Close of December, medical update

Hello friends,

We hope you are enjoying the holidays with family and loved ones near and far.
Denver has become quiet again with a blanket of beautiful snow this week.

Amy continues to work hard in her many therapy appointments. Her days are very full with occupational therapy, physical therapy, speech therapy, nutritionists, hair washes, rehabilitation doctors, meals, and neurosurgeons. Sleep and privacy for Amy are treasured commodities.

Amy has a long road ahead to rebuild neurological connections and find new ways of cognitively processing and adjusting to her injuries. Amy's brain is young and her body is that of a professional athlete, however the brain damage she has sustained is severe and bi-lateral. We all wish we had a crystal ball. Right now simply sitting up in a wheelchair takes a great deal of effort for Amy, physically and cognitively. With only one side of her body working and the trauma of her accident's effect, we are working day by day to expand Amy's world again. This is her life and we are trying to give her the tools to rebuild it in all the possible direction she may choose.

Her courage continues to give me strength everyday. The arrival of Mary from California again has given us all peace as we watch Amy attempt to communicate with her by producing new words and facial expressions, calmed by her presence and voice. We miss Cheryl and Catherine's friendship and helping hands, but stay up to date on news from home including the birth of a healthy baby girl to Aaron and Grace, childhood friends of Amy, Catherine, and I's.

We are looking forward to our move to an intensive cognitive rehabilitation hospital. Amy will be part of a 9am-5pm therapy program with other brain injury survivors, mostly close to her age, throughout the week, followed by weekends for rest.

mid-december update

Today, for the first time since arriving at denver health hospital in October, Amy left her room in a wheelchair to sit on the fourth floor with a beautiful view of snowy down town Denver.

Over the weekend while childhood friends visited from CA, Amy ate her first full meals sending us running to the grocery store.

The physical therapy team continues to work on the right side of Amy's body which was affected most severely from the accident. Left side brain injury impacts right side physicality and visa-versa.

We met this week with a nurse from the traumatic brain rehabilitation center where Amy will be living for intensive therapy for about 6-8 weeks with family. To our delight Amy is nearly strong enough to make the move and we will do so after the holidays. This is the news we have been waiting for.

Amy's room is decorated with beautiful snow flakes and paper cranes made by friends. I'm looking forward to showing Amy posters for the January dance benefit when they are ready. We wish you all safe snowy holiday travels!

2nd week of december update

While Amy sleeps I'd like to quickly update you all on her recovery.

No longer in need of either oxygen support or a neck brace, Amy is resting more peacefully. Although still at a high risk for infection, it is wonderful to see Amy exhibiting more physical stability and thus directing more energy to therapy. Her chief neurosurgeon stopped in yesterday and thought her head was healing well.

Amy's days are full: she has a large therapy team working with her and family to rebuild neurological pathways, empower Amy to have choice and expression, and regain practical abilities like being able to fully extend her spine, hold up her own head, and dangle her feet off of the bed. We are working to help relax Amy's right arm more and her left hand has learned the first four letters of the sign language alphabet. Even though Amy may not be able to spell we are hoping to give her as many avenues to work on brain reactivity, the process of learning, and sequencing.

My apologies for the delay in posting photos here of the dance benefit. A computer glitch has set me back.

We are wishing you all a happy winter solstice!

sucessful surgery

Amy, true to her nature, has made it through her third brain surgery this week. We are all grateful for the care and attentiveness of the medical team working with her.

She will need time to recover and regain strength and responsiveness after this week's hard work at which point she can begin again with her therapy team.

Please check the blog this weekend for some photographs of the moving dance benefit performance put on in Amy's honor a few weeks ago. The expressions of love for Amy keep her and us all strong.

first week of december, medical update

My apologies everyone for the delay in updates.
Amy's progress is less dramatic than in the first weeks after her accident - this is not a bad thing!
We are beginning what will be a 6-18 month process of intensive therapy and re-programing for tasks such as communication and eating among other things. This takes a lot of energy for us all, and mostly from our brave Amy.

Amy's spirits remain good. She smiles, shrugs, gives thumbs ups, and continues to hold hands with determined strength. At the arrival of every card, poster, or picture she lights up and observes each attentively.

Physically Amy remains on a feeding tube as she has to re-learn how to swallow. She is still receiving oxygen support and is on another round of anti-biotics for her current lung infection. It takes a great deal of energy for her body to deal with excess cerebral fluid that is not being properly absorbed and it is likely that a surgery next week will help her deal with this problem for the long term.
Amy's vitals are all stable, however she is highly susceptible to any bug or infection from the outside world with her highly compromised immune system. Please continue to send her your love in emails to be read to her, cards, and pictures of you and loved ones.

Cognitively Amy is about one month into what doctors tell us will be a 6 month process just to reach her new baseline. Our current priorities mostly deal with communication and language. Because Amy was hit on the left side of her brain it is very difficult for her to recall words and even the shape that your mouth makes to pronounce sounds. Amy's speech therapist is working with her and family to access other pathways of potential communication on the right side of her brain such as music and tapping out rhythms. Although, because of an added component of Amy's trake which allows oxygen to be pushed through her vocal cords, she is physically capable of speech it is unlikely that we will hear her voice for a very long time.

When Amy is stable enough, able to participate in three hours of therapy a day, and has had the surgery to return a piece of her skull (which was removed to alleviate pressure from swelling when she first arrived at the hospital,) she will be moved along with family to a live-in brain injury rehabilitation hospital.

I want to emphasize that my sister still looks like herself and behaves like herself. This tragedy has altered her life in significant and undeniable ways which we are all struggling to comprehend, but Amy is still Amy - bright eyes, full head of wavy hair, delicate dancer arms, simply just as beautiful as ever - and loves with the same sincere, tenacious love she has taught us so well over the years. 

We sincerely appreciate your continued support, concern, love, and enthusiasm for Amy. We will continue to update this blog, however if you have specific questions or are concerned between updates please email myself (Jess, writer of these blog updates) at j.genevievebailey@gmail.com, instead of Deanne who needs to focus all of her attention on Amy's health and does not want your emails or calls to go unanswered.

Thanksgiving week, medical update.

Amy continues to settle into the PCU. The walls are now decorated with the beautiful posters made and sent by all of you, and we try to keep music playing.

Amy is fighting a new lung infection. She recovered well from her last case of pneumonia, and while it is not unsurprising given her lengthy respiratory struggle, we are saddened that she has to fight another side battle.

For some of us gratitude is vastly easy this week - for her life, her love, her irreplaceable nature. For some of us I know gratitude is hard - her pain, her undeserved suffering, and her different life.

What is fact is that Amy loves Thanksgiving.

So for no more complex reason then this, I assure you she will be very disappointed if we all forget to eat.

update: week four.

Good afternoon from the Denver Health Progressive Care Unit!
Amy has successfully moved from her ICU room to the Progressive care unit. This unit is still technically part of the ICU and staffed by extremely experienced nurses, however the move is a nod to Amy's growing stability. She will stay here until she is strong enough - physically and cognitively - to move to a brain injury rehabilitation hospital.

Amy's new room is larger and we are excited to decorate it with the beautiful posters, photos and letters which keep arriving for Amy. Amy responds with attentiveness and smiles to cards and envelopes - opening them with her left hand. Please keep sending her mail (I will update the address on this cite under the tab "mail for Amy." If you've recently sent to her ICU address, don't worry: The hospital staff has been bringing all her mail to us from the old room.)

Although Amy's health is improving and her vitals stabilizing, she is still in a very delicate transitional period. Because she has suffered several complications (including a challenging lung infection and respiratory disorder, along with blood clots and air between her lungs and chest wall,) her immune system is still compromised. Especially while she remains on a course of steroids, it is vital that she is not exposed to any colds, coughs, or germs which could easily overwhelm her.

Although Amy has been moved to the progressive care unit, her Nurses and Doctors are emphasizing the importance of slowly building Amy's world again from the familiar to the less familiar. Due to this cognitive rehabilitation strategy, Amy's fragile immune system, and her need to work with physical therapists and then have steady periods of rest, visitation is still being restricted to family. Amy's physical therapists have emphasized how much she will need in person encouragement a little down the road.

However, Amy is a person who deeply values relationships. Although she is still finding ways to communicate with us as she recovers, it is clear that letters and cards comfort her.
In gratitude always for your loving support and enthusiasm for Amy's recovery.

In gratitude

On Sunday November 11th, the Colorado Dance community gathered to dance for Amy.

Over ten companies presented work in honor of Amy's recovery and dedication to dance.

With a standing room only performance, over $6,800 was raised for the Amy Hollinger Benefit Fund. 

The sincerity of passion in the dancers and the audience was beautiful to behold and steadied our hearts. 

Many thanks to all - to those who danced, to those who handed out tickets, to the Dairy Center for the Arts, from stage managers to choreographers to financial managers, each and every person who took a seat or a stand in the audience to celebrate Amy. 

We are most thankful. 

Please check back for pictures of the event. 
If you would like to be involved in the next Amy Hollinger recovery celebration please stay tuned for more information about the upcoming January 19th performance.

week/wekend update

Amy's week passed well in the ICU with the doctors slowly bringing her off her ventilator and some of the heavier medications. As she becomes more aware and physically interactive she will see her team of occupational, speech, and physical therapists more often.

Unfortunately, just as Amy was about to be moved to the hospital's progressive care unit a large blood clot necessitated an operation. Amy is recovering well back in the ICU. Given the demands of surgery on the body we are helping Amy stay calm and sleep as much as possible over the next few days.

Amy loves opening cards and envelopes. The good wishes, kind thoughts, prayers and love that you are all sending fill her room with such peace.

As the weekend progresses we are very excited about tonight's dance benefit in Boulder for Amy! Please join us this evening as Colorado's leading companies dance for Amy. More information can be found a few posts down on this blog.

a good tuesday

As we spend our third week in the Denver Health ICU, Amy has lifted our hearts yesterday and today with her liveliness, affection, and, frankly, suborn determination.

Lessening Amy's sedation is a very delicate process, however today she was deemed strong enough for doctors to negate her heaviest med entirely and cut another in half over last night. Now that she is awake more than asleep, Amy has begun the process of exploring her environment and learning what her current confines of interaction with it are.

Watching the change and seeing glimmers of her personality and facial expressions has been indescribable today. She consistently beats Jess at thumb wars, follows Mom around the room with her eyes, fingers her mail, and glares indignantly at her new respiratory therapist. Tomorrow Amy will meet with a physical therapist and hopefully continue to require less pressure on her ventilator. Her physical condition is still very delicate, and for all the new found fun, rest is paramount.

She breaks my heart and mends it all over again every time she gives me a one-armed hug. It's been a very blessed tuesday in denver.

We are all accompanying Amy on a long road to recovery which will no doubt be scattered with temporary set-backs, continued fears, and a steep learning curve for all of us.
However, what we do know for sure, admits much uncertainty, is that Amy knows she is loved and can consistently and forcefully communicate her own love in return.
We want everything for Amy, but, at the end of the day, this is everything.

weekend/monday update

Over the weekend Amy was resting well, staying calm and occasionally opening her eyes. As Amy was injured on the left side of her brain, her physical mobility along the right side of her body is a concern. However, on Saturday Amy lifted her right arm for the first time and today the right side continues to improve!!

Many of you have been asking about Amy's level of consciousness. "awake" is a complicated word right now. Amy is both heavily sedated in order to facilitate her physical healing and her brain is recovering from large amounts of internal swelling and trauma. She is, however, reactive towards family. She alternatively becomes agitated and then calms, holds our hands and squeezes them, occasionally even strokes our faces. Although her eyes can not be said to track fully yet, she does now move them when open and leans towards us. The majority of the time her eyes remain closed. Today Amy was quite alert for a period of time and had her old strength and determination back to pull out her many tubes and monitors. She's always had an independent streak...

The nurses and doctors are trying to settle Amy into a state where she will be at ease and 'asleep' if undisturbed, letting the ventilator do her breathing, but where she will 'awaken' and become agitated and hopefully logically responsive if disturbed. Bringing Amy back into a realm of potential conscious communication is a slow and delicate process dependent on many factors.

Today Amy is working hard to initiate her own breaths. The ventilator is still helping her significantly - pushing air into Amy's lungs when she asks for it and keeping pressure in her lungs to prevent calapse. Amy still has a condition called ARDS (acute respiratory disorder syndrome) which is a very serious condition, however today's move to let her set her own breathing is an encouraging one.

Amy's days include lots of napping, foot massages and stretching from mom, new finger games with jess, tubes and meds and the beautiful letters and pictures taped to her wall.

medical update, Nov. 1st

As Amy remains in the ICU this week, as she will for approximately the next two to three weeks, the nurses continue to focus on clearing her lungs and regulating her breathing.

Although Amy is young and has very strong, athletic lungs, her respiratory system has been of the greatest concern this week. Currently Amy is resting better and is being weened off of added sedation and slowly receiving less added oxygen. However, she will remain as heavily sedated as necessary to keep her breathing regulated so that her lungs can heal, drain fluid, and fight the infection.

Amy's recovery process will likely include week to week complications as we are experiencing now. Because of how slowly the brain heals and the time it takes it to re-organize its processing of the outside world, we cannot expect day to day changes in Amy's cognitive reactivity right now. The goal for the near future is to stabilize Amy's health in the challenging circumstance we are faced with. Once her overall health stabilizes more, and she is no longer fighting an infection or a fever, then her sedation can begin to be lessened. When this sedation is again lessened we hope she will begin to react again towards family as she had last week and weekend.

At first Amy's condition was changing hour to hour and then day to day in this recovery process. Now we need to adjust our expectations to day to day and week to week as her body works on its own overall healing. Amy's condition is still very serious, but her vitals are currently stable.

It is important for us to remember as Amy's loving friends, supporters, and community that her brain is experiencing an overload of stimulation in the ICU environment and as it begins interacting with the world again. Brain injury patients need to be kept calm and relaxed at all times in order to facilitate the most natural healing and cognitive processing. Amy will remain in the ICU, then spend a period of weeks in a less intensive care unit in the same hospital before being moved to a brain injury recovery center. Amy will not likely have another MRI for about a month as the brain has begun a long process which will be monitored closely for changes over the next 18 months.

In gratitude always for your love and support.

Dance benefit!

The first of many to come:

Dance Performance Benefit for Amy! 

Please join us on November 11th, 7:30pm 

at The Dairy Center for the Arts (2590 Walnut Street Boulder, CO 80302)

for an amazing evening of dance to raise funds to support Amy's recovery. 

{Suggested donation $20.} 

This is the first benefit put together by dancers and dance companies throughout Amy's community. A full list of dancers and companies performing in this benefit will be available on the blog soon.

Some reserved seating is available at this link: https://docs.google.com/spreadsheet/viewform?formkey=dGlFS3R5aDFlZTAxTHY1MmJaWXh1TVE6MQ

Weekend update

Amy continues to fight a fever and a lung infection.

On Sunday, after some challenges new IV catheter lines were placed in her arms which is less invasive then her old central line which was due to be removed for safety at the 8 day mark. She is still on her ventilator and is receiving oxygen to help her breath with the compromised left lung. There has been no change in her reactivity.

Amy's fever is high. The nurses are evaluating all possible sources of infection. It is possible that Amy's body is just re-learning how to control her temperature. However, In order to keep her heart rate low and breathing steady she needs rest.

Amy responds to visitors with an elevated heart rate and agitation which is good. However, at this time Amy does not also respond to visitors trying to calm her. Only family have been able to get Amy back on track when she becomes agitated.

Amy has demonstrated increased fine motor skills with her left hand and appears confident when touching Jess's face. She has also found a new favorite way to hold hands.

Amy will likely be in the ICU for a few more weeks as her condition continues to be labeled as critically stable. Amy knows you all love her and she will need you to hold her hand when she is in a less intensive care unit and at a lower risk of outside illness, cold, and flues.

Please keep up with Amy F., Kathleen, Oliver's and others incredible effort to put on a dance benefit in honor of Amy. More information to come on the blog, but for now here is the facebook page. We are so excited about this.

saturday pm update

Good evening from Denver everyone,

Amy is doing well, however she is running a fever with a manageable lung infection. This is common for someone on a ventilator as they cannot regulate their own fluids properly. The doctors are not concerned and are starting her on a course of antibiotics.

Amy is back on her ventilator and oxygen support today as her lungs need time to rest from how persistently she was trying to breath on her own yesterday. Our girl is a stubborn one. We've got to make sure she rests. The nurses have remarked on how strong her athlete's lungs are.

Given this infection and the restlessness from the fever, Amy needs rest. Please write to her and keep her in your good thoughts.

Amy's room is looking beautiful thanks to all the homemade posters, photographs, and notes you all have sent.

Amy is very curious and determined to explore objects with her left hand. Jess has attached one of Amy's childhood stuffed animals to the bed so she has something to hold on to. It is encouraging to see how strong her grip is and how gentle and fine her motor control can be when plays with Jess's hair.

Please check back with the blog soon to learn about preliminary details for dance performances in honor of Amy.

Contributing to the Amy Hollinger Benefit Fund

Her caring friends in Denver have established a trust at a local bank. There are three ways to donate To the Amy Hollinger Benefit Fund. Here's the info:

1. Go to any First Bank and let them know that you would like to make a donation to the Amy Hollinger Benefit Account

2. Mail a check.
Make the check out to The Amy Hollinger Benefit Account and mail check to:
1st Bank
PO Box 150097
Lakewood, CO 80215

3. Electronic funds transfer online. The name of the institution is First Bank of Colorado
The routing number is: 107005047
The account number is: 5021216532

 

All funds will be used towards Amy's recovery. Thank you all for your support.

Status Update

Amy is still stable and slowly improving. She is running a mild fever, but the test run to date do not indicate that she has an infection, so that's good news. She continues to move around and wake more frequently, which is also a good sign.

Limiting Visitors

The word from the medical professionals at this time that we need to limit the number of visitors that are coming to see Amy. She gets stimulated, which leads to her heart rate and blood pressure rising as well as some agitation as she tries to interact. They have requested that visiting be limited.

Amy's family requests that visitors wait until she is further along in her recovery and is more capable of interacting with her visitors. After they see some progress, some very limited periods of time when visitors may be permitted will be announced.

In the meantime, please continue to send positive thoughts to Amy. The posters and photographs and cards are hanging up in her room. They are a great testament to how much she is a part of the community here in Denver.

Less Sedation, More Reaction

Today was a great day of progress for Amy. She was taken off one of her sedatives, which is a great measure of how far she has come. Less sedation means that the doctors will be able to get a better sense for how well she is following commands and moving her body.

The arrival of Jess from Berkeley had Amy very excited. Amy held Jess' hand and squeezed on multiple occasions. It was clear that Amy wanted Jess to stay with her.

This afternoon, Amy's intubation (tubing down her mouth and throat) was shifted to a tracheotomy, where the airway is routed through a small incision in her throat. The doctors felt that this was a step in the right direction as it is often easier to wean patients off artificial ventilation with a tracheotomy. The procedure to put in the trach (which is how many of the medical staff refer to it) went very well.

Amazing Gathering

Thanks to everyone who came out tonight despite the cold and snow to join in supporting Amy.

A great crowd of friends of Amy met in the chapel at Denver Health Hospital. We talked about Amy, efforts underway to support her across many fronts. It was great for her out of town family and friends to see the fantastic outpouring of support for Amy.

Gathering TONIGHT 10/25

There will be a gathering tonight, Thursday 10/25, at 9:30 PM at the Denver Health Hospital in the Chapel. This is not a service, just a gathering of friends to be supportive and share in hopes for a full recovery. All are welcome to come and join in their support of Amy.

Please drive carefully!

Calendar link

To faciliate sharing important dates, such as when she is expected to shift out of the SICU to the Progressive Care Unit (PCU) and any gatherings for friends in Denver, a public Google Calendar has been created. The link is below. The calendar should also appear in web searches.

Given the limits around who can visit, out of town visitors are encouraged to send an email to amy.choe@gmail.com to avoid overwhelming the SICU. As visitors are expected, the calendar will be updated to indicate when out of town visitors will be in town.

Tonight, Thursday, October 25, at 9:30 PM, there will be a gathering at the Denver Health Hosptial Chapel. Local friends are welcome to join and share their support and love of Amy.

https://www.google.com/calendar/embed?src=9lhgdtvaq4sugudmo2kbsb40c8%40group.calendar.google.com&ctz=America/Los_Angeles

Update from 10/24

I am re-posting the update sent via email here so that other people can see it.

At some time between 10:30 PM to midnight Saturday, October 20th, Amy Hollinger was hit by a car while crossing the street near her home on Downing Street in Denver. The driver was not under the influence of drugs or alcohol and stopped immediately to provide assistance and call for an ambulance. Due to the lack of identification found on her after the accident, Amy's mother and friends did not find out about the incident until late Sunday, when she was missed and everyone began to worry and search for her.

 

Amy was brought to Denver Health Hospital, which is the region's level 1 trauma center. Amy was taken into surgery very quickly to relieve significant swelling and pressure in her brain due to the trauma of the impact. While she has other injuries, the head trauma is by far the most significant and is the primary concern. Neurosurgeons performed a craniotomy to remove a piece of her skull to relieve the pressure of the swelling. She also has some lesser injuries, including a minor laceration to her liver and some road rash to her limbs, none of which are life threatening and all of which the doctors expect to heal on their own without medical intervention.

 

The surgeons have been monitoring Amy's progress closely since Saturday. The swelling of Amy's body, especially her head, has improved throughout the week. She is on a ventilator but she is doing some breathing on her own and she is responsive to voices, especially her mother's, when the sedation has been lowered. She remains heavily sedated to give her brain and body rest to heal. Initial review of the MRI of her brain today showed that she has significant swelling on the left side, as expected. There are initial signs that there were areas of her brain which were deprived of oxygen due to the enormity of the pressure from swelling. The doctors are cautiously optimistic as to her prognosis and continue to emphasize that visible progress may take weeks to see. They have also reiterated that Amy's age and superb fitness are definitely in her favor.

 

At this time, the family is waiting for Amy's condition to improve to the point where doctors can more thoroughly assess her and the extent to which she may be expected to recover. With neurological injuries like this, the doctors have repeatedly emphasized that improvements may be seen for well over a year. Amy's recovery may be long, but they are optimistic as to how much function she may recover.

Amy is currently in the Surgical Intensive Care Unit (SICU) and may be visited by up to two visitors at a time as controlled by the SICU Receptionist. She is unable to receive flowers.

For those of you who do not know me, my name is Amy (Ah-mee) Choe and I am a family friend, based in Sacramento, CA. I am currently in Denver with Deanne through Friday. 

I will be setting up a blog this week where updates will be posted about Amy Hollinger's progress (with information from the hospital staff) and where friends will be welcome to post comments and thoughts. Access to Amy's condition is limited and to allow everyone to stay informed, and information will be posted as it is available and Amy's family permits.

I will also be setting up a calendar so that out of town guests can try to coordinate their visits so as to avoid overwhelming the relatively limited access to Amy's hospital room.

Deanne's access to email is somewhat limited, but she is accessing it as often as she is able. She may not be responding to all emails, but she does see them. She is also limited in her ability to answer her phone as use of cell phone is limited in the hospital. She will be listening to but may not respond to all voice mails.

 

Another family friend has established a trust at First Bank in Denver. The fund is the Amy Hollinger Benefit Fund. The fund has to be named in full to be identified for bank staff.
 

Please forward this on to others. If you are receiving this, it is because either Deanne or I had your email address. I do not anticipate sending out more than one additional mass email, which will contain the URL for the blog to which Amy's progress will be posted. Those who did not receive this email directly from me are welcome to send me your email address and I will make sure to send you the notification of the blog.

Thank you for all your well wishes for Amy Hollinger's recovery.