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Saturday, September 18, 2021

Update #16 - 18Sep 2240

 Slightly disappointing day.  WVU Football Game Day.  Today, VaTech a big rival, came to town and everything shuts down—apparently including rehab centers.  Jennifer got one hour of Occupational Therapy, but that’s all.

Julia did go up and visit from noon-6pm.  Tomorrow she must fly back to SLC to resume her MBA classes.  She had two pretty full days with Jennifer.  A good mother daughter visit.

Today, Julia read to her from EveryMomentHoly, a compilation of liturgies for every conceivable situation.  She read from “A liturgy for the Feeling of Infirmities.” 

There were several phrases that really resonated with Jennifer

- “…a small share of the malady of a frayed creation” (so Grace at the Fray)\
- “may the decline of our bodies incline our hearts and souls ever more vigorously toward your coming kingdom.”

Luke and Jack arrived after a 30 hour continuous cross-country drive from Salt Lake City.  So good to be with them. Tomorrow we hope to all go up and picnic in the grass outside of Jennifer’s window.  



Friday, September 17, 2021

Update #15: 17Sep 22:45

 



A better day in rehab today.  

I didn’t expect that Jennifer’s comment about her situation being a “dystopian reality show” would result in a response which would transform her bleak room into a floral sanctuary.  Thanks all.


Physical therapy worked a lot with her today on balance and movement.  She’s moving better, but still needs a wheelchair or walker to go even short distances (e.g., the bathroom).  The NeuroPsych doc spent over an hour with her giving both encouragement about the possibility of full recovery as well as speaking frankly about how it is impossible to predict what the timeline will look like.  It’s looking like it’s possible that we might be able to transition out of the inpatient rehab in the middle of next week and move her home to our little farm house.  Then we would begin outpatient rehab visits.  It’s beginning to become clear how we are going to be moving continuously from one follow-up visit to another—PT, OT, TBI Clinic, Eye Clinic, PMR…


Meanwhile here at the Farm — or as the kids call it, “Bag End”, Bilbo Baggins and Frodo’s little corner of the Shire—we are preparing for her return.  Setting up a bedroom on the first floor which requires bringing a bed downstairs—through the window because the stairs are so narrow.  Julia and Caleb worked themselves to exhaustion today…cleaning, moving Jennifer’s clothing downstairs, baking cookies, sorting and trashing.  And Jack and Luke (and Botu, their Golden Retriever) are doing a marathon 30-hour drive from Salt Lake City to Buckhannon.  Oh my.





Thursday, September 16, 2021

Update #14 - 16Sep 23:05


 

DAY 1 - Encompass Rehab 

Long day for Jennifer.  They woke her for her first shower in eight days.  She described it as “life giving.” That said, the next comment was that “I feel like I’m in a movie set of a dystopian reality show.”


She participated in speech and cognitive evaluations, recumbent bicycling with the occupational therapist, as well as an evaluation from the rehab attending doctor.


To be honest, it’s been a pretty slow start, with today being primarily just an evaluation day.  While we’ve heard good reports about this facility, we’re concerned that we are heading into a WVU Football weekend (VA Tech, a big rival)—which we experienced last weekend when the entire hospital basically shut down for the event.  Jennifer is also not really being given the space and quietness to get the restful sleep she desperately needs.  Lots of phones ringing and nurse call alarms are really disturbing her.  It’s not what we had hoped for.


So we need wisdom and patience—pray for that. Julia gave us a comprehensive report on her 8-hour day with Jennifer. And then we (Julia, Abby, Caleb and I) strategized for the weekend travel logistics and our plan for advocacy for Jennifer at her facility.


Closing with another quote of the day-

Occupational Therapist: What was your occupation?

Jennifer: You mean What IS my occupation?  I am a pediatrician.

Wednesday, September 15, 2021

Update #13: 15Sep 22:35

 



Breaking News:  Jennifer has been transferred to the Encompass Rehabilitation Hospital! 
 Answer to prayer. Thanks all for the prayers.

The day was long.  Waiting, waiting. But then we got the news and things accelerated quickly.  The most amazing intersection occurred at 5pm:  Jennifer rolled out of the front door of the towering University Hospital in a wheelchair; Julia and Abby arrived from their long SLC-CLT-PIT flight in a car rental; and Josiah and Barbra Bancroft rolled in from Philly on their way to lead a Sonship weekend in Kentucky.  What a reunion!  Mom sucked in the balmy summer air she has been dreaming of and we all feasted our eyes on her sitting in the front of that Jeep, clothed in her WV “Home” t-shirt.


Since only one person could be part of the in-processing at the rehab center, I went to dinner with Josiah and Barbra while the kids took Jennifer to Encompass.  The report from Abby is that Jennifer’s room is “bleak.”  Barren. No decor. No furniture save the hospital bed.  Perhaps it will motivate Jennifer to work harder to graduate from the program and get home.


So now we enter this new phase.  Jennifer will be in intensive Physical, Occupational (and perhaps Speech?) therapy.  We can send only one visitor to joint her from noon-8pm.  Tomorrow-Julia (who leaves Sunday to go back to her MBA classes at U of Utah); Friday-Abby…and beyond that not yet determined.


Luke and Jack (and Botu) are planning to drive from SLC starting Friday.  Those guys are crazy.  Couldn’t talk them out of it.


Prayer Requests for Rehab:

  • Continuing progress in regaining strength, balance, coordination, and sight.
  • Good relationships with the staff for Jennifer.
  • That Jennifer would be encouraged by the visits of her kids, one-at-a-time.


And finally, a Quote of the Day (from early this morning):

Me: Who should we call?  I can’t remember who wanted to talk to you today…

Caleb: Everyone wants to talk to mom.  We should start auctioning off slots to talk to mom.

Mom: Limited time left. Hurry up. 




Tuesday, September 14, 2021

Update #12: 14Sep 7:45pm EDT


 Another day of watching and waiting.  

We continue to wait to hear about a transfer to an inpatient rehab facility—and it all seems dependent on the insurance authorization. 


And today…nothing.  No word.  And pretty much nothing happening for Jennifer in this hospital now.  Only vital signs and continuing respiratory therapy.


She did have the 10 staples removed from the 3 inch laceration in the back of her head—which occurred UNDER her helmet.  Difficult to understand how that happened.  Seems like severe shearing forces as the helmet hit the pavement.  So many things we probably won’t ever understand.


The morning started off pretty rough.  Jennifer feeling despondent about life in general.  Hearing details about what is going on in our teams in Africa—which were meant to encourage—just caused distress.


However, good FaceTime with our kids, Jennifer’s mom, and Ree’L & Jason buoyed her spirit.


And while no therapist came, Caleb took matters into his own hands.  He got her behind the walker and they walked twice as far as the day before.  She felt the paradox of liberation and general exhaustion.  Then back to bed to recover and watch Ted Lasso while I ran some errands.


Please continue to pray we can get into the rehab facility tomorrow and get the next step going.

Monday, September 13, 2021

Update #11: 13Sep 8pm


 So, a good but hard day.  It seems like Jennifer plateaued a bit mental status wise.  Speech still fluid, but with some regular bouts of confusion.


Hospital-wise, today was a busy Monday.

First, Occupational Therapy came.  They did some exercises—sitting, pushing up from lying down, standing, taking some steps with assistance, taking some steps with a walker.  Small shuffling steps.  Exhausting.  Went to the sink and washed her face.  Their assessment was that she is ready for the inpatient rehab.  They think she can handle the three hours of therapy per day.  But the discharge and transfer is the call of the Trauma Surgery Team.


They arrived about 1pm. New attending.  But we all agreed that she is stable with regard to her injuries, making good improvements and is ready for discharge.  Yay.


Third, the Case Manager.  She talked specifically about the Rehab options (for the 7-14day program).  One company—Encompass—two choice locations, Bridgeport (closer to our farm) or Morgantown (around the corner for this current hospital).  We asked for the Bridgeport option but now it’s all about “bed availability” and “insurance approval”.  Pray for those obstacles to be removed.


Last, the call from Encompass.  We talked through most of the things we have already heard.  What to expect issues. While we are thrilled to get her started in the Inpatient Rehab, one big bummer is the different visitor policy.  We have enjoyed the University Hospital’s policy of two visitors in the room from 8am-7pm.  Any two.  Mix and match, swap in and out.  The Rehab policy is “ONE PERSON PER DAY.”  (12-6). That is the same one person.  No more, one person subbing in for another.  One unique individual can visit Jennifer per day.  This policy arose because they had some patients get Covid due to a parade of visitors swapping in and out. This is going to be hard for our kids who are arriving over the next few days.  Julia and Abby coming Wednesday-Sunday. Jack and Luke coming for a week starting Friday. 


A couple more thoughts about Jennifer’s general state of mind.

It’s a continual battle for her to let go and rest.  She feels guilty for being in the hospital, for causing this ruckus (and “it seems like it wouldn’t be so bad to recruit an army of prayer if I was doing something valiant and heroic in Africa…but wiping out on my bicycle in West Virginia?”).  She’s constantly thinking about the team, the Area, the prayer meetings (“have you arranged the biweekly prayer meetings, Scott?”).  Helping her to embrace the fact that her job is to rest and heal IS A BATTLE.


And when the Trauma Team did their rounds, she asked the Trauma surgeon- can I expect to return to normal —or am I looking for find a new Normal? And is this a time line of months or years?  These are questions for which we have no answers.  It’s that fog of uncertainty in which all of us are staggering.

Sunday, September 12, 2021

Update #10: 12Sep 8pm


 Another day of progress.

We arrived to find her more alert and more articulate than yesterday.  The words flowed freely and smoothly throughout the morning.


Quotes of the day.

We came in after she requested the nurse to come in and help her toilet in the bedside commode.

“I told my nurse that my youngest son is 23 years old. It’s seems to have been a 23 year pause between the major indignities. I thought I was done with such indignities but I just took a 23 year pause.” (Needing help to go potty seems to feel like a major humiliation).


Reacting to the news of Biden mandating vaccination for all companies with 100 employees or more— Jennifer said, “Public Health and Personal Choice are often at odds.  And Americans have a hard time when their personal freedoms are limited — but they will agree to it to prevent people from driving drunk or driving 150 mph…”

Caleb said, “I think she’s ready to go home.”


I gave her my iPad and she typed The Quick Brown Fox Jumped Over the Lazy Dog (slowly with a lot of typos- but the autocorrect fixed ‘em).


She stayed awake for about 6 hours today and felt completely exhausted by the dinner time—but that amount of awake time is also a huge piece of progress.


The Chief Trauma Surgeon came is and talked at length about her progress, her prognosis, and the hurdles ahead.  We have a lot of rehab ahead which she warned will generate frustration and anger.  We just need to give her time and space. 


So, tomorrow—potentially—she could be discharged from this the University Hospital to an inpatient rehab facility.  Pray for that.

Saturday, September 11, 2021

Update 9: 11 Sep 9:45pm EDt

     Today’s schedule: 

  • Breakfast - 3 bites of scrambled eggs, 3 spoons of yogurt
  • Sleep
  • Eval by Speech and Swallowing Therapist because of choking episode yesterday.  Result: supposed to thicken all liquids to be more viscous to prevent aspiration
  • Sleep
  • Lunch - 3 spoons of yogurt, one bite of graham cracker (Me: you have to eat to get stronger.  Jennifer: I’m not hungry.  I feel like I got run over by a train).
  • Sleep
  • Neighbor delivering clothes for Jennifer
  • Sleep
  • Visit from the Hyltons
  • Sleep
  • Dinner - delivery and assistance to occur after visiting hours by nursing—so no idea if any bites taken.


The Hyltons buoyed our spirits dramatically.  We heard the highlights of the week’s meetings which we so unexpectedly missed.

They were getting ready to leave and Jennifer said “Wait, I want to see a picture of Emily’s baby, your first grandchild.”  Nice.


After they left, I was filling out the details of our relationship with the Hyltons (Area Director colleagues for many years) to Caleb.  I mentioned that their youngest daughter, Abby, is just a couple of years older than Luke.


Jennifer, who we thought was fast asleep, opened her left eye and corrected me matter-of-factly, “Elizabeth is their youngest.”  And then rolled over and went back to sleep. (I fact checked with the Hyltons and, of course, Jennifer is correct).


Hooray.  Jennifer is back.


(Note- in light of Jennifer’s transfer out of ICU, there is much less data/info to communicate.  So we are moving to once-a-day updates only… and probably slightly less frequent than that in the near future).

Friday, September 10, 2021

Update #8: 10Sep 0945pm EDT


Friday evening.

Jennifer moved from bed to chair and back twice today.  To see her sitting in a chair feels like miraculous progress.  This afternoon we came in to her room after we grabbed a bite to eat in the hospital cafeteria and found her sitting with a styrofoam cup of coffee sitting on the tray in front of her.  

“Where’d you get that,” I said.  

“I asked for it.  They said what would it take to get you up and moving out of bed…I said a cup of coffee,” she said (in a raspy whisper).

Precious.

We have repeatedly recounted the events of the week and it is slowly beginning to stick.  She’s comprehending that we have missed our Area Director Meetings (“That’s the whole reason we came to America.  Aren’t you calling in everyday or something?”).


The neurologist came by to talk to us and examine her again this afternoon.  He did an extensive neuro exam and the only abnormality he found was a slight discoordination of her fine hand movements (and, of course, the right eye movement problems).  He summarized the MRI results for us (mild sub-arachnoid hemorrhage, mild subdural, mild diffuse axonal injury in the right parietal lobe) which is otherwise distilled down to  the blanket diagnosis of Traumatic Brain Injury (TBI).  He said, the most common long term sequelae are: headaches, insomnia, and balance difficulties.  He offered to have her follow-up in the WVU Neuroscience TBI Cohort Clinic.


From one update to the next, I can see the objective progress, but when she says, “Are you still filming the Girl Scouts?” it can be jarring.  And discouraging.  Her brain is still injured and it still hurts to hear the evidence of the injury impacting her ability to think and speak.


On our Bundibugyo Team, we have a family who we recruited for a long period of time.  They agonized whether they should take the risk of uprooting from a great job, community and church and come to Uganda.  And at some point we shared with them a message we heard at Julia’s church (Blacknall Pres) from Alan Poole as she graduated from  Duke.  He said, “Graduates, what you need now is Courage Not Clarity.” I’ve shared this with other potential missionaries and also most recently with our Bundibugyo Summer Interns. 


Ouch.  Yup, because what I want right now is CLARITY.  I want to know THE PLAN!  I want to know how this turns out.  Does Jennifer fully recover? Her balance, her strength, her cognitive brilliance, her ability to type, to write for this blog (!), to see without double vision…?  Do we return to Uganda?  


OK, so surrender the Clarity.  


What about Courage? 

Websters says this:  it is the ability to do something that frightens one; strength in the face of grief or pain. 


Facing fear, grief, or pain (easier said than done). 


Joshua 1:9 says Have I not commanded you? Be strong and courageous.  Do not be frightened, and do not be dismayed, for the Lord your God is with you whereever you go.


How do we face fear or grief?  With the knowledge that God is with us—whereever we are, in whatever circumstance. 


Lord, our eyes are on you

Update#7: Friday 10Sep 11:00am

Jennifer greeted us this morning with a smile. Every day this week has been a small but significant improvement and today is no different. Yesterday we were mostly lip- reading the few words she mouthed, today she is whispering short sentences. Yesterday she took her first breaths on her own, today she is breathing steadily albeit quite shallowly on her own. Yesterday she was still in a collar, today she can roll her head to look out the window, and with great effort is sitting up in a chair!


We’ve come so far this week! But there’s still a marathon to go.


Nurses this morning are already talking about “when she get’s home,” but that feels infinitely far away right now. Three bites of yogurt was all she could handle. The respiratory therapist wants her to float the inspirator indicator about six inches high and she can barely make it flutter in the bottom of the tube. 


We’ve taken this whole week hour by hour, day by day, grateful for the present moment, praying for the next. Now we’re starting to face the mid-term logistical implications and it feels daunting.