Fifth Anniversary Alive Day

Yes! Sam is alive!  In fact, yesterday was his fifth anniversary of that fatal day in Iraq in 2007 when the vehicle he was riding in was hit by a roadside bomb.  Sam made the trip from Iraq to Germany where Erin and Sam’s brother Donny where waiting for him.  He then was sent to the Bethesda Naval Medical Center for a few months.  After he started coming out of his coma, he was sent to the Palo Alto Veterans Hospital.  After about six months of rehab at the VA, Sam was sent to Kentfield Hospital in Marin County.  The last few years, Sam has been residing at the Care Meridian 24 hour skilled nursing facility in Granite Bay.  We have been very pleased with the care Sam has received at Care Meridian.  He receives physical, occupational and vision therapy a couple of times a week.  Most importantly, Sam is treated like a member of the family at this facility.  Sam continues to score very high on the brain related test he is given.  He still has a real hard time with short term memory issues, but long term memory is just fine. 

I tend to get a little down about Sam’s progress and it makes it difficult for me to write blog post about him because I always want to put out really positive reports—for that, I apologize.  I will try to be more forthcoming with my updates.  I will also resist the urge to give you to much information in this single blog post because there has been a lot of very positive things going on in the life of Sam and Erin, but I will make separate updates (preview: Erin graduated from college and getting ready for graduate school, Sam’s official retirement from the Marines, Erin and Sam buying a new house!).

Sam is still making small gains in all areas of his rehabilitation and yesterday proved to be a very good day for him.  As Julie and I were walking in to see him, he was sitting up on the rehab table without the assistance of the therapist.  Here is what Erin said in her facebook updated: 

Today is Sam’s 5th Alive Day! To commemorate the day he had an awesome physical therapy session. He sat with minimal assistance for 1:13, then 1:23. He also used his hip flexors to pick up his right leg before he kicked it out. These are both firsts. I am so proud of him.

On top of Sam’s 5th anniversary “Alive Day”, in a few days (July 27th) Sam and Erin will be celebrating their 9th anniversary of marriage!  Besides going to school and training for marathons and triathlons (another blog post!), Erin can be found at the Care Meridian facility hanging out with Sam almost every day of the week.  Thank you for your support and continued prays for Sam.  He is a live and well and still improving every day.   One final picture of the happy couple.  Happy anniversary Sam and Erin.  We love you!

Holes in VA Brain Injury Care

Last week Erin took a short trip from Kentfield (Marin Co.) to the VA Hospital in Palo Alto to meet with the Advisory Committee on OIF/OEF Veterans and Families.  The VA hospital in Palo Alto is home to one of the four VA polytrauma rehabilitation centers in the United States.  The other three being in Minneapolis MN, Tampa FL and Richmond VA.  One of the specialties of the polytrauma centers is acute care and rehabilitation of patients with traumatic brain injury (TBI).  After Sam was stabilized last year, he was transferred from the National Navel Medical Center in Bethesda Maryland to the VA Polytrauma Center in Palo Alto.  He received wonderful care at the VA facility and Erin was very impressed with the doctors and loved the staff at the facility.  There was only one problem—After being in Palo Alto five months, and still in an “emerging state of consciousness” Sam wasn’t improving enough to move on from the coma stimulation program to the next level of therapy (called C-trip) at the Palo Alto Polytrauma Center.  We were very fortunate (with the help of the doctors and social workers at the Palo Alto VA hospital) to get Sam transferred to the Kentfield Rehabilitation Hospital in Marin County (about 1 hour north of Palo Alto).   Sam has made wonderful improvements since being at Kentfield and he has been fortunate enough to be under the care of Deborah Doherty, MD who has been the Medical Director of the Brain Injury Rehabilitation Program at Kentfield Hospital since 1985.  She has been a wonderful blessing to both Sam and Erin and is widely known throughout the West for her work in treating brain injury patients.

Erin found herself standing before the Advisory Committee last  Wednesday.  It is comprised of retired Generals, other high ranking officers and even the mothers of some wounded soldiers.  Erin told her story and at a certain point was asked, “why did Sam have to leave the VA hospital in Palo Alto?”  Her answer was, “I wasn’t ever really clear on why we had to leave”.  As I said, there is a hole in the acute care and recovery of brain injured patients at the VA polytrauma centers and it seems to be a problem across the board.  In fact, one of the committee members told Erin that they had heard the same story over and over again at other facilities they had visited.  Hopefully, the advisory committee will will take this information back to the secretary of the VA and they will do what ever is necessary to “fill the holes”.  And, as I said, Sam was very fortunate in being sent to Kentfield…it may very well be better for the slow to recover brain injury patients to be sent to places like Kentfield where there are civilian doctors with more experience working with severe brain injury.

Erin’s talk with the Advisory Committee went very well.  She said she was so proud of the fact that she was able to communicate exactly what she wanted to say without getting getting mixed up or fumbling for words.  Although there were other people at the meeting talking to the Advisory Committee, she found that they were focusing in on her and asking her opinion on many aspects of the care received at the VA hospital.

Sam’s medical status (from Sam’s father Eric):

I got to see Sam and Erin a couple of times this week; on Wednesday when she did her presentation at the VA conference in Palo Alto; and again yesterday when I had the pleasure to visit with Sam and Erin along with Tony and Julie. (Erin’s parents) I appreciate Tony & Julie so much…often times it is hard for an outsider to know which kid belongs to who as they love Sam dearly, and I love Erin like my own. Our Love for God, and for our kids; creates a bond that will last for the rest of our lives. Thanks to all of you who prayed for Erin at her conference.  Although she doesn’t love speaking in front of an audience, she felt she did well and underscored a point to the panel members about gaps in the care and rehab process. The panel was appreciative of her testimony and I’m sure will have a long lasting impact on policy and procedure of treatments for future brain injuries. I’m proud of her…

Sam had a great week!  Even with a touch of UTI (urinary tract infection) and a mild cough, he attacked his therapies with vigor and enthusiasm. He broke his own records for sitting alone unassisted, raising himself while on his tummy, and even played checkers while standing in the frame. The most noticeable improvement was his ability to speak in sentences.  Erin and the therapists would ask him questions like name three countries, where in the past he would answer multiple choice questions.  Now he has to generate his own multiple choices.  He chose these:  Singapore, Jordan, and Syria…coming from the middle east, I guess I can understand the latter two, but Singapore? Ha! I was firing many questions to him on Wednesday, to largely test his memory; and when he didn’t know, I’d fill in the correct answers.  He responded, “I didn’t know that”!  But to many, his answers were right on.  I asked Erin yesterday how she comes up with so many ways to stimulate his thinking process, as sometimes I’m just amazed.  She said that sometimes their silliness to each other from prior to the accident is much material for their stimulation now, and besides she continued, it keeps me from getting bored…Ha! See the next picture where Erin is leading Sam in a Bronx cheer, or a duck call, if you will…It was funny to watch and hear…

Much love,
Eric

I too, am very thankful for Sam’s parents (Erin’s other mom and dad).  I couldn’t ask for more loving and caring people to be my daughter’s father and mother-in-law.

A quick note on our (myself and my wife Julie’s) visit to see Sam and Erin.  I don’t think I’ve laughed more on a visit to see Sam and Erin than I did this weekend.  We really had a good time—and both Erin and Sam kept us laughing.  While we were sitting outside on the porch at the hospital, a very pretty young blond walked by and Sam (always looking for a physical therapy opportunity) followed her with his head and eyes as she walked by.  It was so funny and wonderful to see him so “conscious” of a pretty young lady walking by.  Erin of course, asked him, “Hey Sam…were you checking her out?”  and he of course said, “No”.  Erin’s next question to Sam was, “who do you like better—blonds or brunettes”?  and of course his very quick answer was “brunettes!”.

Peace to all,
Tony

DoD must provide official Tri-Care coverage for Cognitive Rehabilitation Therapy

The issue of Tri-Care coverage for cognitive rehab therapy is so incredibly important for the long term care and recovery of our wounded warriors.  I’d like to share with you a letter to Robert M. Gates, Secretary, U.S. Department of Defense from some United States congressmen and woman who understand the importance of long term care for our wounded warriors.  Our military men and women honor our country and our government by putting their lives on the line without questioning the politics or motivation behind such orders.  Some of them pay the ultimate sacrifice by giving their lives.  Others will spend the rest of their lives trying to recover from the injuries they sustained from the sacrifice they made for their country.  As the letter below states, 320,000 troops (and counting) returning from OEF and OIF have experienced some form of traumatic brain injury (TBI).  We as a nation, MUST provide the best possible care and give these men and woman the best possible chance for recovery possible.  NO EXCUSES!

United States Senate
Washington, D.C. 20510

August 4, 2008

The Honorable Robert M. Gates
Secretary, U.S. Department of Defense
1000 Defense Pentagon
Washington, DC 20301-1000

Dear Secretary Gates:

A recent study conducted by the RAND Corporation found that 320,000 troops, or 19 percent of all service members, returning from Operations Enduring Freedom and Iraqi Freedom may have experienced a traumatic brain injury (TBI) during deployment.

We are concerned that at a time when TBI is recognized as the signature wound of the conflicts in Iraq and Afghanistan, one of the most widely accepted and critical rehabilitative treatments for this injury, known as cognitive rehabilitation therapy, is excluded by the military’s TRICARE health insurance program.

Cognitive rehabilitation is a proven regime of medical and therapeutic services designed to improve brain functioning.  Service members who sustain brain injuries frequently have difficulties in attention, concentration, memory, problem-solving, and decision-making that impede their ability to function in everyday activities.  Timely treatment of cognitive dysfunction is vital to the recovery process, as it impacts personal safety, functional independence, productive living, psychological health and social interaction.  Therefore, we urge you to provide official TRICARE coverage for cognitive rehabilitation as an instrumental therapy in the recovery process of America’s wounded warriors.

While the Department of Defense and Veterans Administration have made recent strides to improve our institutional capacity to treat TBI at military and VA hospitals, often the best care for this complex injury is available only from private providers at outside care facilities.  Given the rate of TBI among returning service personnel, we must redouble efforts to remove access barriers to proven therapies.  The Department of Defense Task Force on Mental Health last year issued a recommendation that TRICARE access standards be changed to consider basic mental health care in the same category as primary medical care.  Embracing this recommendation is central to any successful, time-sensitive strategy to treat the invisible wounds of war.  This is particularly true for our most gravely wounded combat veterans.  According to figures provided by your office, 19,922 service members were medically retired with serious injuries in 2007 alone.  We believe these soldiers should be able to access cognitive rehabilitation services at outside care facilities.

We understand that TRICARE authorities have cited a lack of evidence attesting to the efficacy of cognitive rehabilitation as a justification for not covering this treatment.  This assessment contradicts the clear clinical consensus of the American medical community, which recognizes the instrumental role that these therapies play in minimizing disability and maximizing recovery of function in patients with a TBI.  Access to cognitive rehabilitation is a basic element of the continuum of care for brain injury patients.  The National Institutes of Health, the National Academy of Neuropsychology, the Brain Injury Association of America, and the American Speech-Language-Hearing Association validate cognitive rehabilitation as a proven, not an experimental, treatment for TBI.  Numerous public and private insurers currently provide coverage for cognitive rehabilitation in recognition of its proven therapeutic value in treating severe brain injuries.  As of 2006, fourteen states included cognitive rehabilitation under the Medicaid Home and Community-Based Services Waivers.

Individuals who have incurred a traumatic brain injury while serving their country deserve nothing less than the appropriate level of care based on currently accepted and widely utilized treatment modalities.  As in every area of modern medicine, the research and evidence base for treatment of brain injuries continues to evolve.  Service members with a TBI need appropriate and timely treatment options to address cognitive impairments, and best practices must be based on the available body of knowledge at the current time.  While further research in this area is ongoing and appropriate, our military healthcare system should err on the side of providing proven treatment given the serious lifelong consequences of an untreated or under-treated brain injury.

The national media have reported many anecdotal cases of individuals who attest to the vital role that cognitive rehabilitation plays in facilitating meaningful recovery from brain injury. One such example is ABC News journalist Bob Woodruff, who was injured by a roadside bomb in January 2006 while reporting from Iraq.  His remarkable recovery from a severe TBI has been widely cited as a powerful example of the great innovations of our military healthcare system.  Mr. Woodruff has repeatedly emphasized that his cognitive rehabilitation therapy was a vital part of his healing process.  Yet the treatment made available to Mr. Woodruff may be denied to U.S. military personnel who are similarly afflicted.

Congress recently enacted a historic GI bill to honor our responsibility to Iraq and Afghanistan veterans who return home seeking an education and a better future for their families. We have no less of a responsibility to maximize the potential of our wounded warriors returning from battle nursing the wounds of war. Given the prevalence of TBI among returning service personnel, it is difficult to comprehend why the military’s managed healthcare plan does not cover the very therapies that give our soldiers the best opportunities to recover and live full and productive lives.  We are committed to appropriating the necessary funding to ensure that injured service members receive the world-class healthcare they deserve.

Therefore, we urge the Department of Defense to provide official TRICARE coverage of cognitive rehabilitation therapies, so that all returning service personnel can benefit from the best brain injury care this country has to offer.

Thank you for your continued service.

Sincerely,

Evan Bayh, United States Senator
Barack Obama, United States Senator
Hillary Rodham Clinton, United States Senator
Ken Salazar, United States Senator
Edward M. Kennedy, United States Senator
Joe Lieberman, United States Senator
Jeff Bingaman, United States Senator
John F. Kerry, United States Senator
Blanche L. Lincoln, United States Senator
Claire McCaskill, United States Senator
Cc:  Brigadier General Loree Sutton, Major General Elder Granger

Sam’s medical status: I just said hi to Sam over the phone a few  minutes ago–and of course, he said hi back to me!  He continues his steady improvement in talking and continues his cognitive recovery.  Erin said that even though he has days when he’s feeling listless, when Sam gets into therapy, he really works hard to improve his previous days results.  Erin asked him yesterday why he tries so hard in therapy even when he’s not feeling well and he told her, “cuz I love you so much”.  The picture is Sam “going solo” in his motorized wheel chair in the halls of Kentfield Rehabilitation Hospital.  I believe he no longer needs to use the mask as of this week.  All the little micro-organisms that he brought back from Iraq should be out of his system.

Sam is still having seizure issues.  He had one this morning for 20 minutes and a few days ago he had one for 2 hours! According to Erin the seizures are “atypical”.  Normally after a seizure, the patient is very tired and sleepy.  After Sam’s seizures, he is actually wide awake and talkative.  His doctor is coordinating with an Epilepsy specialist from USF to set up a 72 hour EEG study for Sam.

Update! (my internet access has been down a few days!):  Erin said Sam will be going to the University of San Francisco Hospital tomorrow 8/21/08 and will be there for 3 or 4 days so his brain activity can be monitored closely.  Erin will be driving every day to San Francisco to be with Sam during his stay at USF from Kentfield.

100,000 Blog Hits: There is a “BLOG STATS” counter on the right side of this web blog that keeps a running count of how many times this site has been accessed since I started it in August of last year.  The count is now up to 103,988.  I know many of you receive email notifications with the latest blog entry (there are over 100), and don’t go directly to the blog—so that means there are many more than 100,000 hits.  Regardless, I wanted to thank you for your continued interest and prayers for Sam and Erin.  Your support and occasional comments (that Erin continues to read to Sam) really do touch all of Nichols and Neria family.  We don’t feel like we are going at this alone—you’re prayers and good wishes will continue to strengthen our faith, commitment and resolve.  But most of all, you are honoring a young man who had decided at a very young age, that he loves this country so much, he would give up his own life to defend it.  If that isn’t Christ like behavior, I don’t know what is!

Pentagon to spend $300M for study of TBI and PTSD

Wounded Warrior Project:  The above picture was taken at The Charter Hotel at  Beaver Creek, Colorado.  Erin and 18 other wives of wounded Marines and Soldiers were invited to this weekend get-away by the Wounded Warrior Project.  As with the recent trip Erin took to the Brain Injury Association of American Caregivers Conference in Dallas/Ft Worth, all expenses for this trip were paid by the Wounded Warrior Project.  The picture above is a little small, so if you’re having trouble finding Erin, she is kneeling in the front row, third from the left.

Erin had a wonderful time in Beaver Creek.  She said she was really able to connect with all these girls and wishes she had more time to get to know more of them.  The girls were given facials, massages and participated in group therapy sessions.  When we texted Erin on Friday night, she said she was having a great time at the “pajama bunko” party.  One of the girls is going to start a MySpace page so that all of them can continue to stay connected.

If you are not already contributing to a charity that supports veterans and their families, the Wounded Warrior Project is a worthy cause.  They, along with the Marine Corps Semper Fi Foundation and Soldier’s Angeles were there waiting for Erin when she and Sam first arrived in Bethesda NNMC and they continue to be there for Sam and Erin and our whole family today.

DoD Research Funds for TBI and PTSD:  Wonderful news in the TBI research world.  The Pentagon is spending $300 million dollars for research related to TBI and PTSD.  This includes research on 20 different medications related to TBI.  When Erin was at the Brain Injury Association of America Caregivers Conference last week, she mentioned that many caregivers of non-military TBI patients we so thankful that the military TBI issues were giving all TBI research much needed publicity.  It’s estimated that 1.4 million Americans suffer from TBI each year—235,000 of those cases are serious enough to require hospital care (based on findings from the Centers for Disease Control and Prevention.  To read more on this topic, see this article from USA Today.

Sam’s medical status:

Good Evening All,

Erin lent her expertise to the “Wounded Warrior Battalion’s” workshop in Denver this past weekend; so it was Kelley’s and my distinct pleasure to sit and visit with Sam. On Saturday, Kelley took some friends with her that were so excited to be there and pray for Sam. I got the impression they were from a Spanish speaking church and were elated to hear Sam use his voice to talk to Erin by phone. They were blessed, but were a blessing to Sam as well. If we could ask for another prayer this evening; Sam’s Uncle, Rick Hendricks, collapsed at work today and was unresponsive for several hours…We immediately had dozens and dozens of spirit filled believers praying for him and he regained consciousness this evening. Sam in his own voice, “gargled” out this prayer: “Heavenly Father, In Jesus name, we call Rick the healed of God.” They are doing tests tonight to determine the cause of the incident but we are believing the same power that moves Sam along will restore Rick as well.

Sam had a fantastic week full of therapy sessions and tests. He has 3 successive EEG’s and no sign of any seizure activity…He is off of the stronger anti-convulsants and just takes one mild one for now…He doesn’t seem to be displaying severe symptoms of any iinfections either so it is full steam ahead for progress again. The therapists are jazzed to see him back in the “work mode” as he breaks his own record daily for sitting up unassisted. The first picture is of Sam sitting to rebuild the muscles in his core…After a few minutes, he began to tip sideways and he said, “Oh S_ _t! Ha! Erin and the therapists roared…Can’t get all the Marine out of the boy…Ha! The other picture during Physical Therapy is Erin giving him ample reason to work hard. A kiss for motivation…If you look hard you can see the Anniversary ring that Sam gave Erin for their 5th wedding anniversary. Erin was the envy of the nursing staff and they all wanted to know from Sam where their ring was…Sam was hilarious playing to their requests…The last picture is of Erin throwing some jabs at Sam with his night time mitten. It is used to keep him from pulling out essential tubes and such…He is getting very fast with his response time in blocking her…

The last two days he didn’t want the T.V. on at all…he wanted some  reading done for him; and seemed quite content to hear some stories…he listened intently and interacted on several occasions…at one point I looked at him and he seemed to be deep in thought so I asked him what he was thinking about? He threw up his hand as if to say nothing or I don’t know…To be funny, I said while you’re sitting there why don’t you solve world hunger? Without missing a beat he slowly raised his hand to his chin  and began to stroke it in a very thoughtful way…What a character…Yesterday when I arrived I mentioned that maybe we could call Donny later. In about 30 minutes he initiated a phone call by making glasses with his fingers to indicate “Donny” and then did the phone thing to his ear…Erin says that is big for him to initiate that by himself…today he tried to reach behind himself for the pull chain for the overhead light…I doubt if I could have come any closer…

In a two or three week period here we have many celebrations to enjoy with Sam and Erin. His “alive day” (July 24th); Their 5th wedding anniversary (July 27th); and now Sam’s 24th birthday on August 12th…Last year he turned 23 in a coma in Bethesda Naval Hospital’s intensive care unit. Look where God has led him in just one year…Can you see in your mind where he will be on his 25th b’day? I am stating unequivocally that he will be walking and talking perfectly by then…Let me just say a word about their anniversary…My sister said that if you think you are in touch with your emotions, just try and tell someone how you feel about them with out thinking about it in advance…you stumble, stammer, and usually crash and burn…I talked to Erin about their anniversary and tried to delicately find out how her feelings had either been changed or does she do what she does because their love was so perfect before the accident? She did not stutter or hesitate; she said they were best friends, had become closer before the events of last year, and they both had always put each other needs before their own…As I choked down the lump in my throat; I could see it…just as she described it…100% accurate; borne out by actions and not just words…That is how God works; and He is working through Erin…

Much Love,
Eric

One Year Alive Day Anniversary for Sam Nichols

We are approaching a very significant date…July 24th is Sam’s “Alive Day”. This is the day he cheated death—the anniversary of his second birthday so to speak.  Because of the incredible job our corpsmen, nurses and doctors are doing, many service men and women are experiencing their “Alive Day” instead of dying in the battlefield.

Sam has come a long way in his fight for survival.  There have been many close calls over the past year…mostly in Bethesda, but even some at the VA hospital in Palo Alto and even some seizure activity recently at Kentfield.  But—Sam is a fighter…he is a Marine…and he has Erin and his family cheering him on.  And this is something very important to all of us in the immediate family–we have YOU praying for Sam and offering your encouragement.  The neighbors, church families, buddies from ROTC at Casa Robles, brother Marines, Semper Fi Foundation, Veterans Administration employees, Wounded Warriors Project, Soldier’s Angels, Doctors and Nurses and Kentfield…and so many more who offer prayers, support and good wishes.

On the anniversary of Sam’s “Alive Day” I just wanted to say thank you to all who have been reading this blog for the past year.  It humbles me so much that you take the time to keep up with Sam and Erin’s love story.  Sometimes I get so frustrated that Sam is still on a feeding tube and still has so far to go…but then I realize that he is with us…he IS getting stronger every day…and God has chosen to use Sam in a very special way to teach us what is really important in life.  I thank you for your prayers and the encouraging comments you leave when we post updates.  Your prayers and good wishes keep us going and keep us strong.

I would also like you to please click on the “Heroes of Kilo” tab at the top of the blog.  These are the young men who died in the IED attack that wounded Sam.  For the families of Corporal James McRae, Corporal Matthew Zindars, Lance Corporal Robert Lunch, Corpsman Daniel Noble, we continue to pray for your strength as I know this must be a very difficult time for you.  Your son’s names are on the “Hero Bracelet” that I and most of my family and many friends wear on our wrist every day.

Sam’s medical status from his father Eric:

Sam is feeling much better as he “detoxes” from nearly toxic levels of anti-convulsant drugs given him during his recent episode with seizures. The problem, I believe, exists with more than one Doctor prescribing medications to immediately resolve Sam’s symptoms in order to literally save him from a perceived life threatening situation. Am I holding them up to blame? Absolutely not! Instead, I bless them and pray for more of God’s wisdom to be upon them and their decisions. Sam’s primary care rehabilitative Doctor is Deborah Daugherty. A dynamic woman with over 25 years experience in treating traumatic brain injuries who is most recently completing a chapter on Neuropharmacology for a medical textbook. She is nationally known and Sam couldn’t be in better hands. She is attractive, (think Tina Fey from 30 Rock) has a tremendous bedside manner, (Erin relates that she delivers much hope) and I didn’t know this until Friday: that her husband’s name is Sam and her daughter’s name is Erin…no wonder my Sam and Erin are so special to her…She and Erin have a great relationship as I witnessed them betting on a Starbucks “Mocha” recently for something that related to Sam’s care. Erin related another spill-over miracle to me on Friday that happened to the man in the room next to Sam…Erin said that Dr Daughterty had to tell a family that there was little hope for a man who looked to be about 60 or so, that was just unresponsive to many medical attempts. Erin said that the Doc is so full of positive hope that he must have been in very bad shape. Within a few days of her talking to the family, his brain wave monitor began to show life, he woke from his coma; and as Erin and I went to lunch, we observed this gentleman watching T.V…. Wow! Thank you Lord…your mercies know no limits…Can you imagine the sheer joy Dr Daughterty had when she was able to call his family with the news?

One of the worst resulting symptoms from a TBI is muscle tone…No, it doesn’t mean the same as to a healthy person. When you hear it, it sounds positive; something that all would aspire to have, like being in shape. This tone is the tightening of his muscles to where he can’t control or move them. This is why his right side is weak, his left side immobile up until recently, and he has trouble speaking…Erin and Dr Daugherty theorize that the valium related drugs are relaxing him (and the tone) enough to overcome some of this challenge. This includes his jaw, tongue, and facial muscles. We believe this is why he becomes so chatty when he takes these drugs. The picture is of Erin massaging his jaw muscles in an effort to relieve some of that tension and encourage the use of his speech centers.

Erin continues to impress me with the different things she comes up  with to stimulate and encourage Sam’s recovery. The second picture is her assisting Sam with exercises on the harmonica. This simple, but yet complex task of blowing the instrument benefits his muscles, tongue control, strengthening of his airway, and audio coordination. He’ll be banging out the blues in no time at all…She also regularly has him fill in Mad-libs as I’ve reported in past updates. This last week, by use of his alphabet board, he spelled out the words “ghastly” and “papoose” in response to one of Erin’s mad-lib challenges. Not exactly common words that one might think of when playing a game, but then again; Sam is far from ordinary.

Thursday is the one year anniversary of the event that changed so many lives; in my family, friends, and people I’ve never even had the pleasure to meet. Erin’s Aunt Joy said it best; She will celebrate “Sam’s Life” on that day as will I; and I ask that all of you do the same. Remember God’s incredible goodness to Him and Erin over this past year; meeting every challenge with grace and mercy…And as we celebrate Sam’s life, let us remember to ask God to be with the families and friends of Sam’s “Brothers in Arms” that perished that day, giving them peace and comfort that can only come from him…

Sam IS restored…

Much love,
Eric

Treating our Severely Injured Troops Closer to Home

ABC Newsman Bob Woodruff says U.S troops should have the same care he received, and at facilities closer to their families. Mr Woodruff has literally walked in Sam’s shoes. While reporting in Iraq two years ago, he suffered traumatic brain injury after being hit by a road side bomb. He spent a few months at the Bethesda National Naval Medical Center and then was transferred to a hospital closer to his home in New York.

The military currently treats our wounded warriors with traumatic brain injury in only one of four military hospitals dispersed throughout the United States. While staying at the Palo Alto VA Polytrama center, Erin met families from all over the western United States—Oregon, Washington, Colorado and even Alaska.

Bob Woodruff and his wife Lee, recently spoke at a fundraiser for the Drake Center, a rehabilitative hospital in Cincinnati. One of their main points was that our military personal with TBI need to be sent to private facilities closer to their family. It has been a long and hard struggle for both the Nichols and Neria family having to drive back and forth to Palo Alto and now Kentfield on a weekly basis. Although there have been some wonderful military charities that has helped us with travel expenses, the military doesn’t provide anything to the families of our wounded troops. The least they can do is send our wounded to facilities closer to their home.

To read the full story about the Woodruff’s visit to the Drake Center, click here…

Sam’s medical status: Yesterday Sam was transported back to the Kentfield Rehabilitation hospital from Marin General Hospital. Erin said he seemed a little apprehensive and nervous when he arrived back. After a few of the nurses came in to say hi, he started to recognize them and felt much better.

Because everything he’s gone through in the past week, Sam has taken a few steps backwards. Erin said he kept telling her he was bored at Marin General and she thinks that was making him more lethargic. He’s going to be put back on an increasing regime of bromocriptine which was stimulating his speaking before last week. Erin expects after a full week of therapy and his new drug, he’ll be back to improving. Remember, before he got sick he was really starting to hit another level of consciousness.

The doctors at Marin General did find something very interesting. Occasionally it has been thought that Sam has had pneumonia because of a mass that has been seen in the lower left lobe of his lung. The doctors at Marin General determined that this was actually a part of his spleen (it was removed in Germany due to his injuries). The actual cause of his fever this past week was mostly due to a urinary tract infection which is now under control. He still has pseudomonas which is a bacteria that can cause urinary tract infections and/or systemic infections—but it is under control.

Now for an explanation of the pictures—I didn’t share any pictures of Sam for the first 6 months that I’ve maintained this blog. I just didn’t feel comfortable because I knew the pictures were so bad. The picture above on the left was taken after Sam came out of ICU at the Bethesda National Naval Medical Center in August of last year. As you can see, he was pretty bad off at the time. I remember when I first came in to see him, I had to leave the room occasionally because I got so emotional seeing him with all the tubes and wires hanging from him. The picture on the right was taken on Friday by my friend Bernadine. Sam was still not feeling too good, but he was still impressive. I’ll let Bernadine (who I consider my big sister) tell the story of her visit:

Kelley and I took off for the bay area yesterday around 9 so we could stop in Marin County to see Erin & Sam…….I got there while she was in the bathroom, and I was so happy to see Sam so alert, and went in and ran up to his bed and gave him a kiss telling him who it was and he seemed visibly aware I was there for sure! Then Erin came in and she got him to say my name!! very cool!!

He cracks me up the way he does his blowing [see the FLICKR photo to the right], she said he does that to piss her off, ha……..but she also thinks it comes from all the practice of blowing to learn speech! She asked him all sorts of questions to which he signed yes or no…Dr. Erin filled me in on a lot and told me she is going back to school to study Physical Therapy………….she is truly amazing [she hopes to go to Stanford].

I know its hard on Tony, as it was on my mom and dad, to realized the life you thought your daughter would have is not quite as expected [Bernadine has TWO special needs daughters!]. But I also truly believe Erin has accepted this cross in her life with so much love and grace, she will walk along with our Lord all the way, and she will be okay. It was so great to see the progress Sam HAS made…

Yes—Bernadine made me cry when I read that. Bernadine was on her way to Redwood City with her daughter Kelley, 18, for an appointment at Kaiser. Kelley is going to be having brain surgery soon to help relieve the seizures she has been having for much of her life. Keep Bernadine and Kelley in your prayers.

In Praise of VA Health Care

The Palo Alto Polytrauma Center Wing 7D: During the past six months Sam has been a patient in wing 7D of the Veterans Administration Polytrauma Center in Palo Alto California. This facility is a part of the VA Palo Alto Health Care System (VAPAHCS). Since Sam was first wounded in Iraq, I’ve been on the Internet researching subjects related to Sam’s injuries. I’ve also read many stories about the VA Health Care system—most of them being negative.

I’d like to take this opportunity to tell you a different VA Health Care story. This is the story of Sam—a wounded Marine slowly coming out of a coma. He was at the National Naval Medical Center (NNMC) in Bethesda Maryland for two months after his initial injuries and then flown to Palo Alto to continue his recovery. All the while, his loving wife (my daughter has been by his side).

When Sam and Erin first arrived at the VA hospital in Palo Alto, Erin was so upset. She had become so comfortable at the NNMC…she had her cozy room at the Navy Lodge just down the street from the hospital. She had a host of Marines assigned to the hospital who were willing and ready to help her and Sam in any way possible. She was comfortable with the doctors, the nurses and therapist who were all caring and professional.

But an interesting thing happened after a few days in Palo Alto—as Erin got more comfortable with her surroundings she noticed something. The doctors and nurse and therapist at the VA hospital, although not all military, were also caring and professional.

There has been so many horror stories about military and VA hospitals and their lack of cleanliness, old equipment, facilities in disrepair and a lack of motivation by the staff. That was not Erin and Sam’s experience. And I can say from many visits to the VA hospital over the past six months, that has not been my experience either.

The Palo Alto VA hospital is spacious and clean. The staff is friendly and attentive not only to Sam but also to Erin and their visitors. From the doctors assigned to Sam, to the nurses and therapist, the social workers, even the people who clean Sam’s room—they have all been wonderful. Erin feels like these people have become part of her family.

During a time of tragedy and trial for Sam and Erin, the good people of the VA Polytrauma Center wing 7D in Palo Alto have been a source of strength and hope. As Erin’s father, I want to publicly thank them for the work they do for all our wounded warriors. I have been able to sleep soundly at night knowing Sam was so well cared for and Erin was so happy with the treatment he was receiving.

The week before Sam was transferred to Kentfield (I’ll speak more of that below), the hospital staff in wing 7D got together and took a picture with Sam (while Erin was out to lunch). They then framed the picture and all of them wrote a note to Sam and Erin. The framed picture was presented to Erin the day before her and Sam left for Kentfield. It was a very tearful goodbye…

To give you an example of the loving and nurturing environment Sam and Erin were in, I’d like to share with you what one of the staff wrote…This gentleman was one of Sam’s nurses:

Sam and Erin,
My favorite two people—You won my heart. I pray daily for Sam’s recovery and it has been a great pleasure and honor to be able to take care of Sam. I love you both and only pray for my boy to keep improving daily. God has his plan…never lose faith. There is always light at the end of the tunnel. I’ll miss you both…with love—

The Next Chapter: On Wednesday March 6th, 2008 Sam was moved to the Kentfield Rehabilitation Hospital which is about 20 minutes north of the Golden Gate Bridge in San Francisco. This is a private hospital and has a very different feel to it compared to the VA hospital in Palo Alto.

The rooms at Kentfield are very small and there are two people to a room, so it is pretty cramped for visitors. This will take some getting used to since Sam had a single “large” room in Palo Alto.

Sam’s new doctor took a look at a brain scan that was taken at the VA hospital in Palo Alto in February and she was very happy with what she saw. She feels they can really make some positive progress with Sam.

Please pray for Sam and Erin. We believe God has put them in Kentfield for a reason and there will be some wonderful progress made at this hospital…but as with the move from Bethesda to Palo Alto, change is difficult. Erin has said that Sam is comfortable being in Kentfield but it is a little more difficult of a transition for Erin. She had a pretty rough weekend, but had lots of support from Sam’s father who visited on Saturday morning. Myself and my wife were there on Saturday afternoon and Erin’s sister, Allison, spent the whole weekend with her.

The picture above of Sam and Erin was taken by Sam’s father, Eric on Saturday. I received it in an email with an explanatory note from Eric:

Erin had been sitting next to him and talking to us all when
she scooted up beside him and laid her head on his shoulder. He wrapped his arm around her and hugged her tightly. Without a prompt, he lowered his head to kiss the top of her head. It was precious…

Prayer and Healing

A note from Erin about prayer:
I want to share with you all a recent concrete result of our prayers. About 2 weeks ago Eric (Sam’s dad) and Greg (Sam’s Uncle) came to visit, and we prayed specifically for the wound on Sam’s buttocks. The next day, as we went to change the dressing we saw significant improvement. I know my dad mentioned the improvement in a previous blog, but I really wanted to point out the timing of that improvement.

For months we’ve been working on this wound, and even though he has a special skin-care bed and has had the wound-vac for a while now, we still hadn’t seen the improvement that we expected. The day after our prayer session, Sam’s doctor said the words “Wow Sam, you’ve really turned the corner here.” If you’ve never spent a lot of time with doctors before, they are, as a group hopefully pessimistic. To hear a genuinely happy comment from a doctor feels really good. The funny thing is when we (the wound care team and doctor and I) saw the improvement in the wound, they all gave credit to the wound-vac! I however knew that God was answering our prayer, just like He saved Sam’s right leg overnight. Praise God and know that he answers our prayers.

Erin

I can attest to the fact that the wound on Sam’s buttocks was absolutely horrifying to look at.  I saw it about three months ago when I was visiting Sam and Erin in Bethesda.  I just happened to walk into the room when they were turning Sam over and I got a full view which made me turn around and walk back out so that I could catch my breath. 

Prayer really does work and we all thank you for your prayers and faithfulness to God’s work in Sam and Erin’s lives. 

Tony

The miracle that is Sam and Erin

December 24th was the five month anniversary of Sam’s injuries. Five months of disbelief, anger, sadness, relief, prayer and many small miracles.

For the first time in five months of blogging about Sam and Erin, I’ve included a picture of Sam in the hospital. There are different reasons why I haven’t included any pictures up to this point and it’s probably best not to go into them.

For those of you who have been following Sam’s progress, and for all of the wonderful charitable organizations who have helped Sam and Erin and our extended families—I wanted to share with you the ongoing miracle that is Sam and Erin. I say “Sam and Erin” because I really don’t know where Sam would be without his loving wife.

The “miracle” starts with a young Marine who went off to war. As with all wars, the unspeakable happened. Erin received a phone call from an officer at Camp Pendelton saying Sam was severely injured and they needed her to fly to Germany right away to be with him. At the hospital in Germany Erin was told that Sam would most likely not live and that he was in a coma. If he did come out of the coma, the doctors told Erin that Sam would remain unresponsive for the rest of his life. Erin was then asked to sign a DNR form, which she refused.

Sam was in a coma for two months at the National Naval Medical Center in Bethesda. Erin didn’t listen to the prognosis of the neurologist which mirrored what she was told in Germany. Erin took up the battle cry, “faith before fact!”.

Where is Sam now? Physically, he is at the VA hospital Polytrauma Center in Palo Alto California. If you were to walk into his room, he probably wouldn’t look at you and may not even acknowledge your presence. He is still partly in that dark fog that is traumatic brain injury (TBI) and it still takes much willpower for him to even answer a question with basic sign language.

But—take another look at that picture. When Erin is in the room with Sam, there is a connection the two of them share that goes way beyond the explainable. When she comes right up to him in his face, there is an electricity that occurs. He becomes focused and you can feel and see the unspoken communication they share—some sort of cosmic connectivity. And every time I see this phenomenon, I get a lump in my throat and tears in my eyes. Love in it’s purest form?

When Erin knocked on the door to Sam’s room the other day after she stepped out for a few minutes, I witnessed the most incredible smile on Sam’s face—it just melted my heart and I saw the Sam I have always known!

Sam is with us, he is still partly in the fog of brain injury, but he is fighting back. He said his first word last week. He held his head up by himself in the gym for about 45 minutes today. He is coming back to us.

Merry Christmas (we celebrated it today) and we are looking forward to more miracles in the coming year. Thank you all for your prayers and support.

Hero Miles Program

 
In my September 27th blog post, I mentioned the Fisher House that provides a room for Erin to stay on the grounds of the VA hospital in Palo Alto where Sam is being cared for.  This organization has been a God-send to Erin and many other families who have wounded warriors in the VA hospital.  But when Sam and Erin were at the National Naval Medical Center (NNMC) in Bethesda Maryland, our family had to fly across the country to see Erin and Sam.  But, I am happy to say that during that time frame, no one in Sam or Erin’s family had to pay for their round-trip airline ticket from Sacramento to Bethesda.  There are a couple of charitable organizations that coordinate with the military to provide free airfare for the families of wounded warriors.  One of those programs,  called Hero Miles, is a special program offered through the Fisher House.

There are two categories of eligible recipients:

Service men and women with an approved leave of five or more days may be given a free round trip airline ticket for a trip from the medical center to their home and return if they are not eligible for government funded airfare.

Qualifying service men and women may be given free round trip airline tickets to enable their family or close friends to visit them while they are being treated at the medical center.

If you are interested in donating miles from a participating airline, Click here for more information from the Fisher House – Hero Mile web site. 

Correction to my last blog:  In my last blog post, I mentioned that Navy Corpsman Doc Hanson came to visit Sam and Erin.  I also mentioned erroneously  that Doc Hanson was the first person to give Sam medical treatment and probably saved his life. It was actually Doc Couhie who treated Sam who was in the second vehicle that was hit by an IED.  Doc Hanson was treating the Marines in the first vehicle. 

Sam’s medical status: 

Monday December 3rd, 2007:  Sam didn’t have pink eye as was suspected yesterday;  it was more of a sweat gland issue.  He still is getting a fever towards the evening hours, but they believe it has to do the the TBI more than anything else.  Erin was joking yesterday that every time she leaves the room Sam’s temperature seems to go up.  Not sure what to make of that. 

Even though Erin said Sam is having pain issues with his backside, the therapist are going to try to get Sam up and out of bed in some form or fashion today.  Erin said Sam wants to try to get out of bed, so that is a good sign.  He’s still having headache issues in the late afternoon and evening, but I’m sure that is also a part of the TBI fallout. 

As part of the TBI protocol in the polytrauma unit at the VA hospital, the therapist have been giving Sam some type of assessment test (Erin doesn’t know the name, but it’s not the GRS or CRS test that I have described in past blog entries) and Erin said Sam is actually scoring at a higher level than can be scored…or giving responses that are more sophisticated than can be scored on the test.  I’ll ask Erin to find the actual name of the test.

Erin continues to make more paper cut-outs of various things like fruit and other objects and playing matching games with Sam to ensure his cognitive skills continue to improve.  She was just thinking about getting one of those magnetic boards with letters to see if Sam might be able to spell words.  The current alphabet board is a little difficult for Sam to use because his right hand gets the shakes pretty bad while he is trying to point to various letters.

Sunday December 2nd, 2007:  Sam’s had a fever of around 100 the last two days.  He may have pink eye.  Working with the alphabet board, Sam spelled out the names “Dad” (his father, Eric, was in the room) and then “Nichols”.  Erin (who came up to Sacramento on Saturday for her birthday) asked Sam if he remembered that she was not there yesterday and Sam indicated that he did remember her not being there and also that he remembered that she came to visit him later in the evening when she returned.  The reason I mention and continue to mention things like this, is because they are very good signs that he is remembering things from day to day;  a very good sign for someone with severe TBI. 

Saturday December 1st, 2007:  Today Erin took off her Dr. Erin hat and came up to Sacramento to celebrate her birthday with the family.

“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”

– Albert Einstein