4TH PATH : BRIAN FRANK STRONG

 Quick update while I sit with Brian during his 'quiet hour.' Brian's transfer to rehab is being delayed to next week. Nothing is necessarily wrong, the next facility just requires that his secretions are suctioned every 4 hours, and right now his vary between 3-4 hours. They just want that to be more under control. We, as a family, are not concerned or troubled by this. In fact, its kind of a relief to know he can continue to rest and heal before we hit the ground running in the next phase. Yesterday Brian sat upright in a chair for 2hours! They do this to stimulate him, make sure his blood pressure can handle it, reposition his lungs/torso, and activate muscles that he otherwise doesn't engage while in bed. This was great to see because he was upright when I arrived! He also couldn't tolerate more than 12minutes last week, so leaping to 2hours is amazing! Other than that, Brian's vitals and labs are all looking really good and stable still. His white blood cel...

I know I went quiet on here since Friday, so apologies for no news. To be honest, I started feeling pretty tired on Friday and had a pretty hard day, personally, on Saturday. Brian is still doing well & stable. The Dr called me yesterday morning to report that the CT scan did show a reduction in swelling, but also how that revealed to them the 'severe' damage to Brian's brain more clearly. The up side is - this is not new information. There are no new injuries, no new swelling, and no blood present - so overall, our specific prayers were answered here!  Saturday Brian was very restful, he didn't open his eyes much for me. Today he was more 'alert' and was pretty wide eyed when I arrived & I heard his vocal chords vibrating a little more today. Otherwise, it was a quiet weekend & I think Brian's brain and body are resting and healing! Yesterday, my heavy heart and tears were seemingly uncontrollable and inconsolable. It took everything in me to...

Yesterday, Brian had a restful day (on par for his usual progress). Big day Wed, rest day Thurs! I assume all the stimulation + the reduction in his trach hole size is accounting for it. But everything is still stable - vitals & blood work are great! Just waiting for final confirmation of his transfer. Please pray for my patience in this process. I worry about his right eye because it has not made the same progress as the left and I tend to dwell on some of those types of things. Please continue to pray for his full recovery & for his optic nerves & muscles to pull through! Erin (his sister) came again to do some range of motion. He did open his eyes for a brief moment where he fluttered / blinked rapidly , compared to the slower blinking he's been doing. I hadn't seen that from him yet. He also yawned and we heard his vocal chords since his trach is no longer cuffed, so that was new as well! Otherwise, slow & steady over here. I allowed myself to get some rest ...

Today was a good day for Brian - he had his lowest blood pressure yet! He was also very 'alert' today - lots of reactive eye opening to multiple kinds of stimulus (sound / voices, touch, etc.) It's important to note that he is opening his eyes as a response, but it's great sign of his energy and his ability to react to his surroundings. In the last 2 weeks, I have seen this, but usually anywhere from 1-4x per day. Today he opened up about 6x within the first hour I arrived! And continued to do so, on and off, for several hours while Erin, his sister, tried some new OT stimulation. She brought different textured objects that she placed in his hands or rubbed on his arms/shoulders to see if he would react (a few times he did) and she put an ice pack in his hand, which he pushed away! When I left this evening, they downsized his trach hole size, which was the next step in his independent breathing process. Overall, it seems like Brian has done well with every 'challeng...

Brian completed 72 hours (and is now at 81 hours) of independent breathing!!  Vitals are strong & stable, blood gas test came back normal, so the doctors have approved him to move to the acute care facility where they will start a more rigorous approach to stimulate his brain and wake him. The transfer could happen as soon as Monday, so long as there aren't any setbacks with his breathing abilities throughout the rest of the week.  Please pray for Brian's continued progress in the days ahead & for a seamless transition. In this next phase of acute care, my biggest prayer & hope is that the stimulation to 'emerge' him is successful within the first couple of weeks being there ( if after 4 weeks they are unsuccessful, I mentioned before that the options thereafter are not ideal ). BUT, I feel so confident in Brian's strength and the strides he's made so let's continue to pray for his comeback - completely restored! We're both ready to put in th...

Brian had a very restful Sunday. After completing 1.5 days of breathing on his own, the nurses told me that he's likely exhausted (the diaphragm is a big muscle and he hasn't had to work it by himself for over a month). So I didn't get many responses from him aside from slight eye opening and reflexes - but they equate his independent breathing to him running a marathon, so I spent most of our time yesterday talking to him and listening to music. I just called this morning and Brian has been now on his own for 52 hours, and holding stable vitals! At 3am I woke up and spent time praying in gratitude for the direct answers to prayers we have seen: getting over pneumonia & the collapsed lung! strong lungs that can breath independently! stable vitals! a sign that he's fighting back to me (the hand squeezes)! God is answering specific prayers and I believe is protecting Brian while his brain takes the time it needs to heal fully. I'll update if anything changes by EO...

I hesitated to share this because I am still in shock & disbelief - but last night before I left, I asked Brian to squeeze my hand and I felt him respond. My heart stopped. I asked him several times over, with has hand in various positions to make sure I wasn't crazy and I could feel him tightening my hand, subtly sometimes, stronger others. Then he opened his eyes. I was shouting and cheering him on and telling him as much as I could to orient him, encourage him, and tell him he's loved! I spent the whole night in shock. I even convinced myself it was all in my head. But I know it was real - I know Brian hears me and is fighting his way back. Please pray with me today as I eagerly rush back to his side to provoke more of these reactions. Please pray they're stronger, more pronounced and present on both sides!!  Update as of 11:40am: Brian completed 24 hours successfully off the ventilator and his carbon dioxide output is 36 (normal is between 35-40, so he's in a pe...

Today is Brian's 24 hour test off the ventilator! Pray he crushes it like he has the last two days. If it goes well, they'll basically let him breath off of it, independently, for the next 72 hours and then test all his blood levels to make sure everything is functioning properly.  I have no doubts he's strong enough and that it'll go smoothly, but let's continue to pray for that! The nurses and Dr feel confident because of how well he's done. I'm sure he's loving these challenges because we all know Brian loves (friendly) competition...and casually winning. One Dr came in today to listen to his heart & lungs and he said everything sounded perfectly clear (take THAT, pneumonia)! The sun is shining in his room today and I've got the windows open for some fresh air since it's finally warm out! He opened his eyes for me once after I put on his favorite band (Killswitch Engage...lol). And then I was able to have some time just talking to him whil...

Brian successfully went 16 hours off the ventilator on the trach collar! So far today he's been off of it for 9 hours (since 6am) and his vitals are stable.  PT came to sit him upright today and his blood pressure spiked, so that's slowly coming down but aside from that, the weening process is going well! The Dr. called me this morning and said she thinks he's making progress - from her perspective, he seems more alert and both of his eyes were open for her during his exam. She said she *thinks* he tracked her with one eye (followed her) across the room once and then got tired (either way, small progress!). And the pneumonia has cleared up so he's officially off the antibiotics. The swelling on the front right side of his head is *significantly* reduced and I asked about it because it looks concave, but she said that's normal because of the craniectomy and a good sign to see. In the 3 hours I've been here this afternoon, he has spontaneously opened his eyes twic...

Today was day 2 on just the trach collar for Brian. His vitals were stable all day, so that's still going well! The sun came out this afternoon, so he got an hour of Vitamin D which I'm always happy for after a few cloudy days! Brian's CT scan came back with no real changes from the previous ones, aside from reduced swelling. AKA no new information that the Dr's hadn't already known - the reduction in swelling just made those things more clear. EEG results have not been reviewed yet.

 I missed updating this yesterday, so I'll do my best to summarize updates below for Tuesday & today: Brian's PT educated me on the importance of 'brain rest' - which is basically giving him rest between stimulation (talking, music, movement, etc). So 5-10min of stimulus & then rest time for his brain to not be overwhelmed. So thankful to have that knowledge now! Brian's lungs are looking/sounding healthy & he's responded well to the nebulizer treatments for the deflated part of his lung, so as of 10am this morning, he has been weened off of the ventilator and breathing through the trach collar only (and successfully so far - all vitals are very stable). GO BRIAN! Let's pray he can maintain that strength to continue breathing on his own in the days ahead & eventually reduce the size of the trach hole (which would be the next step in the weening / independent breathing process). Follow up CT scan & EEG were done this morning/afternoon. Sti...

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Today marks one month since Brian's accident. And we have come a long way since that horrific day. I still thank God for the immediate attention Brian received in the instant moments after the crash. When I think about the fact that almost all of the people immediately  on-site  were off duty first responders, I can't help but envision those people as guardian angels appointed to protect Brian. Envisioning angels surrounding the scene of the crash is often something that refines my hope and belief that God has his hand in this circumstance & is working to restore Brian's brain and body. I thank God for those people and for the people that have reached out to share that with me. Today, on this sleepy, snowy Monday, Brian remains very stable (all his vitals, like heart rate, temperature, blood pressure, and blood oxygen are in stellar shape) . The Pulmonologist told me that Brian's recovering from the pneumonia & collapsed lung faster than they anticipated and th...

In the early days after Brian’s accident, Lauren was flooded with outreach from family, friends, neighbors, and even strangers sharing stories of survival. That outreach served a very important purpose in that initial week, and helped us all to put on our game face and get ready to fight with Brian. Now that we’re in this second phase of recovery, however, the focus has shifted to Brian’s story, his 4th Path. Our inspiration now and moving forward comes from Brian and the work of God that we see coming through from his healing body.  Thank you for all that you’ve shared, and now we invite you to join in witnessing a recovery which we know is going to be unlike any other we’ve encountered yet. We turn our eyes, hearts, and focus now to Brian and Lauren and their miracle as it unfolds. 

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Since Drs are still seeing visible swelling and possible blood  (hemorrhaging) in Brian's CT scans, they say that would prevent him from waking up, so he just needs time for the swelling to diminish and the hemorrhages will work themselves out as that happens). In order for him to qualify for rehab, conscious or unconscious, Brian has to be able to breath off the ventilator completely. He's currently going through vent weening in order to "graduate" to the next facility. If he goes to the next facility unconscious, they give him 4 weeks to "emerge" from the coma with rigorous stimulation methods. They have a lot of success with this, however, if swelling is present, then we may essentially waste time there and be left with 2 options that are less than ideal (in-home care or a nursing home with no specialists). I share all of this because while pnemonia and a partially collapsed lung sound scary -- the drs feel confident it's normal and solvable -- and to...

Brian’s  vitals were good again today. He has pneumonia and a partially collapsed lung. Doctors expect the collapsed part of the lung to recover within 2-3 days (giving him nebulizer treatments) and the antibiotics for pnemonia should clear that up within a week. Doctors did not express major concern over either.  Lauren did some OT with him, gave a facial and foot massage again. Still got some wiggling in the toes. Brian’s dad George called and played him guitar today. Brian also listened to The Office and to Lauren share her prayers and verses out loud to him. Lauren spoke with the more extensive rehab facility to get some information and get Brian on their radar. He can qualify to go there unconscious for their low level program that's designed to "emerge" patients from comas. To qualify Brian needs to be weened entirely off the vent and the Dr needs to clear him as good to go. The pnemonia and collapsed lung might delay that progress; however, since we know there'...

 

Peaceful day over at LTAC for Brian. Vitals are incredibly stable.  Lauren met one of the respiratory therapists today, another kind soul making their way to Brian.  Lauren got to see a yawn and an eyebrow furrow- which is new!!  She’s just soaking up every ounce and every minute of Brian, and of course pampering his skin- facial, manicure- the works!! Brian wiggled his toe and made some hand/arm movements while getting a massage!  Brian, I’m sure you probably thought you knew how loved you are, but I assure you, it’s even more!! 

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Brian did 16hrs off the vent yesterday but he was pretty tired today so they had him on full support to give him rest. They will continue weaning tomorrow. All vitals are still stable and normal.  Lauren is allowed to visit 5hrs per day and Erin (Brian’s sister) is allowed 2x a week and more to come!  Brian had an EEG on his brain this evening  Drs suspect there is still some swelling / potential blood present at the site of the craniectomy which would be preventing Brian from waking up. The new neurologist and Dr. McFavorite said it's nothing to worry about and it would not change their course of action, it just reaffirms that his brain stil needs more time for that swelling to come down. Lauren got a much needed in-home massage this morning to help release tension (and it worked!)

Brian had a very stable day, all vitals looking good.  Doctors increased the dosage of the initial brain stimulation medication and added a second- he is tolerating both well!  Speech pathology visited today to check Trach and vocal folds.  Lauren did some reflexology work on him.  Patience is the true battle now! 

If you all didn't know- Brian LOVES collecting challenge coins! GY6 has released Frank Strong Coins!! Decals and St Patty's Day shirts can be found there too! https://got-your-6-foundation.myshopify.com/collections/all  

 All around good day! Lauren got to meet with the Care Coordinator at the LTAC facility. She felt really good about the plan that has been set up and the Coordinator herself.  Brian is stable, and they have started some medications designed to stimulate the brain.  They've been putting him on the vent at night to encourage REM, but he's breathing great on his own!  He was moving his head from side to side today.  (updates going forward will likely be later in the day as Lauren typically goes to see Brian in the afternoon) 

She is remarkable, faithful, and resilient to so much all the time.  But she is going on Day 20 without looking into Brian’s eyes; without feeling him kiss or hug her back; without talking, singing, or giggling with the love of her life... So today, as Brian is stable and continues holding his own, let’s flood Lauren with love. Let’s remind her that it’s ok to not be or feel a certain way 100% of the time. That if there is anger, sadness, confusion, frustration- that it does not mean she has lost her faith. It means she is the human that she is always right there to let all of us be.  THE way I knew for sure that Brian was the one for Lauren...  Not by how happy she was (although it radiates from her) Not by the way she described his character (although it was glowing) But by the look in her eyes, the tone of her voice, and the complete honesty in her words when she told me “he sees me like no one has ever seen me before.” It was like watching every part of her that has ...

A new norm.  Brian is very stable today, which is awesome given a change in location and entirely new environment.  The doctor today got a response from his left pupil today.  Lauren is with him right now, pampering him and making sure he knows she’s there and loving him fiercely every minute of every day!  Consult and care plan with his main doctor will be on Monday, but he’s already been consulting with those caring for Brian thus far- so he can jump right in.  Countdown to conscious Brian!! 

 The presence of ISP throughout this whole process has been nothing short of incredible and tonight’s transport to the LTAC facility was no exception. He is now safely at (as Lauren described it) “the place he’s going to open his eyes”  Your people love you Brian!!! 

Hope you all are eating some Chick-fil-a as you read this! Go back and grab a shake before 7!!  Brian us being moved to LTAC tonight!! Dr. McFavorite came and talked us through the move, gave some insight into scope of treatment during this new phase, and comforting information about the background and expertise of the Doctor who will be overseeing Brian’s recovery.  We’re feeling good about a move tonight!!  Might not have any more updates tonight as Brian will just be getting settled in. 

Lots of back and forth with case managers and social workers about the possibility of transfer to LTAC today. That would not be ideal and there are more questions that we want answers to before this transfer happens.  **Nurse updated that during his physical exam this morning he showed localizing in his right arm and opened his eyes to pain. 

Good, stable night for Brian.  His sister, Erin has been using her mad OT skills and doing daily workouts with him; he's looking pretty jacked in his arms and shoulders today, so we might be looking at leg day this afternoon.  Since they are able to put Brian into different positions now, it has helped to clear up the digestive blockage they thought might be going on yesterday.  Brian got his morning facial from Lauren, so he's looking all glowy!  He could be moved to LTAC as early as today, but we are hoping that he can stay here for the weekend and then start Monday off fresh with the transfer.  Don't forget to go get your Chick-fil-a today between 2pm-7pm and mention Brian Frank!! 

 CT scan came back normal! Doctors feel good that he’s holding his progress; making him in a safe situation to transport to an LTAC soon!  Now that the EVD drain is out, they are able to move Brian into different positions to start to activate more muscles and build strength. They had him in a sitting position after his CT scan.  Lauren has been taking such care of Brian. You can bet that at all times his skin is moisturized, lips are chapsticked, cuticles are oiled!! And don’t get me started on the kick ass beard he’s rocking these days. 

Brian is headed for CT on his digestive tract.  He had a swelling (possibly allergic reaction) reaction to the contrast, but it’s not of concern since he has the Trach. They’ll probably give some Benadryl though.  Oral medication to treat and prevent oral bacteria was given and Brian’s body had a “pissed off” reaction. Although hard for Lauren to see him appear to be in discomfort, a response that strong is actually encouraging.  We might have to ultimately annoy him awake :) 

Brain drain (external ventricular drain - EVD) is coming out right now! ICP has been around 9-12 all morning.  Liver enzymes are a bit high and ultrasound showed nutrition consumption is backed up. This is pretty common with patients who have been in a bed with no mobility for over 2 weeks, but they will do a CT scan with contrast at 2pm today to make sure it's nothing more than that.  Withdrawing to pain, saw some bigger movements. Left eye is showing responses; right eye is still being stubborn.  Timeline for transfer to LTAC is still somewhat fluid. 

 Brian’s body is responding very well to having tubes and drains removed this morning. Systems that sometimes take a while to readjust to working are already responding on their own!  Transfer to LTAC could be as early at Friday! 

Ultrasound came back clear, no clots in his legs ICP is holding stead and low and brain drain is still clamped Boost of potassium given to make sure he stays in range

Brain drain has been clamped a full day earlier than they thought because Brian has been managing his fluids on his own and his ICP has been stable! Taking multiple tubes and devices out of him- which is good! Fever overnight, but it's back to normal. Cultures today to ensure there's no other infections; but antibiotic is working to heal him from the pneumonia!  Heartrate is back down to a good range. Swelling in hands and ankles is totally gone. Lauren and Deb got to see a big yawn type movement this morning!  Pennsylvania State Troopers (who met Brian at a conference) drove through the night to bring some symbols of their well wishes: 

Brain drain was challenged even further today. His body is now naturally doing more than the drain. The goal to be off the drain is 30, Brian was pushed to 25 at 9 an and ICP is stable.  Waiting to talk to Dr Parikh for a more in depth discussion about the MRI results from last night and CT from this morning.  Heart rate is a little high, so they will add some propranolol to calm it a little, doctors aren’t worried about that.  Afternoon Update Dr. Parikh reviewed MRI and CT scan results with us. He said that with each image, they’re able to more clearly see the areas of damage- but there’s nothing new or worse . He also feels that the only way to describe some of the injury to the brainstem is that Brian had a brief lack of oxygen at some point very early on, maybe even prior to the first person who arrived on the scene. Ultimately, he said that we want to make sure we pay attention to these little wins that we are seeing and the fact that he hasn’t regained anything th...

ICP steady overnight Brian is moving his jaw on his own Some swelling in arm, ultrasound will come to check for clot LEFT PUPIL HAS SLUGGISH MOVEMENT MRI planned for today  A Trach collar might be in the near future, which is a method that has been scientifically known to help wean patients off of all ventilator support sooner than other methods.  Afternoon Update: Pneumonia confirmed, but doctors aren’t worried, very common for patients with vents. Treating with antibiotics, let’s keep the prayers going that this remains uncomplicated! Ultrasound confirmed clot in picc line; it will be removed and a new one placed on the opposite side.  MRI results confirmed that the assumed injuries thus far have been accurate, which reassured that all treatment thus far has been exactly what Brian has needed. There’s nothing different that doctors could have or should have done so far.  Evening Update: The MRI does show damage that is considered to be “permanent”, but it’s unclear...