter, mother, father or friend.  If they are on the road biking, running or walking it may be their only means of transportation.  They are more likely doing something to improve their health or simply are eco conscious.  No matter if they are out there it is a good thing and they should not have to do it with fear of harm.   I realize that those who do not participate in this type of activity do not notice those who do so much.  If more people got off the couch and became more physically active it would domino.  If you participate in one of these activities your health will improve and you will become more aware of others doing the same while you drive.  Also the more people out there doing it the more aware others are and it may even motivate even more to do it.  Who knows it may even someday become the norm instead of an oddity.  The other way to decrease the risk of this from happening is to decrease the distractions while driving.  Primary problem in my opinion is the !%@$# cell phone.  Next time you are out driving notice how many people have their phone up to their ear.  Pay attention to how many of these people would have put you in harms way had you not been paying attention.  This can not be policed entirely but if law enforcement can ticket for not wearing a seat belt why not this.  Wearing a seat belt only protects those who wear it.  Talking on a cell puts an innocent bystander at risk.  I believe you should be able to do to yourself what you want, survival of the fittest / smartest is a good thing.  No one has the right to put an innocent at risk.  Cell phone use while driving should be banned all together.  I seriously doubt that will happen suspecting the way the majority think (until something like what happened to Jan happens to someone close to them, do not think it will not happen to you because it will) in Mississippi any time soon.  I have had several suggest hands free may be ok.  This still increases the risk.  If it is not a totally hands free system with voice activation then you are still looking at that phone and you are still at significant risk of harming someone.  There is still increase risk even with total voice activation.  In any event I feel the proposed amendment to the 3 foot law making it a felony if killing or seriously injuring someone is a very good start.  Would be good to add to that felony charges if doing it while on a cell phone.

Thank you all for your concern of My Little Darlin.  We are on our way to Atlanta in the morning.


I Love My Little Darlin, we still have a lot of stuff to do

Saturday, June 25, 2011

My Little Darlin, PT day 34, by David

Jan continues to talk a lot and sleep very little.  Most of what she says is nonsensical.  She will give a response to questions, sometimes appropriately and other times not.  Most of the time not or with a simple I don't want to or I don't know.  Many times she will respond with one of these last two even though I am certain she could give a correct response.  She can recall some past events but they are not necessarily accurate.  Her thought pattern has not changed significantly since yesterday.  She is becoming more active physically moving her lower extremities quite a bit now to the point of hanging them off the side of the bed.  We definitely have to keep the bed rails up as she could be unpredictable.  I have clearly seen some increased movement of her left arm.  Hopefully this will continue to increase.  Her tracheostomy was completely removed yesterday.  She still has her PEG tube and continues to receive her nutrition through this.  We have started giving her some ice chips by mouth which she eats easily.  There is no indication of swallowing difficulty.  Hopefully she will get to start eating normally soon.  The PEG must stay in for at least 6 weeks before it can be safely taken out.  Bottom line her body is doing a nice job of healing itself.  By all indications her neurological injuries are coming along as would be expected,  slow improvement but improvement none the less.

We will be headed to Shepherd center in Atlanta early Monday morning.  I have heard nothing but very good things about it and am excited to be getting My Little Darlin over there.

The DA agreed to listen to an interview taped by my attorney with one of the witnesses that we feel contradicts points that he would not bring felony charges against the person that did this to Jan.  It took him a month without keeping us informed as to what was going on in the investigation initially.  We will see if and or when he will give a response to this information.  He has the tape now.  Several attorneys have suggested that this should at least go to a grand jury to decide.

Do not forget what happen in the first place and we need to continue to be advocates to decrease tragedies like what happened to my Little Darlin Jan.  Bottom line this is truly much more important than what DA Allgood and the person that did this to Jan are doing. Please everyone join and support BIKE WALK MISSISSIPPI.  They are our focused, organized advocacy group.   The more active member they have the stronger voice they and any individual has.

To be a bit philosophical as an individual we can all do the right thing by simply (as former presidential candidate Mike Huckabee says) self govern.  If each individual were to always self govern and do the right thing none of the preventable tragedies would occur.  This applies to sharing the road.  Preach to everyone you know that is a life biking, walking, running, working, etc and if you make any contact with them in your 2000 pound plus vehicle their life will end or be severely altered for the worse and yours will be severely altered (well it should be, if not criminally or civilly then at least psychologically).

Preach to everyone you know and self govern yourself about cell phone use while driving.  I will say again, a cell phone is a luxury and not a right.  Using it in a car will get you killed or even worse get someone completely innocent maimed or killed.  If you do this to yourself then you have been warned.  If you do it to someone else then you should go to prison for a long time or at least have nightmares about what you did for the rest of your life.  If you still use a cell phone and drive you are self centered idiot and have no concern for anothers life.  I am not without fault in my past cell phone use while driving but will no more.  Not even hands free.

Get off the couch.  This state and nation to put it bluntly are becoming a people that look like bloated ticks.  As a child I can remember one person that was morbidly obese.  Now if you look anywhere there appear to be more people approaching if not truly morbidly obese than healthy appearing individuals.  I recently heard the statement "all americans diet and all americans are fat".   It is not just the obesity, it is the the array of diseases that go with it that people seem to think is normal.  The cardiac disease, hypertension, diabetes, hypercholesterolemia and other inflammatory diseases that keep this state and nation very unhealthy.  Get out and do something for your self.  Participate and help make people on the road doing a healthy activity the normal rather than the exception and this will be a domino effect by making more and more people aware.  Plus you will be healthier.  This is not rocket surgery.

Thank you all for listening.  Thank you all for being concerned for My Little Darlin.  She has a long way to go but she is going.


I love My Little Darlin more than anything, she is my soulmate.

Friday, June 24, 2011

My Little Darlin, PT day 33, by David

Jan is speaking clearly, loudly and a lot.  I am so happy that she is communicating but it is actually extremely stressful now not only for me but for her.  She is speaking and is clearly understood.  Some of what she says is spontaneous and appropriate.  For instance two of her grand daughters came to see her last night.  One of them leaned over and gave her a hug.  Jan responded with "I love you Arianna" in a clear voice.  Most of what she says is difficult to interpret.  She repeats a few words or phrases over and over.   She seems to be agitated most of the time.  Some of the words and phrases she repeats is "I can't do this", "no", "I don't really like it", "ow".  If I ask her who I am or other simple questions she will occasionally give me the appropriate response but more often will say "I don't know" or "I don't want to".  When I talk to her eye to eye she seems to concentrate and I suspect she fully understands but can not express herself.  When she is awake (and she sleeps very little) she  loudly and continuously repeats herself and is constantly moving her right arm all in an agitated way.  I am suspicious this stems from extreme frustration with understanding her situation and lack of sleep.  I have to say this is physically much more difficult for me now because I am getting very little sleep and it is very difficult mentally for me seeing her like this especially sensing how frustrated she is.  The pain intensifies when I think of the possibility she will not improve from here.  I have to keep telling myself be patient she will improve as she has been,  slowly.

The only invasive device she has left is her tracheostomy but it is capped off and a small IV  in her right arm.  The tracheostomy will be removed in the near future.  The only question on when we go to Shepherd center is whether the orthopedist can give her full weight bearing clearance on her lower extremities.  We want her to be allowed this before she goes to get the full benefit at Shepherd that insurance allows and room availability which is a day to day thing.

The more I think about it the more I think DA Forrest Allgood is wrong about the second act that was heinously done to my wife "driver of V1 exited the vehicle while talking on the phone and observed the victim.  D1 then reentered her vehicle and ran the cyclist over again before being forced from her vehicle by witnesses."  I suspect his ego would not let him change what he has decided but I do not know the man.  I have spoken with him by phone (I will say I was never given the courtesy of a call, I had to call him after his decision)  as has my stepson. He tended to speak in a condescending way to both of us although we are both highly educated.  I think a jury should have decided this womans guilt or innocence but he is not allowing that.  He did tell me as a voter I am in charge.  He was referring to the laws of the state and the state government officials, but he is also an elected official and up for reelection this year.  If the woman who did this to Jan will not be made accountable for her actions by Mr Allgood then perhaps we can make him accountable for his.  We can decide.

I talked yesterday about organization and focusing our energy.  I simply can not do it.  I keep getting tons of legal advice and input.  I only have time for My Little Darlin and am running on fumes as it is.  I should have thought of this before but BIKE WALK MISSISSIPPI is already in place as our advocacy group.  Please everyone go to their website, join and actively participate.  BWM has the organization and know how to get the things done effectively and to channel all of our efforts but they need all of our help.  Every who has said they want to help this is how!


I Love My Little Darlin,  this still hurts awful bad and this is hard

Thursday, June 23, 2011

My Little Darlin, PT day 32 by David

Yesterday Jan's tracheostomy tube was downsized.   This allowed her to breath around it and she began saying  subtly the word no.  She said it a lot.  Her trachea later on was completely capped and she started breathing through her airway normally.  She increased her vocabulary throughout the day and was responding mostly appropriately.   She developed the use of several phrases throughout the day that she used repeatedly.  One of her favorites is "I don't like it".   She also has said a time or two "I am pissed off".  She will answer some questions appropriately but mostly she simply responds with no.  She did call me D Mo which is a nick name commonly used outside of the hospital.  She makes me smile a lot for the first time in a month.  Mostly because she is clearly improving but also she is really cute and entertaining to talk to the way she is now, kind of like what I think a child smoking pot would be like.  She has not slept much (and I have not either) since she has been out of the CCU.  The best way I have found to get her to sleep is to mentally stimulate her.  I can do this by showing her photos and asking her to tell me who she sees.   When doing this she mostly tells me "I don't like it".  She continues to increase use of her R arm but it is still gross somewhat spastic movement.  There is some improvement in her fine hand movement as well.  I think I see some increased movement in her L arm and hand.  Her legs are also becoming more and more active.  Physical therapy put her back brace on yesterday and briefly sat her up on the side of the bed.  She did become orthostatic (her blood pressure dropped) but this is not unexpected given that she has been in the bed for so long.  Will increase slowly her time up and activity.  I also expect since she is doing so well with her tracheostomy capped that this will be removed in the near future.  Over all I give her a great big  !!!!!!!! T I V G T !!!!!!!!.

As every knows by now our very wise justice system has again failed those it is supposed to protect.  This is Mississippi, this is what we have learned to expect.  Several have posted with question as to why Mississippi code 63-3-401 which gives 5-20 years does not apply.  I was given legalese talk by the DA.  I would appreciate it if someone could explain it in laymen terms to me.  I only understand right and wrong and reading this code to me says if you get back in your car and rerun over someone then you have failed to stop and did not comply with the requirement of the code no matter your excuse.  I was told the excuse was panic and trying to move the car off the road so there is no violation.  I am a simple MD, please someone who understands the law explain this to me for my peace of mind.

In any case the law must be amended.  There is an amendment to the three foot law being drafted to be introduced by Representative Margaret Ellis-Rogers of New Albany.

!!!!!!!!!!!! The most important thing every one must do now is flood/call their  own representative and tell them to support this bill !!!!!!!!!!!!!!

Tell them what happened to My Little Darlin Jan.

The other thing that must be addressed is cell phone use in automobile.  I am almost certain what was done to Jan was because this woman was on her cell phone.  The investigators could not pull these records because it is not against the law.  IT SHOULD BE CRIMINAL PUNISHMENT JUST LIKE DRUNK DRIVING if you do what was done to Jan or worse if on a cell phone.  The above amendment should take care of the criminal punishment for this but people will still be using that !%@#$ cell phone while driving and maiming or killing people.  There should be a stiff fine if caught using a cell while driving.

I need help with all of this.  I am having a very difficult trying to take care of Jan, myself and get any sleep.  Jan is my priority.  I will continue this post but my time is much more limited now that Jan is out of the CCU and we are about to head to Atlanta for rehab.  This page has generated cohesiveness but as a like minded group a central point of organization needs to be designated so that the momentum is not lost.  I suggest a start would be all of the cycling and running club leaders of the state to communicate and make some leadership organization.  Please do not let this momentum drop.  I need your help to prevent this. Thank you Robert  Garrett for getting on top of the amendment change.


I love My Little Darlin, I am so happy to still have her with me

Wednesday, June 22, 2011

No Protection by Mississippi Law by David


My Little Darlin, PT day 31 by David

Jan remains aphasic.  She will not speak.  She hears because she will open her eyes and look at me when I speak to her.  I can not tell what is going on in her mind.  There is active movement of her right arm and hand.  She will put her hand on her face and rub it ,  she will also put her hand to her side and try to scratch the top on the sheet with purpose.   These are tiny improvements. I ask her repeatedly to reach up and touch my hand with hers in addition to other smaller tasks but she still will not follow commands.  She does squeeze my hand in response to me squeezing hers.  There is minimal movement of the left upper extremity.  She goes squeeze her thumb slightly.  She will not give any facial expression other than what I perceive as frustration and or depression.  I know her recovery is going to be slow but seeing My Little Darlin like this is hard.  Do not know if these emotional expressions of hers are real but she has a right for them to be.  The fever she was having seems to have abated.  She is breathing very well on the t-tube and will start working towards getting rid of her tracheostomy.

She had a back brace brought in yesterday.  They say they will put it on her today.  Why did they not put it on and sit her up yesterday?  Simple lack of actions like this make me feel like we are wasting time where we are now (step down unit) and that she needs to be at a rehab center asap.  On the other side (as a physician) you are so busy you do not get the sense of how slow it seems things move on this side.  More learning experience for me and more patience needed.  The representative for Shepherd is out of town and yesterday I was told she would not be here until Friday.  My anxiety rises everyday she sits in this room without aggressive therapy.  Late yesterday I sent emails  to Shepherd and to TIRR in Houston.  The representative for Shepherd called me last night and will be here Thursday.  She has begun the process.  Hopefully we can be moved by Friday.  Can not go soon enough for me.  In the meantime I talk to Jan a lot, I read to her, I show her photos mostly of her granddaughters but also several others.  She does look at these.  I can not tell if she recognizes.  I kiss her and tell her I love her a lot.

I still have not heard back from the Mississippi Highway Patrol or the District Attorney?   I am not an attorney but in my simple mind this is a no brainer of right and wrong.  What do I know I have been in a hospital with my wife for the past month and will not be getting out of one any time soon.  I have been very patient with this, a simple phone call from someone who knows as to the explanation of why this investigation is taking so long would be nice.  Perhaps this was not as serious of an incident as I thought it was?  Yes you do detect a bit of sarcasm and frustration!  I have a lot of frustration on several points all secondary to what was done to My Little Darlin and we do not have the luxury to ignore these.

And now my repetitive daily sermon.  There are positive changes happening and others that still need to happen.  There seems to be more awareness at least locally.  A friend of mine told me she rode her bike with trepidation the other day on MS50, the same road Jan was hit on.  She said every motorist was very courteous.  They all would wait until oncoming traffic cleared then moved entirely into the other lane to pass (TIGT).  Share the road signs are going up.  Continue to spread the SHARE THE ROAD MESSAGE.  One surprising outcome that pleases me very much,  I have been told the love I have expressed for my solemate Jan has made others think.  None of us know if we are going to be here tomorrow.  Appreciate every moment you have today with those you love.  What happened to Jan or something similarly tragic could happen to you or them without warning.   I have had many let me know they no longer use the cell phone while driving (TIVGT).  Cell phone use while driving is deadly.  It is equivalent to drunk driving or worse.  There is nothing that can be communicated on that phone while driving that is worth harming or killing someone or being harmed or killed.  If you are a normal person it will ruin both lives.  Cell phone use while driving should be outlawed. NO BRAINER.  It is in my opinion and needs to be law, it there should be criminal charges if you harm someone  driving while using a cell phone.  You should go to jail for a long time for this!  I have been getting many posts about people getting off the couch (TIGT).  The more of us that are active the more visible we are.  Also the more of us that are active encourages even more to do the same.  The long term health benefits are phenomenal.  Jan and I are in our 50's and can(could) and do(did) play with people in their 20's.  Most our age have a hard time getting off the couch.   With some effort that can change.   I could only dream of a healthy society that did not need me as a physician but only as a bicycle mechanic (TIGT).

Thank you for reading these posts, I do read all of your comments


I love My Little Darlin,  I hurt every moment for what she is having to go through

My Little Darlin, PT day 30, by David

Jan was moved out of the CCU yesterday into a step down unit.  I have not left her side since.  She has increasing activity of her right arm.  It seems to be a mostly uncontrolled flinging motion.   She does get her hand to her face and performs an intentional rubbing motion.  This has developed since yesterday and it is an improvement.  When I hold her hand she will squeeze mine if I squeeze hers.  She will not squeeze it on voice command.  She does hear because she opens her eyes and turns to me when I speak.  I read to her and she seems to listen.  She will follow me with her gaze.  She will give a gentle spontaneous squeeze of her L hand.  Since the left arm is clearly lagging behind the other extremities there is concern for a brachial plexus injury (injury of the nerves to the arm after they have exited from the spine).  She clearly moves both legs.  She still does not express any emotions with eye contact.

There is a chair in her room that elongates to allow me to stretch out at night.  I stayed the night and will leave only if someone I know stays in my place.  I can not let myself leave for long.  This will be more difficult on me than when she was in intensive care.  At least in the CCU she was under very the very close watchful eye of a nurse who had only one or two patients to tend.  On this step down unit the nurse to patient ratio is much less.  In her neurological and physical state and in my psychological state I will not leave her alone.  Last night I do not think she slept at all.  She easily could have her day night pattern confused as she is resting while I type this at 6 am.  Anyway a hospital is no place to get rest.  She must be turned every two hours.  Compulsive me was doing that about every hour when we first moved in but I was likely agitating her.  Through the night the nursing staff came in to do this like clockwork.  I know because I had my two hour timer going on my watch.  They were a little late the first time and I had done it just before they came in.  She also coughs periodically through the night.  You can hear mucous build up that she tries to cough out through her tracheostomy.  I can not let her sit there breathing with the sound of this, I fear it is impeding her breathing so I suction her out regularly.  She is on 30% oxygen.  The delivery hose fills up with condensation on a regular basis and I emptied this many times.  The respiratory therapist came in several times during the night to give her aerosolized treatments.  She would also suction her as would the nurse when turning her.  She has several monitors on her.  The results are displayed at the nursing station and in the room.  These are set to alarm with minimal unusual changes most of which are nothing.  These alarms however go off through the night.   All of these disturbances and the flinging I mentioned of Jan's arm (this only happens when she is awake) kept her awake all night.  I also had very little sleep.  There was one point last last night when she appeared so uncomfortable, agitated and likely confused about what had happened to her, this with the helplessness I felt put me in tears.  It does hurt seeing her like this but I have been told many stories of good outcomes with similar trauma.  Baby steps.

Most of the night she seemed agitated.  I could put my hand on the back of her head or back and she would be sweating.  The room to me was very cool.  I had a blanket and my hoodie on and was still cold.  I think her agitation was from being hot and she only had a sheet covering her.  From what I have read her sleep is just as important as her stimulation in rehab.  Sleep here will be extremely poor.  I hope we can get to the rehab center very soon.  An excellent job was done at NMMC to get her to this point but now I feel like time is wasting in this step down unit.  She needs active aggressive rehab now.

We will be aggressively pursuing transfer to the Shepherd Rehab center asap.

I called the MHP accident reconstructionist yesterday.  He was to speak with the District Attorney yesterday afternoon.  I have not heard back from either.  I wonder how the person that did this to Jan slept last night or for the past month.  I suspect she was in her own bed.  She may have slept well thinking she was able to do to Jan what she did without consequences.   Jan did not sleep well in the hospital bed she is still in this morning.  She can not get out of it.   She has been in a hospital bed for the past month.  Most of this time was she was fighting to stay alive,  now she has to try and live.   I do not know when she will be able to sleep in her own bed again or if she will ever have another good night sleep.  I do not know if we will ever be enjoy life the way we used to.  What is wrong with this picture?


I Love My Little Darlin and I hurt for her every day

Monday, June 20, 2011

Quick apology, by john

Hey all, I apologize for not getting days 27-29 out late. I was out of town and had less access to internet than I expected.   I know all of you are faithfully reading this blog, keeping up with Jan's progress.  I'll make sure I have a backup plan in the future.


My Little Darlin, PT day 29, by David

I have always been a fairly patient person and have understood the concept of delayed gratification since I was a child.  These concepts and or traits have benefited me very well over the years.  I am battling both now but have no choice other than to continue to live by both.  This has to do with My Little Darlins current status.  She is far better off than she was just over four weeks ago.  When this first happened and for several days early on I was not sure if she was going to survive.  There have been several fires that developed and were successfully put out to get her where she is today.  The lungs and broken bones are healing.  She is completely independent off the ventilator.  I do not think she will need any kind of invasive intervention on any of her fractures.  The only possibilities would be Kyphoplasty (injection of glue into the vertebral fracture) and at a later date surgery on her L hand.  The vertebral fracture will likely do fine with only a back brace and time.  The finger only if it bothers her down the road.  Her neurological status weighs very heavily on me.  This morning she will maintain eye contact for extended periods of time.  Can not tell if or what she understands.  She will not follow a voice command.  I tried to give her a written command.  She would look at the print but would not give any indication of understanding.  She has numerous facial expressions that are typical of Jan.  The best I can read these suggest concentration.  The brain is too complex for my simple mind but I would venture she is having complex thoughts that she can not express.  I showed her numerous photos including us, grandchildren, children, friends and our dogs.  She would look at them but would not give any expression of understanding or emotion.  Her body movements include the R arm which may be slightly more than it was yesterday.  Moves both legs right more than left.  Still no movement of her L arm but I have felt some muscle contraction.  I have talked to numerous people either directly or by text who have either experienced or had family members with similar injuries and good outcomes.  I am well aware that I will not hear of the ones with bad outcomes but that is ok, I only want to hear about the good ones.  I do not like this but Jan and I have to deal with it.  I realize that there is no choice but to be patient and be encouraged by the small changes.  These can be hard for me to see since I see her hour by hour.  I  worry quite a bit about what is going on inside Jan's head and how frustrated, confused and perhaps angry she must be.   

She is doing well enough that I suspect she will be moved out of critical care and into a step down unit soon if not today.  I will be able to stay with her there.  I would also expect her to be moved to a rehab center in the very near future.

I am getting frustrated with the length of the investigation and no answers.  Hopefully soon.

I am going to repeat over and over to everyone that will listen or read, there are things that need to be done or changed to limit things like what happened to Jan.  

Continue to preach awareness for those that use the road for activity other than driving an auto.  A bicycle is a legal vehicle on public roads.  More importantly it should not be about a law but consideration and respect for another human beings life.  What ever happened to common courtesy!  People should not be afraid to pursue a healthy lifestyle.  I have a novel idea, why not harass people for driving an automobile rather than walking or riding a bike to get where they are going?  How dare me suggest such a thing.

Put the cell phone away when you are in that car.  I do not care who you are or how important you think you are there is nothing you can do or say on that cell phone while driving down the road that warrants putting someones life in jeopardy.  I am not without fault on this but will never use a cell phone again while driving.  Harm someone while doing this, then you should pay a very harsh penalty.  We must make this a law!

Get off the couch. I have spent many hours and days sitting in this critical care waiting room.  The number of morbidly obese people that come through as family and friends is astounding.  I hear them talk about the illness that got someone in the critical care unit and many talk about their own illnesses.  Many of these are preventable having been caused by poor lifestyle choices.  It is not rocket surgery.  


I Love My Little Darlin, she is my solemate,  give me patience, give us her life back, please
Thanks for listening/reading my rambles

My Little Darlin, PT day 28, by David

TIVGT!!!!  (translation - THIS IA A VERY GOOD THING).  Yesterday her versed was stopped completely at 2 pm.  At 5 pm her nurse asked that I come back because she seemed restless.  She was somewhat agitated but her eyes had a bright alert look.  I also felt there were brief moments of direct eye contact.  This morning there was definite prolonged eye contact.  Her eyes were very bright and alert appearing.  She still would not follow commands (as if she has ever minded me;)  She is clearly looking around her room in a focused way.  Her right arm and leg are very active.  She moves her left arm very little and her left leg some.  I feel based on her MRI findings this will improve with time.  Needless to say my mood is much more upbeat today than yesterday and do apologize for my emotional lability.  I am much more encouraged that My Little Darlin is mounting a comeback.  Another TIGT, she is completely off ventilator support.  In other words she is breathing entirely on her own.  She is at 30% oxygen (room air is 21%) but her blood oxygen saturation is 100%.  Nutrition is going well and fever is improving.  She still has a long road to walk but I think she is lacing up her shoes.  We have a lot more adventures to enjoy. We will be growing old (but not feeble) together.

Our immediate future plans have obviously  been placed on hold.  I have told of several of our adventures cone over the years.  To give you an idea of the "Life is For Doing Stuff" philosophy that My Little Darlin lives by,  she had solidly on her schedule a MS 150 ride(150 mile bike ride) in Maine for June.  This was going to be done with our friend Kim who was riding with her when she was run down four weeks ago.  She was to be doing the Ford Florida Ironman (2.4 mile swim, 112 mile bike ride, 26.2 mile run) triathlon in November.  We are also signed up for the Walt Disney World marathon (26.2 mile run) in January.  She was also planning to take the Law School Admission Exam early next year and apply for law school (she just wanted to). She has a bit of harder training (rehab) for another race (Life/stuff) to do instead of these events but just "Wait Til Next Year".  Her battle is not even close to being over but it is looking like just another one of her challenges to tackle.

I am serious about having some good come from what happen to Jan.  The first two are problems that have been and need continued addressing, the third is a passion.  All three involve Life and Death.  These are; 

1.   Share the road / 3 foot law awareness.  People that do not ride a bicycle, run, walk or work on or near the roadway commonly do not notice those who do.  This is not out of indifference or because they are bad people in any way.  These activities are just not part of their life.  An example of the point I am trying to make is if you decide to buy a particular type of car.  When you start the shopping process for that specific car you start noticing just how many of that model there are.  Bicyclist, runners, walkers and road workers see each other, they all know what it feels like to be buzzed either accidentally or on purpose.  They all give each other plenty of room.  Bottom line making others who do not participate in these activities aware would help us all.  There are a few either hateful and angry people and or people of low intelligence that I do not have the answer for.
2.  Put the Cell Phone down while driving.  I would like to see all cell phone use outlawed while driving.  A friend suggested it may be easier to enact a law if it allowed hands free.  Even if you are hands free with an ear bud you still have to look at the cell to dial or answer and in that time it is like texting and you can or will be distracted enough to kill someone.  Hands free has also been shown to impair you while driving. The law should include harsh criminal penalty similar to drunk driving if you harm or kill someone while using a cell phone.  A harsh penalty is the only way to get people to do the right thing.  
3.  Get off the couch.  This tragedy stems from My Little Darlin promoting and living by example a healthy lifestyle.  I am frustrated by the number of diseases that I must deal with as a physician that are preventable.  At the hospital I try to encourage everyone (patients and co-workers) to improve their lifestyle and they will improve their health.  Unfortunately most want the quick "pill" fix.  This treats the symptoms but not the cause.  I make our living as a physician and try to encourage people about what to do that will keep them away from people like me (physicians).  I believe one of the best gifts you can be given is your health but few do anything to help themselves maintain it.  Our bicycle shop Boardtown Bikes is a passion.  Our objective has been for it to be self sustaining (pay the utilities and employees). Jan does not take a salary.  She works in it for the love of it.  Trust me it is an expensive hobby but we love that shop and would not change a thing.   If someone comes in they are interested in doing something fun and good for themselves.  They are happy and trying to be healthy (TIGT).  If you are around people that live a healthy and active lifestyle then you can not help but want to be part of that.  Trust me this is better than being in the hospital all day.  There are a lot of people in poor health out there and they do not have to be.  It is not rocket surgery !!!

Since this happened to Jan I sense the Share the Road and 3 foot law awareness has taken new life (TIGT).  It needs to be perpetual.   I have a mission to get cell phone use while driving and enact harsh criminal penalties for anyone  injuring someone while driving and using a cell phone.  I  know nothing about this process and will need help.  This is the right thing to do.  Lives are on the line.

Thank you all for reading and keeping up with My Little Darlin, I do read all of your comments and they are appreciated


I love My Little Darlin, She is my solemate

My Little Darlin, PT day 27, by David

I have seen My beautiful Little Darlin on every possible visit on every day she has been in this place for the past 27 days.  Her body is clearly healing.  She is no longer of at immediate risk of dying from her injuries.  Now I can not get out of my mind the possibility of a fate worse than death. This is killing me.  For the past few days her versed has been at a much lower level than it was for a few weeks.  Each morning and each visit I go in hoping to see a light in her eyes.  I still have not seen it yet.  I desperately need a tiny bit of encouragement (from her) to know she is there. I am down at the time and will get better I think,  just want to know she will.   Her Neurosurgeon who I have very high respect for tells me to have patience.   I believe him but it does not make it any easier.   This is the definition of despair.  We will soon be looking into going to a neuro rehab center.  Not sure of time line.  It will likely be Shepard Center in Atlanta a dedicated Brain and spine injury center.    I can not write any more than this today, this is hurting too bad.  I know many worry about me along with Jan.  Thank you but I will be ok.  Keep praying for My Little Darlin.

I love My Little Darlin

Friday, June 17, 2011

My Little Darlin, PT day 26, by David

The cyclothymic emotional yo-yo I am riding is rolling on.  After the MRI i felt good. Now tapering My Little Darlin off the versed infusion is forcing me to face the reality of what kind of neurological deficits she may have from the trauma.  The uncertainty is killing me at the moment.   Hopefully this heart wrenching uncertainty will only become a distant thought and this nightmare will end with Jan's full recovery.  With the decreasing medication My Little Darlin's movements are increasing but until now are without purpose or any indication of communication.  She is not totally off the sedative and it will take a while for the effects to be gone even after it is turned completely off.  Can not say how long this will take.  I so badly just want that recognizing look telling me she knows I am there.   At this segment of the nightmare I will remain a basket case until I get it.   My biggest fear all along is that I will never again….

Other than the question of My Little Darlin's neuro status she continues to do well.  Her chest tubes (tubes placed through her chest wall to reexpand her collapsed lungs) were removed yesterday.  The ventilator is supporting her each time she takes a breath but is no longer breathing for her.  Her nutrition is going well and her labs are normal.  Her fever seems to be improving.

I spoke with one of the members of the accident reconstruction team last week who told me the investigation was still on going.  It will be four weeks since My Little Darlin was heinously assaulted.   Jan should be about to get out of bed,  starting to drink the coffee that I would have left for her and preparing to either swim, bike or run, which ever her ironman training schedule called for.  Instead she is lying in that CCU bed suffering more than any of us can imagine.  If her brain is able to process any thought at this time I would suspect she is extremely confused and afraid with no idea of what is happening to her.  I wonder how the person that did this to her is feeling.  Has she had any concern for what she did to my precious solemate?  Is she only remorseful about  what the consequences of her actions may end up being to her?    Has she even thought about what price Jan has had to pay for her act?  I hope the reason the investigation is taking so long is that all I's are being dotted and all t's are being crossed.  I have to trust in the criminal justice system.  I hope it does not disappoint me!



I Love My Little Darlin more than any thing else in this world.  I am afraid I will never have my solemate back and that thought is killing me.  Did not know anything could hurt so bad.

Thursday, June 16, 2011

My Little Darlin, PT day 25 by David

The sedation (versed) is slowly being decreased.  She was on maximum dose for several days/weeks at 30 mg / hr (this is a lot) and it is down to 5 mg / hr this morning.   She still gets intermittent morphine.  The nurses have to use clinical judgement when to do changes in her versed and give her morphine since she can not tell them what she is feeling.  Things that she does to indicate she is uncomfortable are increased breathing rate and increased blood pressure,  They will usually increase her meds slightly when she is being turned, bathed or having range of motion physical therapy.  She is having increased spontaneous movement but still will not make eye contact or follow commands (not that she would ever do what I say;).  I am anxiously waiting for that recognizing eye contact that will let me know she knows I am there.  I am hoping for it to be an ah ha moment but suspect it will be a gradual transition as everything else has been.  Her body continues to do well.  Her blood is very well oxygenated on 30% oxygen.  Her ventilator rate is down to 4 with her doing the rest (TIGT).  She should get her chest tubes out today or tomorrow(TIGT).  Still having fever, getting the chest tubes out may help this.  Her nutrition continues to do very well.  Her labs continue to do very well.

Even if she became fully aware today she still would have a long way to go.  The bone fractures should be healing.  Vertebral compression fracture should take up to six weeks to heal.  These are very painful when they first happen unless lying motionless in bed.  Hopefully it will be stable by the time she starts to get up and about.  It may require injection of glue but the longer she is in bed the less likely this is.  When she does start to get up and about she will be extremely weak.  Lying in bed as long as she has and will still be, she is losing a lot of muscle mass.  This will take work to get back and will be part of her rehab.  We still do not know what long term neurological problems she may have from her brain injury.  I am hopefully optimistic that this will be minimal but only time and rehab will tell.

For all of the guys reading this I may be about to get you into some trouble or in to another one of those uncomfortable spots we get ourselves into (like the anxiety provoking phrase you might hear from your wife "let's talk about our feelings".  Jan will actually say this to me just to watch me squirm and then laughs at me).   She has always loved to dance.  Does not matter what kind, if there is music she wants to dance.  As the spouse I am supposed to dance with her.  I do not like to dance,  no rhythm, no grace, no cool on the dance floor.  Just looks and feels like I am having an uncontrollable seizure.   She would always give me a hard time about not asking her to dance when the music starts.  Well several years ago I bit the bullet and surprised her with a few ball room dance lessons.  Figured we could learn a few cha cha and tango steps and that would earn some brownie points and I would not have to do that spontaneous dancing that I am so bad at.  Nope, did not happen that way.  We took lessons for years (seemed like a long time anyway) .  We learned all of the major ball room dances.  Yea I became a twinkle toes and she was happy.  Foxtrot, waltz, swing, cha cha, tango and rumba (never could get the hip action on this one).  Now many times when we would start a dance I would have to get her to tell me the beat.  One time she even talked me into going to a competition.  I won every category (because I was the only male there!!!!! and she made me wear a puffy shirt).  I think what finally got me out of taking the lessons was when we had a private lesson and she thought the instructor was hitting on me(it was a guy).   I will say I got a whole lot of brownie points for that ball room dancing stuff.

Over the past 25 days I have heard from many others that have had similar or worse tragedies happen to them or a family member.  I have heard from many cyclists or their families telling about how severely they were injured or killed by a car.  I have also heard from many not necessarily on a bicycle or exposed on the road but were injured or killed because of someone driving while using a cell phone.  I took a short walk outside yesterday, crossing the street I noticed as I had even before this happened to us, how many were driving while using their cells.  They did not notice me.  If anything good comes from this I hope that there will be continued increased awareness for cyclists, runners, walkers, workers and anyone else exposed to automobile traffic.  People driving need to understand what will happen to the person they hit, their families and themselves.  There are severe consequences traded for only a few seconds of time and you can not ever take it back.  Jan and I will live with this forever.   I also feel VERY strongly about outlawing the use of cell phones while driving and enforcing criminal (PUT IN PRISON FOR A LONG TIME) punishment if injuring someone with an automobile while using a cell phone.  It is as bad if not worse than drunk driving.  Do not be part of this problem!


I Love My Little Darlin and I would give anything to have her look me in the eyes,

Wednesday, June 15, 2011

My Little Darlin, PT day 24, by David

There is a television commercial that has been playing recently,  early on it is a young girl and boy and shows them older as adults as it progresses. The girl is very active, the boy is reserve.  It asks are you the gas or the brake.  Jan is clearly the gas.  She had a previously life before me. She was a bank teller with two children. Her youngest was ill one time.  He required a lumbar puncture (spinal tap).  Not knowing what was going on and feeling helpless made her decide to pursue nursing.  She blew the top out of some type of entrance exam and her advisor suggested she might try medical school instead.  So she went to medical school.  Out of her anesthesia residency she started her practice as a solo anesthesiologist from scratch,  she later joined a couple of others and they developed a large group.   While she was still practicing anesthesia Derek her oldest son developed leukemia.  Thankfully he is a cure and he and his wife Laura have two bright and beautiful daughters.  Jan became involved with Leukemia and Lymphoma Society Team in Training.  Great organization for a great cause. Team in Training has trained nearly half a million runners, walkers, triathletes, cyclists and hikers.  The participants race with a sense of purpose by raising funds for the Leukemia and Lymphoma Society.  She did several marathons with TNT, contributing thousands of dollars, her first marathon was at age 50.  She also became the state TNT coach for a while.   She retired from anesthesia and decided to get into real-estate investment business.  She did this for the challenge.   She had no restate experience but quickly learned about buying, building  and rehabbing properties, along with rental property and sales.  She learned this business from the ground up including how to make her own contracts.  She became the local real estate investment group president.   We have traveled extensively.  As a side she formed a travel agency.  I previously told the story of how one day we(she) decided we(she) would open a bicycle shop.  She had no retail experience, is not mechanically inclined and knew nothing about bicycles and really could not ride one very well.  Boardtown Bikes has been open almost three years now.  What she is doing now could be considered just her next challenge in her long line of accomplishments.  No doubt this his will be her hardest challenge but with My Little Darlin's grit if it is at all possible, she will succeed.  Do not put it past her to be trying for the Ironman World Championship in the future.

Today she is holding steady. Her sedative is being slowly tapered off.  She has only a small amount of spontaneous movement but this is increasing slightly.  She still remains unaware. I am patiently but anxiously waiting for that recognizing eye contact.  My peace of mind will be greatly improved when that happens.  The ventilator settings are being slowly decreased allowing her to do more work of breathing.  This takes time.  If her pulmonary and ventilator status continues to improve she should have her chest tubes removed in near future.  Her GI tract is working well.  All of her nutrition now is through her PEG tube (no more IV nutrition is required).  She continues to mobilize fluid with the swelling decreasing.  Her lab work is normal.  Has not had her bilirubin checked in a few days but other visible signs indicate this is improving.  Still some fever but this may be trending down.  Have stopped some of the antibiotics she has been on.  Baby steps!

I mentioned something along this line a while back.  This is going to be a very long ride for Jan and me.  I know the "new " wears off of things and we all (well not Jan and me for a very long time) go back to our normal lives and routines.  This is normal and understandable.  I truly appreciate all of the well wishers and prayers.  I appreciate everyone wanting to do something to help.  I do not know the answer to that well meaning question.  The only thing I want and can think about is for My Little Darlin to be alright (right now I would give anything for her to look me in the eyes).  What everyone can continue indefinitely is to not only stay aware and share the road but be an advocate.  Do not forget this can and likely will happen again to someone else.  The more people that are aware the fewer it will happen to.  Trust me if we can prevent this from happening to just one person it would be worthwhile.  Also put the *%*#@$^& cell phone down while driving and tell others to do the same.  If you don't you may as well drive drunk because that will make you a better driver.  I am serious about getting cell phone use while driving outlawed and getting harsh penalties if harming someone driving while using a cell phone.  I need a lot of help with this.  That cell phone convenience is NOT worth a life (drivers or victims).  Thank you all for listening!


I Love My Little Darlin, a look in the eyes would be priceless

Tuesday, June 14, 2011

My Little Darlin, PT day 23, by David

No matter what I say about Jan's progress this is going to be a very long and difficult road to recovery.  I have to keep reminding myself no matter if it is one of my down / depressed days or one of my up, things are bright days (mood swings more closely patterned to between visit intervals) that she does have a road and things could be worse.  I would like to say that I think these mood swings must be the way it feels to be a teenage girl ;).  Now for a TIGT.  Derek (Jan's oldest son and also a radiologist) and I have seen her MRI done last night and have talked to her Neurosurgeon who gave his opinion.  The MRI is better than I expected.  Do not get me wrong, it is not normal.  She has the fairly large area of hemorrhage in the right temporal lobe that we knew about.  This will continue to improve but will take time.  She has the small contusion in the right frontal lobe that is a known finding. This should not cause any significant problem.  No other significant findings are seen(TI VERY GT).  I fully expected other areas of injury in critical regions of the brain but did not see any.  Only time will tell but this suggest she could have significant recovery neurologically.

She also had a good night.  Her oxygen is at 30%, the ventilator rate was at 12 and PEEP (pressure the ventilator keeps on her lungs) is at 6.  She did very well with this and her rate has been decreased to 6 (TIGT).  She is still on a fairly large dose of sedative but this is being decreased gradually.  It will take some time to get her off the vent and sedative but her team is working towards that.  She is in training.  Her labs all looked very good this morning.  Did not check a bilirubin level this morning but her jaundice color is clearly improving indicating improving liver function.  She is totally off the IV nutrition now getting it all through her PEG into her well functioning GI tract (TIGT).  For an unknown reason her blood pressure has been going up and down without an explanation but not critically.  She is still having temperature spikes also without a clear explanation.

There has been one other time in Jan's and my past that I had a very brief fear for her life.  Several years ago we decided to do a white water rafting trip.  This is still one of my all time favorite trips.  This was a week long trip on the middle fork of the Salmon river in Idaho.  Just getting to the start was an ordeal. We flew into Boise then caught a small single engine airplane to Stanley, Idaho.  From there we took an even smaller plane to the start point.  This was interesting since we were flying between the mountains when the pilot did a quick u-turn and dove down to a small dirt landing strip in a deep valley.  For the next seven days there was no easy way out.  We were in a pristine designated wilderness area.  The river was clear and cold from the snow melt.  There were innumerable rapids many of which had to be scouted by the guides before we could go through them.  Between the rapids there were long spans of calm water where we would see river otters playing and big horn sheep on the river edge drinking.  We could swim as we floated or fish for trout.  At night we would camp on the river bank.  We had tents but some of us preferred to sleep out.  One night Derek and I were laying in our sleeping bags watching the stars when this extremely bright light slowly began coming over the mountain. It turned out to be the brightest moon we have ever seen. 
On the river we had several, all inflatable boats.  There was an oar boat that carried the gear.  You could ride on this and let the guide do all of the work.  The six man paddle boat where everyone had to work as a team to get through the rapids without flipping.  And there were several inflatable kayaks.  These always followed the paddle boat when taking the rapids under the watchful eye of the guide.  Before the start of the trip we had a lecture on taking care of the environment (you take it in you take it out, you see any even tiny piece of trash you pick it up, too bad people can not do this all over).  The best safety tip (we found out later) was if you suddenly find your self wet all over and dark all around the boat has flipped and you are under it.  Just go with the flow and feel your way out.  We also were taught about what to do if the boat lodged sideways against a rock.  When this happens the boat is stuck, held by the tons of flowing water force and pressing it against the rock.  When this happens you are supposed to lean towards the rock otherwise you can be pulled under the boat.  Well one day I was in the paddle boat with 5 others.  Jan and a few others were in the one man kayaks.  The river guide instructed the kayakers to wait until told before they took on the section of rapids we were approaching.  We took the raft down first but just before getting through we became wedged on a rock.  We were stable but not going anywhere.  My Little aggressive kayaker Darlin had started her run behind us too soon and hit our raft that was effectively a rock.  She leaned correctly toward us but the edge of her kayak was caught by the current and pulled under our raft.  Everyone that could put a hand on her was grabbing to pull her in our boat but the current was too strong and pulled her under the raft with the kayak.  I was on the back watching this.  I knew she was usually cool in a crises and had listened to the safety talk.  Can not say I was not feeling panicked, I was, but I turned to the downstream side of the boat.  After what seemed like an hour but probably  only a few seconds there she was, face up feeling her way calmly out from under the boat.  The speed and force I used to yank her out of the water probably scared her more than being pulled under.  She tells me my face was white with fear when I saw her and I do not doubt that.  Later that night she let on just how much it had scared her and cried herself to sleep in my arms.   I love My Little Darlin.

I am going to say again and again,  I feel strongly cell phone usage in a vehicle should be outlawed.  It is a luxury not a right and in a car they are as dangerous as a drunk.  Until it is outlawed, and it will be if I have anything to do with it,  put your cell phone away when you drive.  I do not know if this was the cause of Jan's horrible tragedy but this is one act that certainly puts one at risk and is easily prevented.  If you hit someone their life will be severely compromised or ended and your life as you know it will be forever altered in a very bad way and it should be!  You do not want to live through what Jan and I are going through.  Sadly what happened to Jan will happen again to someone else but we have an obligation to do what we can to decrease this risk.  We also need to continue to actively make people aware of all exposed (bikers, runners, walkers, workers etc) and on the roads.  Auto versus person, person always loses and usually in a very bad way.  People who ride a bike, run or walk should be encouraged to do so not discouraged.  I tell people everyday that if they would do things (exercise, eat right, do not smoke) to help themselves and improve their health they would not need people like me (physicians) and TIGT.


I Love My Little Darlin, she is my Solemate and I miss her BAD,

Monday, June 13, 2011

PT Day 22, by David

It is Sunday evening.  They have again started backing down on My Precious Little Darlins sedation.  I can not keep the lump out of my throat, the quiver out of my voice or the tears out of my eyes.  I am as afraid now as I was when this first happened.  She and I both believe in quality of life. The reality of her brain injury will start becoming more apparent now.  I am so afraid that she will not recover to live the quality of life she loves living and it is tearing me up.  At the moment she will open her eyes but is totally unaware.  I hope and pray this is the drugs.  There are other subtle neurologic signs that bother me.  Many of my friends who have a combined massive medical knowledge and experience have reenforced that what I am seeing is at least partly related to the level and duration of sedation she has been given but Jan is my life and I can not help but fear the worst.  I still know how severe the impact of that car hitting her was and can not get that out of my mind.  There have been prayers said for her by a Methodist Minister, Catholic Priest, My Father, innumerable churches and most everyone who knows Jan and knows of Jan.   I have prayed and I have also questioned my faith because of this.  I feel totally helpless.  She is here because of a stupid senseless act.  The sad thing is there is no doubt the same stupid senseless act will be repeated and another life will be wasted or ruined.   This is an almost unbearable hurt.  I just want my solemate back.

Morning, PT day 22.  Her body body functions continue to do well.  Her blood gases are very good on 30% O2.  The next step will be to see how she does with less pressure the ventilator uses to help her breath.  Getting her off the ventilator is a slow weaning process.  Her sedative has been decreased.  Now it is at half the rate it was the past few weeks.  Last night it was at 1/3 the rate but needed to be increased because she was getting agitated.  The way she shows agitation is by breathing faster and less efficently.  Her tube feeding rate is where it is needed so I expect the IV nutrition will be tapered off and stopped in the near future.  Her GI tract is active.  She is still having fever up to 102 F.  Still do not know why.  Her WBC (white blood count) remains normal.  She is well covered on antibiotics.  Her bilirubin (liver function) continues to improve.

Her neuro status weighs very heavily on my mind, as if you could not tell by the note I wrote last night.  I  discussed my concerns with her neurosurgeon this morning.  I have a very high respect for and confidence in this man.  Her recovery from this will be months if not years.  The subtle neuro  changes are not surprising given the severity of the head trauma.  She is to get an MRI today.  As I suspested and he also suspects she likely had some degree of shear injury to her brain that can not be seen on CT.  The MRI should not change what is currently being done but will give a better idea of the extent of her brain injury than the CT and will give a better idea of expected long term recovery. 

There was a front page article about the danger of cycling on the road in the Jackson Clarion Ledger yesterday.  The newspaper blog for this article generated the most comments of all.  Many of these were written by thoughtful intelligent people.  Most reflected why Mississippi remains at or near the bottom in education, health and intolerance to being from different from their way of doing things.   Jan and I have traveled the world and have found that no matter where you are, what language you speak, what religion you practice or what color your skin is the overwhelming majority of all are kind, compassionate and caring people.  That includes Mississippi.  There are a very few who are not this way in all societies.  This was painfully apparent by the blog comments.  These few are an embarrassment  and danger to us all.

My former Mentor and Chairman of the Radiology department where I did my training sent me an interesting link , listing the number of countries that ban cell phone (52) use while driving.  He told me two of his Grandchildren who live in Germany were visiting last summer and were astounded that people use their cell phones while driving.  How many more people are going to have to lose their life before this is changed in this state and or country.  Is it worth the inconvenience to you before or after this happens to you or your family.  Think about it!!!

Jan was always joking that she wanted a bicycle that would allow her to go fast without sweating or breathing hard.  She also wanted to write a book with the title "How to do an Ironman Triathlon on a Ding Dong Diet".  I would give anything for her to ask me to go get her a Ding Dong and to see her on a bike again.  I do not know if either will ever happen.


I Love My Little Darlin more than anything, She is my Solemate.  Unless you have lived it, this hurts worse than anything you can imagine.

Sunday, June 12, 2011

PT Day 21, by David

It has been three weeks.  I have little concept of time.  My days revolve around 6,10,2,6 and 9 visiting times.  I do not miss these, I am not late.  My mental health would not tolerate it.  I still hurt for My Little Darlin all the time.  Now that all of the support devices have been removed from her face, if you only look at her face she looks like an angel sleeping at peace.  Then you look elsewhere and see all of the tubes coming out of her body that she still can not live without.  Since she has been here each time I see her I kiss her and tell her I love her, sadly she does not respond.  I have to believe she will respond when she is off the sedation.  For as long as I can remember, until three weeks ago, every time I left the house in the morning before work I would kiss her good by and tell her I love her.  She would be asleep but she would give me a slight nod of the head.   In the rare instances she was sleeping too deeply to know later she would always ask me why I did not kiss her good by.  For you other husbands out there this is going to get you in trouble but  I also fix her a cup of coffee the way she likes it and place it at her bedside when I leave (sorry guys but I can hear your wives now "you don't ever do anything like that for me").  I know I have been there!  She is clearly better today than she was three weeks ago.  Was not sure then if she would survive what happened to her.  There is still fear for her survival but it is much less.  There are other significant but less significant problems she must overcome now that I fear.  There is a very long road ahead.  The good thing is that the Ironman Triathlon should be easy after this.

She had a good night.  Her oxygen was decreased to 30% this morning and when I saw her at 6am her blood oxygen saturation was holding at 99-100% (TIGT).  Her ventilator rate was also down to 12 breaths per minute from 16 which makes it even better.  She still has the tubes in her chest.  These will stay so long as she needs the ventilator support.   Her tube feedings are up to 40cc per hour and so far she is tolerating this.  The target is 55.  Should be able to stop the intravenous nutrition when she reaches this milestone.  Her bilirubin continues to decrease ( this indicated her liver was not functioning as well as it should probable from some of the meds she was being given and the IV nutrition).  She continues to spike the fever for unknown reasons.  I am still scared to get too excited for fear of backsliding and of the unknown answers that we have not gotten to yet,  but she is going in the right direction at least today and TIGT.

I started writing this Journal to give me an outlet and more importantly hoping that what happened to My Little Darlin Jan did not happen in vain.  This same thing that happened to Jan has happened to countless others with the same or even worse results.  I (hope and think) I am some day going to again be able to tell and show my wife how much I love her, many others are not as fortunate.  These include John Paul Frerer (18), Christina Genco (22), Samuel Sanderford (48) and others killed while riding their bicycle along with many others seriously injured.  Unless you have been through it no one can understand the pain and heartache of seeing someone close to you killed or injured like this or any other way for that matter.  You can get some idea if you try to picture this happening to someone you love.  Accidents happen, we can not prevent them all but I believe we can decrease these horrible tragedies.  I use the word "we" because to make change it will take a cohesive many.  One excellent recent change was the 3 feet Law enacted in honor of John Paul.  It is terrible that John Paul had to give his life to get what should be a simple act of common sense, courtesy and respect for another human beings life made into a law.  This seems so simple and is for the majority but there are a few that do not see a cyclist, runner, worker or anyone else exposed on the road as a human life,  they are only seen as an object in the way.  We must continue to push for awareness.  Walkers and runners face the traffic.  It is very apparent when doing this how many people are using their cell phone and not paying attention to the road.  It is common for me to have to jump out of the way to not get hit and the driver be totally oblivious.  As a biker we really do not know how many near misses there are because of cell phones.  I have the sense but not the data in hand that the number of fatalities and injuries related to biker or runner versus auto has increased with cell phone use.  I have been told there is research showing that cell phone use is equivalent if not worse than drunk driving.  This is where I feel the most important next change needs to be made.   I feel strongly that cell phone use while driving should be outlawed.  I feel that the punishment if driving while using a cell phone should be the same as driving under the influence of alcohol.  I feel if you injure someone when driving while using a cell phone the punishment should be the same as driving under the influence of alcohol (I am not sure but think this is vehicular manslaughter and means prison).  A cell phone is a luxury not a right and most of us are old enough to know we got along fine before cell phones.  Do not wait until you ruin your life by killing or seriously injuring someone or ending or ruining the life of someone else.  My Little Darlin and I are living (thankfully) this nightmare.  I am asking everyone to jump on this wagon. PLEASE!!!!!  I YOUR HELP TO MAKE A DIFFERENCE!!!!


I love My Little Darlin and hurt for her every day,