Day 211 – Grayson’s Journey

Dear family and friends

Grayson was tired today when he returned from the clinic. He slept on the bus and then rested his customary 30 minutes after returning to the residence. When rest time was over, he chose to do his therapeutic home program (THP) from his picture checklist. Today he worked on the proper steps to do a task. He is given 4 steps and he needs to put them in order (Hotel Stay – Make reservation; check in at front desk; get key; move in to room). He did 10 of the 20 questions before becoming frustrated and tired and putting his head down.

Grayson's residential assistant (RA) then had him start to help with dinner prep. During the preparation, Grayson spotted some cookies, and started to try and open the package. I suspect that the cookies were not Grayson's because his roommate said something about it. Grayson took a swing at him, and the RA's kept the two of them apart. Grayson was guided to the recliner in the living room, and was handed the comics. Five minutes later, it was if nothing had happened. He had dinner, took out the trash, cleaned the bathroom and got ready for bed. When I spoke with him tonight, he didn't remember a thing.

I am SO ready for this to pass. These young men are coping with brain injury and neither have socially appropriate responses to frustration and anger. Fortunately, the staff does a wonderful job of keeping the peace and helping each grow to their capacity. While we are frustrated, we are grateful for the caring attitude and helpfulness of the staff. The Lord led us here for a reason. I suspect that He knew that this was the road that we would have to travel and wanted us in the right place.

Pax!

Brant

Day 210 – Grayson’s Journey

Dear family and friends

Today was not a good day for Grayson. For some reason, Grayson was in the grip of the grumpies. The day started to go sour when he responded by hitting another patient in response to an inappropriate comment. The day just didn't get any better, and several other incidents of negative behavior occurred as the day continued. Finally, he went to bed at 7:30, and listened to his audio book, The Hobbit until he went to sleep a few hours later.

Why the sudden increase of aggressive behavior? We have no idea. In looking for the positive side, perhaps this is good news. In the past, if he had negative behavior, he would sit out and cool down for a few minutes, then it would be forgotten – literally forgotten, as Grayson's short term memory is just awful. Today the feelings, emotion or something did not go away. He was upset for hours. Perhaps the brain is again showing its healing side and we should rejoice, but these incidents are just a bit tough to take.

So tomorrow is another day. The sun will come up. Let us pray that Grayson will find another way to express his feelings.

Pax!

Brant

Day 209 – Grayson’s Journey

Dear family and friends

Today it was only 90 in Bakersfield – positively balmy! We enjoyed our day with Grayson. We had a treat at Cold Stone, though I starting to worry that our attempts at putting more weight on Grayson is only adding pounds to me! We had a leisurely early afternoon shopping, including the acquisition of a new pair of sunglasses for Grayson. Later we returned to the residence for an hour or so of pool and cool time.
Regina played with Grayson in and around the pool. They tossed a ball, threw a Frisbee, splashed in the water and worked on swimming. Grayson still has some deficits on the right side that we noted, as he was unable to catch the ball right handed, but he was with his left.

Grayson seemed very low energy and subdued all day and he was rather non-verbal. He also had several times where he got "stuck", unable to do things he has the capacity and the desire to do, but unable to start. He was like that getting out of the car, getting into the pool, and getting dressed.

This evening, Grayson attended a play at a local theater. So we said our farewells, and hugged him good bye as he boarded the bus for the play. It was a nice visit, and a beautiful day to spend outdoors!

Pax!

Brant

Day 208 – Grayson’s Journey

Dear family and friends

It's Friday night – Movie night!

Grayson arrived back from the clinic this afternoon and he was happy and helpful. He uncharacteristically picked up the cleaning wipes and headed into the bathroom to clean it, without being asked. His roommate was watching TV, but when Grayson was prompted to take out the trash, he jumped up to do it. (Grayson ignoring the TV is a huge shock!) He actively helped to prepare his dinner and was happy to be getting ready for the movies. During the bus ride to the theater, he was playing games with the activities coordinator. While in line waiting to go in to the theatre, he was smiling and happy.

Then behavior problems set in, as he had an altercation first with another patient, then the residential assistants (RA) as they tried to control the situation. Grayson got to take a bus back to the residence without seeing the movie, and got an early opportunity to turn in. Well, late for Grayson, but still earlier than he would have otherwise.

Why the behavior? Who knows? Sometimes he is triggered by outside events or stimulus, sometimes by internal issues. One more brain injury challenge we will have to learn to live and cope with.

Pax!

Brant

Day 207 – Grayson’s Journey

Dear family and friends

Grayson had a good day today. He did his therapeutic home program (THP) on the back patio of his apartment while his chicken was baking for dinner. After dinner and clean-up, he picked up the mail. Today he received a letter from a friend that included pictures. This always makes Grayson's day! He put them back in his apartment then went for a walk around the nearby park with his residential assistant (RA). After the walk he got ready for bed, then lay down and listened to The Hobbit, one of his audio books, before slowly drifting off to sleep.

Continuing my debrief on yesterday's patient conference, I'll talk about occupational therapy this evening. Grayson's grip and pinch strength is assumed to be about a 4 on a scale of 1 to 5. The "assumed" part is that it is difficult to measure due to a lack of compliance with the test. He continues to get stuck in the beginning of multi-step activities, even though he has the ability and the desire to complete them.

Grayson is spending a lot of time in the kitchen, as this is such a necessary part of living. He is very curious with the stove, and keeps everyone on their toes for fear that he will burn himself. His short term memory is so bad, that each day he has to relearn where the pots are stored, and after the dishes are done an hour later, he needs to learn it again to put them away.

Grayson has the entire staff laughing at some of the interesting things that he says when refusing to do tasks. Typically his responses have a historical base ("FDR wound have done it that way" or "I won't do that with my arm - it looks too much like a salute to Hitler!") Compared to many of the patients, Grayson is very well read. Actually, Grayson is very well read compared to most people (thanks, teachers)! The worst punishment we could give him and his brother when they were little was to take their reading time away before bed.

Grayson's sense of taste and smell are significantly altered, but not gone as feared earlier. Through smell, he is able to accurately identify pepper, lilac and cinnamon, but he is unable to smell smoke. His taste is pretty significantly impaired, as he is only able to identify salt.

To keep Grayson motivated, the staff has developed a reward system for him. His reward of choice is almost always a few minutes of computer time. He is not able to do much more than watch as the keyboard is too much for him, but this has been a breakthrough motivator for him. For the last 5 minutes of his hour-long session, he gets a reward if he focuses and completes the goals that he helps set at the beginning of the session. Good stuff!

Grayson's functional problem solving is ok, but not great. His initial responses are good, but the follow on actions are not. For example, when asked what he would do if the house was on fire, his initial response was, "Call 9-1-1". Good. Then what? "I don't know." Would he be able to understand the danger and get himself out of the house? We don't know for sure, but that is why Grayson is expected to require supervision during waking hours for quite a while – measured in years.

More tomorrow!

Pax!

Brant

Day 206 – Grayson’s Journey

Dear family and friends

Today Regina and I participated in a two hour patient conference with the Centre for Neuro Skills. All of the therapies were represented, and we received an awesome report (as we have come to expect) of the work that they are doing, and the progress Grayson is making. I'll do my best to boil it down over the next few days so you can get a glimpse with us into the work that Grayson does at the clinic.

We always get an education whenever we have these conferences. One of the things that we learned today was how anoxia (lack of oxygen) affects the brain. The deep structures of the brain are affected first. This includes areas like new memory, and some very basic functions that can affect continence, and the ability to carry out a task, even though the desire and the capability is present (apraxia).

From speech therapy, Grayson improved this month. He has required increasing less cueing at sorting tasks. He can become overwhelmed, but he does understand instructions. For example, if given instructions to sort cards into suits, then handed a deck of cards, he becomes overwhelmed, and throws the cards on the table. If, however, he is handed the cards one at a time, he will sort the entire deck. Grayson's best days are described as: capable of standing up when asked, walking where instructed, and needing prompts and cues to accomplish tasks. His worst days require hand-over-hand help, and are marked with Grayson exiting the area to avoid work or striking out at those prompting the work.

In the residential program, Grayson's independent living score (ILS) is improved, but still well below that which is needed for most residential situations. His incidence of problem behavior is reduced, and his full cooperation has increased to 51% of the time.

I'll try and share more tomorrow. As said previously, this is a journey of miles where progress is measured in inches. Fortunately we are not alone on this journey.

Pax!

Brant

Day 205 – Grayson’s Journey

Dear family and friends,

The Los Angeles Lakers won tonight.

The Los Angeles Dodgers won tonight.

Several candidates are winning nominations tonight.

Grayson sang karaoke tonight and had a great time.

It's all about perspective.

Grace and peace,

Regina