Emily worked really, really hard today. She got to stand in the EZ Stand for the first time in about 10 days and rode the exercise bike for almost 1/2 hour. It occurred to me today that she hasn't complained that her foot or ankle hurts since she started being able to use that leg again yesterday. In OT she tried a new device to help with her typing and it worked really well. Later in the day she was able to send an e-mail to one of her friends with very little help.

Probably the most exciting thing today was PT. Emily and her new therapist started out working on coming to a mid-way stand from a sit and holding it, which is really, really hard. Then they tried some standing in the parallel bars - Em was doing so well that her PT had her try taking steps with her left foot - she stepped forward, back, out and in. It was really cool to watch. She also worked on coming up to her toes to pivot and moving her left foot out and back heel-toe-heel-toe.

Emily's friend Julie visited again this afternoon - she's such a good friend and her visits mean so much to Emily. Emily's Devo coach Mike visited again today too, so she was in a very good mood this evening.

Emily may move over to the transitional rooms in Craig East later this week. She'll still do all of her therapy and have meals in the 2West gym, her room will just be across the bridge. We'll be sure to let everyone know where to find her.

The weekend had its ups and downs. Emily didn't sleep well Friday night and was quite cranky when I got to the hospital Saturday morning. While I was cleaning up our breakfast dishes, Emily went and found her tech and convinced her she needed to use the bathroom. Two minutes later I walk out of the gym to see lights flasing and another tech going into the bathroom. When I open the door, I find Emily and her tech on the floor. She spent the rest of the day with her right foot elevated while her nurse and I watched closely for any signs the surgical areas had been hurt in the fall. Ultimately the foot/ankle were fine, but she had a very stiff back and sore shoulder. The next person who suggests I don't need to be at the hospital all of the time may get an ear full. Late Saturday we moved Emily to another, quieter room, and she slept better and was in a much better mood on Sunday.

She spent the day at home with grandma and grandpa Sunday. She even went with us to walk the dogs (close to a 2 mile walk). We had a nice day and a delicious dinner thanks to our friend JoAnn.

Emily had a good day of classes today. She needed a lot of cueing in Speech this morning to remember what she'd done at home yesterday, but by this afternoon she was spontaneously remembering very detailed stuff. She had a PT/OT Co-Treat this morning, and Laura and Robyn had her doing some nice standing and weight-bearing on both her right leg and her right hand/arm. Robyn was doing some movement exercises with her right arm and she was engaging her deltoid and doing a lot of the up and down movement with her right arm on her own. She did ask me today if she'd had Botox in her right hand. When I said "yes," she asked why it wasn't working. I think she's getting pretty frustrated with it. She did more coming from a sit to a stand work in PT this afternoon and then finished the day with her weekly massage.

Her friend Julie came by to visit late this afternoon and they were enjoying "Avatar" on dvd when I left. Emily is always so happy when her friends visit. All-in-all not a bad day.

The day following surgery is almost always worse than the actual day of the surgery and today was no exception. Emily woke up in a good mood, but once she was dressed and up in her chair, she started hurting. Despite being uncomfortable, she did all of her classes without complaint. In OT she did some work sheets that required her to take her time and control a highlighting pen and then made herself some Easy Mac for lunch. Morning PT focused on stretching, and this afternoon she played balloon volleyball with me and catch with her dad while sitting on pillows on a raised mat so she couldn't touch the floor, which required her to rely completely on her core to maintain her balance.

Emily got a new roommate this afternoon. Isa is a lovely 17-year old who was in a car accident. She's at a much earlier phase in her recovery than Emily, so we moved Emily to the other side of the room so Isa would have easier access to the lift for transfers. There's bound to be adjustment issues, but I'm sure we'll all get used to each other and our routines.

Emily had a great evening - Julie from DSA and Erin and Carrie from Good Shepherd all came to visit, so Ken went to get them pizza and they had a nice little pizza party together. It meant a lot to Emily and I think the girls all had a good time. It was exactly what Emily needed after a long, hard week.

We said goodbye to Jesse L. and his parents this afternoon. They're headed back to North Dakota and we'll pray for Jesse's continued recovery. They've been at this process for 2 months longer than we have and still have a long way to go. We also had to say goodbye to Jessica, one of Emily's physical therapists. Jessica has been a wonderful person to work with and a great advocate in Emily's recovery. We'll miss her lots and wish her well.

We'll be home much of the day tomorrow - as I've said before, please feel free to visit Em here at the house.

Surgery on Emily's right ankle went great. The biggest risks were frankly damage to the vocal chords that we just got working, contraction of other parts of the foot when the achilles was released, and problems with the surgical wound. She's talking great, so Dr. Ruben did a great job with the anesthesia and breathing tube. The orthopedic surgeon only saw contraction in the big toe, so that's the only toe flexer that he released. As far as the surgical wound, we'll just have to watch it but there's no reason to expect any problems. The minute the achilles was released the foot returned to a normal position. She'll be in a cast for 2 - 3 weeks and a brace (AFO) for 6 months. She can start weight-bearing exercises on Monday.

On a stylistic note, we're thinking her AFO is going to need decoration and a "Ski Like A Girl" sticker from Winter Park is the perfect accessory. We're hoping to get up to Winter Park in the next few weeks, but if anyone from WP is making a trip to Denver we'd appreciate a sticker.

So Emily had surgery at 7:30 a.m. We got back to her room around 11:00, and Emily had lunch and made it to all of her afternoon classes.

Emily's surgery is scheduled for 7:30 a.m. tomorrow. The surgery will take until about 9:00 and then she'll probably spend a couple of hours in the recovery room. We won't know until after the surgery if there will be a period when she has to be non-weight bearing. We do know that she'll be in a cast for 2-3 weeks. Hopefully once she's out of the cast and we can get her foot flat, she'll be fitted for a custom brace (AFO) and we can start trying to walk. We're cautiously optimistic given how much strength and movement she's gotten back in that right leg - she even did leg lifts with a 1-pound weight on that ankle today. This afternoon she was working on coming from a sit to a stand in the parallel bars and she was doing great. While standing she was shifting her weight between her left and right side and even let go of the left bar and stood almost completely independently. She was also doing some small standing squats to work on the strength in her hip muscles.

We've been working on putting weight on her right hand and arm - weight bearing is a great way for her weak limbs to start communicating with her brain again and vice-versa. Yesterday she was doing sitting pushups on that arm in OT.

She did a visualization test today in OT and her scores were well within normal range and her responses were generally very quick. The purpose of the test was to make sure her brain is accurately interpreting what she sees.

In speech therapy she's continuing to work on speed of processing (how quickly can she think something through), retrieving new short-term memories, and organizing her thoughts. She's started writing a story about her accident and her therapy.

Finally, for therapeutic recreation this week she went on an outing to play Bocce ball in Washington Park and today she went swimming. In the pool she was able to swim the length of the pool with very little help and worked on both her arm strokes and her kicking. She had good kicking with both legs. She was also able to swim across the pool completely on her own! Hannah went swimming with her today, which alternated between fun and irritating, which I think is the purpose of little sisters.

On a sadder note, our friend Ashley had to return to the ICU at Swedish on Monday. She developed a pretty extensive infection in the skull flap they replaced a few weeks ago and has also developed some blood clots that are a concern. Luckily, the infection has not spread to her brain and her surgeon felt like he was able to remove 95%. She's on very aggressive antibiotics to address the infection. They won't be able to replace the skull flap with a titanium plate for 3-6 months. It's uncertain if rehab at Craig will be effective during the period without a closed skull, so she may have to return to long-term care. Please keep her in your prayers.

On a happy/sad note, our friend Lindsay and her family head home to Nebraska tomorrow. Lindsay has been a good friend to Emily, and as to teenage girls they've shared a lot of the same struggles despite very different injuries. And I've grown very attached to her mom's company at breakfast and lunch and her dad's wonderful sense of humor. We wish them all the best and hope to keep in touch. Emily took her roommates discharge really hard last week and she was awfully sad at Lindsay's going away party this evening. Hopefully Grandma and Grandpa's visit this weekend will cheer her up.

Thanks to everyone who visited this weekend and this afternoon - Mike, Pat, Brendan, and Uncle G you all helped to make Emily much less sad.

Friday and today, PT and OT really started trying to get some weight on that right arm, hand and wrist, which is possible now that she's had the nerve block injections and it's not so painful. The more we can get signals, like weight-bearing, through that right side the quicker her brain can figure out how to talk to it and vice versa. The right ankle continues to be our collective nemesis - she can't straighten her right leg because she's up on the toe, so unless you're really careful with how you position her to stand she ends up hyper-extending her left knee. She did stand in the EZ Stand for 20+ minutes today. It felt good for most of that time and then got sore towards the end. About an hour later she was complaining of pain and there was a little puffiness. If the pain/swelling goes down over night, she'll be able to start standing on a regular basis every morning - at least until Thursday.

Emily saw the orthopedic surgeon today. Surgery to deal with her right ankle is scheduled for 7:30 a.m. on Thursday. The doc and his staff really went all out to accommodate my request that we get this dealt with. The surgeon recommends a stepped approach - he'll lengthen the achilles first and then look for contraction in the toe flexors. If he sees contraction there, he'll address it. Finally, he'll look at the tendon on the inside of the ankle that's pulling it in. There's something somewhat intimidating about trusting your daughter's leg to some guy you've spoken to for all of 5-10 minutes, but he's used to dealing with Craig patients, which my ankle doc and Em's regulator orthopedic surgeon aren't, so we're trusting Dr. W's recommendation. We won't know exactly how long she'll need to be non-weight bearing on that leg until after the surgery on Thursday. Say a prayer.

Emily's short-term memory seems to be fully back. Sometimes she needs a little help, but with just a little prompting she's become adept at retrieving the memory. Her speed of processing is also improving. I think her speech therapist was a little taken aback at how quickly she screamed through identifying the pile of pictures we have of friends from DSA - including identifying each of her identical twin cousins (correctly) without hesitation even though they were completely out of context.

The best news of the day - Emily and I were heading back up to 2West after her trip to the orthopedic surgeon and out of the blue she says, "Oh cool." When I ask what, she proceeds to tell me she's started writing stories again in her head! Just like that.

Finally, please say a prayer tonight for our friend Ashley and her parents, Bryan and Kirsten. We met Ashley at Kindred; she was in a terrible car accident about 3 weeks after Emily's accident. Unlike Emily, Ashley needed to have surgery to remove a section of her skull. Today they found an infection in the incision from the skull flap replacement , so Ashley's skull flap will need to be removed. It could be several months before it can be replaced. She's a beautiful girl with a lovely family and we're praying for her recovery.

Ms. Dubrava - Emily is looking forward to your Monday visit. She's very worried about school right now, so it's a great time for you to come and add your reassurances to ours. Thanks for offering rides to those who need them - perhaps you could contact the elusive Brendan directly?

Sigrid - Once again, you've hit the nail right on the head - Emily has left the time of "forever now" and is very worried about the uncertain future. While cards and notes on the blog certainly help, they are too conceptual for her right now. Emily would love to see you and Richard. She's always loved Richard as a teacher and a friend, and besides we all know that on many levels he does still count as a teenager.

Tanya - Craig Hospital is located at 3425 South Clarkson Street, Englewood. Emily is in room 215b in Craig West. Visitors are welcome any time after 4:00 p.m. Monday - Friday (although it's unlikely Hannah will be there in the evenings), or anytime on the weekends. Since we can now go home during the day on the weekends, it's always better to call first to make sure we're there. The phone number for Craig is (303) 789-8405, if you ask for the 2West nurses station they'll be able to tell you if we're there or when we're expected back.

I've said it before and I want to be sure folks know that I mean it - you're very welcome to visit Emily when we're home on the weekend. Everyone knows how to get hold of us and we're in the phone book. Emily gets pretty sick of the hospital these days, so she likes to come home on the weekends but please, please visit.

Tomorrow Ken will probably head home with Emily around 10:00 a.m. and we'll head back to the hospital after dinner.

We continue to struggle with the ankle. Her regular PT has been out of town for the last few days, so we've spent a lot of time explaining where we are and why we're doing what we're doing. It was really painful tonight, but some time with it elevated and some pain meds eventually helped. We have our long-awaited orthopedic consult on Monday afternoon. Emily had her third, and hopefully last, round of nerve block injections on Thursday afternoon. This time they worked on her shoulder - pec, scap and lat. The injections are incredibly painful, but already today she was putting weight on that shoulder during PT.

In speech she continues to work on her voice, memory and speed of processing. On Wednesday her ST had her doing an exercise that made her use her "working memory" (that's the one Barb doesn't have any more!). Katie was amazed at how quickly she was completing the problems. Getting that working memory going is a big step.

Special thanks to Julie for walking to the hospital almost every weekend - Em loves seeing you and we're always sorry when we've missed you. We'd love to have you visit Em at home and we're happy to give you a ride. Laura, Sandy and Big Sand thanks for visiting last week - you've been great and Em loves "froggy;" I didn't know how much we'd missed you guys till all of this happened. Hendo - you've been with us through it all and means a lot to all of us and Emily really loves seeing you. She asks a lot about the accident these days and she's always so relieved when I remind her you were with her. Finally, Sam and family - we understand completely why you waited and tonight's visit really cheered her up; she hadn't smiled that much all day. She'd love to see you again - and Wii wants to play.

Sunday was exactly 3-1/2 months since Emily's accident. In 106 days Emily has never been angry or sad until today. During post-traumatic amnesia (PTA) a brain injury patient really doesn't create new memories, so they have no concept of time. Now that Emily has emerged from her PTA she's starting to grasp how long it's been, but she doesn't remember all of your love and support during that time. She can look around her room and see all of the birthday cards and we can talk about all of the wonderful things people have done for all of us since the accident, but she has no memories. That means, unfortunately, that except for those of you who have visited really recently, she doesn't remember seeing you and frankly that's what she's sad about - she misses her friends terribly and she's terrified at the prospect of not being able to go back to school right away in the fall.

I know this is a lot for the average teenager to deal with - but I also know that Emily's friends aren't average teenagers. We're really begging all of you to help her to know how much you've been thinking of her. Visitors are welcome Monday - Friday after 4:00 and we can make arrangements around lunch time if that works best. We will start posting a clear schedule for the weekends so you know where we'll be when - and please know you're always welcome at home if that's where we are. For some of you visiting one place or the other (Craig or home) is easier - let us know where and when and we'll be there. We're also more than happy to help with transportation - Ken and I would do almost anything to help put a smile on Emily's face. It's really, really not an imposition - just let us know you need a ride and we'll be there.

It's been a long road, but 30 days from today Emily comes home. That won't be the end of the road, but it will be the beginning of phase 4. With everyone's help and support all of us, especially Emily, will make it through this. Thanks.

I hate to disappoint Brendan, but Emily really enjoyed the new Harry Potter movie, but then again she's not in the mood to diss much of anything these days and she'd seen "Ghost Riders" the night before, so her expectations may have been exceptionally low. In any event, we made it to the movie and we all had a great time. Ken and I set a personal best for a car transfer - 6 minutes!

We got a little positive news on the ankle situation today. We took off the tape and while there's still swelling, there's no blood pooling which there would be with any kind of tear. She did have an x-ray this afternoon and will probablyl have a consult with an orthopedic surgeon later this week, but hopefully we're still just looking at an achilles issue and not that plus torn ligaments. Today's PT's theory is the nerve block took longer than expected to work and it loosened things up while she was in her "ballet" cast. When the cast came off on Thursday, Friday's work stretched everything more than it had been stretched in months, which lead to the pain and swelling. Let's hope today's theory is correct. It doesn't mean she won't need surgery, but it does mean we can continue with really productive PT. We're trying out another new brace and if it continues to look good in a day or two we'll go back to the standing exercises.

Overall we had a good day today. She did some great work in OT, PT and ST. We raced back from X-ray to make mat class. She was in her typical, great mood all day. And tomorrow's another day - exactly 30 days from tomorrow Em will come home!

We're trying to check e-mail in the afternoon around 4-4:30. If you can't visit but are available around that time, I know Em would love to chat.

Today went well. We missed Harry Potter, but Uncle G. successfully charmed the manager of the theater into exchanging our tickets for tomorrow. The ankle still hurts - at one point it hurt when I layed her blanket over her feet - but the swelling seems to have imroved a little (it's hard to tell with all of the tape).

Instead of going to the movie, we went for a walk and out to lunch at the cute little ice cream shop at Clarkson and Hampden. After lunch, everyone else went home to do chores or study, and Emily and I went to her room to rest and elevate/ice her ankle. She had a wonderful visit from her friend Julie - they talked for a while and then watched a movie together. Emily was really happy to see Julie. It's hard for her friends to understand, but for the most part Emily doesn't remember that you've visited since the accident she only clearlyl remembers the last few weeks.

This evening we had a wonderful family picnic on the Craig patio and then went to watch "Ghost Rider" in the entertainment room. Another very entertaining movie with certainly no lasting artistic value.

The plan for tomorrow is to go to the movie and maybe out to lunch. We should be back at Craig and rested by 2:00 - so please, please feel free to visit. Today was the first day I've really seen her down and Julie's visit cured that in a heartbeat.

Well the ankle we've been worried about for so long seems to have finally gone yesterday. One of Emily's PT's has started referring to her right ankle as her "arch nemesis." We aren't sure exactly how or when but sometime yesterday morning those weak tendons probably became torn tendons. By later yestday afternoon any weight - as in sitting in her wheelchair with that foot on the foot plate - was painful and her foot/ankle had started to swell. The therapists were afraid to re-cast it because if it kept swelling we'd have to cut the cast off and if we were successful in gettinig the swelling to go down she would start rolling the ankle inside the cast. So everyone stayed late and got it taped and wrapped as best they could. Unfortunately, by 7:00 it was obvious the wrap was too tight and after talking to her nurse I took the ace bandage off.

All this means that Emily will have to be completely non-weight bearing on that right foot at least over the weekend. Not being able to bear any weight means that transfers and dressing are more difficult and coming home is just too big a risk. So other than going to see Harry Potter tomorrow morning, which she's been looking forward to for weeks, we'll be hanging at Craig this weekend. Yesterday afternoon when she was in pain and could easily see how worried the rest of us were was the first time Emily's spirits have really sagged. She had company in the evening, which helped a lot, and hopefully a good night's sleep will help. I'm sure visits from her friends this weekend would help even more.

Sigrid is absolutely correct - all of Emily's therapy these days force her to integrate the various skills she's been working on individually. For example, she spent the hour between 11-Noon today in a tall kneel, maintaining her balance on her own, while she did spinal twists, reached up and to the side, and played tick-tac-toe. Keeping her balance while she moves her arm or shoulders requires a lot of concentration and core muscle strength. She then finished up with 5 reps of going to a squat from a tall kneel and back up - slowly.

In speech they're trying to help her speed up her mental processes by naming things she's familiar with in lists as quickly as possible - sports, states, cities. One of the tricks her ST wants her to use is to break the problem down into sub-categories. So instead of thinking in terms of the universe of sports which can be overwhelming, to think about it in terms of sports with balls, winter sports, etc.

Emily got her last cast off today. The leg cast seems to have helped the ankle's lateral stability, but we really saw no benefit in the extension of the achilles. I discussed it with both her regular neurologist and the neurologist that has been doing her nerve block treatments and we've agreed the next step will be surgery. She'll have a consultation with an orthopedic surgeon in the near future. In the meantime we're going to try to protect the ankle with braces and avoid any more casts.

She had Botox injections in her forearm, wrist and hand today to relax those muscles. It was pretty painful (imagine a needle the size of an acupuncture needle inserted into the soft underside of your forearm or the palm of your hand). The point is to get those muscles to relax so that her hand and wrist are in a more normal position and some of the smaller muscles can actually work to move her hand and arm.

Uncle Gary's back for another short visit. Last night he and Emily were visiting and he said, "You can't believe how good it is to hear you talk." She responded, "You can't believe how good it is to be able to talk." Says a lot doesn't it? Gary was reminding all of us that when he and his sons were here around Memorial Day weekend Emily wasn't talking at all. When he was back for her birthday, she was just starting to talk. Now she's more and more comfortable talking and her voice is getting much stronger.

Only 5 more weeks at Craig. We've got a lot to accomplish in those 5 weeks.

Emily learned how to maneuver her wheelchair up and down hills today. Since she does it all with one leg, it's a lot more challenging than it sounds. She did great with the uphill - you just turn the chair around and work. Those ski legs come back every now and then. She struggled a little more with downhill. On the downhill you have to control you speed and if you use your foot it tends to get caught under the chair. You have to use your hand on the hand rail to act as a brake. Emily got the handrail brake concept mostly, but she kept forgetting to tuck her fingers around the rail and getting them caught in the spokes of her wheel. We'll just have to keep working on it.

Emily got the cast off of her right late yesterday and the stretch looks good enough that we're going to go back to using splints to maintain the extension of the arm - much easier for showers and swimming. Still no resolution on what to do on the right ankle. They'll take that cast off in the morning and we'll see if a week in a cast has given us any additional range. I talked to her doctor and her PT today - the PT and I agree that the ankle is a real road block right now. I think it's up to the PT to convince the doc.

Finally, Emily did some standing in the parallel bars again today - but today for a minute or two she was able to stand completely on her own with no support from her PT. This is a big accomplishment.

A new patient on 2West (middle-aged man who fell off a ladder) stopped Emily at breakfast yesterday and thanked her for her great outlook and attitude. The two of them shared a mat table during mat class on Monday. It was his first mat class, which can be a little overwhelming, and I think he appreciated the girl next to him that just kept trying to do every exercise despite two casts and extremely limited mobiility on her right side.

Emily got rid of the cast on her right arm yesterday. The week in a straight arm stretch was sufficient to get the arm out and relaxed. She even had some purposeful movement in the arm. She is scheduled for injections in the right wrist and hand on Thursday, so they may cast her wrist and hand next week.

I'll talk to Dr. Weintraub about the right ankle today. Even if we decide today that surgery is necessary, it will take a week+ to get it scheduled, so they will probably try another round of injections in the right calf on Thursday followed by another cast.

In PT Emily is starting to work on independence - she'll start with transfers from her chair to the mat for class and back again and progress to independent bed to chair transfers. Chair to bed is more difficult because it's uphill. I did have a heart-to-heart with her last night about never getting out of bed without calling the nurses first - that'll earn her one of the lovely zip-up "tent" beds. Her PT was really impressed with Emily's core strength - quite surprised when Emily could go from a prone position to sitting upright with no assistance. Nice to know that a lot of the strength from all of those years of training is still there.

Her OT tried adding a 1-pound weight to her right wrist and it seems to help tremendously with her tremors. Last night when we were sitting on the patio before dinner she was doing bicep curls with it. She thought it was a pretty funny joke (which it was).

I'm trying to encourage Emily's independence as well. I'm always there to help, but I've started asking her to head to her next class by herself and staying back more during class. So far she's done just fine.

I'm glad Emily's friends enjoyed getting e-mails from her - she's been trying very hard to get on-line and check e-mail and is always disappointed if no one is on-line to chat. Keep checking on the weekends and in the evening - she just might be there!

We just hung out at home on Sunday and watched a couple of the first Harry Potter movies. Emily's right - there was marked improvement with the third movie. Hopefully the new one is as good. We're planning to see it on Saturday.

Emily had a good day of classes today. Despite massive casts on both her right arm and leg, she still got in 3.5 km on the exercise bike, stood for 1/2 hour, and did the rest of her regular classes. She's getting better and better at coming to a standing position although she can't quite stay standing yet without help. She did maintain her balance on her knees for 15 minutes today without much help - it's a good first step. She's still easily the most eager, willing participant in her classes, although her speech therapist said today that she wants Emily to reserve her excitement for the things she's really excited about. Personally, I think she's missed the point - Emily is truly that excited every time she remembers something that's happened recently.

Emily's voice continues to get stronger, so her vocal chords are healing. We've started to see her right eye move past mid-line to the left, which is a good sign. She'll need to see the eye doctor again soon. Her long-arm cast comes off tomorrow. Whether or not she needs another depends on how well she can keep that right arm relaxed and straight without it. She has been better able to keep her hand relaxed once I stretch it out - and stretching it out is no longer a 2-person job. She's also getting more and more movement in the right leg, despite the 10-pound cast. We won't know how we'll be proceeding with surgery on the right ankle until Dr. Weintraub gets back on Wednesday.

Emily has received three lovely letters from her friend Katherine who's in New Hampshire for the summer. She working on writing Katherine a letter this week with Robyn her OT.

I'm sorry to any folks we missed who wanted to visit at Craig this weekend. Now that we can take Emily home on the weekends it seems to be frowned upon when we don't. Please feel free to visit during the week after 4:00 and to give us a call at home on the weekends - you really are welcome to visit here.

Emily had the procedure on her vocal chords Friday morning. Dr. Reed said it went very well - and he even showed me pictures pre- and post-injection. He ended up injecting the collagen into both the right and left vocal chords to help them close, but he believes both vocal chords are moving and neither is paralyzed. The actual procedure took less than 1/2 an hour - slacker Em did OT in her room, and then after I'd brought her lunch to her announced that she wanted to eat in the dining room and do her afternoon classes. Not bad for a TBI on sedatives!

Emily spent much of today just kind of hanging at home. We did stop at Chipotle for lunch on the way home - she really enjoyed her burrito. Once we were home, she checked her e-mail, played some solitaire, rested, and watched TV. We went to 4:00 Mass at Good Shepherd, which was really nice, and then came home for dinner.

We'll probably be home for much of the day tomorrow - please feel free to visit. Just give us a call and let us know you're coming.

Emily's speech therapist officially declared she it "out of PTA (post-traumatic amnesia)." This means that she is processing and remembering new information. It's a really big milestone. Katie also commented that her processing time is improving - she can see, learn and understand things more quickly.

Emily got her ankle/leg cast today. It's giving her ankle a much needed rest/recuperation from the rolling we've seen, but the cast and the nerve blocks have done nothing to loosen her achilles. I'm going to talk to her doctor tomorrow about proceeding with the surgery to lengthen her achilles - since we only have 6 weeks left at Craig, I want to get the ball rolling before the weekend if possible.

Speaking of ball rolling - Emily finally has her vocal chord procedure tomorrow. Her voice is getting stronger, but it just takes so much energy to talk and be heard. Once she's talking better I think she'll be more comfortable having her cell phone available for evening calls from her friends. She's never been much of one to text message, but I've actually heard the therapists refer to that as good therapy so it may be an option as well.

The other big development for today is that Emily got to stand at the harness table this afternoon. At the harness table she comes to standing from her chair and they use a belt to help keep her hips, knees and ankles where they need to be. This requires much more physical control than the EZ Stand that she's been doing for the last couple of weeks. In the EZ Stand, she starts out sitting and gradually rises to a standing position, but she's pretty locked in - it doesn't require nearly as much balance on her part. She looked really good and I know she felt good standing more naturally like that. Plus while she was standing we played volleyball with a balloon, which required her to move her upper body, while she maintained her balance, while she was standing. I really wish I would have had the camera so I could have taken a picture.

While Emily was standing at the harness table, our friend Z from Las Vegas was in the harness/treadmill apparatus (it has a name that I frankly can't remember). Z has a spinal chord injury and he bore weight on his legs for the first time today and then was able to walk on the treadmill with assistance. It was wonderful watching Z and his lovely wife Tonya. Little miracles happen every day at Craig- you just have to watch for them.

So on Tuesday they put a long arm, fiberglass cast on Emily's right arm. Since the purpose of the cast is to give her elbow a prolonged stretch, her arm is casted in a straight position that adds a whole new dimension to transfers to/from the wheelchair. This cast will stay on for a week, then it will come off and they will evaluate whether the nerve blocks and casting have addressed the tone in her arm (her tendancy to clench it tight to her body with her fist near her chin like a newborn). If a week in the long-arm cast resolves the elbow issues, next weeks cast will focus primarily on the wrist; if not she'll need another long arm cast that probably incorporates her wrist. She's scheduled for the nerve block shots in her right hand and shoulder on July 12.

On Thursday they'll cast her right ankle. There's some concern about her ability to handle two casts at once, but the ankle cast is critical to getting her standing and (hopefully) walking. On Tuesday when we tried to have her stand for a prolonged period (15 minutes is "prolonged" in the land of traumatic brain injury), she kept trying to put all of her weight on her right leg, which would be a good sign if she had a stable ankle. Her right ankle is really a worst-case scenario - the foot is so firmly in a pointed position but the ankle is incredibly wobbly left/right. There's just no way to stabilize it and help her get any sense of balance outside of the EZ Stand - and the EZ Stand doesn't require much of her in terms of balance (although we did eliminate the chest strap on Tuesday which left her completely in charge of her torso, neck and head).

Our schedule for Wednesday is to be at Craig till lunch and then head home for the afternoon. We'll head back to Craig around 6:00 for the 4th of July karaoke and fireworks event. The house is a bit of a disaster right now (a combination of neglect, summer (it's so much easier to keep a house neat when no one's home), and construction), but if you'd like to stop by give us a call and let us know. We'll probably plan on dinner around 5:00.

On Sunday, Em and I had breakfast, she rode the bike-to-nowhere for 20 minutes, I worked on stretching/massaging her right arm/shoulder, we went to chapel services, and then went home for lunch and R&R. After eating and lounging on the couch for a few hours, we went to visit our neighbors Dave and Lisa and their two sons. Dave looks good and appears to be recovering from his surgery. He has a couple more weeks of recovery before he starts radiation.

Emily's voice was much stronger today and she was much more vocal. She had her usual round of therapies. Probably her biggest accomplishment of the day was "standing" on her knees completely unassisted for almost a minute. Since she can't try to stand unassisted on her feet until we get the ankle issue resolved, this is the closest we can get and gives her the sensation of tucking her buns, pulling back her shoulders and maintaining her balance. She did great.

This afternoon we went for our first swim. I learned a lot. It's very difficult for brain injury patients not to suck in under water - so the first "task" of the swim was to overcome that urge. Emily, as a long-time competitive swimmer, took to the water immediately and surprised her therapist with how naturally swimming came to her. The other thing I learned is the pool was cooler than normal - around 85 degrees vs. its usual 90+. Not a big deal for any of us, in fact it felt very nice to me. But brain injury patients have a really tough time controlling their body temperature and the muscle tightness (tone) in her right arm got significantly worse in the "cool" water. In any event, she enjoyed it and got out of her chair in an upright position for an hour, so it was worth it.

Tomorrow they'll put a cast on her right arm to give her tight muscles a prolonged stretch. On Thursday they'll do the same for her right ankle. Hopefully all of this will help her regain the use of her right limbs. Her leg is much recovered - she can almost always move it on command, but she still can't flex her right foot or consistently, purposefully move her right arm. The other thing I learned today is that the large muscles recover the quickest - that's why her leg is so much better than her arm. The smallest muscles will recover last, which means her right hand will be the last thing she'll be able to control.