I flew back to London this afternoon and, as I write, I am back in our London home. This is the first time I have written for the blog. I thought it was about high time! William is out from Harrow tomorrow for the weekend. I will be back in Feldkirch Monday afternoon.
Paul remains in ICU in Feldkirch and is currently stable.
I left the hospital with the clear understanding that I do not need to communicate with the medical team over the weekend unless there is a change in his condition or a decision needs to be taken. I have developed a very trusting relationship with the doctors on ICU. They have the measure of me, and I of them.
I continue to be hugely fortified and sustained by all the love, support and true acts of friendship and kindness that has and is being showed to Paul and me, and our two precious teenagers, Charlotte and Will. I am proud of the way both of them are conducting themselves and continuing on in their busy lives.
The friends and family who have been able to visit Paul in Feldkirch, and the many offers of others to come, has been heart warming. This week I truly believe that Paul was able to 'connect', for the first time, with the familiar voices and faces of Mike Palmer, Keith Falconer and Margie Ogilivy Stewart.
I am also truly blessed to have so many family members who are able to help me continue in the areas that Paul was so able in. Paul and I are also very fortunate to have an excellent and selfless team in Carl and Lisa, who are continuing the management of our home, The White House of Aros, Mull, which I know so many of you know.
I ask you all to follow my example of strength, courage and above all, patience. I thank you all, from the bottom of my heart, and on behalf of Will and Charlotte, for your continuing love and support.
PENNY
Thursday, March 12, 2009
Wednesday, March 11, 2009
Feldkirch, 9-11 March 2009
I arrived here three days ago not knowing what to expect - just wanting to be here for Penny and Paul at a time of great shock and uncertainty and - as the blog reveals - so many of you out there. It's been a huge privlege for me; harrowing, yet at times, particularly yesterday, very moving.
Yesterday afternoon - for the first time since the accident - Paul responded to Penny, which in a way was recognisable. A small, but magic moment. Let's hope there will be more of these to come. It's going to be a long and difficult journey.
Let me start with my first impressions coming face to face with Paul. He is recognisable. The impact was taken on the left hand side of his face, which has been brilliantly rebuilt during the first few days in the critical care unit. There is no visible scarring on his face. Naturally, due to the trauma to the left side of his head, the swelling is going to take time to reduce. The team of doctors are now waiting for the clues of connection and contact - there are a few, but this is where time and patience from everyone is key.
On Monday night the surgeons inserted a small tube to drain fluid from the brain - this in the skull just above his right forehead. He will remain in ICU while this drain is in place. This is all due to the trauma of his head/brain injury.
Paul really has had a most severe accident. Following his very swift helicopter transfer to Feldkirch hospital, the ICU team has done an amazing job to prevent the build up of cranial pressure in the brain during the vital first few hours and days after the impact. No one could have done a better job, and he is being cared for on a one to one basis - they have now got him to the point where he can begin the long journey to the next stage. At the moment no one is able to say where that will be; with severe brain injuries of this type, each case is individual and there are no predictors.
The good news is that he is breathing normally. The drug induced coma and sedation is over, his cranial pressure is normal, and he has pain relieving drugs to relieve any discomfort and distress. He is being fed through a tube into his stomach which is a lot more comfortable for him. He is wired up for all the normal electronic functions we expect in ICU. All vital signs are currently normal.
The best analogy for his condition seems to be that he is like a new born baby - unable to control his body or communicate with the outside world. The trauma his brain has received has broken all kinds of connections. The dedicated team at the ICU has tried to ensure that the "hardware" has survivied so that the neurons still stand a chance to reconnect and recover - it is only time now that will allow the "software" to try to make sense of things again; the motor functions, the memory, the logic and the emotions. All of this is likely to take many long months - and even then the results in all these areas are uncertain. Clinical uncertainy is a fact of life for a long time, which is frustrating and frightening for all of us who love Paul and Penny, Charlotte and William.
How is Penny coping in the face of all this distress and uncertainty? From my observation.... amazingly well.
She is a military commander, operating from her forward HQ in the hotel Alpenrose, here in Feldkirch. Surrounded by two mobiles and her laptop her days are very busy; after breakfast we spend an hour on emails, two and half hours each morning at the ICU talking to Paul and the staff with whom she has built a great relationship of affection, trust and information. Back to HQ for lunch and more communications, then back to the ICU to 7:30pm before dinner at HQ and then bed. Of course she couldn't do any of these things without the skilled and willing help of so many people - the support I have seen has been wonderful from so many family members, friends and business contacts of Paul's and the people of Feldkirch. Inspirational in so many ways. And, like any commander, she has to plan the next move. After so much uncertainty about Paul's survival, living one day at a time, the focus will slowly switch to the longer term.
Now...., back to this little bit of magic I mentioned at the start. I have tried to paint you a picture of a seriously ill man who is alive, stable but really not himself. This is the situation as I see it. But on Tuesday evening something significant happened that suggests that there might - just might - be a smidgen of hope.
When we arrived on Tuesday morning, Paul had been put in a kind of slung arm chair so he was able to sit up. An important step in his recover journey; this he seemed to find very tiring. Helga, his nurse, gave him his first drink from a cup - another small step. When we returned in the afternoon he was asleep and Helga awoke him. Penny and I nattered away for an hour or so, not talking to him directly, and then Penny spent time massaging his feet on Helga's instructions. This was a great success - blood pressure went down, pulse dropped slightly and eyes closed. After she had finished, Penny planted a little kiss on his lips - and then it happened - with the close proximity of her face, he responded by pursing his lips. This is really the first time I saw him respond to visual external stimulus. Not once, but several times. We were both so excited, Penny went and grabbed the team to witness it!
It's on these small steps that we build to the next with a little more hope.
Mike Palmer, 11 March 2009
Yesterday afternoon - for the first time since the accident - Paul responded to Penny, which in a way was recognisable. A small, but magic moment. Let's hope there will be more of these to come. It's going to be a long and difficult journey.
Let me start with my first impressions coming face to face with Paul. He is recognisable. The impact was taken on the left hand side of his face, which has been brilliantly rebuilt during the first few days in the critical care unit. There is no visible scarring on his face. Naturally, due to the trauma to the left side of his head, the swelling is going to take time to reduce. The team of doctors are now waiting for the clues of connection and contact - there are a few, but this is where time and patience from everyone is key.
On Monday night the surgeons inserted a small tube to drain fluid from the brain - this in the skull just above his right forehead. He will remain in ICU while this drain is in place. This is all due to the trauma of his head/brain injury.
Paul really has had a most severe accident. Following his very swift helicopter transfer to Feldkirch hospital, the ICU team has done an amazing job to prevent the build up of cranial pressure in the brain during the vital first few hours and days after the impact. No one could have done a better job, and he is being cared for on a one to one basis - they have now got him to the point where he can begin the long journey to the next stage. At the moment no one is able to say where that will be; with severe brain injuries of this type, each case is individual and there are no predictors.
The good news is that he is breathing normally. The drug induced coma and sedation is over, his cranial pressure is normal, and he has pain relieving drugs to relieve any discomfort and distress. He is being fed through a tube into his stomach which is a lot more comfortable for him. He is wired up for all the normal electronic functions we expect in ICU. All vital signs are currently normal.
The best analogy for his condition seems to be that he is like a new born baby - unable to control his body or communicate with the outside world. The trauma his brain has received has broken all kinds of connections. The dedicated team at the ICU has tried to ensure that the "hardware" has survivied so that the neurons still stand a chance to reconnect and recover - it is only time now that will allow the "software" to try to make sense of things again; the motor functions, the memory, the logic and the emotions. All of this is likely to take many long months - and even then the results in all these areas are uncertain. Clinical uncertainy is a fact of life for a long time, which is frustrating and frightening for all of us who love Paul and Penny, Charlotte and William.
How is Penny coping in the face of all this distress and uncertainty? From my observation.... amazingly well.
She is a military commander, operating from her forward HQ in the hotel Alpenrose, here in Feldkirch. Surrounded by two mobiles and her laptop her days are very busy; after breakfast we spend an hour on emails, two and half hours each morning at the ICU talking to Paul and the staff with whom she has built a great relationship of affection, trust and information. Back to HQ for lunch and more communications, then back to the ICU to 7:30pm before dinner at HQ and then bed. Of course she couldn't do any of these things without the skilled and willing help of so many people - the support I have seen has been wonderful from so many family members, friends and business contacts of Paul's and the people of Feldkirch. Inspirational in so many ways. And, like any commander, she has to plan the next move. After so much uncertainty about Paul's survival, living one day at a time, the focus will slowly switch to the longer term.
Now...., back to this little bit of magic I mentioned at the start. I have tried to paint you a picture of a seriously ill man who is alive, stable but really not himself. This is the situation as I see it. But on Tuesday evening something significant happened that suggests that there might - just might - be a smidgen of hope.
When we arrived on Tuesday morning, Paul had been put in a kind of slung arm chair so he was able to sit up. An important step in his recover journey; this he seemed to find very tiring. Helga, his nurse, gave him his first drink from a cup - another small step. When we returned in the afternoon he was asleep and Helga awoke him. Penny and I nattered away for an hour or so, not talking to him directly, and then Penny spent time massaging his feet on Helga's instructions. This was a great success - blood pressure went down, pulse dropped slightly and eyes closed. After she had finished, Penny planted a little kiss on his lips - and then it happened - with the close proximity of her face, he responded by pursing his lips. This is really the first time I saw him respond to visual external stimulus. Not once, but several times. We were both so excited, Penny went and grabbed the team to witness it!
It's on these small steps that we build to the next with a little more hope.
Mike Palmer, 11 March 2009
Monday, March 9, 2009
Sunday, March 8, 2009
My Weekend 6th-8th March
I spent the weekend with my quite 'inspirational' sister who has taken to the pretty Austrian town of Feldkirch with real purpose. Penny has set up a temporary 'home' in a very charming family run hotel, the Hotel Alpenrose, where she has already been mistaken for the Hotel Manager and where some of the guests no longer dare to complain about a lack of hot water at breakfast! The locals are incredibly kind and they will miss her when she eventually returns to the UK.
Having seen and spent time with Paul, I have to be honest and admit that this is as tough as it gets. He is being cared for quite wonderfully and so professionally and he has to possess the most incredible will power, courage and determination to be where he is today. This is due to the skill and the gift of the medical team. Penny, Charlotte and William are deeply appreciative of the overwhelming love and support that is flooding in from all over the world.
Penny urges patience over the coming weeks and months. It is still far too early to determine where we are heading, but there remains hope and the toughest piece is having to wait. It is going to be many, many weeks before there is any real news and we are able to understand better the full extent of his injuries.
Paul is strong, fit and taking his time. His recovery is going to be 'peaks and troughs'.
I have learnt in the 50 years that I have known my darling sister, that you should never 'under-estimate' Penny.... and my goodness this weekend has only further re-inforced that view! As I write, we are into Day 18 and we have a long way to go.
Please keep your prayers and wonderful love and support coming - particularly via this 'blog'.
Graham - Feldkirch AUS
Having seen and spent time with Paul, I have to be honest and admit that this is as tough as it gets. He is being cared for quite wonderfully and so professionally and he has to possess the most incredible will power, courage and determination to be where he is today. This is due to the skill and the gift of the medical team. Penny, Charlotte and William are deeply appreciative of the overwhelming love and support that is flooding in from all over the world.
Penny urges patience over the coming weeks and months. It is still far too early to determine where we are heading, but there remains hope and the toughest piece is having to wait. It is going to be many, many weeks before there is any real news and we are able to understand better the full extent of his injuries.
Paul is strong, fit and taking his time. His recovery is going to be 'peaks and troughs'.
I have learnt in the 50 years that I have known my darling sister, that you should never 'under-estimate' Penny.... and my goodness this weekend has only further re-inforced that view! As I write, we are into Day 18 and we have a long way to go.
Please keep your prayers and wonderful love and support coming - particularly via this 'blog'.
Graham - Feldkirch AUS
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