This blog is becoming a bit of a (somewhat frightening) mind meld. Sigrid - you are not the first person to suggest that this blog with the addition of Emily's recollections could be great help to others. I promise we'll pursue it.

Brendan & Shiloh - I just suggested to Em's speech therapist today that bringing in her laptop might be a great way for her communicate. Ken backed up her hard drive just this morning and I plan to pursue this idea over the weekend.

On to today. The swallow test showed that she's not swallowing fast enough for thin liquids. Em's ST thinks this explains the cough. I can't imagine she has any idea how heartbreaking this news is to Ken and me because having her water bottle and taking drinks as she wanted was the only little bit of independence Em has at this stage. It's a stupid, little thing and of course we want to protect her lungs, but it's still hard.

On the positive side - the swallow test showed no issues with chewing and swallowing. So, hopefully, Em will be moving on to a soft-solid diet soon. Hopefully, that is not the "all potatoe all the time diet."

Em's appetite changed significantly Monday afternoon - after a week of trying to get her to eat as much as possible, on Monday evening she went to ravenous. The Craig dietician said she'd never seen anyone wolf down a pureed meal like Em today. The poor thing is starving. She eats every bite of every meal plus snacks. She eats every bite of the unidentifiable vegetable! We increased the size of her entree (protein) serving tonight, so hopefully that helps. Emily has lost over 30 pounds since the accident. Today I had an opportunity(?) to really look at her legs without pants on - my God, those incredibly beautiful, strong legs are sticks. You can literally see her knee joint.

On a more positive note, Em's catheter went away today. We were hoping that the G-tube would go by the end of the week, but the swallow test results on thin liquids mean it will stay for the foreseeable future to ensure she gets enough fluids. Most important, Em made the move from her chair to the mat table with a slide board today instead of the lift and sling. Not only is this a huge accomplishment for Em, but it means that she gets more actual therapy time because the move is quicker.

Finally, for our friends at St. A's - Dr. Yarnell charmed Emily into blowing him a kiss this afternoon. When it happened I told him I was going to post it on her blog and that ALL of the St. A's nurses would know. It was really very sweet. And afterwards, he gave me a hug instead of just responding (tolerating?) my hugging him.

Emily continues to touch people - she can't speak and there's no way for any of them to know her the way we do, but somehow they do. Somehow her spirit transcends this injury and I have to believe that's a sign.

After not seeing her for 3 days, Emily's PT and OT were really pleased with how much better she was holding her head and her trunk up today. Her right leg has relaxed so much that the PT was able to get her ankle almost completely flexed with just her hand - something that took me a couple of minutes with my full (considerable) body weight to do just last week.

In Speech Therapy we're having a hard time landing on a consistent way for Em to say yes and no. For everyday questions - are you hungry? do you want to eat in the dining room? would you like to lie down? - thumbs up works really well. I think her speech therapist is having trouble with it when she's doing word recognition/cognitive things. It's frustrating right now for everybody - probably Emily more than anyone.

In Rec Therapy today Emily started a pressed flower candle. She and I will finish it up during her free time this weekend, but it's going to be really pretty when it's finished. We need to pick our Rec Therapy outings for June by this Friday. Unfortunately, Em isn't eligible for the ones she'd really like to try - big thumbs up for hot air balloon and discover scuba. We'll probably start with a few trips to the park.

Emily has her swallow test tomorrow which will determine if she's having difficulty keeping thin liquids, like water, out of her airway. Once those results are in hopefully we can move on from the pureed diet. She wants to feed herself so bad, but the runny, pureed food just makes that so much more difficult. In addition to the kind of soupy foods, her appetite just took off yesterday and she's so hungry by meal time (even with snacks) that she tries to eat too fast and spills even more. I need to meet with the dietician tomorrow and try to get her a larger serving of protein with each meal. If the swallow test results are good, we might also be able to try and have her swallow pills, so the last reason for the G-tube would go away along with, hopefully, the G-tube.

So I think next year we're all going to do the Bolder Boulder. Hendo wants to run it with Emily next year, and I've decided that's a good goal for Ken and me as well (although given my foot/ankle history I may not run). Maybe we can go to the Kuchenrither's party afterwards and Emily and Dick can compare rehab stories.

Today Emily and I went for a walk with the Rec Therapy staff and some other patients. It was fun but we did learn that Emily's current wheel chair is not suitable for distance. It weighs 83 pounds and pulls to the right - so I got a good workout. After our walk and a little rest, we went to the Memorial Day barbecue - it was really crowded and noisy (and amazingly un-wheel chair friendly), so I'm not sure how much Emily really enjoyed it. She did however seem to enjoy the few bites of watermelon I shared with her out of sight of her nurses.

Emily's control of her left arm keeps getting better and better. The pureed diet makes it tough, but she's really doing a great job of feeding herself. At dinner last night she was not just taking the spoon to her mouth but getting the bites from the bowls. Once during lunch today I couldn't find the spoon, then Hannah pointed out to me that Emily had put it back in the bowl. She's also trying really hard to talk - even Dr. Yarnell noticed it this afternoon. Dr. Yarnell also said again today that he thinks her right eye is going to be just fine, although Dr. Weintraub did mention last week that she'll need some very specific therapy to ensure that her eyes track together. Emily still hasn't beeen able to use her right arm, but her right leg is much looser and she moves it almost every day.

She's had a really annoying cough for the last couple of days. Ken and I think it's her allergies. Her nurse tried a throat spray this afternoon and it seemed to help, but she really didn't like it. Hopefully I can talk them into trying some Claritan tomorrow if it continues.

We're looking forward to getting back into therapy tomorrow. Tonight's shower night and she usually sleeps really well on shower night, so she should be ready to go in the morning.

Weekends are really, really quiet at Craig. Quite a change from the week day pace. Emily didn't sleep well Friday night, so she was pretty out of sorts all day yesterday. We went over to Therapeutic Recreation for fruit smoothies in the afternoon and then spent some time outside in the garden and that seemed to cheer her up. Hendo visited and Emily got to see pictures of little Janie Lynn. Once she'd had a shower last night she was very relaxed and had a very restful night. Ken went to the hospital for breakfast and called to say she looked good today and was even able to demonstrate how well she can eat on her own for her nurse.

We had our first Craig milestone yesterday - Emily moved out of her room in the constant monitorig corridor. This is a very good sign that they don't anticipate her needing one-on-one care.

An interesting thing happened on Friday afternoon that I didn't process until about 5:00 this morning - Dr. Yarnell came to see Emily. When he comes in he has a very set pattern: he says "Hi Emily," asks her to take his hand (which she always does), and then asks her to give him a thumbs up. On Friday, Emily gave him a thumbs up BEFORE he'd finished asking her to (as in, "Emily can you.." and her thumb goes right up). Maybe I'm reading too much into it, but it seems to me that indicates she obviously recognizes him and remembers what he's going to ask her to do. Since short-term memory is often affected by brain injuries, this seems important to me.

We're looking forward to everyone's visits today and tomorrow. Ariel, we know you'll visit when you're able. One question for Brendan: You wrote a poem for Emily right after the accident. I've let a few close friends read it and they all think I should post it on the blog. Do you have any objection?

So we had the big conference with our Craig team today. I think it was mostly good news, but I'm frankly still processing everything I heard. Here's what I think I heard, but I may ask Ken to do a separate post if he remembers anything differently.

Emily's recovery is likely to be the reverse of the typical brain injury - her cognitive functions will likely improve much faster than her physical, and we may see significant strides in the cognitive area as her brain continues to heal. She wasn't able to have her MRI this morning (you'd think she'd watched enough "House" episodes to know she needed to lay absolutely still), so it will need to be done next week with an IV sedative. With her brain injury, the MRI will provide much greater detail than the CT Scan - on the CT you can clearly see the injury in the left hemisphere but you only get hints at the injury on the right side. The MRI will also give the doctors a chance to take a better look at her right shoulder and her left hip, both of which may have been hurt in the fall. Her therapy team agreed that they're already seeing cognitive improvements in her ability to follow instructions. There appears to be a small injury to her speech initiation center - so sometimes she needs neuro cues but once given she does very well. When she does start talking her speech will likely be slurred in the beginning. Her ST had her reading words and picking the associated picture today and, while not consistent yet, she was obviously able to read - she was successful well over 50% of the time. In other areas, she can roll herself to either side if asked, right obviously easier than left, and tonight when she saw the harness for the lift she immediately took it and tried to put it behind her and roll.

Other important points from our conference: we'll probably have a very good idea in 6-9 months what, if any, physical limitations she'll have. One really important point - when we were at St. Anthony's we were told that her extended coma didn't bode well for her ultimate prognosis. Dr. Weintraub completely disagreed. With her type of injury, lots of damage to lots of very deep brain circuitry, longer coma periods are not unusual, so there's no negative implications from the 3-weeks she was in a coma. He also made the point, very early in the conference, that we just don't know if the neurological circuits deep in her left hemisphere were badly damaged or just off-set. In either case, this area of the brain in someone this young can have miraculous recoveries.

We're probably looking at a mid-August discharge from Craig with lots and lots of hard work while we're there and out-patient therapy after she's home. The obvious goal will be for her to be able to return to school in the Fall and we'll spend a lot of time trying to determine what kind of assistance she might need to make that happen. Can any of the DSA folks that follow this blog tell me if there's an elevator at school?

Other developments today: I got my "hall pass," so I'm cleared to take her anywhere on the Craig hospital grounds. That means if you visit this weekend and we're not in her room we may be out on the patio enjoying some rays. There's also some interesting activites scheduled in Therapeutic Recreation this weekend - so from 2-3 on Saturday we're likely to be over on the east side making fruit smoothies and at the same time on Sunday watching horse races (no idea, but it's a change of scenery). Friends are welcome.

By the way, Dad got a kiss goodbye when he left after the conference this morning, and I got another goodbye kiss tonight.

Today Emily's OT focused on daily tasks like getting dressed. She did a great job of working with her OT to get dressed and ready for her day. These were some of the same skills we'd been working on at Kindred, so she'd already washed her face and brushed her teeth - by herself. Her second OT session was in the gym and they worked on sitting up straight using her core and raising her head and holding it up. She did great. The OT also spent some time stretching out her poor right arm and hand.

PT was spent mostly stretching and moving her legs, hips and ankles. Her right ankle is still really tight. The PT told me yesterday that they would be using a standing chair to work more on her ankles because bearing her own weight is the best way to get that right achilles stretched out. One cool thing in PT - Emily gets to run the lift that moves her from her wheel chair to the mat table. I'm sure that gives her a much better sense of control over the whole move process.

In ST the focus was on word recognition - following commands to touch her knee, ear, nose, hair and recognizing pictures based on the word. She's also been working a lot on thumbs up for yes and thumbs down for no. This afternoon her ST had her start making sounds.

Dr. Yarnell visited this afternoon and Emily said "hi." Once again she took his hand and gave him a thumbs up immediately when he asked. She also, finally, stuck out her tongue for (at) him. He's going to discuss reducing or eliminating some of her stimulant drugs with her Craig doc.

We have our conference with Dr. Weintraub tomorrow. It's probably too soon for the therapists to have a clear picture, but this will be his opportunity to tell us what he's seen in the various medical tests that have been done. He stopped by today to tell me not to stress out over this meeting - that it will be a good meeting.

Finally - for those of you who read the whole post - the biggest news of the day. When I was saying goodbye to Emily this afternoon so I could go get Hannah, she gave me a kiss. SHE GAVE ME A KISS!!!!!!! I called Uncle Gary the minute I got in the car and cried all the way to Good Shepherd.

Our first full day at Craig was busy. Emily will have two sessions each day with each of her therapists; each session is 30 minutes. Her schedule was interrupted today by her EEG, but she still got in 2 sessions with OT, 1 and 1/2 session with ST, and spent PT being fitted for her wheel chair. Tomorrow we hope to take advantage of the chair to have meals in the dining area instead of her room. She's been practicing with her spoon and I think she's tired of being in her room.

Em hasn't been as tired as everyone predicted after her transition, which I think is probably a good sign. She had really good sessions with her Occupational Therapists and seemed comfortable getting settled into her chair during Physical Therapy. She also seemed really interested in the other patients during her trip to the gym for PT - I'm sure it helps to know others are having similar issues.

Ken and I are busy getting the necessary training to be able to take Em outside this weekend. So hopefully she'll be accepting visitors on the patio in the afternoons.

Big day - big, big, big day. Emily moved to Craig at a little after noon today. Wow-significant change in pace. I haven't seen this much activity since the Emergency Room the day of the accident. She was barely in her room at 1:00, and still this afternoon we had orientation with her RN, visits from both Dr. Yarnell and her new Craig doctor, met her RT (respiratory therapist), had an ultrasound of her arms and legs to verify no blood clot issues, x-rays of her hips, shoulder and something else I can't remember, and a head CT. Side note on her visit with Dr. Yarnell: she was meeting her RN for the first time and really not responding to instruction well at all. In walks Dr. Yarnell, he says "hello Emily, shake my hand," and she immediately put out her left had to him. She then proceeded to do a "thumbs up" for him and tried her darndest to talk to him. I think she recognized him - and I definitely think he earned a good response. He's been with us since the beginning and has come to mean a lot to both Ken and me (and obviously Emily).

Both Ken and I like Dr. Weintraub, her Craig doctor - he was incredibly reassuring and obviously very knowledgeable. We have a conference with him on Thursday to get his medical assessment. She didn't get to meet her Craig therapy team today. I'm sure all of that will happen tomorrow. Then we'll have a follow up meeting with the whole team in a week or so.

With a new hospital comes new rules. Craig strongly discourages visitors during the week. The theory is that it's very easy to over-stimulate brain injury patients and the therapists will be working her hard all day and they want her evenings and nights as free of stimulus as possible. So, for the near-term, we're going to need to limit week nights to family. She can still have company on the weekends from 11 a.m. - 7 p.m. Of course, this means my comment to Sarah and Katie this weekend that "sure the whole chemistry table can visit" is no longer true. The Craig staff wants visits limited to a few people at a time, which everyone's been great about. I'm optimistic that we'll be able to lighten up on the rules once they see how she's doing in person, but for now that's the deal. Craig staff can ask any of us, including Ken and me, to leave if she becomes agitated (can you say "Barbara Biggs issue?"

The bright side of these new restrictions is that they are all very optimistic about Em's ultimate recovery.

Brief notes on this morning's therapy sessions at Kindred: She had a great session with her ST (speech therapist). She was pointing at words (Mom/Dad, Spike/Buffy, yes/no) on a page with two words - finding them on her own. She got to try Cheerios and potato chips - the chips she was taking from her therapist's hand and putting in her mouth and eating! In PT she was playing ball - she didn't quite have the tossing down, but she was reaching (and looking) way up, way left and way right to take the ball from her therapist's hand. Her physical therapist kepty asking "what happened over the weekend?" She handled the move to Craig really well - got to sit up on her gurney in the ambulence, which was a big improvement over other recent trips. Barely napped this afternoon.

I really think she's ready to get to work. It seemed to both Ken and me that she really figured something out this weekend - she was doing a lot more thinking and dexterity stuff and really working that green stress ball of hers.

I couldn't possibly thank everyone who's done something kind or thoughtful for all of us during this journey, but two deliveries yesterday deserve mention. Thank you Jana Clark for saving the day with replacement pictures. Now all of Emily's friends from DSA can continue to be part of her therapy and I promise to keep this set out of harm's way. A second thank you goes to my friend Andrew. It was so sweet of you and Katie to go by the Chop House for mashed potatoes. Emily had a cup of them as soon as we went inside yesterday afternoon. She obviously enjoyed them - white cheddar mashed potatoes and Johnny Depp on the TV, doesn't get much better than that!

We got to go outside yesterday. The nurses were worried about my barcalounger driving abilities, but we did fine. Emily looked beautiful in her Maui Jim's in the sunshine. We stayed out for an hour, walked up and down the block and had company while we were out there. It was really nice to see Katrina, Josef and Chris - we know how hard this has been for you as well and how scary that day must have been.

The pureed french toast didn't go over very well. I think it was too sweet for her. She did much better with her lunch. Now that the trach is gone, the pulse/ox monitor is gone, and they aren't feeding her through her PEG so it's just there for meds. We're almost tube and wire free - which is a great feeling.

We're planning on another outing today - should be outside about 1:00 this afternoon. She may have a couple of (furry) suprise visitors while she's out today.

The trach is gone!!!!! One less tube. All that's left now is the PEG - her gastric feed tube. Now that the trach is gone, after 24 hours they can remove the pulse/ox monitor that's been driving us crazy. No matter where they put it, we have problems. Left fingers and toes move too much. Right fingers - she clenches too tight and whenever I try to do her exercises it beeps (beep being a relative term). Same for right toes. Thank goodness I found the button to silence the alarms (it pays to be observant).

Today was our official first day of real food. She's still on the feeding tube to make sure she gets enough nutrition. She didn't think much of the pureed oatmeal for breakfast, but she enjoyed her few bites of real banana. Lunch was pureed chicken and dumpllings, pureed squash and pureed peaches (there's a theme here). She seemed to like it all and had a few more bites of banana. By lunch she'd also mastered the straw thing, so she had a little bit of milk. We ordered pureed french toast for breakfast, as much out of curiosity as anything else. I had to leave to go to Hannah's mother's day reception and volleyball game (her team won the consolation championship and she was MVP of the game), so Ken had to handle dinner with no instruction. When we talked on the phone he asked how Emily would let him know if she didn't like something or was full - I assured him that she would clearly communicate. This morning all it took was about two bites of that pureed oatmeal before her lips were firmly sealed!

Ron, her OT, told me today she'd met all of her 2-week goals and was well on her way to meeting her 4 week goals (at 2-1/2 weeks, but she's always been a bit of an overachiever). We haven't heard officially, but the grapevine has it that she heads to Craig "early" next week - probably Monday or Tuesday. She also got approval to go outside over the weekend - imagine how good that will feel.

First, let me start by answering questions.

To the Keifers: feel free to visit anytime between 5-7 during the week (M-F) or 1-3 or 5-7 Saturday and Sunday. I know Emily recognizes her friends - she mouthed hi (no sound with words yet - but sounds without words, which is a start) to Kora just last night.

To Brendan, Shiloh, Peaches and Dominic: Mrs. Clark gave me all of the pictures from the creative writing bulletin board and they've been used multiple times every day this week for therapy. I know she recognizes you guys. Unfortunately, some water got spilled on the pictures today. I was able to save some of them, but all of yours were pretty badly damaged. Please, please, please bring me new ones. Ben's picture was also damaged, so if anyone can get hold of Ben and ask for another picture it would be much appreciated. I don't know if he reads the blog or not. To anyone else who might have small individual pictures of friends Emily would recognize, some new faces would be great.

To the Treese family: of course we remember that day near Aspen. Uncle Gary is determined that he and Emily are going to use climbing walls as therapy when she's stronger. He's also looking for a partner for Devil's Tower Chris - we could have a great camp out in Wyoming when Emily's better!

On to today - more good therapy sessions. Emily had a really good session with her speech therapists - spent a good 15+ minutes pointing at pictures of her friends (see note above - those pictures are really important). She also did something we hadn't seen before - she's been practicing writing with a pencil in her left hand for the last couple of days mostly just getting used to the feel of a pencil and drawing lines. Today when they were working on it, she let go of the pencil and used her left hand to try to open the fingers of her right hand - where the pencil should have been! Really cool. In physical therapy her trunk is getting much, much stronger. When the therapists were doing balance exercises, she was able to really push herself up with her left arm. Most importantly, for the first time she was able to lift her head completely up while sitting on the side of the bed - she couldn't hold it there for very long, but that's the first time she's been able to lift it completely up.

Emily had a delicious lunch today of mashed potatoes and gravy. We could really tell she was enjoying it. So starting tomorrow, she gets to have three meals every day. All soft, pureed food - but food! Ken's assignment for the weekend is to go get her some really good mashed potatoes from the Chop House.

Today was Day 2 with the trach capped with absolutely no problems breathing or coughing.

She was opening her right eye a little bit again today. There's really not much we can say about her right eye. The pupil still tries to react to light, but the nerve hasn't recovered enough for it to work properly. The fact that she can open the eye and the pupil reacts to light is a good sign that the nerve is healing, it just takes time.

Thanks to all for the continued love, support, prayers and food. How will I ever learn to cook again?

It's been so nice the last few days to have so many visitors, and we know it means a lot to Emily. In addition to all the wonderful friends that have visited, late this afternoon Emily had a very special visit. Michelle Roark, U.S. Olympic Freestyle Skier, and Mattie, from Rocky Mountain Freestyle, came to visit. As many of you know, Emily got to spend a day skiing with Michelle on Thursday before the accident. Michelle donated a day of skiing and her US Ski Team 2006 Jersey to the Good Shepherd Teachers' Foundation fundraising auction last May. Ken and I bought both items and gave them to Emily for Christmas. The text message we got from Emily the day she skied with Michelle said "This is the best day EVER!"

Michelle's visit really got me thinking about how much Emily loved skiing and other adventure sports. If something like this had to happen, thank God it happened in a freak accident doing something she loved and not as a result of some idiot in a car. The self confidence and determination Emily gained from skiing, kayaking, mountain biking, or rock climbing with Chris, Amy and Sarah near Independence Pass is what will get her through all of this. Just think about how strong she had to be in Telluride to get up and compete two days in a row after that terrible fall training. That was all her - Ken and I both told her she could skip the competition after the fall, she didn't want to.

The last phase of the "goodbye vent" tour began today - they took out her full-size trach tube, replaced it with a much small tube (that won't rub her throat raw), and capped it. She had no problem switching from breathing through the trach to breathing normally. If everything goes well the next few days and she's able to keep her lungs clear with normal coughing, the trach tube can come out for good. I didn't realize until it had been turned off how much I hated the sound of the oxygen. It's so quiet in her room now.

She also had another good round of therapy sessions. Her therapists are working her hard this week to get her ready for Craig. Every day she makes more progress.

Corrected phone number: To call Emily, please call (303) 320-5871, room 422.

I took last night's number from a business card our case worker had given us. Who knew is was her direct number. Sorry Aunt Trice. BTW - Gary wants clarification, you were a math what? Mud wrestling he buys.

Well, it's as definite as things are these days - Emily will be moving to Craig this week or next. Certainly cleared it up for me. Seriously, we'll hear tomorrow and will add it to tomorrow's post.

To Brendan - Sora has been used for visual tracking several times - it may have been an "accident," but it's worked beautifully. Think about it - she spent probably a half an hour today looking at pictures from the Creative Writing bulletin board (thank you Mrs. Clark). Sora was a distraction, although finding Dominic in his picture was entertaining. Emily seems patently disinterested in visually following her therapist's fingers - so interesting pictures ("art"?) are always welcome.

To the VanderReits - we've heard talk of capping her trach, but no capping has taken place. Frankly, we'd like to see the whole thing just gone.

On to today's milestones: continued progress with visual tracking and muscle control. Her neck control has increased significantly. According to her PT most of the body's movement follow the head/neck, so better control of the neck is really important. Yesterday after 30-45 minutes of PT, she struggled to hold her head up in the chair. Today, she was a little weak for the first few minutes, but strong and stable thereafter.

Emily's therapists triple-teamed her between 9 - 11 yesterday morning, so she was pretty tired the rest of the day. Her neck is getting much, much stronger and she's starting to show some really positive startle reactions. Her visual tracking continues to just get better and better - the picture of Sora that Brendan sent her has helped a lot with that. Now that the vent is gone and as her neck gets stronger, we can start getting her out of her room - either to the gym at the hospital for PT or even outside. I know she'd love that.

Yesterday afternoon while Ken and I were at Hannah's volleyball game (they won decisively and move on to a final match Friday night at St. Thomas Moore (Highlands Ranch during rush hour - it just gets better and better)), Uncle Gary stayed with Emily. Gary is currently doing a graduate program with Boston University which has him studying algebra. He told me he was sitting next to Emily working on his homework, looked up and Emily was completely focused on his math work. Not just glancing over, but leaning over and engrossed. His theory was she couldn't believe it was taking him so long to work out the problem.

Sorry she was sleepy when everyone else visited last night - I'm thinking of switching Steve's visiting hours to her low-stim periods - it will help her rest and ensure she's awake for the rest of her visitors!

I think they're planning to "expand" her diet a bit more this week with some other pureed foods. I think anything soft in small quantities is pretty much okay. I'm thinking of bringing her a smoothie this weekend.

Her Speech Therapist suggested that if her friends can't get by to visit her that it would be really good if you could call. She thought just hearing friends' voices would be really good for her - just a few minutes, babbling is fine. The phone number for the hospital is (303) 331-5420 and she's in room 422.

Her case manager from Craig is coming to see her today and I've been told they'll have a bed for her at Craig next week. I think we need to keep her busier on the weekends when she doesn't have therapy. So for her last weekend at Kindred - please stop by and help, I'm afraid I'm getting boring.

Happy Mother's Day.

I've gotten so many wonderful Mother's Day messages from so many of you - thank you all so much. I also want to say Happy Mother's Day, for the first time, to Emily Henderson. She and Chris (a/k/a Hendo), our Emily's ski coach, had their first baby last week. Welcome little Janie Lynn.

So my lovely daughters got me a new Ipod for Mother's Day. It replaces my old Ipod that through a series of really interesting events involving pretty much everyone but the dogs was washed. Take note - they can handle a lot, but a spin in the washing machine is not something they can handle. My new Ipod is an 8 gig nano that, thanks to Leah Pearlman, is engraved on the back with "We love you, Emily and Hannah." It's also one of the red ones so a portion of the proceeds go to fight AIDS in Africa.

I also got a huge gift from God and the staff at Kindred Hospital - when I walked into Emily's room at 7:30 this morning the ventilator was gone. Tomorrow when Terry, the wonderful Speech Therapist, is back we can start the process of capping her trach.

On Friday Emily graduated from ice chips to a sports bottle. Yesterday when I held it out for her she took it from my hand and took it to her mouth for a drink. The first try wasn't flawless, but every time she tried she got better and better.

We worked all weekend on her exercises to help loosen her right arm, strengthen her left arm and keep her ankles flexible. I felt much more give in her ankles when I was stretching them this morning and her right arm is not nearly as tight. When it was time to do her left arm exercises, I asked her to take the yellow band from me - and she did. She's gotten very consistent with her "thumbs up" yes, and a couple of times I asked her to choose (between two different books or between a book and a dvd) and she's been able to make her choice by pointing or taking the book or dvd from my hand. Her neck is also getting much stronger - she needed no "propping" beyond her neck pillow while she was up in the chair today. While Hannah and I were having a Mother's Day lunch, Ken sent me an e-mail that she was sitting quietly, looking at her left hand, and practicing her hand movements - fist, thumbs up, 1 finger, etc. It seems clear to us that she's thinking very hard about the whole process of deciding to move her hand.

Uncle Gary came back for a few days today - drove straight to the hospital so Ken, Hannah and I could have Mother's Day dinner together. He's been such a huge help.

Remember - visitors are welcome 5-7 Monday - Friday (she has therapy until about 3:00 every day and needs a little time to rest afterwards) and pretty much anytime after Noon on Saturday and Sunday (she's napping much less these days and when she does it's for fairly short periods). We'll know more about the move to Craig later this week and will let everyone know.

Two nice developments today.

First, Emily's doctor at Kindred said: "I think we're through with the vent." That's really great news. She been breathing on her own for 36 of the required 72 hours without any problem.

He also told me a story, and he's not a very talkative man. Seems one of his staff doctors was at a party over the weekend and met a women in her 30's with two children for the first time. When the woman heard what he does (doctor at a long-term acute care hospital that works with a lot of brain injuries), she told hiim she'd had a serious brain injury as a teen, spent weeks in a coma and months in rehab. There were no indications she'd ever had the injury. It's been amazing how many people I've heard of with similar stories. Our doctor proceeded to tell me he's not at all worried about Emily - if she were a middle-aged adult he'd be worried, but at her age he's not at all. Those were nice words of encouragement.

The second nice (great) thing was a visit from Dr. Yarnell. Dr. Yarnell is the neurologist that's been with Emily since the first day after the accident. He was thrilled with how alert she was and how well she followed instructions. Between he and Dr. Cilo yesterday, they've reduced all of her stimulant meds because at her stage she doesn't need help from stimulants and they may actually be counterproductive. He actually thought Emily had been at Kindred for a month based on her progress and was surprised when I said it had only been a week. He also expects her to continue to make steady progress.

Emily had good therapy sessions today, although she was a little tired during physical therapy. OT had her raising different numbers of finders in response to random instructions - which she did with no problem. ST continued to work on her tracking, her "thumbs up" yes, and swallowing. I'd mentioned that she liked strawberry applesauce, so the speech therapist got some especially for her. Next week they want to start on some real meals (well, pureed, but still).

Another thing Dr. Yarnell said to me today was important and I wanted to share it - he said in his experience patients with a loved one who can actively participate in their recovery and therapy do much better. I told him I was very impressed with the therapy Emily had gotten at Kindred, and he said part of the reason why the therapy had been so good is because I was there to participate. While this meant a lot to me personally, I think it's also important to acknowledge my boss, Steve Pearlman, Bob Hite and the Board at Metro Wastewater for having the family-friendly leave policies that have allowed me to concentrate on what's really important right now. These are the same people that hired me 16 years ago when I was 8 months pregnant with Emily. I owe them so much, thank you is entirely inadequate.

Emily's on the home stretch with the vent. At a little after 6:00 this morning she started her first 24-hours on the trach collar. On the collar she's breathing completely on her own - no vent support. They place a cup from the oxygen feed over her trach as much for the humidity (they add water) as the oxygen. Assuming she's fine for 24 hours, they'll check her blood gas in the morning and if it's okay she'll go another 48-hours for 72-hours total. Once she completes that 72-hour wean, assuming no lung issues, then she can start trying to breathe with her nose and mouth and she might even be able to make some sounds.

I'm almost afraid to say it, but if all goes well with the vent she'll probably move to Craig next week.

In therapy today she worked on answering simple questions with a thumbs up - Is mom here? Yes. Is dad here? No thumb-no.
Is Buffy the Vampire Slayer here? Yes. Is Spike here? Yes. Are you Emily? Yes. They introduced nodding her head, but she wasn't quite there yet. They also introduced waiving, which she tried really hard to do but needs to work on some more. This afternoon she counted to five with her left fingers again and helped brush her hair. Her right elbow is much less tight and she didn't tighten it at all when the physical therapists got her up on the side of the bed. While she was up on the side of the bed they were able to stretch her back and both calves/ankles. They added a new move today where the PT that was supporting her leaned her to her left and had her support herself on the left elbow, then the right, then back to the left. Second time on the left side, with a little help, she was able to sit back up. She was also able to lift her head up and look at me - I was kneeling at her feet helping to keep her right ankle straight and stretch her achilles (something I know a little about).

All in all a very busy day.

Every day there are small improvements that are a big accomplishment for Emily and really add up over time.

Yesterday, Emily had a fairly productive hour or so with her occupational therapist. Angela is such a dynamo (and a dear) - she's so gentle with Emily and so supportive of me. Since Emily seems to have adopted that "teen sleeping thing" that she was never able to as a member of the WP Freestyle team, Angela is constantly fighting Emily's drowsiness in the mornings. Still, she's visually tracking, counting on her fingers - I've seen her do that on her own at least twice since Angela introduced it yesterday, and working on saying "yes" by putting her thumb up. Today, minutes after Angela gave up keeping her awake, I looked at Emily's left hand and the thumb could not have been more up.

Yesterday she did side-of-the-bed with her physical therapist while her speech therapist was working with her. She ate ice chips, apple sauce and tried her hardest to drink from a glass. She's very good at moving her head from left to right to track things visually, but still struggles with holding it up. One interesting side note - the whole time she's sitting up on the side of her bed her left leg is swinging front to back just like we all do when we're sitting on a stool or bench that doesn't allow us to touch the floor. Today she did over 20 minutes on the slant board making it to 30-degrees without any problem - compared to just 5 minutes last Friday! Since she'd slept all morning, she was still alert and responsive when Terry came in to do speech therapy. She continued her ice chip work, learning to hold a spoon and guide it to her mouth, and drinking, which was much better today. We got Terry's approval to give her ice chips when she's awake. Imagine how good that must taste!

Ken and I have the assignment of playing thumb wars, working with her to make a fist, and trying to ask her simple questions that she can answer with "yes" and a thumbs up. I'm going to meet with the Director of Nursing first thing tomorrow to work on her schedule, so that we have consistent times for everything.

Please don't forget - visitors are welcome Mon-Fri, 5-7, and Sat & Sun, 1-3 and 5-7. The specified times are to give her time to rest and eliminate stimulation for a couple of hours - following high stimulation, like visitors and therapy, with low stimulation, will help her brain heal.

Special side note to our friends at Metro: Holy smokes! Are there any snacks left at WalMart? Hannah thinks she's died and gone to heaven - she's never seen this many cookies and chips in this house. It took our neighbor Julie, her two sons, and her next door neighbor to get it all to our house.

I've been trying my hardest to see some humor in this whole thing, but I must admit it's been difficult. At least now I have the story (already told to Emily) of Brendan spending days talking about watching "Totoro" with Emily only to announce, after I've left for the hospital, that he doesn't actually have a copy of "Totoro." Thank you Ms. Dubrava for bringing a VHS copy, and thank you Ken for making the trip home to get our DVD.

Emily did a 12-hour wean on the ventilator yesterday and spent 6 hours up in a chair. Very hard work, but she did great. This morning she started working on the trach collar and (I really hope Shari from St. Anthony's reads this) she had a lower respiratory rate, lower heart heart and high oxygen saturation on the trach collar than she's ever had on her weans. She was originally going to do a 4-hour stint on the trach collar, but when I left she was at 8 hours and her day RT said that if she resisted going back on the ventilator to rest overnight that we should leave her on the collar. This is really a huge development. Tomorrow the Speech Therapist will decide if we can cap the trach and let her try to breath on her own AND TALK!!!!

My assignments for the weekend were to work on her visual tracking, which I did, introduce new tactile sensations, which I did, and get her up in the chair for 2 hours each day, which I greatly exceeded (hopefully Beth Anne will approve of the longer chair time - we were going for 8 hours today). One assignment I wasn't given, but decided to try anyway, was to ask her to reach for my hand and squeeze it if she wanted me to do what I was offering. In the first case it was to continue to read to her and in the second it was to stop reading and watch an episode of Buffy. I didn't just ask her to squeeze my hand, I asked to take my hand and squeeze it. I hope her therapists agree that this is as big a deal as I think it is.

Emily was very sleepy today. I had a terrible time waking her up until about 1:30 this afternoon (morning in teen-land). I told her she was boring! She was wide awake for quiet time at 3:00, so Ken was going to read to her since she'd slept through her morning high-stim. I wonder if she wasn't just so much more comfortable without the weight and tension of the ventilator tubes on her neck that she was just catching up. In any event I hope she falls asleep tonight so that Ken can get some rest - it's incredibly difficult (read impossible) to leave her alone when she's awake.

Thanks for all your thoughts and prayers.

According to her neurologist Emily has reached Level IV on the Rancho Los Amigos consciousness scale. At this level she's likely to be very agitated and confused. We saw that clearly throughout the day today. The Physical Therapist warned me that this will be the most difficult phase. Bless her heart - she wasn't there for that first night, or the first 72 hours when we couldn't see much of anything beyond the ICP monitor, or the pneumonia, or the subsequent lung congestion, or that week+ when we weren't sure if the nerve for her right eye would heal. She obviously has a different perspective on "most," but I already love her dearly. She is so knowledgeable and caring and inclusive. It makes this whole ordeal so much more bearable if we actually get to be part of the therapy.

Even more difficult for Ken and me, for the first time since the accident we've seen facial expressions that indicate she's in pain. We think she's having muscle spasms and cramps as a result of the muscle tone and spasticity. There are medications that can relax tone, but they tend to have a sedative effect and since Emily was so significantly affected by sedation in those early weeks, the neurologists have hesitated to give her anything that could act as a sedative. Now that she's in pain, that concerns has to take a back seat.

On the positive side she's doing really well tracking objects and responding to her therapists. The goal for the weekend is to continue her visual tracking exercises, her range-of-motion exercises (which also help with the muscle cramps), and start some tactile stimulation. Hopefully by early next week we can start getting some yes/no responses. Her vent weans continue to go well and hopefully she's on track to be off the vent by the end of next week.

We love you all and can't begin to express our thanks for you love, prayers and support. Please bear with us as we start the vistation part of this process. We know all of you can't wait to see Em and that seeing you will help her. Please just bear with us as we do our best to follow the doctor/therapists instructions for the appropriate level of stimulation.

A couple of items I meant to include in last night's post:

Juri - thank you. I didn't mean to forget you on the list of NICU nurses. You were wonderful and kind and found Natalie to braid Emily's hair.

Ryan - Emily would love a visit from the senior creative writing majors. She really, really enjoyed seeing the senior projects last year, so please come. The 3 person rule is officially waived for your visit.

On to today: Emily's not sticking to her prescribed schedule very well. She was wide awake when I got to the hospital at 7:30 and then proceeded to doze during much of her time with Angela the occupational therapist. This afternoon/evening she slept through most of her "high stimulation" times and poor Uncle Gary has had to sit in the dark and just make eye contact with her during much of her low stimulation time. I'm sure the therapists and I will be discussing the schedule more in the days to come. Please just (a) don't be surprised if she's sleeping when you come to visit; and (b) keep an eye on the blog in case the visiting times change to better reflect her schedule. She had a good session with the speech therapists and the occupational therapist said she saw some very positive signs. The consistent, daily therapy is wonderful and we can already see Emily responding.

Emily had visits from both of her neurologists today - Dr. Yarnell from St. Anthony's and Dr. Cilo from Craig. She was wide awake for Dr. Cilo and I think he was pleased with her movement and alertness. In keeping with the last month, she was asleep when Dr. Yarnell came by. Thankfully she's shown him what she can do when she's alert so he didn't feel the need to pinch her. Most interesting, perhaps, is Dr. Yarnell noticed the book I'm reading (a gift from Gary - thank you again) on neuroplasticity. Basically it's a summary of the most current research on the mind's ability to heal the brain. Dr. Yarnell had lots of good things to say about the book. I'm very disappointed neither Ken or I was there when Dr. Yarnell came by (we were home celebrating Hannah's b-day), hopefully he'll stop by next week as well.

Thanks to all of our friends that were at my confirmation hearing this afternoon. All of the support was wonderful.

I'm honestly not sure where to start. We've left the NICU at St. Anthony's - the doctors and nurses there saved Emily's life, stabilized her lungs, and statrted her on her road to recovery. Thank you Drs. Fried and Dennan who got her through that first night and followed up thereafter. Thank you Dr. Lainge for starting every conversation with "I'm so sorry." Thank you Dr. Yarnell for keeping her in ICU until you were comfortable her brain was healing - we look forward to seeing you at Kindred. Thank you Dr. Bost for listening to me and being willing to push Emily and her lungs a little harder. The ICU nurses, I don't know what to say. Aaron, Kori, Seana, Shari, Carol, Sean, Sarah, Chase, Bonnie, both Heathers, and Fergie - thank you. The Respiratory Therapists - Bonnie, Dustin, June, Robert, Cindy, Lance - we know how important you were. I know we've forgotten people, and I apologize, but the message to all is the same - thank you for taking such incredible care of Emily and the rest of us.

Emily is now in Room 422 (they moved her from 427 because now she's closer to the nurse's station and has a better view) at Kindred Hospital, 1920 High Street, Denver. She had a comprehensive therapy - physical, speech and occupational - evaluation this morning. The therapists have put her on a high/low stimulation program. This means that for every 2 hours of therapy and other stimulation she gets 2 hours to rest. It will also ensure that she sleeps at night and is awake and participates in her therapy during the day.

Visiting hours will be from 5-7 Monday thru Friday and 1-3 and 5-7 on Saturday and Sunday. It's very important that we limit visits to these times. We also need to make sure that she doesn't see more than 1-3 people at a time, that visits are limited to 30 minutes (except Brendan when he and Emily watch Totorro), that visitors talk to her (without music, tv, or dvd's) in a clear slow voice, and that folks don't hold side conversations in her room. She needs to be able to tell which conversations she should focus on and try to participate in. I'm sure all of these rules will evolve as her therapy progresses.

For today, Uncle Gary will be with her this evening so that Ken and I can both have dinner with Hannah and celebrate her 11th birthday. Other than today, one of us will be there when you visit. Thanks to everyone for being so patient while Emily was in the ICU and we look forward to seeing you.

I don't know about the rest of you, but I've decided Brendan is the reincarnation of a very wise man. There's no way your typical 8th grade boy could give me this much comfort. While I always knew what a good friend Brendan is to Emily, I had no idea how much comfort I would take in his "beyond his years" insights.

He's absolutely right - long-term is just hospital/insurance vernacular for more than 3 days. This is step 1 in the rehab process. Emily made the cross town trip in an ambulance with her dad without incident. She's settled in Room 427. I have an appointment to do her admitting paperwork at 7:30 tomorrow morning, meet with her therapy team, and help Steve set up Buffy and Spike in her new room. As soon as I know what visiting hours are, I'll let everyone know.

She went from very sleepy to very active today. When I left her with Ken and Uncle Gary, I had to ask the nurses to go in and provide professional help because her head was against one bed rail and her left leg was over the right bed rail and I needed to go get Hannah from piano. She coughed a lot - so hard she disconnected her vent 4 different times - but also stayed on a 10/5 wean from 8:30 a.m. until at least 4 p.m.

Ken and I look forward to seeing all of you come to visit now that we're in a more "visitor friendly" place.