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!

Sentinels of Freedom

In so many ways, the young men and women in our military who are fighting in Iraq and Afghanistan are our Sentinels of Freedom…just like the men and women of fighting forces who have gone before them in other wars, they all stand up for all of us and fight for freedom and democracy around the world.  Without these brave warriors, there would be no General Motors, no Exxon, no Thanksgiving meals or no Fourth of July celebrations in the country we call our home, The United States of America.  And because our military medical technology has become so cutting edge, many of these warriors who died on the battlefield in previous wars are now making it home—many with severe injuries.  I would like to introduce you to an organization who understands that it is our responsibility as a nation to embrace these wounded veterans and assist in getting them back on the road to independence.  This organization is called Sentinels of Freedom and the Sentinels of Freedom Scholarship Foundation.  From their “About Us” section of their website:

We believe it’s not just the governments responsibility to help our wounded and injured troops but each individual and corporation also has to look at their own responsibility in this national issue.

Since the beginning of this nation we have had men and women, young and old willing to stand up and protect our way of life through their selfless service in our Armed Forces.

They have grown up in our communities, gone to our schools, played on our ball fields, attended our churches. When they come home broken and bent we can do more that say ” It’s the governments responsibility”.

Any educated person can draw a direct line to our quality of life and that of those who serve us in our military. Simply put, it is an undeniable fact that without them we would not have a government, corporations, communities or the freedoms we enjoy today.

The VA and Military do an outstanding job but they simply can’t do what we can to assist those who have sacrificed for us when they return home. We bridge that gap.

Erin and Sam were introduced to the Sentinels of Freedom through the Marine Commander of the Wounded Warrior Battalion West, of which Sam is still assigned. I’ve mentioned in previous blog post that we sometimes call Erin, “Dr. Erin”, because she has become so familiar with the doctor and nurse jargon that she can have a conversation with a  neuropsychologist and can translate to the rest of us what they said.  Since Sam’s injuries, Erin has mentioned many times how she has wanted to go into the medical field in order to help veterans like Sam.  I am very proud to say that Erin is now in her second semester (junior year) in the speech pathology and audiology program at Sacramento State University.  She would like to get her bachelor’s degree and also go to grad school and get her master’s in speech pathology.  Erin’s schooling is being sponsored by the Sentinels of Freedom who are paying for her tuition, books and even her rent.  I haven’t seen a more dedicated and motivated student—as can be seen by her 4.0 grade point average from last semester.

As for Sam, he is very healthy and is still making some small improvements.  There was a little accident in mid January while he was in physical therapy using the standing frame.  The therapist and Erin noticed Sam, who never complains of pain, was indeed making some grimaces like he was hurting while they had him in a standing position.  They asked him to rate his pain, 1 to 10, and he said it was a 9 out of 10!  It turns out that due to low bone density, Sam actually broke a bone in his foot.  He is currently in a boot and taking vitamin D and calcium supplements.  They are also taking him outside to get more sun during the day.  He is working on the tilt table five days a week to help strengthen his bones and also has an appointment in eight weeks to get his foot rechecked at the Mather VA Hospital.

Other significant improvements since my last blog post—Sam’s vision has improved significantly.  He is able to complete more complex vision therapy task.  His concentration in all aspects of his physical, vision and occupational therapy have really improved which has led to greater strides overall in Sam’s physical and mental well being.

A good side affect of the foot breaking incident was that the drug he was taking, Vicodin, which normally can make a person drowsy, actually relaxed his muscles more and allowed him to speak much more clearly and more often.  His doctor is working with prescribing him Adivan which should have the same affect as the Vicodin and allow his throat to relax, making it easier for him to speak.

Teach Your Children Well

When Sam was at the VA hospital in Palo Alto during a previous Christmas season, there were always Christmas Cards in a basket in the day room.  The “get well” cards were from local school children “to a wounded soldier” and it was always a treat reading what they had said and looking at the pictures they drew for the wounded men and woman.  Erin would take a few cards into Sam’s room and read them to him to cheer him up.  It was such a good feeling knowing that there were teachers in the local area who where teaching the children about the sacrifice our service men and women make for their country. 

About three months ago I contacted the local elementary school that Erin attended and asked if any of the teachers might like to sponsor Sam and Erin and send get well cards to Sam (Sam is also from Citrus Heights).  I received a very courteous and apologetic reply from the school passing on my request.  The reason was basically that the “war” in the Middle East is controversial and it might upset some students or some parents may object to their children’s participation. [It is not my intention at all to point the finger and any individual or institution so I won’t be mentioning any names…I understand this situation could happen anywhere in our country…sadly].

When I was a young child in elementary school, we would always start out the day by standing next to our desk, put our right hand over our heart, face the flag and recite the pledge of allegiance.  I truly believe this was part of the foundation for the love I have for our country.

I Pledge Allegiance to the flag
of the United States of America
and to the Republic for which it stands,
one Nation under God, Indivisible,
with Liberty and Justice for All.

I wonder if the “Pledge” is still being recited in our elementary schools today? And if so, are the children being taught what it means? [see Red Skelton’s monologue for review] “with Liberty” — do they know what those two words represent?  Do they understand that men and women of our military fought and died for our right to say those words?  Sadly, I think not.

A few weeks ago, I told the above story to a lady who’s daughter goes to another elementary school our town.  In fact, I wrote a blog about her daughter and a club at their school called the Barrett Battalion.  We were all visiting Sam at CareMeridian and this family had come to support Sam and hear myself, my wife and a few friends play Christmas carols for the patients and their families.  A few days ago, we had a small get-together at my parents house and this family was invited.  Towards the end of the evening, the mother pulled out a gift bag and presented it to Erin and me.  It was a beautiful binder with about 120 Christmas letters to Sam written by students from Carriage Elementary and John Barrett Middle School.  Many of the children expressed their appreciation for the sacrifice Sam has made for our country and wished him a speedy recovery.  What an incredible Christmas gift for Sam and Erin…and what an incredible gift these children have been given by their teachers—the gift of respect and honor for their country and those who have sacrificed their lives and health to keep it strong.

Merry Christmas to all…
Tony

Good Morning to All,

It has been a tremendous holiday season with many miracles unfolding around us. Even in the face of diminishing resources, (the county in which I live and work is nearly broke, and from which we derive most of our funding to feed the homeless). My job has seemed to double in scope. Greater need + less resources = miracles of God’s provision. Our annual turkey drive netted us more than double what it did last year; FEMA has come thru with some awesome donations of highly useable foods, and a federally funded program has enabled us to pay young people to gain work experience in our kitchens. Although we should expect the miraculous from God, we often don’t and then act surprised when it happens. The Sam Nichols story is proof that prayer changes circumstances. Prayers offered for Sam from the Nichols and Neria families, our extended families across the country, and a host of friends from around the world that believe in his total restoration; continue to drive his progress in a positive direction.

Erin loves the attached picture. She says that when he attempts to smile, is the only time you can tell the brain injury by merely his appearance. His smile is lopsided and just makes him all the cuter. Sam has had quite a month which includes getting to eat ice cream, the rediscovery of some emotions he hasn’t displayed since the injury, and the introduction of some new and experimental drugs by a new Doctor. His physical therapist is smart and often rewards his hard work with some tastes of ice cream. He thoroughly enjoys this time and it is often the social aspect of the moment that makes it special for him. Although everyone agrees that the new display of emotions is a positive step in the right direction; the behavior is hard to imagine from him as he has been so placid up until now. When Erin brings comfort to another patient, (a young man with a brain injury) by adjusting his pillows in his wheel chair; Sam doesn’t like it. He becomes agitated and surly. When Erin asks what is bothering him, he just replies that he doesn’t like the guy. Ha! Of course he denies that he may be jealous of Erin giving another some attention, and then the next day it is all forgotten and peace has returned. I understand that this type of behavior is to be expected from recovering brain injury patients, but Erin and I can’t help but see the humor in it. It just underlines the man in Superman Sam….Erin is very excited to get to try some treatments for Sam that may or may not be beneficial. He has had some positive reactions in the past to some brain stimulants, so it may be in God’s plan to have these be a part of his recovery. The one thing I always notice is that until he becomes accustomed to the new drug; it totally wipes him out and he gets sleepy. Rest is a good thing as his body does what God intended at creation to help heal itself.

Someone had caught a baby lizard just outside the home where Sam resides and given it to him to observe and hold. He named it Sebastian and when Erin asked him what he wanted to do with it, he replied to keep it in a box. Erin foresaw that pandemonium would ensue from a lizard loose in the rehab home and talked him to letting it go in the garden. He reluctantly agreed. It put me in mind that Sam was the one when small wanted creatures around the house. We had snakes in an aquarium, lizards and bugs in terrariums, crawdads, goldfish, and dogs…It was good training then and I believe has value now.

As Christmas approaches tomorrow, I ask simply that you all remember the reason for the season, and that’s Jesus. It is because he came into this world to reconcile man to God, and restore our blessings that we can boldly stand on God’s statement of fact that by his stripes, Sam is healed. Not will be, but IS! Not some future hope, but now. Faith is evidence of things not yet seen, so just because we haven’t seen it yet doesn’t mean that he doesn’t have it. Rejoice with us in the knowledge that Sam is healed this Christmas….

Much love,
Eric

Citizen Support for our Troops

This weekend my wife Julie and I had the pleasure of visiting Sam and Erin at the VA Polytrauma Center in Palo Alto.  They are settling in very nicely at the VA Hospital.  As Eric mentioned in a previous blog, Sam is in a very spacious room that looks out at the Fisher House where Erin is staying.  The Fisher House is also very beautifully decorated and is such a blessing to the families of the wounded troops at the VA hospital.  I’m always so humbled by the organizations who come to the VA hospital to support the troops.  When Sam was in physical therapy a group of Air Force Reservist came in just to visit with Sam for a while and to let him know they appreciate the sacrifice he has made for his country.  Outside the newly completed dayroom at the Polytrauma Center, a group of volunteers from the Menlo Park Presbyterian Church were busy updating the landscaping in the courtyard outside.  Erin went on line and applied to get a specially adapted home built for her and Sam through  Homes for Our Troops and within 15 minutes of sending her application, she received a phone call from one of the volunteers in that organization telling her they received her application and looked forward to working with her. 

Besides keeping you updated on Sam and Erin, I’ve tried to use this blog as a way of highlighting all the wonderful organizations out there who are watching out for our Iraq and Afghanistan veterans (many of them being veterans of Korea and Vietnam).  There is a Department of Defense website called America Supports You that list many different ways we can support our troops.  The website list ways to donate to support organizations, phone cards, care packages, help for the wounded, military family support, and on and on.  Please take some time to look over their website.   You may be inspired to donate or even volunteer your time to one of these worthy organizations. 

Beyond Manners & Etiquette: 
During a recent physical therapy session that Sam was involved in; another young patient with a frontal brain injury, playfully pulled the pony tail of the physical therapist that was administering Sam’s exercise. This young man was child like and meant no disrespect, but I could see the exasperation from the therapist as she gently, but firmly had to rebuke his inappropriate behavior. The young man had the presence of mind to apologize, but left rather rejected just the same. As Erin and I discussed the incident, we began to discuss Sam’s behavior around the therapists. I believe he is humbled by the amount of care that he must be given. At Wednesday’s P.T. session, they were still laughing about Tuesday’s hour of therapy. When Sam is moved from the chair to the mat or standing frame; he leans his head forward and puts his arm around the therapist (like a hug) so he can assist their muscling him into position. Tuesday as his arm came up around this tiny little Asian therapist, his hand became entangled in the short sleeve arm of her scrubs. As Sam tried to free his hand, he began to  tickle her, but since she was bearing a lot of his weight, she couldn’t do anything until he was seated. They laughingly told this story as they were preparing to move him so Sam was listening. The same little therapist was on duty, so Sam made a wide arc with his arm to ensure getting it on her back. He then gave her a little rub on her back to say thanks for all that you do. Erin says that he does that with the female therapists and for the gentlemen, he pats their back with a little more vigor. Even in this condition and state, I am so proud of the fact that he takes the time to aappreciate the people that work so diligently for him. Erin and I sat and spoke of him and his impeccable manners. He has always had them. Tony & Julie recognized it since the very first time they met Sam; complimenting him by saying he was a throwback to the 50’s. Sam and his brothers were always very much people oriented and compassionate; but since Sam reached adulthood, he blossomed into something much more. Erin uses the word chivalrous. I am not sure if it was the Marine Corps or something else that spurred that final transformation, but it must be true as so many have commented on it. Sam impressed a friend of mine the first time she had met him. He rose when she entered the room, introduced himself and Erin, and then would not sit down again until she was comfortably seated first. I would love to take credit for this remarkable behavior from all of my sons; but I just can’t in all good conscience. I believe that charisma that they all enjoy is a gift from God and a spirit of hospitality. If you are naturally well liked by all you come in contact with; then how much simpler is it to become the leader of people that we all know that Sam is?

I wanted to include a few pictures to show and remind you all of Erin’s active involvement in all of Sam’s therapy. The first pic is of Sam practicing to sit up and to strengthen his lower back and core. Erin sits or lies directly in front of his face for motivation and encouragement. I’ve spoken in the past about her "kissing therapy" which still produces more results than any other. In fact, some teachers have incorporated it into their curriculum. The next picture is of Erin, Sam, and his speech pathologist as they practice swallowing response, word and phrase generation, and the like. If you look hard, you’ll see a watch supplied by his vision therapist. A conventional watch to look at, but it also has two buttons on it that will vocally tell you the time, day of the week, date, month, and year. She was asking Sam what year it was, and instead of answering verbally, he flashed 5 fingers and then 4 more to equal ’09…they are always tickled by his ingenuity. One evening Erin sent me a text to say that after their "good-night prayer", Erin asked Sam if "he was going to be better tomorrow?" He said "Yes", and then she asked "how much better?" His response is priceless to me is he said, "All the way"….Bravo Sam and Erin; That is the kind of faith statement that is going to propel him out of that place on his own 2 good legs. Erin reports that Sam may be suffering from allergies, as he is running a low grade temperature, but NO infection. She also reports that their insurance company has denied the bid to come to Granite Bay which is only 15 minutes from our house. It has to do with the VA and certifications, etc…, but God can easily intervene if that is the best place for Sam. Will you join me in that prayer for this week and that is to have God send him wherever he will have him…

Much love,
Eric

Visitors with Love and Affection

Since that fateful day in July of ’07, Sam and Erin have had many visitors that want to bring them love, support, and comfort. There have been entertainment celebrities, 4 Star Generals, politicians, motorcycle clubs, and a host of friends, family, and well wishers. All of these incredible people have touched the Neria and Nichols’ families very much; but the visits by Sam’s "Comrades in Arms" have moved me the most.  Specifically, his USMC buddies that were there and with him on that hot day of summer in the desert of Iraq. Thresher, Henley, and Kjenstead (Sp?-forgive me) are three of the names of 6 of his buddies that came to pay him homage this last fall. Pardon me if I fail to remember the other’s names; they were all dear to my heart. This past weekend, Erin and I had the pleasure to host the young Marine that was Sam’s driver when his Humvee was hit by a formed projectile. This handsome warrior’s  name is Jarred Reeder. (he gave me permission to use his name and record my thoughts of his visit)…He was joined by his gorgeous girlfriend, Bernadette; whom he jokingly claimed was there "to help drive and to keep him awake." Ha! It was obvious to me that She accompanied Jarred for emotional support, as this turned into a very moving visit. It was very enjoyable for me to hear all over again how Sam is held in high esteem by his fellow Marines. Jarred says that Sam’s name is legendary in the 11th regiment of the 2nd battalion of Marines. He had me laughing when he told of grilling new "boots"; (new men to the unit), if they know about "Nichols"? If they don’t, then they are harangued, and then educated…don’t feel sorry for the boot; it is the way of the Marine Corps. A hazing if you will, that allows bonding, acceptance, and of course educates them as to what is appropriate and a priority. I could see the sincerity in his face when Jarred told me that Sam is one of the men that he would like to emulate. This kid wasn’t blowing smoke at me because Sam was injured. He was the real deal; I’ve seen enough to recognize it when I see and hear it. When Erin was out of earshot, (Jared’s respect for Erin) he told me many details that weren’t previously relayed to me by the Marines. I won’t elaborate here, but suffice to know that ALL of Sam’s comrades are heroes and deserve much more recognition than I feel that they have received. As Jarred and Bernadette were leaving for the day; (they arrived on Friday evening, and stayed till Sunday morning to ensure ample visitation with Sam and Erin) Jarred asked for a few private moments with Sam. I understood and it allowed me to discuss Jarred with Bernadette in the hallway. I don’t know what was said between the two men, but it brought this Bible verse to mind when Jarred emerged from Sam’s room. Jesus was speaking and He said, "Greater love has no one than this, That he lay down his life for his friends". John 15:13…I think that summarizes perfectly the bonds that are exchanged by comrades at arms in general, and certainly by Sam and his friends in Kilo Battery….

You hear from Tony and I often, but not often from the Mom’s associated with Sam’s recovery. I am speaking of Sam’s Mom, Kelley; and Erin’s Mom, Julie. These two ladies are on the forefront of prayer, visitation, and support; but are a little on the shy side when it comes to writing anything for Sam’s blog. Both write  beautifully and from the heart, but are satisfied with letting Tony and I record our observations of God’s miraculous work in Sam’s recovery. Please know that they are always there, willing to do whatever it takes for Sam and Erin, and offer Sam and Erin much love and support in all they do.

Sam’s room in Palo Alto is affectionately referred to as the "Penthouse", as it is big enough to handle 4 beds, a wheel in shower in the bathroom, and a sofa and recliner. He has no roommate at the moment, but it is a welcome relief for visiting as the rooms at Kentfield were quite small. Speaking of which, Sam had his first full shower at Palo Alto. It is amazing how clean Erin and the CNA’s kept him at Kentfield without the full showering facilities. Erin couldn’t stop stroking his soft hair after his shower. Sam is once again invigorated by the daily therapies at Palo Alto. A rigorous physical, occupational, and speech therapy is performed, along with a massage afterwards. Erin, as Sam’s spouse also gets to take advantage of the massages, and has reported improvement in her shoulder injury from them. As the meds he was getting at Kentfield are reduced and eventually eliminated, he was going through some sleepy times, as some of them were stimulants. The busy schedule seems to keep him awake and alert, and I see that as great progress.

As Easter approaches, I am focusing on the "Resurrection Spirit" that raised Jesus from the dead. It is the same Spirit that raised Sam from brain death, and continues to push and lead him forward to full recovery. As I remember to thank God for Jesus’ miracle, I’ll remember to thank him for Sam’s as well….

Much love and Happy Easter,
Eric

A Celebrity Send Off

Sam and Erin are moved into their new homes in Palo Alto. Sam in the Polytrauma Unit at the VA hospital complex, and Erin, once again, at the Fisher House, just a stone’s throw from Sam’s room. (I’ll include their address) I was able to attend a small gathering in a conference room at the Kentfield Rehabilitation Hospital where Sam and Erin have been in residence for the last year. It was a small and rather impromptu party to graduate Sam from their rehab program, and to send them off with much love and good wishes. No less than 3 doctors were in attendance (including Sam’s personal physicians), several of the nursing and technical therapies staff, and even many of the hospital administration staff came to pay their honor and respect to Sam and Erin. Their demonstration of love for Sam and Erin was moving, to the point where Wendy (my girlfriend) had to rise and leave the room to keep from blubbering. A doctor had taken many photographs of the staff and facility, and had the employees write a memento to Sam and Erin by their pictures. Sam and Erin have come a long way in the past year, and although I give all praise and glory to God for that progress; I do thank him for the wonderful people he used at Kentfield to accomplish his will for Sam and Erin.

I am still surprised by the favor that Sam and Erin enjoy wherever they go. Yes, they are an uncommon pair. Sam, a genuine war hero in every sense of the word; and Erin, an “uncommon hero” of immense magnitude for her dedication and love for Sam. This became more clear to me as I drove to work one morning. I leave for work at about 6 am every morning, and it is still very dark at that time. Many mornings I speak to Wendy over the phone, discussing our plans for the day, challenges we are facing, and of course to pray for things we are led to. This particular morning I was driving into a full Moon, and couldn’t help but comment to her of it’s silver color and intense glow of shimmering light. Remembering my 5th grade science, I commented that the Moon has no light of it’s own and is merely a reflector of the Sun’s power and light. Once I said that, this Bible verse popped into my head, which my brother had quoted to me, just a few days before. “But to you who fear my name, The Sun of Righteousness shall arise with healing in his wings…” Malachi 4: v 2…This is a reference to Jesus, and He, like the Sun, is the center of all life as we know it. Scripture says that we will have no need for the sun or moon in eternity, as God’s glory will provide that light and warmth. Anyway, I believe that Sam and Erin reflect the Sun’s (Son’s) light and that is why they continue to have such favor wherever they go. Sam with his dogged determination, cooperative spirit, and true desire to be restored, fuels Erin’s love and dedication, steadfast faithfulness, and humble but assertive attitude for Sam’s recovery. These are Godly traits, and you just can’t help but love the people that display them.

Sam is such a stinker…where he gets that I’ll never know. (tee hee)…He loves to tease Erin and always has. When she would have to pee, he would gently press on her lower abdomen; just to annoy her. Last Friday as she was telling him that she would be right back from the restroom, that little mischievousness came forth and he raised his hand to gently press on her belly. Erin knew immediately what he was doing and burst into laughter as we all did when we were let into the joke. It is a break through when he does something from memory, even if it is something less than acceptable and nice…Ha! As I’ve reported before, Sam is doing better and better in navigating his electric wheelchair. It takes the coordination of a video gamer, and the focus and concentration of an athlete. I witnessed him drive it around the hospital, (with his co-pilot, Erin at his side) with only a few bumps and crashes. (See picture) The day was beautiful and as we sat outside and talked, I asked Sam to throw me a pose. This next shot was what he came up with.

Erin reports that She and Sam could be in Granite Bay (only about 15 minutes from us) in just a few months time, depending on his progress at the VA. They told her that Sam would only be at Kentfield for a few months and that turned into a year. The more he progresses, the longer the stay. It is a win/win scenario for Sam and for us. As he goes to Palo Alto, I wonder whose life will be touched by God using Sam and Erin this time? Have no worries, concerns, or anxieties, for Sam and Erin. They are in God’s hands, and He is calling the shots. They will be fine, PLEASE continue to remember them in your prayers…they are working!

Much love,
Eric

Before I forget, Sam’s new address is:

SGT Sam Nichols, USMC
Palo Alto Polytrama Center
3801 Miranda Ave 7D room 115
Palo Alto Ca. 94304-1290

I wanted to give a special thank you to the doctors and staff at Kentfield Rehabilitation Hospital in Marin.  I will write more about Erin and Sam’s experience at Kentfield in another blog entry, but I just wanted to quickly mention that the Nichols and Neria families are so grateful for the care you have shown Sam and Erin.  Kentfield Rehabilitation Hospital is a wonderful place with an outstanding group of doctors and staff.

Peace and love to all,

Tony

First Annual California TBI Advisory Board Conference

A friend of mine with the California Department of Aging sent me some information on First annual Statewide TBI Advisory Board Conference which is being held in Sacramento on February 9-10, 2009 at the Holiday Inn Capitol Plaza at 300 J Street.  Hopefully myself and Erin will be able to attend this conference.

The target audience for this conference is anyone interested in traumatic brain injury including family members, caretakers, case managers/service coordinators, rehabilitation specialist, neuro/psychologist, counselors, physicians, and others who service individuals with traumatic brain injuries.

One of the workshops at the conference that really caught my eye is called “Serving Returning Service members with TBI which is being moderated by Ted Puntillo, Deputy Secretary California Department of Veteran Affairs.

The purpose of the conference is four fold:

1. Raise the visibility of traumatic brain injury among policy makers and program administrators
2. Promote innovative and successful services and systems to meet the diverse needs of persons with traumatic brain injury
3. Promote collaboration among stakeholders to address challenges faced by individuals with traumatic brain injury and their families
4. Promote opportunities for coordination of resources and services, and provide information to individuals with traumatic brain injury and their families

A conference brochure is available at California Department of Mental Health Website at: http://www.dmh.ca.gov/Services_and_Programs/Adults/docs/TBI_docs/ConfBrochure_09Jan8.pdf

Registration information can be found by going to the website: http://www.regonline.com/builder/site/Default.aspx?eventid=676140

Sam’s medical status:

Happy New Year to All,

My Dad was the product of the dust bowl era when many of the people that lived in Oklahoma and surrounding states migrated to California for a better way of life. At 16, my Dad was thrust into the working role in order to help support his family which included 3 younger brothers. His formal education came to screeching halt and Dad never lost that "Okie" vocabulary that was his by environment. An immature teenager viewed this "ignorance" as a flaw and my relations with my Dad were strained. It wasn’t until God got a firm grip on me that I realized that my Okie Dad was brilliant. He was a self taught, Journeyman Industrial Electrician. This was a feat I could never even dream of accomplishing. When I saw this quote from Mark Twain a few years before my Dad passed away; I finally got it. "When I was 18, I found my Dad ignorant; by the time I was 21, I was surprised by how much my Dad had learned in 3 short years." My sister has explained in her writings that we sometimes view God as we view our natural fathers. That is, if our father abandons us, we see God as distant; or if our father is harsh, we see God as stern and lacking love….One unique thing about my Dad was his predictable generous nature. Dad would follow us out to our cars after a visit home, and literally empty his wallet (he called it a billfold) into our hands. He would give us all he had to give, even if it were only a few dollars or his entire cash allotment for the week; and he did it for all of his kids…(6 of us) It was so regular, we expected it…Well, to the point of my story about my Dad…last week I stated that I was expecting God to move in Sam and Erin’s lives because the medical community had kind of come to a stalemate over some of Sam’s treatment…I prayed about it with some very strong prayer support from some amazing Christians, and God just doesn’t say No…These are reports from Erin that I received by text, phone calls, and actually being able to spend time with Sam on Christmas Day and New Year’s Day….

First Erin reported that Sam became unhappy with his catheter and wanted to use the restroom. He fought his way through the door of the restroom himself using his strong right arm to maneuver his wheelchair into position. He couldn’t go but the doctors were very encouraged that he had not only the sensation to go, but the presence of mind to initiate the move to the restroom. Next as Erin gave Sam a haircut, she presented him with a mirror and asked how he thought he looked? He replied, "sexy as hell". Ha! That’s my boy….One evening Sam informed Erin that "she was in his way"; even brushing her foot off of his wheelchair. She asked where he was going, and he replied, "I’m going to bed" and then attempted to get out of his chair and into bed. One afternoon Erin was doing a Mad-lib with Sam and asked for an adjective. He had trouble getting it out so he took the pen from her hand a wrote the word on a poster board. The word is GREAT and is shown by the first picture. It is hard to see at first, but when I blew it up on my computer screen, it was easily read…And finally, one afternoon, Sam said to Erin that "they should go home now." Erin didn’t think too much about it as she in the past has had to remind him of his injuries and explain the need to stay in the hospital for now. She did that again and she thought he was pacified. Approximately 10 minutes passed, and he thoughtfully declared "he didn’t need to be there" and again tried to get out of bed…Well, I was so happy to hear that out of his own mouth…I truly see it as a faith statement, and some more of that is just what Dr Jesus has ordered. As he progresses in his mind to see what he already holds to be true in his spirit, He will progress exponentially. The fact that he doesn’t see himself as injured, and in need of round the clock care speaks volumes to me…This week is a movement by God on Sam and Erin’s behalf and nothing under the sun will convince me otherwise…

The picture of Sam preparing to throw a football was taken on Christmas Day. Julie, (Erin’s Mom) had wrapped about a dozen gifts for Sam and had brought them down for him to unwrap. He did a masterful job at opening the packages, using the seams of the paper, and tearing when appropriate…The tone from his injuries locks his jaw something fierce, but he was able to gargle out a Merry Christmas to Donny, Brandi, and I on Christmas Day…He was happy to have us around and had me tell him the nativity story; not once, but twice on Christmas Day….

Much love,
Eric

Caregiver Compensation for Injured Veterans

There was a recent article in the New York Times about families of disabled veterans seeking compensation for there roles as caregivers.  Because of better medical technology, many more soldiers have survived serious wounds they received in Iraq and Afghanistan.  According to the Dole-Shalala Commission, in 2007, there were over 3000 recently disabled veterans who required full-time clinical and care-management services.

As the father of a daughter who has spent the last 16 months at the bedside of her severely wounded Marine, I worry about Erin and Sam’s future.  Will Erin need to get a job in order to pay their bills? Eventually Sam will be retired from the Marines and I’m sure will be considered 100 percent disabled.  Will Erin become his full-time caregiver?  During Sam’s stay at the Palo Alto VA hospital, Erin met many wives and mothers of wounded soldiers who had to quit their jobs to be with their wounded veteran.

During the last session of Congress, veterans groups and families asked lawmakers to introduce legislation that would allow families of wounded soldiers with traumatic brain injury who complete training and certification with the VA to be paid for the caregiver services they provide.  The bill has not come up for vote yet, but because President-elect Barack Obama has endorsed many other bills that support veterans’ issues, it is possible the bill will have a greater change for passage in the next congressional session.  Let’s keep our fingers crossed!

Sam’s medical status:

When Sam was a small boy, much like his brothers, he had an unusually adventurous spirit and very little fear. Naturally when you have a kids that embrace life and aggressively approach sporting and play activity; there are resulting injuries. I remember once, while on vacation and immediately following lunch at a Taco Bell, Sam (maybe 6 or 7 years old) was jumping off a bench…sure enough he cracked his head and we spent the next 4 hours in the emergency room while he received a half dozen stitches. Another time (at about 5 years old) he was playing with a wooden dowel that we used as additional security for a sliding glass door; and as he jumped over it, he landed on the end of it. Although he missed all of the vital areas, again we saw the inside of the emergency room with the addition of more stitches to a nasty gash. He was more embarrassed than he was hurt, as his brothers were relentless with names like “Sam-on-a-Stick” or “Sam-cicle”…Ha! I believe that it is this same adventurous spirit that led him to enlist in the Marines, after successfully finishing one year of college. He was bound and determined to return after his tour and return to college and He and Erin had already enrolled and been accepted to the University of Nevada at Reno. At the time, Erin was interested in teaching, (now that interest has turned to speech therapy) and Sam was interested in business. This was solely to prepare himself, as his interest was to open a restaurant/bar with exotic sandwiches (He and Erin had already developed several great sandwiches by experimenting in their kitchen) and super advanced video games dealing with virtual reality. It is this kind of desire for an out of the ordinary life that make them fabulously interesting people. Although their lives may have been steered in another direction; I firmly believe that they will have many adventures ahead of them and WILL fulfill them in God’s good timing. In fact, I would state that this experience will heighten their lives as they apply lesson after lesson, and for the benefit of others. Thank you Lord; for the lessons you’ve taught us all in Sam and Erin’s lives…

This update finds Sam once again in Marin General Hospital, in a medical unit after being admitted through an emergency procedure. His “Port” had become infected. This a line inserted in his shoulder a few months ago, that goes to the big arteries in his chest. It is for easily administering medications and from which to draw blood. Sam is what is referred to as a “hard stick”, meaning he has underground veins. We’ve seen him get stuck up to 10 times before they call for the best (most experienced) person to come and get the blood they need. More antibiotics; Ugh! In addition, he was prescribed a new anti-convulsant after being weaned off of the 4 others he was receiving. It made him temporarily groggy, but Erin reports he is becoming accustomed to it and back to his old self. I saw him twice this week and both days he seemed alert as to all that was going on around him, but chose to relax by keeping his eyes closed. One thing I’m very excited about is their determination to get to the bottom of his recurring UTI’s. He is not going back to Kentfield until that is accomplished. His next stop is the Urology department at the University of San Francisco for a consultation on a surgery to explore (by scope) to try and locate the shrapnel they believe the culprit of his recurring infections. I say it is high time, and am positive it is God’s leading that sends them there. This too will soon be past them and back on the road to recovery. As I spoke to Erin on the phone yesterday to receive the very latest news; Sam wanted to know to whom she was talking. When he found it was me, he wanted to take the phone and talk to me. He said he felt good when asked, and then gave me a resounding Oohh-Rah! He also told me something that we couldn’t make out, but it was just good to hear him use his voice and try to speak out loud. Of course he said, “I Love You, Dad” and for some reason I never have trouble making that one out. Erin said it was the most he had said out loud all day…Donny and Sam had always agreed that they would be each other’s best man at their weddings, so I was testing his memory to find out if he remembered that was approaching, and asked him who was the best man? He pointed at me…don’t ya just love this kid?

Much Love,
Eric

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

Sept 16-18: Advisory Committee on OIF/OEF Veterans and Families at the Palo Alto VA Hospital

I received this important information from http://ptsdcombat.blogspot.com/.  Erin will be attending this meeting and will be speaking before the VA advisory committee:

Please pass this on, especially to those in the area who may wish to add their voices, experiences.  Details in extended below:

The Department of Veterans Affairs (VA) gives notice under Public Law 92–463 (Federal Advisory Committee Act) that the Advisory Committee on OIF/OEF Veterans and Families will conduct a meeting and a site visit in the Palo Alto, California area on September 16–18, 2008. Committee activities will include tours and briefings at various VA facilities.
The purpose of the Committee is to advise the Secretary of Veterans Affairs on the full spectrum of health care, benefits delivery and related family support issues that confront service members during their transition from active duty to veteran status and during their post-service years.
The Committee will focus on the concerns of all men and women with active military service in Operation Iraqi Freedom and/or Operation Enduring Freedom, but will pay particular attention to severely disabled veterans and their families.
The agenda for the September 16–18 meeting will include briefings on recent site visits, discussions on proposed recommendations to the Department of Veterans Affairs (VA), and tours of the VA Medical Center. The Committee will discuss its findings and observations based on previous Committee meetings, site visits, written reports, and personal experiences.

Here are the specifics of the visit by the advisory committee:

On Tuesday, September 16, from 9 a.m. until 12 noon, the Committee will meet at The Cabana Hotel Palo Alto, 4290 El Camino Real, Palo Alto, CA. In the afternoon, the Committee will meet at the Palo Alto VA Medical Center, tour the facility and receive briefings from staff.
On Wednesday, September 17, from 9 a.m. to 12 noon, the Committee will meet in closed session. The Committee will be meeting with clinicians and individual patients receiving services at VA’s Menlo Park facility. The session will be closed to protect the privacy of the patients and to minimize possible interference with the delivery of medical services. Closing the meeting is in compliance with 5 U.S.C. Sec 552b(c)(6). In the afternoon, from 2 p.m.–5 p.m., the Committee will meet in open session at The Cabana Hotel Palo Alto, 4290 El Camino Real, Palo Alto, CA.
On Thursday, September 18, from 9 a.m. to 4 p.m., the Committee will meet in open session at The Cabana Hotel Palo Alto, 4290 El Camino Real, Palo Alto, CA. The meeting will include time reserved for public comments. ******Individuals wishing to make oral statements must pre-register not later than September 10, 2008****** by contacting Syreeta Cherry via e-mail at Syreeta.Cherry@va.gov, and by submitting 1–2 page summaries of their statements for inclusion in the official record of the meeting. Oral statements by the public will be limited to five minutes each and will be received at 3 p.m.–3:30 p.m. on September 17, and 1 p.m.–1:30 p.m. on September 18. Interested individuals may also submit written statements for the Committee’s review to the Advisory Committee on OIF/OEF Veterans and Families (008), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420.
Any member of the public seeking additional information should contact Laura O’Shea, Designated Federal Officer, at (202) 461–5765.

For more information on the advisory committee for OIF/OEF veterans and families, go to http://www1.va.gov/oifoef/

Sam’s medical status:

Good Day All,

I got to Kentfield in time yesterday morning to watch Erin give Sam a professional shave. Sam has an extremely coarse beard and I’m very surprised she wouldn’t nick him more, but inevitably she did. A little, tiny, dot appeared and she apologized profusely. She playfully bantered, “are you going to smack me”? His hand came up quickly and in a most gentle gesture just stroked her face with love and appreciation…just precious. The first picture is of Sam and Erin after that shave. I asked him to smile, and that kind of crooked Elvis smile is what he achieved. Aren’t they a handsome couple?

He seems much improved from last week’s visit and that one was pretty good.  He still shows some signs of seizures, but they are largely diminished. His body seems to be adapting to the anticonvulsant medication called Dilantin; so he is less groggy and is back to his old self in all of his therapies.  Usually he just does one or two of the primary body exercises; but yesterday he did the standing frame, the prone position, (on his stomach) and sitting balance for his core and lower back. Two, extra long sessions, in addition to occupational and speech therapies. Erin reports that they are using a “silver” catheter to reduce the chance of infection. Erin said their “arguments” usually are over who is the most awesome; but one day Erin was telling the nurse something and Sam said; “No I didn’t” and maintained his innocence. Whether accurate or not; it was good to hear his independent thought. Ha! See the second shot for Sam’s best motivation….

The day was perfect and we went out to the deck in between his therapy sessions. Sam enjoys the outdoors, feeling the sunshine on his face and cool breeze, gently blowing. Erin will often push him down the bike trail; (it’s paved) so he gets better scenery than just what is afforded to him at the hospital. I did it once and it tuckered me out; goodness she must be strong for being so tiny…Ha! Yesterday though, we sat and visited and enjoyed the fact that it wasn’t hot like it has been so many days before…As we discussed his care, his cna came in to see if all was well and commented on how good looking he is. He gets that a lot, and it prompted Erin to remark that just about all his doctors, nurses, cna’s, and therapists are women.  This is not only true at Kentfield, but was also true at Palo Alto, Marin General, and Bethesda. It occurred to me that from a spiritual perspective, it couldn’t be more orchestrated by God. When God is given control over a situation, he sends the very best as a resolution to the problem that presents itself. In this case, Sam not only gets the very best medical care possible, but he gets it delivered by caring, nurturing, and loving people.  In Proverbs, Solomon speaks of the “Spirit of Wisdom” in the feminine gender, and have realized for a long time that women possess a certain wisdom that men just don’t have. When God created Eve, he gave her some more of himself then he previously did when he created Adam. Together, we best represent what God truly looks like. Having been surrounded by women all my life; (Mom, Sisters, Sam’s Mom, Aunts and cousins, In-laws, Friends) this truth has been evidenced time and time again. My sister Jan, pointed out recently that God the Father is our idea of an Earthly Dad. Authoritative, just, fair, and of course loving. Jesus is our big brother, getting us out of scrapes and going to bat for us with the Father. The Holy Spirit plays the Mom’s role by bringing us comfort and nurturing just when we need it most. So I say that Sam is largely in the hands of women by design and not by accident; and I thank God for the dedicated women working to restore Sam.  This in no way diminishes my respect for the gentlemen that have given Sam such excellent care to this point, and the several kind and caring men that will have much to do with Sam’s recovery before it is complete.

Just to show Sam’s humor is so present and ever regaining it’s mobility….Erin was helping him brush his teeth. They have a dental quality brush that suctions out the water and toothpaste as she brushes. Sam does a pretty good job on his own, but Erin helps him to get every square inch of his mouth. As she brushed yesterday, his gums bled a little prompting her to remark that Sam needed to remind her more often to have her help him brush.  As she turned to go wash out the brush in the bathroom sink; Sam called out
in a loud voice, “ERIN”! She was somewhat startled, and turned around to hear Sam say, “BRUSH MY TEETH”! Well, she did ask for a reminder, and through much laughter, she dubbed him “Smart Ass”! Ha!

Much Love,
Eric