It is has been a difficult five weeks and we apologize it has taken so long to create an easy access to updates on Kyle’s recovery. We know there are so many people praying for him and sending thoughts and love his way. We want to make sure everyone is updated but it can be a daunting task responding individually to all those that care a great deal about Kyle. To make things easier we have started this blog where we will post regular updates about his recovery. Let’s start by recapping the last four weeks.
Last Tuesday evening marked 4 weeks since Kyle’s accident. On February 23rd Kyle was struck by a vehicle while crossing the street in Portland, OR. His injuries were severe and were focused on his head. He suffered multiple skull and facial fractures, a moderate brain bleed on his right and a severe bleed on the left side of his brain. His brain was also swelling severely due to his head trauma he suffered in the accident. Surgery was performed immediately following the accident to stop the bleeds in his brain and a large part of his skull was removed from the left side of his head to allow his brain to swell during the healing process. He was diagnosed with a severe midline shift to the right which is the shifting of the brain past its center line.
The first two weeks were very difficult for Kyle. It was the doctor's goal to create the most optimal conditions for his brain to begin healing, however Kyle’s injuries were causing major swelling, increased cranial pressure in his brain which is very dangerous. He underwent multiple CTs and many complications were found. He developed a hygroma, fluid pocket in his brain, near his brain stem, a drain was surgically placed to help remove this fluid. He was then retaining fluid in his left ventricle causing increased intracranial pressure and requiring a ventriculostomy, a drain placed in his ventricle to remove the fluid.
He also had a difficult time regulating his body temperature and often had a very high fever requiring cooling blankets and fans. This is common with brain injuries, especially those related to the brain stem. On one of his CTs it was noted that he had brain stem bruising which the doctors had suspected due to his decorticate posturing, abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest. This type of posturing is a sign of severe damage in the brain. The brain stem helps the body maintain temperature so the bruising was causing Kyle difficulty in regulating his temperature.
He also had minor complications with fluid in his lungs in those first few weeks. He was placed on a special ventilator to help clear out his lungs before the fluid accumulation became something worse like pneumonia. The special ventilator and a “vacuuming” procedure of the lungs kept Kyle from any more problems with the fluid in his lungs.
Kyle’s intracranial pressure was finally within normal limits once the ventricular drain was placed. He was finally able to have his intracranial pressure monitor removed in week 3 as well as his drains which meant the doctors were finally able to perform an MRI. (Up to this point he was connected to too many machines that only CTs could be performed.)
A diffuse axial MRI was completed to better determine the damage to his brain. In this scan the imaging shows where the “frayed ends” are in Kyle’s brain. In the brain, axons are connected to dendrites, in severe head trauma such as Kyle’s it is common for many of the connections to break, or fray similar to a fraying electrical cord. The MRI unfortunately showed the most damaged connections were in Kyle’s brain stem. This makes his recovery much more difficult as the brain stem does not heal as efficiently or well as the rest of the brain.
Where are we now you ask?
At nearly five weeks from his accident Kyle is breathing completely on his own. They removed his trach tube just this morning because he is able to chew, swallow, cough, protect his airway and breathe all on his own.
Kyle is also doing much better regulating his temperature. It is right around the standard 98.7 degrees as of the last few days.
Kyle does still require a feeding tube, this has been placed in his stomach as it is the safest location for long-term care.
He was moved out of the ICU, a physical therapist, speech therapist and palliative care doctor have been added to his medical team.
Kyle is still brain storming on occasion. This means his brain is unnecessarily releasing stress chemicals into his body causing stress reactions such as increased heart rate, muscle twitching, increased temperature and perspiration. There can be other symptoms, but these seem to be the only ones that affect Kyle. Due to the severity of his head injuries he will continue to have episodes of this nature for weeks or months while he is recovering. The episodes are becoming milder and lasting less time.
Kyle is currently in the Tracu, trauma unit, which is a step down from the ICU. His neurological responses are minimal at this point. He has not gained consciousness. His eyes open but spontaneously, his pupils are sluggish in their response to stimuli. He cannot focus on things, track people across the room or even directly look at us when speaking. He is not yet responding to commands.
To help explain is current status here is a link to the Rancho scale for traumatic brain injury recovery. According to his team, he is currently a Level 2: responds inconsistently to sounds, sights, movement, touch or pain. The response may be non-specific or non purposeful. Their eyes may be open sometimes. The link is below for more information. http://www.healthpages.org/brain-injury/brain-injury-recovery/
At this point we are working to get him back to MI. He is stable enough to transport, but he will require surgery to put his skull flap back in before returning to MI. This surgery will not happen for another week or so and then he will need time to heal from this before transferring. We are working to find him a nursing facility and coordinate a medical flight. Nancy, Mike and Brandt are staying with Jenny at this time and Meghan and James are visiting as often as they can before Meghan is not allowed to fly.
Thank you for bearing with us and let us know if you have questions. Thank you for all your love and support.