She's Coming Home

Pain

Antonio POV
Gabby fell asleep with Shay asleep on top of her. They both looked so happy and peaceful together but I know Gabby's struggling, she's trying to hid it but I can tell. I take a picture of them snuggling for Casey after Gabby's talked to him. I know I need to talk to her about that but she's going through so much already, I don't want to add to it.

About an hour later dr Abrams came in so I woke Gabby up.
Antonio- Gabby wake up, dr Abrams wants to talk to you. Come on, nap times over.
She slowly opened her eyes, not happy with me for waking her up.
Dr Abrams- we just finished the meeting and have got a plan for the next few weeks.
Gabby- ok
Dr Abrams- we're going to start decreasing the vent settings during the day, hoping to wean you off the vent at least while you awake in a few weeks. We'll keep down the breathing trials a few times a day. We're also going to wean you off of all the IV meds so that everything goes through your tube. You have another CT at the end of the week and if that looks good at your inter-cranial pressure stays in range then reconstructive surgery for your skull will be on Monday. You have PT again really soon and they'll tell you about the therapy plan.
Gabby- ok
Dr Abrams- time to try breathing on your own again before PT so the little one needs to get up or at least move to beside you.
Antonio- which do you want Gabby?
Gabby- up PT soon
So I carefully picked Shay up and let her snuggle into me instead.
Dr Abrams- ok ready
Gabby- yes
He disconnects her from the vent and she struggles to breathe. I hate watching this, she's my little sister I'm supposed to protect her, how am I supposed to protect her from this? Her SATs drop too low and he reconnects the vent. She closes her eyes for a few seconds then opens them again.
Gabby- hard
Antonio- I know, it will get easier.
I hope it will get easier but really I have no clue, I don't think anyone knows. I just want her to be ok.
Dr Abrams- I'll be back later.
He left and a few minutes later the PT team came in.
Gabby- Tonio go please
Antonio- can I stay to hear your therapy plan
Gabby- fine want Shay
Antonio- good compromise, she wants you anyways.
I put Shay back in bed with Gabby and she immediately snuggled in, beside her this time which was new.
Shay(signs)- mama cuddle
Gabby- hug
I moved her arms so she was holding Shay again, when she was settled with Shay she looked up at her therapists.
Janet- I see the eye gaze is working well!
Gabby- yes hard but love it thank you
Janet- I'm glad it's working so we'll already.
Kate- ok so I assume dr Abrams already told you about the meeting and the medical plan?
Gabby- yes
Liam- great so the plan for PT, today is going to be the same as yesterday. By tomorrow we should have the wheelchair ready to try and probably also the hand braces.
Janet- tomorrow will just be getting you into wheelchair and getting it adjusted and figuring out what supports you need then getting you out again. We're going to go slowly with the wheelchair, get you're body used to sitting again. The chair has tilt so you can by tipped back, we'll see how you do with head control, I think that will be the main barrier to getting you upright. There are also multiple headrests to try.
Liam- we'll also fit you're braces tomorrow and those will be worn for as long as you can tolerate every day. We're also going to get an orthotist to come cast your feet to get AFOs(ankle and foot orthotics) made to keep your feet in the right position. Those will be more for when we start trying standing and walking but it takes a while for them to be made. Ok, let's get started on your session now
Gabby- wait. Tonio don't want you watch.
Antonio- I know, me and Shay will head out, see you later.
Antonio(signs)- say bye mama
Shay(signs)- bye
I pick her up and head out

Gabby POV
They start doing all the stretches and I try to ignore the pain. The move on to my legs.
Kate- can you move your legs for me? Yesterday you showed us the movement in your arms and you moved your head. Can you move your legs at all?
I close my eyes and focus on moving. When I try to move I just get even tighter. I try for a few minutes but all I get is everything tightening and my arms pulling up to my chest again. I give up and start trying to explain.
Gabby- no. I try just tight hurt more
Kate- when you try to move it just increase the spasticity?
Gabby- yes why
I'm trying really hard not to cry, not just because I don't want to in front of people but also because it's so much harder to use the device when I'm crying.
Kate- there was a lot of damage to the parts of your brain that control movement. So you think about moving and know how you want to do it but those signals get jumbled so your body either doesn't get the message or gets a different, partial message. That damage is also causing your brain to constantly send signals to your muscles to contract, be tight. So far you're presenting very similarly to severe spastic quadriplegic cerebral palsy. We can try you on muscle relaxant medication, it might help decrease your tone which in turn may give you more control over movements.
Gabby- yes. Want try
Kate- ok, we'll have to discuss it with your doctors and figure out what medication you can have, that won't interfere with other meds you're on.
Gabby- ok
Liam- we also might try Botox injection in your wrists, hands and ankles if we don't start to see an improvement.
Gabby- ok
Liam- now we need to finish your stretches, someone will be here to cast you for braces soon.
Gabby- fine
They stretch and move my legs then start on my ankles again and I can't keep myself from crying anymore. It just hurts, everything hurts all the time but all the stretching hurts so much more. They finally stop as another woman walks in
Callie- hey, I'm Callie I'm here to cast you for some leg braces.
I try to say hi to her but the device is being weird, I think it's because I'm still crying a bit. I look over at Janet hoping she'll notice   She does and I look at the device and back at her, trying to tell her it won't work.
Janet- what's wrong? Is it not working?
She comes over and looks at the device and me
Janet- can I wipe your eyes? It might just not be registering them correctly with the tears.
I look at her for yes and she wipes my eyes then I try the device again and it works.
Gabby- thank you
Janet- no problem, I'm sorry PT is so hard.
Kate- ok, we need to get going but we'll see you tomorrow and hopefully get you out of that bed!
Gabby- bye
Then they all head out leaving me with just Callie

I look over at Callie then start my message.
Gabby- sorry hi nice meet you
Callie- no problem. That device is is really cool. How do you use it?
Gabby- eyes look
Callie- wow, that's awesome. I think that would be amazing for one of my other clients.
Gabby- yes good hard but good
Callie- ok, are you ready to get started
Gabby- yes
Callie- alright, because you're in bed I'm going to need someone to help hold your leg while I cast it. Is there someone you want me to ask to come?
Gabby- yes Nat
Callie- sorry I'm not sure who that is
Gabby- Manning
Callie- oh dr Manning, I can see if she's available.
Callie starts getting things set up and a few minutes later Nat came in
Nat- hey Gabby, how was PT today?
Gabby- hard hurt
Nat- was it any better than yesterday?
Gabby- no but said try meds relax
Nat- well that's good, muscle relaxants should help with your pain as well
Gabby- tomorrow get out bed
Nat- really! What are you doing tomorrow?
Gabby- try wheelchair
Nat- that's awesome, you'll have to come find me
Gabby- tomorrow just fit then bed
Nat- ok, well when you're allowed to be up for longer come find me!
Gabby- ok

Callie- alright, ready to get this started
Gabby- I guess
Nat- I see your ability to communicate your attitude is improving!
I just grin at her. She's right, I'm learning where more words are which is way faster than typing.
Callie- ok, dr Manning I'm going to need you to hold her leg up off the bed while I cast it.
Callie gets my leg in the position she wants than gets Nat to hold it.
Nat- you ok Gabs?
Gabby- yes. Tight but not hurt a lot
Callie- ok, I'll try to be as fast as I can but I'm going to have to stretch your foot and ankle which might hurt.
Gabby- ok
We chatted while she cast both my legs then she packed up her stuff and said she'd see me again when the braces where ready. I told Nat she could go because I wanted to sleep. I slept for a while and when I woke up I waited for April to come check on me so I could ask her something.

Gabby- can you help write Casey tell Shay
April- sure, you just want me to write down what you say.
Gabby- yes so not slow for Matt
April- Alright.
I spent the next hour with April writing out my message to Matt because I want it to be written well. I wasn't done after the hour but I couldn't keep going
Gabby- finished thank you can't do more
April- ok, no problem, let me know if you want to do more later.
I couldn't answer her, I was exhausted and couldn't open my eyes again.
April- sleep, I'll see you later.
She left and I fell back asleep until the next morning