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January
30
2016

Considering the Damage

This has been a long and difficult journey. When it first began, I had so many hopes of healing for Travis. Though I knew, with my limited medical knowledge, what the future might hold, I felt that Travis would be a force to reckon with any injury. He has always battled through daily aches. It has been a rare occurrence to see him sit down, let alone lay down, on account of injury. Only the major breaks have brought him to the couch, to his bed. Within the first few hours of the event, I had friends telling me,
"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.
  





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December
24
2015

The Things We WIsh For Ourselves

Merry Christmas to all of my friends and family. 
I have been reticent to write much here any longer. It is difficult to continue a steady conversation, one-sided at that, on a blog post. Harder still, is trying to create a window into your new world for others to gaze and judge. I created this blog to relay to our nearest and dearest how Travis is doing and what kind of future he may have. I hope I have answered most of the questions at this point. If there are specifics you would like to know, please ask in the comments. I will answer those that are fair and reasonable.
At this writing, Travis is healthy. He is well over his pneumonia. His lower lobes of both lungs are diminished, meaning that they are not filling on his inhales completely. This will forever be so due to either his brain injury or the severe pneumonia he suffered as a result of the injury. 

The brain injury, itself, is ever present and unchanged. Travis has not, overall, improved. He does occasional responses that are noteworthy, even surprising, to us and to his therapists. But, these responses are not often repeatable. He does recognize his family's voices. Mine, his dad, his son, his daughter, and his mother. Travis "perks up" when his family talks to him. He responds to our voices with eyebrow raises, right limb movement, and some occasional vocal sounds. Sometimes, he can respond to a command very quickly, such as giving us a thumbs-up when asked. Mostly, his responses are inconsistent which is inline with his level of consciousness.

The truth of this matter is that right now, and perhaps for the next couple of years, is the best we can hope for. Travis is doing the best he will ever do right now. I fear the future when he will start to decline further in abilities and function. As his injury slowly begins to further atrophy parts of his brain, he will lose functions that are currently working. His breathing will become more compromised as will his organs and immune system. I know, as fact, all this is true. I know to expect it and that is why I am stealing myself for it. 

But it doesn't stop me from wishing. Wishing this never happened. Wishing that if, in some sickly twisted way that if it had to happen to appease some irrational cosmic notion, then if only it could be something he could have healed from completely. Wishing that I had my husband back as he was. Wishing my children had their daddy back to help them through life as it should always have been. 
With the multiple wishes I make everyday, were the rhyme true, there would be no beggars walking in the world at this point. 
I still wish for complete healing. These are furtive, glancing desires. No matter how bad it is, how bad it gets, I can not help but have this tiny twinkling hope. Travis needs that from me. And I need it for myself. If I were to lose my wishful thinking, it would mean that I have also lost hope. 

Alyssa, Taylor, and I wish for you all a Merry Christmas and a joyful New Year. Remember who is important to you. Hold your loved ones tight to your heart and do not, under any circumstances, let them slip away. We have each other in this illogical place. That is all we have. 


October
28
2015

Continuance

I haven't written on here in a while. It feels a bit like speaking into a void. But there are probably a few people who would like to know how Travis is doing, and how this journey is continuing. So I write.





In late September, we admitted Travis to the hospital for pneumonia. He had been fighting it for five weeks, and though we had treated it once with a round of broad-spectrum antibiotics, he never got much better. When I called 911 on September 28th, Travis was in respiratory distress. He was very tachycardic, and not able to keep his oxygen saturation above 78-80 percent. The first three days in the hospital, it was not clear if he would make it.





He was on several bags of IV antibiotics and high-flow oxygen. There was talk of intubation. There was talk of "letting go," and "what comfort do you want administered."

I had the "talk" with my children, again. They understood how close we were to losing their daddy, again.

Really, I didn't need to explain it to them.

They knew.





After six days, Travis's body rallied and it looked like he would be ok. Eight days later, he was discharged. I could go into how many bags of IV antibiotics had been hung, how much oxygen he was needing, or how many sleepless nights were had by his closest loved ones. But, at the end of it, he survived this one illness.





He is now, at home, on supplemental oxygen. We've now been home for two weeks. It will take at least a month for him to recover from this last illness. And always there is the worry, when will the next illness come? What will it bring?

Due to the brain injury, Travis's immune system is compromised.





We continue his therapies, and while I know he will never regain consciousness, we continue to treat his body as though he were going to use it properly. Starting in several weeks, we will begin working on his ankles to get him standing. He will stand using a specialized chair that raises him up slowly all while supporting him in every direction.



Working to keep Travis's body functioning normally, despite the debilitating injury, will keep all parts of his person functioning on a higher level.

Standing up is more important than most people realize. Gravity works on the body in a natural way that we have adapted to over millennia. Getting up works on our blood flow, which leads to proper perfusion, muscle activation, veinous return, blood pressure, and the list goes on.



While it will not bring him back to us, getting Travis standing again will aid in his comfort and, I hope, some life fulfillment. At this writing, Travis has not stood in eleven months, since using a standup chair at Craig Hospital. If we can get him in that stand up chair, it will be a tear-filled moment to see him taller than me; as it should be.



I wish I could properly express what is happening to our little family. It is difficult to manipulate words to the exacting nature of emotion.

My husband is gone. He is gone. My children's dad is gone. He is gone.

Travis is no longer, fully, a part of this space and time.



It has been a hard reality to accept, but it needs be accepted. The alternative is to fight what is real. Of course, that can not end well for the one fighting the truth.

I love my Travis; my boyfriend, my friend, my lover, my partner, my companion. I feel so much love for him it's like my love could lift him up and heal his wounds. With the depth of my love I could bind all his injury; I could make him whole!



But, of course, that is not the case. That is not reality. Consciousness is a by-product of the mind. Debilitate the brain, and you've destroyed the mind. You've rendered the consciousness null.



Travis will never be Travis again. We will take care of him, regardless. We will render therapy to his body to aid him, regardless. We will continue to love him, to speak of him, as the person he is, regardless. He was, and he is, a beloved son, brother, uncle, husband, and father. He continues to be a teacher and inspiration to those who really look, who really care.

June
27
2015

367 Days Later

I felt like posting anything on here for this morbid anniversary would come off as trite. So I've waited a couple of days.
I've put a brief picture on Facebook. I have friends that we met at Craig Hospital who are on there that are curious about Travis.

The one year date has loomed at me for several months. Indeed, I have watched it coming at me as one would anticipate pain.
It is pain. It is every emotional anguish and physical pain you might imagine. One year since I've heard him speak. One year since he's held me. One year since his children saw his smile. One year ago he told me "goodbye, I'll be okay" for the last time.

I have nothing right now. I have no words that can help this. I hug my kids. My words fall hollow. I can't help this. I can not fix this.


Love your family. Tell them so, even if it feels silly, tell them. Hug everyone you love and everyone who means something good to you. We are so fragile. We are so alone. We are so finite.

May
8
2015

Big and Small

Travis's tracheostomy tube was removed 8 days ago. He has been managing his own airway very nicely for the last month, and his doctors and I felt it was time to pull the tube that had become a liability.



One month ago, today, Travis suffered a major infection at his stoma site. The infection went septic and he was hospitalized for three days; receiving several rounds of IV antibiotics while there. We continued antibiotics once at home for the next two weeks. It was lucky that this infection was caught when it was. A few hours more, I would be writing a very different kind of post. With the trach tube gone, we will not need to worry about any more infections at that opening. In truth, we are very lucky there was just the one infection.



The decannulation is a major step and marks a major improvement in his recovery. That he can cough, and manage to keep his trachea clear is very, very good. However, he still can not eat by mouth. He may not regain that ability. Even as we see these big improvements, they are tiny compared to the enormity of this injury. We have had set backs just today that could mean more problems on the horizon.



There is never a moment of just peace; never a moment without struggle or pain. On his "good" days, his wheelchair, inability to speak, walk, respond, or otherwise engage with the world is a steady reminder of all that's been lost.

On the "bad" days, you wonder why anyone should suffer like this. I will forever wonder why, ten months ago, my husband's happy life, my happy life, our children's happy life had to change so irrevocably.



Travis turns forty-two years old this Saturday. How can it be that my husband is like this on his birthday? Why? For what purpose.

There is no purpose. There is no reason; no great plan to this tragedy. It just, and simply, is. I can not see how anything great can come from this. We were just a simple, happy, family.

It has brought us so much grief I sometimes feel the sadness as something palpable. The grief follows you in the house, to the bed, to your chair. It stands next to you in the grocery line. Something sitting next to me in the car as I drive down the road, something with its head bowed and shoulder stooped. It's face dark, withdrawn; it is always looking down.



When I was at Craig Hospital, I asked the therapist there what I can do with the hurt, with this pain--where will it go? "It will become a part of you", he said. I didn't want to hear that from him. From someone who has seen spouses like me so many times, I didn't want that answer. But here we are. This pain is right here. The same anguish from the first night with Travis on the trauma table to the steady everyday melancholy here and now, it all comes together. This type of insult does not leave a family. It stays with you. It becomes a part of you. It will walk with, and sit by, each of us until our final days. Until all of it has been forgotten.

March
8
2015

To Answer Questions

We've been back in Alaska now for just over one month. It's been a smooth transition, for the most part. Travis is medically stable. He still has his trach in, he's still minimally conscious, and we are going to continue caring for him ourselves.

I haven't been updating this site recently, and a few friends have asked me about that. I'm not trying to keep anyone in the dark on Travis's condition or progress. It's simply that his progress is slow. Very, very slow. It is emotionally taxing for those who are caring for him daily to "report" on him often. We see the damage everyday, talking about it or writing about can feel like compounding the negatives.

The whole thing is just sad. From day one until now, I can feel only sadness and hurt where Travis is concerned. We have not had miracles. The good things that have happened are the kindnesses extended by the people we have met, so far, through this journey. I'm so grateful to Craig Hospital for the training it provided so that Travis can be at home. I would've lived a long happy life never knowing any of it.


As to Travis, we are doing what we can to keep him as comfortable as possible everyday; to help him everyday as much as we can. He has physical therapy and speech therapy that we like. He's in relatively good health. We sometimes get responses from him that show us that he is, indeed, somewhat aware.

I am truly thankful for all of the good thoughts and prayers sent our way. It's very helpful to know you are being thought of when life becomes very lonely. I will post here when "big" things happen.

So cheers for now. Keep holding those you love close, and building memories you can hold onto forever.

January
7
2015

What Home Looks Like

We've been here in Craig Hospital for nearly three months and will be going home in a little less than three weeks. I had hoped that Travis would have regained more function and awareness by this time, but the injury he sustained is too severe. He is going home minimally conscious and requiring around the clock care. I will, along with family and outside help, be caring for him at home. We feel that he needs his family close. It is also something we need. We need him close to us.

While we wished for more recovery by this time, we are not giving up on Travis. He will continue to receive rehab therapies at home as well as other stimulants to encourage alertness. Travis, as he was, is gone from us. It's been a hard pill to swallow. Knowing that we have lost him is incredibly hard to live with and the emotion of losing him comes upon you in waves. But it's not unreasonable to expect some more awareness as he recovers. It's possible that he may be able to communicate and thereby engage in his environment.

What it comes down to now, is that Travis is alive and as long as that's the case we will strive for him to heal as much as this devastating injury will allow. Seeing him so healthy, his body still well-muscled and trim, but completely dependent on others for life is the antithesis of what Travis would want; of how he would want to live. This is a catastrophic injury in so many ways.

So homecoming will be different, to put it lightly. Though I have no doubts about caring for him at home. Craig Hospital has been wonderful at giving us the tools to care for Travis. Outside help will be used mostly to relieve myself occasionally and for skilled therapy. I'm happy to care for him. It will feel more natural to, once again, wake up in a house where Travis is also residing. Taking care of his daily needs will replace the usual husband-wife relationship we've shared for these last fourteen years. The kids will not have the benefit of his expertise or advice, but at least they will get time with their daddy in a home environment. I'm hopeful, still, for some small recovery but I do understand that it's selfish to want more.


I will continue to post on here as we see recovery. Again, love you family and friends.

December
25
2014

Christmas

Travis's recovery has made a small upswing over the last ten days. He is swallowing faster and more consistently and he is focusing his left eye on people and objects. He is back to giving us regular smiles. Travis's doctor feels that Travis will continue to regain consciousness, but we have no way of knowing how much, how long, or to what end. We do know it will take two years from now to know the final end game of his recovery.

I want to wish everyone here a truly Happy Christmas. Love your family and your friends. Enjoy them thoroughly.
Many, many thanks to the cards, gifts and well wishes. We feel your love.