Lisa's Account Of My Accident

My great friend and tri training partner, Lisa Mumford, also blogs. You can catch a window into her mind (with her great writing skills), see some adorable kids and read about her first rate family here. When I get back into town with my USB chords I will post about her FIRST PLACE win in the triathlon last Saturday! It was so awesome to see her coming in to the finish line having won the whole shebang! She was riding with me when I had my accident and remembers it all in gory detail. She recently posted about the whole experience. This will be boring to most of you but just in case Lisa's blog is ever removed from my access 20 years down the road, I wanted to have my own copy on my blog. Unless you're a family member that wants to know or are sincerely interested to hear how a random bike accident goes down, feel free to move on. Here it is...my (in Lisa's words) journal entry of the accident.

It all started at the tatoo parlor. Ashley, Micah and I were meeting up on a Saturday morning, the Saturday prior to our triathlon mind you, for a long bike ride. We chose to meet up at the tattoo parlor and then head out on a long, quiet country road North of base, a route we had gone several times prior. We had decided to go out 8 miles, turn around, ride back 8 and then head to base to ride the race course and then go for a run. On the way out, we had encountered a few patches of dogs, which was strange considering I had never really seen dogs on that road before. A big meaty white dog about 4 miles North of base had chased us as we headed North, and we talked about preparing ourselves for his probable chase on the way back.

The conversation was pleasant, light and humorous as usual. We discussed the upcoming race and the changes that had been made to the course. As we approached 8 miles and the smooth road started to become pitted and bumpy, we turned around and headed South as planned. The weather wasn't too hot, the air was fresh and the wind was light. We were cruising along at a comfy 16-17mph riding side by side: Me Micah Ashley. Just like that. I remember thinking "that dog is gonna jump out at us at some point" and I briefly considered my position on the road and that I was closest to the dog's house. That made me a little nervous. We hadn't made a note of where that location was, so it was a surprise when the "white beast" darted out at us.

It all happened so fast. So fast. He ran directly in front of me, then Micah, then Ashley, coming at us from the left. And that's when the accident happened. Micah and I had narrowly missed him, but Ashley hit him directly, and that's when everything gets fuzzy for me. I don't remember any sound. I don't know what happened to the dog, where he went, or how he left the scene. I don't recall the exact mechanism of the bike, the fall, the hit. But I do remember seeing her hit the ground, more specifically her head hitting the ground. I have tears in my eyes just thinking about it right now despite that it was over a week ago and I know she is ok now. The only words I can think of to describe the fall is unnatural and gruesome. Ashley had fallen on the back of her head. Hard. And slid along the pavement a bit. Time stopped. Micah and I quickly headed back to Ashley (remember we were riding 16-17mph).

I remember seeing her lying there from a short distance and I think my mind was playing tricks on me as I thought I saw her moving and assumed she was awake and ok. But by the time I reached her head, her body tangled around her bike, she was breathing very loudly and her eyes were only partially opened...she was not responding to me. I think I went into a bit of shock. There was no way she was unconscious. This was Ashley. She was strong and athletic and invincible. She was the last person in the world I thought of that would ever look so helpless and vulnerable.

Thank heavens for Micah. This was his first ride with us. Infact, he had just decided to do the triathlon the week prior (who decides to do an olympic distance triathlon with only a week and a half to train!? Only an incredible athlete! He's just crazy! We had been training like troops for 7 weeks and I still didn't feel ready!). I don't think it was a coincidence that he had come with us last minute that morning...definitely a blessing from Heaven. I know I would have not responded well to that situation had I been alone with her.

Micah quickly and calmly took over. Oh, did I mention he's a medical doctor? Yeah, that helped. He immediately assessed the situation and new exactly what to do. It is still a bit of a blur, I really think I was in shock! But I remember he asked me to get her shoe out of her clip (one was still attached to the bike, the other wasn't). I tried tugging her foot out of the lock. Micah told me to just get her foot out of the shoe. I told you I was not in my right mind, not recognizing the obvious! We got her untangled from the bike. She came to after a couple of minutes. It had seemed like an eternity! We had talked about calling an ambulance, etc. and decided to call Joey first (her husband, also a doctor). That call occured at 7:31 am. They decided that Joey would come and get her and bring her to the ER. After all, she was with a doctor and the "ambulance" driver was a doctor :).

Once she awoke, she wanted to move. She was confused and in obvious pain and wanted to throw up. She kept trying to sit up and Micah kept trying to get her to relax and stay still so he could further assess her injuries and mental capacity. Once it was determined her spine was ok (she just KEPT trying to move!) we got her off the road and onto the more comfortable grass (that was actually full of stickers...ouch!) on the shoulder. She had several scrapes and road rash on her body, but Micah of course was most concerned about her head.

She kept asking what happened and was very confused. She didn't know that we had been riding bikes. She didn't know why she was on the side of the road in the middle of the country. She didn't know what day it was. She knew who Micah and I were, she knew the names of her husband and kids, but was utterly lost about the PRESENT. She was having a hard time lying still, always sitting up and trying to get into a more comfortable position. As she requested information about what had happened, we would recite to her the course of events. She would lie down for a moment and then try to sit up again and would ask again what had happened. It took me a couple of times of repeating the story to realize she had no short term memory. The story I had just told her had quickly left her brain and she was confused all over again. It was terribly scary.

I estimate it took Joey 10 minutes to wake up his kids, belt them up in the car and drive about 7 miles to where we were. He drove FAST. Based on my cell phone records, we had called at 7:31 and he left the scene with Ashley (and her bike!) in the car at 7:46 when I called Todd to meet Joey at the hospital to get the kids. Joey knew exactly where we were because that same dog had chased him previously on bike rides. Looking back though, those 10 minutes seemed to last forever as we tried to help her and watched her struggle.

Once Joey had left, Micah and I had to pick up our bikes and ride about 4 miles back to the tattoo parlor where Micah and Ashley's cars were parked. What do you talk about on that 4 mile bike ride? Who really wants to get back on a bike after watching that? It was tough and I was super angry (at the dog) and so sad and scared (for Ashley). We got the bikes racked up and headed to Ashley's to drop off her car and belongings and pick up clothes for the kids. Then we headed to the hospital to see how Ashley was.

In the ER, Joey's face said it all. He was very worried, and with his background in medicine, that worried me even more. Of course he would be worried and fearful...it was his wife and she was not making any new memories! She had had a CT scan and the doctor came out with the results as we were there. She had a possible small fracture on the back of her skull and possible small amount of bleeding on her brain. Joey and the doctor began talking about locations to transport her (Lawton vs. OKC ...remember we're in a really small town). At that point, it was appropriate for Micah and I to leave. He took me home (the gate gaurd that let us through is in our ward and was really confused when the Elder's Quorum president and the Primary president (obviously not married) showed up on an early Saturday morning alone together...we definitely had to explain!).

The next few hours of worrying turned in to the next few days of worrying. Ashley finally began to make some new memories and progressed over time during her 3 day hospital stay (is that right?). Thankfully, her husband Joey kept us all updated via her blog. Go here to read Joey's version of that day and then the surrounding posts to see how she progressed and continues to progress. We all (many, many worried friends and family all over the world) hovered over our computers for days waiting for the latest updates from Joey. It is all we could think about and was constantly foremost in our minds. She had (and still has) severe pain in her head and isn't feeling quite herself and gets dizzy easily (am I right, Ashley?) but we know she will make a full recovery. This is a huge blessing. It could have been even worse and had she not been wearing a helmet (which was destroyed by the impact) she would likely not be alive today.

How fragile life is and how quickly it can change! I am so grateful for a merciful Father in Heaven who preserved Ashley's life and that she is recovering more and more every day. Unfortunately it sometimes isn't until you see the people you know and love in such a terrible circumstance before you realize how much they mean to you. Ashley, we are all SO GRATEFUL you are OK and we LOVE YOU!

Posted by Lisa at 10:41 AM

Thanks for those sweet words at the end, Lisa. They will always mean a lot to me. I am so grateful to have had you and Micah there as well. No one could have cared for me ( my possible spine injury etc!) as well as Doc Bahr and I too feel it was such a blessing that he came along with us that morning...it might be for this reason alone that Micah felt so inspired to train for the triathlon a week beforehand!! I think about that sometimes! And no one could have worried about me, cared for my kids (even dropping them off, fixing their hair, letting them borrow clothes, bringing me a meal etc), my car, taken the time to write this all up etc the way that you have. I am so grateful to have had you two with me. I will Love you guys forever!

My Gosh I ♥ PEOPLE!

tibetan gratitude prayer

On Monday, upon my return to from the hospital there was a message on our machine from my friend Adreann.  She had meals lined up for us until Saturday.  I about dropped my jaw on the floor!  SATURDAY!!  Oh my Gosh I love you people!  People had signed up to make meals for ME for a week?!!  I've NEVER receieved more than one real meal at a time in ANY other ward I've ever been in!  And now I'm going to get 6!!!  Joey and I felt so appreciative and it was such a huge relief for both of us!  My Mom had already left us a pot roast in the fridge and a few groceries.  All the work had been done for us!  Joey could just take care of me (lord knows I needed it!)and the house!  Every meal was delicious and, can I say it enough, SOOOO appreciated!  Thanks to Jodi, Lisa, Kristy, Julie, Natalie, Mom and Adreann.  So...Saturday rolls around.  We're mentally preparing ourselves for a grocery shop that afternoon and we are told that someone else wants to bring us a meal on Sunday!  7 meals people!  Do I have the best ward and friends ever!  Ummmm that's a yes!  Sister Balaguy brought us the most delicious flashback from my childhood.   I Lion House-esq salad, stir fry and homemade rolls.   Before we could even finish it all off Joey's nurse came by with Enchiladas, rice and fruit salad for us to enjoy for dinner tomorrow.  What do we have to do to contain you service oriented people?  

Guys, I seriously have not felt up to cooking.  Nor have I felt up to eating the food that my husband would be capable of cooking;)).  I think I would have past out under either of these circomstances!  But even more importantly than any of this, I have felt so loved.  I have felt so warm and fuzzy inside from all the emails, all the cards (yes, a handful of cards every day!), all the phone calls to myself and my parents, all the blog readers, ALL the flowers...my house is perfumed with them!  I just want you all to know how much I love you, all your prayers, all your service and all your show of concern.  I will never forget this time in my life for the love that I have been shown.  Thank you so much.  Someday I'll make it up to each of you individually...if I ever can ♥

My First Eternal birthday

It seems that I didn't take any pictures of our trip until my birthday...which were probably taken by someone else.  Typical!  I have been such a blogging slacker, which I know no one but myself has noticed..but I have missed it.  The journaling, the gratitude I feel from documenting and the amazing ability that blogging has to clarify for me what I think, feel, love and want in my life!  So here it goes:

My First Eternal Birthday

For as long as I can remember asking my grandpa Franklin how old he was his response was always the same: 29.  And I never questioned him.  In his mind, this was the perfect age, neither embarrassingly young nor embarrassingly old.  Perfect.  Being the real 29 myself it would be tricky business if I were to agree with him.  Does that mean that I would be conceding that I have nothing more to learn, that my body couldn't get any better, has never been any better than this and that my wisdom and ability to love have reached their peak?  I certainly couldn't go there with you Grandpa and in my heart of hearts, I hope you're wrong!  I see where you're going with not wanting to claim anything older than 29 though.  It seems to be the very edge of cool, the furthest possible limit to youth.  One of my deepest fears is that my body has reached it's peak and my metabolism will, tomorrow, become my greatest enemy.   Although every time I see a perky, young, high-school aged, bikini donned, teenage girl I am reminded that my peak was definitely more than 7 or 8 years ago.  (Death to their perky, firm, smooth buttox!)All through my twenties I have been torn between this stylish young girl that loves to express herself through clothing, music, dance, jewelry and home decor and the other me that believes strongly in getting old gracefully, no plastic surgery because people are starving in Africa, less is more and that loves the chubby hat and glove wearing grandmas of yesteryear that sit at home baking pies and knitting you a scarf.  Now that I am 29 (29!!..come on) I am already questioning both of those ideals that used to be so me.  I didn't hold them dear...they just were...they were ME!  I've become too financially conservative to want to truly express myself through house and clothing...I do it halfway now!  Who can justify it when A). you live in Altus Oklahoma and NOBODY here dresses up and B). When my idea of truly expressing myself in one outfit would cost me atleast $400!  How on earth could I justify something like that.  You wear it once and then it's done. expressed. time to buy something else.  It's no longer satisfying to me in the long term.  I'm trying my hand at expression through gardening;)!  

But, I then ask myself, what happens when my body no longer allows me to be stylish at all...how can I express that part of myself?  What happens when my eyes can hardly be seen for they are buried in a curtain of wrinkles?  Will I still believe in getting old gracefully?  Will I say no if my dermatologist brother offers me a free injection everytime I visit?  Will I be able to say no again after I turn and look at my sister-in-law who will begin to look younger every time I see her?  I just don't know!  Do I have that kind of self-control?  MAN I hope so!  Because having those high ideals doesn't count when it's easy.  It's when its hard that they count!   Everyday I understand my Mom a little better when she looks in the mirror, focuses on her wrinkles, her tummy and complains.  Sorry, Mom, but I used to roll my eyes at you.  Now I'm scared sh**less.  I don't want to feel so vulnerable to my own vanities and yet I feel that coming on so strongley...and I'm only 29!  What's to become of my when I'm 60!!  Sigh....I just don't know.  

My hope is that I'm getting this all over with so that when 30 rolls around I'll be able to enjoy it!  I'm taking care of this business a year early!  Just being smart about it!  And most days, I do enjoy my journey.  I'm happy to be a mother.  I'm happy to be a wife.  I'm happy to be a friend.  And there's nothing like being in your late twenties in each of those roles.  You're blessed with young children.  A new AND old marriage that's fresh, learning, growing and yet so comfortable all at the same time.  My relationships with friends are deeper, more selfless, more confident than in decades past.  There's no competition, no jealousy, no drama.  Just laughter, support and a listening ear.  And, while I fear many things about getting older, there are so many things to look forward to as well.  I look forward to seeing what my children do.  To knowing them, one day, on an adult level, having made their own life for themselves.  I can't wait to learn about who they are.  And I can't wait to go back to school and perhaps start a career of my own. In many ways life is just beginning.  If only my 24 year old body was aloud to tag along!  Can anyone help me arrange that?!!  Happy twenties to all you babes out there!  Enjoy it while they last!  They're THE BEST!

Utah Day 1

One of the perks of being in the Air Force are the "space A" flights that come up on a somewhat regular basis, especially in Altus where there are fewer military members to snatch up the available seats.  Joey and I have been looking forward to taking a "space A" ever since our move here.  Free, no flight attendants, no seat belt rules, room to roam and nap on the floor, no limit to baggage...what more can a traveler ask for!!  On June 5th a space available flight was being offered to Utah!  Surely this must have been a personal favor they were offering us....don't they know my parents have a home there!! and hundreds of people that we LOVE there!!  Of course this is why they're offering this flight..of course!  They really like us here in Altus, ya know;) And of course we, nor anyone else in our ward could turn down their offer.  (It was a bigger ward activity than the 4th of July BBQ)  Here are a few pictures of a C-17, it's innards and the Merback experience!  I'll move on to the rest of our trip tomorrow.

A few pictures of some friends that flew with us:  

above:  Maile, representing the Bahr family...how did I miss getting a picture of your gang, Julie?  You sat right across from us!?!

below:  The Sizemores, good friends we made in the short time that they lived in Altus, doing some pilot training.  We miss you guys!

Joey and Isaac helping Captain Bingham do his flying thing!

below:  The tiny Mumfords;)  Todd, Jacob, Ryan, Lisa and Anna

above, The Liddells:  Sadie, Adreann, Kennedy, Dallin and Bert

Instead of exiting through stairs, ramps, doors etc.  they just open up the entire butt of the plane.  What an adventure!

I only wish I had taken pictures of the kids laying down on blankets with all their friends coloring pictures, playing games, taking naps and just having a gay old time....as if it were at a family play date or something.  Please don't make me fly commercial EVER again!

p.s.  the bathrooms were lovely Aly;)  So lovely I don't remember anything about them....definitely not buckets.

Still Alive

Thanks again, everyone!  I just finished reading some more comments, recommended wikipedia information and updates on  my brain injury.  Yesterday evening I really felt great and I think that reflected in my post as well as the few phone calls I made and received.  This morning I woke up not feeling quite so perky.  My headache was back to hospital-ish status and I didn't feel much up to talking, eating or moving around too much.  Thankfully, my perfect husband made doing next to nothing very possible!  After my third nap today, however, I woke up without a headache! FINALLY!  and was dreaming of meatballs!  I had a great meal of homemade bread and butternut squash soup waiting for me from my friend Natalie Fischer.  It was so delicious!  Thank you Natalie!  And after reading all the possible outcomes of brain injury I am feeling sooooo very grateful that I am doing as well as I am.  It's making me a bit fearful of what my 100% recovery might turn out to be though, possibly not 100%.  I'm trying not to have those negative thoughts.  I think the main concern is that I might end up with cognitive disabilities, such as difficulty concentrating, less short term memory or irratibility.  Only time will tell.  I don't notice much irrational irritablility on my part...I mean, come on, I've got the headache from HE**, how can I not get a little snippy every once in a while;)  I think that can only be expected!  I hope most of you will cut me some slack in that department if we do some conversing over the next few days!  

I am feeling so grateful and loved during this time in my life!  I know some of you have even lost sleep in worry over me.  (Thanks Bry, Joey, Mom and Dad!)  I am feeling hopeful and much more myself this evening and expect this to last, with improvements, into tomorrow.  I love you all and am grateful to have such wonderful friends and family in my life.  MOre updates to come as I feel up to it.

XOXO

I'm ALIvE!

Dear friends, family, worriers and loved ones -

JOey has been religiously reading your messages of hope, prayer and love to me over the past couple of days and I have been wanting, desperately, to hug, love on and thank each one of you individually!  Thank you so very much for your intense concern, for you prayers, your phone calls and everything else that you have offered on my behalf.  It has meant the world to me.  

ANd the good news is...I'm back!  JOey and I arrived at home at around 4:30pm.  I immediately laid down for a nap and woke up for the first time after about 2 hours without a headache!  I ate my first meal in 72 hours (thank you Jodi!) and am about to eat meal number 2 (thanks Mom) after nap number 2!  I have been experiencing great relief from a headache that has been my constant companion for the last 60 + hours.  I am far from being my normal, comfortable self but feel a world of difference from how I felt the entire time at the hospital.  I am hardly nauseated at all, the knot in the back of my head is barely tender anymore, I am sincerely hungry and I can lay down flat (finally) without feeling like my head is going to spontaneously combust!  My typing skills have dropped dramatically (it's taking me about three tries to finish each sentence properly:) and I'm hoping that is not going to be a long term effect of the accident!   I want to be sure that you all know that I have read each of your responses personally and I am grateful to you for keeping mine and my entire families spirits up.  Thanks and Im sending my love to you all!

Love,

Ash

The toilet clanged

I'm sitting there, reading my book, when I hear the toilet seat clang on the porecelain.  What?  I bolted into the bathroom to find Ashley "taking care of business."  She felt well enough to take a shower and eat the delicious Hawaiian haystacks and homemade bread that Jodi Alley brought over for dinner.  She is feeling great!  Well, comparatively.

Only a matter of time before we hear from her on here.  I have given her the assignment, but at present she is occupied with reassuring her parents.

Update: Well, the shower and dinner were about all she could handle and she is back to sleep.  Sorry!  I'll try again when she wakes up.

Home at last

Ashley immediately crashed on the bed after an uncomfortable car ride home.  I am already feeling good about the decision to come home early, as she does not have the endless stream of people knocking on the hospital room door to disturb her slumber.  A big thanks to Lisa Mumford and Adrienne Liddell for making my trip to the pharmacy to pick up Ashley's pain medication possible.

Here's hoping the next post is composed (or at least dictated) by everyone's favorite head trauma patient.

Going home

Dr. Duncan has just been in to see Ashley.  He offered to discharge Ashley from the hospital given that she hasn't vomited in 24 hours and has taken only oral pain medication since last night.  We thoroughly discussed the potential for a slowly developing brain bleed, which he reassured me is exquisitely rare in healthy young people.  We won't have the ability to give her IV fluids or IV pain medication, but she will be in her own bed and in familiar surroundings.

I left the decision up to Ashley.  And we are going home.

Speech therapy

The speech pathologist was just in to evaluate Ashley.  She put her through a battery of tests, asking her to follow simple and multi-step commands, remember a series of pictures and words, describe simple procedures (making a sandwich), solve simple problems, and several other tests of her memory, speech, hearing, and cognition.  Ashley passed with flying colors.  The only error she made was that she couldn't remember one of the two items she was supposed to get from the grocery store about 2-3 minutes after she was told what the items were.  But she remembered all 3 items from the drug store and all 5 pictures that she had been shown.

The headache continues.  I have to keep reminding Ashley to ask for pain meds, as she seems to not want to put anyone out, even though she is absolutely miserable.  Gotta love her.

Physical therapy

The physical therapist came by to "eval & treat," as physicians are so fond of ordering.  Ashley was able to sit up, stand up, and walk down the hall and back.  Her balance and coordination are excellent, and her strength is impressive.  PT didn't stay very long.  I think it became pretty clear to him that her motor skills will be fine.  The issue holding her back is her headache.

She felt pretty wiped out after the PT session.  She took only a few bites of oatmeal and a few sips of water for breakfast, but she is not feeling nauseated and hasn't vomited since early yesterday afternoon.  There was a 4 or 5 minute window when she felt well enough to have me read some of your comments.  I got through as many as I could before she wanted to go back to sleep.  Despite her agonizing pain and discomfort, she graciously thanked me for watching over her and expressed her love and appreciation for all of you who are thinking about her and sending your messages of love and concern.

Still in pain

Poor Ashley.  Just as I had burst into her ED room wanting to know if any flicker of recollection had returned, this morning I woke up anxious to know if the headache was improving.  Not much.  She complained of a 6/10 overnight and a 5/10 this morning.  I'm sure that it is worse than that, as she still wants to do nothing but lie still and try to sleep.  I am trying to not feel sorry for myself.

And I wish she could communicate with everyone!  Or that I could at least read her some of the tender, moving words that have been sent our way.  Not yet.

Everyone so far is reassuring us that the pain is normal.  We will readdress the issue when Dr. Duncan (the other Dr. Duncan's brother, who is on call this week) visits today.  I truly feel remiss for not having cared for more head trauma patients during my medical training, as I feel as lost as everyone else at times.

Sleepy and stable

Ashley is wanting to do nothing but rest.  She is at peace when her eyes are closed, her body is still, and the air is silent.  I am sorry for those of you wanting to visit her.  I feel your pain.  I want to visit with her, to talk about some "normal life" topics, to start forming more pleasant memories than those of pain and nausea.  But now is not the time.  The absolute best thing that I can do for her right now is to shut my big yapper.

She needed another dose of pain medication a couple of hours ago, but was able to keep down a small amount of yogurt (or that's what it looked like) without vomiting.  I am hoping that a brain contusion is like a sprained ankle.  The pain and swelling increases for the first 48 hours, but then slowly starts to improve over the next few days.

There and back again

Ashley had perked up for her visit from Dr. Duncan and Whitney, the medical student who examined her yesterday.  As emotionally relieved as we were to hear the news, it unfortunately didn't do much to relieve Ashley's misery.  Her headache ratcheted back up to an 8/10 and she continued to have issues with nausea and vomiting.

The plan we worked out, after hearing the good news, was for Nann and Craig to take the kids with them to Houston this evening.  Since Craig had already made the drive to Lawton, I decided to drive back home briefly for refueling and a shower.  Craig was with Ash when they gave her Demerol (narcotic pain medication) and Phenergan (anti-nausea medication).  That has pretty much knocked her out, but it has also greatly relieved her suffering.  Unfortunately, she is in no shape to receive visitors at present.  We appreciate all of the offers, and will let you know as soon as visiting hours resume.

I am back at her bedside and the kids are on their way to Houston.  I am going to sack out, hopefully for a few hours, so I apologize for the pending lapse in updates.  Know that Ashley is sleeping comfortably with the help of modern medicine.  I cannot wait until she is lucid again and can appreciate all of the wonderful sentiments and well-wishes sent her way.  Thanks again.

P.S. I was able to take a look at the helmet that Ashley was wearing during the accident.  It was my Specialized helmet that had been donated for EB Trek 2001, as someone had recently stolen Ashley's helmet.  The back left portion of the hardened styrofoam is cracked in 2 places.  That helmet has done its duty and will now be retired.  It is an odd feeling to look at a piece of shaped synthetic material and have the intense desire to thank it for saving Ashley's life.

CT scan is normal!

No blood collections, no significant brain swelling, not even an obvious fracture, according to Dr. Duncan, the neurosurgeon who took over for Dr. Ofori.  He has ordered some decent narcotic pain meds and will transfer Ashley to the floor instead of the ICU.  At this point, he is mainly keeping her in house until she regains the ability to eat and drink without vomiting.  

She will be evaluated by a speech pathologist tomorrow to obtain an assessment of her current cognitive function.  This will serve as a baseline for comparison should she have any long term issues.  Dr. Duncan was likewise optimistic about her long term prognosis and reassured us that her need for hours upon hours of sleep is completely normal.

Ashley's dad, Craig, is here, and was keeping watch while I tried to doze in the back seat of the Honda.  I am very relieved and looking forward to graduating from the ER after 24+ hours.

Awaiting CT results

Ashley returned from the repeat head CT about 30 minutes ago.  She had been doing well this morning, but has had some setbacks since then.  She became very nauseated trying to get herself into a wheelchair for the CT and was instead wheeled down on her bed.  Since returning from the scan she has been pretty wiped out and wasn't able to keep down the apple juice that she drank.  She continues to be worried about why her head still hurts so badly, why she continues to vomit, and what her long term prognosis is.  I am trying to be reassuring without sugar-coating anything.

We are waiting for the CT results and a visit from Dr. Duncan, the neurosurgeon who took over for Dr. Ofori.  Shelly gave us a glowing review of Dr. Duncan last night.  I will post an update as soon as I can.

Ashley hasn't felt up to listening to everyone's comments and messages yet this morning, but they have been a great support for me as I keep this vigil.  Thanks.

Day Two

Ashley's personality never left.  She was always more concerned with others' well-being than with her own, even as they stood over her in the trauma bay, desperately fearful for her future.  And now, with her short term memory beginning to function, she continues to be that same thoughtful self.   She insisted that I get up off of the linoleum floor and join her.  I tried to be as unobtrusive as possible, wedged between her body and the side rail of the bed.  And, true to form, she kept asking me if I was comfortable.  Thank you, Ash, for sharing your bed made for one.

She gave me a bit of a scare around 1:00 am.  She had gotten up to use the restroom again and was not doing well after returning to bed.  She vomited and dry heaved, even though she had not had anything by mouth for a while.  Then her headache crept up from a stable 6-7/10 to an 8/1o.  She felt as if her head would burst and became fearful of ongoing bleeding.  Shelly duly chastised me for making a head injury patient get out of bed to use the restroom and put the kibosh on any future trips for the time being.  She notified the neurosurgeon, and came back with an ice pack for Ashley's head.  That worked wonders and Ashley was able to rest.  This morning she had almost no pain when she first woke up, but upon moving her head the pain returned, though improved from earlier.

I should explain the Catch-22 that head trauma and headache present.  She keeps complaining of a pressure inside her head and constant pain with pulsatile throbbing added on top.  Our options for pain medications are: 1) narcotics (morphine, oxycodone, etc.), 2) NSAIDs (Toradol, ibuprofen, etc.), and 3) Tylenol.  Problem is, narcotics cause altered mental status, which would interfere with the frequent assessment of Ashley's progress and could greatly confuse the picture.  NSAIDs inhibit platelets and cause problems with bleeding, which is not exactly what you want in a patient who may or may not be slowly collecting subdural blood in her cranial vault.  And Tylenol, well, sucks.

Update and recap

Ashley is still doing well.  She had a brief wave of nausea with some emesis, and her headache is still very much present, but she continues to be lucid and to retain new memories.  She was able to sit up and take her contacts out, which, to me, is no small feat under normal circumstances (much thanks to our optometrist Todd Mumford for the foresight to suggest bringing her supplies).   How many people are lucky enough to get into an accident with a flight surgeon on hand and be visited in the ER by an optometrist?  Rag on podunkville Altus all you want.  We have awesome and talented friends here.

I thought I would take this opportunity to record the details of today as I remember them (pause to appreciate my intact short-term and long-term memory and the wonder of this 3 pound organ composed over 100 million neurons making over 100 trillion connections - or something like that).

I changed Ashley's flat front tire last night at about 10:00 pm.  I gave her my typical overbearing advice to make sure that she checked the tire pressure in case of a slow leak from the patched tire before she left in the morning.  I recollect waking up to the sound of her cell phone alarm at 6:00 am or whatever ghastly hour it was.  My next recollection is the phone ringing at 7:30 am.  Didn't move a muscle.  Until I heard the voice of my good friend Micah on the answering machine: "Joey..."  

My first thought was, "Somebody's got a flat tire."  But then Micah's voice again, "Ashley fell and hit her head."  Fear gripped me as I wrenched myself out of bed.  He gave me the brief rundown and filled in the details later.  They had gone north on Veteran's drive starting at the Altus AFB Jasmine gate.  It is a nice, flat, well-paved road that goes on for about 10 miles up to State Route 19.  I have ridden it a few times myself, and it is a great road for cycling.

Except for the one spot about 3 1/2 miles north of the base.  There is a ranch house on the east side of the street, surrounded by a white metal fence, where lives a large, pale beast.  On one of my rides, he had seen me approaching and came roaring out of the yard.  The owners were screaming at the canine demon with all their might, threatening all sorts of vile punishments if he did not obey.  But to no avail.  Then the reassurances: "Go ahead, he won't chase you.  Don't worry, he won't attack."  Yeah.  Sure.  I walked my bike for about 100 yards, continually turning around to face the hound from hell and make him back down.  Finally, I was able to escape his clutches, but the few times that I have ridden past that house since then I have been alert, watching, waiting, wondering if he were lurking in the bushes, ready to attack again.

When I heard that it was a dog that had assaulted Ashley, I knew exactly where they were.  They had passed the house going north and the monster had chased them.  On the way back south, it appeared that he was lying in wait to spring his trap.  Ashley, Micah, and Lisa road side-by-side, with Ashley on the far right.  The dog came running from the front left, crossed the paths of Micah and Lisa, and struck Ashley's front tire.  The tire spun instantly to the right, and Ashley's body, feet still clipped in to the pedals, was wrenched to the right.  She struck the ground with the back of her helmeted head and slid a few feet.  Dr. Bahr reports that in his estimation, had she not been wearing her helmet, she would have shed this mortal coil.

Micah's first thought was her cervical spine, in case there had been any injury that could threaten the spinal cord.  She was completely unresponsive and was holding her elbows and wrists in a flexed position (also known as flexural or decorticate posturing).  This did not bode well.  Her Glascow Coma Scale at the time was 5.  The bottom end of the scale is 3.  There is no zero.  Micah estimates that within 2 minutes she regained consciousness.  She began trying to get up, which Micah kept trying to prevent her from doing.  It was at this time that he called me.

My instinct was to go.  GO GO GO!!!  Go get her now!  Sometimes that is the wrong instinct.  "Reach, throw, row, THEN go," as the lifeguard mantra goes.  We should have called 911.  I am not blaming Micah or myself.  This was a learning experience for us.  Next time, I call.  Simple as that.  That said, I am grateful beyond words that my colleague was there for my best friend and companion.

I woke up the kids and threw them in the car.  I went about 95 mph (40+ over the speed limit - another good reason to call 911 rather than let your "go" instinct take over).  When I arrived, Ashley was sitting on the ground with the most confused look on her face that I have ever seen.  And that, for those of you who know Ashley well, is saying something.  I embraced her and asked her a few questions:  "Do you know what happened?"  "No."  "Do you know your name?"  "Ashley."  "Do you know what year it is?"  "No."

That was it.  In the car and off to the races again.  In the car, the gravity of the situation began to dawn on me.  No matter how many times I told Ashley what had happened, she would have no recollection of anything I had just said.  I kept talking to her, trying to keep her with me.  The kids didn't say much, but Isaac thought it a good time to discuss how the spanking he had received the night before was not an appropriate part of the Merback discipline protocol.

I pulled up in front of the Jackson County ER and helped Ashley out, leaving the kids in the car (yet another good reason...but I digress).  I have to admit that I pulled the "I'm Dr. Merback and this is my wife..." bit with the receptionist.  She checked us in and had Ashley wait outside for a second while the nurse came out.  I used this opportunity to park the car and grab the kids.  I came back in to see Ashley vomiting on the floor.  We got her into a wheelchair and got her back into the trauma bay.  The ED physician was there almost right away.  I had worked with him before when patients of mine had been admitted or transferred from the ED.  Good guy.  Not easily rattled.  As an ED doc should be.

Almost immediately, Todd Mumford showed up with his 3 kids in tow to pick up an additional 2 for the day.  When I saw my friend and colleague, I broke down for the first time.  The adrenaline was wearing off and the fear was setting in.  

When Ashley kept vomiting, they fast-tracked our route to the CT scanner.  Standing there, alone, watching her confusion and frustration, the fear overwhelmed me.  I starting sobbing in the hallway.  The radiology techs took pity on me and invited me in to the control room, where I saw a very rapid scroll through her CT scan.  White means blood, and I saw no white where it shouldn't have been.  The ED doc agreed, but the radiologist's read was pending.

Micah and Lisa came as soon as they could and helped with all of the non-glorious housekeeping.  Their concern for Ashley had begun to play tricks on their consciences.  What could we have done differently, we feel responsible, etc.  Nonsense.  I am so glad that you were with her.  This could have happened to anyone.  I am probably going to execute that dog.

I began the process of repeating the story to Ashley over and over as she would say, "My head hurts," and look at me for an explanation.  It was at this point that I became very fearful for her memory.  It is one thing to read in a textbook that closed head injury can be associated with transient post-traumatic amnesia.  It is quite another thing to be looking into the face of your beloved, hearing her voice, but not being able to find her anywhere in her expressions or words.  I would intermittently sob, whereupon Ashley would ask, with the most innocent eyes, "Why are you crying?  What's wrong?"  Oh, my love, for you to comfort me in those moments was absurdly precious.

Then I realized I was not alone in my love for this woman.  I called Nann first and got voicemail.  Craig was next, and he picked up.  Here I am, the husband and caretaker of his only daughter, and I am telling him how she has almost died and is mentally nonexistent at the present time, all caused by an activity to which I introduced her.  Thank you, Craig, for your understanding.

I tried my best to keep it together for her father, as I knew what uncontrollable sobbing would do to his state of mind.  But when I called my own mother, I lost it completely.  My wife had almost died.  I felt an overwhelming urge to confide in Ashley during this horribly frightening experience.  There she was, in the same room, yet she was light years away.

The radiologist's reading was not as optimistic as our initial impressions.  Small occipital skull fracture, probable blood in the frontal region.  The ED doc asked my preference regarding transfer to a neurosurgery service.  He was unsure if Lawton would take us on a Saturday, and the only other option would be OKC, 150 miles away.  I wanted Lawton.  I felt confident that, given how difficult it was to spot the "probable blood," she would much more likely be in for observation rather than an emergent craniotomy.  I understand the desire to have your loved one in the best possible facility in the big city.  But 50 miles is much more manageable than 150 miles, especially given the low potential for surgery.

Lawton accepted us.  Micah and Todd reappeared to administer to Ashley.  She kept thanking them for coming and asking if Micah and Lisa were all right.  She also kept asking about the dog (the DOG!!!), wondering what had happened to it.  They stayed with us until Ashley was loaded into the ambulance at about 10:30 am.  My first desire was to go with her (GO!), but that option was not even entertained by the paramedics.

I rushed home and packed.  I grabbed a set of clothes for Ashley, but neglected to bring a bra or footwear.  Well done, Eagle Scout.  (Although, to be fair, they don't teach you about intimate apparel in the Boy Scouts.  Footwear is inexcusable.)  I didn't anticipate how stepping foot in our home would impact me.  Seeing the pictures on the mantle, the rumpled covers on the bed, evidences of her mind at work in the kitchen and TV room (the bike pump on the floor), hit me like a brick.  I wept and swore and cried out for the love of my life, who was nowhere to be found at the moment.

I talked to my parents-in-law, my mother, and my brother, Jake, on the drive out.  All offered to come immediately to Oklahoma.  Nann and Craig were soon on their way.  I know that Jake and my mom felt immensely powerless as they confronted this unknown horror from 1,000 miles away.  I felt the same frustration from across the room.  I very much appreciate their willingness to drop everything for my Ashley.  

I arrived at the hospital at around 11:30 am, 4 hours after the incident.  I burst into Ashley's room and immediately asked if she remembered why she was in the hospital.  Not a hint of recollection.  She was still MIA.  A medical student followed me in and did the intake H&P.  Sharp girl.  When I mentioned that Ashley had a coup contrecoup brain injury she gave me a knowing smile.  The ED doc came later and informed us that the neurosurgeon was on his way.

As we waited, I spoke with various loved ones and shared the agonizing story.  A knock came at the door, but rather than a nurse or neurosurgeon materializing in the hallway, it was Adam Bingham.  He put his hand out, but I gave him a Tommy Boy "brothers gotta hug."  They just picked up and drove to Lawton (confirming this was the right decision over OKC).  And his pregnant wife had just been discharged from the hospital the night before.  I'll say it again.  You mess with Altus, you mess with my friends.

Ashley recognized Adam instantly, but then became seriously confused as to why he was at her bedside.  Adam stayed only briefly, as his pregnant wife was waiting in the, um, waiting room, but he did what bros do.  He asked for my food order.  His visit was just the right thing to break up the monotony and spark Ashley's slumbering memory.  

Dr. Ofori arrived and examined Ashley.  He was as relaxed as I was terrified.  Not the cool detachment of someone who doesn't know and doesn't care, but the confident breeze of someone who has been there, done that numerous times.  When I asked about her post-traumatic amnesia and long-term prognosis, he smiled broadly.  She'll be fine, nothing to worry about.  The weight began to lift.  And the soothsayer from Africa was not to be proven wrong.  After returning from speaking with Ashley's brother Bryant (in Singapore, probably 4:00 am his time), a tiny flicker of my Ashley showed itself.  "I remember Adam was here..."  Oh, the unspeakable joy!  I called Nann and Craig right away and posted the hopeful update to my gloomy introduction.

Adam came back with the grub and Shalisa.  He bypassed the "one visitor" rule by answering "Yes" when they asked if he was family.  Hey, he's my kids' Uncle Bing, he wasn't lying.  Ashley was pretty out of it, but was definitely better than she had been all morning.  She remembered that Shalisa had been in the hospital, and upon finding herself in a hospital with Shalisa, she naturally assumed that Shalisa was the patient.  She kept asking if Shalisa was going to be discharged, which would have been funny had it not been so sad.  But that second visit found its way onto the tabula rasa that was her memory.  She forgot Adam's first visit, which had served its purpose well, and now locked onto the visit of "Adam AND Shalisa."

I had given Micah an update earlier, and during the conversation he asked if we would be okay with visitors.  Yes, yes, absolutely yes.  That was all Julie needed.  Earlier that morning I had called her trying to find Micah.  She knew almost nothing and I unloaded on her, sobbing and fearful.  I know that Julie means a lot to Ashley, and now I know that Ashley means as much to Julie (not that I doubted it).  She became our second pregnant visitor of the day, having found her way to the hospital through tears and worry.  Ashley absolutely lit up for Julie.  She held strong to the Gibraltars of her newly-found memory, but asked enough repeat questions and made enough repeat comments to convey the length of journey that remained.  When someone who has 5 children, and is pregnant, drops everything on a Saturday, buys flowers and a card, and drives an hour to see you, that is just about all you need to know about that person's heart and character.  I owe you a debt of gratitude.

Finally Nann and Craig arrived.  Nann had cried all of her makeup off.  As horrible as they felt to not be present, I am grateful that they did not arrive until Ashley had turned a major corner.  To see her in the fog of amnesia was torture that they did not need.  Their timing was perfect, as Ashley's new nurse, Shelly, was coming on shift at the same time.  Shelly was confident, decisive, knowledgeable, and full of down-home warmth.  I know that Nann and Craig were somewhat concerned about my choosing the close hospital over the big city medical center.  But Shelly erased their doubts.

Thus ends the worst day of my life to this point.  I am oddly grateful that Ashley will not remember most of it, given that I spent the day begging for her to remember any of it.  I am thankful for many things.  For the unconditional love of family.  For friends who amaze with their selflessness and care.  For health care professionals who have worked hard to be good at their job and who make you feel like you are the only patient in the world.  For the engineers and physicists who developed X-ray and computed tomography technology.  For a culture of safety that inspired the design of light-weight yet shock-absorbent helmets, without which my wife would be dead.  For the wireless and satellite infrastructure that makes instant communication possible.  For all of the pioneers behind modern hospitals and western medicine.  For the progressive human spirit, ceaselessly striving to make this world a better place to live in for everyone.  But most of all, I am thankful for my wife, Ashley.  Everyday, from now until the end, is a gift.

Mom and Dad arrive

Nann and Craig Pettey arrived at the hospital to see Ashley.  She was even more alert and lucid than during Julie's visit.  Hopefully it was comforting to Mom and Dad to see their beautiful daughter feeling and looking better.  Her memory is still not 100%, but it is certainly improving.

Ashley is enjoying all of the comments and well wishes on the blog, e-mail, and Facebook.  Thank you for being great friends!

It looks as though we may be spending the night in the ER.  Small price to pay to see my true love get better with every passing moment.

Up and out of bed

Ashley says that she still feels like her head is going to spontaneously combust (independent of the Bings' comment), but she is very thankful for all of your expressions of concern.

She has gotten up to use the restroom and is trying to keep down some Jello and 7up at present.  Julie Bahr came to visit and really brightened Ashley's spirits.  She is adding new memories, but is still not retaining everything.  She keeps asking some of the same questions: "Did I scare Micah to death?  Are both of my parents coming?  How do they know that my brain isn't bleeding?"  It is very interesting to see how, without the benefit of remembering what has been said, she comes up with the same questions and statements over and over.

We are still in the ER (!), but will hopefully make it to the ICU before nightfall...

The Magical Bingham Visit

Ashley is maintaining about 25-50% of her memory from the time that Adam and Shalisa came to visit.  That is her new reference point.  She doesn't remember this morning, the accident, the hospital, the ambulance.  But she remembers the Binghams' visit and a little less than half of the things that I have told her since that time.  

She still has a nasty headache, and on feeling the back of her head the only descriptive word that comes to mind is "boggy."

Thank you to everyone for your expressions of love and concern on the blog and via e-mail.  I have read most of them to Ashley during her wakeful moments.  She wants to know how in the world everyone knows about her accident, but is very grateful that so many of you are thinking about her.  And now she will start to remember your messages of love.

"I fell off of my bike"

Ashley had been asleep for about 30-45 minutes.  She woke up and smiled at me.  I asked her, "Do you know why you are here?"

"I fell off of my bike," was the reply.

Best news I've heard all day!

Slowly improving

Ashley is starting to remember more.  Adam and Shalisa Bingham came back (with Chick-fil-A, which was GREATLY appreciated) to visit again.  About 5 minutes after they had left, I asked Ashley if she remembered who had been in to visit her.  "Adam and Shalisa" was the reply.  She also remembered that I had talked about a dog running in to her bike, that I had told her that her parents were coming, and that the kids are at the Mumford's house.  Certainly not ready to take on the Stanford-Binet, but much improved from this morning!

Dr. Ofori is not worried about her at all.  In his experience, the memory issues can last a few days, and the impaired cognitive functioning can last a week or two.  But regarding long-term prognosis, he feels confident that Ashley will be completely back to 100%.  That made me feel fantastic!  He ordered a repeat CT scan in the morning, and is planning on keeping her at least 24 hrs, maybe longer.  I think Dr. Ofori is from Africa, given his accent, but I didn't pry.  He was very pleasant and seemed very capable.  Pretty rare combination in a neurosurgeon!

Ashley's bicycle accident and head injury

This morning at about 7:30 am central time, Ashley fell off of her bicycle and hit the back of her head.  A dog had run out in front of her and hit her front wheel.  She was wearing a helmet and was traveling at about 16-17 mph.  She was unconscious for about 2 minutes, according to Dr. Micah Bahr, who was riding with her, along with Lisa Mumford.  They were training for the Altus AFB triathlon next Saturday, 18 July.  She woke up confused and could not remember anything about the incident. She was able to remember her name, my name, the kids, etc.  But she was not, and is not at this time, able to form new memories.  

It has been about 7 hours since the accident.  The CT scan showed a small fracture in the back of her skull, and very small areas of probable blood in the front of her brain.  She is alert, recognizes me, and can carry on a conversation.  But she instantly forgets anything that I tell her, and keeps asking me why her head hurts and what is going on.  The technical term is post-traumatic amnesia.

We are in the hospital in Lawton, OK, awaiting admission to the ICU.  Dr. Ofori, the neurosurgeon, has just been in to see her.  He feels very confident that she will regain her short-term memory sometime in the next few days.  I feel very comfortable with the medical care she has received so far.

Update: Ashley has remembered something for the first time since the accident.  Our friend, Adam Bingham, drove out to visit us in the ER, and Ashley remembered that he had been here about 20 minutes ago.  Things are looking up!

A New Sister!

This is Lizzy.  

Lizzy has been in our family (our extended Merback Family) for about 3 years now.  Doesn't she look just so snug in the middle in that picture! But yesterday it became official!  Not that we NEED some authority to tell us who we love, who we don't, who is ours, and who isn't but it sure does make it seem more permanent, make one feel more committed, more accepted and more a part of us.   Lizzy was adopted yesterday.  JOey officially comes from a family of 5, has two sisters, I have two sisters-in-law and the kids now have 5 aunts.  Woo-Hoo!  The more the merrier!  Especially when more means Lizzy!  Welcome to the family Lizzy.  I/We love you so very much and look forward to watching you grow, learn, decide, experience and love.

*to be sealed on July 28 in Reno, NV