Saturday, April 28, 2007

Evening, April 25

(e-mail from B. Parady)

A quiet day today. Shelly describes it as a restful day, the kind that a baby has after a long hard, time. A tired sleep. Recovery. Not a fitful sleep as she has been experiencing.

Basically she was groggy today. The vitals were good all day. Max fever was 100.4, which is OK. Most of the time the temp was 99. There have been no antibiotics administered, Mayer thinks not needed at this point. Her BP and heart rates were excellent. They took her off the Fentanyl drip and went to a patch only meaning that they have her titrated. They added a muscle relaxant which may have accounted for her lack of tightness in the arms and eased expression.

Sabina seemed genuinely sleeping, able to bend arms and had no storms that increased HR or temp.

Shelly really appreciated the visitors as it brightens her day. She is becoming more involved with the other patient families in the unit offering them comfort. Shelly really appreciates Dr Mayer's optimistic approach.

So a prayer of thanks for a good day, and a prayer for Sabina pushing forward to more activity and strength.

Evening, April 24

(e-mail from B. Parady)

Sabina had a day without fever. They have not administered any antibiotics. She had her eyes open from 11:30 to 5:45 and Shelly spent the day talking upbeat, positive things to her.

Sabina has been off the respirator for 24 hours without complication. They removed the St Vincent's tracheostomy with one that Columbia uses.

Sabina's mood and expression was sad and melancholy, but Shelly was working to disabuse her of any negative notions telling her that it as ok to be sad and tired, but that Sabina was not allowed to give up.

Dr Mayer had the consulting neurologist on her fever storming come and visit Sabina.

All in all, Shelly is thrilled to have Dr Mayer on Sabina's side and looks forward to Sabina's continued progress.

Our prayers continue for Sabina's steady climb.

Evening, April 23 (Extra Report)

(e-mail from B. Parady)

We have a lot of good news. To start with Sabina is off the respirator. Amazing. She still breaths through the trach for eases. Second Dr Mayer gives her a 50 percent chance. He says that if Sabina can follow simple commands within one year, she has a chance of recovery. He has seen worse. Her heart is strong and otherwise in good shape.

The doctors are administering a drug cocktail to find Sabina's best place to operate. As soon as medicaid gets approved she can go to Helen Hayes upriver in New York. Dr Mayer is working out options on when to replace her skull flap.

What Sabina needs now is lots of pleasant stimulation via speech. He says that patients do best when they have something to come back to. So I guess this is my appeal for friends to come and visit and visit often.

Amazing. They are really trying to live up to their sign.

Evening, April 23

(e-mail from B. Parady)

Sabina had a great day. Shelly felt that she had Sabina's attention. There is a low grade fever and they have the cooling blanket on. The stanched her high heart rate episodes with Demerol during the early part of the day. Sabina is headed for a restful evening as things go along. Dr Mayer is bringing in another consulting neurologist to help deal with her fever and heart rate storming. They plan to administer botox to her legs to get them out of their rigidity. That alone will cost $1000s.

Shelly is making friends in the ICU with other patient's families and sharing with them. The mood has shifted 180 degrees since yesterday. A prayer of thanksgiving for the day.

Evening, April 22

(e-mail from B. Parady)

It was an up and down day for Sabina. She had a bit of trouble last night and they had to put a cooling blanket on her. The docs are not so concerned with catching the fever so quickly since it tends to come down fast. They are putting her back on antibiotics, but the infection appears trivial and can be treated with ordinary antibiotics.

During the day she was peaceful and not in pain, and we she did fever a bit later she not go into a pained expression. The opiod sedatives are doing their bit. Mostly it was a good day. The care leaves Shelly quite a bit at ease.

A side note. Even though Sabina's case is very difficult and takes a lot of resources, there is much to be gained by the medical profession in learning from her case. Her care and the results will aid others as they face similar circumstances. In a setting like Columbia, Sabina is giving herself even now.

What made the day for Shelly was that there were a steady stream of visitors including a Danville Girl Scout friend. She is looking forward to meeting Dr Mayer who will be on duty for the next couple of weeks. He seems to be very sharp.

My prayers are for Sabina, and for her doctors and nurses for their care and kindness.

Evening, April 21

(e-mail from B. Parady)

Time for me to reveal what was going through my head, and what lead to the effort to transfer Sabina to Columbia. What happened was that I did enough research on Sabina's fevers and condition to know that the fevers meant a very poor prognosis. Why I focused on Columbia was that there some pharmacological means to deal with these lower brain issues (spiking fevers can originate in the hypothalamus). Columbia has the skills to deal with this.

What I am bringing to you is that Dr Otten sat down with us to go over what is going on and what the treatment plans are. When Sabina exhibited her days of responsiveness, that gave everyone, including the doctors at Columbia some hope. What is happening now is that they are titrating her Fentanyl and Demerol to find a spot in consciousness for her to operate. She needs to be relieved of the horrific pains that she is getting enough to mount nerve action. Further on they there employing bromocriptine to control some of the other aspects of the autonomic nervous systems, among other drugs. They are also giving her insulin to control nerve damage in rehab.

The hope is that in the next week they can bring Sabina to some level of consciousness again. Currently she is exhibiting almost not cortical activity, and only brainstem activity. The eye motions are unguided and the body motions are not coordinated. We are back where she was before she became reactive. The hope is that they can bring her out, the fear is that she will not emerge.

Bottom line, Dr Parra gave us the superficial case. Dr Otten is describing the case of hope, very very thin hope. Literally hope against hope. The hope that I wanted to buy by getting Sabina where she is now.

Today Sabina mostly rested and had uneasy moment. This evening she is at ease, and I cannot tell from Shelly if she is showing some signs of comfort, but she may be. They have a sign over the walkways to Milstein that says amazing things happen here. Well, we hope so, and even if they don't we will continue to hold out hope.

My prayers for Sabina to find her consciousness, for her doctors to mount the good fight, for her nurses to manage her through this, and for Shelly and Sabina's friends to stay with her though this. God bless all of you.

Evening, April 20

(e-mail from B. Parady)

As Shelly pointed out, we discussed Sabina's prognosis with Dr Parra. He is not optimistic, then, we were given no reason to be optimistic. When she came here she was in worse shape than she is now. She was tense, pained, and bad off. They are doing EEGs 24/7 to track her activity. They are taking her off anti-convulsives since she seems stable. They are weaning her off the respirator and she is responding. Dr Parra is applying stimulative drugs to perk her up and get some activity going. Sabina does open her eyes now. Earlier this week she did not. She does not track yet with her eyes. She perhaps responded to my touch by opening her eyes. We shall see if this becomes consistent. Dr Parra has been honest, direct, caring, and professional

Dr Parra is planning to reconstruct her skull and will carry out the process to do that. He will not use the flap at St Vincent's. We are working on transition to another facility, whether SCVMC or Helen Hayes Hospital upriver in New York.

She is in the hands of God. May the Lord protect her and strengthen her.

My Precious Daughter

(e-mail from S. Moore)

Today Dr. Parra told us that Sabina's injuries were very severe and he does not expect her to recover from her current state.

Birthday Morning, April 19

(e-mail from B. Parady)

Now she is 24. She got through the night with one fever spike at 6am and just had one as we came in. She was wide awake when we came in and slightly feverish.

They have her on EEG and looking at how all of these episodes are triggered. This will take more research and science to resolve her condition.

I am thankful to be with her and able to do what I can for her care. My prayers for Sabina on her birthday.

Evening, April 18

(e-mail from B. Parady)

A new time, a new place.

I am stunned at the modernity of Columbia Presbyterian. The neuro ICU ward here is second to none. Sabina has found her home for the next couple of weeks.

It is the little things that matter. First they are all computerized. No one messes with paper. All drugs are accessible, not air tubes from pharmacy. Her room is tidy and has not mold or dust near the patient. The professionalism is at the highest level whether physicians, nurses, or healthcare staff. Her bed shakes to reduce bedsores. They came in an percussed her lungs, something was never seen at SVH. Sounded like a massage at a spa. Should be good to clear the passages and lungs.

Her condition was basically sedated because of all the activity. They are using what I consider to be Sabina's prize sedative, Fentanyl. This was the sedative used when she got to the point of following commands. Clearly she has been in a lot of pain, and the source of it needs attention. I do get the feeling that we are going to get somewhere with her in this setting.

At any rate, my current prayers have been answered, now for new prayers. Time for Sabina to get diagnosis and prognosis, and Godspeed her rehabilitation.

Evening, April 17 (Extra Report)

(e-mail from B. Parady)

Well, it was close. A trauma patient moved in just as the transfer was to take place.

So one window closes for today, and we begin again tomorrow with hope that the transfer happens in due course. What was I saying about this all being a roller-coaster.

So Sabina had a good day. She was drying out from all the heavy drugs used Sunday night to stanch her spike. She held her temp at 98.6 all day till evening. It began to spike but the Arctic Sun stanched it and she was left under machine control with excellent vitals.

Tomorrow the anticipation begins again. Pray for no more trauma patients at NYP Columbia.

Evening, April 17

(e-mail from B. Parady)

A couple days early for Sabina's birthday present. She is on her way to NY Presbyterian, Columbia University. Attending will be Dr Augusto Parra.
Transport ambulance has been arranged.

She had a good stable day. Temps steady.

Prayers have been answered, now we need to pray for the resolution of her spiking fevers, which I hope will be coming soon.

Evening, April 16

(e-mail from B. Parady)

An uneventful day fortunately. We kept the Artic Sun at 98.6 all day. The heavy drugs the night before took their toll and left Sabina exhausted and stunned looking most of the day. We are leaving the Arctic Sun on overnight.

They took a 24 hour EEG prior to transferring her. Indications are that transfer is imminent. We look forward to finally having a plan and diagnosis for the spiking fevers. This is long overdue.

Shelly and I are now Sabina's legal guardians and all that entails.

Our prayers go to Sabina's resolution of the fevers and how they will be managed.

Evening, April 14

(e-mail from B. Parady)

Well it was a good day today. A little bit of a fever early, taken care of largely by the Arctic Sun. She had a high degree of open eyes and recognition, coming back from her setback. Kat and Cathy came by which Sabina seemed to enjoy. At the end of the day the fever seemed to want to come back, but was being held in check as we left.

We are encouraged that we can get her into acute rehab, presuming a bed becomes available, here in NYC.

So little progress, and we hope and pray that we can take the next steps in her rehabilitation in the coming week.

Evening, April 13

(e-mail from B. Parady)

Well, I am back in town till Wednesday. Here is the log for the day.

Her agitation threshold has lowered. Becomes uncomfortable very easily. She was very alert all day. Did not respond to commands. Seems to be distracted by the pain. Is becoming used to narcotics. It takes a lot to give her pain relief. Remembering that when she did respond to commands a couple of weeks ago, the pain relief was effective at that time. Other medications may be in order to bring her forward.

Evening, April 12

(e-mail from B. Parady)

Little to report today. One fever spike. Got a diagnosis from a physician that Sabina's spikes are likely due to venous thromboses. Another black mark for SVH in that they have not been effective in dealing with the fever spikes. Sabina was tired after the episode.

Had some good visitors today. I will be travelling tomorrow and will arrive late.

Let's pray for Sabina and the doctors that they work out a method of treatment and deal with the bedsores.

Evening, April 11

(e-mail from B. Parady)

Few things to report. Sabina had some rough periods with fever. She does have two bedsores. Had lots of visitors from Apostles today which was nice. All in all an OK day.

We are looking to transfer her at the earliest opportunity. Still working on it.

Let's pray for healing and good care for the next few days.

Evening, April 9

(e-mail from B. Parady)

Fairly good day, fevers were contained. Sabina seems to be recovering from infections. She was getting more active toward the end of the day with her moving her leg.

Sabina seemed to be getting more agitated which is in the next phase of recovery. Sedation was used to manage the agitation. Shelly plans on inquiring about the use of the helmet.

All in all, favorable. What we pray for, little miracles every day.

Evening, April 9

(e-mail from B. Parady)

It was a good day. Sabina had no fever during the day, but had one last night but only 101. The septicemia seems to be abating under the pressure of the antibiotics. She was alert, showed expression. Later in the evening she grimaced but it turns out it was only a tummy ache and not the onset of fever or headache.

She talked to Hirschfeld about the bone flap and that hospitals do not generally accept them if transferred. Sabina would need to be clear of the septicemia and free of fever for a week before the bone flap could go back in. Other place use artificial substitutes, which I confess after the infection control record of St Vincents makes me wonder if that is not a bad idea.

So a happy Easter for Sabina. Our prayers for the little daily miracles.

Evening, April 7

(e-mail from B. Parady)

An uneventful day. No need for narcotics. She slept a lot clearly recovering. She got frisky at night, and the fever started a bit and was addressed by antidiaphoretics.

She is on 4 antibiotics to address her blood infection.

My thanks to Kenny who stopped by to give Shelly some time off.

Here are my prayers for a wonderful Easter for Sabina and continued recovery. Let hope

Evening, April 6

(e-mail from B. Parady)

An OK day on this Good Friday. Some minor fever spiking because Sabina has a blood infection that is being treated with antibiotic. The good nursing team has been on it right away with dilaudid and motrin and the Arctic Sun. So things never got out of hand.

Some friends have been by today which were welcome breaks for Shelly.

There was some neuro activity on Sabina's part showing emotion and attention. Shelly does feel that when the blood infection clears we will get some more attention back and more out of coma activity.

So it goes. I will be back in NYC briefly late next week, returning early the following week.

My continued prayers for a just another miracle, the miracle of everyday recovery, just a little bit.

Evening, April 5

(e-mail from B. Parady)

Steady day today. Recovery and she is fairly medicated for her fever. She has some sort of blood infection or can be traced by markers in the blood and the docs are are working to stanch it. She was tense but no major issues.

The night nurse is proactive and makes Shelly happy. Neurologically, she is back in coma, but with eyes open occasionally. Shelly feels that Sabina will come back after the infections are treated.

Mom is brushing her teeth, and massaging her calves. Working to deal with issues before they become an issue.

Kenny and JR came by for a visit which was much appreciated. Gave Shelly a break.

My prayers for her recovery and health and comfort.

Morning, April 3

(e-mail from B. Parady)

Had a chat with Hirschfeld, all the good it may do. Sabina seems more unstable than ever after yesterday morning's excursion to near death. I told him that care varied from excellent to catastrophic and he apologized. Words fail me.

He agreed to put Sabina back on Arctic Sun which they use to control spiking fevers associated with TBI. They had been using it until dear Ruth removed it because she was untrained and believed in alcohol swabbing.

Just why am I attending physician and why is the attending neurosurgeon out to lunch? Where is my medical degree? And just what qualifies Hirschfeld to care for my daughter? I am confused.

I need to pray harder than ever for Sabina to overcome the abuse that she has suffered. The Lord protect her, keep her safe and restore her.

Evening, April 1

(e-mail from B. Parady)

Another good day. Started out slow, with Sabina mostly asleep and Shelly falling asleep in her room. I had to leave early on business to the Helmsley. Nice active evening with the fever starting to go up as Shelly left, a bit over 100. Let's hope that it gets moderated. No plans by the staff to administer any antidiaphoretics as yet.

Hirschfeld stated that we could expect various ups and downs as we talked by the elevator. He too was pleased by her activity shown on Friday.

I will await the prognosis offered by the staff at Santa Clara Valley Medical when that comes in.

So we hope for better days, and pray for the nursing staff to guide Sabina through the difficult days.

Friday, April 27, 2007

Evening, March 31

(e-mail from B. Parady)

Welcome back to the roller coaster.

After one really good day, we come back to spiking pneumonia fevers, and seizure when the fever spiked. The doctor let the fever go up to get a better culture of the nasty, but upset me by inducing the seizure. Medicine is sure a fun profession. Must be hard to be a doctor. Rough day for Shelly too, where Sabina spent the day sedated with propofol. Andre and Warren and Trish, some of the best were on duty, which made life much better than if things were going wild.

Sabina had to go back to 40% respiratorand respirator triggered breathing. The episode set back her vent weaning a few more days.

Hard to get through these down days after such wonderful days. I keep praying for some steady, even, level where Sabina can start building a recovery.

Evening, March 30

(e-mail from B. Parady)

I just received Sabina's birthday present to me. The summary is: "she responds to commands".

That as many of you know is perhaps one of the big steps in recovery. I watched as Dr Hirschfeld asked her to lift two fingers, blink her eyes and stick out her tongue. The key now is to controlling infection which tends to move her out of responsivity when she fevers.

Kind of hard to figure out how to celebrate. I think I will stay at the hospital during visiting hours to celebrate.

Brain injury recovery is about a series of miracles that unfold as gifts from God. We are blessed on this day. She has moved from up from a deep coma to a nice level for now which is as I read it, not in coma. Still a long way to go in rehab, a nice gift.

Evening, March 29 (Extra Report)

(e-mail from B. Parady)

Well, someone remembered my birthday. As I had finished my evening email, Susan, Elaine and Louise arrived holding this beautiful cake, saying happy birthday.

The card was really a great gift. Nice to see the signatures of Sabina's longtime friends and New York "family".

Matt and I decided to dig in before Shelly came and enjoyed popping down a couple of big slices. Shelly came later and give it her Home Ec major seal of approval. I hate to say it but birthdays have been many, way too many, but never mind. Let's say if you put candles on the cake and removed them, there would be no frosting left.

So to all who helped me celebrate yet another birthday, my thanks for a cap to a perfect day with Sabina and her mom.

Evening, March 29

(e-mail from B. Parady)

All in all a good, quiet day. No fevers, normal temp, normal pulse, some sedation and little open eye activity under the sedation. In the evening the temperature was sloping up and pulse up slightly. No fever emerged and she had a great alert evening. Mom had a great evening. Made for a happy day.

Good because the vitals were steady. She has her hockey helmet on now. The doc says that she needs to keep it on. It is a peculiar sight. She wears a large since she needs a little extra allowance for her head where the bone was removed. It may take months before the bone is installed.

Found out that the tennis shoes that Shelly bought to keep her soles straight have stylized biohazard symbols. Very Warhol-esque in a hospital sort of way.

Took another step today toward moving her to California. We are trying to get everything aligned for her move to Santa Clara Valley. This appears to be the only option. There is no top facility in NYC that will take an acute rehab patient. I thought that it would be easy but no such luck. NY is out.

So now it remains to get her stabilized which she is not, for the doctors to at both SCVMC and Saint Vincents to review her case and when she should be transferred, and then for me to arrange an air ambulance when the doctors deem it right. Basically the stars need to be aligned. When the call finally does go out, everything happens in 24 hours.

Lots of questions. When and if can they wean her off the ventilator? How much function will Santa Clara require? When will she be ready?

At this point I am praying for her recovery to get her to California, hopefully within the next month.

Evening, March 28

Fairly uneventful day, short of a spike at the beginning of the day in her heart rate. She was sedated throughout the day on either morphine, or dilaudid.

Attention to her heart rate and temp has been better today with the current nursing staff assigned to her. We are now looking to manage her sedation a bit better to produce the kind of result that would be best for respiration and recovery, a tricky balance. We had enough confidence today to leave at 10pm.

Not a lot of activity given the level of sedation, but quiet and rest are something that Sabina needed.

Evening, March 27

(e-mail from B. Parady)

Some good news. It was a great day with her, finally. The nursing crew finally got her stabilized after the weekend crew's neglect caused her fevers to shoot up and her vitals go bad.

It was nice to look into her eyes which were open for over 4 hours at a time even after sedation with morphine. It was a lovely evening.

Then things went a little off, with heart rate and temp going up a bit. It was only through the diligent effort of her mom who pressed the attentive, though overworked, nurse to get her morphine on schedule, a cooling blanket, and tylenol on schedule. Using those methods her vitals were being kept under control. We had to stay till after midnight to see that she was properly cared for.

This points up our issue with St Vincents: It is not the excellent staffers that we have any issue with, it is the management. The management does not have enough resources either in nursing or support services to see to adequate care. They may bring in marginal nurses, or understaff at critical times. Either one of which can threaten Sabina's life and health.

I will be pressing Mt Sinai for transfer. I do not see adequate chance for recovery at St Vincent's unless there is radical change instantly.

Shelly will be playing nurse manager to the nurses seeing that Sabina gets adequate care. Without that, no hope.

Sabina has some disturbance above the pneumonia perhaps, but that think that is a result of improper sedation, not due to serious hypothalmic damage. Everything points that way. The St Vince docs want to lay it on that but the real problem is nursing and medication through this phase of recovery.

Other than that, I am back. Went out in snow, came back to 79 degrees in Newark. Dropping to 40s I hear.

Off to Mt Sinai this morning. Will be on the lookout for burning shrubs.

My prayers for Sabina's safe recovery, and that her caregivers are able to give her the attention that she needs.

Evening, March 26

(e-mail from B. Parady)

This morning I visited Santa Clara Valley Medical Center Brain Trauma rehab center. I have only one thing to say: Wow. This is a world class facility with all aspects of rehab from the vent to driver training. Clean, intense, caring, lovely setting. They gave me a complete explanation of coma, where Sabina is, what can be done. The intake nurse gave me more information on Sabina's condition that all the doctors and nurses at St Vincents.

That is really sad.

Now the question is how to get Sabina out of New York. The nurse at SCVMC told me that transportation on a vent was iffy and that she needed to be stabilized. The problem is that I have little confidence that St Vincent's can deliver the care needed to get Sabina transferred. She questioned that they may not be the best facility to wean her off the vent. They could seriously jeopardize her recovery if they botch it.

So my goal is to get her over to Mt Sinai ASAP.

The staff at St Vincent's asked me to buy a hockey helmet. This seems really mickey mouse. This is so that they can transfer her up to the 14th floor for critical care.

So how was Sabina today? Shelly cried.

Please pray for Sabina and that someone at St Vincent's can deliver the care needed to get her out.

Evening, March 22

(e-mail from B. Parady)

Top notch day. This one rates a B+. Quoting her mother: " A really really good day". She was expressive, relaxed, had good vitals, 101 or less fever, decent pulse rate and good all around.

She had physical therapy from a handsome young man and smiled at him as he lifted her arm over her head. She was wakeful, and responded to nearby conversation by changing her expression in an appropriate manner.

So, as far as things go, she was happy with the nursing staff, the favorites were on duty today, and it may have made a difference. Or it simply may have been an up day.

All in all, I am overjoyed at the little we are getting from Sabina. My thanks to all who express their love.

A Passage

(e-mail from J. Song)

I want to thank all of you in New York for your prayers, love, and steadfast support of Sabina through these four Sundays. Please know that you are not alone, that all throughout the United States people are praying for her--that whole church congregations and communities have been brought closer together through this remarkable young woman.

I can only imagine what it must have been like in the waiting room during those first few hours, what it must have been like to see her so quiet on her bed. Waiting for infrequent updates from thousands of miles away has also been difficult, though I am so thankful for the miracles that we have already witnessed.

There is a story from the Bible that I am reminded of when I think of Sabina, and her role in all of our lives. In Genesis, there is a story of Abraham and his only son, Isaac. God spoke to Abraham and, as a test of his faith, commanded him to take Isaac to the top of a mountain and sacrifice him. On the appointed day, Abraham and Isaac set out on the journey.

Isaac knew there was going to be a sacrifice; only, he didn't know that he himself would be the sacrifice! They got to the mountain, and Isaac noticed that they didn't have an animal to offer. Then, before Isaac knew it, Abraham bound him and put him on top of an altar of stones. Abraham was about to plunge a dagger into his son when an angel called out to him to stop, that Abraham had passed God's test of faith. The angel pointed out a ram caught in a nearby thicket, which Abraham sacrified in thanksgiving to God.

Because he was ready to offer everything, Abraham and all his descendents were blessed.

Before the accident, I did not consider myself very religious. I tried a few times to go to church, to pray, but I found myself doubting, not believing. I was too lazy to go to church, did not feel that my prayers would be answered. But I myself have recently had some incredible experiences, have heard of inspirational prayers and powerful dreams. I have become convinced that she will not be sacrificed, but that she will be returned to us.

And I am reminded of the person she is, and of the progression of her life I have alternately been told and been privileged to experience first-hand. Though I can't start to claim I know the meaning of all this, I believe in my heart that she still has so much work to do in this world...

look at the changes that been wrought in all of us.

If you have any prayers, dreams, or thoughts, please share them here. And let us continue praying, and sending her our love, and giving praise for the miracles that have occurred and those that will surely follow.

Evening, March 16

(e-mail from B. Parady)

Evening looks better than the morning. She has much better vital signs this evening. The central line has been replaced. I am told that infected central lines are common and not much of a concern.

She is showing eye movement. Talked to the doctor, and he said that she has a nasty lung infection and infectious disease people are working on it. He affirmed the eye movements, but cautioned about the arm flexion, apparently not a good neurological sign that has been with her the last few weeks.

So, in sum there is hope, and what hope there is will require a miracle. So far her care has been a miracle, so I need to quit taking miracles for granted and pray for more miracles.

This evening brought visitors in spite of the snow. God bless them. Tomorrow Shelly comes.

Morning, March 16

(e-mail from B. Parady)

Wish I had some good news today. As I am headed into the hospital, she has an infection on her central line and her fevers continue. They will install a new central line.

I pray for her health and restoration.

Evening, March 15

(e-mail from B. Parady)

I did not stay for the evening today. I asked for the lung culture report, but Dr Wagner her respiratory doctor had not looked at it yet. She looked much better than yesterday where she looked drained.

JR and Kenny took me out for a movie. Watched "Amazing Grace" and recommend it to everyone. Interesting story of the curtailing of the slave trade in the UK. After the movie, found myself poorly dressed for the cold weather, and with a cold, headed back to the hotel.

I have a report from Caroline that Sabina opened her eyes a few times, perhaps in response to some stimulus. Nice to see. Recovery is slow.

Sabina is a lady with many miracles and it shows. Lots to be thankful for.

Morning, March 15

(e-mail from B. Parady)

They moved Sabina to another suite in the SICU, 4030. She looks somewhat stable. I talked to Dr Leifer about rehab and the like. She is severely injured and may make significant recovery. Currently there is little to offer in her coma. We need to shed the pneumonia and the like.

Given the extent injury, the only local facility capable of her care is Mt Sinai. If any of you have contacts there please pass them along. Cornell has a rehab, but it is for those who can walk. Sabina has a long road ahead of her.

Basically we need to hope and pray. Time for more miracles. We talked about treatment for her fevers and he suggested the place for treatment with bromocriptine was in the rehab setting.

Now for some discussion about hope and love. I was discussing the choice of the nursing profession with a student nurse name Michael. Some of you may appreciate the irony. He started out in Manhattan as a high powered salesman on Wall Street. He came to the realization one day that he would not get promoted since he was not a buddy with the top dogs. He looked at what he was doing and decided to become an LPN, and is now finishing his RN. The message here is that he came to New York in hope, and over time moved from the profane to the spiritual, and expression of love through nursing. He now supports his family in a way that gives him meaning.

What does this have to do with us? We all (including myself) come to New York with hope. We certainly do not come here for the subways, the vermin, the traffic, the congestion. Many like Ryan of Apostles and Michael come here for base reasons, only to develop hope through love and the spirit.

Many like Sabina and the nutrition/dietitian interns come to New York with hope and the desire to extend their careers. Sabina found love with the pediatric cases that worked.

So, my perspective of New York has not changed, but my perspective of the people who come to New York with hope has changed.

You can find me either in the very back of the cafeteria at a laptop, or with Sabina.

Evening, March 14

(e-mail from B. Parady)

Sabina had some fevers during the day.They worked to manage the temperature. At 5pm they took her for a cat scan. This may have been motivated by the intercession of the Cornell neurologist. If so, that would please me. We expect the results of the acinetobacter culture to be available tomorrow and then perhaps some effective therapy.

After returning, Sabina had a number of visitors. We are gathering in the cafeteria due to crowding in the 11th floor waiting room and the loss of my table to work on. Folks from her church are bringing me dinner which is welcomed. I am encouraging a steady flow of visitors to keep the staff focused and motivated. That more than anything is what can be done to assure her return. I am discouraging bringing items like books and the like to minimize any contamination both inward and outward. I cannot visit her because of my cold and will continue to look in on her.

Let's continue to pray for her recovery and return to health.


(e-mail from C. Stauffer)

I told my friend Judy (a writer / musician) about poor Sabina. She wrote the following affirmation / prayer - which I think works for most religions and / or agnostics. I am passing it along in case it might be helpful, also 'cuz it's pretty.

            The surgery is successful
            the healing has begun
            the dark shadow of trauma has passed
            like the shadow of the great earth against the moon
            she will awaken with the dawning spring
            she will awaken, she will awaken
            with the greening earth and the dawning spring
            she will awaken the healing has begun

Evening, March 13

(e-mail from B. Parady)

Today was full of mixed messages. At noon they did the bronchoscopy. They aspirated and took cultures of her lungs for acinetobacter:

Her outward physical condition seems to get better, with folks say that she is opening her eyes, and blinking. In my view her face is showing an expression, something that she has lacked. She is still in her own coma. Fevers are on and off, due to either pneumonia or reaction to her head injury.

Many kind visitors this evening. The 11th floor waiting room has attracted a new level of clientele. Discussions included "3 to life", "5 to life", "parole", "violenza", "after he seen that he got shot", but never mind. This is all happening on one side while on the other side everyone is preparing for their dietitian tests.

I think that I need a change. We played games here, enjoying our company as wait and as people went down one at a time to visit her in isolation. Remember when you come that you need gloves and gown if you plan to visit. Remember to write a passage in her book when you

Evening, March 12

(e-mail from B. Parady)

Good news bad news day. The acetobacter is invading more, so tomorrow they do a procedure to relieve deal with the nasty. Other bad news is that a second patient in neural ICU has Acetobacter. Seems to be a problem here.

The good news came from Hershfeld: She opened one eye, but not for Hershfeld, it was done for another doctor in the morning, but progress nonetheless.

Lots of folks came by today. A nice friendly day up here on 11. Lots of food and friendship. Thanks to all who came.

We continue to pray for her recovery and restoration in spite of all the hardships it imposes on her.

Morning, March 10

(e-mail from B. Parady)

Visited Sabina this morning. Still had a fever last night. Trying to get her pneumonia cleared. They are planning to take her to MRI this afternoon and prepping her. The nurse and I chatted a bit about sedation, and the more that I learn and talk to people the more that I think that the best thing for her is to be sedated on pentabarbitol for about 4 more weeks and then slowly brought out. It is far to early to try to wake her as they keep on insisting to do. I am working on getting more information from people who know more about this.

At any rate, no progress though vitals are OK but feverish. Sedation helps a lot to keep her quelled. PEG feeding seems to be working well and the view of many is that recovery will be helped by this.

So really not much to report. We must remain steadfast. My son needs to stay by his mother's side and support her through this. We have hope and we have Sabina. It is a miracle that she is alive, and we must have more miracles as we go forward for a recovery.

I am going to make a run to the donut pub later for sustenance and tea.

Let's pray for Sabina and her return to health and well being, and for patience in her caregivers, attendants, and us to see her through.

Evening, March 9

(e-mail from B. Parady)

Things are a bit better today. The good news is that she is off TPM (intravenous feeding) and on PEG feeding directly to the stomach. The CAT scan took place last evening and gave her a pass for tube feeding. Every nutritionist feels that this will assist Sabina's recovery. Other news is that she has had 2 BMs so far which is also good news.

She is on sedation because they are waiting to do her MRI. Last night they had to abort the
MRI because her heart rate rose too much, far too stimulated.

A nice array of visitors, though I was a bit perturbed when someone visited her who was a nurse, but introduced directly though Matt's mother. We are not touching her now because it tends to raise her BP and heart rate. Nice evening with friends in the 11th floor waiting room. Saw lots of Ron's wonderful pictures of Sabina in Italy and Germany.

I am on tear to get some neurology research applied to Sabina's case. Louise and one of the
doctors here are taking this on through Columbia Pres.

Work is proceeding for me quite slowly, but am starting to get things done. I am planning to
return to the bay area on 18 to the 21st for business, then back to NY.

Morning, March 9

(e-mail from B. Parady)

Another cold morning in New York, with not so strong winds and not quite so cold.

Got over here at the same time again, a little after 11. I looked in on her on 4th floor isolation and she still awaits cat scan and MRI. Last night may have been a false alarm.

Her vitals seem to be much more normal. Her temp is being regulated by the Arctic Sun device. I have yet to go over anything with her nurses. On the good side in my view is that she is being sedated (propofol), suggesting that whatever coma she has now is artificial.

I will be contacting patient services to see where things are progressing. I am in the 11th floor waiting room because of the poor accommodations on the 4th floor. Those of you that have followed the progress of Uma, John is arranging, air transport. John assembled a wonderful binder on Uma that he kept in the waiting room. I am going to take a couple of Sabina's pictures down and appoint her room with them.

Sabina has a lot of recovering to do. So far it is nothing but a miracle that she is alive. We need to pray for more miracles.