tag:blogger.com,1999:blog-63435754639963727982024-02-26T09:33:01.665-08:00STEPPING STONES FOR TRAUMATIC BRAIN INJURYKarla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.comBlogger48125tag:blogger.com,1999:blog-6343575463996372798.post-84035776725894561812022-05-21T16:05:00.003-07:002022-05-21T16:22:56.902-07:00<p> Time for an update on Benjamin. Benjamin continues to live in Colorado and is doing very well. He lives in an assisted living home for young TBI survivors. Ben is active and healthy. He handles his activities of daily living well. He reads, loves word find puzzles, takes long walks, and uses an iPad for frequent texting and FaceTime calls. He has friends in his house and honestly makes new friends every time he steps out of the house for activities or errands. The house is in a beautiful suburban neighborhood and looks just like every other home in the area. Ben is not in an institution. Finding this level of care for him is such a place of rest. It is a miracle. The directors of his program love him and take care to see that his life is healthy and full. Jim and I visit as often as we can.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfx689Yq1LA4DA6jLK544RW9DMymopg87bJs5omm6NWxUb59skS6llMSjCmelc-Eh_b8oHBKxFDJ5osbIvoaTEJ9U-c-Gl4O7VA00FfLEI3GqjgDj_BvZwLPl86F3vyyfGZ8qwz4CehU09I--4y5GvDiXuKm6XcY7hssy5gGi_5VMJ-IGc2pkWArC0Og/s4032/27038199-747B-4BBC-A525-601CE537FCF3.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="3024" data-original-width="4032" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfx689Yq1LA4DA6jLK544RW9DMymopg87bJs5omm6NWxUb59skS6llMSjCmelc-Eh_b8oHBKxFDJ5osbIvoaTEJ9U-c-Gl4O7VA00FfLEI3GqjgDj_BvZwLPl86F3vyyfGZ8qwz4CehU09I--4y5GvDiXuKm6XcY7hssy5gGi_5VMJ-IGc2pkWArC0Og/s320/27038199-747B-4BBC-A525-601CE537FCF3.jpeg" width="320" /></a></div><br /><br /><p></p><p>The struggles involving Ben’s memory, cognition and behavioral health remain. Although he can remember much of his former life, Benjamin’s mental age seems about 5 years old. He cannot remember if I visited last week or last month. The same questions are asked over and over again. Handling overly social behavior in public has become routine. He remains on fairly powerful medications for mood stabilization. The medications are working and Ben is happy. The joy is the the first thing people notice when they meet him. </p><p>The dramatic story of Ben’s life seems more settled today. Of course nothing stays settled with long term care of TBI survivors. For now, it is good. Ben still tells everyone God saved him for a reason. Today we are just walking the journey. </p><p><br /></p>Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com12tag:blogger.com,1999:blog-6343575463996372798.post-58532700736775387742019-11-09T11:59:00.000-08:002019-11-09T12:47:30.610-08:00Today is a beautiful day in Colorado. It has been almost a year since the last update on Benjamin. He continues to live in the Denver area in a program for brain injury survivors. I had the opportunity yesterday to bring 2 new friends to visit Ben. Seeing Ben’s situation through their eyes helped affirm that Ben is where he needs to be. The friends were amazed at the bright and well decorated program house.They mentioned that the expected institutionalized atmosphere is totally absent. After looking at a calendar of activities, Ben’s active life was apparent. A tour of Ben’s room sports a wall of family photos and a picture of a world map. It was clean, neat and full of personal touches. The life skills workers in the house were pleasant caring and knowledgeable. Ben has responded to the new atmosphere over the last 2 years well. He is happy, busy and involved with the other residents of the house.<br />
<a name='more'></a>Prior to moving here, boredom and lack of physical activity really showed in Ben’s demeanor. He is involved with shopping, house chores, enjoys music and is constantly working on Word Search puzzles. Ben keeps in touch with family and friends through FaceTime and messaging with an iPad. For now, life has stabilized and I pray we can keep Ben here.<br />
<br />
The struggles with severe TBI are still a daily reality for Ben, however. Since the severe setback in 2016, Ben still has significant deficits in memory, the ability to reason and think. He cannot remember if I visited last month or last week. He cannot remember how long he has been in Colorado. He forgets people and events. Achieving a goal or even minor employment is impossible because the steps to that goal are meaningless. Socially he has moments of inappropriate comments and it is difficult to end a conversation with him. His aggressive behaviors are under control, but this is partially due to a potent medication that has to be constantly monitored because of dangerous side effects. Initially this was a weekly blood test. Some of those side effects involve diminished cognitive ability. We have had to choose between stable mental health vs improved intellectual functioning. The medications also have caused weight gain. The set back in 2016 put Ben back in a wheel chair for over a year. Since then Ben is ambulatory, but clumsy with a shuffling gait. His balance is not predictable.<br />
<br />
All of these issues may seem overwhelming, but Ben has joy. His personality is engaging. He makes people smile and his greatest pleasure is to be out and about with others. He attends a church with modern music and a coffee bar, a major focus of his week. He reads his Bible and is quick to tell others that God is the reason he is alive. It will be good.<br />
<br />Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com1tag:blogger.com,1999:blog-6343575463996372798.post-22377028503072206082018-11-11T05:39:00.000-08:002018-11-11T18:46:23.072-08:00Benjamin continues to enjoy life in Colorado. Many changes have occurred in Ben’s living situation since the last post many months ago, all of them good. When Ben returned from the Oklahoma rehabilitation hospital summer 2017, the door opened for him to initially live in a new program in the Denver area. This program provided basic care and Ben initially did well, but Jim and I felt something was missing. With the set backs in Ben’s medical condition, memory, physical health, and cognition from the seizures in July 2016, we both knew that something needed to change. Ben was bored. He was housebound day after day. It wasn’t enough just to be housed safely, Ben needed a program tailored to his needs. Ben deserved a rich life with friends and activity. He needed to feel significant. God provided the answer. Ben’s advocate, who has helped us from the beginning started a brain injury program a few years ago for all the right reasons. She has such a heart for these injured people and knew she could do it better. This advocate also loves Ben and knows him well. The state of CO approved her application to expand her program and a place opened up for Ben in a new house.<br />
<br />
<a name='more'></a><br />
<br />
Today, however, after spending the day with Ben, I know I should be counting my blessings, but instead I seem to be counting my frustrations. I have my granddaughters with me and I thought Ben would be excited to see all of us especially with the approach of Thanksgiving. Instead, he is overwhelmed. Brain injury is is such an ugly thing. He knows he should be happy to spend time with us, but was relieved when I took him home early. I will pick him up in a couple of hours for dinner. His memory for most short term events, including the location of his house is nonexistent. He easily gets confused. I am constantly “on him” for grooming and personal personal care issues that could affect his health. Outings that should be fun for him can be a huge struggle. Ben’s world right now is so small and I am not helping with expectations for more than he can handle. I am goal driven and it is not working. I believe God is asking me to love more and see Ben through His eyes. The living program Ben is in provides the opportunity for Ben to improve. Their goals are realistic.....mine aren’t and I know better. Choosing acceptance, love and joy tomorrow and for our dinner out tonight. It will be good.<br />
<br />
I know some of the things I wrote in this blog are hard to hear. In the midst of great blessing and provision, brain injury is still ugly. Please keep Ben in your thoughts and prayers. Even though he is struggling, there is hope. I do hear unexpected comments from him on occasion that indicate potential for more recovery. I know God will use this for good. He already has. “ The peace of God, which surpasses all comprehension, will guard (our) hearts and minds in Christ Jesus.” Phil 4:7Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com2tag:blogger.com,1999:blog-6343575463996372798.post-75425352360587346612018-02-10T07:05:00.003-08:002018-02-10T07:05:43.466-08:00Benjamin has been back in Colorado since mid September. Two weeks ago Benjamin and I had a great weekend together. We went to a movie. Ben enjoyed Jumangi, a Starbucks coffee and dinner out. Sunday was spent attending church and going to brunch. He was joyful and engaging and loves talking to everyone he meets. Ben notices people's smiles and gives complements right and left. Jimmy at Chick-Fil-A was doing a good job and Ben told him so. Sometimes it's exhausting, but when I get frustrated with his enthusiasm, I take a step back and watch the effect Ben has on others. People are happy to step into Ben's world and share a conversation. He is open with sharing truth about his motorcycle accident. He tells them that God saved him for aeason. I believe that is true.<br />
<a name='more'></a><br />
There are many things to be thankful for in Ben’s current situation. To give a few details, I want to discuss 4 aspects of Ben's current condition: memory, mood, cognitive function, and physical deficits.<br />
<br />
Since Benjamin's seizures in July of 2016, his short term memory has been profoundly affected. One thing I have learned from my professional mentors knowledgeable in brain injury, is that TBI evolves over time. Months or even years can go by before the final impact of an injury may be known. Ben cannot remember anything he has been told. He will ask questions over and over again with no recollection of any of the information. He cannot remember anything about the multiple hospitalizations in the last 2 years. He does not know how long he has been in Colorado. He does not remember what he has been told 30 second after his question has been answered. He says the same things over and over again. Long term memory is less severely affected.He remembers friends, family and many things about his life before the motorcycle accident. The memories are by no means complete, however, with huge gaps. Every aspect of Ben's day to day life is adversely affected by these deficits.<br />
<br />
Benjamin's tendency toward difficult behaviors and aggression is stable right now. This is a blessing, but requires the most potent psychiatric medications available. Medications that were not necessary prior to the seizures. One medication is considered so potentially dangerous that Ben received weekly blood work to check for toxicity. I am thankful that he is tolerating it well. It is a balance, however, because control of psychiatric symptoms can come at the expense of mental acuity and cognitive function. For the most part Ben is joyful and calm. Psychiatric medications help make this possible.<br />
<br />
Cognitive function continues to be a problem for Ben. He often gets stuck in a rut, not able to move forward. It may be a hyper focus on doing his laundry, an upcoming event or visit or a desired outing. In addition to poor memory, he cannot reason well or process steps to a goal. On Super Bowl Sunday, he kept texting us to ask that Dad come over to watch the game. Walking him through the reasons why Jim couldn't come from Texas in 30 minutes didn't matter. Ben would just ask the same question again 5 minutes later. He asks me daily if I will take him to church, mostly when church isn't in session and when I am in Houston. To compensate I have started Ben with a journal and am asking him to write down the requests and answers to questions as well as noting dates to upcoming events. He does understand that he can't remember information and in order to move ahead with his life, he must find a way to compensate. Journaling may help. I believe that living a more active life would help Ben as well. Although there are outings planned for Ben each weak (bowling, going to the gym) currently the activities are not daily and are not enough to promote mental, physical, and social development. I am praying for opportunity and activity.....daily. Ben desperately needs it.<br />
<br />
Balance, coordination and strength have also been adversely affected by the seizures. Ben is more likely to be off balance than before. His gait is shuffling and uneven. After a walk along the lake in his neighborhood, he tired quickly and even fell getting into the car. Thankfully Ben has not needed his wheelchair for about 9 months, which is a blessing. He remains hearing impaired and I am working on getting hearing aides, at Ben's request.<br />
<br />
I am grateful for progress made. I am grateful for Ben's life. God is working on Ben and God is working on me. God has opened doors to living situations and care for Ben that are nothing short of miraculous over and over again and I know more good things are coming. For every one of the concerns listed, I see God's hand working. In spite of it all, I am joyful and full of praise. It will be good!<br />
<br />
Addendum: I wrote this update on the way to visit Ben’s brother who lives in Wyoming. While waiting for my connecting flight, I was called about new possibilities that will change Ben’s life immeasurable for the better. Exactly what he needs. Once again I am in awe about how God cares for us. It is so good!<br />
<div>
<br /></div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-78397093673948840662017-08-26T11:53:00.001-07:002017-08-26T11:53:43.693-07:00I visited Benjamin a week ago. Followers of the blog may recall that he was admitted to a neurorecovery facility in Tulsa, OK at the beginning of the summer. Unexpected provision allowed Ben a new chance at life and Jim and I were grateful for the opportunity. The facility has been a blessing with a blend of mental health and brain injury behavioral support, tailor made for Ben's needs. Ben's psychiatrist is a committed Christian who is prayerfully walking medical decisions. Ben is on new medications. I continue to hope these medicatons help mental clarity, memory and decision making. There has been progress over the summer, but it has been painstakingly slow. The discharge plan that was in place for Ben's next step was not going to work. Jim and I were faced once again with a dead end. I felt compelled to travel to Tulsa to tackle these issues head on and scheduled a meeting with Ben's multiple caregivers face to face. My old friends, hopelessness and dread, were present in full force. How many times have I been down this road? Almost too many to count. I prayed for answers and peace. For days leading up to the meeting, I felt God's reassurance, but all my human mind could see was the dead end.<a name='more'></a><div>
<br /></div>
<div>
I had been reading 2 Corinthians in my quiet time. Paul talks abut deliverance from suffering. In 2 Corinthians 1:8c he says, "...that we were burdened excessively beyond our strengths that we despaired even of life." The MacArthur Study Bible says the Greek word for despair is "no passage, the total absence of an exit." I know Paul's suffering was extremely severe, beyond what our family is going through, but on the day of Ben's meeting, I felt despair, the place of no passage with the total absence of an exit....again. </div>
<div>
<br /></div>
<div>
Seven minutes before my meeting in Tulsa, I received a phone call that placed the answers to Ben's discharge in my hands. I learned about a community based home in Colorado run by a man who has a heart for those severely affected by brain injury or mental illness. A behavioral therapy program nearby works with those in his care. Our advocate, Teddi, knows him and offered her support. Instead of despair, I walked into the meeting with hope and a plan. A therapist from Touchstone Neurorecovery Center was sitting in the room with the others. He cared for Ben 4 years ago in Texas and was now on staff in Tulsa. He knows my son and listed new community based experiences to be included in Ben's therapy as he heads toward discharge. The meeting was full of peace and planning. </div>
<div>
<br /></div>
<div>
At the airport waiting for a flight to Houston, I received a call from the director of Ben's new future home. He was caring and gracious. He made clear that his program was ready to step into the role of helping us care for Ben. I sat in the airport lounge with tears streaming. It will be good.</div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com1tag:blogger.com,1999:blog-6343575463996372798.post-19660572004916735632017-06-01T19:22:00.002-07:002017-06-01T19:22:52.509-07:00Yesterday I met Benjamin at his new neurorecovery center in Oklahoma. It was a great day. Ben and I went through the admission process together with smiles on our faces. After 7 months in a Colorado medical hospital with little or no outside activity, Ben was excited and happy. He was driven there by car and he enjoyed every moment of being on the road. The events leading up to this unexpected chance at recovery are miraculous and many. Ben had been rejected by every discharge option for care in the entire state of Colorado. As a family, we were not in a good place. Confinement to a general hospital room was causing psychiatric and medical problems and we were powerless to move forward with Ben's care in any way. It was a place of waiting and if you have read any of my blogposts in the past....waiting is not what I do well. Exodus 14:14 says "The Lord will fight for you, and you shall hold your peace and remain at rest." Moses tells this to the Israelites when the Egyptians are bearing down on them by the Red Sea. God fights for his people. I believe the sequence of events leading up to this recover opportunity is a sign of God fighting for Ben when there seemed to be little hope.<br />
<a name='more'></a><br />
<br />
Ben had a case manager at the Colorado hospital who was unrelenting in her pursuit of a therapeutic environment to help restore the function Ben has lost, while retaining grace and optimism. Her optimism and incredible heart was a gift to me. As days turned to months, she never gave up. The staff at the same Colorado hospital was understanding and nonjudgemental. Many of them went far beyond their defined roles to enrich Ben's world. Teddi, a brain injury expert who has advised and supported Ben from the beginning, gave support and advice regarding this discharge plan. It would not have happened without her. The neurorecovery facility in Oklahoma has both behavioral and traumatic brain injury (TBI) support. It is a perfect fit. In the past, mental health facilities have turned Ben down because of the TBI. TBI treatment facilities have turned Ben down because of behavioral issues. This facility has a reputation for positively affecting the lives of even the most difficult patients and it prides itself on rising to the challenge. The daily fees in a facility of this type are high. Ben is fully funded here for 3 months. A way in the wilderness and rivers in the desert. (Psalm 43:19)<br />
<br />
<br />
I wrote this prayer for Ben on the airplane this morning.<br />
<br />
Bless my son and heal him. Lead us through the wilderness. We are desperate to see the other side. Place a stay on all thoughts, words, and deed that are in the way of Ben returning to a productive and fulfilling life. A life filled with you, Lord. I pray for wisdom, discernment and grace for every therapist, doctor, nurse or care worker involved in Ben's care. Open doors for Ben to have a perfect place to live and work when it is time for him to leave Oklahoma. Please give our family peace and rest in this place, Lord, and help us to keep our eyes lifted above pain and circumstance to rest on the One who holds all of us in the palm of his hand. None of this is a surprise to God. He is able and will work all to the good, according to His word and His promise. It WILL be good.<br />
<br />
Amen<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-24489646625424037882017-02-19T14:01:00.002-08:002017-02-19T15:10:42.564-08:00Jim is in Colorado visiting Benjamin this weekend. Ben has been in the hospital for 89 days. Initial admission was for a minor surgery to repair his brain shunt. The distal tube draining in his abdomen was up against the bowel.. easily fixed. The behavioral hospital where he was recovering took the opportunity to refuse to take him back, reasoning that Ben is too medically complicated to be readmitted. He is medically stable at this time. Benjamin's brain function, however, has not recovered since the incident in July when an inappropriate discharge from a different hospital after brain surgery resulted in four days of continual seizures. All of Ben's medications were inexplicably and abruptly stopped as a result of this disastrous discharge. Status epilepticus was the direct result. As mentioned in my previous post, the seizures stole much of Ben's progress made since his brain injury in 2012. Although Ben has not recovered, he is making some progress. He does not need his wheelchair. He can handle self care and calls us on the phone often. He listens to his CD collection and watches movies and sports. Ben's memory is severely damaged. He doesn't know where he is most of the time and his behaviors have been worrisomely aggressive. We are back at the beginning, a "do over", like Ground Hog Day. I have had a few rough moments looking at the picture in front of us. At this time there are no discharge options for Ben's care and he cannot be cared for at home.<br />
<a name='more'></a><br />
<br />
It is easy to be in despair in this world when you forget about God's unseen Kingdom. At this time I am focusing on the unseen. I am not looking at this storm. I am looking at God. In His Kingdom these insurmountable problems are solved. In His Kingdom Ben is whole and healed. God's love is holding us in the palm of His hand and we have nothing to fear. I see peace and refuge in this storm. The more I look up, the more I know God is with us. The solution to our heartache is coming and what is in store will be amazing. The lesson in church last Sunday was from John 6:57. The Amplified Bible says, "Just as the living Father sent Me and I live by (through, because of) the Father, even so whoever continues to feed on Me [whoever takes Me for his food and is nourished by Me] shall [in his turn] live through and because of me." God is giving me peace through His spirit and by His grace I am nourished.<br />
<br />
In the early days of Ben's injury, I learned to look for signs of God's hope and provision in the midst of struggle. These "flickers" of hope allowed me to rest in the knowledge that God was working. In spite of Ben's current set backs, there are many of these "flickers" even now, each and every day. An advocate, named Teddi, who knows Ben well has stepped forward to walk along side of us. She is an expert in brain injury. Teddi hired a behavioral brain injury attendant to work with Ben 4 hours each day. A new medication was started a month ago and seems to be working. Ben has a positive, bright, compassionate case manager at this hospital who has been unrelenting in her search for a solution for living options. I truly believe the doors will be opening soon. I have prayed for only positive thoughts to live in Ben's head, for anger to dissipate and for him to turn to God even though the brain injury limits his ability to think. In the past 2 weeks, all of these things are starting to happen. As a result, Ben is now allowed to go outside and enjoy the hospital courtyard. Colorado has been sunny and beautiful. The freedom has made such a huge difference in his attitude. I believe my next post will list new miracles. It will be good.<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-50857168225861925612016-11-24T20:23:00.000-08:002016-11-24T20:23:09.306-08:00<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal;">
<span style="font-kerning: none;">Today, Ben and I spent Thanksgiving together. Jim and I were called the day before Thanksgiving with the news that Ben’s mental state had deteriorated over the previous 48 hours and that he needed another brain shunt revision. His CT scan once again showed signs of increased pressure. Surgery for shunt revision was performed successfully last evening. Ben was somnolent and minimally responsive for much of the day today as a response to anesthesia, medications, and stress. I was concerned that major ground had been lost again in his recovery. We have been down that road many times. Later today however, he cracked a joke or two with the doctors, watched a hockey game, and spent some time looking at magazines. Ben seems ok tonight. I believe tomorrow will be even better. </span></div>
<a name='more'></a><br />
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal; min-height: 13px;">
<span style="font-kerning: none;"></span><br /></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal;">
<span style="font-kerning: none;">Because Ben’s brain was injured by status epilepticus, (continual seizures) in June of this year, he is climbing the slow road to recovery again. Both physical and cognitive milestones were lost, especially heartbreaking because of how hard Ben has worked to recover from the initial brain injury 4 years ago. Ben is tough, though, and things are getting better. He has moved from his wheelchair to walking independently again. He is even playing a bit of basketball. Language, both speech and understanding, have been affected significantly by July’s seizures. Even in these areas, Ben is 100% better than he was a month ago. He has a tremor that slows down his fine motor skills which I believe is medication induced. The neurosurgeon is encouraged by the result of the surgery today and a new neurologist has stopped the troublesome medication. </span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal; min-height: 13px;">
<span style="font-kerning: none;"></span><br /></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal;">
<span style="font-kerning: none;">In addition to physical and cognitive recovery, a major concern right now is once again discharge options for Ben. The hospital where Ben was staying prior to the current hospital admission feels that he needs more physical therapy, occupational therapy, and speech therapy then they can provide. This hospital does not plan to let Ben come back. We are in limbo once again and need prayer for a therapeutic discharge option to open when Ben is better. Ultimately Ben wants to move back to the home living situation where he thrived for over two years, but he is not ready for that yet.</span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal; min-height: 13px;">
<span style="font-kerning: none;"></span><br /></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal;">
<span style="font-kerning: none;">It is sometimes hard to hope when dealt set back after set back. Today I have had a few rough moments. Psalm 43:5 says, “Why are you in despair, O my soul? And why are you disturbed within me? Hope in God, for I shall yet praise Him, The help of my countenance and my God.” I started with praise today. Praise for Thanksgiving Day. Praise for what God has done for us. Praise for what God will do for Ben in this place. I will delight myself in Him and He will give me the desires of my heart. (Psalm 37:4) That is a promise I claim. I just spoke with Ben’s wonderful nurse. Ben’s story is moving and I believe it speaks to people. I pray it points them to God. Perhaps this struggle exists so Ben can visit every single hospital in Colorado to meet as many people as possible. I HOPE not, but there are days when I wonder. No matter what….it will be good. </span></div>
<br />
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal; min-height: 13px;">
<span style="font-kerning: none;"></span><br /></div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-61207912233412693832016-08-02T20:18:00.000-07:002016-08-02T20:39:26.284-07:00Ben has been in a season of struggle, loss, and medical decline. In April, he started having behavioral struggles coupled with cognitive loss. Experience has taught Jim and I to push for assessment of the VP shunt, which manages fluid in Ben’s brain, when we hear reports of any worrisome changes in behavior. Repetitive brain CT scans were performed as a response to the mental decline over the last 3 months. Finally, when Ben’s mental decline intensified, he was admitted to a hospital for 2 weeks where many of his medications were changed. On June 11th, I visited Ben and became very concerned. Something was wrong. He was irritable, unhappy and mentally slow. The irritability moved to aggression and on July 2nd, Ben was taken to the hospital and placed on a mental health hold. We again asked for a brain CT scan. An astute neurosurgeon reviewed the scan and compared it to all of the scans dating back to April. Ben’s shunt wasn’t working and had not been working for a long time. He had changes in brain ventricular size and this means an increase in brain pressure. July 4th he underwent brain surgery for VP shunt revision. <br />
<a name='more'></a><br />
<br />
Subsequent CT scans showed that the surgery was successful and Ben’s brain ventricle size returned to normal. In the hospital, he began to recover. Medications were not adjusted to what had worked for the past 2 years however, and Ben’s irritability and ability to think did not return to his previous baseline. He was miserable, locked in a hospital room with little hope of consultation with a psychiatrist, neurologist, or transfer to a facility with the appropriate level of care.<br />
<br />
After 2 weeks, Ben stepped out of his hospital room to speak to someone. The events that followed resulted in Ben being discharged from the hospital to an inappropriate level of care a few days later. Ben has a Texas court order that declares him legally incompetent. I am Ben’s legal guardian. The court order was in his hospital chart. The discharge happened when I was not there. The new facility was not informed about the court order.<br />
<br />
In addition to the TBI, Ben has a seizure disorder, is medically fragile and is on multiple medications which should not be stopped abruptly. That's is exactly what happened. He received none of his medications for 48 hours. By the time I could get to him, he was somnolent, no longer understanding language and seizing every 3-5 seconds. I was told by a social worker that he had been that way for 2 days. I informed his caretakers what complex partial seizures look like and that Ben was in status epilepticus. In response, the facility took Ben to the emergency room at a different hospital. By the next morning, Ben was in the ICU. Continuous EEG (brain wave) monitoring recorded continuous seizures for another 21 hours even with excellent care and seizure management. The seizures occurred off and on for another 3 days.<br />
<br />
Ben is now 12 days into his ICU admission. He has lost much. Ben can no longer walk independently. I believe his thought processing and reasoning are similar to where he was almost 2 ½ years ago. He has had regression in language reception, language processing, expressive speech and muscle memory. The wheelchair that he has not needed for 2 years is back at his bedside. Ben’s fragile brain has taken a severe hit.<br />
<br />
Today, however, is a new day. When I arrived at the hospital, Ben greeted me with a smile. I spent the day with him, encouraged by his progress. He is SO much better than I had expected. Last week he had no intelligible speech and had even forgot how to swallow medication. Today he is talking and able to walk with assistance. He can scoot himself around the hospital unit in the wheelchair. All the problems haven’t disappeared, but Ben is a fighter and I have hope for recovery. The worrisome behaviors seem to be gone. Ben has his joy back. This hospital is FULL of amazing, caring, experienced and professional nurses and doctors. God is telling me that all is well in midst of this “storm”. Please keep Ben in your prayers. An ideal situation would be a temporary discharge to a rehabilitation hospital focusing on brain injury to work on regaining what has been lost. Hope is confident expectation. It will be good.<br />
<div>
<br /></div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-27808947406274405982016-06-12T22:10:00.000-07:002016-06-12T22:34:43.761-07:00I am writing this blog update as I sit on a delayed plane waiting to leave for Houston. So far the plane has been delayed 2 hours. Al least the view is beautiful here in Denver. I spent the weekend with Ben in Colorado. Our time together was bittersweet. We have not seen each other for a while. Ben has been struggling with significant physical and mental health issues. After 2 years of health and stability, life became unpredictable. Ben was unhappy and frustrated. The frustration manifested in troubling behaviors that Ben seemed powerless to curtail. The wonderful professionals who run the TBI home where Ben lives, stuck with him through thick and thin, but they were at a loss as to how to help him. Services, medical and psychiatric, are a constant struggle for people who struggle with TBI. As soon as “brain injury” is brought up, doctors and hospitals back pedal as fast as they can. <br />
<a name='more'></a><br />
Ben spent days in an emergency room holding unit until an advocate convinced a hospital to admit him for treatment. Ben is now home and better. His medications have been adjusted appropriately. His physical health has suffered. His cognition is not where I would like it to be. I am looking forward to lifestyle changes implemented by Ben and the home where he lives to help in all these area.<br />
<br />
Ben and I spent time working on a new plan together. We walked and talked in the beautiful Colorado scenery. He has goals. He wants to be “ himself” again. He told the manager at Panera Bread restaurant that God saved him for a reason. I watched him speak kind words to a family with a fussy a baby at a restaurant. A family from his church whose adult son is wheelchair bound with a degenerative muscle disease remembered Ben’s smile and kind words. They took the time to tell me. Ben loves music, cars, and people. His smiles are priceless. We have been down this road before. I refuse to give in to anything but hope.<br />
<br />
I rarely refer to the rest of our family in this blog, but this time I am breaking that unspoken rule. Our youngest son, Jeffrey, a 23 year old graduate student, came down with bacterial endocarditis in April. The infection made him dangerously ill, damaging his mitral heart valve. Jim and I were pulled into a vortex of critical care medicine, moving through 3 separate hospitalizations, one ambulance ride and 6 weeks of home IV antibiotic therapy. Open heart surgery was necessary to repair Jeffrey’s defective valve. He is currently back at school and doing well.<br />
<br />
As the diagnosis and treatment of Jeffrey’s heart failure unfolded, God laid out the answers to every question. Ben’s world fell apart in the same season. Other family crisis situations added even more unexpected stress. Jim and I had our practices to run and our grandchildren to care for. Our family was hit with issue after issue with no time to breathe or recover. Our son, Patrick, is to be married this month. Why was this happening now? We learned once again that God carries us and He is faithful. We learned that was no other choice but to let God fix it. Just like with the Israelites in the wilderness, “He opened the rock, and water gushed out; It ran in the dry places like a river.” Psalm 105:41. Because He is enough.<br />
<br />
God will care for Ben. I absolutely know it. He has done it before. It will be good.<br />
<div>
<br /></div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-83341982723336322492016-02-24T18:50:00.000-08:002016-02-24T18:50:24.441-08:00February 22nd was Ben's 27th birthday. He celebrated by eating birthday cake and had a day of fun with activities and receiving calls and messages from friends and family. Social contact is what Ben loves best and he enjoyed every minute of the day. Ben still lives in Colorado. He still requires a supportive environment that caters to the needs of a traumatic brain injury survivor. Although Ben can do many things, he still has deficits in memory and needs monitoring in social situations. His problematic behaviors have diminished with good medical care and a supportive environment. He is quite a character with a quick smile, a great sense of humor, and an eclectic fashion sense. Everyday I thank God for leading us to Colorado and for the amazing helpers that help Ben navigate his world.<br />
<a name='more'></a><br />
<br />
In May it will be 4 years since Ben's accident. The home where Ben lives has a beautiful mountain view. He has started guitar lessons and has started an exercise program. It is restful. I visited Ben the weekend before his birthday. We shopped for clothes, took long drives, listened to music, tried a new church and had a special birthday dinner out. Ben was joyful and intently interested in everything we did. He tells his story to anyone who wants to listen and is quick to point out that God saved him for a reason. I am backing up Ben's story everywhere we go with the miraculous facts of his survival. It's like walking around with a magnet that draws people in. If you don't want to witness about what God can do, don't go anywhere with Ben. A spotlight seems to follow him wherever he goes. You will be speaking to the manager in every restaurant or store as Ben asks about the business and compliments everyone he sees. You will get opinions from strangers on anything Ben wants to know because Ben will ask. You will see the look of incredulous disbelief on every face when the facts of Ben's life become apparent and are shared. Every time he leaves the house, it is an adventure. Every time he leaves the house, I believe he touches someone's life.<br />
<br />
I do wish there was more progress in areas of struggle for Ben. I want him to remember what I tell him consistently. I want him to control his behavior and self monitor in all situations without help. I want him to process steps to a goal and get started on that goal. Statistically the chance of huge strides in healing diminish as time moves forward. Ben is young, however, and change is happening. More importantly, I believe that good things are happening even now. A wonderful life skills worker shared a video of a friend of hers reading the first few pages of the devotional written about Ben's accident. This person was emotional and obviously touched. He almost couldn't get through it. Ben's story spoke to him deeply. This worker shared this with me at a moment when I was asking God, "So is this it, Lord? Is this what Ben's life will always be?" Even if it is, God is in control and it is enough. It will be for good!Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-68844489674283238692015-10-20T09:37:00.002-07:002015-10-20T09:37:55.796-07:00Jim visited Ben in Colorado last weekend. He is still living in a beautiful Colorado suburb, attends church and like all of us, has daily victories and struggles. Ben has started guitar lessons. I am excited that he is eager to learn something new. He is practicing "Happy Birthday" to play for his dad's birthday next month. Ben has also developed an interest in cooking for the other residents of his house. It is a blessing for Ben to move toward any new goal, no matter how small.<br />
<a name='more'></a><br />
<br />
Ben is 3 years out from the accident. It is a time when recovery is less likely to be dramatic. Ben has days of frustration because he wants to come home, to work, to go back to school. These goals right now are impossible. Ben has severe memory problems. He struggles with emotions, social appropriateness and cannot process steps toward a goal. I want him to read, learn, write, and exercise. I want him to stretch his mind to new accomplishment. It would increase the chances of undamaged parts of his brain to take over for the parts with damage. It would move him closer to where he wants to be in life. Praying for Ben to see what he needs to see and do what he needs to do. There have been so many miracles leading up to this point in our journey. Ben has joy and a relationship with God. His recovery, even with the struggles, is beyond our wildest dreams. He is living in an amazing place with amazing people. God has been faithful in providing everything needed for the journey. For now, however, we are in a season of waiting. Is this all that is in store for Ben's life?. Waiting is hard, especially for someone who is a type "A"personality. That would be me! I believe God is teaching me again about waiting and faith.<br />
<br />
Strife came up unexpectedly in the life of Mary, Martha, and their brother Lazarus. Scripture tells us that this family enjoyed a special relationship with Jesus. The sisters sent a message to Jesus when Lazarus became ill. John 11:3 says that the word that the sister's sent stated "Lord, behold, he whom You love is sick." Jesus knew that Lazarus was to die. Why did he wait to answer ? Why did he delay 2 days to come? Jesus knew that his death and resurrection was imminent. To withstand what what was to come Jesus was about to greatly strengthen the faith of this family and his disciples. There would be no doubt that only the Son of God could do what He was about to do. Lazarus walked out of the tomb. He had been dead for 4 days. Jewish funeral customs were in full force. Professional mourners were wailing. The sisters were grieving. They had no hope that they would see Lazarus again in this world, only in the " resurrection on the last day." Earthly death after four days was final, wasn't it?<br />
<br />
<span style="background-color: rgba(255, 255, 255, 0);">Did Mary and Martha get the exact answer to their prayer? No they got something above and beyond their wildest dreams. Something impossible. If Jesus can raise the dead then Jesus is who He says He is. Why did Jesus delay? Did he not love this family? Why did he allow them to suffer? No, he loved deeply enough to give them a gift beyond measure. Life for Lazarus in the face of hopelessness gave faith beyond measure. Jesus's gift to Mary, Martha, Lazarus, the disciples and to us is priceless. </span><br />
<span style="background-color: rgba(255, 255, 255, 0);"><br /></span>
I believe that I was drawn to the story of Lazarus because it shows what God can do in the face of apparent hopelessness. In this new season of waiting, Jim and I are grateful beyond measure for God's healing and provision for our son. I send up prayers daily asking for immediate healing for Ben. I believe that God's plan for him has to be better than my plan. I have no doubts at all that we can count on God to come through. It will be good!Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-41008533621837937872015-06-30T10:49:00.000-07:002015-06-30T20:58:40.883-07:00My visit with Ben in Colorado last weekend was bittersweet. He has made progress in some areas but discouragingly slow progress in many areas of struggle. I was reading this morning about the common problems for patients recovering from severe traumatic brain injury. Ben has everything on the list. Troubles with problem solving, impulse control, and self monitoring, short term memory, learning, and language retrieval are all there. Ben doesn't grasp the implication of a given action and his impulsivity may show up as verbal utterances, snap decisions and poor judgement. His irritability and emotional instability is much better on medication which is a blessing. The article on TBI sequelae perfectly states these changes by stating "an individual with TBI may have a vague sense that he is 'not who I used to be' and yet struggle to define the specific ways in which his personality differs from prior to the injury."<br />
The article goes on to mention that for many TBI survivors, the ongoing needs for support are not being met. Through the grace of God that is not true for my son. He is in a marvelous place.<br />
<a name='more'></a><br />
<br />
On a positive note, major struggles with behavior, emotions and impulse control are much better since the last blogpost. He is responding to redirection and truly seems to want to improve his social awareness and appropriateness. His desire to move ahead with his life is strong but it is difficult for him to plan which is a huge barrier to progress. He doesn't remember the interests that he had prior to injury unless reminded of them. The staff where he lives questioned me this weekend extensively about what his passions were prior to injury. He will have one on one time with a staff member to pursue something different starting next week. They are planning to increase time in the gym, plan more camp outs, and look for volunteer opportunities for Ben. My prayer for Ben right now is to exercise his mind and body. I want him to read and learn. I want him to become physically active again. I want him to have a hobby and a passion to pursue on his own. I want him to actually use his computer for growth instead of letting it sit there.<br />
<br />
A friend asked me to question Ben about what his life has now that it didn't have before. Ben said "God". He said that he is close to his Savior and talks to him daily. Glory! If I had to answer the same question about Ben's life, I would say "love". Ben is in constant contact with me by text and phone with messages of encouragement and love. He loves his family unconditionally. This weekend we frequented a hair salon, restaurants, an ice-cream parlor and walked through parks. Ben witnesses to others if there is opportunity about what God has done for him. He talks to every person he meets with a smile on his face. Ben spoke via FaceTime with a neurosurgeon who cared for Ben early in his injury.This doctor has become a friend and said he was going to send Ben a book to encourage reading. Ben replied, "You have already given me a gift worth a million bucks. Without you fixing my brain, I wouldn't be able to read." The nursing agency director's email to me said, "Our care givers had some neat stories about Ben. He has such a great personality." Ben is closer to God. He has joy and thankfulness. He loves people. He lives for today as our Savior has taught us to live. (Matthew 6:34)<br />
<br />
Today I woke to this message from Ben. "GOOD MORNING MOM!!!!Today is Tuesday so please slowdown and focus on a simple/productive day. I love you TONS MOM....It makes me HAPPY that you are the woman the kids (my grandchildren) are watching in their lives. I LOVE YOU EVEN MORE AFTER YOUR VISIT THIS WEEKEND."The injury has taken much from Ben, but much has been given through this journey. God is working. It will be for good. I plan to rest in that.<br />
<br />
<br />
<br />Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-41441220804465694032015-04-04T11:44:00.001-07:002015-04-04T11:46:11.108-07:00Last weekend, I traveled to Colorado to see Ben. Jim and I try to visit at least once a month. Medically, Ben has had a few set backs. Behaviors surface occasionally that need care, intervention and sometimes medication adjustments. He had just come out of a period of struggle and things were much better. I have learned through this journey with Ben that God will provide the road, the answers and peace. The director of the home where Ben lives honestly likes him. She feels his sense of humor and personality add much to lives of the other people in the home. She feels like Ben is worth it. This may sound sad, but Jim and I have been fighting this battle for Ben <i>alone</i> for so long, to have someone fighting along side of us is such a relief and a blessing. And....of course God is on our side. Jim and I no longer panic when the wheels seem to fall off the wagon. Either God will fix the wheels or we find out that the wagon rolls just fine without wheels.<br />
<a name='more'></a><br />
<br />
Ben and I took long drives. We ran errands and went shopping. He loves eating out and enjoyed a chicken fried steak at Salt Grass steakhouse. Sunday morning church was restful and full of joy. Ben loves conversation and he is fun.<br />
<br />
One highlight of our visit was a very important FaceTime call with one of the brilliant young neurosurgeons instrumental in saving Ben's life. Dr. George Al Shamy was a neurosurgery resident at Ben Taub General hospital when Ben was admitted through the trauma center immediately after his accident. When Ben left Ben Taub, 7 weeks after the accident, he was only minimally responsive, and the prognosis for his recovery was guarded at best. Physicians involved in the acute care of a patient often are not kept in the loop as the patient moves toward recovery. I have kept in touch with Dr. Al Shamy with reports of Ben's progress over the last 2 1/2 years. He has finished residency and is now a practicing neurosurgeon in the Houston area. I wanted him to know that Ben was doing SO much more than expected. I have been blessed with Dr. Al Shamy's friendship and kind heart. Ben thanked Dr. Al Shamy for saving his life during the FaceTime call. Dr. Al Shamy told Ben, " God saved your life. I was just along for the ride." This doctor is an unbelievable person. Thanking God for his presence in our lives.<br />
<br />
I am so happy to report that <i>Freefall to Faith,</i> the devotional published using Ben's story, is being used at Ben Taub Hospital. The pastor who ministers to Ben Taub's intensive care units sent an email last week to tell me that he is using the book as an essential part of a project involving pastors and spiritual care. He is giving it to families and patients in addition to pastors. As readers move through Ben's story in the devotional, I am hearing that it is helping others. This is my dream. There is a new story that makes me smile every week. It is such a joy and I am touched by each experience. Praising God! It will be good.Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-28215186650008532532015-01-31T22:30:00.001-08:002015-01-31T22:30:34.055-08:00On Wednesday, January 27th I got in my car and made the 40 minute drive to Ben Taub Hospital here in Houston. It has been over 2 1/2 years since Ben was hospitalized in the neurosurgical intensive care unit at Ben Taub. I drove the familiar route and parked in the familiar parking garage, taking care to remember the floor my car was parked on. I have lost count how many times I had forgotten where my car was parked in this garage. Today, I was going to remember. As I walked toward the front door of the hospital, passing people from all walks of life, it didn't seem like years had gone by since Ben's injury. Ben Taub cares for the indigent of Harris County in Texas. And because of it's excellent trauma center, it not only cares for the indigent, it also cares for the wealthy and everything in-between. The medical and nursing staff at Ben Taub is dedicated, skilled, brilliant, and overworked. When Ben was in the intensive care unit, an ICU nurse told me about patients that had walked through the doors of that unit to thank the professionals who had cared for them years after their devastating injury. The hope in her voice led me to believe that this didn't happen nearly often enough. Today I was there to tell them about Ben.<br />
<br />
<a name='more'></a><br /><br />
On January 8th, I published Ben's story on Amazon as a devotional entitled <i>Freefall to Faith. </i>It is a 21 day guide to replacing paralyzing fear with faith in God's plan, peace, and provision. The book is written using the story of our journey with Ben through his traumatic brain injury, but my hope is that it could help anyone facing life-changing tragedy. The devotional was written because I wanted something to place in the hands of every person facing unexpected, unthinkable loss. As I stepped into the Ben Taub neurosurgical ICU that day, I carried a stack of the books, ready to start doing what I had dreamed of doing....helping Ben's story matter and hopefully making a difference in the lives of others.<br />
<br />
The response from the nurses was astounding. Several remembered Ben. They peppered me with questions about how he was doing and asked to see a photo of him. I felt their joy that all their diligent care had made a difference in Ben's life. This is why they work their tails off everyday. I wanted the nurses and staff to see how much it had meant in the life of one young man. The nurses who didn't know Ben, were still astounded and seemed encouraged by Ben's story. The book is dedicated to them and they were touched. Eight books disappeared into the hands of the ICU staff. I left another stack of devotionals for the patients and their loved ones. The ICU chaplain asked for 10 books and told me that he is often asked by families for something to read when he visits patients. I had the opportunity to show him details in several of the entries. There was mention of using it in the support group at BenTaub for head trauma patients. The head of the ICU, Dr. Robertson, took the time to speak with me. I was blessed by her kind heart and appreciation of my visit. The devotional, anecdotally, has information for families about Traumatic Brain Injury deficits and struggles in addition to the faith based message. My prayer is that it helps others early in the course of injury as well as further into the journey.<br />
<br />
I drove off hours later into the Houston grid iron traffic with such <i>joy </i>in my heart! God allowed me to participate in <i>HIS </i>plan<i>. </i>Ben is doing well in Colorado, still with struggles, but the <i>Master planner </i>is in control! God is there. God is working. It will be for good!Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-58774268550110051152014-11-29T20:07:00.003-08:002014-11-29T20:07:46.163-08:00Ben just walked up the sidewalk of his home in Colorado after giving me a hug and a huge smile. He is content. . During this Thanksgiving season, I am SO grateful for the path that brought us here. To find exactly what Ben needs to live a productive life at this stage of his recovery is a miracle. I praise God who never leaves us alone to fight or suffer. He had the miracle planned even when all I could see was darkness.<br />
<br />
The weather in Colorado was warm and beautiful this weekend. Ben and I shopped and went to restaurants. We took drives with the music turned up. Saturday we spent time getting Ben's malfunctioning computer up and running. I put a few finishing touches on his room. But even with all the joy, this is not a fairy tale with a storybook ending. <br />
<a name='more'></a>Ben still has significant deficits is memory, self awareness and behaviors. He knows he can't remember things and it saddens and frustrates him. Even instructions that he understands at the time they are given are forgotten in the blink of an eye. He carries a small notebook everywhere to write down as many cues as possible. Because of memory and problems with complex thinking, Ben can not plan. He knows what he wants to do, but can't figure out how to get there. Please pray for complete healing of Ben's mind. He is young and still has potential for lots of improvement. Nothing is impossible for God.<br />
<br />
Ben is spending time with God. He reads his devotional and prays daily. I believe this time with God has seeded the joy I see on Ben's face. Even though the problems are there, Ben seems more "whole" to me than previous visits. I know God is working and it will be for good.<br />
<br />
"But You, O Lord are a shield for me, my glory, and the lifter of my head" Psalm 3:3Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-82408782997132890652014-10-05T16:16:00.001-07:002014-10-05T16:16:35.795-07:00Today is a beautiful day in Colorado. I am visiting Ben. His life has settled into a routine in the beautiful Colorado neighborhood where he lives. As the months unfold, Ben is still struggling with memory. As predicted, because of the severity of Ben's injury, his capacity for remembering what happens day to day remains impaired. His post injury amnesia has remained which is a poor prognostic sign for long independent term recovery. Behavior issues are better, but often there is no "filter" and things slip out of his mouth that are better left unsaid. He can't process steps to a goal and his stated goals seem out of reach.<br />
<a name='more'></a><br />
<br />
As I write this, it may sound kind of grim. It isn't. Ben is making progress. He is learning.The skilled staff around him work with him everyday on the things he needs to know. Ben diligently works on the lessons developed for TBI patients. He has developed amazing relationship with the residents in the house and the staff. He is out and about in the community everyday and is involved in the shopping and maintenance in his house. Ben lives to engage people as he moves through his day. He is joyful and talks to everyone he meets. He loves Colorado and spends lots of time outdoors.<br />
<br />
Our weekend together consisted of shopping, going to restaurants, getting a haircut, and attending church. With a smile on his face, Ben lavishly complimented the waiter at the restaurant chosen for dinner. Conversation moved toward Ben's accident. Ben told the young man that the Lord had saved him and shared details of the accident. The waiter sat down with a shocked expression and stated that he had lost a dear friend to a motorcycle accident 2 1/2 years ago. He told Ben to come in anytime and ask for him. The conversation was very emotional. The hairdresser, according to Ben, was the best ever and he told her so. At church, the pastor's came up to meet me and a church member was so moved by Ben that he gave me his contact information in case I needed any help for Ben with Jim and I so far away. The clerk at Kohl's department store from the previous day's shopping, came up to us at church with a smile and a welcome. Customers in the store shared a story about a family member with TBI and encouraged Ben. The check out associate told us how encouraging it was to meet Ben. She loved his story. As I sit in the airport waiting to return to Houston, Ben is texting me, "THANK YOU SO MUCH FOR COMING TO SEE ME!!!! I am so happy!!!" No, he is not exactly where I would wish in recovery. He IS in a good place, however. He ministers to others through his story and even through his disabilities. It will be for good.<br />
<br />
<br />Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-8783841891091307762014-07-12T20:56:00.000-07:002014-07-12T21:59:15.453-07:00Today marks 26 months since Ben's injury. Currently it seems to be a season of rest for our family because many of the harsh problems described in previous posts, have resolved or have settled down to a manageable place. The Colorado house where Ben currently lives is staffed with personnel trained to maximize the lives and potential of young men who have sustained a traumatic brain injury. The home is in a beautiful suburban neighborhood with mountain views and wildlife. There is a back deck where Ben spends much of his time outside with nature. Today Ben went to a nearby lake and spent time fishing and hanging out. He has been to festivals and concerts. He goes to the gym three times a week.The staff includes him in shopping, household upkeep, and cooking. Trips to restaurants and movies are frequent. Ben has developed good friends in the place that he lives. It is not all fun and games, however. Ben is still receiving rewards and consequences for his ongoing behavior management program. The director also has a curriculum for working on the cognitive and memory issues that affect all of the residents in this house. Every time I hear about the effort this director puts into her ongoing search for activities to enrich the lives of these young men, I thank God for her heart and calling.<br />
<a name='more'></a><br />
<div>
<br /></div>
<div>
Jim has made two recent trips to visit Ben. They visited Pikes Peak one weekend and traveled to the Keystone area the next weekend. Ben loves Colorado although he still often speaks of coming home to Texas. It's hard to tell him no, but Texas has nothing to enrich his life. God seems to have opened the doors for us in Colorado.<br />
<br />
If you are keeping up with Ben's story, you know that the past few months have not been easy. Ben has been hospitalized in psychiatric facilities three separate times and has been asked to leave one group home for traumatic brain injury since moving to Colorado. Looking back, however, miracles abound in this story. Ben has qualified for both short term and longterm Medicaid in Colorado. He also has been granted a "brain injury waiver" which will help with many of the things he needs. Jim and I carry private medical insurance for him, but this doesn't help with providing a living environment that will move him toward healing. ALL of the tedious paperwork was filled out for us during these hospitalizations. I had no idea what I needed to do. It was taken care of for me in the midst of the mess.<br />
<br />
The largest obstacle to Ben living a productive life in recent months has been difficult behaviors. With every promising living arrangement, an episode of confrontational behavior from Ben, would send us into a tailspin. During the third psychiatric hospitalization, a bright nurse practitioner changed his medications dramatically. Ben, at that time also developed more self-awareness about the consequences of his behavior. (An answer to prayer.) Thirdly, the right home environment presented itself. As mentioned before, it is run by a director who really understands people with traumatic brain injury. The well intentioned staff in the first Colorado group home didn't.<br />
<div>
<br /></div>
<div>
We are believing God for Ben's cognition and memory to improve. There is still much ground to gain in these areas. Ben cannot process steps to a goal. It is difficult to get him to pursue any interest with diligence although he wants to "go back to school". Emotional outbursts, have lessened, but this will be a continual battle for Ben. I am praising God for this miraculous respite although I want so much more for Ben. He is joyful. We hear from him daily through calls, texts, emails and photos. As best he can, Ben shares his life with us. As best we can, we share our lives here in Texas with him. Tonight I told him to shave because he looked like a terrorist. With a smile on his face, I was just treated to the "before and after'" photos of Ben's shave. Ben took a photo of the beautiful night sky and sent it to me earlier this week. The accompanying text, "Ok, I'm just out on the porch upstairs and was looking at this holy scene!!! Thought you might like it, mom!!!" It is good!</div>
</div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-5979551331255153412014-05-17T20:20:00.001-07:002014-05-17T20:20:07.574-07:00Last weekend was memorable for the Ramsey family. Patrick, Ben's younger brother graduated from the University of Wyoming. The university is 125 miles from where Ben is living in Colorado. The plan was to travel to Laramie and then to visit Ben. Snow and horrible weather shut down all roads out of Laramie. Driving behind a snowplow in May was definitely an adventure for this Texan<br />
<a name='more'></a>. <br />
<br />
The storm shortened our visit with Ben considerably. I was concerned about how he would adjust to the change. In the past, it would have not been good. This time, Ben understood and adjusted well. Wow! The last month has been characterized by many of the same challenges that I have described in previous posts. Ben's behavior resulted in a third hospitalization three weeks ago. Instead of defeat, his treatment this time was hugely beneficial. His medical evaluation included new testing and major adjustments were made to his medication. A psychiatric nurse practitioner gifted in medication adjustments made dramatic changes to Ben's treatment plan. Within 3 days of the new medical regiment, Ben said that his mind was calmer and he felt good; better than ever. He has not had another problem. This is SUCH an answer to prayer!<br />
<br />
Ben is living in a home in a beautiful neighborhood. He has a window that overlooks land with deer and greenery. Today he attended a jazz festival all day and had a wonderful time. He is asking Jim to bring him his golf clubs. He is attending church tomorrow. Ben is happy and life is interesting. We talk with him on the phone every night. The living arrangement involves supervision and relationship with people who's life's work is to care for TBI survivors. At every turn God has turned the "darkness before us into light" (Isaiah 42:16) Please continue to pray for stable behaviors and healing for Ben's mind. I want Ben to move toward a happy, fulfilled life. I want him well. God has been so faithful in this journey. It will be good!Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-33134649120431119942014-04-13T22:03:00.000-07:002014-04-13T22:05:04.294-07:00Next month will be the second year anniversary of Ben's accident. I have learned first hand in the last two years that the road to recovery for patients with a traumatic brain injury is often frustrating and long. In the beginning when I didn't know if Ben would live through his injury, I read of the frequent problems of others affected by TBI. The list seemed insignificant at the time....after all we were in a battle for Ben's life. Now I "get it". We are smack dab in the middle of what seems to be common struggles for those recovering. Understanding the mental, physical, and behavioral deficits, learning coping techniques and promoting improvement for these deficits, and looking for the tools to achieve a meaningful life are daily obstacles for us and for many others.<br />
<br />
<a name='more'></a><br /><br />
The first matter involves Ben's medical condition. At the beginning, any sort of functional survival seemed unlikely. I grieved for the loss even as hope was ever present. Physical recovery began with purposeful movement and speech. Although Ben was walking with assistance 3 month post injury, giving up the wheelchair completely became possible June 2013. Today Ben is totally mobile. His balance is off when fatigued, but this doesn't slow him down one bit. Last week Ben started walking on a track as a way to "work out". He is walking at least 6 laps each day and loves including others on these walks. Socializing with others on these walks feeds his spirit. I can hear smiles in his voice. Ben's seizure disorder is stable on medication. Persistent physical deficits include a profound hearing loss and some problems with the visual fields in his right eye. Ben handles all of his grooming and activities of daily living. He does laundry and household chores. He stays in touch with friends and family with a cell phone and is able to use a computer. His speech is still described as paraphasic (the wording may be close but not exactly right). Sometimes I love the word choices, however. I had admonished him for a behavior last week. Ben responded by telling me that he would be "getting the wrinkles out soon." Yesterday Ben sent photos of the batch of cookies he had baked from a recipe he found on the internet.WOW!<br />
<br />
Memory and reasoning remain a huge problem. Benjamin's CT scans of the brain reveal evidence of mild hydrocephalus (extra fluid in the brain ventricles for which he had a shunt placed), evidence of diffuse nerve axonal injury from early high pressures in the brain after injury, and severe diminishment of brain tissue in the right frontal area of the brain where he had bleeding. These injuries manifest as poor memory and difficulties with judgement. He will tell the same stories over and over again. His memory can be uncannily accurate at times, but is extremely poor with recalling the course of his life since the accident. Ben's behaviors can be very difficult when frustrated. This has been the main obstacle to finding the right environment for recovery for him. Brain trauma expert, Dr. Ralph Lilly, has told me many times that keeping Ben in the right environment is key to moving him forward. This CAN get better. Ben knows what he needs to do, but setting emotions aside to deal with frustration appropriately is tough for him. This is an area where I am asking for healing prayer.<br />
<br />
The second issue has been Ben's road to appropriate care. This is one of the many places where I am totally in awe of what God can do. It can be one of the saddest aspects of caring for a loved one with a TBI. The problem is......there are few if any options when the medical condition has stabilized and the therapies available are seeing slower results. That is when insurance stops covering rehabilitation. In Texas there is a program called DARS that may cover for a few more months. When this funding ends, the choices are to go home or into a nursing home. Neither one of these options were a possibility for Ben. For each and every stage of Ben's recovery Jim and I have had provision and direction. I believe that this is miraculous. Recently after encountering dead ends in Texas for care, we moved Ben to Colorado. The first brain trauma group home didn't work out, but the resulting struggle has resulted in Ben being declared a Colorado resident with the funding necessary to keep him in the best environment. We have met WONDERFUL professionals and new friends who are helping lay out the plan that Ben needs. I could never have done this on my own. Colorado has the programs that we cannot find in Texas. God led us here for a reason.<br />
<br />
The third issue is Ben's emotional stability and health. Even though I have listed the struggles, Ben's brain is healing. We see him becoming more aware of what he should be doing with his life as a 25 year old young man. He knows, but can't figure out what he needs to do to get there. He sees himself as the same person he was before the accident, only better. Ben know that he was saved from death for a reason. This has made God even more real to him. In his mind, he should be back in college and involved in family responsibilities. My heart aches when I have to tell him "not yet". Every night I have to tell him why he can't come home. He needs to work out how to stop difficult behaviors. He needs to have continual stimulation to improve memory. He needs to relearn many things . He need to have supervision. He needs to have a satisfying, meaningful life. None of these things can happen at home right now. I told Ben that our timing is not God's timing. I do believe that God can and will heal him. Even this struggle is evidence of the changes that are occurring. Thank you for following this very "wordy" journey. Thank you for your prayers and words of encouragement. It will be good.Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-25031070537823377842014-03-08T22:28:00.003-08:002014-03-08T23:58:15.320-08:00<br />
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
It has been over a month since my last post. I have been waiting for a moment of respite in Ben's story before bringing everyone up to date on his journey. There has been little respite, however. So begins my post.... with the good and the bad. Ben has been in Colorado for a little over a month. Ben moved into a place designated as a home environment with a day programs on site for young adult traumatic brain injury (TBI) patients. Although there are cuts to therapeutic living environments for TBI patients everywhere, Colorado is better than Texas. The option seemed perfect and was definitely an answer to prayer.</div>
<a name='more'></a><br />
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
<br /></div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
After one week, however, it was clear that anxious behaviors were surfacing at an alarming rate. Ben's struggles with frustration tolerance and ability to function in an environment with less structure made it difficult for Ben to stay in the home we had chosen. This emotional instability resulted in a 3 week hospitalization to stabilized Ben's medication. About 2 weeks ago Ben returned to the original home with a much improved demeanor. He was ready to move into a better life. Although the home where Ben resides is occupied by attendants and professionals familiar with troublesome behavior, Ben has again been asked to leave because of brief flurries of verbal aggression that still occur when he is frustrated. Today Ben has had no trouble at all. He is handling more and more of his daily life activities. He is very social and has a huge list of new goals. He wants to go to school. He wants a job. Many good things are still happening.</div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
<br /></div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
The emotional instability is much improved since arriving in Colorado and Ben is very aware of what he needs to do to move ahead in life. The damaged areas in his brain are where behavioral inhibition is initiated. He has to relearn judgement and how to control himself when angry. He is moving ahead in this area. Lately he may start to say something inappropriate, then stop himself and add, "No, I'm not going to be that way."Unfortunately the progress is not enough for this assisted living facility to allow him to stay. </div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
<br /></div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
So, here we are again, in the same place.....looking for what Ben needs for living and recovery. I am VERY tired of this place. I have shed WAY too many tears in this place. It's way too easy to fall into the habit of doubt and fear that all of our hopes will end in failure. Today I was reading a lesson written by Anne Graham Lotz entitled "Resting In the Will of God." According to this lesson we are all in "a designated place" in our lives, placed there by God. She uses the story of the child, Samuel, in 1 Samuel 1:1-3:21 as an example. After years of not being able to conceive, Samuel's mother, Hannah, petitions the priest, Eli, for a child. Scripture says Hannah was "in distress of soul, praying to the Lord and weeping bitterly." (Me too). When Hannah gives birth to a son, she gives him to the Lord as she has promised. Samuel grows up in the place he needed to be in order to prepare for what God wanted him to do. It was God's will that Samuel grow up dedicated to the Lord. Hannah's desperation led to the dedication of Samuel and his preparation for God's purpose.</div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
<br /></div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
This is the designated place for Ben right now and it is the designated place for us. Colorado has blessed us with more opportunity to move forward. I believe that Ben's story is accomplishing something in this place that I may not ever understand this side of heaven. God is lining things up as I write this. I just have no idea where it is going. I have had wonderful new Colorado friends and professionals take time to help us. Better yet, to encourage us. They have refreshed me with kindness and understanding. The solution is coming. It will be good. Hope is confident expectation.</div>
Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0tag:blogger.com,1999:blog-6343575463996372798.post-41911284647013256602014-02-01T19:24:00.002-08:002014-02-01T19:24:53.505-08:00The journey continues in Ben's road to recovery. I am so appreciative of everyone that takes the time to follow Ben's progress. Ben was discharged from the Pate Neurorecovery Center in Anna, TX on January 17th. Jim and I, after exhaustive research, decided that there were limited venues for living and recovery for Ben in Texas. Ben relocated to a living facility in Colorado that offered opportunity for the next step in supporting Ben in his progress toward independence. It is a homelike facility with younger people, specifically geared toward traumatic brain injury. Jim and I were very hopeful that this could be the next step for Ben. He was tired of living in a controlled therapeutic environment and was ready to move toward preparing for school or work. Colorado seemed to have the answers we were looking for after hitting road block after road block to anything even remotely appropriate in Texas.<br />
<a name='more'></a><br />
<br />
Prior to moving, however, there were some signs that problems common to patients with traumatic brain injury were increasing in intensity. Ben was becoming more and more anxious. He was more irritable and the potential for an angry outburst was a concern. Ben's memory is still affected and it is difficult for him to sustain attention for tasks or instructions. He needs supervision but is ready for independence as well. I asked for a reassessment of Ben's medications prior to the transfer to Colorado, seeing trouble on the horizon. The doctor hesitated to act because Ben was doing fairly well at the time of my request. The living center in Colorado was everything Jim and I had hoped for; opportunity with supervision. After one week, however, concerning behaviors surfaced requiring intervention. I received a call at the office with the devastating news. Ben would have to be moved immediately. My journal entry that day states,"I want deliverance, Lord, not more to endure. I want the miracle at the end of the road and I am tired of walking. Fix this. Lord, and let the road open up before me."<br />
<br />
Psalm 34:17 says, " The righteous cry out and the Lord hears then and delivers them from all their troubles". Well, the doors and paths have started opening once again. Ben had to be moved to a facility to quickly adjust his medications. The professionals who helped move him were knowledgeable, kind and experienced. The organization of the transfer was taken out of my hands and handled beautifully. The facility which I found by "accident" is the best by reputation in the area. The doctor who "happened" to be on call has experience with mood problems AND brain injury. I feel that he knows what he is doing. The nurses have been amazing. And even more importantly, the living facility is willing to give him another chance after discharge. If that doesn't work out, there are MORE CHOICES! We had no options to choose from after our last discharge and were left to figure things out on our own. It was a tough place to be in. Just spoke with Ben tonight and he is so much better. Jim told him that phase 1 is to have predictable and less anxious behavior. Phase 2 is to move on with his life.<br />
<br />
I know good things are coming even if this road seems too long. Hope is confident expectation. Please pray, if you have a moment, for Ben. He needs a renewed mind and healing. He needs to have joy in his life once again. It's coming!Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com4tag:blogger.com,1999:blog-6343575463996372798.post-48031441331060107902014-01-04T21:23:00.000-08:002014-01-04T21:55:11.134-08:00 We hope and pray that the new year is full of healing and hope as Ben moves into the 19th month since his traumatic brain injury. Ben continues to work hard in the therapeutic program at the neurorecovery center. Although he is able to do many things well, Ben's significant memory, behavioral and anxiety problems are a barrier to him living independently. Jim and I are currently being faced with struggles for appropriate care as the January discharge date from the neurorecovery draws closer. Ben was able to come home for Christmas. He had not returned home since the injury. It was a joyful time with many bittersweet moments. Ben wanted to stay home. He isn't ready.<br />
<a name='more'></a><br />
Ben's level of function and his sweet heart is a gift. I shed a few tears at the end of the visit because this journey, which has seemed so long, is actually just beginning. Sometimes it is overwhelming when I think of what is in front of us in the midst of our chaotic lives, until I remember that God promises to "make our paths straight."<br />
<br />
The next plan for Ben is to move to an assisted living facility, hopefully in a home like environment, specifically geared toward traumatic brain injury. This would optimally involve more independent living away from a hospital or recovery environment. It will be important to have a instructional day program in place. Ben's doctor in Houston, Dr. Lilly, has often mentioned that the regenerating neurons in Ben's brain have to be continually stimulated because they " don't know where to go". How to structure this environment when residential neurorecovery centers are no longer an option, is a very difficult problem in the state of Texas. Jill Bolte Taylor's book, My Stroke of Insight, is about her recovery from a ruptured brain aneurysm. It took 8 years for complete return of brain function. Ben cannot live in a hospital environment indefinitely. He can't come home yet, and he needs a life.<br />
<br />
Jim and I have learned much. Texas is unique. Ben has private insurance and Texas medicaid. Jim and I are willing to support Ben as he recovers, but the cost of care is unbelievably high. Even if we paid "fee for service' for the level of care Ben needs, there is not one option in the state of Texas that we can find that is a good fit. Texas Medicaid would help if Ben hit the truck before his 18th birthday but not after. Private insurance doesn't cover assistant living level of care. Because traumatic brain injury is not excluded from state insurance coverage in other states, we are learning that other states have more opportunity for living and recovering. I believe God is moving us toward one of those opportunities. The door seems to be opening toward a solution once again. I would appreciate any prayers to help "turn the darkness before us into light".<br />
<br />
As I am writing this, I am answering numerous text messages from Ben. He carries an iPad mini every where he goes. One result is prolific text messaging. Ben also uses the iPad to record things he knows he will forget, listen to music and to take and sent photos. It blows my mind that he can do all these things. His sense of humor is great. Tonight, in conversation, I reminded Ben that he was terrified of sharks when he was little. The response was," Hahaha oh yeah! I was a little dorky Benny boo!?!?" Ben is worried about his future, but he has not lost his joy. We have not lost our confident expectation that this will be good.<br />
<br />
<br />
<br />Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com11tag:blogger.com,1999:blog-6343575463996372798.post-78806155700739386092013-12-03T17:55:00.001-08:002013-12-03T17:55:29.754-08:00<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dytu690FOVQy0iHKaeDblZhqVK8C0Q0E0wAskBEtUZplYh3NHcJcma9iWs-iUOrr6hetVlNFGXA2i0zfVlgVw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div>
Just for fun! Ben doing a parody of a TV cooking show. Love his sense of humor.Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com5tag:blogger.com,1999:blog-6343575463996372798.post-25808009034855931102013-11-17T19:51:00.000-08:002013-11-17T20:12:23.691-08:00Ben continues to live and learn at the neurorecovery center. Jim visited him this weekend. He and Ben went to the movies and enjoyed dinner at a local restaurant. Chicken fried steak has become Ben's favorite meal. Today staff members from the neurorecovery center took Ben to church. Our cousin, Elizabeth, then took Ben to lunch and to the park. Ben sent pictures from his iPad taken at the park. he is "clowning" around. It is a beautiful day. There is pure joy written all over his face.<br />
<a name='more'></a><br />
Elizabeth told me later on the phone that she and her husband had taken Ben to lunch after church with their Sunday school class last week. During the meal she looked up and saw Ben heading toward the kitchen with a pile of dirty dishes. She quickly moved to intercept him, but was told that the owner and the waitstaff were in on it. Ben was working. Afterward the owner of the restaurant told Elizabeth that Ben could come to work there anytime. He was welcome to work or just talk to the patrons of the restaurant. He makes people smile. Many times over the last year I have asked for Ben to have his "joy" back. He not only has it back, he seems to be giving joy to others.<br />
<br />
In therapy Ben is reading, writing essays, and doing math. He is practicing conversation and practicing socially appropriate behaviors. He enjoys music, computer word games and his iPad. Ben especially loves talking and texting friends and family. Ben's memory is still extremely impaired, especially his short term memory. Although he handles many necessary mundane tasks, like laundry and personal care, it will be a long time before he can be independent. This is a concern because we have received notice that Ben's discharge date is in 2 months. Once again, we are looking for care and praying for the next phase in Ben's life. He needs to learn and work. He needs to live in a safe place with as much independence as possible. I am following every suggestion and calling every referral, knowing that the right path WILL open for Ben. Even when circumstances looked bleak in the past, God came through with the answer each and every time. Hope is confident expectation. Please consider praying for the next phase in Ben's life. He knows that big changes are coming. It is hard dealing with the unknown once again but I know it will be good.Karla S Ramsey MDhttp://www.blogger.com/profile/03488683813435237269noreply@blogger.com0