Ray has started to get into a steady rhythm with his outpatient therapies at Brooks. His schedule has remained the same over the past few weeks. Progress in PT, OT, and ST are being assessed at about the same level since moving to outpatient. Ray has even been able to enjoy some extra therapy at the local YMCA to supplement what the VA provides. Medically his mobility is still impaired and he requires the use of a walker for short distances and a wheelchair for longer durations. Progress has been made in his ability to traverse certain obstacles and his speed in doing so has also increased slightly. Posture and balance are still shaky due to elevated and prolonged Holmesian tremors. As a result his ability to read, write, or operate most devices has remained extremely limited. For most tasks involving precision, such as eating or using an i-device, assistance is required. Ray no longer has a feeding tube and currently has no restrictions on diet. The only precaution with food and drink are for him to go slow with thinner liquids. There are also no restrictions on interactions with Ray or involving him in community activities. His level of participation in activities may vary but he has done will with several outings, friends visiting, and weekly bike rides through the neighborhood.
Given Ray’s current limitations there are many activities that may not be suitable or possible for him at this time. The current focus of his plan of care is to address the tremors with new medicine, as there has been no significant change with this in the past four months. A recent consult with a neurologist in Gainesville earlier this month has addressed the need for a change which has been promising news to Ray and the family. As he transitions to the new medicine there should be noticeable changes with the tremors which will allow for him to better engage in therapies and daily activities. Ray will need to be observed on a regular basis by the care team in order to properly assess if the change is working as intended. We will be taking short videos of him doing basic tasks and sending them to the care team for review. Friends visiting Ray can also feel free to video him during this time to help with the evaluation process. Since scheduling with the neurologist is through the VA in Gainesville, Ray may not be able to meet with the physician more than once a month. The videos will help to provide a means for assessment by the doctor in between visits. It is unclear at this point how long the evaluation period will last or what exactly will be involved. Once we know more, there will be another update with a link to the short video clips for review (FB group). We see the change in the plan as a good sign that Ray will be able to gain a better grasp on conquering his limitations.
Today marks ten months post-accident. Ray has been home since early January and has progressed from the VA Home Healthcare into the VA-provided outpatient care. As most are aware there is a limit on what the VA will provide for outpatient therapy. The exact length and extent to what they will provide remains to be seen. It may be possible to continue Ray with the same rehab schedule at Brooks using donation funds once the VA piece has been exhausted, but this will surely not last long and will leave him with no financial reserve for emergencies. As Ray continues to go through his recovery, the VA will be assessing him for potential long-term disabilities. It is still too early to be certain on what the “end-state” will be. Considerations for planning will need to be done by the VA and family on what long-term options should be considered should he need constant care beyond one year. As Ray continues to become more self-aware of his situation he will need the positive and encouraging support from family and friends to help keep him from depression. He has been attempting to cope with his new limitations that appear crippling and impossible to overcome. At times his thoughts can become very dark and he struggles to free himself from the negative feelings. It has been an ongoing effort to provide Ray with the needed support to include therapy and medicine in order to assist him through this phase. Please continue to help lift up Ray and keep him going strong on his road of recovery.