Greg's recovery is coming along quite nicely. Though he only had two days of outpatient therapy this past week (he's supposed to have three - see previous post about billing and insurance snafu), we did get some good news. He was scheduled to have three hours of rehab each day, split up between physical therapy, occupational therapy and speech therapy. However, after meeting with the doctors, it was decided that Greg will not benefit from physical therapy because he has already regained functional movement and control of the functions affected by the brain injury.
This is great news, but really only means that Greg's gross motor function is pretty good. Think of the difference between simply being able to move your arm on command (physical therapy) and being able to manipulate a doorknob (occupational therapy). For more info on the differences between physical therapy and occupational therapy, see these links: physical therapy overview, occupational therapy overview.
Regardless, while Greg still has a way to go with his recovery, it's great to know that he's progressing nicely. He'll continue OT and speech for the foreseeable future. He's also having a CAT scan this upcoming Thursday with a follow up meeting with the neurosurgeon, which should give us more information on how his brain is recovering.
Greg's speech has continued to improve and he's been traveling out of the house for lunch and such. It's somewhat surreal to think that only three and a half weeks ago we were simply hoping he'd make it through the surgery, and now he's home and amazing everyone with his recovery.
As we all know, Jessie is due in three days (never a dull moment with the Rippers). She is super-pregnant and rather eager to be done lugging around her child (at least internally). We'll certainly update the blog when she goes into labor and provide all the pertinent details as they come.
Jess and Greg are honored and humbled by all the support people have been giving them, so thank you all!
Sunday, February 15, 2009
Sunday, February 8, 2009
Holding Pattern
In the complicated world of of medical financing, snafus seem to be the norm as opposed to the exception. I don't know anyone who hasn't spent time on the phone with an insurance company after receiving a bill that they thought was supposed to be covered. Most of the time, the insurance company agrees to pay because the service was incorrectly reported by the hospital or some other minor mistake.
Which is essentially where we are right now. Some sort of reporting problem between insurance/worker's compensation and UPMC has delayed the start of Greg's continued outpatient rehabilitation until sometime this week, most likely Tuesday. So, real information has been short lately.
We have been encouraged by Greg's return home. He is getting around the house pretty well, and he's been talking to visitors and on the phone. His right hand is clearly the furthest from pre-accident normalcy, but it is still considerably better than it was right after the surgery.
Not being back in rehab is getting rather frustrating. In addition to not knowing where Greg is in the recovery process, there's not any specified home rehab that has been given (since he was in inpatient rehabilitation the last time he was in therapy, with the expectation that he'd be back in rehab sooner than this week). With so many unknowns about the window of opportunity for Greg's brain to relearn or rewire some of the functionality he's having trouble with, this lapse in therapy is putting everyone a bit on edge. He has been working on some of the things he was shown during his inpatient stint, so this past week or so hasn't been a total writeoff.
However, we're sure that once Greg gets back into rehab the doctors will show him both how to get results at home, as well as setting some of Greg's near-term recovery goals. While it has been frustrating to be without rehabilitation, the simple fact that it's been less than three weeks since Greg's shocking accident and he's already home is keeping everyone optimistic.
Thanks for your continued support. Greg is getting your messages, so continue leaving comments!
Which is essentially where we are right now. Some sort of reporting problem between insurance/worker's compensation and UPMC has delayed the start of Greg's continued outpatient rehabilitation until sometime this week, most likely Tuesday. So, real information has been short lately.
We have been encouraged by Greg's return home. He is getting around the house pretty well, and he's been talking to visitors and on the phone. His right hand is clearly the furthest from pre-accident normalcy, but it is still considerably better than it was right after the surgery.
Not being back in rehab is getting rather frustrating. In addition to not knowing where Greg is in the recovery process, there's not any specified home rehab that has been given (since he was in inpatient rehabilitation the last time he was in therapy, with the expectation that he'd be back in rehab sooner than this week). With so many unknowns about the window of opportunity for Greg's brain to relearn or rewire some of the functionality he's having trouble with, this lapse in therapy is putting everyone a bit on edge. He has been working on some of the things he was shown during his inpatient stint, so this past week or so hasn't been a total writeoff.
However, we're sure that once Greg gets back into rehab the doctors will show him both how to get results at home, as well as setting some of Greg's near-term recovery goals. While it has been frustrating to be without rehabilitation, the simple fact that it's been less than three weeks since Greg's shocking accident and he's already home is keeping everyone optimistic.
Thanks for your continued support. Greg is getting your messages, so continue leaving comments!
Wednesday, February 4, 2009
Greg @ Home
Just a quick update to let everyone know that Greg has been discharged and is now resting at home. He's still going to be in therapy three days a week, but he's medically sound. One great thing about being at home in terms of his recovery is that he'll be rehabbing constantly just by doing things we all do every day. He's also still on a significant amount of medication. Greg is on 8 (by Jessie's count) medications relating to things ranging from pain management to anti-seizure.
Medications are a good example of the new challenges being home brings. When Greg was at UPMC Southside, trained professionals were around to make sure he received meds on a specific timetable. Now that he's home, the burden is on Greg and Jess to make sure he's taking everything and isn't accidentally skipping doses or taking too much medication.
Of course, the flip side of being home is that, at UPMC Southside, Greg's main function of the day was rehab, with a lot of downtime. At home, he's constantly learning and testing his limits in conversation, walking stairs, using his right hand doing the things he has to do every day, etc.
Greg will be continuing formal rehabilitation three days a week. We're not quite sure of the schedule yet, but we're confident that he'll continue to improve with outpatient rehab and everything he's doing on a daily basis at home.
Sorry for the brevity. Bigger update when the Rippers have had a chance to acclimate. (not quite as brief now)
Medications are a good example of the new challenges being home brings. When Greg was at UPMC Southside, trained professionals were around to make sure he received meds on a specific timetable. Now that he's home, the burden is on Greg and Jess to make sure he's taking everything and isn't accidentally skipping doses or taking too much medication.
Of course, the flip side of being home is that, at UPMC Southside, Greg's main function of the day was rehab, with a lot of downtime. At home, he's constantly learning and testing his limits in conversation, walking stairs, using his right hand doing the things he has to do every day, etc.
Greg will be continuing formal rehabilitation three days a week. We're not quite sure of the schedule yet, but we're confident that he'll continue to improve with outpatient rehab and everything he's doing on a daily basis at home.
Tuesday, February 3, 2009
Gratitude
Hi Everyone,
I just wanted to thank all of you who have shown so much love and support throughout this ordeal. It is greatly appreciated. I especially want to thank RJ for running this blog and keeping everyone up to date and informed. We are so lucky that Greg is alive and doing so very well with his recovery. More and more each day I see my "old Greg" and although we still have a long way to go, I know that he will continue to improve because he is extremely motivated and strong. He also wants me to thank everyone who has shown concern. He is very moved by your caring and it's nice to know we have so many great friends. He will be home tomorrow and maybe I will be able to convince him to post something soon! Until then, the master of information giving (RJ) will keep everyone in the loop.
Again, we feel an overabundance of gratitude towards all of you.
Love,
Jessie
I just wanted to thank all of you who have shown so much love and support throughout this ordeal. It is greatly appreciated. I especially want to thank RJ for running this blog and keeping everyone up to date and informed. We are so lucky that Greg is alive and doing so very well with his recovery. More and more each day I see my "old Greg" and although we still have a long way to go, I know that he will continue to improve because he is extremely motivated and strong. He also wants me to thank everyone who has shown concern. He is very moved by your caring and it's nice to know we have so many great friends. He will be home tomorrow and maybe I will be able to convince him to post something soon! Until then, the master of information giving (RJ) will keep everyone in the loop.
Again, we feel an overabundance of gratitude towards all of you.
Love,
Jessie
Monday, February 2, 2009
Homeward Bound
Exciting news - the doctors at UPMC Southside have decided that Greg is medically ready to come back home on Wednesday, February 4. Before we get too far ahead of ourselves, this doesn't mean that he's completely recovered (he's most certainly not), but he is doing well enough that he won't endanger himself or Jess (or the as-yet unborn baby). As you can imagine, this is great news, and everyone is really excited to get Greg back home.
Therapy will continue three days a week for three hours per day on an outpatient basis. In addition to guided rehabilitation, Greg will be increasing his ability to speak and use his right arm by doing things that he does every day, instead of simulating exercises (though he'll do those during outpatient rehab).
Greg's talking has come along beautifully. He's speaking in full sentences, though his enunciation is not perfect, he stutters on some words and has trouble with others. Greg is aware of these problems, which is both frustrating to watch as well as encouraging. The progress of his speech is one of the most amazing things about his injury: the way the brain can rebound after trauma is astounding. It's also a reminder of how lucky Greg has been, as plenty of TBI patients never regain speech to nearly the extent he has (and still improving!).
Greg's right arm is the main point of concern right now. The strength is improving, but his right hand is still clearly weak. For example, he can lift a styrofoam cup, but bringing it to his lips is next to impossible. He's using large-handled utensils in therapy, and is able to control them but again has difficulty with the strength and control of bringing them to his mouth. The right arm will obviously be a major concentration of his continued therapy.
As Greg comes home, we're hoping he'll be able to make some updates to this blog. Jessie will also make a guest appearance shortly, and we're going to try to get some recovery photos and videos up as well (home being a much more conducive environment to photography than a hospital).
In the meantime, by popular demand, the following is a photograph of Greg's head. While undated, it was taken after he moved to UPMC Southside. As you can see, the surgical scar is quite long on the left side of his head, and the extra stitch to the upper right of the photo is from the drainage tube that stayed in Greg's skull following surgery. And, as so many images and moments since January 21 have, this photo reminds us of how lucky we are that Greg is in a position to recover.
Therapy will continue three days a week for three hours per day on an outpatient basis. In addition to guided rehabilitation, Greg will be increasing his ability to speak and use his right arm by doing things that he does every day, instead of simulating exercises (though he'll do those during outpatient rehab).
Greg's talking has come along beautifully. He's speaking in full sentences, though his enunciation is not perfect, he stutters on some words and has trouble with others. Greg is aware of these problems, which is both frustrating to watch as well as encouraging. The progress of his speech is one of the most amazing things about his injury: the way the brain can rebound after trauma is astounding. It's also a reminder of how lucky Greg has been, as plenty of TBI patients never regain speech to nearly the extent he has (and still improving!).
Greg's right arm is the main point of concern right now. The strength is improving, but his right hand is still clearly weak. For example, he can lift a styrofoam cup, but bringing it to his lips is next to impossible. He's using large-handled utensils in therapy, and is able to control them but again has difficulty with the strength and control of bringing them to his mouth. The right arm will obviously be a major concentration of his continued therapy.
As Greg comes home, we're hoping he'll be able to make some updates to this blog. Jessie will also make a guest appearance shortly, and we're going to try to get some recovery photos and videos up as well (home being a much more conducive environment to photography than a hospital).
In the meantime, by popular demand, the following is a photograph of Greg's head. While undated, it was taken after he moved to UPMC Southside. As you can see, the surgical scar is quite long on the left side of his head, and the extra stitch to the upper right of the photo is from the drainage tube that stayed in Greg's skull following surgery. And, as so many images and moments since January 21 have, this photo reminds us of how lucky we are that Greg is in a position to recover.
Saturday, January 31, 2009
The Tyrrany of Distance
I know a lot of us are pulling for Greg, and it's amazing how many people are part of his life, something we've had the privilege of finding out through this unfortunate circumstance. It's additionally frustrating for those of us who know and love Greg but can't be in Pittsburgh right now.
If you're one of the many who fall into that category (like me), then you're probably finding the biggest frustration with not knowing exactly what's going on, and what Greg and Jess need or could be comforted by. This blog is probably the best way to stay on top of info that comes out, especially since Jess is tough to reach right now, being almost 9 months pregnant and spending most of her time at UPMC Southside. I'm sure she'll be more accessible as Greg continues to improve, but know that she is very appreciative of all the support that so many have sent by email, text, letter, phone, etc.
I would be remiss if I didn't mention that one of the best ways to support the Rippers right now, especially if you're not in Pittsburgh, is to use the Donate link in the left bar of this blog. There are plenty of things we just don't know about what is going to happen with future medical costs, lost income and the baby, not to mention Greg's total recovery (which he's doing great with so far, by the by).
If you'd like to send something to Jess and Greg, please use their home mailing address at:
954 Norwich Avenue
Pittsburgh, PA 15226
We're asking everyone not to send anything to the hospital for a few reasons: first, it can get rather hectic there; second, it's easier to keep track of everything at home (Jess also particularly thanks those of you that have helped with house and dog sitting lately); and finally, Greg's doctors are beginning to talk about discharge dates (more on this in another post).
Anyway, even if you're not physically present for Greg's recovery, know that you are having an impact. Please leave comments on the blog to let Greg's family know that you're keeping him in your thoughts, and let me know if there's something you'd like to see here.
The title of this post is the title of a Ted Leo and the Pharmacists album that Jessie and Greg (maybe more Jessie) enjoy, in case you were wondering.
If you're one of the many who fall into that category (like me), then you're probably finding the biggest frustration with not knowing exactly what's going on, and what Greg and Jess need or could be comforted by. This blog is probably the best way to stay on top of info that comes out, especially since Jess is tough to reach right now, being almost 9 months pregnant and spending most of her time at UPMC Southside. I'm sure she'll be more accessible as Greg continues to improve, but know that she is very appreciative of all the support that so many have sent by email, text, letter, phone, etc.
I would be remiss if I didn't mention that one of the best ways to support the Rippers right now, especially if you're not in Pittsburgh, is to use the Donate link in the left bar of this blog. There are plenty of things we just don't know about what is going to happen with future medical costs, lost income and the baby, not to mention Greg's total recovery (which he's doing great with so far, by the by).
If you'd like to send something to Jess and Greg, please use their home mailing address at:
954 Norwich Avenue
Pittsburgh, PA 15226
We're asking everyone not to send anything to the hospital for a few reasons: first, it can get rather hectic there; second, it's easier to keep track of everything at home (Jess also particularly thanks those of you that have helped with house and dog sitting lately); and finally, Greg's doctors are beginning to talk about discharge dates (more on this in another post).
Anyway, even if you're not physically present for Greg's recovery, know that you are having an impact. Please leave comments on the blog to let Greg's family know that you're keeping him in your thoughts, and let me know if there's something you'd like to see here.
The title of this post is the title of a Ted Leo and the Pharmacists album that Jessie and Greg (maybe more Jessie) enjoy, in case you were wondering.
Thursday, January 29, 2009
Baby Steps
It looks like we're reaching a compromise with Greg's doctors and nurses regarding his pain medication. Today it seemed like he was managing his pain much better, though it's definitely ongoing. That's to be expected just over one week from a horrific accident, but knowing that doesn't make it easier.
It's becoming clearer that progress with a TBI patient is very incremental. We'd all love to see Greg up and running around and doing the things he enjoys, but that's going to be a while from now. Today, Greg was able to walk from his bed to the bathroom and back without calling the nurse for assistance. He is still able to curl the fingers on his right hand, which is a great sign, and it looks like his right arm is getting a bit stronger. We're still not sure how that is going to progress, but the fact that he's moving it voluntarily at all is wonderful.
It's difficult to figure out what Greg's future is going to look like. Right now, if he didn't improve at all, we'd still be thankful that he's alive, but even as he continues to progress it's likely that there will be a ceiling somewhere, and that may not be a "full recovery." TBI prognosis is hard to figure for an individual patient - some never even wake up, some you'd never know had been in the hospital, and everything in between. We're hoping that Greg keeps making little bits of progress while at UPMC Southside and later during outpatient therapy.
It's becoming clearer that progress with a TBI patient is very incremental. We'd all love to see Greg up and running around and doing the things he enjoys, but that's going to be a while from now. Today, Greg was able to walk from his bed to the bathroom and back without calling the nurse for assistance. He is still able to curl the fingers on his right hand, which is a great sign, and it looks like his right arm is getting a bit stronger. We're still not sure how that is going to progress, but the fact that he's moving it voluntarily at all is wonderful.
It's difficult to figure out what Greg's future is going to look like. Right now, if he didn't improve at all, we'd still be thankful that he's alive, but even as he continues to progress it's likely that there will be a ceiling somewhere, and that may not be a "full recovery." TBI prognosis is hard to figure for an individual patient - some never even wake up, some you'd never know had been in the hospital, and everything in between. We're hoping that Greg keeps making little bits of progress while at UPMC Southside and later during outpatient therapy.
Pain and Progress
Greg has started the therapy process, and we're really hopeful that the doctors and nurses at UPMC Southside will be able to help him with our major concerns right now: recover his speech, be able to use his right hand, and walk. We've already seen great progress with his walking, though anything more than a short distance is laborious. He is able to communicate, but he has issues with a lot of words and things like letter order. We're hoping to get some more concrete answers about how his speech works as therapy continues.
Part of today's therapy involved shocking his right arm. Not exactly sure how that works, but the end result is that, for the first time since the accident last Wednesday, he is able to flex his fingers on his right hand, albeit only with great effort.
One of the most frustrating parts of this part of Greg's recovery is the level of pain he's feeling. As directed by his doctors, his pain medication has been lowered significantly. It's amazing to think that one week ago today he had a breathing tube in and was sedated, waiting for brain surgery, but there is a lot of pain associated with head trauma and surgery. We want to make sure that Greg is able to concentrate and focus on recovering, which is hard enough by itself, but is next to impossible if he's in constant pain, so we hope the staff at UPMC Southside can find a balance.
It is really hard to see Greg in pain.
Part of today's therapy involved shocking his right arm. Not exactly sure how that works, but the end result is that, for the first time since the accident last Wednesday, he is able to flex his fingers on his right hand, albeit only with great effort.
One of the most frustrating parts of this part of Greg's recovery is the level of pain he's feeling. As directed by his doctors, his pain medication has been lowered significantly. It's amazing to think that one week ago today he had a breathing tube in and was sedated, waiting for brain surgery, but there is a lot of pain associated with head trauma and surgery. We want to make sure that Greg is able to concentrate and focus on recovering, which is hard enough by itself, but is next to impossible if he's in constant pain, so we hope the staff at UPMC Southside can find a balance.
It is really hard to see Greg in pain.
UPMC Southside
Greg has been transferred to UPMC Southside, where he will be in inpatient therapy and rehabilitation until he is able to come home. He is starting to talk better and even stringing a couple words together, but plenty of words still aren't coming out yet. He is walking with limited assistance, but we still haven't seen much progress with his right hand - he can't move his fingers, though he can feel some pain and temperature change.
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