Tuesday, November 2

2nd Day of Matt 'waking up' / just talked to Kate

We lost the phone connection but she was able to tell me several things. Tomorrow, she hopes to find out more; there was a patient that was coding or having MAJOR problems & the director (who talked to Kate while I was there) said that the situation had kept the nurses extremely busy.
Just the facts - per the director

  • Matt is definitely NOT in a coma anymore; they now use a different scale (1-8); read Stef's comments
  • Monday was an extremely busy day for Matt - physically but, more importantly, mentally
  • At this point, his brain functioning & healing are very fragile
  • The goal is to keep everything low-key so his brain can regrow new pathways & heal
  • MOST IMPORTANTLY, he specified that any type of stimulus should & must be kept to a bare minimum, because...Too much stimuli, i.e., reading to him for more than a few minutes, can cause a reaction in his brain that releases toxic chemicals, which will impede and/or retard healing. He used the quiet short conversation with Kate as an example: at this point, Matt's brain is unable to distinguish that there are 2 different people talking. If they were to talk louder, he said, that would be stressful for Matt's brain. If they talked for longer than the 5 or so minutes that they talked....again, that would be stressful for Matt's brain.
  • He has 4 therapists: speech, physical, occupational & respiratory
From my conversation w/Kate before the director came in

  • Matt was asleep when she got there & hadn't woken up - disappointing
  • He sleeps only with the right side of his face because the left side is damaged; she doesn't have more info on the specifics. But, he definitely took the brunt of the fall on his left side
  • He has grown a mustache, for the 1st time in his life!
  • The nurse told her that familiar voices will help increase and kind of guide his brain in it's job of healing, which includes memory
  • Tomorrow, they will get Matt awake & put him in a wheelchair - again, not sure exactly why or what the purpose of that is...
  • His bed is tilted somewhat, feet down, in order to make it easier on his diaphragm (muscle), thus making it less strenuous to breathe (that's what the nurse told her)
  • The nurse also told Kate that it's normal for patients recovering from comas to have different levels of energy from day to day... it's a lot like a strenuous workout...only it's the brain that is working tremendously hard
  • Matt is breathing on his own but they are using the respirator/ventilator? as an aide
  • When they start working on speech, there is a kind of a cover for the tracheotomy hole; the whole business with the tracheotomy is not a big deal at all..neither the surgery to make it nor the surgery to close it - very surprising (to me)
  • One of the nurses told Kate she had just run into a former coma patient, who arrived in a similar condition as Matt...and now the guy is taking college courses.
What's next for Matt

  • Tomorrow is Wake Up & get in the Wheelchair Day; also do some therapy - sounds like a big day!
  • Kate's going to take a picture of Matt with his mustache before she shaves it off - LOL
  • She asked me if I wanted to see pictures of Matt and I said, "YES!" Then, we decided that it would be interesting if she kind of kept a photo-journal of Matt
  • No tests or anything are being scheduled as far as Kate knows
Interesting Notes (from my perspective)

  • Kate & I didn't realize just how fragile & ...I guess I would use the word "tender" Matt's brain is: that his brain, at this point, can only handle a short amount of stimulus of ANY kind....voices, music, touch (the nurse said that rubbing his arm for any length of time would be way too much stimulation - instead, one could hold his hand & not move it)
  • I am extremely impressed with Kate's innate ability to automatically do things that are specifically helpful to a coma patient. And also that she has thought of so many good ideas & questions that no one else has thought of - way to go, Katherine Kate Hardie!!!
  • She had a good quote, "Everybody {on the staff} has been telling me that he's not going to be the same person he was...things will be different. It's one of those things where you think you understand what they're saying but then all of a sudden realize that you didn't really 'get it' at all."
  • I know it was disappointing for me when she said that she hadn't even gotten to see him awake so I can't even imagine how hard it was to finally get to the hospital and not see him be awake. Neither of us even considered that he would sleep through the whole day today! I am really impressed with her attitude. She was disappointed, of course, at first. But she quickly remarked on the positive aspects..."Well, he's resting today but he might be awake tomorrow...and that will be a good thing." Sorry that this is so long but I felt that it was important to explain Kate's " allright...this isn't quite what I expected, going to be a little I'll just work at it harder" attitude.....cuz, that's a good thing, too.
A good example of her determination under very trying circumstances is what happened to her BEFORE she even got to see Matt today. She left home, all excited, drove a couple miles and her car battery died!!!! No one would give her a ride even though she was carrying a laptop & huge bag. So, what does she do? Let that stop her? No. She just grabs her stuff & starts walkin'. She even called me (cuz I'd been on stand-by for hours) while she's trudging uphill, huffing & puffing because she's got all this junk to carry & made jokes about the whole fiasco.

Matt is so very lucky to have a little sister so determined to see him and help him that she just doesn't give up- no matter what obstacles come up!!
She just climbs over them, around them this case...walks as fast as she can, uphill all the way - because it's the destination that counts.


Anonymous said...

Hi Aunt Susi and family,

You are absolutely right. Kate Hardie is one of the strongest women I know. I keep telling her she's my hero....

Susi, I wanted to re-iterate what you said about too much stimulus... it is so important to keep that to a minimum at this critical stage. For Kate as well. This is NOT the time to visit Matt - it will be overwhelming for him to try to process all of that information at once - he may become agitated, irritable, and regress instead of progress. Kate, as well, needs to focus on what the doctor's are telling her and not be distracted by visitors. I would, at this point, keep visits to a minimum if at all. If you are going to be there, be there for Kate in Spokane - help with Jack, make some meals, do some laundry, and let her deal with Matt.

Thanks for the updates, Susi. I'm so relieved that he is awake.

xo Stef

Susi said...

Thanks Stef, for your input. I am not a medical expert by any means, nor a doctor...altho I feel like I'm Dr. Mom after having 3 sons! I am trying to be factual but I'm only one person. Also, you did a MUCH better job of explaining the danger of too much stimuli - thank you for writing that. It really helps to get another opinion & it validates what Kate is telling me the docs are saying.

Anonymous said...

Hi Susi,

Thanks for that. Dr. Mom counts for a lot - especially with 3 boys. And I wanted to add that the message wasn't directed at you (i.e. that you shouldn't visit...b/c I'm sure Kate would love that). I was more so describing, and trying to avoid, the typical hospital visit scenario whereby well-meaning friends would show up to say hello for an hour a day etc. He probably won't be able to manage such visits for at least a few months, maybe more.

This also depends on his 1-8 scale of consciousness because that is an issue as well. They still need to determine whether his responses will be generalized, localized (requiring total assistance and intervention), or confused/agitated, appropriate/inappropriate etc. Frequent visits/stimulus may cause him such distress that he may try to pull tubes, move from a certain position and injure himself further, etc. Also, going to the NIACH and expecting the usual Matt will be more of a shock than anything. Displaying any kind of shock, sadness, or extreme emotion will not help him in any way. It is best to be very calm, talk very little, move very little, and to not challenge him to think/react in any way. Say "hi Matt. I'm ____. I'm your friend". Try to avoid asking questions like "How are you? How are you feeling? What are you doing today?" Because his mind will be triggered to respond but it will get muddled in the transfer. Imagine being asked a critical question in another language and knowing, inherently, that you should respond immediately but you don't speak the fact, you don't speak. You want so badly to convey something because, somehow, you know you have to, but you can't. You will become frustrated, angry, and perhaps aggressive trying to get the message out. That is how he will feel for these first few days/weeks. Don't ask him questions. Everything should be simple reassurances and cues from Kate - who he knows/trusts. If anyone does visit, keep it BRIEF and simple "Hi. I'm ___ . I'm your friend".

The basic, simple message (if I can beat this to death, please) is: "Things are good. I'm a friend. You're getting better." Reassurance and support are key.

I only know some of this through patients I have worked with at the Homewood (rehab / mental health facility) who have had psychotic breaks, medication induced comas (overdoses), or prolonged amnesia/stupor (due to drugs/alcohol). A lot of the literature on "awakening" and the state of the brain is the same.

Matt Hardie is also one of the strongest and now most miraculous people I know. He may be able to have visitors next week. However, I would watch here for your messages from Kate in that regard. The hospital will work with Kate on all of the protocol surrounding his rehabilitation including visitors.

Thanks again, Susi.

xo Stef

Anonymous said...

Thank you, Stef and Susi, for the guidance. I know we all want to be here for Matt and his family in the way that helps the most. We are so grateful for the updates and the information. Lots of love and encouragement to Matt, Kate, and family! Best, Alli.

Stef said...

These are the 8 levels:

I - No response;
II - Generalized;
III - Localized;
IV - Confused-agitated;
V - Confused, inappropriate, non-agitated;
VI - Confused-appropriate;
VII - Automatic-appropriate;
VIII - Purposeful-appropriate.

I've posted details as to each level here:

It's quite a read but may give you a good understanding of what Matt is facing in terms of working through his cognitive function. Most drug comas recoveries start at about a Level III (some brain damage may have occurred) which includes:

# Turns toward or away from auditory stimuli.
# Blinks when strong light crosses visual field.
# Follows moving object passed within visual field.
# Responds to discomfort by pulling tubes or restraints.
# Responds inconsistently to simple commands.
# Responses directly related to type of stimulus.
# May respond to some persons (especially family and friends) but not to others.

Hope this helps.


Anonymous said...

Hi, I'm a good friend of Rich's and I've been following Matt's (and Kate's!) story on this blog.

I've heard that some patients in Matt's situation respond positively to Reiki, which is a touch therapy, but not rubbing or pressing like massage. Just a very light sort of laying of hands at various places. You might ask NIACH to consider if this would be helpful. Even the US Army does Reiki these days so it must be worthwhile, right?