Today was our family meeting where we discussed the current plan of care for Ray. His care team consists of a primary physician, a resident doctor, nurse practitioner, neuropsychologists, psychologist, physical therapists, speech therapists, case management, the nurse team, vocational rehab, recreational rehab, and a family therapist. We all met to go over our questions and go over Ray’s current assessment and expected recovery. Ray has made small but notable progress in all areas, and is expected to continue on a positive recovery path. There can be no way of knowing at this point how long his recovery will take or what his exact impairments will be. It is anticipated that Ray will remain at the facility in Tampa for another three months. This is a flexible time frame because no one can predict what Ray will need three months from now. Tampa VA will keep Ray in their care until he is ready to be discharged. This will not happen until he has reached his maximum recovery level. The team meets weekly one on one to discuss Ray’s progress and make any necessary adjustments to his current therapies.
From the team’s update, Ray continues to be assessed as a level IV on the Rancho scale-sometimes appearing as if in level V. He exhibits agitation sporadically and will ask you to leave (politely if you are lucky) if he becomes over stimulated. Ray is in what is called the post traumatic amnesia (PTA) stage. This means that he will not remember much of this part of his healing journey. He is in a state of confusion. He cannot recall the date, place or time yet. Because of this state of confusion or “fog”, introducing too many new faces and stimuli can easily overwork his brain. Ray is beginning to become aware that he does not have all the correct answers to the questions being asked of him. This leads to bouts of extreme agitation which halts any kind of therapy. The team is trained on this type of behavior and have protocols in dealing with this temporary symptom.
Phone calls are not recommended by the medical staff at this point since Ray will not remember the conversation, and it will be confusing for him to comprehend the person on the phone is someone he knows. For this same reason, visitation will be limited to only family and close friends (bffs), and on weekends only. Ray has therapies scheduled M – F from 8 – 4 which exhaust all of his mental and physical energy at this time. He will need the benefit of rest to properly recover before the next round. Each time Ray sees someone he has to remember who they are; too many new faces within a short period of time is too overwhelming. He has many new faces at his therapies that we want him to learn and be able to trust and cooperate with for maximum recovery. A great way to keep in contact with Ray is to send him a card. Including your photo with your name on the back could also be a good way to keep in touch if you were close with Ray. Photos of pretty skies and things he would like are also great things for him.
Ray remains on a feeding tube as he is still unable to swallow. When asked by the speech therapist, he can follow commands but he forgets or tires easily. They continue to work with him and monitor his progress and ability. We found out at the care meeting that Ray did suffer from brain shearing. His head injury was very severe with different parts affected. The longer the PTA phase, the higher chance of reduced return to full recovery. It is likely Ray will have cognitive impairments for the remainder of his life. The specifics to those impairments will remain unknown until further into his recovery. We will continue to provide updates, either once a month or as new big achievements occur-such as swallowing.
As always, we would like to thank everyone for their prayers, positive energy, and donations for Ray’s recovery. He continues to need your support on his road to recovery.