When I arrived at the hospital this morning James' Physiotherapist was working with him. He was totally showing off! He reached up to touch her hand with just a little support and straightened and bent his legs when asked too. She suggested that we try him on the pedal machine in the ward gym! She set it so that it moved his feet and then let him do it a bit with coaxing. He did fantastic today! This evening he kicked his legs up to touch my hand too! I asked him what we should do for a "high five" and he kicked his foot up again so I "high fived" his foot and he laughed. I am amazed at what progress he has made this week. The physiotherapist said that he still needs to work on endurance to qualify for rehab. but I am hoping in a month or two we could be deciding where to apply to for rehab! James is still struggling with language but he is making his wants and needs more obvious with grimaces and smiles and laughs.

James may be transferred to comox in the next week! It will feel good to get home, and when he is ready for rehab he can transfer back to Victoria. James was a busy guy today. He has been allowed to get up in his chair twice a day for the last three days. He has gotten up for three hours in the morning and two hours in the late afternoon. Today he was awake and moving around a lot almost all day. He was finally settled when I went to say goodnight tonight. This morning when I arrived at the hospital I sat about midway up his bed facing him and was talking to him when I felt a knee in my back! When I reached back and touched his leg he laughed. Then he did it again . When his nurse came and was talking about suctioning his trach tube, he turned and open and closed his teeth at her. It sure seemed like he was warning her! When I went to see him to say goodnight tonight his nurse told me that he was grouchy with the girl from respiratory therapy too! He was apparently pushing her away and making unhappy noises at her. I think that he is feeling about done with the trach and being suctioned! Yesterday was a beautiful day and we were able to take James outside for the first time in 2 months! It was so nice and I think that the different scenery may have helped to bring him to a slightly higher state of awareness today!

Well,  I guess that the presentation to the nurses went well,  they have asked me to speak to the next class next week!  Last time I made notes on my phone and pretty much winged it.  This time I have put together a power point.  James is going to help me this time too.  The students are going to come to his room.  I think that it will be good for James to see see some young people.  I can get him to help me push the buttons for the power point too.  We might practice a bit this weekend! 

He was in his chair for 4 hours again today.  Today he did a great job of showing off for the occupational therapist.  He opened and closed his hand and kind of arm wrestled with her too.  He got a new head rest for a trial today too.  This head rest has less support,  to help him build neck strength back up.  This afternoon his favourite nurse, Stacy, was working with him.  He was very cooperative with her.  He was much more alert in his chair today too.  He worked really hard trying to move his hands to touch things on his tray.  He only dozed off for about the last 10 minutes in his chair.  He was much more wiggly when he was up today too.  I was constantly putting his feet back on the footrests or asking him to put his head back on the headrest. 

James has been sometimes having a period before he falls asleep where he seems a bit agitated.  He moves his legs up and down the bed,   lifts his head off the pillow and grimaces.  Until a week ago he had the cuff up on his tracheotomy tube and could not make noises because air could not get past his vocal chords.  Last night when he seemed agitated I noticed that he was making a very quiet moaning sound and sometimes a crying sound.  The nurses said that they had not heard it.  Tonight when I went to say goodnight to him,  I heard him from the hallway!  He is still not terribly loud but remarkably louder than he was last night!  I got the nurses to come and hear him.  I feel better that he has a way to communicate,  even if it is pretty basic.  He is opening his right eye a lot more now too.  The nurses are feeling that his pupil in the right eye is responding quicker than it was as well.  Sometimes it appears that his right eye is trying to move with the left eye too! 

My Dad came to Victoria and took me to the book signing of "March Forth"  by Trevor and Debbie Greene.  I had prepared a note to give to them with a brief synopsis of James' story as well as my contact info.  I hoped but did not expect that they would be comfortable contacting me.   They were amazing,  not only are they comfortable but they gave me their info too.  Debbie said that she would ask the neuroscientist that they work with if he will see James when he is on the island in a month or two!  They wrote some words of wisdom in the book for James too.  "Stay the course and never give up! (from Trevor)" and "You can get your life back! (from Debbie)" What a night!  A huge Thank you to my dad for dinner and getting me to the signing and my bestie, Allie for prebuying the book for me!

Tomorrow  I present to the student nurses on our floor about what traits or behaviours that nurses do that are the most helpful to families and patients. 

This morning had an interesting start.   I was heading up to see James just like every other morning.  I did take note as I walked into the hospital that I was so tired that my sight was a bit blurry.  I got in the elevator and another lady got in with me.  She pushed 5th floor and I pushed 6th floor.  When the elevator stopped I somehow forgot about the other lady.  I got off and went to "James' room"  as I was walking through the ward I noticed that there were all new dry erase boards on the walls.  I thought, "Wow they were busy putting those new boards up last night!"  I walked into "his room"  and it was empty!  Then I went to the nurses station (I didnt recognise any of them)  and asked where he went.  They looked at me like I was crazy.  "James who?"  they asked!  Ok now I am getting a little worked up!  "He was there when I came to say goodnight last night!" I told them.  We finally sorted out that I was on the 5th floor instead of the 6th floor.  I was extremely relieved to find him right were I left him,  on the 6th floor!  Why do they make all the wards look the same!  

James was up in his chair for 4 hours again today. Yesterday he was up for 5 hours!  We are still waiting to find out more about the possibility of him transferring to St. Joe's hospital. I am hoping to find out tomorrow if St. Joe's are able to meet his needs. (tracheotomy care, physiotherapy, occupational therapy, and a room hopefully within ear shot of the nurses station.) 

Tomorrow night I am going to the book signing and release of "March Forth" and am excited to meet Trevor and Debbie Greene.  My dad is going to come down and take me to dinner and the signing,  and my bestest friend has prepaid for the book for me!

James' day today was like most of his days.  He sat up in his chair for 4 hours today.  His favourite nurse came to visit him today.  She was the first nurse that he made eye contact with and it was for her that he first opened and closed his hand.   He did a good job showing off for her today.  He opened and closed his hand for her when she asked,  and wiggled his toes for her.  She was very excited to hear that he is moving his arms, legs and head around a lot when he is in bed.  She reminded me that he wasnt doing that last week.

I went down to the EI office today to try to sort out my compassionate leave.  They sure dont make it easy.  They lost some of my paperwork that I submitted a month and a half ago.  They didnt let me know that anything was amiss with my claim though.  I almost went postal.  Not sure if I want to scream or cry.  Sounds like they may make me submit original copies of my Records of employment now.  Almost feels like it would be easier to just forget it,  but I have bills waiting to be paid.

I have been following the story of a soldier (who lives in Nanaimo now)  who sustained a severe brain trauma in Afganistan in 2006.  His wife was told that he would likely never wake up.  He is now learning to walk and has co authored a book with his wife about his experience.  The book is available on March 20th and they will be in Victoria doing a book signing on that day!  I will be finding a way to get there! 

James had a good day today.  I did range of motion exercises with him when he was in his chair  He opened and closed his hand for me when I asked a few times.  The nurses said that he did it for them too today.  They also feel that his responses are getting stronger and less delayed.  He smiled and gave a little laugh a few times today too.   He is doing a lot of spontaneous movement when he is in bed.  He moves his legs around a lot and lifts his head off the pillow. 

We had a planning meeting today.  The doctors say that James medical needs are at a point where St.  Joseph's hospital could meet his needs.  He is not at a point where he is ready for rehab yet,  and he could transfer back when he is ready.  I am looking foreward to going home but am scared about another change.  It is always difficult figuring out the routine and build the trust with the nurses.  We don't know how long it will be before the transfer though.  It could happen very soon or maybe not for weeks. 

Mark and the kids went back home today.  They will just come back down for visits.  I miss them already.

James did great today.  I took him for a wheel around the unit again today.  This time we did two laps and stopped briefly in the 6th floor lobby and looked outside and watched a few minutes of TV.  He has been squeezing my hand to tell me "yes" for a while now,  but he has not done it for the nurses yet.  Often when the nurses come into the room he half closes his eyes or completely closes them.  He has yet to make eye contact with them at all.  When he was at the end of his chair time today,  I thought he was overstimulated and he was pulling his head forward and putting it back and tremoring and moving his left arm alot.  When I asked him if he was "ok"  he sqeezed my hand,  and did not squeeze for " Are you tired?"  When the nurse came in I told her how I thought he was overstimulated but that he squeezed that he was ok.  She asked him to squeeze her hand and he did but he did not release when asked.  He did look right at her though.  She turned his hand over and asked him to close his hand,  and he did.  She asked him to open his hand,  and he did!  She had him repeat this 3 times!  Then wiggle his toes,  he did this too.  She called in another nurse and they had him do it again and he did!  This jumped him up the "Glasgow coma scale"  by two points!  I think that times when I thought he was overstimulated or upset,  he has actually just been trying very hard to make his muscles work!  I was so proud of him today!  It was awesome to see how excited the nurses were about it too.  Seeing their reaction made me feel like I can be excited and hopeful too!

When we went in to see James this morning he had his bite block taken off.  I have been nagging the doctors,  to take it off, but suggested that it be done when I was there.  When I asked when it was taken off the nurse told me last night!  He has done great without it in since last night and I am hopeful that he is done with biting his tongue!  The next day or two will give us a better idea,  but so far so good! He looks so much more comfortable with it out!

James had a pretty full day today.   He was visited by both his doctors,  physiotherapy and Occupational therapy.  OT started asking him to look at different shapes and letters in opposite corners on a peice of paper.  He appeared to be looking at what she asked him to.  He wouldnt fully open his eyes but did peak out of a half opened eye.  I was able to take him for a short wheel around the unit today too.  He was very alert and looking around for that!  He worked very hard at wiggling his thumb for me today.  He has been trying very hard to raise his thumb up for a thumbs up but has been struggling with it.  Today I discovered that if I let his fingers and thumb hang over the edge of his tray of his chair he can wiggle them easier.  He got really going and was wiggling his thumb back and forth really well!  He got very excited and didnt want to stop, but when he gets too excited about something his left arm gets muscle spasms and I had to work hard on getting him to settle down.  He is starting to smile a bit more often and occasionally he will actually give a little laugh.  He seems to find passing gas amusing and will either smile or laugh if he knows that you heard it.  What a boy! 
For short periods of time he will squeeze my hand for "yes"  when I ask him questions.  I need to make the questions count though,  because there seems to be a three or four question limit.  For a few days now,  I have asked him if he wants his glasses.  He has given me a fairly quick,  strong squeeze .  His glasses were lost in the accident,  so I called the eye doctor's office and ordered him new ones.  They were ready today in Courtenay today,  and I was going to have them purolatored down to Victoria.  When I called to make arrangements,  they told me that a staff member is coming to Victoria tomorrow and will deliver them to the hospital tomorrow evening!

I have been reminded that I haven't blogged in almost a week! I think everything has really started to hit me this week.  I had a rough couple of days.  Life is not going to be "normal"  for a long time, I am tired and I miss my big strong boy.  The last couple of days I have been feeling a bit better,  and I think that the key is really making sure I take time to care for me.  It is hard to remember to keep myself healthy both physically and spiritually!  My best buddy from Edmonton came out to visit and I am looking foreward to spending a bit of time with her. James had a busy couple of days.  He had visits from Grandparents and girlfriend.  He really seems to brighten up when his girlfriend comes to visit.  He gave Grampa George and Robin a smile when they visited.  He has had more frequent and longer aware times this last couple of days.  We have been reading a book to him about unusual animal friendships,  and he really looks at the pictures intently.   The staples from his last surgery should be coming out tomorrow.