April 29: Marinucci No. 34 (from Lori and Gina)

From Lori:

A praise report!

The past several days Gerry has increased in his extremity
movement. Particularly he is moving his legs and bending at the knees.
Instead of his muscles being entirely flaccid, he now has some muscle tone
and is resisting back during physical therapy. His eyes are open more often, and there is some movement of his eyes from side to side, especially when he hears familiar voices. His lips open and it appears he is fighting his wired jaw in an attempt to open his mouth. They have put him on the tilt table (strapped in) but his blood pressure elevates when he gets to about 30 degrees. They will continue to work to get him to a standing/sitting position. Apparently being upright triggers some enzymes in the brain that signal you should be awake. Pray for the therapists and continued progress.

These are all small but hopeful steps towards emerging. His following
doctor intends to consult with the neurologist, but is very encouraged by this
progress. He believes Gerry may be in a "locked out" state. He believes
Ger may be aware of everything going on but simply can't yet respond. The Speech Therapist indicated his most acute reactions have been to smells -- maybe he is smelling you:) People who have emerged from comas report they have had a heightened smell and hearing senses.

During visits, if you are comfortable, feel free to massage his hands, arms
or apply lotion which is in the bed stand. The notes in the book have also
been a tremendous encouragement and have been helpful in recording some of these improvements which have stimulated positive discussions with the staff. The hospital staff is very amazed and encouraged by the continued support Gerry and the family receive. I am eternally grateful.

>From my daily devotional, " I love the Lord, because he has heard my voice
and my supplications. Because he hath inclined his ear to me. Therefore
will I call upon him as long as I live--- I will bless the Lord at all times: his
praise shall continually be in my mouth.. in everything give thanks."

Lovingly, Lori
4/29/04, 7:00AM

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From Gina:

Dear Family & Friends,

Mom & I visited Gerry today and were greatly encouraged also! In addition to Gerry moving his legs, he also moved his arms and hands from the elbows down. He squeezed and held onto our hands as we talked to him and was trying to move his head in our direction. We were told that the physical therapist had him up in a chair this morning and he tolerated this well for 30-40 minutes. She said that he responds to her commands at times (e.g. to hold his head up, etc.), but not every time. We are very encouraged to see the daily progress that Gerry has shown this past week. The doctor agrees that after only a week or so of the coma stimulation therapy that this is good! We are still waiting to talk to the neurologist about the possibility of an EEG, but are so grateful that the staff is now communicating very well with us in all areas. This is another answer to prayer, as we ourselves had to learn how to ask for the information, and who to ask.

As Lori said, our hearts are full of gratitude for your continued prayers and support!

Gina

Gina's latest -- April 27

Dear Family & Friends,

Many of you have emailed to ask how Gerry is doing. I'm finally getting to this next update! Thank you for your thoughts & prayers! It has been such an encouragement! I think it's been close to a couple of weeks since Gerry's move to Kindred Hospital in Ontario. He was initially placed in ICU, and was just moved to the Direct Observation Unit (DOU). This is a unit with several beds in a row and a nurses station directly in front for continual observation.

We have been very pleased with Kindred's treatment in several areas. First, they are working consistently to wean Gerry off the vent. Several days ago, Gerr was entirely off the vent from about noon on. Other days, he needs more assistance from the vent in varying degrees. At the maximum the vent will "breathe" 10 times per min. for Gerr, and now that he is being weaned, it varies down to 2 like it was yesterday and today, and completely off at times as he is able. As you can see, they are continually challenging him as much as possible, always keeping Gerry's stability as a priority. This is a process as he gets stronger. He has had some wonderful progress, and the pulmonologist is pleased.

They do rigorous physical therapy six days a week. We were taught basic range of motion exercises when he was at Riverside, which we continue to do during our visits. But here they take it further, seeing what Gerry can handle. The other day they sat him up in bed with his legs dangling over the side, and he tolerated this well. Again, this is a process as he gets stronger and hopefully emerges from the coma, they will continue to do more.

They've been able to get Gerry's blood pressure under control with the right medication, and have since started the coma stimulation therapy. This is where they try to stimulate the five senses with different means. The other day they used ice on Gerry's face, and he moved his head from side to side. They are doing this therapy 3 to 5 times a week, and we're looking forward to hearing more details on this amazing therapy.

We've noticed quite a bit more movement in Gerry's body, especially his legs which he moves from side to side. Today he seemed to pull one leg up a little bit. He moves his feet and toes. We've seen him move his upper body a few times. His eyes continue to open at times, and we look for those short periods of alert times when he will connect with one of us. We've observed his pupils moving around more when he is "awake". The nurses in ICU did not observe him "tracking", but we hope to see that as the nurses in the DOU observe him and as he continues to progress. Lori said during her visit last week with the girls that Gerry's pupils did move toward sound! He's also begun to lightly move his fingers and thumb as we hold his hand and talk to him. At times, this has been in response to our command. We have a guest book for visitors, and a friend visiting yesterday noted that while reading to Gerry for an hour that Gerry squeezed his hand seven times! Today, Mom and I talked to Gerry's primary care doctor, and they have started Gerry on a medication to stimulate him. He is off of all sedatives. We continue to look and pray for purposeful movement and for Gerry to wake up. We are very hopeful about this new activity in Gerry and pray that these are the early signs of his emerging from the coma.

Early last week they did another CT scan on Gerry. The doctor said the results only noted minor swelling in the ventricles. He was looking for more detailed information and is going to talk to the neuro. I asked (upon the advice of our cousin who is a RN) about doing Evoke Potential Testing to see the extent of the brain damage, and the doctor said he would talk to the neuro about that also. Please keep this in your prayers also!

Please continue to pray as we are finding some difficulty getting communication regarding Gerry's progress, test results, etc. from the doctors, nurses and staff. We know that each hospital operates differently, and an adjustment period is normal.

We're all working together to get into a routine for visiting Gerry, and for our lives as we help and support each other and things are coming together well. God continues to show us amazing blessings and support at this difficult time. We are so grateful for your continued prayers for Gerry's healing and recovery, and for emerging from the coma. We ask your continued prayers for Lori and the girls. They are doing well, but they face new challenges every day. Lori continues to work through many decisions, currently about the girls schooling, and I know she appreciates your prayers.

God Bless!

Gina

From Lori -- April 25

Marinucci No. 32

The girls and I had a good visit today. The new medication is controlling
Ger's blood pressure. He is back on the vent... this is an on again, off
again situation they call weaning. He is actually doing very well and the
Respiratory Therapist was pleased.

He has orders to be moved out of ICU as soon as there is a bed in the Direct
Observation Unit (DOU) available. They began
the coma stimulation therapy by putting ice cubes on his face and he did respond by
turning his head from side to side. Gerry is increasing in his movements
every day - Praise God. For physical therapy, they put him in a sitting
position today with his legs dangling over the bed and he tolerated this well.

I need to remind everyone that visitors are always welcome. Familiar voices, singing, reading Scripture are all very valuable for
stimulation, of course as well as prayer. Here are some helpful reminders:
Only one person should talk at a time; turn off the TV or music, if it is on
during your visit. Speak slowly and calmly. Remember, that most people believe that a person in
a coma can hear everything you say. He is not really reacting purposefully
yet, but you may give simple verbal commands such as: "open your eyes", "squeeze
my hand", "wiggle your foot." Who knows, you might be the person he responds
to. Just remember to keep it simple and don't change commands. Also give him
time to respond. Often there may be a very delayed reaction as it takes him
time to process. You may turn the CD player on when you leave.

I encourage everyone to use the guest book as a journal to record your
observations. This is helpful and encouraging to the family and me. It
helps me to know others are visiting and curtails the urge I have to camp out at the
hospital all the time and allows me to attend to my other responsibilities.
Also, please don't hesitate to let me know your impressions or if something is not
right. I will not be offended and it will help me to address any problems.

Thanks to all who are "walking this walk" with me. I am confident God is
doing His good work in me, Ger and the girls. I continue to covet your
prayers and am thankful for all the support I have received.

Lovingly, Lori

4/24/04, 7:30AM

What we want to do here:

This will be an area for Gerry's family to update you on his condition, plus add their own comments and maybe a few pics. Sort of like a family album for Gerry.

steve