"if anyone can make it, it's Travis."
I knew that. I knew it better than anyone. I repeated it to myself as a mantra everyday while in the ICU, and then again while at the long term care hospital. Only a massive injury could fall a man like Travis.
My hopeful optimism continued for the first two months of our stay at Craig Hospital. It saw me through our first six months back at home.
But here we are. It was and still is a massive injury. It is one that is not healed, only partially managed, and only comforts can be given to ease his time.
The 4000 pound machine traveling at 75 knots barely rubbed against the left side of my husbands head. Upon arriving in Anchorage from the clinic in Naknek, eighteen months ago, the only outward sign of injury was the blood at his nose and mouth and what appeared to be a rub-burn on his left scalp. Of course, he was unresponsive as well. This was the beginning of a long 48 hours wherein I was told by the attending ER physician how bad the prognosis was. The attending ER neurologist looking at me over Travis's quiet body and told me that there wasn't anything he could really do to create a better outcome. I was incredulous and demanded to know if they were giving up on my husband. No, they said, of course not. They just wanted me to know how truly devastating an injury he was facing. They were setting me up for the inevitability of his death. It was then around 9pm or 10, I think. As vivid as these memories are now, the shock I was feeling at the those moments has clouded the timeline of those first few hours. I know that within an hour of being prepared for my husband's death, I had ushered our children into the trauma room where we were left alone to say goodbye. Travis lay on the gurney, listing to his right side, still with the blood on his face though the medics and ER team had by now suctioned his nose and mouth. He was intubated and a ventilator was helping him to breathe. I knew he was on a large dose of benzodiazepines and fentanyl. The staff had told me they were not going to re-dose him with these drugs as they wanted him to come out of his sedation so that they may see what level of consciousness he could muster. Travis was nude with a hospital sheet over his lower body. He had no bruises on his chest and no outward sign of broken bones. We could not see the imploded sinuses or the broken bones beneath his left eye and no CT scan had been done yet that would later show the skull fractures at the base of his head. We had no idea that he had starved for air on the way to the clinic.
Alyssa, Taylor, and I stood next to him. Both of them were crying, sobbing and choking out words incoherent and loud. Alyssa began screaming, "Not my daddy! Not my daddy!" Her screams brought nurses and a chaplain running to the room. The chaplain would later tell me, when he came to visit us in ICU, that he would never forget the sound of my little girl's screams for her daddy. My memory of this moment is a pinpoint picture of Travis lying on that gurney. As though I'm looking at him through a tunnel. And though I remember very well my daughter screaming (I will also never forget that gut-wrenching sound) I recall hearing a roar that filled my whole head with noise. My face was wet, but I don't remember making any sounds. I recall wanting to stop my children from hurting but I couldn't because nothing mattered but that man on that bed. I kissed his face and understood the weight of this moment. I was saying goodbye. I was seeing go out of this world my first love, my only love; my whole life on that bed, was leaving and I could do nothing.
Travis survived. His life was saved, the second time, by a wonderful neurosurgeon who was exceptionally honest with me the whole way through. In those first hours, we had no real insight into how long it would take for real healing to begin showing us what deficits would be permanent. We knew only that he would not be the same man who stood in that boat on that Alaskan river around 3:30pm on the 25th of June, 2014.
Today marks the one year anniversary of our return to Alaska from the brain injury rehab hospital in Colorado, where we spent three hopeful, irreplaceable months.
We have taken care of Travis for one full year. We are his life support. The year has not varied much in day-to-day routines for Travis. I stay with him at nights, he in the hospital bed and me on the love seat next to him. He wears a pulse oximeter that alarms if his oxygen saturation drops below a certain percentage or if his heart rate drops too low or rises too high. It is a regular sound at nights when he is struggling to breathe.
I hook up a tube-feed to his stomach tube so that he can get the full amount of calories he needs during a 24 hour period. The feed pump delivers water and liquid formula to him from 8pm to 6am. We do not use the feed pump during the day. Instead, we give him bolus amounts of formula and water, plus his thirteen medications, at four times during his day. I turn him in bed around 10pm and set my alarm for 3am to get up and turn him to his other side. We must turn him every so often or we risk him getting bed sores. I will admit here, that I am proud of the level of care we have given my husband as he has not developed a single sore in our care.
We must help Travis with all his body functions. There is little dignity in the life he lives now. He can not use a toilette, so we wash him every morning. Travis has always been a private person and, mostly, modest. In no way would he be okay with me, or his mother, or his father, or even a nurse cleaning him up. But this is the reality of his life now.
One of my darkest personal moments came this last Christmas, when early in the morning I cleaned my husband in his bed. It was, for a moment, unfathomable that a Christmas morning that should be so bright and cheerful was spent rolling my husband onto his side in his hospital bed so that I could wash him. I try not to feel sorry for myself, but that morning was a hard one to make it through dry-eyed. I did all I could that morning to lift up my kids and help them have a happy Christmas.
Once Travis is clean, we re-situate him in bed and give him his formula via stomach tube and his morning medications, which is the largest number of meds he receives in one dose, consisting of fourteen separate medications at once. It is now around 9am. We partially dress him in bed, applying the urine bag as well. The sling goes under him and we wheel the mechanical lift to him and attach the sling to lift him out of the bed and into his wheel chair. He will spend the next nine hours in this wheelchair. His shirt is put on him and now he is dressed for the day and wearing his Velcro tab sneakers. His shoes protect his toes from getting bumped and helps, only marginally, the severe drop-foot that plagues all patients with severe brain injury. Travis has not stood upright in eleven months. The last time was at Craig Hospital in a special standing frame.
We are working on getting his feet back to the right angle so that he can use a standing frame again. It is looking like we must turn to surgery to correct the foot drop as it is too far advanced to correct another way.
After Travis is settled into his chair, we begin his daily therapies. Every twenty minutes we must recline him in his wheelchair to take weight off his legs, and then we sit him back up when the timer goes off. His therapies at home involve respiratory treatments to help him cough, others are joint exercises, and he is slowly fed his formula as giving it too quickly can cause him to vomit and aspirate. We take him to physical therapy three times a week, where he also receives speech therapy. I have not witnessed Travis saying proper words, though he does make some sounds occasionally that could be the beginning of vocalization. Every other night, myself or a nurse uses the lift to get him out of the wheelchair and into his shower chair so that he may be showered. He seems to enjoy the warm water, we assume, as his heart rate tends to slow and become regular.
He is put to bed around 7pm. An hour later I give his evening medications and start his night-time tube feed. Then the process of sustaining his life begins all over again.
A little over three months ago, I was sure we were going to lose Travis to pneumonia. I had to make some difficult decisions about which I was deeply conflicted. A phone call to his neurologist from Craig Hospital and also to his neurosurgeon in Anchorage helped me to know better, or at least more thoroughly, the prognosis at this point in recovery.
"What you have now is in the ballpark of where he will be."
"Travis seems like a man who would want a natural life, not an existence."
I wrote the paperwork that will aid his eventual departure from this world. Signing those sheets of white paper was the hardest thing I've ever done on my own.
But the fact remains, despite the daily routines of keeping him comfortable, of making sure that therapy is wringing every bit of purposeful response out of him--despite all of it--he is not going to get much better. Right now is our "better." Perhaps it is his best. He will begin a slow but steady decline. There will be further decisions to be made on his behalf. For myself, I want to care for him until he no longer needs me. I want to be there to the very end. I want to be there for the person I've wanted the most to be in my life. I will be there for the man who would do the same for me.
Though I write about it here, I do not dwell on those end-days. I do appreciate every little bit he can do right now. He can open his eyes. He sometimes turns his head to look towards a familiar voice. Our son and daughter get to still say good-night and good-morning to him. They can tell him about their day. I can hug my husband. I can tell him the news of the moment. I still kiss his cheek. Travis is, still, the handsomest man I have ever met. I spend a lot of energy trying not to think about all we have lost.
I feel I need to touch on something here that can not be lightly said, but must be brought out plainly. I know I have been lied to. I knew it the night this happened to my husband. I am not a fool. The month and a half I gave were adequate for the truth to be born out, at the very least, to me directly.
Travis was a no-fault victim. His life was ended that day as surely as any life is snuffed out. My children, his family, and I suffer his loss daily. Every. Single. Day.
I recently heard that there are pilots who believe the story printed in the paper. If I knew their names I would gladly post them here as fair warning to those passengers who might find those "drivers" in the left seat. No passable pilot would dare call himself adequate at flight while still supporting the printed story of what allegedly happened to my husband. Frankly, the nerve of people to assume that they know what my husband was doing at the moment he was struck down is anathema to me.
I am hurt and I am angry, but I am not ignorant about the laws of flight be they judicial or physical.
And like everything else, it seems there is nothing I can do for it but write down these thoughts.