Meaningful

One doctor treating Pádraig once told me that Pádraig would not recover and asked me whether I thought that for someone as beautiful, bright, and intelligent, a life with such a severe injury would be meaningful. (From his point of view, this was, of course, a rhetorical question.)

Today, I went with Pádraig to a supermarket and walked along an aisle with I’d say a good 10 metres of yoghurt of all sorts of different makes, colours and flavours.

Nobody needs this kind of variety. It gives the word ‘meaningful’ a whole new meaning.

This blog is a kind of a journal of Pádraig’s journey. But it’s more than that: it is about his “Lebensfreude”, about his “joie de vivre”, about something that the English language doesn’t seem to have an appropriate word to describe.

Pádraig’s story has a universal message for us all, for all of us who at times feel beaten, not being able to get back up again.

I am beginning to think It’s about the essence of life, about life stripped of all these things we think we need. It’s about life life. Us not chasing things and people and influence and power and bigger, better, brighter, faster, more expensive, more exclusive, more exotic ‘stuff’. Because none of this we need. Instead, it’s about friendship, compassion, big hearts, and tons of love – because this is what is life and what keeps us alive.

It’s a lesson for life you can tell people who feel life has treated them badly; who feel there’s no way out; who feel that another person’s life is a commodity one can put a price on, one can buy, pay for, or put aside, maintain or even let go –  when it suits you or the ‘system’.

Think about it. Life and it being meaningful.

Sensational

We started with the ‘routine’, built up to a deafening crescendo, and ended the day with a robotics session, as usual. Usual?

The ‘routine’ was speech therapy, followed by cognitive therapy. I’ll write about that some other day because today, I want to focus on something I felt was sensational. Look at this picture:

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And now look at it again. I am supporting Pádraig’s head. Daniela is holding his arm. BUT – no-one is holding his upper body except the man himself. He has his left arm on the red cube, but he is not leaning agains the cube. And look at the gap between his stomach and the standing table with the black padding. He is not leaning against the table either. This is the very first time he is standing whilst maintaining his upper body himself. – This is a ‘selfie’ I took. I am sure someone not checking on Pádraig at the same time and looking at us from a bit of a distance would have done a better job taking a picture of this than I did. (And look at Daniela: how proud and happy she is! She wouldn’t dream about complaining of me taking a picture of this brilliant moment, and of sharing it with you here. To the contrary!)

And this is someone who, according to consultants, is not worth ‘investing’ in because there is not ROI, no return in investment – given our health system with limited resources that cannot be wasted on such cases, according to the same consultants. If you took away our accommodation and food costs here in Pforzheim, and just looked at the cost of the treatment, that cost of therapy is not significantly higher (if it is higher at all) than the cost of the care at home. And if you asked me, I would prefer intensive therapy any day over intensive care hours for Pádraig. The reason why intensive, ongoing, and sustainable therapy is not available in Ireland, has nothing got to do with resources. It has everything to do with a health system that is not geared up to deliver what research has demonstrated to be the best, if not the only, appropriate treatment for a severe brain injury.

The standing bit wasn’t all. Pádraig also walked across the room with the help of two therapists and myself. – No mechanical aid. No risk assessment for the therapists. We walked him across the room, turned him around, and walked him back. In Ireland, they do not even allow injured like Pádraig to use the one and only Lokomat in the NRH, because that is reserved for those who can already stand by themselves. Never mind ‘walking’ him across any kind of distance. At home, we were told that three carers were needed to transfer Pádraig from his bed to the wheelchair using a hoist – here, three people walked him across a room and back without any mechanical aids.

In between, I practiced with Pádraig an exercise one of his therapists in Dublin had shown to us. While sitting in the wheelchair, Pádraig lifts up both of his legs, and then lowers one after the other.

He did this four times today and I only managed to get the camera out for the last time…

And, finally, here’s the straw – not the one that broke the camel’s neck, but one that prevents the fluid from running back down when you let it go; it has a little valve on the bottom. Again, look at the picture. You can see that Pádraig managed to pull up some of the drink almost to his mouth.

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There is still a bit missing but this was the first time he pulled up that much using a straw. What is so easy for us, closing our lips around a straw and pulling up the air and with it a drink, is still tremendously difficult for him – but he is getting there. It’s a really good exercise for his lip closure and breathing.

He’ll keep going, and he’ll be getting there. With the help of all of you! Go Dreamboaters. This ain’t no dream. This is real life. This is nothing, but absolutely nothing else but an ROI, a return on investment. Because: Pádraig wouldn’t have got anywhere without it, without the ‘investment’. He could have but never did give up. He kept investing and he is still putting all his energy, all his will power, and all his defiance of logic, physics, medical knowledge, and predicted outcome onto the table. And you know what? He has started to cash in. And I know as well as you do that there’s more where this is coming from! Watch this space!

BBQ

What would have been nicer than to finish the day with a BBQ?

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People in wheelchairs, therapists, carers (PAs:), families, all sitting outside together, having a chat, getting to know each other a little bit better, learning from each other, cracking a few jokes, having a bit of fun… And Germans must be the Weltmeister in BBQs. They even have vegan grill ‘stuff’ that looks like meat. And, of course, there was non-alcoholic beer (before you ask: …and no other beer;). I wanted to tell everybody about Sir Roger Casement and how the German U-Boot had brought him and loads of guns to Ireland a hundred years ago supporting the Irish rebels against the British – but never managed to do so. There was too much going on, and my little story would not have fitted in at all. Even without ‘my’ story (which Pádraig would not have liked me to tell anyway;) it was a perfect evening and end to a long and very busy day. One more day and the first week will be over. Can’t believe it.

Schwarzwald

I think we almost got sun burned today. After another early start, a long day of therapies, and lunch, we sat out on the centre’s famous balcony looking out over the Schwarzwald (where did it get its name – there ain’t anything ‘black’ about this glorious forest). It’s all about Vitamin D, we had been told. But – as Baz Luhrmann had told the ladies and gentlemen of the class of ’99 – “wear sunscreen” is what you do, whatever else you might be up to. Well, we didn’t and we just escaped a little red faced but without a burn…. pphhh!

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To give you an idea of the day.

I get up and get ready myself. Then I do the same with Pádraig. I help him with breakfast in the centre’s Bistro.

This may sound like nothing, but, just to put it into perspective: at home, we have two PAs (carers) arriving at 7am. One leaves at 9, the other at 10.30. There have been days, when they finished washing him and giving him breakfast by 9.45.

Therapies start at 8am. Let’s say we start with speech therapy, followed by cognitive therapy at 9.30, followed by three hours of physio at 11, followed by an hour in the Lokomat at 2pm, and a very late dinner/lunch at 3pm, finishing that at around 4pm. They told us we could use the MOTOMed with arm trainer in the afternoon – just before  Abendbrot (evening meal) starting at 5.30. During the day, I’m the assistant therapist and make sure Pádraig gets enough drink/water and food. I also look after whatever else he might need. At the end of the day, it’s bed time, time to get undressed and go to sleep.

Apart from the help in the morning (5 1/2 person hours), Pádraig get’s another 2 hours at lunch time (should be two but is one PA at present) and a further hour (by two PAs) in the evening.

In terms of therapy, he gets a visit once a week from his community physio and from his community speech and language therapist. The sessions when they work directly with Pádraig are rarely longer than 30 minutes, often shorter. Once a week.

What I find amazing is that I can do all this. I can’t do much more than this because there isn’t enough time, but I can do this. In other words: one person can do all of this. And, apart from the therapy, it’s not only not exhausting, it’s actually the most rewarding thing I can imagine to be doing. It’s stress free and there is no hassle. I feel I am doing the right thing.

And this is what life is all about. Isn’t it?

PS: Just in case – what they do here in Pforzheim with their intensive therapy is a ‘booster’, it cannot be and should not be done over prolonged periods. What does need to be done over a prolonged period and in between these ‘booster’ sessions is regular, meaningful and sustained neuro rehabilitation of about 15 weekly sessions – something along the lines of what An Saol is proposing with its pilot project.

NeuroFeedback

Following an amazing day of therapy with a tiny baby duck, today it was high tech computer EEG-led therapy that doesn’t do magic but, apparently has helped people with different kinds of brain-related illnesses and injuries.

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I’d heard about it. I’d talked about it to some people. I’d read a little about what it does. – But I’d never seen it in action. Today was Pádraig’s first neuro-feedback day. The idea of neuro-feedback is that a computer programme can train self-regulation of brain function at an unconscious level using sound and video feedback in relation to your brain’s activity.

Whether it’ll help or not we don’t know – to me it’s worth a try.

From this afternoon, Pádraig and I will be on our own until Thursday next week. I just thought that I’ll be doing the job of six carers and that I’ve been doing all along. Over the 4-5 weeks that will save the HSE thousands of euro. You wonder what’ll happen to that money… And I wonder whether the HSE should have assessed the risk to me as they had to with the carers who had to hold Pádraig’s head in the tilt table – they now won’t because of the risks to their arm. And just in case you wondered – this is *not* a joke.

 

Duck

The most unlikely kind of therapy: duck. Just five days old. He made Pádraig look at him. With both eyes open. Perfectly aligned. A new “first”!

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Match that! How could it get better today? – It did.

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There is this red box on the screen and loads of pictures that move from right to left across the screen. The trick is to press the button when the picture  you had memorised appears and just as it passes through  the red box on the screen.

Watch it! – No bother to Pádraig!

And here is the famous Lokomat.

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.With Pádraig ‘walking’.

A day full of ‘firsts’! How motivating and exciting is that! Can it get any betters??

 

Plane

Everything is possible. If you want to.

Pádraig can travel in a commercial aircraft. So what?

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Nonetheless, it was a big day today.

And the run up to it was almost as exciting as the day itself.

It felt like as if I had slept about five minutes when I got up really early to pack the car with too many bags, get Pádraig ready, and head for the airport. Aer Lingus were really nice and allowed us to check in our hand luggage for free – which was a life saver because our ‘hand’ luggage was, in fact, three cases of exactly the maximum size of that they allow you to take with you on board.

The following are snaps chronicling what happened today: in Dublin airport at the crack o’dawn out onto the runaway because the bridge had decided to brake down on a weekend when not mechanics are nowhere to be found; “head up” on the plane wasn’t easy when his long legs were pushing against the seat in front; out special service bus waiting beside the plane on the runaway in Frankfurt; the special container-type lift taking us down from the plane and opening up directly into the bus; arrival at our wonderful apartamento, with a balcony and a nice sofa, and a view of the brilliant sensory garden below.

Despite being absolutely exhausted, Pádraig managed to eat for the first time ever since his accident, a full Bratwurst, and drink a glass of orange lemonade. It’s a sign of things to come… in the true dreamboater spirit!

We’re going to bed eearly-ish as we’ll start the programme tomorrow morning at 8am.

What a day! Everything is possible!

Flying

We’ll be going to Pforzheim tomorrow and we’ll have to get up at a time that gives the word “early” a whole new meaning to get the Aer Lingus flight to Frankfurt. Pádraig’s first scheduled flight since his accident.

Flying

Keep your fingers crossed for us (or do what you do to wish someone luck:).

I’ll let you know how it all went tomorrow night. Can you feel the suspense?

Sleepless

Last night, having turned Pádraig, I could not go back to sleep. I stayed up and wrote an email. You know, I know, everybody knows that this is not what you do unless you want to get yourself into deep trouble.

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I did it anyway. And I sent it.

It was an email to someone who cares about An Saol and brain injured people. The person had read the proposal for the An Saol pilot project and proposed that we should get the support of one of the established organisations. The person also raised some concerns about a certain message being sent implicitly to potential readers by the fact that those working in the proposed day care centre would be trained abroad.

What I wrote in the email was that here we are, knowing that the human rights of people with catastrophic injuries are being violated and that social justice is not being done. Now someone comes along and wants to change that situation, is looking for support and advice and is not getting it at home, but, surprisingly, abroad. On this background, telling me who I should work with, i.e. those who are not engaging to the extend required to affect change, did cost me a night’s sleep.

When I went back to bed, I had an hour left before I had to get back up. I went into a half-sleep, one of those that encourage dreams. My early morning dream was of Pádraig standing in front of me, supported by me, and when I let go he managed to stand all by himself. There was a rush of happiness going through my whole body.

When Pádraig was standing in his tilt table later on this morning with his arms around my neck and my body supporting his from the front, he started to give me a big big strong hug, the first really strong hug since his accident.

He must have had the same dream early this morning and together, this morning, we knew that one day, I will be able to let go of him and he will stand there all by himself again.

Heatmap

Someone said to me I should play the Lotto tonight because this was one of these incredible days you never see coming. It was a day packed with visits and activities. There were really brilliant people here from England advising us on different possible technical aids for Pádraig; people from Cork trialling out top-notch communication equipment; an engineer from the City Council who was just walking by the house and remembered that we had applied for a special parking slot for Pádraig – and decided to measure it all out to do the best possible job for him; an absolutely beautiful music therapy session; a person calling in to check all of Pádraig’s dietary needs were covered for Pforzheim; and a birthday boy – one of Pádraig’s friend – calling in for ‘Kaffeetrinken’.

What really and truly took my breath away, however, was this fabulous work of art by Pádraig:

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It’s a ‘heatmap’, a picture Pádraig drew with his eyes on a screen – just by looking at it. He started in the bottom left corner. When I asked him to look to the top right corner of the screen he did that: he quickly moved diagonally up to the right (that’s the red narrow line going up and the bright red spot). He went back and looked at the spot at the bottom where he had started. Then I asked him to look up left. It took him a few seconds and then he looked at the left top corner of the screen (the blue line and spot). After that he looked along the bottom of the screen and then went up to the right (the multi-coloured spots on the right of the screen).

Here is a bit of a video recording to show how he drew the blue and red spots.

There are loads of reasons why this is not just absolutely amazing and a really great achievement – this has the potential to be life-changing for Pádraig. After the eye-tests, we had been told that Pádraig could not move his eyes into any direction but horizontally: this heatmap following his eye movements proves the contrary: he /can/ move his eye into any direction and he can do it when we ask him to do so. I asked him to look to the top right corner, then to the top left corner – and that is what he did. Because he can do this, he should be able to do, or learn to do, so much more with the eye tracker, especially in terms of communication. This is a system similar to that of Stephen Hawkins’ or Simon Fitzpatrick’s – both of them wrote quite influencial books.

The day, today, really left me breathless.