Delays Are OK

Yesterday we had planned to begin the reorganization of our closets/decluttering of our bedroom. Rick wanted to go out hunting in the morning (coyote) first,which was fine. He told me Saturday night that he was going to go out early and we would get started on the bedroom when he came back. I said that was fine,but I did want to start by late morning at the very latest. I am one of those people who cannot begin a project in the middle of the afternoon. I feel the day has already gone by. He replied that he would be back by then. No problem.

Sunday morning,when I woke up,he was laying in his recliner still in his PJ's at 7:30 AM. I asked him if he was going to go hunting,and he said no,he changed his mind. Around 9:00 AM,he changed it again and said that he wanted to go,just for a little while,and we would start when he got back. OK,no problem again. By 10:00,he was gone with Brother B.

They came back around 12:00. Apparently,Rick had slipped on some ice on a dirt road,wrenched his shoulder,hurt his back, and dislocated his right thumb. He said he had to lay down for a while. He usually does take a nap after going hunting or working outside. He said he would be up by 2:30. I knew,of course,that he was not going to feel like doing anything afterwards,because he would be mighty sore from the fall,and I would not want to start a project of that size at that time of day.When he woke up,I was learning how to crochet a snowflake. No organizing for us.

Much of what goes on ( or doesn't go on) around here centers around how Rick is feeling,like I mentioned in my previous post. Of course,he took a nasty fall and hurt himself,which is out of the ordinary.I don't blame him for wanting to lay down-I would've done the same. 

When we plan things,I have to be flexible. I never know what kind of day Rick will have. He could have a great motivated day, a real up and at 'em-or it could be a day where he takes a long time to get going. In this case,it was a bit of lack of motivation, a touch of taking a long time to get out into the woods,and the rarity of getting hurt.

I have learned over time that I have to roll with each day. Things will get done,I just cannot keep beating over the head with it. I can certainly encourage and remind him of things,but I cannot push him. 

Today he is all fired up and ready to go. He has run to the store with Brother B  to get some storage bins so we can begin. I better get myself going as well!

Have a fabulous day on this Fabulous Planet!!

I 

Welcome To The New Year!

I hope everyone had fabulous holidays,whatever you celebrated!

We had a very nice Christmas. We got Zach a Kindle Fire so he could get all the books he wants.His room is small,so it saves room. He has been reading and watching "The Walking Dead" on it. That was his big gift of the year.He also got a few video games,a movies,some clothes,and some flavored hot chocolate.

I was down and out for a few days during Christmas break,thankfully after Christmas. Mother Nature decided to visit,and it was horrible. I lived on extra strength Midol and Advil Migraine for two days. It's been years,if ever,since I had such a bad time. Terrible cramps,migraine headaches,and feeling exhausted. I was in bed for two days. I finally got better just in time for New Years,thankfully!

I made no resolutions this year,as I never keep them. I am just going to keep on working on everything I am already working on. I know I will face set backs,but I am human and I will not let it get me down. It's easy when you see a brand new year stretched out in front of you to make all kinds of promises to yourself,but I know my track record.I throw myself all in, am diligent for a couple of months,then it all falls to pieces. Since Thanksgiving,I haven't done too much,but now that things are back to normal,I am in the swing again. Rick has not had much motivation,and he has admitted as much,so we have planned a couple of jobs around the house to get his feet wet again. I have come to grips with the fact that it will take a long time to get some things around here done,and that is OK. We are not going anywhere,so if it takes another 6 months to finish the kitchen,so be it. We are not trying to impress anyone,and I know my family and friends understand.Rick and I discussed getting him back in to the swing of things,and I am going to to make a list of what needs to be done to finish the kitchen and other things around the house,but I am not going to display the whole list as in the past. He finds that too overwhelming and it makes him feel rushed. So I am going to post one job at a time in order of importance.We are going to start small. Some of these things I am capable of doing,but you have to understand that Rick sees me doing a project that he was suppose to do and it makes him react negatively. " I told you I was going to do that,don't do it," he will say. He gets annoyed and frustrated,and he feels like like failure. This is why some things are taking so very long.

Most of my Christmas decorations are down,with the exception of our tree and some garland in the house,plus my outdoor decorations. Today,the tree decorations are coming down,and the garland.I will leave the outdoor decorations up a few more days.I will make a list of anything I need to replace or get more of ( like my popcorn tree garland) so I remember to get it next year.

Rick and I are embarking on a project very soon.It's not a huge one,but it should make things a bit smoother for him and help make our bedroom a bit better. I will post about that later in a post that I will call " A Tale of Two Closets."

Here's to a wonderful 2013!

Have a fabulous day on this Fabulous Planet!

Taking It Easy

Today is  going to be a down day for me,I think. Yesterday my eyes started burning,and the rims were sore. I awoke with this yet again,but now I have a scratchy throat,my sinuses ache,and I feel wiped out.Could be allergies,or something else that's going around,though to me it feels and sounds like allergies.I do take allergy meds on a daily basis. Up until yesterday,I felt great,upbeat,and full of energy. My,what a difference a day makes.

Yesterday I did get out some photos out,though the ones I was going to hang on the wall I wound up not doing. I just couldn't decide where to put them. I did hang one photo in our bedroom over the bed. Rick took it when we lived in Dalton,MA waay back in 2001 when I was the manager of the Jockey Outlet in Lee. There was a trail up to the reservoir,and the view was pretty,especially in the Fall:

Unfortunately,the photo I took doesn't really do it justice.I tried to block as much of the glare from the window across from our bed as possible. The colors are much more vibrant than they appear here.

 I  took a photo of  the print I bought at the Wilder Farm in Burke,NY so all my fellow Laura fans could see it. I still need to get down to the store to buy a nice frame with matting for it so I can hang it. It's called "Coming Home" and the artist is Sandra A. Young. I feel in love with it as soon as I saw it and had to have it. It brings back great memories of our trip,and how it felt to actually walk the same yard and be in the same home as Almanzo. Isn't it gorgeous? Like Rick's photo above,the colors are a bit muted in the photo,but you can still see how wonderful it is! It conjures up cozy winter feelings,even in the midst of summer.

While I did that yesterday,as well as puttering around the house cleaning,Rick began the oh-so-ever-fun task of decluttering the garage.When I went outside to take a photo,he had pulled some stuff out of it already and had 7 bags of trash.We are not talking stuff we no longer want,we are talking trash.

We had the garage filled right up to the door. As I mentioned in an earlier post,part of the problem is things are not being put back into their proper place,or trash not being disposed of (chicken feed bags that are emptied into our feed bin seem to never find their way to the trash,they are just thrown off to the side for instance). This is Rick's project. He does not want help.I did ask him what his game plan is and we are on the same page: take everything out of the garage,get rid of trash,and put like items together (tools,garden,camping,etc)He checks to see what is still good,or what is broken,and keeps the good items. He then takes what we are going to keep and organizes it in the garage. A tool bench will be made.Part of the problem of not keeping this area organized is when we try to find certain tools,we can't find them,and then wind up buying a replacement. Then,of course,we find the original. It's a waste of time and of money. That is coming to a halt this year. I will have to try and keep Rick on task as far as putting things back because he forgets.I think having him put that reminder into his IPod will help. He now schedules his days with the IPod that the VA gave him for such things and it has been very helpful. This is to help him become more independent so he doesn't have to rely on me to remind him of everything.I always feel like a nag when I have to remind him of this,or question if he did that. It makes for an odd dynamic-almost like a mother and child,which is not a good thing.

Today he is going to continue on the garage. It was very humid yesterday and he worked hard for a good three hours. He is not fast but he is steady. One thing you learn when you have a spouse with a brain injury is that you cannot rush them. They have to do things in their own time so they don't get overwhelmed.,which can be very easy.Sometimes it can be something very small that will set them into tailspin. I have learned that setting time frames for projects is not necessarily a good thing. It can be sometimes,but sometimes it just puts too much pressure on Rick,which then shows up in his demeanor,and he feels even more scattered than he already does,which I don't want. It's a fine balance,which I am still struggling to find.

We did get a nice surprise treat yesterday. Our neighbor across the dirt road stopped by with a homemade apple pie. She buys eggs from me as soon as my sign goes up,and we give her and her family fish on occasion. Last week she came over and asked if she could buy some! She was going camping and thought her parents would love the fish. We said we are more than happy to just give her the fish,no problem! Yesterday she was baking for her church's bake sale/pig roast which is today and made us a pie to thank us for the fish since we wouldn't allow her to pay for it.. How nice to have  good neighbors!.The pie,by the way, was delicious :)

Today I am going read,work on some Christmas gifts,and just relax.

Have a fabulous day on this Fabulous Planet!

How My Veteran Is Doing And New VA Programs For Family Members

Some of you who have been following this blog since it's inception may be wondering how Rick is doing.

He,as he always will,has good days and bad days. A good day is when he doesn't let his limitations frustrate him too much. A bad is when he lets his speech,reading,or thought patterns get to him and he gets overwhelmed and angry.

For those who are new to this blog,my husband was wounded in  an RPG attack in  Ramadi,Iraq on July 28, 2005. He suffers from chronic PTSD, and moderate TBI which has spawned all kinds of issues with reading comprehension,speech,thought process, writing,math,taste,smell,and memory. It has also caused issues with his pituitary gland,so he has to take testosterone shots,and he has hypothyroidism.The trauma also triggered Celiac's Disease. Our journey with the military and the VA,as well as our daily experiences dealing with all this led me to write this blog. It was a great outlet for me,and I was hopeful that perhaps someone who had been going through our experience could find solace in the fact that they are not the only ones who are dealing with these things.

Rick had begun a 12 week program through the VA called Cognitive Therapy. Unfortunately,as soon as he began remembering things that happened in Iraq ( causing him to have a bad flashback which led him to cry for almost an hour) his counselor wound up having to take a medical leave of absence. We are still waiting to  hear when a new counselor will be assigned. There are so many soldiers coming back with PTSD and TBI that the VA is having a heck of a time keeping up,and I am heartened that the President has called on the VA to hire 800 more new counselors and for more money to be spent for mental issues.While it seems frustrating  (and it can be!) the VA is actually in much better shape than in 2006 when Rick started going. The government was just not ready to deal with all the mental challenges that our service men and women were coming home with,and we actually had no TBI diagnosis until 2007. Now testing is mandatory when soldiers enter the VA system. 

At any rate,we are waiting for a new PTSD counselor,although to be honest,Ken (our old one) felt Rick was about ready to  start coming only every few months once the 12 week program was over,instead of every month like he had been doing before he began the program. He has been seeing PTSD counselors since 2006. 

Rick is on what is called in military speak,TDRL ( Temporary Disabled Retirement Program). He can be kept on this for up to 5 years. He has to submit to testing whenever the military wants. This is a mandatory program for all vets who come back with PTSD. The hope is that with counseling,the vet will get better and be able to function in society,work,etc. That is all well and good for a soldier that gets help once they leave theater,but Rick received very little help once he was sent stateside after he was wounded. (He was sent to Fort Gordon,GA med hold) They basically gave him Valium and maybe once a month therapy for an hour,if it wasn't cancelled. Again, the government was not prepared for the influx of soldiers with mental issues. He dealt with this for 9 months  and didn't start getting real help until the middle of 2006 when he started going to the VA,almost a year after his injury.The PTSD combined with his TBI makes me shake my head that the military is bothering to put him in this program,but I suppose rules are rules (even if they don't make sense-and the military rarely makes sense).

This past Spring,we went to Gilford for a physical and Boston for mental evaluations for the military.This was an update from when he went to the med board at Fort Drum three years ago to see if there was any improvement ,regression,or if things remained the same. We just heard back from them,and they want Rick to go through another physical evaluation-for his back (which has some problems with from back surgery long ago),his knees ( which are now fixed) and for his hearing (which,it was noted,has gotten worse). Why they are concentrating on these three issues is beyond me. The main issues are the mental problems,not the physical ones,at least,now since he has had both his knees replaced.The psychiatric Dr in Boston reaffirmed what others had told us-he can never work in the public realm again. Again, I don't understand the military's reasoning,but considering everything else they put us through (three med boards) we are just dealing with it.

Today he began filling out a form for a service dog so he can be more independent and go to stores,etc.They have great programs for vets that have PTSD/TBI. Right now it's too much for him to go to,say Walmart,by himself. We got as far as the second page and he had to stop. His poor brain was on overload.

I am in two new programs in the VA. The first one is the VA Caregiver Support program for spouses who are caregivers for their veterans. We have a phone group that touches base twice a month,and we have a workbook with a different subject for each phone session. I was asked specifically to join this group from the head of the Poly trauma  (PTSD/TBI)  Unit at the Manchester VA (she used to be Rick's PTSD counselor before Ken).She felt that since I had been going through this for so long,I might be able to offer some insight to newer wives. Though it's a good program,I wish it had been available when I really needed it 6 years ago.Most of it is what I have already dealt with,although there are still ongoing subjects that we continue to  struggle with. This program allows us to  have a counselor come to the house every three months to check in on us to see if there is anything she  can help with,any questions she can answer,etc. Her name is Donna ( easy to remember!) and she is nice. She also brings a PTSD counselor that sits down with Brother B and I to discuss whatever issues may have come up. (Brother B is Rick's secondary caregiver).

The second program is called the SAFE Program-Support and Family Education. This is for members of the Caregiver Support Program. We meet once a month in Manchester,and like the previous program,it has a topic for each meeting.This is a more informative program rather  than a counseling type of meeting. Our first meeting is What Causes Mental Illness. Some other topics include Depression,PTSD and it's impact on the family,Setting Boundaries,Problem solving,Creating a Low Stress Environment,Taking Care of Yourself,Managing Stress,TBI, etc. I can go to whatever topic applies,so I don't have to go every month,though I will probably go to most of them. I am very happy that the VA is now not only looking out for the Vets,but their families as well. PTSD and TBI is not just the soldiers problem,as it affects all members and dynamics of the family.No one should be ashamed to ask for help. Too many veterans are committing suicide. It's so sad and horrible.

If you are a vet,or a family member of vet who needs help,please do not wait !!! Go to your local VA. There is no shame in admitting you need help. YOU ARE NOT ALONE!!!!!!!

Have a fabulous day on this Fabulous Planet!

Rick Update-Meds Change Up

Those of you who have been following this blog for a long time know that I started it about Rick and our family's journey with his PTSD and TBI from Iraq,with a bit of other things thrown in.Over time,the main focus of the blog changed,as Rick's issues leveled off.

Today is mostly a Rick update.His knees are doing great.Of course, there are things that he can never do again-jump from a few feet,jog,kneel down without proper knee padding,etc. However, he can walk without pain,and that is the main thing.

One problem that Rick has had is his weight (me too,but that's for different reasons!). He has a few things against him :Celiac's Disease can make your stomach bloat; his pituitary gland was messed up when he received his brain injury,so his thyroid is quite slow(he is on meds) and he body has almost no testosterone anymore,which all help with weight loss (he is now on testosterone shots,which he gives himself every two weeks);and he is on Seroquil (mood inhibitor and antidepressant)which can cause weight gain and possibly diabetes. The second problem is that Rick's blood sugar is high,just below diabetic. Besides the Seroquil being against him in this respect,his mother was also a diabetic. Rick has been on Seroquil now for about four years. It took a while to find the right medication to help,and it was frustrating during the process. However, we understood that the VA was not going to just put him on some heavy duty stuff to start,if something less would work. We didn't want him over medicated,nor did the VA. Finally,the Seroquil was tried,and it seemed to work,so the question then was the dosage per day. He takes 675 mgs a day.

Since his blood sugar is so high,Rick and I began discussing trying another medication.We have batted the idea around in the past,but Rick has always been concerned about trying something else,because the Seroquil works so well,and he was worried about "becoming an asshole again." However,being mindful of his family's history,we figured we would give it try. We made an appt with  Dr Hunt,Rick's meds Dr. She suggested Depakote,which is still a mood inhibitor/anti depressant,but it does not have the same side effects as Seroquil does. The only bad thing is they will have to monitor his liver or his kidneys while he is on it. I guess if it's not one thing,it's another when you are dealing with medications.

Yesterday was his first day on the Depakote. He has to take a certain amount for one week,including his regular Seroquil doses.Next week,he ups his Depakote,keeping his Seroquil doses,then the third week,he again ups the Depakote,but starts reducing the Seroquil,and so it goes until he is off the Seroquil completely. This will be a smoother transition than gradually weaning off the Seroquil,then starting up with the Depakote,which will take at least two weeks to get into his system and work effectively. He felt sick yesterday,we think from the new med,so he was not able to work in the kitchen.He spent a good portion of the day in bed,sleeping. While the medication helps with depression and anger,he still gets nightmares,and can get flashbacks,especially when a helicopter flies overhead.He is also still hyper vigilant,though not as bad as he was before he was on the meds. He will have to deal with these issues indefinitely,but he has learned some tools to help when these issues arise so they aren't quite as bad as they could be. Having a dialogue in his head is one,recognizing what he is feeling and why,and how he is not in danger like he was in Iraq.

It was such a lovely day I went to the end of the road and gathered my greens for the window boxes and the wagon out front. I am so very far behind this year,normally everything would be done by now. Since the kitchen was free,I was able to make my orange slice ornaments for the tree. It takes a while,since the oven has to be at low temp. Brother B brought our tree in,so today it will be decorated. Apparently my wreaths,which were in a garbage bag to protect them from dust in the garage,got accidentally thrown out,so I need to buy three  wreaths today.I also need to pick up some money cards.I need to do my Christmas cards as well.

Have a fabulous day on this fabulous Planet,where ever you might be!!!!

Changes

Those of you who have been following me for a long time know that the main reason I started this blog was to have an outlet for our journey with Rick's PTSD and TBI.I wanted to have a place to not only vent but also to let other folks in our position know that they are not alone. It has been a long process,from when he came home in April in 2006 to now. When he came home,he was the opposite of the man I married. He was no longer outgoing,filled with humor,affectionate,and easy going. He was quick to anger, quiet,kept to himself,and had emotional walls built up. I knew it wasn't going to get better if he didn't get help,so I gave him a "choice"-either get help,or live alone. I was not going to have my son brought in up walking on eggshells,nor did I want to live like that,no matter how much I loved my husband. Or should I say,I loved the man I married,which I knew still existed inside of him somewhere.

Rick has not told me everything that he experienced in Ramadi,but I do know that he was under attack everyday,was in many firefights,,did have to take lives,saw friends die,kicked down doors and took prisoners,gathered intelligence,and had some situations where he was involved in hand to hand combat.Some things he cannot remember,and whether that is due to his brain injury or just blocking it out we don't know.

What I do know is he has come a very long way. He has his sense of humor back,he is more outgoing,and is more comfortable in public.He is affectionate again. That is not to say he still doesn't have flashbacks,or doesn't get  anxious in public or unfamiliar surroundings or situations. He will always suffer from PTSD and will always need meds to help him out. He will always have effects from the brain injury-he gets confused when he reads,and filling out forms is alot for him. He still spells as words sound,not as they suppose to be written. He forgets things. He has to have sound on even numbers on the TV.He is on Ritalin,and that has been a big help in making him focus on tasks. He will never work again,and that bothered him greatly for a long time. He says he is now coming to grips with it. Now that his knees have been fixed that has helped as well.He is no longer in agonizing pain,and is no longer on morphine. Physically,he can now do many more things,even if it can still be overwhelming for him mentally.

Our marriage took a hit for quite a while. I won't lie and say it wasn't difficult. There were many times I would look at our marriage photo and cry because I wanted that man back. It was hard being shut out and being kept at arms length,when I had always been happily wrapped in his arms! Those who have been through it know what I mean. It made me sad,depressed,and angry.  The wall was between us for a few years. However,we worked through it together,and we have our old relationship back. It took 5 years,but we are now in a good place. Rick is in a good place. Which is why I changed the theme of this blog. It's now more about our daily journey here,less about Rick. Things are on a much more even plane now.

Each day we get up and are happy with our lives. We love each other,our son,our home,and plodding along on our little piece of heaven.It's wonderful to see Rick be able to work his own property,at his own pace,and get such a sense of accomplishment.Right now he and Brother B are outside with the tractor,in the drizzle,putting fill in the backyard. He loves it! I am so proud of how far he has come,and am grateful that he can work as hard as he can and have purpose. We are finally back to where we were. I hope that other families who are dealing with PTSD and TBI and survive and come out on the other side as we have.

Happy New Year!

Last night was a very laid back night,at least for me.We had decided a while ago to stay in this year. Our plan was to have appetizers,I would have a drink or two,and we would have some champagne at midnight ( Rick actually said he would have glass this year).

Rick and Zach started assembling his new entertainment center/TV stand. We wanted to help create more space in Zach's room,since it is rather small,so we bought him a 26"flat screen TV and a horizontal TV Stand. He had our old corner entertainment center,which stuck out a bit. This new stand has all kinds of storage space,which is behind doors,so the games,books,and movies are out of sight. Since the TV in our room was beginning to go on the fritz,we now have his old TV in our room. They began this project at 2:00 PM.

One thing I forgot to mention is that Rick has been put on Ritalin,to help with his organizational skills. Many of the issues that those with TBI have are the same as those who have ADHD. They are not acquired in the same way,but Ritalin works the frontal lobe of the brain in the same manner. He takes this at 8:00 AM and again at noon. He says he can feel it working. It does help,though he still gets confused,but he is more focused than before.  He has also been getting more accomplished and has more drive.

At any rate,the building of the TV stand hit some bumps along the way. The instructions called for building the unit upside down,but then when they turned it over,Rick and Zach realized that the instructions called for them to put the back on the wrong  way. So they had to redo it. Then the doors were put on wrong. Zach kept coming out every so often saying," I have good news,and I have bad news..." I felt so bad for Rick,but he did not want my help. They stopped at 6:00 PM for our dinner of grilled chicken quarters,rice,and green beans. They then went back to work. I told Rick to just leave it until tomorrow(which is today),but he said he had promised Zach that his TV and stand would be done and he was determined to keep his promise. So while they were in Zach's room, I sat in my recliner watching Dr Quinn and knitting.  I then lit my candles and finally figured out how to shut off the flash on my camera so I could take some photos...it only took me over a year to think about and do it!

This gives you an idea of what our house looks like on any given winter night,with the exception of the Christmas decorations,of course!

At 8:00 I made the appetizers ( frozen mozzarella sticks and pizza rolls -they were awful...next year I will make my own.I know...what do I expect from frozen,right?)
Rick was going to have unbreaded buffalo wings,but wound up not because he was concentrating on the stand. By 10:00 PM,the stand ( with the exception of a couple shelves) and the TV were done. We sat and just watched New Years Eve coverage on CNN with Anderson Cooper and Kathy Griffin. Midnight rolled around,and I did not feel like drinking champagne. I was tired and didn't want to open the bottle,so we are going to drink it today. Brother B was down at Brother Dale's house,so I would've had to drink most of it myself,and I knew that was not going to happen. We all went to bed by 12:10.

This morning we woke up at 8:00. Brother B came in and was looking out the kitchen window when all of a sudden,he said,"Quick! Look out front!" We did,and there,across the street,were 10 wild turkeys.

You can't really see too well in this photo that Zach took,but you might be able to make out a couple of birds to the left of the tree in the foreground. Apparently,according to our neighbor Kelly,they came out of the field down Avon Lane,and there were 20 of them in our driveway. They then proceeded down the front of the yard( we can see their tracks),down the pathway,and across the street to the woods. By the time we saw them,half of them had already made their way into the woods,and a few were hanging back.

Rick and Zach finished putting the doors on the stand,hooked up his game system and DVD player this AM. It took two hours.

Today our New Year dinner will consist of ham,potatoes,yams,peas,rolls,and pineapple. We will have that this evening. I haven't forgotten the champagne!!!

Happy New Year!!!!

Busy Time

The past week has been a busy one,and that will continue until Christmas. My house has been overrun with boxes containing decorations. I can't see my dining room because of them and I have pile next to me here at the computer. I dried orange slices,and hot glued ornament hooks on pine cones. Friday we got our tree after Zach's dentist appointment.Saturday after I dropped Zach off at a spaghetti dinner fundraiser he was helping out at I put the lights on the tree. Yesterday after we got back from our shift at the Lilac Mall selling popcorn for our Troop I decorated it. This year I went a bit primitive,with orange slices,pine cones,popcorn garland,and a few ornaments. I opted for white lights again this year. Last year I put the Christmas cards we received in the tree,but I am still deciding if I am going to do that again or not. So I am not posting any photos of it until I decide.

Today I am going to put my greenery on my mantle,and on the windowsills. That should do it for the decorating. I do have to make candles,and start making pork pies for various friends and family.

This morning I woke with a terrible headache,so I am lying a tad low until the Excedrine Migraine kicks in. Brother B went with Rick to the Somersworth VA Outpatient Center to Rick's blood work appt. Rick sweats terribly at night,so bad the sheets get stained. We have always been told that it is due to his PTSD,but the Dr that is taking over for Rick's primary care Dr (he is on medical leave) wanted to test his thyroid to see if his thyroid medication might be too high a dose. So we shall see what happens.

There is a very good chance that they might put Rick on a ADHD med. Brain injuries cause symptoms very much like ADHD-lack of focus,organization,etc.We are going to discuss it further when we see Rick's TBI dr, Dr Whitlock,on the 23rd. He had mentioned that it was a possibility,and when we saw Ken,Rick's PTSD counselor,we discussed it with him. Ken used to be a ADHD counselor for kids,and he has extensive knowledge on the subject. One can obtain ADHD from birth,or from a brain injury,such as Rick's. In the list of 9 symptoms,Rick had 8. So Ken put down our discussion in his notes and sent it to Dr Whitlock. I wouldn't be surprised if Dr Whitlock does move forward with that idea. It would be wonderful if it helps.

Still no snow in our neck of the woods. Up north in the mountains they have some. Saturday we woke up to a dusting of snow. Yesterday we had freezing rain and sleet,which actually caused the Spaulding Turnpike to close for a few hours because the highway was an ice rink and 50 cars were off the road,even the sand truck(I can only remember the Turnpike getting closed a couple of times).Everything then turned to rain,and we had a couple inches of that,with some heavy wind. I am surprised we didn't lose power. Right now it's in the 50's (degrees),which is balmy for us this time of the year,then later today the temps are suppose to go down the 20's. According to the Farmers Almanac,we are not suppose to get any snowstorms until January,so it is looking like we may get a green Christmas. I hope we at least get a little snow. It's very strange to be in NH and not have a White Christmas!!!

The Man of the Place

Sue,from Living The Good Life,had inquired how Rick is doing,and I realized that I haven't given any updates for a while. So,for those of you who are wondering how The Man of the Place is doing,here is the scoop.

Rick's knees are doing great. His muscles still get stiff,so sometimes he has to stretch two or three times a day.He does his stretching,exercises,and elliptical bike each day,and he feels great after.Some days his muscles are sore,and other days he feels nothing at all.This is nothing compared to the pain he was in before. He does have days where he feels more comfortable with a cane,but for the most part,he doesn't use it.He does have to pay attention to his walk,though,because he is used to limping when he walked,so he has to get out of that habit.

He is now down to 30 mg of morphine a day,which,considering he was taking 120 mg per day,is wonderful. Next week he will be only taking 15 mg,then the following week,he will be off it completely. While this is good news,it's also bringing his PTSD issues to the forefront again.(We were aware that this would happen) The morphine helped deaden it. Now he is more hyper vigilant,and yesterday was a bad day. We went to his TBI Dr,Dr Whitlock at the Manchester VA. Rick told him he still has long term and short term memory issues,he forgets who people are if he hasn't seen them for a while,his speech still drags sometimes,etc.He also mentioned his PTSD is more pronounced. We decided to stop for breakfast on the way home,and when we were in the restaurant,Rick told me he felt shaky and real anxious,and he didn't know why,but he would be OK. When we got in the truck,it was too much for him and he broke down. "I thought I was past all this,"he said. " It's like it was when I first got back. There's too much coming at me and I can't handle it.I'm on sensory overload." I felt terrible. There was nothing I could do to help him.He sat there crying and all I could say was,"It's OK...it will get better...you are going to start a new PTSD program next week,so that will help....it will be OK..." Rick has a real problem with hyper vigilance-he is on guard all the time,and has to observe everything and everyone.Now that he is more clearheaded without the morphine,the hyper vigilance is more pronounced. He was wiped out by time we got back and took a nap. Today,though,he is in much better spirits,and he and Brother B are off running some errands before they begin splitting wood. PTSD is a roller coaster.Some days, he gives no indication that he has any issues. There are days,though they rarely happen,where everything builds up and he breaks down. It's like any of us-sometimes you just have to vent and get it out of your system...even The Man of the Place.

Hot Day Ahead

We are looking at a day with temperatures hitting the mid to upper 80's. That's a bit warm for our neck of the woods this time of year. It also makes for very hot conditions working outside. The spot where we are putting the coop has a lot of southern and western exposure,though it really only gets direct sun for about 4-5 hours. The sun goes down past the pine trees at about 3:00 PM. This led to a discussion yesterday about window placement in the coop. Our neighbor is giving us a couple of windows,one a small frosted glass square one,the other a rectangular,clear glass window. We don't want to fry the chickens,but we do want some light getting into the coop for the winter months. We decided to put the frosted glass on the south side,and the clear glass on the north western side.

Today Rick is not feeling well. This is due to a jar of spaghetti sauce that had been previously opened. It was in the door to the fridge,and when he made himself some corn spaghetti last night,he had me check it. It smelled OK,and there wasn't any crusty stuff on the jar rim,so he ate it. Well,he told me this morning that the sauce had tasted a bit funny,but he still ate it,which caused everything to run through him early this AM. He is letting it run through his system,then he plans on working outside. I don't know how much he will get accomplished.I will not be here,and like I mentioned above,it's going to be HOT. I am bringing Zach to the Dr's for his annual physical,which he needs to go to Boy Scout Camp this summer.I am picking him up at school at 11:30,we are going out for lunch,then heading down to Newington for his appointment at 1:15.

Yesterday Rick and Brother B started on the floor to the coop. Rick was not having a good day mentally.He kept forgetting things and getting confused,so only part of the floor got done.His speech was not good,either. He would start to say a word,then he would drag out the word a bit. This happened several times. When I asked him about it,he says he really isn't sure,but he thinks that sometimes it's because he has too much going on in his head,and he gets overwhelmed,or sometimes he will start to say something then forget mid word,and then he remembers again.

Yesterday I planted the corn,more peas,and discovered to my horror that I had not planned for my zucchini and summer squash! Where in world was I going to put them? The only bed left was the one for my peppers and green beans. So I rearranged the box plan,and planted two green beans,and had one square apiece for the zucchini and summer squash. I did notice yesterday that my pepper plants FINALLY have their true leaves! I had tried putting them back on the heating pads for a while,and that did nothing. I did give them a bit of plant food a few days ago,before I moved them upstairs,so perhaps that was the missing piece. At any rate, I am happy that I finally have my true leaves on the peppers. My first planting of peas are coming up nicely.

We moved the Jumbo Cornish Game Hens into the empty turkey cage. They are considerably bigger than the other hens,and they were crowding them out and eating most of the food. We put hay down in spots and made small shelter for them,and are using the big feeder and waterer. We checked on them this morning and they were curled up together,sleeping. So they survived the night well. We still get visited by our neighbors chickens. I think it's such a hoot to hear rustling in the tree line,and when we turn around there is a chicken going ," Bawk,bawk," checking things out.

Hope things are lovely in your neck of the woods!

After the Storm

What is that golden orb shining in the sky? Where is all that water coming out of the sky? AH......it's sunshine and NO RAIN!!!

We live in an area with a high water table,so every spring when the snow melts,or when there is alot of rain we get water in the basement. Our sub pump has been running since Monday. Our basement has puddles here and there and a good portion of the floor is wet. We are very lucky,however. Some people have had their homes flooded. Rhode Island has borne the brunt of this last system. I feel bad for everyone who had major damage. It seems like the Springs are getting wetter and wetter,global warming or not.( My personal belief is that the pollution in the air is making the natural cycle of the planet's temperature move along faster. If we were more careful,we could at least slow it down a tad).

Yesterday we went to Concord,the state capital,and the home to the NH National Guard Headquarters. Rick was finally retired yesterday (or, should I say,he signed his paperwork...it's all official on the 23rd) We all had our retirement ID's taken. Zach was excited because this was his first official ID,since he is now 12.He was funny. He was sitting there with his "Sniper-Don't run,you'll only die tired" Tshirt on,and was worried about if he should smile or not for his ID. I told him to do whatever he felt like. He wound up giving a big grin,no teeth showing. We went to Ruby Tuesday's after for a celebratory lunch. It still has not sunk in that he will be retired. I suppose that will take a while,like anything else one waits for that takes a long time. Once it happens,it doesn't sink in for a bit.

We had a couple of appointments in Manchester today. We saw Rick's TBI Dr,and the sleep clinic read his chip in his sleep apnea machine. We mentioned that we have not heard anything about Rick's knees yet,and the TBI Dr had us go talk to Rick's TBI case worker,Lisa. Lisa was Rick's PTSD social worker for a year until she got promoted and moved into the TBI unit. Lisa was in a meeting,so we chatted with Gordon,an intern. We told him that we really needed to get Rick's knees fixed,because they have gotten worse since our appt to Dartmouth in Feb. He said he would relay the info to Lisa,and she would get in touch with whoever she needed to talk to. On the way home,Gordon called Rick's cell and told him that he had spoken to Lisa,and that it looked like all his paperwork was in order,it just needed to be sent to the right place,and she would make sure that it was. So things are starting to roll right along again.

Finally!

It has been 4 years and 8 months since that day in Ramadi,Iraq that changed our lives forever. We have been through 4 med boards,and played the "hurry up and wait" game that military plays.

Now,finally,Rick is heading towards military medical retirement. He will be considered "temporarily" retired on April 23. Hopefully that will be quite temporary and they will be put him full time retirement sooner than later.

This means adjustments as well. We will be making less than we are now. We have been through worse,however.

Rick finally has his sleep apnea machine. The problem is his knees are causing him so much pain,he can't sleep.So he hasn't been using it. He is up till the wee hours,and when I get up he is asleep in his recliner. It is very difficult to wake him up in the morning. Today he said he should just go off the morphine (albeit in stages,because one just does not quit that stuff cold turkey)because it's not doing anything. 120 mg a day,and it doesn't even touch the pain.

His primary physician has been gone the last couple of weeks.Rick called Fee Basis (who OK's major surgeries that might take place outside the VA system)to see if they had received the results from Dartmouth ,but they haven't as of yet. Which means his Primary has not sent them the results. This could actually happen with the VA system,though. The Dr who saw Rick at Dartmouth is also outsourced to the VA in White River Junction,VT. So that could work. We just need to get the ball rolling again.

Rick's memory is still a problem,and he continues to lose blocks of time. The other day he mentioned that he wanted to play some solitaire on the computer ( it helps his brain function to play games like that),but only for a few minutes. He wanted to wash the dishes and get the house situated while I was grocery shopping. He mentioned this because the week before when I went grocery shopping,he lost two hours. I came home and he was shocked that I was home. He lost two hours and it freaked him out.

It happened again.

I came home and he was on the computer. "No! Not again! How long have you been gone?" he asked. I looked at the clock." An hour and a half," I replied. "I thought you just left about 15 minutes ago," he said,shaking his head." I hate this stupid time loss stuff."

Now, we all can lose track of time. However, we tend to lose maybe 15, 20 minutes. Not a couple of hours or a day or two. It really scares him when he will have no recollection of a few days at a time.

The other day he asked me if I was born while my Dad was in the Pacific during WWII. For some reason he was confused about the time line. He knows that I was born in 1967,and I am 5 years younger than he is ( he always jokes that he would never leave me for a younger woman because I am his younger woman!)but for some reason he asked. Not sure what brought that train of thought up.Sometimes he has to say something while it's in his head,otherwise he will forget. It doesn't matter if it's on topic or not. It can be frustrating when trying to discuss something I feel is important,or even important to both of us,and all of a sudden he will switch topics and discuss what's in his head. At first,it was quite disconcerting and it made me feel like what he had to say was more important. However, now I understand that it is how his brain now works. It can still be frustrating at times,I admit. Especially when it's something we have discussed over and over-because he forgets that we have discussed it or he needs affirmation.

Today he and his brother Brian took down the old turkey cage in anticipation of building a bigger one.That will be a good project. Our turkey lurkeys should be arriving in a few weeks.

Breathing While You Sleep Is A Good Thing

Rick's results from his second sleep apnea test came back. The first test he was sitting up all night,and stopped breathing 9 times and hour. He was suppose to be laying down,of course. We wanted a second test. So they conducted a second test,and this time he was laying down....and stopped breathing 30 times an hour. We knew it was going to be more if he was laying down,but the results unnerved Rick a bit. The night we got the test results,he said that he laid there for awhile trying to figure out when he stops breathing,and he became worried about not waking up. I assured him he would be fine. He goes back to the VA in a couple of weeks for another sleep study,this time they are going to give him an oxygen machine,and they are going to gauge how much oxygen he will need during the night.This is a typical machine that they use for sleep apnea.

Sleep apnea is more common than one realizes. My oldest brother has been on a machine for years.My neighbor has one. There are several reasons for sleep apnea.Rick's is caused by his brain injury.One of the questions they ask to help determine if you have a brain injury is if you snore or stop breathing at night.I knew he snored----the man could break windows. We can't even sleep in the same room anymore,he snores so incredibly loud. Before he left for Iraq,he rarely ever snored,and when he did,it wasn't very loud. I remember being thankful because he wasn't a big snorer!! Then he came back and all that changed. Rick's Neuro TBI Dr, Dr Whitlock,asked us if he snored,and I responded how bad it was and how it has affected our lives. He then put in for the original test.Neither one of us knew he stopped breathing.

Now he will not stop breathing,and he will no longer snore. We can actually sleep in the same bed! It's been so long that it will take some getting used to,but I am very happy to oblige!!

Today Rick is having what he terms as not a good day-he is having one of those days where he is quite confused,and his short term memory is really bad. He is also having a bad speech day,where he drags out the sounds of words here and there. We did have fun yesterday,playing with Zach. Zach received Beatles Rock Band for Christmas,and it has been Zach's favorite thing. Zach played the bass, I played guitar for a while but then went back to singing,and Rick played the drums.I asked him if that bothered his knee ( there is a bass pedal)but he replied it didn't really,because he keeps his foot right on the pedal and doesn't really need to push down on it. It's good brain therapy for him. Each drum has it's own color,and when the color hits the bar on the screen,he has to hit the drum. So it's alot of eye -hand coordination,and quick thinking. He is a bit slow,but doesn't do too badly-averages between 60-78 % of his notes. However,after about 30-45 minutes he started to get confused. His brain was going on overload,so he had to stop. However, it's fun,and gets his brain exercised,which is a good thing!

An End In Sight?

Things around here have been busy,as I am sure it is in everybody's home this time of the year.We have been painting our living room from a sage green to "Raffia Cream",putting up crown molding,as well as window and door molding. The room is coming along nicely. Rick has been working to tolerance,as usual. He gets real tired because his brain has been working hard and his knees are in so much pain. There was a big source of frustration:the crown molding. Try as he might,even after reading our Home Depot Book and talking to people who have put up crown molding before,he could not figure out how to get the corners to be right. The molding does not sit flat on the wall,it sits at an angle. He spent four days (a few hours a day was all he could take)trying to get the correct angle on one piece of molding. His brother Brian spoke up and said that he remembered that they sell corner pieces that the molding can butt up against-no cutting! What do you know? The crown molding went up in a couple of days.It is now painted and just needs to be caulked in spots.
Our Christmas tree is up,and it looks nice with the white lights and red and white checked bows. I do have some other ornaments on it,but not many. I wasn't sure I was going to like the white lights,having never used them,but it does look good.
Today was a good day. We got the Narrative Summary from Fort Drum via email for Rick to look over. Tomorrow he needs to call his contact at Fort Drum tomorrow,go over the Narrative Summary. It then goes to Walter Reed,where it will be reviewed by other doctors who will make the determination of how much of a disabiity Rick will get. It is amazing to actually see the end in sight,after four years and three med boards. We have learned,however,to keep hope at a minimum,because of all the curves that this process has thrown our way.This way we don't get overly optimistic just to be disappointed again.
Rick's speech therapist also told us today that Rick does not need to go to sessions any more. We were surprised. She said that he has made good progress in his word associations.There will still be issues going forward,because the memory loss is permanent,but she taught him skills to help him remember words, appointments-basically how to make things easier to remember.For instance,,in his PDA,instead of jotting down "Zach's honors assembly at school",he will write only one or two words that he knows will jog his memory. He wrote "Honors"in the time slot it begins.This one word triggers his memory of what the event is.
Rick also had another sleep study last night. When he had the first one in August,he was not laying down-he slept sitting up in the bed. He stopped snoring 9 times an hour. Well,for a real accurate study,he needed to be laying down. So they did the test again,and we should see by the beginning of the New Year if his sleep apnea is worse when he is laying down. It should be interesting.
The woodstove is making the house so nice and warm. It is very cold outside this evening-with the wind chill it might hit the single digits. Up north in Coos County it may hit -30 below.Brr!!!

Brain Work

Yesterday we had two appointments at the VA-the first one was Speech Therapy,and the second was Neuro TBI.
There was not much to the Neuro TBI appt-it was really just a follow up. He did say that because Rick's Sleep Apnea is mild,there wasn't any need to give him an oxygen machine for when he sleeps. Rick pointed out that when he had the sleep apnea testing,he actually fell asleep in an upright position,and stayed that way the whole night. This made the Dr pause,because sleep apnea is at it's worst when one is laying on their back. So while Rick might stop breathing 9 times an hour sitting up,it could be much worse laying flat. He said he would have to talk to the sleep apnea people,and that Rick might have to redo the test.
We go to Speech Therapy every week. I call it Memory Therapy,because it's also designed to improve his memory. The speech therapist,VerJean,is very nice.Rick started with computer exercises to help with the speed his brain works. He also has done some written exercises-she will give him three directions,and he has to remember what they are. Sometimes he did great,sometimes he would forget one or do one incorrectly. The last couple of weeks,she has been having him respond verbally. For instance, she would read two words that sound the same,but are spelled differently and have different meanings ( for example,hole and whole).He would then have to tell her what each of them mean. He has also had to use specific words in sentences. It sounds easy,but for people with brain injuries,it can get tiring. After a while, he starts getting confused and he takes longer to figure things out.He especially gets tired when she asks him questions about his week. This week she inquired about what he has been doing,and he responded,"Remodeling the hallway and living room." So then she started asking questions: Did you get the materials? What kinds of materials did you get? How much crown molding did you need? How many doors are you working with? What color paint are you using? He did forget a few things,and it took him a while to answer a few of the questions,but with a bit of prompting,he did OK. Because his brain was working so hard and he had so much going on in it trying to remember,he was getting more confused and tired. However,the point is trying to get him to work his brain,access his memory,and be able to put into words what he is trying to say. He has had some issues lately with dragging out words. He will be explaining something,and then all of a sudden, he will linger on a part of a word,for example, he will say, "aaaaaaaapple." We brought this up to both VerJean and his Neuro TBI Dr. She noticed it during the session,and the Neuro TBI Dr thought it might be the medications that Rick is taking combined with lack of sleep. He wants us to keep an eye on it,though.

Changes In Nature and In the House

Today was a beautiful but chilly day here in NH.Our foliage is now past peak,so there are more brown leaves than brightly colored,and many trees are now bare. However,we had a beautiful foliage season.Rick and I always comment at how lucky we are to live in such a beautiful state. 'Imagine,"he said to me,"People come from all over the world to NH see the Fall foliage,and we can just look out of our window and see it everyday." Very lucky indeed. We always impress upon Zachary that he is a very lucky little boy to have such beauty around him all time. He seems to be appreciative of that,which is surprising for a boy of 11.
So now the trees are gearing up for winter,and looking spooky for Halloween. We did have some snow showers last week,and though I always like to see the first flakes of the season,October is a wee bit too early for me.
While there are changes going on outside,there are changes going on inside. We are going forward with our living room/hallway remodeling. Today we bought crown molding,fluted doorframes,door casings,paint,and drywall plaster.We are going to put down lamniate flooring in the hallway,which we put in Zach's room in the Spring,tear down the white paneling (yuck) and old drywall and replace it with new drywall. We are also replacing the doorframes and mopboards. The walls will be pained "Raffia Cream",a fancy name for beige,our molding,doors and ceiling white. Our living room had been started a few years ago( but put on hold due to money issues).New drywall was put up on the walls and ceilingand we painted the room sage. We need to skim some areas on the walls that have dings,and need to put up a new section of drywall on the ceiling. We had an ice dam last year that made water back up,and we had to poke holes in the ceiling to release the water.The crown molding is also going up,and the fluted doorframes,new door casings,mopboards,window frames,window casings,and windowsill. The walls will be the "Raffia Cream",and all the trim,crown moldings and ceiling will be white.
Rick is very motivated to get this done,excited in fact. I like seeing him like this,because he has a hard time getting motivated now sometimes. He took all the measurements today,and we went to both Home Depot and Lowe's. Rick now has a certain thought process since his brain injury,so one has to be patient.Things go slower. The impulse is to give him the answer to help speed things along,but that is not helping him. He needs to do it himself,even if it takes a while. If he is figuring out something,he will go over it a few times before he feels comfortable that he is correct. ( This is part of his Obsessive Compulsiveness that is due to the PTSD and brain injury. He will do something a few times because he is unsure of himself,and it will cause him stress,which he will alleviate by doing it over).You cannot be in a rush.I admit that today I found myself tapping my foot a couple of times,and by the time we were done, I was tired.
Today I did get my bedding washed and the house tided up after we got home. Now I must go make the bed. There is something about settling into a bed with crisp,clean sheets and blankets. It just makes a great ending to the day.

Med Board Findings

We got back from Fort Drum last Friday night,and the week went well. On Tues Rick had Behavioral Health,and Part 1 and Part 2 of his physical. Behavioral Health is a fancy term for "we are going check to see if you really have PTSD." When we went to check in,we were told that the Dr was not in that week,but they would see when they could schedule us,and would we please have a seat? I was sputtering," If they can't do this appointment this week,I am going to be very very angry," among a few other choice phrases. Rick kept telling me to keep my voice down." Let's not get upset yet," he told me."They wouldn't have had us come here if someone wasn't going to see us." I was amazed that he could seem so calm. "Oh,I'm not, "he told me,"but I am trying very hard to hold it together."
About 20 minutes later, a soft spoken woman came over to us. "Specialist Shaw,the Dr you were suppose to see is not here this week,but we have arranged for you to see another Dr via teleconference from Walter Reed Hospital.Please follow me." We both breathed a collective sigh of relief and followed her to another part of the building.They brought us into the teleconference room,and I must admit it was pretty neat.The Dr was there on a big flat screen TV. He went over the report that the Dr had made in March,and asked us questions. I told him that Rick had a NeuroPsych evaluation in May,and did he have access to that report? He said that while he could pull up a few VA reports,he was not able to pull up that one. I told him I had it,and could we fax it to him. He said that would be great,so I went out to the reception area and gave the soft spoken lady the report for her to fax.
He read the report,then asked,"How old is the Dr that administered this test?" Right away our warning flags went up. " He is older, maybe late 60's or early 70's," I told him."That would explain it," he said. "This test is an old testing method. It really doesn't tell me much. Testing for TBI has changed two or three times." Rick and I groaned. Great. However...." Rick is scheduled for another Neuro Psych eval this week," I told him. " Well,it couldn't hurt,"he said. His initial diagnosis was Cognitive Disorder NOS.Because some of the symptoms of PTSD and TBI are the same,there is no way of telling what is what. Apparently this is a new term they use for patients with PTSD and TBI.
Next was Rick's Part 1 Physical,which consisted of blood work,a hearing test,an eye test,a chest xray,and and EKG. Then we went to Part 2,where his medical history is gone over. When we went in March, Part 2 took over 3 hours. We had to fill out all of Rick's medical history. They then go over everything with him and type up their comments. Since most of the work was done,this time they just went over what was written up in the report before,and added any changes.They want Rick to have an EMG done on his right foot-electronic impulse testing-to see if he has any nerve damage,which we are doing through the VA. Rick now walks on the outside of his right foot because of his knee pain,and it is causing blisters and calluses.He also now sort of swings his right foot out to the side in a sort of semi circle when he walks. They also made note of his knees,his sleep apnea,hypopituitaryism,and his hypothyroidism.
Wednesday was Range of Motion,which was for his knees. I hate when they test his knees, because I know how much pain he is in,and I always get tears in my eyes. I can't help it.He told Rick that each knee should bend to 140 degrees,and his only bend to 90 on one and 85 on the other. He said to Rick," Your knees are messed up." They are waiting for a report from the Orthopedic Surgeon at the Boston VA,whom we saw today to see if Rick will have surgery. I will have to post about that appointment separately.
Thursday was a really big test: the NeuroPsych evaluation. This test determines if Rick has TBI,and at what level. The test he had in May said he had TBI,but it was not a very thou rough report. It didn't say at what level it was,and it was a page and a half. The military wanted something more specific,with a longer report. We went to another town to see a civilian PhD,who the military uses. He was very nice,and conducted a medical and mental health record review,clinical interview,and NAB ( Neuropsychological Assessment Battery).He asked about several symptoms,and out of the 30,Rick had 27. He then gave him testing in the following areas:Attention,Language,Memory,Spatial,and Executive Functioning. The tests took 5 hours. Rick thought it had only been 30-60 minutes. He also thought that he was going quickly on the tests,when in actuality he was going rather slowly.
When Rick was done, the Dr said he could give us a preliminary diagnosis based on the test scoring and his impressions. Here is what the test results showed. 100 is considered average.
Attention: 49 Severely impaired
Language:73 Mildly to moderately impaired
Memory:68 Moderately impaired
Spatial:75 Mildly to moderately impaired
Executive Functions: 83 Mildly impaired
Total:64
The bottom line is his brain injury is considered moderate.
We were surprised. Moderate? Not mild? We had been told he had a mild injury because he didn't lose consciousness when the explosion happened. We told the Dr this,and he said, "Who told you that? Excuse my language,but that is bullshit." The blast affected his brain globally.Rick was depressed after this appointment,but we were glad that finally,we have a proper diagnosis.
Once the military has all the information,they will finalize the NARSUM ( Narrative Summary),send it to us,then send it to Walter Reed Hospital,where it will be reviewed by doctors who will determine if Rick can be retired,or temporarily retired ( if they think some of his problems might be able to get better). We should know after the holidays.

An End in Sight?

In my last post,I talked about Rick's knee appt being changed and our disappointment. Well, guess what?
It's been changed again!!!
Rick called Fort Drum,NY (where the med board is) to let them know that the appointment for his knees had been changed. When he told them what date it was,they informed him that he would have to reschedule it. He has to go to back Fort Drum that week.
Let me give a bit of history here. Rick has been to the med board three times. For those who are not aware of what the med board is,the med board is a process that those in the military go through when there is question regarding their fitness for duty. It can be a physical or mental problem. Because we live in NH,we go to Fort Drum,NY. Whatever is in question ( sight,mental problems,range of motion,etc) is examined by doctors. They then make their assessment, and write up what is called a NARSUM ( Narrative Summary),which the solider reads,and if they agree with the diagnosis,the NARSUM is sent to Walter Reed Hospital to go before the rating board. Doctors there read the NARSUM,and decide what percentage of disability to give to the solider. The rating is based on how the injury affects how well they can do their job in the military.
When Rick first got back in 2005,he was sent to the med board while he was in Fort Gordon. At that point, he had not been diagnosed with TBI,but chronic PTSD. While his paperwork was in the process of being sent,he received orders cutting him from active duty and sending him back home. The process stopped.
Then, in 2007,he went to the med board again,this time to Fort Drum. It was there that he was told he was testing positive for TBI. On the last day of his appts,he was told that his paperwork was not in order,so they said he would have to come back.
I am Rick's advocate,because of his memory problems,so when we got the word that he was going back to the med board in March of this year,I went with him. We were assured that this would be his last med board,and that what had happened to him in the past was not acceptable.
We went through all the tests that was required-psych,range of motion ( for his back and legs),optometry and hearing. When we went for the TBI testing,the Dr (who was not military) told us that since in his VA records he had tested positive for TBI,there really wasn't any need to have the testing again. That sounded fine to us. We went home and waited.
Then Fort Drum notified us that they wanted more details regarding the TBI,and we needed to schedule a Neuro Psych eval through the VA. Now,in 2007,Rick had attempted to have this test done,but because his PTSD was not under control ( the proper medication and dose were not discovered yet) he could not complete the test. His attention span was too poor. However, on the basic test,he did screen positive for TBI. Well, alrighty then. I scheduled the test. He completed the three hour test in May. We then waited for the Drs notes and diagnosis to be sent to Fort Drum.
In the meantime,the Dr that examined him for Behavioral Health (Ie-psych) at Fort Drum was being rotated ( shipped) out to another unit. By the time the paperwork reached Fort Drum,he was gone,so this part of the NARSUM was left incomplete.That meant we would have to go back to Fort Drum.
Now, since March, there has been more problems with Rick's health. Not only has the TBI affected his memory,but it has affected him physically. After the Neuro Psych eval,Rick had an appt with a Neuro TBI Dr,who checks for any physical problems related to the TBI. He sent Rick for Sleep Apnea testing,since Rick now snores loud enough to rattle the windows (which he never did before he went to Iraq)and for an appointment with the endocrinologist to check his pituitary gland function. A red flag went up because Rick's thyroid barely works,and his primary Dr put him on meds for it ( again, no issues before Iraq). Rick's strength level is also low,as well as his stamina. ( another red flag,no issues before Iraq).
Now the TBI is responsible for his cognitive problems,memory loss,pituitary gland problems (poor functioning thyroid,low testosterone,and borderline cortisol levels),and sleep apnea. We just got the results of this test yesterday. He stops breathing 9 times an hour,and his oxygen levels go down to 88%. We were told if they were that level all the time,he would be on oxygen.
So now,and rightly so,the folks at Fort Drum want to do an update on all these things,because they were not known in March. His knees are also worse,and we have been told that his double vision will not go away.
So he will have to see Behavioral Health, possibly TBI,range of motion for his knees,optomology,and audiology. We go the week of October 12.
The following week we see the knee referral Dr at the Boston VA.

New Medication

We went to our home away from home,the Manchester VA this morning for the results from Rick's blood work a couple weeks ago. They tested him for everything-cortisol levels,testosterone levels, adrenal fatigue syndrome,etc. Rick has had been very tired doing anything, even walking. He also has has a noted lack of endurance and strength. Not to mention a lack of libido.
Well, his cortisol levels were not too bad,and the Dr did not feel it necessary to put him on steroids,though he did say that if Rick became very ill with the flu or the like that he would want to give him an injection to help him bounce back. No adrenal fatigue syndrome. However...his testosterone is extremely low.
We had always assumed that his being tired had to do with the amount of medication he takes ( which we figured out to slightly over 1,000 pills a month),and his libido has been an issue since he got back from Iraq. It is a symptom of PTSD and TBI. We never thought about hormonal levels,since he's only 47. Well, surprise! His TBI, even though mild,has caused his pituitary gland to not secrete testosterone correctly.
Needless to say,we were both relieved that the Dr found the cause of these problems. Starting tonight, Rick starts using a hormone patch,which he will change every night. If the patch causes any skin irritation,then they will use a topical gel. It should take about 2 weeks before he notices any big changes. This is the approximate time it takes to get fully into the blood stream. Rick is very anxious to start feeling more like his old self.
The only other news we have had is regarding his eyes. The specialist we saw last week said that he felt the double vision that Rick is experiencing was caused by the stroke,and because it's not an eye but a brain issue,there is nothing they can do. It is extremely rare for a patient who suffers from double vision from a stroke to continue to see double.Normally that goes away after a period of time. There is a small chance it could still go away,but because it's been over a year now,it's not likely. I joked, " You don't do anything halfway,do you?"
We go to see an Orthopedist in Boston at the end of the month for a consult. We still don't know for sure what is going on with his knees-what are the dark spots in his bones? Does he have rheumetoid arthritis? They are still considering knee surgery. I hope so. Both knees are so swollen that now his ankles are starting to swell,and the pain can get so bad that it makes him nauseous. This happens even though he takes 6 doses of morphine a day for it. Right now, it does nothing for the pain. If only they can get rid of some it! It would mean so much for his quality of life. Hopefully we will get some answers.
We are also waiting for the results of the sleep study.
As always,many questions, but the answers are taking time in coming.

One Thing Leads To Another

Rick had some blood work done regarding his testosterone and cortisol levels. Lo and behold,they have tanked. Meaning,his testosterone and cortisol levels are almost non existant. This would explain his lack of strength,energy,etc. He has an appointment with the endocrinologist next week to test his pituitary gland. The pituitary controls testosterone and cortisol output,as well as the thyroid (which is shot as well-he has been taking medication for that for a few months now). If this is indeed the problem,he can take medication to bring these things back to normal. His Neuro/TBI doctor told us that this was probably caused by the brain injury,unless there is something else going on, like a tumor on the gland, which ,considering his history is less likely.
At least we now why he gets exhausted so easily,has lost some of his strength,libido,etc. We are anxious for this upcoming appointment to get some definite answers.
He also had his second memory therapy session. He had to decide on what type of mechanism he wanted to use to help him remember things-pen and paper,a PDA,or a mini recorder. It would have to be something he keeps on him at all times. He decided on a PDA,which the VA gave him. He is supposed to make daily lists of what he needs to do and keep referring to the lists,so he is self sufficient and not dependant on me to remind him.Work this week also focused on attention span. He has to meditate daily and try to get up to 10 minutes. Part of the problem is his brain in constantly going-assessing,evaluating,etc,so he has a hard time retaining information ( this stems from both the TBI and the PTSD). By sitting quietly,and focusing on the air he breathes,it gives him a focal point. He can let other thoughts enter,but he needs to just take note of them and just let them go. Then after he has done this exercise,he has some homework. The goal of the homework is to help keep his attention focused on one thing,which will be easier if he is relaxed and his mind is clear.
Next week is another busy week. We have 5 appts over 4 days.
Aug 17- Bone scan for his knees
Aug 18-Memory therapy and the endocrinologist (this was added this week)
Aug 19-sleep study for sleep apnea
Aug 21-Neuro optomology
Rick did recieve his handicap placard for the car. He had mixed feelings about it. On one hand, it is very helpful on his bad days,on the other, it is further confirmation that he has a handicap. He doesn't like that at all.
One of the projects that we have to do soon is rebuild our porch and steps. Rick has a heck of a time getting up the steps,so we are going to also build a ramp so it's not so difficult for him. We hope to get that done by the time the snow flies.