James had a good day yesterday.  His first couple of days post op were tough,  he was miserable and wouldnt look at us or really seem to engage much at all,  but yesterday,  he was back to smiling and has started cooperating with the nurses a bit more.  When they did his mouth care a few days ago he gave them a run for their money,  pushing them away,  and moving his head back and forth.  He still hates it,  but is starting to open his mouth when asked. 

His girlfriend came to visit this weekend,  his look softened as soon as he saw her and he wouldnt stop staring at her.  He even have her a little smile when she did a silly dance around the end of his bed to see if he would track her. 

Two of Mark's buddies from our early years came to visit yesterday and James gave them a great smile when they walked in.

James had his surgery to replace his bone flap on his skull that was removed for his original surgery.  He finally went to surgery at 11:00pm last night.  It all went great and he was back on the ward by 1:30 am.  He has a nurse assigned to just him for the next few days at least,  so we can make sure that he doesnt bite his tongue again.  ( and so his poor mom can sleep)  The last two nights he has bitten his tongue at 9 at night,  I am thinking that by then he is just tired and overstimulated.  It is possible that they might just wire his jaw for the next couple of weeks to protect his tongue and revisit using his mouthguards then. 

I went to see him this morning and he squeezed my hand with his right hand when I asked him to,  and smirked when he had a loud pass of gas!  I had a good talk with his surgeon this morning and told him that we are prepared to figure out a plan to keep James in Victoria for his recovery.  The best resources for trauma patients are here in Victoria. 

We recieved some lovely cards from some of James'  friends in Ohio yesterday,  I put them on his wall in his room with the rest of his cards and the origami from the young men's group.

Well,  James finally moved off of ICU yesterday!  Another up of the day was,  that he smiled a crooked little smile at me,  and then he did it for his silly nurses too.  They were teasing each other and he thought that was pretty entertaining.  I

I ended up sleeping at the ward with him last night though.  He bit his tongue again in the evening,  and I was really not comfortable with the staffing levels.  Today though,  I told them how I was feeling and they brought another nurse on to be with James only for at least the next 24 hours,  maybe longer,  then we will reassess the situation. 

There was suposed to be OR time for the surgeon to put his bone flap back in yesterday,  but it didnt happen because there was a surgery in before him that ran overtime,  the surgeon is hoping for OR time today,  but it may not happen until Friday.

Mark and I (with James nurse) got to take James off of ICU for a little walk today!  Nothing too exciting,  we took him to the hospital chapel.  We parked him in front of the window and looked outside and chatted.  He sat in his chair very comfortably for 3 and a half hours today.  I got him to look at me quite a lot today,  and today I could see him focussing on me.  It was pretty cool.  Tonight when I said goodnight he was really sleepy,  but when I spoke to him he still turned his head towards me. 

James spent 5 hours in his wheelchair today!  He had about and hour where he was doing a lot of moving his legs and exploring the seatbelt and I gave him his stuffed ladybug that his girlfriend bought him. He was moving it around on his lap and picking it up and exploring it.  It is the first time that I have seen him take that much interest in something for that long! He is still on ICU and it sounds like the plan is to keep him there until Tuesday or Wednesday.  A dentist came and made moulds for bite blocks to stop him from biting his tongue.  He brought the bottom one yesterday,  but he is still able to bite his tongue,  just not as hard.  So the top block will be made on Monday and hopefully that will take care of that issue.  They are clear peices that mould to his teeth,  and look a bit like a retainer.  

I finally met an ICU nurse that I dont like.  I had issue with her talking down to me and glaring at me last night. By the time I left ICU to go to bed last night she was much more civil,  but I was upset that she was rude in the first place.  I spoke to the head nurse today and she will have a quiet word with her tonight.  I feel better now that I have acted on the situation.

James almost made it off ICU again today,  but alas,  today was not the day.  The plan was to wire his jaw today and have him move upstairs afterwards.  The specialist came to see him last night and was not  sure that wiring was neccessary.  A dentist came to see him today and he feels that he can make a dental appliance that will prevent him from biting himself and hold his jaw a little bit open so that it is possible to do mouth care.  Only problem,  the appliance may take a week to have made!  It sounds like they may wire his jaw until the appliance comes....we will see what tomorrow brings. 

Today James kept reaching for his monitor leads on his chest and his iv line.  Definetely purposeful movement,  so that is a good sign.  He seemed a bit agitated and scared today too,  also good, but hard to deal with as a mom.  It has been a long, hard day, but all in all I think he did well today.

James almost made it off of ICU today....there is even a bed sitting in the hallway with his name on it to go up to the ward .....and then he bit his tongue again.  He should stop biting his tongue as he becomes more aware.  For now it looks like he may have to get his jaw wired shut until this passes.  He will be a few more days in ICU until they are sure that this problem is resolved. 

On the up side,  he sat in his wheelchair by the window for 3 hours today.  The nurses are letting him listen to the radio during the day.  He seems to enjoy it.  When Sarah and I went to say goodnight to him tonight he was listening to the radio and he started to really move his feet around,  when the song stopped he stopped too! 

James sat in his wheelchair for two hours again today.  He may get to stay in it 3 hours tomorrow.  He had his first session of range of motion physiotherapy today.  I am not sure it was very hard work though because I think he slept through half of it!  He was pretty sleepy this evening because he had some pain control and anesthetic so they could change his trach tube and do some mouth care.  When I went to say goodnight he was back off the ventilator and resting well though.

 Mark pointed out to me today how every doctor that he has had has been there exactly at the right time for James.  The ICU doctors rotate out every Monday.  The doctor that was on when we first arrived is a female doctor and a mother herself.  I really felt that she listened to her intuition and was very gentle with us when we were feeling so terrified and vulnerable.  The next doctor who replaced her has a neurology background and some good experience behind him and was able to give a little hope when we desperatly needed it.  This weeks doctor was very approachable and reasured me when I needed to hear it the most that if this was his son he would make the same decisions that we were making for James.  The doctor who is coming on tomorrow is a respiratory specialist.  The peice that is keeping James on the ICU right now has to do with the next step of starting to breathe through his mouth and nose again.  I am in awe of all the peices that have fallen into place for James during this trying time.  The right people have been in the right place at the right time.  From the first responders at the scene,  to special people who came across the accident and followed their hearts,  to the doctors and nurses , and the countless family and friends who have sent prayers and thoughts and meals and fasted for James and our family!  There have beens so many tender mercies and small miracles so far along this journey and I am sure that there are more to come.  James has come an incredible way in the two and a half weeks since his accident but has a very long, challenging road ahead of him.  I am so thankful for the incredible supports that our family have! 

Pretty exciting day!  James sat in his wheelchair by the window again today,  but today he seemed a bit more alert.  He looked at me and his Dad and when the nurse asked him to do a big wiggle of his foot if he wanted to listen to music,  he wiggled his feet!  She is going to set him up with a radio so he can listen to it a bit when he is awake.  He will probably be on ICU a bit longer because he has been biting his tongue when he coughs.  The doctor feels that that will settle as he becomes more awake. 

I am hoping that James will get to be in his chair a bit more tomorrow.  He looked like he was enjoying it today.  Doesnt look like he will get sunshine tomorrow though. He had lots of visitors today.  When we went to say goodnight tonight he was moving his arms and legs a lot.  He keeps wiggling a leg out of the bed,  so I think he will keep his nurse hopping tonight!  He is opening his eyes a bit more,  but not tracking yet. We are seeing a bit more movement every day. 

James sat in his wheelchair by the window today.  We hope that he may move off ICU soon.  He sat by the window and had the sun on his legs for a couple of hours today.