Dustin LaFortune

Archive for June, 2010

Dear Supporters,

It is with great regret that we announce the shutting down of the Facebook group to comments. Right now our focus needs to be on Dustin, his healing and arrangements for the rest of his life. There are so many of you who are wonderful and supportive and gave so much to the community. We are so sorry all of that was getting lost in the noise.

From now on, we are going to focus our energy on bringing more updates to this website so people stay informed of his progress. To be notified of how Dustin is doing and any other important updates, you can either sign up for the newsletter on the right-hand side of this page or subscribe to the RSS feed in your preferred reader.

If you’d like to become more involved, we have the How You Can Help page with several different ways you can show your support. As always, messages of support and encouragement for the family are welcome! Simply use the form on the Contact page.

Thank you so much to everyone!

Teleconference call – health update

Who was there:

DUSTIN
Neuro – ABI
Occupational Therapist
Physio
Dietician
Neuro RN/Unit Mgr.
Program Co-ord.
Social Work
Renee (Mom)

Goal Updates

Physio:

Dustin continures to work on standing and walking. There was a ‘balance test’ to determine if Dustin could use a two wheeled walker. His co-ordination, balance and core strength must improve a lot before the wheelchair can be replaced with a walker. Core strength and foot placement are the biggest challenges. To help with this, Dustin will be referred to another therapist, who will do a special exercise evaluation using ‘runway lines’. If Dustin can walk with support then an exercise/practice regime (2 X wk.) will be incorporated into the physio program.

Dustin continues to do ‘laps’ with only one person to support him. Endurance has not moved beyond the 5 minute mark so the staff are going to walk with Dustin to further and more interesting parts of the building. They will also try to walk outside (weather permitting).

Occupational Therapy:

Dustin’s balance while sitting is still “iffy”. When sitting on the edge of the bed trying to dress himself, one article at a time, Dustin still gets dizzy, leans to the right or falls forward if he’s not assisted. He still needs help and support with everything except shirts/hoodies with open fronts. Dustin can’t do socks, shoes or pants yet. More practice will be built into ADL (activities of daily living) and the staff will get Dustin into the wheelchair. It is easier for him to dress himself when he is in the wheelchair which has belts and side/back supports.

Another video swallowing test was conducted today. Dustin still has trouble with thin fluids and dry foods. He can’t eat crackers, cookies etc… or drink plain water or coffee. The dental soft diet will continue and liquids will be ‘nectar thick’ consistency until the next test. The inability to swallow is a combination of brain injury and damage/trauma to thyroid cartilage.

Dietary/Nutrition:

Dustin weighs 134 lbs. He is putting on ONE POUND PER DAY! He will be allowed unrestricted calories for another 30 days. His doctor said that because of the starvation, the deprivation and the brain injury (Dustin still forgets that he’s eaten) the weight gain will stop naturally when Dustin’s body reaches it’s ‘normal’ pre-trauma weight. The doctor thinks that Dustin should weigh between 175 – 200 lbs. based on his build. As Dustin approaches his normal weight, more emphasis will be put on HEALTHY food and snacks. The dietician already suggested that Dustin eat bananas between meals (instead of pudding unless it’s Ensure pudding). When Dustin is more physically able to exercise, serious work will begin to build muscle (his muscles are still wasted and his body is storing energy as fat) which will burn off some of the calories. In one month, Dustin will be put on a healthy, normal diet and eat the proper amount of food. Dustin will be given ‘nectar thick’ flavoured water between meals.

The staff are going to have Dustin enter everything he eats and/or drinks on a special chart. He can place ‘check marks’ beside foods/beverages he’s consumed. There will be blank spaces for him to write down all the ‘extras’. The chart will help Dustin remember that he has eaten and what he’s eaten etc…

Medical:

Dustin cannot feel when his lips are open or closed though he does feel tingling pain around his mouth. He cannot make the “M” sound. Dustin cannot open his mouth wide enough to get normal sized bites of food inside his mouth, nor can he close his mouth enough to keep the food inside. Dustin’s teeth are a mess and still quite painful. Stretching exercises may not work because of the damage to Dustin’s jaw and cheeks. There is definitely tissue damage.

The doctor is going to have a dental surgeon visit Dustin. The doctor is also going to consult with the other doctor from plastics. Dustin might get some of his teeth fixed and a bit of reconstructive surgery on his face and lips (SOON) so that he can eat properly and the ABI exercises/goals can proceed. Dustin’s jaw does not function properly. If Dustin’s lips can be reconstructed then he will be able to eat and talk better.

The comprehensive neuropsych assessment is soon. When done, it might be 2 weeks before the results are available and written on the chart.

OTHER:

A referral has been made to the Recreation Therapy and Art Therapy departments. Dustin needs more fun and productive things to do during the day until he can handle longer periods of physio and Occupational Therapy. Dustin was really excited with the prospect of Art Therapy and having access to studio materials. The staff would like Dustin to engage in some social (fun) activities too.

Dustin still has a lot of orientation problems and memory problems which prevent him from doing things independently. He gets lost and/or forgets where he was and/or where he was going. Dustin is able to navigate around the floor by himself because there are staff to prompt and remind him but he is still not oriented enough to go elsewhere in the building. This is a safety/judgment issue as well as an ABI issue.

Th Psychologist is working with Dustin on trauma issues. They will try to have her at the next meeting.

Dustin is trying to transfer from bed to wheelchair independently but he often forgets to put the brakes on the chair. The RN said they are going to make Dustin a list to follow which includes calling a staff to watch him transfer (just in case).

PROGRESS:

The staff are pleased with Dustin’s progress. He’s about ‘average’. The more involved the therapies, the better idea the staff have of how far Dustin has to go before he can function more independently. As the therapies become more involved, it is normal for ‘deficits’ to be highlighted. Deficits result in ‘goals’ that Dustin can work towards. Sometimes Dustin ‘over estimates’ his progress. (This is not a bad thing because Dustin hasn’t hit the wall yet. His progress is slow but steady).

Wednesday Teleconference

Participants:

Dustin
The Doctor
Coordinator
Speech Therapist
Physio
Occupational
Nursing
Social Worker
Renee

1. GOALS
Dustin’s goal: to move back to Winnipeg

Rehab’s goals:
- walk independently
- dress independently
- independent personal care and hygiene (teeth, hair, shaving etc…)
- articulate words better
- work on memory & cognition
- get eyes checked

2. PROGRESS

• Dustin walks for a number of 5 minute sessions each day.  He is still wobbly and requires support but there is improvement in ’strength’.  Once Dustin is able to tolerate longer periods of walking, physio will start working on stairs and put Dustin on an exercise program 2 – 3 times per week.  During the teleconference, Dustin wanted to show everybody that he could walk so he stood up and with the support of two people, Dustin walked across the room and back.  (NOTE:  The Doctor  mentioned that Dustin always leans/moves/walks to the right even if there are obstacles in his path).
• dressing/undressing and personal care  are built into to morning and evening routines.  Dustin still needs help with pants and shoes (balance, flexibility and ABI issue).
• Speech therapy is helping Dustin make ’sounds’ and find new ways to articulate words.  Another video swallowing test is scheduled for next week.  Until then, Dustin remains on a double portion dental soft diet with thickened liquids.  Tomorrow, the therapist is going to do a ‘manual’ bedside swallowing test to determine if it’s okay for Dustin to have coffee (which he wants badly!)
• Neuropsych is going to start the memory and cognition exercises next week.  They asked Dustin about his education and he told them he finished grade ten but then yelled out “..but I’m going to finish grade 12, I promise Mom”.  Everybody laughed.
• Dustin gets dizzy a lot.  He also lean/moves/walks and drives his wheelchair to the right.  He complains of double vision and/or blurry vision in his right eye.  The Doctor would like to determine if this is a neurological (ABI) issue, a vision issue or related to facial fractures (or a combination of all).  The Doctor will have an ophthalmologist examine Dustin.
• Dustin was asked how he liked where he was and he said “I love it here.  I feel so safe.  Everybody is nice to me so I’m going to work really hard to get better.”
• the staff reported that Auntie visits, takes Dustin outside, talks, hangs out and is excellent company.  Dustin looks forward to her visits.
• Blood pressure:  NORMAL
• Weight: 58.1 kg or 128 lbs.

About Dustin’s proposed Rehab program

• Very soon, Dustin will be medically stable enough to participate in rehab.
• The ABI (Acquired Brain Injury) team does not anticipate problems except in areas of stamina and tiredness.
• Dustin’s therapy programs will focus on functional goals, practical skills, activities of daily living, cognition and problem solving.  A section of time will be blocked off so that Dustin can have regular counselling sessions to address psychological and emotional issues.
• Dustin’s schedule will include cognition, memory and safe judgment training & exercises.
• Some of the goals can be met within Dustin’s program, particularly related to ADL’s (Activities of Daily Living) but the cognitive recovery is long term and will continue while Dustin is in the community.
• Dustin will need to stay in rehab until he is safe to return to a more normal life so in terms of mobility Dustin is doing amazingly well and it is expected that he will continue to recover as he gains weight and gets his strength back – he will hopefully be able to do most of the activities of daily living fairly independently.
• Cognitively what is necessary is to hopefully have safe judgment – he is going to need to the help of family and friends for this longer term recovery. The Dr’s experience of 20 years in rehabilitation medicine is that people get better in the real world rather than an institution. It is important to begin to think about planning for what is next and where it is going to take place.
• It may take longer for the cognitive piece; the remembering, thinking and emotional part will take longer but Dustin will not be in rehabilitation for the long term recovery of those aspects. Community and family support will be key.
• The doctors believe Dustin will become independent in dressing, eating and personal care. The key issues will be that of judgment, safety and complex social things.
• The family will need some professional support once Dustin is out of rehabilitation; living with and supporting Dustin 24 hours a day will be the real challenge.
• There is only so much professionals can and will do in these situations – the remainder of the role and support will fall upon Dustin’s informal support network being his family and friends to assist him with his day-to-day living.

First, the start of an FAQ page is put up. Still working on probably a dozen or so questions – will put those up as they are completed. You can see the FAQ here. http://dustinlafortune.com/faq/

And then at long last we have been able to put everything together for the In Trust fund for Dustin. It’s been a bit of a process, but we got there! Thank you for your patience.  You can learn more about donating and the fund here.  http://dustinlafortune.com/donate/

Dustin spent time with his counsellor today. She brought him to the Wasakaw Pisim Centre on the first floor of the hospital where he was able to smudge and speak with an Elder.

• The NG tube is out (no more supplemental calories or vitamins) and Dustin is eating double portions of pureed and minced food. Liquids still have to be thickened. Eating is an all day affair because Dustin still can’t open or close his mouth more than one ‘knuckle/tongue depressor’ width. Occupational therapy is working on exercises to strengthen damaged facial muscles and ligaments.
• Dustin is off isolation restriction. The VRE still shows positive in his blood but he is asymptomatic.
• Dustin is standing and walking several steps at a time (with assistance from two people). His balance is still off.
• He sits for longer and longer periods of time

There has been much talk and many strong opinions about what should and should not be posted about Dustin online. This is Renee’s statement about that.

———————

I took the photos and I arranged Dustin ‘modestly’ but he is ALWAYS squirming and moving all over the place. Some of his movements are reflex (beyond his control) and some are just Dustin trying to position his body in a more comfortable position. I mentioned the diapers and Dustin laughed. He said he has no fat on his butt and it is not like he’s laying around in his underwear. Dustin was not concerned.

The truth is not pleasant. It’s hard for me (and the rest of the family) and it’s hard for the public but the reality check is what it is! Dustin looks 1000% better than the last time I saw him! I think the photos show just how much he’s improved.

I will never be ashamed of my sons – not any of them and certainly not Dustin. I’ve been changing diapers for 32 years and if I have to change diapers for another 32, that’s okay.

Dustin had no problem with the photos, not the diapers and not the pudding. He’s eating and that is not an easy feat when you are minus part of your tongue, your bottom lip and most of your teeth – not to mention the fact that the blow-out fractures and ligament damage prevent him from opening and closing his mouth.

If people are offended then that is their issue. Dustin is improving. Hopefully this story will have a happy ending and the public will be able to see Dustin’s progress from beginning to end.

———————

End of discussion.

Dustin now weighs 52.3 kg (115.3lbs)!

Digital Journal

Winnepeg torture victim Dustin LaFortune improving