Joel medical update & Darcy's last few days!

GOOD NEWS!!! After a LONG process (from Dec - Mar) of completing all of the steps required to get his license, Joel did it! He had numerous tests with Vestibular (I explain Vestibular therapy's function later), Tri-City Medical balance tests and driving test, and the DMV's written and driving test. He was very patient through the process and his patience paid off. We are all so proud of him!

Joel and I met with his doctor at Camp Pendleton for an overall update on his medical progress. I don't feel comfortable leaving the country without an update on how he's doing. I don't want anything to be a surprise while I'm away. Here is the update:

Opthamology (the working of the eye): Joel has great vision, but he still has a blind spot in his right eye. The spot isn't physically blind, but his brain is choosing to not use it (for whatever reason). From what I understand, this can be corrected with therapy. There was not a complete update on this therapy, but hopefully we'll have one soon.

Audiology: Joel has GREAT hearing (much better than mine). In order to determine whether his balance issues came from the inner ear or the brain, they but him quiet, small, dark room strapped in a mechanical chair that spins around and around. He said the speed was so quick that if he was not strapped in, he would "fly out of the chair." He did NOT like this. The claustrophobic feeling it gave him was overwhelming. He said he wanted to stop, but refused to let it defeat him. He slowly became more comfortable with the situation. The results came back, and they think his balance issues are caused by both the brain and the inner ear.

Vestibular (inner workings of the ear - the balance center): Joel has two therapy sessions a week with Vestibular to correct his balance and dizziness. His biggest balance issues come when he is in a hurry or just stands up. His dizziness comes when he leans his head back. Hopefully this intensive therapy will slowly improve these issues.

Speech: When Joel met with the Speech therapist, she didn't see a great need for individual therapy, but suggested group therapy. Joel is not too fond of group therapy, but will try it a few times to see if he can draw any benefits from it.

Concussion Clinic: Joel took the same 4-hr test he took when he arrived to and departed from PTRP. His results were generally the same as they were back in Nov. His main issues are processing speed and receiving verbal instructions. This is so very true. I see it in everyday life! I will talk to this therapist tomorrow about the plan of action to improve not only these things, but also his math ability (which on the test was at about a 5-6 grade level). Also, this therapist will let Joel know when he is ready to tackle a college class or two. He is really looking forward to going to school, but very apprehensive about failing. Luckily, the doc can write a letter allowing Joel more time on tests, additional help, and possibly a person to be his note-taker. I would LOVE to take classes with him and be his note-taker. I wish that could happen.

Mental Health: Joel doesn't have anything haunting him from his past, but he does have the normal stress, pressure to do well, anxiety, etc. For you and me, the effect they have on our cognitive functioning is not noticeable. For Joel, these things GREATLY effect his brain. Because of this, as much as he doesn't like the stigma of going to the Psychologist, he will learn coping procedures. This should have positive long-term effects! I haven't been 30, but I'm assuming it's more stressful than being 25. :)

The Ominous Filter: Remember when Joel's doc at Palo Alto attempted to remove the filter from his intra vena cava? He found that it was slightly tilted, and therefore, fused to the wall of the vein. He was afraid that if he removed it, it would puncture the vein, having fatal results. Well, the staff at Bethesda wants the filter out, so Joel will go down to Balboa for an assessment. The doctors there will decide whether they recommend it be removed, if they want to do the surgery, or if they want to send Joel to Bethesda for the surgery.

Vision Therapy (the workings of the eye - tracking objects, range of movement, etc): I'm very disappointed with this! When Joel left Palo Alto, his vision therapist was adamant that he continue therapy. Camp Pendleton was fully aware of this, but nothing has happened. I brought it up in about Jan, and again, NOTHING happened. Now I brought it up to his doctor who will talk to the same person who has failed to do anything in the past about it. We'll see if anything happens. You can guarantee I'll be following up on that, even when I'm gone.

Weight Gain: Joel has been working out about 4x a week and has been eating generally well, but he's consistently gained weight since he arrived at PTRP. He is exploring reasons at this point. Today he has a blood draw, testing his Thyroid. If that doesn't turn up as the problem, he has the opportunity to go on a diet plan that has proven to restart a metabolism that has been slowed by certain chemical elevations in the body. His buddy went from 230 to 175 on the program. Joel is about 225 and should be around 175, so we're hoping it'll do the same for him. In addition to this, he plans on beginning a 90-day workout program through Wounded Warrior Battalion that should definitely get his muscles back into shape. We'll keep you updated.

BRAIN!!!!: Joel still has and will always have Hydrocephalus. Once the fluid pockets are expanded, they don't go down. However, they want to ensure they don't get bigger, because if they do, it means there might be an obstruction somewhere. So far, there is no change in the size of his fluid pockets (that is NOT the technical term). The left one is still bigger than the right. The left side also has the same size of dead tissue in the frontal lobe area. Another sad thing to see was a bruise on the right side of his brain on the top near the back. This is consistent with previous MRIs. The bad news came when we looked at the lining of his brain. It is the area outside of the brain, but inside of the skull. On the MRI it should look like a black line surrounding the brain. It's normal on the right side, but it's slightly gray on the left side. This is Subdural Accumulation. Because this is a negative change in the state of the brain, Joel will have it monitored at Balboa for months to ensure it doesn't get worse.

Joel was in this meeting with me. As soon as we left, he said, "OK, tell me what we talked about." It's those moments that make me realize how slow his processing speed is and how poor his short-term memory is. Family members have a HUGE part in their loved one's recovery, as they see them in everyday situations when they are not being tested.

As for me, I'll be leaving in a few days. I'll be gone for a year. I'm very sad about leaving Joel, but I'll do good work this year and return safely to him. I'll also maintain as close a grasp on his medical updates as possible, which probably means emailing doctors and therapists every once in a while. :) For my last weekend here, both my family and Joel's family are coming down. We'll probably hang out in San Deezy (aka San Diego).

Lastly, Joel wanted me to ensure you all knew that he recently asked company personnel, "Would I be able to pursue government-funded dance opportunities?" He was told, "Yes," and responded, "Good, because that's my plan: to dance my way to freedom." Seriously. This happened.

I'll write as soon as possible.

HARCH!!! (Joel made me put that.)