The Light and The Tunnel – Kris Update

Dearest loved ones and friends,

Tonight is a night of mixed emotions.  If I were to say there is a light at the end of the tunnel, I’m not certain it would be a fair analogy of the months ahead.  There is a light, however, and there is a plan.

A family care planning meeting was held today at RIOSA with Kris’s commanding officer there, with two Air Force liaison and case managers there along with the case manager from the VA.  Present also were Kris’s RIOSA case workers, representation from the three therapies (physical, occupational and speech therapy), Kris’s husband and George and I.  With us also (and basically conducting the meeting) were three doctors of psychology and rehabilitative care from Brooke Army Medical Center with whom Kris has been meeting over the past few weeks.  These meetings, as I have described in previous updates, have been to evaluate her as they determine her level of cognizance and begin fashioning a plan of care for her future. 

Overall, the meeting went very well.  We were especially pleased that the two doctors from BAMC were honest and explained their findings and their thoughts in great detail.  Their findings were, however, a confirmation of what George and I have already anticipated, but found difficult to hear.  They discussed the potential for continued progress and feel, after a year or more in rehab, Kris’s condition and limitations may not be improved upon to any large degree.  In that regard, however, communication (or the lack thereof) is of the greatest concern.  While she is working extraordinarily well with the speech therapist at RIOSA, the therapist’s area of expertise is limited in that she is just one person with only so much time to devote to Kris.  The doctors offered a plan.

There are at least five VA poly trauma hospitals around the country with dedicated efforts in all areas of rehabilitative work: physical, occupational and (most importantly) speech.  An in-depth augmented speech therapy program designed to meet Kris’s needs specifically would be most helpful, the two doctors believe.  Without having any real basic means to communicate, Kris will always be at the mercy of whomever is taking care of her.  No one, other than those of us who can understand her sign language of sorts and know her facial expressions can really meet her needs.  We simply cannot always be there 24-7, however, and that is the level of care Kris will need going forward.  Bottom line: communication has to be the main focus now.

In the end, it was determined that the team from BAMC would do the investigative work to locate and secure the facility where such a specialized speech program can be arranged.  The facilities they referenced were in Pittsburgh, Atlanta, Richmond, Houston and Chicago.  The decision was based on our top three choices: Houston, Atlanta, and Pittsburgh with Richmond still under consideration if one of the others did not come through.  Tampa had been a choice (my heart skipped a beat), but a contact there felt they could offer no such specialized speech augmentation program.

We were informed (husband and parents) that her stay would be from two to three months at least.  It would be helpful for some family representation to be there at the beginning to help with the transition, they said, and at the end to be trained in the program specifically.  Since Russell is obviously still running the household and working, and we are mobile with our RV as our home away from home, we will go wherever is necessary to get Kris settled in. 

We were all then advised that, based on the evaluation findings and what they have observed, it would be prudent for us (husband, mom and dad) to do some research and look to find a place for Kris.  Even while we expected this, we couldn’t bear to hear it said.  Kris will very likely not be able to go back to a home life and Russell will not be able to handle continued constant care for her 24-7.  Their recommendation is a long term care facility.  Going home on for a visit now and then once she is settled in her new “home” away from home will be possible, even encouraged and enjoyable.  At this point, however, there is too much pain for Kris to see what she can not have, and it’s my opinion going “home” would simply break her heart.  As the doctors from BAMC admonished us, Kris will essentially have two homes: one for her family and where she will visit from time to time, and one where she actually lives because of the level of care she will need.

A time line is difficult to project, but they believe a move will be arranged within two to six weeks.  As a matter of professional courtesy and because she is still an Air Force military career nurse, Kris was brought into the meeting so that the doctors could explain to her directly what will happen.  Her son, Joshua, joined the meeting then as well. 

Kris understands.  She is deeply aware of her injuries, her physical struggles and limitations, and the frustration of not being able to communicate.  I believe she is ready to work hard again, which is what they have asked her to do.  She pointed to the word “yes” on her letter board.  Kris is still a fighter and, being a nurse, she is aware what must be done!!!

There is a light at the end of the tunnel.  It may not be a bright light yet, but in God’s time, it will shine for Kris.  of this, I have no doubt at all, and we do sincerely covet your prayers.

Blessings and love,

Carol and George