Hospitals I have known and loved

Honda CB175K3 Super-Sport

I was born January 8, 1950, at Florence Nightingale Maternity Hospital (now Baylor University Medical Center at Dallas), on Gaston Avenue, not far from my parents’ first apartment, and where my mother learned to drive a car. I have no recollection of that hospital visit.

Over the next five years I regularly was taken to the emergency rooms at various hospitals, once for a benign brain tumor, and at least three times after falling and cracking my skull. Those were part and parcel of my being a free-range child. When I was about four, I was diagnosed with bilateral cryptorchidism, the absence of both testes from the scrotum, which according to Wikipedia is the most common birth defect of the male genitalia. I had to visit a doctor for hormone therapy – twice weekly injections over six months. When that failed, during the summer I was six I was taken to Baylor Dallas on Gaston for two surgeries. I went through the same surgical procedures when I was fifteen, also at Baylor Dallas.

Just before my senior year at East Texas State University, I purchased a motorcycle from my friend Ronnie England, one of the trumpeters in Los Caballeros de Canción. It was a 175-cc Honda Super-Sport, that I had no idea how to ride. Five minutes after I left his house, headed to pick Jean up for lunch, I failed to negotiate a turn from Audelia Rd. onto North West Highway, flew over the handle bars and broke my jaw. The ambulance driver asked me to which hospital I wanted to be taken, and I just said, “Whatever is closest.” He took me to Presbyterian, where I spent four or five days while I got my jaw reset and wired shut. Fortunately it was a clean break between two teeth, so I had not broken any teeth, but I could not open my mouth for the next eight weeks. I ate only what I could suck through a straw. For the first four weeks I was still living at home, and Mom fed me so well I did not lose any weight. The last four weeks were spent in the frat house in Commerce, and fending for myself, I lost about twenty pounds!

The wires were removed on September 17, 1971, and my first meal – pizza – was picked up on mine and Jean’s way to see a Billy Graham crusade, which was the first event held at the newly-constructed Texas Stadium. I could barely open my mouth wide enough to eat.

It was thirty-two years before I would need to be in another hospital. In 2003 I took a job at the Tulsa County Jail to learn to become a Corrections Officer. As a part of that training I had to get some vaccine injections for tuberculosis, tetanus, and hepatitis. About that time I contracted Guillain-Barre syndrome, a rapid-onset weakness of the limbs as a result of an acute polyneuropathy, a disorder affecting the peripheral nervous system. In my case I had no use of my legs and body from my shoulders down. Evan and I had gone to a billiard hall to play pool, but the next morning I had trouble standing up. Evan took me to the doctor’s office. My family practice physician was on a trip to China, and his substitute just told me to rest. The next morning I could no longer walk or even stand up. I called my sister Sande – a registered nurse – and described my symptoms, and she told me to get to the hospital immediately.

After spending a couple of hours waiting in the emergency room at St Francis Hospital, I discovered that even bathrooms designed for the handicapped were not able to handle patients in wheelchairs. Even with some help from Evan, I still ended up peeing all over myself. They finally asked me a few questions – I could not stand or walk – and put me in a room and helped me climb into bed. I spent exactly one month in St Francis, and left in a wheelchair, but able to walk a little bit.

Of course my most recent hospital visit was November 1, 2012, when I was hit by a car. After receiving CPR, which certainly saved my life, I was taken by ambulance to Parkland Hospital. At first the doctors told us – not me, I cannot remember anything until a few days before Christmas of that year – that I could probably go home in a couple of days. Then they realized that my brain was swelling too much and that I needed immediate surgery to remove a part of my skull, about the size of my fist. They stored that section of my skull in a refrigerator for a few weeks, when they decided my brain had ceased swelling enough and replaced that piece of my skull. I spent about seven weeks in Parkland followed by a couple of weeks at the adjacent Zale Lipshy University Hospital. I was then moved to the Centre for Neural Skills, where I lived for another seven months.

I have decided that as much as I like the attention I get in hospitals and other such rehabilitation centers, I think I have done enough of that and hope I can stay out of them for the future.

The happiest day of my life

First, some notes. It has been nearly two months since my last post. There is nothing wrong. I simply ran out of things about which to write. Then I tried to write a couple of weeks ago, but had problems with my computer. And since I can no longer remember how to deal with computer problems, I was stuck. Finally I texted Evan and he found what I needed by searching Google, so hopefully now things are working properly.

Second, Ellie Jade is scheduled to arrive just a week from tomorrow. Mirjam looks like she is wearing a basketball and Evan is thrilled to death in anticipation. So are Jean and I, planning all the ways we will be helping to raise our first grandchild.

But the happiest day of my life – so far – was this past Sunday. I finally got to meet Maria Reyna Paculba, the girl who started my journey through what has been the best two-and-a-half years in my life! After I had moved home from having being in the hospital for two months and then living at the Centre for Neuro Skills for another seven months, Jean gave me a lot of papers that had accumulated over those months, including the Dallas Police report of the accident. From that report I had the name and address of the driver of the car that hit me. On February 24, 2014, I finally wrote her a short letter to tell her that I was doing well and really wanted to meet her. Here is what I wrote:

Maria,

This is Patrick Spreng. I don’t know if you remember me, but I would like to meet you (again). I am the guy you hit with your car on November 1, 2012, and I am now well along on the road to recovery. I only want to meet you and let you know how wonderfully my life is going since that day!

Is there any way you could call me or email me, so we can set up a way to meet and go over “old times”?

I hope to hear from you very soon!

Although it took her fourteen months to get the courage to respond, last Wednesday she emailed me in response to that letter, expressing a willingness to meet me. Sunday the four of us – Jean and I along with Maria and her husband Ruel – had lunch together at La Madeleine, and it was wonderful!

We talked for nearly three hours. When she first saw me, she said, “You look so thinner!” because over the past thirty months I have lost more than ninety pounds! She told me about the incident from her perspective, not being able to see the group of pedestrians because of the sun in her eyes, seeing Alyson Abel Mills extend her hands in surprise. Then she jumped out of her car, ran up to me, found no pulse or any breathing, and immediately began giving me CPR. I also leared that there was a second nurse in the car with her, both of whom had just gotten off work at UT Southwestern, and both of whom worked to give me CPR. Maria also described how difficult it had been for these past two-and-a-half years thinking about what happened to us with anguish.

After the ambulance had taken me to Parkland’s Emergency Room, She had tried to find out what my status was, but the people she spoke with at Parkland would not give her any information – HIPAA security rules prevented that, and she did not even know my name. She says she did hear someone call me “Patrick” while she was trying to save my life, but Parkland would give her no help at all. She did find out from talking to her automobile insurance agent that I was seriously injured, but was still alive and in recovery.

From the emails I had sent her since last Wednesday, she learned about my blog and had read all of it to learn about my development and recovery, but I did go over with her some details that I have not shared here, mostly about my continued recovery and how my life has improved considerably, even to where it is considerably better than before we had first met. I have said this here before, but not only have I lost a lot of weight – I now weigh about what I weighed forty years ago – but I am much more happy and even my wife says I’m a “nicer person.”

One thing that Maria said, that really makes me happy, is she now thinks that “somehow we were meant to be together in some way.” So now we are and will continue to be together.

Email

 

Palm Pre 3

Last night I went through my email history from the first year after my brain injury which happened on November 1, 2012. My last email was October 31, to my son Evan. For more than five months I could not use my smartphone to read or send messages, or do anything else with it. After I awoke from the coma in late December when I was at Zale Lipshy, I wanted to be able to call Jean. She wrote down her telephone number for me, but that did not help much. I tried to use the desk phone in my hospital room but did not know that I also needed to dial “nine” first before dialing the number that Jean had given me. In this post you will see how bad my grammar and spelling were at that time, and a little bit about how it started to improve over the first few months.

The first email from my smartphone was from Jean to a friend of mine in Iowa dated April 8, 2013, titled “Out of touch,” because it had been more than six months since I had written to her. I am including this one because it gives readers of this blog some background:

“Kayoko, I am Jean, Patrick Spreng’s wife. He asked me to send you a message to ask how you & your family are. He always shows me the pictures of your family on your Christmas card! The reason you haven’t heard from Patrick lately is that on Nov. 1st as he was walking to his office, he was hit by a car & had a traumatic brain injury. He was hospitalized for 2 months & now is in a residential treatment center about a half hour drive from his home. He is doing well but is frequently frustrated because he must re-learn how to read & that is going slowly so he asked me to write this to you. Hope you & your family are doing well. God bless you! Jean”

The first email that I sent was to my son Evan on April 11, 2013, titled “Pretty bad,” asking for help with using my phone: “I need more help sometime.”

Jean had come by my apartment on the 10th and used my shower to clean up. I could not find what she had done with the soap, so I sent her this email: “What tide you do with me path soap for my mode? I can’t find it.”

On the 13th I wrote a message to Matthew Goodman, the music leader of our church in Tulsa, titled “Me, again.” “I was will by a car last year end ave spent six months attempting at CNS. I am trying relearn to read and right. I cont know it I’ll ever be able to work again. I don’t know if I’ll ever be able to play again.”

Again that same day I wrote this to Tom Leonardis, President of Whoopi Goldberg’s company, Whoop, Inc. and Executive Producer of One Ho Productions, her production company, titled “Recovering acain:” “I was git be  a car last last October, recovering from being hit  by a car on the street. I cannot writ or read or are a computer. I am moderating new Dallas.” And on April 28 I again wrote Tom, titled “Happened again!” “I have been in treatment for nearly six months after getting hit by a car while calling across the street. I can’t read or right or eat (damaged swallowing), but  I can still walk. I am not wishing for sum  support and should be out of re-hab by the end of this year.”

For my websites I had used the URL acmewebpages.com since 1998 or so. But the GoDaddy account for that expired near the end of January 2013, so none of my websites existed after that. But I was still getting billed each month from my web host, EZ Web Hosting. So my next email was sent to them on May 2, 2013, titled “Please call me at 972-333-4508” and it just said “Please call me.” I cancelled my account and they were willing to cancel the billing since January.

On June 8 Matthew replied to my email from April 13th, titled “Following up” “Diann in the front office forwarded your phone message to me, so I wanted to follow up and see how things are going. John Tyson had seen on facebook that you had an injury late last year, so I’m hopeful that you are recovering. I wonder how you, Jean and Evan are doing these days. Things here seem much the same, though probably vastly different than when you were here, as we tend not to notice incremental change. Our 3 boys (yes, we now have 3!) are 12, 8 and 3 years old, so Kelly and I stay pretty busy, but it’s all good.      “Anyhow, I’ll hope to hear back from you when you have a moment to respond.

So I sent a reply on the 23rd, titled “Following up” “Thinks  aren’t actually going to well for me. While walking across Inwood Road to work, I was hit by a  car. I have been in the hospital and in recovery  since last November 1st with brain damage. I am unable to read or write or even eat  normal food. Recovery is painfully slow-I may not be able to read for months or even years! Life ahs become a struggle, but I may go home next month, mainly because I have little money laft. Machines are helping me wright this, but I cannot re-read it.”

I don’t know why but on June 25 I wrote a third email to Tom Leonardis: “Another dire straight…On November 1st, while walking to work across the street in Dallas, I was hit by a car. A couple of days later I needed  brain surgery and was in the hospital for over a month. I have now been in two area rehab facilities. I cannot read or wright, nor can I rat regular food. It could be months before I can learn to read. I am doing okay and will soon get  to go home. I don’t need any help, I just wanted to keep y’all updated.”

I wrote this on July 2 to my UTD Callier coworker Dave Simcoe: “It looks like I may get to go home next week or so. My English teacher says I may now be reading at a 2nd grade level! I may be at a 6th grade level by the end of this year. I will still be going to school each day at CNS every day. I don’t know when I’ll be able to  drive again – I haven’t driven since last October. It’s good to hear from you.”

By June I had begun making a list of the people I was getting to know and work with at the Centre for Neuro Skills (CNS). Then on July 17 I sent a copy of the list I was making to myself, probably because I did not know how to store that list in my phone:

CNS People, clinic & apartments:
Debby Peters – Eating
Kimberley Webb – Education
Brandy Chancellor-Reid, Conroe
Brian White – conference
—–
NRS PM – Nicole Louglas-Barclay
(Jamaica)
NRS PM – Kem – Bo
NRS PM – Shantell – John
NRS PM – Adriana (Mexico)
NRS AM – Lupe (Irving) John
NRS AM – Sandra (Corpus) John
NRS AM – Ashleh – next door
NRS AM – LaResha – next door
NRS AM – Sheree (Japan)
NRS AM – Wybell (Philippines)
NRS AM – Amanda (Texas BClar)
NRS AM – Bernadette (Vegas)
—–
Tiffany – housing
Catherine – PM Supervisor
Ashley – receptionist
April – transportation
Carl – transportation
Veronica – transportation

Nursing:
Dr Johnson
Dr Karen Kowalski
Selam – Nurse
Sharon – new Nurse (7/15)
Cindy – office meds
Juliuse – Nursing receptionist
—–
Ashley – housing meds

Students:
Me, Garland, OuPa, 7/19
Ryan, Austin, California
Bo, Texas
Charlie, Wisconsin
Bill Wilson, Rockwall, OuPa, 5/??
John Sims, South Texas
Ashton Cerka, OuPa, 6/28
Ken Frisbie, Dallas
David E Deason, Jill; 4353 W Lawther, OuPa, 7/12

PT: Health and exervise
Whitney
Vanessa
Melina (Venezuela)

By this time I was pretty well functional with my cellphone and was able to clearly communicate with most everyone, so most of my emails from this point sound quite mundane and ordinary. Thanks for reading.

Lists

Toroweap Overlook at the Grand Canyon

Probably the worst injury I have from my brain injury is memory loss. I can still remember things about my childhood and most of the years after that, but I cannot remember much about the five or ten years before the accident. I cannot remember anything about the work that I did in my five years at Callier Center. I cannot remember names, places, US states, cities, TV or movie actors, countries, and lots of things like that.

Through my rehab I have been learning many ways to help me remember. For instance to remember the state of Illinois, where I lived when I worked at State Farm Insurance, I can remember the city of Chicago, a city I have visited several times in my life, both from work and from family vacations (see photo above – not Chicago, but from a vacation.). And when I think of Chicago I can easily remember its state, Illinois. So when I want to remember that state I just think of Chicago. Another tool I have been using are lists. Fortunately I have been doing that most of my life.

As a child I made lists of what teachers I had for each class each year, especially after I got to junior high and high school, where I had multiple teachers each day. Like most boys – and probably girls, too – I kept lists of the people I dated or wanted to date, including when we went out, where we went and of course a rating system for each girl. At first I did this in a printed calender, but eventually bought a “little black book” to keep records of that. I don’t have that list any longer because just before Jean and I were married, I destroyed my black book.

But I kept making lists. About our vacations and the places I traveled for work, all the cars I have owned, all the places I worked, my salaries, the places I have lived, the cell phones I have owned, my bank and credit card accounts, recipes, musical instruments and stereo equipment I have owned, hurricanes I have lived through – eight, many of the people I worked with, went to school with, and from my college fraternity. And for some of these lists I kept pretty good details. For instance my list of cars also has the make, model, year manufactured, dates purchased and sold, whether they were new or used, purchased or leased, paint colors, engine size, cylinders, horse power, even the EPA estimated rating when available, where I bought it and how I disposed of it – sold, traded in, or handed down to my son Evan or my brother-in-law Bill.

Early on I used paper and pencil to make these lists, but in the 1970’s when I started working with computers, I used those to keep my lists. In the 80’s I started using personal computers and in 2003 I got my first smartphone, which I have been using ever since.

All of that was long before my brain injury, so it was easy for me to continue doing that. While I was at the Centre for Neuro Skills (CNS), even though it took me six months before I could remember enough to use my phone, I kept lists of my therapists, neuro rehab specialists, roommates, even the meds I was taking. I also made lists of thing I needed to remember like US states, countries around the world that were in the news, all my bills, my medical accounts – Blue Cross, COBRA, Medicare, Social Security, Fidelity (the holder of my five retirement funds – Oncor, John Hancock, Sabre, Nielsen, Hewlett-Packard), unemployment, and of course the ACA Marketplace (obamacare)!

So as you can see I was prepared for brain damage long before it ever happened. There area still may things I have trouble remembering, but now I have plenty of resources I created throughout my life to aid in my recovery.

Brian White

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Brian was my counselor at the Centre for Neuro Skills and he helped me immensely. Like all the other therapists and teachers at CNS, he spent a lot of time when I first arrived there testing me to determine how much I had suffered from my brain damage. He gave me a raft of tests to measure my thinking abilities, but like others at that time he soon discovered that I could not read. I also could not remember very much and so soon realized that I could not answer many of the questions he had for me. That was okay because he was not measuring what I knew, as they do when you are in school, but rather how much I had forgotten.

Brian was a wise and gentle man who, like me, was a computer geek, a libertarian who understood that drugs should be legalized, and that there probably was no god. What we found out through his testing was that I could not remember any of the companies for whom I had worked, the states where I had lived, almost nothing about the countries of the world, and not even any of the streets or towns around Dallas where I lived. Geographically and historically my mind was a blank slate.

We would meet each day in his office and talk about whatever he and I wanted to discuss. We spent many hours trying to recreate my work history over the past forty years. I could only remember two of the six US states in which I have lived. We also spent a lot of time working on my insurance needs and my plans for Jean’s and my retirement. He helped me complete the forms we needed to submit in order to apply for my Social Security Disability Income, which always takes a lot of time – in fact, it was more than a year from the time Brian and I started working on those forms that my SSDI was approved and I began receiving income. We also worked on the forms necessary for my Long Term Disability income, which was what paid our bills (but only 60% of my former salary) after the University of Texas at Dallas had fired me nine months after my injury. That was to have been expected, because even now, more than two years later, I still cannot remember anything about the software I was working on at Callier Center. It can take years for someone to recover from TBI, and I knew the university could not wait that long.

Brian also researched the new Affordable Care Act and even filled out the online forms in the Marketplace web site, so together we suffered through the agonizing problems through the early days of that process. After leaving UTD, I had signed up for COBRA – the Consolidated Omnibus Budget Reconciliation Act of 1985, which increased our medical insurance from about $200 each month to over $1,000. With Brian doing most of the Obamacare application, our health insurance was less than half of what we were paying through COBRA (see this post for complete financial history).

Brian also got me hooked on TED, which began in 1984 as a conference where Technology, Entertainment and Design converged, and today covers almost all topics — from science to business to global issues — in more than 100 languages. Even now I spend several hours each week watching fascinating contributions through TED talks and events.

Thanks for reading my blogs. Please feel free to leave a comment here or use my CONTACT ME page to send me email.

More about Debbie

After moving from Zale Lipshy to the Centre for Neuro Skills, I started my Traumatic Brain Injury rehabilitation with daily classes in physical therapy, occupational therapy, counseling, educational therapy and speech therapy. Debbie, my speech therapist, was also trained in dysphagia recovery, and, as I learned last week, she quickly determined that I had a very severe problem, not only with that condition, but also a version called “silent aspiration.” I had no awareness of my dysphagia. If my dysphagia went untreated, I would put me at a high risk of pulmonary aspiration and even pneumonia from food and liquids going the wrong way into my lungs, because I do not cough or show outward signs of aspirating.

First Debbie limited my eating to using the Gastrostomy Tube (G-Tube), which feeds me through a tube inserted into my abdomen so I cannot swallow at all. Then she began teaching me a number of swallowing maneuvers which are supposed to help keep your trachea closed while swallowing. These include the chin-tuck, where you lower your head until your chin presses onto your chest; effortful swallow; supraglottal swallow, super-glottal swallow; and the Mandelsohn maneuver. There is also a long list of foods and drinks I cannot have, with a much smaller list of those I can have. Along with the swallowing maneuvers, Debbie would use a device (pictured above on my head) that gave my chin electrical shocks each minute during our hourly sessions.

After a couple of months she began fixing me small meals each day consisting only of different flavors of yogurt. After several months of only being fed through my g-tube, yogurt was absolutely wonderful.

Five or six times during the year I was at CNS – about once every two months – I was taken to a large van outside in the parking lot to have a “swallowing test” where I would sit between racks of special equipment that could film what was happening inside my throat whenever I swallowed anything. The people in the van would give me a series of different foods, like puddings or thickened liquids, to see when I swallowed down my trachea, and how much. Sometimes my swallowing would be improved with more going down my esophagus rather than into my lungs. In early July the test was so good that it was decided that I could get completely off the g-tube and begin eating “real” food orally. But by early November when I had my final swallowing test, there had actually been little change since my first test in January.

When I left CNS in November of 2013, Debbie put me on a diet called “mechanical soft.” On that limited diet I was able to eat yogart, cottage cheese, pudding, oatmeal, grits, mashed potatoes, chopped spaghetti, mac and cheese, blended cream soups, applesauce, mashed bananas, well-cooked chopped vegetables, meats that had been finely ground or chopped with gravey, eggs (scrambled or poached) and foods that were pureed. I could not have cold cereal, no bread, no rice, no other soups, no other fruits unless blended in a yogurt-based smoothie, no raw vegetables, no salads, no cookies or cakes, no other meats, and especially no seeds, nuts, chips coconut or popcorn. Much to Debbie’s sadness I told her that I could not live with those restrictions. And the reason was not because I had to have steaks, hamburgers or desserts; it was because I had to have sandwiches or salads. I cannot live with neither of those in my diet. Debbie told me that if I did not conform to these limitations, within a very short time I would get pneumonia and die. I told her that a year earlier I HAD died, on the Inwood Road, lying there with no heartbeat and not breathing, and that I would die eating whatever I wanted rather than live with these restrictions.

Now more than a year after my last swallowing test, I am still pretty much happily eating whatever I want, and still surviving. What I learned then was that there is no cure for dysphagia. It will not go away, not even with all the exercises that Debbie taught me, and there is no surgery to fix it. While there are a number of other causes, mine is a result of brain damage. All I have is a lifetime of dealing with it. I do use the chin tuck whenever I eat, and only eat sitting fully upright. And yes, I will probably die from pneumonia in a couple of years, but I will be quite happy with whatever happens for the rest of my life. I love you Debbie and thanks for all that you did for me, but I want to spend the rest of my days – however short that may be – happily eating everything I love.

Dysphagia

Dysphagia is the medical term for the symptom of difficulty in swallowing. All or part of what I swallow goes down the “wrong way,” into my lungs rather than my stomach. This kind of swallowing happens occasionally to everyone, but they usually then start coughing, which clears the problem. Even most people with this dysphagia can do that. But some – including me – have “silent aspiration” so I don’t realize the swallow has been misdirected, and the food continues into the lungs with no coughing or other awareness. Over the next few hours and even into the next few days I will usual manage to expel that food, but I do that more from “clearing my throat” than simply just coughing, although it is really the same thing; I just have a bit more control over it and it usually isn’t so loud. When I am outdoors I can simply spit it out. Otherwise, I just chew it up and try to swallow it again!

My dysphagia was caused by the accident that also caused my brain damage, or, rather, the subsequent removal of part of my skull in order to relieve the pressure caused by the swelling of my brain. The doctors knew about the dysphagia when they attached a gastrostomy tube (g-tube) to my stomach. But while I was at Zale Lipshy they did not use the g-tube for feeding after I came out of the coma, but rather wanted me to eat normally, and chastised me when I did not want to eat at all.

I just realized that that is not true! That is what I have believed happened to me two years ago, but I have been wrong. The doctors who operated on me at Parkland had no way of knowing about the dysphagia! They inserted the g-tube only because I was going to be needing it for a few weeks while I was in the coma. The people at the Centre for Neuro Skills (CNS) diagnosed  my dysphagia after I moved there in January of 2013. And the folks at Zale Lipshy were not being mean to me because I wouldn’t eat; they did not know!

Debbie, pictured above, is the wonderful therapist who discovered my dysphagia and spent eleven months teaching me how to live with it.

My first attempt at writing

Kimberly, my reading therapist , is now pregnant with her first child!

First things first: Evan and Mirjam found out last Monday that they will be having a GIRL next May!

When I woke up at Zale Lipshy, one of the first things I discovered about my condition was that I could not read. I could not even recognize the written alphabet. Even now, more than two years later, reading is difficult for me. I confuse many letters, like (P, Q and R), which slows my reading down to a crawl. About seven or eight months after my brain injury, Brian White, my CNS Counselor, asked if I had tried to write anything. He then sat me down at his computer and we found that I could write almost as well as before the accident. He told me that two different areas of the brain control our abilities to read and write, and that it appeared that the part that handled my writing must not have been damaged – even after writing something, I still could not read it! Soon after we discovered that I could still write, Alyce in Occupational Therapy had me sit at one of their computers and write about my injury and recover to that point. This is what I wrote, about a year and a half ago (nothing has been corrected):

“November 1, 2012 – Heading to work as I had for nearly five years, I arrived via DART bus at 8:00am. I walked across Inwood Road toward my office at Callier Center, a part of the University of Texas at Dallas.

“As I crossed the street I was struck by a car turning left from Arlington Park Drive onto Inwood Road. Apparently the sun, rising on my left, blinded her such that she struck me on the hood and front window of her car. She immediately stopped, called for an ambulance, and perceiving that I was not breathing, began performing CPR on me.

“I remember nothing of this accident, or the first month after that. I am told that my brain was damaged and that swelling had begun. Dr Rickart at Parkland Hospital performed several hours of surgery on me to relieve the swelling occurring to my head. I was in a coma for a couple of weeks after that surgery. I did not come to until nearly a month after the accident, and even then I was in-and-out of consciousness for the next month (I had been moved nearby to Zale Lipshy University Hospital). While I have very little memory of that time, I do remember over a dozen memories that I had. Some of those memories reflected some of what was happening to me in the “real world,” which I can remember little or none of. For example, I am told that I had had a tracheotomy tube inserted into my throat, which I continued to pull out regularly so that they strapped me to my bed to prevent that. I remember none of that process but I did have a dream where I was strapped to a bed and no one would help me get loose. Similarly, I had other dreams that could later be traced to actual occurrences that I could later identify from things I know or found out about.

“Needing another place to get rehabilitated, my dear wife Jean researched and selected for me a quality rehab center called Centre for Neuro Skills in Irving to continue my recovery. So after two months at Parkland Hospital, and the adjacent Zale Lipshy University Hospital, I was transferred on Wednesday January 2, 2013 to CNS, living in their apartments and attending rehabilitation therapy at their nearby clinic.

“At first I decided I would rather just go home. I had no understanding that my brain damages were severe and quite debilitating; I could not walk (I was in a wheelchair for several months), unable to read, unable to swallow any food without choking (I had a g-tube for feeding), nor could I remember very much (especially names, numbers, history, places and countries). Then during the first few weeks at CNS, I could not get food down – I regurgitated everything that I ate.

“That ended about a week later, and I had a couple of successes in my recovery. The first advance was getting away from my dependence on the wheelchair. After I got over the digestive problems, Sunil told me to get out of my wheelchair and walk. I told him that I could not do that. I could not stand up without it. He would have none of that crap, and insisted that I leave my chair. It took me about another three weeks, but I finally got to the point where I could get into the van that took me back to the apartments without having to use the wheelchair lift at the back of the van. This was a major accomplishment for me. I had been in that wheelchair for nearly four months since I was taken to the hospital.

“How I learned to love the apartments. The first week I was in the apartments, an NRS (probably Kim) wanted to find out what kinds of activities and programs in which I might be interested. Every time she described something like “sports,” “movies,” or “games” I replied “not interested.” All I wanted to do when I returned to that apartment after class was to go to bed and sleep.

“Only after I started to get my brain working a little better, was I able to know some of the people at the apartments. NRS employees, supervisors, transportation drivers, and other patients – I came to realize that this CNS place might be useful.

“I must especially mention the people in PT who provided instruction and support for an anti-exercise master like me. When I first came to CNS, I detested doing any exercise at all. They helped me to understand that (combined with the medical staff) they represented the equals of any fitness resource in the nation.

“I must mention a few of the people at the apartments whom I got to know, an who helped me survive the experience of brain damage. I got to know people like Tiffany, Bernadette, and especially Nicole (and dozens more). By keeping me company and sharing their lives with me, I came to again find that life was very much worth living. Today, I can now read and eat and know that I have survived from traumatic brain damage. I became so excited about learning to be around these people and how they could be people that I loved and be loved by, I now had a reason to get better.

“I must also mention the other people at CNS who helped me beyond belief – educators Sunil, Vanessa, Whitney (PT), Alyce, Carla, Matt (OT), Debbie, Michelle, Veronica (Speech), Kimberly, Amy, Maribel (Education), Brian (Counseling), Brandy (Case Management), Dr Johnson, Selam, Ashley (nursing), April, Bella, Carl, Eduardo and Vanessa (transportation drivers), and many others I don’t have room to list. I was at CNS just under twelve months, and by then I was able to walk up to two miles during Physical Therapy, read fairly well (it can take years for the brain to recover from such injuries), and even eat many types of food. I would not have gotten this far without the assistance of all the friends I made at CNS. I now plan to retire to helping others with such brain injuries and work to get more people aware of the lack of notoriety drawn by such highly debilitating injuries.”

30 Days hath September

Brain damage typically results in severe memory loss. As a result of mine I had – and still have to some degree – an inability to read, count, remember words and names, towns, countries, states and many other things. One loss I felt most deeply was time and dates, especially the months. At CNS we had a van driver named April. Since I could never remember anyone’s name, I had to develop ways in which I could remember those things. April was easy because it is a month, so all I needed to do was think, “January, February, March, APRIL!” There, that’s her name!

I got my first job in the computer business at Computer Language Research (aka Fast-Tax) on May 27, 1975. I interviewed a couple of weeks before that and learned that they developed their applications in PL/I, a programming language developed by IBM about ten years earlier. After I accepted that position, while I was perusing the local Barnes & Nobel, I found a book on PL/I at a reasonable price and took it home to read. That book used the function of printing a 12-month calendar as its way to teach the language, so my first education in writing computer software was to understand how calendars worked and how to design and print them.

One of my first software programs was developing a way to take a year, and develop how to organize and print that calender. First I had to determine on what day of the week January 1st fell, and for each subsequent month whether I needed to print four, five or six rows in a given month. For instance, for next year 2015, February only needs four rows, May and August need six, and all the rest need five. By the time I left Fast-Tax and went to work for Lone Star Gas, I had learned how to determine the start of any year going back to 1752, when Britain and her colonies adopted the Gregorian calendar, and developed a method to print the calendar as 12 months on a page or larger versions with each month filling a single page and leaving room on each day to write notes.  I had even begun adding the ability to include most holidays – even Easter, which requires being able to determine the paschal lunar year and its full moon, and then the Sunday after the paschal lunar month’s 14th day.

Another problem working with calendars was that, having been designed by Julius Caesar and introduced in 46 BC, for the next 1600 years it only used Roman numerals. And that was very different from how we figure dates today using Arabic numerals. For example to the Romans January 8, the date of my birth, would have been written as a.d. V Id. Jan. = ante diem = on the fifth day before the Ides of January. January 4, Jean’s birthday, would have been a.d. I Non. Jan. = ante diem = on the first day before the Nones of January. What I have shown is so complicated that both of these examples are probably wrong!

Anyway, with the introduction of the Arabic numerals and the use of zero, using dates became so much simpler that most of us can do most of what we need calendars for without the aid of a computer. Except for me. I still have to count the months to figure out what month this is, the same way I have to do with the letters of the alphabet.

Nicole

Words I needed to remember

After I had been attending rehab at the Centre for Neuro Skills for a few months, my counselor Brain asked me this question: “Patrick, thinking about your entire life, what was your best day?” Without skipping a beat I replied, “Today. Today is my best day.”

That beautifully captured my heightened awareness, my excitement and anticipation, that comes with working for a great purpose, the way that such reformation brings spice, meaning and joy to life. Through my recovery process, I have met so many wonderful people and made so many lifelong friends, each new day is always my best day.

On Wednesday January 2, 2013, I was loaded into a van on my wheelchair, and moved to CNS. The first person I met at the apartments was Nicole Douglas-Barclay. She was my neuro rehabilitation specialist. It would be many months before I knew what that was, and several months before I could even remember “NRS.” Since my condition kept me from remembering most names I heard, over the next few months I often had to ask my wife Jean what Nicole’s name was. I could not remember that.

Jean soon became aware during my first couple of weeks at the CNS apartments how important Nicole was to my recovery. So much so that when CNS decided to move me into a different apartment there, Jean asked the powers-that-be at CNS if Nicole could also be moved to be my NRS. That change of location and getting to take Nicole with me at each move continued twice again, allowing me to continue with the excellent care and development that Nicole provided me.

No matter to which apartment they moved me, Nicole and I were together. Life was good for both of us. It is good to be in rehabilitation — when learning again how to read and how to remember names and places, recovering from brain damage nothing is better. Food tastes better. Water is more brilliant. Girls are more beautiful. The sky is bluer. For the brain damaged in recovery. My life was the best. I was the happiest man alive.

What did she do for me? Everything. From the first day she would ask me a series of orientation questions, to help rebuild my memory:

What is your name?
What day of the week is it?
What is today’s date?
What month is it?
What year is it?
What is the name of the rehab building you are in?
What is my name?
What type of injury caused you to be here?
What city are you in?
What state are you in?
What country are you in?
What city are you from?
What state are you from?
What season of the year is it?
What is the weather like today?
Who is the president of the U.S.?
How old are you?
Where were you before you came to see me?
What do you do when we have a fire alarm?
What is the address for the apartment and clinic?

At first I knew the answers to none of these questions. By reviewing them each and every day over the months, my brain began to be restored, one answer at a time.

Nicole also spent time helping me to walk. After just a month I was out of my wheelchair and able to walk on my own. Each evening she would have me walk with her around the apartment complex. It was not far, about two-tenths of a mile, but before long I could walk around it twice, then three and eventually five times – a full mile each evening.

She helped me with my reading. Kimberly, my English teacher, gave me a set of flash-cards of short, basic words to read in order to heal my memory and reading ability (see the photo at the top). Nicole spent hours with me each evening showing me all these words so I could remember how to read.

Nicole, standing behind me at the wedding

Nicole went with me to Evan and Mirjam’s wedding. CNS provided a car and driver (Nicole, who had grown up in Jamaica, had no Texas drivers license) to take us to Garland for the wedding and back. CNS also had various events for the patients, such as going to movies, shopping and local parks. Along with some other patients, Nicole would accompany me on these outings. We went to several movies – the only one that I can remember was 42, about Jackie Robinson, although there were several other movies. We would go to local parks in Irving just to walk around and get to know the other patients and NRS’s. I was strong enough that I could help push the other patient’s wheelchairs around the parks. My shopping trips were limited to Target – because I could only eat through my gastrostomy tube (G-tube) Nicole never got to take me to do any grocery shopping.

What is probably Jean’s favorite task that Nicole taught me was to do my own laundry!

Sadly, CNS has a regulation against NRS’s providing patients any of their contact information, so I have not been able to communicate with her in over a year. Please check out my page about her, and contact me if you know how I can reach her,