Friday 07Mar

 Happy Fun Friday! It was a busy day today!

Today Brian had OT, a small amount of PT, and some speech. Today OT helped Brian shave his face! He has been wanting to shave for a few weeks and today he was able to with OT's help. He did most of the work and she just helped clean it up when he was done. He isn't yet cleared to use a razor, but we have a beard trimmer that I got Brian for his birthday that we were able to use today! He also did some walking in the halls with PT. He is really working with her to regain that balance to be safer when walking. Speech this morning worked with Brian using one of their loaner iPads to help Brian with some orientation. They looked at a map to see how far we were from our house, and played around a bit with the calendar app so Brian could keep an eye on his schedule. 

He had another session with speech this afternoon where they were going to try and work more with the iPad. His speech therapist also said that this could help Brian with his communication difficulties he is having right now too. They are also using this iPad to test out how well Brian tolerates screens moving forward. The behavioral team is working to develop his behavior plan and in that plan it will detail what they believe to be possible triggers, possible preventions, and possible strategies. At the beginning of the week it was suggested to keep Brian's environment as low stimulation as possible so he was on no screens (he was already still on the no screens), not much time spent out of the room, lights off, limited people in the room at one time, quiet talking in the room, etc. That low stimulation environment has continued throughout the week and he's still had a few moments each day of irritability/anger. He has been relatively easy to calm back down, which is good. When we get some more info on that behavior plan, I will absolutely share it and hopefully after that we can get an okay to test out some visitors again. 

Brian also had an MRI this afternoon on his right shoulder. In the accident he broke his left humorous (upper arm long bone), his left scapula (shoulder blade) and also his sternum (bone in the center of his chest). He had a significant surgery on his left humorous in order to repair that fracture. What we didn't know until much more recently, when he started moving around more and when he started some PT at the LTAC, is that he also potentially had an injury his right shoulder. He has been extremely tight in both shoulders and he shouldn't have been on the right side from the injuries we knew. He also was not really able to lift his right arm at all on his own but if we helped him his range of motion was pretty decent. It was suggested it could be a rotator cuff tear (which wouldn't have shown up on the X-rays done at Good Samaritan) or it could be neurological since Brian's brain injury is on the left side of his brain which controls the right side of his body. So his doctor at Craig got an MRI ordered in order to determine if it was a neurological issue or a rotator cuff tear in that shoulder. The MRI did show a pretty significant tear in his rotator cuff. While this is not good news necessarily, I am happy it is something that is repairable with surgery. This surgery will be scheduled later on in his recovery because the current top priority is healing his brain past the stage he is currently in (this will alleviate the confusion, anger, and aggression his is currently expressing) and then the shoulder repair is the next priority. 

And finally, to end on the best news of the day, Brian's peg tube is OUT! The GI PA from Swedish came over today to check on Brian's tube and she said it would probably have to wait until Monday, but then she looked at it and it was the type that is an easy removal, so she was able to remove it right away. The whole thing took about 5 minutes and it's now out and it will close up on it's own over the next couple of days! 

🤍