Stryker Brigade News

I went back to the hotel and read the articles. One discussed current treatment of penetrating brain injuries and gave some historical background dating back to World War One. This was a good read and I found citations and summaries for the articles I had heard about at Walter Reed, notably the study of veterans of the Iran-Iraq war. The recovery after cranioplasty issue seems to be a good example of the conflict between research and anecdotal evidence. Research is difficult to do because every injury is different and also because there are so few survivors of the high-velocity impacts caused by military weapons. Anecdotal evidence isn't viewed as scientific enough to base treatment outcomes on it. Some of the materials I found seem to indicate that maybe half of persons who have a cranioplasty (and not everyone with a "cranial defect" does for various reasons) have improvement afterward, most of which is motor-related. It looks like there's no definite answer here and we'll just have to wait until Scott's surgery is over to find out.

Today when I arrived outside Speech Therapy, I asked Tiffany how Scott did last night. She said he threw up up several times and had some other food counter-attack symptoms. She said it took the nurses a while to react to her satisfaction and help him out. She said he was feeling better this morning however.

Next up at Occupational Therapy, Deb the Therapist went over yesterday's cooking performance and Scott got some diaper practice on a stuffed panda. He left for the bathroom toward the end of the session and we discussed his self-report on his readiness to care for Alyson. She said she was impressed that he was able to use such good judgment on the ratings. She expressed the opinion that many patients think they're ready when they're not, so she said Scott was doing very well on this.

After OT, we ran into the Stacy the team social worker in the hallway. She said she heard Scott might be discharged in two to two and a half weeks and was working with Brenda the Walter Reed social worker on convalescent leave and a date for his cranioplasty. Very cool.

After lunch, we got a telephone call from Scott's new troop commander, Captain P. He spoke with Scott for a bit and then I got on at Scott's suggestion. He had some good news.

But before you can read about it, some preparation and instruction is required:

Stand up and put your heels together with your feet at a 45 degree angle. Don't lock your knees or you'll soon impersonate an Air Force visitor at Walter Reed. Fold your fingers up and put the thumbs on top of your index fingers. Line up those thumbs with the seam of your trousers/robe/muu muu/whatever. Hold your head up and put your eyes straight ahead. Shoulders back. Quit eyeballing this screen! There you go, the position of attention.

Attention to orders.
The following person is promoted to the rank of Staff Sergeant (E-6) with an effective date of 19NOV04 (his birthday): Scott A. Thorne.

Whoo hoo!

We made some tentative plans to have Captain P come see Scott when he travels to Minnesota to visit relatives later this month. I told him I'd let him know about Scott's orders for leave and travel to Walter Reed as soon as they become available. Captain P said he had some friends who might be interested in visiting Scott at the hospital. No promises, of course, but he'd try.

After this exciting news, Scott was fired up for some PT. On the way there, we spoke to two of his doctors. Scott told them about his promotion and then went to PT while I spoke with them about discharge plans and recovery outcomes after cranioplasty (I get all the cool conversations). They said they usually discharge people on Friday as it's the end of the work week. I told them I thought they did it on Wednesdays because it was the day after the decisions were made. They said there was some discussion about two or three weeks more at the treatment team meeting. We talked about what kind of after-care (I guess is the correct term) would be available until Scott returned to Walter Reed. I told them it depended on when they wanted him back. If it was a date in early January, Scott probably didn't need much set up. If they didn't want him back until March (for example), then something at Madigan Army Medical Center (the hospital at Ft. Lewis) or the VA facility at American Lake or some combination would be necessary.

By the time I got to PT, Scott was done with his stretches and was about to go for more electrical stimulation on the treadmill. Scott finds this helpful or challenging or both. Scott ended up doing some leg weight work on the machine and then left for the day.

After PT, I took Scott to Stacy the social worker's office so she would know of Scott's promotion and make the news known to the staff at Walter Reed (rank has its you-know-what, you know). I also wanted to know what she had learned, if anything, about leave and surgery dates. She said she might know something tomorrow. I saw a map on the wall behind her and asked for a map of the United States so Scott could use it to discuss where he wanted to be more easily. She gave us a printout of a map. As a test, I had him identify where he had been and where he wants to go. He got them all right.

Scott had some more food-related difficulty in the late afternoon, which may jeopardize his Rec Therapy field trip to Pizza Hut. I'd bet on it, in fact. I returned to the hotel as Julie stayed there today to rest and recover. She's fine, but wanted to take it easy and recover properly.

And now a note about the weather here. It's cold and even a slight breeze or me walking as fast as I usually do makes for pink cheeks. It's not as cold as I've ever been (a tie between guard duty near dawn by a rifle range on the beach at Ft. Ord in January 1973 and riding around Korea in the back of an open truck in March 1975), but it's cold. Some of you have suggested I write a book about all this. If I wrote about the weather, I don't know what I'd call it, but I know the first line would be something like "Call me Nanook."

ST