Broken bones

Although I was a rambunctious child, I never broke any bones until a few weeks before my senior year in college.

I loved climbing – trees, homes, ladders, vehicles, bridges and anything else I could find. By the time I started school I had been in the emergency room at least three times, usually for head injuries from falling down. If someone placed a ladder on our house, I was on the roof immediately. My mother tells me about a time when I was two that she saw me on our roof and tore off her tight skirt to climb up a ladder to get me down. I often fell out of trees and would climb into attics in nearby homes, often even before the construction had been completed. We don’t usually have basements in houses in Texas, but I have been in the attics of most of the homes in my neighborhood. I played all the usual sports, including football, basketball and baseball. I spent hours on end exploring all the nearby bridges, sewers, and drainage ditches – and living next to Duck Creek, there were plenty of those. But even with all that danger in my youth, I never broke any bones. Until I bought a motorcycle.

When I was 21, I purchased a Honda bike from a friend – trumpet player Ronnie England – and drove off without any idea what I was doing on a motorcycle. I headed off to take my girlfriend Jean to lunch. She worked as a waitress at Zuider Zee Restaurant in Medallion Center at Abrams Rd and Northwest Highway. I never made it there, and Jean was ticked! While turning from Audelia Road onto Northwest Highway I was going too fast to make the simple right turn and the bike hit the curb of the center median, throwing me over the handlebars of the bike where I hit my chin, breaking my jaw between my lower right cuspid and bicuspid.

The next thing I knew I was sitting in an ambulance and the driver was asking me to which hospital I wanted to be taken. I simply replied, “Whatever is nearest” so he took me to Presbyterian Hospital. After lying in a gurney for nearly an hour, I was examined by a young doctor who, based on his attire, must have just come from the adjacent golf course – this was on a Sunday afternoon. He said I would need surgery to re-align my teeth, and that he could do that the next day. I was moved to a hospital room where the nurses tried to find a vein to attach an IV. After failing to find one with more than fifteen attempts, they gave up and decided to wait until Monday to let the surgeon do it. He ended up putting the IV on the back of my left hand. He reset my jaw and also put braces on each tooth so that he could wired all my teeth shut. I could not open my jaw for the next eight weeks so I would have to be fed a liquid diet through a straw. He also gave me a set of wire cutters in case I needed to throw up!

For the next four weeks I still lived at home and my mother saw to it that I was well-fed, so I lost not an ounce. After that, I moved back to college at East Texas State University, where I lived in the Delta Chi fraternity house, and I was on my own. I made myself milkshakes every day, adding an egg to give me some additional nutrition. Over the next four weeks I lost nearly 20 pounds! On Saturday, September 17, 1971, I had my braces removed. Jean and I celebrated by buying a pizza on our way to attend a Billy Graham crusade, which was the first event held at the newly constructed Texas Stadium in Irving. After being clamped shut for nearly eight weeks, I could barely open my jaw to eat anything!

The next time I broke any bones was when I was hit by a car on November 1, 2012, and I did not even know about it until nearly two years later. Apparently I landed on my bottom and broke my coccyx. After complaining to my doctor about pain while sitting down, she had me x-rayed, finding that indeed, my coccyx had been broken, but had mended itself – although poorly aligned – over the intervening twenty months, so I still experience some pain on occasion.

So after sixty-five years, I have had only two broken bones, more than forty years apart.

More from when I awoke from the coma

It has been almost two years since I had a fist-sized chunk of my skull removed and stored in a freezer for nearly three weeks, and about another month before I began to awake from all that. By then I had been moved to Zale Lipshy University Hospital, located on Harry Hines Boulevard next to Parkland Memorial Hospital.

Right away I figured out that I was in a hospital somewhere, and that something very wrong had happened to me. I did not know where I was – at first I thought I was in Oklahoma City, most likely because I had dreamed about being there. I had no memory of why I was there or what had happened or how long I had been there. I did not know what day it was and whenever I was told, I quickly forgot. In my mind I thought maybe I had been there for about a year. I knew that my father had died, but I could not remember how long ago that had been (it was actually October 2, 2012, almost a month before I was taken to the hospital). Eventually my family would explain all of this, but it took days and weeks for it to all sink in.

I had been losing weight since shortly after I started working at UTD Callier in November, 2007, and had dropped from 325 to 290 about the time I went into the hospital. After more than two months in Parkland and Zale Lipshy and the brain surgery and the coma, I had lost more than another twenty pounds. I can’t blame that on the quality of the food at Zale Lipshy. In fact they tried very intently to feed me and it was all good stuff – from burgers and pizza to soups, salads, steaks, pasta, baked potatoes, and much more. I could call and order practically anything I wanted. I just was not hungry. They would send me menus of what was available each day with a phone number I could call and place my order, but unfortunately, I could not remember how to use a telephone. My family would offer to call in my order, but I just never felt like eating. The dietitians at Zale Lipshy even began coming to my room to take my order, but I would order nothing or would order just a small amount and then leave it on the table uneaten. I really don’t know why I was never hungry. It might have been the dysphagia, or something else related to the brain damage.

While I was in a coma from the brain surgery, my son Evan flew to the Philippines to fetch Mirjam, his fiance and bring her back to the United States. Evan had gone to the Philippines for over a month just a year earlier and had communicated with her via Skype for over three years. They planned to marry about two months after he brought her to Texas. Meeting and seeing Mirjam for the first time was a thrill for me. She is a very gentle and beautiful woman who has found a new home in our hearts. Instead of “daughter in law,” Jean calls her our “daughter in love.” Mirjam is really special in our lives.

It’s hard for me to imagine that I was only at Zale Lipshy for less than three weeks. Because that is where I began my recovery from the brain surgery, after being unconscious for seven weeks, many of my most powerful memories are from that period. One thing I remember vividly is feeling like the rooms were all tilted 90 degrees to the left! I have no idea why I felt that way. Maybe it was the brain surgery, or being restricted to the wheelchair. I really do not know and cannot explain it, but I kept wondering why the people who worked there didn’t experience it. I kept wondering why they did not topple over while trying to walk around! That awkward sensation vanished only after I moved to the Centre for Neuro Skills in Irving.

I had only two classes that I remember at Zale Lipshy, one for reading and the other for physical therapy. After each class the therapist would roll me into the hall across from the 8th floor reception area to wait for the next therapy class. Those waits were interminable. Sometimes it could be as much as half an hour before some one came to help me. And I was only 30 feet from my room and my bed. I got so tired of sitting in that wheelchair and leaning over 90 degrees, that I would wait until the receptionist wasn’t paying attention and wheel myself back to my room and try to get into bed. So they started locking my wheelchair, but the lock was at the front of the wheels where I could easily release them. So then they started to use something to fasten them on the back or lower down to make it more difficult, so I would holler and complain about the way they kept torturing me, to little or no avail. I only survived by leaving to go to CNS.

If you have any question or comments, please leave me a message on WordPress at spreng.wordpress.com.

 

I still go to therapy class

Lisa, graduate student at Callier Richardson

It has been over 22 months since I suffered a traumatic brain injury, being hit by a car as I walked across the street to work, November 1, 2012. After a couple of days in Parkland Memorial Hospital the doctors determined that my brain was swelling too much and needed immediate attention. During surgery a chunk of my scull, about the size of my hand, was sliced off and placed into a refrigerator for a couple of weeks to allow my brain to complete its swelling and return to normal size. During that time I was in an induced coma so I have no memory from the time I was walking across Inwood Road until I slowly started waking up seven weeks later in a hospital bed at Zale Lipshy, UT Southwestern Medical Center’s neurological diagnostic and treatment centers, adjacent to Parkland.

I was only at Zale Lipshy for a couple of weeks, where I started doing physical therapy (which was very similar to what I had been through nine years earlier, when I was learning to walk again while recovering from Guillain–Barré syndrome). At the same time I received rehab classes with a speech therapist because I could not read – at all. I could not even remember the alphabet.

On the 2nd of January, 2013, I was moved to the Centre for Neuro Skills in Irving, Texas, for more intensive rehabilitation. CNS provides postacute therapeutic rehabilitation and disease management services for those of us recovering from acquired brain injury. I spent eleven months at CNS undergoing daily classes for educational therapy (speech, language, memory and reading), physical therapy, occupational therapy, social counseling and other problems resulting from traumatic brain injury (TBI). Much of my time and therapy was done at CNS’s apartments where I lived full-time for seven months before reaching a level of recovery where I could stay at home and ride their van each day to rehab.

At the apartments there were CNS employees – neuro rehabilitation specialists – who lived and worked around the clock seven days a week. In addition to helping us through our day-to-day activities – going to the bathroom, getting around on the wheelchairs, getting to the clinic and back each day for therapy – they helped prepare us for the essential knowledge of how to live on our own in the outside world – the world beyond rehab. That training included how to do my own laundry, make my bed, prepare meals, learn to make grocery lists for meal plans, and even how to do simple things like take a shower or use the toilet – not easy to do when you are in a wheelchair.

After I left CNS, I really needed to continue my rehab – I still have severe memory loss and can barely read – so I enrolled in classes at Baylor Garland, the nearest TBI therapy clinic to my home. I started there December 10, 2013, less than three weeks after leaving CNS. At CNS I was in the therapy clinic six hours a day, five days a week. At Baylor I was with a therapist two or three days a week for just an hour each visit. Quite a difference, but then I was recovering each say, little by little so that was sufficient.

Unfortunately I only got to stay at Baylor Garland for less than a month because my health plan – ObamaCare – started January 1st and I had to pay the full cost for my therapy until my deductible was fully payed. Fortunately, my therapist, Carey Hammond told me about a TBI therapy program at Callier Center – where I worked at the time I received my brain injury – that was not tied to insurance plans. As a university they only charged a small flat fee per semester because the program was designed to teach UTD graduate students to become therapists. In fact several of the therapists I’d had at CNS had graduated from this program at UTD Callier.

I started at Callier about a week after my last session at Baylor and have been attended their classes ever since. In fact the new fall semester started a couple of days ago. Last spring and this fall semester I am attending one day a week, on Fridays. Over the summer semester I went Mondays, Wednesdays and Fridays, just to see if I really needed that much therapy.

The rehab classes at each facility are quite different. At CNS there were six hour-long classes each day, similar to classes at high school or college, except for the group counseling sessions which consisted of a coundelor and three to six patients. We also had an hour at noon for lunch and we each brought our lunch from the apartments or from home. Most of the time while I was in the apartments I was not able to eat meals at all – I was restricted to a feeding tube because of my dysphagia (difficulty swallowing). I got off the g-tube about two weeks before I moved home, so that was the only time I had anything at the apartments with which to make lunches. After I moved home I made lunch before the van picked me up each morning.

During my brief time in rehab at Baylor Garland I had therapy sessions for one hour a day two or three times each week. Like at CNS, these were one hour sessions one-on-one with a therapist, either Carey or Theresa Welch. At Callier I had Friday therapy class from 9am until 11:30am. The first hour was a group class with half a dozen patients and as many graduate students discussing current events gathered by the students during the week for which they collected news photos to show the class. After this segment we watch a brief portion (ten or fifteen minutes) of a movie or television documentary selected by the instructor – during the spring semester we watched the movie Remember the Titans with Denzel Washington, during the summer we watched Long Way Round, a documentary about two guys riding motorcycles from the UK across Asia and North America to New York City, starring Ewan McGregor and Charlie Boorman.

Finally we would spend 45 minutes one-on-one with one of the students. This would be things like having me read out-loud from a book or read a story and answer question. They would also give me some exercises to strengthen my memory and recall. But the parts I enjoyed the most were just talking about things like their educational goals or my writing of this blog. To me this is the best part of my therapy sessions.

Currently my memory is getting a little better every day, but my reading is not improving as much, if at all. I do not know how much longer I will need to continue therapy, but I will see what happens this semester and won’t have to decide until December.

Paying for rehabilitation

I worked at the University of Texas at Dallas Callier Center for a little over five years. As a part of the University of Texas school system, employees had very good insurance. I usually signed up for the lowest cost options because I rarely got sick. The UT insurance system, unlike most businesses, was based on the school calendar. That is, instead of our calendar year being from January through December, it was from September through August. That meant the annual insurance deductibles were due starting in September.

In July of 2012 when I signed up for the 2012-2013 school year, I looked through the new insurance options and decided that at age 62 maybe I should add long-term disability (LTD) to the products I signed up for. I really don’t know why I did that, but it turned out to be a very good decision.

When I was hit by a car on November 1, 2012, and taken to Parkland Memorial Hospital, I did not know what was happening. I remember nothing from the time I got off the DART bus on my way to work until about December 17 about the time I was moved from Parkland to Zale Lipshy, where I began waking up from the coma. Even after waking up, it took many weeks for me to understand where I was, how I got there, what was happening to me, and particularly how I was paying for everything.

BC/BS of Texas payed for my first two months, though I’m told the insurance carried by Maria Reyna Paculba, the lady whose car struck me, payed some of it. Her insurance covered only $30,000 – the minimum required by Texas law. I’m told I received about half of that, with the other half divided between Parkland and the doctors who took care of me. During my time at Zale Lipshy I was interviewed by people from various rehabilitation companies in and around Dallas, including Pate Rehabilitation, Centre for Neuro Skills and others, apparently because I needed therapy not available at Zale Lipshy.

On January 2, 2013, I was moved to CNS, where I vaguely remember signing a bunch of papers agreeing to donate my son and add CNS to my will – just kidding! I guess they told me then what the costs would be, but I don’t remember any of that. I do remember they told me to immediately begin filing for Social Security Disability Insurance (SSDI), which I did, by telling my wife to find out what to do – I was in no condition to do anything. I had no idea at the time – even though I was probably told – how much any of that was going to cost, or how it would be paid. I do remember being told sometime in May that my Short-Term Disability from UTD had ended – it covered the six months from November 1st through the end of April – and that I was getting the LTD for which I had been paying. What I learned much later, is that while short-term disability pays 100% of your salary, LTD only pays 60%. So my take-home pay dropped from almost $3,300 to less than $2,700 each month.

However on the insurance side, things were good. My Blue Cross was paying 100% of my rehab at CNS, which was a lot. For the nearly seven months I lived at the apartments at CNS, the insurance costs were about $75,000 each month. After I left the apartments and moved back home, CNS would pick me up at my house and took me to the Irving clinic five days a week for another four months. That was costing BC/BS of Texas just $45,000 per month.

In July UTD ended my job at Callier Center. What that meant for me was I lost my insurance. Fortunately, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) is a law passed by the U.S. Congress, that mandates an insurance program giving employees the ability to continue health insurance coverage after leaving employment. What this law did was allow fired workers to get the same insurance they had received from their former employer by paying its full price, without the benefits provided by the company. In my case, instead of paying about $200 each month, I could get the same insurance for about $1,000 a month. I had come across COBRA several times in my career up to then, but had found it to be much too expensive to be useful. Now however, it was a bargain. In August of 2013 I signed up and began paying for my insurance through COBRA. This allowed me to continue my rehab at CNS. I had forgotten about the deductible that restarted each September 1st. I had to pay CNS for the $3,000 deductible (which I am still trying to pay now, and will probably keep paying until sometime in 2017, when it will be fully repaid).

In the fall of 2013, our federal government began offering (requiring?) the Affordable Care Act, or Obamacare. With a lot of help from Brian White, my Counselor at CNS, I looked into Obamacare and found that, compared to my COBRA options, I could get pretty much the same health insurance for half the cost, after figuring in the subsidy. So I signed up and got coverage nearly identical to what I had before. What I did not consider was that this new insurance is on a calendar-year basis, that is, I had to pay the deductible again on January 1st. Because the TBI rehab I was getting at Baylor Garland (after leaving CNS) cost $242 a day, and not being able to afford that out-of-pocket, I had to quit rehab. Paying that was not an option I could afford.

Thankfully, Corey Hummel, my therapist at Baylor Garland, told me about another TBI rehabilitation program available at Callier Center, where I had worked before! This program did not require any insurance – the program existed as much for the masters program students, as for the patients – it only cost $150 per semester. So I have been attending rehab there for two semesters this year (spring and summer), and plan to keep going there through the fall semester.

Waking up

A part of my skull was cut out and removed – they literally stored it in a freezer – for a couple of weeks. My wife tells me that I was in a coma for two weeks, but it was actually more than 45 days from the time I was taken unconscious to the emergency room at Parkland Memorial Hospital until I actually became aware that I was still alive. Of course, I did not know then that I had died on the street after being hit by the car. I remember people coming and going into my bedroom, but at first I did not understand where I was, why I was there and what had happened over the past seven weeks.

I had been moved from my room at Parkland to a room at the adjacent Zale Lipshy. What I do remember, quite vividly, were a dozen or more dreams that I must have had during those weeks. I do not know when I dreamed them exactly, since most of those dreams had no references to time or location. Most were in generic places such as restaurants, bedrooms, houses or other buildings, but I do remember dreaming about being pushed around the halls at Zale Lipshy, so that dream had to have been after I was moved there December 17, 2012. I can also remember a dream where I was in Oklahoma, where we had lived for ten years until about five years before that car hit me.

Here is a list briefly describing some of those dreams:

* A Tex-Mex restaurant operated by a woman, where the theme was a combination of Texas, Mexico and the Lone Ranger. This was one of a small chain of similar restaurants that curiously specialized less on beef and more on pork, sheep, lamb and goat.
* A restaurant where Jean and I waited for an hour to get served, and then our server told us that where we were was not a restaurant, but a part of Zale Lipshy designed to look like a restaurant to test something (I have no idea what). A man came to us to apologize and explain the situation, but I don’t remember what he was telling us.
* I was at Zale Lipshy, in my hospital room in the wheelchair, when I was handed a class of tequila by Willie Nelson. I was then pushed around the floor past several other rooms as the staff tried to get the drink away from me.
* I was helping Whoopi Goldberg set up a Christmas party somewhere near my hospital room. I was walking around talking with her and people who worked for her, like Tom Leonardis, her Assistant/Executive Producer.
* I had a couple of dreams about some pictures my wife had hung in my room at Zale Lipshy, pictures of she and I with Whoopi, pictures of my son and his future wife, etc. in that dream an Asian man had come in and stolen my pictures because he had a “thing” about Whoopi, and wanted to make a copy of those pictures. He did not just copy the picture of Whoopi, he copied the entire set of pictures that were on my wall. In the dream, the man spent a lot of time – several hours – making the picture, and eventually gave them back to me.
* There was a dream where Jean and I had a bad experience at El Chico Cafe. A manager of the Cafe came to me (in my hospital room) to find out what happened, and offered us another dinner at El Chico to make up for the bad problems
* In one I was laying in the anteroom of a church, which in my dream was adjacent to where I was housed at Zale Lipshy. In the dream I was on a small table or bench with my wrists strapped to the table. I have a vivid memory of the design and layout of the church; I was there alone until a man came in to straighten up the area. I asked him to unfasten the restraints, but then I understood that he did not speak English. Since I could not speak Chinese or Japanese or whatever it was that he spoke, we could not communicate, and he could not help me. However, he did return the next morning and proceeded to unfasten my wrists, releasing me from the table.
* I dreamed that my friends from high school and college, Jens and Sheila Stubblefield, came to the hospital to visit me and we talked about Jens being a high school baseball coach.

What did these dreams mean? Some of them were related to what was actually happening to me. For example I am told that Jens and Sheila did come to visit me. So that dream had a source in reality. And my dreams about my wrists being restrained was based on the fact that my wrists really were tied to the rails on the sides of my hospital bed. At the start of the surgery to remove a part of my skull to release the pressure from my expanding brain cavity, the doctors performed a tracheotomy, which is often performed to insert a tube for ventilation, which is often needed for particular types of surgery so that the airway is kept open for sufficient time. My brain surgery which was supposed to take about 90 minutes, ended up taking over three hours. Anyway, several weeks later, I became annoyed by the breathing tube hanging from my throat and kept jerking it off. To stop me from being able to do that, they would tie my wrists to the bed, so that’s where those dreams originated.

Most of the dreams did have roots in my memory, such as the ones about restaurants and about Whoopi, but like any dreaming, I have no idea what they might have meant. Probably nothing more than ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep. I am less interested in what they mean – probably nothing – than the fact that I can remember them so well, even nearly two years after they happened.