2 steps forward...

...1 step back. That's the process we were told, and we're living it.

Mom and I had a teleconference with Dad's case worker and his primary MD, Dr. Mumtaz today (and by teleconference, I mean I was on a cell phone in my office in Chicago while the 3 of them in the Rock figured out how to turn on Mom's cell speakerphone). We discussed where Dad is, what's to be expected, and what he's done that's unexpected. I learned a lot and nothing at all simultaneously.

Overall, it's been a good week. Dad has had two fever spikes, this morning's as high as 105. He's had blood culture's done 3 times to check for infection, and only on the first did they find anything (which was treated). Dr. Mumtaz is pretty sure that the fever's neurological, as A. the brain also helps regulate temp, so if something's amiss it will fluctuate and B. infection temps hover more around 102. But again, with long term care you must think in weeks, not moment-to-moment. If 5 of his last 7 days are good, that week goes in the "win" column.

Dad's official diagnosis from neurology will be severe traumatic brain injury. DO NOT google or Wikipedia unless you're sitting down and prepared. And even then, don't listen to Wikipedia...ever. It's too malleable to be a reliable source. We have not been told where he is on the Glasgow Coma Scale (mostly because I failed to ask, and the neurologist wasn't present). What we do know is that unconsciousness tends to last longer for people with injuries on the left side of the brain than for those to the right. Again, we simply must wait.

That's the worst news. What's better is that Dr Mumtaz believes that Dad's more responsive than ever as of today. He does have periods of eye opening and blinking. His nurse this morning told the doctor that she observed an obvious attempt on his part to follow the "squeeze my hand" command, something we've tried since the beginning unsuccessfully. That's huge. He held his own on two separate TPat breathing attempts (that's a step down from his normal respirator, a good thing), and only when his fever spiked did the techs have to increase his oxygen dosage.

The prognosis is dim, but you can help brighten it. If you're looking to help and happen to be in the Little Rock area, one of the best things you can do is visit Dad and talk to him. Brain stimulation is key to bring him out of this, and the more familiar voices, the merrier. Again, he's at Select Specialty Hospital at St Vincent, Markham and University, 6th floor. A few ground rules:

1. Do not, under any circumstances, visit if you are sick or caring for someone else who is ill. The tiniest risk of infection could have devastating consequences, and we need to keep him healthy. No coughs, no sniffles, nothing. He's going to be there a while, so we can wait until you're better.

2. Speak to him as if he's lucid, wide awake and sharing a glass of tea with you on the front porch. We have no reason to believe that he can't hear and understand everything. Feel free to tell "remember the time" stories about anything. Ask him questions and see if his eyelids flutter. You can even play the squeeze my hand game- first one gets a prize!

3. If you feel overcome with emotion, get out of that room. NO CRYING near the Dad. He needs the happy, not the sad. He's got enough problems and doesn't need any reason to give up hope. I hold both Mom and myself to this same standard, and I've only broken my rule once.

4. The SSH nursing staff has been amazing, so if the staff or techs come by, feel free to ask them questions. Most of their check-ins on Dad won't require you to leave the room, but some might. Don't be surprised if they ask for a little privacy.

5. Talk to Mom as well, about anything that's not involved with this accident and injury. She'll of course debrief you on where we are with Dad, but please also include conversations about something else. Funny stories, tabloid, gossip, anything. Try to make her laugh, but not so hard that she coughs. I know, it's a fine line...

So there's your update. It's not all good, but certainly not all bad. Just keep hoping and helping. I need my Dad. Help me get him back.