Day 67 Patrick Rocks It!!

To better understand yesterday's enormous leap forward (Wednesday, June 6), let me recap some of Patrick's medical issues.  Patrick is paralyzed because an aneurysm burst in his brain and flooded his brain stem, the most fundamental part of the brain, with blood.  Because the blood escaped the circulatory system and oxygen was not being delivered in a way  his brain cells could accept, that part of his brain was damaged.  When we go to make a purposeful, or voluntary movement, the idea begins in the brain, travels down the spinal cord and spinal nerves to the part of the body we want to move.  If you have had a spinal cord injury and the spinal cord is severed, the desire to move begins in the brain, travels down the spinal cord and nerves, stopping where the cord is broken.  So if your spinal cord is severed at the level of your waist, you can think about moving any part of your body above your waist and your nervous system obliges.  You can think about moving parts of your body below your waist, the signal to move will travel down to the waist and stop.  The rest of the spinal cord cannot receive the signal because it has been severed.

Patrick's injury is the opposite.  His spinal cord and spinal nerves are intact and waiting for the brain to send a signal telling them what to do...walk, talk, write, ride a bike, drive a car.  The signal cannot get past the injured part of the brain and communicate with the spinal cord.  BUT, because the cord wasn't severed, and is waiting to receive a signal, it is possible that Patrick's brain can figure out an alternative route.  By pass the injured part and still communicate with the spinal cord.  Not a given, but possible.

Greg describes it as a kinked hose.  You can turn the water on (initiating a thought to move), but a kink keeps the water from flowing steadily through the hose.  So Patrick's neuro signals start in his brain, but get disrupted when passing through the brain stem.  But because Patrick has shown improvements, like being able to lift his right arm and move his right fingers, we know some signals are making it through or around the injured brain.  Sticking with Greg's analogy, sometimes the kink unkinks and the water can flow through the hose.

Yesterday Patrick was working with Stephanie, a great physical therapist (has her doctorate in physical therapy...who knew?), my triathlon buddy and a blast.  Its a little complicated to explain in detail, but Stephanie would turn Patrick's head to the right.  Patrick then pushes against her hand, resisting her, while at the same time, I have his knee bent with his leg parallel to the floor and he is trying to push against my hand.  HE DID IT!!!!!  He was able to push my hand back with his foot!!!  Getting any movement, much less controlled movement in his leg, has been very difficult.  And then, HE DID IT!!!!

Now, the back story is that Patrick was in a really bad mood for a variety of reasons.  When he is really pissed off, he closes his eyes and refuses to talk (with his eyes).  He also does this when he's bored.  So he was refusing to open his eyes for most of the session until the end when he pushed my hand away and was able to repeat it several times.  Stephanie and I went nuts!  Yelling, clapping, just generally going crazy.  Patrick was not able to maintain and we got him to break the silent treatment.  He was smiling and laughing and it was an absolutely fantastic day!!!

He's had a rough couple of weeks.  He's started summer school without much of a break.  He's frustrated that his trach isn't coming out as quickly as he would like.  His friends are home from school and I know he would love to be hanging with them and getting into trouble.  A friend of his died last Friday from a head injury due to fall while drinking.  The wake was Tuesday afternoon and the last thing Patrick wanted was his nurse accompanying him to the wake and funeral.  Just one more indication of being different.  I promised to wear a bag over my head and only communicate with him and his friend Luke with eye contact and hand signals while committing  to walking at least six feet behind them.  I also explained to Patrick that though I was willing to remain as unobtrusive as possible, that is a very difficult demand for a woman of my size and beauty.  He laughed.

Another amazing milestone and effort from Pat.  Over a year and a half in the making.  I can, at the very least, finish the triathlon.